ObjectiveTo systematically review the diagnostic value of contrast transthoracic echocardiography (C-TTE) and contrast transcranial Doppler bubble test (C-TCD) for patent foramen ovale (PFO). MethodsComputer searches were conducted in PubMed, Embase, Web of Science, CNKI, WanFang Data, and CBM databases to collect studies on the diagnostic value of C-TTE and C-TCD for PFO. The retrieval time limit was from the establishment of the databases to September 30, 2024. Two ultrasound diagnostic physicians independently screened the literature, extracted data, and evaluated the risk of bias in the included studies using the QUADAS-2 and QUADAS-C tools. Then, Meta-analysis was performed using Meta-DiSc version 1.4 software and R 4.4.3. ResultsA total of 22 studies including 2 487 patients were included. The results of the meta-analysis showed that for C-TCD in diagnosing PFO, the sensitivity (SEN), specificity (SPE), positive likelihood ratio (+LR), negative likelihood ratio (–LR), and diagnostic odds ratio (DOR) were (0.86, 95% CI 0.81 to 0.90), ( 0.85, 95% CI 0.78 to 0.91), (5.80, 95% CI 3.80 to 9.50), (0.17, 95% CI 0.12 to 0.23), and (34, 95% CI 18.00 to 68.00) respectively; for C - TTE in diagnosing PFO, the SEN, SPE, +LR, –LR, and DOR were (0.81, 95% CI 0.74 to 0.86), (0.92, 95% CI 0.87 to 0.96), (10.2, 95% CI 6.10 to 19.20), (0.21, 95% CI 0.15 to 0.28), and (50, 95% CI 26.00 to 101.00) respectively. The areas under the summary receiver - operating characteristic (SROC) curves (AUC) of C-TCD and C-TTE for diagnosing PFO were 0.90 and 0.85 respectively. ConclusionBoth C-TCD and C-TTE have good sensitivity and specificity in the diagnosis of PFO and can be used as powerful tools for the examination of right-to-left shunt in PFO. However, C-TCD has slightly higher sensitivity and slightly lower specificity than C-TTE. Limited by the number and quality of the included studies, the above conclusions need to be verified by more studies.
Objective To collect and analyze the qualitative studies on patients’ compliance with hypertension management in the community, and to summarize the factors influencing the compliance from the view of patients. Methods Eleven electronic databases and search strategies and words were determined through discussion by experts and the review group. After the selection and critical appraisal of the retrieved studies were performed by two reviewers independently, meta-summary was employed for the results of qualitative studies. Results Five studies were included. The results showed some factors had great impact on the compliance of patients, including patients’ knowledge of hypertension and its treatment, doctor-patient relationship, patients’ financial status, social support, designing of treatment plans, and patients’ individual conditions. Conclusion To improve doctors’ technical competence, building good doctor-patient relationship, strengthening patients’ individualized health education, formulating the proper treatment plan, and making good use of the social support system would promote the compliance with hypertension management in the community.
Abnormal uterine bleeding with ovulatory dysfunction (AUB-O) is a common reproductive endocrine disease with complex and variable clinical manifestations. This disease has a long course and large individual differences. Difficulties in diagnosis and treatment and nonstandardized management are common in primary hospitals. In order to improve the diagnosis and treatment efficiency of AUB-O in primary hospitals, the gynecological endocrinologists in western China proposed this primary diagnosis and treatment norms and referral recommendations for gynecological outpatient clinics in primary hospitals, including the key points of diagnosis, hemostasis and cycle adjustment strategies, adjuvant treatment, and the principle of two-way referral. In particular, individualized treatment recommendations were proposed for young adolescents and menopausal transition patients. This recommendations are expected to serve as an important reference for AUB-O diagnosis, treatment and two-way referral of primary hospitals in western China.
