ObjectivesTo systematically review the efficacy of intra-articular injection of sodium hyaluronate for kashin-beck disease. MethodsDatabases including PubMed, EMbase, The Cochrane Library (Issue 1, 2016), CBM, VIP, WanFang Data, and CNKI were electronically searched from inception to January 2016 to collect randomized controlled trials (RCTs) about sodium hyaluronate in the treatment of kashin-beck disease. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then meta-analysis was performed by using RevMan 5.3 software. ResultsA total of 6 RCTs involving 1 276 patients were included. The result of metaanalysis suggested that the sodium hyaluronate group was significantly superior to the control group in clinical effect (OR=5.89, 95% CI 4.10 to 8.47, P < 0.000 01) and the Lequesne index (SMD=-1.66, 95% CI-2.14 to-1.13, P < 0.000 01). ConclusionIntra-articular injection of sodium hyaluronate is helpful in the improvement of kashin-beck disease in clinical effect and the Lequesne index. Due to the limited quality and quantity of the included studies, more high quality studies are need to verify the above conclusion.
ObjectivesTo systematically review the clinical efficacy and safety of antipsychotics for delirium. MethodsDatabases including The Cochrane Library (Issue 5, 2015), PubMed, MEDLINE, EMbase, CNKI, VIP and WanFang Data were electronically searched for randomized controlled trials (RCTs) about antipsychotics compared with placebo/blank for delirium from inception to May 2015. We also hand-searched related conference proceedings and references of included studies for additional studies. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then, meta-analysis was conducted by using RevMen 5.3 software. ResultsA total of 7 RCTs involving 712 patients were included. The results of meta-analysis showed that there were no significant differences between the antipsychotics group and the placebo/blank group in mortality (RR=1.00, 95%CI 0.90 to 1.10, P=0.99), duration of delirium (MD=-1.53, 95%CI -4.95 to 1.89, P=0.38), length of stay (MD=-0.89, 95%CI -7.69 to 5.90, P=0.80), and ICU stay time (MD=-3.70, 95%CI -15.83 to 8.43, P=0.55). Compared with the placebo/ blank group, the antipsychotics could reduce the severity of delirium (SMD=-1.62, 95%CI -2.32 to -0.93, P<0.000 01). ConclusionCurrent evidence shows that the efficacy of antipsychotics in the treatment of delirium is not clear. Due to the limited quantity and quality of the included studies, the above conclusion needs to be further verified by more high quality studies.
ObjectiveTo assess the comparative efficacy of all kinds of selenium supplementation in the treatment of patients with Kashin-Beck disease (KBD) by network meta-analysis. MethodsWe searched seven electronic databases including PubMed, EMbase, The Cochrane Library (Issue 7, 2016), CBM, VIP, WanFang Data and CNKI databases up to July 2016. All randomized controlled trials (RCTs) assessing the effect of selenium supplementation on KBD were included. Two reviewers independently screened literatures, extracted data and assessed the risk bias of included studies, and then meta-analysis was performed by using Stata13.1 software. ResultsA total of 16 RCTs involving 2 883 participants were included. Direct meta-analysis comparison showed that:Compared with placebo or blank group, sodium selenite (OR=5.00, 95%CI 3.21 to 7.78), selenium supplement salt (OR=7.60, 95%CI 2.34 to 24.67), and combination of sodium selenite and vitamin E (OR=11.05, 95%CI 2.61 to 46.80) had higher metaphysis X-ray improvement (P < 0.05). Ranking on efficacy indicated that combination of sodium selenite and vitamin E were highest, followed by selenium supplement salt, sodium selenite, sodium selenite plus vitamin C, vitamin C, and placebo/blank. ConclusionBased on the results of network meta-analysis, selenium supplement (sodium selenite, combination of sodium selenite and vitamin C, combination of sodium selenite and vitamin E, as well as selenium salt) is more effective than placebo or no treatment in promoting the repairement of metaphysis impairment. The effect of combination of sodium selenite and vitamin E are highest.