ObjectiveTo systematically review the efficacy and safety of early oxygen therapy for patients with acute myocardial infarction (AMI). MethodsWe searched databases including PubMed, EMbase, The Cochrane Library (Issue 11, 2015) and CBM from inception to October 2015, to collect randomized controlled trials (RCTs) about early oxygen therapy for patients with AMI. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed by using RevMan 5.3 software. ResultsA total of 7 RCTs involving 1 388 patients were included. The results of meta-analysis showed that, there were no significant differences between the oxygen therapy group and the control group in mortality (OR=1.12, 95%CI 0.57 to 2.20, P=0.75), the incidence of major cardiovascular and cerebrovascular events (MACCE) (OR=1.00, 95%CI 0.46 to 2.18, P=1.00), the incidence of arrhythmia (OR=1.01, 95%CI 0.45 to 2.24, P=0.98) and the incidence of cardiac death (OR=0.53, 95%CI 0.17 to 1.67, P=0.28). But, the oxygen therapy group had higher risk of recurrent myocardial infarction (OR=5.50, 95%CI 1.44 to 20.99, P=0.01) and longer average hospital length of stay (MD=1.28, 95%CI 1.10 to 1.47, P<0.0001). ConclusionThe efficacy of early oxygen therapy for patients with AMI is not clear, even may increase the risk of recurrent myocardial infarction and the average hospital length of stay. Due to the limited quantity and quality of include studies, more high quality studies are needed to verify the above conclusion.
ObjectiveTo systematically review the implant survival and postoperative aesthetics of immediate versus delayed implant treatment in the anterior maxilla regions.MethodsWe searched databases including PubMed, The Cochrane Library, EMbase, CBM, CNKI and WanFang Data from inception to April 2017, to collect randomized controlled trials (RCTs) and cohort studies on immediate implant and delayed implant in the anterior teeth areas. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, RevMan 5.3 software was used to perform meta-analysis.ResultsA total of 4 RCTs and 12 retrospective cohort studies involving 1 316 implants were finally included. The results of meta-analysis showed that: there was no significant difference between two groups in retention rate (RCT: RR=0.99, 95%CI 0.97 to 1.02, P=0.70; retrospective cohort study: RR=0.99, 95%CI 0.96 to 1.02, P=0.54), the implant stability of permanent restoration for 4 months (MD=0.82, 95%CI –0.11 to 1.76, P=0.08), alveolar bone resorption of long-term permanent crown restoration (12 months: RCT: MD=0.06, 95%CI –0.35 to 0.47, P=0.79; retrospective cohort study: MD=–0.27, 95%CI –0.57 to 0.03, P=0.07; 24 months: retrospective cohort study MD=–0.09, 95%CI –0.18 to 0.00, P=0.05), respectively. The immediate implant group was superior to the control group in alveolar bone resorption of short-term permanent crown restoration (3 months: MD=–0.08, 95%CI –0.13 to –0.04, P=0.000 1; 6 months: MD=–0.23, 95%CI –0.38 to –0.07, P=0.004). The PES score in the immediate implant group was higher than that in the delayed implant group(MD=1.12, 95%CI 0.11 to 2.13, P=0.03).ConclusionsCurrent evidence shows that both immediate and delayed implant procedures have similar outcomes in terms of implant retention, long-term stability and long-term alveolar bone resorption of the implants in the anterior maxilla regions, but the former procedure possesses better short-term reduction of alveolar bone absorption and postoperative gingival aesthetics. Furthermore, due to the limited quality and quantity of the included studies, more large-scale and high-quality studies are needed to verify the above conclusions.
ObjectiveTo systematically review the efficacy and safety of Heluo Shugan capsule in the treatment of hepatitis B fibrosis. MethodWe searched PubMed, The Cochrane Library (Issue 8, 2015), CBM, CNKI, VIP and WanFang Data from their inception to August 2015, to collect randomized controlled trials (RCTs) on Heluo Shugan capsule for hepatitis B fibrosis. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was performed using RevMan 5.3 software. ResultsA total of 15 RCTs involving 1 840 patients were included. The results of meta-analysis showed that: (1) As for reduced level of serum hyaluronic acid (HA), Heluo Shugan capsule was superior to placebo (MD=82.31, 95%CI 37.44 to 127.19, P=0.000 3), but worse than Fuzheng Huayu capsule (MD=-137.45, 95% CI-196.29 to-78.62, P < 0.000 01), Fufang Biejia Ruangan tablet (MD=-51.19, 95% CI-67.58 to-34.81, P < 0.000 01) and Anti-fibrosis decoction (MD=-82.13, 95% CI-102.37 to-61.88, P < 0.000 01). (2) As for reduced level of serum laminin (LN), Heluo Shugan capsule was superior to placebo (MD=36.83, 95% CI 11.84 to 61.82, P=0.004), but worse than Fufang Biejia Ruangan tablet (MD=-36.00, 95% CI-64.29 to-7.71, P=0.01), Ganfujian capsule (MD=-22.14, 95% CI-37.28 to-7.00, P=0.004) and Anti-fibrosis decoction (MD=-38.64, 95% CI-75.00 to-2.29, P=0.04). (3) As for reduced level of serum procollagen type III peptide (PCIII), Heluo Shugan capsule was superior to placebo (MD=47.17, 95% CI 32.68 to 61.66, P < 0.000 01), but worse than Fuzheng Huayu capsule (MD=-4.80, 95% CI-9.08 to-0.51, P=0.03), Dahuang Zhechong pills (MD=-53.77, 95% CI-105.01 to-2.53, P=0.04), Ganfujian capsule (MD=-46.82, 95% CI-66.30 to-27.34, P < 0.000 01) and Anti-fibrosis decoction (MD=-28.68, 95% CI-55.59 to-1.77, P=0.04). (4) As for reduced level of serum type-IV-collagen (IV-C), Heluo Shugan capsule was superior to placebo (MD=72.77, 95% CI 47.65 to 97.89, P < 0.000 01), but worse than Fuzheng Huayu capsule (MD=-34.69, 95% CI-56.65 to-12.73, P=0.002), Dahuang Zhechong pills (MD=-21.26, 95%CI-38.79 to-3.73, P=0.02), Fufang Biejia Ruangan tablet (MD=-69.04, 95%CI-124.38 to-13.69, P=0.01), Ganfujian capsule (MD=-19.84, 95% CI-37.41 to-2.27, P=0.03) and Anti-fibrosis decoction (MD=-37.98, 95% CI-72.99 to-2.96, P=0.03). ConclusionCurrent evidence shows that, Heluo Shugan capsule was superior to placebo, but worse than Fufang Biejia Ruangan tablet, Fuzheng Huayu capsule, Dahuang Zhechong pills, Ganfujian capsule and Anti-fibrosis decoction in reducing the level of serum hepatic fibrosis. Due to the limited quantity and quality of included studies, more high-quality, large-scale RCTs are need to verify the above conclusion.
Objective To systematically review the effect of different nutrient interventions on the physical function of elderly people with frailty through network meta-analysis. Methods The PubMed, Cochrane Library, EMbase and Web of Science were electronically searched to collect randomized controlled trials of different nutrient interventions on physical function of the elderly with frailty, from database inception to June 30, 2022. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Network meta-analysis was then performed using ADDIS 1.16.8, GeMTC 14.3, and Stata 15.0 software. Results A total of 13 studies involving 1 144 patients were included. There was no statistically significant difference in handgrip strength, time up to go test, gait speed, and short physical performance battery (SPPB) among different nutrient interventions. Significant differences were not found in vitamin D+ whey protein (VDWP) vs. placebo and Leu vs. placebo in handgrip strength, or VDWP vs. placebo in SPPB. The probability ranking diagram showed that the most effective of handgrip strength, time up to go test, gait speed, and SPPB were milk protein concentrate (MPC80), L-carnitime (L-Car), leucine (Leu), and MPC80, respectively. Conclusion The current evidence suggests that nutritional intervention did not significantly improve physical function in the frail elderly. MPC80, Leu, L-Car, and VDVEWP may play a role in improving the physical function of frail elderly people. Nutritional support programs that increase the above nutrients, combined with exercise training may become a better way to improve the physical function of frail elderly.
ObjectiveTo systematically review the association between 5α-reductase inhibitors (5ARIs) and risk of sexual dysfunction in subjects with benign prostatic hyperplasia (BPH).MethodsPubMed, Web of Science, The Cochrane Library, EMbase, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect studies on the association between 5ARIs and risk of sexual dysfunction in subjects with BPH from inception to October 2020. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Meta-analysis was then performed by using Stata 12.0 software.ResultsA total of 15 studies involving 17 774 subjects were included. The results of the meta-analysis showed that compared with the placebo group, 5ARIs could significantly increase risk of erectile dysfunction (RR=1.52, 95%CI 1.36 to 1.69, P<0.000 1), while decrease libido (RR=1.79, 95%CI 1.37 to 2.32, P<0.000 1) and ejaculation disorder (RR=2.97, 95%CI 1.82 to 4.83, P<0.000 1) in subjects with BPH. Subgroup analysis of the type of 5ARIs, intervention period, publication year and sample size showed that the 5ARIs had a higher risk of sexual dysfunction than the placebo group.ConclusionsCurrent evidence shows that 5ARIs can increase risk of erectile dysfunction, decrease libido and ejaculation disorder in subjects with BPH. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusions.
Objective To determine the efficacy and complication rate of intramedullary nailing versus compression plate in the treatment of adult humeral shaft fracture. Methods We searched the specialized trials register of The Cochrane Collaboration’s Bone, Joint and Muscle Trauma Group, The Cochrane Library (including CENTRAL), MEDLINE (1966 to 2006), EMbase (1980 to 2006), PubMed (1966 to 2006), NRR , CCT and CBMdisc (1979 to July 2006). We also handsearched some Chinese orthopedic journals. Data were extracted and evaluated by two reviewers independently. Randomize controlled trials comparing intramedullary nailing versus compression plate for humeral shaft fracture in adults were included and the quality of these trials was critically assessed. Data analyses were done using The Cochrane Collaboration’s RevMan 4.2.8. Results Three randomize controlled trials involving 215 patients were included. The meta-analysis showed that intramedullary nailing may increase the re-operation rate (OR=2.68, 95%CI 1.19 to 6.04, P=0.02), pain in the shoulder (OR=13.02, 95%CI 2.23 to 75.95, P=0.004), and the rate of decreased range of motion of the shoulder (OR=18.60, 95%CI 1.01 to 341.83, P=0.05). The rates of no union, infection and iatrogenic radial nerve injury were comparable between intramedullary nailing and compression plate. Meta-analysis was not conducted for the time of union, because the relevant data were not available for the included trials. Conclusions Further well-designed and large-scale randomize controlled trials are required to determine the effects of intramedullary nailing and compression plate on these outcomes, because the trials available for this systematic review are too few and too small.
Objective To evaluate the efficacy and safety of L-ornithine-L-aspartate (LOLA) in the treatment of hepatic encephalopathy (HE). Methods Such databases as PubMed, EMbase, Web of Science, CENTRAL, Chinese Journals Full-text Database, CBM and WanFang Data were searched from the date of their establishment to November 30, 2011 to collect the randomized controlled trials (RCTs) on LOLA in treating HE. The quality of included studies was evaluated by two reviewers independently, data were extracted and cross-checked, and then meta-analysis was performed using Review Manager 5.0 software. Results Among the total six included RCTs, 432 patients were diagnosed as type-C HE and 185 were diagnosed as type-A HE. Compared with the placebo group, for the patients with type-C HE, LOLA could significantly reduce the serum ammonia level (WMD=16.60, 95%CI 8.34 to 24.85, Plt;0.000 1) and the time of number connection test-A (NCT-A) (WMD=9.6, 95%CI 5.26 to 13.93, Plt;0.00 01), and it could also effectively improve the clinical remission rate (RR=1.36, 95%CI 1.06 to 1.73, P=0.01). However, no significant differences were found between the two groups for the patients with type-A HE (Pgt;0.05). Conclusion LOLA is effective for the patients with type-C hepatic encephalopathy, and it could be regarded as a choice in clinic. However, more high-quality RCTs are needed to further evaluate the effect of LOLA in treating type-A hepatic encephalopathy.
Objective To assess the effect of atraumatic restorative treatment (ART) on decayed deciduous and permanent teeth in children. Methods Such databases as CENTRAL of The Cochrane Library, MEDLINE, EMbase, CBM, CNKI, and VIP were searched, and the China clinical trial register center were also searched. The search was conducted by the end of April, 2009 to collect the randomized controlled trials (RCTs) of ART vs. conventional restorative treatment (CRT) for childhood caries. The data extraction was performed by two reviewers independently. The quality of the included studies was critically assessed and the data analyses were performed by the Cochrane Collaboration’s RevMan 5.0.2 software. Results A total of seven randomized controlled trials were included. Only was the descriptive analysis conducted because of the difference of restorative materials used in each study, the types of target teeth, the measure indexes, and the year limit of follow up, which showed that, most of the included studies suggested that the survival rate of restorative materials in all types of caries hole was similar between the ART group and the CRT group; only a few studies suggested that the CRT group was superior to the ART group; the children in the ART group felt more comfortable than those in the CRT group during the treatment procedure; two studies compared the working time and got an opposite results. Conclusion Because of the higher clinical heterogeneity of the include studies, the merger analysis fails to be conducted, so it is impossible to get a precise conclusion about the effect of treating childhood caries with ART vs. CRT, and more RCTs with high quality are needed for confirmation.
目的 评估儿科补充与替代医学(Complementary and alternative medicine,CAM)随机对照试验报告的质量,检验报告质量是否随时间而变化.方法 以包含251篇CAM干预的RCT报告作为系统样本,对每一篇报告质量用CONSORT清单的部分项目,如分配隐藏不清楚的比例和5级质量评价来进行评估.结果 有近一半(40%)的CONSORT清单项目在所有RCT报告中列出,且有增多趋势.大多数RCT(81 3%)未清楚报告分配隐藏方案,且多年无改进.报告质量评分约为Jadad评估最高总评分的40%,且多年无改进.仅有约1/4(22%)的RCT报道了不良反应,而关于医疗成本的报道仅占很小比例(4%).结论 RCT是循证卫生保健决策的重要工具.如果这些研究要作为对CAM评估的一部分,那么高质量地实施和报告这些试验就显得十分重要.应加倍努力以确保儿童及其家庭进入实施和报告偏倚最小的RCT.这样的研究可以让利益共享者的范围更宽广,更具使用价值.
ObjectiveTo evaluate the efficacy and safety of piolitazone combined with metformin for type 2 diabetes mellitus. MethodsThe Cochrane Library (Issue 9, 2015), PubMed, EMbase, CNKI, WanFang Data and VIP databases were searched up to September 2015 for randomized controlled trials (RCTs) about pioglitazone combined with metformin versus sulfonylurea combined with metformin for type 2 diabetes mellitus. Two reviewers independently screened literature, extracted date, and assessed the risk of bias of included studies. Then, meta-analysis was performed by using RevMan 5.3 software. ResultsA total of 7 RCTs involving 3 005 patients were included. The results of metaanalysis showed that when the course of treatment was ≤24 weeks, no significant difference was found in the level of HbA1c between the piolitazone plus metformin group and the sulphonylurea plus metformin group (MD=-0.04, 95%CI -0.26 to 0.19, P=0.74), but the piolitazone plus metformin group had lower risk of hypoglycemia (RR=0.39, 95%CI 0.15 to 1.01, P=0.05); when the course of treatment >24 weeks, only one RCT was included, we didn't conduct pool analysis. ConclusionPiolitazone combined with metformin has similar effect to sulphonylurea combined with metformin in controlling blood sugar, but piolitazone combined with metformin has lower incidence of hypoglycemia. Due to limited quality and quantity of the included studies, the above conclusion need to be verified by more high quality studies.