腰痛宁胶囊联合碳酸钙D3片治疗老年性骨质疏松性骨痛的临床疗效

目的 探讨腰痛宁胶囊联合碳酸钙D₃片在缓解老年性骨质疏松性骨痛方面的临床疗效。方法 收集自2018年9月-2019年12月在陕西中医药大学附属医院骨伤科门诊就诊，符合老年性骨质疏松症诊断标准，疼痛视觉模拟评分法（visual analogue scale，VAS）评分在3~8分患者120例，随机分为对照组（60例）和治疗组（60例）。对照组口服碳酸钙D₃片作为基础治疗，每次0.6 g，1次/d；治疗组在对照组基础上内服腰痛宁胶囊治疗骨质疏松性骨痛，每次4粒，每晚睡前0.5 h黄酒10 mL兑少量温开水送服。降钙素类其他抗骨质疏松药物，医师知情可不改变剂量的情况下继续使用。连续用药2周，入组前及入组后3、7、14 d各随访1次，共4次，时间窗±1 d。治疗结束后根据各访视期VAS评分改变，以疼痛程度改善情况进行疗效评价。测定治疗前、后患者血清中疼痛相关因子。结果 治疗组60例患者总有效率91.7%。对照组60例患者总有效率23.3%，有效率明显低于治疗组，两组差异具有统计学意义（P<0.05）。治疗组治疗后与治疗前比较，从静息痛、触压痛、活动痛三方面观察，VAS评分均有所下降（P<0.05、0.01），疗效肯定；而对照组治疗后与治疗前比较，VAS评分的变化不明显，疗效不佳。经14 d治疗后，对照组患者血清前列腺素E2（PGE₂）、P物质（SP）和5-羟色胺（5-HT）的水平无显著变化，治疗组均显著下降（P<0.01）。结论 腰痛宁胶囊联合碳酸钙D₃片在缓解老年性骨质疏松症骨痛方面起效快，疗效显著。     

Effectiveness of Botulinum Toxin A in Treatment of Hemiplegic Shoulder Pain: A Systematic Review and Meta-analysis

ObjectiveTo evaluate the effectiveness of botulinum toxin A (BTX-A) in the treatment of hemiplegic shoulder pain.Data SourcesPubMed, EMBASE, Elsevier, Springer, Cochrane Library, Physiotherapy Evidence Database, CNKI, and VIP were researched from the earliest records to September 1, 2020.Study SelectionRandomized controlled trials that compared shoulder BTX-A injections vs a control intervention in patients with a history of hemiplegic shoulder pain after stroke were selected. Among the 620 records screened, 9 trials with 301 eligible patients were included.Data ExtractionOutcome data were pooled according to follow-up intervals (1, 2, 4, and 12 wk). The primary evaluation indices were pain reduction (visual analog scale [VAS] score) and range of motion (ROM) improvement. The second evaluation indices were upper limb functional improvement, spasticity improvement, and incidence of adverse events. Cochrane risk-of-bias was used to assess the methodological quality of studies independently by 2 evaluators.Data SynthesisMeta-analysis revealed a statistically significant decrease in the VAS score in the BTX group vs the control group at 1, 4, and 12 weeks postinjection (wk 1: standardized mean difference [SMD], 0.91; 95% confidence interval [CI], 0.27 to 1.54; wk 4: SMD, 1.63; 95% CI, 0.76 to 2.51; wk 12: SMD, 1.96; 95% CI, 1.44 to 2.47). Furthermore, the meta-analysis demonstrated a statistically significant increase in abduction at 1, 4, and 12 weeks postinjection (wk 1: SMD, 3.71; 95% CI, 0 to 7.41; wk 4: SMD, 8.8; 95% CI, 2.22 to 15.37; wk 12: SMD, 19.59; 95% CI, 9.05 to 30.13) and external rotation at 1, 2, 4 weeks postinjection (wk 1: SMD, 5.67; 95% CI, 0.88 to 10.47; wk 2: SMD, 9.62; 95% CI, 5.57 to 13; wk 4: SMD, 6.89; 95% CI, 2.45 to 11.33) in the BTX group.ConclusionsBTX-A injection provided greater analgesic effects and increased shoulder abduction and external rotation ROM compared with steroid or placebo injection for the treatment of HSP.     

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。