热敏灸治疗颈型颈椎病的Meta分析及GRADE证据等级评价

目的系统评价热敏灸及其综合疗法用于颈型颈椎病的临床效果,为热敏灸治疗颈型颈椎病提供更好的证据来源。方法收集国内外各大数据库热敏灸及其综合疗法用于颈型颈椎病的随机对照试验(RCT),通过Revman 5.3软件进行Meta分析,按照GRADE标准对结局指标进行证据质量评价。结果纳入9篇文献共855例患者,Meta分析结果提示:热敏灸及其综合疗法组在提高总有效率(RR=1.19,P<0.01)和治愈率(RR=1.73,P<0.01)、降低视觉模拟量表(VAS)评分(SMD=-0.73,P<0.01)、简化McGill疼痛问卷(SF-MPQ)评分(SMD=-1.28,P<0.05)以及NPQ颈痛量表评分(SMD=-0.81,P<0.05)方面都优于对照组;GRADE证据等级评价提示:前三者为低质量证据,后二者为极低质量证据。结论热敏灸及其综合疗法用于颈型颈椎病在提高临床效果、镇痛以及改善患者生活质量方面更具优势。

腕踝针干预术后疼痛疗效的Meta分析和Grade评价

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。

补肾方剂改善高龄女性自然妊娠结局的Meta分析及GRADE质量评价

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。

Thermal transport in composition graded silicene/germanene heterostructures

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.

Parametric resonance of axially functionally graded pipes conveying pulsating fluid

Based on the generalized Hamilton's principle,the nonlinear governing equation of an axially functionally graded(AFG)pipe is established.The non-trivial equilibrium configuration is superposed by the modal functions of a simply supported beam.Via the direct multi-scale method,the response and stability boundary to the pulsating fluid velocity are solved analytically and verified by the differential quadrature element method(DQEM).The influence of Young's modulus gradient on the parametric resonance is investigated in the subcritical and supercritical regions.In general,the pipe in the supercritical region is more sensitive to the pulsating excitation.The nonlinearity changes from hard to soft,and the non-trivial equilibrium configuration introduces more frequency components to the vibration.Besides,the increasing Young's modulus gradient improves the critical pulsating flow velocity of the parametric resonance,and further enhances the stability of the system.In addition,when the temperature increases along the axial direction,reducing the gradient parameter can enhance the response asymmetry.This work further complements the theoretical analysis of pipes conveying pulsating fluid.

Dynamic Characteristics of Functionally Graded Timoshenko Beams by Improved Differential Quadrature Method

This study proposes an effective method to enhance the accuracy of the Differential Quadrature Method(DQM)for calculating the dynamic characteristics of functionally graded beams by improving the form of discrete node distribution.Firstly,based on the first-order shear deformation theory,the governing equation of free vibration of a functionally graded beam is transformed into the eigenvalue problem of ordinary differential equations with respect to beam axial displacement,transverse displacement,and cross-sectional rotation angle by considering the effects of shear deformation and rotational inertia of the beam cross-section.Then,ignoring the shear deformation of the beam section and only considering the effect of the rotational inertia of the section,the governing equation of the beam is transformed into the eigenvalue problem of ordinary differential equations with respect to beam transverse displacement.Based on the differential quadrature method theory,the eigenvalue problem of ordinary differential equations is transformed into the eigenvalue problem of standard generalized algebraic equations.Finally,the first several natural frequencies of the beam can be calculated.The feasibility and accuracy of the improved DQM are verified using the finite element method(FEM)and combined with the results of relevant literature.

Levels of evidence and grades of recommendation supporting European society for medical oncology clinical practice guidelines

Background:The European Society for Medical Oncology(ESMO)guidelines are among the most comprehensive and widely used clinical practice guidelines(CPGs)globally.However,the level of scientific evidence supporting ESMO CPG recommendations has not been systematically investigated.This study assessed ESMO CPG levels of evidence(LOE)and grades of recommendations(GOR),as well as their trends over time across various cancer settings.Methods:We manually extracted every recommendation with the Infectious Diseases Society of America(IDSA)classification from each CPG.We examined the distribution of LOE and GOR in all available ESMO CPG guidelines across different topics and cancer types.Results:Among the 1,823 recommendations in the current CPG,30%were classified as LOEⅠ,and 43%were classified as GOR A.Overall,there was a slight decrease in LOEⅠ(−2%)and an increase in the proportion of GOR A(+1%)in the current CPG compared to previous versions.The proportion of GOR A recommendations based on higher levels of evidence such as randomized trials(LOEⅠ–Ⅱ)shows a decrease(71%vs.63%,p=0.009)while recommendations based on lower levels of evidence(LOEⅢ–Ⅴ)show an increase(29%vs.37%,p=0.01)between previous and current version.In the current versions,the highest proportion of LOEⅠ(42%)was found in recommendations related to pharmacotherapy,while the highest proportion of GOR A recommendations was found in the areas of pathology(50%)and diagnostic(50%)recommendations.Significant variability in LOEⅠand GOR A recommendations and their changes over time was observed across different cancer types.Conclusion:One-third of the current ESMO CPG recommendations are supported by the highest level of evidence.More well-designed randomized clinical trials are needed to increase the proportion of LOEⅠand GOR A recommendations,ultimately leading to improved outcomes for cancer patients.

Biomimetic MXene membranes with negatively thermo-responsive switchable 2D nanochannels for graded molecular sieving

Negatively thermo-responsive 2D membranes,which mimic the stomatal opening/closing of plants,have drawn substantial interest for tunable molecular separation processes.However,these membranes are still restricted significantly on account of low water permeability and poor dynamic tunability of 2D nanochannels under temperature stimulation.Here,we present a biomimetic negatively thermo-responsive MXene membrane by covalently grafting poly(N-isopropylacrylamide)(PNIPAm)onto MXene nanosheets.The uniformly grafted PNIPAm polymer chains can enlarge the interlayer spacings for increasing water permeability while also allowing more tunability of 2D nanochannels for enhancing the capability of gradually separating multiple molecules of different sizes.As expected,the constructed membrane exhibits ultrahigh water permeance of 95.6 L m^(-2) h^(-1) bar^(-1) at 25℃,which is eight-fold higher than the state-of-the-art negatively thermoresponsive 2D membranes.Moreover,the highly temperature-tunable 2D nanochannels enable the constructed membrane to perform excellent graded molecular sieving for dye-and antibiotic-based ternary mixtures.This strategy provides new perspectives in engineering smart 2D membrane and expands the scope of temperature-responsive membranes,showing promising applications in micro/nanofluidics and molecular separation.

Exact solution for thermal vibration of multi-directional functionally graded porous plates submerged in fluid medium

An analytical method for analyzing the thermal vibration of multi-directional functionally graded porous rectangular plates in fluid media with novel porosity patterns is developed in this study.Mechanical properties of MFG porous plates change according to the length,width,and thickness directions for various materials and the porosity distribution which can be widely applied in many fields of engineering and defence technology.Especially,new porous rules that depend on spatial coordinates and grading indexes are proposed in the present work.Applying Hamilton's principle and the refined higher-order shear deformation plate theory,the governing equation of motion of an MFG porous rectangular plate in a fluid medium(the fluid-plate system)is obtained.The fluid velocity potential is derived from the boundary conditions of the fluid-plate system and is used to compute the extra mass.The GalerkinVlasov solution is used to solve and give natural frequencies of MFG porous plates with various boundary conditions in a fluid medium.The validity and reliability of the suggested method are confirmed by comparing numerical results of the present work with those from available works in the literature.The effects of different parameters on the thermal vibration response of MFG porous rectangular plates are studied in detail.These findings demonstrate that the behavior of the structure within a liquid medium differs significantly from that within a vacuum medium.Thereby,they offer appropriate operational approaches for the structure when employed in various mediums.

Combined Optimal Dispatch of Thermal Power Generators and Energy Storage Considering Thermal Power Deep Peak Clipping and Wind Energy Emission Grading Punishment

Peak load and wind energy emission pressure rise more as wind energy penetration keeps growing,which affects the stabilization of the PS(power system).This paper suggests integrated optimal dispatching of thermal power generators and BESS(battery energy storage system)taking wind energy emission grading punishment and deep peak clipping into consideration.Firstly,in order to minimize wind abandonment,a hierarchical wind abandonment penalty strategy based on fuzzy control is designed and introduced,and the optimal grid-connected power of wind energy is determined as a result of minimizing the peak cutting cost of the system.Secondly,considering BESS and thermal power,the management approach of BESS-assisted virtual peak clipping of thermal power generators is aimed at reducing the degree of deep peak clipping of thermal power generators and optimizing the output of thermal power generators and the charging and discharging power of BESS.Finally,Give an example of how this strategy has been effective in reducing abandonment rates by 0.66% and 7.46% individually for different wind penetration programs,and the daily average can reduce the peak clipping power output of thermal power generators by 42.97 and 72.31 MWh and enhances the effect and economy of system peak clipping.

Teachers’Perception for Evaluation of the Primary School Students With Final Grade

The most difficult and delicate part of the learning process is assessment.Assessment is difficult because during his/her accomplishment the teacher has to consider not only the acquisition of knowledge from students,but also the overall degree of development of their competencies.It is delicate,because through assessment we can influence the emotional side of students and their“willingness”to learn.Despite these facts,teachers need to evaluate students during the learning process.The purpose of the research is to find out what is the perception of teachers about the level of evaluation of students with final grade.The overall results showed that 89%of teachers agree,9%of them have a neutral attitude,and 2%do not agree that the evaluation of students with a final grade is done taking into account many aspects and using many methods,the overall average of the results,M=4.36.Based on the empirical results,it was found that teachers who have completed assessment training have a more positive approach to student assessment,as the average score is higher than teachers who have not completed assessment training.From the qualitative results it was understood that the Teachers did not encounter any difficulties during the assessment of the students.

Free vibration and buckling analysis of polymeric composite beams reinforced by functionally graded bamboo fbers

Natural fibers have been extensively researched as reinforcement materials in polymers on account of their environmental and economic advantages in comparison with synthetic fibers in the recent years.Bamboo fibers are renowned for their good mechanical properties,abundance,and short cycle growth.As beams are one of the fundamental structural components and are susceptible to mechanical loads in engineering applications,this paper performs a study on the free vibration and buckling responses of bamboo fiber reinforced composite(BFRC)beams on the elastic foundation.Three different functionally graded(FG)layouts and a uniform one are the considered distributions for unidirectional long bamboo fibers across the thickness.The elastic properties of the composite are determined with the law of mixture.Employing Hamilton’s principle,the governing equations of motion are obtained.The generalized differential quadrature method(GDQM)is then applied to the equations to obtain the results.The achieved outcomes exhibit that the natural frequency and buckling load values vary as the fiber volume fractions and distributions,elastic foundation stiffness values,and boundary conditions(BCs)and slenderness ratio of the beam change.Furthermore,a comparative study is conducted between the derived analysis outcomes for BFRC and homogenous polymer beams to examine the effectiveness of bamboo fibers as reinforcement materials,demonstrating the significant enhancements in both vibration and buckling responses,with the exception of natural frequencies for cantilever beams on the Pasternak foundation with the FG-◇fiber distribution.Eventually,the obtained analysis results of BFRC beams are also compared with those for carbon nanotube reinforced composite(CNTRC)beams found in the literature,indicating that the buckling loads and natural frequencies of BFRC beams are lower than those of CNTRC beams.

The interplay mechanism between IDH mutation, MGMT-promoter methylation, and PRMT5 activity in the progression of grade 4 astrocytoma: unraveling the complex triad theory

Background:The dysregulation of Isocitrate dehydrogenase(IDH)and the subsequent production of 2-Hydroxyglutrate(2HG)may alter the expression of epigenetic proteins in Grade 4 astrocytoma.The interplay mechanism between IDH,O-6-methylguanine-DNA methyltransferase(MGMT)-promoter methylation,and protein methyltransferase proteins-5(PRMT5)activity,with tumor progression has never been described.Methods:A retrospective cohort of 34 patients with G4 astrocytoma is classified into IDH-mutant and IDH-wildtype tumors.Both groups were tested for MGMT-promoter methylation and PRMT5 through methylation-specific and gene expression PCR analysis.Inter-cohort statistical significance was evaluated.Results:Both IDH-mutant WHO grade 4 astrocytomas(n=22,64.7%)and IDH-wildtype glioblastomas(n=12,35.3%)had upregulated PRMT5 gene expression except in one case.Out of the 22 IDH-mutant tumors,10(45.5%)tumors showed MGMT-promoter methylation and 12(54.5%)tumors had unmethylated MGMT.All IDH-wildtype tumors had unmethylated MGMT.There was a statistically significant relationship between MGMT-promoter methylation and IDH in G4 astrocytoma(p-value=0.006).Statistically significant differences in progression-free survival(PFS)were also observed among all G4 astrocytomas that expressed PRMT5 and received either temozolomide(TMZ)or TMZ plus other chemotherapies,regardless of their IDH or MGMT-methylation status(p-value=0.0014).Specifically,IDH-mutant tumors that had upregulated PRMT5 activity and MGMT-promoter methylation,who received only TMZ,have exhibited longer PFS.Conclusions:The relationship between PRMT5,MGMT-promoter,and IDH is not tridirectional.However,accumulation of D2-hydroxyglutarate(2-HG),which partially activates 2-OG-dependent deoxygenase,may not affect their activities.In IDH-wildtype glioblastomas,the 2HG-2OG pathway is typically inactive,leading to PRMT5 upregulation.TMZ alone,compared to TMZ-plus,can increase PFS in upregulated PRMT5 tumors.Thus,using a PRMT5 inhibitor in G4 astrocytomas may help in tumor regression.

Functionally graded structure of a nitride-strengthened Mg_(2)Si-based hybrid composite

The ex-situ incorporation of the secondary SiC reinforcement,along with the in-situ incorporation of the tertiary and quaternary Mg_(3)N_(2) and Si_(3)N_(4) phases,in the primary matrix of Mg_(2)Si is employed in order to provide ultimate wear resistance based on the laser-irradiation-induced inclusion of N_(2) gas during laser powder bed fusion.This is substantialized based on both the thermal diffusion-and chemical reactionbased metallurgy of the Mg_(2)Si–SiC/nitride hybrid composite.This study also proposes a functional platform for systematically modulating a functionally graded structure and modeling build-direction-dependent architectonics during additive manufacturing.This strategy enables the development of a compositional gradient from the center to the edge of each melt pool of the Mg_(2)Si–SiC/nitride hybrid composite.Consequently,the coefficient of friction of the hybrid composite exhibits a 309.3%decrease to–1.67 compared to–0.54 for the conventional nonreinforced Mg_(2)Si structure,while the tensile strength exhibits a 171.3%increase to 831.5 MPa compared to 485.3 MPa for the conventional structure.This outstanding mechanical behavior is due to the(1)the complementary and synergistic reinforcement effects of the SiC and nitride compounds,each of which possesses an intrinsically high hardness,and(2)the strong adhesion of these compounds to the Mg_(2)Si matrix despite their small sizes and low concentrations.

Application Analysis of Nursing Students'Grades in Course Relevance Based on Association Rule Mining Algorithm Apriori

By analyzing the correlation between courses in students’grades,we can provide a decision-making basis for the revision of courses and syllabi,rationally optimize courses,and further improve teaching effects.With the help of IBM SPSS Modeler data mining software,this paper uses Apriori algorithm for association rule mining to conduct an in-depth analysis of the grades of nursing students in Shandong College of Traditional Chinese Medicine,and to explore the correlation between professional basic courses and professional core courses.Lastly,according to the detailed analysis of the mining results,valuable curriculum information will be found from the actual teaching data.

A Study on the Correlation Between LIWC Word Categories and Chinese Composition Writing Performance of Fourth,Fifth,and Sixth Grade Students

This study focuses on the analysis of the Chinese composition writing performance of fourth,fifth,and sixth grade students in 16 selected schools in Longhua District,Shenzhen during the spring semester of 2023.Using LIWC(Linguistic Inquiry and Word Count)as a text analysis tool,the study explores the impact of LIWC categories on writing performance which is scaled by score.The results show that the simple LIWC word categories have a significant positive influence on the composition scores of lower-grade students;while complex LIWC word categories have a significant negative influence on the composition scores of lower-grade students but a significant positive influence on the composition scores of higher-grade students.Process word categories have a positive influence on the composition scores of all three grades,but the impact of complex process word categories increases as the grade level rises.

Reading Loss in Arabic Language During COVID-19 in the UAE and Proposed Solutions:The Perspectives of Primary-Grade Arabic Language Teachers

The COVID-19 pandemic caused significant disruptions in the field of education worldwide,including in the United Arab Emirates.Teachers and students had to adapt to remote learning and virtual classrooms,leading to various challenges in maintaining educational standards.The sudden transition to remote teaching could have a negative impact on students’reading abilities,especially in the Arabic language.To gain insight into the unique challenges encountered by Arabic language teachers in the UAE,a survey was conducted to explore their assessment of teaching quality,student-teacher interaction,and learning outcomes amidst the COVID-19 pandemic.The results of the survey revealed a significant decline of student reading abilities and identified several major issues in online Arabic language teaching.These issues included limited interaction between students and teachers,challenges in monitoring students’class participation and performance,and challenges in effectively assessing students’reading skills.The results also demonstrated some other challenges faced by Arabic language teachers,including a lack of preparedness,a lack of subscription to relevant platforms,and a lack of resources for online learning.Several solutions to these challenges are proposed,including reevaluating the balance between depth and breadth in the curriculum,integrating language skills into the curriculum more effectively,providing more comprehensive teacher professional development,implementing student grouping strategies,utilizing retired and expert teachers in specific content areas,allocating time for interventions,and improving support from both teachers and parents to ensure the quality of online learning.

穴位贴敷治疗慢性阻塞性肺疾病疗效的Meta分析和Grade评价

[目的]运用循证医学的方法对穴位贴敷疗法治疗慢性阻塞性肺疾病(COPD)的临床疗效和安全性进行系统分析和Grade评价。[方法]计算机检索国内外中英文数据库,检索从各数据库建库至2022年9月31日发表的关于穴位贴敷治疗COPD的随机对照研究(RCT),由两名研究员背对背根据纳入标准及排除标准进行筛查,应用Revman 5.3软件做偏倚风险评估及Meta分析,应用Grade系统进行证据质量评价。[结果]共纳入16篇文献、1500例患者,包括治疗组751例,对照组749例,Meta分析结果显示:与单纯西医治疗相比,穴位贴敷提高总有效率(TE)[OR=4.68,95%CI(3.36,6.53),P<0.00001],改善第1秒用力呼气量占预计值的百分比(FEV1%)[MD=3.04,95%CI(1.76,4.33),P<0.00001]、第一秒用力呼气量/最大肺活量比值(FEV1/FVC)[MD=2.38,95%CI(0.84,3.92),P=0.002],改善动脉血氧分压(PaO2)[MD=7.27,95%CI(4.60,9.95),P<0.00001]、动脉血二氧化碳分压(PaCO_(2))[MD=-8.68,95%CI(-10.28,-7.09),P<0.00001],圣乔治呼吸问卷(SGRQ)、呼吸相关量表(BODE指数、CAT评分)均有明显降低[MD=-7.36,95%CI(-13.22,-1.51),P=0.01;MD=-0.74,95%CI(-0.80,-0.69),P<0.00001;MD=-1.92,95%CI(-2.73,-1.10),P<0.00001],减少急性加重次数[MD=-1.85,95%CI(-2.67,-1.03),P<0.00001],增加不良反应发生率[OR=2.89,95%CI(1.57,5.33),P=0.0007],中医证候积分组间无差异[MD=-0.87,95%CI(-1.84,0.09),P=0.08],Grade证据分级结果显示:FEV1/FVC、PaCO_(2)、不良反应发生率3项结局指标为中质量证据,临床总有效率、FEV1%、CAT评分、急性加重次数4项结局指标为低质量证据,中医证候总积分、PaO2、SGQR评分、BODE指数4项结局指标为极低质量证据。[结论]穴位贴敷联合西医治疗COPD比单纯西医治疗有明显优势,但所纳入研究的证据质量不高,尚需高质量研究为临床提供指导。

前列舒通胶囊联合坦索罗辛治疗慢性前列腺炎的Meta分析及GRADE质量评价

目的系统评价前列舒通胶囊联合坦索罗辛治疗慢性前列腺炎(Chronic prostatitis,CP)的临床疗效。方法在线检索中国知识资源总库(CNKI)、万方数据、维普网、Sinomed、PubMed、Web of Science、Cochrane Library、Embase数据库建库至2023年4月1日期间前列舒通胶囊联合坦索罗辛治疗CP的随机对照研究,采用Cochrane风险偏倚评估工具对文献进行质量评价,运用RevMan 5.3软件进行Meta分析,并对结局指标进行GRADE质量分级。结果共纳入10篇RCT,涉及1013例受试者。Meta分析结果显示:相较于单用坦索罗辛,前列舒通胶囊联合坦索罗辛治疗CP能够显著提高临床有效率[RR=1.23,95%CI(1.16~1.30),P<0.00001],降低NIH-CPSI评分[MD=-5.09,95%CI(-6.84~-3.34),P<0.00001],降低NIH-CPSI疼痛症状评分[MD=-3.17,95%CI(-4.12~-2.23),P<0.00001]、NIH-CPSI排尿症状评分[MD=-2.11,95%CI(-2.55~-1.67),P<0.00001]、NIH-CPSI生活质量评分[MD=-1.79,95%CI(-1.87~-1.71),P<0.00001]、前列腺液白细胞计数[MD=-2.73,95%CI(-4.13~-1.34),P<0.00001],且联合用药不会增加不良反应发生。GRADE证据分级显示:前列舒通胶囊联合坦索罗辛质量在有效率和NIH-CPSI生活质量评分指标为中级,NIH-CPSI评分、NIH-CPSI疼痛症状评分、NIH-CPSI排尿症状评分和前列腺液白细胞计数指标为低级。结论与单用坦索罗辛治疗比较,前列舒通胶囊联合坦索罗辛可以显著改善CP患者临床疼痛、排尿不适等临床症状,且不增加不良反应的发生,但仍需更多高质量、大样本、多中心的RCT予以验证。

Brief Discussion on Specific Grading of Exercises after Class In Implementing Grade English Teaching

With the reform booming in teaching fields,the author carried out Graded English teaching in her teaching classroom and achieved favorable efficiency.In this paper,the author mainly discusses the specific grading of exercise after class in implementing graded teaching,taking for example Section A,Unit 6(Go for it! SB for Grade Eight,Volume A,by People's Education Press and Thomson Learning,2004,2nded).