Objective To investigate the expression of oncostatin M (OSM) in patients with sepsis and its role in early recognition of sepsis. Methods Thirty-four patients with sepsis admitted in Shanxi Bethune Hospital fromJune 3, 2021 to January 18, 2022 were selected as a sepsis group, 15 patients with community acquired pneumonia (CAP) as a case control group, and 16 adults who underwent physical examination in the same period were selected as a healthy control group. The patients in the sepsis group were followed up for 28 days and divided into a survival group and a death group. The serum OSM level and its correlation with clinical indexes (white blood cell, neutrophil, lymphocyte, sequential organ failure assessment score and acute physiology and chronic health evaluation Ⅱ) were analyzed, and the diagnostic value of OSM expression level in the early identification of sepsis was analyzed. Results Compared with the case control group and the healthy control group, the expression level of OSM in the sepsis group was significantly higher [(502.07±209.93)pg/mL vs. (368.22±65.95)pg/mL and (382.09±73.04)pg/mL, P<0.05]. However, the high expression of OSM had no significant correlation with white blood cell, neutrophil, lymphocyte or disease severity score (P>0.05), and there was no significant difference in serum OSM level between the sepsis survival group and the death group. Compared with white blood cell count, the high expression of OSM has certain diagnostic value in the early identification of sepsis. The area under the receiver operator characteristic curve of OSM in predicting sepsis was 0.794 (95% confidence interval 0.666 - 0.922, P<0.05), with the sensitivity of 79.4% and the specificity of 73.3%. Conclusion The expression of OSM in patients with sepsis is significantly increased, and the high expression of OSM has a certain diagnostic value in the early identification of sepsis.
ObjectiveTo evaluate the effect on complication after esophagectomy by comparing the different methods of anastomosis (cervical versus thoracic anastomosis). MethodsWe searched the following databases including PubMed, EMbase, The Cochrane Library, Web of Science, CBM, CNKI, VIP and Wanfang database to identify randomized controlled trials (RCTs) of cervical versus thoracic anastomosis for esophagectomy patients from establishment of each database to October 30, 2014. Quality of the included RCT was evaluated. Meta-analysis was conducted by using RevMan 5.2 software. ResultsWe finally identified 4 RCTs involving 267 patients. In terms of the postoperative complication, the incidence of anastomotic leakage (RR=3.83, 95%CI 1.70 to 8.63, P=0.001) with cervical anastomosis was significantly higher than that of the patients with thoracic anastomosis. However, there was no statistical difference in incidence of anastomotic stricture (RR=1.04, 95%CI 0.62 to 1.76, P=0.87), pulmonary complication (RR=0.73, 95%CI 0.27 to 1.91, P=0.52), and mortality (RR=0.89, 95%CI 0.40 to 1.97, P=0.77) between cervical and thoracic anastomosis. ConclusionCompared with thoracic anastomosis, the method of cervical anastomosis is associated with a higher incidence of anastomotic leakage. But there are many unclear factors about anastomotic stricture, pulmonary complication and mortality, further measurement should be taken.
Objective：To observe the expression of gene and protein l evel of unfolded protein, glucoseregulated protein 78 (GRP78), after retinal d etachment (RD); to find out the relationship between UPR and the cell damage after RD. Methods：Eightyeight Wistar rats were divided into 2 groups: con trol group (11 rats) and RD group (77 rats). In RD group, subretinal injection with 10 mg/ml hyaluronic acid sodium was performed on the left eyes of the rats t o set up RD model, and the left eyes and retinal tissue were collected 1/2 day, 1 day, 2, 4, 8, 1 6 and 32 days after RD; there were 11 rats in each subgroup. The expression of G RP78 mRNA in retina tissue was detected by semiquantitative reverse transcript i on polymerase chain reaction (RT－PCR), the expression of GRP78 protein level wa s detected by Western blotting, and the distribution of GRP78 in each retinal lay er was observed by immunofluorescence labeling method and confocal microscopy. Results：The expression of retinal GRP78 mRNA significantly in creased in 1/2 day , 1 day, 2, and 4 days subgroups after RD (Plt;0.05). The expression of GRP7 8 protein significantly increased in each subgroup after RD compared with which in the control group, and reached the peak in 8, 16, and 32 days subgroups. The expres sion of GRP78 protein was detected in all of the retinal layers after RD. Conclusion：The protection mechanism of UPR starts up after RD, and l eads the correc t pucker of the protein and reduces cellular injury by upregulating the expres s ion of GRP78, which provide the theoretic basis for reducing the cellular injury and improving the visual function in patients with RD.
ObjectiveTo systematically review the efficacy of cognitive behavioral therapy (CBT) for improving mental health and social functions in patients with multiple sclerosis (MS). MethodsWe searched PubMed, EMbase, The Cochrane Library (Issue 4, 2016), CBM and CNKI from inception to May 2016, to collect randomized controlled trials (RCT) about CBT on mental health and social function in patients with MS. 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 11 RCTs involving 1 102 patients were included. The results of meta-analysis showed that, the HADS scores (depression: MD=-1.28, 95%CI-2.07 to-0.48, P=0.002; anxiety: MD=-1.52, 95%CI-2.99 to-0.06, P=0.04), BDI scores (MD=-9.11, 95% CI-15.82 to-2.40, P=0.008), HRDS scores (MD=-7.23, 95% CI-13.65 to-0.82, P=0.03), Chalder scores (MD=-4.88, 95% CI-6.61 to-3.16, P < 0.000 01), MFIS scores (MD=-2.98, 95% CI-4.52 to-1.44, P=0.000 2) and GHQ-12 scores (MD=-3.61, 95%CI-5.20 to-2.02, P < 0.000 01) in the CBT group were lower than that in the control group. No significant difference was found in WSAS scores (MD=-1.98, 95%CI-4.88 to 0.93, P=0.18) between two groups. ConclusionCBT may be effective for improving the negative mental experience, fatigue and quality of life in MS. No evidence to support CBT has benefits in social functions. Due to the limited quantity and quality of the included studies, the above conclusion needs to be verified by more high quality studies.
ObjectiveThe diagnostic efficacy of long non-coding RNA (lncRNA) for tuberculosis was evaluated by systematic review. MethodsData from PubMed, Web of Science, Cochrane Library, Embase, CMJFD, CNKI and WanFang Data were searched. Literatures on the diagnostic value of lncRNA in tuberculosis from the database establishment to August 20, 2024 were selected, and the quality of literatures was assessed using QUADAS-2 tool. Meta-Disc 1.0 software tested the threshold heterogeneity of the included studies. Stata 18.0 software calculated sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio and other effect sizes, and performed subgroup analysis and meta regression to explore the source of heterogeneity. Deeks funnel plot evaluates publication bias. Results A total of 28 case-control studies were included in 14 literatures. The meta-results showed that the combined sensitivity was 0.88 (95%CI 0.81 to 0.93), the specificity was 0.90 (95%CI 0.84 to 0.94), and the PLR was 9.05 (95%CI 5.16 to 15.87). The NLR and DOR were 0.13 (95%CI 0.08 to 0.22) and 67.96 (95%CI 27.27 to 169.39), and the AUC were 0.95 (95%CI 0.93 to 0.97). Subgroup analysis showed that lncRNA was more effective in the diagnosis of tuberculosis when PMBC samples, lncRNA expression was down-regulation, the study sample size was ≤100, there was cut-off value, GAPDH was used as the internal reference, and RNA extraction kit was used. meta regression indicated that lncRNA expression level and sample size were the main sources of heterogeneity. Conclusion LncRNA has high accuracy in the diagnosis of tuberculosis, and is expected to become a new biomarker to assist the diagnosis of tuberculosis.
Objective To evaluate the efficacy, safety and economics of digestive enzyme for dyspepsia. Methods Electronic databases such as PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), CBM, VIP and CNKI were searched from establishment dates of databases to June 2010 to identify the randomized controlled trials (RCTs) of digestive enzyme for dyspepsia. Then studies were identified according to predefined inclusion and exclusion criteria, and their quality was evaluated. The meta-analysis was performed using RevMan 5.0 software. Results Eight studies involving 1 092 patients were included, 3 of which were Grade B while the rest were Grade C. The results of the meta-analysis showed that the total efficacy rate of oryz-aspergillus enzyme and pancreatin tablet, compound digestive enzymes capsule, and compound azintamide enteric-coated tablet for dyspepsia were better than either placebo or blank intervention, with the results as (OR=49.70, 95%CI 17.16 to 143.96), (OR=7.71, 95%CI 3.88 to 15.33) and (OR=16.27, 95%CI 6.85 to 38.66), respectively. The efficacy for treating loss of appetite, abdominal distension, abdominal pain, diarrhea and belching was superior to either placebo or blank intervention. Oryz-aspergillus enzyme and pancreatin tablet was inferior to compound digestive enzyme capsule in treating dyspepsia following cholecystectomy. No significant difference was observed in treating dyspepsia following chronic pancreatitis between compound azintamide enteric-coated tablet and compound digestive enzymes capsule. Drug-related adverse reactions as well as economic evaluation were not reported in included studies. Conclusion Digestive enzyme is effective for dyspepsia caused by various diseases. The OR of digestive enzyme versus the placebo/blank-control group shows that oryz-aspergillus enzyme and pancreatin tablet is better than other digestive enzyme drugs.
ObjectiveTo systematically review the incidence of social isolation in Chinese elderly population. MethodsCNKI, WanFang Data, VIP, CBM, PubMed, EMbase, Web of Science and CENTRAL databases were electronically searched to collect studies on the incidence of social isolation in China from inception to May 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies, then, meta-analysis was performed by using Stata 15.1 software. ResultsA total of 20 studies involving 86 111 subjects were included. Meta-analysis results showed that the incidence of social isolation among the elderly in China was 27.54% (95%CI 22.15% to 57.74%). The results of subgroup analysis showed that gender, age, educational level, marital status, self-assessment of health, living style, year of publication, and region surveyed were all influential factors of the incidence of social isolation among the elderly in China. ConclusionCurrent evidence shows that the incidence of social isolation among the elderly in China is relatively high. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
ObjectiveTo systematically evaluate the association between 936C/T polymorphism in vascular endothelial growth factor (VEGF) gene and the risk of preeclampsia (PE). MethodsSuch databases as PubMed, EMbase, The Cochrane Library (Issue 11, 2014), CBM, CNKI, VIP, and WanFang Data were searched up to November 2014, to collect case-control studies of the association between 936C/T polymorphism in VEGF gene and the risk of PE. Two reveiwers independently screened studies according to the inclusion and exclusion criteria, extracted data, and assessed the risk of bias of included studies. And then, meta-analysis was conducted using RevMan 5.3 software. ResultsA total of nine case-control studies involving 904 PE patients and 1 113 controls were included. The results of meta-analysis showed that, significant association was found between VEGF gene 936C/T polymorphism and the risk of PE in the total analysis (T vs. C:OR=1.61, 95%CI 1.17 to 2.22, P=0.003; TT vs. CC:OR=2.65, 95%CI 1.37 to 5.11, P=0.004; CT vs. CC:OR=1.55, 95%CI 1.09 to 2.22, P=0.02; TT+CT vs. CC:OR=1.68, 95%CI 1.15 to 2.45, P=0.007; TT vs. CT+CC:OR=2.19, 95%CI 1.31 to 3.68, P=0.003). In the subgroup analysis, significant association of the polymorphism was found in Asians but not in Caucasians. ConclusionVEGF gene 936C/T polymorphism may be associated with PE risk in Asians. Due to limited quantity and quality of the included studies, the conclusion should be assessed in further studies.
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.
ObjectivesTo compare the clinical efficacy of different surgical thoracic duct management on prevention of postoperative chylothorax and its impact on the outcome of the patients. MethodsWe searched the electronic databases including PubMed, The Cochrane Library (Issue 4, 2016), Web of Science, CBM, CNKI, VIP and WanFang Data to collect randomized controlled trials (RCTs), cohort studies and case-control studies related to the comparison of different surgical thoracic duct management during esophagectomy on prevention of postoperative chylothorax from inception to May 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then RevMan 5.2 software was used for meta-analysis. ResultsTwenty-three trials were included, involving four RCTs, four cohort studies and 15 case-control studies. The results of meta-analysis indicated:(1) Prophylactic thoracic duct ligation group had lower incidence of postoperative chylothorax compared with non thoracoic duct ligation group (RCT:OR=0.20, 95%CI 0.09 to 0.47, P=0.000 02; Co/CC:OR=0.20, 95%CI 0.14 to 0.28, P<0.000 01); (2) There were no significant differences between the two groups in the respect of mortality, morbidity and the 2-year, 3-year, 5-year survival rates (all P values >0.05); (3) Prophylactic thoracic duct ligation could reduce the reoperation rate of chylothorax complicating esophageal cancer patients (RCT:OR=0.17, 95%CI 0.10 to 0.28, P<0.000 01; Co/CC:OR=0.18, 95%CI to 0.11 to 0.32, P<0.000 01), and increase the cure rate of expectant treatment on them (OR=0.25, 95%CI 0.11 to 0.56, P=0.000 8); (4) En bloc thoracic duct ligation group had a lower incidence of postoperative chylothorax compared with single thoracic duct ligation group (OR=3.67, 95%CI 1.43 to 9.43, P=0.007). ConclusionProphylactic thoracic duct ligation during esophagectomy could effectively reduce the incidence of postoperative chylothorax and is good for reducing the reoperation rate of chylothorax complicating esophageal cancer patients. En bloc thoracic duct ligation has a better efficacy on prevention of postoperative chylothorax compared with single thoracic duct ligation.