Medicine
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Lower extremity deep venous thrombosis (LEDVT) of lower extremities is one of the common clinical diseases. Lack of a timely treatment in the acute stage easily causes pulmonary embolism, thus seriously threatening patients' life. Low-molecular-weight heparin (LMWH), as a new generation of heparin-based anticoagulant and antithrombotic drug, is now commonly used in the clinical treatment of acute lower extremity deep venous thrombosis (ALEDVT). Relevant randomized controlled trials (RCTs) have reported the therapeutic efficacy and safety of Traditional Chinese medicine injection (TCMJ) combined with LMWH on ALDVT, although their conclusions remain controversial. In addition, the efficacy of various TCMJs has rarely been analyzed and compared. This study aims to evaluate the therapeutic efficacy and safety of TCMJ combined with LMWH on ALEDVT through a network meta-analysis. ⋯ This study will provide high-quality, evidence-based medical evidence for comparing the therapeutic efficacy and safety of TCMJ combined with LMWH and LMWH alone on ALEDVT.
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A novel once-daily divalproex-extended release (VPA-ER) dose formulation has been developed, which prolongs therapeutic serum levels compared with that of twice-daily conventional divalproex-delayed release (VPA-DR). Currently, there is lack of meta-analysis focusing on drug retention rate between VPA-ER and VPA-DR. Thus, our study is the first one that aims to systematically examine and compare the efficacy, safety, and retention rate of VPA-ER and VPA-DR. ⋯ Once-daily VPA-ER may present a positive efficacy and not increase the incidence of AEs and has a higher retention rate for patients, which can be used as a substitute for conventional VPA-DR.INPLASY registration number: INPLASY2021110090(DOI: 10.37766/inplasy2021.11.0090).
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Acupuncture combined with Chinese herbal medicine has been widely utilized for pain management in patients with diabetic peripheral neuropathy (DPN). However, its results are still inconsistent, and no systematic review has specifically addressed this issue. Thus, this systematic review will comprehensively and systematically investigate the effectiveness and safety of acupuncture combined with Chinese herbal medicine for pain relief in DPN. ⋯ The protocol of the systematic review does not require ethical approval because it does not involve humans. This article will be published in peer-reviewed journals and presented at relevant conferences.Registration number: INPLASY2021100004.
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Randomized Controlled Trial
The role of virtual reality simulation in surgical training in the light of COVID-19 pandemic: Visual spatial ability as a predictor for improved surgical performance: a randomized trial.
Due to the current COVID-19 pandemic, surgical training has become increasingly challenging due to required social distancing. Therefore, the use of virtual reality (VR)-simulation could be a helpful tool for imparting surgical skills, especially in minimally invasive environments. Visual spatial ability (VSA) might influence the learning curve for laparoscopic surgical skills. However, little is known about the influence of VSA for surgical novices on VR-simulator training regarding the complexity of different tasks over a long-term training period. Our study evaluated prior VSA and VSA development in surgical trainees during VR-simulator training, and its influence on surgical performance in simulator training. ⋯ Our study revealed that that all trainees improved their surgical skills irrespective of previous VSA during structured VR simulator training. An increase in VSA resulted in improvements in surgical performance and training progress, which was more distinct in complex simulator tasks. Further, we demonstrated a positive relationship between VSA and surgical performance of the TG, especially at the beginning of training. Our results identified pre-existing levels of VSA as a predictor of surgical performance.
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Distal posterior inferior cerebellar artery (PICA) aneurysms are extremely rare. Herein, we describe a case of PICA pseudoaneurysm with proximal occlusion achieved using detachable coils, but antegrade recanalization, which showed a normal PICA configuration on follow-up angiography. Possible mechanisms of the recanalization and lesions are also discussed. ⋯ Even if the SAH is scanty and predominantly in the perimesencephalic cistern, performing a catheter-based angiography is essential. In the case of proximal occlusion of the parent artery without internal trapping in endovascular treatment of PICA pseudoaneurysm, follow-up examination with a short-term angiography might be crucial.