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Objective:To evaluate the effect of neuromuscular electrical stimulation (NMES) on muscle strength and duration of mechanical ventilation through cumulative Meta-analysis and sequential trial analysis (TSA).Methods:Randomized controlled trial (RCT) of NMES intervention in intensive care unit (ICU) patients with mechanical ventilation were searched from PubMed database of US National Library of Medicine, EMbase database of Netherlands Medical Abstract, Web of Science, SinoMed database of China, CNKI, Wanfang data, VIP and other Chinese and English databases from database construction to July 15, 2021. The control group received ICU routine nursing or rehabilitation exercise; the experimental group received NMES (low frequency electric current through electrode stimulation to make muscle groups twitch or contract) based on routine care in ICU. Relevant data were screened, evaluated and extracted by two researchers independently. After extracting data, STATA 15.0 and TSA software were used to analyze the data and evaluate the research results. Results:A total of 9 studies were enrolled, including 619 subjects. Among the 9 articles included, 2 were grade A and 7 were grade B, indicating good overall quality. Cumulative Meta-analysis showed that compared with ICU routine care, NMES improved muscle strength of patients undergoing mechanical ventilation [standardized mean difference ( SMD) = 0.64, 95% confidence interval (95% CI) was 0.07 to 1.21] and shortened the duration of mechanical ventilation ( SMD = -1.84, 95% CI was -2.58 to -1.10). TSA analysis of the two outcomes showed that the sample size of muscle strength outcome index ( n = 518) and mechanical ventilation outcome index ( n = 419) did not meet the expected information (RIS; n values of 618 and 685); the cumulative Z-value line of the muscle strength outcome index crossed the traditional boundary line and TSA boundary line, indicating that more tests were not needed to verify this result. In the outcome index of mechanical ventilation duration, it was found that the cumulative Z-value line only crossed the traditional boundary line, but did not cross the TSA boundary line, indicating that further studies in this area should be carried out in the future to demonstrate this result. Conclusion:NMES can improve ICU patients' muscle strength and reduce the duration of mechanical ventilation.
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Objective To systematically evaluate the clinical efficacy of relieving fever with sweet and warm drugs (Ganwen Chure Therapy) for noninfectious fever caused by vital-energy deficiency based on Meta-analysis. Methods Literature about RCTs of Ganwen Chure Therapy for noninfectious fever caused by vital-energy deficiency in CNKI, Wanfang Database, CBM, VIP, Pub Med, Cochrane Library, and Embase was retrieved by computers from establishment of database to April 2017. After two researchers independently conducted literature screening, cross-checking, data extraction, and literature quality evaluation, cumulative Meta-analysis was performed on the outcome indicators in order of publication time and sample size, and the trend of the results was tested. Then the quality of the literature based on GRADE was under an overall evaluation. Results Totally 27 articles were included in this study, involving 2599 patients. The results of cumulative Meta-analysis showed that the total effective rates of using Ganwen Chure Therapy only [OR=3.875, 95％CI (2.87, 5.24), Z=8.82, P=0.000 1]and Ganwen Chure Therapy combined with routine therapy [OR=5.791, 95％CI (3.55, 9.45), Z=7.03, P=0.000 1]were better than the routine therapy, with statistical significance. Trend test showed that there was variability in the timing of drug combination study, showing that the cumulative Meta-analysis results were not stable. Conclusion Ganwen Chure Therapy has certain efficacy for noninfectious fever caused by vital-energy deficiency. However, the overall quality of the included studies was low, with relatively high homogeneity. There are biases in publication, yet more high-quality clinical research is needed for further verification.
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Clinical evidences of acupuncture and moxibustion for sudden hearing loss(SHL) were completely collected, and the quality of the evidences was evaluated by Jadad scale. Cumulative Meta-analysis and the time tendency test for the results were implemented by STATA 12.0. Descriptive and academic cross-sectional investigation was carried out among senior professional doctors with acupuncture and moxibustion background in 31 provin-ces of China, and the advices of specialists were analyzed by fussy comprehensive evaluation. Thirty-eight researches were included. Cumulative Meta-analysis indicated that acupuncture and moxibustion combined with medication achieved better cured and total effects compared with multiple medicines[RR=1.57, 95%CI(1.38,1.79); RR=1.34, 95%CI(1.28,1.81)], and the efficacy had no time variability. The cured and total effects of acupuncture and moxibustion were superior to those of multiple medicines, but the results needed to be further verified. Five hundred and sixty-one questionnaires were put out in the 31 provinces, and 93.40% of ones were collected and eligible. Fuzzy comprehensive evaluation showed a tendency to overall improvement by acupuncture and moxibustion as the main intervention in the specialists' advice. Cumulative Meta-analysis and fussy comprehensive evaluation are applicable to estimate the effect and intervention level of acupuncture and moxibustion with low quality evidence.
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Objective To obtain a reliable estimate of the risk of H. pylori infection in causing pancreatic cancer ,by perform‐ing a M eta‐analysis of the existing observational studies evaluating the association .Methods Observational studies comparing the prevalence of H. pylori infection in patients with pancreatic cancer and healthy controls were identified through systematic search in the Medline ,EMBASE ,the Cochrane ,PubMed ,VIP database .H. pylori infection was confirmed by serological testing using an anti‐gen‐specific enzyme‐linked immunosorbent assay .Pooled adjusted odds ratios (AOR) and associated 95% confidence intervals (CI) were obtained by using a Dersimonian and Laird random‐effects model .Results Six studies involving a total of 2 335 patients met our eligibility criteria .A significant association between H. pylori seropositivity and development of pancreatic cancer (AOR=1 .38 , 95% CI:1 .08-1 .75 ;P=0 .009) was seen .No significant association had been seen on pooled analysis of the three studies assessing the relationship between CagA positivity and pancreatic cancer (AOR=1 .14 ,95% CI:0 .66-1 .97 ,P=0 .639) .Conclusion The da‐ta suggests an association between infection with H. pylori and the development of pancreatic cancer .Further research is needed to confirm our findings .