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Stroke is a major cause of disability and mortality worldwide; yet; prior to this study; there had been no sufficient evidence to support the effectiveness of various transitional care interventions (TCI) on the disability and mortality of stroke survivors. This meta-analysis aimed to assess the effectiveness of TCI in reducing mortality and improving the activities of daily life (ADL) of stroke patients. PubMed; Web of Science; OVID; EMBASE; CINAHL; and Sino-Med were searched for articles published before November 2016. Thirty-one randomized controlled trials (RCTs) were identified in the study. This analysis showed that the total effect of TCI on reducing mortality was limited (Risk Ratio (RR) = 0.86; 95% Confidence Interval (CI): 0.75–0.98); that only home-visiting programs could reduce mortality rates (RR = 0.34; 95% CI: 0.17–0.67) compared with usual care; and that the best intervention was led by a multidisciplinary team (MT) ≤3 months (RR = 0.19; 95% CI: 0.05–0.71). In addition; home-visiting programs also produced ADL benefit (RR = 0.56; 95% CI: 0.31–0.81). Overall; there was a statistically significant difference in improving patients’ independence between TCI and usual care (RR = 1.12; 95% CI: 1.02–1.23). However; none of the interventions was effective when they were differentiated in the analysis. It is the conclusion of this study that home-visiting programs; especially those led by MTs; should receive the greatest consideration by healthcare systems or providers for implementing TCI to stroke survivors.

Background:This pilot study aimed to evaluate the feasibility effectiveness and safety of transcutaneous electrical nerve stimulation (TENS) for patients with acute tinnitus.Methods:A total of 46 eligible patients with acute tinnitus were entered and included in this randomized controlled trial. All the included patients were equally and randomly divided into a verum TENS group and a sham TENS group, each group 23 participants. All patients received parenteral intramuscular therapy of 1 ml Vitamin B12 weekly for a total of 4 weeks. In addition, they also underwent verum or sham TENS 30 min daily, 3 times weekly for 4 weeks. The primary efficacy endpoint was measured by the Tinnitus Severity Scale (TSS) and Tinnitus Questionnaire (TQ) sum score. The secondary efficacy endpoints were assessed by the Tinnitus Handicap Inventory (THI), 12-Item Short Form Health Survey (SF-12) questionnaire, and adverse events. All outcome efficacy endpoints were measured at baseline and after 4 weeks of treatment.Results:After 4-week treatment, the patients undergoing verum TENS showed statistically efficacy of symptoms relief, as measured by the scales of TSS (P < .01), TQ (P < .01), and THI (P < .01), and improvement of quality of life, as assessed by the SF-12 (P < .01), compared with patients receiving sham TENS. In addition, no adverse events related to the treatment were recorded in either group.Conclusions:The results of this study showed that verum TENS may benefit patients with acute tinnitus after 4 weeks of treatment.

BackgroundO6-methylguanine-DNA methyltransferase (MGMT) is one of most important DNA repair enzyme against common carcinogens such as alkylate and tobacco. Aberrant promoter methylation of the gene is frequently observed in non-small cell lung cancer (NSCLC). However, the importance of epigenetic inactivation of the gene in NSCLC published in the literature showed inconsistence. We quantified the association between MGMT promoter methylation and NSCLC using a meta-analysis method.MethodsWe systematically reviewed studies of MGMT promoter methylation and NSCLC in PubMed, EMBASE, Ovid, ISI Web of Science, Elsevier and CNKI databases and quantified the association between MGMT promoter methylation and NSCLC using meta-analysis method. Odds ratio (OR) and corresponding 95% confidence interval (CI) were calculated to evaluate the strength of association. Potential sources of heterogeneity were assessed by subgroup analysis and meta-regression.ResultsA total of 18 studies from 2001 to 2011, with 1, 160 tumor tissues and 970 controls, were involved in the meta-analysis. The frequencies of MGMT promote methylation ranged from 1.5% to 70.0% (median, 26.1%) in NSCLC tissue and 0.0% to 55.0% (median, 2.4%) in non-cancerous control, respectively. The summary of OR was 4.43 (95% CI: 2.85, 6.89) in the random-effects model. With stratification by potential source of heterogeneity, the OR was 20.45 (95% CI: 5.83, 71.73) in heterogeneous control subgroup, while it was 4.16 (95% CI: 3.02, 5.72) in the autologous control subgroup. The OR was 5.31 (95% CI: 3.00, 9.41) in MSP subgroup and 3.06 (95% CI: 1.75, 5.33) in Q-MSP subgroup.ConclusionThis meta-analysis identified a strong association between methylation of MGMT gene and NSCLC. Prospective studies should be required to confirm the results in the future.

The 5-year survival rate of patients with head and neck squamous cell carcinoma (HNSCC) was only 40%-50%. To investigate the prognostic and predictive value of specific mircoRNAs (miRNAs) in HNSCC. We identified 19 miRNAs associated with over survival (OS) of patients with HNSCC in different clinical classes between 492 HNSCC tissues and 44 normal tissues from The Cancer Genome Atlas (TCGA) dataset. A signature of six miRNAs was identified by the supervised principal component method in the training set. The AUC of the ROC curve for the six microRNA signature predicting 5-year survival was 0.737 (95%CI, 0.627-0.825) in the testing set and 0.708 (95%CI, 0.616-0.785) in the total dataset. In the multivariate Cox regression analysis, patients with high-risk scores had shorter OS (HR, 2.380, 95%CI, 1.361-4.303) than patients with low-risk scores in the total dataset. Therefore, these results provided a new prospect for prognostic biomarker of HNSCC.

Several studies have reported a positive association between caesarean section for expeditious pregnancy termination and perinatal outcomes in acute fatty liver of pregnancy (AFLP); however, the risks remain unclear and independent studies have reported conflicting findings. In this meta-analysis, we aimed to confirm the relationship between caesarean section and perinatal outcomes in AFLP. The PubMed, Embase, and China National Knowledge Infrastructure databases were searched (until July 17, 2015) for observational clinical studies focusing on the association between caesarean section and perinatal outcomes in AFLP. Data were extracted and processed independently by 2 authors. We also compared caesarean section with vaginal delivery to further investigate this relationship. We observed that 2 of the 3 primary outcomes in caesarean section exhibited positive effects—the maternal mortality rate was 44% lower (relative risk [RR], 0.56 [0.41–0.76]) and perinatal mortality rate was also reduced (RR, 0.52 [0.38–0.71]), compared to those for vaginal delivery. We did not find any associations between caesarean section and perinatal outcomes in AFLP in terms of neonatal mortality type and maternal multiple organ complications. These findings emphasise the significant prognostic value and clinical implications of caesarean section in AFLP, and suggest that the adverse outcomes should be reduced.

Background Ovarian hyperstimulation syndrome (OHSS) is a common and severe complication for patients undergoing IVF/ICSI-ET. Melatonin widely participates in the regulation of female reproductive endocrine activity. However, whether melatonin participates in the progression of OHSS is largely unknown. This study aims to identify the predictive value of follicular fluid (FF) melatonin for OHSS establishment and the underlying mechanism. Methods All participants of this case-control study were enrolled at the Reproductive Medicine Center located in the First Affiliated Hospital of Zhengzhou University in China from January to October in 2017. Quantitative real-time PCR and western blot were used to examine the mRNA and protein levels. Primary granulosa cells were extracted and cultured for in vitro studies. Melatonin concentration was measured by ELISA. Logistic analysis and receiver-operating characteristic (ROC) curves were used to evaluate the predicting value of melatonin on OHSS occurrence. Main outcome measures The expression level of melatonin receptor 2 (MT2), P450 aromatase cytochrome (aromatase), vascular endothelial growth factor (VEGF), and inducible nitric oxide synthase (iNOS) mRNA in human primary granulosa cells. The concentration of melatonin in FF. The predicting value of melatonin on OHSS and the cut-off value of the prediction. Results FF melatonin concentrations were significantly higher in patients with OHSS compared to non-OHSS group (35.94 ± 10.18 ng/mL vs 23.93 ± 10.94 ng/mL, p <0.001). The expression of MT2 mRNA ( p = 0.0459) and protein in granulosa cells was also significantly higher in the OHSS group. When using a cut-off level of 27.52 ng/ml, the sensitivity and specificity of FF melatonin to predict OHSS was 84.6 and 74.0%, respectively ( p < 0.0001). We also found that melatonin could up-regulates aromatase mRNA, VEGF mRNA expression and down-regulates iNOS mRNA expression in the granulosa cells . Conclusion OHSS patients have higher melatonin in the FF as well as higher MT2 expression in the granulosa cells. The melatonin in FF might be used as an effective predictor for the occurrence of OHSS.