Risk and Cumulative Risk of Acute Ischemic Stroke Recurrence in China:A Systematic Review and Meta-Analysis

Objective:To comprehensively evaluate the risk of recurrence after initial ischemic stroke,and to provide a relatively comprehensive reference for the prevention and control of stroke recurrence.Methods:CNKI,VIP,Wanfang,PubMed,Web of Science,Embase and other databases were collected to investigate the status of recurrence after initial ischemic stroke,the search period of which was from the establishment of databases to March 2019.And then quality evaluation and data extraction were carried out.The overall cumulative risks of stroke recurrence at 3 months,6 months,1 year,2 years and 5 years after initial ischemic stroke were calculated,and heterogeneity analysis was performed.Results:A total of 29 studies from 19 provinces(cities,autonomous regions)in China were included.The cumulative total sample size was 22484 cases,the cumulative recurrent sample size was 3309 cases.The pooled cumulative risk was 4.5%(95%CI:3.1-5.8)at 3 months,7.8%(95%CI:5.6-10.0)at 6 months,13.6%(95%CI:11.0-16.2)at 1 year,17.5%(95%CI:12.4-22.6)at 2 years and 30.9%(95%CI:20.2-41.7)at 5 years after initial ischemic stroke.Conclusions:The recurrence rate of acute ischemic stroke in China is high.It is recommended that all levels of medical and health departments strengthen the prevention and treatment of ischemic stroke recurrence to reduce the recurrence of ischemic stroke and improve the prognosis of patients.

Analysis of the Influence of Probiotics on Intestinal Micro-ecology and Related Diseases

Probiotics are a kind of living microorganisms added into food or drug,which are beneficial to our health.Probiotics can regulate the balance of microecosystem in intestine.Recently,people have paid more attention to the effect on the intestinal microecology.This article mainly made a review on the mechanism and application of probiotics.

Effect of Acupoint Massage on Cognitive Dysfunction:A Systematic Review

Objective:To evaluate the clinical effect of acupoint massage in improving cognitive function,in order to provide a relatively comprehensive reference for dementia prevention and control.Methods:Clinical trial studies on the improvement of cognitive function by acupoint massage were systematically collected from multiple Chinese and foreign databases,consisting of CNKI,VIP,Wanfang,PubMed,Web of Science,Embase,the Cochrane Library,and CINAHL.According to the inclusion and exclusion criteria,the two researchers independently screened the literature,extracted the data,evaluated the quality of the included articles and cross-checked,and then carried out a meta-analysis with the RevMan 5 software.Results:A total of 10 studies were included,and the cumulative total sample size was 818.The results of metaanalysis showed that the improvement of cognitive function in acupoint massage group was significantly better than that in control group.Compared with the control group,acupoint massage significantly increased the total score of mini-mental state examination(MMSE)scale for the elderly[SMD=0.80,95%CI(0.53,1.07),P<0.0001]),and significantly improved the picture memory ability[SMD=-3.69,95%CI(-5.08,2.30),P<0.0001],associative memory ability[SMD=0.24,95%CI(-0.73,1.20),P<0.0001]),understanding and memory ability[SMD=1.33,95%CI(0.58,2.09),P<0.0001]),instantaneous memory ability[SMD=1.70,95%CI(0.77,2.62),P<0.01])of the elderly.Conclusion:Acupoint massage can improve the cognitive function of the elderly and reduce the risk of Alzheimer disease(AD)in the elderly.More large samples,multicenter and high quality randomized controlled trials are needed to verify the intervention effect of acupoint massage on cognitive impairment.

Investigation on the Clinical Readiness of Nurses’Evidence-Based Practice in a 3A-Level General Hospital in Beijing

Objective:To understand the evidence-based practice readiness of developing evidence application projects in a 3A-level general hospital in Beijing,to identify barriers to evidence-based practice and to promote the successful application of evidence.Methods:All the clinical nurses who were going to participate in the application units of the evidence-based practice project were selected as the survey objects,and the self-made“Basic Information Questionnaire”and“Clinical Readiness to Evidence-based Nursing Assessment(CREBNA)”were used to conduct the survey.The total amounts and subscales were calculated.The factors that influence the score of the total scale were scored and analyzed.Results:The CREBNA total score was(119.87±19.18),the evidence subscale score was(47.94±8.54),the organizational environmental subscale score was(36.09±6.11),and the facilitator subscale score was(35.83±7.56).Univariate analysis showed that the total score of the scale was related to years of work,scientific research experience,knowledge of evidence-based care,and participation in evidence-based practice.Conclusion:The current evidence-based practice preparation situation is good.It is feasible to carry out evidence-based practice activities in the hospital.The follow-up development plan should be made based on the corresponding obstacle factors.

Traditional Chinese nursing care for post-stroke depression patients:A review

Objective:To probe into the status quo of degree of mental illness and traditional Chinese nursing care in patients with post-stroke depression,so as to provide evidences for improving patient’ quality of life totally.It will promote the recovery of the depression of the patients more effectively.Methods:Screening,analyzing,summarizing a great deal of domestic and foreign literature on post-stroke depression.Results:The comprehensive nursing interventions of TCM for patients with post-stroke depression is beneficial to the relief of their depressive symptoms and improve the quality of life of patients,such as TCM treatment of acupuncture,acupressure,music therapy,acupuncture,dietary care and rehabilitation training for Chinese medicine,etc.Conclusion:Depression is a problem worthy of attention after stroke.Nursing staff need to master the relevant knowledge to take effective interventions to meet the goals of doctors,nurses and patients.

Introduction to cognitive assessment scales in screening for mild cognitive impairment after stroke: A review

Objective:In order to improve the quality of life of patients more effectively,this paper introduces the types and usages of scales for screening mild cognitive dysfunction after stroke and provides a basis for early identification of mild cognitive impairment.Methods:Read,analyze,summarize,and sort out relevant literature.Results:The mild cognitive impairment assessment scales are broadly divided into two categories:the comprehensive rating scales and the special assessment scales.There are 7 comprehensive assessment scales for the comprehensive rating scales,among which the Mini-mental State of Examination and the Montreal Cognitive Assessment Scale are the most widely used.The special assessment scales are mainly evaluated by the symptoms of cognitive dysfunction and can be divided into five types.Conclusion:Early diagnosis and intervention in patients with cognitive dysfunction will help improve the prognosis of patients.Each assessment scale has its advantages and limitations in both sensitivity and discrimination.Effective use of appropriate scales to diagnose cognitive dysfunction and to screen early,to prevent early,to treat early can effectively improve the quality of life of elderly patients.