Backgroud Chronic hepatitis is the major infectious disease of liver. There is no effective drug for it up to now. Clinical trials have showed that glycyrrhizin have potentional effective for chronic hepatitis. Objective To evaluate the effectiveness, safety and economics of glycyrrhizin for chronic hepatitis B and C. Search strategy The search terms include glycyrrhizin and its products’ name, chronic hepatitis and chronic carrier status. The thais registers of the Cochrane Hepato-Biliary Group, the Cochrane Complementary Medicine Field, and the central database of The Cochrane Library as well as MEDLINE, EMBASE and Chinese Biomedical CD Database were searched from their date of inception onward. And the free Internet search was operated to find ongoing and unpublished researches. Twenty Chinese medical journals and relevant academic conference proceedings have been searched by manual method. The reference lists of identified documents were checked as the complementary search. Inclusion criteria All randomized trials that tested glycryyhizin for chronic hepatitis B virus or hepatitis C virus infection were included in this review. Method of the review According to the principle of Cochrane systematic review, selection of thai for inclusion, assessment of methodological quality, data extraction and data syntheses were conducted by two reviewers.
Objective To investigate the effectiveness of radical debridement, reconstruction with bone allograft, and pedicle screw-rod internal fixation via combined anterior and posterior approach in the treatment of lumbosacral tuberculosis. Methods Between January 2005 and May 2010, 16 patients with lumbosacral tuberculosis were treated. Radical debridement wasperformed via extraperitoneal approach, then tricortical il iac bone allograft was placed and pedicle screw-rod internal fixation was used to reconstruct the spinal column. There were 12 males and 4 females aged 38-65 years (mean, 48 years). The disease duration ranged from 6 to 24 months (mean, 10 months). The main cl inical symptom was persistent pain in lumbosacral area. The involved segments included L4, 5 (3 cases), L5, S1 (8 cases), and L4-S1 (5 cases). The lumbosacral angle was 18-32° (mean, 22°). The erythrocyte sedimentation rate (ESR) was 15-55 mm/1 hour (mean, 25 mm/1 hour). All the patients were given antituberculosis chemotherapy for 12 months after operation. Results The operation time was 120-240 minutes (mean, 180 minutes). The amount of bleeding was 300-600 mL (mean, 420 mL). All wounds healed by first intention, and no relative compl ication occurred. All 16 cases were followed up 12-24 months (mean, 16 months). No recurrence occurred and ESR recovered to normal. Persistent pain in lumbosacral area and radicular pain in lower extremities disappeared. The X-ray films demonstrated that bony fusion was obtained in all patients at 8-12 months postoperatively. The lumbosacral angle was 16-31° (mean, 21°) at last follow-up. Conclusion The extraperitoneal approach can provide direct and safe access to the lesion. The structural il iac bone allograft and posterior instrumentation could reconstruct effectively the stabil ity of the lumbosacral junction.
Objective To collect the report guidelines for systematic reviews and meta-analyses, so as to provide support for the standardized publish and spread of those guidelines. Methods Such databases as Ovid MEDLINE (1996-2010) and EMbase (till April, 2010) were searched with the terms of “guideline”, “report”, “systematic review” and “meta-analysis” to collect the report guidelines for systematic reviews and meta-analyses. The irrelevant literatures (e.g. systematic review of a specific disease, clinical guideline for a certain disease, and other literatures focusing on the methodology of systematic review without mentioning reporting guideline) were excluded by reading the abstracts and titles, and then the further verification was done after the full-texts had been read. The contents about how to report a systematic review or meta-analyses were extracted from the included studies which were classified by its form of the original research (e.g. randomized controlled trial, observational study, diagnostic trial, etc.). Results Primary search ended up with 285 literatures, and 26 literatures of which were included. Among the included literatures about the report guidelines for systematic reviews and meta-analyses, eight were about RCTs, two about non-RCTs, two about observational study, no literature about diagnostic trial, one about animal experiment, two about report searching strategy, five about quality assessment, six about the influence on quality, and the other two about the update of guidelines. Conclusion The report guidelines for systematic reviews and meta-analyses are considerable in number, among which the QUOROM and its updated version PRISMA are relatively mature and widely applied. Report guidelines are beneficial to improve the quality of systematic reviews and meta-analyses, and the report guideline focusing on specific field is needs to be formulate.
The quality of reporting of randomized clinical trials could be significantly improved by the application of CONSORT （Consolidated Standards of Reporting Trials） statement. We compared and analyzed the difference of acceptance of CONSORT statement between Chinese medical journals and Western medical journals, and proposed to disseminate and apply CONSORT statement to improve the quality of reporting of randomized clinical trials and medical journals.
Objective To undertake a preliminary study of the concept and approach of patient value and preference and to learn how to understand and elicit patient preference in the light of evidence-based medicine so as to promote evidence-based practice and improve the relationship between clinicians and patients. Methods The searching key words were developed and pertinent data were retrospectively retrieved for the years of 1992-2002. MEDLINE and CBMdisc were searched along with handsearching 9 Chinese medical journals and 4 evidence-based medicine books. Data were scanned and analyzed. Results A total of 2 646 related articles were identified, most of which were found in MEDLINE (2 403), followed by CBMdisc (185) and the journals (58). Currently there is no original article to study in this field from a point of view of evidence-based medicine in China. Conclusion Patient value and preference have been emphasized in the approach of evidence-based medicine and it is a worthwhile topic for us to explore.
Objective To investigate the number of Chinese clinical trials and the completeness of registered information on the source of their funding. Methods We searched the five primary registers in the World Health Organization’s International Clinical Trial Registration Platform to identify Chinese clinical trials, calculated the number Chinese clinical trials with specific funding and evaluated the completeness of the information on the source of this funding. Results We identified 383 registered Chinese clinical trials, of which 219 (27 trials per year on average) were registered in clinicaltrials.gov, 94 in the Chinese Clinical Trial Register Center (113 per year on average), 62 in controlled-trials.com (12.4 per year on average) and 8 (1.6 per year on average) in the Australian and New Zealand Clinical Trials Registry. 360 trials had some information on their source of funding: 230 from the mainland of China (62 funded by colleges/universities, 47 by national/local organizations, 47 by the Ministry of Science and Technology, 34 by hospitals, 28 by commercial organizations, 9 by international foundations, and 3 by the Ministry of Health), 117 from Hongkong and 13 from Taiwan. The information in the registers on the source of funding was incomplete. Conclusion The number of funded Chinese clinical trials in these registers is too small. The registrations should be improved to improve the completeness of information on the source of funding. It is important to disseminate the importance of registering clinical trials and doing so in a local register to promote the transparency and accessibility of trial registration.
We summarized and analyzed the researches of the workshop on Evidence-Based Medicine for Medical Editors which was recently held concerning its teachers, training method, trainee distribution and recent progress. We hope to provide a new approach to improving the level of medical editors and clinical trials.
Objective To investigate the quality of the randomized controlled trials (RCTs) of traditional Chinese medicine (TCM) integrated with western medicine for severe acute respiratory syndrome (SARS). Method All the randomized controlled trials of traditional Chinese medicine integrated with western medicine for SARS worldwide were gained by electronic searching and hand searching. The quality of the RCTs was analyzed by the quality grade evaluation used in Cochrane handbook.The sample size, the baseline data, the results indexes were also analyzed. Results Seven RCTs included 501 SARS cases were identified. The quality grade of one RCT is B, the other six RCTs were graded C. None pre-specified sample size. One RCT tested the differences of the baseline data by statistic method. One RCT reported quality of life as result index. None reported the adverse events.Conclusions Current RCTs of TCM integrated with western medicine can’t provide b evidence for clinical practice because of the poor quality.
Objective To compare articles published in global primary journals titled “evidence-based” via bibliometric analysis in order to provide suggestion for evidence-based research and development of related journals. Methods We searched electronic databases to retrieve global primary journals titled “evidence-based”, and collected their impact factors, article click, download and citation frequency through the journal’s website and related citation databases. Results Three English and 4 Chinese primary journals titled “evidence-based” met the inclusion criteria. (1) Citation frequency: Evidence-Based Complementary amp; Alternative Medicine and Worldviews on Evidence-Based Nursing were indexed by SCI with impact factor over 1 (5th and 13th in relevant subject category), and their immediacy index was about 7 times as much as that of Chinese journals (0.2 vs 0.03). Chinese Journal of Evidence-Based Pediatrics (CJEBP) had the highest impact factor among 4 Chinese journals (0.946, 23rd in the relevant subject category), while Chinese Journal of Evidence-Based Medicine had the highest immediacy index with 0.07; (2) Download frequency: Journal of Evidencebased Medicine (JEBM) had the highest download frequency per article in database (72 vs 23), but the website download frequencies per article of CJEBM and CJEBP were about 5 to 6 times as much as that of database; (3) Number of articles published: Two English journals published the fewest articles but with the highest impact factors. Chinese Journal of Evidence-Based Medicine had the 2nd highest impact factor although published the most articles, as well as the highest download frequency and immediacy index among the 4 Chinese journals. It suggested that there was no direct relationship between the number of the published articles and the impact factor of a journal. Conclusion The impact of English journals is better than that of Chinese journals. CJEBM and CJEBP are the top 2 ones among the Chinese journals with open access websites. The selection of articles should be driven by readers’ demand, and the impact of journals could be improved by online publication with open access.
Objective To evaluate the quality of the registration information for trials sponsored by China registered in the WHO International Clinical Trial Registration Platform (ICTRP) primary registries or other registries that meet the requirements of the International Committee Medical Journal Editor (ICMJE). Methods We assessed the registration information for trials registered in the 9 WHO primary registries and one other registry that met the requirements of ICJME as of 15 October 2008. We analyzed the trial registration data set in each registry and assessed the registration quality against the WHO Trial Registration Data Set (TRDS). We also evaluated the quality of the information in the Source(s) of Monetary or Material Support section, using a specially prepared scale. Results The entries in four registries met the 20 items of the WHO TRDS. These were the Chinese Clinical Trial Registration Center (ChiCR), Australian New Zealand Clinical Trials Registry (NZCTR), Clinical Trials Registry – India (CTRI), and Sri Lanka Clinical Trials Registry (SLCTR). Registration quality varied among the different registries. For example, using the Scale of TRDS, the NZCTR scoreda median of 19 points, ChiCTR (median = 18 points), ISRCTN.org (median = 17 points), and Clinical trials.org (median = 12 points). The data on monetary or material support for ChiCTR and ISRCTN.org were relatively complete and the score on our Scale for the Completeness of Funding Registration Quality ranged from ChiCTR (median = 7 points), ISRCTN.org (median = 6 points), NZCTR (median = 3 points) to clinicaltrials.gov (median = 2 points). Conclusion Further improvements are needed in both the quantity and quality of trial registration. This could be achieved by full completion of the 20 items of the WHO TRDS. Future research should assess ways to ensure the quality and scope of research registration and the role of mandatory registration of funded research.