目的:通过Meta分析方法定量评估甘油三酯-葡萄糖(TyG)指数与脑卒中发病风险之间的关系。方法:计算机检索中国知网、万方数据库、维普网、中国生物医学文献数据库、PubMed、Embase和Web of Science等数据库中公开发表的TyG指数与脑卒中...目的:通过Meta分析方法定量评估甘油三酯-葡萄糖(TyG)指数与脑卒中发病风险之间的关系。方法:计算机检索中国知网、万方数据库、维普网、中国生物医学文献数据库、PubMed、Embase和Web of Science等数据库中公开发表的TyG指数与脑卒中发病风险关系的前瞻性队列研究,检索时间为自建库至2024年11月7日。由两位研究员使用纽卡斯尔-渥太华量表(NOS)进行文献质量评价后提取纳入文献的相关数据。应用Stata 17.0软件进行统计分析。结果:共纳入17项前瞻性队列研究,449210例研究对象,其中包括28506例脑卒中患者。Meta分析结果显示,TyG指数与脑卒中发病风险呈正相关(HR=1.60,95%CI:1.45~1.76,P<0.05)。剂量-反应Meta分析结果显示,TyG指数与脑卒中发病风险呈线性正相关,TyG指数每升高1个单位,脑卒中发病风险增加20.2%。本研究所纳入文献不存在发表偏倚(Egger's检验P值为0.962,Begg's检验P值为0.967)。结论:TyG指数与脑卒中发病风险呈线性剂量-反应关系,较高的TyG指数增加脑卒中发病风险。展开更多
目的:探索希氏束-浦肯野传导系统起搏[HPCSP,包括希氏束起搏(HBP)和左束支区域起搏(LBBAP)]联合房室结消融治疗心房颤动(房颤)合并心力衰竭(心衰)的有效性及安全性。方法:在PubMed、Cochrane图书馆、Web of Science、Embase、中国知网...目的:探索希氏束-浦肯野传导系统起搏[HPCSP,包括希氏束起搏(HBP)和左束支区域起搏(LBBAP)]联合房室结消融治疗心房颤动(房颤)合并心力衰竭(心衰)的有效性及安全性。方法:在PubMed、Cochrane图书馆、Web of Science、Embase、中国知网、万方数据库、维普网、中华医学期刊全文数据库检索关于HPCSP联合房室结消融治疗房颤合并心衰患者的研究,检索时间为各数据库建库到2024年7月31日。采用纽卡斯尔-渥太华(NOS)量表对纳入的队列研究进行质量评价,使用Cochrane偏倚风险评价方法评估随机对照研究的质量,并用RevMan 5.4、Stata 15.1软件进行Meta分析。结果:共纳入13项研究,共1071例患者。HPCSP联合房室结消融成功率为93.1%。Meta分析结果显示,在有效性方面,与基线相比,随访时患者的左心室舒张末期内径(LVEDD)[均数差(MD)=-3.11,95%CI:-4.16~-2.06,P<0.00001)]及纽约心脏协会(NYHA)心功能分级(MD=-1.36,95%CI:-1.48~-1.24,P<0.00001)明显改善,左心室射血分数(LVEF)(MD=9.86,95%CI:7.02~12.69,P<0.00001)明显提高,房室结消融后,起搏QRS波时限(QRSd)较基线延长(MD=7.83,95%CI:2.79~12.87,P=0.002);在安全性方面,HPCSP术中及随访时的起搏阈值保持稳定(MD=0.07,95%CI:-0.01~0.15,P=0.11),阻抗较围术期明显下降(MD=-78.84,95%CI:-120.21~-37.47,P=0.0002),并发症发生率为7.9%,心衰再住院率为4.5%,死亡率为5.8%。与双心室起搏相比,HPCSP明显缩短起搏QRSd(MD=-39.08,95%CI:-62.35~-15.80,P=0.001),改善随访LVEF(MD=4.38,95%CI:0.37~8.40,P=0.030),二者LVEDD变化(MD=-9.11,95%CI:-19.93~1.72,P=0.100)差异无统计学意义。随访期间,LBBAP起搏阈值低于HBP(MD=0.61,95%CI:0.23~1.00,P=0.002);LBBAP与HBP终点事件发生率差异无统计学意义(RR=1.47,95%CI:0.83~2.60,P=0.190)。结论:HPCSP联合房室结消融治疗房颤合并心衰有效、安全。HPCSP较双心室起搏可更好的促进心电同步并进一步改善患者心功能,LBBAP起搏参数优于HBP。展开更多
目的系统整合体外受精-胚胎移植(in vitro fertilization and embryo transfer,IVF-ET)治疗夫妻的心理体验与调适,为夫妻二元健康管理提供证据。方法计算机检索Cochrane Library、PubMed、Web of Science、CINAHL、Embase、Scopus、Oiv...目的系统整合体外受精-胚胎移植(in vitro fertilization and embryo transfer,IVF-ET)治疗夫妻的心理体验与调适,为夫妻二元健康管理提供证据。方法计算机检索Cochrane Library、PubMed、Web of Science、CINAHL、Embase、Scopus、Oivd、中国知网、万方和维普数据库中关于IVF-ET治疗夫妻心理体验与调适的质性研究,检索时限为建库至2023年12月31日,按照澳大利亚乔安娜布里格斯研究所(Joanna Briggs Institute,JBI)循证卫生保健中心质性研究质量评价标准进行文献方法学质量评价,采用汇集性整合的方法对结果进行Meta整合。结果纳入15篇文献,提炼出31个结果,归纳为9个类别,形成4个整合结果:获得的积极感受和社会支持、面临的身心压力和社会挑战、夫妻采取多种方式应对治疗压力、夫妻关系经过调适发生变化。结论加强以夫妻二元为中心的IVF-ET治疗全周期健康管理,重视夫妻治疗不同阶段的心理体验,提升夫妻积极应对与调适,完善社会文化和医疗支持体系,进而改善治疗结局和夫妻婚姻质量。展开更多
Objective:To perform a meta-analysis to evaluate the diagnostic performance of computed tomography(CT) and transthoracic echocardiography(TTE) in complex congenital heart diseases(CHD) in China.Methods:MEDLINE,Cochran...Objective:To perform a meta-analysis to evaluate the diagnostic performance of computed tomography(CT) and transthoracic echocardiography(TTE) in complex congenital heart diseases(CHD) in China.Methods:MEDLINE,Cochrane library and China National Knowledge Infrastructure(CNKI) database from January 1966 to October 2010,were searched for initial studies in China.All the studies,published in English or Chinese,used TTE,CT,or both as diagnostic tests for CHD and reported the rate of true-positive,true-negative,false-positive and false-negative diagnoses of CHD from TTE and CT findings with the surgical results as the 'gold-standard'(15 studies,XX patients) were collected.The statistic software package,'Meta-Disc 1.4',was used to conduct data analysis.A covariate analysis was used to evaluate the influence of patient or study-related factors on sensitivity.Results:Pooled sensitivity for diagnosis of CHD were 95% [95% confidence interval(CI):94%~96%] for CT studies and 87%(95% CI:85%~88%) for TTE studies.The difference between the pooled sensitivity of CT and that of TTE was statistically significant(P<0.001).TTE had higher sensitivity [0.96(95% CI:0.94~0.97)] for cardiac malformation but lower sensitivity [0.78(95% CI:0.76~0.81)] for extracardiac malformation than CT.Conclusion:CT can provide added diagnostic information compared with TTE in patients with CHD in China,especially for patients suspected of extracardiac malformation.展开更多
OBJECTIVE The purpose of this study is to clarify the association between Cu levels and heart failure(HF)using a meta-analysis approach.METHODS We searched articles in the Pub Med,EMbase,CNKI,Wanfang,VIP and CBM Datab...OBJECTIVE The purpose of this study is to clarify the association between Cu levels and heart failure(HF)using a meta-analysis approach.METHODS We searched articles in the Pub Med,EMbase,CNKI,Wanfang,VIP and CBM Database published as of August 2016.The case control study on the relationship between serum copper levels and HF were collected and read and extracted by two independent researchers.A Meta analysis was conducted using Stata 12.0 software.RESULTS A total of twenty-one eligible articles,including 893 HF and 654 control subjects,were enrolled.The Meta analysis showed that serum copper levels in HF were higher than control group[SMD=0.881,95%CI:(0.487,1.264),Z=4.5,P<0.001].The sensitivity analysis indicated that the results were reliable.Begg′s tests did not find the existence of publication bias.CONCLUSION This metaanalysis indicates that there is a significant association between high Cu serum level and HF.展开更多
文摘目的:通过Meta分析方法定量评估甘油三酯-葡萄糖(TyG)指数与脑卒中发病风险之间的关系。方法:计算机检索中国知网、万方数据库、维普网、中国生物医学文献数据库、PubMed、Embase和Web of Science等数据库中公开发表的TyG指数与脑卒中发病风险关系的前瞻性队列研究,检索时间为自建库至2024年11月7日。由两位研究员使用纽卡斯尔-渥太华量表(NOS)进行文献质量评价后提取纳入文献的相关数据。应用Stata 17.0软件进行统计分析。结果:共纳入17项前瞻性队列研究,449210例研究对象,其中包括28506例脑卒中患者。Meta分析结果显示,TyG指数与脑卒中发病风险呈正相关(HR=1.60,95%CI:1.45~1.76,P<0.05)。剂量-反应Meta分析结果显示,TyG指数与脑卒中发病风险呈线性正相关,TyG指数每升高1个单位,脑卒中发病风险增加20.2%。本研究所纳入文献不存在发表偏倚(Egger's检验P值为0.962,Begg's检验P值为0.967)。结论:TyG指数与脑卒中发病风险呈线性剂量-反应关系,较高的TyG指数增加脑卒中发病风险。
文摘目的:探索希氏束-浦肯野传导系统起搏[HPCSP,包括希氏束起搏(HBP)和左束支区域起搏(LBBAP)]联合房室结消融治疗心房颤动(房颤)合并心力衰竭(心衰)的有效性及安全性。方法:在PubMed、Cochrane图书馆、Web of Science、Embase、中国知网、万方数据库、维普网、中华医学期刊全文数据库检索关于HPCSP联合房室结消融治疗房颤合并心衰患者的研究,检索时间为各数据库建库到2024年7月31日。采用纽卡斯尔-渥太华(NOS)量表对纳入的队列研究进行质量评价,使用Cochrane偏倚风险评价方法评估随机对照研究的质量,并用RevMan 5.4、Stata 15.1软件进行Meta分析。结果:共纳入13项研究,共1071例患者。HPCSP联合房室结消融成功率为93.1%。Meta分析结果显示,在有效性方面,与基线相比,随访时患者的左心室舒张末期内径(LVEDD)[均数差(MD)=-3.11,95%CI:-4.16~-2.06,P<0.00001)]及纽约心脏协会(NYHA)心功能分级(MD=-1.36,95%CI:-1.48~-1.24,P<0.00001)明显改善,左心室射血分数(LVEF)(MD=9.86,95%CI:7.02~12.69,P<0.00001)明显提高,房室结消融后,起搏QRS波时限(QRSd)较基线延长(MD=7.83,95%CI:2.79~12.87,P=0.002);在安全性方面,HPCSP术中及随访时的起搏阈值保持稳定(MD=0.07,95%CI:-0.01~0.15,P=0.11),阻抗较围术期明显下降(MD=-78.84,95%CI:-120.21~-37.47,P=0.0002),并发症发生率为7.9%,心衰再住院率为4.5%,死亡率为5.8%。与双心室起搏相比,HPCSP明显缩短起搏QRSd(MD=-39.08,95%CI:-62.35~-15.80,P=0.001),改善随访LVEF(MD=4.38,95%CI:0.37~8.40,P=0.030),二者LVEDD变化(MD=-9.11,95%CI:-19.93~1.72,P=0.100)差异无统计学意义。随访期间,LBBAP起搏阈值低于HBP(MD=0.61,95%CI:0.23~1.00,P=0.002);LBBAP与HBP终点事件发生率差异无统计学意义(RR=1.47,95%CI:0.83~2.60,P=0.190)。结论:HPCSP联合房室结消融治疗房颤合并心衰有效、安全。HPCSP较双心室起搏可更好的促进心电同步并进一步改善患者心功能,LBBAP起搏参数优于HBP。
文摘Objective:To perform a meta-analysis to evaluate the diagnostic performance of computed tomography(CT) and transthoracic echocardiography(TTE) in complex congenital heart diseases(CHD) in China.Methods:MEDLINE,Cochrane library and China National Knowledge Infrastructure(CNKI) database from January 1966 to October 2010,were searched for initial studies in China.All the studies,published in English or Chinese,used TTE,CT,or both as diagnostic tests for CHD and reported the rate of true-positive,true-negative,false-positive and false-negative diagnoses of CHD from TTE and CT findings with the surgical results as the 'gold-standard'(15 studies,XX patients) were collected.The statistic software package,'Meta-Disc 1.4',was used to conduct data analysis.A covariate analysis was used to evaluate the influence of patient or study-related factors on sensitivity.Results:Pooled sensitivity for diagnosis of CHD were 95% [95% confidence interval(CI):94%~96%] for CT studies and 87%(95% CI:85%~88%) for TTE studies.The difference between the pooled sensitivity of CT and that of TTE was statistically significant(P<0.001).TTE had higher sensitivity [0.96(95% CI:0.94~0.97)] for cardiac malformation but lower sensitivity [0.78(95% CI:0.76~0.81)] for extracardiac malformation than CT.Conclusion:CT can provide added diagnostic information compared with TTE in patients with CHD in China,especially for patients suspected of extracardiac malformation.
文摘OBJECTIVE The purpose of this study is to clarify the association between Cu levels and heart failure(HF)using a meta-analysis approach.METHODS We searched articles in the Pub Med,EMbase,CNKI,Wanfang,VIP and CBM Database published as of August 2016.The case control study on the relationship between serum copper levels and HF were collected and read and extracted by two independent researchers.A Meta analysis was conducted using Stata 12.0 software.RESULTS A total of twenty-one eligible articles,including 893 HF and 654 control subjects,were enrolled.The Meta analysis showed that serum copper levels in HF were higher than control group[SMD=0.881,95%CI:(0.487,1.264),Z=4.5,P<0.001].The sensitivity analysis indicated that the results were reliable.Begg′s tests did not find the existence of publication bias.CONCLUSION This metaanalysis indicates that there is a significant association between high Cu serum level and HF.
