Association of Optimism with Cardiovascular Events and All-Cause Mortality: Systematic Review and Meta-Analysis

BackgroundThe effect of psychological health on cardiovascular disease is an underappreciated yet important area of study. Understanding the relationship between these two entities may allow for more comprehensive care of those with cardiovascular disease. The primary objective of this meta-analysis is to evaluate the relationship between optimism and risk of developing adverse events such as all-cause mortality or fatal and non-fatal cardiovascular disease in community-based populations.MethodA systematic search of electronic databases was conducted from inception through November 2021 for prospective studies evaluating optimism and adverse outcomes. Two reviewers independently selected prospective cohort studies that evaluated optimism and either all-cause mortality or cardiovascular disease and reported hazard ratios of these outcomes between optimistic and non-optimistic groups. Studies that reported odds ratio or other risk assessments were excluded. Pooled hazard ratios were calculated in random-effects meta-analyses.ResultsPooled analysis of six studies (n = 181,709) showed a pooled hazard ratio of 0.87 (95% confidence interval [CI], 0.82-0.92) for all-cause mortality among those with more optimistic mindset. Analysis of seven studies (n = 201,210) showed a pooled hazard ratio of 0.59 (95% CI, 0.37-0.93) for cardiovascular disease and pooled hazard ratio of 0.57 (95% CI, 0.07-4.56) for stroke.ConclusionsIn this pooled meta-analysis, optimism was associated with a reduced risk of all-cause mortality and of cardiovascular disease. These results suggest an important relationship between psychological health and cardiovascular disease that may serve as an area for intervention by clinicians.     

32例新型冠状病毒肺炎患者流行病学和临床特征分析

 目的 探讨武汉外新型冠状病毒肺炎（简称为新冠肺炎）患者流行病学和主要临床特征。方法 收集2020年1月22日—2月28日在某院收治的新冠肺炎确诊病例资料,详细询问患者接触史,比较输入病例与本地病例的临床特征以及实验室检测、影像学检查结果。结果 共纳入32例新冠肺炎确诊患者,包括14例（43.75%）输入病例和18例（56.25%）本地病例。27例（84.38%）患者具有明确的接触史,5例（15.62%）患者接触史不明。家庭聚集（66.67%）为主要传播途径。患者年龄中位数为42（32.5,50.5）岁,女性19例（59.37%）。首发症状主要为干咳（23例,71.88%）、发热（16例,50.00%）和咳痰（13例,40.63%）。潜伏期中位数为6.5（0,9）d,首发症状到确诊中位数为7（4.5,9）d,确诊到出院中位数为12（9,16）d。实验室异常指标包括白细胞计数、淋巴细胞绝对计数、清蛋白、CD4⁺和CD8⁺T淋巴细胞计数降低,C反应蛋白、D-二聚体和纤维蛋白原增高。81.25%（26例）患者肺部双侧受累。输入病例和本地病例的淋巴细胞绝对计数差异具有统计学意义（P=0.044）,其他实验室检查结果无差异（均P>0.05）。32例患者均已治愈出院。结论 该市新冠肺炎疫情处于低流行,主要表现为家庭聚集性传播,输入病例和本地病例的临床特征差异不明显。     

中外循证医学课程教学模式的现状与启示：系统综述

目的 本研究运用定性系统综述的方法对国内外循证医学课程不同教学模式进行评价,为提高我国循证医学教学水平提供依据。方法 系统检索PubMed、Embase、Proquest、Cochrane和Web of Science英文数据库和SinoMed、CNKI、万方和维普中文数据库,筛选循证医学不同教学模式的研究,总结其研究现状。结果 共纳入论文52篇（中文21篇,英文31篇）,共涉及PBL等13种教学模式,其中PBL教学模式是研究最多的教学模式,而且循证医学教学效果与不同教学模式密切相关。结论 目前中外循证医学课程教学模式比较丰富,PBL是最常采用的教学方式,相关原始研究质量较高。     

偏倚风险评估系列:(二)平行设计随机对照试验偏倚评估工具2.0介绍

本文针对平行设计随机对照试验（RCT）Cochrane偏倚评估工具2.0版本（RoB2.0）的主要内容进行介绍,同时对RoB2.0与前一个版本RoB1.0的区别与联系进行阐述,并举例说明RoB2.0的使用方法和注意事项。RoB2.0内容丰富,覆盖全面,为RCT的证据整合与评价提供了更多的偏倚风险信息。RoB2.0仍处于开发与进一步完善中,使用者可持续关注其后续更新与进展。