OBJECTIVE： A meta-analysis of published randomized controlled trials investigating the long- term effect of dexamethasone on the nervous system of preterm infants. DATA SOURCES： Online literature retrieval was condu...OBJECTIVE： A meta-analysis of published randomized controlled trials investigating the long- term effect of dexamethasone on the nervous system of preterm infants. DATA SOURCES： Online literature retrieval was conducted using The Cochrane Library （from January 1993 to June 2013）, EMBASE （from January 1980 to June 2013）, MEDLINE （from Janu- ary 1963 to June 2013）, OVID （from January 1993 to June 2013）, Springer （from January 1994 to June 2013） and Chinese Academic Journal Full-text Database （from January 1994 to June 2013）. Key words were preterm infants and dexamethasone in English and Chinese. STUDY SELECTION： Selected studies were randomized controlled trials assessing the effect of intravenous dexamethasone in preterm infants. The quality of the included papers was evaluated and those without the development of the nervous system and animal experiments were exclud- ed. Quality assessment was performed through bias risk evaluation in accordance with Cochrane Handbook 5.1.0 software in the Cochrane Collaboration. The homogeneous studies were analyzed and compared using Revman 5.2.6 software, and then effect model was selected and analyzed. Those papers failed to be included in the meta-analysis were subjected to descriptive analysis. MAIN OUTCOME MEASURES： Nervous system injury in preterm infants. RESULTS： Ten randomized controlled trials were screened, involving 1,038 subjects. Among them 512 cases received dexamethasone treatment while 526 cases served as placebo control group and blank control group. Meta-analysis results showed that the incidence of cerebral palsy, visual im- pairment and hearing loss in preterm infants after dexamethasone treatment within 7 days after birth was similar to that in the control group （RR = 1.47, 95%CI： 0.97-2.21; RR = 1.46, 95%CI： 0.97-2.20; RR = 0.80, 95%CI： 0.54-1.18; P 〉 0.05）, but intelligence quotient was significantly de- creased compared with the control group （MD = -3.55, 95%CI： -6.59 to -0.51; P = 0.02）. Prete rm infants treated with dexamethasone 7 days after birth demonstrated an incidence of cerebral palsy and visual impairment, and changes in intelligence quotient similar to those in the control group （RR = 1.26, 95%CI： 0.89-1.79; RR = 1.37, 95%CI： 0.73-2.59; RR = 0.53, 95%CI： 0.32-0.89; RR = 1.66, 95%CI： -4.7 to 8.01; P 〉 0.05）. However, the incidence of hearing loss was significantly increased compared with that in the control group （RR = 0.53, 95%CI： 0.32-0.89; P = 0.02）. CONCLUSION： Dexamethasone may affect the intelligence of preterm infants in the early stages after birth, but may lead to hearing impairment at later stages after birth. More reliable conclusions should be made through large-size, multi-center, well-designed randomized controlled trials.展开更多
THE continental dynamics has become a goaI since the beginning of the 1990s and it will still bethe key subject in the 21st century. Orogenic belts, having experienced the most intensechanges of geotherm and mechanics...THE continental dynamics has become a goaI since the beginning of the 1990s and it will still bethe key subject in the 21st century. Orogenic belts, having experienced the most intensechanges of geotherm and mechanics in the lithosphere, are the important research object in thestudy of continental dynamics. For this reason, the study of orogenic belts forms a hot and dif-ficult point in the geological society and the concentration of efforts is needed for overcomingthis difficult point. China has the most orogenic belts of various types in the world, so the De-partment of Earth Sciences caught this scientific chance in the early 1990s, took the展开更多
IN recent years, a series of environmental problems have attracted wide attention in the world.As environmental changes can result from both the operations of natural factors and human ac-tivities, the international s...IN recent years, a series of environmental problems have attracted wide attention in the world.As environmental changes can result from both the operations of natural factors and human ac-tivities, the international science community has the common opinion that environmental prob-lems should be studied in a broader perspect. In other words, the earth environment should beregarded as an entity that consists of many interactive and interrelated parts. Highlighted展开更多
基金supported by the Science and Technology Plan Program of Hunan Province,No.2011SK3234
文摘OBJECTIVE： A meta-analysis of published randomized controlled trials investigating the long- term effect of dexamethasone on the nervous system of preterm infants. DATA SOURCES： Online literature retrieval was conducted using The Cochrane Library （from January 1993 to June 2013）, EMBASE （from January 1980 to June 2013）, MEDLINE （from Janu- ary 1963 to June 2013）, OVID （from January 1993 to June 2013）, Springer （from January 1994 to June 2013） and Chinese Academic Journal Full-text Database （from January 1994 to June 2013）. Key words were preterm infants and dexamethasone in English and Chinese. STUDY SELECTION： Selected studies were randomized controlled trials assessing the effect of intravenous dexamethasone in preterm infants. The quality of the included papers was evaluated and those without the development of the nervous system and animal experiments were exclud- ed. Quality assessment was performed through bias risk evaluation in accordance with Cochrane Handbook 5.1.0 software in the Cochrane Collaboration. The homogeneous studies were analyzed and compared using Revman 5.2.6 software, and then effect model was selected and analyzed. Those papers failed to be included in the meta-analysis were subjected to descriptive analysis. MAIN OUTCOME MEASURES： Nervous system injury in preterm infants. RESULTS： Ten randomized controlled trials were screened, involving 1,038 subjects. Among them 512 cases received dexamethasone treatment while 526 cases served as placebo control group and blank control group. Meta-analysis results showed that the incidence of cerebral palsy, visual im- pairment and hearing loss in preterm infants after dexamethasone treatment within 7 days after birth was similar to that in the control group （RR = 1.47, 95%CI： 0.97-2.21; RR = 1.46, 95%CI： 0.97-2.20; RR = 0.80, 95%CI： 0.54-1.18; P 〉 0.05）, but intelligence quotient was significantly de- creased compared with the control group （MD = -3.55, 95%CI： -6.59 to -0.51; P = 0.02）. Prete rm infants treated with dexamethasone 7 days after birth demonstrated an incidence of cerebral palsy and visual impairment, and changes in intelligence quotient similar to those in the control group （RR = 1.26, 95%CI： 0.89-1.79; RR = 1.37, 95%CI： 0.73-2.59; RR = 0.53, 95%CI： 0.32-0.89; RR = 1.66, 95%CI： -4.7 to 8.01; P 〉 0.05）. However, the incidence of hearing loss was significantly increased compared with that in the control group （RR = 0.53, 95%CI： 0.32-0.89; P = 0.02）. CONCLUSION： Dexamethasone may affect the intelligence of preterm infants in the early stages after birth, but may lead to hearing impairment at later stages after birth. More reliable conclusions should be made through large-size, multi-center, well-designed randomized controlled trials.
文摘THE continental dynamics has become a goaI since the beginning of the 1990s and it will still bethe key subject in the 21st century. Orogenic belts, having experienced the most intensechanges of geotherm and mechanics in the lithosphere, are the important research object in thestudy of continental dynamics. For this reason, the study of orogenic belts forms a hot and dif-ficult point in the geological society and the concentration of efforts is needed for overcomingthis difficult point. China has the most orogenic belts of various types in the world, so the De-partment of Earth Sciences caught this scientific chance in the early 1990s, took the
文摘IN recent years, a series of environmental problems have attracted wide attention in the world.As environmental changes can result from both the operations of natural factors and human ac-tivities, the international science community has the common opinion that environmental prob-lems should be studied in a broader perspect. In other words, the earth environment should beregarded as an entity that consists of many interactive and interrelated parts. Highlighted
