WeChat is a smartphone application that may help patients self-manage peripherally inserted central catheters (PICC), although additional data are needed regarding this topic. This systematic review and meta-analysis aimed to determine whether WeChat helped improve PICC-related complications, self-care ability, PICC maintenance dependency in that the behavior of a patient is in compliance with a doctor’s order or a will, knowledge mastery, and satisfaction among patients with a PICC. The PubMed, Embase, Cochrane Library, China Biology Medicine, China national Knowledge Infrastructure, Wanfang, Wiper, and Baidu Scholar databases were searched to identify related reports that were published up to April 2018. This search revealed 36 reports that were published during 2014–2018, including 2,623 controls and 2,662 patients who used the WeChat application. Relative to the traditional follow-up group, the group that received WeChat follow-up had a lower risk of PICC-related complications (odds ratio [OR]: 0.23, 95% confidence interval [CI]: 0.19–0.27, P < 0.00001), better self-care ability (mean difference: 36.41, 95% CI: 34.68–38.14, P < 0.00001), higher PICC maintenance dependency (OR: 4.27, 95% CI: 3.35–5.44, P < 0.00001), and higher patient satisfaction (OR: 6.20, 95% CI: 4.32–8.90, P < 0.00001). Eight studies reported knowledge mastery, although the different evaluation tools precluded a meta-analysis. Nevertheless, those eight studies revealed that knowledge mastery was significantly higher in the WeChat group than in the traditional follow-up group (P < 0.05). To the best of our knowledge, this is the first meta-analysis to evaluate the effects of WeChat follow-up on self-management among patients who are discharged with a PICC. It appears that WeChat follow-up can help improve the incidence of complications, self-care ability, PICC maintenance dependence, and patient satisfaction. However, the WeChat application itself cannot improve patients’ self-management ability. Further studies are needed to produce high-quality evidence to determine whether WeChat is an effective follow-up tool.
It has been proposed that cancer stem cells (CSCs) are involved in tumor resistance to chemotherapy and tumor relapse. The goal of the present study was to determine the effect of low-dose 5-fluorouracil (5-Fu) on enriched hepatocellular CSC-like cells. Increased cell motility and epithelial-mesenchymal transition were observed by migration assay in human hepatoblastoma PLC/RAF/5 cells following 5-Fu treatment, as well as a significant enhancement in their sphere-forming abilities. CSC-like cells were identified by side population cell analysis. The percentage of CSC-like cells in the surviving cells was greatly increased in response to 5-Fu. These findings indicate that low-dose 5-Fu treatment may efficiently enrich the CSC-like cell population in PLC/RAF/5 cells.
To evaluate the efficacy of laparoscopic percutaneous extraperitoneal closure (LPEC) for unilateral inguinal hernia in children and effect of intraoperative laparoscopic exploration for finding contralateral patent processus vaginalis (CPPV) on prevention of the metachronous contralateral hernia (MCH). We retrospectively analyzed unilateral inguinal hernia ligation in children, which can be diveded into two groups: a total of 252 cases with open surgical ligation from January 2010 to December 2012 (open group), a total of 184 cases underwent laparoscopic percutaneous peritoneal hernia sac high ligation LPEC from January 2013 to March 2015 (LPEC group). Then, we observed postoperative complications, recurrence of hernia, and the postoperative MCH in the two groups and analyzed the influence factors of the MCH. In Open groups and LPEC groups, the complication incidences, respectively, were 4.4 and 1.6 per cent, having statistical difference ( P > 0.05), the average postoperative follow-up duration, respectively, were 42 months and 22 months, whereas the overall incidence of MCH, respectively, were 5.2 and 0.5 per cent ( P < 0.05). In the first 24 months follow-up time, the overall incidence of MCH, respectively, were 3.6 and 0 per cent. Laparoscopic evaluation was positive for CPPV in 67 cases. We found the prevalence of 56.1 per cent of CPPV in LPEC groups aged 0.6 to 2 years old, finding the incidence gradually decline with the increase of age, until 14.3 per cent to 10 to 12 years old group. Our study shows LPEC has proven efficacy in treatment of unilateral inguinal hernia in children, and routine laparoscopic exploration with this simple maneuver should be actively performed to observe CPPV in all chidren.
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