<strong>Background:</strong> A dual bronchodilator, long-acting anticholine drugs (glycopyrronium, LAMA) and the long running <em>β</em>-<sub>2</sub> stimulant (indacaterol, LABA),...<strong>Background:</strong> A dual bronchodilator, long-acting anticholine drugs (glycopyrronium, LAMA) and the long running <em>β</em>-<sub>2</sub> stimulant (indacaterol, LABA), are effective for the treatment of chronic obstructive pulmonary disease (COPD). To evaluate the effectiveness of the perioperative intervention of LAMA/LABA, a randomized prospective trial was performed for the lung cancer patients receiving a lobectomy with normal pulmonary function and COPD. <strong>Methods:</strong> Based on the results of the preoperative pulmonary function test, 25 patients were diagnosed with COPD [% forced expiratory volume in 1 second (%FEV<sub>1</sub>) < 70%]. Thirty-seven patients were enrolled as non-obstructive patients (70% ≤ %FEV<sub>1</sub>), who were randomized into two groups, the LAMA/LABA (n = 19) and the Control group (n = 18). The LAMA/LABA and the COPD groups daily received inhaled LAMA (50 μg) and LABA (110 μg) for 1 week before surgery and for least 4 weeks after surgery. The Control group had no treatment of the dual bronchodilator. The actual values were measured during the perioperative pulmonary function at three points of the preoperative baseline, the postoperative 1 week and the postoperative 4 weeks;these changes and changed ratios were then calculated. The patient-reported outcomes of the quality of life (PRO-QOL) were evaluated by the Cancer Dyspnea Scale (CDS), the COPD assessment test, and the St. George’s Respiratory Questionnaire. <strong>Results:</strong> Regarding the value of FEV<sub>1</sub> at the baseline, that in the LAMA/LABA group was 79.2% ± 6.4% and that in the Control group was 80.9% ± 6.4%, but that in the COPD groups was 57.9% ± 8.7%;there was a significant difference between the COPD and the Control group (p < 0.0001). At the postoperative 1 week point, the FEV<sub>1</sub> value in the Control group was 1.3 ± 0.5 L and that in the LAMA/LABA group was 1.7 ± 0.5 L. On the other hand, that in the COPD group was 1.7 ± 0.5 L, which was significantly higher compared to that in the Control group (p = 0.0251 and p = 0.0369). The intervention of LAMA/LABA for the COPD and non-obstructive patients resulted in the less decreased degree of the pulmonary function in FEV<sub>1</sub> compared to that in the Control group. Based on the PRO-QOL by the CDS, the intervention of LAMA/LABA significantly reduced the total dyspnea in the LAMA/LABA group compared to that in the Control group (p = 0.0348). <strong>Conclusion:</strong> The perioperative intervention of LAMA/LABA should lead to maintaining the postoperative pulmonary function of the FEV<sub>1</sub> during the lobectomy with COPD and non-obstructive patients and the improvement of PRO-QOL.展开更多
Pharmaco-psychosocial treatment (PPST) refers to a treatment paradigm combining pharmacotherapy with psychosocial therapy. We conducted an 18-month randomized controlled tracking study to evaluate the efficacy of soci...Pharmaco-psychosocial treatment (PPST) refers to a treatment paradigm combining pharmacotherapy with psychosocial therapy. We conducted an 18-month randomized controlled tracking study to evaluate the efficacy of social skills training (SST) in 11 individuals with schizophrenia on risperidone monotherapy. They were randomized to either SST or non-SST group, and Global Assessment Functioning (GAF) and Brief Psychiatric Rating Scale (BPRS) scores in the 2 groups showed gradual improvement. In the SST group, Digit Span Distraction Test (DSDT) at 12 and 18 months showed significant improvement. The Subjective Deficit Syndrome Scale (SDSS) scores in the SST group showed significant improvement after 6 months and showed a significant difference in comparison between the groups. After the subjective feeling of health was recovered, the items of motivation were recovered as a direct effect of SST. Some items of the Life Assessment Scale for the Mentally Ill (LASMI) score showed significant improvement (or significant trend) in only the SST group after 6 months. Items of daily life, work skills, and self-recognition were continuously improved. We report 2 cases in the SST group that had DSDT improvement in parallel with change of action and communication as a change of social function. This study is only exploratory due to the small number of cases. However, we have demonstrated potential improvement in cognitive function due to learning experiences that required working memory and attention, thus providing improvement in social life.展开更多
Objective: To evaluate the effect of chewing sugar-free gum on gastrointestinal function recovery after cesarean section. Methods: Randomized controlled trials comparing the use of chewing gum in postoperative recover...Objective: To evaluate the effect of chewing sugar-free gum on gastrointestinal function recovery after cesarean section. Methods: Randomized controlled trials comparing the use of chewing gum in postoperative recovery with a control group were retrieved from the databases including Pubmed, Cochrane Library, Science Direct, Web of Science, CBM, CNKI, Wanfang and VIP, et al. After screening literatures, evaluating the quality of studies, extracting data, the RevMan5.3 software was used for data analysis. Results: A total of 13 RCTs including 2233 patients were analyzed in the study. The results showed that chewing gum after cesarean delivery can effectively shorten the recovery time of bowel sounds, passage of flatus and first defecation (all P Conclusion: Chewing sugar-free gum after cesarean section can promote the early recovery of gastrointestinal function, but the side effects of chewing gum are still unclear, which needs more clinical, large sample and high-quality studies to further verify.展开更多
Random vibration control is aimed at reproducing the power spectral density （PSD） at specified control points. The classical frequency-spectrum equalization algorithm needs to compute the average of the multiple fre...Random vibration control is aimed at reproducing the power spectral density （PSD） at specified control points. The classical frequency-spectrum equalization algorithm needs to compute the average of the multiple frequency response functions （FRFs）, which lengthens the control loop time in the equalization process. Likewise, the feedback control algorithm has a very slow convergence rate due to the small value of the feedback gain parameter to ensure stability of the system. To overcome these limitations, an adaptive inverse control of random vibrations based on the filtered-X least mean-square （LMS） algorithm is proposed. Furthermore, according to the description and iteration characteristics of random vibration tests in the frequency domain, the frequency domain LMS algorithm is adopted to refine the inverse characteristics of the FRF instead of the traditional time domain LMS algorithm. This inverse characteristic, which is called the impedance function of the system under control, is used to update the drive PSD directly. The test results indicated that in addition to successfully avoiding the instability problem that occurs during the iteration process, the adaptive control strategy minimizes the amount of time needed to obtain a short control loop and achieve equalization.展开更多
This paper studies the problem of robust H∞ control of piecewise-linear chaotic systems with random data loss. The communication links between the plant and the controller are assumed to be imperfect （that is, data ...This paper studies the problem of robust H∞ control of piecewise-linear chaotic systems with random data loss. The communication links between the plant and the controller are assumed to be imperfect （that is, data loss occurs intermittently, which appears typically in a network environment）. The data loss is modelled as a random process which obeys a Bernoulli distribution. In the face of random data loss, a piecewise controller is designed to robustly stabilize the networked system in the sense of mean square and also achieve a prescribed H∞ disturbance attenuation performance based on a piecewise-quadratic Lyapunov function. The required H∞ controllers can be designed by solving a set of linear matrix inequalities （LMIs）. Chua＇s system is provided to illustrate the usefulness and applicability of the developed theoretical results.展开更多
目的:神经肌肉训练是近年来较新的一种综合康复治疗方法,对膝骨关节炎的疗效尚存在争议。此次研究通过系统Meta分析评价神经肌肉训练治疗膝骨关节炎的临床疗效。方法:全面检索中国知网、维普、万方、中国生物医学文献数据库、PubMed、We...目的:神经肌肉训练是近年来较新的一种综合康复治疗方法,对膝骨关节炎的疗效尚存在争议。此次研究通过系统Meta分析评价神经肌肉训练治疗膝骨关节炎的临床疗效。方法:全面检索中国知网、维普、万方、中国生物医学文献数据库、PubMed、Web of Science、Cochrane Library、EBSCO和Embase文献数据库中有关神经肌肉训练治疗膝骨关节炎的临床随机对照试验,时间从各数据库建库至2023年10月,神经肌肉训练组(试验组)使用神经肌肉训练或以神经肌肉训练为主要干预方式;对照组为空白组或采用常规康复治疗。结局指标包括西安大略和麦克马斯特大学骨关节炎指数评分(The Western Ontario and McMaster Universities Osteoarthritis Index,WOMAC)、行走计时、膝关节稳定性、30 s内膝关节最大弯曲次数。采用Cochrane偏倚风险评估工具和物理治疗证据数据库量表确定纳入文献质量,使用RevMan5.4软件进行Meta分析。结果:共纳入11项临床随机对照试验,纳入样本量628例。Meta分析结果显示:①WOMAC疼痛评分试验组优于对照组(SMD=0.38,95%CI:0.08-0.69,P=0.01);②膝关节稳定性和30s内膝关节最大弯曲次数试验组均优于对照组(膝关节稳定性:SMD=0.57,95%CI:0.23-0.92,P=0.001;30 s内膝关节最大弯曲次数:SMD=0.35,95%CI:0.05-0.65,P=0.02);两组均可提高膝骨关节炎患者行走速度,改善行走能力,但差异无显著性意义(行走计时:SMD=-0.22,95%CI:-0.48-0.03,P=0.09);③WOMAC身体功能评分试验组优于对照组(SMD=-0.79,95%CI:-1.30至-0.28,P=0.002)。结论:神经肌肉训练可以有效改善膝骨关节炎患者的疼痛,增强膝关节稳定性,促进功能恢复,但仍需要更多高质量随机对照试验进一步研究证实。展开更多
目的分析双歧四联活菌片辅助常规西药治疗老年慢性支气管炎的效果。方法选取2021年4月—2023年12月在淄博市第一医院全科医学科就诊的老年慢性支气管炎患者84例,采用随机数字表法将患者分为常规治疗组(42例,常规西药治疗)、研究组(42例...目的分析双歧四联活菌片辅助常规西药治疗老年慢性支气管炎的效果。方法选取2021年4月—2023年12月在淄博市第一医院全科医学科就诊的老年慢性支气管炎患者84例,采用随机数字表法将患者分为常规治疗组(42例,常规西药治疗)、研究组(42例,常规西药+双歧四联活菌片治疗),对比治疗前/后常规治疗组及研究组炎症指标、T淋巴细胞、肺功能情况,评估疗效并统计患者消化系统症状、过敏等不良反应。结果治疗后研究组血清白细胞介素-8(interleukin-8,IL-8)、白细胞介素-17(interleukin-17,IL-17)水平显著低于常规治疗组;治疗后研究组CD3^(+)、CD4^(+)显著高于常规治疗组,CD8^(+)显著低于常规治疗组;研究组总有效率显著高于常规治疗组;研究组治疗后用力呼气容积(forced vital capacity,FVC)及第一秒用力呼气量(forced expiratory volume in first second,FEV_(1))显著高于常规治疗组,差异均具有统计学意义(P均<0.05)。研究组中枢系统症状、过敏等不良反应总发生率与常规治疗组相比差异无统计学意义(P>0.05)。结论应用双歧四联活菌片辅助常规西药治疗老年慢性支气管炎可显著改善患者炎症反应及肺功能,提高其细胞免疫,增效且不增加不良反应,安全性高。展开更多
目的基于脑功能磁共振成像(Functional magnetic resonance imaging,fMRI),采用Meta分析系统评价针灸治疗抑郁症(Major depressive disorder,MDD)的有效性。方法检索CNKI、CBM、Wan fang、VIP、PubMed、Web of Science、Embase、Cochran...目的基于脑功能磁共振成像(Functional magnetic resonance imaging,fMRI),采用Meta分析系统评价针灸治疗抑郁症(Major depressive disorder,MDD)的有效性。方法检索CNKI、CBM、Wan fang、VIP、PubMed、Web of Science、Embase、Cochrane Library从建库以来至2023年10月31日针灸治疗MDD的随机对照研究(RCT),纳入研究质量评估采用Cochrane偏倚风险评估工具,利用RevMan 5.3软件行Meta分析,并采用Cochrane工具自带的GRADE系统进行证据质量评价。结果纳入文章9篇,包括7篇国内文章,2篇国外文章,总样本量636例(试验组325例,对照组311例)。9项研究均以fMRI为主要观察指标,结果显示针灸可调节差异脑区低频振幅(Amplitude of low frequency fluctuation,ALFF)、低频振幅比率(Fractional of amplitude low-frequency fluctuation,f ALFF)及局部一致性(Region homogeneity,ReHo)值,改变脑功能连接。次要结局指标分析结果显示针灸治疗可明显改善MDD患者的症状,提高临床疗效[OR=1.98,95%CI(1.30,2.99),P=0.001],减轻抗抑郁药物带来的副反应,并有效降低患者的汉密尔顿抑郁量表(Hamilton depression scale,HAMD)评分[MD=-3.08,95%CI(-4.46,-1.70),P<0.0001]、Zung抑郁自评量表(Self-rating depression scale,SDS)评分[MD=-4.67,95%CI(-6.93,-2.40),P<0.0001]、抗抑郁药副反应量表(Side-effect rating scale for antidepressant,SERS)总分,降低血浆促肾上腺皮质激素[MD=-3.22,95%CI(-5.00,-1.43),P=0.0004]水平及血清皮质醇激素水平。结论针灸治疗MDD效果显著,可激活边缘系统脑区,重组MDD发病的认知、情感加工及默认网络结构,并对额叶进行调节,从而改善抑郁。展开更多
目的 观察智能镜像手套任务导向性训练联合低频重复经颅磁刺激(rTMS)对脑卒中患者手功能恢复的效果。方法 2022年10月1日至2023年6月30日,选择苏北人民医院脑卒中患者136例,随机分为对照组、镜像组、rTMS组和联合组,每组34例。各组均给...目的 观察智能镜像手套任务导向性训练联合低频重复经颅磁刺激(rTMS)对脑卒中患者手功能恢复的效果。方法 2022年10月1日至2023年6月30日,选择苏北人民医院脑卒中患者136例,随机分为对照组、镜像组、rTMS组和联合组,每组34例。各组均给予常规康复治疗,镜像组增加智能镜像手套任务导向性训练治疗,rTMS组增加低频rTMS治疗,联合组增加智能镜像手套任务导向性训练与低频rTMS治疗,共4周。比较治疗前后Fugl-Meyer评定量表上肢部分(FMA-UE)评分、Wolf运动功能测定量表(WMFT)评分和前臂伸肌群、屈肌群表面肌电均方根值(RMS)患侧/健侧比值;比较rTMS组和联合组治疗前后经颅磁刺激运动诱发电位(MEP)的差异。结果 对照组4例、镜像组7例、rTMS组5例、联合组6例脱落。4组FMA-UE、WMFT评分和前臂伸肌、屈肌群RMS比的组内效应(F> 996.656, P <0.001)、组间效应(F> 20.333, P <0.001)和交互效应(F> 72.796, P <0.001)均显著,且联合组最优。治疗后,rTMS组和联合组MEP的振幅均增加(|t|> 3.842, P <0.05),联合组明显高于rTMS组(t=-3.060, P <0.01)。结论 智能镜像手套任务导向性训练联合低频rTMS可有效促进脑卒中患者手功能恢复。展开更多
文摘<strong>Background:</strong> A dual bronchodilator, long-acting anticholine drugs (glycopyrronium, LAMA) and the long running <em>β</em>-<sub>2</sub> stimulant (indacaterol, LABA), are effective for the treatment of chronic obstructive pulmonary disease (COPD). To evaluate the effectiveness of the perioperative intervention of LAMA/LABA, a randomized prospective trial was performed for the lung cancer patients receiving a lobectomy with normal pulmonary function and COPD. <strong>Methods:</strong> Based on the results of the preoperative pulmonary function test, 25 patients were diagnosed with COPD [% forced expiratory volume in 1 second (%FEV<sub>1</sub>) < 70%]. Thirty-seven patients were enrolled as non-obstructive patients (70% ≤ %FEV<sub>1</sub>), who were randomized into two groups, the LAMA/LABA (n = 19) and the Control group (n = 18). The LAMA/LABA and the COPD groups daily received inhaled LAMA (50 μg) and LABA (110 μg) for 1 week before surgery and for least 4 weeks after surgery. The Control group had no treatment of the dual bronchodilator. The actual values were measured during the perioperative pulmonary function at three points of the preoperative baseline, the postoperative 1 week and the postoperative 4 weeks;these changes and changed ratios were then calculated. The patient-reported outcomes of the quality of life (PRO-QOL) were evaluated by the Cancer Dyspnea Scale (CDS), the COPD assessment test, and the St. George’s Respiratory Questionnaire. <strong>Results:</strong> Regarding the value of FEV<sub>1</sub> at the baseline, that in the LAMA/LABA group was 79.2% ± 6.4% and that in the Control group was 80.9% ± 6.4%, but that in the COPD groups was 57.9% ± 8.7%;there was a significant difference between the COPD and the Control group (p < 0.0001). At the postoperative 1 week point, the FEV<sub>1</sub> value in the Control group was 1.3 ± 0.5 L and that in the LAMA/LABA group was 1.7 ± 0.5 L. On the other hand, that in the COPD group was 1.7 ± 0.5 L, which was significantly higher compared to that in the Control group (p = 0.0251 and p = 0.0369). The intervention of LAMA/LABA for the COPD and non-obstructive patients resulted in the less decreased degree of the pulmonary function in FEV<sub>1</sub> compared to that in the Control group. Based on the PRO-QOL by the CDS, the intervention of LAMA/LABA significantly reduced the total dyspnea in the LAMA/LABA group compared to that in the Control group (p = 0.0348). <strong>Conclusion:</strong> The perioperative intervention of LAMA/LABA should lead to maintaining the postoperative pulmonary function of the FEV<sub>1</sub> during the lobectomy with COPD and non-obstructive patients and the improvement of PRO-QOL.
文摘Pharmaco-psychosocial treatment (PPST) refers to a treatment paradigm combining pharmacotherapy with psychosocial therapy. We conducted an 18-month randomized controlled tracking study to evaluate the efficacy of social skills training (SST) in 11 individuals with schizophrenia on risperidone monotherapy. They were randomized to either SST or non-SST group, and Global Assessment Functioning (GAF) and Brief Psychiatric Rating Scale (BPRS) scores in the 2 groups showed gradual improvement. In the SST group, Digit Span Distraction Test (DSDT) at 12 and 18 months showed significant improvement. The Subjective Deficit Syndrome Scale (SDSS) scores in the SST group showed significant improvement after 6 months and showed a significant difference in comparison between the groups. After the subjective feeling of health was recovered, the items of motivation were recovered as a direct effect of SST. Some items of the Life Assessment Scale for the Mentally Ill (LASMI) score showed significant improvement (or significant trend) in only the SST group after 6 months. Items of daily life, work skills, and self-recognition were continuously improved. We report 2 cases in the SST group that had DSDT improvement in parallel with change of action and communication as a change of social function. This study is only exploratory due to the small number of cases. However, we have demonstrated potential improvement in cognitive function due to learning experiences that required working memory and attention, thus providing improvement in social life.
文摘Objective: To evaluate the effect of chewing sugar-free gum on gastrointestinal function recovery after cesarean section. Methods: Randomized controlled trials comparing the use of chewing gum in postoperative recovery with a control group were retrieved from the databases including Pubmed, Cochrane Library, Science Direct, Web of Science, CBM, CNKI, Wanfang and VIP, et al. After screening literatures, evaluating the quality of studies, extracting data, the RevMan5.3 software was used for data analysis. Results: A total of 13 RCTs including 2233 patients were analyzed in the study. The results showed that chewing gum after cesarean delivery can effectively shorten the recovery time of bowel sounds, passage of flatus and first defecation (all P Conclusion: Chewing sugar-free gum after cesarean section can promote the early recovery of gastrointestinal function, but the side effects of chewing gum are still unclear, which needs more clinical, large sample and high-quality studies to further verify.
基金Program for New Century Excellent Talents in Universities Under Grant No.NCET-04-0325
文摘Random vibration control is aimed at reproducing the power spectral density （PSD） at specified control points. The classical frequency-spectrum equalization algorithm needs to compute the average of the multiple frequency response functions （FRFs）, which lengthens the control loop time in the equalization process. Likewise, the feedback control algorithm has a very slow convergence rate due to the small value of the feedback gain parameter to ensure stability of the system. To overcome these limitations, an adaptive inverse control of random vibrations based on the filtered-X least mean-square （LMS） algorithm is proposed. Furthermore, according to the description and iteration characteristics of random vibration tests in the frequency domain, the frequency domain LMS algorithm is adopted to refine the inverse characteristics of the FRF instead of the traditional time domain LMS algorithm. This inverse characteristic, which is called the impedance function of the system under control, is used to update the drive PSD directly. The test results indicated that in addition to successfully avoiding the instability problem that occurs during the iteration process, the adaptive control strategy minimizes the amount of time needed to obtain a short control loop and achieve equalization.
基金Project partially supported by the Young Scientists Fund of the National Natural Science Foundation of China(Grant No.60904004)the Key Youth Science and Technology Foundation of University of Electronic Science and Technology of China (Grant No.L08010201JX0720)
文摘This paper studies the problem of robust H∞ control of piecewise-linear chaotic systems with random data loss. The communication links between the plant and the controller are assumed to be imperfect （that is, data loss occurs intermittently, which appears typically in a network environment）. The data loss is modelled as a random process which obeys a Bernoulli distribution. In the face of random data loss, a piecewise controller is designed to robustly stabilize the networked system in the sense of mean square and also achieve a prescribed H∞ disturbance attenuation performance based on a piecewise-quadratic Lyapunov function. The required H∞ controllers can be designed by solving a set of linear matrix inequalities （LMIs）. Chua＇s system is provided to illustrate the usefulness and applicability of the developed theoretical results.
文摘目的:神经肌肉训练是近年来较新的一种综合康复治疗方法,对膝骨关节炎的疗效尚存在争议。此次研究通过系统Meta分析评价神经肌肉训练治疗膝骨关节炎的临床疗效。方法:全面检索中国知网、维普、万方、中国生物医学文献数据库、PubMed、Web of Science、Cochrane Library、EBSCO和Embase文献数据库中有关神经肌肉训练治疗膝骨关节炎的临床随机对照试验,时间从各数据库建库至2023年10月,神经肌肉训练组(试验组)使用神经肌肉训练或以神经肌肉训练为主要干预方式;对照组为空白组或采用常规康复治疗。结局指标包括西安大略和麦克马斯特大学骨关节炎指数评分(The Western Ontario and McMaster Universities Osteoarthritis Index,WOMAC)、行走计时、膝关节稳定性、30 s内膝关节最大弯曲次数。采用Cochrane偏倚风险评估工具和物理治疗证据数据库量表确定纳入文献质量,使用RevMan5.4软件进行Meta分析。结果:共纳入11项临床随机对照试验,纳入样本量628例。Meta分析结果显示:①WOMAC疼痛评分试验组优于对照组(SMD=0.38,95%CI:0.08-0.69,P=0.01);②膝关节稳定性和30s内膝关节最大弯曲次数试验组均优于对照组(膝关节稳定性:SMD=0.57,95%CI:0.23-0.92,P=0.001;30 s内膝关节最大弯曲次数:SMD=0.35,95%CI:0.05-0.65,P=0.02);两组均可提高膝骨关节炎患者行走速度,改善行走能力,但差异无显著性意义(行走计时:SMD=-0.22,95%CI:-0.48-0.03,P=0.09);③WOMAC身体功能评分试验组优于对照组(SMD=-0.79,95%CI:-1.30至-0.28,P=0.002)。结论:神经肌肉训练可以有效改善膝骨关节炎患者的疼痛,增强膝关节稳定性,促进功能恢复,但仍需要更多高质量随机对照试验进一步研究证实。
文摘目的分析双歧四联活菌片辅助常规西药治疗老年慢性支气管炎的效果。方法选取2021年4月—2023年12月在淄博市第一医院全科医学科就诊的老年慢性支气管炎患者84例,采用随机数字表法将患者分为常规治疗组(42例,常规西药治疗)、研究组(42例,常规西药+双歧四联活菌片治疗),对比治疗前/后常规治疗组及研究组炎症指标、T淋巴细胞、肺功能情况,评估疗效并统计患者消化系统症状、过敏等不良反应。结果治疗后研究组血清白细胞介素-8(interleukin-8,IL-8)、白细胞介素-17(interleukin-17,IL-17)水平显著低于常规治疗组;治疗后研究组CD3^(+)、CD4^(+)显著高于常规治疗组,CD8^(+)显著低于常规治疗组;研究组总有效率显著高于常规治疗组;研究组治疗后用力呼气容积(forced vital capacity,FVC)及第一秒用力呼气量(forced expiratory volume in first second,FEV_(1))显著高于常规治疗组,差异均具有统计学意义(P均<0.05)。研究组中枢系统症状、过敏等不良反应总发生率与常规治疗组相比差异无统计学意义(P>0.05)。结论应用双歧四联活菌片辅助常规西药治疗老年慢性支气管炎可显著改善患者炎症反应及肺功能,提高其细胞免疫,增效且不增加不良反应,安全性高。
文摘目的基于脑功能磁共振成像(Functional magnetic resonance imaging,fMRI),采用Meta分析系统评价针灸治疗抑郁症(Major depressive disorder,MDD)的有效性。方法检索CNKI、CBM、Wan fang、VIP、PubMed、Web of Science、Embase、Cochrane Library从建库以来至2023年10月31日针灸治疗MDD的随机对照研究(RCT),纳入研究质量评估采用Cochrane偏倚风险评估工具,利用RevMan 5.3软件行Meta分析,并采用Cochrane工具自带的GRADE系统进行证据质量评价。结果纳入文章9篇,包括7篇国内文章,2篇国外文章,总样本量636例(试验组325例,对照组311例)。9项研究均以fMRI为主要观察指标,结果显示针灸可调节差异脑区低频振幅(Amplitude of low frequency fluctuation,ALFF)、低频振幅比率(Fractional of amplitude low-frequency fluctuation,f ALFF)及局部一致性(Region homogeneity,ReHo)值,改变脑功能连接。次要结局指标分析结果显示针灸治疗可明显改善MDD患者的症状,提高临床疗效[OR=1.98,95%CI(1.30,2.99),P=0.001],减轻抗抑郁药物带来的副反应,并有效降低患者的汉密尔顿抑郁量表(Hamilton depression scale,HAMD)评分[MD=-3.08,95%CI(-4.46,-1.70),P<0.0001]、Zung抑郁自评量表(Self-rating depression scale,SDS)评分[MD=-4.67,95%CI(-6.93,-2.40),P<0.0001]、抗抑郁药副反应量表(Side-effect rating scale for antidepressant,SERS)总分,降低血浆促肾上腺皮质激素[MD=-3.22,95%CI(-5.00,-1.43),P=0.0004]水平及血清皮质醇激素水平。结论针灸治疗MDD效果显著,可激活边缘系统脑区,重组MDD发病的认知、情感加工及默认网络结构,并对额叶进行调节,从而改善抑郁。
文摘目的 观察智能镜像手套任务导向性训练联合低频重复经颅磁刺激(rTMS)对脑卒中患者手功能恢复的效果。方法 2022年10月1日至2023年6月30日,选择苏北人民医院脑卒中患者136例,随机分为对照组、镜像组、rTMS组和联合组,每组34例。各组均给予常规康复治疗,镜像组增加智能镜像手套任务导向性训练治疗,rTMS组增加低频rTMS治疗,联合组增加智能镜像手套任务导向性训练与低频rTMS治疗,共4周。比较治疗前后Fugl-Meyer评定量表上肢部分(FMA-UE)评分、Wolf运动功能测定量表(WMFT)评分和前臂伸肌群、屈肌群表面肌电均方根值(RMS)患侧/健侧比值;比较rTMS组和联合组治疗前后经颅磁刺激运动诱发电位(MEP)的差异。结果 对照组4例、镜像组7例、rTMS组5例、联合组6例脱落。4组FMA-UE、WMFT评分和前臂伸肌、屈肌群RMS比的组内效应(F> 996.656, P <0.001)、组间效应(F> 20.333, P <0.001)和交互效应(F> 72.796, P <0.001)均显著,且联合组最优。治疗后,rTMS组和联合组MEP的振幅均增加(|t|> 3.842, P <0.05),联合组明显高于rTMS组(t=-3.060, P <0.01)。结论 智能镜像手套任务导向性训练联合低频rTMS可有效促进脑卒中患者手功能恢复。
