1.Fecal Microbiota Transplantation for Ulcerative Colitis:An Overview of Systematic Review/meta-analysis
Xueqing GONG ; Tongting LIU ; Lanxin FAN
Chinese Journal of Gastroenterology 2023;28(6):335-343
Background:The morbidity of ulcerative colitis(UC)is high,and is easily recurrent.A number of systematic review/meta-analysis have explored the efficacy and safety of fecal microbiota transplantation(FMT)in the treatment of UC with varying conclusions,however,the quality of these studies has not yet been adequately assessed.Aims:To overview the systematic review/meta-analysis of FMT for UC.Methods:Systematic review/meta-analysis of FMT in the treatment of UC were retrieved from PubMed,Cochrane Library,Embase,Web of Science,CNKI,CBM,Wanfang,VIP and other databases from the date of database establishment to May 2023,while gray literatures were searched and experts were consulted.Literature screening and extract information were performed by two researchers.The PRISMA checklist,AMSTAR-2 tool was used to assess the reporting quality and methodological quality,respectively,as well as to grade the quality of evidence for outcome measurements based on the GRADE system.Results:Seventeen systematic review/meta-analysis were finally included.The original studies included randomized controlled trials and observational studies.Most of the studies drew positive conclusions about the efficacy and safety of FMT in the treatment of UC.The PRISMA checklist score was 12.5-22.5,and the mean score was 17.68.Three studies reported relative completeness;ten had some deficiencies;and four had relatively serious report deficiencies.AMSTAR-2 tool showed that two were of intermediate quality,three were of low quality,and twelve were of very low quality.GRADE system ratings showed that six of the eight outcome measurements were of intermediate quality and two were of low quality.Conclusions:FMT may be a safe and effective treatment for UC,but the quality of the current evidence is low and users of clinical evidence need to treat the above evidence with caution.
2.Fecal Microbiota Transplantation for Ulcerative Colitis:An Overview of Systematic Review and Meta-analysis
Xueqing GONG ; Tongting LIU ; Lanxin FAN
Chinese Journal of Gastroenterology 2023;28(8):460-469
Background:Ulcerative colitis(UC)is highly prevalent and recurrent.A number of systematic review/meta-analysis have explored the efficacy and safety of fecal microbiota transplantation(FMT)in the treatment of UC with varying conclusions,however,the quality of these studies has not yet been adequately assessed.Aims:To overview of systematic review/meta-analysis of FMT for UC.Methods:Systematic review/meta-analysis of FMT for the treatment of UC were retrieved from PubMed,Cochrane Library,Embase,Web of Science,CNKI,CBM,Wanfang,VIP and other databases from the date of database establishment to May 2023,while gray literature was searched manually and experts were consulted.Literature screening and extract information were performed by two researchers.The PRISMA checklist,AMSTAR-2 tool was used to assess the reporting quality and methodological quality,respectively,as well as to grade the quality of evidence for outcome measurements based on the GRADE system.Results:Seventeen systematic review/meta-analysis were finally included.The original studies included randomized controlled trials and observational studies.Most of the studies drew positive conclusions about the effectiveness and safety of FMT in the treatment of UC,but some of them only made inferences about possible effectiveness.The PRISMA checklist score was 12-22.5,and the mean score was 17.68.Four studies(23.5%)reported relative completeness;nine(52.9%)had some deficiencies;and four(23.5%)had relatively serious information deficiencies.AMSTAR-2 score showed that two were of intermediate quality,three were of low quality,and twelve were of very low quality.GRADE ratings showed that five of the eight outcome measurements were of intermediate quality and three were of low quality.Conclusions:FMT may be a safe and effective treatment for UC,but the quality of the current evidence is low and users of clinical evidence need to treat the above evidence with caution.
3.Establishment and Validation of Clinical Prediction Model for 1-year MACEs Risk After PCI in CHD Patients with Blood Stasis Syndrome
Shiyi TAO ; Lintong YU ; Deshuang YANG ; Gaoyu ZHANG ; Lanxin ZHANG ; Zihan WANG ; Jiarong FAN ; Li HUANG ; Mingjing SHAO
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(20):69-80
ObjectiveTo establish and validate a clinical prediction model for 1-year major adverse cardiovascular events(MACEs)risk after percutaneous coronary intervention (PCI) in coronary heart disease (CHD) patients with blood stasis syndrome. MethodThe consecutive CHD patients diagnosed with blood stasis syndrome in the Department of Integrative Cardiology at China-Japan Friendship Hospital from September 1, 2019 to March 31, 2021 were selected for a retrospective study, and basic clinical features and relevant indicators were collected. Eligible patients were classified into a derivation set and a validation set at a ratio of 7∶3, and each set was further divided into a MACEs group and a non-MACEs group. The factors affecting the outcomes were screened out by least absolute shrinkage and selection operator (Lasso) and used to establish a logistic regression model and identify independent prediction variables. The goodness-of-fit of the model was evaluated by the Hosmer-Lemeshow test, and the area under curve (AUC) of the receiver operating characteristic (ROC) curve, calibration curve, decision curve analysis (DCA), and clinical impact curve (CIC) were employed to evaluate the discrimination, calibration, and clinical impact of the model. ResultA total of 731 consecutive patients were assessed and 404 eligible patients were enrolled, including 283 patients in the derivation set and 121 patients in the validation set. Lasso identified ten variables influencing outcomes, which included age, sex, fasting plasma glucose (FPG), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), homocysteine (Hcy), brachial-ankle pulse wave velocity (baPWV), flow-mediated dilatation (FMD), left ventricular ejection fraction (LVEF), and Gensini score. The multivariate Logistic regression preliminarily identified age, FPG, TG, Hcy, LDL-C, LVEF, and Gensini score as the independent variables that influenced the outcomes. Of these variables, male, high FMD and high LVEF were protective factors, and the rest were risk factors. The prediction model for 1-year MACEs risk after PCI in CHD patients with blood stasis syndrome showed χ2=12.371 (P=0.14) in Hosmer-Lemeshow test and the AUC of 0.90. With the threshold probability > 10%, the model showed better prediction performance for 1-year MACEs risk after PCI in CHD patients with blood stasis syndrome than for that in all the patients. With the threshold probability > 60%, the estimated value was much closer to the real number of patients. ConclusionThe established clinical prediction model facilitates the early prediction of 1-year MACEs risk after PCI in CHD patients with blood stasis syndrome, which can provide ideas for the precise treatment of CHD patients after PCI and has guiding significance for improving the prognosis of the patients. Meanwhile, multi-center studies with larger sample sizes are expected to further validate, improve, and update the model.