Literature bias, which can reduce the validity of a systematic review, comes mainly from the fact that all the related studies can not be collected without exception. The following three types of literature bias are most common. (1) Publication bias. The reason is that some studies can not get published, or the publication has been delayed. (2) Literature retrieval bias. This bias is the result that not all published studies are retrieved during the course of systematic review. (3) Literature inclusion bias. While an improper literature selection strategy is adopted, some useful studies are kicked out by error, leading to such bias. A funnel plot (Y-axis is rumple size, X-axis effect) is usually useful to assess literature bias in a systematic review.
In the absence of large trials, it is important for us to discuss whether a well-conducted meta-analysis of smaller randomized controlled trial (RCT) can replace large trials or not. We have evaluated the quality of original literature and methodological quality. The difference between meta-analysis of smaller RCT and the largest randomized trials have also discussed.
The opportunity of vitrectomy for opening eyeball injury is one of the important factors affecting the prognosis. Anterior segment wound repaired by routine suturing needs following and continuous treatment with vitrectomy. The key technique of the following treatment should be the debridement of the inside of wound and expurgation of the surrounding tissues adjacent to the wound, and the emphasis should be put on retinal reattchment and stable repairment.
ObjectiveTo overview the various molecular biological index to judge the prognosis of intrahepatic cholangiocarcinoma (ICC), in order to promote ICC patients follow-up treatment, improve survival rate, and quality of life of the patients. Methods"ICC" and "prognostic factor" were searched as key words by PubMed and CNKI series full-text database retrieval systems from 2000 to 2015. Totally 48 English papers and 15 Chinese papers were obtained. Choice criteria:the molecular biological index that affect the prognosis of ICC patients, and can effectively guide treatment. According to the choice criteria, 45 papers were finally analyzed. ResultsThe indicators of Homer1, mucin 1 (MUC1)\mucin 4 (MUC4), lactate dehydrogenase A (LDH-A), Beclin1, Smad4, protein tyrosine kinase-7 (PTK7), IMP3, cytokeratin 7 (CK7)/cytokeratin 20 (CK20), and sphingosine kinase 1 (SPHK1) could be used as prognostic factors in the survival of patients with ICC, and to determine tumor size and stage, vascular invasion, nerve injury, and lymph node metastasis, are of great clinical significance. ConclusionThese indicators have a significant meanning in the prognosis of ICC and the adjustment of the follow-up treatment.
摘要:目的: 报道同卵双生子间肾移植效果,探讨免疫抑制剂及激素的使用、鉴定同卵双生子的方法以及术后随访。 方法 :个案报道结合文献综述。 结果 :手术获得成功。术后随访8月,患者恢复良好。 结论 :同卵双生间的肾移植安全有效,术后不需要使用免疫抑制剂也能维持移植肾功能正常。Abstract: Objective: Reported the effects of renal transplantation between identical twins,explored the use of immunosuppressive drugs and glucocorticoid, identification method of the identical twins and postoperative followup . Methods :Combining case report and literature review. Results :The operation is success.Followup in 8 months,the patient recover well. Conclusion : The renal transplantation between identical twins is safe and effective,the immunosuppressant is not need for the postoperative patients to maintain the graft`s function.
摘要:目的:调查格列本脲的10年来不良反应情况为临床上合理使用格列本脲提供参考。方法:检索近10年(1999~2009)维普中文科技期刊数据库报道的格列本脲的不良反应文献,进行统计、分析。结果:格列本脲不良反应表现较多,机制复杂,最常见的是低血糖,其次是肝功能损伤。结论:临床上应该重视格列本脲的不良反应情况,针对不同病人合理用药。Abstract: Objective: To investigate the adverse reaction of glibenclamide in resent ten years so as to promote rational clinical glibenclamide Use. Methods: The adverse reaction reports in the vipdatabase (19992009) were summarized and investigated. Results:There exist complicated mechanism and lots of clinical symptoms of the adverse reaction of glibenclamide. The most common adverse reaction of glibenclamide is glycopenia. Conclusion: Great attention should be paid to adverse reactions of glibenclamide for rational drug use. Glibenclamide should be used according to physiological and pathological situation of patients.
Objective To investigate the clinical characteristics and diagnosis and treatment of fungal pulmonary embolism, and to improve the understanding of this disease. Methods The diagnosis and treatment of two patients with fungal main pulmonary embolism in the First Affiliated Hospital of Guangzhou Medical University were summarized and analyzed. Literatures were retrieved from Wanfang database, China national knowledge internet database and Pubmed database with search terms of “pulmonary embolism AND mucor”, “pulmonary embolism AND aspergillus”, “pulmonary embolism AND fungi”, “pulmonary embolism AND Candida”, “pulmonary embolism AND cryptococcus”. Results Case 1, a 53-year-old female was referred, with cough, high fever, breathlessness for 2 years, chest pain for 1 year. The patient had rheumatoid arthritis and systemic lupus erythematosus history with long term prednisone treatment. Finally, the patient was diagnosed main pulmonary artery embolism (aspergillus) and disseminated aspergillosis. Although treatment with voriconazole, amphotericin B, and caspofungin were given for more than 1 year, the patient died with uncontrolled aspergillus infection. Case 2, a 67-year-old female was referred with cough, chest distress, chest pain for 8 months, breathlessness for 6 months. The patient had a history of chronic viral hepatitis C. Finally the patient was diagnosed as main pulmonary artery embolism and pulmonary valve endocarditis (aspergillus, mucor). The patient underwent pulmonary artery lesion resection and tricuspid valvuloplasty (DeVega method). After surgery, the patient was delivered with amphotericin B and posaconazole for 3 months. During the follow-up period of 1 year, the patient recovered almost totally without relapse signs. A total of 42 cases of fungal pulmonary embolism from 1980 to 2021 were retrieved (including 2 cases in this article), and 6 of these cases were main pulmonary artery embolism. Of all the cases, the median age was 49 years and 22 (54.3%) were males. 20 cases were immunocompromised. The infection pathogens included: Aspergillus (21, 50%), Candida (11, 26.2%), Mucor (7, 16.7%), and Aspergillus combined with Mucor (1, 2.5%), Coccidioides spp (1, 2.5%), and Cryptococcus (1, 2.5%). Fifteen cases were complicated with infection other than cardiopulmonary. Twenty-two cases were treated with surgery combined with antifungal medicine, and 9 cases with antifungal medicine alone. Twenty-two cases were dead and the overall mortality rate was 52.4%. There were statistically significant differences in the effects of fungal species, dissemination of other organs other than the heart and lung, and surgical treatment on the survival rate. The survival rate of different fungal species was significantly different. Dissemination to organs other than the heart and lungs reduces survival, whereas surgical treatment improves survival. Conclusions Fungal pulmonary embolism, a disease with high mortality, rarely involves the main pulmonary artery. The possibility of fungal pulmonary embolism should be considered when the cause of pulmonary thrombosis is unknown and the anticoagulant effect is poor. Although there is no unified treatment at present, early surgical combined with standard antifungal treatment may improve the prognosis of patients.
ObjectiveTo reveal and demonstrate the hotspots and further research directions in screening technology for early lung cancer, and provide references for the future studies. MethodsResearches related to lung cancer screening from 2011 to 2021 in the Web of Science database were included. Biblioshiny, a bibliometrics program based on R language, was used to perform content analysis and visualization of the included literature information. ResultsResearches related to lung cancer screening were increasing year by year. Six major cooperation groups were formed between countries. The current research hotspots in the field of early lung cancer screening technology mainly focused on the multi-directional fusion of radiographic imaging, liquid biopsy and artificial intelligence. ConclusionLow-dose spiral CT screening is still the most important and mainstream method for the screening of early lung cancer at present. The combination and integration of artificial intelligence with various screening methods and the innovation of novel testing and diagnostic equipment are the current research hotspots and the future research trend in this field.
ObjectiveTo investigate the capability and demands of medical students of medical information retrieval, and to provide information for medical information literacy education.MethodsWe conducted an online questionnaire survey among medical students from 15th to 21st July, 2019, aiming to analyze basic characteristics of the subjects and their ways and capability to acquire medical information, and evaluated their demands and satisfaction about relevant courses.ResultsFour hundred and nine valid questionnaires were collected. The average age of the respondents was (21±3) years old. Among the respondents, 279 (68.2%) were female, 290 (70.9%) were undergraduates, and 187 (45.7%) majored in clinical medicine. The mostly accessed ways to obtain medical information were textbooks (87.8%) and search engines (84.4%). Among Chinese literature databases, the most commonly used was China National Knowledge Infrastructure (67.7%), followed by Wanfang (54.3%). As for English literature databases, the most commonly used was PubMed (66.0%), while the proportions of respondents who used other databases was less than 1/4. As for the problems when obtaining information, 84.8% of the respondents supposed that no access to some online databases was the main problem. Obtaining information from search engine scored the highest [(3.21±1.00) points, 5 points totally] when they were asked to self-evaluate their ability to obtain medical information by different methods. In terms of training demands, the need for courses about literature authenticity and accuracy evaluation was the highest [(4.05±1.07) points, 5 points totally]. The trainings were expected to be conducted within 1-2 years after enrollment (83.9%). Training through professional courses (86.8%) was the most welcomed training form, followed by courses on MOOC (51.3%), an online course platform. More than 50% of the respondents were satisfied with the current relevant courses and trainings.ConclusionBoth the students’ capability of medical information retrieval and the design of relevant trainings should be improved to better prepare the medical students for further clinical practice and scientific research.
Purpose To analyze the contents of domestic and inter national public ations in neuro-ophthalmology during the past decade. Methods CBM and Medline were separately searched in 2007, by using Medical subject heading for retrieving Chinese and English language neuro-ophthalmic articles which were published between 1997 and 2006. Results A total of 13052 Englishwritten a rticles available for analysis were contributed from more than 70 countries, mainly from USA, United Kingdom, Japan, Germany, Italy and Canada. The order of frequency was visual cortex（4496/13052，34.4%），optic nerve diseases（3870/13052，29.7%），ocular mo tility disorders（2899/13052,22.2%），visual pathway（1191/13052,9.1%）pupil dis orders(596/13052，5.6%). While a total of 3726 articles were retrieved from CBM, the order of frequency being optic nerve diseases（1854,49.8％），ocular motili ty disorders(excluding strabismus, 1357,36.4%),pupil disorders (242, 6.5%)，visual cortex(202, 5.4%), visual pathway(excluding retina, optic nerve, visual cortex, 71). Researchers with diverse specialties contributed to the neuro-ophthalmic publications. Compared with international counterpart, domestic articles relate d to basic researches were much less. Conclusion Neuro-ophtha lmoloy is interdisc iplinary with a wide range of researches and various study hotspots. Domestic basic researches on neuro-ophthalmology remain to be strengthened and improved. (Chin J Ocul Fundus Dis,2008,24:99-102)