心理干预对乳腺癌患者心理应激、抑郁和焦虑影响的Meta分析

目的 评价心理干预对乳腺癌患者的心理应激、抑郁及焦虑的缓解作用.方法 系统检索Pubmed、Embase、Cochrane Library和Web of Science 4个英文数据库和中国期刊全文数据库、中国生物医学文献数据库、维普中文科技期刊数据库、中国医学会数字化期刊库4个中文数据库中关于心理干预与乳腺癌患者心理应激、抑郁和焦虑相关的文献.由2名评价人员独立筛选文章,采用Cochrane系统评价对纳入对象进行逐个评价,之后采用Rev5.3软件对符合纳入和排除标准的文献进行Meta分析.结果 共纳入15篇文献,其中包括2个随机对照研究和13个病例对照研.Meta分析结果显示:采用心理干预有助于乳腺癌患者的心理应激(SMD=0.72,95％ CI 0.59～0.85,P＜0.01)、抑郁(SMD=0.61,95％ CI 0.48～0.73,P＜0.01)和焦虑(SMD 0.69,95％CI 0.50～0.88,P＜0.01)的缓解,结果具有统计学意义.结论 心理干预有助于缓解乳腺癌患者心理应激、抑郁及焦虑等心理障碍,对预防和治疗乳腺癌患者的心理问题具有重要的指导意义.     

团体疗法对乳腺癌患者干预效果的Meta分析

目的 系统评价团体疗法对乳腺癌患者的干预效果。方法 计算机检索Embase、PubMed、Web of Science、中国生物医学文献数据库、中国知网、万方、维普中团体疗法对乳腺癌患者干预效果的随机对照研究,并对纳入的文献进行质量评价与数据提取,采用RevMan 5.3软件进行统计分析。结果 最终纳入12篇文献,共患者753例。Meta分析结果显示,较常规干预措施,团体干预疗法对乳腺癌患者焦虑（SMD = - 0.39,95%CI:- 0.57～- 0.21,P＜0.01）、抑郁（SMD = -0.69,95%CI:- 1.09～- 0.30,P＜0.01）情绪有明显改善,同时缓解患者疲劳感（P = 0.003）、提升其生活质量（P＜0.001）。结论 团体干预疗法能够缓解乳腺癌患者焦虑、抑郁和疲劳感,并提升生活质量。     

益生菌对超重肥胖孕妇妊娠期糖尿病预防效果的Meta分析

目的 探讨益生菌对超重肥胖孕妇妊娠期糖尿病(GDM)的预防效果.方法 采用Meta分析的方法,通过国内外数据平台检索并筛选相关文献,对其进行方法学质量评价并使用RevMan5.4统计软件对结果进行分析.结果 最终纳入5篇文献.Meta分析结果显示,益生菌可有效控制妊娠期空腹血糖(P＜0.05),降低GDM的发病率(P＜...     

团体正念瑜伽缓解孕期焦虑及分娩恐惧的疗效

目的系统评价正念瑜伽团体心理干预改善孕期焦虑及分娩恐惧的疗效。方法计算机检索Cochrane Library、PubMed、Embase、CBM、CNKI、VIP、万方数据库中公开发表的孕期进行正念瑜伽团体心理治疗的随机对照研究。对符合纳入标准的文献,用RevMan 5.3软件进行Meta分析,对比两组的疗效。结果共纳入5项研究,共计422人。运用状态-特质焦虑量表(state-trait anxiety inventory,STAI)对干预和对照组进行了评估,正念瑜伽团体心理干预后干预组患者的STAI-S及STAI-T分数均较对照组显著降低[WMD=-7.81,95%CI(-12.92,-2.70),P=0.003]、WMD=-5.77,95%CI(-11.84,-0.30),P=0.06],焦虑自评量表评分较对照组显著降低[WMD=-15.68,95%CI(-17.40,-13.96),P0.001],分娩恐惧量表评分较对照组显著降低[WMD=-12.08,95%CI(-14.82,-9.34),P0.001]。结论正念瑜伽团体心理干预可缓解孕期的焦虑水平,降低孕妇分娩恐惧。     

临床路径对单病种管理影响的Meta分析

目的 分析实施临床路径对单病种管理的影响.方法 收集有关子宫肌瘤、胆道良性疾病和甲状腺肿瘤3种常见疾病实施临床路径治疗对单病种管理影响的临床对照研究,根据纳入标准,对纳入文献进行Meta分析,并对结果进行敏感性分析.结果 纳入21篇文献,Meta分析结果显示,3种疾病临床路径组患者住院总费用(WMD=-1046.06,95％CI:-1281.15～-810.96,P＜0.00001)和住院天数(WMD=-2.18,95％CI:-2.59～-1.76,P＜0.00001)均低于非临床路径组,两者差异均有统计学意义.结论 实施临床路径可以进一步降低单病种疾病的住院费用,缩短住院天数.     

益生菌对胃肠肿瘤病人术后影响的Meta分析

目的:系统评价益生菌对胃肠肿瘤病人术后的影响. 方法:通过计算机检索中国学术期刊全文数据库(CNKI)、中国生物医学文献数据库(CBMdisc)、万方数据库和Pub Med数据库的文献资料,评价纳入的随机对照研究,应用RevMan 5.2软件进行Meta分析. 结果:通过Meta分析显示,益生菌能降低胃肠肿瘤术后病人C反应蛋白(CRP)的含量[WMD=-9.74,95％ CI(-18,19,-1.29)(P=0.02)]、乳果糖/甘露醇(L/M)比值[WMD=-0.04,95％ CI(-0.04,-0.03)(P＜ 0.000 01)]、病人术后感染率[OR =0.27,95％ CI (0.17,0.43)(P＜0.00 001)]、病人术后发热时间[WMD=-1.24,95％ CI(-2.02,-0.46)(P=0.002)]和抗生素治疗时间[WMD=-1.23,95％CI(-1.68,-0.78)(P ＜0.000 01)].益生菌还有降低病人体内TNF-α的趋势[WMD=-6.14,95％CI(-13.80,1.53)(P=0.12)]和减少病人住院时间的趋势[WMD=-0.72,95％ CI(-1.57,0.14)(P=0.10)],但差异无统计学意义. 结论:益生菌能有效地改善胃肠肿瘤病人术后的营养状况,有利于术后恢复.     

家庭式非药物干预方案对学龄期患儿及其父母术前焦虑干预效果的Meta分析

目的 系统评价家庭式非药物干预方案(non-pharmaceutical intervention for family, NPIF)对学龄期患儿及其父母术前焦虑的干预效果,提供NPIF的循证依据,为后续学龄期患儿及其父母术前焦虑的干预和研究工作提供参考。方法 计算机检索PubMed、Science Direct、Embase、SAGE、Cochrane Library、中国知网(CNKI)、万方数据库(Wangfang Data)和维普数据库(VIP)中涉及NPIF对学龄期患儿及其父母术前焦虑干预效果的随机对照实验(RCT)研究,发表日期截止至2022年3月1日。按照纳入标准筛选文献并采用Cochrane偏倚风险工具进行文献质量评价。使用Rev Man 5.3软件对纳入文献进行Meta分析。结果 最终纳入16项RCT研究,合计1 305对学龄期患儿及父母。Meta分析结果表明,NPIF的实施不仅使实验组患儿比对照组患儿体验到更少的术前焦虑[SMD=-1.04,95%CI(-1.32,-0.75),Z=7.14,P<0.001],也使实验组患儿父母比对照组患儿父母有更轻的术前焦虑...     

隔代抚养与老年人心理健康相关性的Meta分析

目的 对隔代抚养与老年人心理健康关系进行meta分析。 方法 检索PubMed、Embase、the Cochrane Library、Web of Science、中国知网、万方、维普等中英文数据库,收集关于隔代抚养对老年人心理健康影响的相关文献,检索时限为自建库起至2021年5月。对纳入文献进行质量评价及数据整理。所有数据均采用RevMan 5.4软件进行meta分析。结果 最终纳入20篇文献,总样本量69 974例。Meta分析结果显示:在认知功能（SMD = 0.32, 95%CI:0.28～0.36, P＜0.001）、生活满意度（SMD = 0.06, 95%CI:0.04～0.09, P＜0.001）及自评健康（SMD = 0.08, 95%CI:0.02～0.14, P = 0.010）评估中,隔代抚养组评估结果优于非隔代抚养组,呈正相关且有统计学差异;在抑郁状况（SMD = - 0.04, 95%CI: - 0.09～0.01, P = 0.150）评估中,隔代抚养组评估结果劣于非隔代抚养组,呈负相关且有统计学差异。亚组分析结果显示:与非隔代抚养组相比,国外隔代抚养组（SMD = 0.27, 95%CI:0.15～0.39, P＜0.001）;国内隔代抚养组（SMD = - 0.07, 95%CI: - 0.09～ - 0.05, P＜0.001）老年人抑郁状况差异具有统计学意义。祖父抚养组与祖母抚养组（SMD = - 0.32, 95%CI: - 0.40～ - 0.24, P＜0.001）;城镇抚养组与农村抚养组（SMD = - 0.23, 95%CI: - 0.30～ - 0.17, P＜0.001）抑郁状况差异具有统计学意义。结论 隔代抚养对老年人的认知功能、生活满意度及自评健康有维持和促进作用。国家、性别及地域是隔代抚养老年人抑郁状况的重要影响因素。     

益生菌对危重症病人预后影响的Meta分析

目的：通过Meta分析探讨益生菌疗法对危重症病人预后的影响。方法：计算机检索Medline,Embase,CENTRAL数据库中使用益生菌治疗危重症病人的随机对照研究。2名研究者分别纳入文献质量进行评估后,使用RevMan5.4进行统计分析。结果：共纳入22篇使用益生菌治疗危重症病人的文章。经Meta分析,使用益生菌能显著降低呼吸机相关肺炎及院内感染发生率,且有显著差异,分别为[RR=0.75,95%CI:0.63～0.91,P=0.003]、[RR=0.78,95%CI:0.61～1.00,P=0.05]。腹泻发生率、ICU住院时间及总住院时间在益生菌组仅显示降低趋势,但无统计学差异。死亡率在两组无差异。结论：危重症病人给予益生菌能降低呼吸机相关肺炎及院内感染发生率,但不能降低死亡率及住院时间。     

益生菌联合氨基水杨酸诱导溃疡性结肠炎缓解疗效的Meta分析

目的评价益生菌联合氨基水杨酸诱导缓解UC的疗效。方法通过检索1966-2014年4月期间中英文数据库,筛选相关随机对照试验(RCT),结果用比值比(OR)及95%可信区间(CI)表示。评估指标为缓解率。结果共纳入17项RCT,包括1 146名患者。益生菌联用氨基水杨酸组缓解率明显高于单用氨基水杨酸组(OR=1.77,95%CI:1.39~2.25,P0.00001)。益生菌联用柳氮磺胺吡啶组诱导缓解率是单用柳氮磺胺吡啶组的3.01倍(95%CI:1.46~6.19,P=0.003),益生菌联用美沙拉嗪组诱导缓解率是单用美沙拉嗪组的1.67倍(95%CI:1.29~2.16,P0.0001)。结论益生菌与氨基水杨酸联用能明显提高UC患者缓解率。     

Probiotic Supplementation for Promotion of Growth in Children: A Systematic Review and Meta-Analysis

Probiotics are commonly prescribed to promote a healthy gut microbiome in children. Our objective was to investigate the effects of probiotic supplementation on growth outcomes in children 0–59 months of age. We conducted a systematic review and meta-analysis which included randomized controlled trials (RCTs) that administered probiotics to children aged 0–59 months, with growth outcomes as a result. We completed a random-effects meta-analysis and calculated a pooled standardized mean difference (SMD) or relative risk (RR) and reported with a 95% confidence interval (CI). We included 79 RCTs, 54 from high-income countries (HIC), and 25 from low- and middle-income countries (LMIC). LMIC data showed that probiotics may have a small effect on weight (SMD: 0.26, 95% CI: 0.11–0.42, grade-certainty = low) and height (SMD 0.16, 95% CI: 0.06–0.25, grade-certainty = moderate). HIC data did not show any clinically meaningful effect on weight (SMD: 0.01, 95% CI: −0.04–0.05, grade-certainty = moderate), or height (SMD: −0.01, 95% CI: −0.06–0.04, grade-certainty = moderate). There was no evidence that probiotics affected the risk of adverse events. We conclude that in otherwise healthy children aged 0–59 months, probiotics may have a small but heterogenous effect on weight and height in LMIC but not in children from HIC.     

国内团体辅导对大学生社交焦虑干预效果Meta分析

评价国内团体心理辅导对大学生社交焦虑的干预效果,为降低大学生社交焦虑水平提供参考.方法 检索中国知网(CNKI)、维普(VIP)、万方(WanFang Data)、中国生物医学文献数据库(CBM)等国内中文期数据库中从建库至2016年12月期间公开发表的团体辅导干预大学生社交焦虑的所有对照试验研究,由2位评价者对所获文献独立进行文献筛选、资料提取和方法学质量评价,采用RevMan 5.3软件对数据进行Meta分析.结果 符合纳入标准的8篇文献涉及372例研究对象,试验组176例,对照组196例.Meta分析的结果显示,交往焦虑量表(Interaction Anxiousness Scale,IAS)、社交回避及苦恼量表(Social Avoidance and Distress Scale,SAD)、自尊量表(Self-Esteem Scale,SES)、交流恐惧自陈量表(Personal Report of Communication Apprehension,PRCA)、羞怯量表的评分比较合并MD(95%CI)值分别为-4.72(-7.08~-2.35),-5.86(-6.89~-4.83),4.23(2.81~5.64),-5.78(-8.96~-2.60),-4.83(-10.18~0.52).结论 团体心理辅导对大学生社交焦虑具有较好的干预效果,可有效降低社交焦虑水平,提高个体自尊水平,减少社交回避行为,提高大学生社会交往能力.     

A Meta‐Analysis of Probiotic and Synbiotic Use in Elective Surgery

Background: Perioperative nutrition modulation of gut microbiota is increasingly used as a strategy for reducing the infective complications of elective surgery. This meta‐analysis assessed the effect of probiotic and synbiotic preparations on the incidence of postoperative sepsis. Methods: Randomized controlled trials that compared preoperative dosing of probiotics and synbiotics in patients undergoing elective general surgical procedures were included. The primary outcome measure was the postoperative sepsis rate. Pooled outcome measures were determined using random effects models. Results: Thirteen randomized controlled trials totaling 962 patients were included in this analysis (304 received synbiotics and 182 received probiotics). The incidence of postoperative sepsis was reduced in the probiotic group vs the control (pooled odds ratio [OR] = 0.42; 95% confidence interval [CI], 0.23–0.75; P = .003) and in the synbiotic group vs the control (pooled OR = 0.25; 95% CI, 0.1–0.6; P = .002). However, subgroup analysis failed to identify a significant reduction in the incidence of pneumonia, urinary tract infections, or wound infections in the postoperative phase for either treatment group. Synbiotics reduced the length of postoperative antibiotic use (weighted mean differences = ?1.71; 95% CI, ?3.2 to ?0.21; P = .03). Conclusion: Probiotic and synbiotic nutrition strategies reduce the incidence of postoperative sepsis in the elective general surgery setting. These effects appear more pronounced with the use of synbiotics. High‐powered, mechanistic studies are now required for the optimization of pro‐ and prebiotic regimens to further improve their efficacy.     

Effects of group exercise on cognitive functioning and mood in older women

Abstract: A randomised controlled trial was conducted to determine whether a 12–month program of group exercise had beneficial effects on physiological and cognitive functioning and mood in 187 older community–dwelling women. The exercisers ( n = 94) and controls ( n = 93) were well matched in terms of the test measures and a number of health and life–style assessments. The mean number of classes attended by the 71 exercise subjects who completed the program was 59.0 (range 26 to 82). At the end of the trial, the exercisers showed significant improvements in reaction time, strength, memory span and measures of wellbeing when compared with the controls. There was also an indication that anxiety had been reduced in the exercisers. Within the exercise group, improvements in memory span were associated with concomitant improvements in both reaction time and muscle strength. Also, within this group, initial mood measures were significantly inversely associated with improvements at retest, which suggests that the program may have normalised mood states in subjects who had high initial depression, anxiety and stress levels, rather than inducing improvements in all subjects. These findings suggest that group exercise has beneficial effects on physiological and cognitive functioning and wellbeing in older people.     

Efficacy of Probiotics in Rheumatoid Arthritis and Spondyloarthritis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Background: We aimed to provide a systematic review and meta-analysis of randomized controlled trials assessing the effect of probiotics supplementation on symptoms and disease activity in patients with chronic inflammatory rheumatic diseases (rheumatoid arthritis (RA), spondylarthritis (SpA), or psoriatic arthritis). Methods: A systematic literature review and meta-analysis from RA and SpA randomized controlled trials were conducted searching for articles in MEDLINE/PubMed and abstracts from recent international rheumatology meetings. The control group was a placebo or another dietary intervention. The risk of bias of the selected studies was evaluated using the Cochrane Collaboration tool and the Jadad scale. Results: The initial search yielded 173 articles. Of these, 13 studies were included in the qualitative synthesis, 8 concerning a total of 344 RA patients and 2 concerning a total of 197 SpA patients. Three meta-analyses were also analyzed. Probiotic strains and quantities used were different among trials (5 studies using Lactobacillus sp., 1 trial Bacillus coagulans and the others a mix of different probiotic strains). Time to assess response ranged from 8 weeks to one year. Two studies associated probiotic supplementation with a dietary intervention. Meta-analysis showed a statistically significant decrease of C-reactive protein (CRP) concentration (mean difference (MD)) −3.04 (95% CI −4.47, −1.62) mg/L, p < 0.001; I² = 20%, n patients = 209) with probiotics in RA. However, after excluding high-risk-of-bias trials of meta-analysis, there was no difference between probiotics and placebo on DAS28 (standard MD −0.54; 95% CI −1.94 to 0.85, p = 0.45, I² 93%, n patients = 143). The two studies on SpA patients showed no efficacy of probiotics. Conclusions: Probiotic supplementation might decrease RA activity with a moderate decrease effect on CRP, but lack of evidence and studies’ heterogeneity do not allow us to propose them to patients with inflammatory arthritis to control their disease. Further RCTs are required in the future to determinate the efficacy of probiotics and the optimal administration design.     

What is the impact of genetic counselling in women at increased risk of developing hereditary breast cancer? A meta-analytic review

Meta-analytic methods were used to determine the impact of genetic counselling on women with a family history of breast cancer. Published studies with prospective designs and randomized controlled trials were included in the review, and the psychological outcomes assessed were generalized psychological distress, generalized anxiety, depression, and breast cancer anxiety. Other outcomes investigated were the accuracy of perceived risk of developing breast cancer, breast cancer genetics knowledge and breast cancer screening uptake. A meta-analysis was performed to estimate effect size, where sufficient data were available. A total of 12 studies, most of which measured several outcomes, met at least one of the inclusion criteria. A sufficiently large number of studies were available to assess the magnitude of effects on three outcomes: generalized psychological distress, generalized anxiety and accuracy of perceived risk of developing breast cancer. The quantitative synthesis showed that genetic counselling leads to statistically significant decreases in generalized anxiety, with an average weighted effect sizes of r = - 0.17 (p<0.01). In contrast, the reduction in psychological distress exhibited a trend towards statistical significance only, with r = -0.074 (p = 0.052). The impact of genetic counselling on the accuracy of perceived risk was associated with an effect size of r = 0.56 (p<0.01). Thus in this meta-analysis, we demonstrated the efficacy of genetic counselling in meeting two of its objectives: reducing women's anxiety levels and improving the accuracy of their perceived risk. This review highlighted that most research so far focused on generalized distress and anxiety and accuracy of perceived risk, to the exclusion of other, perhaps equally important, types of outcomes. Future studies are likely to lead to more comprehensive assessments if additional emotional, cognitive and behavioural outcomes are included in the assessment.     

益生菌对急性胰腺炎大鼠肠道微生态及紧密连接的影响

目的 探讨经肠道补充益生菌对急性胰腺炎（AP）大鼠肠上皮细胞紧密连接、屏障功能及微生态的影响.方法 经胰管注射3%牛磺胆酸钠造成大鼠AP后,分别给予肠外营养（PN组）和PN＋益生菌（益生菌组）,持续5天;第6天处死大鼠,取腔静脉血、肺及肝组织和肠系膜淋巴结匀浆作细菌培养测细菌易位率;取末段回肠和结肠,采用免疫组织化学法测定其跨膜结合蛋白表达,电镜观察肠上皮细胞紧密连接超微结构;取盲肠内粪便作厌氧培养及细菌种群DNA指纹图谱分析.结果 益生菌组大鼠肠道内乳杆菌和双歧杆菌数量高于PN组（P＜0.05）,而潜在致病菌产气荚膜梭菌低于PN组（P＜0.05）,DNA指纹图谱也显示益生菌组优势菌群的基因条带和正常大鼠具有较高一致性,与PN组相比则有明显差异;益生菌组小肠和大肠跨膜结合蛋白的表达明显优于PN组（P=0.001,P=0.036）,肠上皮细胞紧密连接、微绒毛较完整;益生菌组大鼠的血、肺、肝、肠系膜淋巴组织的细菌易位率低于PN组（P=0.0413）.结论 益生菌能纠正AP大鼠PN时肠道菌群紊乱,增加肠上皮跨膜结合蛋白表达,维持肠上皮紧密连接,减少细菌易位。     

Postoperative Ileus after Stimulation with Probiotics before Ileostomy Closure

Loop ileostomy closure after colorectal surgery is often associated with Postoperative ileus, with an incidence between 13–20%. The aim of this study is to evaluate the efficacy and safety of preoperative stimulation of the efferent loop with probiotics prior to ileostomy closure in patients operated on for colorectal carcinoma. For this, a prospective, randomized, double-blind, controlled study is designed. All patients who underwent surgery for colorectal carcinoma with loop ileostomy were included. Randomized and divided into two groups, 34 cases and 35 controls were included in the study. Postoperative ileus, the need for nasogastric tube insertion, the time required to begin tolerating a diet, restoration of bowel function, and duration of hospital stay were evaluated. The incidence of Postoperative ileus was similar in both groups, 9/34 patients stimulated with probiotics and 10/35 in the control group (CG) with a p = 0.192. The comparative analysis showed a direct relationship between Postoperative ileus after oncological surgery and Postoperative ileus after reconstruction surgery, independently of stimulation. Postoperative ileus after closure ileostomy is independent of stimulation of the ileostomy with probiotics through the efferent loop. There seem to be a relationship between Postoperative ileus after reconstruction and the previous existence of Postoperative ileus after colorectal cancer surgery.     

Effects of Probiotics on Gut Microbiomes of Extremely Preterm Infants in the Neonatal Intensive Care Unit: A Prospective Cohort Study

Background: Probiotics have been previously reported to reduce the incidence of necrotizing enterocolitis (NEC) in extremely preterm infants, but the mechanisms by which the probiotics work remain unknown. We aimed to investigate the effects of probiotics on the gut microbiota of extremely preterm infants. Methods: A prospective cohort study was conducted on 120 extremely preterm neonates (gestational age ≤ 28 weeks) between August 2019 and December 2021. All neonates were divided into the study (receiving probiotics) and the control (no probiotics) groups. Multivariate logistic regression analysis was performed to investigate the significantly different compositions of gut microbiota between these two groups. The effects of probiotics on the occurrence of NEC and late-onset sepsis were also investigated. Results: An increased abundance of Lactobacillus was noted in neonates who received the probiotics (AOR 4.33; 95% CI, 1.89–9.96, p = 0.009) when compared with the control group. Subjects in the probiotic group had significantly fewer days of total parenteral nutrition (median [interquartile range, IQR]) 29.0 (26.8–35.0) versus 35.5 (27.8–45.0), p = 0.004) than those in the control group. The probiotic group had a significantly lower rate of late-onset sepsis than the control group (47.1% versus 70.0%, p = 0.015), but the rate of NEC, duration of hospitalization and the final in-hospital mortality rates were comparable between these two groups. Conclusions: Probiotic supplementation of extremely preterm infants soon after the initiation of feeding increased the abundance of Lactobacillus. Probiotics may reduce the risk of late-onset sepsis, but further randomized controlled trials are warranted in the future.