Prevalence of Burnout in residents of obstetrics and gynecology: A systematic review and meta-analysis

Background: Burnout is currently a major concern among physicians due to their high level ofstress at work. There are several reports on various levels of burnout in residency programs due toseveral predisposing factors. The aim of this systematic review was to estimate a more precise prevalenceof burnout among residents of obstetrics and gynecology.Methods: PubMed, Science Direct and Scopus were searched to identify peer-reviewed Englishlanguagestudies published from January 1974 to 2005 reporting burnout among residents of obstetricsand gynecology. The key words used in the search were as follows: Residents, gynecology andobstetrics, professional burnout, depersonalization, distress, anxiety, or emotional exhaustion. Relevantadditional articles were identified from the lists of the retrieved articles.Results: We identified 12 studies which met our criteria. A total of 2509 participants were includedin this meta-analysis. The overall prevalence rate of burnout on all the three subscales was 44% (95%CI: 30 - 57) in this group of residents.Conclusion: This meta-analysis revealed a high prevalence of burnout syndrome in residents duringobstetrics and gynecology residency program. Therefore, it is recommended to consider and addressthis important issue to develop solutions and interventions which could improve the work conditionof the medical residents.     

主动脉瓣生物瓣膜安全性的系统评价与meta分析

目的 采用系统评价和meta分析的方法评价主动脉瓣置换术中使用生物瓣膜的远期安全性结局。方法 计算机系统检索Medline、Embase、Web of Science、CENTRAL、ClinicalTrial.gov、SinoMed、中国知网、维普和万方数据库在2000年1月1日至2019年1月26日期间发表的随机临床试验、非随机临床试验、队列研究和病例系列研究,纳入标准还包括使用生物瓣膜进行主动脉瓣膜置换术、平均随访时间≥5年、报告了相关安全性结局等。提取研究特征和相关数据,使用Stata 14.0进行meta分析。结果 最终纳入53篇文献共57个研究组,包含47 803名患者。(1)全因死亡率为6.33/100人年(95%CI:5.85~6.84),亚组分析结果显示,猪瓣膜和牛心包瓣膜的死亡率分别为5.69/100人年(95%CI:5.05~6.41)和7.29/100人年(95%CI:6.53~8.13);有支架和无支架瓣膜的死亡率分别为6.69/100人年(95%CI:6.12~7.30)和5.21/100人年(95%CI:4.43~6.14)。(2)血栓栓塞的发生率为1.16/100人年(95%CI:0.96~1.40),心脏起搏器植入率为1.08/100人年(95%CI:0.75~1.54),再手术率为0.77/100人年(95%CI:0.65~0.91),脑卒中的发生率为0.74/100人年(95%CI:0.51~1.06),结构性瓣膜退化的发生率为 0.73/100人年(95%CI:0.59~0.91),大出血的发生率为0.52/100人年(95%CI:0.41~0.65),心内膜炎的发生率为0.38/100人年(95%CI:0.33~0.44),非结构性瓣膜退化的发生率为0.20/100人年(95%CI:0.13~0.31)。结论 生物瓣膜的全因死亡率为6.33/100人年,血栓栓塞、心脏起搏器植入、再手术、脑卒中和结构性瓣膜退化是主要的远期并发症。     

主动脉瓣生物瓣膜安全性的系统评价与meta分析

目的 采用系统评价和meta分析的方法评价主动脉瓣置换术中使用生物瓣膜的远期安全性结局。方法 计算机系统检索Medline、Embase、Web of Science、CENTRAL、ClinicalTrial.gov、SinoMed、中国知网、维普和万方数据库在2000年1月1日至2019年1月26日期间发表的随机临床试验、非随机临床试验、队列研究和病例系列研究,纳入标准还包括使用生物瓣膜进行主动脉瓣膜置换术、平均随访时间≥5年、报告了相关安全性结局等。提取研究特征和相关数据,使用Stata 14.0进行meta分析。结果 最终纳入53篇文献共57个研究组,包含47 803名患者。(1)全因死亡率为6.33/100人年(95%CI:5.85~6.84),亚组分析结果显示,猪瓣膜和牛心包瓣膜的死亡率分别为5.69/100人年(95%CI:5.05~6.41)和7.29/100人年(95%CI:6.53~8.13);有支架和无支架瓣膜的死亡率分别为6.69/100人年(95%CI:6.12~7.30)和5.21/100人年(95%CI:4.43~6.14)。(2)血栓栓塞的发生率为1.16/100人年(95%CI:0.96~1.40),心脏起搏器植入率为1.08/100人年(95%CI:0.75~1.54),再手术率为0.77/100人年(95%CI:0.65~0.91),脑卒中的发生率为0.74/100人年(95%CI:0.51~1.06),结构性瓣膜退化的发生率为 0.73/100人年(95%CI:0.59~0.91),大出血的发生率为0.52/100人年(95%CI:0.41~0.65),心内膜炎的发生率为0.38/100人年(95%CI:0.33~0.44),非结构性瓣膜退化的发生率为0.20/100人年(95%CI:0.13~0.31)。结论 生物瓣膜的全因死亡率为6.33/100人年,血栓栓塞、心脏起搏器植入、再手术、脑卒中和结构性瓣膜退化是主要的远期并发症。     

中国0～6岁儿童孤独症谱系障碍患病率的meta分析

目的:了解中国0～6岁儿童孤独症谱系障碍(autism spectrum disorders,ASD)流行现状及趋势.方法:在Pubmed、Web of Science、Scopus、中国期刊全文数据库(CNKI)、万方数据库、维普数据库(VIP)和中国生物医学文献数据库(CBM)检索于2017年2月25日之前发表的关于中国0～6岁儿童孤独症谱系障碍及其亚型患病率研究的文献,按照设定的纳入和诊断标准进行筛选.采用随机效应模型合并不同时期和不同性别儿童患病率数据,并根据数据来源、年龄、筛查和诊断工具、文献质量进行亚组分析.结果:共有9篇ASD患病率文献和20篇孤独症(au-tism or autistic disorder,AD)患病率文献纳入研究.2006-2010年和2011-2015年0～6岁儿童AD合并患病率分别为1.74‰(95％ CI:1.12‰ ～ 2.69‰)和1.80‰(95％ CI:1.33‰ ～ 2.43‰),差异无统计学意义(P =0.898),但均显著高于1996-2005年合并患病率0.94‰(95％ CI:0.67‰～ 1.33‰) (P =0.031;P=0.005).0～6岁儿童ASD合并患病率在2006-2010年和2011-2015年分别为3.52‰(95％ CI:1.48‰ ～ 8.34‰)和3.48‰(95％ CI:1.77‰ ～6.84‰),差异未见统计学意义(P=0.983).不同性别ASD和AD患病率在不同时期差异均无统计学意义.合并得到2006-2015年0～6岁儿童ASD和AD患病率分别为3.51‰(95％ CI:2.15‰～5.74‰)和1.77‰(95％ CI:1.40‰～ 2.24‰),男女患病率比分别为2.59:1和3.63:1.亚组分析提示月龄和文献质量与ASD或AD合并患病率相关.结论:2006-2015年中国0～6岁儿童ASD和AD患病率均保持稳定,相比2005年以前是否呈上升趋势难以定论.建议开展全国代表性儿童早期ASD和AD现况调查与监测,准确估计ASD及AD流行现状和趋势.     

谷丙、谷草转氨酶与丙种球蛋白无反应型川崎病相关性的Meta分析

目的通过Meta分析探讨ALT、AST与静脉注射丙种球蛋白针（简称丙球）无反应型川崎病的相关性。方法检索Pubmed等6个中英文数据库关于ALT、AST与丙球无反应型川崎病相关性的研究报道,检索时间为2002至2016年,对符合要求的文献提取数据,对于可以合并统计量的研究采用ReviewManager软件（Revman5.2）进行Meta分析,对于无法进行Meta分析的研究进行定性综合。结果共计25个研究纳入最终的系统评价,其中20个研究可以合并统计量,另外5个研究不能合并统计量,进行定性系统评价。在进行Meta分析的20个研究中,ALT共纳入19个研究用于Meta分析,AST共纳入16个研究用于Meta分析;Meta分析结果显示,与丙球敏感的患儿比较,丙球无反应的患儿血中ALT（overallSMD=0.63,95%CI：0.44~0.82,P＜0.01）、AST（overallSMD=0.57,95%CI：0.49~0.65,P＜0.01）水平更高。结论与丙球敏感的患儿相比,丙球无反应的患儿血清中ALT、AST水平更高。     

Regional anesthesia and cancer recurrence in patients with late-stage cancer: a systematic review and meta-analysis

Background:Whether regional anesthesia may help to prevent disease recurrence in cancer patients is still controversial. The stage of cancer at the time of diagnosis is a key factor that defines prognosis and is one of the most important sources of heterogeneity for the treatment effect. We sought to update existing systematic reviews and clarify the effect of regional anesthesia on cancer recurrence in late-stage cancer patients.Methods:Medline, Embase, and Cochrane Library were searched from inception to September 2020 to identify randomized controlled trials (RCTs) and cohort studies that assessed the effect of regional anesthesia on cancer recurrence and overall survival (OS) compared with general anesthesia. Late-stage cancer patients were primarily assessed according to the American Joint Committee on Cancer Cancer Staging Manual (eighth edition), and the combined hazard ratio (HR) from random-effects models was used to evaluate the effect of regional anesthesia.Results:A total of three RCTs and 34 cohort studies (including 64,691 patients) were identified through the literature search for inclusion in the analysis. The risk of bias was low in the RCTs and was moderate in the observational studies. The pooled HR for recurrence-free survival (RFS) or OS did not favor regional anesthesia when data from RCTs in patients with late-stage cancer were combined (RFS, HR = 1.12, 95% confidence interval [CI]: 0.58–2.18, P = 0.729, I² = 76%; OS, HR = 0.86, 95% CI: 0.63–1.18, P = 0.345, I² = 48%). Findings from observational studies showed that regional anesthesia may help to prevent disease recurrence (HR = 0.87, 95% CI: 0.78–0.96, P = 0.008, I² = 71%) and improve OS (HR = 0.88, 95% CI: 0.79–0.98, P = 0.022, I² = 79%).Conclusions:RCTs reveal that OS and RFS were similar between regional and general anesthesia in late-stage cancers. The selection of anesthetic methods should still be based on clinical evaluation, and changes to current practice need more support from large, well-powered, and well-designed studies.     

深圳特区少年儿童龋病流行特征研究

目的 了解深圳特区少年儿童龋病流行特征。方法 随机调查5、7、9、12、15岁年龄组乳牙及恒牙龋患率。结果 5、7、9岁儿童乳牙龋患率为82．38％,龋均4．22;7岁年龄组最高,龋患率为85．80％,龋均5．11;乳牙龋患率无性别差异。5～15岁少年儿童恒牙龋患率为36．89％,女性高于男性,龋患率及龋均随年龄增长呈上升趋势。结论 应加大口腔预防保健投入,组建口腔疾病防治网,探索社区口腔疾病防治。     

Effects of librarian-provided services in healthcare settings: a systematic review

Objective

To assess the effects of librarian-provided services in healthcare settings on patient, healthcare provider, and researcher outcomes.

Materials and methods

Medline, CINAHL, ERIC, LISA (Library and Information Science Abstracts), and the Cochrane Central Register of Controlled Trials were searched from inception to June 2013. Studies involving librarian-provided services for patients encountering the healthcare system, healthcare providers, or researchers were eligible for inclusion. All librarian-provided services in healthcare settings were considered as an intervention, including hospitals, primary care settings, or public health clinics.

Results

Twenty-five articles fulfilled our eligibility criteria, including 22 primary publications and three companion reports. The majority of studies (15/22 primary publications) examined librarians providing instruction in literature searching to healthcare trainees, and measured literature searching proficiency. Other studies analyzed librarian-provided literature searching services and instruction in question formulation as well as the impact of librarian-provided services on patient length of stay in hospital. No studies were found that investigated librarians providing direct services to researchers or patients in healthcare settings.

Conclusions

Librarian-provided services directed to participants in training programs (eg, students, residents) improve skills in searching the literature to facilitate the integration of research evidence into clinical decision-making. Services provided to clinicians were shown to be effective in saving time for health professionals and providing relevant information for decision-making. Two studies indicated patient length of stay was reduced when clinicians requested literature searches related to a patient''s case.     

4335名儿童青少年莱顿强迫问卷调查分析

目的 调查儿童青少年强迫症状情况.方法 以莱顿强迫问卷(儿童版)( Leyton Obsessional Inventory-Child Version,LOI-CV)测量4335名儿童青少年,平均年龄(13.88±2.44)岁,男性占47.7％.结果 儿童青少年LOI-CV是/否得分的频数接近正态分布,而总干扰分的频数接近“J”型分布.儿童青少年LOI-CV是/否总分:女生高于男生[女生(8.55±3.87)分,男生(8.21±3.99)分,t=2.86,P＜0.01];农村和城市差异无统计学意义[(8.57±3.86)分,(8.35±3.9)分,t=1.32,P＞0.05];小学(n=937)、初中(n=1906)、高中(n=1492)差异有统计学意义[小学(7.86±3.82)分,初中(8.52±3.93)分,高中(8.55±3.891)分,F=11.03,P＜0.01],两两比较发现高中＞小学,初中＞小学.总干扰分:男生大于女生,差异有统计学意义[男生(11.35±9.10)分,女生(10.76±8.84)分,t=2.18,P＜0.05];农村大于城市,差异有统计学意义[农村(11.86±9.18)分,城市(10.88±8.92)分,t=2.61,P＜0.01];小学、初中、高中差异有统计学意义[小学(10.05±8.76)分,初中(11.73±9.17)分,高中(10.77±8.76)分,F=12.088,P＜0.01],两两比较发现,总干扰分初中高于小学,初中高于高中.总干扰分从小学四年级到高中三年级依次为:[(10.0±8.78)分,(10.01±8.64)分,(10.19±8.92)分,(11.43±9.16)分,(11.40±8.67)分,(12.58±9.76)分,(10.32±8.42)分,(10.19±8.38)分,(12.48±9.69)分],差异有统计学意义(F=5.90,P＜0.01).干扰分最高的年级为初三和高三.是否总分总的分布趋势同干扰总分相似.结论 强迫症状是儿童青少年中常见的症状,农村的初三或高三男生更容易受到强迫症状的干扰.     

郑州市1773名儿童少年龋齿患病调查

调查了1733名5～16岁儿童少年龋病发生情况。结果表明:总龋患率为56.74%,(男女无差异)9岁组龋患率最高76.70%。并发现饮食习惯、及口腔卫生习惯与龋病关系密切。在普查同时进行了普治,就治率提高了10.75倍。因此加强口腔卫生宣传教育及口腔卫生保健工作,是预防龋齿发生的重要措施。     

儿童及青少年卵巢恶性肿瘤(附74例临床分析)

目的 探讨儿童及青少年卵巢恶性肿瘤的l临床特点和治疗方法,以期提高患者的术后生存质量。方法 回顾分析我院50年内收治的74例年龄≤19岁的卵巢恶性肿瘤患者的l临床资料。结果 患者平均年龄为16．2岁,无有效的早期诊断方法,病理类型以生殖细胞来源为主(63．5％)。临床分期：I期59例(79．7％),Ⅱ期7例(9．5％),Ⅲ期7例(9．5％),Ⅳ期1例(1．4％)。1例于术后11年复发(1．4％),3、5、10年的生存率分别为76．9％、64．0％和53．7％。Ia、Ib患者的5、10年的生存率分别为93．8％和61．8％。结论 手术是主要治疗方法,Ia期患者宜选择保守性手术,晚期患者宜行根治性手术。多因素分析认为,临床分期是影响预后的主要因素。术后辅助治疗能提高Ia期生殖细胞肿瘤患者的生存率,但并不影响上皮性肿瘤患者的预后。     

Virtual reality-based rehabilitation in patients following total knee arthroplasty: a systematic review and meta-analysis of randomized controlled trials

Background: Physical therapy is regarded as an essential aspect in achieving optimal outcomes following total knee arthroplasty (TKA). The coronavirus disease 2019 (COVID-19) pandemic has made face-to-face rehabilitation inaccessible. Virtual reality (VR) is increasingly regarded as a potentially effective option for offering health care interventions. This systematic review and meta-analysis investigate VR-based rehabilitation’s effectiveness on outcomes following TKA.Methods: From inception to...     

Olecranon osteotomy vs. triceps-sparing for open reduction and internal fixation in treatment of distal humerus intercondylar fracture: a systematic review and meta-analysis

BackgroundThe open reduction and internal fixation (ORIF) was a standard treatment approach for fracture at distal humerus intercondylar, whereas the optimal way before ORIF remains inconclusive. We, therefore, performed a systematic review and meta-analysis to assess the efficacy and safety of olecranon osteotomy vs. triceps-sparing approach for patients with distal humerus intercondylar fracture.MethodsThe electronic searches were systematically performed in PubMed, EmBase, Cochrane library, and Chinese National Knowledge Infrastructure from initial inception till December 2019. The primary endpoint was the incidence of excellent/good elbow function, and the secondary endpoints included Mayo elbow performance score, duration of operation, blood loss, and complications.ResultsNine studies involving a total of 637 patients were selected for meta-analysis. There were no significant differences between olecranon osteotomy and triceps-sparing approach for the incidence of excellent/good elbow function (odds ratio [OR]: 1.37; 95% confidence interval [CI]: 0.69–2.75; P = 0.371), Mayo elbow performance score (weight mean difference [WMD]: 0.17; 95% CI: −2.56 to 2.89; P = 0.904), duration of operation (WMD: 4.04; 95% CI: −28.60 to 36.69; P = 0.808), blood loss (WMD: 33.61; 95% CI: −18.35 to 85.58; P = 0.205), and complications (OR: 1.93; 95% CI: 0.49–7.60; P = 0.349). Sensitivity analyses found olecranon osteotomy might be associated with higher incidence of excellent/good elbow function, longer duration of operation, greater blood loss, and higher incidence of complications as compared with triceps-sparing approach.ConclusionsThis study found olecranon osteotomy did not yield additional benefit on the incidence of excellent/good elbow function, while the duration of operation, blood loss, and complications in patients treated with olecranon osteotomy might be inferior than triceps-sparing approach.     

Efficacy and safety of glucosamine,diacerein, and NSAIDs in osteoarthritis knee: a systematic review and network meta-analysis

Background

To conduct a systematic review and network meta-analysis of randomized controlled trials (RCTs) with the aims of comparing relevant clinical outcomes (that is, visual analog scores (VAS), total and sub-Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) scores, Lequesne algofunctional index, joint space width change, and adverse events) between diacerein, glucosamine, and placebo.

Methods

Medline and Scopus databases were searched from inception to 29 August 2014, using PubMed and Scopus search engines and included RCTs or quasi-experimental designs comparing clinical outcomes between treatments. Data were extracted from original studies. A network meta-analysis was performed by applying weight regression for continuous outcomes and a mixed-effect Poisson regression for dichotomous outcomes.

Results

Thirty-one of 505 identified studies were eligible. Compared to placebo, glucosamine showed a significant improvement with unstandardized mean differences (UMD) in total WOMAC, pain WOMAC, function WOMAC, and Lequesne score of −2.49 (95% confidence interval (CI) −4.14, −0.83), −0.75 (95% CI: −1.18, −0.32), −4.78 (95% CI: −5.96, −3.59), and −1.03 (95% CI: −1.34, −0.72), respectively. Diacerein clinically improves visual analog scores, function WOMAC, and stiffness WOMAC with UMD values of −2.23 (95% CI: −2.82, −1.64), −6.64 (95% CI: −10.50, −2.78), and −0.68 (95% CI: −1.20, −0.16) when compared to placebo.

Conclusions

The network meta-analysis suggests that diacerein and glucosamine are equally efficacious for symptom relief in knee OA, but that the former has more side effects.

Electronic supplementary material

The online version of this article (doi:10.1186/s40001-015-0115-7) contains supplementary material, which is available to authorized users.     

单能量去金属伪影算法重建效果的系统评价及Meta分析

目的 通过系统评价和Meta分析评估基于单能量去金属伪影算法的CT后处理技术(SEMAR)对金属伪影的去除效果。 方法 检索2009年1月至2018年1月美国生物医学数据库PubMed、荷兰医学文摘Embase、Web of science、Cochrane图书馆和中国期刊全文数据库等发表的相关中英文文献,通过纳入及排除标准进行筛选,对纳入文献采用Cochrane风险偏移评估工具进行质量评估,提取文献中使用的评估标准及相关数据,并对相应数据进行合并。采用Review Manager 5.0对纳入文献汇总分析,根据文献异质性进行亚组分析及敏感性分析。 结果 符合纳入标准文献9篇,其中英文8篇,中文1篇。Meta分析显示,SEMAR技术可明显提升金属伪影和周围结构的评分,对金属伪影CT值、周围软组织噪声(SD值)具有良好的校正作用,MD_伪影评分=1.19(95%CI:0.99~1.39)、MD_{前列腺/子宫图像质量评分}=1.87(95%CI:0.69~3.05)、MD_{膀胱图像质量评分}=2.31(95%CI:1.28~3.34)、MD_伪影CT值=118.7 HU(95%CI:50.48~186.93)、MD_{周围软组织噪声}=298.05(95%CI:61.66~534.43);明显提高周围病变的检出率RD=0.07(0.02~0.13),但对周围组织的CT值［MD=-21.35(95%CI:-44.0~1.31)］及伪影指数［MD=3.11(95%CI:-0.97~7.15)］的影响无统计学意义。 结论 SEMAR具有良好的去除金属伪影及提升周围病变检出效果,且在去除金属伪影的同时,对周围软组织的CT值无明显影响。     

豆制品摄入量与胃癌发病风险关系的Meta分析

目的 通过Meta分析探讨豆制品摄入量与胃癌发病风险的关系。 方法 两名研究者分别检索PubMed、Web of Science和Embase数据库、中国知网、万方数据库发表的相关文献,用合并OR值和95%CI评价豆制品摄入量与胃癌发病的关系。根据设计类型、研究对象性别和地理区域进行亚组分析。 结果 共纳入53项研究,包括18项队列研究(890 145位参与者中共有5 153例病例)和35项病例对照研究(共有10 692位病例和25 324例对照)。最终共计50项研究(剔除3项质量评分较低的研究)纳入到本次Meta分析中。结果显示:大豆、豆腐和豆浆的高摄入量与胃癌发病风险的降低有关(大豆, OR=0.75,95% CI: 0.66~0.85;豆腐,OR=0.77,95% CI:0.68~0.88;豆浆,OR=0.78,95% CI:0.65~0.94)。亚组分析结果表明,在亚洲人群中较高的大豆和豆腐摄入量与胃癌发病风险呈负相关(大豆,OR=0.80,95% CI: 0.74~0.86;豆腐,OR=0.77,95% CI:0.68~0.88)。 结论 豆制品摄入量增加能降低胃癌的发病风险。     

非甾体类抗炎药直肠给药预防ERCP术后胰腺炎的系统评价

目的评价非甾体类抗炎药（NSAIDs）直肠给药预防ERCP术后胰腺炎的有效性和安全性。方法制定严格纳入和排除标准,计算机检索Coehrane图书馆临床对照试验、Medline、PubMed、Embase、OVID数据库、中国生物医学文献数据库（CBMDisc）、维普中文期刊数据库、中国期刊全文数据库、万方学位论文数据库）。并手工检索相关会议论文集及查阅检索到的所有参考文献,全面收集国内外关于非甾体类抗炎药直肠给药预防ERCP术后胰腺炎的随机对照试验。按照国际Cochrane协作网推荐的方法进行系统评价。结果共纳入10个试验2802例患者,Meta分析显示：①PEP发生率、轻症PEP发生率及中一重症PEP发生率：NSAIDs治疗组优于安慰剂组（均P〈0．001）。②术后高胰淀粉酶血症发生率及术后血胰淀粉酶水平：NSAIDs治疗组优于安慰剂组（均Pd0．001）。③PEP病死率及不良反应发生率：无病死率及NSAIDs治疗相关不良反应的报道。结论NSAIDs直肠给药可以预防ERCP术后胰腺炎的发生,且安全性好。     

Injections of ginkgo in the treatment of cerebral infarction: a systematic review and network Meta-analysis

OBJECTIVE

To assess the clinical effectiveness and safety of injections of ginkgo (GI) combined with Western Medicine (WM) for cerebral infarction (CI).

Efficacy and safety of salmeterol/fluticasone compared with montelukast alone (or add-on therapy to fluticasone) in the treatment of bronchial asthma in children and adolescents: a systematic review and meta-analysis

Background:Despite the recommendation of inhaled corticosteroids (ICSs) plus long-acting beta 2-agonist (LABA) and leukotriene receptor antagonist (LTRA) or ICS/LTRA as stepwise approaches in asthmatic children, there is a lack of published systematic review comparing the efficacy and safety of the two therapies in children and adolescents aged 4 to 18 years. This study aimed to compare the safety and efficacy of salmeterol/fluticasone (SFC) vs. montelukast (MON), or combination of montelukast and fluticasone (MFC) in children and adolescents aged 4 to 18 years with bronchial asthma.Methods:A systematic search was conducted in MEDLINE, EMBASE, the Cochrane Library, China BioMedical Literature Database, Chinese National Knowledge Infrastructure, VIP Database for Chinese Technical Periodical, and Wanfang for randomized controlled trials (RCTs) published from inception to May 24, 2021. Interventions are as follows: SFC vs. MON, or combination of MFC, with no limitation of dosage or duration. Primary and secondary outcome measures were as follows: the primary outcome of interest was the risk of asthma exacerbation. Secondary outcomes included risk of hospitalization, pulmonary function, asthma control level, quality of life, and adverse events (AEs). A random-effects (I² ≥ 50%) or fixed-effects model (I² < 50%) was used to calculate pooled effect estimates, comparing the outcomes between the intervention and control groups where feasible.Results:Of the 1006 articles identified, 21 studies met the inclusion criteria with 2643 individuals; two were at low risk of bias. As no primary outcomes were similar after an identical treatment duration in the included studies, meta-analysis could not be performed. However, more studies favored SFC, instead of MON, owing to a lower risk of asthma exacerbation in the SFC group. As for secondary outcome, SFC showed a significant improvement of peak expiratory flow (PEF)%pred after 4 weeks compared with MFC (mean difference [MD]: 5.45; 95% confidence interval [CI]: 1.57–9.34; I² = 95%; P = 0.006). As for asthma control level, SFC also showed a higher full-controlled level (risk ratio [RR]: 1.51; 95% CI: 1.24–1.85; I² = 0; P < 0.001) and higher childhood asthma control test score after 4 weeks of treatment (MD: 2.30; 95% CI: 1.39–3.21; I² = 72%; P < 0.001) compared with MFC.Conclusions:SFC may be more effective than MFC for the treatment of asthma in children and adolescents, especially in improving asthma control level. However, there is insufficient evidence to make firm conclusive statements on the use of SFC or MON in children and adolescents aged 4 to 18 years with asthma. Further research is needed, particularly a combination of good-quality long-term prospective studies and well-designed RCTs.PROSPERO registration number:CRD42019133156.     

中国2004—2010艾滋病母婴传播率及母婴阻断药物应用状况的系统评价

目的:了解我国2004-2010年艾滋病母婴传播及母婴阻断药物应用状况。方法：全面检索CBM和Pubmed等中英文数据库,检索时间均从建库到2013年5月。对纳入的文献采用参照AHRQ横断面研究评价标准和STROBE声明拟定的四条标准进行质量评价。并将样本量、监测地点和监测年份作为主要异质性来源进行meta回归分析。采用Comprehensive Meta-Analysis V2.0 software 进行meta分析。结果：共检索到文献2356篇,最终纳入51篇进行分析。2004-2010年我国艾滋病母婴传播率依次分别为12.90%（95% CI: 7.48 %- 21.36%）,16.35%（95% CI: 10.41%- 24.73%）,6.45%（95% CI: 3.73 %- 10.93%）,6.25%（95% CI: 2.39%- 15.36%）,5.56%（95% CI: 2.79 %- 10.76%）,3.10%（95% CI: 1.59 %- 5.97%）,2.29%（95% CI: 1.36 %- 3.83%）。2004-2010年,我国艾滋病孕产妇中阻断药物应用率依次分别为70.39%（95% CI: 24.42%-94.59%）,71.99%（95% CI: 61.49%-80.54%）,78.79%（95% CI: 70.19%-85.43%）,86.84%（95% CI: 79.24%-91.94%）,82.71%（95% CI: 76.62%-87.48%）,81.85%（95% CI: 75.55%-86.80%）,86.16%（95% CI: 53.20%-97.15%）。2005-2010年婴儿阻断药物应用率依次分别为80.72%（95%CI: 72.89%-86.70%）,81.84%（95% CI:71.55%-88.98%）,85.43%（95% CI:80.99%-88.97%）,89.75%（95% CI: 81.82%-94.45%）,92.39%（95% CI: 84.97%-96.31%）,90.34%（95% CI: 85.50%-93.68%）。 结论：近年来我国艾滋病母婴传播率呈下降趋势,孕产妇及婴儿阻断药物应用率都有所升高。