BACKGROUND Colorectal cancer is one of the most common cancers worldwide with high mortality and is classified as a single entity,although colon cancer and rectal cancer have largely different diagnoses,treatments,sur...BACKGROUND Colorectal cancer is one of the most common cancers worldwide with high mortality and is classified as a single entity,although colon cancer and rectal cancer have largely different diagnoses,treatments,surgical methods,and recurrence rates.≥16-slice spiral computed tomography(SCT)is mostly applied to detect the local stage of colon cancer;however,its diagnostic accuracy and whether it is conducive to distinguishing between high-risk and low-risk colon cancer are unclear.AIM To systematically review the diagnostic accuracy of≥16-slice SCT for local staging of colon cancer.METHODS Based on the PubMed,EMBASE,Cochrane Library,and Web of Science databases,computers were used to search the literature from the establishment of the database to April 2021,and the results of the diagnostic tests on≥16-slice SCT for local staging of colon cancer were collected according to the inclusion criteria.The data were then extracted and assessed on the basis of the Quality Assessment Checklist of the Institute of Economics of Canada,Reference Citation Analysis(https://www.referencecitationanalysis.com/).Afterward,a meta-analysis was performed using the statistical software Meta-disc 14.0 and Stata 15.0.RESULTS Eleven studies that provided data on 1613 subjects with computed tomography diagnostic tests were included in this study.Meta-analysis revealed that the pooled sensitivity,pooled specificity,pooled negative likelihood ratio(LR),pooled diagnostic odds ratio,and area under the fitted receiver operating characteristic(ROC)curve of≥16-slice SCT for colon cancer T staging were 0.67(95%CI:0.65-0.70),0.81(95%CI:0.80-0.83),4.13(95%CI:2.66-6.41),0.39(95%CI:0.31-0.49),10.81(95%CI:7.33-15.94),and 0.829,respectively,while the specificity,negative LR,diagnostic odds ratio,and area under the fitted ROC curve of≥16-slice SCT for N staging of colon cancer were 0.54(95%CI:0.49-0.59),0.74(95%CI:0.70-0.77),1.92(95%CI:1.36-2.70),0.67(95%CI:0.51-0.87),3.74(95%CI:1.76-7.94),and 0.829 respectively.The sensitivity and specificity of≥16-slice SCT for colon cancer T staging were acceptable,while the sensitivity for colon cancer N staging was relatively low,though its specificity was acceptable.CONCLUSION≥16-slice SCT for local staging of colon cancer has good diagnostic value;however,the accuracy needs to be confirmed by further clinical practice.展开更多
BACKGROUND Yougui pills have long been used to treat hypothyroidism,usually in combination with levothyroxine sodium in clinical treatment,while their clinical efficacy and safety are still controversial when compared...BACKGROUND Yougui pills have long been used to treat hypothyroidism,usually in combination with levothyroxine sodium in clinical treatment,while their clinical efficacy and safety are still controversial when compared to levothyroxine treatment alone.AIM To explore the clinical efficacy and safety of Yougui pills combined with levothyroxine sodium in the treatment of hypothyroidism.METHODS This meta-analysis was performed in accordance with the PRISMA guidelines.Randomized controlled trials on Yougui pills in the treatment of hypothyroidism published from 2008 to May 2021 were searched in a total of 8 databases(4 databases in Chinese and 4 databases in English).The quality of the included studies was evaluated according to the Cochrane risk assessment tool.Weighted mean difference(WMD)was used for continuous variables,and relative risk(RR)was used for binary variables.Data were extracted,and the meta-analysis was conducted with the statistical software of Stata15.0 and RevMan5.0.RESULTS A total of 140 articles were retrieved,and 9 of them were finally included,with a total sample size of 936 cases.The main meta-analysis results are as follows:(1)The group of Yougui pills combined with levothyroxine sodium had a significantly higher overall response rate than the group of levothyroxine sodium(RR=1.20,95%CI 1.12,1.28,P<0.00001);(2)Yougui pills combined with levothyroxine sodium achieved significantly better efficacy than levothyroxine sodium alone in alleviating adverse symptoms[standard mean difference(SMD)=-1.10,95%CI:-1.37,-0.84,P<0.00001];(3)The level of thyrotropin stimulating hormone in the group of Yougui pills combined with levothyroxine sodium was significantly lower than in the control group of levothyroxine sodium(WMD=-1.38,95%CI:-2.10,-0.67,P=0.00001);(4)The level of free triiodothyronine in the group of Yougui pills combined with levothyroxine sodium was higher than that in the control group of levothyroxine sodium(WMD=0.41,95%CI:0.03,0.79,P=0.03);(5)The level of free thyroxine in the group of Yougui pills combined with levothyroxine sodium was significantly higher than that in the control group of levothyroxine sodium(SMD=0.83,95%CI:0.44,1.22,P≤0.0001);and(6)The adverse reactions in the group of Yougui pills combined with levothyroxine sodium were significantly less than those in the control group of levothyroxine sodium(RR=0.33,95%CI:0.20,-0.53,P<0.00001).CONCLUSION In the treatment of hypothyroidism,the combination of Yougui pills with levothyroxine sodium may be better than levothyroxine sodium treatment alone.展开更多
文摘BACKGROUND Colorectal cancer is one of the most common cancers worldwide with high mortality and is classified as a single entity,although colon cancer and rectal cancer have largely different diagnoses,treatments,surgical methods,and recurrence rates.≥16-slice spiral computed tomography(SCT)is mostly applied to detect the local stage of colon cancer;however,its diagnostic accuracy and whether it is conducive to distinguishing between high-risk and low-risk colon cancer are unclear.AIM To systematically review the diagnostic accuracy of≥16-slice SCT for local staging of colon cancer.METHODS Based on the PubMed,EMBASE,Cochrane Library,and Web of Science databases,computers were used to search the literature from the establishment of the database to April 2021,and the results of the diagnostic tests on≥16-slice SCT for local staging of colon cancer were collected according to the inclusion criteria.The data were then extracted and assessed on the basis of the Quality Assessment Checklist of the Institute of Economics of Canada,Reference Citation Analysis(https://www.referencecitationanalysis.com/).Afterward,a meta-analysis was performed using the statistical software Meta-disc 14.0 and Stata 15.0.RESULTS Eleven studies that provided data on 1613 subjects with computed tomography diagnostic tests were included in this study.Meta-analysis revealed that the pooled sensitivity,pooled specificity,pooled negative likelihood ratio(LR),pooled diagnostic odds ratio,and area under the fitted receiver operating characteristic(ROC)curve of≥16-slice SCT for colon cancer T staging were 0.67(95%CI:0.65-0.70),0.81(95%CI:0.80-0.83),4.13(95%CI:2.66-6.41),0.39(95%CI:0.31-0.49),10.81(95%CI:7.33-15.94),and 0.829,respectively,while the specificity,negative LR,diagnostic odds ratio,and area under the fitted ROC curve of≥16-slice SCT for N staging of colon cancer were 0.54(95%CI:0.49-0.59),0.74(95%CI:0.70-0.77),1.92(95%CI:1.36-2.70),0.67(95%CI:0.51-0.87),3.74(95%CI:1.76-7.94),and 0.829 respectively.The sensitivity and specificity of≥16-slice SCT for colon cancer T staging were acceptable,while the sensitivity for colon cancer N staging was relatively low,though its specificity was acceptable.CONCLUSION≥16-slice SCT for local staging of colon cancer has good diagnostic value;however,the accuracy needs to be confirmed by further clinical practice.
基金Supported by the National Natural Science Foundation of China,No.81973754Shaanxi University of Traditional Chinese Medicine Innovation Team Project,No.2019-QN06.
文摘BACKGROUND Yougui pills have long been used to treat hypothyroidism,usually in combination with levothyroxine sodium in clinical treatment,while their clinical efficacy and safety are still controversial when compared to levothyroxine treatment alone.AIM To explore the clinical efficacy and safety of Yougui pills combined with levothyroxine sodium in the treatment of hypothyroidism.METHODS This meta-analysis was performed in accordance with the PRISMA guidelines.Randomized controlled trials on Yougui pills in the treatment of hypothyroidism published from 2008 to May 2021 were searched in a total of 8 databases(4 databases in Chinese and 4 databases in English).The quality of the included studies was evaluated according to the Cochrane risk assessment tool.Weighted mean difference(WMD)was used for continuous variables,and relative risk(RR)was used for binary variables.Data were extracted,and the meta-analysis was conducted with the statistical software of Stata15.0 and RevMan5.0.RESULTS A total of 140 articles were retrieved,and 9 of them were finally included,with a total sample size of 936 cases.The main meta-analysis results are as follows:(1)The group of Yougui pills combined with levothyroxine sodium had a significantly higher overall response rate than the group of levothyroxine sodium(RR=1.20,95%CI 1.12,1.28,P<0.00001);(2)Yougui pills combined with levothyroxine sodium achieved significantly better efficacy than levothyroxine sodium alone in alleviating adverse symptoms[standard mean difference(SMD)=-1.10,95%CI:-1.37,-0.84,P<0.00001];(3)The level of thyrotropin stimulating hormone in the group of Yougui pills combined with levothyroxine sodium was significantly lower than in the control group of levothyroxine sodium(WMD=-1.38,95%CI:-2.10,-0.67,P=0.00001);(4)The level of free triiodothyronine in the group of Yougui pills combined with levothyroxine sodium was higher than that in the control group of levothyroxine sodium(WMD=0.41,95%CI:0.03,0.79,P=0.03);(5)The level of free thyroxine in the group of Yougui pills combined with levothyroxine sodium was significantly higher than that in the control group of levothyroxine sodium(SMD=0.83,95%CI:0.44,1.22,P≤0.0001);and(6)The adverse reactions in the group of Yougui pills combined with levothyroxine sodium were significantly less than those in the control group of levothyroxine sodium(RR=0.33,95%CI:0.20,-0.53,P<0.00001).CONCLUSION In the treatment of hypothyroidism,the combination of Yougui pills with levothyroxine sodium may be better than levothyroxine sodium treatment alone.
