9scores). Results Fifty-five of fifty-seven cases with CT between 0～6 scores,which considered to be resected,underwent tumor resection . The accuracy of prediction of CT was 96.5%. Conclusions Preoperative CT scord could accurately predict the resectability and difficulty of pancreatic cancer.

Objective To investigate the characteristics of respiratory impedance in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods The impulse oscillometry(IOS) and polysomnography (PSG) indices were measured in 52 patients with OSAHS, 13 patients with chronic obstructive pulmonary disease (COPD) and 17 healthy persons. Results The levels of R20, total respiratory impedence and central airway resistance in the patients with OSAHS were significantly higher than those in healthy persons (P

Objective To probe into the inhibiting action of Compound Biejiarangan Troche on alcohol hepatic fibrosis in rats. Methods Forty Wistar male rats were divided into control, model, Compound Biejiarangan Troche and Anfate treatment groups. Alcohol hepatic fibrosis model was established by intragastrical perfusion with mixture of "alcohol-Pyrazole-coil oil" and high-fat diet for sixteen weeks. After four weeks’ intervention, changes of hepatic fibrosis index, liver tissue pathology and expression of TGF-?1 in liver tissue were observed. Results The hepatic function of model rats were changed and abnormal, with obvious fibrosis in hepatic histopathology. After intervention for four weeks, HA decreased (P

ObjectiveTo evaluate the clinical efficacy and safety of gefitinib versus docetaxel in previously treated non-small cell lung cancer.Methods Literatures were searched on database like PubMed,EMBASE,Cochrane Library,Chinese Biomedical Literature Database,China Journal Full Text Database,and Chinese Scientific Journals Full Text Database and Wanfang Database.All the relevant randomized controlled trials that gefitinib versus docetaxel in non-small cell lung cancer patients who have previously received chemotherapy were collected,and the quality of the included trials was assessed by Cochrane Systematic Review Handbook 5.0.2. Meta-analyses were conducted by RevMan 5.0 software. Results Four studies were involved and 2 257 patients were included.Meta-analysis showed that gefitinib can improve objective response rate and quality of life in local advanced non-small cell lung cancer patients who have previously received chemotherapy compared with docetaxel ( P ＜ 0.05) ； and it's low in the 3-4 level adverse reaction rate (P ＜ 0.05 ).But there was no significant difference in overall survival rate,symptoms improving rate and progression-free survival rate (P ＞ 0.05).ConclusionsGefitinib is superior to docetaxel in the objective response rate with local advanced or metastatic non-small cell lung cancer patients who have previously received chemotherapy.The quality of life of the patients is improved significantly.Because of it has high drug tolerance and high safety,gefitinib can be actively promoted application as a kind of current effective second-line drugs at present,but the survival aspect needs to be studied further.

Objective To assess the methodological and ethical quality of randomized controlled trials (RCT) of non-small cell lung cancer ( NSCLC ) in China. Methods The methodological and ethical quality on RCT of NSCLC, covered in CBM, CNKI, VIP and Wanfang was assessed according to the Jadad Scale and Berdeu Scale respectively. Results The average methodological and ethical quality was 62. 24% according to the Jadad Scale and was 18. 79% according to the Berdeu Scale. Correlation analysis showed that the methodological quality was closely correlated with the ethical quality, except that of curative effect of invasive therapy (OR=1. 064, 95%CI:0. 832-1. 361, P>0. 05). Conclusion The methodological and ethical quality of RCT of NSCLC in China is low. The methodological quality is positively correlated with the ethical quality.

Objective To evaluate the efficacy and safety of lentinan injection plus cisplatin (LIC) in the treatment of malignant pleural effusion (MPE).Methods We searched the database of Cochrane Library,PubMed,EMBASE,ISI Web of Knowledge,Chinese Biomedical Literature Database,Chinese Scientific Journals Full-text Database,Chinese Journal Full-text,and Google Scholar,etc.,up to February 28th,2011 to identify randomized controlled trials (RCTs) about lentinan injection (LI) for MPE,evaluate the quality of the included studies,and analyze the data by Cochrane Collaboration's RevMan5.0 software.Results Twenty-nine RCTs involving 1831 patients were included.Meta analysis results suggested that there were some differences when comparing LIC with control groups suffering from MPE,for LIC could improve the near-term curative effect and the quality of life to some extent.Besides,compared with chemotherapy alone,LI plus chemotherapy had an advantage in relieving adverse reactions,such as gastrointestinal reactions,myelosuppression,chest pain,and general malaise.Conclusion The current evidence indicates that LI may have adjuvant therapeutic effects for MPE.

Objective To evaluate the safety and comfort of postoperative patients with hepatocellular carcinoma after interventional therapy in the early stage and late stage, so as to determine the time to get out of bed after operation. Methods We searched PubMed, EMbase, Cochrane Library (2016 second), Web of Science, CBM, Wanfang Data and CNKI database, collect test/ambulation time of hepatocellular carcinoma after interventional therapy were searched from inception to September 10, 2016. Meta analysis was performed by 2 reviewers independently by screening literature, extracting data and evaluating the risk of bias in the study. RevMan 5.0 software was used to analyze the data. Results A total of 9 studies were included in the study, and 1164 patients were included. The Meta analysis results showed that:compared with 24 hours in bed after operation, 12 hours early ambulation method to reduce postoperative pain, postoperative [odds radio (OR)=0.07, 95% confidence interval (CI) 0.03-0.15, P <0.05] and dysuria (OR =0.18, 95% CI 0.10-0.33, P < 0.05), abdominal distension (OR =0.14, 95% CI 0.07-0.29, P<0.05), insomnia (OR=0.15, 95% CI 0.05-0.43, P<0.05). But in the local punctura, such as congestion (OR=0.99, 95%CI 0.45-2.18, P=0.98), hematoma (OR=0.90, 95% CI 0.38-2.13, P=0.80), the difference was not statistically significant. Conclusions The available evidence indicates that the early postoperative 12 hours after interventional therapy can effectively reduce the incidence of postoperative complications. To be included in the quantity and quality of the research, the conclusion still need to carry out more high-quality research to be verified.

Objective: To assess the implementation effects of clinical pathways, compared with usual care, among patients with stroke. Methods:Two investigators independently searched PubMed, Embase, the Cochrane Library, Web of Science, Chinese Biomedical Literature Database and Wanfang Database for studies published before December 2014. Jadad methodological approach was applied to assess the quality of included studies and RevMan software (version 5.2.7) was used for meta-analysis. Results: A total of 11 RCTs involving 913 patients were included in this meta-analysis. The overall results showed that a shorter average length of stay [MD = -2.92; 95% CI (-4.06, -1.78); P < 0.001] and a lower inpatient expenditures [SMD = -1.64; 95% CI (-1.80, -1.48); P < 0.001] in clinical pathways group comparing with the usual care group. The higher score of patient satisfaction was also seen in clinical pathways group. Conclusion: clinical pathways may reduce the average length of stay, reduce the inpatient expenditures, increase patient satisfaction and improve the quality of care in stroke management.

Objective: To assess the implementation effects of clinical pathways, compared with usual care, among patients with stroke. Methods:Two investigators independently searched PubMed, Embase, the Cochrane Library, Web of Science, Chinese Biomedical Literature Database and Wanfang Database for studies published before December 2014. Jadad methodological approach was applied to assess the quality of included studies and RevMan software (version 5.2.7) was used for meta-analysis. Results: A total of 11 RCTs involving 913 patients were included in this meta-analysis. The overall results showed that a shorter average length of stay [MD = -2.92; 95% CI (-4.06, -1.78); P < 0.001] and a lower inpatient expenditures [SMD = -1.64; 95% CI (-1.80, -1.48); P < 0.001] in clinical pathways group comparing with the usual care group. The higher score of patient satisfaction was also seen in clinical pathways group. Conclusion: clinical pathways may reduce the average length of stay, reduce the inpatient expenditures, increase patient satisfaction and improve the quality of care in stroke management.
Stroke

Objective To assess the efficacy of ganciclovir to prevent and cure cytomegalovirus (CMV) infection after renal transplantation. Methods We searched PubMed, EMBASE, Cochrane Library, SCI, China Academic Journals Full-text Databases, Chinese Biomedical Literature Database, Chinese Scientific Journals Databases and Chinese Medical Association Journals to collect randomized controlled trials of ganciclovir to prevent and cure CMV infection after renal transplantation (up to June, 2009). Two reviewers extracted data independently using a designed extraction form. The quality of included trials was evaluated according to the Cochrane Handbook. RevMan 5.0 software was used for data analysis. Results Twelve randomized controlled trials were included. The results of meta-analysis showed that: ①Compared with no receive antiviral agents, ganciclovir couldn't lower CMV infection rate and disease rate in 3 months and 6 months after renal transplantation, but could lower CMV disease rate in 12 months. The delay between transplantation and CMV infection was significantly longer. ②Either valaciclovir or ganciclovir could lower CMV infection rate and disease rate after renal transplantation, without statistical difference. ③Compared with acyclovir, ganciclovir could lower CMV disease rate in 6 months after renal transplantation. ④Compared with CMV-IgG and valganciclovir, ganciclovir didn't have statistical difference in decreasing CMV disease rate (P=0.93;P=0.14). Conclusions Longer prophylaxis by ganciclovior may prevent CMV infection after renal transplantation. Its curative effect is similar to valaciclovir, CMV-IgG and valganciclovir, but better than acyclovir.