The latest global big data evidence indicated the changes of skin and venereal disease burden was huge. HIV/AIDS disease burden was the heaviest diseases among all skin and venereal diseases, and its skin manifestation was serious. The evidence of skin manifestation was searched and classified by subjects such as clinical symptoms, diagnosis & treatment, nursing, etc. The results showed, that the skin manifestation of HIV/AIDS with high incidence was serious, atypical, difficult to cure which was easy to misdiagnose or miss diagnosis. After analyzing the global HIV/AIDS guidelines, we found that many high quality guidelines with widely-covered subjects were produced by developed countries, while quite a few low quality and ones with narrowly-covered subjects were produced by developing countries. Only one guideline was for treatment of HIV/AIDS skin lesion. Based on the current evidence, we call for that all healthcare professionals to increase their awareness, update knowledge, and joint in cooperative prevention and treatment of HIV/AIDS. We also call for that we should produce high quality primary evidence for clinical diagnosis and treatment of HIV/AIDS skin manifestation, and clinical practice guidelines based on good evidence. For the increasing heavy burden of skin and venereal diseases, we should adjust and expand research directions, enrich and improve new interdisciplinary knowledge. We also should constantly train professionals and spread out knowledge in public on prevention and treatment for skin manifestation, so as to transform the evidence in time, effectively protect medical staff and susceptible population, effectively prevent and treat this disease, and improve the satisfaction of our country, hospitals and patients.
ObjectiveTo assess the efficacy and safety of focused ultrasound (FU) and microwave therapy (MW) for cervical ectopy (CE). MethodsWe searched the following databases:PubMed, EMbase, The Cochrane Library, CBM, VIP, CNKI and WanFang Data from inception to 30th August 2014. Two reviewers (Tang XL and Gao Z) independently screened literatures according to the inclusion and exclusion criteria, extracted data and assessed the methodological quality of included studies. Then, meta-analysis was performed by using RevMan 5.2.0 software. ResultsA total of 33 randomized controlled trials (RCTs) involving 1 759 patients were included. All the included studies were considered to be at high risk of bias. The results of meta-analysis showed that:compared with MW, FU could significantly reduce the risk of vaginal bleeding (RR=0.09, 95%CI 0.05 to 0.17, P<0.000 01) and vaginal discharge (RR=0.10, 95%CI 0.04 to 0.24, P<0.000 01), increase cure rate (RR=1.10, 95%CI 1.05 to 1.15, P<0.000 1) and total effective rate (RR=1.04, 95%CI 1.02 to 1.06, P=0.000 5). However, there was no difference in decreasing recurrence rate (RR=0.13, 95%CI 0.02 to 1.00, P=0.05). ConclusionCurrent available evidence suggest that FU is safer and more effective than MW for treating CE. Due to the limitation of quality of included studies, more high quality RCTs are needed to verify the above conclusion.
ObjectiveTo comprehensively collect quality assessment tools of systematic review/meta-analysis (SR/MA) of randomized controlled trials (RCTs), and compare the differences of numbers and contents of items, in order to provide references for optimizing and using these quality assessment tools. MethodsWe searched PubMed and EMbase databases up to December 31th, 2013 for quality assessment tools of SR/MA of RCTs. EndNote X3 software was used for screening literature and Excel 2010 software was used for data extraction. A descriptive analysis was performed. ResultsA total of 61 studies including 32 quality assessment tools were included. Among them, 30 tools were for methodological quality and 2 tools for reporting quality. These tools were developed by different medical universities or colleges, research institutes, national health institutes, and some famous epidemiologists and methodologists from 1984 to 2007. Among the 32 tools, 4 tools were scales, while 28 were checklists. The numbers of items of these tools ranged from 5 to 101, among them, 9 tools had more than 20 items. ConclusionThere are many quality assessment tools for SR/MA, but none of them is generally acknowledged. The quality, contents of items, and applicability of these tools are different, and some of them are too long to use. In practice and decision-making, most of the tools have the problems of low relevance and applicability. How to regularly use these tools to guide the research, practice and decision-making of SR/MA is still needed to be further researched.
ObjectiveTo systematically evaluate the efficacy and safety of epidermal growth factor receptortyrosine kinase inhibitors (EGFR-TKIs) as the first-line treatment for patients with advanced non-small cell lung cancer (NSCLC). MethodDatabases including PubMed, EMbase, The Cochrane Library (Issue 1, 2015) , CBM, CNKI, VIP and WanFang Data were electronically searched from inception to March 2015, to collect randomized controlled trials (RCTs) about EGFR-TKIs versus chemotherapy for advanced NSCLC patients. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then, meta-analysis was performed by RevMan 5.2 software. ResultsA total of 9 RCTs involving 3 841 patients were included. The results of meta-analysis showed that: for patients with EGFR mutation-positive, the rate of progression-free survival (PFS) (HR=0.41, 95%CI 0.31 to 0.54, P<0.000 01) , objective response rate (ORR) (RR=2.23, 95% CI 1.73 to 2.87, P<0.000 01) and quality of life (QoL) in the EGFR-TKI group were superior to the chemotherapy group; There was no statistical difference between two groups in rate of overall survival (OS) (HR=1.04, 95% CI 0.88 to 1.24, P=0.62) . The incidences of diarrhea (RR=3.81, 95% CI 2.15 to 6.76, P<0.001) and rash (RR=8.14, 95% CI 3.55 to 18.68, P<0.001) were significantly higher, but the incidence of blood toxicity was lower in the EGFR-TKI group that those in the chemotherapy group. ConclusionsCurrent evidence shows EGFR-TKI is superior to chemotherapy for advanced NSCLC patients with EGFR mutation-positive. However, due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.