目的系统评价胸腔化疗联合热疗治疗癌性胸腔积液的有效性及安全性。方法 2015年8月—2016年1月,计算机检索Cochrane Library、PubMed、EMBase、Web of Science等外文数据库以及中国生物医学文献数据库、中国知网、维普网和万方数据知识...目的系统评价胸腔化疗联合热疗治疗癌性胸腔积液的有效性及安全性。方法 2015年8月—2016年1月,计算机检索Cochrane Library、PubMed、EMBase、Web of Science等外文数据库以及中国生物医学文献数据库、中国知网、维普网和万方数据知识服务平台等中文数据库,并辅以补充检索手段,收集比较胸腔化疗联合热疗(联合组)与单纯胸腔化疗(对照组)治疗癌性胸腔积液有效性及安全性的随机对照试验。提取纳入文献资料,包括第一作者、发表时间、样本量、年龄、卡氏评分、化疗方案及结局指标,并进行方法学质量评价。结果共纳入23篇文献,包括1 647例患者,其中联合组819例,对照组828例。5篇文献报道了随机方法,各纳入文献均未说明分配隐藏和盲法实施情况,各文献两组患者基本特征具有可比性,1篇文献有患者失访,各文献均无选择性报告结果偏倚。联合组治疗癌性胸腔积液总有效率[OR=3.72,95%CI(2.92,4.74)]、完全缓解率[OR=2.24,95%CI(1.18,2.78)]、生活质量改善率[OR=3.66,95%CI(2.64,5.07)]均高于对照组(P<0.05)。联合组与对照组恶心呕吐[OR=0.80,95%CI(0.60,1.06)]、白细胞计数下降[OR=0.81,95%CI(0.60,1.10)]、发热[OR=0.98,95%CI(0.69,1.40)]、肝脏损害[OR=0.45,95%CI(0.11,1.81)]、气胸[OR=0.41,95%CI(0.06,2.91)]、皮肤烫伤[OR=5.33,95%CI(0.91,31.14)]发生率比较,差异均无统计学意义(P>0.05);联合组胸痛[OR=0.34,95%CI(0.16,0.74)]发生率低于对照组,皮下脂肪硬结[OR=6.27,95%CI(1.08,36.27)]发生率高于对照组(P<0.05)。结论与单纯胸腔化疗相比,胸腔化疗联合热疗可提高癌性胸腔积液患者近期疗效,显著改善患者生活质量,并且临床安全性较好,但其长期疗效和安全性评价尚需大样本高质量的研究进一步验证。展开更多
The revision of CONSORT guidelines for reporting blinding in randomised controlled trials is the subject of controversy and criticism. To determine whether the criticism is justified, in this short communication paper...The revision of CONSORT guidelines for reporting blinding in randomised controlled trials is the subject of controversy and criticism. To determine whether the criticism is justified, in this short communication paper we discuss the problems encountered in the methodology of the assessment of blinding, and the reporting of blinding in randomised controlled trials and the standards of reporting on blinding with reference to their usage in clinical trials of acupuncture for chronic pain. To conclude we recommend two simple guidelines： the development of sound clinical protocols that anticipate potential difficulties and reinforce overall internal validity, and secondly. the accurate reporting of the methodologies used to ensure a clear view of blinding procedures.展开更多
Quantum key distribution(QKD),rooted in quantum mechanics,offers information-theoretic security.However,practi-cal systems open security threats due to imperfections,notably bright-light blinding attacks targeting sin...Quantum key distribution(QKD),rooted in quantum mechanics,offers information-theoretic security.However,practi-cal systems open security threats due to imperfections,notably bright-light blinding attacks targeting single-photon detectors.Here,we propose a concise,robust defense strategy for protecting single-photon detectors in QKD systems against blinding attacks.Our strategy uses a dual approach:detecting the bias current of the avalanche photodiode(APD)to defend against con-tinuous-wave blinding attacks,and monitoring the avalanche amplitude to protect against pulsed blinding attacks.By integrat-ing these two branches,the proposed solution effectively identifies and mitigates a wide range of bright light injection attempts,significantly enhancing the resilience of QKD systems against various bright-light blinding attacks.This method forti-fies the safeguards of quantum communications and offers a crucial contribution to the field of quantum information security.展开更多
Trachoma is one of the most widespread blinding eye diseases, which is harmful to human visual health. The efforts to prevent and control trachoma in China can be divided into three periods, i.e., highly epidemic peri...Trachoma is one of the most widespread blinding eye diseases, which is harmful to human visual health. The efforts to prevent and control trachoma in China can be divided into three periods, i.e., highly epidemic period, research on pathogenesis and control of trachoma, and blinding trachoma elimination and epidemiological evaluation. In 1956, Prof. Feifan Tang and Xiaolou Zhang first discovered and isolated Chlamydia trachomatis, which clarified the cause of trachoma, and kick-started a fresh chapter in trachoma research, prevention, and control around the world. Although, the prevalence of trachoma differed in different areas, the average prevalence once exceeded 50% and was as high as 90% in some areas before and at early liberation of China. Therefore, the government-led efforts were made to comprehensively prevent and control trachoma, including development of National Plan for the Prevention and Control of Trachoma, nationwide screening and treatment of trachoma, implementation of National Patriotic Health Campaign and improvement of water supply and lavatories. After decades of effort, China reached the goal of eliminating blinding trachoma in 2015. China has gained remarkable achievements in the prevention and treatment of trachoma, making outstanding contributions toward the goal of eliminating trachoma worldwide. The research, prevention, and control of trachoma in China were reviewed in this paper.展开更多
As one of the key components of clinical trials, blinding, if successfully implemented, can help to mitigate the risks of implementation bias and measurement bias, consequently improving the validity and reliability o...As one of the key components of clinical trials, blinding, if successfully implemented, can help to mitigate the risks of implementation bias and measurement bias, consequently improving the validity and reliability of the trial results. However, successful blinding in clinical trials of traditional Chinese medicine(TCM) is hard to achieve, and the evaluation of blinding success through blinding assessment lacks established guidelines. Taking into account the challenges associated with blinding in the TCM field, here we present a framework for assessing blinding. Further, this study proposes a blinding assessment protocol for TCM clinical trials, building upon the framework and the existing methods. An assessment report checklist and an approach for evaluating the assessment results are presented based on the proposed protocol. It is anticipated that these improvements to blinding assessment will generate greater awareness among researchers, facilitate the standardization of blinding, and augment the blinding effectiveness. The use of this blinding assessment may further advance the quality and precision of TCM clinical trials and improve the accuracy of the trial results. The blinding assessment protocol will undergo continued optimization and refinement, drawing upon expert consensus and experience derived from clinical trials.展开更多
在针刺随机对照研究中,对照组的合理设置直接关系到研究结果的正确解读。为了解答针刺效应是否超越安慰剂,即针刺是否具有特异性效应的问题,如何设置科学可行的安慰针刺对照组一直是研究的热点和难题。本文结合目前常用的安慰针刺类型,...在针刺随机对照研究中,对照组的合理设置直接关系到研究结果的正确解读。为了解答针刺效应是否超越安慰剂,即针刺是否具有特异性效应的问题,如何设置科学可行的安慰针刺对照组一直是研究的热点和难题。本文结合目前常用的安慰针刺类型,对2020年发表在British Medical Journal上的1项关于针刺治疗无先兆偏头痛的随机对照试验中安慰针刺方法和成功施盲要素进行深入分析,并对如何在针刺治疗痛证中优化安慰针刺提出思考,以期为针刺临床研究提供参考。展开更多
基金Hugh MacPherson is supported by a Career Scientist Award from the National Institute for Health Research,UK
文摘The revision of CONSORT guidelines for reporting blinding in randomised controlled trials is the subject of controversy and criticism. To determine whether the criticism is justified, in this short communication paper we discuss the problems encountered in the methodology of the assessment of blinding, and the reporting of blinding in randomised controlled trials and the standards of reporting on blinding with reference to their usage in clinical trials of acupuncture for chronic pain. To conclude we recommend two simple guidelines： the development of sound clinical protocols that anticipate potential difficulties and reinforce overall internal validity, and secondly. the accurate reporting of the methodologies used to ensure a clear view of blinding procedures.
基金This work was supported by the Major Scientific and Technological Special Project of Anhui Province(202103a13010004)the Major Scientific and Technological Special Project of Hefei City(2021DX007)+1 种基金the Key R&D Plan of Shandong Province(2020CXGC010105)the China Postdoctoral Science Foundation(2021M700315).
文摘Quantum key distribution(QKD),rooted in quantum mechanics,offers information-theoretic security.However,practi-cal systems open security threats due to imperfections,notably bright-light blinding attacks targeting single-photon detectors.Here,we propose a concise,robust defense strategy for protecting single-photon detectors in QKD systems against blinding attacks.Our strategy uses a dual approach:detecting the bias current of the avalanche photodiode(APD)to defend against con-tinuous-wave blinding attacks,and monitoring the avalanche amplitude to protect against pulsed blinding attacks.By integrat-ing these two branches,the proposed solution effectively identifies and mitigates a wide range of bright light injection attempts,significantly enhancing the resilience of QKD systems against various bright-light blinding attacks.This method forti-fies the safeguards of quantum communications and offers a crucial contribution to the field of quantum information security.
文摘Trachoma is one of the most widespread blinding eye diseases, which is harmful to human visual health. The efforts to prevent and control trachoma in China can be divided into three periods, i.e., highly epidemic period, research on pathogenesis and control of trachoma, and blinding trachoma elimination and epidemiological evaluation. In 1956, Prof. Feifan Tang and Xiaolou Zhang first discovered and isolated Chlamydia trachomatis, which clarified the cause of trachoma, and kick-started a fresh chapter in trachoma research, prevention, and control around the world. Although, the prevalence of trachoma differed in different areas, the average prevalence once exceeded 50% and was as high as 90% in some areas before and at early liberation of China. Therefore, the government-led efforts were made to comprehensively prevent and control trachoma, including development of National Plan for the Prevention and Control of Trachoma, nationwide screening and treatment of trachoma, implementation of National Patriotic Health Campaign and improvement of water supply and lavatories. After decades of effort, China reached the goal of eliminating blinding trachoma in 2015. China has gained remarkable achievements in the prevention and treatment of trachoma, making outstanding contributions toward the goal of eliminating trachoma worldwide. The research, prevention, and control of trachoma in China were reviewed in this paper.
基金supported by the National Natural Science Foundation of China(No.82174530).
文摘As one of the key components of clinical trials, blinding, if successfully implemented, can help to mitigate the risks of implementation bias and measurement bias, consequently improving the validity and reliability of the trial results. However, successful blinding in clinical trials of traditional Chinese medicine(TCM) is hard to achieve, and the evaluation of blinding success through blinding assessment lacks established guidelines. Taking into account the challenges associated with blinding in the TCM field, here we present a framework for assessing blinding. Further, this study proposes a blinding assessment protocol for TCM clinical trials, building upon the framework and the existing methods. An assessment report checklist and an approach for evaluating the assessment results are presented based on the proposed protocol. It is anticipated that these improvements to blinding assessment will generate greater awareness among researchers, facilitate the standardization of blinding, and augment the blinding effectiveness. The use of this blinding assessment may further advance the quality and precision of TCM clinical trials and improve the accuracy of the trial results. The blinding assessment protocol will undergo continued optimization and refinement, drawing upon expert consensus and experience derived from clinical trials.
文摘在针刺随机对照研究中,对照组的合理设置直接关系到研究结果的正确解读。为了解答针刺效应是否超越安慰剂,即针刺是否具有特异性效应的问题,如何设置科学可行的安慰针刺对照组一直是研究的热点和难题。本文结合目前常用的安慰针刺类型,对2020年发表在British Medical Journal上的1项关于针刺治疗无先兆偏头痛的随机对照试验中安慰针刺方法和成功施盲要素进行深入分析,并对如何在针刺治疗痛证中优化安慰针刺提出思考,以期为针刺临床研究提供参考。
