目的 系统评价血液透析患者导管相关性血流感染风险预测模型,为临床选择合适的预测模型或开发新模型提供参考依据。方法 检索CINAHL、PubMed、Web of Science、Cochrane Library、Embase、万方数据库、中国知网、维普网、中国生物医学...目的 系统评价血液透析患者导管相关性血流感染风险预测模型,为临床选择合适的预测模型或开发新模型提供参考依据。方法 检索CINAHL、PubMed、Web of Science、Cochrane Library、Embase、万方数据库、中国知网、维普网、中国生物医学文献数据库中有关血液透析患者导管相关性感染风险预测模型的文献,检索时限均为建库至2023年10月1日。由2名研究者独立筛选文献和提取数据,并采用预测模型研究的偏倚风险评估工具(prediction model risk of bias assessment tool,PROBAST)分析纳入文献的偏倚风险和适用性。结果 共纳入7篇文献。4篇关于血液透析患者长期导管相关性感染的风险预测模型,1篇血液透析患者临时导管相关性感染的风险预测模型,2篇关于血液透析患者中心静脉导管相关性感染的风险预测模型。共5篇文献将血清白蛋白水平、导管留滞时间和合并糖尿病都纳为血液透析患者导管相关性感染的主要预测因素,3篇文献将患者的年龄当做血液透析患者导管相关性感染的主要预测因子,置管部位和手卫生预测因素在2篇预测模型中被纳为预测因子。预测模型的受试者工作特征曲线下面积范围为0.734~0.889。7篇文献中共有4个模型进行了Hosmer-Lemeshow校准度分析,模型的呈现形式也大多采用风险评分公式。所有研究适用性较好,但存在方法学缺陷(如缺失数据处理不当、未采用恰当方法选择变量、未提及盲法等)导致较高的偏倚风险。结论 血液透析患者导管相关性血流感染风险预测模型预测性能较好,但存在较高的偏倚风险,不能直接应用于临床实践。未来应选择已有模型进行深入广泛的验证或开展大样本、多人群的前瞻性研究以开发预测性能优良、使用简便的预测模型。展开更多
目的系统评价基于PLISSIT模式的性干预对女性癌症患者性功能的干预效果。方法计算机检索中国知网、万方数据库、维普数据库、the Cochrane Library、PubMed及Web of Science等数据库或平台中PLISSIT模式的性干预对女性癌症患者性功能影...目的系统评价基于PLISSIT模式的性干预对女性癌症患者性功能的干预效果。方法计算机检索中国知网、万方数据库、维普数据库、the Cochrane Library、PubMed及Web of Science等数据库或平台中PLISSIT模式的性干预对女性癌症患者性功能影响的文献,检索时限为1974年至2022年12月30日。使用RevMan 5.3软件进行统计分析。结果共纳入8篇文献,共413例研究对象。Meta分析结果显示,与常规康复指导相比,PLISSIT干预能提高患者的性功能(MD=5.25,95%CI:3.14~7.36,P<0.001),改善女性癌症患者的性生活质量(MD=14.07,95%CI:11.31~16.84,P<0.001)。结论基于PLISSIT模式的性干预能够提高女性癌症患者的性功能,改善其性生活质量。展开更多
Hills Like White Elephants is a short story by Ernest Hemingway.It is a story about an American man and a pregnant girl.As the protagonist,Jig is considered as a submissive woman who has no definite views of her own.T...Hills Like White Elephants is a short story by Ernest Hemingway.It is a story about an American man and a pregnant girl.As the protagonist,Jig is considered as a submissive woman who has no definite views of her own.This paper attempts to analyze the changes of Jig's inner thought during the forty minutes of waiting the train.In addition to how the girl has grown up from a weak and dependent character into a brave and independent female after the painful struggle in the helpless and hopeless states under the great pressure of the man.展开更多
Robert Frost is one of the famous poets of the 20th century American literature who won the Pulitzer Prize for four times. The reason for his popularity is partially because he employs traditional verse form and iambi...Robert Frost is one of the famous poets of the 20th century American literature who won the Pulitzer Prize for four times. The reason for his popularity is partially because he employs traditional verse form and iambic pentameter pattern in poem writing, but the most important reason for the reputation of his poems lies in the thematic concern of something universal, such as death and life, love and hate, war and peace, the good and the evil, the wisdom of human life and etc. . A brief analysis will be given in the following text about the wisdoms of human life embodied in Robert Frost's poems from three aspects: 1. Relaxation and responsibility of man. 2. The decisions in life.展开更多
文摘目的 系统评价血液透析患者导管相关性血流感染风险预测模型,为临床选择合适的预测模型或开发新模型提供参考依据。方法 检索CINAHL、PubMed、Web of Science、Cochrane Library、Embase、万方数据库、中国知网、维普网、中国生物医学文献数据库中有关血液透析患者导管相关性感染风险预测模型的文献,检索时限均为建库至2023年10月1日。由2名研究者独立筛选文献和提取数据,并采用预测模型研究的偏倚风险评估工具(prediction model risk of bias assessment tool,PROBAST)分析纳入文献的偏倚风险和适用性。结果 共纳入7篇文献。4篇关于血液透析患者长期导管相关性感染的风险预测模型,1篇血液透析患者临时导管相关性感染的风险预测模型,2篇关于血液透析患者中心静脉导管相关性感染的风险预测模型。共5篇文献将血清白蛋白水平、导管留滞时间和合并糖尿病都纳为血液透析患者导管相关性感染的主要预测因素,3篇文献将患者的年龄当做血液透析患者导管相关性感染的主要预测因子,置管部位和手卫生预测因素在2篇预测模型中被纳为预测因子。预测模型的受试者工作特征曲线下面积范围为0.734~0.889。7篇文献中共有4个模型进行了Hosmer-Lemeshow校准度分析,模型的呈现形式也大多采用风险评分公式。所有研究适用性较好,但存在方法学缺陷(如缺失数据处理不当、未采用恰当方法选择变量、未提及盲法等)导致较高的偏倚风险。结论 血液透析患者导管相关性血流感染风险预测模型预测性能较好,但存在较高的偏倚风险,不能直接应用于临床实践。未来应选择已有模型进行深入广泛的验证或开展大样本、多人群的前瞻性研究以开发预测性能优良、使用简便的预测模型。
文摘Hills Like White Elephants is a short story by Ernest Hemingway.It is a story about an American man and a pregnant girl.As the protagonist,Jig is considered as a submissive woman who has no definite views of her own.This paper attempts to analyze the changes of Jig's inner thought during the forty minutes of waiting the train.In addition to how the girl has grown up from a weak and dependent character into a brave and independent female after the painful struggle in the helpless and hopeless states under the great pressure of the man.
文摘Robert Frost is one of the famous poets of the 20th century American literature who won the Pulitzer Prize for four times. The reason for his popularity is partially because he employs traditional verse form and iambic pentameter pattern in poem writing, but the most important reason for the reputation of his poems lies in the thematic concern of something universal, such as death and life, love and hate, war and peace, the good and the evil, the wisdom of human life and etc. . A brief analysis will be given in the following text about the wisdoms of human life embodied in Robert Frost's poems from three aspects: 1. Relaxation and responsibility of man. 2. The decisions in life.
