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Background. Necrotizing enterocolitis (NEC) and late-onset sepsis (LOS) are the major contributors to mortality and morbidity in preterm infants. This updated meta-analysis was aimed to assess the effects of mother's milk on the incidence of NEC, LOS, and other clinical outcomes in preterm infants. Methods. PubMed, Embase, and the Cochrane library were searched for papers published up to October 2022. Results. A total of 13 RCTs with 1330 infants were included in the final analysis. Significant difference in NEC (stage 2 or 3) was found between the intervention group and the control group (RR = 0.508, 95% CI: 0.314–0.822, and P = 0.008). The incidence of proven LOS (RR = 0.809, 95% CI: 0.610–1.071, and P = 0.139) and death (RR = 0.800, 95% CI: 0.571–1.122, and P = 0.196) was comparable between the two groups. Statistical differences in the incidence of proven or probable LOS (RR = 0.705, 95% CI: 0.577–0.862, and P = 0.001) and length of hospitalization (WMD = −4.868, 95% CI: −6.608 to −3.128, and P < 0.001) between the intervention group and the control group were observed. Conclusions. The results of this updated meta-analysis showed that compared to the placebo, mother's milk provides better effects in reducing the incidences of NEC, proven or probable LOS, and the length of stay, whereas no significant benefit of mother's milk was observed in reducing the incidence of proven LOS and death. [ABSTRACT FROM AUTHOR]

Introduction: Cancer patients and caregivers have myriad unmet needs which can have detrimental consequences on their psychosocial wellbeing. This systematic review aims to identify the unmet supportive care needs of immigrant and native Chinese cancer patients and caregivers. Methods: We systematically searched various electronic databases (e.g. Scopus, CINAHL, PsycInfo, etc.) from the earliest date available until January 2018. Additional studies were identified through reference lists and citation tracking. Eligibility criteria included: (a) qualitative, quantitative and/or mixed methods studies published in English; (b) immigrant and native Chinese cancer patients and/or caregivers (age ≥18 years); (c) unmet needs and/or their correlates. Studies were assessed for their risk of bias, and a narrative synthesis of findings was performed. Results: Forty‐seven papers from 45 studies met eligibility criteria. The most prevalent area of unmet needs was health system and information. Patients most commonly desired one member of the hospital to talk to about all aspects of their care. Caregivers preferred information about the patient's prognosis and likely outcome. Anxiety was most commonly associated with higher levels of health system and information needs. Conclusion: Chinese patients and caregivers experience a range of unmet health system and information needs, which differ depending on their stage along the cancer trajectory. [ABSTRACT FROM AUTHOR]

Online healthcare platforms serve not just as a medical knowledge-sharing community but also bring about effective interactions between professional physicians and patients. However, it is unclear whether online technology adoption affects such interactions in the same way between traditional Chinese medicine and modern medical departments. By utilizing a large sample of online doctor-patient interaction information from 168,870 doctor-specific interactive webpages recorded in a famous Chinese online healthcare community, this paper studies the differences between 17,513 traditional medicine doctor homepages and 151,357 others from more than 100 different specialty areas. Our chosen platform is representative since it covers about 800,000 physicians working at over 10,000 hospitals across all major provincial regions in China. We document that online medical service users tend to accept and use online health care services. However, patients seeing Chinese medicine doctors exhibit the following unique characteristics. They still prefer choosing doctors according to third-party information and may be reluctant to pay for the current online service price level. This problem is hard to overcome by the platform in the short run. Patients need a long-term process to adapt to the upgraded medical environment gradually. Therefore, establishing a personalized doctor recommendation system has become the most urgent demand presently. [ABSTRACT FROM AUTHOR]

Objective. To evaluate the beneficial and adverse effects of breviscapine injection in combination with antihypertensive drugs for treating hypertensive nephropathy in clinical practice. Methods. We searched PubMed, the Cochrane Library, Embase, CNKI, Sino Med, VIP, and Wanfang Data for relevant literature. The timeframe of retrieval was set from the founding date of each database to September 28, 2018. Results. Fourteen papers were included in this study. The quality of all the studies included was determined to be low. All studies were conducted with Chinese populations. Meta-analysis showed that, compared with single-use antihypertensive drugs, using breviscapine injection in combination with antihypertensive drugs to treat hypertensive nephropathy can reduce serum creatinine (Scr) [WMD = –35.16, 95% CI(–50.01, –20.31), P ≤ 0.001], blood urea nitrogen (BUN) [WMD = –2.00, 95% CI(–3.07, –0.94), P ≤ 0.001], 24-hour urinary total protein (24 h UTP) [WMD = –0.04, 95% CI(–0.05, –0.02), P ≤ 0.001], and the beta-2-microglobulin (B2M) [WMD = –0.09, 95% CI(–0.11, –0.07), P ≤ 0.001], improve creatinine clearance rate (Ccr) [WMD = 7.84, 95% CI(5.20, 10.49), P ≤ 0.001], and increase the clinical efficacy [RR = 1.27, 95% CI(1.05, 1.53), P = 0.014], but does not lower systolic blood pressure (SBP) [WMD = –1.02, 95% CI(–2.88, 0.84), P = 0.281]. There was no significant difference in adverse events between experimental groups and control groups. Conclusion. Breviscapine injection in combination with antihypertensive drugs can improve clinical efficacy and Ccr and reduce Scr, BUN, 24 h UTP, and B2M in patients with hypertensive nephropathy. The present meta-analysis indicated that breviscapine injection can serve as a renal protective effect to patients with hypertensive nephropathy. However, the evidence of methodological quality and sample sizes is weak, and thus, further standardized research is required. [ABSTRACT FROM AUTHOR]

Background. Diabetic cognitive impairment (DCI), a serious complication of diabetes mellitus (DM), is gaining more acceptance and attention. The learning and memory function of diabetics always decreases. Traditional Chinese medicine (TCM) has been demonstrated to be effective in treating the symptoms in China, and thereinto Chinese medicinal herbs (CMH) are the most widely used. The objective of the present study was to review and analyze the existing data about reducing the symptoms in CMH treatment for DCI. Methods. Electronic literature databases (PubMed, EMBASE, CNKI, SinoMed, and Wan fang) were searched for randomized controlled trials conducted in China, comparing CMH with western medicines in the treatment of DCI, up to April 1, 2018. We applied standard meta-analytic techniques to analyze data from papers that reached acceptable criteria. Result. Nine randomized controlled trials (n = 576) on CMH were included. We found moderate evidence that CMH used alone or in combination with western medicines was more effective than western medicines alone in reliving the symptoms for DCI (total effective rate, odds radio (OR) = 4.64 (2.60, 8.29), and 95% confidence interval, P<0.00001). Besides, CMH along or in combination with western medicines showed more beneficial effects on Montreal Cognitive Assessment (MoCA) scale (mean difference (MD) = 1.31(0.75, 1.87), P<0.00001), Mini-Mental State Examination (MMSE) scale (MD = 2.07 (0.86, 3.28), P<0.00001, and TCM symptom score (TCMSS) (MD = -4.89 (-8.44, -1.34), P = 0.007). Most of the included studies showed that there was not a significant difference in the adverse events. Conclusions. These findings demonstrated that CMH used alone or in combination with western medicines were apparently better than western medicines alone in the treatment of DCI. Because of the poor quality of the studies that were available for the present meta-analysis, further researches are still needed to support these early findings. [ABSTRACT FROM AUTHOR]

Objective. The traditional Chinese medicine Kangai injection as an adjuvant method in combination with chemotherapy has been widely used for treating breast cancer in clinical practice in China. This study systematically reviewed the clinical effect and safety of traditional Chinese medicine Kangai injection as an adjuvant method in combination with chemotherapy for treating Chinese patients with breast cancer. Methods. Seven databases were searched in this study, namely, PubMed, the Cochrane Library, Embase, CNKI, Sino Med, VIP, and Wanfang Data. The timeframe of retrieval was set from the founding date of each database to November 1, 2017. Results. Fifteen papers were included in this study. The quality of all the studies included was low. All the studies were carried out among the Chinese population. Meta-analyses showed that, compared with single-use chemotherapy, using a Kangai injection combined with chemotherapy to treat Chinese breast cancer patient can increase the total effective rate [RR = 1.15, 95% CI (1.01, 1.32), and P=0.033], improve the quality of life [RR = 1.30, 95% CI (1.14, 1.48), and P≤0.001], decrease the incidence of weight loss [RR = 0.49, 95% CI (0.32, 0.77), and P=0.002], decrease WBC count [RR = 0.78, 95% CI (0.68, 0.89), and P≤0.001], decrease incidence of renal and liver dysfunction [RR = 0.58, 95% CI (0.46, 0.73), and P≤0.001], and decrease cardiac dysfunction [RR = 0.41, 95% CI (0.18, 0.94), and P=0.035]. For the incidence of gastrointestinal adverse reactions [RR = 0.89, 95% CI (0.65, 1.21), and P=0.452], decreased platelet count [RR=0.49, 95% CI (0.18, 1.30), and P=0.150], and alopecia [RR = 1.01, 95% CI (0.89, 1.14), and P=0.879], these two groups showed no statistically significant differences. Conclusion. Kangai injection as an adjuvant method in combination with chemotherapy for treating Chinese breast cancer patients can improve their life quality and physical conditions and reduce the adverse reactions that result from chemotherapy. However, the present conclusion is only suitable for the Chinese population. The long-term, high-quality researches are required to further verify the above conclusions. [ABSTRACT FROM AUTHOR]

Loneliness is a serious problem for older people, which can be alleviated by social support. The dramatic population ageing together with social and economic change in China increases the likelihood of loneliness and the availability of different sources of social support of older people. The aim of this review was to identify the prevalence of loneliness and its related factors and sources of social support of older people in China. Electronic literature searches were conducted in September 2011 using Web of Science, PsycINFO, MEDLINE, PubMed, CINAHL, China Academic Journal and VIP Database for Chinese Technical Periodicals. Twenty-six papers were identified and reviewed. The prevalence of loneliness varied across the studies, reflecting the different measurements and samples. Marital status, gender, age, educational level, economic level, living arrangements, health status and social support were significant factors related to loneliness. The family was the most important source of social support followed by friends. The receipt of family support improved subjective well-being and mental health, but the effects of support from friends were inconsistent. Chinese older people received relatively little support from neighbours, governmental or other social organisations. Further well-designed studies are needed to identify additional factors related to loneliness and to understand the support from friends, neighbours, formal organisations and other sources. [ABSTRACT FROM AUTHOR]

Facing difficulties like increasing health burden and health inequity, China government started to promote commercial health insurance (CHI) in recent decades. Several policies and announcement have been issued to build up a favorable environment for development of commercial health insurance. Meanwhile, scholar tried to investigate the related issues in purpose to further improve the situation in China. Therefore, we performed this systematic review in order depict a comprehensive picture on the current evidence-based researches of CHI in China. We searched PubMed, ScienceDirect, and CNKI, supplemented with hand search in reference lists, for eligible studies published from 1990 January to 2018 April. Also, hand search was conducted to select suitable articles from international organization and reference list of eligible articles. Two independent reviewers extracted the data from eligible articles and input into a standardized form. Based on the inclusion criteria, 35 articles were included in this systematic review. Most of the studies were quantitative researches with topics such as the development level of commercial health insurance in China, the demand and supply issues related, and the relationship and influence of social health insurance, as well as the moral issues evolved from commercial health insurance system. In summary, CHI in China is still at the early development stage. Among those few evidence-based articles, the findings suggested several policy implication and different market strategy. With the initiation of new health reforms and implementation of taxes policy, more empirical researches should be conducted on issues relating to the practical operation of CHI. [ABSTRACT FROM AUTHOR]

Background. In this meta-analysis, we aimed to systematically compare the efficacy and safety of phacoemulsification and laser peripheral iridotomy (LPI) in the treatment of primary angle-closure glaucoma (PACG). Method. We searched PubMed, MEDLINE, EMBASE, the Cochrane Library, the Chinese Journal Full-text Database (CNKI), the Wanfang database, and the China Science and Technology Journal Database for randomized controlled trials (RCTs) of phacoemulsification and LPI in the treatment of PACG published up to September 30, 2022. Postoperative intraocular pressure (IOP), anterior chamber depth (ACD), complications, corneal endothelial cell count, and best-corrected visual acuity (BCVA) were compared. The effective quantity of measurement data was measured by the mean difference (MD) and 95% confidence interval (CI). The effect of counting data was measured by the odds ratio (OR). Result. A total of 1731 potential studies were identified, and after screening, 8 RCT studies were included. The results of the meta-analysis showed that, compared to the LPI group, the patients in the phacoemulsification group showed lower IOP six and twelve months after operation (MD-3.39, 95% CI −4.15∼−2.63, P < 0.00001 ; −2.29, −3.52∼−1.06, 0.0003). The ACD in the phacoemulsification group was significantly deeper than that in the LPI group (1.59, 1.10∼2.09, 0.00001). Meanwhile, the incidence of complications in the phacoemulsification group was lower than that in the LPI group (OR = 0.46, 0.29∼0.72, 0.0006). There was no statistically significant difference between the phacoemulsification group and the LPI group in corneal endothelial cell count and BCVA at 6 and 12 months after operation (P = 0.38 ; 0.11; 0.81). Conclusion. Compared with LPI, phacoemulsification is safer and more effective in the treatment of PACG, especially in controlling IOP and minimizing postoperative complications. [ABSTRACT FROM AUTHOR]

What is Known and Objective: Except for the transmitted drug resistance (TDR)'s standard sampling and monitoring protocol, China's HIV‐1 pretreatment drug resistance (PDR) and acquired drug resistance (ADR) results vary widely due to the studies' diverse background. This meta‐analysis was conducted to comprehensively understand the drug resistance profiles of Chinese HIV/AIDS patients and compare the drug resistance differences among groups to provide a reference for the further improvement of treatment protocols. Methods: Data sources for this study were WANFANG, VIP, CNKI, SinoMed, PubMed and Web of Science databases from January 1, 2010 to January 13, 2022. Data extracted from the literature were analyzed by R and Stata to evaluate the profile and changing trend of drug resistance in Chinese HIV/AIDS patients. Results and Discussion: One hundred twenty‐one literature were included. The combined PDR and ADR in the Chinese HIV/AIDS patients was 5.56% (95% CI: 4.77%–6.41%) and 51.33% (95% CI: 47.57%–55.38%), respectively. The time trend analysis shows the upward trend of PDR. There were significate differences in ADR among different sample sources, the ADR in the central region were higher than those in all other regions. The PDR in men who have sex with men (MSM) was lower the whole population, while the MSM's ADR was much higher than whole population. What is New and Conclusion: PDR in China showed an upward trend and exceeded the 5% warning line but is still at a low level worldwide. ADR is stable and below the middle level globally; the comprehensively promoted free ART in China still has lasting effects. MSM is the high‐risk drug resistance population, targeted treatment strategies should be used. [ABSTRACT FROM AUTHOR]

Qualitative meta‐synthesis is a coherent approach to answering an overarching research question by synthesising past qualitative studies so as to create new meanings from their results. We conducted a qualitative meta‐synthesis to systematically evaluate and integrate the caregiving experiences of adult children providing care for an elderly parent with cancer. The search was conducted in the databases Web of Science, PubMed, Embase, MEDLINE, Cochrane Library, Grew Literature in the Health Sciences, CNKI, WanFang Data, VIP, SINOMED and China Academic Journals as well as Chinese grey literature databases (China Academic Conference Literature Database/中国学术会议文献数据库, National Science and Technology Library) from inception to June 9, 2021. Thirteen studies were included in the final synthesis. The caregiver experiences they describe are synthesised into three primary themes: care needs, care burden and care gains, with numerous secondary themes. Besides our findings that seem to align with those from studies focused on other cultures, we have highlighted three main discoveries from the synthesis that stand out in the Chinese context: (1) many sub‐themes related to specific caregiving skills; (2) a strong expectation for health professionals to improve their communication skills with family caregivers; (3) the negative and positive influences of filial piety in caregiving experiences. Our findings can help multidisciplinary healthcare teams in China support adult children as caregivers in their emphasis on improving caregiver education and training, ways of making the most of potential care gains, and ways of easing care burdens. [ABSTRACT FROM AUTHOR]

Objective. By conducting a systematic review of the efficacy of acupoint application on children with asthma. Methods. We searched Chinese databases (CNKI, VIP, and Wanfang) and English databases (PubMed, Embase, and Cochrane Library) for studies from the establishment of the database to October 2021. The included literature studies were randomized control studies investigating the treatment of asthma in children by acupoint application. The primary outcomes included the cure rate, the resolution time of cough, and the resolution time of wheezing. The secondary outcomes included pulmonary function and interleukins. Stata 15 and RevMan 5.4 were used to analyze the extracted data. Results. A total of 24 related studies were included containing 2716 cases. The meta-analysis showed that TCM group was superior to control group in terms of cure rate, pulmonary function (FEV1), and resolution time of wheezing in children with asthma [RR = 1.26,95% (1.21,1.31), P < 0.05 ; SMD = 0.81, 95%CI (0.05,1.56), P < 0.05 ; WMD = −1.40, 95%CI (−1.75, −1.05), P < 0.05 ]. Conclusions. The present study shows that acupoint application is an effective treatment for children with asthma in China, especially in alleviating wheezing and improving quality of life. [ABSTRACT FROM AUTHOR]

A rare type of pneumonia later on referred to as COVID-19 was reported in China in December 2019. Investigations revealed that this disease is caused by a coronavirus previously identified as SARS-CoV-2, and since then, it has become a global pandemic with new strains emerging rapidly as a result of genetic mutations. Various therapeutic options are being explored in order to eradicate this pandemic even though approved vaccine candidates are being currently rolled out globally. Most medicinal plant extracts have astonishing properties, and they can therefore be used in the biosynthesis of effective antiviral nanoparticles. In this systematic review, we aimed to highlight the specific attributes that make Azadirachta indica (neem plant) a suitable candidate for the biosynthesis of anti-SARS-CoV-2 nanoparticles. A systematic investigation was therefore carried out in PubMed, Scopus, Web of Science, and AJOL databases with the keywords "Nanoparticles," "Biosynthesis," "Antivirals," "SARS-CoV-2," and "Azadirachta indica." 1216 articles were retrieved by the 21st of February 2022, but we screened studies that reported data on biomedical and antimicrobial assessment of Azadirachta indica extracts. We also screened studies that were reporting nanoparticles possessing antiviral properties against SARS-C0V-2, narrowing our results to 98 reports. Herein, the SARS-CoV-2 viral structure is briefly discussed with nanoparticles of biomedical importance in the design of SARS-CoV-2 antivirals. Most importantly, we focused on the biomedical and antiviral properties of Azadirachta indica extracts that could be of importance in the design of potential anti-SARS-CoV-2 nanoformulations. [ABSTRACT FROM AUTHOR]

Objective: To overview the colonoscopy adherence in cascade screening of colorectal cancer (CRC) and evaluate potential influence of the initial tests based on an ecological evaluation. Methods: The performance of the initial screening tests and adherence to subsequent colonoscopy were extracted from relevant studies published up to 16 October 2020. The age‐standardised incidence (ASRi) of CRC in populations in the year of screening was derived from the Cancer Statistics. Results: One hundred sixty‐six observational studies and 60 experimental studies were identified. Most studies applied cascade screening with faecal occult blood tests (FOBTs) as an initial test. The adherence to colonoscopy varied greatly across populations by continents, gross national income and type of initial tests, with a median (interquartile range) of 79.8% (63.1%–87.8%) in observational studies and 82.1% (66.7%–90.4%) in randomised trials. The adherence was positively correlated with the ASRi of CRC (r = 0.145, p = 0.023) and positive predictive value (PPV) of the initial tests (r = 0.206, p = 0.002) in observational studies and correlated with ASRi of CRC (r = 0.309, p = 0.002) and sensitivity of the initial tests (r = −0.704, p = 0.003) in experimental studies. Conclusions: Adherence to colonoscopy varies greatly across populations and is related with performance of the initial tests, indicating the importance to select appropriate initial tests. [ABSTRACT FROM AUTHOR]

Aim: This review aims to demonstrate the current core competencies of the Chinese midwifery workforce and to summarize the influencing factors of core competencies. Background: Midwifery core competencies are crucial to providing high‐quality maternal and newborn health care, but little is known about the overall status of the core competencies of the Chinese midwifery workforce. Evaluation: A scoping review was conducted following the latest Joanna Briggs Institute (JBI) scoping review methodology and Preferred Reporting Items for Systematic reviews and Meta‐Analyses extension for Scoping Reviews (PRISMA‐ScR) checklist. Key issues: Forty‐one studies were included in this review. Regarding core competency assessment tools, the Midwife Core Competency Scale was used most frequently among 16 identified tools. Generally, the core competencies of the Chinese midwifery workforce were at a moderate or high level, but the competencies in pre‐pregnancy, public health care and integrative competence were relatively inadequate. The main factors influencing the core competencies of the midwifery workforce were their working years, educational level and training experience. Conclusion: This review provides a comprehensive overview of the core competencies of the Chinese midwifery workforce at the national level. Future studies are encouraged to use objective instruments to reflect core competencies and explore the intervenable influencing factors of core competencies. Implications for Nursing Management: Core competency assessment tools can be used to select the qualified midwifery workforce. Targeted core competency enhancement programmes should be formulated based on the current core competencies level and the factors influencing core competencies. [ABSTRACT FROM AUTHOR]

Aims. To explore whether Astragalus or its formulations could prevent upper respiratory infection in children with nephrotic syndrome and how best to use it. Methods. We transformed a common clinical question in practice to an answerable question according to the PICO principle. Databases, including the Cochrane Library (Issue 5, 2012), PUBMED (1966-2012.8), CBM (1978-2012.8), VIP (1989-2012.8), and CNKI (1979-2012.8), were searched to identify Cochrane systematic reviews and clinical trials. Then, the quality of and recommendations from the clinical evidence were evaluated using the GRADEpro software. Results. The search yielded 537 papers. Only two studies with high validity were included for synthesis calculations. The results showed that Astragalus granules could effectively reduce URTI in children with nephrotic syndrome compared with prednisone treatment alone (23.9% versus 42.9%; RR = 0.56 and 95% CI = 0.33-0.93). The dose of Astragalus granules was 2.25 gram (equivalent to 15 gram crude Astragalus) twice per day, at least for 3-6 months. The level of evidence quality was low, but we still recommended the evidence to the patient according to GRADEpro with the opinion of the expert. Followup showed the incidence of URTI in this child decreased significantly. Conclusions. Astragalus granules may reduce the incidence of URTI in children with nephrotic syndrome. [ABSTRACT FROM AUTHOR]

Objective. This paper systematically evaluated the efficacy and safety of compound Danshen dropping pill (CDDP) in patients with acute myocardial infarction (AMI). Methods. Randomized controlled trials (RCTs), comparing CDDP with no intervention, placebo, or conventional western medicine, were retrieved. Data extraction and analyses were conducted in accordance with the Cochrane standards. We assessed risk of bias for each included study and evaluated the strength of evidence on prespecified outcomes. Results. Seven RCTs enrolling 1215 patients were included. CDDP was associated with statistically significant reductions in the risk of cardiac death and heart failure compared with no intervention based on conventional therapy for AMI. In addition, CDDP was associated with improvement of quality of life and impaired left ventricular ejection fraction. Nevertheless, the safety of CDDP was unproven for the limited data. The quality of evidence for each outcome in the main comparison (CDDP versus no intervention) was "low" or "moderate." Conclusion. CDDP showed some potential benefits for AMI patients, such as the reductions of cardiac death and heart failure. However, the overall quality of evidence was poor, and the safety of CDDP for AMI patients was not confirmed. More evidence from high quality RCTs is warranted to support the use of CDDP for AMI patients. [ABSTRACT FROM AUTHOR]

Acupuncture as an oriental natural healing therapy with prolonged history has been extensively utilized in the management of great numbers of disorders. Deqi, a renowned acupuncture needling sensation, is profoundly regarded as the predictor and also the prerequisite of a preferable acupuncture treatment efficacy Till now, there is still no consistency being reached towards the mechanism of acupuncture Deqi as a result of the discrepancy for publicly acknowledged evidence. Recent visualized research on Deqi using modern technologies has demonstrated possible central mechanism towards it. However, there is a conspicuous paradox underway in the research of cerebral response to acupuncture Deqi. This paper provided a view of up-to-date studies using visualized tools to characterize the brain response to acupuncture Deqi, such as functional magnetic resonance imaging (fMRI) and positron emission tomography/computed tomography (PET/CT). The paradox was extruded to highlight certain reasons from a TCM view. It is hypothesized that acupoints located at different dermal sites, state of participant, and needling manipulation can all contribute to the current paradox. Hence, further studies on acupuncture Deqi should pay more attention to the strategy of experiment design with generalized measurement, valid sham control methods, and more to subjects in diseased condition. [ABSTRACT FROM AUTHOR]

Objective Sex and intimacy are basic needs and important aspects of quality of life among humans. This focus of this review was to synthesise and present the best available qualitative evidence on the sexual life experiences and needs of Chinese adults living with cancer. Moreover, the first‐hand experience, meaning and perspective about the sexual life changes and support needs during the survival and extended treatment period were synthesised in this study. Methods: A systematic review of qualitative studies was undertaken using the Joanna Briggs Institute System for the Unified Management, Assessment and Review of Information (JBI‐SUMARI). A comprehensive search of five databases: CINAHL, MEDLINE, PubMed, Scopus and Google Scholar were undertaken from 2010 until February 2020 using defined criteria. Methodological quality and data extraction were undertaken using JBI‐SUMARI. Results: Eight studies were included in the review. A total of 39 findings were extracted and aggregated into eight categories based on similarity of meaning. Three synthesised themes were generated: (i) misconceptions and lack of education or information regarding sexual activity exists for patients with cancer, (ii) concerns for overall health and well‐being as well as physical and psychological changes can alter sexual desire and behaviours in patients with cancer and (iii) lack of sexual activity and intimacy can create relationship problems. Conclusions: Sexual relationships are intimate, personal and private in Chinese culture and beliefs. Chinese adults living with cancer report many neglected issues on sexual well‐being in various domains. Adequate and consistent education about sexual intimacy issues from health care providers was identified as an important need. Unaddressed needs might affect adults' coping strategies in managing their sexual relations during various stages of cancer treatment and beyond. It must be noted that there are many Chinese ethnic minorities living with cancer outside the Greater China region. The evidence provides valuable recommendations to health care providers globally to consider the specific sexual needs and initiate culturally sensitive sexuality education and care support for Chinese adults living with cancer. [ABSTRACT FROM AUTHOR]

Internet's online information services can deliver high-quality services to the public while eliminating social alienation and virus transmission. From 2013 until the fourth quarter of 2020, China has had the highest number of Internet users in the world. Public access to information in the health care business in China is mostly through the Internet. In the healthcare business, high-quality information services are the fundamental obstacle because of their importance and effect on human lives. This article uses Chinese hospitals as a case study, covering assessment system development and empirical research. A total of 217 questionnaires were issued, 212 of which were valid, and the effective rate was 97.6 percent. The outcomes of the research show that the extensive epidemiological information services of the hospital website during an epidemic outbreak have a significant influence on the public's use of the hospital website. Secondly, high-quality epidemic-related information services are critical to enhancing website information services during outbreaks. Finally, in the epidemic, the high-quality service of the hospital's website has a greater impact on the worth of information in comparison to the content of information service. [ABSTRACT FROM AUTHOR]

Background. Evidence on the carcinogenicity of coalmine dust in occupational settings is still conflicting. Therefore, we conducted this research to evaluate the mortality risk of lung cancer for coalminers exposed to occupational dust when compared to population with no or low dust exposure. Methods. Databases of PubMed and Chinese National Knowledge Infrastructure as well as reference lists were searched updated to September 18, 2020. The enrolled articles should report lung cancer mortality risk for coalminers exposed to occupational dust. Basic information was extracted such as the author and publication year, area and ethnicity, the type and estimates of outcome, duration of follow-up, and the study design. The checklists from Agency for Healthcare Research and Quality and the Newcastle-Ottawa Scale were used for the assessment of quality and bias risk for descriptive studies, cohort studies, and case control studies, respectively. The overall relative risks were calculated while Begg's and Egger's tests and sensitivity analysis were performed to explore potential heterogeneity sources. Metaregression and subgroup analyses were also conducted to give more detailed information for the correlation between dust exposure and lung cancer mortality. Results. A total of 19 articles with 22 different studies (descriptive study, case control study, and cohort study) including 8909 observed deaths from 1964 to 2017 were enrolled with a significant heterogeneity ( I 2 = 95 % , P < 0.001). The pooled relative risk of mortality from lung cancer was 1.16 (1.03-1.30) for coalminers. Results of metaregression analysis indicated that the high heterogeneity among these enrolled studies might be caused by the ethnicity differences (P = 0.011). Subgroup analysis also indicated that the pooled estimate for Asian population in China was 4.94 (3.95-6.17) with I 2 = 39.3 % and P = 0.192. All these results suggested that exposure to occupational dust would significantly increase the mortality risk of lung cancer, especially for Asian population in China, which should be measured and controlled more strictly. Discussion. This systematic review and meta-analysis provides high-quality evidence that exposure to occupational dust might increase the mortality risk of lung cancer, especially for Asian populations in China. The magnitude of this effect is of major public health importance in view of the ubiquitous existence of coalmining industry in China and even in the world. However, these pooled estimates should be interpreted cautiously because of the high heterogeneity among these publications. Other. This study was supported by the National Key Research and Development Program of China (Grant No. 2016YFC1302501). [ABSTRACT FROM AUTHOR]

Diarrhea and pneumonia are common and serious complications in hospitalized patients requiring nasogastric enteral feeding. Our study aimed to compare the risk of diarrhea and pneumonia between intermittent nasogastric enteral feeding (IEF) and continuous nasogastric enteral feeding (CEF). We systematically searched PubMed, Web of Science, and Cochrane for relevant articles published from August 9, 1992, to September 1, 2019. A total of 637 IEF and CEF patients were included in our meta-analysis. Odds ratios (ORs) with associated 95% confidence intervals (CIs) were calculated to estimate the effects of diarrhea and pneumonia. We showed that hospital patients that required IEF had an increased risk of diarrhea compared with CEF. In the subgroup analyses, similar conclusions were identified in the non-China group and small sample size group (size < 100). However, our results showed no significant differences in the China group or large sample size group (size ≥ 100). Furthermore, our analysis showed that no significant association was observed for the risk of pneumonia between IEF and CEF patients. For inpatients requiring nasogastric enteral feeding, CEF is a better method of enteral nutrition compared with IEF, of which patients experience a significantly increased risk of diarrhea. [ABSTRACT FROM AUTHOR]

Background. Myopia prevalence varies across the country among schoolchildren in China. Recently, environmental factors have been shown to be important in myopia development and progression. Given China's geographical diversity with variable environmental factors, we investigated whether environmental factors could explain the regional variations in myopia in mainland China. Methods. We searched PubMed, Web of Science, and Chinese Science Periodical Databases for studies with reports of myopia prevalence in schoolchildren in mainland China from the years 1979 to 2019. Data on environmental factors (annual sunshine hours, temperature, and population density) were obtained from past records. A random-effect univariate metaregression analysis was used to investigate the association between the environmental factors and myopia prevalence and to determine the proportion of variation in regional myopia prevalence that can be attributed to each factor. Results. Forty-nine eligible studies were identified that included 666,864 schoolchildren aged 6 to 20 years. The pooled estimate of myopia prevalence was 32.88% (95% confidence interval: 26.69–39.08%). Univariate metaregression analysis indicated that annual sunshine hours (27.97% of variance), annual temperature (24.66%), and population density (7.06%) significantly contributed to regional myopia prevalence variation (each p < 0.05), while seasonal variation in sunshine hours (1.54%, p = 0.604) was not a significant predictor of myopia prevalence. However, only annual sunshine hours was significantly associated with myopia prevalence in the multivariate metaregression model. Conclusion. Myopia prevalence in children was higher in regions with low sunshine hours, and annual sunshine hours was significantly associated with regional variation in myopia prevalence in mainland China. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effect of art therapy on cancer patients' quality of life and physical and psychological symptoms. Methods: The databases PubMed, Embase, Web of Science, The Cochrane Library, Clinical Trial.gov, the China National Knowledge Infrastructure (CNKI), Wanfang and the Chinese Biomedical Literature Database (CBM) were searched from their inception up to 20 August 2019. Trials examining the effects of art therapy on physical and psychological symptoms and quality of life versus a control group were included. The methodological quality of the included randomised controlled trials was assessed using the risk of bias tool of Cochrane Handbook. Meanwhile, the Newcastle‐Ottawa Quality Assessment Scale (NOS) was used to evaluate the methodological quality of the non‐randomised studies. Results: Twelve studies involving 587 cancer patients were included. The results revealed that art therapy significantly reduced anxiety symptoms (standard mean difference [SMD] = −0.46, 95% confidence interval [CI] [−0.90, 0.02], p =.04), depression symptoms (SMD = −0.47, 95% CI [−0.72, 0.21], p <.01), and fatigue (SMD = −0.38, 95% CI [−0.68, −0.09], p =.01) in cancer patients. Art therapy also significantly improved the quality of life of cancer patients (SMD = 0.43, 95% CI [0.18, 0.68], p <.01). Conclusions: Art therapy had a positive effect on quality of life and symptoms in cancer patients and can be used as a complementary treatment for cancer patients. [ABSTRACT FROM AUTHOR]

Background. Shoutai Pill (STP), a famous classic herbal formula documented in traditional Chinese medicine (TCM), is widely available in China for treating unexplained recurrent spontaneous abortion (URSA). This systematic review and meta-analysis aims at evaluating the efficacy and safety of STP in the first trimester of pregnancy in women with a history of unexplained recurrent spontaneous abortion. Methods. The following eight databases were searched from their establishment to Dec 31, 2019, for randomized controlled trials (RCTs): PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), the Chinese BioMedical database (CBM), Chinese Scientific Journal Database (VIP), and the Wanfang database. The quality of evidence was estimated by the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Results. A total of 12 studies (916 patients) with URSA were contained in this meta-analysis. The forest plot showed that patients treated with Shoutai Pill and western medicine had a significantly lower incidence of early pregnancy loss (RR: 0.42; 95% CI: 0.34–0.52; P < 0.01 , I 2 = 0 %). Subgroup analysis revealed that different types of TCM syndrome differentiation had the similar results. Also, in the combined group, patients had a lower TCM syndromes and symptoms and serum D-dimer level, while higher incidence of live birth. Conclusions. Our findings suggest that cotreatment with STP and western medicine might be superior to western medicine alone in the first trimester of pregnancy to prevent miscarriage in women with unexplained recurrent spontaneous abortion, and there was no adverse event in the experimental group reported. However, the methodological quality of included RCTs was unsatisfactory; it is necessary to verify its effectiveness with further more standardized researches of rigorous design. [ABSTRACT FROM AUTHOR]

Aim. This study aimed to evaluate the effects and safety of moxibustion in the management of constipation. Background. Constipation is extremely common in clinical practice and causes physical and mental pain to patients. This study aimed to evaluate the effects and safety of moxibustion in the management of constipation. Methods. Studies on moxibustion for constipation published up to November 2019 were searched in PubMed; EBSCO; EMBASE; Cochrane Library; and three Chinese databases, namely, China National Knowledge Internet, Wanfang, and China Biomedical Network. The methodological quality of the included studies was assessed on the basis of the CLEAR NPT system evaluation methods of Boutron. Further meta-analysis was performed using the RevMan 5.3 and Stata 15.0 software. Results. Ten randomized controlled trials involving 760 patients were included in this study. The meta-analysis revealed that, in comparison to western medicine treatment or other Chinese medicine methods (control group), moxibustion (experimental group) had a higher total effective rate (RR = 1.30, 95% CI [1.21, 1.40], P < 0.00001), and the clinical effectiveness of the experimental group was higher than that of the control group in any subgroup analysis. The first defecation time of the experimental group was shorter than that of the control group (SMD = −1.36, 95% CI [−2.03, −0.68], P < 0.0001). The clinical symptom score of the patients in the experimental group was lower than that in the control group (SMD = −0.65, 95% CI [−1.00, −0.30], P = 0.0003). The patients in the experimental group had higher scores on Bristol stool form scale than those in the control group (MD = 0.99, 95% CI [0.48, 1.50], P = 0.0001). However, there was no obvious difference in safety between the two groups (RR = 0.38, 95% CI [0.01, 11.8], P = 0.58). Conclusions. Moxibustion may have better effect than other treatments on constipation. However, it is not yet possible to assess the safety level of moxibustion therapy, and the quality of the included literature is low, so rigorous studies are warranted. Implications for Nursing and Health Policy. The focus of this study was to evaluate the effectiveness and safety of moxibustion therapy in constipation. This evaluation showed that moxibustion therapy has a good effect on constipation and provides an effective treatment for constipation patients. Whether moxibustion therapy can be used for different syndrome types deserves further discussion. [ABSTRACT FROM AUTHOR]

Aim: To appraise the quality of current nursing clinical practice guidelines (N‐CPGs) in China and explore the methodology for N‐CPGs development. Background: Implementation of quality improvement projects based on N‐CPGs has becoming an hot topic for nursing with proliferation in the number of N‐CPGs in China in recent years. The methodology for developing N‐CPGs is worthy of exploration. Methods: A systematic literature search was performed using PubMed, CINAHL, Web of Science, CNKI, Wanfang, VIP and CBM and relevant representative guidelines repositories from inception to July 31, 2019. Two authors independently selected eligible guidelines and performed data extraction. Four appraisers independently assessed the quality of the N‐CPGs using the AGREE II tool. Results: 20 N‐CPGs were eventually included in this review. After AGREE II appraisal, the final domain scores ranged between 0.00 and 83.33%. When comparing the total domain scores, "Scope and purpose" and "Clarity of presentation" scored highest with a total of 63.89 (59.37–69.79) (%, median, interquartile range (IQR)), and 63.89 (58.33–75.70) (%), respectively. "Editorial independence" obtained the lowest ranking with a total score of 0 (0–81.25) (%). The total scores of "Stakeholder involvement", "Rigour of development", "applicability" and "editorial independence" were lower than 50%. Conclusion: The quality of N‐CPGs in China is not very high and the process of guideline development still needs to improve. Implications for Nursing Management: N‐CPGs are important documents used to guide nursing quality improvement. High quality N‐CPGs are beneficial for nursing management. [ABSTRACT FROM AUTHOR]

Aims: To review the studies on nursing research capacity and the managerial approaches that have been taken to promote nursing research capacity building in China. Background: In the nursing profession, research has become increasingly important worldwide. Over the last two decades, continuous efforts have been devoted to improving nursing research capacity in China. However, the results of these efforts were rarely evaluated in a national scale. Evaluation: A systematic literature review was conducted in accordance with the PRISMA checklist and guidelines. The literature was sourced from PubMed, CINAHL and two Chinese databases. In total, 19 articles were selected and their results were integrated, compared and analysed. Key issues: The development of nursing research has become a recent phenomenon in China. Chinese nurses' perceptions regarding research were mostly positive. However, their participation in research activity has traditionally been minimal. The factors associated with nursing research capacity in China were nurses' personal characteristics and organisational contexts. Several effective strategies (e.g. on‐the‐job research education) have been used to promote nursing research capacity. Conclusion: Currently, nursing research capacity in China is low despite hospital‐promoting efforts. Systematic approaches need to be implemented to increase nursing research capacity in China in the near future. Implications for nursing management: Nursing administrators need to seek innovative strategies to resolve issues (e.g. lack of research time and limited nursing research resources). They also need to strengthen their leadership skills in order to achieve the above objectives. [ABSTRACT FROM AUTHOR]

Background. Chronic simple pharyngitis (CSP) is a common clinical chronic respiratory inflammation with persistent and intransigent symptoms. We analyzed the clinical data to find the evidence that herbal tea, a traditional Chinese medicine treatment in China, could improve the symptoms of CSP patients in a simple way. Methods. We systematically reviewed the clinical data of randomized controlled treatments from April 2019 and evaluated the results using the improved Jadad scale and the Cochrane bias risk assessment tool. RevMan 5.3 software was used for chart analysis. In addition, we used Excel to conduct frequency statistics on Chinese herbs from included articles and analyze its medication rules. Results. Among the collection of 161 articles, 6 RCTs published in Chinese journals were included in this review. The methodological quality of the treatments was low, and most of them only provide diagnostic criteria. Inclusion and exclusion criteria were not specified, and none of the 6 RCTs used the blind method on the result evaluator. Furthermore, only one RCT evaluated the baseline level variance. For these reasons, we did not make a network meta-analysis. Conclusions. The traditional Chinese herbs involved in herbal tea did have ingredients to alleviate CSP symptoms. However, our research showed that the current research could not draw any credible conclusions on the curative effect of herbal tea, which indicated that the overall level of TCM clinical research needs to be improved to evaluate the efficacy of herbal tea. [ABSTRACT FROM AUTHOR]

Background. The Traditional Chinese Medicine (TCM) Tian Wang Bu Xin Dan (TWBXD) has been used widely for treating insomnia in China. The purpose of this meta-analysis was to evaluate the efficacy and safety of TWBXD in the treatment of insomnia. Objective. This study evaluated the efficacy and safety of TWBXD for insomnia. Methods. We searched seven main databases including PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Chinese Biomedicine Database (CBM), China National Knowledge Infrastructure (CNKI), Chinese Scientific Journals Database (VIP), and Wan-fang. We identified randomized-controlled trials (RCTs) for insomnia treatment involving TWBXD, TWBXD combined with conventional Western medicine, and conventional Western medicine from their inception to May 2018. The quality of literature was evaluated by Cochrane assessing tool to reduce the risk of bias. Meta-analysis and heterogeneity of results across the trials were performed. RevMan 5.3 was used to synthesize the results. Results. 14 studies involving 1,256 participants were identified in this systematic review. Methodological deficiencies existed in most of the included trials. Few studies described the generation of a random sequence in detail, the concealment of allocation, and the methods of blinding. No placebo was used in treatment. 12 trials compared TWBXD with conventional Western medicine and 2 trials compared TWBXD combined with conventional Western medicine. The results of our meta-analysis showed relative benefits in effective rates in favor of TWBXD (Odds Ratio [OR] 2.71, 95% confidence interval [CI] 1.67 to 4.39, P < 0.00001) and TWBXD combined with conventional Western medicine (OR 5.05, 95% CI 1.58 to 16.12, P=0.006). The Pittsburgh Sleep Quality Index (PSQI) scores showed similar results, which favored TWBXD (Weighted Mean Difference [WMD] -1.82, 95% CI -3.00 to -0.64, P=0.003). Only 5 trials reported adverse events, whereas the other 9 trials did not provide the safety information. Conclusion. This review demonstrates that although the effects of TWBXD on insomnia were promising, they need to be interpreted with caution, due to the poor methodological quality and the small number of trials of the included studies. TWBXD seems to be generally safe, but there is insufficient evidence to make conclusions on the safety because fewer studies reported the adverse events. Further studies on a larger scale with more rigorous designs are required to evaluate the role of TWBXD in the insomnia treatment. [ABSTRACT FROM AUTHOR]

Numerous designs of punctal and canalicular plugs are available on the market. This variety presents challenges to ophthalmologists when choosing punctal plugs for the management of various ocular conditions. The aim of this literature review is to provide a classification system for lacrimal occlusive devices based on their location and duration of action as well as to identify different characteristics of each one of them. We want to give a comprehensive overview on punctal and canalicular plugs including their manufacturing companies, indications, and complications that have been reported in various articles. PubMed and Google Scholar were used to identify articles written in English as well as few articles written in Japanese, Chinese, Slovak, and Spanish that had abstracts in English. Nine different companies that manufacture punctal and canalicular plugs were identified and their plugs were included in this review. Punctal and canalicular plugs are used in the management of various ocular conditions including dry eye disease and punctal stenosis as well as in ocular drug delivery. Although they are a relatively safe option, associated complications have been reported in the literature such as infection, allergic reaction, extrusion, and migration. [ABSTRACT FROM AUTHOR]