Objective To assess the effectiveness and safety of nedaplatin combined with 5-fluorouracil (5-Fu) for advanced esophageal cancer. Methods Such databases as PubMed, The Cochrane Library, EMbase, CBM, CNKI, VIP and WanFang Data were searched from the date of their establishment to May 4th, 2012 to collect the randomized controlled trials (RCTs) about nedaplatin combined with 5-Fu versus cisplatin combined with 5-Fu for advanced esophageal cancer. According to the inclusion and exclusion criteria, two reviewers independently screened literature, extracted data and assessed the quality of the included studies. Then meta-analysis was conducted using RevMan 5.1 software. Results A total of 15 RCTs invloving 863 patients were included. The results of meta-analysis suggested that, compared with cisplatin combined with 5-Fu, nedaplatin combined with 5-Fu could improve short-term effects (RR=1.31, 95%CI 1.14 to 1.52, P=0.000 2) and reduce gastrointestinal reaction and renal function impairment, but it was associated with aggravated myelosuppression, increase of thrombocytopenia and leukopenia, and decrease of hemoglobin. There were no significant differences between the two groups in liver function impairment, diarrhea and peripheral neurovirulence. Conclusion Nedaplatin combined with 5-fluorouracil can increase short-term effects and reduce gastrointestinal reaction and renal function impairment. However, nedaplatin is associated with aggravated myelosuppression, so it should be applied in clinic with cautious. Nedaplatin combined with 5-fluorouracil can be used as a replacement chemotherapy regimen for advanced esophageal cancer, but the evidence about long-term effects and safety is still required. For the quality and quantity limitation of the included studies which decreases the level of evidence, so the conclusion of this systematic review only provides some references for clinical practice and research.
Backgroud Chronic hepatitis is the major infectious disease of liver. There is no effective drug for it up to now. Clinical trials have showed that glycyrrhizin have potentional effective for chronic hepatitis. Objective To evaluate the effectiveness, safety and economics of glycyrrhizin for chronic hepatitis B and C. Search strategy The search terms include glycyrrhizin and its products’ name, chronic hepatitis and chronic carrier status. The thais registers of the Cochrane Hepato-Biliary Group, the Cochrane Complementary Medicine Field, and the central database of The Cochrane Library as well as MEDLINE, EMBASE and Chinese Biomedical CD Database were searched from their date of inception onward. And the free Internet search was operated to find ongoing and unpublished researches. Twenty Chinese medical journals and relevant academic conference proceedings have been searched by manual method. The reference lists of identified documents were checked as the complementary search. Inclusion criteria All randomized trials that tested glycryyhizin for chronic hepatitis B virus or hepatitis C virus infection were included in this review. Method of the review According to the principle of Cochrane systematic review, selection of thai for inclusion, assessment of methodological quality, data extraction and data syntheses were conducted by two reviewers.
Background Hepatitis B is one of the major infectious diseases of mankind, and up to now, there is no effective way to handle it. Recent clinical trials have shown the potential advantages of Kurorinone an extract of Chinese herb, in treament of chronic HBV infection. Objectives Systermically review the safety and efficacy of Kurorinone in treatment of chronic HBV infection. Search strategy With the searching terms including Kurorinone, its products’ name, hepatitis B and chronic carrier status, the trials registers of the Cochrane Hepato- Biliary Group, the Cochrane Complementary Medicine Field, and the central database of the Cochrane Library as well as MEDILINE, EMBASE and Chinese Biomedical CD Database were searched from their date of inception onward. 20 Chinese medical journals and relevant academic conference proceedings have been searched by hand. The reference lists of identified documents were checked as the complementary search. Inclusion Criteria All RCTs that tested Kurorinone for chronic HBV infection were included in this review. Method of the review According the demand of Cochrane systematic review, selection of trial for inclusion, assessment of methodological quality, data extraction and data syntheses would be conducted for each included trial.
Background In the latter of 20th century, a global growth in allergic diseases has been witnessed, accompanying with spring-out of therapeutic drugs. However, trials did not clarify the comparative effectiveness and pharmaceutical economics of these agents. Severe adverse drug effects have been reported increasingly in the last few years. These made it difficult for clinical practice and selection of national essential drugs. Objective To assess astemizole, loratadine, cetirizine and tefenadine for allergic rhinitis (AR) and urticaria in terms of effectiveness, heart-related drug adverse effects and pharmaceutical economics. Search strategy Cochrane Library, Medline, Embase and Chinese Biomedical Database will be searched. Additional database should be searched for safety and economic studies. Selection Criteria The publication languages are restrained to English and Chinese. 1) Effectiveness: high-quality randomized controlled trials (RCTs) and systematic Reviews (SRs)/ meta-analysis for AR and uritcaria are included, with comparisons restrained to among these four drugs; 2) Safety: a hierarchy of evidences of these four drugs for allergic diseases are included. 3) Economical evaluation: cost-effectiveness and cost-utility assessment of these four drugs for AR and urticaria should be included. Methods of review data extraction sheet and quality appraisal table are separately designed. QUOROM STATEMENT and Jadad Scale are applied, respectively, to SRs and RCTs. Two reviewers independently select the studies, appraise the quality and extract the data. Any disagreement is solved by discussion. Data analysis Fixed effect model is first applied. Sensitivity analysis is employed to study the heterogeneity between trials. Randomized effect model is alternatively used when compromised.
Background AIDS (acquired immune deficiency syndrome) has become the most devastating disease which humankind has ever encountered. Human immune-deficiency virus (HIV) is transmitted through blood, sexual behavior and mother-to-baby, with more efficient transmission through blood transfusion. HIV risk among blood transfusion was severe due to lack of effective and correctly applied screening method and rigorous management, especially in some developing countries. Since the first HIV screening reagent was approved by FDA to screen the blood in 1985, the fourth generation test has been produced till now. Initially, HIV test was primarily used to screen the blood supply, it also became an important aspect of HIV prevention, especially screening among people donating blood. Today, HIV testing is seen as an integral part of both the nation’s prevention and treatment efforts. Objective To assess the effectiveness of any intervention tests for HIV screening among people donating blood, and find appropriate tests for HIV screening to decrease the risk of HIV transmission by blood transfusion. Search strategy MEDLINE, Cochrane Controlled Trials Register (CENTRAL/CCTR), AIDSLINE, EMBASE, CBM were be searched with the terms: "HIV", "AIDS", "screening", "test", "blood donor", "blood bank" and the detailed screening method. The websites of WHO, UNAIDS, CDC, FDA, and their related links were searched. Letters were mailed to various agencies and experts in this field to acquire unpublished reports. Inclusion criteria RCT and CCT for screening HIV among blood. donors will be included. Observational studies such as cohort studies, cased-control studies, and historical controlled studies will be used for sensitivity analysis. Method of the review According to the principles of Cochrane Review, selection of trials for inclusion, quality assessment of studies, data extraction and syntheses were conducted by reviewers.
To assess the efficacy and safety of thrombolytic therapy. Electronic search was applied to the Cochrane Airways Group register (MEDLINE, EMBASE, CINAHL standardized searches) with the date up to 2003 April. Hand searched respiratory journals and meeting abstracts. All randomized controlled trials comparing thrombolytic therapy with heparin alone or surgical intervention (eg. embolectomy) met the inclusion criteria. Two reviewers independently selected trials, assessed trial quality and extracted the data.
支气管哮喘防治全球创议(GINA)将哮喘的严重程度分为三度四级，其中三级和四级属于中度和重度哮喘。在整个哮喘人群当中，中重度哮喘大约只占1／3，但在临床上轻度哮喘患者很少就诊，中重度哮喘大约占就诊患者的2／3甚至更多。中重度哮喘患者由于症状明显，频繁就诊，因为哮喘控制不良，经常出现急性发作，需要住院治疗，虽然人数不是很多，但占用了大部分的医疗资源。无论是从提高哮喘防治的整体水平的角度，还是从减少哮喘疾病负担的角度，都应当将中重度哮喘作为哮喘长期管理的主要的目标人群。
Objective To summarize the injury characteristics of the whole hand degloving injury and to explore its classification and treatment. Methods Between December 1999 and May 2010, 41 cases of the whole hand degloving injury were admitted for treatment. There were 28 males and 13 females with an average age of 35 years (range, 18-58 years). The causesof injury included mangled injury in 28 cases and crush injury in 13 cases. The interval between injury and surgery was 1-10 hours (mean, 3 hours). According to self-made classification standard for whole hand degloving injury, 11 cases were rated as type I, 5 cases as type II, 4 cases as type III, 8 cases as type IV, and 13 cases as type V. Type I injury was treated by replantation surgery with vascular anastomosis, type II by reconstruction with thumb flap and the second toe containing dorsal skin flap, type III by reconstruction with the second toe containing dorsal skin flap of both feet, type IV by replantation surgery with vascular anastomosis, and type V by reconstruction with thumb flap containing dorsal skin flap (8 cases) or repairing with abdominal flap (5 cases). The size of the dorsal flap was between 9 cm × 6 cm and 17 cm × 11 cm and the dorsal donor site was covered with free skin grafting. Results After surgery, partial necrosis occurred at fingers in 6 patients with type I injury, and at fingers and palm skin in 6 patients with type IV injury; the flaps, the reconstructed fingers, and replanted skin all survived in the others. The grafted skin at donor sites successfully healed. Forty cases were followed up from 6 months to 7 years (mean, 14 months). The skin color and texture were close to normal hand in the cases undergoing replantation, who had the best function restoration with S2-S4 sensory recovery; the hand function was basically restored with S2-S3 sensory recovery in the cases undergoing finger reconstruction with thumb and toe flaps; and the restoration of the hand function was not satisfactory with S1-S2 sensory recovery in the cases undergoing abdominal flaps. Conclusion Whole hand degloving injury can be classified into different types according to injury degree and this will help choose the cl inical treatment plan. The appropriate treatment based on these types can obtain better cl inical effectiveness.
Random allocation to intervention groups remains the best method of ensuring that the groups being compared are similar at the onset of study and of avoiding removing selection bias between groups of patients. The success of randomization depends on two interrelated processes. First, an unpredictable allocation sequence must be generated based on a random procedure. Second, strict implementation of that sequence must be secured through an assignment mechanism called allocation concealment to prevent those involved in a trial from knowing upcoming assignments. Inadequate allocation concealment can lead to clinicians scheduling patient’s assignment and compromising the unpredictable allocation sequence.