目的:系统评价中国居民癌症防治核心知识知晓率及其影响因素.方法:主要基于计算机检索知网、万方、维普、中国生物医学文献数据库等中文数据库中涉及中国居民癌症防治核心知识影响因素的横断面研究.由2名研究者独立进行文献检索,时限从2000至2022年7月,对文献进行筛选和资料提取后,采用RevMan 5.4和Stata 16.0软件进行 Meta 分析.结果:共纳入 27 篇研究进行分析.结果显示,中国居民癌症防治核心知识知晓率为 71.30％(95％CI:63.70％～78.80％);影响因素分析结果显示,女性(OR = 1.10,95％CI:1.03～1.18,P = 0.003)、较高学历(OR=1.39,95％CI:1.27～1.153,P＜0.001)、吸烟(OR=1.06,95％CI:1.03～1.09,P＜0.001)、癌症患病经历或恶性肿瘤家族史(OR=1.24,95％CI:1.10～1.39,P＜0.001)是中国居民癌症防治核心知识知晓水平的保护因素.而高龄(OR=0.91,95％CI:0.81～1.03,P=0.130)、城乡(OR=1.06,95％CI:0.9～1.25,P=0.480)与中国居民癌症防治核心知识的关系无统计学意义.结论:我国癌症防治核心知识知晓率处于中等水平,性别、学历、收入、吸烟、恶性肿瘤家族史是其主要影响因素,相关部门应采取措施,有计划地提高居民癌症防治核心知识知晓率.

目的 探讨PICC置管患者的恐惧心理状态,为改善患者心理体验提供参考.方法 检索国内外数据库中有关PICC置管患者真实体验的质性研究文献,检索时限为建库至2021年9月,采用Meta整合方法对研究结果进行整合归纳.结果 共纳入12项研究,提炼34个结果.归纳形成9个新类别,整合成4个结果,即恐动(导管位置特殊,对穿刺针的畏惧,害怕导管断裂、脱出),疾病羞耻感(害怕别人看到导管,害怕被当作异类),知识缺乏导致的恐惧心理(专业信息获取障碍,知识缺乏),害怕结局不良(惧怕穿刺失败,导管相关并发症).结论 护理人员应重视患者的恐惧消极心理,实施针对性的健康教育和心理护理,促进患者身心健康.

Objective To systematically review and synthesize the life experience of hemodialysis patients and provide reference for improving the quality of patient life and boosting the quality of nursing service.Methods The databases of Cochrane Library, PubMed, Embase, CBM,CNKI,VIP and WanFang were searched for qualitative researches on the life experience of hemodialysis patients from inception to July 2020.Results A total of 17 studies were included, 34 results extracted, 7 categories summarized and 3 integration results synthesized.Integration result I:Positive and negative emotional coexistence in patients; Integration result II:Hemodialysis patients faced challenges in exercise, diet and social intercourse; Integration result III:Patients were eager to gain supports from the outside world, enable positive changes, establish a future outlook and cherish the present.Conclusion Healthcare practitioners should pay due attention to life situation, emotional experience and actual needs, intensify targeted psychological interventions, provide necessary assistance and elevate the quality of life of hemodialysis patients.

目的:分析与评价护士夜班的负性身心体验.方法:检索the Cochrane Library、PubMed、EMbase、Web of Science、CINAHL、万方数据库、中国知网、维普中文期刊全文数据库、中国生物医学文献数据库中有关护士夜班负性身心体验质性研究的文献,检索时限为各数据库建库至2019年10月,采用2016版澳大利亚JBI循证卫生保健中心质性研究质量评价标准进行文献质量评价,采用Meta整合方法对结果进行整合分析.结果:共纳入9项研究,提炼32个结果,归纳形成7个新类别,整合成2个整合结果:①护士夜班的负性心理问题;②负性感受调节因素.结论:医院管理者应重视夜班给护士带来的负性身心健康问题,满足其夜班需求,强化支持系统,减缓夜班对护士身心负性影响,提高护理质量.

目的 观察经颅直流电刺激(tDCS)联合丹红注射液对脑卒中病人运动功能恢复及血清低氧诱导因子-1α(HIF-1α)、血管内皮生长因子(VEGF)及脑源性神经生长因子(BDNF)水平的影响.方法 选取2018年1月—2020年1月中国人民解放军联勤保障部队第九二一医院收治的脑卒中病人107例,给予病人tDCS联合丹红注射液治疗,采用酶联免疫吸附法(ELISA)检测治疗前后病人HIF-1α、VEGF及BDNF水平.采用Fugl-Meyer评分(FMA)与改良Barthel指数量表(MBIS)评定病人治疗前后运动功能.结果 tDCS联合丹红注射液治疗前后病人血清HIF-1α、VEGF及BDNF表达比较,差异均有统计学意义(P<0.01);运动功能相关评分FMA及MBIS比较,差异均有统计学意义(P<0.05).病人血清HIF-1α含量与FMA、MBIS评分呈负相关(r=-0.517,P<0.01;r=-0.494,P<0.01);血清VEGF、BDNF含量与FMA评分呈正相关(r=0.474,P<0.05;r=0.504,P<0.01),与MBIS评分呈正相关(r=0.461,P<0.05;r=0.583,P<0.01);VEGF含量与BDNF含量呈正相关(r=0.485,P<0.05).结论 tDCS联合丹红注射液治疗可降低脑卒中病人外周血HIF-1α水平,提高外周血VEGF及BDNF水平,并改善运动功能,其机制可能是通过影响脑卒中病人HIF-1α、VEGF及BDNF表达促进运动功能恢复.

背景 131I辅助治疗甲状腺癌可显著提高患者生存率,但由此引起的唾液腺损伤严重影响患者生存质量.目前对于防治唾液腺损伤的药物有多种,但缺乏药物疗效之间的比较,因此进行网状Meta分析至关重要.目的 采用网状Meta分析方法评价不同药物干预方案对131I辅助治疗甲状腺癌患者唾液腺功能的保护作用.方法 计算机检索Cochrane Central Register of Controlled Trials、Web of Science、PubMed、EMBase、维普网、中国知网、万方数据知识服务平台、中国生物医学文献服务系统建库至2021年1月发表的不同药物干预方案对131I辅助治疗甲状腺癌患者唾液腺功能保护作用的随机对照试验或非随机对照试验.由两名研究者筛选文献,提取研究资料;使用Cochrane Handbook 5.10偏倚风险评估工具和MINORS评价文献质量,Stata 16.0软件进行一致性检验、发表偏倚分析和图形绘制,OpenBUGS 3.2.3软件进行网状Meta分析.结果 共纳入11篇文献,涉及7种药物干预方案,分别为氨磷汀、维生素C、氨磷汀+维生素C、柠檬酸、维生素E、硒、丙硫氧嘧啶.网状Meta分析结果显示,对腮腺排泌分数(EF)的防护作用氨磷汀+维生素C、氨磷汀高于柠檬酸和丙硫氧嘧啶,氨磷汀高于常规治疗(P<0.05);累积排序概率图下面积(SUCRA)排序:氨磷汀+维生素C>氨磷汀>维生素C>常规治疗>维生素E>硒>柠檬酸>丙硫氧嘧啶.对颌下腺EF的防护作用维生素E、氨磷汀+维生素C、氨磷汀、常规治疗高于丙硫氧嘧啶(P<0.05);SUCRA排序:维生素E>氨磷汀+维生素C>氨磷汀>硒>维生素C>柠檬酸>常规治疗>丙硫氧嘧啶.腮腺EF和颌下腺EF的漏斗图对称性良好.结论 氨磷汀+维生素C可能是防护131I辅助治疗甲状腺癌患者腮腺排泌功能的最佳干预方案,维生素E可能是防护131I辅助治疗甲状腺癌患者颌下腺排泌功能的最佳干预方案,氨磷汀+维生素C次之;但因网状Meta分析的局限性,仍需谨慎对待此结果,建议进行更多高质量、大样本的临床研究进一步验证.

目的 综合评价分级转运在急危重症患者院内转运中的应用价值.方法 全面检索中国生物医学数据库(CBM)、中国学术期刊全文数据库(CNKI)、中国维普数据库(VIP)和万方数据库,提取资料,评价质量,采用RevMan 5.3软件进行统计分析.结果 最终共纳入16篇文献.结果显示,与常规转运相比,分级转运模式能降低不良事件发生率(P<0.01);缩短至CT室、重症监护室、手术室、普通病房、介入室的转运时间(P<0.01).结论 分级转运模式可以降低急危重症患者院内转运中不良事件的发生率,对转运时间的影响仍待高质量的研究验证,以提高院内转运效率与安全.

我国是糖尿病患病大国,糖尿病患者的饮食护理和食物结构引发了人们新的思考,适用于糖尿病患者的全营养素配方食品得到了社会的广泛关注.对患者进行营养管理是医疗过程中的重要干预手段.全营养素配方食品是特殊医学用途配方食品(food for special medical purpose,FSMP)的一种,有利于控制糖尿病患者的血糖,改善临床症状,提高患者的生活质量.本文介绍了FSMP的生产方法 、国内外FSMP的管理方式、糖尿病患者全营养素食品配方、几种常见的糖尿病患者全营养素食品配方补充剂,为糖尿病患者的饮食护理提供参考.

Objective: To systematically review the care experience of caregivers of burn children, so as to provide references for guiding the continuing care in hospitals, communities, and homes. Methods: Databases including Cochrane Library, PubMed, ScienceDirect, ProQuest, Web of Science, and CINAHL were retrieved with the search terms of " burn" , " care/caregivers/nursing/father/mother/relatives" , " needs/perceptions/exceptions/attitudes/feelings/demands/experiences" , " qualitative research" , and the Chinese Journals Full-text Database, China Biology Medicine disc, VIP Database, and Wanfang Data were retrieved with the search terms in Chinese version of "//" , "//////" , "/////" , "" to search the qualitative researches on care experience of caregivers of burn children published from the establishment of the databases to November 2019. After screening and extracting the data, the quality evaluation criteria for qualitative research of the Australian Joanna Briggs Institute Evidence-Based Health Care Center and its integrative/aggregative synthesis method were used to assess the quality of the included literature and meta-integrate the research results respectively. Results: A total of 16 studies and 269 caregivers were enrolled. The quality of one included literature was grade A, and the quality of 15 included literature was grade B. A total of 65 research results were extracted with totally 6 categories formed after summarization, and 2 integrated results obtained as follows: (1) The caregivers experienced heavy psychological pressure and burden in the care process, which had a significant impact on family, social relations, and daily life. (2) With the care time lapsing, through the support of all sectors of society and self-adjustment, the caregivers gradually accepted the reality and actively took various countermeasures, but they still faced many challenges in disease care. Conclusions: The caregivers of burn children have many physical and mental health problems and face many care challenges. The government, medical and health institutions, and society should give a great attention to these issues, improve the social support system and security system, reduce the family-related pressure of burn children's families, and improve the quality of family life.

在当前社会医疗背景下,全髋关节置换术需求持续增加,出院准备指导有利于保障患者安全,提高其生活质量.本文通过分析全髋关节置换术患者出院准备现状及其影响因素,提出改善出院准备指导的新思路,以期为临床提供参考.

目的 通过Meta分析整合2型糖尿病合并骨质疏松的疾病影响因素.方法 计算机检索中国知网、万方数据库、维普中文科技期刊数据库、中国生物医学文献数据.检索时间从建库至2019年3月1日,内容为国内公开发表的2型糖尿病合并骨质疏松影响因素的文献,采用Stata12.0软件进行统计分析;结果共检索出79篇文献,最终纳入16篇文献.Meta分析结果显示年龄(OR=1.252,95％CI=1.160～1.351)、性别(OR=2.588,95％CI=1.902～3.520)、糖化血红蛋白(OR=1.75,95％CI=1.425～ 2.417)、糖尿病病程(OR=1.237,95％CI=1.113～ 1.375)、体重指数(OR=0.885,95％CI=0.783～1.002)、尿微量白蛋白(OR=1.698,95％CI=0.808～3.569)是糖尿病合并骨质疏松的危险因素,空腹血糖(OR=1.363,95％CI=1.204～ 1.543)是糖尿病合并骨质疏松的保护因素.敏感性分析与发表偏倚提示结果具有一定异质性但不影响定量合并.结论 年龄≥55岁、绝经期女性、低体重指数、糖尿病病程长、糖化血红蛋白值异常、合并糖尿病并发症是2型糖尿病合并骨质疏松的主要危险因素.

目的 探讨长沙市三级甲等医院缺血性脑卒中患者生活质量的影响因素.方法 采用问卷调查法对长沙市3所三级甲等医院210例缺血性脑卒中住院患者进行调查.结果 缺血性脑卒中患者生活质量总分为(140.00±34.15)分,标准化得分为57.14％,处于中等水平.家庭人均月收入、伤残接受度量表中的价值观范围的扩大、身体形态的从属性和对比价值到固有价值的转变维度以及医学应对方式量表中的回避应对方式是影响生活质量的主要因素.结论 缺血性脑卒中患者的生活质量处于中等水平,护理人员应加强对低收入患者的关注,提高患者的伤残接受水平.引导患者采取积极的应对方式,从而提高患者的生活质量.

[目的]系统评价口服水化对预防冠状动脉介入术后病人造影剂肾病(CIN)发生的效果.[方法]计算机系统检索中国知网 、万方数据库 、维普数据库 、中国生物医学文献数据库(CBMdisc)、Cochrane图书馆 、PubMed、EMbase、OVID生物医学数据库,检索时间为建库至2018年3月,检索关于口服水化预防冠状动脉介入术后CIN的随机对照试验(RCT).文献质量评价和筛选由2名研究者进行,参照Cochrane Handbook 5.1.0进行文献质量评价,采用RevMan 5.3进行Meta分析.[结果]最终共纳入8项RCT.结果显示,口服水化可降低CIN的发病率[RR=0.33,95％CI(0.11,0.97),P=0.04],同时有计划水化可减轻病人胃部不舒适感[RR=0.34,95％CI(0.17,0.67),P=0.002].[结论]有计划地进行口服水化管理是预防CIN的有效措施,但受纳入研究质量的限制,上述结论还需开展更多高质量研究予以验证.

目的 了解缺血性脑卒中患者伤残接受度、生活质量现状及其相关性.方法 应用伤残接受度量表、脑卒中专用生活质量量表对210例缺血性脑卒中患者进行调查.结果 伤残接受度总分66.44±15.27,4个维度得分(10.03±2.14)～(20.39±4.77);生活质量总分140.00±34.15,12个维度得分(6.64士3.33)～(17.22±4.07);伤残接受度及4个维度与生活质量及各维度呈正相关(r=0.229～0.856,均P＜0.01).结论 缺血性脑卒中患者伤残接受度处于中等偏低水平,医护人员应及早评估患者的伤残接受度,采取针对性干预措施提高患者伤残接受水平,从而提高患者的生活质量.

This article summarized the status quo of pain-related psychological and quality of life of patients with lumbar disc herniation, and provided a basis for improving the quality of life of patients with high risk of lumbar disc herniation.

Objective To assessment the treatment efficacy of modafinil versus placebo for hypersomnia.Method A system-atic review of randomized controlled trials with meta -analysis by searching databases of PubMed,EMBASE and the Cochrane Central.Randomized controlled trials comparing modafinil and placebo therapies in hypersomnia patients.Results Four trials were analyzed,132 patients involved.Meta -analysis showed that modafinil for clinical cure rate in hypersomnia patients (χ2 =1.68,P<0.05).Conclusion Modafinil is effective for treatment of hypersomnia patients.

目的 调查腰椎间盘突出症患者的疼痛信念现状,并分析其影响因素.方法 采用一般资料调查表、疼痛信念与感知量表、Roland-Morris功能障碍问卷、视觉模拟量表对207例腰椎间盘突出症患者进行问卷调查.结果 腰椎间盘突出症患者疼痛信念总分的中位数为6.00分,腰椎间盘突出症患者疼痛信念的影响因素为文化程度、家庭人均月收入、医疗费用支付方式、疼痛程度以及功能障碍程度(P＜0.01或P＜0.05).结论 腰椎间盘突出症患者在面对疾病时存在一定的负性信念,医护人员应根据疼痛信念的影响因素实施有效的干预措施,减少患者的负性疼痛信念,从而提高其生活质量.

目的 了解腰椎间盘突出症患者疼痛信念、生活质量现状及两者的相关性.方法 选取长沙市2所三级甲等医院住院的207例腰椎间盘突出症患者为调查对象,运用疼痛信念与感知量表、简明健康状况调查量表(SF 36)进行调查.结果 腰椎间盘突出症患者疼痛信念得分为-20～31(5.36±9.94,M=6.00)分,其中认为疼痛不可解除得分最高,认为会持续疼痛、认为疼痛不可解除及疼痛信念总分与生活质量各维度呈负相关(P＜0.05,P＜0.01).结论 护理人员应重视患者的疼痛信念对生活质量的影响,提高患者对疼痛的认识,增强患者积极的疼痛信念,从而提高患者的生活质量.

Objective To investigate the status of coping style and uncertainty in illness in family member of patients with cerebral infarction,to analyze their relationship. Method About 108 family member of patients with cerebral infarction were in-vestigated by the General Information Questionnaire,the Mishel Uncertainty in Illness Scale-Family version( MUIS-FM)and the Simplified Coping Styles Scale. Results The total mean score of MUIS-FM was(89. 41 ± 11. 76),there was a high level of uncertainty in illness. The total score of coping styles were( 26. 56 ± 7. 48 ). the total score of uncertainty in illness and the four dimension scores were all negatively correlated with positive coping style(χ2 = -0. 213~ -0. 404,P﹤0. 05,P﹤0. 01). Con-clusion The uncertainty level is high in the family member of patients with CI,This suggests nursing staff not only should encour-age patients to adopt positive coping style,but also attach great importance to family members to reduce the uncertainty in illness so as to promote the rehabilitation of patients.

Objective To understand the current status and analyze the influence factors of sleep quality in knee replacement patients. Methods With convenient sampling, totally 104 patients with knee arthroplasty in two first-class third-level hospitals in Changsha were investigated by general information questionnaire, Pain Belief Scale and Pittsburgh sleep quality index (PSQI). Results The total score of PSQI was 8.00 ±5.42 and gender and pain degree were the influence factors of sleep quality in knee replacement patients (P<0.01). Conclusion Patients of knee arthroplasty present poor sleep quality. Medical stuff should take some measures to improve patients’ sleep quality and pay great attention to female patients and those with severe pain.