Objective To assess the effectiveness and safety of moxifloxacin versus levofloxacin for the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Such databases as PubMed, EMbase, The Cochrane Library, CBM, CNKI and VIP were electronically searched, and the relevant conference proceedings were also hand-searched. The search time was up to July, 2011. Randomized controlled trials (RCTs) on moxifloxacin versus levofloxacin for AECOPD were included. Literature was screened according to inclusive and exclusive criteria, data were extracted, quality was assessed, and then meta-analysis was performed using RevMan 5.0. Results A total of 6 RCTs involving 482 patients with AECOPD were included. The results of meta-analysis showed that moxifloxacin group was significantly superior to levofloxacin group in the effective rate (OR=3.15, 95%CI 1.80 to 5.49, Plt;0.000 1). The bacterial clearance rate in moxifloxacin group was also higher than that in the levofloxacin group (OR=2.79, 95%CI 1.30 to 5.97, P=0.008). In addition, adverse effects of moxifloxacin group were less than levofloxacin (OR=0.48, 95%CI 0.24 to 0.98, P=0.04). Conclusion Based on current studies, moxifloxacin is superior to levofloxacin in improving effective rate and bacterial clearance rate, and in lowering side effects when treating AECOPD. Hence it is considerable to use moxifloxacin instead of levofloxacin in the treatment of AECOPD if necessary. Due to the limitation of both quantity and quality of included studies, this conclusion should be further confirmed with more high quality and large sample studies.
The formulation of inclusive criteria is very important for the quality of systematic reviews as well as the reliability of results. However, among the systematic reviews based on randomized controlled trials (RCTs) published in Chinese periodicals, there are differences existing in the definition of inclusive criteria of RCTs, which may lead to the incomplete or inequitable inclusion. In addition, the relatively lower quality of domestic RCTs may also cause the possibility of bias. In this study, sampling analysis is applied to assess the current situation of both the RCTs definition for inclusive criteria of domestic systematic reviews and the types of practically included RCTs, so as to figure out the existing problems.
Objective To systematically evaluate the effectiveness and safety of zoledronic acid combined with radiotherapy in treating bone metastasis of malignant tumor. Methods Such databases as PubMed, EMbase, The Cochrane Library (Issue 10, 2012), CBM, CNKI, VIP and WanFang Data were searched to collect randomized clinical trials (RCTs) on bone metastasis of malignant tumor from inception to October, 2012. References of included studies were also retrieved. Two reviewers independently screened studies according to exclusion and inclusion criteria, extracted data, and assessed the methodological quality. Then, meta-analysis was performed using RevMan 5.1 software. Results Twenty nine trials were included involving 2 021 patients. The results of meta-analysis showed that, compared with the radiotherapy alone group, zoledronic acid combined with radiotherapy improved the effectiveness rate of pain relieving at the end of treatment (OR=3.08, 95%CI 2.30 to 4.12, Plt;0.000 01), the effectiveness rate of pain relieving two weeks after treatment (OR=3.39, 95%CI 2.52 to 4.56, Plt;0.000 01), the quality of life (OR=2.74, 95%CI 1.66 to 4.52, Plt;0.000 01) and the ability of movement (OR=2.96, 95%CI 2.16 to 4.05, Plt;0.000 01). Zoledronic acid combined with radiotherapy also reduced the incidence of new bone metastasis (OR=0.21, 95%CI 0.10 to 0.45, Plt;0.000 1) and the incidence rate of bone-related events (OR=0.17, 95%CI 0.03 to 0.92, P=0.04). The adverse reactions of zoledronic acid combined with radiotherapy such as fever (OR=11.92, 95%CI 6.31 to 22.48, Plt;0.000 01) and hypocalcaemia (OR=8.82, 95%CI 1.61 to 48.36, P=0.01), significantly increased. Conclusion Compared with radiotherapy alone, zoledronic acid combined with radiotherapy can relieve bone metastatic pain, effectively enhance patients’ ability of movement, improve quality of life, and decrease new bone metastasis and the occurrence of bone-related events.
Objective To investigate whether adding 1 transverse screw (TS) to the triangular parallel cannulated screw (TPCS) fixation has a mechanical stability advantage for Pauwels type Ⅲ femoral neck fractures by conducting finite element analysis on four internal fixation methods. Methods Based on CT data of a healthy adult male volunteer’s femur, three Pauwels type Ⅲ femoral neck fracture models (Pauwels angle 70°, Pauwels angle 80°, and Pauwels angle 70° combined with bone defect) were constructed using Mimics 21.0 software and SolidWorks 2017 software. Four different internal fixation models were built at the same time, including TPCS, TPCS+TS, three cross screws (TCS), and TPCS+medial buttress plate (MBP). The mechanical stability of different models under the same load was compared by finite element analysis. Results The femoral model established in this study exhibited a maximum stress of 28.62 MPa, with relatively higher stress concentrated in the femoral neck. These findings were comparable to previous studies, indicating that the constructed femoral finite element model was correct. The maximum stress of internal fixation in finite element analysis showed that TCS was the lowest and TPCS+MBP was the highest in Pauwels angle 70° and 80° models, while TPCS+TS was the lowest and TCS was the highest in Pauwels angle 70° combined with bone defect model. The maximum displacement of internal fixation in each fracture model was located at the top of the femoral head, with TCS having the highest maximum displacement of the femur. The maximum stress of fracture surface in finite element analysis showed that TCS was the lowest and TPCS was the highest in the Pauwels angle 70° model, while TPCS+MBP was the lowest and TPCS/TCS were the highest in the Pauwels angle 80° model and the Pauwels angle 70° combined with bone defect model, respectively. The maximum displacement of fracture surfece analysis showed that TPCS+MBP was the lowest and TCS was the highest in Pauwels angle 70° and 80° models, while TPCS+TS was the lowest and TCS was the highest in Pauwels angle 70° combined with bone defect model. Conclusion For Pauwels type Ⅲ femoral neck fractures, the biomechanical stability of TPCS+TS was superior to that of TPCS alone and TCS, but it has not yet reached the level of TPCS+MBP.
Objective To evaluate the clinical effectiveness and safety of radiotherapy (RT) combined with hyperthermia (HT) for locally-advanced non-small cell lung cancer (NSCLC). Methods The randomized controlled trials (RCTs) on RT plus HT vs. RT alone for locally-advanced NSCLC were searched in PubMed, The Cochrane Library, EMbase, VIP, CNKI, CBM and other electronic databases from inception to November 2011. Two reviewers independently screened studies according to the inclusion and exclusion criteria, extracted data and assessed quality of the included studies independently. Then meta-analyses were performed using RevMan 5.0.2. Results A total of 9 RCTs involving 527 cases were included. The results of meta-analyses showed that compared with the RT alone group, the RT plus HT group could increase the total effective rate (OR=2.08, 95%CI 1.44 to 3.02, P=0.000 1) and the progression-free survival rate (OR=4.85, 95%CI 1.88 to 12.48, P=0.001). However, there were no significant differences between the two groups in the overall survival rate (OR=1.13, 95%CI 0.64 to 1.98, P=0.68), symptoms improve rate (OR=3.37, 95%CI 1.68 to 6.78, P=0.000 6), and other acute adverse reactions. Conclusion Current results of systematic review show that radiotherapy combined with hyperthermia can obviously increase the total effective rate and improve the progression-free survival rate for locally-advanced NSCLC, and doesn’t increase the incidence of adverse reaction. Therefore, radiotherapy combined with hyperthermia is a fairly reasonable and effective treatment method for locally-advanced NSCLC.