Objectives To systematically review the association between TM6SF2 (transmembrane six superfamily member 2- rs58592426) polymorphism and liver lesion and the severity of liver fibrosis. Methods We electronically searched databases including PubMed, CNKI, WanFang Data and CBM from inception to January 27, 2016, to collect cross-sectional studies about the association between the TM6SF2 polymorphism and the liver lesion and the severity of liver fibrosis. Two reviewers independently screened literature, extracted data and assessed the methodological quality included studies. Then, meta-analysis was performed using Stata 12.0 software. Results A total of 23 studies including 96 594 patients were included. The results of meta-analysis showed that: TM6SF2 polymorphism was associated with increased risk of the severity of liver fibrosis, the levels of TG, TC and LDL-C (all P values < 0.05). Carriers of the T allele showed lower levels of TG, TC, and LDL-C. Carriers of the T allele revealed higher levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) when compared with homozygous EE. Conclusion TM6SF2 polymorphism is associated with lipid traits in different population, the variants shows lower levels of lipid traits in blood serum and increases the risk of the severity of liver fibrosis and liver lesion.
ObjectiveTo systematically review the diagnostic value of FDG-PET, Aβ-PET and tau-PET for Alzheimer ’s disease (AD).MethodsPubMed, EMbase, The Cochrane Library, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect diagnostic tests of FDG-PET, Aβ-PET and tau-PET for AD from January 2000 to February 2020. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies; then, meta-analysis was performed by Meta-Disc 1.4 and Stata 14.0 software.ResultsA total of 31 studies involving 3 718 subjects were included. The results of meta-analysis showed that, using normal population as control, the sensitivity/specificity of FDG-PET and Aβ-PET in diagnosing AD were 0.853/0.734 and 0.824/0.771, respectively. Only 2 studies were included for tau-PET and meta-analysis was not performed.ConclusionsFDG-PET and Aβ-PET can provide good diagnostic accuracy for AD, and their diagnostic efficacy is similar. Due to limited quality and quantity of the included studies, more high quality studies are required to verify the above conclusions.
ObjectivesTo systematically review the efficacy of laparoscopic hepatectomy (LH) and open hepatectomy (OH) on the hepatocellular carcinoma patients with cirrhosis.MethodsPubMed, EMbase, Web of Science, The Cochrane Library, CBM, CNKI, WanFang Data and VIP databases were searched online to collect the cohort studies of LHvs.OH on hepatocellular carcinoma patients with cirrhosis from inception to November 31st, 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 15 cohort studies involving 1 720 patients were included. The results of meta-analysis showed that: compared with OH, LH had less blood loss (MD=–226.94, 95%CI –339.87 to –114.01, P<0.000 1), lower transfusion rate (OR=0.48, 95%CI 0.27 to 0.83,P=0.009), less occurrence of complications (OR=0.32, 95%CI 0.23 to 0.45, P<0.000 01), shorter postoperative hospital stay (MD=–3.66, 95%CI –5.19 to –2.14,P<0.000 01), lower mortality rate (OR=0.47, 95%CI 0.24 to 0.92,P=0.03), wider surgical margin (OR=0.78, 95%CI 0.20 to 1.36, P=0.009), higher 1, 3 and 5-year survival rate (OR=2.47, 95%CI 1.35 to 4.51, P=0.003; OR=1.62, 95%CI 1.11 to 2.36, P=0.01; OR=1.58, 95%CI 1.19 to 2.10, P=0.002, respectively) and 1-year disease free survival rate (OR=1.69, 95%CI=1.20 to 2.39, P=0.003). There were no significant differences in operation time (MD=28.64, 95%CI –7.53 to 64.82, P=0.12), tumor size (MD=–0.37, 95%CI –0.75 to 0.02, P=0.06), 3-year disease free survival rate (OR=1.14, 95%CI 0.86 to 1.51, P=0.36) and 5-year disease free survival rate (OR=0.99, 95%CI 0.77 to 1.28, P=0.97) between the two groups.ConclusionsThe perioperation and short-term postoperative outcomes of LH are significant in HCC patients with cirrhosis, and which have good long-term prognosis. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.
ObjectivesTo systematically review the efficacy of home-based telerehabilitation (HTR) for stroke survivors.MethodsPubMed, EMbase, Web of Science, Joanna Briggs Institute Library, The Cochrane Library, CNKI, VIP and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) on HTR for stroke survivors from inception to January 1st, 2019. 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 11 RCTs involving 793 patients were included. The results of meta-analysis showed that: after 1 to 2 years of treatment, BI scores (MD=20.22, 95%CI 17.10 to 23.35, P<0.000 01) in HTR group were higher than those in the traditional rehabilitation group. However, there were no statistical differences between two groups in ARAT scores (SMD=0.16, 95%CI ?0.14 to 0.45, P=0.30) after 1 to 2 months of treatment, as well as MBI scores (SMD=0.98, 95%CI ?0.33 to 2.29, P=0.14) and FMA scores (SMD=0.57, 95%CI ?0.08 to 1.23, P=0.09) after 3 months of treatment, and CSI scores (MD=?1.48, 95%CI ?3.90 to 0.94, P=0.23) and BBS scores (MD=1.33, 95%CI ?1.15 to 3.81, P=0.29) after 6 months of treatment. The results of descriptive analysis indicated that there was no statistically significant difference in quality of life between the two groups at 6 months after intervention. However, the HTR group was superior to the traditional rehabilitation group after 2 years of treatment.ConclusionsCurrent evidence shows that, compared with traditional rehabilitation, long-term intervention (1-2 years) with HTR can improve the ability to perform activities of daily living and quality of life of stroke survivors. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusion.
ObjectiveTo systematically review the efficacy of antidepressants in the prevention of poststroke depression (PSD). MethodsWe searched The Cochrane Library (Issue 2, 2015), PubMed, MEDLINE, EMbase, CNKI and VIP databases to collect randomized controlled trials (RCTs) about antidepressants in preventing PSD from inception to April 2015. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software. ResultsA total of 26 RCTs involving 2 190 patients were included. The results of meta-analysis showed that:compared with the control group, the antidepressants group could significantly reduce the incidence of PSD (OR=0.24, 95%CI 0.17 to 0.36, P<0.000 01). Subgroup analysis based on types of drugs showed that:the selective serotonin reuptake Inhibitor (SSRI) could significantly reduce the incidence of PSD (OR=0.23, 95%CI 0.15 to 0.37, P<0.000 01). Subgroup analysis based on length of time showed that antidepressants could decrease the incidence of PSD in short term (OR=0.11, 95%CI 0.06 to 0.19, P<0.000 01), middle term (OR=0.31, 95%CI 0.21 to 0.46, P<0.000 01) and long term (OR=0.30, 95%CI 0.19 to 0.49, P<0.000 01). In addition, there was no statistical difference in the incidence of adverse effect between the antidepressants group and the control group (P>0.05). ConclusionAntidepressants is effective in the prevention of PSD, and may not affect patient's life quality. Due to the limited quantity and quality of included studies, more high quality studies are needed to verify the above conclusion.
Objective To systematically review the relationship between the expression of Survivin mRNA and ovarian cancer. Methods PubMed, The Cochrane Library (Issue 11, 2016), CBM, CNKI, VIP and WanFang Data databases were searched to identify case-control studies concerning the association between the expression of Survivin mRNA and ovarian cancer up to November 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.2 software. Results A total of 10 studies were included. The positive of Survivin mRNA in ovarian cancer group was significantly higher than that in control group (OR=24.63, 95% CI 13.44 to 45.15,P<0.000 01). The positive of Survivin in low differentiated group was significantly higher than that in high differentiation group (OR=3.69, 95% CI 2.29 to 5.93,P<0.000 01). The positive of Survivin in clinical stage of Ⅲ-Ⅳ was significantly higher than that in clinical stage of Ⅰ-Ⅱ (OR=4.76, 95% CI 2.99 to 7.57,P<0.000 01), respectively. However, the expression of Survivin mRNA was not associated with lymph node metastasis, ascites and histological type. Conclusion The current evidence indicates that the expression of Survivin mRNA is significantly correlated with ovarian cancer and its clinicopathologic features. Due to the limited quantity and quality of includes studies, the above conclusions are needed to be verified by more high quality studies.
Objective To evaluate the efficacy and safety of melatonin as an adjuvant therapy for the tumor patients receiving chemotherapy or radiotherapy. Methods Such databases as MEDLINE (1980 to Jan. 2010), The Cochrane Library (Issue 4, 2009), WanFang Data (1980 to Jan. 2010), CBM (1980 to Jan. 2010), CNKI (1980 to Jan. 2010), ELSEVIER ScienceDirect (SDOS, 1980 to Jan. 2010), Nature (1980 to Jan. 2010) and ongoing clinical trials (www.clinicaltrials.gov and www.controlled-trials.com) were searched to collect randomized controlled trials (RCTs). The data were extracted and the quality of the included RCTs was assessed by two reviewers. Then meta-analyses were performed by using Stata 10.1 software. Results Eight RCTs were included. The results of meta-analyses showed that melatonin significantly improved the remission rate for tumor patients (RR=1.98, 95% CI 1.52 to 2.58) and the one-year survival rate (RR=1.90, 95%CI 1.28 to 2.83), and significantly reduced the toxic effects of bone marrow suppression caused by chemotherapy or radiotherapy (RR=0.12, 95%CI 0.06 to 0.27). No reports of adverse events were associated with melatonin. Conclusion The existing evidence reveals that the melatonin, as an adjuvant therapy drug for tumor, plays a certain role in improving disease remission rate, reducing the toxicity of chemotherapy and radiotherapy, and prolonging the life. It requires more high-quality RCTs for further verification because of the limitation of the included studies.
ObjectiveTo systematically evaluate the effect of pars plana vitrectomy (PPV) combined total peeling of internal limiting membrane (ILM) versus fovea-sparing peeling of ILM for myopic foveoschisis. MethodsA evidence-based medicine study. Chinese and English as search terms for myopic foveoschisis, vitrectomy, and peeling of internal limiting membrane were used to search literature in China National Knowledge Infrastructure, Wanfang database, VIP database, PubMed of National Library of Medicine, Medline, Embase, and Cochrane Library. The high myopic macular schisis was selected as the research object, the intervention method was PPV combined with complete ILM peeling and combined with foveal preservation ILM peeling surgery clinical control study between Jan 1, 2010, and Jun 31, 2021. Incomplete or irrelevant literature and review literature were excluded. The method of Newcastle-Ottawa Scale system was used to evaluate the included literature. The literature was meta-analyzed by RevMan5.3 software. The mean difference (MD) and a confidence interval (CI) of 95% were used to describe the effect sizes of continuous data, fixed effects model was performed. The data including the best corrected visual acuity (BCVA), central fovea thickness (CFT), and postoperative macular hole (MH) were analyzed. ResultsIn those databases, 232 articles based search stratery were totally retrieved, and 10 articles (417 eyes) were finally included for meta-analysis with 245 eyes for PPV combined total peeling of ILM and 172 eyes for PPV combined fovea-sparing peeling of ILM. Meta-analysis results showed there was no significant difference in BCVA and CFT between the two groups (BCVA: MD=0.05, 95%CI 0.00-0.11; P＞0.05; CFT: MD=－4.79, 95%CI －18.69-9.11, P＞0.05). It was compared with the incidence of MH, the difference was statistically significant (odds ratio=5.70, 95%CI 2.22-14.61, P＜0.05). ConclusionBCVA and CFT could be improved by PPV combined total and fovea-sparing peeling of ILM for myopic foveoschisis; compared with complete ILM peeling, the incidence of MH was lower after foveal-sparing ILM peeling.
Objective To systematically assess the effectiveness of self-management during adjuvant treatment for breast cancer. Methods Through formulating the inclusion and exclusion criteria and the search strategy, such databases as The Cochrane Library, PubMed (1966 to 2010), OVID, ELSEVIER, CINAHL, EMbase, CNKI (1980 to 2010), WanFang Data, VIP (1989 to 2010) and CBM (1978 to 2010) were searched to collect the randomized controlled trials (RCTs) about postoperative self-management in breast cancer. Two reviewers evaluated the quality of the included studies, extracted and crosschecked the data; the Review Manager 5.0 software was used to perform the test for heterogeneity, and the cumulative effect was calculated with either fixed or random effects models. Results Among the included ten studies in English, three revealed that the program of self-management had no impact on the overall life quality of patients, three revealed that it could enhance the self-care ability of patients (P=0.004), three revealed that it could not reduce the anxiety level of patients, and two revealed that it had certain influence on the depression level of patients. Conclusion The program of self-management can enhance the patients’ self-care ability, but its influence on patients’ overall life quality as well as the level of anxiety and depression is still undefined.
ObjectiveTo systematically review the efficacy of exercise interventions on thoracic kyphosis in adults. MethodsThe PubMed, EMbase, Web of Science, CINAHL, Cochrane Library, CNKI, CBM, WanFang Data and VIP databases were electronically searched to collect randomized controlled trials (RCTs) related to the objective from inception to November 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 RevMan 5.4 software. ResultsA total of 10 RCTs involving 482 patients were included. The results of meta-analysis showed that exercise interventions could reduce kyphosis angle (MD=?5.27, 95%CI ?8.37 to ?2.17, P<0.01) and improve quality of life (SMD=0.78, 95%CI 0.52 to 1.04, P<0.01) in thoracic kyphosis in adults, but there were no significant differences between the two groups in pain and physical function. ConclusionCurrent evidence suggests that exercise interventions can reduce thoracic kyphosis angle and improve quality of life in adults, but the effects on pain and physical function are unclear. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.