RESUMO
Background: Pediatric rectal prolapse is a common issue in clinical practice. Among various managements, sclerotherapy is an important method to successfully treat pediatric rectal prolapse, especially for the first injection. The knowledge of the first injection of sclerotherapy can be revealed by a systemic review and meta-analysis of randomized clinical trials. Methods: We performed a systematic search and a meta-analysis for the retrospective clinical studies of sclerotherapy in pediatric rectal prolapse. The comparison between remission and recurrence after the first injection of sclerotherapy was performed to find if the first injection of sclerotherapy can treat rectal prolapse completely. After a restricted selection, 17 studies involving 1,091 pediatric rectal prolapse subjects with sclerotherapy were enrolled in a variety of classifications of injection agents. The focused outcome was to check whether the first injection of sclerotherapy can achieve a remission status. The meta-analysis was performed by Review Manager 5.4. Results: Among the subjects receiving sclerotherapy, the meta-analysis favors the remission status after receiving the first injection of sclerotherapy. The meta-analysis results showed significant remission tests for the overall effect and significant heterogeneities in odds ratio and the fixed-effects model. The significant therapeutic effects remained, however, even after testing in the relative risk and the random-effects model. Conclusions: Despite significant heterogeneity and relatively low quality of evidence, the first injection of sclerotherapy may conceivably demonstrate therapeutic effects to help the patients of pediatric rectal prolapse achieve a remission status.
RESUMO
BACKGROUND: Crop phenology change is co-determined by climate change and adaptation strategies, such as crop management, but their combined and isolated impacts on rice phenology are still unclear. Quantifying the impacts and identifying the main contributors are critical to food security under climate change. Thus we distinguished and quantified the relative contribution of climate change and crop management to rice (Oryza sativa L.) phenological changes in China from 1981 to 2010, using a first-difference multivariate regression method. RESULTS: Rice phenology has changed over the past 30 years in China. The mean length of the phenological stage from emergence to transplanting was shortened, whereas the mean length of the stage from transplanting to heading, from heading to maturity, was prolonged. The relative contribution of crop management was greater than that of climate change for single and late rice, which took up over 90% of the total change in certain phenology stages. Among the climatic factors, temperature was the dominant contributor, which accounted for more than 50% of the change in rice phenology. The stage from transplanting to heading of early rice and late rice had strongly negative sensitivities to increasing temperature. CONCLUSIONS: Crop management has offset the adverse effects of climate change on single and early rice phenology in China over the past 30 years to some extent, while further adaptation measures such as adjusting sowing date, shifting rice varieties, applying nitrogen fertilizer and irrigation should be applied to late rice in southern China, especially in a warmer future. © 2021 Society of Chemical Industry.
