AIM:To conduct a systematic review and Meta-analysis to determine the differential effects of combined lutein and zeaxanthin supplementation on myopia prevention in teenagers.It also investigates the effects of supple...AIM:To conduct a systematic review and Meta-analysis to determine the differential effects of combined lutein and zeaxanthin supplementation on myopia prevention in teenagers.It also investigates the effects of supplements dosage,intervention duration,and geographical variation on intervention results.METHODS:A systematic search and screening of randomized controlled trials(RCTs)completed between 2014 and 2023 was undertaken using the PubMed,EMBASE,Cochrane Library,and Web of Science databases,in accordance with the PRISMA recommendations.The Cochrane risk of bias method was used to assess the quality of the studies.A Meta-analysis was performed using Stata 17.0 to calculate standardized mean differences(SMDs)and 95%confidence intervals(CIs).Subgroup analyses were performed to look at the effects of different doses,intervention periods,and geographic areas.Additionally,publication bias was assessed using Egger’s test.RESULTS:Ten studies including 1035 participants with myopia were analyzed.Supplementation with lutein and zeaxanthin resulted in a significant reduction in axial length elongation among adolescents in the intervention group(SMD=-0.40,P=0.001),an increase in macular pigment optical density(SMD=0.50,P=0.010),and an enhancement in visual sensitivity(SMD=0.53,P=0.008).Subgroup analyses revealed that participants receiving high doses and those undergoing intervention for more than 12mo exhibited significantly improved outcomes compared to those in the low-dose and short-term groups(high-dose vs low-dose:SMD=-0.41 vs-0.22,P=0.003;>12mo vs 6-12mo:SMD=-0.43 vs-0.23,P=0.004,respectively).Furthermore,Egger’s test indicated no significant publication bias(P=0.094).CONCLUSION:Combined lutein and zeaxanthin supplementation has a significant effect on myopia prevention in adolescents,with more pronounced benefits observed in high-dose and long-term interventions.The findings provide scientific evidence for its use as an adjunctive approach in myopia control.展开更多
BACKGROUND Postoperative delirium(POD)is a common and serious complication in surgical patients,particularly older adults.Alterations in cholinergic function have been implicated in its pathophysiology.AIM To evaluate...BACKGROUND Postoperative delirium(POD)is a common and serious complication in surgical patients,particularly older adults.Alterations in cholinergic function have been implicated in its pathophysiology.AIM To evaluate the association between preoperative serum cholinesterase(ChE)activity—specifically butyrylcholinesterase(BuChE)and acetylcholinesterase(AChE)—and the risk of POD in adult surgical patients in a meta-analysis.METHODS A systematic search was conducted in PubMed,EMBASE,and Web of Science up to March 28,2025 for studies reporting preoperative serum BuChE or AChE activity in relation to subsequent POD incidence.Standardized mean differences(SMDs)and odds ratios(ORs)with 95%confidence intervals(CIs)were pooled using random-effects models.Subgroup and sensitivity analyses were performed based on follow-up duration and analytic models.RESULTS Thirteen studies(n=2730 patients)were included.Patients who developed POD had significantly lower preoperative BuChE activity than those who did not(SMD=-0.28;95%CI:-0.39 to-0.16;I²=18%).Higher BuChE activity was associated with a reduced risk of POD(OR per 100 unit increment=0.97;95%CI:0.95-0.99;I2=0%).In contrast,pooled AChE activity did not differ significantly between POD and non-POD groups(SMD=-0.25;95%CI:-0.53 to 0.03;P=0.08;I2=80%),and the ORs per 1 unit increment in AChE activity were not statistically significant(OR=0.98;95%CI:0.95-1.01).CONCLUSION Lower preoperative serum BuChE activity is associated with an increased risk of POD in adults undergoing surgery.BuChE activity may serve as a potential preoperative biomarker for POD risk stratification.展开更多
BACKGROUND Regorafenib is approved as a second-line treatment for advanced hepatocellular carcinoma(HCC),but its comparative efficacy remains under evaluation.AIM To evaluate the efficacy and safety of regorafenib vs ...BACKGROUND Regorafenib is approved as a second-line treatment for advanced hepatocellular carcinoma(HCC),but its comparative efficacy remains under evaluation.AIM To evaluate the efficacy and safety of regorafenib vs other second-line therapies in advanced HCC.METHODS This systematic review and meta-analysis were conducted in accordance with PRISMA guidelines.A comprehensive search of PubMed,EMBASE,Web of Science,and the Cochrane Library was performed on June 6,2025.Studies were included if they reported at least one relevant clinical outcome:Overall survival,progression-free survival,objective response rate,or disease control rate.Data was extracted independently by two reviewers.Quality was assessed using the Cochrane Risk of Bias 2.0 tool for randomized controlled trials and the Newcastle-Ottawa Scale for cohort studies.Pooled effect estimates were calculated using random-or fixed-effects models depending on the degree of heterogeneity.Sensitivity analyses and Egger’s test were performed to evaluate the robustness of the results and potential publication bias.RESULTS Nine studies met inclusion criteria.Regorafenib significantly improved overall survival compared to controls[weighted mean difference=2.54 months;95%confidence interval(CI):0.26-4.81;P<0.05],but no significant benefit was observed for progression-free survival(weighted mean difference=1.04;95%CI:-1.27 to 3.36).The pooled objective response rate showed no overall difference,though regorafenib was inferior to nivolumab in subgroup analysis(odds ratio=0.34;95% CI:0.20-0.58).Disease control rate did not differ significantly.No publication bias was detected.CONCLUSION Regorafenib offers a survival advantage in advanced HCC but does not significantly improve tumor response rates compared to alternative therapies.展开更多
BACKGROUND Post-endoscopic retrograde cholangiopancreatography pancreatitis(PEP)is a prevalent and potentially serious complication in patients undergoing endoscopic retrograde cholangiopancreatography.AIM To comprehe...BACKGROUND Post-endoscopic retrograde cholangiopancreatography pancreatitis(PEP)is a prevalent and potentially serious complication in patients undergoing endoscopic retrograde cholangiopancreatography.AIM To comprehensively assess the efficacy of indomethacin therapy in reducing PEP risk.METHODS We searched PubMed,EMBASE,Scopus,and Cochrane Library databases to identify randomized controlled trials(RCTs)that compared rectal indomethacin with a control group to prevent PEP.Duplicates were removed,and studies were included based on the established inclusion criteria.We used the Cochrane Collaboration’s tool to assess the risk of bias in the RCTs.A random-effects model was applied to produce pooled risk ratios(RRs)with 95%confidence intervals(CIs).RESULTS We included a total of 30 RCTs involving 16977 patients.Compared to the control group,rectal indomethacin showed comparable rates of overall PEP(PEP;RR=0.85,95%CI:0.69-1.04,I2=79%)with no statistically significant difference of RR in mild(RR=0.92,95%CI:0.74-1.14),moderate(RR=0.78,95%CI:0.59-1.02),or severe PEP(RR=1.12,95%CI:0.75-1.67).There was also no difference in cases of adverse events(RR=0.97,95%CI:0.69-1.35),abdominal pain(RR=1.14,95%CI:0.80-1.62),bleeding(RR=1.07,95%CI:0.70-1.63),or mortality(RR=0.86,95%CI:0.56-1.33)between the two groups.Subgroup analyses were also performed.CONCLUSION Rectal indomethacin appears to be safe and may offer benefit in selected high-risk patients,though findings should be interpreted with caution due to high heterogeneity.展开更多
BACKGROUND Aseptic loosening remains the leading cause of revision in primary total hip arthroplasty(pTHA).However,the literature demonstrates significant variability regarding the relative contributions of different ...BACKGROUND Aseptic loosening remains the leading cause of revision in primary total hip arthroplasty(pTHA).However,the literature demonstrates significant variability regarding the relative contributions of different factors.AIM To investigate the key determinants of aseptic loosening,we performed a systematic review and meta-analysis.METHODS A comprehensive search of PubMed,Web of Science,EMBASE,and the Cochrane Library was conducted,encompassing studies from database inception to January 1,2025.Meta-analyses were performed to evaluate factors associated with aseptic loosening following pTHA.Inclusion and exclusion criteria were systematically applied at each stage to ensure methodological transparency and reproducibility.Study quality was assessed using standardized categories.Pooled odds ratio(OR)with corresponding 95%confidence interval were calculated with random-or fixed-effects models to generate reliability estimates,and study heterogeneity was visualized using forest plots.Ten factors,categorized into patient-,surgeon-,and device-related domains,were reviewed and meta-analyzed.Funnel plot analysis demonstrated a relatively symmetrical distribution,suggesting minimal publication bias.RESULTS A meta-analysis of 20 studies(520789 participants)found a pooled prevalence of 1.96%.Significant risk factors for aseptic loosening after pTHA included elevated body mass index(OR=1.116,P<0.001),higher Charlson comorbidity index(OR=1.378,P<0.001),prosthesis-related factors(OR=1.497,P<0.001),and adverse lifestyles(OR=2.198,P=0.037).Protective factors were non-white race(OR=0.445,P<0.001)and favorable genetics(OR=0.723,P<0.001).Male sex increased risk(OR=1.232,P=0.016),while age and anatomy were not significant.Surgical expertise showed a slight protective effect(OR=1.048,P<0.001).A comprehensive understanding of the modifiable and non-modifiable factors contributing to aseptic loosening after pTHA requires consideration of patient-related factors,surgical expertise,and prosthesis characteristics.CONCLUSION The identification of these factors is critical for risk mitigation.High-risk patients should receive targeted counseling regarding individualized profiles.Further studies are warranted to establish clearer causal relationships and identify additional contributing factors.展开更多
Background:Neurological disorders(NDs),including ischemic stroke(IS),Parkinson’s disease(PD),and Alzheimer’s disease(AD),are major contributors to global morbidity and mortality.Boswellia extract has demonstrated ne...Background:Neurological disorders(NDs),including ischemic stroke(IS),Parkinson’s disease(PD),and Alzheimer’s disease(AD),are major contributors to global morbidity and mortality.Boswellia extract has demonstrated neuroprotective properties,yet a comprehensive systematic review assessing its efficacy remains absent.This study aims to evaluate the efficacy of Boswellia extract in treating NDs,with a particular focus on its effects in AD and its potential for long-term neurorestoration,thereby supporting further investigation into Boswellia’s therapeutic role in ND management.Methods:A systematic literature search was performed in PubMed,Web of Science,ScienceDirect,and Google Scholar for English-language studies published up to March 2024.Eighteen studies met the inclusion criteria and were included in the meta-analysis.The study protocol was registered on PROSPERO(CRD42024524386).Eligible studies involved rodent models of IS,PD,or AD with post-operative interventions using Boswellia extract.Data extraction focused on mechanisms of action,dosages,treatment durations,and therapeutic outcomes.Studies were excluded if they involved non-ND models,combined treatments,or had incomplete data.Two researchers independently conducted literature screening and data extraction.Statistical analyses were conducted using Stata(version 17)and RevMan(version 5.4),employing fixed or random-effects models based on heterogeneity assessments.Result s:Boswellia extract significantly improved the mean effect size for NDs(ES=1.28,95%CI(1.05,1.51),P<0.001).Specifically,it reduced cerebral infarct volume in IS(SMD=−2.87,95%CI(−3.42,−2.32))and enhanced behavioral outcomes in AD(SMD=3.26,95%CI(2.07,5.14))and PD(SMD=5.37,95%CI(3.93,6.80)).Subgroup analyses revealed that Boswellia extract exhibited superior efficacy in AD when administered orally and via intra-cerebroventricular injection.Long-term treatment with Boswellia extract suggested potential neurorestorative effects.Additionally,Boswellia extract was more effective than its monomeric constituents,highlighting its promising role in ND treatment.Conclusion:Boswellia extract demonstrates significant neuroprotective effects across various NDs,particularly in AD and in promoting long-term neurorestoration.These findings support the need for further research into Boswellia’s potential as a therapeutic agent in the management of neurological disorders.展开更多
With the accelerated pace of population aging in China,the number of patients suffering from myocardial infarction(MI)is increasing annually.During disease progression,patients are at significantly higher risk of deve...With the accelerated pace of population aging in China,the number of patients suffering from myocardial infarction(MI)is increasing annually.During disease progression,patients are at significantly higher risk of developing severe negative emotions,and emerging evidence suggests that post-traumatic stress disorder(PTSD)is significantly associated with cardiovascular disease,which seriously affects patients’quality of life.Objective:The aim of this study was to comprehensively assess the prevalence and influencing factors of PTSD in MI patients through systematic review and Meta-analysis.Methods:A computerized search of PubMed,the Cochrane Library,Embase,Web of Science,PsycINFO,China Knowledge Network(CNKI),WanFang Data,VIP,and China Biomedical Literature Database(CBM)was conducted to collect longitudinal studies,case-control studies,and cross-sectional studies related to PTSD prevalence rates and influencing factors in MI patients published up to August 1,2024.Literature screening,data extraction and quality assessment were done independently by two researchers and Meta-analysis was done using Stata 16.0 software.This study has been registered on the PROSPERO platform,registration number:CRD42024577243.Results:A total of 16 papers were included,with a total sample size of 3,768 cases involving 8 influencing factors.The results of the Meta-analysis showed that the prevalence of PTSD in patients with MI was 20.4%(95%CI=15.0–26.5%).Female(OR=3.12,95%CI=1.97–4.97,P<0.001),high neuroticism score(OR=2.21,95%CI=1.20–4.07,P=0.011),and high intrusive rumination score(OR=2.95,95%CI=1.50–5.83,P=0.002)were the risk factors for PTSD in MI patients.While age(OR=1.01,95%CI=0.98–1.04,P=0.440),education level(OR=0.55,95%CI=0.07–4.48,P=0.574),social support rating scale(OR=0.81,95%CI=0.52–1.26,P=0.346),Killip cardiac function classification(OR=2.29,95%CI=0.91–5.80,P=0.080)and creatine kinase isoenzyme(OR=1.03,95%CI=0.99–1.05,P=0.124)were not associated with the development of PTSD in MI patients.Conclusion:The prevalence of PTSD was higher in patients with MI.The prevalence varied by evaluation tool and study area.Risk factors were multifactorial,including general factors(female)and overall assessment(high neuroticism score,high invasive rumination score).Therefore,early intervention and proper de-escalation of PTSD symptoms in patients with MI by medical staff are needed in clinical practice to reduce the risk of PTSD.展开更多
Background:The use of complementary and alternative medicine(CAM)is common among individuals with underlying chronic illnesses.Objective:This systematic review and meta-analysis investigated the global prevalence and ...Background:The use of complementary and alternative medicine(CAM)is common among individuals with underlying chronic illnesses.Objective:This systematic review and meta-analysis investigated the global prevalence and patterns of CAM use among individuals with chronic kidney disease(CKD).Search strategy:PubMed,Embase,and Cumulative Index to Nursing and Allied Health Literature Plus were searched from inception until 26th February 2024.Inclusion criteria:Original articles reporting the use of at least one type of CAM among individuals aged above 18 years old and at all stages of CKD or undergoing any form of kidney replacement therapy.Data extraction and analysis:Two independent reviewers performed the literature screening.The data were extracted from the included studies by one reviewer and cross-checked by another.Discrepancies were resolved by discussion and consensus among two reviewers.Primary information included prevalence of CAM use,types of CAM used,reasons for CAM use,factors associated with CAM use,and disclosure to healthcare providers.Meta-analyses were performed to determine the pooled prevalence of CAM use and non-disclosure of CAM using a random effect model.Results:Forty-one studies were included in this systematic review and meta-analysis.The pooled prevalence of CAM use was 43%(95%confidence interval:34%,51%),I2=99.46%.The reasons for CAM use included treatment of underlying comorbidities,complications or symptoms,maintenance of general health,and treatment of CKD.Nutritional approaches were the most common CAM modality,with 412different herbal and dietary supplements reported;psychological and physical approaches included massage therapy,relaxation techniques,and mind–body practices;and other complementary health approaches such as homeopathy,traditional Chinese medicine,and Ayurvedic medicine were also frequently reported.Factors associated with CAM use included sociodemographic characteristics such as older age,female gender,or higher income;disease or therapy factors such as not having diabetes,relying on hemodialysis,or poor adherence to medication;and patient or internal factors such as positive attitude towards CAM and perceived safety of CAM.About 66%(61%,72%)of CAM users did not disclose the use of CAM to their healthcare providers.Conclusion:CAM use is prevalent among individuals with CKD,and healthcare providers should communicate openly and effectively to emphasize the rational use of CAM to avoid potential harm.展开更多
BACKGROUND Helicobacter pylori(H.pylori)stands as the predominant infectious agent linked to the onset of gastritis,peptic ulcer diseases,and gastric cancer(GC).Identified as the exclusive bacterial factor associated ...BACKGROUND Helicobacter pylori(H.pylori)stands as the predominant infectious agent linked to the onset of gastritis,peptic ulcer diseases,and gastric cancer(GC).Identified as the exclusive bacterial factor associated with the onset of GC,it is classified as a group 1 carcinogen by the World Health Organization.The elimination of H.pylori plays a crucial role in the primary prevention of GC.While the prevalence has declined in recent decades,H.pylori infection is still highly prevalent in China,accounting for a significant part of the disease burden of GC.Therefore,updated prevalence information for H.pylori infection,especially regional and demographic variations in China,is an important basis for the design of targeted strategies that will be effective for the prevention of GC and application of policies for H.pylori control.AIM To methodically evaluate the occurrence of H.pylori infection throughout China and establish a reference point for subsequent investigations.METHODS A systematic review and meta-analysis was conducted following established guidelines,as detailed in our methodology section.RESULTS Our review synthesized data from 152 studies,covering a sample of 763827 individuals,314423 of whom were infected with H.pylori.We evaluated infection rates in China's Mainland and the combined prevalence of H.pylori was 42.8%(95%CI:40.7-44.9).Subgroup analysis indicated the highest prevalence in Northwest China at 51.3%(95%CI:45.6-56.9),and in Qinghai Province,the prevalence reached 60.2%(95%CI:46.5-73.9).The urea breath test,which recorded the highest infection rate,showed a prevalence of 43.7%(95%CI:41.4-46.0).No notable differences in infection rates were observed between genders.Notably,the prevalence among the elderly was significantly higher at 44.5%(95%CI:41.9-47.1),compared to children,who showed a prevalence of 27.5%(95%CI:19.58-34.7).CONCLUSION Between 2014 and 2023,the prevalence of H.pylori infection in China decreased to 42.8%,down from the previous decade.However,the infection rates vary considerably across different geographical areas,among various populations,and by detection methods employed.展开更多
Male factor infertility affects 30%-50% of infertile couples worldwide, and there is an increasing interest in the optimal management of these patients. In studies comparing double and single intrauterine insemination...Male factor infertility affects 30%-50% of infertile couples worldwide, and there is an increasing interest in the optimal management of these patients. In studies comparing double and single intrauterine insemination （IUI）, a trend towards higher pregnancy rates in couples with male factor infertility was observed. Therefore, we set out to perform a meta-analysis to examine the superiority of double versus single IUI with the male partner＇s sperm in couples with male factor infertility. An odds ratio （OR） of 95% confidence intervals （CIs） was calculated for the pregnancy rate. Outcomes were analysed by using the ManteI-Haesel or DerSimonian-Laird model accordingto the heterogeneity of the results. Overall, five trials involving 1125 IUI cycles were included in the meta-analysis. There was a two-fold increase in pregnancies after a cycle with a double IUI compared with a cycle with a single IUI （OR. 2.0; 95% CI. 1.07-3.75; P〈O.03）. Nevertheless, this result was mainly attributed to the presence of a large trial that weighted as almost 50% in the overall analysis. Sensitivity analysis, excluding this large trial, revealed only a trend towards higher pregnancy rates among double IUI cycles （OR. 1.58; 95% CI. 0.59-4.21）, but without statistical significance （P=0.20）. Our systematic review highlights that the available evidence regarding the use of double IUI in couples with male factor infertility is fragmentary and weak. Although there may be a trend towards higher pregnancy rates when the number of IUIs per cycle is increased, further large and well-designed randomized trials are needed to provide solid evidence toide current clinical practice.展开更多
AIM To determine hepatitis C virus(HCV)infection prevalence in each country of the Middle-East and the overall prevalence of the region.METHODS In this systematic review,we gathered all documents related to HCV infect...AIM To determine hepatitis C virus(HCV)infection prevalence in each country of the Middle-East and the overall prevalence of the region.METHODS In this systematic review,we gathered all documents related to HCV infection prevalence among hemodialysis patients in 17 middle-east countries from April 2006 to March 2016.We selected only cross-sectional studies that had proper sampling and measurement methods as well as a valid statistical analysis.RESULTS After screening of 7311 documents,56 studies were selected reporting the prevalence of HCV infection among hemodialysis patients from 10 countries of the region.Seven countries including United Arab Emirates,Afghanistan,Qatar,Bahrain,Kuwait,Oman,Israel,and Cyprus did not have any relevant document;thus,their latest reports were just mentioned.We performed the meta-analysis and determined the prevalence rates for each country as well as the whole region.The overall HCV infection prevalence among hemodialysis patients in the region was reported to be 25.3%;Egypt and Syria had the highest reported rates while Iran and Lebanon had the lowest.Further investigations are still needed to provide more reliable databases,find main risk factors,and to improve diagnosis and treatment plans,particularly in higher prevalent countries.CONCLUSION Controlling the prevalence and improving the management methods of HCV infection among hemodialysis patients are of a great concern in the Middle-East region.展开更多
AIM To analyze the effect of intralesional steroid injections in addition to endoscopic dilation of benign refractory esophageal strictures.METHODS A comprehensive search was performed in three databases from inceptio...AIM To analyze the effect of intralesional steroid injections in addition to endoscopic dilation of benign refractory esophageal strictures.METHODS A comprehensive search was performed in three databases from inception to 10 April 2017 to identify trials, comparing the efficacy of endoscopic dilation to dilation combined with intralesional steroid injections. Following the data extraction, meta-analytical calculations were performed on measures of outcome by the randomeffects method of Der Simonian and Laird. Heterogeneity of the studies was tested by Cochrane's Q and I^2 statistics. Risk of quality and bias was assessed by the Newcastle Ottawa Scale and JADAD assessment tools.RESULTS Eleven articles were identified suitable for analyses, involving 343 patients, 235 cases and 229 controls in total. Four studies used crossover design with 121 subjects enrolled. The periodic dilation index(PDI) was comparable in 4 studies, where the pooled result showed a significant improvement of PDI in the steroid group(MD:-1.12 dilation/month, 95% CI:-1.99 to -0.25 P = 0.012; I^2 = 74.4%). The total number of repeat dilations(TNRD) was comparable in 5 studies and showed a non-significant decrease(MD:-1.17, 95%CI:-0.24-0.05, P = 0.057; I^2 = 0), while the dysphagia score(DS) was comparable in 5 studies and did not improve(SMD: 0.35, 95%CI:-0.38, 1.08, P = 0.351; I^2 = 83.98%) after intralesional steroid injection.CONCLUSION Intralesional steroid injection increases the time between endoscopic dilations of benign refractory esophageal strictures. However, its potential role needs further research.展开更多
Aromatase activity has commonly been associated with male infertility characterized by testicular dysfunction with low serum testosterone and/or testosterone to estradiol ratio.In this subset of patients,and particula...Aromatase activity has commonly been associated with male infertility characterized by testicular dysfunction with low serum testosterone and/or testosterone to estradiol ratio.In this subset of patients,and particularly in those with hypogonadism,elevated levels of circulating estradiol may establish a negative feedback on the hypothalamic–pituitary–testicular axis by suppressing follicle-stimulating hormone(FSH)and luteinizing hormone(LH)production and impaired spermatogenesis.Hormonal manipulation via different agents such as selective estrogen modulators or aromatase inhibitors to increase endogenous testosterone production and improve spermatogenesis in the setting of infertility is an off-label option for treatment.We carried out a systematic review and meta-analysis of the literature of the past 30 years in order to evaluate the benefits of the use of aromatase inhibitors in the medical management of infertile/hypoandrogenic males.Overall,eight original articles were included and critically evaluated.Either steroidal(Testolactone)or nonsteroidal(Anastrozole and Letrozole)aromatase inhibitors were found to statistically improve all the evaluated hormonal and seminal outcomes with a safe tolerability profile.While the evidence is promising,future prospective randomized placebo-controlled multicenter trials are necessary to better define the efficacy of these medications.展开更多
BACKGROUND Diabetic foot ulcers(DFUs)present a significant clinical challenge due to their high prevalence and profound impact on morbidity.Ultrasound-assisted wound debridement(UAWD)has emerged as a potential therape...BACKGROUND Diabetic foot ulcers(DFUs)present a significant clinical challenge due to their high prevalence and profound impact on morbidity.Ultrasound-assisted wound debridement(UAWD)has emerged as a potential therapeutic modality to improve healing outcomes in DFU management.AIM To evaluate the efficacy of UAWD in treating DFUs on wound closure rates,treatment duration,and quality of life outcomes.METHODS This systematic review and meta-analysis followed PRISMA guidelines,systematically searching PubMed,Embase,Web of Science,and the Cochrane Library with no date restrictions.Randomized controlled trials(RCTs)that evaluated the efficacy of UAWD in DFU treatment were included.Data were independently extracted by two reviewers,with discrepancies resolved through consensus or third-party consultation.The risk of bias was assessed using the Cochrane tool.χ2 and I2 statistics assessed heterogeneity,informing the use of fixed or random-effects models for meta-analysis,supplemented by sensitivity analysis and publication bias assessment through funnel plots and Egger's test.RESULTS From 1255 articles,seven RCTs met the inclusion criteria.The studies demonstrated that UAWD significantly reduced DFU healing time(standardized mean difference=-0.78,95%CI:-0.97 to-0.60,P<0.001)and increased healing rates(odds ratio=9.96,95%CI:5.99 to 16.56,P<0.001)compared to standard care.Sensitivity analysis confirmed the stability of these results,and no significant publication bias was detected.CONCLUSION UAWD is a promising adjunctive treatment for DFUs,significantly reducing healing times and increasing healing rates.These findings advocate for the integration of UAWD into standard DFU care protocols.展开更多
AIM:To summarize the data of epidemiological studies on cataract prevalence over 50 years old in urban and rural areas of China from 2000 to 2020,and to analyze the prevalence of cataract and operation rate in China.M...AIM:To summarize the data of epidemiological studies on cataract prevalence over 50 years old in urban and rural areas of China from 2000 to 2020,and to analyze the prevalence of cataract and operation rate in China.METHODS:By searching Pub Med,EMBASE,Web of Science,Wanfang Data and CNKI,Chinese and English literatures on the prevalence of cataract in China were retrieved,and the relevant characteristic data were extracted.Then,Stata v15 SE software was used for Metaanalysis and heterogeneity test.According to the results of heterogeneity,the corresponding effect models were selected to combine the extracted data.RESULTS:A total of 20 studies were included in this study,with a total of 111434 cases.Meta-analysis showed heterogeneity.According to the random effect model,the overall prevalence of cataract in Chinese people over 50 years old was 27.45%,that in rural was 28.79%,and that in urban was 26.66%.The overall coverage rate of cataract surgery was 9.19%.CONCLUSION:The prevalence of cataract is high in China,and there is still room for improvement in surgical coverage,so it is very important to promote cataract screening and prevention.展开更多
Objective: This study seeks to review current and relevant literature on global Angle class III malocclusion prevalence. Materials and Methods: The electronic databases PubMed, ISI Web of Knowledge, and the Cochrane D...Objective: This study seeks to review current and relevant literature on global Angle class III malocclusion prevalence. Materials and Methods: The electronic databases PubMed, ISI Web of Knowledge, and the Cochrane Database of Systematic Review were searched using specific inclusion criteria to obtain applicable articles. All pertinent references were also examined for acceptability. Results: A total of 20 articles were identified using the inclusion criteria. The prevalence of Angle class III malocclusion ranged from 0 to 26.7% in different populations reported in the literature examined. Meta-regression analysis showed no statistically significant association between prevalence rates and the method of assessment, age group and year of the study. However, much of the study-to-study variation (approximately 40%) could be explained by population. Conclusion: These results suggest that the prevalence of Angle class III malocclusion varies greatly within different races and geographic regions. Chinese and Malaysian populations have a higher prevalence of Angle class III malocclusion compared to other racial groups, while Indian populations have a lower prevalence than all other racial groups examined.展开更多
OBJECTIVE:To systematically review the benefits of integrated traditional and Western medicine therapies based on the Hamilton depression scale(HAMD) following syndrome differentiation of depression.METHODS:We searche...OBJECTIVE:To systematically review the benefits of integrated traditional and Western medicine therapies based on the Hamilton depression scale(HAMD) following syndrome differentiation of depression.METHODS:We searched six English and Chinese electronic databases for randomized clinical trials(RCTs) on integrated traditional and Western medicine for treatment of depression.Two authors extracted data and independently assessed the trial quality.RevMan 5 software was used for data analyses with an effect estimate presented as weighted mean difference(WMD) with a 95% confidence interval(CI).RESULTS:Seven RCTs with 576 participants were identified for this review.All trials were eligible for the meta-analysis and were evaluated as unclear or having a risk of bias.Meta-analysis showed,compared with Western medicine alone,integrated traditional and Western medicine based on syndrome differentiation could improve the effect of treatment represented by the HAMD [WMD=-2.39,CI(-2.96,-1.83),Z=8.29,P<0.00001].There were no reported serious adverse effects that were related to integrated traditional and Western medicine based therapies in these trials.CONCLUSIONS:Integrated traditional and Western medicine based therapies for the syndrome differentiation of depression significantly improved the HAMD,illustrating that combining therapies from integrated traditional and Western medicine for treatment of depression is better than Western medicine alone.However,further large,rigorously designed trials are warranted due to the insufficient methodological rigor seen in the trials included in this study.展开更多
BACKGROUND The side effects of prostate cancer(PCa)treatment are very prominent,with cancer-related fatigue(CRF)being the most common.Fatigue is a distressing symptom that interferes with daily functioning and serious...BACKGROUND The side effects of prostate cancer(PCa)treatment are very prominent,with cancer-related fatigue(CRF)being the most common.Fatigue is a distressing symptom that interferes with daily functioning and seriously affects patient quality of life during,and for many years after,treatment.However,compared with other types of cancer,such as breast cancer,little is known about the prevalence of PCa-related fatigue.AIM To determine the prevalence of CRF in patients with PCa.METHODS A systematic search of EMBASE,PubMed,Web of Science,Cochrane Library,Chinese National Knowledge Infrastructure,WANFANG DATA,Technology Journal Database and the Chinese Biological Medical Database was conducted up to July 28,2020.Included studies measured the incidence of PCa-related fatigue and differentiated fatigue outcomes(incidence)between treatment modalities and fatigue assessment times.In our meta-analysis,both fixed and random-effects models were used to estimate the pooled prevalence of PCa-related fatigue.Subgroup analyses were performed using treatment modalities and fatigue assessment times.Publication and sensitivity bias analyses were performed to test the robustness of the associations.RESULTS Fourteen studies,involving 4736 patients,were eligible for the review.The pooled CRF prevalence was 40%in a total sample of 4736 PCa patients[95%confidence interval(CI):29-52;P<0.01;I2=98%].The results of the subgroup analyses showed the prevalence of CRF after androgen deprivation therapy treatment,radical prostatectomy and radiotherapy to be 42%(95%CI:20-67,P<0.01,I2=91%),21%(95%CI:16-26,P=0.87,I2=0%)and 40%(95%CI:22-58,P<0.01,I2=90%),respectively.The prevalence of acute and persistent fatigue was 44%(95%CI:25-64;P<0.01;I2=93%)and 29%(95%CI:25-32;P=0.30;I2=17%),respectively.CONCLUSION Our meta-analysis showed that fatigue is a common symptom in men with PCa,especially those using hormone therapy.展开更多
Objective To understand drug resistance prevalence among treatment-failure and treatment-nave HIV-positive individuals in China.Methods We searched five electronic databases（Wanfang,CNKI,CQVIP,SinoMed,and Pubmed） fo...Objective To understand drug resistance prevalence among treatment-failure and treatment-nave HIV-positive individuals in China.Methods We searched five electronic databases（Wanfang,CNKI,CQVIP,SinoMed,and Pubmed） for studies of HIV drug resistance.Random-effects models were carried out to estimate the prevalence of drug resistance among treatment-failure and treatment-nave individuals,respectively.Results The estimated nationwide rates of HIV drug resistance to any-class drugs among treatment-failure and treatment-nave individuals were 57%（95% CI：49%-65%） and 3.23%（95% CI：2.47%-4.07%）,respectively.Among the drug classes,the prevalence of resistance to PIs was low（1.45%;95% CI：0.73%-2.33%） in treatment-failure individuals,although high rates of resistance to NNRTIs（54%;95% CI：45%-63%） and NRTIs（40%;95% CI：32%-49%） were found.Resistance to any-class drugs,NNRTIs and NRTIs manifested regional differences,but resistance to PIs did not.Positive correlations were observed between resistance to NNRTIs and NRTIs among treatment-failure and treatment-nave individuals,respectively.Conclusion The prevalence of HIV drug resistance to NNRTIs and NRTIs among treatment-failure individuals was high.In contrast,the prevalence of drug resistance among treatment-nave individuals was low.The epidemics of drug resistance matched current treatment strategies and interventions in China.Surveillance for HIV drug resistance is necessary to assess the sustainability and durability of current treatment regimens.展开更多
Objectives:This systematic review and meta-analysis aimed to identify and synthesize the factors correlated with posttraumatic growth(PTG)in patients with colorectal cancer(CRC).Methods:PubMed,Web of Science,Embase,Ps...Objectives:This systematic review and meta-analysis aimed to identify and synthesize the factors correlated with posttraumatic growth(PTG)in patients with colorectal cancer(CRC).Methods:PubMed,Web of Science,Embase,PsycINFO,CINAHL,Cochrane Library,China National Knowledge Infrastructure(CNKI),Wanfang database,China Science and Technology Journal Database(VIP)and SinoMed were searched for studies that reported data on the correlated factors associated with PTG in patients with CRC from inception to September 3,2024.The methodological quality of the included studies was assessed via the Agency for Healthcare Research and Quality(AHRQ)methodology checklist and the Newcastle-Ottawa Scale(NOS).Pearson correlation coefficient(r)was utilized to indicate effect size.Meta-analysis was conducted in R Studio.Results:Thirty-one eligible studies encompassing 6,400 participants were included in this review.Correlated factors were identified to be significantly associated with PTG in patients with CRC including demographic factors:residential area(r=0.13),marital status(r=0.10),employment status(r=0.18),education level(r=0.19),income level(r=0.16);disease-related factors:time since surgery(r=0.17),stoma-related complications(r=0.14),health-promoting behavior(r=0.46),and sexual function(r=0.17);psychosocial factors:confrontation coping(r=0.68),avoidance coping(r=-0.65),deliberate rumination(r=0.56),social support(r=0.47),family function(r=0.50),resilience(r=0.53),selfefficacy(r=0.91),self-compassion(r=-0.32),psychosocial adjustment(r=0.39),gratitude(r=0.45),stigma(r=-0.65),self-perceived burden(r=-0.31),fear of cancer recurrence(r=-0.45);and quality of life(r=0.32).Conclusions:This meta-analysis identified 23 factors associated with PTG in CRC patients.Medical workers can combine those relevant factors from the perspective of positive psychology,further explore the occurrence and development mechanism of PTG,and establish targeted interventions to promote PTG.展开更多
文摘AIM:To conduct a systematic review and Meta-analysis to determine the differential effects of combined lutein and zeaxanthin supplementation on myopia prevention in teenagers.It also investigates the effects of supplements dosage,intervention duration,and geographical variation on intervention results.METHODS:A systematic search and screening of randomized controlled trials(RCTs)completed between 2014 and 2023 was undertaken using the PubMed,EMBASE,Cochrane Library,and Web of Science databases,in accordance with the PRISMA recommendations.The Cochrane risk of bias method was used to assess the quality of the studies.A Meta-analysis was performed using Stata 17.0 to calculate standardized mean differences(SMDs)and 95%confidence intervals(CIs).Subgroup analyses were performed to look at the effects of different doses,intervention periods,and geographic areas.Additionally,publication bias was assessed using Egger’s test.RESULTS:Ten studies including 1035 participants with myopia were analyzed.Supplementation with lutein and zeaxanthin resulted in a significant reduction in axial length elongation among adolescents in the intervention group(SMD=-0.40,P=0.001),an increase in macular pigment optical density(SMD=0.50,P=0.010),and an enhancement in visual sensitivity(SMD=0.53,P=0.008).Subgroup analyses revealed that participants receiving high doses and those undergoing intervention for more than 12mo exhibited significantly improved outcomes compared to those in the low-dose and short-term groups(high-dose vs low-dose:SMD=-0.41 vs-0.22,P=0.003;>12mo vs 6-12mo:SMD=-0.43 vs-0.23,P=0.004,respectively).Furthermore,Egger’s test indicated no significant publication bias(P=0.094).CONCLUSION:Combined lutein and zeaxanthin supplementation has a significant effect on myopia prevention in adolescents,with more pronounced benefits observed in high-dose and long-term interventions.The findings provide scientific evidence for its use as an adjunctive approach in myopia control.
文摘BACKGROUND Postoperative delirium(POD)is a common and serious complication in surgical patients,particularly older adults.Alterations in cholinergic function have been implicated in its pathophysiology.AIM To evaluate the association between preoperative serum cholinesterase(ChE)activity—specifically butyrylcholinesterase(BuChE)and acetylcholinesterase(AChE)—and the risk of POD in adult surgical patients in a meta-analysis.METHODS A systematic search was conducted in PubMed,EMBASE,and Web of Science up to March 28,2025 for studies reporting preoperative serum BuChE or AChE activity in relation to subsequent POD incidence.Standardized mean differences(SMDs)and odds ratios(ORs)with 95%confidence intervals(CIs)were pooled using random-effects models.Subgroup and sensitivity analyses were performed based on follow-up duration and analytic models.RESULTS Thirteen studies(n=2730 patients)were included.Patients who developed POD had significantly lower preoperative BuChE activity than those who did not(SMD=-0.28;95%CI:-0.39 to-0.16;I²=18%).Higher BuChE activity was associated with a reduced risk of POD(OR per 100 unit increment=0.97;95%CI:0.95-0.99;I2=0%).In contrast,pooled AChE activity did not differ significantly between POD and non-POD groups(SMD=-0.25;95%CI:-0.53 to 0.03;P=0.08;I2=80%),and the ORs per 1 unit increment in AChE activity were not statistically significant(OR=0.98;95%CI:0.95-1.01).CONCLUSION Lower preoperative serum BuChE activity is associated with an increased risk of POD in adults undergoing surgery.BuChE activity may serve as a potential preoperative biomarker for POD risk stratification.
文摘BACKGROUND Regorafenib is approved as a second-line treatment for advanced hepatocellular carcinoma(HCC),but its comparative efficacy remains under evaluation.AIM To evaluate the efficacy and safety of regorafenib vs other second-line therapies in advanced HCC.METHODS This systematic review and meta-analysis were conducted in accordance with PRISMA guidelines.A comprehensive search of PubMed,EMBASE,Web of Science,and the Cochrane Library was performed on June 6,2025.Studies were included if they reported at least one relevant clinical outcome:Overall survival,progression-free survival,objective response rate,or disease control rate.Data was extracted independently by two reviewers.Quality was assessed using the Cochrane Risk of Bias 2.0 tool for randomized controlled trials and the Newcastle-Ottawa Scale for cohort studies.Pooled effect estimates were calculated using random-or fixed-effects models depending on the degree of heterogeneity.Sensitivity analyses and Egger’s test were performed to evaluate the robustness of the results and potential publication bias.RESULTS Nine studies met inclusion criteria.Regorafenib significantly improved overall survival compared to controls[weighted mean difference=2.54 months;95%confidence interval(CI):0.26-4.81;P<0.05],but no significant benefit was observed for progression-free survival(weighted mean difference=1.04;95%CI:-1.27 to 3.36).The pooled objective response rate showed no overall difference,though regorafenib was inferior to nivolumab in subgroup analysis(odds ratio=0.34;95% CI:0.20-0.58).Disease control rate did not differ significantly.No publication bias was detected.CONCLUSION Regorafenib offers a survival advantage in advanced HCC but does not significantly improve tumor response rates compared to alternative therapies.
文摘BACKGROUND Post-endoscopic retrograde cholangiopancreatography pancreatitis(PEP)is a prevalent and potentially serious complication in patients undergoing endoscopic retrograde cholangiopancreatography.AIM To comprehensively assess the efficacy of indomethacin therapy in reducing PEP risk.METHODS We searched PubMed,EMBASE,Scopus,and Cochrane Library databases to identify randomized controlled trials(RCTs)that compared rectal indomethacin with a control group to prevent PEP.Duplicates were removed,and studies were included based on the established inclusion criteria.We used the Cochrane Collaboration’s tool to assess the risk of bias in the RCTs.A random-effects model was applied to produce pooled risk ratios(RRs)with 95%confidence intervals(CIs).RESULTS We included a total of 30 RCTs involving 16977 patients.Compared to the control group,rectal indomethacin showed comparable rates of overall PEP(PEP;RR=0.85,95%CI:0.69-1.04,I2=79%)with no statistically significant difference of RR in mild(RR=0.92,95%CI:0.74-1.14),moderate(RR=0.78,95%CI:0.59-1.02),or severe PEP(RR=1.12,95%CI:0.75-1.67).There was also no difference in cases of adverse events(RR=0.97,95%CI:0.69-1.35),abdominal pain(RR=1.14,95%CI:0.80-1.62),bleeding(RR=1.07,95%CI:0.70-1.63),or mortality(RR=0.86,95%CI:0.56-1.33)between the two groups.Subgroup analyses were also performed.CONCLUSION Rectal indomethacin appears to be safe and may offer benefit in selected high-risk patients,though findings should be interpreted with caution due to high heterogeneity.
基金Supported by the National Natural Science Foundation of China,No.82402789Beijing Jishuitan Hospital Youcai Plan,No.KYYC202402+2 种基金Beijing Jishuitan Research Funding,No.HL202402and Beijing Natural Science Foundation,No.L232062No.L222063.
文摘BACKGROUND Aseptic loosening remains the leading cause of revision in primary total hip arthroplasty(pTHA).However,the literature demonstrates significant variability regarding the relative contributions of different factors.AIM To investigate the key determinants of aseptic loosening,we performed a systematic review and meta-analysis.METHODS A comprehensive search of PubMed,Web of Science,EMBASE,and the Cochrane Library was conducted,encompassing studies from database inception to January 1,2025.Meta-analyses were performed to evaluate factors associated with aseptic loosening following pTHA.Inclusion and exclusion criteria were systematically applied at each stage to ensure methodological transparency and reproducibility.Study quality was assessed using standardized categories.Pooled odds ratio(OR)with corresponding 95%confidence interval were calculated with random-or fixed-effects models to generate reliability estimates,and study heterogeneity was visualized using forest plots.Ten factors,categorized into patient-,surgeon-,and device-related domains,were reviewed and meta-analyzed.Funnel plot analysis demonstrated a relatively symmetrical distribution,suggesting minimal publication bias.RESULTS A meta-analysis of 20 studies(520789 participants)found a pooled prevalence of 1.96%.Significant risk factors for aseptic loosening after pTHA included elevated body mass index(OR=1.116,P<0.001),higher Charlson comorbidity index(OR=1.378,P<0.001),prosthesis-related factors(OR=1.497,P<0.001),and adverse lifestyles(OR=2.198,P=0.037).Protective factors were non-white race(OR=0.445,P<0.001)and favorable genetics(OR=0.723,P<0.001).Male sex increased risk(OR=1.232,P=0.016),while age and anatomy were not significant.Surgical expertise showed a slight protective effect(OR=1.048,P<0.001).A comprehensive understanding of the modifiable and non-modifiable factors contributing to aseptic loosening after pTHA requires consideration of patient-related factors,surgical expertise,and prosthesis characteristics.CONCLUSION The identification of these factors is critical for risk mitigation.High-risk patients should receive targeted counseling regarding individualized profiles.Further studies are warranted to establish clearer causal relationships and identify additional contributing factors.
基金supported by the National Natural Science Foundation of China,specifically through grants(No.8227431382304947)Key Research and Development Project of Shaanxi Province(2023GHZD43).Peer re v iew information。
文摘Background:Neurological disorders(NDs),including ischemic stroke(IS),Parkinson’s disease(PD),and Alzheimer’s disease(AD),are major contributors to global morbidity and mortality.Boswellia extract has demonstrated neuroprotective properties,yet a comprehensive systematic review assessing its efficacy remains absent.This study aims to evaluate the efficacy of Boswellia extract in treating NDs,with a particular focus on its effects in AD and its potential for long-term neurorestoration,thereby supporting further investigation into Boswellia’s therapeutic role in ND management.Methods:A systematic literature search was performed in PubMed,Web of Science,ScienceDirect,and Google Scholar for English-language studies published up to March 2024.Eighteen studies met the inclusion criteria and were included in the meta-analysis.The study protocol was registered on PROSPERO(CRD42024524386).Eligible studies involved rodent models of IS,PD,or AD with post-operative interventions using Boswellia extract.Data extraction focused on mechanisms of action,dosages,treatment durations,and therapeutic outcomes.Studies were excluded if they involved non-ND models,combined treatments,or had incomplete data.Two researchers independently conducted literature screening and data extraction.Statistical analyses were conducted using Stata(version 17)and RevMan(version 5.4),employing fixed or random-effects models based on heterogeneity assessments.Result s:Boswellia extract significantly improved the mean effect size for NDs(ES=1.28,95%CI(1.05,1.51),P<0.001).Specifically,it reduced cerebral infarct volume in IS(SMD=−2.87,95%CI(−3.42,−2.32))and enhanced behavioral outcomes in AD(SMD=3.26,95%CI(2.07,5.14))and PD(SMD=5.37,95%CI(3.93,6.80)).Subgroup analyses revealed that Boswellia extract exhibited superior efficacy in AD when administered orally and via intra-cerebroventricular injection.Long-term treatment with Boswellia extract suggested potential neurorestorative effects.Additionally,Boswellia extract was more effective than its monomeric constituents,highlighting its promising role in ND treatment.Conclusion:Boswellia extract demonstrates significant neuroprotective effects across various NDs,particularly in AD and in promoting long-term neurorestoration.These findings support the need for further research into Boswellia’s potential as a therapeutic agent in the management of neurological disorders.
文摘With the accelerated pace of population aging in China,the number of patients suffering from myocardial infarction(MI)is increasing annually.During disease progression,patients are at significantly higher risk of developing severe negative emotions,and emerging evidence suggests that post-traumatic stress disorder(PTSD)is significantly associated with cardiovascular disease,which seriously affects patients’quality of life.Objective:The aim of this study was to comprehensively assess the prevalence and influencing factors of PTSD in MI patients through systematic review and Meta-analysis.Methods:A computerized search of PubMed,the Cochrane Library,Embase,Web of Science,PsycINFO,China Knowledge Network(CNKI),WanFang Data,VIP,and China Biomedical Literature Database(CBM)was conducted to collect longitudinal studies,case-control studies,and cross-sectional studies related to PTSD prevalence rates and influencing factors in MI patients published up to August 1,2024.Literature screening,data extraction and quality assessment were done independently by two researchers and Meta-analysis was done using Stata 16.0 software.This study has been registered on the PROSPERO platform,registration number:CRD42024577243.Results:A total of 16 papers were included,with a total sample size of 3,768 cases involving 8 influencing factors.The results of the Meta-analysis showed that the prevalence of PTSD in patients with MI was 20.4%(95%CI=15.0–26.5%).Female(OR=3.12,95%CI=1.97–4.97,P<0.001),high neuroticism score(OR=2.21,95%CI=1.20–4.07,P=0.011),and high intrusive rumination score(OR=2.95,95%CI=1.50–5.83,P=0.002)were the risk factors for PTSD in MI patients.While age(OR=1.01,95%CI=0.98–1.04,P=0.440),education level(OR=0.55,95%CI=0.07–4.48,P=0.574),social support rating scale(OR=0.81,95%CI=0.52–1.26,P=0.346),Killip cardiac function classification(OR=2.29,95%CI=0.91–5.80,P=0.080)and creatine kinase isoenzyme(OR=1.03,95%CI=0.99–1.05,P=0.124)were not associated with the development of PTSD in MI patients.Conclusion:The prevalence of PTSD was higher in patients with MI.The prevalence varied by evaluation tool and study area.Risk factors were multifactorial,including general factors(female)and overall assessment(high neuroticism score,high invasive rumination score).Therefore,early intervention and proper de-escalation of PTSD symptoms in patients with MI by medical staff are needed in clinical practice to reduce the risk of PTSD.
文摘Background:The use of complementary and alternative medicine(CAM)is common among individuals with underlying chronic illnesses.Objective:This systematic review and meta-analysis investigated the global prevalence and patterns of CAM use among individuals with chronic kidney disease(CKD).Search strategy:PubMed,Embase,and Cumulative Index to Nursing and Allied Health Literature Plus were searched from inception until 26th February 2024.Inclusion criteria:Original articles reporting the use of at least one type of CAM among individuals aged above 18 years old and at all stages of CKD or undergoing any form of kidney replacement therapy.Data extraction and analysis:Two independent reviewers performed the literature screening.The data were extracted from the included studies by one reviewer and cross-checked by another.Discrepancies were resolved by discussion and consensus among two reviewers.Primary information included prevalence of CAM use,types of CAM used,reasons for CAM use,factors associated with CAM use,and disclosure to healthcare providers.Meta-analyses were performed to determine the pooled prevalence of CAM use and non-disclosure of CAM using a random effect model.Results:Forty-one studies were included in this systematic review and meta-analysis.The pooled prevalence of CAM use was 43%(95%confidence interval:34%,51%),I2=99.46%.The reasons for CAM use included treatment of underlying comorbidities,complications or symptoms,maintenance of general health,and treatment of CKD.Nutritional approaches were the most common CAM modality,with 412different herbal and dietary supplements reported;psychological and physical approaches included massage therapy,relaxation techniques,and mind–body practices;and other complementary health approaches such as homeopathy,traditional Chinese medicine,and Ayurvedic medicine were also frequently reported.Factors associated with CAM use included sociodemographic characteristics such as older age,female gender,or higher income;disease or therapy factors such as not having diabetes,relying on hemodialysis,or poor adherence to medication;and patient or internal factors such as positive attitude towards CAM and perceived safety of CAM.About 66%(61%,72%)of CAM users did not disclose the use of CAM to their healthcare providers.Conclusion:CAM use is prevalent among individuals with CKD,and healthcare providers should communicate openly and effectively to emphasize the rational use of CAM to avoid potential harm.
基金Supported by The Zhongyuan Famous Doctor,No.ZYYCYU202012119Scientific Research Special Project of Traditional Chinese Medicine in Henan Province,No.2024ZY2004Scientific Research Special Project of the National TCM Inheritance and Innovation Center of Henan Provincial Health Commission,No.2023ZXZX1093.
文摘BACKGROUND Helicobacter pylori(H.pylori)stands as the predominant infectious agent linked to the onset of gastritis,peptic ulcer diseases,and gastric cancer(GC).Identified as the exclusive bacterial factor associated with the onset of GC,it is classified as a group 1 carcinogen by the World Health Organization.The elimination of H.pylori plays a crucial role in the primary prevention of GC.While the prevalence has declined in recent decades,H.pylori infection is still highly prevalent in China,accounting for a significant part of the disease burden of GC.Therefore,updated prevalence information for H.pylori infection,especially regional and demographic variations in China,is an important basis for the design of targeted strategies that will be effective for the prevention of GC and application of policies for H.pylori control.AIM To methodically evaluate the occurrence of H.pylori infection throughout China and establish a reference point for subsequent investigations.METHODS A systematic review and meta-analysis was conducted following established guidelines,as detailed in our methodology section.RESULTS Our review synthesized data from 152 studies,covering a sample of 763827 individuals,314423 of whom were infected with H.pylori.We evaluated infection rates in China's Mainland and the combined prevalence of H.pylori was 42.8%(95%CI:40.7-44.9).Subgroup analysis indicated the highest prevalence in Northwest China at 51.3%(95%CI:45.6-56.9),and in Qinghai Province,the prevalence reached 60.2%(95%CI:46.5-73.9).The urea breath test,which recorded the highest infection rate,showed a prevalence of 43.7%(95%CI:41.4-46.0).No notable differences in infection rates were observed between genders.Notably,the prevalence among the elderly was significantly higher at 44.5%(95%CI:41.9-47.1),compared to children,who showed a prevalence of 27.5%(95%CI:19.58-34.7).CONCLUSION Between 2014 and 2023,the prevalence of H.pylori infection in China decreased to 42.8%,down from the previous decade.However,the infection rates vary considerably across different geographical areas,among various populations,and by detection methods employed.
文摘Male factor infertility affects 30%-50% of infertile couples worldwide, and there is an increasing interest in the optimal management of these patients. In studies comparing double and single intrauterine insemination （IUI）, a trend towards higher pregnancy rates in couples with male factor infertility was observed. Therefore, we set out to perform a meta-analysis to examine the superiority of double versus single IUI with the male partner＇s sperm in couples with male factor infertility. An odds ratio （OR） of 95% confidence intervals （CIs） was calculated for the pregnancy rate. Outcomes were analysed by using the ManteI-Haesel or DerSimonian-Laird model accordingto the heterogeneity of the results. Overall, five trials involving 1125 IUI cycles were included in the meta-analysis. There was a two-fold increase in pregnancies after a cycle with a double IUI compared with a cycle with a single IUI （OR. 2.0; 95% CI. 1.07-3.75; P〈O.03）. Nevertheless, this result was mainly attributed to the presence of a large trial that weighted as almost 50% in the overall analysis. Sensitivity analysis, excluding this large trial, revealed only a trend towards higher pregnancy rates among double IUI cycles （OR. 1.58; 95% CI. 0.59-4.21）, but without statistical significance （P=0.20）. Our systematic review highlights that the available evidence regarding the use of double IUI in couples with male factor infertility is fragmentary and weak. Although there may be a trend towards higher pregnancy rates when the number of IUIs per cycle is increased, further large and well-designed randomized trials are needed to provide solid evidence toide current clinical practice.
文摘AIM To determine hepatitis C virus(HCV)infection prevalence in each country of the Middle-East and the overall prevalence of the region.METHODS In this systematic review,we gathered all documents related to HCV infection prevalence among hemodialysis patients in 17 middle-east countries from April 2006 to March 2016.We selected only cross-sectional studies that had proper sampling and measurement methods as well as a valid statistical analysis.RESULTS After screening of 7311 documents,56 studies were selected reporting the prevalence of HCV infection among hemodialysis patients from 10 countries of the region.Seven countries including United Arab Emirates,Afghanistan,Qatar,Bahrain,Kuwait,Oman,Israel,and Cyprus did not have any relevant document;thus,their latest reports were just mentioned.We performed the meta-analysis and determined the prevalence rates for each country as well as the whole region.The overall HCV infection prevalence among hemodialysis patients in the region was reported to be 25.3%;Egypt and Syria had the highest reported rates while Iran and Lebanon had the lowest.Further investigations are still needed to provide more reliable databases,find main risk factors,and to improve diagnosis and treatment plans,particularly in higher prevalent countries.CONCLUSION Controlling the prevalence and improving the management methods of HCV infection among hemodialysis patients are of a great concern in the Middle-East region.
基金Supported by the Project Grant(KH125678 to PH)an Economic Development and Innovation Operative Program Grant(GINOP 2.3.2-15-2016-00048 to PH)from the National Research,Development and Innovation Office
文摘AIM To analyze the effect of intralesional steroid injections in addition to endoscopic dilation of benign refractory esophageal strictures.METHODS A comprehensive search was performed in three databases from inception to 10 April 2017 to identify trials, comparing the efficacy of endoscopic dilation to dilation combined with intralesional steroid injections. Following the data extraction, meta-analytical calculations were performed on measures of outcome by the randomeffects method of Der Simonian and Laird. Heterogeneity of the studies was tested by Cochrane's Q and I^2 statistics. Risk of quality and bias was assessed by the Newcastle Ottawa Scale and JADAD assessment tools.RESULTS Eleven articles were identified suitable for analyses, involving 343 patients, 235 cases and 229 controls in total. Four studies used crossover design with 121 subjects enrolled. The periodic dilation index(PDI) was comparable in 4 studies, where the pooled result showed a significant improvement of PDI in the steroid group(MD:-1.12 dilation/month, 95% CI:-1.99 to -0.25 P = 0.012; I^2 = 74.4%). The total number of repeat dilations(TNRD) was comparable in 5 studies and showed a non-significant decrease(MD:-1.17, 95%CI:-0.24-0.05, P = 0.057; I^2 = 0), while the dysphagia score(DS) was comparable in 5 studies and did not improve(SMD: 0.35, 95%CI:-0.38, 1.08, P = 0.351; I^2 = 83.98%) after intralesional steroid injection.CONCLUSION Intralesional steroid injection increases the time between endoscopic dilations of benign refractory esophageal strictures. However, its potential role needs further research.
文摘Aromatase activity has commonly been associated with male infertility characterized by testicular dysfunction with low serum testosterone and/or testosterone to estradiol ratio.In this subset of patients,and particularly in those with hypogonadism,elevated levels of circulating estradiol may establish a negative feedback on the hypothalamic–pituitary–testicular axis by suppressing follicle-stimulating hormone(FSH)and luteinizing hormone(LH)production and impaired spermatogenesis.Hormonal manipulation via different agents such as selective estrogen modulators or aromatase inhibitors to increase endogenous testosterone production and improve spermatogenesis in the setting of infertility is an off-label option for treatment.We carried out a systematic review and meta-analysis of the literature of the past 30 years in order to evaluate the benefits of the use of aromatase inhibitors in the medical management of infertile/hypoandrogenic males.Overall,eight original articles were included and critically evaluated.Either steroidal(Testolactone)or nonsteroidal(Anastrozole and Letrozole)aromatase inhibitors were found to statistically improve all the evaluated hormonal and seminal outcomes with a safe tolerability profile.While the evidence is promising,future prospective randomized placebo-controlled multicenter trials are necessary to better define the efficacy of these medications.
基金Hubei Province Top Medical Youth Talent Program,Wuhan Knowledge Innovation Special Basic Research Project,No.2023020201020558Clinical Research Project of Affiliated Hospital of Guangdong Medical University,No.LCYJ2021B004 and No.LCYJ2019B010Science and Technology Plan Project of Zhanjiang,No.2022A01191.
文摘BACKGROUND Diabetic foot ulcers(DFUs)present a significant clinical challenge due to their high prevalence and profound impact on morbidity.Ultrasound-assisted wound debridement(UAWD)has emerged as a potential therapeutic modality to improve healing outcomes in DFU management.AIM To evaluate the efficacy of UAWD in treating DFUs on wound closure rates,treatment duration,and quality of life outcomes.METHODS This systematic review and meta-analysis followed PRISMA guidelines,systematically searching PubMed,Embase,Web of Science,and the Cochrane Library with no date restrictions.Randomized controlled trials(RCTs)that evaluated the efficacy of UAWD in DFU treatment were included.Data were independently extracted by two reviewers,with discrepancies resolved through consensus or third-party consultation.The risk of bias was assessed using the Cochrane tool.χ2 and I2 statistics assessed heterogeneity,informing the use of fixed or random-effects models for meta-analysis,supplemented by sensitivity analysis and publication bias assessment through funnel plots and Egger's test.RESULTS From 1255 articles,seven RCTs met the inclusion criteria.The studies demonstrated that UAWD significantly reduced DFU healing time(standardized mean difference=-0.78,95%CI:-0.97 to-0.60,P<0.001)and increased healing rates(odds ratio=9.96,95%CI:5.99 to 16.56,P<0.001)compared to standard care.Sensitivity analysis confirmed the stability of these results,and no significant publication bias was detected.CONCLUSION UAWD is a promising adjunctive treatment for DFUs,significantly reducing healing times and increasing healing rates.These findings advocate for the integration of UAWD into standard DFU care protocols.
文摘AIM:To summarize the data of epidemiological studies on cataract prevalence over 50 years old in urban and rural areas of China from 2000 to 2020,and to analyze the prevalence of cataract and operation rate in China.METHODS:By searching Pub Med,EMBASE,Web of Science,Wanfang Data and CNKI,Chinese and English literatures on the prevalence of cataract in China were retrieved,and the relevant characteristic data were extracted.Then,Stata v15 SE software was used for Metaanalysis and heterogeneity test.According to the results of heterogeneity,the corresponding effect models were selected to combine the extracted data.RESULTS:A total of 20 studies were included in this study,with a total of 111434 cases.Meta-analysis showed heterogeneity.According to the random effect model,the overall prevalence of cataract in Chinese people over 50 years old was 27.45%,that in rural was 28.79%,and that in urban was 26.66%.The overall coverage rate of cataract surgery was 9.19%.CONCLUSION:The prevalence of cataract is high in China,and there is still room for improvement in surgical coverage,so it is very important to promote cataract screening and prevention.
文摘Objective: This study seeks to review current and relevant literature on global Angle class III malocclusion prevalence. Materials and Methods: The electronic databases PubMed, ISI Web of Knowledge, and the Cochrane Database of Systematic Review were searched using specific inclusion criteria to obtain applicable articles. All pertinent references were also examined for acceptability. Results: A total of 20 articles were identified using the inclusion criteria. The prevalence of Angle class III malocclusion ranged from 0 to 26.7% in different populations reported in the literature examined. Meta-regression analysis showed no statistically significant association between prevalence rates and the method of assessment, age group and year of the study. However, much of the study-to-study variation (approximately 40%) could be explained by population. Conclusion: These results suggest that the prevalence of Angle class III malocclusion varies greatly within different races and geographic regions. Chinese and Malaysian populations have a higher prevalence of Angle class III malocclusion compared to other racial groups, while Indian populations have a lower prevalence than all other racial groups examined.
基金supported by the National Natural Science Foundation of China (81072756,30672578)the Chinese National Funds for Distinguished Young Scientists (30825046)+1 种基金the Hi-Tech Research and Development Program of China (2008AA02Z406)the Program for Innovative Research Teams in Beijing University of Chinese Medicine (2011CXTD-07)
文摘OBJECTIVE:To systematically review the benefits of integrated traditional and Western medicine therapies based on the Hamilton depression scale(HAMD) following syndrome differentiation of depression.METHODS:We searched six English and Chinese electronic databases for randomized clinical trials(RCTs) on integrated traditional and Western medicine for treatment of depression.Two authors extracted data and independently assessed the trial quality.RevMan 5 software was used for data analyses with an effect estimate presented as weighted mean difference(WMD) with a 95% confidence interval(CI).RESULTS:Seven RCTs with 576 participants were identified for this review.All trials were eligible for the meta-analysis and were evaluated as unclear or having a risk of bias.Meta-analysis showed,compared with Western medicine alone,integrated traditional and Western medicine based on syndrome differentiation could improve the effect of treatment represented by the HAMD [WMD=-2.39,CI(-2.96,-1.83),Z=8.29,P<0.00001].There were no reported serious adverse effects that were related to integrated traditional and Western medicine based therapies in these trials.CONCLUSIONS:Integrated traditional and Western medicine based therapies for the syndrome differentiation of depression significantly improved the HAMD,illustrating that combining therapies from integrated traditional and Western medicine for treatment of depression is better than Western medicine alone.However,further large,rigorously designed trials are warranted due to the insufficient methodological rigor seen in the trials included in this study.
基金Supported by National Natural Science Foundation of China,No.81701029.
文摘BACKGROUND The side effects of prostate cancer(PCa)treatment are very prominent,with cancer-related fatigue(CRF)being the most common.Fatigue is a distressing symptom that interferes with daily functioning and seriously affects patient quality of life during,and for many years after,treatment.However,compared with other types of cancer,such as breast cancer,little is known about the prevalence of PCa-related fatigue.AIM To determine the prevalence of CRF in patients with PCa.METHODS A systematic search of EMBASE,PubMed,Web of Science,Cochrane Library,Chinese National Knowledge Infrastructure,WANFANG DATA,Technology Journal Database and the Chinese Biological Medical Database was conducted up to July 28,2020.Included studies measured the incidence of PCa-related fatigue and differentiated fatigue outcomes(incidence)between treatment modalities and fatigue assessment times.In our meta-analysis,both fixed and random-effects models were used to estimate the pooled prevalence of PCa-related fatigue.Subgroup analyses were performed using treatment modalities and fatigue assessment times.Publication and sensitivity bias analyses were performed to test the robustness of the associations.RESULTS Fourteen studies,involving 4736 patients,were eligible for the review.The pooled CRF prevalence was 40%in a total sample of 4736 PCa patients[95%confidence interval(CI):29-52;P<0.01;I2=98%].The results of the subgroup analyses showed the prevalence of CRF after androgen deprivation therapy treatment,radical prostatectomy and radiotherapy to be 42%(95%CI:20-67,P<0.01,I2=91%),21%(95%CI:16-26,P=0.87,I2=0%)and 40%(95%CI:22-58,P<0.01,I2=90%),respectively.The prevalence of acute and persistent fatigue was 44%(95%CI:25-64;P<0.01;I2=93%)and 29%(95%CI:25-32;P=0.30;I2=17%),respectively.CONCLUSION Our meta-analysis showed that fatigue is a common symptom in men with PCa,especially those using hormone therapy.
基金supported by the National Megaprojects of Science Research for the 12th Five-Year Plan(2012ZX10001-001)
文摘Objective To understand drug resistance prevalence among treatment-failure and treatment-nave HIV-positive individuals in China.Methods We searched five electronic databases（Wanfang,CNKI,CQVIP,SinoMed,and Pubmed） for studies of HIV drug resistance.Random-effects models were carried out to estimate the prevalence of drug resistance among treatment-failure and treatment-nave individuals,respectively.Results The estimated nationwide rates of HIV drug resistance to any-class drugs among treatment-failure and treatment-nave individuals were 57%（95% CI：49%-65%） and 3.23%（95% CI：2.47%-4.07%）,respectively.Among the drug classes,the prevalence of resistance to PIs was low（1.45%;95% CI：0.73%-2.33%） in treatment-failure individuals,although high rates of resistance to NNRTIs（54%;95% CI：45%-63%） and NRTIs（40%;95% CI：32%-49%） were found.Resistance to any-class drugs,NNRTIs and NRTIs manifested regional differences,but resistance to PIs did not.Positive correlations were observed between resistance to NNRTIs and NRTIs among treatment-failure and treatment-nave individuals,respectively.Conclusion The prevalence of HIV drug resistance to NNRTIs and NRTIs among treatment-failure individuals was high.In contrast,the prevalence of drug resistance among treatment-nave individuals was low.The epidemics of drug resistance matched current treatment strategies and interventions in China.Surveillance for HIV drug resistance is necessary to assess the sustainability and durability of current treatment regimens.
基金supported by the‘Double First-Class’Construction Specialized Discipline Project at Zhejiang University(No HL2024012).
文摘Objectives:This systematic review and meta-analysis aimed to identify and synthesize the factors correlated with posttraumatic growth(PTG)in patients with colorectal cancer(CRC).Methods:PubMed,Web of Science,Embase,PsycINFO,CINAHL,Cochrane Library,China National Knowledge Infrastructure(CNKI),Wanfang database,China Science and Technology Journal Database(VIP)and SinoMed were searched for studies that reported data on the correlated factors associated with PTG in patients with CRC from inception to September 3,2024.The methodological quality of the included studies was assessed via the Agency for Healthcare Research and Quality(AHRQ)methodology checklist and the Newcastle-Ottawa Scale(NOS).Pearson correlation coefficient(r)was utilized to indicate effect size.Meta-analysis was conducted in R Studio.Results:Thirty-one eligible studies encompassing 6,400 participants were included in this review.Correlated factors were identified to be significantly associated with PTG in patients with CRC including demographic factors:residential area(r=0.13),marital status(r=0.10),employment status(r=0.18),education level(r=0.19),income level(r=0.16);disease-related factors:time since surgery(r=0.17),stoma-related complications(r=0.14),health-promoting behavior(r=0.46),and sexual function(r=0.17);psychosocial factors:confrontation coping(r=0.68),avoidance coping(r=-0.65),deliberate rumination(r=0.56),social support(r=0.47),family function(r=0.50),resilience(r=0.53),selfefficacy(r=0.91),self-compassion(r=-0.32),psychosocial adjustment(r=0.39),gratitude(r=0.45),stigma(r=-0.65),self-perceived burden(r=-0.31),fear of cancer recurrence(r=-0.45);and quality of life(r=0.32).Conclusions:This meta-analysis identified 23 factors associated with PTG in CRC patients.Medical workers can combine those relevant factors from the perspective of positive psychology,further explore the occurrence and development mechanism of PTG,and establish targeted interventions to promote PTG.
