We herein present a case involving a 41-year-old woman in whom ultrasound examination revealed multiple liver hemangiomas more than 3 years ago.Follow-up ultrasound examination revealed that the masses had significant...We herein present a case involving a 41-year-old woman in whom ultrasound examination revealed multiple liver hemangiomas more than 3 years ago.Follow-up ultrasound examination revealed that the masses had significantly increased;the largest was located in the right lobe(about 8.2 cm×7.4 cm×6.0cm).Abdominal multidetector computed tomographyrevealed multiple well-circumscribed,heterogeneous,hypodense masses(largest,6.4 cm×6.3 cm×5.0cm)with significant contrast enhancement during the arterial and portal phases and with contrast washout and peripheral enhancement during the delayed phases.Magnetic resonance images demonstrated multiple well-circumscribed,heterogeneous,hypointense hepatic masses with significant contrast enhancement(largest,6.4 cm×6.5 cm×5.1 cm);multiple enlarged porta lymph nodes;and multiple s l i g h t l y e n l a rg e d re t ro p e r i t o n e a l l y m p h n o d e s.Histological and immunohistochemical examination of the right mass biopsy specimen suggested a malignant neoplasm that had originated from a neuroendocrine cell type(grade 2 well-differentiated neuroendocrine carcinoma).After performing a systemic examination to exclude metastasis from an extrahepatic primary site,we considered that the masses had arisen from a primary hepatic neuroendocrine tumor with multiple liver metastases.The patient underwent transcatheter arterial chemoembolization using a combination of oxaliplatin(150 mg)mixed with one bottle of gelatin sponge particles(560-710μm)and lipiodol(6 m L).Primary neuroendocrine tumors of the liver are extremely rare.This case is interesting because of the rarity of this neoplasm and previous misdiagnosis as multiple liver hemangiomas.Previously reported cases in the literature are also reviewed.展开更多
Breast cancer can metastasize to other organs following initial treatment.Bones, liver, and the lung are the most common sites of breast cancer metastases.The digestive tract, on the other hand, is rarely involved.The...Breast cancer can metastasize to other organs following initial treatment.Bones, liver, and the lung are the most common sites of breast cancer metastases.The digestive tract, on the other hand, is rarely involved.The incidence of mesorectal metastasis(a special category of rectal metastases) from breast cancer has not been described before.The case reported herein concerns a 68-year-old woman who underwent mastectomy.A pelvic mass with no symptoms was subsequently identified by computed tomography in the patient.We ultimately confirmed that this mass was a metastasis from breast cancer located in the mesorectum using surgical exploration and pathology results.展开更多
Objective:To evaluate the value of18F-fluorodeoxyglucose positron emission tomography/computed tomography(18F-FDG PET/CT)in the diagnosis of cervical lymph node metastasis of oral carcinoma.Methods:China national know...Objective:To evaluate the value of18F-fluorodeoxyglucose positron emission tomography/computed tomography(18F-FDG PET/CT)in the diagnosis of cervical lymph node metastasis of oral carcinoma.Methods:China national knowledge infrastructure,Wanfang,Chinese sci-tech journal database,PubMed,EMbase,the Cochrane Library and Web of Science were searched for18F-FDG PET/CT in cervical lymph node metastasis oral cancer.Literature screening,data extraction and literature quality evaluation were carried out independently by two researchers according to the unified classification criteria.Stata13.0 software and Meta-Disc1.4 software were used for meta-analysis.Results:A total of 14 studies with 849 cases of patients with cervical metastasis of oral cancer were included,among which 9 studies were conducted on patients,with a total of 299 patients,and 5 studies were conducted on lymph nodes,with 1965 patients with cervical lymph node proved pathologically.The results of meta analysis showed that18F-FDG PET/CT had good sensitivity and specificity in the diagnosis of cervical lymph node metastasis of oral cancer.The results showed that sensitivity=0.81(95%CI:0.73-0.87),specificity=0.90(95%CI:0.83-0.94),combined likelihood ratio=7.9(95%CI:4.9-12.7),negative likelihood ratio=0.21(95%CI:0.15-0.30),diagnostic odds ratio=37(95%CI:20-67),and receiver operating characteristic curve=0.91(95%CI:0.89-0.94).Conclusions:18F-FDG PET/CT has high sensitivity and specificity in the diagnosis of cervical lymph node metastasis,and can be used as an important preoperative evaluation method for oral cancer.展开更多
目的系统评价妊娠早期循环metastin/kisspeptin水平与自然流产(SAB)的相关性。方法计算机检索PubMed、EMbase、The Cochrane Library、Web of Science、中国知网、万方、维普中文科技期刊数据库和中国生物医学文献数据库,搜集有关妊娠...目的系统评价妊娠早期循环metastin/kisspeptin水平与自然流产(SAB)的相关性。方法计算机检索PubMed、EMbase、The Cochrane Library、Web of Science、中国知网、万方、维普中文科技期刊数据库和中国生物医学文献数据库,搜集有关妊娠早期循环kisspeptin水平与SAB相关性的研究,检索文献的时间设置均为从建库至2020年6月。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan5.3软件进行meta分析。结果共纳入3个巢式病例对照研究、2个病例对照研究和1个前瞻性队列研究,包括SAB患者157例,作为对照的正常宫内妊娠(IUP)孕妇1018例。meta分析显示,SAB组kisspeptin水平低于IUP组[SMD=-1.68,95%CI:-2.65~-0.72,P=0.0006]。结论循环metastin/kisspeptin水平降低与SAB有一定相关性,受纳入研究数量和质量的限制,上述结论尚待更多高质量研究予以验证。展开更多
In microwave communication systems,focusing and imaging have attracted widespread attention due to their application prospects in the information processing and communication fields.Most existing multi-channel focusin...In microwave communication systems,focusing and imaging have attracted widespread attention due to their application prospects in the information processing and communication fields.Most existing multi-channel focusing and imaging are implemented by interleaved metasurfaces.However,the disadvantages of their large size and low efficiency limit their practical applications in large-capacity and low-loss integrated systems.To solve these issues,here,we propose a non-interleaved polarization-frequency multiplexing metasurface for high-efficiency multi-channel focusing and imaging.The meta-atoms of the non-interleaved metasurface are composed of a metallic ground plate,two dielectric layers,a larger cross-shaped metal structure,and a smaller cross-shaped metal structure embedded by a circular metal aperture.By altering the size of two cross-shaped structures,the designed meta-atom can obtain the independent complete 2π phase coverage with high reflection efficiency at two different frequency ranges for two orthogonal linear polarization(LP)incidences,realizing polarization multiplexing and frequency multiplexing.Moreover,two types of metasurfaces based on the above meta-atoms are designed to realize multi-channel focusing and imaging with high efficiency.As a proof,the focusing metasurface is fabricated and measured,and the measured results are well consistent with simulated results.Therefore,the proposed scheme has the advantages of high efficiency,multi-channel,and compact size,which possesses broad application prospects in low-loss and multichannel communication integrated systems.展开更多
To the Editor:In recent years,the treatment for metastatic hormone-sensitive prostate cancer(mHSPC)has undergone rapid developments.Docetaxel(DOC)or androgen receptor-targeted agent(ARTA)and androgen deprivation thera...To the Editor:In recent years,the treatment for metastatic hormone-sensitive prostate cancer(mHSPC)has undergone rapid developments.Docetaxel(DOC)or androgen receptor-targeted agent(ARTA)and androgen deprivation therapy(ADT)are the most commonly used systemic therapies.Multiple meta-analyses or network meta-analyses(NMAs)have been undertaken to evaluate and contrast the various treatment options available for mHSPC.However,the clinical efficacy of DOC in triplet therapy for mHSPC is yet to be confirmed,especially in categorizing the patients based on both volume of disease and timing of metastases.Bringing these controversies to light may have a timely and important impact on further clinical trials.Moreover,based on these trials and our NMA study,triplet therapy has evident benefits on overall survival(OS)and progression-free survival(PFS)in patients with mHSPC.The NMA study presented in this thesis is one of the first studies that assessed the efficacy of DOC and selected patients who will benefit from triplet therapy.展开更多
In modern science and technology,on-demand control of the polarization and wavefront of electromagnetic(EM)waves is crucial for compact opto-electronic systems.Metasurfaces composed of subwavelength array structures i...In modern science and technology,on-demand control of the polarization and wavefront of electromagnetic(EM)waves is crucial for compact opto-electronic systems.Metasurfaces composed of subwavelength array structures inject infinite vitality to shape this fantastic concept,which has fundamentally changed the way humans engineer matter–wave interactions.However,achieving full-space arbitrarily polarized beams with independent wavefronts in broadband on a single metasurface aperture still remains challenging.Herein,the authors propose a generic method for broadband transmission-reflection-integrated wavefronts shaping with multichannel arbitrary polarization regulation from 8 to 16 GHz,which is based on the chirality effect of full-space non-interleaved tetrameric meta-molecules.Through superimposing eigen-polarization responses of the two kinds of enantiomers,the possibility for high-efficiency evolution of several typical polarization states with specific wavefronts is demonstrated.As proofs-of-concept,the feasibility of our methodology is validated via implementing miscellaneous functionalities,including circularly polarized(CP)beam splitting,linearly polarized(LP)vortex beams generation,and CP and LP multifoci.Meanwhile,numerous simulated and experimental results are in excellent agreement with the theoretical predictions.Encouragingly,this proposed approach imaginatively merges broadband polarization and phase control into one single full-space and shared-aperture EM device,which can extremely enhance the functional richness and information capacity in advanced integrated systems.展开更多
目的基于Meta分析方法讨论中成药联合替格瑞洛治疗冠心病心绞痛的有效性。方法检索中英文数据库,包括中国知网、万方、维普、PubMed、Embase和Web of Science等,筛选中成药联合替格瑞洛治疗冠心病心绞痛的随机对照试验,检索时间为建库至...目的基于Meta分析方法讨论中成药联合替格瑞洛治疗冠心病心绞痛的有效性。方法检索中英文数据库,包括中国知网、万方、维普、PubMed、Embase和Web of Science等,筛选中成药联合替格瑞洛治疗冠心病心绞痛的随机对照试验,检索时间为建库至2024年12月。采用RevMan5.3软件对纳入的文献进行数据分析及绘图。结果共纳入24篇文献,Meta分析结果提示:与对照组比较,试验组的治疗总有效率升高,每周发作次数和发作持续时间显著降低(P<0.00001)。结论中成药联合替格瑞洛可以提高冠心病心绞痛患者的治疗总有效率,明显减少心绞痛每周发作次数与发作持续时间,这对于缓解患者症状、提升生活质量具有积极意义。展开更多
目的:探讨髓芯减压联合不同治疗策略对早中期股骨头坏死患者的疗效及安全性评价。方法:系统检索PubMed、Web of Science、Cochrane Library、EMbase、中国知网、维普、万方和中国生物医学文献数据库,纳入截至2025-01-19发表的关于髓芯...目的:探讨髓芯减压联合不同治疗策略对早中期股骨头坏死患者的疗效及安全性评价。方法:系统检索PubMed、Web of Science、Cochrane Library、EMbase、中国知网、维普、万方和中国生物医学文献数据库,纳入截至2025-01-19发表的关于髓芯减压联合治疗早中期股骨头坏死的随机对照试验。采用Cochrane偏倚风险评估工具对文献质量进行评价,运用GRADE系统评价证据等级,基于贝叶斯框架构建网状Meta分析模型。采用标准化均数差进行效应估计,结果以累积排序概率曲线下面积进行干预优效性排序。敏感性分析采用逐项剔除法评估模型稳健性,并通过基线协变量评估传递性假设。结果:最终纳入73项随机对照试验,共计5148例患者、5777个髋关节,涵盖15种联合治疗方法。结果显示:①在提高综合临床疗效方面,髓芯减压联合自体骨髓单核细胞浓缩注射、骨髓间充质干细胞移植、支撑性植骨及补肾活血类中药复方汤剂等均优于单纯髓芯减压,其中髓芯减压联合自体骨髓单核细胞浓缩注射显示出最优的干预效果(累积排序概率曲线下面积=96.23%);②在髋关节功能改善方面,髓芯减压联合中医药序贯治疗疗效最优(累积排序概率曲线下面积=93.85%);③在疼痛缓解方面,髓芯减压联合中成药(补肾活血+活血化瘀)与活血化瘀类中药复方汤剂效果突出;④在影像学改善方面,髓芯减压联合自体源性干细胞局部植入效果最佳(累积排序概率曲线下面积=82.56%);⑤在临床安全性方面,髓芯减压联合活血化瘀类中药复方汤剂在降低不良事件发生率方面具有相对优势(P<0.05)。为评估结果稳健性,采用逐项剔除法进行敏感性分析,显示模型稳定,主要干预结果对单项研究不敏感,传递性假设成立。结论:髓芯减压联合干细胞移植、中医药序贯治疗等多种治疗方案在改善早中期股骨头坏死临床疗效方面优于单纯髓芯减压,表现为关节功能保护、结构重建与疼痛控制等多重优势。考虑部分干预文献数量有限及研究质量差异,仍需高质量、多中心、大样本随机对照试验进一步验证。展开更多
背景跌倒是老年人的常见和严重的问题之一,跌倒效能是跌倒的重要影响因素,提高老年人跌倒效能的运动方式多样但各种运动干预效果的优劣尚无定论。目的分析比较不同运动方式对老年人跌倒效能的影响,旨在为患者选择最佳运动方式提供参考...背景跌倒是老年人的常见和严重的问题之一,跌倒效能是跌倒的重要影响因素,提高老年人跌倒效能的运动方式多样但各种运动干预效果的优劣尚无定论。目的分析比较不同运动方式对老年人跌倒效能的影响,旨在为患者选择最佳运动方式提供参考。方法计算机检索中国知网、万方数据知识服务平台、维普网、SinoMed、PubMed、CINAHL、Web of Science、Embase、Cochrane Library、FMRS等数据库中关于运动提高老年人跌倒效能的相关文献,检索时限为建库至2025-08-15。结局指标为国际版跌倒效能量表(FES-I)、Berg平衡量表(BBS)、计时起立-行走测试(TUGT)。采用Cochrane偏倚评估工具进行文献质量评价,采用Stata 18.0软件进行网状Meta分析,采用累积概率排名曲线下面积(SUCRA)对不同方案的效果进行排名。结果共纳入35项研究,包括2627例研究对象、13种运动方式。在跌倒效能方面,奥塔戈(MD=8.94,95%CI=3.51~14.38)、太极拳(MD=9.24,95%CI=4.96~13.51)、方步运动(MD=8.60,95%CI=2.56~14.64)、普拉提(MD=6.86,95%CI=1.19~12.53)的效果优于常规护理组(P<0.05),太极拳成为最佳干预措施的可能性最大(SUCRA=81.2)。在平衡功能方面,奥塔戈(MD=3.87,95%CI=2.71~5.02)、太极拳(MD=3.87,95%CI=1.71~6.03)、抗阻+平衡训练(MD=3.26,95%CI=0.53~6.00)的效果优于常规护理组(P<0.05),奥塔戈成为最佳干预措施的可能性最大(SUCRA=68.1)。在移动能力方面,奥塔戈(MD=3.90,95%CI=2.77~5.04)、太极拳(MD=4.44,95%CI=3.50~5.39)、八段锦(MD=2.25,95%CI=1.47~3.02)、八卦掌(MD=2.35,95%CI=1.26~3.43)、步态平衡操(MD=3.60,95%CI=2.15~5.05)的效果优于常规护理组(P<0.05),太极拳成为最佳干预措施的可能性最大(SUCRA=95.0)。结论太极拳、奥塔戈运动在改善老年人跌倒效能、平衡功能、移动能力方面效果较好。临床医护人员应结合老年人健康状况及需求,合理选择运动方式,以提高老年人跌倒效能,有效预防跌倒,促进患者健康。未来仍需进一步开展更多高质量的研究以验证此结论。展开更多
文摘We herein present a case involving a 41-year-old woman in whom ultrasound examination revealed multiple liver hemangiomas more than 3 years ago.Follow-up ultrasound examination revealed that the masses had significantly increased;the largest was located in the right lobe(about 8.2 cm×7.4 cm×6.0cm).Abdominal multidetector computed tomographyrevealed multiple well-circumscribed,heterogeneous,hypodense masses(largest,6.4 cm×6.3 cm×5.0cm)with significant contrast enhancement during the arterial and portal phases and with contrast washout and peripheral enhancement during the delayed phases.Magnetic resonance images demonstrated multiple well-circumscribed,heterogeneous,hypointense hepatic masses with significant contrast enhancement(largest,6.4 cm×6.5 cm×5.1 cm);multiple enlarged porta lymph nodes;and multiple s l i g h t l y e n l a rg e d re t ro p e r i t o n e a l l y m p h n o d e s.Histological and immunohistochemical examination of the right mass biopsy specimen suggested a malignant neoplasm that had originated from a neuroendocrine cell type(grade 2 well-differentiated neuroendocrine carcinoma).After performing a systemic examination to exclude metastasis from an extrahepatic primary site,we considered that the masses had arisen from a primary hepatic neuroendocrine tumor with multiple liver metastases.The patient underwent transcatheter arterial chemoembolization using a combination of oxaliplatin(150 mg)mixed with one bottle of gelatin sponge particles(560-710μm)and lipiodol(6 m L).Primary neuroendocrine tumors of the liver are extremely rare.This case is interesting because of the rarity of this neoplasm and previous misdiagnosis as multiple liver hemangiomas.Previously reported cases in the literature are also reviewed.
基金Supported by Affiliated Zhongshan Hospital of Dalian University,Dalian,Liaoning,China
文摘Breast cancer can metastasize to other organs following initial treatment.Bones, liver, and the lung are the most common sites of breast cancer metastases.The digestive tract, on the other hand, is rarely involved.The incidence of mesorectal metastasis(a special category of rectal metastases) from breast cancer has not been described before.The case reported herein concerns a 68-year-old woman who underwent mastectomy.A pelvic mass with no symptoms was subsequently identified by computed tomography in the patient.We ultimately confirmed that this mass was a metastasis from breast cancer located in the mesorectum using surgical exploration and pathology results.
文摘Objective:To evaluate the value of18F-fluorodeoxyglucose positron emission tomography/computed tomography(18F-FDG PET/CT)in the diagnosis of cervical lymph node metastasis of oral carcinoma.Methods:China national knowledge infrastructure,Wanfang,Chinese sci-tech journal database,PubMed,EMbase,the Cochrane Library and Web of Science were searched for18F-FDG PET/CT in cervical lymph node metastasis oral cancer.Literature screening,data extraction and literature quality evaluation were carried out independently by two researchers according to the unified classification criteria.Stata13.0 software and Meta-Disc1.4 software were used for meta-analysis.Results:A total of 14 studies with 849 cases of patients with cervical metastasis of oral cancer were included,among which 9 studies were conducted on patients,with a total of 299 patients,and 5 studies were conducted on lymph nodes,with 1965 patients with cervical lymph node proved pathologically.The results of meta analysis showed that18F-FDG PET/CT had good sensitivity and specificity in the diagnosis of cervical lymph node metastasis of oral cancer.The results showed that sensitivity=0.81(95%CI:0.73-0.87),specificity=0.90(95%CI:0.83-0.94),combined likelihood ratio=7.9(95%CI:4.9-12.7),negative likelihood ratio=0.21(95%CI:0.15-0.30),diagnostic odds ratio=37(95%CI:20-67),and receiver operating characteristic curve=0.91(95%CI:0.89-0.94).Conclusions:18F-FDG PET/CT has high sensitivity and specificity in the diagnosis of cervical lymph node metastasis,and can be used as an important preoperative evaluation method for oral cancer.
文摘目的系统评价妊娠早期循环metastin/kisspeptin水平与自然流产(SAB)的相关性。方法计算机检索PubMed、EMbase、The Cochrane Library、Web of Science、中国知网、万方、维普中文科技期刊数据库和中国生物医学文献数据库,搜集有关妊娠早期循环kisspeptin水平与SAB相关性的研究,检索文献的时间设置均为从建库至2020年6月。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan5.3软件进行meta分析。结果共纳入3个巢式病例对照研究、2个病例对照研究和1个前瞻性队列研究,包括SAB患者157例,作为对照的正常宫内妊娠(IUP)孕妇1018例。meta分析显示,SAB组kisspeptin水平低于IUP组[SMD=-1.68,95%CI:-2.65~-0.72,P=0.0006]。结论循环metastin/kisspeptin水平降低与SAB有一定相关性,受纳入研究数量和质量的限制,上述结论尚待更多高质量研究予以验证。
基金National Natural Science Foundation of China(62075052,6227419)National Key Research and Development Program of China(2024YFE0108300)+2 种基金Science and Technology Major Project of Guangxi,China(Gui Ke AA21077015,Gui Ke AA24263032)Science Foundation of the National Key Laboratory of Science and Technology on Advanced Composites in Special Environments(JCKYS2020603C009,6142905212711)Project of Innovative and Entrepreneurship Training Program for College Students in Heilongjiang Province(201810214105)。
文摘In microwave communication systems,focusing and imaging have attracted widespread attention due to their application prospects in the information processing and communication fields.Most existing multi-channel focusing and imaging are implemented by interleaved metasurfaces.However,the disadvantages of their large size and low efficiency limit their practical applications in large-capacity and low-loss integrated systems.To solve these issues,here,we propose a non-interleaved polarization-frequency multiplexing metasurface for high-efficiency multi-channel focusing and imaging.The meta-atoms of the non-interleaved metasurface are composed of a metallic ground plate,two dielectric layers,a larger cross-shaped metal structure,and a smaller cross-shaped metal structure embedded by a circular metal aperture.By altering the size of two cross-shaped structures,the designed meta-atom can obtain the independent complete 2π phase coverage with high reflection efficiency at two different frequency ranges for two orthogonal linear polarization(LP)incidences,realizing polarization multiplexing and frequency multiplexing.Moreover,two types of metasurfaces based on the above meta-atoms are designed to realize multi-channel focusing and imaging with high efficiency.As a proof,the focusing metasurface is fabricated and measured,and the measured results are well consistent with simulated results.Therefore,the proposed scheme has the advantages of high efficiency,multi-channel,and compact size,which possesses broad application prospects in low-loss and multichannel communication integrated systems.
基金funded by grants from the Shanghai Science Committee Foundation(No.19411967700)the National Natural Science Foundation of China(No.31570993)the Wu Jieping Medical Foundation(No.320.6750.2020-14-7).
文摘To the Editor:In recent years,the treatment for metastatic hormone-sensitive prostate cancer(mHSPC)has undergone rapid developments.Docetaxel(DOC)or androgen receptor-targeted agent(ARTA)and androgen deprivation therapy(ADT)are the most commonly used systemic therapies.Multiple meta-analyses or network meta-analyses(NMAs)have been undertaken to evaluate and contrast the various treatment options available for mHSPC.However,the clinical efficacy of DOC in triplet therapy for mHSPC is yet to be confirmed,especially in categorizing the patients based on both volume of disease and timing of metastases.Bringing these controversies to light may have a timely and important impact on further clinical trials.Moreover,based on these trials and our NMA study,triplet therapy has evident benefits on overall survival(OS)and progression-free survival(PFS)in patients with mHSPC.The NMA study presented in this thesis is one of the first studies that assessed the efficacy of DOC and selected patients who will benefit from triplet therapy.
基金National Key Research and Development Program of China(SQ2022YFB3806200)National Natural Science Foundation of China(62301596,62101588)+1 种基金Young Talent Fund of Association for Science and Technology in Shaanxi(20240129)Postdoctoral Fellowship Program of CPSF(GZC20242285)。
文摘In modern science and technology,on-demand control of the polarization and wavefront of electromagnetic(EM)waves is crucial for compact opto-electronic systems.Metasurfaces composed of subwavelength array structures inject infinite vitality to shape this fantastic concept,which has fundamentally changed the way humans engineer matter–wave interactions.However,achieving full-space arbitrarily polarized beams with independent wavefronts in broadband on a single metasurface aperture still remains challenging.Herein,the authors propose a generic method for broadband transmission-reflection-integrated wavefronts shaping with multichannel arbitrary polarization regulation from 8 to 16 GHz,which is based on the chirality effect of full-space non-interleaved tetrameric meta-molecules.Through superimposing eigen-polarization responses of the two kinds of enantiomers,the possibility for high-efficiency evolution of several typical polarization states with specific wavefronts is demonstrated.As proofs-of-concept,the feasibility of our methodology is validated via implementing miscellaneous functionalities,including circularly polarized(CP)beam splitting,linearly polarized(LP)vortex beams generation,and CP and LP multifoci.Meanwhile,numerous simulated and experimental results are in excellent agreement with the theoretical predictions.Encouragingly,this proposed approach imaginatively merges broadband polarization and phase control into one single full-space and shared-aperture EM device,which can extremely enhance the functional richness and information capacity in advanced integrated systems.
文摘目的基于Meta分析方法讨论中成药联合替格瑞洛治疗冠心病心绞痛的有效性。方法检索中英文数据库,包括中国知网、万方、维普、PubMed、Embase和Web of Science等,筛选中成药联合替格瑞洛治疗冠心病心绞痛的随机对照试验,检索时间为建库至2024年12月。采用RevMan5.3软件对纳入的文献进行数据分析及绘图。结果共纳入24篇文献,Meta分析结果提示:与对照组比较,试验组的治疗总有效率升高,每周发作次数和发作持续时间显著降低(P<0.00001)。结论中成药联合替格瑞洛可以提高冠心病心绞痛患者的治疗总有效率,明显减少心绞痛每周发作次数与发作持续时间,这对于缓解患者症状、提升生活质量具有积极意义。
文摘目的:探讨髓芯减压联合不同治疗策略对早中期股骨头坏死患者的疗效及安全性评价。方法:系统检索PubMed、Web of Science、Cochrane Library、EMbase、中国知网、维普、万方和中国生物医学文献数据库,纳入截至2025-01-19发表的关于髓芯减压联合治疗早中期股骨头坏死的随机对照试验。采用Cochrane偏倚风险评估工具对文献质量进行评价,运用GRADE系统评价证据等级,基于贝叶斯框架构建网状Meta分析模型。采用标准化均数差进行效应估计,结果以累积排序概率曲线下面积进行干预优效性排序。敏感性分析采用逐项剔除法评估模型稳健性,并通过基线协变量评估传递性假设。结果:最终纳入73项随机对照试验,共计5148例患者、5777个髋关节,涵盖15种联合治疗方法。结果显示:①在提高综合临床疗效方面,髓芯减压联合自体骨髓单核细胞浓缩注射、骨髓间充质干细胞移植、支撑性植骨及补肾活血类中药复方汤剂等均优于单纯髓芯减压,其中髓芯减压联合自体骨髓单核细胞浓缩注射显示出最优的干预效果(累积排序概率曲线下面积=96.23%);②在髋关节功能改善方面,髓芯减压联合中医药序贯治疗疗效最优(累积排序概率曲线下面积=93.85%);③在疼痛缓解方面,髓芯减压联合中成药(补肾活血+活血化瘀)与活血化瘀类中药复方汤剂效果突出;④在影像学改善方面,髓芯减压联合自体源性干细胞局部植入效果最佳(累积排序概率曲线下面积=82.56%);⑤在临床安全性方面,髓芯减压联合活血化瘀类中药复方汤剂在降低不良事件发生率方面具有相对优势(P<0.05)。为评估结果稳健性,采用逐项剔除法进行敏感性分析,显示模型稳定,主要干预结果对单项研究不敏感,传递性假设成立。结论:髓芯减压联合干细胞移植、中医药序贯治疗等多种治疗方案在改善早中期股骨头坏死临床疗效方面优于单纯髓芯减压,表现为关节功能保护、结构重建与疼痛控制等多重优势。考虑部分干预文献数量有限及研究质量差异,仍需高质量、多中心、大样本随机对照试验进一步验证。
文摘背景跌倒是老年人的常见和严重的问题之一,跌倒效能是跌倒的重要影响因素,提高老年人跌倒效能的运动方式多样但各种运动干预效果的优劣尚无定论。目的分析比较不同运动方式对老年人跌倒效能的影响,旨在为患者选择最佳运动方式提供参考。方法计算机检索中国知网、万方数据知识服务平台、维普网、SinoMed、PubMed、CINAHL、Web of Science、Embase、Cochrane Library、FMRS等数据库中关于运动提高老年人跌倒效能的相关文献,检索时限为建库至2025-08-15。结局指标为国际版跌倒效能量表(FES-I)、Berg平衡量表(BBS)、计时起立-行走测试(TUGT)。采用Cochrane偏倚评估工具进行文献质量评价,采用Stata 18.0软件进行网状Meta分析,采用累积概率排名曲线下面积(SUCRA)对不同方案的效果进行排名。结果共纳入35项研究,包括2627例研究对象、13种运动方式。在跌倒效能方面,奥塔戈(MD=8.94,95%CI=3.51~14.38)、太极拳(MD=9.24,95%CI=4.96~13.51)、方步运动(MD=8.60,95%CI=2.56~14.64)、普拉提(MD=6.86,95%CI=1.19~12.53)的效果优于常规护理组(P<0.05),太极拳成为最佳干预措施的可能性最大(SUCRA=81.2)。在平衡功能方面,奥塔戈(MD=3.87,95%CI=2.71~5.02)、太极拳(MD=3.87,95%CI=1.71~6.03)、抗阻+平衡训练(MD=3.26,95%CI=0.53~6.00)的效果优于常规护理组(P<0.05),奥塔戈成为最佳干预措施的可能性最大(SUCRA=68.1)。在移动能力方面,奥塔戈(MD=3.90,95%CI=2.77~5.04)、太极拳(MD=4.44,95%CI=3.50~5.39)、八段锦(MD=2.25,95%CI=1.47~3.02)、八卦掌(MD=2.35,95%CI=1.26~3.43)、步态平衡操(MD=3.60,95%CI=2.15~5.05)的效果优于常规护理组(P<0.05),太极拳成为最佳干预措施的可能性最大(SUCRA=95.0)。结论太极拳、奥塔戈运动在改善老年人跌倒效能、平衡功能、移动能力方面效果较好。临床医护人员应结合老年人健康状况及需求,合理选择运动方式,以提高老年人跌倒效能,有效预防跌倒,促进患者健康。未来仍需进一步开展更多高质量的研究以验证此结论。
