ABSTRACT
BACKGROUND:Autologous bone marrow mesenchymal stem cels (BMSCs) transplantation has been used for clinical treatment of dilated cardiomyopathy. But the efficacy and safety of autologous BMSCs transplantation remains controversial. OBJECTIVE: To systematicaly assess the efficacy and safety of autologous BMSCs transplantation for treatment of dilated cardiomyopathy by using meta-analysis approach. METHODS:PubMed, Cochrane Library (Issue 2, 2016), Embase, CNKI, CBM, VIP, WanFang were systemicaly searched for relevant randomized controled trials (RCTs) about autologous BMSCs transplantation and conventional drugs for the treatment of dilated cardiomyopathy. After information extracting and quality assessing, Meta-analysis of left ventricular ejection fraction, left ventricular end-diastolic diameter, 6-minute walking distance, percentage of myocardial perfusion defect, mortality, incidence of malignant arrhythmia events and heart transplantation rate during treatment and folow-up was performed using R3.1.0 software. RESULTS AND CONCLUSION:A total of 7 RCTs involving 341 patients were included. Meta-analysis results showed that for efficacy, compared with the conventional drugs, BMSCs can increase the left ventricular ejection fraction [1 month post-treatment: mean difference (MD)=3.02, 95% confidence interval (CI) (1.55, 4.49); 3 months post-treatment:MD=4.38, 95%CI(3.55, 5.52); 6 months post-treatment:MD=6.47, 95%CI(4.78, 8.15);≥ 12 months post-treatment:MD=8.23, 95%CI(5.15, 9.19)]; decrease the left ventricular end-diastolic diameter after 3 months [3 months post-treatment:MD=-0.65, 95%CI(-0.72,-0.59); 6 months post-treatment:MD=-0.12, 95%CI(-0.21,-0.03);≥ 12 months post-treatment:MD=-0.19, 95%CI(-0.24,-0.13)]; increase 6-minute walking distance after 6 months [6 months post-treatment:MD=87.70, 95%CI(51.55, 123.85);≥ 12 months post-treatment:MD=143.83, 95%CI(122.73, 164.93)]; and decrease percentage of myocardial perfusion defect at 3 months [MD=-3.56, 95%CI(-5.57,-1.55)]. For safety, BMSCs can decrease the mortality [risk ratio=0.46, 95%CI(0.24, 0.89)], but there is no significant difference in the incidence of malignant arrhythmia events and heart transplantation rate between two treatment groups. To conclude, these results indicate that BMSCs transplantation for dilated cardiomyopathy is one of effective and safe treatments.
ABSTRACT
Objective To compare the safety and effectiveness between ozone (O3) and hyaluronic acid (HA) in treating knee osteoarthritis(KOA) by using the meta analysis method.Methods The relevant randomized controlled trials(RCTs) in PubMed,Cochrane Library (issue 1,2016),Embase,CNKI,CBM,VIP,and Wan-Fang databases were retrieved from their establishment to January 23,2016.Two reviewers independently screened the literatures,extracted the data and evaluated the quality of the included RCTs.The results were performed the statistical analysis by using the RevMan5.3 and Stata13.0 software.Results Twenty RCTs involving 2 136 KOA patients were included.Compared with the HA treatment of KOA,the O3 treatment had higher treatment effective rate[odds ratio(OR) =2.78,P＜0.01],and better pain relief effect[at 1,3,6 month after treatment:mean difference(MD) =-0.25,-0.71,-1.70,P＜0.01].There were no statistically significant differences in complications between the two treatment methods[OR=0.84,P=0.56].Conclusion Current evidences indicate that the short-term therapeutic effect of O3 for KOA is superior to HA,and the safety is similar.