ObjectiveTo investigate the status of research and development methods of Cochrane overviews. MethodsThe Cochrane Library and PubMed were searched up to March 2014 to identify Cochrane overviews. According to the inclusion and exclusion criteria, two reviewers independently screened literature, extracted data, and assessed and analyzed search strategy, quality assessment method, data analysis, and study results. ResultsA total of 18 Cochrane overviews were included. Among them, 4 (22.2%) overviews included formal statistical indirect comparison; 8 (44.4%) included only results from direct comparison; 6 (33.4%) only systematically analyzed current studies without data pooling; 12 (66.7%) only searched The Cochrane Library, while 6 (33.3%) expanded search to other databases; 14 (77.8%) applied the AMSTAR tool to assess methodological quality of included literature; 12 (66.7%) applied the GRADE system to assess the quality of evidence; and 9 (50%) yielded new outcomes. ConclusionCurrently, the development and reporting standards of Cochrane overviews are still immature. Investigators should choose proper methods based on research objectives when developing Cochrane overviews.
ObjectiveTo investigate the significance of 99Tcm-MIBI SPECT dual-phase imaging, B-ultrasound and CT in the diagnosis of primary hyperparathyroidism, and its relationship with the level of serum calcium (CA). MethodsThe clinical data of 73 patients with parathyroid dysfunction (serum parathyroid hormone (PTH) > 130 pg/mL) were retrospectively analyzed. The 99Tcm-MIBI SPECT double phase imaging were performed in 73 cases, 63 cases underwent cervical B-ultrasound examination, and 16 cases underwent CT examination. According to the serum calcium (CA) levels, the patients were divided into CA < 2.7 mmol/L group and CA > 2.7 mmol/L group, and the postoperative pathological examination and followed-up results were as the standard, the sensitivity, specificity, positive predictive value, and negative predictive value of 99Tcm-MIBI SPECT dual-phase imaging, B-ultrasound and CT for diagnosis of PHPT in different serum CA levels were compared. ResultsThe sensitivity of 99Tcm-MIBI SPECT dual-phase imaging, B-ultrasound and CT examination for diagnosis of PHPT was 87.6%, 81.8% and 35.7%, respectively; the specificity was 87.5%, 75.5% and 50.0%, respectively; the positive predictive value was 98.2%, 93.7% and 83.3%, respectively; and the negative predictive value was 46.7%, 33.3% and 10%, respectively. The sensitivity, specificity, positive predictive value and negative predictive value of 99Tcm-MIBI SPECT dual-phase imaging and B-ultrasound examination for diagnosis of PHPT were significantly higher than those of CT examination(P < 0.05). The sensitivity, specificity, positive predictive value and negative predictive value of 99Tcm-MIBI SPECT dual-phase imaging for diagnosis of PHPT were higher than those of B-ultrasound examination, but the difference was not statistically significant (P > 0.05). In the CA < 2.7 mmol/L group, the sensitivity of 99Tcm-MIBI SPECT dual-phase imaging, B-ultrasound and CT examination for diagnosis of PHPT was 91.1%, 84.7% and 37.9%, respectively; the specificity was 80.2%, 72.9% and 49.7%, respectively; the positive predictive value was 96.8%, 96.0% and 79.4%, respectively; and the negative predictive value was 50.0%, 37.5% and 10.0%. In the CA > 2.7 mmol/L group, The sensitivity of 99Tcm-MIBI SPECT dual-phase imaging, B-ultrasound and CT examination for diagnosis of PHPT was 87.9%, 83.9% and 42.8%, respectively; the specificity was 83.3%, 79.2% and 50.0%, respectively; the positive predictive value was 96.9%, 94.1% and 75.0%, respectively; and the negative predictive value was 50.0%, 40.5% and 20.0%. There were no significant difference in the diagnostic accuracy between the 3 methods and the level of serum CV in different levels. ConclusionsThe diagnostic accuracy of 99Tcm-MIBI SPECT dual-phase imaging and B-ultrasound examination for diagnosis of PHPT patients with PTH > 130 pg/mL (especially parathyroid adenoma) were higher than that of CT examination, and it is not associated with the serum CA concentration.
ObjectiveTo investigate the advantages of magnetic compressive anastomosis (MCA) for non-suture femoral artery anastomosis. MethodsTwelve adult health mongrel dogs,weighing (16.5±3.6) kg,were selected for in situ end-to-end anastomosis of the femoral artery.One side of the femoral artery was anastomosised with MCA (group A) and the other side of the femoral artery was anastomosised by hand-suturing (group B).The anastomosis time,complications,and vascular bursting pressure were recorded.Gross observation,histological staining (HE and Masson),and scanning electron microscopy observation were performed at 2,4,12,and 24 weeks postoperatively. ResultsThe anastomosis time in group A [(3.89±1.16) minutes] was significantly shorter than that in group B [(14.16±3.72) minutes] (t=14.226,P=0.000).The complication rate of group A (0) was significantly lower than that of group B (75%)(P=0.000).At immediate,4 and 12 weeks after operation,the vascular bursting pressure of anastomosis site in group A was more than 280 mm Hg (1 mm Hg=0.133 kPa),and was (140.11±15.23),(180.31±24.55),and more than 280 mm Hg in group B,showing significant differences at immediate and 4 weeks (P<0.05),but no significant difference at 12 weeks (P>0.05).In group A at 4 weeks,good intima contact,smooth endothelium,and regular arrangement of endothelial cells were observed;at 12 weeks,chronic inflammation was present,with a few lymphocytes infiltration;and at 24 weeks,inflammation significantly decreased.But in group B,obvious suture foreign body and scar formation were observed,which led to uneven surface with lumen incomplete intima,and irregular endothelial cells in arrangement disorder. ConclusionCompared with traditional hand-suturing,the MCA has the advantages of shorter operation time,higher patency rate,less complication,and better healing at the anastomotic site.Non-suture anastomosis of the femoral artery by MCA can achieve reliable results.