Objective To systematically review the association between Chinese eye exercises and myopia onset in children and adolescents to provide a theoretical basis for clinical prevention of myopia. Methods The PubMed, Web of Science, EMbase, The Cochrane Library, CNKI, VIP, WanFang Data and CBM databases were searched from inception to March 2022 to collect observational studies about the association between Chinese eye exercises and myopia onset in children and adolescents. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using RevMan 5.3 software. Results A total of 28 studies were included, including 217 112 subjects. The results of meta-analysis showed that doing eye exercises, doing eye exercises ≥2 times per day, doing eye exercises regularly or consistently, doing eye exercises seriously and doing eye exercises correctly and normatively were the protective factors of myopia onset in children and adolescents. Conclusion Current evidence shows that doing eye exercises, doing eye exercises ≥2 times per day, doing eye exercises regularly or consistently, doing eye exercises seriously, doing eye exercises correctly and normatively can prevent myopia onset in children and adolescents. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
Individual patient data meta-analyses are conducted through development of collaboration with trial investigators, central collection and checking of individual patient data of all eligible trials, and pooling of patient data to produce the best estimate of effects of health care interventions. They ensure study data to be update, accessible, reliable and complete so as to minimize the risk of bias, and are the gold standard of systematic reviews addressing effects of health care interventions. Meta-analyses using individual patient data enable higher flexibility of data analyses and more completeness and balance of results interpretation. The study conduct differs between individual patient data versus conventional meta-analyses. This article discussed the steps of conducting individual patient data meta-analyses.
Objective To evaluate the efficacy and safety of intravitreal bevacizumab (IVB) as a preoperative adjunct to vitrectomy for prevention of postoperative vitreous hemorrhage (VH) in proliferative diabetic retinopathy (PDR) patients.Methods This was a meta analysis of randomized controlled trials (RCT). A computerized search was conducted in the Medline, Embase, Cochrane Library, Chinese Biomedical Database and Chinese Journal Full text Database combined with manually searching of bibliographies of pertinent articles, journals and literature reference proceedings. RCT on IVB as a preoperative adjunct to vitrectomy for prevention of postoperative VH in PDR were selected according to inclusion and exclusion criteria. After the data extraction, methodological quality assessment of RCT that were included using the Jadad scale. The outcome measures included the incidence of postoperative VH, postoperative best corrected visual acuity (BCVA), the incidence of postoperative retinal reattachment and postoperative complications. The statistical analysis was performed by Stata/SE 11.2. The weighted mean difference (WMD) with 95% confidence interval (CI) was calculated for continuous variable, and odds ratio (OR) with 95% CI for dichotomous variable. Results In total, seven RCT that fulfilled the eligibility criteria were included in the metaanalysis involving 170 patients in IVB group and 161 patients in control group. According to the Jadad scale, one RCT scored 5 points, one RCT scored 3 points and the other 5 RCT scored 1 point. The results suggested that IVB group achieved lower incidence of postoperative VH than control group both within four weeks after surgery (OR=3.28, 95% CI: 1.58-6.82,P=0.00), and over four weeks after surgery (OR=2.51, 95% CI1.21-5.22,P=0.01). There was no significant differences in incidence of postoperative VH between IVB and control group either at postoperative 3 months (OR=2.52, 95% CI: 0.74-8.57,P=0.14), or at postoperative 6 months (OR=3.26, 95% CI: 0.50-21.45,P=0.22). The results suggested that IVB group achieved better postoperative BCVA than control group (WM1=0.29, 95% CI: 0.13-0.44,P=0.00), but no significant differences were found between IVB and control group on the incidence of postoperative retinal reattachment (OR=0.39, 95% CI:0.10ndash;1.59,P=0.19), postoperative retinal re-detachment (OR=2.36, 95% CI: 0.74- 7.56, P=0.15) and postoperative neovascular glaucoma (OR=1.47, 95% CI: 0.28ndash;7.71,P=0.65). Conclusions IVB as a preoperative adjunct to vitrectomy could prevent postoperative VH in PDR effectively, and be relatively safe. However, a high-quality, multicenter, large sample, long-term RCT is warranted to be further investigated.
ObjectiveTo investigate the overall accuracy of interleukin-12 (IL-12) for diagnosis of tuberculous pleurisy. MethodsWe searched in PubMed, Embase, Web of Science, China National Knowledge Infrastructure databases, WanFang Data, and VIP Information for qualified studies that reported diagnostic accuracy of IL-12 for tuberculous pleurisy up to February 2014. The methodological quality of each study was evaluated by Quality assessment of diagnostic accuracy studies. Statistical analyses were performed by Meta-Disc 1.4 software and the pooled sensitivity, specificity and other diagnostic indexes. Meta-analysis of the reported accuracy of each study and summary receiver operating characteristic (SROC) curve were also performed. ResultsEight studies met the inclusion criteria for the analysis. The summary estimates for IL-12 in the diagnosis of tuberculous pleurisy were:sensitivity 0.80 [95% CI (0.76, 0.84)], specificity 0.76 [95% CI (0.71, 0.81)], positive likelihood ratio 3.23 [95% CI (2.26, 4.60)], negative likelihood ratio 0.30 [95% CI (0.20, 0.45)], diagnostic odds ratio 13.57 [95% CI (6.66, 27.64)], and the area under the curve of SROC was 0.86. ConclusionIL-12 plays a valuable role in the diagnosis of tuberculous pleurisy, and IL-12 may be a useful diagnostic marker for tuberculous pleurisy.
ObjectiveTo systematically review the clinical efficacy of low-dose erythromycin in patients with stable chronic obstructive pulmonary disease (COPD). MethodsRandomized controlled trials (RCTs) about low-dose erythromycin plus routine treatment versus routine treatment/placebo plus routine treatment in treating stable COPD was electronically searched in PubMed, EMbase, CBM, The Cochrane Library (Issue 4, 2013), CNKI, VIP and WanFang Data from the their establishment dates to May 2013. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed methodological quality. The results of meta-analysis was performed using RevMan 5.2 software. ResultsA total of eight RCTs involving 526 patients were finally included. The results of metaanalysis showed that:a) compared with the control group, low-dose erythromycin significantly improved six-minute walk distance (SMD=0.30, 95%CI 0.05 to 0.55, P=0.02), reduced the frequency of acute exacerbation (RR=0.44, 95%CI 0.25 to 0.78, P=0.005), and decreased the concentrations of IL-8 (SMD=-1.63, 95%CI-2.17 to-1.09, P < 0.000 01), TNF-α (SMD=-1.49, 95%CI-2.36 to-0.62, P=0.000 8), and neutrophil elastase (NE) (SMD=-0.94, 95%CI-1.36 to-0.51, P < 0.000 1) in sputum. b) the erythromycin therapy could improve forced expiratory volume in one second (FEV1) (SMD=0.19, 95%CI-0.19 to 0.58, P=0.32) but without significant differences compared with the control group. ConclusionLow-dose erythromycin could improve exercise tolerance, reduce the frequency of acute exacerbation, and help relieve airway inflammation, but in the improvement of FEV1, low-dose erythromycin is not better than routine treatment. Due to limited quantity and quality of the included studies, larger scale, multicenter, high quality RCTs are needed to verify the aforementioned conclusion.
Objective To systematically evaluate the clinical effect and safety of Bifidobacterium tetravaccine tablets in the treatment of antibiotic associated diarrhea (ADD) in infants in China. Methods Randomized controlled trials (RCTs) of treatment of AAD by Bifidobacterium tetravaccine in infants were searched by computer from China Knowledge Resource Integrated Database, VIP and Wanfang Data from their inception to November 2016. Meta-analysis of the data was carried out by RevMan 5.3 software. Results Twelve RCTs were chosen, which included 1 761 infant patients. The Meta analysis showed that the effects of treatment of ADD were significantly superior to those of the control group [OR=5.74, 95%CI (4.14, 7.96),P<0.000 01]. Among the 12 RCTs, 8 had no adverse reactions, while the rest4 articles did not mention adverse reactions. Conclusions Based on the present clinical evidences, treatment of ADD by Bifidobacterium tetravaccine in infants is effective and safe. But due to the small number and different quality of RCTs, this conclusion still needs to be confirmed by large sample, multicenter, and high-quality clinical RCTs.
ObjectiveTo assess the association of vascular endothelial growth factor (VEGF) gene-460C/T and-634C/G polymorphism with diabetic retinopathy (DR) among patients in Asia and European by meta-analysis. MethodsA systematic search of electronic databases (PubMed, Cochrane Library, EMBASE, VIP, Wanfang technological, CNKI, etc.) was carried out until Jun, 2014. Case-control studies on the relationship between genetic polymorphism of VEGF-460C/T and VEGF-634C/G with diabetic retinopathy were included in this analysis. The data were quantitatively analyzed by RevMan 5.0 software after assessing the quality of included studies. The pooled odds ratios (OR) and their corresponding 95% confidence intervals (CI) were used to assess the strength of the association. ResultsVEGF-460C/T (7 studies:899 cases and 786 controls) and VEGF-634C/G (10 studies:1615 cases and 1861 controls) were inclued in this meta-analysis. Significant association was found for-460C/T polymorphism in Aisa (C versus T:OR=1.52, 95%CI was, Z=3.72, P=0.0002; CC versus CT+TT:OR=1.61, 95%CI was[1.22, 1.90], Z=3.05, P=0.002; TT versus CT+CC:OR=0.64, 95%CI was[1.19, 2.19], Z=2.07, P=0.04), and VEGF-634CC gene type was associated with DR in European (OR=1.56, 95%CI[1.08, 2.25], Z=2.37, P=0.02). No significant publication bias was found. ConclusionsThe meta-analysis demonstrated that DR was associated with VEGF-460C/T polymorphism in Asia, and C alleles and CC gene type was the risk polymorphism; VEGF-634C/G polymorphism was not associated with DR, but its CC genotype maybe the risk factor in European. Further case-control studies based on larger sample size are still needed, especially for-634C/G polymorphism.
ObjectiveTo systematically review the risk of hemorrhage in pregnant cerebral arteriovenous malformation (CAVM) patients. MethodsThe Web of Science, PubMed, Cochrane Library, WanFang Data, VIP and CNKI databases were electronically searched to collect clinical studies related to hemorrhage in pregnant CAVM patients from inception to June, 2023. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using Stata 13.1 and R 4.0.4 software. ResultsA total of 13 studies involving 2 273 patients were included. The results of meta-analysis showed that the pooled incidence of hemorrhage in pregnant CAVM patients was 0.18 (95%CI 0.12 to 0.24). The subgroup analyses were carried out based on world regions and the study duration, with the higher pooled incidence of 0.37 (95%CI 0.05 to 0.80) in Europe and 10 to 20 years of study duration of 0.37 (95%CI 0.17 to 0.57). Conclusion Current evidence shows that the incidence of hemorrhage in pregnant CAVM patients is about 18%. 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 efficacy and safety of electroacupuncture in animal hyperlipidemia models. MethodsDatabases such as CNKI, WanFang Data, VIP, CBM, PubMed, EMbase and The Cochrane Library (Issue 12, 2013) were searched for studies concerning the efficacy and safety of electroacupuncture in animal hyperlipidemia models up to December 2013. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data and assessed the methodological quality of included studies by using reformative CAMARADES List. Then, meta-analysis was performed by using RevMan 5.2 software. ResultsA total of 4 studies involving 89 rats were included. The average score of CAMARADES List was 4. The results of meta-analysis showed that:there were no significant differences between electroacupuncture group and medication group in reducing the levels of TC (MD=0.06, 95%CI -0.08 to 0.20, P=0.40), TG (MD=-0.01, 95%CI -0.08 to 0.06, P=0.74), LDL-C (MD=0.01, 95%CI -0.04 to 0.03, P=0.65) and increasing the level of HDL-C (MD=-0.00, 95%CI -0.09 to 0.08, P=0.93). ConclusionCurrent evidence shows that there are no differences between electroacupuncture and medication in reducing levels of TC, TG, LDL-C and increasing the level of HDL-C in hyperlipidaemia rats. But due to the limitation of sample size of included studies, more large-scale, high quality studies are needed.
Object To evaluate the sensitivity, specificity, and accuracy of magnetic resonance imaging (MRI) for the preoperative T staging of gastric cancer. MethodsThe databases such as the PubMed, Cochrane Database Systematic Reviews, EMbase, CNKI, and Wanfang Data were searched on computer from 1993 to 2012.The reviewers screened the trials according to inclusion and exclusion criteria strictly, extracted the data, and assessed the methodology quality.Meta-analysis were performed using the Metadisc 1.40 software, the pathology diagnosis as gold standard.The acquired pooled sensitivity, specificity, and summary receiver operating characteristic curve (SROC) were used to describe the value of MRI in T staging. ResultsEight case-control studies involving 302 patients with gastric cancer were included in the study.The pooled statistical results of Meta-analysis showed that:the pooled sensitivity and specificity of MRI for T1-stage gastric cancer were 85%(55%-98%) and 97%(91%-99%) respectively, and the area under the SROC curve (AUC) was 0.961.The pooled sensitivity and specificity of MRI for T2-stage gastric cancer were 73%(60%-84%) and 93%(89%-96%) respectively, and the AUC was 0.935.The pooled sensitivity and specificity of MRI for T3-stage gastric cancer were 87%(81%-92%) and 82%(74%-88%) respectively, and the AUC was 0.914.The pooled sensitivity and specificity of MRI for T4-stage gastric cancer were 75%(62%-86%) and 97%(94%-99%) respectively, and the AUC was 0.963. ConclusionMRI has the high consistency in preoperative T staging with pathology, and should be recommended as a preferred to increase the accuracy of preoperative staging, and improve the prognosis.