目的系统评价热疗联合化疗(热化)与单纯化疗(单化)比较治疗晚期胃癌的疗效和安全性。方法计算机检索Cochrane Library、PubMed、EMBASE、中国生物医学文献数据库、中国期刊全文数据库、中文科技期刊数据库和万方数据-数字化期刊全文数据...目的系统评价热疗联合化疗(热化)与单纯化疗(单化)比较治疗晚期胃癌的疗效和安全性。方法计算机检索Cochrane Library、PubMed、EMBASE、中国生物医学文献数据库、中国期刊全文数据库、中文科技期刊数据库和万方数据-数字化期刊全文数据库,同时辅以其他检索。收集所有比较热疗联合化疗与单纯化疗的随机对照试验。根据Cochrane系统评价员手册5.1质量评价标准对纳入文献进行质量评价,并使用STATA SE 12.0软件进行Meta分析。结果最终纳入5个随机对照试验(351例晚期胃癌患者)。Meta分析结果显示:在疗效方面,热化组的完全缓解率[OR=2.13,95%CI(1.17,3.86),P=0.013]及总有效率[OR=1.37,95%CI(1.09,1.73),P=0.006]均高于单化组,其差异均有统计学意义;在安全性方面,热化组与单化组的不良反应均无统计学差异。结论与单纯化疗相比,热疗联合化疗治疗晚期胃癌可明显提高完全缓解率与总有效率,不良反应发生率未增加。受纳入研究质量和数量所限,上述结论尚需开展更多高质量研究,特别是大样本、关注更多主要结局指标的随机对照试验。推荐结合患者具体情况进行临床应用。展开更多
目的:通过Meta分析系统评价参麦注射液联合西医疗法治疗脓毒性休克的临床疗效。方法:检索PubMed、Cochrane图书馆、Embase、Web of Science、中国知网(CNKI)、中华医学期刊全文数据库、中国生物医学数据库、万方数据库、维普网等电子数...目的:通过Meta分析系统评价参麦注射液联合西医疗法治疗脓毒性休克的临床疗效。方法:检索PubMed、Cochrane图书馆、Embase、Web of Science、中国知网(CNKI)、中华医学期刊全文数据库、中国生物医学数据库、万方数据库、维普网等电子数据库中有关参麦注射液联合西医疗法治疗脓毒性休克的随机对照研究(RCT)。根据纳入、排除标准进行文献筛选和资料提取,采用RevMan 5.3软件进行Meta分析。结果:纳入11项RCT,共935例患者,其中参麦组468例,对照组467例。参麦组较对照组能够降低28 d病死率﹝OR=0.58,95%CI(0.36,0.93),P=0.02﹞,提高临床总有效率﹝OR=4.16,95%CI(1.67,10.39),P=0.002﹞,改善7 d后急性生理学与慢性健康状况评分系统(APACHE-Ⅱ)评分、血降钙素原(PCT)水平、血乳酸水平,差异均有统计学意义(P<0.01)。结论:参麦注射液联合西医疗法能够提高脓毒性休克患者的治疗效果。展开更多
Background: Emerging evidence indicates that chemotherapy for lung cancer may alter EGFR mutation status. However, whether chemotherapy as a firstline treatment may increase or reduce the frequency of EGFR mutations i...Background: Emerging evidence indicates that chemotherapy for lung cancer may alter EGFR mutation status. However, whether chemotherapy as a firstline treatment may increase or reduce the frequency of EGFR mutations in NSCLC remains uncertain. Therefore, we conducted a meta-analysis to evaluate whether chemotherapy leads to altered EGFR mutation status. Methods: A systematic literature search was performed using the PubMed, OVID, Science Direct, Cochrane Library, and CNKI databases for studies on pre- and post-chemotherapy EGFR mutation status. Relevant studies documenting perichemotherapy EGFR mutation ratios were included. Analyses of pooled odds ratios (OR) were performed. Results: Six studies involving 656 patients were included in this meta-analysis. It was found that chemotherapy may alter EGFR status (OR = 1.93, 95% CI 1.05 - 3.56;p < 0.0001). No significant differences in EGFR mutation alterations were observed in terms of gender, smoking history, EGFR loci, or chemotherapy response in NSCLC patients. Conclusions: Chemotherapy may contribute to altered EGFR status. NSCLC patients with EGFR mutations might need to be considered for EGFR status redeterminations prior to second-line EGFR-TKI treatment or upon tumor recurrence after chemotherapy. Further randomized clinical trials should investigate the impact of neoadjuvant or first-line chemotherapy on EGFR mutation status in NSCLC patients.展开更多
目的评价实体器官移植(Solid Organ Transplantation,SOT)受者接种三价流行性感冒灭活疫苗(Trivalent Influenza Inactivated Vaccine,TIV)的免疫原性。方法电子检索美国国家医学图书馆数据库(National Center for Biotechnology Inform...目的评价实体器官移植(Solid Organ Transplantation,SOT)受者接种三价流行性感冒灭活疫苗(Trivalent Influenza Inactivated Vaccine,TIV)的免疫原性。方法电子检索美国国家医学图书馆数据库(National Center for Biotechnology Information,NCBI)、Cochrane协作网图书馆、中国生物医学文献数据库(China Biology Medicine disc,CBMd)、中国期刊全文数据库(China National Knowledge Infrastructure,CNKI)和万方全文数据库(Wanfang Database,WF),将有关评价SOT受者接种TIV免疫原性的前瞻性研究纳入分析。以接种1剂次TIV后针对A/H1N1、A/H3N2和B型3个疫苗株的短期血清抗体阳转率(Seroconversion Antibody Rate,SR)作为结局指标,使用Rev Man5.3软件合并所有研究的SR和对照设计研究的率差(Risk Difference,RD)。结果纳入21篇文献,有15篇为对照设计,余6篇为非对照设计。SOT受者接种TIV后针对A/H1N1、A/H3N2和B型疫苗株的SR分别为56%(95%CI:42%~70%)、55%(95%CI:43%~67%)和46%(95%CI:30%~63%);SOT受者与对照组接种TIV后各型疫苗株SR的RD分别为-18%(95%CI:-31%^-5%)、-18%(95%CI:-29%^-7%)和-13%(95%CI:-23%^-3%),其中成人SOT组与对照组各型疫苗株SR的RD分别为-14%(95%CI:-18%^-9%)、-23%(95%CI:-28%^-18%)和-20%(95%CI:-25%^-15%);肾移植受者与对照组各型疫苗株SR的RD分别为-21%(95%CI:-36%^-5%)、-16%(95%CI:-28%^-4%)和-9%(95%CI:-15%^-3%)。结论 SOT受者接种TIV后免疫应答低于普通人群,但接种TIV仍可使SOT受者获益,建议SOT受者及其医护人员、密切接触者、家庭成员每年接种TIV。展开更多
文摘目的系统评价热疗联合化疗(热化)与单纯化疗(单化)比较治疗晚期胃癌的疗效和安全性。方法计算机检索Cochrane Library、PubMed、EMBASE、中国生物医学文献数据库、中国期刊全文数据库、中文科技期刊数据库和万方数据-数字化期刊全文数据库,同时辅以其他检索。收集所有比较热疗联合化疗与单纯化疗的随机对照试验。根据Cochrane系统评价员手册5.1质量评价标准对纳入文献进行质量评价,并使用STATA SE 12.0软件进行Meta分析。结果最终纳入5个随机对照试验(351例晚期胃癌患者)。Meta分析结果显示:在疗效方面,热化组的完全缓解率[OR=2.13,95%CI(1.17,3.86),P=0.013]及总有效率[OR=1.37,95%CI(1.09,1.73),P=0.006]均高于单化组,其差异均有统计学意义;在安全性方面,热化组与单化组的不良反应均无统计学差异。结论与单纯化疗相比,热疗联合化疗治疗晚期胃癌可明显提高完全缓解率与总有效率,不良反应发生率未增加。受纳入研究质量和数量所限,上述结论尚需开展更多高质量研究,特别是大样本、关注更多主要结局指标的随机对照试验。推荐结合患者具体情况进行临床应用。
文摘Background: Emerging evidence indicates that chemotherapy for lung cancer may alter EGFR mutation status. However, whether chemotherapy as a firstline treatment may increase or reduce the frequency of EGFR mutations in NSCLC remains uncertain. Therefore, we conducted a meta-analysis to evaluate whether chemotherapy leads to altered EGFR mutation status. Methods: A systematic literature search was performed using the PubMed, OVID, Science Direct, Cochrane Library, and CNKI databases for studies on pre- and post-chemotherapy EGFR mutation status. Relevant studies documenting perichemotherapy EGFR mutation ratios were included. Analyses of pooled odds ratios (OR) were performed. Results: Six studies involving 656 patients were included in this meta-analysis. It was found that chemotherapy may alter EGFR status (OR = 1.93, 95% CI 1.05 - 3.56;p < 0.0001). No significant differences in EGFR mutation alterations were observed in terms of gender, smoking history, EGFR loci, or chemotherapy response in NSCLC patients. Conclusions: Chemotherapy may contribute to altered EGFR status. NSCLC patients with EGFR mutations might need to be considered for EGFR status redeterminations prior to second-line EGFR-TKI treatment or upon tumor recurrence after chemotherapy. Further randomized clinical trials should investigate the impact of neoadjuvant or first-line chemotherapy on EGFR mutation status in NSCLC patients.
文摘目的评价实体器官移植(Solid Organ Transplantation,SOT)受者接种三价流行性感冒灭活疫苗(Trivalent Influenza Inactivated Vaccine,TIV)的免疫原性。方法电子检索美国国家医学图书馆数据库(National Center for Biotechnology Information,NCBI)、Cochrane协作网图书馆、中国生物医学文献数据库(China Biology Medicine disc,CBMd)、中国期刊全文数据库(China National Knowledge Infrastructure,CNKI)和万方全文数据库(Wanfang Database,WF),将有关评价SOT受者接种TIV免疫原性的前瞻性研究纳入分析。以接种1剂次TIV后针对A/H1N1、A/H3N2和B型3个疫苗株的短期血清抗体阳转率(Seroconversion Antibody Rate,SR)作为结局指标,使用Rev Man5.3软件合并所有研究的SR和对照设计研究的率差(Risk Difference,RD)。结果纳入21篇文献,有15篇为对照设计,余6篇为非对照设计。SOT受者接种TIV后针对A/H1N1、A/H3N2和B型疫苗株的SR分别为56%(95%CI:42%~70%)、55%(95%CI:43%~67%)和46%(95%CI:30%~63%);SOT受者与对照组接种TIV后各型疫苗株SR的RD分别为-18%(95%CI:-31%^-5%)、-18%(95%CI:-29%^-7%)和-13%(95%CI:-23%^-3%),其中成人SOT组与对照组各型疫苗株SR的RD分别为-14%(95%CI:-18%^-9%)、-23%(95%CI:-28%^-18%)和-20%(95%CI:-25%^-15%);肾移植受者与对照组各型疫苗株SR的RD分别为-21%(95%CI:-36%^-5%)、-16%(95%CI:-28%^-4%)和-9%(95%CI:-15%^-3%)。结论 SOT受者接种TIV后免疫应答低于普通人群,但接种TIV仍可使SOT受者获益,建议SOT受者及其医护人员、密切接触者、家庭成员每年接种TIV。
