目的系统评价布地奈德联合肺表面活性物质(PS)治疗新生儿胎粪吸入综合征(MAS)的有效性与安全性。方法计算机检索PubMed、Cochrane Central Register of Controlled Trials(Central)、Embase、Web of Science、SinoMed、VIP、WanFang Dat...目的系统评价布地奈德联合肺表面活性物质(PS)治疗新生儿胎粪吸入综合征(MAS)的有效性与安全性。方法计算机检索PubMed、Cochrane Central Register of Controlled Trials(Central)、Embase、Web of Science、SinoMed、VIP、WanFang Data和CNKI数据库,搜集关于布地奈德联合PS治疗新生儿MAS的随机对照试验(RCT),检索时限均从建库至2023年9月2日。由2位研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.4软件进行Meta分析。结果共纳入6个RCT,包括544例患儿。Meta分析结果显示,与单用PS相比,布地奈德联合PS治疗患儿的总有效率较高[RR=1.29,95%CI(1.17,1.41),P<0.001]、住院时间较短[MD=-6.35,95%CI(-9.25,-3.46),P<0.001]、吸氧时间较短[MD=-1.61,95%CI(-2.23,-0.98),P<0.001]、呼吸机使用时间较短[MD=-26.46,95%CI(-35.98,-16.95),P<0.001],治疗后各时段患儿的血气分析指标均改善(P<0.05);布地奈德联合PS组患儿总并发症及不良反应发生率明显低于单用PS组[RR=0.35,95%CI(0.25,0.47),P<0.001]。亚组分析显示,布地奈德联合PS组患儿的持续肺动脉高压(PPHN)发生率[RR=0.38,95%CI(0.19,0.74),P=0.004]、肺出血发生率[RR=0.26,95%CI(0.10,0.69),P=0.007]均低于单用PS组;两组心力衰竭、败血症发生率差异均无统计学意义(P>0.05)。结论当前证据显示,布地奈德联合PS治疗新生儿MAS可改善患儿的症状、体征、血气分析指标,加快病情康复,缩短病程,有助于降低并发症、PPHN、肺出血的发生风险,而不会增加心力衰竭、败血症的发生风险。但受纳入研究数量的限制,上述结论尚需更多高质量、大样本的RCT予以验证。展开更多
In recent years,water pollution has become increasingly serious in China.Meanwhile,decrease of water bodies in quality,frequent pollution incidents,safety of drinking water and water shortage have become prominent day...In recent years,water pollution has become increasingly serious in China.Meanwhile,decrease of water bodies in quality,frequent pollution incidents,safety of drinking water and water shortage have become prominent day by day.However,water pollution can not be controlled effectively.To clear underlying reasons for increasingly worsening water environment,the external effects of pollution behavior and fictitious property right of pollution control bodies were analyzed using property right theory,and then internal reasons for serious water pollution were discussed.Finally,control measures of water pollution were put forward.展开更多
It is a basic national policy of China and the most important problem in the current development process to control pollution and protect environment.Since environmental and ecological management has strong externalit...It is a basic national policy of China and the most important problem in the current development process to control pollution and protect environment.Since environmental and ecological management has strong externality,there is little room for the private sector to play,and government governance becomes the most important means.To rationally assess government effectiveness in ecological management and clarify the main factors affecting the effective governance,Zhengzhou City is taken as research object.By referring to advanced experience of policy evaluation at home and abroad,two level-one indexes(ecological effect and economic effect)and eight level-two indexes(days of good air,concentrations of main air pollutants,energy consumption of per unit GDP,total energy consumption,per capita GDP,energy consumption of heavy industry,added value of industries above designated size,and annual fixed asset investment)are constructed to evaluate effectiveness of air pollution control policy in Zhengzhou City.Moreover,the factors affecting effectiveness of air pollution control policy in Zhengzhou City are analyzed.Finally,corresponding suggestions are proposed based on these factors:perfecting laws and regulations of air pollution control in Zhengzhou City,establishing accountability mechanism and cross regional governance system,adjusting industry and energy structure,valuing environmental technology and social participation,and improving government and people's awareness of environmental protection.展开更多
文摘目的系统评价布地奈德联合肺表面活性物质(PS)治疗新生儿胎粪吸入综合征(MAS)的有效性与安全性。方法计算机检索PubMed、Cochrane Central Register of Controlled Trials(Central)、Embase、Web of Science、SinoMed、VIP、WanFang Data和CNKI数据库,搜集关于布地奈德联合PS治疗新生儿MAS的随机对照试验(RCT),检索时限均从建库至2023年9月2日。由2位研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.4软件进行Meta分析。结果共纳入6个RCT,包括544例患儿。Meta分析结果显示,与单用PS相比,布地奈德联合PS治疗患儿的总有效率较高[RR=1.29,95%CI(1.17,1.41),P<0.001]、住院时间较短[MD=-6.35,95%CI(-9.25,-3.46),P<0.001]、吸氧时间较短[MD=-1.61,95%CI(-2.23,-0.98),P<0.001]、呼吸机使用时间较短[MD=-26.46,95%CI(-35.98,-16.95),P<0.001],治疗后各时段患儿的血气分析指标均改善(P<0.05);布地奈德联合PS组患儿总并发症及不良反应发生率明显低于单用PS组[RR=0.35,95%CI(0.25,0.47),P<0.001]。亚组分析显示,布地奈德联合PS组患儿的持续肺动脉高压(PPHN)发生率[RR=0.38,95%CI(0.19,0.74),P=0.004]、肺出血发生率[RR=0.26,95%CI(0.10,0.69),P=0.007]均低于单用PS组;两组心力衰竭、败血症发生率差异均无统计学意义(P>0.05)。结论当前证据显示,布地奈德联合PS治疗新生儿MAS可改善患儿的症状、体征、血气分析指标,加快病情康复,缩短病程,有助于降低并发症、PPHN、肺出血的发生风险,而不会增加心力衰竭、败血症的发生风险。但受纳入研究数量的限制,上述结论尚需更多高质量、大样本的RCT予以验证。
文摘In recent years,water pollution has become increasingly serious in China.Meanwhile,decrease of water bodies in quality,frequent pollution incidents,safety of drinking water and water shortage have become prominent day by day.However,water pollution can not be controlled effectively.To clear underlying reasons for increasingly worsening water environment,the external effects of pollution behavior and fictitious property right of pollution control bodies were analyzed using property right theory,and then internal reasons for serious water pollution were discussed.Finally,control measures of water pollution were put forward.
文摘It is a basic national policy of China and the most important problem in the current development process to control pollution and protect environment.Since environmental and ecological management has strong externality,there is little room for the private sector to play,and government governance becomes the most important means.To rationally assess government effectiveness in ecological management and clarify the main factors affecting the effective governance,Zhengzhou City is taken as research object.By referring to advanced experience of policy evaluation at home and abroad,two level-one indexes(ecological effect and economic effect)and eight level-two indexes(days of good air,concentrations of main air pollutants,energy consumption of per unit GDP,total energy consumption,per capita GDP,energy consumption of heavy industry,added value of industries above designated size,and annual fixed asset investment)are constructed to evaluate effectiveness of air pollution control policy in Zhengzhou City.Moreover,the factors affecting effectiveness of air pollution control policy in Zhengzhou City are analyzed.Finally,corresponding suggestions are proposed based on these factors:perfecting laws and regulations of air pollution control in Zhengzhou City,establishing accountability mechanism and cross regional governance system,adjusting industry and energy structure,valuing environmental technology and social participation,and improving government and people's awareness of environmental protection.
