Chinese Scientific Journals Full-text Database Research Articles

A Comparison of the Performance of the I-gel™ vs. the LMA-S™during Anesthesia: A Meta-Analysis of Randomized Controlled Trials

Background and ObjectiveConflicting results were found between the I-gel™ and the LMA-Supreme™ during anesthesia, so we conducted a meta-analysis of randomized controlled trials (RCTs) to compare the effectiveness and safety of the I-gel™ vs. the LMA-Supreme™during anesthesia.MethodsA comprehensive search was conducted using Pubmed, EMbase, ISI Web of Knowledge, the Cochrane Library, China Journal Full-text Database, Chinese Biomedical Database, Chinese Scientific Journals Full-text Database, CMA Digital Periodicals, and Google scholar to find RCTs that compare the LMA-S™ with the i-gel™during anesthesia. Two reviewers independently selected trials, extracted data, and assessed the methodological qualities and evidence levels. Data were analyzed by RevMan 5.0 and comprehensive meta-analysis software.ResultsTen RCTs were included. There were no significant differences in oropharyngeal leak pressures (mean difference [MD] 0.72, 95% confidence interval [CI] –1.10 2.53), device placement time (MD –1.3, 95%CI –4.07 1.44), first attempt insertion success (risk ratio [RR] 1.01, 95% CI 0.9 1.14), grade 3 and 4 fiberoptic view (RR 0.89, 95%CI 0.65 1.21), and blood on removal (RR 0.62, 95%CI 0.32 1.22) between the i-gel™ and the LMA-Supreme™, respectively. However, the LMA-Supreme™was associated with easier gastric tube insertion (RR 1.17, 95%CI 1.07 1.29), and more sore throat (RR 2.56, 95%CI 1.60 4.12) than the i-gel™ group.ConclusionsThe LMA-Supreme™ and i-gel™ were similarly successful and rapidly inserted. However, the LMA-Supreme™ was shown to be easier for gastric tube insertion and associated with more sore throat compared with the i-gel™.

Meta-Analysis of the Clinical Value of Danshen Injection and Huangqi Injection in Liver Cirrhosis

Objective. To evaluate the clinical value of Danshen injection and Huangqi injection for the treatment of liver cirrhosis. Methods. The Chinese Biomedical Literature Database (CBM), Chinese Scientific Journals Full-Text Database (VIP), Wanfang Database, China National Knowledge Infrastructure (CNKI), PubMed, and EMBASE database were searched to collect the literatures about the randomized controlled trials involving the treatment of liver cirrhosis with Danshen injection combined with Huangqi injection, and the data analyses were performed using RevMan 4.2 software. Results. A total of 11 studies involving 1086 patients (trials group: 554 cases, control group: 532 cases) were included in this study. Compared with those in control group, the meta-analysis showed-that the total effectiveness rate and the level of serum albumin increased, while serum total bilirubin, alanine transmninase, type III procollagen, hyaluronic acid, laminin, and type-IV collagen decreased in trials group. The Jadad score ranged from 1 to 2 and the funnel plot analysis suggests that publication bias may occur. Conclusions. Danshen injection combined with Huangqi injection may promote the curative efficacy of liver cirrhosis, which is a promising novel treatment approach. The exact outcome needs to perform rigorously designed, multicenter, and large randomized controlled trials.

Aspirin for the prevention of colorectal adenomas: a systematic review

Objective To assess the effect of aspirin for the chemoprevention of colorectal adenomas by meta analysis of the published literature.Methods Cochrane strategy in combination with manual search was used to identify previously published randomized controlled trials by searching PubMed,EMBase,Cochrane Library,China Journal Full-text Database(CNKI),Chinese Scientific Journal Full-text Database (CSJD) and Chinese Biomedical Literature Database (CBM).Results Six randomized controlled trials involving a total of 2 858 patients were studied.Of the six trials,two trials were performed in China,four trials were in the Europe and the United States.Some sufficient evidence were found to support that aspirin could prevent of colorectal adenomas compared with placebo group ( P =0.003,RR =0.66,95％ CI:0.50-0.86).No adaquate evidence supported the role of aspirin in the prevention of development of colorectal cancer ( P =0.29,RR =0.65,95％ CI:0.30-1.44).High-dose aspirin ( P =0.10,RR =0.85,95％ CI:0.71-1.30 ) and low-dose aspirin could prevent colorectal adenomas compared with placebo group( P =0.02,RR =0.57,95％ CI:0.36-0.90),and a dose-dependent associtation was found.The risk of stroke was higher in any dose of aspirin compared with placebo group ( P =0.04),and the risks of adverse events had no significant differences in all groups.Conclusion Aspirin might prevent the development of colorectal adenomas in individuals,but could not prevent the colorectal cancer. Key words: Aspirin; Chemprevention; Colorectal neoplasms; Meta-analysis

Q-003 EFFECTS OF METABOLIC SYNDROME ON LEFT VENTRICULAR HYPERTROPHY IN CHINESE POPULATION

Background Metabolic syndrome(MS) have a role in the progress of left ventricular. We evaluate the influence factors of left ventricular hypertrophy of MS in Chinese population. Methods Cochrane Library, PubMed, EMBASE, Chinese Biomedical Literature Database, Chinese Scientific Journals Full-text Database, and Chinese Journal Full-text Database up to April 2011 were used to identify controlled trial in China that directly compared left ventricular hypertrophy in the MS combining with hypertension and hypertension only. The items of investigation included body mass index(BMI), systolic blood pressure(SBP), diastolic blood pressure(DBP), fasting plasma glucose(FPG), high density lipoprotein cholesterol(HDL-c), low density lipoprotein cholesterol(LDL-c), total cholesterol(TC), triglyceride(TG), left ventricular posterior wall thickness(LVPWT), left ventricular end-diastolic diameter(LVEDd), left ventricular mass(LVM), left ventricular mass index(LVMi) and interventricular septum thickness(IVSt). Data was extracted and analyzed by Cochrane Collaboration's RevMan 5.0 software. Results Eight trials involving 2979 patients were included. The results showed that there was no significant difference in DBP and SBP within 2 groups. The patients of MS with hypertension presented higher BMI (95% CI: 2.38 ∼ 5.93), FPG (95% CI: 0.53 ∼ 1.08), LDL-c (95% CI: 0.06 ∼ 0.75), TC (95% CI: 0.22 ∼ 0.89), TG (95% CI: 0.90 ∼ 1.43), LVPWT (95% CI: 0.31 ∼ 0.64), LVEDd (95% CI: 0.49 ∼ 2.03), LVM (95% CI: 9.29 ∼ 16.61), LVMi (95% CI: 4.55 ∼ 13.37), IVSt (95% CI: 0.27 ∼ 0.51), and lower HDL-c (mean difference = −0.35,95% CI: −0.57 ∼ −0.13) compared with those patients of hypertension only(P < 0.05). Conclusion The MS with hypertension have more factors to promote left ventricular hypertrophy in Chinese population. Due to the limitation of sample sight, the quality of original studies and the publication bias, this issue need to be confirmed by large multicenter randomized controlled trials.

Human Immunodeficiency Virus Prevalence Is Increasing Among Men Who Have Sex With Men in China: Findings From a Review and Meta-Analysis

Multiple studies reported a fast-spreading human immunodeficiency virus (HIV) epidemic among men who have sex with men (MSM) in China. This study aimed to estimate the magnitude and time trends of HIV prevalence among MSM in different geographical regions of China through a systemic review and meta-analysis. A total of 94 articles were identified (25 in English and 69 in Chinese) and analyzed. National HIV prevalence among Chinese MSM has increased over this period, from 1.4% (95% confidence interval [CI]: 0.8%-2.4%) in 2001 to 5.3% (95% CI: 4.8%-5.8%) in 2009. MSM in Southwest China have the highest HIV prevalence, of 11.4% (95% CI: 9.6%-13.5%) in comparison with other regions, which range 3.5% to 4.8%. Significant increases in HIV prevalence among MSM were consistently observed across all Chinese regions. There is an urgent need for implementation of effective public health interventions to curb the spread of HIV infection among MSM across China, especially in the Southwest.

Surgical treatment for primary angle closure-glaucoma: a Meta analysis.

To evaluate the efficacy and safety of trabeculectomy, phacotrabeculectomy plus intraocular lens implantation(phacotrab+IOL group) and phacoemulsification with IOL(phaco+IOL) in primary angle-closure glaucoma(PACG). It was a systematic review and meta-analysis, randomized controlled trials(RCT) and clinical controlled trials(CCT) were collected through electronic searches of the Cochrane Library, PubMed, EMbase, Wanfang Database online, Chinese journal Full-text Database, Chinese Scientific Journals Full-text Database (from the date of building the database to October 2010) We also checked the bibliographies of retrieved articles. All the related data that matched our standards were abstracted. The quality of included trials was evaluated according to the Dutch Cochrane Centre. RevMan 5.0 software was used for Meta-analysis. A total of 5 RCT and 11 CCT involving 1495 eyes were included. The results of meta-analysis showed that phacotrab+IOL group was superior than trabeculectomy(trab group) (MD -3.93,95%CI [-7.31, -0.54]) which was also superior than phaco+IOL group(MD 0.52,95%CI [0.10, 0.95]) in decreasing Intraocular Pressure(IOP). Phacotrab group(MD -1.45,95%CI [-1.68, -1.22])and phaco group (MD-1.12,95%CI [-1.87, -0.37])are both deeper than trab group in the anterior chamber depth. In increasing the coefficient of outflow facility of aqueous humor(C values) there was no statistical difference in the three groups. And there was no statistical difference between phacotrab groups and phaco groups in visual acuity but phacotrab group was superior than phaco group (MD 1.07, 95%CI [0.73, 1.40])in the use of IOP-lowering drugs. There was no statistical difference among three groups. Current evidence suggests that phacotrab+ IOL group was superior than trab group which was also superior than phaco+IOL group in decreasing IOP. Phacotrab group and phaco group are both deeper than trab group in the anterior chamber depth. Phacotrab group was superior than phaco group in the use of IOP-lowering drugs.

Preemptive versus prophylactic protocol to prevent cytomegalovirus infection after renal transplantation: a meta‐analysis and systematic review of randomized controlled trials

This review was conducted to assess the efficacy of preemptive versus prophylactic protocols for the prevention and treatment of cytomegalovirus (CMV) infection and disease after renal transplantation. PubMed, EMBASE, the Cochrane Library, SCI, the China Journal Full-text Database, the Chinese Biomedical Database, the Chinese Scientific Journals Full-text Database, and the CMA Digital Periodicals were searched to collect randomized controlled trials (RCTs) of preemptive versus prophylactic protocols for the prevention and treatment of CMV infections after renal transplantation (up to April 2010). Two reviewers independently extracted data using a designed extraction form. The quality of the included trials was evaluated according to the Cochrane Handbook. RevMan 5.0 software was used for data analysis. Seven RCTs, involving 560 patients, were included. The results of the meta-analysis were as follows: the prophylactic protocol was significantly more effective than the preemptive protocol in reducing CMV infections and the recurrence rates of CMV infection; both the preemptive protocol and the prophylactic protocol reduced the risk of CMV disease, with no significant differences; no significant differences were observed in the risks of mortality, acute rejection, graft loss, other infections, or neutropenia between preemptive therapy and prophylaxis. Preemptive protocols are as effective as prophylaxis in reducing the risk of CMV disease in renal transplant recipients, whereas the prophylactic protocols could more effectively reduce the CMV recurrence rates. However, the trial data were very sparse, so further observations of the long-term effects of the protocols are needed.

A meta-analysis of pemetrexed plus platinum chemotherapy versus gemcitabine plus platinum chemotherapy for advanced non-small cell lung cancer

背景与目的培美曲塞联合铂类方案（PP方案）作为晚期非小细胞肺癌（non-small cell lung cancer, NSCLC）一线化疗方案的疗效是否优于吉西他滨联合铂类方案（GP方案），目前尚无定论。本研究旨在评价采用PP方案与GP方案治疗晚期NSCLC的疗效及安全性。方法计算机检索Pubmed、EMBASE、Cochrane Library、中国期刊全文数据库、中国生物医学文献数据库、中文科技期刊全文数据库等，同时追查纳入文献的参考文献，纳入PP方案对比GP方案治疗晚期NSCLC的随机对照试验（randomized controlled trial, RCT）。根据Cochrane Handbook 5.0的质量评价标准，用RevMan 5.0软件进行统计学分析。结果共纳入4项RCT，2, 235例患者，meta分析结果显示采用PP方案与GP方案治疗后在1年生存率（OR=1.09, 95%CI: 0.91-1.29）、有效率（OR=1.00, 95%CI: 0.40-2.52）等方面的差异无统计学意义，而在总生存时间（MD=0.26, 95%CI: 0.21-0.30）、脱发（OR=0.51, 95%CI: 0.39-0.66）及血液毒性等方面的差异有统计学意义。结论PP方案与GP方案在1年生存率、有效率方面疗效相当，在总生存时间、不良反应等方面有差异，PP方案可能对不耐受血液毒性、脱发等患者更适合。

Effect of dexamethasone on atrial fibrillation after cardiac surgery: a meta-analysis

To assess the effect of preoperative dexamethasone on the occurrence of postoperative atrial fibrillation. Random controlled trails were gathered though searches of PubMed (1966 - 2009.11), EMBASE (1974 - 2009.11), Cochrane Library (issue 4, 2009), Chinese Biomedical Literature Database (1978 - 2009.11), China Journal Full-text Database (1994 - 2009.11), Chinese Scientific Journals Full-text Database (1989 - 2009.11). Two reviewers independently assessed eligibility and quality of trials, then extracted data. Data were synthesized using RevMan5.0 software provided by the Cochrane Collaboration. A total of four randomized controlled trials (667 participants) were included for systematic review. Meta-analysis showed that there were statistical differences between dexamethasone and placebo in postoperative atrial fibrillation (RR = 0.6, 95%CI: 0.40 to 0.92, P = 0.02), dexamethasone did not reduce post-operative mortality (RR = 0.79, 95%CI: 0.28 to 2.22, P = 0.66). The current evidence shows that dexamethasone could reduce the incidence of atrial fibrillation after cardiac surgery, not decrease mortality. There were few limitations in our study may lead to weaken reliability of the conclusions, such as small simple size, different operation types, or the dosage, time and frequency of dexamethasone were unclear. Its effectiveness was needed to further validate in future clinical studies.

The diagnostic value of urine-based survivin mRNA test using reverse transcription-polymerase chain reaction for bladder cancer: a systematic review

Survivin has gradually become an important target in diagnosis, prognosis prediction and treatment of tumor. There are many studies on urine-based survivin mRNA test using reverse transcription-polymerase chain reaction (RT-PCR) as a noninvasive examination for bladder cancer. However, its clinical value remains controversial. This study was to evaluate the diagnostic value of urine survivin mRNA detection with RT-PCR for bladder cancer by a systematic review of related studies. With the search terms such as bladder neoplasm, survivin, RT-PCR, sensitivity, specificity and diagnosis, we systematically searched through PubMed, EMBASE, SCI, Cochrane Library, Chinese Biomedical Literature Database (CBM), Chinese Scientific Journal Full-text Database (CSJD), China Journal Full-text Database (CJFD), Chinese Medical Association (CMA) digital periodicals and Google Scholar totally from January 1997 to April 2009 for diagnostic trials with RT-PCR detection of urine survivin mRNA for bladder cancer. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS) items were used to evaluate the quality of the included studies. Meta-disc software was used to calculate outcome indicators. Twenty-six studies, totally 2 416 patients, were eligible. Meta-analysis showed that compared with pathologic examination, the summary values of sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and summary receiver operating characteristic curve (SROC) of urine-based survivin mRNA test using RT-PCR for bladder cancer were 88%, 94%, 14.56, 0.13 and 0.9736, respectively. Nested RT-PCR got the highest sensitivity, specificity and SROC and the values were 91%, 95% and 0.9805, respectively. The sensitivity and specificity of general RT-PCR were the second highest, which were 87% and 94%, respectively. The sensitivity of quantitative RT-PCR was 80% and the specificity was 93%. Comparing with pathologic examination, the sensitivity and specificity of urine-based survivin mRNA test using RT-PCR are relatively high. It can be used as an important adjunct method for cystoscope in early screening and postoperative monitoring of bladder cancer.

Efficacy and safety of abdominal drainage after gastrectomy for gastric cancer patients:a systematic review

To assess the efficacy and safety of gastrectomy abdominal drainage after gastrectomy in gastric cancer patients. Cochrane systematic evaluation was used to search through Cochrane library (2007-No.3) of clinical comparative trail, PubMed (1976-2008), Embase (1982-2008), Chinese Biomedical Literature Database (CBM 1979-2008), Chinese Scientific Journal Full-text Database (CSJD 1989-2008) and Chinese Journal Full-text Database (CJFD1994-2008), aided with manual retrieval and other retrievals. The quality of the assessment was independently evaluated and cross-checked by two evaluators. The results of homogeneous studies were analyzed with RevMan4.2.10 software. A total of 47 articles were retrieved. Three randomized controlled trials were involved. A total of 338 patients were studied. Of the 338 patients, 160 were treated with total gastrectomy, 178 subtotal gastrectomy. Among the 338 patients, 167 were treated without abdominal drainage. Above 3 trials did not report blind method and did not describe method of allocation concealment. No significant differences were found in pulmonary complication, wound infection, intra-abdominal abscess, clinical leakage and initiation of soft diet between abdominal drainage group and without abdominal drainage group. Statistical results showed odds ratio (OR)=1.23, 95% CI=0.49-3.07 for pulmonary complication; OR=1.09, 95% CI=0.36-3.29 for wound infection; OR=1.28, 95% CI=0.28-5.8 for intra-abdominal abscess; OR=1.53, 95% CI=0.25-9.42 for anastomotic leakage; OR=1.78, 95% CI=0.37-8.56 for hospital mortality; WMD=0.12, 95% CI=-0.11-0.35 for initiation of soft diet. Besides, significant difference was found in hospital stay (WMD=0.65, 95% CI=0.03-1.26), and abdominal drainage group was longer. Abdominal drainage after gastrectomy should not be recommended as a regular treatment for gastric cancer patients.

Irinotecan/cisplatin versus Etoposide/cisplatin for Patients with Extensive Stage Small Cell Lung Cancer: A Systematic Review.

It is unclear whether etoposide/cisplatin (EP) regimen is the optimal chemotherapy regimen in the treatment patients with extensive small cell lung cancer (SCLC), this study was aimed to evaluate the efficacy and safety of patients with extensive SCLC treated with irinotecan/cisplatin (IP) versus EP. We searched EMBASE, PubMed, the Cochrane Library, China journal full-text database (CJFD), Chinese scientific journal full-text database (CSJD), Chinese biomedicine literature database (CBM) for randomized controlled trials comparing IP with EP regimens. Two reviewers independently assessed the quality of included studies and extracted data. We analyzed the data using Review Manager (version 5.0). Four randomized controlled trials totaling 1 180 patients were included. The results of meta analysis were as follows: there was no significant difference between IP regimen and EP regimens in one year survive rate (RR=1.22, 95%CI: 0.97-1.54), two year survive rate (RR=2.26, 95%CI: 0.46-11.21). There was significant difference between IP regimen and EP regimens in overall response rate (RR=1.13, 95%CI: 1.03-1.25), grade 3/4 neutropenia (RR=0.48, 95%CI: 0.34-0.69), thrombopenia (RR=0.23, 95%CI: 0.15-0.36), grade 3 anemia (RR=0.55, 95%CI: 0.40-0.77), grade 3/4 diarrhea (RR=9.56, 95%CI: 4.91-18.59), grade 3 nausea/vomiting (RR=1.70, 95%CI: 1.19-2.43). There is no significant difference between IP group and EP group with regard to one year survive rate, two year survive rate, but IP regimen improves reponse rate. IP regimen has less hematologic & greater gastrointestinal toxicity compared with EP, EP regimen remain the main standard chemotherapy in the treatment extensive small cell lung cancer due to cheapness, they still need to be confirmed by randomized controlled trials.