中医药治疗强直性脊椎炎临床研究概况

本文主要综述了国内近十年来强直性脊柱炎的中医药临床治疗状况,概述中医辩证论治、针灸、中药熏蒸、推拿等,并探讨中医药治疗该病目前存在的问题及,临床研究展望。     

脑卒中患者远程康复运动管理有效性及安全性的系统评价再评价

目的 检索、再评价脑卒中患者远程康复运动管理的系统评价,为临床医护人员临床决策及康复运动干预策略的持续改进提供借鉴。 方法 计算机检索Cochrane Library、Embase、PubMed、Web of Science、CINAHL、澳大利亚乔安娜布里格斯研究所（Joanna Briggs Institute,JBI）循证卫生保健中心数据库以及万方数据库、中国知网、维普数据库和中国生物医学文献数据库,查找关于脑卒中患者运动功能远程康复管理相关的系统评价/Meta分析/荟萃分析,检索时限为建库至2021年9月19日。2名经过循证知识系统培训的研究人员应用系统评价方法学质量评价工具（Assessment of Mutiple Systematic Reviews,AMSTAR）对文献进行方法学质量评价后,采用推荐分级的评估、制订与评价（Grades of Recommendations Assessment,Development and Evaluation,GRADE）系统进行证据汇总与分级。 结果 初检文献124篇,纳入文献14篇,AMSTAR质量评价结果显示,中等质量文献有5篇,其余9篇为高等质量,纳入文献的整体方法学质量较高。采用GRADE系统对14篇系统评价的67条主要结局指标的证据质量评价结果显示,22条证据为中等质量,29条证据为低等质量,16条证据为极低质量。 结论 该研究纳入的系统评价方法学质量较高,但其结局指标证据质量较低。远程康复运动管理有利于改善患者的运动功能、生活自理能力及生活质量,可提高患者的满意度与参与度,但远程运动管理干预方式的研究设计及结局指标的客观性仍需改进。     

Effect of acupuncture in eczema: An overview of systematic reviews

BackgroundEczema is a common chronic relapsing inflammatory skin disease, which is characterized by intense itching. Acupuncture can be effective for eczema, and it is thus regarded as a common complementary treatment.ObjectiveThe intention of this overview is to methodically appraise and synthesize evidence about systematic reviews/meta-analyses (SRs/MAs) on acupuncture in eczema.MethodsWe searched for SRs/MAs of acupuncture with eczema in eight databases. We evaluated the methodological quality by Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2), the reporting quality with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020 Checkist), and the evidence quality according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system.ResultsA total of 7 SRs/MAs were included. According to AMSTAR-2, all the SRs/MAs included were categorized as critically low-quality. According to the PRISMA 2020 checklist, none of the reviews completed all the 27 items, thus their compliance was relatively weak. On the base of GRADE system, 2 of the 12 outcomes were rated as moderate, and 5 outcomes were rated as low-quality, while the others were regarded as very low-quality.ConclusionCompared with the control group, the included reviews of the acupuncture group were more effective and safer; however, the conclusion should be treated cautiously because the quality of evidence was not high enough to support it. In order to improve the quality, more rigorous, standardized, and comprehensive SRs/MAs need designing in the future.     

中医治疗排卵障碍性不孕症的临床研究进展

从辨证论治、中药调周、中药配合针灸、中西医结合治疗等4个方面综述了近年来中医治疗排卵障碍性不孕症的概况。并在此基础上进行讨论。结论：中医治疗排卵障碍性不孕有较好的临床疗效。     

发展和完善中的系统评价再评价

语本期新开辟了循证医学方法学的栏目,特别邀请了兰州大学循证医学中心杨克虎教授及其团队就近年来相关系统评价进行再评价的一种综合研究新方法——系统评价再评价(简称Overviews)进行专门介绍,以飨读者。本刊欢迎关于Overviews的文章和循证医学方法学研究文章的投稿,希望有志于上述研究的国内外循证医学方法学专家和临床医生将本刊开辟的循证医学方法学栏目作为学术交流的平台。     

Computer assistance for intraoperative navigation in ENT surgery

The intraoperative need for exact orientation during interventions in the paranasal sinuses and the augmented need for navigational aids in lateral skull base surgery have lead to the development of computer-aided tools during the last fifteen years. These tools, which provide the position of a tool or a pointer in the patient's preoperative radiologic imaging, have quickly gained a wide acceptance for revision surgeries and the surgical treatment of complex pathologies in Ear-, Nose- and Throat (ENT-) surgery. Currently, the use of such systems is spreading from academic centers to smaller hospitals and will become a standard tool in the near future. We review the present state of computer-aided surgery (CAS) systems, based on our experience as clinical and research centers with a long experience in the field, provide some technological background information and, based on selected cases, show the merits of this technology. The systems we have been working with cover a wide variety of intraoperative navigational systems in ENT surgery (Easy Guide, MedScan II, MKM, SNN, STN, SurgiGATE ORL, Treon, VectorVision, Viewing Wand, [without claiming completeness]), and virtually the whole area of ENT surgeries: macroscopic, (video-)endoscopic and microscopic procedures. The 3D tracking technologies involved cover mechanical, optical (active and passive), magnetic and robotic principles. The visualization tools used are computer monitors, video monitors, head-up-displays and the microscope's oculars, thus spanning the area from pointer-systems to real navigators and a surgical telepresence demonstrator, implementing the majority of available patient-to-image referencing strategies. Clinically, the systems can be operated with an acceptable accuracy of around 1?mm, whereas in laboratory settings and in cadaver studies application accuracy may be pushed to its limits: the physical resolution of the radiologic imaging used for navigation.     

中医“痰瘀”证的现代生物学基础

中医痰瘀相关学说萌芽于先秦,发端于晋唐,兴盛于宋元,深化于明清,在中医经典理论痰与瘀血的基础上经历代医家不断发挥、发展而形成的。本文从痰瘀理论的形成和发展、痰瘀的生理和病理基础及临床应用方面进行综述。