内关穴按压改善癌症病人化疗相关性恶心、呕吐效果的Meta分析

[目的]系统评价内关穴按压对缓解癌症病人化疗引起恶心、呕吐症状的临床疗效。[方法]计算机检索Medline、EMbase、Cochrane Library、CINAHL、Web of Science、中国生物医学数据库、万方数据库、中国知网和重庆维普中文科技期刊数据库,检索时间为建库至2018年12月4日,收集内关穴按压缓解癌症病人化疗引起恶心、呕吐症状的随机对照试验研究,采用Revman5. 3软件进行统计学分析。[结果]共纳入11篇文献,涉及癌症化疗病人606例;Meta分析结果显示,与对照组相比,试验组内关穴按压能有效改善癌症病人化疗引起的恶心症状的严重程度[MD=-1. 75,95%CI(-2. 95,-0. 55),P=0. 004]、呕吐症状严重程度[MD=-1. 10,95%CI(-1. 87,-0. 33),P=0. 005]、恶心症状发生频率[MD=-0. 84,95%CI(-1. 37,-0. 31),P=0. 002]、呕吐症状发生频率[MD=-0. 64,95%CI(-1. 24,-0. 05),P=0. 03]和干呕发生频率[MD=-0. 31,95%CI(-0. 53,-0. 09),P=0. 006];而在改善干呕症状的严重程度[MD=-0. 40,95%CI(-0. 90,0. 10),P=0. 12]和呕吐症状经历时间[MD=-0. 52,95%CI(-1. 21,0. 17),P=0. 14]方面效果不明显。[结论]当前证据表明,内关穴按压能改善癌症病人化疗引起恶心、呕吐症状严重程度,降低恶心、呕吐和干呕的发生频率,但在改善干呕严重程度和呕吐经历时间方面效果不明显。     

膝关节周围是否注射镇痛药物对全膝关节置换术后疗效评价的Meta分析

目的通过Meta分析的方法研究膝关节周围混合镇痛药物注射与否(又称"鸡尾酒疗法")对全膝关节置换(TKA)术后疼痛缓解及功能恢复的疗效分析。方法献检索PUBMED、Springer Link、EMBASE、Cochrane library、万方、中国生物医学文献数据库(CBM)、中国知网(CNKI)数据库,收集TKA患者术中是否运用"鸡尾酒疗法"的病例对照相关文献,严格按照满足随机对照试验、干预措施等纳入和排除标准对文献进行筛选,提取相关数据,采用Review Manager 5.3软件进行数据分析。结果最终共纳入随机对照试验10篇。资料分析显示,试验组TKA术后1 d及4 d视觉模拟量表(VAS)评分较低[MD=-1.32,95%CI(-2.26,-0.38),P<0.05;MD=-0.21,95%CI(-0.42,0.00),P=0.05];直腿抬高试验平均所需时间缩短[MD=-22.28,95%CI(-23.58,-20.98),P<0.05];术后关节弯曲可达到90°所需平均时间缩短[MD=-2.49,95%CI(-3.36,-1.62),P<0.05];TKA术后患者恶心、呕吐、尿潴留、深静脉血栓等不良反应下降[RR=0.57,95%CI(0.44,0.72),P<0.05]。结论 "鸡尾酒疗法"可以缓解TKA术后膝关节早期疼痛,改善抬高,减少术后关节弯曲可达到90°所需平均时间,降低TKA术后患者恶心、呕吐、尿潴留、深静脉血栓等不良反应。     

耳穴疗法治疗癌症化疗相关不良反应的Meta分析

目的 探讨耳穴疗法对肿瘤化疗所致的恶心、呕吐和负面情绪的影响。方法 研究者通过Pub Med、Web of Science、Embase、Cochrane、Sino Med、中国知网(CNKI)、万方数据、维普数据库(VIP)，查询了关于耳穴疗法治疗化疗后恶心呕吐的随机对照试验(RCT)，检索时间自建库至2023年4月9日，研究者严格筛选，从中提取有效数据，并运用Revman 5.4软件进行Meta分析。结果 15项文献被纳入本研究，总样本量1 164例，其中实验组577例，对照组587例。Meta分析结果显示，耳穴疗法在临床总有效率[RR=1.33,95%CI(1.24,1.43),Z=7.77,P<0.000 01]、完全缓解率[RR=2.43,95%CI(1.77,3.33),Z=5.54,P<0.000 01]、汉密尔顿焦虑量表(HAMA)评分[MD=-6.76,95%CI(-11.24,-2.28),P=0.003]、汉密尔顿抑郁量表(HAMD)评分[MD=-7.46,95%CI(-10.47,-4.52),P<0.000 01]方面优于对照组。结论 耳穴疗...     

延迟脐带结扎对早产儿短期结局影响的系统评价

[目的]系统评价延迟脐带结扎对早产儿短期结局的影响。[方法]计算机检索国内外有关延迟断脐对早产儿短期结局影响的随机对照试验。严格质量评价后,采用RevMan 5.3软件进行分析。[结果]最终纳入15篇文献,共1 060例病人。Meta分析结果表明,延迟断脐可以提高早产儿出生后24h内的红细胞比容[MD=4.94,95%CI(3.54,6.33),P0.000 01]和血红蛋白水平[MD=20.24,95%CI(12.15,28.34),P0.000 01],降低输血率[OR=0.34,95%CI(0.16,0.72),P=0.005],降低脑室内出血[OR=0.68,95%CI(0.47,0.96),P0.05]和新生儿坏死性小肠结肠炎发生率[OR=0.59,95%CI(0.36,0.97),P0.05],且不提高血清胆红素峰值[MD=0.17,95%CI(-0.52,0.87),P0.05]。[结论]与早期断脐相比,延迟断脐有益于早产儿的短期结局。     

渐进性肌肉放松训练与药物在化疗所致恶心呕吐中应用的比较研究

目的 探讨渐进性肌肉放松训练(PMRT)和引导意想疗法在胃肠道恶性肿瘤化疗所引起恶心和呕吐中的作用.方法 以120例接受FOLFOX方案化疗的胃肠道恶性肿瘤患者为研究对象,分别采用PMRT和引导意想疗法、凯特瑞和胃复安治疗化疗所致的恶心和呕吐,观察其效果,并进行效果分析.结果 急性呕吐组三者防治恶心、呕吐的平均有效率分别为63.6%、90.9%和27.3%;延迟性呕吐组三者防治恶心、呕吐的平均有效率分别为77.8%、33.3%和22.2%,急性呕吐组中PMRT和引导意想疗法与凯特瑞的疗效差异有统计学意义(P＜O.05),凯特瑞与胃复安的疗效有明显的统计学差异;延迟性呕吐组中PMRT和引导意想疗法与凯特瑞、胃复安的疗效有明显的统计学差异,凯特瑞与胃复安的疗效差异无统计学意义.结论 PMRT和引导意想疗法对化疗药物所致的恶心、呕吐有一定的疗效;凯特瑞能有效预防化疗药物所致的急性恶心、呕吐,对延迟性恶心、呕吐有部分疗效;胃复安预防化疗药物所致的恶心、呕吐的效果较差.PMRT和引导意想疗法是肿瘤化疗安全、有效、经济的方法之一.     

耳穴贴压对胆囊切除患者术后胃肠功能恢复影响的Meta分析

目的 :系统评价耳穴贴压在胆囊切除患者术后胃肠功能恢复中应用的效果。方法 :计算机检索CNKI、CBM、VIP、WANFANG Data、Pub Med、EMBASE、SCI和The Cochrane Library数据库中关于耳穴贴压应用于胆囊切除患者的随机对照试验(RCT)。筛选文献、数据提取、纳入文献的评价均由两名评价者独立进行,核对无误后运用Revman 5.3软件进行数据分析。结果 :最终纳入9篇文献,包括1 060例患者。Meta分析结果显示耳穴贴压在肠鸣音恢复时间[MD=-9.45,95%CI(-13.55,-5.35),P=0.01]、肛门首次排气时间[MD=-11.64,95%CI(-15.63,-7.65),P0.001]、首次进食时间MD=-6.50,95%CI(-6.78,-6.22),P0.001]方面与常规疗法相比时间均缩短。耳穴贴压在降低腹胀发生率[OR=0.18,95%CI(0.11,0.28),P0.001]、恶心呕吐发生率[OR=0.26,95%CI(0.11,0.63),P=0.003]、术后疼痛评分[MD=-1.22,95%CI(-2.37,-0.08),P=0.04]方面均优于常规疗法。结论 :耳穴贴压有助于缩短肠鸣音恢复时间、首次排气时间、首次进食时间,降低腹胀和恶心呕吐的发生率,降低患者术后疼痛评分,但仍需要大样本、高质量的RCT进行验证。     

芳香疗法在高危神经母细胞瘤患儿化疗相关恶心呕吐中的应用研究

[目的]探讨芳香疗法对高危神经母细胞瘤(NB)患儿化疗相关恶心呕吐(CINV)的影响。[方法]选取2015年11月—2016年7月就诊于北京儿童医院血液肿瘤中心需要接受大剂量药物联合化疗的高危NB患儿为研究对象,化疗方案包括CAV方案(环磷酰胺+阿霉素+长春新碱)或CVP方案(顺铂+依托泊苷),采用自身前后对照,根据随机数字表将使用相同化疗方案的同一例患儿分别归入试验组和对照组,试验组在药物止吐的基础上给予芳香疗法,对照组仅给予药物止吐,干预及评估天数为5d,使用中文版恶心、呕吐、干呕症状评估量表评价两组患儿恶心、呕吐和干呕3个症状的发生频率、经历时间和发生时的严重程度,评估患儿使用芳香疗法后恶心呕吐的自评结果和患儿对此疗法的可接受程度。[结果]39例患儿纳入研究,共进行化疗76例次,有效72例次,试验组36例次,对照组36例次,应用CAV方案46例次,CVP方案26例次。患儿CINV的经历时间、发生频率和症状严重程度逐渐加重,在化疗第3天~第4天达到高峰,但试验组均低于对照组(除当日外)。试验组恶心呕吐、干呕的症状经历时间、发生频率、严重程度低于对照组,其中症状严重程度差异有统计学意义(P0.05)。应用CAV化疗期间,两组患儿CINV比较差异无统计学意义(P0.05);应用CVP方案期间,试验组第3天恶心的经历时间和发生频率低于对照组(P0.05),第3天~第5天呕吐的严重程度低于对照组(P0.05);第3天~第5天干呕的经历时间和严重程度低于对照组(P0.05)。家长自评结果:5例次(13.9%)患儿使用芳香疗法后恶心呕吐明显好转,25例次(69.4%)好转,4例次(11.1%)没有变化,2例次(5.6%)觉得更加恶心想吐;接受程度上,19例次(52.8%)患儿家长认为芳香疗法非常简单,17例次(47.2%)认为很简单;9例次(25.0%)家长对芳香疗法非常满意,22例次(61.1%)很满意,4例次(11.1%)认为一般,1例次(2.8%)不满意;8例次(22.2%)家长非常希望继续使用,20例次(55.6%)很希望继续使用,7例次(19.4%)一般,1例次(2.8%)不希望继续使用。未见过敏反应。[结论]高危NB患儿CINV在化疗结束当日至结束后1d内发生率最高且最严重,以延迟性恶心呕吐为主;芳香疗法可以缓解高危NB患儿恶心呕吐的严重程度,尤其是缓解CVP化疗期间第3天~第5天干呕的经历时间、严重程度和呕吐的严重程度,家长和年长患儿可以接受。     

腹腔镜和开腹行胰十二指肠切除手术疗效的Meta分析

目的系统评价腹腔镜与传统开腹行胰十二指肠切除术的近期疗效及安全性,为临床治疗提供客观依据。方法通过计算机检索CNKI、WangFang和PubMed(1990~2013.11),收集腹腔镜和传统开腹胰十二指肠切除术疗效和安全性比较的非随机临床对照试验研究。采用Cochrane协作网专用软件Rev Man 5.0对数据进行Meta分析。结果共纳入5篇非随机临床对照试验,合计471例患者。Meta分析结果 :①手术时间:两组比较差异有显著性[MD=105.73,95%CI(16.03,195.44),P=0.02];②术中出血量:两组比较差异有显著性[MD=-446.08,95%CI(-845.35,-46.80),P=0.03];③再次手术率:两组比较差异无显著性[RR=0.8,95%CI(0.28,2.34),P=0.69];④住院时间:两组比较差异无显著性[MD=-2.16,95%CI(-4.90,0.58),P=0.12];⑤围手术期死亡率:两组比较差异有显著性[RR=0.76,95%CI(0.27,2.29),P=0.66];⑥胰漏发生率:两组比较差异无显著性[RR=0.95,95%CI(0.57,1.56),P=0.83];⑦切口感染率:两组比较差异有显著性[RR=0.45,95%CI(0.22,0.92),P=0.03];⑧延迟性胃排空率:两组比较差异无显著性[RR=1.05,95%CI(0.56,1.97),P=0.88]。结论与开腹组相比,腹腔镜组具有术中出血少和切口感染率低,但手术时间较长,而再次手术率、住院时间、、围手术期死亡率、胰漏发生率和延迟性胃排空率无差别,因此该手术可以在有条件且有经验基础的大型医院开展。     

SBAR标准化沟通模式在护理交接班中应用效果的Meta分析

目的评价SBAR标准化沟通模式在护理交接班中的应用效果。方法检索万方数据知识服务平台、CNKI、VIP、CBM、PubMed、Cochrane library、Web of Science、EMBASE和CINAHL数据库,两位研究者独立检索文献、筛选并提取资料,评价纳入文献的质量,双方核对讨论后,采用Rev Man 5.3软件进行统计分析。结果共纳入文献15篇。结果证实:SBAR标准化沟通模式可以缩短交接班平均耗时[MD=-5.95,95%CI(-7.64,-4.26),P0.01];增加护士对患者病情的掌握度:诊断及病情[MD=1.74,95%CI(1.41,2.08),P0.01]、辅助检查[MD=2.37,95%CI(1.96,2.79),P0.01]、治疗护理措施[MD=1.14,95%CI (0.75,1.53),P0.01]、护理重点[MD=1.78,95%CI (1.46,2.10),P0.01];降低护理不良事件的发生率[OR=0.24,95%CI(0.18,0.32),P0.01];提高护士自我效能感[MD=0.50,95%CI(0.39,0.61),P0.01]。结论 SBAR标准化沟通模式在临床护理交接班中缩短交接班平均耗时、增加护士对患者病情的掌握度、降低护理不良事件的发生率、提高护士自我效能感方面效果确切,值得推广。     

悬吊运动疗法治疗慢性非特异性腰痛疗效的Meta分析

目的探讨悬吊运动疗法治疗慢性非特异性腰痛(CNLBP)的临床疗效。方法计算机检索2007年6月至2017年6月CNKI、维普数据库(VIP)、万方数据库、Pub ed、Web of Science、The Cochrane Library及Embase,搜集悬吊运动疗法治疗CNLBP的随机对照试验(RCT)。对纳入文献进行筛选,资料提取,质量评价和风险评估后,采用Rev Man 5.3软件进行Meta分析。结果共纳入15个RCT,789例患者。悬吊运动疗法在改善视觉模拟量表(VAS)评分[MD=-1.15,95%CI(-1.41,-0.90),Z=8.82,P0.00001]和Oswestry腰痛功能障碍指数评定量表(ODI)评分[MD=-1.29,95%CI(-1.80,-0.78),Z=4.94,P0.00001]方面优于物理治疗;悬吊运动疗法在改善VAS评分[MD=-0.94,95%CI(-1.52,-0.37),Z=3.21,P=0.001]和ODI评分[MD=-5.96,95%CI(-9.41,-2.51),Z=3.38,P=0.0007]优于其他运动疗法,但悬吊运动疗法在改善疼痛数字评分量表(NPRS)评分方面与其他运动疗法无显著性差异[MD=0.35,95%CI(-0.23,0.93),Z=1.19,P=0.23];悬吊运动疗法在改善VAS评分方面与中医疗法无显著性差异[MD=-5.29,95%CI(-20.27,9.70),Z=0.69,P=0.49]。结论悬吊运动疗法在一定程度上可以改善患者疼痛和功能受限。因纳入文献数量有限及质量不高,上述确切结论仍需开展大样本高质量的RCT加以验证。     

The Effects of Peppermint Oil on Nausea,Vomiting and Retching in Cancer Patients Undergoing Chemotherapy: An Open Label Quasi–Randomized Controlled Pilot Study

ObjectivesThe current study evaluated the effects of peppermint oil on the frequency of nausea, vomiting, retching, and the severity of nausea in cancer patients undergoing chemotherapy.DesignA quasi-randomized controlled study.SettingPatients were recruited from the ambulatory chemotherapy unit of a public hospital located (Batman, Turkey) between September 2017 and September 2018.InterventionsThe participants in the intervention group applied one drop the aromatic mixture on the spot between their upper lip and their nose, three times a day for the five days following chemotherapy administration, in addition to the routine antiemetic treatment. Participants in the control group underwent only the routine antiemetic treatment. Main outcome measures VAS-the severity of nausea and the Index of Nausea, Vomiting, and Retching.ResultsThe VAS nausea score was significantly lower after peppermint oil applying in the patients receiving Folfirinox (treatment effect (mean dif.): 4.00±2.28; P<0.001), Paclitaxel-Trastuzumab (treatment effect (mean dif.): 1.70±0.90; P=0.014), Carboplatin-Paclitaxel (treatment effect (mean dif.): 3.71±1.41; P<0.001), and Cyclophosphamide-Adriamycin (treatment effect (mean dif.): 1.41±0.73; P=0.005) excluding cisplatin scedule (treatment effect (mean dif.): 0.56±2,18; P=0.642). We detected a statistical significant difference in the change in frequency of nausea, vomiting, retching in the other all schedules excluding cisplatin schedule (P<0.05).ConclusionsThe peppermint oil was significantly reduced the frequency of nausea, vomiting, retching and the severity of nausea in cancer patients undergoing chemotherapy. Therefore, usage of peppermint oil together with antiemetics after chemotherapy with moderate and low emetic risk may be recommended to cope with CINV.     

国内护理干预对乳腺癌患者依从性影响文献的meta分析

目的 评价护理干预对乳腺癌患者化疗依从性、患肢功能锻炼依从性、减轻化疗不良反应及并发症发生率的影响。方法 通过在中国知网全文数据库、中国生物医学文献数据库、万方数据库、山西医科大学移动图书馆检索护理干预对乳腺癌患者依从性影响的随机对照实验的文献,由2名评价员独立检索、筛查文献、提取数据、评价纳入文献的方法学质量并交叉核对后,筛选出符合评价标准的文献,用RevMan 5.0软件进行meta分析。结果 共纳入8篇文献,累计病例732例。Meta分析结果显示,护理干预有助于提高乳腺癌患者化疗依从性[OR=5.79,95%CI(2.59,12.93),P<0.001];肢体功能锻炼依从性[OR=5.57,95%CI(2.59,11.99),P<0.001];减轻化疗引起的恶心、呕吐[OR=0.28,95%CI(0.12,0.68),P<0.005]、口腔溃疡[OR=0.18,95%CI(0.05,0.69),P=0.01]、降低静脉炎的发生率[OR=0.18,95%CI(0.04,0.85),P=0.03],而肢体肿胀发生率方面差异无统计学意义[OR=0.42,95%CI(0.12,1.41),P=0.16]。结论 护理干预能改善乳腺癌患者化疗、患肢功能锻炼依从性,减轻化疗不良反应及静脉炎的发生,从而提高患者的生存质量。     

老年人桡骨远端骨折治疗后腕关节屈伸及旋转活动的Meta分析

背景：目前老年桡骨远端骨折是否需切开复位钢板内固定以恢复影像学上的解剖复位还存在争议。目的：对老年人桡骨远端骨折手术与非手术治疗的疗效进行系统评价。 方法：计算机检索 PubMed,Springer 以及万方等数据库,手工检索相关的中英文骨科杂志。收集所有对手术与非手术治疗老年人桡骨远端骨折疗效进行比较的文献。利用Cochrane协作网提供的RevMan5.0软件进行统计学分析。 结果与结论：共纳入符合标准的文献6篇,其中随机对照研究2篇,回顾性队列研究4篇。Meta分析结果显示：两组腕关节背伸活动度[MD=-0.87,95% CI（-3.31,1.58）, P=0.49],屈曲活动度[MD=-2.79,95%CI（-6.47,0.88）,P=0.14],旋前活动度[MD=-0.08,95%CI（-1.49,1.64）,P=0.92],旋后活动度[MD=-0.7,95%CI（-3.52,2.12）,P=0.63]以及并发症的发生[MD=1.35,95%CI（0.71,2.56）,P=0.36]差异均无显著性意义;手术组桡骨长度更接近于正常的解剖长度[MD=2.46,95% CI（1.78,3.15）,P 〈0.01];手术组尺倾角[MD=3.73,95%CI（2.97,4.48）,P〈0.00001]以及掌倾角[MD=6.81,95%CI（3.72,9.90）,P〈0.0001]更接近于正常的解剖角度。两组患肢腕关节屈伸,旋前旋后活动度以及并发症的发生差异均无显著性意义,而手术组解剖复位程度明显优于非手术组。     

风险分级管理模式对糖尿病足溃疡预防效果的Meta分析

目的：评价风险分级管理模式对糖尿病足溃疡的预防效果。方法：运用Meta分析法,检索中英文数据库搜集风险分级管理模式对糖尿病足溃疡预防效果的临床随机对照试验,参照Cochrane系统评价手册5.1.0进行文献质量评价,采用RevMan 5.3软件进行Meta分析。 结果：最终纳入8篇随机对照试验（RCT）研究,1295例研究对象。相较于对照组,风险分级管理模式降低了3% 的糖尿病足溃疡发生风险,差异有统计学意义[RD=-0.03, 95%CI(-0.05,0.00), P=0.04]。风险分级管理组的动脉踝肱指数（ABI）高于对照组,差异有统计学意义（P＜0.001）。同时,风险分级管理组的运动神经传导速度[MD=3.53, 95%CI(2.02,5.05), P<0.01]和感觉神经传导速度[MD=4.53, 95%CI（2.93,6.13）,P<0.01]优于对照组,且有统计学意义。结论：风险分级管理模式在糖尿病足溃疡预防的应用效果显示出优越性。相较于常规健康管理,该管理模式可以降低DF的发病率,明显改善患者动脉血管及周围神经状况。     

昂丹司琼预防术后寒战的效果和安全性的Meta分析

目的 系统评价昂丹司琼预防术后寒战的效果和安全性。 方法 根据Cochrane系统评价方法,计算机检索Cochrane图书馆、OVID、EMbase、PubMed、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、万方等数据库,搜索时限1999年1月－2013年9月,收集与昂丹司琼预防术后寒战相关的随机对照试验（RCT）,按纳入和排除标准筛选文献,采用RevMan 5.0软件进行Meta分析。 结果 共纳入9个RCT,包括665例患者。Meta分析显示手术结束前静脉推注昂丹司琼组比手术结束前静脉推注生理盐水术后寒战发生率低[RR=0.32,95%CI（0.24,0.42）,P＜0.05];术后恶心呕吐发生率手术结束前静脉推注昂丹司琼组比手术结束前静脉推注生理盐水低[RR=0.30,95%CI（0.14,0.63）,P＜0.05],新生儿出生后1 min Apgar评分、5 min Apgar评分昂丹司琼组和生理盐水组差异无统计学意义[WMD=0.03分,95%CI（？0.02,0.09） 分,P=0.26;WMD=？0.02分,95%CI（？0.12,0.08）分,P=0.68]。 结论 术前静脉推注昂丹司琼能明显降低患者术后寒战的发生率,且明显降低术后恶心呕吐发生率,不良反应少。     

Validation and psychometric assessment of a short clinical scale to measure chemotherapy-induced nausea and vomiting: the MASCC antiemesis tool

There is a lack of clinical tools to facilitate communication between clinicians and patients about chemotherapy-induced nausea and vomiting (CINV). The Multinational Association of Supportive Care in Cancer (MASCC) has developed such a tool, which is an eight-item scale for the assessment of acute and delayed nausea and vomiting, and is completed once per cycle of chemotherapy. The aim of the current study was to assess its psychometric properties, specifically reliability and validity, cultural transferability and equivalence, and congruence with proxy assessments, as well as to determine if accuracy of recall of CINV events using the MASCC Antiemesis Tool (MAT) differed over time from chemotherapy. A prospective study was carried out with adult cancer patients and their informal carers from two hospitals, one each in the United Kingdom (UK) and United States of America (U.S.). Patients completed the Rhodes Index for nausea, vomiting and retching (INVR) daily for the first five days after chemotherapy and were then asked to complete the MAT at one week, two weeks, or three weeks after chemotherapy. Carers completed an adapted MAT concurrently with patients. The sample consisted of 87 patients and 22 informal carers. The internal consistency reliability of the scale was high, with Cronbach alphas of 0.77 (patient sample) and 0.82 (carer sample). Responses were similar between the UK and U.S. samples in terms of nausea and vomiting, and both samples found the scale easy to use. Contrasted-groups validity (using age as a grouping variable) and concurrent validity (MAT compared with INVR) suggested that the scale is sensitive to detect the different dimensions of CINV and performed well against a daily assessment of nausea/vomiting (total score correlation r=0.86, P<0.001). Recall of events was high even three weeks after chemotherapy (correlations with INVR of 0.44-0.99, all P<0.01). Factor analysis clearly identified three factors, namely vomiting, acute nausea, and delayed nausea. Proxy assessments by carers were congruent with the patients' responses, especially in relation to vomiting. The MAT is a reliable, valid, clear, and easy-to-use clinical tool that could facilitate discussion between clinicians and patients about their nausea and vomiting experience, thereby potentially aiding treatment decisions. Regular assessment of nausea and vomiting after chemotherapy has the potential to significantly improve CINV management.     

八段锦对轻度认知障碍患者记忆力影响的系统评价与Meta分析

目的系统评价八段锦对轻度认知障碍(mild cognitive impairment,MCI)患者记忆力的康复效果。方法计算机检索数据库中与八段锦对MCI患者记忆力影响有关的临床随机对照试验,纳入的文献使用Cochrane系统评价手册中的文献质量评价标准进行质量评价,记忆力相关指标运用RevMan 5.4软件进行Meta分析。结果最终纳入9篇研究,共计588例,Meta分析结果显示,八段锦干预后,MCI患者的AVLT延时回忆评分[MD=2.49,95%CI(2.11,2.86),P<0.001],延时再认评分[MD=1.65,95%CI(1.35,1.96),P<0.001],即刻回忆中第一遍回忆评分[MD=1.94,95%CI(1.14,2.73),P<0.001],即刻回忆中第二遍回忆评分[MD=2.00,95%CI(1.15,2.84),P<0.001],即刻回忆中第三遍回忆评分[MD=2.30,95%CI(1.44,3.15),P<0.001];WMS-RC理解记忆[MD=1.83,95%CI(1.35,2.30),P<0.001],图片回忆[MD=2.00,95%CI(1.28,2.72),P<0.001],联想记忆[MD=1.73,95%CI(1.13,2.33),P<0.001],背数[MD=1.60,95%CI(0.90,2.31),P<0.001],心智1-100[MD=1.95,95%CI(0.62,3.29),P=0.004],心智100-1[MD=1.71,95%CI(0.28,3.14),P=0.02],图片再认[MD=1.74,95%CI(0.46,3.01),P=0.008]。与对照组相比差异均具有统计学意义(P<0.05)。结论八段锦可有效改善MCI患者的记忆力。     

持续静脉-静脉血液滤过联合血液灌流治疗高脂血症性急性胰腺炎疗效的系统评价

目的系统评价持续静脉-静脉血液滤过（CVVH）联合血液灌流（HP）治疗高脂血症性急性胰腺炎（HLAP）的疗效。 方法计算机检索Cochrane Library、PubMed、维普科技期刊数据库、万方数据库、中国知网数据库自建库至2018年12月发表的关于CVVH联合HP治疗HLAP疗效的临床随机对照试验（RCT）。由2位研究者按照纳入与排除标准独立进行文献筛选、资料提取和质量评价后,采用Review Manager 5.1软件进行Meta分析。 结果最终纳入10篇RCT,共有687例患者,其中试验组（CVVH联合HP治疗）患者343例,对照组（CVVH治疗）患者344例。Meta分析结果显示,与对照组比较,试验组患者治疗后血清甘油三酯水平[均数差（MD）=-7.37,95%置信区间（CI）（-10.54,-4.20）,Z = 4.55,P < 0.000 01]、住院病死率[相对危险度= 0.43,95%CI（0.26,0.71）,Z = 3.32,P = 0.000 9],急性病生理学和长期健康评价Ⅱ评分[MD =-1.93,95%CI（-2.63,-1.23）,Z = 5.40,P < 0.000 01],血清肿瘤坏死因子α水平[MD = -67.21,95%CI（-98.88,-35.54）,Z = 4.16,P < 0.000 1]及血清白细胞介素6水平[MD = -50.60,95%CI（-62.91,-38.28）,Z = 8.05,P < 0.000 1]均显著降低。 结论在常规治疗的基础上,CVVH联合HP治疗HLAP的疗效优于单用CVVH治疗。     

Phase II trial of encapsulated ginger as a treatment for chemotherapy-induced nausea and vomiting

Goals of work  Ginger has been used to treat numerous types of nausea and vomiting. Ginger has also been studied for its efficacy for acute chemotherapy-induced nausea and vomiting (CINV). However, its efficacy for delayed CINV in a diverse oncology population is unknown. Materials and methods  We performed a randomized, double-blind, placebo-controlled trial in 162 patients with cancer who were receiving chemotherapy and had experienced CINV during at least one previous round of chemotherapy. All participants were receiving a 5-HT₃ receptor antagonists and/or aprepitant. Participants were randomized to receive either 1.0 g ginger, 2.0 g ginger daily, or matching placebo for 3 days. The primary outcome was change in the prevalence of delayed CINV. Secondary outcomes included acute prevalence of CINV, acute and delayed severity of CINV, and assessment of blinding. Main results  There were no differences between groups in the prevalence of delayed nausea or vomiting, prevalence of acute CINV, or severity of delayed vomiting or acute nausea and vomiting. Participants who took both ginger and aprepitant had more severe acute nausea than participants who took only aprepitant. Participants were able to accurately guess which treatment they had received. Ginger appeared well tolerated, with no difference in all adverse events (AEs) and significantly less fatigue and miscellaneous AEs in the ginger group. Conclusions  Ginger provides no additional benefit for reduction of the prevalence or severity of acute or delayed CINV when given with 5-HT₃ receptor antagonists and/or aprepitant. This trial is registered in ClinicalTrials.gov ID: NCT00065221.