China National Knowledge Infrastructure Research Articles

Caregiving experience of family caregivers for people with colorectal cancer: a qualitative systematic review protocol.

This review aims to synthesize the most robust evidence regarding family caregivers' experiences of caring for people with colorectal cancer (CRC). Caring for people with CRC places a significant burden on caregivers that can affect their physical and psychological well-being. Understanding the unique experiences of family caregivers is essential for developing effective support systems that enhance their well-being. This review will consider studies exploring the experiences of family caregivers caring for people with primary CRC. The studies will focus on qualitative data, including designs such as phenomenology, grounded theory, ethnography, qualitative descriptive studies, action research, feminist research, mixed methods studies, and program evaluations with embedded qualitative data. The review will follow the JBI methodology for systematic reviews of qualitative evidence. The search strategy will aim to locate published and unpublished studies, with no date or language restrictions. PubMed, CINAHL (EBSCOhost), Web of Science Core Collection, PsycINFO (EBSCOhost), Scopus, China National Knowledge Infrastructure, and Wanfang databases will be searched. The search for gray literature will include Google Scholar and ProQuest Dissertations and Theses. Two reviewers will independently select the studies, extract data, and critically appraise the methodological quality of the studies using the JBI critical appraisal checklist for qualitative research. The findings will be pooled using the meta-aggregation approach or presented in narrative format. The final synthesized findings will be graded for certainty according to the ConQual approach. PROSPERO CRD42024517472. PROSPERO CRD 42024517472.

The protective effect of dietary sphingomyelin supplementation against impaired lipid metabolism in obese mice: a systematic review and meta-analysis of randomized controlled trials

Studies have shown that sphingomyelin (SM) supplementation can improve lipid metabolism, regulate intestinal microbiota, and attenuate chronic metabolic diseases in obese mice or mice fed a high-fat diet (HFD). Therefore, we hypothesized that dietary SM supplementation benefits mice with disturbed lipid metabolism. To test our hypothesis, we conducted a meta-analysis to evaluate the effects of dietary SM supplementation on physiological indicators such as body weight, hepatic, and blood parameters in normal C57BL/6 mice or obese model mice fed a HFD. Multiple databases including PubMed, Web of Science, Cochrane Library, Embase, and China National Knowledge Infrastructure were searched to identify randomized controlled trials that were set to investigate the effects of dietary SM supplementation in obese mice fed a HFD. The search was limited to studies published between January 1, 2000, and September 30, 2024. The Cochrane bias risk assessment tool was used to evaluate and cross-check the literature quality of the included animal experiments. The meta-analysis was performed using Review Manager 5.4 software. A total of 14 articles were included in this study, and the experimental mice were divided into two categories with a total of 612 animals. One study included normal C57BL/6 mice fed a HFD, and the other studies used obese model mice. Compared with the control group, dietary SM supplementation did not affect blood SM and total phospholipids content in obese mice fed a HFD. The addition of dietary SM supplementation significantly reduced the levels of hepatic total lipids, triglyceride, total cholesterol (TC) and liver weight in both normal and obese mice, lowered intestinal cholesterol absorption, and substantially increased fecal lipid profile including total lipids, and TC levels in normal mice. Furthermore, dietary SM improved inflammatory cytokine levels and glycemic profile. The findings of this meta-analysis indicate that SM supplementation in the diet may have a protective effect against impaired lipid metabolism in obese mice. Basic research and further clinical trials are needed.

The Effectiveness of Acupressure on Sleep Quality in Cancer Patients: A Systematic Review and Meta-Analysis of Randomised Controlled Trials.

To examine the effectiveness of acupressure on sleep quality in cancer patients and to identify the population-level and intervention-level characteristics associated with the intervention outcome of sleep quality. Systematic review and meta-analysis. PubMed, EMBASE, APA PsycInfo, Web of Science, CINAHL, Cochrane Library, China National Knowledge Infrastructure and WanFang were searched for eligible randomised controlled trials from inception to April 2024. Methodological quality was assessed using the Cochrane Risk of Bias Tool for Randomised Trials 2.0. A random-effects model was used for the meta-analysis. Subgroup analyses and the meta-regression aimed to investigate potential heterogeneity and identify characteristics that may be associated with more favourable acupressure outcomes. In total, 22 randomised controlled trials involving 2113 participants were included in this meta-analysis. Compared with various control groups, acupressure exhibited a significant beneficial effect on sleep quality in cancer patients at post-intervention (SMD = -1.38, 95% CI [-1.81, -0.95], p < 0.001) and at 4-week follow-up (SMD = -0.33, 95% CI [-0.56, -0.10], p = 0.004). Acupressure also showed statistically significant improvements in sleep efficiency (SMD = 0.77, 95% CI [0.27, 1.26], p = 0.002) and total sleep time (SMD = 0.68, 95% CI [0.15, 1.22], p = 0.010) at post-intervention. None of the characteristics significantly affected the overall effect size on sleep quality. Acupressure appears to be a promising intervention for enhancing sleep quality among cancer patients. Future studies should elucidate the long-term effects of acupressure on sleep quality, identify effective acupressure characteristics and determine which types of cancer patients benefit from this intervention. This study provides a comprehensive summary of evidence supporting the use of acupressure to enhance sleep quality in cancer patients and demonstrates its effectiveness in clinical nursing practice. PRISMA 2020 statement. No Patient or Public Contribution.

Effects of multidisciplinary teamwork in non-hospital settings on healthcare and patients with chronic conditions: a systematic review and meta-analysis

BackgroundThere is evidence that multidisciplinary teams can improve health outcomes for patients with chronic conditions, enhance the quality and coordination of care, and promote teamwork among staff in hospital settings. However, their effectiveness in non-hospital settings remains unclear. Therefore, we conducted a systematic review and meta-analysis to assess the effects of multidisciplinary teams on patients with chronic conditions, health professionals, and healthcare in non-hospital settings.MethodsWe searched PubMed, Web of Science, Embase, EconLit, OpenGrey, China National Knowledge Infrastructure (CNKI), and WanFang for randomised controlled trials published before March 2025. Narrative syntheses were used to synthesise the characteristics of multidisciplinary teams, interventions, and effects. Data were statistically pooled using both random-effects and fixed-effects meta-analyses to synthesize the outcomes. The methodological quality of the included studies was assessed using Cochrane’s risk of bias tool.ResultsThirty-nine studies were analyzed, with a total of 8186 participants. Nurses, general practitioners, and specialists were the most common members of the multidisciplinary teams. Staffing models, shared care and role expansion or task shifting are the most common multidisciplinary teamwork interventions. Narrative syntheses revealed improvements in self-management, self-efficiency, satisfaction, health behaviours, and knowledge. A meta-analysis found a significant reduction in hospitalisation days for patients with chronic obstructive pulmonary disease (MD=-0.66, 95% CI -1.05 to -0.26, I2 = 0%) and significant improvement in quality of life for patients with chronic heart failure (MD=-4.63, 95% CI: -8.67 to -0.60, I2 = 0%). There is no consistent evidence of other indicators of this effect.ConclusionsMultidisciplinary teamwork can improve patient-reported outcomes for patients with chronic conditions in non-hospital settings, but the effects on clinical outcomes, health utilisation, and costs are not evident.Trial registrationThe study protocol was registered with PROSPERO on January 21, 2019, with the registration number CRD42019121109.

Optimizing Urban Environments for Sustainable Development: Strategies and Practices to Enhance Mobility Among Older Adults

Population aging is an irreversible global trend, with China experiencing an aging trajectory far exceeding that of most low- and middle-income and high-income countries. Emerging evidence highlights the urban built environment (BE) as a critical determinant of older adults’ travel behavior (TB), exerting a greater effect than commuter populations. However, findings on BE-TB associations remain inconsistent. This study systematically reviewed 46 studies from 1666 articles retrieved from Web of Science and China National Knowledge Infrastructure databases, applying CiteSpace 6.4.R1 for keyword co-occurrence and temporal clustering analysis. This review synthesizes research trends, theoretical frameworks, key determinants, and methodological approaches by integrating knowledge from multiple fields such as urban planning, transportation engineering, public health, and social policy. It provides a comprehensive perspective on how the BE influences the TBs of the aging population. This article can contribute to improving the quality of life for older adults, promoting intergenerational harmony, reducing healthcare costs, fostering economic development, and encouraging green transportation. By identifying critical gaps and future research directions, our findings offer insights to inform strategies for promoting healthy aging and sustainable urban development.

Meta analysis of the prevalence and risk factors of non-alcoholic fatty liver disease in overweight and obese children and adolescents in China

To systematically evaluate the prevalence and risk factors of non-alcoholic fatty liver disease (NAFLD) in overweight and obese children and adolescents in China. Databases including China National Knowledge Infrastructure, Wanfang Data, VIP Database, China Biomedical Literature Database, PubMed, Embase, Web of Science, and Cochrane Library were searched, from database inception to October 2024. Two researchers independently screened the literature, extracted data, and assessed the quality of the studies according to inclusion and exclusion criteria. A Meta analysis was conducted using Stata 16.0 software. A total of 42 studies involving 16 481 overweight and obese children and adolescents were included. The Meta analysis results showed that the prevalence of NAFLD among overweight and obese children in China was 43% (95%CI: 37%-48%). Factors associated with NAFLD included being male (OR=1.61, 95%CI: 1.17-2.04), increased weight (MD=10.33, 95%CI: 9.08-11.57), increased waist circumference (MD=5.49, 95%CI: 3.36-7.62), longer duration of obesity (MD=0.31, 95%CI: 0.02-0.61), higher body mass index (MD=3.11, 95%CI: 2.07-4.16), elevated fasting blood glucose levels (MD=0.17, 95%CI: 0.06-0.29), higher triglyceride levels (MD=0.32, 95%CI: 0.17-0.47), elevated total cholesterol levels (MD=0.15, 95%CI: 0.10-0.21), higher low-density lipoprotein cholesterol levels (MD=0.14, 95%CI: 0.04-0.23), increased alanine aminotransferase levels (MD=24.39, 95%CI: 18.57-30.20), increased aspartate aminotransferase levels (MD=12.49, 95%CI: 9.67-15.32), elevated serum insulin levels (MD=4.47, 95%CI: 2.57-6.36), higher homeostasis model assessment-insulin resistance (MD=0.45, 95%CI: 0.30-0.59), and elevated uric acid levels (MD=55.91, 95%CI: 35.49-76.32) (P<0.05). The prevalence of NAFLD among overweight and obese children and adolescents in China is high. Male gender, increased weight, increased waist circumference, prolonged obesity duration, higher body mass index, dyslipidemia, and elevated levels of fasting blood glucose, liver enzymes, serum insulin, homeostasis model assessment-insulin resistance, and uric acid are potential risk factors for NAFLD in this population.

Current Situation, Problems and Optimization Paths of Thesis Topic Selection in Cultural Teaching for Master’s Degree in International Chinese Language Education: An Empirical Analysis based on CNKI from 2019-2023

The topic selection of master's degree theses in cultural teaching within international Chinese language education is a significant indicator of practical and theoretical development in this field. This study uses literature analysis, data statistics, and SATI tools to analyze 727 cultural teaching theses collected by China National Knowledge Infrastructure (CNKI) from 2019 to 2023, focusing on two dimensions: topic directions (teaching objectives, content, methods, country-specific research) and types (teaching experiment reports, teaching designs, etc.). The study found that existing topics are highly concentrated on classroom practice research (67.3%), showing a prominent feature of "strong practical orientation and insufficient theoretical construction". Research methods mainly rely on empirical analysis (82.1%), but there are core problems such as homogenization of topic selection, fragmentation of country-specific research, and lack of interdisciplinary integration. Based on this, this paper proposes optimizing paths from balancing topic directions, strengthening systematic country-specific research, and integrating interdisciplinary methods to promote innovation and practicality in cultural teaching research, providing references for the professional and localized development of international Chinese language education.

Regulatory role of gut microbiota in immunotherapy of hepatocellular carcinoma.

The gut microbiota plays a role in triggering innate immunity and regulating the immune microenvironment (IME) of hepatocellular carcinoma (HCC) by acting on various signaling receptors and transcription factors through its metabolites and related molecules. Furthermore, there is an increasing recognition of the gut microbiota as a potential therapeutic target for HCC, given its ability to modulate the efficacy of immune checkpoint inhibitors (ICIs). This review will discuss the mechanisms of gut microbiota in modulating immunotherapy of HCC, the predictive value of efficacy, and the therapeutic strategies for modulating the gut microbiota in detail. We conducted a systematic literature search in PubMed, Embase, Scopus, Cochrane Library, China National Knowledge Infrastructure, and Wanfang Chinese databases for articles involving the influence of gut microbiota on HCC immunotherapy. The mechanisms underlying the effect of gut microbiota on HCC immunotherapy include gut-liver axis, tumor immune microenvironment (TIME), and antibodies. Patients who benefit from ICIs exhibit a higher abundance of gut microbiota. Antibiotics, fecal microbiota transplantation (FMT), probiotics, and prebiotics are effective methods to regulate gut microbiota. The strong connection between the liver and gut will provide numerous opportunities for the development of microbiome-based diagnostics, treatments, or prevention strategies for HCC patients.

The Status of Presenteeism Among Clinical Nurses in China: A Systematic Review and Meta-Analysis.

Background: With the evolution of healthcare, the demand for medical services is rising. Nurses, facing high workloads and job indispensability, are at risk of presenteeism due to health issues, which impairs their focus and productivity. Nursing is a high-risk, high-stress profession, and compared to other medical personnel, nurses are more susceptible to presenteeism. Presenteeism can have severe consequences for nursing staff, the quality of care, and healthcare institutions. Although previous studies have explored the prevalence of presenteeism among nurses, there are variations in reported data due to differences in regions and assessment tools, and there is a scarcity of meta-analyses specifically addressing the prevalence of presenteeism among Chinese nurses. Objectives: The study systematically assesses the incidence rate of presenteeism among nurses and evaluates the impact of various factors, including gender, marital status, department, professional title, position, education level, and employment relationship, on the incidence rate of presenteeism. Design: Systematic review and meta-analysis. Date Sources: The following databases were searched: China National Knowledge Infrastructure (CNKI), Wanfang Database, VIP Database, China Biomedical Literature Database (CBM), PubMed, Web of Science, Embase, CINAHL, and PsycINFO. The search covered all literature published before June 15, 2024. Review Methods: Researchers independently conducted all literature screening, quality assessment, and data extraction and analysis. The average scores and standard deviations of the Chinese version of the Health and Productivity Loss (SPS-6) scale were pooled using Stata 14.0 with a random-effects meta-analysis. Finally, subgroup analysis was employed to explore the sources of heterogeneity between studies. Result: In this systematic review and meta-analysis, a total of 26 studies were included, involving 12,366 clinical nurses from China. Our findings indicate that the overall average score for absenteeism was 16.48 (95% CI: 15.64-17.32). Furthermore, subgroup analysis revealed that female nurses, married nurses, those with the title of nurse practitioner, clinical nurses, those with a secondary vocational education, contract nurses, and nurses from the ICU had higher presenteeism scores. Conclusion: The level of presenteeism among clinical nurses in China is moderate. Female nurses, married nurses, those with the title of nurse practitioner, clinical nurses, nurses with a secondary vocational education, contract nurses, and those from the ICU exhibit more pronounced presenteeism. These findings may provide a theoretical basis for hospital managers to address and manage presenteeism. Registration: PROSPERO number: CRD42024557555.

Genes Affecting Cotton Fiber Length: A Systematic Review and Meta-Analysis

Cotton fiber length is an important measurement for application in the textile industry, and researchers are seeking to cultivate cotton plants with longer fibers. In this study, cotton fiber genes were systematically reviewed through meta-analysis in terms of extending and shortening fiber and the use of different research technologies for the first time. PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), and Baidu Xueshu databases were included as literature retrieval sources. A total of 21,467 articles were retrieved, and 45 articles were used in the final analysis. Data analysis was performed using RevMan 5.4 software. To shorten cotton fiber length, clustered regularly interspaced short palindromic repeats (CRISPR)-Cas9 technology was superior to virus-induced gene silencing (VIGS) technology and RNA interference (RNAi) technology [p = 0.002, MD = −1.05, 95% CI (−1.73, −0.37), Chi2 = 39.89]. To increase cotton fiber length, CRISPR-Cas9 technology had a similar effect as VIGS technology [p = 0.12, MD = −0.59, 95% CI (−1.33, −0.15), Chi2 = 0.17]. When some genes (GhLAC15, GhALDH7B4, GhMDHAR1A/GhDHAR2A, STTM-miR396b, GhMYB44, GhFP2, GhMYB7, GhKNL1, GhTCP4, GhHDA5, GhGalT1, GhKNOX6, GhXB38D, and GhBZR3) were damaged, cotton fiber length increased. Furthermore, we found that after gene interference, the fiber-shortening genes occurred more frequently than the fiber-elongating genes. Synergistic research on these genes may better promote cotton fiber elongation.

"Internet+" Mobile Application for Blood Pressure Management in Hypertensive Patients: A Meta-Analysis

Objective: To investigate the effectiveness of mobile applications in blood pressure control. Methods: Randomized controlled trials (RCTs) examining the effects of "Internet+" mobile application-based nursing interventions on blood pressure management in hypertensive patients were retrieved from five databases: China National Knowledge Infrastructure (CNKI), Wanfang, VIP, PubMed, and Embase. The search spanned up to April 7, 2024. Following literature screening, abstract review, and risk-of-bias assessment, a meta-analysis was conducted using RevMan 5.4.1 software. Results: Seven studies were included, with the following outcome measures analyzed: ① Systolic blood pressure (SBP): MD = 2.60, 98% CI (1.47, 3.73), P &lt; 0.05; ② Diastolic blood pressure (DBP): MD = 1.63, 98% CI (0.52, 2.75), P &lt; 0.05; ③ Medication adherence: SMD = 0.36, 98% CI (0.21, 0.51), P &lt; 0.05. Conclusion: "Internet+" mobile healthcare nursing interventions significantly improve blood pressure management outcomes in hypertensive patients, enhance medication adherence, and promote better blood pressure control.

Enhanced recovery after surgery or fast-track surgery and the perioperative period of acute gastrointestinal perforation: a systematic review and meta-analysis

BackgroundReports of an association between enhanced recovery after surgery (ERAS) or fast-track surgery (FTS) and the perioperative period of acute gastrointestinal perforation are inconsistent. Therefore, we systematically evaluate the safety and efficacy of ERAS or FTS in the perioperative of acute gastrointestinal perforation.MethodsRandomized controlled trial (RCT) or controlled clinical trial (CCT) on the application of ERAS/FTS in the perioperative management of acute gastrointestinal perforation was conducted by PubMed, Medline, Web of Science, Ovid, Elsevier ScienceDirect, Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Database (CBM), Wanfang Data, and WHIP. The methodology quality and data extraction were evaluated by two researchers, and meta-analysis was performed by Stata 11 software.ResultsA total of 20 RCTs and 7 CCTs were included in the study, involving 1,864 patients—917 in the ERAS/FTS group and 947 in the control group. The results of the meta-analysis showed that the stress response CRP and complication rate of the ERAS/FTS group were significantly lower than those of the traditional treatment group, the time of first out-of-bed activity and the time of postoperative first exhaust and eating were advanced, and the cost and the length of hospital stay were decreased (p &amp;lt; 0.05). Egger's test showed no publication bias (p &amp;gt; 0.1). However, only two and three studies mentioned operative time and pain management, respectively, so the meta-analysis could not be performed.ConclusionThe application of ERAS/FTS in perioperative management of acute gastrointestinal perforation is safe and effective.

Differences in depression prevalence among older adults in China before and during the COVID-19 pandemic: a systematic review and meta-analysis.

Changes in the prevalence of depression during the COVID-19 (Coronavirus disease 2019) pandemic among older adults in China have not been systematically evaluated. We aimed to systematically summarize existing evidence to conduct a meta-analysis to quantify changes in the prevalence of depression before and during the COVID-19 pandemic. The PubMed, Web of Science, Scopus, Embase, PsycINFO, China National Knowledge Infrastructure (CNKI), WangFang Data, CQVIP, and China Biology Medicine disc (CBMdisc) databases were searched from January 1, 2017, to November 20, 2024. Studies reporting the prevalence of depression among Chinese individuals aged 60 or older using validated diagnostic tools were included. A random-effects model was applied to estimate pooled prevalence, with subgroup analyses performed by demographic and socio-economic factors. Relative risks (RR) were calculated to compare prevalence across different pandemic stages. A total of 101 studies involving 264,758 participants were included. The pooled prevalence of depression among older adults was 25.8% (95% CI [21.7-29.9]) from 2017-2019 and 23.8% (95% CI [19.8-27.8]) from 2020-2023. During the early pandemic stage (January-April 2020), prevalence significantly decreased (RR = 0.849, P<.001) but increased in later stages, reaching 24.4% by 2021-2023. The prevalence of depression among older adults during the COVID-19 pandemic showed a significant increasing trend (P trend <.001). Subgroup analyses revealed higher prevalence among females, rural residents, individuals with lower education levels, and those living alone. Depression prevalence among older adults in China decreased during the early pandemic response but showed an increasing trend over time, reflecting the complex mental health impact of prolonged public health measures. Effective interventions are needed to address the specific needs of vulnerable subgroups during and beyond public health crises.

Global Prevalence and Distribution of H9 Subtype of Avian Influenza Viruses in Wild Birds: Literature Review with Meta-Analysis.

Background: As a natural accelerator of highly pathogenic avian influenza in wild birds, the H9 subtype of avian influenza poses a substantial threat to both humans and the poultry industry. A comprehensive meta-analysis is necessary to assess the current status of the global H9 outbreak. In this research, a literature review and meta-analysis are presented on the surveillance studies of the H9 subtype of avian influenza in wild birds worldwide up to 2024. Methods: A comprehensive search strategy was employed, utilizing the China Science and Technology Journal Database, China National Knowledge Infrastructure, PubMed, Google Scholar, and Scientific Direct databases. The exclusion criteria for this study included duplicate studies, reviews, other host studies, as well as research with inconsistent or insufficient data. An analysis was conducted on data obtained from a total of 31 publications. The rate-conversion analyses were conducted using a random-effects model in the "meta" package of the "R" software, with the PFT method implemented. Results: In the meta-analysis, the prevalence of wild bird H9 avian influenza virus (AIV) was found to be 0.02% (193 out of 365,972). Statistically significant higher prevalences of wild bird influenza A virus were observed in Norway and South Africa (0.87%, 21/2417 and 0.44%, 10/1155, respectively) in comparison with other regions. Within the Anseriformes family, the prevalence rate was much greater (0.17%, 80 out of 90,014) compared with other species. In addition, we performed subgroup analyses that included geographical variables. These assessments showed a higher prevalence of H9 in wild birds in cold regions (0.08%, 30/100,691). Conclusion: In summary, our results suggest that the occurrence of H9 AIV in avian populations differs among different geographical areas and species. Therefore, it is necessary to conduct further surveillance on the prevalence of AIV in wild birds to guide the creation of strong and efficient regulatory strategies targeted at eradicating the transmission of AIV across different species.

Coordinates-based meta-analysis for vestibular migraine and the underlying mechanisms behind it

BackgroundVestibular migraine (VM) is a leading cause of recurrent vertigo episodes. Voxel-based morphometry (VBM) is a reliable technique to analyze structural changes, particularly in gray matter (GM) volume, across various neurological conditions. Despite the growing amount of neuroimaging data in recent decades, a comprehensive review of GM alterations in VM remains lacking.MethodsWe conducted a systematic review of three English-language databases (PubMed, Embase, and Web of Science) and two Chinese-language databases (China National Knowledge Infrastructure and Wanfang) to evaluate existing neuroimaging data on GM volume in VM patients. A coordinate-based meta-analysis (CBMA) was performed using the latest algorithm, seed-based d mapping with permutation of subject images (SDM-PSI), to identify brain alterations across individual studies.ResultsFive studies (103 VM patients, 107 HCs) were included. The CBMA demonstrated a significant reduction in GM volume in VM patients compared to HCs, with peak convergence in the left rolandic operculum (SDM-Z = −3.68, p-corrected = 0.004, voxels = 629; Brodmann area 48), extending to the posterior insula. Heterogeneity across studies was low (I2 = 19.35%), and no publication bias was detected (Egger’s test: p = 0.826).ConclusionThis meta-analysis confirms reliable GM volume alterations in the posterior insula–operculum region of VM patients. Longitudinal studies with standardized imaging protocols are needed to clarify whether these changes are causes or consequences of VM.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42021277684.

Examining the effect of Kuntai capsule combined with HRT in the treatment of premature ovarian insufficiency: A systematic review and meta?analysis.

While Chinese herbal medicines have been used to treat premature ovarian insufficiency (POI), their efficacy is currently unclear. The present study aimed to review and evaluate the efficacy of the Kuntai capsule combined with hormone replacement therapy (HRT) in treating POI. The China National Knowledge Infrastructure, WanFang, Chinese Biomedical Literature, PubMed, Embase and Cochrane Library databases were searched from the inception of the database to 25th October 2020, for studies comparing the therapeutic effect of Kuntai capsule combined with HRT vs. HRT alone in women with POI. The Cochrane Risk of Bias assessment tool was used to assess the quality of the studies, and the results were reported as weighted mean differences (MD) with 95% confidence intervals (CI). The present study included 10 trials involving 742 women with POI. When compared with HRT alone, HRT combined with Kuntai capsule significantly increased the number of antral follicles (AFC) (MD=0.88; 95% CI, 0.48-1.29; P<0.00001), anti-Müllerian hormone (AMH) levels (MD=0.24, 95% CI, 0.13 to 0.35, P<0.00001) and significantly improved peri-menopausal symptoms [MD=-2.26; 95% CI, -3.77-(-0.75); P=0.003]. The combined treatment regimen significantly decreased the levels of follicle-stimulating hormone [MD=-5.60; 95% CI, -7.98-(-3.22); P<0.00001] and luteinizing hormone [MD=-2.42; 95% CI, -3.40-(-1.44), P<0.00001] and significantly increased the level of estradiol (MD=13.94; 95% CI, 4.16-23.71; P<0.00001). Therefore, the Kuntai capsule combined with HRT could potentially be used as a supplementary therapy to alleviate menstrual disorders and peri-menopausal symptoms and improve serum sex hormone levels in women with POI. The observed increase in the number of AFC in patients with POI treated with the combined therapy was indicative of improved ovarian reserve function. Therefore, combining the Kuntai capsule and HRT had am improved curative effect for POI treatment compared with HRT alone. However, as the present study was limited by the quality of the included reports, additional high-quality studies with extensive sample sizes are required to verify the findings.

Efficacy of acupuncture-related therapy for postmenopausal osteoporosis: a systematic review and network meta-analysis based on randomized controlled trials

IntroductionTo compare and analyze the clinical effects of acupuncture-related therapies for postmenopausal osteoporosis (PMOP) and propose the optimal scheme, we utilized a network meta-analysis to evaluate the therapeutic effects of various commonly used acupuncture methods for PMOP.MethodsRandomized controlled trials of acupuncture-related therapies for PMOP were searched in eight databases (PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, China Science and Technology Journal Database, China Biomedical Literature Database, and Wanfang database) from January 1, 2002 to December 31, 2023. Our primary outcomes included overall clinical effectiveness rate, bone mineral density (BMD), and visual analog scale scores (VAS). The secondary outcome is adverse events. The entire process of literature screening and data analysis was conducted by 2 independent investigators.ResultsA total of 30 studies with 2,342 participants provided data suitable for analysis. We compared six interventions: manual acupuncture, electroacupuncture, acupoint catgut embedding, moxibustion, acupoint application, and warm acupuncture. The results of the network meta-analysis revealed that, when compared to conventional Western medication (CWM), multiple acupuncture therapies had a greater impact on the overall clinical effectiveness rate. Electroacupuncture combined with CWM demonstrated superior clinical effectiveness and lumbar spine BMD improvement. Moxibustion with CWM ranked highest for femoral neck BMD, while warm acupuncture showed optimal effects on Ward’s triangle and trochanter BMD. Acupoint catgut embedding provided the greatest pain reduction. The most prevalent minor adverse effects included hematoma, discomfort, and scorching.ConclusionThe results suggest that several acupuncture-related therapies, either alone or in conjunction with CWM, outperform CWM alone and may be regarded as an alternative or supplementary therapy to PMOP, though higher-quality trials are needed.

A Systematic Review of risk factors for major adverse cardiovascular events in patients with coronary heart disease who underwent percutaneous coronary intervention

ObjectiveThis study aims to systematically review the risk factors for major adverse cardiovascular events (MACE) in patients with coronary heart disease who have undergone percutaneous coronary intervention (PCI).DesignSystematic review and meta-analysis.Data sourcesThe Cochrane Library, PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Database, and VIP Database for Chinese Technical Periodicals (VIP) were screened until December 2024.Eligibility criteria for selecting studiesCase-control studies or cohort studies on the risk factors for MACE in patients with coronary heart disease who underwent PCI. Data extraction and synthesis: The literature review, data extraction, and quality evaluation were conducted by two independent researchers, and the meta-analysis was performed using RevMan 5.4 software.Main outcomesThe main outcome was that MACE occurred during the follow-up period.ResultsA total of 40 articles were included. The meta-analysis erevealed that dyslipidemia (OR = 1.50; 95% CI [1.19, 1.89], p = 0.0007), diabetes mellitus (OR = 1.70; 95% CI [1.43, 2.02], p &amp;lt; 0.00001), hypertension (OR = 1.62; 95% CI [1.35, 1.96], p &amp;lt; 0.0001), history of smoking (OR = 2.08; 95% CI [1.51, 2.85], p &amp;lt; 0.0001), poorer ventricular function (OR = 2.39; 95% CI [2.17–2.64], p &amp;lt; 0.0001), impaired left ventricular ejection fraction (LVEF) (OR = 1.86; 95% CI [1.71–2.03], p &amp;lt; 0.0001), door to balloon (D-to-B) time (OR = 0.61; 95% CI [0.42–0.88]; p = 0.009), thrombolysis in myocardial infarction (TIMI) (OR = 1.41; 95% CI [1.17, 1.70], p = 0.0004), renal dysfunction (OR = 1.82; 95% CI [1.37, 2.43], p &amp;lt; 0.0001), and multi-vessel coronary artery disease (OR = 0.41; 95% CI [0.37, 0.46], p &amp;lt; 0.0001) were significantly associated with MACE after PCI.ConclusionThe independent risk factors of MACE after PCI are dyslipidemia, hypertension, diabetes mellitus, smoking history, Killip class &amp;gt; II, LVEF ≤40%, D-to-B time &amp;gt;90 min, TIMI flow grade ≤ II, renal insufficiency, and multivessel disease.

Off-label use of sodium cantharidinate and vitamin B6 injection in cancer: a protocol for a systematic review and meta-analysis

BackgroundIn China, sodium cantharidinate/vitamin B6 (SC/VB6) injection has been approved since 2002 for the treatment of lung cancer and primary liver cancer. In addition to these authorized indications, clinical application of SC/VB6 is also common in various other types of cancer. However, there is a lack of comprehensive understanding on this topic. Thus, this systematic review and meta-analysis aims to consolidate evidence regarding the efficacy and safety of off-label use of SC/VB6 in oncology.MethodsInternational databases including PubMed, Embase, Cochrane Library, Web of Science, and CINAHL Plus, as well as Chinese databases including China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), and Wanfang, will be searched from the inception to 31 December 2024. Comparative studies that evaluated the add-on effect of SC/VB6 to conventional cancer treatments against the use of conventional treatments alone will be considered in the scope of this review. The primary outcomes are objective response rate and performance status. Secondary outcomes are disease control rate (DCR), progression-free survival (PFS), disease-free survival (DFS), overall survival (OS), and adverse events (AEs). Depending on heterogeneity, data will be synthesized using either the Mantel–Haenszel fixed-effect or the DerSimonian and Laird random-effect model. Subgroup analyses will be conducted for the following variables: type of cancer, study design, SC/VB6 dosage, treatment duration, and combined therapies, provided that each subgroup contains at least two studies. Sensitivity analyses will be performed on efficacy outcomes. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) will be utilized to appraise the overall quality of evidence.DiscussionThis review will encompass both randomized controlled trials (RCTs) and cohort studies, thereby enabling us to synthesize and assess evidence across experimental and real-world observational settings. Our findings will contribute to a better understanding on the benefit-risk profile regarding the off-label use of SC/VB6 in oncology, guiding the trajectory of future research, and offering a robust scientific foundation to inform clinical and regulatory decision-making process.Systematic review registrationPROSPERO CRD42024504977.

A meta-analysis of the influence of traditional Chinese exercises on cognitive function in the elderly

BackgroundThis study seeks to assess the impact of traditional Chinese exercises (Tai Chi, Baduanjin, Yijinjing, Wuqinxi, and Liuzijue) on cognitive function in older adults through a systematic review and meta-analysis. It examines their effects on global cognitive performance, as well as specific cognitive domains, providing robust evidence to support the enhancement of cognitive function in the elderly.MethodsA thorough search was executed across eight key databases, including PubMed, Embase, Cochrane Library, EBSCO, Web of Science, Wanfang Data, the Chinese Science and Technology Journal Database, and China National Knowledge Infrastructure. The quality of the studies that met the inclusion criteria was assessed using the Cochrane Collaboration tool for evaluating risk of bias. Data synthesis was performed using Review Manager 5.4, where pooled intervention outcomes were expressed as mean differences (MD) alongside their 95% confidence intervals (CI). Additional sub-group analysis was conducted to explore potential factors contributing to heterogeneity.ResultsThis systematic review and meta-analysis evaluated data from 29 randomized controlled trials, encompassing a total of 2,489 participants. The results demonstrate that traditional Chinese exercises substantially improve language abilities (Category Verbal Fluency: MD = 0.90, 95% CI: 0.38 to 1.41), executive function (TMT B: MD = −13.70, 95% CI: −16.06 to −11.35), short-term memory (MD = 0.85, 95% CI: 0.42 to 1.29), and long-term delayed recall (MD = 1.39, 95% CI: 0.72 to 2.06). Sub-group analysis indicated that baseline cognitive function plays a critical role in determining the effectiveness of the intervention. Patients with cognitive impairment derive significantly greater benefits from traditional Chinese exercise interventions than those with normal cognitive function.ConclusionThis study found that the traditional Chinese exercises can enhance cognitive function in the elderly, particularly in those with mild cognitive impairment. The effects of traditional Chinese exercises differed across various cognitive domains, indicating that when utilizing traditional Chinese exercise as an intervention, it is crucial to consider the specific cognitive status of the patient to design precisely tailored intervention strategies.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42024535287, identifier [CRD42024535287].