头针联合工娱治疗对脑卒中后偏瘫的康复预后影响

目的评估头针联合工娱治疗对脑卒中后偏身功能障碍治疗的临床效果。方法选取2015年1月—2018年12月期间大连市友谊医院康复科病房收治的90例脑卒中恢复期存在偏身功能障碍的患者,病程在30~90 d,采取随机的方法,分为头针组30人,工娱组30人;综合组(头针联合工娱治疗组)30人。3组均给予运动疗法训练。头针组予头针治疗;工娱组予工娱治疗;综合组予头针+工娱治疗。治疗周期为4周,采用MAS运动量表进行肢体功能评定,比较3组临床疗效。经过四周的治疗后,三组患者治疗后MAS运动量表评分高于同一组治疗前评分,差异有统计学意义(P<0.05);3组患者治疗后MAS运动量表评分比较,综合组明显高于头针组及工娱组,差异有统计学意义(P<0.01)。结论头针联合工娱治疗可显著改善脑卒中后患者偏身功能障碍。     

布地奈德联合特布他林对慢性阻塞性肺疾病患者肺功能的影响

目的:探究布地奈德与特布他林联合应用于慢性阻塞性肺疾病(COPD)患者中的治疗效果,并探究其对患者肺功能的影响。方法:选取某院2018年4月~2019年3月收治的COPD患者(n=82例)为实验对象,依据不同的治疗方法,将入选患者分为联合组及单一组,每组41例,其中单一组采用特布他林治疗,联合组采用特布他林联合布地奈德治疗。观察两组患者的治疗效果、不良反应及其治疗前后的肺功能改善情况。结果:联合组的治疗总有效率为95.12%,与单一组的75.61%比较,两者差异显著(χ^2=6.248,P<0.05)。联合组治疗后FEV1为(2.46±0.97)L,显著高于单一组[(1.35±0.32)L,P<0.05];FVC为(2.84±0.66)L,显著高于单一组[(2.26±0.15)L,P<0.05];FEV1/FVC为(65.51±8.96),显著高于单一组[(58.31±7.93),P<0.05]。联合组的总不良反应率为7.32%,低于单一组的12.20%,但差异不显著(χ^2=0.554,P>0.05)。结论:布地奈德结合特布他林治疗COPD具有较好的治疗效果,可显著改善患者的肺功能,减少不良反应,安全性高。     

Association of Multiple Plasma Biomarker Concentrations with Progression of Prevalent Diabetic Kidney Disease: Findings from the Chronic Renal Insufficiency Cohort (CRIC) Study

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Comparative Efficacy and Safety of Phosphate Binders in Hyperphosphatemia Patients With Chronic Kidney Disease

Background: In this study, we coordinated a network meta‐analysis to establish the efficacy and safety of different agents used in the treatment of hyperphosphatemia patients with chronic kidney disease. Methods: PubMed, CNKI, and Embase were systematically searched to retrieve relevant studies. Outcomes were presented by mean differences, odds ratios, and corresponding 95% credible intervals for continuous outcomes and binary outcomes, respectively. Each therapy was ranked according to the value of surface under the cumulative ranking curve. Consistencies between direct and indirect comparisons were assessed with a node‐splitting plot. Results: In terms of efficacy end points (including levels of serum phosphate, serum calcium, serum intact parathyroid hormone, and serum calcium × phosphorus product), all 7 kinds of agents outperformed or performed at least equally to placebo, with iron‐based phosphate‐binding agents being potentially the most effective. As for safety end points (including mortality, adverse events, and all‐cause discontinuation), almost all agents were equivalent in term of mortality and all‐cause discontinuation except in the comparison between iron‐based phosphate‐binding agents and placebo. Meanwhile, iron‐based phosphate‐binding agents colestilan and nicotinic acid performed poorly compared with placebo in terms of adverse events. Furthermore, iron‐based phosphate‐binding agents were potentially the safest agents followed sequentially by calcium‐based phosphate‐binding agents and placebo. Conclusion: Iron‐based phosphate‐binding agents were the preferable agents when considering efficacy and safety simultaneously.     

Chronic traumatic stress and chronic pain in the majority world: notes towards an integrative approach

Post Traumatic Stress Disorder (PTSD) and chronic pain have been identified as global health challenges for health professionals, and there is a robust literature linking PTSD and chronic pain. Much of the research is focused on high-income countries, leaving a serious gap when chronic pain is considered globally. Using the concept of Continuous Traumatic Stress (CTS), we look at how broader social conditions impact on the experience of chronic pain. We review the relevant literature on chronic pain, PTSD, and CTS, and suggest a research agenda for a more globally relevant and contextual understanding of chronic pain.