Mild traumatic brain injury has a large number of patients in China. In recent years, studies have pointed out that the return to work is a key goal for rehabilitation, indicating that patients can start integrating into society again and resume normal work and life as soon as possible, which has a positive impact on their rehabilitation. This article summarizes the relevant factors that affect the return to work from four aspects: individual, disease, occupation, and social support, and introduces intervention measures such as follow-up and health education, neuromodulatory technology, symptom management, social support, cognitive and occupational rehabilitation, and multidisciplinary occupational rehabilitation, aiming to provide a reference for promoting the research and development of patients with mild traumatic brain injury returning to work in China.
Objective To evaluate the effect of exogenous melatonin and its analogues on the prevention of delirium in critically ill patients by meta-analysis. Methods Randomized controlled trials of exogenous melatonin and its analogues in the prevention of delirium in critically ill patients were searched by computer from the Cochrane Library, PubMed, Web of Science, Embase, China National Knowledge Infrastructure, Chongqing VIP, Wanfang, and SinoMed databases. The trial group was treated with melatonin or its analogues, while the control group was treated with placebo. The retrieval period was from the establishment of database to January 14th, 2021. Two researchers independently evaluated the literature quality, and meta-analysis was performed using RevMan 5.4 software. Results A total of 11 randomized controlled trials containing 1177 patients were enrolled, including 588 patients in the trial group and 589 patients in the control group. The results showed that exogenous melatonin and its analogues could reduce the occurrence of delirium in critically ill patients [odds ratio (OR)=0.45, 95% confidence interval (CI) (0.22, 0.91), P=0.03] and shorten the time of mechanical ventilation [standard mean difference (SMD)=−0.49, 95%CI (−0.94, −0.03), P=0.04], while might not affect the mortality rate [OR=0.73, 95%CI (0.46, 1.17), P=0.19] or length of intensive care unit stay [SMD=−0.05, 95%CI (−0.26, 0.15), P=0.61]. Conclusions The current evidence shows that exogenous melatonin and its analogues have some effect on reducing the occurrence of delirium and shortening the duration of mechanical ventilation in critically ill patients, and have no significant effect on reducing the mortality or length of intensive care unit stay. The above conclusions need to be confirmed by more high-quality studies.
ObjectiveTo systematically review the efficacy of pidotimod in children.MethodsPubMed, The Cochrane Library, EMbase, CNKI, CBM, VIP and WanFang Data databases were searched online to collect randomized controlled trials (RCTs) on pidotimod in children from inception to January, 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 310 RCTs involving 30 525 children were included. The results of meta-analysis showed that, compared with conventional therapy, conventional therapy combined with pidotimod could not improve the efficacy of children with respiratory infections (RR=1.78, 95%CI 0.99 to 3.20, P>0.05). However, pidotimod could significantly reduce the number of respiratory tract infection (MD=−2.79, 95%CI −3.12 to −2.46, P<0.05), shorten the time of respiratory tract infection (MD=−4.15, 95%CI −4.72 to −3.58, P<0.05), and the time of fever (MD=−1.47, 95%CI −1.77 to −1.17, P<0.05) in recurrent respiratory tract infection. Pidotimod could also reduce the time of fever (MD=−0.90, 95%CI −1.60 to −0.20, P<0.05) in children with mycoplasma pneumoniae pneumonia, the time of fever (MD=−1.51, 95%CI −1.91 to −1.11, P<0.05) in children with hand-foot-mouth disease, and reduce the incidence of anaphylactoid purpura followed up for 6 months (RR=0.42, 95%CI 0.30 to 0.61, P<0.05) in children with anaphylactoid purpura. However, there was no significant difference between two groups in the recurrence of asthma for 1 year follow-up (RR=0.80, 95%CI 0.60 to 1.06, P>0.05).ConclusionCurrent evidence shows that pidotimod may be effective for children with respiratory tract infection, asthma, hand-foot-mouth disease, could reduce disease relapse and relieve symptoms related to illness.