Objective To compare the clinical outcomes following arthroscopic repair for articular-sided partial rotator cuff tear using transtendon repair versus repair after completion of the tear by meta-analysis. Methods Randomized controlled trials on arthroscopic repair for articular-sided partial rotator cuff tear using transtendon repair versus repair after completion of the tear were identified from Cochrane Library, PubMed, Embase, Chinese National Knowledge Infrastructure, Wanfang database, and Chongqing VIP database, with a timespan from the inception of database to November 2024. Pain score, American Shoulder and Elbow Surgeons (ASES) score, Constant-Murley score, postoperative adhesive capsulitis and postoperative retear were obtained as the outcomes to compare the clinical effect of the two methods. Meta-analyses were conducted using RevMan 5.3 software, with mean difference (MD) and relative risk (RR) as the effect scales. Results A total of 6 randomized controlled trial studies were included in the meta-analysis. The studies enrolled 370 patients, including 188 cases in the transtendon repair group and 182 cases in the repair after completion of the tear group. Pooled analyses demonstrated that the pain score [MD=0.26, 95% confidence interval (CI) (0.09, 0.42), P=0.003] and ASES score [MD=2.02, 95%CI (0.95, 3.10), P=0.0002] were higher in the transtendon repair group than those in the repair after completion of the tear group, the Constant-Murley score was lower in the transtendon repair group than that in the repair after completion of the tear group [MD=−3.32, 95%CI (−6.17, −0.46), P=0.02], and there was no significant difference in the incidence of postoperative adhesive capsulitis [RR=1.12, 95%CI (0.36, 3.42), P=0.85] or the incidence of retear [RR=0.32, 95%CI (0.10, 1.03), P=0.06] between two groups. Conclusions Transtendon technique is less effective in reducing pain for articular-sided partial rotator cuff tear. There is no significant difference in the incidence of postoperative adhesive capsulitis or retear between the two gorups.
Objective To review the current state of lung rehabilitation in China and explore the effect of lung rehabilitation on chronic respiratory diseases. Methods Database of CNKI ( 1979-2009) , VIP Chinese Periodical Database ( 1989-2009 ) , and Wanfang Data ( 1982-2009) resources were searched. Studies of lung rehabilitation were collected, and randomized and controlled trials were included. Data were extracted on study population, interfering and evaluating methods. The meta-analyses were performed by using RevMan 4. 2 software. The heterogeneity was analyzed by X2 and P value. Results A total of 3 clinical trials met the inclusion criteria. The study population were all severe and very severe chronic obstructive pulmonary diseases ( COPD) patients. Lung rehabilitation could improve daily activity( WMD:1. 29, 95% CI: 1. 05-1. 54) and dyspnea level ( SMD: - 1. 27, 95% CI: - 1. 67 to - 0. 86) of COPD patients. Conclusion The general level of studies on lung rehabilitation is not satisfied. Meta-analysis comfirmes that lung rehabilitation is beneficial in improving daily activity and dyspnea level of COPD patients.
ObjectivesTo systematically review the efficacy and safety of controlled hypotension for total hip or knee replacement.MethodsPubMed, EMbase, The Cochrane Library, CNKI, WanFang Data and CBM databases were electronically searched to collect randomized controlled trials (RCTs) on controlled hypotension for total hip or knee replacement from inception to September 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by RevMan 5.3 software.ResultsA total of 15 RCTs involving 854 patients were included. The results of meta-analysis showed that compared with no controlled hypotension during surgery, controlled hypotension could reduce intraoperative blood loss (MD=−267.35, 95%CI −314.54 to −220.16, P<0.000 01), allogeneic blood transfusion (MD=−292.84, 95%CI −384.95 to −200.73, P<0.000 01), and 24 h postoperative mini-mental state examination (MMSE) score (MD=−1.08, 95%CI −1.82 to −0.34, P=0.004). However, there were no significant differences in 96 h postoperative MMSE score (MD=−0.11, 95%CI −0.50 to 0.28, P= 0.57) and intraoperative urine volume (MD=57.93, 95%CI −152.57 to 268.44, P=0.59).ConclusionsThe current evidence shows that controlled hypotension during total hip or knee replacement can reduce intraoperative blood loss and allogeneic blood transfusion. Furthermore, there is no obvious effect on the maintenance of blood perfusion in important organs, despite certain effects on the postoperative cognitive function, which can be recovered in short term. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.
ObjectiveTo systematically review the risk factors associated with sleep disorders in ICU patients.MethodsWe searched The Cochrane Library, PubMed, EMbase, Web of Science, CNKI, Wanfang Data, VIP and CBM databases to collect cohort studies, case-control studies and cross-sectional studies on the risk factors associated with sleep disorders in ICU patients from inception to October, 2018. Two reviewers independently screened literature, extracted data and evaluated the bias risk of included studies. Then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 9 articles were included, with a total of 1 068 patients, including 12 risk factors. The results of meta-analysis showed that the combined effect of equipment noise (OR=0.42, 95%CI 0.26 to 0.68, P=0.000 4), patients’ talk (OR=0.53, 95%CI 0.42 to 0.66, P<0.000 01), patients’ noise (OR=0.39, 95%CI 0.21 to 0.74, P=0.004), light (OR=0.29, 95%CI 0.18 to 0.45, P<0.000 01), night treatment (OR=0.36, 95%CI 0.26 to 0.50, P<0.000 01), diseases and drug effects (OR=0.17,95%CI 0.08 to 0.36, P<0.000 01), pain (OR=0.37, 95%CI 0.17 to 0.82, P=0.01), comfort changes (OR=0.34,95%CI 0.17 to 0.67,P=0.002), anxiety (OR=0.31,95%CI 0.12 to 0.78, P=0.01), visit time (OR=0.72, 95%CI 0.53 to 0.98, P=0.04), economic burden (OR=0.63, 95%CI 0.48 to 0.82, P=0.000 5) were statistically significant risk factors for sleep disorders in ICU patients.ConclusionCurrent evidence shows that the risk factors for sleep disorders in ICU patients are environmental factors (talking voices of nurses, patient noise, and light), treatment factors (night treatment), disease factors (disease itself and drug effects, pain,) and psychological factors (visiting time, economic burden). Due to the limited quality and quantity of included studies, more high quality studies are needed to verify the above conclusions.
Objective To systematically evaluate the diagnostic value of artificial intelligence assisted narrow-band imaging endoscopy diagnostic system for colorectal adenomatous polyps. Methods Pubmed, Embase, Web of Science, Cochrane Library, SinoMed, China National Knowledge Infrastructure, Chongqing VIP and Wanfang databases were searched. The diagnostic trials of the artificial intelligence assisted narrow-band imaging endoscopy diagnostic system for colorectal adenomatous polyps were comprehensively searched. The search time limit was from January 1, 2000 to October 31, 2022. The included studies were evaluated according to the Quality Assessment of Diagnostic Accuracy Studies-2, and the data were meta-analysed with RevMan 5.3, Meta-Disc 1.4 and Stata 13.0 statistical softwares. Results Finally, 11 articles were included, including 2178 patients. Meta-analysis results of the artificial intelligence assisted narrow-band imaging endoscopy diagnostic system for colorectal adenomatous polyps showed that the pooled sensitivity was 0.91, the pooled specificity was 0.88, the pooled positive likelihood ratio was 7.41, the pooled negative likelihood ratio was 0.10, the pooled diagnostic odds ratio was 76.45, and the area under the summary receiver operating characteristic curve was 0.957. Among them, 5 articles reported the diagnosis of small adenomatous polyps (diameter <5 mm) by the artificial intelligence assisted narrow-band imaging endoscopy diagnostic system. The results showed that the pooled sensitivity and the pooled specificity were 0.93 and 0.91, respectively, and the area under the summary receiver operating characteristic curve was 0.971. Five articles reported the accuracy of endoscopic diagnosis for adenomatous polyps of those with insufficient experience. The results showed that the pooled sensitivity and the pooled specificity were 0.84 and 0.76, respectively. The area under the summary receiver operating characteristic curve was 0.848. Compared with the artificial intelligence assisted narrow-band imaging endoscopy diagnostic system, the difference was statistically significant (Z=1.979, P=0.048). Conclusion The artificial intelligence assisted narrow-band imaging endoscopy diagnostic system has a high diagnostic accuracy, which can significantly improve the diagnostic accuracy for colorectal adenomatous polyps of those with insufficient endoscopic experience, and can effectively compensate for the adverse impact of their lack of endoscopic experience.
Objective To systematically evaluate the clinical effectiveness of platelet-rich plasma (PRP) combined with grafting material for the treatment of periodontal intrabony defects. Methods The following databases such as PubMed, The Cochrane Library, EMbase, CNKI, CBM and WanFang Data were searched on computer from inception to August, 2012 to collect the relevant randomized controlled trials (RCTs) on PRP combined with grafting material versus grafting material alone for periodontal intrabony defects. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data, and assessed the methodological quality of the included studies. RevMan 5.2 software was applied for meta-analysis. Results A total of 11 RCTs involving 342 patients were included. The pooled analysis on 7 RCTs showed that there was a significant difference in lower increase of clinical attachment loss (WMD=0.70, 95%CI 0.51 to 0.90, Plt;0.000 01) between the PRP combined with grafting material group and the grafting material alone group. But there was no significant difference in the gingival recession (WMD= −0.01, 95%CI −0.15 to 0.13, P=0.86). The pooled analysis on 9 RCTs showed that there was no significant difference in the reduction of plaque index (WMD= −0.04, 95%CI −0.09 to 0.02, P=0.20) between the two groups. Conclusion PRP combined with grafting material is superior to grafting material alone in the clinical attachment loss. But, there are no significant differences in gingival recession and plaque index. However, given the limited sample size and incomplete measure indexes of included studies, this conclusion still needs to be further proved by conducting more high-quality and large-scale RCTs.
Objective To evaluate the efficiency of prevention and control strategies of carbapenem-resistant organism (CRO) in medical institutions in China using meta-analysis method. Methods PubMed, Embase, Medline (Ovid), Web of Science, China National Knowledge Infrastructure, Chongqing VIP and Wanfang Database were systematically searched for studies on CRO prevention and control in Chinese medical institutions from the establishment of databases to 2023 for meta-analysis. Results A total of 21 studies were included, consisting of 3 randomized controlled studies and 18 non-randomized controlled studies. The meta-analysis results showed that compared with standard prevention and control measures, strengthened intervention measures (including active screening, information-based transparent supervision mode, comprehensive intervention, and bundled prevention and control strategies) could effectively reduce the CRO infection rate [relative risk (RR)=0.40, 95% confidence interval (CI) (0.25, 0.65), P<0.05]. Proactive screening could effectively reduce the CRO infection rate [RR=0.52, 95%CI (0.30, 0.91), P<0.05] and carbapenem-resistant Enterobacteriaceae (CRE) infection rate [RR=0.47, 95%CI (0.24, 0.93), P<0.05]. Information-based transparent supervision could reduce the CRE infection rate by improving compliance with standard prevention and control measures [RR=0.42, 95%CI (0.28, 0.62), P<0.05]. Conclusions Compared with standard prevention and control measures, strengthened intervention measures can effectively reduce the risk of in-hospital transmission and infection of CRO. In clinical practice, bundled comprehensive intervention can be combined with information-based transparent supervision, and if necessary, proactive screening of CRO in high-risk populations should be carried out.
Objective To evaluate the short-term clinical efficacy and safety of 10-Hydroxy-camptothecin （10- HCPT ） chemotherapy on gastrointestinal carcinoma. Methods We searched electronic database including CNKI （ 1995 - 2005 ）, MEDLINE （ 1995 - 2005 ） and The Cochrane Library （ Issue 1, 2005 ）. More related research data were odtained by cantacting with researchers. Randomized controlled trials of gastrointestinal carcinoma chemotherapy comparing only or including 10-HCPT chemotherapy with normal chemotherapy on efficacy rate, digestive and hematology system toxicity were included. Data related to the clinical outcome were extracted by two reviewers independently. Statistical analysis was performed by using RevMan4. 2.2. Results Twenty-five trials including 1 881 patients met the inclusion criteria. The results of meta-analysis were hsted as follows： 10-HCPT could significantly improve the short-term chemotherapy efficacy for colorectal cancer （ RR. 1.62, 95% CI 1.37 to 1.92） and gastric cancer （RR 1.48, 95% CI 1.18 to 1.85）in chemotherapy curative efficacy in short-term. 10-HCPT induced severe toxicity of lower digestive system（RR. 0.96,95% CI 0.62 to 1.50 ） without statistical significance, while severe toxicity of hematology system was significantly higher than that of control with RR 1.27,95% CI 1.02 to 1.58. Conclusions Current evidence suggests that 10-HCPT can improve hematology system short-term chemotherapy efficacy for gastrointestinal carcinoma and increase the incidence of severe toxicity. Further research is needed to value its influence on the prognosis of gastrointestinal carcinoma.
Objective To assess the effectiveness of psychological intervention on post-stoke depression. Methods Such databases as the JBI Database of Systematic Review (1980 to June, 2010), The Cochrane Library (1980 to June, 2010), PubMed (1966 to 2010), CINAHL(1982 to May, 2000), CBM (1978 to 2010), and CNKI (1979 to 2010) were searched to collect randomized controlled trials (RCTs). In accordance with the predefined inclusion and exclusion criteria, the quality of included studies was evaluated, and then meta-analyses were performed by using RevMan 5.0 software. Results A total of 33 RCTs were included. The results of meta-analyses showed: (1) Compared with the control group, the short-term effect of psychological intervention was more effective in decreasing depression score. The subgroup analysis showed that the intervention effects at the time of four weeks, six weeks, eight weeks, and 12 weeks were better than those of the control group. (2) The long-term effect of psychological intervention was more effective in decreasing depression score. The subgroup analyses showed that the intervention effects at the interval of eight weeks, 24 weeks, and 48 weeks were better than those of the control group. (3) The combined or single application of either cognitive-behavioral psychotherapy or supportive psychotherapy was more effective in decreasing depression score than the control group. However, there was no significant difference between the general psychological treatment group and the control group. (4) The subgroup analyses showed that the different qualities of the included studies were more effective than those of the control group. Conclusion Various psychological intervention is effective in decreasing the patient’s depression score, and cognitive-behavioral therapy and supportive psychotherapy, especially, can significantly improve the depression state and promote recovery.
Objective To systematically review the efficacy and safety of laparoscopic hepatectomy (LH) and open hepatectomy (OH) for patients with hepatocellular carcinoma (HCC). Methods PubMed, EMbase, The Cochrane Library, CBM, WanFang Data, CNKI databases were electronically searched to collect the case-control studies about LH vs. OH for patients with HCC from inception to December, 2015. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then meta-analysis was performed by using RevMan 5.3 software. Results A total of 28 studies involving 1 908 patients were included. The results of meta-analysis showed that: the LH group was superior to OH group on complications (OR=0.35, 95%CI 0.26 to 0.48, P<0.000 01), hospital stay (MD=–4.18, 95%CI (–5.08, –3.29),P<0.000 01), and five years overall survival rate (OR=1.65, 95%CI 1.23 to 2.19,P=0.000 7) and disease-free survival rate (OR=1.51, 95%CI 1.12 to 2.03, P=0.006). However, no significant differences were found in one year and three years overall survival rate, disease-free survival rate, and postoperative recurrence rate. Conclusion Current evidence shows that the LH is superior to OH for the treatment of HCC, and may be amenable to surgery because of its safety and longtime efficacy. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify above conclusion.