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| 1 | Big-data analysis: A clinical pathway on endoscopic retrograde cholangiopancreatography for common bile duct stones显示文摘BACKGROUND A clinical pathway(CP)is a standardized approach for disease management.However,big data-based evidence is rarely involved in CP for related common bile duct(CBD)stones,let alone outcome comparisons before and after CP implementation.AIM To investigate the value of CP implementation in patients with CBD stones undergoing endoscopic retrograde cholangiopancreatography(ERCP).METHODS This retrospective study was conducted at Nanjing Drum Tower Hospital in patients with CBD stones undergoing ERCP from January 2007 to December 2017.The data and outcomes were compared by using univariate and multivariable regression/linear models between the patients who received conventional care(non-pathway group,n=467)and CP care(pathway group,n=2196).RESULTS At baseline,the main differences observed between the two groups were the percentage of patients with multiple stones(P<0.001)and incidence of cholangitis complication(P<0.05).The percentage of antibiotic use and complications in the CP group were significantly less than those in the nonpathway group[adjusted odds ratio(OR)=0.72,95%confidence interval(CI):0.55-0.93,P=0.012,adjusted OR=0.44,95%CI:0.33-0.59,P<0.001,respectively].Patients spent lower costs on hospitalization,operation,nursing,medication,and medical consumable materials(P<0.001 for all),and even experienced shorter length of hospital stay(LOHS)(P<0.001)after the CP implementation.No significant differences in clinical outcomes,readmission rate,or secondary surgery rate were presented between the patients in the non-pathway and CP groups.CONCLUSION Implementing a CP for patients with CBD stones is a safe mode to reduce the LOHS,hospital costs,antibiotic use,and complication rate. | Wei Zhang Bing-Yi Wang Xiao-Yan Du Wei-Wei Fang Han Wu Lei Wang Yu-Zheng Zhuge Xiao-Ping Zou | 2019 | World Journal of Gastroenterology2019，25，8： | 14 |
| 2 | 尖锐心肌的梗塞: 在在新加坡的年轻成年人的临床的特征和结果显示文摘 AIM: To investigate the clinical features and in-hospital outcomes of young adults with acute myocardial infarction (AMI) in Singapore. METHODS: Between January 2005 to September 2010, 333 consecutive patients aged ≤ 45 years old were diagnosed to have AMI at our institution. As Singapore is a multi-ethnic society, we also analysed whether ethnic differences exist between the three dominant ethnic groups, Malay, Chinese and Indian with regards to the clinical features. Clinical data was collected retrospectively on demographic characteristics, presenting signs and symptoms, blood investigation, angiographic findings and in-hospital clinical outcomes. RESULTS: The mean age at presentation was 40.2 ± 4.0 years with male predominance (94%). The majority of patients were Chinese (51%) followed by Indians (31%) and Malays (18%). The most common risk factor was smoking (74%) followed by hypertension (28.5%) and hyperlipidemia (20.0%). 37% of patients were obese. The majority of patients had single vessel disease (46%) on coronary angiography. The mean total cholesterol, low-density lipoprotein and highdensity lipoprotein levels were 5.6±1.2 mmol/L, 3.8±1.1 mmol/L and 0.93±0.25 mmol/L respectively. The mean left ventricular function was 44%±10% with the incidence of heart failure 3% and cardiogenic shock 4.5%. Overall in-hospital mortality was low with 4 deaths (1.2%). For ethnic subgroup analysis, Indians have a 3-fold risk of developing premature AMI when compared to other ethnic groups. CONCLUSION: Young AMI patients in Singapore are characterized by male predominance, high incidence of smoking and obesity. Overall in-hospital clinical outcomes are favourable. Among the 3 ethnic groups, Indians have the highest risk of developing premature AMI. | Chun Pong Wong Seet Yoong Loh Kwok Kong Loh Paul Jau Lueng Ong David Foo Hee Hwa Ho | 2012 | World Journal of Cardiology2012，4，6： | 13 |
| 3 | One-year outcomes of percutaneous renal denervation for thetreatment of resistant hypertension: the first Chinese experience显示文摘Background As a novel device-based approach targeting the renal sympathetic nerves, percutaneous renal denervation(RDN) has been shown to be effective and safe for reducing blood pressure. However, while considerable data on RDNhave been obtained from Western populations, there is limited findings from East Asian populations. The purpose of thisstudy was to evaluate one-year outcomes of RDN for the treatment of resistant hypertension in Chinese patients.Methods Between February and August 2012, 14 patients (mean age 39+8 years, 10 males) with resistant hypertensionunderwent successful RDN at the Fuwai Hospital. All 14 patients were followed up at 1, 3, 6 and 12 months post-procedure. Blood pressure, use of antihypertensive agents, renal function, and complications were investigated.Results Baseline values included mean office blood pressure of 164/103+14/10 mmHg, mean 3.9+0.6 anti-hypertensiveagents, and an estimated glomerular filtration rate of (79+19) ml·min-1·1.73 m-2. Office blood pressure after the procedurewas reduced by -14/-10, -17/-11, -21/-12, and -24/-14 mmHg at 1, 3, 6, and 12 months respectively, and thereduction of the number of antihypertensive agents at the above corresponding time points was -1.3, -1.5, -1.7 and -1.8respectively (all P 〈0.001). The mean reduction of 24-hour ambulatory blood pressure was similar to the reduction of officeblood pressure at the four corresponding time points. Renal function did not significantly change at any time point (all P〉0.05). No clinical complications were observed at 12-month follow-up.Conclusion This study showed that RDN seems to be effective in reducing blood pressure of Chinese patients withresistant hypertension, with minimal adverse events at 12-month follow-up. | | 2014 | Chinese Medical Journal2014，，6： | 12 |
| 4 | Temozolomide for treatment of brain metastases: A review of 21 clinical trials显示文摘Brain metastases from solid tumours are associated with poor prognosis despite aggressive treatment. Temozolomide can be used for the treatment of glioblastoma multiforme as well as melanoma. It has also been shown to have activity in patients with brain metastases from various malignancies, since it can cross the blood-brain barrier. To better understand the efficacy of temozolomide in the treatment of brain metastases, we carried out a review of 21 published clinical trials to determine whether temozolomide would benefit patients with brain metastases from solid tumours. Information regarding complete response, partial response, stable disease, objective response and objective response rate were collected to assess clinical outcomes. A modest therapeutic effect was observed when temozolomide was used as a single agent, however, the combination of temozolomide with whole-brain radiotherapy and/or other anticancer drugs exhibited encouraging activity. Thus, future high quality studies are warranted to confirm our findings. | Wei Zhu Li Zhou Jia-Qi Qian Tian-Zhu Qiu Yong-Qian Shu Ping Liu | 2014 | World Journal of Clinical Oncology2014，5，1： | 6 |
| 5 | Efficacy and Safety of Tofacitinib in Chinese Patients with Rheumatoid Arthritis显示文摘Background:Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis (RA).This study assessed the efficacy and safety of tofacitinib in Chinese patients with RA enrolled in Phase 3and long-term extension (LTE)studies. Methods:ORAL Sync was a 1-year,randomized,placebo-controlled,Phase 3trial.Patients received tofacitinib 5 or 10 mg twice daily (BID)or placebo advanced to tofacitinib 5 or 10 mg BID at 3 or 6 months.All patients remained on >1background conventional synthetic disease-modifying antirheumatic drug.ORAL Sequel is an open-label LTE study (data-cut:March 2015;data collection and analyses were ongoing,and study database was not locked at the time of analysis;study was closed in 2017).Efficacy outcomes:American College of Rheumatology (ACR)20/50/70response rates and Disease Activity Score in 28 joints using erythrocyte sedimentation rate (DAS28-4[ESR]).Patient-and physician-reported outcomes:HealthAssessment Questionnaire-Disability Index (HAQ-DI),Patient and Physician Global Assessment of Arthritis,and pain (visual analog scale).Safety was assessed throughout. Results:ORAL Sync included 218 patients;192 were subsequently enrolled into ORAL Sequel.In ORAL Sync,more patients achieved ACR20(tofacitinib 5 mg BID,67.4%;10 mg BID,70.6%;placebo,34.1%)and DAS28-4(ESR)<2.6(tofacitinib 5 mg BID,7.1%; 10mg BID,13.1%;placebo,2,3%)with tofacitinib versus placebo at Month 6.Mean changes from baseline in HAQ-DI were greater with tofacitinib versus placebo at Month 6.In ORAL Sequel,efficacy was consistent to Month 48.Incidence rates for adverse events of special interest in tofacitinib-treated patients were similar to the global population. Conclusions:To.facitinib significantly reduced signs/symptoms and improved physical function and quality of life in Chinese patients with moderate-to-severely active RA up to Month 48.The safety profile was consistent with the global population. | Zhan-Guo Li Yi Liu Hu-Ji Xu Zhi-Wei Chen Chun-De Bao Jie-Ruo Gu Dong-Bao Zhao Yuan An Lie-Ju Hwang Lisy Wang Joel Kremer Qi-Zhe Wu | 2018 | Chinese Medical Journal2018，，22： | 5 |
| 6 | Sarcopenia in pancreatic cancer–effects on surgical outcomes and chemotherapy显示文摘Sarcopenia is found in up to 65% of pancreatic cancer patients. The definition and diagnostic methods for sarcopenia have changed over the years, and the measurement of skeletal muscle mass with cross-sectional imaging has become the most popular way of assessment, although the parameters measured vary among different studies. It is still debatable that there is an association between sarcopenia and postoperative pancreatic fistula, but most studies showed a higher risk in patients with sarcopenic obesity. Long-term survival is worse in sarcopenic patients, as shown by meta-analysis. Sarcopenia is also associated with decreased survival and higher toxicity in patients receiving chemotherapy, and chemotherapy also tends to potentiate sarcopenia. Treatment for sarcopenia still remains an area for research, although oral supplements, nutritional modifications and exercise training have been shown to improve sarcopenia. | Miu Yee Chan Kenneth Siu Ho Chok | 2019 | World Journal of Gastrointestinal Oncology2019，11，7： | 4 |
| 7 | Effect of intraoperative fluid administration on perioperative outcomes in patients undergoing McKeown esophagogastrectomy显示文摘Objective: Fluid therapy is one of the key components of perioperative management. However, evidence of intraoperative fluid(IOF) administration affecting clinical outcomes following McKeown esophagogastrectomy remains limited. This study investigated the impact of IOF on clinical outcomes after McKeown esophagogastrectomy.Methods: Patients who underwent McKeown esophagogastrectomy between July 2013 and July 2016 were identified. Preoperative, intraoperative and postoperative variables for each eligible patient were retrospectively collected from our electronic medical records and anesthetic records. IOF rates were determined and their relationships to postoperative clinical outcomes were compared.Results: A total of 546 patients were enrolled in the analysis. The median IOF rate was 8.87 mL/kg/h. We divided the patients into two groups: a low fluid volume group(LFVG <8.87 mL/kg/h, n=273) and a high fluid volume group(HFVG ≥8.87 mL/kg/h, n=273). No statistically significant differences in postoperative clinical outcomes were found between LFVG and HFVG either before or after propensity score matching.Conclusions: No effect of IOF administration on clinical outcomes in patients undergoing McKeown esophagogastrectomy was identified. Further high-quality studies examining the influence of IOF administration on clinical outcomes following McKeown esophagogastrectomy are still needed. | Hongliang Wu Wen Wang Gefei Zhao Qi Xue | 2019 | Chinese Journal of Cancer Research2019，31，5： | 3 |
| 8 | Establishing minimum clinically important difference values for the Patient-Reported Outcomes Measurement Information System Physical Function, hip disability and osteoarthritis outcome score for joint reconstruction, and knee injury and osteoarthritis out显示文摘AIM To establish minimum clinically important difference(MCID) for measurements in an orthopaedic patient population with joint disorders.METHODS Adult patients aged 18 years and older seeking care for joint conditions at an orthopaedic clinic took the Patient-Reported Outcomes Measurement Information System Physical Function(PROMIS~? PF) computerized adaptive test(CAT), hip disability and osteoarthritis outcome score for joint reconstruction(HOOS JR), and the knee injury and osteoarthritis outcome score for joint reconstruction(KOOS JR) from February 2014 to April 2017. MCIDs were calculated using anchorbased and distribution-based methods. Patient reports of meaningful change in function since their first clinic encounter were used as an anchor.RESULTS There were 2226 patients who participated with a mean age of 61.16(SD = 12.84) years, 41.6% male, and 89.7% Caucasian. Mean change ranged from 7.29 to 8.41 for the PROMIS~? PF CAT, from 14.81 to 19.68 for the HOOS JR, and from 14.51 to 18.85 for the KOOS JR. ROC cut-offs ranged from 1.97-8.18 for the PF CAT, 6.33-43.36 for the HOOS JR, and 2.21-8.16 for the KOOS JR. Distribution-based methods estimated MCID values ranging from 2.45 to 21.55 for the PROMIS~? PF CAT; from 3.90 to 43.61 for the HOOS JR, and from 3.98 to 40.67 for the KOOS JR. The median MCID value in the range was similar to the mean change score for each measure and was 7.9 for the PF CAT, 18.0 for the HOOS JR, and 15.1 for the KOOS JR.CONCLUSION This is the first comprehensive study providing a wide range of MCIDs for the PROMIS? PF, HOOS JR, and KOOS JR in orthopaedic patients with joint ailments. | Man Hung Jerry Bounsanga Maren W Voss Charles L Saltzman | 2018 | World Journal of Orthopedics2018，9，3： | 3 |
| 9 | Survival and clinical outcomes in patients with metastatic epidural spinal cord compression after spinal surgery:a prospective,multicenter,observational cohort study显示文摘Background:High quality studies have been challenging to undertake in patients with metastatic epidural spinal cord compression.Nonetheless,in the article 'Survival and Clinical Outcomes in Surgically Treated Patients With Metastatic Epidural Spinal Cord Compression:Results of the Prospective Multicenter AOSpine Study' recently published in the Journal of Clinical Oncology,our team provided convincing evidence that spinal surgery improves overall quality of life in patients with this potentially devastating complication of cancer.Considering that metastatic spinal lesions treated with surgery have the highest mean cost among all oncological musculo-skeletal issues,it is essential to provide high quality data to optimize the therapeutic approaches and cost-effective use of health care resources.Main body:Although the AOSpine Study provided high quality prospective data,it was primarily limited by the lack of non-operative controls and the relatively small sample size.Given the dearth of medical equipoise and the fundamental difference between patients deemed to be adequate surgical candidates and those who are not amenable to operative intervention,conducting a randomized controlled trial in this patient population was not felt to be ethically or medically feasible.Consequently,the optimal option to overcome limitations of both the lack of controls and the relatively small sample size is through collection of large prospective datasets through rigorously developed and maintained registries.Conclusions:With the alarming increase in the incidence of cancer in China and China's parallel growing cancer control efforts,China would offer a fantastic platform to set up a national metastatic spinal lesion registry.Such registry would not only enhance metastatic epidural spinal cord compression translational research but also optimize patient care. | Anick Nater Michael G.Fehlings | 2016 | Chinese Journal of Cancer2016，35，4： | 3 |
| 10 | Anterior cruciate ligament reconstruction using a double bundle hamstring autograft configuration in patients under 30 years显示文摘BACKGROUND Anterior cruciate ligament reconstruction(ACLR)has a high incidence of re-tear in younger patients.Despite comparable functional outcomes,the incidence of retear using single and double bundle ACLR methods has not been well reported.AIM To hypothesize that double bundle hamstring ACLR has a lower graft rupture rate compared with single bundle hamstring ACLR grafts in young patients.METHODS One hundred and twelve patients<30 years of age at the time of primary double bundle ACLR were eligible for study participation.91(81.3%)could be contacted,with a mean age of 20.4 years(range 13-29)and mean post-operative follow-up time of 59 mo(range 25-107).Telephone questionnaires evaluated the incidence(and timing)of subsequent re-tear and contralateral ACL tear,further surgeries,incidence and time to return to sport,and patient satisfaction.RESULTS Of the 91 patients,there were 6(6.6%,95%CI:1.4-11.7)ACL graft re-ruptures,with a mean time to re-rupture of 28 mo(range 12-84).Fourteen patients(15.4%)experienced a contralateral ACL rupture and 14 patients(15.4%)required further surgery to their ipsilateral knee.fifty patients(54.9%)returned to pre-injury level of sport.Of those<20 years(n=45),4 patients(8.9%,95%CI:0.4-17.3)experienced a re-rupture,with mean time to re-injury 15 mo(range 12-24).Comparative analysis with existing literature and revealed a non-significant Chisquared statistic of 2.348(P=0.125).CONCLUSION A trend existed toward lower graft rupture rates in young patients undergoing double bundle ACLR utilizing a hamstring autograft,compared with rates reported after single bundle ACLR. | Christopher Reece Lim Tamalee Henson Jay Ebert Peter Annear | 2019 | World Journal of Orthopedics2019，10，12： | 2 |
| 11 | Are the data on quality of life and patient reported outcomes from clinical trials of metastatic non-small-cell lung cancer important?显示文摘Majority of the patients with advanced non-small-cell lung cancer(NSCLC)experience two or more disease related symptoms,which may have a negative impact on their health-related quality of life(HR QOL).These patients prefer a therapy that would improve disease related symptoms,as opposed or treatment that slightly prolongs their survival without improving symptoms.The improvements of the symptoms augment the significance of improved response rates or progression free survivals.The choice of the questionnaires to evaluate patients-reported outcomes(PROs)and HRQOL benefits and methods of collecting the data and their interpretations are very important and are discussed in this manuscript.PROs and HR QOL outcomes are important in patients with advanced NSCLC only when the data are collected and analyzed correctly.Then they can be viewed as components of the total value of a treatment,providing a comprehensive picture of the benefits and risks of anticancer therapies.Enabling the patients to feel during the last months of their lives more comfortable and not be dependent on their loved ones is a very important task in the treatment of advanced NSCLC. | Vera Hirsh | 2013 | World Journal of Clinical Oncology2013，4，4： | 0 |
| 12 | 在肠胃病学和内视镜检查法的结果研究显示文摘 Although the field of outcomes research has received increased attention in recent years,there is still considerable uncertainty and confusion about what is 'outcomes research'.The following editorial is designed to provide an overview on this topic,illustrate specific examples of outcomes research in clinical gastroenterology and endoscopy,and discuss its importance as a whole.In this article,we review the definition and specific goals of outcomes research.We outline the difference between traditional clinical research and outcomes research and discuss the benefits and limitations of outcomes research.We summarize the types of outcomes studies and methods utilized for outcomes assessment,and give specific examples of the impact of outcomes studies in the field of gastroenterology and endoscopy. | Parantap Gupta Jonathan M Buscaglia | 2012 | World Journal of Gastrointestinal Endoscopy2012，4，6： | 0 |
| 13 | Undiscovered pathology of transient scaffolding remains a driver of failures in clinical trials显示文摘AIM To statistically examine the released clinical trials and meta-analyses of polymeric bioresorbable scaffolds resuming the main accomplishments in the field with a translation to the routine clinical practice. METHODS The statistical power in clinical trials such as ABSORB Japan, ABSORB China, EVERBIO II, AIDA, and few meta-analyses by the post hoc odds ratio-based sample size calculation, and the patterns of artery remodeling published in papers from ABSORB A and B trials were evaluated. RESULTS The phenomenal admiration from the first ABSORB studies in 2006-2013 was replaced by the tremendous disappointment in 2014-2017 due to reported relatively higher rates of target lesion failure(a mean prevalence of 9.16%) and device thrombosis(2.38%) in randomized controlled trials. Otherwise, bioresorbable vascular scaffold(BVS) performs as well as the metallic drugeluting stent(DES) with a trend toward some benefits for cardiac mortality [risk ratio(RR), 0.58-0.94, P > 0.05]. The underpowered design was confirmed for some studies such as ABSORB Japan, ABSORB China, EVERBIO Ⅱ, AIDA trials, and meta-analyses of Polimeni, Collet, and Mahmoud with some unintentional bias(judged by the asymmetrical Funnel plot). Scaffold thrombosis rates with Absorb BRS were comparable with DES performed with a so-called strategy of the BVS implantation with optimized pre-dilation(P), sizing(S) and post-dilation(P)(PSP) implantation(RR, PSP vs no PSP 0.37) achieving 0.35 per 100 patient-years, which is comparable to the RR 0.49 with bare-metal stents and the RR 1.06 with everolimus DES. Both ABSORB Ⅱ and ABSORB Ⅲ trials were powered enough for a five-year follow-up, but the results were not entirely conclusive due to the mostly non-significant fashion of data. The powered metaanalyses were built mostly on statistically poor findings. CONCLUSION The misunderstanding of the pathology of transient scaffolding drives the failures of the clinical trials. More bench studies of the vascular response are required. Several next-generation BVS including multifunctional electronic scaffold grant cardiology with a huge promise to make BVS technology great again. | Alexander N Kharlamov | 2018 | World Journal of Cardiology2018，10，10： | 0 |
| 14 | Recurrence-free survival as a putative surrogate for overall survival in phase Ⅲ trials of curative-intent treatment of colorectal liver metastases:Systematic review显示文摘AIM To verify whether recurrence-free survival(RFS) surrogates overall survival(OS) in phase Ⅲ trials for resectable colorectal liver metastases(CRLM).METHODS MEDLINE,EMBASE,and Scopus databases were consulted.Eligible studies were phase Ⅲ trials testing any type of systemic therapy(neoadjuvant,adjuvant or perioperative) added to surgery in patients with resectable CRLM.A linear regression model based on hazard ratios(HR) of OS and RFS was performed.RESULTS Of 3059 studies,5 phase Ⅲ trials(1162 patients) were included for analyses.A linear regression weighted by each trial was used to estimate the association between each HR and RFS.The originated formula was:OS HR =(0.93 × RFS HR) + 0.14;with RFS 95%CI(0.48-1.38),with P = 0.007.CONCLUSION This association suggests that RFS could work as a putative surrogate endpoint of OS in this population,avoiding bigger,longer and more resource-consuming trials.The OS could be assumed based on RFS and our model could be useful to better estimate sample size calculations of phase Ⅲ trials of CRLM aiming for OS. | Raphael LC Araujo Paulo Herman Rachel P Riechelmann | 2017 | World Journal of Clinical Oncology2017，8，3： | 0 |
| 15 | Beta-blockers and 1-year clinical outcomes in hospitalized heart failure patients with atrial fibrillation显示文摘OBJECTIVE To assess the association between beta-blockers and 1-year clinical outcomes in heart failure(HF)patients with atrial fibrillation(AF),and further explore this association that differs by left ventricular ejection fraction(LVEF)level.METHODS We enrolled hospitalized HF patients with AF from China Patient-centered Evaluative Assessment of Cardiac Events Prospective Heart Failure Study.COX proportional hazard regression models were employed to calculate hazard ratio of betablockers.The primary outcome was all-cause death.RESULTS Among 1762 HF patients with AF(756 women[41.4%]),1041(56%)received beta-blockers at discharge and 1272(72.2%)had an LVEF>40%.During one year follow up,all-cause death occurred in 305(17.3%),cardiovascular death occurred in203 patients(11.5%),and rehospitalizations for HF occurred in 622 patients(35.2%).After adjusting for demographic characteristics,social economic status,smoking status,medical history,anthropometric characteristics,and medications used at discharge,the use of beta-blockers at discharge was not associated with all-cause death[hazard ratio(HR):0.86;95%Confidence Interval(CI):0.65-1.12;P=0.256],cardiovascular death(HR:0.76,95%CI:0.52-1.11;P=0.160),or the composite outcome of all-cause death and HF rehospitalization(HR:0.97,95%CI:0.82-1.14;P=0.687)in the entire cohort.There were no significant interactions between use of beta-blockers at discharge and LVEF with respect to all-cause death,cardiovascular death,or composite outcome.In the adjusted models,the use of beta-blockers at discharge was not associated with all-cause death,cardiovascular death,or composite outcome across the different levels of LVEF:reduced(<40%),mid-range(40%-49%),or preserved LVEF(≥50%).CONCLUSION Among HF patients with AF,the use of beta-blockers at discharge was not associated with 1-year clinical outcomes,regardless of LVEF. | Fu-Wei XING Li-Hua ZHANG Hai-Bo ZHANG Xue-Ke BAI Dan-Li HU Xin ZHENG Jing LI | 2021 | Journal of Geriatric Cardiology2021，18，9： | 0 |
| 16 | The effect of pharmaceutical care in the elderly patients with type 2 diabetes mellitus显示文摘Pharmaceutical care plays a crucial role in reducing mortality and morbidities of the patients.A hospital based quasiexperimental study was conducted with elderly patients with type 2 diabetes who attended at the diabetes clinic of No.(2)Military Hospital(500-Bedded)in Myanmar from April 2013 to February 2014.The aim of this study was to evaluate the effect of pharmaceutical care in elderly patients with type 2 diabetes mellitus.A total of 52 respondents enrolled in this study.The clinical outcomes and quality of life of patients before and eight months after intervention were assessed.Pharmaceutical care program was implemented as intervention.Of the total number of respondents,52 drug related problems were identified. | Win Myat Maw Mi Mi Saw Theingi Kyaw Khin Ohnmar Kyaing Zaw Min Latt KyawZaw Lin Aung PyaePhyo | 2016 | Asian Journal of Pharmaceutical Sciences2016，11，1： | 0 |
| 17 | Measuring quality of life in oculoplastic patients显示文摘AIM: To investigate if there is any published evidence of impaired quality of life in conditions which are corrected by oculoplastic surgery and whether there is proven benefit in the quality of life such procedures. ·METHODS: We searched a number of databases to determine the level of evidence available for common conditions amenable to oculoplastic surgery. Search terms concentrated on quality of life measures rather than anatomical correction of deformities. ·RESULTS: The level of evidence available for different conditions was very variable. Certain conditions had extensive research documenting reduction in quality of life,with some evidence for improvement after surgery. Some other common conditions had little or no evidence supporting of reduction in quality of life to support the need for surgery. ·CONCLUSION: The evidence is sparse for quality of life improvement after some of our most commonly performed procedures. Many of these procedures are now being identified by primary care trusts(PCTs) as of 'low clinical value',and are no longer being routinely commissioned in certain parts of the UK. There is a need to address this lack of evidence to determine whether oculoplastic surgery should continue to be commissioned by PCTs. | Edward Ridyard Clare Inkster | 2014 | International Journal of Ophthalmology(English edition)2014，7，1： | 0 |
| 18 | Risk factors for adverse in-hospital outcomes in acute colonic diverticular hemorrhage显示文摘AIM: To investigate the factors associated with transfusion, further bleeding, and prolonged length of stay.METHODS: In total, 153 patients emergently hospitalized for diverticular bleeding who were examined by colonoscopy were prospectively enrolled. Patients in whom the bleeding source was identified received endoscopic treatment such as clipping or endoscopic ligation. After spontaneous cessation of bleeding withconservative treatment or hemostasis with endoscopic treatment, all patients were started on a liquid food diet and gradually progressed to a solid diet over 3d, and were discharged. At enrollment, we assessed smoking, alcohol, medications [non-steroidal antiinflammatory drugs(NSAIDs)], low-dose aspirin, and other antiplatelets, warfarin, acetaminophen, and oral corticosteroids), and co-morbidities [hypertension,diabetes mellitus, dyslipidemia, cerebro-cardiovascular disease, chronic liver disease, and chronic kidney disease(CKD)]. The in-hospital outcomes were need for transfusion, further bleeding after spontaneous cessation of hemorrhage, and length of hospital stay.The odds ratio(OR) for transfusion need, further bleeding, and prolonged length of stay were estimated by logistic regression analysis.RESULTS: No patients required angiographic embolization or surgery. Stigmata of bleeding occurred in 18% of patients(27/153) and was treated by endoscopic procedures. During hospitalization, 40patients(26%) received a median of 6 units of packed red blood cells. Multivariate analysis revealed that female sex(OR = 2.5, P = 0.02), warfarin use(OR= 9.3, P < 0.01), and CKD(OR = 5.9, P < 0.01)were independent risk factors for transfusion need.During hospitalization, 6 patients(3.9%) experienced further bleeding, and NSAID use(OR = 5.9, P = 0.04)and stigmata of bleeding(OR = 11, P < 0.01) were significant risk factors. Median length of hospital stay was 8 d. Multivariate analysis revealed that age > 70years(OR = 2.1, P = 0.04) and NSAID use(OR = 2.7,P = 0.03) were independent risk factors for prolonged hospitalization(≥ 8 d).CONCLUSION: In colonic diverticular bleeding, female sex, warfarin, and CKD increased the risk of transfusion requirement, while advanced age and NSAID increased the risk of prolonged hospitalization. | Naoyoshi Nagata Ryota Niikura Tomonori Aoki Shiori Moriyasu Toshiyuki Sakurai Takuro Shimbo Katsunori Sekine Hidetaka Okubo Kazuhiro Watanabe Chizu Yokoi Junichi Akiyama Mikio Yanase Masashi Mizokami Kazuma Fujimoto Naomi Uemura | 2015 | World Journal of Gastroenterology2015，21，37： | 0 |
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