Taken together, although there are some clear limitations regarding the body of research reviewed in this study, a tentative conclusion can be reached that acupuncture, Tuina, Tai Chi, Qigong, or TCM-FEMT represent beneficial adjunctive therapies. Future study reporting in this field should be improved regarding both method and content of interventions and research methods.

Background. Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy, and nutritional therapy is the basis of GDM treatment. However, the effects of different forms of nutritional supplementation on improving gestational diabetes are uncertain. Objective. We conducted a network meta-analysis to evaluate the effects of supplementation with different nutrients on glucose metabolism in women with GDM. Methods. We conducted a literature search using PubMed, EMBASE, and the Cochrane Library to identify randomized controlled trials (RCTs) comparing the differences between different nutritional strategies in women with GDM. The Cochrane tool was used to assess the risk of bias. Pairwise meta-analysis and network meta-analysis were used to compare and rank the effects of nutritional strategies for the improvement of fasting plasma glucose (FPG), serum insulin, and homeostasis model assessment-insulin resistance (HOMA-IR). Results. We included thirteen RCTs with a total of 754 participants. Compared with placebo, omega-3, magnesium, vitamin D, zinc, and probiotics were more beneficial for improving FPG, serum insulin, and HOMA-IR. Network analysis showed that vitamin D supplementation was superior to omega-3 (-3.64 mg/dL, 95% CI: -5.77 to -1.51), zinc (-5.71 mg/dL, 95% CI: -10.19 to -1.23), probiotics (-6.76 mg/dL, 95% CI: -10.02 to -3.50), and placebo (-12.13 mg/dL, 95% CI: -14.55 to -9.70) for improving FPG. Magnesium supplementation was more beneficial for decreasing serum insulin compared with probiotics (-5.10 μIU/mL, 95% CI: -9.32 to -0.88) and placebo (-7.80 μIU/mL; 95% CI-11.95, -3.65). Vitamin D was more effective than probiotics (-0.99, 95% CI: -1.84 to -0.14) and placebo (-1.80, 95% CI: -2.45 to -1.16) for improving HOMA-IR. Conclusion. Vitamin D supplementation significantly reduced FPG and regulated HOMA-IR. Magnesium supplementation was superior in decreasing serum insulin than supplementation with other nutrients. Nutrient supplementation seemed to have an effect on glucose homeostasis maintenance in patients with GDM and may be considered an adjunctive therapy.

Aim To develop and evaluate psychometric property of quality nursing care scale (QNCS) from nurses’ perspective in the Chinese context. Design A cross‐sectional survey design. Methods This study was conducted in two phases. In Phase I, literature review and interviews were conducted to develop the items. In Phase II, content validity was evaluated by five experts. Construct validity was tested through exploratory factor analysis (EFA) among 302 nurses and confirmatory factor analysis (CFA) among 510 nurses from October 2014 to January 2015. Additionally, internal consistency reliability was tested. Results The EFA extracted six factors including staff characteristics, task‐oriented activities, human‐oriented activities, physical environment, patient outcomes and precondition. All six factors accounted for 74.78% of the total variance to explain quality nursing care. The modified measurement model of the final version of QNCS was supported by the CFA with 48 items in six dimensions. The internal consistency reliability of final QNCS was acceptable.

No abstract

Background：Currently, the interaction between proton pump inhibitors (PPI) and their effects on hemodialysis (HD) patients has not been clarified. Here, we aimed to explore the association between PPI and adverse outcomes in HD patients. Methods：A search was performed on the PubMed, Embase, Cochrane Library, and Web of Science databases for relevant articles published up to April 10, 2022. Studies examining the association (odds ratio [OR]) between PPI and side effects were identified. The study followed guidelines prescribed in the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), and was registered with PROSPERO (CRD42021291177). Results: A total of 12 studies comprising 4,227,497 HD patients with PPI were identified. Results showed that PPI use was associated with increased risk of bone fracture and hip fracture in the HD patients (pooled OR = 1.29, 95% CI = 1.21-1.37, p<0.00001, I2=0%; pooled OR = 1.37, 95% CI = 1.12-1.67, p=0.002, I2=82%). Besides, HD patients who received PPI were more likely to develop hypomagnesemia compared with those who did not receive PPI (pooled OR = 2.79, 95% CI = 1.95-4.00, p<0.00001, I2=0%). In addition, PPI use was linked to abdominal aortic calcification and all-cause mortality (pooled OR=2.03, 95% CI=1.28-3.24, p =0.003, I2=0%), (pooled OR = 1.44, 95% CI = 1.17-1.78, p = 0.0006, I2=0%). Conclusions: Taken together, the present results demonstrate that PPI use in HD patients is independently associated with adverse reactions such as hip fracture, hypomagnesemia, abdominal aortic calcification, and all-cause mortality. Thus, the use of PPI in HD patients should be carefully evaluated and optimized.