Objective To evaluate the efficacy of intravertebral analgesia for external cephalic version. Methods We electronically searched The Cochrane Library (Issue 4, 2009), PubMed (1980 to 2009), Ovid MEDLINE (1950 to 2009), Ovid EBM Database (1991 to 2009), EMbase (1980 to 2009), CBM (1978 to 2009) and CNKI (1979 to 2009) to collect literature about intravertebral analgesia for external cephalic version. We screened randomized controlled trials (RCTs) according to the predefined inclusion and exclusion criteria, extracted data and evaluated the quality of the included studies, and then performed meta-analyses by using RevMan 5.0.13 software. Results Seven RCTs involving 620 women met the inclusion criteria. Five trials were of relatively high quality, and 1 of low quality and 2 not clear. The result of meta-analyses showed that intravertebral analgesia was superior in external cephalic version with a RR 1.53 and 95%CI 1.24 to 1.88. Conclusion Intravertebral analgesia can increase the successful rate of external cephalic version in the treatment of breech presentation compared with intravenous medicine for systematic use or no analgesia.
Objective To assess the effect of atraumatic restorative treatment (ART) on decayed deciduous and permanent teeth in children. Methods Such databases as CENTRAL of The Cochrane Library, MEDLINE, EMbase, CBM, CNKI, and VIP were searched, and the China clinical trial register center were also searched. The search was conducted by the end of April, 2009 to collect the randomized controlled trials (RCTs) of ART vs. conventional restorative treatment (CRT) for childhood caries. The data extraction was performed by two reviewers independently. The quality of the included studies was critically assessed and the data analyses were performed by the Cochrane Collaboration’s RevMan 5.0.2 software. Results A total of seven randomized controlled trials were included. Only was the descriptive analysis conducted because of the difference of restorative materials used in each study, the types of target teeth, the measure indexes, and the year limit of follow up, which showed that, most of the included studies suggested that the survival rate of restorative materials in all types of caries hole was similar between the ART group and the CRT group; only a few studies suggested that the CRT group was superior to the ART group; the children in the ART group felt more comfortable than those in the CRT group during the treatment procedure; two studies compared the working time and got an opposite results. Conclusion Because of the higher clinical heterogeneity of the include studies, the merger analysis fails to be conducted, so it is impossible to get a precise conclusion about the effect of treating childhood caries with ART vs. CRT, and more RCTs with high quality are needed for confirmation.
ObjectiveTo systematically review the efficacy and safety of laryngeal mask versus endotracheal tubes for laparoscopic surgery.MethodsPubMed, EMbase, The Cochrane Library, CNKI, WanFang Data and CBM databases were electronically searched to collect the randomized controlled trials (RCTs) about the efficacy and safety of laryngeal mask versus endotracheal tubes for laparoscopic surgery from inception to April, 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 16 RCTs involving 1 593 patients were included. The results of meta-analysis showed that: there was no significant difference in the success rate of the first insertion (RR=0.99, 95%CI 0.96 to 1.02, P=0.55). The airway pressure of patients whose position were head higher than foot was significantly lower in the laryngeal mask group than in the tracheal intubation group (MD=–1.20, 95%CI –1.81 to –0.59, P=0.000 1), but there was no significant difference between two groups in reverse position patients (MD=0.48, 95%CI –0.90 to 1.87, P=0.49). The incidence of sore throat (RR=0.58, 95%CI 0.46 to 0.74, P<0.000 01), the incidence of blood stain (RR=0.48, 95%CI 0.30 to 0.77, P=0.002), the incidence of laryngeal spasm/bronchial spasm (OR=0.30, 95%CI 0.11 to 0.80, P=0.02) and the incidence of cough/hiccup (RR=0.10, 95%CI 0.07 to 0.15, P<0.000 01) in the laryngeal mask group were significantly lower than those in the tracheal intubation group.ConclusionThe current evidence shows that compared with tracheal intubation, laryngeal mask can effectively reduce airway pressure of patients whose position are head higher than foot. The risks of various complications are significant higher in tracheal intubation in laparoscopic surgery. Laryngeal mask can maintain patients' normal respiratory functions while reduce damage and do not increase the occurrence of reflux aspiration. Due to limited quantity and quality of the included studies, more high quality studies are needed to verify above conclusion.
ObjectiveTo systematically review the efficacy of different nucleosides (acids) in preventing hepatitis B virus reactivation after chemotherapy in cancer patients. MethodsThe Cochrane Library, PubMed, EMbase, Web of Science, CNKI, WanFang Data, and VIP databases were electronically searched to collect randomized controlled trials (RCTs) of different nucleosides (acids) to prevent HBV reactivation after chemotherapy in cancer patients from inception to June 7th, 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Network meta-analysis was then performed by using Stata 16.0 software. ResultsA total of 43 RCTs involving 3 269 patients were included. There were 7 interventions, namely entecavir (ETV), lamivudine (LAM), adefovir dipivoxil (ADV), telbivudine (LdT), tenofovir dipivoxil (TDF), lamivudine combined with entecavir (LAM+ETV), and lamivudine combined with adefovir dipivoxil (LAM+ADV). The results of network meta-analysis showed that the efficacy of reducing the reactivation rate of ETV, LAM, ADV, LdT, TDF, LAM+ETV, LAM+ADV were superior than the control group. The ETV, LAM and ADV were not as effective as LAM+ETV. The leading drug combinations were LAM+ETV (94.8%), LdT (81.5%) and LA+ADV (58.0%). ConclusionsCurrent evidence shows that LAM+ETV, LdT, and LA+ADV are more effective in preventing hepatitis B virus reactivation after chemotherapy in cancer patients. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify the above conclusions.
Objective To assess the efficacy of topical non-steroidal anti-inflammatory drugs （NSAIDs） in the treatment of osteoarthritis （OA）. Methods MEDLINE, EMBASE, Scientific Citation Index, CINAHL, The Cochrane Library, CBMdisc and abstracts from conference were searched from 1966 to March 30, 2005. Randomized controlled trials （R.CT） comparing topical non-steroidal anti-inflammatory drug （NSAIDs） with placebo or oral NSAIDs in OA were induded. Effect size （ES） was calculated for pain, function and stiffness. Relative risk （RR） was calculated for dichotomous data such as clinical response rate and adverse effect rate. Number needed to treat to obtain the clinical response was estimated. The quality of trials was assessed and sensitivity analyses were undertaken. Results Topical NSAIDs were superior to placebo in relieving pain due to osteoarthritis only in the first 2 weeks of treatment; ES （95% CI） were 0.41 （0. 16 to 0.66） and 0.40 （0.15 to 0.65） at week 1 and 2 respectively. However, the effects were short-lived and no benefit was observed over placebo at the third and fourth week. A similar pattern was observed with function, stiflhess and clinical response RR and number needed to treat. Topical NSAIDs were inferior to oral NSAIDs at week 1, and associated with more local side effects such as rash, itch or burning （RR 5.29, 95% CI 1.14 to 24. 51 ）. Conclusions Only very shortterm （less than 4 weeks） RCTs have assessed topical NSAID efficacy in OA ; after 2 weeks no efficacy above placebo has been obsevrved. There are no trial data to support the long-term use of topical NSAIDs in osteoarthritis.
Objective To systematically review the efficacy of six cognitive interventions on cognitive function of patients with mild cognitive impairment after stroke. Methods The PubMed, EMbase, Cochrane Library, SinoMed, WanFang Data and CNKI databases were electronically searched to collect randomized controlled trials on the effects of non-drug interventions on the cognitive function of patients with mild cognitive impairment after stroke from inception to March 2023. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Network meta-analysis was then performed using Openbugs 3.2.3 and Stata 16.0 software. Results A total of 72 studies involving 4 962 patients were included. The results of network meta-analysis showed that the following five cognitive interventions improved the cognitive function of stroke patients with mild cognitive impairment: cognitive control intervention (SMD=−1.28, 95%CI −1.686 to −0.90, P<0.05) had the most significant effect on the improvement of cognitive function, followed by computer cognitive training (SMD=−1.02, 95%CI −1.51 to −0.53, P<0.05), virtual reality cognitive training (SMD=−1.20, 95%CI −1.78 to −0.62, P<0.05), non-invasive neural regulation (SMD=−1.09, 95%CI −1.58 to −0.60, P<0.05), and cognitive stimulation (SMD=−0.94, 95%CI −1.82 to −0.07, P<0.05). Conclusion Five cognitive interventions are effective in improving cognitive function for stroke patients with mild cognitive impairment, among which cognitive control intervention is the most effective. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
ObjectivesTo systematically review the efficacy and safety of ciprofloxacin for non-cystic fibrosis bronchiectasis.MethodsDatabases including PubMed, EMbase, The Cochrane Library, CBM, VIP, CNKI and WanFang Data were electronically searched from inception to August 2018 to collect randomized controlled trials (RCTs) on ciprofloxacin in the treatment of non-cystic fibrosis bronchiectasis. Two reviewers independently screened literature, extracted data, and assessed risk of bias of included studies. Then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 9 RCTs involving 1 666 patients were included. The results of meta-analysis showed that: compared with control group, the ciprofloxacin more efficiently eradicate bacteria from sputum (RR=4.34, 95%CI 2.04 to 9.23, P=0.000 1), decrease risk of the exacerbations (RR=0.81, 95%CI 0.71 to 0.93, P=0.002) and the mean bacterial load (MD=–4.08, 95%CI –6.29 to –1.87, P=0.001). However, there were no significant differences between two groups in clinical efficiency and adverse events.ConclusionsThe current evidence shows that, ciprofloxacin can decrease the mean bacterial load and risk of the exacerbation, and more efficiently eradicate bacteria from sputum in non-cystic fibrosis bronchiectasis patients. Due to limited quality and quantity of the included studies, more studies are required to verify the conclusions.
Objective To compare the anesthetic effects of traditional digital block with single-injection digital block in digital injury patients for subcutaneous digital blocks. Methods Patients with one or two digits injured were randomized to the traditional digital block group and single-injection digital block group. All of the blocks were conducted by one investigator. The patients and outcome assessor were blinded to the treatment allocation. Both of the per-protocol-population (PP) analysis and the intention-to-treatment (ITT) analysis were performed to compare the two block techniques in terms of the pain during infiltration, the onset time of anesthesia and the failure rate of anesthesia. Results A total of 93 patients (109 digits) were included with 51 (61 digits) in the traditional block group and 42 (48 digits) in the single-injection block group.Two patients (3 digits) dropped out. Both of the PP analysis and ITT analysis showed that no significant difference between the two groups were detected in terms of the pain during infiltration, the onset time of anesthesia and the failure rate of anesthesia (P﹥0.05). Conclusions The subcutaneous single-injection digital block is as effective as the traditional digital block, but is much easier to perform. This technique is indicated for the digital anesthesia of palmar aspect distal to the proximal digital crease and dorsal aspect of the distal and middle phalanxes.
ObjectivesTo systematically review the efficacy of His-bundle pacing (HBP) and right ventricular pacing (RVP).MethodsPubMed, The Cochrane Library, Web of Science, EMbase, CNKI, VIP and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) and cohort studies on efficacy of HBP and RVP from inception to December, 2018. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies, then, meta-analysis was performed using RevMan 5.3 software.ResultsA total of 8 studies involving 1 130 patients were included. The results of meta-analysis showed that: HBP group was superior to RVP group in QRS duration (MD=–43.88, 95%CI –52.53 to –35.22, P<0.000 01), LVEF (MD=4.53, 95%CI 2.67 to 6.38, P<0.000 01), and NYHA (MD=–0.85, 95%CI –1.14 to –0.56, P<0.000 01). However, the operation time (MD=15.21, 95%CI 11.44 to 18.98, P<0.000 01) and fluoroscopy duration (MD=2.98, 95%CI 2.10 to 3.85, P<0.000 01) of HBP group were longer than that of RVP group.ConclusionsCurrent evidence shows that, compared with RVP, HBP is superior in maintaining of QRS duration, LVEF and NYHA; however, the operation time is longer. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusion.
Objective To systematically review the effectiveness of forced air warming for the maintenance of perioperative core temperature, so as to provide clinical evidence for an appropriate warming plan during the perioperative period. Methods We electronically searched PubMed, The Cochrane Library, EMbase, Web of Science, CBM and CNKI from 2000 to 2012, so as to comprehensively collect randomized controlled trials (RCTs) about the effectiveness of different warming methods for the maintenance of perioperative core temperature (including forced air warming, resistive-heating blanket/electric heating pad, circulating water mattress, and infrared ray radiant heating system) for maintenance of perioperative core temperature. References of the included studies were also retrieved. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data and assessed the quality of the included studies. Then, meta-analysis was performed using RevMan 5.1 software. Results Eleven RCTs involving 577 patients were included. The results of meta-analysis indicated that, in the maintenance of core temperature during the perioperative period, forced air warming was superior to resistive-heating blanket/electric heating pad (SMD= –0.40, 95%CI –0.73 to –0.06), circulating water mattress (SMD= –1.10, 95%CI –1.55 to –0.66), and infrared ray radiant heating system (SMD= –0.69, 95%CI –1.06 to –0.32). In the incidence of hypothermia during the perioperative period, the group of forced air warming was lower than the group of blanket/electric heating pad (RR=1.76, 95%CI 1.15 to 2.69), but it was the same as the group of infrared ray radiant heating system (RR=1.37, 95%CI 0.83 to 2.27). In the incidence of shivering during the perioperative period, the group of forced air warming was the same as the group of blanket/electric heating pad (RR=0.75, 95%CI 0.18 to 3.21) and the group of infrared ray radiant heating system (RR=0.8, 95%CI 0.19 to 3.36). Conclusion Compared with resistive-heating blanket/electric heating pad, circulating water mattress, and infrared ray radiant heating system, forced air warming maintains patients’ core temperature better during the perioperative period, with a lower incidences of hypothermia. Due to the limited quantity and quality of the included studies, more high quality RCTs with large sample size are needed to verify the above conclusion.