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.

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.

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.

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.

颈前路减压融合ROI-C^(TM)自锁系统治疗退行性颈椎病的Meta分析

目的:颈前路减压融合术是治疗退行性颈椎病的经典手术方式,钉板的使用增加了融合率及稳定性的同时,间接导致了邻近椎体退变和术后吞咽困难的发生。文章通过Meta分析方法比较ROI-C^(TM)自锁系统和传统融合器联合钉板内固定治疗退行性颈椎病患者的临床结果和并发症情况,为颈前路减压融合术中内固定方式的选择提供循证学支持。方法:检索中国知网、万方、维普、PubMed、Cochrane Library、Web of Science和Embase数据库,检索关于颈前路减压融合术中应用ROI-C^(TM)自锁系统与融合器联合钉板内固定治疗退行性颈椎病的中英文文献。检索时间范围为各数据库建库至2023年7月。由2名研究者严格按照纳入与排除标准选择文献,采用Cochrane偏倚风险工具对随机对照试验进行质量评价,NOS量表对队列研究进行质量评价。采用RevMan 5.4软件进行Meta分析。结局指标包括手术时间、术中出血量、日本骨科协会(Japanese Orthopaedic Association Scores,JOA)评分、颈椎功能障碍指数、C_(2)-C_(7)Cobb角、融合率、邻近椎体退变发生率、融合器沉降率和吞咽困难发生率。结果:共纳入13项研究,其中回顾性队列研究11项,随机对照试验2项,共1136例患者,ROI-C组569例,融合器联合钉板组567例。Meta分析结果显示:ROI-C组与融合器联合钉板组在手术时间(MD=-15.52,95%CI:-18.62至-12.42,P<0.00001),术中出血量(MD=-24.53,95%CI:-32.46至-16.61,P<0.00001),术后邻近节段退变率(RR=0.40,95%CI:0.27-0.60,P<0.00001)和术后总吞咽困难发生率(RR=0.18,95%CI:0.13-0.26,P<0.00001)均具有显著性差异。两者在术后JOA评分、颈椎功能障碍指数、C_(2)-C_(7)Cobb角、融合率和融合器沉降率方面无显著性差异(P≥0.05)。结论:在颈椎前路减压融合术中应用ROI-C^(TM)自锁系统与传统融合器联合钉板内固定治疗退行性颈椎病均可达到满意的临床效果,ROI-C^(TM)自锁系统操作更加简单,相比融合器联合钉板内固定能明显减少手术时间及术中出血量,在减少术后吞咽困难及邻近节段退变发生率等方面具有明显优势,对于跳跃型颈椎病及邻椎病翻修患者,更加推荐使用ROI-C^(TM)自锁系统。但鉴于其可能存在较高的沉降率,对于多节段且合并融合器沉降高危因素如骨质疏松、椎体终板破损的退行性颈椎病患者,仍建议使用融合器联合钉板内固定。

国人A型行为与冠心病关系的Meta-analysis

目的应用Meta-analysis方法对国内9个有关A型行为与冠心病关系的病例对照研究进行综合定量分析。方法采用Fleiss模型和DerSimonianandNanLaird模型（D—L模型）处理数据。结果累积病例为1139人，对照为967人。采用Fleiss模型计算合并OR为2.32（95％CI1.93～2.79），D—L模型计算合并OR为2.32（95％CI1.80～2.99）。失效安全数远大于56。结论A型行为与冠心病有关，失效安全数大，可能的偏倚和混杂因素影响小。

基于Meta-analysis的中国马铃薯地膜覆盖产量效应分析

为了定量综合分析中国近30 a地膜覆盖对马铃薯的增产效果,该研究综合已发表的田间试验研究数据,应用Meta-analysis方法定量分析使用地膜后马铃薯产量的增产率或减产率,并探讨其时空分异特征及其影响因素。通过文献检索,共获得84篇有关地膜覆盖马铃薯生产试验文献。经严格筛选,共从42篇文献中获得52组数据,分布于中国14个省(市、区),涵盖西北、西南和东南3个主要区域。主体数据经Meta分析表明:地膜覆盖在西北地区增产效应最显著,相对增产率为35.6%;其次是东南和西南地区,相对增产率分别为20%和12%;从全国时间序列看,1990年以后地膜相对增产率较高,但2010年后地膜增产效果有降低趋势;白色地膜与黑色地膜、垄作和平作对地膜增产效应影响不显著;在年均降水量<500 mm和年均温<10℃的区域地膜增产效应最明显,地膜相对增产率分别为40.5%和37.6%。进一步分析表明,2010年后地膜覆盖效果在年均降水量<500 mm且年均温<10℃的地区和年均降水量>500 mm且年均温>10℃的地区均呈现降低趋势,说明全球气候变暖可能对地膜增产产生负面影响,或随着使用年限增加地膜开始表现出对产量的负面效应。该研究可为地膜覆盖技术应用提供参考。

基于Meta-analysis的中国北方地区免耕玉米产量效应研究

【目的】定量分析免耕对中国北方地区玉米产量的时空效应和影响机制,为该地区免耕的科学应用和推广提供依据。【方法】以中国北方为研究区域,以传统耕作为对照,通过检索文献整合已发表的相关田间试验数据(截止2017年4月共获得68篇文献和82组试验数据,将数据按照区域(东北、华北和西北)、年降水量(<500 mm和≥500 mm)、年均气温(<10℃和≥10℃)、耕作模式(平作和垄作)、种植制度(连作和轮作)、是否秸秆还田、试验年份(2000年之前、2000—2009年和2010年之后)和免耕持续年限(1—2 a、3—5 a、6—9 a和≥10 a)进行分组),利用Meta-analysis方法系统探究免耕对玉米产量的时空效应与影响因素。具体分析过程包括异质性检验、综合效应量计算、发表偏倚检验、敏感性分析、累积Meta-analysis和亚组分析(影响因素分析)。【结果】与传统耕作相比,免耕总体上可显著提高玉米产量,平均增产率为3.1%(置信区间0.7%—5.5%,数据不存在发表偏倚和极端值)。2000年之前,免耕的累积增产效应不稳定(平均-0.7%—6.6%);2000年之后,免耕与传统耕作的累积产量差异逐渐由不显著变为显著。在东北地区,免耕表现出显著的增产效应(平均5.3%,置信区间1.5%—9.2%);而在华北和西北地区,免耕的增产效应不显著,分别为-2.6%—6.4%和-1.0%—6.4%。在年降水量<500 mm、年均气温<10℃的地区和轮作、秸秆还田条件下,免耕的增产率显著提高,平均分别为5.4%(置信区间1.7%—9.1%)、3.8%(置信区间0.8%—6.7%)、4.4%(置信区间1.3%—7.5%)和3.3%(置信区间0.8%—5.8%)。平作和垄作下,免耕的增产效应均不显著。2010年之后,免耕的增产效应显著提高(平均6.1%),且变幅较小(2.5%—9.7%)。随着免耕持续年限的延长,玉米增产率呈先增加后降低的趋势,当持续3—5 a时,免耕的增产效应显著且达到峰值(平均3.8%,置信区间1.6%—6.0%)。【结论】在年降水量较少或年均气温较低的区域,轮作或秸秆还田条件下,有利于发挥免耕的增产效应;东北地区较华北和西北地区更适宜免耕;3—5 a为较合理的免耕持续年限。

我国居民饮酒与脑卒中关系的Meta-analysis研究

为了评价我国居民饮酒与脑卒中的联系，采用随机效应模型（Ｄ—Ｌ法）对检索到的国内１４篇有关流行病学研究文献进行综合定量分析，结果总合并比值比（９５％可信区间）为１．８９０９（１．５５０２～２．３０６４）；按脑卒中类型分层合并分析，结果饮酒与出血性脑卒中、缺血性脑卒中和脑卒中（未区分亚型）联系的比值比分别为２．２５９０（１．４２４０～３．５８３６）、２．０１３０（１．４８８８～２．７２１９）和１．４７４９（１．２８３６～１．６９４８）。本研究认为饮酒是我国居民脑卒中及其亚型重要的危险因素，控制饮酒是脑卒中病因预防的一项重要措施。

基于Meta-analysis的循证检索探讨

目的:调查Meta-analysis的作者们报道检索策略效果证据的范畴。材料:对近10年EBSCO数据库MEDLINE全文子集标引“Meta-analysis”为出版物类型的论文,进行随机抽样调查(n=100)。方法:将这些论文分为三类。结论:最后分析的93篇论文样本中,A类占8.6%(8篇),B类占61.3%(57篇),C类占30.1%(28篇)。讨论:A类论文报道了先前有效的、公开发表了的或者基于专家意见的检索策略。专家评审标准一定要力争得到进一步发展,那就要求Meta-analysis的作者,对他们检索策略的效果证据要加以报道。

Meta-analysis:一种新的定量综合方法

Meta-analysis是一种定量综合研究结果的方法,在国外已应用于医学各领域,其在诊断、治疗、危险度评价、干预、预防及决策等方面起着独特的作用.本文阐述了Meta-analysis研究方法的基本原理、研究过程与内容,介绍了二个常用统计方法即固定效应模型和随机效应模型,并有部分实例应用.

幽门螺杆菌感染与胃癌关系的Meta-analysis研究

目的:探讨幽门螺杆菌(Hp)感染胃粘膜与胃癌的关系。方法:根据资料一致性检验结果,采用随机效应模型(D-L法)对检索到的国内23篇有关流行病学研究文献进行了综合定量分析。结果:Hp感染与胃癌的发生有明显的联系(OR=2.72,95%CI:1.91-3.87);其中与胃非贲门部癌、腺癌的联系具有统计学意义,其合并OR(95%CI)依次为2.72(1.91-3.87)、3.94(2.41-6.42);与胃贲门部癌及非腺癌的联系无统计学意义(OR=1.38,95%CI:0.91-2.08)、(OR=1.55,95%CI:0.99-2.44)。结论:Hp感染与胃癌的发生有联系。文中对该综合分析结果及可能出现的偏倚进行了讨论。

我国居民吸烟与脑卒中关系的Meta-analysis研究

为了评价我国居民吸烟与脑卒中的关系，根据资料一致性检验结果，采用随机效应模型（ＤＬ法）对检索到的国内１５篇有关流行病学研究文献进行了综合定量分析，结果吸烟与出血性脑卒中的联系无统计学意义（ＯＲ＝１０９９８，９５％ＣＩ：０５１９７～２３２７３）；吸烟与缺血性脑卒中、脑卒中和总合并脑卒中有较弱联系，其合并ＯＲ（９５％ＣＩ）依次为１６８４７（１２８５２～２２０８４）、１７２４８（１３６６５～２１７７０）和１５３２５（１２４５７～１８８５４）。文中对该综合分析结果及其可能的偏倚进行了讨论。

基于Meta-analysis的中国干旱半干旱区土地利用变化的土壤碳氮效应研究

通过整合分析方法,对中国干旱、半干旱区农田、林地、灌丛和草地4种土地利用方式下地表土壤有机碳、氮含量进行了定量分析。结果表明,不同土地利用方式对表土碳、氮含量影响显著;草地转化为农田将降低土壤有机碳、全氮含量(-60.9%和-54.3%),草地转化为林地将导致土壤有机碳、全氮含量的降低(-21.5%和-31.3%);草地转化为灌木林地将增加土壤有机碳含量(+33.6%)和降低土壤全氮含量(-5.9%)。可见,受人类活动干扰最为强烈的农田的土壤有机碳、全氮含量最低,而草地、灌木林地具有较好的土壤肥力和土壤质量保持功能。因此,开展灌草植被恢复和农田弃耕(自然恢复)可有效改善土壤肥力和增加土壤碳、氮存贮。

Meta-analysis研究方法述评

整合分析是一种用效应值对某一问题的定量研究进行综合、整合和解释的研究方法。介绍了整合分析的概念、历史、研究步骤和心理学中常见的数据报告形式的效应值的计算以及在我国的应用现状。并对整合分析这种研究方法进行了简要的评价。

Meta-analysis法探讨复发性口腔溃疡和微量元素锌的关系

为了探讨血清锌与复发性口腔溃疡的关系，本文应用Ｍｅｔａ－ａｎａｌｙｓｉｓ法对所收集的国内相关研究文献进行综合的定量分析。结果表明：复发性口腔溃疡组的血清锌浓度比正常组的血清锌浓度平均低０．３５１７倍标准差，９５％置信区间为（－１．１００２～０．３９７２），因此，可以认为缺锌是复发性口腔溃疡的病因之一。

女性吸烟与肺癌关系的Meta-analysis

本文应用Meta—analysis方法对国内12个有关女性吸烟与肺癌关系的病例对照研究进行了定量合并分析。采用固定效应模型和随机效应模型处理数据。女性吸烟因素合并OR为2.18(95％可信限:1.93～2.48),PAR为30.34％;吸烟量、吸烟年数及开始吸烟年龄与患肺癌OR间存在剂量反应关系;患鳞癌的合并OR和PAR分别为7.45(5.21～10.67)和53.97％;而患腺癌分别为1.09(0.82～1.44)和1.65％;被动吸烟合并OR为1.004(0.74～1.35),PAR为0.16％。另对可能的偏倚与混杂进行了讨论。

乳腺癌危险因素的Meta-analysis

目的 :为了评价女性乳腺癌危险因素的作用 ,为乳腺癌的病因学研究和预防提供依据。方法 :应用Meta -analysis分析方法对我国 1 990年～ 2 0 0 0年间公开发表的十篇有关乳腺癌病例对照研究的资料进行了综合分析。结果 :危险因素为乳腺炎史、乳癌家族史、初产年龄晚、初潮年龄早及服用避孕药史 ,它们与乳腺癌OR分别为 4.31 ( 3.2 1～ 5 .76)、4.36( 2 .46～ 7.75 )、1 .5 0 ( 1 .2 4～ 1 .81 )、1 .5 0 ( 1 .0 5～ 2 .1 6)、1 .5 1 ( 1 .0 7～ 2 .1 3)。哺乳为保护因子OR为 0 .64( 0 .5 0～ 0 .83)。结论 :乳腺癌与乳腺炎、乳癌家族史、初产年龄初潮年龄有密切联系 ,哺乳对乳腺癌有预防作用。