To the editor:“A recent systematic review shows that the risk of death by suicide is 100 times higher in people living with HIV than in the general population”—World Health Organization,2022 The estimate that the r...To the editor:“A recent systematic review shows that the risk of death by suicide is 100 times higher in people living with HIV than in the general population”—World Health Organization,2022 The estimate that the risk of suicide is 100-fold higher in people with HIV(PWH)than in the general population is widely cited,including in the World Health Organization’s(WHO’s)World Mental Health report from which the above quote is taken.1 This figure originates from a systematic review and meta-analysis by Pelton and colleagues,who estimated the‘lifetime incidence’of suicide among PWH2 and directly compared this measure to the WHO’s annual global suicide mortality rate.展开更多
Dear Editor,We read with a great interest the recently published systematic review by Shamsikhani and Hosseini titled,“Foot reflexology on nausea and vomiting:A systematic review.”[1]While the authors provided a com...Dear Editor,We read with a great interest the recently published systematic review by Shamsikhani and Hosseini titled,“Foot reflexology on nausea and vomiting:A systematic review.”[1]While the authors provided a comprehensive qualitative synthesis of six studies meeting their inclusion criteria,we believe that additional quantitative analysis would strengthen the evidence base for foot reflexology in managing nausea and vomiting.We conducted a complementary meta-analysis to provide quantitative evidence supporting the qualitative findings presented in the systematic review.展开更多
We sincerely thank the authors of the commentary1 for their thoughtful analysis and constructive critique of our systematic review on ischemic preconditioning(IPC)and placebo effects in exercise capacity and athletic ...We sincerely thank the authors of the commentary1 for their thoughtful analysis and constructive critique of our systematic review on ischemic preconditioning(IPC)and placebo effects in exercise capacity and athletic performance.2Their attention to methodological details,particularly concerning the inclusion and timing of warm-up protocols across studies,is commendable and contributes meaningfully to the ongoing refinement of IPC research in sports science.展开更多
We highly commend Dr Souza et al.1for their systematic review research.The authors conducted a detailed investigation into the effects of ischemic preconditioning(IPC)on athletic performance,comparing it with placebo ...We highly commend Dr Souza et al.1for their systematic review research.The authors conducted a detailed investigation into the effects of ischemic preconditioning(IPC)on athletic performance,comparing it with placebo and no-intervention conditions.The study found that while IPC demonstrated superior effects over the no-intervention group in certain metrics(e.g.,time to exhaustion),its performance did not significantly surpass that of the placebo group.This suggests that the potential benefits of IPC may partially stem from participants’psychological expectations,or placebo effects.The study also highlighted the significant impact of placebo interventions on athletic performance,emphasizing the importance of distinguishing between placebo and no-intervention conditions in experimental designs.展开更多
BACKGROUND Upper gastrointestinal cancer(UGIC),including esophageal and gastric cancers,poses a major global health challenge due to its high morbidity and mortality.During the preoperative period,patients often face ...BACKGROUND Upper gastrointestinal cancer(UGIC),including esophageal and gastric cancers,poses a major global health challenge due to its high morbidity and mortality.During the preoperative period,patients often face functional decline,malnutrition,and psychological stress,which can impair recovery.Prehabilitation,a multidisciplinary preoperative intervention,shows promise in optimizing patients'physical and mental status.AIM To evaluate the impact of prehabilitation on patients undergoing UGIC surgery and provide a basis for implementation of the prehabilitation compound plan.METHODS A computerized search of databases including Web of Science,PubMed,EMBASE,The Cochrane Library,Cumulative Index to Nursing and Allied Health Literature,China National Knowledge Infrastructure,Wanfang,and Chinese Science and Technology Journal Database was used to collect clinical trials on the impact of prehabilitation on patients undergoing UGIC surgery.After screening,a meta-analysis was conducted using Review Manager 5.0 software,and linear regression analysis was performed on the prehabilitation duration and outcome indicators.RESULTS A total of 13 clinical trials were ultimately included,with 8 literature quality evaluations at A level and 5 literature quality evaluations at B level.The meta-analysis results showed that compared with conventional nursing,the prehabilitation group had higher six-minute walk distance,lower postoperative complications and mortality rates,and shorter hospital stays,with statistically significant differences;there were no statistically significant differences in intensive care unit monitoring time and albumin levels between the two groups;regression analysis between prehabilitation duration and outcome indicators showed no significant relationship.CONCLUSION Prehabilitation can improve the perioperative functional ability of patients with UGIC and promote postoperative recovery,but its impact on nutrition,psychology,and quality of life needs to be further explored through more high-quality trials;in addition,further research is needed on the prehabilitation time,location,and specific plan.展开更多
BACKGROUND The beneficial effects of sodium-glucose co-transporter-2 inhibitors(SGLT2i)on adverse cardiac outcomes in diabetic patients are well-established.However,the effects of SGLT2i against cancer therapy-related...BACKGROUND The beneficial effects of sodium-glucose co-transporter-2 inhibitors(SGLT2i)on adverse cardiac outcomes in diabetic patients are well-established.However,the effects of SGLT2i against cancer therapy-related cardiotoxicity remain understudied.We investigated the association between SGLT2i and cardiac outcomes in cancer patients.METHODS PubMed,Embase,and the Cochrane Library were searched from their inception until September 30,2024 for studies evaluating the effects of SGLT2i in patients with cancer.The primary outcomes included incident heart failure(HF),HF exacerbation,HF hospitalization,atrial fibrillation/atrial flutter(AF/AFL),myocardial infarction,and all-cause mortality.The secondary outcomes included acute kidney injury and sepsis.Odds ratio(OR)with 95%CI was pooled.RESULTS Thirteen studies with 85,596 patients were included.Compared to non-SGLT2i use,SGLT2i treatment was associated with lower risks of incident HF(OR=0.51,95%CI:0.32-0.79,P=0.003),HF exacerbation(OR=0.74,95%CI:0.63-0.87,P<0.001),AF/AFL(OR=0.67,95%CI:0.55-0.82,P<0.001),myocardial infarction(OR=0.61,95%CI:0.41-0.90,P=0.01),and all-cause mortality(OR=0.44,95%CI:0.28-0.69,P<0.001),but not for HF hospitalization(OR=0.58,95%CI:0.22-1.55,P=0.28).As for safety outcomes,SGLT2i use was associated with lower risks of acute kidney injury(OR=0.68,95%CI:0.57-0.81,P<0.001)and sepsis(OR=0.32,95%CI:0.23-0.44,P<0.001).CONCLUSIONS SGLT2i were associated with lower risks of incident HF,HF exacerbation,AF/AFL,myocardial infarction,allcause mortality,acute kidney injury,and sepsis in cancer patients.展开更多
BACKGROUND Cardiac resynchronization therapy(CRT)has been a major therapeutic advancement for patients with heart failure and electrical dyssynchrony.While CRT improves symptoms,reduces hospitalizations,and enhances s...BACKGROUND Cardiac resynchronization therapy(CRT)has been a major therapeutic advancement for patients with heart failure and electrical dyssynchrony.While CRT improves symptoms,reduces hospitalizations,and enhances survival,the role of implantable cardioverter-defibrillators(ICDs)alongside CRT in patients with non-ischemic cardiomyopathy(NICM)remains controversial.To evaluate and compare the outcomes of CRT with ICD(CRT-D)versus CRT with pacemaker-only(CRT-P)in individuals diagnosed with NICM,with a specific focus on the elderly.METHODS A comprehensive search of PubMed,Embase,and the Cochrane Central Register of Controlled Trials was conducted in January 2024.Studies comparing CRT-D and CRT-P in patients with NICM were included,with subgroup analyses focusing on patients aged 75 years and older.RESULTS Twelve studies,including two randomized clinical trials,with a total of 62,145 patients and 16,754 pooled death events(9,171 in CRT-D and 7,583 in CRT-P),were analyzed.CRT-D was associated with a significantly lower risk of all-cause mortality compared to CRT-P(pooled OR=0.72;95%CI:0.61-0.85;P<0.01),with significant heterogeneity(I2=83%).RCT subgroup analysis,was not statistically significant(pooled OR=0.82;95%CI:0.64-1.06;P=0.41;I2=0%).In patients older than 75 years,no significant difference in mortality risk was observed(pooled OR 0.96;95%CI:0.81-1.15;I2=39%).CONCLUSION Our meta-analysis suggests that the addition of ICD therapy to CRT in patients with NICM significantly reduces all-cause mortality.However,this benefit does not extend to cardiovascular mortality,likely due to the primary role of ICDs in preventing sudden cardiac death rather than other causes such as progressive heart failure.The survival advantage of CRT-D is most pronounced in younger patients,with those over 75 years of age deriving less benefit.This highlights the importance of careful patient selection,considering age and comorbidities,when deciding on ICD implantation in NICM patients.展开更多
Measuring cardiorespiratory fitness(CRF)is an important predictor of morbidity and mortality in epidemiological studies and clinical settings.1 However,the feasibility of measuring maximal CRF is low due to the time,e...Measuring cardiorespiratory fitness(CRF)is an important predictor of morbidity and mortality in epidemiological studies and clinical settings.1 However,the feasibility of measuring maximal CRF is low due to the time,equipment,and expertise needed to conduct laboratory cardiopulmonary exercise testing(CPET)to determine the maximal rate of oxygen uptake(VO2max)as an objective measure of CRF.Alternatively,indirect estimates of CRF have been applied by measuring maximal duration on treadmill or cycle ergometer tests,2,3 extrapolating maximal CRF from workload or heart rate during submaximal fitness tests,4,5 and using non-exercise algorithms to estimate CRF from an individual’s age,sex,body mass,and physical activity habits.6 It is assumed that objectively measured VO2max is superior to extrapolated and estimated values due to errors associated with the estimated values;7,8 however,until Singh et al.9 newly released article in the Journal of Sport and Health Science,the comparability of these methods in identifying risks for all-cause and cardiovascular disease(CVD)mortality was unknown.展开更多
BACKGROUND Hepatocellular carcinoma(HCC)ranks sixth globally in cancer incidence and third in mortality rates.Unfortunately,over 70% of HCC patients forego the opportunity for curative surgery or liver transplantation...BACKGROUND Hepatocellular carcinoma(HCC)ranks sixth globally in cancer incidence and third in mortality rates.Unfortunately,over 70% of HCC patients forego the opportunity for curative surgery or liver transplantation due to inadequate physical examinations,poor physical condition,and limited organ availability upon diagnosis.Clinical guidelines endorse transarterial chemoembolization(TACE)as the frontline treatment for intermediate to advanced-stage HCC.Cryoablation(CRA)is an emerging local ablative therapy increasingly used in HCC management.Recent studies suggest that combining CRA with TACE offers complementary and synergistic effects,potentially improving long-term survival rates.However,the superiority of combined TACE+CRA therapy over TACE alone for HCC lesions equal to or exceeding 5 cm requires further investigation.AIM To compare the efficacy and safety of TACE combined with CRA vs TACE alone in the treatment of HCC with a diameter of≥5 cm.METHODS PubMed,EMBASE,Cochrane Library,CNKI,Wanfang,and VIP databases were searched to retrieve all relevant studies on TACE and CRA up to July 2022.Meta-analysis was performed using RevMan 5.3 software.RESULTS After screening according to the inclusion and exclusion criteria,6 articles were included,including 2 randomized controlled trials and 4 nonrandomized controlled trials,with a total of 575 patients included in the meta-analysis.The results showed that the objective response rate[odds ratio(OR)=2.56,95%confidence interval(CI):1.66-3.96,P<0.0001],disease control rate(OR=3.03,95%CI:1.88-4.89,P<0.00001),1-year survival rate(OR=3.79,95%CI:2.50-5.76,P<0.00001),2-year survival rate(OR=2.34,95%CI:1.43-3.85,P=0.0008),and 3-year survival rate(OR=3.34,95%CI:1.61-6.94,P=0.001)were all superior to those of the control group;the postoperative decrease in alpha-fetoprotein value(OR=295.53,95%CI:250.22-340.85,P<0.0001),the postoperative increase in CD4 value(OR=10.59,95%CI:8.78-12.40,P<0.00001),and the postoperative decrease in CD8 value(OR=6.47,95%CI:4.44-8.50,P<0.00001)were also significantly higher than those in the TACE-alone treatment group.CONCLUSION Compared with TACE-alone treatment,TACE+CRA combined treatment not only improves the immune function of HCC patients with a diameter of≥5 cm,but also enhances the therapeutic efficacy and long-term survival rate,without increasing the risk of complications.Therefore,TACE+CRA combined treatment may be a more recommended treatment for patients with HCC with a diameter of≥5 cm.展开更多
BACKGROUND The effect of serum iron or ferritin parameters on mortality among critically ill patients is not well characterized.AIM To determine the association between serum iron or ferritin parameters and mortality ...BACKGROUND The effect of serum iron or ferritin parameters on mortality among critically ill patients is not well characterized.AIM To determine the association between serum iron or ferritin parameters and mortality among critically ill patients.METHODS Web of Science,Embase,PubMed,and Cochrane Library databases were searched for studies on serum iron or ferritin parameters and mortality among critically ill patients.Two reviewers independently assessed,selected,and abstracted data from studies reporting on serum iron or ferritin parameters and mortality among critically ill patients.Data on serum iron or ferritin levels,mortality,and demographics were extracted.RESULTS Nineteen studies comprising 125490 patients were eligible for inclusion.We observed a slight negative effect of serum ferritin on mortality in the United States population[relative risk(RR)1.002;95%CI:1.002-1.004].In patients with sepsis,serum iron had a significant negative effect on mortality(RR=1.567;95%CI:1.208-1.925).CONCLUSION This systematic review presents evidence of a negative correlation between serum iron levels and mortality among patients with sepsis.Furthermore,it reveals a minor yet adverse impact of serum ferritin on mortality among the United States population.展开更多
BACKGROUND Imipenem is a highly effective carbapenem antibiotic,which is widely used in the treatment of many serious bacterial infections.At the same time,it can also cause some adverse reactions,mental abnormalities...BACKGROUND Imipenem is a highly effective carbapenem antibiotic,which is widely used in the treatment of many serious bacterial infections.At the same time,it can also cause some adverse reactions,mental abnormalities are the most concerned central nervous system adverse reactions.Different patients respond differently to imipenem,and the effect of imipenem on psychiatric disorders is unclear.Therefore,meta-analysis summarizing the results of multiple previous studies can provide stronger evidence support for clinical guidelines to guide clinical rational use of imipenem to minimize risks.After reviewing the literature published between 2003 and 2017,seven controlled trials with a total of 550 patients were included,with 273 and 277 patients in the control and experimental groups,respectively.The sample size of the study ranged from a minimum of 30 cases to a maximum of 61 cases.Patients in the experimental group were treated with imipenem while the control group was treated with conventional drugs.Meta-analysis showed that the incidence of mental disorders in the experimental group was higher than that in the control group(odds ratio=3.66,95%confidence interval:1.11-12.11,P=0.030);however,there was no significant difference in the incidence of adverse reactions between the two groups(odds ratio=0.05,95%confidence interval:0.00 to 0.10,P=0.060).Funnel diagrams showed that the scattered points of each study were symmetrical and distributed in an inverted funnel shape;therefore,there was no publication bias.CONCLUSION Imipenem can cause mental disorders in patients.However,the low quality of the included literature may have affected the final results.Therefore,it is necessary to conduct a high-quality randomized controlled study with multiple samples to further confirm the mechanism of imipenem-induced mental disorders and provide effective guidance for clinical treatment.展开更多
Objective: To compare the clinical efficacy of conventional Western medicine combined with Qiliqiangxin capsule and western medicine alone in the treatment of chronic heart failure, and to prove that Qiliqiangxin caps...Objective: To compare the clinical efficacy of conventional Western medicine combined with Qiliqiangxin capsule and western medicine alone in the treatment of chronic heart failure, and to prove that Qiliqiangxin capsule combined treatment has more advantages, providing reference for clinical decision-making in the treatment of chronic heart failure. Methods: Randomized controlled trials (RCTs) of conventional Western medicine treatment and Western medicine combined with Qiliqiangxin capsule in the treatment of chronic heart failure were searched in databases such as PubMed, Embase, Webofscience, CNKI, WanFang, VIP, and CBM. The bias risk assessment was conducted using the RCT tool recommended by Cochrane, and then the meta-analysis was performed using RevMan5.4 and Stata17 software. Compare the efficacy evaluation of cardiac function, left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDD), cardiac stroke output (SV), 6-minute walking test (6MWT), and N-terminal proBNP in the conventional western medicine combined with Qiliqiangxin capsule group (hereinafter referred to as the treatment group) and the conventional western medicine group (hereinafter referred to as the control group). Results: A total of 20 RCTs meeting the criteria were included, including 2953 patients, including 1508 in the treatment group and 1445 in the control group. The results of meta-analysis showed that the treatment group had significantly better cardiac function evaluation, LVEF, LVEDD, SV, 6MWT, and NT-proBNP improvement than the control group. Its central functional efficacy evaluation (OR=2.09,95% CI: 1.71-2.55, P<0.001), LVEF (WMD=7.05,95% CI: 5.30-8.79, P<0.00001), LVEDD (WMD=6.73, 95% CI: 3.18-10.29, P=0.0002), SV (WMD=6.73, 95% CI: 3.18-10.29, P=0.0002), 6MWT (SMD=0.70,95% CI: 0.54-0.87, P<0.00001), NT-proBNP (SMD=-1.95,95% CI: -2.5 2 to 1.38 (P<0.0001), with statistically significant differences. Conclusion: Conventional western medicine combined with Qiliqiangxin capsule can significantly improve the clinical efficacy of heart failure, improve LVEF, LVEDD, SV, and NT-proBNP index, and improve exercise tolerance. It is worth using for reference in the treatment.展开更多
BACKGROUND Psilocybin,a naturally occurring psychedelic compound found in certain species of mushrooms,is known for its effects on anxiety and depression.It has recently gained increasing interest for its potential th...BACKGROUND Psilocybin,a naturally occurring psychedelic compound found in certain species of mushrooms,is known for its effects on anxiety and depression.It has recently gained increasing interest for its potential therapeutic effects,particularly in patients with advanced cancer.This systematic review and meta-analysis aim to evaluate the effects of psilocybin on adult patients with advanced cancer.AIM To investigate the therapeutic effect of psilocybin in patients with advanced cancer.METHODS A comprehensive search of electronic databases was conducted in PubMed,Cochrane Central Register of Controlled Trials,and Google Scholar for articles published up to February 2023.The reference lists of the included studies were also searched to retrieve possible additional studies.RESULTS A total of 7 studies met the inclusion criteria for the systematic review,comprising 132 participants.The results revealed significant improvements in quality of life,pain control,and anxiety relief following psilocybin-assisted therapy,specifically results on anxiety relief.Pooled effect sizes indicated statistically significant reductions in symptoms of anxiety at both 4 to 4.5 months[35.15(95%CI:32.28-38.01)]and 6 to 6.5 months[33.06(95%CI:28.73-37.40)].Post-administration compared to baseline assessments(P<0.05).Additionally,patients reported sustained improvements in psychological well-being and existential distress fo-llowing psilocybin therapy.CONCLUSION The findings provided compelling evidence for the potential benefits of psilocybin-assisted therapy in improving quality of life,pain control,and anxiety relief in patients with advanced cancer.展开更多
[Objectives] To compare the clinical efficacy and cost-effectiveness of Yangxin Dingji capsule in conjunction with conventional Western medicine therapy against the use of conventional Western medicine therapy alone i...[Objectives] To compare the clinical efficacy and cost-effectiveness of Yangxin Dingji capsule in conjunction with conventional Western medicine therapy against the use of conventional Western medicine therapy alone in the treatment of tachyarrhythmia.[Methods] A meta-analysis was conducted to evaluate the efficacy of Yangxin Dingji capsule in conjunction with conventional Western medicine therapy for the treatment of tachyarrhythmia, compared to conventional Western medicine therapy alone. A decision tree model was developed to conduct a cost-effectiveness analysis from the perspective of the healthcare system. The effect parameter was the clinical effectiveness rate obtained from a meta-analysis of clinical literature. The cost parameter was represented by the drug treatment cost. The incremental cost-effectiveness ratio (ICER) was subsequently calculated, and the robustness of the primary analysis results was assessed through one-way sensitivity analysis.[Results] The results of the meta-analysis indicated that, over an 8-week treatment period, the clinical efficacy of Yangxin Dingji capsule in conjunction with conventional Western medicine for the treatment of tachyarrhythmia was superior to that of conventional Western medicine therapy alone, and the difference was found to be statistically significant [ OR =3.32, 95% CI (2.22-4.96), P <0.000 01]. The clinical efficacy of Yangxin Dingji capsule in conjunction with conventional Western medicine for the treatment of tachyarrhythmia was found to be superior when the treatment duration was 4 weeks, and the difference was found to be statistically significant [ OR =2.39, 95% CI (1.45-3.96), P =0.000 7]. The cost-effectiveness analysis indicated that with an 8-week treatment regimen, each 1% increase in the clinical effectiveness rate of Yangxin Dingji capsule in conjunction with conventional Western medical therapy for the treatment of arrhythmia, as compared to conventional Western medical therapy alone, resulted in an increase in cost of 91.78 yuan. Conversely, when the treatment duration was 4 weeks, each 1% increase in the clinical effectiveness rate of the Yangxin Dingji capsule combined with conventional Western medical therapy led to a cost increase of 70.84 yuan.[Conclusions] In the management of tachyarrhythmia, the clinical efficacy of Yangxin Dingji capsule in conjunction with conventional Western medicine therapy is superior to that of conventional Western medicine therapy alone. When the willingness-to-pay value exceeds the corresponding ICER, the combination of Yangxin Dingji capsule with conventional Western medicine therapy is deemed more cost-effective than the use of conventional Western medicine therapy alone.展开更多
Objective To evaluate the clinical efficacy of acupuncture in treatment of postpartum depression. Methods Pubmed database and Embase database were retrieved online in English, and China National Knowledge Internet （C...Objective To evaluate the clinical efficacy of acupuncture in treatment of postpartum depression. Methods Pubmed database and Embase database were retrieved online in English, and China National Knowledge Internet （CNKI）, China Biology Medicine disc （CBM）, VIP database and Wanfang Data were retrieved in Chinese. Literature in recent 10 years relating to clinical randomized controlled trials of acupuncture in treatment of postpartum depression were collected, and Meta analysis was performed by adopting RevMan5.3. Results Fourteen articles were included in the study in total; it was shown from HAMD result that after combination, WMD=-2.27, 95%CI （-2.55, 0.01）; according to Z-test, Z=2.95, P=0.05, and the difference in efficacy between treatment group and control group was statistically significant. It was shown from EPDS result that after combination, WMD=-0.53, 95%CI （-0.92, -0.03）; according to Z-test, Z=2.08, P〈0.05, and the difference in efficacy between treatment group and control group was statistically significant. During the analysis taking estradiol as standard, it was shown from the result that after combination, WMD=63.99, 95%CI （13.39, 114.60）; according to Z-test, Z=2.48, P〈0.05, and the difference in efficacy between treatment group and control group had remarkably statistical significance. During the analysis taking effective rate as standard, it was shown from the result that after combination, OR=3.15, 95%CI （2.19, 4.55）; according to Z-test, Z=6.14, P〈0.05, and the difference in efficacy between treatment group and control group had remarkably statistical significance. Conclusion Acupuncture treatment for postpartum depression is effective, but more clinical randomized controlled trials with high quality and large sample size are still needed to verify the result.展开更多
Objective To evaluate the efficacy and safety of scalp acupuncture in the treatment of ischemic stroke. Methods The method recommended in the Cochrane Collaboration was used for the systematic evaluation of the random...Objective To evaluate the efficacy and safety of scalp acupuncture in the treatment of ischemic stroke. Methods The method recommended in the Cochrane Collaboration was used for the systematic evaluation of the randomized controlled trials （RCTs） of scalp acupuncture in the treatment of ischemic stroke. Results One thousand three hundred and ninety-five cases from 13 papers in Chinese version were in compliance with the inclusive criteria and all of them were the low-quality trials. The results of the included 5 trials in Meta analysis indicated that the efficacy of scalp acupuncture was superior to medication in the treatment of ischemic stroke （RR=1.27, 95% CI 1.06, 1.51）. The results of 3 trials in Meta analysis suggested that the recovery in the nerve function defect of the patients with ischemic stroke treated with scalp acupuncture was apparent as compared with medication （WMD = -2.96, 95% C1-4.00, -1.92）. The results of 5 trials in Meta analysis showed that the efficacy of scalp acupuncture on ischemic stroke was potentially superior to body acupuncture （RR=I.10, 95% CI 0.93, 1.28）. Conclusion It is seen in the Meta analysis results of the included 13 RCTs that scalp acupuncture achieves the definite efficacy on ischemic stroke. Due to the limitation of the inclusive numbers and quality of the research, especially the lack of long-term indices, the conclusion reliability of this research is relatively low. Hence, it is required much more evidences for a further confirmation from the large scale and multiple central RCTs with high quality and intrinsic authenticity.展开更多
Objective To investigate the use of the Gibbs Sampler method in evaluating the relationship between clinic events and health risks in a meta analysis of multiple clinical trials Methods By using a generalized li...Objective To investigate the use of the Gibbs Sampler method in evaluating the relationship between clinic events and health risks in a meta analysis of multiple clinical trials Methods By using a generalized linear model with random effects, Gibbs Sampler technique was used in a meta analysis of multiple clinical trials of angiotensin converting enzyme (ACE) inhibitors in patients with myocardial infarction (MI) Results When heterogeneity across different trials can not be ignored, compared with the classic method, the odds ratio of relative reinfarction risk estimated by the Gibbs Sampler method would have less variation The gain in the reduction of variation in estimate of the overall odds ratio was 9 52% Conclusion Implementation of the Gibbs Sampler technique in meta analysis of multiple clinical trials has the potential of reducing the inaccuracy caused by heterogeneity across trials展开更多
Objective To explore the effectiveness of applying scalp acupuncture in treating child cerebral palsy. Method Computer was adopt to retrieve relevant literature about scalp acupuncture based therapy in treating childr...Objective To explore the effectiveness of applying scalp acupuncture in treating child cerebral palsy. Method Computer was adopt to retrieve relevant literature about scalp acupuncture based therapy in treating children cerebral palsy published during 2999-2024 in PubMed, China National Knowledge Infrastructure （CNKI）, China Biology Medicine Disc （CBM）, VIP database, Wan fang database, Longyuan Electronic Journal and People＇s University Copying Periodical Resources Full-Text Database. The quality of literature about scalp acupuncture based therapy in treating children cerebral palsy was systematically evaluated and Meta analysis was conducted for integrated data by adopting evidence-based medicine and bibliometrics and through RevMan 5.2 statistical software. Results Two hundred and thirty-four literature were retrieved in total, within which, 7 of them were included. There were 796 cases in included literature, which were divided into a treatment group （416 cases） and a control group （380 cases）. The total effective cases in the treatment group was 378, with the total effective rate of 90.9%, and the total effective cases of the control group was 282, with the total effective rate of 73.9%, which could provide evidence for the fact that the treatment of scalp acupuncture has increased the effective rate of child cerebral palsy by 17%. It is shown by Meta analysis that： OR is 0.16, 95% CI is （0.22, 0.22） and combined effect test is Z=6.27, P〈0.02, indicating that the combined effect size of several studies included is of statistical significance, and the difference between the control group and the treatment group is statistically significant. Conclusion The total effective rate of scalp acupuncture based therapy in treating children cerebral palsy is higher than that of modern medicine comprehensive rehabilitation treatment, and the treatment method of scalp acupuncture could be widely applied to clinic; but since articles about scalp acupuncture based therapy in treating children cerebral palsy published domestically are not qualified enough, only a few literature are included, hence, more power and strong evidences shall be verified by literature with higher quality.展开更多
基金supported by the Swiss National Science Foundation(grant numbers 193381 and 189498)the US National Institutes of Health(the National Institute of Allergy and Infectious Diseases,the Eunice Kennedy Shriver National Institute of Child Health and Human Development,the National Cancer Institute,the National Institute of Mental Health,the National Institute on Drug Abuse,the National Heart,Lung,and Blood Institute,the National Institute on Alcohol Abuse and Alcoholism,the National Institute of Diabetes and Digestive and Kidney Diseases and the Fogarty International Center)(grant numbers U01AI069924 and 1K43TW012840-01).
文摘To the editor:“A recent systematic review shows that the risk of death by suicide is 100 times higher in people living with HIV than in the general population”—World Health Organization,2022 The estimate that the risk of suicide is 100-fold higher in people with HIV(PWH)than in the general population is widely cited,including in the World Health Organization’s(WHO’s)World Mental Health report from which the above quote is taken.1 This figure originates from a systematic review and meta-analysis by Pelton and colleagues,who estimated the‘lifetime incidence’of suicide among PWH2 and directly compared this measure to the WHO’s annual global suicide mortality rate.
文摘Dear Editor,We read with a great interest the recently published systematic review by Shamsikhani and Hosseini titled,“Foot reflexology on nausea and vomiting:A systematic review.”[1]While the authors provided a comprehensive qualitative synthesis of six studies meeting their inclusion criteria,we believe that additional quantitative analysis would strengthen the evidence base for foot reflexology in managing nausea and vomiting.We conducted a complementary meta-analysis to provide quantitative evidence supporting the qualitative findings presented in the systematic review.
文摘We sincerely thank the authors of the commentary1 for their thoughtful analysis and constructive critique of our systematic review on ischemic preconditioning(IPC)and placebo effects in exercise capacity and athletic performance.2Their attention to methodological details,particularly concerning the inclusion and timing of warm-up protocols across studies,is commendable and contributes meaningfully to the ongoing refinement of IPC research in sports science.
文摘We highly commend Dr Souza et al.1for their systematic review research.The authors conducted a detailed investigation into the effects of ischemic preconditioning(IPC)on athletic performance,comparing it with placebo and no-intervention conditions.The study found that while IPC demonstrated superior effects over the no-intervention group in certain metrics(e.g.,time to exhaustion),its performance did not significantly surpass that of the placebo group.This suggests that the potential benefits of IPC may partially stem from participants’psychological expectations,or placebo effects.The study also highlighted the significant impact of placebo interventions on athletic performance,emphasizing the importance of distinguishing between placebo and no-intervention conditions in experimental designs.
基金Supported by Key Project of Jiangsu Provincial Health(ZD2022052).
文摘BACKGROUND Upper gastrointestinal cancer(UGIC),including esophageal and gastric cancers,poses a major global health challenge due to its high morbidity and mortality.During the preoperative period,patients often face functional decline,malnutrition,and psychological stress,which can impair recovery.Prehabilitation,a multidisciplinary preoperative intervention,shows promise in optimizing patients'physical and mental status.AIM To evaluate the impact of prehabilitation on patients undergoing UGIC surgery and provide a basis for implementation of the prehabilitation compound plan.METHODS A computerized search of databases including Web of Science,PubMed,EMBASE,The Cochrane Library,Cumulative Index to Nursing and Allied Health Literature,China National Knowledge Infrastructure,Wanfang,and Chinese Science and Technology Journal Database was used to collect clinical trials on the impact of prehabilitation on patients undergoing UGIC surgery.After screening,a meta-analysis was conducted using Review Manager 5.0 software,and linear regression analysis was performed on the prehabilitation duration and outcome indicators.RESULTS A total of 13 clinical trials were ultimately included,with 8 literature quality evaluations at A level and 5 literature quality evaluations at B level.The meta-analysis results showed that compared with conventional nursing,the prehabilitation group had higher six-minute walk distance,lower postoperative complications and mortality rates,and shorter hospital stays,with statistically significant differences;there were no statistically significant differences in intensive care unit monitoring time and albumin levels between the two groups;regression analysis between prehabilitation duration and outcome indicators showed no significant relationship.CONCLUSION Prehabilitation can improve the perioperative functional ability of patients with UGIC and promote postoperative recovery,but its impact on nutrition,psychology,and quality of life needs to be further explored through more high-quality trials;in addition,further research is needed on the prehabilitation time,location,and specific plan.
基金supported by the National Natural Science Foundation of China(No.82170327&No.82370332)the Tianjin Key Medical Discipline(Specialty)Construction Project(TJYXZDXK-029A).
文摘BACKGROUND The beneficial effects of sodium-glucose co-transporter-2 inhibitors(SGLT2i)on adverse cardiac outcomes in diabetic patients are well-established.However,the effects of SGLT2i against cancer therapy-related cardiotoxicity remain understudied.We investigated the association between SGLT2i and cardiac outcomes in cancer patients.METHODS PubMed,Embase,and the Cochrane Library were searched from their inception until September 30,2024 for studies evaluating the effects of SGLT2i in patients with cancer.The primary outcomes included incident heart failure(HF),HF exacerbation,HF hospitalization,atrial fibrillation/atrial flutter(AF/AFL),myocardial infarction,and all-cause mortality.The secondary outcomes included acute kidney injury and sepsis.Odds ratio(OR)with 95%CI was pooled.RESULTS Thirteen studies with 85,596 patients were included.Compared to non-SGLT2i use,SGLT2i treatment was associated with lower risks of incident HF(OR=0.51,95%CI:0.32-0.79,P=0.003),HF exacerbation(OR=0.74,95%CI:0.63-0.87,P<0.001),AF/AFL(OR=0.67,95%CI:0.55-0.82,P<0.001),myocardial infarction(OR=0.61,95%CI:0.41-0.90,P=0.01),and all-cause mortality(OR=0.44,95%CI:0.28-0.69,P<0.001),but not for HF hospitalization(OR=0.58,95%CI:0.22-1.55,P=0.28).As for safety outcomes,SGLT2i use was associated with lower risks of acute kidney injury(OR=0.68,95%CI:0.57-0.81,P<0.001)and sepsis(OR=0.32,95%CI:0.23-0.44,P<0.001).CONCLUSIONS SGLT2i were associated with lower risks of incident HF,HF exacerbation,AF/AFL,myocardial infarction,allcause mortality,acute kidney injury,and sepsis in cancer patients.
文摘BACKGROUND Cardiac resynchronization therapy(CRT)has been a major therapeutic advancement for patients with heart failure and electrical dyssynchrony.While CRT improves symptoms,reduces hospitalizations,and enhances survival,the role of implantable cardioverter-defibrillators(ICDs)alongside CRT in patients with non-ischemic cardiomyopathy(NICM)remains controversial.To evaluate and compare the outcomes of CRT with ICD(CRT-D)versus CRT with pacemaker-only(CRT-P)in individuals diagnosed with NICM,with a specific focus on the elderly.METHODS A comprehensive search of PubMed,Embase,and the Cochrane Central Register of Controlled Trials was conducted in January 2024.Studies comparing CRT-D and CRT-P in patients with NICM were included,with subgroup analyses focusing on patients aged 75 years and older.RESULTS Twelve studies,including two randomized clinical trials,with a total of 62,145 patients and 16,754 pooled death events(9,171 in CRT-D and 7,583 in CRT-P),were analyzed.CRT-D was associated with a significantly lower risk of all-cause mortality compared to CRT-P(pooled OR=0.72;95%CI:0.61-0.85;P<0.01),with significant heterogeneity(I2=83%).RCT subgroup analysis,was not statistically significant(pooled OR=0.82;95%CI:0.64-1.06;P=0.41;I2=0%).In patients older than 75 years,no significant difference in mortality risk was observed(pooled OR 0.96;95%CI:0.81-1.15;I2=39%).CONCLUSION Our meta-analysis suggests that the addition of ICD therapy to CRT in patients with NICM significantly reduces all-cause mortality.However,this benefit does not extend to cardiovascular mortality,likely due to the primary role of ICDs in preventing sudden cardiac death rather than other causes such as progressive heart failure.The survival advantage of CRT-D is most pronounced in younger patients,with those over 75 years of age deriving less benefit.This highlights the importance of careful patient selection,considering age and comorbidities,when deciding on ICD implantation in NICM patients.
文摘Measuring cardiorespiratory fitness(CRF)is an important predictor of morbidity and mortality in epidemiological studies and clinical settings.1 However,the feasibility of measuring maximal CRF is low due to the time,equipment,and expertise needed to conduct laboratory cardiopulmonary exercise testing(CPET)to determine the maximal rate of oxygen uptake(VO2max)as an objective measure of CRF.Alternatively,indirect estimates of CRF have been applied by measuring maximal duration on treadmill or cycle ergometer tests,2,3 extrapolating maximal CRF from workload or heart rate during submaximal fitness tests,4,5 and using non-exercise algorithms to estimate CRF from an individual’s age,sex,body mass,and physical activity habits.6 It is assumed that objectively measured VO2max is superior to extrapolated and estimated values due to errors associated with the estimated values;7,8 however,until Singh et al.9 newly released article in the Journal of Sport and Health Science,the comparability of these methods in identifying risks for all-cause and cardiovascular disease(CVD)mortality was unknown.
文摘BACKGROUND Hepatocellular carcinoma(HCC)ranks sixth globally in cancer incidence and third in mortality rates.Unfortunately,over 70% of HCC patients forego the opportunity for curative surgery or liver transplantation due to inadequate physical examinations,poor physical condition,and limited organ availability upon diagnosis.Clinical guidelines endorse transarterial chemoembolization(TACE)as the frontline treatment for intermediate to advanced-stage HCC.Cryoablation(CRA)is an emerging local ablative therapy increasingly used in HCC management.Recent studies suggest that combining CRA with TACE offers complementary and synergistic effects,potentially improving long-term survival rates.However,the superiority of combined TACE+CRA therapy over TACE alone for HCC lesions equal to or exceeding 5 cm requires further investigation.AIM To compare the efficacy and safety of TACE combined with CRA vs TACE alone in the treatment of HCC with a diameter of≥5 cm.METHODS PubMed,EMBASE,Cochrane Library,CNKI,Wanfang,and VIP databases were searched to retrieve all relevant studies on TACE and CRA up to July 2022.Meta-analysis was performed using RevMan 5.3 software.RESULTS After screening according to the inclusion and exclusion criteria,6 articles were included,including 2 randomized controlled trials and 4 nonrandomized controlled trials,with a total of 575 patients included in the meta-analysis.The results showed that the objective response rate[odds ratio(OR)=2.56,95%confidence interval(CI):1.66-3.96,P<0.0001],disease control rate(OR=3.03,95%CI:1.88-4.89,P<0.00001),1-year survival rate(OR=3.79,95%CI:2.50-5.76,P<0.00001),2-year survival rate(OR=2.34,95%CI:1.43-3.85,P=0.0008),and 3-year survival rate(OR=3.34,95%CI:1.61-6.94,P=0.001)were all superior to those of the control group;the postoperative decrease in alpha-fetoprotein value(OR=295.53,95%CI:250.22-340.85,P<0.0001),the postoperative increase in CD4 value(OR=10.59,95%CI:8.78-12.40,P<0.00001),and the postoperative decrease in CD8 value(OR=6.47,95%CI:4.44-8.50,P<0.00001)were also significantly higher than those in the TACE-alone treatment group.CONCLUSION Compared with TACE-alone treatment,TACE+CRA combined treatment not only improves the immune function of HCC patients with a diameter of≥5 cm,but also enhances the therapeutic efficacy and long-term survival rate,without increasing the risk of complications.Therefore,TACE+CRA combined treatment may be a more recommended treatment for patients with HCC with a diameter of≥5 cm.
基金Supported by The National Natural Science Foundation of China,No.82104989.
文摘BACKGROUND The effect of serum iron or ferritin parameters on mortality among critically ill patients is not well characterized.AIM To determine the association between serum iron or ferritin parameters and mortality among critically ill patients.METHODS Web of Science,Embase,PubMed,and Cochrane Library databases were searched for studies on serum iron or ferritin parameters and mortality among critically ill patients.Two reviewers independently assessed,selected,and abstracted data from studies reporting on serum iron or ferritin parameters and mortality among critically ill patients.Data on serum iron or ferritin levels,mortality,and demographics were extracted.RESULTS Nineteen studies comprising 125490 patients were eligible for inclusion.We observed a slight negative effect of serum ferritin on mortality in the United States population[relative risk(RR)1.002;95%CI:1.002-1.004].In patients with sepsis,serum iron had a significant negative effect on mortality(RR=1.567;95%CI:1.208-1.925).CONCLUSION This systematic review presents evidence of a negative correlation between serum iron levels and mortality among patients with sepsis.Furthermore,it reveals a minor yet adverse impact of serum ferritin on mortality among the United States population.
基金Supported by the Education Research Program Project of Zhejiang Province,No.Y202043224.
文摘BACKGROUND Imipenem is a highly effective carbapenem antibiotic,which is widely used in the treatment of many serious bacterial infections.At the same time,it can also cause some adverse reactions,mental abnormalities are the most concerned central nervous system adverse reactions.Different patients respond differently to imipenem,and the effect of imipenem on psychiatric disorders is unclear.Therefore,meta-analysis summarizing the results of multiple previous studies can provide stronger evidence support for clinical guidelines to guide clinical rational use of imipenem to minimize risks.After reviewing the literature published between 2003 and 2017,seven controlled trials with a total of 550 patients were included,with 273 and 277 patients in the control and experimental groups,respectively.The sample size of the study ranged from a minimum of 30 cases to a maximum of 61 cases.Patients in the experimental group were treated with imipenem while the control group was treated with conventional drugs.Meta-analysis showed that the incidence of mental disorders in the experimental group was higher than that in the control group(odds ratio=3.66,95%confidence interval:1.11-12.11,P=0.030);however,there was no significant difference in the incidence of adverse reactions between the two groups(odds ratio=0.05,95%confidence interval:0.00 to 0.10,P=0.060).Funnel diagrams showed that the scattered points of each study were symmetrical and distributed in an inverted funnel shape;therefore,there was no publication bias.CONCLUSION Imipenem can cause mental disorders in patients.However,the low quality of the included literature may have affected the final results.Therefore,it is necessary to conduct a high-quality randomized controlled study with multiple samples to further confirm the mechanism of imipenem-induced mental disorders and provide effective guidance for clinical treatment.
基金National Natural Science Foundation of China Regional Science Foundation Project(No.82160887)General Project of Guangxi Natural Science Foundation(No.2021GXNSFAA220111)Guangxi Natural Science Foundation Project Youth Science Foundation Project(No.2021GXNSFBA196018)。
文摘Objective: To compare the clinical efficacy of conventional Western medicine combined with Qiliqiangxin capsule and western medicine alone in the treatment of chronic heart failure, and to prove that Qiliqiangxin capsule combined treatment has more advantages, providing reference for clinical decision-making in the treatment of chronic heart failure. Methods: Randomized controlled trials (RCTs) of conventional Western medicine treatment and Western medicine combined with Qiliqiangxin capsule in the treatment of chronic heart failure were searched in databases such as PubMed, Embase, Webofscience, CNKI, WanFang, VIP, and CBM. The bias risk assessment was conducted using the RCT tool recommended by Cochrane, and then the meta-analysis was performed using RevMan5.4 and Stata17 software. Compare the efficacy evaluation of cardiac function, left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDD), cardiac stroke output (SV), 6-minute walking test (6MWT), and N-terminal proBNP in the conventional western medicine combined with Qiliqiangxin capsule group (hereinafter referred to as the treatment group) and the conventional western medicine group (hereinafter referred to as the control group). Results: A total of 20 RCTs meeting the criteria were included, including 2953 patients, including 1508 in the treatment group and 1445 in the control group. The results of meta-analysis showed that the treatment group had significantly better cardiac function evaluation, LVEF, LVEDD, SV, 6MWT, and NT-proBNP improvement than the control group. Its central functional efficacy evaluation (OR=2.09,95% CI: 1.71-2.55, P<0.001), LVEF (WMD=7.05,95% CI: 5.30-8.79, P<0.00001), LVEDD (WMD=6.73, 95% CI: 3.18-10.29, P=0.0002), SV (WMD=6.73, 95% CI: 3.18-10.29, P=0.0002), 6MWT (SMD=0.70,95% CI: 0.54-0.87, P<0.00001), NT-proBNP (SMD=-1.95,95% CI: -2.5 2 to 1.38 (P<0.0001), with statistically significant differences. Conclusion: Conventional western medicine combined with Qiliqiangxin capsule can significantly improve the clinical efficacy of heart failure, improve LVEF, LVEDD, SV, and NT-proBNP index, and improve exercise tolerance. It is worth using for reference in the treatment.
文摘BACKGROUND Psilocybin,a naturally occurring psychedelic compound found in certain species of mushrooms,is known for its effects on anxiety and depression.It has recently gained increasing interest for its potential therapeutic effects,particularly in patients with advanced cancer.This systematic review and meta-analysis aim to evaluate the effects of psilocybin on adult patients with advanced cancer.AIM To investigate the therapeutic effect of psilocybin in patients with advanced cancer.METHODS A comprehensive search of electronic databases was conducted in PubMed,Cochrane Central Register of Controlled Trials,and Google Scholar for articles published up to February 2023.The reference lists of the included studies were also searched to retrieve possible additional studies.RESULTS A total of 7 studies met the inclusion criteria for the systematic review,comprising 132 participants.The results revealed significant improvements in quality of life,pain control,and anxiety relief following psilocybin-assisted therapy,specifically results on anxiety relief.Pooled effect sizes indicated statistically significant reductions in symptoms of anxiety at both 4 to 4.5 months[35.15(95%CI:32.28-38.01)]and 6 to 6.5 months[33.06(95%CI:28.73-37.40)].Post-administration compared to baseline assessments(P<0.05).Additionally,patients reported sustained improvements in psychological well-being and existential distress fo-llowing psilocybin therapy.CONCLUSION The findings provided compelling evidence for the potential benefits of psilocybin-assisted therapy in improving quality of life,pain control,and anxiety relief in patients with advanced cancer.
文摘[Objectives] To compare the clinical efficacy and cost-effectiveness of Yangxin Dingji capsule in conjunction with conventional Western medicine therapy against the use of conventional Western medicine therapy alone in the treatment of tachyarrhythmia.[Methods] A meta-analysis was conducted to evaluate the efficacy of Yangxin Dingji capsule in conjunction with conventional Western medicine therapy for the treatment of tachyarrhythmia, compared to conventional Western medicine therapy alone. A decision tree model was developed to conduct a cost-effectiveness analysis from the perspective of the healthcare system. The effect parameter was the clinical effectiveness rate obtained from a meta-analysis of clinical literature. The cost parameter was represented by the drug treatment cost. The incremental cost-effectiveness ratio (ICER) was subsequently calculated, and the robustness of the primary analysis results was assessed through one-way sensitivity analysis.[Results] The results of the meta-analysis indicated that, over an 8-week treatment period, the clinical efficacy of Yangxin Dingji capsule in conjunction with conventional Western medicine for the treatment of tachyarrhythmia was superior to that of conventional Western medicine therapy alone, and the difference was found to be statistically significant [ OR =3.32, 95% CI (2.22-4.96), P <0.000 01]. The clinical efficacy of Yangxin Dingji capsule in conjunction with conventional Western medicine for the treatment of tachyarrhythmia was found to be superior when the treatment duration was 4 weeks, and the difference was found to be statistically significant [ OR =2.39, 95% CI (1.45-3.96), P =0.000 7]. The cost-effectiveness analysis indicated that with an 8-week treatment regimen, each 1% increase in the clinical effectiveness rate of Yangxin Dingji capsule in conjunction with conventional Western medical therapy for the treatment of arrhythmia, as compared to conventional Western medical therapy alone, resulted in an increase in cost of 91.78 yuan. Conversely, when the treatment duration was 4 weeks, each 1% increase in the clinical effectiveness rate of the Yangxin Dingji capsule combined with conventional Western medical therapy led to a cost increase of 70.84 yuan.[Conclusions] In the management of tachyarrhythmia, the clinical efficacy of Yangxin Dingji capsule in conjunction with conventional Western medicine therapy is superior to that of conventional Western medicine therapy alone. When the willingness-to-pay value exceeds the corresponding ICER, the combination of Yangxin Dingji capsule with conventional Western medicine therapy is deemed more cost-effective than the use of conventional Western medicine therapy alone.
文摘Objective To evaluate the clinical efficacy of acupuncture in treatment of postpartum depression. Methods Pubmed database and Embase database were retrieved online in English, and China National Knowledge Internet （CNKI）, China Biology Medicine disc （CBM）, VIP database and Wanfang Data were retrieved in Chinese. Literature in recent 10 years relating to clinical randomized controlled trials of acupuncture in treatment of postpartum depression were collected, and Meta analysis was performed by adopting RevMan5.3. Results Fourteen articles were included in the study in total; it was shown from HAMD result that after combination, WMD=-2.27, 95%CI （-2.55, 0.01）; according to Z-test, Z=2.95, P=0.05, and the difference in efficacy between treatment group and control group was statistically significant. It was shown from EPDS result that after combination, WMD=-0.53, 95%CI （-0.92, -0.03）; according to Z-test, Z=2.08, P〈0.05, and the difference in efficacy between treatment group and control group was statistically significant. During the analysis taking estradiol as standard, it was shown from the result that after combination, WMD=63.99, 95%CI （13.39, 114.60）; according to Z-test, Z=2.48, P〈0.05, and the difference in efficacy between treatment group and control group had remarkably statistical significance. During the analysis taking effective rate as standard, it was shown from the result that after combination, OR=3.15, 95%CI （2.19, 4.55）; according to Z-test, Z=6.14, P〈0.05, and the difference in efficacy between treatment group and control group had remarkably statistical significance. Conclusion Acupuncture treatment for postpartum depression is effective, but more clinical randomized controlled trials with high quality and large sample size are still needed to verify the result.
基金Supported by Sichuan Science and Technology Support Program: 2011 SZ0253
文摘Objective To evaluate the efficacy and safety of scalp acupuncture in the treatment of ischemic stroke. Methods The method recommended in the Cochrane Collaboration was used for the systematic evaluation of the randomized controlled trials （RCTs） of scalp acupuncture in the treatment of ischemic stroke. Results One thousand three hundred and ninety-five cases from 13 papers in Chinese version were in compliance with the inclusive criteria and all of them were the low-quality trials. The results of the included 5 trials in Meta analysis indicated that the efficacy of scalp acupuncture was superior to medication in the treatment of ischemic stroke （RR=1.27, 95% CI 1.06, 1.51）. The results of 3 trials in Meta analysis suggested that the recovery in the nerve function defect of the patients with ischemic stroke treated with scalp acupuncture was apparent as compared with medication （WMD = -2.96, 95% C1-4.00, -1.92）. The results of 5 trials in Meta analysis showed that the efficacy of scalp acupuncture on ischemic stroke was potentially superior to body acupuncture （RR=I.10, 95% CI 0.93, 1.28）. Conclusion It is seen in the Meta analysis results of the included 13 RCTs that scalp acupuncture achieves the definite efficacy on ischemic stroke. Due to the limitation of the inclusive numbers and quality of the research, especially the lack of long-term indices, the conclusion reliability of this research is relatively low. Hence, it is required much more evidences for a further confirmation from the large scale and multiple central RCTs with high quality and intrinsic authenticity.
文摘Objective To investigate the use of the Gibbs Sampler method in evaluating the relationship between clinic events and health risks in a meta analysis of multiple clinical trials Methods By using a generalized linear model with random effects, Gibbs Sampler technique was used in a meta analysis of multiple clinical trials of angiotensin converting enzyme (ACE) inhibitors in patients with myocardial infarction (MI) Results When heterogeneity across different trials can not be ignored, compared with the classic method, the odds ratio of relative reinfarction risk estimated by the Gibbs Sampler method would have less variation The gain in the reduction of variation in estimate of the overall odds ratio was 9 52% Conclusion Implementation of the Gibbs Sampler technique in meta analysis of multiple clinical trials has the potential of reducing the inaccuracy caused by heterogeneity across trials
文摘Objective To explore the effectiveness of applying scalp acupuncture in treating child cerebral palsy. Method Computer was adopt to retrieve relevant literature about scalp acupuncture based therapy in treating children cerebral palsy published during 2999-2024 in PubMed, China National Knowledge Infrastructure （CNKI）, China Biology Medicine Disc （CBM）, VIP database, Wan fang database, Longyuan Electronic Journal and People＇s University Copying Periodical Resources Full-Text Database. The quality of literature about scalp acupuncture based therapy in treating children cerebral palsy was systematically evaluated and Meta analysis was conducted for integrated data by adopting evidence-based medicine and bibliometrics and through RevMan 5.2 statistical software. Results Two hundred and thirty-four literature were retrieved in total, within which, 7 of them were included. There were 796 cases in included literature, which were divided into a treatment group （416 cases） and a control group （380 cases）. The total effective cases in the treatment group was 378, with the total effective rate of 90.9%, and the total effective cases of the control group was 282, with the total effective rate of 73.9%, which could provide evidence for the fact that the treatment of scalp acupuncture has increased the effective rate of child cerebral palsy by 17%. It is shown by Meta analysis that： OR is 0.16, 95% CI is （0.22, 0.22） and combined effect test is Z=6.27, P〈0.02, indicating that the combined effect size of several studies included is of statistical significance, and the difference between the control group and the treatment group is statistically significant. Conclusion The total effective rate of scalp acupuncture based therapy in treating children cerebral palsy is higher than that of modern medicine comprehensive rehabilitation treatment, and the treatment method of scalp acupuncture could be widely applied to clinic; but since articles about scalp acupuncture based therapy in treating children cerebral palsy published domestically are not qualified enough, only a few literature are included, hence, more power and strong evidences shall be verified by literature with higher quality.
