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.
Objective To review the association between chlamydia pneumoniae (CP) infection and cerebral infarction. Methods We electronically searched MEDLINE, BIOSIS, VIP database, and China Full Text Journal Database from Jan. 1990 through Dec. 2007 to identify case-control studies about the association of CP and cerebral infarction. The quality of the included studies was assessed and the RevMan 4.2 software was used for meta-analyses. Results A total of 22 studies were included. The results of meta-analyses showed: ① When the microimmunofluorescence (MIF) method was used to examine CP antibody in serum, the positive rate of the cerebral infarction group was higher than that of the control group when the positive infection was defined by IgA≥1?16 [n=8, OR=2.18, 95%CI (1.49 to 3.49), Plt;0.0001]; but when positive infection was defined by IgA≥1?32 (n=3), IgG≥1?32 (n=6), or IgG≥1?64 (n=5), there were no significant differences in the positive rate between the two groups [OR (95%CI) were 1.47 (0.97 to 2.24), 1.24 (0.82 to 1.86), and 1.23 (0.98 to 1.55), respectively]; ② When the ELISA method was used to examine CP-IgG antibody in serum, the positive rate of the cerebral infarction group was higher than that of the controlled group [n=8, OR=2.40, 95%CI (1.42 to 4.06), P=0.000 2]. ③ The acute and chronic CP infections were associated with the incidence of cerebral infarction [n=4, OR=7.22, 95%CI (2.68 to 19.49); n=4, OR=4.30, 95%CI (3.40 to 7.40)]. Conclusion ① The association between CP infection and cerebral infarction is determined by the positive criterion. IgA antibody is more sensitive than the IgG antibody. When the positive infection is determined by IgA≥1?16, CP infection is associated with cerebral infarction. ② The results of ELISA for examining CP-IgG support the association between CP infection and cerebral infarction. ③ Both acute and chronic CP infections are associated with cerebral infarction, but these associations needed to be proven by more scientific studies.
ObjectiveTo systematically review the clinical efficacy and effects on pregnancy outcomes of S-adenosy-L-methionine combined with ursodesoxycholic acid in the treatment of intrahepatic cholestasis of pregnancy. MethodsDatabases such as PubMed, The Cochrane Library, CNKI, VIP, WanFang Data were searched for the studies about the clinical efficacy and effects on pregnancy outcomes of S-adenosy-L-methionine combined with ursodesoxycholic acid in the treatment of intrahepatic cholestasis of pregnancy up to December 31st, 2013. Two reviewers independently screened literature, extracted data and evaluated methodological quality. Then meta-analysis was conducted using RevMan 5.0.24 software. ResultsA total of 11 RCTs involving 776 patients were included. The results of meta-analysis showed that, combined medication reduced blood biochemical indexes inlcuding ALT (MD=3.63, 95%CI 0.63 to 6.64, P=0.02), TB (MD=3.70, 95%CI 1.45 to 5.96, P=0.001), and AST (MD=7.61, 95%CI 2.47 to 12.75, P=0.004). Combined therapy significantly decreased the rates of amniotic fluid contamination (OR=0.29, 95%CI 0.19 to 0.45, P=0.000 01), cesarean section (OR=0.53, 95%CI 0.36 to 0.79, P=0.002), postpartum hemorrhage (OR=0.32, 95%CI 0.12 to 0.90, P=0.03), preterm birth (OR=0.36, 95%CI 0.24 to 0.55, P < 0.000 01), fetal distress (OR=0.33, 95%CI 0.19 to 0.58, P=0.000 1) and neonates asphyxia (OR=0.30, 95%CI 0.19 to 0.47, P < 0.000 01). Combined therapy was also beneficial to improving pruritus symptoms (MD=0.20, 95%CI 0.08 to 0.31, P=0.000 08) and benefiting fetus growth (MD=0.45, 95%CI 0.23 to 0.66, P < 0.000 1). ConclusionThe combination of S-adenosy-L-methionine and ursodesoxycholic acid is superior to ursodesoxycholic acid alone in improving clinical symptoms and pregnant outcomes of patients with intrahepatic cholestasis of pregnancy.
ObjectiveTo evaluate the efficacy and safety of bisphosphonates in preventing and treating glucocorticoid induced osteoporosis. MethodsDatabases including PubMed, EMbase, The Cochrane Library (Issue 1, 2016), CNKI, WanFang Data and VIP were searched to collect randomized controlled trials (RCTs) related bisphosphonates for the prevention and treatment of glucocorticoid induced osteoporosis from inception to January 2016. Two reviewers independently screened literature, extracted data, and evaluated the risk of bias of included studies. Meta-analysis was performed using RevMan 5.3 software. ResultsA total of 20 RCTs were included, which involved 2 330 patients. The results of meta-analysis showed that, compared with the placebo group, the bisphosphonates group could significantly increase the bone mineral density (BMD) at lumbar and femoral neck (MD=3.70, 95%CI 2.65 to 4.75, P<0.000 01; MD=2.18, 95%CI 1.30 to 3.06, P<0.000 01), but the bisphosphonates group could not decrease the incidence rates of vertebral fracture or non-vertebral fracture (OR=0.66, 95%CI 0.38 to 1.16, P=0.15; OR=0.73, 95%CI 0.42 to 1.28, P=0.28). There were no significant differences in the incidence rates of total adverse reactions and total severe adverse reactions between the two groups (OR=0.89, 95%CI 0.62 to 1.28, P=0.53; OR=0.93, 95%CI 0.62 to 1.39, P=0.72). ConclusionCurrent evidence shows that, compared with placebo, bisphosphonates canld effectively prevent and treat the decrease of bone mineral density of glucocorticoid induced osteoporosis, not decrease the incidence of fracture, but not increase the incidence of adverse reactions.
Objective To determine the value of 99m Tc-MIBI scintimmmography in diagnosing primary breast cancer and axillary lymph node metastases.Methods Independent, prospective, blinded studies were selected from the Cochrane Library, MEDLINE, Springer, Elsevier and China National Knowledge Infrastructure, Sensitivity, specificity, and accuracy of scintimammography were estimated by comparison with the results of biopsy. Subsequently, the characteristics of included articles such as sensitivity, specificity of 99m
ObjectiveTo systematically review the intervention effects of high-intensity interval training (HIIT) on weight loss and blood lipid metabolism in overweight/obese populations. MethodsThe computer conducted searches in the PubMed, Embase, Cochrane Library, Web of Science, CNKI, and WanFang Data database to collect randomized controlled trials (RCTs) related to HIIT and weight loss, fat reduction, and blood lipid metabolism in overweight/obese populations. The search was conducted from the inception of the databases to March 31, 2023. Two researchers independently conducted literature screening and data extraction. After evaluating the risk of bias of the included studies, a meta-analysis was performed using RevMan 5.4 software. ResultsA total of 19 RCTs, involving 595 overweight/obese participants, were included. The meta-analysis results showed that compared wtih the control group, HIIT interventions effectively reduced body weight (MD=−2.63, 95%CI −4.04 to −1.23, P<0.05), BMI (MD=−1.21, 95%CI −1.95 to −0.48, P<0.05), Fat% (MD=−1.66, 95%CI −2.28 to −1.04, P<0.05), TG (MD=−0.13, 95%CI −0.25 to −0.01, P=0.04), HDL (MD=0.14, 95%CI 0.05 to 0.23, P<0.05), and LDL (MD=−0.26, 95%CI −0.39 to −0.13, P<0.05) levels but did not improve TC (MD=−0.15, 95%CI −0.36 to 0.06, P=0.15) levels. ConclusionHIIT intervention can effectively improve body weight, BMI, Fat%, TG, HDL, and LDL levels in overweight/obese populations, particularly showing a more pronounced improvement in lipid profiles among overweight/obese adolescents, but it does not reduce TC levels. This study demonstrates that HIIT may be an effective strategy to assist in weight loss and prevent cardiovascular diseases in overweight/obese populations, with potential for broader application.
Objective To systematically evaluate the efficacy and safety of sirolimus-eluting stents (SES) versus bare-metal stents (BMS) in treating patients with ST-segment elevation myocardial infarction. Methods The databases such as PubMed (1960 to Mar. 2011), EMbase (1980 to Mar. 2011), the Cochrane Central Register of Controlled Trials (1989 to Mar. 2011), CBM (1979 to Mar. 2011), VIP (1989 to Mar. 2011) and CNKI (1979 to Mar. 2011) were searched to collect all the randomized controlled trials (RCTs) on SES versus BMS in patients with ST-segment elevation myocardial infarction. After the data extraction and methodological quality evaluation, meta-analysis was conducted with RevMan 4.2 software. Results A total of 7 RCTs were included. Among 2 555 patients involved, 1 282 were in the SES group, while the other 1273 were in the BMS group. The results of meta-analyses showed that SES was superior to BMS in the target-lesion revascularization (OR=0.27, 95%CI 0.16 to 0.45, Plt;0.000 01) and target-vessel revascularization (OR=0.33, 95%CI 0.24 to 0.46, Plt;0.000 01). In contrast, there were no differences between SES and BMS in death, stent thrombosis and recurrence of myocardial infarction. Conclusion With the one-year clinical outcomes, SES is more effective than BMS in reducing the rate of target-vessel revascularization and target-lesion revascularization.
ObjectiveTo systematically review the correlation between the birth number and the risk of breast cancer of Chinese female. MethodsWe electronically searched databases including the CNKI, WanFang Data and VIP databases from inception to September 1st 2015, to collect case-control studies about the correlation between the number of births and the risk of breast cancer among Chinese female. Two reviewers independently screened literature, extracted data, and evaluated the risk of bias of included studies. Then meta-analysis was performed by using Stata software. ResultsA total of 14 case-control studies involving 3 428 patients and 3 906 controls were included. The results of meta-analysis showed that:the females who had term birth had significant lower incidence of breast cancer than those without childbirth history (OR=0.429, 95%CI 0.322 to 0.571). Subgroup analysis based on the number of term birth showed that:Compared with the female without childbirth history, those who had term birth of one time (OR=0.464, 95%CI 0.321 to 0.670), two times (OR=0.394, 95%CI 0.269 to 0.576) and≥3 times (OR=0.340, 95%CI 0.232 to 0.499) had significant lower incidence of breast cancer. ConclusionTerm birth is a protective factor for breast cancer of Chinese female, and more times of term birth will decrease the risk of breast cancer.
Objective To perform a systematic review on the safety (i.g. cardiovascular, mortality and gastrointestinal bleeding) of clopidogrel versus clopidogrel combined with proton pump inhibitors (PPIs) for the patients with coronary heart disease. Methods Such databases as The Cochrane Library, PubMed, EMbase, SSCI, VIP, CNKI, and CBM were searched from the date of their establishment to September 2010. The bibliographies of the retrieved articles were also checked. The data was extracted and evaluated by two reviewers independently. The RevMan 5.0 software was used for meta-analyses. Results A total of 29 studies were included. The results of meta-analyses showed that the use of clopidogrel combined with PPIs was associated with increasing the risk of cardiovascular events (RR=1.27, 95%CI 1.09 to 1.47), as well as myocardial infarction (RR=1.45, 95% CI 1.20 to 1.76), total mortality (RR=1.23, 95%CI 1.06 to 1.43), and rethrombosis (RR=1.37, 95%CI 1.01 to 1.86). However, there was no enough evidence to reach the conclusion that the combination use could benefit the situation of gastrointestinal bleeding (RR=0.84, 95%CI 0.47 to 1.50). Conclusion?Compared with clopidogrel, the combination use of clopidogrel and PPIs increases cardiovascular events, mortality, and the risks of myocardial infarction and rethrombosis. However, more clinical studies are required to assess the effect of reducing gastrointestinal bleeding.
ObjectiveTo systematically review the incidence and influencing factors of early enteral nutritional feeding interruptions in critically ill patients. MethodsThe PubMed, Web of Science, Embase, Cochrane Library, CNKI, WanFang Data and CBM databases were electronically searched to collect observational studies on the early enteral nutritional feeding interruptions in critically ill patients from inception to January 2, 2024. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using Stata 17.0 software. ResultsA total of 12 studies including 1 121 patients were included. Meta-analysis showed that the incidence of early enteral nutritional feeding interruptions in critically ill patients was 75.0% (95%CI 64.0% to 84.0%). Influenced by feeding intolerance, airway management, tube problems, radiological examination, and endoscopy, surgery and so on, interruptions of early enteral nutritional feeding frequently occur in critically ill patients. ConclusionCurrent evidence shows that early enteral feeding interruptions in critically ill patients are affected by many factors, and the incidence is high. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.