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ABSTRACT: To evaluate the incidence and risk factors of lower extremity amputation among inpatients with diabetic foot.
For this retrospective study, a total of 685 inpatients with diabetic foot (Wagner grade 1-5) admitted at a multi-disciplinary Diabetic Foot Care Center, West China Hospital, Sichuan University during January 1, 2005 and June 30, 2011. The data of each patient including clinical information, laboratory results and final outcome were collected and analyzed. They were divided into non-amputated and amputated groups. And the latter included minor and major amputation groups according to amputation site.
The overall amputation rate was 11.4% in diabetic foot inpatients. The incidences of minor amputation and major amputation were 5.4% and 6.0% respectively. 17.9% of amputated patients experienced a second amputation. The amputated patients had a longer hospitalized stay, higher counts of white blood cells and neutrophils, greater HbA1c and lower serum levels of hemoglobin and albumin than the non-amputation patients (P < 0.05). The prevalence of diabetic peripheral neuropathy was significantly higher in the amputation group than that in the non-amputation group (P < 0.05). However, no difference existed between the minor and major amputation groups (P > 0.05). Ankle brachial index (ABI) in the amputation group was significantly lower than that in the non-amputation group (0.41 ± 0.25 vs 0.91 ± 0.36, P < 0.01). Minor and major amputation inpatients had similar ABI (0.43 ± 0.24 vs 0.39 ± 0.26, P = 0.087). Ordinal regression showed that HbA1c (P = 0.015), ABI (P = 0.016), history of amputation (P < 0.01) and Wagner grade of diabetic foot (P < 0.01) were the independent risk factors of amputation.
Diabetic foot inpatients have a higher rate of lower extremity amputation. The risk factors of amputation include HbA1c, ABI, history of amputation and Wagner grade of diabetic foot. And diabetic peripheral neuropathy, ischemia of lower limbs (especially peripheral arterial diseases below knees), infection and nutritional state are closely associated with amputation of diabetic foot inpatients.
Zhonghua yi xue za zhi 06/2012; 92(24):1686-9.
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ABSTRACT: To assess the effects of long-term beta blockers in patients with stable angina.
We reviewed the literature up to June 2010 from CENTRAL, MEDLINE, EMBASE, CBM, and CNKI for randomized controlled trials. The appropriate data were meta-analysed using Revman 5.0.
Twenty-six trials including 6108 patients were identified. The treatment with beta blockers has significantly decreased all-cause mortality when compared with no control (OR 0.40, 95% CI 0.20 to 0.79), but has had no statistically differences when compared with placebo (OR 0.92, 95% CI 0.62 to 1.38) and with calcium-channel blocker (CCB) (OR0.84, 95% CI 0.49 to 1.44). This was similar in patients with fatal and non-fatal acute myocardial infarction when compared with placebo (OR 0.82, 95% CI 0.57 to 1.17) or CCB (OR 1.08, 95% CI 0.71 to 1.66); on revascularization and quality of life. The beta blockers reduced the incident of unstable angina compared to no treatment (OR 0.14, 95% CI0.07 to 0.29), but increased unstable angina compared to placebo (OR 3.32, 95% CI 1.50 to 7.36). There was a significant reduction of nitrate consumption when beta blockers were compared with CCBs (OR 1.18, 95% CI 1.54 to 0.82),but not with placebo and trimetazidine. There was no significant difference in angina attack between each group. Side effects in beta blocker were similar with ones in controls.
Beta blockers may decrease the death and unstable angina when compared with no treatment, but no more effective than other anti-anginal agents on prophylaxis of myocardial ischaemia in stable angina patients.
European journal of preventive cardiology. 06/2012; 19(3):330-41.
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ABSTRACT: The chemopreventive effects of Allium vegetables (onions, garlic, shallots, leeks, chives, and so forth) have been studied extensively, although their effect on gastric cancer risk is controversial. We performed a meta-analysis of cohort and case-control studies to analyze this association.
We searched MEDLINE for studies of Allium vegetable consumption and gastric cancer that were published in any language, from January 1, 1966, to September 1, 2010. We analyzed 19 case-control and 2 cohort studies, of 543,220 subjects. We pooled the relative risks from individual studies using a random-effects model and performed dose-response, heterogeneity, and publication bias analyses.
In a pooled analysis of all studies, consumption of large amounts of Allium vegetables (in a comparison of the highest and lowest consumption groups) reduced the risk for gastric cancer (odds ratio, 0.54; 95% confidence interval, 0.43-0.65). Specific analyses for onion, garlic, leek, Chinese chive, scallion, garlic stalk, and Welsh onion yielded similar results, except for onion leaf. The estimated summary odds ratio for an increment of 20 g/day of Allium vegetables consumed (approximately the average weight of 1 garlic bulb) was 0.91 (95% confidence interval, 0.88-0.94), based on case-control studies from the dose-response meta-analysis.
In a meta-analysis, consumption of high levels of Allium vegetables reduced the risk for gastric cancer risk. Because of potential confounding factors and exposure misclassification, further studies are required to establish this association.
Gastroenterology 04/2011; 141(1):80-9. · 11.68 Impact Factor
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ABSTRACT: To investigate the associations between the patterns of change of self-monitored blood glucose (SMBG) and the parameters of intraday blood glucose variability [mean absolute glucose excursions (MAGE), mean postprandial glucose excursion (MPPGE) and standard deviation of blood glucose (sBG)] measured by the continuous glucose monitoring system.
A 72-hour continuous glucose monitoring was performed in a sample 105 people with impaired glucose tolerance (IGR, n=51) and newly-diagnosed type 2 diabetes mellitus (T2DM, n=54) to calculate MAGE, MPPGE and sBG. Meanwhile, fingertip blood glucose self-monitoring was performed to determine fasting blood glucose (FBG), blood glucose after breakfast (BG(AB)), blood glucose before lunch (BG(BL)), blood glucose after lunch (BG(AL)), blood glucose before supper (BG(BS)), blood glucose after supper (BG(AS)), and blood glucose before sleeping (BG(BR)) at the same period of time. Multiple stepwise regression analysis was performed to generate equations for predicting MAGE, MPPGE and sBG with age and the self-monitoring blood glucose parameters in 80% of the subjects (41 IGR and 44 T2DM, randomly selected from the overall sample). These equations were then cross-validated in the remaining 20% subjects (10 IGR and 10 T2DM).
BG(AA), BG(AB), BGAL and FBG entered into the regression equations predicting MAGE, sBG and MPPGE for the IGR subject, while age only entered into the regression equations predicting MPPGE and sBG. For the subjects with T2DM, BG(AS), BG(AL) and age entered into the equation predicting MAGE; BG(AS), BG(AL), BG(BL) and BG(BS) entered into the equation predicting MPPGE; BG(AS), BG(AL) and FBG entered into the equation predicting sBG. The cross-validation study showed that the differences between predicted and observed values of MAGE in the subjects with IGR and T2DM were 4.1% and 8.2%, respectively; the differences between predicted and observed values of MPPGE in the subjects with IGR and T2DM were 23.1% and 1.3%, respectively; and the differences between predicted and observed values of sBG in the subjects with IGR and T2DM were 1.2% and 6.8%, respectively. Except for MPPGE in the subjects with IGR, the goodness of fit between predicted and observed values were good.
The MAGE and sBG in people with IGR and the MAGE, MPPGE and sBG in patients with T2DM can be well predicted with age and self-monitored blood glucose.
Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition 01/2011; 42(1):95-100.
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Li-fang Lü,
Chun Wang,
Yan-zhi Yang,
Li-ping He, Guan-jian Liu,
Da-wei Chen,
Li Zhong,
Li-hong Chen,
Hao-ming Tian,
Jian Zhou,
Wei-ping Jia,
Xing-wu Ran
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ABSTRACT: To evaluate the accuracy and safety of continuous glucose monitoring system (CGMS) in subjects with normal glucose tolerance (NGT), impaired glucose regulation (IGR) and newly-diagnosed type 2 diabetes mellitus (T2DM).
A total of 162 subjects (53 NGT, 53 IGR and 56 newly diagnosed T2DM) at 22 - 72 years old were recruited. Each subject received a continuous glucose monitoring (CGM) of CGMS SYSTEM GOLD(TM) (Medtronic Minimed, Northridge, CA) for 3 consecutive days and was instructed to self-calibrate the interstitial glucose levels with finger-stick blood glucose measurements (self-monitoring of blood glucose, SMBG) 7 times daily. Means of median absolute difference (median AD) and median absolute relative difference (median RAD) were calculated to assess the difference between CGM and SMBG values. The correlation between CGM and SMBG values were analyzed with the liner regression analysis. The data were analyzed by the ISO criteria for home glucose meters and Clarke error grid analysis.
All participants showed a good tolerance to the insertion of CGMS sensor and wearing the device. The mean duration of CGMS recording was (75.6 ± 8.3) h. A total of 4324 glucose meter values were paired with glucose measurements from CGMS. Overall, a good relationship (r = 0.943, P = 0.000) and no significant difference (P > 0.05) over a wide range (2.2 - 22.2 mmol/L) were found between CGM and SMBG values. The median AD was 0.5 (0.2 - 0.9) mmol/L and the median RAD 7.55% (3.33% - 14.09%) with 87.16% of sensor values meeting the ISO home glucose meter criteria. The Clarke error grid analysis showed that 99.58% of the readings from CGMS fell into the clinical acceptable zones including 87.5% values in zone A (clinical exact) and 12.1% values in zone B (benign error).
Both safe and well-tolerated, continuous glucose monitoring provides comparatively accurate blood glucose values to guide the diagnosis and treatment of diabetes.
Zhonghua yi xue za zhi 11/2010; 90(42):2967-70.
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ABSTRACT: To discuss the diagnostic value of English, Chinese and Japanese standards of TW2 to skeletal age assessment of children with central precocious puberty (CPP), then to confirm the normal thresholds.
Sixty one children as patient group were definitely assured CPP. The control group had 67 children. Among them, 61 were normal children, another 6 children as a special control group. Left hand-wrist X-ray radiographs were retrospectively analyzed by two doctors separately and their skeletal ages were assessed with the three standards of TW2 method. The differences between skeletal age and chronological age were analyzed with ROC in SPSS 13.0.
(1) The skeletal age results showed kappa value is 0.776 deduced by two clinical doctors(u = 16.128, P < 0.05). (2) There were no statistic differences for the areas under ROC curves among three methods. (3) d > or = 1.15 years in TW2, d > or = 1.25 years in TW2-CHN and d > or = 0.65 years in TW2-JP were more susceptive and specific points.
TW2, TW2-CHN and TW2-JP provided a higher value for the diagnosis of skeletal age in unhealthy children, and TW2-CHN is highest value for Chinese children.
Fa yi xue za zhi 06/2010; 26(3):181-4.
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ABSTRACT: This cross-sectional study aimed to assess the association of risk of cognitive impairment with level of serum uric acid (SUA) among very old people, specifically in a cohort of 694 unrelated Chinese aged 90-108 years. Cognitive function was measured using the 30-item Mini-Mental State Examination (MMSE) and SUA level was determined by the uricase-peroxidase method. Cognitive impairment was defined as a score below 18 on the Folstein MMSE. Men had significantly higher cognitive function scores than did women: 17.6+/-5.6 vs. 14.0+/-5.2 (P<0.05). In the total sample, the prevalence of cognitive impairment was 71.6%, with the rates being 50.9% and 81.6% for males and females, respectively (P<0.000). Men had significantly higher SUA levels than women: 354.1+/-85.7 vs. 303.8+/-81.7mmol/L (P=0.000). Binary logistic regression analysis indicated an inverse correlation between the risk of cognitive impairment and SUA (OR=0.996) in men. In conclusion, in male nonagenarians and centenarians, the higher level of SUA is related to the lower risk of cognitive impairment.
Experimental gerontology 05/2010; 45(5):331-5. · 3.34 Impact Factor
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ABSTRACT: Studies investigating the association between interleukin10 (IL10) -592 promoter polymorphism and gastric cancer risk report conflicting results. The objective of this study was to quantitatively summarize the evidence for such a relationship.
Two investigators independently searched the MEDLINE and Embase databases. This meta-analysis included ten case-control studies, which included 1,715 gastric cancer cases and 2,783 controls.
The combined results based on all studies showed that there was no significant difference in genotype distribution (AA odds ratio [OR] = 0.88, 95% confidence interval [CI] = 0.66, 1.18; AC OR = 1.09, 95% CI = 0.95, 1.24; CC OR = 1.03, 95% CI = 0.89, 1.18) between gastric cancer and noncancer patients. When stratifying for race, the results were similar, except that patients with gastric cancer had a significantly lower frequency of AA (OR = 0.67, 95% CI = 0.52, 0.87) and a higher frequency of AC (OR = 1.34, 95% CI = 1.07, 1.68) than noncancer patients among Asians. When stratifying by the location of gastric cancer, we found that patients with cardia gastric cancer had a significantly lower frequency of AA (OR = 0.41, 95% CI = 0.20, 0.84) than those with noncardia gastric cancer among Caucasians. When stratifying by Lauren's classification of gastric cancer, we found that patients with diffuse gastric cancer had a significantly higher frequency of AA (OR = 1.91, 95% CI = 1.07, 3.41) than those with intestinal gastric cancer among Caucasians.
This meta-analysis suggests that the IL10 -592 promoter polymorphism may be associated with gastric cancer among Asians, and that differences in genotype distribution may be associated with the location and Lauren's classification of gastric cancer.
Digestive Diseases and Sciences 09/2009; 55(6):1525-32. · 2.12 Impact Factor
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ABSTRACT: The Glutathione S-transferases (GSTs) play multiple roles in the pathogenesis and treatment of cancer. Studies investigating the association between Glutathione S-transferase M1 (GSTM1) null genotype and gastric cancer risk report conflicting results. The purpose of this study was to quantitatively summarize the evidence for such a relationship.
This meta-analysis included 35 studies, which included 4,505 gastric cancer cases and 9,062 controls. The combined results based on all studies showed that the GSTM1 null genotype was associated with an increased risk of gastric cancer (OR = 1.15, 95% confidence interval [CI] = 1.02, 1.29). When stratifying for race, results were similar among Asians (OR = 1.24, 95% CI = 1.07, 1.44) except Caucasians (OR = 1.04, 95% CI = 0.88, 1.24). When stratifying by the location, stage, Lauren's classification, histological differentiation, lymph node metastasis, smoking, and Helicobacter pylori infection of gastric cancer, we observed that patients with diffuse classification had a significantly higher frequency null genotype (OR = 4.80, 95% CI = 1.65,13.94) than those with intestinal classification among Caucasians.
This meta-analysis suggests that the GSTM1 null genotype may be associated with gastric cancer among Asians.
Digestive Diseases and Sciences 09/2009; 55(7):1824-30. · 2.12 Impact Factor
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ABSTRACT: Studies investigating the association between glutathione S-transferase P1 (GSTP1) codon 105 polymorphism and gastric cancer risk report conflicting results. The objective of this study was to quantitatively summarise the evidence for such a relationship. Two investigators independently searched the Medline and Embase databases. This meta-analysis included 10 case-control studies, which included 1161 gastric cancer cases and 2847 controls. The combined results based on all studies showed that there was no significant difference in genotype distribution [AA odds ratio (OR)=1.14, 95% confidence interval (CI)=0.91, 1.44; AG (OR=0.82, 95% CI=0.66, 1.03); GG (OR=1.11, 95% CI=0.55, 2.24)] between gastric cancer and non-cancer patients. When stratifying for race, results were similar except that patients with gastric cancer had a significantly higher frequency of AA (OR=1.53, 95% CI=1.14, 2.06) and lower frequency of AG (OR=0.70, 95% CI=0.55, 0.89) than non-cancer patients among Caucasians. When stratifying by the location and Lauren's classification of gastric cancer, we observed no statistically significant differences in genotype distribution. This meta-analysis suggests that the GSTP1 codon 105 polymorphism may be associated with gastric cancer among Caucasians.
European journal of cancer (Oxford, England: 1990) 02/2009; 45(8):1438-42. · 4.12 Impact Factor
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ABSTRACT: Acute ischaemic stroke is a common cause of death and disability. A number of studies published in China have shown that acanthopanax is beneficial for acute ischaemic stroke.
To assess the efficacy and safety of acanthopanax in patients with acute ischaemic stroke.
We searched the Cochrane Stroke Group Trials Register (last searched January 2008), the Chinese Stroke Trials Register (last searched March 2008), and the Trials Register of the Cochrane Complementary Medicine Field (last searched January 2008). In addition, we searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 1, 2008), MEDLINE (1966 to March 2008), EMBASE (1980 to March 2008), CINAHL (1982 to March 2008), AMED (1985 to March 2008), and nine Chinese databases, including the China Biological Medicine Database (CBM-disc) (1979 to March 2008). We handsearched three Chinese journals and searched reference lists, relevant clinical trials registers and research databases. In an attempt to identify further published, unpublished, and ongoing trials, we contacted a pharmaceutical company, researchers and study authors.
We included randomised controlled trials comparing acanthopanax with placebo or open control (no placebo) in patients with acute ischaemic stroke.
Two review authors selected trials for inclusion, assessed trial quality and extracted the data independently.
We included 13 trials (962 participants); the period of follow up in all included trials ranged from 10 to 30 days. None of the trials reported the pre-specified primary outcome death or dependency during the follow-up period. The outcome measure in all included trials was the improvement of neurological deficit after treatment; acanthopanax was associated with a significant increase in the number of participants whose neurological impairment improved (risk ratio (RR) 1.22, 95% confidence interval (CI) 1.15 to 1.29). Two trials reported adverse events; five trials reported no adverse events.
The risk of bias in all the included trials was high, and hence the data were not adequate to draw reliable conclusions about the efficacy of acanthopanax in acute stroke. Much larger trials of greater methodological quality are needed.
Cochrane database of systematic reviews (Online) 02/2009; · 5.72 Impact Factor
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ABSTRACT: Thrombolytic therapy is usually reserved for patients with clinically serious or massive pulmonary embolism (PE). Evidence suggests that thrombolytic agents may dissolve blood clots more rapidly than heparin and might reduce the death rate associated with PE. However, there are still concerns about the possible risk of adverse effects of thrombolytic therapy, such as major or minor haemorrhages. This is an update of a Cochrane review first published in 2006.
To assess the effectiveness and safety of thrombolytic therapy in patients with acute PE.
For this update the Cochrane Peripheral Vascular Diseases Review Group searched their Specialised Register (last searched April 2009) and the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library (last searched Issue 2, 2009). We also searched individual trial collections and private databases, along with bibliographies of relevant articles. Relevant medical journals were handsearched.
Randomised controlled trials (RCTs) that compared thrombolytic therapy with placebo or heparin or surgical intervention in patients with acute PE. We did not include trials comparing two different thrombolytic agents or different doses of the same thrombolytic drug.
Two authors (DB and WQ) assessed the eligibility and quality of trials and extracted data.
We included eight trials, with a total of 679 patients, in this review. Results between thrombolytics compared with heparin alone or placebo and heparin were similar in terms of: a) death rate: odds ratio (OR) 0.89; 95% confidence interval (CI) 0.45 to 1.78; b) recurrence of pulmonary embolism: OR 0.63; 95% CI 0.33 to 1.20; c) major haemorrhagic events: OR 1.61; 95% CI 0.91 to 2.86; d) minor haemorrhagic events: OR 1.98; 95% CI 0.68 to 5.75.We found no trials comparing thrombolytic therapy to surgical intervention.Using recombinant tissue-type plasminogen activator (rt-PA) and heparin together compared to heparin alone appeared to reduce the need for further treatment for in-hospital events (OR 0.35; 95% CI 0.17 to 0.71).Thrombolytics improved haemodynamic outcomes, perfusion lung scanning, pulmonary angiogram assessment and echocardiograms to a greater extent than heparin alone.
Based on the limited evidence found we cannot conclude whether thrombolytic therapy is better than heparin for pulmonary embolism. More double-blind RCTs, with subgroup analysis of patients presenting with haemodynamically stable acute pulmonary embolism compared to those patients with a haemodynamic unstable condition, are required.
Cochrane database of systematic reviews (Online) 02/2009; · 5.72 Impact Factor
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ABSTRACT: Mailuoning is widely used in the treatment of acute ischaemic stroke in China.
To determine the efficacy and safety of mailuoning in the treatment of patients with acute ischaemic stroke.
We searched the Cochrane Stroke Group Trials Register (January 2008), the Chinese Stroke Trials Register (December 2007), the Trials Register of the Cochrane Complementary Medicine Field (December 2007), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 4, 2007), MEDLINE (1966 to December 2007), EMBASE (1980 to January 2008), AMED (1985 to December 2007), the China Biological Medicine Database (CBM-disc 1979 to December 2007) and the Chinese National Knowledge Infrastructure (1979 to December 2007). We searched clinical trials and research registers, handsearched 10 Chinese journals including relevant conference proceedings, scanned reference lists and contacted the pharmaceutical company manufacturing mailuoning. We also attempted to contact trial authors to obtain further data.
Randomised controlled trials comparing mailuoning with placebo or mailuoning plus other treatment compared with the other treatment in patients with acute ischaemic stroke.
Two review authors independently selected trials for inclusion, assessed trial quality and extracted the data.
Fifteen trials involving 1280 participants were included. Numbers of deaths and dependent patients at the end of follow up of at least three months were not reported in the included trials. From six trials that reported adverse events, five events occurred in two trials. Fourteen trials were assessed to be of inferior quality; when analysing these trials together, mailuoning was associated with a significant increase in the number of patients with improved neurological deficit (risk ratio (RR) 0.30; 95% confidence interval (CI) 0.22 to 0.42). One placebo-controlled trial, assessed to be of good methodological quality, failed to show an improvement of neurological deficit at the end of three months follow up (mean difference (MD) 0.69; 95% CI -3.42 to 4.80), or in activities of daily life. Quality of life, assessed in one trial, did not show significant improvement.
We found no convincing evidence, from trials of sufficient methodological quality, to support the routine use of mailuoning to promote recovery after stroke. High-quality and large-scale randomised controlled trials are needed to confirm its efficacy.
Cochrane database of systematic reviews (Online) 02/2009; · 5.72 Impact Factor
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ABSTRACT: Studies investigating the association of polymorphisms in the 5'-untranslated regions (5'UTR) and 3'-untranslated regions (3'UTR) of thymidylate synthase with gastric cancer susceptibility and sensitivity to fluoropyrimidine-based chemotherapy report conflicting results. The objective of this study was to quantitatively summarize the evidence for such a relationship. This meta-analysis included ten studies, which included 1,730 gastric cancer cases and 1,843 controls. The combined results based on all studies showed that there was no significant difference in genotype distribution of 5'UTR or 3'UTR between gastric cancer and noncancer patients. When stratifying for race, we found that: (1) among Asians, patients with gastric cancer had significantly higher frequency of 2R/2R of 5'UTR than did noncancer patients, and (2) among Caucasians, patients with gastric cancer had significantly lower frequency of ins6/ins6 and higher frequency of ins6/del6 of 3'UTR than did noncancer patients. No significantly different response rate or survival of gastric cancer with fluoropyrimidine-based chemotherapy were observed with genotype distribution of 5'UTR or 3'UTR among Caucasians or Asians. This meta-analysis suggests that polymorphisms in the 5'UTR and 3'UTR of thymidylate synthase may be associated with gastric cancer susceptibility, but are not correlated with sensitivity of gastric cancer to fluoropyrimidine-based chemotherapy.
Digestive Diseases and Sciences 12/2008; 54(7):1379-85. · 2.12 Impact Factor
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ABSTRACT: Studies investigating the association between interleukin-10 (IL-10) -1082 promoter polymorphism and gastric cancer risk report conflicting results. The objective of this study was to quantitatively summarise the evidence for such a relationship. Two investigators independently searched the Medline and Embase databases. This meta-analysis included 13 case-control studies, which included 2227 gastric cancer cases and 3538 controls. The combined results based on all studies showed that there was no significant difference in genotype distribution [AA odds ratio (OR)=0.92, 95% confidence interval (CI)=0.73, 1.14; AG (OR=1.09, 95% CI=0.87, 1.36); GG (OR=1.03, 95% CI=0.85, 1.25)] between gastric cancer and noncancer patients. When stratifying for race, results were similar except that patients with gastric cancer had a significantly lower frequency of AA (OR=0.71, 95% CI=0.52, 0.97) and higher frequency AG (OR=1.53, 95% CI=1.15, 2.03) than noncancer patients among Asians. When stratifying by the location of gastric cancer, we found that patients with cardia gastric cancer had a significantly lower frequency of AA (OR=0.53, 95% CI=0.34, 0.83) and higher frequency AG (OR=1.50, 95% CI=1.06, 2.11) than those with noncardia gastric cancer among Caucasians. When stratifying by the Lauren's classification of gastric cancer, we observed no statistically significant differences in genotype distribution. This meta-analysis suggests that the IL-10 -1082 promoter polymorphism may be associated with gastric cancer among Asians, and that differences in genotype distribution may be associated with the location of gastric cancer.
European journal of cancer (Oxford, England: 1990) 09/2008; 44(17):2648-54. · 4.12 Impact Factor
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ABSTRACT: Studies investigating the association between p53 codon 72 polymorphism and gastric cancer risk report conflicting results. The objective of this study was to quantitatively summarize the evidence for such a relationship. Two investigators independently searched the Medline and Embase databases. This meta-analysis included 12 case-control studies, which included 1,665 gastric cancer cases and 2,358 controls. The combined results based on all studies showed that there was no significant difference in genotype distribution [Arg/Arg odds ratio (OR) = 0.96, 95% confidence interval (CI) = 0.79, 1.16; Pro/Pro (OR = 1.21, 95% CI = 0.92, 1.58); Pro/Arg (OR = 0.95, 95% CI = 0.79, 1.14)] between gastric cancer and noncancer patients. When stratifying for race, results were similar except that patients with gastric cancer had a significantly lower frequency of Arg/Arg (OR = 0.84, 95% CI = 0.72, 0.99) than noncancer patients among Asians. Stratified the various studies by the location, stage, Lauren's classification, and histological differentiation of gastric cancer, we found that (i) patients with cardia gastric cancer had a significantly higher frequency of Pro/Pro (OR = 3.20, 95% CI = 1.46,7.01) than those with noncardia gastric cancer among Asians; (ii) patients with advanced (stage III/IV) gastric cancer had a significantly higher frequency of Arg/Arg (OR = 1.48, 95% CI = 1.01, 2.16) than those with early (stage I/II) gastric cancer among Asians; (iii) patients with poor differentiation had a significantly lower frequency of Pro/Pro (OR = 0.13, 95% CI = 0.03, 0.64) than those with well differentiation among Caucasians. This meta-analysis suggests that the p53 codon 72 polymorphism may be associated with gastric cancer among Asians, and that difference in genotype distribution may be associated with the location, stage, and histological differentiation of gastric cancer.
International Journal of Cancer 11/2007; 121(7):1481-6. · 5.44 Impact Factor
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Gang Wang,
Bing Mao,
Ze-Yu Xiong,
Tao Fan,
Xiao-Dong Chen,
Lei Wang, Guan-Jian Liu,
Jia Liu,
Jia Guo,
Jing Chang,
Tai-Xiang Wu,
Ting-Qian Li
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ABSTRACT: The number of randomized controlled trials (RCTs) of traditional Chinese medicine (TCM) is increasing. However, there have been few systematic assessments of the quality of reporting of these trials. Objective: This study was undertaken to evaluate the quality of reporting of RCTs in TCM journals published in mainland China from 1999 to 2004.
Thirteen TCM journals were randomly selected by stratified sampling of the approximately 100 TCM journals published in mainland China. All issues of the selected journals published from 1999 to 2004 were hand-searched according to guidelines from the Cochrane Centre. All reviewers underwent training in the evaluation of RCTs at the Chinese Centre of Evidence-based Medicine. A comprehensive quality assessment of each RCT was completed using a modified version of the Consolidated Standards of Reporting Trials (CONSORT) checklist (total of 30 items) and the Jadad scale. Disagreements were resolved by consensus.
Seven thousand four hundred twenty-two RCTs were identified. The proportion of published RCTs relative to all types of published clinical trials increased significantly over the period studied, from 18.6% in 1999 to 35.9% in 2004 (P < 0.001). The mean (SD) Jadad score was 1.03 (0.61) overall. One RCT had a Jadad score of 5 points; 14 had a score of 4 points; and 102 had a score of 3 points. The mean (SD) Jadad score was 0.85 (0.53) in 1999 (746 RCTs) and 1.20 (0.62) in 2004 (1634 RCTs). Across all trials, 39.4% of the items on the modified CONSORT checklist were reported, which was equivalent to 11.82 (5.78) of the 30 items. Some important methodologic components of RCTs were incompletely reported, such as sample-size calculation (reported in 1.1% of RCTs), randomization sequence (7.9%), allocation concealment (0.3 %), implementation of the random-allocation sequence (0%), and analysis of intention to treat (0%).
The findings of this study indicate that the quality of reporting of RCTs of TCM has improved, but remains poor.
Clinical Therapeutics 07/2007; 29(7):1456-67. · 2.32 Impact Factor
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ABSTRACT: The authors briefly introduced the management of clinical test for new drug development, clinical trials for drugs prepared in hospital and post-market drugs, and other types of clinical trials. The mechanism of WHO International Clinical Trial Register Platform (WHO ICTRP), Chinese Clinical Trial Register (ChiCTR) and Chinese Clinical Trial Registration and Publishing Collaboration (ChiCTRPC) were also introduced. The authors suggested the trialists to practice the basic philosophy of evidence-based medicine as the rules of their thought and action, and considered that this is the inner guarantee system for the validity of clinical trials.
Journal of Chinese Integrative Medicine 06/2007; 5(3):229-33.
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ABSTRACT: To compare three assessment methods (TW2, TW2CH, and TW3) for carpal bone age and their potential applications in diagnosis of idiopathic precocious puberty (IPP) in Chinese girls.
Fifty-five (55) girls with IPP and 83 normal girls as control group were selected in this study. The X-ray films of the left hand-wrist taken at their first visit were analyzed retrospectively. Three assessment methods were used to estimate the carpal bone age with single-blinded method and percentiles were set at 5 different decision thresholds (1)>97th percentile, (2)>90 th percentile, (3)>75th percentile, (4)>50 th percentile, and (5)< or =50th percentile.
All of the three methods showed similar high sensitivity and specificity at the threshold above 90th percentile.
Our data indicate that all of the three methods for estimation of the carpal bone age are useful in diagnosis of IPP. TW2CH and TW3 methods appear to be superior to TW2 method.
Fa yi xue za zhi 05/2007; 23(2):97-100.
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ABSTRACT: To evaluate the clinical value of HER2 overexpression in breast cancer and its prognostic implication in patients with lymph node negative breast carcinoma.
The following electronic database were extracted using appropriate inclusive and exclusive standards: Cochrane library, PUBMED, Embase (1984 - 2003), OVID, CMCC and CNKI. Excel and RevMan 4.2 were used for statistical analysis.
Fifty-six articles were extracted to calculate the positive rate of HER2 overexpression. The pooled positive rate was 23.14% [19.54%, 26.73%], with positive immunohistochemistry (IHC) rate of 23.13% [19.49%, 26.77%] and positive FISH rate of 20.90% [15.54%, 26.25%]. Seven articles were used to evaluate prognostic predication of HER2 expression. It was concluded that in patients with lymph node negative breast carcinoma, HER2 overexpression (both IHC and FISH) independently predicted a poor prognosis based on disease-free survival (DFS) and overall survival (OS) with a P < 0.05. For DFS, the pooled RR was 1.38 [1.07, 1.80] with 1.16 [1.02, 1.31] for IHC and 1.98 [1.56, 2.52] for FISH. For OS, the pooled RR was 1.58 [1.16, 2.14] with 1.37 [1.14 to 1.64] for IHC and 2.33 [1.45 to 3.75] for FISH. HER2 overexpression effectively predicted DFS/OS of patients without adjuvant therapy and OS of patients with the therapy, but not for DFS, with the pooled RR of 1.46 [1.02, 2.09] and 1.11 [0.95, 1.31] for DFS, respectively and the pooled RR of 1.93 [1.44 to 2.58] and 1.25 [1.01, 1.56] for OS, respectively.
In patients with lymph node negative breast carcinoma, the positive rate of HER2 overexpression is 23.14%. HER2 overexpression indicates a poor prognosis and adjuvant therapy after surgery should be recommended.
Zhonghua bing li xue za zhi Chinese journal of pathology 04/2005; 34(3):140-6.
