中国住院癌症患者自杀意念发生率Meta分析

目的 了解中国住院癌症患者自杀意念发生率的总体情况,为住院癌症患者自杀行为预防及干预提供参考.方法 系统检索Web of Science、Cochrane Library、PubMed、EMbase、中国知网、中国生物医学文献服务系统、万方数据库、维普数据库自建库至2020年10月的相关文献,采用R4.0.2软件对数据...     

首发抑郁症伴自杀意念患者中缝核功能连接的改变

目的 观察首发抑郁症伴自杀意念（SI）患者中缝核功能连接（FC）改变。方法 前瞻性纳入98例首发抑郁症患者,根据伴SI与否将其分为伴SI组（n=56）与不伴SI组（n=42）;另以47名健康志愿者为对照组。以静息态功能MRI观察背侧中缝核（DRN）、中缝中央核（MRN）与全脑间的FC;比较3组及两两组间FC,分析伴SI组差异脑区FC与临床资料的相关性。结果 相比对照组,伴与不伴SI组DRN与左侧小脑及左侧壳核的FC均降低（P均<0.05）,MRN与右侧颞下回的FC均升高而与左侧额下回、右侧枕上回、左侧顶下小叶及左侧壳核的FC均降低（P均<0.05）;其中,伴SI组DRN与左侧壳核的FC高于不伴SI组（P<0.05）;相比不伴SI组及对照组,伴SI组MRN与右侧中央后回的FC升高（P均<0.05）。伴SI组MRN与左侧壳核的FC与24项汉密尔顿抑郁量表（HAMD-24）体质量得分呈正相关（r_s=0.297,P=0.026）。结论 首发抑郁症伴SI患者中缝核与皮层和皮层下区的FC存在异常改变,且其MRN与左侧壳核的FC与HAMD-24体质量得分呈正相关。     

肺癌患者自杀意念现状及影响因素分析

目的 了解肺癌患者自杀意念现况,并探讨联结中断、心理痛苦、绝望对其自杀意念的影响,为干预措施的制定提供参考。 方法 采用患者健康问卷、联结中断量表、心理痛苦量表及Beck绝望量表对366例肺癌患者进行调查,通过结构方程模型分析各因素间的关系。 结果 肺癌患者自杀意念发生率为22.68%;联结中断、心理痛苦、绝望均可直接影响自杀意念（直接效应值为0.13、0.37、0.17）;联结中断通过心理痛苦、绝望可间接影响自杀意念（间接效应值为0.38）,其总效应值最大（为0.51）,且可调节绝望对自杀意念的影响;绝望可通过心理痛苦间接影响自杀意念（间接效应值为0.17）,二者无交互作用。 结论 肺癌患者自杀意念发生率高,以增强肺癌患者联结感为关键,通过减轻患者心理痛苦、增加其希望对减少自杀意念的发生尤为重要。     

基于人工智能技术的微博"树洞"用户自杀意念分析

目的分析微博"树洞"用户留言的自杀意念相关信息,为自杀预警及网络干预提供思路。方法 "树洞"智能机器人24 h监控2018年8～10月"走饭"微博树洞留言,依据知识图谱筛选含自杀意念的信息,自动识别6～10级高自杀风险信息,进行自杀风险分级。结果 "树洞"机器人共抓取"走饭"微博树洞留言信息11.8万条。微博留言在22:00至凌晨2:00达高峰期;存在6～10级高自杀风险留言信息达711条,留言用户主要集中在16～26岁年龄段;跳楼、割腕、烧炭、自缢、跳河是高自杀风险人群表达的主要自杀方式。结论人们通过网络表达自杀意念的现象越来越普遍,人工智能技术可用于识别和救助高自杀风险人群。自杀预防工作应健全24 h危机预警及干预机制,重视青少年心理健康,并营造良好的网络社交环境。     

癌症患者自杀意念心理体验的质性研究

目的了解癌症患者自杀意念发生发展的心路历程和内心需求,为临床医护人员预防住院患者自杀提供建议和依据。方法采用现象学研究方法,对16例有自杀意念的住院癌症患者进行半结构式深入访谈;访谈资料选用Claizzi七步分析法进行分析。结果癌症患者的心理体验可以分为危险因素和保护因素两个方面。危险因素包括生理因素(生存质量低下或疾病预后不良)、心理因素(孤独感、累赘感、愤怒、自责、生命无意义感)、社会因素(负性生活事件和经济压力)。保护性因素包括对死亡的害怕、对家庭的责任感、亲友支持和心理弹性。结论癌症患者自杀的预防和干预,不仅要注重降低患者自杀的危险因素,也要发掘患者的保护性因素,从而降低甚至打消患者自杀的念头。     

急诊科自杀未遂患者的简要自杀风险干预

目的 探讨降低急诊科自杀未遂患者自杀意念的有效方法.方法 依据《照顾有自杀风险的成年患者——急诊科共识指南》制订简要自杀风险干预流程清单,对57例急诊科住院或留观的自杀未遂患者进行干预.结果 57例患者均未再出现自杀行为.干预前及干预后6个月患者自杀态度及自杀意念比较,差异有统计学意义(均P＜0.01).结论 实施简要...     

国内成人癌症患者鼻肠管肠内营养不良反应发生率的Meta分析

目的 系统评价国内成人癌症患者鼻肠管肠内营养的不良反应发生率。方法 计算机检索PubMed、Web of Science、中国生物医学文献数据库、维普数据库、中国知网、万方数据库,收集关于国内成人癌症患者鼻肠管肠内营养不良反应发生率的文献,检索时限为建库至2022年2月。两名研究者独立筛选文献,并分别提取资料、独立评价文献质量后,采用Stata 15.1进行Meta分析。结果 共纳入25篇文献,符合纳入标准的研究对象共2 132例。Meta分析结果显示,国内成人癌症患者鼻肠管肠内营养的不良反应发生率为41%[95%CI(33%～49%)]。亚组分析结果显示,发表年份为2005～2009年、胃癌、术后24 h后开始EN、EN开始前鼻饲温水、术前白蛋白水平≤35 g/L、住院时长<15天、置管深度距吻合口远端15～20 cm的成年癌症患者肠内营养不良反应发生率更高。结论 目前我国成人癌症患者鼻肠管肠内营养的不良反应发生率较高,应高度重视并积极采取预防措施。     

脊柱手术后静脉血栓发生率的Meta分析

目的 :利用Meta分析的方法评价脊柱手术后发生静脉血栓的相关影响因素。方法:计算机检索2017年7月31日以前PubMed、Web of Science、EMBASE、the Cochrane Library等英文数据库和万方、知网、维普等中文数据库中关于脊柱手术后静脉血栓自然发生率的相关研究,采用NOS量表对纳入的研究进行质量评价,提取年龄、性别、体重指数(BMI)、手术方式与部位、手术时间、出血量、高血压、糖尿病、心脏病、D-二聚体水平、术前行走障碍等病史信息,将这些信息通过Review Manager 5.3软件进行Meta分析。结果:共纳入22篇文献,包含2841542例脊柱术后患者,其中发生静脉血栓者7557例,纳入文献的NOS评分在5~8分。Meta分析结果示,脊柱手术后静脉血栓发生者年龄[WMD=6.05,95%CI(3.62,8.48),P0.0001]、失血量[SMD=2.22,95%CI(1.03,3.41),P=0.0003]、手术时间[WMD=59.60,95%CI(10.27,108.93),P=0.02]均高于非静脉血栓者;男性患者术后静脉血栓发生率低于女性患者[OR=0.59,95%CI(0.38,0.94),P=0.03];手术方式中脊柱融合术患者术后静脉血栓发生率高于非融合术患者[OR=1.67,95%CI(1.40,1.99),P0.00001];术前有高血压[OR=1.78,95%CI(1.51,2.10),P0.00001]、糖尿病[OR=1.48,95%CI(1.40,1.57),P0.00001]、行走障碍史者[OR=4.47,95%CI(4.47,10.98),P=0.001]均增加了术后静脉血栓发生率;而BMI、手术入路、手术部位、心脏病史和D-二聚体水平对脊柱手术后静脉血栓发生率影响差异无统计学意义(P0.05)。结论:年龄偏高、女性、行脊柱融合术、失血量大、手术时间长者及伴有高血压、糖尿病、行走障碍史者术后易发生静脉血栓,临床应加以防范。     

中国乳腺癌患者静脉血栓危险因素的Meta分析

目的 系统评价中国乳腺癌患者静脉血栓的危险因素。方法 检索中文数据库(CNKI、维普数据库、万方数据库、SinoMed)和英文数据库(PubMed、EMbase、Web of Science、Cochrane、Medline、EBSCO、Wiley online library),收集建库至2021-12-12发表的中国乳腺癌患者静脉血栓危险因素的文献,用RevMan5.3软件分析。结果 共纳入18篇文献,其中病例对照研究17篇,队列研究1篇,相关因素12个。Meta分析结果显示,术前危险因素：年龄(OR=0.43,95%CI为0.20～0.92)、体质量指数(OR=0.43,95%CI为0.33～0.56)、病理分期(OR=0.73,95%,CI为0.58～0.93)、诊断方法(OR=1.49,95%CI为1.23～1.81)、绝经(OR=1.39,95%CI为1.19～1.63)、冠心病(OR=2.18,95%CI为1.48～3.20)。术中危险因素：手术时间(OR=0.62,95%CI为0.48～0.80)是乳腺癌患者静脉血栓危险因素(均P<0.05)。结论 年龄≥60岁、...     

护士亲历患者自杀事件后真实体验质性研究的Meta整合

目的 系统评价护士亲身经历患者自杀事件后真实体验的质性研究,为设计有效的应对策略提供依据.方法 检索Cochrane Library、Ovid、中国知网等数据库中护士亲历患者自杀后的质性研究.采用澳大利亚JBI循证卫生保健中心质性研究质量评价标准对纳入文献的方法学进行质量评价,依据其汇集性整合方法进行结果整合.结果 共...     

Decreasing suicide risk among patients with prostate cancer: Implications for depression,erectile dysfunction,and suicidal ideation screening

Objective

Prostate cancer is the most common malignancy among males, accounting for 19% of cancers, and the third most common cancer-related cause of death. Suicide rates in the United States have increased among males over the last decade. Further, suicide rates are higher in oncology patients, including patients with prostate cancer, compared to the general population. The objective of this article is to review the current literature and address the relationship between prostate cancer, depression, erectile dysfunction, and suicidal ideation.

Differential experiences during the holocaust and suicidal ideation in older adults in treatment for depression

Data were used on 275 Jewish individuals aged 50 and older in outpatient treatment for depression in this retrospective cross-sectional study. Holocaust survivors who were in work camps, in ghettos, or in hiding (HS-WGH) and holocaust survivors who were in concentration camps (HS-CC) were more likely to suffer posttraumatic stress disorder compared to other survivors (HS-OT) and controls. The HS-WGH and HS-CC groups had at least a threefold greater odds of suicidal ideation compared to controls. Suicidal ideation rates did not differ significantly between HS-OT group and controls. Among survivors, HS-WGH had a threefold greater odds of suicidal ideation compared to HS-OT. The results are applicable to survivors of similar atrocities and show that differing types and severities of traumatic experiences have important implications for treatment planning.     

Prevalence of pulmonary hypertension in peritoneal dialysis patients: a meta-analysis

Purpose

Recent epidemiological evidence indicates an association between peritoneal dialysis (PD) patients and pulmonary hypertension (PH). However, the true prevalence of PH associated with PD has not been well described. So we conducted a meta-analysis to summarize the point prevalence of PH in adults with PD.

Methods

PubMed, EMBASE, the Cochrane Collaboration, and the reference lists of relevant articles were searched to identify eligible studies. We used a random-effect meta-analysis model to estimate the prevalence of PH. We also performed sensitivity analyses and assessments of publishing bias.

Results

Fourteen observational studies (n?=?1483 participants) were included in this meta-analysis. The result of analysis in random-effect model showed that the pooled prevalence was 21% (95% CI 16–28), with significant heterogeneity between these studies (I²?=?84%, p?<?0.01). Sensitivity analysis further demonstrated the results to be robust. Besides, the Egger’s test (p?=?0.287) showed no significant publication bias.

Conclusions

PH is highly prevalent in patients with PD. Further studies are encouraged to definitively clarify the relationship between PH and PD.

     

老年慢性阻塞性肺疾病患者衰弱现状及影响因素的Meta分析

目的 系统评价老年慢性阻塞性肺疾病患者衰弱现状及其影响因素。方法 计算机检索各数据库,检索时限为2000年至2022年2月。由2名研究者独立进行文献筛选、质量评价、信息提取,分别采用Stata12.0和RevMan5.3软件进行患病率及影响因素的Meta分析。结果 共纳入26篇文献,6 849例患者。Meta分析结果显示,COPD患者衰弱患病率为34%,其中年龄（OR=1.15）、GOLD分级（OR=3.00）、呼吸困难指数（OR=3.44）、抑郁（OR=3.36）、并存疾病（OR=3.39）、多重用药（OR=4.09）、营养不良（OR=5.79）是衰弱的主要危险因素。结论 老年慢性阻塞性肺疾病患者衰弱发生率高,影响因素较多。应针对衰弱危险因素进行早期筛查、早期干预,以减少不良结局对患者的影响。     

Prevalence of depression in patients with chronic obstructive pulmonary disease: a systematic review

BACKGROUND—Patients with chronic obstructive pulmonary disease (COPD) have repeatedly been characterised as a population of chronically ill patients with a higher than normal prevalence of depression. Susceptibility for depression has been noted in patients with certain other chronic conditions. This systematic review was conducted to achieve a more definite answer to the question: do patients with COPD show a higher than normal prevalence of depression?METHODS—Studies in English language journals were retrieved by an electronic search over the period from 1966 to December 1997 and by an extended search of reference lists, and were included or excluded according to a system of diagnostic and methodological criteria.RESULTS—Ten studies were included, of which only four had a case-control design. Three of the case-control studies reported an increased prevalence of depression among patients with COPD which was statistically significant in only one. The fourth controlled study found a significantly increased depression score among COPD patients. Of the remaining six uncontrolled studies three found a high baseline prevalence of depression among their study group.CONCLUSIONS—An association between COPD and depression was found in the four controlled studies. The two methodologically best conducted studies that did not detect a statistically significant higher prevalence lacked power. The two studies that did find a significant association used a questionable depression measure. The prevalence of depression was high compared with general population figures in three of six non-controlled studies. The empirical evidence for a significant risk of depression in patients with COPD remains inconclusive, due to the poor methodological quality of most of the published studies, the lack of studies with an adequate sample size, and variability in instruments and cut off scores used to measure depression.     

Prevalence of pulmonary hypertension in patients with chronic kidney disease without dialysis: a meta-analysis

Purpose

Recent epidemiological evidence attempts to demonstrate the risk of pulmonary hypertension (PH) among patients with chronic kidney disease (CKD) without dialysis, but prevalence estimates of PH in CKD without dialysis vary widely in the existing studies. This meta-analysis was to summarize the point prevalence of PH in adults with CKD without dialysis.

Methods

PubMed, EMBASE, the Cochrane Collaboration, and the reference lists of relevant articles were searched to identify eligible studies. We used a random-effect meta-analysis model to estimate the prevalence of PH. Associations were tested in subgroups and meta-regression analyses. We also performed sensitivity analyses and assessments of publishing bias.

Results

Twenty-one observational studies (n?=?8012 participants) were included in this meta-analysis. The result of analysis in random-effect model showed that the pooled prevalence was 32% (95% CI 23–42%), with significant heterogeneity between these studies (I²?=?98%, P?<?0.01). Stratified analyses found that the study design, region, sample size, year of publication, and definition of PH based on PASP?≥?35 mmHg may explain the variation between studies. Sensitivity analysis further demonstrated the results to be robust. There was no evidence of publication bias.

Conclusions

PH is highly prevalent in patients with CKD without dialysis. Owing to the high heterogeneity, future well-designed and large prospective studies are encouraged to confirm the findings and definitively clarify the potential biological mechanisms.