Objective To evaluate the effectiveness of topical fluoride on prevention of enamel demineralization during the orthodontic treatment in China. Methods The Cochrane Library（Issue 9, 2012), MEDLINE (1996 to 2012.10), EMbase (1974 to 2012.10), CNKI (1994 to 2012.10), VIP (1994 to 2012.10), WanFang data (1998 to 2012.10) and CBM (1978 to 2012.10) are searched for the randomized controlled trials (RCTs) and quasi-Randomized controlled trials (qRCTs) about topical fluoride preventing enamel demineralization during the orthodontic treatment. The bibliographies of the included studies were searched, too. Two reviewers evaluated the quality of the included studies and extracted data critically and independently, and then the extracted data were analyzed using RevMan 5.2 software. Results A total of 20 studies within 19 articles were included, which involved 26 323 teeth. The results of meta-analysis results show that, the rate of enamel demineralization of the fluoride varnish group (8.4%) was lower than that of the control group (16.0%) (OR=0.44, 95%CI 0.33 to 0.59, Plt;0.000 01); the rate of enamel demineralization of the fluoride coating group (8.3%) was lower than that of the control group (17.7%) (OR=0.46, 95%CI 0.35 to 0.60, Plt;0.000 01); the rate of enamel demineralization of the fluoride toothpaste group (9.0%) was lower than that of the control group (14.5%) (OR=0.59, 95%CI 0.49 to 0.71, Plt;0.000 01); the rate of enamel demineralization of the fluoride foam group (11.6%) was lower than that of the control group (18.2%) (OR=0.48, 95%CI 0.24 to 0.96, P=0.04); the rate of enamel demineralization of other groups (12.0%) was lower than that of the control group (21.8%) (OR=0.43, 95%CI 0.30 to 0.60, Plt;0.000 01). Two outcomes were low quality in the GRADE system and the other three are very low quality. Conclusion Current domestic evidence shows that topical fluoride is effective to prevent enamel demineralization during the orthodontic treatment. However, given the low methodological quality of most included studies, this conclusion still needs to be further proved by conducting more strictly-designed, high-quality and large-scale studies.
R Software is an open, free of use and charge statistical software which has a powerful graphic capability; however, it requires more complex codes and commands to perform network meta-analysis, which causes errors and difficulties in operation. WinBUGS software is based on Bayesian theory, which has a powerful data processing capability, and especially its codes are simple and easy to operate for dealing with network meta-analysis. However, its function of illustrating statistical results is very poor. In order to fully integrate the advantages of R software and WinBUGS software, an R2WinBUGS package based on R software has been developed which builds a “bridge” across two of them, making network meta-analysis process conveniently, quickly and result illustration more beautiful. In this article, we introduced how to use the R2WinBUGS package for performing network meta-analysis using examples.
Objective To evaluate the effect of different topical fluorides for preventing dental caries in children. Methods Literature was searched according to the methods of systematic review in the following databases: CENTRAL, Medline, EMbase, CNKI, VIP, WanFang Data, CBM and Gray literature databases such as Open Grey and National Technical Information Service (NTIS) online, and the relevant journals and professional materials were also searched manually. The quality of the selected studies was appraised using Cochrane criteria, and then Meta-analysis was conducted suing RevMan 5.0, GRADEprofiler and Stata.11 software. Results 18 RCTs involving 19 359 children were included. A result of eight RCTs showed that the prevalence rate of caries of the fluoride varnish group (50.62%) was lower than that of the control group (70.89%) (OR=0.43, 95%CI 0.34 to 0.44, Plt;0.000 01). A result of four RCTs showed that the prevalence rate of caries of the fluoride ion group (32.04%) was lower than that of the control group (44.94%) (OR=0.50, 95%CI 0.45 to 0.55, P=0.02). A result of six RCTs showed that the prevalence rate of caries of the fluoride foam group (55.90%) was lower than that of the control group (67.20%) (OR=0.53, 95%CI 0.47 to 0.60, Plt;0.000 01). The quality of the above three results was low according to the GRADE analysis. Conclusion This systematic review shows topical fluoride is effective to prevent dental caries in children without side effects. But more high-quality RCTs are needed to prove this conclusion due to the low quality of the included studies.
R software is a free and powerful statistical tool, including Metafor, Meta as well as Rmeta packages, all of which could conduct meta-analysis. Metafor package provides functions for meta-analyses which include analysis of continuous and categorical data, meta-regression, cumulative meta-analysis as well as test for funnel plot asymmetry. The package can also draw various plots, such as forest plot, funnel plot, radial plot and so forth. Mixed-effects models (involving single or multiple categorical and/or continuous moderates) can only be fitted with Metafor packages. Advanced methods for testing model coefficients and confidence intervals are also implemented only in this package. This article introduces detailed operation steps of Metafor package for meta-analysis using cases.
Objective To systematically evaluate the efficacy and safety of tacrolimus and glucocorticoid for oral lichen planus (OLP). Methods The Cochrane review’s method was adopted and computer-based retrieval was performed on The Cochrane Library, MEDLINE, EMbase, CBM, and CNKI (from their establishment to November 2010) to collect randomized controlled trials (RCTs) comparing the clinical efficacy of tacrolimus in treating OLP with that of triamcinolone. The study was selected according to the inclusion and exclusion criteria, the data were collected, and the methodological quality of the included studies was evaluated. The RevMan 5.0.25 software was applied for statistical analyses. Results Four RCTs involving 164 patients were included. Two studies showed that the tacrolimus effectively reduced lesion area and alleviated pain of patients with OLP. The results of meta-analyses showed that the total effective rate of tacrolimus was not higher than that of glucocorticoid (OR=4.38, 95%CI 0.67 to 28.73), and there was no significant difference between the tacrolimus group and the glucocorticoid group in adverse events during the treatment session (OR=3.49, 95%CI 0.49 to 24.84), and there was no significant difference in recurrence rate between those two groups (OR=0.82, 95%CI 0.27 to 2.46). Conclusion Topical tacrolimus can remarkably improve the OLP sign (lesion area) and symptom (pain), which is in line with the findings of other non-RCTs. The current evidence proves that the tacrolimus is similar to glucocorticoid in terms of the total effective rate of treating OLP, the incidence of side reaction during treatment, and the recurrence rate after stopping treatment. Some studies included in this systematic review apply different assessment methods, hence more RCTs with high-quality, multi-center, and therapeutic evaluation indexes with corresponding evaluation methods are required to provide more reliable evidence.
Objective To evaluate the effectiveness of repetitive transcranial magnetic stimulation (rTMS) for treating dysfunction in patients with Parkinson’s disease (PD). Methods We searched the Cochrane Library (Issue 1, 2010), MEDLINE, EMbase, CBMdisc, and CNKI from the date of the database establishment to April 2010. Randomized controlled trials (RCTs) of rTMS for patients with PD were collected. The quality of the included RCTs was critically appraised and data were extracted by two reviewers independently. Meta-analyses were conducted for the eligible RCTs. Results Eight RCTs were included. The pooled results of the first 2 RCTs showed that, there was no significant difference compared with control group about treating PD patients with clinical motor dysfunction by high-frequency rTMS 10 days later (WMD= –4.75, 95%CI –13.73 to 4.23). The pooled analysis of another 3 studies showed that, no significant difference were found about improving symptoms with treatment of low-frequency rTMS for 1 month compared with control group (WDM= –8.51, 95%CI –18.48 to 1.46). The pooled analysis of last 3 studies showed that, patient with treatment of low-frequency rTMS for 3 months, had been significantly improved in clinical symptoms such as neurological, behavior and emotional state, clinical motor function, and activities of daily living (WDM= –5.79, 95%CI –8.44 to –1.13). The frontal or motor cortex rTMS manifested as low frequency (≤1Hz), high intensity (≥90% RMT), multi-frequency (≥3 times) and long time (≥3 months) had a positive effect on the clinical symptoms of patients with PD and also had a long-term effect. Conclusions rTMS can improve clinical symptoms and dysfunction of the patients with PD.
The netmeta package is specialized for implementing network meta-analysis. This package was developed based on the theories of classical frequentist under R language framework. The netmeta package overcomes some difficulties of the software and/or packages based on the theories of Bayesian, for these software and/or packages need to set prior value when conducting network meta-analysis. The netmeta package also has the advantages of simple operation process and ease to operate. Moreover, this package can calculate and present the individual matched and pooled results based on the random and fixed effect model at the same time. It also can draw forest plots. This article gives a briefly introduction to show the process to conduct network meta-analysis using netmeta package.
ObjectiveTo systematically review clinical efficacy and safety of bone marrow stem cells transplantation in treating primary dilated cardiomyopathy (DCM). MethodsSuch databases as PubMed, CENTRAL, EMbase, Web of Knowledge, VIP, CNKI, CBM and WanFang Data were searched from inception to March 2014 for the randomized controlled trials (RCTs) about bone marrow stem cells transplantation for DCM. According to the inclusion and exclusion criteria, two reviewers independently screened literature, extracted data, and assessed methodological quality of included studies. Then meta-analysis was performed using RevMan 5.2.0 software. ResultsA total of ten RCTs involving 374 patients were included. The results of meta-analysis showed that, a) for safety, after 3 months there was no significant difference in the incidence of malignant arrhythmia events between bone marrow stem cell transplantation group and routine treatment group (RR=0.81, 95%CI 0.38 to 1.72, P=0.58); and b) for efficacy, compared with the control group, left ventricular ejection fraction (LVEF) increased in the bone marrow stem cell transplantation group after 3 months (WMD=3.86, 95% CI 2.53 to 5.20, P<0.000 01) and after 6 months (WMD=5.54, 95%CI 3.02 to 8.06, P<0.000 1). The bone marrow stem cell transplantation group were better in increased 6-minute walking distance after 3 months (WMD=22.12, 95%CI 7.78 to 36.46, P=0.003), increased 6-minute walking distance after 6 months (WMD=102.79, 95%CI 50.16 to 155.41, P=0.000 1), decreased perfusion defect of myocardium percentage after 3 months (WMD=-4.00, 95%CI -5.87 to -2.13, P<0.000 1). However, there was no significant difference in left ventricular end-diastolic diameter (LVEDD) between two groups after 3 months (WMD=-0.37, 95%CI -1.67 to 0.93, P=0.57) and after 6 months (WMD=-0.70, 95%CI -2.76 to 1.36, P=0.51). ConclusionBone marrow stem cells transplantation for dilated cardiomyopathy is effective in improve patients' heart function with good safety, with significant difference. Due to limited quantity and quality of the included studies, more high quality and large-scale RCTs are needed to verify the above conclusion.
Objective To explore the correlation between overweight, obesity and incidence of type 2 diabetes mellitus (T2DM). Methods Databases including PubMed, EMbase, The Cochrane Library (Issue 3, 2012), CNKI, VIP, CBM and WanFang Data were searched from inception to May, 2012 to collect the cohort studies on the correlation between overweight, obesity and incidence of T2DM. The studies were screened according to the inclusion and exclusion criteria by two researchers independently, the quality was evaluated, the data were extracted, and then meta-analysis was performed using RevMan 5.1 and Stata 11.0 software. Results A total of 8 studies involving 101 864 participants were included. The results of meta-analysis showed that, compared with the normal weight population, the onset risk of T2DM was obviously higher in the overweight (RR=2.59, 95%CI 2.11 to 3.19, Plt;0.000 01), and obese (RR=6.28, 95%CI 4.99 to 7.91, Plt;0.000 01) populations. In the subgroup analysis, the onset risk of T2DM was higher in the western obese population (RR=6.91, 95%CI 5.59 to 8.56) than the eastern obese population (RR=4.19, 95%CI 2.93 to 5.99). Based on the Grading of Recommendations Assessment, Development and Evaluation (GRADE), the quality of the included studies on T2DM developed by overweight and obesity was low and medium respectively. Conclusion Overweight and obesity can increase the onset risk of T2DM which is higher in the female and western obese populations than the male and eastern obese populations respectively.