ABSTRACT
Objective To explore the clinical efficacy of lymph node involved-field irradiation (IFI) and elective nodal irradiation (ENI) for treatment of esophageal cancer among Asian populations. Methods The randomized controlled trials and retrospective analyses of Asian esophageal cancer patients treated by IFI and ENI were retrieved by computer in Cochrane Library, PubMed, Embase, CNKI, and Wanfang database. The last retrieval time was May 2018. According to the inclusion and exclusion criteria, the clinical efficacy, adverse reactions and failure modes were selected in each study. A Meta-analysis was performed by using Review Manager 5.3 software to compare the advantages and disadvantages of IFI group and ENI group in treatment of Asian esophageal cancer patients. Results Eventually, a total of 18 domestic and foreign literature that meet the standards (6 randomized controlled trials, 12 retrospective analyses) were included, with a total of 2220 patients. There were no significant differences in the overall survival rate, the local control rate, the local/regional failure rate, the distant metastasis rate, the intra-field recurrence rate, and the field recurrence rate between the IFI group and the ENI group (all P>0.05). The overall failure rate of ENI group was slightly lower than that of IFI group (P= 0.05). The incidence of radiation pneumonitis in ENI group was higher than that in IFI group (P= 0.004), and the incidence of radiation esophagitis was higher than that in IFI group (P< 0.01). Conclusion For Asian patients with esophageal cancer, ENI has no obvious advantage compared with IFI, including the increase of adverse reactions.
ABSTRACT
OBJECTIVE： To systematically evaluate the effects of roflumilast on lung function of Asian patients with chronic obstructive pulmonary disease （COPD）， and to provide evidence-based reference for rational drug use in the clinic. METHODS： Retrieved from Cochrane library， PubMed， Embase， CBM， CNKI， VIP and Wanfang database， RCTs about roflumilast or roflumilast combined with routine treatment or placebo （trial group） versus routine treatment or placebo （control group） in the treatment of Asian COPD patients were collected. After literature screening， data extraction and quality evaluation with Cochrane bias risk evaluation tool， Meta-analysis was conducted by using Rev Man 5.2 software. RESULTS： Totally 6 RCTs were included， involving 1 494 patients. Meta-analysis showed that pre-bronchodilator FEV1 （pre-FEV1） [MD＝75.19， 95％CI（53.21， 97.17）， P＜0.000 01]， post-bronchodilator FEV1 （post-FEV1） [MD＝56.60， 95％CI（27.56， 85.63）， P＝0.000 1]， forced vital capacity （FVC） [MD＝43.67， 95％CI （15.91，71.43）， P＝0.002]， average flow rate of post-bronchodilator 25％-75％ of forced vital capacity （post-FEF25％-75％） [MD＝14.58， 95％CI （8.43， 20.73）， P＜0.001]， the incidence of diarrhea [RR＝5.06， 95％CI （1.26，20.27）， P＝0.02]， respiratory infection [RR＝1.94， 95％CI （1.30，2.90）， P＝0.001]， decreased appetite [RR＝7.43， 95％CI （2.94，18.79）， P＝0.001]， body weight decrease [RR＝5.46， 95％CI （2.12，14.03）， P＝0.001]， headache [RR＝7.73， 95％CI （1.42，42.16）， P＝0.02]， dizziness [RR＝3.44， 95％CI （1.28，9.27）， P＝0.01]， gastritis [RR＝5.09， 95％CI （1.49， 17.45）， P＝0.01] and anorexia [RR＝5.06， 95％CI （1.97， 13.00）， P＝0.001] in trial group were significantly higher than control group； St. George’s Respiratory Questionnaire （SGRQ） total score [MD＝－5.82， 95％CI（－7.77， －3.87）， P＜0.001]， respiratory symptom score [MD＝－1.67， 95％CI （－2.51， －0.84）， P＜0.001]， activity limited score [MD＝－1.55， 95％CI （－2.14， －0.97）， P＜0.001] and disease impact score [MD＝－2.59， 95％CI （－3.40，－1.79）， P＜0.001] of trial group were significantly lower than those of control group. CONCLUSIONS： Roflumilast can improve lung function and dyspnea in Asian COPD patients， but it can increase the risk of ADR.
ABSTRACT
Objective The aim of this study was to explore the association of tumor necrosis factor-α (TNF-α)promoter-308A/G polymorphism with rheumatoid arthritis(RA)susceptibility in East Asian population based on the meta-analysis. Methods We searched all the publications about the association between TNF-α promoter -308A/G polymorphism and RA in East Asian population from PubMed, Ebsco, Chinese Biomedical Literature Database(CBM), Chinese National Knowledge Infrastructure(CNKI), and Wanfang (Chinese). Meta-analysis was performed for genotypes AA versus GG, GA versus GG, AA versus GG+GA,GA+AA versus GG, and A allele versus G allele in a fixed/random effect model. Results A total of 4 studies (957 cases and 1196 controls)were included in the current meta-analysis(three Chinese and one Japanese studies). When all groups were pooled, significant association of A allele and decreased RA risk was found (OR=0.36, 95%CI=0.16～0.80, P=0.01). When analyses were limited to race homogeneous population,significant association of A allele and decreased RA risk was found in Chinese population(OR=0.40, 95%CI=0.16～1.01, P=0.05). Conclusion This meta-analysis demonstrates significant negative association between TNF-α promoter-308A/G polymorphism and RA in East Asian and Chinese population.