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长江经济带岩溶塌陷分布、成因及其对工程建设的影响

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中国地质 2024年第1期51卷 184-202页

作者：戴建玲雷明堂蒋小珍 zhou wanfang 蒙彦吴远斌管振德贾龙殷仁朝潘宗源尹欧陈英姿杨涛雷柱平黄敬军杨荣康中国地质科学院岩溶地质研究所/中国地质调查局岩溶塌陷防治技术创新中心/广西岩溶资源环境工程技术研究中心广西桂林541004 联合国教科文组织国际岩溶研究中心/岩溶动力系统与全球变化国际联合研究中心广西桂林541004 Zeo环境有限责任公司美国田纳西州诺克斯维尔37934 湖南省地质调查院湖南长沙410116 湖南省地质矿产勘查开发局四一八队湖南娄底417009 湖北省地质环境总站湖北武汉430034 安徽省地质环境监测总站安徽合肥230001 江苏省地质调查研究院江苏南京210018 贵州省地质环境监测院贵州贵阳550001

[研究目的]岩溶塌陷是长江经济带主要环境地质问题之一,开展长江经济带岩溶塌陷分布、成因及其对工程建设的影响研究,对长江经济带立体综合交通走廊建设和新型城镇化建设地质环境安全保障具有重要意义。[研究方法]本文系统梳理了长江经... 详细信息

[研究目的]岩溶塌陷是长江经济带主要环境地质问题之一,开展长江经济带岩溶塌陷分布、成因及其对工程建设的影响研究,对长江经济带立体综合交通走廊建设和新型城镇化建设地质环境安全保障具有重要意义。[研究方法]本文系统梳理了长江经济带岩溶塌陷研究成果,从岩溶环境特征、岩溶塌陷的成因类型和机制、发育及分布规律、对工程建设的影响及防控措施几个方面进行论述。[研究结果]研究结果表明,长江经济带岩溶塌陷易发区面积约25.4万km^(2),有记录的岩溶塌陷灾害2146处,矿山疏干排水、抽水、工程施工等是这一地区岩溶塌陷的主要诱发因素。长江经济带岩溶塌陷具有以下发育分布规律:一是具有区域性和地带性的分布特征;二是发育地层一般为均匀状纯碳酸盐岩,沿断裂破碎带、褶皱轴部裂隙发育带、可溶岩与非可溶岩接触地带等岩溶洞隙密集发育带分布;三是多发生在岩溶地下水强径流带、河流两岸等地下水位变化幅度大、水动力条件易发生急剧变化的地段;四是多发生在人类工程活动强烈的地区,塌陷的规模取决于人类活动的性质和强度。为了降低岩溶塌陷对工程建设和安全运营影响,本文同时提出了相关建议和对策。[结论]长江经济带岩溶塌陷分布广、危害大,高易发区内线性工程、重要城市群等规划建设应对这一环境地质问题引起重视,该研究成果可为长江经济带国土空间规划、地质灾害防治提供基础支撑和理论依据。

关键词：岩溶塌陷地质灾害分布成因工程建设地质调查工程长江经济带

Efficacy and Challenges of Using Springs for Early Detection of Contaminant Release from Waste Disposal Facilities Constructed in Karst Terranes

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Journal of Geoscience and Environment Protection 2020年第9期8卷 107-125页

作者： wanfang zhou Mingtang Lei Zeo Environmental LLC Knoxville TN USA Institute of Karst Geology Guilin China

Early detection of groundwater contamination from waste disposal facilities is challenging in karst terranes. First, one needs to demonstrate that the groundwater system at the study site is monitorable. Both springs and wells are potential monitoring locations if they are effectively connected to the groundwater system, and they are not impacted by any other disposal facilities. Second, due to dynamic responses to recharge events, particularly discharge and chemical constituents at karst springs, multiple-parameter, long-term, and high-frequency monitoring may be required to collect background data. Sampling and analysis plans should be designed to reflect the unique characteristics of the monitoring locations. Characterization of the natural variations in water quality may require sampling efforts under different flow conditions. Third, evaluation of the potential impact of waste disposal units on the groundwater system requires an effective statistical evaluation program. Due to heterogeneity of karst aquifers, intra-locational comparison is generally preferred to inter-locational comparison. Sufficient groundwater monitoring data prior to construction of waste disposal units are required to develop the intra-locational statistical evaluation. In the case study presented in this paper, procedures to address these above-mentioned challenges were presented for two springs using seven dye tracing tests, two spring instrumentations, nine background sampling, flow-weighted concentrations, and an innovative statistical evaluation method were presented. These procedures were developed to evaluate potential contaminant release from a solid waste disposal facility constructed in a relatively isolated karst terrane. Although the specific procedures may not be duplicated, the overall technical approaches discussed in the paper may shed light on groundwater monitoring programs in other karst areas.

关键词： Karst Spring Dye Tracing Flow-Weighted Concentration Waste Disposal Statistical Evaluation

Prognostic factors associated with gastrointestinal dysfunction after gastrointestinal tumor surgery:A meta-analysis

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World Journal of Gastrointestinal Surgery 2024年第5期16卷 1420-1429页

作者： Jia Song Cong zhou Tian Zhang Department of Operating Room The Fourth Affiliated Hospital of Nanjing Medical UniversityNanjing 210031Jiangsu ProvinceChina Department of Gastrointestinal Surgery Tongji Hospital of Huazhong University of Science and TechnologyWuhan 430073Hubei ProvinceChina Department of Disinfection Supply Center The Fourth Affiliated Hospital of Nanjing Medical UniversityNanjing 210031Jiangsu ProvinceChina

BACKGROUND Explore the risk factors of gastrointestinal dysfunction after gastrointestinal tumor surgery and to provide evidence for the prevention and intervention of gastrointestinal dysfunction in patients with gastrointestinal tumor *** To investigate the potential risk factors for gastrointestinal dysfunction following gastrointestinal tumor surgery and to present information supporting the prevention and management of gastrointestinal dysfunction in surgery *** Systematically searched the relevant literature from PubMed,Web of Science,Cochrane Library,Embase,CNKI,China Biomedical Database,wanfang Database,and Weipu Chinese Journal Database self-established until October 1,*** Manager 5.3 software was used for meta-analysis after two researchers independently screened literature,extracted data,and evaluated the risk of bias in the included *** A total of 23 pieces of literature were included,the quality of which was medium or above,and the total sample size was *** results of meta-analysis showed that the patients were male(OR=1.58,95%CI:1.25-2.01,P=0.002)and≥60 years old(OR=2.60,95%CI:1.76-2.87,P<0.001),physical index≥25.3 kg/m2(OR=1.6,95%CI:1.00-1.12,P=0.040),smoking history(OR=1.89,95%CI:1.31-2.73,P<0.001),chronic obstructive pulmonary disease(OR=1.49,95%CI:1.22-1.83,P<0.001),enterostomy(OR=1.47,95%CI:1.26-1.70,P<0.001),history of abdominal surgery(OR=2.90,95%CI:1.67-5.03,P<0.001),surgical site(OR=1.2,95%CI:1.40-2.62,P<0.001),operation method(OR=1.68,95%CI:1.08-2.62,P=0.020),operation duration(OR=2.65,95%CI:1.92-3.67,P<0.001),abdominal adhesion grade(OR=2.52,95%CI:1.90-3.56,P<0.001),postoperative opioid history(OR=5.35,95%CI:3.29-8.71,P<0.001),tumor TNM staging(OR=2.58,95%CI:1.84-3.62,P<0.001),postoperative blood transfusion(OR=2.92,95%CI:0.88-9.73,P=0.010)is a risk factor for postoperative gastrointestinal dysfunction in patients with gastrointestinal *** There are many factors affecting gastroint

关键词： Gastrointestinal tumor surgery Postoperative gastrointestinal dysfunction Intestinal paralysis Risk factors Metaanalysis

特重度烧伤瘢痕患者应用经外周静脉穿刺置入中心静脉导管置管一例的护理体会

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解放军护理杂志 2017年第4期34卷 62-64页

作者：方文姣周万芳朱咏梅钱火红第二军医大学长海医院烧伤科上海200433 第二军医大学长海医院感染科第二军医大学长海医院护理部

目的了解经外周静脉穿刺置入中心静脉导管(peripherally inserted central venous catheters,PICC)在大面积疑难烧伤病例中的作用及其使用情况。方法分析2016年7月上海市某三级甲等综合性医院烧伤科收治1例大面积深度烧伤后瘢痕增生患者... 详细信息

目的了解经外周静脉穿刺置入中心静脉导管(peripherally inserted central venous catheters,PICC)在大面积疑难烧伤病例中的作用及其使用情况。方法分析2016年7月上海市某三级甲等综合性医院烧伤科收治1例大面积深度烧伤后瘢痕增生患者,施行PICC置管的过程。结果由于该患者全身大面积瘢痕增生及手术部位限制无法建立外周静脉通道或中心静脉通道(central venous catheters,CVC),遂在超声引导赛丁格穿刺下成功置入PICC导管,留置52d,并顺利完成了相关治疗后拔管。结论该案例PICC的成功实施,拓宽了其在烧伤及疑难置管病例中的使用范围。

关键词：特重度烧伤瘢痕经外周静脉穿刺置入中心静脉导管

新型冠状病毒肺炎疫情期间援鄂医务人员不适现状调查及影响因素分析

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中华损伤与修复杂志（电子版） 2021年第4期16卷 326-332页

作者：张丽君冯苹张玲邱文娟周万芳海军军医大学第一附属医院烧伤科上海200433 海军军医大学第一附属医院护理处上海200433 海军军医大学第一附属医院日间病房上海200433

目的调查新型冠状病毒肺炎疫情期间援鄂医务人员不适现状并分析其影响因素。方法采用便利抽样法选取2020年2月至4月在湖北省某3家新型冠状病毒肺炎定点收治医院工作的医务人员为研究对象。由研究者自行设计人口学特征问卷及援鄂医务人... 详细信息

目的调查新型冠状病毒肺炎疫情期间援鄂医务人员不适现状并分析其影响因素。方法采用便利抽样法选取2020年2月至4月在湖北省某3家新型冠状病毒肺炎定点收治医院工作的医务人员为研究对象。由研究者自行设计人口学特征问卷及援鄂医务人员不适症状问卷,其中人口学特征问卷包括性别、年龄、原单位级别、职业、工作年限等因素;援鄂医务人员不适症状问卷包括生理维度11个条目,心理维度2个条目,社会支持维度1个条目。另外增加1个开放式问题。各个条目采用Likert 5级评分法,各条目得分1~2分代表轻度不适;3~4分代表中度不适;5分代表重度不适。采用“问卷星”微信小程序,由研究者于调查开始前对调查对象进行统一指导,之后以二维码形式在线发放问卷。调查对象于开展工作2周后根据自身实际感受填写问卷,研究者于后台进行资料收集。按照因子分析的具体要求计算样本量。分析援鄂医务人员不适问卷的内部一致性信度和结构效度;统计援鄂医务人员人口学特征,并进行援鄂医务人员不适因素的单因素分析和多元线性回归分析。数据比较采用t检验、单因素方差分析、非参数检验、多元线性逐步回归。结果通过对前期收集的72份预实验问卷数据进行统计分析,本研究问卷的Cronbach′s系数为0.89,生理维度和心理维度的Cronbach′s系数分别为0.86和0.88,表明该问卷具有较好的内部一致性信度;对各条目进行探索性因子分析,Bartlett球形检验χ^(2)值为364.54,差异有统计学意义(P<0.05),KMO值为0.85,3个公因子的累计方差贡献率为61.98%,说明本问卷具有较好的结构效度。本研究共发放问卷240份,回收240份,有效问卷216份,有效回收率90%。经统计,援鄂医务人员各条目不适总均分为(3.03±0.76)分,不适得分处于中度水平。身体部位受挤压、皮肤改变、失眠/多梦、呼吸困难/缺氧及肢体酸痛是援鄂医务人员主要的不适症状;对援鄂医务人员不适得分进行单因素分析,结果显示性别、职业、工作年限、职称、工作时长、是否有相关疾病史差异有统计学意义(P<0.05),进一步对以上因素进行多因素分析结果显示,职业、职称及是否有相关疾病史是援鄂医务人员不适得分的主要影响因素(t=6.24、5.15、-5.84,P<0.05)。开放式问题调查结果显示防护用品穿戴问题和合理排班问题也是援鄂医务人员存在不适的问题。结论新型冠状病毒肺炎疫情期间援鄂医务人员存在不同程度的身心不适,管理者需重视抗疫期间医务人员的不适症状,关注医务人员是否有相关疾病史,从职业、职称方面进行干预,并采取综合性护理管理对策,减少引起援鄂医务人员不适的影响因素,使援鄂医务人员的不适程度降至最低,保持最佳的状态参与抗疫。

关键词：医务人员问卷调查新型冠状病毒肺炎不适影响因素

沉默非肌肉肌球蛋白Ⅱ骨髓间充质干细胞移植对内毒素/脂多糖诱导急性肺损伤大鼠肺细胞外基质的影响

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中华烧伤与创面修复杂志 2022年第5期38卷 422-433页

作者：尹希周万芳侯文佳范明枝伍国胜刘晓彬马琪敏王玉松朱峰张家港市第一人民医院(苏州大学附属张家港医院)烧伤整形科苏州215600 海军军医大学第一附属医院烧伤科上海200433

目的探讨沉默非肌肉肌球蛋白Ⅱ(NMⅡ)基因的骨髓间充质干细胞(BMMSC)对内毒素/脂多糖(LPS)诱导的急性肺损伤(ALI)大鼠肺细胞外基质(ECM)和肺纤维化的影响。方法采用实验研究方法。取4只1周龄雄性SD大鼠股骨和胫骨骨髓腔细胞并经流式细... 详细信息

目的探讨沉默非肌肉肌球蛋白Ⅱ(NMⅡ)基因的骨髓间充质干细胞(BMMSC)对内毒素/脂多糖(LPS)诱导的急性肺损伤(ALI)大鼠肺细胞外基质(ECM)和肺纤维化的影响。方法采用实验研究方法。取4只1周龄雄性SD大鼠股骨和胫骨骨髓腔细胞并经流式细胞术鉴定为BMMSC。取第3代BMMSC用于后续实验。取细胞,分为用含NMⅡ基因的小干扰RNA序列的pHBLV-U6-ZsGreen-Puro质粒转染的沉默NMⅡ组,转染空载质粒的空载组及未进行任何处理的空白对照组,采用蛋白质印迹法检测干预后72 h的NMⅡ的蛋白表达(样本数为3)。取细胞,于倒置相差显微镜下观察形态;另取细胞,用氯甲基苯甲酰胺(CM-DiⅠ)标记,于倒置荧光显微镜下观察体外细胞标记情况。取20只4周龄雄性SD大鼠,按随机数字表法分为空白对照组、单纯ALI组、ALI+BMMSC组及ALI+沉默NMⅡ的BMMSC组,每组5只大鼠。对空白对照组不进行任何处理,其余3组大鼠均给予LPS诱导ALI。造模后即刻,单纯ALI组大鼠经尾静脉注射1 mL生理盐水,ALI+BMMSC组、ALI+沉默NMⅡ的BMMSC组大鼠分别经尾静脉注入1 mL 1×10^(7)个/mL CM-DiⅠ标记的BMMSC、NMⅡ基因沉默的BMMSC,空白对照组大鼠于相同时间点通过尾静脉注射1 mL生理盐水。干预后24 h,取肺组织于倒置荧光显微镜下观察BMMSC肺内归巢情况。干预后24 h、1周、2周,取肺组织行苏木精-伊红染色观察肺部炎症情况,行Masson染色观察肺纤维化程度并采用改良Ashcroft评分法对干预后2周肺纤维化程度进行评分(样本数为5)。采用免疫组织化学法检测干预后2周α平滑肌肌动蛋白(α-SMA)、基质金属蛋白酶2(MMP-2)、MMP-9的含量(样本数均为3),采用酶联免疫吸附测定法检测干预后24 h超氧化物歧化酶(SOD)、丙二醛、髓过氧化物酶(MPO)活性(样本数均为3),采用免疫荧光染色法检测干预后1周CD11b和含表皮生长因子样模块黏蛋白样激素受体1(EMR1)蛋白表达(样本数均为3)。对数据行单因素方差分析、Bonferroni法及Kruskal-Wallis H检验。结果干预后72 h,沉默NMⅡ组细胞NMⅡ蛋白表达水平显著低于空白对照组和空载组(P值均0.05)。与空白对照组比较,单纯ALI组大鼠肺组织MMP-9含量显著升高(P<0.01);与单纯ALI组比较,ALI+BMMSC组、ALI+沉默NMⅡ的BMMSC组大鼠肺组织MMP-9含量均显著降低(P<0.01)。干预后24 h,与空白对照组比较,单纯ALI组、ALI+BMMSC组、ALI+沉默NMⅡ的BMMSC组大鼠肺组织丙二醛、SOD、MPO活性均显著升高(P<0.01);与单纯ALI组比较,ALI+沉默NMⅡ的BMMSC组大鼠肺组织丙二醛活性显著升高(P<0.05),ALI+BMMSC组、ALI+沉默NMⅡ的BMMSC组大鼠肺组织SOD活性均显著升高(P<0.01);与ALI+BMMSC组比较,ALI+沉默NMⅡ的BMMSC组大鼠

关键词：急性肺损伤间充质干细胞细胞外基质基因沉默非肌肉肌球蛋白Ⅱ

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我国临床专科护士岗位胜任力研究进展

解放军医院管理杂志 2021年第11期28卷 1085-1087,1097页

作者：张丽君冯苹雷永慧姜玉周万芳海军军医大学第一附属医院烧创伤病区上海200433

通过对现有文献中有关护士岗位胜任力要素的文章进行系统综述,以期为构建中国特色专科护士(clinical nurse specialist,CNS)岗位胜任力评价体系提供依据。综述结果表明,国内CNS岗位胜任力研究处于初级阶段,研究工具较多,评价标准不一,... 详细信息

通过对现有文献中有关护士岗位胜任力要素的文章进行系统综述,以期为构建中国特色专科护士(clinical nurse specialist,CNS)岗位胜任力评价体系提供依据。综述结果表明,国内CNS岗位胜任力研究处于初级阶段,研究工具较多,评价标准不一,影响因素研究多为横断面调查,目前的研究结果只供参考,缺乏纵向研究及针对影响因素的干预研究。CNS胜任力的提高需要参考不同层级的培训需求,制定相应的胜任力标准。国外有关CNS岗位胜任力的研究较为成熟,可借鉴国外经验,依据中国国情,统一我国CNS岗位胜任力标准,基于CNS岗位胜任力需求进行临床干预,提高我国临床CNS的岗位胜任力。

关键词： CNS 护理胜任力岗位胜任力

Effects of Aromatherapy on Physical and Mental Health of Cancer Patients Undergoing Radiotherapy and/or Chemotherapy: A Meta-Analysis

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Chinese Journal of Integrative Medicine 2024年第5期30卷 449-457页

作者： XIE Shuang-ran MA Liang XU Xin-yu zhou Shu XIE Hui-miao XIE Chang-sheng The First Clinical Medical College Zhejiang Chinese Medical UniversityHangzhou 310053China Department of Medical Oncology Hangzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical UniversityHangzhou 310007China Department of Dermatology the Third Xiangya HospitalCentral South UniversityChangsha 410013China Department of Famous Chinese Medicine Clinic the Second Affiliated Hospital of Zhejiang Chinese Medical UniversityHangzhou 310005China Department of Medical Oncology the First Affiliated Hospital of Zhejiang Chinese Medical UniversityHangzhou 310006China

Backgroup:Currently,aromatherapy is being increasingly utilized in clinical practice,particularly in managing the side effects associated with radiotherapy and ***,it remains to be established whether aromatherapy can effectively alleviate these ***:To investigate the effects of aromatherapy on the physical and mental health of patients with cancer undergoing radiotherapy and ***:Seven databases were researched from inception until September 29,2023,including PubMed,Scopus,and Web of Science,Chinese National Knowledge Infrastructure,wanfang database,China Biology Medicine disc and VIP Chinese Medical Journal *** Manager version 5.3 was utilized for data *** Cochrane Risk of Bias tool RoB2 was employed to evaluate the quality of the literature included in the *** quality rating was assessed using the Grading of Recommendations Assessment,Development,and Evaluation(GRADE) approach through the GRADEpro GDT online ***:Nineteen studies involving 1,541 patients were *** can alleviate nausea [relative risk(RR)=0.64,95% confidence interval(CI):0.53 to 0.78,P<0.05,I^(2)=46%;standardized mean difference(SMD)=-0.86,95% CI:-1.21 to-0.51,P<0.05,I^(2)=64%] and vomiting(RR=0.54,95% CI:0.42 to 0.69,P<0.05,I^(2)=35%;SMD=-1.28,95% CI:-1.52 to-1.03,P<0.05,I^(2)=92%),improve sleep disorders [mean difference(MD)=-3.39,95% CI:-3.95 to-2.84,P<0.05,I^(2)=0%],relieve pain(SMD=-1.58,95% CI:-1.96 to-1.21,P<0.05,I^(2)=0%),mitigate fatigue(SMD=-1.28,95% CI:-2.44 to-0.11,P<0.05,I^(2)=93%) and enhance quality of life(SMD=0.50,95% CI:0.22 to 0.79,P<0.05,I^(2)=0%) in cancer patients after radiotherapy and chemotherapy,but it may not have a significant effect on *** risk of bias was high in the included studies using the Cochrane Risk of Bias tool RoB2,and no studies were considered to be of high grade according to the GRADE ***:Aromatherapy is an efficacious,safe a

关键词： aromatherapy cancer chemoradiotherapy physical psychological

Efficacy and safety of extracorporeal shock wave therapy combined with sodium hyaluronate in treatment of knee osteoarthritis:a systematic review and Meta-analysis

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Journal of Traditional Chinese Medicine 2024年第2期44卷 243-250页

作者： zhou Mingwang DONG Zhuanli WEI Changhao FENG Lufang WANG Xiaoping LIU Haiping JI Xing YANG Kehu LI Shenghua Department of Orthopaedics Gansu Provincial Hospital of Traditional Chinese MedicineLanzhou 730050China Department of Quality Management Lanzhou Petrochemical General HospitalLanzhou 730050China Department of Orthopaedics Lanzhou Petrochemical General HospitalLanzhou 730050China Evidence-Based Social Science Research Center School of Public HealthLanzhou UniversityLanzhou730000China Evidence-Based Medicine Center School of Basic Medical SciencesLanzhou UniversityLanzhou 730000China Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province Lanzhou 730000China Center for Translational Medicine Gansu Provincial Hospital of Traditional Chinese MedicineLanzhou 730050China Department of Orthopaedics Gansu Provincial Hospital of Traditional Chinese MedicineLanzhou 730000China

OBJECTIVE:To assess the efficacy and safety of extracorporeal shockwave therapy(ESWT)combined with sodium hyaluronate(HA)for the treatment of knee osteoarthritis(KOA).METHODS:PubM ed,Embase,the Cochrane Library,Web of Science,China National Knowledge Infrastructure,wanfang database,China Science and Technology Journal Database,and SinoMed were searched from inception to July *** quality of the randomized controlled trials was evaluated independently by two reviewers according to the criteria in the Cochrane Collaboration for Systematic *** identified articles were then screened individually using EndnoteX9 for eligibility in this *** heterogeneity among the articles was evaluated using ***:A total of 17 studies,comprising 2000 individuals,were included in this *** results showed that a significant improvement was observed in knee pain and function based on the clinical efficacy of ESWT combined with *** analysis of clinical efficacy showed that[relative risk(RR)=1.21,95%confidence interval(CI)(1.12,1.30),P<0.01].Statistical analysis of visual analog scale showed that[standardized mean difference(SMD)=-2.84,95%CI(-4.01,-1.66),P<0.01].Western Ontario and McMaster University osteoarthritis index statistical analysis showed that[SMD=-1.57,95%CI(-2.52,-0.61),P<0.01].Lysholm score statistical analysis showed that[SMD=1.71,95%CI(0.98,2.44),P<0.01].In addition,only minor side effects,such as redness and swelling of the skin,were ***:Medium to low quality evidence showed that ESWT combined with HA offers an inexpensive,welltolerated,safe,and effective method to improve pain and functionality in patients with ***,tightly controlled,randomized,large multicenter trials are warranted to validate the current findings.

关键词： osteoarthritis knee randomized controlled trial extracorporeal shockwave therapy hyaluronic acid Meta-analysis