Chinese Journal Full-text Database Research Articles

Effects of lanthanum carbonate and calcium carbonate on cardiovascular calcification in hemodialysis patients: A systematic review and meta-analysis.

This paper was written to systematically review and meta-analyze the evidence on the efficacy of lanthanum carbonate (LC) and calcium carbonate (CC) and the risk of cardiovascular calcification on hemodialysis (HD) patients. The Cochrane library, PubMed, Web of Science, Chinese journal full-text database (CNKI), WANGFANG DATA, and Sino Med were searched between January 1946 and December 2020. The literature with respect to the randomized controlled clinical trial comparing LC and CC in HD patients was selected. The main outcomes include coronary artery calcification score (CACS), cardiovascular events, and serum phosphorus (mmol/L). The statistical program used for meta-analysis was Stata V14.0. Of 388 original titles screened, data was extracted from 9 studies (625 participants). LC can significantly reduce the progression of coronary artery calcification compared to CC (standardized mean deviation (SMD) = -0.59, 95% CI: -0.94 to -0.25, p < 0.01). The LC group had lower serum phosphorus levels (SMD = -1.35, 95% CI: -2.33 to -0.36, p < 0.01), lower serum calcium levels (SMD = -1.03, 95% CI: -1.83 to -0.23, p = 0.012), and lower fibroblast growth factor 23 (FGF-23) level (SMD = -4.80, 95% CI: -7.96 to -1.64, p = 0.003) than the CC group. The Egger regression test of CACS showed no potential publication bias (p = 0.72). Compared with CC, LC can significantly delay the process of coronary artery calcification, and at the same time reduce patients' serum phosphate, serum calcium, and FGF-23. Therefore, we recommend LC as a phosphorus-lowering drug for HD patients.

Systematic review and meta-analysis of traditional Chinese medicine compound in treating infertility caused by endometriosis.

To perform meta-analysis to investigate the efficacy and safety of traditional Chinese medicine (TCM) compound in the treatment of endometriosis (EMS)-induced infertility. The databases of PubMed, Embase, Cochrane Library, Chinese Journal Full-text Database (CNKI), VIP, Wanfang Science and Technology Journal Full-text Database, and Chinese Biomedical Literature (CBM) were used to search for articles on the treatment of EMS-induced infertility with TCM compound from database establishment to September 2021. Endnote X9 software was used to screen the articles. Stata 15.1 and RevMan 5.3 software were used to record the data, and a meta-analysis was performed on the effective rate, pregnancy rate, abortion rate, incidence of adverse reactions, luteinizing hormone (LH) level, and estradiol (E2) level of TCM compound in the treatment of EMS-induced infertility. Finally, the reliability of the results was assessed by sensitivity analysis. A funnel plot was used to evaluate the publication bias of the articles. A total of 11 articles were included. Meta-analysis showed that when TCM compound was used to treat EMS-induced infertility, the effective rate of the trial group was significantly higher than that in the control group [odds ratio (OR) =1.26; 95% confidence interval (CI): 1.00 to 1.60; P=0.049], and the difference was statistically significant; the pregnancy rate of the trial group was significantly higher than that in the control group (OR =1.94; 95% CI: 1.50 to 2.50; P<0.05), and the difference was statistically significant; the abortion rate of the trial group was significantly lower than that in the control group (OR =0.16; 95% CI: 0.06 to 0.48; P=0.01), and the difference was statistically significant; and the incidence of adverse reactions in the trial group was not significantly different from the control group (OR =0.48; 95% CI: 0.17 to 1.34; P=0.162); the LH level of the trial and control group [standardized mean difference (SMD) =0.51; 95% CI: -1.73 to 2.75; P=0.658], and the E2 level (SMD =1.65; 95% CI: -0.77 to 4.07; P=0.182) had no statistical difference. Chinese herbal compound is effective in the treatment of endometriotic infertility and has a positive effect on improving the pregnancy rate.

Clinical efficacy and safety of removing blood stasis and removing phlegm in the treatment of epilepsy with cognitive impairment: A protocol for systematic review and meta-analysis.

Background:Epilepsy is a chronic encephalopathy caused by abnormal discharge of neurons in the brain, resulting in brain dysfunction. Cognitive impairment is one of the most common complications of epilepsy. The current treatment of epilepsy in the control of symptoms at the same time cause a lot of side effects, especially the aggravation of cognitive impairment. Many literatures have stated that the efficacy and safety of integrated traditional Chinese and western medicine in the treatment of epilepsy with cognitive impairment is superior to that of western medicine alone. In this systematic review, we intend to evaluate the clinical efficacy and safety of removing stasis and resolving phlegm in the treatment of epilepsy with cognitive impairment.Methods:We will search The Cochrane Library, EMbase, Pubmed, Web of Science, Chinese Journal Full-Text Database (CNKI), Wanfang Database, and VIP database. Simultaneously we will retrieval relevant meeting minutes, eligible research reference lists, symposium abstracts, and gray literatures. We will not apply any restrictions to the language and publication date. All randomized controlled trials about the efficacy and safety of removing blood stasis and phlegm in the treatment of epilepsy with cognitive impairment will be included. Two authors will independently carry out. Any objections will be worked out by a third author through consultation. We will use the Revman 5.3 and Stata 13.0 software for data synthesis, sensitivity analysis, meta regression, subgroup analysis, and risk of bias assessment. The grading of recommendations assessment, development, and evaluation standard will be used to evaluate the quality of evidence.Results:This systematic review will synthesize the data from the present eligible high quality randomized controlled trials to assess whether the treatment of removing blood stasis and phlegm is effective and safety for epilepsy with cognitive impairment from various evaluation aspects including clinical efficacy of epilepsy, EEG improvement rate, MOCA score, QOLIE-31 cognitive function score, traditional Chinese medicine symptom score, incidence of adverse reactions, frequency of seizures of epilepsy, and duration of seizure of epilepsy.Conclusion:The systematic review will provide evidence to assess the efficacy and safety of removing blood stasis and phlegm in the treatment of patients with epilepsy with cognitive impairment.PROSPERO registration number:CRD42021224893.

Efficacy and safety of probiotics in the induction and maintenance of inflammatory bowel disease remission: a systematic review and meta-analysis.

Probiotics have been widely used in the treatment of inflammatory bowel disease (IBD) due to their special conditioning effects on the intestinal flora, but their efficacy in inducing and maintaining remission is still controversial. In the present study, we analyzed randomized controlled trials (RCTs) on the treatment of probiotics in IBD to systematically evaluate the efficacy of probiotics on the induction and maintenance of remission of IBD. PubMed, Cochrane Central Register of Controlled Trials, Embase, Web of Science, Chinese Journal Full-text Database, Chinese Biomedical Literature Database, Wanfang, and Weipu databases were searched for RCTs on the treatment of probiotics in IBD induction and/or maintenance of remission. Two researchers independently extracted literature data and cross-checked the extracted data. The Cochrane bias risk assessment tool and the Jadad score were used to evaluate the quality of the literature. RevMan 5.20 software was used for the meta-analysis. A total of ten RCTs were included, which included 777 patients with ulcerative colitis (UC) and Crohn's disease (CD). Meta-analysis showed that there was no significant difference between the clinical recurrence rate of probiotics in the CD remission phase and the control group [relative risk (RR): 0.80, 95% confidence interval (CI): 0.61-1.06, P=0.12]. The clinical recurrence rate of UC in remission phase, the efficacy of probiotics compared with control group were not significantly different (RR: 1.07, 95% CI: 0.80-1.42, P=0.65). The induction remission rate of UC during the active phase, the efficacy of probiotics is better than that of the control group (RR: 1.47, 95% CI: 1.09-1.98, P=0.01). In the present study, a systematic analysis of the efficacy of probiotics in CD and UC found that probiotics can induce remission during the active period of UC, but have no obvious therapeutic advantage in maintaining CD and UC remission.

Arthroscopic surgery combined with platelet-rich plasma for meniscus injury:a Meta analysis

To evaluate clinical efficacy of arthroscopic with platelet-rich plasma (PRP) in treating meniscus injury. From January 2015 to December 2019, clinical control study on repair meniscus injury by arthroscopic with PRP between arthroscopic were searched by PubMed, Science Direct, Cochrane library, Chinese Journal Full-text Database, Wanfang and VIP database. Literature screening, data extraction and quality evaluation according to inclusion and exclusion criteria. Visual analogue scale(VAS) of knee joint and Lysholm score at 1, 6 and 12 months after opertaion between two groups were compared, and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) at 3, 6 and 12 months after opertaion between twogroups were also compared. Totally 9 literatures and 329 patients with meniscal injuries were screened, include 146 patients treated by arthroscopic with PRP and 183 patients treated by arthroscopic. There were no statistical differences in VAS between two groups at 1, 6 and 12 months after opertaion. There were differences in Lysholm score at 1 and 6 months after operation between two groups [MD=3.85, 95%CI (1.25, 6.44), P<0.05], [MD=2.88, 95%CI (0.13, 5.63), P<0.05];while there was no difference at 12 months[MD=5.88, 95%CI(-8.72, 20.48), P=0.43]. There were differneces in WOMAC score at 3 and 6 months after operation between two groups[MD=-8.07, 95%CI(-11.17, -4.89), P<0.000 01], [MD=-7.96, 95%CI(-11.44, -4.48), P<0.000 01];and no difference at 12 months after operation[MD=-6.61, 95%CI (-16.64, 3.41), P>0.05]. Arthroscopic with PRP for repair meniscus injury has short term efficacy of knee function and delay arthritis, while has similar effect in long term clinical efficacy and relieve pain.

Reproductive Health in First-degree Relatives of Patients With Polycystic Ovary Syndrome: A Review and Meta-analysis

Polycystic ovary syndrome (PCOS) is a highly heritable disease. Emerging evidence elucidated the elevated prevalence of reproductive abnormalities in first-degree relatives (FDRs) of patients with PCOS. To explore the reproductive health in FDRs of patients with PCOS. Ten databases were searched in December 2020 (PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, Chinese Biological Medical Literature, Chinese National Knowledge Infrastructure, Chinese Journals Full-text Database, WanFang, and World Health Organization international clinical trials registry platform). This study included cohort, case-control, or cross-sectional studies. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement was followed. Dichotomous data from each of the eligible studies were combined by the Mantel-Haenszel model. Standard mean differences with 95% CIs were assessed. Heterogeneities were assessed using I2 statistics, and the quality of evidence was evaluated by a US Agency for Healthcare Research and Quality Evidence-based Practice Center program and Grading of Recommendations, Assessment, Development and Evaluation approach. Thirty-eight studies were included. The prevalence of PCOS (0.22; 95% CI, 0.16 to 0.29), menstrual irregularities (0.28; 95% CI, 0.22 to 0.34, P < .01), and ovary morphological changes were elevated in female PCOS FDRs. Female FDRs also presented with increased levels of luteinizing hormone, total testosterone (standard mean difference, 0.53; 95% CI, 0.28 to 0.78, P < .01), unconjugated testosterone, free androgen index, dehydroepiandrosterone sulfate (DHEAS), and antimüllerian hormone levels. Subgroup analyses indicated that some of these changes begun in pubertal girls. Furthermore, fathers of PCOS patients had a higher risk of premature baldness. The DHEAS level was elevated in male FDRs. The findings of this analysis suggested that FDRs of patients with PCOS suffered from reproductive endocrinological dysregulations. Thus, more attention should be focused on this population.

Systematic review of the epidemiological characteristics of inhalation injury in burn patients in China

Objective: To study the epidemiological characteristics of inhalation injury in burn patients in China. Methods: The systematic review method was performed. Chinese Journal Full-text Database, Wanfang Database, and Chinese Biomedical Literature Database were searched with the Chinese search terms of ", , ", and PubMed and Embase were searched with the search terms of "burns, inhalation injury" to retrieve the collected retrospective studies on the epidemiological characteristics of inhalation injury in burn patients in China from the establishment of each database to January 2019. Data were extracted from the included articles, including the first author, study institution, study period, study subjects, number of burn patients, incidence of inhalation injury, and gender, age, causes of injury, mortality, and causes of death in patients with inhalation injury. Results: A total of 24 articles were included in this study with the first authors being from multiple research institutions across the country. The articles reported single or multi-center epidemiological studies with statistics on the incidence of inhalation injury in burn patients or severe burn patients admitted to key burn treatment institutions in many provinces/cities in China from 1958 to 2016. The number of burn patients included was 103-64 320 cases in the studies, and the incidence of inhalation injury in hospitalized burn patients ranged from 4.89% to 11.28%, with no obvious trend. The incidence of inhalation injury in severe burn patients was still high, from 19.09% to 32.38% as most articles reported. The number of men with inhalation injury was larger than that of women, with a male-to-female ratio of 1.61 ∶1.00-4.95 ∶1.00; young and middle-aged people were the high-risk population, and flame burn was the main cause of injury. The mortality of patients with inhalation injury was 5.17%-58.67%, of which the mortality was 5.17%-24.75% since 2000, in accordance with reports from hospitals in various regions that the mortality in the later period decreased significantly compared with the previous period. The causes of death in patients with inhalation injury included upper respiratory tract obstruction, sepsis, respiratory failure, and severe pulmonary infection. Conclusions: From 1958 to 2016, there is no obvious trend in the incidence of inhalation injury among burn patients in China; the incidence of inhalation injury is high in young and middle-aged males, and the main cause of inhalation injury is flame burn. The mortality of inhalation injury generally decreased since 2000 compared with the previous period.

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.

The Impact of Subclinical Hypothyroidism on Patients with Polycystic Ovary Syndrome: A Meta-Analysis.

The association between subclinical hypothyroidism (SCH) and polycystic ovary syndrome (PCOS) has been shown in many studies. These findings are still controversial, however. It is unclear whether the co-incidence of subclinical hypothyroidism and polycystic ovary syndrome will affect the severity of metabolism. Therefore, we performed this meta-analysis to investigate the association. A comprehensive search strategy was developed to obtain all relevant studies published in PubMed, EMBASE, Cochrane Library, and Chinese Academic Journal Full-text Database (CNKI) up to 31 December 2020. We adopted the standardized mean difference (SMD) with 95% confidence intervals (CI) for evaluation, and sensitivity analysis was performed. Publication bias was analyzed and represented by a funnel plot, and funnel plot symmetry was assessed with Egger's test. Twenty-seven studies with 4821 participants (1300 PCOS patients with SCH, 3521 PCOS patients without SCH) were included in the present meta-analysis,among which 71.31% chinese patients out of the total. The results showed that PCOS patients with SCH had higher levels of HOMA-IR, TG, TC, LDL, FBG, FCP, PRL and lower levels of HDL, LH and T. It also recognized the limitation of the lack of a consistent definition of hypothyroidism in the 27 studies included. The results of this study indicated that SCH may aggravate lipid and glucose metabolism in patients with PCOS.

MO585EFFECTS OF LANTHANUM CARBONATE AND CALCIUM CARBONATE ON CARDIOVASCULAR CALCIFICATION IN HEMODIALYSIS PATIENTS: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract Background and Aims Commonly used phosphorus-lowering drugs include calcium-containing phosphate-binding agents and non-calcium-containing phosphate-binding agents, the latter mainly including lanthanum carbonate (LC). In recent years, some studies have explored the effect of lanthanum carbonate compared with calcium carbonate on serum calcium. However, the results are different. Therefore, we conducted this review to systematically review and meta-analyze evidence on the efficacy of lanthanum carbonate and calcium carbonate (CC) and the risk of cardiovascular calcification in hemodialysis (HD) patients, and to provide reference for phosphorus-lowering drugs in HD patients. Method The Cochrane library, PubMed, Web of Science, Chinese journal full-text database (CNKI), WANGFANG DATA and Sino Med were searched between January 1946 and December 2020. The literatures with respect to the randomized controlled clinical trial comparing lanthanum carbonate and calcium carbonate in HD patients were selected. The two evaluators independently collected the data according to the retrieval strategy, screened the literatures according to the inclusion criteria and exclusion criteria, and summarized the literatures that met the criteria. The risk ratio (RR) and 95% confidence interval (CI) were used to represent the counting data. The standard deviation from mean (SMD) and 95%CI were used to represent the continuous variables. Forest plots, sensitivity analysis, Egger regression test and TSA were used to summarized the test performance characteristics. Results Of 388 original titles screened, data was extracted from 9 studies included 625 participants (Table 1). There was moderate-certainty evidence from 9 trials (625 participants) that LC can significantly reduce the progression of coronary artery calcification than CC (SMD= -0.59, 95%CI -0.94 to -0.25, P&amp;lt; 0.01) (Figure 2). The serum phosphorus level in the LC group was significantly lower than that in the CC group (SMD= -1.35, 95%CI: -2.33 to -0.36, P&amp;lt; 0.01), and the serum calcium level was significantly reduced (SMD= -1.03, 95% CI: -1.83 to -0.23, P= 0.012). The fibroblast growth factor 23 (FGF-23) level in the LC group was significantly lower than that in the CC group (SMD= -4.80, 95%CI: -7.96 to -1.64, P= 0.003). The Egger regression test of coronary artery calcification score (CACS) showed no potential publication bias (P= 0.72). Conclusion In this systematic review, compared with calcium carbonate, lanthanum carbonate can significantly delay the process of coronary artery calcification, and at the same time reduce the patient's serum phosphate, serum calcium and FGF-23. Therefore, we recommend LC as phosphorus-lowering drugs for HD patients.

Acupuncture Treatment for Cough-Variant Asthma: A Meta-Analysis

Background In recent years, there have been many clinical reports on acupuncture treatment of cough-variant asthma, but no researcher has objectively analysed and evaluated the efficacy and safety of acupuncture treatment of cough-variant asthma from the perspective of evidence-based medicine. Objective To systematically evaluate the clinical efficacy and safety of acupuncture in treating cough-variant asthma and to provide reference values for clinical decision-making. Methods The comprehensive computer retrieval Chinese journal full-text database (CNKI), Chinese science and technology periodical database (VIP), ten thousand data knowledge service platform (WanFang Data), PubMed, Embase, and the Cochrane Library were used to collect literature for relevant randomized controlled trials (RCT) of acupuncture treatment of cough-variant asthma, as well as to retrieve papers and add reference retrieval after literature review, in accordance with the standard of literature filtering, data extraction, and quality evaluation. The data were meta-analysed using ReviewManager5.3 software recommended by Cochrane. Results A total of 11 randomized controlled clinical studies were screened and included, comprising 929 patients. The results of the meta-analysis showed that, compared with the control group, acupuncture intervention on CVA could enhance the total clinical effectiveness rate, reduce the relapse rate of drug withdrawal, relieve symptoms of cough, phlegm, and diaphragmatic congestion, and improve lung function-related indicators and immune inflammation indicators. There were statistically significant differences in all efficacy evaluation criteria. Conclusion The clinical curative effect of acupuncture treatment for cough-variant asthma is precise and has certain advantages in relieving symptoms and reducing the recurrence rate. However, the low quality of the evaluation in the RCT research literature is a problem, and more high-quality clinical randomized controlled trials are needed to further verify the comprehensive clinical efficacy and safety of this treatment. Registration number: PROSPERO (no. CRD42020155244) (https://www.crd.york.ac.uk/prospero/).

Clinical efficacy and safety of modified Sijunzi decoction for the treatment of ulcerative colitis: A protocol for a systematic review and meta-analysis.

Background:Ulcerative colitis (UC) is a chronic non-specific intestinal inflammatory disease with unknown etiology. In recent years, the global incidence has been increasing. Sijunzi decoction (SJZD) is a traditional Chinese medicine that has been used for treatment of other diseases in previous studies as it has no side effects and it has a pharmacological effect in gastrointestinal function, immune system, ulcers, and tissue repair.Methods:PubMed, Embase, Cochrane Library, GeenMedical, China National Knowledge Infrastructure, Chinese Sci-tech Journals full-text Database, Chinese Biomedical Database, and Chinese Science Citation Database were searched to screen the related literatures of “ulcerative colitis” and “Jiawei Sijunzi decoction”. The research data extracted from above studies was analyzed by Review Manager 5.3 and Stata14.2 software.Results:This systematic review and meta-analysis will evaluate the efficacy and safety of Jiawei SJZD in the treatment of UC and provide effective evidence for clinical use.Conclusion:In this study, the published evidence of modified SJZD in the treatment of UC was systematically summarized and evaluated, so that it can be better applied in clinic.INPLASY registration number:INPLASY2020100102

Research on biological movement rehabilitation characteristics of human tendon based on biodegradable nano-biomaterials

Objective: This paper discusses the current status of the treatment and rehabilitation of sports muscle tendon injuries and the application of biomaterials in the repair of sports muscle tendon injuries. Methods: The Chinese Journal Full-text Database (CNKI: 1990/2009) was searched by computer. According to the inclusion and exclusion criteria, the literature was screened, the data was collected and the quality was evaluated, and a total of 28 articles were included. It summarises from the aspects of the mechanism of muscle tendon injury caused by exercise, the treatment and rehabilitation methods of biological materials to repair muscle tendon injury and injury. Results: The research and development of treatment and recovery methods for muscle and tendon injury have always been important issues to be solved urgently. The biomaterials used to repair sports tendon injuries are compatible with human tissues, easily absorbed by tissues, not easily infected, non-adhesive and fractured, and non-repellent, which shows its advantages. Traditional Chinese medicine treatment, sports treatment and medicine are the main rehabilitation methods for functional recovery after tendon injury. Conclusion: In the repair of sports muscle injuries, biomaterials develop rapidly. With the development of research, various treatment and rehabilitation methods for repairing sports muscle tendon injuries will continue to improve.

Meta-analysis of the effects of triamcinolone acetonide alone and in combination with 5-fluorouracil for treating keloids

Objective: To compare the efficacy and safety of triamcinolone acetonide (TA) alone and in combination with 5-fluorouracil (5-FU) for treating keloids using meta-analysis. Methods: Databases including PubMed, Embase, and Cochrane Library were retrieved with the search terms of " triamcinolone acetonide, 5-fluorouracil, glucocorticoid, fluorouracil, keloid, scar, TAC, 5-FU, hypertrophic scar " and databases including Chinese Journal Full-Text Database, Chinese Biomedical Database, and Wanfang Data were retrieved with the search terms of ",, 5-,," in Chinese to obtain the publicly published randomized controlled trials about the effects of TA alone and in combination with 5-fluorouracil for treating keloids from the establishment of each database to august 2019. The outcome indexes included effective proportion of treatment, incidence proportion of adverse reactions, and recurrence proportion of keloids. RevMan 5.3 and Stata 14.0 statistical software were used to conduct a meta-analysis of eligible studies. Results: A total of 1 326 patients with keloids were included in 14 studies, including 668 patients in TA+ 5-fluorouracil group whose keloids were injected with TA and 5-fluorouracil and 658 patients in TA alone group whose keloids were injected with TA alone. A total of 7 articles achieved 1 to 3 points in modified Jadad score, while 7 articles achieved 4 to 7 points in modified Jadad score. Patients in TA+ 5-fluorouracil group had a higher effective proportion of treatment than that of TA alone group (relative risk=1.28, 95% confidence interval=1.16-1.41, P<0.01). Subgroup analysis showed that the quality of the included literature and ethnic factors might be the source of heterogeneity in effective proportion of treatment. Patients in TA+ 5-fluorouracil group had a lower incidence proportion of adverse reactions than that of TA alone group (relative risk=0.44, 95% confidence interval=0.25-0.75, P<0.01). Patients in TA+ 5-fluorouracil group had a lower recurrence proportion of keloids than that of TA alone group (relative risk=0.25, 95% confidence interval=0.14-0.44, P<0.01). There was no publication bias in incidence proportion of adverse reactions (P>0.05), while the effective proportion of treatment and recurrence proportion of keloids had publication bias (P<0.05). Conclusions: TA combined with 5-fluorouracil is more effective than TA alone for treating keloids, with less incidence of adverse reactions and recurrence.

Correlation between ABCB1 C3435T gene polymorphism and clopidogrel resistance：a meta analysis

Objective： To systematically evaluate the correlation between ABCB1 C3435T gene polymorphism and clopidogrel resistance（CR）.Methods： The databases，such as Wanfang Data，the Chinese Biomedical Literature Database（CBM），the Chinese Journal Fulltext Database in China National Knowledge Infrastructure（CNKI），the China Science and Technology Journal Database（VIP），Science Citation Index（SCI），PubMed and EMBase，were searched from the inception to October 2019.The quality of clinical studies which met the inclusion criteria was evaluated，and meta analysis was performed using Stata 14.0 software.Results： Ten papers were included and 2642 patients were enrolled，including 878 cases in the clopidogrel-resistance group and 1764 cases in the non-clopidogrel resistance group.Results of meta-analysis showed that due to ABCB1 C3435T gene polymorphism，the overall effect of each subgroup was statistically significant（P&lt;0.05）： allele gene model OR=1.39，95% CI（1.07，1.81）， dominant gene model OR=1.37，95% CI（1.13，1.66），recessive gene model OR=1.62，95% CI（1.02，2.57）， homozygous gene model OR=1.92，95% CI（1.14，3.22），and heterozygous gene model OR=1.33，95% CI（1.06，1.66）.Conclusion： Current findings confirmed that ABCB1 C3435T gene polymorphism is associated with clopidogrel resistance.

Systematic review of the qualitative researches on care experience of caregivers of burn children

Objective: To systematically review the care experience of caregivers of burn children, so as to provide references for guiding the continuing care in hospitals, communities, and homes. Methods: Databases including Cochrane Library, PubMed, ScienceDirect, ProQuest, Web of Science, and CINAHL were retrieved with the search terms of " burn" , " care/caregivers/nursing/father/mother/relatives" , " needs/perceptions/exceptions/attitudes/feelings/demands/experiences" , " qualitative research" , and the Chinese Journals Full-text Database, China Biology Medicine disc, VIP Database, and Wanfang Data were retrieved with the search terms in Chinese version of "//" , "//////" , "/////" , "" to search the qualitative researches on care experience of caregivers of burn children published from the establishment of the databases to November 2019. After screening and extracting the data, the quality evaluation criteria for qualitative research of the Australian Joanna Briggs Institute Evidence-Based Health Care Center and its integrative/aggregative synthesis method were used to assess the quality of the included literature and meta-integrate the research results respectively. Results: A total of 16 studies and 269 caregivers were enrolled. The quality of one included literature was grade A, and the quality of 15 included literature was grade B. A total of 65 research results were extracted with totally 6 categories formed after summarization, and 2 integrated results obtained as follows: (1) The caregivers experienced heavy psychological pressure and burden in the care process, which had a significant impact on family, social relations, and daily life. (2) With the care time lapsing, through the support of all sectors of society and self-adjustment, the caregivers gradually accepted the reality and actively took various countermeasures, but they still faced many challenges in disease care. Conclusions: The caregivers of burn children have many physical and mental health problems and face many care challenges. The government, medical and health institutions, and society should give a great attention to these issues, improve the social support system and security system, reduce the family-related pressure of burn children's families, and improve the quality of family life.

Meta-Analysis Treatment Hyperphosphatemia Chronic Renal Failure Based on Nano Lanthanum Hydroxide.

In this study, our aim is to investigate the effect of lanthanum carbonate in chronic treatment renal failure complicated with hyperphosphatemia. Using methods with lanthanum carbonate, hyperphosphatemia, placebos, calcium carbonate, end-stage renal disease as keywords, we searched the Chinese Journal Full-text Database, Chinese sci-tech journal database, Wanfang Data knowledge service platform, web of science, PubMed, and other databases for literature quality; meta analysis was carried out after a subsequent evaluation. The meta analysis results showed a significant difference in the control of the blood phosphorus level between weighted mean difference WMD = -0.60, 95% CI: -0.75~-0.45, lanthanum carbonate and placebo; WMD = -0.01, 95% CI: -0.07~-0.05; the lanthanum carbonate and placebo had no significant difference in the control of the blood calcium levels after treatment; WMD = -29.75, 95% CI: -39.22 for the control of blood PIH level after treatment, indicating that the difference between lanthanum carbonate and placebo in the control of the parathyroid hormone (PTH) level was statistically significant. WMD=0.41, 95% CI: -0.48~0.34; the difference between the lanthanum carbonate and calcium carbonate in the control of the blood phosphorus level was statistically significant; WMD = 0.19, 95% CI: -0.25~0.13, lanthanum carbonate and calcium carbonate were statistically significant in blood control calcium level; WMD = 174.66, 95% CI: -150.86~150.46, lanthanum carbonate and calcium carbonate were statistically significant in the control of blood PIH level; the difference was statistically significant. Conclusion: Lanthanum carbonate can significantly reduce blood phosphorus and PIH complicated hyperphosphatemia, and has no significant effect on blood calcium, which is superior to calcium carbonate in effectiveness.

Efficacy and safety of tripterygium glycosides in the treatment of hyperthyroidism

Background:Hyperthyroidism is a condition in which the thyroid gland is overreactive and produces excess amounts of thyroid hormone. Tripterygium glycosides, traditional Chinese medicine has been widely used in the treatment of rheumatoid arthritis, nephrotic syndrome, hyperthyroidism and other diseases due to its anti-inflammatory and immunosuppressive effects. Evidence-based research is becoming popular especially with the application of Chinese traditional medicine. This paper systematically reviews and evaluates existing clinical data on the efficacy and safety of Tripterygium glycosides in the treatment of hyperthyroidism.Materials and methods:PubMed, Cochrane library and EMBase, Chinese biomedical literature database (CBM), Chinese journal full-text database (CNKI), Wan fang digital periodical full-text database and China Science and Technology Journal Database (VIP) were searched based on the defined inclusion and exclusion criteria. Data extraction, research quality assessment and meta-analysis were conducted with RevMan5.3 software. Trial sequential analysis (TSA) was used to evaluate information size and treatment benefits.Results:Seventeen randomized controlled clinical trials with 1536 participants were included in the systematic review. In the meta-analysis, there were two subgroups: Tripterygium glycosides combined with thiamazole and prednisone group; Tripterygium glycosides combined with thiamazole group. The study results revealed that the degree of exophthalmos, FT3, FT4, BGP, and AKP decreased while TSH, SOD, GSH-PX increased after the addition of Tripterygium glycosides. This study results suggested that Tripterygium glycosides combined with western medicine are an effective therapy for hyperthyroidism.Conclusion:This study indicates that Tripterygium glycosides enhances the effect of thiamazole and prednisone in the treatment of hyperthyroidism and without increasing the risk of adverse events.

Traditional Chinese medicine Lianhua Qingwen treating corona virus disease 2019(COVID-19): Meta-analysis of randomized controlled trials.

As the global epidemic continues to spread, countries have tapped effective drugs to treat new coronavirus pneumonia. The therapeutic effect of the traditional Chinese medicine Lianhua Qingwen in this new coronary pneumonia epidemic has attracted attention from all walks of life, and relevant research reports continue to appear. Therefore, we conducted a systematic review of the clinical efficacy and safety of the traditional Chinese medicine Lianhua Qingwen in the treatment of new coronavirus pneumonia (COVID-19) (referred to as "new coronary pneumonia"), and evaluated the overall level of research quality. We searched seven databases and retrieved the Chinese Journal Full-text Database (CNKI), Vip Database (VIP), China Biomedicine (SinoMed), Wanfang Database and PubMed, Cochrane Central, EMBASE from October 2019 to May 2020 Literature references. We included randomized controlled trials (RCTs) that tested the efficacy of the traditional Chinese medicine lotus clearing plague in the treatment of new coronavirus pneumonia. The authors extracted data and independently assessed quality. We used Stata15.1 software to analyze the data of randomized trials. A total of 2 articles were identified, including 154 patients. All the participating patients were diagnosed with new coronavirus pneumonia (COVID-19). The meta-analysis results showed that the disappearance rate of the main clinical symptoms of Chinese medicine Lianhua Qingwen in the treatment of new coronavirus pneumonia was significantly higher than that of the control group [OR = 3.34, 95% CI (2.06, 5.44), P <0.001]; the disappearance rate of other clinical secondary symptoms is significantly higher than the control group [OR = 6.54, 95% CI (3.59, 11.90), P <0.001]. The duration of fever was significantly lower than that of the control group [OR = -1.04, 95% CI (-1.60, -0.49), P <0.001]. It is confirmed that the traditional Chinese medicine Lianhua Qingwen treatment improves the clinical effectiveness, and also has certain advantages in relieving cough and fever. The treatment of new pneumonia with traditional Chinese medicine lotus clearing plague can be used as an effective therapy to improve the clinical symptoms of new coronary pneumonia. More rigorous design, multi-center, and prospective RCTs are necessary to further determine the effectiveness and safety of the traditional Chinese medicine lotus decoction in the treatment of new pneumonia.

A PRISMA-compliant systematic review and meta-analysis of integrated Chinese and Western medicine in treating hepatitis C.

Objective:To conduct a meta-analysis evaluating the effect of combining traditional Chinese medicine (TCM) with Western medicine in treating hepatitis C, and to provide an evidence-based medical strategy.Methods:Randomized controlled trials (RCTs) comparing the effect of pegylated interferon (Peginterferon) combined with ribavirin (PR) alone and its combination with TCM were manually retrieved from the Weipu Information Resources System (VIP), Wan Fang Database, PubMed, and the Chinese Journal Full Text Database (CNKI). Studies meeting the inclusion criteria were selected and analyzed using the Review Manager 5.3 software. Suitable tests were also performed to determine the quality, heterogeneity, and sensitivity of the studies included in the meta-analysis.Results:Twenty-eight RCTs met the inclusion criteria. The combination therapy or intervention group showed significantly greater HCV-RNA negative rate post-treatment compared to the monotherapy or the control group (P < .05). In addition, the serum levels of the liver function indicators alanine aminotransferase (ALT), aspartate aminotransferase (AST), and albumin (ALB) were significantly improved after the combination therapy compared to PR alone (P < .05), while total bilirubin (TB) and r-glutamyltransferase (GGT) levels were not affected by TCM (P > .05). Finally, the parameters of liver fibrosis were also reduced by the combination therapy more effectively than the monotherapy.Conclusion:The combination of TCM and PR can improve the Comprehensive Clinical Efficacy of hepatitis C and have a better negative rate of HCV-RNA with a better benefit in the liver function. The effect of TCM + PR is better than that of PR alone in treating hepatitis C.