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The application of clinical pathways in laparoscopic cholecystectomy

Hepatobiliary & Pancreatic Diseases International 2014年第4期13卷 348-353页

作者： Min Zhang Shu-Yang Zhou Mei-Yuan Xing Jian Xu Xiao-Xiao Shi Shu-Sen Zheng Department of General Surgery First Affiliated Hospital Zhejiang University School of Medicine library First Affiliated Hospital Zhejiang University School of Medicine

BACKGROUND： Laparoscopic cholecystectomy（LC） is one of the most frequent abdominal surgical procedures. The present meta-analysis aimed to estimate the clinical effects of implementing a clinical pathway for LC compared with standard medical care by evaluating the length of hospital stay,costs, and the outcomes of patients undergoing *** SOURCES： Data were extracted from the following databases： PubMed, EMBASE, the Cochrane Central Register of Controlled Trials, Chinese Medical Citation Index（CMCI）,Chinese Medical Current Contents（CMCC）, and China BioMedical Literature Database（CBM）. We also searched the reference lists of the relevant articles and conference *** randomized controlled trials and controlled clinical trials published from 1980 to 2013 were included. We did not set restrictions on language and country of publications. All of the data were evaluated and analyzed by two reviewers independently with RevMan software（version 5.0）.RESULTS： A total of 7 trials with 1187 patients were *** patients who underwent LC with clinical pathway had shorter hospital stay [weighted mean difference=-1.90, 95%CI：-2.65 to-1.16, P〈0.00001], lower cost [standard mean difference=-0.69, 95% CI：-0.82 to-0.56, P〈0.00001], and better questionnaires based satisfaction with the medical ***： The applications of the clinical pathway for LC effectively reduced hospital stay and total costs. However,there was insufficient evidence for proving the differences in postoperative complications. Future research should focus on patient outcomes and identify the mechanisms underlying the effect of the clinical pathway.

关键词： laparoscopic cholecystectomy clinical pathways complications

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Cilostazol for secondary stroke prevention:systematic review and meta-analysis

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Stroke & Vascular Neurology 2021年第3期6卷 410-423,I0035-I0053页

作者： Choon Han Tan Andrew GR Wu Ching-Hui Sia Aloysius ST Leow Bernard PL Chan Vijay Kumar Sharma Leonard LL Yeo Benjamin YQ Tan Department of medicine Lee Kong Chian School of MedicineNanyang Technological UniversitySingapore Department of medicine Yong Loo Lin School of MedicineNational University of SingaporeSingapore Department of Cardiology National University Heart CentreSingapore Division of Neurology Department of MedicineNational University Health SystemSingapore

Background Stroke is one of the leading causes of death ***,an antiplatelet and phosphodiesterase 3 inhibitor,has not been clearly established for ischaemic stroke *** aim to determine the efficacy and safety of cilostazol for secondary stroke *** MEDLINE,EMBASE,Cochrane library,Web of Science and *** were searched from inception to 25 September 2020,for randomised trials comparing the efficacy and safety of cilostazol monotherapy or dual therapy with another antiplatelet regimen or placebo,in patients with ischaemic *** 2 of the Cochrane risk-of-bias tool for randomised trials(RoB 2)was used to assess study *** meta-analysis was reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)*** Eighteen randomised trials comprising 11429 participants were included in this *** trials possessed low risk of bias and were of low *** significantly reduced the rate of ischaemic stroke recurrence(risk ratio,RR=0.69,95%CI 0.58 to 0.81),any stroke recurrence(RR=0.64,95%CI 0.54 to 0.74)and major adverse cardiovascular events(RR=0.67,95%CI 0.56 to 0.81).Cilostazol did not significantly decrease mortality(RR=0.90,95%CI 0.64 to 1.25)or increase the rate of good functional outcome(Modified Rankin Scale score of 0–1;RR=1.07,95%CI 0.95 to 1.19).Cilostazol demonstrated favourable safety profile,significantly reducing the risk of intracranial haemorrhage(RR=0.46,95%CI 0.31 to 0.68)and major haemorrhagic events(RR=0.49,95%CI 0.34 to 0.70).Conclusions Cilostazol demonstrated superior efficacy and safety profiles compared with traditional antiplatelet regimens such as aspirin and clopidogrel for secondary stroke prevention but does not appear to affect functional *** randomised trials can be conducted outside East Asia,or compare cilostazol with a wider range of antiplatelet agents.

关键词： prevention Cilostazol regimen

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Changes in sensorimotor regions of the cerebral cortex in congenital amusia:a case-control study

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Neural Regeneration Research 2021年第3期16卷 531-536页

作者： Jun-Jie Sun Xue-Qun Pan Ru Yang Zhi-Shuai Jin Yi-Hui Li Jun Liu Da-Xing Wu Department of Radiology the Second Xiangya Hospital of Central South UniversityChangshaHunan ProvinceChina Department of Radiology the Affiliated Zhuzhou Hospital of Xiangya College of MedicineCentral South UniversityZhuzhouHunan ProvinceChina Lister Hill national Center for Biomedical Communication National Library of MedicineBethesdaMDUSA Medical Psychological Center the Second Xiangya Hospital of Central South UniversityChangshaHunan ProvinceChina

Perceiving pitch is a central function of the human auditory system;congenital amusia is a disorder of pitch *** underlying neural mechanisms of congenital amusia have been actively ***,little attention has been paid to the changes in the motor rain within congenital *** this case-control study,17 participants with congenital amusia and 14 healthy controls underwent functional magnetic resonance imaging while resting with their eyes closed.A voxel-based degree centrality method was used to identify abnormal functional network centrality by comparing degree centrality values between the congenital amusia group and the healthy control *** found decreased degree centrality values in the right primary sensorimotor areas in participants with congenital amusia relative to controls,indicating potentially decreased centrality of the corresponding brain regions in the auditory-sensory motor feedback *** found a significant positive correlation between the degree centrality values and the Montreal Battery of Evaluation of Amusia *** conclusion,our study identified novel,hitherto undiscussed candidate brain regions that may partly contribute to or be modulated by congenital *** evidence supports the view that sensorimotor coupling plays an important role in memory and musical *** study was approved by the Ethics Committee of the Second Xiangya Hospital,Central South University,China(***20180101GZ01)on February 9,2019.

关键词： congenital amusia degree centrality lifelong impairment local functional connectivity music discrimination primary motor area primary sensorimotor area primary sensory area resting-state functional magnetic resonance imaging voxel-based analysis

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Evaluation of 4 three-dimensional representation algorithms in capsule endoscopy images

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World Journal of Gastroenterology 2013年第44期19卷 8028-8033页

作者： Alexandros Karargyris Emanuele Rondonotti Giovanna Mandelli Anastasios Koulaouzidis national library of medicine National Institutes of Health Bethesda MD 20892 United States Gastroenterology Unit Ospedale Valduce 22100 Como Italy Centre for Liver and Digestive Disorders The Royal Infirmary of Edinburgh Edinburgh EH16 4SAScotland United Kingdom

AIM:To evaluate the three-dimensional(3-D)representation performance of 4 publicly available Shapefrom-Shading(SfS)algorithms in small-bowel capsule endoscopy(SBCE).METHODS:SfS techniques recover the shape of objects using the gradual variation of *** are4 publicly available SfS *** the best of our knowledge,no comparative study with images obtained during clinical SBCE has been performed to *** experienced reviewers were asked to evaluate 54 twodimensional(2-D)images(categories:protrusion/inflammation/vascular)transformed to 3-D by the aforementioned SfS 3-D *** best algorithm was selected and inter-rater agreement was ***:Four publicly available SfS algorithms were ***’s SfS algorithm outperformed the rest(selected as best performing in 45/54 SBCE images),followed by Ciuti’s algorithm(best performing in 7/54images)and Torre o’s(in 1/54 images).In 26/54 images;Tsai’s algorithm was unanimously selected as the best performing 3-D representation SfS ***’s 3-D algorithm superiority was independent of lesion category(protrusion/inflammatory/vascular;P=0.678)and/or CE system used to obtain the 2-D images(MiroCam/PillCam;P=0.558).Lastly,the interobserver agreement was good(kappa=0.55).CONCLUSION:3-D representation software offers a plausible alternative for 3-D representation of conventional capsule endoscopy images(until optics technology matures enough to allow hardware enabled-"real"3-D reconstruction of the gastrointestinal tract).

关键词： Capsule endoscopy Small-bowel Threedimensional Software Algorithm Reconstruction Technology Advance

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Small-bowel capsule endoscopy: A ten-point contemporary review

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World Journal of Gastroenterology 2013年第24期19卷 3726-3746页

作者： Anastasios Koulaouzidis Emanuele Rondonotti Alexandros Karargyris Centre for Liver and Digestive Disorders the Royal Infirmary of EdinburghEdinburgh EH16 4SA Scotland United Kingdom Gastroenterology Unit Ospedale Valduce 22100 Como Italy national library of medicine National Institutes of HealthBethesda MD 20814 United States

The introduction of capsule endoscopy (CE) in clinical practice increased the interest for the study of the small-bowel. Consequently, in about 10 years, an impressive quantity of literature on indications, diagnostic yield (DY), safety profile and technical evolution of CE has been published as well as several reviews. At present time, there are 5 small-bowel capsule enteroscopy (SBCE) models in the worldwide market. Head-to-head trials have showed in the great majority of studies comparable results in terms of DY, image quality and completion rate. CE meta-analyses formed the basis of national/international guidelines; these guidelines place CE in a prime position for the diagnostic work-up of patients with obscure gastrointestinal bleeding, known and/or suspected Crohn's disease and possible small-bowel neoplasia. A 2-L polyethylene glycol-based purge, administered the day before the procedure,is the most widely practiced preparation regimen. Whether this regimen can be further improved (i.e. , by further decreasing its volume, changing the timing of administration, coupling it with prokinetics and/or other factors) or if it can really affect the DY, is still under discussion. Faecal calprotectin has been used in SBCE studies in two settings: in patients taking non-steroidal anti-inflammatory drugs, to evaluate the type and extent of mucosal damage and, more importantly from a clinical point of view, in patients with known or suspected Crohn's disease for assessment of inflam-mation activity. Although there is still a lot of debate around the exact reasons of SBCE poor performance in various small-bowel segments, it is worth to remember that the capsule progress is non-steerable, hence more rapid in the proximal than in lower segments of the small-bowel. Capsule aspiration, a relatively unexpected complication, has been reported with increasing frequency. This is probably related with the increase in the mean age of patients undergoing CE. CE video review is a ti

关键词： Capsule endoscopy Calprotectin Meta- analysis Review Preparation Reading software Complication Indications

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Capsule-odometer: A concept to improve accurate lesion localisation

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World Journal of Gastroenterology 2013年第35期19卷 5943-5946页

作者： Alexandros Karargyris Anastasios Koulaouzidis national library of medicine National Institutes of HealthBethesda MD 20814 United States Endoscopy Unit Centre for Liver and Digestive Disorders The Royal Infirmary of EdinburghEdinburgh EH16 4SA Scotland United Kingdom

In order to improve lesion localisation in small-bowel capsule endoscopy,a modified capsule design has been proposed incorporating localisation and-in theorystabilization *** proposed design consists of a capsule fitted with protruding wheels attached to a *** would act as a miniature odometer,leading to more accurate lesion localization information in relation to the onset of the investigation(spring expansion e.g.,pyloric opening).Furthermore,this capsule could allow stabilization of the recorded video as any erratic,non-forward movement through the gut is ***-dimensional(3-D)printing technology was used to build a capsule ***,miniature wheels were also 3-D printed and mounted on a spring which was attached to conventional capsule endoscopes for the purpose of this proof-of-concept *** vitro and ex vivo experiments with porcine small-bowel are presented *** experiments have been scheduled.

关键词： Capsule endoscopy Odometer Localisation Hardware Software

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Effectiveness of mobile health interventions on management of patients with hypertension:a systematic review of systematic reviews

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Frontiers of Nursing 2025年第1期12卷 1-12页

作者： Si-Si Wu Xue-Mei Tu Gui-Qin Mou Chun-Hua Long Sha-Sha Li Department of Cardiovascular medicine Chongqing University Three Gorges HospitalChongqing 404020China

Objective:To systematically evaluate the effectiveness of mobile health(mHealth)interventions on self-management and blood pressure(BP)control in patients with hypertension and to provide recommendations for the clinic and future ***:Databases including Embase,Cochrane library,CINAHL,CNKI,SinoMed,Wanfang,and Weipu were searched to collect systematic reviews(SRs)and meta-analyses on mHealth interventions for hypertension *** researchers independently screened the articles and extracted data,and the Assessment of Multiple Systematic Reviews(AMSTAR 2)was used to evaluate the methodological quality of the included ***:A total of 11 SRs were included:1 review was rated as high quality,3 as low quality,and 7 as critically low *** mobile phone was the most common intervention type,followed by the *** reviews performed meta-analyses and showed that mHealth was associated with a significant reduction in systolic blood pressure(SBP),from 2.28 mmHg(95%CI-3.90 to-0.66;I^(2)=40%)to 14.77 mmHg(95%CI 11.76-17.77;I^(2)=89.7%),and diastolic blood pressure(DBP),from 1.50 mmHg(95%CI-2.20 to-0.08;I^(2)=62%)to 8.17 mmHg(95%CI 5.67-10.67;I^(2)=86%).Self-management behaviors included medication adherence(MA),diet,smoking,alcohol drinking,physical activity,and BP *** were inconsistent results on the effectiveness of mHealth ***:mHealth interventions can improve BP control,MA,diet,and smoking in patients with hypertension,but the evidence for the efficacy of mHealth on physical activity and alcohol drinking improvement is *** methodological quality of existing SRs on the management of BP in patients with hypertension was relatively low,and more well-designed SRs or meta-analyses were needed to provide more *** interventions are useful for improving BP control of patients with hypertension.

关键词： blood pressure hypertension mobile health self-management smartphone systematic review

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Risk prediction models for post-intensive care syndrome of ICU discharged patients:A systematic review

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International Journal of Nursing Sciences 2025年第1期12卷 81-88,I0004页

作者： Pengfei Yang Fu Yang Qi Wang Fang Fang Qian Yu Rui Tai School of Nursing Shanghai Jiao Tong University School of MedicineShanghaiChina Department of Nursing Shanghai General HospitalShanghaiChina School of Public Health Shanghai Jiao Tong University School of MedicineShanghaiChina

Objectives:This systematic review aimed to assess the properties and feasibility of existing risk prediction models for post-intensive care syndrome outcomes in adult survivors of critical ***:As of November 1,2023,Cochrane library,PubMed,Embase,CINAHL,Web of Science,PsycInfo,China national Knowledge Infrastructure(CNKI),SinoMed,Wanfang database,and China Science and Technology Journal Database(VIP)were *** the literature screening process,we extracted data encompassing participant sources,post-intensive care syndrome(PICS)outcomes,sample sizes,missing data,predictive factors,model development methodologies,and metrics for model performance and *** conducted a review and classification of the PICS domains and predictive factors identified in each *** Prediction Model Risk of Bias Assessment Tool was employed to assess the quality and applicability of the ***:This systematic review included a total of 16 studies,comprising two cognitive impairment studies,four psychological impairment studies,eight physiological impairment studies,and two studies on all three *** discriminative ability of prediction models measured by area under the receiver operating characteristic curve was *** predictive performance of most models was excellent,but most models were biased and *** predictive factors tend to encompass age,pre-ICU functional impairment,in-ICU experiences,and early-onset new ***:This review identified 16 prediction models and the predictive factors for ***,due to the numerous methodological and reporting shortcomings identified in the studies under review,clinicians should exercise caution when interpreting the predictions made by these *** avert the development of PICS,it is imperative for clinicians to closely monitor prognostic factors,including the in-ICU experience and early-onset new symptoms.

关键词： Critical care Post-intensive care syndrome Prediction model Systematic review

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The genus Liriope： Phytochemistry and pharmacology

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Chinese Journal of Natural medicines 2017年第11期15卷 801-815页

作者： SHANG Zhan-Peng WANG Fei ZHANG Jia-Yu WANG Zi-Jian LU Jian-Qiu WANG Huai-You LI Ning School of Chinese Pharmacy Beijing University of Chinese Medicine Beijing 100102 China Beijing Research Institute of Chinese medicine Beijing University of Chinese Medicine Beijing 100029 China library of Beijing University of Chinese medicine Beijing University of Chinese Medicine Beijing 100029 China Shenzhen Research Institute Hong Kong University of Science and Technology Shenzhen 518057 China

Liriope(Liliaceae) species have been used as folk medicines in Asian countries since ancient times. From Liriope plants(8 species), a total of 132 compounds(except polysaccharides) have been isolated and identified, including steroidal saponins, flavonoids, phenols, and eudesmane sesquiterpenoids. The crude extracts or monomeric compounds from this genus have been shown to exhibit anti-tumor, anti-diabetic, anti-inflammatory, and neuroprotective activities. The present review summarizes the results on phytochemical and biological studies on Liriope plants. The chemotaxonomy of this genus is also discussed.

关键词： Liriope Liliaceae Chemical constituents Biological activities

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Use of enhancement algorithm to suppress reflections in 3-D reconstructed capsule endoscopy images

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World Journal of Gastrointestinal Endoscopy 2013年第9期5卷 465-467页

作者： Anastasios Koulaouzidis Alexandros Karargyris Endoscopy Unit Centre for Liver and Digestive Disorders the Royal Infirmary of Edinburgh national library of medicine National Institutes of Health

In capsule endoscopy(CE), there is research to develop hardware that enables ‘‘real'' three-dimensional(3-D) video. However, it should not be forgotten that ‘‘true'' 3-D requires dual video images. Inclusion of two cameras within the shell of a capsule endoscope though might be unwieldy at present. Therefore, in an attempt to approximate a 3-D reconstruction of the digestive tract surface, a software that recovers information-using gradual variation of shading-from monocular two-dimensional CE images has been proposed. Light reflections on the surface of the digestive tract are still a significant problem. Therefore, a phantom model and simulator has been constructed in an attempt to check the validity of a highlight suppression algorithm. Our results confirm that 3-D representation software performs better with simultaneous application of a highlight reduction algorithm. Furthermore, 3-D representation follows a good approximation of the real distance to the lumen surface.

关键词： Capsule endoscopy Three-dimensional reconstruction Phantom Experiment PillCam Software Accuracy

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