China Hospital Knowledge Database Research Articles

A comprehensive analysis on economic evaluation of HIV vaccination strategies

Objective: To summarize the progress in research of economic evaluation of HIV vaccination strategies in the world, and provide reference for future decision-making and research on HIV vaccination. Methods: The key words used for literature retrieval were "HIV/AIDS", and "vaccine/vaccination" and "economic evaluation/cost-effectiveness analysis/cost-utility analysis/cost-benefit analysis/HTA". Literatures about the economic evaluation of HIV vaccination strategies published as of July 31, 2022, were retrieved from Wanfang Data (Wanfang), China Hospital Knowledge Database (CHKD), and PubMed databases. The quality of the articles was evaluated and analyzed comprehensively. Results: A total of 17 study articles with good quality were included. Results from the comprehensive analysis showed that HIV vaccination is a cost-saving or cost-effective strategy for key populations or the whole population. HIV vaccination could effectively reduce new infections and improve the quality of life of population. Factors, such as vaccine efficiency, coverage rate, price, and risk behavior change after vaccination, would affect the vaccination effect in different targeted populations. Conclusions: There were limited high-quality research data about the economic evaluation of HIV vaccination strategies. It is necessary to conduct in-depth research based on real-world evidence.

Maxillary gingival neurolemmoma: a case report and literature review

ObjectiveTo explore and summarize the clinical features, differential diagnosis and treatment of the oral maxillofacial schwandoma.Case presentationThis is a report of a case of a 46-year-old female patients with neurolemmoma in the maxillary gingiva. The clinical features, pathological features, differential diagnosis and treatment were analyzed. Literature review was conducted in search of domestic and overseas journal full-text database from 1986 ~ 2017. 39 reports on the oral and maxillofacial Neurolemmoma from 1986 to 2017 in the database of China hospital knowledge database and the PubMed database, there were 405 patients. There were 23 cases of gingival mucosa, 17 in foreign literature and only 6 in the domestic literature.ConclusionsThe incidence of gingival Neurolemmoma is extremely low, the predilection age is similar to other parts, it is middle-aged and young, and there is no obvious gender tendency. About 25–45% of schwannomas are found in the head and neck, and rarely in the mouth (only 1%). The most common internal location of the mouth is the tongue, followed by the floor of the mouth, buccal mucosa, palate, gums, and lips. Schwannomas are slow-growing benign tumors that are rare in the gums. Gingival schwannoma is usually a single occurrence, and the clinical manifestations are mostly painless gum mass, tooth loosening and displacement, without peripheral bone changes and regional lymph node metastasis. It is difficult to diagnose this tumor according to clinical manifestations, and pathological diagnosis is still the basis for the diagnosis of gingival schwannoma. So far, surgical resection is the preferred treatment for this disease, and the prognosis is good.

Clinical and Genetic Comparison of Birt-Hogg-Dubé Syndrome (Hornstein-Knickenberg Syndrome) in Chinese: A Systemic Review of Reported Cases.

BackgroundBirt–Hogg–Dubé syndrome (BHD), also named Hornstein–Knickenberg syndrome, is a rare autosomal dominant disease characterized by lung cysts, recurrent pneumothoraxes, renal cell carcinoma and skin fibrofolliculomas.PurposeThis study summarizes the clinical and genetic information of Chinese BHD patients from all available reported cases and explores the relationship between the clinical and genetic spectrum in the hope of improving the prognosis of Chinese BHD patients.MethodsRelative studies were collected by searching PubMed, Cochrane Library, Embase, OVID medicine, SinoMed, Web of Science, China National Knowledge Infrastructure, Wanfang Data and China Hospital Knowledge Database from January 1, 1977 to December 31, 2021. The search strategy included the following term keys: (Birt–Hogg–Dubé syndrome OR Hornstein-Kinckenberg syndrome OR familial pulmonary cysts OR familial spontaneous pneumothorax OR fibrofolliculomas OR trichodiscomas OR inherited renal cancer syndromes OR FLCN) AND (Chinese OR China).ResultsIn total, 287 Chinese patients from 143 families described in 31 references were included in this article. Chinese BHD patients tended to present more pulmonary symptoms but fewer skin lesions and renal malignancies, which appeared to be atypical when compared with Caucasian patients. The FLCN mutation spectrum among Chinese BHD patients was established with the mutational hot spot c.1285depC/delC as the most frequent mutation. In addition, this mutation spectrum also showed some differences from other races, with a relatively frequent large deletion c.872–429_1740+1763del (exon 9–14 deletion) reported only in Chinese individuals but no observation of the two mutational hot spots found in Japanese individuals. We also attempted to establish potential pheno-genotype correlations in Chinese BHD patients, but the results were negative.ConclusionTo improve the prognosis of BHD patients, physicians need to increase their awareness of BHD by focusing on the family history of pneumothorax as well as skin lesions in patients with lung cysts and promptly advising patients on genetic sequencing.

The positive role of traditional Chinese medicine as an adjunctive therapy for cancer.

Traditional Chinese medicine (TCM), especially Chinese herbal medicines and acupuncture, has been traditionally used to treat patients with cancers in China and other East Asian countries. Numerous studies have indicated that TCM not only alleviates the symptoms (e.g., fatigue, chronic pain, anorexia/cachexia, and insomnia) of patients with cancer and improves their quality of life (QOL) but also diminishes adverse reactions and complications caused by chemotherapy, radiotherapy, or targeted-therapy. Therefore, Chinese herbal medicines and acupuncture and other alternative therapies need to be understood by TCM physicians and other health care providers. This review mainly summarizes the experimental results and conclusions from literature published since 2010, and a search of the literature as been performed in the PubMed, MEDLINE, Web of Science, Scopus, Springer, ScienceDirect, and China Hospital Knowledge Database (CHKD) databases. Some Chinese herbal medicines (e.g., Panax ginseng, Panax quinquefolius, Astragali radix, Bu-zhong-yi-qi-tang (TJ-41), Liu-jun-zi-tang (TJ-43), Shi-quan-da-bu-tang (TJ-48), and Ban-xia-xie-xin-tang (TJ-14)) and some acupuncture points (e.g., Zusanli (ST36), Zhongwan (CV12), Neiguan (PC6) and Baihui (GV20)) that are commonly used to treat cancer-related symptoms and/or to reduce the toxicity of chemotherapy, radiotherapy, or targeted-therapy are highlighted and summarized. Through a review of literature, we conclude that TCM can effectively alleviate adverse gastrointestinal reactions (including diarrhea, nausea, and vomiting) to these anti-cancer therapies, decrease the incidence of bone marrow suppression, alleviate cardiotoxicity, and protect against chemotherapy-induced peripheral neuropathy and radiation-induced pneumonitis. Moreover, TCM can alleviate epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI)-related acneiform eruptions, diarrhea, and other adverse reactions. The hope is that this review can contribute to an understanding of TCM as an adjuvant therapy for cancer and that it can provide useful information for the development of more effective anti-cancer therapies. However, more rigorously designed trials involving cancer treatment must be conducted in the future, including complete quality control and standardized models at the cellular, organic, animal and clinical levels, in order to study TCM in multiple forms and at multiple levels.

Identification of a novel SDHB c.563\u2009T\u2009>\u2009C mutation responsible for Paraganglioma syndrome and genetic analysis of the SDHB gene in China: a case report

BackgroundPheochromocytoma/paraganglioma (PPGL) is a rare neuroendocrine tumor. Succinate dehydrogenase (SDH) deficiency has been confirmed to be associated with PPGL in various studies. SDHB mutations play an important role in PPGL. However, genetic screening of PPGL patients has not been widely carried out in clinics in China, and only a few related studies have been reported.Case presentationWe report a case of a 23-year-old woman with paraganglioma (PGL) caused by a novel missense SDHB mutation, c.563 T > C (p.Leu188Pro), who presented with paroxysmal hypertension. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed a PGL in the right retroperitoneum and no metastasis. The patient was treated with surgical excision and did not have postsurgerical paroxysmal hypertension. In addition, we searched the literature related to variations in SDHB genes in Chinese patients with PPGL using multiple online databases, including PubMed, China Hospital Knowledge Database and Wanfang Data. Ultimately, 14 studies (published between 2006 and 2019) comprising 34 cases of SDHB-related PGL or pheochromocytoma (PCC) were found. In total, 35 patients were enrolled in this study, and 25 mutations were identified. The common genetic alterations of SDHB in China were c.136C > T (11.4%), c.18C > A (11.4%) and c.725G > A (8.5%). Some carriers of SDHB mutations (28.1%) developed metastatic PPGL, and a high frequency of head and neck PGLs (HNPGLs) (59.4%) was reported.ConclusionsWe describe a classic case with a novel SDHB c.563 T > C mutation. Based on our literature review, common SDHB gene mutations in Chinese PPGL patients are c.136C > T, c.18C > A and c.725G > A.

Effects of nursing intervention on medication compliance in HIV/AIDS patients: a Meta analysis

Objective To explore the effects of nursing intervention on medication compliance in HIV/AIDS patients. Methods Literatures related to effects of nursing intervention on medication compliance in HIV/AIDS patients published from 2010 to 2016 were searched in the China Hospital Knowledge Database (CHKD) , Wanfang Data database and PubMed database. This paper evaluated literature quality, heterogeneity of included literature, effect sizes by fixed effect model or random effect model, publication bias, and analyzed sensitivity. Results The medication compliance of intervention group was 1.42 times as that of control group with (1.33, 1.51) for 95% credibility interval (CI) . The rate of medication compliance of intervention group was higher than that of control group with 0.26 for rate difference and (0.22, 0.29) for 95% CI. Conclusions Nursing intervention has an important role in improving medication compliance of AIDS patients. In the future antiviral therapy, relevant units should actively carry out nursing intervention so as to enhance medication compliance of patients and guarantee treatment effect. Key words: Acquired immunodeficiency syndrome; Nursing care; Meta-analysis; Compliance

Pharmacoeconomics of parenteral nutrition in surgical and critically ill patients receiving structured triglycerides in China.

A prior meta-analysis showed favorable metabolic effects of structured triglyceride (STG) lipid emulsions in surgical and critically ill patients compared with mixed medium-chain/long-chain triglycerides (MCT/LCT) emulsions. Limited data on clinical outcomes precluded pharmacoeconomic analysis. We performed an updated meta-analysis and developed a cost model to compare overall costs for STGs vs MCT/LCTs in Chinese hospitals. We searched Medline, Embase, Wanfang Data, the China Hospital Knowledge Database, and Google Scholar for clinical trials comparing STGs to mixed MCT/LCTs in surgical or critically ill adults published between October 10, 2013 and September 19, 2015. Newly identified studies were pooled with the prior studies and an updated meta-analysis was performed. A deterministic simulation model was used to compare the effects of STGs and mixed MCT/LCT's on Chinese hospital costs. The literature search identified six new trials, resulting in a total of 27 studies in the updated meta-analysis. Statistically significant differences favoring STGs were observed for cumulative nitrogen balance, pre- albumin and albumin concentrations, plasma triglycerides, and liver enzymes. STGs were also associated with a significant reduction in the length of hospital stay (mean difference, -1.45 days; 95% confidence interval, -2.48 to -0.43; p=0.005) versus mixed MCT/LCTs. Cost analysis demonstrated a net cost benefit of ¥675 compared with mixed MCT/LCTs. STGs are associated with improvements in metabolic function and reduced length of hospitalization in surgical and critically ill patients compared with mixed MCT/LCT emulsions. Cost analysis using data from Chinese hospitals showed a corresponding cost benefit.

Structured triglycerides versus physical mixtures of medium- and long-chain triglycerides for parenteral nutrition in surgical or critically ill adult patients: Systematic review and meta-analysis

New generations of parenteral lipid emulsions combine Long Chain Triglycerides (LCTs) with Medium Chain Triglycerides (MCTs) either by physically mixing MCT- and LCT-containing oils or by using synthetically structured triglycerides (STGs). In order to clarify some open issues relating to their comparative effect, in particular in terms of clinical outcomes, pertinent evidence was systematically identified, reviewed and meta-analyzed. PubMed, Scopus, Wanfang Data, China Hospital Knowledge Database and Google Scholar were searched for published clinical trials comparing STGs vs. MCTs/LCTs PN regimens administered over 5-7 days in surgical and/or critically ill patients. Two independent investigators performed screening and data extraction using a predefined list of parameters. Data were pooled using RevMan® 5.2. Quality of evidence was assessed according to Cochrane's risk of bias tool. Pre-specified high quality (HQ), incremental analyses and a post hoc subgroup analysis were performed. 21 studies were included. The meta-analysis revealed a significantly better cumulative nitrogen balance (Std. mean difference [95% CI]) (1.34 [0.98-1.7], p<0.00001), as well as higher values for pre-albumin (24.99mg/L [6.71-43.27], p<0.000001), and albumin (1.22g/L [0.66-1.77] p<0.0001), while plasma triglycerides were significantly lower (-0.28mmol/L [-0.41 to -0.15], p<0.0001) in the STG vs. MCT/LCT group. ALT, AST, and GGT were significantly lower with STGs than with MCTs/LCTs, while for total bilirubin and ALP only a trend was observed. STGs were also associated with a trend to a shorter hospital length of stay (LOS) (-1.74 days [-3.49 to 0.01] p=0.05). Quality of evidence was affected by an unclear risk of selection bias, mostly due to the lack of detailed reporting (random sequence generation, allocation concealment). For the other domains, most of the weighted information was judged at low risk of bias. HQ estimated effects, incremental and subgroup analyses were consistent with the main analysis. In postsurgical and/or critically ill patients, the administration of STGs vs. MCT/LCTs was significantly associated with improved protein economy, better liver tolerance and a more efficient triglyceride elimination. With regard to clinical outcomes a strong trend towards reduced LOS was observed for STG patients.

Ligustrazine for the Treatment of Unstable Angina: A Meta-Analysis of 16 Randomized Controlled Trials.

Ligustrazine is a principal ingredient of chuanxiong. Concerns regarding the evaluation of the effectiveness of ligustrazine in the treatment of UA have resulted in a meta-analysis combined with recent clinical evidence. Seven computer databases that included the China hospital knowledge database (CHKD), Wanfang Med Online, the Chinese medical journal database (CMJD), PubMed, Cochrane, Embase (Ovid), and Medline (Ovid) were systematically searched. We included randomized controlled trials and quasi-randomized controlled trials. Our systematic review identified 16 RCTs that met our eligibility criteria. Ligustrazine combined with conventional medicine was associated with an increased rate of marked improvement in symptoms and an increased rate of marked improvement of ECG compared with conventional Western medicine alone. Additionally, the use of ligustrazine was associated with significant trends in the reduction of the consumption of nitroglycerin and the level of fibrinogen when compared with conventional Western medicine alone. No firm results were found between the intervention and the control method groups in the reduction of the time of onset or the frequency of acute attack angina due to the high level of heterogeneity. In conclusion, our meta-analysis found that ligustrazine was associated with some benefits for people with unstable angina.

Retroperitoneal Versus Transperitoneal Laparoscopic Partial Nephrectomy: A Systematic Review and Meta-analysis

To review published literatures comparing the safety and effectiveness of retroperitoneal laparoscopic partial nephrectomy (RLPN) with transperitoneal laparoscopic partial nephrectomy (TLPN) and provide reference for clinical work. The search strategy was performed to identify relevant papers from the Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE, Google Scholar, China Hospital Knowledge Database, Wangfang Chinese Periodical Database, and VIP Chinese Periodical Database. All papers comparing RLPN with TLPN were included from 2000 to 2015. Two to three reviewers independently screened, evaluated, and extracted the included papers. A Meta-analysis was executed by using Review Manager 5.3 software. The interesting outcomes were tumor size, operating time, estimated blood loss, warm ischaemia time, length of hospital stay, positive margin rate, open conversion rate, overall complication rate, and recurrence rate. The literature search obtained 378 papers, then 10 of them were ultimately met the inclusion criteria and included in the systematic review. Finally, 6 of the 10 papers were included in the Meta-analysis. RLPN had significantly less operating time [P = 0.01, mean difference (MD)=-33.68, 95% confidence interval (CI) within (-60.35, -7.01)] and shorter length of hospital stay [P < 0.0001, MD=-1.47, 95% CI within (-2.18, -0.76)] than TLPN. Significant differences were not found between RLPN and TLPN in other outcomes. RLPN may be equally safe and be faster than TLPN. Each center can choose a modality according to your own operating habits and experience.

Aeromonas Sobria Infection in Patients with Acute Leukemia:Clinical Features and Outcome

To investigate the clinical features and outcome of patients with acute leukemia and Aeromonas sobria infection. The clinical data of two patients from Peking Union Medical College Hospital from 1994 to 2014 as well as patients reported in English literature (from PubMed and Medline databases) and Chinese literature (China Hospital Knowledge Database) during the same period were retrospectively analysed. Data were extracted and analyzed using Chi-square tests. Totally 15 patients worldwide were available for analysis with a male-to-female ratio of 12:3 and an acute myeloid leukemia to acute lymphoblastic leukemia ratio of 10:5. The median age was 49.5 years (range:27-80 years). Most patients were neutropenic at the time of onset of fever,and the most common manifestation was lower limb infection (66.7%). Despite empirical antibiotics treatment,the mortality was still as high as 80%. Chi-square tests revealed that among the dead patients,the rates of lower limb infection (P<0.01) and septic shock (P=0.02) were significantly higher. Aeromonas sobria infection is an uncommon but highly fatal condition that requires special attention in clinical settings.

Morita therapy for anxiety disorders in adults.

Morita therapy, first proposed in 1919, is a systematic psychological therapy for anxiety disorders that is based on eastern philosophy. It is mainly used as an alternative therapy for anxiety disorders in Asian countries such as Japan and China. Varying foci of treatment outcomes have been reported. To date, there has been no systematic review to investigate the strength of evidence for Morita therapy in anxiety disorders. To assess the effects of Morita therapy compared with pharmacological therapy, other psychological therapy, no intervention or wait list for anxiety disorders in adults. We searched The Cochrane Collaboration Depression, Anxiety and Neurosis Group's Specialised Register (CCDANCTR, which includes relevant randomised controlled trials from MEDLINE (1950 to date), EMBASE (1974 to date) and PsycINFO (1967 to date)), Dissertation Abstracts International (DAI) and four main Chinese medical databases (Chongqing VIP Database, Wanfang Database, China Hospital Knowledge Database, China Biology Medicine disc) as described in the protocol of this review to December 2014. Furthermore, we extended our search in the Cochrane Central Register of Controlled Trials (CENTRAL) and the World Health Organization International Clinical Trials Registry Platform (ICTRP) and the Sagace, a web-based search engine for biomedical databases in Japan. We applied no date or language restrictions. We contacted experts in the field for supplemental data. We included all relevant randomised controlled trials comparing Morita therapy with any other treatment in the treatment of anxiety disorders. Two authors independently selected studies and extracted data. For homogenous dichotomous data, we calculated fixed-effect risk ratios (RR), 95% confidence intervals (CI) and, where appropriate, numbers needed to treat for an additional beneficial outcome (NNTB) on an intention-to-treat basis. For continuous data, we calculated fixed-effect standardised mean differences (SMD) and 95% CI. We found seven small Chinese studies (449 participants), six of which provided useable data for meta-analysis. No study compared Morita therapy with an inactive control. Unclear randomisation methods, lack of blinding and low quality reporting of outcomes were common in the included studies. We graded the overall risk of bias as high and the quality of the evidence as very low.Two social phobia studies (75 outpatients) directly compared Morita therapy with pharmacological therapy. In this comparison, the pooled RR of global state was 1.85 (95% CI 1.27 to 2.69) and the NNTB was 3 (95% CI 2 to 5), indicating a significant difference between groups favouring Morita therapy in the short term (up to 12 weeks' post-treatment). Data regarding drop-outs was insufficient and no description of adverse effects was provided. We graded the quality of the evidence for this comparison as very low, mainly due to high risk of bias in the studies and insufficient information in the results.Four studies (288 inpatients) investigated the effect of Morita therapy plus pharmacological therapy versus pharmacological therapy alone, three studies for the treatment of obsessive-compulsive disorder (OCD) (228 participants) and one study for generalised anxiety disorder (60 participants). One of the OCD studies reported incomplete data of global state while the outcome of global state was missing in the other three studies. There was no significant difference between groups for drop-outs for any reason in two OCD studies in the short term (RR 1.76, 95% CI 0.47 to 6.67; I(2) = 44%). Information pertaining to drop-outs for adverse effects was unclear. We rated the risk of bias of this comparison as high. We graded the quality of the evidence as very low. The evidence base on Morita therapy for anxiety disorders was limited. All studies included in this review were conducted in China, and the results may not be applicable to Western countries. These included studies were small, provided insufficient information about drop-outs and adverse effects, and contained considerable risk of bias. Therefore, we graded the evidence as very low quality and were unable to draw conclusions on the effectiveness of Morita therapy in the treatment of anxiety disorders. Well-designed future studies that employ adequate allocation concealment, recruit large sample sizes, report drop-outs and adverse effects, and report outcomes clearly and consistently are needed to establish the effectiveness of Morita therapy for anxiety disorders.

Research progress on seroepidemiological study of enterovirus 71 and coxsackievirus A16 infection among children

Most common causative agents for hand, foot and mouth disease (HFMD) are enterovirus 71 (EV-A71) and coxsackievirus A16 (CV-A16). The symptomatic and asymptomatic cases could transmit the disease in population. Many sero-epidemiological surveys were launched to estimate the sero-incidence of EV-A71 and CV-A16 enterovirus, the susceptibility of different sub-population, and to observe the dynamics of neutralizing antibody. A literature search of sero-epidemiological study focused on EV-A71 or CV-A16 was conducted via PubMed and China Hospital Knowledge Database. Based on the 20 selected studies, the different age groups' antibody level, the susceptibility, the dynamics of antibody and sero-incidence of EV-A71 or CV-A16 were analyzed. From our results, the antibody level against EV-A71 or CV-A16 in neonates was associated with their mothers, which was similar with that of adults. The antibody level against EV-A71 or CV-A16 in neonates dropped to lowest level at one years-old, and started to dramatically increase until four years-old, and reached a plateau at five years-old. In conclusion, the infants aged 6-12 months were the priority group to receive vaccination when the EV-A71 vaccine is licensed in the future.

Hepatitis C virus genotypes in China: a systematic review

To provide information on the geographical distribution of hepatitis C virus (HCV) genotype and subtypes in the Chinese population. A comprehensive search was carried out in CHKD (China Hospital Knowledge Database), Wanfang (Chinese), CBMDisc and PubMed databases to identify all the papers being published on HCV genotypes/serotypes and subtypes in China. All studies were grouped according to the sites, period and objects of the studies, to analyse the distribution of HCV genotype. A total of 140 studies were included in this Meta-analysis program, which contained 168 records. We found that the predominate genotypes in China were 1b and 2a subtype, and the distributions of HCV subtypes were different in the western or southern parts of the country. Subtypes 3a, 3b and 6a had been significantly increased along with the decrease of subtypes 1b and 2a. There were various HCV subtypes among injection drug users with subtypes 3a, 3b and 6a found among them. The distribution of HCV genotypes and subtypes in the Chinese population had changed significantly.

Safety of tumor necrosis factor inhibitors use for rheumatoid arthritis and ankylosing spondylitis in Africa, the Middle East, and Asia: focus on severe infections and tuberculosis

Multiple studies of patients in Western countries with rheumatoid arthritis (RA) and ankylosing spondylitis (AS) have indicated increased risk for active tuberculosis (TB) and other infections among these individuals. It has also been consistently reported that patients receiving tumor necrosis factor (TNF) inhibitors for these conditions have higher rates of active TB and other infections than RA or AS patients not receiving these medications. These issues have been studied less extensively in the Asia and Africa-Middle East regions, and information from these regions is important because of higher rates of TB in the general population. This paper reviews studies of RA and AS patients from Asia, Africa, and the Middle East who received TNF inhibitors. A literature search was conducted using http://www.ncbi.nlm.nih.gov/pubmed to collect and report these data. The years included in the PubMed literature search ranged from January 2000 to October 2011. Additionally, information from the China Hospital Knowledge Database was used to report data from Chinese patients with RA and AS treated with TNF inhibitors. Results from these studies indicate that the risk for active TB and other infections in AS and RA patients from Asia, Africa, and the Middle East are increased in patients receiving TNF inhibitors and that the risk is higher among those treated with monoclonal antibodies versus soluble TNF receptor.

Meta-analysis of Chinese Medicines for prevention and treatment of radiation esophagitis

ObjectiveTo systematically assess the clinical effectiveness of Chinese medicines for prevention and treatment of radiation esophagitis by meta-analysis. MethodsThe articles were mainly retrieved from the “CHKD (China Hospital Knowledge Database) periodical full text databank”, the “China periodical full text databank”, the “CHKD doctor's and Master's degree student full text databank”, and the “China doctor's degree student thesis databank”, and they were selected according to the literature selection standard. The effects of Chinese medicines and Western medicines on radiation esophagitis were compared by meta-analysis. ResultsBased on 13 articles, we found that the effectiveness of Chinese medicines for prevention and treatment of radiation esophagitis was superior to Western medicines, with no obvious side effects. Meta-analysis showed that the total odds ratio was 0.426 and the 95% confidence interval was 0.368, 0.493. ConclusionChinese medicines are superior to Western medicines in preventing and treating radiation esophagitis. However, some methodological problems in the literature may have affected the authenticity of the results. Therefore, more rigorous, multi-central, randomized controlled trials with a large sample size should be designed to obtain a more reliable conclusion.

Investigation and analysis on the adverse reactions caused by 12 kinds of commonly used traditional Chinese medicine injections

This study was aimed to explore the characteristics and rules of the adverse drug reactions (ADR) caused by the 12 kinds of traditional Chinese medicine injections and to provide reference for rational clinical drug use. Retrospective study methods are adopted to make statistical analysis on the cases of ADR caused by the 12 kinds of commonly used traditional Chinese medicine injections, such as Chuanhuning, Yanhuning, Chuanxiongzine, Bupleurum, etc. reported in the knowledge resource database in the China Hospital Knowledge Database (CHKD) from 2006 to 2010. The ADR of these 12 kinds of traditional Chinese medicine injections have high incidence in elderly patients and occur mostly within 30 min after drug usage; this results mainly as systemic damage, manifested as allergic reaction, severe case can cause allergic shock, and each traditional Chinese medicine injection has its own features. The clinical medical care personnel shall learn more about the ADR of traditional Chinese medicine injections and reduce or avoid the occurrence of ADR. Key words: Traditional Chinese medicine injection, adverse drug reaction, rational drug use.

Original Article. Effectiveness of Hemorrhagic Fever with Renal Syndrome Bivalent Vaccine in China: A Metaanalysis

Abstract Objective To evaluate the effectiveness of Hemorrhagic Fever with Renal Syndrome (HFRS) bivalent vaccine in field. Methods The articles on effectiveness of HFRS bivalent vaccine were retrieved from Vip Database, China Journal Full-text Database, Wanfang database, China Hospital Knowledge Database, Chinese Biomedical Literature Database, MEDLINE and ProQuest. Two persons extracted data and evaluated the quality of data together for meta-analysis. Results Seven articles were included into the analysis, and two articles were random clinical trials, five were quasi-trials. Meta-analysis showed that the overall effectiveness of HFRS bivalent vaccine was 85% (95% confidence interval: 53%-95%) within one year after vaccination, and the effectiveness in two-dose recipients and three-dose recipients was 87% (95% confidence interval: 54%-96%) and 60%, respectively; it was 96% (95% confidence interval: 78%-99%) within 2-5 years after vaccination, and the effectiveness in two-dose recipients and three-dose recipients was 95% (95% confidence interval: 19%-100%) and 96% (95% confidence interval: 70%-99%), respectively; it was 100% (only one article included) within 6-9.6 years after vaccination. The effectiveness in two-dose recipients was 88% (95% confidence interval: 62%-96%) during 1-2.5 years after vaccination, and that in three-dose recipients was 94% (95% confidence interval: 70%-99%) during 1-5 years after vaccination. Conclusions HFRS bivalent vaccine is effective in field, and there is no difference between two-dose recipients and three-dose recipients. We should do some further studies on the long-term effectiveness of HFRS bivalent vaccine and on the age of vaccine reception.

Epidemiology and clinical phenomenology for Parkinson's disease with pain and fatigue

We conducted a cross-sectional analysis with 901 Parkinson's disease (PD) patients in China to understand the epidemiological characteristics of PD pain among Chinese patients. In addition, we searched PubMed and the China Hospital Knowledge Database for epidemiological studies of pain and fatigue among PD patients from 1999 to 2011 to understand the prevalence of these symptoms around the world and associated clinical features. The 901 PD cases were recruited from 42 university affiliated hospitals randomly selected from seven provincial capitals across four economic regions of China. We documented motor and non-motor symptoms via clinical examinations and questionnaire surveys. Using logistic regression models, we evaluated factors that were associated with PD pain among these Chinese patients. Of the 901 Chinese patients, 269 (29.9%) had PD-related pain. After adjusting for confounders, only dyskinesias (OR = 2.66) and depression (OR = 2.88) were independently associated with PD pain. The literature search identified a total of 16 eligible studies on PD-pain and 19 on PD fatigue with various tools for symptom assessment. The data suggest a crude prevalence of 33.7% for PD pain in Asia and 79.4% in Northern Europe; the prevalence for PD fatigue was 35.4% in Northern Europe and 59.1% in Western Europe. Interestingly, Northern-European PD patients reported the highest prevalence of pain, but the lowest prevalence of fatigue. These studies suggest that motor complications and depression are likely key predictors for PD pain, while disease severity, depression and sleep disturbance are associated with PD fatigue. More studies with standardized methods would be needed to better understand the prevalence of PD pain and fatigue across various regions of the world.

Primary risk factors of hepatitis C virus infection: a Meta-analysis

To provide evidence for decision-making on primary hepatitis C prevention through analyzing the main risk factors of hepatitis C virus infection. A comprehensive search was carried out in China Hospital Knowledge Database (CHKD), Wanfang Data, EBSCO, FMJS and Elsevier databases to identify all case-control and cohort studies published from 1994 to 2010 that evaluated the risk factors on the transmission of hepatitis C virus. Data manipulation and statistical analyses were performed using Stata 11.0 and RevMan 5.0 softwares. A total of 25 case-control studies were included in this Meta-analysis, which contained 4370 cases and 8606 controls. In univariate analysis, the pooled odds ratio (OR) and 95% confidence interval (CI) on the risk factors associated with HCV seropositivity were "blood transfusion" 4.23 (2.82 - 6.35), "having had surgical operations" 2.13 (1.70 - 2.67), "intravenous drug use" 52.28 (34.12 - 80.11), "having sex with intravenous drug users" 7.19 (3.13 - 16.51), "histories of having had STDs" 3.43 (2.70 - 4.34). In multivariate analysis, pooled OR and 95%CI of the risk factors associated with HCV seropositivity were:having had following "histories as blood transfusion" 6.03 (3.97 - 9.15), "surgeries" 2.10 (1.44 - 3.07), "intravenous drug use" 44.90 (31.13 - 64.76), "having sex with intravenous drug users"3.87 (2.07 - 7.24), "having STDs" 2.05 (1.19 - 3.52). Blood transfusion, intravenous drug use and having sex with intravenous drug users were the risk factors of HCV infection. Due to existing biases, the relationship between having had surgical operations and HCV infection was inconclusive. There appeared weak correlation between STDs and HCV infection, but the result was not so stability.