Objective:To systematically review the influence of psychological intervention of midwives on the delivery mode and outcomes.Methods:Databases including Cochrane Library,PubMed,Medline,EMBASE,CINAHL,CNKI,Wangfang,and ...Objective:To systematically review the influence of psychological intervention of midwives on the delivery mode and outcomes.Methods:Databases including Cochrane Library,PubMed,Medline,EMBASE,CINAHL,CNKI,Wangfang,and VIP were searched for randomized controlled trials studying the effects of midwife-led psychological nursing on puerpera.Two evaluators independently searched and screened the papers,extracted relevant data,and quality assessment of the included studies,followed by a meta-analysis of the papers using RevMan 5.3 software.Results:12 studies with 1,395 patients were included.The results of the meta-analysis showed that compared to conventional nursing,midwife-led psychological intervention can improve the number of people who choose natural delivery[Z=7.53,95%CI(2.07,3.45),P<0.001],shorten the duration of the first stage of delivery[Z=45.10,95%CI(-4.43,-4.06),P<0.001),reduce postpartum hemorrhage after delivery for two hours[Z=21.68,95%CI(-63.92,-53.32),P<0.001];these differences were statistically significant.Conclusion:Psychological interventions led by midwives can improve the natural delivery rate of pregnant women,shorten the duration of the first stage of delivery,and decrease postpartum hemorrhage after delivery for two hours;thus,it can be popularized for clinical use.展开更多
Background:Low and middle income countries(LMICs)face severe resource limitations but the highest burden of disease.There is a growing evidence base on effective and cost-effective interventions for these diseases.How...Background:Low and middle income countries(LMICs)face severe resource limitations but the highest burden of disease.There is a growing evidence base on effective and cost-effective interventions for these diseases.However,questions remain about the most cost-effective method of delivery for these interventions.We aimed to review the scope,quality,and findings of economic evaluations of service delivery interventions in LMICs.Methods:We searched PUBMED,MEDLINE,EconLit,and NHS EED for studies published between 1st January 2000 and 30th October 2016 with no language restrictions.We included all economic evaluations that reported incremental costs and benefits or summary measures of the two such as an incremental cost effectiveness ratio.Studies were grouped by both disease area and outcome measure and permutation plots were completed for similar interventions.Quality was judged by the Drummond checklist.Results:Overall,3818 potentially relevant abstracts were identified of which 101 studies were selected for full text review.Thirty-seven studies were included in the final review.Twenty-three studies reported on interventions we classed as“changing by whom and where care was provided”,specifically interventions that entailed task-shifting from doctors to nurses or community health workers or from facilities into the community.Evidence suggests this type of intervention is likely to be cost-effective or cost-saving.Nine studies reported on quality improvement initiatives,which were generally found to be cost-effective.Quality and methods differed widely limiting comparability of the studies and findings.Conclusions:There is significant heterogeneity in the literature,both methodologically and in quality.This renders further comparisons difficult and limits the utility of the available evidence to decision makers.展开更多
Background Hypoxemia sometimes occurs in the emergency room in the patients with acute myocardial infarction （AMI） after percutaneous coronary intervention （PCI）, even in those with administration of conventional ...Background Hypoxemia sometimes occurs in the emergency room in the patients with acute myocardial infarction （AMI） after percutaneous coronary intervention （PCI）, even in those with administration of conventional high-flow oxygen inhalation. The objective of the present study was to evaluate the effectiveness of non-invasive ventilation （NIV） in improving blood oxygen content and hemorheology in patients with AMI and hypoxemia. Methods This prospective study enrolled 50 consecutive eligible patients with AMI （aged 72.3 ± 9.5 years）, who had undergone PCI and been administered high-flow oxygen but still had hypoxemia. Blood was taken before NIV and at 0.5, 1, and 2 h after NIV. Blood gases, hemorheological variables including erythrocyte deformability, erythrocyte aggregation, erythrocyte osmotic fragility, membrane fluidity, and oxidative stress level were measured. Results Blood PaO2 increased to normal by 1 h after NIV. Assessed hemorheological variables had all improved and plasma malondialdehyde concentration decreased significantly after 2 h of NIV. Conclusions Our data suggest that NIV can help to improve blood oxygen content, hemorheological status, and minimize plasma lipid peroxidation injury in hypoxemic patients with AMI who have undergone PCI.展开更多
Pain interventional therapy,known as the most promising medical technology in the 21st century,refers to clinical treatment technology based on neuroanatomy,neuroimaging,and nerve block technology to treat pain diseas...Pain interventional therapy,known as the most promising medical technology in the 21st century,refers to clinical treatment technology based on neuroanatomy,neuroimaging,and nerve block technology to treat pain diseases.Compared with traditional destructive surgery,interventional pain therapy is considered a better and more economical choice of treatment.In recent years,a variety of minimally invasive pain interventional therapy techniques,such as neuroregulation,spinal cord electrical stimulation,intervertebral disc ablation,and intrasheath drug infusion systems,have provided effective solutions for the treatment of patients with post-herpetic neuralgia,complex regional pain syndrome,cervical/lumbar disc herniation,and refractory cancer pain.展开更多
Objective: To assess the role of a nurse-assisted early warning intervention in improving prophylaxis against obstetric venous thromboembolism(VTE)and preventing VTE following cesarean delivery(CD).Methods: A prospect...Objective: To assess the role of a nurse-assisted early warning intervention in improving prophylaxis against obstetric venous thromboembolism(VTE)and preventing VTE following cesarean delivery(CD).Methods: A prospective cohort study conducted between January 1,2020,and December 30,2022,enrolled pregnant women who underwent CD in the obstetric unit of Women’s Hospital of Nanjing Medical University,Nanjing Maternity and Child Health Care Hospital.The patients were assigned to a control group(routine nursing care)or the intervention group(nurse-assisted early warning intervention)depending on whether or not the nurse-assisted early warning intervention had been implemented.The χ^(2) test and Student’s t-test were used for statistical analysis.The primary outcome was the incidence of systemic VTE following CD,and secondary outcomes were the rates of mechanical or pharmacologic prophylaxis receipts for VTE and the frequency and severity of adverse events related to pharmacologic prophylaxis.Results: A total of 27,074 cases were enrolled.The incidence of symptomatic VTE following CD was significantly lower in the intervention group(0.29 per 1000 deliveries)than in the control group(2.4 per 1000 deliveries)(P<0.001).Significantly more cases received mechanical and pharmacological VTE prophylaxis in the intervention group than in the control group(respectively,19.8%vs.12.6%receiving mechanical prophylaxis and 0.9%vs.0.2%receiving pharmacological prophylaxis).No cases of life-threatening bleeding occurred in either group.Conclusion: The application of nurse-assisted early warning intervention may be an effective method for preventing VTE following CD.展开更多
Parkinson's disease(PD) is a chronic debilitating disease affecting approximately 1% of the population over the age of 60. The severity of PD is correlated to the degree of dopaminergic neuronal loss. Apomorphine ...Parkinson's disease(PD) is a chronic debilitating disease affecting approximately 1% of the population over the age of 60. The severity of PD is correlated to the degree of dopaminergic neuronal loss. Apomorphine has a similar chemical structure as the neurotransmitter dopamine and has been used for the treatment of advanced PD patients. In PD patients,apomorphine is normally administered subcutaneously with frequent injections because of the compound's extensive hepatic first-pass metabolism. There is, hence, a large unmet need for alternative administrative routes for apomorphine to improve patient compliance.The present review focuses on the research and development of alternative delivery of apomorphine, aiming to highlight the potential of non-invasive apomorphine therapy in PD,such as sublingual delivery and transdermal delivery.展开更多
Stuck up and fracture of coronary angioplasty hardware are unwonted complications of percutaneous coronary interventions (PCI) for which surgical retrieval and management is once in a while required. We present one ca...Stuck up and fracture of coronary angioplasty hardware are unwonted complications of percutaneous coronary interventions (PCI) for which surgical retrieval and management is once in a while required. We present one case of a 59-year-old diabetic, a hypertensive gentleman who attended the emergency room (ER) with central chest pain for 2 hours. After evaluation of the patient <span>by physical and noninvasive diagnostic tests, he was diagnosed as a case of</span> acute myocardial infarction (AMI) with stable hemodynamic. For the aforementioned findings, the patient was treated first with a thrombolytic agent in <span>ER and then shifted to Cardiology Department for monitoring and further</span> <span>coronary evaluation by coronary angiography (CAG). CAG revealed essen</span><span>tially single vessel disease (SVD) with complex left anterior descending (LAD) </span>artery lesion, so PCI was attempted but failed with an unfortunate incidence of the broken delivery shaft and left <i>in vivo</i>. Immediate decision making and <span>surgical management for retrieval of lost angioplasty device and correction</span> coronary lesion with revascularization save the patient from grave complica<span>tion. All the series of events and management approaches of this very com</span>plex coronary artery lesion are discussed in this article.展开更多
文摘Objective:To systematically review the influence of psychological intervention of midwives on the delivery mode and outcomes.Methods:Databases including Cochrane Library,PubMed,Medline,EMBASE,CINAHL,CNKI,Wangfang,and VIP were searched for randomized controlled trials studying the effects of midwife-led psychological nursing on puerpera.Two evaluators independently searched and screened the papers,extracted relevant data,and quality assessment of the included studies,followed by a meta-analysis of the papers using RevMan 5.3 software.Results:12 studies with 1,395 patients were included.The results of the meta-analysis showed that compared to conventional nursing,midwife-led psychological intervention can improve the number of people who choose natural delivery[Z=7.53,95%CI(2.07,3.45),P<0.001],shorten the duration of the first stage of delivery[Z=45.10,95%CI(-4.43,-4.06),P<0.001),reduce postpartum hemorrhage after delivery for two hours[Z=21.68,95%CI(-63.92,-53.32),P<0.001];these differences were statistically significant.Conclusion:Psychological interventions led by midwives can improve the natural delivery rate of pregnant women,shorten the duration of the first stage of delivery,and decrease postpartum hemorrhage after delivery for two hours;thus,it can be popularized for clinical use.
基金This research was commissioned by the National Institute for Health Research using Official Development Assistance(ODA)funding.
文摘Background:Low and middle income countries(LMICs)face severe resource limitations but the highest burden of disease.There is a growing evidence base on effective and cost-effective interventions for these diseases.However,questions remain about the most cost-effective method of delivery for these interventions.We aimed to review the scope,quality,and findings of economic evaluations of service delivery interventions in LMICs.Methods:We searched PUBMED,MEDLINE,EconLit,and NHS EED for studies published between 1st January 2000 and 30th October 2016 with no language restrictions.We included all economic evaluations that reported incremental costs and benefits or summary measures of the two such as an incremental cost effectiveness ratio.Studies were grouped by both disease area and outcome measure and permutation plots were completed for similar interventions.Quality was judged by the Drummond checklist.Results:Overall,3818 potentially relevant abstracts were identified of which 101 studies were selected for full text review.Thirty-seven studies were included in the final review.Twenty-three studies reported on interventions we classed as“changing by whom and where care was provided”,specifically interventions that entailed task-shifting from doctors to nurses or community health workers or from facilities into the community.Evidence suggests this type of intervention is likely to be cost-effective or cost-saving.Nine studies reported on quality improvement initiatives,which were generally found to be cost-effective.Quality and methods differed widely limiting comparability of the studies and findings.Conclusions:There is significant heterogeneity in the literature,both methodologically and in quality.This renders further comparisons difficult and limits the utility of the available evidence to decision makers.
文摘Background Hypoxemia sometimes occurs in the emergency room in the patients with acute myocardial infarction （AMI） after percutaneous coronary intervention （PCI）, even in those with administration of conventional high-flow oxygen inhalation. The objective of the present study was to evaluate the effectiveness of non-invasive ventilation （NIV） in improving blood oxygen content and hemorheology in patients with AMI and hypoxemia. Methods This prospective study enrolled 50 consecutive eligible patients with AMI （aged 72.3 ± 9.5 years）, who had undergone PCI and been administered high-flow oxygen but still had hypoxemia. Blood was taken before NIV and at 0.5, 1, and 2 h after NIV. Blood gases, hemorheological variables including erythrocyte deformability, erythrocyte aggregation, erythrocyte osmotic fragility, membrane fluidity, and oxidative stress level were measured. Results Blood PaO2 increased to normal by 1 h after NIV. Assessed hemorheological variables had all improved and plasma malondialdehyde concentration decreased significantly after 2 h of NIV. Conclusions Our data suggest that NIV can help to improve blood oxygen content, hemorheological status, and minimize plasma lipid peroxidation injury in hypoxemic patients with AMI who have undergone PCI.
基金supported by the Lishui Science and Technology Plan Project(Grant Number:2022SJZC020)the Medical Health Science and Technology Project of the Zhejiang Provincial Health Commission(Grant Number:2020KY1084)
文摘Pain interventional therapy,known as the most promising medical technology in the 21st century,refers to clinical treatment technology based on neuroanatomy,neuroimaging,and nerve block technology to treat pain diseases.Compared with traditional destructive surgery,interventional pain therapy is considered a better and more economical choice of treatment.In recent years,a variety of minimally invasive pain interventional therapy techniques,such as neuroregulation,spinal cord electrical stimulation,intervertebral disc ablation,and intrasheath drug infusion systems,have provided effective solutions for the treatment of patients with post-herpetic neuralgia,complex regional pain syndrome,cervical/lumbar disc herniation,and refractory cancer pain.
文摘Objective: To assess the role of a nurse-assisted early warning intervention in improving prophylaxis against obstetric venous thromboembolism(VTE)and preventing VTE following cesarean delivery(CD).Methods: A prospective cohort study conducted between January 1,2020,and December 30,2022,enrolled pregnant women who underwent CD in the obstetric unit of Women’s Hospital of Nanjing Medical University,Nanjing Maternity and Child Health Care Hospital.The patients were assigned to a control group(routine nursing care)or the intervention group(nurse-assisted early warning intervention)depending on whether or not the nurse-assisted early warning intervention had been implemented.The χ^(2) test and Student’s t-test were used for statistical analysis.The primary outcome was the incidence of systemic VTE following CD,and secondary outcomes were the rates of mechanical or pharmacologic prophylaxis receipts for VTE and the frequency and severity of adverse events related to pharmacologic prophylaxis.Results: A total of 27,074 cases were enrolled.The incidence of symptomatic VTE following CD was significantly lower in the intervention group(0.29 per 1000 deliveries)than in the control group(2.4 per 1000 deliveries)(P<0.001).Significantly more cases received mechanical and pharmacological VTE prophylaxis in the intervention group than in the control group(respectively,19.8%vs.12.6%receiving mechanical prophylaxis and 0.9%vs.0.2%receiving pharmacological prophylaxis).No cases of life-threatening bleeding occurred in either group.Conclusion: The application of nurse-assisted early warning intervention may be an effective method for preventing VTE following CD.
基金The Lundbeck Foundation for the financial support(R108-A10772)
文摘Parkinson's disease(PD) is a chronic debilitating disease affecting approximately 1% of the population over the age of 60. The severity of PD is correlated to the degree of dopaminergic neuronal loss. Apomorphine has a similar chemical structure as the neurotransmitter dopamine and has been used for the treatment of advanced PD patients. In PD patients,apomorphine is normally administered subcutaneously with frequent injections because of the compound's extensive hepatic first-pass metabolism. There is, hence, a large unmet need for alternative administrative routes for apomorphine to improve patient compliance.The present review focuses on the research and development of alternative delivery of apomorphine, aiming to highlight the potential of non-invasive apomorphine therapy in PD,such as sublingual delivery and transdermal delivery.
文摘Stuck up and fracture of coronary angioplasty hardware are unwonted complications of percutaneous coronary interventions (PCI) for which surgical retrieval and management is once in a while required. We present one case of a 59-year-old diabetic, a hypertensive gentleman who attended the emergency room (ER) with central chest pain for 2 hours. After evaluation of the patient <span>by physical and noninvasive diagnostic tests, he was diagnosed as a case of</span> acute myocardial infarction (AMI) with stable hemodynamic. For the aforementioned findings, the patient was treated first with a thrombolytic agent in <span>ER and then shifted to Cardiology Department for monitoring and further</span> <span>coronary evaluation by coronary angiography (CAG). CAG revealed essen</span><span>tially single vessel disease (SVD) with complex left anterior descending (LAD) </span>artery lesion, so PCI was attempted but failed with an unfortunate incidence of the broken delivery shaft and left <i>in vivo</i>. Immediate decision making and <span>surgical management for retrieval of lost angioplasty device and correction</span> coronary lesion with revascularization save the patient from grave complica<span>tion. All the series of events and management approaches of this very com</span>plex coronary artery lesion are discussed in this article.
