Objective To systematically evaluate the correlation between coffee and risk of endometrial cancer. Methods Such databases as CBM, CNKI, WanFang data, PubMed, EMbase and The Cochrane Library (Issue 5, 2012) were searched to collect the prospective cohort studies about correlation between coffee and endometrial cancer. The retrieval time was by the end of May 2012, and the references of the included literature were also retrieved. Two evaluators independently screened the literature according to the inclusion and exclusion criteria, extracted the data, and assessed the quality, and then the statistical analysis was conducted by using Stata 12.0 software. Results A total of 10 cohort studies involving 4 484 patients with endometrial cancer were included. The results of meta-analysis showed that, compared with the women who didn’t drink coffee or drank in the lowest dose, the women who drank coffee in the highest dose had a decreased risk of endometrial cancer (RR=0.69, 95%CI 0.62 to 0.78), same as the women who drank coffee frequently (RR=0.83, 95%CI 0.77 to 0.89). The results of dose-response analysis revealed that, when there was an increase of 2 more cups of coffee per day, there was the risk of endometrial cancer decreased by 12%. Conclusion Drinking coffee frequently (more than 2 cups per day) can decrease the risk of endometrial cancer which can be significantly decreased when drinking in a big dose (more than 5 cups per day).
ObjectiveTo systematically review the efficacy and safety of laparoscopic versus open nephrectomy in the treatment of autosomal dominant polycystic kidney disease (ADPKD). MethodsWe searched databases including MEDLINE, EMbase, The Cochrane Library (Issue 1, 2015), Web of Science, CBM and WanFang Data to collect relevant clinical studies comparing the efficacy and safety of laparoscopic versus open nephrectomy for ADPKD from inception to Jan, 2015. Two reviewers independently screened literature, extracted data and assessed the risk bias of included studies. Then, RevMan 5.4 software was used for meta-analysis. ResultsA total of six retrospective cohort studies involving 182 patients were included. The results of the meta-analysis showed that:compared with the open nephrectomy group, the average hospitalization time was shorter (MD=-4.38 days, 95%CI -5.93 to -2.83, P=0.000 01) and the blood transfusion risk was lower (OR=0.25, 95%CI 0.10 to 0.62, P=0.003) in the laparoscopic nephrectomy group. However, there was no significant difference between two groups in the incidence of overall complications (OR=0.51, 95%CI 0.24 to 1.06, P=0.07). ConclusionThe application of laparoscopic nephrectomy for ADPKD can reduce the hospitalization time and blood transfusion risk when compared with the open nephrectomy, but the two operations have similar overall complication rate. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
ObjectiveTo systematically review the safety of low molecular weight heparin (LMWH) in pregnancy. MethodsPubMed, EMbase, The Cochrane Library, WanFang Data, VIP, and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) and cohort studies on the safety of LMWH in pregnancy from inception to March 30th, 2020. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Meta-analysis was then performed using RevMan 5.3 software. ResultsA total of 77 RCTs and 13 cohort studies were included. The results of meta-analysis showed that LMWH increased the incidence of postpartum hemorrhage (RR=1.50, 95%CI 1.00 to 2.25, P=0.05). However, there was no significant difference. The incidence of hematological adverse events was different from the results of RCTs and cohort studies. The results of RCT subgroup analysis showed that LMWH increased ecchymosis at the injection site (RR=1.60, 95%CI 1.24 to 2.08, P=0.000 4). However, the incidence of overall skin system adverse events did not increase significantly. LMWH reduced the incidence of cardiovascular adverse events (RR=0.18, 95%CI 0.07 to 0.46, P=0.000 3). LMWH failed to increase the occurrence of fetal congenital malformations, digestive system, central nervous system, skeletal system, and systemic adverse events. ConclusionsCurrent evidence suggests that LMWH is relatively safe to use during pregnancy. However, whether it increases postpartum hemorrhage and hematological adverse events is unclear. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify the above conclusions.
ObjectiveTo systematically review the correlation between type 2 diabetes mellitus (T2DM) and the risk of kidney cancer. MethodsPubMed, EMbase, Web of Science, CBM, VIP and CNKI databases were electronically searched to collect cohort studies on the association between T2DM and kidney cancer from inception to August 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis then performed by using Stata 15.0 software. ResultsA total of 17 cohort studies involving 2 003 165 T2DM patients were included. The results of meta-analysis showed that patients with T2DM had a higher kidney cancer risk than controls (RR=1.51, 95%CI 1.39 to 1.64, P<0.001). Subgroup analysis showed that the incidence of kidney cancer in T2DM patients was higher in different gender, region, population, follow-up time, diabetes assessment method and other subgroups. ConclusionsCurrent evidence shows that T2DM is a risk factor for kidney cancer.
In response to the specific requirements of nutrition research, Schwingshackl’s research group developed the NutriGrade grading system, which independently assessed the quality of evidence in randomized controlled trials and cohort studies in nutrition, aiming to summarize the associations or effects between different nutritional factors and outcomes and meet the specific needs of evidence users. It has the advantages of novel classification, quantifiability, independence and pertinence, and it has better consistency, fairness, reliability and feasibility. Well-designed prospective cohort studies are more feasible in the field of nutrition than randomized controlled trials. The grading of the evidence quality for cohort studies included the following eight items: a) risk of bias, study quality, and study limitations; b) precision; c) heterogeneity; d) directness; e) publication bias; f) funding bias; g) effect size; and h) dose-response. Based on the evaluation results of the above items, the evidence quality could be divided into four grades: high (8-10), moderate (<8), low (<6), and very low (<4). The purpose of this paper was to introduce the basic principles, specific contents, and application methods of the NutriGrade grading system for cohort studies and cite examples to provide references for relevant researchers.
ObjectiveTo evaluate the efficacy of myomectomy via transumbilical laparoendompic single-site surgery (TU-LESS) and traditional multiport laparoscopy.MethodsThe study was conducted at Chengdu Western Hospital from June 2019 to June 2020. Fifty patients underwent TU-LESS myomectomy (TU-LESS group), while another 50 patients underwent traditional multiport laparoscopic myomectmy (multiport laparoscopy group). The conditions of operation, extra analgetic usage, VAS grade, and patients’ satisfaction degree were compared between two groups.ResultsPatients in both groups had similar age, BMI, fibroma volume, operative time, expelling gas day, blood loss, complication rate, and hospitalized costs (P>0.05). Compared with traditional multiport laparoscopy, the TU-LESS group resulted in significantly shorter hospitalization day, lower VAS score of the 1st/3nd/7th days after surgery, less use of analgetic after surgery, and higher satisfaction degree.ConclusionsTU-LESS is safe and feasible for myomectomy, and it is associated with less pain, shorter hospitalization day, and higher satisfaction degree.
Objective To investigate the expression of Bcl-2 in acute leukemia of different pathological states and its relationship with chemotherapeutic efficacy. Methods Case-control studies and cohort studies were collected by searching the electronic bibliographic databases such as CBMdisc (1979 to 2010), Chinese Sic-tech Periodical Full-text Database (1989 to 2010), WanFang (1982 to 2010), Chinese Journals Full-text Database (since 1994), China Master’s Theses Full-text Database (since 1999), and China Doctor Dissertations Full-text Database (since 1999). All the relevant studies were identified and the quality of the included studies was assessed. The RevMan 5.0 software was used for meta-analysis. Results A total of 10 studies were included. The results of meta analyses showed: the complete remission of acute leukemia with Bcl-2 positivity was lower than that of the Bcl-2 negative patients after chemotherapy and the difference between them was significant (OR=0.26, 95%CI 0.14 to 0.46); the difference between acute lymphocytic leukemia and acute non-lymphocytic leukemia in terms of Bcl-2 positive rate was not significant (OR=0.87, 95%CI 0.46 to 1.65); the Bcl-2 positive rate in complete remission (CR) patients after chemotherapy was significantly lower than that of partial remission (PR) and none remission (NR) patients (SMD= –0.87, 95%CI –1.53 to –0.20, P=0.01). Conclution The current domestic evidence proves that Bcl-2 is significantly correlated with the remission rate of acute leukemia patients, but more high-quality studies are still needed.
ObjectiveTo systematically review the prognostic value of circulating tumour cells (CTCs) in non-metastatic breast cancer patients. MethodsWe electronically searched PubMed, EMbase, WanFang Data, CNKI and CBM for collecting cohort studies about the prognostic relevance of CTCs in the peripheral blood of stage I to Ⅲ breast cancer patients from inception to March 20th, 2014. Two reviewers independently screened studies according to the inclusion and exclusion criteria, extracted data and assessed methodological quality. Meta-analysis was conducted using RevMan 5.2 software. ResultsA total of 7 studies involving 1 780 patients were eligible for final analyses. The results of meta-analysis showed that, the presence of CTCs was associated with both poor DFS (RR=2.24, 95%CI 1.92 to 2.61, P < 0.000 01) and OS (RR=2.55, 95%CI 1.99 to 3.28, P < 0.000 01). The results of subgroup analysis by detection time of CTCs showed that CTCs detected before and after adjuvant chemotherapy was a statistically significant prognostic factor (P≤0.000 4). ConclusionCTCs is an adverse prognostic factor in non-metastatic breast cancer patients, which is not significantly influenced by adjuvant chemotherapy.
ObjectivesTo systematically review the risk factors of complete uterine rupture so as to provide evidence for prevention of uterine rupture.MethodsPubMed, EMbase, The Cochrane Library, CBM and CNKI databases were electronically searched to collect case-control studies or cohort studies on the risk of complete uterine rupture from inception to October, 2019. Two reviewers independently screened literature, extracted data and assessed the quality of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 18 studies, involving 2 104 607 cases were included. The results of meta-analysis showed that the risk factors of complete uterine rupture included single-layer suture of uterine incision (OR=1.78, 95%CI 1.15 to 2.78, P=0.01), induction of labor (OR=1.72, 95%CI 1.21 to 2.45, P=0.003) (case-control studies) and (OR=2.66, 95%CI 1.87 to 3.79, P<0.000 01) (cohort studies), induction with prostaglandins (OR=3.23, 95%CI 1.48 to 7.06, P=0.003), induction with oxytocin (OR=3.97, 95%CI 1.65 to 9.59, P=0.002), and augmentation of labor with oxytocin (OR=2.17, 95%CI 1.53 to 3.09, P<0.000 1) (case-control studies) and (OR=2.29, 95%CI 1.24 to 4.23, P=0.008) (cohort studies). There was no significant relationship between birth weight and complete uterine rupture (OR=1.26, 95%CI 0.74 to 2.17, P=0.40).ConclusionsCurrent evidence shows that single layer suture of uterine incision, induction of labor, induction with prostaglandins, induction with oxytocin and augmentation of labor with oxytocin are the risk factors of complete uterine rupture. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify above conclusions.
Objective To systematically review the correlation between diabetes and the incidence rate of colorectal cancer, so as to provide objective proof for early screening diabetic patients with colorectal cancer. Methods The databases such as MEDLINE and EMbase published from January 1990 to July 2010 were searched to include cohort studies. The meta-analysis including seventeen qualified studies was performed by using the Cochrane Collaboration’s RevMan 4.3 software. Results The results of meta-analyses of 17 cohort studies involving 1 690 869 participants indicated that the diabetes patients had a higher incidence rate of colorectal cancer compared with the control group (16.50‰ vs. 10.13‰). The odds ratio (OR) was 1.43, and the 95% confidence interval (CI) was from 1.29 to 1.60. The results were consistent by sex compared with the control group, although the OR for colorectal cancer in diabetes was little higher in males than females (1.47 vs. 1.41). Conclusion Diabetes mellitus is a risk factor of inducing colorectal cancer.