ObjectiveTo systematically review the efficacy and safety of cisplatin combined with etoposide versus other platinum combined with etoposide in the treatment of small cell lung cancer (SCLC).
MethodsWe searched PubMed, The Cochrane Library (Issue 8, 2013), MEDLINE (Ovid), CNKI, VIP and WanFang Data to collect randomized controlled trials (RCTs) concerning the efficacy and safety of cisplatin combined with etoposide (the cisplatin group) versus other platinum combined with etoposide (the control group) for SCLC. The search was up to August 2013. Two reviewers screened literatures according to the inclusion and exclusion criteria, extracted data and assessed the methodological quality of included studies. And then, meta-analysis was performed by using RevMan 5.2 software.
ResultsA total of 6 RCTs involving 684 patients were included. The results of meta-analysis showed that there were no significant differences in disease control rate (DCR) (RR=1.03, 95%CI 0.91 to 1.17, P=0.63), overall response rate (ORR) (RR=1.04, 95%CI 0.97 to 1.11, P=0.33), occurrence of leukocytopenia (RR=0.97, 95%CI 0.81 to 1.17, P=0.77), decreased hemoglobin (RR=0.89, 95%CI 0.61 to 1.31, P=0.56) between the cisplatin group and the control group. Occurrence of thrombocytopenia was lower (RR=0.49, 95%CI 0.38 to 0.63, P<0.000 01) while occurrence of nausea and vomiting was higher (RR=1.80, 95%CI 1.40 to 2.31, P<0.000 01) in the cisplatin group.
ConclusionCurrent evidence shows that the clinical efficacy of cisplatin combined with etoposide for SCLC is equal to other platinum combined with etoposide, but it has a certain advantage in decreasing the aggregative rate of platelets, while the gastrointesnial reaction patients should avoid using cisplatin combined with etoposide.
Ciliary body tumor is a rare intraocular tumor. Due to its unique anatomical location, its correct diagnosis and reasonable treatment are very difficult problems. In terms of diagnosis and differential diagnosis, ophthalmologists need to fully utilize the role of slit lamp microscope and transillumination experiment to capture secondary changes in the anterior segment caused by hidden ciliary body tumors, such as monocular localized cataract, lens indentation, and pigment dissemination, etc. Ophthalmological imaging methods, especially ultrasound biomicroscopy, can achieve the purpose of early detection and early diagnosis. According to the size, location and morphological characteristics of the tumor, a reasonable treatment plan is formulated. Since ciliary body tumors are mostly benign, the recurrence rate of local resection is low, which can satisfy the pathological diagnosis and preserve part of the patient's vision. Therefore, eye-preserving treatment should be advocated. However, enucleation remains the treatment of choice for tumors that are too large to be treated with local excision or radiation, eyes with refractory glaucoma, and tumors that do not respond to radiation therapy.
ObjectiveTo investigate effects of vitamin K2 in combination with 5-fluorouracil (5-FU) on proliferation, migration, and invasiveness of hepatocellular carcinoma cells in vitro.
MethodsHuman hepatocellular carcinoma PLC/RAF/5 cells were cultured in vitro and exposed to vitamin K2 (10 μmol/L) and 5-FU (10 μg/mL) alone or in combination for 24 h. The cell proliferation, migration, and invasiveness were measured by CCK-8 assay, wound-scratch assay, and Matrigel invasion chamber assay, respectively.
ResultsThe abilities of proliferation, migration, and invasion of PLC/RAF/5 cells were significantly decreased after either alone vitamin K2 or 5-FU treatment (all P<0.05) as compared with the control cells, and above effects were further enhanced by the vitamin K2 in combination with 5-FU treatment as compared with either alone drug treatment (all P<0.05).
ConclusionCombination use of vitamin K2 and 5-FU might be an effective method for inhibiting growth, migration, and invasiveness of hepatocellular carcinoma cells.
Objective ① To document the way in which allocation concealment is described and coded for studies included in Cochrane Reviews.②To feed back any gaps or miscodings to individual review groups.③ To suggest changes and expansions to advice on how to code and describe allocation concealment methods.Methods The coding and description of methods of allocation concealment for studies included in all 1 596 reviews on issue 1, 2003 of The Cochrane Library are being extracted.So far results are available for 10.8% (173/1 596) of reviews containing 1 844 studies, from 10 Collaborative Review Groups (CRGs).Discrepancies, and inconsistencies with the Cochrane Reviewers’ Handbook, are being documented and analysed.Results The current coding of the adequacy of allocation concealment in studies included in Cochrane reviews is not likely to be very accurate.This is due to failure to describe methods of allocation concealment (38.6% of the sample of 1 844 studies) as well as miscoding (at least an additional 9.2%).The most common method for studies coded A was some variation of envelope use (133/675-19.7% of all A codes). The most common "method" for studies coded B was method unclear or not described in the report of the study (426/665, 64% of all B codes).Conclusions Since adequate allocation concealment is so important in protecting against bias in randomised controlled trials, it needs to be accurately coded and described.We need to improve how this is done for studies included in Cochrane Reviews.Since over half the studies coded as D were likely to have been where reviewers omitted to enter a code, the default should be changed from D to "code not supplied".Structural changes to RevMan are suggested-ideally the addition of a separate new study quality assessment table with fixed headings as well as the facility to enter free text.Suggestions for improving coding in particular reviews will be fed back to CRGs in the next stages of this project.Suggestions for additions to the Cochrane Reviewers’ Handbook are also made.
Background AIDS (acquired immune deficiency syndrome) has become the most devastating disease which humankind has ever encountered. Human immune-deficiency virus (HIV) is transmitted through blood, sexual behavior and mother-to-baby, with more efficient transmission through blood transfusion. HIV risk among blood transfusion was severe due to lack of effective and correctly applied screening method and rigorous management, especially in some developing countries. Since the first HIV screening reagent was approved by FDA to screen the blood in 1985, the fourth generation test has been produced till now. Initially, HIV test was primarily used to screen the blood supply, it also became an important aspect of HIV prevention, especially screening among people donating blood. Today, HIV testing is seen as an integral part of both the nation’s prevention and treatment efforts. Objective To assess the effectiveness of any intervention tests for HIV screening among people donating blood, and find appropriate tests for HIV screening to decrease the risk of HIV transmission by blood transfusion. Search strategy MEDLINE, Cochrane Controlled Trials Register (CENTRAL/CCTR), AIDSLINE, EMBASE, CBM were be searched with the terms: "HIV", "AIDS", "screening", "test", "blood donor", "blood bank" and the detailed screening method. The websites of WHO, UNAIDS, CDC, FDA, and their related links were searched. Letters were mailed to various agencies and experts in this field to acquire unpublished reports. Inclusion criteria RCT and CCT for screening HIV among blood. donors will be included. Observational studies such as cohort studies, cased-control studies, and historical controlled studies will be used for sensitivity analysis. Method of the review According to the principles of Cochrane Review, selection of trials for inclusion, quality assessment of studies, data extraction and syntheses were conducted by reviewers.
ObjectiveTo summarize current widely-used therapies for cutaneous neurofibroma (cNF) and related research progress. MethodsBased on extensive investigation of domestic and foreign research, the existing treatment of cNF, including the indications, effectiveness and trials of targeted drugs were reviewed. ResultscNF is a hallmark feature of neurofibromatosis type 1 and has a dramatic negative impact on patient appearance and quality of life. At present, there is no standard management of cNF. Invasive treatment is a commonly-used treatment. Surgical removal gives excellent cosmetic results, but it is difficult for multiple tumors; CO2 laser ablation, laser photocoagulation, electro-drying, and radiofrequency ablation are effective in treating lots of cNF at one time. Although fast and effective, these therapies can lead to depigmentation, hyperpigmentation, or extensive scarring. There is no targeted drug approval for cNF, and a series of studies have been carried out on the Ras-MEK pathway, Ras-mTOR pathway, receptor tyrosine kinase, et al. ConclusionThe treatment of cNF has developed rapidly in recent years and has broad prospects, but the individualization and precision of the treatment still needs further clinical research.
Objective To assess the improvement of different resistance training regimens on blood lipid metabolism and insulin resistance in patients with type 2 diabetes mellitus (T2DM). Methods PubMed, ProQuest, Embase, Web of Science, China National Knowledge Infrastructure, Wanfang, and VIP databases were searched to collect randomized controlled trials of resistance training intervention to improve blood lipids and insulin resistance in patients with T2DM. The search time range was from the establishment of the databases to May 2023. Two reviewers assessed the risk of bias of the included studies using the Physiotherapy Evidence Database scale, and performed a network meta-analysis of the extracted data using Stata 16.0 software. Results In the end, 24 articles were included, and a total of 983 participants were enrolled. The result of network meta-analysis showed that high-frequency and moderate-intensity resistance exercise significantly improved the levels of insulin resistance [standardized mean difference=?1.71, 95% confidence interval (CI) (?2.75, ?0.67)], triglycerides [weighted mean difference (WMD)=?0.27 mmol/L, 95%CI (?0.51, ?0.04) mmol/L], and total cholesterol [WMD=?0.16 mmol/L, 95%CI (?0.20, ?0.12) mmol/L], but had no significant effect on improving the level of high-density lipoprotein [WMD=0.05 mmol/L, 95%CI (?0.02, 0.11) mmol/L] or low-density lipoprotein [WMD=?0.20 mmol/L, 95%CI (?0.42, 0.03) mmol/L]. The results of cumulative probability ranking showed that high-frequency and moderate-intensity resistance exercise was the best in improving insulin resistance, triglycerides, high-density lipoprotein and low-density lipoprotein levels. Conclusion Based on current evidence, high-frequency and moderate-intensity resistance exercise may be the best resistance exercise regimen to improve insulin resistance and lipid metabolism in patients with T2DM.
