The summary of finding (SoF) table for network meta-analysis (NMA) was developed by the GRADE working group to facilitate and consolidate understanding NMA findings and GRADE certainty of evidence. This paper introduces the development process, the structure of NMA-SoF and limitations. A NMA publication was presented as an example to comprehensively illustrate the application of the NMA-SoF table.
Objective To study the relation between the pathogenesis of gallstone and blood lipid and protein.Methods Then indexes of blood lipid and protein in 204 cases of gallstone patients were measured and analysed by statistical software SPSS. Results There was a significant difference between the gallstone group and control in the value of proalbumin, total cholesterol, high density lipoprotein and carrier protein B (Ｐ＜0.01), the value of total protein, triglyceride, low density lipoprotein cholesterol, very low density lipoprotein cholesterol and carrier protein A1 were higher than those in the control (Ｐ＜0.05). Conclusion The indexes mentioned above may play an important role in the gallstone formation.
ObjectiveTo understand the current status of oral frailty in older patients with colostomy, and analyze the factors affecting oral frailty. MethodsA retrospective analysis was conducted on older patients with colostomy who visited the Department of Gastrointestinal Surgery, Shandong Provincial Hospital from May 2023 to December 2023. The questionnaire survey was conducted using the general data questionnaire, oral frailty index-8 (OFI-8), the edmonton frail scale (EFS), and the nutritional risk screening score 2002. According to the OFI-8 score, the patients were divided into oral frailty group and non-oral frailty group, and the two-classified logistic regression model was used for multivariate analysis to explore the factors affecting the oral frailty of older patients. ResultsA total of 283 survey subjects were collected, and the incidence of oral frailty in older patients was 66.4% (188/283). Multivariate analysis showed that old age [OR=1.181, 95% CI (1.015, 1.373), P=0.032], history of smoking [OR=2.721, 95%CI (1.122, 6.599), P=0.027], history of alcohol [OR=2.878, 95%CI (1.185, 6.991), P=0.020], dentures [OR=3.173, 95%CI (1.297, 7.759), P=0.011], postoperative oral diseases≥2 [OR=5.802, 95%CI (1.911, 17.615), P=0.002], nutritional risk [OR=2.744, 95%CI (1.033, 7.284), P=0.043], high EFS score [OR=1.823, 95% CI (1.309, 2.538), P<0.001], permanent stoma [OR=2.659, 95%CI (1.126, 6.275), P=0.026] were risk factors for oral frailty in older patients with colostomy. ConclusionsThe incidence of oral frailty in older patients with colostomy is relatively high. We should pay more attention to the patients’ oral frailty, and implement precise intervention measures for high-risk factors to prevent the occurrence of oral frailty or improve the condition of oral frailty.
【Abstract】Objective To explore the changes of expression of AFP mRNA in human hepatocellular carcinoma （HCC） tissues after oral Xeloda therapy.Methods Total RNA was extracted from HCC tissue samples collect after operation and nested reverse transcription polymerase chain reaction （RT-nested PCR） assay was performed to determine the expression of AFP mRNA in this study.Results The final product of AFP mRNA amplified by RT-PCR was 174 bp and by RT-nested PCR was 101 bp. The AFP mRNA is positive in 12 of 21 patients (positive rate 57.14%) amplified by RT-nested PCR assay in Xeloda treatment group which is much lower than control group: 18 of 20 patients (positive rate 90.00%),P＜0.05.The serum AFP value of Xeloda treatment group 〔(23.2±12.8) μg/L〕 is much lower than that of control group 〔(39.6±24.3) μg/L〕 four weeks after operation (P＜0.05). However, There was no difference between two groups in serum AFP value before operation.Conclusion Xeloda can effectively suppress the expression of AFP mRNA in human HCC tissues and lower it’s product serum AFP value.The clinical application of Xeloda in HCC patients deserve further study.
In observational studies, multivariable analysis is commonly used to control confounding and reduce bias in the estimation of causal effect between exposure and outcome. However, in clinical problems with complex causal relationships, researchers select covariates for adjustment through clinical intuition and data-driven methods, which may lead to biased results. In recent years, directed acyclic graphs (DAGs) have become a popular method for visualizing causal relationships between variables. An appropriately constructed DAG can help researchers identify confounders, intermediate variables and other non-confounding variables, thereby improving covariates selection for multivariable analysis. In practice, researchers should incorporate clinical knowledge, systematic methods and transparent reporting to fully utilize DAG in causal inference, and support more reliable clinical decisions.
Randomized controlled trials are the gold standard for evaluating the effects of medical interventions, primarily providing estimates of the average effect of an intervention in the overall study population. However, there may be significant differences in the effect of the same intervention across sub-populations with different characteristics, that is, treatment heterogeneity. Traditional subgroup analysis and interaction analysis tend to have low power to examine treatment heterogeneity or identify the sources of heterogeneity. With the recent development of machine learning techniques, causal forest has been proposed as a novel method to evaluate treatment heterogeneity, which can help overcome the limitations of the traditional methods. However, the application of causal forest in the evaluation of treatment heterogeneity in medicine is still in the beginning stage. In order to promote proper use of causal forest, this paper introduces its purposes, principles and implementation, interprets the examples and R codes, and highlights some attentions needed for practice.
ObjectiveTo systematically review the risk factors leading to postoperative persistence of children diagnosed with obstructive sleep apnea (OSA) after adenoidectomy and tonsillectomy. MethodsPubMed, EMbase, The Cochrane Library, ClinicalTrials.gov, CNKI, VIP, WanFang Data and SinoMed databases were electronically searched to collect case-control studies and cohort studies related to risk factors for postoperative persistence of OSA in children from inception to July 2019. Two reviewers independently screened literature, extracted data, and evaluated the risk of bias of the included studies. Meta-analysis was then performed using RevMan 5.3 software. ResultsA total of 12 cohort studies involving 1 659 OSA patients were included. Meta-analysis results showed that the risk of postoperative persistence of OSA in children with preoperative obesity was 3.47 times higher than that in non-obese children (RR=3.47, 95%CI 2.04 to 5.92, P<0.000 01). Compared with normal-weight children, obese children had 4.11 times higher risk of postoperative residual OSA (RR=4.11, 95%CI 1.68 to 10.07, P<0.000 01).ConclusionsPreoperative obesity is a risk factor for postoperative persistence of OSA in children. Due to the limited quantity and quality of included studies, more high-quality studies are needed to verity the above conclusions.
ObjectivesTo systematically review the efficacy and safety of Orlistat for obese patients with cardiovascular risk including hyperlipidemia, hypertension, diabetes and prediabetes.MethodsSinomed, CNKI, WanFang Data, PubMed, EMbase, The Cochrane Library and ClinicalTrails.gov databases were electronically searched to collect randomized controlled trials (RCTs) of Orlistat for obese patients with cardiovascular risk such as hyperlipemia, diabetes, prediabetes and hypertension from inception to Jan 7th, 2017. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then, meta-analysis was performed using Stata 14.0 software.ResultsA total of 28 RCTs were included. The results of meta-analysis showed that, compared with placebo, Orlistat could significantly reduce the weight (MD=–2.85, 95%CI –3.47 to –2.24, P=0.000), waist (MD=–2.45, 95%CI –3.07 to –1.83, P=0.000) and BMI (MD=–1.29, 95%CI –2.08 to –0.49, P=0.002) of patients. Orlistat could also control the blood pressure, blood glucose and other cardiovascular risk factors well. Compared with the blank control, Orlistat could improve the waist and parts of cardiovascular risk factors (P<0.05). The incidence of adverse events of Orlistat was slightly higher than that of placebo, but most could be self-healing.ConclusionsCurrent evidence shows that compared with placebo and blank control, Orlistat is effective for improving both weight loss and some cardiovascular risk factors. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify above conclusion.
