Evidence Based Medicine Center

Lanzhou, China

Evidence Based Medicine Center

Lanzhou, China
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Tam K.-W.,Taipei Medical University Hospital | Tsai L.-W.,Evidence Based Medicine Center | Wu C.-C.,Evidence Based Medicine Center | Wei C.-F.,Taipei Medical University Hospital | Chen S.-C.,Taipei Medical University Hospital
Journal of Evaluation in Clinical Practice | Year: 2011

Rationale, aims and objectives Evidence-based medicine (EBM) journal clubs are used by health care practitioners to critique and remain updated on relevant health literature. Vote cards, in three different colours (green/yellow/red), allow participants to express their opinions (agree/doubt/reject) on the quality and possibility of clinical application regarding the article being reviewed. Our aim is to assess the efficacy of using vote cards in EBM journal clubs. Methods Evidence-based medicine journal club is held on a weekly basis in the Department of Surgery in Taipei Medical University Hospital, Taiwan. The participants of EBM journal clubs include medical students, resident doctors and primary care faculty members. After the presentation, participants use their vote cards to critically appraise the literature and decide if the rationales could be applied in their own practice. After a 12-week period, we evaluated the effectiveness of the vote cards based on survey findings of the participants. Results The majority of 66 respondents agreed that vote cards can improve the overall quality of EBM journal clubs, may encourage active participation and improve critical appraisal skills. They also rated the vote cards more favourably than traditional hand voting and agree that vote cards should be used in future EBM journal clubs. Conclusion We suggest the regular and routine use of vote cards in EBM journal clubs. © 2011 Blackwell Publishing Ltd.


Pan Y.,Chinese Institute of Basic Medical Sciences | Wang R.,College of Logistics | Zhang F.,Peoples Hospital of Gansu Province | Chen Y.,Lanzhou University | And 3 more authors.
International Journal of Clinical and Experimental Pathology | Year: 2015

MiR-130a has been demonstrated to play important roles in many types of cancers. Nevertheless, its biological function in breast cancer remains largely unknown. In this study, we found that the expression level of miR-130a was down-regulated in breast cancer tissues and cells. Overexpression of miR-130a was able to inhibit cell proliferation, invasion and migration in MCF7 and MDA-MB-435 cells. With the bioinformatics analysis, we further identified that RAB5A was a directly target of miR-130a, and its mRNA and protein level was negatively regulated by miR-130a. Immunohistochemistry verified RAB5A was upregulated in breast cancer tissues. Therefore, the data reported here demonstrate that miR-130a is an important tumor suppressor in breast cancer, and imply that miR-130a/RAB5A axis have potential as therapeutic targets for breast cancer.


Hu S.-Y.,Affiliated Hospital of Zunyi Medical College | Chen Y.-W.,Affiliated Hospital of Zunyi Medical College | Pan Z.-Q.,Affiliated Hospital of Zunyi Medical College | Lv H.,Affiliated Hospital of Zunyi Medical College | And 2 more authors.
World Chinese Journal of Digestology | Year: 2014

RESULTS: Nineteen studies involving 1989 patients with liver failure related hospital infection, including 1842 deaths, were included. Meta-analysis results showed that the odds ratio of liver failure related hospital infection was significantly different between the death group and alive group (OR = 4.13). The odds ratio of death was significantly different between subacute and chronic liver failure groups (OR = 0.52), between total bilirubin (TBIL) ≤ 342.2 µmol/L and > 342.2 µmol/L groups (OR = 0.47), between albumin (ALB) ≤ 30 g/L and > 30 g/L groups (OR = 2.85), and between PTA < 20% and ≥ 20% groups (OR = 14.49).CONCLUSION: The prognostic indexes of liver failure related hospital infection are complex and diverse. Chronic liver failure, multi-site hospital infection, TBIL > 342.2 µmol/L, ALB ≤ 30 g/L and PTA < 20% are key indexes.AIM: To assess the prognosis of liver failure related hospital infection in China by systematically reviewing all related studies.METHODS: We retrieved all clinical articles about the prognosis of liver failure related hospital infection in China in CNKI, Wanfang, VIP, CBM, PubMed, ISI web of knowledge, Embase and Cochrane library and evaluated the risk of bias of all included studies by Newcastle-Ottawa scale and analyzed all data by qualitative analysis and meta-analysis. © 2014 Baishideng Publishing Group Inc. All rights reserved.


PubMed | The Tumor Hospital of Gansu Province Lanzhou, Peoples Hospital of Gansu Province, College of Logistics, Lanzhou University and 2 more.
Type: Journal Article | Journal: International journal of clinical and experimental pathology | Year: 2015

MiR-130a has been demonstrated to play important roles in many types of cancers. Nevertheless, its biological function in breast cancer remains largely unknown. In this study, we found that the expression level of miR-130a was down-regulated in breast cancer tissues and cells. Overexpression of miR-130a was able to inhibit cell proliferation, invasion and migration in MCF7 and MDA-MB-435 cells. With the bioinformatics analysis, we further identified that RAB5A was a directly target of miR-130a, and its mRNA and protein level was negatively regulated by miR-130a. Immunohistochemistry verified RAB5A was upregulated in breast cancer tissues. Therefore, the data reported here demonstrate that miR-130a is an important tumor suppressor in breast cancer, and imply that miR-130a/RAB5A axis have potential as therapeutic targets for breast cancer.


Li L.,Evidence Based Medicine Center | Li L.,Lanzhou University | Ying X.-J.,Evidence Based Medicine Center | Ying X.-J.,Lanzhou University | And 9 more authors.
Asian Pacific Journal of Cancer Prevention | Year: 2012

Background and Objective: A comprehensive overall review of gastric cancer (GC) risk and protective factors is a high priority, so we conducted the present study. Methods: Systematic searches in common medical electronic databases along with reference tracking were conducted to include all kinds of systematic reviews (SRs) about GC risk and protective factors. Two authors independently selected studies, extracted data, and evaluated the methodological qualities and the quality of evidence using R-AMSTAR and GRADE approaches. Results: Beta-carotene below 20 mg/day, fruit, vegetables, non-fermented soy-foods, whole-grain, and dairy product were GC protective factors, while beta-carotene 20 mg/day or above, pickled vegetables, fermented soy-foods, processed meat 30g/d or above, or salty foods, exposure to alcohol or smoking, occupational exposure to Pb, overweight and obesity, helicobacter pylori infection were GC risk factors. So we suggested screening and treating H. pylori infection, limiting the amount of food containing risk factors (processed meat consumption, beta-carotene, pickled vegetables, fermented soy-foods, salty foods, alcohol), stopping smoking, avoiding excessive weight gain, avoidance of Pb, and increasing the quantity of food containing protective components (fresh fruit and vegetables, non-fermented soy-foods, whole-grain, dairy products). Conclusions: The conclusions and recommendations of our study were limited by including SRs with poor methodological bases and low quality of evidence, so that more research applying checklists about assessing the methodological qualities and reporting are needed for the future.


Costa J.,Evidence Based Medicine Center | Costa J.,University of Lisbon | Magro F.,University of Porto | Caldeira D.,University of Lisbon | And 4 more authors.
Inflammatory Bowel Diseases | Year: 2013

Background: We systematically reviewed infliximab benefit in reducing hospitalizations and/or major surgery rates in patients with inflammatory bowel disease (IBD). Methods: A literature search to May 2012 was performed to identify all studies (experimental and observational) evaluating patients with IBD treated with infliximab and providing data on hospitalizations and/or major surgery rates. Three reviewers independently performed studies' selection, quality assessment, and data extraction. Analyses were carried according to study design (randomized clinical trials [RCTs] and observational studies) and IBD type (Crohn's disease [CD] and ulcerative colitis [UC]). Random-effects meta-analysis was used to derive pooled and 95% confidence intervals (CIs) estimates of odds ratios (OR). Heterogeneity was assessed with I2 test. Results: Twenty-seven eligible studies were included (9 RCTs and 18 observational studies). Infliximab reduced hospitalization risk, both in pooled RCTs (OR, 0.51; 95% CI 0.40-0.65; I2 = 0%) and results of observational studies (OR, 0.29, 95% CI, 0.19-0.43; I2 = 87%), without differences between CD and UC. Infliximab reduced surgery risk in pooled RCTs results, both in CD (OR, 0.31; 95% CI, 0.15-0.64; I2 = 0%) and UC (OR, 0.57; 95% CI, 0.37-0.88; I2 = 0%). Pooled estimate from observational studies favored infliximab for patients with CD (OR, 0.32; 95% CI, 0.21-0.49; I2 = 77%), but not for patients with UC. Conclusions: The best evidence available points toward a reduction of the risk of hospitalization and major surgery requirement in patients with IBD treated with infliximab. This impact is clinically and economically relevant because hospitalization and surgery are considered to be markers of disease severity and significantly contribute to the total direct costs associated with IBD. Copyright © 2013 Crohn's & Colitis Foundation of America, Inc.


Trinquart L.,Evidence based Medicine Center | Trinquart L.,French Institute of Health and Medical Research | Ray P.,University Pierre and Marie Curie | Ray P.,French Institute of Health and Medical Research | And 4 more authors.
American Journal of Emergency Medicine | Year: 2011

Purposes: The aim of the study was to assess the usefulness of systematic natriuretic peptide testing in the management of patients presenting with acute dyspnea to emergency departments (EDs). Methods: We performed a systematic review and meta-analysis of randomized controlled trials assessing the usefulness of B-type natriuretic peptide (BNP) or its N-terminal fragment (NT-proBNP) in the management of patients presenting with dyspnea into ED. We searched Medline, Embase, and conference proceedings without restriction on neither language nor publication year. Selection of studies, data collection, and assessment of risk of bias were performed by 2 reviewers independently and in duplicate. Outcomes included hospital admission rate, time to discharge, and length of hospital stay, mortality and rehospitalization rates, and total direct medical costs. Combined risk ratios were estimated using fixed or random effects model. Duration and cost data were not combined. Findings: Four randomized controlled trials, representing 2041 patients, were selected. In 4 trials, there was a tendency for hospital admission to be reduced in the intervention group (combined risk ratio, 0.95; 95% confidence interval, 0.89-1.01). Time to discharge was significantly reduced in 2 trials, whereas there was no significant reduction in hospital length of stay in 3 trials. There was no significant effect on in-hospital and 30-day mortality rates or rehospitalization rates (3 trials reporting each outcome). Two trials found significant reduction in direct costs. Conclusions: The current evidence remains inconclusive on whether systematic natriuretic peptide testing is useful for the management of patients presenting to ED with acute dyspnea. © 2011 Elsevier Inc.


Bai Z.,Evidence Based Medicine Center | Chang J.,Evidence Based Medicine Center | Chen C.,Lanzhou University | Li P.,Lanzhou University | And 2 more authors.
Journal of Human Hypertension | Year: 2015

Some evidence from previous randomized controlled trials and systematic reviews has demonstrated a positive association between hypertension and transcendental meditation (TM). However, other trials and reviews showed the effect of TM on blood pressure (BP) was unclear but did not use subgroup analysis to rigorously investigate this relationship. The American Heart Association has stated that TM is potentially beneficial but did not give a standard indication. The present study explored several subgroup analyses in systematic reviews to investigate the effect of TM on BP. Medline, Embase, Cochrane Library, Web of Science and Chinese BioMedical Literature Database were searched through August 2014. Randomized controlled trials of TM as a primary intervention for BP were included. Two reviewers independently used the Cochrane Collaboration's quality assessment tool to assess each study's quality. Twelve studies with 996 participants indicated an approximate reduction of systolic and diastolic BP of -4.26 mm Hg (95% CI=-6.06, -2.23) and -2.33 mm Hg (95% CI=-3.70, -0.97), respectively, in TM groups compared with control groups. Results from subgroup analysis suggested that TM had a greater effect on systolic BP among older participants, those with higher initial BP levels, and women, respectively. In terms of diastolic BP, it appears that TM might be more efficient in a short-term intervention and with individuals experiencing higher BP levels. However, some biases may have influenced the results, primarily a lack of information about study design and methods of BP measurement in primary studies. © 2015 Macmillan Publishers Limited.


Li L.,Lanzhou University | Li L.,Evidence Based Medicine Center | Li L.,Ottawa Hospital Research Institute | Li L.,University of Ottawa | And 10 more authors.
Journal of Clinical Epidemiology | Year: 2014

Objective Network meta-analyses (NMAs) aim to rank the benefits (or harms) of interventions, based on all available randomized controlled trials. Thus, the identification of relevant data is critical. We assessed the conduct of the literature searches in NMAs. Study Design Published NMAs were retrieved by searching electronic bibliographic databases and other sources. Two independent reviewers selected studies and five trained reviewers abstracted data regarding literature searches, in duplicate. Search method details were examined using descriptive statistics. Results Two hundred forty-nine NMAs were included. Eight used previous systematic reviews to identify primary studies without further searching, and five did not report any literature searches. In the 236 studies that used electronic databases to identify primary studies, the median number of databases was 3 (interquartile range: 3-5). MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials were the most commonly used databases. The most common supplemental search methods included reference lists of included studies (48%), reference lists of previous systematic reviews (40%), and clinical trial registries (32%). None of these supplemental methods was conducted in more than 50% of the NMAs. Conclusion Literature searches in NMAs could be improved by searching more sources, and by involving a librarian or information specialist. © 2014 Elsevier Inc. All rights reserved.


Wang X.,Lanzhou University | Tian H.J.,Evidence Based Medicine Center | Yang H.K.,Lanzhou University | Wanyan P.,Lanzhou University | Peng Y.J.,Lanzhou University
European Journal of Gastroenterology and Hepatology | Year: 2011

OBJECTIVE: To compare cyclooxygenase-2 (Cox-2) inhibitors alone with NSAIDs plus proton pump inhibitors (PPIs) in preventing gastrointestinal adverse events: upper gastrointestinal (UGI) adverse events and gastrointestinal symptoms in Osteoarthritis and Rheumatoid arthritis. METHODS: PubMed, the Cochrane Library, EMBASE, ISI Web of Knowledge, Chinese Biomedical Literature Database, and reference lists of relevant papers for articles published 1990-2010.12 were searched. The related data matching standards set for this study were extracted. Statistical analyses were carried out using RevMan (5.0) software. RESULTS: The meta-analysis of six randomized controlled trials with a total of 6219 patients revealed that there was no difference in the UGI adverse events between Cox-2 inhibitors and nonselective NSAIDs with concurrent use of PPIs [relative risk (RR) 0.61, 95% confidence interval (CI) 0.34-1.09]. There was no significant difference in gastrointestinal symptoms (RR 1.10, 95% CI: 0.88-1.39) and the cardiovascular adverse events (RR 1.67, 95% CI: 0.78-3.59) between the two groups. CONCLUSION: Cox-2 inhibitors are no better than nonselective NSAIDs with PPIs in regard to UGI adverse events, gastrointestinal symptoms and cardiovascular adverse events in Osteoarthritis and Rheumatoid arthritis. On the basis of the current evidence and the combined wishes of the patient, clinicians should carefully consider and weigh both gastrointestinal and cardiovascular risk before selecting NSAID plus PPIs or Cox-2 inhibitors. © 2011 Wolters Kluwer Health | Lippincott Williams &Wilkins.

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