Chinese medical sciences journal = Chung-kuo i hsüeh k'o hsüeh tsa chih / Chinese Academy of Medical Sciences
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Clinical Trial
Surface-Based Morphometry of Human Brain: Intra-Individual Comparison Between 3T and 7T High Resolution Structural MR Imaging.
ObjectiveHigh resolution structural MR imaging can reveal structural characteristics of cerebral cortex and provide an insight into normal brain development and neuropsychological diseases. The aim of this study was to compare cortical structural characteristics of normal human brain between 3T and 7T MRI systems using surface-based morphometry based on high resolution structural MR imaging. Methods Twelve healthy volunteers were scanned by both 3T with 3D T1-weighted fast spoiled gradient recalled echo (3D T1-FSPGR) sequence and 7T with 3D T1-weighted magnetization-prepared rapid gradient echo (3D T1-MPRAGE) sequence. ⋯ Results Measurements of mean cortical thickness, total white matter surface area and gray matter surface area of 3T were larger than those of 7T (left hemisphere: P=0.000, 0.006, 0.020 respectively; right hemisphere: P=0.000, 0.000, 0.000 respectively). Surface-based morphometry over the whole brain demonstrated both reduced and increased measurements of cortical thickness, white and gray surface area, convexity, and curvature at 7T compared to 3T. Conclusions Inconsistency of brain structural attribute between 3T and 7T was confirmed, and researchers should be cautious about data when using ultrahigh field MR system to investigate brain structural changes.
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Objective To investigate the efficacy and safety of continuous local anesthetic wound infiltration following open abdominal partial hepatectomy. Methods We performed a prospective, non-randomized, concurrent and controlled study. Patients undergoing open abdominal partial hepatectomy, according to their willingness, accepted one of the following managements for the postoperative pain: continuous wound catheter (CWC) infiltration, patient-controlled epidural analgesia (PCEA), patient-controlled intravenous analgesia of morphine (PCIAM), and patient-controlled intravenous analgesia of sufentanil (PCIAS). ⋯ No severe adverse effects associated with continuous wound infiltration were observed during the study period. Conclusions CWC has a comparable analgesic effect compared with traditional analgesia Methods at most time points postoperatively. CWC is a safe alternative for the postoperative analgesic management of open liver surgery.
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Review Meta Analysis
Efficacy and Safety of SGLT2 Inhibitors in Patients with Type 1 Diabetes: A Meta-analysis of Randomized Controlled Trials.
Objective To assess the efficiency and safety of a novel sodium-glucose co-transporter 2 (SGLT2) inhibitor-SGLT2 inhibitors, in combination with insulin for type 1 diabetes mellitus (T1DM). Methods We searched Medline, Embase, and the Cochrane Collaboration Library to identify the eligible studies published between January 2010 and July 2016 without restriction of language. The Food and Drug Administration (FDA) data and ClinicalTrials (http://www.clinicaltrials.gov) were also searched. ⋯ SGLT2 inhibitors could also increase the excretion of urine glucose (MD 131.09 g/24 h, 95%CI 91.79 to 170.39, P<0.001). There were no significant differences in the incidences of hyperglycemia [odds ratio (OR) 1.82, 95%CI 0.63 to 5.29, P=0.27], urinary tract infection (OR 0.95, 95%CI 0.19 to 4.85, P=0.95), genital tract infection (OR 0.27, 95%CI 0.01 to 7.19, P=0.43), and diabetic ketoacidosis (OR 6.03, 95%CI 0.27 to 135.99, P=0.26) between the two groups. Conclusion SGLT2 inhibitors combined with insulin might be an efficient and safe treatment modality for T1DM patients.
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Comparative Study
Value of Multi-detector CT in Detection of Isolated Spontaneous Superior Mesenteric Artery Dissection.
Objective To investigate the role of multi-detector computed tomography (CT) in the diagnosis and classification of isolated spontaneous superior mesenteric artery dissection (ISSMAD). Methods From July 2012 to December 2016, 30 consecutive patients with ISSMAD underwent CT scan at least two times. We retrospectively summarized the clinical characteristics and CT findings of them. ⋯ Follow-up was complete in 30 cases. Follow-up CT angiography of superior mesenteric artery showed dissection remodeling in 12 patients. Conclusion Multi-detector CT is a valuable method in diagnosis and classification of ISSMAD and monitoring the changes of dissection.
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Randomized Controlled Trial
Early Enteral Combined with Parenteral Nutrition Treatment for Severe Traumatic Brain Injury: Effects on Immune Function, Nutritional Status and Outcomes.
Objective To compare the conjoint effect of enteral nutrition (EN) and parenteral nutrition (PN) with single EN or PN on immune function, nutritional status, complications and clinical outcomes of patients with severe traumatic brain injury (STBI). Methods A prospective randomized control trial was carried out from January 2009 to May 2012 in Neurological Intensive Care Unit (NICU). Patients of STBI who met the enrolment criteria (Glasgow Coma Scale score 6~8; Nutritional Risk Screening ≥3) were randomly divided into 3 groups and were admi- nistrated EN, PN or EN+PN treatments respectively. ⋯ Compared to the EN group, the complication occurrence rates of EN+PN group were significantly lower in aspirated pneumonia (27.5% vs. 50.0%; χ2= 6.39, P<0.05), hypoproteinemia (17.5% vs. 55.0%; χ2= 18.26, P<0.01) and diarrhea (20.0% vs. 60.0%; χ2= 20.00, P<0.01). The EN+PN group also had significant less length of stay in NICU (t=2.51, 4.82; P<0.05, P<0.01), number of patients receiving assisted mechanical ventilation (χ2= 6.08, 12.88; P<0.05, P<0.01) and its durations (t=3.41, 9.08; P<0.05, P<0.01), and the death rate (χ2=7.50, 16.37; P<0.05, P<0.01) than those of EN or PN group. Conclusion Early EN+PN treatment could promote the recovery of the immune function, enhance nutritional status, decrease complications and improve the clinical outcomes in patients with severe traumatic brain injury.