兰州大学循证社会科学交叉创新实验室 Innovation Laboratory of Evidence-based Social Sciences,Lanzhou University
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Applications and Assessment of Social Media in Pediatric Orthopedics: Scoping Review.
Background: With the continuous advancement of science and technology, the demand for health knowledge about pediatric orthopedics is also gradually growing. The traditional paper-based and multimedia health education models can no longer fully meet the needs of society. Fortunately, the emergence of social media has mitigated the problem of insufficient medical education resources. However, there is currently relatively little published evidence on the use of social media in pediatric orthopedics. Objective: This study aimed to examine the current applications of social media in pediatric orthopedics and to evaluate the quality and readability of related online health information. Its purpose is to provide relevant evidence to promote the understanding and development of the field. Methods: This review followed the methodological framework of Arksey and O'Malley and the Joanna Briggs Institute reviewer manual. First, a literature search was performed in the PubMed, Embase, CINAHL, Web of Science, and Cochrane databases. The search time range was from the establishment of the databases to September 21, 2023. We endeavored to include research articles related to social media and involving pediatric orthopedics in the review. The literature was reviewed at the title, abstract, and full-text levels. Results: We included 35 of 3400 (1.03%) studies retrieved. Most of the articles used social media to help with medical staff and patient education and training (23/35, 66%) and to disseminate information (21/35, 60%), followed by helping medical staff collect data (8/35, 23%). Medical institutions and staff also used social media to increase attention (6/35, 17%), enhance social support (5/35, 14%), facilitate the recruitment of research participants (3/35, 9%), support professional development (3/35, 9%) and implement health intervention (2/35, 6%). Five general quality of information (QOI) tools, 7 specific QOI tools, and 6 readability tools were used in 12 studies analyzed for quality and readability, with overall quality being fair and readability exceeding the recommended level. According to the research data, people are increasingly interested in pediatric orthopedics on social media platforms and eager to obtain and learn relevant knowledge. Conclusions: This scoping review found that social media has a growing body of literature on pediatric orthopedic conditions and is playing an increasingly important role in knowledge dissemination and education. A variety of tools are being used for assessing the QOI, but little attention has been paid to the readability of the information. The QOI was largely fair, with readability above the recommended level. Future research should further explore the role of social media in pediatric orthopedics and continue to optimize QOI and information readability.
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Global burden of human noroviruses contamination in drinking water sources and drinking water: A systematic review and meta-analysis identifying GII.4 and GII.17 as dominant genotypes.
Human Noroviruses (HuNoVs) are the leading etiologic agents responsible for viral gastroenteritis. Drinking water (DW) serves as a significant vehicle for the transmission of HuNoVs. This study aimed to assess the occurrence of HuNoVs in drinking water sources (DWS) and DW. A systematic search spanning Web of Science, EMBASE, PubMed, and Cochrane Central Register of Controlled Trials was executed up to July 15, 2024. Following rigorous screening, 76 eligible studies underwent meta-analysis with heterogeneity assessment via Stata 14.0 using a random-effects model. The results indicated that the pooled occurrence of HuNoVs was 11 % (95 % CI: 8-14), with occurrence of 15 % (95 % CI: 10-21) in DWS and 6 % (95 % CI: 3-9) in DW. Subgroup meta-analysis demonstrated that genogroup II (GII) of HuNoVs exhibited the highest contamination occurrence of 7 % (95 % CI: 4-10), with GII.4 and GII.17 being the predominant genotypes. The two continents with the highest number of studies were Asia (n = 27) and Europe (n = 19), with HuNoVs occurrence of 14 % (95 % CI: 8-22) and 15 % (95 % CI: 7-26), respectively. Furthermore, the occurrence showed no significant differences across the four seasons: in spring, the occurrence was 11 % (95 % CI: 3-23); in summer, 15 % (95 % CI: 7-25); in autumn, 11 % (95 % CI: 2-24); and in winter, 18 % (95 % CI: 10-27). These findings provided valuable epidemiological insight into the global occurrence, seasonal variation, and genotypic distribution of HuNoVs in DWS and DW, aiding policy development and public health strategies.
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Analysis and 15-Year Projections of the Global Burden of Tension-Type Headache by Sex from 1990 to 2021: A Systematic Review of GBD 2021 Data.
Background: Tension-type headache (TTH) is a prevalent primary headache disorder significantly impacting quality of life and healthcare resource utilization, with females typically bearing a higher disease burden. However, comprehensive analyses and predictive studies on the global TTH burden stratified by gender are currently lacking. Aim: This study utilized data from the Global Burden of Disease (GBD) Study to analyze the global burden of tension - type headache by sex from 1990 to 2021 and conducted a 15 - year projection (up to 2036). Methods: We conducted a systematic review of GBD 2021 data, employing Joinpoint regression analysis and decomposition analysis to assess TTH incidence, prevalence, YLDs, and DALYs. Additionally, we used the ARIMA model for a 15-year predictive analysis of TTH burden trends. Results: From 1990 to 2021, global female TTH cases rose from 669.54 million (95% UI: 586.2-751.8 million) to 1.04 billion (95% UI: 923.0-1.1 billion), with incidence increasing from 242.9 million (95% UI: 218.8-267.0 million) to 369.86 million (95% UI: 332.5-407.2 million). Male cases grew from 616.82 million (95% UI: 537.2-696.4 million) to 970 million (95% UI: 851.0-1.0 billion). Decomposition analysis indicated population growth was the primary driver of the increase in female TTH prevalence. Projections suggest that by 2036, the incidence will reach 9,174.84 per 100,000 females (95% UI: 8,854.8-9,494.9), prevalence will be 25,135.1 per 100,000 females (95% UI: 23,977.2-26,283.0), YLD rate will be 62.76 per 100,000 females (95% UI: 58.8-66.7), and DALY rate will be 60.97 per 100,000 females (95% UI: 56.7-65.2). Conclusion: This study highlights the significance of gender in TTH burden, particularly the heightened risk for females. Through temporal trend analysis and predictive modeling, we provide insights into future TTH disease trajectories, aiding global public health policy formulation and healthcare resource allocation.
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Systematic evaluation of the associations between schizophrenia and autoimmune diseases: An umbrella review.
Objective: This study aims to assess research trends in the association between schizophrenia and autoimmune diseases, systematically review their relationship, and evaluate the credibility of existing evidence. Methods: Bibliometric analysis was conducted using the bibliometrix package in R, along with VOSviewer and CiteSpace. Relevant systematic reviews and meta-analyses were retrieved from six databases: PubMed, Web of Science, Embase, CINAHL, PsycINFO, and the Cochrane Library. Summary risk estimates were recalculated using the DerSimonian and Laird method under a random-effects model, and the credibility of the evidence was assessed. Results: The bibliometric analysis found that "meta-analysis" has become a frequently used keyword and may be a focal point for future research. The umbrella review included 17 articles, containing 24 report data points from 12 quantitative reviews. Results indicated that 9 reports assessed the relationship between schizophrenia and autoimmune diseases. Schizophrenia was significantly associated with autoimmune neurological disorders (RR = 1.42; 95 % CI = 1.18-1.72), providing suggestive evidence. Seven reports evaluated the impact of schizophrenia on autoimmune diseases, showing highly suggestive evidence that schizophrenia patients had a pooled relative risk of 2.22 (95 % CI = 1.95-2.52) for psoriasis. Eight reports assessed the impact of autoimmune diseases on schizophrenia, with bullous pemphigoid patients showing significantly higher schizophrenia prevalence (OR = 2.63; 95 % CI = 2.03-3.39). Conclusions: This study synthesizes evidence of varying levels, highlighting the association between schizophrenia and autoimmune diseases. It offers new insights for future exploration, fosters interdisciplinary collaboration, and provides valuable implications for public health policy development.
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Nurse-Delivered Telehealth in Home-Based Palliative Care: Integrative Systematic Review.
Background: Telehealth technologies can enhance patients' and their families' access to high-quality resources in home-based palliative care. Nurses are deeply involved in delivering telehealth in home-based palliative care. However, no previous integrative systematic reviews have synthesized evidence on nurses' roles, facilitators, and barriers to implementing nurse-delivered telehealth in home-based palliative care. Objective: This integrative systematic review aimed to provide a comprehensive understanding of the roles of nurses and the multilevel facilitators and barriers to implementing nurse-delivered telehealth in home-based palliative care, which could inform future policy development, research, and clinical practice. Methods: This integrative systematic review was conducted using Joanna Briggs Institute methodological guidance. We followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. We systematically searched articles published from January 1, 2014, to May 2024 in PubMed, Embase, Web of Science, CINAHL, and Cochrane Library. We included English-language; peer-reviewed; original; and qualitative, quantitative, and mixed methods studies that centered on nurse-delivered telehealth in home-based palliative care. We used the Mixed Methods Appraisal Tool to assess the quality of the included articles. Furthermore, 3 authors independently assessed eligibility, extracted data, and assessed the quality of articles. The entities to extract were identified by research questions of interest regardless of the type of study. We applied a convergent synthesis approach to integrate quantitative and qualitative data. Guided by the updated Consolidated Framework for Implementation Research (CFIR) 2.0, we synthesized the facilitators and barriers to implementing nurse-delivered telehealth in home-based palliative care. Results: This integrative systematic review identified 4819 unique articles, including 34 papers encompassing 29 unique primary research studies. Innovations were mainly delivered by nurses (n=8) and nurse-involved multiprofessional teams (n=18). The roles of nurses in telehealth home-based palliative care involve palliative care nurses, community nurses, nurse coordinators, nurse coaches or nurse navigators, and nurse case managers. Guided by CFIR 2.0, facilitators and barriers to implementing nurse-delivered, telehealth, home-based palliative care were identified to 6 implementation levels and 20 constructs. The key facilitators included the COVID-19 pandemic, cost avoidance to the health care system, engagement of patients and their family caregivers, and so on. The barriers included a lack of reimbursement and payment mechanisms, technical problems, insufficiently trained health care providers, and so on. Conclusions: This integrative systematic review synthesizes evidence on nurses' evolving roles in telehealth home-based palliative care and identifies multilevel facilitators and barriers to nurse-delivered, home-based palliative care implementation. With the empowerment of telehealth technologies, nurses could establish a stronger professional identity and develop leadership in home-based palliative care. Nurses should leverage influence to promote nursing practice, clinical management, and policy support in the implementation of telehealth home-based palliative care. Trial registration: PROSPERO CRD42024541038; https://www.crd.york.ac.uk/PROSPERO/view/CRD42024541038.
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The Effect of the COVID-19 Pandemic Lockdown on Self-Harm: A Meta-Analysis.
Objective: The Coronavirus disease 2019 (COVID-19) pandemic caused a range of mental health problems, particularly self-harm. Lockdowns are the usual methods of responding to these public health emergencies. However, the effect of the COVID-19 lockdown on self-harm remains poorly characterized. This study aimed to investigate the influence of the COVID-19 pandemic on the incidence of self-harm. The findings may inform future policy development and strategies for managing pandemic-related mental health challenges. Methods: A meta-analysis was conducted using several database searches: APA PsycINFO, Embase, PubMed, Web of Science, CNKI, and Wan Fang. Published studies with data on the incidence of self-harm during visits to medical institutions, before and during the COVID-19 pandemic, were included. The pooled risk ratio (RR) value of self-harm incidence variation before and during the COVID-19 lockdown period, expressed as the comparison of clinical institution visits before and during the pandemic, was calculated. Results: Fifteen retrospective cohort studies with observational designs involving 253,600 participants were included. The pooled RR value of self-harm incidence variation was 1.386 (95% confidence interval (CI), 1.205-1.595, I2 = 58.9%, p = 0.002). The subgroup analysis showed that "emergency department type" (p = 0.004) and "mean age of the sample" were the sources of the RR values' heterogeneity (p = 0.026). Conclusions: Our findings suggest that the lockdown during the COVID-19 pandemic was a risk factor for self-harm. Therefore, special attention should be paid to individuals visiting the emergency department and the middle-aged and elderly populations. The prospero registration: This study was registered in PROSPERO (CRD42023373026), https://www.crd.york.ac.uk/PROSPERO/view/CRD42023373026.
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Fuzzy-set qualitative comparative analysis of influencing factors on family doctor service performance during major public health emergencies.
Objective: By studying the Technology-Organization-Environment Framework (TOE), this research explores the impact of various indicators in technology, organization, and environment on the performance of family doctor services during major public health emergencies. It aims to identify the driving paths to improve performance. Methods: A stratified sampling of 34 community health service centers in Shanghai was conducted, using the comprehensive performance score of family doctors as the outcome variable. The Average Internet Medical Service Person-times and the Information Technology Expenditure per Thousand Population were considered as technology-related variables. The Fiscal Allocation per Thousand Population (/1,000), the Family Doctor Team Members per Thousand Population, and the Medical Social Workers and Volunteers per Thousand Population were identified as organization-related variables. The Proportion of Older Adult Population, Fiscal Allocation per Thousand Population, and the number of patient self-education organizations per thousand population were taken as environment-related variables. Fuzzy-set Qualitative Comparative Analysis (fsQCA) was employed to conduct necessity analysis, truth table analysis, and configurational analysis of antecedent conditions, with robustness tests performed by adjusting consistency thresholds and case frequencies. Results: The study found that the performance of family doctor services was influenced by multiple factors, with no single decisive factor. In overall communities, five configurations, including per capita fiscal allocation and community participation, affected performance, explaining 4.2% of the variance. In central urban areas, information technology expenditure and the Proportion of Older Adult Population were core conditions, influencing 27.5% of performance paths. In non-central urban areas, core conditions such as financial support and IT covered 53.9% of data cases. The fsQCA results, which were robustly tested, begin to provide a strong basis for resource allocation and policy formulation. Conclusion: This study begins to fill the gap in research on family doctor service performance during major public health emergencies, exploring the synergistic effects and causal asymmetry among multiple indicators such as technology, organization, and environment from a holistic, or configurational, perspective.
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敌草快急性中毒患者预后影响因素的meta分析
摘要:目的 探讨与敌草快(diquat,DQ)急性中毒患者预后有关的影响因素,为辨别预测效能高、可靠性稳定的预后指标,合理诊疗急性DQ中毒患者提供循证依据.方法 以"敌草快""中毒""危险因素""预后""影响因素"等中文及相应的英文检索词为主题词或自由词,检索中国知网、万方医学网、维普数据库、中国优秀硕士学术论文全文数据库、中国生物医学数据库、PubMed、Embase、Web of science、The Cochrane Library等数据库截至2024年1月1日收录的相关文献,依据纳入排除标准提取数据资料,并评价文献的质量;应用R软件,对急性敌草快中毒患者预后影响因素进行meta分析.结果 初步检索到759篇文献,最终纳入11篇文献,其中英文文献2篇,中文文献9篇,均来自中国,且均为高质量文献.纳入759例急性DQ中毒患者,其中死亡组296例,存活组463例.依据加尔布雷斯图结果、敏感性分析结果,剔...
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中国人群丙肝知识知晓的Meta分析
目的 综合评估中国人群丙肝知识知晓率现状,为开展丙肝防治工作提供参考依据。方法 检索中国知网、万方、维普、PubMed等数据库,收集2010-2024年公开发表的丙肝知识知晓率的调查研究文献,用STRORE声明对文献质量进行了评估,使用Stata17.0软件对丙肝知识知晓率进行Meta分析,采用随机效应模型合并各样本知晓率,并按地区、人群为分组开展知晓率的亚组分析。结果 共纳入34项文献,含中国人群57 902人。Meta分析结果显示,中国人群丙肝知识知晓率为56.61%(95%CI:47.42%~68.51%)。亚组分析结果显示,不同地区丙肝知识知晓率异质性无统计学意义(P>0.05),不同人群的丙肝知识知晓率异质性差异有统计学意义(P<0.05),医务人员丙肝知识知晓率(80.29%)明显高于普通人群(45.28%)(P<0.01)。结论 中国人群丙肝知识知晓率偏低,通过多种途径加强人群丙肝知识的健康科普在目前显得尤为迫切。
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肥胖和超重儿童参与身体活动的健康效益:系统综述的系统综述
目的 评估身体活动对肥胖和超重儿童青少年身体健康、心理健康以及身体活动相关的健康行为的效益。方法 遵循PRISMA指南,系统性检索Web of Science、PubMed、Scopus、PsycINFO、Cochrane Library和中国知网中2016年至2024年间发表在科学引文索引Q4区及以上期刊的系统综述或Meta分析,内容涵盖身体活动或运动干预对6~18岁肥胖或超重儿童和青少年身体或心理健康的影响。采用AMSTAR 2工具对纳入文献进行质量评估,对中高水平质量文献进行系统综述。结果 共纳入8篇系统综述和Meta分析,涉及24 567例儿童和青少年,其中6篇为高质量,2篇为中等质量。在身体健康方面,结合有氧和阻力训练的复合运动干预在降低体质量指数(BMI)和体脂率方面表现最佳。每次60 min以上、每周3次、持续12周或更长时间的中、高强度运动干预可以显著降低肥胖和超重儿童的BMI和体脂率,且能提升心肺耐力和肌肉力量。在心理健康方面,身体活动对缓解儿童青少年抑郁和焦虑、提升自尊心具有积极效果。特别是舞蹈、户外探险活动和团队运动对改善儿童青少年的社交能力和情绪状态具有显著作用...
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肥胖和超重儿童参与身体活动的健康效益:系统综述的系统综述
目的 评估身体活动对肥胖和超重儿童青少年身体健康、心理健康以及身体活动相关的健康行为的效益。方法 遵循PRISMA指南,系统性检索Web of Science、PubMed、Scopus、PsycINFO、Cochrane Library和中国知网中2016年至2024年间发表在科学引文索引Q4区及以上期刊的系统综述或Meta分析,内容涵盖身体活动或运动干预对6~18岁肥胖或超重儿童和青少年身体或心理健康的影响。采用AMSTAR 2工具对纳入文献进行质量评估,对中高水平质量文献进行系统综述。结果 共纳入8篇系统综述和Meta分析,涉及24 567例儿童和青少年,其中6篇为高质量,2篇为中等质量。在身体健康方面,结合有氧和阻力训练的复合运动干预在降低体质量指数(BMI)和体脂率方面表现最佳。每次60 min以上、每周3次、持续12周或更长时间的中、高强度运动干预可以显著降低肥胖和超重儿童的BMI和体脂率,且能提升心肺耐力和肌肉力量。在心理健康方面,身体活动对缓解儿童青少年抑郁和焦虑、提升自尊心具有积极效果。特别是舞蹈、户外探险活动和团队运动对改善儿童青少年的社交能力和情绪状态具有显著作用...
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基于格林模式的健康教育对脑卒中患者干预效果的Meta分析
目的 系统评价基于格林模式的健康教育对脑卒中患者的干预效果。方法 计算机检索PubMed、Embase、Cochrane library、Web of Science、中国知网、维普数据库、万方数据库和中国生物医学文献数据库,检索格林模式健康教育对脑卒中患者干预效果影响的随机对照试验,时限为建库~2023年11月20日。由2名研究者独立筛选文献、资料提取和文献质量评价。采用RevMan 5.4软件进行Meta分析。结果 共纳入11篇文献,包括982例患者。Meta分析结果显示,与传统健康教育相比,格林模式的健康教育能有效改善脑卒中患者的整体健康行为水平(自我实现、健康责任、锻炼依从性、营养、人际关系、压力应对)、肢体运动功能、神经功能和自我感受负担。但在提升脑卒中患者日常生活能力方面,两组间未见显著差异。此外,根据亚组分析结果显示,干预时间≥6个月时,试验组锻炼依从性与对照组之间比较无明显差异[SMD=1.590,95%CI(-0.380,3.570),P=0.110]。结论 格林模式的健康教育有助于改善脑卒中患者整体健康行为水平,促进患者身体功能恢复和提升其生活质量。
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终末期肝病病人营养管理的最佳证据总结
目的:检索、评价并总结终末期肝病病人营养管理的最佳证据,为临床应用提供参考。方法:根据“6S”证据模型,自上而下检索数据库中有关终末期病人术后营养管理的临床决策、指南、专业共识、系统评价和原始研究等证据。由4名研究者对文献的方法学质量进行独立评价,并根据主题提取和汇总证据。结果:共纳入文献23篇,包括指南及专家共识5篇、系统评价及Meta分析6篇,随机对照试验12篇,从多学科营养管理、营养筛查与评估、营养物质推荐量、营养支持与评价、健康教育5个维度汇总30条证据。结论:总结了终末期肝病病人营养管理的最佳证据,建议临床人员结合医疗情境及病人自身情况等制订符合个体化营养管理方案。
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终末期肝病病人营养管理的最佳证据总结
目的:检索、评价并总结终末期肝病病人营养管理的最佳证据,为临床应用提供参考。方法:根据“6S”证据模型,自上而下检索数据库中有关终末期病人术后营养管理的临床决策、指南、专业共识、系统评价和原始研究等证据。由4名研究者对文献的方法学质量进行独立评价,并根据主题提取和汇总证据。结果:共纳入文献23篇,包括指南及专家共识5篇、系统评价及Meta分析6篇,随机对照试验12篇,从多学科营养管理、营养筛查与评估、营养物质推荐量、营养支持与评价、健康教育5个维度汇总30条证据。结论:总结了终末期肝病病人营养管理的最佳证据,建议临床人员结合医疗情境及病人自身情况等制订符合个体化营养管理方案。
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地舒单抗治疗骨质疏松的快速卫生技术评估
目的:对地舒单抗治疗骨质疏松的有效性、安全性和经济性进行快速卫生技术评估(HTA),为临床治疗提供循证证据。方法:计算机检索PubMed、Embase、the Cochrane Library、中国知网、万方数据库、维普数据库、中国生物医学文献服务系统及相关HTA网站、数据库,搜集地舒单抗治疗骨质疏松的高质量临床证据、药物经济学评价文献(干预组患者采用地舒单抗治疗;对照组患者采用唑来膦酸等药物及支持治疗),检索时限均为建库至2024年8月30日。由2名研究者独立筛选文献、提取资料和评价纳入研究的质量后,对结果进行定性描述与分析。结果:共纳入27篇文献,其中HTA报告2篇,系统评价/Meta分析12篇,药物经济学研究13篇。有效性方面,地舒单抗能够显著提高腰椎、髋部、股骨颈的骨密度,降低骨标志物水平,联合用药效果较单一用药效果更佳。安全性方面,地舒单抗主要导致耳鼻喉和胃肠道感染,总体发生率较低,在老年患者中心血管方面更为获益。经济学研究结果显示,地舒单抗治疗原发性骨质疏松具有成本-效益优势。结论:地舒单抗治疗骨质疏松具有一定的有效性和安全性,仍需高质量、大样本、多中心研究更进一步揭示其有...
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Synergistic therapy with celastrol-curcumin multifunctional nanomedicine: Anti-hepatocellular carcinoma and reduced hepatotoxicity.
Hepatocellular carcinoma is one of the leading causes of cancer deaths globally and a key hindrance to extending life expectancy. Celastrol (CEL) demonstrates excellent antitumor activity, but faces challenges like low solubility and a narrow therapeutic window, limiting its clinical application. To address these limitations, drug combinations and nano-delivery systems have emerged as effective solutions. Curcumin (CUR), known for its antitumor and hepatoprotective effects, also exhibits good biocompatibility and the ability to mitigate drug-induced liver injury. Considering the complementary properties of CEL and CUR, including CEL's potent antitumor activity and CUR's hepatoprotective effects, we developed a novel self-assembling nanodrug delivery system (CCPN) for the co-loading of both compounds. CCPN nanoparticles were constructed through non-covalent interactions, including hydrogen bonding, π-π stacking, and electrostatic forces, which confer good stability and significantly enhance the solubility and bioavailability of CEL and CUR. Extensive in vitro and in vivo experiments demonstrated that CCPN effectively reduced CEL-induced hepatotoxicity in zebrafish and mouse models, exhibiting good biosafety. Additionally, CUR's fluorescence provides a unique advantage for real-time monitoring of drug distribution and release, facilitating the tracking of therapeutic progress. Furthermore, CCPN nanoparticles enhanced delivery efficiency in HepG2 cells, exhibiting superior anti-liver tumor outcomes, which are associated with the promotion of apoptosis in tumor cells. This study presents CCPN as a promising therapeutic strategy for hepatocellular carcinoma, integrating reduced hepatotoxicity, self-monitoring capabilities, and superior therapeutic efficacy.
研究证据
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社区老年人口腔健康相关生活质量影响因素的meta分析
目的:对社区老年人口腔健康相关生活质量(OHRQoL)的影响因素进行系统评价。方法:使用计算机检索国内外相关数据库,搜集关于社区老年人OHRQoL影响因素的文献。筛选文献、提取数据并评价纳入文献的偏倚风险。最终纳入的文献运用Stata 13.0软件进行meta分析。结果:共纳入文献11篇,社区老年人13 086例。现存牙齿数量、经济收入、假牙是否合适、口腔疾病、文化程度、抑郁症状、牙齿疼痛、自评一般健康状况、自评口腔健康状况是社区老年人OHRQoL的影响因素。结论:社区老年人OHRQoL是生理、心理、社会、其他等多种因素共同作用的结果。医护人员应该对OHRQoL下降的老年人根据其特点采取针对性口腔健康干预,改善其口腔健康及生活质量,促进老年人健康老龄化。
研究证据
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离散选择实验在卫生人员工作偏好领域应用情况综述
目的:系统综述离散选择实验(discrete choice experiment,DCE)在卫生人员工作偏好研究中的应用,提供使用DCE方法调查卫生人员工作偏好的参考,并提出激励卫生人才队伍高质量发展的建议。方法:本研究共纳入26篇国内外相关文献,通过系统综述分析DCE在卫生人员工作偏好中的应用方式及分析结果,并对工作属性排名、支付意愿、情景模拟等结果进行统计分析。结果:通过系统综述发现国内外的研究时间处于动态变化,研究对象多集中于发展中国家;相较于国外,国内研究目的更集中在探究激励机制和提高卫生人员稳定性上;大部分研究均采用了多种分析模型,包括混合Logit、潜变量Logit模型等。国内外研究中所设置的工作属性存在差异,国内外研究均表明工作环境和工资奖金是关键属性。结论:建议政策制定者和管理者应重视工作环境、工作时长、地点、社会认同和编制等多元因素,结合实际制定相关政策制度,以促进国内卫生人才队伍建设的高质量发展。
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Health Technology Assessment: Evaluation of 8 CGRP-Targeted Therapy Drugs for the Treatment of Migraine.
Purpose: In order to scientifically evaluate the clinical value of the comprehensive attributes of Calcitonin gene-related peptide (CGRP) inhibitor drugs, a comprehensive literature-based clinical evaluation of CGRP-targeted therapy drugs was conducted using the drug evaluation method modified by expert discussion in the Rapid Guide for Drug Evaluation and Selection in Chinese Medical Institutions (Second Edition). Methods: Based on evidence-based data and the relevant elements and weighting in the "Selection Guidelines" quantification record form for drug evaluation and selection in medical institutions, adjustments were made according to the characteristics of CGRP-targeted therapy drugs. We systematically evaluated erenumab, galcanezumab, fremanezumab, eptinezumab, rimegepant, ubrogepant, atogepant, zavegepant for safety, efficacy, economy, and pharmacological properties. Results: The final assessment result scores from highest to lowest were rimegepant (84.5 points), erenumab (75.78 points), galcanezumab (74.02 points), fremanezumab (73.93 points), atogepant (72.64 points), eptinezumab (71.69 points), ubrogepant (70.37 points), zavegepant (56.44 points). Conclusion: Rimegepant, erenumab, fremanezumab, atogepant, galcanezumab, eptinezumab, ubrogepant can be entered into the medication list of medical institutions as strongly recommended drugs.
研究证据
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The involvement of specialists in primary healthcare teams for managing diabetes: a systematic review and meta-analysis.
Background: Diabetes mellitus requires ongoing management and care coordination. The majority of patients with diabetes were managed in primary healthcare settings. Several quality improvement programs have introduced specialist involvement in primary healthcare teams. However, synthesized evidence is needed to support policy improvements regarding the impact of specialist-primary healthcare coordination on glycemic control in diabetes care. Objective: This systematic review and meta-analysis aimed to assess the effectiveness of specialist involvement in primary healthcare teams on glycemic control of patients with diabetes. Methods: A search of five electronic databases (PubMed, Embase, Web of Science Core Collection, CNKI, and Wanfang Database) was conducted to identify relevant studies published until October 21st, 2023. We assessed the methodological quality of the included studies using the suggested risk of bias criteria for EPOC (Cochrane Effective Practice and Organization of Care). We conducted the certainty assessment using the GRADE guideline. The outcome measured was the HbA1c level. Meta-analyses were performed using random-effects models. Results: A total of 12 studies (7 randomized controlled trials and 5 controlled before-after studies) were included in the meta-analysis. The involvement of specialists in primary healthcare teams was associated with a statistically significant reduction in HbA1c level compared to usual or standard care (mean difference - 0.57, 95% CI: -0.86 to -0.27, I2 = 88.17%). Conclusion: The findings revealed that the interventions might improve the care delivered and patients' health outcomes. However, due to the very low certainty of evidence on the effectiveness on glycemic control, the interventions implemented in the included studies should be employed with caution in future policy-making to achieve improved HbA1c levels. Further research with a more rigorous design is needed to provide evidence of higher certainty and quality. Registration: The systematic review and meta-analysis was registered in the PROSPERO International Prospective Register of Systematic Reviews (registration No. CRD42022384589 available at https://www.crd.york.ac.uk/prospero/#searchadvanced ).
研究证据
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