The Chinese herbal Formula Tongxieyaofang for irritable bowel syndrome:a protocol for meta-analysis of randomized controlled trials

Background:Irritable bowel syndrome(IBS)is a chronic functional bowel disorder characterized by abdominal pain and altered bowel function.The TongXieYaoFang(TXYF)is a Chinese herbal formula with a long history for the management of chronic diarrhea accompanied by abdominal pain,and it is always used to relieve symptoms of IBS.Although there are some studies were published,there is no consensus on its effects.Moreover,new relevant study was published recently.Therefore,a systematic review and meta-analysis is needed to assess the safety and eff ectiveness of the Chinese herbal medicine TongXieYaoFang for IBS.Methods and analysis:PubMed,EMBASE,the Cochrane library,CNKI,WanFang,VIP and CBM databases will be searched without search date and language restrictions.We will include randomized controlled trial(RCT)comparing TXYF with another therapy method for IBS.The quality of included studies will be independently assessed using Risk of bias tool in the Cochrane Handbook 5.1.0,and be categorized as being at low,unclear or high risk of bias.The primary outcome is the disappearance and significant improvement in global symptoms,and the secondary outcomes including visual analog scale(VAS)score,adverse event,rehospitalization rate and the quality of life.The Meta-analysis will be performed using the Cochrane Collection’s tool RevMan 5.3 software.Results:This study is ongoing and will be submitted to a peerreviewed journal for publication.Conclusion:This study will provide a confirmed evidence on the safety and eff ectiveness of TXYF for IBS.Ethics and dissemination:Ethical approval and patient consent are not required because of the study is a systematic review and meta-analysis based on literatures.The results of this study will be submitted to a peer-reviewed journal for publication.

Contrast-enhanced ultrasound and contrast-enhanced computed tomography for differentiating mass-forming pancreatitis from pancreatic ductal adenocarcinoma:a meta-analysis

Background:Patients with mass-forming pancreatitis(MFP)or pancreatic ductal adenocarcinoma(PDAC)presented similar clinical symptoms,but required different treatment approaches and had different survival outcomes.This meta-analysis aimed to compare the diagnostic performance of contrast-enhanced ultrasound(CEUS)and contrast-enhanced computed tomography(CECT)in differentiating MFP from PDAC.Methods:A literature search was performed in the PubMed,EMBASE(Ovid),Cochrane Library(CENTRAL),China National Knowledge Infrastructure(CNKI),Weipu(VIP),and WanFang databases to identify original studies published from inception to August 20,2021.Studies reporting the diagnostic performances of CEUS and CECT for differentiating MFP from PDAC were included.The meta-analysis was performed with Stata 15.0 software.The outcomes included the pooled sensitivity,specificity,positive likelihood ratio(+LR),negative likelihood ratio(-LR),diagnostic odds ratio(DOR),and summary receiver operating characteristic(SROC)curves of CEUS and CECT.Meta-regression was conducted to investigate heterogeneity.Bayesian network meta-analysis was conducted to indirectly compare the overall diagnostic performance.Results:Twenty-six studies with 2115 pancreatic masses were included.The pooled sensitivity and specificity of CEUS for MFP were 82%(95%confidence interval[CI],73%-88%;I^(2)=0.00%)and 95%(95%CI,90%-97%;I^(2)=63.44%),respectively;the overall+LR,-LR,and DOR values were 15.12(95%CI,7.61-30.01),0.19(95%CI,0.13-0.29),and 78.91(95%CI,30.94-201.27),respectively;and the area under the SROC curve(AUC)was 0.90(95%CI,0.87-92).However,the overall sensitivity and specificity of CECT were 81%(95%CI,75-85%;I^(2)=66.37%)and 94%(95%CI,90-96%;I^(2)=74.87%);the overall+LR,-LR,and DOR values were 12.91(95%CI,7.86-21.20),0.21(95%CI,0.16-0.27),and 62.53(95%CI,34.45-113.51),respectively;and,the SROC AUC was 0.92(95%CI,0.90-0.94).The overall diagnostic accuracy of CEUS was comparable to that of CECT for the differential diagnosis of MFP and PDAC(relative DOR 1.26,95%CI[0.42-3.83],P>0.05).Conclusions:CEUS and CECT have comparable diagnostic performance for differentiating MFP from PDAC,and should be considered as mutually complementary diagnostic tools for suspected focal pancreatic lesions.