Objective To identify the best therapy regime for dyspnea in an end-stage cancer patient.Method We searched The Cochrane Library (Issue 2, 2006), SUMsearch (1978 to 2006) and MEDLINE (1978 to 2006), and identified 4 systematic reviews and 28 randomised controlled trials. We critically assessed the quality of these studies. Result Evidence supported the use of breathing exercise, desensitisation, oral or parenteral opioids and antianxiety drugs to pall iate breathlessness. Patients with hypoxemia were found to benefit from oxygen therapy. Conclusions Physiotherapy, psychotherapy, oxygen therapy, opioids and antianxiety drugs can be considered in treating cancer patients with dyspnea.
Objective To study the effectiveness, safety and tolerance of testosterone undecanoate （TU） in improving exhaustion and quality of life （QOL） of the elderly male patients with chronic disease in advanced stage. Methods Using a simple randomized controlled trial design, eighty patients were randomized into two groups. The treatment group took routine therapy and TU and the control group with routine therapy alone. Results 1. Baseline characteristics in both groups were similar. 2. The PADAM grade decreased, and the QOL scale increased in the treatment group （P〈0.05 ）. 3. Serum total testosterone in the treatment group rose, upper arm circumference and right hand grip improved （P〈0.05 ）. 4. There were no significant differences in adverse effects between both groups. Conclusions TU can improve the clinical health status in the elderly male patients with chronic disease in advanced stage and increase serum testosterone level, there is a satisfactory tolerances and few adverse reactions.
Objective To evaluate the rationality of drug treatment for cardiovascular diseases in aged people and the effects of evidence-based practice. Methods Descriptive study was conducted to compare the therapies for the patients suffering from cardiovascular diseases before and after evidence-based practice by investigating drug use during 1998-1999 (211 cases) and 2002-2003 (211 cases). Results Among antihypertensive drugs, the ACEIs and diuretics played a more important role than before. CCBs and ACEIs were still the most frequently used drugs, and drug combination was more common, comparing to that before evidence-based practice. Lipid lowering drugs and ACEIs were used more common in coronary heart disease. Quality of life of patients was more emphasized and combination use of anti-anxiety drugs was adopted. When treating heart failure, β-receptor blockers, aldadinc and ACEIs were more frequently used. Conclusions After evidence-based practice, drug use is much more based on evidence instead of experience and textbook. As a result, the rate of reaching ideal blood pressure is higher than before. The rate of rational drug use before and after evidence-based practice has increased from 42% to 78%, respectively.
【摘要】 目的 應用調查問卷分析培訓前后成都市社區醫生對肺炎球菌疫苗的認識，為推動社區肺炎球菌疫苗接種奠定基礎。 方法 對215名成都市社區醫生進行肺炎球菌疾病及預防知識的培訓，并在培訓前后行問卷調查，回收問卷并分析。 結果 經培訓，社區醫生提高了對肺炎球菌疾病及疫苗接種知識的掌握程度，加深了對肺炎球菌疾病及疫苗接種重要性的認識。 結論 對社區醫生進行肺炎球菌相關知識的培訓，有利于提高社區醫生對肺炎球菌疫苗接種推薦的專業性和成功率。【Abstract】 Objective To know the community doctors’ understanding of pneumococcal vaccine before and after the education via questionnaire. Methods A total of 215 community doctors in Chengdu were educated in pneumococcal disease and the prevention knowledge. Questionnaire investigation was performed before and after the education and the results were analyzed. Results After the education, the acknowledgement of pneumococcal vaccination of the community doctors was improved. Conclusion The education of the knowledge of pneumococcal vaccine for the community doctors helps to improve the acknowledgement of pneumococcal vaccination.
Objective To evaluate the effectiveness, safety, cost and optimal dosing regimen of bone morphogenetic protein (BMP) used in the lumbar spine arthrodesis. Methods We formulated the clinical questions according to the PICO principle. We searched the ACP Journal Club (1991 to February 2008), The Cochrane Library (Issue 4, 2007) and PubMed (1990 to February 2008) as well as other relevant databases. The evidence retrieved was critically appraised. Results Current evidence showed that BMP was a satisfactory and safe behavior in lumbar arthrodesis. Its cost was equal to that of autogenous iliac bone graft. The types of BMP currently used in clinical practice are BMP-2 and BMP-7. Finished product of fixed composition ratio was recommended in anterior lumbar inter-body fusion, while in posterolateral fusion, 20mg of BMP-2 or 3.5mg of BMP-7 for each side was recommended, with proper carrier according to the place where it was used. Conclusion BMP may be introduced to China for lumbar spine arthrodesis. Before it is applied extensively, further large-scale, high-quality randomized controlled trials are needed. Meanwhile, more research is necessary to determine the proper dosage and preparation form for the dominant Chinese population.
Cirrhosis is an end stage of condition of various liver diseases with specific clinic and pathologic process. The incidence is high and it seriously affects the quality of life for patients. In order to obtain the best prevention and treatment for end-stage cirrhosis, we searched The Cochrane Library (Issue 3, 2004), SUMsearch (1981~2004) and MEDLINE (1981~2004), and identified 15 systematic reviews and 65 randomized controlled trials. We critically assessed the quality of studies. The results showed the principal treatment of cirrhosis was to deal with complications, such as the prevention and treatment of variceal bleeding, the treatment of ascites etc.
目的 全面了解空巢老人認知功能障礙危險因素。 方法 檢索Ovid Medline、Ovid Embase、Cochrane 圖書館及中國生物醫學文獻數據庫（光盤版）等數據庫，檢索時間為各數據庫建庫至2011年12月31日。文獻納入標準：年齡≥60歲或作者指明以老人為研究對象；居住狀態包括老人無子女或未與子女同住。兩位研究者獨立地對符合納入標準的試驗進行質量評價和資料提取。 結果 4篇文獻（共1 485例）分析了養老機構老人認知障礙的影響因素，合并分析顯示年齡[WMD=2.10歲，95%CI（1.28，2.92）歲，P＜0.000 01]、女性[OR=3.61，95%CI（1.63，8.01），P=0.002]、失能[SMD=0.78，95%CI （0.36，1.20），P=0.000 2]、軀體健康[SMD=0.06，95%CI （0.01，0.11），P=0.02]、未婚/寡居[OR=3.16，95%CI（1.43，6.96），P＜0.000 01]、文盲[OR=2.94，95%CI（1.06，8.14），P=0.04]、社會支持差[OR=7.29，95%CI（2.27，23.39），P=0.000 8]、朋友關系差[OR=2.14，95%CI（1.35，3.39），P=0.001]、參加活動少[OR=2.11，95%CI（1.36，3.29），P=0.000 9]及遠離子女[OR=5.73，95%CI（3.33，9.87），P＜0.05]是其危險因素。 結論 養老機構老人認知功能障礙的危險因素包括老年、女性、文盲、未婚/寡居、社交差、與子女距離遠、軀體健康水平差及抑郁等。結果僅來源于較少的研究和數量較小的對象，且均為橫斷面研究，需謹慎看待上述結論。