Medicine
-
Induction of labor is the process of artificially stimulating the uterus to start labor before the spontaneous onset of labor. It has several medical indications. Commonly used agents are vaginal misoprostol, vaginal prostaglandin E2 (dinoprostone), and oral misoprostol. ⋯ Vaginal misoprostol is more effective at inducing labor but may be less safe than vaginal dinoprostone. Oral misoprostol is generally as safe as vaginal dinoprostone. Vaginal dinoprostone requires lower doses but may need more oxytocin administration.
-
Traditional Chinese medicine (TCM) demonstrates significant effects on renal function, yet it remains unclear which TCM treatment yields the best clinical outcomes for renal hypertension (RH) management. This study aims to evaluate the safety and effectiveness of various TCM treatments for RH compared to conventional Western medicine (CWM). ⋯ Combination therapy of TCM with CWM surpasses CWM alone in treating renal hypertension. This study identifies the most effective combination treatment for RH, as well as optimal treatments for lowering blood pressure (Zishen Pinggan prescription + CWM) and improving renal function (Bailing capsule + CWM).
-
Meta Analysis Comparative Study
Endoscopic ultrasound-guided gastroenterostomy versus duodenal stenting for gastric outlet obstruction: A systematic review, meta-analysis, and meta-regression.
Gastric outlet obstruction (GOO) refers to mechanical obstruction at the level of the gastric outlet and is associated with significantly impacted quality of life and mortality. Duodenal stenting (DS) offers a minimally invasive approach to managing GOO but is associated with a high risk of stent obstruction. Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is a novel intervention that uses lumen-apposing metal stents to open the restricted lumen. The current evidence comparing EUS-GE to DS is limited and inconsistent. ⋯ EUS-GE is associated with higher clinical success, longer total procedural time, lower re-intervention rate, and lower risk of adverse events than DS. Technical success and the length of hospital stay were comparable between the 2 groups. EUS-GE appears to be a safe and effective procedure for managing GOO. Further large, multicentric randomized controlled trials are warranted to investigate the safety and outcomes of EUS-GE in patients with malignant GOO.
-
Acupuncture is a traditional Chinese medicine therapy that is treatment by placing a needle or pressure in a specific position on the patient's skin. Although used in the treatment of various diseases, acupuncture is effective in the treatment of ischemic stroke (IS), and has made some progress in the mechanism of action of the treatment of this disease. IS is difficult to treat, and there is a high rate of disability. ⋯ Among them, acupuncture is getting more and more attention as a more popular treatment method. Therefore, this study excavates the high-quality randomized controlled trials and meta-analysis of acupuncture for IS in recent years to further summarize the efficacy of acupuncture for IS. In this review, we provide an overview of the current understanding of acupuncture and IS, and the current studies investigating the effectiveness of acupuncture in the treatment of IS.
-
Review Case Reports
Splenic rupture following endoscopic mucosal resection: A case report and literature review.
This study aims to highlight the rare but severe complication of splenic rupture following colorectal endoscopic mucosal resection (EMR), advocating for increased vigilance during procedures near the splenic flexure. ⋯ Although splenic rupture after EMR is extremely rare, it is a serious and potentially life-threatening complication. When obtaining informed consent, it is important to emphasize not only common complications like bleeding and perforation but also the risk of splenic injury. Physicians should select appropriate instruments and carefully adjust the angle and force of needle insertion, avoiding excessively long needles and vertical insertion. The procedure should be performed gently to minimize the risk of splenic rupture. For lesions near the splenic flexure, if postoperative abdominal pain occurs, regardless of left shoulder pain, splenic rupture should be considered, and a computed tomography scan promptly performed. Postoperatively, physicians should closely monitor vital signs and repeatedly check blood counts and coagulation parameters. Treatment should be tailored to the splenic injury's extent and the patient's overall condition, with immediate surgery if necessary. High-risk patients should be regularly followed up and instructed to monitor for physical changes. Endoscopists should remain vigilant during procedures, fully understanding potential complications, and closely monitoring the patient's condition postoperatively. This vigilance is key to preventing severe complications and ensuring optimal outcomes.