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Objective To retrieve,evaluate and summarize the best evidence of prehabilitation interventions of patients undergoing elective gastrointestinal surgery,so as to provide references for clinical application.Methods All evidence on prehabilitation interventions of patients undergoing elective gastrointestinal surgery was retrieved from databases and websites including UpToDate,JBI Library,PubMed,CINAHL,Cochrane Library,CNKI,CBM,Wanfang and NGC,SIGN,NICE,NZGG,RNAO,ONS,ESPEN,CGC,CACA,CAMCSPEN.The retrieved evidence inclu-ded guidelines,clinical decisions,expert consensuses,evidence summaries,systematic reviews,randomized controlled trials,et al.The retrieval time limit was from the database construction to March,2022.Results Totally 21 articles were involved,including 6 guidelines,8 expert consensuses,2 meta-analyses and 5 systematic reviews.The overall quality of the included literature was high.Finally,22 pieces of best evidence about nutritional support,exercise training and psychological intervention were summarized.Conclusion The best evidence for prehabilitation intervention of patients undergoing elective gastrointestinal surgery summarized in this study is scientific and practical to a certain extent,which can provide bases for clinical workers to carry out prehabilitation clinical practice.
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Objective·To investigate the level of stoma adaptation in patients with permanent enterostomy and its influencing factors.Methods·In this cross-sectional study,260 patients with permanent enterostomy from North Campus in Hongkou and South Campus in Songjiang of Shanghai General Hospital,Shanghai Jiao Tong University School of Medicine were recruited by convenience sampling approach from January to December,2022.The level and the influencing factors of stoma adaptation were investigated by general information questionnaire,Chinese version of Ostomy Adjustment Inventory-20(OAI-20),Hospital Anxiety and Depression Scale,Stoma Self-Efficacy Scale,Body Image Scale,and The Revised Dyadic Adjustment Scale.Statistical description used mean and standard deviation,frequency and percentage.T test,ANOVA,Spearman correlation and multiple linear regression analyses were preformed to explore the influencing factors of the level of stoma adaptation.Results·The mean score of OAI-20 was(42.28±11.47).One-way ANOVA results showed the effects of registered residence(P=0.001),monthly income(P=0.000)and the ostomy-related complications(P=0.000)on the OAI-20 score were statistically significant.Spearman correlation analysis results showed that the OAI-20 score was positively correlated with stoma self-efficacy and marital adjustment score(r=0.713,P=0.000;r=0.645,P=0.000),but negatively correlated with anxiety and depression and body image score(r=-0.391,P=0.000;r=-0.523,P=0.000).Four of the eleven variables,ostomy-related complications,anxiety,self-efficacy of ostomy caring and marital satisfaction,were selected by the multiple linear stepwise regression analysis,and could explain 59.8%of total variance(P=0.000).Conclusion·Most patients with permanent enterostomy have a low level of adaptation.Ostomy-related complications,anxiety,self-efficacy of ostomy caring and marital satisfaction are the main influencing factors of the level of stoma adaptation.
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Public health interventions refer to a series of organized and specific measures implemented in specific situations to achieve goals related to improving health, preventing and controlling diseases, and more. As research on intervention measures has deepened, the classification of public health interventions has gradually developed, clarifying the nature, categories and intervention targets of these measures. This typological study can help standardize the concepts of public health interventions, develop, select, and evaluate the effectiveness of intervention measures, and improve the effectiveness of public health actions. This paper reviews the main international classification models of intervention measures, analyzes and summarizes five classification methods of public health interventions, namely, based on goals, nature, objects, hierarchies, and modes of action, and introduces relevant cases. The paper proposes that China should conduct further in-depth and systematic research on public health interventions, develop evidence-based intervention measures and practices, promote the effective transformation of intervention measures and results, and facilitate the development of public health.
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Humans , Public Health , ChinaРеферат
Diabetes is one of the most important non-communicable chronic diseases. Although a large amount of clinical evidence on the effectiveness of diabetes prevention and treatment interventions has been established, the current quality of care and results are still insufficient. Implementation Research can bridge the gap between research and practice. Implementation Research on diabetes management can clarify what is effective and what is ineffective in management, and promote the transformation of complex, multi-component interventions into medical practice faster and more effectively. This paper reviews the main research contents and application of implementation research of diabetes management at home and abroad, aiming to provide reference for related research and promote the application of implementation research in diabetes management in China.
Тема - темы
Humans , Self Care/methods , China , Diabetes Mellitus/prevention & controlРеферат
Public health interventions refer to a series of organized and specific measures implemented in specific situations to achieve goals related to improving health, preventing and controlling diseases, and more. As research on intervention measures has deepened, the classification of public health interventions has gradually developed, clarifying the nature, categories and intervention targets of these measures. This typological study can help standardize the concepts of public health interventions, develop, select, and evaluate the effectiveness of intervention measures, and improve the effectiveness of public health actions. This paper reviews the main international classification models of intervention measures, analyzes and summarizes five classification methods of public health interventions, namely, based on goals, nature, objects, hierarchies, and modes of action, and introduces relevant cases. The paper proposes that China should conduct further in-depth and systematic research on public health interventions, develop evidence-based intervention measures and practices, promote the effective transformation of intervention measures and results, and facilitate the development of public health.
Тема - темы
Humans , Public Health , ChinaРеферат
Diabetes is one of the most important non-communicable chronic diseases. Although a large amount of clinical evidence on the effectiveness of diabetes prevention and treatment interventions has been established, the current quality of care and results are still insufficient. Implementation Research can bridge the gap between research and practice. Implementation Research on diabetes management can clarify what is effective and what is ineffective in management, and promote the transformation of complex, multi-component interventions into medical practice faster and more effectively. This paper reviews the main research contents and application of implementation research of diabetes management at home and abroad, aiming to provide reference for related research and promote the application of implementation research in diabetes management in China.
Тема - темы
Humans , Self Care/methods , China , Diabetes Mellitus/prevention & controlРеферат
Objective:To establish ICU transitional care program.Methods:Delphi method was used to interview 25 experts and two rounds of mailing interview were taken.Results:The returning rates of two rounds of mailing were both 100%. The authority coefficient of the experts was 0.808, and coordination coefficient of experts ′ opinion was 0.179. The program included 7 first level indexes, 8 second level indexes, and 40 third level indexes, including purpose, nursing object, implementer, time point, place, nursing content and evaluation indicators. According to different time points, it was divided to three phases: before, during, and after transfer from the ICU to a general ward. Conclusions:The program developed in this study is scientific and reliable, which can provide some reference for the practice and research of ICU transitional care in China.
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<p><b>OBJECTIVE</b>To evaluate the safety and feasibility of simultaneous bilateral carotid stenting for treating patients with bilateral atherosclerotic carotid stenosis.</p><p><b>METHODS</b>The clinical data of 39 consecutive patients with bilateral atherosclerotic carotid stenosis undergoing simultaneous bilateral carotid artery stenting in Fuwai hospital from January 2005 to December 2009 were collected and analyzed retrospectively. The reduction of the angiographic diameter stenosis after stenting and clinical outcomes of 30 days after stenting including hyperperfusion syndrome, hemodynamic depression, stroke, myocardial infarction and death were assessed.</p><p><b>RESULTS</b>The patients were 43 - 78 (65.9 ± 8.5) years old, and there were 25 (64.1%) male. Carotid stenting procedure success rate was 100%. Distal embolic protection devices were used in all patients, and 20 (51.3%) out of 39 patients underwent coronary artery bypass surgery after carotid stenting. The angiographic diameter stenosis reduced from (87.0 ± 5.8)% to (10.2 ± 5.6)% after stenting (P < 0.01). Up to 30 days after carotid artery stenting, the incidence of hyperperfusion syndrome, hemodynamic depression, minor stroke, major stroke, myocardial infarction and death was 2.6% (1/39), 28.2% (11/39), 5.1% (2/29), 0, 2.6% (1/39), 2.6% (1/39), respectively.</p><p><b>CONCLUSION</b>The data show that simultaneous bilateral carotid stenting is a technically feasible and safe alternative for patients with severe bilateral atherosclerotic carotid stenosis.</p>
Тема - темы
Adult , Aged , Female , Humans , Male , Middle Aged , Angioplasty, Balloon , Carotid Arteries , Carotid Stenosis , General Surgery , Retrospective Studies , Stents , Treatment OutcomeРеферат
<p><b>OBJECTIVE</b>To investigate the effect of mannatide injection (MI) in enhancing the efficacy of radiotherapy in two therapeutic schedules in mice bearing Lewis lung cancer.</p><p><b>METHODS</b>C57BL/6 mice bearing Lewis lung cancer xenograft were assigned randomly into control group, fractionated schedule (FS) group, nonfractionated schedule (NFS) group, MI group, FS+MI group, and NFS+MI group (n=10). MI (4.5 mg/kg) or saline was given intraperitoneally for 14 consecutive days in the corresponding groups. Radiation with 8 MeV electron beam was delivered in a single 4 Gy dose in NFS and in 4 fractions (total dose 4 Gy) in FS. Tumor inhibition rate and the spleen and thymus index were calculated after the treatments.</p><p><b>RESULTS</b>MI significantly enhanced the efficacy of radiotherapy with a tumor inhibition rate reaching 70% in FS+MI group (P<0.01). FS resulted in a significantly higher tumor inhibition rate than NFS (P<0.05), but the rates were comparable between FS+MI and NFS+MI groups. The spleen index and thymus indices were significantly higher in FS+MI and NFS+MI groups than in FS and NFS groups (P<0.05).</p><p><b>CONCLUSION</b>MI can enhance the efficacy of radiotherapy with different therapeutic schedules in mice bear Lewis lung cancer, and MI plus fractionated radiation produces the optimal effect.</p>
Тема - темы
Animals , Male , Mice , Biological Products , Therapeutic Uses , Carcinoma, Lewis Lung , Drug Therapy , Radiotherapy , Combined Modality Therapy , Dose Fractionation, Radiation , Dose-Response Relationship, Radiation , Mice, Inbred C57BL , Neoplasm Transplantation , Radiation-Sensitizing Agents , Therapeutic Uses , StreptococcusРеферат
<p><b>OBJECTIVE</b>To study the cost-effectiveness, benefit and utility of infant hepatitis B vaccination in Shanghai from 1992 to 2001.</p><p><b>METHODS</b>To calculate the cost of hepatitis B vaccination by cost analysis method. Both the numbers of persons with HBsAg positive and patient with hepatitis B, cirrhosis and liver cancer decreased as the index of direct effect. To study the sick-time and the cost of treating hepatitis B, cirrhosis and liver cancer patients, a face to face questionnaire was used and quasi method was adopted to understand the effect of cure and the course of hepatitis B. The cost benefit analysis method was also used to calculate the cost benefit of HBV vaccine. The disability adjusted life years (DALY) was regarded as an index of utility to measure the disease burden.</p><p><b>RESULTS</b>Input of 501,129.49 Yuan might have the result of reducing one liver cancer patient, ten cirrhosis patients, one hundred chronic hepatitis B patients and one thousand HBsAg positive people. The cost of hepatitis B vaccination was 0.24 hundred million Yuan during the past ten years in Shanghai, which had obtained the total benefit value of 41.22 hundred million Yuan, with a cost benefit ratio of 1:172 Yuan. It was estimated that the total disease burden of hepatitis B, cirrhosis and liver cancer patients was 59,762.55 DALY in order to reduce one DALY loss cost of 402.50 Yuan.</p><p><b>CONCLUSION</b>HBV vaccine inoculation in infants seemed to be a low-cost input and high-effect output strategy.</p>