Flank versus prone position in percutaneous nephrolithotomy: a meta-analysis of randomized controlled studies.

The objective of this study is to assess the safety and efficacy of the flank position in percutaneous nephrolithotomy (PCNL). We searched PubMed, Embase, SCOPUS, the Cochrane database libraries, and the Chinese Biomedical Literature Database, and randomized controlled trials (RCTs) assessing PCNL in flank position are included in this meta-analysis. The related trials met the inclusion criteria were analyzed using RevMan 5.4. Seven randomized controlled trials were included, involving a total of 587 patients. We found that there was a lower decrease in hemoglobin levels in the flank position group compared to prone-position group (mean difference [MD] = - 0.15, 95% confidence interval (CI) - 0.22 to - 0.08, P < 0.00001). Moreover, our meta-analysis demonstrated no significant differences between groups regarding stone-free rate (relative risk [RR] = 1.00, 95% CI 0.93 to 1.06, P = 0.92), operative time(MD = 0.76, 95% CI - 5.31 to 6.83, P < 0.00001), hospital stay (MD = 0.03, 95% CI - 0.32 to 0.32, P < 0.00001), and complications Clavien grade I (RR = 1.01, 95% CI 0.98 to 1.05, P = 0.54), Clavien grade II (RR = 1, 95% CI 0.97 to 1.02, P = 0.78), and Clavien grade III (RR = 1, 95% CI 0.98 to 1.03, P = 0.77). The use of flank position for PCNL is associated with reduced hemoglobin change without an increase in complications. This positioning technique can be considered safe for patients with nephrolithiasis and may be particularly suitable for high-risk individuals such as those who are obese or have decreased cardiopulmonary function. However, further randomized trials are needed to confirm these findings.

Efficiency and safety of quadratus lumborum block in percutaneous nephrolithotomy: a meta-analysis of randomized controlled studies.

To evaluate the effect of quadratus lumborum block (QLB) for postoperative analgesia after percutaneous nephrolithotomy (PCNL), we searched Pubmed, Embase, Cochrane library, the Chinese Biomedical Literature Database, and randomized controlled trials (RCTs) assessing analgesic efficacy of QLB for PCNL are included in this meta-analysis. The related trials met the inclusion criteria were analyzed using RevMan 5.4 software, the weighted mean difference (WMD), with their corresponding 95% CI, was calculated to compare continuous variables. Nine RCTs are included in the meta-analysis showed that QLB group had significantly lower opioids consumption (WMD - 29.59 95% CI - 43.64 to - 15.55; P < 0.00001), lessen visual analog scale (VAS) after surgery 2 h (WMD - 1.35, 95% CI - 1.93 to - 0.76; P < 0.00001), 6 h (WMD - 1.47, 95% CI - 2.04 to - 0.91; P < 0.00001) 12 h (WMD - 1.75, 95% CI - 3.17 to - 0.32; P = 0.02) and 24 h (WMD - 1.4, 95% CI - 1.86 to - 0.94; P < 0.00001), shorter hospital stay(WMD - 0.7, 95% CI -1.26 to - 0.14, P < 0.00001) and reduce intestinal exhaust recovery time (WMD - 7.41, 95% CI - 9.36 to - 5.46, P < 0.00001) than in the control group. QLB offers some potential advantages in terms of opioids consumption, VAS, hospital stay and intestinal exhaust recovery time. However, good quality and large studies with long-term follow-up are warranted for further research.

Curcumin-loaded hydroxypropyl-ß-cyclodextrin inclusion complex with enhanced dissolution and oral bioavailability for epilepsy treatment.

Curcumin, the main bioactive component of turmeric, has a wild range of beneficial effects on central nervous diseases, including anti-Alzheimer's disease, antioxidant stress, and anti-inflammation. Currently, it has been demonstrated the anti-epileptic potential. However, curcumin has poor water solubility, high sensitivity to light and heat, and low absorption, which results in low bioavailability and greatly limits the clinical application of curcumin, as well as the elusive effects in anti-epileptic treatment.This study aimed to develop a curcumin hydroxypropyl-ß-cyclodextrin inclusion complex (CUR-HP-ß-CD) to improve its bioavailability and facilitate its potential development as an anti-epileptic drug. The CUR-HP-ß-CD was generated by the solvent evaporation method, which has efficient entrapment, high solubility, and facilitated bioavailability and brain distribution.The solubility of the CUR-HP-ß-CD was 63.5, 60.1, and 52.9 times that of the unformulated curcumin in H2O, HCl (pH 1.2), and PBS (pH 6.8), respectively. The bioavailability of CUR-HP-ß-CD is improved 2.8 times and 38.7 folds higher brain concentrations. Moreover, the therapeutic anti-epileptic effects of CUR-HP-ß-CD were much more effective in pentylenetetrazol (PTZ)-induced zebrafish and mouse models.This study showed a simple and reproducible strategy to effectively improve the bioavailability and therapeutic effects of curcumin, which could be potentially used in epilepsy treatment.

Textual Features and Risk Preference Effects on Mental Health Education Among Teenager Students in Chongqing, China.

Background: Mental health is a public health problem of great concern. Previous studies show that textual features and individual psychological characteristics can influence the effect of receiving information. Purpose: This study explores whether textual features influence the persuasiveness of teenager students' mental health education while considering the influence of risk preference. Methods: From November to December 2021, a cross-sectional study was conducted among 1,869 teenager students in grade 7-12 in Chongqing, China. Wilcoxon signed-rank test, multiple logistic regression, and subgroup analysis were used to analyze the data. Results: Among the four textual features mentioned in this study, a significant difference was reported in the persuasive effects of information with and without numerical features (p < 0.001), and such information tended to include digital features. The result for the symbolic features (p < 0.001) was consistent with the numerical features. The persuasive effects of positive and negative emotional information significantly differed (p < 0.001), with the former showing a better performance. No significant differences were observed between the persuasive effects of information with and without emotional conflicts (p > 0.05). Combined with those from the risk preference analysis, results showed that the regulatory effect of risk preference was only reflected in emotional conflicts. Students who prefer having no emotional conflict in the text showed the characteristics of risk avoidance, or lower grades, or rural or school accommodation. Most teenager students are also risk averse, especially females (or = 2.223, 95%CI:1.755-2.815) and juniors (or = 1.533, 95%CI: 1.198-1.963). Conclusion: The numbers, symbols, and positive emotions in the text generate an active effect on teenager students receiving mental health education. Students avoiding risk are inclined to read texts without emotional conflicts. The probability of male choosing texts with positive emotional polarity is 33.5% lower than that of female. Female students and those from lower grades also demonstrate a higher inclination to risk avoidance compared with their male and higher grade counterparts. Therefore, educational materials with different text characteristics should be developed for teenager students with varying characteristics.

Framing Effects and Evidence Type: Influence on the Persuasive Effect of Myopia Prevention Messages Among Elementary School Students in China.

Background: The myopia is a public health issue that attracts much attention. However, limited attention has been paid to the effect of primary school students' acceptance of health messages. Previous studies have found that framing effects and evidence types influence the persuasive effect of messages. Purpose: This study explored whether framing effects and evidence type influence the persuasive effect of myopia prevention messages among elementary school students and the influence of children's myopia prevention cognition was considered. Methods: A cross-sectional study was conducted among 1,493 elementary school students aged 9 to 13 in China from May to July 2020 by convenience sampling. Wilcoxon signed-rank test and multinomial logistic regression were used for data analysis. Results: Significant differences were found in the persuasive effect between statistical and non-statistical evidence messages (p < 0.001). Among non-statistical evidence messages, gain-framed messages showed a greater persuasive effect than loss-framed messages (p < 0.001). Among statistical evidence messages, loss-framed messages performed better than gain-framed messages (p < 0.001). Children's myopia prevention cognition exerted no significant effect on the persuasive effect of the messages (p > 0.05). Conclusion: This study demonstrated the influence of framing effect on the persuasive effect of myopia prevention messages among children aged 9 to 13 in China. Non-statistical evidence messages showed a better persuasive effect than statistical evidence messages. Different types of evidence influenced the persuasive effect of gain- and loss- framed messages. These findings have implications for strategies more or less likely to work in making myopia prevention messages for children.

Public awareness and anxiety during COVID-19 epidemic in China: A cross-sectional study.

OBJECTIVE: The study aims to investigate public awareness of coronavirus disease 2019 (COVID-19) and measure levels of anxiety during the outbreak. METHOD: A total of 2115 subjects from 34 provinces in China were evaluated. A questionnaire was designed, which covers demographic characteristics, knowledge of COVID-19, and factors that influenced anxiety during the outbreak to test public awareness and determine the impact of the outbreak on people's lives. In addition, a generalized anxiety disorder (GAD) scale was utilized to assess anxiety levels during the outbreak. Lastly, the chi-square test and multiple logistic regression analysis were used to identify factors associated with levels of public anxiety. RESULTS: A majority of respondents reported high levels of awareness of COVID-19. A total of 1107 (52.3%), 707 (33.4%), 154 (7.3%), and 147 (7%) respondents exhibited no, mild, moderate, and severe levels of anxiety, respectively. Results of the chi-square test and multiple logistic regression analysis demonstrated that respondents (a) with no college education, (b) are unaware of neighbors who may have been infected, (c) who spent considerable time collecting information and browsing negative information related to the virus, (d) are unhealthy, and (e) displayed low levels of awareness of the transmission routes were highly likely to be anxious. CONCLUSION: During the outbreak, the majority of people exhibited high levels of awareness and knowledge regarding preventive measures from COVID-19. The absence of psychological anxiety was observed in more than half of the respondents. Adaptive responses to anxiety and high levels of awareness about COVID-19 may have protected the public during the outbreak.

Risk assessment of workplace violence towards health workers in a Chinese hospital: a cross-sectional study.

OBJECTIVE: This study aimed to assess the risk factors associated with workplace violence towards health workers (HWs) in a Chinese hospital. METHODS: We conducted a cross-sectional survey in a Chinese secondary hospital in 2019 using an international survey questionnaire, and collected valid data from 1028 HW respondents via mobile phone. Alongside analysing the potential association between exposure to violence and respondents' characteristics, we compared the workplace violence between this survey and a baseline survey in the same hospital using the same questionnaire in 2018, and investigated the existing measures. RESULTS: A total of 5.45% of respondents had encountered physical violence while 41.63% had experienced psychological violence. Women (OR=3.45, 95% CI 1.87 to 6.38), those working in outpatient and emergency departments (OR=7.96, 95% CI 2.27 to 27.95), and those with extremely high concern about workplace violence (OR=7.94, 95% CI 1.04 to 60.85) were significantly more likely to suffer physical violence. Working in the outpatient and emergency department (OR=2.03, 95% CI 1.23 to 3.34), having direct physical contact/interaction with patients (OR=2.98, 95% CI 1.62 to 5.49), and extremely high worry about workplace violence (OR=6.47 95% CI 3.38 to 12.40) significantly increased the risk of psychological violence. When the results of the baseline survey were compared with those in this survey, it was shown that physical violence declined significantly from 8.79% in 2018 to 5.45% in 2019, while psychological violence declined significantly from 47.14% in 2018 to 41.63% in 2019. The most recognised measures were security measures (81.03%) while the least recognised measures were check-in procedures for staff (11.19%). CONCLUSION: Workplace violence towards HWs is a global problem with country-specific features. In our study, workplace violence in the hospital is of great concern. While demonstrating the effectiveness of measures in some degree, there is significant room for improvement. To achieve the vision of 'zero violence' in the health sector, aligned comprehensive measures should be systematically adopted.

Factors Associated With Influential Health-Promoting Messages on Social Media: Content Analysis of Sina Weibo.

BACKGROUND: Social media is a powerful tool for the dissemination of health messages. However, few studies have focused on the factors that improve the influence of health messages on social media. OBJECTIVE: To explore the influence of goal-framing effects, information organizing, and the use of pictures or videos in health-promoting messages, we conducted a case study of Sina Weibo, a popular social media platform in China. METHODS: Literature review and expert discussion were used to determine the health themes of childhood obesity, smoking, and cancer. Web crawler technology was employed to capture data on health-promoting messages. We used the number of retweets, comments, and likes to evaluate the influence of a message. Statistical analysis was then conducted after manual coding. Specifically, binary logistic regression was used for the data analyses. RESULTS: We crawled 20,799 Sina Weibo messages and selected 389 health-promoting messages for this study. Results indicated that the use of gain-framed messages could improve the influence of messages regarding childhood obesity (P<.001), smoking (P=.03), and cancer (P<.001). Statistical expressions could improve the influence of messages about childhood obesity (P=.02), smoking (P=.002), and cancer (P<.001). However, the use of videos significantly improved the influence of health-promoting messages only for the smoking-related messages (P=.009). CONCLUSIONS: The findings suggested that gain-framed messages and statistical expressions can be successful strategies to improve the influence of messages. Moreover, appropriate pictures and videos should be added as much as possible when generating health-promoting messages.

Impact of tobacco control auxiliary resources on the 5As behavior in nursing interns: Self-reports from students.

INTRODUCTION: The help of healthcare professionals for smokers to quit is critically important to increase quit rates. In the future, internship nursing students will potentially become the largest population of medical professionals. This study explored the impact of the use and awareness of universal tobacco control auxiliary resources on nursing students' 5As behavior in helping patients to quit smoking during a 40-week clinical internship in the last year of nursing school in Chongqing, China. METHODS: A survey was conducted in 13 teaching hospitals selected from 29 in Chongqing, China, in 2019, by a random cluster sampling method. It investigated, by self-reported questionnaires, student 5As behavior in helping patients to quit smoking and use and knowledge of tobacco cessation auxiliary resources (tobacco cessation self-education manual, tobacco cessation guidelines, tobacco cessation drugs, tobacco cessation websites, and hotline). The relationship between tobacco cessation auxiliary resources and 5As behavior in helping patients to quit smoking was analyzed with a multivariate linear mixed-effect model. RESULTS: In all, 534 (39.3%) students, of a total of 1358, reported that the majority of internship units provided a tobacco control self-education manual; 674 (49.6%) ever skimmed through tobacco cessation guidelines; 641 (47.2%) browsed tobacco cessation websites; 738 (54.3%) knew some cessation-assistance drugs; and 93 (6.8%) knew of and could recall the tobacco cessation hotline. Except for tobacco cessation websites, tobacco cessation auxiliary resources affected nursing interns' 5As behavior in helping patients to quit (p<0.05). CONCLUSIONS: Tobacco cessation auxiliary resources influenced students' 5As behavior in helping patients to quit smoking. Students knew a little of tobacco cessation auxiliary resources. To improve students' 5As behavior for helping patients to quit, more tobacco cessation resources need to be developed and more students need to become acquainted with them.

Goal-Framing and Temporal-Framing: Effects on the Acceptance of Childhood Simple Obesity Prevention Messages among Preschool Children's Caregivers in China.

A range of intervention models are available for childhood obesity prevention; however, few studies have examined the effectiveness of intervention messages. This study developed childhood simple obesity prevention messages on the basis of goal-framing and temporal-framing effects to improve message acceptance among the caregivers of preschool children and explored associated factors. A cross-sectional study was conducted among 592 caregivers of preschool children in urban kindergartens in China during March to April 2019. The framing messages were developed based on prospect theory and construal level theory. The majority (48.4%) of caregivers found the gain-framed, present-oriented message most salient for acceptance. We found that gender, education background, theme, and the use of negative words have impacts on goal-framing effects; and previous participation in a health related intervention, career category, and the theme have impacts on temporal-framing effects (p < 0.001). Goal-framing effects and temporal-framing effects can influence each other (p < 0.001). The findings suggest that the gain-framed, present-oriented message could be considered a strategy to improve the acceptance of information by caregivers. When framing a message, subtle differences like using negative words might affect the exertion of framing effects.

The Perception and Intervention of Internship Nursing Students Helping Smokers to Quit: A Cross-Sectional Study in Chongqing, China.

Background: Smoking is among the most preventable causes of death globally. Tobacco cessation can lessen the number of potential deaths. The China Tobacco Cessation Guidelines encourage medical staff to perform the 5As (Ask, Advise, Assess, Assist, Arrange) when delivering tobacco dependence treatments to patients. Nursing students will develop to be nurses in the future and they have to finish 9 months of clinical practicum study in the last year at hospitals or care centers. However, the frequency of behaviors used to help smokers quit among Chinese nursing internship students is unclear. This study analyzed the rate of nurse interns' performance of the 5As and which demographic characteristics, perceptions of smoking and knowledge predicted higher performance of the 5As. Methods: The cluster sampling method was used to select 13 teaching hospitals among 29. All nursing intern students were expected to finish the questionnaire about their 5As behaviors to help patients quit smoking. Their 5As performances were scored from one to five with 5 being the best and scores were summed. A multivariate linear mixed-effect model was employed to test the differences between their 5As. Results: Participating in the survey were 1358 interns (62.4% response rate). The average scores were as follows-Ask-3.15, Advise-2.75, Assess-2.67, Assist-2.58 and Arrange-2.42. A total of 56.3% students perceived that medical staff should perform the 5As routinely to help patients quit smoking. On the other hand, 52.1% viewed clinical preceptors as role models of the 5As. School education regarding tobacco control, smoking dependence treatment, self-efficacy and positive intentions were predictors of higher performance of the 5As (p < 0.001). Conclusions: Nursing internship students seldom administered tobacco dependence treatments to patients. It is essential to improve the corresponding education, skills and self-efficacy of the 5As. Meanwhile, clinical preceptors should procure more training in the responsibilities and skills related to tobacco cessation. In this way, clinical preceptors can be role models of the 5As and impart positive influences on interns.

Effects of Goal-Framed Messages on Mental Health Education Among Medical University Students: Moderating Role of Personal Involvement.

Mental health problem among university students is an emerging public health issue, and mental health education has always been the focus of attention for universities. However, limited attention has been paid to the effect of students' acceptance of health messages. Previous studies have found that message framing plays a key role in the process of responding to health-promoting messages. In this backdrop, the study aimed to examine the effects of goal-framed messages on mental health education among medical university students and investigate the moderating role of personal involvement. A cross-sectional study was conducted on medical university students. An online self-administered questionnaire was used to collect data. Wilcoxon rank-sum test and ordinal logistic regression were used for data analysis. Results showed significant differences in message acceptance between the gain- and loss-framed groups (p < 0.001). Participants with high personal involvement had higher message acceptance than those with low personal involvement in gain- and loss-framed message models (p < 0.05). Specifically, participants who related to roommates with high intimacy had higher message acceptance than those who related to roommates generally (p < 0.05). Participants who were concerned about their health condition had higher message acceptance than those who were neutral about their health condition (p < 0.001). Evidence of advantages of gain- over loss-framed messages on mental health among medical university students was found. The hypothesis that personal involvement with a health issue affects the acceptance of message framing was supported. Public health advocates can use framed message as a strategy to improve the efficacy of intervention in mental health education.

Personal Involvement Moderates Message Framing Effects on Food Safety Education among Medical University Students in Chongqing, China.

OBJECTIVE: This study explored whether the efficacy of food safety education interventions can be increased by message framing among medical university students, and demonstrated the role of personal involvement within the message recipient in moderating framed effects. METHODS: A cross-sectional study of food safety message framing was conducted among medical university students (randomly selected 1353 participants). An online self-administered questionnaire was used to collect information. Wilcoxon rank-sum test and Ordered multivariate logistic regression were utilised in the data analyses. RESULTS: The present study showed significant differences in acceptance between the gain- and loss-framed groups (p < 0.001). Participants with higher personal involvement had higher acceptance than those with low personal involvement in gain- and loss-framed message models (p < 0.001). The acceptance of participants who were concerned about their health condition was higher than those who were neutral regarding their health condition (p < 0.001) and participants who suffered a food safety incident had higher acceptance than those who did not (p < 0.05). CONCLUSIONS: This study portrayed the selection preference of message framing on food safety education among medical university students in southwest China. Participants exposed to loss-framed messages had higher message acceptance than those exposed to gain-framed messages. Personal involvement may affect the food safety message framing. Public health advocates and professionals can use framed messages as a strategy to enhance intervention efficacy in the process of food safety education.

Long noncoding RNA GAS5 regulates the proliferation, migration, and invasion of glioma cells by negatively regulating miR-18a-5p.

INTENTION: Long noncoding RNAs, transcribed from a recently discovered class of noncoding genes, may play a critical role in regulating cellular processes, such as cell proliferation and apoptosis, as well as in cancer progression and metastasis. We previously detected the induction of growth arrest-specific 5 (GAS5) during glioma cell death. However, the function and underlying mechanism of GAS5 in human gliomas remain to be elucidated. METHODS: Cell proliferation was detected using CellTiter 96® AQueous Non-Radioactive Cell Proliferation Assay (MTS) and tumorigenicity assay in nude mice. Wound-healing assay and transwell assay were utilized to examine the effects of GAS5 expression on glioma cells migration and invasion. In situ hybridization (ISH) was performed to evaluate GAS5 and microRNA (miR)-18a-5p levels in tissue microarrays. The relationship between GAS5 and miR-18a-5p was evaluated by quantitative reverse-transcription polymerase chain reaction and RNA precipitation. RESULTS: In this study, we demonstrated that overexpression of GAS5 inhibits malignant phenotypes in glioma cells, including proliferation, migration, and invasion, whereas GAS5 knockdown enhances these phenotypes. We further observed Argonaute 2-dependent reciprocal repression between GAS5 and miR-18a-5p in glioma cells. Downregulation of GAS5 and upregulation of miR-18a-5p were observed in glioma tissue microarrays relative to normal brain tissue by ISH. By deletion analysis, we identified one miR-18a-5p-binding site within exon 2 of GAS5 that is partially responsible for the tumor-suppressor functions of GAS5. CONCLUSION: Taken together, our findings suggest that GAS5 is a tumor suppressor in human gliomas that acts in part by repressing miR-18a-5p.

Associations of sleep duration and prediabetes prevalence in a middle-aged and elderly Chinese population with regard to age and hypertension: The China Health and Retirement Longitudinal Study baseline survey.

BACKGROUND: The aim of the present study was to examine the age-specific associations between self-reported sleep duration and prevalent prediabetes in middle-aged and elderly Chinese with or without hypertension. METHODS: In all, 2985 Chinese adults aged ≥45 years from the China Health and Retirement Longitudinal Study (CHARLS) baseline survey were selected for analysis. Sleep duration was assessed by structured questionnaires and then categorized into three groups (≤6, 6-8, and >8 h). The prevalence of prediabetes was defined using fasting plasma glucose (100-125 mg/dL) and/or HbA1c (5.7%-6.4%) in conjunction with no previous diabetes diagnosis and no antidiabetic medication. Relationships between self-reported sleep duration and prevalent prediabetes were examined according to age (45-60 years, middle-aged; ≥60 years, elderly) and hypertension groups using Poisson regression models to estimate prevalence ratios (PRs) and 95% confidence intervals (CI). RESULTS: Compared with the reference group of 6-8 h sleep/night, short sleep (≤6 h/night) was associated with an increased risk of prediabetes in the whole sample (PR 1.09, 95% CI 1.01-1.17) after adjusting for confounders. This association was more pronounced in elderly participants without hypertension (PR 1.27, 95% CI 1.07-1.51). CONCLUSION: This study suggests that participants with a short sleep period are at a moderately increased risk of prediabetes, particularly in elderly subjects without hypertension. Aging and hypertension may be important in the relationship between short sleep and impaired glucose metabolism.

Prevalence and risk factors of fatty liver disease in young and middle-aged population: one center study in Southwestern China.

BACKGROUND AND AIM: Fatty liver disease has become common hepatic disease not only in western countries but also in developing countries in Asia-Pacific area. Our aim was to determine the prevalence and risk factors of fatty liver disease as well as its correlation with metabolic syndrome in young and middle-aged population. METHODS: Data were collected from check-up center at the 1st Affiliated Hospital of Chongqing Medical University in 2011. Relationships of fatty liver disease and age, body mass index, and metabolic syndrome were determined. Logistic regression was performed to identify the risk factors for fatty liver disease. RESULTS: Data of 18 676 subjects (mean age 40.55 ± 9.94 ranging from 18 to 59) were analyzed. The prevalence of fatty liver disease was 22.0% and increased along with age, body mass index, and the presence and severity of metabolic syndrome. In logistic regression, living area was significantly associated with fatty liver in total population. Male, overweight and obese, waist-to-height ratio ≥ 0.5, hypertension, hypercholesterolemia, high triglyceride, low high-density lipoprotein cholesterol, and fasting plasma glucose ≥ 7.0 mmol/L were common independent risk factors for fatty liver disease in urban and rural areas. Older age and white blood cell over 5.5 ×10(9) /L were related to fatty liver disease in urban area. Obesity was the most important factors in both areas. CONCLUSION: Fatty liver disease was prevalent in young and middle-aged population and mainly associated to multiple metabolic disorders.

Narrow band imaging diagnosis of bladder cancer: systematic review and meta-analysis.

UNLABELLED: What's known on the subject? and What does the study add? In recent years, more attention has focused on the role of narrow band imaging (NBI) in bladder cancer detection and NBI technology has spread rapidly. It is an important method for diagnosing new or recurrent bladder cancer. But its diagnostic accuracy is still uncertain. This paper summarizes the diagnostic accuracy of NBI in bladder cancer and compares NBI with white light imaging. The results show that NBI cystoscopy significantly improves the detection accuracy in bladder cancer, compared with white light imaging. However, some limitations still exist. Multicentre randomized studies are recommended to determine whether the visual advantages of NBI can translate into real therapeutic benefit for individual patients. OBJECTIVE: • To assess the test performance and clinical effectiveness of narrow band imaging (NBI) cystoscopy compared with white light imaging (WLI) cystoscopy in people suspected of new or recurrent bladder cancer. METHODS: • Literature on NBI cystoscopy in the diagnosis of bladder cancer was searched in PubMed, EMBASE, Cochrane Library, MEDLINE and CNKI, with hand searching of relevant congress abstracts and journals. • The literature was selected according to inclusion and exclusion criteria. The Meta-DiSc1.4 software was used to review management and analysis. RESULTS: • Eight studies including 1022 patients assessed test performance. • On a per-person analysis, the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio of NBI and WLI were respectively 0.943 (95% CI 0.914-0.964) and 0.848 (95% CI 0.803-0.885), 0.847 (95% CI 0.812-0.878) and 0.870 (95% CI 0.831-0.903), 7.038 (95% CI 3.357-14.754) and 6.938 (95% CI 2.052-23.465), 0.054 (95% CI 0.012-0.237) and 0.181 (95% CI 0.091-0.361), and 185.32 (95% CI 45.714-751.26) and 42.931 (95% CI 8.088-227.88). • The area under the curve and Q* of NBI and WLI were respectively 0.9781 and 0.8944, and 0.9337 and 0.8253. • For the characterization of carcinoma in situ, the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio of NBI were 0.927 (95% CI 0.878-0.960), 0.768 (95% CI 0.730-0.802), 4.545 (95% CI 2.820-7.325), 0.125 (95% CI 0.051-0.304) and 48.884 (95% CI 15.642-152.77) on a per-person analysis. • The area under the curve and Q* were 0.9391 and 0.8763. CONCLUSION: • NBI is an effective method for the identification of abnormal lesions including carcinoma in situ and can provide higher diagnostic precision of bladder cancer than WLI.