[目的]基于已发表的齐拉西酮速效针剂对精神分裂症患者激越症状治疗的中英文文献,综合分析齐拉西酮针剂治疗激越症状的疗效及其相关影响因素。[方法]检索PubMed、EMBASE、W eb of Knowledge、Cochrane Library、万方数据,中国期刊全文...[目的]基于已发表的齐拉西酮速效针剂对精神分裂症患者激越症状治疗的中英文文献,综合分析齐拉西酮针剂治疗激越症状的疗效及其相关影响因素。[方法]检索PubMed、EMBASE、W eb of Knowledge、Cochrane Library、万方数据,中国期刊全文数据库,中国生物医学文献数据库(C BMdisc)和维普网,应用随机临床试验报告的声明(CONSORT)为参照标准进行入组和评价文献,采用STATA软件进行Meta分析,以疗效的效应值为因变量,性别、年龄、治疗前PANSS量表总分、是否合并口服抗精神病药物等为协变量,进行Meta回归模型分析。[结果]根据GRADE方法,主要结局指标的证据水平为“中度”。共有14项研究纳入Meta分析和Meta回归,其中英文5篇、中文9篇。治疗前后样本量分别为1197和1149。随机效应Meta分析结果显示齐拉西酮针剂疗效显著[SMD=2.04,95%CI(1.47,2.61),P=0.000]。Meta回归分析显示,疗效与基线PANSS分数(t=5.57,P=0.011)、合并使用口服抗精神病药物(t=4.07,P=0.027)有关,与文献发表语种(t=-0.57,P=0.625)、年龄(t=0.74,P=0.539)无关,女性相对于男性有疗效更优的统计学差异趋势(t=-2.95,P=0.060)。[结论]齐拉西酮速效针剂治疗精神分裂症患者激越症状疗效良好,Meta回归模型显示治疗前病情较重、合并口服抗精神病药物的患者疗效更好。展开更多
Objective:To explore the relationship between Hashimoto's autoimmune hypothyroidism(HT)and male fertility,focusing on hormonal and seminal factors.Methods:A systematic literature search was conducted across databa...Objective:To explore the relationship between Hashimoto's autoimmune hypothyroidism(HT)and male fertility,focusing on hormonal and seminal factors.Methods:A systematic literature search was conducted across databases such as PubMed,Web of Science,EMBASE,Scopus,Cochrane,and Google Scholar,covering studies published from January 2000 to March 2024.Studies investigating the impact of HT on semen quality parameters and reproductive hormones were included.Pooled effect estimates were calculated using standard mean difference(SMD)and 95%confidence intervals(CI).Results:A total of 8 studies with 8965 participants were included.HT significantly affected semen quality and reproductive hormone levels.Specifically,there was a notable decrease in progressive morphology(SMD=-0.78;95%CI:-1.40 to-0.17;P=0.01)and sperm motility(SMD=-1.151;95%CI:-1.876 to-0.425;P=0.002).In addition,there were no significant changes in reproductive hormones,although there were elevated levels of luteinizing hormone(SMD=0.437;95%CI:0.000 to 0.874;P=0.050)and follicle-stimulating hormone(SMD=0.293;95%CI:-0.171 to 0.758;P=0.216),with a slight impact on testosterone levels(SMD=-1.143;95%CI:-2.487 to 0.200;P=0.095).Conclusions:This systematic review and meta-analysis provides robust evidence of the detrimental effects of HT on semen quality and reproductive hormones,underscoring the necessity for thorough evaluation and management of thyroid function in male infertility assessments.展开更多
AIM： To compare two treatments for ruptured cerebral aneurysm with reference to the relative risk of develop-ing hydrocephalus.METHODS： We reviewed the English language litera-ture on the risk of developing hydrocep...AIM： To compare two treatments for ruptured cerebral aneurysm with reference to the relative risk of develop-ing hydrocephalus.METHODS： We reviewed the English language litera-ture on the risk of developing hydrocephalus after an-eurysm treatment. Data were divided by type of study （randomized controlled trial, cohort trial, nonrandomized comparison, prospectively- and retrospectively-collected observational study）. They were also divided by type of aneurysm treatment （microvascular - clipping, or endo-vascular - coiling）. Additional predictive variables collected for each publication were average age, gender distribu-tion, measures of hemorrhage volume and subarachnoid hemorrhage severity, aneurysm locations, time to treat-ment, duration of follow-up and date of publication. Weemployed meta-analysis to calculate pooled risk ratios of developing hydrocephalus in cases receiving aneurysm clipping vs those receiving coiling. Meta-regression was used to correct pooled results for covariates.RESULTS： Because indications for the two treatments are different, there is little clinical equipoise for treat-ing most cases. The single randomized, controlled trial dealt with a small subset of ruptured aneurysms. Nei-ther this nor pooled values from other studies which compared the two treatments had the power to dem-onstrate signifcant differences between the two treat-ments. Nor was there an apparent difference when observational data were meta-analytically pooled. How-ever, when meta-regression was used to correct for predictive variables known to differ between the two treatment groups, a highly-significant difference ap-peared. Coiling is used more commonly in older, sicker patients with aneurysms in certain locations. These cases are more likely to develop hydrocephalus. When corrected for these covariates, the risk of hydrocepha-lus was found to be significantly lower in coiled vsclipped cases （P = 0.014）.CONCLUSION： Pooled observational data were nec-essary to demonstrate that coiling ruptured cer展开更多
BACKGROUND Glucagon-like peptide-1 receptor agonists(GLP-1RA)and sodium-glucose co-transporter-2 inhibitors(SGLT-2I)are associated with significant cardiovascular benefit in type 2 diabetes(T2D).However,GLP-1RA or SGL...BACKGROUND Glucagon-like peptide-1 receptor agonists(GLP-1RA)and sodium-glucose co-transporter-2 inhibitors(SGLT-2I)are associated with significant cardiovascular benefit in type 2 diabetes(T2D).However,GLP-1RA or SGLT-2I alone may not improve some cardiovascular outcomes in patients with prior cardiovascular co-morbidities.AIM To explore whether combining GLP-1RA and SGLT-2I can achieve additional benefit in preventing cardiovascular diseases in T2D.METHODS The systematic review was conducted according to PRISMA recommendations.The protocol was registered on PROSPERO(ID:42022385007).A total of 107049 participants from eligible cardiovascular outcomes trials of GLP-1RA and SGLT-2I were included in network meta-regressions to estimate cardiovascular benefit of the combination treatment.Effect modification of prior myocardial infarction(MI)and heart failure(HF)was also explored to provide clinical insight as to when the INTRODUCTION The macro-and micro-vascular benefits of glucagon-like peptide-1 receptor agonists(GLP-1RA)and sodium-glucose co-transporter-2 inhibitors(SGLT-2I)are independent of their glucose-lowering effects[1].In patients with type 2 diabetes(T2D),the major cardiovascular outcome trials(CVOT)showed that dipeptidyl peptidase-4 inhibitors(DPP-4I)did not improve cardiovascular outcomes[2],whereas cardiovascular benefit of GLP-1RA or SGLT-2I was significant[3,4].Further subgroup analyses indicated that the background cardiovascular risk should be considered when examining the cardiovascular outcomes of these newer glucose-lowering medications.For instance,prevention of major adverse cardiovascular events(MACE)was only seen in those patients with baseline atherosclerotic cardiovascular disease[3,4].Moreover,a series of CVOT conducted in patients with heart failure(HF)have demonstrated that(compared with placebo)SGLT-2I significantly reduced risk of hospitalization for HF or cardiovascular death,irrespective of their history of T2D[5-8].However,similar cardiovascular benefits were not observed in those 展开更多
Assessment of population parameters and genetic diversity is critical for the economic and threatened species,including Oreochromis mossambicus.The morphometric and population parameters data for O.mossambicus were ex...Assessment of population parameters and genetic diversity is critical for the economic and threatened species,including Oreochromis mossambicus.The morphometric and population parameters data for O.mossambicus were extracted based on the available literature from various countries.Phylogenetic and genetic diversity were analyzed based on cytochrome c oxidaseⅠ(COⅠ)sequences of the mitochondrial DNA(mtDNA)gene.The population parameters(asymptotic length(L_(∞)),growth constant(K),growth performance index(Ø),approximate maximum age(t_(max)),standard length(L),and weight(W))results revealed a variation among the populations studied.The result categorized the population into two groups:South African populations located close to Zimbabwe,Mozambique,Namibia,Australia,and China,as GroupⅠ,and the Indian population placed close to Thailand,the Philippines,Indonesia,America,and Mexico as GroupⅡ.The meta-regression results reveal that temperature strongly correlated with weight.In contrast,other population factors showed no significant differences.The haplotype analysis based on COI of mtDNA displayed 21 haplotypes,which revealed low nucleotide(π=0.025)diversity.Haplotype diversity(HD)was 0.65.The haplotype analysis showed that Tajima(D)was negative(-0.82)and Fu’s Fs was positive(2.2),and both tests were not significant(P>0.05),whereas the overall F-statistic(F_(st))value was 0.40(P<0.001).In conclusion,population parameters,and genetic analysis indices a high variation among the O.mossambicus from different locations.Additionally,the population parameters for O.mossambicus in America,Asia,and Australia were more influenced by ecological factors.At the same time,the population parameters in the African continent were influenced more by genetic factors.展开更多
Background:The effects of acupuncture have varied in different randomized controlled trials(RCTs),and there are many factors that influence treatment effect of acupuncture in different outcomes,with conflicting result...Background:The effects of acupuncture have varied in different randomized controlled trials(RCTs),and there are many factors that influence treatment effect of acupuncture in different outcomes,with conflicting results.Objective:To identify factors and their impact on the treatment effect of acupuncture in different outcomes.Methods:Acupuncture RCTs were searched from 7 databases including Medline(Pub Med),Embase,Cochrane Central Register of Controlled Trials,China National Knowledge Infrastructure,Wanfang Database,VIP Database,and China Biology Medicine disc between January 1st,2015 and December 31st,2019.Eligible studies must compare acupuncture to no acupuncture,sham acupuncture,or waiting lists,and report at least 1patient-important outcome.A multi-level meta-regression was conducted using a 3-level robust mixed model and univariate analyses were performed for all independent variables,even those excluded from the multivariable model due to collinearities.We used thresholds of 0.2 and 0.4 for the difference of standardized mean differences(SMDs),categorising them as small(<0.2),moderate(0.2–0.4),or large(>0.4) effects.Results:The pain construct analysis involved 211 effect estimates from 153 studies and 14 independent variables.High-frequency acupuncture treatment sessions produced larger effects compared to low-frequency sessions [large magnitude,the difference of adjusted SMDs 0.46,95% confidence interval(CI) 0.07 to 0.84;P=0.02].The non-pain symptoms construct analysis comprised 323 effect estimates from 231 studies and 15 independent variables.Penetrating acupuncture showed moderately larger effects when compared to non-penetrating acupuncture(0.30,95% CI 0.06 to 0.53;P=0.01).The function construct analysis included 495 effect estimates from 274 studies and 14 independent variables.Penetrating acupuncture and the flexible acupuncture regimen showed moderately larger effects,compared to non-penetrating acupuncture and fixed regimen,respectively(0.40,95% CI 0 to 0.80;P=0.05;0.29,95% CI 0.06 to 0.53;P=0.01展开更多
Background Chinese dietary reference intakes for calcium are largely based on foreign studies. We undertook meta- regression to estimate calcium requirements for Chinese adults derived from calcium balance data in Chi...Background Chinese dietary reference intakes for calcium are largely based on foreign studies. We undertook meta- regression to estimate calcium requirements for Chinese adults derived from calcium balance data in Chinese adults. Methods We searched PubMed, Cochrane CENTRAL, and SinoMed from inception to March 5, 2014, by using a structured search strategy. The bibliographies of any relevant papers and journals were also screened for potentially eligible studies. We extracted a standardized data set from studies in Chinese adults that reported calcium balance data. The relationship between calcium intake and output was examined by an individual participant data （IPD） and aggregate data （AD） meta-regression. Results We identified 11 metabolic studies in Chinese adults within 18-60 years of age. One hundred and forty-one IPD （n=35） expressed as mg/d, 127 IPD （n=32） expressed as mg.kg body wt-l-d-1, and 44 AD （n=132） expressed as mg/d were collected. The models predicted a neutral calcium balance （defined as calcium output （Y） equal to calcium intake （C）） at intakes of 460 mg/d （Y=0.60C＋183.98） and 8.27 mg.kg body wt-l.d-1 （Y=0.60C＋3.33） for IPD, or 409 mg/d （Y=0.66C＋139.00） for AD. Calcium requirements at upper intakes were higher than that at lower intakes in all these models. Conclusion Calcium requirement for Chinese adults 18-60 years of age approximately ranges between 400 mg/d and 500 mg/d when consuming traditional plant-based Chinese diets.展开更多
文摘Objective:To explore the relationship between Hashimoto's autoimmune hypothyroidism(HT)and male fertility,focusing on hormonal and seminal factors.Methods:A systematic literature search was conducted across databases such as PubMed,Web of Science,EMBASE,Scopus,Cochrane,and Google Scholar,covering studies published from January 2000 to March 2024.Studies investigating the impact of HT on semen quality parameters and reproductive hormones were included.Pooled effect estimates were calculated using standard mean difference(SMD)and 95%confidence intervals(CI).Results:A total of 8 studies with 8965 participants were included.HT significantly affected semen quality and reproductive hormone levels.Specifically,there was a notable decrease in progressive morphology(SMD=-0.78;95%CI:-1.40 to-0.17;P=0.01)and sperm motility(SMD=-1.151;95%CI:-1.876 to-0.425;P=0.002).In addition,there were no significant changes in reproductive hormones,although there were elevated levels of luteinizing hormone(SMD=0.437;95%CI:0.000 to 0.874;P=0.050)and follicle-stimulating hormone(SMD=0.293;95%CI:-0.171 to 0.758;P=0.216),with a slight impact on testosterone levels(SMD=-1.143;95%CI:-2.487 to 0.200;P=0.095).Conclusions:This systematic review and meta-analysis provides robust evidence of the detrimental effects of HT on semen quality and reproductive hormones,underscoring the necessity for thorough evaluation and management of thyroid function in male infertility assessments.
文摘AIM： To compare two treatments for ruptured cerebral aneurysm with reference to the relative risk of develop-ing hydrocephalus.METHODS： We reviewed the English language litera-ture on the risk of developing hydrocephalus after an-eurysm treatment. Data were divided by type of study （randomized controlled trial, cohort trial, nonrandomized comparison, prospectively- and retrospectively-collected observational study）. They were also divided by type of aneurysm treatment （microvascular - clipping, or endo-vascular - coiling）. Additional predictive variables collected for each publication were average age, gender distribu-tion, measures of hemorrhage volume and subarachnoid hemorrhage severity, aneurysm locations, time to treat-ment, duration of follow-up and date of publication. Weemployed meta-analysis to calculate pooled risk ratios of developing hydrocephalus in cases receiving aneurysm clipping vs those receiving coiling. Meta-regression was used to correct pooled results for covariates.RESULTS： Because indications for the two treatments are different, there is little clinical equipoise for treat-ing most cases. The single randomized, controlled trial dealt with a small subset of ruptured aneurysms. Nei-ther this nor pooled values from other studies which compared the two treatments had the power to dem-onstrate signifcant differences between the two treat-ments. Nor was there an apparent difference when observational data were meta-analytically pooled. How-ever, when meta-regression was used to correct for predictive variables known to differ between the two treatment groups, a highly-significant difference ap-peared. Coiling is used more commonly in older, sicker patients with aneurysms in certain locations. These cases are more likely to develop hydrocephalus. When corrected for these covariates, the risk of hydrocepha-lus was found to be significantly lower in coiled vsclipped cases （P = 0.014）.CONCLUSION： Pooled observational data were nec-essary to demonstrate that coiling ruptured cer
基金Supported by China Scholarship Council,No.202006920018Key Talent Program for Medical Applications of Nuclear Technology,No.XKTJ-HRC2021007+2 种基金the Second Affiliated Hospital of Soochow University,No.SDFEYBS1815 and No.SDFEYBS2008National Natural Science Foundation of China,No.82170831The Jiangsu Innovation&Career Fund for PhD 2019.
文摘BACKGROUND Glucagon-like peptide-1 receptor agonists(GLP-1RA)and sodium-glucose co-transporter-2 inhibitors(SGLT-2I)are associated with significant cardiovascular benefit in type 2 diabetes(T2D).However,GLP-1RA or SGLT-2I alone may not improve some cardiovascular outcomes in patients with prior cardiovascular co-morbidities.AIM To explore whether combining GLP-1RA and SGLT-2I can achieve additional benefit in preventing cardiovascular diseases in T2D.METHODS The systematic review was conducted according to PRISMA recommendations.The protocol was registered on PROSPERO(ID:42022385007).A total of 107049 participants from eligible cardiovascular outcomes trials of GLP-1RA and SGLT-2I were included in network meta-regressions to estimate cardiovascular benefit of the combination treatment.Effect modification of prior myocardial infarction(MI)and heart failure(HF)was also explored to provide clinical insight as to when the INTRODUCTION The macro-and micro-vascular benefits of glucagon-like peptide-1 receptor agonists(GLP-1RA)and sodium-glucose co-transporter-2 inhibitors(SGLT-2I)are independent of their glucose-lowering effects[1].In patients with type 2 diabetes(T2D),the major cardiovascular outcome trials(CVOT)showed that dipeptidyl peptidase-4 inhibitors(DPP-4I)did not improve cardiovascular outcomes[2],whereas cardiovascular benefit of GLP-1RA or SGLT-2I was significant[3,4].Further subgroup analyses indicated that the background cardiovascular risk should be considered when examining the cardiovascular outcomes of these newer glucose-lowering medications.For instance,prevention of major adverse cardiovascular events(MACE)was only seen in those patients with baseline atherosclerotic cardiovascular disease[3,4].Moreover,a series of CVOT conducted in patients with heart failure(HF)have demonstrated that(compared with placebo)SGLT-2I significantly reduced risk of hospitalization for HF or cardiovascular death,irrespective of their history of T2D[5-8].However,similar cardiovascular benefits were not observed in those
文摘Assessment of population parameters and genetic diversity is critical for the economic and threatened species,including Oreochromis mossambicus.The morphometric and population parameters data for O.mossambicus were extracted based on the available literature from various countries.Phylogenetic and genetic diversity were analyzed based on cytochrome c oxidaseⅠ(COⅠ)sequences of the mitochondrial DNA(mtDNA)gene.The population parameters(asymptotic length(L_(∞)),growth constant(K),growth performance index(Ø),approximate maximum age(t_(max)),standard length(L),and weight(W))results revealed a variation among the populations studied.The result categorized the population into two groups:South African populations located close to Zimbabwe,Mozambique,Namibia,Australia,and China,as GroupⅠ,and the Indian population placed close to Thailand,the Philippines,Indonesia,America,and Mexico as GroupⅡ.The meta-regression results reveal that temperature strongly correlated with weight.In contrast,other population factors showed no significant differences.The haplotype analysis based on COI of mtDNA displayed 21 haplotypes,which revealed low nucleotide(π=0.025)diversity.Haplotype diversity(HD)was 0.65.The haplotype analysis showed that Tajima(D)was negative(-0.82)and Fu’s Fs was positive(2.2),and both tests were not significant(P>0.05),whereas the overall F-statistic(F_(st))value was 0.40(P<0.001).In conclusion,population parameters,and genetic analysis indices a high variation among the O.mossambicus from different locations.Additionally,the population parameters for O.mossambicus in America,Asia,and Australia were more influenced by ecological factors.At the same time,the population parameters in the African continent were influenced more by genetic factors.
基金Supported by the National Natural Science Foundation of China (No.81973968)the China Academy of Chinese Medical Sciences (No.CI2021A03503, GH201901, and 2020YJSZX-1)。
文摘Background:The effects of acupuncture have varied in different randomized controlled trials(RCTs),and there are many factors that influence treatment effect of acupuncture in different outcomes,with conflicting results.Objective:To identify factors and their impact on the treatment effect of acupuncture in different outcomes.Methods:Acupuncture RCTs were searched from 7 databases including Medline(Pub Med),Embase,Cochrane Central Register of Controlled Trials,China National Knowledge Infrastructure,Wanfang Database,VIP Database,and China Biology Medicine disc between January 1st,2015 and December 31st,2019.Eligible studies must compare acupuncture to no acupuncture,sham acupuncture,or waiting lists,and report at least 1patient-important outcome.A multi-level meta-regression was conducted using a 3-level robust mixed model and univariate analyses were performed for all independent variables,even those excluded from the multivariable model due to collinearities.We used thresholds of 0.2 and 0.4 for the difference of standardized mean differences(SMDs),categorising them as small(<0.2),moderate(0.2–0.4),or large(>0.4) effects.Results:The pain construct analysis involved 211 effect estimates from 153 studies and 14 independent variables.High-frequency acupuncture treatment sessions produced larger effects compared to low-frequency sessions [large magnitude,the difference of adjusted SMDs 0.46,95% confidence interval(CI) 0.07 to 0.84;P=0.02].The non-pain symptoms construct analysis comprised 323 effect estimates from 231 studies and 15 independent variables.Penetrating acupuncture showed moderately larger effects when compared to non-penetrating acupuncture(0.30,95% CI 0.06 to 0.53;P=0.01).The function construct analysis included 495 effect estimates from 274 studies and 14 independent variables.Penetrating acupuncture and the flexible acupuncture regimen showed moderately larger effects,compared to non-penetrating acupuncture and fixed regimen,respectively(0.40,95% CI 0 to 0.80;P=0.05;0.29,95% CI 0.06 to 0.53;P=0.01
文摘Background Chinese dietary reference intakes for calcium are largely based on foreign studies. We undertook meta- regression to estimate calcium requirements for Chinese adults derived from calcium balance data in Chinese adults. Methods We searched PubMed, Cochrane CENTRAL, and SinoMed from inception to March 5, 2014, by using a structured search strategy. The bibliographies of any relevant papers and journals were also screened for potentially eligible studies. We extracted a standardized data set from studies in Chinese adults that reported calcium balance data. The relationship between calcium intake and output was examined by an individual participant data （IPD） and aggregate data （AD） meta-regression. Results We identified 11 metabolic studies in Chinese adults within 18-60 years of age. One hundred and forty-one IPD （n=35） expressed as mg/d, 127 IPD （n=32） expressed as mg.kg body wt-l-d-1, and 44 AD （n=132） expressed as mg/d were collected. The models predicted a neutral calcium balance （defined as calcium output （Y） equal to calcium intake （C）） at intakes of 460 mg/d （Y=0.60C＋183.98） and 8.27 mg.kg body wt-l.d-1 （Y=0.60C＋3.33） for IPD, or 409 mg/d （Y=0.66C＋139.00） for AD. Calcium requirements at upper intakes were higher than that at lower intakes in all these models. Conclusion Calcium requirement for Chinese adults 18-60 years of age approximately ranges between 400 mg/d and 500 mg/d when consuming traditional plant-based Chinese diets.
