Model-based meta-analysis (MBMA) is a new type of quantitative analysis method, random effects in statistics will be found and put into the model as well as covariates. The final model has a strong predictive ability, can be conducted to make clinical decisions and evaluation. For its complexity, MBMA study is difficult to perform which restricted its application. By summarizing current published MBMA studies as well as the authors' experience, this article introduced the principle, method and status of MBMA.
ObjectiveTo analyze the pressure change and distribution of the intervertebral disc of upper thoracic spine in vertical pressure and 5° flexion, extension, or lateral bending. MethodsTwelve thoracolumbar spinal specimens were harvested from mini pigs and were divided into 2 groups (n=6). T1, 2, T3, 4, T5, 6, and T7, 8 segments were included in one group, and T2, 3, T4, 5, T6, 7, and T8, 9 segments were included in the other group. The data from both groups represented the complete upper thoracic vertebra data. Biomechanical machine and pressure sensitive film were used to measure the pressure on the vertebral columns under loadings of 100, 150, and 200 N in vertical pressures and 5° flexion, extension, or lateral bending. The pressure change of each intervertebral disc under different loads and in different movement conditions was analyzed. ResultsIn flexion, the anterior annulus pressure of the upper thoracic vertebra increased (P < 0.05), whereas the posterior annulus pressure showed no significant change (P > 0.05) or an increasing trend (P < 0.05). In extension, the anterior annulus pressure of the upper thoracic vertebra decreased (P < 0.05), whereas the posterior annulus pressure decreased (P < 0.05) or had no obvious change (P > 0.05). In lateral bending, the pressure on the concave side of the annulus increased significantly (P < 0.05). ConclusionThe upper thoracic vertebra has unique biomechanical characteristics under different loadings; moreover, the posterior vertebral structure plays an important role in the movement of the upper thoracic vertebral segment and pressure distribution. In lateral bending of the upper thoracic vertebra, the concave side pressure will increase significantly, which suggests that asymmetrical force is an important cause of scoliosis progression. Gravity plays an important role in the progression of scoliosis.
ObjectiveTo systematically review the safety and immunogenicity of quadrivalent HPV vaccine among healthy population. MethodsDatabases including PubMed, EMbase, CBM, The Cochrane Library (Issue 9, 2013), CNKI, Web of Science and WanFang Data were searched for randomized controlled trials (RCTs) about safety and immunogenicity of quadrivalent HPV vaccine from inception to October 2013. Meanwhile handwork retrieval was also conducted and references of included literature were retrieved. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed methodological quality of included studies. Meta-analysis was then conducted using RevMan 5.2 software. ResultsA total of 9 studies were finally included consisting of 8 RCTs and involving 39 688 patients. The result of meta-analysis showed that:a) for safety, the incidence of injection adverse reaction (swelling and red spots) in vaccine group was higher than that in placebo group (RR=1.22, 95%CI 1.13 to 1.32, P<0.000 01); while the incidences of systemic adverse reaction (RR=1.03, 95%CI 0.99 to 1.07, P=0.1) and serious adverse reaction (RR=1.06, 95%CI 0.75 to 1.50, P=0.74) were alike between the two groups; and b) for immunogenicity, the serum antibody seroconversion rates in the vaccine group (including subtypes of HPV6, HPV11 HPV16 and HPV18) were all higher than those in the placebo group, with significant differences. ConclusionCompared with placebo, quadrivalent HPV vaccine has relatively high incidences of adverse reaction and high-degree immunogenicity, which can be widely used in the prevention of relevant diseases of human papillomavirus infection among adolescents. The main adverse reaction is local dysfunction, which is well tolerated, so the vaccine can be safely used. Due to limited quantity and quality of the included studies, the above conclusion should be verified by further conducting more large-scale, multicentre, high quality RCTs.
ObjectiveTo evaluate the effectiveness of liquid wound dressing in the treatment of chronic ulcer wounds. MethodsBetween January 2014 and October 2015, 84 patients with chronic ulcer wounds were included and divided into 2 groups randomly. The chronic ulcer wounds were covered with liquid wound dressing in the treatment group (n=44) and were managed with iodophor in the control group (n=40). There was no significant difference in age, gender, causes, location, wound area, and disease duration between 2 groups (P > 0.05). The frequency of dress changing, effective rate of treatment, wound healing time, wound healing rate at 5, 10, and 20 days, positive rate of bacteria culture at 1, 5, and 10 days, and the rate of side effect were recorded and compared between 2 groups. Vancouver scar scale was used to evaluate scar formation. ResultsThe effective rate of the treatment group (100%) was significantly higher than that of the control group (85%) (P=0.009). The frequency of dress changing in the treatment group[(11.36±3.40) times] was significantly lower than that in the control group[(16.94±4.51) times] (t=-6.231, P=0.000). The wound healing rates at 5, 10, and 20 days were significantly increased (P < 0.05) and the wound healing time was significantly decreased (t=-6.627, P=0.000) in the treatment group when compared with the control group. The positive rates of bacteria culture at 5 and 10 days in the treatment group were significantly lower than those in the control group (χ2=12.313, P=0.000; P=0.005), but no significant difference was found at 1 day (χ2=0.066, P=0.797). Side effect was observed in 4 cases of the control group. Vancouver scar scale score was 8.59±1.32 in the treatment group and was 9.85±1.65 in the control group, showing significant difference (t=-3.752, P=0.000). ConclusionThe application of the liquid wound dressing in the treatment of chronic ulcer wound can improve the wound healing rate, shorten the healing time and decrease the frequency of dress change, which could promote the wound healing process.