Objective To identify evidence-based treatment choices for a patient with increased intracranial pressure after acute traumatic brain injury. Methods We searched The Cochrane Library (Issue 2, 2006), MEDLNE (1981 to August 2006) and CBMdisc (1978 to August 2006) to identity systematic reviews (SRs), randomized controlled trials (RCTs), controlled clinical trials (CCTs) and prospective cohort studies involving the efficacy and safety of pharmacotherapy and non-pharmacotherapy for increased intracranial pressure after acute traumatic brain injury. Results We found 2 SRs and 8 RCTs on pharmacotherapy, and 6 SRs and 2 RCTs on non-pharmacotherapy. Conventional-dose mannitol was no better than hypertonic saline, but was better than other intracranial pressure lowering agents. High-dose mannitol can reduce mortality and the incidence of severe disability compared with conventional-dose mannitol. There were no studies comparing high-dose mannitol and hypertonic saline. Non-pharmacotherapy was not recommended for routine use due to the lack of good quality evidence. Conclusion For patients with increased intracranial pressure after acute traumatic brain injury, mannitol is effective in reducing the mortality and the incidence of severe disability. However, more large-scale RCTs are required to compare high-dose mannitol versus other drugs. Non-pharmacotherapy is not recommended as an adjunct therapy at present.
ObjectiveTo systematically review the efficacy of different non-pharmacological interventions for smoking cessation. MethodsPubMed, EMbase, The Cochrane Library, Web of Science, CBM, WanFang Data, VIP and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) of different non-pharmacological interventions for smoking cessation from inception to November, 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies; then, network meta-analysis was performed by using Stata 15.1 software. ResultsA total of 27 RCTs involving 14 interventions were included. The results of the network meta-analysis showed that compared with conventional advice, video counseling (OR=2.34, 95%CI 1.32 to 4.15), mobile phone text message (OR=1.82, 95%CI 1.03 to 3.20), motivational interview (OR=2.00, 95%CI 1.11 to 3.59) and health education (OR=3.40, 95%CI 1.52 to 7.57) were higher in quitting rate (P<0.05). The sort results showed that health education was the most likely to be the best intervention (86.20%), followed by video consultation (74.10%). ConclusionCurrent evidence shows that the smoking cessation effects of health education, video counseling, telephone counseling, mobile phone text message and motivational interview. Among them, health education may be the best. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.