Effects of Sodium Valproate Monotherapy on Blood Liver Enzyme Levels
                    in Patients with Epilepsy: A Meta-Analysis

AbstractWe conducted this meta-analysis to assess the effects of sodium valproate (VPA) monotherapy on blood liver enzymes in patients with epilepsy. PubMed, Web of Science, EBSCO, Cochrane Library, Wanfang, China national knowledge infrastructure databases were searched. Nine studies were included. Results showed: (1) The overall SMD for blood AST, ALT, and GGT levels of VPA monotherapy group versus control group were 0.70 (95% CI=0.31 to 1.09, Z=3.52, p=0.0004), 0.47 (95% CI=− 0.01 to 0.95, Z=1.91, p=0.06), 0.44 (95% CI=0.29 to 0.60, Z=5.55, p<0.00001), respectively. (2) In subgroup meta-analysis, increased blood AST and GGT levels were observed in epileptic minors (AST: total SMD=0.85, 95% CI=0.40 to 1.30, Z=3.69, p=0.0002; GGT: total SMD=0.46, 95% CI=0.29 to 0.63, Z=5.25, p<0.00001). Elevated blood ALT level was observed in Asian patients receiving VPA monotherapy (total SMD=0.70, 95% CI=0.51 to 0.90, Z=7.01, p<0.00001), and the early stage of VPA monotherapy (total SMD=0.93, 95% CI=0.57 to 1.29, Z=5.09, p<0.00001). Overall, our results indicated that blood AST and GGT were significantly increased in epileptic minors receiving VPA monotherapy. The elevation of blood ALT was observed in Asian patients and the early stage of VPA monotherapy. However, due to the small number of included studies, our results should be considered with caution.

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Effects of dexmedetomidine on neurocognitive disturbance after elective non-cardiac surgery in senile patients: a systematic review and meta-analysis

Journal of International Medical Research ◽

10.1177/03000605211014294 ◽

2021 ◽

Vol 49 (5) ◽

pp. 030006052110142

Author(s):

Xiaobo Bi ◽

Jingxia Wei ◽

Xia Zhang

Keyword(s):

Cardiac Surgery ◽

Postoperative Delirium ◽

Meta Analysis ◽

Postoperative Cognitive Dysfunction ◽

Cochrane Library ◽

Control Group ◽

China National Knowledge Infrastructure ◽

Neurocognitive Dysfunction ◽

Knowledge Infrastructure ◽

Positive Effect

Objective Senile patients often experience neurocognitive disturbance after non-cardiac surgery. Several clinical trials have investigated if the perioperative intravenous use of dexmedetomidine has a positive effect on the prevention of neurocognitive dysfunction, but the results have been inconsistent. We performed a meta-analysis to investigate the effects of dexmedetomidine on neurocognitive disturbance after elective non-cardiac surgery in senile patients. Methods The PubMed, Cochrane Library, EMBASE and China National Knowledge Infrastructure databases were comprehensively searched for all randomized controlled trials published before 1 February 2020 that investigated the efficacy of dexmedetomidine in the prevention of postoperative delirium (POD) or postoperative cognitive dysfunction (POCD). Results Sixteen studies involving 4376 patients were included in this meta-analysis. Compared with the control (i.e., saline), the perioperative intravenous use of dexmedetomidine significantly reduced the incidence of POD and POCD. However, patients in the dexmedetomidine group were more likely to develop bradycardia and hypotension during the administration of dexmedetomidine than patients in the control group. There were no differences between the two groups in the incidence of nausea and vomiting or mortality rate. Conclusion Dexmedetomidine has a positive effect on the prevention of neurocognitive disturbance in senile patients after elective non-cardiac surgery.

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The Effect of Letrozole Combined with Dydrogesterone for Endometriosis in China: A Meta-Analysis

BioMed Research International ◽

10.1155/2021/9946060 ◽

2021 ◽

Vol 2021 ◽

pp. 1-10

Author(s):

Shumei Sun ◽

Hao Zhang ◽

Peicheng Zhong ◽

Zhihong Xu

Keyword(s):

Meta Analysis ◽

Carbohydrate Antigen ◽

Cochrane Library ◽

Control Group ◽

China National Knowledge Infrastructure ◽

Carbohydrate Antigen 125 ◽

Knowledge Infrastructure ◽

Significant Difference ◽

Mean Differences ◽

Endothelial Growth Factor

Purpose. To discuss the effects of dydrogesterone combined with letrozole on the effectiveness, sex hormone levels, and serological indicators in patients with endometriosis. This study is registered with PROSPERO (CRD42020213172). Methods. We searched relevant randomized controlled trials (RCTs) through PubMed, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang, and VIP Database. The standardized mean differences (SMDs), the mean differences (MDs), or odds ratios (ORs) with their 95% confidence intervals (95% CIs) were computed to be outcome indicators, including total effectiveness, Vascular Endothelial Growth Factor (VEGF) level, Carbohydrate Antigen 125 (CA125) level, Follicle-Stimulating Hormone (FSH) level, Luteinizing Hormone (LH) level, estrogen (E2) level, progesterone (P) level, interleukin-6 (IL-6) level, and tumor necrosis factor-a (TNF-a) level. Results. A total of 19 RCTs involving 1,591 patients were included in this study. Our results showed that letrozole combined with dydrogesterone can significantly reduce the levels of VEGF (SMD -2.23, 95% CI -2.39 to -2.07; p < 0.00001 ), CA125 (MD -10.53, 95% CI -11.19 to -9.88; p < 0.00001 ), E2 (SMD -1.64, 95% CI -1.81 to -1.47; p < 0.00001 ), P (MD -5.11, 95% CI -6.26 to -3.96; p < 0.00001 ), IL-6 (MD -4.41, 95% CI -5.16 to -3.67; p < 0.00001 ), and TNF-a (MD -5.67, 95% CI -6.34 to -5.00; p < 0.00001 ) in patients with endometriosis compared with the control group. In addition, the results indicated that total effectiveness was significantly higher in the experiment group (OR 6.21, 95% CI 4.17 to 9.24; p < 0.00001 ) compared to the control. However, there was no significant difference between FSH and LH levels in both groups ( p > 0.05 ). Conclusion. This combination therapy can effectively decrease the levels of VEGF, CA125, E2, P, IL-6, and TNF-a and increase the total effectiveness when comparing with the control group.

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Efficacy of perioperative intravenous dexmedetomidine administration for the prevention of postoperative sore throat: a meta-analysis

Journal of International Medical Research ◽

10.1177/03000605211017686 ◽

2021 ◽

Vol 49 (5) ◽

pp. 030006052110176

Author(s):

Yuanhui Liu ◽

Dongmei Ai ◽

Xiaobin Wang

Keyword(s):

Sore Throat ◽

Meta Analysis ◽

Clinical Work ◽

Cochrane Library ◽

Control Group ◽

Postoperative Sore Throat ◽

China National Knowledge Infrastructure ◽

Related Complication ◽

Anesthetic Drugs ◽

Knowledge Infrastructure

Objective Postoperative sore throat (POST) is an undesirable intubation-related complication after surgery. Several studies have investigated the efficacy of perioperative intravenous dexmedetomidine administration for the prevention of POST, but the results have been inconsistent. We aimed to summarize all existing evidence and draw a more precise conclusion to guide future clinical work. Methods PubMed, Cochrane Library, EMBASE and China National Knowledge Infrastructure databases were comprehensively searched for all randomized controlled trials published before 1 February 2021 that investigated the efficacy of dexmedetomidine for the prevention of POST. Results Nine studies involving 400 patients were included in our meta-analysis. Compared with the control groups (i.e., saline and anesthetic drugs), perioperative intravenous use of dexmedetomidine significantly reduced the incidence of POST [risk ratio (RR): 0.56; 95% confidence interval (CI): 0.40–0.77; I2 = 0%) and coughing on the tube during extubation (RR: 0.58; 95% CI: 0.41–0.82; I2 = 0%). Additionally, patients in the dexmedetomidine group were more likely to develop bradycardia (RR: 2.46; 95% CI: 1.28–4.71; I2 = 0%) and hypotension (RR: 3.26; 95% CI: 1.14–9.33; I2 = 0%) during the administration of dexmedetomidine than those in the control group. Conclusion Perioperative intravenous administration of dexmedetomidine has a positive effect on the prevention of POST.

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Traditional Chinese Medicine Yimucao Injection Combined with Western Medicine for Preventing Postpartum Hemorrhage after Cesarean Section: A Systematic Review and Meta-Analysis

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2019/7475151 ◽

2019 ◽

Vol 2019 ◽

pp. 1-13

Author(s):

Shichun Chen ◽

Baocheng Xie ◽

Hao Tian ◽

Shaobo Ding ◽

Chengyu Lu

Keyword(s):

Blood Loss ◽

Cesarean Section ◽

Postpartum Hemorrhage ◽

Western Medicine ◽

Randomized Clinical Trials ◽

Meta Analysis ◽

Cochrane Library ◽

Control Group ◽

China National Knowledge Infrastructure ◽

Knowledge Infrastructure

Objective. Yimucao injection combined with several contraction uterus drugs is in use for preventing postpartum hemorrhage after cesarean section. The present study is a meta-analysis comparing the efficacy and safety of these drugs. Methods. PubMed, Cochrane Library, Embase, the China National Knowledge Infrastructure (CNKI), the Chinese Biomedical Database (CBM), VIP, and Wanfang database were searched until June 2018. We selected RCTs of Yimucao injection combined with western medicine for preventing postpartum hemorrhage and study quality was assessed using the revised Cochrane risk of bias tool. Forty-eight RCTs are comprised of 7,330 participants. Results. The overall response rate of Yimucao injection combined with western medicine as a class (OR=4.19, 95%CI=2.83, 6.20, P<0.00001) was found to be significantly improved than western medicine alone. Yimucao injection combined with western medicine group could significantly reduce blood loss in intraoperative (SMD= -1.15, 95%CI= -1.43, -0.87, P<0.00001), compared with control group. The treatment group could significantly reduce postpartum blood loss within 2 hours (SMD= -1.73, 95%CI= -2.01, -1.46, P<0.00001) and had a significantly lower blood loss within 24 hours (SMD= -1.92, 95%CI= -2.21, -1.63, P<0.00001) than control group. Additionally, in terms of the safety, Yimucao injection group reduced the risk of adverse events in the course of prevention than the western medicine group. Conclusions. This study demonstrated that Yimucao injection combined with western medicine may be more effective for preventing postpartum hemorrhage after cesarean section. However, high-quality and large multicenter randomized clinical trials will be needed to prove the consequence in the further.

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Evaluation of the efficacy and safety of different class III anti-arrhythmic drugs for treating patients with atrial fibrillation: a network meta-analysis

10.21203/rs.2.17803/v1 ◽

2019 ◽

Author(s):

Chuang Yang ◽

Zhibo Li ◽

Xin Xue ◽

yu fei

Keyword(s):

Atrial Fibrillation ◽

Adverse Reactions ◽

Meta Analysis ◽

Heart Rhythm ◽

Cochrane Library ◽

Control Group ◽

Class Iii ◽

China National Knowledge Infrastructure ◽

Significant Treatment ◽

Knowledge Infrastructure

Abstract Background Class III anti-arrhythmic drugs (AADs) are used to control heart rhythm or rate in the management of atrial fibrillation (AF). In this study, we evaluated the most effective and safe class III AADs used to treat patients with AF. Methods We searched the PubMed, Cochrane Library, Web of Science, Embase, WanFang databases, as well as the China National Knowledge Infrastructure from 2014 to 2019 to identify studies that reported the use of class III ADDs to treat AF. Results We identified 31 articles (24 Chinese and 7 English), that included 2,894 AF patients (treatment group = 1,498, control group = 1,396) for our analysis. Several class III AADs showed significant treatment effects in AF patients compared to conventional treatment. The ADDs were ranked in terms of efficacy from good to bad as follows: vernakalant (relative risk (RR) =2.7, 95% confidence interval (CI):1.9-3.7), ibutilide (RR=2.0, 95% CI:1.7-2.4), nifekalant (RR=1.5, 95% CI:1.2-2.0), and amiodarone (RR=1.4,95% CI:1.3-1.5). There were no significant differences in the incidence of adverse reactions among the different class III AADs. These ADDs were ranked from least to most adverse reactions as follows: vernakalant(RR=0.46, 95% CI:0.20-1.0), sotalol (RR=0.52, 95% CI:0.25-1.0), ibutilide (RR=0.64, 95% CI:0.33-1.2), amiodarone (RR=0.79, 95% CI:0.58-1.1), and nifekalant (RR=1.0, 95% CI:0.44-2.5). Conclusion Our network meta-analysis shows that different class III AADs can be used to treat patients with AF both safely and effectively. Vernakalant appears to offer optimal therapeutic effect with minimal adverse reactions.

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Combined Therapy of Diabetic Peripheral Neuropathy with Breviscapine and Mecobalamin: A Systematic Review and a Meta-Analysis of Chinese Studies

BioMed Research International ◽

10.1155/2015/680756 ◽

2015 ◽

Vol 2015 ◽

pp. 1-11 ◽

Cited By ~ 10

Author(s):

Chanjiao Zheng ◽

Weilin Ou ◽

Huanyu Shen ◽

Zhiheng Zhou ◽

Jiaji Wang

Keyword(s):

Peripheral Neuropathy ◽

Diabetic Peripheral Neuropathy ◽

Combined Therapy ◽

Meta Analysis ◽

Cochrane Library ◽

Control Group ◽

China National Knowledge Infrastructure ◽

Knowledge Infrastructure ◽

Chinese Studies ◽

Better Than

Objective. A meta-analysis on combined therapy of diabetic peripheral neuropathy (DPN) with breviscapine and mecobalamin was performed to evaluate the efficacy of this therapy.Methods. Six English databases (Medline, Cochrane Library, PubMed, EMBASE, Web of Science, and CINAHL) and four Chinese databases (China National Knowledge Infrastructure, VIP Journals Database, CBM, and Wanfang database) were searched for studies on the clinical trials in which DPN was treated with breviscapine and mecobalamin, and RevMan 5.1 package was employed for analyzing pooled trials and publication bias.Results. A total of 17 articles including 1398 DPN patients were identified. Homogeneity was observed among different studies (P=0.74). The efficacy of combined therapy with breviscapine and mecobalamin was significantly better than that in control group [P<0.0001(OR=5.01, 95% CI: 3.70–6.78)].Conclusion. Available findings suggest that the therapeutic efficacy of breviscapine combining mecobalamin is superior to mecobalamin alone, and this strategy is required to be popularized in clinical practice.

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Effect of somatometric parameters on the prevalence and severity of varicocele: a systematic review and meta-analysis

Reproductive Biology and Endocrinology ◽

10.1186/s12958-021-00695-3 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Runqing Li ◽

Junjie Liu ◽

Yushan Li ◽

Quanxian Wang

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Cochrane Library ◽

China National Knowledge Infrastructure ◽

Random Effects Models ◽

Knowledge Infrastructure ◽

Regression Test ◽

Mean Differences ◽

Q Statistic ◽

The Relationship

Abstract Background Published studies have shown contradictory results regarding the relationship between somatometric parameters and varicoceles. We performed a systematic review and meta-analysis to investigate the possible effects of age, height, weight, and body mass index (BMI) on the presence and severity of varicoceles. Methods Databases including EMBASE, MEDLINE, PubMed, Cochrane Library, China National Knowledge Infrastructure (CNKI), Web of Science, and Google Scholar were systematically searched to identify relevant articles published up to March 2020. Two researchers independently identified eligible articles and extracted data. Cochran’s Q statistic and I2 statistics were used to assess heterogeneity. Meta-analysis was performed using StataSE 12.0 software (StataCorp LP, USA). Random-effects models were used to obtain the weighted mean differences (WMDs) and 95% confidence intervals (CIs). Publication bias was assessed using Begg’s funnel plot and Egger’s regression test. Results The search strategy produced 272 articles, of which 18 articles were eligible according to the inclusion/exclusion criteria. A total of 56,325 patients with varicocele and 1,334,694 patients without varicocele were included in the meta-analysis to evaluate the effect of somatometric parameters on the presence and severity of varicocele. The overall results demonstrated that the presence of varicoceles was significantly associated with height (WMD = 1.41, 95% CI = 1.07 to 1.74, P < 0.001) and inversely correlated with BMI (WMD = − 1.35, 95% CI = -1.67 to − 1.03, P < 0.001) but not with age (WMD = -0.93, 95% CI = -2.19 to 0.33, P = 0.149) or weight (WMD = 0.24, 95% CI = -2.24 to 2.72, P = 0.850). The severity of varicocele was inversely correlated with increased BMI but not with age. Conclusion The presence of varicoceles was significantly associated with height and inversely correlated with BMI.

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Individual or combined transcatheter arterial chemoembolization and radiofrequency ablation for hepatocellular carcinoma: a time-to-event meta-analysis

World Journal of Surgical Oncology ◽

10.1186/s12957-021-02188-4 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Chuang Jiang ◽

Gong Cheng ◽

Mingheng Liao ◽

Jiwei Huang

Keyword(s):

Hepatocellular Carcinoma ◽

Radiofrequency Ablation ◽

Transcatheter Arterial Chemoembolization ◽

Meta Analysis ◽

Combined Treatment ◽

Similar Rate ◽

Cochrane Library ◽

China National Knowledge Infrastructure ◽

Knowledge Infrastructure ◽

Arterial Chemoembolization

Abstract Background There is still some debate as to whether transcatheter arterial chemoembolization (TACE) plus radiofrequency ablation (RFA) is better than TACE or RFA alone. This meta-analysis aimed to compare the efficacy and safety of TACE plus RFA for hepatocellular carcinoma (HCC) with RFA or TACE alone. Methods We searched PubMed, MEDLINE, Embase, Cochrane Library, and CNKI (China National Knowledge Infrastructure) for all relevant randomized controlled trials and retrospective studies reporting overall survival (OS), recurrence-free survival (RFS), and complications of TACE plus RFA for HCC, compared with RFA or TACE alone. Results Twenty-one studies involving 3413 patients were included. TACE combined with RFA was associated with better OS (hazard ratio [HR]=0.62, 95% confidence intervals [CI] = 0.55–0.71, P < 0.001) and RFS (HR = 0.52, 95% CI = 0.39–0.69, P < 0.001) than TACE alone; compared with RFA alone, TACE plus RFA resulted in longer OS (HR = 0.63, 95% CI = 0.53–0.75, P < 0.001) and RFS (HR = 0.60, 95% CI = 0.51–0.71, P < 0.001). Subgroup analyses by tumor size also showed that combined treatment resulted in better OS and RFS compared with RFA alone in patients with HCC larger than 3 cm. Combined treatment resulted in similar rate of major complications compared with TACE or RFA alone (OR = 1.78, 95% CI = 0.99–3.20, P = 0.05; OR = 1.00, 95% CI = 0.42–2.38, P = 1.00, respectively). Conclusions TACE combined with RFA was more effective for HCC than TACE alone. For patients with a tumor larger than 3 cm, the combined treatment also achieved a better effect than RFA alone.

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Efficacy and Safety of Topical Timolol Eye Drops in the Treatment of Myopic Regression after Laser In Situ Keratomileusis: A Systematic Review and Meta-Analysis

Journal of Ophthalmology ◽

10.1155/2015/985071 ◽

2015 ◽

Vol 2015 ◽

pp. 1-8 ◽

Cited By ~ 3

Author(s):

Xiaochen Wang ◽

Guiqiu Zhao ◽

Jing Lin ◽

Nan Jiang ◽

Qian Wang ◽

...

Keyword(s):

Meta Analysis ◽

Treated Group ◽

Laser In Situ Keratomileusis ◽

Control Group ◽

Eye Drops ◽

Efficacy And Safety ◽

China National Knowledge Infrastructure ◽

Knowledge Infrastructure ◽

Significant Difference

Aims. The aim of this study was to assess the efficacy and safety of timolol in the treatment of myopic regression after laser in situ keratomileusis (LASIK).Methods. We searched MEDLINE, CENTRAL, EMBASE, China National Knowledge Infrastructure (CNKI), and Chinese Biological Medicine (CBM) from the inception to July 2015 for relevant randomized controlled trials that examined timolol therapy for myopic regression. The methodological quality of the studies included was assessed using the Revman 5.3 software.Results. We included six clinical trials involving 483 eyes in this review, including 246 eyes in treated group and 237 eyes in controlled group. We observed statistically significant improvements on the postoperative SE in the 3 months. However, the change of CCT was not statistically different between the control group and the experimental group. There were fewer cases of IOP, UDVA, and CDVA in treated group having significant difference from the controlled group.Conclusions. Topical timolol could be an effective treatment for reduction of myopic regression especially the spherical errors after myopic LASIK. Further RCTs with larger sample sizes for these trials are warranted to determine the efficacy and limitation for myopic regression after LASIK.

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Association of inflammatory markers with the severity of COVID-19

10.1101/2020.04.14.20065680 ◽

2020 ◽

Cited By ~ 2

Author(s):

Furong Zeng ◽

Ying Guo ◽

Mingzhu Yin ◽

Xiang Chen ◽

Guangtong Deng

Keyword(s):

Inflammatory Markers ◽

Fixed Effects ◽

Weighted Mean Difference ◽

Meta Analysis ◽

Cochrane Library ◽

Global Public Health ◽

China National Knowledge Infrastructure ◽

Bias Assessment ◽

Knowledge Infrastructure ◽

Severe Group

AbstractBackgroundThe ongoing worldwide epidemic of Coronavirus Disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV- 2), has posed a huge threat to global public health. However, with regard to the effects of inflammatory markers on the severity of COVID-19, studies have reported associations that vary in strength and direction.AimsIn the meta-analysis, we aimed to provide an overview of the association of inflammatory markers with severity of COVID-19.MethodsThe following databases were searched: PubMed, Embase, Cochrane Library, Wanfang database and CNKI (China National Knowledge Infrastructure) database until March 20, 2020. Weighted mean difference (WMD) and 95% confidence intervals (CIs) were pooled using random or fixed-effects models.ResultsA total of 16 studies were included in our analysis comprising of 3962 patients with COVID-19. Random-effects results demonstrated that patients with COVID-19 in non-severe group had lower levels for CRP (WMD = -41.78 mg/l, 95% CI = [-52.43, - 31.13], P < 0.001), PCT (WMD = -0.13 ng/ml, 95% CI = [-0.20, -0.05], P < 0.001), IL- 6 (WMD = -21.32 ng/l, 95% CI = [-28.34, -14.31], P < 0.001), ESR (WMD = - 8.40 mm/h, 95% CI = [-14.32, -2.48], P = 0.005), SAA (WMD = -43.35 μg/ml, 95% CI = [-80.85, -5.85], P = 0.020) and serum ferritin (WMD = -398.80 mg/l, 95% CI = [- 625.89, -171.71], P < 0.001), compared with those in severe group. Moreover, survivors had lower level for IL-6 than non-survivors with COVID-19 (WMD = -4.80 ng/ml, 95% CI = [-5.87, -3.73], P < 0.001). These results were consistent through sensitivity analysis and publication bias assessment.ConclusionsThe meta-analysis highlights the association of inflammatory markers with the severity of COVID-19. Measurement of inflammatory markers might help clinicians to monitor and evaluate the severity and prognosis of COVID-19.

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