ObjectiveTo evaluate the monitoring value of brain injury biomarkers in the patients during extracorporeal membrane oxygenation (ECMO). MethodsWe searched PubMed, EMbase, the Cochrane Library, CNKI, and CBM from inception of each database to May 2015 to identify randomized controlled trials, or case-control trials, or cohort trials of brain injury biomarkers predict brain injury during ECMO. Data were extracted independently by two reviewers. Meta-analysis was conducted using STATA 12.0 software. ResultsFour retrospective trials were included. The results showed that compared with patients without brain injury, the patients with brain injury had a higher level of S100B protein (P < 0.05). The incidence of major neurological events was higher for high neuron-specific enolase level patients than mild-to-moderate neuron-specific enolase level patients (85% vs. 29%, P=0.01). The incidence of brain injury was higher for normal glial fibrillary acidic protein level than patients with glial fibrillary acidic protein > 0.436 ng/ml (OR=11.5, 95%CI 1.3-98.3). ConclusionsBrain injury biomarkers may be used as an indicator for earlier diagnosis of brain injury in patients during ECMO.
ObjectiveTo determine teratogenicity of beta-blockers in early pregnancy. MethodsWe searched PubMed, EMbase, Cochrane Clinical Trials, clinicaltrials.gov, CBM, Wanfang database, and CNKI from establishment of each database to December 2014. We evaluated the quality of included literature. Statistical analysis was conducted in RevMan5.3 software. ResultsFifteen population-based case-control or cohort studies were identified. The score of included studies changed from 5-7 points. Based on meta-analysis, first trimester oral beta-blocker use showed no increased odds of all or major congenital anomalies. While in analysis examining organ-specific malformations, statistically increased odds of cardiovascular (CV) defects with OR 2.21 and 95% CI 1.63 to 3.01, cleft lip/palate (CL/P) with OR 3.11 and 95% CI 1.78 to 9.89, and neural tube (NT) defects with OR 3.56 and 95% CI 1.19 to 10.67 were observed. ConclusionCausality is difficult to interpret given small number of heterogeneous studies and possibility of biases. Given the frequency of this exposure in pregnancy, further research is needed.