<strong>Background:</strong> A dual bronchodilator, long-acting anticholine drugs (glycopyrronium, LAMA) and the long running <em>β</em>-<sub>2</sub> stimulant (indacaterol, LABA),...<strong>Background:</strong> A dual bronchodilator, long-acting anticholine drugs (glycopyrronium, LAMA) and the long running <em>β</em>-<sub>2</sub> stimulant (indacaterol, LABA), are effective for the treatment of chronic obstructive pulmonary disease (COPD). To evaluate the effectiveness of the perioperative intervention of LAMA/LABA, a randomized prospective trial was performed for the lung cancer patients receiving a lobectomy with normal pulmonary function and COPD. <strong>Methods:</strong> Based on the results of the preoperative pulmonary function test, 25 patients were diagnosed with COPD [% forced expiratory volume in 1 second (%FEV<sub>1</sub>) < 70%]. Thirty-seven patients were enrolled as non-obstructive patients (70% ≤ %FEV<sub>1</sub>), who were randomized into two groups, the LAMA/LABA (n = 19) and the Control group (n = 18). The LAMA/LABA and the COPD groups daily received inhaled LAMA (50 μg) and LABA (110 μg) for 1 week before surgery and for least 4 weeks after surgery. The Control group had no treatment of the dual bronchodilator. The actual values were measured during the perioperative pulmonary function at three points of the preoperative baseline, the postoperative 1 week and the postoperative 4 weeks;these changes and changed ratios were then calculated. The patient-reported outcomes of the quality of life (PRO-QOL) were evaluated by the Cancer Dyspnea Scale (CDS), the COPD assessment test, and the St. George’s Respiratory Questionnaire. <strong>Results:</strong> Regarding the value of FEV<sub>1</sub> at the baseline, that in the LAMA/LABA group was 79.2% ± 6.4% and that in the Control group was 80.9% ± 6.4%, but that in the COPD groups was 57.9% ± 8.7%;there was a significant difference between the COPD and the Control group (p < 0.0001). At the postoperative 1 week point, the FEV<sub>1</sub> value in the Control group was 1.3 ± 0.5 L and that in the LAMA/LABA group was 1.7 ± 0.5 L. On the other hand, that in the COPD group was 1.7 ± 0.5 L, which was significantly higher compared to that in the Control group (p = 0.0251 and p = 0.0369). The intervention of LAMA/LABA for the COPD and non-obstructive patients resulted in the less decreased degree of the pulmonary function in FEV<sub>1</sub> compared to that in the Control group. Based on the PRO-QOL by the CDS, the intervention of LAMA/LABA significantly reduced the total dyspnea in the LAMA/LABA group compared to that in the Control group (p = 0.0348). <strong>Conclusion:</strong> The perioperative intervention of LAMA/LABA should lead to maintaining the postoperative pulmonary function of the FEV<sub>1</sub> during the lobectomy with COPD and non-obstructive patients and the improvement of PRO-QOL.展开更多
Objective:This trial is aimed at evaluating the efficacy and safety of acupuncture on treating FC.Methods:We describe the protocol for a randomized,patient-assessor-blinded,sham controlled trial.Seventy-two eligible p...Objective:This trial is aimed at evaluating the efficacy and safety of acupuncture on treating FC.Methods:We describe the protocol for a randomized,patient-assessor-blinded,sham controlled trial.Seventy-two eligible patients will be randomly assigned to the intervention group(acupuncture)or the control group(sham acupuncture).All treatment will be given 26 sessions of acupuncture or sham acupuncture over 8 weeks(5 times per week in the first 2 weeks,3 times per week during weeks 3-6,and 2 times per week during weeks 7 and 8).Each treatment will last for 20 min.The primary outcome is the change in mean complete spontaneous bowel movements(CSBMs)per week.The secondary out?comes are patient assessment of constipation quality of life questionnaire(PAC-QOL),self-rating anxiety scale(SAS),and the dosage of the medication.All adverse events will be recorded in detail and managed by corresponding researchers as quickly as possible.Outcomes will be evaluated at baseline(1 week before treatment),2 weeks after intervention begins,6 weeks after intervention begins,8 weeks after intervention begins,4 weeks follow-up,and 12 weeks follow-up.Discussion:The results of this study will provide the evidence of the efficacy and safety of acupuncture as a traditional treatment methods for functional constipation.Trial registration:Chinese Clinical Trial Registry,ChiCTR-INR-17011472.Registered on 23 May 2017.展开更多
OBJECTIVE:To evaluate the effectiveness of a combined Traditional Chinese Medicine(TCM) therapy versus conventional treatment on adolescent idiopathic scoliosis.METHODS:One hundred twenty outpatients with mild and mod...OBJECTIVE:To evaluate the effectiveness of a combined Traditional Chinese Medicine(TCM) therapy versus conventional treatment on adolescent idiopathic scoliosis.METHODS:One hundred twenty outpatients with mild and moderate adolescent idiopathic scoliosis were randomly divided into a TCM group(TCMG)and a brace group(CG).TCMG patients underwent Daoyin,Tuina,and acupotomology therapies.CG patients were treated with a Milwaukee brace.Each patient's Cobb angle was measured after 12 and 24 months of treatment,and pulmonary function was determined after 12 months of treatment.Average electromyogram(AEMG) ratio of the surface electromyogram was measured after 6 and 12 months of treatment and followed-up after 18 and 24 months.RESULTS:The Cobb angle significantly decreased in both groups after 12 months of treatment compared with before treatment(P< 0.05).The percentages of original Cobb angle in TCMG and CG were51.4%and 47.8%(P > 0.05) after 12 months and62.5%and 34.7%(P < 0.05) after 24 months,respectively.Pulmonary function significantly improved after 12 months in TCMG(P < 0.05) but significantly decreased in CG(P < 0.05).The AEMG ratio was significantly lower(P < 0.01) and tended to remain at1 after stopping treatment in TCMG,but increased in CG(P<0.05).CONCLUSION:TCM combined therapy can prevent the progression of scoliosis.The AEMG ratio is a promising index that could replace radiography in the evaluation of treatment effect and progression in scoliosis.展开更多
OBJECTIVE:To investigate the effect of transcutaneous electrical acupoint stimulation (TEAS) on enhanced recovery after surgery (ERAS) in laparoscopic colorectal cancer resection and its clinical significance.METHODS:...OBJECTIVE:To investigate the effect of transcutaneous electrical acupoint stimulation (TEAS) on enhanced recovery after surgery (ERAS) in laparoscopic colorectal cancer resection and its clinical significance.METHODS:Sixty-four patients undergoing laparoscopic colorectal resection were randomly divided into two groups,the control group (group A) and the TEAS group (group B).Patients in the TEAS group received electroacupuncture stimulation of bilateral Zusanli (ST 36) at 30 min before anesthesia to the end of surgery.The patients in the control group were not given the stimulation.Perioperative anesthesia management of the two groups were performed according to the ERAS guidelines,and postoperative patient-controlled intravenous analgesia (PCIA) was used.The amount of remifentanil used in the two groups was observed and recorded,and the visual analogue scale (VAS) of the 4,12,24 and 48 h after surgery in the two groups was recorded.Moreover,postoperative anal exhaust time,postoperative feeding time,postoperative first ambulation time and postoperative hospital stay length were compared between the two groups.RESULTS:Compared with group A,the VAS score of group B decreased significantly at 48 h after operation (P < 0.05).The postoperative anal exhaust time in group B was significantly shorter than that of group A (P < 0.05).There was no significant difference between the two groups with regards to remifentanil consumption,postoperative feeding time,postoperative first ambulation time and postoperative hospital stay (all P > 0.05).CONCLUSION:TEAS can promote the recovery of postoperative gastrointestinal function and reduce the pain intensity 48 h after surgery,thus satisfying the need of early postoperative analgesia.展开更多
Pharmaco-psychosocial treatment (PPST) refers to a treatment paradigm combining pharmacotherapy with psychosocial therapy. We conducted an 18-month randomized controlled tracking study to evaluate the efficacy of soci...Pharmaco-psychosocial treatment (PPST) refers to a treatment paradigm combining pharmacotherapy with psychosocial therapy. We conducted an 18-month randomized controlled tracking study to evaluate the efficacy of social skills training (SST) in 11 individuals with schizophrenia on risperidone monotherapy. They were randomized to either SST or non-SST group, and Global Assessment Functioning (GAF) and Brief Psychiatric Rating Scale (BPRS) scores in the 2 groups showed gradual improvement. In the SST group, Digit Span Distraction Test (DSDT) at 12 and 18 months showed significant improvement. The Subjective Deficit Syndrome Scale (SDSS) scores in the SST group showed significant improvement after 6 months and showed a significant difference in comparison between the groups. After the subjective feeling of health was recovered, the items of motivation were recovered as a direct effect of SST. Some items of the Life Assessment Scale for the Mentally Ill (LASMI) score showed significant improvement (or significant trend) in only the SST group after 6 months. Items of daily life, work skills, and self-recognition were continuously improved. We report 2 cases in the SST group that had DSDT improvement in parallel with change of action and communication as a change of social function. This study is only exploratory due to the small number of cases. However, we have demonstrated potential improvement in cognitive function due to learning experiences that required working memory and attention, thus providing improvement in social life.展开更多
Objective: To evaluate the effect of chewing sugar-free gum on gastrointestinal function recovery after cesarean section. Methods: Randomized controlled trials comparing the use of chewing gum in postoperative recover...Objective: To evaluate the effect of chewing sugar-free gum on gastrointestinal function recovery after cesarean section. Methods: Randomized controlled trials comparing the use of chewing gum in postoperative recovery with a control group were retrieved from the databases including Pubmed, Cochrane Library, Science Direct, Web of Science, CBM, CNKI, Wanfang and VIP, et al. After screening literatures, evaluating the quality of studies, extracting data, the RevMan5.3 software was used for data analysis. Results: A total of 13 RCTs including 2233 patients were analyzed in the study. The results showed that chewing gum after cesarean delivery can effectively shorten the recovery time of bowel sounds, passage of flatus and first defecation (all P Conclusion: Chewing sugar-free gum after cesarean section can promote the early recovery of gastrointestinal function, but the side effects of chewing gum are still unclear, which needs more clinical, large sample and high-quality studies to further verify.展开更多
Random vibration control is aimed at reproducing the power spectral density （PSD） at specified control points. The classical frequency-spectrum equalization algorithm needs to compute the average of the multiple fre...Random vibration control is aimed at reproducing the power spectral density （PSD） at specified control points. The classical frequency-spectrum equalization algorithm needs to compute the average of the multiple frequency response functions （FRFs）, which lengthens the control loop time in the equalization process. Likewise, the feedback control algorithm has a very slow convergence rate due to the small value of the feedback gain parameter to ensure stability of the system. To overcome these limitations, an adaptive inverse control of random vibrations based on the filtered-X least mean-square （LMS） algorithm is proposed. Furthermore, according to the description and iteration characteristics of random vibration tests in the frequency domain, the frequency domain LMS algorithm is adopted to refine the inverse characteristics of the FRF instead of the traditional time domain LMS algorithm. This inverse characteristic, which is called the impedance function of the system under control, is used to update the drive PSD directly. The test results indicated that in addition to successfully avoiding the instability problem that occurs during the iteration process, the adaptive control strategy minimizes the amount of time needed to obtain a short control loop and achieve equalization.展开更多
This paper studies the problem of robust H∞ control of piecewise-linear chaotic systems with random data loss. The communication links between the plant and the controller are assumed to be imperfect （that is, data ...This paper studies the problem of robust H∞ control of piecewise-linear chaotic systems with random data loss. The communication links between the plant and the controller are assumed to be imperfect （that is, data loss occurs intermittently, which appears typically in a network environment）. The data loss is modelled as a random process which obeys a Bernoulli distribution. In the face of random data loss, a piecewise controller is designed to robustly stabilize the networked system in the sense of mean square and also achieve a prescribed H∞ disturbance attenuation performance based on a piecewise-quadratic Lyapunov function. The required H∞ controllers can be designed by solving a set of linear matrix inequalities （LMIs）. Chua＇s system is provided to illustrate the usefulness and applicability of the developed theoretical results.展开更多
目的:通过网状Meta分析整合直接与间接证据,比较不同非侵入性脑刺激技术及参数对帕金森病患者步态和平衡功能的影响,并排序最佳干预方案。方法:检索CNKI、万方、维普、CBM、PubMed、Cochrane图书馆、EMbase和Web of Science数据库,筛选...目的:通过网状Meta分析整合直接与间接证据,比较不同非侵入性脑刺激技术及参数对帕金森病患者步态和平衡功能的影响,并排序最佳干预方案。方法:检索CNKI、万方、维普、CBM、PubMed、Cochrane图书馆、EMbase和Web of Science数据库,筛选有关非侵入性脑刺激改善帕金森病患者步态和平衡障碍的随机对照试验,检索时限截止到2025-06-16。对纳入的研究进行数据提取,采用RevMan 5.4.1软件和Stata 17.0软件进行统计学处理。结果:①纳入47篇研究,共2767例患者,试验组1399例、对照组1368例;②传统Meta分析结果显示,高频重复经颅磁刺激可以降低统一帕金森病评定量表第三部分(UPDRSⅢ)评分、冻结步态问卷(FOG-Q)评分,缩短起立-行走计时试验(TUGT)时间,增加步长,改善步速,提高Berg平衡量表评分,且均优于常规治疗(P<0.05);经颅直流电刺激可以降低冻结步态问卷评分、缩短起立-行走计时试验时间,增加步长,改善步速,提高Berg平衡量表评分,且均优于常规治疗(P<0.05);低频重复经颅磁刺激可以降低统一帕金森病评定量表第三部分评分,与常规治疗比较有显著性差异(P<0.05);3种脑刺激方法对于步频的改善均无统计学意义(P>0.05),受限于研究数量少,需进一步验证;③网状Meta分析结果显示(以下排序均基于间接比较),在降低统一帕金森评定量表第三部分评分方面:高频重复经颅磁刺激选择初级运动皮质区(M1)+背外侧前额叶皮质区(DLPFC)双侧靶点联合刺激的累积概率排序最高(95.2%),在初级运动皮质区上刺激排序次之(72.5%);在缩短起立-行走计时试验时间方面:高频重复经颅磁刺激在背外侧前额叶皮质区刺激的累积概率排序最高(85.5%),在初级运动皮质区上刺激排序次之(69.0%);在改善步速方面:高频重复经颅磁刺激在背外侧前额叶皮质区的累积概率排序最高(92.5%),在初级运动皮质区上刺激排序次之(76.7%);在提高Berg平衡量表评分方面:高频重复经颅磁刺激在初级运动皮质区上刺激的累积概率排序最高(79.9%),经颅直流电刺激在小脑上刺激排序次之(79.8%);④GRADE证据质量评价结果显示,统一帕金森评定量表第三部分、冻结步态问卷评分、起立-行走计时试验、步长证据等级为中级,步速、步频、Berg平衡量表评分为低级。结论:不同类型非侵入性脑刺激都可以改善帕金森病患者的步态和平衡功能。背外侧前额叶皮质区靶向的高频重复经颅磁刺激对步态功能的改善优于初级运动皮质(中等证据),而初级运动皮质靶向的高频重复经颅磁刺激对平衡功能的改善优于小脑靶向的经颅直流电刺激(低级证据)。展开更多
AIM:To evaluate the therapeutic effects of itopride vs other drugs(placebo,domperidone,mosapride) for functional dyspepsia(FD).METHODS:Randomized controlled trials(RCTs) of itopride for FD were retrieved from database...AIM:To evaluate the therapeutic effects of itopride vs other drugs(placebo,domperidone,mosapride) for functional dyspepsia(FD).METHODS:Randomized controlled trials(RCTs) of itopride for FD were retrieved from databases.Relevant information was extracted and analyzed,using the relative risk(RR) and weighted mean deviation,as appropriate.A random or fixed effect model was used,based on the heterogeneity of the included articles,and visual inspection of funnel plots was used to evaluate publication bias.RESULTS:Nine RCTs enrolling 2620 FD cases were included;1372 cases received itopride treatment and 1248 cases received placebo or other drugs(control groups).Compared with control groups,itopride had superior RR values of 1.11 [95%CI:(1.03,1.19),P = 0.006],1.21 [95%CI:(1.03,1.44),P = 0.02],and1.24 [95%CI:(1.01,1.53),P = 0.04] for global patient assessment,postprandial fullness,and early satiety,respectively.For the Leeds Dyspepsia Questionnaire score,the weighted mean deviation was-1.38 [95%CI:(-1.75,-1.01),P < 0.01].The incidence of adverse effects was similar in the itopride and control groups.The funnel plots for all indicators showed no evidence of publication bias.CONCLUSION:Itopride has good efficacy in terms of global patients assessment,postprandial fullness,and early satiety in the treatment of patients with FD and shows a low rate of adverse reactions.Itopride can greatly improve FD syndromes-score.展开更多
目的:神经肌肉训练是近年来较新的一种综合康复治疗方法,对膝骨关节炎的疗效尚存在争议。此次研究通过系统Meta分析评价神经肌肉训练治疗膝骨关节炎的临床疗效。方法:全面检索中国知网、维普、万方、中国生物医学文献数据库、PubMed、We...目的:神经肌肉训练是近年来较新的一种综合康复治疗方法,对膝骨关节炎的疗效尚存在争议。此次研究通过系统Meta分析评价神经肌肉训练治疗膝骨关节炎的临床疗效。方法:全面检索中国知网、维普、万方、中国生物医学文献数据库、PubMed、Web of Science、Cochrane Library、EBSCO和Embase文献数据库中有关神经肌肉训练治疗膝骨关节炎的临床随机对照试验,时间从各数据库建库至2023年10月,神经肌肉训练组(试验组)使用神经肌肉训练或以神经肌肉训练为主要干预方式;对照组为空白组或采用常规康复治疗。结局指标包括西安大略和麦克马斯特大学骨关节炎指数评分(The Western Ontario and McMaster Universities Osteoarthritis Index,WOMAC)、行走计时、膝关节稳定性、30 s内膝关节最大弯曲次数。采用Cochrane偏倚风险评估工具和物理治疗证据数据库量表确定纳入文献质量,使用RevMan5.4软件进行Meta分析。结果:共纳入11项临床随机对照试验,纳入样本量628例。Meta分析结果显示:①WOMAC疼痛评分试验组优于对照组(SMD=0.38,95%CI:0.08-0.69,P=0.01);②膝关节稳定性和30s内膝关节最大弯曲次数试验组均优于对照组(膝关节稳定性:SMD=0.57,95%CI:0.23-0.92,P=0.001;30 s内膝关节最大弯曲次数:SMD=0.35,95%CI:0.05-0.65,P=0.02);两组均可提高膝骨关节炎患者行走速度,改善行走能力,但差异无显著性意义(行走计时:SMD=-0.22,95%CI:-0.48-0.03,P=0.09);③WOMAC身体功能评分试验组优于对照组(SMD=-0.79,95%CI:-1.30至-0.28,P=0.002)。结论:神经肌肉训练可以有效改善膝骨关节炎患者的疼痛,增强膝关节稳定性,促进功能恢复,但仍需要更多高质量随机对照试验进一步研究证实。展开更多
文摘<strong>Background:</strong> A dual bronchodilator, long-acting anticholine drugs (glycopyrronium, LAMA) and the long running <em>β</em>-<sub>2</sub> stimulant (indacaterol, LABA), are effective for the treatment of chronic obstructive pulmonary disease (COPD). To evaluate the effectiveness of the perioperative intervention of LAMA/LABA, a randomized prospective trial was performed for the lung cancer patients receiving a lobectomy with normal pulmonary function and COPD. <strong>Methods:</strong> Based on the results of the preoperative pulmonary function test, 25 patients were diagnosed with COPD [% forced expiratory volume in 1 second (%FEV<sub>1</sub>) < 70%]. Thirty-seven patients were enrolled as non-obstructive patients (70% ≤ %FEV<sub>1</sub>), who were randomized into two groups, the LAMA/LABA (n = 19) and the Control group (n = 18). The LAMA/LABA and the COPD groups daily received inhaled LAMA (50 μg) and LABA (110 μg) for 1 week before surgery and for least 4 weeks after surgery. The Control group had no treatment of the dual bronchodilator. The actual values were measured during the perioperative pulmonary function at three points of the preoperative baseline, the postoperative 1 week and the postoperative 4 weeks;these changes and changed ratios were then calculated. The patient-reported outcomes of the quality of life (PRO-QOL) were evaluated by the Cancer Dyspnea Scale (CDS), the COPD assessment test, and the St. George’s Respiratory Questionnaire. <strong>Results:</strong> Regarding the value of FEV<sub>1</sub> at the baseline, that in the LAMA/LABA group was 79.2% ± 6.4% and that in the Control group was 80.9% ± 6.4%, but that in the COPD groups was 57.9% ± 8.7%;there was a significant difference between the COPD and the Control group (p < 0.0001). At the postoperative 1 week point, the FEV<sub>1</sub> value in the Control group was 1.3 ± 0.5 L and that in the LAMA/LABA group was 1.7 ± 0.5 L. On the other hand, that in the COPD group was 1.7 ± 0.5 L, which was significantly higher compared to that in the Control group (p = 0.0251 and p = 0.0369). The intervention of LAMA/LABA for the COPD and non-obstructive patients resulted in the less decreased degree of the pulmonary function in FEV<sub>1</sub> compared to that in the Control group. Based on the PRO-QOL by the CDS, the intervention of LAMA/LABA significantly reduced the total dyspnea in the LAMA/LABA group compared to that in the Control group (p = 0.0348). <strong>Conclusion:</strong> The perioperative intervention of LAMA/LABA should lead to maintaining the postoperative pulmonary function of the FEV<sub>1</sub> during the lobectomy with COPD and non-obstructive patients and the improvement of PRO-QOL.
基金supported by the Shanghai Municipal Commission of Health and Family Planning(Grant No.2016LQ015)
文摘Objective:This trial is aimed at evaluating the efficacy and safety of acupuncture on treating FC.Methods:We describe the protocol for a randomized,patient-assessor-blinded,sham controlled trial.Seventy-two eligible patients will be randomly assigned to the intervention group(acupuncture)or the control group(sham acupuncture).All treatment will be given 26 sessions of acupuncture or sham acupuncture over 8 weeks(5 times per week in the first 2 weeks,3 times per week during weeks 3-6,and 2 times per week during weeks 7 and 8).Each treatment will last for 20 min.The primary outcome is the change in mean complete spontaneous bowel movements(CSBMs)per week.The secondary out?comes are patient assessment of constipation quality of life questionnaire(PAC-QOL),self-rating anxiety scale(SAS),and the dosage of the medication.All adverse events will be recorded in detail and managed by corresponding researchers as quickly as possible.Outcomes will be evaluated at baseline(1 week before treatment),2 weeks after intervention begins,6 weeks after intervention begins,8 weeks after intervention begins,4 weeks follow-up,and 12 weeks follow-up.Discussion:The results of this study will provide the evidence of the efficacy and safety of acupuncture as a traditional treatment methods for functional constipation.Trial registration:Chinese Clinical Trial Registry,ChiCTR-INR-17011472.Registered on 23 May 2017.
基金Supported by Outstanding Youth Fund of the Administration of Traditional Chinese Medicine of Zhejiang Province,China(No.2012ZQ011)
文摘OBJECTIVE:To evaluate the effectiveness of a combined Traditional Chinese Medicine(TCM) therapy versus conventional treatment on adolescent idiopathic scoliosis.METHODS:One hundred twenty outpatients with mild and moderate adolescent idiopathic scoliosis were randomly divided into a TCM group(TCMG)and a brace group(CG).TCMG patients underwent Daoyin,Tuina,and acupotomology therapies.CG patients were treated with a Milwaukee brace.Each patient's Cobb angle was measured after 12 and 24 months of treatment,and pulmonary function was determined after 12 months of treatment.Average electromyogram(AEMG) ratio of the surface electromyogram was measured after 6 and 12 months of treatment and followed-up after 18 and 24 months.RESULTS:The Cobb angle significantly decreased in both groups after 12 months of treatment compared with before treatment(P< 0.05).The percentages of original Cobb angle in TCMG and CG were51.4%and 47.8%(P > 0.05) after 12 months and62.5%and 34.7%(P < 0.05) after 24 months,respectively.Pulmonary function significantly improved after 12 months in TCMG(P < 0.05) but significantly decreased in CG(P < 0.05).The AEMG ratio was significantly lower(P < 0.01) and tended to remain at1 after stopping treatment in TCMG,but increased in CG(P<0.05).CONCLUSION:TCM combined therapy can prevent the progression of scoliosis.The AEMG ratio is a promising index that could replace radiography in the evaluation of treatment effect and progression in scoliosis.
文摘OBJECTIVE:To investigate the effect of transcutaneous electrical acupoint stimulation (TEAS) on enhanced recovery after surgery (ERAS) in laparoscopic colorectal cancer resection and its clinical significance.METHODS:Sixty-four patients undergoing laparoscopic colorectal resection were randomly divided into two groups,the control group (group A) and the TEAS group (group B).Patients in the TEAS group received electroacupuncture stimulation of bilateral Zusanli (ST 36) at 30 min before anesthesia to the end of surgery.The patients in the control group were not given the stimulation.Perioperative anesthesia management of the two groups were performed according to the ERAS guidelines,and postoperative patient-controlled intravenous analgesia (PCIA) was used.The amount of remifentanil used in the two groups was observed and recorded,and the visual analogue scale (VAS) of the 4,12,24 and 48 h after surgery in the two groups was recorded.Moreover,postoperative anal exhaust time,postoperative feeding time,postoperative first ambulation time and postoperative hospital stay length were compared between the two groups.RESULTS:Compared with group A,the VAS score of group B decreased significantly at 48 h after operation (P < 0.05).The postoperative anal exhaust time in group B was significantly shorter than that of group A (P < 0.05).There was no significant difference between the two groups with regards to remifentanil consumption,postoperative feeding time,postoperative first ambulation time and postoperative hospital stay (all P > 0.05).CONCLUSION:TEAS can promote the recovery of postoperative gastrointestinal function and reduce the pain intensity 48 h after surgery,thus satisfying the need of early postoperative analgesia.
文摘Pharmaco-psychosocial treatment (PPST) refers to a treatment paradigm combining pharmacotherapy with psychosocial therapy. We conducted an 18-month randomized controlled tracking study to evaluate the efficacy of social skills training (SST) in 11 individuals with schizophrenia on risperidone monotherapy. They were randomized to either SST or non-SST group, and Global Assessment Functioning (GAF) and Brief Psychiatric Rating Scale (BPRS) scores in the 2 groups showed gradual improvement. In the SST group, Digit Span Distraction Test (DSDT) at 12 and 18 months showed significant improvement. The Subjective Deficit Syndrome Scale (SDSS) scores in the SST group showed significant improvement after 6 months and showed a significant difference in comparison between the groups. After the subjective feeling of health was recovered, the items of motivation were recovered as a direct effect of SST. Some items of the Life Assessment Scale for the Mentally Ill (LASMI) score showed significant improvement (or significant trend) in only the SST group after 6 months. Items of daily life, work skills, and self-recognition were continuously improved. We report 2 cases in the SST group that had DSDT improvement in parallel with change of action and communication as a change of social function. This study is only exploratory due to the small number of cases. However, we have demonstrated potential improvement in cognitive function due to learning experiences that required working memory and attention, thus providing improvement in social life.
文摘Objective: To evaluate the effect of chewing sugar-free gum on gastrointestinal function recovery after cesarean section. Methods: Randomized controlled trials comparing the use of chewing gum in postoperative recovery with a control group were retrieved from the databases including Pubmed, Cochrane Library, Science Direct, Web of Science, CBM, CNKI, Wanfang and VIP, et al. After screening literatures, evaluating the quality of studies, extracting data, the RevMan5.3 software was used for data analysis. Results: A total of 13 RCTs including 2233 patients were analyzed in the study. The results showed that chewing gum after cesarean delivery can effectively shorten the recovery time of bowel sounds, passage of flatus and first defecation (all P Conclusion: Chewing sugar-free gum after cesarean section can promote the early recovery of gastrointestinal function, but the side effects of chewing gum are still unclear, which needs more clinical, large sample and high-quality studies to further verify.
基金Program for New Century Excellent Talents in Universities Under Grant No.NCET-04-0325
文摘Random vibration control is aimed at reproducing the power spectral density （PSD） at specified control points. The classical frequency-spectrum equalization algorithm needs to compute the average of the multiple frequency response functions （FRFs）, which lengthens the control loop time in the equalization process. Likewise, the feedback control algorithm has a very slow convergence rate due to the small value of the feedback gain parameter to ensure stability of the system. To overcome these limitations, an adaptive inverse control of random vibrations based on the filtered-X least mean-square （LMS） algorithm is proposed. Furthermore, according to the description and iteration characteristics of random vibration tests in the frequency domain, the frequency domain LMS algorithm is adopted to refine the inverse characteristics of the FRF instead of the traditional time domain LMS algorithm. This inverse characteristic, which is called the impedance function of the system under control, is used to update the drive PSD directly. The test results indicated that in addition to successfully avoiding the instability problem that occurs during the iteration process, the adaptive control strategy minimizes the amount of time needed to obtain a short control loop and achieve equalization.
基金Project partially supported by the Young Scientists Fund of the National Natural Science Foundation of China(Grant No.60904004)the Key Youth Science and Technology Foundation of University of Electronic Science and Technology of China (Grant No.L08010201JX0720)
文摘This paper studies the problem of robust H∞ control of piecewise-linear chaotic systems with random data loss. The communication links between the plant and the controller are assumed to be imperfect （that is, data loss occurs intermittently, which appears typically in a network environment）. The data loss is modelled as a random process which obeys a Bernoulli distribution. In the face of random data loss, a piecewise controller is designed to robustly stabilize the networked system in the sense of mean square and also achieve a prescribed H∞ disturbance attenuation performance based on a piecewise-quadratic Lyapunov function. The required H∞ controllers can be designed by solving a set of linear matrix inequalities （LMIs）. Chua＇s system is provided to illustrate the usefulness and applicability of the developed theoretical results.
文摘目的:通过网状Meta分析整合直接与间接证据,比较不同非侵入性脑刺激技术及参数对帕金森病患者步态和平衡功能的影响,并排序最佳干预方案。方法:检索CNKI、万方、维普、CBM、PubMed、Cochrane图书馆、EMbase和Web of Science数据库,筛选有关非侵入性脑刺激改善帕金森病患者步态和平衡障碍的随机对照试验,检索时限截止到2025-06-16。对纳入的研究进行数据提取,采用RevMan 5.4.1软件和Stata 17.0软件进行统计学处理。结果:①纳入47篇研究,共2767例患者,试验组1399例、对照组1368例;②传统Meta分析结果显示,高频重复经颅磁刺激可以降低统一帕金森病评定量表第三部分(UPDRSⅢ)评分、冻结步态问卷(FOG-Q)评分,缩短起立-行走计时试验(TUGT)时间,增加步长,改善步速,提高Berg平衡量表评分,且均优于常规治疗(P<0.05);经颅直流电刺激可以降低冻结步态问卷评分、缩短起立-行走计时试验时间,增加步长,改善步速,提高Berg平衡量表评分,且均优于常规治疗(P<0.05);低频重复经颅磁刺激可以降低统一帕金森病评定量表第三部分评分,与常规治疗比较有显著性差异(P<0.05);3种脑刺激方法对于步频的改善均无统计学意义(P>0.05),受限于研究数量少,需进一步验证;③网状Meta分析结果显示(以下排序均基于间接比较),在降低统一帕金森评定量表第三部分评分方面:高频重复经颅磁刺激选择初级运动皮质区(M1)+背外侧前额叶皮质区(DLPFC)双侧靶点联合刺激的累积概率排序最高(95.2%),在初级运动皮质区上刺激排序次之(72.5%);在缩短起立-行走计时试验时间方面:高频重复经颅磁刺激在背外侧前额叶皮质区刺激的累积概率排序最高(85.5%),在初级运动皮质区上刺激排序次之(69.0%);在改善步速方面:高频重复经颅磁刺激在背外侧前额叶皮质区的累积概率排序最高(92.5%),在初级运动皮质区上刺激排序次之(76.7%);在提高Berg平衡量表评分方面:高频重复经颅磁刺激在初级运动皮质区上刺激的累积概率排序最高(79.9%),经颅直流电刺激在小脑上刺激排序次之(79.8%);④GRADE证据质量评价结果显示,统一帕金森评定量表第三部分、冻结步态问卷评分、起立-行走计时试验、步长证据等级为中级,步速、步频、Berg平衡量表评分为低级。结论:不同类型非侵入性脑刺激都可以改善帕金森病患者的步态和平衡功能。背外侧前额叶皮质区靶向的高频重复经颅磁刺激对步态功能的改善优于初级运动皮质(中等证据),而初级运动皮质靶向的高频重复经颅磁刺激对平衡功能的改善优于小脑靶向的经颅直流电刺激(低级证据)。
基金Supported by The Natural Science Foundation of Zhejiang Province of China,No. LY12H29002Traditional Chinese Medicine Science Foundation of Zhejiang Province of China,No. 2011ZB032
文摘AIM:To evaluate the therapeutic effects of itopride vs other drugs(placebo,domperidone,mosapride) for functional dyspepsia(FD).METHODS:Randomized controlled trials(RCTs) of itopride for FD were retrieved from databases.Relevant information was extracted and analyzed,using the relative risk(RR) and weighted mean deviation,as appropriate.A random or fixed effect model was used,based on the heterogeneity of the included articles,and visual inspection of funnel plots was used to evaluate publication bias.RESULTS:Nine RCTs enrolling 2620 FD cases were included;1372 cases received itopride treatment and 1248 cases received placebo or other drugs(control groups).Compared with control groups,itopride had superior RR values of 1.11 [95%CI:(1.03,1.19),P = 0.006],1.21 [95%CI:(1.03,1.44),P = 0.02],and1.24 [95%CI:(1.01,1.53),P = 0.04] for global patient assessment,postprandial fullness,and early satiety,respectively.For the Leeds Dyspepsia Questionnaire score,the weighted mean deviation was-1.38 [95%CI:(-1.75,-1.01),P < 0.01].The incidence of adverse effects was similar in the itopride and control groups.The funnel plots for all indicators showed no evidence of publication bias.CONCLUSION:Itopride has good efficacy in terms of global patients assessment,postprandial fullness,and early satiety in the treatment of patients with FD and shows a low rate of adverse reactions.Itopride can greatly improve FD syndromes-score.
文摘目的:神经肌肉训练是近年来较新的一种综合康复治疗方法,对膝骨关节炎的疗效尚存在争议。此次研究通过系统Meta分析评价神经肌肉训练治疗膝骨关节炎的临床疗效。方法:全面检索中国知网、维普、万方、中国生物医学文献数据库、PubMed、Web of Science、Cochrane Library、EBSCO和Embase文献数据库中有关神经肌肉训练治疗膝骨关节炎的临床随机对照试验,时间从各数据库建库至2023年10月,神经肌肉训练组(试验组)使用神经肌肉训练或以神经肌肉训练为主要干预方式;对照组为空白组或采用常规康复治疗。结局指标包括西安大略和麦克马斯特大学骨关节炎指数评分(The Western Ontario and McMaster Universities Osteoarthritis Index,WOMAC)、行走计时、膝关节稳定性、30 s内膝关节最大弯曲次数。采用Cochrane偏倚风险评估工具和物理治疗证据数据库量表确定纳入文献质量,使用RevMan5.4软件进行Meta分析。结果:共纳入11项临床随机对照试验,纳入样本量628例。Meta分析结果显示:①WOMAC疼痛评分试验组优于对照组(SMD=0.38,95%CI:0.08-0.69,P=0.01);②膝关节稳定性和30s内膝关节最大弯曲次数试验组均优于对照组(膝关节稳定性:SMD=0.57,95%CI:0.23-0.92,P=0.001;30 s内膝关节最大弯曲次数:SMD=0.35,95%CI:0.05-0.65,P=0.02);两组均可提高膝骨关节炎患者行走速度,改善行走能力,但差异无显著性意义(行走计时:SMD=-0.22,95%CI:-0.48-0.03,P=0.09);③WOMAC身体功能评分试验组优于对照组(SMD=-0.79,95%CI:-1.30至-0.28,P=0.002)。结论:神经肌肉训练可以有效改善膝骨关节炎患者的疼痛,增强膝关节稳定性,促进功能恢复,但仍需要更多高质量随机对照试验进一步研究证实。
