Ac

泪道阻塞性疾病
  • 文章类型: Journal Article
    背景:紧急胆囊切除术是治疗急性胆囊炎(AC)的主要手段。在实际的实践中,围手术期预防性抗生素用于预防术后感染并发症(PIC),但其有效性缺乏证据.我们的目的是探讨预防性抗生素在急诊胆囊切除术中的疗效。
    方法:我们搜索了PubMed,Embase,科克伦中部,WebofScience(WOS),和Scopus至2023年6月14日。我们纳入了随机对照试验(RCT),该试验涉及根据东京指南诊断为轻度至中度AC的患者,这些患者正在接受紧急胆囊切除术,并在术前和/或术后给予抗生素作为干预组,并与安慰剂组进行比较。对于二分数据,我们应用了风险比(RR)和95%置信区间(CI),而对于连续数据,我们使用均差(MD)和95%CI。
    结果:我们纳入了7个RCTs,包含1747例患者的总体样本量。我们的分析显示总PIC没有显著差异(RR=0.84,95%CI(0.63,1.12),P=0.23),手术部位感染(RR=0.79,95%CI(0.56,1.12),P=0.19),远处感染(RR=1.01,95%CI(0.55,1.88),P=0.97),非感染性并发症(RR=0.84,95%CI(0.64,1.11),P=0.22),死亡率(RR=0.34,95%CI(0.04,3.23),P=0.35),和再入院(RR=0.69,95%CI(0.43,1.11),P=0.13)。
    结论:轻中度急性胆囊炎患者围手术期使用抗生素对急诊胆囊切除术后术后感染并发症没有明显的减少。(PROSPERO注册号:CRD42023438755)。
    BACKGROUND: Emergency cholecystectomy is the mainstay in treating acute cholecystitis (AC). In actual practice, perioperative prophylactic antibiotics are used to prevent postoperative infectious complications (PIC), but their effectiveness lacks evidence. We aim to investigate the efficacy of prophylactic antibiotics in emergency cholecystectomy.
    METHODS: We searched PubMed, Embase, Cochrane CENTRAL, Web of Science (WOS), and Scopus up to June 14, 2023. We included randomized controlled trials (RCTs) that involved patients diagnosed with mild to moderate AC according to Tokyo guidelines who were undergoing emergency cholecystectomy and were administered preoperative and/or postoperative antibiotics as an intervention group and compared to a placebo group. For dichotomous data, we applied the risk ratio (RR) and the 95% confidence interval (CI), while for continuous data, we used the mean difference (MD) and 95% CI.
    RESULTS: We included seven RCTs encompassing a collective sample size of 1747 patients. Our analysis showed no significant differences regarding total PIC (RR = 0.84 with 95% CI (0.63, 1.12), P = 0.23), surgical site infection (RR = 0.79 with 95% CI (0.56, 1.12), P = 0.19), distant infections (RR = 1.01 with 95% CI (0.55, 1.88), P = 0.97), non-infectious complications (RR = 0.84 with 95% CI (0.64, 1.11), P = 0.22), mortality (RR = 0.34 with 95% CI (0.04, 3.23), P = 0.35), and readmission (RR = 0.69 with 95% CI (0.43, 1.11), P = 0.13).
    CONCLUSIONS: Perioperative antibiotics in patients with mild to moderate acute cholecystitis did not show a significant reduction of postoperative infectious complications after emergency cholecystectomy. (PROSPERO registration number: CRD42023438755).
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  • 文章类型: Journal Article
    硒是生物体正常细胞功能的基本要素。然而,硒的毒性浓度仅比必需浓度高3至5倍。环境水中存在的无机形式(主要是亚硒酸盐和硒酸盐)通常表现出比有机形式更高的毒性(高达40倍)。因此,测定水中低水平的不同无机硒是一个分析挑战。在确定硒物质之前,固相萃取已被用作分离和/或预浓缩技术,因为需要精确测量极低含量的水中硒物质。本文对已发表的使用固相萃取作为预浓缩程序的水样中无机硒形态形成方法进行了严格的评论。根据超过75个参考文献,用于此任务的不同物种形成策略已被强调和分类。还讨论了固相萃取吸附剂以及已开发的Se形态形成方法的性能和分析特征。
    Selenium is an essential element for the normal cellular function of living organisms. However, selenium is toxic at concentrations of only three to five times higher than the essential concentration. The inorganic forms (mainly selenite and selenate) present in environmental water generally exhibit higher toxicity (up to 40 times) than organic forms. Therefore, the determination of low levels of different inorganic selenium species in water is an analytical challenge. Solid-phase extraction has been used as a separation and/or preconcentration technique prior to the determination of selenium species due to the need for accurate measurements for Se species in water at extremely low levels. The present paper provides a critical review of the published methods for inorganic selenium speciation in water samples using solid phase extraction as a preconcentration procedure. On the basis of more than 75 references, the different speciation strategies used for this task have been highlighted and classified. The solid-phase extraction sorbents and the performance and analytical characteristics of the developed methods for Se speciation are also discussed.
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  • 文章类型: Journal Article
    背景:过敏性眼病很常见,发病率很高。白三烯与季节性和常年性过敏性结膜炎(AC)的发病机理有关,常见于过敏性鼻炎,以及春季角膜结膜炎和特应性角膜结膜炎。
    目的:评估白三烯受体拮抗剂(LTRAs)对过敏性眼病眼部症状影响的现有证据。
    方法:选定的研究,用系统的审查搜索方法确定,是单/双盲,随机化,将LTRA与其他常见治疗方法进行比较的对照试验。
    结果:18项试验,使用LTRA孟鲁司特(仅限AC),已确定。六项研究适用于荟萃分析,在季节性AC[治疗超过2周的患者中,症状分为0(轻度)至3(严重)]。这些试验的偏倚风险较低,没有明显的异质性。对6项试验进行分析,结果显示孟鲁司特比安慰剂更能改善患者的眼部症状,与基线相比的平均变化评分差异为-0.10(95%CI,-0.14至-0.07;P<.00001)。三项试验比较了孟鲁司特与口服抗组胺药。与基线相比的平均变化评分差异为0.08(95%CI,0.02至0.14;P=.007),支持抗组胺药.两项试验比较了孟鲁司特和口服抗组胺药与安慰剂。与基线相比的平均变化评分差异为-0.30(95%CI,-0.38至-0.21;P<.00001),有利于联合治疗。
    结论:在季节性AC中,LTRAs比安慰剂更有效,但在成年患者中的效力低于口服抗组胺药。应进行临床试验,以确定LTRA和口服抗组胺药的联合治疗是否具有协同作用。需要进一步的研究来阐明LTRAs在其他过敏性眼病中的作用。
    BACKGROUND: Allergic eye diseases are common and cause significant morbidity. Leukotrienes are implicated in the pathogenesis of seasonal and perennial allergic conjunctivitis (AC), commonly seen in conjunction with allergic rhinitis, and in vernal keratoconjunctivitis and atopic keratoconjunctivitis.
    OBJECTIVE: To assess the available evidence for an effect of leukotriene receptor antagonists (LTRAs) on the ocular symptoms of allergic eye diseases.
    METHODS: Selected studies, identified with systematic review search methods, were single/double-blind, randomized, controlled trials that compared LTRAs with other common treatments.
    RESULTS: Eighteen trials, using the LTRA montelukast (in AC only), were identified. Six studies were suitable for meta-analysis, in patients with seasonal AC [treated over a 2-week period, symptoms scored 0 (mild) to 3 (severe)]. These trials were at low risk of bias without significant heterogeneity. Six trials were analyzed and showed that montelukast improved patients\' ocular symptoms to a greater extent than placebo, with a difference in mean change-from-baseline score of -0.10 (95% CI, -0.14 to -0.07; P < .00001). Three trials compared montelukast with oral antihistamine. The difference in mean change-from-baseline score was 0.08 (95% CI, 0.02 to 0.14; P = .007), in favor of antihistamines. Two trials compared montelukast and oral antihistamine with placebo. The difference in mean change-from-baseline score was -0.30 (95% CI, -0.38 to -0.21; P < .00001), in favor of combination treatment.
    CONCLUSIONS: In seasonal AC LTRAs are more efficacious than placebo but less efficacious than oral antihistamines in adult patients. Clinical trials should be conducted to determine whether combination treatment with LTRA and oral antihistamine has a synergistic effect. Further research is required to clarify the role of LTRAs in other allergic eye diseases.
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  • 文章类型: Journal Article
    各种技术,如物理,化学,生物,高级氧化和电化学用于处理工业废水。常用的常规生物处理工艺耗时,需要较大的操作面积,对含有有毒元素的废水无效。高级氧化技术导致高处理成本,并且通常用于获得高纯度等级的水。化学混凝技术速度慢,产生大量污泥。由于其多功能性和环境相容性,电凝聚作为处理工业废水的潜在技术最近引起了人们的注意。该技术使用浸入流出物中的金属电极之间的直流电源,这导致电极板溶解到流出物中。金属离子,在适当的pH值,可以形成广泛的凝结物质和金属氢氧化物,使颗粒不稳定并聚集或沉淀并吸附溶解的污染物。因此,本手稿的目的是回顾电凝聚处理工业废水的潜力,主要从纺织废水中去除染料。
    Various techniques such as physical, chemical, biological, advanced oxidation and electrochemical are used for the treatment of industrial effluent. The commonly used conventional biological treatment processes are time consuming, need large operational area and are not effective for effluent containing toxic elements. Advanced oxidation techniques result in high treatment cost and are generally used to obtain high purity grade water. The chemical coagulation technique is slow and generates large amount of sludge. Electrocoagulation has recently attracted attention as a potential technique for treating industrial effluent due to its versatility and environmental compatibility. This technique uses direct current source between metal electrodes immersed in the effluent, which causes the dissolution of electrode plates into the effluent. The metal ions, at an appropriate pH, can form wide range of coagulated species and metal hydroxides that destabilize and aggregate particles or precipitate and adsorb the dissolved contaminants. Therefore, the objective of the present manuscript is to review the potential of electrocoagulation for the treatment of industrial effluents, mainly removal of dyes from textile effluent.
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