Iron and ferritin effects on intensive care unit mortality:A metaanalysis

BACKGROUND The effect of serum iron or ferritin parameters on mortality among critically ill patients is not well characterized.AIM To determine the association between serum iron or ferritin parameters and mortality among critically ill patients.METHODS Web of Science,Embase,PubMed,and Cochrane Library databases were searched for studies on serum iron or ferritin parameters and mortality among critically ill patients.Two reviewers independently assessed,selected,and abstracted data from studies reporting on serum iron or ferritin parameters and mortality among critically ill patients.Data on serum iron or ferritin levels,mortality,and demographics were extracted.RESULTS Nineteen studies comprising 125490 patients were eligible for inclusion.We observed a slight negative effect of serum ferritin on mortality in the United States population[relative risk(RR)1.002;95%CI:1.002-1.004].In patients with sepsis,serum iron had a significant negative effect on mortality(RR=1.567;95%CI:1.208-1.925).CONCLUSION This systematic review presents evidence of a negative correlation between serum iron levels and mortality among patients with sepsis.Furthermore,it reveals a minor yet adverse impact of serum ferritin on mortality among the United States population.

Meta-analysis of transarterial chemoembolization combined with cryoablation vs transarterial chemoembolization alone for≥5 cm hepatocellular carcinoma

BACKGROUND Hepatocellular carcinoma(HCC)ranks sixth globally in cancer incidence and third in mortality rates.Unfortunately,over 70% of HCC patients forego the opportunity for curative surgery or liver transplantation due to inadequate physical examinations,poor physical condition,and limited organ availability upon diagnosis.Clinical guidelines endorse transarterial chemoembolization(TACE)as the frontline treatment for intermediate to advanced-stage HCC.Cryoablation(CRA)is an emerging local ablative therapy increasingly used in HCC management.Recent studies suggest that combining CRA with TACE offers complementary and synergistic effects,potentially improving long-term survival rates.However,the superiority of combined TACE+CRA therapy over TACE alone for HCC lesions equal to or exceeding 5 cm requires further investigation.AIM To compare the efficacy and safety of TACE combined with CRA vs TACE alone in the treatment of HCC with a diameter of≥5 cm.METHODS PubMed,EMBASE,Cochrane Library,CNKI,Wanfang,and VIP databases were searched to retrieve all relevant studies on TACE and CRA up to July 2022.Meta-analysis was performed using RevMan 5.3 software.RESULTS After screening according to the inclusion and exclusion criteria,6 articles were included,including 2 randomized controlled trials and 4 nonrandomized controlled trials,with a total of 575 patients included in the meta-analysis.The results showed that the objective response rate[odds ratio(OR)=2.56,95%confidence interval(CI):1.66-3.96,P<0.0001],disease control rate(OR=3.03,95%CI:1.88-4.89,P<0.00001),1-year survival rate(OR=3.79,95%CI:2.50-5.76,P<0.00001),2-year survival rate(OR=2.34,95%CI:1.43-3.85,P=0.0008),and 3-year survival rate(OR=3.34,95%CI:1.61-6.94,P=0.001)were all superior to those of the control group;the postoperative decrease in alpha-fetoprotein value(OR=295.53,95%CI:250.22-340.85,P<0.0001),the postoperative increase in CD4 value(OR=10.59,95%CI:8.78-12.40,P<0.00001),and the postoperative decrease in CD8 value(OR=6.47,95%CI:4.44-8.50,P<0.00001)were also significantly higher than those in the TACE-alone treatment group.CONCLUSION Compared with TACE-alone treatment,TACE+CRA combined treatment not only improves the immune function of HCC patients with a diameter of≥5 cm,but also enhances the therapeutic efficacy and long-term survival rate,without increasing the risk of complications.Therefore,TACE+CRA combined treatment may be a more recommended treatment for patients with HCC with a diameter of≥5 cm.

Mechanism of imipenem-induced mental disorder: A meta-analysis

BACKGROUND Imipenem is a highly effective carbapenem antibiotic,which is widely used in the treatment of many serious bacterial infections.At the same time,it can also cause some adverse reactions,mental abnormalities are the most concerned central nervous system adverse reactions.Different patients respond differently to imipenem,and the effect of imipenem on psychiatric disorders is unclear.Therefore,meta-analysis summarizing the results of multiple previous studies can provide stronger evidence support for clinical guidelines to guide clinical rational use of imipenem to minimize risks.After reviewing the literature published between 2003 and 2017,seven controlled trials with a total of 550 patients were included,with 273 and 277 patients in the control and experimental groups,respectively.The sample size of the study ranged from a minimum of 30 cases to a maximum of 61 cases.Patients in the experimental group were treated with imipenem while the control group was treated with conventional drugs.Meta-analysis showed that the incidence of mental disorders in the experimental group was higher than that in the control group(odds ratio=3.66,95%confidence interval:1.11-12.11,P=0.030);however,there was no significant difference in the incidence of adverse reactions between the two groups(odds ratio=0.05,95%confidence interval:0.00 to 0.10,P=0.060).Funnel diagrams showed that the scattered points of each study were symmetrical and distributed in an inverted funnel shape;therefore,there was no publication bias.CONCLUSION Imipenem can cause mental disorders in patients.However,the low quality of the included literature may have affected the final results.Therefore,it is necessary to conduct a high-quality randomized controlled study with multiple samples to further confirm the mechanism of imipenem-induced mental disorders and provide effective guidance for clinical treatment.

Meta analysis of the efficacy of western medicine combined with Qiliqiangxin capsule versus western medicine alone in the treatment of chronic heart failure

Objective: To compare the clinical efficacy of conventional Western medicine combined with Qiliqiangxin capsule and western medicine alone in the treatment of chronic heart failure, and to prove that Qiliqiangxin capsule combined treatment has more advantages, providing reference for clinical decision-making in the treatment of chronic heart failure. Methods: Randomized controlled trials (RCTs) of conventional Western medicine treatment and Western medicine combined with Qiliqiangxin capsule in the treatment of chronic heart failure were searched in databases such as PubMed, Embase, Webofscience, CNKI, WanFang, VIP, and CBM. The bias risk assessment was conducted using the RCT tool recommended by Cochrane, and then the meta-analysis was performed using RevMan5.4 and Stata17 software. Compare the efficacy evaluation of cardiac function, left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDD), cardiac stroke output (SV), 6-minute walking test (6MWT), and N-terminal proBNP in the conventional western medicine combined with Qiliqiangxin capsule group (hereinafter referred to as the treatment group) and the conventional western medicine group (hereinafter referred to as the control group). Results: A total of 20 RCTs meeting the criteria were included, including 2953 patients, including 1508 in the treatment group and 1445 in the control group. The results of meta-analysis showed that the treatment group had significantly better cardiac function evaluation, LVEF, LVEDD, SV, 6MWT, and NT-proBNP improvement than the control group. Its central functional efficacy evaluation (OR=2.09,95% CI: 1.71-2.55, P<0.001), LVEF (WMD=7.05,95% CI: 5.30-8.79, P<0.00001), LVEDD (WMD=6.73, 95% CI: 3.18-10.29, P=0.0002), SV (WMD=6.73, 95% CI: 3.18-10.29, P=0.0002), 6MWT (SMD=0.70,95% CI: 0.54-0.87, P<0.00001), NT-proBNP (SMD=-1.95,95% CI: -2.5 2 to 1.38 (P<0.0001), with statistically significant differences. Conclusion: Conventional western medicine combined with Qiliqiangxin capsule can significantly improve the clinical efficacy of heart failure, improve LVEF, LVEDD, SV, and NT-proBNP index, and improve exercise tolerance. It is worth using for reference in the treatment.

Investigating the therapeutic efficacy of psilocybin in advanced cancer patients: A comprehensive review and meta-analysis

BACKGROUND Psilocybin,a naturally occurring psychedelic compound found in certain species of mushrooms,is known for its effects on anxiety and depression.It has recently gained increasing interest for its potential therapeutic effects,particularly in patients with advanced cancer.This systematic review and meta-analysis aim to evaluate the effects of psilocybin on adult patients with advanced cancer.AIM To investigate the therapeutic effect of psilocybin in patients with advanced cancer.METHODS A comprehensive search of electronic databases was conducted in PubMed,Cochrane Central Register of Controlled Trials,and Google Scholar for articles published up to February 2023.The reference lists of the included studies were also searched to retrieve possible additional studies.RESULTS A total of 7 studies met the inclusion criteria for the systematic review,comprising 132 participants.The results revealed significant improvements in quality of life,pain control,and anxiety relief following psilocybin-assisted therapy,specifically results on anxiety relief.Pooled effect sizes indicated statistically significant reductions in symptoms of anxiety at both 4 to 4.5 months[35.15(95%CI:32.28-38.01)]and 6 to 6.5 months[33.06(95%CI:28.73-37.40)].Post-administration compared to baseline assessments(P<0.05).Additionally,patients reported sustained improvements in psychological well-being and existential distress fo-llowing psilocybin therapy.CONCLUSION The findings provided compelling evidence for the potential benefits of psilocybin-assisted therapy in improving quality of life,pain control,and anxiety relief in patients with advanced cancer.

Vericiguat treatment of heart failure: A systematic review and metaanalysis

BACKGROUND Heart failure(HF),an end-stage manifestation of various cardiac diseases,poses an enormous economic and health burden on society.Vericiguat may be an effective drug in the treatment of HF.AIM To explore by meta-analysis the efficacy and safety of Vericiguat in treating chronic heart failure.METHODS Databases,including PubMed,EMBASE,Web of Science,and Cochrane Library,were searched to collect all published randomized controlled trials(RCTs)on Vericiguat treatment of chronic heart failure from the earliest electronic records to those published in March 2023.Two investigators independently screened the literature according to inclusion and exclusion criteria,evaluated the quality of the studies,and extracted valid data before conducting a meta-analysis using RevMan5.4.RESULTS Four RCTs with 5919 patients were included,and the meta-analysis showed that treatment with 10 mg Vericiguat reduced the incidence of the primary endpoint(a composite of cardiovascular mortality and first heart-failure-related hospital-ization)in patients with chronic heart failure compared to placebo[relative risk(RR)=0.91,95%confidence interval(CI):0.85–0.98,P=0.01],and reduced the incidence of heart-failure-related hospitalization(RR=0.92,95%CI:0.84–1.00,P=0.05).However,for the incidence of cardiovascular and all-cause death,there were no significant differences between the Vericiguat and placebo groups.In addition,the two groups did not show significant differences in blood pressure,heart rate,and Kansas Cardiomyopathy Questionnaire physical limitation score.In terms of safety,10 mg Vericiguat did not increase the risk of adverse effects in patients with chronic heart failure.Vericiguat may increase the risk of symp-tomatic hypotension(RR=1.17,95%CI:0.98–1.39,P=0.08)and syncope(RR=1.18,95%CI:0.90–1.55,P=0.24),but not significantly.CONCLUSION Vericiguat(10 mg)was more effective than placebo in treating patients with chronic heart failure and had a better safety profile.

Meta-analysis of efficacy and safety of concurrent or staged bilateral total knee arthroplasty

Objective: To study the safety and efficacy of concurrent bilateral total knee arthroplasty orstaged bilateral total knee replacement using meta-analysis. Methods: The databases of ChinaWanfang, CNKI, PubMed, Cochrane Library, and Web of Science were searched conducted formeta-analysis of the extracted data using Review Manager 5.3 software. Results: ①A total of 18retrospective cohort studies were included, 72 831 patients in the same period group and 103595 patients in the staging group. ②The results of meta showed that in the staging group, theincidence of postoperative cardiac complications[OR= 1.21, 95%CI=(1.10~1.34), P<0.000 1] ,neurological complications[OR=1.67, 95%CI=(1.29~2.16), P<0.000 1], deep vein thrombosis[OR=1.38, 95%CI(1.27~1.50), P<0.000 01], mortality[OR=2.18, 95%CI=(1.67~2.84),P<0.000 01] and perioperative blood loss [OR=246.75, 95%CI=(233.30~260.20)] were lessthan those in the same period group (P<0.000 01);The postoperative deep infection rate in thesame period group [OR=0.61, 95%CI=(0.52~0.71), P<0.000 01] was lower than that in thestaging group;The postoperative superficial infection rate [OR=0.96, 95%CI=(0.66~1.40)],revision rate of joint replacement [OR= 1.04, 95%CI=( 0.96~1.12)], HSS score [OR=0.10,95%CI=(-0.61~0.80), P=0.79] and knee joint activity score [OR=-0.23, 95%CI=(-1.25~0.78)]were not statistically significant between the two groups(P>0.05).Conclusion: Stagingbilateral total knee replacement can more effectively reduce the incidence of perioperativecomplications and reduce the amount of blood transfusion, while concurrent bilateral total kneereplacement can reduce the rate of deep infection. To further compare the efficacy and safety ofconcurrent or staged bilateral total knee arthroplasty, further studies must be conducted in theform of a randomized clinical trial to evaluate the results mentioned in this meta-analysis.

Efficacy and safety of Revlimid combined with Rituximab in the treatment of follicular lymphoma: A meta-analysis

Objective:To evaluate the clinical efficacy and safety of lenalidomide combined with rituximab for treating follicular lymphoma.Methods:We searched PubMed,Web of Science,Cochrane Library,Embase,China Medical Biological Service system(CBM),VIP database(VIP),Wan fang database(Wan Fang Data),China Knowledge Network(CNKI),and ClinicTrails.gov for literature related to lenalidomide combined with rituximab for treating follicular lymphoma(until June 23,2022).The literature that met the requirements were screened out according to the established criteria,and the data were analyzed by RevMan5.4 and Stata14.0 to conduct a meta-analysis.Results:Eight studies involving 865 patients with follicular lymphoma were included.The results of the meta-analysis showed that the objective remission rate(RR=1.43,95%CI:1.26–1.61)and complete remission rate(RR=1.67,95%CI:1.27–2.21)of lenalidomide combined with rituximab for treating follicular lymphoma were significantly higher than those of rituximab alone.However,adverse reactions(neutropenia,diarrhea,nausea and vomiting,rash)were more likely to occur in the lenalidomide combined with the rituximab group,albeit at a low level.Conclusion:Compared to rituximab alone,lenalidomide combined with rituximab could significantly improve the objective and complete remission rates of patients with follicular lymphoma.However,as combination therapy may be associated with adverse reactions,timely corresponding measures should be taken during treatment.Therefore,to confirm the efficacy and safety of lenalidomide combined with rituximab for treating follicular lymphoma,it is necessary to conduct multicenter,multi-sample,randomized double-blind controlled trials,and single-arm trials.

Meta-analysis of the efficacy of volar plate internal fixation versus closed reduction and external fixation in the treatment of adult distal radius fractures

Objective:To compare the efficacy of open reduction and volar locking plate internal fixation with closed reduction and external fixation in the treatment of distal radius fractures by using meta analysis.Methods:The databases of CNKI,Wanfang,Weipu,Chinese biomedical literature,Pubmed,Embase,and Cochrane Library were retrieved,and the randomized controlled studies that directly compared the efficacy of plate internal fixation and closed reduction external fixation in the treatment of distal radius fractures published publicly from the establishment of the database to April 2023 were collected.The two researchers independently screened the retrieved literature according to the inclusion and exclusion criteria,extracted data,used Cochrane risk bias assessment tool for quality assessment,and used RevMan 5.4 software for meta analysis.Results:A total of 10 randomized controlled trials were included,all of which were in English.There were 1042 patients in total,and 9 of them were rated as low risk.Meta analysis results showed that one year after the treatment of distal radius fracture with volar locking plate internal fixation,DASH score[MD=-5.64,95%CI(-7.21,-4.06),P<0.00001];One year later,PRWE score[MD=-5.90,95%CI(-8.88,-2.92),P=0.001];Palm flexion[MD=5.92,95%CI(1.29,10.55),P=0.01];Pronation[MD=2.48,95%CI(0.59,4.36),P=0.01];Postrotation[MD=4.73,95%CI(2.15,7.31),P=0.0003];Grip strength[MD=0.61,95%CI(0.12,1.10),P=0.02];palmar tilt angle[MD=9.84,95%CI(5.66,14.02),P<0.00001];Radial inclination[MD=4.33,95%CI(2.97,5.69),P<0.00001]was superior to closed reduction plaster or splint external fixation.One year later,the European Five dimensional Health Scale(EQ-5D-5L)score[MD=0.02,95%CI(-0.01,0.05),P=0.27];Back extension[MD=2.22,95%CI(-4.15,8.59),P=0.49];Ulnar deviation[MD=3.49,95%CI(-0.80,7.78),P=0.11];Radial deviation[MD=2.05,95%CI(-2.39,6.50),P=0.37];Ulnar variance[MD=-1.14,95%CI(-3.16,0.88),P=0.27];There was no significant difference in complications[MD=0.77,95%CI(0.54,1.10),P=0.16](P>0.05).Conclusion:Based on the current clinical data,internal fixation with volar locking plate is more conducive to mid-term DASH score and grip strength recovery than closed reduction plaster or splint external fixation,but there is no significant difference in the quality of life and complications of patients.For adult distal radius fractures,surgical indications should be carefully grasped,and non operative treatment should be given priority.

System Evaluation and Meta Analysis of Total Clinical Effective Rate of Acupuncture and Moxibustion in Treating Depression during 2019-2022

[Objectives]To systematically evaluate the total clinical effective rate of acupuncture treatment of depression,and provide clinical reference for the scheme design and selection of acupuncture treatment of depression.[Methods]By searching CNKI,Wanfang Data,CBM,VIP,Cochrane Library,Cochrane Central,Springer and other databases,randomized controlled experiment(RCT)on acupuncture and moxibustion treatment of depression from January 1,2019 to August 31,2022 was collected,to extract relevant data of total clinical effective rate and conduct methodological quality evaluation.ReviewManager 5.4.1 software was used for Meta analysis.[Results]22 RCTs were included,1602 patients in total.Among them,there were 804 cases in treatment group and 798 cases in control group.Meta analysis results displayed that acupuncture and moxibustion treatment of depression may be better than the control group in improving the total clinical effective rate,and the difference was statistically significant[MD=1.16,95%CI(1.11,1.21)].[Conclusions]Acupuncture and moxibustion can achieve a higher total clinical effective rate in the treatment of depression,which is worthy of clinical application.However,due to fewer studies included in this systematic evaluation,small sample size,and low quality,there was a high possibility of bias.Therefore,the above conclusions needed to be verified by high-quality,large-sample,and multi-center RCTs.

A Meta-analysis of the spirit turtle eight method Acupuncture Therapy for Insomnia

Objective:To systematically evaluate the efficacy and safety of the spirit turtle eight method acupuncture therapy in the treatment of insomnia,to better serve the clinic and provide reference ideas for the treatment of insomnia.Methods:Search CNKI,CBM,Wanfang,Weipu,China Clinical Trial Registry databases on the use of the spirit turtle eight method compared with others interventions to treat insomnia.The search period is from the library until August 1,2021,two researchers will conduct independent quality evaluation and effect size extraction on the literature,and use STATA16.0 and Review5.3 to conduct Meta analysis and quality evaluation on the literature.Through screening,a total of 18 eligible documents participated in the meta-analysis,with a total of 1583 cases.Results:①The effective rate of the spirit turtle eight method in the treatment of insomnia is higher than the control group[RR=1.213,95%CI(1.155,1.274),Z=7.71,P<0.01];②The Pittsburgh Sleep Quality Index(PSQI)score is lower than other acupuncture treatments[WMD=-2.33,95%CI(-2.75,-1.91),Z=10.97,P<0.01];③The one-month follow-up PSQI score after the treatment of insomnia by the spirit turtle eight method is lower than the control group[WMD=-3.263,95%CI(-3.446,-3.080),Z=34.96,P<0.01];④No studies have reported serious adverse reactions in the treatment group and control group.Conclusion:Based on the current research,the spirit turtle eight method are better than the control group in the treatment of insomnia,and are suitable for clinical application.However,more high-quality clinical studies are still needed to prove its efficacy.

Meta-analysis of the impact of hyperuricemia on contrast agent-related acute kidney injury after percutaneous coronary intervention

Objective:To evaluate the impact of hyperuricemia on the occurrence of contrast agentrelated acute kidney injury after percutaneous coronary intervention.Methods:Retrieve PubMed,Embase,Cochrane Library,Web of Science,CNKI,Wanfang,and VIP databases,and publish articles on the correlation between hyperuricemia and contrast agent-related acute kidney damage after percutaneous coronary intervention from the establishment of the database to August 162023.Two researchers independently conducted literature screening and data extraction to evaluate the bias risk of inclusion in the study,and conducted metaanalysis using Review Manager 5.4 software.Results:A total of 12 articles were included,including 11676 patients.The meta-analysis results showed that compared with patients without hyperuricemia,patients with hyperuricemia had a higher risk of developing PC-AKI,with an incidence rate of 22.3%.Hyperuricemia was a risk factor for the occurrence of PCAKI(OR=2.03,95%CI:1.58-2.61);Patients with hyperuricemia have a higher risk of death after PC-AKI,with a mortality rate of 7.5%.Hyperuricemia is a risk factor for early death in PC-AKI patients(OR=2.33,95%CI:1.81-3.00);The probability of CRRT treatment after PCAKI in patients with hyperuricemia is higher,at 3.14%.Hyperuricemia is an influencing factor for CRRT treatment in PC-AKI patients(OR=7,95%CI:2.83-17.30).Conclusion:Existing research evidence suggests that the presence of hyperuricemia is an independent risk factor for the occurrence of PC-AKI,and it significantly increases the hospital mortality rate and the risk of renal replacement therapy in PC-AKI patients.

Meta analysis of safety and effectiveness of anastomosis of esophagus and jejunum overlap in total laparoscopic total gastrectomy

Objective:To systematically evaluate and compare the safety and effectiveness of esophagojejunostomy and traditional esophagojejunostomy in total laparoscopic total gastrectomy in the treatment of gastric cancer,providing evidence-based medical evidence for clinical practice.Methods:PubMed,Embase,Cochrane Library,Web of Science,CNKI,Wanfang and VIP databases were searched by computer,and the retrieval time was up to December 2021.Relevant literatures were obtained,and eligible studies were gradually screened and included.Cochrane ROB bias risk assessment tool and NOS scale were used to evaluate the quality of the articles,and required data were extracted from high-quality literatures.Finally,meta-analysis was performed using Review Manager 5.3 software.Results:Eleven studies were finally included,including 1398 patients,including 566 patients receiving overlap anastomosis and 832 patients receiving traditional anastomosis.The results show that overlap anastomosis and traditional anastomosis had the advantages of operation time(MD=0.63,95%CI=7.22,8.48,P=0.88),postoperative first exhaust time(MD=-0.13,95%CI=0.43,0.18,P=0.42),postoperative first feeding time(MD=0.02,95%CI=0.33,0.37,P=0.91),anastomotic leakage(OR=1.38,95%CI=0.73,2.63,P=0.32),and postoperative hospital stay(MD=-0.16,95%CI=0.82,0.51,P=0.64)had no significant differences(all P>0.05).Compared with traditional anastomosis,overlap anastomosis had longer anastomosis time(MD=5.60,95%CI=0.59,10.62,P=0.03),higher incidence of anastomotic bleeding(OR=2.48,95%CI=1.08,5.69,P=0.03),less intraoperative bleeding(MD=-6.42,MD=-6.42,OR=2.48,95%CI=1.08,P=0.03).95%CI=10.28,-2.56,P=0.001)and anastomotic stenosis(OR=0.17,95%CI=0.06,0.46,P=0.0006).Conclusion:Overlap esophagojejunostomy is a safe,effective and prognostic surgical method,and is expected to become the standard esophagojejunostomy in total laparoscopic total gastrectomy.

Meta-analysis of the effects of high-intensity intermittent exercise on cardiopulmonary function rehabilitation in patients with stroke

Objective:Systematically evaluate the rehabilitation effect of high-intensity intermittent exercise(HIIT)on cardiovascular function in stroke patients,in order to provide a basis for selecting the best rehabilitation plan for stroke patients.Methods:Computer retrieval of CNKI,WanFang Data,VIP,CBM,Pubmed,EMbase,Web of science,The Cochrane Library databases was conducted from the establishment of the database until March 2023.Randomized controlled trials on HIIT improving cardiovascular function in stroke patients were included,and the included literature was screened,data extracted,and bias risk evaluated.Then,metaanalysis was conducted using RevMan 5.4 software and Stata17.0 software.Results:In the end,9 articles met the research criteria,with a total of 428 patients.The meta-analysis results showed that compared with the control group,HIIT had significant effects on peak oxygen uptake(VO2peak)[MD=3.87,95%CI(3.43,4.31),P<0.00001],minute ventilation(VE)[MD=7.14,95%CI(4.34,9.94),P<0.00001],peak power(WRpeak)[MD=17.13,95%CI(13.7320.54),P<0.00001],6-minute walking distance(6MWD)[MD=43.82,95%CI(16.08,71.56),P=0.002],The intervention effect of the 10 meter walking test(10MWT)[MD=-2.00,95%CI(-2.91,-1.08),P<0.0001]was better than that of the control group.Conclusion:The current analysis results show that compared to conventional rehabilitation therapy or continuous aerobic exercise,HIIT has more advantages in improving the cardiopulmonary function of stroke patients.

The diagnostic value of the expression of the thymidine kinase 1 in lung cancer:A meta analysis

Objective:To study is to evaluate the diagnostic value of the expression of thymidine kinase 1(TK1)in lung cancer through literature review and meta-analysis.Methods:Firstly,we searched Pubmed,Embase,Cochrane,Web of Science,CBM,CNKI,Wanfang and other databases up to June 2022.Then two researchers separately selected the clinical study on diagnosis of lung cancer by the expression of the TK1 and treatment and obtained the full text of the literature.Then we evaluated the systematic quality and bias risk of the included literatures by using Revman 5.3 software,and the consistency among the covariables in meta analysis.Finally,the Sensitivity(Sen),the Specificity(Spe)and other indicators were analyzed by using Stata16.0 software.Results:The study included 37 literatures,including 3218 lung cancer cases and 2976 control cases.The meta-analysis showed that the Ser and Spe of the expression of the TK1 in the diagnosis of lung cancer were 0.63(95%CI:0.57,0.68)and 0.88(95%CI:0.84,0.91),while positive likelihood ratio(PLR)was 5.34(95%CI:4.02,7.1)and negative likelihood ratio(NLR)was 0.42(95%CI:0.37,0.48),diagnostic odd sratio(DOR)was 12.69(95%CI:8.91,18.08),and the area under the ROC curve(AUC)was 0.82(95%CI:0.79,0.85).When TK1,CEA and CYFRA21-1 were used as combined diagnostic indexes of lung cancer,Sen was 0.82(95%CI:0.76,0.86),Spe 0.78(95%CI:0.46,0.94),PLR 3.69(95%CI:1.28,10.66),NLR 0.24(95%CI:0.18,0.31),DOR 15.59(95%CI:4.56,53.36),AUC 0.84(95%CI:0.80,0.87).The Youden index of combined diagnosis was 0.60,which was higher than that of TK1 alone.Conclusion:TK1 alone as a diagnostic index of lung cancer has low Sen,but its Sep is higher.So it has a certain diagnostic value.TK1 combined with CEA and CYFRA21-1 has higher Sen in the diagnosis of lung cancer,and the diagnostic value is better.

Meta analysis and data mining of the method of yishenhuoxue in the treatment of nonproliferative diabetic retinopathy

Objective:To evaluate the efficacy and safety of the method of Yishen Huoxue in the intervention of nonproliferative diabetic retinopathy(NPDR)by Meta analysis and explore the medication regularity of Chinese Medicine(TCM)based on data mining.Methods:The related literature of TCM in the treatment of NPDR published in CNKI,VIP,WF,PubMed,the Cochrane Library,SinoMed,Embase were collected.The quality of the included literature was evaluated with reference to the Cochrane System Evaluators'Handbook,and statistical analysis was performed by applying Revman 5.4.1 software.After normalization of the Chinese medicine names,association rule analysis was performed by using SPSS Modeler 18,and then Cytoscape was used to produce complex network diagrams.Results:20 RCTs were included.Meta-analysis results showed that the method of Yishen Huoxue or Yishen Huoxue combined with western medicine were better than the control group in improving the total clinical efficiency[RR=1.21,95%CI(1.16,1.27),P<0.00001],TCM symptom efficacy[RR=1.28,95%CI(1.18,1.39),P<0.00001],and visual acuity[MD=0.11,95%CI(0.05,0.17),P=0.0001],HDL-C[MD=0.14,95%CI(0.03,0.25),P=0.02];reducing the number of fundus hemangiomas[MD=-3.51,95%CI(-5.73,-1.28),P=0.002],hemorrhagic spot area[MD=-0.70,95%CI(-0.95,-0.46),P<0.00001],CMT[MD=-35.31,95%CI(-55.47,-15.14),P=0.0006],FBG[MD=-0.39,95%CI(-0.72,-0.05),P=0.02],LDL-C[MD=-0.36,95%CI(-0.64,-0.08),P=0.01],whole high blood viscosity[MD=-0.43,95%CI(-0.75,-0.12),P=0.006],plasma viscosity[MD=-0.36,95%CI(-0.67,-0.06),P=0.02]and fibrinogen[MD=-0.50,95%CI(-0.81,-0.19),P=0.002].The differences were statistically significant.The 20 recipes entered involved a total of 70 herbal medicines.It is analyzed that the high-frequency drugs and the core drugsare gou qi,san qi,dan shen,haung qi,sheng di huang,et al.The association rule analysis summarizes the commonly used pairs including:sheng di huang-san qi,sheng di huang-gou qi,et al.Conclusions:Compared with western medicine treatment alone,the method of Yishen Huoxue or Yishen Huoxue combined with western medicine produce better effects,but it still needs to be verified by higher quality clinical studies.

Meta-analysis of the acupoint application therapy for stable chronic obstructive pulmonary disease

Objective:To systematically evaluate the clinical efficacy and safety of acupoint application in the treatment of stable chronic obstructive pulmonary disease.Methods:A comprehensive search of domestic and international databases,the search time is limited to nearly ten years,collecting traditional Chinese medicine acupoint application in the treatment of chronic obstructive pulmonary disease in stable phase of randomized controlled trials.Literature screening,information extraction and literature quality evaluation were carried out independently by two researchers,and Meta analysis was carried out by Revman software.Results:A total of 42 RCTs with a total of 4192 patients were included.The results of Meta analysis showed that:Compared with the routine treatment of western medicine,the addition of acupoint application therapy can significantly increase the effective rate[RR=1.23,95%CI(1.19,1.27),P<0.00001]and FEV1/FVC[MD=4.46,95%CI(3.17,5.76),P<0.00001].Significantly improved BODE index[MD=-0.63,95%CI(-0.87,-0.40),P<0.00001],SGRQ score[MD=-6.77,95%CI(-9.81,-3.72),P<0.00001],CAT score[MD=-3.33,95%CI(-3.87,-2.79),P<0.00001]and TCM syndrome integral[MD=-3.51,95%CI(-3.96,-3.06),P<0.00001].The differences is statistically significant and the safety profile is good.Conclusion:On the basis of routine treatment of COPD western medicine,acupoint application therapy can significantly improve the clinical symptoms of patients with less adverse reactions.However,due to the limitations of the research,high-quality research is still needed to provide further evidence.

Meta‑analysis of influencing factors associating with treatment outcome of multidrug resistant tuberculosis

Objective:To systematically review the influencing factors of the treatment outcome of multidrug-resistant pulmonary tuberculosis and provide reference for the prevention and treatment of multidrug-resistant pulmonary tuberculosis.Method:Case control studies on the factors influencing the treatment outcome of multidrug-resistant pulmonary tuberculosis in Chinese databases(CNKI,VIP,Wanfang,Sinomed)and English databases(Pubmed,Web of science,Medline,Embase,Scopus)were searched and collected by computer.The search period was from the establishment of the database to January 2023.After screening and quality evaluation,RevMan5.4 was used for meta-analysis.Result:Totally 18 articles were ultimately included,with a sample size of 7328 people.The results showed that retreatment,complications,adverse reactions,and gender were related to the treatment outcome of multidrug-resistant pulmonary tuberculosis.The OR values and 95%CI of each factor were 0.22(0.17-0.29),0.38(0.32-0.46),0.27(0.17-0.44),and 0.43(0.33-0.56),respectively.Conclusion:Complications,retreatment,adverse reactions,and male gender are effective risk factors for the treatment outcome of multidrug-resistant pulmonary tuberculosis.In clinical practice,more targeted measures are needed for different types of patients.Due to the limitations of the number of studies,the above conclusions require more research to support them.

A Meta-Analysis: Safety and Efficacy of Phacoemulsification with Goniosynechialysis versus Trabeculectomy for Acute Angle Closure Glaucoma in China

Aim: The aim is to evaluate the safety and efficacy of phacoemulsification with goniosynechialysis versus trabeculectomy in the treatment of acute angle closure glaucoma (AACG) systematically. Methods: From January 1, 2000 to August 31, 2022, we searched PubMed, Science Citation Index Database, China National Knowledge Infrastructure, and Wanfang Database for pertinent material about the treatment of AACG with various operations. The imported literature was carefully vetted using the inclusion and exclusion criteria, assessed for quality, and the raw data were retrieved and integrated into EndNoteX9. For the meta-analysis, STATA 16.0 and RevMan 5.3 were used as the tools. Results: The meta-analysis includes 20 clinical investigations in all, involving 1463 eyes. The quality of the literature was rated as excellent and the data homogeneity among the studies was excellent based on the various study types that were included in the literature. According to a meta-analysis, phacoemulsification with goniosynechialysis is superior to trabeculectomy for treating acute angle-closure glaucoma because it results in improved postoperative visual acuity, lower intraocular pressure, a broader anterior chamber depth, and fewer complications. Conclusion: If conditions allow, phacoemulsification in conjunction with goniosynechialysis performs better than trabeculectomy in terms of visual acuity, intraocular pressure, anterior chamber depth, and comorbidities.

A Meta-Analysis: Safety and Efficacy of Phacoemulsification with Goniosynechialysis versus Trabeculectomy for Acute Angle Closure Glaucoma in China

Aim: The aim is to evaluate the safety and efficacy of phacoemulsification with goniosynechialysis versus trabeculectomy in the treatment of acute angle closure glaucoma (AACG) systematically. Methods: From January 1, 2000 to August 31, 2022, we searched PubMed, Science Citation Index Database, China National Knowledge Infrastructure, and Wanfang Database for pertinent material about the treatment of AACG with various operations. The imported literature was carefully vetted using the inclusion and exclusion criteria, assessed for quality, and the raw data were retrieved and integrated into EndNoteX9. For the meta-analysis, STATA 16.0 and RevMan 5.3 were used as the tools. Results: The meta-analysis includes 20 clinical investigations in all, involving 1463 eyes. The quality of the literature was rated as excellent and the data homogeneity among the studies was excellent based on the various study types that were included in the literature. According to a meta-analysis, phacoemulsification with goniosynechialysis is superior to trabeculectomy for treating acute angle-closure glaucoma because it results in improved postoperative visual acuity, lower intraocular pressure, a broader anterior chamber depth, and fewer complications. Conclusion: If conditions allow, phacoemulsification in conjunction with goniosynechialysis performs better than trabeculectomy in terms of visual acuity, intraocular pressure, anterior chamber depth, and comorbidities.