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.

A Meta-Analysis of the Prognostic and Clinicopathological Significance of circZFR in Human Gastrointestinal Cancers

Background: Studies of gastrointestinal (GIT) cancers have shown that circZFR could be involved in the development and progression of various GIT cancers. However, small sample sizes limit the clinical significance of these studies. Here, a meta-analysis was conducted to ascertain the actual involvement of circZFR in the development and prognosis of GIT cancers. Methods: PubMed, Embase, Web of Science, and the Cochrane Library were searched up to December 31, 2023. Hazard ratios (HRs) or odds ratios (ORs) with 95% confidence intervals (CIs) were pooled to evaluate the association between circZFR expression and overall survival (OS). Publication bias was measured using the funnel plot and Egger’s test. Results: 10 studies having 659 participants were enrolled for meta-analysis. High circZFR expression was associated with poor OS (HR = 1.4, 95% CI: 1.20, 1.70). High circZFR expression also predicted larger tumor size (OR = 4.38, 95% CI 2.65, 7.25), advanced clinical stage (OR = 5.33, 95% CI 3.10, 9.16), and tendency for distant metastasis (OR = 2.89, 95% CI: 1.62, 5.11), but was not related to age, gender, and histological grade. Conclusions: In summary, high circZFR expression was associated with poor OS, larger tumor size, advanced stage cancer and tendency for distant metastasis. These findings suggested that circZFR could be a prognostic marker for GIT cancers.

Carbocysteine as Adjuvant Therapy in Acute Respiratory Tract Infections in Patients without Underlying Chronic Conditions: Systematic Review and Meta-Analysis

Objective: This study aims to systematically examine the existing evidence regarding the clinical benefits of carbocysteine as an adjunctive treatment in acute bronchopulmonary and otorhinological processes. Design: Systematic review and meta-analysis. Data sources: An electronic search was conducted across PubMed, Cochrane Library, clinicaltrials.gov, and the European Clinical Trial Register, with the search dated to May 2023. Bibliographic references from other literature reviews and meta-analyses were also reviewed. The search was limited to randomized clinical trials published in any language and year. It was completed by cross-checking the references of the located articles. Methods: Inclusion criteria covered studies assessing systemic or inhaled carbocysteine, regardless of dosing regimen. Concomitant medication use was acceptable if balanced between intervention and control groups. Authors independently extracted data, resolving disagreements through consensus. Methodological quality assessment relied on critical reading of each study. Dichotomous variables were analyzed using odds ratio (OR), and a final effect size was calculated. Statistical significance was established when confidence intervals did not cross the neutral value. Heterogeneity was assessed via the X2 test and I2 index. Results: Out of 318 initially identified studies, 4 met inclusion criteria. The meta-analysis for poor general condition yielded an OR of 0.45 in favor of intervention, p = 0.013, with non-significant heterogeneity. Cough events showed a percentage of 15.8% for carbocysteine vs. 27.2% for placebo. On the seventh day, expectoration rates were 18.37% for carbocysteinevs 33.3% for placebo. Conclusions: The observed clinical benefits align with carbocysteine’s mucoactive and muco-regulatory properties, complemented by anti-inflammatory and antioxidant actions. Carbocysteine stands out among mucolytic agents. In the context of persistent infectious diseases, the study emphasizes the need for further exploration of carbocysteine’s therapeutic potential as an adjunctive treatment for acute respiratory infections. These findings underscore its significance in the evolving landscape of respiratory healthcare.

Prevalence of Latent Tuberculosis Infection [LTBI] in Prison Officers: A Systematic Review and Meta-Analysis

This study aimed to perform a systematic review and meta-analysis to determine the LTBI prevalence in prison officers worldwide. A systematic search was performed in PubMed, WoS, Embase, and BVS, including all articles related to LTBI prevalence and risk factors. After critical evaluation and qualitative synthesis of the identified articles, a meta-analysis was used. Five studies carried out between 2012 and 2022 were included, with a total sample size of 1718 prison officers. The overall LTBI prevalence was 50% [95% confidence interval [CI]: 48% - 52%;n = 816], with high heterogeneity between studies. Smoking [OR = 1.76;CI 95% = 1.26 - 2.46] and males [OR = 2.08;CI 95% = 1.31 - 3.31] were positively related to a higher LTBI prevalence among prison officers. Thus, preventive measures and the rapid and accurate diagnosis of new cases should be emphasized to ensure tuberculosis control, especially among risk groups such as prison officers.

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.

A network meta-analysis on comparison of invasive and non-invasive sampling methods to characterize intestinal microbiota of birds

Birds maintain complex and intimate associations with a diverse community of microbes in their intestine.Multiple invasive and non-invasive sampling methods are used to characterize these communities to answer a multitude of eco-evolutionary questions related to host-gut microbiome symbioses.However,the comparability of these invasive and non-invasive sampling methods is sparse with contradicting findings.Through performing a network meta-analysis for 13 published bird gut microbiome studies,here we attempt to investigate the comparability of these invasive and non-invasive sampling methods.The two most used non-invasive sampling methods(cloacal swabs and fecal samples)showed significantly different results in alpha diversity and taxonomic relative abundances compared to invasive samples.Overall,non-invasive samples showed decreased alpha diversity compared to intestinal samples,but the alpha diversities of fecal samples were more comparable to the intestinal samples.On the contrary,the cloacal swabs characterized significantly lower alpha diversities than in intestinal samples,but the taxonomic relative abundances acquired from cloacal swabs were similar to the intestinal samples.Phylogenetic status,diet,and domestication degree of host birds also influenced the differences in microbiota characterization between invasive and non-invasive samples.Our results indicate a general pattern in microbiota differences among intestinal mucosal and non-invasive samples across multiple bird taxa,while highlighting the importance of evaluating the appropriateness of the microbiome sampling methods used to answer specific research questions.The overall results also suggest the potential importance of using both fecal and cloacal swab sampling together to properly characterize bird microbiomes.

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.

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.

Literature Review, Meta-Analysis, and Mega-Analysis in Ecological and Agricultural Sciences

Literature review is an important component in any scientific research. In ecological and agricultural sciences, many studies have been conducted over years. With accumulation of scientific studies and published papers, it is critical to summarize and evaluate these previous research findings. Different literature review methods have been applied, including traditional qualitative literature review, quantitative meta-analysis, and more recently, mega-analysis, or meta-meta-analysis. Here we briefly describe these different approaches and draw attention to the recent development of data synthesis. Several case studies were used to illustrate the application of these methods in the ecological and agricultural sciences.

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.

Comparison of external treatment of Acupuncture and moxibustion and intervention of Chinese and Western Medicine on postoperative pain of hemorrhoids:A systematic review and meta-analysis

Background To evaluate the clinical efficacy and safety of acupuncture and moxibustion in the treatment of postoperative pain of hemorrhoids compared with traditional Chinese medicine and western medicine.Methods CNKI,PubMed,Cochrane Library,Science Direct,Wan Fang,VIP,CBM,WOS,Bailian Yun Library and other databases were systematically retrieved from January 1,2017 to October 31,2022 for clinical randomized controlled trials of acupuncture versus traditional Chinese medicine and Western medicine for postoperative pain in hemorrhoids.The two evaluators independently retrieved,sifted through literature and extracted data for inclusion in a randomized controlled trial of acupuncture for the treatment of hemorrhoid pain that matched the study.Literature quality assessment was performed using RevMan5.4 for meta-analysis.Results A total of 540 related literature articles were retrieved,of which 139 were from CNKI,104 from Wan Fang,26 from VIP,7 from PubMed,9 from Cochrane Library,35 from WOS,173 from CMB,1 from Science Direct and 46 from the Bailian Yun Library,Screening resulted in inclusion of 10 RCTs including 870 patients.Meta analysis showed no statistically significant difference between the degree of pain in 2 hours[MD=-0.01,95%CI(-0.23,0.24),P=0.95].And it showed that the total effective rate of the two groups was[RR=1.14,95%CI(1.06,1.24),P=0.001],intervention for 2 days pain degree was[MD=0.41,95%CI(0.13,0.69),P=0.004],the length of hospital stay was[SMD=1.10,95%CI(0.73,1.48),P<0.00001],the incidence of adverse reaction was[RR=0.15,95%CI(0.03,0.79),P=0.03],the difference was statistically significant(P<0.05).Conclusion Drug treatment is effective quickly,analgesia effect is better than acupuncture in early treatment,but the effect is not lasting.Acupuncture treatment is slow to start but the effects of acupuncture will gradually become apparent at a later stage.However,due to the poor quality of collection,multicenter,large sample size and double-blind randomized controlled trials are still needed.

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.

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 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.

A Systematic Review and Meta-Analysis of Randomized Control Trials to Check Role of Non-Steroidal Anti-inflammatory Drugs as Protective Factor in Alzheimer Disease Subjects

Background: Alzheimer’s disease is the major neurodegenerative disease, affecting more than two third cases of dementia in the world. NSAIDs are widely used anti-inflammatory analgesic agents representing 7.7% of worldwide prescriptions of which 90% are in patients over 65 years old. Based on mixed findings observed by different RCTs, a systematic review and meta-analysis were conducted to develop a better understanding of the protective role of Non-steroidal anti-inflammatory drugs (NSAIDs) in AD. Methods: Database search was Pubmed, WebScience, and Embase. RCTs investigating the effect of NSAIDs on AD or test scores assessing cognitive function in people without AD at baseline were included. Three indicators were MMSE Score, ADAS-cog score, and CDR-sob. 10 studies were included in the present Meta-analysis. Results: For the ADAS-cog score, the pooled effect size was -0.31 with 95% CI -0.06 to 0.02, which was statistically significant (p = 0.03). MMSE score difference, the pooled effect size was -0.06 with 95% CI -0.22 to 0.10, which was statistically insignificant (p-value = 0.47). For the MMSE average score, the pooled effect size was -0.002 with 95% CI -0.03 to 0.07, which was statistically insignificant (p-value = 0.87). For the CDR-sob score difference, the pooled effect size calculated using the random effect model was -0.06 with 95% CI -0.39 to 0.05 which was statistically insignificant (p = 0.14). For CDR-sob average score, the pooled effect size calculated using the random effect model was 0.21 with 95% CI -0.09 to 0.51, which was statistically insignificant (p-value = 0.17). Conclusion: Present Meta-analysis shows that NSAIDs in general are not effective in the treatment of AD. They also have no protective effect against the development of AD on their sustained use.

Non-Steroidal Anti-Inflammatory Drugs as Protective Factor in Alzheimer’s Diseases: A Systematic Review and Meta-Analysis Protocol

Introduction: NSAIDs inhibit COX-2, which is responsible for regulating neurons leading to neurodegeneration in Alzheimer’s disease. Alzheimer’s disease is a neurodegenerative disease affecting the geriatric population, as it affects more than two third cases of dementia in the sphere. Results obtained from experimental and observational studies were unclear regarding the protective role of NSAIDs in AD, therefore this justifies the need for meta-analysis. Methods: Database search was PubMed, Web of Science, and Embase. Experimental studies and Observational studies investigating the effect of NSAIDs on AD. For experimental studies indicators used were MMSE score, ADAS-cog score, CDR-sob score, NPI score, and Hazard ratio. Similarly for Observational studies, Odds Ratio and Relative Risk are used. Results: As this is the study protocol, therefore it is not possible to write the results of the study in the study protocol. There is a total of 06 (MMSE, ADAS-cog, CDR-sob, HR, RR, and OR) indicators used in the study, so 06 results will be obtained showing the pooled effect size which will indicate the use of NSAIDs as a protective factor for Alzheimer’s disease. Discussion: The present systematic review will improve the understanding of the relative efficacies of NSAIDs in AD and possibly guide clinical practices by providing the current best evidence on the efficacy of various regimens of NSAIDs in the management of AD subjects. Conclusion: Conclusion can be drawn only after the final meta-analysis using three study design (RCT, Cohort and Case-control study designs) and six indicators.

Meta-Analysis Study of the Effects of Yeast Probiotic Supplementation on Milk Production and Energy Corrected Milk of Lactating Dairy Cows

The aim of this study was to use a meta-analytic approach to evaluate the effect of commercially available yeast probiotic “Actisaf®; Sc 47” (Saccharomyces cerevisiae CNCM I-4407) produced and marketed by Phileo by Lesaffre on milk performance in dairy cows. Data from 22 trials including 17 with parallel designs and 5 with cross-over designs were collected, and only data with parallel designs were analyzed. From those trials, 4 are published and 13 are from technical reports. In total, 34 comparisons and 1074 dairy cows met the criteria for inclusion in the final analysis of milk yield (MY). For energy corrected milk (ECM), six trials with 12 comparisons and 476 dairy cows met the criteria for inclusion in the final analysis. Because the data are from different trials with different conditions, the statistical model defined includes the fixed effect of the treatment (with vs. without Actisaf® Sc 47) and the random effect of the trial. The meta-analysis showed a moderate heterogeneity for MY and ECM. The random effect meta-analysis showed an estimated mean difference +1.72 kg/d [95% confidence interval (CI): 1.01 to 2.44] and +2.45 kg/d (95% CI: 1.73 to 3.17) for MY and ECM respectively, in favour of Actisaf® Sc 47. The analysis of data without trials conducted under heat stress conditions showed positive effect of Actisaf® Sc 47. The random effect meta-analysis showed an estimated mean difference of +1.69 kg/d [95% CI: 1.24 to 2.14] and +2.92 kg/d (95% CI: 2.45 to 3.40) for MY and ECM respectively, in favour of Actisaf® Sc 47. These observations provide strong evidence that this commercially available yeast probiotic can significantly improve milk performances of dairy cows under different conditions.

Association between the TP53 Arg72Pro Polymorphisms and Gastric Cancer Risk: An Updated Meta-Analysis and Re-Analysis of Systematic Meta-Analyses

Background: A latest Meta-analysis on TP53 Arg72Pro polymorphism with gastric cancer (GC) risk was published in 2015 including 20 literatures, while our study included 43 studies. Moreover, the results of previously published original studies were inconsistent and the credibility of the significant correlation between the statistical results has been ignored. Therefore, an updated Meta-analysis was conducted to further explore these associations. Objective: To explore whether these two gene polymorphisms are related to the risk, clinical manifestations, and pathological features of GC. Methods: We searched several Chinese and English databases. The crude odds ratio (OR) with 95% confidence interval (CI) was used to evaluate the correlation. In addition, false positive reporting probability (FPRP), bayesian false discovery probability (BFDP), and Venice criteria were used to assess the reliability of statistically significant correlation. Results: Overall, the TP53 Arg72Pro polymorphism was related to a significantly increased GC risk (AP vs. AA: OR = 1.12, 95% CI = 1.02 - 1.24;PP + AP vs. AA: OR = 1.12, 95% CI = 1.02 - 1.24;P vs. A: OR = 1.07, 95% CI = 1.00 - 1.15). However, after excluding the low quality and Hardy–Weinberg Disequilibrium (HWD) studies, significant changes were found on the TP53 Arg72Pro polymorphism with GC risk in Caucasians (PP vs. AA: OR = 1.48, 95% CI = 1.01 - 2.16) and non-gastric cancer control groups (PP vs. AP + AA: OR = 1.33, 95% CI = 1.07 - 1.64)). However, the above significant results were considered unreliable after being adjusted with Bayesian error detection probability (BFDP) and false positive reporting probability (FPRP). These unreliable results were confirmed again, and no new reliable results were found in the further sensitivity analysis (only studies that met the quality assessment criteria). Conclusions: After considering the quality of the study and the reliability of the results, this Meta-analysis showed that TP53 codon 72 polymorphisms had no significant correlation with GC risk. Because of various confounding factors, the result that these polymorphisms increase GC risk is more likely to be a false positive result.