Efficacy and safety of polidocanol in the treatment of varicose veins of lower extremities: A protocol for systematic review and meta-analysis

Background:The varicose veins of the lower extremities showed earthworm-like dilatation and venous protrusion of the lower extremities. Polidocanol foam sclerotherapy, as a minimally invasive treatment with rapid recovery, less trauma and not easy to relapse, has achieved good results in clinical, but it is lack of evidence-based medicine. The purpose of this study is to evaluate the efficacy and safety of polidocanol in the treatment of varicose veins of the lower extremities by meta-analysis.Method:Chinese National Knowledge Infrastructure, Wanfang Database, Chinese Scientifific Journals Database, China Biology Medicine disc, PubMed, EMBASE database, Web of Science, and Cochrane Library will be used as search sources to conduct for randomized controlled trials of polidocanol in the treatment of varicose veins of lower extremities. The search time is set from the establishment of the database in December 2020 in this study. Two researchers independently extract, delete files, extract data and evaluate the quality. Revman software version 5.3 will be used for statistical analysis of data.Result:In this study, the efficacy and safety of polidocanol in the treatment of varicose veins of the lower extremities will be evaluated in terms of total effective rate, incidence of complications and recurrence rate.Conclusion:This study will provide reliable evidence-based evidence for the clinical application of polidocanol in the treatment of varicose veins of lower extremities.Ethics and dissemination:Private information from individuals will not be published. This systematic review also does not involve endangering participant rights. Ethical approval will not be required. The results may be published in a peer-reviewed journal or disseminated at relevant conferences.OSF Registration number:DOI 10.17605/OSF.IO/AUR4X.     

Do patients with cystic fibrosis participating in clinical trials demonstrate placebo response? A meta-analysis

BackgroundPatients' and families' expectation that a cure for cystic fibrosis (CF) will be found is high. In other debilitating conditions, high expectation has been shown to drive a strong placebo response (PR). Therefore, our goal was to evaluate PR on objective continuous outcomes (FEV₁, BMI) and the CF Questionnaire Revised-Respiratory Domain (CFQR-RD) monitored during randomised clinical trials (RCTs) for CF.MethodsWe conducted a meta-analysis after a systematic review of the literature carried out to identify RCTs with FEV₁, CFQR-RD and BMI as outcome measures. The standardised mean difference (SMD) was calculated to estimate the PR. A meta-regression analysis was conducted to assess other contributing factors on PR such as study design, trial duration, patient age and disease severity.ResultsOut of 289 RCTs found in the search, we identified 61 articles (published from 1987 to 2017) with respectively 59, 17 and 9 reporting FEV₁, CFQR-RD and BMI at the start and at the end of the RCTs. No significant PR was found on FEV₁ or CFQR-RD. However, a small but significant PR was found on BMI SMD, 0.09 (95% CI (0.01; 0.17); p = 0.03).ConclusionThe PR seems higher when measuring BMI. However, it is not clear whether this improvement can be explained by a PR alone.     

Exercise,health outcomes,and pædiatric obesity: A systematic review of meta-analyses

Objectives

This study is a systematic review of meta-analyses that have addressed the effects of exercise-based interventions alone and the health outcomes (anthropometric, body composition, cardiometabolic, hepatic, vascular, and cardiorespiratory fitness parameters) in overweight and obese children and adolescents.

TVT治疗单纯性女性压力性尿失禁临床疗效的荟萃分析

目的 对经阴道无张力性尿道中段悬吊术（TVT）治疗女性压力性尿失禁的客观成功率和并发症发生率进行荟萃分析。方法计算机并配合手工检索PubMed、EMBASE及中国生物医学文献数据库（CBMdisc）、中国期刊全文数据库、万方数据库和相关会议中所有对比TVT和膀胱颈悬吊术（Burch）疗效的临床随机对照试验，进行质量评价后用RevMan4．2软件进行荟萃分析，主要分析客观成功率、并发症率。结果共纳入7个随机对照试验。Meta分析结果显示：1年以上，TVT客观成功率高于Burch（RR为1．12，95％可信区间1．02-1．22，P〈0．05）；术后1年以内．TVT和Burch客观成功率相似（RR为1．03，95％可信区间0．95～1．12，P〉0．05）。TVT组客观成功率与“金标准”术式开腹Burch相似（RR为1．01，95％可信区间0．92～1．11，P〉0．05），并发症率低于微创术式腹腔镜Burch（RR为0．49．95％可信区间0．31-0．77，P〈0．05）。结论 TVT是一种疗效可靠、并发症少的治疗女性压力性尿失禁的微创术式。     

中医药治疗更年期综合征随机对照试验文献的质量评价

目的:评价国内中医药治疗更年期综合征随机对照试验已发表文献的质量.方法:电子、手工检索获得发表的关于中医药治疗更年期综合征的随机对照试验或半随机对照试验或自称是随机对照试验无论是否采用盲法的文献,由两名研究者独立进行文献选择和资料提取工作,遵循循证医学的原则和文献系统性评价质量评价的原则,对文献质量进行分析评价.纳入试验的方法学质量采用Jadad评分标准与随机分配隐藏.结果:共51篇关于中医药治疗更年期综合征的随机对照试验满足纳入标准,2篇双盲试验被评为高质量试验,其余均为低质量.51篇文献中指出了具体随机方法的占7.9%,没有1篇提到分配隐匿;有明确诊断标准的占62.7%,明确疗效评价标准出处者占29.4%,明确指出组间有可比性的占56.9%,运用盲法的占7.8%,说明选择相应的统计学方法的依据或理由的占7.8%.结论:中医药治疗更年期综合征的随机对照研究中,高质量的随机对照试验较少,研究质量的总体水平亟待提高,应努力开展有资金资助的大样本、多中心、严格的前瞻性随机对照试验.     

贝伐单抗治疗转移性乳腺癌有效性与安全性的Meta分析

目的：系统评价贝伐单抗治疗转移性乳腺癌的有效性与安全性,以期为临床提供循证参考。方法：计算机检索PubMed、EMbase、The Cochrane Library（2017年第8期）、CBM、CNKI、VIP和WanFang Data,检索时间均从建库至2017年8月。由 2 名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3统计软件进行Meta分析。结果：共纳入6项RCT,共计4 235例患者。Meta分析结果显示：与对照组相比,贝伐单抗组PFS [HR=0.71,95%CI（0.60,0.84）,P<0.000 1]明显延长,客观缓解率ORR[RR=1.42,95%CI（1.27,1.59）,P<0.000 01]、1年生存率[RR=1.06,95%CI（1.02,1.11）,P=0.003]显著提高。而OS[HR=0.92,95%CI（0.84,1.02）,P=0.11]、死亡率[RR=0.88,95%CI（0.75,1.04）,P=0.14]较对照组差异无统计学意义。安全性方面,贝伐单抗组较对照组高血压[RR=1.75,95%CI（1.34,2.28）,P<0.000 01]、蛋白尿[RR=1.75,95%CI（1.34,2.28）,P<0.000 01]发生率增加,同时增加出血、感觉障碍发生风险,差异均有统计学意义。结论：当前证据表明,与传统化疗相比,贝伐单抗联合化疗在转移性乳腺癌治疗中可显著延长PFS,增加客观缓解率、1年生存率,同时降低死亡率。不良反应以高血压、蛋白尿发生最为常见。受纳入研究数量和质量的限制,上述结论尚需开展更多高质量研究予以验证。     

推拿治疗小儿夜啼的随机对照试验的Meta分析

目的:通过meta分析系统评价推拿治疗小儿夜啼的临床疗效和安全性,指导临床实践。方法:选取以推拿为主要治疗方案治疗儿童夜啼病的随机对照试验研究(Randomized Controlled Trials, RCTs)。主要检索的数据库包括:中国知网(CNKI)、万方学位及会议论文数据库(万方)、中国科技期刊数据库(VIP)、中国生物医学文献数据库(SinoMed)、Cochrane图书馆、PubMed等数据库。通过查找文献,筛选符合纳入标准的随机对照试验,应用RevMan5.3软件进行数据分析。结果:本次研究共纳入8篇文献,717例夜啼患儿。合并的结果显示小儿推拿治疗能够显著增加临床疗效[RR=1.21,95%CI(1.14,1.28),P<0.0001]。结论:小儿推拿治疗对于夜啼疗效显著。     

中西医结合治疗原发性肾病综合征的系统评价

[目的]应用Meta-分析评价中西医结合治疗原发性肾病综合征是否有助于提高疗效;中西医结合治疗对难治性肾病综合征是否亦能提高疗效.[方法]以中西医结合、原发性肾病综合征为主题词,采用电子和手工检索中国生物医学文献数据库(CBM disc)、中国期刊全文数据库(CNKI,1994～2006.12)、维普中文科技期刊数据库(1989～)、中国循证医学/Cochrane 中心数据库(CEBM/CCD)、Cochrane图书馆等数据库,搜集关于中西结合治疗原发性肾病综合征的随机对照试验(RCTs);采用Cochrane协作网专用软件RevMan4.2进行统计分析.[结果]检索符合RCTs纳入标准的治疗原发性肾病综合征的随机对照试验16篇,共584例病人;治疗小儿原发性肾病综合征的随机对照实验4篇,共101例病人;治疗难治性肾病综合征的随机对照实验4篇,共181例病人,Meta分析显示中西医结合治疗原发性肾病综合征可以提高完全缓解率,降低复发率,对难治性肾病及小儿原发性肾病综合征亦有效.[结论]中西医结合治疗原发性肾病综合征可以提高疗效,减少复发;中西医结合治疗原发性肾病综合征确切疗效尚有待于设计严格的多中心、大样本随机对照实验进一步证实.