Objective:To evaluate the clinical effect of acupuncture-moxibustion as the adjuvant therapy on frozenthawed embryo transfer(FET)using network meta-analysis.Methods:In PubMed,Embase,Cochrane Library,Chinese National K...Objective:To evaluate the clinical effect of acupuncture-moxibustion as the adjuvant therapy on frozenthawed embryo transfer(FET)using network meta-analysis.Methods:In PubMed,Embase,Cochrane Library,Chinese National Knowledge Infrastructure(CNKI),Wanfang database(WanFang),VIP database and Chinese Biomedical Literature Database(SinoMed),the randomized controlled trials(RCTs)of the adjuvant therapy of acupuncture-moxibustion for FET were retrieved,from database inception to April 1,2021.Cochrane risk of bias assessment tool was used to screen and evaluate the quality of the included studies,and RevMan 5.3,GeMTC0.14.3 and Stata16.0 software were adopted to complete the network meta-analysis.Results:Twenty-nine RCTs comprising 2880 patients were finally included,involving 17 interventions and 4 outcome measures.The results of network meta-analysis showed that the top three therapies under each outcome based on the magnitude of SUCRA values were:(1)Clinical pregnancy rate(CPR,%):"transcutaneous electrical acupoint stimulation+herbal medicine"(76.4),"moxibustion+herbal medicine"(74.7),"acupuncture+moxibustion"(73.3);(2)Biochemical pregnancy rate(BPR):"moxibustion+herbal medicine"(89.3),"acupuncture+moxibustion"(82.1),"acupuncture+herbal medicine"(78.7);(3)Endometrial thickness:"acupoint injection+Western medicine"(87.2),auricular therapy(76.8),"acupuncture+herbal medicine"(73.5);(4)Type A endometrial morphology rate:"acupoint injection+Western medicine"(78.3),"moxibustion+herbal medicine"(58.0)and"acupuncture+moxibustion"(52.6).Conclusion:The combined treatment of acupuncture-moxibustion was superior to single therapy for FET patients.The combined therapy of transcutaneous electrical acupoint stimulation and herbal medicine had the best effect for improving CPR,"moxibustion+herbal medicine"obtained the best average comprehensive effect,and"acupoint injection+Western medicine"was conductive to ameliorate the endome trial thickness and morphology.Due to the limitations of existing studies,more high-quality RCTs are needed in the future to further verify these conclusions.展开更多
Background Given the critical importance of medication adherence in HIV/AIDS treatment,this study aims to com-pare medication adherence measured by self-report(SR)and indirect measurement among antiretroviral therapy(...Background Given the critical importance of medication adherence in HIV/AIDS treatment,this study aims to com-pare medication adherence measured by self-report(SR)and indirect measurement among antiretroviral therapy(ART)patients,exploring the differences of adherence results measured by different tools.Methods We systematically searched PubMed,Embase,and the Cochrane Library to identify all relevant literature published up to November 22,2023,without language restrictions,reporting adherence to ART measured by both SR and indirect measurement methods,while also analyzing individual and group adherence separately.Discrepancies between SR and indirect measurement results were assessed using the Mann-Whitney U test or Wilcoxon signed-rank test,with correlations evaluated using the Pearson correlation coefficient.Following one-to-one comparisons,meta-epidemiological one-step analysis was conducted,and network meta-analysis techniques were applied to compare results obtained through specific adherence assessment tools reported in the identified articles.Results The analysis encompassed 65 original studies involving 13,667 HIV/AIDS patients,leading to 112 one-to-one comparisons between SR and indirect measurement tools.Statistically significant differences were observed between SR and indirect measurement tools regarding both individual and group adherence(P<0.05),with Pear-son correlation coeffcients of 0.843 for individual adherence and 0.684 for group adherence.During meta-epide-miological one-step analysis,SR-measured adherence was determined to be 3.94%(95%Cl:-4.48-13.44%)higher for individual adherence and 16.14%(95%Cl:0.81-18.84%)higher for group adherence compared to indirectly measured results.Subgroup analysis indicated that factors such as the year of reporting and geographic region appeared to influence the discrepancies between SR and indirect measurements.Furthermore,network meta-analysis revealed that for both individual and group adherence,the results obtained from most SR and indirect measurement tools were higher than those from electronic monitoring devices,with some demonstrating statistical significance(P<0.05).Conclusions The findings underscored the complexity of accurately measuring medication adherence among ART patients.Significant variability was observed across studies,with self-report methods showing a significant tendency towards overestimation.Year of reporting,geographic region,and adherence measurement tools appeared to influence the differences between SR and indirect measurements.Future research should focus on developing and validating integrated adherence measurements that can combine SR data with indirect measures to achieve a more comprehensive understanding of adherence behaviors.展开更多
Background:Metastatic triple-negative breast cancer(mTNBC)is an aggressive histological subtype with poor prognosis.Several first-line treatments are currently available for mTNBC.This study conducted a network meta-a...Background:Metastatic triple-negative breast cancer(mTNBC)is an aggressive histological subtype with poor prognosis.Several first-line treatments are currently available for mTNBC.This study conducted a network meta-analysis to compare these first-line regimens and to determine the regimen with the best efficacy.Methods:A systematic search of PubMed,EMBASE,the Cochrane Central Register of Controlled Bases,and mi-nutes of major conferences was performed.Progression-free survival(PFS),overall survival(OS),and objective response rate(ORR)were analyzed via network meta-analysis using the R software(R Core Team,Vienna,Austria).The efficacy of the treatment regimens was compared using hazard ratios and 95%confidence intervals.Results:A total of 29 randomized controlled trials involving 4607 patients were analyzed.The ranking was based on the surface under the cumulative ranking curve.Network meta-analysis results showed that cisplatin combined with nab-paclitaxel or paclitaxel was superior to docetaxel plus capecitabine in terms of PFS and ORR.For programmed death-ligand 1(PD-L1)and breast cancer susceptibility gene(BRCA)mutation-positive tumors,atezolizumab/pembrolizumab combined with nab-paclitaxel and talazoparib was superior to docetaxel plus capecitabine.No significant difference was observed among the treatments in Os.Neutropenia,diarrhea,and fatigue were common serious adverse events.Conclusion:Cisplatin combined with nab-paclitaxel or paclitaxel is the preferred first-line treatment for mTNBC.For PD-L1 and BRCA mutation-positive tumors,atezolizumab/pembrolizumab combined with nab-paclitaxel and talazoparib is an effective treatment option,Neutropenia,diarrhea,and fatigue are frequently occurring serious adverseevents.展开更多
基金Supported by TCM Evidence-Based Capacity Construction Project,National Administration of Traditional Chinese Medicine,2019:2019XZZX-ZJ007National Key Research and Development Program:2019YFC1709104。
文摘Objective:To evaluate the clinical effect of acupuncture-moxibustion as the adjuvant therapy on frozenthawed embryo transfer(FET)using network meta-analysis.Methods:In PubMed,Embase,Cochrane Library,Chinese National Knowledge Infrastructure(CNKI),Wanfang database(WanFang),VIP database and Chinese Biomedical Literature Database(SinoMed),the randomized controlled trials(RCTs)of the adjuvant therapy of acupuncture-moxibustion for FET were retrieved,from database inception to April 1,2021.Cochrane risk of bias assessment tool was used to screen and evaluate the quality of the included studies,and RevMan 5.3,GeMTC0.14.3 and Stata16.0 software were adopted to complete the network meta-analysis.Results:Twenty-nine RCTs comprising 2880 patients were finally included,involving 17 interventions and 4 outcome measures.The results of network meta-analysis showed that the top three therapies under each outcome based on the magnitude of SUCRA values were:(1)Clinical pregnancy rate(CPR,%):"transcutaneous electrical acupoint stimulation+herbal medicine"(76.4),"moxibustion+herbal medicine"(74.7),"acupuncture+moxibustion"(73.3);(2)Biochemical pregnancy rate(BPR):"moxibustion+herbal medicine"(89.3),"acupuncture+moxibustion"(82.1),"acupuncture+herbal medicine"(78.7);(3)Endometrial thickness:"acupoint injection+Western medicine"(87.2),auricular therapy(76.8),"acupuncture+herbal medicine"(73.5);(4)Type A endometrial morphology rate:"acupoint injection+Western medicine"(78.3),"moxibustion+herbal medicine"(58.0)and"acupuncture+moxibustion"(52.6).Conclusion:The combined treatment of acupuncture-moxibustion was superior to single therapy for FET patients.The combined therapy of transcutaneous electrical acupoint stimulation and herbal medicine had the best effect for improving CPR,"moxibustion+herbal medicine"obtained the best average comprehensive effect,and"acupoint injection+Western medicine"was conductive to ameliorate the endome trial thickness and morphology.Due to the limitations of existing studies,more high-quality RCTs are needed in the future to further verify these conclusions.
基金This research work was funded by the National Natural Science Foundation of China(grant numbers 72074161)Sichuan Science and Technology Program(grant numbers 2022YFS0229)+1 种基金Liangshan Prefecture Science and Technology Bureau Program(grant numbers 23ZDYF0025)Study on the Drug Resistance and Risk Transmission Network of HIV-HCV Co infection in Liangshan Prefecture(grant numbers 23ZDYF0112).
文摘Background Given the critical importance of medication adherence in HIV/AIDS treatment,this study aims to com-pare medication adherence measured by self-report(SR)and indirect measurement among antiretroviral therapy(ART)patients,exploring the differences of adherence results measured by different tools.Methods We systematically searched PubMed,Embase,and the Cochrane Library to identify all relevant literature published up to November 22,2023,without language restrictions,reporting adherence to ART measured by both SR and indirect measurement methods,while also analyzing individual and group adherence separately.Discrepancies between SR and indirect measurement results were assessed using the Mann-Whitney U test or Wilcoxon signed-rank test,with correlations evaluated using the Pearson correlation coefficient.Following one-to-one comparisons,meta-epidemiological one-step analysis was conducted,and network meta-analysis techniques were applied to compare results obtained through specific adherence assessment tools reported in the identified articles.Results The analysis encompassed 65 original studies involving 13,667 HIV/AIDS patients,leading to 112 one-to-one comparisons between SR and indirect measurement tools.Statistically significant differences were observed between SR and indirect measurement tools regarding both individual and group adherence(P<0.05),with Pear-son correlation coeffcients of 0.843 for individual adherence and 0.684 for group adherence.During meta-epide-miological one-step analysis,SR-measured adherence was determined to be 3.94%(95%Cl:-4.48-13.44%)higher for individual adherence and 16.14%(95%Cl:0.81-18.84%)higher for group adherence compared to indirectly measured results.Subgroup analysis indicated that factors such as the year of reporting and geographic region appeared to influence the discrepancies between SR and indirect measurements.Furthermore,network meta-analysis revealed that for both individual and group adherence,the results obtained from most SR and indirect measurement tools were higher than those from electronic monitoring devices,with some demonstrating statistical significance(P<0.05).Conclusions The findings underscored the complexity of accurately measuring medication adherence among ART patients.Significant variability was observed across studies,with self-report methods showing a significant tendency towards overestimation.Year of reporting,geographic region,and adherence measurement tools appeared to influence the differences between SR and indirect measurements.Future research should focus on developing and validating integrated adherence measurements that can combine SR data with indirect measures to achieve a more comprehensive understanding of adherence behaviors.
文摘Background:Metastatic triple-negative breast cancer(mTNBC)is an aggressive histological subtype with poor prognosis.Several first-line treatments are currently available for mTNBC.This study conducted a network meta-analysis to compare these first-line regimens and to determine the regimen with the best efficacy.Methods:A systematic search of PubMed,EMBASE,the Cochrane Central Register of Controlled Bases,and mi-nutes of major conferences was performed.Progression-free survival(PFS),overall survival(OS),and objective response rate(ORR)were analyzed via network meta-analysis using the R software(R Core Team,Vienna,Austria).The efficacy of the treatment regimens was compared using hazard ratios and 95%confidence intervals.Results:A total of 29 randomized controlled trials involving 4607 patients were analyzed.The ranking was based on the surface under the cumulative ranking curve.Network meta-analysis results showed that cisplatin combined with nab-paclitaxel or paclitaxel was superior to docetaxel plus capecitabine in terms of PFS and ORR.For programmed death-ligand 1(PD-L1)and breast cancer susceptibility gene(BRCA)mutation-positive tumors,atezolizumab/pembrolizumab combined with nab-paclitaxel and talazoparib was superior to docetaxel plus capecitabine.No significant difference was observed among the treatments in Os.Neutropenia,diarrhea,and fatigue were common serious adverse events.Conclusion:Cisplatin combined with nab-paclitaxel or paclitaxel is the preferred first-line treatment for mTNBC.For PD-L1 and BRCA mutation-positive tumors,atezolizumab/pembrolizumab combined with nab-paclitaxel and talazoparib is an effective treatment option,Neutropenia,diarrhea,and fatigue are frequently occurring serious adverseevents.
