Technical Periodicals Research Articles

Meta-analysis of the condylar position changes produced by functional appliances in class Ⅱ malocclusion

This study aimed to analyze the condylar position changes produced by functional appliances in class Ⅱ malocclusion by systematic review. Electronic search was conducted using Chinese Biomedical Literature Database, China National Knowledge Infrastructure, VIP Database for Chinese Technical Periodicals, Medline, Embase, Pubmed, and Cochrane Central Register of Controlled Trials. Studies on condylar position changes produced by functional appliances in class Ⅱ malocclusion were included. Risk of bias assessment and data extraction of included studies were conducted by two reviewers independently. The meta-analysis was carried out using Revman 5.1. Six studies were included (five high quality and one low quality). The condylar position showed no changes after Herbst treatment. The condylar posterior space after Twin-block treatment averagely increased by 0.31 mm (P<0.000 01), whereas the condylar anterior space averagely reduced by 0.32 mm (P<0.000 01). Twin-block appliance enables forward movement of the condylar position. This result contributes to the correction of class Ⅱ malocclusion.

Dietary magnesium and calcium intake and risk of depression in the general population: A meta-analysis.

Several epidemiological studies have evaluated the associations between dietary magnesium (Mg) and calcium (Ca) intake and the risk of depression. However, the results of these studies remain controversial. Thus, we performed a meta-analysis to explore these associations and to investigate the possible dose-response relationship between dietary Mg intake and risk of depression. MEDLINE, Web of Science, Embase, Cochrane CENTRAL, CINAHL database, Chinese National Knowledge Infrastructure, Wan fang databases and Databases of Chinese Scientific and Technical Periodicals were searched for eligible publications up to September 2016. Pooled relative risks with 95% confidence intervals were calculated using random-effects model. Publication bias was estimated using Egger's test and the funnel plot. Dose-response relationship was assessed by restricted cubic spline functions. A total of 17 epidemiological studies from 12 articles were included in the present meta-analysis. Among these studies, 11 studies evaluated the association between dietary Mg intake and risk of depression and 6 studies evaluated the association between dietary Ca intake and risk of depression. When comparing the highest with the lowest intake, the pooled relative risks of depression were 0.81 (95% confidence interval = [0.70, 0.92]) for Mg and 0.66 (95% confidence interval = [0.42, 1.02]) for Ca. Dietary Mg intake was significantly associated with a reduced risk of depression among studies conducted in Asia (relative risk = 0.57; 95% confidence interval = [0.44, 0.74]) and in studies adjusting for energy intake (relative risk = 0.73; 95% confidence interval = [0.58, 0.92]). For dose-response analysis, evidence of a nonlinear relationship was found between dietary Mg intake and risk of depression, and the largest risk reductions were observed for 320 mg/day. This meta-analysis indicated that moderate Mg intake may be inversely associated with the risk of depression, which still needs to be confirmed by larger prospective cohort studies.

IL-10 -1082A/G, -592C/A, and -819T/C polymorphisms in association with lung cancer susceptibility: a meta-analysis.

Numerous studies have examined the association between interleukin-10 (IL-10 -1082A/G, -592C/A, and -819T/C) gene polymorphisms and risk of lung cancer, but these have revealed inconsistent results. The aim of this study was to clarify the relationship between these polymorphisms and the risk of lung cancer by performing a meta-analysis. The published literature concerning IL-10 polymorphisms and lung cancer risk were retrieved by systematically searching PubMed, Embase, Web of Science, China National Knowledge Infrastructure, WanFang, and Database of Chinese Scientific and Technical Periodicals (VIP) database. Statistical analysis was conducted with Stata 12.0 software. A total of ten published articles comprising of 19 studies were selected, including seven studies (1,960 controls and 1,321 cases) for IL-10 -1082A/G, seven studies (2,613 controls and 1,839 cases) for IL-10 -592C/A, and five studies (1,558 controls and 926 cases) for IL-10 -819T/C. This study found that the IL-10 -1082A/G and -592C/A polymorphisms were significantly associated with the risk of lung cancer in the overall analysis. When stratified by ethnicity, significantly increased risks were observed for IL-10 -1082A/G, -592C/A, and -819T/C polymorphisms in Asians (for -1082A/G, AA vs [AG + GG]: odds ratio [OR] =1.20, confidence interval [CI] =1.05–1.39, P<0.05; for C-592A, C vs A, OR =1.36, CI =1.20–1.53, P<0.05; CC vs AA, OR =1.85, CI =1.45–2.37, P<0.05; CC vs [CA + AA], OR =1.36, CI =1.15–1.61, P<0.05; for -819T/C, T vs C: OR =1.21, CI =1.06–1.38, P<0.05; TT vs CC, OR =1.54, CI =1.18–2.01, P<0.05; [TT + TC] vs CC, OR =1.51, CI =1.17–1.95, P<0.05). Moreover, the data indicated that there was a significant association between IL-10 -819T/C polymorphism and non-small-cell lung cancer risk. No significant publication bias was detected under the four genetic models (allele model, homozygous model, dominant model, and recessive model) in this meta-analysis. On the basis of these 19 studies, this study found that the IL-10 -1082A/G and -819T/C polymorphisms might have a significant association with risk of lung cancer in Asian populations.

Bioactive components of Chinese herbal medicine enhance endogenous neurogenesis in animal models of ischemic stroke: A systematic analysis.

Background:Chinese herbal medicine (CHM) has been used to treat stroke for thousands of years. The objective of the study is to assess the current evidence for bioactive components of CHM as neurogenesis agent in animal models of ischemic stroke.Methods:We searched PubMed, China National Knowledge Infrastructure, WanFang Database, and VIP Database for Chinese Technical Periodicals published from the inception up to November 2015. The primary measured outcome was one of neurogenesis biomarker, including Bromodeoxyuridine (BrdU), Nestin, doublecortin (DCX), polysialylated form of the neural cell adhesion molecule (PSA-NCAM), neuronal nuclear antigen (NeuN), and glial fibrillary acidic protein (GFAP).Results:Thirty eligible studies were identified. The score of quality assessment ranged from 2 of 10 to 7 of 10. Compared with controls, 10 studies conducting neurobehavioral evaluation showed significant effects on bioactive components of CHM for improving neurological deficits score after ischemic insults (P < 0.01 or P < 0.05); 6 studies in Morris water-maze test showed bioactive components of CHM significantly decreased escape latency and increased residence time (P < 0.05); 5 studies demonstrated that bioactive components of CHM significantly reduced infarct volume after ischemic stroke (P < 0.05); 25 of 26 studies showed that bioactive components of CHM significantly increased the expression of BrdU and/or Nestin markers in rats/mice brain after ischemic injury (P < 0.05, or P < 0.01); 4 of 5 studies for promoting the expression of PSA-NCAM or DCX biomarker (P < 0.05); 5 studies for improving the expression of NeuN biomarker (P < 0.05); 6 of 7 studies for promoting the expression of GFAP biomarker in brain after ischemic stroke (P < 0.05).Conclusion:The findings suggest that bioactive components of CHM may improve neurological function, reduce infarct volume, and promote endogenous neurogenesis, including proliferation, migration, and differentiation of neural stem cells after ischemic stroke. However, evidences are supported but limited because only a few studies were available for each descriptive analysis. Further rigor study is still needed.

Acupuncture for polycystic ovarian syndrome

Polycystic ovarian syndrome (PCOS) is characterised by the clinical signs of oligo-amenorrhoea, infertility and hirsutism. Conventional treatment of PCOS includes a range of oral pharmacological agents, lifestyle changes and surgical modalities. Beta-endorphin presents in the follicular fluid of both normal and polycystic ovaries. It was demonstrated that the beta-endorphin levels in ovarian follicular fluid of otherwise healthy women who were undergoing ovulation were much higher than the levels measured in plasma.Given that acupuncture has an impact on beta-endorphin production, which may affect gonadotropin-releasing hormone (GnRH) secretion, it is postulated that acupuncture may have a role in ovulation induction and fertility. To assess the effectiveness and safety of acupuncture treatment of oligo/anovulatory women with polycystic ovarian syndrome (PCOS). We identified relevant studies from databases including the Cochrane Central Register of Controlled Trials (CENTRAL), Ovid MEDLINE, EMBASE, PsycINFO, CNKI and trial registries. The data are current to 19 October 2015. We included randomised controlled trials (RCTs) that studied the efficacy of acupuncture treatment for oligo/anovulatory women with PCOS. We excluded quasi- or pseudo-RCTs. Primary outcomes were live birth and ovulation (primary outcomes), and secondary outcomes were clinical pregnancy, restoration of menstruation, multiple pregnancy, miscarriage and adverse events. We assessed the quality of the evidence using GRADE methods. Two review authors independently selected the studies, extracted data and assessed risk of bias. We calculated Mantel-Haenszel odds ratios (ORs) and mean difference (MD) and 95% confidence intervals (CIs). We included five RCTs with 413 women. They compared true acupuncture versus sham acupuncture (two RCTs), true acupuncture versus relaxation (one RCT), true acupuncture versus clomiphene (one RCT) and electroacupuncture versus physical exercise (one RCT). Four of the studies were at high risk of bias in at least one domain.No study reported live birth rate. Two studies reported clinical pregnancy and found no evidence of a difference between true acupuncture and sham acupuncture (OR 2.72, 95% CI 0.69 to 10.77, two RCTs, 191 women, very low quality evidence).Three studies reported ovulation. One RCT reported number of women who had three ovulations during three months of treatment but not ovulation rate. One RCT found no evidence of a difference in mean ovulation rate between true and sham acupuncture (MD -0.03, 95% CI -0.14 to 0.08, one RCT, 84 women, very low quality evidence). However, one other RCT reported very low quality evidence to suggest that true acupuncture might be associated with higher ovulation frequency than relaxation (MD 0.35, 95% CI 0.14 to 0.56, one RCT, 28 women).Two studies reported menstrual frequency. One RCT reported true acupuncture reduced days between menstruation more than sham acupuncture (MD 220.35, 95% CI 252.85 to 187.85, 146 women). One RCT reported electroacupuncture increased menstrual frequency more than no intervention (0.37, 95% CI 0.21 to 0.53, 31 women).There was no evidence of a difference between the groups in adverse events. Evidence was very low quality with very wide CIs and very low event rates.Overall evidence was low or very low quality. The main limitations were failure to report important clinical outcomes and very serious imprecision. Thus far, only a limited number of RCTs have been reported. At present, there is insufficient evidence to support the use of acupuncture for treatment of ovulation disorders in women with PCOS.

TRANSPORTATION SYSTEMS; THE MAIN FACTORS OF URBAN MACRO FORMS DEVELOPMENTS

Urban macro forms developments depend very on Transportation Systems changes. This systems have a triple effects on congestion; styles and degrees of urban extension; social and morphological points and problems of it .There are at least four social – technical periods according to dominant transportation modes as the linear model of transportation: walking city ; tram city ; tracked city and rubber city . each of these periods have their special and unique features and affect the size and form of the cities according to their range or ability to increase the distance from origin to destination .The purpose of this article is evaluation of different transportation periods as the linear model of transportation according to their role in urban macro forms developments and offers that it is better for cities to use this model in the opposite direction. This research method is descriptive analytical study based on a library and resource world and the result was that cities should attend more to transportation patterns of the past such as walking and cycling and also network rail transportations and attend to construction of dense urban neighborhoods and groups which reduce the need for transportation and handling.

A Systematic Review of Des-γ-Carboxy Prothrombin for the Diagnosis of Primary Hepatocellular Carcinoma.

Determining the serum des-γ-carboxy-prothrombin (DCP) level is of great importance for the diagnosis of primary hepatocellular carcinoma (PHC). Although several studies have investigated the accuracy of diagnostic DCP tests for PHC, the results have been inconsistent.The aim of this study was to systematically evaluate DCP as a diagnostic standard for PHC.Several databases, including PubMed, EMBASE, MEDLINE (Ovid), the Chinese National Knowledge Infrastructure (CNKI), the VIP Database for Chinese Technical Periodicals (VIP), WanFang Data, and the China Biological Medicine Database (CBM), were searched from the date of database inception until July 1, 2015 to collect published international and domestic studies of DCP in the diagnosis of PHC. Two investigators screened the literature according to the inclusion and exclusion criteria, extracted the data, and assessed the methodological quality of the included studies.A total of 38 studies involving 11,124 cases were included (5298 cases in the PHC group and 5826 cases in the control group). A meta-analysis was then performed using Meta-Disc 1.4 and RevMan 5.2 software. The overall sensitivity, specificity, positive likelihood ratio (+LR), and negative likelihood ratio (−LR) of DCP for the detection of PHC were 0.66 (95% confidence interval [CI]: 0.65–0.68), 0.88 (95% CI: 0.87–0.90), 7.13 (95% CI: 5.73–8.87), and 0.33 (95% CI: 0.29–0.38), respectively. The area under the curve (AUC) of the summary receiver-operating characteristic curve (SROC) was 0.9002. In conclusion, DCP has moderate diagnostic utility for PHC. Owing to the heterogeneity and limitations of the included studies, the above conclusion requires further support from additional high-quality studies.

Awareness and knowledge about human papillomavirus vaccination and its acceptance in China: a meta-analysis of 58 observational studies.

BackgroundThe human papillomavirus (HPV) vaccines have been widely introduced in immunization programs worldwide, however, it is not accepted in mainland China. We aimed to investigate the awareness and knowledge about HPV vaccines and explore the acceptability of vaccination among the Chinese population.MethodsA meta-analysis was conducted across two English (PubMed, EMBASE) and three Chinese (China National Knowledge Infrastructure, Wan Fang Database and VIP Database for Chinese Technical Periodicals) electronic databases in order to identify HPV vaccination studies conducted in mainland China. We conducted and reported the analysis in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.ResultsFifty-eight unique studies representing 19 provinces and municipalities in mainland China were assessed. The pooled awareness and knowledge rates about HPV vaccination were 15.95 % (95 % CI: 12.87–19.29, I2 = 98.9 %) and 17.55 % (95 % CI: 12.38–24.88, I2 = 99.8 %), respectively. The female population (17.39 %; 95 % CI: 13.06–22.20, I2 = 98.8 %) and mixed population (18.55 %; 95 % CI: 14.14–23.42, I2 = 98.8 %) exhibited higher HPV vaccine awareness than the male population (1.82 %; 95 % CI: 0.50–11.20, I2 = 98.5 %). Populations of mixed ethnicity had lower HPV vaccine awareness (9.61 %; 95 % CI: 5.95–14.03, I2 = 99.0 %) than the Han population (20.17 %; 95 % CI: 16.42–24.20, I2 = 98.3 %). Among different regions, the HPV vaccine awareness was higher in EDA (17.57 %; 95 % CI: 13.36–22.21, I2 = 98.0 %) and CLDA (17.78 %; 95 % CI: 12.18–24.19, I2 = 97.6 %) than in WUDA (1.80 %; 95 % CI: 0.02–6.33, I2 = 98.9 %). Furthermore, 67.25 % (95 % CI: 58.75–75.21, I2 = 99.8 %) of participants were willing to be vaccinated, while this number was lower for their daughters (60.32 %; 95 % CI: 51.25–69.04, I2 = 99.2 %). The general adult population (64.72 %; 95 % CI: 55.57–73.36, I2 = 99.2 %) was more willing to vaccinate their daughters than the parent population (33.78 %; 95 % CI: 26.26–41.74, I2 = 88.3 %). Safety (50.46 %; 95 % CI: 40.00–60.89, I2 = 96.6 %) was the main concern about vaccination among the adult population whereas the safety and efficacy (68.19 %; 95 % CI: 53.13–81.52, I2 = 98.6 %) were the main concerns for unwillingness to vaccinate their daughters.ConclusionsLow HPV vaccine awareness and knowledge was observed among the Chinese population. HPV vaccine awareness differed across sexes, ethnicities, and regions. Given the limited quality and number of studies included, further research with improved study designis necessary.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-2873-8) contains supplementary material, which is available to authorized users.

Learning Curve for Laparoscopic Pancreaticoduodenectomy: a CUSUM Analysis

BackgroundLaparoscopic pancreaticoduodenectomy (LPD), an advanced minimally invasive technique, has demonstrated advantages to open pancreaticoduodenectomy (OPD). However, this complex procedure requires a relatively long training period to ensure technical proficiency. This study was therefore designed to analyze the learning curve for LPD. MethodsFrom October 2010 to September 2015, 63 standard pancreaticoduodenectomy procedures were to be performed laparoscopically by a single surgeon at the Department of Pancreatic Surgery, West China Hospital, Sichuan University, China. After applying the inclusion and exclusion criteria, a total of 57 patients were included in the study. Data for all the patients, including preoperative, intraoperative, and postoperative variables, were prospectively collected and analyzed. The learning curve for LPD was evaluated using both cumulative sum (CUSUM) and risk-adjusted CUSUM (RA-CUSUM) methods. All of the variables among the learning curve phases were compared. ResultsBased on the CUSUM and the RA-CUSUM analyses, the learning curve for LPD was grouped into three phases: phase I was the initial learning period (cases 1–11), phase II represented the technical competence period (cases 12–38), and phase III was regarded as the challenging period (cases 39–57). The operative time, intraoperative blood loss, and postoperative ICU demand significantly decreased with the learning curve. More lymph nodes were collected after the initial learning period. There were no significant differences in terms of postoperative complications or the 30-day mortality among the three phases. More challenging cases were encountered in phase III. ConclusionsAccording to this study, the learning curve for LPD consisted of three phases. Conservatively, to attain technical competence for performing LPD, a minimum of 40 cases are required for laparoscopic surgeons with a degree of laparoscopic experience.

Bibliometric analysis of the studies on nursing competency from 2004 to 2014

Obejective To analyze the related papers on nursing competency in China from 2004 to 2014, and to learn the current status and developing trends of nursing competency, so as to provide reference for further research and development of nursing competency. Methods All literature related to nursing competency from 2004 to 2014 were searched in the China National Knowledge Infrastructure (CNKI) , VIP Database for Chinese Technical Periodicals (VIP) , and Wanfang database. Bibliometric analysis methods were used to analyze the distribution time, area, journal distribution and research categories by using Microsoft Excel. Results Totally 199 articles related to nursing competency were collected and the number of publications increased in recent years. About 78.89% (157/199) papers were published in the statistical source journal and 34.17% (68/199) papers were focused on survey research about nursing competency. Conclusions Nursing competency have been paid more attention to, but the quality of the literature still need to be improved. Key words: Nursing care; Nursing competency; Bibliometrics

Arginine-containing desensitizing toothpaste for the treatment of dentin hypersensitivity: a meta-analysis.

ObjectiveTo estimate the effect of arginine-containing desensitizing toothpaste on dentin hypersensitivity (DH).MethodsDatabases including China National Knowledge Infrastructure, VIP Database for Chinese Technical Periodicals, China Biology Medicine disc, Wangfang Data, PubMed, Web of Science, and Cochrane Trials Register were searched, and Google was used as a supplementary tool to search for information through February 2014. Randomized controlled trials (RCTs) of the treatment of DH with arginine-containing toothpaste were included. Relevant information was extracted, and a quality evaluation was performed. Meta-analyses were performed using RevMan 5.2 software.ResultsEighteen RCTs with 1,423 patients were included. The results of the meta-analyses demonstrated that at days 0 and 3; weeks 2, 4, and 8; and more than 12 weeks, arginine-containing toothpaste led to significantly improved results on the tactile sensitivity test (standardized mean difference [SMD] =1.95, 95% confidence interval [CI] [1.14, 2.76]) and the air-blast test (SMD =−1.60, 95% CI [−2.14, −1.05]) at 4 weeks and the tactile sensitivity test (SMD =2.01, 95% CI [1.41, 2.61]) and the air-blast test (SMD =−1.41, 95% CI [−1.83, −0.98]) at 8 weeks compared to toothpastes containing other desensitizing components, thus indicating a superior therapeutic effect of arginine-containing desensitizing toothpaste. However, no significant differences between arginine-containing toothpaste and toothpastes containing other desensitizing components were observed in the air-blast test at days 0 and 3 and week 2 and in the tactile sensitivity and air-blast tests at more than 12 weeks.ConclusionThe current evidence indicates that arginine-containing toothpaste is effective for DH. However, further high-quality, large-sample RCTs are needed.

Rapid Onset of the Effects of Combined Selective Serotonin Reuptake Inhibitors and Electroacupuncture on Primary Depression: A Meta-Analysis.

To evaluate the efficacy and safety of combined selective serotonin reuptake inhibitors (SSRIs) and electroacupuncture therapies for the early treatment of primary depression. Randomized controlled trials (RCTs) were analyzed to compare therapy combining SSRIs and electroacupuncture to SSRI therapy alone. The RCTs were identified by searching, among others, PubMed, the Cochrane Library, the Chinese National Knowledge Infrastructure, the Chongqing VIP database for Chinese Technical Periodicals, WANFANG DATA, and the Chinese Biological Medical Literature Database. Scores from Self-Rated Depression Scale (SDS), the Hamilton Depression Scale (HAMD), the Side Effect Rating Scale (SERS), and the Treatment Emergent Symptom Scale (TESS) were analyzed and coded by two independent investigators and used to evaluate the safety and efficacy of treatment. Statistical analyses were performed using RevMan 5.2 software. Six RCTs were analyzed. The meta-analysis revealed that the combined therapy of SSRIs and electroacupuncture were associated with superior scores on the HAMD, SDS, and SERS measures compared with SSRIs alone after 1-4 weeks of treatment: HAMD scores, mean difference (MD)(1 week), 2.32 (95% confidence interval [CI](1 week), 1.47-3.16, p(1 week)<0.00001); MD(2 weeks), 2.65 (95% CI(2 weeks), 1.81- 3.50, p(2 weeks)<0.00001); MD(4 weeks), 2.70 (95% CI(4 weeks), 1.90-3.51, p(4 weeks)<0.00001); SDS scores: MD(1 week), 3.13 (95% CI(1 week), 1.22-5.03, p(1 week) = 0.001); MD(2 weeks), 4.05 (95% CI(2 weeks), 0.22-7.87, p(2 weeks) = 0.04); MD(4 weeks), 5.02 (95% CI(4 weeks), 1.61-8.43, p(4 weeks) = 0.004); SERS scores: MD(2 weeks), 2.20 (95% CI(2 weeks), 1.43-2.96, p(2 weeks)<0.00001); MD(4 weeks), 2.12 (95% CI(4 weeks), 1.42-2.83, p(4 weeks)<0.00001). However, two of the aforementioned outcomes were rated as medium quality because of heterogeneity, as assessed using the Grading of Recommendations Assessment, Development and Evaluation system. The available evidence suggests that the early treatment of primary depression using both SSRI and electroacupuncture therapies is more efficient than treatments with SSRIs alone and leads to a better and earlier control of depressive symptoms.

Bibliometric analysis of the literature on nursing professional basic experiment research in China ten years

Objective To describe the research status, analyze the existing problems and summarize development trend of basic experiment research in China by analyzing the papers publication year, publication journals, geographical distribution, fund status, cooperation situation and the main experimental methods or technologies. It was aimed at providing guidance for further research and development of nursing scientific research. Methods All literatures related to nursing professional basic experiment research were extracted by searching through the China National Knowledge Infrastructure, VIP Database for Chinese Technical Periodicals and Wan-fang database from January 2005 to November 2014. Bibliometric analysis methods were used to analyze the search results. Results 472 references were retrieved to meet the requirements, about 76.3% (360/472) papers were published in the statistical source journals, 10.0% (47/472) of the literatures were published in the nursing professional journals; 68.9% (325/472) of the literatures had funding source, 21.0% (99/472) for national fund support, 35.4% (167/472) were supported by provincial fund; literature cooperation degree was 4.38(2 065/472), the co-authored rate was 97.2% (459/472). The level of research focused on tissue and cells, a few involved in molecular level. Conclusions All the literatures on the nursing professional basic experiment research show a increased trend year by year. Nursing professional journals' publication volume is not high for such research. Scientific research fund contributions remain to be improved. The interdisciplinary cooperation needs to be expanded. Nursing experimental research will provide a possible for discipline development. Key words: Bibliometrics; Nursing; Experiment study

Breastfeeding and the incidence of endometrial cancer: A meta-analysis.

Several epidemiological studies have investigated the association between breastfeeding and endometrial cancer (EC). However, the results of the studies are controversial. Thus, we conduct this meta-analysis to explore the association between breastfeeding and EC and to evaluate the possible does-response relationship between duration of breastfeeding and EC. PubMed, Web of Science, Chinese National Knowledge Infrastructure, China biology medical literature database, Wan fang databases and Database of Chinese Scientific and Technical Periodicals were searched for eligible observational studies up to 11 July 2015. Random effects model was used to calculate the pooled relative risks (RRs) and restricted cubic spline model was adopted for the does-response analysis.Fifteen articles with 623570 participants were identified. The RRs of these studies suggested that breastfeeding was associated with the reduced risk of EC (high versus low/no: RR = 0.74; 95% confidence interval (CI), 0.58-0.95). In subgroup analyses, a significant association of breastfeeding with EC risk was found in Asia (RR = 0.57, 95% CI 0.37-0.87), and an inverse association of breastfeeding with EC risk was found in cohort studies (RR = 0.62, 95% CI 0.41-0.94). The results were also significant after adjusted for hormone use (RR = 0.63, 95% CI 0.41-0.97) and body mass index (RR=0.65, 95% CI 0.44-0.96). A linear relationship was found of breastfeeding with EC (p for nonlinearity = 0.93), and it indicated that EC risk decreased by 1.2% for one month increment of breastfeeding. This meta-analysis indicates that long term breastfeeding might be associated with decreased risk of EC.

Can Ashi points stimulation have specific effects on shoulder pain? A systematic review of randomized controlled trials.

To provide an evidence-based overview regarding the efficacy of Ashi points stimulation for the treatment of shoulder pain. A comprehensive search [PubMed, Chinese Biomedical Literature Database, China National Knowledge Infrastructure (CNKI), Chongqing Weipu Database for Chinese Technical Periodicals (VIP) and Wanfang Database] was conducted to identify randomized or quasi-randomized controlled trials that evaluated the effectiveness of Ashi points stimulation for shoulder pain compared with conventional treatment. The methodological quality of the included studies was assessed using the Cochrane risk of bias tool. RevMan 5.0 was used for data synthesis. Nine trials were included. Seven studies assessed the effectiveness of Ashi points stimulation on response rate compared with conventional acupuncture. Their results suggested significant effect in favour of Ashi points stimulation [odds ratio (OR): 5.89, 95% confidence interval (CI): 2.97 to 11.67, P<0.01, heterogeneity: χ(2) =3.81, P=0.70, I (2) =0% ]. One trial compared Ashi points stimulation with drug therapy. The result showed there was a significantly greater recovery rate in group of Ashi points stimulation (OR: 9.58, 95% CI: 2.69 to 34.12). One trial compared comprehensive treatment on the myofascial trigger points (MTrPs) with no treatment and the result was in favor of MTrPs. Ashi points stimulation might be superior to conventional acupuncture, drug therapy and no treatment for shoulder pain. However, due to the low methodological quality of included studies, a firm conclusion could not be reached until further studies of high quality are available.

Assessment of the quality of randomized controlled trials of delirium prevention of elderly in China

Objective To assess the quality of randomized controlled trials (RCTs) of delirium prevention of elderly published in China. Methods The literatures from China National Knowledge Infrastructure(CNKI), WANFANG Data and VIP Database for Chinese Technical Periodicals were evaluated according to Cochrane collaboration's tool for assessing risk of bias and Jadad scale. Results A total of 53 RCTs were included, 14 (26.4%,14/53) described radom number table used to generate the random allocation sequence, 4 (7.5%,4/53) conducted experiments in a blinded manner, 7 (13.2%, 7/53) did not use intention-to-treat to analyse those who did not complete the study, 9 (17.0%, 9/53) had high risk of other bias, none described allocation concealment mechanism and blinding to participants and intercention implementers. Based on Jadad scales, the score was 1-4, average score was (2.3±0.8), 19 (35.8%, 19/53) were high-quality literatures. Conclusions The quality of present published literatures is not high, the further domestic studies should be designed high-quality to better improve clinical practice. Key words: Randomized controlled trial; Delirium; Bias; Assessing risk of bias; Jadad scale; Literature evaluation

Prevalence of suicidal ideation and suicide attempts in the general population of China: A meta-analysis.

The objective of this meta-analysis is to estimate the pooled prevalence of suicidal ideation and suicide attempts in the general population of Mainland China. A systematic literature search was conducted via the following databases: PubMed, PsycINFO, MEDLINE, China Journals Full-Text Databases, Chongqing VIP database for Chinese Technical Periodicals, and Wan Fang Data. Statistical analysis used the Comprehensive Meta-Analysis program. Eight studies met the inclusion criteria for the analysis; five reported on the prevalence of suicidal ideation and seven on that of suicide attempts. The estimated lifetime prevalence figures of suicidal ideation and suicide attempts were 3.9% (95% confidence interval: 2.5%-6.0%) and 0.8% (95% confidence interval: 0.7%-0.9%), respectively. The estimated female-male ratio for lifetime prevalence of suicidal ideation and suicide attempts was 1.7 and 2.2, respectively. Only the difference of suicide attempts between the two genders was statistically significant. This was the first meta-analysis of the prevalence of suicidal ideation and suicide attempts in the general population of Mainland China. The pooled lifetime prevalence of both suicidal ideation and suicide attempts are relatively low; however, caution is required when assessing these self-report data. Women had a modestly higher prevalence for suicide attempts than men. The frequency for suicidal ideation and suicide attempts in urban regions was similar to those in rural areas.

Acupuncture therapy for sudden sensorineural hearing loss: a systematic review and meta-analysis of randomized controlled trials.

ObjectiveAcupuncture has commonly been used in China, either alone or in combination with Western medicine, to treat sudden sensorineural hearing loss (SSHL). The purpose of this systematic review is to assess the efficacy and safety of acupuncture therapy for patients with SSHL.MethodsWe searched PubMed, the Cochrane Library, Embase, China National Knowledge Internet (CNKI), Database for Chinese Technical Periodicals (VIP), and Chinese Biomedical literature service system (SinoMed) to collect randomized controlled trials of acupuncture for SSHL published before July 2014. A meta-analysis was conducted according to the Cochrane systematic review method using RevMan 5.2 software. The evidence level for each outcome was assessed using the GRADE methodology.ResultsTwelve trials involving 863 patients were included. A meta-analysis showed that the effect of manual acupuncture combined with Western medicine comprehensive treatment (WMCT) was better than WMCT alone (RR 1.33, 95%CI 1.19–1.49) and the same as the effect of electroacupuncture combined with WMCT (RR 1.33, 95%CI 1.19–1.50). One study showed a better effect of electroacupuncture than of WMCT (RR 1.34, 95%CI 1.24–1.45). For mean changes in hearing over all frequencies, the meta-analysis showed a better effect with the combination of acupuncture and WMCT than with WMCT alone (MD 10.85, 95%CI 6.84–14.86). However, the evidence levels for these interventions were low or very low due to a high risk of bias and small sample sizes in the included studies.ConclusionThere was not sufficient evidence showing that acupuncture therapy alone was beneficial for treating SSHL. However, interventions combining acupuncture with WMCT had more efficacious results in the treatment of SSHL than WMCT alone. Electroacupuncture alone might be a viable alternative treatment besides WMCT for SSHL. However, given that there were fewer eligible RCTs and limitations in the included trials, such as methodological drawbacks and small sample sizes, large-scale RCTs are required to confirm the current findings regarding acupuncture therapy for SSHL.

The prevalence of Health Literacy in residents of China in 2011-2013: a Meta-analysis

Objective To explore the prevalence of health literacy in China in 2011-2013. Methods The eligible studies were identified by searching China National Knowledge Infrastructure (CNKI), Chinese BioMedical Literature Database (CBM), VIP Database for Chinese Technical Periodicals (VIP), Wanfang database, PubMed and Embase. The Meta-analysis was applied with Stata 12.0 software. Subgroup analysis and sensitivity analysis were performed to test the robust of the results. Results A total of 28 studies, including 53 308 residents, were finally included in the review. Meta-analysis revealed the prevalence of health literacy in China to be 16% (95%CI 15%-16%), and the prevalence of health concepts and knowledge was 25% (95%CI 25%-26%), and healthy lifestyles and behaviors was 13% (95%CI 12%-14%), and health skills was 32% (95%CI 31%-32%). Conclusions The health literacy levels of residents showed a rising trend. There were differences between rural and urban health literacy levels and different regions. Rural residents' health literacy level increased more significantly than that of the city. Due to limited kinds of methods, more scientific and effective methods were needed to evaluate the health literacy. Key words: Meta-analysis; Health literacy; Resident

Cleaning effect of ultrasonic activation as an adjunct to syringe irrigation of root canals: a systematic review

To investigate evidence supporting whether ultrasonic irrigation as a supplement is more effective than syringe irrigation in root canal cleaning. An electronic search was conducted in PubMed, Embase, Web of Science, Cochrane Library, ProQuest Dissertation and Theses, Database for Chinese Technical Periodicals, China National Knowledge Infrastructure, Wanfang Database, and Chinese Biomedical Literature Database. Studies were retrieved from January 1, 1985 to March 1, 2014. The Chinese journals on stomatology and the bibliography of all relevant articles were manually searched. Relevant clinical randomized controlled trial (RCT) and clinical controlled trial (CCT) were selected. Two investigators evaluated the risk of bias of the included trials in accordance with Cochrane risk of bias assessment tools and collected data of included studies. Meta-analysis was then performed in RevMan 5.2. Nine articles that satisfied the eligibility criteria were included in this Meta-analysis. Seven studies showed low bias risk, and the remaining studies exhibited moderate bias risk. Histological results showed that ultrasonic irrigation supplement could significantly improve canal and isthmus debridement at the apical area (P < 0.01). Antibacterial efficacy was evaluated by bacterial culture (P = 0.26) and polymerase chain reaction (P = 0.99) methods, no significant differences in antibacterial efficacy were observed. Ultrasonic irrigation supplement is more effective than syringe irrigation in root canal debridement at the apical area. However, antibacterial efficacy is not statistically significant.