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Objective@#To systematically evaluate the efficacy of pressure therapy in treating patients with hypertrophic scars by meta-analysis.@*Methods@#Databases including PubMed, Embase, Web of Science, and Cochrane Library were retrieved with the search terms"hypertrophic scar, hyperplastic scar, HTS, pressure therapy, pressure treatment, and the Chinese Journals Full-text Database was retrieved with the search terms in Chinese version"增生性瘢痕,瘢痕增生,肥厚性瘢痕,压力治疗,压力疗法"to obtain the publicly published randomized controlled trials about pressure therapy in the treatment of patients with hypertrophic scar from the establishment of each database to July 2017. The measurement indexes included the effective ratio, Vancouver Scar Scale (VSS) score, scar vascularity, scar hardness, scar pigment, scar thickness, and value of scar color (brightness, red, and yellow). RevMan 5.3 and Stata 12.0 statistical software were used to conduct a meta-analysis of eligible studies.@*Results@#A total of 667 hypertrophic scar patients were enrolled in 11 articles, including 362 patients in pressure therapy group who received pressure treatment and 305 patients in untreated group who received no treatment. The bias risks of the 11 studies included were uncertain. Compared with those of untreated group, the effective ratio of patients in pressure therapy group was significantly increased, with the relative risk of 5.98 (95% confidence interval=1.83-19.46, P<0.01); the VSS score and scar vascularity of patients in pressure therapy group were obviously decreased, with weighted mean differences of -2.24 and -0.66 respectively (95% confidence interval=-4.16--0.33, -1.21--0.12, P<0.05); the scar hardness, scar pigment, scar thickness, and value of scar color (brightness, red, and yellow) of patients in pressure therapy group were not changed obviously (P≥0.05). Significant heterogeneity existed in the included studies of the effective ratio, VSS score, scar vascularity, scar hardness, scar pigment, and scar thickness, P<0.01, I2=90%, 87%, 80%, 93%, 86%, 94%. Pressure range might be the heterogeneity source of effective ratio, and pressure clothing combined with pressure pad therapy might be a heterogeneous source of VSS score. Sensitivity analysis showed that the combined effect size results were stable in the effective ratio and scar pigment, but not stable in the VSS score, scar thickness, scar hardness, and scar vascularity. There was no publication bias in the effective ratio, VSS score, scar hardness, scar pigment, and scar vascularity (P>0.1), while there was publication bias in the scar thickness (95% confidence interval=-19.77--3.30, P<0.1).@*Conclusions@#Compared with patients without treatment, in the treatment of hypertrophic scars, pressure therapy can obviously increase the effective ratio, reduce the VSS score and scar vascularity, but can not obviously improve the scar hardness, scar pigment, scar thickness, and value of scar color (brightness, red, and yellow).
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OBJECTIVE@#To investigate the current status on knowledge for unintentional injury and risky behavior among school-age children in Changsha, China, and to provide scientific evidence for the preventive strategies. @*METHODS@#A cross-sectional study was conducted on 866 students who were between 6 and 12 years old in Changsha. Two primary schools were selected by stratified cluster random sampling from all primary schools of Changsha city to collect the information regarding knowledge for unintentional injury and risky behavior occurring in the 6-month period before the survey. @*RESULTS@#The mean score for knowledge of unintentional injury was 11.83±2.38. The levels of knowledge for unintentional injury differed significantly in child's age, parents' education background and child's injury history (P0.05). @*CONCLUSION@#It is a common phenomenon in school-age children who are lack of the knowledge for unintentional injury and risky behavior. This study provides useful information on the risk factors for unintentional injury and risky behavior, which would be significant for prevention program.
Subject(s)
Child , Humans , Accidents , China , Cross-Sectional Studies , Parents , Risk Factors , Risk-Taking , Schools , Students , Surveys and Questionnaires , Wounds and InjuriesABSTRACT
OBJECTIVE@#To evaluate the predictive accuracy of the triage early warning score (TEWS) in the prognosis and emergency treatment for trauma patients admitted to the emergency department (ED).@*METHODS@#A total of 456 trauma patients (>12 years old) admitted to ED at an education and research hospital in approximately 4 months were prospectively studied. Th e TEWS was recorded in all patients. Th e primary end-point was during 28 days and the emergency responses (such as cardiopulmonary resuscitation/electrical defibrillation, mechanical ventilation) in the ED.@*RESULTS@#Patients with TEWS less than or equal to 9, from 10 to 13, or greater or equal to 14 had mortality rates of 0.98%, 52.63%, or 80%, respectively. An increase in 1 point within the range of 17-point TEWS would be associated with an odds ratio (OR) of 2.14 for death [95% confidence interval (CI): 1.759 to 2.604]. In predicting mortality rates during 28 days, the cut-point was greater than 8, the sensitivity was 87.10% (95% CI: 70.2% to 96.4%), the specificity was 92.47% (95% CI: 89.5% to 94.8%), and the areas under the receiver operating characteristic curves (AUCROC) was 0.929 (95% CI: 0.902 to 0.951). Th e AUCROC of TEWS in predicting the emergency responses for CPR/electrical defibrillation application or mechanical ventilation was 0.969 (95% CI: 0.949 to 0.983) or 0.897 (95% CI: 0.865 to 0.923), respectively.@*CONCLUSION@#TEWS is effective in predicting the prognosis and emergency treatment for trauma patients admitted to ED.