The choice of genetic models was main difficulty in the meta-analysis of gene-disease association studies. In this study, we made a further discussion about the genetic model-free approach that proposed by Minelli et al. The program that coded by JAGS and R was carried out to perform the Bayesian procedure. In a real example, several kinds of prior distribution were used, including non-informative prior distribution and external clinical prior information. Especially, compared to Minelli’s study, we introduced clinical prior information. The results indicated that the pooled results were rather robust no matters the prior distribution were non-informative or informative, especially when the number of included studies were large.
ObjectiveTo systematically review the safety of propofol versus sevoflurane for pediatric surgery. MethodsEMbase, PubMed, The Cochrane Library, CSCD, CNKI, WanFang Data were searched to collect randomized controlled trials (RCTs) about propofol versus sevoflurane for pediatric surgery from inception to January 2015. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then metaanalysis was performed by using RevMan 5.3 software. ResultsFifteen RCTs involving 1 065 children were included finally. Meta-analysis results showed that, compared with the sevoflurane group, the propofol group could reduce the incidence of emergence agitation (OR=0.23, 95%CI 0.16 to 0.34, P<0.000 01) and the incidence of postoperative vomiting (OR=0.32, 95%CI 0.20 to 0.51, P<0.000 01). There were no significant differences between the two groups in extubation time (MD=0.98, 95%CI -0.26 to 2.21, P=0.12), eye-opening time (MD=3.32, 95%CI -2.65 to 9.29, P=0.28) and postoperative analgesic requirements (OR=0.60, 95%CI 0.30 to 1.23, P=0.16). ConclusionIn reducing the incidence of emergence agitation and postoperative vomiting, propofol is superior to sevoflurane, so propofol is safer than sevoflurane for children's surgery.
ObjectiveTo systematically review the satisfaction of Chinese residents with the contract services of family doctors. MethodsCNKI, WanFang Data, VIP, PubMed, Web of Science, and EMbase databases were electronically searched to collect cross-sectional studies related to the Chinese residents' satisfaction with the service of family doctors from January 2011 to May 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Meta-analysis was then performed using Stata 14.1 software. ResultsA total of 42 cross-sectional studies were included. The results of meta-analysis showed that the overall satisfaction rate of residents with the contract services of family doctors was 77.7% (95%CI 73.7% to 81.7%). The results of subgroup analysis showed that the satisfaction rate of the male and female residents were 83.0% and 84.3%; <60 and ≥60 years old residents were 83.5% and 81.7%; junior high school or below, senior high school or technical secondary school, junior college or above educational level residents were 84.1%, 76.4% and 81.2%; the monthly income less than 4000 yuan and more than 4000 yuan residents were 78.5% and 79.3%; with and without diseases residents were 85.3% and 79.7%; with and without spouse residents were 80.6% and 82.4%; on and off the job residents were 77.7% and 73.9%; urban and rural residents were 78.7% and 80.0%; in 2011-2015 and 2016-2020 were 67.6% and 76.2%; eastern and western regions residents were 76.5% and 79.7%; relevant studies which were conducted by random sampling and nonrandom sampling were 80.5% and 73.5%. ConclusionsThere is still room for improvement in residents' satisfaction with family doctor contract service. Residents with different education levels, disease situations, on-the-job situations, time, regions and sampling methods have differences in their satisfaction with the contract services of family doctors.
Objective To systematically review the efficacy of total glycosides extracted from Rehmannia glutinosa Libosch leaf in the treatment of diabetic nephropathy. Methods Databases including PubMed, EMbase, MEDLINE, The Cochrane Library, Web of Science, CNKI, WanFang Data and VIP were electronically searched to collect randomized controlled trials of total glycosides from Rehmannia glutinosa Libosch for diabetic nephropathy from inception to May 30th, 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. RevMan 5.4 software was then used to perform meta-analysis. Results A total of 7 RCTs involving 504 patients were included. The results of meta-analysis showed that there were no significant differences in creatinine levels (MD=?1.71, 95%CI ?3.97 to 0.56, P=0.14) and urea (MD=?0.18, 95%CI ?0.44 to 0.08, P=0.19) between the two groups. In terms of regulating proteinuria, the urinary albumin excretion rate (MD=?39.41, 95%CI ?48.46 to ?30.36, P<0.000 01), urinary microalbumin (MD＝?9.94, 95%CI ?12.16 to ?7.73, P<0.000 01), and 24-hour urinary protein (MD=?0.67, 95%CI ?0.85 to ?0.49, P<0.000 01) were all lower in the treatment group compared with control group. However, there were no differences between groups in terms of blood glucose metabolism as indicated by changes in levels of the long-term blood glucose metabolism indicator (HbA1c: MD=?0.16, 95%CI ?0.67 to 0.35, P=0.53). Only one study suggested that short-term blood glucose metabolism indicators, fasting blood glucose and postprandial blood glucose levels were not different between groups. In terms of blood lipid metabolism, only one study suggested glycoside treatment produced lower serum levels of cholesterol and triglycerides compared with control group. Conclusions Current evidence suggests that adjunctive therapy with total Rehmannia glutinosa Libosch glycosides can benefit diabetic nephropathy patients more than angiotensin II receptor inhibitor or pancreatic kininogen by alleviating proteinuria and likely improving lipid metabolism. However, no benefit is observed in terms of renal function improvement or blood glucose metabolism. Due to limited quality and quantity of included studies, more high-quality studies are required to verify the above conclusions.
The comparative diagnostic test accuracy (CDTA) study is an important part of diagnostic test accuracy, which aims to compare the accuracy of two or more index tests in the same study. With the development of CDTA studies and the methodology of systematic reviews, the number of CDTA systematic reviews has grown year by year and has provided evidence to support clinical decision-making. Compared with systematic review of single diagnostic test accuracy, the CDTA systematic review has its own unique features, especially in data extraction, risk of bias, and statistical analysis. This paper introduced the steps and precautions for writing a CDTA systematic review to provide references for CDTA systematic reviewers.
Objective To review evidences of the relationship between olfactory ensheathing cells (OECs) transplantation and motor functional restitution of spinal cord injury (SCI). Methods We searched the CBM, CNKI, VIP and PubMed databases for collecting relative studies published from January 1989 to December 2009. Randomized controlled experiments of treating rats SCI with OECs transplantation were included. Quality of included experiments was assessed by Jadad scale, and the available data were abstracted and meta-analyzed with RevMan 4.2 software. Results A total of 12 randomized controlled experiments were identified. Meta-analysis showed that, OECs group was higher than control group in both BBB score (WMD=1.67, 95%CI 0.99 to 2.36; WMD=3.61, 95%CI 1.97 to 5.26; WMD=6.50, 95%CI 5.76 to 7.24; WMD=4.23, 95%CI 1.19 to 7.28; WMD=1.90, 95%CI 1.22 to 2.58; WMD=3.30, 95%CI 2.63 to 3.97) and MEP latency period (WMD= –?3.98, 95%CI –?5.71 to –?2.25), but there was no statistical significance in SEP latency period or amplitude period (WMD= –?7.13, 95%CI –?16.49 to 2.23; WMD=3.00, 95%CI –?1.12 to 7.11; WMD=1.95, 95%CI –?0.89 to4.78). Conclusions This meta-analysis based on current experiments suggests that OECs transplantation is superior in motor function restitution after spinal cord injury, but is similar as control group in SEP latency or amplitude.
ObjectiveTo systematically review the efficacy and safety of probiotics for the treatment of Helicobacter pylori (H.pylori) infection in children. MethodsWe electronically searched The Cochrane Library, PubMed, EMbase, CNKI, VIP and WanFang Data databases to collect randomized controlled trials (RCTs) about probiotics for the treatment of H.pylori infection in children from inception to January 2015. The references of included studies and conference proceedings were manually searched for additional studies. Two reviewers independently screened literature, extracted data and assessed the risk of bias of include studies. Then, meta-analysis was performed by using RevMan 5.3 software. ResultsA total of twelve RCTs were included, involving 1 227 patients. The result of meta-analysis showed that the probiotics adjuvant therapy group was superior to the control group in H.pylori eradication rates (OR=2.23, 95%CI 1.66 to 2.99, P<0.000 01) and the incidence of adverse effect (OR=0.31, 95%CI 0.18 to 0.53, P<0.000 1). ConclusionCurrent evidence shows that probiotics adjuvant therapy may be a new effective and safe solution in the treatment of H.pylori infections in children. Due to the limited quality and quantity of the included studies, more higher quality studies are needed to verify the above conclusion.
Objective To evaluate the short-term clinical efficacy and safety of 10-Hydroxy-camptothecin （10- HCPT ） chemotherapy on gastrointestinal carcinoma. Methods We searched electronic database including CNKI （ 1995 - 2005 ）, MEDLINE （ 1995 - 2005 ） and The Cochrane Library （ Issue 1, 2005 ）. More related research data were odtained by cantacting with researchers. Randomized controlled trials of gastrointestinal carcinoma chemotherapy comparing only or including 10-HCPT chemotherapy with normal chemotherapy on efficacy rate, digestive and hematology system toxicity were included. Data related to the clinical outcome were extracted by two reviewers independently. Statistical analysis was performed by using RevMan4. 2.2. Results Twenty-five trials including 1 881 patients met the inclusion criteria. The results of meta-analysis were hsted as follows： 10-HCPT could significantly improve the short-term chemotherapy efficacy for colorectal cancer （ RR. 1.62, 95% CI 1.37 to 1.92） and gastric cancer （RR 1.48, 95% CI 1.18 to 1.85）in chemotherapy curative efficacy in short-term. 10-HCPT induced severe toxicity of lower digestive system（RR. 0.96,95% CI 0.62 to 1.50 ） without statistical significance, while severe toxicity of hematology system was significantly higher than that of control with RR 1.27,95% CI 1.02 to 1.58. Conclusions Current evidence suggests that 10-HCPT can improve hematology system short-term chemotherapy efficacy for gastrointestinal carcinoma and increase the incidence of severe toxicity. Further research is needed to value its influence on the prognosis of gastrointestinal carcinoma.
Objective To evaluate the efficacy of statins pretreatment in patients before percutaneous coronary intervention (PCI). Methods Published literature on relevant randomized controlled trials (RCTs) were retrieved via electronic and handsearch in databases CNKI, CBM, MEDLINE and The Cochrane Library from January 1990 to May 2011. The references of these articles were also retrieved. Two reviewers independently identified articles according to the inclusion and exclusion criteria, extracted the data, assess the quality of the included studies, and then conducted meta-analysis using RevMan 5.0 software. Results A total of 10 trials involving 3 012 patients were included. The results of meta-analyses showed that: during the periprocedural period, the trial group had a lower incidence than the control group (98 of 1 514 cases, incidence 6.5%) in periprocedural myocardial infarction with a significant difference (OR=0.43, 95% CI 0.34 to 0.56, Plt;0.000 01). The composite of death, myocardial infarction, or target vessel revascularization in one month, essentially driven by periprocedural myocardial infarction, was reported 6.8% in the trial group and 15.1% in the control group (OR=0.41, 95% CI 0.32 to 0.53, Plt;0.000 01). Conclusion Current evidence supports the effectiveness of statin pretreatment used to reducing the rate of periprocedural myocardial infarction in patients before receiving PCI.
Objective To systematically evaluate the risk factors and population attributable risk of children leukemia in China, so as to provide references for policy-making. Methods The case-control studies about risk factors of children leukemia in China were searched in PubMed, CNKI, CBM, VIP and WanFang Data from inception to December 2011. According to the inclusion and exclusion criteria, two reviewers independently screened articles, extracted data, and evaluated the quality of the included studies. Then Meta-analysis was performed using STATA 11 and Excel 2003. The pooled odds ratio (OR) and 95% confidence interval (95%CI) of each risk factor were calculated, and the population attributable risk percent (PARP) based on the exposure rate of the risk factors was computed, and published bias was estimated according to the fail-safe number. Results A total of 15 case-control studies were included. The first 5 risk factors related to children leukemia were: dwelling environmental pollution (OR=2.782, 95%CI 2.268 to 3.413), house decoration (OR=2.525, 95%CI 1.736 to 3.673), maternal exposure to chemical hazards (OR=2.428, 95%CI 1.976 to 2.985), family history of tumor (OR=2.212, 95%CI 1.677 to 2.919), and child exposure to electromagnetic field around dwelling (OR=2.144, 95%CI 1.761 to 2.610). Factors with higher PARP were influenza history (37.56%), house decoration history (32.95%), X-ray exposure history (20.47%), and chemical hazards exposure history (17.37%). The fail-safe number showed the results were generally reliable. Conclusion In order to prevent and control children leukemia, positive and effective measures should be taken in the following aspects: strengthening child care, avoiding unnecessary X-ray exposure, and providing good living environment.