目的系统评价机械通气患者进行早期活动的效果。方法通过计算机检索PubMed、EMBASE、Web of Science、Cochrane Central Register of Controlled Trials(CENTRAL)、CINAHL、Physiotherapy Evidence Database(PEDro)、中国知网(CNKI)与...目的系统评价机械通气患者进行早期活动的效果。方法通过计算机检索PubMed、EMBASE、Web of Science、Cochrane Central Register of Controlled Trials(CENTRAL)、CINAHL、Physiotherapy Evidence Database(PEDro)、中国知网(CNKI)与万方数据库中关于机械通气患者早期活动的随机对照试验,经筛选文献,提取资料与评价质量后行Meta分析。结果共纳入14项随机对照试验,Meta分析结果显示,与常规护理措施相比,早期活动能够缩短机械通气时间[MD=-46.98,95%CI(-66.49,-27.48),P<0.001]、ICU治疗时间[MD=-1.96,95%CI(-2.86,-1.05),P<0.001]和总住院时间[MD=-5.41,95%CI(-8.67,-2.14),P=0.001],并且能降低病死率[RR=0.67,95%CI(0.45,0.99),P=0.040]。结论机械通气开始后5d内开始早期活动能够缩短通气时间、ICU治疗时间和住院时间,且不增加病死率,建议临床推广使用。展开更多
A growing understanding of the benefits of exercise over the past few decades has prompted researchers to take an interest in the possibilities of exercise therapy.Because each sport has its own set of characteristics...A growing understanding of the benefits of exercise over the past few decades has prompted researchers to take an interest in the possibilities of exercise therapy.Because each sport has its own set of characteristics and physiological complications that tend to occur during exercise training,the effects and underlying mechanisms of exercise remain unclear.Thus,the first step in probing the effects of exercise on different diseases is the selection of an optimal exercise protocol.This review summarizes the latest exercise prescription treatments for 26 different diseases:musculoskeletal system diseases(low back pain,tendon injury,osteoporosis,osteoarthritis,and hip fracture),metabolic system diseases(obesity,type 2 diabetes,type 1 diabetes,and nonalcoholic fatty liver disease),cardio-cerebral vascular system diseases(coronary artery disease,stroke,and chronic heart failure),nervous system diseases(Parkinson’s disease,Huntington’s disease,Alzheimer’s disease,depression,and anxiety disorders),respiratory system diseases(chronic obstructive pulmonary disease,interstitial lung disease,and after lung transplantation),urinary system diseases(chronic kidney disease and after kidney transplantation),and cancers(breast cancer,colon cancer,prostate cancer,and lung cancer).Each exercise prescription is displayed in a corresponding table.The recommended type,intensity,and frequency of exercise prescriptions are summarized,and the effects of exercise therapy on the prevention and rehabilitation of different diseases are discussed.展开更多
背景与目的:癌症患者的生命质量研究受到全球关注,美国、欧洲已经开发出相应的测定量表体系FACT(癌症治疗功能评价系统)和QLQ(生命质量量表系列)并得到了广泛的应用,但中国缺乏相应的测定量表体系。本文拟研制中国人使用的癌症患者生命...背景与目的:癌症患者的生命质量研究受到全球关注,美国、欧洲已经开发出相应的测定量表体系FACT(癌症治疗功能评价系统)和QLQ(生命质量量表系列)并得到了广泛的应用,但中国缺乏相应的测定量表体系。本文拟研制中国人使用的癌症患者生命质量测定量表体系共性模块(quality of life instruments for cancer patients-general module,QLICP-GM)。方法:采用议题小组和核心小组的程序化决策方式,通过定性和定量相结合的量表开发理论和方法对条目进行初步筛选、评价和修改,形成初步量表。随机抽取恶性肿瘤患者448人,采用变异度法、因子分析、聚类分析和相关分析等统计学方法对结果进行分析。结果:研制出QLICP-GM,该测定量表体系含有躯体功能、心理功能、社会功能、共性症状及副作用4个领域32个条目。结论:QLICP-GM反映了WHO关于生命质量的内涵及癌症患者的共同问题,具有较好的内容效度。展开更多
Background and purpose Stroke is the leading cause of mortality and disability in China.Precise aetiological classification,imaging and biological markers may predict the prognosis of stroke.The Third China National S...Background and purpose Stroke is the leading cause of mortality and disability in China.Precise aetiological classification,imaging and biological markers may predict the prognosis of stroke.The Third China National Stroke Registry(CNSR-Ⅲ),a nationwide registry of ischaemic stroke or transient ischaemic attack(TIA)in China based on aetiology,imaging and biology markers,will be considered to clarify the pathogenesis and prognostic factors of ischaemic stroke.Methods Between August 2015 and March 2018,the CNSR-Ⅲrecruited consecutive patients with ischaemic stroke or TIA from 201 hospitals that cover 22 provinces and four municipalities in China.Clinical data were collected prospectively using an electronic data capture system by face-to-face interviews.Patients were followed for clinical outcomes at 3 months,6 months and 1-5 year annually.Brain imaging,including brain MRI and CT,were completed at baseline.Blood samples were collected and biomarkers were tested at baseline.Results A total of 15166 stroke patients were enrolled,among which 31.7%patients were women with the average age of 62.2±11.3 years.Ischaemic stroke was predominant(93.3%,n=14146)and 1020(6.7%)TIAs were enrolled.Conclusions CNSR-Ⅲis a large scale nationwide registry in China.Data from this prospective registry may provide opportunity to evaluate imaging and biomarker prognostic determinants of stroke.展开更多
This article reviews the evidence for efficacy and safety of Saccharomyces boulardii(S.boulardii) for various disease indications in adults based on the peerreviewed,randomized clinical trials and pre-clinical studies...This article reviews the evidence for efficacy and safety of Saccharomyces boulardii(S.boulardii) for various disease indications in adults based on the peerreviewed,randomized clinical trials and pre-clinical studies from the published medical literature(Medline,Clinical Trial websites and meeting abstracts) between 1976 and 2009.For meta-analysis,only randomized,blinded controlled trials unrestricted by language were included.Pre-clinical studies,volunteer studies and uncontrolled studies were excluded from the review of efficacy and meta-analysis,but included in the systematic review.Of 31 randomized,placebo-controlled treatment arms in 27 trials(encompassing 5029 study patients),S.boulardii was found to be significantly efficacious and safe in 84% of those treatment arms.A meta-analysis found a significant therapeutic efficacy for S.boulardii in the prevention of antibiotic-associated diarrhea(AAD)(RR = 0.47,95% CI:0.35-0.63,P < 0.001).In adults,S.boulardii can be strongly recommended for the prevention of AAD and the traveler's diarrhea.Randomized trials also support the use of this yeast probiotic for prevention of enteral nutrition-related diarrhea and reduction of Heliobacter pylori treatment-related symptoms.S.boulardii shows promise for the prevention of C.difficile disease recurrences;treatment of irritable bowel syndrome,acute adult diarrhea,Crohn's disease,giardiasis,human immunodeficiency virus-related diarrhea;but more supporting evidence is recommended for these indications.The use of S.boulardii as a therapeutic probiotic is evidence-based for both efficacy and safety for several types of diarrhea.展开更多
文摘目的系统评价机械通气患者进行早期活动的效果。方法通过计算机检索PubMed、EMBASE、Web of Science、Cochrane Central Register of Controlled Trials(CENTRAL)、CINAHL、Physiotherapy Evidence Database(PEDro)、中国知网(CNKI)与万方数据库中关于机械通气患者早期活动的随机对照试验,经筛选文献,提取资料与评价质量后行Meta分析。结果共纳入14项随机对照试验,Meta分析结果显示,与常规护理措施相比,早期活动能够缩短机械通气时间[MD=-46.98,95%CI(-66.49,-27.48),P<0.001]、ICU治疗时间[MD=-1.96,95%CI(-2.86,-1.05),P<0.001]和总住院时间[MD=-5.41,95%CI(-8.67,-2.14),P=0.001],并且能降低病死率[RR=0.67,95%CI(0.45,0.99),P=0.040]。结论机械通气开始后5d内开始早期活动能够缩短通气时间、ICU治疗时间和住院时间,且不增加病死率,建议临床推广使用。
基金supported by Natural Science Foundation of China (No. 31671242)the National Key R&D Program of China (No. 2018YFC1314701)
文摘A growing understanding of the benefits of exercise over the past few decades has prompted researchers to take an interest in the possibilities of exercise therapy.Because each sport has its own set of characteristics and physiological complications that tend to occur during exercise training,the effects and underlying mechanisms of exercise remain unclear.Thus,the first step in probing the effects of exercise on different diseases is the selection of an optimal exercise protocol.This review summarizes the latest exercise prescription treatments for 26 different diseases:musculoskeletal system diseases(low back pain,tendon injury,osteoporosis,osteoarthritis,and hip fracture),metabolic system diseases(obesity,type 2 diabetes,type 1 diabetes,and nonalcoholic fatty liver disease),cardio-cerebral vascular system diseases(coronary artery disease,stroke,and chronic heart failure),nervous system diseases(Parkinson’s disease,Huntington’s disease,Alzheimer’s disease,depression,and anxiety disorders),respiratory system diseases(chronic obstructive pulmonary disease,interstitial lung disease,and after lung transplantation),urinary system diseases(chronic kidney disease and after kidney transplantation),and cancers(breast cancer,colon cancer,prostate cancer,and lung cancer).Each exercise prescription is displayed in a corresponding table.The recommended type,intensity,and frequency of exercise prescriptions are summarized,and the effects of exercise therapy on the prevention and rehabilitation of different diseases are discussed.
文摘背景与目的:癌症患者的生命质量研究受到全球关注,美国、欧洲已经开发出相应的测定量表体系FACT(癌症治疗功能评价系统)和QLQ(生命质量量表系列)并得到了广泛的应用,但中国缺乏相应的测定量表体系。本文拟研制中国人使用的癌症患者生命质量测定量表体系共性模块(quality of life instruments for cancer patients-general module,QLICP-GM)。方法:采用议题小组和核心小组的程序化决策方式,通过定性和定量相结合的量表开发理论和方法对条目进行初步筛选、评价和修改,形成初步量表。随机抽取恶性肿瘤患者448人,采用变异度法、因子分析、聚类分析和相关分析等统计学方法对结果进行分析。结果:研制出QLICP-GM,该测定量表体系含有躯体功能、心理功能、社会功能、共性症状及副作用4个领域32个条目。结论:QLICP-GM反映了WHO关于生命质量的内涵及癌症患者的共同问题,具有较好的内容效度。
基金This study was supported by grants from the Ministry of Science and Technology of the People’s Republic of China(2016YFC0901001,2016YFC0901002,2017YFC1310901,2017YFC1310902,2018YFC1311700 and 2018YFC1311706)grants from Beijing Municipal Commission of Health and Family Planning(No.2016-1-2041,SML20150502).
文摘Background and purpose Stroke is the leading cause of mortality and disability in China.Precise aetiological classification,imaging and biological markers may predict the prognosis of stroke.The Third China National Stroke Registry(CNSR-Ⅲ),a nationwide registry of ischaemic stroke or transient ischaemic attack(TIA)in China based on aetiology,imaging and biology markers,will be considered to clarify the pathogenesis and prognostic factors of ischaemic stroke.Methods Between August 2015 and March 2018,the CNSR-Ⅲrecruited consecutive patients with ischaemic stroke or TIA from 201 hospitals that cover 22 provinces and four municipalities in China.Clinical data were collected prospectively using an electronic data capture system by face-to-face interviews.Patients were followed for clinical outcomes at 3 months,6 months and 1-5 year annually.Brain imaging,including brain MRI and CT,were completed at baseline.Blood samples were collected and biomarkers were tested at baseline.Results A total of 15166 stroke patients were enrolled,among which 31.7%patients were women with the average age of 62.2±11.3 years.Ischaemic stroke was predominant(93.3%,n=14146)and 1020(6.7%)TIAs were enrolled.Conclusions CNSR-Ⅲis a large scale nationwide registry in China.Data from this prospective registry may provide opportunity to evaluate imaging and biomarker prognostic determinants of stroke.
文摘This article reviews the evidence for efficacy and safety of Saccharomyces boulardii(S.boulardii) for various disease indications in adults based on the peerreviewed,randomized clinical trials and pre-clinical studies from the published medical literature(Medline,Clinical Trial websites and meeting abstracts) between 1976 and 2009.For meta-analysis,only randomized,blinded controlled trials unrestricted by language were included.Pre-clinical studies,volunteer studies and uncontrolled studies were excluded from the review of efficacy and meta-analysis,but included in the systematic review.Of 31 randomized,placebo-controlled treatment arms in 27 trials(encompassing 5029 study patients),S.boulardii was found to be significantly efficacious and safe in 84% of those treatment arms.A meta-analysis found a significant therapeutic efficacy for S.boulardii in the prevention of antibiotic-associated diarrhea(AAD)(RR = 0.47,95% CI:0.35-0.63,P < 0.001).In adults,S.boulardii can be strongly recommended for the prevention of AAD and the traveler's diarrhea.Randomized trials also support the use of this yeast probiotic for prevention of enteral nutrition-related diarrhea and reduction of Heliobacter pylori treatment-related symptoms.S.boulardii shows promise for the prevention of C.difficile disease recurrences;treatment of irritable bowel syndrome,acute adult diarrhea,Crohn's disease,giardiasis,human immunodeficiency virus-related diarrhea;but more supporting evidence is recommended for these indications.The use of S.boulardii as a therapeutic probiotic is evidence-based for both efficacy and safety for several types of diarrhea.
