3.Development and Quality Evaluation of Evidence-based Clinical Practice Guidelines of Chinese Medicine.
Chinese Journal of Integrated Traditional and Western Medicine 2016;36(1):11-15
More attentions have been paid to the development of evidence-based clinical practice guidelines (ECPGs) of Chinese medicine (CM). International guideline evaluation instruments such as Appraisal of Guidelines for Research and Evaluation (AGREE I) has been gradually applied in ECPGs quality evaluation of CM. Nowadays, there are some certain methodological defects in partial ECPGs of Chinese medicine, with relatively low applicability and slowly update. It is suggested to establish technical specifications of CM-ECPGs in accordance with the characteristics of CM and international general specification, strengthen the quality evaluation of CM-ECPGs, attach great importance to the regularly update as well as popularization and application of CM-ECPGs.
Evidence-Based Medicine
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Humans
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Medicine, Chinese Traditional
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Practice Guidelines as Topic
8.Efficacy and safety of Bevacizumab versus MMC in augmenting trabeculectomy：a Meta-analysis
Yue, WANG ; Min, KE ; Wen-Huan, WANG
International Eye Science 2016;16(11):2030-2035
AIM: To compare the efficacy and safety of bevacizumab with mitomycin ( MMC ) in augmenting trabeculectomy for glaucoma.
METHODS: Databases including PubMed, CBM, CNKI, VIP and WanFang Data were electronically searched for all randomized controlled trials ( RCTs) about comparing the efficacy and safety between bevacizumab and MMC in augmenting trabeculectomy for glaucoma before the date of Jun. 2016. Two reviewers independently screened literatures according to the inclusion and exclusion criteria, and evaluated the included studies. Then, Meta-analysis was performed.
RESULTS: A total 4 RCT involving 286 eyes ( 143 for bevacizumab group, 143 for MMC group) were included. The results of Meta-analysis showed that there was no significant difference between bevacizumab and MMC in the last follow-up after surgery in IOP (WMD=2. 21, 95%CI: -0.17 to 4.58, P=0.07), complete success rate (OR=0. 69, 95%CI:0. 26 to 1. 81, P=0. 45) and the numbers of anti-glaucoma medicine ( OR= 0. 12, 95%CI: -0. 15 to 0.39,P=0. 39). And there was no significant difference between bevacizumab and MMC in postoperative complications:hypotony (OR=0.7, 95%CI:0.12 to 4.05, P=0.69), bleb leak (OR=1, 95%CI: 0. 21 to 4. 74,P=1), encapsulated bleb (OR=1. 15, 95%CI: 0. 38 to 3. 44, P=0.81), choroidal detachment (OR=1. 22, 95%CI: 0. 29 to 5.22, P=0. 78) and cataract (OR=1. 15, 95%CI: 0. 38 to 3.44, P=0. 81).
CONCLUSION: Bevacizumab and MMC in augmenting trabeculectomy for glaucoma have similar efficacy and safety. Bevacizumab can't result in better outcome in term of IOP reduction. Clinicians should choose suitable solution according to disease characteristics.
9.Duration of active phase affects delivery mode and pregnancy outcomes
Xiaowei ZHANG ; Ke MA ; Yue DONG
Chinese Journal of Perinatal Medicine 2013;(3):148-152
Objective To investigate the effects of duration of active phase on delivery mode and pregnancy outcome.Methods Data of 417 women with abnormal active phase identified from 1744 term-birth,singleton,cephalic presentation primiparas who had tried vaginal delivery in Peking University First Hospital from January 1,2009 to December 31,2009 were retrospectively studied.Effects of different durations of protracted active phase on pregnancy outcomes were compared between women with vaginal delivery or cesarean section by Chi square test.Results The incidence of protracted active phase was 23.9％ (417/1744); and the incidence of prolonged active phase was 2.9％ (50/1744).There were 205 cases of cesarean section and 212 cases of vaginal deliveries.The incidence of neonates hospitalization in Department of Pediatrics in vaginal delivery group with active phase ≥6 h was higher than that of those with active phase ＜6 h [20.6％ (26/126) vs 8.1％ (7/86),x2 =6.07,P＜0.05].The incidence of intrauterine infection in cesarean section group with active phase ＜6 h were higher than that of those with active phase ≥6 h [22.7％ (30/132) vs 6.8％(5/73),x2 =8.37,P＜0.01].In vaginal group with protracted active phase before 6 cm of cervical dilation,the incidences of postpartum hemorrhage (4.8％,9/186),maternal complications (3.8％,7/186) and neonates hospitalization (15.6％,29/186) were similar with those after 6 cm of cervical dilation [6.2％ (1/16),x2=0.12; 0.0％ (0/16),x2=0.01 and 12.5％ (2/16),x2=0.00; all P＞0.05] respectively.In cesarean delivery group with cervical dilation ≥6 cm,the incidence of neonates hospitalization was higher than that of those with cervical dilation ＜6 cm [60.0％ (6/10) vs 19.9％ (34/171),x2 =8.83,P＜0.05].There were no difference in maternal age,gestational age,body mass index at delivery,volume of postpartum hemorrhage and neonatal birth weight between women with cesarean section whose protracted active phase ≥4 h or ＜4 h when cervical dilation at 3 cm (P＞ 0.05 respectively).The incidence of neonates hospitalization was low in women whose indication of cesarean section was protracted active phase (11.2％,9/80),while it was high when protracted active phase complicated with intrauterine infection (42.1％,16/38).Conclusions Protracted active phase with cervical dilation less than 6 cm might not need active management if neither the mother nor the fetus is compromised.The infants born vaginally should be closely monitored if the active phase is over 6 h.
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