To systematically review the therapeutic effect of continuous high positive end-expiratory pressure (PEEP) ventilation in patients with non-acute lung injury/acute respiratory distress syndrome (non-ALI/ARDS) under general anesthesia mechanical ventilation in the intensive care unit (ICU).
PubMed, JBI Evidence-based Nursing Center Library, Cochrane Library, Embase, Medline, Wanfang Date, CNKI and VIP Database were searched for randomized controlled trials (RCT) and clinical controlled trials (CCT) using different levels of PEEP for the treatment of patients (uncombined ALI/ARDS) in ICU. The search period was from January 1st, 1990 to November 30th, 2018. Compared with the control group, the experimental group was treated with relatively high levels of PEEP ventilation. Outcome indicators were hospital mortality or 28-day mortality, partial oxygen pressure, and incidence of ARDS, atelectasis, and lung infections, etc. The RevMan 5.3 software was used for Meta-analysis.
Twelve articles were included, all of which were RCT studies; with 2 Chinese articles and 10 English articles. Meta-analysis showd that there was no statistically significant difference in the effect of different levels of PEEP on the mortality of patients [hospital mortality: odds ratio (OR) = 1.06, 95% confidence interval (95%CI) was 0.57 to 1.96, P = 0.85; 28-day mortality: OR = 0.34, 95%CI was 0.09 to 1.32, P = 0.12]. Compared with low PEEP, persistently high PEEP could increase the patient's partial oxygen pressure [weighted mean difference (WMD) = 48.27, 95%CI was 22.56 to 73.97, P = 0.000 2], prevent the occurrence of ARDS (OR = 0.32, 95%CI was 0.13 to 0.82, P = 0.02), and decrease the incidence of lung infection (OR = 0.52, 95%CI was 0.30 to 0.89, P = 0.02), but there was no significant difference in the incidence of atelectasis between the two groups (OR = 0.69, 95%CI was 0.23 to 2.06, P = 0.51).
In the treatment of patients in ICU with non-ALI/ARDS under general anesthesia mechanical ventilation, using relatively high levels of PEEP (10-16 cmH

[Effect of positive end-expiratory pressure on the incidence of acute respiratory distress syndrome in non-acute lung injury/acute respiratory distress syndrome patients in ICU: a Meta-analysis].

Previous studies have found several biomarkers for acute respiratory distress syndrome (ARDS), but the accuracy of most biomarkers is still in doubt due to the occurrence of other comorbidities. In this systematic review and meta-analysis, we aimed to explore ideal ARDS biomarkers which can reflect pathophysiology features precisely and better identify at-risk patients and predict mortality. Web of Science, PubMed, Embase, OVID, and the Cochrane Library were systematically searched for studies assessing the reliability of pulmonary-originated epithelial proteins in ARDS. A total of 32 studies appeared eligible for meta-analysis, including 2654 ARDS/ALI patients in this study. In the at-risk patients' identification group, the highest pooled effect size was observed in Krebs von den Lungren-6 (KL-6) (SMD: 1.17 [95% CI: 0.55, 1.79]), followed by club cell proteins 16 (CC16) (SMD: 0.74 [95% CI: 0.01, 1.46]), and surfactant proteins-D (SP-D) (SMD: 0.71 [95% CI: 0.57, 0.84]). For the mortality prediction group, CC16 exhibited the largest effect size with SMD of 0.92 (95% CI: 0.42, 1.43). Meanwhile, the summary receiver operating characteristic (SROC) of CC16 for ARDS diagnosis reached an AUC of 0.80 (95% CI: 0.76, 0.83). In conclusion, this study provides a ranking system for pulmonary-originated epithelial biomarkers according to their association with distinguishing at-risk patients and predicting mortality. In addition, the study provides evidence for the advantage of biomarkers over traditional diagnostic criteria. The performance of biomarkers may help to clinically improve the ARDS diagnosis and mortality prediction.

Circulating Pulmonary-Originated Epithelial Biomarkers for Acute Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis.

Prevention of Postdental Procedure Bacteremia: A Network Meta-analysis. Zeng BS, Lin SY, Tu YK, et al. J Dent Res 2019 Oct;98(11):1204-1210.
There were no sources of funding associated with the work.
Systematic review with meta-analysis of data.

Amoxicillin Is the Most Effective Oral Antibiotic Prophylaxis Regimen for Reducing Post-Invasive Dental Procedure Bacteremia.

The effectiveness of Alt-RAMEC combined with maxillary protraction in the treatment of patients with a class III malocclusion: a systematic review and meta-analysis, Mohammed Almuzian, Elise McConnell, M. Ali Darendeliler, Fahad Alharbi & Hisham Mohammed. J Orthod 2018;45(4);250-9.
No financial support was reported.
Systematic review.

Alternate Rapid Maxillary Expansion and Constriction (Alt-RAMEC) May Be More Effective Than Rapid Maxillary Expansion Alone for Protraction Facial Mask Treatment.

Polycyclic aromatic hydrocarbons (PAHs) exposure is associated with heart rate variability (HRV) reduction, a widely used marker of cardiovascular autonomic dysfunction. The role of DNA methylation in the relationship between PAHs exposure and decreased HRV is largely unknown. This study aims to explore epigenome-wide DNA methylation changes associated with PAHs exposure and further evaluate their associations with HRV alternations among non-current smokers. We measured 10 mono-hydroxylated PAHs (OH-PAHs) in urine and DNA methylation levels in blood leukocytes among participants from three panels of Chinese non-current smokers (152 in WHZH, 99 in SY, and 53 in COW). We conducted linear regression analyses between DNA methylation and OH-PAHs metabolites with adjustment for age, gender, body mass index, drinking, blood cell counts, and surrogate variables in each panel separately, and combined the results by using inverse-variance weighted fixed-effect meta-analysis to obtain estimates of effect size. The median value of total OH-PAHs ranged from 0.92 × 10

Exposure to polycyclic aromatic hydrocarbons, DNA methylation and heart rate variability among non-current smokers.

The placebo response of sham acupuncture in patients with primary dysmenorrhea is a substantial factor associated with analgesia. However, the magnitude of the placebo response is unclear.
This meta-analysis assessed the effects of sham acupuncture in patients with primary dysmenorrhea and the factors contributing to these effects.
PubMed, Embase, Web of Science, and Cochrane CENTRAL databases were searched from inception up to August 20, 2022.
Randomized controlled trials (RCTs) using sham acupuncture as a control for female patients of reproductive age with primary dysmenorrhea were included.
Pain intensity, retrospective symptom scale, and health-related quality of life were outcome measures used in these trials. Placebo response was defined as the change in the outcome of interest from baseline to endpoint. We used standardized mean difference (SMD) to estimate the effect size of the placebo response.
Thirteen RCTs were included. The pooled placebo response size for pain intensity was the largest (SMD = -0.99; 95% confidence interval [CI], -1.31 to -0.68), followed by the retrospective symptom scale (Total frequency rating score: SMD = -0.20; 95% CI, -0.80 to -0.39. Average severity score: SMD = -0.35; 95% CI, -0.90 to -0.20) and physical component of SF-36 (SMD = 0.27; 95% CI, -0.17 to 0.72). Studies using blunt-tip needles, single-center trials, studies with a low risk of bias, studies in which patients had a longer disease course, studies in which clinicians had < 5 years of experience, and trials conducted outside Asia were more likely to have a lower placebo response.
Strong placebo response and some relative factors were found in patients with primary dysmenorrhea. PROSPERO registration number: CRD42022304215. Please cite this article as: Sun CY, Xiong ZY, Sun CY, Ma PH, Liu XY, Sun CY, Xin ZY, Liu BY, Liu CZ, Yan SY. Placebo response of sham acupuncture in patients with primary dysmenorrhea: A meta-analysis. J Integr Med. 2023; 21(5): 455-463.

Placebo response of sham acupuncture in patients with primary dysmenorrhea: A meta-analysis.

Red yeast rice (RYR), a natural lipid-lowering agent, is widely used in clinical practice. However, the existing meta-analyses concerning the safety of RYR preparations have yielded inconsistent results, and the credibility of the evidence has not been quantified.
This study was designed to evaluate the existing evidence and offer a comprehensive understanding of the associations between the use of RYR preparations and various adverse health outcomes.
Seven literature databases were searched from inception to May 5, 2023, using medical subject headings and free-text terms (e.g., "red yeast rice," "Xuezhikang," and "Zhibitai").
Meta-analyses that investigated and quantitatively estimated associations between the use of RYR preparations and adverse health outcomes were included in this study.
Two researchers independently extracted data using a standardized data collection table; any disagreements were resolved by consulting a third researcher. Based on the participant, intervention, comparator and outcome (PICO) framework in each eligible meta-analysis, a series of unique associations between the use of RYR preparations and adverse health outcomes were determined. The associations' effect estimates were re-evaluated using random-effect models.
Fifteen meta-analyses, comprising 186 (164 unique) randomized controlled trials, were identified. Based on A MeaSurement Tool to Assess Systematic Reviews version 2, 3 (20%) and 12 (80%) of these meta-analyses had low and critically low confidence, respectively. A total of 61 unique associations between the use of RYR preparations and adverse health outcomes were extracted from eligible meta-analyses. Based on the random-effect models, 10 (16.4%) associations indicated a significant protective effect of RYR preparations against adverse health outcomes, while 5 (8.2%) indicated an increased risk of adverse health outcomes related to uric acid, alanine transaminase and aspartate transaminase levels. The other 46 (75.4%) associations showed no significant difference between the use of RYR preparations and control treatments. Regarding the credibility of the evidence, 21 (34.4%), 34 (55.7%) and 6 (9.8%) associations showed moderate, low and very low credibility, respectively.
The evidence examined in this study suggests that RYR preparations are safe; however, the credibility of the evidence was not high. Further high-quality evidence is required. Please cite this article as: Ma ZY, Yang SP, Li Y, Xu TT, Yang YL, Yang HY, Li HB, Zhou LJ, Diao Y, Li SY. Associations between the use of red yeast rice preparations and adverse health outcomes: An umbrella review of meta-analyses of randomized controlled trials. J Integr Med. 2024; 22(2): 126-136.

Associations between the use of red yeast rice preparations and adverse health outcomes: An umbrella review of meta-analyses of randomized controlled trials.

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