ObjectiveTo systematically review the efficacy of convalescent plasma (CP) in the treatment of coronavirus disease 2019 (COVID-19). MethodsPubMed, EMbase, The Cochrane Library, VIP, WanFang Data and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy of CP in the treatment of COVID-19 from inception to September 15th, 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies; then, meta-analysis was performed using RevMan 5.4.1 software. ResultsA total of 16 RCTs involving 15 301 patients were included. The results of meta-analysis showed that CP treatment did not reduce mortality compared with no-placebo (RR=0.99, 95%CI 0.93 to 1.05, P=0.63) or normal saline (RR=1.06, 95%CI 0.60 to 1.86, P=0.84). However, compared with standard plasma, the mortality of CP group was lower (RR=0.59, 95%CI 0.37 to 0.95, P=0.03). In addition, compared with no-placebo or normal saline, CP treatment could not improve the clinical condition at 28-30 days, reduce mortality at early treatment and in patients without invasive mechanical ventilation when randomized. ConclusionCurrent evidence shows that compared with no-placebo or normal saline, CP does not reduce mortality in patients with COVID-19. However, when the disease progresses to the point where standard plasma is required, CP may reduce mortality. In addition, use of CP in patients with early or non-critical COVID-19 failed to reduce mortality. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify the above conclusion.
Objective To systematically evaluate the efficacy and safety of single and bilateral lung transplantation in the treatment of end-stage chronic obstructive pulmonary disease (COPD). Methods Chinese and English databases were searched by computer, including PubMed, Web of Science, The Cochrane Library, EMbase, CNKI, Wanfang database, VIP database and CBM. Case-control studies on single lung transplantation or bilateral lung transplantation for COPD were collected from the inception to July 31, 2022. We evaluated the quality of the literature via Newcastle-Ottawa Scale (NOS). All results were analyzed using Review Manager V5.3 and STATA 17.0. Results A total of 8 studies were included covering 14076 patients, including 8326 patients in the single lung transplantation group and 5750 patients in the bilateral lung transplantation group. NOS scores were≥6 points. The results of meta-analysis showed that there was no statistical difference in the postoperative 1-year survival between the two groups (P=0.070). The 2-year survival rate (P=0.002), 3-year survival rate (P<0.001), 5-year survival rate (P<0.001), overall survival rate (P＜0.001), postoperative forced expiratory volume in one second/predicted value (P<0.001), postoperative forced vital capacity (P<0.001), and postoperative 6-minute walking distance (P=0.002) were lower or shorter than those in the bilateral lung transplantation group, the postoperative intubation time (P=0.030) was longer than that in the bilateral lung transplantation group. Bilateral lung transplantation group showed better surgical results. There was no statistical difference in the mortality, obliterative bronchiolitis, length of hospitalization, primary graft dysfunction, or postoperative adverse events (P>0.05). Conclusion Bilateral lung transplantation is associated with better long-term survival and postoperative lung function compared with single lung transplantation. In-hospital mortality and postoperative complications are similar between them.
目的 系統評價標準桃金娘油治療分泌性中耳炎的療效及安全性。 方法 電子檢索Cochrane圖書館、PubMed、EMBASE、中國期刊全文數據庫（CNKI）、維普（VIP）、中國生物醫學文獻數據庫（CBM）六大數據庫，檢索時間自建庫截止至2012年2月。根據Cochrane協作網手冊評估納入隨機對照試驗（RCT）的方法學質量，采用RevMan 5.0軟件對數據進行Meta分析。 結果 共納入8個RCT，研究結果顯示，標準桃金娘油聯合常規治療分泌性中耳炎的總有效率優于單用常規治療，但差異無統計學意義[RR=1.21，95% CI（0.98，1.50），P=0.08]。 結論 標準桃金娘油治療分泌性中耳炎有一定療效，但并不顯著。因納入研究質量較低，上述結論還需高質量、大樣本的研究進一步驗證。
Objective To systematically evaluate the effectiveness of dasatinib in doses of 140 mg once daily and 70 mg twice daily for chronic myeloid leukemia (CML). Methods The randomized controlled trials (RCTs) were retrieved from Embase (1974 to November 2011), Pubmed (1966 to November 2011), The Cochrane Library (Issue 11, 2011), CBM (1979 to November 2011), VIP (1989 to November 2011), CNKI (1994 to November 2011), Wanfang Data (1997 to November 2011) and references listed in all articles. RCTs meeting inclusive criteria were included, the data were extracted, the quality was evaluated and cross-checked by two reviewers independently according to Cochrane Handbook for Systematic Reviews of Interventions, and then meta-analyses were conducted using RevMan 5.1 software. Results A total of four studies involving two RCTs and 862 patients were included. Results of meta-analyses showed that when dasatinib was used in the long-term treatment of CML, no significant difference was found between 140 mg once daily and 70 mg twice daily in the complete hematologic response (RR=0.97, 95%CI 0.88 to 1.07, P=0.58), complete cytogenetic response (RR=0.94, 95%CI 0.80 to 1.11, P=0.47) and major cytogenetic response (RR=0.99, 95%CI 0.86 to 1.13, P=0.86). In the short-term treatment of CML, there were no significant differences in the complete hematologic response (RR=0.99, 95%CI 0.90 to 1.07, P=0.73), complete cytogenetic response (RR=0.99, 95%CI 0.78 to 1.26, P=0.95) and major cytogenetic response (RR=1.01, 95%CI 0.83 to 1.22, P=0.95). The subgroup analyses on the long-term treatment of CML in both chronic phase and advanced phase showed that there were no significant differences in the complete hematologic response, major cytogenetic response and complete cytogenetic response. Conclusion In the effectiveness of dasatinib for CML, the dose of 140 mg once daily is similar to the dose of 70 mg twice daily. Considering possible moderate selection bias existing in the methodological quality of the included studies which may affect the authenticity of outcomes, this conclusion should be further proved by conducting more high-quality, large-scale and double- blinded RCTs.
Objective To systematically review the association between exposure to bisphenol A during pregnancy and spontaneous abortion. Methods The PubMed, Web of Science, EMbase, CNKI, WanFang Data and VIP databases were electronically searched to identify cohort studies and case-control studies related to bisphenol A exposure and spontaneous abortion from inception to April 1st, 2022. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using Stata 16.0 software. Results A total of 7 case-control studies and 1 cohort study were included, with a total of 1 179 subjects. The results of meta-analysis showed that there was a statistically significant difference in bisphenol A concentrations between the spontaneous abortion group and the control group regardless of whether the sample source was serum or urine (SMD serum=1.05, 95%CI 0.34 to 1.77, P=0.004; SMD urine=0.20, 95%CI 0.02 to 0.38, P=0.027). Conclusion The current evidence shows that exposure to bisphenol A during pregnancy may lead to unexplained recurrent spontaneous abortion. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo systematically evaluate the influencing factors of disaster resilience for medical rescue workers. MethodsPubMed, Cochrane Library, Web of Science, CINAHL, APA PsycInfo, EMbase, Scopus, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect studies on the influencing factors of disaster resilience for medical rescue workers from inception to November 1, 2022. 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 16.0 software. ResultsA total of 36 studies involving 7 974 medical rescue workers were included. The meta-analysis results showed that personal influencing factors, including active coping, rescue confidence, disaster preparedness, knowledge attainment, physical health, and exercise were positively correlated with the disaster resilience of healthcare workers. However, depression, anxiety, stress, and a history of mental illness were negatively related to the disaster resilience of medical rescue workers. Environmental and background factors, including social support, relief supplies, disaster training, economic condition, rescue experience, length of service, and technical title, were positively correlated with the disaster resilience of medical rescue workers. ConclusionCurrent evidence shows that the disaster resilience of medical rescue workers is affected by a variety of personal factors and environmental/background factors. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo investigate the expression and clinical significance of octamer-binding transcription factor 4(Oct-4) in gastric cancer (GC) tissues with meta-analysis. MethodsPubMed, EMBASE, Web of Science, CBM, VIP, CNKI, and WanFang Database were searched from their establishment to Oct.2012 for related studies, to investigate the relationship between expression of Oct-4 and the clinicopathological characteristics of GC.After evaluating methodo-logical quality of studies that met the inclusion criteria, RevMan 5.1 software was used to data analysis. ResultsEight studies which enrolled 623 cases of GC were identified.The results of the meta-analysis showed that, as for the positive expression rate of Oct-4, there were significant differences between GC tissues and normal stomach tissues (OR=37.50, 95% CI: 4.76-295.51, P < 0.01), as well as the cell differentiation (OR=0.27, 95% CI: 0.16-0.45, P < 0.01), for that the positive expression rate of Oct-4 in low differentiation of gastric cancer tissues was higher than those of moderate-high differentation group.But there were no significant differences between GC tissues with lymph node metastasis and non-lymph node metastasis (OR=2.09, 95% CI: 0.63-6.94, P=0.23), as well as Ⅰ-Ⅱ stage and Ⅲ-Ⅳ stage (OR=0.62, 95% CI: 0.25-1.54, P=0.30) of GC tissues. ConclusionsOct-4 may participate in the whole course of carcinogenesis of GC, but the relationship between expression of Oct-4 and lymph node metastasis as well as the TNM stage of GC is unclear, which needs more high quality studies to explore the question clearly.
Objective To systematically review the association between ALDH2 polymorphism and ischemic stroke. Methods Web of Science, PubMed, CNKI, CBM and WanFang data were searched to collect case-control studies about the association between ALDH2 polymorphism and ischemic stroke from the 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 Stata 12.0 software. Results A total of seven case-control studies were included. The results of meta-analysis showed that the A allele and AA genotype in ALDH2 was associated with the risk of ischemic stroke (Avs. G: OR=1.430, 95%CI 1.006 to 2.033,P=0.046; AAvs. AG+GG: OR=1.734, 95%CI 1.267 to 2.373,P=0.001; AAvs. GG: OR=1.757, 95%CI 1.274 to 2.424,P=0.001). Conclusion ALDH2 gene polymorphism may related to ischemic stroke for Chinese and A allele of ALDH2 may be the risk factors.
Objective To systematically evaluate the influence of alcohol intervention on the outcome of rats and mice with ischemic stroke. Methods Databases including PubMed, EMbase, BIOSIS and CNKI were electronically searched from establishment dates of databases to June 2012 to retrieve animal experiments on the influence of alcohol intervention on the outcome of rats and mice with ischemic stroke. The relevant studies were identified according to the predefined inclusion and exclusion criteria, the data were extracted, and the quality was evaluated. Then meta-analysis was performed using RevMan 5.1 software. Results Eight studies were included. The results of meta-analysis showed that no significant difference was found between the alcohol intervention group and the control group (MD=?6.98%, 95%CI ?20.38% to 6.43%, P=0.31). However, compared with the control group, low dose of acute alcohol intervention (less than 2 g/kg) improved the prognosis of ischemic stroke with a significant difference (MD=?22.83%, 95%CI ?38.77% to ?6.89%, P=0.005), and highly-concentrated of chronic alcohol intervention worsened the cerebral ischemic damage of rats and mice with a significant difference (MD=24.06%, 95%CI 10.54% to 37.58%, P=0.000 5). Conclusion Low dose of acute alcohol intervention (less than 2 g/kg) could improve the prognosis of rats and mice with ischemic stroke which has the potential neuro-protective effects. However, highly-concentrated chronic alcohol intervention could worsen the cerebral ischemic damage. Due to the limitations of the included studies such as publication bias, the influence of alcohol intervention on the outcome of rats and mice with ischemic stroke could be overestimated.
Objective To analyze published literature about the clinical studies on elective single versus double embryo transfer using meta-analysis, so as to provide more convincing evidence for the clinical application of elective single embryo transfer. Methods We electronically searched foreign and domestic biomedical databases including PubMed, Ovid, EMbase, MEDLINE and CENTRAL, to collect randomized controlled trials (RCTs) on elective single versus double embryo transfer. According to Cochrane systematic review method, two reviewers independently screened studies according to inclusion and exclusion criteria, extracted data, and assessed methodological quality of the included studies. Then, meta-analysis was performed using RevMan 5.1 software. Results A total of 9 RCTs involving 2 784 cases were included, of which, 1 452 were in the trial group while the other 1 332 were in the control group. The results of meta-analysis indicated that, compared with elective double embryo transfer, during each transfer period elective single embryo transfer reduced the live birth rate (RR=0.66, 95%CI 0.59 to 0.73, Plt;0.000 01), multiple pregnancy rate (RR=0.05 95%CI 0.02 to 0.11, Plt;0.000 01), preterm birth rate (RR=0.39, 95%CI 0.26 to 0.60, Plt;0.000 1), and low birth weight rate (RR=0.25, 95%CI 0.15 to 0.44, Plt;0.000 01). However, it had no effect on the ectopic pregnancy rate (RR=0.55, 95%CI 0.11 to 2.77, P=0.47), miscarriage rate (RR=1.33, 95%CI 0.92 to 1.91, P=0.13), and neonatal mortality rate (RR=0.31, 95%CI 0.03 to 2.76, P=0.29). Conclusion Compared with elective double embryo transfer, during each transfer period elective single embryo transfer reduces the live birth rate, multiple pregnancy rate, preterm birth rate, and low birth weight rate. No significant difference was found between the two groups in the other indicators.