There are many tools for symptom assessment of patients with heart failure, but there is a lack of standardized evaluation studies on the quality of such tools, which brings difficulties to the selection of tools.
To evaluate the measurement property and methodological quality of symptom assessment tools in patients with heart failure, and to provide reference for relevant personnel to choose symptom assessment tools.
The Chinese and English databases such as PubMed, Embase, and CNKI were searched for relevant studies from the date of library construction to July 30, 2023. The Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) guideline was employed to evaluate the scale and form recommendations.
Eleven studies were included for quality assessment, including eight tools for assessing symptoms in patients with heart failure: Chinese version of Memorial Symptom Assessment Scale Heart Failure (MSAS-HF), Heart Failure Somatic Perception Scale (HF-SPS), M.D.Anderson Symptom Inventory Heart Failure (MDASI-HF), Symptom Status Questionnaire Heart Failure (SSQ-HF), Shortness of Breath in Heart Failure Instrument (SOB-HF), Minnesota Living with Heart Failure Questionnaire (MLHFQ), Chronic Heart Failure Assessment Tool (CHAT) and Kansas City Cardiomyopathy Questionnaire (KCCQ). Regarding the measurement property, scales such as Chinese version of MSAS-HF, MDASI-HF, MLHFQ, and KCCQ were demonstrated a "sufficient" level of content validity. Conversely, HF-SPS, SSQ-HF, and SOB-HF were exhibited an "uncertain" level of content validity, while CHAT was categorized as having "insufficient" content validity. Finally, Chinese version of MSAS-HF and MLHFQ were recommended as level A, and the other six scales were recommended as level B.
Certainly, both Chinese version of MSAS-HF and MLHFQ demonstrate a remarkable level of reliability. Considering the distinct attributes of assessment tools, it is highly advisable to utilize Chinese version of MSAS-HF for the purpose of symptom assessment in patients suffering from heart failure.
Traditionally, open reduction with Kirschner wire fixation (ORKF) is used to treat paediatric patients with significantly displaced lateral humeral condyle fractures. However, in recent years, the use of closed reduction percutaneous pinning (CRPP) to treat lateral humeral condyle fractures in children has been increasingly reported. However, there is some controversy as to which surgical technique is more effective and safe.
To evaluate the efficacy and safety of CRPP and ORKF in paediatric patients with lateral humeral condyle fractures.
Chinese databases including CNKI, Wanfang Data, VIP and CBM and English databases including PubMed, Embase, Cochrane Library and Web of Science were searched from inception to 2023-01-01 for the case-control studies of CRPP and ORKF to treat the lateral humeral condyle fractures, the quality of the literature was evaluated and data were extracted. RevMan 5.3 software was performed to conduct a meta-analysis comparing the relevant efficacy and safety indexes of the two surgical techniques.
A total of 16 studies involving 1 165 cases were included for this meta-analysis. The results of meta-analysis indicated that CRPP was superior in status of surgical time (MD=-11.81, 95%CI=-15.04 to -8.58, P<0.000 01), intraoperative bleeding (MD=-3.36, 95%CI=-4.37 to -2.36, P<0.000 01), postoperative fracture healing time (MD=-3.92, 95%CI=-6.80 to -1.03, P=0.008), Kirschner wire rtention time (MD=-3.35, 95%CI=-6.33 to -0.38, P=0.03), and postoperative functional recovery of elbow joint (OR=0.44, 95%CI=0.25 to 0.76, P=0.006). The incidence of overall postoperative complications (OR=0.33, 95%CI=0.19 to 0.56, P<0.000 1) and superficial infections (OR=0.39, 95%CI=0.21 to 0.73, P=0.003) was lower than that in the ORKF group. However, there is no statistically significant difference in the deep infections, poor fracture healing, and ischemic necrosis of the lateral condyle between the two groups (P>0.05) .
CRPP was superior to ORKF in the treatment of pediatric lateral humeral condyle fractures, both in terms of efficacy and overall complications, but more high-quality studies are needed to further validate CRPP in terms of specific complications.
In recent years, the incidence of Mycoplasma pneumoniae pneumonia in children has continued to rise, with a corresponding increase in the number of severe Mycoplasma pneumoniae pneumonia, attracting widespread attention from clinical physicians. Understanding the risk factors associated with severe Mycoplasma pneumoniae pneumonia with the aim to determine the severity of the condition in affected children, prevent the occurrence of severe cases, and reduce sequelae has been a focal point in research. Although numerous studies have been conducted on the risk factors of severe Mycoplasma pneumoniae pneumonia, variations in time and geographical regions of the studies necessitate a systematic review and analysis for a comprehensive understanding.
To systematically review the risk factors for severe Mycoplasma pneumoniae pneumonia.
CNKI, Wanfang Data, VIP, CBM, Duxiu, Yiigle, Cochrane Library, PubMed, Embase, Web of Science, Science Direct, and BioMed Central were searched for studies related to risk factors of severe Mycoplasma pneumoniae pneumonia in children from inception to August 2023. Two investigators independently screened literature, extracted data, and assessed the bias risk of included studies. Meta-analysis was performed using Stata 14.0 and RevMan 5.4 software.
A total of 22 retrospective case-control studies involving 4 531 childre were included. Meta-analysis showed that C-reactive protein (CRP) (OR=1.92, 95%CI=1.72-2.15, P<0.000 01), erythrocyte sedimentation rate (ESR) (OR=2.61, 95%CI=2.12-3.22), P<0.000 01), procalcitonin (PCT) (OR=2.60, 95%CI =1.43-4.75, P=0.002), D-dimer (OR=4.36, 95%CI=2.93-6.50, P<0.000 01), white blood cell count (WBC) (OR=1.98, 95%CI=1.66-2.36, P<0.000 01), lower lobe lesions (OR=5.70, 95%CI=3.48-9.35, P<0.000 01), large patchy lesions (OR=6.37, 95%CI=4.09-9.92, P<0.000 01), high Mycoplasma pneumoniae antibody titers (OR=2.83, 95%CI=1.78-4.49, P<0.000 1), lactate dehydrogenase (LDH) (OR=1.03, 95%CI=1.00-1.05, P=0.05), and duration of fever (OR=8.33, 95%CI=3.38-20.56, P<0.000 01) were positively correlated with severe Mycoplasma pneumoniae pneumonia in children.
Elevated inflammatory markers (CRP, ESR, PCT, LDH, WBC), the presence of characteristic imaging changes (large patchy consolidation, lower lobe lesions), high Mycoplasma pneumoniae antibody titer, elevated D-dimer, and prolonged fever duration may be risk factors for severe Mycoplasma pneumoniae pneumonia in children. Future high-quality studies are needed to further explore the relationship of other clinical, radiographic, and laboratory findings with severe Mycoplasma pneumoniae pneumonia in children, and develop prognostic models based on identified risk factors.
Acute ischemic stroke (AIS) is a serious cerebrovascular disease, which causes a heavy burden on society and patients. Ligustrazine injection has been widely used in the treatment of AIS with significant efficacy, but there is still a lack of direct or indirect comparison between ligustrazine injections.
To systematically evaluate the efficacy and safety of ligustrazine injection in the adjuvant treatment of AIS within 72 hours.
CNKI, Wanfang Data Knowledge Service Platform, VIP, PubMed, Cochrane Library, Embase, and Web of Science databases were searched for randomized controlled trials (RCTs) about the efficacy and safety of ligustrazine injection in the treatment of AIS from inception to April 2023. Literature was independently screened, extracted and quality assessed by 2 investigators using the Cochrane Evaluation Tool. RevMan 5.3, Stata 17, Addis and RStudio software were used to statistically compare and rank the efficacy and safety of different types of ligustrazine injection.
A total of 71 papers involving 7 304 cases were included, and the interventions included Salvia Miltiorrhiza Ligustrazine Injection (DSCXQ), Shenxiong Glucose Injection (SXPTT), Xingxiong Sodium Chloride Injection (XXLHN), Ligustrazine Phosphate Injection (LSCXQ) and Ligustrazine Hydrochloride Injection (YSCXQ) combined with conventional western medical therapy (CT), respectively, and CT alone. Direct Meta-analysis results showed that in improving all the outcome indicators of AIS, the total effective rate, NIHSS score, fibrinogen level, and incidence of adverse reactions of ligustrazine injection combined with CT were better than those of CT alone (P<0.05). The results of network Meta-analysis showed that the order of cumulative probability in total effective rate was SXPTT+CT (0.60) >YSCXQ+CT (0.20) >LSCXQ+CT (0.15) >DSCXQ+CT (0.03) >XXLHN+CT (0.02) >CT (0) ; the order of cumulative probability in improving NIHSS score was SXPTT+CT (0.55) >XXLHN+CT (0.26) >YSCXQ+CT (0.12) >DSCXQ+CT (0.07) >CT (0) ; the order of cumulative probability in reducing fibrinogen level was XXLHN+CT (0.32) >LSCXQ+CT (0.22) >DSCXQ+CT (0.17) >SXPTT+CT (0.15) >YSCXQ+CT (0.14) >CT (0) ; the order of cumulative probability in safety was SXPTT+CT (0.79) >XXLHN+CT (0.13) >CT (0.04) >DSCXQ+CT (0.03) >YSCXQ+CT (0.01) .
Ligustrazine injection is effective and safe in adjuvant treatment of AIS, among which Shenxiong glucose injection was the best in total effective rate and improving NIHSS scores, with the least adverse reactions; Xingxiong sodium chloride injection has the most advantages in fibrinogen level.
In recent years, the promotion of "health-centered" concept and the increasing demands for health care of patients have placed greater demands on healthcare providers. The establishment of effective health care team is regarded as an important approach to improve service quality. The selection of objective and valid teamwork assessment tools is particularly important for the assessment of cooperation status among team members and team building.
To perform a systematic review of domestic and international assessment tools for medical teamwork, in order to provide a reference for the rational selection of medical teamwork assessment tools according to different situations.
Pubmed, CNKI, Wanfang and VIP databases were searched in April 2022 for literature related to medical teamwork assessment tools from January 2016 to April 2022. Literature screening and information extraction were performed independently by two investigators and cross-checked. The Chinese version of COSMIN study design checklist was used to evaluate the quality of the assessment tools.
A total of 30 articles were included, involving 32 medical teamwork assessment tools, localized versions of the tools were also included in their original versions of the tools, and a total of 49 medical teamwork assessment tools were finally included. The results of the overall design and methodological quality evaluation of 32 medical teamwork assessment tools covered by 30 included papers showed that in terms of the overall design of the tools, 20 were considered as "very good", 2 as "good", and 10 as "vague"; in terms of the content validity, 1 was considered as "very good", 12 as "good", and 19 as "vague"; in terms of the construct validity, 19 were considered as "very good", 10 as "good", and 3 as "poor"; in terms of internal consistency, 29 were considered as "very good", 1 as "good", and 2 as "vague"; in terms of stability, 6 were considered as "very good", 8 as "good", 1 as "vague" and other relevant information was not reported. The assessment tools were divided into the interprofessional teamwork assessment tools (n=43) and intraprofessional teamwork assessment tools (n=6) based on the professional background of the team members. The interprofessional teamwork assessment tools were divided into the physician-nurse team assessment tools (n=20) and integration of multiple roles team assessment tools (n=23) including physicians, nurses, pharmacists, therapists, dietitians and others based on the job categories.
The research on the assessment tools of medical teamwork has received increasing attention from scholars at home and abroad. The content of the assessment tools is relatively rich, but further development is needed to construct a teamwork assessment tool specifically applicable to primary health care team.
The presence of insomnia symptoms reduces the quality of life of perimenopausal women and increases their risk of developing other diseases. Currently, there are numerous non-pharmacological interventions available to improve perimenopausal insomnia symptoms, with disagreement as to which intervention is most effective.
To evaluate the efficacy of non-pharmacological interventions in improving perimenopausal insomnia symptoms using a network meta-analysis.
In March 2022, Cochrane Library, PubMed, EmBase, Web of Science, CNKI, Wanfang Data Knowledge Service Platform, VIP and CBM were searched for the randomized controlled trials (RCTs) on the improvement of perimenopausal insomnia symptoms by non-pharmacological interventions from inception to March 2022. Two investigators independently screened the literature, extracted data, and evaluated the risk of bias of the included literature using the RCT bias risk assessment tool recommended by the Cochrane Manual of Systematic Review 5.1.0. A Bayesian network meta-analysis was performed on the overall response rate to the improvement of perimenopausal insomnia symptoms, as well as improvement in Pittsburgh Sleep Quality Index Scale (PSQI) score, Kupperman score and estradiol (E2) level under different non-pharmacological interventions by using R 4.1.3 software and the GeMTC package.
A total of 44 RCTs including 3 354 patients were selected, involving 12 non-pharmacological interventions (moxibustion, electroacupuncture, acupoint pressing with beans, scraping, fire dragon pot, thumbtack needle, massage, warm acupuncture, bee acupuncture, acupoint embedding, music therapy, acupuncture). The results of meta-analysis showed that moxibustion, electroacupuncture, and acupuncture were superior to sedative-hypnotic western drugs in overall response rate to the improvement of perimenopausal insomnia symptoms (P<0.05), and moxibustion was identified as the most probable superior intervention. Moxibustion, electroacupuncture, scraping, and acupuncture were superior to sedative-hypnotic western drugs (P<0.05), moxibustion was more effective than warm acupuncture (P<0.05) in the improvement of PSQI score and identified as the most probable superior intervention. There was no significant difference in the improvement of Kupperman score and E2 level among different interventions (P>0.05), with scraping emerging and acupuncture as the most probable superior intervention, respectively.
Current evidence demonstrates that moxibustion is superior in overall response rate to the improvement of perimenopausal insomnia symptoms and PSQI score in perimenopausal women, while scraping is superior in improving Kupperman score and acupuncture has advantages in improving E2 level, however, further validation of this conclusion is needed by conducting more high-quality studies.
Obstructive sleep apnea hypopnea syndrome (OSAHS) is associated with bone metabolism in Western population. Chinese population manifest different development progress of OSAHS and bone metabolism owing to their own specific physiological characteristics compared to the Western population. Although the association between OSAHS and bone metabolism may be confounded by underlying diseases, the association between them among healthy Chinese people remains unknown.
To examine the relationship between OSAHS and bone metabolism in Chinese people without underlying conditions using a review and Meta-analysis, providing evidence for improving bone health.
This review was conducted following the PRISMA guidelines. Electronic databases, such as PubMed, Embase, and CINAHL, were searched from inception to December 2020 for studies regarding bone metabolism and OSAHS in Chinese adults (aged≥18 years) in which those with and without OSAHS were classified as OSAHS and control groups, respectively (OSAHS was diagnosed based on the Guidelines for the Diagnosis and Management of Obstructive Sleep Apnea Hypopnea Syndrome) . Outcome indicators include one or more bone metabolism indicators. Three researchers independently performed literature screening and data extraction. Two researchers independently performed the quality appraisal using the JBI Critical Appraisal Checklist for Analytical Cross Sectional Studies. Data were analyzed using Stata 15.1.
Ten studies were included, with a total of 898 participants, and 653 of whom had OSAHS. Nine were cross-sectional studies and one was a quasi-experimental study. According to the JBI quality assessment tool, the nine cross-sectional studies were of high quality on items 1 to 5, and 4 of which did not control for the confounding factors. Based on the Meta-analysis, compared to the control group, OSAHS group had lower lumbar BMD 〔SMD (95%CI) =-1.758 (-2.300, -1.217) 〕, lower femoral neck BMD〔SMD (95%CI) =-1.260 (-1.949, -0.571) 〕, higher β-CTX〔SMD (95%CI) =0.803 (0.122, 1.484) 〕, and higher P1NP〔SMD (95%CI) =0.820 (0.318, 1.321) 〕. Apnea-hypopnea index had a negative correlation with lumbar BMD〔r (95%CI) =-0.36 (-0.57, -0.12) 〕 and positive correlations with β-CTX〔r (95%CI) =0.39 (0.29, 0.47) 〕and P1NP〔r (95%CI) =0.36 (0.16, 0.53) 〕.
Among Chinese adults without underlying conditions, OSAHS may reduce BMD by increasing bone resorption, thereby elevating the risk of osteoporosis or fractures.
Acute kidney injury (AKI) is a common complication and a key poor prognostic factor in severe acute pancreatitis (SAP) . It is rather challengeable to prevent and treat AKI in SAP, but early assessment and intervention of related risk factors can prevent or delay its development.
To systematically analyze the risk factors of AKI in SAP.
Databases of PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang Data, CQVIP and SinoMed were searched for articles about the risk factors of AKI in SAP from inception to January 2022. Two researchers independently performed literature screening according to inclusion and exclusion criteria, data extraction, and methodological quality assessment. RevMan 5.4 and Stata 15.1 were employed for Meta-analysis.
In total, 21 studies were included, including 3 823 patients. Meta-analysis demonstrated that being male〔OR=1.42, 95%CI (1.21, 1.68) , P<0.001〕, drinking history〔OR=1.51, 95%CI (1.14, 2.01) , P=0.004], higher APACHE Ⅱ score〔MD=5.69, 95%CI (2.95, 8.44) , P<0.001〕, Ranson score〔MD=2.58, 95%CI (2.27, 2.88) , P<0.001〕, and CTSI score〔MD=1.48, 95%CI (0.17, 2.80) , P=0.030〕; increased lencocyte count〔MD=0.96, 95%CI (0.47, 1.44) , P<0.001〕, IL-33〔MD=28.36, 95%CI (19.05, 37.67) , P<0.001〕, CRP〔MD=17.38, 95%CI (12.39, 22.38) , P<0.001〕, Scr〔MD=49.50, 95%CI (24.80, 74.19) , P<0.001〕, PCT〔MD=6.74, 95%CI (3.36, 10.12) , P<0.001〕, neutrophil gelatinase-associated lipocalin (NGAL) 〔MD=18.31, 95%CI (11.82, 24.80) , P<0.001〕, and serum lactate〔MD=0.87, 95%CI (0.27, 1.46) , P=0.004〕; prevalence of hypoxemia〔OR=9.42, 95%CI (4.81, 18.44) , P<0.001〕, hypertension〔OR=1.35, 95%CI (1.06, 1.72) , P=0.010〕, diabetes〔OR=1.56, 95%CI (1.20, 2.04) , P<0.001〕, and coronary heart disease〔OR=3.20, 95%CI (1.41, 7.24) , P=0.005〕; use of mechanical ventilation〔OR=5.00, 95%CI (2.76, 9.07) , P<0.001〕; prevalence of shock〔OR=11.60, 95%CI (3.37, 39.91) , P<0.001〕, infection〔OR=5.78, 95%CI (3.10, 10.79) , P<0.001〕, multiple organ dysfunction syndrome (MODS) 〔OR=7.28, 95%CI (3.56, 14.88) , P<0.001〕, abdominal bleeding〔OR=5.51, 95%CI (1.38, 22.09) , P=0.020〕, acute respiratory distress syndrome (ARDS) 〔OR=9.61, 95%CI (4.14, 22.27) , P<0.001〕, and abdominal compartment syndrome (ACS) 〔OR=5.79, 95%CI (3.75, 8.93) , P<0.001〕; long stay in the ICU〔MD=8.77, 95%CI (2.76, 14.79) , P=0.004〕were risk factors of AKI in SAP.
Male, drinking history, higher APACHEⅡ score, Ranson score and CTSI score, elevated inflammatory markers (lencocyte count, IL-33, CRP, Scr, PCT, NGAL) and elevated serum lactate, underlying disease prevalence (hypoxemia, hypertension, diabetes, coronary heart disease) , use of mechanical ventilation, prevalence of shock, infection, MODS, abdominal bleeding, ARDS, and ACS, long stay in the ICU may be risk factors for AKI in SAP. Clinical medical workers should early identify and intervene SAP patients with the above-mentioned risks, so as to reduce the incidence of AKI.
