目的对射频消融联合经导管动脉化疗栓塞治疗原发性肝癌的系统评价/Meta分析进行再评价。方法计算机检索中国知网、万方、维普、中国生物医学文献数据库、PubMed、Embase、Web of Science数据库,检索截止时间为2022年12月31日,搜索射频...目的对射频消融联合经导管动脉化疗栓塞治疗原发性肝癌的系统评价/Meta分析进行再评价。方法计算机检索中国知网、万方、维普、中国生物医学文献数据库、PubMed、Embase、Web of Science数据库,检索截止时间为2022年12月31日,搜索射频消融联合经导管动脉化疗栓塞治疗原发性肝癌的系统评价/Meta分析。应用AMSTAR 2量表、PRISMA声明和GRADE分级系统对纳入文献的报告质量、方法学质量和证据级别进行再评价。结果共纳入13篇系统评价/Meta分析,发表年份为2011年-2022年。AMSTAR 2量表评价结果显示,4篇为低质量,余均为极低质量,无中、高质量系统评价/Meta分析。PRISMA声明评价结果显示,9篇文献的评分为15~21分,存在一定的报告缺陷,仅4篇报告相对完整。GRADE系统对9个临床结局指标75个证据体的评价结果显示,无高等证据质量,中等证据质量占29%,低等证据质量占32%,极低等证据质量占39%。结论射频消融联合经导管动脉化疗栓塞可提高原发性肝癌患者1年、3年总生存率,证据质量等级为中等;但其对5年总生存率、无复发生存率、并发症的影响以及是否对直径3~5 cm的肝细胞癌患者更有效,仍需更多高质量的临床研究及系统评价加以验证。展开更多
AIM: To analyze through meta-analyses the benefits of two types of stents in the inoperable malignant biliary obstruction.METHODS: A systematic review of randomized clinical trials(RCT) was conducted, with the last up...AIM: To analyze through meta-analyses the benefits of two types of stents in the inoperable malignant biliary obstruction.METHODS: A systematic review of randomized clinical trials(RCT) was conducted, with the last update on March 2015, using EMBASE, CINAHL(EBSCO), MEDLINE, LILACS/CENTRAL(BVS), SCOPUS, CAPES(Brazil), and gray literature. Information of the selected studies was extracted in sight of six outcomes: primarily regarding dysfunction, complication and reintervention rates; and secondarily costs, survival, and patency time. The data about characteristics of trial participants, inclusion and exclusion criteria and types of stents were also extracted. The bias was mainly assessed through the JADAD scale. This meta-analysis was registered in the PROSPERO database by the number CRD42014015078. The analysis of the absolute risk of the outcomes was performed using the software Rev Man, by computing risk differences(RD) of dichotomous variables and mean differences(MD) of continuous variables. Data on RD and MD for each primary outcome were calculated using the MantelHaenszel test and inconsistency was qualified and reported in χ2 and the Higgins method(I2). Sensitivity analysis was performed when heterogeneity was higher than 50%, a subsequent assay was done and other findings were compiled. Student's t-test was used for the comparison of weighted arithmetic means regarding secondary outcomes.RESULTS: Initial searching identified 3660 studies; 3539 were excluded through title, repetition, and/or abstract, while 121 studies were fully assessed and were excluded mainly because they did not compare self-expanding metal stents(SEMS) and plastic stents(PS), leading to thirteen RCT selected, with 13 articles and 1133 subjects meta-analyzed. The mean age was 69.5 years old, that were affected mostly by bile duct(proximal) and pancreatic tumors(distal). The preferred SEMS diameter used was the 10 mm(30 Fr) and the preferred PS diameter used was 10 Fr. In the metaanalysis, SEMS had lower overall stent dysfunction comp展开更多
目的:系统评价补肾法治疗少弱精症的疗效及安全性。方法:检索建库至2016年9月CBM、CNKI、The Coc hrane Library、Pub Med等中英文数据库中补肾法治疗少弱精症的随机/半随机对照试验,运用Rev Man 5.3对临床结局指标进行Meta分析或描述...目的:系统评价补肾法治疗少弱精症的疗效及安全性。方法:检索建库至2016年9月CBM、CNKI、The Coc hrane Library、Pub Med等中英文数据库中补肾法治疗少弱精症的随机/半随机对照试验,运用Rev Man 5.3对临床结局指标进行Meta分析或描述性分析。结果:共纳入30项临床研究,共3699例患者。与对照组相比,在补肾填精法治疗基础上,分别加用肾阴阳双补法、温补肾阳法、补肾祛湿法、补益脾肾法或补肾活血法可显著提高患者临床有效率(P≤0.05),而补肾疏肝法则无明显差异(P>0.05);此外,在补肾填精法治疗基础上,加用肾阴阳双补法、温补肾阳或补肾祛湿法可显著提高患者配偶妊娠率(P≤0.05),而补肾活血和补肾疏肝法效果不明显(P>0.05)。在安全性方面,除1项临床试验外,其余治疗组不良反应发生率均低于对照组。结论:在补肾填精法基础上,加用肾阴阳双补法、温补肾阳法或补肾祛湿法治疗效果较佳,且安全性良好;其次为补益脾肾法或补肾活血法,而补肾疏肝法未显示出更多优势。展开更多
文摘AIM: To analyze through meta-analyses the benefits of two types of stents in the inoperable malignant biliary obstruction.METHODS: A systematic review of randomized clinical trials(RCT) was conducted, with the last update on March 2015, using EMBASE, CINAHL(EBSCO), MEDLINE, LILACS/CENTRAL(BVS), SCOPUS, CAPES(Brazil), and gray literature. Information of the selected studies was extracted in sight of six outcomes: primarily regarding dysfunction, complication and reintervention rates; and secondarily costs, survival, and patency time. The data about characteristics of trial participants, inclusion and exclusion criteria and types of stents were also extracted. The bias was mainly assessed through the JADAD scale. This meta-analysis was registered in the PROSPERO database by the number CRD42014015078. The analysis of the absolute risk of the outcomes was performed using the software Rev Man, by computing risk differences(RD) of dichotomous variables and mean differences(MD) of continuous variables. Data on RD and MD for each primary outcome were calculated using the MantelHaenszel test and inconsistency was qualified and reported in χ2 and the Higgins method(I2). Sensitivity analysis was performed when heterogeneity was higher than 50%, a subsequent assay was done and other findings were compiled. Student's t-test was used for the comparison of weighted arithmetic means regarding secondary outcomes.RESULTS: Initial searching identified 3660 studies; 3539 were excluded through title, repetition, and/or abstract, while 121 studies were fully assessed and were excluded mainly because they did not compare self-expanding metal stents(SEMS) and plastic stents(PS), leading to thirteen RCT selected, with 13 articles and 1133 subjects meta-analyzed. The mean age was 69.5 years old, that were affected mostly by bile duct(proximal) and pancreatic tumors(distal). The preferred SEMS diameter used was the 10 mm(30 Fr) and the preferred PS diameter used was 10 Fr. In the metaanalysis, SEMS had lower overall stent dysfunction comp
文摘目的:系统评价补肾法治疗少弱精症的疗效及安全性。方法:检索建库至2016年9月CBM、CNKI、The Coc hrane Library、Pub Med等中英文数据库中补肾法治疗少弱精症的随机/半随机对照试验,运用Rev Man 5.3对临床结局指标进行Meta分析或描述性分析。结果:共纳入30项临床研究,共3699例患者。与对照组相比,在补肾填精法治疗基础上,分别加用肾阴阳双补法、温补肾阳法、补肾祛湿法、补益脾肾法或补肾活血法可显著提高患者临床有效率(P≤0.05),而补肾疏肝法则无明显差异(P>0.05);此外,在补肾填精法治疗基础上,加用肾阴阳双补法、温补肾阳或补肾祛湿法可显著提高患者配偶妊娠率(P≤0.05),而补肾活血和补肾疏肝法效果不明显(P>0.05)。在安全性方面,除1项临床试验外,其余治疗组不良反应发生率均低于对照组。结论:在补肾填精法基础上,加用肾阴阳双补法、温补肾阳法或补肾祛湿法治疗效果较佳,且安全性良好;其次为补益脾肾法或补肾活血法,而补肾疏肝法未显示出更多优势。
