1.Effect of psychological intervention on postoperative outcomes of adolescent patients undergoing scoliosis correction: a Meta-analysis
Yaqi CHEN ; Tong HAN ; Yingli WANG ; Huizhen WANG
Chinese Journal of Modern Nursing 2022;28(31):4317-4323
Objective:To evaluate the effect of psychological intervention on postoperative outcomes of adolescent idiopathic scoliosis (AIS) patients undergoing correction.Methods:A computer-based online search of PubMed, Embase, Cochrane Library, Web of Science, CINAHL, MEDLINE, PsycINFO, PQDT, China National Knowledge Infrastructure (CNKI) , Wanfang Database, VIP Chinese Journal Database, China Biology Medicine disc, controlled-trials and chictr clinical controlled trial databases from establishment to July 25, 2021 was performed for randomized controlled trials (RCTs) on the effect of psychological intervention on adolescent AIS patients undergoing correction surgery. RevMan 5.3 statistical software was used for meta-analysis.Results:Finally, 10 articles were included, with a total of 621 patients. Meta-analysis showed that psychological intervention could reduce postoperative pain ( SMD=-0.62, 95% CI: -1.15- -0.08, P=0.02) and reduce postoperative anxiety ( SMD=-0.54, 95% CI: -1.03- -0.06, P=0.03) , descriptive analysis showed that cognitive behavioral therapy could improve postoperative quality of life and mobility. Conclusions:Psychological intervention can reduce the pain and anxiety level of patients with scoliosis after surgery, improve the quality of life after surgery and improve the activity ability. However, due to the small number of studies and high heterogeneity of results, higher quality and large sample studies are needed to further validate the intervention effect and provide guidance for clinical practice.
2.Serious hypoglycemia, lactic acidosis and pancytopenia caused by Linezolid in elderly patients: a case report and literature review
Yan WANG ; Yaqi TONG ; Jing CHEN ; Zheng TAN ; Shuhong MING ; Baomin FANG
Chinese Journal of Geriatrics 2020;39(5):539-544
Objective:To analyze and summarize adverse reactions such as hypoglycemia, lactic acidosis and pancytopenia caused by Linezolid in elderly patients, in order to enhance clinicians' awareness of adverse reactions of Linezolid.Methods:One case with Linezolid-induced lactic acidosis, pancytopenia and hypoglycemia was reported in a patient receiving long-term and repeated use of Linezolid for recurrent urinary tract infections(RUTI)in Beijing Hospital.National and international literature on the three severe and rare adverse reactions caused by Linezolid before December 2018 was reviewed, and the risk factors, clinical characteristics and prognosis of the three severe adverse reactions caused by Linezolid were summarized and analyzed.Results:A total of 86 cases with Linezolid-induced adverse reactions such as hypoglycemia, lactic acidosis and pancytopenia were analyzed.Among them, the ratio of males to females was 1.8∶1.0, the median age was 64.5 years, and 44 cases were over 65 years, accounting for 51.2%.Among the 57 patients with lactic acidosis, 25 lactic acidosis cases were combined with liver and kidney diseases, which were the most commonly involved organs(43.9%, 25/57). The time of onset for lactic acidosis was 4 h-109 d, with a median value of 32 d, and the peak values of blood lactate were 2.6-38.1 mmol/L, with a median value of 13.3 mol/L.Pancytopenia occurred 4 h-120 days after the treatment, and the median value was 21 days.The time of onset for hypoglycemia was 8 h-26, and the median time was 10.3 days.The lowest value of blood glucose was 0.2 mmol/L.Of the 86 cases, 61(70.9%)patients improved, and 12 cases of 51 patients with lactic acidosis died, with a mortality rate of 23.5%.Conclusions:Clinicians should be aware of serious adverse reactions including hypoglycemia, lactic acidosis and pancytopenia during Linezolid treatment in elderly patients.It is recommended to monitor changes in blood glucose, blood lactate and blood cell count during Linezolid treatment, and to avoid long-term use of Linezolid, so as to maximize the benefits for patients.
4.Exploring the Essential Factors of Applying the Consensus Methods in the Development of Traditional Chinese Medicine Guidelines: A Qualitative Interview
Changhao LIANG ; Dingran YIN ; Meijun LIU ; Guanxiang YIN ; Xun LI ; Yaqi WANG ; Siqi LIU ; Min TONG ; Pengwei LIU ; Xiangfei SU ; Yutong FEI
Medical Journal of Peking Union Medical College Hospital 2023;15(4):942-952
This study delves into the pivotal factors influencing the consensus process within traditional Chinese medicine guideline development, with the objective of augmenting the quality of this process through methodological recommendations aimed at elevating standardization. Semi-structured qualitative interviews were used to interview guideline leaders, working groups and consensus groups to explore the pertinent elements impacting the credibility of consensus and gather insights into the constitution and progression of the consensus methodology. The study encompassed interviews with 26 participants, yielding 212 codes that were subsequently categorized into five domains: establishment of the consensus group, integration of patient participation, adeptness of the meeting moderator, preparation for consensus formulation, and overarching factors influencing consensus. The research distilled three fundamental phases for forming a consensus group and delineated 17 fundamental tenets for applying the consensus methodology. In forthcoming guideline development endeavors, it is advisable to bolster methodological training ahead of the consensus process while ensuring comprehensive engagement of methodologists. Encouraging experts to navigate differences judiciously and prioritizing meticulous methodology and evidentiary groundwork are recommended. The process should involve openly disclosing the selection of consensus group members, heightening the involvement of patients, and effective management and disclosure of conflicts of interest. This collective approach helps curtail bias, enhance transparency, bolster reliability, and fortify the scientific rigor of consensus outcomes.