BackgroundManual lymphatic drainage (MLD) is widely used in the treatment of breast cancer–related postmastectomy lymphedema (BCRL). However, the therapeutic benefit of MLD on BCRL remains controversial.ObjectiveThe aim of this study was to analyze the efficacy of MLD for BCRL.MethodFour electronic databases were systematically searched for trials comparing MLD and no MLD treatment as options for BCRL. Comparative treatment results included reduction of upper extremity limb volume with subgroup analysis by the number and duration of treatments.ResultsA total of 457 patients were included in the analysis. There was no significant difference in the amount of upper extremity edema between the MLD treatment and control or no MLD groups (P = .11). However, when the treatment course was ≥20 sessions, there was a significant reduction in the upper extremity volume (P = .03). There was also a significant reduction in the upper extremity volume when treatment duration was >2 weeks (P = .03).ConclusionManual lymphatic drainage treatment statistically did not reduce the upper extremity limb volume of BCRL, but upper extremity volume was reduced at statistically significant levels when treatment number were ≥20 sessions or the duration of treatment was >2 weeks.Implication for PracticeReduction in upper limb volume is dependent on the number and duration of treatments. When treatment number were ≥20 sessions, or the duration of treatment was >2 weeks, reduction of upper limb volume was statistically achieved. Manual lymphatic drainage treatment can be clinically recommended to treat BCRL according to these parameters.

Polyurethane is a medical material, which has excellent physical properties and high mechanical compatibility. At present, one of the most effective application methods for antibacterial bacterial biofilm is to combine polyurethane with nano-silver, so that the polyurethane material itself has bactericidal performance and finally plays a good antibacterial effect. From August 2011 to January 2014, 75 patients with crush injury or avulsion injury who had difficulty healing were randomly divided into 5 groups. Results: Comparison of colony count results of different concentrations of nano-silver polyurethane; comparison of colony count results of two groups in vitro; comparison of anticoagulant degree and determination of whole blood coagulation time; comparison of coagulation routine examination results of two groups; comparison of epithelial growth factor levels at different time after treatment; comparison of tumor necrosis factor- a levels at different time after treatment between two groups; comparison of change times, visual analogue score of pain during treatment and hospitalization time of two groups; comparison of white blood cell count of two groups of polyurethane patients within 1 week; comparison of clinical efficacy between two groups. Conclusion: The medical material containing nano-silver polyurethane is a good bacteriostatic biomaterial, which can inhibit common iatrogenic pathogens in vitro. The application of 5% nano-silver polyurethane medical material to open wound, especially in patients with avulsion and crush injury in orthopaedics, can inhibit the growth of common hospital pathogenic bacteria. can significantly reduce the level of tumor necrosis factor- a in the wound, reduce the local inflammatory response, and can significantly improve the clinical effect of the treatment of complex wounds, which is worthy of clinical promotion.

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Our findings provide likely ionic mechanisms of shortened repolarization in induced atrial tachycardia with a decrease in I(Ca,L) and I(to) densities, which is the likely mechanism for a decrease in action potential duration rate adaptation in the canine rapid pacing model more pronounced in the PVs pacing group underlying the crucial role of PVs in initiating AF.

Background: Berberine is a nutraceutical that may improve lipid profiles. Berberine may also affect sex hormones and exert sex-specific effects, which has been overlooked. Objectives: To comprehensively review the efficacy and safety of lipid-lowering effect of berberine with consideration of potential sex disparity. Methods: Eligible studies were randomized controlled trials in adults that compared berberine versus placebo and measured blood lipids or lipoproteins. Studies were identified from Medline, Embase, Wanfang, CNKI, two clinical trial registries and previous systematic reviews. Mean differences (MD) were estimated using inverse variance weighting with random effects models. Risk of bias was assessed using the Cochrane risk of bias tool for randomized trials. Results: 16 studies were included with treatment of 4 to 24 weeks. Berberine reduced lowdensity lipoprotein (LDL) cholesterol (-0.45 mmol/L, 95% CI -0.60 to -0.31, 12 studies, n=1,224), total cholesterol (-0.47 mmol/L, 95% CI -0.61 to -0.33, 15 studies, n=1,397), triglycerides (-0.32 mmol/L, 95% CI -0.44 to -0.19, 16 studies, n=1,421) and apolipoprotein B (-0.25 mg/dL, 95% CI -0.40 to -0.11, 2 studies, n=127). Berberine increased high-density lipoprotein (HDL) cholesterol by 0.06 mmol/L (95% CI 0.00 to 0.12, 13 studies, n=1,248). Notably, the effect on HDL cholesterol was different in women (0.11 mmol/L, 95% CI 0.09 to 0.13) from that in men (-0.07 mmol/L, 95% CI -0.16 to 0.02). Gastrointestinal adverse events were the most frequently reported adverse events. Conclusions: Berberine decreased LDL cholesterol, triglycerides, and apolipoprotein B, with a potential sex-specific effect on HDL cholesterol. Large-scale trials considering sex disparity are required.