目的评价控制体质量(BM)在女性尿失禁病人中的有效性。方法检索中国知网(CNKI)、万方数据库(Wanfang Date)和维普数据库(VIP)等中文数据库以及Cochrane Library、Pubmed和Web of science等英文数据库中有关控制BM对尿失禁病人的队列研...目的评价控制体质量(BM)在女性尿失禁病人中的有效性。方法检索中国知网(CNKI)、万方数据库(Wanfang Date)和维普数据库(VIP)等中文数据库以及Cochrane Library、Pubmed和Web of science等英文数据库中有关控制BM对尿失禁病人的队列研究、病例对照研究和随机对照试验,同时筛检纳入文章的参考文献,检索建库至2019年5月期间公开发表的文章。采用RevMan 5.3软件进行Meta分析。结果共纳入13篇文献,涉及1079例病人。Meta分析结果显示,在6个月和12个月的随访中,控制BM显著降低了病人尿失禁的发生率[RR=2.02,95%CI(1.25~3.24),P<0.01],降低了病人的BMI[MD=12.22,95%CI(9.51~14.93),P<0.01],提高了病人的生活质量[MD=0.77,95%CI(0.43~1.00),P<0.01],改善了病人的盆底功能[MD=2.22,95%CI(13.13~31.11),P<0.01],减轻了病人尿失禁症状的严重程度[MD=4.03,95%CI(1.77~6.28),P<0.01]。结论控制BM能有效降低病人尿失禁的发生率、BMI,有效改善病人盆底功能以及尿失禁症状的严重程度,有助于提高病人的生活质量。展开更多
Nonalcoholic steatohepatitis (NASH), which is the most severe histologic form of nonalcoholic fatty liver disease (NAFLD), is emerging as the most common clinically important form of liver disease in obese patients. T...Nonalcoholic steatohepatitis (NASH), which is the most severe histologic form of nonalcoholic fatty liver disease (NAFLD), is emerging as the most common clinically important form of liver disease in obese patients. The prevalence of NASH may increase with the rise in the rate of obesity and metabolic syndrome in affluent communities. The aim of this work is to describe clinical and histopathologic findings and correlate liver tissue damage to the length of duration of the obesity in the group of patients who underwent surgery as obesity treatment. Eighty-seven severely or morbidly obese patients underwent gastroplasty. Each patient was evaluated with complete clinical and laboratory medical assessment together with wedge liver biopsy taken from 59 unselected patients during the surgery. Patients were followed up for 41 months. Repeat liver biopsy was taken from 10 patients. Pathologic analysis recorded the presence and degree of steatosis, portal and lobular inflammation and fibrosis. Age, body mass index (BMI), and laboratory assessment correlated with pathologic data. Male patients showed more pronounced metabolic syndrome and fatty liver damage. Patients who become obese in childhood or as teenagers showed no differences in metabolic syndrome and NAFLD in mature age. There was statistically significant association between BMA, elevated transaminases, NAFLD, and fibrosis. Significant weight reduction was observed within first year after surgery,was slower in the second year, and stabilized within third year. Remarkable improvement followed in biological markers of metabolic syndrome. Ninety-six percent of initial liver biopsies had steatosis; 16%developed steatohepatitis and mild perivenular fibrosis. Significant improvement of the degenerative and inflammatory hepatic lesions in repeated biopsies and liver function readings was noted within 8 months after surgery. Obesity is a major and independent risk factor for the metabolic syndrome, NAFLD, NASH, and fibrosis. Surgical treatment improves metabolic abnorma展开更多
文摘Nonalcoholic steatohepatitis (NASH), which is the most severe histologic form of nonalcoholic fatty liver disease (NAFLD), is emerging as the most common clinically important form of liver disease in obese patients. The prevalence of NASH may increase with the rise in the rate of obesity and metabolic syndrome in affluent communities. The aim of this work is to describe clinical and histopathologic findings and correlate liver tissue damage to the length of duration of the obesity in the group of patients who underwent surgery as obesity treatment. Eighty-seven severely or morbidly obese patients underwent gastroplasty. Each patient was evaluated with complete clinical and laboratory medical assessment together with wedge liver biopsy taken from 59 unselected patients during the surgery. Patients were followed up for 41 months. Repeat liver biopsy was taken from 10 patients. Pathologic analysis recorded the presence and degree of steatosis, portal and lobular inflammation and fibrosis. Age, body mass index (BMI), and laboratory assessment correlated with pathologic data. Male patients showed more pronounced metabolic syndrome and fatty liver damage. Patients who become obese in childhood or as teenagers showed no differences in metabolic syndrome and NAFLD in mature age. There was statistically significant association between BMA, elevated transaminases, NAFLD, and fibrosis. Significant weight reduction was observed within first year after surgery,was slower in the second year, and stabilized within third year. Remarkable improvement followed in biological markers of metabolic syndrome. Ninety-six percent of initial liver biopsies had steatosis; 16%developed steatohepatitis and mild perivenular fibrosis. Significant improvement of the degenerative and inflammatory hepatic lesions in repeated biopsies and liver function readings was noted within 8 months after surgery. Obesity is a major and independent risk factor for the metabolic syndrome, NAFLD, NASH, and fibrosis. Surgical treatment improves metabolic abnorma
