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.
Objective We searched for evidence on mycophenolate mofetil(MMF) as a treatment for patients with diffuse proliferative lupus nephritis. Methods We attempted to find the current best evidence by searching The Cochrane Library(Issue 4, 2005), MEDLINE(1990 to June 2007), CMB(1980 to December 2006), CNKI(1979 to October 2007). We critically appraised the available evidence. Results Four systematic reviews and 6 randomized controlled trials of high quality were available. MMF and prednisolone were found to be an effective continuous induction-maintenance treatment for diffuse proliferative lupus nephritis. MMF was associated with less drug toxicity. Conclusion Given the current evidence and our clinical experience, and considering the patient and the values and preferences of his family,MMF was given at 1 g daily in combination with steroids at the beginning. No obvious adverse effects occurred during 3 months of follow-up.
Abstract: Objective To analyze the characteristics of pathogens isolated from patients with lung cancer after surgery, and provide instructions for the prevention and treatment of postoperative infection. Methods A retrospective investigation of the pathogenic microbiology data of 159 patients（142 males and 17 females with average age at 61.8±9.6 years) with lung cancer after surgery in West China Hospital from January 2009 to December 2011 was performed.We got the specimen from the patients by routine methods, identified the pathogens, and conducted drug susceptibility tests in vitro. Results The pathogens were mainly isolated from sputum of the patients （90.6%, 155/171）. Canidia albicans（25.7%, 44/171）, Klebsiella pneumonia（15.2%, 26/171）, Acinetobacter calcoaceticus-A. baumannii（13.4%, 23/171）and Pseudomonas aeruginosa（8.2%, 14/171） were the predominant species. Among A. calcoaceticus-A. baumannii isolates, 39.1%（9/23） of them were multidrug resistant strains. And 23.1%（6/26）of K. pneumonia isolates produced extended spectrum beta-lactamases. P. aeruginosa isolates showed high in vitro susceptibility to the antibacterial agents. Conclusion Pathogens are mainly isolated from sputum of patients after surgery for lung cancer. Canidia albicans and gram-negative bacilli are predominant isolates and should be the major targets for the prevention and treatment of postoperative infection.
Objective To determine whether Xingnaojing injection can improve functional outcome without causing harm in patients with intracerebral hemorrhage. Methods We searched the electronic bibl iographic databases: Cochrane Central Register of Controlled Trials(CENTRAL, Issue 3, 2007), MEDLINE (1996 to November 2007),EMBASE (1984 to November 2007) and China Biological Medicine Database (1978 to November 2007). We also did handsearching to identify other publ ished and unpubl ished data. Data were extracted and evaluated by two reviewers independently with a designed extraction form. The Cochrane Collaboration’s RevMan 4.2.10 was used for data analysis. Results Thirteen randomized trials involving 1 035 patients were included. The number of people who had died or were dependent at the end of long-term follow-up (at least 3 months) were reported in three trials. Eleven trials measured neurological deficit at the end of treatment. No severe adverse events were reported. The results of meta-analyses indicated that Xingnaojing injection might decrease the number of death or dependency compared to the control group, but the difference was not statistically significant (Peto-OR 0.57, 95％CI 0.32 to 1.01); and Xingnaojing injection were associated with a significant improvement in neurological deficit (Peto-OR 3.70, 95%CI 2.67 to 5.13). Conclusion The evidence currently available showed that Xingnaojing injection may decrease the risk of death or dependency, and can also reduce neurological deficit in patients with intracerebral hemorrhage. However, more high-qual ity trials are needed.