RESUMO
Snakebite is a global public health concern, which often occurs in tropical and subtropical underdeveloped areas, but it is often neglected. In the southern China, Naja naja atra (Chinese cobra) is a common venomous snake that causes swelling and necrosis of local tissues, even amputation and death. Currently, the main therapy is the administration of Naja atra antivenom, which greatly reduces mortality. However, the antivenom is not particularly effective in the improvement of local tissue necrosis. Clinically, antivenom is mainly administered intravenously. We speculated that the method of injection influences the efficacy of antivenom. In this study, the rabbit model was used to explore the effects of different antivenom injection methods on systemic and local poisoning symptoms. If topical injection of antivenom contributes to ameliorate tissue necrosis, then we need to reconsider the use of Naja atra antivenom.
RESUMO
BACKGROUND: Exercise therapies has been shown to be safe and effective as a non-pharmacological management for treating heart failure, At the same time, many clinical trials, systematic review, and meta-analyses have demonstrated the advantages of exercise therapies in heart failure. However, the methodological quality of these systematic reviews and the differences in efficacy between different exercise modes are unclear. Therefore, this study intends to overview of systematic reviews and network meta-analysis of exercise therapies intervention in heart failure, and finally to rank the effects of exercise therapies in the intervention of heart failure, so as to provide certain reference for clinical decision-making. METHODS: From the seven databases: PubMed, EMBASE.com, Web of Science, the Cochrane Library, Chinese biomedical literature database (CBM), Chinese National Knowledge Infrastructure (CNKI), Wan fang Database, and Chongqing VIP (CQVIP) databases. To search for systematic or meta-analysis of different exercise therapies for heart failure from inception to August 2020. According to the inclusion criteria and exclusion criteria, the two researchers independently selected articles and extracted data. In case of differences, a third party shall be sought for settlement. The AMSTAR2 scale, PRISMA scale and GRADE were used to assess the quality and evidence grade of the literature. The eligible randomized controlled trials (RCTs) were selected from the included systematic reviews and updated RCTs from the above systematic reviews to August 2020. GRADE was used for the risk of bias of the included RCTs. Pairwise meta-analyses were performed using the random-effects model, and network meta-analysis of the included RCTs were performed the frequentist framework. All data analyses were completed in Stata 15.0. RESULTS: Finally, a total of 33 articles related to systematic review and meta-analysis were included, there are 28 articles in Chinese and 5 articles in English. The results of this overview and network meta-analysis will be submitted to a peer-reviewed journal for publication. CONCLUSION: This review will provide a comprehensive overview of existing systematic reviews of exercise therapies interventions for heart failure and provide recommendations for clinical practice or guidelines. PROTOCOL REGISTRATION: INPLASY202080118.
