①供体授精:我们发现,在供体授精的效果方面,尚缺乏高质量证据.②胞浆内精子注射+体外授精:1篇系统评价发现,尚无足够的证据说明胞浆内精子注射+体外授精与单独使用体外授精何者效果更好.③宫腔内人工授精:两篇系统评价发现,宫腔内人工授精较宫颈内授精或自然性交,能明显增加每个周期的妊娠率.④体外授精与配子输卵管内移植:1个RCT显示,尚无足够证据证明体外授精与配子输卵管内移植何者效果更好.
①住院与门诊患者治疗比较：缺乏比较急性单纯性肾盂肾炎女性住院与门诊患者治疗的随机对照试验（RCT）。②静脉用抗生素治疗单纯性感染女性住院患者（氨苄西林，增效复方磺胺）：缺乏静脉用抗生素与不用抗生素治疗比较的RCT；然而，这种RCT不可能实施。1个在女性单纯性肾盂肾炎住院患者中进行的RCT发现，静脉用氨苄西林＋庆大与静脉用增效复方磺胺＋庆大相比，在临床反应或尿细菌复现上无明显差异。1个在女性单纯性肾盂肾炎住院患者中进行的RCT发现，在临床治疗成功率方面，单剂静脉用妥布霉素＋口服环丙沙星与口服环丙沙星＋安慰剂相比无明显差异。缺乏设计良好的比较新、老静脉用抗生素的试验。③口服抗生素治疗单纯性感染妇女（增效复方磺胺、co-fimoxiclav或fluoroquinolone）：缺乏口服抗生素与不用抗生素比较的RCT；然而，这种RCT不可能实施。1篇有关单纯性肾盂肾炎女性患者的系统评价及随后的1篇RCT发现，在细菌学或临床治愈率方面，口服增效复方磺胺、co-amoxiclav或afluoroquinolone（环丙沙星、诺氟沙星、左氧氟沙星或洛美沙星）之间无差别。
To explain how to treat common gastric diseases like chronic gastritis, peptic ulcer, functional dyspepsia and gastric oesophageal reflux disease (GORD) based on evidence-based medicine. Through this paper, we try to help readers find and use clinical evidence to solve clinical problems.
Objective To investigate the current status of randomized controlled trials (RCTs) and clinical controlled trials (CCTs) on pressure sore in China. Methods We searched Chinese Journal of Nursing, Chinese Journal of Practical Nursing and Journal of Nurses Training in CNKI and VIP (January 2000 to December 2005) for Chinese articles on pressure sore, using "pressure sore", "bed sore", "nursing", "treatment", "prevention", "evaluation" and "management" as search terms. The retrieved articles were summarized. Results We identified 16 reports (10 RCTs and 6 CCTs). The studies were judged to be of low quality.There was one study on the evaluation, two on the prevention, and 13 on the treatment of pressure sores. Conclusion The current studies on pressure sore in China are focusing on treatment. Randomized controlled trials of large sample size of pressure sore are needed to improve nursing quality.
Perineal care is a classic topic for obstetrics. After thousands of years of practice, we have accumulated some experience and meanwhile, we are also taking some attempts. The effectiveness and reliability of these methods need evaluation. Nowadays, the best evidence comes from randomized controlled trials (RCT) and systematic reviews (SR). We searched The Cochrane Library (Issue 3, 2007), MEDLINE (Jan. 1980 to May 2007) databases and CBM-disc (Jan. 1980 to May 2007) to obtain current best evidence for perineal care.
This paper introduces the process of design and implementation on the clinical evidence database of acupuncture (ACU-CED), including establishing expert groups on the basis of demands to formulate top-design, project implementation plans and standard, comprehensively searching publications of clinical randomized controlled trials (RCTs) of acupuncture and moxibustion, conducting strictly data extraction and evaluation, and eventually achieve automatic utilization of clinical evidence. ACU-CED will become the first structural data platform with the function of searching-screening-result, analysis-data, and statistics-evidence extraction, which fills in gapes in database of clinical evidence sources, increases efficiency of evidence transformation, and reduces waste of resources. It will also achieve auto-completion of systematic review/meta-analysis as well as visualization of clinical evidence, so as to provide evidence for clinical decision, guidelines and disease spectrum of acupuncture therapy.
Having searched The Cochrane Library (Issue 4, 2005), we found: fluoride can reduce the occurrence and severity of white spot lesions; removal of premature contacts of the primary teeth can prevent posterior crossbite; expanding the top teeth can decrease the risk of a posterior crossbite; CSF may help retaining teeth; clear overlay retainer may settle teeth quicker than Hawley retainer; adhesives for fixed orthodontic brackets is still in dispute.
Objective To give an individualized treatment to a young woman with primary dysmenorrhea. Methods According to the basic principle and methods of evidence-base medicine, we searched The Cochrane Library (Issue 1, 2009), MEDLINE (PubMed, January 1950 to May 2009), ACP Journal Club (OVID, January 1991 to May 2007) for systematic reviews and randomized controlled trials (RCTs) to acquire the best clinical evidence on the treatment of primary dysmenorrhea. Results A total of 11 systematic reviews and 1 RCT were identified. A reasonable treatment plan was made through combining the patient’s will with her family members’. Conclusion The treatment effect on primary dysmenorrhea of the young woman is improved by an individualized treatment plan based on an evidence-based method.