China Journal Full-text Database Research Articles

Bibliometric and visual analysis of neurological damage caused by electrical welding operations

Objective: To analyze and summarize the trends and hot spots in the field of neurological damage caused by electric welding operations, and to provide ideas for new researches by searching the domestic and international literature. Methods: In December 2022, using Web of Science Citation Index (Web of Science), China Journal Full-Text Database (CNKI) and Wanfang Database as search databases, literature search was conducted on the Chinese and English search terms related to eletrical welding operations and neurological damage. The bibliometric analysis software VOSviewer 1.6.18 and CiteSpace 6.1.6 were used to visualize the publication year, publication quantity, country, research institution and key words of the literature. Results: A total of 309 articles (112 in Chinese and 197 in English) were included in this study. The first domestic and international papers were published in 1976 and 1994 respectively, and the number of papers reached the peak in 2006 and 2018, and then showed a downward trend to varying degrees. In China, Shandong First Medical University (including Shandong Institute of Occupational Health and Occupational Disease Prevention and Shandong Academy of Medical Sciences) and Wuhan University of Science and Technology had the largest number of publications. The 309 articles were from 52 Chinese journals and 86 English journals. The co-occurrence analysis of key words showed that the domestic research mainly focused on eletrical welding operation, welding workers, neurobehavioral function and manganese, and the nervous system damage caused by manganese in welding smoke was the field of international attention. Long term exposure, risk, and performance were key buzzwords in the field. Conclusion: The research focus in the field of nervous system damage caused by electric welding operation has an obvious trend of time evolution, gradually transiting from clinical manifestations to its toxic mechanism and early biomarkers.

Meta-analysis of the efficacy of ω-3 polyunsaturated fatty acids when treating patients with polycystic ovary syndrome.

To systematically assess the efficacy of ω-3 polyunsaturated fatty acids (PUFAs) when treating polycystic ovary syndrome (PCOS). This meta-analysis follows Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria. We searched PubMed, EMBASE, ScienceDirect, Cochrane Library, China journal full-text database, VIP full-text Database, Wanfang Database, and Chinese Biomedical Literature Data for clinical trials on ω-3 PUFAs' efficacy in treating PCOS. Two independent reviewers examined and analyzed studies, resolving inconsistencies through discussion. RevMan5.3 software performed heterogeneity-based fixed and random-effects meta-analysis. We assessed bias using the Cochrane bias risk assessment tool. Our meta-analysis included 7 clinical control studies comprising 574 samples to evaluate the impact of ω-3 PUFAs on various metabolic markers in PCOS patients. We observed a significant reduction in total cholesterol (TC) and triglyceride (TG) levels (P < .05), along with a decrease in insulin resistance as measured by the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) (P < .05). Testosterone (T) levels were also lowered in the study group post-treatment (P < .05). However, no notable effects were found on body mass index (BMI), fasting blood sugar (FBS), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and Ferriman-Gallwey (mFG) scores (P > .05). Publication bias was not detected, enhancing the robustness of our results. Our study suggests that ω-3 PUFAs could be beneficial in managing specific metabolic markers in PCOS, although the results showed marked heterogeneity. In PCOS patients, PUFAs can enhance reproductive endocrine, glucose, and lipid levels. However, additional research and extended follow-up are required to confirm this.

Preoperative pelvic floor muscle exercise for continence after radical prostatectomy: a systematic review and meta-analysis.

We performed a systematic review and meta-analysis to evaluate the effect of preoperative pelvic floor muscle exercise on urinary incontinence after radical prostatectomy. We searched the literature for randomized controlled trials evaluating the diagnostic analysis of preoperative pelvic floor muscle exercise (PFME) and postprostatectomy incontinence in the MEDLINE, EMBASE, PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), PsycINFO, China Biomedical Literature Database, China Journal Full-text Database, Wanfang Database and Weipu Database. The retrieval time limit is from the establishment of the database to January 2023. We used a risk ratio with accompanying 95% confidence interval (CI) to express estimates. Reviewer Manager (RevMan) 5.1.0 was used to complete all statistical analyses. Twelve studies were included based on the selection criteria. The total number of patients included in the final analysis was 1,365. At 1th month, there was no difference in continence rates between the groups [odds ratio (OR): 0.47; 95% confidence interval (CI), 0.22-1.02, p = 0.06]. At 3th month, there was statistically significant difference in PFME group before operation (OR: 0.61; 95% CI, 0.37-0.98, p = 0.04). At 6th and 12th months, there was no difference between groups (OR: 0.57; 95% CI, 0.28-1.17, p = 0.13), (OR: 0.56; 95% CI, 0.27-1.15, p = 0.12). Preoperative pelvic floor muscle exercise can improve postoperative urinary incontinence at 3rd months after radical prostatectomy, but it cannot improve urinary incontinence at 6th months or longer after surgery, which indicates that preoperative PFME can improve early continence rate, but cannot improve long-term urinary incontinence continence rate.

Prevalence and factors influencing depression among empty nesters in China: A meta-analysis

BackgroundEmpty nesters are older people who live alone or an older couple without children to care for them. In China, empty nesters make up a significant community and are more likely to experience emotional issues, particularly depression. This study investigated the prevalence of depression and the factors influencing depression among Chinese home-bound empty nesters using meta-analysis.MethodsBased on previous studies, we used search terms relating to empty nesters and depression in English and Chinese. Databases, including China Journal Full Text Database (CNKI), Wanfang, Wipu, China Biomedical Literature Database (CBM), PubMed, Web of Science, Embase, The Cochrane Library, and UptoDate, were searched in April 2022, for relevant articles. Details including names of authors, year of publication, region of investigation, study type, sample size, depression detection scale, depression detection rate, and influencing factors were captured. The heterogeneity of the studies was assessed based on the I2 index, and data analysis was performed using Stata 16.0 software.ResultsA total of ten research articles involving 5337 Chinese empty nesters were evaluated in the present meta-analysis. The overall prevalence of depression among empty nesters in China was 43%. The prevalence of depression among urban empty nesters was 38% (95% CI: 0.24,0.52), and 36% (95% CI: 0.18,0.55) among rural empty nesters. Many factors, including female, income, marital status, chronic illness, relationship with children, and social support were linked to depression among urban empty nesters.ConclusionThe prevalence of depression among empty nesters was 43%. Therefore, based on the factors influencing depression, government departments can intervene early to improve the mental health of empty nesters.LimitationsThe meta-analysis only included cross-sectional studies. Therefore, there is a need for more future original studies investigating depression among empty nesters in China.

Meta-analysis of risk factors for carotid plaque formation in type 2 diabetes mellitus

Objective: To investigate the risk factors of carotid artery plaque formation in type 2 diabetes mellitus in China through meta-analysis. Methods: The literature on the risk factors of carotid plaque formation in type 2 diabetes mellitus in China was retrieved from China Journal Full-text Database (CNKI), Wanfang Digital Journal Full-text Database (Wanfang), VIP journal Resource integration Service platform (VIP) and PubMed database. Newcastle-Ottawa Scale(NOS) used the most comprehensive case-control trial data collection to evaluate the quality of the literature excerpts combined with inclusion and exclusion criteria.Literatures with scores ≥7 were included in the study, and finally meta-analysis was conducted by RevMan5.4. Results: 32 literatures met the inclusion criteria, and the cumulative number of cases and controls were 5710 and 5405, respectively. The results of meta-analysis showed that the risk factors of carotid plaque formation in type 2 diabetes mellitus in China were as follows: Triglyceride (TG) (OR= 2.74, 95%CI: 2.25-3.33), total cholesterol (TC) (OR=2.50, 95%CI: 2.22-2.83), glycosylated hemoglobin (HbA1c) (OR=1.41, 95%CI:1.33 ~ 1.50), history of hypertension (OR=2.03, 95%CI:1.69 ~ 2.44), low density lipoprotein (LDL-C) (OR=1.64, 95%CI:1.31 ~ 2.06), age (OR=1.12, 95%CI:1.09 ~ 1.14), diabetes duration (OR=1.04, 95%CI:1.03 ~ 1.06), smoking (OR=1.30, 95%CI:1.18 ~ 1.44), systolic blood pressure (SBP) (OR=1.04, 95%CI:1.02 ~ 1.05). Conclusion: TG, TC, HbA1c, hypertension history, LDL-C, age, diabetes course, smoking and SBP are independent risk factors for carotid plaque formation in type 2 diabetes mellitus. Smoking cessation, balanced diet, prevention and active treatment of hypertension have great significance for the formation of carotid plaque in type 2 diabetes mellitus.

Analysis of Acupoints Combination for Cancer-Related Anorexia Based on Association Rule Mining.

We investigated the acupoint selection regulations and workable core acupoint combinations in cancer-related anorexia (CA) treatment. The Apriori algorithm, complemented by the FP-growth algorithm, was used to mine association rules based on retrieved randomized control trials (RCTs) and clinical control trials (CCTs). We searched the following databases for acupuncture treatment regimens for CA: PubMed, Embase, Cochrane Central, Web of Science, WanFang Data, VIP, China Journal Full-Text Database (CNKI), and SinoMed (CBM). We extracted acupoints prescriptions from the 27 enrolled RCTs and CCTs for analysis. There have been 38 acupoints refined from 27 prescriptions. The pinnacle three regularly chosen acupoints were Zusanli (ST36), Zhongwan (RN12), and Sanyinjiao (SP6). We investigated 10 association rules, and the consequences confirmed that {RN4} ≥ {RN12}, {PC6} ≥ {ST36}, {RN12, SP6} ≥ {RN4}, {HT7} ≥ {RN12}, and {DU20} ≥ {RN12} had been the most frequent associated rules in the adoption literature. Zusanli (ST36), Sanyinjiao (SP6), Guanyuan (RN4), Zhongwan (RN12), Neiguan (PC6), Shenmen (HT7), and Baihui (DU20) would be regarded as acupuncture prescriptions in the treatment of CA.

Study on molecular biological mechanism of Chinese herbal medicines for the treatment of gastric precancerous lesions based on data mining and network pharmacology.

To explore the molecular biological mechanisms of Chinese herbal medicines for the treatment of gastric precancerous lesions by data mining and network pharmacology. The keywords "gastric precancerous lesions""gastric precancerous disease""gastric mucosal intraepithelial neoplasia""gastric mucosal heterogeneous hyperplasia""gastric precancerous state""chronic gastritis, atrophic""combined Chinese and Western medicine""Chinese medicine therapy""efficacy evaluation" "randomized controlled trial"were searched in China Journal Full-text Database, Wanfang Data, VIP database, PubMed and Embase from 2001 to 2021. The information was extracted from the literature which met the inclusion and exclusion criteria, and the database was constructed to identify the high-frequency herbal medicines. The top six Chinese herbal medicines were analyzed by the network pharmacology methods, including the acquisition of herbs compounds and gastric precancerous lesions targets using Pharmacology Database and Analysis Platform and GeneCards databases, construction of protein-protein interaction network, and screening of core targets, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis of core targets through Metascape platform, etc., to elucidate their active components, targets and pathways. A total of 482 compound prescriptions with 603 herbal medicines were included, and the top 6 herbal medicines with higher application frequency were Ume plum (63.35%), Curcuma longa (58.54%), Paeonia lactiflora (54.06%), Salvia miltiorrhiza (49.92%), Rhizoma alba (46.43%), and Astragalus membranaceus (45.44%). The results of the network pharmacological analysis showed that the active ingredients were 4 types from Ume plum, 3 from Curcuma longa, 9 from Paeonia lactiflora, 13 from Salvia miltiorrhiza, 7 from Astragalus alba, and 9 from Astragalus; 77 predicted targets were in Ume plum, 11 in Curcuma longa, 33 in Paeonia lactiflora, 58 in Salvia miltiorrhiza, 65 in Astragalus alba and 89 in Astragalus; and 98 crossover genes were obtained after these targets were compared with the disease genes, among which HSP90AA1, AKT1, TP53, STAT3, MAPK1 and TNF had higher relevance to the treatment of gastric precancerous lesions. The results of the GO enrichment analysis showed that the active ingredients of high frequency Chinese medicine mostly acted through biological processes such as response to inorganic substance, response to hormone, gland development, positive regulation of cell migration, positive regulation of cell motility, etc. The targets include cellular components such as vesicle lumen, secretory granule lumen, cytoplasmic vesicle lumen, transcription regulator complex, and with molecular functions such as kinase binding, protein kinase binding and DNA-binding transcription factor binding. The results of the KEGG pathway enrichment analysis showed that Paeonia lactiflora, Ulmus lucidus, Salvia miltiorrhiza and Astragalus mainly act through the cancer pathway and PI3K-AKT pathway; Curcuma longa and Rhizoma alba mainly act through the cancer pathway and proteoglycans in cancer, and all six herbs were involved in the cancer pathway and five herbs are involved in the PI3K-AKT pathway. In this study, we obtained the top 6 high-frequency Chinese herbal medicines in the treatment of gastric precancerous lesions by data mining method, and revealed that their mechanisms are involved in cell proliferation, differentiation, immunity, inflammation and other processes mainly through cancer pathway, PI3K-AKT signaling pathway, proteoglycans in cancer.

Comparison on the prognosis of severe aortic stenosis patients treated with transcatheter aortic valve replacement versus surgical aortic valve replacement: a systematic review and meta-analysis

Objective: To systematically review the prognosis of transcatheter aortic valve replacement (TAVR) versus surgical aortic valve replacement (SAVR) in patients with severe aortic stenosis. Methods: A systematic search of PubMed, EMBASE, Scopus, Cochrane Library, China biomedical literature database, China journal full text database (CNKI), Wanfang database and VIP database from January 2012 to February 2022 was conducted for randomized controlled trial (RCT) that comparing TAVR and SAVR in the treatment of severe aortic stenosis. The primary outcomes were the incidence of all-cause mortality, stroke incidence, reoperation rate and complications (pacemaker implantation, atrial fibrillation) at 1 month and 1, 2, 5 years after operation. Jadad scale was used to evaluate the literature quality of RCTs. All statistical analyses were performed using the standard statistical procedures provided in RevMan 5.4.1. Results: A total of 17 studies including 11 712 patients were identified, including 6 007 patients treated with TAVR and 5 705 patients treated with SAVR. There were 4 high-quality studies and 13 medium-quality studies. The results of meta-analysis showed that the rate of new onset atrial fibrillation was lower in TAVR group than that in SAVR group (RR=0.28, 95%CI 0.21-0.38, P<0.001), and there was no significant difference in all-cause death, stroke, pacemaker implantation and reoperation rate (all P>0.05) at 30 days follow-up. At one year after TAVR and SAVR treatment, all-cause mortality (RR=0.85, 95%CI 0.74-0.97, P=0.01) and new onset atrial fibrillation (RR=0.28, 95%CI 0.20-0.39, P<0.001) were lower in TAVR group than SAVR group. However, the pacemaker implantation rate was higher in TAVR group than that of SAVR group (RR=1.79, 95%CI 1.11-2.89, P=0.02), while there was no significant difference in the incidence of stroke and reoperation between the two groups (P>0.05). At two years after TAVR and SAVR treatment, the pacemaker implantation rate was higher in TAVR group than that in SAVR group (RR=2.23, 95%CI 1.28-3.86, P=0.004), and the rate of new atrial fibrillation was lower in TAVR group than that in SAVR group (RR=0.46, 95%CI 0.38-0.56, P<0.001). There was no significant difference in all-cause death, stroke and reoperation rates between the two groups (P>0.05). At five years after TAVR and SAVR treatment, the pacemaker implantation rate (RR=1.89, 95%CI 1.13-3.17, P=0.02) and reoperation rate (RR=3.64, 95%CI 1.75-7.58, P=0.000 5) were higher in TAVR group than those in SAVR group, while the rate of new onset atrial fibrillation was lower in TAVR group than that in SAVR group (RR=0.45, 95%CI 0.37-0.55, P<0.001). There was no significant difference in all-cause death and stroke incidence between the two groups (all P>0.05). Conclusions: The all-cause mortality and the incidence of new onset atrial fibrillation after TAVR are lower than SAVR, and TAVR is a preferred therapy for patients with aortic stenosis.

A Systematic Review and Meta-Analysis of the Efficacy of Uterine Artery Embolization in the Treatment of Endometriosis.

Objective To compare the efficacy of uterine artery embolization (UAE) with traditional methods for treating endometriosis. Methods The randomized controlled trials of uterine artery embolization and other medical treatments for endometriosis in PubMed, Embase, Web of Science, Cochrane Library, China Journal Full-Text Database, Wanfang Database, VIP Database, and China Biomedical Literature Database were retrieved by computer. The search time was up to June 2022. The quality of articles was evaluated by Cochrane ROB 2.0, and meta-analysis was performed by Stata15.1 software. Results 7 studies were finally included. Meta-analysis showed that the serum CA125 level after uterine artery embolization was significantly lower than that in the control group (SMD = −0.85, 95%CI (−1.12, −0.59)], and the postoperative visual analogue scale (VAS) of dysmenorrhea was significantly lower than that in the control group (SMD = −1.86, 95%CI (−2.21, −1.50)) There was no significant difference in the effective rate, FSH level, E2 level, and LH level between the two groups. Conclusion UAE can effectively reduce the VAS score of dysmenorrhea and serum CA125 level for treating endometriosis. However, due to the limitation of the quality of included articles, more large sample size and high quality RCTs are needed to provide stronger evidence-based medicine evidence for clinical practice.

Overview of the systematic reviews of premature ovarian insufficiency treated with acupuncture 针灸治疗早发性卵巢功能不全系统评价的再评价

ObjectiveTo assess the reliability of the methodological quality and outcome measures of systematic reviews (SR)/meta-analysis of premature ovarian insufficiency (POI) treated with acupuncture. MethodsSR/meta-analysis of POI treated with acupuncture were searched on POI from the databases including PubMed, Web of Science, EMBase, the Cochran Library, Chinese biomedical literature database (SinoMed), China journal full-text database (CNKI), Wanfang data knowledge service platform (Wanfang) and VIP information Chinese periodical service platform (VIP), from inception to 1st May 2021. Using A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2) scale and Grades of Recommendations Assessment, Development and Evaluation (GRADE) system, the methodological quality and outcome measures of the included studies were appraised. ResultsTen articles of SR/meta-analysis were included, published from 2015 to 2020. Using AMSTAR 2, 5 articles of SR/meta-analysis were rated as critical low quality in methods, 3 articles as low quality, and 2 articles as moderate quality. The results of GRADE showed that among the 50 outcomes the quality of evidence of 22 outcomes was very low, that of 25 outcomes was low and that of 3 outcomes was moderate. ConclusionThe methodological quality and the reliability of outcome measures were not high in existing SR/meta-analysis on POI treated with acupuncture, which may affect the translation of the SR/meta-analysis findings into clinical practice. It is necessary to further strengthen the methodological quality and reporting standard of SR/meta-analysis, as well as the robustness of design and implementation of randomized controlled trials(RCTs), in order to generate high quality evidences for clinical decision-making and practice.

Acupuncture-related treatments improve cognitive and physical functions in Alzheimer's disease: A systematic review and meta-analysis of randomized controlled trials

Objective To determine acupuncture-related treatments’ effects and duration on improving cognitive function, physical function, and quality of life in patients with Alzheimer's disease. Data sources Eight electronic databases were searched for eligible randomized controlled trials from database inception to January 2021, including Medline, PubMed, EBSCO, Embase, Cochrane, Airiti Library, China National Knowledge Infrastructure, and China Journal Full-text Database. Review methods A systematic review and meta-analysis were conducted on acupuncture types, cognitive function, activity of daily life, muscle strength and quality of life. Results Sixty-six studies in total with 4191 participants, the overall risk of bias was classified 60% as low and 24% as high. Acupuncture-related treatments for cognitive function and self-care ability revealed a moderate effect size, with a significant difference in noninvasive and invasive remedies (p < 0.001). Cognitive function showed significant differences in 6, 8, 12, and 24 weeks while self-care ability in the latter two weeks (p < 0.001). Meta-regression analysis showed cognitive function increased by 0.05 points (p = 0.002) and self-care ability decreased by 0.02 points (p = 0.04) after weekly treatment. There was a significant difference in muscle strength (p = 0.0003). Conclusion Acupuncture-related treatments effectively improved cognitive function with the treatment lasted 6 weeks at least, but self-care ability started showing effects after 12 weeks of treatment. The improvement of muscle strength was also confirmed. Acupuncture-related treatments, particularly noninvasive ones, have few complications and high safety, perhaps providing patients and caregivers diversified choices and clinical care guidelines for reference.

Research Progress of Tonifying Kidney and Promoting Blood Circulation in the Treatment of Steroid-induced Necrosis of Femoral Head

Osteonecrosis of the femoral head is a common disability disease of the hip joint in China, and osteonecrosis of the femoral head caused by hormone factors is the most common, which is related to the gradual increase in the utilization rate of glucocorticoids in recent years. It is a refractory disease in orthopaedics with a poor prognosis. For this disease, the treatment of traditional Chinese medicine has certain advantages. In view of this, the author reads, analyzes and summarizes its materials by searching China Journal full-text Database and Wanfang Database. This paper reviews the mechanism and clinical research progress of tonifying kidney and activating blood circulation in the prevention and treatment of steroid-induced osteonecrosis of the femoral head, hoping to provide help for the clinical treatment of hormone-related osteonecrosis of the femoral head.

Quantitative Analysis of Literature on Radiation-Induced Fibrosis Based on CNKI Database

Objective To carried a bibliometric analysis of the related researches on radiation-induced fibrosis in China, and provide some theoretical support for the corresponding research in future clinical work. Methods Searching the literatures related to radiation-induced fibrosis published from the establishment of China journal full-text database to January 15, 2022 were searched, and conducting statistical analysis on the time, journals, institutions, authors, citations, keywords, and research content of their publications combined with Citespace. Results A total of 37 papers were included, of which the earliest was published in 2003; the papers were sourced from 29 journals and 44 institutions; 69 authors were included in the included papers; 3 were funded by funds, and the research content was mainly about radiation pulmonary fibrosis, ionizing radiation, epithelial-mesenchymal transition (emt), etc. Conclusion At present, there are few studies on radiation-induced fibrosis in our country, and the distribution of research journals is relatively scattered. But it is closely related to ionizing radiation and cells, and it is unknown whether it may become an emerging research hotspot. At present, more evidence-based medical exploration is needed.

Systematic review and meta-analysis on perioperative intervention to prevent postoperative atelectasis complications after thoracic surgery.

In clinical general thoracic surgery, the prevalence of atelectasis is relatively high. Perioperative interventions can affect the probability of patients with atelectasis after surgery. Therefore, the incidence of perioperative intervention to prevent atelectasis after thoracic surgery was discussed using meta-analysis in this study. The articles were searched in the English database PubMed and Chinese databases including China National Knowledge Infrastructure (CNKI), VIP, and China Journal Full-text Database (CJFD). The duration for publication time of the articles was from the database inception to March 2021, and the articles were required to be randomized controlled trials (RCTs) using interventions [such as changing the dose of general anesthesia, continuous positive end expiratory pressure (PEEP), non-invasive pressure support ventilation, and physical therapy] after thoracic surgery (such as pulmonary lobectomy, sternum surgery, and lung cancer surgery) for the treatment of atelectasis. The software RevMan 5.3 provided by the Cochrane Collaboration was used for meta-analysis. A total of 5 articles were obtained, including 375 cases in the control group and 268 cases in the intervention treatment group. A meta-analysis was performed on the included articles, combined effect model analysis results showed that compared with the control group, the use of PEEP during mechanical ventilation can significantly reduce the incidence of atelectasis [odds ratio (OR) =0.46; 95% confidence interval (CI): 0.31-0.67; Z=3.94; P<0.0001]. Perioperative intervention was more effective for postoperative atelectasis and other complications.

Systematic review and meta-analysis of various risk factors of death from emergency cerebrovascular diseases in the department of neurology.

Cerebrovascular disease is one of the leading causes of death and disability in China. Preventive measures to reduce the incidence of cerebrovascular disease are important, so the risk factors associated with death need to be identified. Most studies showed that cerebrovascular disease has many risk factors for death, such as hypertension, hyperlipidemia, family history of stroke, diabetes, overweight, alcohol consumption, and smoking. A literature search was conducted in the English database PubMed and Chinese databases including CNKI, VIP, and China Journal Full-text Database. The time limit for retrieval was from establishment of the database to March 2021. All randomized controlled trials (RCTs) involving hypertension, hyperlipidemia, family history of stroke, diabetes, overweight, drinking, smoking and cerebrovascular diseases (i.e., stroke and cerebral infarction) were included. Review Manager 5.3 provided by the Cochrane Collaboration was used for meta-analysis. A total of 10 studies (with 32,664 patients in trial and control groups) were included: 14,743 cases in the control group and 17,901 cases in the risk factor group. The combined odds ratio (OR) and 95% confidence interval (95% CI) of all risk factors in patients with emergency cerebrovascular diseases in the Department of Neurology were 2.33 (1.83-2.98) for hypertension, 2.65 (1.80-3.91) for hyperlipidemia, 2.18 (1.73-2.73) for family history of stroke, 4.78 (3.07-7.42) for overweight, 2.97 (1.95-4.52) for alcoholism, and 2.98 (2.11-4.2) for smoking. P values were all less than 0.05, and the differences were statistically significant. The 10 articles included in this meta-analysis studied the effects of various mortality risk factors (hypertension, hyperlipidemia, family history of stroke, diabetes, overweight, alcohol consumption, and smoking) on the death of patients with emergency cerebrovascular diseases in the Department of Neurology. Attention should be paid to the treatment or care of the above factors in clinical practice to reduce the mortality of patients.

Economic status and catastrophic health expenditures in China in the last decade of health reform: a systematic review and meta-analysis

BackgroundIn order to solve the problem of “expensive medical treatment and difficult medical treatment” for patients and improve the equity of medical services, China started the health-care reform in 2009, and proposed ambitious goals of providing fair and high-quality basic medical and health services to all citizens and reducing economic burden of diseases. This study was to systematically explore the association between population economic status and incidence of catastrophic health expenditures (CHE) in mainland China in the last decade since 2009 health reform.MethodsThis systematic review was reported according to the standard of preferred reporting items for systematic reviews and meta-analyses (PRISMA). We systematically searched Chinese Electronic literature Database of China Journal Full Text Database, Chinese Biomedical Journal Database, Wan fang Data Resource System, VIP Database, and English literature databases of PubMed, SCI, EMbase and Cochrane Library from January 2000 to June 2020, and references of included studies. Two reviewers independently selected all reports from 2000 to 2020 for empirical studies of CHE in mainland China, extracted data and evaluated the quality of the study. We conducted meta-analysis of the incidence of CHE and subgroup analysis according to the time of the study and the economic characteristics of residents.ResultsFour thousand eight hundred seventy-four records were retrieved and eventually 47 studies with 151,911 participants were included. The quality scores of most of studies were beyond 4 points (91.49%). The pooled incidence of CHE of Chinese residents in the last two decades was 23.3% (95% CI: 21.1 to 25.6%). The CHE incidence increased from 2000 to 2017, then decreased over time from 2017 to 2020. From 2000 to 2020, the CHE incidence in rural areas was 25.0% (95% CI: 20.9 to 29.1%) compared to urban 20.9% (95% CI: 18.3 to 23.4%); the CHE incidence in eastern, central and western China was 25.0% (95% CI: 19.2 to 30.8%), 25.4% (95% CI: 18.4 to 32.3%), and 23.1% (95% CI: 17.9 to 28.2%), respectively; the CHE incidence was 30.9% (95% CI: 22.4 to 39.5%), 20.3% (95% CI: 17.0 to 23.6%), 19.9% (95% CI: 15.6 to 24.1%), and 23.7% (95% CI: 18.0 to 29.3%) in poverty group, low-income group, middle-income group, and high-income group, respectively.ConclusionsIn the past two decade, the incidence of CHE in rural areas is higher than that of urban residents; higher in central areas than in eastern, western and other regions; in poverty households than in low-income, middle-income and high-income regions. Further measures should be taken to reduce the incidence of CHE in susceptible people.

Systematic review and Meta analysis on the effectiveness and safety of tuina in treatment of functional constipation

To review systematically the effectiveness and safety of tuina (Chinese massage)in treatment of functional constipation. The articles on functional constipation treated with tuina were collected by computer retrieval from 7 databases from the date of establishment to March 28, 2020, including Chinese biomedical literature database (SinoMed), China journal full-text database (CNKI), full-text database of Wanfang academic journals (Wanfang), VIP Chinese science and technology journal database(VIP), PubMed, Dutch medical literature database (EMbase) and the Cochrane Library. After data extraction and quality evaluation of the included articles, Meta analysis was conducted with RevMan5.3 software. A total of 16 articles were included, with 1424 cases involved. Meta analysis results showed: ①The total effective rate in the treatment group was higher than that in the control group (RR=1.28, 95%CI: 1.16-1.42, P<0.000 01). ②The effective rate for the symptoms of functional constipation in traditional Chinese medicine in the treatment group was higher than that in the control group (RR=1.38, 95%CI :1.25-1.52, Z=6.31, P<0.000 01). ③Adverse reactions in the treatment group in the treatment of functional constipation were less than those in the control group (RR=0.10, 95%CI: 0.02-0.49, Z=2.81, P=0.005).④The effective rate of functional constipation treated on the base of syndrome differentiation in the treatment group was higher than that of the control group (RR=1.50, 95%CI: 1.08-2.10, Z=2.39, P=0.02).⑤The improvements in fecal characteristics, defecation time and defecation frequency of the patients with functional constipation in the treatment group were better than those in the control group (P<0.05). Tuina therapy presents a certain advantages on its curative effect on functional constipation, has less adverse reactions and relieves the relevant symptoms of functional constipation. But more randomized controlled trials with high quality and large sample are required to provide further verification of its effect.

The diagnostic accuracy of mid-regional pro-adrenomedullin for sepsis: a systematic review and meta-analysis.

The incidence and mortality of sepsis are high, and common biomarkers are not perfect. To identify a biomarker with high specificity and sensitivity for sepsis, we evaluated the current literature on the performance of mid-regional pro-adrenomedullin (MR-proADM) in the diagnosis of sepsis. According to appropriate eligibility and exclusion criteria, PubMed, EMBASE, Cochrane Library, China Journal full-text Database, Wanfang Database and Chinese Journal Full Text Database were searched for "mid-regional pro-adrenomedullin," "MR-proADM," "sepsis," "pyemia," "pyohemia," "septicemia," and "blood poisoning." The publication dates considered for the search were from inception until August 31st, 2020. The risk of bias was assessed according to QUADAS-2 criteria. Eleven studies involving 2038 cases were included. MR-proADM had high sensitivity and specificity in the diagnosis of sepsis, with values of 0.83 (95% CI: 0.79-0.87) and 0.90 (95% CI: 0.83-0.94), respectively. The odds ratio of a combined diagnosis was 41.35, and the area under the curve (AUC) was 0.91. The best cut-off value for MR-proADM diagnosis of sepsis is 1-1.5 nmol/L. MR-proADM may also have value in distinguishing pathogens and identifying sepsis severity and organ failure. MR-proADM is an excellent biomarker for the diagnosis of sepsis with high sensitivity and specificity. The best cut-off value for MR-proADM diagnosis of sepsis is 1-1.5 nmol/L.

AB0398 CASE SERIES OF PATIENTS WITH CHOLESTEROL CRYSTAL EMBOLISM SYNDROME THAT MIMICS SYSTEMIC VASCULITIS

Background:Cholesterol crystal embolism (CCE) syndrome is a multisystemic disorder caused by small arteries cholesterol crystal emboli subsequent to small pieces of atheromatous plaques from the aorta or other major arteries break off. CCE is often overlooked because it mimics symptoms of systemic vasculitis due to its clinical characteristics such as ulceration and gangrene of toes, livedo reticularis, renal insufficiency. Acute inflammatory reactants such as ESR, CRP may elevate in CCE patients since the cholesterol crystals trigger a foreign-body inflammatory reaction around the arterioles.Objectives:This study aimed to explore the clinical characteristics of CCE patients, to make rheumatologists learn more about this disease.Methods:Peer-reviewed articles in the electronic databases Medline, PubMed, Science Citation Index, China Biomedical Literature Database (CBM), China Journal Full Text Database (CNKI), and WANFANG Data were searched using the terms “cholesterol crystal embolism syndrome”, “cholesterol embolism”, “atherosclerotic embolism”, “atherosclerotic nephropathy”, or “CCE”. Only articles or case reports containing detailed medical records of CCE patients were included. We also included CCE patients in our department.Results:A 66-year-old male CCE patient presented with multiple ulceration and gangrene of toes and heels (Figure 1), subacute renal insufficiency, and elevated CRP and ESR. This patient had been considered as “suspected systemic vasculitis” and was referred to our rheumatology department. Another 39 Chinese CCE patients from the above databases were qualified for analysis. Among these 40 patients, 87.5% (35/40) were male and the mean age was 68±6 years. The most common involved was kidney and 90% (36/40) of patients presenting with renal insufficiency including the progressive increase of serum creatinine, hematuria, proteinuria, or sudden (or sharp) aggravation of hypertension. Next common involved was skin that occurred in 87.5% (35/40) of patients, especially in the toes and heels. For skin manifestations, blue toe syndrome occurred in 82.5% (33/40) of patients, ulceration or gangrene in 25% (10/40), and livedo reticularis in 15% (6/40). Additionally, 12.5% (5/40) showed ocular involvement such as visual impairment and visual field defect. In 2 patients, embolized cholesterol crystal in retinal arteries that is called Hollenhorst plaques was detected by fundoscopy. There were 62.5% (25/40) of patients having elevated CRP or ESR. The positive rate for skin or subcutaneous biopsies was 58% (11/19) and for kidney biopsies was 100% (6/6). The precipitating factors preceding the occurrence of classical symptoms such as blue toe syndrome, livedo reticularis and/or subacute renal insufficiency is important for CCE diagnosis especially for patients who had contraindications or were intolerant to biopsy. The precipitating factors include endovascular intervention (80%), vascular surgery (5%), and anticoagulant or thrombolytic therapy (2.5%). Only 12.5% (5/40) of patients were spontaneous and didn’t have any predisposing factors. General interventions of CCE included statins (82.5%), antiplatelets (32.5%), and dialysis (32.5%). Twelve patients (30%) received glucocorticoids and 75% (9/12) of them renal function improved and ulceration healed (Figure 1). Among 36 patients who presented with renal insufficiency, the renal function returned to normal after treatment in 2 patients (5.6%), but 27 patients (75%) still showed abnormal renal function even though somewhat improved, and 7 patients (19.4%) needed renal replacement therapy or dialysis for maintenance.Conclusion:This study reported CCE patients had high prevalence of renal insufficiency, blue toe syndrome, and ulceration or gangrene of toes, as well as elevated CRP or ESR, thus rheumatologists should be alert to this disease as one of the differential diagnosis of systemic vasculitis, especially for elderly patients with evidence of atherosclerosis who undergo a recent cardiovascular procedure.Disclosure of Interests:None declared

Evaluation of association between methylenetetrahydrofolate reductase and azoospermia: Retraction

Background:Infertility affects childbearing age couples all over the world. One of the important reasons for infertility is genetic factors. Our study evaluated the association between methylenetetrahydrofolate reductase (MTHFR) and azoospermia.Methods:Multiple databases like MEDLINE, EMBASE, Cochrane library, and China journal full-text database were used to search for relevant studies, and full-text articles involved in the evaluation of MTHFR and azoospermia. The results were evaluated using STATA 12.0. Heterogeneity analysis, sensitivity analysis, and bias analysis were also performed on the data.Results:Thirteen related studies eventually met the inclusion criteria. Significant association between C677T polymorphism and azoospermia (relative risk [RR] = 0.94 [0.90, 0.99], I2 = 60.9%, P = .002), and between A1298C polymorphism and azoospermia (RR = 0.98 [0.94, 1.02], I2 = 56.3%, P = .011) was observed. Meanwhile, in subgroup analysis, Caucasians had higher risk than Mongolians in association between MTHFR and azoospermia.Conclusion:There was association between MTHFR polymorphism and azoospermia. Caucasian populations had higher risk than Mongolian populations in association between MTHFR and azoospermia.