Objective To evaluate the efficacy and safety of trimetazidine (TMZ) in the treatment of Stable Angina Pectoris (SAP). Methods Randomized controlled trials (RCTs) on the efficacy and safety of Trimetazidine in treating patients with SAP were retrieved in the following databases as CNKI (1997 to June 2011), WanFang Data (1989 to June 2011), MEDLINE (1966 to June 2011), EMbase (1974 to June 2011), CBM (1989 to June 2011) and Cochrane Central Database (1989 to June 2011). The literature which met the inclusion and exclusion criteria were selected, data were extracted, the quality was evaluated, and meta-analysis was performed by using RevMan 5.0 software. Results A total of 15 RCTs involving 1 500 patients were included. The meta-analysis showed that, compared with the control group, TMZ was significantly superior in the following 5 aspects: the time to 1 mm drop of ST segment (WMD=0.84, 95%CI 0.74 to 0.93, P=0.000 01), duration of doing exercise (WMD=0.82, 95%CI 0.73 to 0.91, P=0.000 01), and time to onset of angina (WMD=1.18, 95%CI 0.87 to 1.50, Plt;0.000 01) in the treadmill test, weekly mean number of angina attacks (WMD= –1.79, 95%CI –1.93 to –1.66, Plt;0.000 01), and weekly side effects between TMZ and the control group (RR=0.83, 95%CI 0.52 to 1.32, P=0.42). Conclusion Based on current studies, TMZ is superior to other medicines in the control group for SAP at present, and it has no significant difference in side effects compared with the control group, so it is regarded as an effective and safe drug. For the quality restrictions and possible publication bias of the included studies, this conclusion needs to be confirmed by more high quality, large sample, multi-center, double blind RCTs.
ObjectiveTo evaluate the association between tumor necrosis factor alpha (TNF-α) gene -308G/A polymorphism and the risk of endometriosis (EM). MethodsDatabases including PubMed, EMbase, CBM, CNKI, VIP, and WanFang Data were searched to collect case-control studies about the association between TNF-α gene -308G/A polymorphism and the risk of EM from inception to October 2014. 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. ResultsA total of seven case-control studies were included, which involved 687 patients and 877 controls. The results of meta-analysis showed that, AA genotype carriers presented 2.06-fold (OR=2.06, 95%CI 1.10 to 3.83, P=0.02) and 1.94-fold (OR=1.94, 95%CI 1.18 to 3.18, P<0.01) higher risk of EM than GG genotype carriers and AG+GG genotype carriers, respectively; but sensitivity analysis showed that the robustness of these results was unstable. No statistical significance was found in the allele model, co-dominant model, and dominant model (A vs. G: OR=1.37, 95%CI 0.87 to 2.17, P=0.18; AG vs. GG: OR=1.09, 95%CI 0.77 to 1.53, P=0.63; AA+AG vs. GG: OR=1.29, 95%CI 0.95 to 1.77, P=0.11). While excluding studies that controls were not in HWE, no significant association was observed in these five genetic models; and no significant association was found in the results of subgroup analysis by ethnicity. ConclusionThe AA genotype of TNF-α gene -308G/A polymorphism might contribute to the risk of EM, but the association between other genotypes and EM susceptibility is unclear. In addition, due to the limited quantity and quality of included studies, more high quality studies are needed to verify the above conclusion.
Objective To evaluate the effectiveness and safety of implanted sustained-release fluorouracil in gastric cancer surgery. Methods Literature search was conducted in the following databases: PubMed, EMbase, The Cochrane Library (Issue 6, 2012), CNKI, VIP and WanFang Data from inception to June, 2012. Randomized controlled trials (RCTs) or quasi-randomized controlled trials on implanted sustained-release fluorouracil for gastric cancer were included. Two reviewers independently identified the literature according to the inclusion and exclusion criteria, and then extracted the data and assessed the quality of the included studies. Then, meta-analysis was conducted using RevMan 5.1 software. Results A total of 7 studies involving 742 patients were included. The results of meta-analysis showed no significant difference in the rate of postoperative complications between the two groups (OR=0.93, 95%CI 0.54 to 1.59, P=0.79), while a significant reduction was found in the recurrence rate in the sustained-release fluorouracil group during 1 to 3 year follow-up (1 year after surgery: OR=0.32, 95%CI 0.22 to 0.46, P=0.02; 2 years after surgery: OR=0.19, 95%CI 0.08 to 0.42, Plt;0.001; 3 years after surgery: OR=0.40, 95%CI 0.24 to 0.67, P=0.004). As for the survival rate, no significant difference was found between the two groups 1 year after surgery (OR=1.98, 95%CI 0.92 to 4.25, P=0.08), while it was significantly higher in the sustained-release fluorouracil group than in the control group 2 to 3 years after surgery (2 years after surgery: OR=2.63, 95%CI 1.17 to 5.91, P=0.02; 3 years after surgery: OR=2.42, 95%CI 1.53 to 3.83, P=0.002). Adverse reaction rates in the sustained-release fluorouracil group were lower than those in the control group, but without significantly differences between the two groups (OR=1.22, 95%CI 0.49 to 3.07, P=0.67). Conclusion Compared with the control group, implanted sustained-release fluorouracil for gastric cancer can significantly reduce the recurrence rate 1 to 2 years after surgery and improve the overall survival rate 2 to 3 years after surgery without increasing the incidences of the postoperative complications and adverse reaction. However, due to the limitation of quantity and quality of the included studies, this conclusion should be further confirmed by more high quality, larger sample and multi-center RCTs.
ObjectivesTo systematically review the efficacy of exercise therapy on functional and activity recovery after anterior cruciate ligament reconstruction (ACL).MethodsPubMed, EMbase, WanFang Data and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy of exercise therapy on functional and activity recovery after ACL from inception to May 2019. 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 602 patients were included. The results of meta-analysis showed that: 1 week (MD=3.07, 95%CI 1.37 to 4.77, P=0.000 4) and 3 weeks (MD=4.53, 95%CI 2.34 to 6.71, P<0.000 1) conventional exercise training rehabilitation effects were better than natural recovery under orthopedic routine care in promoting knee joint function recovery. The recovery effects of over 6 months neuromuscular training was significantly increased compared with conventional rehabilitation (MD=11.48, 95%CI 8.25 to 14.71, P<0.000 01). In addition, there was significant difference between open and closed chain exercise rehabilitation after more than 6 months rehabilitation training (MD=6.77, 95%CI 0.86 to 12.68, P=0.02).ConclusionsThe current evidence shows that over 6 months neuromuscular training significantly enhance the recovery of motor function after anterior cruciate ligament reconstruction. According to different reconstruction methods, individualized rehabilitation program is developed to maximize the recovery of knee joint function. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify above conclusions.
Objective To systematically review the efficacy of noninvasive positive pressure ventilation (NPPV) by helmet in adults with acute respiratory failure. Methods Randomized controlled trials (RCTs) or cohort studies about noninvasive positive pressure ventilation (NPPV) by helmet in adults with acute respiratory failure were retrieved in PubMed, The Cochrane Library (Issue 11, 2016), Web of Science, EMbase, CBM, CNKI and WanFang Data databases from inception to November 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Stata 12.0 software was then used to perform meta-analysis. Results A total of eight studies were included. The results of meta-analysis showed that, NPPV by helmet could significantly reduce the carbon dioxide partial pressure (cohort study: SMD=–0.46, 95%CI –0.75 to –0.18, P=0.001), tracheal intubation rate (RCT: OR=0.36, 95%CI 0.17 to 0.77, P=0.008) and hospital mortality (RCT: OR=0.48, 95%CI 0.24 to 0.98, P=0.044), improve the positive end expiratory pressure (RCT: SMD=1.27, 95%CI 0.87 to 1.67, P<0.05) and respiratory status (RCT: SMD=–0.45, 95%CI –0.81 to –0.08,P=0.017). There was no significant difference in the duration of NPPV(cohort study: OR=–0.20, 95%CI –0.50 to 0.09, P=0.177; RCT: OR=–0.24, 95%CI –0.86 to 0.38, P=0.445). Conclusion NPPV by helmet can reduce the carbon dioxide partial pressure, tracheal intubation rate, hospital mortality and improve the positive end expiratory pressure, respiratory status. But the effects in the duration of NPPV and oxygenation index are uncertain. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify above conclusion.
Objective To systematically review the endometrial receptivity evaluated by transvaginal ultrasound and predict the clinical pregnancy outcome of in vitro fertilization-embryo transfer (IVF-ET). Methods PubMed, The Cochrane Library, EMbase, Web of Science, CNKI, WanFang Data and VIP databases were electronically searched to collect studies on transvaginal ultrasound evaluation of endometrial receptivity to predict the clinical pregnancy outcome of IVF-ET from inception to December 1st, 2021. Two researchers independently screened literature, extracted data and evaluated the risk of bias of the included studies. RevMan 5.4 software and Stata 16.0 software were used to perform meta-analysis. Results A total of 24 cohort studies and 1 case-control study were included. The total sample size was 6 632 cases, including 3 340 in non-pregnancy group and 3 292 in pregnancy group. The results of meta-analysis showed that there was no difference in endometrial volume (MD=?0.11, 95%CI ?0.33 to 0.11, P=0.34) or uterine artery S/D (MD= ?0.04, 95%CI ?0.17 to 0.09, P=0.55) between the two groups. The endometrial thickness measured on human chorionic gonadotrophin (HCG) day in the non-pregnant group (MD=?0.48, 95%CI ?0.77 to ?0.18, P=0.001) was thinner than that in the pregnant group. On embryo transfer (ET) day, uterine artery pulsatility index (PI) (MD=0.08, 95%CI 0.02 to 0.15, P=0.01) and resistance index (RI) (MD=0.01, 95%CI 0.01 to 0.01, P<0.000 01) were higher than those in the pregnancy group. Conclusion Endometrial volume and uterine artery S/D measured during IVF-ET were not correlated with clinical pregnancy outcome, while endometrial thickness measured on HCG day and uterine artery PI and RI measured on ET day were correlated with clinical pregnancy outcome. Transvaginal ultrasound evaluation of endometrial receptivity has a certain predictive value for clinical pregnancy outcome of IVF-ET. Due to the limited quality and quantity of included studies, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo systematically review the association between PVT1 expression and digestive system tumors (DST). MethodsPubMed, EMbase, Web of Science, The Cochrane Library, CBM, and CNKI databases were electronically searched to collect case-control studies on the correlation between PVT1 expression and DST from inception to June 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Meta-analysis was then performed by using Stata 16.0 software. ResultsA total of 34 case-control studies involving 3 882 DST patients were included. The results of meta-analysis showed that the high expression of PVT1 was significantly associated with tumor size (>5 cm), differentiation degree (poor), T stage (T3-T4), lymph node metastasis (N+), distant metastasis (M+), and clinical stages (Ⅲ-Ⅳ) of DST; however, it was not associated with gender, age and venous invasion. In addition, the high expression of PVT1 in DST tissues was significantly correlated with the low rates of 1, 3 and 5-year overall survival and poor prognosis (HR=1.96, 95%CI 1.70 to 2.26, P<0.000 1). Subgroup analysis showed that the high expression of PVT1 was significantly associated with poor prognosis of gastric cancer, colorectal cancer, pancreatic cancer and liver cancer.ConclusionsCurrent evidence shows that the high expression of PVT1 is correlated with the clinic pathological features (tumor size >5 cm, poor differentiation, T3-T4 stage, lymph node metastasis, distant metastasis, and clinical stage Ⅲ-Ⅳ) and indicates poor prognosis in most patients with DST (gastric cancer, colorectal cancer, pancreatic cancer, liver cancer).
R software is a free and powerful statistical tool, including Metafor, Meta as well as Rmeta packages, all of which could conduct meta-analysis. Metafor package provides functions for meta-analyses which include analysis of continuous and categorical data, meta-regression, cumulative meta-analysis as well as test for funnel plot asymmetry. The package can also draw various plots, such as forest plot, funnel plot, radial plot and so forth. Mixed-effects models (involving single or multiple categorical and/or continuous moderates) can only be fitted with Metafor packages. Advanced methods for testing model coefficients and confidence intervals are also implemented only in this package. This article introduces detailed operation steps of Metafor package for meta-analysis using cases.
Objective To conduct Meta-analyses on published literatures about the Jianpi Bushen Decoction combined with western medicine for dysfunctional uterine bleeding (DUB), so as to evaluate its efficacy and safety compared with the western medicine treatment. Methods The following databases such as PubMed (1995 to 2011), EMCC (1995 to 2011), CBM (1995 to 2011), CNKI (1995 to 2011), Wanfang (1989 to 2011) and VIP (1989 to 2011) were searched to collect the randomized controlled trials (RCTs) on Jianpi Bushen Decoction combined with western medicine for DUB. The selection of studies, assessment of methodological quality and data extraction were performed independently by two reviewers according to the Cochrane systematic review methods, and Meta-analyses were performed by using RevMan5.0 software. Results A total of 12 RCTs involving 925 cases were included, of which 471 ones were in the experimental group while the other 454 ones were in the control group. Each study was comparable in baseline data, all with reporting of using random methods, but no mention of detailed random methods, blind methods and allocation concealment. The results of Meta-analyses indicated that compared with single therapy of western medicine, Jianpi Bushen Decoction combined with western medicine for DUB was superior in the total effective rate (OR=5.60, 95%CI 3.25 to 9.67, Plt;0.000 01), bleeding recovery rate (OR=3.79, 95%CI 2.70 to 5.32, Plt;0.000 01), and bleeding recurrence rate (OR=0.14, 95%CI 0.05 to 0.42, P=0.000 5), with significant differences. Conclusions The integrated treatment of Jianpi Bushen Decoction and western medicine has certain effects on dysfunctional uterine bleeding, and it may be a promising treatment option. Due to the poor quality and high possibility of bias of the included studies, more well-designed multi-centered RCTs should be performed.
Objectives To systematically review the prevalence of sleep disorders in Chinese elderly population. Methods CNKI, Wanfang, VIP, PubMed and Web of Science were searched to collect studies on the prevalence of sleep disorders the Chinese elderly from January 2000 to November 2017. Two reviewers independently screened literatures, extracted data and evaluated risk of bias of the included studies, then meta-analysis was performed by Stata 14.0 software. Results A total of 19 cross-sectional studies were included. The results of the meta-analysis showed that, the overall prevalence of sleep disorders was 41.2% (95% CI 36.2% to 46.2%). Male and female prevalence rates were 35.7% and 45.0%, respectively. For individuals aged between 60 to 70, 70 to 80 and above 80, the prevalence rates were 29.9%, 42.0%, 44.2%, respectively. For individuals with primary school education and below, junior/high school education, college degree or above, the prevalence rates were 29.0%, 23.1%, 22.4%, respectively. The prevalence rate of individuals with normal marital status was 31.5%, and those with abnormal marital status (widowed, divorced, single, etc.) was 41.0%. The prevalence rate in individuals with in people with physical illness was 45.7%, and those without physical illness was 32.4%. For the urban population, the prevalence rate was 36.4%, while for the rural population, the prevalence rate was 42%. Conclusions The overall prevalence of sleep disorders in the Chinese elderly is high. The prevalence rate of sleep disorders among gender, age, educational level, marital status, physical illness, and living space is different.