Objective To evaluate the efficacy and safety of adalimumab for rheumatoid arthritis failing to respond to disease-modifying anti-rheumatic drugs (DMARDs). Methods The Cochrane Library, PubMed, EMbase, CBM, CNKI, VIP and Wanfang (from the date of their establishments to June 2010) were searched, and journals of relevant fields were retrieved to identify randomized controlled trials (RCTs). The data were analyzed by using RevMan 5.0 software. Results Four RCTs were included, all of which were from abroad and with good methodological quality. The baseline data of each trial were comparable. Meta-analyses showed that there was a significant difference between the adalimumab and the placebo in terms of ACR20, ACR50, ACR70, tender joint count, swollen joint count, patient assessment of pain, patient global assessment of disease activity, doctor global assessment of disease activity, and disability index of the HAQ. There was no difference between the adalimumab and the placebo in terms of serious adverse events, intractable adverse events and serious infection. Conclusion Adalimumab can treat rheumatoid arthritis failing to respond to DMARDs, but clinically the doctor should balance the benefit and the risk of the adalimumab.
Objective To evaluate the effect of nursing interventions on the medical behavior of diabetic patients. Methods We searched CMB (1978 to September 2007), CNKI (1994 to September 2007), VIP (1989 to September 2007) and Papers on Academic Conference of China (1989 to September 2007), and hand-searched relevant journals. We identified randomized controlled trials (RCTs) and quasi-RCTs of nursing interventions plus routine therapy versus simple routine therapy for diabetic patients. The methodological quality of included studies was assessed and data was extracted and analyzed by using The Cochrane Collaboration’s RevMan 4.2.10 software. Results In total, 10 RCTs and 2 quasi-RCTs were included. Two of these studies described blinding. The quality of the included trials was low. Meta-analyses showed that nursing interventions significantly improved medication compliance (RR 1.33, 95%CI 1.21 to 1.45), medical behaviors of physical therapy (RR 1.48, 95%CI 1.30 to 1.69), diet control (RR 1.54, 95%CI 1.39 to 1.71), blood glucose monitoring (RR 1.56, 95%CI 1.41 to 1.72) and regular inspection (RR 1.66, 95%CI 1.41 to 1.96) in patients with diabetes. Conclusion Nursing interventions can improve the medical behavior of diabetic patients, increase patient-controlled capacity and enhance awareness of diabetes. It is also beneficial for blood glucose control and stability.