Active and passive smoking with breast cancer risk for Chinese females: a systematic review and meta-analysis

Previous studies suggested that smoking and passive smoking could increase the risk of breast cancer, but the results were inconsistent, especially for Chinese females. Thus, we systematically searched cohort and case-control studies investigating the associations of active and passive smoking with breast cancer risk among Chinese females in four English databases(PubMed, Embase, ScienceDirect, and Wiley) and three Chinese databases(CNKI, WanFang, and VIP). Fifty-one articles(3 cohort studies and 48 casecontrol studies) covering 17 provinces of China were finally included in this systematic review. Among Chinese females, there was significant association between passive smoking and this risk of breast cancer [odds ratio(OR): 1.62; 95% confidence interval(CI): 1.39–1.85; I2 = 75.8%, P < 0.001; n = 26] but no significant association between active smoking and the risk of breast cancer(OR: 1.04; 95% CI: 0.89–1.20; I2 = 13.9%, P = 0.248; n = 31). The OR of exposure to husband's smoking and to smoke in the workplace was 1.27(95% CI: 1.07–1.50) and 1.66(95% CI: 1.07–2.59), respectively. The OR of light and heavy passive smoking was 1.11 and 1.41, respectively, for women exposed to their husband's smoke(< 20 and ≥ 20 cigarettes per day), and 1.07 and 1.87, respectively, for those exposed to smoke in the workplace(< 300 and ≥ 300 min of exposure per day). These results imply that passive smoking is associated with an increased risk of breast cancer, and the risk seems to increase as the level of passive exposure to smoke increases among Chinese females. Women with passive exposure to smoke in the workplace have a higher risk of breast cancer than those exposed to their husband's smoking.

Association of three single nucleotide polymorphisms of ESR1 with breast cancer susceptibility:a meta-analysis

Expression of estrogen receptors is correlated with breast cancer risk,but inconsistent results have been reported.To clarify potential estrogen receptor（ESR）-related breast cancer risk,we analyzed genetic variants of ESR1 in association with breast cancer susceptibility.We performed a meta-analysis to investigate the association between rs2234693,rs1801132,and rs2046210（single nucleotide polymorphisms of ESR1）,and breast cancer risk.Our analysis included 44 case-control studies.For rs2234693,the CC genotype had a higher risk of breast cancer compared to the TT or CT genotype.For rs2046210,the AA,GA,or GA ＋ GG genotype had a much higher risk compared to the GG genotype.No significant association was found for the rs 1801132 polymorphism with breast cancer risk.This meta-analysis demonstrates association between the rs2234693 and rs2046210 polymorphisms of ESR1 and breast cancer risk.The correlation strength between rs2234693 and breast cancer susceptibility differs in subgroup assessment by ethnicity.

Relationship between high dietary fat intake and Parkinson’s disease risk: a meta-analysis

OBJECTIVE: To assess whether dietary fat intake influences Parkinson’s disease risk. DATA SOURCES: We systematically surveyed the Embase and PubMed databases, reviewing manuscripts published prior to October 2018. The following terms were used:(“Paralysis agitans” OR “Parkinson disease” OR “Parkinson” OR “Parkinson’s” OR “Parkinson’s disease”) AND (“fat” OR “dietary fat” OR “dietary fat intake”). DATA SELECTION: Included studies were those with both dietary fat intake and Parkinson’s disease risk as exposure factors. The Newcastle-Ottawa Scale was adapted to investigate the quality of included studies. Stata V12.0 software was used for statistical analysis. OUTCOME MEASURES: The primary outcomes included the relationship between high total energy intake, high total fat intake, and Parkinson’s disease risk. The secondary outcomes included the relationship between different kinds of fatty acids and Parkinson’s disease risk. RESULTS: Nine articles met the inclusion criteria and were incorporated into this meta-analysis. Four studies scored 7 and the other five studies scored 9 on the Newcastle-Ottawa Scale, meaning that all studies were of high quality. Meta-analysis results showed that high total energy intake was associated with an increased risk of Parkinson’s disease (P = 0.000, odds ratio (OR)= 1.49, 95% confidence interval (CI): 1.26–1.75);in contrast, high total fat intake was not associated with Parkinson’s disease risk (P = 0.123, OR = 1.07, 95% CI: 0.91–1.25). Subgroup analysis revealed that polyunsaturated fatty acid intake (P = 0.010, OR = 1.03, 95% CI: 0.88–1.20) reduced the risk of Parkinson’s disease, while arachidonic acid (P = 0.026, OR = 1.15, 95% CI: 0.97–1.37) and cholesterol (P = 0.002, OR = 1.09, 95% CI: 0.92–1.29) both increased the risk of Parkinson’s disease. Subgroup analysis also demonstrated that, although the results were not significant, consumption of n-3 polyunsaturated fatty acids (P = 0.071, OR = 0.88, 95% CI: 0.73–1.05),α-linolenic acid (P = 0.06, OR = 0.86, 95% CI: 0.72–1.02), and the n-3 to n-6 ratio (P = 0.458, OR = 0.89, 95% CI: 0.75–1.06) were all linked with a trend toward reduced Parkinson’s disease risk. Monounsaturated fatty acid (P = 0.450, OR = 1.06, 95% CI: 0.91–1.23), n-6 polyunsaturated fatty acids (P = 0.100, OR = 1.15, 95% CI: 0.96–1.36) and linoleic acid (P = 0.053, OR = 1.11, 95% CI: 0.94–1.32) intakes were associated with a non-significant trend toward higher PD risk. Saturated fatty acid (P = 0.619, OR = 1.01, 95% CI: 0.87–1.18) intake was not associated with Parkinson’s disease. CONCLUSION: Dietary fat intake affects Parkinson’s disease risk, although this depends on the fatty acid subtype. Higher intake of polyunsaturated fatty acids may reduce the risk of Parkinson’s disease, while higher cholesterol and arachidonic acid intakes may elevate Parkinson’s disease risk. However, further studies and evidence are needed to validate any link between dietary fat intake and Parkinson’s disease.

Assessment of tumor response to chemotherapy in patients with breast cancer using ^(18)F-FLT: a meta-analysis

Purpose： To determine the diagnostic performance of 3＇-deoxy-3＇-18F-fluorothymidine positron emission tomography/computed tomography（FLT PET/CT） and FLT PET for evaluating response to chemotherapy in patients with breast cancer.Methods： Databases such as Pub Med（MEDLINE included） and excerpta medica database（EMBASE）, were searched for relevant original articles. The included studies were assessed for methodological quality with quality assessment of diagnosis accuracy studies（QUADAS） score tool. Histopathological analysis and/or clinical and/or radiological follow-up for at least 6 months were used as the reference standard. The data were extracted by two reviewers independently to analyze the sensitivity, specificity, summary receiver operating characteristic（SROC） curve, area under the curve（AUC）, and heterogeneity.Results： The present study analyzed a total of 4 selected articles. The pool sensitivity was 0.773 [95% confidence interval（CI）： 0.594-0.900]. The pooled specificity was 0.685（95% CI： 0.479-0.849） on basis of FEM. The pooled LR^＋, LR^-, and DOR were 2.874（1.492-5.538）, 0.293（0.146-0.589）, and 14.891（3.238-68.475）, respectively. The AUC was 0.8636（±0.0655）, and the Q＊ index was 0.7942（±0.0636）.Conclusions： Our results indicate that 18^F-FLT PET/CT or PET is useful to predict chemotherapy response in breast cancer with reasonable sensitivity, specificity and DOR. However, future larger scale clinical trials will be needed to assess the regimen of 18^F-FLT PET/CT or PET in monitoring the response to chemotherapy in breast cancer patients.

Beneficial effects of auricular acupressure on preventing constipation in breast cancer patients undergoing chemotherapy:evidence from systematic review and meta-analysis

Objective： To evaluate the available evidence from randomized controlled trials （RCTs） of auricular acupressure （AA） therapy for preventing constipation in breast cancer patients undergoing chemotherapy. Methods： The following databases were searched from their inception until August 2017： Ovid Medline, Embase, the Cochrane Central Register of Controlled Trials （CENTRAL）, and Allied and Alternative Medieine （AMED）. We also searched four Chinese databases： Chinese BioMedical Database （CBM）, China National Knowledge Infrastructure （CNKI）, WANFANG Data, and Chinese VIP Database. Only the RCTs related to the effects of AA therapy on preventing constipation in breast cancer patients undergoing chemotherapy were included in this study. Quantitative syntheses of data from RCTs were conducted using RevMan 5.3 software. Study selection, data extraction, and validation were performed independently by two authors. Cochrane criteria for risk of bias were used to assess the methodological quality of the trials. Results： Four RCTs met the inclusion criteria, and most were of low methodological quality. Study participants in the AA plus routine care group showed significantly greater improvements in the response rate （risk ratio [RR] = 1.27, 95% confidence interval [CI] [1.14, 1.42], P 〈 0.01） with low heterogeneity （x2=2.31, P =0.31, F = 14%）. In addition, when compared with routine care alone, one RCT suggested favorable statistically significant effects of AA plus routine care on Constipation Assessment Scale （CAS; mean difference [MD] =-5.07, 95% CI [-6.86, -3.28], P 〈 0.01）. Furthermore, when compared with routine care alone, one RCT suggested positive statistically significant effects of AA plus routine care on Patient Assessment of Constipation-Quality of Life （PAC-QOL; MD = -1.26, 95% CI [-1.59, -0.93], P 〈 0.01）. Conclusions： Overall, as a potential safety therapy, only weak evidence can support the hypothesis that AA can effectively prevent constipation in breast cancer patients undergoing chemotherapy.

Migraine History and Breast Cancer Risk: A Systematic Review and Meta-Analysis

Objective: The relationship between migraine and breast cancer risk has been reported inconsistently across different epidemiological studies. This meta-analysis was performed to explore the overall effect of migraine on breast cancer risk. Method: An electronic search of different major databases was conducted, including PubMed, Scopus, ScienceDirect, and the Cochrane library until February 1st, 2015. Of 652 retrieved studies, six population-based studies including two cohort studies with 130,812 and four case-control studies with 14,396 people were included in the analysis. Results: There was an inverse relationship between migraine and breast cancer risk (OR = 0.77;95% CI: 0.64, 0.92). Conclusion: The results of this meta-analysis showed that women with migraine history have a decreased risk of breast cancer. Further biological studies are needed to address the association.

Meta-Analysis: ¹⁸F-FDG PET or PET/CT for the Evaluation of Neoadjuvant Chemotherapy in Locally Advanced Breast Cancer

Purpose: To evaluate the accuracy and the predictive value of 18F-FDG PET or PET/CT in the assessment of neoadjuvant chemotherapy (NAC) in locally advanced breast cancer by meta-analysis. Materials and Methods: Relevant studies were identified by systematic searches of PUBMED and COCHRANE databases, published in English. To ensure homogeneity of all included studies, selection criteria were established and all the studies were scored according to Quality Assessment of Diagnostic Accuracy Studies (QUADAS) criteria. Meta-analysis was done on the diagnostic performance data from eligible studies. Draw funnel plots to explore the publication bias. Draw forest plots to exclude abnormal data(s). Use Spearman correlation coefficients p, likelihood ratio x2 test and I2 index in order to indicate heterogeneity. Estimate and compare the weighted summary sensitivities (SEs), specificities (SPs), diagnostic odds ratios (DORs), and summary receiver operating characteristic (SROC) curves of PET and other examinations (measuring the size of tumor). Subgroup analyses were performed to identify heterogeneity potential sources. Do Z test to find significant difference between each results. Results: 27 groups of data in 19 eligible studies were included with a total of 1164 subjects evaluated by 18F-FDG PET or PET/CT and 291 ones evaluated by other examinations. Funnel plots showed the existence of publication bias. Spearman correlation coefficients p, likelihood ratio x2 test and I2 index explored the heterogeneity. The Results of the Weighted Summary: SEPET was significantly higher than SED [83.7% (329/393) vs. 59.0% (98/166), p SPPET was significantly higher than SPD [66.8% (512/766) vs. 40.8% (51/125), p DORPET was significantly higher than DORD (14.02 vs. 1.29, p AUCPET and Q*PET were both significantly higher than AUCD and Q*D (AUCs 0.8838 vs. 0.6046;Q*s 0.8143 vs. 0.5788, p st or 2nd cycle of NAC was a litter better than later with higher SE (p = 0.083). Standardized uptake value (SUV) reduction rate between 40% and 45% as FDG-PET response threshold value was used for its highest SP (p = 0.01), while no significant difference was found comparing SEs and DORs (p > 0.05). Trend of higher SE and lower SP were found at ER negative breast cancers than ER positive ones (SEs 93.94% vs. 83.33%;SPs 35.76% vs. 62.24%), though Z test did not find significant difference (p > 0.05). Conclusion: This meta-analysis showed that FDG-PET or PET/CT does have a higher global accuracy in assessing the response for NAC in breast cancer. Comparing with clinical response, metabolic response plays a potential role in directing therapy for breast cancer. Factors which affected the accuracy of FDG-PET assessment included PET timing point, SUV reduction rate as threshold value and ER expression.

非药物康复干预对乳腺癌患者化疗相关认知障碍影响的网状Meta分析

目的:评价非药物康复干预措施对乳腺癌患者化疗相关认知障碍的治疗效果。方法:检索Pubmed,Cochrane library,Embase,Web of science,中国知网,万方,维普,CBM数据库符合研究目的的随机对照试验,检索时限截止到2022年2月,应用Stata 16.0软件进行网状Meta分析。结果:纳入研究22项,共10种非药物干预方法,并且纳入的研究均未报告显著不良事件,表明这10种非药物干预措施对于治疗化疗相关认知障碍是安全的。网状结果显示,相比于常规护理,最有效的干预措施排序为正念疗法、认知训练。结论:非药物康复干预对乳腺癌化疗相关认知障碍的治疗安全有效,其中正念疗法和认知训练的干预效果可能最佳,这一结果为临床决策提供了循证数据支持,未来需进行更多高质量研究探索最佳性价比的干预措施。

4种CDK4/6抑制剂用于晚期乳腺癌的安全性网状Meta分析

目的利用网状Meta分析方法对周期蛋白依赖性激酶4/6(CDK4/6)抑制剂在晚期乳腺癌中的安全性进行分析。方法在中英文数据库中检索阿贝西利、哌柏西利、瑞波西利、达尔西利治疗晚期或转移性乳腺癌的临床研究,检索时间截至2023年6月12日。使用ADDIS软件进行网状Meta分析,探索阿贝西利、哌柏西利、瑞波西利、达尔西利联合内分泌治疗之间的安全性差异,并对该类药物的血液毒性进行对比分析。结果共纳入14项研究,共5种干预措施,6513例患者。对严重不良事件(SAE)进行分析,SAE发生率从高到低依次为阿贝西利+内分泌治疗、瑞波西利+内分泌治疗、达尔西利+内分泌治疗、哌柏西利+内分泌治疗、内分泌治疗。血液学毒性方面,中性粒细胞减少发生率从高到低依次为达尔西利+内分泌治疗、哌柏西利+内分泌治疗、瑞波西利+内分泌治疗、阿贝西利+内分泌治疗、内分泌治疗;白细胞减少发生率从高到低依次为达尔西利+内分泌治疗、哌柏西利+内分泌治疗、阿贝西利+内分泌治疗、瑞波西利+内分泌治疗、内分泌治疗;贫血发生率从高到低依次为达尔西利+内分泌治疗、阿贝西利+内分泌治疗、哌柏西利+内分泌治疗、瑞波西利+内分泌治疗、内分泌治疗;血小板减少发生率从高到低依次为哌柏西利+内分泌治疗、达尔西利+内分泌治疗、阿贝西利+内分泌治疗、瑞波西利+内分泌治疗、内分泌治疗。结论阿贝西利+内分泌治疗的SAE发生率高于其他CDK4/6抑制剂,达尔西利+内分泌治疗的中性粒细胞减少、白细胞减少、贫血发生率高于其他CDK4/6抑制剂,哌柏西利+内分泌治疗的血小板减少发生率高于其他CDK4/6抑制剂,单纯内分泌治疗的SAE和血液毒性发生率最低,但上述结果还需更多高质量的头对头随机对照试验验证。临床医生和药师应更有针对地使用CDK4/6抑制剂,并及时对患者的不良反应做出积极、有效的应对,以最大限度提高药物疗效,降低患者用药风险。

中西医结合治疗乳腺癌术后相关性抑郁患者疗效的Meta分析

目的:系统评价中西医结合治疗乳腺癌术后抑郁的临床应用价值。方法:检索PubMed、维普数据库、Web of Science、中国生物医学文献数据库、万方数据库、Embase、Cochrane Library、中国知网从建库至2023年2月有关中西医结合治疗乳腺癌术后抑郁的随机对照试验研究,并通过RevMan 5.4以及Stata 14软件分析数据。结果:纳入文献11篇,患者888例。Meta分析结果表明:中西医结合治疗对比单纯西医治疗乳腺癌术后抑郁更能够降低患者中医证候积分(MD=-6.81,95%CI[-7.97,-5.66],P<0.00001),提高患者Karnofsky功能状态评分法(Karnofsky Performance Status Scale,KPS)评分改善有效率(RR=1.65,95%CI[1.16,2.35],P=0.005),提高患者免疫指标T淋巴细胞CD4^(+)(MD=7.46,95%CI[6.16,8.76],Z=11.25,P<0.00001)、CD4^(+)/CD8^(+)(MD=0.55,95%CI[0.18,0.91],Z=2.94,P=0.003),降低乳腺癌术后抑郁患者抑郁自评量表(Self Rating Depression Scale,SDS)积分(SMD=-0.85,95%CI[-1.08,-0.61],Z=7.00,P<0.0001),降低乳腺癌术后抑郁患者汉密尔顿抑郁量表(Hamilton Depression Rating Scale,HAMD)积分(MD=-7.03,95%CI[-8.37,-5.69],Z=10.28,P<0.0001),但对于免疫指标T淋巴细胞亚群中的CD8^(+)(MD=-6.69,95%CI[-16.20,2.83],Z=1.38,P=0.17),中西医结合治疗并不能提高患者免疫指标CD8~+。通过中药使用频率的分析,柴胡、芍药、茯苓、当归、甘草、白术、地黄为治疗乳腺癌患者术后相关性抑郁的常用中药。结论:中西医结合治疗乳腺癌术后抑郁能够降低患者的SDS积分、HAMD积分及中医证候积分,改善症状,提高KPS评分改善有效率及免疫指标T淋巴细胞亚群(CD4~+、CD4~+/CD8~+),但治疗前后免疫指标CD8~+的差异没有统计学意义,未来需要开展多中心、大样本、高质量的研究来探究中西医结合治疗对CD8~+的影响。

戈舍瑞林对绝经前乳腺癌患者卵巢功能保护的meta分析

目的通过meta分析方法系统评价戈舍瑞林对绝经前乳腺癌患者卵巢功能保护的能力。方法检索中国知网、万方数据库、维普数据库、PubMed、Web of Science、Scopus及Cochrane Library,提取从建库至2023年10月戈舍瑞林治疗绝经前乳腺癌的对照试验。由2名研究者根据纳入与排除标准独立筛选文献、提取数据,并采用Cochrane协作网风险偏倚评价工具对纳入研究质量进行评价,运用RevMan 5.3软件进行数据分析。结果共纳入28项研究,共8782例研究对象,其中试验组4372例,对照组4410例。meta分析结果显示:试验组总有效率高于对照组(OR=2.87,95%CI 1.94~4.26,P<0.00001);试验组基础卵泡刺激素(bFSH)水平低于对照组(MD=-3.81,95%CI-4.35~-3.27,P<0.00001);试验组窦状卵泡数(bAFC)水平高于对照组(MD=3.27,95%CI 2.83~3.72,P<0.00001);两组雌二醇(E2)水平比较,差异无统计学意义(SMD=0.85,95%CI-0.69~2.40,P=0.28);试验组促黄体生成素(LH)高于对照组(MD=8.75,95%CI 7.84~9.67,P<0.00001);试验组卵巢早衰(POI)低于对照组(OR=0.24,95%CI 0.08~0.73,P=0.01);试验组月经复潮率高于对照组(OR=3.09,95%CI 1.01~9.46,P=0.05);试验组无病生存期(DFS)高于对照组(OR=1.91,95%CI 1.28~2.85,P=0.002);试验组总生存期(OS)高于对照组(OR=1.35,95%CI 1.14~1.59,P=0.0004);试验组无进展生存时间(PFS)高于对照组(MD=30.15,95%CI 29.47~30.83,P<0.00001);试验组不良反应发生率低于对照组(OR=0.48,95%CI 0.25~0.90,P=0.02)。结论戈舍瑞林治疗绝经前乳腺癌患者能有效保护其卵巢功能,提高患者生存时间,同时具有较好的安全性。

乳腺癌植入式静脉输液港患者导管相关性血栓形成危险因素的Meta分析

目的 分析乳腺癌植入式静脉输液港患者导管相关性血栓形成的危险因素,为避免发生导管相关性血栓提供参考。方法 计算机检索中国知网、万方、维普、中国生物医学文献服务系统、PubMed、Web of Science、Embase、Cochrane Library等数据库中关于乳腺癌植入式静脉输液港患者导管相关性血栓形成危险因素的病例对照研究和队列研究,检索时限为建库至2024年1月,采用RevMan5.3软件进行Meta分析。结果 共纳入19篇文献,9938例乳腺癌患者。年龄≥60岁(OR=0.44,P=0.005)、体质量指数>24 kg/m2(OR=1.85,P=0.001)、硅胶导管材质(OR=0.75,P=0.040)、左侧置管(OR=1.23,P=0.040)、上臂输液港植入(OR=0.23,P=0.010)、蒽环类与紫杉类联合化疗方案(OR=1.95,P=0.030)、肿瘤临床分期Ⅲ~Ⅳ期(OR=0.53,P<0.001)、静脉血栓史(OR=3.24,P=0.030)、高凝状态(OR=2.43,P<0.001)、高血压史(OR=1.84,P=0.001)是乳腺癌植入式静脉输液港患者导管相关性血栓形成的危险因素。结论 医护人员应加强高危乳腺癌患者的管理,针对上述危险因素提前采取措施,以降低导管相关性血栓的发生率,提高其生活质量。

酪氨酸激酶抑制剂治疗Her-2阳性乳腺癌脑转移疗效的单臂meta分析

目的探讨酪氨酸激酶抑制剂(TKIs)在Her-2阳性乳腺癌脑转移(BCBM)中的疗效。方法检索从建库至2022年4月11日数据库(PubMed、Cochranelibrary、Embase)中TKIs治疗Her-2阳性BCBM的临床研究,采用STATA 17.0进行meta分析。结果纳入15项研究,其中3项关于TKIs单药治疗,12项关于联合治疗,meta分析显示TKIs单药治疗的疗效欠佳,与未使用TKIs治疗相比总生存期(OS)差异不显著(P>0.05),但TKIs联合治疗的疗效改善,与未使用TKIs治疗、未使用抗Her-2治疗或仅基于曲妥珠单抗治疗相比,OS差异有统计学意义(P<0.05);中枢神经系统(CNS)进展为TKIs单药或联合药物治疗的主要进展方式,发生率为59.0%~82.2%,而TKIs联合放疗的CNS复发率降低为22.9%。结论基于TKIs的联合治疗能够改善Her-2阳性BCBM的预后,但CNS复发率仍然很高,TKIs联合放疗能够降低CNS复发率,但相关的前瞻性临床研究较少,需更多前瞻性临床研究进一步确定最佳治疗策略。

运动干预对乳腺癌新辅助化疗患者心肺耐力影响的Meta分析

目的 评价运动干预对乳腺癌新辅助化疗患者的影响。方法 系统检索PubMed、Web of Science、中国知网等数据库中关于乳腺癌新辅助化疗患者在常规护理的基础上联合运动训练的临床干预试验,检索时间为建库至2023年12月。根据纳入与排除标准筛选文献、提取资料。对文献进行质量评估,采用RevMan 5.4软件进行Meta分析。结果 最终纳入8篇文献,文献质量中等,共203例患者,其中对照组99例,干预组104例。结果显示运动干预能有效提高乳腺癌新辅助化疗患者心肺耐力,干预组峰值摄氧量(MD 3.97,95%CI 1.59~6.34,P=0.001)、最大摄氧量(MD 3.67,95%CI 0.59~6.76,P=0.02)、6 min步行试验(MD 89.18,95%CI 66.50~111.86,P <0.00001)均优于对照组;干预组BMI改善情况优于对照组(MD-4.00,95%CI-5.53~-2.47,P <0.00001);两组生命质量(MD 5.95,95%CI-4.39~16.30,P=0.26)和癌因性疲乏(MD-1.64,95%CI-7.75~4.46,P=0.60)差异无统计学意义。结论 运动干预能有效提高乳腺癌新辅助化疗患者的心肺耐力和改善BMI。

中医护理对乳腺癌化疗病人恶心呕吐防治效果的网状Meta分析

目的:采用网状Meta分析方法,对防治乳腺癌化疗病人恶心呕吐的不同中医护理措施效果进行评估和比较。方法:计算机检索Embase、PubMed、Web of Science、the Cochrane Library、CINAHL、中国知网等数据库公开发表的缓解乳腺癌病人化疗期间恶心呕吐的中医护理措施的随机对照试验,检索时限均为建库至2023年5月30日。经过文献筛选、质量评价、信息提取后,使用STATA 17.0软件和ADDIS 1.16.6软件进行网状Meta分析。结果:共纳入20篇文献,涉及11种中医护理干预措施,包括1 939例乳腺癌化疗病人。网状Meta分析结果显示,5种单一中医护理干预中,吸入芳香疗法缓解乳腺癌化疗病人化疗所致恶心呕吐(chemotherapy-induced nausea and vomiting, CINV)的效果最佳,有效控制率为93.2%;6种联合中医护理措施中,穴位贴敷联合情志护理效果最佳,有效控制率为92.9%。结论:当前证据表明,吸入芳香疗法以及穴位贴敷联合情志护理可较好地改善乳腺癌化疗病人恶心呕吐状况,可优先考虑应用。

基于PERMA模式的护理对乳腺癌患者干预效果的Meta分析

目的 系统评价基于PREMA模式的护理对乳腺癌患者的干预效果。方法 检索CINAHL、PubMed、Embase、Web of Science、Medline、Scopus、Cochrane Library、PsycInfo、中国生物医学文献数据库、中国知网、万方数据知识服务平台、维普中文科技期刊数据库中基于PERMA模式的护理对乳腺癌患者干预效果的随机对照试验,检索时限为建库至2024年2月27日,运用RevMan 5.4软件分析数据。结果 共纳入7项研究,672例患者。Meta分析显示,与对照组相比,基于PREMA模式的护理可降低乳腺癌患者的焦虑[SMD=-2.58,95%CI(-3.37,-1.79),P<0.001]、抑郁[SMD=-3.79,95%CI(-4.91,-2.66),P<0.001]、恐惧疾病进展[MD=-5.70,95%CI(-6.85,-4.56),P<0.001]、疲乏[SMD=-8.16,95%CI(-15.34,-0.98),P=0.030],提高幸福感[SMD=1.63,95%CI(0.88,2.38),P<0.001]和心理资本[MD=17.12,95%CI(12.12,22.13),P<0.001]。结论 基于PREMA模式的护理干预能够降低乳腺癌患者的负性情绪及疲乏症状,并利于提升患者的幸福感和心理资本。但仍需开展大样本、高质量的随机对照试验来进一步验证该干预的有效性。

不同锻炼方式改善乳腺癌术后患者肩关节功能的网状Meta分析

目的评价不同康复锻炼方式改善乳腺癌术后肩关节功能的效果。方法检索中国知网、维普网、万方数据、SinoMed、PubMed、Embase、Cochrane Library、Web of Science数据库中关于锻炼方式改善乳腺癌术后患者肩关节功能的随机对照试验,检索时限为建库至2024年1月,采用Stata17.0软件进行文献的质量评价与数据分析。结果共纳入13项研究,涉及9种锻炼方式和994例患者。网状Meta分析结果表明,在改善肩部屈曲功能方面,水疗法和渐进式康复操的效果优于常规护理(均P<0.05),其中以水疗法的效果最佳;在改善肩部伸展功能方面,渐进式康复操、本体感觉神经肌肉促进术、推拿的效果优于常规护理(均P<0.05),其中以渐进式康复操的效果最佳;在改善肩部外旋功能方面,渐进式康复操的效果优于常规护理(P<0.05);在改善肩部内旋功能方面,涉及的锻炼方式两两比较均未产生统计学差异;在缓解疼痛方面,抗阻力训练的干预效果优于常规护理(P<0.05)。结论水疗法能更好地改善肩部屈曲功能,渐进式康复操在改善肩部伸展、外旋功能方面更具优势,抗阻力训练改善肩部疼痛的效果最优。