ABSTRACT
BACKGROUND: Posterior circulation ischemic vertigo (PCIV) is one of the most complaint symptoms in clinical, and is associated with high risk of recurrence. Current studies show that acupuncture has therapeutic effect on releasing symptom as well as improving the blood flow of posterior circulation. In this review, we aim to assess the efficacy and safety of acupuncture for PCIV. METHODS: Literature of clinical randomized control trials regarding acupuncture for PCIV published before August of 2020 will be searched in databases, including 5 English databases and 4 Chinese databases. For the included studies, methodological quality will be assessed according to Cochrane Risk of Bias Tool, and evidence quality will be evaluated with Grading of Recommendations Assessment, Development and Evaluation guidelines. Data analysis will be performed using Review Manager Software. RESULTS: The primary outcomes involve changes of PCIV symptoms and blood flow velocity of vertebrobasilar. The secondary outcomes include Barthel Index, National Institute of Health Stroke Scale, clinical effectiveness, and adverse reactions. CONCLUSION: Based on current clinical studies, this systematic review and meta-analysis will provide evidence-based basis for the efficacy and safety of acupuncture in treating PCIV. TRIAL REGISTRATION: The protocol for this review has been registered in the INPLASY network (Registration number: INPLASY202070116).
Subject(s)
Acupuncture Therapy , Brain Ischemia/therapy , Vertigo/therapy , Brain Ischemia/complications , Humans , Vertigo/etiology , Meta-Analysis as TopicABSTRACT
Recently, cancer research microRNA studies have drawn great attention. However, the results of these studies have been inconsistent and variable regarding the availability of circulating miRNAs in gastric cancer (GC) diagnosis. Thus, results should be interpreted cautiously. The purpose of the present study was to assess the diagnostic performance of circulating miRNAs in GC diagnosis. We conducted a systematic and comprehensive approach for the inclusion of studies. The sensitivity, specificity, and diagnostic odds ratio were pooled with random effects models, and a summary of receiver operator characteristic (SROC) curves were plotted. The potential heterogeneity was assessed with Q test and I2 statistics. Subgroup analyses and metaregressions further investigated the sources of heterogeneity. A total of 77 studies from 48 articles were eligible for the metaanalysis. The results revealed a sensitivity of 0.76, a specificity of 0.81, and an AUC of 0.86 for gastric cancer diagnosis with circulating miRNAs. In addition, subgroup analyses indicated that multiple miRNAs assays, nonmicroarray screening approaches, and serumbased miRNA assays exhibited good diagnostic performance in contrast to a single miRNA assay, microarray expression profiling screening, and plasmabased miRNA group analysis. The diagnostic ability of miRNAs in early stage III groups and the high expression group were approximately similar to that in the stage IIV groups and the low expression group. For the circulating miRNAs, our metaanalysis identified a combination of multiple miRNAs, nonmicroarray chip screening, and serumbased miRNA assays were associated with the most effective GC diagnostic performance. However, many unclear molecular mechanisms limited the accuracy of the diagnostic results, and should be interpreted with caution. Further largescale prospective studies are required for validating the diagnostic applicability of circulating miRNAs in gastric cancer patients.
