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Enhancing recombinant antibody yield in Chinese hamster ovary cells 提高中国仓鼠卵巢细胞中重组抗体的产量
IF 1.5 Q2 Medicine Pub Date : 2024-05-24 DOI: 10.4103/tcmj.tcmj_315_23
Chee-Hing Yang, Hui-Chun Li, Shih-Yen Lo
ABSTRACT A range of recombinant monoclonal antibodies (rMAbs) have found application in treating diverse diseases, spanning various cancers and immune system disorders. Chinese hamster ovary (CHO) cells have emerged as the predominant choice for producing these rMAbs due to their robustness, ease of transfection, and capacity for posttranslational modifications akin to those in human cells. Transient transfection and/or stable expression could be conducted to express rMAbs in CHO cells. To bolster the yield of rMAbs in CHO cells, a multitude of approaches have been developed, encompassing vector optimization, medium formulation, cultivation parameters, and cell engineering. This review succinctly outlines these methodologies when also addressing challenges encountered in the production process, such as issues with aggregation and fucosylation.
摘要 一系列重组单克隆抗体(rMAbs)已被用于治疗各种疾病,包括各种癌症和免疫系统疾病。中国仓鼠卵巢(CHO)细胞因其稳健性、易转染性以及与人体细胞相似的翻译后修饰能力,已成为生产这些 rMAbs 的主要选择。瞬时转染和/或稳定表达可用于在 CHO 细胞中表达 rMAbs。为提高 CHO 细胞中 rMAbs 的产量,已开发出多种方法,包括载体优化、培养基配方、培养参数和细胞工程。本综述简明扼要地概述了这些方法,同时也探讨了生产过程中遇到的挑战,如聚集和岩藻糖基化问题。
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引用次数: 0
Aromatherapy for the prevention of postoperative nausea and vomiting: A systematic review and meta-analysis 预防术后恶心和呕吐的芳香疗法:系统回顾与荟萃分析
IF 1.5 Q2 Medicine Pub Date : 2024-05-24 DOI: 10.4103/tcmj.tcmj_240_23
Jian-Ying Wang, Hsueh-Yang Huang, Wan-O Chu, Tzu-Rong Peng, Ming-Chia Lee, Shih-Ming Chen, Jen-Ai Lee
ABSTRACT Postoperative nausea and vomiting (PONV) are common complications following surgical procedures. While drug-based treatments are standard, there is increasing interest in nonpharmacological alternatives, such as aromatherapy, due to potential benefits and minimal side effects. This study aimed to assess the effectiveness of aromatherapy in preventing PONV. A comprehensive systematic review and meta-analysis were conducted using PubMed, Cochrane Library, EMBASE, and CINAHL databases for studies published up to May 2023. The included studies were randomized controlled trials (RCTs) and nonrandomized studies of interventions that examined the impact of aromatherapy on PONV. The risk of bias was assessed, and the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach was employed to evaluate the certainty of the evidence. Eleven studies were selected for review, with eight RCTs included in the meta-analysis. Aromatherapy effectively reduced postoperative nausea severity (standardized mean difference [SMD]: −0.93, 95% confidence interval [CI]: −1.64 to −0.22; P = 0.010), but the reduction in vomiting episodes was not statistically significant (SMD: −0.81, 95% CI: −1.98-0.37; P = 0.180). Subgroup analysis indicated that ginger essence, lavender, and peppermint oils were particularly effective in managing postoperative nausea. However, due to significant statistical heterogeneity and potential biases in the studies, the results should be interpreted with caution. The certainty of the evidence, as evaluated by the GRADE approach, was low. Preliminary evidence supports the potential benefit of aromatherapy in reducing the severity of postoperative nausea. However, given the low certainty of current evidence, more rigorous and standardized research is needed. The safety, affordability, and potential benefits to patient comfort make aromatherapy a promising area for further research in postoperative care.
摘要 术后恶心和呕吐(PONV)是外科手术后常见的并发症。虽然以药物为基础的治疗是标准疗法,但由于芳香疗法等非药物疗法具有潜在的益处和最小的副作用,越来越多的人对其产生了兴趣。本研究旨在评估芳香疗法在预防 PONV 方面的有效性。 我们使用 PubMed、Cochrane Library、EMBASE 和 CINAHL 数据库对截至 2023 年 5 月发表的研究进行了全面的系统综述和荟萃分析。纳入的研究包括随机对照试验(RCT)和非随机干预研究,这些研究均探讨了芳香疗法对 PONV 的影响。对偏倚风险进行了评估,并采用建议、评估、发展和评价分级法(GRADE)对证据的确定性进行了评估。 共选择了 11 项研究进行审查,其中 8 项 RCT 纳入了荟萃分析。芳香疗法有效降低了术后恶心的严重程度(标准化平均差 [SMD]:-0.93,95% 置信区间 [CI]:-0.93,95% 置信区间[CI]:-1.64 至 -0.22;P = 0.010),但呕吐次数的减少并无统计学意义(SMD:-0.81,95% 置信区间[CI]:-1.98 至 0.37;P = 0.180)。亚组分析表明,生姜精油、薰衣草精油和薄荷精油对控制术后恶心特别有效。然而,由于研究中存在明显的统计异质性和潜在偏差,因此在解释结果时应谨慎。根据 GRADE 方法评估,证据的确定性较低。 初步证据支持芳香疗法在降低术后恶心严重程度方面的潜在益处。不过,鉴于目前证据的确定性较低,因此需要进行更严格和标准化的研究。芳香疗法的安全性、经济性和对患者舒适度的潜在益处使其成为术后护理中一个很有前景的进一步研究领域。
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引用次数: 0
Lower urinary tract dysfunction in the central nervous system neurogenic bladder and the real-life treatment outcome of botulinum toxin A 中枢神经系统神经源性膀胱的下尿路功能障碍和 A 型肉毒毒素的实际治疗效果
IF 1.5 Q2 Medicine Pub Date : 2024-05-24 DOI: 10.4103/tcmj.tcmj_29_24
H. Kuo
ABSTRACT Neurogenic lower urinary tract dysfunction (NLUTD) is common in patients with central nervous system (CNS) lesions. Cases of cerebrovascular accidents (CVA), Parkinson’s disease, dementia, and other intracranial lesions develop poor bladder control with or without urinary difficulty due to loss of cortical perception of bladder filling sensation and poor coordination of urethral sphincter relaxation during reflex micturition. Patients with CNS lesions usually have overactive bladder (OAB) symptoms, including urgency, frequency, incontinence, voiding symptoms of dysuria, large postvoid residual volume, and retention. In elderly patients with severe CNS disease the OAB symptoms are usually difficult to adequately relieve by medical treatment, and thus, their quality of life is greatly. Botulinum toxin A (BoNT-A) is currently licensed and has been applied in patients with idiopathic and neurogenic OAB due to spinal cord injury or multiple sclerosis. However, the application of BoNT-A in the treatment of urinary incontinence due to NLUTD in chronic CNS lesions has not been well-documented. Although cohort studies and case series support BoNT-A treatment for neurogenic OAB, chronic urine retention after intravesical BoNT-A injection for OAB and exacerbated urinary incontinence after urethral BoNT-A injection for voiding dysfunction have greatly limited its application among patients with NLUTD due to CNS lesions. This article reviews the pathophysiology and clinical characteristics of NLUTD in patients with CNS lesions and the clinical effects and adverse events of BoNT-A injection for patients with NLUTD. A flowchart was created to outline the patient selection and treatment strategy for neurogenic OAB.
摘要 神经源性下尿路功能障碍(NLUTD)常见于中枢神经系统(CNS)病变患者。脑血管意外(CVA)、帕金森病、痴呆和其他颅内病变患者由于大脑皮层对膀胱充盈感的知觉丧失,以及反射性排尿时尿道括约肌放松的协调性差,导致膀胱控制能力差,伴有或不伴有排尿困难。中枢神经系统病变患者通常会出现膀胱过度活动症(OAB)症状,包括尿急、尿频、尿失禁、排尿困难、排尿后残余尿量大和尿潴留等排尿症状。对于患有严重中枢神经系统疾病的老年患者来说,膀胱过度活动症的症状通常很难通过药物治疗得到充分缓解,因此他们的生活质量也会大打折扣。肉毒杆菌毒素 A(BoNT-A)目前已获得许可,并已应用于因脊髓损伤或多发性硬化症导致的特发性和神经源性 OAB 患者。然而,BoNT-A 用于治疗慢性中枢神经系统病变引起的无排尿障碍性尿失禁还没有得到充分证实。虽然队列研究和系列病例支持 BoNT-A 治疗神经源性 OAB,但膀胱内注射 BoNT-A 治疗 OAB 后的慢性尿潴留以及尿道注射 BoNT-A 治疗排尿功能障碍后的尿失禁加重,极大地限制了其在中枢神经系统病变所致 NLUTD 患者中的应用。本文回顾了中枢神经系统病变患者 NLUTD 的病理生理学和临床特征,以及 BoNT-A 注射治疗 NLUTD 患者的临床效果和不良反应。本文创建了一个流程图,概述了神经源性 OAB 患者的选择和治疗策略。
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引用次数: 0
Adipose-derived stem cells and antibiotics: A novel synergistic approach for treating implant-related osteomyelitis 脂肪源性干细胞和抗生素:治疗植入物相关骨髓炎的新型协同方法
IF 1.5 Q2 Medicine Pub Date : 2024-05-24 DOI: 10.4103/tcmj.tcmj_48_24
Kuang-Ting Yeh, Wen-Tien Wu, Chen-Chie Wang, Ru-Ping Lee
ABSTRACT Implant-related osteomyelitis poses a significant challenge in orthopedic practice, particularly due to the increasing prevalence of antibiotic-resistant infections and biofilm-associated complications. This article focused on exploring the potential of combination therapy with adipose-derived stem cells (ADSCs) and antibiotics to overcome these challenges, thereby enhancing treatment efficacy. A systematic synthesis of the results of recent in vivo studies, predominantly those using rat models, was performed. Studies that evaluated the effectiveness of ADSCs combined with antibiotics against common pathogens in implant-related osteomyelitis, particularly Staphylococcus aureus and methicillin-resistant Staphylococcus epidermidis, were selected. A significant reduction in symptoms such as swelling, abscess formation, and bacterial burden in the ADSCs + antibiotic-treated group was observed in all studies. In addition, microcomputed tomography revealed reduced osteolysis, indicating enhanced bone preservation. Furthermore, histological examination revealed improved tissue structure and altered immune response, signifying the dual role of ADSCs in enhancing antibiotic action and modulating the immune system. This review highlights the promising role of the concurrent use of ADSCs and antibiotics in the treatment of implant-related osteomyelitis. This novel therapeutic strategy has the potential to revolutionize the management of complex orthopedic infections, especially those resistant to conventional treatments. However, further research is required to translate the results of animal studies into clinical applications and to develop optimized treatment protocols for human use.
摘要 植入物相关骨髓炎是骨科实践中的一项重大挑战,特别是由于抗生素耐药性感染和生物膜相关并发症的日益流行。本文重点探讨了脂肪源性干细胞(ADSCs)和抗生素联合疗法克服这些挑战的潜力,从而提高治疗效果。文章对最近的体内研究结果进行了系统综合,主要是使用大鼠模型的研究。这些研究评估了 ADSCs 与抗生素结合对植入物相关骨髓炎常见病原体(尤其是金黄色葡萄球菌和耐甲氧西林表皮葡萄球菌)的疗效。所有研究均观察到 ADSCs + 抗生素治疗组的肿胀、脓肿形成和细菌负荷等症状明显减轻。此外,微计算机断层扫描显示骨溶解减少,表明骨保存得到加强。此外,组织学检查显示组织结构得到改善,免疫反应发生改变,这表明 ADSCs 在增强抗生素作用和调节免疫系统方面发挥着双重作用。本综述强调了同时使用 ADSCs 和抗生素治疗植入物相关骨髓炎的前景。这种新型治疗策略有可能彻底改变复杂骨科感染的治疗方法,尤其是对传统治疗方法产生抗药性的感染。不过,要将动物实验结果转化为临床应用,并开发出供人类使用的优化治疗方案,还需要进一步的研究。
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引用次数: 0
Extracellular vesicles: Function, resilience, biomarker, bioengineering, and clinical implications. 细胞外囊泡:功能、复原力、生物标记、生物工程和临床意义。
IF 1.4 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-05-24 eCollection Date: 2024-07-01 DOI: 10.4103/tcmj.tcmj_28_24
Der-Shan Sun, Hsin-Hou Chang

Extracellular vesicles (EVs) have emerged as key players in intercellular communication, disease pathology, and therapeutic innovation. Initially overlooked as cellular debris, EVs are now recognized as vital mediators of cell-to-cell communication, ferrying a cargo of proteins, nucleic acids, and lipids, providing cellular resilience in response to stresses. This review provides a comprehensive overview of EVs, focusing on their role as biomarkers in disease diagnosis, their functional significance in physiological and pathological processes, and the potential of bioengineering for therapeutic applications. EVs offer a promising avenue for noninvasive disease diagnosis and monitoring, reflecting the physiological state of originating cells. Their diagnostic potential spans a spectrum of diseases, including cancer, cardiovascular disorders, neurodegenerative diseases, and infectious diseases. Moreover, their presence in bodily fluids such as blood, urine, and cerebrospinal fluid enhances their diagnostic utility, presenting advantages over traditional methods. Beyond diagnostics, EVs mediate crucial roles in intercellular communication, facilitating the transfer of bioactive molecules between cells. This communication modulates various physiological processes such as tissue regeneration, immune modulation, and neuronal communication. Dysregulation of EV-mediated communication is implicated in diseases such as cancer, immune disorders, and neurodegenerative diseases, highlighting their therapeutic potential. Bioengineering techniques offer avenues for manipulating EVs for therapeutic applications, from isolation and purification to engineering cargo and targeted delivery systems. These approaches hold promise for developing novel therapeutics tailored to specific diseases, revolutionizing personalized medicine. However, challenges such as standardization, scalability, and regulatory approval need addressing for successful clinical translation. Overall, EVs represent a dynamic frontier in biomedical research with vast potential for diagnostics, therapeutics, and personalized medicine.

细胞外囊泡(EVs)已成为细胞间通信、疾病病理和治疗创新的关键角色。细胞外囊泡最初被认为是细胞碎片,但现在人们认识到它是细胞间交流的重要媒介,能运送蛋白质、核酸和脂质等货物,提供细胞应对压力的复原力。这篇综述全面概述了EVs,重点是EVs在疾病诊断中作为生物标记物的作用、EVs在生理和病理过程中的功能意义以及生物工程在治疗应用中的潜力。EVs为无创疾病诊断和监测提供了一个前景广阔的途径,它反映了起源细胞的生理状态。它们的诊断潜力涵盖一系列疾病,包括癌症、心血管疾病、神经退行性疾病和传染病。此外,EVs 存在于血液、尿液和脑脊液等体液中,增强了其诊断效用,与传统方法相比更具优势。除诊断外,EVs 还在细胞间通信中发挥关键作用,促进生物活性分子在细胞间的转移。这种交流调节着各种生理过程,如组织再生、免疫调节和神经元交流。EV介导的通讯失调与癌症、免疫紊乱和神经退行性疾病等疾病有关,这凸显了它们的治疗潜力。生物工程技术提供了操纵 EVs 用于治疗的途径,从分离和纯化到工程货物和靶向递送系统。这些方法有望开发出针对特定疾病的新型疗法,从而彻底改变个性化医疗。然而,要成功实现临床转化,还需要解决标准化、可扩展性和监管审批等挑战。总之,EVs 代表了生物医学研究中一个充满活力的前沿领域,在诊断、治疗和个性化医疗方面具有巨大潜力。
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引用次数: 0
Exploring mindfulness interventions for stress resilience in newly graduated nurses: A qualitative study 探索针对新毕业护士压力复原力的正念干预:定性研究
IF 1.5 Q2 Medicine Pub Date : 2024-05-15 DOI: 10.4103/tcmj.tcmj_250_23
Shu-Chen Wang, Shih-Ming Shih, Li-Chuan Kuo
ABSTRACT In an aging society coping with workforce challenges, successful hospital management hinges on the recruitment and retention of nurses. It is of utmost priority to address job stress and fortify mental resilience. While quantitative research supports investigating the stress-alleviating effects of mindfulness for nursing staff, obtaining a direct perspective from nurses is essential to comprehend how they navigate burnout and apply mindfulness for stress management. This qualitative study aimed to explore newly graduated nurses’ experiences who participated in a mindfulness course and evaluate the practical application of acquired strategies in their work and daily lives, providing insights for retention strategies in health-care institutions. Thirty-one recently graduated nurses participated in an 8-session weekly in the mindfulness program. Qualitative data were obtained through focus group discussions during each session and subjected to thematic analysis. Five key themes were generated to show how nurses experience mindfulness training: (1) shedding light on workplace stress and adaptation; (2) stress upon entering the workforce; (3) reactions to the vicious cycle of anxiety responses to stress through mindfulness practices; (4) discovery of daily life pleasures and obstacles encountered during the mindfulness course; (5) obstacles encountered during the mindfulness course. Through participation in the program, the subjects’ levels of mindfulness of stress responses were enhanced. This study underscores the advantages of mindfulness courses for newly graduated nurses and emphasizes the crucial role of workplace support. Practical recommendations for nursing administrators and educators include fostering familiarity with the health-care environment, promoting teamwork, and addressing anxiety related to handovers. Mindfulness breathing training has proven effective in alleviating pressure during shift transitions. Nursing managers can enhance staff well-being by creating moments of happiness, encouraging positive experience sharing, and organizing outdoor activities. Suggestions for future research involve refining the implementation of the Mindfulness-Based Stress Reduction course for accessibility and effectiveness, extending courses to other health-care professionals to promote team harmony, and positively impacting nursing staff’s well-being and performance.
摘要 在应对劳动力挑战的老龄化社会中,医院管理的成功与否取决于护士的招聘和留用。解决工作压力和增强心理复原力是重中之重。虽然定量研究支持调查正念对护理人员的压力缓解作用,但直接从护士的角度了解他们如何应对职业倦怠和运用正念进行压力管理至关重要。本定性研究旨在探讨刚毕业的护士参加正念课程的经历,并评估她们在工作和日常生活中实际应用正念策略的情况,从而为医疗机构的留住人才策略提供启示。 31 名刚毕业的护士参加了每周 8 课时的正念课程。我们通过每节课的焦点小组讨论获得了定性数据,并进行了主题分析。 研究产生了五个关键主题,以展示护士如何体验正念训练:(1)揭示工作场所的压力和适应;(2)进入职场后的压力;(3)通过正念练习对压力下焦虑反应的恶性循环的反应;(4)在正念课程中发现日常生活的乐趣和遇到的障碍;(5)在正念课程中遇到的障碍。通过参与该计划,受试者对压力反应的正念水平得到了提高。 本研究强调了正念课程对新毕业护士的优势,并强调了工作场所支持的关键作用。对护理管理者和教育者提出的实用建议包括:培养对医疗环境的熟悉程度、促进团队合作以及解决与交接班有关的焦虑。事实证明,正念呼吸训练能有效缓解交接班时的压力。护理管理者可以通过创造快乐时刻、鼓励积极的经验分享和组织户外活动来提高员工的幸福感。对未来研究的建议包括:完善正念减压课程的实施,提高其可及性和有效性;将课程推广至其他医护人员,促进团队和谐;对护理人员的幸福感和工作表现产生积极影响。
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引用次数: 0
Risk factors for reoperation after discectomy of lumbar herniated intervertebral disc disease. 腰椎间盘突出症椎间盘切除术后再次手术的风险因素。
IF 1.4 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-04-30 eCollection Date: 2024-07-01 DOI: 10.4103/tcmj.tcmj_206_23
Cheng-Huan Peng, Ing-Ho Chen, Tzai-Chiu Yu, Jen-Hung Wang, Wen-Tien Wu, Kuang-Ting Yeh

Objectives: Discectomy is the most common surgery for lumbar herniated intervertebral disc (HIVD) disease. However, 5%-24% of patients undergo a second surgery due to recurrent disc herniation.

Materials and methods: This study was aimed to identify the risk factors for reoperation after discectomy of lumbar HIVD and recommend treatment for patients with a high risk of reoperation. We recruited patients diagnosed as having single-level lumbar HIVD who underwent open discectomy from January 1, 2000, to December 31, 2012 in our hospital. We used a survival curve to inspect the survival time and reoperation rate after surgery. We discussed the correlation of reoperation rate with discectomy level, body mass index, heavy lifting after surgery, sex, and age. Furthermore, we investigated the correlation between the experience of a surgeon and the reoperation rate.

Results: A total of 619 patients were enrolled in our study. Most patients were 40-60 years old (48.8%), and most of them had herniation at L4/5 level (48.9%). The 8-year survival rate was 92%. Weight lifting after surgery may increase the reoperation rate by 115 and 18 times for those >60 years and <40 years, respectively. In addition, less experience of the surgeon and female sex had a high reoperation rate.

Conclusion: Postoperative working modification may be very important for preventing patients from recurrent HIVD. For elderly people with HIVD, a more conservative therapy could be selected. If patients with lumbar spine hypermobility or severe degeneration require wide laminectomy, primary fusion should be considered.

目的:椎间盘切除术是治疗腰椎间盘突出症(HIVD)最常见的手术。然而,5%-24%的患者会因复发性椎间盘突出症而接受第二次手术:本研究旨在确定腰椎间盘突出症(HIVD)椎间盘切除术后再次手术的风险因素,并对再次手术风险高的患者提出治疗建议。我们招募了 2000 年 1 月 1 日至 2012 年 12 月 31 日期间在我院接受开刀椎间盘切除术的单层腰椎 HIVD 患者。我们用生存曲线来检验术后生存时间和再手术率。我们讨论了再手术率与椎间盘切除水平、体重指数、术后重体力劳动、性别和年龄的相关性。此外,我们还研究了外科医生的经验与再手术率之间的相关性:共有 619 名患者参与了我们的研究。大多数患者的年龄在 40-60 岁之间(48.8%),大多数患者的腰椎疝位于 L4/5 水平(48.9%)。8年生存率为92%。术后举重可能会使再次手术率增加 115 倍,年龄大于 60 岁的患者可能会增加 18 倍:术后调整工作对于防止患者复发 HIVD 可能非常重要。对于患有 HIVD 的老年人,可以选择更为保守的疗法。如果腰椎活动度大或退变严重的患者需要进行宽椎板切除术,则应考虑进行初次融合术。
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引用次数: 0
The level of discomfort during the use of different circuits of the mechanical ventilator. 使用机械呼吸机不同回路时的不适程度。
IF 1.4 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-04-30 eCollection Date: 2024-07-01 DOI: 10.4103/tcmj.tcmj_236_23
Meng-Yi Liu, Pei-Shan Hsu, Chiu-Feng Wu, Yao-Kuang Wu, Mei-Chen Yang, Wen-Lin Su, I-Shiang Tzeng, Chou-Chin Lan

Objectives: Endotracheal tube (ETT) intubation is a life-saving procedure in patients with respiratory failure. However, the presence of an ETT can cause significant discomfort. A tracheostomy tube is used to administer a mechanical ventilator, resulting in a more stable airway and fewer serious injuries. Noninvasive ventilators (NIPPVs) administer ventilation through masks and must be tightly fixed to the face. ETT, tracheostomy, and NIPPV are the most common methods of ventilator maintenance. However, these interventions often cause discomfort to patients. This study aimed to compare discomfort associated with ETT, tracheostomy, and NIPPV.

Materials and methods: Forty-nine conscious patients with postextubation NIPPV and eight conscious patients who underwent postextubation tracheotomy were evaluated for discomfort. A questionnaire survey on discomfort was performed before and after NIPPV or tracheostomy. These patients reported their level of discomfort on a visual analog scale.

Results: The levels of sore throat, nasal pain, body pain, activity limitation, respiratory discomfort, oral discomfort, difficulty coughing sputum, worry about respiratory tube disconnection, back pain, anxiety, worry about long-term admission, sleep disturbance, and general discomfort during ETT intubation were higher than during tracheostomy or NIPPV (all P < 0.05). The mean level of discomfort was approximately 5-6 points (moderate) in patients with ETT and 2-3 points (mild) in patients with NIPPV or tracheostomy.

Conclusion: The level of discomfort was higher in patients who underwent ETT intubation than in those who underwent NIPPV or tracheostomy. However, the level of discomfort was similar between the patients with NIPPV and those who underwent tracheostomy.

目的:气管内插管(ETT)是呼吸衰竭患者的一项救生程序。然而,气管内插管会给患者带来明显不适。气管插管用于使用机械呼吸机,可使气道更加稳定,减少严重损伤。无创呼吸机(NIPPV)通过面罩进行通气,必须紧紧固定在面部。ETT、气管切开术和 NIPPV 是最常见的呼吸机维护方法。然而,这些干预措施往往会给患者带来不适。本研究旨在比较与 ETT、气管切开术和 NIPPV 相关的不适感:对 49 名接受拔管后 NIPPV 的神志清醒患者和 8 名接受拔管后气管切开术的神志清醒患者进行了不适感评估。在 NIPPV 或气管切开术前后进行了不适感问卷调查。这些患者用视觉模拟量表报告了他们的不适程度:结果:在 ETT 插管期间,患者的咽喉疼痛、鼻腔疼痛、身体疼痛、活动受限、呼吸道不适、口腔不适、咳痰困难、担心呼吸管断开、背部疼痛、焦虑、担心长期入院、睡眠障碍和全身不适程度均高于气管切开术或 NIPPV 期间(所有 P <0.05)。ETT患者的平均不适程度约为5-6分(中度),NIPPV或气管切开患者的平均不适程度约为2-3分(轻度):结论:接受 ETT 插管的患者的不适程度高于接受 NIPPV 或气管切开术的患者。不过,NIPPV 患者和气管切开术患者的不适程度相似。
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引用次数: 0
Utilization of apitherapy in allergic asthma: A systematic review of clinical and preclinical studies. 在过敏性哮喘中使用哮喘治疗法:临床和临床前研究的系统回顾。
IF 1.4 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-04-30 eCollection Date: 2024-10-01 DOI: 10.4103/tcmj.tcmj_233_23
Nicolas Daniel Widjanarko, Jonathan Christianto Subagya, Josephine Immanuel Maksi, Felicia Grizelda Suryatenggara, Sharon Claudia Ethelyn Sihole

Objectives: This systematic review aimed to summarize the benefit of apitherapy in human and animal models of asthma.

Materials and methods: The procedures in this review were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020 protocol, where MEDLINE, ProQuest, and EBSCOhost databases were used to obtain eligible studies dating to 2023. Furthermore, the risk of bias was assessed using Risk of Bias Tool 2.0 (RoB-2) for randomized-control trials and Systematic Review Centre for Laboratory Animal Experimentation's RoB for animal studies.

Results: A total of 12 studies were included in the review based on the predetermined eligibility criteria, consisting of 4 human and 8 animal model reports. Among the four human studies, two had a low risk, while the other two had some concerns of bias. In the case of eight animal model of asthma, a total of three domains had a high risk of bias. Moreover, the anti-inflammatory properties of apitherapy were demonstrated by its capacity to inhibit NF-κB, nuclear factor of activated T cells, and IgE antibodies, leading to decreased production of tumor necrosis factor-α, interleukin-2 (IL-2), IL-6, and IL-8, and an increase in IL-10 levels. These beneficial effects were reported to be associated with improvements in clinical manifestations and lung function parameters in human subjects. The use of apitherapy was also related to the restoration of airway structure, and reduction of inflammatory cell infiltration, epithelial thickness, and mucus secretion in lung tissue of animal model of asthma.

Conclusion: Based on the results, apitherapy was effective in improving asthma symptoms and reducing inflammation in human and animal models of asthma.

目的:本系统综述旨在总结哮喘治疗对人类和动物模型的益处:本综述根据《2020年系统综述和荟萃分析首选报告项目》(Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020 protocol)执行,使用MEDLINE、ProQuest和EBSCOhost数据库获取2023年前符合条件的研究。此外,随机对照试验采用偏倚风险工具 2.0(RoB-2)评估偏倚风险,动物研究采用实验室动物实验系统综述中心的 RoB 评估偏倚风险:根据预先确定的资格标准,共有 12 项研究被纳入审查范围,其中包括 4 项人体研究和 8 项动物模型报告。在 4 项人体研究中,有 2 项风险较低,而另外 2 项则存在一些偏倚问题。在 8 个哮喘动物模型中,共有 3 个领域存在高偏倚风险。此外,抗哮喘疗法的抗炎特性还体现在它能够抑制 NF-κB、活化 T 细胞核因子和 IgE 抗体,从而减少肿瘤坏死因子-α、白细胞介素-2(IL-2)、IL-6 和 IL-8 的产生,并提高 IL-10 的水平。据报道,这些有益效果与人体临床表现和肺功能参数的改善有关。哮喘动物模型肺组织中的炎症细胞浸润、上皮厚度和粘液分泌减少也与使用哮喘治疗法恢复气道结构有关:结论:根据研究结果,气道疗法能有效改善人类和动物哮喘模型的哮喘症状并减轻炎症反应。
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引用次数: 0
Comparison of the surgical outcomes between paravaginal repair and anterior colporrhaphy: A retrospective case–control study 阴道旁修补术与前结肠切除术的手术效果比较:回顾性病例对照研究
IF 1.5 Q2 Medicine Pub Date : 2024-04-24 DOI: 10.4103/tcmj.tcmj_237_23
Pei-Chen Chen, Wing Lam Tsui, D. Ding
ABSTRACT This study compared the surgical outcomes of anterior vaginal wall repair (A-repair) and paravaginal repair (PVR) for laparoscopic pelvic organ prolapse (POP) surgeries. This retrospective case–control study recruited patients who underwent laparoscopic POP surgeries in our hospital from May 1, 2013, to May 31, 2022, using the health insurance surgical code payment system (laparoscopic colpopexy/hysteropexy/cervicopexy: 80025B) in Taiwan. The patients were divided into A-repair (group 1) and PVR (group 2). Patients aged <20 years, without postoperative outcomes, and without baseline characteristics were excluded. Baseline characteristics (age, menopausal status, parity, diabetes mellitus, and hypertension) were collected. The outcome was to compare the changes in Pelvic Organ Prolapse Quantification (POP-Q) scores (Aa, Ba, and total vaginal length) preoperatively and 1–2 months, 3–6 months, and 1 year postoperatively in the two groups. After exclusion, 23 and 10 patients in A-repair and PVR, respectively, were recruited. There was no significant difference in baseline characteristics between the two groups. Patients in both groups showed significant improvement in Aa and Ba of POP-Q 1–2 months and 3–6 months postoperatively, except for those in group 2 1 year postoperatively. However, there was no significant difference in postoperative scores between the two groups at 1–2 months, 3–6 months, and 1 year postoperatively. The estimated blood loss did not exhibit a significant difference between the two groups; however, PVR had a longer duration of operation. The surgical outcomes of A-repair and PVR for the anterior compartment were comparable at 1–2 months, 3–6 months, and 1 year postoperatively.
摘要 本研究比较了腹腔镜盆腔脏器脱垂(POP)手术中阴道前壁修补术(A-repair)和阴道旁修补术(PVR)的手术效果。 这项回顾性病例对照研究招募了2013年5月1日至2022年5月31日期间在我院接受腹腔镜盆腔器官脱垂手术的患者,使用的是台湾健保手术代码支付系统(腹腔镜阴道整形术/宫颈整形术/宫颈环切术:80025B)。患者分为 A 型修复术(第 1 组)和 PVR 型修复术(第 2 组)。年龄小于 20 岁、无术后结果和无基线特征的患者被排除在外。收集基线特征(年龄、绝经状态、胎次、糖尿病和高血压)。结果是比较两组患者术前、术后1-2个月、3-6个月和1年的盆腔器官脱垂量化(POP-Q)评分(Aa、Ba和阴道总长度)的变化。 经排除后,A修复组和PVR组分别有23名和10名患者入选。两组患者的基线特征无明显差异。两组患者在术后 1-2 个月和 3-6 个月后,POP-Q 的 Aa 和 Ba 均有明显改善,但术后 1 年的第 2 组患者除外。不过,两组患者在术后 1-2 个月、3-6 个月和 1 年的术后评分没有明显差异。两组患者的估计失血量无明显差异,但 PVR 组的手术时间更长。 在术后1-2个月、3-6个月和1年,A-修复术和PVR术对前室的手术效果相当。
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引用次数: 0
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Tzu Chi Medical Journal
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