Objective To assess the clinical effectiveness and safety of paclitaxel liposomes and carboplatin for ovarian cancer. Methods The databases such as The Cochrane Library, PubMed, EMBASE, CNKI and CBM were searched to collect all randomized control trials (RCTs) about the clinical effectiveness and safety of paclitaxel liposomes and carboplatin for ovarian cancer. Literatures were screened according to the inclusive and exclusive criteria, the data were extracted, the methodological quality of the included studies was assessed in line with Cochrane Handbook 5.0.1, and Meta-analysis was performed by using RevMan 5.0.24 software. Results Three RCTs involving 214 patients were included. Meta-analysis showed that compared with the paclitaxel plus carboplatin group, the paclitaxel liposomes plus carboplatin group didn’t show significant differences in the total effective rate (P=0.62), while it was obviously superior in reducing the adverse events, such as muscle and joint pain (Plt;0.000 01), peripheral neurotoxicity (P=0.04), nausea or vomiting (P=0.000 2), facial blushing (P=0.03) and rashes (P=0.003). But there were no significant differences between the two groups in trichomadesis, dyspnea, diarrhea, bellyache and blood system abnormalities. Conclusion As current clinical evidences shows, the paclitaxel liposomes and carboplatin in treating ovarian cancer is as effective as the paclitaxel and carboplatin, and it can reduce some of the adverse reactions. Therefore, the paclitaxel liposomes and carboplatin is available for ovarian cancer as a new, safe and effective treatment. Due to small scale and low quality of the included studies, this conclusion has to be further proved with more high-quality, large-scale, and double-blind RCTs.
Objective To evaluate the diagnostic value of all diagnostic tests detecting the ethambutol resistance in Mycobacterium tuberculosis. Methods PubMed, EMbase, Chinese Biomedical Database (CBM), Chinese Scientific Journals Full-Text Database (CSJD), and Chinese Journal Full-text Database (CJFD) were searched, and QUADAS items were used to evaluate the quality of included studies. Meta-disc software was used to handle data from included studies. Such index as sensitivity, specificity, and SROC were applied to assess the diagnostic value of individual diagnostic test. Results Nine studies were included. The results of meta-analyses showed that compared with proportion method, the summary sensitivity, summary specificity, positive likelihood ratio, negative likelihood ratio, and SROC area under curve of a nitrate reductase assay were 92%, 99%, 30.50, 0.13, and 0.975 2, respectively, while compared with BACTEC 460 TB, the above mentioned indexes of BACTEC MGIT 960 System were 92%, 99%, 6.27, 0.11, and 0.9, respectively. Bacteriophage biological amplification method revealed relative good analysis effectiveness on MB/BacT. Conclusion According to the results, it is recommended that nitrate reductase assay can replace proportion method as screening test of ethambutol resistance in Mycobacterium tuberculosis, and BACTEC MGIT 960 System can replace BACTEC 460 as final diagnostic test of ethambutol resistance in Mycobacterium tuberculosis.
Objective To evaluate the effectiveness and safety of misoprostol versus gemeprost for the first and second-trimester induction of abortion. Methods We searched randomized controlled trials（RCTs） and quasi-randomized controlled trials of misoprostol versus gemeprost for the first and second-trimester induction of abortion operation. MEDLINE （1974 - 2003 ）, EMBASE （1974 - 2003 ）, The Cochrane Library （Issue 3, 2003 ）, CBM （1979 - 2003 ）, CNKI （1989 - 2003 ）, CMCC （1994 - 2003 ）, VIP （1989 - 2003 ） were searched. Twelve journals and reference lists of eligible studies were handsearched. Two reviewers independently screened the studies for eligibility, evaluated the quality, and extracted data from eligible studies with confirmation by cross checking. Any disputes were decided by a third person. Meta-analysis was conducted using RevMan 4.2 software. Results Seven RCTs were included, three for the first-trimester and four for the second- trimester. Statictical differences were tested between the misoprostol and gemeprost groups with OR 4. 79,95% CI 1.35 to 16.94 in laxation and dilation rate,with WMD -1.50,95% CI -3.00 to 0.00 in operation time for the first-trimester abortion. However, there was no statistical difference in the amount of bleeding during operation with WMD - 14. 40, 95% CI 30.30 to 1.30. For the second-trimester abortion, compared with gemeprost, no consistent results of gravid excluding time were obtained. Compared with gemeprost, the rate of complete abortion was higher and digest system morbidity was lower in misoprostol alone group. But there was no statistical difference between the two groups when they were both combined with mifestone.Conclusions Some evidence indicates that compared with gemeprost, misoprostol may increase laxation and dilation rate of the cervix, shorten gravid exclusion time, improve the rate of complete abortion and make the laxation and dilation range of the cerix larger than gemeprost before the first and second-trimester abortive surgery. Due to the hmited evidence indentified, we can not draw a b conclusion. More radomiased controlled trails of high quahty are required.
Objective To evaluate the efficacy and the adverse reactions of intensive therapy compared with conventional therapy. Methods We searched the Cochrane Central Register of Controlled Trials (Issue 3, 2008), MEDLINE (January 1980 to June 2008), EMbase (1984 to June 2008), CBM-disc (January 1980 to June 2008) and CNKI (1994 to June 2008) to get all the randomized control trials (RCTs) about paclitaxel intensive versus conventional therapy for ovarian cancer. We used RevMan 5 to perform meta-analysis. Results Six RCTs involving 572 patients were included. Metaanalysis showed the efficacy of intensive therapy and conventional therapy was similar. There were no significant differences in response rate (RR 1.06, 95%CI 0.94 to 1.20), median survival time, survival rate, median progression free survival and median time to progression between the two groups. When taking safety into consideration, intensive therapy significantly reduced the occurrence of grade Ⅲ or higher neutropenia (RR 0.49, 95%CI 0.35 to 0.69, Plt;0.000 1) and Grade Ⅲ or higher neuropathy (RR 0.43, 95%CI 0.24 to 0.78, P=0.006). But there were no significant differences between intensive therapy and conventional therapy in flush, grade Ⅲ or higher vomiting, anemia, leucopenia, grade Ⅲ or higher thrombocytopenia and alopecia. Conclusion Paclitaxel intensive therapy has similar efficacy and adverse reactions compared with conventional therapy in ovarian cancer. Above all, intensive therapy can reduce the incidence of grade Ⅲ or higher neutropenia and neuropathy. It is a good substitution for the conventional therapy.
Objective To evaluate the prognostic value of the level of serum neurone specific enolase (NSE) in patients with small cell lung cancer (SCLC). Methods We searched MEDLINE, EMbase, CBMdisc, and The Cochrane Central Register of Controlled Trials (1950 to December 2007). Studies meeting the eligibility criteria were retrieved and their bibliographies were checked for other relevant publications. The quality of included studies was evaluated by 2 reviewers independently. Meta-analyses were performed for the results of homogeneous studies using STATA 7.0 software. Results Nine studies involving 2 021 SCLC patients were included. About 66.0% of patients had high serum levels of NSE, according to the cut-off value defined by the authors. The hazard ratio (HR) of high levels of NSE for overall survival (OS) was 1.27 times of that of low levels of NSE for OS in SCLC patients (95% CI 1.19 to 1.35, P=0.281). Conclusion Patients with high levels of NSE appear to have a poorer OS compared with those with low levels of NSE, thus the level of NSE has a prognostic value in SCLC patients. Due to the potential publication bias, selection bias, and measurement bias among these studies, the conclusion should be interpreted carefully. More high-quality homogeneous studies are required to accurately evaluate the prognostic value of NSE.
【摘要】 目的 研究合并2型糖尿病的冠心病患者冠状动脉病变程度与血清视黄醇结合蛋白4（retinol-binding protein 4，RBP4）水平的相关性。 方法 2008年10月-2010年4月选择性冠状动脉造影确诊的冠心病患者共120例，分为单纯冠心病组（A组）60例和冠心病合并糖尿病组（B组）60例，检测血糖、血脂、胰岛素以及脂联素、RBP4水平；根据冠状动脉造影结果，以Gensini评分评判冠状动脉病变程度。 结果 B组空腹血糖、胰岛素、RBP4均显著高于A组（Plt;0.05）；冠状动脉病变程度更重（Plt;0.05）。相关性分析显示RBP4水平与低密度脂蛋白胆固醇、胰岛素抵抗和冠状动脉病变积分呈正相关（r=0.312、0.322、0.314，Plt;0.05）。与脂联素水平呈负相关（r=-0.362，Plt;0.01）。 结论 冠心病合并2型糖尿病患者RBP4明显升高，且与冠状动脉狭窄程度呈正相关。【Abstract】 Objective To explore the relationship between the level of serum retinol-binding protein 4 (RBP4) and the extent of coronary lesions in coronary heart disease (CHD) patients accompanied with type 2 diabetes mellitus (T2DM). Methods A total of 120 patients with CHD diagnosed by coronary arteriongraphy between October 2008 and April 2010 were enrolled. The patients were divided into two groups: CHD group (60 patients); CHD accompanied with T2DM group (60 patients). The levels of serum insulin, adiponectin and RBP4 were measured. All the patients underwent coronary angiography and the extent of coronary lesions was assessed quantitatively based on the Gensini′s scoring system. Results The levels of serum insulin, plasma RBP4 and the extent of coronary artery stenosis in CHD accompanied with T2DM group were significantly higher than those in CHD group (Plt;0.05). Correlation analysis showed that the level of RBP4 was positively correlated with LDL-C, insulin resistance index and the coronary artery narrow degree（r=0.312, 0.322, 0.314; Plt;0.05); and negatively correlated with adiponectin (r=-0.362, Plt;0.01). Conclusion The significant elevated plasma RBP4 in CHD patients accompanied with T2DM is positively correlated with the extent of coronary artery lesion.
目的：探讨雌激素影响人精子顶体反应的可能机制。方法：应用异硫氰酸荧光素标记豌豆凝集素荧光染色法（FITC-PSA）分析精子顶体反应（AR）、以分光光度比色法测定顶体酶（ACE）活性。结果：17β-雌二醇（17β-E2）可促进精子发生AR，并增强精子顶体酶的活性；去除培养液中的Ca2+后，17β-E2不能诱导精子发生AR；PKC抑制剂能明显降低17β-E2所诱导的AR；E2-BSA亦能够促进精子发生AR，其作用与17β-E2无显著差异。结论：雌激素对人精子顶体反应有一定的促进作用，增强精子顶体酶活性可能是其作用途径之一，此过程涉及了胞外Ca2+、PKC及精子膜上的ER或雌激素结合位点的参与。