ABSTRACT
The clinical research is an important cornerstone of medical innovation and development.In the past decade,there have been some breakthrough achievements in the field of urological clinical research internationally.However,there is still a large gap between Chinese urological clinical research and the international level.Urologists across China should improve the clinical research to a new level of awareness,starting with the idea of patients' expectation being our concern,and making clinical research our priority.The multi-center clinical research should be the priority,involving the real-world study,prospective randomized controlled trails,translational medicine,and artificial intelligence,etc.The standardized method must be adopted and the integrity of scientific research should be concerned in the process of clinical research.The clinical research results should not only be published in the international journals,but more importantly be published in the domestic journals.The proposal of "publishing the studies on the land of our motherland" should be vigorously advocated.
ABSTRACT
Objective To evaluate the tolerance and efficacy of nasogastric enteral nutrition (NGEN) in the treatment of severe acute pancreatitis (SAP). Methods PUBMED, Web of Science and The Cochrane Central Register of Controlled Trials from 1966 to 2011 (up to October) and Chinese Journals Full-text Database (CNKI), Database for Chinese Technical Periodicals (VIP) and Wanfang Digital Journal Full-text Database from 1978 to 2011 (up to October) were retrieved to collect clinical randomized controlled trials of NGEN to compare with nasojejunal enteral nutrition (NJEN) in the treatment of SAP. Two reviewers independently screened the literature for eligibility and evaluated the quality with confirmation of cross-check. Different opinions would be decided by the third party. Statistical analysis was performed by meta-analysis using Review Manager 4.2. Results Three randomized controlled trails including 159 patients with SAP met the inclusion criteria, involving 82 patients in NGEN group and 77 in NJEN group. There was no significant difference between NGEN and NJEN group in the risk of mortality of SAP (RR=0.69, 95%CI: 0.37-1.29, P=0.25), conversion to surgery (RR=2.09, 95% CI: 0.55-7.92, P=0.28), diarrhea subsequent to enteral nutrition (RR=1.43, 95% CI: 0.59-3.45, P=0.43), rate of tube displacement (RR=0.42, 95%CI: 0.08-2.17, P=0.30) and pain related with enteral nutrition (RR=0.94, 95%CI: 0.32-2.70, P=0.90). While compared with NJEN, the risk of infectious complications was lower than NGEN (RR=0.64, 95%CI: 0.42-0.99, P=0.04). Conclusion In enteral nutrition support of SAP, NGEN is comparable to NJEN in efficacy and tolerance, but the former has the lower rate of infectious complications and easier to operate, and there is a tendency of NEGN to replace the latter.
ABSTRACT
Objective To estimate the current quality of the reporting of randomized controlled trials (RCTs) related to digestive diseases in China. Methods All the papers related to RCTs published in Chinese Journal of Digestion from 1999 to 2008 were hand-searched by professional staff then evaluated and analyzed them according to the international reference standard. ResultsIn the 3298 issues of the recent ten years, there were 92 research papers of RCTs which was accounting for 2.8%. The sample size ranged from 18 to 5241. Sixty-one (66.0%) trials included the exact standard of internalize and exclusion. Sixteen (17.4%) trails told the specific method of random allocation and 22(23.9%) were double-blinded. Fifty-eight (63.0%) trials compared the baseline condition of each groups. Seventy-three(79.3%) trails showed the specific approach of statistic. In the end, only 7(5.7%) trails were identified as the strictly-designed RCTs. Conclusions The quantity and quality of the clinical RCTs can not satisfy the demand of clinical practice. Strictly-scientific designed, multicentered, large sample prospective clinical RCT should be advocated.
ABSTRACT
Objective To evaluate the effect of probiotics on inducing and maintaining remission of ulcerative colitis (UC). Methods PubMed, EMBase, Web of Science and The Cochrane Central Register of Controlled Trials from 1966 to 2009 (up to August), and China Journal Full-text Database, Chinese Technologic Journal Database (Weipu), Wan Fang Digital Journal Full-text Database from 1978 to 2009 (up to August) were retrieved in order to collect clinical randomized controlled trials regarding the effect of probiotics in remission induction and maintenance in UC patients. Statistical analysis was performed by meta-analysis using Review Manager 4.2.10. Results Eleven randomized controlled trials met the inclusion criteria, of which five studies were included in the control trial of probiotics and placebo to evaluate the clinical remission rate, seven studies were included to compare probiotics with placebo (3 trials) or with mesalazine (4 trials) to evaluate the clinical relapse rate (one of the trials was included in the induction treatment group and the maintenance treatment group). Meta-analysis showed that: a) On the basis of combining with conventional therapy, probiotics were superior to placebo in clinical remission rate (OR=0.28, 95%CI: 0.16-0.49, P