RESUMEN
Objective. To explore and define the current optimal submucosal injection solution used in ESD and EMR for gastrointestinal tract neoplasms in terms of clinical outcomes and other aspects. Methods. PubMed, Cochrane Library, Embase, and clinical trials register center were searched with terms of "endoscopic resection" and "submucosal injection solution" to identify relevant randomized controlled trials (RCTs). Both direct comparison using traditional meta-analysis method and indirect comparison using network meta-analysis method were performed. Results. A total of 11 RCTs with 1152 patients were included. Meta-analysis showed that, compared with normal saline, other submucosal injection solutions induced a significant increase in terms of en bloc resection rate (I (2) = 0%, OR = 2.11, 95% CI (1.36, 3.26), and P = 0.008) and complete resection rate (I (2) = 0%, OR = 2.14, 95% CI (1.41, 3.24), and P = 0.0003); and there was no significant difference in the incidence of total complications (I (2) = 0%, OR = 0.87, 95% CI (0.59, 1.29), and P = 0.49). Conclusions. Other newly developed submucosal injection solutions significantly increased en bloc resection rate and complete resection rate and decreased bleeding rate and finical cost of endoscopic resection in gastrointestinal tract, while current evidence did not find the difference between them, which need to be explored by further studies.
RESUMEN
The effectiveness and safety of acupuncture-moxibustion for the treatment of agrypnia was systematically reviewed. The clinical randomized controlled trial (RCT) of acupuncture-moxibustion for agrypnia were collected. The literature and document on acupuncture-moxibustion RCT for the treatment of agrypnia that published from January of 2001 to March of 2012 was searched with computer in PubMed, CNKI, Wanfang and VIP database. According to Cochrane Handbook 5. 1. 0, the bias risk and quality assessment were performed on every included trial and RevMan 5. 0 software was applied to make the Meta analysis. Totally 14 researches were included, involving 2662 cases. The Meta analysis showed that the differences of total effective rate between acupuncture-moxibustion and clinical routine treatment were significant [RR = 1.16, 95% CI (1.12, 1.19), Z = 9.32, P < 0.000 01]. The results indicate that total effective rate of acupuncture-moxibustion for agrypnia is obviously superior to that of clinical routine treatment, meaning clinical efficacy of acupuncture-moxibustion is served credit.