Medicine
-
Review Meta Analysis
Clinicopathologic Significance and Prognostic Value of B7 Homolog 1 in Gastric Cancer: A Systematic Review and Meta-Analysis.
Immunologic checkpoint marker B7 homolog 1 (B7-H1) plays a fundamental role in the initiation and progression of gastric cancer (GC); however, the clinicopathologic significance and prognostic value of B7-H1 in GC remains controversial. In this study, we aimed to assess their relationship through a meta-analysis. Medline/PubMed, EMBASE, the Cochrane Library databases, and Grey literature were searched up to August 10, 2015, for eligible studies of the association between B7-H1 expression and overall survival in GC. ⋯ The pooled results showed that positive B7-H1 expression was a negative predictor for overall survival with hazard ratio of 1.74 (95% CI: 1.40-2.17; Pheterogeneity = 0.146) in GC. Additionally, increased B7-H1 was found to be significantly associated with positive lymph node metastasis (OR = 2.61, 95% CI: 1.78-3.84; Pheterogeneity = 0.004) and poorer tumor stage (OR = 2.28, 95% CI: 1.39-3.74; Pheterogeneity = 0.006); however, higher B7-H1 expression was not significantly correlated with poorer tumor differentiation (OR = 1.29, 95% CI: 0.90-1.86; Pheterogeneity = 0.013) and bigger tumor size (OR = 1.18, 95% CI: 0.81-1.73; Pheterogeneity = 0.104). The meta-analysis suggested that B7-H1 could act as a significant biomarker in the poor prognosis of gastric carcinoma.
-
Review Meta Analysis
Piezoelectric Versus Conventional Rotary Techniques for Impacted Third Molar Extraction: A Meta-analysis of Randomized Controlled Trials.
Impacted third molars are frequently encountered in clinical work. Surgical removal of impacted third molars is often required to prevent clinical symptoms. Traditional rotary cutting instruments are potentially injurious, and piezosurgery, as a new osteotomy technique, has been introduced in oral and maxillofacial surgery. ⋯ Additionally, there was a trend of less postoperative pain and trismus in the piezosurgery groups. The number of included randomized controlled trials and the sample size of each trial were relatively small, double blinding was not possible, and cost analysis was unavailable due to a lack of data. Our meta-analysis indicates that although patients undergoing piezosurgery experienced longer surgery time, they had less postoperative swelling, indicating that piezosurgery is a promising alternative technique for extraction of impacted third molars.
-
Meta Analysis Comparative Study
Network Meta-Analysis Comparing Relatively Selective COX-2 Inhibitors Versus Coxibs for the Prevention of NSAID-Induced Gastrointestinal Injury.
Currently 2 difference classes of cyclooxygenase (COX)-2 inhibitors, coxibs and relatively selective COX-2 inhibitors, are available for patients requiring nonsteroidal anti-inflammatory drug (NSAID) therapy; their gastroprotective effect is hardly directly compared. The aim of this study was to compare the gastroprotective effect of relatively selective COX-2 inhibitors with coxibs. MEDLINE, EMBASE, and the Cochrane Library (from their inception to March 2015) were searched for potential eligible studies. ⋯ Network meta-analyses suggested that relatively selective COX-2 inhibitors and coxibs were associated with comparable incidences of total adverse events (AEs) (RR, 1.09; 95% CI, 0.93-1.31), gastrointestinal AEs (RR, 1.04; 95% CI, 0.87-1.25), total withdrawals (RR, 1.00; 95% CI, 0.74-1.33), and gastrointestinal AE-related withdrawals (RR, 1.02; 95% CI, 0.57-1.74). Relatively selective COX-2 inhibitors appear to be associated with similar gastroprotective effect and tolerability as coxibs. Owing to the indirectness of the comparisons, future research is required to confirm the study conclusion.
-
During robot-assisted laparoscopic prostatectomy, specific physiological conditions such as carbon dioxide insufflation and the steep Trendelenburg position can alter the cardiac workload and cerebral hemodynamics. Inadequate arterial blood pressure is associated with hypoperfusion, organ damage, and poor outcomes. Dynamic arterial elastance (Ea) has been proposed to be a useful index of fluid management in hypotensive patients. ⋯ The optimal cut-off value of dynamic Ea for predicting an MAP increase of ≥ 15% after fluid challenge was 0.74. Dynamic Ea can predict an MAP increase ≥ 15% after fluid challenge during robot-assisted laparoscopic prostatectomy. This result suggests that evaluation of arterial pressure responsiveness using dynamic Ea helps to maintain an adequate arterial blood pressure and to improve perioperative outcomes in preload-dependent patients receiving robot-assisted laparoscopic prostatectomy under pneumoperitoneum and in the steep Trendelenburg position.
-
Meta Analysis
Effect of Probiotics on Blood Lipid Concentrations: A Meta-Analysis of Randomized Controlled Trials.
Previous clinical studies have reported mixed results regarding the effect of probiotics on lipid metabolism. Therefore, we conducted a meta-analysis of randomized controlled trials to quantify the direction and magnitude of the potential effect of probiotics on blood lipid concentrations. Eligible studies were randomized, placebo-controlled trials whose interventions were probiotic products containing live bacteria. ⋯ In addition, industry sponsorship may affect study findings. These results suggest that the use of probiotics may improve lipid metabolism by decreasing total and LDL cholesterol concentrations. However, both the efficacy of probiotics for cholesterol lowering and safety should be investigated further in well-designed clinical trials.