目的:探讨骨髓细胞形态学变化特征在鉴别诊断骨髓增生异常综合征(MDS-RA)及巨幼红细胞性贫血(MA)中的意义。方法:骨髓片瑞氏染色,记数骨髓中有核细胞200个,并观察其形态。结果:(1)MDS的骨髓象除巨幼样变外,还有形态的异常。以淋巴样小巨核细胞最具有诊断意义。(2)巨幼红细胞性贫血三系血细胞的巨变程度比MDS-RA明显.结论:MDS-RA与MA细胞形态学既具有相似性,又具有各自不同特征。
ObjectiveTo compare the effects of aerobic exercise, resistance exercise, aerobic combined with resistance exercise, routine nursing and no intervention on depression and anxiety in adolescents by means of network meta-analysis. MethodsA computer search was conducted in CNKI, WanFang Data, VIP, CBM, Web of Science, EBSCO, PubMed, Cochrane Library and Embase to collect randomized controlled trials (RCTs) related to exercise intervention for depression and anxiety in children and adolescents from inception to April 2023. After two researchers independently screened the literature, extracted data and evaluated the methodological quality of the included studies, Stata 14.0 and RevMan 5.3 software were used for statistical analysis. ResultsFinally 27 RCTs were included, covering 3 210 children and adolescents. The results of the network meta-analysis showed that in terms of improving depression, resistance exercise (SMD=−0.37, 95%CI −0.64 to −0.10, P<0.05) and aerobic exercise (SMD=−0.19, 95%CI −0.34 to −0.04, P<0.01) were significantly better than the no intervention group; in relieving anxiety, aerobic exercise (SMD=−0.29, 95%CI −0.54 to −0.03, P<0.05) was significantly better than the no intervention group. In improving self-worth, aerobic combined with resistance exercise (SMD=0.26, 95%CI 0.01 to 0.52, P<0.05) was statistically different from the no intervention group. The results of SUCRA probability sequence showed that in reducing depression, resistance exercise (95.0%) > aerobic exercise (64.4%) > aerobic combined with resistance exercise (60.7%) > routine nursing (22.9%) > no intervention (7.0%). In relieving anxiety, aerobic exercise (72.4%) > routine nursing (69.0%) > aerobic combined with resistance exercise (55.3%) > no intervention (3.4%). In improving self-worth, aerobic combined with resistance exercise (94.0%) > resistance exercise (67.3%) > aerobic exercise (35.1%) > no intervention (32.7%) > routine nursing (21.0%). ConclusionLimited evidence suggests that resistance exercise has advantages in improving depression in children and adolescents, aerobic exercise has advantages in relieving anxiety in children and adolescents, and aerobic combined with resistance exercise has advantages in improving self-worth in children and adolescents. Due to the limitation of the number and quality of included studies, more high-quality studies are needed to verify the above conclusions.
Objective To systematically review the effects of various exercise modalities on obese children and adolescents with metabolic syndrome (MetS). MethodsChinese and English databases such as CNKI, WanFang Data, VIP, PubMed and Web of Science were selected to search for RCTs on the effects of exercise on obese children and adolescents with MetS, and the search period was from January 2000 to November 2024 And two researchers independently screened the literature, extracted data and evaluated the risk of bias of the included studies, and net meta−analysis was performed using Stata 17.0 and RevMan 5.4 software. Results A total of 15 RCT trials involving 968 obese children and adolescents with MetS were included. The results of reticulated meta−analysis showed that compared with the non−exercise intervention group, aerobic exercise was effective in improving the patients' body mass index (BMI) (SMD=−1.21, 95% CI −2.31 to −0.11, P=0.031), total cholesterol (TC) (SMD=−0.44, 95% CI −0.82 to −0.05, P=0.028), triglyceride (TG) (SMD=−1.10, 95% CI −1.98 to −0.22, P=0.014), fasting blood glucose (FBG) (SMD=−0.70, 95% CI −1.34 to −0.07, P=0.030), systolic blood pressure (SBP) (SMD=−1.10, 95% CI −1.83 to −0.38, P=0.003), diastolic blood pressure (DBP) (SMD=−0.93, 95% CI −1.49 to −0.37, P=0.001); Resistance exercise can effectively improve the HDL cholesterol (SMD=0.55, 95% CI 0.09 to 1.02, P=0.020) and SBP (SMD=−1.16, 95% CI −2.18 to −0.14, P=0.025); aerobic combined with resistance exercise can effectively improve waist circumference (WC) (SMD=−1.09, 95% CI −1.74 to −0.44, P=0.001), BMI (SMD=−1.22, 95% CI −2.32 to −0.12, P=0.030), HDL (SMD=0.56, 95% CI 0.13 to 1.00, P=0.011), and FBG (SMD=−0.57, 95% CI −1.13 to −0.02, P=0.044). The results of cumulative probability ranking showed that aerobic exercise was the most effective in improving TG, TC, FBG and DBP; resistance exercise was the most effective in improving SBP; and aerobic combined with resistance exercise was the most effective in improving WC, BMI and HDL. ConclusionDifferent exercise modes have different improvement effects on various body indexes in obese children and adolescents with MetS. Due to the limitation of the number and quality of included studies, more high−quality studies are needed to verify the above conclusions.