Brain-derived neurotrophic factor is a crucial neurotrophic factor that plays a significant role in brain health. Although the vast majority of meta-analyses have confirmed that exercise interventions can increase bra...Brain-derived neurotrophic factor is a crucial neurotrophic factor that plays a significant role in brain health. Although the vast majority of meta-analyses have confirmed that exercise interventions can increase brain-derived neurotrophic factor levels in children and adolescents, the effects of specific types of exercise on brain-derived neurotrophic factor levels are still controversial. To address this issue, we used meta-analytic methods to quantitatively evaluate, analyze, and integrate relevant studies. Our goals were to formulate general conclusions regarding the use of exercise interventions, explore the physiological mechanisms by which exercise improves brain health and cognitive ability in children and adolescents, and provide a reliable foundation for follow-up research. We used the Pub Med, Web of Science, Science Direct, Springer, Wiley Online Library, Weipu, Wanfang, and China National Knowledge Infrastructure databases to search for randomized controlled trials examining the influences of exercise interventions on brain-derived neurotrophic factor levels in children and adolescents. The extracted data were analyzed using Review Manager 5.3. According to the inclusion criteria, we assessed randomized controlled trials in which the samples were mainly children and adolescents, and the outcome indicators were measured before and after the intervention. We excluded animal experiments, studies that lacked a control group, and those that did not report quantitative results. The mean difference(MD;before versus after intervention) was used to evaluate the effect of exercise on brain-derived neurotrophic factor levels in children and adolescents. Overall, 531 participants(60 children and 471 adolescents, 10.9–16.1 years) were included from 13 randomized controlled trials. Heterogeneity was evaluated using the Q statistic and I^(2) test provided by Review Manager software. The meta-analysis showed that there was no heterogeneity among the studies(P = 0.67, I^(2) = 0.00%). The combined effect of the interventions was significant(MD = 2.88, 95% CI: 1.53–4.22, P < 0.0001), indicating that the brain-derived neurotrophic factor levels of the children and adolescents in the exercise group were significantly higher than those in the control group. In conclusion, different types of exercise interventions significantly increased brain-derived neurotrophic factor levels in children and adolescents. However, because of the small sample size of this meta-analysis, more high-quality research is needed to verify our conclusions. This metaanalysis was registered at PROSPERO(registration ID: CRD42023439408).展开更多
This study presents a systematic review of xu-based studies in an attempt to clarify the construct of the xu-argument and the effectiveness of continuation tasks in foreign language learning.This review adopted a meta...This study presents a systematic review of xu-based studies in an attempt to clarify the construct of the xu-argument and the effectiveness of continuation tasks in foreign language learning.This review adopted a meta-analytic procedure consisting of effect-size aggregation and moderator analysis.While the former quantitatively synthesized evidence in support of xu-based interventions,the latter contextualized evidence in relation to learner and task features.Meta-analytic results indicated a medium-to-large effect of xu-based interventions for foreign language learning(g=1.18 and g=0.49 for within-group and between-group contrasts respectively).This effect was comparatively larger for(a)university-level students,(b)multilingual settings,(c)foreign languages other than English(LOTEs),(d)longer instructional treatments,and(e)specific language features.We interpret supportive evidence for xu-based interventions with respect to theoretical,methodological and pedagogical relevance,and provide empirically grounded recommendations for future task design and research on xu-based practices.展开更多
Background:Bacterial pneumonia continues to be a significant global health concern,particularly among high-risk groups,necessitating the development of precise and early diagnostic biomarkers.While the efficacy of pro...Background:Bacterial pneumonia continues to be a significant global health concern,particularly among high-risk groups,necessitating the development of precise and early diagnostic biomarkers.While the efficacy of procalcitonin(PCT)and C-reactive protein(CRP)as inflammatory markers is widely recognized,their relative diagnostic performance across different age groups remains debate.This meta-analysis was designed to assess the diagnostic accuracy of PCT and CRP in bacterial pneumonia.Methods:In this meta-analysis adhering to PRISMA guidelines,we searched PubMed,Web of Science,and the Cochrane Library for relevant diagnostic accuracy studies.From 19 included studies(n=2,603),data were extracted to construct tables.Study quality was assessed with the QUADAS-2 tool.The bivariate random-effects model was employed to derive pooled sensitivity,specificity,positive and negative likelihood ratios,and summary AUCs.To explore the substantial heterogeneity(I^(2)>80%),we performed pre-specified subgroup analyses based on age demographics.Results:Our findings indicate superior diagnostic performance for PCT,evidenced by a pooled sensitivity of 0.8841 and specificity of 0.8499,relative to CRP’s sensitivity of 0.8371 and specificity of 0.7185.The area under the ROC curve(AUC)for PCT was 0.992,a value significantly higher than that of CRP(0.987).Intriguingly,subgroup analyses revealed age-dependent variations:CRP demonstrated enhanced diagnostic utility in minors,while PCT proved substantially more effective in non-elderly adults.Conclusion:These results reinforce the clinical relevance of PCT as a more dependable biomarker for bacterial pneumonia,particularly in informing antibiotic treatment and mitigating misuse.This study uniquely includes age-stratified analyses based on predefined groups(minors and non-elderly adults),providing refined insights for individualized diagnostic approaches.We propose further multicenter research endeavors to confirm threshold optimization and explore combined biomarker strategies.展开更多
BACKGROUND Previous research yielded conflicting results regarding the association between prediabetes and colorectal cancer(CRC).AIM To systematically assess the incidence of CRC in individuals with prediabetes compa...BACKGROUND Previous research yielded conflicting results regarding the association between prediabetes and colorectal cancer(CRC).AIM To systematically assess the incidence of CRC in individuals with prediabetes compared with individuals with normoglycemia via a meta-analysis.METHODS Relevant cohort studies were acquired by searching MEDLINE,Web of Science,and EMBASE.A random-effects model was applied to combine the findings after accounting for heterogeneity.Several subgroup analyses were conducted to assess the impact of study characteristics on the results.RESULTS Eleven cohort studies involving 4996352 participants,including 383917(7.7%)with prediabetes at baseline,were analyzed in this meta-analysis.Over a mean follow-up period of 6.5 years,the combined findings revealed that individuals with prediabetes at baseline had a higher likelihood of developing CRC than those with normoglycemia[risk ratio(RR)=1.18,95%confidence interval=1.11 to 1.25,P<0.001]with low statistical heterogeneity(I2=27%).Subgroup analyses indicated that the association between prediabetes and an increased risk of CRC was mainly observed in studies defining prediabetes using impaired fasting glucose(RR=1.24)and slightly elevated hemoglobin A1c levels(RR=1.18)but not in those that defined prediabetes using impaired glucose tolerance(RR=1.06).Other study characteristics such as design,country,participant age and sex,the duration of follow-up,or adjustment for body mass index did not significantly impact the results(all P>0.05).CONCLUSION People with prediabetes might have a higher likelihood of developing CRC than individuals with normoglycemia.展开更多
BACKGROUND Diabetic foot ulcers(DFUs)are a major complication of diabetes mellitus,and anemia is commonly observed in diabetic patients.However,the relationship between anemia and the risk of developing DFUs remains u...BACKGROUND Diabetic foot ulcers(DFUs)are a major complication of diabetes mellitus,and anemia is commonly observed in diabetic patients.However,the relationship between anemia and the risk of developing DFUs remains unclear.AIM To investigate the relationship between anemia and the risk of DFUs in diabetic patients through a meta-analysis.METHODS A systematic search was conducted across PubMed,Embase,and Web of Science databases to identify studies that reported the co-occurrence of anemia and DFUs in diabetic patients.The primary outcome was an association between anemia and DFU risk,expressed as odds ratios(ORs).Secondary outcomes included the risk of DFU per 1-g/dL decrease in hemoglobin and the difference in hemoglobin le-vels between patients with and without DFU.Statistical analyses were performed using random-effects models to account for heterogeneity.RESULTS Sixteen studies involving 170,949 diabetic patients were included in the analysis.The results indicated a significant association between anemia and an increased risk of DFUs(eight studies,n=166173,OR:2.72,95%CI:1.73–4.25,P<0.001;I2=93%).Subgroup analyses sup-ported consistent findings across various patient characteristics,analytic models,and study quality scores(P for subgroup differences,all>0.05).Additionally,each 1-g/dL decrease in hemoglobin was associated with an excess risk of DFUs(four studies,n=2543,OR:1.65,95%CI:1.21–2.27,P=0.002;I2=68%).Furthermore,diabetic patients with DFUs exhibited significantly lower hemoglobin levels compared to those without DFUs(nine studies,n=3986,mean difference:-2.13 g/dL,95%CI:-2.58 to-1.68,P<0.001;I2=90%).CONCLUSION Anemia can be associated with an increased risk of DFUs in diabetic patients.Monitoring and managing anemia in diabetic population may help mitigate the risk of DFUs,emphasizing the need for early interventions.Further research is required to investigate the underlying mechanisms and potential therapeutic strategies.展开更多
Background:Sleeve lobectomy(SL)presents an attractive option compared to pneumonectomy(PN)for patients with central or locally advanced non-small cell lung cancer(NSCLC).This study aimed to assess the advantages of SL...Background:Sleeve lobectomy(SL)presents an attractive option compared to pneumonectomy(PN)for patients with central or locally advanced non-small cell lung cancer(NSCLC).This study aimed to assess the advantages of SL over PN for NSCLC via a meta-analysis.Methods:We performed a systematic review and cumulative analysis of comparative studies that reported both postoperative and survival outcomes for SL and PN.This was accomplished through a thorough search of electronic databases,including PubMed,EMBASE,and the Cochrane library,from inception to April 2023.Results:A total of 5727 patients(SL:1945;PN:3782)from thirty-one studies were analyzed.The meta-analysis focused on perioperative mortality,local recurrence,and overall survival.The SL group exhibited a significantly lower rate of perioperative mortality(OR=0.43,95%CI=0.32–0.60,P<0.0001).However,no significant difference was observed in local recurrence rates between SL and PN(OR=1.25;95%CI,0.92 to 1.69;P=0.16).Additionally,the survival rates at 1 year and 5 years in the SL cohort(1-year:0.14,95%CI:0.12 to 0.17,p<0.0001;5-year:2.15,95%CI:1.77 to 2.61,p<0.0001)along with the survival in patients with pN0 or pN1 at 5 years(OR=0.13,95%CI 0.04 to 0.22;P=0.006)were notably superior compared to those undergoing PN.Conclusions:Sleeve lobectomy should be regarded as a viable alternative to pneumonectomy for treating NSCLC.展开更多
BACKGROUND Schizophrenia is a chronic psychiatric condition with complex symptomatology,including debilitating auditory hallucinations.Transcranial direct current stimulation(tDCS)has been explored as an adjunctive tr...BACKGROUND Schizophrenia is a chronic psychiatric condition with complex symptomatology,including debilitating auditory hallucinations.Transcranial direct current stimulation(tDCS)has been explored as an adjunctive treatment to alleviate such symptoms.AIM To evaluate the therapeutic efficacy of tDCS in schizophrenia.METHODS Adhering to PRISMA guidelines,we systematically searched PubMed,Embase,Web of Science,and the Cochrane Library on September 19,2023,for randomized controlled trials examining the efficacy of tDCS in schizophrenia,with no language or time restrictions.We included studies that compared tDCS with a control condition and reported clinically relevant outcomes.Data extraction and quality assessments were performed by independent evaluators using the Cochrane Collaboration's risk of bias tool.Statistical heterogeneity was evaluated,and a random-effects model was applied due to moderate heterogeneity(I2=41.3%).RESULTS Nine studies comprising 425 participants(tDCS group:219,control group:206)were included.The meta-analysis demonstrated a significant reduction in auditory hallucination scores following tDCS treatment(weighted mean difference:-2.18,95%confidence interval:-4.0 to-0.29,P<0.01).Sensitivity analysis confirmed the robustness of the results,with no significant influence from individual studies.Additionally,publication bias was not detected,supporting the reliability and generalizability of the findings.These results underscore the efficacy of tDCS as a therapeutic intervention for auditory hallucinations in schizophrenia.CONCLUSION tDCS significantly reduces auditory hallucinations in schizophrenia,suggesting its potential as an effective adjunctive treatment for managing this disabling symptom.The findings highlight the practical significance of tDCS in clinical settings,particularly for patients with treatment-resistant auditory hallucinations.展开更多
BACKGROUND Pelvic fractures are often associated with significant morbidity,including injuries to the urinary tract.Understanding the incidence and risk factors for urinary tract injury in these patients is crucial fo...BACKGROUND Pelvic fractures are often associated with significant morbidity,including injuries to the urinary tract.Understanding the incidence and risk factors for urinary tract injury in these patients is crucial for prompt diagnosis and management.This meta-analysis aims to synthesize existing evidence to determine the overall incidence and identify specific risk factors associated with urinary tract injuries in patients with pelvic fractures.AIM To determine the incidence and risk factors for urinary tract injuries in patients with pelvic fractures.METHODS A systematic search of PubMed,EMBASE,Scopus,and the Cochrane Library was conducted without date restrictions.Studies examining the incidence and risk factors of urinary tract injuries in patients with pelvic fractures were included.Data extracted included demographics,injury mechanism,pelvic fracture type,urinary tract injury incidence,mortality,and discharge disposition.Review Manager 5.4 was used for data analysis.RESULTS Ten studies comprising 22700 patients were included.The pooled incidence of urinary tract injury associated with pelvic fracture was 6.88%(95%CI:6.20%-7.55%).Vehicle,motorcycle,and pedestrian accidents were identified as risk factors for urinary tract injury,with relative risks(RR)of 1.08(95%CI:1.06-1.11),1.89(95%CI:1.78-2.00),and 1.53(95%CI:1.20-1.95),respectively.Pubic fracture and pelvic ring disruption were significantly associated with urinary tract injury[odds ratio(OR)1.94,95%CI:1.09-3.44 and OR 5.53,95%CI:4.67-6.54,respectively)].Patients without urinary tract injury were more likely to be discharged home(RR 0.79,95%CI:0.67-0.92).Mortality was higher in patients with urinary tract injury(OR 1.92,95%CI:1.77-2.09).CONCLUSION Urinary tract injury occurs in nearly 7%of patients with pelvic fractures.Motorcycle accidents,pubic fractures,and pelvic ring disruptions are significant risk factors.Urinary tract injury following pelvic fracture is associated with increased mortality.展开更多
Desertification is a global crucial ecological and environmental issue,and China is among the countries most seriously affected by desertification.In recent decades,numerous independent studies on desertification dyna...Desertification is a global crucial ecological and environmental issue,and China is among the countries most seriously affected by desertification.In recent decades,numerous independent studies on desertification dynamics have been carried out using remote sensing technology,but there has been a lack of systematic research on desertification trends in China.This study employed the meta-analysis to integrate the findings of 140 published research cases and examined the dynamics of desertification in the eight major deserts,four major sandy lands,and their surrounding areas in China from 1970 to 2019,with a comparative analysis of differences between the eastern(including the Mu Us Sandy Land,the Otindag Sandy Land,the Hulunbuir Sandy Land,the Horqin Sandy Land,and the Hobq Desert)and western(including the Taklimakan Desert,the Gurbantunggut Desert,the Kumtagh Desert,the Ulan Buh Desert,the Qaidam Basin Desert,the Badain Jaran Desert,and the Tengger Desert)regions.The results revealed that from 1970 to 2019,desertification first expanded and then reversed in the whole region.Specifically,desertification expanded from 1980 to 1999 and reversed after 2000.The desertification trend exhibited distinct spatio-temporal variations between the eastern and western regions.From 1970 to 2019,the western region experienced relatively minor changes in desertified land area compared to the eastern region.In the context of global climate change,beneficial climatic conditions and ecological construction projects played a crucial role in reversing desertification.These findings provide valuable insights for understanding the development patterns of desertification in the most representative deserts and sandy lands in China and formulating effective desertification control strategies.展开更多
BACKGROUND Hypoxia-inducible factor 1α(HIF-1α)plays a crucial role in the prognosis of breast cancer,but the current evidence remains inconclusive.AIM To provide comprehensive evidence about the correlation of alter...BACKGROUND Hypoxia-inducible factor 1α(HIF-1α)plays a crucial role in the prognosis of breast cancer,but the current evidence remains inconclusive.AIM To provide comprehensive evidence about the correlation of altered HIF-1αexpression with overall survival(OS)and disease-free survival(DFS)in breast cancer patients.METHODS A systematic search was conducted in PubMed,Embase,and Web of Science databases to collect relevant articles that were published before April 8,2024.A meta-analysis was used to assess the impact of altered HIF-1αexpression on the OS and DFS of breast cancer patients.Subgroup and sensitivity analyses were also performed in this meta-analysis.RESULTS This meta-analysis included 40 studies.The average percentage of breast cancer patients with high HIF-1αexpression was 39.6%.The overall meta-analysis results demonstrated that high HIF-1αexpression is strongly linked to poor outcomes in patients of breast cancer.Compared with low HIF-1αexpression,the overall hazard ratio for OS in patients with high HIF-1αexpression was 1.47[95%confidence interval(CI):1.29-1.69],and the overall hazard ratio for DFS was 1.82(95%CI:1.56-2.12).Furthermore,both OS[1.18(95%CI:1.01-1.38)]and DFS[1.79(95%CI:1.03-3.11)]were markedly shorter in triple-negative breast cancer cases with high HIF-1αexpression.Subgroup analysis revealed that the antibody used to detect HIF-1αexpression affected only the correlation linking HIF-1αexpression to DFS in breast cancer patients(P=0.0004).Furthermore,the sensitivity analysis demonstrates that the overall conclusions of the meta-analysis were unaffected by the removal of individual studies.CONCLUSION Compared to patients with low HIF-1αexpression,those with high expression level had shorter OS and DFS.However,the prognostic significance of high HIF-1αexpression varies across molecularly stratified breast cancer cohorts needs to be further elucidated.展开更多
BACKGROUND Gestational diabetes mellitus(GDM)poses a substantial health risk during pregnancy.However,the role of myo-inositol(MI)in GDM prevention and management remains controversial due to conflicting evidence and ...BACKGROUND Gestational diabetes mellitus(GDM)poses a substantial health risk during pregnancy.However,the role of myo-inositol(MI)in GDM prevention and management remains controversial due to conflicting evidence and methodological limitations in previous studies.AIM To assess the efficacy of MI in preventing and treating GDM,providing evidencebased guidance for clinical practice.METHODS A systematic review was conducted on studies published on the PubMed,Web of Science,and Embase databases from their inception date to July 2024.Twelve studies encompassing 9018 patients were included in the meta-analysis using fixed-effect and random-effects models.Heterogeneity was quantified with I2 statistics and the Cochrane Q test,and study quality was appraised using the A Measurement Tool to Assess Systematic Reviews 2 checklist.RESULTS MI significantly reduced GDM incidence[relative risk(RR):0.37;95%confidence interval(CI):0.32-0.42],fasting blood glucose[standard mean differences(SMD):-1.31 mg/dL;95%CI:-1.83 to-0.79],and improved glucose tolerance test outcomes at 1-hour(SMD:-2.63 mg/dL;95%CI:-3.87 to-1.40)and 2-hour(SMD:-0.95 mg/dL;95%CI:-1.56 to-0.34).It also decreased the risk of preterm birth(RR:0.37;95%CI:0.28-0.47)and pregnancy-induced hypertension(RR:0.34;95%CI:0.25-0.47).A non-significant trend towards reduced cesarean section rates was observed(RR:0.82;95%CI:0.71-0.94).MI reduced birth weight(SMD:-0.25 kg;95%CI:-0.32 to-0.17),but had no effect on neonatal hypoglycemia(RR:0.30;95%CI:0.08-1.21)or gestational age at birth(SMD:-0.13 weeks;95%CI:-0.04 to 0.29).CONCLUSION MI demonstrates therapeutic potential in GDM prevention and management,supporting its potential use as a preventive supplement in early pregnancy for high-risk women.Nonetheless,its therapeutic effects in women diagnosed with GDM require further validation.展开更多
BACKGROUND Hepatocellular carcinoma(HCC)is one of the most common malignancies,with high recurrence rates after treatment.Identifying reliable biomarkers for predicting recurrence is essential for improving patient ou...BACKGROUND Hepatocellular carcinoma(HCC)is one of the most common malignancies,with high recurrence rates after treatment.Identifying reliable biomarkers for predicting recurrence is essential for improving patient outcomes.Hepatitis B corerelated antigen(HBcrAg)has shown potential as a predictive marker for HCC recurrence.AIM To evaluate the association between HBcrAg levels and the risk of HCC recurrence.METHODS A systematic review was conducted following PRISMA guidelines.PubMed,EMBASE,Web of Science,and the Cochrane Library were searched without restrictions on date or language.Observational studies reporting hazard ratios(HRs)for HBcrAg as a predictor of HCC recurrence were included.Data extraction and quality assessment were performed independently by two reviewers.Statistical analyses used a random-effects model to account for heterogeneity(I²≥50%),and sensitivity analysis was performed to ensure the robustness of the results.RESULTS A total of 1339 articles were initially identified,and 17 studies were included in the final meta-analysis after screening.The pooled analysis showed a significant association between elevated HBcrAg levels and HCC recurrence(HR=4.42,95%confidence interval:3.43-5.41)with substantial heterogeneity(I²=92.6%).Subgroup analysis revealed higher pooled HRs in studies with≥500 participants(HR=4.18)and HBcrAg cut-offs≥4.0 LogU/mL(HR=5.29).Studies with≥10 years of follow-up showed a lower HR(2.89)compared to those with<10 years(3.27).Patients treated with nucleos(t)ide analogs had a pooled HR of 1.98,while those without nucleos(t)ide analog had a higher HR of 3.87.Sensitivity analysis confirmed the robustness of the results,with no significant publication bias detected.CONCLUSION This meta-analysis provides strong evidence that elevated HBcrAg levels are associated with an increased risk of HCC recurrence.HBcrAg may serve as a valuable biomarker for predicting recurrence,aiding personalized management and surveillance strategies for HCC patients.展开更多
BACKGROUND Clostridium difficile infection(CDI)is common in patients with inflammatory bowel disease(IBD).AIM To assess the association of CDI with clinical outcomes of IBD.METHODS PubMed,EMBASE,Web of Science,and the...BACKGROUND Clostridium difficile infection(CDI)is common in patients with inflammatory bowel disease(IBD).AIM To assess the association of CDI with clinical outcomes of IBD.METHODS PubMed,EMBASE,Web of Science,and the Cochrane Library databases were searched from inception to March 2024.Eligible articles included observational studies that reported on outcomes such as mortality,colectomy,hospitalization,intensive care unit(ICU)admission,complication rates,and length of hospital stay in IBD patients with and without CDI.Data were extracted,and a randomeffects model was used to calculate pooled odds ratios(ORs)and mean differences(MDs).RESULTS As shown in the data from 21 studies with 1249158 participants,CDI significantly increased the risk of mortality in IBD patients[pooled OR=4.569,95%confidence intervals(95%CI):2.584 to 8.079].Although the pooled OR for colectomy was 1.409(95%CI:0.922 to 2.155),it was not statistically significant.Similarly,CDI did not impact hospitalization(pooled OR=1.056,95%CI:0.512 to 2.179)and ICU admission outcomes(pooled OR=1.970,95%CI:0.420 to 9.246)of patients with IBD.The rate of complications was comparable in the two groups(pooled OR=0.658,95%CI:0.378 to 1.147).However,CDI was associated with a significantly more extended hospital stay(pooled MD=0.349 days,95%CI:0.002 to 0.696).CONCLUSION CDI is linked to increased mortality and prolonged hospitalization in IBD patients.These results emphasize the need for early detection and appropriate management.Implementing routine CDI screening during IBD flare-ups and stringent infection control measures could mitigate severe complications and reduce the healthcare burden.展开更多
The effect of prenatal exposure to ambient particulate matter(PM)on birth weight varies considerably across studies,and the findings remain inconclusive.In this study,we conducted a meta-analysis to assess the associa...The effect of prenatal exposure to ambient particulate matter(PM)on birth weight varies considerably across studies,and the findings remain inconclusive.In this study,we conducted a meta-analysis to assess the associations between exposure to PM_(2.5) and PM10 and birth weight.A total of 74 studies were identified through searches in Web of Science,PubMed,Embase,and Ovid Medline,as well as manual searches,up to October 2024.We found that for each 10μg/m^(3) increase in PM_(2.5),the risk of low birth weight(LBW)increased significantly during the entire pregnancy(odds ratio[OR]=2.41,95%confidence interval[CI]:1.99–2.91)and in all trimesters.Similarly,for every 10μg/m^(3) increase in PM10 concentration,the risk of LBW increased significantly during the entire pregnancy(OR=1.46,95%CI:1.16–1.84).Subgroup analysis by maternal age for PM_(2.5) showed that mothers aged 30 and above had a significantly higher risk of LBW(OR=3.69,95%CI:2.81–4.84),compared with those under 30.In conclusion,maternal exposure to PM_(2.5) and PM_(10) is associated with an increased risk of LBW across all trimesters.Additionally,mothers aged 30 and above are at a higher risk of LBW,compared with younger mothers.Further research is needed to clarify the biological mechanisms by which PM pollution may contribute to LBW.展开更多
BACKGROUND Gestational diabetes mellitus(GDM)has recently been associated with abnormal profiles of inflammatory cells and cytokines,though the findings remain incon-sistent and unclear.AIM To elucidate the peripheral...BACKGROUND Gestational diabetes mellitus(GDM)has recently been associated with abnormal profiles of inflammatory cells and cytokines,though the findings remain incon-sistent and unclear.AIM To elucidate the peripheral immune status in GDM.METHODS We systematically screened databases including Web of Science,PubMed,and EMBASE for eligible studies.Original articles reporting different immune cell levels in GDM compared to normal glucose-tolerance pregnant women were included to extract usable data.The pooled mean difference(MD)with 95%confidence interval(CI)was analyzed as the outcome measure.The Newcastle-Ottawa scale was employed to assess study quality.RESULTS A total of 19 studies involving various immune cell subgroups were included in our analysis.Specifically,total CD4+T cells(WMD=3.08;95%CI:0.81-5.35)were significantly increased in GDM groups.In contrast,total lymphocytes(SMD=0.05;95%CI:-0.16 to 0.26),CD3+T cells(SMD=-0.34;95%CI:-1.01 to 0.32),CD8+T cells(SMD=0.21;95%CI:-0.31 to 0.73),and natural killer T(NKT)Cells(SMD=0.83;95%CI:-1.10 to 2.75)showed no significant changes in GDM.Activation markers(HLA-DR+or CD69+)on CD4+T cells(WMD=0.20;95%CI:0.06-0.34)were increased in GDM patients.Treg cells,a classical subgroup of CD4+T cells,showed a decreasing trend in GDM compared to controls(SMD=-0.83;95%CI:-1.31 to-0.34).These results indicate an abnormal immune status in the peripheral profiles of GDM.CONCLUSION GDM may not only be a dysglycemia-related condition but also an immune disorder characterized by abnormal peripheral immune profiles,including higher levels of CD4+T cells and a reduced population of Treg cells.Tr-eating immune dysregulation could be a new direction for GDM management,although further research is needed to understand the precise mechanisms of immune overactivation in GDM.展开更多
Objective:To systematically evaluate the effectiveness of research-oriented integrated nursing interventions on cancer pain management in hospitalized oncology patients in China.Methods:A computerized search of Chines...Objective:To systematically evaluate the effectiveness of research-oriented integrated nursing interventions on cancer pain management in hospitalized oncology patients in China.Methods:A computerized search of Chinese and English databases was conducted to identify relevant studies.Two researchers independently assessed the quality of included literature using the Newcastle-Ottawa Scale(NOS).Data were extracted and analyzed via Stata 14.A random-effects model was applied due to significant heterogeneity(I²>50%).Sensitivity analysis and Egger’s test were performed to assess bias.Results:12 eligible studies(2014-2024)were included.Meta-analysis demonstrated that integrated nursing interventions significantly reduced cancer pain scores compared to routine care(SMD=-1.51,95%CI:-1.90 to-1.12;I²=84.8%),with superior efficacy.Subgroup-analyses revealed enhanced effects for“Nursing modes”(SMD=-2.11)and“cancer pain education”(SMD=-2.30).Conclusion:Research-oriented integrated nursing interventions significantly improve cancer pain management in Chinese hospitalized oncology patients,particularly through synergistic effects of“Nursing modes”and“can-cer pain education.”However,implementation bias from“additive interventions”in teaching hospitals and high heterogeneity warrant attention.Future studies should optimize designs to enhance clinical applicability.展开更多
AIM:To summarize and quantitatively evaluate vasculature alteration of foveal zone in systemic lupus erythematosus(SLE)patients by secondary literature analysis.METHODS:A systematic search of PubMed,Embase,Web of Scie...AIM:To summarize and quantitatively evaluate vasculature alteration of foveal zone in systemic lupus erythematosus(SLE)patients by secondary literature analysis.METHODS:A systematic search of PubMed,Embase,Web of Science,Cochrane Library,CBM,CNKI WanFang Data and VIP was conducted.Studies were about retinal vessel density in SLE patients from January 2000 to April 2023 and valid data were extracted.The Joanna Briggs Institute(JBI)critical appraisal checklist was used to evaluate the cross-sectional studies and prospective studies.The measurement data for combined effect size were weighted mean difference(WMD)and 95%confidence interval(CI).The heterogeneity was evaluated by I2 test.The fixed-effect model was adopted when P>0.1 or I2<50%,and random-effect model was adopted in the contrary.Subgroup and sensitivity analysis were utilized to analyze the sources of heterogeneity.The publication bias was evaluated by Egger tests and funnel plots.RESULTS:A total of 14 studies with 445 subjects and 441 healthy controls from 9 countries were enrolled and 11 studies were included in Meta-analysis.The JBI scores of studies were no less than 14 points.The Metaanalysis results indicated that mean parafoveal superficial vessel density(SVD;WMD=-1.22,95%CI:-1.67,-0.76),mean perifoveal SVD(WMD=-1.42,95%CI:-1.95,-0.89),mean whole SVD(WMD=-1.66,95%CI:-2.53,-0.79),mean parafoveal deep vessel density(WMD=-1.67,95%CI:-2.75,-0.59)and mean whole deep vessel density(WMD=-4.09,95%CI:-7.67,-0.52)was significantly lower than the control,while mean foveal SVD(WMD=-1.71,95%CI:-4.65,1.24),mean foveal avascular zone(FAZ)area(WMD=0.04,95%CI:-0.01,0.09)and mean acircularity index(AI;WMD=0.00,95%CI:-0.02,0.02)were not different between SLE patients and controls.Subgroup analysis indicated that the heterogeneity in SVD was partially due to the scanning area.Ocellus or binoculus data contributed partially to the heterogeneity in parafoveal deep vessel density and FAZ area.Sensitivity analysis indicated that the results were robust after changing the analysis model except for foveal SVD and FAZ area.There was no bias in included studies except whole SVD.CONCLUSION:Parafoveal superficial and deep vessel density are significantly lower in SLE patients while FAZ area and AI are not different between SLE patients and the control.展开更多
BACKGROUND Enhanced recovery after surgery(ERAS),a multidisciplinary and multimodal perioperative care protocol,has been widely used in several surgical fields.However,the effect of this care protocol on liver transpl...BACKGROUND Enhanced recovery after surgery(ERAS),a multidisciplinary and multimodal perioperative care protocol,has been widely used in several surgical fields.However,the effect of this care protocol on liver transplant recipients with endstage liver disease remains unclear.AIM To compare the clinical outcomes of the ERAS protocol and standard care(SC)for liver transplant recipients with end-stage liver disease.METHODS PubMed,Web of Science,Cochrane Library,and EMBASE databases were systematically searched to identify literature reporting the effects of the ERAS protocol on clinical outcomes in patients undergoing liver transplant recipients with endstage liver disease.All articles published to January 1,2025 were searched,followed by data extraction of the included literature and independent quality assessment.Then pooled mean difference(MD)and odds ratio(OR)with a 95%confidence interval(CI)were calculated by either a random-effects or fixed-effects model.RESULTS Overall,eight relevant studies(including two randomized controlled trials,two prospective cohort studies,and four retrospective cohort studies)involving 1220 patients(704 patients in the ERAS group and 516 patients in the SC group).The primary outcomes evaluated included intensive care unit(ICU)stay duration,hospital length of stay,overall complication rates,mortality,and 30-day readmission rates.Our findings showed that ERAS protocols significantly reduced ICU stay duration(MD:-1.21 days,95%CI:-2.08 to-0.34;P=0.006),hospital length of stay(MD:-4.91 days,95%CI:-7.45 to-2.37;P=0.0002),overall complication rates(OR=0.32,95%CI:0.22-0.46;P<0.0001),and mortality(OR=0.57,95%CI:0.33-0.98;P=0.04).However,ERAS was associated with an increased 30-day readmission rate(OR=3.20,95%CI:1.54-6.67;P=0.003).CONCLUSION The current meta-analysis indicated that ERAS protocols can significantly improve short-term clinical outcomes in liver transplant recipients,although the increased readmission rate requires further investigation.Future studies should aim to refine ERAS protocols and explore their long-term efficacy and underlying mechanisms.展开更多
Objective Observational studies have found associations between inflammatory bowel disease(IBD)and the risk of dementia,including Alzheimer’s dementia(AD)and vascular dementia(VD);however,these findings are inconsist...Objective Observational studies have found associations between inflammatory bowel disease(IBD)and the risk of dementia,including Alzheimer’s dementia(AD)and vascular dementia(VD);however,these findings are inconsistent.It remains unclear whether these associations are causal.Methods We conducted a meta-analysis by systematically searching for observational studies on the association between IBD and dementia.Mendelian randomization(MR)analysis based on summary genome-wide association studies(GWASs)was performed.Genetic correlation and Bayesian colocalization analyses were used to provide robust genetic evidence.Results Ten observational studies involving 80,565,688 participants were included in this metaanalysis.IBD was significantly associated with dementia(risk ratio[RR]=1.36,95%CI=1.04-1.78;I2=84.8%)and VD(RR=2.60,95%CI=1.18-5.70;only one study),but not with AD(RR=2.00,95%CI=0.96-4.13;I^(2)=99.8%).MR analyses did not supported significant causal associations of IBD with dementia(dementia:odds ratio[OR]=1.01,95%CI=0.98-1.03;AD:OR=0.98,95%CI=0.95-1.01;VD:OR=1.02,95%CI=0.97-1.07).In addition,genetic correlation and co-localization analyses did not reveal any genetic associations between IBD and dementia.Conclusion Our study did not provide genetic evidence for a causal association between IBD and dementia risk.The increased risk of dementia observed in observational studies may be attributed to unobserved confounding factors or detection bias.展开更多
BACKGROUND Internet gaming disorder(IGD)is a growing concern among adolescents and adults,necessitating effective treatment strategies beyond pharmacological interventions.AIM To evaluated the effectiveness of non-inv...BACKGROUND Internet gaming disorder(IGD)is a growing concern among adolescents and adults,necessitating effective treatment strategies beyond pharmacological interventions.AIM To evaluated the effectiveness of non-invasive interventions for treating IGD among adolescents and adults.METHODS A total of 11 randomized controlled trials published between 2020 and 2025 were included in this meta-analysis,encompassing 1208 participants from diverse geographic and cultural contexts.The interventions examined included cognitive behavioral therapy(CBT),internet-based CBT,neurofeedback,virtual reality therapy,abstinence-based programs,and school-based prevention.The primary outcomes assessed were reductions in gaming time and IGD severity.Secondary outcomes included improvements in mood,anxiety,and psychosocial functioning(e.g.,stronger peer relationships,better academic or work performance,and healthier daily-life role fulfillment).RESULTS The pooled standardized mean difference for IGD symptom reduction significantly favored non-invasive interventions(Hedges’g=0.56,95%CI:0.38-0.74,P<0.001),with moderate heterogeneity observed(I2=47%).Subgroup analyses indicated that CBT-based programs,both in-person and online,yielded the strongest effects,particularly when caregiver involvement or self-monitoring was incorporated.Funnel plot asymmetry was minimal,suggesting a low risk of publication bias.CONCLUSION These findings support the efficacy of scalable,low-risk non-invasive interventions as first-line treatment options for IGD,particularly in youth populations.Future studies should prioritize investigating long-term outcomes,comparing the effectiveness of different non-invasive modalities,and developing culturally adaptive delivery methods.展开更多
基金supported by the STI 2030-Major Projects,No. 2021ZD0200500 (to XS)。
文摘Brain-derived neurotrophic factor is a crucial neurotrophic factor that plays a significant role in brain health. Although the vast majority of meta-analyses have confirmed that exercise interventions can increase brain-derived neurotrophic factor levels in children and adolescents, the effects of specific types of exercise on brain-derived neurotrophic factor levels are still controversial. To address this issue, we used meta-analytic methods to quantitatively evaluate, analyze, and integrate relevant studies. Our goals were to formulate general conclusions regarding the use of exercise interventions, explore the physiological mechanisms by which exercise improves brain health and cognitive ability in children and adolescents, and provide a reliable foundation for follow-up research. We used the Pub Med, Web of Science, Science Direct, Springer, Wiley Online Library, Weipu, Wanfang, and China National Knowledge Infrastructure databases to search for randomized controlled trials examining the influences of exercise interventions on brain-derived neurotrophic factor levels in children and adolescents. The extracted data were analyzed using Review Manager 5.3. According to the inclusion criteria, we assessed randomized controlled trials in which the samples were mainly children and adolescents, and the outcome indicators were measured before and after the intervention. We excluded animal experiments, studies that lacked a control group, and those that did not report quantitative results. The mean difference(MD;before versus after intervention) was used to evaluate the effect of exercise on brain-derived neurotrophic factor levels in children and adolescents. Overall, 531 participants(60 children and 471 adolescents, 10.9–16.1 years) were included from 13 randomized controlled trials. Heterogeneity was evaluated using the Q statistic and I^(2) test provided by Review Manager software. The meta-analysis showed that there was no heterogeneity among the studies(P = 0.67, I^(2) = 0.00%). The combined effect of the interventions was significant(MD = 2.88, 95% CI: 1.53–4.22, P < 0.0001), indicating that the brain-derived neurotrophic factor levels of the children and adolescents in the exercise group were significantly higher than those in the control group. In conclusion, different types of exercise interventions significantly increased brain-derived neurotrophic factor levels in children and adolescents. However, because of the small sample size of this meta-analysis, more high-quality research is needed to verify our conclusions. This metaanalysis was registered at PROSPERO(registration ID: CRD42023439408).
文摘This study presents a systematic review of xu-based studies in an attempt to clarify the construct of the xu-argument and the effectiveness of continuation tasks in foreign language learning.This review adopted a meta-analytic procedure consisting of effect-size aggregation and moderator analysis.While the former quantitatively synthesized evidence in support of xu-based interventions,the latter contextualized evidence in relation to learner and task features.Meta-analytic results indicated a medium-to-large effect of xu-based interventions for foreign language learning(g=1.18 and g=0.49 for within-group and between-group contrasts respectively).This effect was comparatively larger for(a)university-level students,(b)multilingual settings,(c)foreign languages other than English(LOTEs),(d)longer instructional treatments,and(e)specific language features.We interpret supportive evidence for xu-based interventions with respect to theoretical,methodological and pedagogical relevance,and provide empirically grounded recommendations for future task design and research on xu-based practices.
基金supported by the National Natural Science Foundation of China(82360801,82460822)Natural Science Foundation of Inner Mongolia Autonomous Region(2022LHQN08001,2023QN08050,2025LHMS08061)+4 种基金the Scientific Research Project of Higher Education Institutions in Inner Mongolia Autonomous Region(NJZY23135)the Laboratory Open Fund of Inner Mongolia Medical University(2024ZN23)and the General Project of Inner Mongolia Medical University(YKD2025MS047Inner Mongolia Medical University Undergraduate Science and Technology Innovation"Talent Cultivation"Project(YCPY2025028,YCPY2025024)Inner Mongolia Medical University Undergraduate Innovation and Entrepreneurship Training Program Project(101322025034).
文摘Background:Bacterial pneumonia continues to be a significant global health concern,particularly among high-risk groups,necessitating the development of precise and early diagnostic biomarkers.While the efficacy of procalcitonin(PCT)and C-reactive protein(CRP)as inflammatory markers is widely recognized,their relative diagnostic performance across different age groups remains debate.This meta-analysis was designed to assess the diagnostic accuracy of PCT and CRP in bacterial pneumonia.Methods:In this meta-analysis adhering to PRISMA guidelines,we searched PubMed,Web of Science,and the Cochrane Library for relevant diagnostic accuracy studies.From 19 included studies(n=2,603),data were extracted to construct tables.Study quality was assessed with the QUADAS-2 tool.The bivariate random-effects model was employed to derive pooled sensitivity,specificity,positive and negative likelihood ratios,and summary AUCs.To explore the substantial heterogeneity(I^(2)>80%),we performed pre-specified subgroup analyses based on age demographics.Results:Our findings indicate superior diagnostic performance for PCT,evidenced by a pooled sensitivity of 0.8841 and specificity of 0.8499,relative to CRP’s sensitivity of 0.8371 and specificity of 0.7185.The area under the ROC curve(AUC)for PCT was 0.992,a value significantly higher than that of CRP(0.987).Intriguingly,subgroup analyses revealed age-dependent variations:CRP demonstrated enhanced diagnostic utility in minors,while PCT proved substantially more effective in non-elderly adults.Conclusion:These results reinforce the clinical relevance of PCT as a more dependable biomarker for bacterial pneumonia,particularly in informing antibiotic treatment and mitigating misuse.This study uniquely includes age-stratified analyses based on predefined groups(minors and non-elderly adults),providing refined insights for individualized diagnostic approaches.We propose further multicenter research endeavors to confirm threshold optimization and explore combined biomarker strategies.
基金Supported by National High Level Hospital Clinical Research Funding,No.2023-NHLHCRF-YXHZ-ZRMS-06.
文摘BACKGROUND Previous research yielded conflicting results regarding the association between prediabetes and colorectal cancer(CRC).AIM To systematically assess the incidence of CRC in individuals with prediabetes compared with individuals with normoglycemia via a meta-analysis.METHODS Relevant cohort studies were acquired by searching MEDLINE,Web of Science,and EMBASE.A random-effects model was applied to combine the findings after accounting for heterogeneity.Several subgroup analyses were conducted to assess the impact of study characteristics on the results.RESULTS Eleven cohort studies involving 4996352 participants,including 383917(7.7%)with prediabetes at baseline,were analyzed in this meta-analysis.Over a mean follow-up period of 6.5 years,the combined findings revealed that individuals with prediabetes at baseline had a higher likelihood of developing CRC than those with normoglycemia[risk ratio(RR)=1.18,95%confidence interval=1.11 to 1.25,P<0.001]with low statistical heterogeneity(I2=27%).Subgroup analyses indicated that the association between prediabetes and an increased risk of CRC was mainly observed in studies defining prediabetes using impaired fasting glucose(RR=1.24)and slightly elevated hemoglobin A1c levels(RR=1.18)but not in those that defined prediabetes using impaired glucose tolerance(RR=1.06).Other study characteristics such as design,country,participant age and sex,the duration of follow-up,or adjustment for body mass index did not significantly impact the results(all P>0.05).CONCLUSION People with prediabetes might have a higher likelihood of developing CRC than individuals with normoglycemia.
基金Supported by General Program of Hainan Natural Science Foundation,No.824MS143.
文摘BACKGROUND Diabetic foot ulcers(DFUs)are a major complication of diabetes mellitus,and anemia is commonly observed in diabetic patients.However,the relationship between anemia and the risk of developing DFUs remains unclear.AIM To investigate the relationship between anemia and the risk of DFUs in diabetic patients through a meta-analysis.METHODS A systematic search was conducted across PubMed,Embase,and Web of Science databases to identify studies that reported the co-occurrence of anemia and DFUs in diabetic patients.The primary outcome was an association between anemia and DFU risk,expressed as odds ratios(ORs).Secondary outcomes included the risk of DFU per 1-g/dL decrease in hemoglobin and the difference in hemoglobin le-vels between patients with and without DFU.Statistical analyses were performed using random-effects models to account for heterogeneity.RESULTS Sixteen studies involving 170,949 diabetic patients were included in the analysis.The results indicated a significant association between anemia and an increased risk of DFUs(eight studies,n=166173,OR:2.72,95%CI:1.73–4.25,P<0.001;I2=93%).Subgroup analyses sup-ported consistent findings across various patient characteristics,analytic models,and study quality scores(P for subgroup differences,all>0.05).Additionally,each 1-g/dL decrease in hemoglobin was associated with an excess risk of DFUs(four studies,n=2543,OR:1.65,95%CI:1.21–2.27,P=0.002;I2=68%).Furthermore,diabetic patients with DFUs exhibited significantly lower hemoglobin levels compared to those without DFUs(nine studies,n=3986,mean difference:-2.13 g/dL,95%CI:-2.58 to-1.68,P<0.001;I2=90%).CONCLUSION Anemia can be associated with an increased risk of DFUs in diabetic patients.Monitoring and managing anemia in diabetic population may help mitigate the risk of DFUs,emphasizing the need for early interventions.Further research is required to investigate the underlying mechanisms and potential therapeutic strategies.
文摘Background:Sleeve lobectomy(SL)presents an attractive option compared to pneumonectomy(PN)for patients with central or locally advanced non-small cell lung cancer(NSCLC).This study aimed to assess the advantages of SL over PN for NSCLC via a meta-analysis.Methods:We performed a systematic review and cumulative analysis of comparative studies that reported both postoperative and survival outcomes for SL and PN.This was accomplished through a thorough search of electronic databases,including PubMed,EMBASE,and the Cochrane library,from inception to April 2023.Results:A total of 5727 patients(SL:1945;PN:3782)from thirty-one studies were analyzed.The meta-analysis focused on perioperative mortality,local recurrence,and overall survival.The SL group exhibited a significantly lower rate of perioperative mortality(OR=0.43,95%CI=0.32–0.60,P<0.0001).However,no significant difference was observed in local recurrence rates between SL and PN(OR=1.25;95%CI,0.92 to 1.69;P=0.16).Additionally,the survival rates at 1 year and 5 years in the SL cohort(1-year:0.14,95%CI:0.12 to 0.17,p<0.0001;5-year:2.15,95%CI:1.77 to 2.61,p<0.0001)along with the survival in patients with pN0 or pN1 at 5 years(OR=0.13,95%CI 0.04 to 0.22;P=0.006)were notably superior compared to those undergoing PN.Conclusions:Sleeve lobectomy should be regarded as a viable alternative to pneumonectomy for treating NSCLC.
文摘BACKGROUND Schizophrenia is a chronic psychiatric condition with complex symptomatology,including debilitating auditory hallucinations.Transcranial direct current stimulation(tDCS)has been explored as an adjunctive treatment to alleviate such symptoms.AIM To evaluate the therapeutic efficacy of tDCS in schizophrenia.METHODS Adhering to PRISMA guidelines,we systematically searched PubMed,Embase,Web of Science,and the Cochrane Library on September 19,2023,for randomized controlled trials examining the efficacy of tDCS in schizophrenia,with no language or time restrictions.We included studies that compared tDCS with a control condition and reported clinically relevant outcomes.Data extraction and quality assessments were performed by independent evaluators using the Cochrane Collaboration's risk of bias tool.Statistical heterogeneity was evaluated,and a random-effects model was applied due to moderate heterogeneity(I2=41.3%).RESULTS Nine studies comprising 425 participants(tDCS group:219,control group:206)were included.The meta-analysis demonstrated a significant reduction in auditory hallucination scores following tDCS treatment(weighted mean difference:-2.18,95%confidence interval:-4.0 to-0.29,P<0.01).Sensitivity analysis confirmed the robustness of the results,with no significant influence from individual studies.Additionally,publication bias was not detected,supporting the reliability and generalizability of the findings.These results underscore the efficacy of tDCS as a therapeutic intervention for auditory hallucinations in schizophrenia.CONCLUSION tDCS significantly reduces auditory hallucinations in schizophrenia,suggesting its potential as an effective adjunctive treatment for managing this disabling symptom.The findings highlight the practical significance of tDCS in clinical settings,particularly for patients with treatment-resistant auditory hallucinations.
文摘BACKGROUND Pelvic fractures are often associated with significant morbidity,including injuries to the urinary tract.Understanding the incidence and risk factors for urinary tract injury in these patients is crucial for prompt diagnosis and management.This meta-analysis aims to synthesize existing evidence to determine the overall incidence and identify specific risk factors associated with urinary tract injuries in patients with pelvic fractures.AIM To determine the incidence and risk factors for urinary tract injuries in patients with pelvic fractures.METHODS A systematic search of PubMed,EMBASE,Scopus,and the Cochrane Library was conducted without date restrictions.Studies examining the incidence and risk factors of urinary tract injuries in patients with pelvic fractures were included.Data extracted included demographics,injury mechanism,pelvic fracture type,urinary tract injury incidence,mortality,and discharge disposition.Review Manager 5.4 was used for data analysis.RESULTS Ten studies comprising 22700 patients were included.The pooled incidence of urinary tract injury associated with pelvic fracture was 6.88%(95%CI:6.20%-7.55%).Vehicle,motorcycle,and pedestrian accidents were identified as risk factors for urinary tract injury,with relative risks(RR)of 1.08(95%CI:1.06-1.11),1.89(95%CI:1.78-2.00),and 1.53(95%CI:1.20-1.95),respectively.Pubic fracture and pelvic ring disruption were significantly associated with urinary tract injury[odds ratio(OR)1.94,95%CI:1.09-3.44 and OR 5.53,95%CI:4.67-6.54,respectively)].Patients without urinary tract injury were more likely to be discharged home(RR 0.79,95%CI:0.67-0.92).Mortality was higher in patients with urinary tract injury(OR 1.92,95%CI:1.77-2.09).CONCLUSION Urinary tract injury occurs in nearly 7%of patients with pelvic fractures.Motorcycle accidents,pubic fractures,and pelvic ring disruptions are significant risk factors.Urinary tract injury following pelvic fracture is associated with increased mortality.
基金supported by the State Key Research and Development Program of China(2023YFF1305304)the Open Bidding for Selecting the Best Candidates Project of Inner Mongolia Autonomous Region(2024JBGS0020).
文摘Desertification is a global crucial ecological and environmental issue,and China is among the countries most seriously affected by desertification.In recent decades,numerous independent studies on desertification dynamics have been carried out using remote sensing technology,but there has been a lack of systematic research on desertification trends in China.This study employed the meta-analysis to integrate the findings of 140 published research cases and examined the dynamics of desertification in the eight major deserts,four major sandy lands,and their surrounding areas in China from 1970 to 2019,with a comparative analysis of differences between the eastern(including the Mu Us Sandy Land,the Otindag Sandy Land,the Hulunbuir Sandy Land,the Horqin Sandy Land,and the Hobq Desert)and western(including the Taklimakan Desert,the Gurbantunggut Desert,the Kumtagh Desert,the Ulan Buh Desert,the Qaidam Basin Desert,the Badain Jaran Desert,and the Tengger Desert)regions.The results revealed that from 1970 to 2019,desertification first expanded and then reversed in the whole region.Specifically,desertification expanded from 1980 to 1999 and reversed after 2000.The desertification trend exhibited distinct spatio-temporal variations between the eastern and western regions.From 1970 to 2019,the western region experienced relatively minor changes in desertified land area compared to the eastern region.In the context of global climate change,beneficial climatic conditions and ecological construction projects played a crucial role in reversing desertification.These findings provide valuable insights for understanding the development patterns of desertification in the most representative deserts and sandy lands in China and formulating effective desertification control strategies.
基金Supported by the Henan Province Medical Science and Technology Tackling Plan Joint Construction Project,No.LHGJ20220684Zhengzhou University Tianjian Advanced Biomedical Laboratory Funding Project,No.BS20240101.
文摘BACKGROUND Hypoxia-inducible factor 1α(HIF-1α)plays a crucial role in the prognosis of breast cancer,but the current evidence remains inconclusive.AIM To provide comprehensive evidence about the correlation of altered HIF-1αexpression with overall survival(OS)and disease-free survival(DFS)in breast cancer patients.METHODS A systematic search was conducted in PubMed,Embase,and Web of Science databases to collect relevant articles that were published before April 8,2024.A meta-analysis was used to assess the impact of altered HIF-1αexpression on the OS and DFS of breast cancer patients.Subgroup and sensitivity analyses were also performed in this meta-analysis.RESULTS This meta-analysis included 40 studies.The average percentage of breast cancer patients with high HIF-1αexpression was 39.6%.The overall meta-analysis results demonstrated that high HIF-1αexpression is strongly linked to poor outcomes in patients of breast cancer.Compared with low HIF-1αexpression,the overall hazard ratio for OS in patients with high HIF-1αexpression was 1.47[95%confidence interval(CI):1.29-1.69],and the overall hazard ratio for DFS was 1.82(95%CI:1.56-2.12).Furthermore,both OS[1.18(95%CI:1.01-1.38)]and DFS[1.79(95%CI:1.03-3.11)]were markedly shorter in triple-negative breast cancer cases with high HIF-1αexpression.Subgroup analysis revealed that the antibody used to detect HIF-1αexpression affected only the correlation linking HIF-1αexpression to DFS in breast cancer patients(P=0.0004).Furthermore,the sensitivity analysis demonstrates that the overall conclusions of the meta-analysis were unaffected by the removal of individual studies.CONCLUSION Compared to patients with low HIF-1αexpression,those with high expression level had shorter OS and DFS.However,the prognostic significance of high HIF-1αexpression varies across molecularly stratified breast cancer cohorts needs to be further elucidated.
基金Supported by the Natural Science Foundation of Guangxi in China,No.2024GXNSFAA010444Doctoral Scientific Research Start-up Foundation of University of South China,No.5525QD005Hunan Province Innovation and Entrepreneurship Training Program for College Students,No.S202410555233.
文摘BACKGROUND Gestational diabetes mellitus(GDM)poses a substantial health risk during pregnancy.However,the role of myo-inositol(MI)in GDM prevention and management remains controversial due to conflicting evidence and methodological limitations in previous studies.AIM To assess the efficacy of MI in preventing and treating GDM,providing evidencebased guidance for clinical practice.METHODS A systematic review was conducted on studies published on the PubMed,Web of Science,and Embase databases from their inception date to July 2024.Twelve studies encompassing 9018 patients were included in the meta-analysis using fixed-effect and random-effects models.Heterogeneity was quantified with I2 statistics and the Cochrane Q test,and study quality was appraised using the A Measurement Tool to Assess Systematic Reviews 2 checklist.RESULTS MI significantly reduced GDM incidence[relative risk(RR):0.37;95%confidence interval(CI):0.32-0.42],fasting blood glucose[standard mean differences(SMD):-1.31 mg/dL;95%CI:-1.83 to-0.79],and improved glucose tolerance test outcomes at 1-hour(SMD:-2.63 mg/dL;95%CI:-3.87 to-1.40)and 2-hour(SMD:-0.95 mg/dL;95%CI:-1.56 to-0.34).It also decreased the risk of preterm birth(RR:0.37;95%CI:0.28-0.47)and pregnancy-induced hypertension(RR:0.34;95%CI:0.25-0.47).A non-significant trend towards reduced cesarean section rates was observed(RR:0.82;95%CI:0.71-0.94).MI reduced birth weight(SMD:-0.25 kg;95%CI:-0.32 to-0.17),but had no effect on neonatal hypoglycemia(RR:0.30;95%CI:0.08-1.21)or gestational age at birth(SMD:-0.13 weeks;95%CI:-0.04 to 0.29).CONCLUSION MI demonstrates therapeutic potential in GDM prevention and management,supporting its potential use as a preventive supplement in early pregnancy for high-risk women.Nonetheless,its therapeutic effects in women diagnosed with GDM require further validation.
文摘BACKGROUND Hepatocellular carcinoma(HCC)is one of the most common malignancies,with high recurrence rates after treatment.Identifying reliable biomarkers for predicting recurrence is essential for improving patient outcomes.Hepatitis B corerelated antigen(HBcrAg)has shown potential as a predictive marker for HCC recurrence.AIM To evaluate the association between HBcrAg levels and the risk of HCC recurrence.METHODS A systematic review was conducted following PRISMA guidelines.PubMed,EMBASE,Web of Science,and the Cochrane Library were searched without restrictions on date or language.Observational studies reporting hazard ratios(HRs)for HBcrAg as a predictor of HCC recurrence were included.Data extraction and quality assessment were performed independently by two reviewers.Statistical analyses used a random-effects model to account for heterogeneity(I²≥50%),and sensitivity analysis was performed to ensure the robustness of the results.RESULTS A total of 1339 articles were initially identified,and 17 studies were included in the final meta-analysis after screening.The pooled analysis showed a significant association between elevated HBcrAg levels and HCC recurrence(HR=4.42,95%confidence interval:3.43-5.41)with substantial heterogeneity(I²=92.6%).Subgroup analysis revealed higher pooled HRs in studies with≥500 participants(HR=4.18)and HBcrAg cut-offs≥4.0 LogU/mL(HR=5.29).Studies with≥10 years of follow-up showed a lower HR(2.89)compared to those with<10 years(3.27).Patients treated with nucleos(t)ide analogs had a pooled HR of 1.98,while those without nucleos(t)ide analog had a higher HR of 3.87.Sensitivity analysis confirmed the robustness of the results,with no significant publication bias detected.CONCLUSION This meta-analysis provides strong evidence that elevated HBcrAg levels are associated with an increased risk of HCC recurrence.HBcrAg may serve as a valuable biomarker for predicting recurrence,aiding personalized management and surveillance strategies for HCC patients.
文摘BACKGROUND Clostridium difficile infection(CDI)is common in patients with inflammatory bowel disease(IBD).AIM To assess the association of CDI with clinical outcomes of IBD.METHODS PubMed,EMBASE,Web of Science,and the Cochrane Library databases were searched from inception to March 2024.Eligible articles included observational studies that reported on outcomes such as mortality,colectomy,hospitalization,intensive care unit(ICU)admission,complication rates,and length of hospital stay in IBD patients with and without CDI.Data were extracted,and a randomeffects model was used to calculate pooled odds ratios(ORs)and mean differences(MDs).RESULTS As shown in the data from 21 studies with 1249158 participants,CDI significantly increased the risk of mortality in IBD patients[pooled OR=4.569,95%confidence intervals(95%CI):2.584 to 8.079].Although the pooled OR for colectomy was 1.409(95%CI:0.922 to 2.155),it was not statistically significant.Similarly,CDI did not impact hospitalization(pooled OR=1.056,95%CI:0.512 to 2.179)and ICU admission outcomes(pooled OR=1.970,95%CI:0.420 to 9.246)of patients with IBD.The rate of complications was comparable in the two groups(pooled OR=0.658,95%CI:0.378 to 1.147).However,CDI was associated with a significantly more extended hospital stay(pooled MD=0.349 days,95%CI:0.002 to 0.696).CONCLUSION CDI is linked to increased mortality and prolonged hospitalization in IBD patients.These results emphasize the need for early detection and appropriate management.Implementing routine CDI screening during IBD flare-ups and stringent infection control measures could mitigate severe complications and reduce the healthcare burden.
文摘The effect of prenatal exposure to ambient particulate matter(PM)on birth weight varies considerably across studies,and the findings remain inconclusive.In this study,we conducted a meta-analysis to assess the associations between exposure to PM_(2.5) and PM10 and birth weight.A total of 74 studies were identified through searches in Web of Science,PubMed,Embase,and Ovid Medline,as well as manual searches,up to October 2024.We found that for each 10μg/m^(3) increase in PM_(2.5),the risk of low birth weight(LBW)increased significantly during the entire pregnancy(odds ratio[OR]=2.41,95%confidence interval[CI]:1.99–2.91)and in all trimesters.Similarly,for every 10μg/m^(3) increase in PM10 concentration,the risk of LBW increased significantly during the entire pregnancy(OR=1.46,95%CI:1.16–1.84).Subgroup analysis by maternal age for PM_(2.5) showed that mothers aged 30 and above had a significantly higher risk of LBW(OR=3.69,95%CI:2.81–4.84),compared with those under 30.In conclusion,maternal exposure to PM_(2.5) and PM_(10) is associated with an increased risk of LBW across all trimesters.Additionally,mothers aged 30 and above are at a higher risk of LBW,compared with younger mothers.Further research is needed to clarify the biological mechanisms by which PM pollution may contribute to LBW.
文摘BACKGROUND Gestational diabetes mellitus(GDM)has recently been associated with abnormal profiles of inflammatory cells and cytokines,though the findings remain incon-sistent and unclear.AIM To elucidate the peripheral immune status in GDM.METHODS We systematically screened databases including Web of Science,PubMed,and EMBASE for eligible studies.Original articles reporting different immune cell levels in GDM compared to normal glucose-tolerance pregnant women were included to extract usable data.The pooled mean difference(MD)with 95%confidence interval(CI)was analyzed as the outcome measure.The Newcastle-Ottawa scale was employed to assess study quality.RESULTS A total of 19 studies involving various immune cell subgroups were included in our analysis.Specifically,total CD4+T cells(WMD=3.08;95%CI:0.81-5.35)were significantly increased in GDM groups.In contrast,total lymphocytes(SMD=0.05;95%CI:-0.16 to 0.26),CD3+T cells(SMD=-0.34;95%CI:-1.01 to 0.32),CD8+T cells(SMD=0.21;95%CI:-0.31 to 0.73),and natural killer T(NKT)Cells(SMD=0.83;95%CI:-1.10 to 2.75)showed no significant changes in GDM.Activation markers(HLA-DR+or CD69+)on CD4+T cells(WMD=0.20;95%CI:0.06-0.34)were increased in GDM patients.Treg cells,a classical subgroup of CD4+T cells,showed a decreasing trend in GDM compared to controls(SMD=-0.83;95%CI:-1.31 to-0.34).These results indicate an abnormal immune status in the peripheral profiles of GDM.CONCLUSION GDM may not only be a dysglycemia-related condition but also an immune disorder characterized by abnormal peripheral immune profiles,including higher levels of CD4+T cells and a reduced population of Treg cells.Tr-eating immune dysregulation could be a new direction for GDM management,although further research is needed to understand the precise mechanisms of immune overactivation in GDM.
文摘Objective:To systematically evaluate the effectiveness of research-oriented integrated nursing interventions on cancer pain management in hospitalized oncology patients in China.Methods:A computerized search of Chinese and English databases was conducted to identify relevant studies.Two researchers independently assessed the quality of included literature using the Newcastle-Ottawa Scale(NOS).Data were extracted and analyzed via Stata 14.A random-effects model was applied due to significant heterogeneity(I²>50%).Sensitivity analysis and Egger’s test were performed to assess bias.Results:12 eligible studies(2014-2024)were included.Meta-analysis demonstrated that integrated nursing interventions significantly reduced cancer pain scores compared to routine care(SMD=-1.51,95%CI:-1.90 to-1.12;I²=84.8%),with superior efficacy.Subgroup-analyses revealed enhanced effects for“Nursing modes”(SMD=-2.11)and“cancer pain education”(SMD=-2.30).Conclusion:Research-oriented integrated nursing interventions significantly improve cancer pain management in Chinese hospitalized oncology patients,particularly through synergistic effects of“Nursing modes”and“can-cer pain education.”However,implementation bias from“additive interventions”in teaching hospitals and high heterogeneity warrant attention.Future studies should optimize designs to enhance clinical applicability.
文摘AIM:To summarize and quantitatively evaluate vasculature alteration of foveal zone in systemic lupus erythematosus(SLE)patients by secondary literature analysis.METHODS:A systematic search of PubMed,Embase,Web of Science,Cochrane Library,CBM,CNKI WanFang Data and VIP was conducted.Studies were about retinal vessel density in SLE patients from January 2000 to April 2023 and valid data were extracted.The Joanna Briggs Institute(JBI)critical appraisal checklist was used to evaluate the cross-sectional studies and prospective studies.The measurement data for combined effect size were weighted mean difference(WMD)and 95%confidence interval(CI).The heterogeneity was evaluated by I2 test.The fixed-effect model was adopted when P>0.1 or I2<50%,and random-effect model was adopted in the contrary.Subgroup and sensitivity analysis were utilized to analyze the sources of heterogeneity.The publication bias was evaluated by Egger tests and funnel plots.RESULTS:A total of 14 studies with 445 subjects and 441 healthy controls from 9 countries were enrolled and 11 studies were included in Meta-analysis.The JBI scores of studies were no less than 14 points.The Metaanalysis results indicated that mean parafoveal superficial vessel density(SVD;WMD=-1.22,95%CI:-1.67,-0.76),mean perifoveal SVD(WMD=-1.42,95%CI:-1.95,-0.89),mean whole SVD(WMD=-1.66,95%CI:-2.53,-0.79),mean parafoveal deep vessel density(WMD=-1.67,95%CI:-2.75,-0.59)and mean whole deep vessel density(WMD=-4.09,95%CI:-7.67,-0.52)was significantly lower than the control,while mean foveal SVD(WMD=-1.71,95%CI:-4.65,1.24),mean foveal avascular zone(FAZ)area(WMD=0.04,95%CI:-0.01,0.09)and mean acircularity index(AI;WMD=0.00,95%CI:-0.02,0.02)were not different between SLE patients and controls.Subgroup analysis indicated that the heterogeneity in SVD was partially due to the scanning area.Ocellus or binoculus data contributed partially to the heterogeneity in parafoveal deep vessel density and FAZ area.Sensitivity analysis indicated that the results were robust after changing the analysis model except for foveal SVD and FAZ area.There was no bias in included studies except whole SVD.CONCLUSION:Parafoveal superficial and deep vessel density are significantly lower in SLE patients while FAZ area and AI are not different between SLE patients and the control.
文摘BACKGROUND Enhanced recovery after surgery(ERAS),a multidisciplinary and multimodal perioperative care protocol,has been widely used in several surgical fields.However,the effect of this care protocol on liver transplant recipients with endstage liver disease remains unclear.AIM To compare the clinical outcomes of the ERAS protocol and standard care(SC)for liver transplant recipients with end-stage liver disease.METHODS PubMed,Web of Science,Cochrane Library,and EMBASE databases were systematically searched to identify literature reporting the effects of the ERAS protocol on clinical outcomes in patients undergoing liver transplant recipients with endstage liver disease.All articles published to January 1,2025 were searched,followed by data extraction of the included literature and independent quality assessment.Then pooled mean difference(MD)and odds ratio(OR)with a 95%confidence interval(CI)were calculated by either a random-effects or fixed-effects model.RESULTS Overall,eight relevant studies(including two randomized controlled trials,two prospective cohort studies,and four retrospective cohort studies)involving 1220 patients(704 patients in the ERAS group and 516 patients in the SC group).The primary outcomes evaluated included intensive care unit(ICU)stay duration,hospital length of stay,overall complication rates,mortality,and 30-day readmission rates.Our findings showed that ERAS protocols significantly reduced ICU stay duration(MD:-1.21 days,95%CI:-2.08 to-0.34;P=0.006),hospital length of stay(MD:-4.91 days,95%CI:-7.45 to-2.37;P=0.0002),overall complication rates(OR=0.32,95%CI:0.22-0.46;P<0.0001),and mortality(OR=0.57,95%CI:0.33-0.98;P=0.04).However,ERAS was associated with an increased 30-day readmission rate(OR=3.20,95%CI:1.54-6.67;P=0.003).CONCLUSION The current meta-analysis indicated that ERAS protocols can significantly improve short-term clinical outcomes in liver transplant recipients,although the increased readmission rate requires further investigation.Future studies should aim to refine ERAS protocols and explore their long-term efficacy and underlying mechanisms.
基金supported by the China Postdoctoral Science Foundation(Grant No.2021M703366)Shenzhen Science and Technology Program(Grant No.KQTD20190929172835662).
文摘Objective Observational studies have found associations between inflammatory bowel disease(IBD)and the risk of dementia,including Alzheimer’s dementia(AD)and vascular dementia(VD);however,these findings are inconsistent.It remains unclear whether these associations are causal.Methods We conducted a meta-analysis by systematically searching for observational studies on the association between IBD and dementia.Mendelian randomization(MR)analysis based on summary genome-wide association studies(GWASs)was performed.Genetic correlation and Bayesian colocalization analyses were used to provide robust genetic evidence.Results Ten observational studies involving 80,565,688 participants were included in this metaanalysis.IBD was significantly associated with dementia(risk ratio[RR]=1.36,95%CI=1.04-1.78;I2=84.8%)and VD(RR=2.60,95%CI=1.18-5.70;only one study),but not with AD(RR=2.00,95%CI=0.96-4.13;I^(2)=99.8%).MR analyses did not supported significant causal associations of IBD with dementia(dementia:odds ratio[OR]=1.01,95%CI=0.98-1.03;AD:OR=0.98,95%CI=0.95-1.01;VD:OR=1.02,95%CI=0.97-1.07).In addition,genetic correlation and co-localization analyses did not reveal any genetic associations between IBD and dementia.Conclusion Our study did not provide genetic evidence for a causal association between IBD and dementia risk.The increased risk of dementia observed in observational studies may be attributed to unobserved confounding factors or detection bias.
基金Supported by Basic Science Research Program through the National Research Foundation of Korea(NRF)Funded by the Ministry of Education,No.NRF-RS-2023-00237287.
文摘BACKGROUND Internet gaming disorder(IGD)is a growing concern among adolescents and adults,necessitating effective treatment strategies beyond pharmacological interventions.AIM To evaluated the effectiveness of non-invasive interventions for treating IGD among adolescents and adults.METHODS A total of 11 randomized controlled trials published between 2020 and 2025 were included in this meta-analysis,encompassing 1208 participants from diverse geographic and cultural contexts.The interventions examined included cognitive behavioral therapy(CBT),internet-based CBT,neurofeedback,virtual reality therapy,abstinence-based programs,and school-based prevention.The primary outcomes assessed were reductions in gaming time and IGD severity.Secondary outcomes included improvements in mood,anxiety,and psychosocial functioning(e.g.,stronger peer relationships,better academic or work performance,and healthier daily-life role fulfillment).RESULTS The pooled standardized mean difference for IGD symptom reduction significantly favored non-invasive interventions(Hedges’g=0.56,95%CI:0.38-0.74,P<0.001),with moderate heterogeneity observed(I2=47%).Subgroup analyses indicated that CBT-based programs,both in-person and online,yielded the strongest effects,particularly when caregiver involvement or self-monitoring was incorporated.Funnel plot asymmetry was minimal,suggesting a low risk of publication bias.CONCLUSION These findings support the efficacy of scalable,low-risk non-invasive interventions as first-line treatment options for IGD,particularly in youth populations.Future studies should prioritize investigating long-term outcomes,comparing the effectiveness of different non-invasive modalities,and developing culturally adaptive delivery methods.
