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
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
AIM: To compare the efficacy and safety of endoscopic papillary large balloon dilation (EPLBD) with endoscopic sphincterotomy (EST) in retrieval of common bile duct stones (≥ 10 mm).
Objective To systematically evaluate the efficacy of heat-sensitive moxibustion in treatment of cervical spondylotic radiculopathy（CSR）. Methods Chinese National Knowledge Infrastructure（CNKI）, China Biology Medi...Objective To systematically evaluate the efficacy of heat-sensitive moxibustion in treatment of cervical spondylotic radiculopathy（CSR）. Methods Chinese National Knowledge Infrastructure（CNKI）, China Biology Medical（CBM） database, Chinese Science and Technology Periodical Database（VIP）, Wan Fang Data, Pubmed and Cochrane Library were retrieved to search the randomized controlled trials（RCT） on heat-sensitive moxibustion in treatment of CSR, and Meta analysis was conducted by applying Rev Man 5.3 software. Results Eventually, 10 papers were included in this study, including 1008 subjects. Meta analysis result showed： the total effective rate of treatment group was higher than that of control group, and the difference was statistically significant [RR=1.13, 95%CI（1.06, 1.21）, Z=3.54, P=0.000 4]; the cure rate of treatment group was higher than that of control group, and the difference was statistically significant [RR=1.80, 95%CI（1.52, 2.13）, Z=6.82, P〈0.000 01]; the improvement of short-form Mc Gill pain questionnaire（SF-MPQ） of treatment group was superior to that of control group, and the difference was statistically significant [MD=–4.44, 95%CI（–6.38,-2.50）, Z=4.49, P〈0.000 01]; visual analogue scale（VAS） of treatment group was lower than that of control group, and the difference was statistically significant [MD=-0.36, 95%CI（-0.50, –0.23）, Z=5.42, P〈0.00001]; and the improvement of interleukin-6（IL-6） of treatment group was superior to that of control group, and the difference was statistically significant [MD=–7.32, 95%CI（-11.49, –3.14）, Z=3.44, P=0.000 6]. Conclusion It is indicated from the Meta analysis result that the clinical efficacy of heat-sensitive moxibustion or acupuncture combined with heat-sensitive moxibustion in treatment of CSR is superior to that of simple acupuncture or traditional suspended moxibustion, providing a new therapeutic method for treatment of CSR. However, the abovementioned conclusion still needs to be confirmed through randomized blind controlled trials with high quality and large sample size since the sample size of included studies was small, and the quality was low.展开更多
OBJECTIVE:To systematically evaluate the curative effect of acupuncture on post-stroke depression(PSD).METHODS:The internet was used to retrieve the Wanfang Medical Data System,Chinese Periodical Net,the Weipu Informa...OBJECTIVE:To systematically evaluate the curative effect of acupuncture on post-stroke depression(PSD).METHODS:The internet was used to retrieve the Wanfang Medical Data System,Chinese Periodical Net,the Weipu Information Resources System,PubMed and the Cochrane Library Database.Relevant articles,up to September 2010,were manually retrieved.These papers included studies that had performed random and semi-random control trials for the use of acupuncture to treat PSD.Fifteen random control tests involving 1096 patients were included in this study and individual cases,interventional measures and curative effects were extracted from this research.Grade methodological quality evaluation and meta-analysis were performed on these studies.RESULTS:Comparison between the acupuncture group and the Western medicine group for the curative rate on PSD revealed an OR of 1.48,95% CI = [1.11 1.97] and P=0.008.Comparison of obviously effective rate shows that OR=1.39,95% CI=[1.08 1.80] and P=0.01.Comparison of effective rate showsthatOR=0.83,95%CI=[0.631.09]andP=0.18.CONCLUSION:Comparison between the acupuncture group and Western medicine group in treating PSD revealed that there is a statistical difference in curative rate and remarkably effective rate,but no difference in effective rate.展开更多
AIM: To study the cannulation and complication rates of early pre-cut sphincterotomy vs persistent attempts at cannulation by standard approach.METHODS: Systematic search of PubMed, EMBASE, Web of Science, and the Coc...AIM: To study the cannulation and complication rates of early pre-cut sphincterotomy vs persistent attempts at cannulation by standard approach.METHODS: Systematic search of PubMed, EMBASE, Web of Science, and the Cochrane Library for relevant studies published up to February 2013. The main outcome measurements were cannulation rates and postendoscopic retrograde cholangiopancreatography(ERCP) complications. A comprehensive systematic search of the Cochrane library, PubMed, Google scholar, Scopus, National Institutes of Health, meta-register of controlled trials and published proceedings from major Gastroenterology journals and meetings until February 2013 was conducted using keywords. All Prospective randomized controlled trials(RCT) studies whichmet our inclusion criteria were included in the analysis. Prospective non-randomized studies and retrospective studies were excluded from our meta-analysis. The main outcomes of interest were post-ERCP pancreatitis, overall complication rates including cholangitis, ERCPrelated bleeding, perforation and cannulation success rates. RESULTS: Seven RCTs with a total of 1039 patients were included in the meta-analysis based on selection criteria. The overall cannulation rate was 90% in the pre-cut sphincterotomy vs 86.3% in the persistent attempts group(OR = 1.98; 95%CI: 0.70-5.65). The risk of post-ERCP pancreatitis(PEP) was not different between the two groups(3.9% in the pre-cut sphincterotomy vs 6.1% in the persistent attempts group, OR = 0.58, 95%CI: 0.32-1.05). Similarly, there was no statistically significant difference between the groups for overall complication rate including PEP, cholangitis, bleeding, and perforation(6.2% vs 6.9%, OR = 0.85, 95%CI: 0.51-1.41). CONCLUSION: This meta-analysis suggests that precut sphincterotomy and persistent attempts at cannulation are comparable in terms of overall complication rates. Early pre-cut implementation does not increase PEP complications.展开更多
Objective: The goal of this study is to explore effective treatments for peripheral facial paralysis and to evaluate the clinical efficacies of warm needling therapy and acupuncture in peripheral facial paralysis.Meth...Objective: The goal of this study is to explore effective treatments for peripheral facial paralysis and to evaluate the clinical efficacies of warm needling therapy and acupuncture in peripheral facial paralysis.Methods: PubMed(1979-2017), the Chinese National Knowledge Infrastructure database(CNKI, 1979-2017), Wanfang databases(1990-2017), and the Chongqing VIP full-text periodical database(VIP, 1989-2017) were searched by computer. Randomized controlled trials of warm needling therapy and acupuncture in the treatment of peripheral facial paralysis were collected. The clinical trials that met the inclusion criteria were selected for quality assessment using the Cochrane 5.0 Handbook for systematic evaluation.RevMan5.3 was used for statistical analysis.Results: A total of 23 articles with 1756 patients met the inclusion criteria.(1) The meta-analysis of 11 articles showed that the total effective rate of warm needling therapy for peripheral facial paralysis was higher than that of acupuncture [RR = 1.18, 95% Cl(1.11,1.25), P< 0.00001].(2) The meta-analysis of 7 articles showed that the total effective rate of warm needling therapy combined with electroacupuncture in the treatment of peripheral facial paralysis was higher than that of acupuncture combined with electroacupuncture [RR= 1.15, 95% Cl(1.09, 1.21), P< 0.00001].(3) The meta-analysis of 5 articles showed that the total effective rate of warm needling therapy combined with other therapies in the treatment of peripheral facial paralysis was higher than that of acupuncture combined with other therapies [RR= 1.08,95% Cl(1.03, 1.14), P=0.002].(4) The meta-analysis of 5 articles showed that warm needling therapy could improve the House-Brackmann(H-B) scores of patients with peripheral facial paralysis more than acupuncture [mean difference(MD)=-2.85, 95% Cl(-5.08,-0.62), Z = 2.51, P = 0.01], indicating that warm needling therapy provides superior improvement in the function of facial nerve innervation in the patients. No adverse events were reported in the included studies. The methodological quality of the included studies was generally low.Conclusion: The results of this meta-analysis showed that warm needling therapy is superior to acupuncture in treating peripheral facial paralysis, providing a therapeutic option for the treatment of peripheral facial paralysis. However, due to the small sample size and the low quality of the included studies, the above conclusion still needs to be validated with high-quality, large-scale, randomized, blinded controlled trials.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.
基金Supported by Technology Foundation for Selected Overseas Chinese Scholar,Zhejiang Province,No.188020-710903/016
文摘AIM: To compare the efficacy and safety of endoscopic papillary large balloon dilation (EPLBD) with endoscopic sphincterotomy (EST) in retrieval of common bile duct stones (≥ 10 mm).
基金Supported by Anhui Provincial Colleges science research platform team building program:2015TD033Provincial demonstrating experiment and practice training center:20100541
文摘Objective To systematically evaluate the efficacy of heat-sensitive moxibustion in treatment of cervical spondylotic radiculopathy（CSR）. Methods Chinese National Knowledge Infrastructure（CNKI）, China Biology Medical（CBM） database, Chinese Science and Technology Periodical Database（VIP）, Wan Fang Data, Pubmed and Cochrane Library were retrieved to search the randomized controlled trials（RCT） on heat-sensitive moxibustion in treatment of CSR, and Meta analysis was conducted by applying Rev Man 5.3 software. Results Eventually, 10 papers were included in this study, including 1008 subjects. Meta analysis result showed： the total effective rate of treatment group was higher than that of control group, and the difference was statistically significant [RR=1.13, 95%CI（1.06, 1.21）, Z=3.54, P=0.000 4]; the cure rate of treatment group was higher than that of control group, and the difference was statistically significant [RR=1.80, 95%CI（1.52, 2.13）, Z=6.82, P〈0.000 01]; the improvement of short-form Mc Gill pain questionnaire（SF-MPQ） of treatment group was superior to that of control group, and the difference was statistically significant [MD=–4.44, 95%CI（–6.38,-2.50）, Z=4.49, P〈0.000 01]; visual analogue scale（VAS） of treatment group was lower than that of control group, and the difference was statistically significant [MD=-0.36, 95%CI（-0.50, –0.23）, Z=5.42, P〈0.00001]; and the improvement of interleukin-6（IL-6） of treatment group was superior to that of control group, and the difference was statistically significant [MD=–7.32, 95%CI（-11.49, –3.14）, Z=3.44, P=0.000 6]. Conclusion It is indicated from the Meta analysis result that the clinical efficacy of heat-sensitive moxibustion or acupuncture combined with heat-sensitive moxibustion in treatment of CSR is superior to that of simple acupuncture or traditional suspended moxibustion, providing a new therapeutic method for treatment of CSR. However, the abovementioned conclusion still needs to be confirmed through randomized blind controlled trials with high quality and large sample size since the sample size of included studies was small, and the quality was low.
基金Supported by Specific scientific research fund for doctoral points of higher learning institutions of Education Ministry,20094425110005State natural science fund,30772828+1 种基金Guangdong provincial natural science fund,07004846Project in sci-tech plan of sci-tech department of Guangdong province,2008B030301206
文摘OBJECTIVE:To systematically evaluate the curative effect of acupuncture on post-stroke depression(PSD).METHODS:The internet was used to retrieve the Wanfang Medical Data System,Chinese Periodical Net,the Weipu Information Resources System,PubMed and the Cochrane Library Database.Relevant articles,up to September 2010,were manually retrieved.These papers included studies that had performed random and semi-random control trials for the use of acupuncture to treat PSD.Fifteen random control tests involving 1096 patients were included in this study and individual cases,interventional measures and curative effects were extracted from this research.Grade methodological quality evaluation and meta-analysis were performed on these studies.RESULTS:Comparison between the acupuncture group and the Western medicine group for the curative rate on PSD revealed an OR of 1.48,95% CI = [1.11 1.97] and P=0.008.Comparison of obviously effective rate shows that OR=1.39,95% CI=[1.08 1.80] and P=0.01.Comparison of effective rate showsthatOR=0.83,95%CI=[0.631.09]andP=0.18.CONCLUSION:Comparison between the acupuncture group and Western medicine group in treating PSD revealed that there is a statistical difference in curative rate and remarkably effective rate,but no difference in effective rate.
文摘AIM: To study the cannulation and complication rates of early pre-cut sphincterotomy vs persistent attempts at cannulation by standard approach.METHODS: Systematic search of PubMed, EMBASE, Web of Science, and the Cochrane Library for relevant studies published up to February 2013. The main outcome measurements were cannulation rates and postendoscopic retrograde cholangiopancreatography(ERCP) complications. A comprehensive systematic search of the Cochrane library, PubMed, Google scholar, Scopus, National Institutes of Health, meta-register of controlled trials and published proceedings from major Gastroenterology journals and meetings until February 2013 was conducted using keywords. All Prospective randomized controlled trials(RCT) studies whichmet our inclusion criteria were included in the analysis. Prospective non-randomized studies and retrospective studies were excluded from our meta-analysis. The main outcomes of interest were post-ERCP pancreatitis, overall complication rates including cholangitis, ERCPrelated bleeding, perforation and cannulation success rates. RESULTS: Seven RCTs with a total of 1039 patients were included in the meta-analysis based on selection criteria. The overall cannulation rate was 90% in the pre-cut sphincterotomy vs 86.3% in the persistent attempts group(OR = 1.98; 95%CI: 0.70-5.65). The risk of post-ERCP pancreatitis(PEP) was not different between the two groups(3.9% in the pre-cut sphincterotomy vs 6.1% in the persistent attempts group, OR = 0.58, 95%CI: 0.32-1.05). Similarly, there was no statistically significant difference between the groups for overall complication rate including PEP, cholangitis, bleeding, and perforation(6.2% vs 6.9%, OR = 0.85, 95%CI: 0.51-1.41). CONCLUSION: This meta-analysis suggests that precut sphincterotomy and persistent attempts at cannulation are comparable in terms of overall complication rates. Early pre-cut implementation does not increase PEP complications.
基金Supported by the National famous veteran TCM expert YANG Jun inheritance studiothe Project for the National Key Basic Research and Development Program(973):2010CB530500+1 种基金Key Science and Technology National Program of Anhui Province:1604b0602020Construction project "Innovation team of acupuncture theory,technology and application" of the platform for research and innovation in colleges and universities in Anhui:2015 TD 033~~
文摘Objective: The goal of this study is to explore effective treatments for peripheral facial paralysis and to evaluate the clinical efficacies of warm needling therapy and acupuncture in peripheral facial paralysis.Methods: PubMed(1979-2017), the Chinese National Knowledge Infrastructure database(CNKI, 1979-2017), Wanfang databases(1990-2017), and the Chongqing VIP full-text periodical database(VIP, 1989-2017) were searched by computer. Randomized controlled trials of warm needling therapy and acupuncture in the treatment of peripheral facial paralysis were collected. The clinical trials that met the inclusion criteria were selected for quality assessment using the Cochrane 5.0 Handbook for systematic evaluation.RevMan5.3 was used for statistical analysis.Results: A total of 23 articles with 1756 patients met the inclusion criteria.(1) The meta-analysis of 11 articles showed that the total effective rate of warm needling therapy for peripheral facial paralysis was higher than that of acupuncture [RR = 1.18, 95% Cl(1.11,1.25), P< 0.00001].(2) The meta-analysis of 7 articles showed that the total effective rate of warm needling therapy combined with electroacupuncture in the treatment of peripheral facial paralysis was higher than that of acupuncture combined with electroacupuncture [RR= 1.15, 95% Cl(1.09, 1.21), P< 0.00001].(3) The meta-analysis of 5 articles showed that the total effective rate of warm needling therapy combined with other therapies in the treatment of peripheral facial paralysis was higher than that of acupuncture combined with other therapies [RR= 1.08,95% Cl(1.03, 1.14), P=0.002].(4) The meta-analysis of 5 articles showed that warm needling therapy could improve the House-Brackmann(H-B) scores of patients with peripheral facial paralysis more than acupuncture [mean difference(MD)=-2.85, 95% Cl(-5.08,-0.62), Z = 2.51, P = 0.01], indicating that warm needling therapy provides superior improvement in the function of facial nerve innervation in the patients. No adverse events were reported in the included studies. The methodological quality of the included studies was generally low.Conclusion: The results of this meta-analysis showed that warm needling therapy is superior to acupuncture in treating peripheral facial paralysis, providing a therapeutic option for the treatment of peripheral facial paralysis. However, due to the small sample size and the low quality of the included studies, the above conclusion still needs to be validated with high-quality, large-scale, randomized, blinded controlled trials.
