Journal Database Research Articles

Autogenic relaxation on pain reduction in mothers post caesarean section: Literature review

Postoperative pain after cesarean section is one of the main problems that affect the comfort and recovery process of mothers. Inadequate pain management can affect the physical and psychological function of patients. Autogenic relaxation therapy, which involves self-relaxation techniques, is believed to help reduce pain intensity through control of physiological and emotional responses. The purpose of this study was to analyze journals on autogenic therapy for reducing pain in mothers with post-cesarean section surgery. Data collection method using a literature review study method using the Google Scholar journal database in the last 10 years, as many as 5 appropriate journals showed that there was an effect of autogenic therapy on reducing pain given on average for 3 days after 4 to 6 hours after surgery. The conclusion from the results of the analysis was a decrease in pain after autogenic relaxation therapy was given.

Effect of Acupuncture on Anxiety, Depression, and Quality of Life in Patients with Irritable Bowel Syndrome: A Meta-Analysis.

Irritable bowel syndrome (IBS) has been effectively treated with acupuncture, but the significance of quality of life, depression, and anxiety in the assessment of IBS patients has received little consideration. This study examined the impact of acupuncture on depression, anxiety, and quality of life in IBS patients. PubMed, Cochrane Library, China National Knowledge Infrastructure (CNKI), EMBASE, China Science and Technology Journal Database (VIP), Chinese Biological Medical (CBM, SinoMed) Database, and the Wan Fang Database were among the electronic databases from which relevant randomized controlled trials (RCTs) were systematically retrieved between their inception and July 2023. The outcomes included adverse events, total response rate, anxiety, and symptoms of depression, as well as quality of life. In this study, the heterogeneity, publication bias, standardized mean difference (SMD), and risk ratios (RR) with 95% confidence intervals (CI) were estimated. In this study, 29 RCTs including 3114 participants for analysis (treatment group, 1730; control group, 1384) were included. Compared to other therapies, acupuncture significantly improved the quality of life (SMD = 0.61, 95% CI = [0.26, 0.96], P < 0.001) and alleviated anxiety (SMD = - 0.72, 95% CI = [- 1.76, 0.32], P = 0.18) and depression (SMD = - 0.74, 95% CI = [- 1.18, - 0.3], P < 0.001) in IBS patients. A statistically significant improvement was recorded in their quality of life, and they also displayed fewer symptoms of depression. The total response rate (RR = 1.18, 95% CI = [1.12,1.25], P < 0.001) indicated that acupuncture significantly affected IBS treatment in comparison to other methods. Subgroup analysis of primary outcome indicators revealed that acupuncture demonstrated better results regardless of the duration of intervention and was more effective than Western medicine or sham acupuncture. In addition to the total response rate (I2 = 0%), the other three outcome indicators showed significant heterogeneity (I2 > 50%). No publication bias was noted in RR (P < 0.05); however, a significant publication bias was observed in quality of life (P > 0.05). Acupuncture can enhance the quality of life and relieve anxiety and depression in patients with IBS with apparent safety; however, a large number of high-quality RCTs are still needed.

Navigating the shots: Parental willingness to immunize their children with COVID-19 vaccines in Saudi Arabia explored through a systematic review and meta-analysis.

Although COVID-19 vaccines have been recommended for children and adolescents since 2021, suboptimal vaccination uptake has been documented. No previous systematic review/meta-analysis (SRMA) investigated parents' willingness to administer COVID-19 vaccines for their children in Saudi Arabia. Accordingly, this SRMA aimed to estimate parents' willingness to immunize their children with COVID-19 vaccines in Saudi Arabia and to identify reasons and determinants influencing parents' decisions. This SRMA adhered to the PRISMA guidelines and the protocol was registered on PROSPERO (ID: CRD42023492760). An extensive systematic search was performed across electronic databases including Pub Med, Pub Med Central, ISI Web of science, Web of Science Core Collection, Medline, KCI-Korean Journal Database, ProQuest, and SciELO, to identify relevant studies published from January 1, 2020 to October 30, 2023. A random-effects model was utilized to estimate the pooled effects considering the expected variability across studies. Heterogeneity, risk of bias, publication bias and quality of studies were considered and evaluated by relevant appropriate tests to ensure robust results. Twenty-five studies with 30,844 parents were included. The overall pooled rate of parents who intended to immunize their children with COVID-19 vaccines was 48.0% (95% CI: 41.0-54.0%) with high heterogeneity (I2 = 99.42%). The main reason for parents to vaccinate children was to protect child, family and community from COVID-19. Perceived efficacy/safety of vaccines were the most significant determinants associated with parents' willingness to vaccinate children. This was the first SRMA from Saudi Arabia which emphasized the priority to focus on vaccine-related factors as main/key strategy of COVID-19 vaccines' drivers to convince parents in a logical way based on accurate cumulative and emerging scientific data about efficacy and safety of COVID-19 vaccines to optimize their uptake by children/adolescents. This SRMA can provide valuable insights for development of evidence-based policies to improve parental willingness to vaccinate children, which is crucial for controlling SARS-CoV-2 spread and promoting herd immunity in the community particularly if the virus continues to pose a major threat.

Effects of Jianpi therapy for cancer-related fatigue:a meta-analysis of randomized controlled trials

PurposeThe Jianpi therapeutic strategy in traditional Chinese medicine aims to enhance the spleen’s digestive function and overall wellness. It has shown promise in improving cancer-related fatigue (CRF). This research systematically evaluates the effectiveness of Jianpi therapy in reducing fatigue in cancer patients through a meta-analytic review.MethodsAn exhaustive search was performed within PubMed, Embase, Web of Science, Cochrane Library, SinoMed, Wanfang Data, China Science and Technology Journal Database, and China National Knowledge Infrastructure (CNKI) for randomized controlled trials concerning the application of Jianpi therapy to address CRF. The search spanned from the commencement of each database’s records to April 1, 2024. The extracted data were subjected to analysis using Stata (Version 15.1), with the selection of either a random-effects or fixed-effects model based on the heterogeneity among studies. Outcome measures were demonstrated with standardized mean differences (SMDs) or mean differences (MDs), and each complemented by a 95% confidence interval (CI). The Cochrane Risk of Bias Assessment Tool 2.0 was utilized to assess the potential biases within the studies.ResultsA comprehensive analysis was performed on 45 eligible studies, all of which were conducted within China and encompassed a total of 3,596 participants. The meta-analysis indicated that Jianpi decoction alone exhibited the most significant improvement in the proportion of CD4 cells (SMD=1.34, 95% CI 0.54 to 2.31, P&amp;lt;0.001) and hemoglobin (MD=7.45, 95% CI 4.18 to 10.72, Z=4.47, P&amp;lt;0.001), while also more significantly reducing Piper Fatigue Scale scores (SMD=-2.05, 95% CI -2.71 to -1.39, P&amp;lt;0.001). The combined therapy, which integrated Jianpi therapy with standard care, demonstrated the greatest advantage in enhancing the proportion of CD3 cells (SMD=1.25, 95% CI 0.46 to 2.04, P&amp;lt;0.001). Furthermore, Jianpi therapy was found to be effective in lowering tumor necrosis factor-alpha levels (MD=-7.79, 95% CI -11.24 to -4.34, P&amp;lt;0.001) and concurrently enhancing interferon-gamma (MD=5.15, 95% CI 3.20 to 7.09, P=0.002), interleukin-2 (MD=8.37, 95% CI 6.14 to 10.59, P&amp;lt;0.001).ConclusionOur research indicates that Jianpi therapy effectively alleviates CRF, reduces inflammation, and strengthens immune function. However, further high-quality, multicenter randomized controlled trials are essential to confirm these findings and strengthen the evidence.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024566739.

Caregivers’ experience of having a child with Down syndrome: a meta-synthesis

BackgroundThis study aimed to integrate the experiences of caregivers of children with Down syndrome during the care process and understand their feelings and needs.MethodsWe used Page et al.’s (2021) Preferred Reporting Items for Systematic Reviews and Meta-synthesis Statement. Ten databases (Web of Science, PubMed, EMBASE, Cochrane Library, CINAHL, PsycInfo, China Biology Medicine, China National Knowledge Infrastructure, Wanfang Data, and China Science and Technology Journal Database) were searched for relevant studies published from the inception of the database to October 2023. Eight qualitative studies were analysed. The following seven themes were included: ‘feeding pressure’, ‘hope for education’, ‘societal rejection and stigma’, ‘psychological pressure’, ‘caring burden’, ‘family burden’, and ‘family adaptation and self-growth’.ResultsWe found that feeding pressures, educational concerns, language difficulties, and discrimination and stigmatisation led to psychological, economic, and family stress in caregivers of children with Down syndrome. We document the need for strong coping mechanisms and support systems for these families from medical and psychological institutions and a need for public education and awareness.ConclusionsWe summarised the daily care experiences of caregivers of children with Down syndrome. Our findings provide a scientific basis for further research focused on reducing physical and mental pressure on caregivers and improving the quality of family life.

Virtual Mental Health Counselling

What Is the Issue? The rate of mental illnesses, such as major depressive disorder and generalized anxiety disorder, has significantly increased among people aged 15 and older living in Canada. In Canada, more than 1 in 3f those with mental illnesses do not receive adequate mental health (MH) services, with notable geographic disparities in the availability and quality of services. Specialized MH services remain particularly scarce in remote and rural areas. Providing MH counselling through virtual platforms has the potential to enhance the accessibility of MH services and reduce the stigma associated with in-person services. A review of the clinical effectiveness and evidence-based guidelines is required to help understand the potential role of virtual MH counselling in clinical practice. What Did We Do? To inform decisions regarding the use of virtual MH counselling for people with depression, anxiety, obsessive-compulsive disorder (OCD) or posttraumatic stress disorder (PTSD), we conducted a rapid review and summarized evidence that compared the clinical effectiveness of MH counselling provided in a virtual setting versus in person. We also sought to identify evidence-based guidelines regarding the use of virtual MH counselling for these populations. We searched key resources, including journal citation databases, and conducted a focused internet search for relevant evidence published since 2019. One reviewer screened articles for inclusion based on predefined criteria, critically appraised the included studies, and narratively summarized the findings. What Did We Find? We found 6 systematic reviews (SRs) relevant to the present review that evaluated the clinical effectiveness of MH counselling provided through virtual versus in-person settings. Most SRs and their included randomized controlled trials (RCTs) reported results on the reduction of depression and anxiety, followed by PTSD and OCD. For depression, PTSD and specific anxiety outcomes (generalized anxiety disorder, social anxiety disorder, and panic disorder), the effectiveness of virtual MH counselling in improving these outcomes was comparable to in-person settings. For OCD, results were inconsistent, suggesting virtual MH counselling can be an alternative treatment where in-person MH counselling is not readily available. We found 5 evidence-based guidelines that provide recommendations on the use of virtual MH counselling for adults with depression, anxiety, and PTSD, based mostly on low-quality evidence or expert opinion. We did not find any evidence-based guidelines or relevant recommendations regarding the use of virtual MH counselling for people of any age with OCD nor children and youth with depression, anxiety, and PTSD. Virtual MH counselling is recommended as a first-line intervention for adults with mild depression and for reducing symptoms of anxiety in older adults. Virtual MH counselling is recommended as second-line adjunctive or alternative intervention for adults with moderate-severe depression, certain anxiety disorders, and PTSD. What Does This Mean? Virtual MH counselling may improve clinical outcomes for people with depression, anxiety, OCD, or PTSD and can be used as a comparable or alternative treatment to in-person MH counselling. Virtual MH counselling may address equity issues regarding access to evidence-based MH services where in-person MH counselling is not readily available. Clinicians and health care decision-makers can use the evidence summarized in this review to inform decisions regarding the implementation of virtual MH counselling for adults with depression, anxiety, OCD, or PTSD.

Ultrasound renal denervation in hypertensive patients: A systematic review and meta-analysis.

Hypertension is the leading noncommunicable disease case affecting 1.28 billion individuals worldwide, with most cases located in low- and middle-income countries. While there are numerous techniques for treating mild to moderate hypertension, properly controlling severe or resistant hypertension poses substantial challenges. Ultrasound-based renal denervation (uRDN) has emerged as a promising non-pharmacological approach. This study aims to investigate the safety and efficacy of uRDN in hypertensive patients. The literature search across PubMed, ScienceDirect, BMJ Journals, ProQuest, and Springer databases yielded 419 articles. A total of 395 articles were filtered, leading to 24 articles assessed for eligibility and overall analysis, which resulted in eight included studies for quantitative synthesis. Quality appraisal used RoB 2.0, while meta-analysis used RevMan 5.4. Our analysis results indicated significant improvements in 24-hour, daytime, and home ambulatory blood pressure measurements, favoring the uRDN over control. The mean difference (MD) for 24-hour measurements was -0.84 mmHg [95% CI -1.14, -0.55; p < 0.00001], for daytime measurements -1.27 mmHg [95% CI -1.59, -0.95; p < 0.00001], and for home measurements -1.98 mmHg [95% CI -2.32, -1.64; p < 0.00001], with moderate heterogeneity observed. Office ambulatory measurements also favored the uRDN with a significant MD of -1.51 mmHg [95% CI -1.91; -1.10; p < 0.00001]. Funnel plots revealed some outliers, indicating true heterogeneity among the studies. uRDN was associated with a significant reduction (-2.32 to -0.10 mmHg) in blood pressure of hypertensive patients.

Efficacy of virtual reality balance training on rehabilitation outcomes following anterior cruciate ligament reconstruction: A systematic review and meta-analysis.

The objective of this systematic review and meta-analysis is to clarify the rehabilitation efficacy of virtual reality (VR) balance training after anterior cruciate ligament reconstruction (ACLR). This meta-analysis was registered in PROSPERO with the registration number CRD42024520383. The electronic databases PubMed, Web of Science, Cochrane Library, MEDLINE, Embase, China National Knowledge Infrastructure, Chinese Biomedical Literature, China Science and Technology Journal Database, and Wanfang Digital Periodical database were systematically searched to identify eligible studies from their inception up to January 2024. The investigated outcomes included International Knee Documentation Committee (IKDC) score, visual analogue scale (VAS), Holden grading, Extensor peak torque (EPT), Flexor peak torque (FPT), knee reaction time, knee reproduction angle difference. The pooled mean difference (MD) and 95% confidence intervals (CIs) were calculated using the random-effects model. Six RCTs with a total of 464 patients after unilateral ACLR were included for 8-12 weeks of VR balance training intervention. Analysis of the results showed that compared with the conventional rehabilitation control group, the VR balance training group significantly improved the International Knee Documentation Committee (IKDC) score (MD = 3.88, 95%CI: 0.95~6.81), Holden grading (MD = 0.42, 95%CI: 0.33~0.51), Extensor peak torque (EPT) (MD = 12.03, 95%CI: 3.28~20.78)and Flexor peak torque (FPT) (MD = 14.57, 95%CI: 9.52~19.63) in postoperative ACLR patients, and significantly reduced knee reaction time (MD = -0.30, 95%CI: -0.35~-0.25), knee angle reproduction difference at 30° (MD = -0.88, 95%CI: -1.16~-0.61), knee angle reproduction difference at 60° (MD = -0.80, 95%CI: -1.09~-0.50), and VAS score (MD = -0.52, 95%CI: -0.65~-0.39). Since many of the included results are based on low-or very-low-quality evidence, although the results show a certain trend, the conclusion has great uncertainty. In the rehabilitation training following ACLR and lower-limb balance training, the application of VR might be advantageous for the recovery of patients' knee joint function, lower-limb muscle strength, proprioception, and pain management. The level of immersion may influence the rehabilitation outcome. Because of the limitations in data quality and heterogeneity as well as the small sample size, the strength of the conclusions is weakened. These findings should be verified in further large-scale prospective studies.

Efficacy and safety of hemoporfin photodynamic therapy in treating port-wine stains in Chinese children: a systematic review and meta-analysis.

The purpose of this study is to explore the efficacy and safety of hematoporphyrin monomethyl ether mediated photodynamic therapy (HMME-PDT) in treating children with port-wine stains (PWS). Literature related to the topic was searched in PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang, and China Science Technology Journal Database online databases. The quality of the literature was evaluated using the Effective Public Health Practice Project. The I2 statistic was used to evaluate the consistency of the results. A total of 19 papers were included. Meta-analysis showed that more than half of the children (56.3%) achieved efficacy I (improvement ≥ 60%). 17% of children achieved efficacy II (improvement ≥ 75%). Regardless of whether the outcome variable was efficacy I or efficacy II, the therapeutic efficacy in children with PWS aged 0-3 years was superior to those aged 3-6 and 6-18 years, and children who underwent a treatment course of ≥3 sessions showed better outcomes compared to those who have only 1 or 2 sessions. After treatment with HMME-PDT, better efficacy was seen in the PWS of the face and neck and pink/red PWS. Additionally, almost all children with PWS treated with HMME-PDT developed edema (99.9%), more than half presented purpura (67.6%), some developed crust (30.8%) and hyperpigmentation (15.0%), and a few occurred scar (2.4%) and hypopigmentation (1.4%). After HMME-PDT treatment, more than half of the pediatric patients showed an improvement of ≥60%, and no serious adverse reaction events occurred. This study demonstrated that HMME-PDT possessed promising therapeutic efficacy in children with PWS, suggesting that HMME-PDT could be considered a recommended treatment strategy for pediatric PWS. However, future development of standardized assessment guidelines and comparative studies are needed to validate the aforementioned conclusions. https://www.crd.york.ac.uk/prospero/#loginpage, PROSPERO (CRD42024592367).

Risk prediction models for feeding intolerance in patients with enteral nutrition: a systematic review and meta-analysis.

Although more risk prediction models are available for feeding intolerance in enteral-nourishment patients, it is still unclear how well these models will work in clinical settings. Future research faces challenges in validating model accuracy across populations, enhancing interpretability for clinical use, and overcoming dataset limitations. To thoroughly examine studies that have been published on feeding intolerance risk prediction models for enteral nutrition patients. Conducted a systematic review and meta-analysis of observational studies. A comprehensive search of the literature was conducted using a range of databases, including China National Knowledge Infrastructure (CNKI), Wanfang Database, China Science and Technology Journal Database (VIP), SinoMed, PubMed, Web of Science, The Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Embase. The search scope was confined to articles within the database from its inception until August 12th, 2024. The data from the selected studies should be extracted, including study design, subjects, duration of follow-up, data sources, outcome measures, sample size, handling of missing data, continuous variable handling methods, variable selection, final predictors, model development and performance, and form of model presentation. The applicability and bias risk were evaluated using the Prediction Model Risk of Bias Assessment Tool (PROBAST) checklist. A total of 1,472 studies were retrieved. Following the selection criteria, 18 prediction models sourced from 14 studies were incorporated into this review. In the field of model construction, only one study employed the use of multiple machine-learning techniques for the development of a model. In contrast, the remaining studies used logistic regression to construct FI risk prediction models. The incidence of FI in enteral nutrition was 32.4-63.1%. The top five predictors included in the model were APACHE II, age, albumin levels, intra-abdominal pressure, and mechanical ventilation. The reported AUC, or area under the curve, exhibited a range of values between 0.70 and 0.921. All studies were identified as having a high risk of bias, primarily due to the use of inappropriate data sources and inadequate reporting within the analysis domain. Although the included studies reported a certain degree of discriminatory power in their predictive models to identify feeding intolerance in patients undergoing enteral nutrition, the PROBAST assessment tool deemed all the included studies to carry a significant risk of bias. Future research should emphasize the development of innovative predictive models. These endeavors should incorporate more extensive and diverse sample sizes, adhere to stringent methodological designs, and undergo rigorous multicenter external validation to ensure robustness and generalizability. Identifier CRD42024585099, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=585099.

Exploring the Current State of Information Literacy Education: A Systematic Literature Review

Information Literacy Education is a skill taught to students of various educational levels, from elementary school to college and even postgraduate programs. This research aims to present the current state of Information Literacy Education, identify the dominant research themes, the methods of teaching and learning used, the context of learning in which the skill is taught, and recommends future research development in related fields. A systematic literature review was conducted using large electronic journal databases such as Taylor and Francis, and Science Direct, which obtained 37,633 articles. Furthermore, The PICOC and PRISMA protocols were applied to analyze 17 relevant articles and identify 14 themes in learning, 14 learning methods, 12 research methods used, and 7 scientific fields in the implementation of Information Literacy Learning from 2017 to 2021. These results provide direction for future research and contribute to enhanced information literacy curriculum development, effective integration of information literacy in specific disciplines, transitioning to online information literacy instruction, development of engaging and interactive information literacy modules, assessing learning outcomes and informing instructional strategies, collaboration and professional development in information literacy, diverse and effective teaching methods, and advancements in research methods for information literacy.

Comparison of clinical efficacy between femoral neck system and cannulated screw in Pauwels type III femoral neck fracture: A meta-analysis

Background In recent years, the femoral neck system (FNS) has become increasingly widely used for Pauwels type III femoral neck fractures. Objective We performed a meta-analysis to investigate the safety and efficacy of FNS and the mainstream internal fixation method, cannulated screw (CS), in the treatment of Pauwels type III femoral neck fractures. Methods We systematically searched all research studies from PubMed, Embase, Web of Science, Cochrane, WANFANG, and the Chinese Academic Journal Full-Text Database (CNKI) from 2018 to July 2024 and conducted data extraction. The study was conducted on July 26, 2024. We used the PRISMA guidelines to assess the quality of the results of all included studies. In addition, we searched for references to relevant articles. After completing the literature search, we performed a manual literature screening to obtain studies that met the inclusion criteria. The outcomes were Harris Hip Score, operation duration, intraoperative blood loss, hospital stay, healing time, and postoperative complications. Results This meta-analysis ultimately included nine studies (n = 524) and conducted quality evaluations. All nine articles were retrospective cohort studies. The study exhibited statistically significant variations between the FNS and CS groups in relation to total complications (95% confidence interval (CI)= [0.11, 0.40], odds ratio (OR) = 0.21, P &lt; 0.001), Harris Hip Score (95%CI = [2.14, 3.65], mean difference (MD) = 2.89, P &lt; 0.001), Femoral head necrosis (95%CI = [0.17, 0.86], OR = 0.38, P = 0.02), Internal fixation failure (95%CI = [0.06, 0.50], OR = 0.17, P = 0.001), Medium femoral neck shortening (95%CI = [0.17, 0.53], OR = 0.30, P &lt; 0.001), intraoperative blood loss (95%CI = [11.57, 26.80], MD = 19.19, P &lt; 0.001), Operation duration (95%CI = [−15.20, −2.17], MD = −8.69, P = 0.009), and healing time (95%CI = [−1.30, −0.32], MD = −0.81, P = 0.001). Conclusion This meta-analysis showed that in Pauwels type III femoral neck fractures, the femoral neck system has a shorter operative time, a lower rate of postoperative complications, a shorter healing time, less shortening of the femoral neck, and a higher Harris Hip Score compared with cannulated screws, but increases intraoperative blood loss. However, more clinical studies are needed to confirm our conclusions due to our small sample size and lack of randomized controlled trials.

Implementation Of The Second Preceptive Of Pancasila To Overcome The Crisis Generation Z Identity In The Globalization Era

In the era of globalization, Generation Z is faced with rapid social, cultural, and technological changes. This can have a significant impact on values and identity in daily life. However, the sophistication of technology does not always have a positive impact; there are also negative ef ects experienced by Generation Z, namely an identity crisis. Therefore, this research aims to understand the application of Pancasila values, particularly the second principle, in the daily lives of Generation Z in Indonesia and to evaluate the extent to which this application contributes to addressing the identity crisis in this generation. This research uses the literature review method, by reviewing and analyzing previously conducted research articles. The data collection technique used was through journal databases related to the targeted research topic. Research results show the importance of instilling Pancasila values through civic education, character education, and multicultural education to address the identity crisis in Generation Z, who are the future leaders that will realize Indonesia's goals and aspirations by instilling Pancasila values as the state ideology

Lingguizhugan Decoction in the Treatment of Non-Alcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis.

This study systematically evaluated the efficacy and safety of Ling Gui Zhu Gan Decoction for treating non-alcoholic fatty liver disease. Registered under CRD42024501460 on the PROSPERO platform, we searched eight major databases, including Web of Science, PubMed, Cochrane, Embase, China National Knowledge Infrastructure, Wanfang database, Chinese Scientific Journals Database, and Chinese Biomedicine Database, from inception to December 2023 for randomized controlled trials on Ling Gui Zhu Gan Decoction in non-alcoholic fatty liver disease treatment. We extracted data on total efficiency, TC, TG, ALT, AST, GGT, and HOMA-IR, analyzing results with RevMan 5.4 software. Twelve studies met the inclusion criteria, encompassing 970 cases. Ling Gui Zhu Gan Decoction, alone or combined with standard therapy, significantly improved non-alcoholic fatty liver disease outcomes, regardless of treatment duration. Only one study reported adverse events, including bloating, diarrhea, nausea, vomiting, and rash. Ling Gui Zhu Gan Decoction appears to be an effective and safe option for non-alcoholic fatty liver disease treatment. However, due to limited studies and methodological weakness, further rigorous randomized controlled trials are necessary for conclusive results.

Effectiveness of Virtual Reality Training in Improving Outcomes for Dialysis Patients: Systematic Review and Meta-Analysis.

Virtual reality (VR) training uses computer-generated simulations that enable users to engage with immersive virtual environments, simulating real-world activities or therapeutic exercises. This technology is increasingly recognized as a promising intervention to address the physical and psychological challenges faced by dialysis patients, who frequently experience diminished physical function, social isolation, and emotional distress associated with prolonged treatment regimens. Given the increasing prevalence of dialysis patients and the limitations of conventional rehabilitation approaches, VR presents a novel, interactive method that has the potential to enhance patient well-being and improve quality of life. This meta-analysis aimed to evaluate the effectiveness of VR training interventions for dialysis patients, with a focus on assessing their impact on motor abilities, psychological symptoms (specifically anxiety and depression), social functioning, and self-efficacy. This analysis also explores whether VR can offer comprehensive benefits to support both the physical and mental health of dialysis patients. The meta-analysis was conducted following Cochrane guidelines. Comprehensive searches were performed across major databases, including China National Knowledge Infrastructure, Wanfang database, China Science and Technology Journal Database, China Biomedical Literature database, Cochrane library, Web of Science, PubMed, and Embase, encompassing all studies up to December 2023. Inclusion criteria targeted studies assessing VR's impact on motor performance, psychological well-being, social functioning, and self-efficacy in dialysis patients. Two reviewers independently extracted data and assessed methodological quality using Cochrane's risk of bias criteria, ensuring data synthesis reliability. A total of 12 studies, involving 625 dialysis patients in total, met the inclusion criteria. The meta-analysis demonstrated that VR training led to significant improvements across multiple domains. VR interventions were associated with improved physical capacity, evidenced by higher scores in the 6-minute walk test (standardized mean difference [SD]=29.36, 95% CI 14.32-44.4, P<.001, I2=46%). VR training was associated with significant reductions in depression (SD=-6.30, 95% CI -7.14 to -5.47, P<.001, I2=96%) and anxiety (SD=-8.91, 95% CI -9.69 to -8.14, P<.001, I2=95%). In addition, VR interventions enhanced social functioning (SD=16.20, 95% CI 14.49-17.9, P<.001, I2=72%), and improved self-efficacy (SD=20.47, 95% CI 18.55-22.39, P<.001, I2=99%). However, VR training did not yield significant differences in gait speed, balance, or functional tests (Ten Sit-to-Stand Test, Five Sit-to-Stand Test, Sixty Sit-to-Stand Test, Timed Up and Go Test, and fatigue) compared with control groups. The findings suggest that VR training is a promising intervention for dialysis patients, providing benefits in physical endurance, social engagement, and psychological well-being. Despite these advantages, VR remains underused among peritoneal dialysis patients compared with hemodialysis patients. Further studies with larger sample sizes and more refined experimental designs are recommended to validate these results and support VR as a complementary tool in the holistic care of dialysis patients.

Methadone for Surgical Patients

What Is the Issue? Opioids such as morphine and hydromorphone are commonly used to treat postoperative pain; however, they are associated with serious risks such as respiratory depression. Methadone (a synthetic opioid) has been proposed as a potential option for preoperative or postoperative analgesia that may improve pain relief and reduce overall opioid requirements. What Did We Do? We sought to identify and summarize studies of the clinical effectiveness and safety of oral methadone for preoperative or postoperative analgesia in adults as well as recommendations from evidence-based guidelines. We searched key resources, including journal citation databases, and conducted a focused internet search for relevant evidence published since 2019. One reviewer screened articles for inclusion based on predefined criteria, critically appraised the included publications, and narratively summarized the findings. What Did We Find? We identified 1 randomized controlled trial (RCT) that evaluated the use of preoperative oral methadone versus placebo in adults undergoing sternotomy for isolated coronary artery bypass graft surgery. We did not identify any studies that compared oral methadone to other analgesics that met our criteria. We did not identify any evidence-based guidelines that included recommendations on the use of oral methadone for preoperative and postoperative analgesia. There were no differences in pain scores 24, 48, and 72 hours postoperatively in patients who received oral methadone versus placebo. Postoperative morphine requirements were lower in the methadone group than the placebo group at 24 hours; however, there were no differences between groups at 48 or 72 hours. There were no differences in common side effects related to opioid use (nausea, vomiting, pruritus, constipation, urinary retention, hypoventilation, or hypoxia) between patients undergoing surgery treated with oral methadone versus placebo at 24, 48, or 72 hours. What Does It Mean? We identified very limited evidence on the use of oral methadone for preoperative or postoperative analgesia in patients undergoing surgery. There were no differences between patients undergoing surgery treated preoperatively with oral methadone versus placebo in most of the pain outcomes measured in the included RCT. Additional evidence may be necessary to aid decision-making around the use of oral methadone as preoperative or postoperative analgesia for adult patients undergoing surgery.

A Summary of the Best Evidence for Wet Pack Management.

Wet pack after steam sterilization of medical devices in healthcare facilities are unacceptable. To retrieve, evaluate and integrate the best evidence related to wet pack management. We searched the JBI, Up To Date, BMJ, National Guideline Clearinghouse (NGC), National Institute for Health and Care Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN), Cochrane library, PubMed, Guideline International Network (GIN), AORN Journal, and other databases using the pyramid "6S" model for guidelines, expert consensus, systematic reviews, evidence summaries, decisions, recommended practices, and technical reports on wet pack management. The period of the literature search is from the establishment of the database to January 2024. Two researchers evaluated the literature quality independently, and evidence was extracted from the literature that met the quality standards. AGREE II assessment system, Cochrane bias risk assessment, and JBI Evidence-Based Health care center authenticity assessment were used as the literature evaluation criteria and the JBI 2014 edition evidence pre-grading system for intervention studies. For all types of research, the literature quality and evidence level was evaluated, extracted, and summarized according to the theme. Based on the inclusion criteria, seven pieces of literature were selected, including three guidelines, three randomized controlled trials, and consensus from an expert. Twenty pieces of evidence were obtained from seven different aspects: device packaging stage, loading stage, sterilization stage, unloading and cooling stage, distribution stage, wet package evaluation and analysis, and personnel training. This study summarizes the best evidence on wet pack management and can provide a reference for staff practices in disinfection supply centers to reduce the incidence of wet packs.

Effectiveness of different traditional Chinese medicine injections in patients with diabetic lower extremity arterial disease: A Bayesian network meta-analysis.

Numerous studies have demonstrated the effectiveness of Chinese medicine injections (CMIs) in treating diabetic lower extremity arterial disease (Dia-LEAD). However, with the variety of CMIs available, it has become challenging to determine the optimal choice for Dia-LEAD patients. This study aims to compare and rank the efficacy of CMIs for Dia-LEAD to provide references and evidence for clinicians in optimising drug selection. We conducted a comprehensive search for randomised controlled trials (RCTs) of CMIs for treating Dia-LEAD, which included the China National Knowledge Infrastructure (CNKI), Wanfang, China Weipu Science and Technology Journal Database (VIP), Chinese Biomedical Literature Database (CBM), PubMed, the Cochrane Library, Embase, and Web of Science, covering inception to 15 October 2023. We used the Cochrane Risk of Bias Tool 2.0 to assess bias risk, and RevMan 5.4.1, GeMTC, STATA 13.0, and R 4.2.1 for statistical analysis and visualization of the network meta-analysis. We analysed 38 studies with 12 CMIs. Compared with other interventions, Shuxuening injection (SXN)+conventional treatment (CT) was superior in terms of the total effective rate (surface under the cumulative ranking (SUCRA) 86.2%). Danshen injection (DS)+CT ranked first in improving the ankle-brachial index (ABI) (SUCRA 95.1%) and dorsalis pedis artery blood flow (DPABF) (SUCRA 88.8%). Danhong injection (DH)+CT showed the highest probability of effectiveness in improving the plasma viscosity (SUCRA 91.6%). Chuanxiongqin injection (CXQ)+CT yielded favourable results in regulating fibrinogen levels (SUCRA 77.1%). Furthermore, no significant differences in adverse reactions were detected between the treatment and control groups. The study demonstrated that CMIs have potential as a complementary therapy for treating Dia-LEAD, and it supports the positive effects of combining CMIs with CT on a number of outcome indicators. Especially when it comes to improving the haemodynamics indices and the haemorheology indices, DS in combination with CT may be a more effective intervention. However, further confirmation in more rigorous, high-quality, and multicentre RCTs is needed to strengthen the validity and generalisability of the results.

Plant-derived natural compounds for the treatment of acute lung injury: A systematic review of their anti-inflammatory effects in animal models.

Acute lung injury (ALI) is a complex pulmonary disease characterized by a severe inflammatory response. The management of ALI presents a formidable challenge due to the intricate nature of its inflammatory cascade. Numerous studies have highlighted the potential therapeutic benefits of plant-derived natural compounds (PNCs) in treating inflammatory diseases. Our study aims to provide robust current evidence regarding the anti-inflammatory effects and underlying molecular mechanisms of PNCs for ALI treatment. The systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and the protocol was registered in PROSPERO (CRD42024468401). A comprehensive search was conducted in electronic databases including PubMed, Scopus, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal database (VIP), Wanfang database, and China biomedical literature service system (SinoMed) up until November 2023. Preclinical studies published in both English and Chinese were included. Our research encompassed 81 studies, comprising a total of 71 PNCs, including flavonoids, phenylpropanoids, terpenoids, polyphenols, alkaloids, saponins, glycosides, and miscellaneous compounds. This systematic review demonstrated that PNCs played a beneficial role on ALI by regulating the immune response and reducing the release of inflammatory mediators and cytokines. The molecular mechanisms were partially associated with the regulation of Th17/Treg responses, promotion of the polarization of M1-type macrophages to M2-type macrophages, induction of immune cell apoptosis, reversal of microbial dysbiosis in the lungs and the gut, epigenetic modification, and the modulation of inflammatory pathways, including NF-κB, MAPK, TLR4/MyD88, NLRP3/Caspase-1, TGF-β/Smad, Nrf2/HO-1, Rho/ROCK, TLR7/MyD88, and PI3K/AKT, thereby alleviating inflammatory responses and lung damage. The therapeutic effects of PNCs on ALI are mediated through the modulation of immunity and inflammatory pathways. In light of their potential, PNCs represent a promising pharmacological intervention for the treatment of ALI.

Increased activity of the catalase enzyme after physical exercise as a signal for reducing hydrogen peroxide (H2O2): a systematic review

Oxidative stress is a process of oxidation reactions in the body, one of which is triggered by physical exercise. Physical exercise triggers an increase in ROS (reactive oxygen species), which also has an impact on increasing endogenous antioxidants in the body such as the enzyme catalase. The aim of this research is to determine how physical activity impacts the increase in catalase enzyme and how the role of catalase enzyme in counteracting free radicals caused by oxidative stress during exercise, one of which is its role in reducing H2O2 (hydrogen peroxide). For this study, a number of journal databases were searched, including Embase, PubMed, Web of Science, Science Direct, and Scopus. The study took into account a number of factors, such as studies on physical exercise, endogenous antioxidants, and the enzyme catalase published in the previous five years. Only articles published in non-reputable journals and not indexed in the databases specified in the inclusion criteria were excluded from our study. A total of 1,560 papers were located using Embase, Web of Science, PubMed, Science Direct, and Scopus databases. About ten carefully selected and peer-reviewed papers addressed the need for this systemic change. Systematic Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) items were used in the creation of the standard operating procedures of the investigation. The findings of the systemic analysis showed that sports has been shown to increase the enzyme catalase as one of the endogenous antioxidants. ROS has been shown to increase during exercise. Catalase enzyme as an endogenous antioxidant functions to reduce the production of free radicals by reducing H2O2 to H2O so that it is not reactive. Regular physical exercise is strongly recommended to counteract free radicals by increasing endogenous antioxidants and improving overall health. The limitations in this review only discuss the effect of exercise on increasing the catalase enzyme (CAT) and how it plays a role in reducing H2O2 (hydrogen peroxide). For the next review, the effects of exercise on genes related to endogenous antioxidants and how signal transmission affects them can be studied in depth.