目的运用循证医学方法对腕踝针干预术后疼痛的疗效和安全性进行系统评价和Grade评价。方法计算机检索中国知网、万方、维普、中国生物医学文献数据库、PubMed、Embase、Web of Science、Cochrane Library中关于腕踝针干预术后疼痛的随...目的运用循证医学方法对腕踝针干预术后疼痛的疗效和安全性进行系统评价和Grade评价。方法计算机检索中国知网、万方、维普、中国生物医学文献数据库、PubMed、Embase、Web of Science、Cochrane Library中关于腕踝针干预术后疼痛的随机对照试验,检索时限为建库至2023年10月。采用RevMan 5.4软件进行Meta分析。结果纳入23篇文献,共计1968例患者,Meta分析结果显示,与常规治疗相比,腕踝针能够提高术后疼痛患者的总有效率[OR=4.42,95%CI(2.60,7.50),P<0.001],术后镇痛泵药量使用减少[MD=-9.03,95%CI(-12.09,-5.98),P<0.001],术后疼痛评分降低[MD=-1.39,95%CI(-1.68,-1.09),P<0.001],可减少不良反应发生率[RR=0.40,95%CI(0.32,0.48),P<0.001]以及临床满意度[OR=3.94,95%CI(2.40,6.48),P<0.001]。Grade证据分级结果显示:总有效率、不良反应发生率和临床满意度3项结局指标为中等质量证据,VAS评分指标为低质量证据,镇痛泵药量使用指标为极低质量证据。结论腕踝针可提高总有效率,减少术后镇痛药用量,不良反应少,安全性高,为患者提供了一种安全有效的镇痛方式。展开更多
为了系统评价参芪扶正注射液联合常规治疗作为干预措施对慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者的临床疗效和安全性。检索中国国家知识基础设施(China national knowledge infrastructure,CNKI)、PubMed、...为了系统评价参芪扶正注射液联合常规治疗作为干预措施对慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者的临床疗效和安全性。检索中国国家知识基础设施(China national knowledge infrastructure,CNKI)、PubMed、万方数据知识服务平台(Wanfang Data)、维普中文科技期刊数据库(Weipu China science and technology journal database,VIP)等数据库,筛选并纳入2023年6月18日以前发表的参芪扶正注射液联合常规疗法治疗COPD患者的随机对照试验(randomized controlled trials,RCT),采用Cochrane风险评价工具及评估、发展和评价建议分级(grading of recommendations assessment,development and evaluation,GRADE)系统进行文献证据质量评价,用RevMan 5.4软件对临床疗效及安全性指标进行Meta分析。结果表明,共纳入16项RCTs,1 486例患者。Meta分析结果显示,参芪扶正注射液辅助治疗可提高患者总有效率和第1秒用力呼气容积/用力肺活量比值(forced expiratory volume in one second/forced vital capacity,FEV1/FVC)指标,与对照组相比具有优势(P<0.000 01、P<0.000 1);不良反应少,无严重不良反应(adverse drug reactions,ADR),两组对比无统计学差异(P=0.32);GRADE评价结果显示,有效率及不良反应指标的证据质量均为中等级,肺功能为低等级。可见参芪扶正注射辅助治疗COPD可以提高患者临床疗效,改善肺功能,且具有良好的安全性。但所纳入研究具有局限性,证据质量不高,仍需结合中药辨证使用特点,规范实验方案,开展更多的高质量RCT研究。展开更多
BACKGROUND The models for assessing liver function,mainly the Child–Pugh(CP),albuminbilirubin(ALBI),and platelet–ALBI(PALBI)classifications,have been validated for use in estimating the prognosis of hepatocellular c...BACKGROUND The models for assessing liver function,mainly the Child–Pugh(CP),albuminbilirubin(ALBI),and platelet–ALBI(PALBI)classifications,have been validated for use in estimating the prognosis of hepatocellular carcinoma(HCC)patients.However,thrombocytopenia is a common finding and may influence the prognostic value of the three models in HCC.AIM To investigate and compare the prognostic performance of the above three models in thrombocytopenic HCC patients.METHODS A total of 135 patients with thrombocytopenic HCC who underwent radical surgery were retrospectively analyzed.Preoperative scores on the CP,ALBI and PALBI classifications were estimated accordingly.Kaplan–Meier curves with logrank tests and Cox regression models were used to explore the significant factors associated with overall survival(OS)and recurrence-free survival(RFS).RESULTS The preoperative platelet counts were significantly different among the CP,ALBI and PALBI groups.After a median follow-up of 28 mo,39.3%(53/135)of the patients experienced postoperative recurrence,and 36.3%(49/135)died.Univariate analysis suggested thatα-fetoprotein levels,tumor size,vascular invasion,and ALBI grade were significant predictors of OS and RFS.According to the multivariate Cox regression model,ALBI was identified as an independent prognostic factor.However,CP and PALBI grades were not statistically significant prognostic indicators.CONCLUSION The ALBI grade,rather than CP or PALBI grade,is a significant prognostic indicator for thrombocytopenic HCC patients.展开更多
目的系统评价补肾方剂改善高龄女性自然妊娠结局的临床疗效和安全性。方法检索中国知网、万方数据库、维普数据库、SinoMed、PubMed、Web of Science、Cochrane Library、Embase等数据库建库至2022年6月收录的补肾方剂改善高龄女性自然...目的系统评价补肾方剂改善高龄女性自然妊娠结局的临床疗效和安全性。方法检索中国知网、万方数据库、维普数据库、SinoMed、PubMed、Web of Science、Cochrane Library、Embase等数据库建库至2022年6月收录的补肾方剂改善高龄女性自然妊娠结局的随机对照研究(RCT)。运用偏倚风险工具进行质量评估,使用RevMan软件进行Meta分析。结果共纳入14篇RCT。Meta分析结果显示:补肾方剂联合西药治疗在提高妊娠率[RR=1.71,95%CI(1.45,2.01),P<0.00001]、降低卵泡刺激素(FSH)水平[SMD=-1.63,95%CI(-2.84,-0.43),P=0.008]、提高雌二醇(E_(2))水平[SMD=3.97,95%CI(1.76,6.17),P=0.0004]、增加排卵期子宫内膜厚度[SMD=2.12,95%CI(1.07,3.18),P<0.0001]方面均优于西药组;且补肾方剂单独使用在提高妊娠率[RR=1.94,95%CI(1.31,2.88),P=0.001]、降低FSH水平[SMD=-0.48,95%CI(-0.74,-0.22),P=0.0003]方面也具有显著疗效。结论与西医治疗比较,补肾方剂可以显著改善高龄女性自然妊娠结局,且不良反应较少,但仍需更多高质量、大样本、多中心的RCT予以验证。展开更多
目的:评价温针灸治疗原发性痛经的有效性和安全性。方法:根据PRISMA指南进行系统综述和荟萃分析。收集PubMed、Web of Science、EMBASE、Cochrane Library、中国知网、维普、万方、中国生物医学数据库自建库至2023年5月的随机对照试验...目的:评价温针灸治疗原发性痛经的有效性和安全性。方法:根据PRISMA指南进行系统综述和荟萃分析。收集PubMed、Web of Science、EMBASE、Cochrane Library、中国知网、维普、万方、中国生物医学数据库自建库至2023年5月的随机对照试验。使用Review Manager 5.4对所有获得的数据进行分析。结果:温针灸治疗原发性痛经在提高临床疗效{风险比(RR)=1.21,95%置信区间(CI)[1.16,1.25],P<0.00001},改善阻力指数(RI){均数差(MD)=-0.14,95%CI[-0.19,-0.08],P<0.00001}、搏动指数(PI)(MD=-0.55,95%CI[-0.69,-0.40],P<0.00001)、β-内啡肽(β-EP){标准化均数差(SMD)=1.36,95%CI[0.90,1.82],P<0.00001}、痛经证候积分(MD=-1.82,95%CI[-2.77,-0.87],P=0.0002)、疼痛视觉模拟评分法(VAS)评分(MD=-1.16,95%CI[-1.48,-0.83],P<0.00001)方面的作用优于单独的常规治疗,并且在不良反应发生率(P=0.01)方面低于对照组。证据质量等级评价结果显示临床疗效为中级,其他多为低级。结论:温针灸治疗原发性痛经的疗效明确,并且具有一定的安全性。展开更多
目的分析PTGD后择期LC治疗对GradeⅡ急性胆囊炎ACTH、MPO及Cor水平的影响。方法选取2021年12月至2023年5月安徽中科庚玖医院收治的急性胆囊炎患者121例,根据治疗方案分为三组,即甲组(急诊行LC治疗,未行PTGD)38例、乙组(PTGD引流管拔出后...目的分析PTGD后择期LC治疗对GradeⅡ急性胆囊炎ACTH、MPO及Cor水平的影响。方法选取2021年12月至2023年5月安徽中科庚玖医院收治的急性胆囊炎患者121例,根据治疗方案分为三组,即甲组(急诊行LC治疗,未行PTGD)38例、乙组(PTGD引流管拔出后72 h后行LC,早期)43例和丙组(PTGD引流管拔出后14~30 d后行LC,晚期)40例。对比三组手术情况、炎症因子、肝功能、ACTH、MP、Cor水平及并发症发生率。结果甲组LC手术时长、术后卧床时长及住院天数均长于丙组、乙组,失血量、中转开腹率高于丙组、乙组,差异有统计学意义(P<0.05);丙组LC手术时长、术后卧床时长及住院天数均长于乙组,差异具有统计学意义(P<0.05)。LC术后1 d hs-CRP、PCT、IL-6、ST、ALT、ALP、ACTH、MPO及Cor:甲组>丙组>乙组,差异有统计学意义(P<0.05)。并发症发生率:甲组>丙组>乙组,差异有统计学意义(P<0.05)。结论PTGD后择期LC治疗对GradeⅡ急性胆囊炎ACTH、MPO及Cor水平影响小,且并发症低;而PTGD后早期行LC能有效改善肝功能、炎症因子,且术后应激反应更低,值得临床推广。展开更多
Through equilibrium and non-equilibrium molecular dynamics simulations,we have demonstrated the inhibitory effect of composition graded interface on thermal transport behavior in lateral heterostructures.Specifically,...Through equilibrium and non-equilibrium molecular dynamics simulations,we have demonstrated the inhibitory effect of composition graded interface on thermal transport behavior in lateral heterostructures.Specifically,we investigated the influence of composition gradient length and heterogeneous particles at the silicene/germanene(SIL/GER)heterostructure interface on heat conduction.Our results indicate that composition graded interface at the interface diminishes the thermal conductivity of the heterostructure,with a further reduction observed as the length increases,while the effect of the heterogeneous particles can be considered negligible.To unveil the influence of composition graded interface on thermal transport,we conducted phonon analysis and identified the presence of phonon localization within the interface composition graded region.Through these analyses,we have determined that the decrease in thermal conductivity is correlated with phonon localization within the heterostructure,where a stronger degree of phonon localization signifies poorer thermal conductivity in the material.Our research findings not only contribute to understanding the impact of interface gradient-induced phonon localization on thermal transport but also offer insights into the modulation of thermal conductivity in heterostructures.展开更多
Solar-powered interfacial evaporation is an energy-efficient solution for water scarcity.It requires solar absorbers to facilitate upward water transport and limit the heat to the surface for efficient evaporation.Fur...Solar-powered interfacial evaporation is an energy-efficient solution for water scarcity.It requires solar absorbers to facilitate upward water transport and limit the heat to the surface for efficient evaporation.Furthermore,downward salt ion transport is also desired to prevent salt accumulation.However,achieving simultaneously fast water uptake,downward salt transport,and heat localization is challenging due to highly coupled water,mass,and thermal transport.Here,we develop a structurally graded aerogel inspired by tree transport systems to collectively optimize water,salt,and thermal transport.The arched aerogel features root-like,fan-shaped microchannels for rapid water uptake and downward salt diffusion,and horizontally aligned pores near the surface for heat localization through maximizing solar absorption and minimizing conductive heat loss.These structural characteristics gave rise to consistent evaporation rates of 2.09 kg m^(-2) h^(-1) under one-sun illumination in a 3.5 wt%NaCl solution for 7 days without degradation.Even in a high-salinity solution of 20 wt%NaCl,the evaporation rates maintained stable at 1.94 kg m^(-2) h^(-1) for 8 h without salt crystal formation.This work offers a novel microstructural design to address the complex interplay of water,salt,and thermal transport.展开更多
文摘目的运用循证医学方法对腕踝针干预术后疼痛的疗效和安全性进行系统评价和Grade评价。方法计算机检索中国知网、万方、维普、中国生物医学文献数据库、PubMed、Embase、Web of Science、Cochrane Library中关于腕踝针干预术后疼痛的随机对照试验,检索时限为建库至2023年10月。采用RevMan 5.4软件进行Meta分析。结果纳入23篇文献,共计1968例患者,Meta分析结果显示,与常规治疗相比,腕踝针能够提高术后疼痛患者的总有效率[OR=4.42,95%CI(2.60,7.50),P<0.001],术后镇痛泵药量使用减少[MD=-9.03,95%CI(-12.09,-5.98),P<0.001],术后疼痛评分降低[MD=-1.39,95%CI(-1.68,-1.09),P<0.001],可减少不良反应发生率[RR=0.40,95%CI(0.32,0.48),P<0.001]以及临床满意度[OR=3.94,95%CI(2.40,6.48),P<0.001]。Grade证据分级结果显示:总有效率、不良反应发生率和临床满意度3项结局指标为中等质量证据,VAS评分指标为低质量证据,镇痛泵药量使用指标为极低质量证据。结论腕踝针可提高总有效率,减少术后镇痛药用量,不良反应少,安全性高,为患者提供了一种安全有效的镇痛方式。
文摘为了系统评价参芪扶正注射液联合常规治疗作为干预措施对慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者的临床疗效和安全性。检索中国国家知识基础设施(China national knowledge infrastructure,CNKI)、PubMed、万方数据知识服务平台(Wanfang Data)、维普中文科技期刊数据库(Weipu China science and technology journal database,VIP)等数据库,筛选并纳入2023年6月18日以前发表的参芪扶正注射液联合常规疗法治疗COPD患者的随机对照试验(randomized controlled trials,RCT),采用Cochrane风险评价工具及评估、发展和评价建议分级(grading of recommendations assessment,development and evaluation,GRADE)系统进行文献证据质量评价,用RevMan 5.4软件对临床疗效及安全性指标进行Meta分析。结果表明,共纳入16项RCTs,1 486例患者。Meta分析结果显示,参芪扶正注射液辅助治疗可提高患者总有效率和第1秒用力呼气容积/用力肺活量比值(forced expiratory volume in one second/forced vital capacity,FEV1/FVC)指标,与对照组相比具有优势(P<0.000 01、P<0.000 1);不良反应少,无严重不良反应(adverse drug reactions,ADR),两组对比无统计学差异(P=0.32);GRADE评价结果显示,有效率及不良反应指标的证据质量均为中等级,肺功能为低等级。可见参芪扶正注射辅助治疗COPD可以提高患者临床疗效,改善肺功能,且具有良好的安全性。但所纳入研究具有局限性,证据质量不高,仍需结合中药辨证使用特点,规范实验方案,开展更多的高质量RCT研究。
基金Supported by Key Projects of Natural Science Foundation of Bengbu Medical College,No.2021byzd050Science and Technological Fund of Anhui Province for Outstanding Youth,No.2008085J37.
文摘BACKGROUND The models for assessing liver function,mainly the Child–Pugh(CP),albuminbilirubin(ALBI),and platelet–ALBI(PALBI)classifications,have been validated for use in estimating the prognosis of hepatocellular carcinoma(HCC)patients.However,thrombocytopenia is a common finding and may influence the prognostic value of the three models in HCC.AIM To investigate and compare the prognostic performance of the above three models in thrombocytopenic HCC patients.METHODS A total of 135 patients with thrombocytopenic HCC who underwent radical surgery were retrospectively analyzed.Preoperative scores on the CP,ALBI and PALBI classifications were estimated accordingly.Kaplan–Meier curves with logrank tests and Cox regression models were used to explore the significant factors associated with overall survival(OS)and recurrence-free survival(RFS).RESULTS The preoperative platelet counts were significantly different among the CP,ALBI and PALBI groups.After a median follow-up of 28 mo,39.3%(53/135)of the patients experienced postoperative recurrence,and 36.3%(49/135)died.Univariate analysis suggested thatα-fetoprotein levels,tumor size,vascular invasion,and ALBI grade were significant predictors of OS and RFS.According to the multivariate Cox regression model,ALBI was identified as an independent prognostic factor.However,CP and PALBI grades were not statistically significant prognostic indicators.CONCLUSION The ALBI grade,rather than CP or PALBI grade,is a significant prognostic indicator for thrombocytopenic HCC patients.
文摘目的系统评价补肾方剂改善高龄女性自然妊娠结局的临床疗效和安全性。方法检索中国知网、万方数据库、维普数据库、SinoMed、PubMed、Web of Science、Cochrane Library、Embase等数据库建库至2022年6月收录的补肾方剂改善高龄女性自然妊娠结局的随机对照研究(RCT)。运用偏倚风险工具进行质量评估,使用RevMan软件进行Meta分析。结果共纳入14篇RCT。Meta分析结果显示:补肾方剂联合西药治疗在提高妊娠率[RR=1.71,95%CI(1.45,2.01),P<0.00001]、降低卵泡刺激素(FSH)水平[SMD=-1.63,95%CI(-2.84,-0.43),P=0.008]、提高雌二醇(E_(2))水平[SMD=3.97,95%CI(1.76,6.17),P=0.0004]、增加排卵期子宫内膜厚度[SMD=2.12,95%CI(1.07,3.18),P<0.0001]方面均优于西药组;且补肾方剂单独使用在提高妊娠率[RR=1.94,95%CI(1.31,2.88),P=0.001]、降低FSH水平[SMD=-0.48,95%CI(-0.74,-0.22),P=0.0003]方面也具有显著疗效。结论与西医治疗比较,补肾方剂可以显著改善高龄女性自然妊娠结局,且不良反应较少,但仍需更多高质量、大样本、多中心的RCT予以验证。
文摘目的分析PTGD后择期LC治疗对GradeⅡ急性胆囊炎ACTH、MPO及Cor水平的影响。方法选取2021年12月至2023年5月安徽中科庚玖医院收治的急性胆囊炎患者121例,根据治疗方案分为三组,即甲组(急诊行LC治疗,未行PTGD)38例、乙组(PTGD引流管拔出后72 h后行LC,早期)43例和丙组(PTGD引流管拔出后14~30 d后行LC,晚期)40例。对比三组手术情况、炎症因子、肝功能、ACTH、MP、Cor水平及并发症发生率。结果甲组LC手术时长、术后卧床时长及住院天数均长于丙组、乙组,失血量、中转开腹率高于丙组、乙组,差异有统计学意义(P<0.05);丙组LC手术时长、术后卧床时长及住院天数均长于乙组,差异具有统计学意义(P<0.05)。LC术后1 d hs-CRP、PCT、IL-6、ST、ALT、ALP、ACTH、MPO及Cor:甲组>丙组>乙组,差异有统计学意义(P<0.05)。并发症发生率:甲组>丙组>乙组,差异有统计学意义(P<0.05)。结论PTGD后择期LC治疗对GradeⅡ急性胆囊炎ACTH、MPO及Cor水平影响小,且并发症低;而PTGD后早期行LC能有效改善肝功能、炎症因子,且术后应激反应更低,值得临床推广。
基金Project supported by the National Natural Science Foundation of China (Grant No.12104291)。
文摘Through equilibrium and non-equilibrium molecular dynamics simulations,we have demonstrated the inhibitory effect of composition graded interface on thermal transport behavior in lateral heterostructures.Specifically,we investigated the influence of composition gradient length and heterogeneous particles at the silicene/germanene(SIL/GER)heterostructure interface on heat conduction.Our results indicate that composition graded interface at the interface diminishes the thermal conductivity of the heterostructure,with a further reduction observed as the length increases,while the effect of the heterogeneous particles can be considered negligible.To unveil the influence of composition graded interface on thermal transport,we conducted phonon analysis and identified the presence of phonon localization within the interface composition graded region.Through these analyses,we have determined that the decrease in thermal conductivity is correlated with phonon localization within the heterostructure,where a stronger degree of phonon localization signifies poorer thermal conductivity in the material.Our research findings not only contribute to understanding the impact of interface gradient-induced phonon localization on thermal transport but also offer insights into the modulation of thermal conductivity in heterostructures.
基金financially supported by the Research Grants Council of Hong Kong SAR(16200720)Environment and Conservation Fund of Hong Kong SAR(Project No.21/2022)+2 种基金Young Scientists Fund of National Natural Science Foundation of China(Grant No.52303106)Research Institute for Advanced Manufucturing(Project No.CD8R)the startup fund for new recruits of PolyU(Project Nos.P0038855 and P0038858)。
文摘Solar-powered interfacial evaporation is an energy-efficient solution for water scarcity.It requires solar absorbers to facilitate upward water transport and limit the heat to the surface for efficient evaporation.Furthermore,downward salt ion transport is also desired to prevent salt accumulation.However,achieving simultaneously fast water uptake,downward salt transport,and heat localization is challenging due to highly coupled water,mass,and thermal transport.Here,we develop a structurally graded aerogel inspired by tree transport systems to collectively optimize water,salt,and thermal transport.The arched aerogel features root-like,fan-shaped microchannels for rapid water uptake and downward salt diffusion,and horizontally aligned pores near the surface for heat localization through maximizing solar absorption and minimizing conductive heat loss.These structural characteristics gave rise to consistent evaporation rates of 2.09 kg m^(-2) h^(-1) under one-sun illumination in a 3.5 wt%NaCl solution for 7 days without degradation.Even in a high-salinity solution of 20 wt%NaCl,the evaporation rates maintained stable at 1.94 kg m^(-2) h^(-1) for 8 h without salt crystal formation.This work offers a novel microstructural design to address the complex interplay of water,salt,and thermal transport.
