Objective To give an individualized treatment to a young woman with primary dysmenorrhea. Methods According to the basic principle and methods of evidence-base medicine, we searched The Cochrane Library (Issue 1, 2009), MEDLINE (PubMed, January 1950 to May 2009), ACP Journal Club (OVID, January 1991 to May 2007) for systematic reviews and randomized controlled trials (RCTs) to acquire the best clinical evidence on the treatment of primary dysmenorrhea. Results A total of 11 systematic reviews and 1 RCT were identified. A reasonable treatment plan was made through combining the patient’s will with her family members’. Conclusion The treatment effect on primary dysmenorrhea of the young woman is improved by an individualized treatment plan based on an evidence-based method.
Objective To investigate the current status of randomized controlled trials (RCTs) and clinical controlled trials (CCTs) on pressure sore in China. Methods We searched Chinese Journal of Nursing, Chinese Journal of Practical Nursing and Journal of Nurses Training in CNKI and VIP (January 2000 to December 2005) for Chinese articles on pressure sore, using "pressure sore", "bed sore", "nursing", "treatment", "prevention", "evaluation" and "management" as search terms. The retrieved articles were summarized. Results We identified 16 reports (10 RCTs and 6 CCTs). The studies were judged to be of low quality.There was one study on the evaluation, two on the prevention, and 13 on the treatment of pressure sores. Conclusion The current studies on pressure sore in China are focusing on treatment. Randomized controlled trials of large sample size of pressure sore are needed to improve nursing quality.
We searched The Cochrane Library（Issue 3, 2005）, MEDLINE（1996-2005） ,CMCC（1996-2005）, VIP（1996-2005） ,CNKI（1996-2005） to summarize the available evidence of topiramate for an intractable epilepsy. After scanning all these articles, we identified 11 articles including meta-analysis, randomised controlled trials and systematic reviews to evaluate. Topiramate offered an alternative in the treament for intractable epilepsy, especially for partial epilepsy, and its efficacy was proven. Patients had good tolerance. And no intercross effects with the traditional anti-epileptic drugs were found. So topiramate had broad clinical value. The primary dosage of topiramate was 200mg/d. The sustaining dosage was 400-600mg/d. And we didn＇t recommend the dosage of more than 600mg/d.
Objective To define an evidence-based conclusion concerning ultrasound screening for fetal genital system malformations during pregnancy. Methods In order to assess whether or not ultrasound screening for fetal genital system malformations is effective and feasible, we searched The Cochrane Library (Issue 3, 2009), MEDLINE (1981 to 2009), ACP Journal Club (1991 to 2008), and BMJ Clinical Evidence (1999 to 2008) for systematic reviews, randomized controlled trials (RCTs), cohort studies, and controlled clinical trials. Results Five cohort studies and three crosssectional studies were retrieved. The results showed ultrasound screening detected fetal sex determination by the contour of the rump and the angle of the genital tubercle to a horizontal line through the lumbosacral skin surface in the first trimester. Scrotal size and penile length increases with gestational age for male fetuses, and by 32 weeks, bilateral testicular descent was observed in most cases. Ultrasonographic scans, fetal genetic studies, and hormonal assays of amniotic fluid can diagnosis certain diseases, fetal sex differentiation disorders, fetal endocrinal disorders, and chromosome abnormality. Conclusion The findings of this study should reassure physicians and parents alike that ultrasound screening is an reliable option for the prenatal diagnosis of fetal genital system malformations, but more randomized controlled trials are needed to further supply relevant evidence.
Evidence-based dentistry has been established for more than a decade, and described as ‘the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients＇. However, Orthodontic clinicians in China still tend to base their treatment protocols on the ‘it works in my hands＇evidence provided by their peers, mainly due to their weak experience in searching and applying clinical evidences. In this article, authors are willing to share their experience with their Chinese peers, and to promote the dissemination and application of evidence-based orthodontics in clinical practice.
This paper introduces the process of design and implementation on the clinical evidence database of acupuncture (ACU-CED), including establishing expert groups on the basis of demands to formulate top-design, project implementation plans and standard, comprehensively searching publications of clinical randomized controlled trials (RCTs) of acupuncture and moxibustion, conducting strictly data extraction and evaluation, and eventually achieve automatic utilization of clinical evidence. ACU-CED will become the first structural data platform with the function of searching-screening-result, analysis-data, and statistics-evidence extraction, which fills in gapes in database of clinical evidence sources, increases efficiency of evidence transformation, and reduces waste of resources. It will also achieve auto-completion of systematic review/meta-analysis as well as visualization of clinical evidence, so as to provide evidence for clinical decision, guidelines and disease spectrum of acupuncture therapy.
Objective To search evidence of angiotensin-converting-enzyme inhibitors for microalbumin-uria in type 2 diabetes for guiding clinical practice. Methods We searched MEDLINE （ 1970 -Jun. 2005 ） to identify randomized controlled trials （RCT）of the effect on angiotensin-converting-enzyme inhibitors to prevent microalbuminuria in type 2 diabetes. Results One RCT （n =1 204）was identified. The result showed that angiotensin-converting-enzyme inhibitors were significantly more effective in prevention of microalbuminuria than other medicines in type 2 diabetes. However, angiotensin-converting-enzyme inhibitors may increase the risk of cardiac mortality. We explained the evidence to patients and they were satisfied with our explanation. Conclusions Angiotensin-converting-enzyme inhibitors can decrease the incidence of microalbuminuria in patients with type 2 diabetes and hypertension.
Objective To evaluate the effect of vitamin A (Vit A) supplementation on the morbidity and mortality in children with infectious diseases. Methods We searched Cochrane Library (Issue 1, 2004), MEDLINE (1966-2004.3) and The PedsCCM Evidence-Based Journal Club (1992-2002). Relevant systematic reviews and randomized controlled trials (RCTs) of Vit A supplementation on morbidity and mortality in children with infectious diseases were obtained. Results We collected 107 studies and identified 13 systematic reviews or RCTs. The evidence showed that the effect of Vit A supplementation on morbidity and mortality was affected by the nutritional status of the children. Vit A supplementation given to Vit A deficient children could reduce the morbidity of diarrhea and mortality of measles. However, Vit A supplementation would increase the morbidity of diarrhoea and respiratory infections in children with sufficient nutrition. Conclusions The nutritional status of children correlates with morbidity and mortality of some infectious diseases, and the nutritional status and serum Vit A level should be evaluated before Vit A supplementation applied.
