Objective To evaluate the value of MRI and MDCT in detecting both inferior vena cava tumor thrombus and vena cava wall invasion in renal cell carcinoma. Methods Databases including PubMed, EMbase, The Cochrane Library, MEDLINE (Ovid), CBM, CNKI, VIP and WanFang Data were searched from January 2000 to February 2012. Relevant studies were screened on the basis of the inclusion and exclusion criteria, and then quality assessment and data extraction were conducted. Then heterogeneity test and meta-analysis were conducted using RevMan 5 and Meta-disc 1.4. Results A total of 6 trials involving 244 patients and 246 cases of renal cell carcinoma were included. The results of meta-analysis showed that, for the MRI group and the MDCT group, the sensitivity was 0.963 and 0.952, the specificity was 0.969 and 0.979, the value of +LR was 9.759 and 15.57, the value of −LR was 0.091 and 0.108, and the dOR was 198.71 and 251.54, respectively. There were no significant differences in pooled effect-size among groups (Pgt;0.05). The area under curve (AUC) of summary ROC curve analysis as well as Q index of the MDCT group were 0.981 8 and 0.940 7, respectively. Conclusion There is no significant difference in the value of MRI and MDCT in detecting inferior vena cava tumor thrombus induced by renal cell carcinoma. More original studies on vena cava wall invasion by tumor thrombus should be conducted in the future due to the limitation of current materials.
Objective To evaluate the value of 3-D reconstruction in multi-detector spiral CT urography (MDCTU) for diagnosing upper urinary tract diseases (UUTDs) by means of both diagnostic sensitivity and ROC curve. Methods A total of 41 patients with UUTD were collected. All of them took MDCTU as well as reconstructions including MPR, MIP and VR. Compared with golden standards, the diagnostic value of MDCTU, MPR, MIP and VR were evaluated using both diagnostic sensitivity and ROC curve. Results a) A total of 49 upper urinary tract lesions were detected in those 41 patients; b) For UUTD, the localization diagnostic sensitivities of MPR, MIP, and VR were 48/49 (98.0%), 27/49 (53.2%), and 19/49 (38.8%), respectively; while their qualitative diagnostic sensitivities were 47/49 (95.9%), 17/49 (34.7%), and 13/49 (26.5%), respectively; the differences between MPR and the others were significantly (Plt;0.05); c) For distinguishing benign from malignant lesions, the Az value (area under ROC curve) of MPR, MIP, and VR were 0.998, 0.736 and 0.669, respectively; the differences between MPR and the others were significant (Plt;0.05); and d) MPR was completely the same as MDCTU in both diagnostic sensitivity and Az value. Conclusion The common 3-D reconstructions in MDCTU were different in value. MPR is highest in the diagnostic efficiency, which is similar to MDCTU, and is regarded as the basis of diagnosis; while MIP and VR are more stereo and intuitive. So it shows that the comprehensive application of CTU 3-D reconstructions has important value for diagnosing UUTD and distinguishing benign from malignant.
ObjectiveTo study the difference of femoral condylar twist angle (CTA) measurement in three dimensional (3-D) reconstruction digital models of human knee joint based on the two dimensional (2-D) images of MRI and CT so as to provide a reference for selecting the best method of CTA measurement in preoperative design for the femoral prosthesis rotational position. MethodsThe CTA of 10 human cadaveric knee joint was measured in 3-D digital models based on MRI (group A), in 3-D digital models based on CT (group B), in the cadaveric knee joint with cartilage (group C), and in the cadaveric knee joint without cartilage (group D), respectively. The statistical analysis of the differences was made among the measurements of the CTA. ResultsThe CTA values measured in 3-D digital models were (6.43±0.53)° in group A and (3.31±1.07)° in group B, showing significant difference (t=10.235, P=0.000). The CTA values measured in the cadaveric knee joint were (5.21±1.28)° in group C and (3.33±1.12)° in group D, showing significant difference (t=5.770, P=0.000). There was significant difference in the CTA values between group B and group C (t=5.779, P=0.000), but no significant difference was found between group A and group C (t=3.219, P=0.110). ConclusionThe CTA values measured in the 3-D digital models based on MRI are closer to the actual values measured in the knee joint with cartilage, and benefit for preoperative plan.
Objective To analyze and screen the risk factors of both immunohistochemistry and pathology for lung cancer lymphatic metastasis, and to build a mathematical model for preliminary evaluation. Methods By conducting retrospective studies, the information of lung cancer patients in the General Hospital of Air Force from 2009 to 2011 were collected. Both single and multiple unconditional logistic regression analyses were applied to screen total 27 possible factors for lymphatic metastasis. After the factors with statistical significance were selected, the relevant mathematical model was built and then evaluated by means of receiver operating characteristic (ROC) analysis. Results A total of 216 patients were included. The single analyses on 27 possible factors showed significant differences in the following 10 factors: pathological grade (P=0.00), age (P=0.00), tumor types (P=0.01), nm23 (P=0.00), GSTII (P=0.01), TTF1 (P=0.01), MRP (P=0.01), CK14 (P=0.02), CD56 (P=0.02), and EGFR (P=0.03). The multiple factors unconditional logistic regression analyses on those 10 risk factors screened 4 relevant factors as follows: pathological grade (OR=2.34), age (OR=1.02), nm23 (OR=1.66), and EGFR (OR=1.47). Then a mathematical diagnostic model was established based on those 4 identified risk factors, and the result of ROC analysis showed it could improve the diagnostic sensitivity and specificity compared with the single factor mathematical diagnostic model. Conclusion Pathological grade, age, nm23, and EGFR are related with lung cancer lymphatic metastasis, and all of them are the risk factors which have higher adjuvant diagnostic value for lung cancer lymphatic metastasis.
The resistance of non-small cell lung cancer (NSCLC) to epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) has been brought into focus. COX-2 signal pathway was found to be closely related to EGFR signal pathway by recent researches, and there has been a growing interest to focus the researches on whether COX-2 pathway inhibition improves the efficacy of EGFR-TKIs in treating advanced NSCLC. In this review, we will illustrate recent advances of combined inhibition of EGFR and COX-2 signal pathways in NSCLC therapy.
Vascular endothelial cell(VEC) is a kind of simple squamous epithelium lined on the inner surface of blood vessels. VEC is an important barrier between the blood and tissue and it also plays a key role in regulating inflammation, thrombosis, endothelial cells mediated vasodilatation and endothelial regeneration. These processes should be controlled by a variety of complex mechanism which requires us to find out. With results of the researches in vascular endothelial cell function, the important roles that microRNA in vascular endothelial cell function draws more and more researchers' attention. MicroRNAs control gene expression in post-transcriptional level and affect the function of endothelial cells. This review focuses on the research progress on regulatory mechanism of microRNA to endothelial cell inflammation, thrombosis, vasodilation and endothelium regeneration.
Objective To investigate the correlation between RUNX3 expression and human gastric cancer, as well as its clinically pathologic features. Methods Such databases as PubMed, EMbase, VIP, WanFang Data and CBM were searched from their inception to February 28th, 2013 to collect case-control studies about the correlation between RUNX3 expression and human gastric cancer, as well as its clinically pathologic features, and the relevant references of the included literature were also retrieved. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data, and assessed the methodological quality. Then meta-analysis was conducted using RevMan 5.0 software. Results A total of 6 case-control studies were included, which included 405 cases in the gastric cancer group and 185 cases in the normal gastric mucosa group. The results of meta-analysis showed that, RUNX3 expression was lower in the gastric cancer group than the normal gastric mucosa group, with a significant difference (OR=0.07, 95%CI 0.04 to 0.12, Plt;0.000 01); it was also lower in the subgroup of gastric cancer accompanied with lymph node metastasis than that without lymph node metastasis (OR=0.37, 95%CI 0.23 to 0.61, Plt;0.000 1); but it was higher in the subgroup of gastric cancer that had infiltrated into serosa than that had not, with a significant difference (OR=3.92, 95%CI 2.29 to 6.71, Plt;0.000 01); and it was also higher in the subgroup of well differentiated gastric cancer that the moderately and poorly differentiated, with a significant difference (OR=0.36, 95%CI 0.22 to 0.58, Plt;0.000 1). Conclusion RUNX3 expression is notably correlated to gastric cancer and its clinically pathologic features. For the quantity and quality limitation of the included studies, this conclusion still needs to be further proved by performing more high quality studies.
Objective To assess the reporting quality of systematic reviews/meta-analyses related to interventions published in Chinese Journal of Evidence-Based Medicine by PRISMA guidelines, and to analyze its influencing factors. Methods The systematic reviews/meta-analyses related to interventions were searched in the Chinese Journal of Evidence-Based Medicine from its inception to 2011. The quality of the included reviews was assessed in accordance with the PRISMA checklist. Based on the degree of conformity with each criterion of PRISMA, the reviews were scored as “1”, “0.5” or “0” orderly. The data were put into Excel, and the Meta-analyst software was used for statistical analysi. Results Among all literature in the volume 11 (95) of the Chinese Journal of Evidence-Based Medicine from 2001 to 2011, a total of 379 studies were included, and the number of publication showed a yearly rising trend. The PRISMA scale score ranged from 8.5 to 26 (X±SD) was 19.97±3.15. Among all studies, 25 (6.60%) scored 21-27 points, which were regarded as the complete reporting; 226 (59.63%) scored 15-21 points, regarded as relatively complete reporting; and 128 (33.77%) scored less than 15 points, regarded as serious lack of information. The results of stratified analysis showed that, both the issue of PRISMA and fund support could improve the reporting quality, with a significant difference (Plt;0.05); and authors more than 3, authors from universities, and authors from more than 2 institutions could improve the reporting quality, but without a significant difference (Pgt;0.05). Conclusion The overall reporting quality of systematic reviews/meta-analyses related to interventions published in the Chinese Journal of Evidence-Based Medicine is poor, and it is influenced by the factors of protocol and registration, risk of bias across studies, other analyses, and fund support, which have to be taken seriously. The reasonable utilization of the PRISMA checklist will improve the reporting quality of systematic reviews/meta-analyses.
Objective To assess the methodological quality of systematic reviews or meta-analyses of intervention published in the Chinese Journal of Evidence-Based Medicine, so as to provide evidence for improving the domestic methodological quality. Methods The systematic reviews or meta-analyses of intervention published from 2001 to 2011 were identified by searching the Chinese Journal of Evidence-Based Medicine. The methodological quality of included studies was assessed by AMSTAR scale. The Excel software was used to input data, and Mata-Analyst software was used to conduct statistical analysis. Results A total of 379 studies were included. The average score of AMSTAR was 6.15±1.35 (1.5-9.5 point). Just some items of AMSTAR scale were influenced by the following features of included studies: publication date, funded or not, number of author, author’s unit, and number of author’s unit. The total AMSTAR score of studies published after 2008 was higher than those published before 2008 (P=0.02), but the improvement of methodological quality was limited. While the total AMSTAR score of studies published by 3 or more than 3 authors were higher than those published by 2 or less than 2 authors (P=0.04). Conclusion The methodological quality of the included studies published in the Chinese Journal of Evidence-Based Pediatrics is uneven. Although the methodological quality improves somewhat after the publication of AMSTAR scale, there is no big progress, so it still needs to be further improved.
Objective To evaluate the quality of Chinese clinical practice guidelines published in domestic medical journals in 2011. Methods The following 4 Chinese databases including WanFang Data, VIP, CNKI and CBM were searched from January 2011 to December 2011. The quality of included guidelines was assessed by using AGREE II. Results A total of 75 guidelines published in 2011 were included. Among them, 10 guidelines (13%) stated the conflict of interest, 10 guidelines (13%) mentioned evidence-based developing, 5 guidelines (7%) performed evidence grading system, 8 guidelines (11%) performed recommendation strength grading system, and 4 guidelines (5%) performed both evidence and recommendation strength grading systems. The ratio of the 6 domains’ scores of AGREEⅡ were as follows: scope and purpose (18%), stakeholder involvement (11%), rigour of development (8%), clarity of presentation (34%), applicability (5%), and editorial independence (14%). Conclusion Compared with the guidelines published before, the guidelines of 2011 have a higher quality and some of them are progressively standardized in developing methodology.