The impact of atosiban on pregnancy outcomes in women undergoing in vitro fertilization-embryo transfer: A meta-analysis.

BACKGROUND: Atosiban is administered to women undergoing in vitro fertilization-embryo transfer (IVF-ET) to improve pregnancy outcomes. However, the results of this treatment were controversial. We conducted this meta-analysis to investigate whether atosiban improves pregnancy outcomes in the women undergoing in vitro fertilization (IVF). METHODS: Databases of PubMed, EMBASE, Web of Science, China BioMedicine, and Google Scholar were systematically searched. Meta-analyses were performed to investigate whether atosiban improves pregnancy outcomes in the women undergoing IVF. RESULTS: Our results showed that atosiban was associated with higher implantation (OR = 1.63, 95% CI: 1.17-2.27; P = 0.004) and clinical pregnancy (OR = 1.84, 95% CI: 1.31-2.57; P < 0.001) rates. However, atosiban showed no significant association with the miscarriage, live birth, multiple pregnancy or ectopic pregnancy rates. When a further subgroup analysis was performed in the women undergoing repeated implantation failure (RIF), implantation (OR = 1.93, 95% CI: 1.45-2.57; P < 0.001), clinical pregnancy (OR = 2.48, 95% CI: 1.70-3.64; P <0.001) and the live birth (OR = 2.89, 95% CI: 1.78-4.67; P < 0.001) rates were significantly higher in the case group. Nevertheless, no significant difference was detected in the miscarriage and multiple pregnancy rates between the case and control groups. CONCLUSION: Atosiban may be more appropriate for women undergoing RIF and play only a limited role in improving pregnancy outcomes in the general population of women undergoing IVF. These conclusions should be verified in large and well-designed studies.

Evaluation and clinical significance of cyclin-dependent kinase5 expression in cervical lesions: a clinical research study in Guangxi, China.

BACKGROUND: Studies have been reported that cyclin-dependent kinase5 (CDK5) was associated with the development of several cancers. However, the relationship between CDK5 level and clinicopathological factors is still poorly understood in cervical diseases. The aim of the current study was to investigate the expression of CDK5 and its clinical significance in variant cervical lesions. METHODS: Immunohistochemistry (IHC) was used to detect CDK5 expression in 54 cases of chronic cervicitis, 42 cases of condyloma acuminate (CA), 38 cases of carcinoma in situ, and 360 cases of cervical cancers [adenocarcinoma, n = 63; squamous cell carcinoma (SCC), n = 263; adenosquamous carcinoma, n = 34]. The clinicopathological characteristics in relation to CDK5 were examined by Pearson's Chi-square test. RESULTS: The positive rates of CDK5 were 27.8, 31.0, 50, 54.0, 58.8, and 62.7 % in chronic cervicitis, CA, carcinoma in situ, adenocarcinoma, adenosquamous carcinoma and SCC, respectively. Statistically analysis showed that CDK5 expression in cervical cancer tissues was higher than non-cervical cancer tissues (inflammation and CA) (P < 0.001). The overexpression of CDK5 was significantly correlated with lymph node metastasis (r = 0.317; P < 0.001), histological type (r = 0.198; P < 0.001), FIGO stage (r = 0.358; P < 0.001), TNM stage (r = 0.329; P < 0.001) and pathological grade (r = 0.259; P < 0.001) in cervical lesions evaluated by Pearson's Chi-square test. Furthermore, the positive relationships were found between CDK5 and lymph node metastasis (P < 0.001), FIGO stage (P < 0.001), TNM stage (P < 0.001) and pathological grade (P < 0.001) in SCC. CDK5 was positively interrelated to TNM stage (P = 0.017) in adenosquamous carcinoma. CONCLUSIONS: CDK5 may play a vital role in the development of cervical cancer, which may be a marker for the diagnosis, therapy and prognosis of cervical cancer.

[Study on the efficacy graded-disease-spectrum of acupuncture and moxibustion by the fuzzy comprehensive evaluation techniques: musculoskeletal and connective tissue diseases].

The descriptive cross sectional surveys were carried out among the outstanding clinical physicians in the field of acupuncture and moxibustion by using the survey sampling. The fuzzy comprehensive evaluation techniques was applied to evaluate the opinions of clinical experts in the field of acupuncture and moxibustion in order to classify the spectrum of diseases related to the musculoskeletal and connective tissue. After the statistical analysis on sixty-four diseases with 104 subtypes, the spectrum of diseases were determined as grade I spectrum of diseases with 13 subtypes of diseases, grade II spectrum of diseases with 51 subtypes of diseases, grade III spectrum of diseases with 10 subtypes of diseases, and grade IV spectrum of diseases with 30 subtypes of diseases. The outcomes reveal that acupuncture and moxibustion therapy have been applied widely for musculoskeletal diseases and connective tissue related diseases.

[Survey clinical evidence of acupuncture therapy for depressive neurosis].

OBJECTIVE: To evaluate the clinical studies of acupuncture for treatment of depressive neurosis, collect the high quality evidence relative to clinical acupuncture practice for clinical decision-making reference. METHODS: Around crucial common questions of acupuncture clinical practice, the documents of clinical study were comprehensively retrieved. According to 5-grade criterion of evidence-based medicine, the evidence from high to low level were selected to answer corresponding clincal questions and RevMan 5.0.20 was used to analyze the final indicator. RESULTS: Nineteen documents of clinical study accord with the inclusive criterion were retrieved. Level-A evidence showed effectiveness of acupuncture. Acupuncture might be superior or equal to fluoxetine, with little adverse effect and high safety. Level-C evidence showed acupuncture might be superior or equal to Amitriptyline, with little adverse effect and high safety. And no relative clinicial evidence compared effect of acupuncture with that of psychotherapy or behavior therapy. Only one level-C evidence showed there was no effect difference between acupuncture combined with bloodletting therapy and bloodletting alone. Two level-C evidence showed the effect of acupuncture combined with western medicine was superior to that of medicine alone, eg. catgut embedding therapy combined with Fluoxetine, electroacupuncture combined with Seroxat. CONCLUSION: Acupuncture for depressive nerosis has a positive effect. Acupuncture has an equal effect compared with western medicine, while strictly designed equivalent and non-inferior studies are demanded. The effect of acupuncture combined with medicine has some advantage, but need high quality studies to verify.

[Systematic evaluation of therapeutic effect of acupuncture for treatment of simple obesity].

OBJECTIVE: To evaluate the therapeutic effect of acupuncture for treatment of simple obesity, and to analyze the current situation of clinical studies. METHODS: Randomized controlled trials (RCTs) involving acupuncture treatment for simple obesity were searched from PubMed (1979-2008), OVID (1979-2008), EBSCO (1973-2008), Cochrane Library (Issue 2, 2008), CBM (1978-2008), CNKI (1979-2008), VIP (1989-2008) and WanFang Database (1998-2008). Literatures were enrolled focusing on RCTs related to acupuncture treatment for simple obesity; the quality of literatures were evaluated by two evaluators unaidedly. Meta-analyses were conducted with the Cochrane Collaboration's RevMan 4.2.8 software. RESULTS: Eight papers including 1,017 cases, conformed with the enrolled criteria. Meta-analyses showed that there were significant difference between acupuncture groups and western medicine groups in the effective rate [combined RR (fixed effects model) = 1.11, 95% CI (1.05, 1.18), P=0.0006]. There was a significant difference between acupuncture and Sibutramine in the body mass [combined WMD (fixed effects model) = 1.94, 95%CI (1.73, 2.16), P<0.00001] and body mass index (BMI) [combined WMD (fixed effects model) = 0.52, 95% CI (0.33, 0.70), P<0.00001]. However, acupuncture was not superior to Sibutramine in hip circumference (HC) [combined WMD (fixed effects model) = -0.35, 95% CI (-0.56, -0.15), P<0.0007]. CONCLUSION: For treating simple obesity, besides reasonable diet and exercise, acupuncture is safe and effective, which may be more effective than routine western medicine. The quantity of literature was limited and the quality of some literatures was low. Thus, more high-quality and large-scale of RCTs are needed.