ObjectiveTo systematically review the risk factors of related infections on the totally implantable venous access device (TIVAD) in adult.MethodsPubMed, EMbase, CINAHL, The Cochrane Library, CBM, WanFang Data, CNKI and VIP databases were electronically searched to collect case-control studies and cohort studies about the risk factors of TIVAD-related infections in adult from inception to April 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of one case-control study and 12 retrospective cohort studies involving 9 166 patients were included. The results of meta-analysis showed that: longer catheter utilization-days in the previous months (RR=1.06, 95%CI 1.02 to 1.10, P=0.001), inpatient treatment (RR=2.53, 95%CI 1.68 to 3.81, P<0.000 01), palliative care (RR=2.71, 95%CI 1.77 to 4.15,P<0.000 01), parenteral nutrition (RR=3.89, 95%CI 2.37 to 6.40,P<0.000 01), neutropenia (RR=2.20, 95%CI 1.30 to 3.72,P=0.003) and haematological malignancies (RR=3.54, 95%CI 2.03 to 6.17, P<0.000 01) were associated with increased risk of TIVAD-related infections in adult.ConclusionCurrent evidence shows that the risk factors of TIVAD-related infections include catheter utilization-days in the previous months, inpatient, palliative care, parenteral nutrition, neutropenia and hematological malignancies. Due to limited quality and quantity of the included studies, more high-quality studies are needed to verify conclusion.
ObjectiveTo systematically review the predictive value of ezrin expression in bone and soft tissue sarcomas.MethodsDatabases including PubMed, EMbase, The Cochrane Library (Issue 2, 2016), CNKI, CBM, VIP, and WanFang Data were searched to collect cohort studies about the prognostic value of ezrin expression in bone and soft tissue sarcomas from inception to May 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was performed by using RevMan 5.3 software.ResultsFinally, a total of 17 cohort studies, involving 1 460 patients were included. The results of meta-analysis showed that: the overall survival (HR=1.90, 95%CI 1.70 to 2.13, P<0.000 01), event-free survival (HR=2.42, 95%CI 1.53 to 3.84, P=0.0002), metastasis-free survival (HR=2.09, 95%CI 1.10 to 3.97, P=0.02) in the bone and soft tissue sarcomas patients with ezrin high expression were lower than patients with lower expression. The same results were also observed in subgroup analysis according to histologica type and ethnicity in overall survival.ConclusionEzrin high expression may be used as a predictive maker for poor prognosis in bone and soft tissue sarcomas. For the quantity and quality limitation of the included studies, this conclusion still needs to be further proved by performing more high quality studies.
ObjectivesTo systematically review the clinical response rate of CD19 chimeric antigen receptor modified-T cells (CD19CART) in the treatment of B cell hematological malignancies.MethodsPubMed, EMbase, CNKI, WanFang Data and VIP databases were searched to collect cohort studies about CD19CART in the treatment of B cell hematological malignancies from 2000 to 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, a single rate meta-analysis was performed by R software and SPSS 16.0 software.ResultsA total of 13 prospective cohort studies were included. The results of single group rate meta-analysis showed that the overall pooled response rate of CD19 CART was 68% (95%CI 0.51 to 0.82). The 6 months and 1-year PFS after CD19 CART infused by Kaplan-Meier were 46% (95%CI 0.35 to 0.56) and 24% (95%CI 0.16 to 0.34), respectively. The median duration was 180 days (95%CI 138 to 222). The COX regression model showed lymphodepletion to be the only influence factor of PFS.ConclusionsCD19 CART has a good clinical response rate in the treatment of B cell hematological malignancies. Lymphodepletion is the only important impact on the response rate and PFS. Due to limited quality and quantity of included studies, more high quality studies are required to verify the above conclusions.
Objective To systematically review the association between exposure to bisphenol A during pregnancy and spontaneous abortion. Methods The PubMed, Web of Science, EMbase, CNKI, WanFang Data and VIP databases were electronically searched to identify cohort studies and case-control studies related to bisphenol A exposure and spontaneous abortion from inception to April 1st, 2022. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using Stata 16.0 software. Results A total of 7 case-control studies and 1 cohort study were included, with a total of 1 179 subjects. The results of meta-analysis showed that there was a statistically significant difference in bisphenol A concentrations between the spontaneous abortion group and the control group regardless of whether the sample source was serum or urine (SMD serum=1.05, 95%CI 0.34 to 1.77, P=0.004; SMD urine=0.20, 95%CI 0.02 to 0.38, P=0.027). Conclusion The current evidence shows that exposure to bisphenol A during pregnancy may lead to unexplained recurrent spontaneous abortion. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo systematically review the correlation between type 2 diabetes mellitus (T2DM) and the risk of kidney cancer. MethodsPubMed, EMbase, Web of Science, CBM, VIP and CNKI databases were electronically searched to collect cohort studies on the association between T2DM and kidney cancer from inception to August 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis then performed by using Stata 15.0 software. ResultsA total of 17 cohort studies involving 2 003 165 T2DM patients were included. The results of meta-analysis showed that patients with T2DM had a higher kidney cancer risk than controls (RR=1.51, 95%CI 1.39 to 1.64, P<0.001). Subgroup analysis showed that the incidence of kidney cancer in T2DM patients was higher in different gender, region, population, follow-up time, diabetes assessment method and other subgroups. ConclusionsCurrent evidence shows that T2DM is a risk factor for kidney cancer.
ObjectivesTo systematically review the risk factors of complete uterine rupture so as to provide evidence for prevention of uterine rupture.MethodsPubMed, EMbase, The Cochrane Library, CBM and CNKI databases were electronically searched to collect case-control studies or cohort studies on the risk of complete uterine rupture from inception to October, 2019. Two reviewers independently screened literature, extracted data and assessed the quality of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 18 studies, involving 2 104 607 cases were included. The results of meta-analysis showed that the risk factors of complete uterine rupture included single-layer suture of uterine incision (OR=1.78, 95%CI 1.15 to 2.78, P=0.01), induction of labor (OR=1.72, 95%CI 1.21 to 2.45, P=0.003) (case-control studies) and (OR=2.66, 95%CI 1.87 to 3.79, P<0.000 01) (cohort studies), induction with prostaglandins (OR=3.23, 95%CI 1.48 to 7.06, P=0.003), induction with oxytocin (OR=3.97, 95%CI 1.65 to 9.59, P=0.002), and augmentation of labor with oxytocin (OR=2.17, 95%CI 1.53 to 3.09, P<0.000 1) (case-control studies) and (OR=2.29, 95%CI 1.24 to 4.23, P=0.008) (cohort studies). There was no significant relationship between birth weight and complete uterine rupture (OR=1.26, 95%CI 0.74 to 2.17, P=0.40).ConclusionsCurrent evidence shows that single layer suture of uterine incision, induction of labor, induction with prostaglandins, induction with oxytocin and augmentation of labor with oxytocin are the risk factors of complete uterine rupture. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify above conclusions.
Objective To systematically review the efficacy and safety of totally laparoscopic total gastrectomy (TLTG) versus laparoscopic-assisted total gastrectomy (LATG) for patients with gastric cancer. Methods Databases including PubMed, EMbase, The Cochrane Library, CBM, WanFang Data and CNKI were searched to collect cohort studies about TLTG vs. LATG for gastric cancer from inception to February 28th 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed using RevMan 5.3 software. Results A total of six cohort studies were included, of which 407 cases were in the TLTG group, and 315 cases were in the LATG group. The results of meta-analysis showed that compared with LATG group, patients in TLTG group had shorter operation time (MD=–8.97, 95%CI –16.21 to –1.73, P=0.02), and initial postoperative feeding time (MD=–0.30, 95%CI –0.57 to –0.03, P=0.03). However, the anastomic time, bleeding volume, the number of dissected lymph nodes, proximal resection margin, initial flatus time, postoperative hospital stay, overall postoperative complications, anastomotic fistula, and anastomotic stenosis were similar between two groups (all P values>0.05)． Conclusions Compared with LATG, TLTG has shorter operation and recovery time for patients with gastric cancer. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.
ObjectiveTo systematically review the association between use of proton pumps inhibitors (PPIs) and clostridium difficile infection (CDI), so as to provide evidence for doctors' prescription. MethodsWe electronically searched databases including PubMed, The Cochrane Library (Issue 8, 2015), Web of Science, Ovid, CBM, CNKI, VIP, WanFang Data to collect case-control studies and cohort studies about the association between use of PPIs and CDI from January 1990 to October 2015. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was performed using RevMan 5.3 software. ResultsA total of 47 articles involving 50 studies with 309620 cases were included. According to whether infected by clostridium difficile or not, these cases were divided into the case group (n=15913) and the control group (n=293707). The result of meta-analysis showed that the CDI rate of the PPIs therapy group was higher than that of the control group (OR=1.99, 95%CI 1.72 to 2.31, P<0.01, I2=87%) but a significant heterogeneity was found among studies. So subgroup analyses were performed according to the type of study design, type of patients, sample size and NOS scores of included studies. The results showed that, within different subgroups, the CDI rate of the PPIs therapy group was higher than that of the control group with significance, but the heterogeneity among studies was still existed. ConclusionCurrent evidence shows the use of PPI is associate with a 2-fold increase of the risk of CDI. Due to limited quality of the included studies, the above conclusion needs to be verified by more high quality studies.
ObjectiveTo systematically review the association between migraine and lacunar infarcts on MR image.MethodsPubMed, EMbase, The Cochrane Library, CNKI, VIP and WanFang Data databases were electronically searched to collect randomized controlled trials, cohort studies and cross-sectional studies on the association between migraine and lacunar infarcts from inception to March 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by RevMan 5.3 software.ResultsA total of 5 studies involving 5 104 participants were included. The results of meta-analysis showed that: there were no significant associations of migraine (OR=0.93, 95%CI 0.78 to 1.12, P=0.470) and aura (OR=1.10, 95%CI 0.89 to 1.36, P=0.390) with lacunar infarcts on MR image. Subgroup analysis by age, presence or absence of aura showed no significant tendency.ConclusionsThere is no significant relationship between migraine and lacunar infarcts. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.
ObjectiveTo systematically review the efficacy and safety of intravascular cooling versus surface cooling for induced mild hypothermia on the prognosis of patients with cardiac arrest (CA) after resuscitation.MethodsPubMed, EMbase, The Cochrane Library, CNKI and WanFang Data databases were electronically searched to collect cohort studies and randomized controlled trials (RCTs) about the efficacy and safety of intravascular cooling versus surface cooling for CA patients after resuscitation from inception to July 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using Stata 13.0 software.ResultsA total of 9 cohort studies and 3 RCTs involving 2 104 patients were included. The results of meta-analysis showed that: the rate of good neurological function was significantly higher (OR=1.45, 95%CI 1.18 to 1.78, P<0.001) and the induction time was significantly shorter (SMD=−1.35, 95%CI −2.34 to −0.36, P=0.008) in the intravascular cooling group, but there was no statistical difference in mortality between two groups (OR=0.84, 95%CI 0.70 to 1.00, P=0.053). In terms of complications related to mild hypothermia, the rate of excessive hypothermia (OR=0.27, 95%CI 0.18 to 0.41, P<0.001) and arrhythmia (OR=0.60, 95%CI 0.40 to 0.89, P=0.012) was significantly lower in the patients treated with intravascular cooling, but the incidence of coagulopathy was higher (OR=1.61, 95%CI 1.05 to 2.49, P=0.03). There was no statistical difference in the incidence of pneumonia between two groups (OR=1.20, 95%CI 0.94 to 1.53, P=0.147).ConclusionCurrent evidence shows that intravascular cooling has significant neurological protection for patients with CA compared with surface cooling since it can decrease the induction time and the rate of excessive hypothermia and arrhythmia, but it may have a negative effect on the coagulation function. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.