ObjectiveTo systematically review the efficacy of convalescent plasma (CP) in the treatment of coronavirus disease 2019 (COVID-19). MethodsPubMed, EMbase, The Cochrane Library, VIP, WanFang Data and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy of CP in the treatment of COVID-19 from inception to September 15th, 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies; then, meta-analysis was performed using RevMan 5.4.1 software. ResultsA total of 16 RCTs involving 15 301 patients were included. The results of meta-analysis showed that CP treatment did not reduce mortality compared with no-placebo (RR=0.99, 95%CI 0.93 to 1.05, P=0.63) or normal saline (RR=1.06, 95%CI 0.60 to 1.86, P=0.84). However, compared with standard plasma, the mortality of CP group was lower (RR=0.59, 95%CI 0.37 to 0.95, P=0.03). In addition, compared with no-placebo or normal saline, CP treatment could not improve the clinical condition at 28-30 days, reduce mortality at early treatment and in patients without invasive mechanical ventilation when randomized. ConclusionCurrent evidence shows that compared with no-placebo or normal saline, CP does not reduce mortality in patients with COVID-19. However, when the disease progresses to the point where standard plasma is required, CP may reduce mortality. In addition, use of CP in patients with early or non-critical COVID-19 failed to reduce mortality. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify the above conclusion.
Objective To systematically evaluate the effectiveness of dasatinib in doses of 140 mg once daily and 70 mg twice daily for chronic myeloid leukemia (CML). Methods The randomized controlled trials (RCTs) were retrieved from Embase (1974 to November 2011), Pubmed (1966 to November 2011), The Cochrane Library (Issue 11, 2011), CBM (1979 to November 2011), VIP (1989 to November 2011), CNKI (1994 to November 2011), Wanfang Data (1997 to November 2011) and references listed in all articles. RCTs meeting inclusive criteria were included, the data were extracted, the quality was evaluated and cross-checked by two reviewers independently according to Cochrane Handbook for Systematic Reviews of Interventions, and then meta-analyses were conducted using RevMan 5.1 software. Results A total of four studies involving two RCTs and 862 patients were included. Results of meta-analyses showed that when dasatinib was used in the long-term treatment of CML, no significant difference was found between 140 mg once daily and 70 mg twice daily in the complete hematologic response (RR=0.97, 95%CI 0.88 to 1.07, P=0.58), complete cytogenetic response (RR=0.94, 95%CI 0.80 to 1.11, P=0.47) and major cytogenetic response (RR=0.99, 95%CI 0.86 to 1.13, P=0.86). In the short-term treatment of CML, there were no significant differences in the complete hematologic response (RR=0.99, 95%CI 0.90 to 1.07, P=0.73), complete cytogenetic response (RR=0.99, 95%CI 0.78 to 1.26, P=0.95) and major cytogenetic response (RR=1.01, 95%CI 0.83 to 1.22, P=0.95). The subgroup analyses on the long-term treatment of CML in both chronic phase and advanced phase showed that there were no significant differences in the complete hematologic response, major cytogenetic response and complete cytogenetic response. Conclusion In the effectiveness of dasatinib for CML, the dose of 140 mg once daily is similar to the dose of 70 mg twice daily. Considering possible moderate selection bias existing in the methodological quality of the included studies which may affect the authenticity of outcomes, this conclusion should be further proved by conducting more high-quality, large-scale and double- blinded RCTs.
Objective To systematically review the association between exposure to bisphenol A during pregnancy and spontaneous abortion. Methods The PubMed, Web of Science, EMbase, CNKI, WanFang Data and VIP databases were electronically searched to identify cohort studies and case-control studies related to bisphenol A exposure and spontaneous abortion from inception to April 1st, 2022. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using Stata 16.0 software. Results A total of 7 case-control studies and 1 cohort study were included, with a total of 1 179 subjects. The results of meta-analysis showed that there was a statistically significant difference in bisphenol A concentrations between the spontaneous abortion group and the control group regardless of whether the sample source was serum or urine (SMD serum=1.05, 95%CI 0.34 to 1.77, P=0.004; SMD urine=0.20, 95%CI 0.02 to 0.38, P=0.027). Conclusion The current evidence shows that exposure to bisphenol A during pregnancy may lead to unexplained recurrent spontaneous abortion. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo systematically evaluate the efficacy of fiberoptic bronchoscopy for patients with stroke-associated pneumonia (SAP).MethodsAll randomized controlled trials on fiberoptic bronchoscopy in treating SAP were collected from Embase, PubMed, Cochrane Library, China National Knowledge Infrastructure, Chinese Biology Medicine database, Wanfang database, and Chongqing VIP database. Two reviewers screened the literature, extracted data, and assessed the methodological quality of included studies. And then meta-analysis was conducted using RevMan 5.3 software.ResultsTwelve studies with 1 107 patients were included. Compared with the routine therapy, the fiberoptic bronchoscopy combined with routine therapy showed a better efficacy [relative risk (RR)=1.26, 95% confidence interval (CI) (1.17, 1.36), P<0.000 01], and indicated a shorter hospital-stay [mean difference (MD)=–4.29 days, 95%CI (–5.06, –3.52) days, P<0.000 01] and lower Clinical Pulmonary Infection Score values [MD=–1.13, 95%CI (–1.77, –0.49), P=0.000 5]. Meanwhile, a downward trend in the level of procalcitonin [standardized mean difference (SMD)=–3.86, 95%CI (–4.22, –3.50), P<0.000 01], tumor necrosis factor α [SMD=–2.75, 95%CI (–3.84, –1.66), P<0.000 01], and C-reactive protein [SMD=–2.55, 95%CI (–3.83, –1.26), P=0.000 1], as well as a higher level of partial pressure of oxygen in arterial blood [MD=15.34 mm Hg (1 mm Hg=0.133 kPa), 95%CI (6.38, 24.31) mm Hg, P=0.000 8] appeared after the combined treatment.ConclusionBased on the conventional therapy, the treatment of fiberoptic bronchoscopy can improve the efficacy, shorten the hospital stay, relieve the systemic inflammatory responses, and improve the oxygenation of SAP patients.
ObjectiveTo systematically evaluate the influencing factors of disaster resilience for medical rescue workers. MethodsPubMed, Cochrane Library, Web of Science, CINAHL, APA PsycInfo, EMbase, Scopus, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect studies on the influencing factors of disaster resilience for medical rescue workers from inception to November 1, 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using Stata 16.0 software. ResultsA total of 36 studies involving 7 974 medical rescue workers were included. The meta-analysis results showed that personal influencing factors, including active coping, rescue confidence, disaster preparedness, knowledge attainment, physical health, and exercise were positively correlated with the disaster resilience of healthcare workers. However, depression, anxiety, stress, and a history of mental illness were negatively related to the disaster resilience of medical rescue workers. Environmental and background factors, including social support, relief supplies, disaster training, economic condition, rescue experience, length of service, and technical title, were positively correlated with the disaster resilience of medical rescue workers. ConclusionCurrent evidence shows that the disaster resilience of medical rescue workers is affected by a variety of personal factors and environmental/background factors. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo investigate the expression and clinical significance of octamer-binding transcription factor 4(Oct-4) in gastric cancer (GC) tissues with meta-analysis.
MethodsPubMed, EMBASE, Web of Science, CBM, VIP, CNKI, and WanFang Database were searched from their establishment to Oct.2012 for related studies, to investigate the relationship between expression of Oct-4 and the clinicopathological characteristics of GC.After evaluating methodo-logical quality of studies that met the inclusion criteria, RevMan 5.1 software was used to data analysis.
ResultsEight studies which enrolled 623 cases of GC were identified.The results of the meta-analysis showed that, as for the positive expression rate of Oct-4, there were significant differences between GC tissues and normal stomach tissues (OR=37.50, 95% CI: 4.76-295.51, P < 0.01), as well as the cell differentiation (OR=0.27, 95% CI: 0.16-0.45, P < 0.01), for that the positive expression rate of Oct-4 in low differentiation of gastric cancer tissues was higher than those of moderate-high differentation group.But there were no significant differences between GC tissues with lymph node metastasis and non-lymph node metastasis (OR=2.09, 95% CI: 0.63-6.94, P=0.23), as well as Ⅰ-Ⅱ stage and Ⅲ-Ⅳ stage (OR=0.62, 95% CI: 0.25-1.54, P=0.30) of GC tissues.
ConclusionsOct-4 may participate in the whole course of carcinogenesis of GC, but the relationship between expression of Oct-4 and lymph node metastasis as well as the TNM stage of GC is unclear, which needs more high quality studies to explore the question clearly.
Objective To systematically review the effectiveness of forced air warming for the maintenance of perioperative core temperature, so as to provide clinical evidence for an appropriate warming plan during the perioperative period. Methods We electronically searched PubMed, The Cochrane Library, EMbase, Web of Science, CBM and CNKI from 2000 to 2012, so as to comprehensively collect randomized controlled trials (RCTs) about the effectiveness of different warming methods for the maintenance of perioperative core temperature (including forced air warming, resistive-heating blanket/electric heating pad, circulating water mattress, and infrared ray radiant heating system) for maintenance of perioperative core temperature. References of the included studies were also retrieved. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data and assessed the quality of the included studies. Then, meta-analysis was performed using RevMan 5.1 software. Results Eleven RCTs involving 577 patients were included. The results of meta-analysis indicated that, in the maintenance of core temperature during the perioperative period, forced air warming was superior to resistive-heating blanket/electric heating pad (SMD= –0.40, 95%CI –0.73 to –0.06), circulating water mattress (SMD= –1.10, 95%CI –1.55 to –0.66), and infrared ray radiant heating system (SMD= –0.69, 95%CI –1.06 to –0.32). In the incidence of hypothermia during the perioperative period, the group of forced air warming was lower than the group of blanket/electric heating pad (RR=1.76, 95%CI 1.15 to 2.69), but it was the same as the group of infrared ray radiant heating system (RR=1.37, 95%CI 0.83 to 2.27). In the incidence of shivering during the perioperative period, the group of forced air warming was the same as the group of blanket/electric heating pad (RR=0.75, 95%CI 0.18 to 3.21) and the group of infrared ray radiant heating system (RR=0.8, 95%CI 0.19 to 3.36). Conclusion Compared with resistive-heating blanket/electric heating pad, circulating water mattress, and infrared ray radiant heating system, forced air warming maintains patients’ core temperature better during the perioperative period, with a lower incidences of hypothermia. Due to the limited quantity and quality of the included studies, more high quality RCTs with large sample size are needed to verify the above conclusion.
ObjectiveTo systematically review the efficacy of treatments for β-coronaviruses.MethodsPubMed, EMbase, Web of Science, The Cochrane Library, SinoMed, CNKI and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) and non-randomized controlled trials (non-RCTs) of treatments for β-coronaviruses from inception to June 17th, 2020. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed using Stata 14.0 software.ResultsA total of 109 studies invoving 23 210 patients were included. The results of the systematic review showed that compared with standard of care, corticosteroids could reduce mortality and increase cure rate for COVID-19. However, chloroquine could decrease cure rate. In severe acute respiratory syndrome (SARS) patients, corticosteroids could decrease the cure rate. In Middle East respiratory syndrome (MERS) patients, ribavirin/interferon/both drugs showed higher mortality.ConclusionsThe currently limited evidence shows that corticosteroids may be effective to COVID-19 patients while having limited effects on SARS patients. Hydroxychloroquine or chloroquine may have negative effects on COVID-19 patients. Ribavirin/interferon may be harmful to MERS patients. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusions.
ObjectivesTo systematically review the efficacy of unicompartmental knee arthroplasty on forgotten joint score (FJS) in patients with knee osteoarthritis.MethodsPubMed, EMbase, The Cochrane Library, Web of Science, CNKI, CBM, WanFang Data and VIP databases were electronically searched to collect randomized controlled trials (RCTs) and cohort studies on unicompartmental knee arthroplasty on FJS in patients with knee osteoarthritis from inception to December 31st, 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 2 RCTs and 11 cohort studies were included. The results of meta-analysis based on RCTs showed that: compared to posterior stabilized total knee arthroplasty (PS-TKA), unicompartmental knee arthroplasty could improve FJS on 12-month (MD=9.23, 95%CI 0.53 to 17.93, P=0.04) after operation. The results of meta-analysis based on cohort studies showed that: compared to PS-TKA, unicompartmental knee arthroplasty could improve FJS on 6-week (MD=8.90, 95%CI 6.87 to 10.94, P<0.000 01), 6-month (MD=18.72, 95%CI 8.71 to 28.74, P=0.000 2), 1-year after operation (MD=13.41, 95%CI 8.87 to 17.95, P<0.000 01), and the last follow-up (MD=0.99, 95%CI 0.47 to 1.54, P=0.000 2).ConclusionsCurrent evidence shows that, comparing with PS-TKA, unicompartmental knee arthroplasty in knee osteoarthritis shows advantage in the improvement of FJS. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify above conclusions.
Objective To systematically evaluate the effectiveness and safety of Puerarin on diabetic peripheral neuropathy. Methods A systematic review and evaluation of all available relevant randomized or quasi-randomized controlled trials of Puerarin for diabetic peripheral neuropathy from Cochrane Controlled Trials Register (150 issue of 2003), Medline (1966-2003. 2), EMbase (1984-2001. 12. 4), and the Chinese Biological Medicine Database (1978-2003. 2) were performed. The selection of studies, data extraction, and assessment of methodological quality were performed independently by two reviewers. The following outcomes were assessed: effectiveness of clinical symptoms, sensory nerve and motor nerve conduction velocities, and severe adverse events of Puerarin. Results Ten randomized controlled clinical trials including 726 patients met the inclusion criteria. At the end of the treatment, compared to general treatment or vitamin B, Puerarin showed significant positive effects on the total effect rate of therapy and increased peripheral nerve conduction velocity. No severe adverse events were observed during the treatment period. However, most included trials show some degree of study design or analysis defect. Conclusions Our analysis suggests that Puerarin appears to be an effective and safe treatment for diabetic peripheral neuropathy. However, due to the low quality trials included in this review, more rigorously designed, randomized, double-blind, placebo-controlled trials of Puerarin for diabetic peripheral neuropathy are needed to further assess its usefulness in diabetes peripheral neuropathy patients.
