Objective To assess the differences between a glucose meter and autoanalyzer at home and broad.Method MEDLINE, CNKI, FMJS, and CBM were searched electronically (1995 to May, 2008). The statistical analysisof included studies was performed according to the Cochrane systematic reviews method. Result Twenty four studies, including 11 English records and 19 Chinese records involving 4 963 specimens, were included in this study. Meta-analysis showed us the blood glucose values of Abbott, Roche, and Johnson abroad subgroups are higher than the laboratory method, and their WMD (95%CI) are 0.57 (0.34,0.80), 0.43 (0.04,0.81), 0.41 (0.11,0.71). The blood glucose values of the Abbot and Roche domestic subgroups are comparable to the laboratory method [WMD= 0.60, 95%CI (– 0.79, 1.99); WMD= – 0.13, 95%CI (– 0.56, 0.29)]. The blood glucose value of the Johnson domestic subgroup is lower than laboratory method [WMD= – 0.95, 95%CI (– 1.42, – 0.48)]. Conclusion The results of the abroad studies are relatively consistent, and the blood glucose values of all abroad subgroups are higher than laboratory method. The domestic studies are different because of other factors.
ObjectivesTo systematically review the efficacy and safety of local endometrial mechanical stimulation in patients with recurrent embryo implantation failure in vitro fertilization.MethodsPubMed, EMbase, The Cochrane Library, CNKI, WanFang Data and VIP databases were electronically searched to collect clinical controlled studies on the efficacy and safety of local endometrial mechanical stimulation in patients with recurrent embryo implantation failure from inception to March 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 10 studies, including 8 randomized controlled trials and 2 case-control studies, and involving 1 274 patients were included. The results of meta-analysis showed that: the clinical pregnancy rate of endometrial mechanical stimulation group was higher than that of control group (RR=1.40, 95%CI 1.04 to 1.89, P=0.03). However, no significant differences were found in implantation rate (RR=0.75, 95%CI 0.50 to 1.13, P=0.17), live births rate (RR=1.38, 95%CI 0.99 to 1.93, P=0.06), miscarriage rate (RR=0.83, 95%CI 0.55 to 1.24, P=0.36) and rate of multiple pregnancy (RR=0.90, 95%CI 0.61 to 1.35, P=0.63).ConclusionCurrent evidence shows that, for patients with repeated implantation failure, mechanical endometrial stimulation before re-transplantation may help to improve the clinical pregnancy rate of test-tube infants, however, it has no significant effects on implantation rate, live birth rate, abortion rate, multiple pregnancy rate and ectopic pregnancy rate. Due to limited quality and quantity of the included studies, more high quality studies are needed required to verify above conclusions.
Objectives To assess the effectiveness and safety of carnitine in the treatment of idiopathic asthenozoospermia. Methods The Cochrane Library, MEDLINE, EMbase, and CNKI were searched between Jan 1995 and Dec 2006. Both English and Chinese studies were included in the review if they were randomized controlled trials (RCTs) involving men with idopathic asthenozoospermia who were treated with carnitine. Trial screening, data extraction, and quality assessment of included trials were conducted by method recommended by Cochrane Collaboration. Statistical analysis was conducted using RevMan 4.2.10 software. Results Five RCTs involving 346 patients met the inclusion criteria, and 307 patients were included in the meta-analysis. The results showed that: after being treated with carnitine for 3 and 6 months, the difference of the patients’ partners’ spontaneous pregnancy rate between treatment group and control group was statistically significant with RR2.46 and 95% CI1.12 to 5.43 (Z=2.23, P=0.03). After being treated with carnitine for 3 and 6 months, the difference of forward motile sperm per ejaculate between treatment group and control group was not statistically significant with WMD 9.16 and 95%CI 0.14 to 18.18 (Z=1.99, P=0.05) and WMD 5.28 and 95%CI –4.45 to 15.01 (Z=1.06, P=0.29). After being treated with carnitine for 3 and 6 months, the difference of percentage of forward sperm motility between treatment group and control group was not statistically significant with WMD 14.56 and 95%CI –4.49 to 33.61( Z=1.50 ,P=0.13), and WMD 7.34 and 95%CI –5.93 to 20.61 (Z=1.08, P=0.28). After being treated with carnitine for 3 and 6 months, the difference of total motile sperm per ejaculate between treatment group and control group was not statistically significant with WMD 15.32 and 95%CI –1.34 to 31.98 (Z=1.80, P=0.07) and WMD 6.20, 95%CI –3.00 to 15.39 (Z=1.32, P=0.19).After being treated with carnitine for 3 and 6 months, the difference of percentage of total sperm motility between treatment group and control group was not statistically significant with WMD 2.97 and 95%CI –5.75 to 11.69 (Z=0.67, P=0.50) and WMD 4.48 and 95%CI-9.17 to18.14 (Z=0.64, P=0.52). After being treated with carnitine for 3 and 6 months, the difference of semen volume between treatment group and control group was not statistically significant with WMD –0.12 and 95%CI –0.55 to 0.30 (Z=0.57, P=0.57) and WMD 0.03 and 95%CI –0.38 to 0.45 (Z=0.16, P=0.87). After being treated with carnitine for 3 and 6 months, the difference of sperm concentration between treatment group and control group was not statistically significant with WMD 7.92 and 95%CI – 2.85 to18.68 (Z=1.44, P=0.15), and WMD 1.02 and 95%CI –5.09 to 7.14 (Z=0.33, P=0.74). Three RCTs reported that there were no serious side effects of carnitine during the treatment period. Conclusions The available evidence indicates that spontaneous pregnancy rate would increase with carnitine therapy, while it is short of improvement of semen parameters. There is no serious side effect of carnitine. Because of lack of evidence, we cannot conclude that carnitine is effective in improving the prognosis of infertile patients with idiopathic asthenozoospermia. More high quality trials with large sample are proposed.
Objective To evaluate the efficacy and safety of trimetazidine (TMZ) in the treatment of Stable Angina Pectoris (SAP). Methods Randomized controlled trials (RCTs) on the efficacy and safety of Trimetazidine in treating patients with SAP were retrieved in the following databases as CNKI (1997 to June 2011), WanFang Data (1989 to June 2011), MEDLINE (1966 to June 2011), EMbase (1974 to June 2011), CBM (1989 to June 2011) and Cochrane Central Database (1989 to June 2011). The literature which met the inclusion and exclusion criteria were selected, data were extracted, the quality was evaluated, and meta-analysis was performed by using RevMan 5.0 software. Results A total of 15 RCTs involving 1 500 patients were included. The meta-analysis showed that, compared with the control group, TMZ was significantly superior in the following 5 aspects: the time to 1 mm drop of ST segment (WMD=0.84, 95%CI 0.74 to 0.93, P=0.000 01), duration of doing exercise (WMD=0.82, 95%CI 0.73 to 0.91, P=0.000 01), and time to onset of angina (WMD=1.18, 95%CI 0.87 to 1.50, Plt;0.000 01) in the treadmill test, weekly mean number of angina attacks (WMD= –1.79, 95%CI –1.93 to –1.66, Plt;0.000 01), and weekly side effects between TMZ and the control group (RR=0.83, 95%CI 0.52 to 1.32, P=0.42). Conclusion Based on current studies, TMZ is superior to other medicines in the control group for SAP at present, and it has no significant difference in side effects compared with the control group, so it is regarded as an effective and safe drug. For the quality restrictions and possible publication bias of the included studies, this conclusion needs to be confirmed by more high quality, large sample, multi-center, double blind RCTs.
This is the sixth paper in the evidence-based medicine glossary series. In this paper, We mainly introduced the concept of research synthesis, systematic review and meta-analysis and review developing process of these glossary.
ObjectivesTo systematically review the safety of harmonic scalpel and conventional resection in superficial parotidectomy.MethodsPubMed, EMbase, The Cochrane Library, CNKI, WanFang Data and CBM databases were electronically searched to collect randomized controlled trials (RCTs) or cohort studies of harmonic scalpel and conventional resection in superficial parotidectomy from the inception of the database to December, 2018. Two reviewers independently screened literatures, extracted data and assessed risk of bias of the included studies. Then meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 10 studies involving 671 post-cesarean section patients (361 patients in harmonic scalpel group and 310 patients in conventional resection group) were included. The results of meta-analysis showed that: compared with conventional resection, harmonic scalpel had shorter operative time (MD=?23.82, 95%CI ?31.20 to ?16.44, P<0.000 01), less postoperative drain output (MD=?26.25, 95%CI ?38.95 to ?13.55, P<0.000 1), less intraoperative blood loss (MD=?23.78, 95%CI ?28.64 to ?18.91, P<0.000 01), shorter duration of hospital stay (MD=?1.19, 95%CI ?2.14 to ?0.23, P=0.02), and lower temporary facial nerve palsy rate (OR=0.27, 95%CI 0.14 to 0.50, P<0.000 1). However, there was no significant difference in the incidence of parotid gland leakage between two groups (OR=0.42, 95%CI 0.16 to 1.06, P=0.07).ConclusionsThe current evidence demonstrates that, compared to conventional resection, harmonic scalpel resection is safer. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify above conclusions.
ObjectiveTo systematically review the clinical efficacy of low molecular weight heparin (LMWH) in treating patients with acute exacerbation of chronic obstructive pulmonary disease (COPD).
MethodsDatabases including PubMed, The Cochrane Library (Issue 10, 2013), EMbase, CBM, CNKI, VIP and WanFang Data were searched for the randomized controlled trials (RCTs) about LMWH in treating acute exacerbation of COPD from the establishment to October 2013. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed methodological quality of the included studies. Meta-analysis was then performed using RevMan 5.2 software.
ResultsA total of 6 RCTs involving 501 patients were finally included. The results of meta-analysis showed that:compared with the control group, LMWH significantly improved levels of D-dimmer (MD=-0.28, 95%CI-0.50 to-0.05, P=0.02), reduced carbon dioxide partial pressure (PaCO2) (MD=-3.42, 95%CI-6.66 to-0.18, P=0.04), improved coagulation (PT) (MD=1.85, 95%CI 1.29 to 2.42, P < 0.000 01), and improved clinical symptoms and signs (RR=1.33, 95%CI 1.12 to 1.58, P=0.001), but it did not improve oxygen partial pressure (PaO2) (MD=0.28, 95%CI-3.04 to 3.61, P=0.87). During treatment, no severe adverse reaction occurred in both groups.
ConclusionLMWH could significantly improve symptoms caused by acute exacerbation of COPD. Due to limited quantity and quality of the included studies, the above conclusion needs to be confirmed by conducting more high quality RCTs with larger sample size.
ObjectivesIn order to provide baseline data for the establishment of urban health indicator system in China and other cities, the indicators, characteristics and problems of 24 urban health indicator systems in China were researched.MethodsCNKI, Wan Fang Data, VIP, as well as China’s all provinces and cities’ websites of government and family planning commission and patriotic health campaign commission were searched to collect literatures and government documents on " Healthy city” and its index system. They were then been extracted, classified and summarized.ResultsThe final search involved 24 healthy city indicators system in China, including 1 531 indicators and 14 dimensions, 5 operations and 8 special operations. Seven dimensions (health, health services, environmental health, social indicators, indicators of policy, indicator of health promoting) were widely used. 38 indicators were used above five times, while 441 indicators were used merely once.ConclusionsThe structure of urban health indicator systems in China are almost consistent with WHO’s. They all have the characteristics of diversity, characteristic, national policy, civilian etc. However, there still exists problems with indicators of quantity, definition, classification and lack of indicators on mental health, children health, pregnant woman health as well as elderly health. It is urgent to develop the principles, methods, processes and standards for urban health indicators.
