<strong>Objectives:</strong> To evaluate the diagnostic performance of the quantitative iodine parameters, including Iodine Concentration (IC), Normalized Iodine Concentration (NIC), and λ<sub>HU<...<strong>Objectives:</strong> To evaluate the diagnostic performance of the quantitative iodine parameters, including Iodine Concentration (IC), Normalized Iodine Concentration (NIC), and λ<sub>HU</sub>, in distinguishing malignant and benign thyroid nodules. <strong>Methods:</strong> Relevant studies were searched from Web of Science, PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure database and other complementary sources from inception to May 20, 2020. Study selection, data extraction, quality assessment, and data analyses were performed following the Cochrane standards and the PRISMA-DTA guideline. <strong>Results: </strong>Eight studies were included (595 patients with 737 thyroid nodules). The pooled sensitivity, specificity and summary diagnostic odds ratio of IC were 79% (95% CI: 69% - 86%), 76% (95% CI: 65% - 84%) and 11 (95% CI: 5 - 27) respectively;those of NIC were 78% (95% CI: 70% - 85%), 80% (95% CI: 74% - 85%) and 15 (95% CI: 9 - 24) respectively;those of λ<sub>HU</sub> were 80% (95% CI: 71% - 87%), 77% (95% CI: 70% - 83%) and 14 (95% CI: 8 - 24) respectively. <strong>Conclusion: </strong>DECT can be a potential evaluation tool for thyroid nodules. The NIC may be the most sensitive iodine parameter and could be comparable between different DECT machines in thyroid nodule assessment.展开更多
Objective The benefit of short-term dual antiplatelet therapy(DAPT) following second-generation drug-eluting stents implantation has not been systematically evaluated. To bridge the knowledge gap,we did a meta-analysi...Objective The benefit of short-term dual antiplatelet therapy(DAPT) following second-generation drug-eluting stents implantation has not been systematically evaluated. To bridge the knowledge gap,we did a meta-analysis to assess the efficacy of ≤6 months versus ≥12 months DAPT among patients with second-generation drug-eluting stents. Methods We searched online databases and identified randomized controlled trials that assess the clinical impact of short-term DAPT(≤6 months) published before March 3,2016. The efficacy endpoints included the incidence of all-cause death,myocardial infarction,cerebrovascular accidents,and definite or probable stent thrombosis. Safety endpoint defined as major bleeding was also evaluated and discussed. Results We included 5 trials that randomized 9473 participants(49.8%,short-term DAPT duration vs. 50.2%,standard duration). A total of 9445(99.7%) patients reported the efficacy endpoints,and the safety endpoint was available from 4 studies(n=8457). There was no significant difference in efficacy endpoints between short-term and standard DAPT duration(≥12 months) [risk ratio(RR) 0.96; 95% confidence intervals(CI),0.80-1.15]. Short-term DAPT duration did not significantly increase the individual risk of all-cause death,myocardial infarction,cerebrovascular accidents,or definite or probable stent thrombosis. Although short-term DAPT obviously reduced risk of major bleeding compared with standard DAPT(RR 0.53; 95% CI,0.29-0.96),significant publication bias was found when accessing the safety endpoint of the 4 studies(Egger's test,P=0.009). Conclusions The efficacy of short-term DAPT was comparable with that of standard duration DAPT.DAPT less than 6 months may be appropriate for patients receiving second-generation drug-eluting stents implantation.展开更多
目的对2010-2016年发表的有关中国人骨质疏松症流行病学研究数据进行汇总,运用Meta分析方法汇总分析中国老年人骨质疏松症患病率情况。方法检索Pub Med、EMbase、Web of Science、Ovid、万方数据、中国知网及VIP中的英文和中文文献,提...目的对2010-2016年发表的有关中国人骨质疏松症流行病学研究数据进行汇总,运用Meta分析方法汇总分析中国老年人骨质疏松症患病率情况。方法检索Pub Med、EMbase、Web of Science、Ovid、万方数据、中国知网及VIP中的英文和中文文献,提取纳入研究的特征信息。数据分析采用R3.3.0软件,检验异质性,根据异质性结果选择相应的效应模型对提取数据进行加权定量合并。结果共纳入33项研究,样本总量30526例。33项研究存在异质性,按照随机效应模型计算中国60岁以上人群骨质疏松症总体患病率为36%,其中男性为23%,女性为49%,差异有统计学意义。结论骨质疏松症是中国老年人高发疾病,开展骨质疏松宣传防治工作意义重大。展开更多
目的评价替罗非班联合双抗治疗进展性脑卒中(progressive ischemic stroke,PIS)的有效性及安全性。方法检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、PubMed、Web of Science、Scopus、EMbase、Cochrane图书馆数据库...目的评价替罗非班联合双抗治疗进展性脑卒中(progressive ischemic stroke,PIS)的有效性及安全性。方法检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、PubMed、Web of Science、Scopus、EMbase、Cochrane图书馆数据库,检索时间设定为自建库至2022-10-31,语种设定为中文和英文,按纳入文献和排除文献标准筛选常规治疗+替罗非班联合双抗(简称试验组)与常规治疗+双抗治疗(简称对照组)PIS患者的对照研究,采用Meta分析替罗非班联合双抗治疗PIS患者的疗效及安全性。结果共纳入15项研究,共计1302例患者,其中6项为队列研究,9项为随机对照试验(randomized controlled trial,RCT)。Meta分析结果显示,试验组美国国立卫生院卒中量表(National Institute of Health stroke scale,NIHSS)评分低于对照组(MD=-2.47,95%CI:-2.99~-1.94;P<0.01),试验组预后良好率高于对照组(OR=1.96,95%CI:1.03~3.71;P=0.04),试验组血清超敏C反应蛋白(hs-CRP)水平(MD=-0.72,95%CI:-0.95~-0.49)、血小板聚集率(MD=-2.72,95%CI:-4.82~-0.62)、纤维蛋白原水平(MD=-0.50,95%CI:-0.66~-0.34)均低于对照组(均P<0.01),而两组间脑出血发生率差异无统计学意义(OR=1.59,95%CI:0.53~4.83;P=0.41),但试验组其他系统出血发生率高于对照组(OR=1.78,95%CI:1.03~3.09;P=0.04)。结论替罗非班联合双抗治疗PIS有效,能改善PIS患者早期神经功能缺损症状及3个月时的功能预后,能降低PIS患者血清hs-CRP水平,能抑制血小板聚集,不增加脑出血的发生率,但增加其他系统出血的发生率。展开更多
目的:通过网状Meta分析评估伴有冠心病和/或接受经皮冠状动脉介入治疗(PCI)治疗的心房颤动患者应用双联与三联抗栓治疗的有效性与安全性。方法:计算机检索中国知网、万方、维普、中国生物医学文献数据库、PubMed、Embase、Web of Scienc...目的:通过网状Meta分析评估伴有冠心病和/或接受经皮冠状动脉介入治疗(PCI)治疗的心房颤动患者应用双联与三联抗栓治疗的有效性与安全性。方法:计算机检索中国知网、万方、维普、中国生物医学文献数据库、PubMed、Embase、Web of Science、Cochrane Library等数据库,筛选出符合标准的文献提取数据后进行Meta分析,研究终点包括不良心血管事件,全因死亡,心血管死亡,MI,ST,卒中等有效性及主要出血事件,颅内出血等安全性指标。结果:共纳入6篇文献,包括12044例伴有冠心病和/或接受PCI治疗的心房颤动患者。网状Meta分析结果表明,与VKA+DAPT相比,VKA+P2Y12抑制剂(OR=0.52,95%CI:0.31~0.86)及NOAC+P2Y12抑制剂(OR=0.52,95%CI:0.35~0.76)主要出血事件发生率较低,差异均有统计学意义;NOAC+DAPT(OR=0.71,95%CI:0.42~1.19),VKA+阿司匹林(OR=0.93,95%CI:0.34~2.52)与VKA+DAPT相比差异均无统计学意义。与VKA+DAPT相比,各种干预措施在不良心血管事件,全因死亡,心血管死亡,MI,ST,卒中等事件发生率上差异均无统计学意义(P>0.05)。结论:在伴有冠心病和/或接受PCI的AF患者中,NOAC+P2Y12抑制剂与VKA+DAPT相比,出血并发症较少(包括颅内出血),在缺血事件上差异无统计学意义。另外其他DAT方案相比于VKA+DAPT出血风险较低或有降低趋势,因此应避免在此类患者中应用VKA+DAPT抗栓疗法。展开更多
文摘<strong>Objectives:</strong> To evaluate the diagnostic performance of the quantitative iodine parameters, including Iodine Concentration (IC), Normalized Iodine Concentration (NIC), and λ<sub>HU</sub>, in distinguishing malignant and benign thyroid nodules. <strong>Methods:</strong> Relevant studies were searched from Web of Science, PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure database and other complementary sources from inception to May 20, 2020. Study selection, data extraction, quality assessment, and data analyses were performed following the Cochrane standards and the PRISMA-DTA guideline. <strong>Results: </strong>Eight studies were included (595 patients with 737 thyroid nodules). The pooled sensitivity, specificity and summary diagnostic odds ratio of IC were 79% (95% CI: 69% - 86%), 76% (95% CI: 65% - 84%) and 11 (95% CI: 5 - 27) respectively;those of NIC were 78% (95% CI: 70% - 85%), 80% (95% CI: 74% - 85%) and 15 (95% CI: 9 - 24) respectively;those of λ<sub>HU</sub> were 80% (95% CI: 71% - 87%), 77% (95% CI: 70% - 83%) and 14 (95% CI: 8 - 24) respectively. <strong>Conclusion: </strong>DECT can be a potential evaluation tool for thyroid nodules. The NIC may be the most sensitive iodine parameter and could be comparable between different DECT machines in thyroid nodule assessment.
文摘Objective The benefit of short-term dual antiplatelet therapy(DAPT) following second-generation drug-eluting stents implantation has not been systematically evaluated. To bridge the knowledge gap,we did a meta-analysis to assess the efficacy of ≤6 months versus ≥12 months DAPT among patients with second-generation drug-eluting stents. Methods We searched online databases and identified randomized controlled trials that assess the clinical impact of short-term DAPT(≤6 months) published before March 3,2016. The efficacy endpoints included the incidence of all-cause death,myocardial infarction,cerebrovascular accidents,and definite or probable stent thrombosis. Safety endpoint defined as major bleeding was also evaluated and discussed. Results We included 5 trials that randomized 9473 participants(49.8%,short-term DAPT duration vs. 50.2%,standard duration). A total of 9445(99.7%) patients reported the efficacy endpoints,and the safety endpoint was available from 4 studies(n=8457). There was no significant difference in efficacy endpoints between short-term and standard DAPT duration(≥12 months) [risk ratio(RR) 0.96; 95% confidence intervals(CI),0.80-1.15]. Short-term DAPT duration did not significantly increase the individual risk of all-cause death,myocardial infarction,cerebrovascular accidents,or definite or probable stent thrombosis. Although short-term DAPT obviously reduced risk of major bleeding compared with standard DAPT(RR 0.53; 95% CI,0.29-0.96),significant publication bias was found when accessing the safety endpoint of the 4 studies(Egger's test,P=0.009). Conclusions The efficacy of short-term DAPT was comparable with that of standard duration DAPT.DAPT less than 6 months may be appropriate for patients receiving second-generation drug-eluting stents implantation.
文摘目的对2010-2016年发表的有关中国人骨质疏松症流行病学研究数据进行汇总,运用Meta分析方法汇总分析中国老年人骨质疏松症患病率情况。方法检索Pub Med、EMbase、Web of Science、Ovid、万方数据、中国知网及VIP中的英文和中文文献,提取纳入研究的特征信息。数据分析采用R3.3.0软件,检验异质性,根据异质性结果选择相应的效应模型对提取数据进行加权定量合并。结果共纳入33项研究,样本总量30526例。33项研究存在异质性,按照随机效应模型计算中国60岁以上人群骨质疏松症总体患病率为36%,其中男性为23%,女性为49%,差异有统计学意义。结论骨质疏松症是中国老年人高发疾病,开展骨质疏松宣传防治工作意义重大。
文摘目的评价替罗非班联合双抗治疗进展性脑卒中(progressive ischemic stroke,PIS)的有效性及安全性。方法检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、PubMed、Web of Science、Scopus、EMbase、Cochrane图书馆数据库,检索时间设定为自建库至2022-10-31,语种设定为中文和英文,按纳入文献和排除文献标准筛选常规治疗+替罗非班联合双抗(简称试验组)与常规治疗+双抗治疗(简称对照组)PIS患者的对照研究,采用Meta分析替罗非班联合双抗治疗PIS患者的疗效及安全性。结果共纳入15项研究,共计1302例患者,其中6项为队列研究,9项为随机对照试验(randomized controlled trial,RCT)。Meta分析结果显示,试验组美国国立卫生院卒中量表(National Institute of Health stroke scale,NIHSS)评分低于对照组(MD=-2.47,95%CI:-2.99~-1.94;P<0.01),试验组预后良好率高于对照组(OR=1.96,95%CI:1.03~3.71;P=0.04),试验组血清超敏C反应蛋白(hs-CRP)水平(MD=-0.72,95%CI:-0.95~-0.49)、血小板聚集率(MD=-2.72,95%CI:-4.82~-0.62)、纤维蛋白原水平(MD=-0.50,95%CI:-0.66~-0.34)均低于对照组(均P<0.01),而两组间脑出血发生率差异无统计学意义(OR=1.59,95%CI:0.53~4.83;P=0.41),但试验组其他系统出血发生率高于对照组(OR=1.78,95%CI:1.03~3.09;P=0.04)。结论替罗非班联合双抗治疗PIS有效,能改善PIS患者早期神经功能缺损症状及3个月时的功能预后,能降低PIS患者血清hs-CRP水平,能抑制血小板聚集,不增加脑出血的发生率,但增加其他系统出血的发生率。
文摘目的:通过网状Meta分析评估伴有冠心病和/或接受经皮冠状动脉介入治疗(PCI)治疗的心房颤动患者应用双联与三联抗栓治疗的有效性与安全性。方法:计算机检索中国知网、万方、维普、中国生物医学文献数据库、PubMed、Embase、Web of Science、Cochrane Library等数据库,筛选出符合标准的文献提取数据后进行Meta分析,研究终点包括不良心血管事件,全因死亡,心血管死亡,MI,ST,卒中等有效性及主要出血事件,颅内出血等安全性指标。结果:共纳入6篇文献,包括12044例伴有冠心病和/或接受PCI治疗的心房颤动患者。网状Meta分析结果表明,与VKA+DAPT相比,VKA+P2Y12抑制剂(OR=0.52,95%CI:0.31~0.86)及NOAC+P2Y12抑制剂(OR=0.52,95%CI:0.35~0.76)主要出血事件发生率较低,差异均有统计学意义;NOAC+DAPT(OR=0.71,95%CI:0.42~1.19),VKA+阿司匹林(OR=0.93,95%CI:0.34~2.52)与VKA+DAPT相比差异均无统计学意义。与VKA+DAPT相比,各种干预措施在不良心血管事件,全因死亡,心血管死亡,MI,ST,卒中等事件发生率上差异均无统计学意义(P>0.05)。结论:在伴有冠心病和/或接受PCI的AF患者中,NOAC+P2Y12抑制剂与VKA+DAPT相比,出血并发症较少(包括颅内出血),在缺血事件上差异无统计学意义。另外其他DAT方案相比于VKA+DAPT出血风险较低或有降低趋势,因此应避免在此类患者中应用VKA+DAPT抗栓疗法。