Objective To systematically review the efficacy and safety of nicergoline on chronic cerebrovascular insufficiency (CCVI).Methods Databases including the Cochrane Library,PubMed,CNKI,VIP and WanFang Date were electronically searched for relevant randomized controlled trails (RCTs) which studied the effectiveness and safety of Nicergoline on chronic cerebrovascular insufficiency.Two reviewers independently screened literature according to the inclusion and exclusion criteria,extracted data,and assessed the methodological quality.Metaanalysis was performed by using RevMan 5.2 software.Results Totally 9 studies involving 1 030 patients were included.The meta-analysis results showed that,compared with conventional treatment alone,the Nicergoline group was superior in improving the velocity of middle cerebral artery(MCA) in both systolic(MD=16.43,95％CI:10.39-22.46) and the late diastolic (MD=11.48,95％CI:5.34-17.63).Besides,Nicergoline significantly improved the pulse index (PI) of MCA (MD=-0.37,95％CI:-0.48--0.26).Likewise,it obviously improved the velocity in both systolic (MD=11.23,95％CI:6.10-16.35),the late diastolic (MD=8.80,95％CI:5.20-12.40) and the PI of vertebral artery (VA) (MD=-0.38,95％CI:-0.47--0.28).The remission rate of the nicergolinegroup was higher than that of the control group (OR=3.93,95％ CI:2.66-5.81).Drug-related adverse reactions were not reported in included studies.Conclusions Nicergoline shows a certain efficacy on CCVI without obvious adverse reactions.

Objective: To systematically evaluate the influencing factors for medication compliance in patients with comorbidities of chronic diseases, so as to provide the evidence for improving medication compliance. Methods: Literature on influencing factors for medication compliance in patients with comorbidities of chronic diseases were retrived from CNKI, Wanfang Data, VIP, SinoMed, PubMed, Web of Science, Cochrane Library and Embase from inception to January 20, 2024. After independent literature screening, data extraction, and quality assessment by two researchers, a meta-analysis was performed using RevMan 5.4 and Stata 16.0 softwares. Literature were excluded one by one for sensitivity analysis. Publication bias was assessed using Egger's test. Results: Initially, 7 365 relevant articles were retrieved, and 35 of them were finally included, with a total sample size of about 150 000 individuals. There were 30 cross-sectional studies and 5 cohort studies; and 11 high-quality studies and 24 medium-quality studies. The meta-analysis showed that the demographic factors of lower level of education (OR=2.148, 95%CI: 1.711-2.696), lower economic income (OR=1.897, 95%CI: 1.589-2.264), male (OR=0.877, 95%CI: 0.782-0.985), living alone (OR=2.833, 95%CI: 1.756-4.569) and unmarried (OR=2.784, 95%CI: 1.251-6.196); the medication treatment factors of polypharmacy (OR=1.794, 95%CI: 1.190-2.706), potentially inappropriate medication (OR=2.988, 95%CI: 1.527-5.847), low frequency of daily medication (OR=0.533, 95%CI: 0.376-0.754) and adverse drug reactions (OR=3.319, 95%CI: 1.967-5.602); the disease factors of long course of disease (OR=2.118, 95%CI: 1.643-2.730), more comorbidities (OR=1.667, 95%CI: 1.143-2.431) and cognitive impairment (OR=2.007, 95%CI: 1.401-2.874); and the psychosocial factors of poor belief in taking medication (OR=1.251, 95%CI: 1.011-1.547), poor self-rated health (OR=1.990, 95%CI: 1.571-2.522) and being guided by healthcare professionals (OR=0.151, 95%CI: 0.062-0.368) were the influencing factors for medication compliance in patients with chronic comorbidities. Conclusion The medication compliance in patients with comorbidities of chronic diseases is associated with demographic factors, pharmacological factors, disease factors and psychosocial factors, mainly including living alone, adverse drug reactions, course of disease, number of comorbidities and medication beliefs.

Objective To systematically evaluate the effectiveness and safety of different calcium channel blockers (CCBs) in preventing stroke in hypertensive patients.Methods PubMed,Cochrane Library,Embase,Wanfang,CNKI,CBM,and other databases were comprehensively retrieved,and the randomized controlled trials of different CCBs in the prevention of stroke in hypertensive patients were collected.The retrieval time was from the establishment of the databases to November 5,2018.The languages were limited to Chinese and English.The literature screening,study inclusion,information extraction,and quality evaluation were independently conducted by two professional reviewers.A network diagram was drawn using Stata 13.0,and a meta-analysis of the included studies was performed using the Bayes model of the GeMTC 1.4.3 software.Results A total of 12 studies with 58 468 patients were enrolled.Network metaanalysis showed that nitrendipine (odds ratio 0.63,95％ confidence interval 0.44-0.89) and nifedipine (odds ratio 0.68,95％ confidence interval 0.46-0.92) were statistically significant in reducing the incidence of stroke.Other CCBs were not statistically significant in reducing the incidence of stroke,but had clinical differences.For the effectiveness of applying different CCBs to reduce the incidence of stroke,lacidipine should be preferred,followed by amlodipine,nitrendipine,nifedipine,and felodipine.However,there were no statistically significant differences in the effectiveness of different CCBs in preventing stroke.Conclusion Different CCBs can effectively reduce the incidence of stroke.In terms of specific drug types,lacidipine should be considered first,followed by amlodipine,nitrendipine,nifedipine,and felodipine.

OBJECTIVETo investigate the risk factors of postoperative urinary retention after rectal cancer surgery.

METHODSClinical data of 133 patients with rectal cancer undergoing radical surgery from January 2013 to September 2014 in the General Hospital of the PLA Rocket Force were retrospectively analyzed. Time to the first removal of urinary catheter, incidence of postoperative urinary retention, and time to re-insert indwelling catheter were recorded. Risk factors of urinary retention were analyzed.

RESULTSOf 133 patients, 70 were males and 63 were females, with a median age of 62 (20-79) years old. Distance from tumor lower margin to anal verge were ≤5 cm in 58 patients, >5 cm to 10 cm in 41 patients, and >10 cm to 15 cm in 34 patients. The postoperative TNM stage was recorded in 35 patients with stage I(, 34 with stage II(, 59 with stage III( and 5 with stage IIII(. Surgical procedures included anterior resection (AR) for 92 patients, abdominoperineal resection (APR) for 25 patients and intersphincteric resection (ISR) for 16 patients. Laparoscopic approach was performed in 89 patients compared with open operation in 44 patients. Time to the first removal of urinary catheter was 2-7 days after operation (median, 5 days) and 36 (27.1%) patients developed urinary retention. All the 36 patients achieved spontaneous voiding by re-inserting urinary catheter for 2-28 days (median, 6 days). Univariate analysis showed that elderly (>65 years) and laparoscopic approach had significantly higher incidence of urinary retention [37.5%(21/56) vs. 19.5%(15/77), χ=5.333, P=0.021; 34.8%(31/89) vs. 11.4%(5/44), χ=8.214, P=0.004; respectively]. Multivariate logistic analysis demonstrated that old age(OR=3.949, 95%CI:1.622 to 9.612, P=0.002), laparoscopic approach (OR=5.665, 95%CI:1.908 to 16.822, P=0.002), and abdominoperineal resection (OR=3.443, 95%CI:1.199 to 9.887, P=0.022) were independent risk factors of urinary retention after rectal cancer surgery.

CONCLUSIONSPatients undergoing rectal cancer surgery have a high risk of postoperative urinary retention. More attention should be paid to the old patients, especially those undergoing laparoscopic procedure or abdominoperineal resection, to prevent postoperative urinary retention and urinary dysfunction.

Adult ; Age Factors ; Aged ; Anal Canal ; surgery ; Colon, Sigmoid ; surgery ; Digestive System Surgical Procedures ; adverse effects ; methods ; statistics & numerical data ; Factor Analysis, Statistical ; Female ; Humans ; Laparoscopy ; adverse effects ; statistics & numerical data ; Male ; Middle Aged ; Postoperative Complications ; epidemiology ; Rectal Neoplasms ; classification ; surgery ; Rectum ; surgery ; Retrospective Studies ; Risk Factors ; Urinary Catheterization ; statistics & numerical data ; Urinary Retention ; epidemiology ; Urination ; physiology

Objective To establish a scientific, practical, systematic prevention group of patients with cranial nerve injury after neurosurgery aspiration to standardize nursing system, and reduce the incidence of aspiration pneumonia.Methods From January to December 2014, 226 cases of posterior fossa tumor patients were selected as the control group and received routine nursing. The risk factors of occurrence of aspiration pneumonia were retrospectively analyzed, and standard aspiration prevention system was built, which consisted of aspiration risk screening, effective communication among medical staff and patients, the standardized management of airway, the standardized management of enteral nutrition, rehabilitation guidance, etc., and this system was applied to the clinics in January 2015. 237 cases of posterior fossa tumor patients admitted in our hospital from January to December 2015 were selected as the intervention group, and were given standard aspiration prevention. The incidence of aspiration pneumonia in two groups was compared before and after the implementation of standard aspiration prevention system. Results The incidence of aspiration pneumonia was 4. 4% in the intervention group, and it was 0. 8% in the control group (χ2 = 5. 882, P < 0. 01 ) . Conclusions Standard aspiration prevention system can help nursing staff to master preventive measures of system, effectively prevent and reduce the incidence of aspiration pneumonia in patients with posterior cranial nerve injury, and to ensure patients′safety.

Objective To explore the effects of health education video based on Knowledge, Attitude and Practice (KAP) model in patients with initial stroke. Methods A total of 146 patients with initial stroke hospitalized in General Hospital of Guangzhou Military Command of PLA from January to August 2016 were selected and randomly divided into control group (n=74) and observation group (n=72) according to the hospitalized ward. The control group received routine health education. In the observation group, health education videos based on KAP mode were circulated daily in the ward on the basis of the control group. Before the intervention, at the time of discharge, and one month after discharge, the scores of the disease related knowledge and the Champion Health Belief Model Scale (CHBMS) were compared between the two groups. One month after discharge, the scores of the Morisky Medication Adherence Scale (MMAS-8) were compared between the two groups. Results At the time of discharge, the scores of disease related knowledge and CHBMS were (6.49±1.34) and (111.58±17.95) respectively, which were both higher than those of the control group, with statistical significance (t=4.448, 6.695;P＜0.01). One month after discharge, the score of MMAS-8 was (6.05±1.43), which was higher than that of the control group (4.50±1.06), with statistical significance (t=7.454, P＜ 0.01). Conclusions Health education video based on KAP model can improve the knowledge, health belief and medication compliance of patients with initial stroke. The video strengthens the knowledge of patients with initial stroke, which is conducive to the formation of the correct attitude and behavior of patients, suitable for further promotion in the future.

Objective:To summarize the best evidence of medication adherence interventions for patients with multiple chronic conditions.Methods:According to the "6S" evidence model, literature on medication adherence in patients with multiple chronic conditions was retrieved from BMJ Best Clinical Practice, UpToDate, Medlive, National Institute for Health and Clinical Excellence, Cochrane Library, Embase, PubMed, Web of Science, China Biology Medicine disc, China National Knowledge Infrastructure, WanFang data and so on. The search period was from establishing the database to August 30, 2023.Results:A total of 16 articles were included, including three guidelines, four expert consensus, seven systematic reviews, and two meta-analyses. Twenty-seven pieces of evidence were summarized from six aspects of compliance assessment, educational intervention, behavioral intervention, optimized treatment program, technical reminder intervention, and social-psychological-emotional intervention.Conclusions:The best evidence of medication adherence interventions for patients with multiple chronic conditions summarized provides a reference for medical and nursing staff to develop medication adherence interventions.

Objective: To evaluate the efficacy and safety of sofosbuvir (Nanjing Zhengda Tianqing Pharmaceutical Co., Ltd.) combined with ribavirin in patients with genotype 2 chronic hepatitis C virus infection. Methods: Treatment-naïve or treatment experienced genotype 2 chronic hepatitis C patients from sixteen research centers of China were screened. All subjects received once-daily dose of sofosbuvir (400 mg) combined with ribavirin (body weight < 75 kg, 1 000 mg/day, 400 mg in the morning and 600 mg in the evening; body weight > 75 kg, 1 200 mg/d, 600 mg in the morning and 600 mg in the evening) for 12 weeks. Patients were followed-up for a period of 12 weeks after discontinuation of treatment. Continuous variables were expressed as mean ± standard deviation. The proportion of subjects with virologic response at different follow-up time points and 95% confidence intervals were estimated by maximum likelihood ratio and Clopper-Pearson interval. Results: 132 cases with genotype 2 chronic hepatitis C virus infection from sixteen research centers of China were included, 12 cases of whom were associated with cirrhosis, and the remaining 120 cases were not associated with cirrhosis. One hundred and thirty-one cases completed the study, and one patient lost to follow-up at week 4 after the end of treatment. The sustained virological response rate was 96.2% (95% confidence interval: 92.37% - 99.16%) after 12 weeks of drug withdrawal. Virological relapse occurred in four cases. Of the 132 subjects enrolled in the study, 119 (90.2%) reported 617 adverse events during treatment, of which 359 (76.5%) were TEAE related to sofosbuvir and/or ribavirin. There were nine TEAEs of grade 3 and above, and six cases (4.5%) of them had six severe adverse events. Only one serious adverse event was associated with sofosbuvir and ribavirin (unstable angina pectoris). There were no adverse events leading to drug discontinuation or death. Conclusion Sofosbuvir combined with ribavirin has a high SVR rate in the treatment of genotype 2 chronic hepatitis C virus infection, and most of the adverse events occurred were mild with acceptable safety profile.