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.

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.

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.

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 olfactory ensheathing cell transplantation promoting functional recovery of motor nerves in rats with complete spinal cord transection

OBJECTIVE： To evaluate the effects of olfactory ensheathing cell transplantation on functional recovery of rats with complete spinal cord transection. DATA SOURCES： A computer-based online search of Medline （1989-2013）, Embase （1989- 2013）, Cochrane library （1989-2013）, Chinese Biomedical Literature Database （1989-2013）, China National Knowledge Infrastructure （1989-2013）, VIP （1989-2013）, Wanfang databases （1989-2013） and Chinese Clinical Trial Register was conducted to collect randomized controlled trial data regarding olfactory ensheathing cell transplantation for the treatment of complete spinal cord transection in rats. SELECTION CRITERIA： Randomized controlled trials investigating olfactory ensheathing cell transplantation and other transplantation methods for promoting neurological functional recov- ery of rats with complete spinal cord transection were included in the analysis. Meta analysis was conducted using RevMan 4.2.2 software. MAIN OUTCOME MEASURES： Basso, Beattie and Bresnahan scores of rats with complete spinal cord transection were evaluated in this study. RESULTS： Six randomized controlled trials with high quality methodology were included. Meta analysis showed that Basso, Beattie and Bresnahan scores were significantly higher in the olfacto- ry ensheathing cell transplantation group compared with the control group （WMD = 3.16, 95% （21 （1.68, 4.65）; P 〈 0.00001）. CONCLUSION： Experimental studies have shown that olfactory ensheathing cell transplantation can promote the functional recovery of motor nerves in rats with complete spinal cord transection.

Meta analysis on the relationship between gene polymorphisms of vascular endothelial growth factorand retinal prognosis risk of prematurity

AIM: To explore the relationship between gene polymorphisms of (VEGF) and retinopathy of prematurity (ROP). METHODS: Literature materials related to gene polymorphisms of VEGF and ROP in PubMed, EMBASE, Cochrane and CBM database were retrieved. These materials were screened according to inclusion and exclusion standards. Patients diagnosed with ROP in clinic were regarded as control group and ROP patients who were in treatment were regarded as observation group. The indexes in two groups were matched except birth weight (BW), gender and gestational weeks. Meta5.1 was used to analyze the relationship between gene polymorphisms of VEGF and ROP. RESULTS: Four random control tests (RCT) were included in this research, including 2611 patients. Met) analysis results showed that VEGF affected ROP, having statistical significance. The combined ratio was 0.44 (95% CI, 0.07, 0.80), 0.42 (95%CI, 0.09, 0.74) and 0.75 (95%CI, 0.02, 1.49), respectively. Carrying +405 allele might increase the premature infants risk of having ROP. CONCLUSION: ROP may be related to its carrying of +405 allele. Large-scale, multi-factor RCT researches are still needed in order to identify the relation between VEGF and ROP.

Meta analysis of efficacy and safety of traditional Chinese medicine combined with hydroxychloroquine sulfate in the treatment of Sjogren's syndrome

Objective:To systematically evaluate the efficacy and safety of traditional Chinese medicine combined with hydroxychloroquine sulfate in the treatment of Sjogren's Syndrome(SS).Methods:Two researchers searched the databases of Chinese National Knowledge Infrastructure(CNKI),Wanfang Database,Weipu Database,Chinese Biomedical Literature Database,PubMed Database,Web of science Database and The Cochrane Library Database(the retrieval period is from the establishment of the database to October 2020)and screened the literatures independently.The data were extracted for bias risk assessment,and then meta-analysis was performed using Revman 5.3 software.Results:A total of 19 articles involving 1185 patients were included,including 617 cases in the treatment group and 568 cases in the control group.Combined data analysis showed that the total effective rate of traditional Chinese medicine combined with hydroxychloroquine sulfate in the treatment of Sjogren's syndrome was significantly higher than that of hydroxychloroquine sulfate alone[R R=1.34,95%CI(1.24,1.44),P<0.00001].The improvement of salivary gland[SMD=0.66,95%CI(0.47,0.85),P<0.00001],tear secretion function[MD=2.56,95%CI(1.29,3.83),P<0.0001]and reducing CRP[MD=-3.53,95%CI(-3.93,-3.14),P<0.00001],ESR[MD=-5.80,95%CI(-8.48,-3.13),P<0.00001]were better than those of the control group.However,there was no significant difference in the reduction of IgG and the incidence of adverse reactions between the two groups.Conclusion:Traditional Chinese medicine combined with hydroxychloroquine sulfate in the treatment of SS is superior to the control group in total effective rate,improvement of salivary gland and tear secretion function,and reduction of CRP and ESR,and we didn’t see the significantly increase on the adverse event.However,due to the small sample size and low quality of the included studies,the conclusion needs to be verified by larger sample and higher quality randomized controlled trials.

Meta analysis of Xuesaitong injection in the treatment of angina pectoris of coronary heart disease

Objective:To evaluate the efficacy and safety of Xuesaitong Injection in the treatment of angina pectoris.Methods:CNKI and WAN were retrieved Fang,VIP,CBMdisc,PubMed and Cochrane libraries published a randomized controlled trial of Xuesaitong Injection in the treatment of angina pectoris of coronary heart disease from the beginning of the establishment of the database to January 2020.29 cases were finally included in the study through layer by layer selection.The total sample size was 2560 cases,including 1307 cases in the experimental group and 1253 cases in the control group.The data collected were meta analyzed by Revman 5.3 software.Results:on the basis of routine western medicine treatment,Xuesaitong injection was added in the clinical comprehensive effective rate([RR=1.31;95%CI(1.25,1.39)]),angina symptom improvement rate([RR=1.16;95%CI(1.07,1.26)]),ECG improvement rate([RR=1.25;95%CI(1.14,1.38)]),angina attack times([RR=-2.49;95%CI(-3.27,-1.70)]);fibrinogen([MD=-0.61;95%CI(-0.77,-0.45)]),plasma(specific)viscosity([MD=-0.19;95%CI(-0.22,-0.16)]),hematocrit([MD=-0.04;95%CI(-0.05,-0.03)])and other aspects were superior to the conventional treatment of Western medicine,the difference was statistically significant.Safety aspect:the reported adverse reactions were mild and tolerable events such as headache,dizziness,flush,etc.,no serious adverse events,and no separation from the report was found.Conclusion:on the basis of conventional western medicine,Xuesaitong injection can effectively improve the clinical efficacy,and has a high safety.However,due to the low quality of the included study and the small sample size,there is a potential bias in the study;therefore,the application and promotion of the research conclusions need to be cautious,and need to be further verified by more large sample,multicenter,double-blind clinical randomized controlled trials.

Meta analysis of Masquelet technology and Llizarov technology in the treatment of infectious bone defects

Objective: To systematically evaluate the clinical efficacy and safety of Masquelet technology and Llizarov group technology in the treatment of infectious bone defects by meta-analysis. Methods: The computer searched China Knowledge Network (CNKI), Wanfang, VIP, Chinese Biomedical Literature Database (CBM), Pubmed, Medline, Cochrane Llibrary databases. The retrieval time was from the time of the establishment of the database to January 2020. According to the inclusion and exclusion criteria, randomized controlled trials on the treatment of infectious bone defects using Masquelet technology and Llizarov technology were collected, and the retrieved literature was independently screened, evaluated, and data extracted by two researchers, and then RevMan5.3 software was used so for meta-analysis. Results: A total of 10 RCT documents were included, with a total of 496 patients, including 242 in the Masquelet group and 254 in the Llizarov group. The results of the meta-analysis showed that: in terms of bone defect healing time, total weight bearing time, treatment cost, and complication rate, the Masquelet group was significantly different from the Llizarov group, and the Masquelet group was better than the Llizarov group (P <0.05);In terms of knee joint Lowa score and SF-36 score, Masquelet group has significant differences compared with Llizarov group, Llizarov group is better than Masquelet group (P <0.05);in excellent rate, number of operations, ankle Lowa score, infection control rate In terms of excellent rate of affected limb function, there was no significant difference between Masquelet group and Llizarov group (P> 0.05). Conclusion:Compared with Llizarov technology, Masquelet technology has obvious advantages in the treatment of infectious bone defects in terms of bone defect healing time, total weight-bearing time, treatment cost, and complication rate. In terms of scoring, it has advantages over Masquelet technology, but in terms of excellent treatment rate, number of operations, and ankle lowa score. In terms of infection control rate and excellent function of affected limbs, there was no significant difference between Masquelet technology and Llizarov technology,However, due to the low quality of the included studies and the small sample size, the exact efficacy still needs to be confirmed by higher quality RCT studies.

Meta analysis and medication analysis of TCM compound in the treatment of senile osteoporosis

Objective:Tsystematic evaluation and Meta analysis were used to evaluate the effectiveness of TCM compound in the treatment of senile osteoporosis and to analyze the regularity of its medication.Methods:Electronic retrieval of CNKI,Wangfang Data,VIP,CBM,PubMed,Embase,Cochrane Library and other databases was conducted to include the clinical randomized controlled trial(RCT)of TCM compound as intervention measures for the treatment of senile osteoporosis as the study object.The retrieval time was set up until October 2019.The two researchers independently screened the literature according to inclusion criteria,extracted the data,and evaluated the quality of the included studies using Cochrane 5.1.0 bias risk assessment tool,and then used RevMan5.3 software for data analysis.Results:a total of 19 RCT literatures were included in the experimental group.In the control group,844 patients were treated with calcium or non-calcium.Meta analysis showed that total effective rate(RR=1.30,95%ci:1.19-1.43,P<0.05),lumbar vertebral bone density(MD=0.02,95%ci:0.01-0.04,P<0.05),femoral neck bone density(MD=0.01,95%ci:0.00~0.02,P<0.05),VAS score(MD=-1.04,95%ci:-1.67~0.40,P<0.05),BMC value(MD=0.06,95%ci:0.01~0.11,P=0.03),radial bone density(MD=0.04,95%ci:0.03~0.05,P<0.05),TCM syndrome score(MD=-6.76,95%ci:-7.94^-5.59,P<0.05),and TCM syndrome efficacy rate(RR=1.49,95%ci:1.28~1.73,P<0.05)were all statistically significant.ALP(MD=4.72,95%ci:-6~15.44,P=0.39),estradiol(MD=10.45,95%ci:-1.75~22.64,P=0.09),root bone index(MD=0.01,95%ci:-0.17~0.18,P=0.95),other bone mineral density(MD=0.11,95%ci:-0.01~0.22,P=0.06),urinary calcium/urinary creatinine(MD=-0.09,95%ci:There was no significant difference in serum calcium(MD=-0.01,95%ci:-0.11~0.09,P=0.83),serum phosphorus(MD=0.03,95%ci:-0.01~0.07,P=0.09).Among the Chinese herbal compounds used,astragalus is the most frequently used tonic.Conclusion:traditional Chinese medicine compound is effective in treating senile osteoporosis,and it is mainly used as tonic.

Systematic review and meta analysis of the TCM therapy of Fuzheng and Kangai combined with chemotherapy in treating advanced NSCLC

Objective:To systematically evaluate TCM of Fuzheng and Kangai combined with chemotherapy in the treatment of Advanced NSCLC,including the efficacy and effect on the quality of life of patients.Methods:Two researchers independently searched the literature of clinical trails from Jan.2010 until Jun.2020 in the Cochrane Library,Pubmed,Embase,CBM,CNKI,WanFang Data and VIP database.Also,they had been evaluated and extracted strictly by REVMAN 5.3.Results:A total of 1303 patients were included in 15 articles.The meta analysis shows that the TCM of Fuzheng and Kangai combined with chemotherapy can improve the objective response rate[OR=2.14,95%CI(1.67,2.74),P<0.00001],disease control rate[OR=2.54,95%CI(1.88,3.42),P<0.00001]and KPS score[OR=3.28,95%CI(1.92,5.60),P<0.0001],decrease the incidence rate of liver injury[OR=0.34,95%CI(0.21,0.54),P=0.003],hemoglobin reduction[OR=0.53,95%CI(0.28,1.01),P=0.05],leukopenia[OR=0.22,95%CI(0.13,0.39),P<0.00001],thrombocytopenia[OR=0.32,95%CI(0.21,0.50),P<0.00001],toxic effects on the digestive systems[OR=0.30,95%CI(0.19,0.46),P<0.00001].Conclusions:the experimental group was better than control one in short-term efficacy and KPS score.Furthermore,the experimental group can reduce the incidence rate of myelosuppression,toxicity of digestive system and liver.

Meta analysis of clinical efficacy and safety of berberine in the treatment of non-alcoholic fatty liver

Objective:To evaluate the clinical efficacy and safety of berberine in the treatment of non-alcoholic fatty liver.Methods:Randomized controlled studies were searched in Chinese and English databases from March 30,2020.The quality was evaluated after literature screening and statistical analysis by RevMan5.3 software.Results:Nine studies were included,involving 780 patients.Meta analysis showed that berberine alone or in combination could reduce total cholesterol(MD=-0.50,95%CI),low density lipoprotein(MD=-0.34,95%CI)and glutamyltransferase(MD=-20.79,95CI%).Subgroup analysis showed that berberine combined with berberine could reduce glycosylated hemoglobin level[MD=-0.68,95%CI(-0.98 maxim 0.38)],while in patients with diabetes treated with berberine,alanine aminotransferase(MD=-9.38,95CI%)and aspartate oxaloacetic transaminase(MD=-9.03,95CI%)decreased significantly.The above differences were statistically significant(P<0.01).In addition,berberine has a tendency to decrease triglyceride,fasting blood glucose,body mass index and improve insulin resistance.There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Berberine can regulate glucose and lipid metabolism in patients with non-alcoholic fatty liver and has a tendency to improve liver function and insulin resistance.

Clinical effect of extracorporeal shockwave therapy for knee osteoarthritis: A meta analysis

Objective:To provide evidence-based evidence for the clinical use of shockwave therapy in KOA.Methods: Two researchers independently searched the randomized controlled study of shockwave therapy for KOA in the databases of CNKI、VIP、WanFang Data、 Sinomed and PubMed. Jadad rating scale was used for literature quality evaluation, and the extracted data was meta-analyzed by RevMan5.3 software.Results: A total of 15 randomized controlled trials involving 1248 patients were included. The results of meta-analysis showed: The clinical effective rate of shock wave therapy for knee osteoarthritis was reliable[RR=1.12, 95%CI(1.03, 1.20), p=0.005], and the efficacy was reliable in reducing the visual analogue scale [MD=-1.73, 95%CI(-2.31, -1.14), p<0.00001] , Lequesne osteoarthritis severity index[MD=-1.60, 95%CI(-2.55, -0.64), p<0.00001] and WOMAC[MD=-6.03, 95%CI(-9.49,-2.57) p=0.0006] of KOA patients, without serious adverse reactions.Conclusion:At present, the evidence shows that shock wave can effectively improve the pain and other related symptoms in KOA patients, and the curative effect is reliable.

Meta analysis of clinical efficacy of combination of traditional Chinese and western medicine in the treatment of venous ulcer of lower extremities

Objective: To test the therapeutic effect of integrated traditional Chinese and western medicine on venous ulcer of lower limbs by Meta analysis method, and then to propose the best clinical treatment scheme. Methods: Domestic databases in the past 20 years (January 1999-December 2019) were searched by computer, including China Journal Full-text Database (CNKI), VIP, Wanfang and CBM. Literature was screened according to inclusion and exclusion criteria. Cochrane risk assessment tool was used to evaluate the quality of the included literature. Two-classification method was used to extract data. RevMan 5.3 software was used to make statistical analysis of the data. Results: Eleven articles were finally included, totaling 1,576 patients, 804 cases in the treatment group and 772 cases in the control group. Meta-analysis results show that there is no difference in heterogeneity and bias among the included literatures. The total effective rate (risk ratio [RR]=1.12, 95% confidence interval [CI]=1.09-1.15) of integrated traditional Chinese and western medicine in treating venous ulcer of lower limbs is higher, which is obviously better than that of western medicine alone. Conclusion: Through data analysis, it is concluded that in the study population, the treatment of integrated traditional Chinese and western medicine has a significant effect on venous ulcer of lower limbs. Make up for the deficiency of simple western medicine treatment, improve the cure rate and reduce the recurrence rate. However, there is currently a lack of relevant high-quality literature, so a large sample size, rigorous and standardized experimental design and randomized double-blind clinical study are needed to further test the conclusions.

Editor's Choice—Meta analysis of acupuncture efficacy for the treatment of nervous system diseases

Meta analysis of randomized, controlled, clinical studies of acupuncture for the treatment of nervous system diseases has demonstrated that acupuncture effectively treats optic atrophy and depression. However, the quality of selected studies is low and evidence is inadequate. Therefore,

Comprehensive meta analysis——多功能Meta分析软件介绍

本文简要介绍了Comprehensive meta analysis软件的数据录入、分析及结果保存的整个过程。该软件操作方便，指导帮助实时化，在分析数据的类型、处理异质性和发表偏移等方面显示出优势，能够为医务科研工作者提供很好的Meta分析平台。

Meta Analysis of the Efficacy of Nonpharmaceutical Chinese Medicine Therapy in the Treatment of Obese Polycystic Ovary Syndrome

Objective:To systematically evaluate the effects of acupuncture,auricular point sticking,acupoint catgut embedding,cupping and other non-pharmaceutical Chinese medicine therapies on sex hormone as well as glucose and lipid metabolism in patients with obese polycystic ovary syndrome.Method:The databases such as China National Knowledge Infrastructure were searched by computer to collect the literature on the treatment of obese polycystic by non-pharmaceutical Chinese medicine therapy combined with western medicine or lifestyle change,and the literature quality of the included literature was evaluated,and finally the data were analyzed.A total of 15 randomized controlled trial(RCT)literature were included in this study,with a total of 1263 patients.Results:Non-pharmaceutical Chinese medicine therapy combined with metformin or lifestyle can reduce body mass index,insulin resistance index,fasting plasma insulin,fasting blood glucose,luteinizing hormone,ratio of luteinizing hormone to follicle stimulating hormone,testosterone,but it has no obvious advantage over follicle stimulating hormone(FSH).Conclusion:Compared with simple application of metformin or lifestyle change,traditional Chinese medicine non drug therapy combined with metformin or lifestyle change can better improve sex hormone and blood glucose metabolism in obese PCOS patients.

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.