P物质与急、慢性胰腺炎的关系

近10年来的研究发现，胰腺炎时，胰腺中P物质水平及其受体NK－1R的表达均明显增加，与胰腺组织血浆外渗，损害程度以及慢性胰腺炎疼痛关系密切。作者就近年来一些相关文献作一综述，探讨P物质及其受体在胰腺炎发病机制中的作用。     

首发精神障碍家庭照顾者经历的系统评价

目的：系统评价首发精神障碍家庭照顾者的经历,为患者早期康复及照顾者心理健康问题的干预提供循证依据。方法：计算机检索The Cochrane Library、Ovid、PubMed、Embase、Web of Science、CBM、CNKI、VIP和WANFANG DATE数据库,检索时限均从建库至2021年7月31日,使用“JBI循证卫生保健中心质性研究质量评价标准”评价符合纳入标准的文献,并采用汇集性整合法对研究结果进行整合。结果：纳入12篇文献,提炼出60个研究结果,整理成8个类别,得出3个整合结果。分别是多维度的挑战、成长或缺如的角色结局、急需的社会支持。结论：亟需提高全民心理健康素质及去精神障碍疾病污名化,营造患者及家属无障碍化就医环境;关注家庭照顾者早期心理健康的干预,满足其社会支持的需要,提高该类人群应激应对能力,促进照顾者心理康复。     

医源性胆管损伤的诊断和治疗

医源性胆管损伤是腹部手术中一种严重的手术并发症，根据损伤发生的部位和程度，其临床表现、手术治疗的时机以及手术方式都各不相同，处理相当棘手。一旦延误诊断或者处理不当，都将给患者带来灾难性的后果，严重影响患者的生活质量。本文就医源性胆管损伤的诊断及治疗措施予以综述。     

Statistical Methods for the Analysis of Food Composition Databases: A Review

Evidence-based knowledge of the relationship between foods and nutrients is needed to inform dietary-based guidelines and policy. Proper and tailored statistical methods to analyse food composition databases (FCDBs) could assist in this regard. This review aims to collate the existing literature that used any statistical method to analyse FCDBs, to identify key trends and research gaps. The search strategy yielded 4238 references from electronic databases of which 24 fulfilled our inclusion criteria. Information on the objectives, statistical methods, and results was extracted. Statistical methods were mostly applied to group similar food items (37.5%). Other aims and objectives included determining associations between the nutrient content and known food characteristics (25.0%), determining nutrient co-occurrence (20.8%), evaluating nutrient changes over time (16.7%), and addressing the accuracy and completeness of databases (16.7%). Standard statistical tests (33.3%) were the most utilised followed by clustering (29.1%), other methods (16.7%), regression methods (12.5%), and dimension reduction techniques (8.3%). Nutrient data has unique characteristics such as correlated components, natural groupings, and a compositional nature. Statistical methods used for analysis need to account for this data structure. Our summary of the literature provides a reference for researchers looking to expand into this area.     

宫颈癌中医分期辨治研究进展

运用中医学理论,结合现代医学,从中医分期辨证的角度出发,对宫颈癌前病变期、围手术期、放化疗期3个阶段进行概述.根据宫颈癌形成、发展的不同时期,治疗上第一阶段应侧重祛邪为主,佐以补虚;第二阶段应补虚与祛邪并重,同时注重术后并发症的预防与治疗;第三阶段着重扶助正气,兼顾他症.倡导中医药使用不同的治法进行分期论治,提高人们对...     

The Relationship between Fat Mass Percentage and Glucose Metabolism in Children and Adolescents: A Systematic Review and Meta-Analysis

To assess the relationship between fat mass percentage (FMP) and glucose metabolism in children aged 0–18 years we performed a systematic review of the literature on Medline/PubMed, SinoMed, Embase and Cochrane Library using the PRISMA 2020 guidelines up to 12 October 2021 for observational studies that assessed the relationship of FMP and glucose metabolism. Twenty studies with 18,576 individuals were included in the meta-analysis. The results showed that FMP was significantly associated with fasting plasma glucose (FPG) (r = 0.08, 95% confidence interval (CI): 0.04–0.13, p < 0.001), fasting plasma insulin (INS) (r = 0.48, 95% CI: 0.37–0.57, p < 0.001), and homeostasis model assessment (HOMA)- insulin resistance (IR) (r = 0.44, 95% CI: 0.33–0.53, p < 0.001). The subgroup analysis according to country or overweight and obesity indicated that these associations remained significant between FMP and INS or HOMA-IR. Our results demonstrated that there is a positive relationship between FMP and FPG. Moreover, subgroup analysis according to country or overweight and obesity indicated that FMP is significantly associated with INS and HOMA-IR. This is the first known systematic review and meta-analysis to determine the associations of FMP with glucose metabolism in children and adolescents.     

Imaging Findings of Hepatic Ewing’s Sarcoma on Computed Tomography and Gadobenate Dimeglumine-enhanced Magnetic Resonance Imaging: A Case Report and Literature Review

Ewing’s sarcoma (ES) is a tumor that often occurs in the long bones and rarely arises from visceral organs primarily. Here, we report a case of primary hepatic ES, discuss its computed tomography (CT) and gadobenate dimeglumine-enhanced magnetic resonance (MRI) features. This is the first Chinese and fifth primary hepatic ES case reported, based on a literature review. Imaging examinations showed that the tumor was solid, with necrosis and hemorrhage. Contrast-enhanced images showed that the tumor was hypervascular and especially had heterogeneous signal intensity on hepatobiliary phase MRI images. Intratumoral vessels and vascular invasion were also present.     

中药治疗青光眼疗效及安全性的文献系统评价

目的:系统评价分析中药治疗青光眼的有效性和不良反应.方法:检索Medline(1966/2006),EMBASE(1974/2006),中国生物医学文献数据库1978/2006,中文科技期刊全文数据库1977/2006,和中文学术期刊全文数据库1994/2006;并手工检索相关领域杂志.纳入标准以确诊为青光眼患者为研究对象、比较中医药与其它疗法疗效的随机或半随机对照试验,评价纳入研究的质量,并用RevMan4.2.9版软件进行Meta分析.结果:共纳入19篇文献,共1 202例1 651眼.部分中药或中西医结合治疗对改善或恢复青光眼患者的视野损害,可能有一定疗效,但是这种疗效具有选择性.对眼压因研究数较少或文献质量低尚无法确定,对视力有部分研究表明中药对青光眼视力的改善无意义,中药治疗未发现明显的副作用.结论:中药治疗青光眼有一定的疗效,但证据十分有限.     

Positioning the six‐month review in the recovery process post‐stroke: The ideology of personal responsibility

Stroke is the UK's fourth highest cause of death and an estimated 300,000 people in England are living with related disability. This paper explores the six‐month review (6MR), a policy initiative that aimed to ameliorate unmet need. A multiple case study approach underpinned by critical realism was used to elicit the views of patients, carers, providers and commissioners across three sites using interviews, observations and documentation. Forty‐six patients (age range 28–91 years), 30 carers and 28 professionals were interviewed between December 2015 and October 2016. Twenty‐nine reviews were observed. Data was analysed thematically across sites. 6MRs carried out by stroke nurse specialists (SNSs) were found to be more medically orientated than those completed by a Stroke Association (SA) co‐ordinator who focused on social issues. Reviewers regarded reviews primarily as an opportunity to address unmet need and signpost to further services. Patients responded in three different ways: proactive and engaged, reflected an active orientation to recovery and self‐management; proactive and self‐managing on their own terms, encompassed patients who were striving for independence but took their own approach sometimes at odds with that of clinicians; and passive orientation, whereby patients did not engage in rehabilitation or self‐management. Patients identified different priorities to those of reviewers, particularly those with other long‐term conditions and this appeared to contribute to the dissatisfaction that some expressed. In conclusion, there was little evidence that the 6MR played a key role in recovery. Locally defined outcomes for the 6MR reflecting national policy were not substantiated by the findings. Our findings suggest that the 6MR should review therapy goals and facilitate patient‐led goals. Reviewers should be allowed the freedom to individualise the process rather than adhering to a rigid framework dictated by national policy and local protocols.