The study aimed to analyze the reporting and methodological quality of systematic reviews(SRs)/meta-analyses(MAs)of animal models to provide references for later studies and avoid the waste of medical resources.EMBASE...The study aimed to analyze the reporting and methodological quality of systematic reviews(SRs)/meta-analyses(MAs)of animal models to provide references for later studies and avoid the waste of medical resources.EMBASE and MEDLINE databases were searched from inception to November 2017,with no language restriction.Two reviewers selected inclusion dependently and extracted the basic characteristics.Review Manager 5.3,stata 12.0,and SPSS 21 software were used to conduct analyses.A total of 46 SRs/MAs were included.The results showed that the English databases with high retrieval frequency are PubMed/MEDLINE,EMBASE,and Web of Science.67.31%(31/46)of the articles reported the search strategy in the full text or the appendix.65.22%(30/46)reported the literature screening flow diagram,and only 19.57%(9/46)reported the number of works of literature retrieved in each database.60.87%(28/46)illustrated supplement retrieval.Through 2 subgroup analyses,it was found that there were no significant differences in the quality of reports of PRISMA items.But referring to the methodological quality or reporting of PRESS items,SCI was better than that of non-SCI,while there seemed a source of funding to have no significant impact on the methodological quality or the items of PRESS.The results of PRESS,AMSTAR 2,and PRISMA were correlated,and the correlation between PRISMA and AMSTAR 2 was strong.These results demonstrated that search strategies of animal model SRs/MAs are still not enough comprehensive,report specification and methodological quality still need to be ameliorated.To show users the scientificity and rigor of the study,future research should focus on these various guidelines like PRESS,PRISMA,and AMSTAR 2 checklists that have been issued,it can help to increase the value of research and improve the utilization of medical resources.展开更多
OBJECTIVE:To reevaluate systematic reviews and Meta-analysis(SR/MAs)on the efficacy and safety of acupuncture in treating arrhythmias.METHODS:SR/MAs of acupuncture treatment for arrhythmias were retrieved from four En...OBJECTIVE:To reevaluate systematic reviews and Meta-analysis(SR/MAs)on the efficacy and safety of acupuncture in treating arrhythmias.METHODS:SR/MAs of acupuncture treatment for arrhythmias were retrieved from four English databases(Pub Med,Embase,Web of Science,Cochrane Library)and four Chinese databases(China National Knowledge Infrastructure Database,China Science and Technology Journal Database,Wanfang Data and Chinese Biomedical Literature Database)up to December 2023.Data were extracted according to predefined criteria.The methodological quality of included SR/MAs was assessed using the A Measurement Tool to assess systematic Reviews 2,the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Grading of Recommendations,Assessment,Development,and Evaluation were used to assess the reporting quality and evidence quality of the included SR/MAs.RESULTS:A total of 10 SR/MAs were included,involving 8 types of arrhythmias(atrial fibrillation,atrial flutter,paroxysmal supraventricular tachycardia,atrial premature beat,ventricular premature beat,sinus tachycardia,sinus bradycardia,and sick sinus syndrome)and 10 outcome indicators.The evaluation of efficacy and safety showed that acupuncture can effectively improve the average heart rate and clinical efficacy of patients with various types of arrhythmias,reduce the number of premature beats in patients with premature beats based on 24-h dynamic electrocardiography,increase the rate of sinus rhythm conversion in patients with atrial fibrillation,shorten the time to convert to sinus rhythm,etc.,without serious adverse reactions.The results of methodological quality,reporting quality,and evidence quality of the included SR/MAs showed that the methodological quality evaluation was very low;reporting quality evaluation included 5 items rated as“somewhat deficient”and 5 items rated as“relatively complete”;evidence quality evaluation included 0 items rated as high,4 items rated as medium,13 items rated as low,and 17 items rated as very low.CONCLUSION:Acupuncture as an adjuvant treatment for arrhythmias is clinically effective.However,due to the low quality of existing evidence,further improvement in the quality of original research design and SR/MAs is needed to provide strong scientific evidence and clear conclusions.展开更多
Objectives:Healthcare students experience significant stress due to their rigorous graduate school curricula.These levels of stress are associated with higher risks of depression,self-harm,and exhaustion.Coping interv...Objectives:Healthcare students experience significant stress due to their rigorous graduate school curricula.These levels of stress are associated with higher risks of depression,self-harm,and exhaustion.Coping interventions have been shown to help students develop healthy stress coping strategies.The purpose of this systematic review and meta-analysis was to examine the diverse array of coping interventions and what characteristics of coping interventions were most effective at decreasing stress among healthcare students.Methods:Any intervention designed to address coping for academic stress was included among medical,dental,nursing,physician assistant,allied health,veterinary,psychology,etc.students.A comprehensive literature search was completed to include multiple databases,Ancestry,and hand-searching from EBSCO and Google Scholar articles.A final total of 17 studies were included.Standardized mean difference effect sizes(ES)were synthesized across studies using a random-effects model in the Comprehensive Meta-Analysis Software for changes in coping levels in healthcare students.Moderator analyses were performed to explore the study,intervention,and participants’characteristics.The risk of bias was assessed by RoB2 and ROBINS-I.Results:Coping interventions significantly reduced stress outcomes among healthcare students(d=0.74;95%CI[0.48–1.01],95%PI[−0.41–1.90],p<0.001,Q=228.49,I^(2)=93.0%,T=0.52,T^(2)=0.28,p<0.001).Moderator analysis showed that interventions with stress education,established professional guidance,and fewer hours led to better stress management outcomes.Conclusions:This study demonstrates that coping interventions produce an overall moderate-to-large effect on stress reduction.Future research investigating coping interventions on academic and long-term outcomes would be beneficial.展开更多
Background:Assess ChatGPT and Bard's effectiveness in the initial identification of articles for Otolaryngology—Head and Neck Surgery systematic literature reviews.Methods:Three PRISMA-based systematic reviews(Ja...Background:Assess ChatGPT and Bard's effectiveness in the initial identification of articles for Otolaryngology—Head and Neck Surgery systematic literature reviews.Methods:Three PRISMA-based systematic reviews(Jabbour et al.2017,Wong et al.2018,and Wu et al.2021)were replicated using ChatGPTv3.5 and Bard.Outputs(author,title,publication year,and journal)were compared to the original references and cross-referenced with medical databases for authenticity and recall.Results:Several themes emerged when comparing Bard and ChatGPT across the three reviews.Bard generated more outputs and had greater recall in Wong et al.'s review,with a broader date range in Jabbour et al.'s review.In Wu et al.'s review,ChatGPT-2 had higher recall and identified more authentic outputs than Bard-2.Conclusion:Large language models(LLMs)failed to fully replicate peer-reviewed methodologies,producing outputs with inaccuracies but identifying relevant,especially recent,articles missed by the references.While human-led PRISMA-based reviews remain the gold standard,refining LLMs for literature reviews shows potential.展开更多
Objective:Current research highlights periodontal disease as a systemic inflammatory condition that may influence extra-oral diseases such as prostatic diseases,which prompted us to explore the potential association.T...Objective:Current research highlights periodontal disease as a systemic inflammatory condition that may influence extra-oral diseases such as prostatic diseases,which prompted us to explore the potential association.To evaluate whether periodontal disease is associated with an increased risk of prostatic disease,including prostate cancer,benign prostatic hyperplasia(BPH),and prostatitis.Methods:A systematic search of observational studies concerning the relationship between periodontal disease and prostatic disease was performed in online databases PubMed,Embase,Web of Science,Scopus,CENTRAL,CNKI,and WanFang.Searches were conducted from database inception to 31 July 2025.Pooled hazard ratio(HR)or odds ratio(OR)with 95%confidence intervals(CIs)were synthesized.Subgroup analysis was used to detect the origin of heterogeneity,sensitivity analysis was employed to evaluate the robustness of the results,and publication bias analyses were also performed.R software was used to perform statistical analyses.Results:Sixteen studies that met the preset criteria were included in this study.In the pooled analysis,periodontal disease was associated with increased risk of prostate cancer(HR=1.23,95%CI:1.16-1.29,p<0.001)or BPH(OR=1.55,95%CI:1.41-1.70,p<0.001).Sensitivity analysis confirmed the robustness of the results.No obvious publication biaswas found in the meta-analysis.Only one cohort study reported that chronic periodontitis increases the risk of prostatitis(HR=2.521,95%CI:1.685-4.005,p<0.001).The effect of periodontal treatment on prostatic disease is still unclear.Conclusions:The systematic review and meta-analysis identified an observational association between periodontal disease and increased risks of prostate cancer and BPH.Because all included studies were observational,these results indicate association rather than causation,and further prospective and mechanistic studies are required to clarify temporality and causality.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
Stroke remains a leading cause of death and disability worldwide,and electroacupuncture has a long history of use in stroke treatment.This meta-analysis and systematic review aimed to evaluate the efficacy of electroa...Stroke remains a leading cause of death and disability worldwide,and electroacupuncture has a long history of use in stroke treatment.This meta-analysis and systematic review aimed to evaluate the efficacy of electroacupuncture and explore its potential mechanisms in animal models of ischemic stroke.The PubMed,EMBASE,Web of Science,CENTRAL,and CINAHL databases were comprehensively searched up to May 1,2024.This review included articles on preclinical investigations of the efficacy and mechanisms of electroacupuncture in treating ischemic stroke.Data from 70 eligible studies were analyzed in Stata 18.0,using a random-effects model to calculate the standardized mean difference(Hedge’s g).The risk of bias was assessed using RevMan 5.4 software,and the quality of evidence was rated according to the Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)system.Subgroup analyses were conducted to test the consistency of the results and sensitivity analyses were used to assess their robustness.The quality assessment revealed that most studies adequately handled incomplete data and selective reporting.However,several methodological limitations were identified:only 4 studies demonstrated a low risk of allocation concealment,26 achieved a low risk of outcome assessment bias,and 9 had a high risk of randomization bias.Additionally,there was an unclear risk regarding participant blinding and other methodological aspects.The GRADE assessment rated 12 outcomes as moderate quality and 6 as low quality.The mechanisms of electroacupuncture treatment for ischemic stroke can be categorized as five primary pathways:(1)Electroacupuncture significantly reduced infarct volume and apoptotic cell death(P<0.01)in ischemic stroke models;(2)electroacupuncture significantly decreased the levels of pro-inflammatory factors(P<0.01)while increasing the levels of anti-inflammatory factors(P=0.02);(3)electroacupuncture reduced the levels of oxidative stress indicators(P<0.01)and enhanced the expression of antioxidant enzymes(P<0.01);(4)electroacupuncture significantly promoted nerve regeneration(P<0.01);and(5)electroacupuncture influenced blood flow remodeling(P<0.01)and angiogenesis(P<0.01).Subgroup analyses indicated that electroacupuncture was most effective in the transient middle cerebral artery occlusion model(P<0.01)and in post-middle cerebral artery occlusion intervention(P<0.01).Dispersive waves were found to outperform continuous waves with respect to neuroprotection and anti-inflammatory effects(P<0.01),while scalp acupoints demonstrated greater efficacy than body acupoints(P<0.01).The heterogeneity among the included studies was minimal,and sensitivity analyses indicated stable results.Their methodological quality was generally satisfactory.In conclusion,electroacupuncture is effective in treating cerebral ischemia by modulating cell apoptosis,oxidative stress,inflammation,stroke-induced nerve regeneration,blood flow remodeling,and angiogenesis.The efficacy of electroacupuncture may be influenced by factors such as the middle cerebral artery occlusion model,the timing of intervention onset,waveform,and acupoint selection.Despite the moderate to low quality of evidence,these findings suggest that electroacupuncture has clinical potential for improving outcomes in ischemic stroke.展开更多
Background:Coronavirus disease 2019(COVID-19)is a rapidly spreading disease that has caused an extensive burden to the world.Consequently,a large number of clinical trials have examined the efficacy of traditional Chi...Background:Coronavirus disease 2019(COVID-19)is a rapidly spreading disease that has caused an extensive burden to the world.Consequently,a large number of clinical trials have examined the efficacy of traditional Chinese medicine(TCM)for treating and preventing COVID-19,with coinciding proliferation of reviews summarizing these studies.Objective:This study aimed to evaluate the methodological quality and evidence quality of systematic reviews and meta-analyses on the efficacy of TCM.Search strategy:Seven electronic databases,including PubMed,Cochrane Library,Web of Science,China National Knowledge Infrastructure,Chongqing VIP,Wanfang Data and SinoMed,were searched for systematic reviews and meta-analyses in October 2021.Search terms such as“Chinese medicine,”“Lianhua Qingwen”and“COVID-19”were used.Inclusion criteria:Systematic reviews and meta-analyses of randomized controlled trials that evaluated the efficacy of TCM treatment of COVID-19 were included.Data extraction and analysis:A Measurement Tool to Assess Systematic Reviews Version 2.0(AMSTAR 2)was used to evaluate the methodological quality.The quality of evidence was graded using the Grading of Recommendations Assessment,Development,and Evaluation(GRADE)system.Data extraction and analysis were performed by two reviewers independently.Results:There were 17 meta-analyses included in our overview.The intervention group was defined as TCM combined with Western medicine,while the control group was Western medicine alone.The methodological quality of all the included studies was moderate to poor.A total of 89 outcome indicators were evaluated,of which,8 were rated as moderate quality,39 as low quality,and 41 as very low quality.Only one outcome measure was graded as being of high quality.The moderate quality of evidence indicated that,for the treatment of COVID-19,the clinical efficacy of TCM in combination with Western medicine was better,in terms of lung recovery,rate of conversion to severe/critical cases,symptom scores,duration of symptoms,mortality,and length of hospital stay.Conclusion:Evidence from the included studies shows that,compared with conventional Western medical therapy alone,the addition of TCM to COVID-19 treatment may improve clinical outcomes.Overall,the quality of evidence of TCM for COVID-19 was moderate to poor.Meta-analyses of the use of TCM in the treatment of COVID-19 can be used for clinical decision making by accounting for the experiences of clinical experts,medical policies,and other factors.展开更多
Background:Acupuncture is used to relieve symptoms,reducing recurrence,and improve the lives of patients with skin diseases.Objective:To identify,describe,and organize the available evidence on acupuncture for atopic ...Background:Acupuncture is used to relieve symptoms,reducing recurrence,and improve the lives of patients with skin diseases.Objective:To identify,describe,and organize the available evidence on acupuncture for atopic eczema(AE)using evidence mapping of randomized controlled trials(RCTs),systematic reviews(SRs),and metaanalyses.Methods:We searched eight databases from inception to October 30,2021,for RCTs,SRs,and metaanalyses of acupuncture for patients with AE.Two reviewers screened the papers,before extracting the data and assessing the quality of the included studies.The basic and clinical characteristics,and quality of assessment of the studies were assessed using descriptive statistics and qualitative analyses.A bubble plot was used to visualize the evidence map to indicate the relationship between the type and frequency of outcomes,the quality and overall effects of acupuncture,and the outcomes of the studies.Results:Forty-five studies(Forty RCTs,five SRs,and meta-analyses)were included.The number of publications increased rapidly after 2013 and peaked in 2019.The most frequently applied intervention was one type of acupuncture therapy.The most frequent comparison was between acupuncture and active medicine.The symptomatic outcome was the most commonly used,and the quality of the included studies was relatively low.All included studies showed a significantly better outcome in the acupuncture group compared to the control group(P<0.05).Most outcomes in the included studies were of low or critically low quality.Several symptomatic outcomes and health-related quality of life outcomes in the included RCTs indicated moderate quality,while some symptomatic outcomes and global symptom improvement in the included SRs and meta-analyses indicated low quality.Conclusion:The majority of studies related to acupuncture for AE indicated promising results,but with relatively low quality;thus,further studies with more robust designs should be conducted to validate the results.展开更多
Objective: This study assessed the methodological quality of systematic reviews/meta-analysis of the effectiveness of probiotics against irritable bowel syndrome (IBS) using the accepted methodological quality assessm...Objective: This study assessed the methodological quality of systematic reviews/meta-analysis of the effectiveness of probiotics against irritable bowel syndrome (IBS) using the accepted methodological quality assessment scale AMSTAR and explored the factors that influenced the quality of methodology. It was designed to provide a reference for future research and systematic reviews/metaanalysis. Methods: The methodological quality of existing systematic reviews/meta-analysis was evaluated using the AMSTAR scale. Influencing factors of methodological quality were statistically analyzed using RevMan 5.3 software. The included systematic reviews/metaanalysis must include the following characteristics:(1) methods using systematic evaluation/meta-analysis,(2) probiotic intervention, and (3) language limitation to Chinese and English. Results: The AMSTAR score was 5-9 (7.42 ± 1.22), and the quality is above average. The factors affecting the methodological quality are the number of authors and whether they cooperate with the institution. Conclusions: Studies have shown that current systematic reviews/meta-analysis of the effectiveness of probiotics on IBS does not fully comply with methodological quality standards, and therefore the methodological quality of research in this area needs to be strengthened. To better clarify how probiotics affect IBS, future systematic reviews and meta-analyses should not only follow methodological quality standards but also include more effective outcome measures, and they should focus more on the discussion of research results. We look forward to the development of higher-quality randomized controlled trials in the future.展开更多
BACKGROUND Coronavirus disease 2019(COVID-19)has left a significant impact on the world's health,economic and political systems;as of November 20,2020,more than 57 million people have been infected worldwide,with ...BACKGROUND Coronavirus disease 2019(COVID-19)has left a significant impact on the world's health,economic and political systems;as of November 20,2020,more than 57 million people have been infected worldwide,with over 1.3 million deaths.While the global spotlight is currently focused on combating this pandemic through means ranging from finding a treatment among existing therapeutic agents to inventing a vaccine that can aid in halting the further loss of life.AIM To collect all systematic reviews and meta-analyses published related to COVID-19 to better identify available evidence,highlight gaps in knowledge,and elucidate further meta-analyses and umbrella reviews that are yet to be performed.METHODS We explored studies based on systematic reviews and meta-analyses with the keyterms,including severe acute respiratory syndrome(SARS),SARS virus,coronavirus disease,COVID-19,and SARS coronavirus-2.The included studies were extracted from Embase,Medline,and Cochrane databases.The publication timeframe of included studies ranged between January 01,2020,to October 30,2020.Studies that were published in languages other than English were not considered for this systematic review.The finalized full-text articles are freely accessible in the public domain.RESULTS Searching Embase,Medline,and Cochrane databases resulted in 1906,669,and 19 results,respectively,that comprised 2594 studies.515 duplicates were subsequently removed,leaving 2079 studies.The inclusion criteria were systematic reviews or meta-analyses.860 results were excluded for being a review article,scope review,rapid review,panel review,or guideline that produced a total of 1219 studies.After screening articles were categorized,the included articles were put into main groups of clinical presentation,epi-demiology,screening and diagnosis,severity assessment,special populations,and treatment.Subsequently,there was a second subclassification into the following groups:gastrointestinal,cardiovascular,neurological,stroke,thrombosis,anosmia and dysgeusia,ocular manifestations,nephrology,cutaneous manifestations,D-dimer,lymphocyte,anticoagulation,antivirals,convalescent plasma,immunosuppressants,corticosteroids,hydroxychloroquine,renin-angiotensin-aldosterone system,technology,diabetes mellitus,obesity,pregnancy,children,mental health,smoking,cancer,and transplant.CONCLUSION Among the included articles,it is clear that further research is needed regarding treatment options and vaccines.With more studies,data will be less heterogeneous,and statistical analysis can be better applied to provide more robust clinical evidence.This study was not designed to give recommendations regarding the management of COVID-19.展开更多
OBJECTIVE:To evaluate and summarise the evidence from published Meta-analyses/systematic reviews(MAs/SRs)of Traditional Chinese Medicine(TCM)in the treatment of recurrent respiratory tract infections(RRTIs)and to prov...OBJECTIVE:To evaluate and summarise the evidence from published Meta-analyses/systematic reviews(MAs/SRs)of Traditional Chinese Medicine(TCM)in the treatment of recurrent respiratory tract infections(RRTIs)and to provide a scientific basis for the clinical treatment of RRTIs with TCM.METHODS:Studies were retrieved from Chinese and English databases including the China National Knowledge Infrastructure,Wanfang database,China Science and Technology Journal Database,SinoM ed,PubM ed,Web of Science,the Cochrane Library and EMbase from their establishment date to March 2023.Involved studies were screened,extracted,and evaluated for quality by two researchers independently.The a measurement tool to assess systematic reviews(AMSTAR)2 scale was used for methodological quality evaluation,as well as the preferred reporting items for systematic reviews and Meta-analyses(PRISMA)2020 statement for report quality evaluation,the risk of bias in systematic reviews(ROBIS)tool for risk of bias,and the grading of recommendations,assessment,development and evaluation(GRADE)quality assessment tool for evidence quality.RESULTS:Twenty MAs/SRs studies were included,including analyses of 274 original studies involving 38335 patients with RRTIs.The AMSTAR 2 scale evaluation results showed that 19 studies were of very low quality and one of moderate quality.The ROBIS evaluation results showed that 11 MAs/SRs were at high risk and nine at low risk of bias.The PRISMA 2020 report quality showed the included studies had scores between 23.5 and 35.5,among them one with high quality,17 with moderate quality and two with low quality.The GRADE system results showed that among 126 outcome indicators,only 17 had moderate quality of evidence,27 had low quality,82 had very low quality,and none had high quality.CONCLUSIONS:The MAs/SRs methodological quality of using TCM for treatment RRTIs is generally poor,the quality of reports as well as of evidence is generally low,and the risk of bias is high;therefore we should treat these results with caution.展开更多
With the rapid advancement of Artificial Intelligence(AI)technologies,its applications have become increasingly widespread across various aspects of geography,offering unprecedented analytical capabilities across disc...With the rapid advancement of Artificial Intelligence(AI)technologies,its applications have become increasingly widespread across various aspects of geography,offering unprecedented analytical capabilities across disciplinary boundaries.Despite this revolutionary potential,a comprehensive understanding of the current research landscape and development trajectory of AI in geographical sciences remains limited.To fill this gap,we conducted a large-scale systematic review based on 400,000 geographical publications published from 1990 to 2023.We utilized large language model(LLM)prompt engineering,topic modeling and other natural language processing techniques to analyze the publications.Our findings reveal that AI applications constitute 8.1% of geographical research,with publication volume having increased 20-fold over three decades.Both China and the United States have been the leading contributors to AI-driven geographical studies,together accounting for 62.78% of all publications in this field.Notably,more than half of the studies used traditional machine learning methods.Among the various geographical topics,remote sensing applications and spatial data analysis emerged as the most extensively explored areas using AI techniques,with image feature extraction being the topic with the deepest level of adoption and most significant ongoing impact of AI methods.This systematic review provides critical insights into the integration trajectory of AI within geographical sciences,establishing a foundation for identifying emerging research opportunities and enhancing our understanding of AI’s transformative role in advancing geographical knowledge.展开更多
Objectives This review aimed to systematically synthesize the available research on the disclosure of diagnosis and related issues in childhood cancer from the perspectives of healthcare professionals,with the goal of...Objectives This review aimed to systematically synthesize the available research on the disclosure of diagnosis and related issues in childhood cancer from the perspectives of healthcare professionals,with the goal of informing the optimization of disclosure processes and meeting the communication needs of affected families.Methods In accordance with the Joanna Briggs Institute(JBI)methodology for mixed methods systematic reviews,the convergent segregated approach was used in this review.Articles were retrieved from 11 databases,including PubMed,Web of Science,CINAHL,CENTRAL,Embase,Ovid/Medline,PsycINFO,PsycArticles,Scopus,ERIC,and China National Knowledge Infrastructure(CNKI).The quality of the selected articles was assessed using the Mixed Method Appraisal Tool(MMAT).The review protocol was registered on PROSPERO(CRD42024542746).Results A total of 21 studies from 10 countries were included.Their methodological quality was generally medium to high,with MMAT scores ranging from 60%to 100%.The synthesis yielded three core themes:1)the spectrum of professional and societal attitudes toward disclosure;2)the dynamic practices of navigating disclosure amid uncertainty,including timing and environment,stakeholders,and content of disclosure;and 3)factors influencing disclosure,including children’s,parental,healthcare professionals’,and socio-cultural factors.Conclusions This review synthesized the perspectives and experiences of healthcare professionals regarding disclosure in childhood cancer,highlighting the complexity and multidimensional nature of this process in clinical practice.Future research should further investigate the experiences and needs of children and their parents,explore cultural variations in disclosure practices,develop context-appropriate assessment tools,and construct multidimensional intervention strategies to enhance the humanistic care and professional effectiveness of the disclosure process.展开更多
Mitochondrial dysfunction and oxidative stress are widely regarded as primary drivers of aging and are associated with several neurodegenerative diseases.The degeneration of motor neurons during aging is a critical pa...Mitochondrial dysfunction and oxidative stress are widely regarded as primary drivers of aging and are associated with several neurodegenerative diseases.The degeneration of motor neurons during aging is a critical pathological factor contributing to the progression of sarcopenia.However,the morphological and functional changes in mitochondria and their interplay in the degeneration of the neuromuscular junction during aging remain poorly understood.A defined systematic search of the Pub Med,Web of Science and Embase databases(last accessed on October 30,2024)was conducted with search terms including'mitochondria','aging'and'NMJ'.Clinical and preclinical studies of mitochondrial dysfunction and neuromuscular junction degeneration during aging.Twentyseven studies were included in this systematic review.This systematic review provides a summary of morphological,functional and biological changes in neuromuscular junction,mitochondrial morphology,biosynthesis,respiratory chain function,and mitophagy during aging.We focus on the interactions and mechanisms underlying the relationship between mitochondria and neuromuscular junctions during aging.Aging is characterized by significant reductions in mitochondrial fusion/fission cycles,biosynthesis,and mitochondrial quality control,which may lead to neuromuscular junction dysfunction,denervation and poor physical performance.Motor nerve terminals that exhibit redox sensitivity are among the first to exhibit abnormalities,ultimately leading to an early decline in muscle strength through impaired neuromuscular junction transmission function.Parg coactivator 1 alpha is a crucial molecule that regulates mitochondrial biogenesis and modulates various pathways,including the mitochondrial respiratory chain,energy deficiency,oxidative stress,and inflammation.Mitochondrial dysfunction is correlated with neuromuscular junction denervation and acetylcholine receptor fragmentation,resulting in muscle atrophy and a decrease in strength during aging.Physical therapy,pharmacotherapy,and gene therapy can alleviate the structural degeneration and functional deterioration of neuromuscular junction by restoring mitochondrial function.Therefore,mitochondria are considered potential targets for preserving neuromuscular junction morphology and function during aging to treat sarcopenia.展开更多
Objectives:Immunotherapy based on immune checkpoint blockade(ICB)has become a key treatment for melanoma.However,the increasing number of cases of melanoma resistant to immunotherapy highlights the need to develop met...Objectives:Immunotherapy based on immune checkpoint blockade(ICB)has become a key treatment for melanoma.However,the increasing number of cases of melanoma resistant to immunotherapy highlights the need to develop methods to overcome this resistance.This study aims to collect the most recent information on melanoma immunotherapy,discuss potential strategies to overcome resistance to immunotherapy,and identify areas that require further analysis.Methods:To achieve this goal,scientific publications from 2021-2024 available in PubMed and Google Scholar databases were analyzed.The databases were searched using the following terms:“melanoma”,“immunotherapy”,“Immune Checkpoint Blockade”,and“immunoresistance”.Results:The results of preclinical and early-stage clinical research indicate the potential application of tank-binding kinase 1(TBK-1),fecal microbiota transplant(FMT),Toll-like Receptor 9(TLR9),lipid nanoparticles(LNPs)containing a stimulator of an interferon gene agonist(STING),BRAF inhibitors,Lymphocyte Activation Gene(LAG-3),T-Cell Immunoglobulin and ITIM Domain(TIGIT),and oncolytic viruses(OVs)as potential methods to enhance melanoma sensitivity to ICB.Discussion:To optimize immunotherapy,further research is needed to determine the detailed mechanisms of action,safety profiles,tolerability,and precise patient selection criteria for methods capable of overcoming melanoma’s immunoresistance.展开更多
Background:The Colorectal Cancer(CRC)pathogenesis and therapeutic efficacy are influenced by the gut microbiome,making it a promising biomarker for predicting treatment responses and adverse effects.This systematic re...Background:The Colorectal Cancer(CRC)pathogenesis and therapeutic efficacy are influenced by the gut microbiome,making it a promising biomarker for predicting treatment responses and adverse effects.This systematic review aims to outline the gut microbiome composition in individuals with CRC undergoing the same therapeutic regimen and evaluate interindividual microbiome profile variations to better understand how these differences may influence therapeutic outcomes.Methods:Key studies investigating the microbiome’s role in therapeutic approaches for CRC were searched in both PubMed and Cochrane databases on 12 and 22 March 2025,respectively.Eligible studies included free full-text English-language randomized clinical trials and human observational studies reporting on gut microbiome composition and treatment outcomes.RoB 2 and ROBINS-I were employed in the evaluation of bias for randomized trials and observational studies,respectively.Data extracted was narratively analyzed.Results:Six studies involving a total of 361 individuals were included.Therapeutic interventions,either standard treatments and/or those targeting the gut microbiome,generally increased probiotic taxa and reduced pro-carcinogenic bacteria.However,no consistent pattern of improved clinical outcomes was observed,suggesting that treatment mechanisms,the tumor’s nature,and individual characteristics play critical roles in microbiome modulation.Conclusion:The gut microbiome holds significant potential in clinical settings.Nonetheless,further research is needed to better understand its functional aspects and to consider the influence of treatment mechanisms,the tumor’s nature,and individual characteristics as modulators,in order to optimize clinical outcomes.展开更多
Background:Artificial intelligence(AI)-assisted threedimensional(3D)surgical platforms,integrated with augmented reality,have the potential to improve intraoperative anatomical recognition and provide surgeons with an...Background:Artificial intelligence(AI)-assisted threedimensional(3D)surgical platforms,integrated with augmented reality,have the potential to improve intraoperative anatomical recognition and provide surgeons with an immersive,dynamic operating environment during urooncological procedures.This review aims to examine the current applications of AI in robotic uro-oncology,with a particular focus on its role in facilitating intraoperative navigation during complex surgeries.Methods:A systematic literature search was performed across PubMed,the National Library of Medicine,MEDLINE,the Cochrane Central Register of Controlled Trials(CENTRAL),ClinicalTrials.gov,and Google Scholar to identify relevant studies published up to July 2025.The search strategy incorporated a predefined set of keywords,including AI,machine learning,radical prostatectomy(RP),robotic-assisted radical prostatectomy(RARP),robotassisted partial nephrectomy(RAPN),and robot-assisted radical cystectomy(RARC).Only clinical trials,full-text peer-reviewed publications,and original research articles were included.Studies were eligible for inclusion if they evaluated or described applications of AI in RARP,RAPN,or RARC.Results:Technological advancements have substantially transformed the field of uro-oncologic surgery.In particular,AI and AI-assisted intraoperative navigation in RARP demonstrate considerable potential to objectively assess surgical performance and predict clinical outcomes.In RAPN,the adoption of preoperative,interactive 3D virtualmodels for surgical planning has influenced surgical decisions,thus,enhanced precision in resection planning correlates with superior nephron-sparing outcomes and optimized selective clamping.AI applications in RARC,techniques such as augmented reality(AR)can overlay critical information on the surgical field,by facilitating navigation through complex anatomical planes and enhancing identification of critical structures.Conclusion:AI appears to enhance robotic uro-oncologic procedures by increasing operative precision and supporting individualised surgical treatment strategies.展开更多
Background:While the treatment of metastatic renal cell carcinoma(mRCC)is evolving due to immune checkpoint inhibitors(ICIs),optimal strategies for later lines of therapy have yet to be defined.The combination of lenv...Background:While the treatment of metastatic renal cell carcinoma(mRCC)is evolving due to immune checkpoint inhibitors(ICIs),optimal strategies for later lines of therapy have yet to be defined.The combination of lenvatinib and everolimus represents a viable option,and the present review aimed to summarize its activity,effectiveness,and safety.Methods:A systematic review of the literature was conducted using PubMed,targeting studies published between 2018 and 2025.Eligible studies included English-language prospective and retrospective trials reporting survival outcomes in mRCC patients treated with lenvatinib and everolimus after at least one ICI-containing regimen.Results:Nine studies met the inclusion criteria,encompassing a total of 441 patients.The lenvatinib and everolimus combination was primarily used in the third and subsequent lines of therapy.Median overall survival ranged from 7.5 to 24.5 months,while median progression-free survival was more consistent,between 6.1 and 6.7 months,except for one study reporting 12.9 months.Objective response rates varied widely(14.0%–55.7%).Adverse events of grade≥3 did not exceed the expected rate,with diarrhoea and proteinuria as the most reported events.Dose reductions and treatment discontinuations due to toxicity occurred but were generally lower than in prior pivotal trials.Conclusions:Real-world evidence suggests that lenvatinib and everolimus represent an effective and safe option after ICI failure in mRCC patients.Nevertheless,the lack of randomized phase III trials and the heterogeneity of existing studies highlight the need for more robust prospective research to guide post-ICI therapeutic strategies.展开更多
With the introduction and development of evidence-based medicine in China, it has been spread rapidly in the area of integrative medicine（IM） and has become a new unique discipline. During almost 20 years, as one of...With the introduction and development of evidence-based medicine in China, it has been spread rapidly in the area of integrative medicine（IM） and has become a new unique discipline. During almost 20 years, as one of the most important parts of evidence-based IM, systematic review（SR）/meta-analysis（MA） of IM have shown a good development momentum in the aspects of quantity, depth, breadth and influence, but also face the harsh situation of the uncontrolled quantity and quality, especially for SRs in Chinese. Therefore, how to supervise and standardize this area effectively becomes a problem to be solved. Based on the experience both at home and abroad, the authors put forward several kinds of solutions for laying the foundation for further development such as promoting the registration system of SR/MA of IM, effectively setting up the regulatory platform of quality and quantity, launching professional training for SR/MA reviewers, formingqualification registration, developing the data transfer and sharing platform to realize the transparency of evidence process.展开更多
文摘The study aimed to analyze the reporting and methodological quality of systematic reviews(SRs)/meta-analyses(MAs)of animal models to provide references for later studies and avoid the waste of medical resources.EMBASE and MEDLINE databases were searched from inception to November 2017,with no language restriction.Two reviewers selected inclusion dependently and extracted the basic characteristics.Review Manager 5.3,stata 12.0,and SPSS 21 software were used to conduct analyses.A total of 46 SRs/MAs were included.The results showed that the English databases with high retrieval frequency are PubMed/MEDLINE,EMBASE,and Web of Science.67.31%(31/46)of the articles reported the search strategy in the full text or the appendix.65.22%(30/46)reported the literature screening flow diagram,and only 19.57%(9/46)reported the number of works of literature retrieved in each database.60.87%(28/46)illustrated supplement retrieval.Through 2 subgroup analyses,it was found that there were no significant differences in the quality of reports of PRISMA items.But referring to the methodological quality or reporting of PRESS items,SCI was better than that of non-SCI,while there seemed a source of funding to have no significant impact on the methodological quality or the items of PRESS.The results of PRESS,AMSTAR 2,and PRISMA were correlated,and the correlation between PRISMA and AMSTAR 2 was strong.These results demonstrated that search strategies of animal model SRs/MAs are still not enough comprehensive,report specification and methodological quality still need to be ameliorated.To show users the scientificity and rigor of the study,future research should focus on these various guidelines like PRESS,PRISMA,and AMSTAR 2 checklists that have been issued,it can help to increase the value of research and improve the utilization of medical resources.
基金National Natural Science Foundation of China:Mechanistic Study of the“Treating Different Diseases with the Same Therapy”of Yin-Nourishing,Wind-Extinguishing,and CollateralsConnecting Method in Regulating Calcium Ion Homeostasis for the Prevention and Treatment of Myocardial Infarction and Ventricular Arrhythmias(82405324)Tianjin University of Traditional Chinese Medicine First Affiliated Hospital“Tuoxin Project”Funded Research Topic:Mechanistic Study of the Core Medicinal Pair of Yin-Nourishing,Wind-Extinguishing,and Collaterals-Connecting Formula in Regulating Late Sodium Current to Inhibit Early Afterdepolarizations(2023003)+1 种基金Special Fund for Scientific and Technological Research of Traditional Chinese Medicine from the National Administration of Traditional Chinese Medicine:National Traditional Chinese Medicine Inheritance and Innovation Team Project-Inheritance and Innovation Team for Traditional Chinese Medicine Prevention and Treatment of Cardiovascular Diseases(ZYYCXTD-C-202203)Nankai District,Tianjin,Traditional Chinese Medicine Inheritance and Innovation Development Demonstration Pilot Project:Survey of the Traditional Chinese Medicine Syndrome Characteristics of Ventricular Premature Contractions and Exploration of the Efficacy and Possible Mechanisms of the Yin-Nourishing,Wind-Extinguishing,and Collaterals-Connecting Formula(NKQPT2024010)。
文摘OBJECTIVE:To reevaluate systematic reviews and Meta-analysis(SR/MAs)on the efficacy and safety of acupuncture in treating arrhythmias.METHODS:SR/MAs of acupuncture treatment for arrhythmias were retrieved from four English databases(Pub Med,Embase,Web of Science,Cochrane Library)and four Chinese databases(China National Knowledge Infrastructure Database,China Science and Technology Journal Database,Wanfang Data and Chinese Biomedical Literature Database)up to December 2023.Data were extracted according to predefined criteria.The methodological quality of included SR/MAs was assessed using the A Measurement Tool to assess systematic Reviews 2,the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Grading of Recommendations,Assessment,Development,and Evaluation were used to assess the reporting quality and evidence quality of the included SR/MAs.RESULTS:A total of 10 SR/MAs were included,involving 8 types of arrhythmias(atrial fibrillation,atrial flutter,paroxysmal supraventricular tachycardia,atrial premature beat,ventricular premature beat,sinus tachycardia,sinus bradycardia,and sick sinus syndrome)and 10 outcome indicators.The evaluation of efficacy and safety showed that acupuncture can effectively improve the average heart rate and clinical efficacy of patients with various types of arrhythmias,reduce the number of premature beats in patients with premature beats based on 24-h dynamic electrocardiography,increase the rate of sinus rhythm conversion in patients with atrial fibrillation,shorten the time to convert to sinus rhythm,etc.,without serious adverse reactions.The results of methodological quality,reporting quality,and evidence quality of the included SR/MAs showed that the methodological quality evaluation was very low;reporting quality evaluation included 5 items rated as“somewhat deficient”and 5 items rated as“relatively complete”;evidence quality evaluation included 0 items rated as high,4 items rated as medium,13 items rated as low,and 17 items rated as very low.CONCLUSION:Acupuncture as an adjuvant treatment for arrhythmias is clinically effective.However,due to the low quality of existing evidence,further improvement in the quality of original research design and SR/MAs is needed to provide strong scientific evidence and clear conclusions.
文摘Objectives:Healthcare students experience significant stress due to their rigorous graduate school curricula.These levels of stress are associated with higher risks of depression,self-harm,and exhaustion.Coping interventions have been shown to help students develop healthy stress coping strategies.The purpose of this systematic review and meta-analysis was to examine the diverse array of coping interventions and what characteristics of coping interventions were most effective at decreasing stress among healthcare students.Methods:Any intervention designed to address coping for academic stress was included among medical,dental,nursing,physician assistant,allied health,veterinary,psychology,etc.students.A comprehensive literature search was completed to include multiple databases,Ancestry,and hand-searching from EBSCO and Google Scholar articles.A final total of 17 studies were included.Standardized mean difference effect sizes(ES)were synthesized across studies using a random-effects model in the Comprehensive Meta-Analysis Software for changes in coping levels in healthcare students.Moderator analyses were performed to explore the study,intervention,and participants’characteristics.The risk of bias was assessed by RoB2 and ROBINS-I.Results:Coping interventions significantly reduced stress outcomes among healthcare students(d=0.74;95%CI[0.48–1.01],95%PI[−0.41–1.90],p<0.001,Q=228.49,I^(2)=93.0%,T=0.52,T^(2)=0.28,p<0.001).Moderator analysis showed that interventions with stress education,established professional guidance,and fewer hours led to better stress management outcomes.Conclusions:This study demonstrates that coping interventions produce an overall moderate-to-large effect on stress reduction.Future research investigating coping interventions on academic and long-term outcomes would be beneficial.
文摘Background:Assess ChatGPT and Bard's effectiveness in the initial identification of articles for Otolaryngology—Head and Neck Surgery systematic literature reviews.Methods:Three PRISMA-based systematic reviews(Jabbour et al.2017,Wong et al.2018,and Wu et al.2021)were replicated using ChatGPTv3.5 and Bard.Outputs(author,title,publication year,and journal)were compared to the original references and cross-referenced with medical databases for authenticity and recall.Results:Several themes emerged when comparing Bard and ChatGPT across the three reviews.Bard generated more outputs and had greater recall in Wong et al.'s review,with a broader date range in Jabbour et al.'s review.In Wu et al.'s review,ChatGPT-2 had higher recall and identified more authentic outputs than Bard-2.Conclusion:Large language models(LLMs)failed to fully replicate peer-reviewed methodologies,producing outputs with inaccuracies but identifying relevant,especially recent,articles missed by the references.While human-led PRISMA-based reviews remain the gold standard,refining LLMs for literature reviews shows potential.
文摘Objective:Current research highlights periodontal disease as a systemic inflammatory condition that may influence extra-oral diseases such as prostatic diseases,which prompted us to explore the potential association.To evaluate whether periodontal disease is associated with an increased risk of prostatic disease,including prostate cancer,benign prostatic hyperplasia(BPH),and prostatitis.Methods:A systematic search of observational studies concerning the relationship between periodontal disease and prostatic disease was performed in online databases PubMed,Embase,Web of Science,Scopus,CENTRAL,CNKI,and WanFang.Searches were conducted from database inception to 31 July 2025.Pooled hazard ratio(HR)or odds ratio(OR)with 95%confidence intervals(CIs)were synthesized.Subgroup analysis was used to detect the origin of heterogeneity,sensitivity analysis was employed to evaluate the robustness of the results,and publication bias analyses were also performed.R software was used to perform statistical analyses.Results:Sixteen studies that met the preset criteria were included in this study.In the pooled analysis,periodontal disease was associated with increased risk of prostate cancer(HR=1.23,95%CI:1.16-1.29,p<0.001)or BPH(OR=1.55,95%CI:1.41-1.70,p<0.001).Sensitivity analysis confirmed the robustness of the results.No obvious publication biaswas found in the meta-analysis.Only one cohort study reported that chronic periodontitis increases the risk of prostatitis(HR=2.521,95%CI:1.685-4.005,p<0.001).The effect of periodontal treatment on prostatic disease is still unclear.Conclusions:The systematic review and meta-analysis identified an observational association between periodontal disease and increased risks of prostate cancer and BPH.Because all included studies were observational,these results indicate association rather than causation,and further prospective and mechanistic studies are required to clarify temporality and causality.
基金Supported by the National Natural Science Foundation of China,No.82402789Beijing Jishuitan Hospital Youcai Plan,No.KYYC202402+1 种基金Beijing Jishuitan Research Funding,No.HL202402and Beijing Natural Science Foundation,No.L232062,No.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,Nos.82174496(to NW),82374574(to NW),82302865(to LL)Shanghai Science and Technology Committee Sailing Program,Nos.23YF1403800(to LL),23YF1405200(to YX)Shanghai Hospital Development Center Foundation-Shanghai Municipal Hospital Rehabilitation Medicine Specialty Alliance,No.SHDC22023304(to YW).
文摘Stroke remains a leading cause of death and disability worldwide,and electroacupuncture has a long history of use in stroke treatment.This meta-analysis and systematic review aimed to evaluate the efficacy of electroacupuncture and explore its potential mechanisms in animal models of ischemic stroke.The PubMed,EMBASE,Web of Science,CENTRAL,and CINAHL databases were comprehensively searched up to May 1,2024.This review included articles on preclinical investigations of the efficacy and mechanisms of electroacupuncture in treating ischemic stroke.Data from 70 eligible studies were analyzed in Stata 18.0,using a random-effects model to calculate the standardized mean difference(Hedge’s g).The risk of bias was assessed using RevMan 5.4 software,and the quality of evidence was rated according to the Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)system.Subgroup analyses were conducted to test the consistency of the results and sensitivity analyses were used to assess their robustness.The quality assessment revealed that most studies adequately handled incomplete data and selective reporting.However,several methodological limitations were identified:only 4 studies demonstrated a low risk of allocation concealment,26 achieved a low risk of outcome assessment bias,and 9 had a high risk of randomization bias.Additionally,there was an unclear risk regarding participant blinding and other methodological aspects.The GRADE assessment rated 12 outcomes as moderate quality and 6 as low quality.The mechanisms of electroacupuncture treatment for ischemic stroke can be categorized as five primary pathways:(1)Electroacupuncture significantly reduced infarct volume and apoptotic cell death(P<0.01)in ischemic stroke models;(2)electroacupuncture significantly decreased the levels of pro-inflammatory factors(P<0.01)while increasing the levels of anti-inflammatory factors(P=0.02);(3)electroacupuncture reduced the levels of oxidative stress indicators(P<0.01)and enhanced the expression of antioxidant enzymes(P<0.01);(4)electroacupuncture significantly promoted nerve regeneration(P<0.01);and(5)electroacupuncture influenced blood flow remodeling(P<0.01)and angiogenesis(P<0.01).Subgroup analyses indicated that electroacupuncture was most effective in the transient middle cerebral artery occlusion model(P<0.01)and in post-middle cerebral artery occlusion intervention(P<0.01).Dispersive waves were found to outperform continuous waves with respect to neuroprotection and anti-inflammatory effects(P<0.01),while scalp acupoints demonstrated greater efficacy than body acupoints(P<0.01).The heterogeneity among the included studies was minimal,and sensitivity analyses indicated stable results.Their methodological quality was generally satisfactory.In conclusion,electroacupuncture is effective in treating cerebral ischemia by modulating cell apoptosis,oxidative stress,inflammation,stroke-induced nerve regeneration,blood flow remodeling,and angiogenesis.The efficacy of electroacupuncture may be influenced by factors such as the middle cerebral artery occlusion model,the timing of intervention onset,waveform,and acupoint selection.Despite the moderate to low quality of evidence,these findings suggest that electroacupuncture has clinical potential for improving outcomes in ischemic stroke.
基金This work was supported by the Key Research and Development Projects from the Department of Science and Technology of Zhejiang Province(No.2020c03126)the Health Commission of Zhejiang Province(No.2017KY502),China.
文摘Background:Coronavirus disease 2019(COVID-19)is a rapidly spreading disease that has caused an extensive burden to the world.Consequently,a large number of clinical trials have examined the efficacy of traditional Chinese medicine(TCM)for treating and preventing COVID-19,with coinciding proliferation of reviews summarizing these studies.Objective:This study aimed to evaluate the methodological quality and evidence quality of systematic reviews and meta-analyses on the efficacy of TCM.Search strategy:Seven electronic databases,including PubMed,Cochrane Library,Web of Science,China National Knowledge Infrastructure,Chongqing VIP,Wanfang Data and SinoMed,were searched for systematic reviews and meta-analyses in October 2021.Search terms such as“Chinese medicine,”“Lianhua Qingwen”and“COVID-19”were used.Inclusion criteria:Systematic reviews and meta-analyses of randomized controlled trials that evaluated the efficacy of TCM treatment of COVID-19 were included.Data extraction and analysis:A Measurement Tool to Assess Systematic Reviews Version 2.0(AMSTAR 2)was used to evaluate the methodological quality.The quality of evidence was graded using the Grading of Recommendations Assessment,Development,and Evaluation(GRADE)system.Data extraction and analysis were performed by two reviewers independently.Results:There were 17 meta-analyses included in our overview.The intervention group was defined as TCM combined with Western medicine,while the control group was Western medicine alone.The methodological quality of all the included studies was moderate to poor.A total of 89 outcome indicators were evaluated,of which,8 were rated as moderate quality,39 as low quality,and 41 as very low quality.Only one outcome measure was graded as being of high quality.The moderate quality of evidence indicated that,for the treatment of COVID-19,the clinical efficacy of TCM in combination with Western medicine was better,in terms of lung recovery,rate of conversion to severe/critical cases,symptom scores,duration of symptoms,mortality,and length of hospital stay.Conclusion:Evidence from the included studies shows that,compared with conventional Western medical therapy alone,the addition of TCM to COVID-19 treatment may improve clinical outcomes.Overall,the quality of evidence of TCM for COVID-19 was moderate to poor.Meta-analyses of the use of TCM in the treatment of COVID-19 can be used for clinical decision making by accounting for the experiences of clinical experts,medical policies,and other factors.
基金Supported by China Academy of Chinese Medical Sciences Innovation FundC12021A03503National Natural Science Fund of China81973968+1 种基金Fundamental Research Funds for Central Public Welfare Scientific Research InstitutesZZ13-024-9"The Belt and Road"TCM Cooperation Project of China Academy of Chinese Medical Sciences in 2019GH201901。
文摘Background:Acupuncture is used to relieve symptoms,reducing recurrence,and improve the lives of patients with skin diseases.Objective:To identify,describe,and organize the available evidence on acupuncture for atopic eczema(AE)using evidence mapping of randomized controlled trials(RCTs),systematic reviews(SRs),and metaanalyses.Methods:We searched eight databases from inception to October 30,2021,for RCTs,SRs,and metaanalyses of acupuncture for patients with AE.Two reviewers screened the papers,before extracting the data and assessing the quality of the included studies.The basic and clinical characteristics,and quality of assessment of the studies were assessed using descriptive statistics and qualitative analyses.A bubble plot was used to visualize the evidence map to indicate the relationship between the type and frequency of outcomes,the quality and overall effects of acupuncture,and the outcomes of the studies.Results:Forty-five studies(Forty RCTs,five SRs,and meta-analyses)were included.The number of publications increased rapidly after 2013 and peaked in 2019.The most frequently applied intervention was one type of acupuncture therapy.The most frequent comparison was between acupuncture and active medicine.The symptomatic outcome was the most commonly used,and the quality of the included studies was relatively low.All included studies showed a significantly better outcome in the acupuncture group compared to the control group(P<0.05).Most outcomes in the included studies were of low or critically low quality.Several symptomatic outcomes and health-related quality of life outcomes in the included RCTs indicated moderate quality,while some symptomatic outcomes and global symptom improvement in the included SRs and meta-analyses indicated low quality.Conclusion:The majority of studies related to acupuncture for AE indicated promising results,but with relatively low quality;thus,further studies with more robust designs should be conducted to validate the results.
文摘Objective: This study assessed the methodological quality of systematic reviews/meta-analysis of the effectiveness of probiotics against irritable bowel syndrome (IBS) using the accepted methodological quality assessment scale AMSTAR and explored the factors that influenced the quality of methodology. It was designed to provide a reference for future research and systematic reviews/metaanalysis. Methods: The methodological quality of existing systematic reviews/meta-analysis was evaluated using the AMSTAR scale. Influencing factors of methodological quality were statistically analyzed using RevMan 5.3 software. The included systematic reviews/metaanalysis must include the following characteristics:(1) methods using systematic evaluation/meta-analysis,(2) probiotic intervention, and (3) language limitation to Chinese and English. Results: The AMSTAR score was 5-9 (7.42 ± 1.22), and the quality is above average. The factors affecting the methodological quality are the number of authors and whether they cooperate with the institution. Conclusions: Studies have shown that current systematic reviews/meta-analysis of the effectiveness of probiotics on IBS does not fully comply with methodological quality standards, and therefore the methodological quality of research in this area needs to be strengthened. To better clarify how probiotics affect IBS, future systematic reviews and meta-analyses should not only follow methodological quality standards but also include more effective outcome measures, and they should focus more on the discussion of research results. We look forward to the development of higher-quality randomized controlled trials in the future.
文摘BACKGROUND Coronavirus disease 2019(COVID-19)has left a significant impact on the world's health,economic and political systems;as of November 20,2020,more than 57 million people have been infected worldwide,with over 1.3 million deaths.While the global spotlight is currently focused on combating this pandemic through means ranging from finding a treatment among existing therapeutic agents to inventing a vaccine that can aid in halting the further loss of life.AIM To collect all systematic reviews and meta-analyses published related to COVID-19 to better identify available evidence,highlight gaps in knowledge,and elucidate further meta-analyses and umbrella reviews that are yet to be performed.METHODS We explored studies based on systematic reviews and meta-analyses with the keyterms,including severe acute respiratory syndrome(SARS),SARS virus,coronavirus disease,COVID-19,and SARS coronavirus-2.The included studies were extracted from Embase,Medline,and Cochrane databases.The publication timeframe of included studies ranged between January 01,2020,to October 30,2020.Studies that were published in languages other than English were not considered for this systematic review.The finalized full-text articles are freely accessible in the public domain.RESULTS Searching Embase,Medline,and Cochrane databases resulted in 1906,669,and 19 results,respectively,that comprised 2594 studies.515 duplicates were subsequently removed,leaving 2079 studies.The inclusion criteria were systematic reviews or meta-analyses.860 results were excluded for being a review article,scope review,rapid review,panel review,or guideline that produced a total of 1219 studies.After screening articles were categorized,the included articles were put into main groups of clinical presentation,epi-demiology,screening and diagnosis,severity assessment,special populations,and treatment.Subsequently,there was a second subclassification into the following groups:gastrointestinal,cardiovascular,neurological,stroke,thrombosis,anosmia and dysgeusia,ocular manifestations,nephrology,cutaneous manifestations,D-dimer,lymphocyte,anticoagulation,antivirals,convalescent plasma,immunosuppressants,corticosteroids,hydroxychloroquine,renin-angiotensin-aldosterone system,technology,diabetes mellitus,obesity,pregnancy,children,mental health,smoking,cancer,and transplant.CONCLUSION Among the included articles,it is clear that further research is needed regarding treatment options and vaccines.With more studies,data will be less heterogeneous,and statistical analysis can be better applied to provide more robust clinical evidence.This study was not designed to give recommendations regarding the management of COVID-19.
基金the National Natural Science Foundation of China:Study on the Mechanisms of Multi-target Immunomodulation by Hydrolyzed Nanzhu Tablets in Children with RRTI Based on scRNAseq Technology(No.82060825)Huang Danian-type Teacher Team of National Universities-Teacher Team of Basic Course of Chinese and Western Medicine(Ministry of Education Teacher Letter[2022]No.2)+2 种基金Guangxi Famous Chinese Medicine Doctor Lin Jiang Inheritance Studio(Gui TCM Science and Education Development[2021]No.6)Guangxi First-class Discipline of Chinese Medicine(Gui Textbook Research[2022]No.1)Guangxi Interdisciplinary Innovation Team of Chinese Medicine(GZKJ2302)。
文摘OBJECTIVE:To evaluate and summarise the evidence from published Meta-analyses/systematic reviews(MAs/SRs)of Traditional Chinese Medicine(TCM)in the treatment of recurrent respiratory tract infections(RRTIs)and to provide a scientific basis for the clinical treatment of RRTIs with TCM.METHODS:Studies were retrieved from Chinese and English databases including the China National Knowledge Infrastructure,Wanfang database,China Science and Technology Journal Database,SinoM ed,PubM ed,Web of Science,the Cochrane Library and EMbase from their establishment date to March 2023.Involved studies were screened,extracted,and evaluated for quality by two researchers independently.The a measurement tool to assess systematic reviews(AMSTAR)2 scale was used for methodological quality evaluation,as well as the preferred reporting items for systematic reviews and Meta-analyses(PRISMA)2020 statement for report quality evaluation,the risk of bias in systematic reviews(ROBIS)tool for risk of bias,and the grading of recommendations,assessment,development and evaluation(GRADE)quality assessment tool for evidence quality.RESULTS:Twenty MAs/SRs studies were included,including analyses of 274 original studies involving 38335 patients with RRTIs.The AMSTAR 2 scale evaluation results showed that 19 studies were of very low quality and one of moderate quality.The ROBIS evaluation results showed that 11 MAs/SRs were at high risk and nine at low risk of bias.The PRISMA 2020 report quality showed the included studies had scores between 23.5 and 35.5,among them one with high quality,17 with moderate quality and two with low quality.The GRADE system results showed that among 126 outcome indicators,only 17 had moderate quality of evidence,27 had low quality,82 had very low quality,and none had high quality.CONCLUSIONS:The MAs/SRs methodological quality of using TCM for treatment RRTIs is generally poor,the quality of reports as well as of evidence is generally low,and the risk of bias is high;therefore we should treat these results with caution.
基金supported by the Strategic Priority Research Program of the Chinese Academy of Sciences(Grant No.XDB0740100)the National Natural Science Foundation of China(Grants No.42571540 and 42222110).
文摘With the rapid advancement of Artificial Intelligence(AI)technologies,its applications have become increasingly widespread across various aspects of geography,offering unprecedented analytical capabilities across disciplinary boundaries.Despite this revolutionary potential,a comprehensive understanding of the current research landscape and development trajectory of AI in geographical sciences remains limited.To fill this gap,we conducted a large-scale systematic review based on 400,000 geographical publications published from 1990 to 2023.We utilized large language model(LLM)prompt engineering,topic modeling and other natural language processing techniques to analyze the publications.Our findings reveal that AI applications constitute 8.1% of geographical research,with publication volume having increased 20-fold over three decades.Both China and the United States have been the leading contributors to AI-driven geographical studies,together accounting for 62.78% of all publications in this field.Notably,more than half of the studies used traditional machine learning methods.Among the various geographical topics,remote sensing applications and spatial data analysis emerged as the most extensively explored areas using AI techniques,with image feature extraction being the topic with the deepest level of adoption and most significant ongoing impact of AI methods.This systematic review provides critical insights into the integration trajectory of AI within geographical sciences,establishing a foundation for identifying emerging research opportunities and enhancing our understanding of AI’s transformative role in advancing geographical knowledge.
基金supported by the Fuxing Nursing Research Foundation of Fudan University[FNF202352].
文摘Objectives This review aimed to systematically synthesize the available research on the disclosure of diagnosis and related issues in childhood cancer from the perspectives of healthcare professionals,with the goal of informing the optimization of disclosure processes and meeting the communication needs of affected families.Methods In accordance with the Joanna Briggs Institute(JBI)methodology for mixed methods systematic reviews,the convergent segregated approach was used in this review.Articles were retrieved from 11 databases,including PubMed,Web of Science,CINAHL,CENTRAL,Embase,Ovid/Medline,PsycINFO,PsycArticles,Scopus,ERIC,and China National Knowledge Infrastructure(CNKI).The quality of the selected articles was assessed using the Mixed Method Appraisal Tool(MMAT).The review protocol was registered on PROSPERO(CRD42024542746).Results A total of 21 studies from 10 countries were included.Their methodological quality was generally medium to high,with MMAT scores ranging from 60%to 100%.The synthesis yielded three core themes:1)the spectrum of professional and societal attitudes toward disclosure;2)the dynamic practices of navigating disclosure amid uncertainty,including timing and environment,stakeholders,and content of disclosure;and 3)factors influencing disclosure,including children’s,parental,healthcare professionals’,and socio-cultural factors.Conclusions This review synthesized the perspectives and experiences of healthcare professionals regarding disclosure in childhood cancer,highlighting the complexity and multidimensional nature of this process in clinical practice.Future research should further investigate the experiences and needs of children and their parents,explore cultural variations in disclosure practices,develop context-appropriate assessment tools,and construct multidimensional intervention strategies to enhance the humanistic care and professional effectiveness of the disclosure process.
基金supported by grants from Collaborative Research Fund(Ref:C4032-21GF)General Research Grant(Ref:14114822)+1 种基金Group Research Scheme(Ref:3110146)Area of Excellence(Ref:Ao E/M-402/20)。
文摘Mitochondrial dysfunction and oxidative stress are widely regarded as primary drivers of aging and are associated with several neurodegenerative diseases.The degeneration of motor neurons during aging is a critical pathological factor contributing to the progression of sarcopenia.However,the morphological and functional changes in mitochondria and their interplay in the degeneration of the neuromuscular junction during aging remain poorly understood.A defined systematic search of the Pub Med,Web of Science and Embase databases(last accessed on October 30,2024)was conducted with search terms including'mitochondria','aging'and'NMJ'.Clinical and preclinical studies of mitochondrial dysfunction and neuromuscular junction degeneration during aging.Twentyseven studies were included in this systematic review.This systematic review provides a summary of morphological,functional and biological changes in neuromuscular junction,mitochondrial morphology,biosynthesis,respiratory chain function,and mitophagy during aging.We focus on the interactions and mechanisms underlying the relationship between mitochondria and neuromuscular junctions during aging.Aging is characterized by significant reductions in mitochondrial fusion/fission cycles,biosynthesis,and mitochondrial quality control,which may lead to neuromuscular junction dysfunction,denervation and poor physical performance.Motor nerve terminals that exhibit redox sensitivity are among the first to exhibit abnormalities,ultimately leading to an early decline in muscle strength through impaired neuromuscular junction transmission function.Parg coactivator 1 alpha is a crucial molecule that regulates mitochondrial biogenesis and modulates various pathways,including the mitochondrial respiratory chain,energy deficiency,oxidative stress,and inflammation.Mitochondrial dysfunction is correlated with neuromuscular junction denervation and acetylcholine receptor fragmentation,resulting in muscle atrophy and a decrease in strength during aging.Physical therapy,pharmacotherapy,and gene therapy can alleviate the structural degeneration and functional deterioration of neuromuscular junction by restoring mitochondrial function.Therefore,mitochondria are considered potential targets for preserving neuromuscular junction morphology and function during aging to treat sarcopenia.
文摘Objectives:Immunotherapy based on immune checkpoint blockade(ICB)has become a key treatment for melanoma.However,the increasing number of cases of melanoma resistant to immunotherapy highlights the need to develop methods to overcome this resistance.This study aims to collect the most recent information on melanoma immunotherapy,discuss potential strategies to overcome resistance to immunotherapy,and identify areas that require further analysis.Methods:To achieve this goal,scientific publications from 2021-2024 available in PubMed and Google Scholar databases were analyzed.The databases were searched using the following terms:“melanoma”,“immunotherapy”,“Immune Checkpoint Blockade”,and“immunoresistance”.Results:The results of preclinical and early-stage clinical research indicate the potential application of tank-binding kinase 1(TBK-1),fecal microbiota transplant(FMT),Toll-like Receptor 9(TLR9),lipid nanoparticles(LNPs)containing a stimulator of an interferon gene agonist(STING),BRAF inhibitors,Lymphocyte Activation Gene(LAG-3),T-Cell Immunoglobulin and ITIM Domain(TIGIT),and oncolytic viruses(OVs)as potential methods to enhance melanoma sensitivity to ICB.Discussion:To optimize immunotherapy,further research is needed to determine the detailed mechanisms of action,safety profiles,tolerability,and precise patient selection criteria for methods capable of overcoming melanoma’s immunoresistance.
基金supported by FCT/MCTES UIDP/05608/2020(https://doi.org/10.54499/UIDP/05608/2020)UIDB/05608/2020(https://doi.org/10.54499/UIDB/05608/2020).
文摘Background:The Colorectal Cancer(CRC)pathogenesis and therapeutic efficacy are influenced by the gut microbiome,making it a promising biomarker for predicting treatment responses and adverse effects.This systematic review aims to outline the gut microbiome composition in individuals with CRC undergoing the same therapeutic regimen and evaluate interindividual microbiome profile variations to better understand how these differences may influence therapeutic outcomes.Methods:Key studies investigating the microbiome’s role in therapeutic approaches for CRC were searched in both PubMed and Cochrane databases on 12 and 22 March 2025,respectively.Eligible studies included free full-text English-language randomized clinical trials and human observational studies reporting on gut microbiome composition and treatment outcomes.RoB 2 and ROBINS-I were employed in the evaluation of bias for randomized trials and observational studies,respectively.Data extracted was narratively analyzed.Results:Six studies involving a total of 361 individuals were included.Therapeutic interventions,either standard treatments and/or those targeting the gut microbiome,generally increased probiotic taxa and reduced pro-carcinogenic bacteria.However,no consistent pattern of improved clinical outcomes was observed,suggesting that treatment mechanisms,the tumor’s nature,and individual characteristics play critical roles in microbiome modulation.Conclusion:The gut microbiome holds significant potential in clinical settings.Nonetheless,further research is needed to better understand its functional aspects and to consider the influence of treatment mechanisms,the tumor’s nature,and individual characteristics as modulators,in order to optimize clinical outcomes.
文摘Background:Artificial intelligence(AI)-assisted threedimensional(3D)surgical platforms,integrated with augmented reality,have the potential to improve intraoperative anatomical recognition and provide surgeons with an immersive,dynamic operating environment during urooncological procedures.This review aims to examine the current applications of AI in robotic uro-oncology,with a particular focus on its role in facilitating intraoperative navigation during complex surgeries.Methods:A systematic literature search was performed across PubMed,the National Library of Medicine,MEDLINE,the Cochrane Central Register of Controlled Trials(CENTRAL),ClinicalTrials.gov,and Google Scholar to identify relevant studies published up to July 2025.The search strategy incorporated a predefined set of keywords,including AI,machine learning,radical prostatectomy(RP),robotic-assisted radical prostatectomy(RARP),robotassisted partial nephrectomy(RAPN),and robot-assisted radical cystectomy(RARC).Only clinical trials,full-text peer-reviewed publications,and original research articles were included.Studies were eligible for inclusion if they evaluated or described applications of AI in RARP,RAPN,or RARC.Results:Technological advancements have substantially transformed the field of uro-oncologic surgery.In particular,AI and AI-assisted intraoperative navigation in RARP demonstrate considerable potential to objectively assess surgical performance and predict clinical outcomes.In RAPN,the adoption of preoperative,interactive 3D virtualmodels for surgical planning has influenced surgical decisions,thus,enhanced precision in resection planning correlates with superior nephron-sparing outcomes and optimized selective clamping.AI applications in RARC,techniques such as augmented reality(AR)can overlay critical information on the surgical field,by facilitating navigation through complex anatomical planes and enhancing identification of critical structures.Conclusion:AI appears to enhance robotic uro-oncologic procedures by increasing operative precision and supporting individualised surgical treatment strategies.
文摘Background:While the treatment of metastatic renal cell carcinoma(mRCC)is evolving due to immune checkpoint inhibitors(ICIs),optimal strategies for later lines of therapy have yet to be defined.The combination of lenvatinib and everolimus represents a viable option,and the present review aimed to summarize its activity,effectiveness,and safety.Methods:A systematic review of the literature was conducted using PubMed,targeting studies published between 2018 and 2025.Eligible studies included English-language prospective and retrospective trials reporting survival outcomes in mRCC patients treated with lenvatinib and everolimus after at least one ICI-containing regimen.Results:Nine studies met the inclusion criteria,encompassing a total of 441 patients.The lenvatinib and everolimus combination was primarily used in the third and subsequent lines of therapy.Median overall survival ranged from 7.5 to 24.5 months,while median progression-free survival was more consistent,between 6.1 and 6.7 months,except for one study reporting 12.9 months.Objective response rates varied widely(14.0%–55.7%).Adverse events of grade≥3 did not exceed the expected rate,with diarrhoea and proteinuria as the most reported events.Dose reductions and treatment discontinuations due to toxicity occurred but were generally lower than in prior pivotal trials.Conclusions:Real-world evidence suggests that lenvatinib and everolimus represent an effective and safe option after ICI failure in mRCC patients.Nevertheless,the lack of randomized phase III trials and the heterogeneity of existing studies highlight the need for more robust prospective research to guide post-ICI therapeutic strategies.
基金Supported by Funding of Major Supporting Departments(KFKFC) of Rehabilitation Medicine,Wuxi People's Hospital Affiliated to Nanjing Medical Universitythe Second Batch of National "Ten Thousand Talents Plan" of Scientific and Technological Innovation Leading Talents(No.W02020052)
文摘With the introduction and development of evidence-based medicine in China, it has been spread rapidly in the area of integrative medicine（IM） and has become a new unique discipline. During almost 20 years, as one of the most important parts of evidence-based IM, systematic review（SR）/meta-analysis（MA） of IM have shown a good development momentum in the aspects of quantity, depth, breadth and influence, but also face the harsh situation of the uncontrolled quantity and quality, especially for SRs in Chinese. Therefore, how to supervise and standardize this area effectively becomes a problem to be solved. Based on the experience both at home and abroad, the authors put forward several kinds of solutions for laying the foundation for further development such as promoting the registration system of SR/MA of IM, effectively setting up the regulatory platform of quality and quantity, launching professional training for SR/MA reviewers, formingqualification registration, developing the data transfer and sharing platform to realize the transparency of evidence process.
