Objective To evaluate the quality of randomized controlled trials in otorhinolaryngology in China and provide to comprehend the possibility of its contribution in providing reliable, evidence in clinical practice; thus providing evidence to elevate the clinical treatment level. Methods Five Chinese clinical otorhinolaryngology journals were searched and randomized controlled trials were identified and analyzed according to the standards of evidence-based medicine. Results Two hundred and eighty seven issues were referred to and eighty-one randomized controlled trials were identified and analyzed. Of these randomized controlled trials, 34.57% (28/81) had definite diagnostic standards, 38.27% (31/81) had inclusion standards and 33.33% (27/81) had exclusion standards; only 1.23% (1/81) got the approval of the participants; 40.74% (33/81) had moderate sample size; 3.70% (3/81) had large sample size and no one mentioned sample size estimation; 81.48% (66/81) didn’t report the method of randomization and 38.27% (31/81) had baseline comparison; 18.52% (15/81) didn’t define the control interventions and 8.64% (7/81) even didn’t explicate the experimental interventions; 32.10% (26/81) used blank comparison; 86.42% (70/81) didn’t use blindness; 37.04% (30/81) didn’t mention the adverse effects; 23.46% (19/81) used accredited standards to evaluate the outcomes; l l.11% (9/81) mentioned the loss of participants and only 1.23% (1/81) treated the loss with statistics methods. Conclusions The quantity and quality of the otorbinolaryngologic randomized controlled trials in present review can not meet the clinical need. Higher quality of randomized controlled trials are required to improve the level of prevention and the treatment of otorhinolaryngologic diseases.
ObjectiveTo explore the role of nutritional support in adjuvant therapy for respiratory failure. MethodsWe took 72 patients with respiratory failure who were treated in our hospital from August 2011 to January 2013 as the research objects. They were divided into two groups:control group and trial group, with 36 patients in each group. The division of the groups was in accordance with the state food and drug administration clinical trial institution ethics committee standard operating procedures. In the control group, 36 patients were provided with regular treatments according to their condition, like maintaining the respiratory tract unobstructed, oxygen therapy, mechanical ventilation and anti-infection. In the trial group, we offered nutritional support in addition to the normal treatment. Consecutive 20 days was a course of treatment. After four courses, we inspected and put down two groups' respective clinical features, and made a contrast of their treatment conditions. We analyzed the treatments through observational indexes including assessment of eutrophication, treatment efficiency, pulmonary function and arterial blood gases. ResultsBoth groups had obvious therapeutic effects. The observational indexes in the trial group were better than those in the control group. The total effective rate was 91.7% in the trail group after treatment, significantly higher than that in the control group (66.7%) (χ2=8.692, P=0.003); the lung capacity, the ventilation flow ratio and arterial blood gas analysis values in the trial group was better than those in the control group. ConclusionThe effect of the nutritional support for the respiratory failure treatment is much better than the regular treatment. The total effective rate is improved while the death rate is lower than before and the patients recover quickly.
Objective To assess the effects and safety of vasodilators for sudden sensorineurial hearing loss (SSHL). Search strategy Electronic databases: MEDLINE from 1966, EMBASE from 1974, the Cochrane Controlled Trials Register, Chinese Bio-medicine Database from 1989. Hand search: Five kinds of Chinese otolaryngology journals were searched. Literature references were checked intensively. Selection criteria Randomized controlled trials comparing vasodilators with placebo or other drugs in patients with SSHL. Data collection and analysis At least two reviewers independently assessed trials quality and extracted data. Main results Thirteen trials with 1 155 patients were eligible and included in the systematic review. Ten of the trials were from developed countries and them were from P. R. China. None of the four trials showed that the effects of vasodilators were better than placebo for SSHL. None of the seven trials showed that the effects of one kind of vasodilators were better than that of the other vasodilators. Two trials showed that other drugs, such as batroxobin and hypaque,were probably better than some vasodilators (dextran, papaverine, 654-2, danshen). Eight trials reported the side effects of vasodilators, such as pruritus, allergy, etc. Reviewers’ conclusions Base on the systematic review of current eligible randomized controlled trials, there is no evidence to prove that vasodilator therapy is better than placebo or other therapies for SSHL, or the effects of one kind of vasodilator are better than that of the other vasodilators. We can’t draw a reliable conclusion about the effects of vasodilators for SSHL at the moment. And we must pay attention to their potential adverse reactions.
Objective This study aimed to quantitatively investigate the preferences and willingness of patients with breast cancer to pay for central venous access and to provide implications for the clinical selection of appropriate chemotherapy pathways. Methods A discrete-choice experiment survey was conducted to elicit the preferences for central venous access in three hospitals in east, middle and west China. The conditional logit model was used to analyse the relative importance of six central venous access-related attributes: risk of thrombosis, risk of infections, restriction of daily activities, maintenance interval, catheter incision size and out-of-pocket costs. Results The valid data for a total of 103 patients was collected from three hospitals. All six attributes significantly influenced patients’ preferences for central venous access. The risk of thrombosis (RIS=26.0%) and risk of infections (RIS=24.3%) were the top two attributes influencing patients’ preferences for central venous access. To reduce the risk of thrombosis and infection from 12% and 8% to 1%, patients were willing to pay 14 861.2 yuan and 13 907.2 yuan, respectively. The catheter incision size was of least concern (RIS=4.6%); the patients were only willing to pay 2 653.6 yuan for smaller catheter incisions. Conclusion Thrombosis and infection are the primary factors that affect the choice of central venous access for patients with breast cancer. Patients have a sensitive trade-off between safety and out-of-pocket costs; with the change in thrombosis and infection risk, patients’ willingness to pay changes accordingly.