Objective To assess the efficacy of lamivudine in patients with HBeAg positive chronic hepatitis B.Methods MEDLINE, SCI, Current Content Connect, The Cochrane Library, and Chinese Biomedical Database were searched from the beginning to September 2005, and the references of eligible studies were manually screened. R.andomized controlled trials comparing lamivudine with non-antiviral interventions （ placebo, no treatment and standard care ） in patients with chronic hepatitis B were eligible for inclusion. Two investigators independently assessed the quality and extracted the data. Heterogeneity was examined by Chi-square test. Fixed and random effect meta-analysis were used to pool the data. Subgroup analyses were used in treatment course. Results Eleven R.CTs were included （ n = 1 237 ）. All reported the effect of lamivudine （100 mg/d） , and one of them included lamivudine （25 mg/d）. The treatment duration of 52 weeks and less than 26 weeks were reported in eight and three RCTs, respectively. Six RCTs adequately applied randomization, while other five RCTs were not reported in detail. Four RCTs adequately enforced allocation concealment, five RCTs enforced blinding bitterly. The others were not reported in detail. It was found by meta-analysis that, compared with the control, lamivudine （100 mg/d, 52 W） could significantly clear HBeAg [42.6% vs. 13% , RR 3.20, 95% CI （2.33, 4. 38）] and clearHBVDNA [71.78% vs. 20, 36%, RR3.42, 95%CI （2.80,4.19）], normalize ALT [65% vs. 34.9%, RR1.91, 95%CI （1.64,2.21）], achieve HBeAgseroconversion [16.1% vs. 7.29% , RR2.12, 95%CI （1.24,3.80） ] and histology response [57. 9% vs. 26.2%, RR 2. 17, 95% CI （ 1.67,2.81 ） ] ; Lanfivudine （100 mg/ d, 12 W） could effectively clear HBV DNA [ 50.7% vs 3.92% , RR 8.68, 95% CI （1.72,43.74 ） ] , but was not effective in loss of HBeAg, HBeAg seroconversion and normalization of ALT, Lamivudine （25 mg/d） could effectively clear HBV DNA [97.7% vs. 22.2% , RR 4.41, 95% CI （2.86,6.79） ] and improve histology response [59.3% vs. 30% , RR1.98, 95% CI （1.31,2.99 ） ], but was not effective in HBeAg seroconversion. Conclusions Lamivudine （100 mg/ d） is effective in clearing HBV DNA and HBeAg, normalizing ALT and achieving HBeAg seroconversion.
Objective To explore the application of peer education in TB prevention at middle schools in Kai County of Chongqing and compare it with traditional education, and to provide theory support for further policy making. Methods Four complete middle schools were randomly selected as the control group, the peer education group, the traditional education group and the combined group of peer education and traditional education, respectively. Effect evaluation was performed one month later (instant evaluation) and six months later (long-term evaluation), respectively, after the intervention period. Results The instant and long-term evaluation showed that the knowledge, attitude and practice scores of the three intervention groups were higher than the scores before intervention or those of the control group (Plt;0.01). Besides, the behavior score of the peer education group had no significant difference between instant and longterm evaluation. All scores in the instant evaluation were higher than those of long-term evaluation both in the peer education group and the traditional education group (Plt;0.01). For the knowledge, attitude and practice scores, there was no significant difference between instant and long-term evaluation in the combined group of peer education and traditional education. Conclusion Compared with the peer education group and the traditional education group, the combined group achieves an enduring effect. There is obvious instant effect in the traditional education group, and peer education has a long-term influence on students’ behavior.
Objective To assess the effect of Dengzhanhua Injection for angina pectoris. Methods We performed an electronic search for MEDLINE (1966 to 2004), EMBASE (1974 to 2004), The Cochrane Library (Issue 4, 2004), CBM and CNKI (1980 to 2004). We included randomized controlled trials that met the inclusion and exclusion criteria and evaluated the quality of those trials and performed the meta-analysis by RevMan 4.2.7. Results Eight trials were included involving 634 patients. However, they were of poor quality. The results of meta-analysis indicated that there were statistical difference on symptoms and electrocardiogram (ECG) improvements between Dengzhanhua and control group (Breviscarpine≥30 mg) with RR 1.26, 95%CI 1.11 to 1.44 and RR 1.30, 95%CI 1.14 to 1.49, respectively. However, Dengzhanhua Injection (Breviscarpinelt;30 mg) vs. basic therapy showed no statistical difference in either symptom improvement (RR 1.03, 95%CI was 0.90 to 1.18) or ECG improvement (RR 1.01, 95%CI 0.86 to 1.20). In addition, Dengzhanhua decreased the myocardial infarction attacks in one year following up (OR 0.06, 95%CI 0.01 to 0.29). Conclusions Little evidence shows that Dengzhanhua is superior to simple basic therapy in the symptoms and ECG improvements as an auxiliary drug. However, this systematic review can not draw a conclusion about the effectiveness of Dengzhanhua Injection compared to simple basic therapy in the treatment of angina pectoris due to the poor quantity of included trials.
ObjectiveTo survey the current situation of post-intensive care syndrome (PICS) among patients in respiratory intensive careunit (RICU), and explore the effect factors of PICS.MethodsBy convenience sampling, 125 patients in the RICU of Peking University First Hospital were recruited in the study. The patients were tested for PICS using Mini-mental State Examination (MMSE), Confusion Assessment Method for the ICU (CAM-ICU), Hospital Anxiety and Depression Scale (HADS), Medical Research Council (MRC), Activities of Daily Living (ADL), Pittsburg Sleep Quality Index (PSQI), Fatigue Scale-14 (FS-14), including three aspects of cognition, psychology and physiology. The effect factors of PICS were measured through researcher-created Questionnaire on Patients’ General Information and Questionnaire on Disease-Related Information.ResultsIn this study, the actual effective sample size was 110 cases, among which 59 cases developed PICS, with an incidence of 53.6%. Logistic regression showed that effect factors of PICS were age, invasive mechanical ventilation time, noninvasive ventilator assisted ventilation time and coronary atherosclerotic heart disease (P< 0.05).ConclusionsThe incidence of PICS in RICU patients is 53.6%, which is at a high level. Advanced age, long duration of invasive mechanical ventilation, long duration of non-invasive ventilator assisted ventilation, and coronary atherosclerotic heart disease are the risk factors of PICS. Medical and nursing staff should pay more attention to PICS, intervene in the risk factors of the patient, and take targeted measures to prevent the occurrence of PICS.
Objective To observe the midterm haemodynamic manifestation of the home made C-L pugestrut tilting disc mechanical valve in aortic valve replacement, and to evaluate its function. Methods Twenty patients underwent aortic valve replacement over 5 years were collected and divided into two groups, the C-L pugestrut group （n=10）：aortic valve was replaced by home-made C-L pugestrut tilting disc mechanical valve（21mm）; Medtronic-Hall group （n=10）：aortic valve was replaced by Medtronic-Hall mechanical valve （21mm）. The peak transprosthetic gradients （△P）, mean transprosthetic gradients （△Pm）and effective orifice area（EOA） at rest were compared between two groups. Results At rest, △P of the C-L pugestrut group and Medtronic-Hall group were 11.63±3.23mmHg vs. 9. 78±3. 35mmHg; △Pm of the C-L pugestrut group and Medtronic-Hall group were 6. 25±2. 32 mmHg vs. 5.85±2.32mmHg： EOA of the C-L pugestrut group and Medtronic-Hall group were 1.07±0.17 cm2 vs. 1.25±0.27 cm2. There was no statistically significance in △P, △Pm and EOA between two groups（P〉0.05）. Conclusions The midterm haemodynamic results of the home-made C-L pugestrut tilting disc mechanical valve show that it has comparable haemodynamic results to those of Medtronic-Hall mechanical valve ,and it has well-done function. The home-made C-L pugestrut valve is one of the reliable mechanical heart valves.
Objective To evaluate the effectiveness of TCu380AIUD comparing with other common IUDs. Methods CBMDISC (1979 to 2005), Wanfang (1994 to 2005), CNKI (1974 to 2005), CMCC (1979 to 2005), CMAC (1994 to 2005), EMbase (1974 to 2004), MEDLINE (1974 to 2005), WHO/RHL (2004 to 2005), The Cochrane Library (Issue 4, 2004), SCI (1985 to 2005), POPLINE (1966 to 2003) and 9 relevant journals were searched for randomized controlled trials (RCTs) comparing TCu380AIUD with other common IUDs. The quality of included trials was critically appraised. RevMan4.2.7 software was used for statistical analysis. Results Fifteen published studies involving 20 417 participants were included. The results of meta-analyses were expressed with OR (cumulative expulsion rate, cumulative pregnancy rate, cumulative rate of removing for medical reasons) and 95% CI. Compared with TCu380A, TCu220C resulted in lower cumulative expulsion rate at 0.5 and 1 year of follow-up [OR 0.36 (0.18 to 0.70); 0.44 (0.31 to 0.62), respectively], higher cumulative pregnancy rate at ten years of follow-up [1.22 (1.04 to 1.43)], lower cumulative rate of removing for medical reasons at 0.5 year of follow-up [0.59 (0.36 to 0.97)]; MLCu375 resulted in higher cumulative expulsion rate at 1 year of follow-up [2.17 (1.29 to 3.67)], higher cumulative pregnancy rate at 1 and 2 years of follow-up [1.72 (1.18 to 2.50); 1.28 (1.02 to 1.60)]; UCD300 resulted in lower cumulative expulsion rate at five years of follow-up [0.38 (0.27 to 0.56)]; Medicated Gamma 380IUD resulted in lower cumulative rate of removing for medical reasons at 1 year of follow-up [0.31 (0.14 to 0.70)]. Conclusions Compared with TCu380A which is considered as a standard of IUDs, the performance of TCu220C is inferior in contraception, but TCu220C is also a good IUD in performance; The overall clinical performance of MLCu375IUD was as good as that of TCu380A; UCD300 is of the characteristic of lower cumulative expulsion rate; Medicated Gamma 380IUD can decrease side effects effectively. However, larger multi-center randomized comparative trials with longer follow-up periods are needed to confirm the conclusion
To compare the effectiveness between open reduction combined with internal fixation and artificial radial head replacement in treating Mason type-III comminuted fracture of radial head, to provide the evidence for available treatment methods. Methods Between January 2004 and June 2008, 65 cases of Mason type-III comminuted fractures were treated with open reduction, AO mini plate and screw system or a combination of Kirschner treatment (internal fixation group, n=35) and with artificial radial head replacement (replacement group, n=30). In internal fixation group, there were 21 males and 14 females with an age range of 21 to 35 years (mean, 30.7 years); the causes of injury were traffic accidentin 12 cases, fall ing from height in 8 cases, and a fall in 15 cases; the locations were left side in 23 cases and right side in 12 cases; and the time between injury and surgery was 1-7 days (mean, 3 days). In replacement group, there were 19 males and 11 females with an age range of 23 to 67 years (mean, 32.5 years); the causes of injury were traffic accident in 7 cases, fall ing from height in 8 cases, and a fall in 15 cases; the locations were left side in 17 cases and right side in 13 cases; and the time between injury and surgery was 1-6 days (mean, 1.5 days). There was no significant difference in gender, age, disease cause, disease duration, or other general information between 2 groups (P gt; 0.05), so that 2 series of patients had comparabil ity. Results Incisions healed primarily in 2 groups. All patients were followed up 1 to 4 years with an average of 2.5 years. There were significant differences in elbow flexion angle, extension angle, and forearm rotation angle between 2 groups (P lt; 0.05), but no significant difference in elbow pronation or supination weakness (P gt; 0.05). In internal fixation group, primary union occurred in 29 cases, delayed union in 2 cases, nonunion with ectopic ossification in 2 cases, and internal fixation failure in 2 cases. In replacement group, elbow flexion angle lost beyond 30º in 1 case after 1 year, elbow stiffness occurred in 1 case because prosthesis was too long. According to Broberg and Morrey elbow scores system, the scores were 69.51 ± 10.23 in internal fixation group and 81.55 ± 12.06 in replacement group, showing significant difference (P lt; 0.05). The results were excellent in 15 cases, good in 5 cases, fair in 11 cases, and poor in 4 cases with an excellent and good rate of 57.1% in internal fixation group; the results were excellent in17 cases, good in 5 cases, fair in 6 cases, and poor in 2 cases with an excellent and good rate of 73.3%. Conclusion Artificial radial head replacement can achieve better joint function compared with open reduction combined with internal fixation in treating Mason type-III comminuted fractures of radial head.
Objective When making causal inferences in observational studies, in order to improve the robustness of the results of observational studies, statistical analysis techniques are often used to estimate the impact of unmeasured potential confounding factors. By systematically reviewing the application progress of the E-value, one of the sensitivity analysis methods, the advantages and limitations of using the E-value were discussed, to provide references for the application, reporting and interpretation of the E-value. Methods In the PubMed database, E-value was used as a keyword for title, abstract and key paper citation retrieval, and the literature that used the E-value analysis method for sensitivity analysis during 2016-2021 was screened. Results The E-value was widely used not only in cohort studies (n=215) and case-control studies (n=15), but also in cross-sectional studies (n=28), randomized controlled trials (n=6) and meta-analysis (n=16). The E-value was often combined with other sensitivity analysis methods, such as hierarchical analysis, instrumental variables, and multiple statistical regression models that correct different covariates, to further explore the reliability and robustness of the results. Conclusion When the E-value is used to evaluate the confounding factors in observational studies, the confidence interval and P value can be combined to evaluate the sensitivity of the results more comprehensively.
Objective To assess the necessity and safety of ureteral stenting after ureteroscopic lithotripsy in treatment of middle and distal ureteral calculi. Methods We electronically searched MEDLINE, EMbase, Cochrane Library, CBM, VIP and CNKI to collect randomized controlled trials (RCTs) involving men with or without ureteral stenting after ureteroscopic lithotripsy from 2000 to March 2010. The quality of included trials was assessed. Data were extracted and analyzed with RevMan5.0 software. Results Six RCTs involving 543 patients were identified. The results of meta-analysis showed that: a) There was no statistical difference between two groups in stone clearance rate (RR=0.45, 95% CI 0.98 to 1.01, P=0.15), dysuria rate (RR=1.35, 95% CI 0.99 to 1.84, P=0.06), and hematuria rate (RR=2.12, 95% CI 1.00 to 4.49, P=0.05); b) There was statistical difference between two groups in frequent micturition rate (RR=2.17, 95% CI 1.13 to 4.17, P=0.02), the mean visual analog score 3 days postoperatively (WMD=0.94, 95% CI 0.47 to 1.42, P=0.000?1), and the operation time (WMD=3.57, 95% CI 1.40 to 5.72, P=0.001). Without postoperative ureteral stenting can shorten the operation time, decrease the irritation signs of bladder, and can improve quality of postoperative life without influence on stone clearance. Couclusions The routine ureteral stenting after ureteroscopic lithotripsy may be not necessary in order to keep patients from unsafety. More reasonable randomized double blind controlled trails with large sample are required to provide proofs with high quality because the methodology quality of included studies is lower.