Objective To systematically review the efficacy of short message intervention on glycosylated hemoglobin (HbAlc) and blood glucose levels on patients with type 2 diabetes mellitus. Methods We electronically searched databases including PubMed, EMbase, The Cochrane Library, CNKI and CBM from inception to August 2016, to collect randomized controlled trials (RCTs) about short message intervention in type 2 diabetes mellitus patients. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then meta-analysis was performed using Stata 12.0 software. Results A total of 17 RCTs involving 2 879 patients were included. The results of meta-analysis showed that, on the basis of basic treatment, the use of text messages could lower the levels of HbA1c (SMD3 months=–0.50, 95%CI –0.67 to –0.34, P<0.001; SMD6 months=–0.33, 95%CI –0.59 to –0.07, P=0.012), FBG (SMD3 months=–0.28, 95%CI –0.45 to –0.11, P=0.001; SMD9 months=–0.99, 95%CI –1.44 to –0.54, P<0.001), PBG (SMD3 months=–0.99, 95%CI –1.54 to –0.44, P<0.001; SMD6 months=–0.81, 95%CI –1.25 to –0.36, P<0.001; SMD9 months=–0.78, 95%CI –1.23 to –0.34, P=0.001). Conclusion The current evidence shows that the use of SMS can improve glycosylated hemoglobin and blood glucose levels on type 2 diabetes patients. Due to limited quality and quantity of the included studies, the above conclusions are needed to be verified by more high quality studies.
Objective To systematically review the effectiveness of short message intervention on smoking cessation. Methods Databases including PubMed, The Cochrane Library, EMbase, CBM were searched from inception to August 2016, to collect randomized controlled trials (RCTs) about short message service (SMS) for smoking cessation. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was performed using Stata 12.0 software. Results A total of 14 RCTs involving 15 543 participants were included. The results of meta-analysis showed that, compared with the control group, no significant difference was found in self-reported three months continuous abstinence (RR=0.830, 95%CI 0.679 to 1.014, P=0.069), 30 day point quit rate (RR=0.878, 95%CI 0.687 to 1.122, P=0.076). However, there were significant differences in the self-reported 7-day point abstinence (RR=1.149, 95%CI 1.014 to 1.303, P=0.03), the CO biochemical verification abstinence (RR=0.571, 95%CI 0.357 to 0.914, P=0.020), and the average number of cigarettes smoked per day (SMD=–0.25, 95%CI –0.37 to –0.12, P<0.001). Conclusion The available evidence indicates that short message intervention has a better effect on short-term smoking cessation. Therefore, more long-term studies are needed to determine the association between SMS and quit smoking behavior.
ObjectivesTo investigate sources of evidence of the clinical pathways approved by the Chinese government.MethodsThe approved clinical pathways were obtained from the website of the National Health and Family Planning Commission. Two reviewers independently extracted the basic information, approval date, types of evidence of the clinical pathways and time of evidence. The variance analysis was performed for the diagnosis and treatment parts of clinical pathways and the LSD method was further used for comparison.ResultsThe main types of evidence were guidelines, textbooks, standard indicators and consensus views. Approximately 80% of the pathways cited clinical practice guidelines and 36% cited the textbooks. The median number of evidence for each clinical pathway was 2. Approximately 85% of the evidence could be obtained the time when the evidence published. The average time interval (between the time when the pathways released and the time when the evidence published) was 5.2 years. Specifically, textbooks constituted the largest proportion in all evidence that was over 15 years of time interval. In addition to the textbook comparison standard indicators, there were significant differences in time interval between guidelines or consensus and textbooks or standard indicators.Conclusions The evidence types selection is based on the concept of evidence-based medicine, yet the time span of the referred evidence is larger. Therefore, developing clinical pathways not only need to refer to the latest research evidence comprehensively and enhance transparency of clinical pathways, but also use evidence quality evaluation standards to evaluate and select the referred evidences.
Objective To investigate the efficacy on clinical condition assessment and the safety of ultrasound-guided osteofascial chamber puncture manometry in evaluating the pressure of the osteofascial chamber in patients with venomous snake bites. Methods Patients with venomous snake bites admitted to the Department of Emergency Medicine of West China Hospital of Sichuan University between April 2021 and January 2023 were prospectively included, and their basic information, physiological indicators (heart rate, blood pressure), laboratory examination indicators, physical signs, treatment methods and prognosis were collected. The patients whose extremal pressure was measured by osteofascial chamber puncture under ultrasound guidance were selected as the manometry group. Patients who were bitten by venomous snakes at the same time without puncture pressure measurement were randomly selected as the control group at a ratio of 1∶1. The bleeding, infection, nerve injury, length of hospital stay and long-term prognosis of the two groups were compared to explore the safety of ultrasound-guided osteofascial chamber puncture manometry. The correlation between the pressure measured in the manometry group and creatine kinase (a representative index of acute poisoning severity score) was analyzed to explore the efficacy of ultrasound-guided osteofascial chamber puncture manometry in evaluating the disease. Results There was no significant difference between the manometry group and the control group in new or aggravated infection, bleeding, nerve injury (such as numbness and anesthesia), hospital treatment time, final detumescence time of the affected limb, or final adverse prognosis (P>0.05). There was a positive correlation between the measured pressure and creatine kinase (rs=0.286, P=0.002). Conclusions The higher pressure measured by ultrasound-guided osteofascial chamber puncture manometry is, the more serious the poisoning condition may be. In addition, ultrasound-guided osteofascial chamber puncture manometry does not prolong the hospital time of patients or the final swelling reduction time of the affected limb, and does not increase the incidence of bleeding, infection, nerve damage or eventual adverse prognosis events. It has clinical practicability and feasibility.