The Effect of the Team Members Teaching Design vs. Regular Lectures method on the Self-efficacy of the Multiple sclerosis Patients in Iran. Randomised Controlled Trial / El efecto del diseño de enseñanza colaborativa frente al método de clases regulares sobre la autoeficacia de los pacientes con esclerosis múltiple en Irán. Ensayo Controlado Aleatorizado / O efeito do design de ensino colaborativo versus método de aula regular na autoeficácia de pacientes com esclerose múltipla no Irã. Teste controlado e aleatório

Objective. This study was conducted with the aim of the effect of team members teaching design (TMTD) vs. regular Lectures method on the self-efficacy of the multiple sclerosis patients. Methods. This research is a randomized controlled trial study. In this study, 48 multiple sclerosis persons of members of Jahrom MS Society participated. The persons were selected by simple random sampling and then divided into three groups of: TMTD (n=16), regular lecture method (n=16), and control (n=16), by random allocation method. In the intervention groups, six training sessions were held twice a week; control group did not receive education. Data was collected by the MS self-efficacy questionnaire of Rigby et al. in the before, immediately and one month after the intervention. Results. Patients in three intervention and control groups were similar in terms of demographic variables. The results of the repeated measurement test before, immediately and one month after the intervention showed that the mean of the all dimensions of self-efficacy in two intervention groups had increased significantly (p<0.05). While these changes were not significant in the control group (p ≥ 0.05). Also, there was a significant difference in the mean of the all dimensions of self-efficacy between the intervention groups of TMTD and regular lectures. Conclusion. Based on the findings, TMTD compared to regular lectures method had a more significant effect on improving the self-efficacy of multiple sclerosis patients. Therefore, it is recommended that nursing use this educational approach to increase patients' self-efficacy.

Objetivo. Determinar el efecto del diseño de la enseñanza colaborativa de los miembros del equipo (En inglés: Team Members Teaching Design -TMTD) frente al método de las clases regulares sobre la autoeficacia de los pacientes con esclerosis múltiple (EM).Métodos. Ensayo controlado aleatorizado realizado con la participación de 48 personas con esclerosis múltiple afiliados a la Sociedad de Esclerosis Múltiple de Jahrom (Iran), que fueron seleccionados por muestreo aleatorio simple y luego asignados en forma randomizada en tres grupos, dos de intervención: TMTD (n=16) y método de clases regulares (n=16), y un grupo control (n=16). En los grupos de intervención se impartieron seis sesiones educativas (dos por semana); mientras que el grupo control no recibió educación. Se empleó el cuestionario de autoeficacia en EM de Rigby et al. en los momentos: antes, inmediatamente después de terminada la intervención y un mes de finalizada la misma.Resultados. Los pacientes de los tres grupos de intervención y control eran similares en cuanto a variables demográficas. Los resultados de la prueba de medidas repetidas antes, inmediatamente y un mes después de la intervención mostraron que la media de todas las dimensiones de autoeficacia en los dos grupos de intervención había aumentado significativamente (p<0.05). Mientras que estos cambios no fueron significativos en el grupo de control (p ≥ 0.05). Además, hubo una diferencia significativa en la media de todas las dimensiones de autoeficacia entre los grupos de intervención de TMTD y clases regulares, siendo mayor en TMTD. Conclusión. El TMTD comparado con el método de clases regulares, tuvo un mejor efecto en el aumento de la autoeficacia de los pacientes con EM. Por lo tanto, se sugiere a enfermería utilizar este enfoque educativo para aumentar la autoeficacia de los pacientes.

Objetivo. Determinar o efeito do desenho de ensino colaborativo dos membros da equipe (em inglês: Team Members Teaching Design -TMTD) comparado ao método de aulas regulares na autoeficácia de pacientes com esclerose múltipla (EM). Métodos. Ensaio controlado randomizado realizado com a participação de 48 pessoas com esclerose múltipla afiliadas à Sociedade de Esclerose Múltipla de Jahrom (Irã), que foram selecionadas por amostragem aleatória simples e depois distribuídas aleatoriamente em três grupos, dois grupos de intervenção: TMTD (n=16 ) e método de aula regular (n=16), e um grupo controle (n=16). Foram ministradas seis sessões educativas nos grupos de intervenção (duas por semana); enquanto o grupo de controle não recebeu educação. Foi utilizado o questionário de autoeficácia em SM de Rigby et al. nos momentos: antes, imediatamente após o término da intervenção e um mês após seu término. Resultados. Os pacientes dos três grupos intervenção e controle foram semelhantes em termos de variáveis demográficas. Os resultados do teste de medidas repetidas antes, imediatamente e um mês após a intervenção mostraram que a média de todas as dimensões da autoeficácia nos dois grupos de intervenção aumentou significativamente (p<0.05). Embora essas alterações não tenham sido significativas no grupo controle (p ≥ 0.05). Além disso, houve diferença significativa na média de todas as dimensões de autoeficácia entre os grupos de intervenção TMTD e aulas regulares, sendo maior no TMTD. Conclusão. O TMTD comparado ao método de aula regular teve melhor efeito no aumento da autoeficácia dos pacientes com EM. Portanto, sugere-se que a enfermagem utilize essa abordagem educativa para aumentar a autoeficácia dos pacientes.

Immunomodulation as a Treatment for Parkinson´s Disease in Current Trials: A Systematic Review and Meta-Analysis

ABSTRACT Background: Immunomodulatory drugs and immunotherapies are being evaluated in clinical trials for the treatment of neuroinflammation, as the latter is an essential mechanism for the development and progression of Parkinson´s disease. Objective: The objective of the study is to review recent evidence on the evaluation of immunomodulators in randomized controlled clinical trials measuring improvement of motor symptoms. Methods: A meta-analysis of Movement Disorder Society-Unified Parkinson´s disease Rating Scale (MDS-UPDRS III) scores extracted from seven articles selected after an online search of PubMed, Cochrane Library, and Clarivate's Web of Science for randomized controlled clinical trials published between 2000 and July 2023 was performed. The selected articles reported clinical trials evaluating the effects of specific immunomodulators or treatments with known effects on the immune system and inflammation. MDS-UPDRS III scores were reported in these studies, and the results of the placebo groups were compared with those of the treatment groups. Results: A total of 590 patients treated with immunomodulators and 622 patients treated with placebo were included. A test for heterogeneity yielded an I2 value > 50%. The mean standard difference for change in MDS-UPDR III score was −0.46 (CI [95%] = −0.90 - −0.02, p < 0.01). No significant differences were found in the change in mean MDS-UPDR III score between the treatment and placebo groups; however, two studies showed a trend toward separation from the mean. Conclusion: The immunomodulatory treatments included in this study showed no efficacy in improving motor symptoms in Parkinson´s disease patients. Further clinical trials with larger patient populations are needed.

The Effect of an Educational Intervention Based on the Health Action Process Approach on Nurses' Communication Skills / Efecto de una intervención educativa basada en el enfoque del proceso de acción en salud sobre las habilidades comunicativas de las enfermeras / Efeito de uma intervenção educativa baseada na abordagem do processo de ação em saúde nas habilidades de comunicação do enfermeiro. Estudo quase experimental com grupo controle

Objective. This study aimed to the effects of the Health Action Process Approach (HAPA) in promoting the quality of nurses' communication skills among nurses. Methods.The present quasi-experimental research was conducted on 148 nurses (76 in the intervention and 72 in the control group) in Yazd province (Iran). In this study, the total number of nurses in one hospital was selected as the intervention group, while the nurses from another hospital were chosen as the control group. The participants were recruited from public hospitals in Ardakan and Meibod cities. The data collection instrument was a questionnaire based on the Health Action Process Approach (HAPA) Constructs and a communicative skill questionnaire. The data were collected from the two groups before, one month after, and four months after the intervention. The control group did not receive any educational training during the course of the study. Results. In the pretest, no statistically significant difference was found between the intervention and control groups regarding the behavioral stages of effective communication with patients. In the posttest, the mean task self-efficacy score was significantly increased in the intervention group compared to the control (p<0.001). The mean coping self-efficacy score was also significantly higher in the intervention group than the control in the posttest (p<0.001). Moreover, the mean coping planning score was significantly increased in the post-test intervention group(p<0.001). The mean communicative skill score was also significantly increased in the intervention group compared to the post-test control (p=0.03). Conclusion. The intervention used in the present study based on the target model (HAPA) significantly affected nurses' self-efficacy and communicative skills in the experimental group.

Objetivo. Evaluar el efecto del enfoque del proceso de acción sanitaria (Health Action Process Approach (HAPA), en inglés) en la promoción de la calidad de las habilidades de comunicación de las enfermeras. Métodos. La presente investigación cuasiexperimental se llevó a cabo con 148 enfermeras (76 en el grupo de intervención y 72 en el de control) de la provincia de Yazd (Irán). Los participantes fueron reclutados en los hospitales públicos de las ciudades de Ardakan y Meibod. El instrumento de recogida de datos fue un cuestionario basado en los constructos HAPA y un cuestionario de habilidades comunicativas. Se recogieron datos de los dos grupos antes, un mes después y cuatro meses después de la intervención. El grupo de control no recibió ninguna formación educativa durante el estudio. Resultados. En la preprueba, no se encontraron diferencias estadísticamente significativas entre los grupos de intervención y de control en cuanto a las etapas conductuales de la comunicación eficaz con los pacientes. En la prueba posterior, la puntuación media de autoeficacia en la tarea aumentó significativamente en el grupo de intervención en comparación con el grupo de control (p<0.001). La puntuación media de autoeficacia en el afrontamiento también fue significativamente mayor en el grupo de intervención que en el grupo de control en el postest (p<0.001). Además, la puntuación media en planificación del afrontamiento aumentó significativamente en el grupo de intervención después de la prueba (p<0.001). La puntuación media en habilidades comunicativas también aumentó significativamente en el grupo de intervención en comparación con el grupo de control después de la prueba (p=0.03). Conclusión.La intervención utilizada en el presente estudio basada en el modelo HAPA mejoró significativamente la autoeficacia y las habilidades comunicativas de las enfermeras del grupo experimental.

Objetivo. Avaliar o efeito da Abordagem do Processo de Ação em Saúde (HAPA) na promoção da qualidade das habilidades de comunicação dos enfermeiros. Métodos. A presente pesquisa quase-experimental foi realizada com 148 enfermeiros (76 no grupo de intervenção e 72 no grupo de controle) da província de Yazd (Irã). Os participantes foram recrutados em hospitais públicos nas cidades de Ardakan e Meibod. O instrumento de coleta de dados foi um questionário baseado nos construtos do HAPA e um questionário de habilidades de comunicação. Os dados foram coletados dos dois grupos antes, um mês depois e quatro meses após a intervenção. O grupo de controle não recebeu nenhum treinamento educacional durante o estudo. Resultados. No pré-teste, não foram encontradas diferenças estatisticamente significativas entre os grupos de intervenção e controle em termos de estágios comportamentais da comunicação eficaz com os pacientes. No pós-teste, a pontuação média de autoeficácia na tarefa aumentou significativamente no grupo de intervenção em comparação com o grupo de controle (p<0.001). A pontuação média de autoeficácia de enfrentamento também foi significativamente maior no grupo de intervenção do que no grupo de controle no pós-teste (p<0.001). Além disso, a pontuação média do planejamento de enfrentamento aumentou significativamente no grupo de intervenção após o pós-teste (p<0.001). A pontuação média em habilidades de comunicação também aumentou significativamente no grupo de intervenção em comparação com o grupo de controle no pós-teste (p=0.03). Conclusão. A intervenção usada no presente estudo com base no modelo HAPA melhorou significativamente a autoeficácia e as habilidades de comunicação dos enfermeiros do grupo experimental.

Clinical Effect Observation of Apatinib Combined with 131I for Radioiodine-Refractory Differentiated Thyroid Cancer and Prognostic Significance Analysis of Macrophage Inflammatory Protein-1alpha After Treatment: A Cell Regulation Study / Observación del Efecto Clínico de Apatinib Combinado con 131I para el Cáncer de Tiroides Diferenciado Resistente al Yodo Radiactivo y Análisis de Importancia Pronóstica de la Proteína Inflamatoria 1alfa de Macrófagos Después del Tratamiento: Un Estudio de Regulación Celular

SUMMARY: The objective of this study was to observe the clinical efficacy of apatinib (AP) combined with 131I in the treatment of radioiodine-refractory differentiated thyroid cancer (RAIR-DTC) and the prognostic significance of MIP-1α after treatment, and to provide reference and guidance for future treatment and disease assessment of RAIR-DTC. One hundred and six patients with RAIR- DTC admitted to our hospital from January 2019 to October 2020 were selected for the study. All the patients were treated with TC surgery with 131I at our hospital, and 58 of them were subsequently transferred to AP treatment, which was considered as the research group; the other 48 patients were transferred to thyroid stimulating hormone (TSH) suppression treatment, which was considered as the control group. The clinical efficacy of the research group was better than that of the control group (P 0.05). After treatment, Tg, TL, maximum diameter of C/B lymph nodes, number of lymph nodes and number of calcified spots were lower in the research group than in the control group (P < 0.05). ROC analysis revealed that the predictive sensitivity of MIP-1α for prognosis of 3-year RAIR-DTC death in the research group of patients was 84.63 % and the specificity was 72.16 %. AP combined with 131I is effective in the treatment of RAIR-DTC and is worth using in the clinical practice. In addition, elevated levels of MIP-1α predicted a poor prognosis for patients with RAIR-DTC.

El objetivo de este estudio fue observar la eficacia clínica de apatinib (AP) combinado con 131I en el tratamiento del cáncer de tiroides diferenciado refractario al yodo radiactivo (RAIR-DTC) y la importancia pronóstica de MIP-1α después del tratamiento, y proporcionar referencia y orientación para futuros tratamientos y enfermedades. Evaluación de RAIR- DTC. Se seleccionaron para el estudio 106 pacientes con RAIR- DTC ingresados en nuestro hospital desde enero de 2019 hasta octubre de 2020. Todos los pacientes fueron tratados con cirugía CT con 131I, y 58 de ellos fueron trasladados posteriormente a tratamiento AP, los que fueron considerados como grupo de investigación; los otros 48 pacientes fueron transferidos a tratamiento de supresión de la hormona estimulante de la tiroides (TSH), que se consideró como grupo de control. La eficacia clínica del grupo de investigación fue mejor que la del grupo de control (P 0,05). Después del tratamiento, Tg, TL, diámetro máximo de los linfonodos C/B, número linfonodos y número de manchas calcificadas fueron menores en el grupo de investigación que en el grupo de control (P <0,05). El análisis ROC reveló que la sensibilidad predictiva de MIP-1α para el pronóstico de muerte por RAIR-DTC a 3 años en el grupo de pacientes de investigación fue del 84,63 % y la especificidad fue del 72,16 %. AP combinado con 131I es eficaz en el tratamiento del RAIR-DTC y vale la pena utilizarlo en la práctica clínica. Además, los niveles elevados de MIP-1α predijeron un mal pronóstico para los pacientes con RAIR- DTC.

Effectiveness of virtual teaching programme regarding palliative care on knowledge, self-efficacy and attitude of Nursing Personnel in North India / Efectividad de un programa de enseñanza virtual sobre cuidados paliativos en los conocimientos, la autoeficacia y la actitud del personal de enfermería en el norte de la India / Eficácia de um programa virtual de ensino de cuidados paliativos sobre conhecimento, autoeficácia e atitude da equipe de enfermagem no norte da Índia

Objective.To evaluate the effectiveness of Virtual Teaching (VT) Programme regarding palliative care on knowledge, self-efficacy and attitude among Nursing Personnel working in selected hospitals of North India. Methods. A quasi-experimental study with non-equivalent control group pre-test-post-test design was conducted on 121 Nursing Personnel, selected by convenient sampling technique. Knowledge, self-efficacy and attitude were assessed using structured knowledge questionnaire, Palliative Care Self-efficacy Scale, and Frommelt Attitudes toward care of dying scale respectively. Nursing personnel in experimental group received Virtual Teaching Programme regarding palliative care whereas those in comparison group received conventional teaching (CT). The study included a pre-test followed by the teaching (virtual/ conventional) on day one. The post-test was conducted on 15th day after the intervention. Results. The results showed that there was a significant difference in mean post-test knowledge (VT group: 17.11 to CT group: 25.05; t=9.25, p<0.001), self-efficacy (VT group: 39.27 to CT group: 43.38; t=6.39, p<0.001) and attitude (VT group: 108.86 to CT group: 133.23; t=9.27, p<0.001) scores between virtual teaching group and conventional teaching group. ANCOVA test revealed statistically significant differences in the mean scores of knowledge [F (1.11) = 86.61, p<0.001], self-efficacy [F (1.11) = 841.75, p<0.001] and attitude [F (1.11) = 82.92, p<0.001] between the groups, with higher means obtained in the CT group. Conclusion. Virtual Teaching programme and Conventional teaching both were effective in enhancing the knowledge, self-efficacy and attitude among Nursing Personnel regarding palliative care with conventional teaching being more effective.

Objetivo. Evaluar la efectividad de un programa de Enseñanza Virtual (EV) sobre cuidados paliativos en cuanto a conocimientos, autoeficacia y actitud entre el personal de enfermería que trabaja en hospitales seleccionados del norte de la India. Métodos. Se llevó a cabo un estudio cuasiexperimental con un diseño de grupo de control no equivalente. Se realizaron pre y post-prueba a 121 miembros del personal de enfermería, seleccionados mediante una técnica de muestreo por conveniencia. Se evaluaron los conocimientos, la autoeficacia y las actitudes mediante un cuestionario estructurado de conocimientos, una escala de autoeficacia en cuidados paliativos y una escala de actitudes de Frommelt hacia el cuidado de personas al final de su vida. El personal de enfermería del grupo experimental recibió un programa de EV sobre cuidados paliativos, mientras que el del grupo de comparación recibió enseñanza convencional (EC). El estudio incluyó una preprueba seguida de la enseñanza virtual o convencional el primer día y una prueba posterior al decimoquinto día después de la intervención. Resultados. Los resultados mostraron que había una diferencia significativa en las puntuaciones medias post-test entre los grupos en: conocimientos (EV: 17.11 y EC: 25.05; t=9.25, p<0.001), autoeficacia (grupo VT: 39.27 y grupo CT: 43.38; t=6.39, p<0.001) y actitud (grupo EV: 108.86 y grupo EC: 133.23; t=9.27, p=<0.001) La prueba ANCOVA también reveló diferencias estadísticamente significativas en las puntuaciones medias de conocimientos [F (1.11) = 86.61, p=<0.001], autoeficacia [F (1.12) =841.75, p=<0.001] y actitud [F (1.11) = 82.91, p<0.001] entre los grupos, obteniéndose medias más altas en el grupo CT. Conclusión. Tanto el programa de enseñanza virtual como la enseñanza convencional fueron efectivos para mejorar los conocimientos, la autoeficacia y la actitud del personal de enfermería en relación con los cuidados paliativos, siendo el beneficio mucho mayor la enseñanza convencional.

Objetivo. Avaliar a eficácia de um programa de Aprendizagem Virtual (VE) sobre cuidados paliativos em termos de conhecimento, autoeficácia e atitude entre a equipe de enfermagem que trabalha em hospitais selecionados no norte da Índia. Métodos. Um estudo quase experimental foi conduzido com um desenho de grupo controle não equivalente. Foram realizados pré e pós-testes em 121 membros da equipe de enfermagem, selecionados por meio de técnica de amostragem por conveniência. Foram utilizados os instrumentos: questionário de conhecimento estruturado, escala de autoeficácia em cuidados paliativos e escala de atitudes de Frommelt em relação ao cuidado de pessoas em fim de vida. A equipe de enfermagem do grupo experimental recebeu um programa de VE sobre cuidados paliativos, enquanto o grupo controle recebeu ensino convencional (CE). O estudo incluiu um pré-teste seguido de ensino virtual ou convencional no primeiro dia e um pós-teste no 15º dia após a intervenção. Resultados. Os resultados mostraram que houve diferença significativa nas médias dos escores pós-teste entre os grupos em: conhecimento (EV: 17.11 e EC: 25.05; t=9.25, p<0.001), autoeficácia (grupo VT: 39.27 e grupo CT: 43.38; t=6.39, p<0.001) e atitude (grupo EV: 108.86 e grupo EC: 133.23; t=9.27, p=<0.001). O teste ANCOVA também revelou diferenças estatisticamente significativas nas pontuações médias de conhecimento [F (1.11) = 86.61, p=<0.001], autoeficácia [F (1.12) =841.75, p=<0.001] e atitude [F (1.11) = 82.91, p<0.001] entre os grupos, obtendo maiores médias em o grupo CT. Conclusão. Tanto o programa de ensino virtual quanto o ensino convencional foram eficazes na melhoria do conhecimento, da autoeficácia e da atitude da equipe de enfermagem em relação aos cuidados paliativos, sendo o benefício muito maior com o ensino convencional.

Desenho de Estudo de um Estudo Observacional Brasileiro sobre o uso de Edoxabana em Pacientes com Fibrilação Atrial (EdoBRA) / Study Design of a Brazilian Observational Study of Edoxaban in Patients with Atrial Fibrillation (EdoBRA)

Resumo Fundamento: Os ensaios clínicos demonstraram a segurança da Edoxabana, um anticoagulante oral não dependente de vitamina K (NOAC), e a sua eficácia na prevenção de acidente vascular cerebral e embolia sistémica em pacientes com fibrilação atrial não valvar (FANV) e também na prevenção e tratamento de tromboembolismo venoso. No entanto, pesquisas adicionais são necessárias para avaliar a segurança e a eficácia da Edoxabana em um cenário real na população brasileira. Objetivo: A fim de compreender os riscos e benefícios do uso da Edoxabana em cenários clínicos de rotina, o estudo EdoBRA está sendo conduzido para obter informações sobre a segurança e eficácia do uso da Edoxabana em pacientes não pré-selecionados com FANV no Brasil. Métodos: O estudo EdoBRA é um estudo multicêntrico, prospectivo e observacional, realizado em 36 centros no Brasil. São elegíveis para este estudo pacientes com FANV, ≥ 18 anos de idade, tratados com Edoxabana disponível comercialmente, que iniciaram o tratamento por pelo menos 14 dias e não mais do que 90 dias antes da data de inclusão no estudo, e que não estão participando de nenhum outro estudo de intervenção. Ao todo, 700 pacientes devem ser inscritos e acompanhados por um ano, com coletas de dados programadas para o período basal e 3, 6 e 12 meses após a inscrição no estudo. O objetivo primário de segurança é o sangramento clinicamente relevante (de acordo com critérios da Sociedade Internacional de Trombose e Hemostasia - ISTH), e o objetivo secundário de eficácia são desfechos cardiovasculares relevantes relacionados à FANV. Conclusão: O estudo observacional EdoBRA gerará informações adicionais relevantes sobre a Edoxabana enquanto NOAC em diversos aspectos do manejo de pacientes no atendimento clínico de rotina, como perfil de segurança e efetividade em pacientes com FANV no Brasil.

Abstract Background: Clinical trials showed the safety of Edoxaban, a non-vitamin K-dependent oral anticoagulant (NOAC), and its efficacy to prevent stroke and systemic embolism in non-valvular atrial fibrillation (NVAF) patients and also to prevent and treat venous thromboembolism. However, additional research is needed to evaluate the safety and effectiveness of Edoxaban in a real-world scenario in the Brazilian population. Objective: In order to understand the risks and benefits of Edoxaban use in routine clinical settings, the EdoBRA study is being conducted to gain insight into the safety and effectiveness of Edoxaban use in non-preselected patients with NVAF in Brazil. Methods: The EdoBRA study is a multicenter, prospective, observational study conducted in 36 sites in Brazil. NVAF patients ≥ 18 years treated with commercially available Edoxaban who initiated treatment for at least 14 days and no longer than 90 days prior to enrollment, and who are not simultaneously participating in any interventional study are eligible for this study. Seven hundred patients are planned to be enrolled and one-year of follow up, with data collections expected at baseline and 3, 6, and 12 months after the study enrollment. The primary safety objective is ISTH Clinically Relevant Bleeding, and the secondary effectiveness objective focuses on relevant cardiovascular outcomes related to NVAF. Conclusion: EdoBRA observational study will generate relevant additional information about NOAC Edoxaban on various aspects of patient management in routine care, such as its safety and effectiveness profile in patients with NVAF in Brazil.

Postpartum depression in adolescent mothers before and during COVID-19 and the role of self-esteem, maternal self-efficacy, and social support / Depresión posparto en madres adolescentes antes y durante la pandemia por COVID-19 el papel de la autoestima, la autoeficacia materna y el apoyo social

Abstract Introduction Although the COVID-19 pandemic negatively impacted the mental health of vulnerable populations, such as adolescent mothers, very few studies have documented the prevalence of postpartum depression (PPD) in this population. Objective a) Determine the frequency of PPD (Edinburgh Postnatal Depression Scale [EPDS] ≥ 9) in adolescent mothers before (AM-BP) and during (AM-DP) the pandemic, b) Examine psychosocial factors (self-esteem, maternal efficacy, social support, depression and anxiety in pregnancy, planned and wanted pregnancy) in AM-BP and AM-DP, and c) Determine whether being an AM-DP was a significant factor for experiencing PPD (EPDS ≥ 9). Method Cross sectional study. Subjects: Forty-one AM-BP recruited at Health Centers and interviewed face to face and forty-one AM-DP surveyed online. Results PPD (EPDS ≥ 9) was 42% (p = .001) more frequent in AM-DP. The groups differed significantly in all psychosocial factors, with AM-DP faring worse. Unadjusted regressions showed that being an AM-DP, having lower maternal efficacy and self-esteem, greater dissatisfaction with social support, and depression and/or anxiety in pregnancy increased PPD (EPDS ≥ 9). Adjusted multiple analysis indicated that lower self-esteem was the only factor to maintain its association with PPD (EPDS ≥ 9; p = .017). Discussion and conclusion The pandemic negatively affected PPD (EPDS ≥ 9) and psychosocial factors in AM-DP, as compared to AM-BP, with self-esteem being the main factor associated with PPD (EPDS ≥ 9). In situations of extreme stress as happened in the pandemic, the mental health of adolescent mothers should be prioritized to prevent negative effects such as PPD. PPD preventive and treatment interventions should consider strengthening self-esteem.

Resumen Introducción La pandemia por COVID-19 tuvo un impacto negativo en la salud mental de poblaciones vulnerables, como las madres adolescentes, no obstante, escasos estudios documentaron la prevalencia de depresión posparto (DPP) en esta población. Objetivo a) Conocer la frecuencia de DPP (Escala Edinburgh para la Depresión Postnatal [EPDS] ≥ 9) en madres adolescentes antes de la pandemia (MA-AP) y durante la pandemia (MA-DP), b) Examinar algunos factores psicosociales (autoestima, eficacia materna, apoyo social, depresión y ansiedad en el embarazo, embarazo planeado y deseado) en MA-AP y MA-DP, y, c) Analizar si ser MA-DP, fue un factor significativo para experimentar DPP (EPDS ≥ 9). Método Estudio transversal. Participantes: 41 MA-AP captadas en Centros de Salud y 41 MA-DP encuestadas en línea. Resultados La DPP (EPDS ≥ 9) fue 42% (p = .001) más frecuente en las MA-DP. Los grupos difirieron significativamente en todos los factores psicosociales, en detrimento de las MA-DP. Las regresiones no ajustadas mostraron que ser MA-DP, tener menor eficacia materna y autoestima, mayor insatisfacción con el apoyo social, y depresión y/o ansiedad en el embarazo incrementaron la DPP (EPDS ≥ 9). El análisis múltiple ajustado indicó que una menor autoestima fue el único factor que mantuvo su asociación con DPP (EPDS ≥ 9; p = .017). Discusión y conclusión La pandemia tuvo un efecto negativo en la DPP (EPDS ≥ 9) y en factores psicosociales en MA-DP; la autoestima fue el principal factor asociado a la misma. Ante situaciones de estrés extremo, la salud mental de madres adolescentes debería ser prioritaria para prevenir efectos negativos como la DPP. Intervenciones preventivas y de tratamiento de DPP deben fortalecer la autoestima.

Traducción y validación de la Escala de Autoeficacia en Lactancia Materna BSES-SF en población colombiana / Translation and Validation of the Breastfeeding Self-Efficacy Scale bses-sfin a Colombian Population / Tradução e validação da Escala de Autoeficácia em Amamentação bses-sfna população colombiana

La autoeficacia en la lactancia materna es la confian-za de la madre en su capacidad para amamantar a su hijo(a), la cual se evalúa mediante el cuestionario Breastfeeding Self Efficacy Scale (bses). Diversos estu-dios han explorado las propiedades psicométricas del instrumento con resultados adecuados en diferentes países. Este estudio presenta el proceso de traducción y validación de la escala en su versión breve, de 14 ítems, en una muestra de mujeres colombianas. En total, se evaluaron 243 mujeres lactantes con hijos alrededor de los cuatro meses de edad. Se analizó la consistencia y estructura interna de la escala, así como su relación con otras variables. La escala evidenció adecuados indicios respecto a su consistencia interna (α = .91), se identificó una estructura factorial de dos dimensiones que explican un 48 % de la varianza, la relación con otras variables como la autoestima (ρ = .28) y el estrés percibido (ρ = .30) fueron débiles o moderadas, y las diferencias en las puntuaciones respecto a la historia obstétrica y las variables sociodemográficas fueron analizadas. Las evidencias psicométricas apoyan la utilización de la escala, tanto en el ámbito clínico como en el investigativo para evaluar la autoeficacia en mu-jeres lactantes colombianas

2Adriana Trujillo, Rubby Castro-Osorio, Natalia Maldonado-AvendañoAvances en Psicología Latinoamericana / Bogotá (Colombia) / Vol. 42(1) / pp. 1-20 / 2024 / ISSNe2145-4515obstétrica y las variables sociodemográficas fueron analizadas. Las evidencias psicométricas apoyan la utilización de la escala, tanto en el ámbito clínico como en el investigativo para evaluar la autoeficacia en mu-jeres lactantes colombianas.Palabras clave: autoeficacia; lactancia materna; bses-sf; psicometría.AbstractBreastfeeding self-efficacy is the mother's confidence in her ability to breastfeed her child and is assessed using the Breastfeeding Self-Efficacy Scale (bses). Several studies have explored the psychometric properties of the questionnaire with adequate results in different countries. The present study presents the translation and validation process of the 14-item brief version of the scale in a sample of Colombian women. In to-tal, 243 lactating women with children around four months of age were evaluated. The consistency and internal structure of the scale was analysed, as well as its relationship with other variables. The scale evidenced adequate internal consistency (α = .91), a factorial structure of two dimensions explaining 48 % of the variance was identified, the relationship with other variables such as self-esteem (ρ = .28) and perceived stress (ρ = .30) was weak or moderate, and the differences in scores regarding the obstetric history and sociodemographic variables were analyzed. The psychometric evidence supports the use of the scale in both clinical and research settings to assess self-efficacy in Colombian lactating women.

A autoeficácia na amamentação é a confiança da mãe em sua capacidade de amamentar seu filho e é avaliada por meio do questionário Breastfeeding Self Efficacy Scale(bses). Vários estudos exploraram as propriedades psi-cométricas do instrumento com resultados adequados em diferentes países. O presente estudo apresenta o processo de tradução e validação da escala em sua versão breve de 14 itens em uma amostra de mulheres colombianas. No total, foram avaliadas 243 lactantes com filhos em torno de quatro meses de idade. Foram analisadas a consistência e a estrutura interna da escala, bem como sua relação com outras variáveis. A escala apresentou indicações adequadas quanto à sua consistência interna (α = 0,91), foi identifi-cada uma estrutura fatorial bidimensional que explicou 48% da variância. A relação com outras variáveis como a autoestima (ρ = 0,28) e percepção ao estresse (ρ = 0,30) foi fraca ou moderada, e, foram analisadas diferenças nos escores referentes ao histórico obstétrico e às variáveis sociodemográficas. Evidências psicométricas apoiam o uso da escala tanto em ambientes clínicos como de pesquisa para avaliar a autoeficácia na amamentação em mulheres lactantes colombianas.

Reducción del craving en una adolescente en tratamiento residencial para adicciones a través una intervención breve: Un estudio de caso / Reduction of craving in an adolescent in residential treatment for addictions through a brief intervention: A case study

RESUMEN Introducción: El craving es un deseo subjetivo por consumir sustancias. Se ha encontrado que el craving es uno de los mejores predictores de recaídas, por lo que resulta importante abordarlo durante el tratamiento para las adicciones. El Programa de Intervención Breve para Adolescentes (PIBA) ha demostrado ser eficaz para reducir el patrón de consumo de drogas, aumentar la autoeficacia para enfrentarse a situaciones de consumo y disminuir los problemas asociados al consumo en adolescentes que se encuentran en escuelas de nivel medio o medio superior, así como en instituciones de atención de adicciones de tipo ambulatorio. Sin embargo, la efectividad de este programa no se ha probado con adolescentes que se encuentran en tratamiento residencial ni para reducir el craving. Objetivo: Evaluar la efectividad del PIBA para reducir el craving y aumentar la autoeficacia de una adolescente que se encontraba en un centro residencial. Método: Se aplicó un diseño de caso único que consistió en la aplicación del tratamiento y el seguimiento a cuatro meses, intencional y no probabilístico con una adolescente de 16 años. Resultados: Se encontró una reducción del craving a lo largo del tratamiento, que se mantuvo durante el seguimiento, así como un aumento en la autoeficacia. Conclusión: Estos hallazgos extienden la eficacia del PIBA a componentes de la adicción y a poblaciones no exploradas antes, sugiriendo que el PIBA puede ser una alternativa para trabajar con estos componentes y poblaciones.

ABSTRACT Introduction: Craving refers to a subjective desire to consume substances. It has been found that craving is one of the best predictors of relapse, so it is important to address it during addiction treatment. The Brief Intervention Program for Adolescents (PIBA) has been shown to be effective in reducing drug consumption patterns, increasing self-efficacy to deal with consumption situations, and reducing problems associated with consumption in adolescents who are in middle or high school schools, as well as in outpatient addiction care institutions. However, the effectiveness of this program has not been tested with adolescents in residential treatment or in reducing craving. Objective: To evaluate the effectiveness of PIBA in reducing craving and increasing self-efficacy in a female adolescent who was in a residential center. Method: A single-case design was applied, consisting of the treatment and a follow-up at four months, intentional and non-probabilistic, with a 16-year-old female adolescent. Result: A reduction in craving was found throughout the treatment and maintained during the follow-up, as well as an increase in self-efficacy. Conclusion: These findings extend the effectiveness of PIBA to addiction components and populations not previously explored, suggesting that PIBA may be an alternative to work with these components and populations.

Meta-analysis of efficacy and safety of aspirin versus other anticoagulants in the prevention of thromboembolism after orthopedic surgery / 中国药房

OBJECTIVE To evaluate the clinical efficacy and safety of aspirin versus other anticoagulants in the prevention of thromboembolism after orthopedic surgery. METHODS Retrieved from PubMed， Embase， the Cochrane Library， CNKI， Wanfang data and VIP， randomized controlled trials （RCTs） and cohort studies about aspirin （trial group） versus other anticoagulants （control group） were collected during the inception and June 1st， 2023. After literature screening， data extraction and quality evaluation， the meta-analysis was conducted by using RevMan 5.4 software. RESULTS A total of 22 studies were included， involving 9 RCTs and 13 cohort studies. RCT results showed that the incidences of deep vein thrombosis （DVT） [RR＝1.81， 95%CI（1.36， 2.40）， P＜0.000 1] and postoperative pulmonary embolism （PE） [RR＝1.55， 95%CI（1.01， 2.40）， P＝0.05] in trial group were significantly higher than control group. There was no statistically significant difference in the incidences of postoperative massive bleeding， postoperative surgical site infection， all-cause death， or any bleeding after surgery between 2 groups. In the cohort study， the incidence of any bleeding in trial group was significantly lower than control group [RR＝0.71，95%CI （0.64， 0.79）， P＜0.000 1]， while the differences in other indicators were not statistically significant （P＞0.05）. The results of subgroup analysis based on different anticoagulants showed that in RCT， the incidences of DVT and PE after surgery in patients using low-molecular-weight heparin （LMWH） were significantly lower than using aspirin （P＜0.05）； in the cohort study， the incidences of DVT and PE after surgery were significantly lower in patients using direct oral anticoagulants （DOAC） than using aspirin （P＜0.05）. There was no statistically significant difference in the incidence of major bleeding between patients using aspirin and using DOAC and LWMH （P＞0.05） in both RCT and cohort study. CONCLUSIONS Aspirin is equally safe as other anticoagulants for the prevention of thromboembolism after orthopedic surgery， but its efficacy may not be as good as other anticoagulants. After orthopedic surgery， other anticoagulants should be preferred to prevent venous thromboembolism， and aspirin should be carefully considered.

Meta-analysis of the efficacy and safety of Saccharomyces boulardii versus Bifidobacterium triple live bacteria in the treatment of pediatric diarrhea / 中国药房

OBJECTIVE To compare the efficacy and safety of Saccharomyces boulardii and Bifidobacterium triple live bacteria in the treatment of pediatric diarrhea. METHODS Retrieved from PubMed， Embase， the Cochrane Library， CBM， Wanfang data， CNKI and VIP， randomized controlled trials （RCTs） about S. boulardii （S. boulardii group） versus Bifidobacterium triple liver bacteria （Bifidobacterium group） were collected. After screening the literature， extracting data and evaluating the quality， meta-analysis was performed by using RevMan 5.3 software. RESULTS A total of 9 RCTs were included， involving 898 patients. Results of meta-analysis showed there was no statistical significance in total response rate [OR＝1.69， 95%CI （0.93， 3.09）， P＝0.09]， duration of diarrhea [MD＝－1.39， 95%CI （－3.35， 0.57）， P＝0.16]， the time of abdominal pain disappearance [MD＝0.09， 95%CI（－0.87， 1.05），P＝0.86] or the incidence of adverse reactions [OR＝0.65， 95%CI （0.05， 8.03）， P＝0.74]. The number of stools in S. boulardii group was significantly less than Bifidobacterium group [MD＝－0.91， 95%CI （－1.80， －0.02）， P＝0.04]. The results of subgroup analysis showed that the duration of diarrhea in children with antibiotic-associated diarrhea in S. boulardii group was significantly shorter than Bifidobacterium group （P＜0.05）. CONCLUSIONS The efficacy and safety of S. boulardii are similar to those of Bifidobacterium in the treatment of diarrhea， but S. boulardii is better than Bifidobacterium in terms of stool number， the duration of diarrhea in children with antibiotic-associated diarrhea.

Meta-analysis of efficacy and safety of sedative therapy with midazolam and dexmedetomidine/propofol in critically ill patients undergoing mechanical ventilation / 中国药房

OBJECTIVE To systematically evaluate the efficacy and safety of midazolam and dexmedetomidine/propofol for the sedation of critically ill patients undergoing mechanical ventilation， and to provide evidence-based reference for clinical treatment. METHODS Retrieved from PubMed， Embase， Web of Science， Cochrane Library， Clinical trials. gov， China Journal Full Text Database， Chinese Science and Technology Journal Database， Wanfang database and China Biomedical Literature Database， the data on the efficacy and safety of midazolam and dexmetomidine/propofol for the sedation of critically ill patients undergoing mechanical ventilation were collected from the establishment of the database to March 31， 2023. After extracting data from clinical studies that met the inclusion criteria， the meta-analysis was conducted by using the RevMan 5.3 statistical software. RESULTS A total of 31 literature were included， with a total of 2 765 patients. Results of meta-analysis showed that the mechanical ventilation time [MD＝14.13， 95%CI （13.75， 14.52）， P＜0.000 01] and the length of hospitalization in the intensive care unit [MD＝0.92， 95%CI （0.54， 1.30）， P＜0.000 01] of patients in the midazolam group was longer than dexmedetomidine/ propofol group. The incidence of bradycardia in midazolam group was lower dexmedetomidine/propofol group [OR＝0.60， 95%CI （0.41， 0.90）， P＝0.01]， but there was no statistically significant difference in the incidence of hypotension between the two groups [OR＝0.69， 95%CI （0.47， 1.01）， P＝0.06]. The incidence of delirium [OR＝3.88， 95%CI （2.74， 5.49）， P＜0.000 01]， ventilator- associated pneumonia [OR＝2.32， 95%CI （1.19， 4.51）， P＝0.01]， and respiratory depression [OR＝5.70， 95%CI （3.09， 10.52）， P＜0.000 01] in midazolam group were higher than dexmedetomidine/propofol group. CONCLUSIONS Compared with dexmedetomidine/propofol， midazolam increases patients’ mechanical ventilation time and the length of hospitalization in the intensive care unit in terms of efficacy， and increases the risk of delirium and pulmonary complications in terms of safety， but has a smaller cardiovascular impact.

Efficacy and safety of tyrosine kinase inhibitors in the treatment of HER2-positive breast cancer：a meta-analysis / 中国药房

OBJECTIVE To evaluate the efficacy and safety of tyrosine kinase inhibitors （TKI） in the treatment of HER2- positive breast cancer in order to provide evidence-based evidence for clinical medication. METHODS Retrieved from CNKI， Wanfang database， VIP， PubMed， Cochrane Library， Embase and Web of Science， randomized controlled trial （RCT） about TKI （trial group） versus drugs excluding TKI （control group） in the treatment of HER2-positive breast cancer were collected from the establishment of the database to April 2023. Meta-analysis and sensitivity analysis were performed by using RevMan 5.4.1 and Stata 17 software. RESULTS Total of 24 RCT studies were included， involving 15 538 HER2-positive breast cancer patients. The meta- analysis results showed that compared with the control group， the progression-free survival （PFS） [HR＝0.91， 95%CI （0.80， 1.02）， P＝0.12]， overall survival （OS） [HR＝0.95， 95%CI （0.89， 1.01）， P＝0.11]， objective response rate （ORR） [OR＝1.21， 95%CI （0.86， 1.69）， P＝0.27]， and pathological complete response rate （pCR） [OR＝1.44， 95%CI （0.91， 2.27）， P＝0.12] had no statistically significant difference in the trial group； among the 3/4 grade ADRs， the trial group had a higher incidence of anemia [OR＝1.77， 95%CI （1.16，2.70）， P＝0.008]， rash [OR＝11.26， 95%CI （7.32，17.31）， P＜0.000 01]， paronychia [OR＝8.67， 95%CI（1.62，46.53）， P＝0.01]， diarrhea [OR＝10.17， 95%CI（5.03，20.58）， P＜0.000 01]， oral mucositis inflammation [OR＝ 9.34， 95%CI （3.13， 27.83）， P＜0.000 1]， elevated aspartate aminotransferase [OR＝2.09， 95%CI （1.13，3.84）， P＝0.02]， and hypokalemia [OR＝2.37， 95%CI （1.31，4.30）， P＝0.005] than that of the control group. Subgroup analysis results showed that compared with the placebo group， TKI could improve OS and ORR （P＜0.05）， while compared with trastuzumab， TKI had no advantage in PFS， OS， ORR， and pCR， and TKI combined with trastuzumab could significantly improve PFS， OS， ORR， and pCR compared with the trastuzumab group （P＜ 0.05）. Sensitivity analysis suggested that the results were relatively robust and the risk of publication bias was low. CONCLUSIONS Compared with trastuzumab， TKI has no advantages in PFS， OS， ORR and pCR in the treatment of HER2- positive breast cancer， but TKI combined with trastuzumab can significantly improve PFS， OS， ORR and pCR； TKI can increase the risk of grade 3/4 anemia， rash， paronychia， diarrhea， oral mucositis， elevated aspartate aminotransferase， and hypokalemia.

Textual Research of Pediatric Famous Classical Formula Daochisan Based on Ancient and Modern Literature / 中国实验方剂学杂志

Daochisan is a pediatric famous classical formula in traditional Chinese medicine（TCM） specializing in clearing the heart， disinhibiting water and enriching Yin， which has been inherited and developed by medical experts of successive generations. The formula can be traced back to Xiaoer Yaozheng Zhijue written by QIAN Yi from Song dynasty， and most of the later-developed Daochisan（Daochitang） is based on this formula with additions and subtractions. So as to promote the literature excavation of this formula， this paper conducts a thorough textual research and analysis of the composition， processing， preparation methods， clinical applications of Daochisan based on a systematic collation of relevant ancient and modern literature in the method of bibliometrics. A total of 127 pieces of data involving 86 antient TCM books were collected. Statistical analysis showed that the drug origin of Daochisan is basically clear， we suggest that Rehmanniae Radix is the root tuber of Rehmannia glutinosa of Scrophulariaceae， Akebiae Caulis is the dry stem of Akebia quinata of Lardizabalaceae， Glycyrrhizae Radix et Rhizoma is the dry root and stem of Glycyrrhiza uralensis of legume， bamboo leaf is the dry leaves of Phyllostachys nigra var. henonis of gramineous plants. Four herbs are recommended to use its raw products. The key information of the dosage and decocting method is supposed to be "4.13 g each of raw Rehmanniae Radix， raw Glycyrrhizae Radix et Rhizoma， Akebiae Caulis， adding 300 mL of water， and then adding 4.13 g of bamboo leaf， decocting together to 150 mL， taking warmly after meal". Daochisan has the effect of clearing the heart and enriching Yin， disinhibiting water and relieving stranguria， and is widely used in treating symptoms such as heart vexed hotness， hydrodipsia and reddish complexion. Modern studies have showed that Daochisan are frequently used in treating oral ulcer， herpetic stomatitis， urinary tract infection， herpes zoster and other diseases. The above research results can provide scientific reference for the future development and research of Daochisan.

Meta analysis and GRADE evidence level evaluation of therapeutic efficacy and safety of plum-blossom needle in treating vitiligo / 重庆医学

Objective To systematically evaluate the efficacy and safety of plum-blossom needle therapy for vitiligo by using the systematic review and meta analysis.Methods The randomized controlled trials(RCT)on plum-blossom needle for treating vitiligo were systematically retrieved from the databases of the PubMed,China Biological Medicine Database,CNKI,Wanfang Data and VIP database from the database estab-lishment to June 2,2022.The literatures were screened according to the inclusion and exclusion criteria.The finally included literatures conducted the data extraction.The RevMan 5.4 software was used for conducting the data analysis.The methodological quality evaluation on the included trials was performed by the ROB tool.The GRADE method was used to assess the evidence level.Results A total of 7 trials involving 469 pa-tients were finally included.The meta analysis results showed that the plum-blossom needle combined with other therapies(including laser or ultraviolet irradiation,tacrolimus ointment,compound Kaliziran tincture)was superior to the other therapies alone in the aspects of improving vitiligo skin lesion including reducing the of white spot skin lesion area(MD=-1.11,95％CI:-1.92 to-0.30,P=0.007),increasing the repigment-ation rate of vitiliginous lesions(MD=18.09,95％CI:1.55 to 34.63,P=0.030)and enhancing the pigment deposition in vitiligo lesions(MD=0.92,95％CI:0.32 to 1.52,P=0.003),and improving the patients'quali-ty of life(MD=-7.48,95％CI:-8.04 to-6.92,P＜0.001),and the differences were statistically signifi-cant.In terms of safety,there was no statistically significant difference in adverse events between plum blos-som acupuncture combined with other therapies and other therapies alone(RR=1.20,95％CI:0.77 to 1.84,P=0.420).Conclusion Low or very low evidence shows that plum-blossom needle combined with other therapies for treating vitiligo may enhance the effect in the aspects of improving the white spot skin lesions and quality of life in the patients with vitiligo,moreover which is relatively safe.

Study on the therapeutic effect of Xuefu Zhuyu Capsule combined with sacubitril valsartan on patients with dilated cardiomyopathy / 重庆医学

Objective To study the therapeutic effect of Xuefu Zhuyu Capsule combined with sacubitril valsartan on dilated cardiomyopathy.Methods A total of 70 patients with dilated cardiomyopathy who were hospitalized in the Hospital from January to December 2020 were selected as the research objects and random-ly divided into control group and experimental group,with 35 cases in each group.The control group was only treated with sacubitril valsartan,and the experimental group was treated with Xuefu Zhuyu Capsule combined with sacubitril valsartan.According to the patient's blood pressure and renal function,sacubitril valsartan was titrated from a small dose to the maximum dose.Xuefu Zhuyu Capsule was uesd 2.4 g each time,twice a day,and the treatment time was three months.The symptoms of heart failure,glycosylated hemoglobin(HbA1c),low density lipoprotein(LDL),total cholesterol(TC),triglyceride(TG),ALT,AST,N-terminal pro-brain natriuretic peptide(NT-proBNP),left ventricular end-systolic diameter(LVEDd),left ventricular end-dias-tolic diameter(LVEDs),ejection fraction(EF)and the incidence of arrhythmia were observed in the two groups after treatment.Results After treatment,the level of NT-proBNP in the experimental group was sig-nificantly lower than that in the control group(P＜0.05).There was no significant difference in LDL,TC,TG,LVEDd,LVEDs and EF between the two groups(P＞0.05).The incidence of atrial tachycardia and ven-tricular premature beat in the experimental group was higher than that in the control group(P＜0.05).Con-clusion Xuefu Zhuyu Capsule combined with sacubitril valsartan can significantly improve the symptoms of patients with heart failure and reduce the level of NT-proBNP,but it may increase the proportion of patients with atrial tachycardia and ventricular premature beats.

Comparative study on the clinical efficacy of intermittent oral administration of fosfomycin trometamol for a long time after removal of upper urinary infection stones / 重庆医学

Objective To investigate the clinical efficacy and safety of long-term intermittent oral ad-ministration of fosfomycin trometamol(FMT)in the control of urinary tract infection and the reduction of stone recurrence rate after removal of upper urinary infection stones.Methods A total of 171 patients who met the inclusion criteria were enrolled and divided into the FMT group(using FMT),cephalosporin group(using cefixime),and blank group(not using antibiotics)according to the random number method,with 57 cases in each group.Finally,55 cases in the FMT group,47 cases in the cephalosporin group and 48 cases in the blank group were included in the statistical analysis,and the urinary tract infection and stone recurrence of the three groups were followed up regularly after the stone removal operation.Results There was no statisti-cal significance in the baseline data of the three groups(P>0.05).There were significant differences in the recurrence rate of urinary tract infection at the 3rd and 6th month among the 3 groups(P=0.010,P<0.001).Further pair-wise comparison showed that the recurrence rate of urinary tract infection at the 3rd month in the FMT group was lower than that in the blank group(P<0.05),but there was no statistical difference compared with the cephalosporin group(P>0.05).The recurrence rate of urinary tract infection at the 6th month in the FMT group was lower than that in the cephalosporin group and blank group(P<0.05).The recurrence rate of stones in the 1st and 3rd year of the three groups were statistically different(P= 0.028,0.015).Further pair-wise comparison showed that the 1st year stone recurrence rate of the FMT group was lower than that of the cephalosporin group and blank group(P<0.05).The 3rd year stone recurrence rate of the FMT group was lower than that of the blank group(P<0.05),but there was no statistical difference compared with the cephalosporin group(P>0.05).There was no significant difference in the total incidence of adverse drug re-action between the FMT group and cephalosporin group(P=0.131).Conclusion FMT is superior to cephalospo-rin in the control of urinary tract infection after lithotripsy for upper urinary tract infection.

Clinical Observation of Modified Banxia Houpu Decoction Plus Deanxit for the Treatment of Cancer-Related Depression of Phlegm Blended with Qi Type / 广州中医药大学学报

Objective To investigate the clinical efficacy of modified Banxia Houpu Decoction plus Deanxit for the treatment of cancer-related depression(CRD)of phlegm blended with qi type.Methods Sixty-four CRD patients with phlegm blended with qi type were randomly divided into the treatment group and the control group,with 32 patients in each group.The control group was given oral use of Deanxit,and the treatment group was treated with modified Banxia Houpu Decoction plus Deanxit orally.The course of treatment covered 4 weeks.The changes of Karnofsky Performance Status(KPS)scores,self-rating depression scale(SDS)scores,and traditional Chinese medicine(TCM)syndrome scores in the two groups were observed before and after the treatment.Moreover,the efficacy for improving KPS scores and TCM syndrome efficacy in the two groups were also evaluated.Results(1)After 4 weeks of treatment,the total effective rate for improving KPS scores in the treatment group was 90.63%(29/32),and that in the control group was 78.13%(25/32).The intergroup comparison showed that the efficacy for improving KPS scores in the treatment group was significantly superior to that in the control group(P＜0.01).(2)In terms of the efficacy of TCM syndromes,after 4 weeks of treatment,the total effective rate for improving TCM syndrome scores in the treatment group was 87.50%(28/32),and that in the control group was 40.63%(13/32),and the efficacy of TCM syndromes in the treatment group was significantly superior to that in the control group(P＜0.05).(3)After treatment,the KPS scores in the treatment group were significantly increased compared with those before treatment(P＜0.05),and the KPS scores in the control group tended to increase compared with those before treatment,but the difference was not statistically significant(P＞0.05).The intergroup comparison showed that the effect on increasing KPS scores in the treatment group was significantly superior to that in the control group(P＜0.05).(4)After treatment,the SDS scores in the two groups were lower than those before treatment(P＜0.05),and the effect on lowering SDS scores in the treatment group was significantly superior to that in the control group(P＜0.05).(5)After treatment,the TCM syndrome scores of the two groups were lower than those before treatment(P＜0.05),and the effect on lowering TCM syndrome scores in the treatment group was significantly superior to that in the control group(P＜0.05).Conclusion Modified Banxia Houpu Decoction plus Deanxit exerts certain effect for the treatment of CRD of phlegm blended with qi type.The combined therapy can effectively improve the depression mood and quality of life of the patients,and its efficacy is superior to that of Deanxit alone.

Clinical Efficacy of Ziyin Huatan Prescription in the Treatment of Benign Thyroid Nodules with Yin Deficiency and Phlegm Coagulation Type / 广州中医药大学学报

Objective To investigate the clinical efficacy of Ziyin Huatan Prescription(derived from flavored Xiaoluo Pills,mainly with the functions of nourishing yin and resolving phlegm)in the treatment of benign thyroid nodules(TN)of yin deficiency and phlegm coagulation type.Methods Sixty-two benign TN patients with yin deficiency and phlegm coagulation type were randomly divided into the trial group and the control group,with 31 patients in each group.Both groups were required to stick to a light diet with less spicy and stimulating food,appropriate exercise and ease of mind.Moreover,the trial group was given oral use of Ziyin Huatan Prescription,and the control group was given oral use of Levothyroxine Sodium Tablets for a period of 3 months.The changes of traditional Chinese medicine(TCM)syndrome scores,maximum diameter of thyroid nodules and thyroid function indexes in the two groups were observed before and after the treatment.After treatment,the clinical disease efficacy and TCM syndrome efficacy were evaluated in the two groups.Results(1)After 3 months of treatment,the total effective rate for disease efficacy in the trial group was 90.32%(28/31),and that in the control group was 48.39%(15/31).The intergroup comparison showed that the clinical disease efficacy of the trial group was significantly superior to that of the control group(P＜0.05).(2)After 3 months of treatment,the total effective rate for TCM syndrome efficacy in the trial group was 77.42%(24/31),and that in the control group was 38.71%(12/31).The intergroup comparison showed that the TCM syndrome efficacy of the trial group was significantly superior to that of the control group(P＜0.01).(3)After treatment,the TCM syndrome scores of the trial group were significantly decreased compared with those before treatment(P＜0.01),while no obvious changes were shown in the control group(P＞0.05).The intergroup comparison showed that the reduction of TCM syndrome scores in the trial group was significantly superior to that in the control group(P＜0.05).(4)After treatment,the maximum diameter of TN in both groups was reduced compared with that before treatment(P＜0.05 or P＜0.01),and the reduction of the maximum diameter of TN in the trial group was superior to that in the control group(P＜0.05).(5)There were no significant changes in the thyroid function indexes of the two groups before and after treatment,and the differences were not statistically significant(P＞0.05).Conclusion Ziyin Huatan Prescription is effective on improving clinical symptoms and reducing the size of TN in patients with benign TN,without obvious adverse effects and with high safety.

Clinical Observation on the Modified Huangan Lipi Decoction Combined with Acupuncture at Sifeng Points in the Treatment of Children with Tic Disorders / 广州中医药大学学报

Objective To observe the clinical efficacy of the modified Huangan Lipi Decoction(mainly composed of Sclerotium Poriae Pararadicis,Paeoniae Radix Alba,Atractylodis Macrocephalae Rhizoma,Polygalae Radix,Acori Tatarinowii Rhizoma,and Curcumae Radix)combined with acupuncture at Sifeng(EX-UE10)points in the treatment of children with tic disorders(TD).Methods Seventy cases of TD children with spleen deficiency and liver hyperactivity syndrome were randomly divided into the treatment group and the control group,with 35 cases in each group.The control group was treated with conventional western medicine of Tiapride Hydrochloride Tablets,while the treatment group was treated with the combination of the modified Huangan Lipi Decoction and acupuncture at Sifeng points.Both groups were treated for 8 weeks.The changes of the Yale Global Tic Severity Scale(YGTSS)item scores of tic muscle group,tic frequency,tic intensity,complexity and interference degree as well as their total scores in the two groups were observed before and after treatment.Moreover,the clinical efficacy and safety in the two groups were evaluated.Results(1)After 8 weeks of treatment,the total effective rate of the treatment group was 88.57%(31/35),and that of the control group was 68.57%(24/35).The intergroup comparison showed that the total effective rate(tested by chi-square test)and the overall therapeutic efficacy(tested by rank-sum test)of the treatment group were significantly superior to those of the control group,and the differences were statistically significant(P＜0.05).(2)After treatment,the YGTSS item scores of tic muscle group,tic frequency,tic intensity,complexity and interference degree as well as their total scores in the two groups were significantly lower than those before treatment(P＜0.01),and the effect on lowering the above scores of the treatment group was significantly superior to that of the control group,the differences being all statistically significant(P＜0.01).(3)During the treatment,the incidence of adverse reactions in the treatment group was 2.86%(1/35)and that in the control group was 8.57%(3/35).The intergroup comparison showed that the incidence of adverse reactions in the treatment group tended to be lower than that of the control group,but the difference was not statistically significant(P＞0.05).Conclusion Modified Huangan Lipi Decoction combined with acupuncture at Sifeng points exert certain effect in the treatment of TD children with spleen deficiency and liver hyperactivity syndrome,and its efficacy is superior to that of the western medicine Tiapride Hydrochloride Tablets.