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论著

基于 FAERS 数据库的美托洛尔不良事件信号挖掘

Signal data mining of metoprolol adverse events based on FAERS

:106-112
 
       目的   挖掘使用美托洛尔后的药物不良事件(ADE),为临床合理用药提供参考意见。方法   对美国食品药品管理局(FDA)FDA药物ADE报告系统(FAERS)数据库进行信号挖掘,采用报告比值比法和比例报告比值法,分析FAERS数据库中2004年第1季度至2023年第2季度关于美托洛尔的ADE报告。   在FAERS数据库中收集到美托洛尔相关ADE共24 184例、667个阳性信号,共涉及27个系统器官分类。ADE严重报告共16 766(占69.33%),ADE报告频次排名前3的分别是头晕、心动过缓、呼吸困难。结论   美托洛尔的不良反应主要集中在全身性疾病及给药部位各种反应、心脏器官疾病和各类损伤。在使用美托洛尔过程中发生ADE时,应该及时采取相应的干预措施。
       Objective  To explore the adverse drug events(ADEs)after the use of metoprolol and provide  reference opinions for clinical rational drug use.Methods  Signal mining was conducted on the FDA Adverse Event Reporting System(FAERS)database in the United States.The  reporting  ratio method and proportional  reporting  ratio method were used to analyze ADEs reports related to metoprolol in the FAERS database from the first quarter of 2019 to the second quarter of 2023.Results  A total of 24 184 cases of metoprolol related ADEs were collected in the FAERS database,with 667 positive signals and a total of 27 system organ class involved.Conclusions  The adverse reactions of metoprolol mainly focus on systemic diseases,various reactions at the administration site,heart organ diseases,and various injuries.It is recommended that timely intervention measures should be taken when ADE occurs during the use of metoprolol.
论著

不同湿化方法对喉癌患者术后气道湿化效果的网状 Meta 分析

Effects of airway humidification for postoperative with laryngeal cancer:A network Meta-analysis

:89-98
 
       目的   评估多种气道湿化方法对喉癌患者术后气道湿化的效果。方法   检索PubMed、Cochrane、Embase、Web of Science、Ovid、中国知网、万方、CBM、Google Scholar等数据库和网站,检索时限为建库至2023年2月。搜集关于喉癌患者术后不同气道湿化方法的随机对照试验,采用JBI2016年随机对照试验RCT评价标准评价文献质量。使用ADDIS1.16.5软件进行网状Meta分析。结果   纳入18篇研究,共1 596例患者。结果显示,镇痛泵持续泵入与注射器间断滴入、喷雾瓶间断喷雾在痰痂形成方面比较差异有统计学意义[OR(95%CI)=537.70(4.18,124 511.88)、0(0,0.52),P<0.05];湿化满意度方面,注射器间断滴入与喷雾瓶间断喷雾比较差异有统计学意义[OR(95%CI)=8.55(1.40,73.35),P<0.05];其余比较差异无统计学意义(P>0.05)。概率排序显示,降低肺部感染、黏膜出血和痰痂形成、痰液黏稠度、咳嗽和湿化不满意的发生,最优方法分别为湿化泵持续泵入、镇痛泵持续泵入、MR400湿化器和输液器持续泵入。结论   综合网状Meta分析及概率排序结果,考虑到喉癌患者术后早期下床活动,推荐便携式持续湿化方法。
       Objective  To access the effects of multiple airway humidification methods for postoperative patients with laryngeal cancer.Methods  PubMed,Cochrane Library,EMbase,Web of Science,Ovid,China National Knowledge Infrastructure,Wanfang database,CBM and Google Scholar were searched systematically from establishment to February 2023,respectively.Related  randomized controlled trials on airway humidification for postoperative patients with laryngeal cancer was analyzed and the quality of the literature was assessed using the JBI 2016 RCT evaluation.The network Meta analysis was performed using ADDIS 1.16.5 softwares.Results  A total of 18 articles and 1596 patients were inciuded.The results showed that the analgesia pump continued to pump into the airway compared with the syringe intermittently drip and the spray bottle intermittent spray was statistically different in the formation of sputum[OR(95%CI)=537.70(4.18,124 511.88),0(0,0.52),P<0.05].In terms of satisfaction of wetness,the difference between the intermittent drop of the syringe and the intermittent spray of the spray bottle was statistically different[OR(95%CI)=8.55(1.40,73.35),P<0.05],the others were not statistically different(P0.05).Probability ranking table shows that the optimal methods were the humidification pump continues to pump into the airway,the analgesia pump continued to pump into the airway,the MR400 humidifier and the infusion set continuously pumped into the airway,which were beneficial to the reduction in pulmonary infection,tracheal mucosal hemorrhage and formation of phlegm callus,the degree of sputum viscosity,cough and unsatisfactory wetness.Conclusions  Based on the comprehensive mesh meta-analysis and probability ranking results,a portable continuous humidification method is  recommended considering the early post-operative activities of laryngeal cancer patients.
论著

癌症患者生命质量测定量表体系之肾癌量表(QLICP-REV2.0)的条目筛选

Items selection on the Specific Module of Quality of Life Instruments for patients with renal cancer (QLICP-REV2.0)

:77-81
 
       目的   开发适合中国肾癌患者的生命质量测定量表的特异模块。   采用议题小组和核心小组的程序化决策方式,提出条目池,形成初步量表,采用医生及患者重要性评分法、相关系数法、变异度法、因子分析法和克朗巴赫系数α对20例肾癌患者和20名医护人员进行的数据进行统计分析。结果   经过上述方法进行筛检,结合专家小组的建议,最终得到含有11个条目的肾癌生命质量测定量表的特异模块。结论 肾癌的生命质量测定量表特异模块严格按照程序执行,具有较好的内容效度。
      Objective  To develop the specific module of the quality of life instruments for patients with renal cancer(QLICP-RE).Methods  With the structured group(nominal group and focus group)methods,the item pool was put forward and a preliminary instrument was formed.The data from 20 renal cancer patients and 20 doctors/nurses were analyzed by statistical procedures.Doctors and patients’ importance rating procedure,correlation analysis,method of coefficient of variation,factor analysis,and Cronbach’s α.Results  By above statistical procedures and advises of expert panel,11-items of the specific module were formed finally.Conclusions  The specific module of QLICP-RE developed on the strict procedures has good content validity and representativeness.
眼科专题:近视防控

西藏林芝市 3 ~ 6 年级学生屈光状态及参数相关性研究

Analysis of refractive status and parameter correlations among three to six grade students in Nyingchi,Tibet

:32-41
 
      目的   分析高原地区3~6年级学生屈光状态及屈光参数之间的关系。方法  2023年9月,采用随机抽样方法选取林芝市波密县某两所小学3~6年级535名学生进行校园筛查。计算并记录裸眼远视力(UCVA),非睫状肌麻痹电脑验光下散光及其轴位、等效球镜(SE)、眼轴(AL)、角膜曲率半径(CR)和眼轴/角膜曲率半径轴率比(AL/CR)。采用SPSS 22.00统计软件分析数据。结果  3~6年级学生AL和AL/CR大体趋势为随年级升高而增长,SE随年级升高而降低。3~6年级学生总体筛查性近视患病率为29.91%,且3~6年级筛查性近视患病率分别为20.35%、25.53%、30.53%和51.38%。总体散光患病率为51.59%,其中顺规散光、逆规散光及斜轴散光分别占90.22%、7.61%及2.17%。视力不良者约40.37%。以非睫状肌麻痹验光SE≤-0.50 D同时UCVA<5.0作为筛查性近视的诊断,AL/CR诊断筛查性近视的灵敏度为0.656、特异度为0.887和Youden指数为0.534,曲线下面积(AUC)为0.802,优于AL评估(AUC=0.764)。结论   高原地区3~6年级学生的筛查性近视患病率随年级升高而快速增长,且散光患病率较高,视力不良者较多。AL/CR值对筛查性近视监测具有一定的临床意义。
      Objective  To analyze the  relationship  between  refractive  status and  refractive  parameters of  students in grades three-six in plateau area.Methods  In September,2023,a random sampling method was used to select 535 students from grades three-six of two primary schools in Bomi County,Nyingchi City,for school screening.Distance uncorrected visual acuity(UCVA),astigmatism and its axis position,equivalent spherical(SE),axial length(AL),corneal radius(CR),and axial length/corneal radius ratio(AL/CR)were calculated and recorded.The data was analyzed using the statistical software SPSS 22.00.Results  The general trend of AL and AL/CR for grade three-six students was increased with grade increasing,while SE decreased with grade increasing.The overall prevalence of screening myopia was 29.91%,and the prevalence of screening myopia in grades three to six was 20.35%,25.53%,30.53% and 51.38%,respectively.The overall prevalence rate of astigmatism was 51.59%,including 90.22%,7.61% and 2.17% for astigmatism with the rule,astigmatism against the rule and oblique astigmatism,respectively.About 40.37% of the students had poor vision.Screening myopia was diagnosed using non-cycloplegic optometry with SE ≤-0.50 D combined with UCVA<5.0.The sensitivity and specificity of AL/CR for screening myopia were 0.656 and 0.887,respectively,with a Youden index of 0.534 and an area under the curve(AUC)of 0.802.This was superior to the AL evaluation,which had an AUC of 0.764.Conclusions  The prevalence of screening myopia increased rapidly with the increase of grade in grade 3 to 6 in plateau area.And there were high prevalence of astigmatism and more poor vision.AL/CR value has a certain clinical significance in the monitoring of screening myopia.
眼科专题:近视防控

羽毛球颠球运动对低年级小学生近视影响的研究

Study on the impact of badminton juggling on myopia in lower grade primary school students

:26-31
 
    目的   研究羽毛球颠球运动对低年级小学生近视的改善效果,为制定儿童青少年近视干预方案提供依据。方法   采用方便抽样方法,抽取广州市1个城区1所小学三年级4个班共182名学生作为研究对象。基线调查完成后,以班为单位,采用随机数字表法将4个班分为干预组(2个班,91例)和对照组(2个班,91例),干预组安排羽毛球颠球项目体育活动,对照组按原教学计划安排非球类常规体育活动。比较两组干预前后筛查性近视率、视力不良率和近视进展程度。结果  干预前两组的年龄、性别、筛查性近视率、视力不良率及近视分级比较,差异均无统计学意义(P>0.05)。两组干预后的等效球镜度数(SE)比较,差异无统计学意义(P>0.05);对照组干预后的裸眼远视力(UDVA)低于干预组,△UDVA、△SE均高于干预组,差异均有统计学意义(P<0.05)。对照组新发筛查性近视率29.13%、累积筛查性近视率49.45%、累积视力不良率68.13%及近视进展程度,均高于干预组新发筛查性近视率7.69%、累积筛查性近视率34.07%、累积视力不良率52.74%及近视进展程度,差异均有统计学意义(P<0.05)。结论   羽毛球颠球运动能降低低年级小学生视力不良进展速度,减少近视的发生率及近视程度,学校可结合引起近视的因素进行灵活应用,以预防近视的发生发展。
      Objective  To study the impact of badminton juggling on the myopia of lower-grade primary school students and to provide a basis for developing myopia intervention strategies for children and adolescents.Methods  By using the convenience sampling method,182 third-grade students from four classes in a primary school in a district of Guangzhou were selected as subjects.After completing the baseline survey,the four classes were divided into an intervention group(2 classes,91 students)and a control group(2 classes,91 students)using a random number table.The intervention group was arranged to participate in badminton juggling sports activities,while the control group followed the original teaching plan without ball games.The study compared the screening rate of myopia,the rate of poor vision,and the degree of myopia progression before and after the study in both groups.Results  On baseline,there were no statistically significant differences between the two groups in terms of age,gender,rate of screening myopia,poor vision,and myopia grading(P>0.05).After 12 months,there was no statistically significant difference in the spherical equivalent(SE) comparison between the two groups(P>0.05).However,the uncorrected distance visual acuity(UDVA) of the control group after 12 months was significantly lower than that of the intervention group,and both △UDVA and △SE were significantly higher than those of the intervention group,with all differences being statistically significant(P<0.05).Incidence of screening myopia in the control group (29.13%),the cumulative rate of screening myopia(49.45%),the cumulative rate of poor vision (68.13%),and the degree of myopia progression was significantly higher than those in the intervention group,which had incidence of screening myopia at 7.69%,the cumulative rate of screening myopia at 34.07%,cumulative rate of poor vision at 52.74%.All these differences were statistically significant(P<0.05).Conclusions  Badminton juggling can slow down vision deterioration,reduce the incidence and severity of myopia in lower grade primary school students.Schools can flexibly apply these findings in conjunction with factors that contribute to myopia to prevent its occurrence and development.
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