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Peritoneal dialysis(PD) is one of the most efficient methods in end-stage kidney disease, and it is very important for PD to perform well. No research has been conducted to evaluate the effect of various types of PD catheters on the prognosis of post-operative wound complications. While recent meta-analyses are in favour of straight tubing, there is still uncertainty as to whether direct or coiled PD is beneficial. The purpose of this meta-analysis was to compare the efficacy of direct and coiled PD catheters on the incidence of post-operative wound infection, bleeding and peritonitis. A comprehensive search was carried out on three databases, including PubMed and Embase, and a manual search was carried out on the links in the paper. The results showed that the incidence rate of bleeding after operation and the degree of infection among the straight and coiled pipes were compared. The results showed that there were no statistically significant differences in the incidence of post-operative wound infection among straight PD patients with coiled PD (OR, 0.79; 95% CI, 0.58–1.08 p = 0.13). No statistical significance was found in the case of PD with coiled tubing compared with that of straight PD group in wound leakage (OR, 1.17; 95% CI, 0.71–1.93 p = 0.55). No statistically significantly different rates of post-operative peritonitis were observed for coiled tubing compared with straight ones in PD patients (OR, 1.06; 95% CI, 0.78–1.45 p = 0.7). There is no statistical significance on the rate of wound infection, wound leakage and peritonitis among coiled and straight tube in PD.
Operative therapy for superficial esophagus carcinoma is the main way to treat the disease. Endoscopic excision of lesions in the esophagus has become an alternative to surgical treatment for patients with esophageal carcinoma. To overcome the disadvantages of endoscope mucosa excision (EMR), an endoscopic submucosal dissection (ESD) technique has been developed. Although ESD is one of the most effective methods of endoscopy in patients with digestive tract tumors, there are potential complications after surgery, including hemorrhage in the surgical area and stenosis of the esophagus. The objective of this study was to evaluate EMR versus ESD based on post-operative hemorrhage and esophagus stenosis. All the related articles were retrieved from the e-databases. The main results were postoperative perforation, hemorrhage, and stenosis after surgery. There were no statistically significant differences in the incidence of post-operative wound hemorrhage (OR, 1.08; 95% CI, 0.36–3.29 p = 0.89). Similarly, there were no statistically significant differences in the rate of perforation after surgery (OR, 0.57; 95% CI, 0.17–1.95 p = 0.37). There were no statistically significant differences in the incidence of esophageal stricture after surgery (OR, 1.15; 95% CI, 0.26–5.15 p = 0.85). This analysis was different from the earlier meta-analysis because ESD and EMR did not show any notable differences with respect to the incidence of perforation after surgery, the hemorrhage of the wound or the stenosis of the esophagus. These findings must, however, be supported by more high-quality studies.
Diabetic foot ulcer (DFU), a common intractable chronic complication of diabetes mellitus (DM), has a prevalence of up to 25%, with more than 17% of the affected patients at risk of amputation or even death. Vascular risk factors, including vascular stenosis or occlusion, dyslipidemia, impaired neurosensory and motor function, and skin infection caused by trauma, all increase the risk of DFU in patients with diabetes. Therefore, diabetic foot is not a single pathogenesis. Preclinical studies have contributed greatly to the pathogenesis determination and efficacy evaluation of DFU. Many therapeutic tools are currently being investigated using DFU animal models for effective clinical translation. However, preclinical animal models that completely mimic the pathogenesis of DFU remain unexplored. Therefore, in this review, the preparation methods and evaluation criteria of DFU animal models with three major pathological mechanisms: neuropathy, angiopathy and DFU infection were discussed in detail. And the advantages and disadvantages of various DFU animal models for clinical sign simulation. Furthermore, the current status of vitro models of DFU and some preclinical studies have been transformed into clinical treatment programs, such as medical dressings, growth factor therapy, 3D bioprinting and pre-vascularization, Traditional Chinese Medicine treatment. However, because of the complexity of the pathological mechanism of DFU, the clinical transformation of DFU model still faces many challenges. We need to further optimize the existing preclinical studies of DFU to provide an effective animal platform for the future study of pathophysiology and clinical treatment of DFU.
To describe the lived experiences of family caregivers of individuals with dementia during the coronavirus disease (COVID-19) outbreak in China.
This study used a descriptive phenomenological research method.
Between May and September 2021, semi-structured interviews were conducted with 22 family caregivers of people with dementia. Colaizzi's method was used for manual analysis.
Qualitative data revealed an overarching experience of finding ‘There is always good fortune in misfortune to encourage us in coping with difficulties’. Three themes emerged: family reactions to the COVID-19 outbreak, feeling supported by multiple resources performing respective functions and resilient adaptation to new situations.
During the COVID-19 outbreak, family caregivers of people living with dementia in China looked for positive aspects among difficulties and experienced corresponding reactions, social support resources and resilient adapted coping styles.
Nurses in China and other countries facing similar pandemic characteristics, cultures or economic development levels, can guide family caregivers to look at family hardships from a positive perspective, develop interventions to rapidly respond to families' reactions after a disaster and help them identify social support resources and form adapted coping styles.
We identified the resilience and the positive experiences of Chinese family caregivers of individuals with dementia during the COVID-19 outbreak. The results can inform countries with similar cultures and economic levels, offering measures to support their adaptation to pandemics.
This study followed the COREQ guidelines.
Family caregivers of people with dementia who met the inclusion criteria and who were interested in sharing their understanding of their experiences, participated in the study.
This study aimed to compare early endovenous sclerotherapy with superficial venous reflux combined with compression therapy and deferred intervention in patients with venous leg ulcers (VLUs). A total of 80 patients with 80 VLUs treated at the Department of General Surgery, Shangjin Nanfu Hospital, Chengdu, China, between February 2022 and January 2023 were included in the study. The primary outcome was the time to ulcer healing from the date of compression therapy or endovenous sclerotherapy. Secondary outcome measures were the rate of ulcer healing at 6 months, the rate of ulcer recurrence at 6 months, and patient-reported health-related quality of life. A total of 54 patients received early intervention and 26 received deferred intervention. The patient and clinical characteristics at baseline were similar between the two treatment groups. The median time to ulcer healing was 1.5 months (95% confidence interval [CI], 1.3–1.7 months) in the early-intervention group and 3.5 months (95% CI, 2.9–4.1 months) in the deferred-intervention group. The time to ulcer healing was shorter in the early-intervention group than in the deferred-intervention group (p < 0.001). The rate of ulcer healing at 6 months was 94% in the early-intervention group and 92% in the deferred-intervention group. The rate of ulcer recurrence before the end of the 6-month follow-up period was 2% in the early-intervention group and 4% in the deferred-intervention group. In conclusion, early endovenous sclerotherapy for superficial venous reflux resulted in faster healing of VLUs than deferred endovenous sclerotherapy.
Aimed to clarify the effect of quercetin and its derivatives on wound healing in animal experiments. PubMed, Embase, Science Direct, Web of Science, SinoMed, Vip Journal Integration Platform, China National Knowledge Infrastructure and WanFang databases were searched for animal experiments investigating the effect of quercetin and its derivatives on wound healing to April 2023. The Review Manager 5.4 software was used to conduct meta-analysis. Eighteen studies were enrolled in this article. According to the SYRCLE's RoB tool assessment, these studies exposed relatively low methodological quality. It was shown that animals with cutaneous wound receiving quercetin had faster wound healing in wound closure (%) than the control group. Moreover, the difference in efficacy gradually emerged after third day (WMD = 7.13 [5.52, 8.74]), with a peak reached on the tenth day after wounding (WMD = 19.78 [17.82, 21.74]). Subgroup analysis revealed that quercetin for wound closure (%) was independent of the types of rats and mice, wound area and with or without diabetes. Clear conclusion was also shown regarding the external application of quercetin for wound healing (WMD = 17.77 [11.11, 24.43]). A significant reduction in the distribution of inflammatory cells occurred in the quercetin group. Quercetin could increase blood vessel density (WMD = 1.85 [0.68, −3.02]), fibroblast distribution and collagen fraction. Biochemical indicators, including IL-1β, IL-10, TNF-α, TGF-β, vascular endothelial growth factor (VEGF), hydroxyproline and alpha-smooth muscle actin (α-SMA), had the consistent results. Quercetin and its derivatives could promote the recovery of cutaneous wound in animals, through inhibiting inflammatory response and accelerating angiogenesis, proliferation of fibroblast and collagen deposition.
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