Objective To evaluate the efficacy and safety of proton pump inhibitor (PPI)plus prokinetic drug on the treatment of laryngopharyngeal reflex .Methods According to predetermined criteria of inclusion and exclu-sion ,Cochrane Central Register of Controlled Trails(CENTRAL) ,Embase ,Elsevier ,Pubmed ,VIP ,Wanfang Data , CNKI and CBM were searched for the randomized controlled trails of proton pump inhibitor and prokinetic drug on the treatment of laryngopharyngeal reflex diseases from the date of establishment of the datebases to November 2012 .Revman 5 .1 software and GRAED profiler 3 .6 software were applied to analysis the data ,which was extrac-ted by three independent evaluators .Results A total of 346 related articles were obtained ,7 trails were included , 614 patients in total .The results of Meta -analysis showed that :the overall effictive rate of combination therapy with proton pump inhibitors plus prokinetic drug in patients with laryngopharyngeal reflex was higher than those in the control group [RR=1 .18 ,95% CI(1 .10 ,1 .28) ,P<0 .0001] .The rate of improvement of laryngeal signs exam-ined by fiberoptic laryngoscope was higher than those in the control group [RR= 1 .38 ,95% CI(1 .16 ,1 .65) ,P<0 .001] .The average relief time of dysphonia symptoms was shorter than those in the control group [MD = -1 .70 , 95 CI (-2 .95 ,-0 .45) ,P<0 .001] .Conclusion The effect of proton pump inhibitor plus prokinetic drug on the treatment of laryngopharyngeal reflex is superior to those of proton pump inhibitors or prokinetic drug only ,but in terms of safety ,more large-sample ,high-quality randomized controlled trails are required .

Objective To explore the trend in self-management efficacy and exercise compliance among patients within 6 months after radical resection of lung cancer and analyse the predictive correlation between the factors to provide references for improvement of exercise compliance in patients after lung cancer surgery.Methods Convenience sampling was used to select patients who had surgery of radical resection of lung cancer for the first time in the departments of thoracic surgery of two Grade IIIA hospitals in Nanchong between December 2022 and May 2023.The Chinese-version strategies used by people to promote health(C-SUPPH)and exercise compliance scale were employed to assess the self-management efficacy and patient exercise compliance at four time points:1 day before discharge(T1)and 1 month(T2),3 months(T3)and 6 months(T4)after surgery.A cross-lagged model was constructed to analyse the causal correlation between self-management efficacy and exercise compliance.Results Within 6 months after surgery,both of self-management efficacy and exercise compliance in the patients after radical resection of lung cancer were seen initially increased and then decreased(P<0.05).The cross-lagged model revealed that self-management efficacy and exercise compliance during the early postoperative period(TI-T2)exhibited reciprocal causation(β=0.254,P=0.003;β=0.332,P=0.007).Between T2 and T3,higher self-management efficacy positively predicted an increased exercise compliance(β=0.286,P<0.001).However,during T3 and T4,no predictive relationship was observed between the indicators(P>0.05).Conclusion The self management efficacy of patients after lung cancer sugery is at middle level and their exercise compliance is at low level.This study indicates that the initial levels of self-management efficacy and exercise compliance among patients after radical resection of lung cancer do not necessarily reflect a long-term trend.The predictive correlation between the two factors also varies over the time.Healthcare providers should consider the dynamic changes and individual differences across different stages after surgery,and implement timely and targeted intervention.

Objective To explore the longitudinal trajectories of symptom clusters in patients with rectal cancer within 6 months after laparoscopic anal preservation surgery,and analyze the predictive factors of each trajectory subgroup.Methods A longitudinal survey was conducted to select 128 patients who underwent laparoscopic anal preservation surgery for rectal cancer at the Department of Gastrointestinal Surgery,a tertiary hospital in Nanchong from November 2021 to April 2022.The general information questionnaire,Chinese version of Anderson Symptom Inventory for Gastrointestinal Cancer and Charlson Comorbidity Index were used to conduct follow-up surveys of the selected patients at 2 weeks,1 month,3 months and 6 months after surgeiy.The symptom cluster were extracted by exploratory factor analysis,and the latent category growth model was constructed to identify the trajectory subgroups of each symptom cluster.The predictive factors of each trajectory subgroup were analyzed by Mplus statistical software.Results There were 4 symptom clusters within 6 months after laparoscopic anus preserving surgeiy for rectal cancer,which were named as sickness symptom cluster,psychological-sleep symptom cluster,gastrointestinal symptom cluster,and psychological-treatment-related symptom cluster.The variance contribution rates were 65.173％,66.225％,62.421％,and 60.492％,respectively.The latent class growth model identified that there are 4 to 5 trajectory subgroups in the symptom cluster.Gender,education level,Charles Comorbidity Index,clinical T stage,medical cost burden,and treatment method were the predictors of high-risk trajectory subgroups in the symptom cluster(P＜0.05).Conclusion There are 4 symptom clusters within 6 months after laparoscopic anus preserving surgeiy for rectal cancer.The gastrointestinal symptom cluster is a specific symptom cluster for this type of patients with the heaviest symptom burden.The overall trajectory of each symptom cluster shows a dynamic decline trend,but individual trajectoiy subgroups still have an exacerbation trend.There are differences in predictive factors for different symptom clusters.Clinical medical staff should pay attention to the management of symptom clusters in patients with female patients,low education level,high Charles Comorbidity Index,high clinical T stage,heavy medical cost burden,and patients whose treatment method is chemotherapy plus surgery.High-risk groups should be timely identified;corresponding intervention methods were dynamically adjusted;the quality of precision nursing was improved.