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.

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.

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.

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.

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.

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...

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...

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.

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。

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.

Background: The Trans-theoretical Model (TTM) has been applied in numerous empirical studies concerning physical activity (PA) interventions for children and adolescents. Consequently, the aim of this review is to identify and synthesize the evidence regarding the effectiveness of TTM-based interventions in promoting PA behavior change among this demographic, with the goal of informing future research and policy development. Methods: A systematic review was performed followed the PRISMA guideline, protocol was registered in PROSPERO (CRD42023416216). Computer-based searches were conducted in the CNKI, Wan-Fang, VIP, Web of Science (WOS), PubMed, and EBSCO databases to identify relevant literature. Two researchers independently conducted the literature screening and quality assessment. The quality of the randomized controlled trials (RCTs) was evaluated using the Risk of Bias Assessment Tool version 5.1.0, as recommended by the Cochrane Collaboration Network. For quality assessment of quasi experiments (QEs), the Risk Of Bias In Non-randomised Studies-of Interventions (ROBINS-I) tool was employed. Results: A total of 22 articles were included in the systematic review. Stage-matched interventions and interventions designed based on a more complete structure of the TTM are more likely to promote an increase in the actual levels of PA among children and adolescents, as well as to facilitate an increase in their PA stages. Interventions that combine health information and health behavior feedback are more likely to promote an increase in actual PA levels and the advancement of PA stages; while interventions that include PA programs are more likely to facilitate improvements in health indicators. Conclusion: The effectiveness of TTM-based PA behavior change interventions for children and adolescents depends on the specific measures employed. Interventions that are stage-matched and integrate multiple behavior change techniques using the complete TTM structure are more likely to enhance PA and its associated health benefits. However, there are several normative issues that remain. These include the misuse of incremental stages as a substitute for PA, neglect of stage specificity when applying the model, a lack of framework for behavior change techniques in targeted interventions, and an absence of a dynamic feedback process.

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 ).

目的 为临床合理、安全应用度普利尤单抗治疗中重度特应性皮炎（AD）提供循证依据。方法 采用计算机检索PubMed,Embase,The Cochrane Library及中国知网（CNKI）、万方（WanFang）数据库和各国卫生技术评估（HTA）官方网站中自建库起至2023年12月1日关于度普利尤单抗治疗中重度AD的HTA报告、系统评价/Meta分析、药物经济学研究。采用系统性评价方法学质量工具AMSTAR2量表评价系统评价/Meta分析的质量，采用卫生经济学评价报告标准共识（CHEERS）评价药物经济学文献的质量。采用快速HTA法对结果进行描述性分析。结果 共纳入11篇文献，其中系统评价/Meta分析9篇、药物经济学研究2篇。有效性方面，度普利尤单抗较安慰剂/外用糖皮质激素（TCS）可显著改善湿疹面积和严重程度指数（EASI）评分、研究者整体评估（IGA）评分、瘙痒指数（NRS）评分、体表受累面积（BSA）较基线下降的百分比、皮肤病生活质量指数（DLQI）评分、湿疹测量（POEM）评分较基线下降的百分比、AD严重程度积分量表（SCORAD）评分较基线下降的百分比（P <0.0...

目的：评估转移性结直肠癌（metastatic colorectal cancer,mCRC）三线治疗口服药瑞戈非尼（regorafenib,Rego）、呋喹替尼（fruquintinib,Fruq）与曲氟尿苷替匹嘧啶（trifluridine/tipiracil,TAS102）的安全性、有效性与经济性，为临床决策提供循证依据。方法：系统检索HTA机构官方网站、PubMed、Cochrane Library、Embase、Web of Science、中国知网、万方、维普、中国生物医学文献数据库，纳入Rego、Fruq与TAS102用于mCRC三线治疗的系统评价/Meta分析、HTA报告和药物经济学研究，以描述性分析方法研究数据。结果：纳入14篇系统评价/Meta分析和8篇经济学研究。在mCRC三线治疗中，Fruq相比TAS102在无进展生存期和疾病控制率方面的获益更大。三药间的总生存期和客观缓解率相似。对于KRAS野生型患者，Fruq相比其余两药在无进展生存期方面的表现更优，但尚需更丰富的证据进一步验证。三药相比，Rego更易导致肝功能异常，TAS102更易发生白细胞、中性粒细胞减少...

目的 对信息框架效应理论在健康管理领域内的应用进行范围综述，为相关研究者利用信息框架效应理论进行实践研究提供参考。方法 采用Arksey和O’ Malley范围综述的方法，系统检索中国知网、万方、维普、Sinomed、PubMed、Web of Science、Cochrane Library、Embase、CINAHL等国内外数据库，检索时间为建库至2023年12月，收集信息框架效应理论应用于健康管理领域的相关研究。结果 共检索出2 855篇文献，最终共纳入16篇文献。其中英文15篇，中文1篇。基于信息框架效应的健康管理内容要素涉及提供疾病知识、治疗等健康相关信息，自我护理，决策支持3个方面；应用形式涵盖视频、文本信息、电子信息、知识讲座、随访、健康手册、手机短信7种形式；结局指标涉及自我管理行为、身体活动行为、药物和治疗依从性3个方面，健康管理均有积极效果。结论 基于信息框架效应理论的实践研究是可行有效的，能显著提高患者的健康行为和健康信念，应用前景广阔；但我国研究与国外研究尚存在较大差距，我国学者应重视对该理论的解读，并在其指导下启动在健康管理方面的实践研究。

目的：评价注射用乌司他丁(UTI)治疗急性循环衰竭(ACF)的有效性、安全性及经济性，为临床合理用药提供循证依据。方法：在PubMed、the Cochrane Library、Embase、万方数据库、中国知网、中国生物医学文献数据库以及卫生技术评估(HTA)机构官方网站中进行检索，收集关于UTI治疗ACF的系统评价/Meta分析、经济学研究及HTA报告，检索时间为建库至2024年6月。由2名研究者根据纳入与排除标准独立进行文献筛选、质量评价和数据提取。结果：共纳入5篇文献，均为Meta分析，未检索到经济学研究及HTA报告。目前纳入的研究在有效性方面选择炎症介质、多器官功能障碍综合征发生率、肝肾功能指标、心功能及死亡率等指标进行分析，联合应用UTI治疗ACF较单纯使用常规治疗具有明显优势，能显著降低炎症介质水平、改善器官损伤。结论：UTI用于ACF的治疗效果确切，安全性良好。

网络化心理干预近年来逐渐应用于改善丧亲人群的心理健康状况,系统考察其干预效果及其调节因素有助于指导临床实践。这项研究通过文献检索与筛选,选取了47个丧亲人群网络化心理干预研究,其中19项随机对照试验满足了元分析标准(N=1222),元分析共包括68个效应值。结果发现,干预对总体心理健康的效应达到显著的中等水平(g=0.54; 95%CI=[0.39, 0.70]);具体而言,干预对病理性哀伤(g=0.56; 95%CI=[0.39, 0.74])、抑郁(g=0.51; 95%CI=[0.36, 0.67])和创伤后应激(g=0.63; 95%CI=[0.45, 0.81])症状的改善都达到显著的中等效果。在改善总体心理健康水平方面,未使用意义建构、干预次数大于或等于10次和给予治疗反馈的网络化心理干预效果更好,干预频率为一周多于一次的干预效果要好于一周一次。但是,理论取向、干预过程中是否包含暴露练习、认知重构和行为激活的干预策略、是否设置提醒以及脱落率的高低均不存在调节作用。本研究说明网络化心理干预对改善丧亲人群的心理健康状况效果较为理想,并且在不同条件下网络化心理干预具有不同的效果。

Background: Lifestyle interventions have been acknowledged as effective strategies for preventing type 2 diabetes mellitus (T2DM). However, the accessibility of conventional face-to-face interventions is often limited. Digital health intervention has been suggested as a potential solution to overcome the limitation. Despite this, there remains a significant gap in understanding the effectiveness of digital health for individuals with prediabetes, particularly in reducing T2DM incidence and reverting to normoglycemia. Objective: This study aimed to assess the effectiveness of different intervention modes of digital health, face-to-face, and blended interventions, particularly the benefits of digital health intervention, in reducing T2DM incidence and facilitating the reversion to normoglycemia in adults with prediabetes compared to the usual care. Methods: We conducted a comprehensive search in 9 electronic databases, namely MEDLINE, Embase, ACP Journal Club, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Clinical Answers, Cochrane Methodology Register, Health Technology Assessment, and NHS Economic Evaluation Database through Ovid, from the inception to October 2024. This review included randomized controlled trials (RCTs) that studied the effectiveness of lifestyle interventions in adults with prediabetes. The overall intervention effect was synthesized using a random-effects model. The I² statistic was used to assess heterogeneity across the RCTs. We performed a subgroup analysis to explore the effectiveness of digital health, face-to-face, and blended interventions compared with the control group, which received usual care. Results: From an initial 7868 records retrieved from 9 databases, we identified 54 articles from 31 RCTs. Our analysis showed that face-to-face interventions demonstrated a significant 46% risk reduction in T2DM incidence (risk ratio [RR] 0.54, 95% CI 0.47-0.63; I²=43%; P<.001), and a 46% increase in the reversion to normoglycemia (RR 1.46, 95% CI 1.11-1.91; I²=82%; P=.006), when compared with the control group. On the other hand, digital health interventions, compared with the control group, were associated with a 12% risk reduction in T2DM incidence (RR 0.88, 95% CI 0.77-1.01; I²=0.6%; P=.06). Moreover, the blended interventions combining digital and face-to-face interventions suggested a 37% risk reduction in T2DM incidence (RR 0.63, 95% CI 0.49-0.81;I²<0.01%; P<.001) and an 87% increase in the reversion to normoglycemia (RR 1.87, 95% CI 1.30-2.69; I²=23%; P=.001). However, no significant effect on the reversal of prediabetes to normoglycemia was observed from the digital health interventions. Conclusions: Face-to-face interventions have consistently demonstrated promising effectiveness in both reductions in T2DM incidence and reversion to normoglycemia in adults with prediabetes. However, the effectiveness of digital health interventions in these areas has not been sufficiently proven. Given these results, further research is required to provide more definitive evidence of digital health and blended interventions in T2DM prevention in the future. Trial registration: PROSPERO CRD42023414313; https://tinyurl.com/55ac4j4n.

目的:评价德曲妥珠单抗(trastuzumab deruxtecan, T-DXd)在晚期或转移性乳腺癌治疗中的有效性、安全性和经济性。方法:系统检索中英文数据库及卫生技术评估(health technology assessment, HTA)相关网站，遴选相关研究并提取数据，进行描述性统计分析。结果:共纳入5篇HTA报告、19篇Meta分析/系统综述和14篇经济学研究。在人表皮生长因子受体2(human epidermal growth factor receptor 2,HER2)阳性晚期或转移性乳腺癌的二线治疗中，T-DXd对比恩美曲妥珠单抗(trastuzumab emtansine, T-DM1)有效性更佳。T-DXd常见不良事件包括胃肠道反应、血液毒性、疲劳、脱发等，特殊不良事件主要为间质性肺病。由于药品价格限制，对于中国支付者，T-DXd相比T-DM1和化疗方案均不具成本效益。结论:T-DXd有效性良好、安全性可控，暂不具备经济性。

目的 检索、评价和总结出血性脑卒中患者围术期静脉血栓栓塞症（venous thromboembolism,VTE）非药物管理的相关证据，为临床提供参考。方法 按“6S”证据金字塔模型，采用计算机检索BMJ Best Practice(BMJ),UpToDate，乔安娜布里格斯研究所（Joanna Briggs Institute,JBI）循证卫生保健中心数据库，美国国立指南库（national guideline clearinghouse,NGC），英国国家卫生与临床优化研究所指南网（national institute for health and care excellence,NICE），苏格兰院际指南网（Scottish intercollegiate guidelines network,SIGN），加拿大安大略注册护士学会（registered Nurses’Association of Ontario,RNAO）指南网，加拿大心脏与卒中基金会（Canadian Heart and Stroke Foundation,HSF），美国心脏协会/美国脑卒中协会（American Heart Association/American Stroke Association,AHA/ASA），美国神经重症监护学会（Neuro-critical Care Society,NCS），欧洲脑卒中组织（European Stroke Organization,ESO）,Cochrane Library、PubMed,Medline,CNKI,Web of Science,Embase,SinoMed，万方，医脉通，维普数据库，中华医学期刊全文数据库关于出血性脑卒中患者围术期静脉血栓栓塞症非药物管理的相关证据，包括临床实践指南，专家共识，系统评价，证据总结等。检索时限为建库至2024年4月11日。由2名研究人员独立对文献质量进行评价，提取、整合和总结出最佳证据。结果 共纳入23篇文献，包括12篇指南、5篇系统评价、4篇专家共识，2篇证据总结。从多学科团队合作、风险评估与筛查、基础预防、机械预防和健康教育5个方面汇总了31条最佳证据。结论 本研究总结了出血性脑卒中患者围术期VTE非药物管理的最佳证据，可为临床医护人员提供循证依据。