Objective To study the relation between the pathogenesis of gallstone and blood lipid and protein.Methods Then indexes of blood lipid and protein in 204 cases of gallstone patients were measured and analysed by statistical software SPSS. Results There was a significant difference between the gallstone group and control in the value of proalbumin, total cholesterol, high density lipoprotein and carrier protein B (Ｐ＜0.01), the value of total protein, triglyceride, low density lipoprotein cholesterol, very low density lipoprotein cholesterol and carrier protein A1 were higher than those in the control (Ｐ＜0.05). Conclusion The indexes mentioned above may play an important role in the gallstone formation.
The summary of finding (SoF) table for network meta-analysis (NMA) was developed by the GRADE working group to facilitate and consolidate understanding NMA findings and GRADE certainty of evidence. This paper introduces the development process, the structure of NMA-SoF and limitations. A NMA publication was presented as an example to comprehensively illustrate the application of the NMA-SoF table.
【Abstract】Objective To explore the changes of expression of AFP mRNA in human hepatocellular carcinoma （HCC） tissues after oral Xeloda therapy.Methods Total RNA was extracted from HCC tissue samples collect after operation and nested reverse transcription polymerase chain reaction （RT-nested PCR） assay was performed to determine the expression of AFP mRNA in this study.Results The final product of AFP mRNA amplified by RT-PCR was 174 bp and by RT-nested PCR was 101 bp. The AFP mRNA is positive in 12 of 21 patients (positive rate 57.14%) amplified by RT-nested PCR assay in Xeloda treatment group which is much lower than control group: 18 of 20 patients (positive rate 90.00%),P＜0.05.The serum AFP value of Xeloda treatment group 〔(23.2±12.8) μg/L〕 is much lower than that of control group 〔(39.6±24.3) μg/L〕 four weeks after operation (P＜0.05). However, There was no difference between two groups in serum AFP value before operation.Conclusion Xeloda can effectively suppress the expression of AFP mRNA in human HCC tissues and lower it’s product serum AFP value.The clinical application of Xeloda in HCC patients deserve further study.
Randomized controlled trials are the gold standard for evaluating the effects of medical interventions, primarily providing estimates of the average effect of an intervention in the overall study population. However, there may be significant differences in the effect of the same intervention across sub-populations with different characteristics, that is, treatment heterogeneity. Traditional subgroup analysis and interaction analysis tend to have low power to examine treatment heterogeneity or identify the sources of heterogeneity. With the recent development of machine learning techniques, causal forest has been proposed as a novel method to evaluate treatment heterogeneity, which can help overcome the limitations of the traditional methods. However, the application of causal forest in the evaluation of treatment heterogeneity in medicine is still in the beginning stage. In order to promote proper use of causal forest, this paper introduces its purposes, principles and implementation, interprets the examples and R codes, and highlights some attentions needed for practice.
In observational studies, multivariable analysis is commonly used to control confounding and reduce bias in the estimation of causal effect between exposure and outcome. However, in clinical problems with complex causal relationships, researchers select covariates for adjustment through clinical intuition and data-driven methods, which may lead to biased results. In recent years, directed acyclic graphs (DAGs) have become a popular method for visualizing causal relationships between variables. An appropriately constructed DAG can help researchers identify confounders, intermediate variables and other non-confounding variables, thereby improving covariates selection for multivariable analysis. In practice, researchers should incorporate clinical knowledge, systematic methods and transparent reporting to fully utilize DAG in causal inference, and support more reliable clinical decisions.
近十年，在药品不良反应监测领域，基于医疗保健数据库的安全信号检测方法受到越来越多的关注，已成为弥补自发报告固有局限性的重要手段。目前数据挖掘方法主要基于比值失衡分析法（disproportionality analysis）、传统药物流行病学设计（如自身对照设计）、序列对称分析（sequence symmetry analysis，SSA）、序贯统计检验（sequential statistical testing）、时序关联规则（temporal association rules）、监督机器学习（supervised machine learning，SML）、树状扫描统计量方法（tree-based scan statistic）等。本文从应用场景和实用性角度对医疗保健数据库中安全信号检测方法及其性能进行介绍。
混合模型框架下的模型，如潜变量增长混合模型（latent growth mixture modeling，LGMM）或潜类别增长分析（latent class growth analysis，LCGA），因估算过程中涉及多个决策过程，导致潜变量轨迹分析结果的报告呈现多样性。为解决这一问题，指南制订小组按照系统化的制订流程，通过 4 轮德尔菲法调查，遵循专家小组意见，提出了各领域报告潜变量轨迹分析结果时需采用统一的标准，最终确定了报告轨迹研究结果必要的关键条目，发布了潜变量轨迹研究报告规范（guidelines for reporting on latent trajectory studies，GRoLTS），并利用 GRoLTS 评价了 38 篇使用 LGMM 或 LCGA 研究创伤后应激轨迹的论文的报告情况。
ObjectiveTo systematically review the risk factors leading to postoperative persistence of children diagnosed with obstructive sleep apnea (OSA) after adenoidectomy and tonsillectomy. MethodsPubMed, EMbase, The Cochrane Library, ClinicalTrials.gov, CNKI, VIP, WanFang Data and SinoMed databases were electronically searched to collect case-control studies and cohort studies related to risk factors for postoperative persistence of OSA in children from inception to July 2019. Two reviewers independently screened literature, extracted data, and evaluated the risk of bias of the included studies. Meta-analysis was then performed using RevMan 5.3 software. ResultsA total of 12 cohort studies involving 1 659 OSA patients were included. Meta-analysis results showed that the risk of postoperative persistence of OSA in children with preoperative obesity was 3.47 times higher than that in non-obese children (RR=3.47, 95%CI 2.04 to 5.92, P<0.000 01). Compared with normal-weight children, obese children had 4.11 times higher risk of postoperative residual OSA (RR=4.11, 95%CI 1.68 to 10.07, P<0.000 01).ConclusionsPreoperative obesity is a risk factor for postoperative persistence of OSA in children. Due to the limited quantity and quality of included studies, more high-quality studies are needed to verity the above conclusions.
ObjectivesTo evaluate the improvement of symptoms in patients with moderate to severe asthma aged 5-18 years treated with GINA (Global Initiative for Asthma) guidelines by network meta-analysis. Methods Randomized controlled trials (RCTs) about asthma patients aged 5 to 18 years with reported asthma symptom scores were collected from PubMed, Embase, Cochrane Library, CNKI, WanFang Data, VIP, SinoMed and clinical trial registry platform (ClinicalTrials.gov). The search time limit was from the inception to August 26, 2023. After two researchers independently screened literature, extracted data and evaluated the risk of bias of included studies, Stata 15.0 software was used for network meta-analysis. ResultsA total of 23 studies were included, 23 of which reported daytime asthma symptom scores. Compared with symptom scores in the low-dose ICS group, there was a statistically significant difference in improvement of daytime symptoms between low-dose ICS+LABA+LTRA (SMD=−1.4, 95%CI −1.99 to −0.81) and low-dose ICS+LABA+SABA (SMD=−1.43, 95%CI −2.48 to −0.39). Symptom scores for nighttime asthma were reported in 20 RCTs, and there was a statistically significant difference in symptom scores for low-dose ICS+LABA+LTRA (SMD=−1.20, 95%CI −2.20 to −0.21) compared with the low-dose ICS group. After the ranking of efficacy, the number one asthma symptom score in both daytime and nighttime was low-dose ICS+LABA+LTRA group. ConclusionLow dose ICS+LABA+LTRA has the best efficacy in improving daytime and nighttime asthma symptom scores.
ObjectiveThis study aims to conduct a bibliometric analysis of the dataset obtained from a systematic review of Model-Based Meta-Analysis (MBMA) studies to uncover research trends in MBMA. MethodsWe conducted a systematic search across databases including Embase, MEDLINE, Cochrane Library, Web of Science, CNKI, VIP, WanFang Data, and Sinomed. Relevant literature pertaining to MBMA was screened and included. Qualitative and quantitative analyses were performed to assess author contributions, temporal trends, national distribution, and disease prevalence. ResultsA total of 129 articles were included in the analysis, most published in being China (n=48), the United States (n=47), and the United Kingdom (n=7). The time span covered by these articles ranged from 2005 to 2023. A total of 531 researchers contributed to the included studies, with first authors from 15 different countries. The compilation encompassed 402 keywords, with the three most frequently used being “Meta-analysis” (n=28), “Model-based meta-analysis” (n=27), and “Pharmacokinetics” (n=14). The study covered 16 distinct disease categories, with the top three neoplasms (n=16), neurological disorders (n=14), and endocrine and metabolic diseases (n=13). ConclusionBibliometric analysis showed that the number of MBMA studies has increased significantly over the past three years, using a variety of key diseases as carriers. However, this new type of quantitative research has not yet attracted sufficient attention, and the research power is still concentrated in China and the United States; Moreover, a core group of authors has not yet been formed, it is necessary for scholars from various countries to strengthen multidisciplinary cooperation and communication to promote the production and translation of high-quality evidence.