Basic life support for cardiac arrest associates cardiopulmonary resuscitation(CPR)and defibrillation.CPR relies on chest compressions(CC)and ventilation.Current guidelines on CPR recommend a depth of 5-6 cm at a rhyt...Basic life support for cardiac arrest associates cardiopulmonary resuscitation(CPR)and defibrillation.CPR relies on chest compressions(CC)and ventilation.Current guidelines on CPR recommend a depth of 5-6 cm at a rhythm of 100-120 times/min for CC.[1,2]Interruptions of the CC must be as short as possible and are related to ventilation,defibrillation and turnover of the rescuers.Most of the automated external defibrillators(AEDs)require interruptions of the CC to perform rhythm analysis.Among the numerous marketed models of AEDs,some provide real-time feedback about the quality of the CC.展开更多
The current study aimed to evaluate the efficacy and safety of Compound Danshen Dripping Pills(CDDP)in improving cardiac function in patients with acute anterior ST-segment elevation myocardial infarction(AAMI).Betwee...The current study aimed to evaluate the efficacy and safety of Compound Danshen Dripping Pills(CDDP)in improving cardiac function in patients with acute anterior ST-segment elevation myocardial infarction(AAMI).Between February 2021 and February 2023,247 eligible patients with AAMI after primary percutaneous coronary intervention were enrolled and randomly assigned(1∶1)to receive CDDP(n=126)or placebo(n=121),with a follow-up of 48 weeks.Compared with the placebo group,the CDDP group demonstrated a significant increase in left ventricular ejection fraction values after 24 weeks of treatment(least squares mean:3.31;95%confidence interval[CI]:1.72–4.90;P<0.001)and at the 48-week follow-up(least squares mean:4.35;95%CI:2.76–5.94;P<0.001).Significant reductions in N-terminal pro-B-type natriuretic peptide levels were observed in both groups at the 24-and 48-week visits with no significant difference between the two groups(P>0.1 for all).The incidence of major adverse cardiovascular and cerebrovascular events was 6.35%in the CDDP group and 5.79%in the placebo group(P=0.822).Notably,no serious adverse events were attributed to CDDP.These findings suggest that CDDP may be well tolerated and could improve left ventricular ejection fraction in patients with AAMI at 24 and 48 weeks.展开更多
OBJECTIVE:To evaluate the efficacy and safety of 14-day Qingwei Zhitong pellets(清胃止痛微丸,QZ)-containing quadruple therapy(QZQT)compared to bismuth-containing quadruple therapy(BQT)in treatment-naive patients with ...OBJECTIVE:To evaluate the efficacy and safety of 14-day Qingwei Zhitong pellets(清胃止痛微丸,QZ)-containing quadruple therapy(QZQT)compared to bismuth-containing quadruple therapy(BQT)in treatment-naive patients with Helicobacter pylori(H.pylori)infection.METHODS:This single-center,randomized controlled clinical trial enrolled 333 patients,who were divided into either the QZQT group(QZ pellets,3.2 g,three times daily;rabeprazole,10 mg,twice daily;amoxicillin 1000 mg,twice daily;clarithromycin,500 mg,twice daily)or the BQT group(bismuth potassium citrate,1000 mg,three times daily;rabeprazole,10 mg,twice daily;amoxicillin,1000 mg,twice daily;clarithromycin,500 mg,twice daily)for 14 d.The 13C-urea breath test assessed eradication success at least four weeks after treatment.The primary outcome focused on the eradication rate,with secondary outcomes including safety and patient compliance.RESULTS:From August 2022 to June 2023,342 subjects were screened,and 333 were randomized.The QZQT and BQT groups showed eradication rates of 68.9%and 67.8%(P=0.838)by intention-to-treat(ITT)analysis,respectively,and 71.1%and 68.3%(P=0.612)by perprotocol(PP)analysis,respectively.QZQT was non-inferior to BQT in both ITT and PP analyses.QZQT was associated with fewer side effects(57.8%of patients)than BQT(90.4%)(P<0.001).CONCLUSION:The 14 d QZQT treatment demonstrates equal efficacy in eradicating H.pylori infection and improved patient compliance and safety compared to BQT.These results provide evidence supporting 14-day QZQT as an acceptable treatment for H.pylori infection.展开更多
AIM:To compare the endomicroscopic image quality of integrated confocal laser endomicroscopy(iCLE)and sedation efficacy of propofolvs midazolam plus fentanyl(M/F).METHODS:Consecutive outpatients undergoing iCLE were p...AIM:To compare the endomicroscopic image quality of integrated confocal laser endomicroscopy(iCLE)and sedation efficacy of propofolvs midazolam plus fentanyl(M/F).METHODS:Consecutive outpatients undergoing iCLE were prospectively recruited and randomized to the propofol group(P group)or M/F group.The patient,performing endoscopist and endoscopic assistant were blinded to the randomization.The quality of endomicro-scopic images and anesthetic efficacy outcomes were blindly evaluated after iCLE examination.RESULTS:There were significantly more good quality endomicroscopic images in the propofol group than in the M/F group(72.75%vs 52.89%,P<0.001).The diagnostic accuracy for upper gastrointestinal mucosal lesions using confocal laser endomicroscopy favors the P group,although this did not reach statistical significance.Adverse events and patient assessment were not significantly different for M/F vs propofol except for more frequent intraprocedural recall with M/F.Procedure duration and sedation times were significantly longer in the M/F group,while the scores of endoscopist,anesthetist and assistant assessment were all significantly better in the P group.CONCLUSION:Sedation with propofol might increase the proportion of good quality endomicroscopic images,and may result in improved procedural efficacy and diagnostic accuracy during iCLE examination.展开更多
Nonintubated video-assisted thoracic surgery （VATS） that is also defined awake VATS entails thoracoscopic procedures performed by regional anesthesia in spontaneously ventilating,mildly sedated or fully awake patients.
Background During primary percutaneous coronary intervention （PCI）, manual thrombectomy may reduce distal embolization and thus improve microvascular peffusion. Small trials have suggested that thrombectomy improves...Background During primary percutaneous coronary intervention （PCI）, manual thrombectomy may reduce distal embolization and thus improve microvascular peffusion. Small trials have suggested that thrombectomy improves surrogate and clinical outcomes, but a larger trial has reported conflicting results.展开更多
The amount of scientific knowledge from randomized parallel group trials have been improved by the CONSORT Guideline, but important intelligence with important clinical implications remains to be extracted. This may t...The amount of scientific knowledge from randomized parallel group trials have been improved by the CONSORT Guideline, but important intelligence with important clinical implications remains to be extracted. This may though be obtained if the conventional statistical significance testing is supplied by 1) Addition of an unbiased and reproducible quantification of the magnitude or size of the clinical significance/importance of a difference in treatment outcome;2) Addition of a quantification of the credulity of statements on any possible effect size and finally;3) Addition of a quantification of the risk of committing an error when the null hypothesis is either accepted or rejected. These matters are crucial to proper conversion of trial results into good usage in every-day clinical practice and may produce immediate therapeutic consequence in quite opposite direction to the usual ones. In our drug eluting stent trial “SORT OUT II”, the implementation of our suggestions would have led to immediate cessation of use of the paclitaxel-eluting stent, which the usual Consort like reporting did not lead to. Consequently harm to subsequent patients treated by this stent might have been avoided. Our suggestions are also useful in cancer treatment trials and in fact generally so in most randomized trial. Therefore increased scientific knowledge with immediate and potentially altered clinical consequence may be the result if hypothesis testing is made complete and the corresponding adjustments are added to the CONSORT Guideline—first of all— for the potential benefit of future patients.展开更多
In the present study, we aimed to evaluate the effects of cilnidipine and L-type calcium channel blockers（L-type CCBs） on renal function in hypertensive patients. The randomized controlled trials（RCTs） of cilnidip...In the present study, we aimed to evaluate the effects of cilnidipine and L-type calcium channel blockers（L-type CCBs） on renal function in hypertensive patients. The randomized controlled trials（RCTs） of cilnidipine and L-type CCBs on hypertension treatment were selected from Pubmed, Embase, Google Scholar, CNKI, Science Direct, Ebsco, Springer, Ovid, Cochrane Library, Medline, VIP and Wanfang databases（from the date of databases＇ establishment to September 2014）. Data were independently evaluated following the Jadad standard. The percentage changes of serum creatinine（SCr） value, urinary protein excretion（UPE）, urinary protein/creatinine ratio（UPCR） and estimated glomerular filtration rate（e GFR） pre- and post-treatment were extracted for the subsequent meta-analysis. The mean difference（MD） and the 95% confidence interval（95% CI） were determined using RevM an 5.3 software. A total of 10 RCTs of high quality were included and analyzed by fixedor random-effect models. The results indicated that UPE（MD = –36.59, 95% CI： –70.85, –2.33） or UPCR（MD = –46.56, 95% CI： –88.50, –4.62） was significantly reduced by cilnidipine compared with L-type CCBs. However, such significant difference was not detected in reduction of SCr（MD = 0.01, 95% CI： –2.97, 2.98） or eG FR（MD = 1.56, 95% CI： –0.19, 3.31）. Compared with L-type CCBs, cilnidipine was more effective in reducing proteinuria or preventing the proteinuria progression. In addition, we did not find significant differences in SCr and eG FR between the two groups.展开更多
AIM: To compare iron depletion to lifestyle changes alone in patients with severe nonalcoholic fatty liver disease (NAFLD) and hyperferritinemia, a frequent feature associated with more severe liver damage, despite at...AIM: To compare iron depletion to lifestyle changes alone in patients with severe nonalcoholic fatty liver disease (NAFLD) and hyperferritinemia, a frequent feature associated with more severe liver damage, despite at least 6 mo of lifestyle changes.展开更多
AIM: To evaluate the long-term risk of gastroduodenal ulcer and cardiovascular events induced by celecoxib in a population-based, randomized, double-blind, placebo-controlled study.METHODS: From 2004 to 2006, a total ...AIM: To evaluate the long-term risk of gastroduodenal ulcer and cardiovascular events induced by celecoxib in a population-based, randomized, double-blind, placebo-controlled study.METHODS: From 2004 to 2006, a total of 1024 Chinese patients (aged 35 to 64 years) with severe chronic atrophic gastritis, intestinal metaplasia or dysplasia were randomly assigned to receive 200 mg of celecoxib twice daily or placebo in Linqu County (Shandong Province, China), a high-risk area of gastric cancer. All gastroduodenal ulcer and cardiovascular events occurred were recorded and the patients were followed up for 1.5 years after treatment. At the end of the trial, a systematic interview survey about other adverse events was conducted. RESULTS: Gastroduodenal ulcer was detected in 19 of 463 (3.72%) patients who received celecoxib and 17 of 473 (3.31%) patients who received placebo, respectively (odds ratio = 1.13, 95% CI = 0.58-2.19). Cardiovascular (CV) events occurred in 4 patients who received celecoxib and in 5 patients who received placebo, respectively. Compared with those who received placebo, patients who received celecoxib had no signif icant increase in occurrence of CV events (hazard ratio = 0.84, 95% CI = 0.23-3.15). Among the adverse events acquired by interview survey, only the frequency of bloating was signif icantly higher in patients treated with celecoxib than in those treated with placebo. CONCLUSION: Treatment of gastric cancer with celecoxib is not associated with increased risk of gastroduodenal ulcer and cardiovascular events.展开更多
Objective:To evaluate the effectiveness and safety of Chinese herbal medicines(CHMs)for incomplete immune reconstruction in patients with HIV/AIDS.Methods:Eight electronic databases were searched for randomized contro...Objective:To evaluate the effectiveness and safety of Chinese herbal medicines(CHMs)for incomplete immune reconstruction in patients with HIV/AIDS.Methods:Eight electronic databases were searched for randomized controlled trials(RCTs)on the use of CHM for patients with HIV/AIDS with incomplete immune reconstruction.Outcomes included CD4þcell count,quality of life,and adverse events/effects.The Cochrane Risk of Bias was employed to evaluate the methodological quality of the included RCTs.Results:We identified 13 eligible RCTs,with an overall high risk of bias,on 10 different CHMs.There was a significant increase in CD4þcell count after the use of Jianpi Yiqi medicinal paste for 3 months;tripterygium glycosides tablets(TGTs)for 3 months(mean difference[MD]52.63 cells/mL,95%confidence interval[CI,46.98,58.28]),6,9,and 12 months;Wenshen Jianpi granules for 6 months;Shenling Fuzheng capsules for 6 months(MD 49.53 cells/mL,95%CI[8.45,90.61])and 12 months;Aikeqing granules for 9 months(MD 61.51 cells/mL,95%CI[16.25,106.77])and 12 months;Guipi decoction for 12 months;Mianyi No.2 granules(JT)for 12 and 18 months;and Chinese medicine granules for 18 months.The increase in the mean difference of CD4þcell count from 6 to 18 months was larger in Chinese medicine granules and Mianyi No.2 granules(JT).Guipi decoction and Jianpi Qushi decoction improved the Karnofsky score.Four RCTs reported the outcome of adverse events/effects,while four cases of minor adverse effects were reported in the TGTs group.Conclusion:Jianpi Yiqi medicinal paste,Wenshen Jianpi granules,Shenling Fuzheng capsules,Aikeqing granules,Guipi decoction,and TGTs may be effective in increasing CD4þwithin 12 months,and Mianyi No.2 granules(JT)and Chinese medicine granules may show long-term effects.High-quality large RCTs on the effectiveness and safety of CHMs are still warranted.展开更多
The introduction of prostate-specific antigen （PSA） for prostate cancer screening in the late 1980s led to an epidemic of prostate cancer, particularly in developed countries. However, the first valid reports from r...The introduction of prostate-specific antigen （PSA） for prostate cancer screening in the late 1980s led to an epidemic of prostate cancer, particularly in developed countries. However, the first valid reports from randomized controlled trials on the efficacy of screening were not published until 2009. Men in the screening group in the European Randomized Study of Screening for Prostate Cancer were 20% less likely than those in the control group to die from prostate cancer. The absolute difference was only 0.7/1000, implying that over 1400 men needed to be screened to prevent one prostate cancer death. Screening was also associated with a 70% increased risk for being diagnosed with prostate cancer. The American Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial found no survival benefit for screening. Results were not conclusive because a substantial proportion of study subjects had previously undergone PSA testing, over half of the control group had PSA testing, follow-up was relatively short, and fewer than 100 subjects died from prostate cancer. Balancing the potential survival benefit from screening is the risk of overdiagnosis--finding cancers that would not otherwise cause clinical problems^and the risk of treatment complications, including urinary, sexual and bowel dysfunction. Prostate cancer screening efforts would benefit from improved biomarkers, which more readily identify clinically important cancers. Cancer control efforts might also need to include chemoprevention, though currently available agents are controversial. In the meantime, oatients need to be supoorted in achievine informed decisions on whether to be screened for orostate cancer.展开更多
Background:Yiqi Peiyuan(YQPY)prescription,a composite prescription of traditional Chinese medicine,has been used to prevent or delay the continued deterioration of renal function after acute kidney injury(AKI)in some ...Background:Yiqi Peiyuan(YQPY)prescription,a composite prescription of traditional Chinese medicine,has been used to prevent or delay the continued deterioration of renal function after acute kidney injury(AKI)in some institutions and has shown considerable efficacy.Objective:This is the first randomized controlled trial to assess efficacy and safety of YQPY for improving short-term prognosis in adult patients with AKI.Design,setting,participants and interventions:This is a prospective,double-blind,multicenter,randomized,and placebo-controlled clinical trial.A total of 144 enrolled participants were randomly allocated to two groups according to a randomization schedule.Participants,caregivers and investigators assessing the outcomes were blinded to group assignment.Patients in the YQPY group received 36 g YQPY granules twice a day for 28 days.Patients in the placebo group received a placebo in the same dose as the YQPY granules.Main outcome measures:The primary outcome was the change in the estimated glomerular filtration rate(eGFR)between baseline and after 4 and 24 weeks of treatment.The secondary outcomes were the change of serum creatinine(Scr)level between baseline and after treatment,and the incidence of endpoint events,defined as eGFR increasing by more than 25%above baseline,eGFR>75 mL/min per1.73 m2or the composite endpoint,which was defined as the sum of patients meeting either of the above criteria.Results:Data from a total of 114 patients(59 in the YQPY group and 55 in the control group)were analyzed.The mean changes in eGFR and Scr in weeks 4 and 24 had no difference between the two groups.In further subgroup analysis(22 in the YQPY group and 31 in the control group),the mean change in eGFR after treatment for 4 weeks was 27.39 mL/min per 1.73 m2in the YQPY group and 5.78 mL/min per1.73 m2in the placebo group,and the mean difference between groups was 21.61 mL/min per 1.73 m2(P<0.001).Thirteen(59.1%)patients in the YQPY group and 5(16.1%)in the placebo group reached the composite endpoints(P=0.002).During the intervention,2 and 4 severe adverse events were reported in the YQPY and placebo groups,respectively.Conclusion:The YQPY granules can effectively improve the renal function of patients 4 weeks after the onset of AKI,indicating that it has good efficacy for improving short-term renal outcomes in patients with AKI.The YQPY granules may be a promising therapy for adults with AKI.展开更多
BACKGROUND Test anxiety is prevalent among medical students and leads to impaired academic performance.Test-related attentional bias has been identified as an important maintaining factor in test-anxious individuals.A...BACKGROUND Test anxiety is prevalent among medical students and leads to impaired academic performance.Test-related attentional bias has been identified as an important maintaining factor in test-anxious individuals.AIM To evaluate whether hypnosis and progressive muscle relaxation(PMR)could modify medical college students’test anxiety and attentional bias.METHODS A total of 598 medical students were screened.The participants were divided into higher and lower test anxiety groups according to their scores on the test anxiety scale(TAS).Ninety medical college students with high TAS score were randomly assigned to a hypnosis or PMR group.Another 45 students with low TAS score were included,forming a baseline control group.The intervention was conducted weekly for 6 wk,and each session lasted approximately 30 min.The total intervention time and the number of intervention sessions for the hypnosis and PMR groups were equal.Data were collected at the pretest,posttest,and 2-mo follow-up.RESULTS Hypnosis group participants had a significantly lower TAS score at posttest(t=-21.827,P<0.001)and at follow-up(t=-14.824,P<0.001),compared to that at pretest.PMR group participants also had a significantly lower TAS score at posttest(t=-10.777,P<0.001)and at follow-up(t=-7.444,P<0.001),compared to that at pretest.At the posttest level,the hypnosis group had a significantly lower TAS score than the PMR group(t=-3.664,P<0.001).At the follow-up level,the hypnosis group also had a significantly lower TAS score than the PMR group(t=-2.943,P=0.004).Clinically significant improvement was found in both the hypnosis and PMR groups(hypnosis=64.0%;PMR=62.22%).Hypnosis was more effective than PMR in reducing test anxiety among medical college students.Hypnosis could modify attentional bias toward threatening stimuli,but PMR could not.CONCLUSION These results suggest that attentional bias plays an important role in test anxiety treatment.展开更多
Objectives:To determine whether providing a choice between high-intensity interval training(HIIT)and moderateintensity continuous training(MICT)within a 4-week diabetes prevention program may lead to greater perceived...Objectives:To determine whether providing a choice between high-intensity interval training(HIIT)and moderateintensity continuous training(MICT)within a 4-week diabetes prevention program may lead to greater perceived autonomy support,motivation regulation,free-living physical activity,and cardiorespiratory fitness 6 months postintervention when compared to imposed exercise.Methods:In a preliminary pragmatic randomized trial,77 individuals at risk of type 2 diabetes(Mage=61.5(±9.8)years;Nfemales=58)were randomized to one of three exercise conditions:HIIT,MICT,or the choice thereof(CHOICE).Perceived autonomy supportwas assessed post-intervention.Changes in motivation,physical activity,and cardiorespiratory fitness were assessed 6 months post-intervention.Linear mixed models and Bonferroni-adjusted pairwise comparisons on estimated marginal means were used to derive effect estimates after adjusting for stratified allocation factors.Results:Perceived autonomy support was not different among conditions[F(2,47)=0.068,p=0.934].No effects were detected for motivation regulation,physical activity,or cardiorespiratory fitness(ps>0.05).Participants in the CHOICE condition self-reported significantly more physical activity 6 months post-intervention compared to preintervention[t(31)=2.922,p=0.019].Improvements in cardiorespiratory fitness were seen in CHOICE[t(65)=2.509,p=0.044]and MICT[t(65)=3.492,p=0.003].Conclusions:Providing choice between HIIT and MICT did not significantly affect individuals’perceived autonomy support or motivation regulation compared to imposed exercise.However,physical activity and cardiorespiratory fitness improved over time for the CHOICE condition.Providing choice between HIIT and MICT may be a feasible exercise strategy among this population.展开更多
Background:Recovery after stroke is often hindered when healthcare professionals work in isolation.Coordinated efforts between nurses and physiotherapists may improve patient outcomes.Objective:The objective of this s...Background:Recovery after stroke is often hindered when healthcare professionals work in isolation.Coordinated efforts between nurses and physiotherapists may improve patient outcomes.Objective:The objective of this study was to examine the effect of nurse-physiotherapist collaborative rehabilitation on functional recovery,motor function,quality of life,and disability among stroke patients.Materials and Methods:A parallel-group randomized controlled trial was conducted at the University of Uyo Teaching Hospital,Nigeria.Ninety adult stroke patients were randomized into intervention(n=45)and control(n=45)groups.The intervention group received a 6-week rehabilitation program combining joint goal setting,coordinated nursing and physiotherapy sessions,shared documentation,and weekly team reviews,whereas the control group received standard care.Outcomes were measured at baseline,6 weeks,and 3 months using the Barthel Index(primary),Fugl-Meyer assessment,stroke-specific quality of life(SS-QOL),and modified Rankin scale(mRS).Data were analyzed with repeated measures analysis of variance,with P<0.05 considered significant.Results:Patients in the intervention group showed greater functional improvement than controls.Barthel Index scores increased from 35.4±10.2 at baseline to 85.1±10.7 at 3 months,compared with 36.1±9.8-68.9±12.0 in controls(P<0.001).Similar patterns were observed for Fugl-Meyer assessment,SS-QOL,and mRS.High adherence,few adverse events,and consistent program fidelity supported feasibility.Improvements were attributed to the combination of nursing reinforcement,structured physiotherapy,patient education,and psychosocial support.Conclusion:Nurse-physiotherapist collaboration significantly enhances functional recovery,motor function,quality of life,and reduces disability in stroke patients.Implementing structured interprofessional rehabilitation in clinical practice is feasible and beneficial.展开更多
Introduction:Echinococcosis is a zoonotic parasitic disease that necessitates regular deworming of canines.The efficacy of the conventional manual deworming(CMD)is impeded by geography,the workforce,and severe weather...Introduction:Echinococcosis is a zoonotic parasitic disease that necessitates regular deworming of canines.The efficacy of the conventional manual deworming(CMD)is impeded by geography,the workforce,and severe weather conditions.This study evaluated the effectiveness and cost-effectiveness of the smart health education pillbox(SHEP)compared to CMD in canine echinococcosis control.Methods:A 12-month cluster randomized trial was conducted across nine endemic Chinese counties,where townships were randomly assigned to either the SHEP or CMD group.The primary outcomes included Echinococcus antigen positivity rates in dog feces,deworming frequency,and cost components.Data analysis was conducted using SPSS 27.0,employing Generalized Estimating Equations(GEE),odds ratios(OR),relative risk(RR),relative risk reduction(RRR),and protective efficacy(1/RR).Results:SHEP implementation significantly reduced Echinococcus infection risk by 35.45%and demonstrated 1.55-fold higher protective efficacy than CMD.The total deworming costs decreased by 22.62%,with substantial savings in personnel(53.15%),transportation(79.48%),and operational time requirements(30.13%).The proportion of dogs that achieved the target annual deworming frequency(9-12 times)increased from 51.89%to 91.38%,representing a relative improvement of 52.59%.Conclusion:SHEP,which integrates automated reminders of praziquantel(PZQ)tablet delivery,is a promising tool for diminishing resource utilization and mitigating Echinococcus transmission in endemic areas.展开更多
Objectives:To explore the efficacy and safety of virtual reality(VR)in relieving negative emotions in patients with breast cancer with different personalities.Methods:A randomized controlled trial was conducted.Betwee...Objectives:To explore the efficacy and safety of virtual reality(VR)in relieving negative emotions in patients with breast cancer with different personalities.Methods:A randomized controlled trial was conducted.Between April 2023 and October 2023,we enrolled patients with breast cancer treated in the Department of Breast Cancer and Oncology at Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University,Guangdong Province.The patients were randomly divided into an intervention group(n=118)and a control group(n=119)using block randomization.The intervention group received the VR intervention 3-5 times over 5±2 weeks using natural landscapes with music or relaxation guidance,and the duration of each VR intervention was 15±3 min.The control group received routine nursing care,including disease education and psychological counseling.Patients were assessed using the Type D Scale,Positive and Negative Affect Scale,and Distress Thermometer,and adverse events during the intervention were recorded.Results:Overall,85 patients completed the study(44 in the intervention group and 41 in the control group).Patients with Type D personalities showed more negative emotions[25.0(21.5,27.5)vs.19.0(16.0,24.0),P=0.001]and distressed attitudes[4.0(2.0,5.0)vs.3.0(1.0,4.0),P=0.020]with fewer positive emotions(27.2±5.6 vs.31.0±5.9,P=0.014)than those with non-Type D personalities.Total population analysis revealed no significant differences between the groups.However,in the subgroup analysis,patients with Type D personalities in the intervention group showed greater relief from negative emotions than those in the control group[median difference,-5.0(-9.0,-2.5)vs.-2.0(-4.0,2.0),P=0.046].No significant differences were found between groups of patients with non-Type D personality traits.The proportion of adverse events was not significantly different between groups(P=0.110).Conclusions:Breast cancer patients with Type D personalities suffer more severe negative emotions and distress,and more attention should be paid to them.VR intervention significantly and safely reduced negative emotions in patients with Type D personalities.展开更多
OBJECTIVE:To evaluate the efficacy of electroacupuncture(EA)at scalp motor area for treating post-stroke wrist dyskinesia and its influence on the function of wrist movement-related agonistic muscles.METHODS:A randomi...OBJECTIVE:To evaluate the efficacy of electroacupuncture(EA)at scalp motor area for treating post-stroke wrist dyskinesia and its influence on the function of wrist movement-related agonistic muscles.METHODS:A randomized,single-blind,controlled clinical trial was conducted.Sixty-six patients undergoing post-stroke wrist dyskinesia were enrolled and randomized 1:1 to EA or control group.Patients in the control group received manual acupuncture in the scalp motor area(MS 6)on the lesion side.The same acupoint was selected to accept EA stimulation in the EA group.All patients were treated six times a week for three weeks.The primary outcome was the Chinese Stroke Scale(CSS)score.The secondary outcomes included upper limb-related Barthel Index(BI)score,active range of motion(AROM)of the wrist joint,and root mean square(RMS)of the four agonistic muscles associated with wrist motion on the hemiplegic side of patients,i.e.,the extensor carpi radialis longus(ECRL),extensor digitorum(ED),flexor carpi radialis(FCR)and flexor carpi ulnaris(FCU).The above indicators were measured before and after three weeks of treatment.RESULTS:After 3-week treatment,the CSS score and AROM of wrist dorsiflexion of the EA group were better than those in the control group(P=0.038,P=0.047).The differences between the two groups of BI scores and AROM of wrist flexion were not significant(P>0.05).All RMS of the EA group were higher than those in the control group(ECRL:P=0.047,ED:P=0.048,FCR:P=0.049,FCU:P=0.047).The total effective rate in the EA group was 87.50%(28/32),which was higher than that in the control group(77.42%,24/31,P=0.048).CONCLUSION:EA stimulation of the scalp motor area can promote the recovery of the strength and function of the agonistic muscles related to wrist movement and effectively improve post-stroke wrist dyskinesia.展开更多
OBJECTIVE:To explore the efficacy and safety of acupuncture combined with atlantoaxial joint bone-setting therapy for the treatment of Tourette syndrome.METHODS:We randomly divided 600 patients at a ratio of 1∶1∶1 i...OBJECTIVE:To explore the efficacy and safety of acupuncture combined with atlantoaxial joint bone-setting therapy for the treatment of Tourette syndrome.METHODS:We randomly divided 600 patients at a ratio of 1∶1∶1 into three groups:group A(acupuncture combined with atlantoaxial joint bone setting therapy group),group B(acupuncture group),and group C(tiapride group).After two months of treatment,the Yale global tic severity scale(YGTSS)score reduction,improvement in social function impairment,clinical efficacy,and long-term efficacy in the three groups were compared.RESULTS:After treatment,in the analysis of YGTSS score reduction,social function impairment improvement,the clinical control rate,and long-term efficacy,the results were all Group A>Group B>Group C,with a statistically significant difference(P<0.05).However,the total clinical efficacy of treatment in group A(94.9%)was not significantly different from that in group B(91.8%).Adverse reactions did not occur in groups A and B,and several adverse reactions occurred in 29%(n=58)of the group C patients.CONCLUSION:Compared with traditional drug therapy,acupuncture combined with atlantoaxial joint bone setting therapy has better clinical and long-term efficacy.This treatment strategy can improve the social function of children and prevent adverse reactions to drugs.展开更多
文摘Basic life support for cardiac arrest associates cardiopulmonary resuscitation(CPR)and defibrillation.CPR relies on chest compressions(CC)and ventilation.Current guidelines on CPR recommend a depth of 5-6 cm at a rhythm of 100-120 times/min for CC.[1,2]Interruptions of the CC must be as short as possible and are related to ventilation,defibrillation and turnover of the rescuers.Most of the automated external defibrillators(AEDs)require interruptions of the CC to perform rhythm analysis.Among the numerous marketed models of AEDs,some provide real-time feedback about the quality of the CC.
基金supported by Tasly Pharmaceutical Group Co.,Ltd.(Grant No.303100031BA20)。
文摘The current study aimed to evaluate the efficacy and safety of Compound Danshen Dripping Pills(CDDP)in improving cardiac function in patients with acute anterior ST-segment elevation myocardial infarction(AAMI).Between February 2021 and February 2023,247 eligible patients with AAMI after primary percutaneous coronary intervention were enrolled and randomly assigned(1∶1)to receive CDDP(n=126)or placebo(n=121),with a follow-up of 48 weeks.Compared with the placebo group,the CDDP group demonstrated a significant increase in left ventricular ejection fraction values after 24 weeks of treatment(least squares mean:3.31;95%confidence interval[CI]:1.72–4.90;P<0.001)and at the 48-week follow-up(least squares mean:4.35;95%CI:2.76–5.94;P<0.001).Significant reductions in N-terminal pro-B-type natriuretic peptide levels were observed in both groups at the 24-and 48-week visits with no significant difference between the two groups(P>0.1 for all).The incidence of major adverse cardiovascular and cerebrovascular events was 6.35%in the CDDP group and 5.79%in the placebo group(P=0.822).Notably,no serious adverse events were attributed to CDDP.These findings suggest that CDDP may be well tolerated and could improve left ventricular ejection fraction in patients with AAMI at 24 and 48 weeks.
基金the China Zhongguancun Precision Medicine Science and Technology Foundation:Study on the Evaluation of Eradication Rate and Safety of Helicobacter Pylori in a Quadruple Therapy using Qingwei Zhitong Pellets as a Substitute for Bismuth Agent(320.6799.2022.09.24)。
文摘OBJECTIVE:To evaluate the efficacy and safety of 14-day Qingwei Zhitong pellets(清胃止痛微丸,QZ)-containing quadruple therapy(QZQT)compared to bismuth-containing quadruple therapy(BQT)in treatment-naive patients with Helicobacter pylori(H.pylori)infection.METHODS:This single-center,randomized controlled clinical trial enrolled 333 patients,who were divided into either the QZQT group(QZ pellets,3.2 g,three times daily;rabeprazole,10 mg,twice daily;amoxicillin 1000 mg,twice daily;clarithromycin,500 mg,twice daily)or the BQT group(bismuth potassium citrate,1000 mg,three times daily;rabeprazole,10 mg,twice daily;amoxicillin,1000 mg,twice daily;clarithromycin,500 mg,twice daily)for 14 d.The 13C-urea breath test assessed eradication success at least four weeks after treatment.The primary outcome focused on the eradication rate,with secondary outcomes including safety and patient compliance.RESULTS:From August 2022 to June 2023,342 subjects were screened,and 333 were randomized.The QZQT and BQT groups showed eradication rates of 68.9%and 67.8%(P=0.838)by intention-to-treat(ITT)analysis,respectively,and 71.1%and 68.3%(P=0.612)by perprotocol(PP)analysis,respectively.QZQT was non-inferior to BQT in both ITT and PP analyses.QZQT was associated with fewer side effects(57.8%of patients)than BQT(90.4%)(P<0.001).CONCLUSION:The 14 d QZQT treatment demonstrates equal efficacy in eradicating H.pylori infection and improved patient compliance and safety compared to BQT.These results provide evidence supporting 14-day QZQT as an acceptable treatment for H.pylori infection.
基金Supported by Grants from Ministry of Health of China(2010)Shandong Province Science and Technology Committee,No.2007BSB02087Graduate Independent Innovation Fund of Shandong University
文摘AIM:To compare the endomicroscopic image quality of integrated confocal laser endomicroscopy(iCLE)and sedation efficacy of propofolvs midazolam plus fentanyl(M/F).METHODS:Consecutive outpatients undergoing iCLE were prospectively recruited and randomized to the propofol group(P group)or M/F group.The patient,performing endoscopist and endoscopic assistant were blinded to the randomization.The quality of endomicro-scopic images and anesthetic efficacy outcomes were blindly evaluated after iCLE examination.RESULTS:There were significantly more good quality endomicroscopic images in the propofol group than in the M/F group(72.75%vs 52.89%,P<0.001).The diagnostic accuracy for upper gastrointestinal mucosal lesions using confocal laser endomicroscopy favors the P group,although this did not reach statistical significance.Adverse events and patient assessment were not significantly different for M/F vs propofol except for more frequent intraprocedural recall with M/F.Procedure duration and sedation times were significantly longer in the M/F group,while the scores of endoscopist,anesthetist and assistant assessment were all significantly better in the P group.CONCLUSION:Sedation with propofol might increase the proportion of good quality endomicroscopic images,and may result in improved procedural efficacy and diagnostic accuracy during iCLE examination.
文摘Nonintubated video-assisted thoracic surgery （VATS） that is also defined awake VATS entails thoracoscopic procedures performed by regional anesthesia in spontaneously ventilating,mildly sedated or fully awake patients.
基金Funded by Medtronic and the Canadian Institutes of Health ResearchTOTAL Clinical Trials.gov number,NCT01149044
文摘Background During primary percutaneous coronary intervention （PCI）, manual thrombectomy may reduce distal embolization and thus improve microvascular peffusion. Small trials have suggested that thrombectomy improves surrogate and clinical outcomes, but a larger trial has reported conflicting results.
文摘The amount of scientific knowledge from randomized parallel group trials have been improved by the CONSORT Guideline, but important intelligence with important clinical implications remains to be extracted. This may though be obtained if the conventional statistical significance testing is supplied by 1) Addition of an unbiased and reproducible quantification of the magnitude or size of the clinical significance/importance of a difference in treatment outcome;2) Addition of a quantification of the credulity of statements on any possible effect size and finally;3) Addition of a quantification of the risk of committing an error when the null hypothesis is either accepted or rejected. These matters are crucial to proper conversion of trial results into good usage in every-day clinical practice and may produce immediate therapeutic consequence in quite opposite direction to the usual ones. In our drug eluting stent trial “SORT OUT II”, the implementation of our suggestions would have led to immediate cessation of use of the paclitaxel-eluting stent, which the usual Consort like reporting did not lead to. Consequently harm to subsequent patients treated by this stent might have been avoided. Our suggestions are also useful in cancer treatment trials and in fact generally so in most randomized trial. Therefore increased scientific knowledge with immediate and potentially altered clinical consequence may be the result if hypothesis testing is made complete and the corresponding adjustments are added to the CONSORT Guideline—first of all— for the potential benefit of future patients.
基金Chongqing Municipal Commission of Health and Family Planning(Grant No.2015ZBXM005)
文摘In the present study, we aimed to evaluate the effects of cilnidipine and L-type calcium channel blockers（L-type CCBs） on renal function in hypertensive patients. The randomized controlled trials（RCTs） of cilnidipine and L-type CCBs on hypertension treatment were selected from Pubmed, Embase, Google Scholar, CNKI, Science Direct, Ebsco, Springer, Ovid, Cochrane Library, Medline, VIP and Wanfang databases（from the date of databases＇ establishment to September 2014）. Data were independently evaluated following the Jadad standard. The percentage changes of serum creatinine（SCr） value, urinary protein excretion（UPE）, urinary protein/creatinine ratio（UPCR） and estimated glomerular filtration rate（e GFR） pre- and post-treatment were extracted for the subsequent meta-analysis. The mean difference（MD） and the 95% confidence interval（95% CI） were determined using RevM an 5.3 software. A total of 10 RCTs of high quality were included and analyzed by fixedor random-effect models. The results indicated that UPE（MD = –36.59, 95% CI： –70.85, –2.33） or UPCR（MD = –46.56, 95% CI： –88.50, –4.62） was significantly reduced by cilnidipine compared with L-type CCBs. However, such significant difference was not detected in reduction of SCr（MD = 0.01, 95% CI： –2.97, 2.98） or eG FR（MD = 1.56, 95% CI： –0.19, 3.31）. Compared with L-type CCBs, cilnidipine was more effective in reducing proteinuria or preventing the proteinuria progression. In addition, we did not find significant differences in SCr and eG FR between the two groups.
基金Supported by Associazione Malattie Metaboliche del Fegato ONLUS(Non-profit organization for the Study and Care of Metabolic Liver Diseases),Centro Studi Malattie Metaboliche del Fegato,Universitàdegli Studi di Milano
文摘AIM: To compare iron depletion to lifestyle changes alone in patients with severe nonalcoholic fatty liver disease (NAFLD) and hyperferritinemia, a frequent feature associated with more severe liver damage, despite at least 6 mo of lifestyle changes.
基金(in part) Grants from National High Technology R&D Program (No. 2002BA711A06) National "211" Project in Peking University 529 and 533, Beijing Municipal Commission of Science and Technology (No. H209-20030130)+1 种基金 National Natural Science Foundation of China (No. 30471957)Research Grant Council Earmarked Grant (HKU 7256/01M) of the Hong Kong Special Administration Region, and Research Grant from Peking University School of Oncology, Beijing Cancer Hospital & Institute, China
文摘AIM: To evaluate the long-term risk of gastroduodenal ulcer and cardiovascular events induced by celecoxib in a population-based, randomized, double-blind, placebo-controlled study.METHODS: From 2004 to 2006, a total of 1024 Chinese patients (aged 35 to 64 years) with severe chronic atrophic gastritis, intestinal metaplasia or dysplasia were randomly assigned to receive 200 mg of celecoxib twice daily or placebo in Linqu County (Shandong Province, China), a high-risk area of gastric cancer. All gastroduodenal ulcer and cardiovascular events occurred were recorded and the patients were followed up for 1.5 years after treatment. At the end of the trial, a systematic interview survey about other adverse events was conducted. RESULTS: Gastroduodenal ulcer was detected in 19 of 463 (3.72%) patients who received celecoxib and 17 of 473 (3.31%) patients who received placebo, respectively (odds ratio = 1.13, 95% CI = 0.58-2.19). Cardiovascular (CV) events occurred in 4 patients who received celecoxib and in 5 patients who received placebo, respectively. Compared with those who received placebo, patients who received celecoxib had no signif icant increase in occurrence of CV events (hazard ratio = 0.84, 95% CI = 0.23-3.15). Among the adverse events acquired by interview survey, only the frequency of bloating was signif icantly higher in patients treated with celecoxib than in those treated with placebo. CONCLUSION: Treatment of gastric cancer with celecoxib is not associated with increased risk of gastroduodenal ulcer and cardiovascular events.
基金supported by the National Natural Science Foundation of China(81673828).
文摘Objective:To evaluate the effectiveness and safety of Chinese herbal medicines(CHMs)for incomplete immune reconstruction in patients with HIV/AIDS.Methods:Eight electronic databases were searched for randomized controlled trials(RCTs)on the use of CHM for patients with HIV/AIDS with incomplete immune reconstruction.Outcomes included CD4þcell count,quality of life,and adverse events/effects.The Cochrane Risk of Bias was employed to evaluate the methodological quality of the included RCTs.Results:We identified 13 eligible RCTs,with an overall high risk of bias,on 10 different CHMs.There was a significant increase in CD4þcell count after the use of Jianpi Yiqi medicinal paste for 3 months;tripterygium glycosides tablets(TGTs)for 3 months(mean difference[MD]52.63 cells/mL,95%confidence interval[CI,46.98,58.28]),6,9,and 12 months;Wenshen Jianpi granules for 6 months;Shenling Fuzheng capsules for 6 months(MD 49.53 cells/mL,95%CI[8.45,90.61])and 12 months;Aikeqing granules for 9 months(MD 61.51 cells/mL,95%CI[16.25,106.77])and 12 months;Guipi decoction for 12 months;Mianyi No.2 granules(JT)for 12 and 18 months;and Chinese medicine granules for 18 months.The increase in the mean difference of CD4þcell count from 6 to 18 months was larger in Chinese medicine granules and Mianyi No.2 granules(JT).Guipi decoction and Jianpi Qushi decoction improved the Karnofsky score.Four RCTs reported the outcome of adverse events/effects,while four cases of minor adverse effects were reported in the TGTs group.Conclusion:Jianpi Yiqi medicinal paste,Wenshen Jianpi granules,Shenling Fuzheng capsules,Aikeqing granules,Guipi decoction,and TGTs may be effective in increasing CD4þwithin 12 months,and Mianyi No.2 granules(JT)and Chinese medicine granules may show long-term effects.High-quality large RCTs on the effectiveness and safety of CHMs are still warranted.
文摘The introduction of prostate-specific antigen （PSA） for prostate cancer screening in the late 1980s led to an epidemic of prostate cancer, particularly in developed countries. However, the first valid reports from randomized controlled trials on the efficacy of screening were not published until 2009. Men in the screening group in the European Randomized Study of Screening for Prostate Cancer were 20% less likely than those in the control group to die from prostate cancer. The absolute difference was only 0.7/1000, implying that over 1400 men needed to be screened to prevent one prostate cancer death. Screening was also associated with a 70% increased risk for being diagnosed with prostate cancer. The American Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial found no survival benefit for screening. Results were not conclusive because a substantial proportion of study subjects had previously undergone PSA testing, over half of the control group had PSA testing, follow-up was relatively short, and fewer than 100 subjects died from prostate cancer. Balancing the potential survival benefit from screening is the risk of overdiagnosis--finding cancers that would not otherwise cause clinical problems^and the risk of treatment complications, including urinary, sexual and bowel dysfunction. Prostate cancer screening efforts would benefit from improved biomarkers, which more readily identify clinically important cancers. Cancer control efforts might also need to include chemoprevention, though currently available agents are controversial. In the meantime, oatients need to be supoorted in achievine informed decisions on whether to be screened for orostate cancer.
基金National Natural Science Foundation of China(No.82170685,81970574)Shanghai Municipal Health Commission(No.ZXYXZ-201904,ZY[2021-2023]-0208,ZY[2021-2023]-0302)+1 种基金Shanghai Jiaotong University School of Medicine(No.18ZXY001)Shanghai Bureau of Public Health(No.2018JP005)。
文摘Background:Yiqi Peiyuan(YQPY)prescription,a composite prescription of traditional Chinese medicine,has been used to prevent or delay the continued deterioration of renal function after acute kidney injury(AKI)in some institutions and has shown considerable efficacy.Objective:This is the first randomized controlled trial to assess efficacy and safety of YQPY for improving short-term prognosis in adult patients with AKI.Design,setting,participants and interventions:This is a prospective,double-blind,multicenter,randomized,and placebo-controlled clinical trial.A total of 144 enrolled participants were randomly allocated to two groups according to a randomization schedule.Participants,caregivers and investigators assessing the outcomes were blinded to group assignment.Patients in the YQPY group received 36 g YQPY granules twice a day for 28 days.Patients in the placebo group received a placebo in the same dose as the YQPY granules.Main outcome measures:The primary outcome was the change in the estimated glomerular filtration rate(eGFR)between baseline and after 4 and 24 weeks of treatment.The secondary outcomes were the change of serum creatinine(Scr)level between baseline and after treatment,and the incidence of endpoint events,defined as eGFR increasing by more than 25%above baseline,eGFR>75 mL/min per1.73 m2or the composite endpoint,which was defined as the sum of patients meeting either of the above criteria.Results:Data from a total of 114 patients(59 in the YQPY group and 55 in the control group)were analyzed.The mean changes in eGFR and Scr in weeks 4 and 24 had no difference between the two groups.In further subgroup analysis(22 in the YQPY group and 31 in the control group),the mean change in eGFR after treatment for 4 weeks was 27.39 mL/min per 1.73 m2in the YQPY group and 5.78 mL/min per1.73 m2in the placebo group,and the mean difference between groups was 21.61 mL/min per 1.73 m2(P<0.001).Thirteen(59.1%)patients in the YQPY group and 5(16.1%)in the placebo group reached the composite endpoints(P=0.002).During the intervention,2 and 4 severe adverse events were reported in the YQPY and placebo groups,respectively.Conclusion:The YQPY granules can effectively improve the renal function of patients 4 weeks after the onset of AKI,indicating that it has good efficacy for improving short-term renal outcomes in patients with AKI.The YQPY granules may be a promising therapy for adults with AKI.
基金Supported by the Anhui Natural Science Foundation,No.1808085MH291the Project of human Social Science of Anhui Province,No.SK2016A047Grants for Scientific Research of BSKY from Anhui Medical University,No.XJ201826.
文摘BACKGROUND Test anxiety is prevalent among medical students and leads to impaired academic performance.Test-related attentional bias has been identified as an important maintaining factor in test-anxious individuals.AIM To evaluate whether hypnosis and progressive muscle relaxation(PMR)could modify medical college students’test anxiety and attentional bias.METHODS A total of 598 medical students were screened.The participants were divided into higher and lower test anxiety groups according to their scores on the test anxiety scale(TAS).Ninety medical college students with high TAS score were randomly assigned to a hypnosis or PMR group.Another 45 students with low TAS score were included,forming a baseline control group.The intervention was conducted weekly for 6 wk,and each session lasted approximately 30 min.The total intervention time and the number of intervention sessions for the hypnosis and PMR groups were equal.Data were collected at the pretest,posttest,and 2-mo follow-up.RESULTS Hypnosis group participants had a significantly lower TAS score at posttest(t=-21.827,P<0.001)and at follow-up(t=-14.824,P<0.001),compared to that at pretest.PMR group participants also had a significantly lower TAS score at posttest(t=-10.777,P<0.001)and at follow-up(t=-7.444,P<0.001),compared to that at pretest.At the posttest level,the hypnosis group had a significantly lower TAS score than the PMR group(t=-3.664,P<0.001).At the follow-up level,the hypnosis group also had a significantly lower TAS score than the PMR group(t=-2.943,P=0.004).Clinically significant improvement was found in both the hypnosis and PMR groups(hypnosis=64.0%;PMR=62.22%).Hypnosis was more effective than PMR in reducing test anxiety among medical college students.Hypnosis could modify attentional bias toward threatening stimuli,but PMR could not.CONCLUSION These results suggest that attentional bias plays an important role in test anxiety treatment.
基金funded by a Grant-in-Aid program provided to the corresponding author by the Heart&Stroke Foundation of Canada(G-18-0022225).
文摘Objectives:To determine whether providing a choice between high-intensity interval training(HIIT)and moderateintensity continuous training(MICT)within a 4-week diabetes prevention program may lead to greater perceived autonomy support,motivation regulation,free-living physical activity,and cardiorespiratory fitness 6 months postintervention when compared to imposed exercise.Methods:In a preliminary pragmatic randomized trial,77 individuals at risk of type 2 diabetes(Mage=61.5(±9.8)years;Nfemales=58)were randomized to one of three exercise conditions:HIIT,MICT,or the choice thereof(CHOICE).Perceived autonomy supportwas assessed post-intervention.Changes in motivation,physical activity,and cardiorespiratory fitness were assessed 6 months post-intervention.Linear mixed models and Bonferroni-adjusted pairwise comparisons on estimated marginal means were used to derive effect estimates after adjusting for stratified allocation factors.Results:Perceived autonomy support was not different among conditions[F(2,47)=0.068,p=0.934].No effects were detected for motivation regulation,physical activity,or cardiorespiratory fitness(ps>0.05).Participants in the CHOICE condition self-reported significantly more physical activity 6 months post-intervention compared to preintervention[t(31)=2.922,p=0.019].Improvements in cardiorespiratory fitness were seen in CHOICE[t(65)=2.509,p=0.044]and MICT[t(65)=3.492,p=0.003].Conclusions:Providing choice between HIIT and MICT did not significantly affect individuals’perceived autonomy support or motivation regulation compared to imposed exercise.However,physical activity and cardiorespiratory fitness improved over time for the CHOICE condition.Providing choice between HIIT and MICT may be a feasible exercise strategy among this population.
基金the staff of UUTH for their support during data collection.
文摘Background:Recovery after stroke is often hindered when healthcare professionals work in isolation.Coordinated efforts between nurses and physiotherapists may improve patient outcomes.Objective:The objective of this study was to examine the effect of nurse-physiotherapist collaborative rehabilitation on functional recovery,motor function,quality of life,and disability among stroke patients.Materials and Methods:A parallel-group randomized controlled trial was conducted at the University of Uyo Teaching Hospital,Nigeria.Ninety adult stroke patients were randomized into intervention(n=45)and control(n=45)groups.The intervention group received a 6-week rehabilitation program combining joint goal setting,coordinated nursing and physiotherapy sessions,shared documentation,and weekly team reviews,whereas the control group received standard care.Outcomes were measured at baseline,6 weeks,and 3 months using the Barthel Index(primary),Fugl-Meyer assessment,stroke-specific quality of life(SS-QOL),and modified Rankin scale(mRS).Data were analyzed with repeated measures analysis of variance,with P<0.05 considered significant.Results:Patients in the intervention group showed greater functional improvement than controls.Barthel Index scores increased from 35.4±10.2 at baseline to 85.1±10.7 at 3 months,compared with 36.1±9.8-68.9±12.0 in controls(P<0.001).Similar patterns were observed for Fugl-Meyer assessment,SS-QOL,and mRS.High adherence,few adverse events,and consistent program fidelity supported feasibility.Improvements were attributed to the combination of nursing reinforcement,structured physiotherapy,patient education,and psychosocial support.Conclusion:Nurse-physiotherapist collaboration significantly enhances functional recovery,motor function,quality of life,and reduces disability in stroke patients.Implementing structured interprofessional rehabilitation in clinical practice is feasible and beneficial.
基金Supported by National Key Research and Development Program of China[grant numbers 2021YFC2300800 and 2021YFC2300804].
文摘Introduction:Echinococcosis is a zoonotic parasitic disease that necessitates regular deworming of canines.The efficacy of the conventional manual deworming(CMD)is impeded by geography,the workforce,and severe weather conditions.This study evaluated the effectiveness and cost-effectiveness of the smart health education pillbox(SHEP)compared to CMD in canine echinococcosis control.Methods:A 12-month cluster randomized trial was conducted across nine endemic Chinese counties,where townships were randomly assigned to either the SHEP or CMD group.The primary outcomes included Echinococcus antigen positivity rates in dog feces,deworming frequency,and cost components.Data analysis was conducted using SPSS 27.0,employing Generalized Estimating Equations(GEE),odds ratios(OR),relative risk(RR),relative risk reduction(RRR),and protective efficacy(1/RR).Results:SHEP implementation significantly reduced Echinococcus infection risk by 35.45%and demonstrated 1.55-fold higher protective efficacy than CMD.The total deworming costs decreased by 22.62%,with substantial savings in personnel(53.15%),transportation(79.48%),and operational time requirements(30.13%).The proportion of dogs that achieved the target annual deworming frequency(9-12 times)increased from 51.89%to 91.38%,representing a relative improvement of 52.59%.Conclusion:SHEP,which integrates automated reminders of praziquantel(PZQ)tablet delivery,is a promising tool for diminishing resource utilization and mitigating Echinococcus transmission in endemic areas.
基金supported by a project of the National Natural Science Foundation of China:Research on the integration of artificial intelligence and virtual reality technology to promote psychological rehabilitation of breast cancer patients with different personalities(project approval no.82073408).
文摘Objectives:To explore the efficacy and safety of virtual reality(VR)in relieving negative emotions in patients with breast cancer with different personalities.Methods:A randomized controlled trial was conducted.Between April 2023 and October 2023,we enrolled patients with breast cancer treated in the Department of Breast Cancer and Oncology at Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University,Guangdong Province.The patients were randomly divided into an intervention group(n=118)and a control group(n=119)using block randomization.The intervention group received the VR intervention 3-5 times over 5±2 weeks using natural landscapes with music or relaxation guidance,and the duration of each VR intervention was 15±3 min.The control group received routine nursing care,including disease education and psychological counseling.Patients were assessed using the Type D Scale,Positive and Negative Affect Scale,and Distress Thermometer,and adverse events during the intervention were recorded.Results:Overall,85 patients completed the study(44 in the intervention group and 41 in the control group).Patients with Type D personalities showed more negative emotions[25.0(21.5,27.5)vs.19.0(16.0,24.0),P=0.001]and distressed attitudes[4.0(2.0,5.0)vs.3.0(1.0,4.0),P=0.020]with fewer positive emotions(27.2±5.6 vs.31.0±5.9,P=0.014)than those with non-Type D personalities.Total population analysis revealed no significant differences between the groups.However,in the subgroup analysis,patients with Type D personalities in the intervention group showed greater relief from negative emotions than those in the control group[median difference,-5.0(-9.0,-2.5)vs.-2.0(-4.0,2.0),P=0.046].No significant differences were found between groups of patients with non-Type D personality traits.The proportion of adverse events was not significantly different between groups(P=0.110).Conclusions:Breast cancer patients with Type D personalities suffer more severe negative emotions and distress,and more attention should be paid to them.VR intervention significantly and safely reduced negative emotions in patients with Type D personalities.
基金Supported by the National Natural Science Foundation of China:Exploration of Key Factors and Mechanisms of Modulating Motor Function Reconstruction After Cerebral Infarction Through Multimodal Brain Functional Connectivity Perspective in Procedural Acupoint Electrical Stimulation Research(No.82374601)the Jointly Guided Program of Natural Science Foundation of Heilongjiang Province:Quantitative Study on the Role of Scalp Acupuncture in the Motor Area in Promoting Motor Function Reconstruction after Stroke(No.LH2019H113)+1 种基金the Innovation Team Construction Project of Heilongjiang University of Chinese Medicine:Construction of a Doctoral Research and Innovation Team in Acupuncture Science(No.2017sit01)the Traditional Chinese Medicine Research Project of Heilongjiang Province:Clinical Study on the Promotion of Upper Limb Motor Function Reconstruction in Post-Stroke Patients Using Optimal Limb Positioning with Electroacupuncture(No.ZHY2022-171)。
文摘OBJECTIVE:To evaluate the efficacy of electroacupuncture(EA)at scalp motor area for treating post-stroke wrist dyskinesia and its influence on the function of wrist movement-related agonistic muscles.METHODS:A randomized,single-blind,controlled clinical trial was conducted.Sixty-six patients undergoing post-stroke wrist dyskinesia were enrolled and randomized 1:1 to EA or control group.Patients in the control group received manual acupuncture in the scalp motor area(MS 6)on the lesion side.The same acupoint was selected to accept EA stimulation in the EA group.All patients were treated six times a week for three weeks.The primary outcome was the Chinese Stroke Scale(CSS)score.The secondary outcomes included upper limb-related Barthel Index(BI)score,active range of motion(AROM)of the wrist joint,and root mean square(RMS)of the four agonistic muscles associated with wrist motion on the hemiplegic side of patients,i.e.,the extensor carpi radialis longus(ECRL),extensor digitorum(ED),flexor carpi radialis(FCR)and flexor carpi ulnaris(FCU).The above indicators were measured before and after three weeks of treatment.RESULTS:After 3-week treatment,the CSS score and AROM of wrist dorsiflexion of the EA group were better than those in the control group(P=0.038,P=0.047).The differences between the two groups of BI scores and AROM of wrist flexion were not significant(P>0.05).All RMS of the EA group were higher than those in the control group(ECRL:P=0.047,ED:P=0.048,FCR:P=0.049,FCU:P=0.047).The total effective rate in the EA group was 87.50%(28/32),which was higher than that in the control group(77.42%,24/31,P=0.048).CONCLUSION:EA stimulation of the scalp motor area can promote the recovery of the strength and function of the agonistic muscles related to wrist movement and effectively improve post-stroke wrist dyskinesia.
基金Supported by Traditional Chinese medicine foundation of Zhejiang province:Clinical Study on the Correlation Between Tourette Syndrome and Anatomical Changes in the Atlantoaxial Joint(2010ZB162)Medical Health Science and Technology Project of Zhejiang Provincial Health Commission:Study on Protein Fingerprinting of Tourette Syndrome(2011KYB142)+1 种基金Renowned Traditional Chinese Medicine Expert Inheritance Studio Construction Project of Zhejiang province(No.GZS2020049)Key Disciplines of Traditional Chinese Medicine Foundation of Zhejiang Province(2012-XK-D20)。
文摘OBJECTIVE:To explore the efficacy and safety of acupuncture combined with atlantoaxial joint bone-setting therapy for the treatment of Tourette syndrome.METHODS:We randomly divided 600 patients at a ratio of 1∶1∶1 into three groups:group A(acupuncture combined with atlantoaxial joint bone setting therapy group),group B(acupuncture group),and group C(tiapride group).After two months of treatment,the Yale global tic severity scale(YGTSS)score reduction,improvement in social function impairment,clinical efficacy,and long-term efficacy in the three groups were compared.RESULTS:After treatment,in the analysis of YGTSS score reduction,social function impairment improvement,the clinical control rate,and long-term efficacy,the results were all Group A>Group B>Group C,with a statistically significant difference(P<0.05).However,the total clinical efficacy of treatment in group A(94.9%)was not significantly different from that in group B(91.8%).Adverse reactions did not occur in groups A and B,and several adverse reactions occurred in 29%(n=58)of the group C patients.CONCLUSION:Compared with traditional drug therapy,acupuncture combined with atlantoaxial joint bone setting therapy has better clinical and long-term efficacy.This treatment strategy can improve the social function of children and prevent adverse reactions to drugs.
