ObjectiveTo evaluate the effect of soft silicone dressing in radiation dermatitis after radiotherapy for head and neck tumors.MethodsThe data of Cochrane Library, Web of Science, JBI Library, CINAHL, Embase, Medline, China National Knowledge Infrastructure, Wanfang Database and Chinese Biomedical Literature Database were searched by computer, and the literature of soft silicone dressing in the treatment of radiation dermatitis were collected. The intervention group was treated with soft silicone dressing and the control group was treated with burn ointment and other methods. The retrieval time was from their inception to March 2019. After screening, quality evaluation and data extraction by two independent evaluators, meta-analysis was carried out by RevMan 5.3 software.ResultsA total of 7 articles were included, including 2 in English and 5 in Chinese, with a total of 487 patients. The results of meta-analysis showed that soft silicone dressing could shorten the wound healing time of radiation dermatitis [mean difference=−4.05 days, 95% confidence interval (CI) (−6.69, −1.42) days, P=0.003], reduce the severity of radiation dermatitis symptoms rated by the Radiation Therapy Oncology Group grade [odds ratio =7.99, 95% CI (2.69, 23.75), P=0.000 2], and reduce the score of Radiation-Induced Skin Reaction Assessment Scale (RISRAS) [standardized mean difference=−1.32, 95%CI (−2.64, −0.00), P=0.05]. To some extent, the curative effect was better than that of other methods. Wound healing time and RISRAS score combined with heterogeneity, after sensitivity analysis, the results were stable. ConclusionSoft silicone dressing can improve the concomitant symptoms of radiation dermatitis after radiotherapy of head and neck tumor, and may relieve the pain of radiation dermatitis to a certain extent, and promote the healing speed of dermatitis wound.
ObjectiveTo perform a meta-analysis on the positive rate of hepatitis C virus (HCV) antibody among pregnant females in China from 2008 to 2018, so as to provide scientific references for the prevention and treatment of HCV infection among pregnant females.MethodsDatabases including PubMed, Web of Science, SinoMed, CNKI, VIP, and WanFang Data were electronically searched to collect observational studies on the positive rate of HCV antibody among pregnant females in China from January, 2008 to December, 2018. Two reviewers independently screened literature, extracted data and evaluated risk of bias of included studies. Meta-analysis was then performed using Stata 15.0 software.ResultsA total of 108 studies involving 657 765 individuals were included. Results of meta-analysis showed that the overall positive rate of HCV antibody among pregnant females in Chinese was 0.235% (95%CI 0.189% to 0.286%). Subgroup analysis showed that the positive rate of HCV antibody among pregnant females in western China to be the highest 0.291% (95%CI 0.221% to 0.378%), the northeast China to be 0.240% (95%CI 0.099% to 0.442%), the central China to be 0.235% (95%CI 0.016% to 0.319%), and the east China to be the lowest 0.193 % (95%CI 0.119% to 0.281%). The HCV antibody positive rate of pregnant females from hospital was 0.291% (95%CI 0.221% to 0.372%) and was higher than that from AIDS surveillance site which was 0.164% (95%CI 0.122% to 0.207%).ConclusionsThe prevalence of HCV antibody among pregnant females maintains at a low level in China.
ObjectiveTo systematically review the efficacy of five types of rehabilitation exercises, including Baduanjin, aquatic exercise, Taijiquan, somatosensory exercise and whole body vibration training for the intervention of motor function in stroke patients. MethodsWeb of Science, PubMed, EMbase, The Cochrane Library, CNKI, CBM, CSJD and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) of rehabilitation exercise interventions for motor function in stroke patients from inception to October 2020. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies; then, network meta-analysis was performed by using R and ADDIS software. ResultsA total of 50 RCTs involving 1 838 patients were included. The results of the meta-analysis showed that all five types of rehabilitation exercises were superior to conventional rehabilitation group in terms of balance in stroke patients (P<0.05), with the best ranking occupied by Baduanjin. In terms of lower limb strength, only the aquatic exercise was superior to conventional rehabilitation (P<0.05). In terms of walking function, somatic training and aquatic exercise were superior to conventional rehabilitation (P<0.05), with somatic exercises ranking first. ConclusionCurrent evidence shows that Baduanjin has an advantage in improving the balance, somatosensory interactive game exercise has an advantage in improving the walking capability and aquatic exercise has an advantage in improving the lower limb strength of stroke patients. Due to limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.
Objective To evaluate the efficacy and safety of Polyunsaturated phosphatidylcholine (PPC) for chronic hepatitis. Methods We searched EMBASE (1980May,2003), MEDLINE(1966May,2003), CBM (1979May,2003), The Cochrane Library Issue 2, 2003 and handsearched 8 related Chinese journals. Randomized controlled trials(RCT) comparing PPC versus placebo/no treatment for chronic hepatitis were included with no restrictions of blinding, language and publication. Two reviewers independently performed data extraction and assessed the quality . Data were entered and analyzed by RevMan 4.2 software supplied by the Cochrane Collaboration .Results Six high quality trials involving 568 patients were included. Four studies involving 451 patients showed the clinical effective rate of PPC for chronic hepatitis was 52.5% while the control group was 37.5% with statistical difference [RR1.81,95%CI(1.41,2.33),Z=4.69, Plt;0.00001].A meta-analysis involving three studies with 100 patients showed the PPC can statically improve histopathology of chronic hepatitis comparing with control group [RR 2.58,95%CI (1.61,4.15),Z=3.91,Plt;0.0001].No serious adverse events were reported.Conclusions PPC is a safe medicine used for treating chronic viral hepatitis and may relieve clinical symptoms and signs.At the same time ,it has positive effect on hepatic histopathology for patients .However ,more high quality clinical trials are required.
ObjectiveTo systematically review the effectiveness and safety of intensive blood pressure lowering in intracerebral hemorrhage (ICH). MethodsRandomised controlled trials (RCTs) and quasi-RCTs about ICH patients receiving intensive blood pressure lowering were searched from PubMed, EMbase, SCIE, The Cochrane Library (Issue 2, 2013), CBM, CNKI, VIP and WanFang Data until March, 2014. Literature was screened according to the exclusion and inclusion criteria by two reviewers independently and meta-analysis was conducted using RevMan 5.2 software after data extraction and quality assessment. ResultsA total of 24 studies were included involving 6 299 patients, of which 10 were RCTs and 14 were quasi-RCTs. The results of meta-analysis showed that intensive blood pressure lowering was superior to guideline-recommended intervention in reducing 24-h hematoma expansion rates (OR=0.36, 95%CI 0.28 to 0.46, P < 0.05), 24-h hematoma expansion volume (MD=-3.71, 95%CI-4.15 to-3.28, P < 0.05) and perihematomal edema volume (MD=-1.09, 95%CI-1.92 to-0.22, P < 0.05). Meanwhile, intensive blood pressure lowering improved 21-d NIHSS score (MD=-3.44, 95%CI-5.02 to-1.87, P < 0.05). But there was no significant difference in mortality and adverse reaction between the two groups. ConclusionCurrent evidence shows that intensive blood pressure lowering could reduce hematoma expansion volume and perihematomal edema volume, which is beneficial to recovery of neurological function, but ICH patients' long-term prognosis needs to be further studied. Due to the limited quantity and quality of the included studies, high quality studies are needed to verify the above conclusion.
Objective To evaluate the short-term clinical efficacy and safety of 10-Hydroxy-camptothecin （10- HCPT ） chemotherapy on gastrointestinal carcinoma. Methods We searched electronic database including CNKI （ 1995 - 2005 ）, MEDLINE （ 1995 - 2005 ） and The Cochrane Library （ Issue 1, 2005 ）. More related research data were odtained by cantacting with researchers. Randomized controlled trials of gastrointestinal carcinoma chemotherapy comparing only or including 10-HCPT chemotherapy with normal chemotherapy on efficacy rate, digestive and hematology system toxicity were included. Data related to the clinical outcome were extracted by two reviewers independently. Statistical analysis was performed by using RevMan4. 2.2. Results Twenty-five trials including 1 881 patients met the inclusion criteria. The results of meta-analysis were hsted as follows： 10-HCPT could significantly improve the short-term chemotherapy efficacy for colorectal cancer （ RR. 1.62, 95% CI 1.37 to 1.92） and gastric cancer （RR 1.48, 95% CI 1.18 to 1.85）in chemotherapy curative efficacy in short-term. 10-HCPT induced severe toxicity of lower digestive system（RR. 0.96,95% CI 0.62 to 1.50 ） without statistical significance, while severe toxicity of hematology system was significantly higher than that of control with RR 1.27,95% CI 1.02 to 1.58. Conclusions Current evidence suggests that 10-HCPT can improve hematology system short-term chemotherapy efficacy for gastrointestinal carcinoma and increase the incidence of severe toxicity. Further research is needed to value its influence on the prognosis of gastrointestinal carcinoma.
Objective To compare the efficacy and safety of different cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) combined with endocrine therapy (ET) for the treatment of hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2−) advanced or metastatic breast cancer. Methods Randomized controlled trials (RCTs) on CDK4/6i for the treatment of HR+/HER2− metastatic or advanced breast cancer were retrieved from databases including PubMed, EMbase, Web of Science, The Cochrane Library, CNKI, Wanfang, VIP, and SinoMed, with the search period ranging from database inception to August 2023. Bayesian network meta-analysis was conducted using R 4.2.0 software. Results A total of 18 RCTs from 25 articles, involving 8 031 patients and 11 treatment regimens, were included. There was no significant difference in progression-free survival (PFS) or overall survival (OS) among different CDK4/6i+ET combinations. The highest cumulative probability for PFS was observed with dalpiciclib (DAL)+fulvestrant (FUL), while ribociclib (RIB)+FUL ranked first for OS. In terms of efficacy, abemaciclib (ABE)+aromatase inhibitors (AI) and ABE+FUL ranked first in objective response rate and clinical benefit rate, respectively. Regarding safety, statistically significant difference in grade 3-4 adverse events was observed among certain types of CDK4/6i (P<0.05). Conclusion Current evidence suggests that CDK4/6i+ET is superior to ET alone for the treatment of HR+/HER2− advanced/metastatic breast cancer. Different CDK4/6i+ET combinations demonstrate comparable or similar efficacy; however, the incidence of adverse reactions is higher with combination therapy. Treatment regimens should be selected based on individual conditions.
ObjectiveTo explore the relation of preoperative red blood cell distribution width (RDW) with prognosis in esophageal cancer.MethodsThe PubMed, EMbase, Web of Science, Cochrane Library, VIP, Wanfang, CNKI and SinoMed databases were searched to identify potential studies assessing the correlation between preoperative RDW and prognosis of esophageal cancer patients from establishment of databases to February 2019. The endpoint events included the overall survival (OS), cancer-specific survival (CSS) and disease-free survival (DFS). The Stata 12.0 software was applied for the meta-analysis and the hazard ratio (HR) and 95% confidence interval (CI) were calculated.ResultsA total of 10 retrospective studies involving 4 260 esophageal cancer patients from China or Japan were included. The score of Newcastle-Ottawa scale (NOS) of the included studies was more than 6 points. The results demonstrated that elevated preoperative RDW was significantly associated with poor CSS (HR=1.50, 95% CI 1.14 to 1.99, P=0.004) and DFS (HR=1.45, 95% CI 1.14 to 1.85, P=0.002), while no significant association between preoperative RDW and OS in esophageal cancer was observed (HR=1.17, 95% CI 0.95 to 1.45, P=0.143). Subgroup analysis based on the pathology revealed that preoperative RDW had high prognostic value in esophageal squamous carcinoma (ESCC) (HR=1.37, 95% CI 1.05 to 1.77, P=0.018).ConclusionPreoperative RDW may be an independent prognostic factor for Chinese and Japanese esophageal cancer patients, especially for ESCC patients. However, more prospective studies with bigger sample sizes from other countries are still needed to verify our findings.
ObjectiveTo systematically evaluate the risk factors for postoperative delirium after surgery for Stanford type A aortic dissection. MethodsWe searched the CNKI, SinoMed, Wanfang data, VIP, PubMed, Web of Science, EMbase, The Cochrane Library database from inception to September 2022. Case-control studies, and cohort studies on risk factors for postoperative delirium after surgery for Stanford type A aortic dissection were collected to identify studies about the risk factors for postoperative delirium after surgery for Stanford type A aortic dissection. Quality of the included studies was evaluated by the Newcastle-Ottawa scale (NOS). The meta-analysis was performed by RevMan 5.3 software and Stata 15.0 software. ResultsA total of 21 studies were included involving 3385 patients. The NOS score was 7-8 points. The results of meta-analysis showed that age (MD=2.58, 95%CI 1.44 to 3.72, P＜0.000 01), male (OR=1.33, 95%CI 1.12 to 1.59, P=0.001), drinking history (OR=1.45, 95%CI 1.04 to 2.04, P=0.03), diabetes history (OR=1.44, 95%CI 1.12 to 1.85, P=0.005), preoperative leukocytes (MD=1.17, 95%CI 0.57 to 1.77), P=0.000 1), operation time (MD=21.82, 95%CI 5.84 to 37.80, P=0.007), deep hypothermic circulatory arrest (DHCA) time (MD=3.02, 95%CI 1.04 to 5.01, P=0.003), aortic occlusion time (MD=8.94, 95%CI 2.91 to 14.97, P=0.004), cardiopulmonary bypass time (MD=13.92, 95%CI 5.92 to 21.91, P=0.0006), ICU stay (MD=2.77, 95%CI 1.55 to 3.99, P＜0.000 01), hospital stay (MD=3.46, 95%CI 2.03 to 4.89, P＜0.0001), APACHEⅡ score (MD=2.76, 95%CI 1.59 to 3.93, P＜0.000 01), ventilation support time (MD=6.10, 95%CI 3.48 to 8.72, P＜0.000 01), hypoxemia (OR=2.32, 95%CI 1.40 to 3.82, P=0.001), the minimum postoperative oxygenation index (MD=−79.52, 95%CI −125.80 to −33.24, P=0.000 8), blood oxygen saturation (MD=−3.50, 95%CI −4.49 to −2.51, P＜0.000 01), postoperative hemoglobin (MD=−6.35, 95%CI −9.21 to −3.50, P＜0.000 1), postoperative blood lactate (MD=0.45, 95%CI 0.15 to 0.75, P=0.004), postoperative electrolyte abnormalities (OR=5.94, 95%CI 3.50 to 10.09, P＜0.000 01), acute kidney injury (OR=1.92, 95%CI 1.34 to 2.75, P=0.000 4) and postoperative body temperature (MD=0.79, 95%CI 0.69 to 0.88, P＜0.000 01) were associated with postoperative delirium after surgery for Stanford type A aortic dissection. ConclusionThe current evidence shows that age, male, drinking history, diabetes history, operation time, DHCA time, aortic occlusion time, cardiopulmonary bypass time, ICU stay, hospital stay, APACHEⅡ score, ventilation support time, hypoxemia and postoperative body temperature are risk factors for the postoperative delirium after surgery for Stanford type A aortic dissection. Oxygenation index, oxygen saturation, and hemoglobin number are protective factors for delirium after Stanford type A aortic dissection.
Objective To systematically evaluate the clinical effectiveness of right ventricular outflow tract (RVOT) pacing for heart disease. Methods We searched the electronic bibliographic databases, including The Cochrane Library, PubMed, EMbase, CBM, VIP, CNKI, and WANFANG database to assemble the randomized controlled trials (RCTs) of RVS Pacing compared with right ventricular apical (RVA) pacing for heart disease. The deadline of the retrieval time was January 2010. Data were extracted and evaluated by two reviewers independently with a designed extraction form. The RevMan 5.0 software was used for meta-analysis. Results A total of 16 RCTs involving 926 patients were included. The results of meta-analyses showed that right ventricular outflow tract (RVOT) pacing significantly increased the left ventricular ejection fraction of 3 months and 18 months (WMD= 3.53, 95%CI 1.02 to 6.04; WMD= 8.94, 95%CI 7.35 to 10.52).Compared with RVA pacing, RVOT pacing could significantly reduce the QRS wave duration (WMD= –22.42, 95%CI –31.05 to – 13.80) immediately after the operation. Conclusion RVOT pacing can give patients a good physiological state which is more consistent with biventricular electric conduction and lead to the hemodynamic improvement in the short term, but the long-term result is not confident.