Objectives To evaluate the effectiveness of cognitive behavioral therapy (CBT) treating insomnia in patients with breast cancer. Methods Such databases as CENTRAL (April 2011), The Cochrane Library (2005 to November 2011), MEDLINE (1948 to April 2011), EMbase (Junuary 1966 to April 2011), CINAHL (Cumulative Index to Nursing and Allied Health Literature, 1982 to April 2011), CBM (1978 to 2011) and CNKI (1979 to 2011) were searched to collect the randomized controlled trials (RCTs) about CBT treating insomnia in patients with breast cancer. Literature screening, data extraction and methodological quality assessment of the included studies were conducted according to the inclusion and exclusion criteria. Then RevMan 5.0 software was used for meta-analysis. Results A total of 5 RCTs were included. The results of meta-analysis showed that, compared with the control group, the CBT group was higher in the score of subjective sleep efficiency; however, it was lower in the subjective sleep onset latency. There were no significant differences between the two groups in the sleep efficiency, total sleep time, sleep onset latency and wake time after sleep onset measured by hypnocinematograph. Conclusion Cognitive behavioral therapy may improve the subjective sleep efficiency and sleep quality, and shorten the sleep onset latency in patients with breast cancer. However, its effect of improving objective sleep quality is still unverifiable at present. It suggests the following measures should be taken for providing better evidences: increasing sample size, adopting blind methods, confirming allocation concealment, and using unified hypnocinematograph.
Objective To explore the incidence, age distribution and change tendency of female breast cancer in urban Shenyang from 2000 to 2009. Methods The incidence data of female breast cancer recorded in Shenyang Center for Disease Control and Prevention from 2000 to 2009 were collected, and the incidence and standardized incidence of breast cancer were analyzed by using SPSS 16.0 software. The incidence trend was analyzed by means of χ2 trend test and linear regression. Results The annual average crude incidence rate of female breast cancer in urban Shenyang from 2000 to 2009 was 46.03/100 000, while the annual average standardized incidence rate was 35.63/100 000, increased by 160.41% and 109.39% respectively during past 10 years, and the annual average increase was 11.22% and 8.56%, respectively. Both crude incidence rate and standardized incidence rate were in increasing trends with statistical significance (Plt;0.001). The crude incidence rate of the female at age of 50-64 showed a perpendicular rise trend, increased by 271.97%, and the annual average increase was 15.72%. The χ2 trend test and linear regression showed a significant difference (χ2=276.743, P=0.000; y= –22 355.560+11.205x, P=0.000). Conclusion The incidence of female breast cancer in urban Shenyang tends to rise with a younger-aged trend, and the female at age of 50-64 are commonly affected.
Objective To systematically review the clinical value of color Doppler ultrasonic for diagnosing female breast cancer. Methods We electronicaaly searched the databases including The Cochrane Library (Issue 2, 2013), EMbase, PubMed, CNKI, WanFang Data, MedaLink ,VIP and CBM for diagnostic tests on breast cancer diagnosed with color Doppler ultrasonic vs. with pathological biopsy (golden criteria) from 1982 to the March, 2013. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of the included studies according to QUADAS items. The Meta-DiSc software (version 1.4) was used to conduct pooling on sensitivity, specificity, positive likelihood radio, and negative likelihood radio. Heterogeneity test was performed and the summary receiver operating characteristic curve (SROC) was drawn for area under the curve (AUC). Results A total of 25 studies involving 3 274 patients were included. The results of meta-analysis showed that, SPE, SEN, +LR, −LR and DOR were (0.76, 95%CI 0.74 to 0.78), (0.80, 95%CI 0.78 to 0.82), (3.58, 95%CI 2.63 to 4.87), (0.28, 95%CI 0.22 to 0.35) and (13.76, 95%CI 8.47 to 22.36), respectively. The AUC of SROC curve was 0.865 7. Conclusion Current evidence shows that color Doppler ultrasonic has high sensitivity (80%) and high specificity (76%) in the diagnosis of high-frequency Ultrasound. The positive rate in the breast cancer group is 13.76 times as high as that in non-breast cancer, which indicates color Doppler ultrasonic has good diagnostic value for breast cancer.
Objective To evaluate the effectiveness of exercise and rehabilitation program in improving shoulder function and quality of life for breast cancer patients after mastectomy. Method We searched the Cochrane Database of Systematic Reviews, JBI Database of Systematic Reviews, MEDLINE (1966 to 2008), EMbase (1989 to 2007), CINAHL (Cumulative Index to Nursing and Allied Health literature), CBMdisc (1978 to 2008), and CNKI (1994 to 2008) to collect randomized controlled trials (RCTs). The quality of RCTs was critically appraised and data were extracted by 3 reviewers independently. Meta-analyses were conducted for the eligible RCTs. Result Nineteen RCTs were included. Stepwise upper extremity exercise and body exercise were reported in the rehabilitation program. Nine studies indicated that the rehabilitation program significantly improved the shoulder function of breast cancer patients after mastectomy. Four studies demonstrated its effect on cardiopulmonary function and body endurance. Six RCTs proved the effect of rehabilitation program on health-related quality of life and fatigue alleviation. Conclusion Rehabilitation program consisting of stepwise upper extremity exercise and full-body exercise is effective in improving the shoulder function and enhancing the quality of life of breast cancer patients after mastectomy. It also has a positive effect in reducing fatigue for those undergoing chemotherapy or radiotherapy.