Meta-analysis comparing differing methods of endoscopic therapy for colorectal lesions

AIM: To compare the outcomes of endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) of colorectal lesions. METHODS: An electronic systematic literature search of four computerized databases was performed in July 2014 identifying studies reporting the outcomes of colorectal ESD and EMR. The primary outcome measures were en-bloc resection rate, endoscopic clearance rate and lesion recurrence rate of the patients followed up. The secondary outcome was the complication rate (including bleeding, perforation and surgery post EMR or ESD rate). Statistical pooling and random effects modelling of the studies calculating risk difference, heterogeneity and assessment of bias and quality were performed. RESULTS: Six observational studies reporting the outcomes of 1324 procedures were included. The en-bloc resection rate was 50% higher in the ESD group than in the EMR group (95%CI: 0.17-0.83, P < 0.0001, I² = 99.7%). Endoscopic clearance rates were also significantly higher in the ESD group (95%CI: -0.06-0.02, P < 0.0001, I² = 92.5%). The perforation rate was 7% higher in the ESD group than the EMR group (95%CI: 0.05-0.09, P > 0.05, I² = 41.1%) and the rate of recurrence was 50% higher in the EMR group than in the ESD group (95%CI: 0.20-0.79, P < 0.001, I² = 99.5%). Heterogeneity remained consistent when subgroup analysis of high quality studies was performed (with the exception of piecemeal resection rate), and overall effect sizes remained unchanged for all outcomes. CONCLUSION: ESD demonstrates higher en-bloc resection rates and lower recurrence rates compared to colorectal EMR. Differences in outcomes may benefit from increased assessment through well-designed comparative studies.     

Systematic review and meta-analysis of Statins-Fibrates therapy in diabetic dyslipidemia patients

AIM: To evaluate the efficacy,effect of preventing cardiovascular diseases and safety of statins-fibrates combination therapy in diabetic dyslipidemia patients.METHODS: We searched the databases of MEDLINE,EMBASE,web of knowledge and Cochrane central register of Controlled Trials for literatures about the coadministration of statins and fibrates as the treatment of patients with dyslipidemia and type 2 diabetes mellitus.We included related randomized controlled trials,controlled clinical trials and cross-sectional studies and excluded animal trials and clinical observations.The primary endpoints outcomes were the concentration of plasma total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C) and low density lipoprotein cholesterol(LDL-C).The secondary outcomes were cardiovascular diseases(CVD) and adverse events.RESULTS: Ten studies were included in this metaanalysis.For lipid modifying efficacy,the combination of statins and fibrates therapy had more significant effecton reducing TC [P = 0.004,weighted mean difference(WMD) =-8.19,95%CI:-13.82--2.56] and TG concentration(P 0.001,WMD =-47.29,95%CI:-68.66--25.92) and increasing HDL-C concentration(P 0.00001,WMD = 3.79,95%CI: 2.25-5.33) when compared with statins monotherapy,while the effect of reducing LDL-C concentration(P = 0.50,WMD =-2.52,95%CI:-9.76-4.72) was insignificant.To fibrates monotherapy,the combination therapy was more effective on reducing TC(P 0.00001,WMD =-48.51,95%CI:-57.14--39.89),TG(P 0.00001,WMD =-26.07,95%CI:-30.96--21.18),LDL-C concentration(P 0.00001,WMD =-45.74,95%CI:-53.35--38.13) and increasing HDL-C concentration(P = 0.04,WMD = 1.38,95%CI: 0.04-2.73).For cardiovascular diseases,the coadministration therapy had no significant effect on reducing the incidence of these events when compared with monotherapy(For primary clinical endpoints,P = 0.12,OR = 0.61,95%CI: 0.33-1.14); for secondary clinical endpoints,P = 0.13,OR = 0.66,95%CI: 0.38-1.14).For adverse events happened during the follow-up,both the incidence of hepatic-related(alanine aminotransferase and/or aspartate aminotransferase of patients were ≥ 3 times of upper limit of normal)(P = 0.38,OR = 0.55,95%CI: 0.15-2.06) and muscular-related(myopathy and/or creatine phosphokinase ≥ 3 times of upper limit of normal) adverse events(P = 0.10,OR = 1.62,95%CI: 0.91-2.86) had no significant difference between these two therapies.CONCLUSION: The results showed statins-fibrates combination therapy was more effective on lipid modification and well tolerated but there was no significant effect on preventing cardiovascular diseases.     

Statin use and risk of liver cancer: A meta-analysis of 7 studies involving more than 4.7 million patients

AIM: To pool data currently available to determine the association between statin use and the risk of liver cancer. METHODS: A computerized literature search was conducted to identify those relevant studies between January 1966 and March 2013. Stata 11.0 (Stata Corp, College Station, Texas) was used for statistical analyses. Pooled relative risk (RR) estimates with 95%CI were calculated for overall analysis and subgroup analyses, using the random- and fixed-effects models. Heterogeneities between studies were evaluated by Cochran’s Q test and I² statistic. The Begg’s funnel plot and Egger’s regression asymmetry test were used to detect the publication bias. RESULTS: Seven studies were included in our meta-analysis according to the selection criteria, including four cohort studies and three case-control studies. These studies involved 4725593 people and 9785 liver cancer cases. The overall analysis showed that statin use was statistically associated with a significantly reduced risk of liver cancer (random-effects model, RR = 0.61, 95%CI: 0.49-0.76, P < 0.001; fixed-effects model, RR = 0.64, 95%CI: 0.57-0.71, P < 0.001); however, significant heterogeneity was found between studies (Cochran’s Q statistic = 19.13, P = 0.004; I² = 68.6%). All subgroup analyses provided supporting evidence for the results of overall analysis. Begg’s (Z = 0.15, P = 0.881) and Egger’s test (t =-0.44, P = 0.681) showed no significant risk of having a publication bias. CONCLUSION: Statin use was associated with the reduced risk of liver cancer. To clearly clarify this relationship, more high quality studies are required.     

Sleep-associated movement disorders and the risk of cardiovascular disease: A systematic review and metaanalysis

AIM:To investigate whether an association exists between sleep-associated movement disorders and cardiovascular disease(CVD).METHODS:Several studies have observed the relationship of sleep-associated movement disorders such as restless legs syndrome(RLS)and periodic limb movements during sleep with CVD,but the results were still contradictory.We performed an extensive literature search on Pub Med,Medline and Web of Science published from inception to December 2014.Additional studies were manually searched from bibliographies of retrieved studies.Meta-analyses were conducted with Stata version 12.0(Stata Corp,College Station,Texas).Pooled odds ratios(ORs)and 95%CIs were calculated to assess the strength of association using the random effects model.Sensitivity and subgroup analyses were performed to explore the underlying sources of heterogeneity.The publication bias was detected using Egger’s test and Begg’s test.RESULTS:A total of 781 unique citations were indentified from electronic databases and 13 articles in English were finally selected.Among these studies,nine are cohort studies;two are case-control studies;and two are cross-sectional studies.The results showed that the summary OR of CVD associated with sleepassociated movement was 1.51(95%CI:1.29-1.77)in a random-effects model.There was significant heterogeneity between individual studies(P for heterogeneity=0.005,I2=57.6%).Further analysis revealed that a large-scale cohort study may account for this heterogeneity.A significant association was also found between RLS and CVD(OR=1.54,95%CI:1.24-1.92).In a fixed-effects model,we determined a significant relationship between sleep-associatedmovement disorders and coronary artery disease(CAD)(OR=1.34,95%CI:1.16-1.54;P for heterogeneity=0.210;I2=30.0%).Our meta-analysis suggests that sleep-associated movement disorders are associated with prevalence of CVD and CAD.CONCLUSION:This finding indicates that sleep-associated movement disorders may prove to be predictive of underlying CVD.     

Efficacy of therapeutic ultrasound vs sham ultrasound on pain and physical function in people with knee osteoarthritis: A meta-analysis of randomized controlled trials

AIM: To determine the efficacy of therapeutic ultrasound vs sham for improving pain and physical function immediately post-intervention in people with knee osteoarthritis(OA). METHODS: We hand searched meta-analyses on the topic published in 2010 and updated the search in three electronic databases(MEDLINE, EMBASE, CINAHL) January 1, 2009 to September 5, 2013 to identify relevant studies. The inclusion criteria were human randomized controlled trials published in the English language in which active therapeutic ultrasound was compared tosham ultrasound, data for people with knee OA were reported separately, participants were blinded to treatment allocation and outcomes assessed before and after treatment included pain, self-reported physical function and performance-based physical function. Two reviewers independently screened titles and abstracts retrieved in the search to identify trials suitable for full text review. Data extraction and risk of bias assessment of the identified trials were completed independently by two reviewers. Pooled analyses were conducted using inverse-variance random effects models.RESULTS: We screened 1013 titles and abstracts. Meta-analysis of pain outcomes from 5 small trials(281 participants/OA knees) showed that, compared to sham ultrasound, therapeutic ultrasound improves pain [standardized mean difference(SMD)(95%CI) =-0.39(-0.70--0.08); P = 0.01] but not physical function [self-reported in 3 trials(130 participants/OA knees): SMD(95%CI) =-0.21(-0.55-0.14), P = 0.24; walking performance in 4 trials(130 participants/OA knees): SMD(95%CI) =-0.11(-0.59-0.37), P = 0.65). For the walking performance outcome, the dispersion of the estimated effects exceeded that expected due to sampling error(χ2 = 8.37, P = 0.04, I 2 = 64%). Subgroup analyses of three trials that administered high dose ultrasound improved the consistency(I2 = 28%) but the treatment effect remained insignificant.CONCLUSION: Meta-analyzed double-blind placebocontrolled randomized trials provide low-strength evidence that therapeutic ultrasound decreases knee OA pain and very low-strength evidence that it does not improve physical function.     

延续性健康促进模式对老年痴呆患者生活质量干预效果的Meta分析

目的 系统分析延续性健康促进模式对老年痴呆患者生活质量的干预效果。方法 通过检索中国知网、维普、万方及Pubmed、Elsevier等数据库,全面的查阅延续性健康促进影响老年痴呆患者生活质量的相关文献,并运用RevMan 5.3软件对纳入文献进行meta分析。结果 共纳入8篇随机对照实验(randomized controlled trial,RCT)研究,共545例老年痴呆患者。分析发现延续性健康促进模式能改善老年痴呆患者智能状况[WMD=2.28,95%CI(1.60,2.96),P<0.001] ,日常生活能力[WMD=-4.63 ,95%CI(-6.44,-2.81), P<0.001],健康状况[WMD=-8.15,95%CI(-13.49,-2.82),P=0.003],社会活动能力[WMD=2.32,95%CI(0.89,3.75),P=0.001]。 结论 实施积极有效的延续性健康促进有利于提高老年痴呆患者的社会适应能力,改善生活质量。     

Effect of supervised exercise on aerobic capacity in cancer survivors: Adherence and workload predict variance in effect

AIM: To examine the efficacy of supervised aerobic exercise training on aerobic capacity in survivors of cancer. METHODS: We conducted a systematic search identifying randomized controlled trials of supervised aerobic exercise interventions among adult cancer survivors with aerobic capacity (VO_2max/peak) as the primary outcome. We calculated pooled effect sizes and performed multiple regression moderator analysis. RESULTS: We identified 18 studies including 1149 survivors of cancer. Studies included mixed cancer groups (4 studies), breast cancer (10 studies), hematological cancers (2 studies), lung cancer (1 study) and liver cancer (1 study). Survivors of cancer who participated in supervised aerobic exercise training improved aerobic capacity (VO_2peak) more than controls (18 comparisons, 1093 participants; standardized mean effect: 0.74; 95%CI: 0.52, 0.96; P < 0.001). However, there was significant heterogeneity among the included trials (I²: 63%; P < 0.001). Sixty-six percent of the between-study heterogeneity was explained by differences in exercise adherence and total exercise workload among studies (R²: 65.8%; P < 0.04). CONCLUSION: Supervised aerobic exercise training provides a moderate-to-large beneficial effect on aerobic capacity among survivors of cancer. Aerobic capacity was improved to a greater degree in exercise studies with better participant attendance and higher overall exercise workload.     

Hypertension in Zimbabwe: A meta-analysis to quantify its burden and policy implications

AIM: To estimate the pooled prevalence of hypertension in Zimbabwe and describe its trend since independence in 1980 using secondary source data. METHODS: MEDLINE, EMBASE and Scopus databases from April 1980 to December 2013 were searched for population and community based studies on the prevalence of hypertension among adults (≥ 18 years) in Zimbabwe. The key words used were “prevalence”, “epidemiologic studies”, “hypertension” or “high blood pressure”, based on the cut-off (≥ 140 mmHg systolic blood pressure and/or ≥ 90 mmHg diastolic blood pressure). We conducted a meta-analysis on the published studies, using the random-effects model to estimate the pooled prevalence. RESULTS: The search retrieved 87 publications, of which four studies met the selection criteria. The four studies had a total of 4829 study participants between 1997 and 2010 across 5 provinces in Zimbabwe. Two studies were in urban areas, while the other two had mixed study settings (urban and rural). The overall pooled prevalence of hypertension was 30% (95%CI: 19%, 42%, I²= 98%, χ² = 164.15, P = 0.00). CONCLUSION: Our results show a high prevalence of hypertension in Zimbabwe, with urban areas having higher prevalence than rural areas.     

LEARNS模式在妊娠期糖尿病患者健康教育中的应用

目的 探讨LEARNS模式在妊娠期糖尿病患者健康教育中的应用效果。方法 选取产科门诊收治的120例妊娠期糖尿病患者为研究对象,采用随机数字表法将其分为对照组和观察组,每组各60例。对照组给予常规健康教育,观察组采用LEARNS模式开展健康教育。比较2组血糖水平及体质量控制情况、患者自我管理能力、妊娠并发症及妊娠结局。结果 观察组空腹血糖、餐后2 h血糖、糖化血红蛋白及体质量控制的达标率均高于对照组(χ² =6.171,P=0.013;χ² =9.219,P=0.002;χ² =9.259,P=0.002;χ² =9.412,P=0.002),观察组自我管理能力评分高于对照组(t=12.972,P<0.001),羊水过多、巨大儿及早产发生率均低于对照组(χ² =6.982,P=0.008;χ² =7.688,P=0.006;χ² =4.904,P=0.027);2组妊娠期高血压、胎膜早破及新生儿低血糖发生率比较,差异均无统计学意义(P＞0.05)。结论 LEARNS模式可明显提高妊娠期糖尿病患者自我管理能力,改善其血糖及体质量控制水平,降低妊娠并发症的发生风险。     

Red meat intake and the risk of endometrial cancer: Meta-analysis of observational studies

AIM: To evaluate whether red meat intake is related to the risk of endometrial cancer (EC) using meta-analysis. METHODS: We searched PubMed, EMBASE, and the Cochrane Library up to June 2013, using common keywords related to red meat and EC. Case-control studies and cohort studies comparing the risk of endometrial cancer among categories by the amount of intake were included. Eleven case-control studies and five cohort studies met our criteria. We performed a conventional and a dose-response meta-analysis of case-control studies using the DerSimonian-Laird method for random-effects. For cohort studies we performed a conventional meta-analysis. Publication bias was evaluated using Egger’s test. RESULTS: In the meta-analysis of 11 case-control studies including 5419 cases and 12654 controls, higher red meat consumption was associated with an increased risk of EC [summary relative risk (SRR) = 1.43, 95%CI: 1.15-1.79; I² = 73.3% comparing extreme intake categories). In a dose-response analysis, for red meat intake of 100 g/d, SRR was 1.84 (95%CI: 1.64-2.05). In contrast, in the meta-analysis of five prospective studies including a total of 2549 cases among 247746 participants, no significant association between red meat intake and EC risk (SRR = 0.97, 95%CI: 0.85-1.11; I² = 4.9% comparing extreme intake categories) was observed. CONCLUSION: Our meta-analysis found a significant linear association between red meat intake and EC risk based on case-control studies but this was not confirmed in prospective studies.     

Association between SHBG (TAAAA)n and AR (CAG)n polymorphisms and PCOS risk: A meta-analysis

AIM: To systematically assess the association between sex hormone-binding globulin (SHBG) (TAAAA)n and androgen receptor (AR) (CAG)n polymorphisms and polycystic ovarian syndrome (PCOS) risk. METHODS: We searched MEDLINE (PubMed), EMBASE and Web of Science database from inception to May 2014. To avoid missing any additional studies, we looked through all the references of relevant articles. Case-control studies concerning the (CAG)n variants in the AR gene or the (TAAAA)n polymorphism in the SHBG gene in PCOS patients were included. Five studies regarding the (TAAAA)n polymorphism in the SHBG gene and 14 studies regarding the (CAG)n polymorphism in the AR gene met our criteria. Odd ratio (OR) and weighted mean difference (WMD) were selected as the effect size measurements to evaluate the influence of the (TAAAA)n polymorphism and (CAG)n variants on PCOS risk. Begg’s test was used for the evaluation of publication bias. RESULTS: With respect to the relationship between the (TAAAA)n polymorphism and PCOS risk, the statistical results showed that there was no significant difference between PCOS patients and controls in the alleles of TAAAA (S: OR = 0.91, 95%CI: 0.78-1.05; L: OR = 1.10, 95%CI: 0.95-1.27). Subgroup analyses of the combination of alleles indicated similar results (short-short: OR = 0.87, 95%CI: 0.66-1.14; short-long: OR = 1.12, 95%CI: 0.86-1.46; long-long: OR = 1.03, 95%CI: 0.72-1.47). As for the relationship between the (CAG)n polymorphism and PCOS risk, we found no association between CAG repeat variants and PCOS risk (WDM = 0.03, 95%CI: -0.13-0.08). Subgroup analyses by race and diagnosis criteria indicated the same results (Asian: WMD = -0.03, 95%CI: -0.14-0.07; Caucasian: WMD = -0.02, 95%CI: -0.24-0.21; the criteria of Rotterdam: WMD = 0.01, 95%CI: -0.01-0.03). CONCLUSION: There is no association between (TAAAA)n polymorphism in SHBG gene, (CAG)n repeat variants in AR gene and PCOS.     

Excel表格提醒功能结合在线文档编辑在用物管理中的应用

目的 探讨Excel表格提醒功能结合在线文档编辑在临床无菌物品及药品管理中的应用效果。方法 2017年6月—2018年5月科室采用传统方法进行物资清点及管理,2018年6月-2019年5月科室用采用Excel表格提醒功能结合在线文档编辑进行科室无菌物品及药品管理。比较Excel表格提醒功能结合在线文档编辑使用前后,护士清点药品和物品的耗时,无菌物品过期发生率、药品过期发生率和近期药品未及时更换发生率,及护士对无菌物品、药品管理的满意度。结果 应用Excel表格提醒功能结合在线文档编辑后,护士清点物品和无菌药品所需时间均明显短于应用前(t=10.168,P=0.005;t=11.738,P=0.003),无菌物品、药品过期发生率和近效期药品未及时更换发生率均低于应用前(χ²=11.640,P=0.001;χ²=6.186,P=0.029;χ²=20.195,P＜0.001),护士对无菌物品及药品管理的满意度高于应用前(P<0.05)。结论 应用Excel表格提醒功能结合在线文档编辑,可以有效降低无菌物品、药品的管理缺陷发生率,提高了护理工作效率,促进了护理工作的创新。     

Expression of epithelial cellular adhesion molecule in gastric cancer: A meta-analysis

AIM: To obtain an accurate evaluation of the association between high expression of epithelial cellular adhesion molecule (EpCAM) and gastric cancer (GC) risk. METHODS: Studies that had examined the association between high expression of EpCAM and GC risk were identified by searching electronic databases PubMed, EMBASE, Cochrane library and Chinese Biomedical Literature database. Risk ratios (RRs) together with their 95%CIs were used to assess the association between high expression of EpCAM and GC risk. We selected eligible studies based on inclusion criteria. RevMan 5.3 software was used to calculate the pooled values. RESULTS: A total of 14 studies were included in this meta-analysis. EpCAM-positive cases were significantly associated with tumor size (RR: 1.68, 95%CI: 1.47-1.91, P < 0.00001 fixed-effect), depth of invasion (RR: 1.37, 95%CI: 1.11-1.68, P = 0.003 random-effect), TNM stage (RR: 2.02, 95%CI: 1.35-3.02, P = 0.0007 random-effect), tumor location (RR: 0.80, 95%CI: 0.71-0.91, P = 0.0007 fixed-effect), histologic differentiation (RR: 1.23, 95%CI: 1.13-1.33, P < 0.00001 fixed-effect) and lymph node metastasis (RR: 1.89, 95%CI: 1.28-2.80, P = 0.001 random-effect). However, we did not observe any significant association between the presence of EpCAM with age, gender, distant metastasis, Borrmann type or Lauren classification. Additionally, EpCAM expression was not associated with the overall survival rate. The pooled HR of the overall effect was 1.39 (95%CI: 0.30-6.48, P = 0.67 random-effect). CONCLUSION: Our meta-analysis indicates that EpCAM contributes to GC risk, which acts as a prognostic factor and a marker of poor outcome.     

幼年特发性关节炎患儿血管内皮功能的系统评价和meta分析

目的 通过系统评价肱动脉血流介导的血管舒张(flow mediated dilation,FMD)功能与幼年特发性关节炎患儿(juvenile idiopathic arthritis,JIA)的相关性,探讨JIA患儿的血管内皮功能.方法 计算机检索Pubmed、Embase、Web of Science、The Co...     

Ascorbic acid and low-volume polyethylene glycol for bowel preparation prior to colonoscopy: A meta-analysis

AIM: To evaluate the benefits of low-volume polyethylene glycol (PEG) with ascorbic acid compared to full-dose PEG for colonoscopy preparation. METHODS: MEDLINE, Cochrane Central Register of Controlled Trials and Database of Systematic Reviews, CINAHL, PubMed, and recent abstracts from major conferences were searched (January 2012). Only randomized-controlled trials on adult subjects comparing low-volume PEG (2 L) with ascorbic acid vs full-dose PEG (3 or 4 L) were included. Meta-analysis for the efficacy of low-volume PEG with ascorbic acid and full-dose PEG were analyzed by calculating pooled estimates of number of satisfactory bowel preparations as well as adverse patient events (abdominal pain, nausea, vomiting). Separate analyses were performed for each main outcome by using OR with fixed and random effects models. Heterogeneity was assessed by calculating the I² measure of inconsistency. RevMan 5.1 was utilized for statistical analysis. RESULTS: The initial search identified 242 articles and trials. Nine studies (n = 2911) met the inclusion criteria and were analyzed for this meta-analysis with mean age range from 53.0 to 59.6 years. All studies were randomized controlled trials on adult patients comparing large-volume PEG solutions (3 or 4 L) with low-volume PEG solutions and ascorbic acid. No statistically significant difference was noted between low-volume PEG with ascorbic acid and full-dose PEG for number of satisfactory bowel preparations (OR 1.07, 95%CI: 0.86-1.33, P = 0.56). No statistically significant difference was noted between low-volume PEG with ascorbic acid and full-dose PEG for abdominal pain (OR 1.09, 95%CI: 0.81-1.48, P = 0.56), nausea (OR 0.70, 95%CI: 0.49-1.00, P = 0.05), or vomiting (OR 0.99, 95%CI: 0.78-1.26, P = 0.95). No publication bias was noted. CONCLUSION: Low-volume PEG with the addition of ascorbic acid demonstrates no statistically significant difference to full-dose PEG for satisfactory bowel preparation and side-effects.     

Relationship between apolipoprotein E gene polymorphism and total cholesterol level in patients with kidney diseases

AIM: To evaluate the association between apolipoprotein E (apoE) gene polymorphism and total cholesterol (TC) level in patients with kidney diseases. METHODS: A predefined literature search was performed to collect data from the electronic databases of PubMed, Embase and the Cochrane Library and eligible relevant studies reporting the association of apoE gene polymorphism with TC level in patients with kidney diseases were recruited for meta-analysis. RESULTS: Twenty-one studies were identified for the analysis of association between apoE gene polymorphism and TC level in patients with kidney disease. Subjects with E3E4 had a higher TC than those with E3E3 [weighted mean differences (WMD) = 2.14, P = 0.01] and subjects with E2E3 had a lower TC than those with E3E3 (WMD = -1.93, P = 0.01). Subjects with ε2 had a lower TC than those with ε3 (ε2 vs ε3: WMD = -1.23, P = 0.002; ε2 vs ε4: WMD = -2.77, P ﹤0.0001) and subjects with 3 had a lower TC than those with 4 (WMD = -0.79, P = 0.03). CONCLUSION: Subjects with apoE E3E4 and ε4 had a higher TC level and subjects with apoE E2E3 and ε2 had a higher TC level in patients with kidney disease. However, more well-designed studies should be performed in the future to confirm these findings.     

基于移动终端智慧护理信息系统在儿科临床护理工作中的应用实践

目的 探讨移动终端智慧护理信息系统各模块功能的应用,对提高儿科护士临床工作质量的效果.方法 选取某三甲综合性医院2019年5-7月在儿科住院的患儿699例设为对照组,运用传统的移动护理工作站核对患儿信息、人工采集生命体征并录入电脑、使用表格清点记录急救设备等;选取2019年8-10月在儿科住院的患儿671例设为观察组,...     

智能化疼痛管理决策与质量监测系统在跟骨骨折内固定手术患者中应用

目的 探讨智能化疼痛管理决策与质量监测系统在跟骨骨折内固定手术患者中的应用效果。方法 选取2019年1-6月收治的跟骨骨折内固定术患者40例为对照组,行常规性疼痛干预,选取2019年7-12月骨科收治的跟骨骨折内固定术患者42例为研究组,应用智能化疼痛管理决策与质量检测系统对患者实施疼痛管理,比较2组干预前后疼痛评分、睡眠质量、术后锻炼依从率、并发症发生率、足踝功能恢复情况及患者满意率。结果 研究组干预后数字疼痛评分量表(numerical rating scale, NRS)评分、匹兹堡睡眠质量指数(Pittsburgh sleep quality index, PSQI)、并发症发生率均低于对照组(t=5.464,P<0.001;t=16.940,P<0.001;χ²=5.550,P=0.018),术后锻炼依从率、Morrey评分、MaryLand评分及满意率均高于对照组(χ²=9.217,P=0.002;t=12.906,P<0.001;t=10.687,P<0.001;χ²=6.717,P<0.001)。结论 智能化疼痛管理决策与质量监测系统能有效减轻患者跟骨骨折内固定术后的疼痛感,提高锻炼的依从性,降低并发症的发生率,有利于患者术后的康复,提高患者的满意度。     

婴幼儿时期血管瘤患儿特异性生活质量现状及影响因素分析

目的 了解婴幼儿时期血管瘤患儿特异性生活质量现状,并分析其影响因素。方法 采用便利抽样法,选取2021年1月-2022年1月在笔者所在医院住院的126例血管瘤患儿及其父母为研究对象,采用一般资料问卷、中文版婴儿血管瘤特异性生活质量问卷、家庭复原力评定量表以及社会支持量表对其进行调查。结果 血管瘤患儿特异性生活质量问卷得分为(54.69±6.85)分,与家庭复原力以及社会支持均呈负相关(r=-0.681,P=0.001;r=-0.754,P=0.001)。多元线性回归分析结果显示,是否为独生子女、父母文化程度、家庭复原力以及社会支持水平是血管瘤患儿特异性生活质量的独立影响因素(R²=0.736,_△R²=0.695,F=15.241,P＜0.001)。结论 血管瘤患儿特异性生活质量处于中等水平,有待进一步提高,医护人员要着重关注非独生子女、父母文化程度低、家庭复原力以及社会支持水平低的血管瘤患儿及其父母,从个人、家庭以及社会不同层面对患儿及其父母提供支持,提升其特异性生活质量。     

Periodontal disease is associated with increased coronary heart disease risk: A meta-analysis based on 38 case-control studies

AIM: To investigate whether periodontal disease (PD) is associated with increasing coronary heart disease (CHD) risk by performing a meta-analysis. METHODS: Two authors independently searched PubMed and China National Knowledge Infrastructure up to January 10^th, 2013 for relevant case-control studies that investigated the association between PD and CHD. After quality assessment using Newcastle-Ottawa Scale and data extraction by two independent authors, the overall and subgroup meta-analyses were performed and publication bias were examined using the Comprehensive Meta-Analysis V2 software. Potential publication bias was assessed using visual inspection of the funnel plots, Egger linear regression test, and trims and fill method. RESULTS: Finally 38 relevant case-control studies were identified, involving 4950 CHD patients and 5490 controls. Eleven studies were rated low quality and 27 were high quality. Based on random-effects, a significant association was identified between PD and CHD (OR 3.79, 95%CI: 2.23-6.43, P < 0.001, I² = 98.59%), and sensitivity analysis showed that this result was robust. Subgroup analyses according to adjusted/unadjusted ORs, source of control, methodological quality, end point, assessment of PD/CHD, and ethnicity also indicated a significant association. Publication bias was detected, and the estimated OR including the “missing” studies did not substantially differ from our estimate with adjustment for missing studies (OR 4.15, 95%CI: 2.62-6.54, P < 0.001). CONCLUSION: Based on the meta-analysis, PD is probably associated with CHD risk independently and significantly.