Objective To evaluate the efficacy of n-3 PUFAs (fish oil) for prevention of cardiovascular events. Methods Randomized controlled trials (RCTs) were searched from the following electronic databases: PubMed, EMbase, The Cochrane Library (Issue 1, 2009), CBM, and CNKI. Quality assessment and data extraction were conducted by two reviewers independently. Disagreement was resolved through discussion. All data were analyzed by using Review Manager 4.2 software. Results Five studies involving 37 689 participants met the inclusion criteria. Meta-analysis results showed that: 1) Compared with placebo, the incidence rates of the cardiovascular death (RR=0.91, 95% CI 0.84 to 0.98), cardiovascular events (RR=0.95, 95%CI 0.91 to 0.98), angina (RR=0.79, 95%CI 0.64 to 0.96), and myocardial infarction (RR=0.79, 95%CI 0.65 to 0.96) could be reduced by n-3 PUFAs (fish oil). 2) There were no significant differences in death from any cause, the hospitalization rates of cardiovascular disease, sudden death, and heart failure (RR=0.95, 95%CI 0.90 to 1.00; RR=0.97, 95%CI 0.93 to 1.02; RR=0.90, 95%CI 0.79 to 1.01; RR=0.98, 95%CI 0.91 to 1.06). 3) Compared with placebo, the incidence rates of the arrhythmia and stroke could be increased, but there were no significant differences (RR=1.14, 95%CI: 0.80 to 1.62; RR=1.12, 95%CI 0.97 to 1.30). Conclusion Compared with placebo, n-3 PUFAs (fish oil) has good effects on reducing the incidence rates of total cardiovascular events, cardiovascular death, myocardial infarction, and angina pectoris, and it has the same efficacy in death from all cause, sudden death, heart failure, and the hospitalization rates of cardiovascular disease. There are no significant differences in the increased rates of arrhythmia and stroke.
ObjectiveTo integrate person imagery from drawing tests in screening for mental disorders through meta-analysis to identify indicators that can effectively predict mental disorders. MethodsA computerized search of CNKI, WanFang Data, VIP, PubMed, Web of Science, and EBSCO databases was conducted to collect studies related to mental disorders and drawing tests, with a search timeframe of the period from the creation of the database to May 8, 2023. Meta-analysis was performed using CMA 3.0 after two researchers independently screened the literature, extracted information, and assessed the risk of bias. ResultsA total of 43 studies were included, with 791 independent effect sizes and 8 444 subjects. Meta-analysis revealed that a total of 29 person imagery traits significantly predicted mental disorders, which could be categorized into 7 types according to the features: absent, bizarre, blackened, simplified, static, detailed, and holistic. The subgroup analysis revealed that the specific indicators of affective disorders included "excessive separation among items", "oversimplified person", "rigid and static person" and "hands behind the back". The specific indicators of thought disorders were "absence of limbs", "absence of facial features" and "disproportionate body proportions". Moreover, there were seven common indicators of mental disorders, including "oversimplified drawing", "very small drawing", "very small person", "weak or intermittent lines", "single line limb", "absence of hands or feet" and "no expression or dullness''. ConclusionThe findings could provide a reference standard for selection and interpretation of drawing indicators, promote standardization of the drawing test, and enhance the accuracy of results in screening for mental disorders.
Objective To systematically evaluate the difference in leg length discrepancy (LLD) between robot-assisted total hip arthroplasty (THA) and traditional THA. Methods The Cochrane Library, PubMed, Web of Science, EMbase, CNKI, Wanfang, VIP, and CBM databases were searched by computer to collect cohort studies of robot-assisted and traditional THAs from inception to August 11th, 2021. Two researchers independently screened the literature, extracted the data, and evaluated the risk of bias of the included studies. Meta-analysis was performed using RevMan 5.3 software. ResultsA total of 10 high-quality cohort studies were included. The results of Meta-analysis showed that compared with traditional THA, LLD after robot-assisted THA was smaller [MD=−1.64, 95%CI (−2.25, −1.04), P<0.001], Harris scores at 3 and 12 months after operation were higher [MD=1.50, 95%CI (0.44, 2.57), P=0.006; MD=7.60, 95%CI (2.51, 12.68), P=0.003]. However, the operative time was longer [MD=8.36, 95%CI (4.56, 12.17), P<0.000 1], and the postoperative acetabular anteversion angle was larger [MD=1.91, 95%CI (1.43, 2.40), P<0.001]. There was no significant difference in Harris score at 6 months, amnesia index (Forgotten joint score, FJS), postoperative acetabular abduction angle, and incidence of complication between the two groups (P>0.05). Conclusion Robot-assisted THA is superior to traditional THA in postoperative LLD.
Objective To investigate confidence interval estimation for the amount of heterogeneity in meta-analysis. Methods On the basis of BT’s method, the approximate Q-statistic distribution following linear transformation of Chi-square was applied to improve the accuracy of Q-statistic distribution, and to obtain the confidence interval for the amount of heterogeneity in meta-analysis. Results In case, the Q1 distribution obtained 95%CI 0.07 to 2.20, while the Q2 distribution obtained 95%CI 0.00 to 1.41; The proposed method Q2 narrowed down the range of confidence interval. Conclusion On account of improving the accuracy of Q-statistic distribution, the proposed method effectively strengthens the coverage probabilities of the confidence interval for the amount of heterogeneity. And the proposed method can also improve the precision of the confidence interval estimation for the amount of heterogeneity.
ObjectiveTo systematically review the efficacy and safety of laryngeal mask versus endotracheal tubes for laparoscopic surgery.MethodsPubMed, EMbase, The Cochrane Library, CNKI, WanFang Data and CBM databases were electronically searched to collect the randomized controlled trials (RCTs) about the efficacy and safety of laryngeal mask versus endotracheal tubes for laparoscopic surgery from inception to April, 2017. 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.ResultsA total of 16 RCTs involving 1 593 patients were included. The results of meta-analysis showed that: there was no significant difference in the success rate of the first insertion (RR=0.99, 95%CI 0.96 to 1.02, P=0.55). The airway pressure of patients whose position were head higher than foot was significantly lower in the laryngeal mask group than in the tracheal intubation group (MD=–1.20, 95%CI –1.81 to –0.59, P=0.000 1), but there was no significant difference between two groups in reverse position patients (MD=0.48, 95%CI –0.90 to 1.87, P=0.49). The incidence of sore throat (RR=0.58, 95%CI 0.46 to 0.74, P<0.000 01), the incidence of blood stain (RR=0.48, 95%CI 0.30 to 0.77, P=0.002), the incidence of laryngeal spasm/bronchial spasm (OR=0.30, 95%CI 0.11 to 0.80, P=0.02) and the incidence of cough/hiccup (RR=0.10, 95%CI 0.07 to 0.15, P<0.000 01) in the laryngeal mask group were significantly lower than those in the tracheal intubation group.ConclusionThe current evidence shows that compared with tracheal intubation, laryngeal mask can effectively reduce airway pressure of patients whose position are head higher than foot. The risks of various complications are significant higher in tracheal intubation in laparoscopic surgery. Laryngeal mask can maintain patients' normal respiratory functions while reduce damage and do not increase the occurrence of reflux aspiration. Due to limited quantity and quality of the included studies, more high quality studies are needed to verify above conclusion.
ObjectiveTo systematically review the efficacy of MitraClip therapy in heart failure patients with mitral insufficiency. MethodsDatabases including PubMed, The Cochrane Library (Issue 11, 2014), EMbase, CBM, CNKI, VIP and WanFang Data were searched from October 2005 to October 2015 to collect before-after controlled studies about the efficacy of MitraClip therapy in heart failure patients with mitral insufficiency. Two reviewers independently screened literature, extracted data and assessed the methodological quality of included studies. Then, meta-analysis was performed using RevMan 5.2 software. ResultsA total of 9 studies involving 782 patients were included. The results of meta-analysis showed that, compared with their conditions before treatment, patients after the MitraClip implantation had a declined NYHA class Ⅲ-Ⅳ ratio (RD=0.72, 95%CI 0.60 to 0.85, P<0.000 01), increased left ventricular ejection fraction (LVEF) (MD=-2.97，95%CI -5.06 to -0.89，P<0.005) and improved performance in 6 min walk-test (6-MWT) (MD=-88.73, 95%CI -157.16 to -20.31, P=0.01). ConclusionMitraClip therapy can, to a certain extent, improve the cardiac function of patients with heart failure and mitral insufficiency. However, further studies are needed to confirm its effects on improving the long-term survival of patients.
Objective To assess the efficacy of topical non-steroidal anti-inflammatory drugs （NSAIDs） in the treatment of osteoarthritis （OA）. Methods MEDLINE, EMBASE, Scientific Citation Index, CINAHL, The Cochrane Library, CBMdisc and abstracts from conference were searched from 1966 to March 30, 2005. Randomized controlled trials （R.CT） comparing topical non-steroidal anti-inflammatory drug （NSAIDs） with placebo or oral NSAIDs in OA were induded. Effect size （ES） was calculated for pain, function and stiffness. Relative risk （RR） was calculated for dichotomous data such as clinical response rate and adverse effect rate. Number needed to treat to obtain the clinical response was estimated. The quality of trials was assessed and sensitivity analyses were undertaken. Results Topical NSAIDs were superior to placebo in relieving pain due to osteoarthritis only in the first 2 weeks of treatment; ES （95% CI） were 0.41 （0. 16 to 0.66） and 0.40 （0.15 to 0.65） at week 1 and 2 respectively. However, the effects were short-lived and no benefit was observed over placebo at the third and fourth week. A similar pattern was observed with function, stiflhess and clinical response RR and number needed to treat. Topical NSAIDs were inferior to oral NSAIDs at week 1, and associated with more local side effects such as rash, itch or burning （RR 5.29, 95% CI 1.14 to 24. 51 ）. Conclusions Only very shortterm （less than 4 weeks） RCTs have assessed topical NSAID efficacy in OA ; after 2 weeks no efficacy above placebo has been obsevrved. There are no trial data to support the long-term use of topical NSAIDs in osteoarthritis.
ObjectivesTo systematically review the efficacy and safety of ciprofloxacin for non-cystic fibrosis bronchiectasis.MethodsDatabases including PubMed, EMbase, The Cochrane Library, CBM, VIP, CNKI and WanFang Data were electronically searched from inception to August 2018 to collect randomized controlled trials (RCTs) on ciprofloxacin in the treatment of non-cystic fibrosis bronchiectasis. Two reviewers independently screened literature, extracted data, and assessed risk of bias of included studies. Then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 9 RCTs involving 1 666 patients were included. The results of meta-analysis showed that: compared with control group, the ciprofloxacin more efficiently eradicate bacteria from sputum (RR=4.34, 95%CI 2.04 to 9.23, P=0.000 1), decrease risk of the exacerbations (RR=0.81, 95%CI 0.71 to 0.93, P=0.002) and the mean bacterial load (MD=–4.08, 95%CI –6.29 to –1.87, P=0.001). However, there were no significant differences between two groups in clinical efficiency and adverse events.ConclusionsThe current evidence shows that, ciprofloxacin can decrease the mean bacterial load and risk of the exacerbation, and more efficiently eradicate bacteria from sputum in non-cystic fibrosis bronchiectasis patients. Due to limited quality and quantity of the included studies, more studies are required to verify the conclusions.
ObjectiveTo explore the diagnostic value of fractional exhaled nitric oxide (FeNO) in adult asthma.MethodsPubMed, Embase, Cochrane Library, Wanfang, CNKI and VIP databases were searched for relevant literatures from the time of database establishment to February 2021. Data analysis were made by Revman and Stata.ResultsA total of 44 articles with 47 records and 9654 subjects were included. The diagnosis sensitivity, specificity, positive and negative predictive value of FeNO were 0.71 (95%CI 0.65 - 0.76), 0.80 (95%CI 0.75 - 0.84), 3.47 (95%CI 2.86 - 4.21), and 0.37 (95%CI 0.31 - 0.43), respectively. The diagnostic odds ratio was 9.49 (95%CI 7.13 - 12.61), and the area under the receiver operating characteristic curve was 0.82 (95%CI 0.79 - 0.85).ConclusionsFeNO has certain diagnostic value in diagnosis of asthma. Types of asthma, region and cut-off value all have impact on the diagnostic efficiency of FeNO.
Objectives To assess the relationship between subclinical hyperthyroidism and the incidence of coronary heart disease (CHD). Methods PubMed, EMbase, The Cochrane Library, Web of Science, CNKI, VIP, WanFang Data and CBM databases were searched for studies on the relationship between subclinical hyperthyroidism and the incidence of CHD from inception to October 2016. 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 and Stata 12.0 software. Results In total, 14 cohort studies were included. The results of meta-analysis showed that subclinical hyperthyroidism was associated with the incidence of coronary heart disease (RR=1.19, 95%CI 1.01 to 1.40, P=0.04) and all-cause mortality (RR=1.36, 95%CI 1.11 to 1.67, P=0.003). Conclusions Subclinical hyperthyroidism is associated with an increased risk of CHD and all-cause mortality. Due to the limitation of quality and quantity of the studies, the above conclusions are required to be verified by large-scale and high quality research.