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OBJECTIVE@#To re-evaluate the systematic review/Meta-analysis of acupuncture and moxibustion for childhood autism (CA), aiming to provide decision-making basis for clinical diagnosis and treatment.@*METHODS@#The systematic review and/or Meta-analysis of acupuncture and moxibustion for CA were searched in PubMed, EMbase, Cochrane Library, SinoMed, CNKI and Wanfang databases. The retrieval time was from the database establishment to May 5th, 2022. PRISMA (preferred reporting items for systematic reviews and Meta-analyses) was used to evaluate the report quality, and AMSTAR 2 (a measurement tool to assess systematic reviews 2) was used to evaluate the methodological quality, bubble map was used to construct the evidence map and GRADE was used to evaluate the quality of evidence.@*RESULTS@#A total of 9 systematic reviews were included. The PRISMA scores ranged from 13 to 26. The report quality was low, and there was a serious lack in the aspects of program and registration, search, other analysis and funding. The main problems in methodology included not making prespecified protocol, incomplete retrieval strategy, not providing a list of excluded literatures, and incomplete explanation on heterogeneity analysis and bias risk. The evidence map showed that 6 conclusions were valid, 2 conclusions were possible valid and 1 conclusion was uncertain valid. The overall quality of evidence was low, and the main factors leading to the downgrade were limitations, followed by inconsistency, imprecision and publication bias.@*CONCLUSION@#Acupuncture and moxibustion has a certain effect for CA, but the quality of reporting, methodology and evidence in included literature need to be improved. It is suggested to perform high-quality and standardized research in the future to provide evidence-based basis.
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Child , Humans , Acupuncture Therapy/methods , Autistic Disorder , Moxibustion/methods , Publication Bias , Research Design , Systematic Reviews as Topic , Meta-Analysis as TopicABSTRACT
OBJECTIVE@#Percutaneous aspiration sclerotherapy is indicated for treatment of symptomatic renalcysts. The efficacy and safety of the different sclerosing agents have been sources of debate anddisagreement. The purpose of this study was to assess the efficacy and safety of using tetracyclineaspiration sclerotherapy in a systematic review of the literature.@*MATERIALS AND METHODS@#A systematic search was conducted on the following electronic databases:Cochrane Central Register of Controlled Trials, EMBASE, PubMed and HERDIN (until November2017). Studies of cyst volume reduction after tetracycline aspiration sclerotherapy were included forfull text evaluation. The quality of the studies and the risk of bias were assessed independently by theauthors, based on the Cochrane Handbook for Systematic Reviews of Interventions.@*RESULTS@#Three studies were included for full-text assessment. They included 87 patients. Overall, riskof bias was high. Complete renal cyst disappearance ranged between 29%-100% after a follow-upperiod of 3-36 months. Partial success/>50% renal cyst reduction ranged between 85.7%-100%.Complications were minor and self-limited, postoperative procedural pain occurred most frequently.@*CONCLUSION@#The authors found good results with respect to efficacy and safety after tetracyclineaspiration sclerotherapy of renal cysts. However, due to high risk of bias in the included studies,definite conclusions regarding efficacy could not be drawn.
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<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of different operation time for acute spinal cord injury(SCI) based on systematic review.</p><p><b>METHODS</b>PubMed database, EMBASE database, Cochrane Library, ISI Web of knowledge, CBM database, VIP database, CNKI database and Wanfang database were searched from their start year up to February 2017 for relevant randomized clinical trials on the treatment of acute spinal cord injury with different intervention times.</p><p><b>RESULTS</b>Four randomized clinical trials of total 156 cases were included. Early surgical intervention for the patients with incomplete spinal cord injury can improve the ASIA motor function score [MD=3.29, 95%CI(-7.90, 14.49), =0.56] and overall Frankel score[=7.65, 95%CI(2.69, 21.74), =0.000 1]. There was no significant difference in the improvement of the overall Frankel score[=4.88, 95%CI(0.74, 32.09), =0.10] for the patients with complete spinal cord injury between the early surgery and delayed surgery group. There was no significant difference in hospitalization time[MD=-3.4, 95%CI(-8.12, 1.32), =0.16], death rate [=1.07, 95%CI(0.21, 5.56), =0.93]and incidence of decubitus[=1.07, 95%CI(0.17, 6.69), =0.94] between the early surgery and delayed surgery group.</p><p><b>CONCLUSIONS</b>Early surgical intervention can promote the nerve function recovery after spinal cord injury, whithout further incidence of complications, but random control trails with higher quality are still required for this conclusion.</p>
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Humans , Randomized Controlled Trials as Topic , Recovery of Function , Spinal Cord Injuries , General Surgery , Time FactorsABSTRACT
<p><b>OBJECTIVE</b>This study aims to assess the remineralization effect of casein phosphopeptide (CPP)-amorphous calcium phosphate (ACP) on enamel demineralization by performing system review of randomized controlled trials (RCT) involving the treatment of enamel demineralization with CPP-ACP.</p><p><b>METHODS</b>The study was developed based on the Cochrane handbook for systematic reviews of interventions (Version 5.1.0) and included the following: search strategy, selection criteria, data extraction, and risk of bias assessment. We searched electronic databases such as PubMed, Embase, Cochrane Library, CNKI, Wanfang and VIP up to September 2016. RCT of treating enamel demineralization with CPP-ACP were included. Data extraction and domain-based risk of bias assessment were independently performed by two reviewers.</p><p><b>RESULTS</b>Twelve RCTs were included. Because of the difference of experimental design and evaluation standards, the quantitative analysis can not be carried out.</p><p><b>CONCLUSIONS</b>There is no strong evidence that CPP-ACP is superior to conventional fluoride formulations in enamel remineralization. However, due to the limitations of sample size, follow-up time and study design, more high quality and large-sample RCT are needed to further verify the evidence.</p>
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OBJECTIVE:To systematically review therapeutic efficacy of Haikun shenxi capsule in the treatment of chronic renal failure (CRF).METHODS:Retrieved from Central,PubMed,EMBase,CJFD,CBM,VIP and Wanfang database,randomized clinical trials (RCTs) about Haikun shenxi capsule combined with routine treatment (trial group)vs.single routine treatment (control group) in the treatment of CRF were collected.Meta-analysis was performed by Rev Man 5.3 software after screening literature,extracting data and evaluating quality by using risk bias evaluation of Cochrane collaboration network.RESULTS:A total of 10 RCTs were included eventually,involving 704 patients.The results of analysis showed that compared to general therapy,Haikun shenxi capsule could improve total effective rate [RR =4.42,95 ％ CI (2.70,7.22),P＜ 0.001],and could reduce SCr[MD =-140.37,95 ％ CI (-191.72,-89.03),P＜ 0.001],BUN[MD =-5.49,95 ％ CI (-8.36,-2.63),P＜ 0.001] and 24 h-Upro [MD =-0.43,95 ％ CI (-0.62,-0.23),P＜ 0.001],with statistical significance.CONCLUSIONS:The clinical efficacy of Haikun shenxi capsule in the treatment of CRF is good and significantly improve related indexes of renal function.
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OBJECTIVE:To systematically review therapeutic efficacy of Haikun shenxi capsule in the treatment of chronic renal failure (CRF).METHODS:Retrieved from Central,PubMed,EMBase,CJFD,CBM,VIP and Wanfang database,randomized clinical trials (RCTs) about Haikun shenxi capsule combined with routine treatment (trial group)vs.single routine treatment (control group) in the treatment of CRF were collected.Meta-analysis was performed by Rev Man 5.3 software after screening literature,extracting data and evaluating quality by using risk bias evaluation of Cochrane collaboration network.RESULTS:A total of 10 RCTs were included eventually,involving 704 patients.The results of analysis showed that compared to general therapy,Haikun shenxi capsule could improve total effective rate [RR =4.42,95 ％ CI (2.70,7.22),P＜ 0.001],and could reduce SCr[MD =-140.37,95 ％ CI (-191.72,-89.03),P＜ 0.001],BUN[MD =-5.49,95 ％ CI (-8.36,-2.63),P＜ 0.001] and 24 h-Upro [MD =-0.43,95 ％ CI (-0.62,-0.23),P＜ 0.001],with statistical significance.CONCLUSIONS:The clinical efficacy of Haikun shenxi capsule in the treatment of CRF is good and significantly improve related indexes of renal function.
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OBJECTIVE:To systematically review the efficacy and safety of intrathecal injection of vancomycin combined with dexamethasone in the treatment of intracranial infection,and to provide evidence-based reference in the clinic. METHODS:Re-trieved from PubMed,Medline,CJFD,VIP,Wanfang databases,randomized controlled trials(RCTs)about intrathecal injection of vancomycin combined with dexamethasone in the treatment of intracranial infection were collected. Two reviewers independently screened literature,extracted data and assessed the risk of bias of included studies according to Cochrane system review manual 5.0.1. Then Meta-analysis was conducted by Rev Man 5.2 statistical software. RESULTS:Total of 8 RCTs were included,involv-ing 543 patients. Meta-analysis showed that,compared with intravenous dripping of ceftriaxone or vancomycin,intrathecal injec-tion of vancomycin combined with dexamethasone could significantly increase response rate [RR=1.18,95%CI(1.11,1.26),P<0.001] and bacterial clearance rate of CSF[RR=1.13,95%CI(1.01,1.27),P<0.001] of intracranial infection patients,shortened treatment time [SMD=-1.60,95%CI(-1.89,-1.30),P<0.001],reduce the incidence of ADR [RR=0.48,95%CI(0.32,0.73), P<0.001]. At the same time,it also could improve changes of intracranial pressure[SMD=-1.78,95% CI(-2.10,-1.47),P<0.001],changes of protein quantitation of CSF[SMD=-0.18,95%CI(-0.25,-0.11),P<0.001] and changes of glucose quantita-tion of CSF[SMD=1.77,95%CI(0.91,2.63),P<0.001],with statistical significance. CONCLUSIONS:Intrathecal injection of van-comycin combined with dexamethasone shows good clinical efficacy for intracranial infection,improves bacterial clearance rate, shortens treatment duration,significantly lowers intracranial pressure and protein quantitation,improves glucose quantitation of cere-brospinal fluid,with good safety.
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Objective To systematically evaluate the efficacy of acupotomy treatment for the stenosing tenovaginitis of flexor digitorum.Methods Articles about RCTs of acupotomy treatment and local blocking for the treatment of stenosing tenovaginitis of flexor digitorum were retrieved from CBM, CNKI, VIP, Wanfang database, PubMed, Embase, and Cochrane library. And then according to the requirement of Cochrane Handbook for Systemetic Reviews 5.1.0, two reviewers independently chose tests, extracted data, had a cross check, accessed methodological qualities and finally used RevMan 5.3 software for Meta analysis. The total effective rate, cure rate and improvement rate of acupotomy treatment and local blocking in treating stenosing tenovaginitis of flexor digitorum were assessed by using odds ratio (OR).Results Totally 10 articles involving 1426 cases were included. The cure rate in acupotomy treatment group was higher than that of local blocking group [OR=13.11 (95% CI: 8.23–20.89),Z=10.83 (P<0.000 01)], funnel plot Begg’s testP=0.858, Egger’s testP=0.579; the improvement rate of local blocking rate was higher than that of acupotomy treatment group [OR=0.14 (95% CI: 0.10–0.19),Z=11.60 (P<0.000 01)], funnel plot Begg’s test P=1.000, Egger’s testP=0.926; the total effective rate of acupotomy treatment group was higher than that of local blocking group [OR=18.26 (95% CI: 9.95–33.50),Z=9.38 (P<0.000 01)], funnel plot Begg’s testP=0.592, Egger’s testP=0.936.Conclusion Acupotomy treatment for stenosing tenovaginitis of flexor digitorum is superior to local blocking injection. However, the quality of the RCTs is low, so more large-sample, multi-center, and high-quality clinical RCTs are required for further verification.
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OBJECTIVE: To study the regulation law "medical device regulation" (State Council Decree No. 650) published on 2014, thus system reviews its impacts on the medical devices premarket evaluation in China. METHODS: Based on system theory and analytic hierarchy process, an analysis is carried out on seven aspects including premarket evaluation, change of registration, continuation of registration, also a comparative study made with international practice. RESULTS AND CONCLUSION: "Medical device regulation" aim to strengthen and loose regulation based on the risk of medical devices, which is an application of regulation theory. In order to apply the new lay effectively, supporting regulations should be carefully designed and organized, thus make a comprehensive regulation system with laws, regulations and guidance documents.
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Objective:To assess the metabolic side effects of the following atypical antipsychoties head-to-head:amisulpride,olanzapine,aripiprazole,quetiapine,risperidone,ziprasidone.Methods:We searched the MED-LINE,EMBASE,Cochrane Library,PubMed,CNKI,Web of science,Sinomed,WANGFANG DATA databases for randomized,blineded studies comparing the above mentioned atypical antipsychoties in the treatment of schizophre-nia or related disorders.At last three reviewers extracted the data independently.All the data would be analysed with meta ananlysis and the analysis software of the RevMan 5.1 provided by Cochrane network.Results:There were 49 studies in which 45 were written in English and 4 were written in Chinese included in the review.Olanzapine pro-duced statistically significantly more weight gain than all other second-generation antipsychotics.Risperidone pro- duced significantly more weight gain than amisulpride.Olanzapine produced statistically significantly more increase in glucose levels from baseline to endpoint than all other second-genetation antipsychotics.Risperidone produced statistically significantly more increase in glucose levels from baseline to endpoint than aripiprazole,quetiap-ine.Olanzapine produced statistically significantly more increase in cholesterol than aripiprazole,risperidone and zi-prasidone.Quetiapine produced significantly more increase in cholesterol than risperidone and ziprasi-done.Risperidone produced significantly more increase in cholesterol compared to aripiprazole and ziprasidone.Conclusion:Some atypical antipsychoties lead to substantially more metabolic side effects than other a-typical antipsychoties.When choosing an atypical antipsychotic agent for an individual patient these side effects with their potential cause of secondary diseases should be weighed against efficacy and characteristics of the individual patient.
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@#Gap junction has been considered allowing direct transfer of small metabolites between cells to maintain homeostasis in multicellular organisms. Deficient gap junction involved in genesis and development of many central neurological disorder, and may be a potential target for the treatment of them.
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@#This article mainly discussed the concept and application of dynamic neuromuscular stabilization in order to make up for the defect that some of the traditional training only focus on large muscle groups, and ignore the deep trunk muscles, especially the small deep muscles.
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Objective To evaluate the effectiveness and safety of Tao Hong Si Wu decoction in treating Diabetic nephropathy (DN).Methods Randomized controlled trials (RCTs) on Tao Hong Si Wu decoction in treatment of DN were searched in PubMed,EMbase,Cochrane Library,CMCC,VIP,CNKI,CBM.Data were strictly extracted using the fundamental evaluation method recommended in Cochrane Handbook and Meta-analysis was performed using RevMan 5.0.24 software.Results Eleven RCTs of 956 patients of DN were analyzed.The content and methodological quality of these 11 test samples were low,which could not be undertaken high quality research of sensitivity analysis.Meta-analysis results showed that:Tao Hong Si Wu decoction could be reduced to some extent,the early and clinical stage of DN patients with 24 h UPE reduce the Ⅲ,Ⅳ of Scr,and improve renal function to a certain extent.The results also showed that Tao Hong Si Wu decoction could lower TG and CHO,better control FBG and HbAlc of DN patients,besides,serious adverse reactions have not been found during the treatment.Conclusion Tao Hong Si Wu Decoction could be a relatively safe and effective treatment of DN drugs.However,a high probability of selection bias and measurement bias in the included studies was bound to affect the strength of the results.
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Background Nowadays,keratoplasty is widely used in the treatment of keratoconus.Deep lamellar keratoplasty(DLKP)is one of the research hotspots.However,its effacacy and safety are still concerned.Objective This paper was to evaluate and compare the therapeutic outcomes between DLKP and penetrating keratoplasty(PKP) for keratoconus.Methods The peer-reviewed and published literature was searched from PubMed database,Cochrane Library,EMBase and CNKI to identify relevant trails comparing DLKP with PKP for keratoconus.Methodological quality and Meta-analysis were carried out according to the principle of evidence-based medicine.The statistical analysis was performed using Review Manager 5.0 software.Results Eleven studies with 2950 eyes were identified that compared the results of DLKP and PKP procedures for keratoconus directly.Of those studies reporting vision and refractive data,less patients underwent DLKP achieved a best corrected visual acuity (BCVA)of≥0.5 than DLKP(RR=0.91,95％ CI:0.84-0.99,P=0.030) ;patients with DALK had severer myopia that those with PKP(RR =-0.60,95％ CI:-1.43-0.23,P =0.150),but the astigmatism was comparative (WMD =0.21,95％ CI:-0.48-0.91,P =0.550).Endothelial cell density values were higher in the DLKP group and the differences were significant.Endothelial immune graft rejection did not occur after DALK,and PKP had a higher overall graft rejection rate than DLKP(RR=0.06,95％ CI:0.01-0.31,P=0.001).Conclusions According to the available data,PKP can imporve the BCVA and refractive results,but DLKP can avoid the risk of endothelial rejection and reduce the risk of late endothelial failure for keratconus.
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Objective To study whether BED-capture enzyme immunoassay (CEIA) is feasible to be used in wide-ranging population, we collect papers and conference abstracts related to BED-CEIA and HIV-1 incidence. Methods 10 papers are included for the discussion, regarding the concordance between the estimated HIV-1 incidence from BED-CEIA and the results from a cohort studies; and 11 papers are selected to discuss the related misclassification on the estimation of HIV-1incidence. Results Concordance between the two sets is related to the districts and design of research. Results from Africa are not so satisfactory, but researches, those BED-CEIA samples are collected during the follow-up of the cohort study, have shown better outcomes than other ones. There are totally 7303 samples of LTI (long-term infections) collected for analyzing the misclassification of BED-CEIA. 432 LTI are misclassified as new infections, making the raw rate of misclassification as 5.9% with 95% confidential interval between 5.36 and 6.44. Data from systematic review shows that the BED-CEIA's misclassification rate relates to the count of CD4+T lymphocytes and time after the infection but has no relation to the classification of sub-populations (female sexual workers and intravenous drug users in China) and districts (China and Africa). Conclusion Our results reveal that the misclassification is relevant to the immune-status of the infected persons.
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Age-related macular degeneration(AMD)causes severe vision loss due to the development of choroidal neovascularization(CNV).The critical role of VEGF in the pathogenesis of CNV is well understood and known.Ranibizumab is a fragment of a humanized monoelonal antibody.It plays an inhibitory role on CNV and reduces vascular permeability by binding to VEGF.Some clinical trials and literature have proved the clinical efficacy of ranibizumab via intravitreal injection for wet AMD.But the systematized administration is vital important.Some high-quality researches showed that the optimal timing for ranibizumab treating wet AMD is the first 3 months.It is recommended that ranibizumab is intravitreally injected monthly in the initiation for least 3 months.Sequent managing regimen should be made depended on the image of optical coherence topography and fundus fluorescine angiography and visual acuity change.Individuated strategy or combined method with PDT are beneficial to the active lesion in the consecutive treatment of ranibizumab for CNV and may be a good choice in order to decrease the injection times.This article systematically searched and summarized the relative literature and offered the high-quality evidences for the clinical evaluation of ranibizumab treating wet AMD.
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@#This paper reviewed the research of functional electrical stimulation (FES) in China, including mainland, Taiwan and Hong Kong, based on the literature. Specially, the research and development on FES system and device was discussed.
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@#There are many factors which can affect the genesis and prognosis of the stress-induced arrhythmias,besides the automatic nerve system,the personality,central nervous system and hereditary factors have been involved.It is very important to comprehend the relationship and effects of these factors for prevention of stress-induced arrhythmias.