Objective To learn the postoperative wound complications of thyroid and parathyroid, respiratory complications, duration of hospital stay and postoperative mortality, so as to further clarify the clinical effectiveness of placing drainage tube after thyroid and parathyroid surgery. Methods The following databases as The Cochrane Library, MEDLINE, EMbase, SCI and CNKI were retrieved orderly from the date of their establishment to March 29th, 2011. The literature was screened strictly according to inclusive criteria, included studies were analyzed using RevMan5.1.2 software, and the evidence levels of all indicators were evaluated using GRADEpro 3.5.1 software. Results A total of 16 studies involving 1 907 participants were included. There was no high-quality literature. No case reports of death and respiratory distress syndrome. Comparing the drainage group with the non-drainage group among the 16 studies, no significant difference was found in the incidence of re-operation, wound hematoma/seroma, wound infection and subcutaneous fluids. Incision pain score was significantly different between the two groups (RR=2.15, 95%CI 1.10 to –4.23, P=0.03); and the duration of hospital stay was significantly prolonged in the drainage group (SMD=0.79, 95%CI 0.38 to –1.20, I2=93%, P=0.000 2). Conclusion The evidence shows that drainage after thyroid and parathyroid surgery can not significantly reduce the incidence of postoperative complications; but increase the duration of hospital stay. Current evidence is based on the circumstance of non-substernal goiter surgery, normal coagulation indexes and non neck lymphadenectomy, which does not apply to the conclusion of this study. It is suggested that this issue should be further studied in the future due to the lack of high-quality, multi-center and large-scale RCTs.
Objectives To evaluate the efficacy of interferon (IFN) maintenance therapy in patients with small cell lung cancer (SCLC). Methods We searched MEDLINE (1966-Jan.2006), EMbase (1984-Jan.2006), The Cochrane Library(Issue 1, 2006)and the Chinese Biomedical Database (1980-Jan.2006). We checked the references in the reports of related studies and handsearched the education books of ASCO and ESMO meetings. The quality of the included trials was evaluated. Data were extracted by two reviewers independently into a specially designed extraction form. The Cochrane Collaboration’s RevMan 4.2.7 software was used for data analysis. Results Five randomized controlled trials involving 587 patients were included. The pooled result of the 5 studies showed that IFN plus chemotherapy induction treatment did not have a significant effect on 1-year (RR 1.19, 95%CI 0.88-1.6) or 2-year survival rate (RR 1.44, 95% CI 0.99-2.10). However, IFN maintenance therapy significantly increased 2-year (RR 2.08, 95%CI 1.16-3.72) and 1-year survival (RR 2.99, 95%CI 1.13-7.93). Conclusion IFN maintenance therapy may increase 2-year and 1-year survival rates after patients have achieved complete or partial response to chemotherapy. Further randomized, double-blind multi-center trials are needed to investigate this further.
Objective To enhance medical quality evaluation by conducting a systematic review and evidence-based synthesis of relevant research. Methods Such databases as CBM (1978 to 2009), VIP (1989 to 2009), CNKI (1990 to 2009), WanFang Dissertation database (1997 to 2009), and relevant websites were searched to identify relevant Chinese studies for the synthetical evaluation on methods evaluating medical quality. Results A total of 216 articles including 184 observational studies, 29 traditional reviews, and 3 experts’ opinions were identified. Twenty-one synthetical evaluation methods were used among 216 articles, and the top three methods which had been quoted more than 30 times were: RSR (19.72%), TOPSIS method (19.03%), and comprehensive index (12.80%). Among the 184 observational research papers, the documents using one kind of comprehensive evaluation took up 89.13% (164/184), the ones using two kinds of evaluation methods accounted for 9.78% (18/184), and those using three kinds of methods accounted for 1.09% (2/184). Conclusion a) The joint use of two or more than two methods is not common. The majority of studies using single comprehensive evaluation method focus on RSR, TOPSIS and comprehensive index method; b) The comprehensive evaluation method is considered non-uniform, some not even standardized; c) Most of the medical literatures do not correct the value of quality assessment; and d) Considerably most studies perform retrospective evaluation with historical data.