Weipu Data Research Articles

Clinical efficacy and complications of blocking screw in the treatment of lower limb long bone fracture: An updated systematic review and meta-analysis.

Blocking screw technique has been widely applied in the treatment of long shaft fractures. However, the evidence with regard to whether intramedullary nail combined with blocking screw technique has better clinical efficacy over other is not clear. The aim of the study was to explore the clinical efficacy and complications of intramedullary nail combined with blocking screw technique in the treatment of femoral or tibial shaft fractures. The PuMed, Embase, OVID, Cochrane library, Web of Science, Wanfang, CNKI and Weipu data were searched for studies of intramedullary nail combined with blocking screw in treatment of femoral or tibial shaft fracture published up to Aug 31 2023. Methodological quality of the trials was assessed, relevant data were extracted, and RevMan 5.3 and Stata 15.0 software were used to perform the meta-analysis of parameters related to the consequences. Twenty articles were included, including 1267 patients. Meta-analysis results showed that compared with the non-blocking screw group, the blocking screw group had longer operation time (WMD = 13.24; 95% CI = 5.68-20.79, P = .0006) and more intraoperative fluoroscopy times (WMD = 57.62; 95% CI = 25.82-89.42, P = .0002). However, the postoperative therapeutic response rate was higher (OR = 5.60; 95% CI = 2.10-14.93, P = .0006), postoperative ankle joint function was better (OR = 3.48; 95% CI = 1.20-10.13, P = .02), and fracture healing rate was higher (OR = 3.56; 95% CI = 1.43-8.89, P = .006), fracture healing time was shorter (WMD = -3.59; 95% CI = -4.96 to -2.22, P < .00001), intraoperative blood loss was less (WMD = -54.80; 95% CI = -88.77 to -20.83, P = .002), hospitalization time was shorter (WMD = -1.66; 95% CI = -2.08 to -1.24, P < .00001), and complications were less (OR = 0.38; 95% CI = 0.16-0.89, P = .01). There was no statistical significance in the range of motion of knee joint between the 2 groups (WMD = 10.04; 95% CI = -1.51 to 21.59, P = .09). Current evidence shows that intramedullary nail combined with blocking screw technique in the treatment of lower limb long bone fracture has the advantages of good clinical efficacy, high fracture healing rate, short fracture healing time, good joint function, less complications and so on, which is worthy of clinical recommendation.

A Network Meta-Analysis of the Dose-Response Effects of Dapagliflozin on Efficacy and Safety in Adults With Type 1 Diabetes.

BackgroundMost patients with type 1 diabetes (T1DM) do not reach the blood glucose goal with treatment of insulin. In our research, we intended to estimate the therapeutic effect and safety of additional different doses of dapagliflozin on insulin treatment in T1DM.MethodsWe performed direct and indirect network meta-analysis using Bayesian models and graded different dosages of dapagliflozin by mixed therapy contrasts. We retrieved information from the PubMed, Embase, The Cochrane Library, Web of Science, China Biology Medicine (CBM) disc, China National Knowledge Infrastructure (CNKI), Wanfang Data, and WEIPU Data. Our research included randomized controlled trials (RCTs) including T1DM treated with insulin and additional dapagliflozin 5 mg or dapagliflozin 10 mg from January 2012 to June 2021. Thirteen RCTs with 10,701 participants were divided into three groups as below: insulin alone, dapagliflozin 5 mg + insulin, and dapagliflozin 10 mg + insulin.ResultsDapagliflozin dose-dependently exhibited reductions in glycated hemoglobin (HbA1c), total insulin daily dose (TDD), and body weight. Neither dapagliflozin 5 mg nor 10 mg could induce hypoglycemia or severe hypoglycemia. However, both doses of dapagliflozin increased the incidence of diabetic ketoacidosis (DKA) and genital infection.ConclusionsDapagliflozin 10 mg could achieve a better outcome in efficacy and could not increase the risk of hypoglycemia. Although it may induce a higher risk of DKA and genital infection, there was no significant difference between dapagliflozin 10 mg and 5 mg. Our outcomes indicate that dapagliflozin 10mg has a high reliability of being graded prior as a supplementary treatment to insulin in T1DM.

Care Experience of Parents of Children with Type 1 Diabetes Using Diabetes Treatment Technology: A Meta-Synthesis of Qualitative Studies

The systematic integration of the qualitative research on the real experience of the parents of children with type 1 diabetes using the diabetes treatment technology, to provide a reference for the promotion of the clinical use of diabetes. A systematic review and meta- synthesis of qualitative studies. Qualitative studies reporting the use of diabetes treatment Technology A qualitative study on raising experience of children with type 1 diabetes were retrieved from electronic databases of PubMed, Web of Science, Medline, Ovid, The Cochrane Library, Embase, CINAHL, Sinomed, JBI Evidence-based Health Care International Cooperation Center Library and WANFANG data, CNKI and WEIPU data from inception to May 31, 2021. Eight study were included, 11categories and 3 integration results were extracted, including using attitudes; perceive benefits; and facing difficulties and challenges. Diabetes treatment technology has many benefits in actual use, but there are also many obstacles. Clinical medical staff should take active measures against the obstacles in combination with the current situation to promote the clinical advancement of diabetes technology.

Effect of exercise rehabilitation on exercise capacity and quality of life in children with bronchial asthma: a systematic review.

To systematically evaluate the effect of exercise rehabilitation on exercise capacity and quality of life in children with bronchial asthma. PubMed, Cochrane Library, Web of Science, EBSCO, China National Knowledge Infrastructure, Weipu Data, and Wanfang Data were searched for randomized controlled trials (RCTs) on the effect of exercise rehabilitation on children with bronchial asthma published up to February 2021. RevMan 5.3 was used to perform a Meta analysis. A total of 14 studies were included, with 990 subjects in total. The Meta analysis showed that compared with the conventional treatment group, the exercise rehabilitation group had significantly better exercise capacity (distance covered in the 6-minute walk test: MD=108.13, P<0.01; rating of perceived effort: MD=-2.16, P<0.001; peak power: MD=0.94, P=0.001) and significantly higher total score of quality of life (SMD=1.28, P=0.0002), activity score (SMD=1.38, P=0.0002), symptom score (SMD=1.02, P<0.001), and emotional score (SMD=0.86, P<0.001) assessed by the Pediatric Asthma Quality of Life Questionnaire. Current evidence shows that exercise rehabilitation has a positive effect in improving exercise capacity and quality of life in children with bronchial asthma. Due to limited number and quality of studies included in the analysis, further research is needed.

Dignity therapy, psycho-spiritual well-being and quality of life in the terminally ill: systematic review and meta-analysis

ObjectivesDignity therapy (DT) is a brief, individualised psychotherapy that aims to alleviate psychosocial and spiritual distress in the final stages of life. It is unknown yet whether DT can enhance...

Safety and efficacy of eltrombopag in the treatment of children with immune thrombocytopenia: a Meta analysis.

To systematically assess the efficacy and safety of eltrombopag in the treatment of children with immune thrombocytopenia (ITP). PubMed, Embase, Cochrane Library, Weipu Data, CNKI, and Wanfang Data were searched for studies on eltrombopag used for the treatment of children with ITP. RevMan 5.3 and R version 3.6 were used to perform a Meta analysis of included studies. A total of 11 studies were included, with 2 randomized controlled trials and 9 cohort studies. The Meta analysis of the 9 cohort studies showed that eltrombopag had a response rate of about 70% (95%CI: 65%-76%) in the treatment of children with ITP, with no serious adverse events. The Meta analysis of the randomized controlled trials showed that the eltrombopag group had a higher response rate than the placebo group (RR=2.64, 95%CI: 1.58-4.44, P<0.05), while there was no significant difference in the incidence rates of adverse events and serious adverse events between the two groups (P>0.05). Eltrombopag has good efficacy and safety as a second-line treatment regimen for children with ITP.

Clinical features of children with recurrent Kawasaki disease: a Meta analysis

Objective To study the clinical features of children with recurrent Kawasaki disease (KD). Methods PubMed, Web of Science, Embase, CNKI, Wanfang Med Online, and Weipu Data were searched for case-control studies on the clinical features of initial and recurrent KD. The articles were screened according to the inclusion and exclusion criteria. RevMan 5.3 software was used to perform the Meta analysis. Effect models were selected based on the results of heterogeneity test, and then pooled OR or weighted mean difference (WMD), and their 95% CI were calculated. Results A total of 9 case-control studies were included, with 12 059 children with KD in total, among whom 206 children had recurrent KD (127 boys/61.7%; 79 girls/38.3%). The results of the Meta analysis showed that compared with the initial KD onset, the children with recurrent KD had a shorter duration of fever (WMD=-1.81, 95%CI:-2.99 to -0.64) and a lower proportion of children with swelling of the hands and feet (OR=0.46, 95%CI:0.26 to 0.80). There was no significant difference in the incidence rate of coronary artery lesions between recurrent KD and initial KD (OR=1.34, 95%CI:0.84 to 2.14). Conclusions Current evidence shows that children with recurrent KD tend to have a shorter duration of fever and a lower incidence of swelling of the hands and feet. KD recurrence is more common in boys. Current evidence does not show an increased risk of developing coronary artery lesions in children with recurrent KD.

GLI1 expression in pancreatic ductal adenocarcinoma correlates the clinical significance and prognosis: A meta-analysis.

Glioma-associated oncogene homolog 1(GLI1) expression correlates with the clinical significance and prognosis of several cancers. However, the evaluation of the role GLI1 expression plays in pancreatic ductal adenocarcinoma (PDAC) clinicopathological features and outcomes still lacks. The present study systemic reviewed the association of GLI1 expression and clinical significance as well as patients survival in PDAC. We systematically searched the database of The Cochrane Library, PubMed, Embase, CNKI, Weipu data, and Wanfang data according to the inclusion and exclusion criteria. (The search ended on January 1, 2019; no language restrictions). The Newcastle-Ottawa Scale (NOS) scale was implemented to assess the quality of the literature and the Review Manager 5.3 Software was used to conduct a meta-analysis. Finally, 9 studies, a total of 1058 patients, have been included. GLI1 is more likely expressed in PDAC tissue rather than para-carcinoma tissue (OR = 2.86, 95%CI = 1.87-4.36, P < .00001). GLI1 expression is associated with the TNM stage (OR = 3.11, 95%CI = 2.01-4.79, P < .00001), perineural invasion (OR = 2.50, 95%CI = 1.28-4.91, P = .008), and lymphatic metastasis (OR = 2.73, 95%CI = 1.71-4.36, P < .0001). But the association with differentiation (OR = 1.20, 95%CI = 0.74-1.96, P = .46) and tumor size (OR = 2.41, 95%CI = 0.97-6.00, P = .06) was not significant. GLI1 expression is related to the worse overall survival in PDACs (HR = 1.68, 95%CI = 1.40-2.02, P < .00001). Positive GLI1 expression promotes the progression and metastasis of PDACs and plays an important role in the clinical significance and the patients survival.

Efficacy and safety of vitamin D as adjuvant therapy for childhood pneumonia: a Meta analysis

To study the efficacy and safety of vitamin D as an adjuvant therapy for childhood pneumonia through a systematic review. Cochrane Library, PubMed, EMbase, CNKI, Wanfang Data, and Weipu Data were searched for randomized controlled trials (RCTs) of vitamin D as the adjuvant therapy for childhood pneumonia published up to August 2019. Literature screening, quality assessment, and data extraction were performed based on inclusion and exclusion criteria. Revman 5.3 was used to perform the Meta analysis of outcome indicators. A total of 7 RCTs with 1 527 children were included, with 762 children in the vitamin D adjuvant therapy group and 765 children in the control group. The results of the Meta analysis showed that vitamin D adjuvant therapy had no effect on recovery time (P=0.67), length of hospital stay (P=0.73), and time to relief of fever (P=0.43). Furthermore, it did not reduce the recurrence rate (P=0.14), rate of adverse events (P=0.20), and mortality rate (P=0.98) of childhood pneumonia. Current evidence shows that vitamin D adjuvant therapy has no marked efficacy in the treatment of childhood pneumonia.

Sutureless technique versus conventional surgery in the primary treatment of total anomalous pulmonary venous connection: a systematic review and meta-analysis

BackgroudA meta-analysis was performed to compare the differences in outcomes between sutureless technique and conventional surgery for primary repair of Total Anomalous Pulmonary Venous Connection(TAPVC).MethodsElectronic databases, including PubMed, EMbase, Medline, CNKI, Wanfang Data and Weipu Data were searched systematically for the literature aimed mainly at comparing the therapeutic effects for primary repair of TAPVC administered by sutureless technique and conventional surgery. Corresponding data sets were extracted and two reviewers independently assessed the methodological quality.ResultsSeven studies meeting the inclusion criteria were included, involving a total of 1293 subjects. It was observed that sutureless technique entailed a lower occurrence rate of post-operative Pulmonary Veins Obstruction (PVO) (OR, 0.52 95%CI, 0.32–0.86; P = 0.01) and re-operation due to PVO (OR, 0.28;95%CI, 0.09–0.87; P = 0.03). However, meta-analyses of hospitalization time (WMD, 5.92; 95%CI, − 7.97-19.80; P = 0.40) and post-operative mortality (OR, 0.65; 95%CI, 0.41–1.04; P = 0.07) showed no significant differences between sutureless technique and conventional surgery. Meta-analysis of Cardiopulmonary Bypass (CPB) time and aortic cross-clamp time also showed no significant differences between the two surgical approaches (WMD, 5.07; 95%CI, − 9.29-19.42; P = 0.49); (WMD, 5.73; 95%CI, − 7.76-19.23; P = 0.40), but the result remained inconclusive due to pooling result changes after sensitivity analysis.ConclusionsCompared with conventional surgery, a lower occurrence rate of post-operative PVO and re-operation due to PVO were associated with sutureless technique. Meanwhile, hospitalization time and post-operative mortality were not statistically different between the two surgical approaches. Pooling result of CPB and aortic cross-clamp time between the two groups remained inconclusive.

Association of single nucleotide polymorphisms of transcription factors with congenital heart diseases in the Chinese population: a Meta analysis

To study the association of single nucleotide polymorphisms (SNPs) of transcription factors (NKX2.5, GATA4, TBX5, and FOG2) with congenital heart disease (CHD) in the Chinese population. PubMed, Google Scholar, CNKI, Wanfang Data, and Weipu Data were searched for articles on the association of SNPs of target genes with CHD in the Chinese population. If one locus was mentioned in at least two articles, the random or fixed effect model was used to perform a pooled analysis of study results and to calculate the pooled OR and its 95%CI. If a locus was mentioned in only one article, related data were extracted from this article to analyze the association between the SNPs of this locus and CHD. Twenty-three articles were included. The Meta analysis showed that there were significant differences between the CHD and control groups in the genotype and allele frequencies of GATA4 rs1139244 and rs867858 and the genotype frequency of GATA4 rs904018, while there were no significant differences in the SNPs of the other genetic loci between the two groups. The single-article analysis showed that there were significant differences between the two groups in the allele frequencies of NKX2.5 rs118026695/rs703752, GATA4 rs884662/rs12825/rs12458/rs3203358/rs4841588, and TBX5 rs6489956. There were no significant differences in the SNPs of FOG2 locus between the two groups. The SNPs of some loci in NKX2.5, GATA4, and TBX5 are associated with CHD in the Chinese population, but the association between the SNPs of FOG2 locus and the development of CHD has not been found yet.

Effects of hospital-community integrated management mode on diabetes mellitus: a systematic review

Objective To systematically review the effects of hospital-community integrated management mode in diabetes mellitus. Methods To comprehensively search the database including CNKI, Taiwan Airiti library, WanFang Data, WeiPu Data and PubMed, we manually searched the relevant references of literature for the RCTs on hospital-community integrated management mode in diabetes mellitus, and Meta-analysis was used by software Revman 5.2, and making descriptive analysis of the outcomes which could not be merged. Results A total of 15 RCTs were included involving 3 in English and 12 in Chinese, and 7 studies with high-quality and 8 of them with low-quality. According to the 11 evaluation focused outcomes indexes, the result of Meta-analysis showed that compared with conventional management, the hospital-community integration mode could effectively improve patients′ biochemical indicators such as glycated hemoglobin (HbA1c)[MD=-0.39, 95%CI(-0.56, -0.22), P<0.001], fasting plasma glucose[MD=-0.75, 95%CI (-1.16, -0.33), P<0.001], triglycerides[MD=-0.36, 95%CI (-0.63, -0.10), P=0.007], high-density lipoprotein (HDL-C)[MD=0.09, 95%CI (0.04, 0.14), P<0.001], low density lipoprotein (LDL-C)[MD=-0.15, 95%CI (-0.23, -0.06), P=0.001], but there was no effect on total cholesterol[MD=-0.27, 95%CI (-0.58, 0.03), P=0.080]. At the same time, the descriptive analysis presented that the model could improve patients′ awareness rate of diabetes health knowledge and promote the correct behavior of medication and regular exercise, in addition it could increase the score of life quality and reduce medical expenses. Conclusions Diabetes hospital-community integrated management can effectively improve the level of blood glucose and blood lipids, reduce the occurrence and development of related complications and provide a reliable basis for the management of diabetic patients. There is a positive impact to improve the patients′ behavior and quality of life, but it requires more randomized controlled studies to be analyzed and verified. Key words: Diabetes; Systematic review; Meta-analysis; Hospital-community integrated management mode

The efficacy of intrauterine devices for emergency contraception: a systematic review of 35 years of experience

Intrauterine devices (IUDs) have been studied for use for emergency contraception for at least 35 years. IUDs are safe and highly effective for emergency contraception and regular contraception, and are extremely cost-effective as an ongoing method. The objective of this study was to evaluate the existing data to estimate the efficacy of IUDs for emergency contraception. The reference list for this study was generated from hand searching the reference lists of relevant articles and our own article archives, and electronic searches of several databases: Medline, Global Health, Clinicaltrials.gov, Popline, Wanfang Data (Chinese) and Weipu Data (Chinese). We included studies published in English or Chinese, with a defined population of women who presented for emergency contraception and were provided with an IUD, and in which the number of pregnancies was ascertained and loss to follow-up was clearly defined. Data from each article were abstracted independently by two reviewers. The 42 studies (of 274 retrieved) that met our inclusion criteria were conducted in six countries between 1979 and 2011 and included eight different types of IUD and 7034 women. The maximum timeframe from intercourse to insertion of the IUD ranged from 2 days to 10 or more days; the majority of insertions (74% of studies) occurred within 5 days of intercourse. The pregnancy rate (excluding one outlier study) was 0.09%. IUDs are a highly effective method of contraception after unprotected intercourse. Because they are safe for the majority of women, highly effective and cost-effective when left in place as ongoing contraception, whenever clinically feasible IUDs should be included in the range of emergency contraception options offered to patients presenting after unprotected intercourse. This review is limited by the fact that the original studies did not provide sufficient data on the delay between intercourse and insertion of the IUD, parity, cycle day of intercourse or IUD type to allow analysis by any of these variables.