ObjectiveTo systematically evaluate the association between MTHFR gene C677T polymorphism and susceptibility to young and middle-aged adult ischemic stroke among Chinese population. MethodsSuch databases as PubMed, EMbase, The Cochrane Library (Issue 11, 2013), CBM, CNKI, VIP and WanFang Data were systemically searched to collect case-control studies published from Jan 1990 to Dec 2013. RevMan 5.2 was used to quantitatively analyzed the qualified and included studies, the pooled odds ratio (ORs) with 95% confidence interval (CI) were calculated; Stata 12.0 software were used for sensitivity and publication bias analysis. ResultsA total of 10 studies were included, which involved 787 cases and 766 controls. The results of meta-analysis showed that, in overall young and middle-aged adult group (aged less than 60), individuals that carried T allele risked more with ischemic stroke than those carried C allele (OR=1.42, 95%CI 1.07 to 1.89, P=0.02); more susceptibility to ischemic stroke was found among people of TT genotype compared with those of CC genotype (OR=2.11, 95%CI 1.58 to 2.81, P=0.00), as well as those of TT+TC genotype compared with CC genotype (OR=1.97, 95%CI 1.55 to 2.51, P=0.00), and those of TT genotype compared with TC+CC genotype (OR=1.42, 95%CI 1.13 to 1.77, P=0.00). Increased risk was also observed in TT+TC genotype compared with CC genotype in young adult subgroup (aged less than 45) (OR=1.66, 95%CI 1.19 to 2.32, P=0.00). ConclusionMTHFR gene C677T polymorphism is significantly associated with susceptibility to young and middle-aged adult ischemic stroke among Chinese population, and more risk may exist in middle-aged adult population.
ObjectivesTo systematically review the efficacy of telephone-delivered cognitive behavioral therapy (CBT) for insomnia. MethodsDatabases including PubMed, EMbase, PsycINFO, The Cochrane Library (Issue 7, 2015), CBM and CNKI were searched from inception to July 2015, to collect randomized controlled trials (RCT) about telephone-delivered CBT for insomnia. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, RevMan 5.2 software was used to performing meta-analysis. ResultsFive RCTs involving 322 patients were included. The results of meta-analysis showed that:Compared with the waiting group, the sleep onset latency was shorter (MD=-30.31, 95% CI -40.41 to -20.22, P<0.00001), the waking after sleep onset was shorter (MD=-15.59, 95% CI -24.09 to -7.09, P=0.0003) and the sleep efficiency was higher (MD=11.02, 95% CI 7.87 to 14.18, P<0.00001) in the telephone-delivered CBT group, but there was no significant difference between the two groups in total sleep time (MD=13.45, 95% CI -37.01 to 63.92, P=0.60). ConclusionCurrent evidence shows, telephone-delivered CBT is effective for insomnia. Due to limited quantity and quality of the included studies, the above conclusion needs to be verified by more large-scale, high quality RCTs.