小气道病变曾经是全球呼吸界研究的热点，许多肺功能测定方法和指标被用于小气道功能的诊断，其后热度骤减，最近又引起一些学者的重视。
ObjectiveTo systematically review the clinical efficacy and safety of hyperbaric oxygen therapy as adjunctive treatment for diabetic foot ulcers. MethodsSuch databases as The Cochrane Library (Issue 1, 2014), PubMed, EMbase, CBM, VIP, CNKI and WanFang Data were searched up to January 2014 for randomized controlled trials (RCTs) about hyperbaric oxygen therapy as adjunctive treatment for diabetic foot ulcers. According to the inclusion and exclusion criteria, two reviewers independently screened literature, extracted data, and assessed methodological quality of included studies. Then, meta-analysis was performed using RevMan 5.2 software. ResultsFourteen RCTs involving 910 patients were included. The results of meta-analysis showed that, hyperbaric oxygen therapy combined with routine therapy was superior to routine therapy alone regarding ulcer healing rates (RR=2.16, 95%CI 1.43 to 3.26, P=0.000 3), incidence of major amputation (RR=0.20, 95%CI 0.10 to 0.38, P < 0.000 01), reduction of ulcer area (MD=1.73, 95%CI 1.34 to 2.11, P < 0.000 01), and improvement of transcutaneous oxygen tension (MD=14.75, 95%CI 2.01 to 27.48, P=0.02). However, no significant difference was found between the two group in minor amputation rates (RR=0.70, 95%CI 0.24 to 2.11, P=0.53). In addition, neither relevant serious adverse reaction nor complications were reported when using hyperbaric oxygen therapy as adjunctive treatment. ConclusionCurrent evidence shows that hyperbaric oxygen therapy as adjunctive treatment could improve ulcer healing and reduce incidence of major amputation.
ObjectiveTo investigate the effect of PDCA cycle on the overall nursing care of patients in the hemodialysis center. MethodsTwenty hemodialysis patients between June and July 2014 were randomly selected as the intervention group, and another 20 hemodialysis patients between March and April 2014 were chosen as the control group. We compared the two groups of patients in terms of patients' satisfaction and the overall care quality of the nurses. ResultsOne month after the intervention, patients in the intervention group had a significantly higher satisfaction rate than the control group (P<0.05); Nurses in the intervention group achieved significantly higher scores in basic requirements, basic items and effect evaluation than those in the control group (P<0.05). ConclusionPDCA cycle can effectively improve the overall quality of nursing care in hemodialysis center and improve patients' satisfaction.
Objective To study the effect of comprehensive nursing on the treatment compliance and depression of patients with pulmonary tuberculosis complicated with depression. Methods Fifty-seven patients with pulmonary tuberculosis complicated with depression treated between May 2012 and June 2014 were randomly divided into study group (n=30) which was given comprehensive nursing, and control group (n=27) which accepted routine nursing. The scores of depression, treatment compliance and clinical treatment outcome were compared between the two groups. Results The scores of Hamilton Depression Scale were respectively 19.18±2.36, 18.65±2.61, 17.43±1.78 and 16.57±2.05 at the time of 3, 4, 5 and 6 months after nursing intervention, while the same scores of the control group were 22.05±3.03, 21.88±2.85, 20.96±2.06 and 20.04±1.39. The sputum negative conversion rates in the study group at those time periods were respectively 66.7%, 76.7%, 80.0% and 86.7%, while the rates in the control group were 37.0%, 44.4%, 51.6% and 63.0%. The CT lung lesions absorption rates in the study group were 43.3%, 56.7%, 63.3% and 76.7%, while the rates in the control group were 18.5%, 25.9%, 35.3% and 40.7%. The above indicators between the two groups were all statistically significant (P<0.05). The compliance of treatment in the study group was 90.0%, which was significantly higher than that in the control group (63.0%) (P<0.05). Conclusion Comprehensive nursing can help to improve negative emotion, enhance treatment compliance and clinical treatment effect, and promote the early recovery of patients with pulmonary tuberculosis combined with depression.
Objectives To assess the efficacy and safety of cytidine diphosphate choline for patients with acute stroke. Methods Such databases as PubMed, The Cochrane Library, EMbase, Web of Science, CNKI, VIP Database and Chinese Medical Association Journals were searched from the establishment to September of 2010, and the references of the included literatures were also searched to collect randomized controlled trials (RCTs) of cytidine diphosphate choline for patients with acute stroke. The data were extracted by two reviewers independently in accordance with the inclusion criteria. The quality of included trials was evaluated according to the Jadad scale standard. RevMan5.0 software was used for data analyses. Results Thirteen RCTs involving 2837 patients were included. The results of meta-analyses showed that, there was no significant difference in the mortality or the rate of dependency at the end of follow-up (OR=0.94, 95%CI 0.66 to 1.36, P=0.75) between the cytidine diphosphate choline group and the placebo group. But the total effective rate of the cytidine diphosphate choline group was higher than that of the placebo group with a significant difference (OR=1.72, 95%CI 1.41 to 2.10, Plt;0.000 01). Five trials reported the incidence of adverse reaction of cytidine diphosphate choline treatment which showed the adverse reaction was mild; no severe adverse events (SAEs) were reported and the clinical application was safe. Conclusion The cytidine diphosphate choline is effective and safe for acute stroke. However, it is invalid to reduce the mortality and the rate of dependency at the end of three months’ follow-up.