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.

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.

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.

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.

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。

Gibbs Sampler approach for meta analysis of multiple clinical trials using generalized linear model with random effects

Objective To investigate the use of the Gibbs Sampler method in evaluating the relationship between clinic events and health risks in a meta analysis of multiple clinical trials Methods By using a generalized linear model with random effects, Gibbs Sampler technique was used in a meta analysis of multiple clinical trials of angiotensin converting enzyme (ACE) inhibitors in patients with myocardial infarction (MI) Results When heterogeneity across different trials can not be ignored, compared with the classic method, the odds ratio of relative reinfarction risk estimated by the Gibbs Sampler method would have less variation The gain in the reduction of variation in estimate of the overall odds ratio was 9 52% Conclusion Implementation of the Gibbs Sampler technique in meta analysis of multiple clinical trials has the potential of reducing the inaccuracy caused by heterogeneity across trials

我国医用X射线工作者染色体畸变的Meta-analysis

目的 了解我国医用X线工作者近年来染色体畸变的状况。材料与方法 收集了1993年-2001年来中国7个地域的关于医用X线工作者染色体畸变分析的公开发表的文章共8篇。以检查细胞数、染色体畸变细胞数和畸变率为基本数据,应用Meta分析方法对数据进行综合处理。结果与结论 我国医用X线工作者外周血淋巴细胞的染色体畸变率从统计学的角度讲已明显高于对照组,相关人员应加强防护。

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。

Endoscopic papillary large balloon dilation vs endoscopic sphincterotomy for retrieval of common bile duct stones:A meta-analysis

AIM: To compare the efficacy and safety of endoscopic papillary large balloon dilation (EPLBD) with endoscopic sphincterotomy (EST) in retrieval of common bile duct stones (&#x02265; 10 mm).

Early precut sphincterotomy and the risk of endoscopic retrograde cholangiopancreatography related complications: An updated meta-analysis

AIM: To study the cannulation and complication rates of early pre-cut sphincterotomy vs persistent attempts at cannulation by standard approach.METHODS: Systematic search of PubMed, EMBASE, Web of Science, and the Cochrane Library for relevant studies published up to February 2013. The main outcome measurements were cannulation rates and postendoscopic retrograde cholangiopancreatography(ERCP) complications. A comprehensive systematic search of the Cochrane library, PubMed, Google scholar, Scopus, National Institutes of Health, meta-register of controlled trials and published proceedings from major Gastroenterology journals and meetings until February 2013 was conducted using keywords. All Prospective randomized controlled trials(RCT) studies whichmet our inclusion criteria were included in the analysis. Prospective non-randomized studies and retrospective studies were excluded from our meta-analysis. The main outcomes of interest were post-ERCP pancreatitis, overall complication rates including cholangitis, ERCPrelated bleeding, perforation and cannulation success rates. RESULTS: Seven RCTs with a total of 1039 patients were included in the meta-analysis based on selection criteria. The overall cannulation rate was 90% in the pre-cut sphincterotomy vs 86.3% in the persistent attempts group(OR = 1.98; 95%CI: 0.70-5.65). The risk of post-ERCP pancreatitis(PEP) was not different between the two groups(3.9% in the pre-cut sphincterotomy vs 6.1% in the persistent attempts group, OR = 0.58, 95%CI: 0.32-1.05). Similarly, there was no statistically significant difference between the groups for overall complication rate including PEP, cholangitis, bleeding, and perforation(6.2% vs 6.9%, OR = 0.85, 95%CI: 0.51-1.41). CONCLUSION: This meta-analysis suggests that precut sphincterotomy and persistent attempts at cannulation are comparable in terms of overall complication rates. Early pre-cut implementation does not increase PEP complications.

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.

Shenqi Fuzheng injection combined with GP chemotherapy in the treatment of advanced non-small cell lung cancer： a meta-analysis

Objective： To evaluate the clinical efficacy of Shenqi Fuzheng injection combined with gemcitabine plus cisplatin（GP） in the treatment of advanced non-small cell lung cancer （NSCLC）. Methods： we performed a systematicsearch in the electronic databases such as Cochrane Library, Pubmed, Embase, Chinese Journal Full-text Database,Chinese Biomedical Literature Database, Chinese Science and Technology Periodical Full-text Database andWanfang Database up to 30 January 2017. Randomized controlled trials （RCT） of Shenqi Fuzheng Injectioncombined with GP chemotherapy in the treatment of advanced NSCLC were searched, and all the RCTs wereconducted on methodological quality assessment. Data extraction and data analysis were according to standards ofCochrane systematic review. Results： Eight trials were included including a total of 701 patients. Meta-analysisresults： Shenqi Fuzheng injection combined with GP chemotherapy could significantly improve the functionalstatus of patients with NSCLC （OR = 3.44, 95% CI [2.26, 5.25], P 〈 0.0001） and clinical treatment efficacy （OR =（OR = 0.31, 95%CI [0.20, 0.47], P 〈 0.0001. The rate of leukopenia （OR = .31, 95%CI [0.20,0.47], P 〈 0.0001）,thrombocytopenia （OR = 0.58, 95%CI [0.37, 0.91], P = 0.020）, hemoglobin decline （（OR = 0.31, 95%CI [0.16,0.59], P = 0.0004） and incidence of gastrointestinal reactions （OR = 0.58,P 〈 0.05） could be reduced. Conclusion：Shenqi Fuzheng injection combined with GP chemotherapy in the treatment of advanced NSCLC obtainedsignificantly clinical efficacy. The quality of the literature incorporated is low, the conclusion requires high-qualityresearch to further prove.

Optical coherence tomography assessed retinal nerve fiber layer thickness in patients with Alzheimer's disease:a meta-analysis

AIM:To investigate the difference of retinal nerve fiber layer(RNFL) thickness between Alzheimer's disease patients and normal people,so as to provide clue for the early diagnosis of Alzheimer's disease.· METHODS:The articles on the association of RNFL thickness and Alzheimer's disease were retrieved by searching international and national databases.The qualified articles were assessed by meta analysis with Stata11.0 software.The results were pooled using weighted mean difference(WMD) with a corresponding 95% confidence interval(CI).· RESULTS:Totally 7 studies enrolled 324 eyes were included in the meta-analysis.The results of meta analysis showed that in AD patients,there was a significant average RNFL thickness reduction compared with the control group [WMD=-17.561,95%CI:(-23.971,-11.151)].There were significant differences in superior,inferior,nasal and temporal RNFL thickness between the two groups.WMD with a 95%CI were [-18.829,95%CI:(-25.915,-11.743);P<0.05],[-25.775,95%CI:(-34.304,-17.247);P <0.05],[-16.877,95%CI:(-29.141,-4.613);P<0.001] and [-14.565,95%CI:(-28.002,-1.128);P<0.001] respectively.Begg's test and Egger's test did not show significant difference,funnel plot was basically symmetrical,indicating that there was no publication bias existed.· CONCLUSION:There are significant differences in the RNFL thickness in all quadrants between the two groups.RNFL thickness is reduced in AD patients compared with the control group.·

Is endoscopic retrograde appendicitis therapy a better modality for acute uncomplicated appendicitis? A systematic review and metaanalysis

BACKGROUND Previous studies had shown endoscopic retrograde appendicitis therapy(ERAT)is an effective treatment for acute appendicitis.However,different studies reported conflicting outcomes regarding the effectiveness of ERAT in comparison with laparoscopic appendectomy(LA).AIM To compare the effectiveness of ERAT with LA.METHODS Randomized controlled trials(RCTs)and retrospective studies of ERAT for acute uncomplicated appendicitis were searched in PubMed,Cochrane Library,Web of Science,Embase database,China National Knowledge Infrastructure(CNKI),the WanFang Database,and Chinese Scientific Journals Database(VIP)from the establishment date to March 12021.Heterogeneity was assessed using the Isquared statistic.Pooled odds ratios(OR),weighted mean difference(WMD),and standard mean difference(SMD),with 95%confidence intervals(CI)were calculated through either fixed-effects or random-effects model.Sensitivity analysis was also performed.Publication bias was tested by Egger's test,and Begg’s test.The quality of included RCT were evaluated by the Jadad scale,while Newcastle-Ottawa scale is adopted for assessing the methodological quality of case-control studies.All statistical analysis was performed using Stata 15.1 statistical software.All statistical analysis was performed using Stata 15.1 statistical software.This study is registered with PROSPERO,CRD42021243955.RESULTS After screening,10 RCTs and 2 case-control studies were included in the current systematic review.Firstly,the length of hospitalizations[WMD=-1.15,95%CI:-1.99,-0.31;P=0.007]was shorter than LA group.Secondly,the level of postoperative CRP[WMD=-10.06,95%CI:(-17.39,-2.73);P=0.007],TNF-α[WMD=-7.70,95%CI:(-8.47,-6.93);P<0.001],and IL-6 Levels[WMD=-9.78,95%CI:(-10.69,-8.88);P<0.001;P<0.001]in ERAT group was significantly lower than LA group.Thirdly,ERAT group had a lower incidence of intestinal obstruction than LA group.[OR=0.19,95%CI:(0.05,0.79);P=0.020].Moreover,the quality of 10 RCTs were low with 0-3 Jadad scores,while the methodological quality of two case-control studies were fair with a score of 2(each).CONCLUSION Compared with LA,ERAT reduces operation time,the level of postoperative inflammation,and results in fewer complications and shorter recovery time,with preserving the appendix and its immune and biological functions.

Meta-analysis of the effect of Xuesaitong combined with edaravone on hemorheological indexes in patients with acute cerebral infarction

Objective:To systematically evaluate the effect of Xuesaitong injection combined with edaravone injection on hemorheology indexes in patients with acute cerebral infarction.Methods:Search CNKI,WanFang,VIP,SinoMed,PubMed,Cochrane Library and other databases,collect randomized controlled trials(RCTs)of Xuesaitong combined with edaravone in the treatment of acute cerebral infarction from the establishment of the database to November 2020,using RevMan 5.3 software Perform Meta analysis.Results:10 RCTs were included,with a total of 834 patients,417 in the experimental group and 417 in the control group.The results of Meta analysis showed that the experimental group was better than the control group in improving the whole plasma viscosity(MD=-0.73,95%CI[-0.83,-0.63],P<0.00001);in terms of improving the thrombosis coefficient,the test group is better than the control group(MD=-0.19,95%CI[-0.22,-0.15],P<0.00001);In terms of platelet aggregation rate,the test group was better than the control group(MD=-0.21,95%CI[-0.25,-0.17],P<0.00001).GRADE systematically evaluates whole plasma viscosity,thrombosis coefficient,and platelet aggregation rate,showing that the level of evidence is low or very low,and the strength of the recommendation is weak.Conclusion:Xuesaitong injection combined with edaravone injection has relatively satisfactory results in improving hemorheology indexes in patients with acute cerebral infarction,and there is no obvious safety problem.However,due to the small number of included studies and the total sample size,and the limitation of the quality of the included original studies,the results of this study need to be designed with strict,high-quality,large-sample,multi-center,and more internationally recognized clinical outcome indicators and efficacy experiments to verify,in order to obtain stronger evidence-based medicine.

Vericiguat treatment of heart failure: A systematic review and metaanalysis

BACKGROUND Heart failure(HF),an end-stage manifestation of various cardiac diseases,poses an enormous economic and health burden on society.Vericiguat may be an effective drug in the treatment of HF.AIM To explore by meta-analysis the efficacy and safety of Vericiguat in treating chronic heart failure.METHODS Databases,including PubMed,EMBASE,Web of Science,and Cochrane Library,were searched to collect all published randomized controlled trials(RCTs)on Vericiguat treatment of chronic heart failure from the earliest electronic records to those published in March 2023.Two investigators independently screened the literature according to inclusion and exclusion criteria,evaluated the quality of the studies,and extracted valid data before conducting a meta-analysis using RevMan5.4.RESULTS Four RCTs with 5919 patients were included,and the meta-analysis showed that treatment with 10 mg Vericiguat reduced the incidence of the primary endpoint(a composite of cardiovascular mortality and first heart-failure-related hospital-ization)in patients with chronic heart failure compared to placebo[relative risk(RR)=0.91,95%confidence interval(CI):0.85–0.98,P=0.01],and reduced the incidence of heart-failure-related hospitalization(RR=0.92,95%CI:0.84–1.00,P=0.05).However,for the incidence of cardiovascular and all-cause death,there were no significant differences between the Vericiguat and placebo groups.In addition,the two groups did not show significant differences in blood pressure,heart rate,and Kansas Cardiomyopathy Questionnaire physical limitation score.In terms of safety,10 mg Vericiguat did not increase the risk of adverse effects in patients with chronic heart failure.Vericiguat may increase the risk of symp-tomatic hypotension(RR=1.17,95%CI:0.98–1.39,P=0.08)and syncope(RR=1.18,95%CI:0.90–1.55,P=0.24),but not significantly.CONCLUSION Vericiguat(10 mg)was more effective than placebo in treating patients with chronic heart failure and had a better safety profile.

Systemic evaluation and Meta-analysis of Wenxin Keli in treatment of idiopathic premature beats in randomized controlled trails

Objective:To evaluate the efficacy and safety of Wenxin Keli for premature beats in structurally normal heart systematically.Methods:Eight databases at home and abroad were searched to collect randomized controlled trials of Wenxin Keli for premature beats without cardiac diseases.The included literatures were systematically evaluated with Cochrane Handbook 5.1 evaluation criteria and tools,and Meta analysis was performed with software RevMan5.3.Results:A total of 13 randomized controlled trials with 1278 subjects were included.The exprimental group used Wenxin Keli alone while the control group used antiarrhythmic medicine.The Meta analysis results showed that the total effective rate(RR=1.06,95%CI[0.97,1.16],P=0.23)and clinical symptom effective rate(RR=1.16,95%CI[0.94,1.44],P=0.18)of Wenxin Keli on idiopathic premature beats was not significantly different from western medicine group.The subgroup analysis of total effective rate showed that Wenxin Keli had no significant difference with metoprolol(RR=1.04,95%CI[0.95,1.15],P=0.41),bisoprolol(RR=1.32,95%CI[0.85,2.05],P=0.22)and propanone(RR=1.07,95%CI[0.90,1.26],P=0.44).ECG changes showed that the PR intervals(MD=-12.57,95%CI[-16.15,-8.99],P<0.00001)and QTc intervals(MD=-8.09,95%CI[-15.52,-0.65],P=0.03)in the western medicine group were prolonged significantly more than those of Wenxin Keli.In terms of safety,the incidence of adverse reactions of Wenxin Keli was significantly less than that of western medicine group(RR=0.32,95%CI[0.19,0.54],P<0.0001).Conclusion:The efficacy of Wenxin Keli in the treatment of premature beats with structurally normal heart is accurate,and there are no serious adverse reactions.However,because of the low quality of the included papers,which affected the reliability of the conclusions,high-quality clinical research is needed to further demonstrate.

Efficacy of Wendan Decoction series for coronary heart disease with anxiety and depression:A systematic review and meta-analysis

Objective:To systematically evaluate the clinical efficacy of Wendan Decoction series combined with conventional western medicine in the treatment of coronary heart disease complicated with anxiety and depression.Methods:We searched four Chinese databases including CNKI,WanFang,VIP,SinoMed,and five English databases of PubMed,Cochrane Library,Web of Science,EMBASE,Springer Link for clinical randomized controlled trials of using Wendan Decoction series in the treatment of coronary heart disease complicated with anxiety and depression.Time range for searching was from the establishment of these databases to January 2022.Then we screened the retrieved literature according to the inclusion and exclusion criteria,and conducted data extraction and quality evaluation of the selected literature.Meta analysis was conducted using RevMan 5.3 software.Results:A total of 13 RCT studies and 1007 patients with coronary heart disease complicated with anxiety and depression were included.Meta-analysis showed that Wendan Decoction series combined with conventional western medicine treatment showed better effects in the improvement rate of clinical anxiety[RR=1.21,95%CI=(1.12,1.31),P<0.00001],the improvement rate of depression[RR=1.30,95%CI=(1.10,1.53),P=0.002],the improvement rate of angina pectoris[RR=1.28,95%CI=(1.13,1.44),P<0.0001],increasing the ECG improvement rate[RR=1.29,95%CI=(1.07,1.55),P=0.008],increasing the rate of reducing nitroglycerin usage[RR=1.68,95%CI=(1.25,2.25,P=0.0006],as well as increasing the improvement rate of TCM symptoms[RR=1.15,95%CI=(1.04,1.26),P=0.004].It also showed better effects in reducing clinical anxiety and depression scores(SAS,SDS,HAMA,HAMD),SAQ scores and TCM symptom scores.The differences were statistically significant.Conclusion:Wendan Decoction series combined with conventional western medicine shows advantages in treating coronary heart disease patients complicated with anxiety and depression in reducing the angina pectoris score,anxiety and depression score,as well as improving the clinical TCM symptoms.

Meta-analysis of the efficacy and safety of Lianhua Qingwen combined with western medicine in the treatment of common patients with new coronary pneumonia

Objective:To evaluate the clinical efficacy of Lianhua Qingwen combined with Western medicine in the treatment of common patients with new coronary pneumonia by Meta analysis system.Methods:Computer retrieval of Chinese Journal Full-text Database,Weipu Chinese Scientific and Technical Periodical Full-text Database,Wanfang Data Knowledge Service Platform,Chinese Biomedical Literature Database,PubMed Database and manual retrieval of relevant literature.The search period is from database establishment to April 2020 Two researchers independently searched,screened the literature,and performed data extraction and quality evaluation on the included literature according to the Cochrane systematic review methodology.RevMan5.3 software was used for Meta analysis.Results:A total of 5 RCT literatures were included in this study,and the total effect value was combined using a fixed-effect model.As a result,3 literatures were used for clinical efficacy statistics RR=2.59,95%CI(1.68,3.98),Z=4.32,P<0.05,statistically significant;there are 3 literatures on the disappearance rate of the main symptoms,including the disappearance of fever,cough and fatigue,subgroup study,no heterogeneity between the three groups(I2=0%,P=0.88),combined with RR=3.27,95%CI(2.18,4.91),Z=5.75,P<0.05,with statistical significance;there are 3 articles with statistics on the disappearance rate of comorbidities RR=13.68,95%CI(2.80,66.79),Z=3.23,P<0.05,which is statistically significant;there are 2 literatures that count the fever remission time MD=-1.07,95%CI(-1.77,-0.37),Z=2.99,P<0.05,Statistically significant;2 literatures reported aggravating conditions in the treatment group,RR=0.33,95%CI(0.13,0.81),Z=2.41,P<0.05,statistically significance.Conclusion:Lianhua Qingwen combined with Western medicine is effective in the treatment of common patients with new coronary pneumonia,and there are few adverse reactions.However,due to the limitations of the included literature,the Meta analysis results also have corresponding limitations,so more high-quality RCT is needed to further In-depth study.