Disparities in Receipt of Breast and Cervical Cancer Screening for Rural Women Age 18 to 64 with Disabilities

BackgroundPrevious research has found breast and cervical cancer screening disparities between women with and without disabilities, and between women living in rural versus urban areas. Living in a rural area may add to the barriers women with disabilities experience when attempting to obtain screening for breast and cervical cancer. The purpose of this study was to examine the combination of disability status and rurality in association with receipt of breast and cervical cancer screening among women age 18 to 64 in the United States.MethodsWe conducted cross-sectional analyses of data from the Medical Expenditure Panel Survey, using pooled annual data files from 2002 through 2008. We compared recent receipt of breast and cervical cancer screening among four groups: 1) urban women without disabilities, 2) urban women with disabilities, 3) rural women without disabilities, and 4) rural women with disabilities.FindingsOverall, women with disabilities were less likely to be up to date with mammograms and Pap tests compared with women with no disabilities. Similarly, women in rural areas were less likely to have received breast or cervical cancer screening within recommended timeframes. Women who both had a disability and lived in a rural area were the least likely to be current with screening.ConclusionsOur findings suggest that living in rural regions compounds disparities in receipt of cancer screening among women with disabilities. Increased attention is needed to improve receipt of cancer screening among rural women with disabilities.     

The Metabolic Effects of Oats Intake in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis

The present study aimed to comprehensively assess if oats intake is beneficial for diabetic patients. The literature search was conducted in PubMed database up to 23 August 2015. Fourteen controlled trials and two uncontrolled observational studies were included. Compared with the controls, oats intake significantly reduced the concentrations of glycosylated hemoglobin A1c (HbA1c) (MD, −0.42%; 95% CI, −0.61% to −0.23%), fasting blood glucose (FBG) (MD, −0.39 mmol/L; 95% CI, −0.58 to −0.19 mmol/L), total cholesterol (TC) (MD, −0.49 mmol/L; 95% CI, −0.86 to −0.12 mmol/L), low-density lipoprotein cholesterol (LDL-C) (MD, −0.29 mmol/L; 95% CI, −0.48 to −0.09 mmol/L). Oatmeal significantly reduced the acute postprandial glucose and insulin responses compared with the control meal. The present study has revealed a beneficial effect of oats intake on glucose control and lipid profiles in type 2 diabetic patients. Further investigations of oats intake in patients with type 1 diabetes and the safety of oats consumption are required.     

旋覆夏麻芎芍草汤加减治疗慢性咳嗽临床观察

目的:观察旋覆夏麻芎芍草汤加减治疗慢性咳嗽的临床疗效。方法:纳入60例慢性咳嗽(风寒犯肺证)患者,采用随机数字表分为治疗组和对照组,每组30例。对照组患者给予镇咳、化痰等西医常规治疗,治疗组患者给予旋覆夏麻芎芍草汤加减治疗,治疗周期均为3周。评价两组患者的临床疗效,比较两组患者的日间和夜间咳嗽症状评分,采用莱切斯特咳嗽问卷(LCQ)评价患者的生活质量,检测所有患者的用力肺活量(FVC)、第1秒用力呼气容积(FEV_1)占预计值百分比(FEV_1%)、最大呼气流量(PEF)。结果:①治疗后,治疗组患者的临床总有效率为90.0%,对照组为76.7%,治疗组的疗效优于对照组(P0.05)。②治疗后,两组患者的日间和夜间咳嗽症状评分较治疗前均明显降低(P0.01),且治疗组患者的日间和夜间咳嗽症状评分低于对照组(P0.05)。③治疗后,两组患者的LCQ生理、心理、社会维度评分及总分较治疗前均升高(P0.05),且治疗组患者的LCQ生理、心理、社会维度评分及总分高于对照组(P0.05)。④治疗后,两组患者的FVC、FEV_1%、PEF水平较治疗前均显著升高(P0.05),且治疗组患者的FVC、FEV_1%、PEF水平高于对照组(P0.05)。结论:旋覆夏麻芎芍草汤加减治疗慢性咳嗽具有较好的临床疗效,能够有效改善患者的咳嗽症状和肺功能,提高患者的生活质量。     

药物临床试验安全性报告的规范

从药物临床试验的定义及各分期对安全性的要求强调安全性报告的重要性。简单介绍药物临床试验安全性报告的现状,并对CONSORT声明扩展版中针对药物有害性临床试验报告的标准及条目进行解释。     

Endocrine tumours and their significance to anaesthesia

Hormonally active tumours of the endocrine system are uncommon conditions, but they present a considerable anaesthetic challenge. The relative rarity of these tumours has meant that there are few, if any, comparative, controlled trials of one anaesthetic technique against another. Most of the management regimes advocated are based on anecdotal experience, and even though such experience may be considerable, it is difficult to establish one form of anaesthetic management as superior to another. This paper will review currently recommended approaches to the management of secreting endocrine tumours.     

MINITRACHEOSTOMY IN VENTILATORY INSUFFICIENCY

Sputum retention is a very common problem in comatose and postoperative patients. The biochemical changes of hypoxia and hypercarbia associated with it ultimately lead to respiratory failure. Tracheobronchial toilet can be achieved by various methods all of which have their disadvantages. Minitracheostomy has been suggested as the best available method for tracheobronchial toilet Nineteen patients in our series underwent minitracheostomy for tracheobronchial toilet Fifteen patients showed full recovery. The oxygen saturation improved from 85.47% to 98.53%. There were very few complications and the procedure was comfortable and acceptable to patients.     

金芪降糖片治疗2型糖尿病改善胰岛功能的系统评价

[目的]系统评价金芪降糖片治疗2型糖尿病改善胰岛功能的有效性和安全性。[方法]计算机检索中文全文期刊数据库（CNKI）、万方数据库（Wanfang Data）、中国生物医学文献数据库（SinoMed）,英文数据库检索PubMed、Embase、the Cochrane library,检索金芪降糖片治疗2型糖尿病,报告胰岛素敏感性或胰岛素抵抗指数等反应胰岛功能相关指标的随机对照试验（RCTs）。检索时间为建库至2023年6月。由两位研究者独立进行文献筛选、资料提取并,采用Cochrane手册推荐的偏倚风险评估工具对纳入研究进行偏倚风险评价,采用RevMan 5.3.0软件进行统计分析。[结果]研究纳入16个RCTs,包含患者1 306例。主要结局指标结果如下：在降低胰岛素抵抗（HOMA-IR）方面,金芪降糖片联合胰岛素促泌剂优于胰岛素促泌剂单用,组间差异有统计学意义[MD=-0.69,95%CI(-1.04,-0.35)];金芪降糖片联合噻唑烷二酮类（TZDs）优于TZDs单用,组间差异有统计学意义[MD=-0.86,95%CI(-1.06,-0.66)]。在改善胰岛β功能（HOMA-...     

中药注射剂治疗非小细胞肺癌临床试验结局指标文献研究

[目的]分析中药注射剂治疗非小细胞肺癌随机对照试验(RCT)的结局指标,为构建肺癌临床试验的核心指标集提供基础.[方法]计算机检索中国知网数据库(CNKI),万方数据(WanFang),维普数据库(VIP),中国生物医学文献服务系统(SinoMed),Embase,Cochrane library,Web of Sci...