中医手法治疗颈型颈椎病随机对照试验的质量评价研究

背景 中医手法是治疗颈型颈椎病的重要手段。随着研究的不断发展，大量中医手法治疗颈型颈椎病的随机对照试验已经发表，但质量水平参差不齐，限制了中医手法的推广和高质量临床证据的产生。 目的 评价目前中医手法治疗颈型颈椎病随机对照试验的文献质量。 方法 计算机检索中国知网、万方数据知识服务平台、维普网、中国生物医学文献服务系统、PubMed、Embase和Cochrane Library数据库中手法治疗颈型颈椎病的随机对照试验，检索时限为建库至2021年6月。由2名研究者完成文献筛选和资料提取。采用物理治疗证据数据库（PEDro）量表、Cochrane偏倚风险评估工具、临床试验报告标准（CONSORT）声明2010版及附加指标评价纳入文献的质量。 结果 共纳入81篇文献，其中2006—2014年共发表文献28篇，年平均发表3.11篇；2015—2021年共发表文献53篇，年平均发表7.57篇。文献质量评价结果显示，PEDro量表总分≥7分的高质量文献仅7篇（8.6%）。Cochrane偏倚风险评估工具显示，高偏倚风险文献所占比例最少，低偏倚风险文献次之，大部分条目因为报告信息不全，评分偏倚风险不确定。CONSORT声明2010版评价结果显示，纳入文献的文题和摘要、方法、结果、讨论、其他信息部分报告率不足。附加指标中采用多中心、伦理审批、干预措施质量控制、志谢报告率低。 结论 目前中医手法治疗颈型颈椎病随机对照试验的文献质量普遍偏低，建议今后研究者参照PEDro量表、Cochrane偏倚风险评估工具、CONSORT声明对中医手法治疗颈型颈椎病的随机对照试验进行规范性报告。     

The brief sense of community scale: Testing dimensionality and measurement invariance by gender among Hispanic/Latinx youth

Psychological sense of community is defined as feelings of belongingness and a shared belief that community members will meet one another's needs. Psychological sense of community has four dimensions: membership, influence, needs fulfillment, and emotional connection. In this study, multigroup confirmatory factor analysis was used to examine the first and second-order factor structure of the brief sense of community scale (BSCS) between male and female Hispanic/Latinx adolescents from an urban community (N = 947). To help validate the BSCS model, the second-order factor model was tested with regression to predict the measures of intrapersonal psychological empowerment and ethnic identity, as constructs conceptually related to psychological sense of community. Findings support that: (1) psychological sense of community can be measured through the BSCS and as a four-factor model among Hispanic/Latinx youth, supporting McMillan and Chavis's (1986) original theoretical discussions; (2) while no differences between genders were present at the model-level, there was path-specific variation; and (3) intrapersonal psychological empowerment and ethnic identity were associated with psychological sense of community.     

Enablers and inhibitors: A review of the situation regarding mHealth adoption in low- and middle-income countries

Objective

The objective of this review is to identify enabling and inhibiting factors for mHealth adoption in low resource settings, by giving emphasis on the stakeholders representing the caregiving side. Another objective of this study is to support implementation agencies (governmental and non-governmental) in designing scalable mHealth interventions.

Mucosal co-delivery of ketorolac and lidocaine using polymeric wafers for dental application

The current study aimed to investigate the effectiveness of a developed sodium alginate and polyvinylpyrrolidone K-25 (PVP K-25) polymeric wafer for the co-delivery of ketorolac and lidocaine to soft tissues for healing and pain control following gingivectomy. Nine ketorolac/lidocaine lyophilized wafers were formulated and assessed for their hydration capacity, mucoadhesion ability and in vitro release profile to select the optimum system for further clinical investigation. Wafer F6 containing 2:1 sodium alginate to PVP K-25 and 10% glycerol showed optimum properties and was selected for the clinical study. Twenty patients were included in the study and the ketorolac/lidocaine wafer was assessed versus a market product. Visual pain analog was evaluated daily for the first week and wound healing index was evaluated for one week, two weeks and one month following the procedure. The developed ketorolac/lidocaine polymeric wafer proved to be an effective method of reducing pain and discomfort together with enhancing wound healing following gingivectomy.     

Inhibitory Control and Impulsivity Levels in Women Crack Users

Objective: investigate impulsivity levels and inhibitory control in women crack users and explore the relationships between impulsivity and inhibitory control. Method and Design: 52 healthy women (M = 32.83 years; SD = 9.54) and 46 crack cocaine users (M = 31.02 years; SD = 7.73), in abstinence, performed the assessment protocol included a Sociodemographic Data Questionnaire, Mini-Mental State Examination (MMSE), a GO/No-Go Task and the Barratt Impulsiveness Scale–11 (BIS-11). It was a quantitative research with cross-sectional design and control group. Results: crack group showed higher levels of impulsivity in all domains when compared to the control group (crack group M = 76.39, SD = 11.39, control group M = 58.53, SD = 10.76, p <.01). Participants from the crack group presented a significantly higher total reaction time in the Go-NoGo task (F(1,93) = 9.93, p =.002; effect size =.09, observed power =.87) and significantly more commission (F(1,93) = 7.20, p =.009; effect size =.07, observed power =.75) and omission errors (F(1,93) = 6.04, p =.01; effect size =.06, observed power =.68), in Go/NoGo Task. Groups did also significantly differ on total standard deviations suggesting that variability in total reaction time was significantly greater in the crack group. Results showed that only in the crack group there were significant correlations between Go-NoGo parameters and Barratt Impulsiveness Scale. Conclusions: Our findings are consistent that impulsivity and inhibitory control are closely linked to crack use in women. Future studies should consider to evaluate crack users in different withdrawal times, controlling the impact of abstinence time in the variables studied.     

预防保健措施对老年高血压合并糖尿病患者血压及血糖的控制分析

目的分析预防保健措施对老年高血压合并糖尿病患者血压及血糖的控制情况。方法选择120例上海市静安区彭浦新村街道社区卫生服务中心2016年6月—2017年6月接诊的高血压合并糖尿病的老年患者进行研究,遵循随机数表法被均分为观察组和对照组各60例。对照组患者采用单纯药物治疗,观察组患者在采用常规护理措施的同时实施预防保健措施。观察两组患的收缩压、舒张压、空腹血糖、餐后2 h血糖、焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分以及患者的服药及饮食指导依从性。结果实施前,两组患者的收缩压、舒张压、空腹血糖和餐后2 h血糖均无明显差异(P0.05);实施后,两组患者的收缩压、舒张压、空腹血糖和餐后2 h血糖均明显降低,且观察组明显低于对照组(P0.05)。实施前,两组患者的SAS评分及SDS评分无明显的差异(P0.05);实施后,两组的SAS评分及SDS评分均明显降低,且观察组明显低于对照组(P0.05)。实施后,观察组的服药依从性为96.67%,对照组为86.67%,两组比较有显著性差异(χ~2=3.397,P0.05);观察组的饮食指导依从性为88.33%,对照组为73.33%,两组比较有显著性差异(χ~2=4.357,P0.05)。结论预防保健措施可有效地提高患者的服药依从性和饮食依从性,消除负性情绪,降低患者的血压及血糖,其预防保健措施值得广泛运用并大力推广。     

不同评分系统对急性中毒预后评估价值的比较

目的比较PSS、APACHEII、SAPSII、SOFA 4种评分系统在急性中毒预后评估中的价值。方法回顾性分析2015年1月至2016年10月收住我院急诊重症监护室EICU的231例急性中毒患者的临床资料,收集入院24h内PSS评分、APACHEII评分、SAPSII评分、SOFA评分,根据28d临床结局分为存活组和死亡组,比较两组临床资料的差异,分析两组患者的的PSS评分、APACHEII评分、SAPSII评分、SOFA评分的相关性,并对4种评分系统分值及ROC曲线下面积进行比较,评估4种评分系统的预测价值。结果与死亡组比较,存活组PSS评分、APACHEII评分、SAPSII评分、SOFA评分的差异有统计学意义(P<0.01)。PSS评分、APACHEII评分、SAPSII评分、SOFA评分之间呈明显正相关关系(P<0.01),4种评分系统的ROC曲线下面积(AUC)分别为0.833、0.887、0.843、0.843。APACHEII评分曲线下面积大于PSS评分、SAPSII评分、SOFA评分,差异有统计学意义(z=2.351,2.317,2.217;P=0.019,0.021,0.027),另3种评分曲线下面积(AUC)比较的差异无统计学意义(P>0.05)。PSS评分、APACHEII评分、SAPSII评分、SOFA评分截断值(cut-off)、灵敏度、特异度、准确率分别为(2.5,93.1%,50.9%,61.5%)、(14.5,82.8%,75.7%,77.48%)、(31.5,77.6%,76.90%,77.08%)、(5.5,77.60%,74.60%,75.35%)。结论4种评分系统均可对急性中毒患者的预后进行评估,APACHEII评分对预后的评估能力及准确率优于其他3种评分系统。     

我国常用的吸毒人员抑郁状况调查量表评述

毒品滥用是个世界性的难题,复吸率高是其中表现之一。吸毒人群心理因素是目前公认的高复吸率的主要因素之一。抑郁症是其中心理因素的表现,抑郁症的测试多采用问卷式量表。本文对国内吸毒人员抑郁调查常用的几种量表进行评述。