ObjectiveTo systematically review the efficacy and safety of brucea javanica oil emulsion with/without cisplatin in the treatment of malignant pleural effusion (MPE). MethodsWe electronically search PubMed, The Cochrane Library (Issue 6, 2013), EMbase, CBM, WanFang Data, VIP and CNKI to collect randomized controlled trial about brucea javanica oil emulsion for MPE from the establishment dates to June 2013. According to the inclusion and exclusion criteria, two reviewers independently screened literature, extracted data, and assessed the methodological quality of included studies. Then meta-analysis was performed using RevMan 5.1 software. ResultsA total of twenty-five RCTs involving 1 620 patients were included. The results of meta-analysis showed that:compared with using cisplatin alone, brucea javanica oil emulsion plus cisplatin could improve clinical efficiency (RR=1.45, 95%CI 1.34 to 1.57, P < 0.000 01) and patients' quality of life (RR=1.36, 95%CI 1.18 to 1.56, P < 0.000 1), and relieved the incidences of bone marrow depression (OR=0.31, 95%CI 0.22 to 0.42, P < 0.000 01) and digestive tract reaction (OR=0.36, 95%CI 0.24 to 0.54, P < 0.000 01, ) and fever (OR=0.18, 95%CI 0.08 to 0.40, P < 0.000 1). ConclusionCurrent evidence indicates that brucea javanica oil emulsion could improve chemotherapy effects MPE. However, due to the limited quality of the included studies, more high quality studies with large sample size are needed to verify the conclusion.
ObjectiveTo systematically review the effectiveness and safety of the open preperitoneal approaches and the Lichtenstein technique in the repair of inguinal hernias. MethodsDatabases including PubMed, EMbase, Web of Science, The Cochrane Library (Issue 10, 2013), CBM, CNKI, WanFang Data and VIP were electronically searched for relevant studies from their inception to October 2013. References of the included studies were also retrieved. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of the included studies. Then, meta-analysis was performed using RevMan 5.2.5 software. ResultsA total of 9 RCT involving 1 246 patients were included. The results of meta-analysis showed that:compared with Lichtenstein repair, the preperitoneal technique was associated with a lower incidence of chronic pain (RR=0.39, 95%CI 0.26 to 0.58, P < 0.000 01), sensation of a foreign body (RR=0.49, 95%CI 0.31 to 0.79, P=0.003), recurrence (RR=0.37, 95%CI 0.15 to 0.89, P=0.03), and hematoma (RR=0.41, 95%CI 0.26 to 0.67, P=0.000 3). However, there was no significant difference in the incidence of wound infection (RR=0.89, 95%CI 0.29 to 2.76, P=0.85) and urine retention (RR=0.75, 95%CI 0.35 to 1.61, P=0.46). ConclusionThe open preperitoneal approach is a feasible alternative for inguinal hernia repair with less postoperative complication compared with Lichtenstein procedure. Due to the limited quantity and quality of the included studies, the aforementioned conclusion still needs to be verified by conducting more high quality studies.