scholarly journals Systematic Evaluation of the Safety and Therapeutic Effects of Para-aortic Lymphadenectomy for Advanced Gastric Cancer: a Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Jie Ge ◽  
Xiaofeng Liao ◽  
Mimi Tang ◽  
Zhiyun Yang ◽  
Tingyu Zhao ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Randomized Controlled Trials ◽  
Advanced Gastric Cancer ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Therapeutic Effects ◽  
D2 Lymphadenectomy ◽  
Randomized Controlled ◽  
D2 Surgery

Abstract Background: At present, there is still no definite conclusion on whether advanced gastric cancer requires additional para-aortic nodes dissection (PAND). The purpose of this study is an attempt to provide significant data to guide clinical decision-making. Methods: The literature was searched using the terms of gastric cancer, para-aortic lymphadenectomy and D2+ lymphadenectomy and D3 lymphadenectomy. The databases searched included PubMed, Embase, Cochrane library, Web of Science, China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, VIP Database for Chinese Technical Periodicals, and China Biology Medicine disc. RevMan 5.3 software was used for the meta-analysis.Results: In total, 20 studies were included, consisting of 6 randomized controlled trials (RCT) and 14 non-randomized controlled trials (nRCT). These studies involved 5643 patients. The meta-analysis showed the following results: (1) compared with group D2 (D2 lymphadenectomy), the operating time in group D2+ (D2+ lymphadenectomy) was longer [mean difference (MD)=99.45 min, 95% confidence interval (CI) (48.93, 149.97), P<0.001], with more intra-operative blood loss [MD=262.14 mL, 95%CI (165.21, 359.07), P<0.001]; (2) there were no significant differences in five-year overall survival [HR=1.09, 95%CI (0.95, 1.25), P=0.22] and post-operative mortality [RR=0.96, 95%CI (0.59, 1.57), P=0.88] between the two groups; (3) the rate of post-operative complication in group D2+ was higher than that in group D2 [RR=1.42, 95%CI (1.11, 1.81), P<0.001]. Conclusions: It is noteworthy that the combination of perioperative chemotherapy and D2+ surgery, particularly D2+ PAND, shows some survival advantages for specific patients. Although prophylactic D2+ surgery is not recommended as it increases postoperative complications and does not improve long-term survival in patients with advanced gastric cancer.

scholarly journals Jianpi Bushen, a Traditional Chinese Medicine Therapy, Combined with Chemotherapy for Gastric Cancer Treatment: A Meta-Analysis of Randomized Controlled Trials

2018 ◽  
Vol 2018 ◽  
pp. 1-14 ◽  
Author(s):  
Yunbo Chen ◽  
Guijuan Zhang ◽  
Xiaoping Chen ◽  
Xuefeng Jiang ◽  
Fengjie Bie ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Cancer Treatment ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Gastric Cancer Treatment

Objective. To investigate the effects of Jianpi Bushen (JPBS), a traditional Chinese medicine that is used to invigorate the spleen and tonify the kidney, combined with chemotherapy for the treatment of gastric cancer. Methods. Literature retrieval was performed in PubMed, EMBASE, Cochrane Library, MEDLINE, CNKI, Wanfang Data Information Site, and VIP from inception to October 2017. Randomized controlled trials to evaluate the effects of JPBS combined with chemotherapy were identified. The primary reported outcomes were KPS (Karnofsky Performance Status), clinical curative efficiency, immune function, blood system, and nonhematologic system. Review Manager 5.3 (RevMan 5.3) was used for data analysis, and the quality of the studies was also appraised. Results. A total of 26 studies were included with 3098 individuals. The results of the meta-analysis indicated that treatment of gastric cancer with the combination of JPBS and chemotherapy resulted in better outcomes compared to chemotherapy alone. Conclusion. Evidence from the meta-analysis suggested that JPBS combined with chemotherapy has a positive effect on gastric cancer treatment. However, additional rigorously designed and large sample randomized controlled trials are required to confirm the efficacy and safety of this treatment.

scholarly journals The Therapeutic Effects of a Traditional Chinese Medicine Formula Wuzi Yanzong Pill for the Treatment of Oligoasthenozoospermia: A Meta-Analysis of Randomized Controlled Trials

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Ming Peng Zhao ◽  
Xiao Shi ◽  
Grace Wing Shan Kong ◽  
Chi Chiu Wang ◽  
Justin Che Yuen Wu ◽  
...  
Keyword(s):  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Male Infertility ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Semen Parameters ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Therapeutic Effects ◽  
Randomized Controlled

Oligoasthenozoospermia is a crucial factor in male infertility. Wuzi Yanzong (WZYZ) pill is a popular traditional Chinese medicine (TCM) formula which has been used for male infertility treatment for years. However, its effects on semen quality remain controversial. We conducted a preregistered meta-analysis to assess the effect of WZYZ pill for the therapeutic effects on oligoasthenozoospermia. Five randomized controlled trials including 960 participants were selected from databases of domains in North-East Asian regions, PubMed, Embase, and Cochrane Library. WZYZ pill group yielded a greater mean increment on sperm concentration (5 trials: MD 5.99, 95% CI 2.12–9.85, P=0.002), sperm motility (5 trials: MD 4.57, 95% CI 0.47–8.68, P=0.03), sperm morphology (2 trials: MD −1.93, 95% CI −4.87–1.01, P=0.20), activity of acrosomal enzyme (2 trials: MD 28.27, 95% CI 12.41–44.14, P<0.01), volume of semen (2 trials: MD 0.56, 95% CI 0.21–0.91, P=0.002), and a decrement of sperm DNA fragmentation index (2 trials: MD −3.82, 95% CI −6.45–−1.19, P=0.004). However, qualities of selected studies were generally unsatisfactory, and there was inherent heterogeneity among some of the outcomes. Despite these limitations, the WZYZ pill improved sperm quality by improving several semen parameters and decreasing DNA damage in oligoasthenozoospermia patients.

Effectiveness of Acupuncture for Poststroke Aphasia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2021 ◽  
pp. 1-11
Author(s):  
Yu Zhang ◽  
Zhijie Wang ◽  
Xudong Jiang ◽  
Zimeng Lv ◽  
Lin Wang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Reading Ability ◽  
Meta Analysis ◽  
Reporting Quality ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Therapeutic Effects ◽  
China National Knowledge Infrastructure ◽  
Randomized Controlled

<b><i>Background:</i></b> Aphasia is one of the common complications of stroke, and it considerably influences the quality of life of patients. Acupuncture, a therapy used in traditional Chinese medicine for aphasia after stroke, has potential therapeutic effects. We aimed to investigate the therapeutic effect of acupuncture on individuals with poststroke aphasia. <b><i>Methods:</i></b> Randomized controlled trials (RCTs) on acupuncture for poststroke aphasia (either alone or combined with other therapies) were included and compared. We conducted a systematic review and meta-analysis by searching databases, such as MEDLINE, Cochrane Library, Embase, China National Knowledge Infrastructure, VIP, and Wanfang, from inception to July 15, 2019. No language restrictions were applied in this study. <b><i>Results:</i></b> Fourteen trials involving 936 participants had poor reporting and methodological quality. Our meta-analysis showed that compared to the speech and language therapy (SLT) group, acupuncture combined with SLT could improve the rate of Boston Diagnostic Aphasia Examination (BDAE) (OR: 0.15, 95% confidence interval [CI]: 0.04–0.25, <i>p</i> = 0.005), scores of Aphasia Battery of Chinese (ABC) which includes repeating ability (SMD: 1.46, 95% CI: 1.24–1.69,<i> p</i> &#x3c; 0.00001), reading ability (SMD: 1.57, 95% CI: 1.25–1.90, <i>p</i> &#x3c; 0.00001), writing ability (SMD: 1.52, 95% CI: 1.19–1.86, <i>p</i> &#x3c; 0.00001), naming ability (SMD: 1.40, 95% CI: 1.04–1.76, <i>p</i> &#x3c; 0.00001), and listening comprehension ability (SMD: 0.57, 95% CI: 0.22–0.92, <i>p</i> = 0.001). All RCTs were considered at high risk of biased assessment. <b><i>Conclusions:</i></b> Acupuncture (either alone or combined with SLT) may be effective for poststroke aphasia. In the future, rigorous clinical trials with an accurate method design and high reporting quality are required to validate our results.

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