Objective To systematically review the effectiveness of Yindan Xinnaotong capsule for cardiovascular and cerebrovascular diseases. Methods We electronically searched databases including PubMed, MEDLINE, CBM, CNKI, VIP, WanFang Data for published articles of randomized controlled trials (RCTs) of Yindan Xinnaotong capsule plus conventional drugs versus conventional drugs for cardiovascular and cerebrovascular diseases from inception to April, 2016. According to the inclusion and exclusion criteria, two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software. Results A total of 62 RCTs involving 6 306 patients with cardiovascular and cerebrovascular diseases were included. The results of meta-analysis showed that the improvement of symptoms, such as the total clinical effective rate of cerebrovascular disease indications (stroke) (RR=1.25, 95% CI 1.19 to 1.31,P<0.000 01), and the total clinical effective rate of cerebrovascular disease (ischemic headache) indications (RR=1.27, 95% CI 1.17 to 1.38,P<0.000 01), and the total clinical effective rate of coronary heart disease and angina pectoris (RR=1.21, 95% CI 1.17 to 1.25,P<0.000 01), were superior in the combination arm to the conventional drugs alone arm. Conclusion The current evidence shows that the combination of Yindan Xinnaotong capsule and conventional drugs may significantly improve the effectiveness. Due to the limited quality and quantity of the included studies, the above conclusions need more high quality studies to verify.
ObjectiveTo systematically review the efficacy and safety of Yangyinqingfei decoction for chronic cough and chronic obstructive pulmonary disease (COPD) patients.MethodsWe electronically searched databases including PubMed, Web of Science, CBM, CNKI, VIP and WanFang Data for randomized controlled trials (RCTs) of Yangyinqingfei decoction for chronic cough and COPD patients from inception to August 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, RevMan 5.3 software was used for meta-analysis.ResultsTwenty-four RCTs involving 2 268 patients with COPD and chronic cough were included. The results of meta-analysis showed that compared with the control group, Yangyinqingfei decoction combined with the conventional medicine could significantly improve clinical effective rate (RR=1.21, 95%CI 1.16 to 1.27, P<0.000 01) and lung function (SMD=0.76, 95%CI 0.59 to 0.94, P<0.000 01) in patients with COPD. Yangyinqingfei decoction combined with the conventional medicine group was superior to the control group (RR=1.41, 95%CI 1.22 to 1.64, P<0.000 01) in clinical efficacy for adults patients with chronic cough. In terms of safety, seven cases occurred adverse reactions in the Yangyinqingfei decoction group, while 13 were found in the control group, the types and degree of adverse reactions in both groups were almost the same.ConclusionThe combination of Yangyinqingfei plus conventional medicine may significantly improve the clinical efficacy for chronic cough and COPD with reliable safety. However, due to the limited quality and quantity of included studies, the above conclusions are needed to verify by more high quality studies.
The risk of vertebral cortical shell fracture increases with aging. However, it remains unclear how aging contributes to cortex fracture at present. The aim of this study is to make understanding of the mechanism of how the spinal aging influences the cortical shell strain. Two finite element (FE) models of spinal segments (mildly and fully aged) were created, and then were compared to the FE models of the healthy spinal segment. The FE models of the aged spinal segments were generated by modifying both the geometry of the intervertebral disc (IVD) and the material properties of the spinal components. To find out under which case the cortical shell strain was influenced more, we created two types of FE model comparison methods: one with changes only in the spinal material properties and the other with changes only in the IVD geometry. The results showed that the cortical shell strains increased with aging and that compared to the changes of IVD geometry, the changes of spinal material property have a higher influence on the cortical shell strains. This study may suggest that for the prevention and treatment of vertebral cortex fracture, the augmentation of the vertebral body is a more effective treatment.
ObjectiveTo systematically review the diagnostic value of common screening questionnaires for chronic obstructive pulmonary disease (COPD). MethodsThe Cochrane Library, Web of Science, PubMed, EMbase, CNKI, WanFang Data and VIP databases were electronically searched to collect diagnostic studies on the effectiveness of COPD screening questionnaires from inception to January 31 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies,then network meta-analysis was performed by using Meta-disc 1.4 and Stata 15.0 software. ResultsA total of 28 studies involving 4 screening questionnaires were included. The results of the network meta-analysis showed that, sensitivity sorting was CDQ17 > LFQ > COPD-PS4 > CDQ20 > COPD-SQ > COPD-PS5, the specificity sorting was COPD-SQ > COPD-PS5 > CDQ20 > CDQ17 > COPD-PS4 > LFQ. Subgroup analysis showed the sensitivity of CDQ17 and specificity of CDQ20 were the highest in China, the sensitivity of LFQ and specificity of COPD-PS5 were the highest in foreign countries. ConclusionCurrent evidence suggests that CDQ and LFQ have high sensitivity but poor specificity, while COPD-SQ and COPD-PS have strong specificity but poor sensitivity. In China, CDQ is recommended for screening of COPD patients. Due to limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo systematically review the clinical efficacy and safety of glucocorticoids, acetaminophen and antimicrobial drugs in the treatment of intrapartum fever in labor analgesia. MethodsThe PubMed, Embase, Cochrane Library, Web of Science, CBM, VIP, and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) of glucocorticoids, acetaminophen, and antimicrobial drugs for intrapartum fever in labor analgesia from inception to June 30, 2023. Two reviewers independently screened the literature, extracted data, and evaluated the risk of bias of the included literature. Meta-analysis was then performed by using RevMan 5.4 software. ResultsA total of 10 RCTs involving 1 337 women were included. Meta-analysis showed that the use of glucocorticoids reduced the incidence of intrapartum fever in women with labor analgesia compared with the control group (OR=0.52, 95%CI 0.33 to 0.82, P<0.01). But there was no statistically significant difference between acetaminophen or antimicrobial drugs and the control group. ConclusionCurrent evidence shows that the use of glucocorticoids can reduce the incidence of intrapartum fever in labor analgesia, but the use of acetaminophen and antimicrobial drugs cannot reduce the incidence of intrapartum fever. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
ObjectivesTo evaluate the methodological quality and the reliability of the conclusions of systematic reviews (SRs) on traditional Chinese medicine (TCM) treatment for essential hypertension. MethodsPubMed, EMbase, The Cochrane Library, CNKI, VIP and WanFang Data databases were searched to collect the SRs which focused on the TCM for essential hypertension from January 2015 to June 2019. PRISMA statement, AMSTAR 2 tool and GRADE system were respectively applied to evaluate report quality, methodological quality and evidence quality assessment of included outcomes of SRs.ResultsA total of 25 SRs involving 65 outcomes were included. PRISMA evaluation results showed that the quality of 25 SRs reports was good. However, all studies did not report item 5 " Was an ‘a prior’ design provided?”. AMSTAR 2 tool evaluation results showed that the 25 SRs of quality levels were markedly low, where most problems concerned item 2 " If there is ‘a prior’ published in advance”, item 3 " Were reasons about selection of the study designs explained”, item 7 " Were the list of exclude of studies and justify the exclusions provided”, item 10 " Were the sources of funding for the studies reported”, and item 12 " If meta-analysis was performed, whether the author assesses the potential impact of risk of bias”. The results of grading showed that most outcomes were graded as " low” or " very low” quality. The main factors contributing to downgrading evidence quality were limitations, followed by inconsistencies, inaccuracies and publication bias.ConclusionsCurrent evidences shows that the treatment of essential hypertension by TCM has been supported by low quality evidence-based medical evidence. However, the SRs methodology for the treatment of essential hypertension by TCM is generally poor in quality and the standardization still require improvement.
ObjectiveTo overview the systematic reviews (SRs) on the efficacy of traditional Chinese medicine (TCM) in the treatment of atrial fibrillation.MethodsPubMed, The Cochrane Library, EMbase, CNKI, CBM, WanFang Data and VIP database were electronically searched to collect SRs of TCM in the treatment of atrial fibrillation from inception to July 2019. Two researchers independently screened literature, extracted data and then the methodological quality, reporting quality and evidence quality of the included documents were evaluated by AMSTAR2 tool, PRISMA statement and GRADE method.ResultsA total of 20 SRs were included. In which, 15 SRs evaluated clinical efficacy and 12 SRs analyzed adverse reactions. The methodological quality evaluation by AMSTAR2 was generally low and none of them being high quality, 1 of them being low quality and 19 of them being extremely low quality. The items with poor scores were item 2, 7, 8, 9, 10, 12, 13, 14 and 16. The PRISMA score ranged from 14 to 22.5. The quality question of the report was mainly manifested in the aspects of scheme and registration, data item, other analysis methods and sources of fundings. Evidence quality evaluation of GRADE outcome indicators was generally low.ConclusionTraditional Chinese medicine for atrial fibrillation can improve clinical efficacy and reduce adverse reactions. The overall methodological quality of the included literature is not high, and the quality of evidence is generally low. It suggest that further high-quality clinical studies should be carried out to provide a basis for evaluating the clinical efficacy of traditional Chinese medicine in treatment of atrial fibrillation.
ObjectiveTo compare the imaging characteristics and surgical methods of pulmonary nodules in the external 1/3 group and internal 2/3 group. MethodsA retrospective analysis of clinical data from patients who underwent thoracoscopic preoperative CT-guided lung nodule localization at the Department of Radiology, the First Affiliated Hospital of Xiamen University from September 2020 to April 2022 was conducted. ResultsA total of 215 patients were enrolled (247 pulmonary nodules), including 70 males and 145 females, with a median age of 48.0 years. Based on the location of the nodules under CT guidance, those located in the external 1/3 area of the lung were classified into an external 1/3 group, while those located in the middle 1/3 and inner 1/3 areas were classified into an internal 2/3 group. There was no statistical difference between the two groups in terms of general clinical data, nature of pulmonary nodules, distribution of pulmonary nodules in lobes, localization time, and localization complications (P>0.05). However, there were statistical differences in the distance of pulmonary nodules from the pleura [0.6 (0.0-1.9) cm vs. 1.8 (0.0-4.5) cm, P<0.001], size of pulmonary nodules [0.7 (0.2-1.8) cm vs. 1.0 (0.2-2.0) cm, P<0.001], and surgical methods (P=0.002). In the external 1/3 group, 92.1% of nodules underwent thoracoscopic wedge resection, while fewer patients underwent other procedures; in the internal 2/3 group, 77.1% of nodules underwent thoracoscopic wedge resection, and 19.3% underwent segmentectomy. ConclusionThe diameter of pulmonary nodules, the distance of pulmonary nodules from the pleura, and surgical methods differ between the external 1/3 group and internal 2/3 group. Thoracic surgeons can develop more precise surgical plans based on the location and size of pulmonary nodules.
Ultrasonic microfluidic technology is a technique that couples high-frequency ultrasonic excitation to microfluidic chips. To improve the issues of poor disturbance effects with flexible tip structures and the susceptibility of bubbles to thermal deformation, we propose an enhanced ultrasonic microchannel structure that couples flexible tips with bubbles aiming to improve the disturbance effects and the stability duration. Firstly, we used finite element analysis to simulate the flow field distribution characteristics of the flexible tip, the bubble, and the coupling structure and obtained the steady-state distribution characteristics of the velocity field. Next, we fabricated ultrasonic microfluidic chips based on these three structures, employing 2.8 μm polystyrene microspheres as tracers to analyze the disturbance characteristics of the flow field. Additionally, we analyzed the bubble size and growth rate within the adhering bubbles and coupling structures. Finally, we verified the applicability of the coupling structure for biological samples using human red blood cells (RBCs). Experimental results indicated that, compared to the flexible tip and adhering bubble structures, the flow field disturbance range of the coupling structure increased by 439.53% and 133.48%, respectively; the bubble growth rate reduced from 14.4% to 3.3%. The enhanced ultrasonic microfluidic structure proposed in this study shows great potential for widespread applications in micro-scale flow field disturbance and particle manipulation.
Objective To investigate the effectiveness of minimally invasive plate fixation in treatment of unstable pelvic fractures. Methods Between May 2006 and December 2009, 21 patients with unstable pelvic fractures were treated. There were 13 males and 8 females with an average age of 39 years (range, 21-66 years). The causes of injury included traffic accident in 9 cases, falling from height in 6 cases, and heavy pound injury in 6 cases. The time from injury to hospitalization was 1 to 4 hours with an average of 2.8 hours. According to Tile’s classification, there were 12 cases of type B and 9 cases of type C. After admission, bone traction and exo fixation were performed, and minimally invasive plate fixation was given at 5-24 days after injury. Results All incisions healed by first intention, and no complications of nerve and vessel injuries occurred. According to the reduction criteria of Matta radiography, anatomic reduction was achieved in 16 cases, satisfactory reduction in 4 cases, and fair reduction in 1 case. All patients were followed up 12 months. The X-ray films showed all fractures healed at 2-4 months (mean, 2.6 months). According to Majeed clinical evaluation, the results were excellent in 12 cases, good in 7 cases, and fair in 2 cases. Conclusion Minimally invasive plate fixation can provide effective fixation, reconstruct pelvic ring, and reduce perioperative complications in the treatment of unstable pelvic fractures.