Hypothermia therapy is a promising therapeutic strategy for traumatic brain injury (TBI); however, some trials have shown that hypothermia therapy has a negative effect on patients with TBI. The treatment of hypothermia in children with TBI remains controversial. We conducted a search of six online databases to validate the literature on comparing hypothermia with normal therapy for children with TBI. Eight randomized controlled trials (514 patients) were included. The meta-analysis indicated that hypothermia therapy may increase the Glasgow Outcome Scale (GOS) scores. However, in terms of improving the rate of complications, intracranial pressure (ICP), mortality, cerebral perfusion pressure (CPP), and length of stay both in hospital as well as pediatric ICU, the difference was not statistically significant. Hypothermia therapy may have clinical advantages in improving the GOS scores in children with TBI compared with normothermic therapy, but hypothermia therapy may have no benefit in improving the incidence of complications, ICP, mortality, CPP, and length of stay both in pediatric ICU as well as hospital. The decision to implement hypothermia therapy for children with TBI depends on the advantages and disadvantages from many aspects and these must be considered comprehensively.

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Background At present, there is no relevant research on the application effect of "basic package + personalized package" family doctor contract service mode in hypertension management, therefore, this study intended to evaluate the application effect of this service model in the management of hypertension patients. We speculated that the implementation of this mode would improve the health outcomes of elderly patients with hypertension. Methods Patients with hypertension who participated in family doctor contract services in a community health service center in Chengdu, Southwest China from January 1, 2018 to December 31, 2020 were selected as the subjects of the study. According to the inclusion and exclusion criteria of the study, a total of 968 patients were included. The patients were divided into observation group and control group according to the type of service package they received. The primary outcomes included mean blood pressure (systolic, diastolic) and the rate of blood pressure control, Secondary outcomes included the level of cardiovascular disease risk and the level of self-management ability. All outcomes were assessed at baseline and 6 months after signing up. Results Of the 10,970 patients screened for eligibility, 968 (8.8%) were enrolled and divided into observation group (receiving "basic package + personalized package [hypertension]" service) (n = 403) and control group (receiving "basic package" service) (n = 565) according to the type of service package they received. Participants in the observation group compared with the control group showed better improvement in mean systolic blood pressure, the rate of blood pressure control, the level of cardiovascular disease risk, and the level of self-management ability at 6 months after signing up (Mean systolic blood pressure, P = 0.023; the rate of blood pressure control, P < 0.001; the level of cardiovascular disease risk, P < 0.001; the level of self-management ability, P < 0.001). There was no significant difference in mean diastolic blood pressure between the two groups (P = 0.735). Conclusions The family doctor contract service model of "basic package + personalized package (hypertension)" has a good application effect in the management of elderly hypertension, which can improve the average blood pressure, the rate of blood pressure control, the level of cardiovascular disease risk and the level of self-management ability of elderly hypertension patients.

ObjectivesWe conducted this study to assess the application effect of the family doctor contract service mode of ‘basic package+personalised package’ in the management of hypertension patients.DesignObservational study.SettingThe study was conducted at a community health centre in Southwest China. Data were collected from 1 January 2018 to 31 December 2020.ParticipantsFrom 1 January 2018 to 31 December 2020, hypertensive patients (age ≥65 years) who participated in the contract services of family doctors at a community health service centre in Chengdu, Southwest China, were selected as the study subjects.Main outcome measuresThe primary outcomes included mean blood pressure (systolic, diastolic) and the rate of blood pressure control, secondary outcomes included the level of cardiovascular disease risk and self-management ability. Assessments of baseline and 6 months after signing up were conducted on all outcomes. The major statistical analysis methods included two independent sample t-tests, paired t-tests, Pearson’s χ2test, McNemar’s test, two independent sample Mann-Whitney U tests and paired sample marginal homogeneity tests.ResultsOf the 10 970 patients screened for eligibility, 968 (8.8%) were separated into an observation group (receiving ‘basic package+personalised package (hypertension)’ service) (n=403) and a control group (receiving ‘basic package’ service) (n=565) according to the type of service package they received. In comparison to the control group, the observation group had lower mean systolic blood pressure (p=0.023), higher blood pressure control rate (p<0.001), lower cardiovascular disease risk level (p<0.001) and higher self-management ability level (p<0.001) at 6 months after signing up. The mean diastolic blood pressure of the two groups was not significantly different (p=0.735).ConclusionsThe family doctor contract service model of ‘basic package+personalised package (hypertension)’ has a good application effect in the management of elderly hypertension, which can improve the average blood pressure, the rate of blood pressure control, the level of cardiovascular disease risk and self-management ability of the elderly with hypertension.