Vitamin D supplementation in pregnant women or infants for preventing allergic diseases: a systematic review and meta-analysis of randomized controlled trials

Background: It is still unclear if and to what extent antenatal or infant or childhood vitamin D supplementation would affect the development of allergy diseases later in life. This study aimed to review the efficacy of vitamin D supplementation in pregnant women, infants, or children for the prevention of allergies.Methods: MEDLINE (PubMed), EMBASE (OVID), and the Cochrane Central Register of Controlled Trials were searched up to March 1, 2020. We included only randomized controlled trials (RCT...     

Aggressive versus controlled fluid resuscitation in acute pancreatitis: A systematic review and meta-analysis of randomized controlled trials

Background: Early fluid resuscitation is one of the fundamental treatments for acute pancreatitis (AP), but there is no consensus on the optimal fluid rate. This systematic review and meta-analysis aimed to compare the efficacy and safety of aggressivevs. controlled fluid resuscitation (CFR) in AP.Methods: The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and Web of Science databases were searched up to September 30, 2022, for randomized controlled trials (RCTs) comp...     

Factors and Their Impact on Treatment Effect of Acupuncture in Different Outcomes: A Meta-Regression of Acupuncture Randomized Controlled Trials

Background: The effects of acupuncture have varied in different randomized controlled trials(RCTs), and there are many factors that influence treatment effect of acupuncture in different outcomes, with conflicting results. Objective: To identify factors and their impact on the treatment effect of acupuncture in different outcomes. Methods: Acupuncture RCTs were searched from 7 databases including Medline(Pub Med), Embase,Cochrane Central Register of Controlled Trials, China National Knowledge In...     

自助心理干预对老年人抑郁情绪治疗效果的Meta分析

目的 全面回顾自助心理干预对减轻老年人抑郁症状的文献并进行Meta分析,以探讨这些干预措施的有效性.方法 检索中国知网、万方、维普、中国生物医学文献数据库、PubMed、Web of Science和Cochrane Central Register of Controlled Trials数据库.根据纳入标准和排除标...     

中草药治疗2型糖尿病

背景:长期以来,人们使用传统中草药治疗糖尿病,也做过许多对照试验来研究其有效性。目的:评价中草药治疗2型糖尿病患者的效果。检索策略:作者检索了Cochrane图书馆对照试验中心注册库(Cochrane Central Register of Controlled Trials,CEN- TRAL)、中国生物医学文献数据库、MEDLINE、EMBASE和LILACS,并结合手工检索了中文期刊和会议论文汇编。最后的检索日期至2004年4月。没有设定语言限制。纳入标准:与安慰剂、药物或非药物干预措施对比,疗程不少于2个月的随机对照试验。     

Quality Assessment of Clinical Research on Liver Cancer Treated by Intra-Arterial Infusion of Chinese Medicine

Objective：To assess the methodological quality of clinical research on Chinese medicine（CM）applied by infra-arterial infusion in treating primary liver cancer（PLC）.Methods：Cochrane Central Register of Controlled Trials（CENTRAL）,PubMed,and three Chinese databases,including Chinese BioMedical Database（CBM）,China National Knowledge Infrastructure（CNKI）and China Academic Journal（VIP）were searched.Chinese articles were also searched manually in 16 journals.Two reviewers independently selected studies,the quality of literatures were assessed according to the Cochrane Collaboration method of quality assessment.Results：A total of 14 articles met the inclusion criteria for this review.Only three of these articles described the randomization method used.None of the studies was blinded.All of the articles didn＇t report the calculation of the sample size.Only six studies mentioned adverse reactions.All of the studies were of grade C according to the Cochrane Collaboration method.Six studies reported results of survival,and only two of these reported better efficacy in the treatment groups.Conclusions：The quality of studies concerned intra-arterial infusion of CM in treating with PLC was poor and the exact effect of these medicines still need evaluation.Well designed RCTs with large sample sizes,adequate follow-up data and reliable methods of assessment are needed to better appraise the real effect of CMs in the treatment of PLC patients.     

中草药治疗肠易激综合征

背景:长期以来传统草药被用于治疗包括肠易激综合征在内的胃肠道疾病。因此,我们有必要对中草药治疗肠易激综合征疗效的临床研究证据进行系统地综述。目的:评价中草药治疗肠易激综合征的有效性和安全性。检索策略:我们检索了以下电子数据库:Cochrane图书馆临床试验注册资料库(Cochrane Central Register of Controlled Trials,CENTRAL)、MEDLINE、EMBASE、Allied and Com- plementary Medicine,AMED)、拉丁美洲数据库LILACS以及中国生物医学数据库(Chinese Biomedical Database,CBM),检索时间均截止至2004年7月。手工检索中文期刊和会议记录,检索时间截止至2003年末。没有语言限制。纳入标准:中草药与不治疗、安慰剂或药物干预手段对照的随机临床试验。     

Wendan Decoction(温胆汤) for Treatment of Schizophrenia: A Systematic Review of Randomized Controlled Trials

Objective: To assess the beneficial and adverse effects of Wendan Decoction(温胆汤, WDD) for the treatment of schizophrenia. Methods: Five electronic databases were searched until May 2014, including the Chinese National Knowledge Infrastructure, the Chinese Biomedical Literature Database, the Chinese Scientist Journal Database, Pub Med, and the Cochrane Central Register of Controlled Trials in the Cochrane Library. The randomized controlled trials(RCTs) testing WDD against placebo, antipsychotic drugs, or WDD combined with antipsychotic drugs against antipsychotic drugs alone were included. Study selection, data extraction, quality assessment, and data analyses were conducted according to the Cochrane standards. Results: Thirteen RCTs(involving 1,174 patients) were included and the methodological quality was evaluated as generally low. The pooled results showed that WDD combined with antipsychotic drugs were more effective in clinical comprehensive effect, Positive and Negative Syndrome Scale(PANSS) scores and Brief Psychiatric Rating Scale scores compared with antipsychotic drugs alone. However, WDD had less effectiveness compared with antipsychotics in clinical comprehensive effect; and WDD was not different from antipsychotic drugs for PANSS scores. The side effects were significantly reduced in the intervention group compared with the control group. Conclusions: WDD appears to be effective on improving symptoms in patients with schizophrenia. However, due to poor methodological quality in the majority of the included trials, the potential benefit from WDD needs to be confirmed in rigorous trials and the design and reporting of trials should follow the international standards.     

Effect of Huangshukuihua(Flos Abelmoschi Manihot) on diabetic nephropathy:a Meta-analysis

OBJECTIVE: To assess the efficacy of Huangshukuihua(Flos Abelmoschi Manihot) on diabetic nephropathy(DN).METHODS: Articles were retrieved from Pub Med,EMBASE, the Cochrane Central Register of Controlled Trials, Web of Science, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure Database, Chinese Evidence-Based Medicine Database, and Wanfang Database. Two reviewers independently reviewed the article. Only randomized controlled trials were included and 27 were identified involving 2239 patients(1143 in the treatment group and 1096 in the control group).RESULTS: Huangshukuihua(Flos Abelmoschi Manihot) had a significant effect on renal function by improving blood urea nitrogen and serum creatinine,reducing urine protein(24-h urine protein, and urinary albumin excretion rate), and improving serum albumin level, compared with the control group.CONCLUSION: Our findings suggest that, although the bioactive ingredients and mechanism underlying renal protection are unknown, the role of Huangshukuihua(Flos Abelmoschi Manihot) in the treatment of DN deserves further investigation.     

Serum interleukin-10 levels and adverse events in patients with acute coronary syndrome: a systematic review and meta-analysis

Background Several studies investigating the prognostic utility of interleukin-10 （IL-10） in patients with acute coronary syndrome （ACS） have provided conflicting findings.The aim of the study was to assess the existing evidence regarding association between serum IL-10 levels and adverse events.Methods Literature search was performed in PubMed,EMBASE,and Cochrane Trials Register databases from their inception to September 30,2012.In addition,reference lists of the included articles and their related citations in PubMed were also reviewed for additional pertinent studies.Results A total of 12 eligible studies comprising a total of 5882 patients were identified.The pooled relative risks for both studies reporting the risk estimates by IL-10 categories and studies reporting the risk estimates by unit IL-10 indicated an association between high IL-10 levels and adverse events.Sensitivity and subgroup analysis indicated that the results obtained in IL-10 categories were not stable.Conclusions Data from our meta-analysis supported the existence of a relationship between high serum IL-10 levels and adverse events in patients with ACS.Large study with longer follow-up is needed to confirm the findings.     

运动病发病机制及诊治的研究进展

［］运动病是指机体受现实或虚拟环境刺激而引起的头晕、恶心、呕吐等前庭和自主神经反应症候群,其发病机制尚未完全阐明。由于运动病的多症状性及高个体变异性,目前尚无单一且有效的治疗方法,习服训练仍是最有效的策略之一。传统中医的创新发展及其与电神经刺激等西医设备方法的联合应用,对运动病的防治展现出极大的潜力。本文就运动病的发病机制和诊治进展进行综述,旨在为探究运动病新的有效防治方案提供指导。     

托烷司琼与昂丹司琼预防全身麻醉术后恶心呕吐效果的比较:系统评价和Meta分析

目的 系统评价托烷司琼与昂丹司琼预防全身麻醉(以下简称全麻)术后恶心呕吐的效果。方法 遵循PRISMA声明,系统检索了PubMed、EMBASE、Cochrane Central Register of Controlled Trials、Web of Science、CNKI、CBM、万方和维普数据库中有关静脉注射托烷司琼与昂丹司琼后24 h内预防全麻术后恶心呕吐的随机对照临床试验。检索时限为从建库至2015年9月。研究者筛选文献,对纳入的研究进行质量评价、数据提取和Meta分析,并对证据进行GRADE分级。结果 共纳入9篇临床试验报道。Meta分析结果显示,与安慰剂相比,托烷司琼和昂丹司琼均能有效地预防术后恶心呕吐 [RR=0.62, 95%CI(0.43,0.90),P=0.01] [RR=0.67, 95% CI(0.49,0.90), P=0.009];托烷司琼与昂丹司琼预防术后恶心呕吐、术后呕吐、术后恶心的效果差异无统计学意义 [RR=0.95, 95%CI(0.81,1.11), P=0.50] [RR=1.26, 95%CI(0.83,1.91), P=0.28] [RR=0.88, 95%CI(0.42,1.83), P=0.73]。结论 在术后24 h内托烷司琼与昂丹司琼均能有效地预防术后恶心呕吐,但就目前的证据而言,托烷司琼与昂丹司琼预防术后恶心呕吐的效果没有差别。     

延期缝合对比一期缝合处理阑尾炎污染切口的Meta分析

 目的 系统评价延期缝合对比一期缝合处理阑尾污染切口的临床疗效。方法 计算机检索Cochrane图书馆临床对照试验资料库（2010年第1期）,PubMed（1966-2010.5）,EMBASE（1974--2010.5）,中国期刊全文数据库（1994--2010.5）,中国生物医学文献数据库（1978--2010.5）,中文科技期刊数据库（1989--2010.5）,中华医学会数字化期刊库（1998--2010.5）。由 2 名评价者独立评价并交叉核对纳入研究的质量,对同质研究采用RevMan5.0软件进行Meta分析。结果 共纳入5个RCT,包括331例患者。Meta分析结果显示：延期缝合对比一期缝合处理污染的阑尾手术切口,除延期缝合有缩短住院时间的趋势外,在切口部位的感染率 [OR=0.32, 95%CI(0.06,1.84)],二期愈合率 [OR=0.48, 95%CI(0.01,16.33)]方面均无差异。结论 对于污染的阑尾切口的处理,一期缝合在切口部位的感染率、二期愈合率具有与延期缝合相似的临床疗效,但限于纳入研究的局限性,尚需高质量的RCT进一步验证。     

阿罗洛尔治疗原发性高血压的Meta分析

目的：利用Meta分析方法探讨阿罗洛尔治疗原发性高血压的有效性及安全性。方法：计算机检索Cochrane图书馆临床对照试验资料库(2008年第3期)、MEDLINE(1991-2009年3月)、EMbase(1991年1月-　2009年3月)、CBMdisc (1991年1月-2009年3月)、CNKI (1994年1月-2009年3月)以及手工检索关于阿罗洛尔治疗原发性高血压的相关文献,在严格质量评价的基础上,应用RevMan 4.2软件对数据进行Meta分析。结果：共初检出176篇文献,经筛选最终纳入6篇8项关于阿罗洛尔与其他常用抗高血压药治疗原发性高血压的文献。同质性检验,有效性：χ2=4.41,df=7,P=0.73;安全性：χ2=2.96,df=4,P=0.56。二者合并效应量的估计,有效性：Z=0.64（P=0.52）,合并OR=1.17,OR95％CI (0.72～1.85);安全性：Z=1.75（P=0.08）,合并OR=0.60,OR95％CI (0.34～1.06)。结论：阿罗洛尔治疗原发性高血压与对照组比较具有相似的有效性及安全性。     

几种中西药抗人实验模拟运动病效果观察

目的 :选用中药“治晕灵”的主要成分生姜、明天麻等六味草药煎成汤剂、或半量汤剂配西药脑益嗪、山莨菪碱各1 4临床常用量配成复方中西药制剂 ,与目前常用抗晕药晕海宁等中、西药的药效进行比较 ,看中药制剂或中西药复方制剂是否具有较好的抗运动病效果。方法 :选 7名敏感被试者 (女性 ,19～ 2 1岁 ) ,用旋转刺激诱发运动病至出现恶心。按拉丁方设计 ,与安慰剂 (淀粉 10 0mg)及晕海宁 (5 0mg)进行对比 ,分别观察了生姜合剂 (30ml)、晕可平 (30ml)、山莨菪碱 (10mg)、脑益嗪 (2 5mg)及上述复方中西药制剂口服后的运动病耐力。结果 :与安慰剂比较 ,晕海宁、山莨菪碱、脑益嗪、晕可平、生姜合剂、复方中西药制剂分别使运动病耐力提高 5 .4%、7.5 %、5 .9%、7.4%、32 .3 %、2 0 .4% ;生姜合剂效果较优 ,除口服时有辛辣味外 ,无明显的副作用。复方中西药制剂各成分未显示协同作用 ,而只是简单的作用相加。结论 :生姜合剂具有较好的抗运动病作用     

厄贝沙坦氢氯噻嗪复方制剂治疗原发性高血压有效性及安全性的Meta分析

目的:利用Meta分析方法探讨厄贝沙坦氢氯噻嗪复方制剂治疗原发性高血压的有效性及安全性,为其临床应用提供依据.方法:计算机检索Cochrane图书馆临床对照试验资料库(2010年第03期)、Ovid-medline全文数据库(1966-2010.09)、PubMed数据库(1948-2010.09)、EMBASE数据库...     

针刺治疗癌痛疗效的系统综述

背景：近20年有不少研究报道运用针刺疗法治疗癌痛有效,但学术界对针刺治疗癌痛的效果仍有争议。 目的：运用循证医学系统综述方法评价针刺治疗癌痛的疗效。 检索策略：计算机检索Cochrane图书馆（2008年第3期）、医学文摘数据库（Excerpta Medica Database, EMBASE）、PubMed、ScienceDirect数据库、对照试验索引、重庆维普资讯中文科技期刊数据库、中国知网中国期刊全文数据库、中国生物医学文献数据库（CBMdisc）,检索日期始于各数据库起始日期,截止至2008年6月30日。手工检索6种中文期刊（2007年1月～2008年6月）上发表的相关文献。 纳入标准：收集比较各种针刺疗法与安慰剂、西药、中药对比治疗癌痛的随机对照试验（randomized controlled trial, RCT）。针刺和药物联用与各种药物比较的RCT也予以纳入。 资料提取与分析：两名评价员独立选择试验并提取资料,如遇不一致,通过讨论解决。对纳入的文献采用Cochrane协作网提供的软件RevMan 5.0进行meta分析,如果纳入文献无法进行meta分析,则进行定性分析。 结果：7篇RCT共634例病人符合纳入标准,其中高质量研究1篇。由于绝大部分文献在试验设计和报告上存在明显缺陷,各试验间存在较大差异,不符合meta分析条件,因而只进行了定性分析。结果显示,除1篇有关耳针疗法的高质量研究报告耳针在镇痛效果上显著优于安慰耳针外,其他均是与非安慰对照且低质量的RCT,但都提示针刺疗法有一定效果。 结论：针刺治疗癌痛有效,但入选的绝大部分试验质量不高,降低了该结论的可靠性,还需更多设计严谨的高质量RCT来证实。     

Ginger: an ancient remedy and modern miracle drug

Ginger has been used safely for thousands of years in cooking, and medicinally in folk and home remedies. Advanced technology enables the validation of these traditional experiences. The National Center for Complementary and Alternative Medicine (NCCAM) has evaluated the results of the available studies, rating the reports from "suggestive" (for short-term use of Ginger for safe relief from pregnancy related nausea and vomiting), to "mixed" (when used for nausea caused by motion sickness, chemotherapy, or surgery), and to "unclear" for treating rheumatoid arthritis, osteoarthritis, or joint and muscle pain). NCCAM has funded investigators to study interactions of ginger with drugs (immunosuppressants), its effect of reducing nausea in patients receiving chemotherapy, and the safety and effectiveness of its use for health purposes, as well as its impact on inflammation. Upon completion of these studies, the scope of ginger's use will be clearly identified and incorporated into mainstream therapeutic options, thereby integrating east and west, old with new, to render ginger as a true "Universal Remedy".     

A Cochrane Systematic Review finds no significant difference in outcome or risk of postoperative complications between day care and in-patient cataract surgery

This review was conducted to determine reliable evidence regarding the safety, feasibility, effectiveness, and cost-effectiveness of cataract extraction performed as a day care versus in-patient procedure. The search to identify randomized controlled trials comparing day care and in-patient surgery for age-related cataract included the Cochrane Eyes and Vision Group Trials Register, the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE and LILACS Latin American and Caribbean Literature on Health Sciences. Assessment of methodological quality was based on criteria defined by the Cochrane Collaboration. The primary outcome was the achievement of a satisfactory visual acuity 6 weeks after operation. Two trials, involving a total of 1284 people, are included. One trial reported statistically significant differences in early postoperative complication rates in the day care group, which had no clinical relevance to visual outcomes 4 months postoperatively. Mean change in visual acuity Snellen lines of the operated eye 4 months postoperatively was 4.1 standard deviation SD 2.3 for the day care group and 4.1 SD 2.2 for the in-patient group. Costs were 20% more for the in-patient group attributable to higher costs for overnight stay.