Effects of dance therapy on cognitive and mood symptoms in people with Parkinson's disease: A systematic review and meta-analysis

ObjectiveTo investigate whether the dance therapy was more beneficial than non-dance therapy on cognitive and mood symptoms in patients with Parkinson's disease (PD).MethodsMEDLINE, CINAHL, Embase and the Cochrane Central Register of Controlled Trials were searched from inception to December 11, 2018. Risk of bias for the included trials was assessed using criteria in the Cochrane Handbook for Systematic Reviews of Interventions.ResultsSeven randomized controlled trials were identified on cognitive and mood symptoms in patients with PD. There were significant differences in favor of dance in executive function (WMD = 1.17, 95% CI:0.39 to 1.95, P = 0.003; I² = 0%, P = 0.45), but not in outcomes of global cognitive function, depression and apathy.ConclusionsDance therapy is beneficial in improving executive function for adults with PD. However, there are no positive effects were founded on global cognitive function, depression and apathy for PD.     

Heat and cold therapy reduce pain in patients with delayed onset muscle soreness: A systematic review and meta-analysis of 32 randomized controlled trials

ObjectiveThe aim of this review and meta-analysis was to evaluate the effect of heat and cold therapy on the treatment of delayed onset muscle soreness (DOMS).MethodsWe followed our protocol that was registered in PROSPERO with ID CRD42020170632. A systematic review and meta-analysis of randomized controlled trials (RCT) was conducted. Nine databases were searched up to December 2020. Data was extracted from the retained studies and underwent methodological quality assessment and meta-analysis.ResultsA total of 32 RCTs involving 1098 patients were included. Meta-analysis showed that, the application of cold therapy within 1 h after exercise could reduce the pain of DOMS patients within 24 h (≤24 h) after exercise (SMD -0.57,95%CI -0.89 to −0.25, P = 0.0005) and had no obvious effect within more than 24 h (>24 h) (P = 0.05). In cold therapies, cold water immersion (SMD -0.48, 95%CI -0.84 to −0.13, P = 0.008) and other cold therapies (SMD -0.68, 95%CI -1.28 to −0.08, P = 0.03) had the significant effects within 24 h. Heat treatment could reduce the pain of patients. It had obvious effects on the pain within 24 h (SMD -1.17, 95%CI -2.62 to −0.09, P = 0.03) and over 24 h (SMD -0.82, 95%CI -1.38 to −0.26, P = 0.004). Hot pack effect was the most obvious, which reduced the pain within 24 h (SMD -2.31, 95%CI -4.33 to −0.29, P = 0.03) and over 24 h (SMD -1.78, 95%CI -2.97 to −0.59, P = 0.003). Other thermal therapies were not statistically significant (P > 0.05). Both cold and heat showed effect in reducing pain of patients, however there was no significant difference between cold and heat group (P = 0.16).ConclusionsThe current evidence indicated that the application of cold and heat therapy within 1 h after exercise could effectively reduce the pain degree of DOMS patients for 24 h cold water immersion and hot pack therapy, which had the best effect, could promote the recovery of DOMS patients. But more high-quality studies are needed to confirm whether cold or heat therapy work better.     

A systematic review of Tuina for irritable bowel syndrome: Recommendations for future trials

ObjectivesThis systematic review assessed whether Tuina (therapeutic massage) is more effective and safer than no treatment or routine medical treatment for irritable bowel syndrome (IBS).MethodsEleven databases were searched for randomized controlled trials of IBS diagnosed based on Manning or Rome criteria. Tuina with or without routine treatments (RTs) was tested against RTs. The Cochrane risk of bias was evaluated for each trial. RevMan 5.3 was used to conduct a meta-analysis.ResultsA total of 8 trials (5 IBS-diarrhea and 3 IBS-constipation) with 545 participants using 8 different manipulations were included. All trials were published in Chinese. For overall symptom improving rate (> 30 % improvement in overall symptom scores), it had not been shown that Tuina was significantly better than RTs (RR 1.23, 95 % CI 0.94–1.60, 197 participants, 3 studies, I² = 65 %) for IBS-diarrhea, and Tuina combined with RTs showed more benefit than RTs alone (RR 1.29, 95 % CI 1.08–1.54, 115 participants, 3 studies) for IBS-diarrhea. All trials did not report adverse effect in relation to Tuina. Risk of bias was generally unclear across all domains.ConclusionsTuina combined with RTs may be superior to RTs for improving overall symptom of IBS-diarrhea. Due to the existing methodological issues and the heterogeneity of Tuina manipulation, current findings need to be confirmed in large scale, multicenter, and robust randomized trials (especially on outcome assessing blinding and allocation concealment).     

高血压与中医体质相关性的荟萃分析＊

目的 通过Meta分析研究高血压与中医体质的相关性，为高血压防治提供依据。方法 通过检索国内文献库，纳入符合要求的高血压与中医体质相关性文献，提取原始文献资料并评价研究的质量；以RevMan 5.3软件进行异质性检验和Meta分析，并通过亚组分析探索异质性来源，以漏斗图评估发表偏倚。结果 共有10篇文献符合纳入标准，涉及高血压病人4 401例，对照组7 934例，全部为横断面研究。痰湿质（OR = 2.24，95%CI：1.77 - 2.83，P < 0.001）、阴虚质（OR = 1.28，95%CI：1.13 - 1.45，P < 0.001）、气虚质（OR = 1.21，95%CI：1.06 - 1.37，P = 0.005）、血瘀质（OR = 1.24，95%CI：1.06 - 1.46，P = 0.007）是高血压人群更易出现的体质类型；而平和质是对照组更易出现的体质类型（OR = 0.56，95%CI：0.51 - 0.61，P < 0.001）；阳虚质、气郁质、湿热质、特禀质在高血压人群和非高血压人群的分布无明显统计学差异。亚组分析显示是否明确纳入既往诊断的高血压和研究质量是异质性主要来源；目测漏斗图未发现明显发表性偏倚。结论 痰湿质、阴虚质、气虚质、血瘀质是高血压易感体质，平和质是保护体质，但由于纳入研究质量不佳，且存在设计缺陷，无法说明中医体质与高血压发生的因果关系，结论需谨慎对待。     

有机磷农药与再生障碍性贫血发病关系的Meta分析

目的 评价有机磷农药与再生障碍性贫血发病的关系,为一级预防提供科学依据。方法 检索1990年1月至2014年8月公开发表在中国生物医学文献数据库(CBM)、中国知网(CNKI)、PubMed和EMBASE关于有机磷农药与再生障碍性贫血发病关系的病例对照研究。制定纳入和排除标准,对符合纳入标准的文献进行质量评价,利用Review Manager 5.0软件计算有机磷农药的合并OR值及其95%CI,并对文献的研究人群和有机磷农药使用方式进行亚组分析。结果 最终共纳入9篇文献,5 833例研究对象,其中病例组1 404人,对照组4 429人。结果显示有机磷农药可增加再生障碍性贫血的发病风险(OR=1.97,95%CI:1.60～2.44)。亚组分析显示亚洲人群再生障碍性贫血的发病风险(OR=2.01,95%CI:1.52～2.66)高于欧美人群(OR=1.93,95%CI:1.39～2.67);使用单一有机磷类农药(OR=2.15,95%CI:1.60～2.88)比使用有机磷类农药的混配制剂(OR=1.82,95%CI:1.34～2.47)更易引发再生障碍性贫血。结论 有机磷农药可能是再生障碍性贫血的危险因素。在日常生活和工农业生产中,减少有机磷农药的暴露,可以预防再生障碍性贫血的发生。     

Multimorbidity and mortality in older adults: A systematic review and meta-analysis

ObjectiveTo review literature and provide a pooled effect for the association between multimorbidity and mortality in older adults.MethodsA systematic review was performed of articles held on the PUBMED database published up until January 2015. Studies which used different diseases and other conditions to define frailty, evaluated multimorbidity related only to mental health or which presented disease homogeneity were not included. A meta-analysis using random effect to obtain a pooled effect of multimorbidity on mortality in older adults was conducted only with studies which reported hazard ratio (HR). Stratified analysis and univariate meta-regression were performed to evaluate sources of heterogeneity.ResultsOut of 5806 identified articles, 26 were included in meta-analysis. Overall, positive association between multimorbidity and mortality [HR: 1.44 (95%CI: 1.34; 1.55)] was detected. The number of morbidities was positively related to risk of death [HR: 1.20 (95%CI: 1.10; 1.30)]. Compared to individuals without multimorbidity, the risk of death was 1.73 (95%CI: 1.41; 2.13) and 2.72 (95%CI: 1.81; 4.08) for people with 2 or more and 3 or more morbidities, respectively. Heterogeneity between studies was high (96.5%). The sample, adjustment and follow-up modified the associations. Only nine estimates performed adjustment which included demographic, socioeconomic and behaviour variables. Disabilities appear to mediate the effect of multimorbidity on mortality.ConclusionsMultimorbidity was associated with an increase in risk of death. Multimorbidity measurement standardization is needed to produce more comparable estimates. Adjusted analysis which includes potential confounders might contribute to better understanding of causal relationships between multimorbidity and mortality.     

中医药治疗经间期出血的Meta分析

目的：系统评价中医药治疗经间期出血的疗效。方法：检索近8年中医药干预经间期出血的随机对照临床试验，并对文献结果进行Meta分析。结果：最终15篇临床研究文献入选，研究结果异质性检验：x2＝14.93，P＝0.38。故采用固定效应模型进行统计分析，合并后OR值为5.21，95%，可信区间为3.54～7.66，菱形位于中间线的右侧，经Z检验，Z＝8.39，P〈0.00001，中医药治疗效果显著。“漏斗图”图形显示存在发表偏倚。结论：①中医药治疗经间期出血与西药治疗疗效相当，且可发挥其副作用少、安全性高的优势；②在有力证据方面，中医药（尤其针灸）治疗经间期出血需要更多高质量的研究文献，现阶段文献资料欠严谨。     

All-inside versus inside-out meniscal repair: A systematic review and meta-analysis

BackgroundMeniscal repair using all-inside devices has garnered popularity compared to inside-out repair, yet few studies directly compare the two techniques in terms meniscal healing rates, surgical time, patient outcomes and incidence of complications.MethodsA systematic literature review was performed using the Medline, Cochrane and Embase databases. English-language studies comparing all-inside and inside-out arthroscopic meniscal repair techniques directly were included. Randomised controlled trials (RCTs) and observational studies with at least 10 patients in each treatment arm were included. Meta-analyses were performed using a fixed effect (when I2 < 50%) or random effects model (I2 ≥ 50%).ResultsA total of 1042 studies were identified with seven being sui for inclusion (n = 505 patients). These comprised of one RCT two prospective and four retrospective, comparative, observational studies. Meta-analyses demonstrated that there was a significant reduction in operating time favouring all-inside repair (ratio of means [ROM] 0.62, 95% confidence interval [CI] 0.48–0.79; p = 0.0002) based on 3 studies (n = 208 patients). Based on 5 studies (n = 370 patients), there was no significant difference in meniscal healing rates between the groups (OR 1.26, 95% CI 0.52–3.10; p = 0.61). Nerve injury was more common after inside-out repair. There was a 85% reduction in the odds of nerve injury with the all-inside technique (OR 0.15, 95% CI 0.05–0.47; p = 0.0013). A qualitative data analysis suggested no difference in functional outcomes between the two techniques.ConclusionsAll-inside meniscal repair is associated with reduced operative time and a lower odds of nerve injury complications compared to inside-out repair, without compromising meniscal healing or functional results.