Efficacy of pericapsular nerve group (PENG) block on perioperative pain management in elderly patients undergoing hip surgical procedures: a protocol for a systematic review with meta-analysis and trial sequential analysis
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Abstract:
An increasing number of elderly patients suffer from hip diseases associated with moderate to severe perioperative pain during the accelerating global ageing process. Optimal analgesia can decrease perioperative complications and facilitate elderly patients' perioperative recovery. Pericapsular nerve group (PENG) block is a relatively new, analgesia adequate and motor-sparing block technique for perioperative pain management of hip diseases. However, the efficacy of PENG block remains unclear as the limited clinical evidence. Then, we will perform a protocol for a systematic review and meta-analysis to identify the efficacy of PENG block for perioperative pain management.Keywords:
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Objective
To systematically review the relationship between arsenic exposure through drinking water and human cancer risk.
Methods
China National Knowledge Infrastructure (CNKI), VIP Database, WanFang Data, China Biology Medicine Disc (CBM), PubMed, Embase and Cochrane Library were searched through computer to find out the relationship between arsenic exposure and tumorigenesis. The search period was from January 1, 1997 to January 1, 2017. Meta-analysis was performed using RevMan 5.3. The heterogeneity of the literatures that met the inclusion criteria was examined, and analysis was performed by using fixed effect model or random effect model. OR and 95%CI were calculated, the publication bias was evaluated by inverted funnel plot, and sensitivity analysis was performed.
Results
Totally 14 literatures entered into this study, 13 927 people in arsenic exposure group, 5 720 people in control group. The meta-analysis showed that, 14 literatures were homogeneous through the heterogeneity test, and was analyzed in the fixed effect model with OR (95%CI)= 1.20 (1.09, 1.33), which suggested that the risk of cancer in the arsenic exposure group was 1.20 times higher than that in control group. Inverted funnel plot was basically symmetrical, literatures publication bias was small; the result was more reliable by sensitivity analysis.
Conclusion
Arsenic exposure through drinking water may be a risk factor of tumor.
Key words:
Arsenic; Drinking water; Tumor; Meta-analysis
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Background: Growing evidences have advocated the potential benefits of traditional Chinese exercise (TCE) on symptomatic improvement of knee osteoarthritis (KOA). However, most of them have been derived from cross-sectional studies or case reports; the effectiveness of TCE therapies has not been fully assessed with a randomized control trial (RCT). In order to evaluate the combined clinical effectiveness of TCE for KOA, we conducted a systematic review and meta-analysis on the existing RCTs on KOA. Methods: A systematic search was performed in four electronic databases: PubMed, Web of Science, Cochrane Library, and EMBASE from the time of their inception to February 2020. All eligible RCTs were included in which TCE was utilized for treating KOA as compared to a control group. Two reviewers independently extracted the data and evaluated the risk of bias following the Cochrane Risk of Bias Tool for RCT. The symptoms of KOA evaluated by the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and the Knee Injury and Osteoarthritis Outcome Score (KOOS) were regarded as the primary outcomes in this study. Each outcome measure was pooled by a standardized mean difference (SMD) with 95% confidence intervals (CI). A meta-analysis was applied with a random or fixed effect model for the collected data to calculate the summary SMD with 95% CI based on different statistical heterogeneity. In addition, subgroup analyses were used to investigate heterogeneity and sensitivity analysis was carried out for the results of the meta-analysis. Egger’s test and the funnel plots were used to examine the potential bias in the RCTs. Results: A total of 14 RCTs involving 815 patients with KOA were included. Compared with a control group; the synthesized data of TCE showed a significant improvement in WOMAC/KOOS pain score (SMD = −0.61; 95% CI: −0.86 to −0.37; p < 0.001), stiffness score (SMD = −0.75; 95% CI: −1.09 to −0.41; p < 0.001), and physical function score (SMD = −0.67; 95% CI: −0.82 to −0.53; p < 0.001). Conclusions: Our meta-analysis suggested that TCE may be effective in alleviating pain; relieving stiffness and improving the physical function for patients with KOA. Yet; given the methodological limitations of included RCTs in this meta-analysis; more high-quality RCTs with large sample size and long-term intervention are required to further confirm the effectiveness and underlying mechanisms of TCE for treating KOA.
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Background: Neoadjuvant chemotherapy has been used for treatment of cervical cancer for a long time; however, the role of early non-response on prognosis is still confusing. This study was designed to assess its impact on disease-free survival (DFS). Methods: Databases "PubMed", "Embase" and the "Cochrane Library" were searched out through May 2020, and both random effects model and fixed effect model were employed to calculate the main pooled results. I2 and Cochrane Q test were used to test the heterogeneity among the studies. Funnel plot with Begg's and Egger's tests was used to assess the publication bias that may exist in the study. Sensitivity analysis was performed to detect the origin of the heterogeneity. Results: A total of 1,349 articles were found at first; then, after several rounds of exclusion, we identified 8 articles with 9 studies which were accordant with the standards of the inclusion. A combined analysis was performed among the 1,462 responders and 490 non-responders. For 1-year DFS, sub-analysis showed hazard ratio (HR) was 0.25 (95% CI: 0.14–0.43) using RECIST criteria; and HR was 0.52 (95% CI: 0.36–0.75) using WHO criteria; Egger's test showed that P=0.35 for RECIST criteria and P=0.57 for WHO criteria; Begg's test showed P=0.34 for RECIST criteria and P=0.60 for WHO criteria. For 3-year DFS, HR was 0.26 (95% CI: 0.16–0.43) using RECIST criteria and was 0.47 (95% CI: 0.30–0.73) using WHO criteria. For 5-year DFS, HR was 0.26 (95% CI: 0.16–0.42) using RECIST criteria and was 0.49 (95% CI: 0.33–0.71) using WHO criteria. Discussion: Early non-response to neoadjuvant chemotherapy was significantly associated with higher recurrence of cervical cancer. Prospective randomized studies are warranted to validate this finding.
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Respiratory viral infections (RVIs) are a major health concern, and some previous studies have shown that wearing masks was effective in preventing RVIs, while others failed to show such effect. Therefore, a systematic review and meta-analysis was conducted to investigate the effectiveness of wearing masks.PubMed, ScienceDirect, Web of Science, the Cochrane Library, EMBASE, MEDLINE, China National Knowledge Infrastructure (CNKI), and Chinese Scientific Journal Database (VIP database) were searched for studies evaluating the effectiveness of wearing masks. The risk ratio (RR) was used to measure the effectiveness of wearing masks in preventing RVIs for randomized controlled trials (RCTs) and cohort studies, and the odds ratio (OR) was used for case-control studies. Forest plots were used to visually assess pooled estimates and corresponding 95% CIs. The I2 test was used to examine the heterogeneity, and subgroup analysis was used to explore the possible explanations for heterogeneity or compare the results between subgroups. Sensitivity analysis was conducted to assess robustness of the synthesized results. Begg's test and Egger's test were used to assess the publications bias.Thirty-one studies (13,329 participants) were eligible for meta-analyses. Overall, the results showed that wearing masks was effective in preventing RVIs. The sensitivity analysis showed that the results of those meta-analyses were robust and reliable. There was no significant publication bias in meta-analysis of case-control studies and most subgroup analyses.Wearing masks might be effective in preventing RVIs. To reduce their RVI risk, people should wear masks when they go out in public.https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42021296092.
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Abstract Background Published studies have shown contradictory results regarding the relationship between somatometric parameters and varicoceles. We performed a systematic review and meta-analysis to investigate the possible effects of age, height, weight, and body mass index (BMI) on the presence and severity of varicoceles. Methods Databases including EMBASE, MEDLINE, PubMed, Cochrane Library, China National Knowledge Infrastructure (CNKI), Web of Science, and Google Scholar were systematically searched to identify relevant articles published up to March 2020. Two researchers independently identified eligible articles and extracted data. Cochran’s Q statistic and I 2 statistics were used to assess heterogeneity. Meta-analysis was performed using StataSE 12.0 software (StataCorp LP, USA). Random-effects models were used to obtain the weighted mean differences (WMDs) and 95% confidence intervals (CIs). Publication bias was assessed using Begg’s funnel plot and Egger’s regression test. Results The search strategy produced 272 articles, of which 18 articles were eligible according to the inclusion/exclusion criteria. A total of 56,325 patients with varicocele and 1,334,694 patients without varicocele were included in the meta-analysis to evaluate the effect of somatometric parameters on the presence and severity of varicocele. The overall results demonstrated that the presence of varicoceles was significantly associated with height (WMD = 1.41, 95% CI = 1.07 to 1.74, P < 0.001) and inversely correlated with BMI (WMD = − 1.35, 95% CI = -1.67 to − 1.03, P < 0.001) but not with age (WMD = -0.93, 95% CI = -2.19 to 0.33, P = 0.149) or weight (WMD = 0.24, 95% CI = -2.24 to 2.72, P = 0.850). The severity of varicocele was inversely correlated with increased BMI but not with age. Conclusion The presence of varicoceles was significantly associated with height and inversely correlated with BMI.
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Background: Cinnamon is a spice used in cooking and in large quantities as a medical complement with hypoglycemic and lipid-lowering properties. The potential pharmacological mechanisms underlying cinnamon's anti-diabetic properties and its active ingredients have not been adequately determined. The current meta-analysis aims to systematically review the potential pharmacological mechanisms underlying the hypoglycemic and hypolipidemic efficacy of cinnamon administration and summarize clinical recommendations of cinnamon and its active ingredients. Method: Relevant randomized clinical trials (RCTs) were identified through a literature search that spanned the years January 2005 to April 2022. Retrieve electronic databases including Web of Science, PubMed, Embase, Medline, and the Cochrane Library. To obtain standardized mean differences (SMDs), continuous outcomes were pooled and 95 percent confidence intervals (CIs) were provided. Categorical outcomes were aggregated to calculate relative risks (RRs) and were accompanied by 95% CIs. Heterogeneity was measured using the Cochrane Q-test and I2 statistics, with a p < 0.05 considered as substantial heterogeneity. If I2 was less than 50%, a fixed effect model was employed; otherwise, a random effect model was used. Subgroup analyses and sensitivity analyses were performed to identify the origins of heterogeneity. Publication bias was retrieved by means of a funnel-plot analysis and Egger's test. The data were analyzed using revman (V.5.3) and stata (V.15) software packages. Results: These 16 RCTs included a total of 1,020 patients who were followed for a duration ranging from 40 days to 4 months. According to the current meta-analysis results, glycolipid levels in diabetic individuals who received cinnamon were significantly improved as compared to those who got placebo (All p < 0.05). An adverse effect was only detected in one patient. Conclusion: These findings imply that cinnamon has a significant influence on lipid and glucose metabolism regulation. An even more pronounced effect was observed in patients with HbA1c of 8%. The results of this study suggested that cinnamon may be utilized as hypoglycemic and lipid-lowering supplement in clinical settings with a guaranteed safety profile.Systematic Review Registration: [PROSPERO], identifier [CRD42022322735].
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// Juanjuan Zhang 1, * , Yanyan Yu 1, * , Ying Li 1 and Lunshou Wei 2 1 Department of Ultrasound, Huaihe Hospital of Henan University, Kaifeng, China 2 Department of Gastroenterology, Huaihe Hospital of Henan University, Kaifeng, China * Co-first authors Correspondence to: Lunshou Wei, email: weilunshou@163.com Keywords: hepatocellular carcinoma, contrast-enhanced ultrasound, diagnostic value, meta-analysis Received: June 28, 2017 Accepted: July 26, 2017 Published: August 07, 2017 ABSTRACT Background: This meta-analysis is aimed at determining the diagnostic value of hepatocellular carcinoma (HCC) with contrast-enhanced ultrasound (CEUS). Materials and Methods: A comprehensive literature search of Pubmed, Web of Science, and the Cochrane Library was performed to identify published studies. The methodological quality of the included studies was evaluated. Data from eligible studies were used to estimate the pooled sensitivity, specificity, diagnostic odds ratio (DOR), positive and negative likelihood ratio (LR) and summary receiver operating characteristic (SROC) curve. Meta-Disc and STATA softwares were utilized for all statistical analyses. Results: Fifty-three eligible studies (publication years ranged from 1998 to 2016) were selected according to inclusion criteria. The meta-analysis showed that the pooled sensitivity and specificity of CEUS to detect HCC were 0.85 (95% CI: 0.84–0.86) and 0.91 (95% CI: 0.90–0.92), respectively. The pooled positive and negative LRs were 6.28 (95% CI: 4.49–8.77) and 0.16 (95% CI: 0.12–0.22), respectively. The pooled DOR was 55.01 (95% CI: 35.25–83.47). The area under the SCOR curve was 0.9432. Meta-regression and funnel plot indicated that sample size, type of contrast agents and publication bias might be the major sources of heterogeneity. Conclusions: CEUS is a valuable diagnostic tool for identifying HCC in clinic with highly sensitive and specific.
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Background MicroRNA-21 (miR-21) is significantly expressed in a variety of cancers and could be used as a tumor biomarker. However, the results are varied, and no studies on the diagnostic usefulness of miR-21 in Asian esophageal cancer (EC) patients have been published. This meta-analysis was aimed at exploring whether miR-21 can be used as a diagnostic marker and assessing its effectiveness. Methods The relevant literature was identified in six main databases: Ovid MEDLINE, PsycINFO, PubMed MEDLINE, Embase, Web of Science, and the Cochrane Library. Two researchers independently selected the literature based on the inclusion and exclusion criteria, extracted data, and evaluated the risk of bias. The meta-analysis was carried out using Review Manager 5.4, Meta-Disc 1.4 and STATA 15.1 software. In the end, 987 patients from 12 different studies were included. Quality evaluation of diagnostic accuracy studies 2 (QUADAS—2) was used to examine the risk of bias. Results The pooled sensitivity (SEN) was 0.72 (95% CI [0.69–0.75]), the pooled specificity (SPE) was 0.78 (95% CI [0.75–0.81]), the pooled positive likelihood ratio (PLR) was 2.87 (95% CI [2.28–3.59]), the pooled negative likelihood ratio (NLR) was 0.36 (95% CI [0.31–0.43]), the pooled diagnostic odds ratio (DOR) was 10.00 (95% CI [7.73–12.95]), and the area under the curve 0.82 (95% CI [0.79–0.85]). A Deeks’ funnel plot shows that there was no publication bias ( P = 0.99). Conclusion Our findings suggest miR-21 might be the potential biomarker for detecting EC in Asian populations, with a good diagnostic value.
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Objective To explore the hypothesis that diabetes mellitus (DM) may cause hepatocellular carcinoma (HCC),by evaluating the association between DM and HCC by means of meta-analysis.Methods Cochrane Library,Medline,PubMed,EMBASE,OVID and CBMdisc databases were searched,and a manual search of citations from relevant original studies and literature also was performed. The data were pooled using RevMan 4.3 software for meta-analysis,and the potential bias was assessed by sensitivity analysis,funnel plot and fail-safe number.Results A total of 15 cohort studies were included,and 6 studies (the outcome of HCC was occurrence) were analyzed. DM was associated significantly with the occurrence of HCC (pooled RR=2.37,95%CI:1.76~3.21). Sensitivity analysis showed the results of meta-analysis were insusceptible,publication bias was found in the studies,but it's effect was too limited to be ignored.Conclusion A significant causal association between DM and HCC was observed,it suggests that DM may be a risk factor of HCC.
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