Low-intensity extracorporeal shockwave therapy (Li-ESWT) has been reported as a useful and noninvasive treatment for erectile dysfunction (ED). Systematic review and meta-analysis are utilized to evaluate the efficacy of Li-ESWT by comparing the changes in the International Index of Erectile Function erectile function domain (IIEF-EF) and the Erection Hardness Score (EHS) versus sham therapy in men with ED. A systematic search of the MEDLINE, EMBASE, ClinicalTrials.gov, CBM, CNKI, WANGFANG, and VIP was conducted to obtain randomized controlled trials (RCTs) published in peer-reviewed journals or presented in abstract forms of Li-ESWT for ED treatment from January 2010 to June 2018. If RCTs are published in peer-reviewed literature and IIEF-EF scores and EHS are used to assess erectile function outcomes, they are eligible for inclusion. A meta-analysis was used to summarize the estimates. The meta-analysis included seven RCTs involving 522 participants. The data revealed that men treated with Li-ESWT showed significant improvement in pooled mean IIEF-EF scores from baseline to follow-up compared with sham therapy (MD: 1.99 points; 95% CI [1.35, 2.63]; p < .00001). Changes in the IIEF-EF score increased significantly in the treatment group (MD: 3.62; 95% CI [2.99, 4.25]; p < .00001). The EHS increased significantly in the treatment group in four studies (OR: 16.02; 95% CI [7.93, 32.37]; p < .00001). Patients with moderate and/or severe ED reported better results in mean IIEF scores (MD: 3.95; 95% CI [2.44, 5.46]; p < .00001). In meta-analysis of seven RCTs with men who received Li-ESWT for ED, there was evidence that the IIEF-EF and EHS experienced improvements following Li-ESWT.
Vasectomy is a simple, safe, effective, and economical method used worldwide for long-term male contraception. As a surgical operation, it has short-term and long-term complications such as hematoma formation, infection, sterilization failure, sperm granulomas, short-term postoperative pain (nodal pain, scrotal pain, and ejaculation pain), and chronic pain syndrome. Whether it increases the risk of autoimmune disease, cardiovascular disease, testicular cancer, or prostate cancer is still controversial. Changes in plasma concentrations of luteinizing hormone, follicle-stimulating hormone, and testosterone after vasectomy have also been studied, as well as the relation between vasectomy and sexual function. Sperm quality decreases very slowly after vasectomy, and vasovasostomy and intracytoplasmic sperm injection could help a couple achieve a pregnancy if they change their minds at any point. We include a follow-up strategy and suggestions for follow-up care at the end of this review.
Objective Following the emergence of a novel coronavirus, SARS-CoV-2, and its spread outside of Wuhan, China, the human society has experienced a pandemic of coronavirus disease 2019 (COVID-19). While the development of vaccine and pharmaceutical treatment has been undergoing, government authorities in China implemented unprecedented non-pharmaceutical interventions as primary barriers to curb the spread of the deadly SARS-CoV-2. Although the decline of COVID-19 cases coincided with this implementation of interventions, we looked for evidence to demonstrate the efficacy of these interventions, since artifactual factors, such as the environment, the pathogen itself, and the phases of epidemic, may also alter the pattern of case development. Methods We surveyed common viral respiratory infections that have a similar pattern of transmission, tropism, and clinical manifestation as COVID-19 under such interventions during this season with pandemic, and compared it with historical data in previous seasons without the interventions. Results Our survey shows that the rates for common respiratory infections, such as influenza and respiratory syncytial virus infections, decreased dramatically from previous annual 13.7% (95% CI, 10.82-16.58) and 4.64% (95% CI, 2.88-7.64) to 0.73% (95% CI, 0.02-1.44) and 0.0%, respectively, in this season. Conclusions Our surveillance provides compelling evidence that the interventions are cost-effective ways to curb the spread of contagious agents, and may be the only practical approach to limiting the evolving of epidemic until vaccine and pharmaceutical treatment are available.
Introduction: With the widespread spread of novel coronavirus pneumonia, more and more countries have been affected. Some research reports have shown that traditional Chinese medicine has a significant effect on COVID-19 infection, and the treatment of traditional Chinese medicine is used in some special people, such as children. At present, there is a lack of high-quality systematic reviews on the safety and efficacy of using Chinese medicine to treat children with novel coronavirus pneumonia. Materials and methods: We will search Cochran library, MEDLINE, EMBASE, China National Knowledge Infrastructure Database (CNKI), China Biomedical Database (CBM), VIP Database (VIP), and Wanfang database for research. This study includes randomized controlled trials (RCTs) and non-RCTs, and uses the Cochrane systematic review to review the safety and efficacy of traditional Chinese medicine in preventing and treating children with novel coronavirus pneumonia. RCT research tools and quantitative research quality assessment tools for non-randomized studies will be used to assess the risk of bias in studies included in the systematic review. We will use Revman 5.3 software for meta-analysis, the main result is odds ratio, and then a subgroup analysis will be performed based on the age, intervention degree, and disease severity of the patients reviewed. Ethics and dissemination: This systematic review protocol is designed to provide evidence regarding the effectiveness and safety of traditional Chinese medicine for the treatment of children with COVID-19, such evidence may be useful and important for clinical treatment decisions. The results should be disseminated through publication in a peer-reviewed journal. Since the data and results used in the systematic review will be extracted exclusively from published studies, approval from an ethics committee will not be required. Registration information: PROSPERO CRD42020179150.
This study aimed to evaluate the efficacy and safety of acupuncture for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). A search of PUBMED, EMBASE, Central Register of Controlled Trials (CENTRAL), Web of Science, Chinese Biomedicine Literature (CBM), China National Knowledge Infrastructure (CNKI), Wang-Fang Database, Chinese Scientific Journal Database (VIP), and other available resources was made for studies (up to February 2019). Searches were limited to studies published in English and Chinese. Only randomized controlled trials (RCTs) related to the efficacy and/or safety of acupuncture for CP/CPPS were included. Two investigators independently evaluated the quality of the studies. A total of 11 studies were included, involving 748 participants. The results revealed that compared with sham acupuncture (MD: −6.53 [95% CI: −8.08 to −4.97]) and medication (MD: −4.72 [95% CI: −7.87 to −1.56]), acupuncture could lower total NIH-CPSI score more effectively. However, there are no significant differences between acupuncture and sham acupuncture in terms of IPSS score. In terms of NIH-CPSI voiding domain subscore, no significant differences were found between acupuncture and medication. Compared with sham acupuncture (OR: 0.12 [95% CI: 0.04 to 0.40) and medication (OR: 3.71 [95% CI: 1.83 to 7.55]), the results showed favorable effects of acupuncture in improving the response rate. Acupuncture plus medication is better than the same medication in improving NIH-CPSI total score and NIH-CPSI pain domain subscore. In conclusion, the evidence suggests that acupuncture may be an effective intervention for patients with CP/CPPS. However, due to the heterogeneity of the methods and high risk of bias, we cannot draw definitive conclusions about the entity of the acupuncture’s effect on alleviating the symptoms of CP/CPPS. The adverse events of acupuncture are mild and rare.
Background: Male fertility has gradually become a worldwide problem. Because of the limitation of treatment, many drugs have been used for improving sperm quality. Among them, alpha-lipoic acid (ALA), as a treatment of diabetic neuropathy, has been applied to improve the quality of sperm in clinical practice, with satisfactory effect. However, there is still no systematic review on the field of male infertility treating with oral ALA. Methods: The databases of MEDLINE, EMBASE, Web of Science, Clinicaltrials.org., China National Knowledge Infrastructure Database (CNKI), China Biology Medicine Database (CBM), Wan fang Database, VIP Science Technology Periodical Database, and Cochrane Library were retrieved. Grey literature will be searched in OpenGrey. Related Randomized controlled trials (RCTs) will be collected and selected before December 30, 2019. We will search English literature and Chinese literature using search terms including “male infertility”, “semen”, “sperm”, “alpha-lipoid acid”, “ alpha lipoid acid”, “lipoid acid”. We will start to search database in November 20, 2019. Sperm concentration, motility and morphology, sperm DNA fragmentation index, sperm number of per ejaculate, sperm viability and adverse events will be evaluated. RevMan 5.3 and Stata 14.0 will be used for Systematic review and Meta-analysis. This protocol reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement, and we will report the systematic review by following the PRISMA statement. Results: Through systematic review, and meta-analysis when necessary, we can obtain the effect of ALA on sperm quality, including sperm motility, concentration, morphology and other indicators. Conclusion and dissemination: Efficacy and safety of oral ALA on male sperm quality in infertile men will be assessed. The results will be published in a public issue journal to provide evidence-based medical evidence for urologists and andrologists to make better clinical decisions.
Introduction: The pandemic caused by the coronavirus disease 2019 (COVID-19) infection has exposed vulnerable populations to an unprecedented global health crisis. Research reported that Chinese traditional medicine injections were used in patients with COVID-19 infection and showed significant effects, and there have been no systematic review and meta-analyses to investigate the effects and safety of Chinese traditional medicine injections. Materials and methods: This systematic review and meta-analysis protocol is based on the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols 2015 statement. The literature search will involve Cochran library, Web of science, PubMed, MEDLINE, Embase, China Biology Medicine Database, China National Knowledge Infrastructure Database, VIP, Wang Fang database, and China Clinical Trial Registration Center for articles and research published form December 2019. This search will include randomized controlled trials and nonrandomized studies. The Cochrane Collaboration's tool for randomized controlled trial studies and the Quality Assessment Tool for Quantitative Studies for nonrandomized studies will be used to assess the risk of bias among the studies included in the systematic review. Review Manager 5.3 software will be used for the meta-analysis, and odds ratio are calculated as the primary outcomes. Subgroup analyses will then be performed based on the characteristics of the interventions and populations included in the studies examined. Ethics and dissemination: This systematic review protocol is designed to provide evidence regarding the effects and safety of Chinese traditional medicine injections on patients with COVID-19, such evidence may be useful and important for clinical treatment decisions. The results should be disseminated through publication in a peer-reviewed journal. Since the data and results used in the systematic review will be extracted exclusively from published studies, approval from an ethics committee will not be required.
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