Objective To systematically evaluate the effectiveness and safety of mycophenolate mofetil (MMF) for IgA Nephropathy (IgAN). Methods Databases including CNKI, CBM, MEDLINE, PubMed, The Cochrane Library and SCI were searched from January 1997 to January 2012, and the domestic conference data and relevant published articles were also searched manually. All randomized controlled trials (RCTs) on MMF in treating IgAN were independently collected and screened according to the inclusion and exclusion criteria by two reviewers. The data were extracted, the quality of the included studies was assessed and cross-checked, and then meta-analysis was conducted using RevMan 5.0 software. Results A total of 8 RCTs involving 272 patients with IgAN were included. The results of meta-analyses showed that: a) There were no significant differences in the overall effective rate (RR=0.72, 95%CI 0.21 to 2.52, P=0.61) between the MMF group and the placebo group, but the overall effective rate was higher in the MMF+hormone group than the CTX+hormone group (RR=4.21, 95%CI 1.86 to 9.53, Plt;0.000 1) and other immunosuppressants +hormone groups (RR=3.03, 95%CI 1.47 to 6.25, P=0.003); and b) Adverse reaction: The overall incidence rate of adverse reaction in the MMF+hormone group was lower than the CTX+hormone group (RR=0.16, 95%CI 0.07 to 0.37, Plt;0.000 1). There were no significant differences in the elevated serum creatinine rate (RR=2.28, 95%CI 0.65 to 7.94, P=0.20) and the case number of developing end-stage renal disease (ESRD) (RR=2.37, 95%CI 0.44 to 12.83, P=0.32) between the MMF group and the control group. Conclusion MMF combined with hormone in treating IgAN can increase the overall effective rate and decrease the overall incidence rate of adverse reaction, but its effectiveness of improving long-term survival rate has to be further proved by conducting more high-quality, multi-center and large-scale clinical trials. MMF alone has the same effect as the placebo dose, and it shows no differences in elevated serum creatinine after the treatment compared with conventional therapies.
ObjectivesTo systematically review the prevalence of depression in the elderly in China.MethodsPubMed, Web of Science, CBM, CNKI, WanFang Data and VIP databases were electronically searched to collect cross-sectional studies on the prevalence of depression of Chinese elderly from January 2010 to July 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 22 cross-sectional studies involving 12 656 patients were included. Meta-analysis showed that the overall prevalence of depression in Chinese elderly was 25.55% (95%CI 19.81% to 31.29%). Subgroup analysis showed that the prevalence of females was higher than that of males; the prevalence in the north was higher than that in the south; the prevalence in rural areas was higher than that in cities; the prevalence of CES-D assessment scale was higher than that of GDS-30; the prevalence of depression increased annually of data collection.ConclusionThe prevalence of depression in the elderly (aged 60 years and above) in China is high. More attention should be paid to this situation and more psychological intervention should be provided to the elderly. Due to the limited quantity and quality of the included studies, more high-quality studies are required to verify the above conclusion.
Objective To investigate the value of contrast-enhanced ultrasonography in detection and diagnosis of small primary liver cancer. Methods SonoVue-enhanced ultrasonography were performed on 353 patients with 378 primary liver cancer, less than 3 cm in diameter. Enhancement patterns and enhancement phases of hepatic lesions on contrast-enhanced ultrasonography were analyzed and compared with the results of histopathology. Results In all hepatic tumors, 96.6% （365/378） lesions enhanced in the arterial phase. Among them, 317 (83.9%) tumors enhanced earlier than liver parenchyma and 48 (12.7%) tumors enhanced synchronously with liver parenchyma, and 342 (90.5%) tumors showed early wash-out in the portal and late phases. With regard to the enhancement pattern, 329 (87.0%) tumors presented whole-lesion enhancement, 35 (9.3%) to be mosaic enhancement and 14 (3.7%) to be rim-like enhancement. If taking the whole-lesion enhancement and mosaic enhancement in arterial phase as diagnotic standard for primary liver cancer on contrast-enhanced ultrasonography, the sensitivity was 92.9%(351/378), and if the earlier or synchronous enhancement of the tumor compared with liver parenchyma in arterial phase and the wash-out in portal phase were regarded as the stardand, the sensitivity was 87.3%(330/378). Conclusion Contrast-enhanced ultrasonography could display real-time enhancement patterns as well as the wash-out processes both in hepatic tumors and the liver parenchyma. It might be of clinical value in diagnosis of primary liver cancer based on the hemodynamics of hepatic tumors on contrast-enhanced ultrasonography.
Intervertebral disc degeneration is a multifactorial pathological process which is one of the leading causes of disability worldwide. The main pathological changes of intervertebral disc degeneration are the degradation of extracellular matrix, apoptosis, autophagy, senescence and inflammation. Dysregulation of microRNAs has been implicated in various pathologies, including various degenerative diseases such as disc degeneration. This article reviews the research status of microRNA in degenerative disc pathology, with emphasis on the biological mechanisms and potential therapeutic prospects of microRNA in extracellular matrix degradation, apoptosis, inflammation, and cartilage endplate degeneration.
