Objective To systematically review the efficacy and safety of polyethylene glycol and sodium phosphate in bowel preparation of capsule endoscopy. Methods We searched CNKI, CBM, WanFang Data, PubMed, EMbase, and The Cochrane Library (Issue 6, 2016) up to June 2016, to collect randomized controlled trials (RCTs) about polyethylene glycol and sodium phosphate in bowel preparation of capsule endoscopy. Two reviewers independently screened literatures, extracted data and assessed the risk of bias of included studies, and then meta-analysis was performed by using RevMan 5.0 software. Results A total of six RCTs involving 531 patients were included. The results of meta-analysis showed that: compared with the sodium phosphate solution group, the polyethylene glycol solution group had poor intestinal cleansing effect (OR=0.43, 95%CI 0.21 to 0.88,P=0.02), higher incidence of adverse reaction (OR=3.20, 95%CI 1.13 to 9.06,P=0.03); but shorter gastric retention time (OR=–11.61, 95%CI –13.71 to –9.51,P<0.000 01) and residence time in the small intestine (OR=–4.17, 95%CI –7.74 to –0.60,P=0.02). Conclusion The efficacy of oral polyethylene glycol is poor in cleaning effect and adverse reaction than sodium phosphate solution, but better in the digestive tract residence time for capsule endoscopy. Due to the limited quality and quantity of included studies, the above conclusion is still needed to be proved by more high-quality studies.
Objective To evaluate the effect of nursing interventions on the medical behavior of diabetic patients. Methods We searched CMB (1978 to September 2007), CNKI (1994 to September 2007), VIP (1989 to September 2007) and Papers on Academic Conference of China (1989 to September 2007), and hand-searched relevant journals. We identified randomized controlled trials (RCTs) and quasi-RCTs of nursing interventions plus routine therapy versus simple routine therapy for diabetic patients. The methodological quality of included studies was assessed and data was extracted and analyzed by using The Cochrane Collaboration’s RevMan 4.2.10 software. Results In total, 10 RCTs and 2 quasi-RCTs were included. Two of these studies described blinding. The quality of the included trials was low. Meta-analyses showed that nursing interventions significantly improved medication compliance (RR 1.33, 95%CI 1.21 to 1.45), medical behaviors of physical therapy (RR 1.48, 95%CI 1.30 to 1.69), diet control (RR 1.54, 95%CI 1.39 to 1.71), blood glucose monitoring (RR 1.56, 95%CI 1.41 to 1.72) and regular inspection (RR 1.66, 95%CI 1.41 to 1.96) in patients with diabetes. Conclusion Nursing interventions can improve the medical behavior of diabetic patients, increase patient-controlled capacity and enhance awareness of diabetes. It is also beneficial for blood glucose control and stability.
Objective To systematically review the efficacy of noninvasive positive pressure ventilation (NPPV) by helmet in adults with acute respiratory failure. Methods Randomized controlled trials (RCTs) or cohort studies about noninvasive positive pressure ventilation (NPPV) by helmet in adults with acute respiratory failure were retrieved in PubMed, The Cochrane Library (Issue 11, 2016), Web of Science, EMbase, CBM, CNKI and WanFang Data databases from inception to November 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Stata 12.0 software was then used to perform meta-analysis. Results A total of eight studies were included. The results of meta-analysis showed that, NPPV by helmet could significantly reduce the carbon dioxide partial pressure (cohort study: SMD=–0.46, 95%CI –0.75 to –0.18, P=0.001), tracheal intubation rate (RCT: OR=0.36, 95%CI 0.17 to 0.77, P=0.008) and hospital mortality (RCT: OR=0.48, 95%CI 0.24 to 0.98, P=0.044), improve the positive end expiratory pressure (RCT: SMD=1.27, 95%CI 0.87 to 1.67, P<0.05) and respiratory status (RCT: SMD=–0.45, 95%CI –0.81 to –0.08,P=0.017). There was no significant difference in the duration of NPPV(cohort study: OR=–0.20, 95%CI –0.50 to 0.09, P=0.177; RCT: OR=–0.24, 95%CI –0.86 to 0.38, P=0.445). Conclusion NPPV by helmet can reduce the carbon dioxide partial pressure, tracheal intubation rate, hospital mortality and improve the positive end expiratory pressure, respiratory status. But the effects in the duration of NPPV and oxygenation index are uncertain. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify above conclusion.
ObjectiveTo evaluate the effect of prone position ventilation on mortality in ARDS patients by cumulative meta-analysis.MethodsDatabases including PubMed, EMbase, Web of Science, The Cochrane Library, CBM, CNKI, VIP, WanFang Data were searched from inception to September 30th, 2016 to collect randomized controlled trials (RCTs) about prone position ventilation in ARDS patients. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. In accordance with the published literature or published in chronological order, cumulative meta-analysis was performed using Stata12.0 software, and the trial sequencing analysis (TSA) method was used to assess the reliability and authenticity of the results.ResultsA total of 9 RCTs involving 2 359 patients were included. The cumulative meta-analysis results showed that the prone position ventilation could reduce the mortality in ARDS patients (OR=0.60, 95%CI 0.40 to 0.90). The TSA results showed that the definite conclusion had been obtained before the desired amount of information had been reached.ConclusionThe current evidence shows that prone position ventilation is associated with decreased mortality in ARDS patients. Due to limited quality and quantity of included studies, the above results are needed to validate by more studies.
Objectives To systematically review the preventive effects of different pressure relief devices. Methods Databases including PubMed, The Cochrane Library, Web of Science, EMbase, CBM, CNKI, VIP and WanFang Data were searched to collect randomized control trials (RCTs) on the preventive effects of pressure relief devices for the surgical pressure sore from inception to December 2017. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Network meta-analysis was then performed using gemtc package of R 3.5.0 software, Stata 13.0 and JAGS 3.4.0 software. Results A total of 20 RCTs involving 4 183 patients were included. The network meta-analysis showed that micropulse dynamic pad was superior to standard pad. The gel pad was superior to sponge pad. The standard pad and cotton gauze pad. The foam dressing was superior to gel pad. All of the differences were statistically significant. The results of the ranking probability plot suggested foam dressing as an optimal resolution for preventing surgical pressure sore. Conclusions According to the network meta-analysis and rankings, foam dressing is superior to other decompression devices in preventing surgical pressure sores.
ObjectiveTo systematically review the risk factors associated with sleep disorders in ICU patients.MethodsWe searched The Cochrane Library, PubMed, EMbase, Web of Science, CNKI, Wanfang Data, VIP and CBM databases to collect cohort studies, case-control studies and cross-sectional studies on the risk factors associated with sleep disorders in ICU patients from inception to October, 2018. Two reviewers independently screened literature, extracted data and evaluated the bias risk of included studies. Then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 9 articles were included, with a total of 1 068 patients, including 12 risk factors. The results of meta-analysis showed that the combined effect of equipment noise (OR=0.42, 95%CI 0.26 to 0.68, P=0.000 4), patients’ talk (OR=0.53, 95%CI 0.42 to 0.66, P<0.000 01), patients’ noise (OR=0.39, 95%CI 0.21 to 0.74, P=0.004), light (OR=0.29, 95%CI 0.18 to 0.45, P<0.000 01), night treatment (OR=0.36, 95%CI 0.26 to 0.50, P<0.000 01), diseases and drug effects (OR=0.17,95%CI 0.08 to 0.36, P<0.000 01), pain (OR=0.37, 95%CI 0.17 to 0.82, P=0.01), comfort changes (OR=0.34,95%CI 0.17 to 0.67,P=0.002), anxiety (OR=0.31,95%CI 0.12 to 0.78, P=0.01), visit time (OR=0.72, 95%CI 0.53 to 0.98, P=0.04), economic burden (OR=0.63, 95%CI 0.48 to 0.82, P=0.000 5) were statistically significant risk factors for sleep disorders in ICU patients.ConclusionCurrent evidence shows that the risk factors for sleep disorders in ICU patients are environmental factors (talking voices of nurses, patient noise, and light), treatment factors (night treatment), disease factors (disease itself and drug effects, pain,) and psychological factors (visiting time, economic burden). Due to the limited quality and quantity of included studies, more high quality studies are needed to verify the above conclusions.
ObjectivesTo assess the efficacy of non-drug interventions on improving sleep quality in ICU patients by network meta-analysis.MethodsThe Cochrane Library, PubMed, EMbase, Web of Science, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect randomized controlled trials (RCTs) on non-drug interventions on improving sleep quality in ICU patients from inception to December, 2018. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies, then, network meta-analysis was performed by using the Stata 13.0 software.ResultsA total of 12 RCTs, involving 1 223 patients and 9 non-pharmacological interventions (music therapy, comprehensive nursing intervention, TCM emotions, music therapy+TCM emotions, Chinese medicine pillow therapy, ear acupressure, eye mask+earplugs+music, eye mask+earplugs, regular care) were included. The results of Pittsburgh sleep quality index (PSQI) showed that eye mask+earplugs, eye masks, and comprehensive nursing interventions were superior to conventional care in improving sleep quality in ICU patients, and the rankings were: eye mask+earplugs>eye mask>comprehensive nursing intervention, music therapy+TCM emotional>Chinese medicine emotional>music therapy>general care. The results of Richards-Campbell sleep scale (RCSQ) showed that eye mask+earplugs+music, Chinese medicine pillow therapy, and auricular pressure beans were superior to conventional care, and the rankings were: eye mask+earplugs+music>Chinese medicine pillow therapy>music therapy>ear acupressure beans>general care.ConclusionsThe evidence shows that in improving the sleep quality of ICU patients, eye mask + earplug, eye mask, comprehensive nursing intervention, music therapy + TCM emotional characteristics may all be effective intervention methods. It is suggested that more non-drug interventions should be carried out in the future for enhancing the sleep quality of ICU patients.
ObjectiveTo analyze the treatment effect of sequential noninvasive following invasive mechanical ventilation in chronic obstructive pulmonary disease (COPD) patients with respiratory failure.MethodsA review of randomized controlled trials with meta-analysis performed by searching databases of PubMed, the Cochrane Library, Embase, Chinese BioMedical Literature Database, China National Knowledge Infrastructure, and WanFang data. Randomized controlled trials by using sequential noninvasive following invasive mechanical ventilation in COPD patients with respiratory failure were eligible for inclusion.ResultsEleven trials were included, involving 553 COPD patients with respiratory failure. Meta-analysis showed that sequential noninvasive following invasive mechanical ventilation reduced the mortality rate [RR=0.37, 95%CI(0.22 to 0.61), P=0.000 1], the incidence of ventilator-associated pneumonia (VAP) [RR=0.20, 95%CI(0.13 to 0.32), P<0.000 01], reintubation rate [RR=0.40, 95%CI(0.23 to 0.68), P=0.0008]; it also decreased the duration of invasive mechanical ventilation [MD=–10.47, 95%CI(–13.80 to –7.14), P<0.000 01] and duration of mechanical ventilation [MD=–4.54, 95%CI(–7.01 to –2.06), P=0.000 3], which also shortened the lengths of stay in an intensive care unit (ICU) [MD=–8.75, 95%CI(–13.49 to –4.01), P=0.000 3], as well as length of hospital stay [MD=–9.11, 95%CI(–11.68 to –6.55), P<0.000 01］.ConclusionSequential noninvasive following invasive mechanical ventilation can significantly reduce the incidence of VAP, the duration of invasive mechanical ventilation, the length of hospital stay in COPD patients with respiratory failure, and reduce the mortality, reintubation rate, the duration of mechanical ventilation and the length of ICU stay as well.
ObjectiveTo observe the effectiveness of core endurance isokinetic strength training on subacromial impingement syndrome (SAIS) rehabilitation.MethodsSAIS patients were selected from the Rehabilitation Department, Second Affiliated Hospital of Inner Mongolia Medical University from January 2018 to June 2019. The patients were randomly divided into observed group and control group by random number table method. The patients in control group were treated by keritherapy, cold, standard physiotherapy (PT) and exercise. At the same time, the patients in observed group were treated by core endurance isokinetic strength training combined with keritherapy, cold and standard PT. Both two groups were treated for 8 weeks. The patients were scored with visual analogue scale (VAS), Shoulder Pain and Disability Index (SPADI), Short Form 36 Healthsurvey Questionnaire (SF-36), flexor peak torque (FPT) and extensor peak torque (EPT) in pre and post treatment.ResultsA total of 59 patients with SAIS were enrolled. No exfoliating cases. There were 31 cases in the observed group and 28 cases in the control group. Pre-treatment, there were no significant difference in FPT, EPF, VAS, SPADI and SF-36 between the two groups (P>0.05). Post-treatment, there were no significant difference in EPT and VAS between the two groups (P>0.05); FPT [(62.65±10.17) N·m], SPADI [(53.18±10.25) points] and SF-36 [(35.54±11.39) points] in the observed group were significantly improved compared with the control group [(56.28±9.55) N·m, (61.05±9.41) points, (42.65±10.74) points] (t=2.473, 3.061, 2.460; P=0.014, 0.003, 0.017); FPT in both groups, and EPT in the observed group were improved compared with that of the pre-treatment (P<0.05); the EPT of the control group was improved compared with that of the pre-treatment, but the difference was not statistically significant (P>0.05); VAS, SPADI and SF-36 in the two groups were improved compared with those of the pre-treatment (P<0.05).ConclusionsCore endurance isokinetic strength training could improve the core stability of subacromial impingement syndrome patients. Satisfactory musculoskeletal dynamic chain plays a vital role in subacromial impingement syndrome rehabilitation.
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.