Correction to: Effect of JAK inhibitors on high- and low-density lipoprotein in patients with rheumatoid arthritis: a systematic review and network meta-analysis

Clinical Rheumatology -     

基于理论域框架的ICU护士执行身体约束缩减行动障碍因素的质性研究

目的：探讨ICU护士执行身体约束缩减行动的障碍因素，为制定身体约束标准化管理方案提供依据。方法：基于理论域框架（TDF）制定访谈提纲，采用目的抽样法对天津市某三级甲等医院的12名ICU护士进行半结构式访谈，按照TDF的相关领域对转录后的资料进行归类，用内容分析法对访谈资料进行分析。结果：ICU护士对身体约束缩减行动理解存在偏差、对约束替代措施内容的不熟悉是其执行身体约束缩减行动的障碍因素之一；身体约束缩减方案评估工具、决策流程的不规范对缩减约束行动的开展造成了一定阻碍；环境因素的限制及对缩减约束结果的担忧，使ICU护士没有足够的信心去执行；科室缺乏支持缩减约束的组织氛围，难以引起护士对执行约束缩减行动的重视，进而削减执行的动力。结合理论域框架将上述因素分别归属为知识、自我效能、环境背景和资源、社会影响、行为规范5个领域。结论：知识、自我效能、环境背景和资源、社会影响及行为规范为ICU护士执行身体约束缩减行动的障碍因素。科室要在明确障碍因素的基础上，加强领导层对执行缩减约束的重视和支持。制定缩减约束评估决策规范化流程以及培训方案，倡导团队协作，创造支持身体约束缩减行动的组织氛围，坚定ICU护士执行缩减约束的信心，促进身体约束缩减行动的持续实施。     

Impact of the COVID-19 pandemic on the hospital attendance of patients with primary cervical cancer in Heilongjiang,China

Information regarding the impact of the coronavirus disease 2019 (COVID-19) pandemic on cervical cancer in mainland China is lacking. We explored its impact on the hospital attendance of patients with primary cervical cancer. We included 1918 patients with primary cervical cancer who initially attended Harbin Medical University Cancer Hospital between January 23, 2019, and January 23, 2021. Attendance decreased by 31%, from 1135 in 2019 to 783 in 2020, mainly from January to June (𝜒² = 73.362, P < .001). The percentage of patients detected by screening decreased from 12.1% in January-June 2019 to 5.8% in January-June 2020 (𝜒² = 7.187, P = .007). Patients with stage I accounted for 28.4% in 2020 significantly lower than 36.6% in 2019 (𝜒² = 14.085, P < .001), and patients with stage III accounted for 27.1% in 2020 significantly higher than 20.5% in 2019 (𝜒² = 11.145, P < .001). Waiting time for treatment was extended from 8 days (median) in January-June and July-December 2019 to 16 days in January-June (𝜒² = 74.674, P < .001) and 12 days in July-December 2020 (𝜒² = 37.916, P < .001). Of the 179 patients who delayed treatment, 164 (91.6%) were for the reasons of the healthcare providers. Compared to 2019, the number of patients in Harbin or non-Harbin in Heilongjiang Province and outside the province decreased, and cross-regional medical treatment has been hindered. The COVID-19 pandemic has negatively impacted cervical cancer patient attendance at the initial phase. These results are solid evidence that a strategy and mechanism for the effective attendance of cervical cancer patients in response to public health emergencies is urgently needed.     

川东北地区社会心理服务现状调查

目的 调查川东北地区各组织机构开展社会心理服务的现状以及居民的心理健康状况，为该地区社会心理服务体系建设工作的进一步开展提供参考。方法 采用自编调查表对巴中市通江县、广元市利州区、达州市大竹县共计148家组织机构进行调查，包括各组织机构社会心理服务体系建设工作现状及心理健康服务开展情况；采用患者健康问卷抑郁量表（PHQ-9）、广泛性焦虑障碍量表（GAD-7）和自编心理健康服务需求调查表，对三地试点地区21 505名居民的心理健康状况及其对心理服务的需求进行调查。结果 在试点地区148家组织机构中，81家（54.7%）机构有开展心理健康服务的场所，58家（39.2%）机构配备了专兼职心理健康服务工作人员。在2019年，有95家（64.2%）机构开展了职工心理健康服务活动，104家（70.3%）机构开展了心理健康科普宣传活动。在75家教育机构中，67家（89.3%）机构对学生开展了心理健康教育活动，47家（62.7%）机构实现了心理健康课程在学生中全覆盖。居民的抑郁、焦虑检出率分别为36.8%和30.8%，有83.7%的居民有心理健康服务的需求，主要集中在个人成长、婚姻家庭、子女教育和压力管理方面。结论 川东北三市试点地区的社会心理服务工作有序进行，场地、经费及人才保障有待进一步加强。居民的抑郁和焦虑问题较突出，且对心理健康服务的需求较高。     

荔枝草治疗急性咽炎有效部位筛选＊

目的 筛选荔枝草治疗急性咽炎的有效部位，研究治疗急性咽炎的作用机制，为荔枝草资源的药食两用开发提供理论依据。方法 通过二甲苯致小鼠耳肿胀试验筛选荔枝草抗炎有效部位，采用氨水刺激喉部法建立大鼠急性咽炎模型，通过行为学观察、ELISA双抗夹心检测、病理形态学观察和咽部组织蛋白表达研究乙酸乙酯部位对大鼠急性咽炎的治疗效果。结果 荔枝草乙酸乙酯提取物对二甲苯致小鼠耳肿胀有明显的抑制作用，氨水刺激建立的急性咽炎模型符合急性咽炎动物模型特征，乙酸乙酯部位提取物可显著改善急性咽炎大鼠的咽部病理形态学表现。不同剂量治疗组大鼠血清及咽部组织中IL-1β、IL-6及TNF-α炎性因子数量均下降，高剂量组下降最为明显。荔枝草乙酸乙酯提取物可明显增加大鼠咽部组织IκBα蛋白表达，降低NF-κBp65蛋白表达。结论 荔枝草乙酸乙酯部位提取物对急性咽炎具有治疗作用，可能与抑制咽部炎症病理改变的发生，能调节血液中炎症因子、抑制NF-κB表达和IκBα解离有关。     

Diffusion-weighted magnetic resonance imaging in rat kidney using two-dimensional navigated,interleaved echo-planar imaging at 7.0 T

The purpose of this study was to investigate the feasibility of two-dimensional (2D) navigated, interleaved multishot echo-planar imaging (EPI) to enhance kidney diffusion-weighted imaging (DWI) in rats at 7.0 T. Fully sampled interleaved four-shot EPI with 2D navigators was tailored for kidney DWI (Sprague–Dawley rats, n = 7) on a 7.0-T small bore preclinical scanner. The image quality of four-shot EPI was compared with T₂-weighted rapid acquisition with relaxation enhancement (RARE) (reference) and single-shot EPI (ss-EPI) without and with parallel imaging (PI). The contrast-to-noise ratio (CNR) was examined to assess the image quality for the EPI approaches. The Dice similarity coefficient and the Hausdorff distance were used for evaluation of image distortion. Mean diffusivity (MD) and fractional anisotropy (FA) were calculated for renal cortex and medulla for all DWI approaches. The corticomedullary difference of MD and FA were assessed by Wilcoxon signed-rank test. Four-shot EPI showed the highest CNR among the three EPI variants and lowest geometric distortion versus T₂-weighted RARE (mean Dice: 0.77 for ss-EPI without PI, 0.88 for ss-EPI with twofold undersampling, and 0.92 for four-shot EPI). The FA map derived from four-shot EPI clearly identified a highly anisotropic region corresponding to the inner stripe of the outer medulla. Four-shot EPI successfully discerned differences in both MD and FA between renal cortex and medulla. In conclusion, 2D navigated, interleaved multishot EPI facilitates high-quality rat kidney DWI with clearly depicted intralayer and interlayer structure and substantially reduced image distortion. This approach enables the anatomic integrity of DWI-MRI in small rodents and has the potential to benefit the characterization of renal microstructure in preclinical studies.