Objective To systematically evaluate the efficacy and safety of iris-registration in wavefront-guided LASIK (IR+WG LASIK) versus conventional LASIK for correction of myopia accompanied with astigmatism. Methods Such databases as PubMed, EMbase, The Cochrane library (Issue 2, 2012), CBM, CNKI, VIP, and WangFang Data were searched to collect the randomized controlled trials (RCTs) and quasi-RCTs about IR+WG LASIK versus conventional LASIK for correction of myopia accompanied with astigmatism. The retrieval time was from inception to February 2012, and the language was in both Chinese and English. Two reviewers independently screened the literature, extracted the data and assessed the quality of the included studies. Then the meta-analysis was performed by using RevMan 5.1 software. Results A total of 9 studies involving 3 903 eyes were included. The results of meta-analysis showed that, compared with the conventional LASIK group, the IR+WG LASIK group had a higher ratio in patients with postoperative uncorrected visual acuity no less than 1.0 (RR=1.03, 95%CI 1.01 to 1.05, P=0.002), as well as in patients with best-corrected visual acuity gained over 1 line (RR=1.75, 95%CI 1.49 to 2.16, Plt;0.000 01); it was smaller in the postoperative high order aberration RMS (WMD=−0.16, 95%CI −0.21 to −0.11, Plt;0.000 01), coma-like RMS (WMD=−0.05, 95%CI −0.11 to 0.00, P=0.07), spherical-like RMS (WMD=−0.15, 95%CI −0.23 to −0.07, P=0.000 2), and residual astigmatism (WMD=0.14, 95%CI 0.10 to 0.18, Plt;0.000 01); moreover, it was lower in the incidence of postoperative glare (RR=0.27, 95%CI 0.15 to 0.50, Plt;0.000 1), and it was higher in the subjective satisfaction of patients (RR=1.08, 95%CI 1.04 to 1.13, P=0.000 3). Conclusion Compared with conventional LASIK, IR+WG LASIK can more effectively reduce astigmatism, postoperative high order aberration RMS and spherical-like RMS. It can also get visual function including uncorrected visual acuity and best-corrected visual acuity, consequently increase patient’s satisfaction. But further studies are still required for its long-term effect.
Objective To systematically evaluate the effectiveness and safety of disodium cantharidinate and vitamin B6 injection plus chemotherapy compared with chemotherapy alone, in the treatment of non-small cell lung cancer (NSCLC). Methods The Cochrane Library (Issue 1, 2011), MEDLINE (1966 to November 2011), EMbase (1984 to November 2011), CBM (1978 to November 2011), CNKI (1995 to November 2011) and VIP (1989 to November 2011) were searched electronically, and the randomized controlled trials (RCTs) about disodium cantharidinate and vitamin B6 injection plus chemotherapy for NSCLC were included. The quality of the included studies was assessed and crosschecked by two reviewers independently, and meta-analyses were performed for homogeneous studies by using Cochrane Collaboration’s RevMan 5.1 software. Results Eight RCTs involving 539 patients met inclusion criteria were included in meta-analyses. The quality of all studies was in Grade B. The results of meta-analyses showed that disodium cantharidinate and vitamin B6 injection plus chemotherapy, compared with chemotherapy alone, could increase effective rate (RR=1.32, 95%CI 1.07 to 1.62) and clinical benefit rate (RR=1.24, 95%CI 1.12 to 1.37), improve quality of life (RR=2.23, 95%CI 1.55 to 3.19) and clinical symptoms (RR=1.55, 95%CI 1.24 to 1.95), increase body weight (RR=2.72, 95%CI 1.74 to 4.25), and decrease bone marrow suppression (leucocyte reduction rate) (RR=0.36, 95%CI 0.21 to 0.61). Conclusion The evidence available indicates that the treatment regimen of disodium cantharidinate and vitamin B6 injection plus chemotherapy is superior to chemotherapy alone in increasing effects and decreasing toxicity for the patients with NSCLC. More high-quality and multi-center RCTs with larger sample and longer follow-up are proposed.
ObjectiveTo summarize the research progress of bioenergetic metabolic mechanisms regulated of tumor cells by microRNA in recent years. MethodsLiteratures about the recent studies on the bioenergetic metabolic mechanisms regulated of tumor cells by microRNA were reviewed according to the results searched from PUBMED. ResultsAerobic glycolysis(Warburg effect) is the most significant characteristics of bioenergetic metabolism in tumor cells. MicroRNAs can regulate many key progressions involved in tumor cells bioenergetic metabolism, such as uptake of glucose, glycolytic pathway, tricarboxylic acid cycle(TAC), and the relationship among lipid metabolism, amino acid metabolism and TAC, resulting in accelerated uptake of glucose and glycolysis. Thus we believe that the transportation and metabolic procession are vital important for tumor cells and related to poor prognosis of patients. ConclusionsThe studies on relationship between microRNA and bioenergetic metabolism have come an important insight for malignant biological behavior of tumor cells based on abnormal bioenergetic metabolism and also become new and important supplementary means of diagnosis and treatment of cancer. As far as the research progress about tumor cells bioenergetic metabolism regulated by microRNA, one of the things must be revealed is that which metablic factors can directly change tumor biological behavior after tumor cells bioenergetic metabolism changed caused by microRNA.
ObjectiveTo summarize the application and the complications of pancreaticogastrostomy (PG) after pancreaticoduodenectomy(PD). MethodThe domestic and international publications involving the theory, methods, and clinical application of PG were retrieved and reviewed. ResultsPG was gradually concerned on the choice of the method of the digestive tract reconstruction after PD, in view of its advantages in theory and operation. The literatures about PG were increased in recent years. But the discussion of decreasing complications of PG after PD had yet to be unified. ConclusionsPG is one of the important operations of digestive tract reconstruction after PD. The factors of operator and patient should be comprehensively considered in the choice of PG.
ObjectiveTo evaluate the effectiveness of levetiracetam (LEV) added on to usual care, in treating children refractory partial seizure epilepsy.MethodsWe searched the Cochrane library, EMBASE and PubMed between January 1998-January 2017, We systematically searched CNKI database and Wanfang data, Chinese biology medline and the manual retrieval related magazines.RevMan 5.3 statistical software for Meta analysis.ResultsAccording to the enrollment criteria, fourtrials were included involving 498 participants according to the intent-to-treat, 268 for LEV, and 230 for placebo groups.We assessed the following outcomes: 50% or greater seizure reduction, seizure freedom, adverse effects, proportion of dropouts and quality of life. There was no evidence of statistical heterogeneity between trials.We assessed outcomes by using a meta-analysis to calculate odds ratio (OR) with 95% confidence intervals (95% CI). For the 50% or greater reduction in focal seizure frequency outcome, the OR was significantly in favour of LEV [OR=2.94, 95% CI(1.99, 4.34)].Participants were significantly more likely in LEV groups than placebo groups to get seizure free[OR=5.31, 95% CI(2.49, 11.32)]. There was no significance between LEV groups and placebo groupsin the rate of Treatment withdrawal[OR=0.76, 95% CI(1.32, 1.82)]. Somnolence[OR=2.57, 95% CI(1.36, 4.86)]and changes in behaviour [OR=2.54, 95% CI(1.56, 4.14)] were significantly associated with LEV. Other adverse effects were not significantly associated with LEV in children.ConclusionThe existing evidence suggests that LEV add in treatment of children refractory epilepsy have definite curative effect, LEV long-term treatment effect is stable, good security, retention rate is higher, can be used in clinical further promotion.
ObjectiveTo investigate the effect of extranodal extension of axillary lymph nodes on the prognosis of triple-negative breast cancer (TNBC). MethodsThe TNBC patients with axillary lymph node metastasis admitted to the Nanyang Central Hospital from January 2017 to January 2019 were collected, and the patients were assigned into a negative soft tissue group and positive soft tissue group according to the status of soft tissue of external lymph node. The clinicopathologic characteristics and prognosis of the two groups were compared, and the factors affecting the prognosis were analyzed. ResultsA total of 216 patients were included, 123 and 93 of whom were in the negative soft tissue group and positive soft tissue group, respectively. Compared with the patients in the negative soft tissue group, the patients in the positive soft tissue group had a higher proportion of higher histological grade (grade Ⅲ), more number of metastatic lymph node (10 or more), and greater tumor diameter (5 cm or more), P<0.05. The 5-year cumulative disease-free survival (DFS) rate of the negative soft tissue group was higher than that of the positive soft tissue group (83.3% vs. 70.2%, χ2=? , P=0.008). The 5-year cumulative overall survival (OS) rate had no statistically significant difference between the the negative soft tissue group and positive soft tissue group (82.1% vs. 75.3%, χ2=? , P=0.161). The results of multivariate analysis showed that the higher histological grade (grade Ⅲ) and extranodal extension of axillary lymph nodes were the risk factors affecting the OS and DFS of the TNBC patients (P<0.05). It was also found that the number of metastatic lymph nodes (10 or more) and higher HER-2 expression were the risk factors affecting the OS of the TNBC patients (P<0.05), but which were not related to the DFS of the TNBC patients (P>0.05). ConclusionThe prognosis of TNBA patients with extranodal extension of axillary lymph nodes is worse, especially those with histological grade Ⅲ, lymph node metastasis number >10, and higher HER-2 expression.