Efficacy and safety of plasma exchange or immunoadsorption for the treatment of option neuritis in demyelinating diseases: A systematic review and meta-analysis

2021 ◽  
pp. 112067212110652
Author(s):  
Jianping Zhang ◽  
Aifang Fan ◽  
Lili Wei ◽  
Shihui Wei ◽  
Lindan Xie ◽  
...  
Keyword(s):  
Plasma Exchange ◽  
Meta Analysis ◽  
Visual Outcome ◽  
Acute Attack ◽  
Demyelinating Diseases ◽  
Cochrane Library ◽  
China National Knowledge Infrastructure ◽  
Knowledge Infrastructure ◽  
Disability Status ◽  
Study Characteristics

Background There are no systematic reviews yet that evaluated the effects of PE/IA in patients with optic neuritis (ON) in demyelinating diseases. A meta-analysis of available study is needed to further explore the value of plasma exchange (PE) or immunoadsorption (IA) in treating ON in demyelinating diseases. Methods All relevant articles published on PubMed, Web of Science, Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), VIP Database, Wanfang, Sinomed and ophthalmology professional websites were searched. Study characteristics, demographic characteristics, clinical features and outcome measures were extracted. Response rate, adverse events (AE) rate, serious adverse event (SAE) rate, the log of the minimum angle of resolution (logMAR), visual outcome scale (VOS) and expanded disability status scales (EDSS) were evaluated using a random-effects model. Results 35 studies were included between 1985 and 2020, containing 1191 patients. The response rates of PE and IA in acute attack of ON were 68% and 82% respectively. LogMAR (−0.60 to − 1.42) and VOS (−1.10 to −1.82) had been significantly improved from within 1 month to more than 1 month after PE treatment. Besides, we found that logMAR improved 1.78, 0.95 and 0.38, respectively ,when the time from symptom onset to the first PE/IA was less than 21 days, 21–28 days, and more than 28 days. The pooled mean difference of EDSS was −1.14.Adverse effects rate in patients with PE or IA were 0.20 and 0.06, respectively. Conclusion The meta-analysis provided evidence that PE/IA treatment was an effective and safe intervention, and it is recommended that early initiation of PE/IA treatment is critical.

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

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.

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

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.

scholarly journals Association of inflammatory markers with the severity of COVID-19

2020 ◽  
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.

scholarly journals Efficacy and Safety of Modified Yunu-Jian in Patients with Periodontitis: A Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Yuanyuan Yue ◽  
Meng Gao ◽  
Yanru Deng ◽  
Jiemin Shao ◽  
Yingguang Sun
Keyword(s):  
Western Medicine ◽  
Combined Therapy ◽  
Meta Analysis ◽  
Effective Rate ◽  
Cochrane Library ◽  
Efficacy And Safety ◽  
China National Knowledge Infrastructure ◽  
Knowledge Infrastructure ◽  
Oral Inflammation

Background. Modified Yunu-Jian (mYJ), a Chinese medicine (CM) formula, is thought to clear heat and nourish yin. Clinically, it is often used to treat oral inflammation. However, its efficacy remains controversial. Methods. The study aims to evaluate the efficacy and safety of mYJ for treating patients with periodontitis. We searched electronic databases (PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure, Wanfang database, VIP database, and CBM) from inception to December 2020. Only randomized controlled trials investigating modified Yunu-Jian, with or without other medications, against controlled intervention in the treatment of patients diagnosed with periodontitis were included. Both Review Manager 5.3 and Stata 15.0 software were used to analyze the data. The Cochrane Collaborations risk of bias tool was used to assess the quality of the methods. Results. Thirteen clinical trials, involving 1179 participants, were included in our investigation. The results showed that the combination of mYJ with western medicine improved the total effective rate compared with western medicine alone (RR = 1.17, 95% CI (1.12, 1.23), P  < 0.00001). The sensitivity analysis and Harbord’s test ( P  = 0.255) both showed that the results were statistically robust. Moreover, the periodontal indexes (GI, SBI, PLI, and PD; P  < 0.00001) of patients with periodontitis were also significantly improved after receiving the combined therapy. No serious adverse reactions were observed in the experimental groups. Conclusions. Evidence from the meta-analysis suggested that mYJ appeared to be effective and relatively safe for treating periodontitis. Because of the low quality of the methods used in the included RCTs, further studies with larger sample sizes and well-designed models are required to confirm our findings.

scholarly journals Large Dosage of Chishao in Formulae for Cholestatic Hepatitis: A Systematic Review and Meta-Analysis

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Xiao Ma ◽  
Ji Wang ◽  
Xuan He ◽  
Yanling Zhao ◽  
Jiabo Wang ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Cholestatic Hepatitis ◽  
Cochrane Library ◽  
Efficacy Rate ◽  
China National Knowledge Infrastructure ◽  
Randomized Controlled ◽  
Knowledge Infrastructure ◽  
Novel Treatment ◽  
Large Dosage ◽  
Biochemical Indices

Objective. To evaluate the efficacy and safety of large dosage of Chishao in formulae for treatment of cholestatic hepatitis.Methods. The major databases (PubMed, Embase, Cochrane Library, Chinese Biomedical Database Wanfang, VIP medicine information system, and China National Knowledge Infrastructure) were searched until January 2014. Randomized controlled trials (RCTs) of large dosage of Chishao in formulae that reported on publications in treatment of cholestatic hepatitis with total efficacy rate, together with the biochemical indices including alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), and direct bilirubin (DBIL), were extracted by two reviewers. The Cochrane tool was used for the assessment of risk of bias included trials. Data were analyzed with RevMan 5.2.7 software.Results. 11 RCTs involving 1275 subjects with cholestatic hepatitis were included. Compared with essential therapy, large dosage of Chishao in formulae demonstrated more efficiently with down regulation of serum ALT, AST, TBIL, DBIL. Meanwhile, there were no obvious adverse events.Conclusion. As a promising novel treatment approach, widely using large dosage of Chishao in formulae may enhance the curative efficacy for cholestatic hepatitis. Considering being accepted by more and more practitioners, further rigorously designed clinical studies are required.

scholarly journals Effects and safety of intraoperative intermittent pneumatic compression for preventing postoperative venous thromboembolism: a meta-analysis

2021 ◽  
Author(s):  
Yanping Yang ◽  
Jianhua Li
Keyword(s):  
Cohort Studies ◽  
Retrospective Cohort ◽  
Meta Analysis ◽  
Intermittent Pneumatic Compression ◽  
Surgical Patients ◽  
Cochrane Library ◽  
China National Knowledge Infrastructure ◽  
Knowledge Infrastructure ◽  
Retrospective Cohort Studies ◽  
Newcastle Ottawa Scale

IntroductionIntermittent pneumatic compression (IPC) has been used for venous thrombosis (VTE) prevention. It’s necessary to evaluate the effects and safety of intraoperative use of IPC devices in the prevention of VTE in surgical patients.Material and methodsTwo authors independently searched the PubMed, Cochrane Library, MedLine, EMbase, China national knowledge infrastructure (CNKI), Wanfang databases for randomized controlled trials (RCTs) and cohort studies on the use of IPC in surgical patients up to June 10, 2021. The Cochrane Collaborations risk of bias tool and Newcastle-Ottawa Scale (NOS) were used for quality assessment. RevMan 5.3 software were used for statistical analyses.ResultsA total of 13 studies including seven RCTs and six retrospective cohort studies involving 6673 surgical patients were included, 1883 patients underwent IPC intervention. The synthesized RCT results indicated that IPC was beneficial to the reduce the incidence of DVT (RR0.30, 95%CI0.22~0.40, P<0.001) and VTE (RR0.51, 95%CI0.27~0.95, P=0.03). The synthesized results from retrospective cohort studies indicated that IPC is beneficial to the reduce the incidence of DVT (RR0.63, 95%CI0.42~0.96, P=0.03) and PE (RR0.34, 95%CI0.16~0.72, P=0.005). No significant publication biases were found for all synthesized outcomes (all p>0.05).ConclusionsIPC seems to be safe and effective in the prevention and management of intraoperative VTE. Limited by sample size, this conclusion still needs to be further confirmed by large-sample, multi-center, high-quality clinical studies.

scholarly journals A Chinese Prescription Chuanxiong Chatiao San for Migraine: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2019 ◽  
Vol 2019 ◽  
pp. 1-17 ◽  
Author(s):  
Yu Wang ◽  
Yajun Shi ◽  
Xiaofei Zhang ◽  
Junbo Zou ◽  
Yulin Liang ◽  
...  
Keyword(s):  
Conventional Medicine ◽  
Meta Analysis ◽  
Blood Rheology ◽  
Plasma Viscosity ◽  
Favorable Effect ◽  
Cochrane Library ◽  
Total Efficiency ◽  
China National Knowledge Infrastructure ◽  
Knowledge Infrastructure ◽  
The Cochrane Library

Backgrounds. Chuanxiong Chatiao san (CXCT) is a famous Chinese classical prescription. It has a favorable effect in treating migraine. It is reported that CXCT combined with Western conventional medicine (WCM) could increase the therapeutic efficacy on migraine. The purpose of this paper is to systematically assess the clinical efficacy, safety, and some indexes of CXCT for migraine. Methods. PubMed, Embase Database, China National Knowledge Infrastructure (CNKI), Wanfang Database, the Cochrane Library, and the CBM were searched from January 2000 to February 2019. We made a detailed record of outcome measurements. Meta-analysis was performed using RevMan 5.3 software. Results. A total of 3307 patients were included in the 37 articles. Meta-analysis showed that CXCT significantly increased the total efficiency rate (TER), compared with Western medicine treatment (WMC) (P < 0.00001). When CXCT is combined with WMC, the result showed that P < 0.00001. CXCT was significantly reduced the adverse events (AEs) compared with WMC (P < 0.00001). The levels of VAS, number of migraine episodes (NE), and time of headache duration (TD) were significantly reduced (P < 0.00001). Platelet function and blood rheology level were improved via a significantly decrease in 5-HT and β-EP (P < 0.00001). Other indicators such as substance P, CGRP high-cut viscosity, low-cut viscosity, plasma viscosity, and fibrinogen were significantly reduced (P < 0.00001). Conclusion. Our findings provide evidence that CXCT and CXCT combined with WMC have higher efficacy in the treatment of migraine compared with WCM alone. Methodological quality was generally low, so the conclusion of this paper has some limitations and it has to be carefully evaluated.

scholarly journals Acupuncture for Obstructive Sleep Apnea (OSA) in Adults: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Liaoyao Wang ◽  
Jia Xu ◽  
Yijun Zhan ◽  
Jian Pei
Keyword(s):  
Subgroup Analysis ◽  
Assessment Tool ◽  
Meta Analysis ◽  
Biomedical Literature ◽  
Cochrane Library ◽  
China National Knowledge Infrastructure ◽  
Knowledge Infrastructure ◽  
Obstructive Sleep ◽  
Clinically Significant

Objective. Our aim was to assess the efficacy and safety of acupuncture for OSA patients with various severities of the disorder. Methods. Eight databases including PubMed, Cochrane Library, EMBASE, Web of Science, China National Knowledge Infrastructure (CNKI), Chongqing VIP (CQVIP), Wanfang Data, and Chinese Biomedical Literature Database (CBM) were comprehensively searched till July 2019. Randomized controlled trials (RCTs) testing acupuncture in the treatment of OSA were eligible for inclusion. Studies were selected for inclusion, and data were extracted by two authors independently. The Cochrane Collaboration’s Risk of Bias Assessment Tool and RevMan software (version 5.3) were used to evaluate the quality of studies and conduct statistical analysis. Results. Nine RCTs with 584 participants were included. The trials covered acupuncture and electropuncture. Acupuncture caused clinically significant reductions in AHI (MD: -6.18; 95% CI: -9.58 to -2.78; Z=3.56, P=0.0004) as well as in ESS (MD: -2.84; 95% CI: -4.80 to -0.16, Z=2.09, P=0.04). AHI was reduced more in the subgroup analysis of moderate OSA patients (MD: -9.44; 95% CI: -12.44 to -6.45; Z=6.18, P<0.00001) and severe OSA patients (MD: -10.09; 95% CI: -12.47 to -7.71; Z=8.31, P<0.00001). ESS was also reduced more in the subgroup analysis of moderate OSA patients (MD: -2.40; 95% CI: -3.63 to -1.17; Z=3.83, P=0.0001) and severe OSA patients (MD: -4.64; 95% CI: -5.35 to -3.92; Z=12.72, P<0.00001). Besides, acupuncture had a beneficial effect on LSaO2 (MD: 5.29; 95% CI: 2.61 to 7.97; Z=3.86, P=0.0001). The outcome of AHI and LSaO2 yielded consistent results after sensitivity analysis, but the direction of the outcome of ESS was reversed. And the quality of evidence was mainly low to very low. Conclusions. Acupuncture therapy is effective for OSA patients in reducing AHI and ESS and in improving the LSaO2 of various severities, especially in moderate and severe OSA patients. High-quality trials are urgently needed.

scholarly journals TLR9 Rs352140 polymorphism contributes to a decreased risk of bacterial meningitis: evidence from a meta-analysis

2020 ◽  
Vol 148 ◽  
Author(s):  
Haiyi Xue ◽  
Huan Peng ◽  
Jiaoming Li ◽  
Mingming Li ◽  
Song Lu
Keyword(s):  
Bacterial Meningitis ◽  
Genetic Model ◽  
Meta Analysis ◽  
Relevant Literature ◽  
Cochrane Library ◽  
Case Control Studies ◽  
China National Knowledge Infrastructure ◽  
Knowledge Infrastructure ◽  
Increased Risk ◽  
The Cochrane Library

Abstract Some studies have suggested that the Toll-like receptor 9 polymorphism (TLR9 rs352140) is closely related to the risk of bacterial meningitis (BM), but this is subject to controversy. This study set out to estimate whether the TLR9 rs352140 polymorphism confers an increased risk of BM. Relevant literature databases were searched including PubMed, Embase, the Cochrane Library and China National Knowledge Infrastructure (CNKI) up to August 2020. Seven case-control studies from four publications were enrolled in the present meta-analysis. Odds ratios (OR) and confidence intervals (95% CI) were calculated to estimate associations between BM risk and the target polymorphism. Significant associations identified were allele contrast (A vs. G: OR 0.66, 95% CI 0.59–0.75, P = 0.000), homozygote comparison (AA vs. AG/GG: OR 0.62, 95% CI 0.49–0.78, P = 0.000), heterozygote comparison (A vs. G: OR 0.74, 95% CI 0.61–0.91, P = 0.005), recessive genetic model (AA vs. AG/GG: OR 0.78, 95% CI 0.65–0.93, P = 0.006) and dominant genetic model (AA vs. AG/GG: OR 0.70, 95% CI 0.57–0.85, P = 0.000). The findings indicate that, in contrast to some studies, the TLR9 rs352140 polymorphism is associated with a decreased risk for BM.

Early Childhood Neglect Among 3- to 6-Year-Old Children in China: A Meta-Analysis

2021 ◽  
pp. 152483802110131
Author(s):  
Huiping Zhang ◽  
Mengmeng Ji ◽  
Yang Wang ◽  
Shuo Xu ◽  
Rui Shi
Keyword(s):  
Early Childhood ◽  
Meta Analysis ◽  
Well Being ◽  
Cochrane Library ◽  
China National Knowledge Infrastructure ◽  
Random Effects Models ◽  
Childhood Neglect ◽  
Knowledge Infrastructure ◽  
High Prevalence ◽  
Medical Neglect

Background: This review aims to estimate the prevalence of the neglect of 3- to 6-year-old children in China. Method: We systematically searched both English- (Web of Science, PsychINFO, PubMed, and Cochrane Library) and Chinese-language databases (China National Knowledge Infrastructure, Wanfang, Weipu, and Biomedical Database). We extracted data related to the prevalence of early childhood neglect and its subtypes and pooled it using random effects models. Findings: We included 21 eligible studies, with a total of 35,175 3- to 6-year-old children, in the analyses. The pooled neglect prevalence was 32.1% at a 95% confidence interval (95% CI [27.0%, 37.2%]). The prevalence of physical, emotional, educational, security, and medical neglect was 15.2% (95% CI [11.9%, 18.5%]), 15.2% (95% CI [10.7%, 19.6%]), 10.4% (95% CI [7.4%, 13.4%]), 13.8% (95% CI [9.9%, 17.8%]), and 11.5% (95% CI [8.1%, 14.9%]), respectively. No gender or location differences were found to affect early childhood neglect or its subtypes. Interpretation: Our results revealed a high prevalence of early childhood neglect—including all its subtypes—among 3- to 6-year-old children in China. Improved child policies and prevention programs tailored to preschool children are needed to protect the well-being of younger children.

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