OBJECTIVE: To comprehend the progress of tissue engineering research and speculate its developmental trends. METHODS: MEDLINE search was conducted to retrieve the papers published between 1987 to 1999 under the main headings of tissue engineering. Years, nationalities, languages, journals, authors and heading frequencies of 314 papers were analyzed by bibliometrics. RESULTS: Since 1990, the number of tissue engineering research literatures had doubled, and papers between 1998 and 1999 made up 57.96% of the total papers. All papers came from 15 nations, in 6 languages and 140 journals; 64.97% came from United States and 25.79% from England, Netherlands and Germany; 93.95% was in English; 42.04% was published on 15 journals. Vacanti JP and 19 other authors presented 5 to 24 papers. Heading frequencies were cytology 22.89%, transplantation 13.30%, scaffolds and extracellular matrixes 11.72%, implanting 10.60%, polymers 8.91%, potential applications 8.91%, artificial substitutes 6.88%, tissue culture 6.70% and biogenetics 4.96%. CONCLUSION: Tissue engineering literatures mainly come from United States, England, Netherlands and Germany. English is the major language. J Biomed Mater Res and 14 other journals are important journals about tissue engineering research. Vacanti JP and 19 other authors are prolific authors. Cytology, transplantation, scaffolds and extracellular matrixes and implanting are hot topics and key points on tissue engineering research.
Decision-making is often a complex and hard-to-routinize process. Based on the decision-making experience of fighting COVID-19, policymakers have gradually realized that climate action, quality education, and other societal challenges, as well as the sustainable development goals (SDGs) need to be addressed with the best available evidence using an evidence-informed decision-making (EIDM) approach. The Global Commission on Evidence was established in 2021. In addition, the Evidence Commission issued reports in 2022 and 2023. A systematic methodology to address societal challenges with EIDM has been constructed in the report. Five types of domestic evidence (data analytics, evaluation, modeling, qualitative insights, and behavioural/implementation research) and four steps in decision-making process (understanding a problem and its causes, selecting an option for addressing the problem, identifying implementation considerations, and monitoring implementation and evaluating impacts) were used to support four types of decision-makers (government policymakers, organizational leaders, professionals and citizens) in EIDM, as demonstrated by the reports. To further disseminate the concept and methodology of EIDM globally, the secretariat works with 25 Evidence Commissioners to write the report, and continues to cooperate with Country Leads Group from 12 countries to conduct rapid evidence-support system assessments (RESSAs), and collaborates with Evidence Commission Implementation Council to accelerate the implementation of 24 recommendations. The main history, core methodology, and latest developments of the Global Committee on Evidence were systematically reviewed in this paper. We aimed to show decision-makers a new version of how to scientifically address the societal challenges of EIDM.
Objective To assess the clinical effectiveness of vacuum-formed versus Hawley retainers in the period of retention. Methods PubMed, The Cochrane Library, EMbase, CBM, CNKI, VIP, and WanFang Data were searched from the date of their establishment to December 31, 2011, to collect the randomized controlled trials (RCTs) about the clinical effectiveness of vacuum-formed versus Hawley retainers. The quality of the included studies was evaluated by two reviewers independently, and meta-analysis was performed by using RevMan 5.1.4 software. Results Six RCTs including 935 patients were identified. The results of meta-analyses showed significantly fewer changes in irregularity of the maxillary incisors (MD=0.13, 95%CI 0.04 to 0.21) and mandibular incisors (MD=0.29, 95%CI 0.24 to 0.33) in the vacuum-formed group than in the Hawley group. There were no significant differences between the two groups in maxillary intercanine width (MD=?–0.01, 95%CI –0.03 to 0.01), mandibular intercanine width (MD=0.04, 95%CI –0.02 to 0.10), maxillary intermolar width (MD=?–0.01, 95%CI –0.03 to 0.00) and mandibular intermolar width (MD=?–0.02, 95%CI –0.08 to 0.04). The results of qualitative analysis were consistent with the results of meta-analysis and there were no significant differences in overjet and overbite. Conclusion Vacuum-formed retainers are more effective than Hawley retainers at maintaining position of incisors in the period of retention. In other aspects, they are similar. In consideration of the factors such as the limited quality and incomplete measure index of primary studies, RCTs of higher methodological quality are needed.
Objective The objective of this study is to find individualized, evidence-based treatment for a patientwith extensive small cell lung cancer, malignant pleural effusion, and liver metastasis.Methods According to the PICO (patient intervention comparison outcome) principle, evidence was collected and critically assessed. The patient’s preference was also taken into consideration in the decision making process. Results We included 10 randomized controlled trials, 13 systematic reviews and meta-analyses, and three clinical guidelines. The evidence indicated that chemotherapeutic treatment prolongs survival in patients with extensive small cell lung cancer and AiDi injections could relieve adverse effects caused by chemotherapy or radiotherapy. Cisplatin and etoposide are considered major standard cytotoxic drugs for small cell lung cancer. We drained the pleural cavity and infused Bleomycin into the pleural cavity. We also used an EP regimen of chemotherapy after the patient’s condition had improved. This patient survived longer than the average survival time for small cell lung cancer patients and has enjoyed a higher quality of life. Conclusion Chemotherapy is the main medical treatment for patients with extensive small cell lung cancer, backed up by symptomatic treatment and supportive care. Prophylactic cranial irradiation decreases brain metastases incidence and improves survival in complete response small cell lung cancer patients.
Objective To evaluate the efficacy of glucose-insul in-potassium (GIK) in patients with acute myocardialinfarction (AMI). Methods Both foreign language databases including The Cochrane Library (issue 4, 2007), PubMed, EMBASE and Chinese databases involving CBM, VIP and CJFD were searched to identify randomized controlled trials (RCTs) that reported the effect of GIK on the heart function (left ventricular ejection fraction LVEF, ST changes, left ventricular remodel ing) of patients with AMI. Two reviewers assessed the qual ity of each trial and extracted data independently. The Cochrane Collaboration’s RevMan 4.2.10 software was used for statistical analysis. Results Five RCTs were included, all of which came from abroad. The methodological qual ity of the included studies was good. The basel ine data of each trial were comparable. Meta-analyses showed that no significant difference was observed in the improvement of LVEF between the GIK group and the control group (WMD=1.87, 95%CI -0.32 to 4.06, P =0.09), whereas GIK was more beneficial in decreasing ST (OR=1.92, 95%CI 1.25 to 2.96,P =0.003) and preventing left ventricular remodel ing (OR=0.08, 95%CI 0.01 to 0.68, P=0.02). Conclusion Based on the above evidence, although GIK may, to some extent, be beneficial for both ST decreasing and long-term prognoses in patients with AMI, it can not yet be concluded that GIK can improve the heart function of those patients. Therefore, it is imperative to design and implement further stricter, large-scale RCTs, so as to accurately identify the therapeutic effect of GIK solution in patients with myocardial infarction.
Objective To assess the efficacy and safety of low-dose urokinase plus conventional treatment versus conventional treatment alone in patients with unstable angina. Methods We searched the database PubMed, EMBASE, The Cochrane Library, SCI, CBM, CNK, VIP and Wanfang database on line by computer, and handsearched relevant professional journals by two independent screening and extract information. The quality of the included documents was evaluated by the criterion of Cochrane handbook 4.2.6. The cochrane collaboration’s Revman 4.2.10 software was used for data analyses. Results A total of 19 randomized controlled trials were included (2 273 patients) Meta-analyses showed that the low-dose urokinase group was better than the conventional treatment group in efficiency [OR= 4.18, 95%CI (3.24, 5.41)] and ECG [OR= 2.81, 95%CI (2.04, 3.88)], and there were no differences between the two groups in cardiovascular outcomes [OR= 0.74, 95%CI (0.44,1.24)], mucocutaneous bleeding [OR= 1.43, 95%CI (0.90, 2.28)], gums bleeding [OR= 1.88, 95%Cl (0.46, 7.70)] and microscopic hematuria [OR= 3.82, 95%CI (0.77, 18.92)]. Conclusion The low dose urokinase group is higher efficient than the conventional treatment group. As the samples of the included studies are small and their quality is low, more randomized, double-blind, high-quality and big- sample trials are required.
Objective To systematically evaluate the clinical effectiveness and safety of raltitrexed plus cisplatin in the treatment of malignant pleural mesothelioma (MPM) when compared with other chemotherapy regimens. Methods We electronically searched PubMed, Embase, The Cochrane Library and Chinese Biomedicine Database to March, 2007. Randomized controlled trials (RCTs) and quasi-RCTs were identified, and Revman 4.2.10 was applied for statistical analyses. Results One RCT involving 250 patients was included, which compared raltitrexed plus cisplatin versus cisplatin alone in the treatment of MPM. In the intention-to-treat population, the median survival time was statistically longer in the raltitrexed plus cisplatin group as compared to cisplatin alone group. (11.4 versus 8.8 months, P=0.048). The incidence of grade 3/4 toxicities was similar between the two groups. Conclusion The current evidence available showed that, the combination of raltitrexed and cisplatin may prolong the survival time for MPM patients, with a low incidence of grade 3/4 toxicities. However, more high-quality RCTs are required to further define its clinical effectiveness.
Objective To assess the effectiveness and safety of laryngeal mask airway (LMA) and endotracheal tube (ETT) for airway management in pediatric general anesthesia. Methods Randomized controlled trials were collected through electronic searches of the PubMed, The Cochrane Library, EMbase, CBM, WanFang Data, VIP, CNKI from the date of establishment to November 2010. All the related data that matched the standards were abstracted by two reviewers independently. The quality of the included trials was evaluated according to the Cochrane Handbook 5.0. RevMan 5.0 software was used for meta-analysis of the complications, success of insertion on the first attempt and hemodynamic changes. Results A total of 39 trials involving 2 612 patients were included. The results of meta-analyses showed that LMA was superior to ETT in terms of less cough (RR=0.21, 95%CI 0.15 to 0.28, Plt;0.000 01), laryngospasm or bronchospasm (RR=0.37, 95%CI 0.18 to 0.77, P=0.008) and agitation (RR=0.14, 95%CI 0.09 to 0.22, Plt;0.000 01) during emergency. The incidence of postoperative sore throat (RR=0.32, 95%CI 0.19 to 0.55, Plt;0.000 1), hoarse voice (RR=0.09, 95%CI 0.03 to 0.27, Plt;0.000 1), nausea and vomiting (RR=0.46, 95%CI 0.26 to 0.80, P=0.006) was significantly lower in the LMA group. The hemodynamic changes during insertion and extraction of LMA were more stable than ETT, such as the heart rate changes in insertion, extraction and post-extraction period (SMD= –1.18, 95%CI –1.59 to –0.77, Plt;0.000 01; SMD= –1.29 95%CI –1.72 to –0.86, Plt;0.000 01; and SMD= –1.51 95%CI –2.15 to –0.87, Plt;0.000 01, respectively) and the MAP changes in insertion, extraction and post-extraction period (SMD= –1.21, 95%CI –1.39 to –1.02, Plt;0.000 01; SMD= –1.31, 95%CI –1.77 to –0.85, Plt;0.000 01; and SMD= –0.85, 95%CI –1.24 to –0.46, Plt;0.000 1, respectively); but no significant differences in postoperative regurgitation and aspiration (RR=3.00, 95%CI 0.62 to 14.61, P=0.17) and successful insertion on the first attempt (RR=0.99, 95%CI 0.94 to 1.05, P=0.84) were found between the LMA and ETT groups. Conclusion Current evidence indicates that the laryngeal mask airway is superior to endotracheal tube in terms of fewer complications during emergency and after operation as well as stable hemodynamic changes. So, it is a selective, safe and effective airway management for children.
Objective To evaluate the diagnostic value of MR imaging for anterior cruciate ligament. Methods We searched PubMed, EMBASE, CBM, CSJD and CJFD to find all diagnostic tests about MR imaging in anterior cruciate ligament. QUADAS items were used to evaluate the quality of the included studies. We used Meta-disc software for data collection, and sensitivity, specificity and SROC curves were calculated to assess the diagnostic value of individual diagnostic tests. Results Twenty-nine studies met the eligibility criteria and were included. Compared with arthroscope, the summary values of sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and SROC curve of MR imaging were 93%, 93%, 9.85, 126.39, and 0.971 4, respectively. Conclusion MR imaging can be regarded as an effective and feasible method for ACL tears diagnosis and screening clinically, based on the results of this systematic review.
Objective To evaluate the effect of standardized patient (SP) used in nursing fundamental. Methods Randomized controlled trials (RCTs) or quasi randomized controlled trials (q-RCTs) about comparing standardized patients with traditional teaching method in nursing fundamental were searched from the following electronic databases: PubMed, EMbase, The Cochrane Library, CNKI, CBM, VIP and so on. The methodological quality of the included RCTs was assessed according to the quality assessment scale developed by Smits PB, and the valid data were extracted and meta-analyzed with the Cochrane Collaboration’s RevMan 5.0.17 software. Results Five RCTs and one q-RCT involving 585 participants were included. The results of quality evaluation showed that the scores of five studies were more than or equaled 30. Descriptive analyses were only used because there was clinical heterogeneity between different studies. Comparing with traditional teaching method, SP teaching method in nursing fundamental improved the nursing procedure skills, the communication ability with patients and the ability of clinical judgment for nursing students. Conclusion The standardized patient teaching method is a prospective teaching mode. Because of the lack of RCTs about SP used in nursing fundamental, and the big difference of the teaching method and examine criteria in different studies, it is necessary to be verified in future by unified assessment methods and more researches with high quality.
