AMSTAR (Assessment of Multiple Systematic Reviews) is currently developed as a measurement tool with extensive application to assess the methodological quality of systematic review/meta-analysis. It has good reliability, validity, and responsibility, and has been widely applied. This paper introduces AMSTAR to researchers and users in China, in view of development procedure, assessment items, and application status.
Objective To investigate the expression of urokinase-type plasminogen activator (uPA) mRNA in gastric cancer tissues and cancer-adjacent tissues and the relationship between its expression and biologic behavior of tumor. Methods Fourty-eight cases with gastric cancer were detected for the expression of uPA mRNA by fluorogenic probe quantitative reverse transcription polymerase chain reaction (RTPCR). Results The positive expression rate of uPA mRNA was 83.3%, 25.0%, 93.8% and 62.5% in gastric cancer tissues,cancer-adjacent tissues, gastric cancer tissues with lymph node metastasis and with non-lymph node metastasis respectively. Expression of uPA mRNA was positively related with the invasion depth of gastric cancer. Conclusion Expression of uPA mRNA is significantly increased in gastric cancer and it can be used as an indicator to judge the metastasis and prognosis of tumor.
Objective To assess the efficacy of acupuncture versus western medicine in the treatment of depression in China. Methods Randomized controlled trials (RCTs) involving acupuncture versus western medicine in the treatment of depression in China were identified from CNKI (1979 to 2007), VIP (1989 to 2007), WANFANG Database (1998 to 2007) and CBM (1978 to 2007). We also hand searched relevant journals and conference proceedings. Data were extracted and evaluated by two reviewers independently with a specially designed extraction form. The Cochrane Collaboration’s RevMan4.2.8 software was used for data analyses. Results A total of 8 trials involving 619 patients were included. Meta-analyses showed that the total effective rate in the acupuncture group was similar when compared with fluoxetine (RR 1.03, 95%CI 0.94 to 1.14), doxepin (RR 1.14, 95%CI 0.91 to 1.43), amitriptyline (RR 0.95, 95%CI 0.70 to 1.29) and venlafaxine (RR 1.02, 95%CI 0.90 to 1.16). As for the HAMD score at week 2, no significant difference was noted between acupuncture and fluoxetine (WMD 0.03, 95%CI -1.26 to 1.31) or amitriptyline (WMD –?0.33, 95%CI –?1.88 to 1.23); for the HAMD score at week 4, no significant difference was observed between acupuncture and fluoxetine (WMD –?0.24, 95%CI –?1.85 to 1.37) or amitriptyline (WMD –?0.57, 95%CI –?2.02 to 0.88); for the HAMD score at week 6, acupuncture also had similar effects to fluoxetine (WMD –?0.19, 95%CI –?1.51 to 1.13). In terms of the SDS scores at week 2, 4, 6 and 8, no significant differences were noted between acupuncture and fluoxetine. Two trials reported adverse events and these observed no adverse events in the acupuncture group, but 31 and 25 patients experienced adverse events in the western medicine groups of these two trials. Conclusion Acupuncture is not inferior to western medicine, and it is worth noting that acupuncture is associated with few adverse reactions. Further large-scale trials are required to define the role of acupuncture in the treatment of depression.
【Abstract】ObjectiveTo investigate the relationship between the expression of urokinase-type plasminogen activator (uPA) mRNA and breast cancer, lymph node metastasis. MethodsSixty patients with breast tumor were selected randomly and the expression of uPA mRNA was detected with RT-PCR. The patients were divided into benign group (18 cases) and malignant group (42 cases) which included 22 cases with lymph node metastasis and 20 cases without lymph node metastasis. The relationship between uPA mRNA expression and breast cancer, lymph node metastasis was analyzed. ResultsAmong these 18 benign tumors, low expression of uPA mRNA was found in 2 cases and the others were negative. While in 42 cases of malignant tumor, uPA mRNA were positive in 22 cases of lymph node metastasis, 16 of which were high expression, 5 of which were moderate expression, and 1 was low expression. uPA mRNA were positive in 18 of 20 cases of nonmetastatic lymph node, 1 of which was high expression, 5 of which were moderate expression and 12 of which were low expression, the other 2 were negative expression. The expression of uPA mRNA had significant difference between benign and malignant tumors (P＜0.05). The expression in lymph node metastasis was much higher than no lymph node metastasis (P＜0.05). ConclusionThe expression of uPA mRNA in malignant breast cancer is obviously higher than that in benign breast tumor. The expression tensity of uPA is highly relevant to lymph node metastasis in malignant breast cancer, which can provide evidence for clinical staging and therapy.
ObjectiveTo systematically review the efficacy of moxibustion in the treatment of model rabbits with knee osteoarthritis (KOA).MethodsCNKI, WanFang Data, VIP, CBM, PubMed, EMbase and The Cochrane Library databases were electronically searched to collect animal experiments on moxibustion in the treatment of model rabbits with KOA from inception to January 31st, 2019. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Meta-analysis was then performed by using RevMan 5.3 software.ResultsA total of 13 articles involving 226 model rabbits were included. The results of meta-analysis showed that moxibustion could reduce Mankin score (MD=−6.47, 95%CI −7.63 to −5.32, P<0.000 01), positive expression rate of chondrocyte apoptosis (MD=−22.21, 95%CI −23.22 to −21.21, P<0.000 01), level of IL-1β in joint fluid (SMD=−8.40, 95%CI −15.09 to −1.72, P=0.01), NO content in joint fluid (SMD=−11.03, 95%CI −17.87 to −4.19, P=0.002), the level of serum IL-1β (MD=−19.94, 95%CI −23.61 to −16.27, P<0.05), and serum NO content (MD=−22.69, 95%CI −28.77 to −16.61, P<0.05) of model rabbits with KOA.ConclusionsCurrent evidence shows that moxibustion can improve articular cartilage injury, strengthen chondrocyte activity, inhibit the inflammatory response, and inhibit chondrocyte apoptosis of model rabbits with KOA. Due to the limited quality and quantity of the included studies, more high-quality studies are required to verify the above conclusions.
ObjectiveTo systematically review the efficacy of acupuncture for PCOS infertility.MethodsPubMed, EMbase, The Cochrane Library, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect randomized controlled trials (RCTs) of acupuncture for PCOS infertility from inception to January 5th, 2020. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Meta-analysis was then performed using RevMan 5.3 software.ResultsA total of 28 RCTs involving 2 192 patients were included. The results of meta-analysis showed that compared with western medicine alone, acupuncture could increase the pregnancy rate (RR=1.80, 95%CI 1.45 to 2.23, P<0.000 01) and ovulation rate (RR=1.33, 95%CI 1.15 to 1.54, P=0.000 1), and reduce levels of LH (SMD=−0.62, 95%CI −0.96 to −0.28, P=0.000 4) and LH/FSH (SMD=−0.65, 95%CI −1.02 to −0.29, P=0.000 5). Acupuncture combined with western medicine could increase the pregnancy rate (RR=1.75, 95% CI 1.50 to 2.03, P<0.000 01) and ovulation rate (RR=1.29, 95%CI 1.18 to 1.41, P<0.000 01), decrease levels of LH (SMD=−1.09, 95%CI −1.64 to −0.53, P=0.000 1), LH/FSH (SMD=−1.30, 95%CI −2.35 to −0.25, P=0.02), and levels of T (SMD=−1.13, 95%CI −1.59 to −0.66, P<0.000 01).ConclusionsCurrent evidence shows that acupuncture alone or combined with western medicine can significantly improve ovulation rate, pregnancy rate and reduce hormone level. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify above conclusions.
Objective To assess the efficacy and safety of Guizhifuling capsule versus western medicine in the treatment of uterine myoma. Methods Randomized controlled trials (RCTs) involving Guizhifuling capsule versus western medicine in the treatment of uterine myoma were identified from CBM (1978 to 2009), VIP (1989 to 2009), WANFANG Database (1998 to 2009), CNKI (1979 to 2009). We also manually searched relevant journals from Tianjin University of Traditional Chinese Medicine. Data were extracted and evaluated by two reviewers independently with a specially designed extraction form. The Cochrane Collaboration’s RevMan 5.0.22 software was used for data analyses. Results A total of 8 trials involving 798 patients were included. The results of meta-analyses showed that, a) the mean uterine myoma volume in the experimental group was different when compared with the mifepristone group (WMD= 0.64, 95%CI 0.56 to 0.71); b) no difference was found between the experimental group and the mifepristone group in serums hormone level, such as, follicle-stimulating hormone (WMD= 2.40, 95%CI –?3.09 to 7.89), luteinizing hormone (WMD= 1.22, 95%CI –?1.05 to 3.49), estriol (WMD= 11.07, 95%CI –?7.70 to 29.84), and P (WMD= 0.52, 95%CI –?0.33 to 1.37); c) As for clinical symptoms effective rate, significant difference was noted between the experimental group and the mifepristone group, such as, menorrhagia (RR= 0.49, 95%CI 0.25 to 0.94), dysmenorrheal (RR= 0.12, 95%CI 0.04 to 0.38), and bellyache and abdominal distension (RR= 0.28, 95%CI 0.12 to 0.62); d) In terms of the total effective rate, significant differences were noted between the experimental group and the mifepristone group (RR= 1.16, 95%CI 1.02 to 1.32); and e) Four trials reported the long-term follow-up results in which the experimental group was better than that in the control group.Conclusion The treatment of uterine myoma by Guizhifuling capsule plus mifepristone is superior to that by mifepristone alone in reducing uterine myoma volume, clinical symptom, and long-term follow-up results. Singly using Guizhifuling capsule is not inferior to western medicine. Further large-scale trials are required to define the role of Guizhifuling capsule in the treatment of uterine myoma.
Objective To investigate the effect of S-adenosylmethionine (SAM) on mitochondrial injury that was induced by ischemia-reperfusion in rat liver. Methods Fifty-four rats were randomly divided equally into 3 groups: control group, ischemia-reperfusion group (I/R group), and SAM-treated group (SAM group). Hepatic ischemia had been only lasted for 30 min by obstructing the blood stream of hepatic portal vena (the portal vena was only separated but not obstructed in control group). The rats of SAM group received SAM intraperitoneally 2 h prior to ischemia. Blood samples of each group were collected from the inferior cava vena at 0, 1 and 6 h after reperfusion and the serum levels of AST and ALT were detected. Mitochondrial super oxidedismutase (SOD), malondialdehyde (MDA), adenosine triphosphate (ATP) and energy charge (EC) in samples of liver tissue were detected, and the mitochondrial ultrastructure was observed with electronmicroscope. Results The serum levels of AST, ALT and mitochondrial MDA at 0, 1 and 6 h after reperfusion in the I/R group were significantly higher than those in the control group, whereas the levels of mitochondrial SOD, ATP and EC were significantly lower than those in the control group (P＜0.01). Except the value of 0 h, when it comes to SAM group, the levels of AST, ALT and mitochondrial MDA were significantly lower (P＜0.05) and the levels of mitochondrial SOD, ATP and EC were significantly higher (P＜0.05, P＜0.01) than those in the I/R group, respectively. The mitochondrial ultrastructure was injured obviously in I/R group when compared with that in control group. The number of mitochondria decreased and the mitochondria swelled, making the crista became obscure and the density of matrix became lower. The above changes in SAM group were less obvious when compared with those in I/R group. Conclusion SAM may protect mitochondrion against hepatic ischemia injury, since it may prevent mitochondrial lipid peroxidation, increase ATP, and eventually improve energy metabolism after ischemia-reperfusion.
ObjectiveTo systematically review the efficacy and safety of fire needle in the treatment of post-herpetic neuralgia. MethodsPubMed, EMbase, The Cochrane Library, CNKI, WanFang Data, VIP, and CBM databases were electronically searched to collect randomized controlled trials (RCTs) of fire needle for post-herpetic neuralgia from inception to June 5th, 2021. 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 31 RCTs involving 2 755 patients were included. The results of meta-analysis showed that compared with western medicine, fire needle could reduce VAS score (SMD=−1.00, 95%CI −1.36 to −0.63, P<0.000 01). Fire needle combined with western medicine could improve the total efficiency (RR=1.15, 95%CI 1.06 to 1.23, P=0.000 3), reduce VAS score (SMD=−1.92, 95%CI −2.87 to −0.97, P<0.000 1), and SAS rating (SMD=−0.89, 95%CI −1.20 to −0.59, P<0.000 01). Compared with conventional acupuncture, fire needle could reduce VAS score (SMD=−1.37, 95%CI −2.35 to −0.39, P=0.006), and immediate analgesic time (SMD=−0.64, 95%CI −0.88 to −0.39, P<0.000 01). Compared with the traditional Chinese medicine, fire needle could reduce VAS score (SMD=−1.00, 95%CI −1.53 to −0.47, P=0.000 2), SDS rating (SMD=−1.59, 95%CI −1.18 to −1.31, P<0.000 01), SAS rating (SMD=−1.79, 95%CI −2.08 to −1.49, P<0.000 01). In addition, the incidence of adverse reactions in experimental group was significantly lower than that in the control group. ConclusionCurrent evidence shows that fire needle can significantly reduce pain intensity, relieve anxiety, and improve the quality of life of post-herpetic neuralgia patients. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify the above conclusion.
According to the evidence pyramid model, systematic review (SR)/meta-analysis (MA) is one of the essential sources with a high level of clinical evidence. A high-quality SR/MA can effectively guide clinical decision-making and practice. The preferred reporting items for systematic reviews and meta-analyses extension for Chinese herbal medicines (PRISMA-CHM) were officially published in 2020. In this study, based on research cases, the features of PRISMA-CHM were interpreted in detail, so as to help domestic users accurately grasp the details of the reports, in order to improve the quality of the reports of SR/MA of traditional Chinese medicine.