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。
Objective To assess the effectiveness of intensive versus routine education on diabetes mellitus for preventing diabetic foot ulcer. Methods We electronically searched CENTRAL (Issue 1, 2013), PubMed (1978-2013), EMbase (1978-2013), VIP (1989-2013) and WanFang Data (1980-2013), hand-searched correlated proceedings and retrieved the references of included studies, for the randomized controlled trials on intensive versus routine education on diabetes mellitus for preventing diabetic foot ulcer all over the world. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of included studies. Then, meta-analysis was performed using RevMan 5.2 software. Results Twelve trials involving 1 841 patients were finally included. The results of meta-analysis showed that: a) the incidence of diabetic foot ulcer in the intensive education group was lower than the routine group, with a significant difference (RR=0.51, 95%CI 0.30 to 0.84, P=0.008); b) two groups were alike in the amputation rate, with no significant difference (OR=0.54, 95%CI 0.17 to 1.67, P=0.28); and c) the score of knowledge on diabetes mellitus was higher in the intensive education group than in the routine education group, with a significant difference (MD=7.32, 95%CI 3.57 to 11.06, P=0.000 1). Conclusion Current evidence shows that: compared with routine education, intensive education could reduce the incidence of diabetic foot ulcer effectively. However, the above conclusion should be verified by conducting more high quality studies.
Objective To observe the feature of post-operative hyperglycemia after coronary artery bypass grafting(CABG) surgery in department of intensive care unit（ICU） patients.Methods Patients who had CABG surgery in Zhongshan Hospital from January 2005 to December 2005 were enrolled.Data were collected including the history of diabetes，pre-operative and post-operative blood glucose(BG) levels，and the time that post-operative hyperglycemia and peak BG occurred.The patients were divided into diabetic and non-diabetic groups according to the diabetic history.The data were compared and analyzed between the two groups.Results 200 patients were enrolled in this study.The incidence of post-operative hyperglycemia was 77%，and about 99.4% occurred in the first 24 hours admitted to ICU，which was independent on diabetic history (χ2=2.58，P=0.108)，but was related to the BG level above 6.1 mmol/L (χ2=12.31，P=0.000).In 80% of the patients，peak BG occurred in the first 24 hours admitted to ICU，which was significantly earlier in the non-diabetic group compared with the diabetic group (8.5 h vs 18.5 h，P=0.02 ).In the patients who had post-operative hyperglycemia，the median time of the BG peak is 10 hours，and 75.3% of the BG peak occurred in the first 24 hours admitted to ICU.Conclusion There is a high incidence of post-operative hyperglycemia in post-CABG patients which always occur within 24 hours after operation and relate to pre-operative high BG.
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.
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.