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Objective:To evaluate the effect of early mobilization on mortality in intensive care unit (ICU) patients with mechanical ventilation after discharge by Meta-analysis.Methods:Databases including SinoMed, China National Knowledge Infrastructure (CNKI), Wanfang data, PubMed, the Cochrane Library, Web of Science, and Embase were searched from inception to September 17th, 2020, to collect randomized controlled trials (RCT) about early mobilization on mortality of patients with mechanical ventilation in ICU after discharge, the references included in the literature were traced. The control group was given routine care, the experimental group was given early mobilization on the basis of the control group, including passive or active mobilization on the bed, sitting on the bed, standing by the bed, transferring to the bedside chair and assisting walking. The literature screening, data extracting, and the bias risk assessment of included studies were conducted independently by two reviewers. Stata 12.0 software was then used to perform Meta-analysis. Funnel plot was used to test publication bias.Results:A total of 10 RCT studies involving 1 323 patients were included, with 660 patients in the control group and 663 patients in the experimental group. The results of literature quality evaluation showed that 7 studies were grade A and 3 studies were grade B, indicating that the overall quality of included literatures was high. The Meta-analysis results showed that early mobilization did not increase the mortality of patients with mechanical ventilation in ICU after discharge [odds ratio ( OR) = 0.92, 95% confidence interval (95% CI) was 0.75-1.13, P = 0.449]. Subgroup analysis results showed that early mobilization had a tendency to reduce the mortality of ICU patients with mechanical ventilation at 3, 6 and 12 months after discharge, but the difference was not statistically significant (3-month mortality: OR = 1.02, 95% CI was 0.74-1.40, P = 0.927; 6-month mortality: OR = 0.95, 95% CI was 0.70-1.27, P = 0.712; 12-month mortality: OR = 0.60, 95% CI was 0.33-1.10, P = 0.101). Funnel plot showed that the distribution of included literatures was not completely symmetrical, suggesting that publication bias might exist. Conclusions:Early mobilization does not increase the mortality of ICU patients with mechanical ventilation after discharge. Although it tends to have a favorable outcome in reducing mortality, and has a trend to reduce the mortality. However, due to the small number of included literatures, small sample size and differences in the specific implementation of early mobilization among various studies, a large number of high-quality RCT studies are still needed for further verification.
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Objective:To evaluate the effect of preventing and treatment of pharmaceuticals on intensive care unit-acquired weakness (ICU-AW) by systematic review.Methods:The randomized controlled trials (RCTs) concerning pharmaceutical prevention and treatment about ICU-AW in SinoMed, CNKI, Wanfang data, PubMed, Cochrane Library, Web of Science, EMbase, and other sources were searched from their foundation to May 30th, 2019. The patients in the intervention group were treated with drugs to prevent or treat ICU-AW; and those in control group were treated with other rehabilitation methods. Data searching, extracting and quality evaluation were assessed by two reviewers independently. Stata 12.0 software was then used for Meta-analysis. Only descriptive analysis was conducted when only one study was enrolled.Results:A total of 11 RCTs were enrolled with 1 865 patients in the intervention group and 1 894 in the control group. The results of quality evaluation showed that 4 studies were A-level and 7 studies were B-level, indicating that the overall quality of the enrolled literature was high. Meta-analysis showed that intensive insulin therapy could prevent ICU-AW [relative risk ( RR) = 0.761, 95% confidence interval (95% CI) was 0.662-0.876, P = 0.000], but reduced phenylalanine loss (nmol·100 mL -1·min -1: -3±3 vs. -11±3, P < 0.05) and glutamine intake (nmol·100 mL -1·min -1: -97±22 vs. -51±13, P < 0.05). There was no significant difference in the prevention and treatment of ICU-AW between other drugs (including growth hormone, glutamine, dexmedetomidine, neostigmine, oxandrolone, and intravenous immunoglobulin) and control group. Conclusions:Intensive insulin therapy can prevent ICU-AW, but the risk of hypoglycemia will increase. Other drugs including growth hormone, glutamine, dexmedetomidine, neostigmine, oxandrolone, and intravenous immunoglobulin have no obvious advantages in the prevention and treatment of ICU-AW, so no drug has been recommended to prevent and treat ICU-AW.
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Objective To investigate the correlation of suicidal ideation with social support and quality of life among only-child loss people.Methods Totally 320 only-child loss people were collected by using stratified cluster random sampling method.Social support rating scale(SSRS) and general quality of life inventory(GQOLI) were used to investigate the suicidal ideation status.The association of suicidal ideation with social support and quality of life was analyzed by Pearson correlation analysis.Results The suicidal risk rate of only-child loss people was 45.0％.Compared with control group((4.87±2.32),(35.50±9.33),(139.46±37.80)),only-child loss group had lower scores in suicidal ideation,SSRS,GQOLI ((8.94±3.99),(29.97±9.15),(29.97±9.15) respectively,t=1.997-15.009,P＜0.05 or P＜0.01).The suicidal ideation total score was negatively correlated with scores of SSRS and all its 4 items,GQOLI,physical function,psychological function(r=-0.121--0.270,P＜0.05 or P＜0.01).The score of suicidal ideation in the past year was positively correlated with scores of material function (r=0.135,P＜ 0.05).Regression analysis showed that age,marriage,objective support,subjective support and GQOLI were the influencing factors(t=-3.251-3.160,P＜ 0.01 or P＜0.05).Conclusion Only-child loss people have higher suicidal risks,which is negatively correlated with lower social support and quality of life,and influenced by age,marriage,SSRS and GQOLI factors.
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Objective To explore the alteration of the peripheral thyroid hormone level in patients with chronic alcohol dependence and its relationship with depressive emotion.Methods Data were collected from 21 male patients with chronic alcohol dependence (case group) and 21 male health control (control group).Hamilton Depression Scale-24 (HAMD-24) and Alcohol Dependence Screening Scale (MAST) were used.The level of thyroid stimulating hormone (TSH),free triiodothyronine (FT3),free thyroxine (FT4),triiodothyronine (T3) and four iodine thyroxine (T4) of case group and control group were separately determined.The level of above-mentioned hormones and scale score of case group were evaluated in the first and sixth week of the period of temperance.Data of control group were collected once at baseline.Results The level of FT3 in case group was decreased significantly in the first week of the period of temperance compared with the control group ((4.34± 1.01) pmol/L,(5.85 ± 0.78) pmol/L,t =5.56,P＜ 0.01),while the level of TSH in case group was increased((2.62±0.69) uIU/ml,(1.70±0.81)uIU/ml,t=-3.96,P＜0.01).The level of FT3 and T3 in case group decreased significantly in the sixth week of the period of temperance comparedwith the control group(FT3:(5.22±0.92) pmol/L,(5.85±0.78) pmol/L,t=2.45,P＜ 0.05;T3:(1.54±0.54)pmol/L,(1.84±0.34)pmol/L,t=2.92,P＜0.01).The level of FT3 of the case group in the first week decreased significantly compared with the sixth week in the period of temperance (t=-4.12,P＜0.01),while the level of FT4 were increased significantly (t=-3.93,P＜0.01).In case group,the scores of HAMD-24 and the level of T3 (r=-0.465,P＜0.05),TSH (r=-0.489,P＜0.05) were negative correlation in the first week of the period of temperance.No correlation were observed between the score of HAMD-24 and the level of FT3,FT4,TSH,T3,T4 (r=-0.303-0.047,all P＞ 0.05)in the sixth week of the period of temperance.Conclusion The level of serum thyroid is disordered in patients with chronic alcohol dependence.The disorder will recover in the period of temperance and is associated with depressive emotion.
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Objective To explore the alteration of the peripheral thyroid hormone level in patients with chronic alcohol dependence and its relationship with depressive emotion.Methods Data were collected from 21 male patients with chronic alcohol dependence (case group) and 21 male health control (control group).Hamilton Depression Scale-24 (HAMD-24) and Alcohol Dependence Screening Scale (MAST) were used.The level of thyroid stimulating hormone (TSH),free triiodothyronine (FT3),free thyroxine (FT4),triiodothyronine (T3) and four iodine thyroxine (T4) of case group and control group were separately determined.The level of above-mentioned hormones and scale score of case group were evaluated in the first and sixth week of the period of temperance.Data of control group were collected once at baseline.Results The level of FT3 in case group was decreased significantly in the first week of the period of temperance compared with the control group ((4.34± 1.01) pmol/L,(5.85 ± 0.78) pmol/L,t =5.56,P＜ 0.01),while the level of TSH in case group was increased((2.62±0.69) uIU/ml,(1.70±0.81)uIU/ml,t=-3.96,P＜0.01).The level of FT3 and T3 in case group decreased significantly in the sixth week of the period of temperance comparedwith the control group(FT3:(5.22±0.92) pmol/L,(5.85±0.78) pmol/L,t=2.45,P＜ 0.05;T3:(1.54±0.54)pmol/L,(1.84±0.34)pmol/L,t=2.92,P＜0.01).The level of FT3 of the case group in the first week decreased significantly compared with the sixth week in the period of temperance (t=-4.12,P＜0.01),while the level of FT4 were increased significantly (t=-3.93,P＜0.01).In case group,the scores of HAMD-24 and the level of T3 (r=-0.465,P＜0.05),TSH (r=-0.489,P＜0.05) were negative correlation in the first week of the period of temperance.No correlation were observed between the score of HAMD-24 and the level of FT3,FT4,TSH,T3,T4 (r=-0.303-0.047,all P＞ 0.05)in the sixth week of the period of temperance.Conclusion The level of serum thyroid is disordered in patients with chronic alcohol dependence.The disorder will recover in the period of temperance and is associated with depressive emotion.