雷公藤多苷片联合地氯雷他定治疗慢性特发性荨麻疹的临床疗效Meta分析

目的采用Meta分析系统评价雷公藤多苷片联合地氯雷他定治疗慢性特发性荨麻疹的临床疗效。方法通过检索CNKI、WANFANG DATA、VIP、CBM disc及Pubmed数据库,收集雷公藤多苷片联合地氯雷他定治疗慢性特发性荨麻疹的随机对照试验,采用Rev Man 5.3软件进行Meta分析。结果共纳入文献8篇,患者累计945例。Meta分析结果显示,雷公藤多苷片联合地氯雷他定可显著提高两药对CIU患者的总有效人数并显著降低复发人数,且不良反应发生人数未明显增高。结论雷公藤多苷片联合地氯雷他定治疗慢性特发性荨麻疹的疗效确切。     

CP式教学与PBL结合应用效果的Meta分析

目的评价CP式教学与PBL结合的应用效果。方法对多个中外医学数据库进行检索,收集关于CP式教学与PBL结合在临床实习带教中的应用的随机对照实验,使用NoteExpress、REVMAN 5.3等多个软件进行文献筛选、质量评价与Meta分析。结果纳入RCT研究文献10篇,共纳入研究对象823人。Meta分析结果显示,与传统带教方法相比,CP+PBL模式能提高学生的综合成绩、理论成绩、操作成绩、病例分析成绩、对教学模式的满意率(P<0.05)。结论CP+PBL能整体地提升教学效果,在临床实习生的带教中具有一定的优势,同时具有较高的受欢迎程度。由于纳入文献具有较大的异质性,未来相关研究需要建立相对统一的干预方案和操作措施,以减少干预时间、科室教学水平的差异对结论可靠性的影响。     

Citrus fruit intake and stomach cancer risk: a quantitative systematic review

Background The purpose of this systematic review was to investigate the association between dietary intake of citrus fruits and gastric cancer risk. Methods We searched electronic databases and the reference lists of publications on diet and stomach cancer studies until April 2007. All of the epidemiological studies that obtained individual data on dietary intake of citrus fruits and presented risk estimates of the association between intake of citrus fruits and risk of stomach cancer were identified and included in this review. Using general variance-based methods, study-specific odds ratio (OR)/ relative risk (RR) and associated confidence interval (CI)/ standard error (SE) for highest versus lowest intake of citrus fruits level were extracted from each article. Results Fourteen articles, including six hospital-based case-control studies, six community-based case-control studies, and two cohort studies, proved eligible. Overall summary OR using a fixed-effect model showed a 28% reduction in risk of stomach cancer associated with high intake of citrus fruits (summary OR = 0.72; 95% CI = 0.64–0.81; P value <0.0001); results were consistent across studies (I² = 0, where I² describes the percentage of total variation across studies because of heterogeneity rather than chance). Also, visual inspection of the results did not suggest a publication bias. Conclusion Pooled results from observational studies support a protective effect of high citrus fruit intake in the risk of stomach cancer.     

中西医结合治疗术后早期炎性肠梗阻随机对照试验的系统评价

目的:评价中西医结合治疗术后早期炎性肠梗阻的疗效及安全性.方法:计算机检索中国生物医学文献数据库(CB M)(1979/2011-03),清华同方中国期刊全文数据库(CNKI)(1980/2011-03),重庆维普中文科技期刊数据库(VIP)(1989/2011-03),万方数据库(Wanfang)(1998/2011...     

A tale of two RCTs: Using Randomized Controlled Trials to benchmark Routine Clinical (psychological) Treatments for chronic pain

This article reports the development of natural history and active treatment benchmarks for psychological treatments of chronic pain. The benchmarks were derived from randomized controlled trials (RCTs) reported in a published meta-analysis. In two preliminary studies we surveyed small samples of active clinicians working in UK pain management programs. Study 1 assessed the fit between routine clinical treatment and the selected RCTs. In study 2 Delphi methodology was used to determine a set of outcome domains to be used in the development of benchmarks. In study 3 we extracted data from a set of RCTs where both pre- and post-treatment data were reported. Measures were allocated to 1 of 5 outcome domains (cognitive coping and appraisal, pain experience, pain behavior, emotional functioning, and physical functioning). Pre-treatment to post-treatment effect sizes (Cohen’s d) were computed and, where necessary, aggregated within trial so that each trial contributed a single estimate to outcome domain. Effect size (ES) benchmarks were computed for all trials and those trials with an explicit cognitive behavior therapy protocol. In no case did the ES estimates for the untreated control deviate from 0. The average ES across outcome domains for the treatment arms was approximately 0.35. These benchmarks may be used to assess the effectiveness of routine clinical treatments for chronic pain. The application of these data and the limitations of the study are discussed.     

应用meta分析方法研究肺纤维化TNF-α时空变化规律

【目的】探讨肺纤维化与TNF-α的时空变化规律。【方法】检索Cochrane图书馆、MEDLINE、CBM-disc等数据库，纳入18篇TNF-α与博来霉素诱导的肺纤维化文章进行meta分析。【结果】肺组织、肺巨噬细胞、血清内部各组总效应Z值（P值）分别为5．20（0.00001）、2．22（0.03）、0．91（0．36）。肺组织第1、3、7、14、21、28天总效应Z值（P值）分别为0．03（0．98）、3．85（0．0001）、5．18（0．00001）、5．37（0．00001）、2．39（0．02）、5．20（0．00001）。【结论】肺组织中TNF-α表达明显，血清中表达不明显，造模后第14天为肺纤维化TNF-α变化的明显拐点。     

系统评价异甘草酸镁辅助治疗重症急性胰腺炎的有效性和安全性

目的 系统评价异甘草酸镁静辅助治疗重症急性胰腺炎（SAP）的有效性和安全性。方法 计算机检索中国学术期刊全文数据库（CNKI）、维普中文期刊全文数据库（VIP）、中国生物医学文献数据库（CBM）、万方数据库、PubMed、EmBase和The Cochrane Library数据库有关常规治疗联合异甘草酸镁（试验组）对比常规治疗（对照组）治疗SAP的随机对照试验（RCTs）,检索时间为从建库到2020年10月。提取数据、评价文献质量后,采用RevMan 5.3软件进行Meta分析。结果 最终纳入12篇RCTs和1 161例受试者。Meta分析结果显示：试验组临床有效率[RR=1.23,95% CI=（1.17,1.30）,P<0.01]显著大于对照组;试验组CRP水平下降值[SMD=-1.67,95% CI=（-2.41,-0.93）,P<0.01]、TNF-α水平下降值[SMD=-1.17,95% CI=（-1.55,-0.78）,P<0.01]和IL-6水平下降值[SMD=-1.40,95% CI=（-1.86,-0.94）,P<0.01]均显著大于对照组;试验组治疗后ALT水平[SMD=-2.35,95% CI=（-2.90,-1.79）,P<0.01]和AST水平[SMD=-1.77,95% CI=（-2.46,-1.08）,P<0.01]均显著小于对照组。ADR发生率组间比较无显著性差异[RR=1.49,95% CI=（0.88,2.54）,P=0.14]。结论 异甘草酸镁能显著降低SAP患者炎性因子,改善肝肾功能,减少临床体征改善时间,改善早期预后,且安全性好。     

射频消融术与传统手术治疗小肝癌疗效与安全性的Meta分析

目的 对比射频消融术（radiofrequency ablation,RFA）与传统手术（traditional surgery,TS）在小肝癌中的疗效和安全性。方法 检索国内外公开数据库,检索员至少2人,检索的数据库主要包括：国外数据库如Embase、PubMed、the Cochrane Library,中文数据库如中国知网数据库、中国生物医学文献 数据库、万方数据库、维普数据库。检索射频消融术与传统手术治疗小肝癌的对照试验,年限为2008年 1月至2018年1月,以Cochrane系统评价手册内的质量评价标准进行筛选和评价,用Revman 5.3软件进行 Meta分析。结果 本研究共纳入10篇文献,射频组共1 503例,手术组共1 657例。Meta分析结果表明：在 1年总生存率方面,二组无统计学差异（P＞0.05）,而在 3、5年总生存率和1、3、5年无瘤生存率方面,手 术组的生存率高于射频组（P＜0.05）。在并发症方面,射频组并发症发生率低于手术组患者（P＜0.05）。 结论 在长期生存率方面,传统手术对于小肝癌的疗效要优于射频消融术;但射频消融术并发症少,安全 性更高。     

白芍总苷联合甲氨蝶呤与来氟米特治疗类风湿关节炎疗效和安全性Meta分析

目的:系统评价白芍总苷(TGP)联合甲氨蝶呤(MTX)与来氟米特(LEF)治疗类风湿关节炎(RA)的疗效和安全性.方法:计算机检索PubMed、Cochrance Library、Embase及中国知网期刊全文数据库、维普中文科技期刊全文数据库、万方医药期刊数据库、中国生物医学文献服务系统,搜集TGP联合MTX与LEF...