摘要： Currently,there is no cure for traumatic spinal co rd injury but one therapeutic approach showing promise is gene therapy.In this systematic review and meta-analysis,we aim to assess the efficacy of gene therapies in pre-clinical models of spinal cord injury and the risk of bias.In this metaanalysis,registe red at PROSPERO(Registration ID:CRD42020185008),we identified relevant controlled in vivo studies published in English by searching the PubMed,Web of Science,and Embase databases.No restrictions of the year of publication were applied and the last literature search was conducted on August 3,2020.We then conducted a random-effects meta-analysis using the restricted maximum likelihood estimator.A total of 71 studies met our inclusion crite ria and were included in the systematic review.Our results showed that overall,gene therapies were associated with improvements in locomotor score(standardized mean difference[SMD]:2.07,95%confidence interval[CI]:1.68-2.47,Tau^(2)=2.13,I^(2)=83.6%)and axonal regrowth(SMD:2.78,95%CI:1.92-3.65,Tau^(2)=4.13,I^(2)=85.5%).There was significant asymmetry in the funnel plots of both outcome measures indicating the presence of publication bias.We used a modified CAMARADES(Collaborative Approach to M eta-Analysis and Review of Animal Data in Experimental Studies)checklist to assess the risk of bias,finding that the median score was 4(IQR:3-5).In particula r,reports of allocation concealment and sample size calculations were lacking.In conclusion,gene therapies are showing promise as therapies for spinal co rd injury repair,but there is no consensus on which gene or genes should be targeted.

摘要： Soil microbial biomass nitrogen(MBN)contains the largest proportion of biologically active nitrogen(N)in soil,and is considered as a crucial participant in soil N cycling.Agronomic management practices such as crop rotation and monocropping systems,dramatically affect MBN in agroecosystems.However,the influence of crop rotation and monocropping in agroecosystems on MBN remains unclear.A meta-analysis based on 203 published studies was conducted to quantify the effect of crop rotation and mono-cropping systems on MBN under synthetic N fertilizer application.The analysis showed that crop rotation significantly stimulated the response ratio(RR)of MBN to N fertilization and this parameter reached the highest levels in upland-fallow rotations.Upland mono-cropping did not change the RR of MBN to N application,however,the RR of MBN to N application in paddy mono-cropping increased.The difference between crop rotation and mono-cropping systems appeared to be due to the various cropping management scenarios,and the pattern,rate and duration of N addition.Crop rotation systems led to a more positive effect on soil total N(TN)and a smaller reduction in soil pH than mono-cropping systems.The RR of MBN to N application was positively correlated with the RR of mineral N only in crop rotation systems and with the RR of soil pH only in mono-cropping systems.Combining the results of Random Forest(RF)model and structural equation model showed that the predominant driving factors of MBN changes in crop rotation systems were soil mineral N and TN,while in mono-cropping systems the main driving factor was soil pH.Overall,our study indicates that crop rotation can be an effective way to enhance MBN by improving soil N resources,which promote the resistance of MBN to low pH induced by intensive synthetic N fertilizer application.

摘要： BACKGROUND Annually,there are an estimated 1187000 new patients worldwide diagnosed with haematological malignancies.Effective strategies are needed to alleviate side effects and prevent the physical and psychosocial degeneration of patients in active treatment for haematological malignancies.AIM To explore the effects of physical exercise on quality of life(Qo L)of patients with haematological malignancies and thrombocytopenia.METHODS Cochrane Library,Pub Med and Embase were searched for all relevant articles reporting randomized controlled trials(RCTs)that were published up to 31 July 2021.Two authors independently selected articles in accordance with the inclusion criteria,evaluated their quality,and collected information.Any controversy was resolved through discussion with a third senior author.The PRISMA 2009 checklist was followed.RESULTS Seven RCTs were selected in the systematic review and three were included in the final meta-analysis.There were significant differences in Qo L between physical exercise groups[mean score difference=8.81;95%confidence interval(CI):1.81-15.81,P=0.01],especially in emotional functioning(mean score difference=12.34;95%CI:4.64-20.04,P=0.002)and pain(mean score difference=–12.77;95%CI:-3.91 to-21.63,P=0.005).CONCLUSION Physical exercise has clinical effects on Qo L and improves emotional function and pain indices of patients with haematological malignancies and thrombocytopenia.

摘要： BACKGROUND In recent years,the predictive role of YKL-40 for long-term survival in colorectal cancer patients has been gradually investigated.However,whether it is a reliable and valuable prognostic indicator for patients with colorectal carcinoma has not been verified.AIM To identify the prognostic value of serum/plasma concentration of YKL-40 or expression status of YKL-40 in tumor cells in colorectal carcinoma patients.METHODS Several electronic databases including the PubMed,EMBASE,Web of Science,CNKI,VIP and WanFang were searched for relevant studies.The hazard ratios(HR)and 95%confidence intervals(CI)were combined and the primary and secondary outcomes were overall survival(OS)and progression-free survival(PFS),respectively.All statistical analysis were conducted by STATA 15.0 software.RESULTS A total of nine studies involving 2545 patients were included.The pooled results indicated that YKL-40 was significantly associated with poor OS(HR=1.80,95%CI:1.32-2.45,P<0.001)and PFS(HR=1.62,95%CI:1.22-2.16,P=0.001).Subgroup analysis stratified by the treatment,tumor type and source of YKL-40 showed similar results.CONCLUSION Elevated serum/plasma concentration of YKL-40 or positive expression in tumor cells was related with worse prognosis of colorectal carcinoma patients.YKL-40 might serve as a novel and reliable indicator for the evaluation of prognosis in colorectal cancer.

摘要： Objectives:To evaluate the benefits of traditional Chinese herbal medicine(TCHM)plus triple therapy(TT)in the management of Helicobacter pylori(H.pylori)-induced chronic atrophic gastritis(CAG).Methods:A comprehensive access and electronic database search were carried out from inception to June 2020.Prospective randomized trials(TCHM plus TT vs.TT)were selected to assess the eradication rate of H.pylori(ER of H.pylori),clinical symptom relief rate(SRR),treatment-related adverse reactions(TRAR)and 95%confidence intervals(CI)in the meta-analysis and cumulative meta-analysis(CMA).Meta-regression analysis was used to analyze heterogeneity between studies and publication bias.Results:33 studies contained 3,226 participants were included.Compared with the TT group,TCHM plus TT group showed a significantly higher ER of H.pylori(OR=4.14,95%CI:3.21-5.35;P=0.000)and SRR(OR=4.50,95%CI:3.59-5.64).Meanwhile,the TRAR of TCHM plus TT remedy was significantly lower than TT monopoly(RR=0.43,95%CI:0.29-0.64;P=0.000).The results of the CMA,sorted by publication year,duration of treatment,and sample size,confirmed that combined treatment remedy was superior to TT monopoly in respect of ER of H.pylori and SRR.Conclusions:The present study obtained reliable and convincing evidence suggesting that TCHM plus TT remedy was efficacious and safe in treating H.pylori-induced CAG.

摘要： BACKGROUND Over the past decades,clinical pathways(CPs)for hip and knee arthroplasty have been strongly and continuously evolved based on scientific evidence and innovation.AIM The present systematic review,including meta-analysis,aimed to compare the safety and efficacy of enhanced recovery pathways(ERP)with regular pathways for patients with hip and/or knee arthroplasty.METHODS A literature search in healthcare databases(Embase,PubMed,Cochrane Library,CINAHL,and Web of Science)was conducted from inception up to June 2018.Relevant randomized controlled trials as well as observational studies comparing ERP,based on novel evidence,with regular or standard pathways,prescribing care as usual for hip and/or knee arthroplasty,were included.The effect of both CPs was assessed for(serious)adverse events[(S)AEs],readmission rate,length of hospital stay(LoS),clinician-derived clinical outcomes,patient reported outcome measures(PROMs),and financial benefits.If possible,a meta-analysis was performed.In case of considerable heterogeneity among studies,a qualitative analysis was performed.RESULTS Forty studies were eligible for data extraction,34 in meta-analysis and 40 in qualitative analysis.The total sample size consisted of more than 2 million patients undergoing hip or knee arthroplasty,with a mean age of 66 years and with 60%of females.The methodological quality of the included studies ranged from average to good.The ERP had lower(S)AEs[relative risk(RR):0.9,95%confidence interval(CI):0.8-1]and readmission rates(RR:0.8,95%CI:0.7-1),and reduced LoS[median days 6.5(0.3-9.5)],and showed similar or improved outcomes for functional recovery and PROMs compared to regular pathways.The analyses for readmission presented a statistically significant difference in the enhanced recovery pathway in favor of knee arthroplasties(P=0.01).ERP were reported to be cost effective,and the cost reduction varied largely between studies(€109 and$20573).The overall outcomes of all studies reported using Grading of Recommendation,Assessment,Development and Evaluation,presented moderate or high quality of evidence.CONCLUSION This study showed that implementation of ERP resulted in improved clinical and patient related outcomes compared to regular pathways in hip and knee arthroplasty,with a potential reduction of costs.

摘要： BACKGROUND Some studies investigated the prognostic role of several blood biomarkers,including the neutrophil/lymphocyte ratio(NLR),platelet/lymphocyte ratio(PLR),lymphocyte/monocyte ratio(LMR)and Glasgow prognostic score(GPS),in osteosarcoma,but their results were inconsistent with each other.AIM To identify the prognostic value of NLR,PLR,LMR and GPS in osteosarcoma patients through reviewing relevant studies.METHODS The PubMed,EMBASE,Web of Science and CNKI databases were searched up to October 2,2021.The primary and second outcomes were overall survival(OS)and disease-free survival(DFS),respectively.The hazard ratios(HRs)with 95%confidence intervals(CIs)were combined to assess the association between these indicators and prognosis of osteosarcoma patients.RESULTS A total of 13 studies involving 2087 patients were eventually included.The pooled results demonstrated that higher NLR and GPS were significantly associated with poorer OS(HR=1.88,95%CI:1.38-2.55,P<0.001;HR=2.19,95%CI:1.64-2.94,P<0.001)and DFS(HR=1.67,95%CI:1.37-2.04,P<0.001;HR=2.50,95%CI:1.39-4.48,P<0.001).However,no significant relationship of PLR and LMR and OS(P=0.085;P=0.338)and DFS(P=0.396;P=0.124)was observed.CONCLUSION Higher NLR and GPS were related with worse prognosis and might serve as novel prognostic indicators for osteosarcoma patients.

摘要： BACKGROUND Depression is recognized as a major public health problem with a substantial impact on individuals and society.Complementary therapies such as acupressure may be considered a safe and cost-effective treatment for people with depression.An increasing body of research has been undertaken to assess the effectiveness of acupressure in various populations with depression,but the evidence thus far is inconclusive.AIM To examine the efficacy of acupressure on depression.METHODS A systematic literature search was performed on PubMed,PsycINFO,Scopus,Embase,MEDLINE,and China National Knowledge(CNKI).Randomized clinical trials(RCTs)or single-group trials in which acupressure was compared with control methods or baseline in people with depression were included.Data were synthesized using a random-effects or a fixed-effects model to analyze the impacts of acupressure treatment on depression and anxiety in people with depression.The primary outcome measures were set for depression symptoms.Subgroups were created,and meta-regression analyses were performed to explore which factors are relevant to the greater or lesser effects of treating symptoms.RESULTS A total of 14 RCTs(1439 participants)were identified.Analysis of the betweengroup showed that acupressure was effective in reducing depression[Standardized mean differences(SMDs)=-0.58,95%CI:-0.85 to-0.32,P<0.0001]and anxiety(SMD=-0.67,95%Cl:-0.99 to-0.36,P<0.0001)in participants with mildto-moderate primary and secondary depression.Subgroup analyses suggested that acupressure significantly reduced depressive symptoms compared with different controlled conditions and in participants with different ages,clinical conditions,and duration of intervention.Adverse events,including hypotension,dizziness,palpitation,and headache,were reported in one study.CONCLUSION The evidence of acupressure for mild-to-moderate depressive symptoms was significant.Importantly,the findings should be interpreted with caution due to study limitations.Future research with a well-designed mixed method is required to consolidate the conclusion and provide an in-depth understanding of potential mechanisms underlying the effects.

摘要： BACKGROUND Factors that are associated with the short-term rehospitalization have been investigated previously in numerous studies.However,the majority of these studies have not produced any conclusive results because of their smaller sample sizes,differences in the definition of pneumonia,joint pooling of the in-hospital and post-discharge deaths and lower generalizability.AIM To estimate the effect of various risk factors on the rate of hospital readmissions in patients with pneumonia.METHODS Systematic search was conducted in PubMed Central,EMBASE,MEDLINE,Cochrane library,ScienceDirect and Google Scholar databases and search engines from inception until July 2021.We used the Newcastle Ottawa(NO)scale to assess the quality of published studies.A meta-analysis was carried out with random-effects model and reported pooled odds ratio(OR)with 95%confidence interval(CI).RESULTS In total,17 studies with over 3 million participants were included.Majority of the studies had good to satisfactory quality as per NO scale.Male gender(pooled OR=1.22;95%CI:1.16-1.27),cancer(pooled OR=1.94;95%CI:1.61-2.34),heart failure(pooled OR=1.28;95%CI:1.20-1.37),chronic respiratory disease(pooled OR=1.37;95%CI:1.19-1.58),chronic kidney disease(pooled OR=1.38;95%CI:1.23- 1.54) and diabetes mellitus (pooled OR = 1.18;95%CI: 1.08-1.28) had statistically significantassociation with the hospital readmission rate among pneumonia patients. Sensitivity analysisshowed that there was no significant variation in the magnitude or direction of outcome,indicating lack of influence of a single study on the overall pooled estimate.CONCLUSIONMale gender and specific chronic comorbid conditions were found to be significant risk factors forhospital readmission among pneumonia patients. These results may allow clinicians and policymakersto develop better intervention strategies for the patients.

摘要： Objective:To systematically review the efficacy and safety of Shenshuaining granule combined with Western medicine treatment for Diabetic kidney disease(DKD)by meta-analysis.Methods:Databases including CNKI,WanFang Data,VIP,CBM,TheCochrane,Embase and PubMed were electronically searched from inception to May 2020 to collect randomized controlled trials of Shenshuaining granule with western medicine treatment for Diabetic nephropathy.The trial was screenedbased on inclusion and exclusion criteria,and the methodological quality of the included relevant trial was assessed by Cochrane Handboo-k.Meta-analysis was then performed by Revman 5.3 software.Results:A total of 9 studies involving 892 patients were included.Both groupinclude 446 patients.The result of meta-analysis showed that Shenshuaining granule combined with Western medicine treatment significantly improved the total effective rate of diabetic nephropathy[RR=1.26,95%CI(1.17,1.37),P<0.00001],further reduced ser umurea nitrogen[MD=-1.65,95%CI(-2.53,-0.77),P=0.0002],24h urine albumin excretion rat[SMD=-4.21,95%CI(-6.23,-2.19),P<0.0001],serum creatinine[MD=-21.50,95%CI(-28.48,-14.50),P<0.00001].However,the difference of fasting blood glucose[MD=-0.46,95%CI(-1.18,0.27),P=0.22]was not statistically significant.Conclusions:Shenshuaining granule can improve the rate o-f renal pellet filtration in patients with diabetic nephropathy,reduce kidney injury and protect kidney function.Although there are sideeffects,it is relatively safe.

摘要： Objective Several epidemiological studies suggest that tobacco smoking increases the risk of oral cancer.No systematic review, however, has been reported to examine how consistent the evidence is across the studies.We undertook a mesa-analysis of epidemiological studies investigating the magnitude relationship between tobacco smoking and oral cancer in order to offer scientific basis for health education and decision of prevention.Methods All case-control studies about tobacco smoking and risk of oral cancer were obtained after retrieving literatures comprehensively.All statistic analyses and heterogeneity test were performed using Rev Man 4.2.8 software.The meta-analysis was applied for calculation of pooled OR value (with 95%CI) of oral cancer.Results There were 14 literatures being accorded with the inclusion criteria.A total of 4508 oral cancer cases and 11725controls were included.There was heterogeneity in the pooled OR estimate across the studies.The combined odds ratio for tobacco smoking related to oral cancer was 2.86(95%CI: 2.16, 3.78).Also, the highest combined odds ratio was belong to America continents (OR=6.45; 95%CI: 5.26, 7.91)and the lowest was in Africa (OR= 1.37; 95%CI:1.05, 1.77).With increasing the amount of smoking, the risk of oral cancer was increasing(the pooled OR value.increased from 2.42 to 4.88).Conclusion Our results clearly indicate that tobacco smokers are at increased risk of oral cancer.The cancer risk can be reduced by controlling of tobacco smoking in different countries.

摘要： Objective Several epidemiological studies suggest that tobacco smoking increases the risk of oral cancer.No systematic review, however, has been reported to examine how consistent the evidence is across the studies.We undertook a mesa-analysis of epidemiological studies investigating the magnitude relationship between tobacco smoking and oral cancer in order to offer scientific basis for health education and decision of prevention.Methods All case-control studies about tobacco smoking and risk of oral cancer were obtained after retrieving literatures comprehensively.All statistic analyses and heterogeneity test were performed using Rev Man 4.2.8 software.The meta-analysis was applied for calculation of pooled OR value (with 95%CI) of oral cancer.Results There were 14 literatures being accorded with the inclusion criteria.A total of 4508 oral cancer cases and 11725controls were included.There was heterogeneity in the pooled OR estimate across the studies.The combined odds ratio for tobacco smoking related to oral cancer was 2.86(95%CI: 2.16, 3.78).Also, the highest combined odds ratio was belong to America continents (OR=6.45; 95%CI: 5.26, 7.91)and the lowest was in Africa (OR= 1.37; 95%CI:1.05, 1.77).With increasing the amount of smoking, the risk of oral cancer was increasing(the pooled OR value.increased from 2.42 to 4.88).Conclusion Our results clearly indicate that tobacco smokers are at increased risk of oral cancer.The cancer risk can be reduced by controlling of tobacco smoking in different countries.

摘要： Objective Several epidemiological studies suggest that tobacco smoking increases the risk of oral cancer.No systematic review, however, has been reported to examine how consistent the evidence is across the studies.We undertook a mesa-analysis of epidemiological studies investigating the magnitude relationship between tobacco smoking and oral cancer in order to offer scientific basis for health education and decision of prevention.Methods All case-control studies about tobacco smoking and risk of oral cancer were obtained after retrieving literatures comprehensively.All statistic analyses and heterogeneity test were performed using Rev Man 4.2.8 software.The meta-analysis was applied for calculation of pooled OR value (with 95%CI) of oral cancer.Results There were 14 literatures being accorded with the inclusion criteria.A total of 4508 oral cancer cases and 11725controls were included.There was heterogeneity in the pooled OR estimate across the studies.The combined odds ratio for tobacco smoking related to oral cancer was 2.86(95%CI: 2.16, 3.78).Also, the highest combined odds ratio was belong to America continents (OR=6.45; 95%CI: 5.26, 7.91)and the lowest was in Africa (OR= 1.37; 95%CI:1.05, 1.77).With increasing the amount of smoking, the risk of oral cancer was increasing(the pooled OR value.increased from 2.42 to 4.88).Conclusion Our results clearly indicate that tobacco smokers are at increased risk of oral cancer.The cancer risk can be reduced by controlling of tobacco smoking in different countries.