Objective To conduct Meta-analyses on published literatures about the Jianpi Bushen Decoction combined with western medicine for dysfunctional uterine bleeding (DUB), so as to evaluate its efficacy and safety compared with the western medicine treatment. Methods The following databases such as PubMed (1995 to 2011), EMCC (1995 to 2011), CBM (1995 to 2011), CNKI (1995 to 2011), Wanfang (1989 to 2011) and VIP (1989 to 2011) were searched to collect the randomized controlled trials (RCTs) on Jianpi Bushen Decoction combined with western medicine for DUB. The selection of studies, assessment of methodological quality and data extraction were performed independently by two reviewers according to the Cochrane systematic review methods, and Meta-analyses were performed by using RevMan5.0 software. Results A total of 12 RCTs involving 925 cases were included, of which 471 ones were in the experimental group while the other 454 ones were in the control group. Each study was comparable in baseline data, all with reporting of using random methods, but no mention of detailed random methods, blind methods and allocation concealment. The results of Meta-analyses indicated that compared with single therapy of western medicine, Jianpi Bushen Decoction combined with western medicine for DUB was superior in the total effective rate (OR=5.60, 95%CI 3.25 to 9.67, Plt;0.000 01), bleeding recovery rate (OR=3.79, 95%CI 2.70 to 5.32, Plt;0.000 01), and bleeding recurrence rate (OR=0.14, 95%CI 0.05 to 0.42, P=0.000 5), with significant differences. Conclusions The integrated treatment of Jianpi Bushen Decoction and western medicine has certain effects on dysfunctional uterine bleeding, and it may be a promising treatment option. Due to the poor quality and high possibility of bias of the included studies, more well-designed multi-centered RCTs should be performed.
Objective To assess the effectiveness and safety of sodium ozagrel combined with edaravone for cerebral infarction. Methods Such databases as PubMed (1995 to 2010), EMCC (1995 to 2010), CBM (1995 to 2010), CNKI (1995 to 2010), and VIP (1989 to 2010) were searched to collect randomized controlled trials (RCTs) of odium ozagrel combined with edaravone for cerebral infarction. Then the retrieved studies were screened according to the predefined inclusion and exclusion criteria, the data were extracted, the quality of the included studies was evaluated, and meta-analyses were performed by using the Cochrane Collaboration’s RevMan 5.0 software. Results A total of 32 RCTs involving 3 059 cases were involved, among which 1 559 cases were in the treatment group and the other 1500 were in the control group. All studies with comparable baseline data reported the application of random methods without explaining the detailed methods, the blinding method and the allocation concealment. The results of meta-analyses indicated that sodium ozagrel combined with edaravone had significant differences in the effective rate for cerebral infarction compared with both single sodium ozagrel (OR=3.51, 95%CI 2.70 to 4.57) and routine treatment (OR=3.77, 95%CI 2.58 to 5.52), and it had significant differences in treating the defect of neurological function compared with both sodium ozagrel (WMD= –4.26, 95%CI –4.97 to –3.55) and routine treatment (WMD= –3.89, 95%CI –4.96 to –2.82). In addition, Sodium ozagrel combined with edaravone was superior to sodium ozagrel (WMD=13.57, 95%CI 9.84 to 17.30) in improving the ability of daily living. Conclusion This systematic review shows that sodium ozagrel combined with edaravone is quite effective in treating cerebral infarction, and it can improve the nerve dysfunction. This conclusion should be treated cautiously for the poor quality and higher possibility of bias in the included studies which may impact on the power of proof, so more double-blind RCTs with high quality are expected to provide high-quality evidence.
Objective To explore the effect of endovascular treatment guided by ultrasonography combined with portosystemic shunts on the patients with Budd-Chiari Syndrome （BCS）.Methods The clinical data of 136 patients with BCS treated by balloon angioplasty and stent implantation guided by Doppler ultrasonography in our hospital from January 1995 to January 2011 were retrospectively analyzed.After balloon angioplasty,53 patients were treated by inferior vena cava （IVC） stent implantation and 31 patients with hepatic venous occlusion underwent portosystemic shunts （PSSs） at one week after endovascular treatment.The long-and short-term effects after treatment were studied.Results After endovascular procedures,the IVC pressure of patients significantly decreased （P＜0.01）,while IVC diameter, flow velocity in the lesion,and right atrial pressure of patients showed significant increase（P＜0.01）.Slight heart dysfunction appeared in 13 cases of patients.After shunting,acute pancreatitis occurred in 3 cases, and 1 patient died of upper gastrointestinal hemorrhage on the 10 d after PSSs.Doppler ultrasonography for IVC and shunt vessels showed：the swollen liver and spleen lessened on 3d after endovascular procedures.The swollen liver lessened 2-7cm （mean 5.5cm）,swollen spleen lessened 3-8cm （mean 5.8cm）, and the time of ascites disappearance was 3-60d （mean 14d）.All the patients were followed up for 1 month to 15 years with an average of 3 years.Restenosis of the distal part of stent was found in 1 patient in 2 years after operation, hepatic vein occlusion occurred in 1 case in 1 year after treatment,hepatocellular carcinoma occurred in 1 patient in 3 years after stent implantation,and 1 patient died of C type hepatitis after 1 year,and 5 out of 6 cases of patients with infertility had babies after 1 year.All patients had no stent migration or occlusion of shunts and the symptoms of portal hypertension were obviously relieved.Conclusions Endovascular treatment guided by Doppler ultrasonography is a convenient,safe,and effective method for BCS.Portosystemic shunts are commended to patients with hepatic venous occlusions.The above mentioned methods provide a feasible and effective means for IVC stenosis and short segment occlusion with hepatic vein occlusion of BCS.
Objective To summarize the probability of pulmonary embolism （PE） induced by lower extremity deep venous thrombosis （DVT） and investigate the role of vena cava filter （VCF） in preventing from PE. Methods The clinical data of 1 058 patients with lower extremity DVT from January 2005 to January 2012 were analyzed retrospectively. Results The PE rate was 3.21% （34/1 058） and the death rate was 1.42% （15/1 058） in 1 058 patients with lower extremity DVT. The VCF was implanted in 171 of 1 058 patients. The VCFs of 151 patients were implanted from femoral vein， 20 patients were implanted from jugular vein. The PE rates were 3.61% （32/887） and 1.17% （2/171） and the death rates were 1.69% （15/887） and 0 （0/171） in patients without VCF and with VCF， respectively. Both of them occurred in the first ten days. PE could keep as long as 35 d. The PE rate and death rate in the patients without VCF were significantly higher than those in the patients with VCF （P＜0.01）. The PE rates and death rates in both lower extremities DVT were higher than those in patients with the right and left ones （P＜0.05）， which in the right lower extremity were higher than those in the left one （P＜0.05）. The PE rate and death rate in the patients with lower extremity DVT combined with vena cava thrombosis were significantly higher than those in the patients with central type （P＜0.05）， which in the central type were significantly higher than those in the peripheral type （P＜0.05）， there were no significant differences between peripheral type and mixed pattern. The follow-up time was from 1 month to 7 years with （39±19） months， the patency rate of VCF was 98.7%. There were no filter migration， declination， and failure of expansion. Conclusions VCF can prevent from PE effectively， but the indications must be controlled.