ObjectiveTo systematically review the impact of ACEI/ARB (angiotensin converting enzyme inhibitor/ angiotensin receptor antagonist) treatment on the clinical outcomes of Chinese patients with COVID-19 infections. MethodsPubMed, EMbase, Web of Science, The Cochrane Library, CNKI, WanFang Data, and VIP databases were electronically searched to collect cohort studies on the impact of the treatment with ACEI/ARB on the clinical outcomes of Chinese patients with COVID-19 infections from January 2020 to January 2022. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of the included studies. Then, meta-analysis was performed using RevMan 5.3 software. ResultsA total of 17 cohort studies involving 4 912 subjects were included. The results of meta-analysis showed that patients who were prescribed ACEI/ARB had shorter hospital stays (SMD=−0.28, 95%CI −0.46 to −0.11, P=0.002) and a lower mortality rate (OR=0.47, 95%CI 0.36 to 0.62, P<0.000 01) than patients who did not take ACEI/ARB. ConclusionCurrent evidence shows that the use of ACEI/ARB drugs can improve the clinical prognosis of Chinese patients with COVID-19 infections. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.
Objective To assess the value of vascular endothelial growth factor (VEGF) expression in the prognosis of esophageal cancer. Methods PubMed and EMbase were searched for collecting retrospective cohort studies on the correlation between VEGF expression and prognosis of esophageal cancer, and relevant articles were also retrieved from inception to June, 2012. Two reviewers independently screened the literature, extracted the data, and evaluated the quality. Then the meta-analysis was performed by using RevMan5.0 software, and the publication bias of literature was evaluated by means of Begg’s funnel plot and Egger’s method. Results Finally 10 cohort studies involving 811 patients were included. The meta-analysis showed that, patients with high level of VEGF had poor overall survival (HR=1.55, 95%CI 1.25 to 1.91). The results of subgroup analyses including VEGF subtype, critical value of VEGF and source of patient showed that: a) there was no correlation between patient’s prognosis and high level of VEGF-C; b) The high level of VEGF subtype in cancer tissue indicated a higher risk of death when the critical value was 10%, while it was not related to the prognosis when the critical value was 30%; and c) The high level of VEGF in cancer tissue was more valuable to predict the prognosis of esophageal cancer for Chinese patients rather than non-Chinese patients. Conclusion The level of VEGF’s expression in cancer tissue is valuable to predict the prognosis of esophageal cancer.
Objective To systematically review the relationship between obesity and the incidence of digestive system cancers. Methods The PubMed, EMbase, The Cochrane Library, CNKI and WanFang Data databases were electronically searched to collect cohort studies on the relationship between obesity and digestive system cancers from January 1st, 2001 to October 31st, 2021. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed by using RevMan 5.4 software. Results A total of 16 cohort studies were included. The results of meta-analysis revealed that compared with normal weight, obesity increased the incidence rate of various cancers of the digestive system, including colorectal cancer (RR=1.25, 95% CI 1.13 to 1.39, P<0.000 1), liver cancer (RR=1.65, 95%CI 1.41 to 1.92, P<0.000 01), pancreatic cancer (RR=1.34, 95%CI 1.19 to 1.51, P<0.000 01), gastric cancer (RR=1.09, 95%CI 1.05 to 1.14, P<0.000 1), and esophageal cancer (RR=2.39, 95%CI 1.98 to 2.89, P<0.000 01). Conclusion The current evidence indicates that obesity can increase the incidence rate of digestive system cancers. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo systematically review the correlation between type 2 diabetes mellitus (T2DM) and the risk of kidney cancer. MethodsPubMed, EMbase, Web of Science, CBM, VIP and CNKI databases were electronically searched to collect cohort studies on the association between T2DM and kidney cancer from inception to August 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis then performed by using Stata 15.0 software. ResultsA total of 17 cohort studies involving 2 003 165 T2DM patients were included. The results of meta-analysis showed that patients with T2DM had a higher kidney cancer risk than controls (RR=1.51, 95%CI 1.39 to 1.64, P<0.001). Subgroup analysis showed that the incidence of kidney cancer in T2DM patients was higher in different gender, region, population, follow-up time, diabetes assessment method and other subgroups. ConclusionsCurrent evidence shows that T2DM is a risk factor for kidney cancer.
ObjectiveTo systematically review the safety of low molecular weight heparin (LMWH) in pregnancy. MethodsPubMed, EMbase, The Cochrane Library, WanFang Data, VIP, and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) and cohort studies on the safety of LMWH in pregnancy from inception to March 30th, 2020. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Meta-analysis was then performed using RevMan 5.3 software. ResultsA total of 77 RCTs and 13 cohort studies were included. The results of meta-analysis showed that LMWH increased the incidence of postpartum hemorrhage (RR=1.50, 95%CI 1.00 to 2.25, P=0.05). However, there was no significant difference. The incidence of hematological adverse events was different from the results of RCTs and cohort studies. The results of RCT subgroup analysis showed that LMWH increased ecchymosis at the injection site (RR=1.60, 95%CI 1.24 to 2.08, P=0.000 4). However, the incidence of overall skin system adverse events did not increase significantly. LMWH reduced the incidence of cardiovascular adverse events (RR=0.18, 95%CI 0.07 to 0.46, P=0.000 3). LMWH failed to increase the occurrence of fetal congenital malformations, digestive system, central nervous system, skeletal system, and systemic adverse events. ConclusionsCurrent evidence suggests that LMWH is relatively safe to use during pregnancy. However, whether it increases postpartum hemorrhage and hematological adverse events is unclear. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify the above conclusions.
ObjectiveTo systematically review the implant survival and postoperative aesthetics of immediate versus delayed implant treatment in the anterior maxilla regions.MethodsWe searched databases including PubMed, The Cochrane Library, EMbase, CBM, CNKI and WanFang Data from inception to April 2017, to collect randomized controlled trials (RCTs) and cohort studies on immediate implant and delayed implant in the anterior teeth areas. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, RevMan 5.3 software was used to perform meta-analysis.ResultsA total of 4 RCTs and 12 retrospective cohort studies involving 1 316 implants were finally included. The results of meta-analysis showed that: there was no significant difference between two groups in retention rate (RCT: RR=0.99, 95%CI 0.97 to 1.02, P=0.70; retrospective cohort study: RR=0.99, 95%CI 0.96 to 1.02, P=0.54), the implant stability of permanent restoration for 4 months (MD=0.82, 95%CI –0.11 to 1.76, P=0.08), alveolar bone resorption of long-term permanent crown restoration (12 months: RCT: MD=0.06, 95%CI –0.35 to 0.47, P=0.79; retrospective cohort study: MD=–0.27, 95%CI –0.57 to 0.03, P=0.07; 24 months: retrospective cohort study MD=–0.09, 95%CI –0.18 to 0.00, P=0.05), respectively. The immediate implant group was superior to the control group in alveolar bone resorption of short-term permanent crown restoration (3 months: MD=–0.08, 95%CI –0.13 to –0.04, P=0.000 1; 6 months: MD=–0.23, 95%CI –0.38 to –0.07, P=0.004). The PES score in the immediate implant group was higher than that in the delayed implant group(MD=1.12, 95%CI 0.11 to 2.13, P=0.03).ConclusionsCurrent evidence shows that both immediate and delayed implant procedures have similar outcomes in terms of implant retention, long-term stability and long-term alveolar bone resorption of the implants in the anterior maxilla regions, but the former procedure possesses better short-term reduction of alveolar bone absorption and postoperative gingival aesthetics. Furthermore, due to the limited quality and quantity of the included studies, more large-scale and high-quality studies are needed to verify the above conclusions.
ObjectiveTo systematically review the risk factors of related infections on the totally implantable venous access device (TIVAD) in adult.MethodsPubMed, EMbase, CINAHL, The Cochrane Library, CBM, WanFang Data, CNKI and VIP databases were electronically searched to collect case-control studies and cohort studies about the risk factors of TIVAD-related infections in adult 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 one case-control study and 12 retrospective cohort studies involving 9 166 patients were included. The results of meta-analysis showed that: longer catheter utilization-days in the previous months (RR=1.06, 95%CI 1.02 to 1.10, P=0.001), inpatient treatment (RR=2.53, 95%CI 1.68 to 3.81, P<0.000 01), palliative care (RR=2.71, 95%CI 1.77 to 4.15,P<0.000 01), parenteral nutrition (RR=3.89, 95%CI 2.37 to 6.40,P<0.000 01), neutropenia (RR=2.20, 95%CI 1.30 to 3.72,P=0.003) and haematological malignancies (RR=3.54, 95%CI 2.03 to 6.17, P<0.000 01) were associated with increased risk of TIVAD-related infections in adult.ConclusionCurrent evidence shows that the risk factors of TIVAD-related infections include catheter utilization-days in the previous months, inpatient, palliative care, parenteral nutrition, neutropenia and hematological malignancies. Due to limited quality and quantity of the included studies, more high-quality studies are needed to verify conclusion.
ObjectiveTo systematically review the effects of unicompartmental keen arthroplasty (UKA) and total keen arthroplasty (TKA) in patients with unicompartmental osteoarthritis of the keen. MethodsWe electronically searched PubMed, MEDLINE (Ovid), ProQuest, EBSCO, The Cochrane Library (Issue 10, 2014), EMbase, CNKI, VIP, CBM and WanFang Data from inception to November 2014, to collect randomized controlled trials (RCTs) and cohort studies of UKA versus TKA for patients with unicompartmental osteoarthritis of the keen. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.2 software. ResultsA total of 6 RCTs and 6 cohort studies involving 940 keens were included. The results of meta-analysis indicated that patients underwent UKA enjoyed a quicker rehabilitation to achieve a flexion of 90° (RCT:P<0.05; cohort study:SMD=-1.70, 95%CI -2.07 to -1.34, P<0.000 01), had better range of motion (cohort study:SMD=0.59, 95%CI 0.41 to 0.78, P=0), and were less likely to get DVT (RCT:RR=0.31, 95%CI 0.12 to 0.82, P=0.02), but the patients underwent UKA were more likely to have a revision (RCT:RR=7.59, 95%CI 1.76 to 32.85, P=0.007). The keen scores of the UKA group were similar to the TKA group (RCT:P=0.626; cohort study:MD=1.78, 95%CI -0.09 to 3.65, P=0.06). ConclusionCurrent evidence shows that, compared with patients underwent TKA, patients underwent UKA have a quicker rehabilitation and fewer rates of DVT, and are more likely to have a revision. The medium to long-term follow up result of keen scores in both groups was equivalent. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
Objective To systematically review the efficacy and safety of totally laparoscopic total gastrectomy (TLTG) versus laparoscopic-assisted total gastrectomy (LATG) for patients with gastric cancer. Methods Databases including PubMed, EMbase, The Cochrane Library, CBM, WanFang Data and CNKI were searched to collect cohort studies about TLTG vs. LATG for gastric cancer from inception to February 28th 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed using RevMan 5.3 software. Results A total of six cohort studies were included, of which 407 cases were in the TLTG group, and 315 cases were in the LATG group. The results of meta-analysis showed that compared with LATG group, patients in TLTG group had shorter operation time (MD=–8.97, 95%CI –16.21 to –1.73, P=0.02), and initial postoperative feeding time (MD=–0.30, 95%CI –0.57 to –0.03, P=0.03). However, the anastomic time, bleeding volume, the number of dissected lymph nodes, proximal resection margin, initial flatus time, postoperative hospital stay, overall postoperative complications, anastomotic fistula, and anastomotic stenosis were similar between two groups (all P values>0.05)． Conclusions Compared with LATG, TLTG has shorter operation and recovery time for patients with gastric cancer. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.