Misoprostol in preventing postpartum hemorrhage: a meta-analysis.

OBJECTIVE: To assess misoprostol's ability to prevent postpartum hemorrhage (PPH) where no alternatives exist. Comparison to oxytocics demonstrates how similarly misoprostol achieves a level of effectiveness-obtainable only in hospitals-in remote locations around the world. METHOD: Using the Mantel-Haenszel fixed-effects model and the DerSirmonian and Laird random-effects model, summary statistics indicated that misoprostol's excess risk of PPH was only 4% when compared to oxytocics. RESULT: This risk difference was well within the range of expected results for all uterotonic agents and does not warrant branding misoprostol as an inferior drug. CONCLUSION: Conventional uterotonic drugs should not be used to set the lowest-accepted level of effectiveness in settings where they are entirely unsuitable. Continuing to weigh the benefits of one effective drug against another only delays the distribution of misoprostol in countries where it is the only feasible choice and must be measured against no treatment at all.     

术前术野剃毛与术后切口感染关系的Meta分析

目的探讨术前术野剃毛能否降低术后切口感染率.方法在中文期刊全文库、中国生物医学文献光盘数据库、PUBMED 3个电子文献数据库中,检索出10篇有关术前术野剃毛与术后切口感染关系的文献进行Meta分析.结果术前术野剃毛组与非剃毛组的术后切口感染率差异没有统计学意义（P〉0.05）.结论术前术野剃毛不能减低术后切口感染率.推荐只剪去影响手术操作的毛发,不必进行常规的术野剃毛.     

Sensitivity of effect variables in rheumatoid arthritis: A meta-analysis of 130 placebo controlled NSAID trials controlled NSAID trials

In a meta-analysis of placebo controlled NSAID trials, the sensitivity of the effect variables was calculated as the correlation coefficient and as the difference between drug and placebo, divided by the placebo group standard deviation. The patient's global evaluation was the most sensitive variable overall. Pain was more sensitive than Ritchie's index. Several variables may be omitted from clinical trials, especially if two active drugs are being compared. For example, the best maximum estimate for the difference in ESR between NSAADs and placebo was 1.0 mm/hr (95% confidence interval −1.5 to 3.4 mm/hr), and for joint size 0.44% (−1.0 to 1.9%), corresponding to a quarter of a millimeter for each of the 10 joints usually measured. It is suggested to record only the patient's global evaluation, pain, and morning stiffness.     

绝经后高血压危险因素的Meta分析

背景 流行病学研究表明,绝经后女性的高血压患病率高于老年男性。近年来,有关绝经后高血压的临床表现、病理特征、发病机制、治疗方法等受到越来越多的关注,但由于受到研究设计、样本量、人群特征、资源不足等因素的影响,其危险因素的研究结果不一致且缺乏全面报道。目的 运用系统评价方式探讨女性绝经后高血压的危险因素,为更好地预防和管理绝经后高血压提供循证证据。方法 于2022年1—5月,计算机检索中国知网、万方数据知识服务平台、中国生物医学文献服务系统、PubMed、EmBase、the Cochrane Library、Web of Science电子数据库,获取与绝经后高血压危险因素相关的队列及病例对照研究。检索时限为建库起至2022-05-20。由2名研究者独立根据纳入和排除标准筛选文献、提取资料,采用纽卡斯尔-渥太华量表（NOS）对所提取的文献进行偏倚风险评估,将得分≥6分（高质量）的文献纳入研究,最后采用RevMan 5.3对其进行Meta分析。结果 共纳入10篇文献,5篇为队列研究,5篇为病例对照研究,共涉及16个危险因素,总样本量为34 864,且均为高质量文献。Meta分析结果显示,...     

The vaginal microbiota and its association with human papillomavirus,Chlamydia trachomatis,Neisseria gonorrhoeae and Mycoplasma genitalium infections: a systematic review and meta-analysis

Background

The vaginal microbiota may modulate susceptibility to human papillomavirus (HPV), Chlamydia trachomatis, Neisseria gonorrhoeae and Mycoplasma genitalium infections. Persistent infection with a carcinogenic HPV is a prerequisite for cervical cancer, and C. trachomatis, N. gonorrheae and M. genitalium genital infections are all associated with pelvic inflammatory disease and subsequent infertility issues.

Ankylosing spondylitis susceptibility loci defined by genome-search meta-analysis

In genome scans of ankylosing spondylitis (AS), with the exception of the HLA loci, linkage has not been easy to replicate across studies. We applied the genome-search meta-analysis (GSMA) method to genome scans of AS and spondyloarthropathy (SpA) to assess evidence for linkage across studies. Three AS genome scans and one SpA scan including 430 families with 1,048 affected individuals were used. All four original genome scans mainly analyzed Caucasian families. Seven bins had both Psumrnk and Pord<0.05, suggesting these bins most likely contain AS-linked loci; bin 6.2, 6.1, 6.3, 16.3, 19.2, 17.1, and 16.4. The GSMA produced significant genome-wide evidence for linkage on chromosome 6p22.3–6p21.1 (Psumrnk=0.000003), including the HLA locus. In addition to the HLA-B27 locus, strong linkage evidence was found on chromosome 6p25.3–6p22.3 (Psumrnk=0.0013) and 6p21.1–6p15 (Psumrnk=0.043). In the GSMA of four genome scans including one SpA study, the bin 9.4 (9q21.32–9q33.1) was newly found for linkage (Psumrnk=0.043, Pord=0.013). This GSMA added the evidence of the HLA loci as the greatest susceptibility factor to AS and showed evidences of chromosome 6, 16q, 19, 17p, and 9q as non-HLA susceptibility loci.     

Attachment security: a meta-analysis of maternal mental health correlates

This meta-analysis addresses the association between attachment security and each of three maternal mental health correlates. The meta-analysis is based on 35 studies, 39 samples, and 2,064 mother-child pairs. Social-marital support (r = .14; based on 16 studies involving 17 samples and 902 dyads), stress (r = .19; 13 studies, 14 samples, and 768 dyads), and depression (r = .18; 15 studies, 19 samples, and 953 dyads) each proved significantly related to attachment security. All constructs showed substantial variance in effect size. Ecological factors and approach to measuring support may explain the heterogeneity of effect sizes within the social-marital support literature. Effect sizes for stress varied according to the time between assessment of stress and assessment of attachment security. Among studies of depression, clinical samples yielded significantly larger effect sizes than community samples. We discuss these results in terms of measurement issues (specifically, overreliance on self-report inventories) and in terms of the need to study the correlates of change in attachment security, rather than just the correlates of attachment security per se.     

中国人群肝癌发病危险因素病例对照研究的meta分析

目的 对中国人群肝癌发病危险因素的病例对照研究进行综合定量分析,为肝癌的防控和卫生决策提供理论依据。方法 系统地检索Pubmed、中国知网、万方数据库、中国医院知识仓库发表的中国人群肝癌影响因素的病例对照研究,检索自数据库建立到2021年5月1日的所有中英文文献。用纽卡斯尔-渥太华量表评价文献质量,用R 4.0.2软件进行meta分析。结果 共检索文献1799篇,根据纳入与排除标准筛选,最终有53篇病例-对照研究纳入系统评价。meta分析结果显示,肝癌的危险因素按照其关联性由强到弱依次为:HBV感染、肝病史、精神因素、HCV感染、癌症家族史、糖尿病、食用霉变食物、饮酒、吸烟、饮用不洁水源,合并 OR值最高为9.79（95%CI:7.93~11.65）,最低为1.32（95%CI:1.08~1.56）。饮茶为保护因素,合并OR值为0.28（95%CI:0.17~0.39）。敏感性分析、发表偏倚检验与剪补法分析结果显示,本研究纳入的文献整体上敏感性低,发表偏倚控制较好。结论 病毒感染、肝病史、饮酒等不健康生活方式为我国人群肝癌发病的危险因素,饮茶为保护因素。建议积极接种乙肝疫苗,改变不良饮食习惯和生活方式,加强肝癌的早预防、早发现、早诊断、早治疗。     

中国社区老年人营养风险检出率的Meta分析

目的 系统评价中国社区老年人营养风险检出率。方法 计算机检索CNKI、CBM、WanFang Data、VIP、PubMed、EMbase、The Cochrane Library、Web of Science、CINAHL数据库有关于中国社区老年人营养状况的研究,检索时限均为2000年1月1日至2021年9月。由2名研究者独立筛选文献、提取资料并对纳入研究进行偏倚风险评价后,采用Stata 14.0软件进行Meta分析。结果 共纳入47个研究,包含47508例老年人,共16923例老年人检出营养风险。Meta分析结果显示,中国社区老年人的营养风险检出率为36.6%［95%CI(30.4%~42.8%)］。亚组分析结果显示,女性44.6%［95%CI(32.4%~56.9%)］、高龄46.8%［95%CI(31.0%~62.5%)］、低文化程度54.8%［95%CI(40.8%~68.8%)］、独居49.7%［95%CI(38.7%~60.6%)］、伴慢性疾病39.0%［95%CI(31.1%~46.8%)］、居住地农村51.8%［95%CI(30.3%~73.4%)］、华中地区56.7%［95%CI(27.5%~85.9%)］、ADL受损70.6%［95%CI(57.0%~84.1%)］、认知功能障碍62.6%［95%CI(38.8%~86.5%)］和衰弱52.6%［95%CI(31.7%~73.6%)］的社区老年人营养风险检出率更高。结论 当前证据显示,我国社区居家老年人营养风险检出率较高,针对检出率较高的特征人群应尽早进行筛查、诊断和干预,减少社区老年人营养风险的发生。