Objective To investigate problems in applying clinical epidemiology and evidence-based medicine in the field of dentistry in China. Method In early April of 2001, about 200 copies of a questionnaire were sent to chief editors of dental journals, directors and famous experts of the university dental schools and/or dental departments of the provincial/metropolitan hospitals located in the mainland of China. The sent back questionnaires were summarized and analysized. Results At the end of June, 2001, 40 replies from the experts of 12 universities and one metropolitan dental hospital were received. The main points are summarized as following: EBM in China is at starting stage of "anti-illiteracy" campaign. There are 6 out of 12 universities having delivered clinical epidemiology courses to postgraduates (2 to undergraduates), only 3 added lectures on evidence-based medicine to dental students and/or professionals, only one university held intensive training courses on EBM to clinicians. In dental practice there are still scram dentists making decisions simply by experiences. In the research practice some dentists are eager for quick success, and instant benefits, ignoring, scientific design aid quality control of the studies. Randomized controlled clinical trials are seldom appeared in Chinese dental journals. To popularize EBM in all dental clinicians is important for them to use and produce the best evidences. Conclusions EBM in dental field of China is at starling stage. Collection and dissemination of best dental evidences in dental professionals is a key to raise the dental care levels in China.
Objective To compare BODE index with GOLD staging for the severity evaluation in patients with chronic obstructive pulmonary disease ( COPD) . To investigate the relationship between BODE index and quality of life. Methods A total of 100 patients with stable COPD were enrolled. All participants were examined with lung function test and St George’s Respiratory Questionnaire ( SGRQ) for evaluation of quality of life. BODE index and it’s four components including body mass index( BMI) , airflow obstruction ( FEV1%pred) , dyspnea( MMRC) , and exercise capacity( 6MWD) were calculated. The participants were divided into four groups of severity using GOLD guidelines and BODE index quartiles. Results The associations between SGRQ total score and SGRQ subscales, and BODE index were significant( P lt;0. 01) .BODE index was a significant predictor of the quality of life, explaining 41. 3% of the total score of the SGRQ ( P lt;0. 01) . However, GOLD classification showed a correlation only with SGRQ activity score ( P lt;0. 05) but not with other SGRQ scores. There were significant differences in SGRQ total score and SGRQsubscales between different severity groups of BODE index( P lt;0. 01) . But there was no difference in SGRQ score between different severity groups of GOLD classification, except SGRQ activity score. Conclusion BODE scoring system is better correlated with the quality of life as assessed by the disease severity inpatients with COPD than the GOLD staging criteria.
ObjectiveTo investigate the therapeutic effect of glucosamine hydrochloride on chronic lumbago and backache. MethodsWe selected 328 outpatients with chronic lumbago and backache diagnosed between May 2014 and May 2015, and randomly (with single blind method) divided them into study group (n=172) and control group (n=156). Patients in the control group were treated with ibuprofen and placebo, while those in the study group were treated with ibuprofen and glucosamine hydrochloride. The short-form McGill pain questionnaire (SF-MPQ) was used for investigation at three time points (before the treatment, one month and two months after the treatment). ResultsThe score of SF-MPQ in the study group was 64.34±23.35 before the treatment, 44.04±13.22 one month after the treatment, and 19.87±8.11 two months after the treatment. While in the control group, the results at those three time points were 65.19±24.12, 47.04±11.36, and 54.44±21.39, respectively. There was no obvious difference between the two groups one month after the treatment (P>0.05). The pain was alleviated in both of the two groups one month after the treatment, while the therapeutic effect in the study group was significantly better than that in the control group two months after the treatment (P<0.05). Archenteric complications were found in 3 patients (1.74%) in the study group and 2 (1.28%) in the control group without a significant difference (P>0.05). ConclusionGlucosamine hydrochloride may effectively alleviate the lumbago and backache without any obvious adverse reactions.
ObjectiveTo investigate the feasibility and effect of early pulmonary rehabilitation (PR) in patients after acute exacerbation of chronic obstructive pulmonary disease (COPD) in a district hospital. MethodsA single-centre prospective study was conducted. The COPD patients after an episode of acute exacerbation and referred to the outpatient department were recruited from January 2013 to December 2014. They were randomized to a group with PR (PR group) and a group without PR (wPR group). The following data were recorded and evaluated including age, gender, forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and FEV1 as a percentage of the predicted value (FEV1% pred).The baseline and the post-PR medical research council scale (MRC), St. George's respiratory questionnaire (SGRQ), and six-minute walk distance (6MWD) were also compared. ResultsA total of 91 cases were enrolled with 46 cases in the PR group and 45 cases in the wPR group. The age, gender, the severity of COPD were similar in two groups (P > 0.05). The MRC score and SGRQ score of the PR group were significantly improved 3 months later compare with the baseline (P < 0.05), and did not changed significantly in the wPR group (P > 0.05). There were 26 patients whose SGRQ scores decreased > 4 in the PR group (26/46, 56.5%), which was significantly higher than the wPR group (7/45, 15.6%) (P < 0.05). The 6MWD of the PR group was significantly increased 3 months later compare with the baseline (P < 0.05), and did not changed significantly in the wPR group (P > 0.05). There were 22 patients whose 6MWD increased > 54 meters in the PR group (22/46, 47.8%), which was significantly higher than the wPR group (9/45, 20.0%) (P < 0.05). ConclusionsIt is feasible and safety to perform early PR in patients after acute exacerbation of COPD in the district hospital. The early PR can improve the MRC score, SGQR score, and 6MWD in COPD patients.
ObjectiveTo systematically review the efficacy of Tai Chi on patients with heart failure.MethodsDatabases including CNKI, VIP, WanFang Data, Web of Science, PubMed, EMbase and The Cochrane Library (Issue 8, 2016) were searched from inception to August, 2016 to collect randomized controlled trials (RCTs) of Tai Chi for heart failure patients. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then meta-analysis was performed using RevMan 5.3 software.ResultsA total of 10 RCTs involving 689 patients were included. The results of meta-analysis showed that, compared with the control group, the heart failure patients in Tai Chi group had better score of minnesotaliving with heart failure questionnaire (MLHFQ) (MD=–9.37, 95%CI –13.09 to –5.65, P<0.000 01), longer six minute walk test (6MWT) (MD=40.37, 95%CI 9.48 to 71.27, P=0.01), higher left ventricular ejectionfractions (LVEF) (MD=7.89, 95%CI 3.01 to 12.77, P=0.002) and lower level of BNP (brain natriuretic peptide) (MD=–10.75, 95%CI –13.20 to –8.30, P<0.000 01); however, as to the maximal oxygen consumption (VO2max) (MD=0.29, 95%CI –1.223 to 1.81, P=0.71), systolic pressure (SBP) (MD=–2.81, 95%CI –8.52 to 2.90, P=0.33) and diastolic pressure (DBP) (MD=0.37, 95%CI –3.73 to 4.48, P=0.86), there were no significant differences between both groups.ConclusionThe current evidence shows that Tai Chi is feasible for patients with heart failure as it has positive effects on life quality, physiological functions. Due to the limited quality and quantity of included studies, the above conclusion should be validated by more high quality studies.
Objective To investigate the opinions of operating room nurse (ORN) on enhanced recovery after surgery (ERAS). Methods A questionnaire survey was performed among 215 ORNs in West China Hospital. There were 10 males and 205 females at age of 33.4±8.84 years. Results A total of 154 ORNs (71.6%) thought that we already had very good ERAS theory but we still needed more practice. Thirty-four ORNs(15.8%) thought that the application of ERAS was poor in our clinic comparing to other countries.A percentage of 84.2% (181/215) ORNs thought the criteria to judge whether the ERAS succeed or not should be average days of hospitalization, patients' feeling, and experience and social satisfactions. Besides, 78.1% (168/215) ORNs selected team building as the key point of ERAS success. There were 91.2% (196/215) ORNs who believed expert consensus and ERAS guide should be worked out and propagandized through academic forum or conference in order to popularize the ERAS. Conclusion The theory of ERAS has already been accepted by almost all the clinicians and team building is the best way to make ERAS work well.
Objective To analyze the nurses' current view and perceptions of enhanced recovery after surgery (ERAS) by a questionnaire and to promote the clinical application of ERAS. Methods We conducted a questionnaire study for nurses who attended the First West China Forum on Chest ERAS in Chengdu during September 26-27, 2016 and 259 questionnaires were collected for descriptive analysis. Results (1) The application status of ERAS: There were 13.5% responders whose hospital took a wait-an-see attitude, while the others' hospital took different actions for ERAS; 85.7% of nurses believed that ERAS in all surgeries should be used; 58.7% of nurses believed that the concept of ERAS was more in theory than in the practice; 40.2% of nurses thought that all patients were suitable for the application of ERAS; (2) 81.9% of nurses believed that the evaluation criteria of ERAS should be a combination of the average hospital stay, patients’ comprehensive feelings and social satisfaction; (3) 70.7% of nurses thought that the combination of subjects integration, surgery orientation and surgeon-nurse teamwork was the best model of ERAS; 44.8% of nurses thought the hospital administration was the best way to promote ERAS applications; (4) 69.1% of responders believed that immature plan, no consensus and norms and insecurity for doctors were the reasons for poor compliance of ERAS; 79.5% of nurses thought that the ERAS meeting should include the publicity of norms and consensus, analysis and implementation of projects and the status and progress of ERAS. Conclusion ERAS concept has been recognized by most nurses. Multidisciplinary collaboration and hospital promotion is the best way to achieve clinical applications.
Objective To investigate the prevalence and related factors of primary palmar hyperhidrosis in adolescents in Yangzhou. Methods On-site questionnaire survey was performed on students selected by cluster random sampling from the two colleges and two high or middle schools, with each class as a unit. Data were collected through the questionnaire to make the diagnosis and severity grading. Results A total of 3 487 copies of the questionnaire were distributed in the survey and 3 299 were finished, among which 3 083 were effective with an effective rate of 88.41%. Among them, 1 358 respondents were males and 1 725 were females; 933 were middle school students, 809 high school students, and the remaining 1 341 college students. According to the diagnostic criteria, 104 respondents were diagnosed with palmar hyperhidrosis with an overall prevalence of 3.37%. There were 60 (4.41%) males and 44 (2.55%) females. Although the prevalence of palmar hyperhidrosis in males was higher than that of females (χ2=8.130, P<0.05), severe palmar hyperhidrosis was more often to be observed in females than in males, and females were also more likely to have hyperhidrosis in other parts of the body. In addition, the age of the first onset of the disease was mainly 10 to 20 years old and 36.54% of the patients had a family history. Conclusion The prevalence of palmar hyperhidrosis in adolescents in Yangzhou was 3.37%, and there is a significant difference in the gender. The palmar hyperhidros is often accompanied by hyperhidrosis symptoms of other parts of body, and the disease shows an obvious genetic predisposition.
Objective To analyze the current status and difficulties of ERAS applicated in thoracic surgery in different regional hospitals. Methods A total of 773 valid questionnaires were collected during the First West China Forum on Chest ERAS and analyzed by geographical distribution. The content of the questionnaire was divided into two parts, including the respondents’ institute and personal information, as well as 10 questions about ERAS. Results There were 83.57%, 83.82%, 89.58%, 93.75%, 94.74% and 92.86% of surgeons and nurses in Sichuan province, municipalities, the eastern, western, southern and northern respectively who believed that ERAS in all surgeries should be used. There were 61.84%, 60.29%, 65.97%, 81.25%, 73.68% and 75.00% of surgeons and nurses who thought that the concept of ERAS was more in the theory than in the practice; 77.99%, 80.88%, 74.31%, 78.13%, 83.33% and 69.64% of respondents agreed that average hospital stay, patients’ experience and social satisfaction should be the evaluation standard of ERAS practice while 58.50%, 63.24%, 54.86%, 62.50%, 70.18% and 58.93% of respondents believed that immature procedure, lack of consensus and specifications and insecurity for doctors were the reasons for poor compliance of ERAS; 63.23%, 67.65%, 59.72%, 68.75%, 72.81% and 67.86% of respondents thought that the best team of ERAS should be based on the combination of subject integration, surgery orientation and surgeon-nurse teamwork; 43.73%, 44.12%, 43.75%, 46.88%, 59.65% and 41.07% of respondents thought that multidisciplinary cooperation, multi-modality conducted and surgical programming should be the best way for ERAS implementation; 72.98%, 69.12%, 62.50%, 65.63%, 80.70% and 55.36% of responders agreed that the ERAS forum or conference should include the norms and consensus, analysis and implementation of projects and the status and progress of ERAS. Conclusion There are more consistent views on the clinical application of ERAS in all regions. The subject integration, surgeon-nurse teamwork and multidisciplinary, multi-modality cooperation are the best team and best way for ERAS program implementation.
ObjectiveTo analyze responsiveness of Chinese version of Neck Outcome Score (NOOS-C) and provide a reliable measure to assess intervention effect for patients with neck pain.MethodsCross-cultural adaptation of NOOS was performed according to the Beaton’s guidelines for cross-cultural adaptation of self-report measures. Eighty patients with neck pain were recruited between September 2016 and May 2017. Those patients were assessed using NOOS-C and Chinese version of Neck Disability Index (NDI) before and after intervention. And 71 patients completed those questionnaires. The statistic differences of the score of each subscale and the total scale before and after intervention were evaluated by paired-samples t test. Internal responsiveness was determined by effect size (ES) and standardized response mean (SRM) based on the calculated difference before and after intervention. External responsiveness was analyzed by Spearman correlation coefficient.ResultsThe differences in symptom subscale, sleep disturbance subscale, participating in everyday life subscale, every day activity and pain subscale, and the scale between before and after intervention were significant (P<0.05) except for mobility subscale (P>0.05). The difference of NDI-C before and after intervention was –12.11%±17.45%, ES was 0.77, and SRM was 0.69. The difference of NOOS-C before and after intervention was 13.74±17.22, ES was 0.83, and SRM was 0.80. Spearman correlation analysis revealed that the relativity about NOOS-C and NDI-C before and after intervention were both negative (r=–0.914, P=0.000; r=–0.872, P=0.000).ConclusionNOOS-C’s responsiveness is good.