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Dose-response relationship between exercise and hepatic steatosis:A systematic review with Bayesian network meta-analysis of randomized controlled trials 认领 引用
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作者 Xinyun Tan Huihui Zou +5 位作者 Manjie Guo Jiayu Liu Xinjuan Huang Ruoling Yu Xuelian Liu Chunxiang Qin 《Journal of Sport and Health Science》 SCIE CAS CSCD 2026年第5期32-43,共12页
Background:Current guidelines offer unclear recommendations on exercise types and doses for metabolic dysfunction-associated steatotic liver disease(MASLD).This study aimed to:(a)identify the most effective exercise t... Background:Current guidelines offer unclear recommendations on exercise types and doses for metabolic dysfunction-associated steatotic liver disease(MASLD).This study aimed to:(a)identify the most effective exercise type;(b)model the dose-response relationship between exercise and hepatic steatosis;(c)determine the minimum clinically significant dose.Methods:We searched Pub Med,Web of Science,Embase,the Cochrane Library,CINAHL,Scopus,Rehabilitation&Sports Medicine Source,clin icaltrials.gov,China Knowledge Network Infrastructure(CNKI),Wanfang,VIP,and Sinomed databases from establishment to May 27,2025 for randomized controlled trials on exercise interventions in MASLD.Network meta-analysis and dose-response network meta-analysis were used.Results:Among 24 studies(961 participants),combined aerobic-resistance exercise showed the highest surface under the cumulative ranking curve(0.81).A non-linear dose-response revealed benefits plateauing at 630 metabolic equivalents(METs)-min/week(mean=-0.68,95%CI:-0.95 to-0.40)and peaking at 850 MET-min/week(mean=-0.72,95%CI:-0.97 to-0.49).Optimal doses were 640 MET-min/week for combined aerobic-resistance exercise,880 for high-intensity circuit training,and 590 for moderate-intensity continuous training.High-intensity interval training showed progressive benefits,while resistance exercise required exceeding 640 MET-min/week.The minimum clinically significant dose was 460 MET-min/week,but combined aerobic-resistance exercise achieved this at only 130 MET-min/week.Conclusion:A non-linear curve underscores key dose thresholds for efficacy and safety:460(minimum),630(cost-effective),and850 MET-min/week(plateau).These equate to moderate-intensity exercise(4.5 METs)for 20,30,or,40 min 5 times/week,or vigorous-intensity exercise(7.5 METs)for 30 min 2,3,or 4 times/week.Combined aerobic-resistance exercise offered both efficacy and dose advantages. 展开更多
关键词 Hepatic steatosis Network meta-analysis Dose-response meta-analysis Metabolic dysfunction-associated steatotic liver disease Exercise intervention
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Data-driven insights into nonradical activation mechanisms for biochar inverse design:A synergistic approach using DFT and machine learning with meta-analysis 认领 引用 被引量：1
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作者 Honglin Chen Rupeng Wang +1 位作者 Zixiang He Shih-Hsin Ho 《Chinese Chemical Letters》 SCIE CAS CSCD 2026年第2期708-712,共5页
Machine learning(ML)is recognized as a potent tool for the inverse design of environmental functional material,particularly for complex entities like biochar-based catalysts(BCs).Thus,the tailored BCs can have a disti... Machine learning(ML)is recognized as a potent tool for the inverse design of environmental functional material,particularly for complex entities like biochar-based catalysts(BCs).Thus,the tailored BCs can have a distinct ability to trigger the nonradical pathway in advance oxidation processes(AOPs),promising a stable,rapid and selective degradation of persistent contaminants.However,due to the inherent“black box”nature and limitations of input features,results and conclusions derived from ML may not always be intuitively understood or comprehensively validated.To tackle this challenge,we linked the front-point interpretable analysis approaches with back-point density functional theory(DFT)calculations to form a chained learning strategy for deeper sight into the intrinsic activation mechanism of BCs in AOPs.At the front point,we conducted an easy-to-interpret meta-analysis to validate two strategies for enhancing nonradical pathways by increasing oxygen content and specific surface area(SSA),and prepared oxidized biochar(OBC500)and SSA-increased biochar(SBC900)by controlling pyrolysis conditions and modification methods.Subsequently,experimental results showed that OBC500 and SBC900 had distinct dominant degradation pathways for 1O2 generation and electron transfer,respectively.Finally,at the end point,DFT calculations revealed their active sites and degradation mechanisms.This chained learning strategy elucidates fundamental principles for BC inverse design and showcases the exceptional capacity to integrate computational techniques to accelerate catalyst inverse design. 展开更多
关键词 Machine learning DFT Biochar-based catalysts Nonradical activation Peroxymonosulfate Inverse design Meta-analysis
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A meta-analysis based on epidemiological studies to identify the key environmental pollutants inducing gestational diabetes mellitus 认领 引用
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作者 Yun Deng Shujun Yi +3 位作者 Chi Zhang Rongyan Yang Wenjue Zhong Lingyan Zhu 《Journal of Environmental Sciences》 SCIE EI CAS CSCD 2026年第7期468-478,共11页
Exposure to environmental pollutants intricately contributes to the incidence of gestational diabetes mellitus(GDM),thus it is imperative to identify the key contaminants which may induce GDM risk in humans.Herein,we ... Exposure to environmental pollutants intricately contributes to the incidence of gestational diabetes mellitus(GDM),thus it is imperative to identify the key contaminants which may induce GDM risk in humans.Herein,we conducted a systematic review and meta-analysis on a total of 112 epidemiological studies to clarify the environmental risk factors for GDM occurrence.A total of 10 air pollutants,26 metal elements,and 8 categories of organic compounds were examined.Fixed-and random-effect models were used to calculate the pooled odds ratio and 95%confidence interval for evaluating the effects of contaminants.The results showed that exposure to air pollutants significantly increased GDM risk,with black carbon,PM2.5,PM10,carbon monoxide,nitric oxide,nitrogen oxides,and sulfur dioxide identified as potential risk factors(p<0.05).There was a markedly positive relationship between metal exposure and GDM risk,with aluminum,antimony,mercury,and rubidium contributing significantly to GDM incidence(p<0.05).Higher exposure to organic compounds was also associated with a greater risk of GDM,with polybrominated diphenyl ethers,per-and poly-fluoroalkyl substances(PFAS),phthalates,polychlorinated biphenyls,and organophosphate esters making significant contributions(p<0.05).Several specific homologues were identified to make a dominant contribution within each class of these organic chemicals,such as perfluorooctanoic acid(36.54%)and perfluorononanoic acid(32.09%),which were the most risky PFAS compounds.These findings provide a critical insight into the etiology of GDM and may inform strategies to protect against pregnancy complications. 展开更多
关键词 Environmental pollutants Gestational diabetes mellitus Epidemiological studies Risk factors Meta-analysis
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A Meta-analysis of Traditional Chinese Medicine constitution distribution in people with functional constipation 认领 引用
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作者 WANG Xuehui SUN Yuxin +10 位作者 Birling Yoann LI Xun ZHAO Ruotong ZHENG Youyou SONG Zhenmei ZHANG Yanli DU Hongbo WANG Jianyun LI Yinqing LIU Zhaolan LIU Jianping 《Journal of Traditional Chinese Medicine》 SCIE CAS CSCD 2026年第2期261-273,共13页
OBJECTIVE:To investigate the distribution of Traditional Chinese Medicine(TCM)constitution among individuals with functional constipation,which would provide insights for developing constitution-targeted prevention an... OBJECTIVE:To investigate the distribution of Traditional Chinese Medicine(TCM)constitution among individuals with functional constipation,which would provide insights for developing constitution-targeted prevention and treatment strategies.METHODS:A systematic search was conducted across eight databases(China National Knowledge Infrastructure Database,Wanfang Database,China Science and Technology Journal for Chinese Technical Periodicals,Sino Med,Pub Med,Web of Science,Embase,and the Cochrane Library)to identify relevant observational studies assessing Traditional Chinese Medicine(TCM)constitution types among people with functional constipation.The protocol for this review has been registered on International Prospective Register of Systematic Reviews(registration number:CRD42022345996).RESULTS:A total of sixteen cross-sectional studies involving 2976 participants were included in this review.Among functional constipation patients,the proportions of Yin-deficiency,Yang-deficiency,and Qi-deficiency constitution were 27.0%[95%confidence interval(CI)19.9%to 36.7%],25.2%(95%CI 17.5%to 35.0%)and 23.7%(95%CI 15.8%to 34.0%),respectively.Besides,females accounted for a higher percentage of the population with functional constipation in the included studies,and most patients were aged 45 years or older.These findings may reflect the demographic characteristics of the general functional constipation population,where older adults and women are more commonly affected.The impact of gender and age on TCM constitution distribution merits further exploration.CONCLUSION:Our finding revealed that Yin-deficiency,Yang-deficiency,and Qi-deficiency are the predominant TCM constitution types in people with functional constipation.This study suggests that clinicians should focus on patients with these TCM constitution types in the prevention and management of functional constipation.Larger sample sizes and more rigorous methodological designs are needed in future studies.Furthermore,future researches should also focus on developing individualized prevention and treatment strategies based on different TCM constitution types. 展开更多
关键词 physical constitution theory cross-sectional studies correlation systematic review Meta-analysis
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Acupoint stimulation for pain management in patients after transcatheter arterial chemoembolization: A systematic review and meta-analysis 认领 引用
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作者 Wen-yi WANG Xiao-min QUAN +4 位作者 Ze-yu HE Hong-yang CHEN Xun LI Guan-hu YANG Chao AN 《World Journal of Acupuncture-Moxibustion》 CAS CSCD 2026年第1期29-43,共15页
Objective:To systematically evaluate the clinical efficacy of acupoint stimulation for managing posttranscatheter arterial chemoembolization(TACE) pain and to provide a reliable evidence-based foundation for its clini... Objective:To systematically evaluate the clinical efficacy of acupoint stimulation for managing posttranscatheter arterial chemoembolization(TACE) pain and to provide a reliable evidence-based foundation for its clinical application in post-TACE pain management.Methods:Clinical randomized controlled trials evaluating acupoint stimulation for post-TACE pain were retrieved from the Chinese National Knowledge Infrastructure,Wanfang Data Knowledge Service Platform,VIP Chinese Science and Technology Journal Database,China Biology Medicine disc,PubMed,Embase,Web of Science,the Cochrane Library,and ClinicalTrials.gov,covering all records from database inception to July 28,2025.Articles were screened and data were extracted according to predefined inclusion and exclusion criteria.The methodological quality of the included studies was assessed using the Cochrane Risk of Bias Assessment Tool.Statistical analyses were conducted using Review Manager 5.4.1and Stata 15.0.The certainty of evidence for each outcome was evaluated using the Grading of Recommendations Assessment,Development,and Evaluation approach.This study was registered on PROSPERO(CRD420251108966).Results:A total of 17 studies involving 1525 patients with liver cancer who experienced acute postoperative pain following TACE were included.Meta-analysis results demonstrated that acupoint stimulation significantly reduced pain intensity scores(Numerical rating scale:mean difference [MD]=-0.83,95 %confidence interval [CI] [-0.96,-0.71], P <0.00001;Visual analog scale:MD=-1.15,95 % CI [-1.67,-0.63],P <0.0001),increased the complete pain remission rate(Risk ratio [RR]=1.74,95% CI [1.35,2.23],P <0.0001),shortened the onset time of analgesia(MD=-25.39 min,95 % CI [-27.53,-23.26],P <0.00001),prolonged the duration of analgesia(MD=3.03 h,95% CI [0.40,5.66],P=0.02),and reduced the need for rescue analgesics(RR=0.43,95% CI [0.28,0.64],P <0.0001).Furthermore,acupoint stimulation improved liver function indicators(Alanine aminotransferase:MD=-5.27 U/L,95%CI [-6.90,-3.63],P <0.00001;Aspartate aminotransferase:MD=-6.76 U/L,95 % CI [-8.39,-5.12],P <0.00001),lowered plasma substance P levels(MD=-18.28 ng/L,95% CI [-30.97,-5.60],P=0.005),and enhanced patient satisfaction(RR=1.33,95% CI [1.05,1.69],P=0.02).Regarding safety,acupoint stimulation significantly reduced the risk of adverse events compared with blank controls(RR=0.24,95% CI [0.10,0.56],P=0.001).However,no statistically significant differences in the risk of adverse events were observed when acupoint stimulation was combined with analgesics(RR=0.91,95 % CI [0.39,2.13],P=0.82) or compared directly to analgesics alone(RR=0.79,95% CI [0.04,14.95],P=0.87).Conclusion:Acupoint stimulation demonstrates favorable effects in alleviating pain following TACE.However,the relatively low methodological quality of the included studies limits the strength of the conclusions.Additional high-quality studies are needed to provide more robust evidence to guide clinical practice. 展开更多
关键词 Acupoint stimulation Transcatheter arterial chemoembolization Postoperative pain Liver cancer Meta-analysis
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Association between periodontal disease and prostatic disease:a systematic review and meta-analysis of observational studies 认领 引用
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作者 Qiang Li Lan Wu +5 位作者 Yi Zhang Di Huang Song Ou-Yang Jia-Yu Yang Bing-Hui Li Xian-Tao Zeng 《The Canadian Journal of Urology》 SCIE 2026年第1期7-20,共14页
Objective:Current research highlights periodontal disease as a systemic inflammatory condition that may influence extra-oral diseases such as prostatic diseases,which prompted us to explore the potential association.T... Objective:Current research highlights periodontal disease as a systemic inflammatory condition that may influence extra-oral diseases such as prostatic diseases,which prompted us to explore the potential association.To evaluate whether periodontal disease is associated with an increased risk of prostatic disease,including prostate cancer,benign prostatic hyperplasia(BPH),and prostatitis.Methods:A systematic search of observational studies concerning the relationship between periodontal disease and prostatic disease was performed in online databases PubMed,Embase,Web of Science,Scopus,CENTRAL,CNKI,and WanFang.Searches were conducted from database inception to 31 July 2025.Pooled hazard ratio(HR)or odds ratio(OR)with 95%confidence intervals(CIs)were synthesized.Subgroup analysis was used to detect the origin of heterogeneity,sensitivity analysis was employed to evaluate the robustness of the results,and publication bias analyses were also performed.R software was used to perform statistical analyses.Results:Sixteen studies that met the preset criteria were included in this study.In the pooled analysis,periodontal disease was associated with increased risk of prostate cancer(HR=1.23,95%CI:1.16-1.29,p<0.001)or BPH(OR=1.55,95%CI:1.41-1.70,p<0.001).Sensitivity analysis confirmed the robustness of the results.No obvious publication biaswas found in the meta-analysis.Only one cohort study reported that chronic periodontitis increases the risk of prostatitis(HR=2.521,95%CI:1.685-4.005,p<0.001).The effect of periodontal treatment on prostatic disease is still unclear.Conclusions:The systematic review and meta-analysis identified an observational association between periodontal disease and increased risks of prostate cancer and BPH.Because all included studies were observational,these results indicate association rather than causation,and further prospective and mechanistic studies are required to clarify temporality and causality. 展开更多
关键词 Periodontal diseases prostatic diseases prostatic neoplasms prostatic hyperplasia systematic review meta-analysis
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Acupuncture on 5-hydroxytryptamine levels and clinical outcomes in depression:A systematic review and meta-analysis of randomized controlled trials 认领 引用
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作者 Yi Wang Peng-Tao Wu +3 位作者 Ittipalanukul Penpat Fei-Cui Zeng Qun Lu Zhi-Hai Hu 《World Journal of Psychiatry》 SCIE 2026年第2期377-390,共14页
BACKGROUND Depression is a prevalent global mental health issue with substantial disease burden.Although pharmacotherapy remains the first-line treatment,its efficacy and tolerability are limited.Acupuncture,a core mo... BACKGROUND Depression is a prevalent global mental health issue with substantial disease burden.Although pharmacotherapy remains the first-line treatment,its efficacy and tolerability are limited.Acupuncture,a core modality in traditional Chinese medicine,has shown promise in improving depressive symptoms via neurotransmitter modulation.However,prior meta-analyses often considered manual and electroacupuncture together,increasing heterogeneity.This review focuses solely on traditional acupuncture to clarify its therapeutic role and provide evidence for standardized clinical application.AIM To evaluate the efficacy of acupuncture in patients with depression and explore its feasibility as an adjunctive treatment.METHODS Twenty randomized controlled trials on traditional acupuncture for depression—whose quality was assessed using the Cochrane tool—were included in this meta-analysis.Primary outcomes were the Hamilton Depression Rating Scale(HAM-D),Beck Depression Inventory-II(BDI-II),Self-Rating Depression Scale(SDS),and MontgomeryÅsberg Depression Rating Scale(MADRS).Secondary outcomes were the Pittsburgh Sleep Quality Index(PSQI),Hamilton Anxiety Rating Scale(HAMA),Self-Rating Scale for the Side Effects(SERS),and serum 5-hydroxytryptamine(5-HT)levels.RevMan 5.4 software was employed for the meta-analysis.RESULTS Results revealed that acupuncture significantly reduced HAM-D,SDS,and MADRS scores.Although BDI-II scores improved in some studies,its overall effect was not statistically significant.Acupuncture also significantly improved HAMA and PSQI scores and increased serum 5-HT levels.Notably,SERS analysis indicated that acupuncture can significantly alleviate adverse reactions associated with antidepressants.However,most pooled results revealed substantial heterogeneity.CONCLUSION The efficacy of traditional acupuncture improving symptoms,sleep,and anxiety and alleviating antidepressant side effects is highly encouraging.However,the low quality of the included studies warrants cautious interpretation. 展开更多
关键词 Acupuncture Depression Meta-analysis 5-hydroxytryptamine Sleep disturbance Anxiety
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Tissue-Agnostic Targeting in Solid Tumors:A PRISMA-Compliant Meta-Analysis of Efficacy,Safety,and Resistance Determinants Across Histologies 认领 引用
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作者 Marwa Balaha Saad A.Aldosari +2 位作者 Ahmed A.Alamer Nehad Ahmed Mohamed F.Balaha 《Oncology Research》 SCIE 2026年第7期98-121,共24页
Objectives:Tissue-agnostic oncology personalizes treatments based on shared molecular biomarkers,addressing challenges like assay variability,control-arm rigor,and non-proportional hazards.Integrating efficacy,safety,... Objectives:Tissue-agnostic oncology personalizes treatments based on shared molecular biomarkers,addressing challenges like assay variability,control-arm rigor,and non-proportional hazards.Integrating efficacy,safety,and resistance factors with consistent estimands is essential for evaluating biomarker-matched therapies across histologies.This review aims to quantify and compare their efficacy and safety,and to identify determinants of resistance,using PRISMA-compliant methods.Methods:We conducted a systematic review and random-effects meta-analysis of 38 studies(15,018 participants),employing dual screening,standardized bias assessment,and evaluations of heterogeneity and small-study effects.Hazard ratios(HRs)with 95%CIswere estimated for time-to-event outcomes,and restricted mean survival times were used when the proportional hazards assumption was violated.Results:Trastuzumab deruxtecan improved objective response rates and extended progression-free survival(PFS)and overall survival(OS)in HER2-positive gastric and gastroesophageal junction cancers and in HER2-low metastatic breast cancer,showing longer response durations.In metastatic colorectal cancer with microsatellite instability-high(MSI-H)or deficient mismatch repair(dMMR),PD-1 blockade significantly increased PFS and five-year OS despite crossover,with restricted mean survival time gains of about 11 months.In endometrial cancer,dostarlimab combined with chemotherapy improved PFS in both dMMR/MSI-H and mismatch repair–proficient disease and increased OS overall.Encorafenib-based therapies reduced progression and death in BRAF V600E metastatic colorectal cancer.Safety profiles were class-specific:PD-1 inhibitors caused fewer grade 3 or higher adverse events than chemotherapy,whereas trastuzumab deruxtecan was associated with increased interstitial lung disease(ILD)or pneumonitis and higher rates of treatment discontinuation.Conclusion:Biomarker-matched therapies confer significant survival benefits with predictable toxicities.Confidence is strongest for PD-1 inhibitors in MSI-H/dMMR tumors,trastuzumab deruxtecan in HER2-low or HER2-positive cancers,and encorafenib-based regimens in BRAF V600E metastatic colorectal cancer.Implementation should include validated assays(including reconfirmation of HER2 status),prioritize earlier treatment lines where gains are greatest,and require vigilant ILD monitoring.Head-to-head trials and assay standardization,especially for tumor mutational burden,remain priorities. 展开更多
关键词 Tissue-agnostic therapy PRISMA meta-analysis MSI-H/dMMR PD-1 inhibitor HER2-low antibodydrug conjugate interstitial lung disease BRAF V600E NTRK fusion
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Correlation between bariatric surgery and breast cancer risk in women:A systematic review and meta-analysis 认领 引用
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作者 Yan-Fei He Huan-Zhi Wang +6 位作者 Ning Bian Xiao-Dong Hu Qin-Tong He Jun-Qiang Liu Hu-Ming Li Shuang-Feng Lu Ni Wu 《World Journal of Clinical Oncology》 2026年第3期223-238,共16页
BACKGROUND Obesity is a significant global public health challenge and a key risk factor for several types of cancer.Breast cancer,the most common malignant tumor among women,is strongly associated with obesity.Curren... BACKGROUND Obesity is a significant global public health challenge and a key risk factor for several types of cancer.Breast cancer,the most common malignant tumor among women,is strongly associated with obesity.Currently,bariatric surgery is the most effective approach for long-term weight management and improving metabolic health.Although research indicates that bariatric surgery decreases the likelihood of developing certain cancers,its impact on breast cancer incidence is unclear.AIM To investigate the relationship between bariatric surgery and breast cancer risk in women.METHODS We conducted a comprehensive search of multiple electronic databases for original studies comparing the incidence of breast cancer in women who underwent bariatric surgery to that in a control group.For the metaanalysis,we used a random-effects model and performed stratified analyses based on variables such as menopausal status,tumor stage,and hormone receptor status to examine effect modification.We evaluated the rigor of the study methods using the Risk of Bias in Non-randomized Studies of Interventions tool.We quantified heterogeneity using the I2 statistic and assessed the quality of the evidence using the Grading of Recommendations,Assessment,Development and Evaluation approach.Additionally,we created a funnel plot and performed a Begg’s test to evaluate publication bias.RESULTS A total of 17 observational studies,including 7129194 female patients,were included in the analysis.Of those patients,513601 underwent bariatric surgery,and 6615593 were in the control group.A meta-analysis revealed that bariatric surgery is significantly associated with a reduced overall risk of breast cancer[relative risk(RR)=0.52;95%confidence interval(CI):0.38-0.71;P<0.00001].However,substantial heterogeneity was observed(I2=98%).Subgroup analysis showed a consistent reduction in risk among premenopausal(RR=0.84;95%CI:0.72-0.99;P=0.04)and postmenopausal(RR=0.75;95%CI:0.60-0.92;P=0.006)women.Analysis by disease stage revealed an 18%increase in the RR of stage I cancer in the surgery group(RR=1.18;95%CI:1.06-1.32;P=0.003).Conversely,the incidence of stage III-IV cancer decreased significantly(RR=0.50;95%CI:0.31-0.82;P=0.006).The incidence of stage II cancer did not change significantly(RR=0.89;95%CI:0.73-1.10;P=0.28).No significant association was observed for hormone receptor-positive(estrogen receptor-positive,progesterone receptor-positive,and human epidermal growth factor receptor 2+)subtypes.The overall risk of bias was moderate to high.Based on the Grading of Recommendations,Assessment,Development and Evaluation criteria and other considerations,the quality of the evidence was ultimately rated as“moderate”.CONCLUSION According to observational data,bariatric surgery appears to reduce the overall risk of breast cancer,especially among postmenopausal women.However,the observed association with an increased risk of stage I cancer should be interpreted with caution.Further prospective studies are needed to establish causality. 展开更多
关键词 Bariatric surgery Metabolic surgery Obesity surgery Roux-en-Y gastric bypass Breast cancer Female-specific cancer Obesity-related cancer Gastric bypass surgery Meta-analysis
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Comparison of predictive values of Acute Physiology and Chronic Health Evaluation scores for mortality in sepsis:a systematic review and meta-analysis 认领 引用
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作者 Ping Xu Wei You +1 位作者 Shihao Liu Cheng Zhang 《World Journal of Emergency Medicine》 SCIE CAS CSCD 2026年第4期312-321,共10页
BACKGROUND:Acute Physiology and Chronic Health Evaluation(APACHE)scores are widely used in emergency medicine and critical care settings,yet their prognostic accuracy for sepsis-related mortality across different vers... BACKGROUND:Acute Physiology and Chronic Health Evaluation(APACHE)scores are widely used in emergency medicine and critical care settings,yet their prognostic accuracy for sepsis-related mortality across different versions remains to be assessed thoroughly.This study aimed to compare the pooled prognostic performance of APACHEⅡ,Ⅲ,andⅣin predicting in-hospital mortality in patients with sepsis.METHODS:We conducted a systematic review and meta-analysis by searching for articles in the Pub Med,Embase,Web of Science,and Cochrane databases,with a publication date range from February 23,2016,to June 8,2024.Random effects models were employed to analyse pooled data,focusing on key metrics such as the area under the curve(AUC),diagnostic odds ratio(DOR),sensitivity,specificity,positive likelihood ratio(PLR),and negative likelihood ratio(NLR).RESULTS:A total of 33 articles were analyzed,3 of which examined multiple APACHE scores.These articles collectively involved 60,041 patients:25 articles with 9,619 patients assessed APACHEⅡ,4 articles with 32,862 patients assessed APACHEⅢ,and 8 articles with 21,741 patients assessed APACHEⅣ.The AUC for in-hospital mortality improved progressively across versions:0.75(95%CI 0.66–0.83)for APACHEⅡ,0.81(95%CI 0.73–0.89)for APACHEⅢ,and 0.85(95%CI:0.78–0.92)for APACHEⅣ.APACHEⅣshowed numerically more favorable pooled prognostic estimates,with a DOR of 2.76(95%CI 2.08–3.78),sensitivity of 0.78(95%CI 0.66–0.86),specificity of 0.83(95%CI 0.68–0.92),PLR of 4.29(95%CI 2.33–7.89),and NLR of 0.28(95%CI 0.17–0.46).CONCLUSION:APACHEⅣdemonstrated the superior prognostic accuracy to the other versions for sepsis-related mortality.With the increasing adoption of automated calculations through standardized software,APACHEⅣmight be incorporated into routine clinical workflows. 展开更多
关键词 Acute Physiology and Chronic Health Evaluation scores Sepsis Mortality prediction Prognostic accuracy Meta-analysis
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Predictive value of preoperative computed tomography parameters for meniscal and cruciate ligament injuries in tibial plateau fractures:Meta-analysis 认领 引用
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作者 Ahmed Abdelazim A Hassan Ahmed A Khalifa +2 位作者 Antia Rodriguez Villalon Dimitri Hauri Tracy Y Zhu 《World Journal of Orthopedics》 2026年第4期163-176,共14页
BACKGROUND Tibial plateau fractures(TPFs),although comprising only 1%of all fractures,pose significant diagnostic and management challenges due to their frequent association with meniscal and ligamentous injuries.Comp... BACKGROUND Tibial plateau fractures(TPFs),although comprising only 1%of all fractures,pose significant diagnostic and management challenges due to their frequent association with meniscal and ligamentous injuries.Computed tomography(CT),widely employed in preoperative assessment of TPFs,may provide predictive insights into soft tissue injuries.AIM To evaluate the diagnostic accuracy of preoperative quantitative CT parameters in predicting meniscal and cruciate ligament injuries associated with TPFs.METHODS A systematic review was conducted per the PRISMA guidelines.Two databases(PubMed and Scopus)were searched up to October 2024.Studies were included if they involved skeletally mature patients with TPFs,reported at least one CT parameter predictive of soft tissue injury,and used arthroscopy or open surgery as the diagnostic gold standard.A risk of bias assessment was conducted using the Quality Assessment of Diagnostic Accuracy Studies 2 tool,and meta-analyses were performed where appropriate,using the random-effects model.RESULTS Lateral plateau depression(LPD)and lateral plateau widening(LPW)were the most commonly assessed parameters.Pooled analysis revealed that LPD and LPW were significantly higher in patients with lateral meniscus injuries(mean difference,5.23 mm and 1.37 mm,respectively;P<0.00001 and P=0.02).No significant associations were found for medial plateau depression or LPD with medial meniscus or posterior cruciate ligament injuries.Lateral area of depression and LPW were reported in a single study to be predictive of anterior cruciate ligament injuries.CONCLUSION Preoperative CT parameters,particularly LPD and LPW,provide a strong predictive value for lateral meniscus injuries in TPFs,potentially aiding in early diagnosis and management.However,their utility in predicting cruciate or medial meniscus injuries remains limited.CT scan remains a valuable first-line tool,especially where magnetic resonance imaging is inaccessible,and can guide further investigation or intraoperative planning. 展开更多
关键词 Tibial plateau fracture Meniscal injury Computed tomography Cruciate ligament injury Meta-analysis Systematic review
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Safety and efficacy of sodium-glucose cotransporter-2 inhibitors in adults with type 2 diabetes fasting during Ramadan:A meta-analysis 认领 引用
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作者 Abul Bashar Mohammad Kamrul-Hasan Shehla Shaikh +4 位作者 Hamid Ashraf Mohammad Shafi Kuchay Lakshmi Nagendra Deep Dutta Joseph M Pappachan 《World Journal of Diabetes》 SCIE 2026年第2期228-242,共15页
BACKGROUND Sodium-glucose cotransporter-2 inhibitors(SGLT2i)are widely used in managing type 2 diabetes(T2D).A significant number of these patients choose to observe religious fasting during Ramadan.Although existing ... BACKGROUND Sodium-glucose cotransporter-2 inhibitors(SGLT2i)are widely used in managing type 2 diabetes(T2D).A significant number of these patients choose to observe religious fasting during Ramadan.Although existing guidelines recommend caution when administering SGLT2i during Ramadan due to potential adverse effects,there is limited data on their use in this patient population.AIM To assess the safety and effectiveness of SGLT2i in patients with T2D who fast during Ramadan.METHODS Relevant studies involving adults with T2D who received an SGLT2i in the intervention arm and other glucoselowering drugs in the control arm were systematically searched through electronic databases.The primary outcome was the occurrence of adverse events in the two groups;additional outcomes included changes in glycemic and anthropometric parameters during the peri-Ramadan period.RevMan Web was used to conduct meta-analysis using random-effects models.Outcomes were presented as mean differences(MDs)or risk ratios(RRs)with 95%CI.RESULTS Twelve studies involving 3625 subjects were included.The risks of postural dizziness(RR=6.39,95%CI:1.58-25.80,P=0.009,I2=44%),hypotension/postural hypotension(RR=4.43,95%CI:1.35-14.55,P=0.01,I2=31%),and sodium loss(MD=-1.00 mmol/L,95%CI:-1.34 to-0.67,P<0.00001,I2=0%)were higher in the SGLT2i group compared to the non-SGLT2i group.The SGLT-2i group achieved larger reductions in systolic(MD=-2.41 mmHg,95%CI:-4.52 to-0.30,P=0.02,I2=46%)and diastolic blood pressure(MD=-1.71 mmHg,95%CI:-2.70 to-0.72,P=0.0007,I2=20%),and experienced a lower risk of symptomatic hypoglycemia(RR=0.53,95%CI:0.29-0.97,P=0.04,I2=69%).The two groups exhibited comparable changes in glycated hemoglobin,body weight,and renal function.The risks of other specific adverse events,including dehydration,dizziness,volume depletion,symptomatic hyperglycemia,severe hypoglycemia,and genitourinary infections,were identical in the two groups.CONCLUSION SGLT2i may be generally safe and effectively manage T2D during Ramadan;however,the results are less robust and should be interpreted with caution.Large multicenter randomized trials are necessary to confirm their safety,especially for at-risk groups,and to improve clinical decision-making. 展开更多
关键词 Type 2 diabetes Sodium-glucose cotransporter-2 inhibitors Ramadan Religious fasting Safety Meta-analysis
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Factors associated with aseptic loosening after primary total hip arthroplasty:A systematic review and meta-analysis 认领 引用
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作者 Guo-Qing Li Ji Zhang Yong Huang 《World Journal of Orthopedics》 2026年第1期149-163,共15页
BACKGROUND Aseptic loosening remains the leading cause of revision in primary total hip arthroplasty(pTHA).However,the literature demonstrates significant variability regarding the relative contributions of different ... BACKGROUND Aseptic loosening remains the leading cause of revision in primary total hip arthroplasty(pTHA).However,the literature demonstrates significant variability regarding the relative contributions of different factors.AIM To investigate the key determinants of aseptic loosening,we performed a systematic review and meta-analysis.METHODS A comprehensive search of PubMed,Web of Science,EMBASE,and the Cochrane Library was conducted,encompassing studies from database inception to January 1,2025.Meta-analyses were performed to evaluate factors associated with aseptic loosening following pTHA.Inclusion and exclusion criteria were systematically applied at each stage to ensure methodological transparency and reproducibility.Study quality was assessed using standardized categories.Pooled odds ratio(OR)with corresponding 95%confidence interval were calculated with random-or fixed-effects models to generate reliability estimates,and study heterogeneity was visualized using forest plots.Ten factors,categorized into patient-,surgeon-,and device-related domains,were reviewed and meta-analyzed.Funnel plot analysis demonstrated a relatively symmetrical distribution,suggesting minimal publication bias.RESULTS A meta-analysis of 20 studies(520789 participants)found a pooled prevalence of 1.96%.Significant risk factors for aseptic loosening after pTHA included elevated body mass index(OR=1.116,P<0.001),higher Charlson comorbidity index(OR=1.378,P<0.001),prosthesis-related factors(OR=1.497,P<0.001),and adverse lifestyles(OR=2.198,P=0.037).Protective factors were non-white race(OR=0.445,P<0.001)and favorable genetics(OR=0.723,P<0.001).Male sex increased risk(OR=1.232,P=0.016),while age and anatomy were not significant.Surgical expertise showed a slight protective effect(OR=1.048,P<0.001).A comprehensive understanding of the modifiable and non-modifiable factors contributing to aseptic loosening after pTHA requires consideration of patient-related factors,surgical expertise,and prosthesis characteristics.CONCLUSION The identification of these factors is critical for risk mitigation.High-risk patients should receive targeted counseling regarding individualized profiles.Further studies are warranted to establish clearer causal relationships and identify additional contributing factors. 展开更多
关键词 Factors Aseptic loosening Primary total hip arthroplasty Systematic review Meta-analysis
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Key considerations in a meta-analysis of physiology-guided percutaneous vs surgical revascularization in multivessel coronary artery disease 认领 引用
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作者 Tsung Ying Tsai Patrick W Serruys Scot Garg 《World Journal of Cardiology》 2026年第3期161-163,共3页
We read the meta-analysis by Kataveni et al with great interest;however,we have identified two major methodological errors.First,the population from the Fractional Flow Reserve Versus Angiography for Multivessel Evalu... We read the meta-analysis by Kataveni et al with great interest;however,we have identified two major methodological errors.First,the population from the Fractional Flow Reserve Versus Angiography for Multivessel Evaluation 3(FAME 3)trial appears to have been double-counted through inclusion of both Fearon et al(primary FAME 3 trial)and Dillen et al(a FAME 3 bifurcation substudy),likely violating the independence assumptions required for meta-analytic pooling.Second,the study by Di Gioia et al(2020)has been misclassified as a randomized controlled trial,whereas it is a registry-based,non-randomized study.Because the authors'conclusions rely on the inclusion of"three randomized controlled trials"with minimal heterogeneity,these errors may overstate the certainty of the evidence and introduce bias into the pooled estimates.We request that the authors address these concerns,perform a re-analysis as required,and revise the manuscript accordingly.Ultimately,these issues reflect the general paucity of high-quality randomized data in this field. 展开更多
关键词 Fractional flow reserve Percutaneous coronary intervention Coronary artery bypass grafting Randomized controlled trial Meta-analysis
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Efficacy of regorafenib in the treatment of advanced hepatocellular carcinoma:A systematic review and meta-analysis 认领 引用
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作者 Zhang Cheng Ai-Min Yue 《World Journal of Gastrointestinal Oncology》 SCIE 2026年第1期221-232,共12页
BACKGROUND Regorafenib is approved as a second-line treatment for advanced hepatocellular carcinoma(HCC),but its comparative efficacy remains under evaluation.AIM To evaluate the efficacy and safety of regorafenib vs ... BACKGROUND Regorafenib is approved as a second-line treatment for advanced hepatocellular carcinoma(HCC),but its comparative efficacy remains under evaluation.AIM To evaluate the efficacy and safety of regorafenib vs other second-line therapies in advanced HCC.METHODS This systematic review and meta-analysis were conducted in accordance with PRISMA guidelines.A comprehensive search of PubMed,EMBASE,Web of Science,and the Cochrane Library was performed on June 6,2025.Studies were included if they reported at least one relevant clinical outcome:Overall survival,progression-free survival,objective response rate,or disease control rate.Data was extracted independently by two reviewers.Quality was assessed using the Cochrane Risk of Bias 2.0 tool for randomized controlled trials and the Newcastle-Ottawa Scale for cohort studies.Pooled effect estimates were calculated using random-or fixed-effects models depending on the degree of heterogeneity.Sensitivity analyses and Egger’s test were performed to evaluate the robustness of the results and potential publication bias.RESULTS Nine studies met inclusion criteria.Regorafenib significantly improved overall survival compared to controls[weighted mean difference=2.54 months;95%confidence interval(CI):0.26-4.81;P<0.05],but no significant benefit was observed for progression-free survival(weighted mean difference=1.04;95%CI:-1.27 to 3.36).The pooled objective response rate showed no overall difference,though regorafenib was inferior to nivolumab in subgroup analysis(odds ratio=0.34;95% CI:0.20-0.58).Disease control rate did not differ significantly.No publication bias was detected.CONCLUSION Regorafenib offers a survival advantage in advanced HCC but does not significantly improve tumor response rates compared to alternative therapies. 展开更多
关键词 Regorafenib Hepatocellular carcinoma Second-line therapy Overall survival Meta-analysis
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Staging laparoscopy in esophagogastric junction cancer:Systematic review and meta-analysis 认领 引用 被引量：1
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作者 Roberto de la Plaza Llamas Diego Ribera Díaz +5 位作者 Paula Betancor Díaz Daniel A Díaz Candelas Raquel A Latorre-Fragua Ludovica Gorini Rodrigo Arellano González Ignacio A Gemio del Rey 《World Journal of Gastrointestinal Surgery》 SCIE 2026年第1期376-394,共19页
BACKGROUND Staging laparoscopy(SL)is a valuable tool for detecting occult peritoneal or hepatic metastases in patients with gastroesophageal junction(GEJ)cancer,especially when imaging suggests resectability.Despite a... BACKGROUND Staging laparoscopy(SL)is a valuable tool for detecting occult peritoneal or hepatic metastases in patients with gastroesophageal junction(GEJ)cancer,especially when imaging suggests resectability.Despite advances in cross-sectional imaging methodologies such as computed tomography,positron emission tomography/computed tomography and endoscopic ultrasound,these techniques may miss low-volume or superficial peritoneal disease.Early identification of metastatic spread through SL can avoid unnecessary surgery,reduce morbidity,and improve treatment planning.However,its use in GEJ tumors-particularly Siewert types Ⅰ and Ⅱ-remains debated.Understanding the diagnostic performance(DP)of SL is essential for optimizing staging strategies.AIM To evaluate the DP of SL in identifying abdominal metastatic disease in patients with clinically resectable GEJ tumors.METHODS Systematic review and meta-analysis in accordance with PRISMA 2020 guidelines.A comprehensive PubMed search was performed up to March 29,2024,using Medical Subject Headings terms related to GEJ,laparoscopy,and cancer staging.Inclusion criteria:Studies assessing SL in patients with GEJ tumors.Primary outcome was the rate of upstaging to stage Ⅳ due to peritoneal or hepatic metastases.Secondary outcomes included details on techniques,patient characteristics,and procedural factors.Risk of bias was evaluated using Risk of Bias in Non-randomised Studies of Interventions and certainty of evidence with Grading of Recommendations,Assessment,Development and Evaluation.RESULTS Eighteen studies involving 1591 patients were included.SL upstaged 22%of patients(95%confidence interval:17-27)to stage Ⅳ due to occult metastatic disease.The pooled positivity rates were positive peritoneal malignancy(17.5%),peritoneal carcinomatosis(13%),malignant peritoneal cytology(9%),and hepatic metastases(9.2%).SL avoided unnecessary surgery in 19.8%of cases.Subgroup analysis revealed consistent performance in Siewert Ⅱ tumors(DP=13%,I2=0),while in Siewert Ⅰ tumors it was more heterogeneous(DP=18%,I2=93.7%).Only five studies reported complications,mostly minor,with no procedure-related mortality.No comorbidities,carcinomatosis scoring,conversion to open surgery,complications of follow-up,readmissions,postoperative length of stay,or delay in initiating neoadjuvant therapy were recorded.CONCLUSION SL improves staging accuracy in GEJ cancers,especially Siewert Ⅱ.Despite heterogeneity and limited data stratification,SL may guide therapeutic decisions and help avoid unnecessary or futile surgeries. 展开更多
关键词 Esophagogastric junction Laparoscopy Neoplasm staging Staging laparoscopy Systematic review Meta-analysis
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Cemented vs uncemented femoral fixation in total hip arthroplasty:A systematic review and meta-analysis of periprosthetic fracture risk 认领 引用 被引量：1
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作者 Mohammed H Abushal Osama M Embaby +2 位作者 Mahmoud Mersal Emran Badghish Mohamed Elalfy 《World Journal of Orthopedics》 2026年第2期132-142,共11页
BACKGROUND Periprosthetic femoral fractures(PFFs)represent a devastating complication following primary total hip arthroplasty(THA),associated with significant morbidity,mortality,and healthcare costs.The choice of fe... BACKGROUND Periprosthetic femoral fractures(PFFs)represent a devastating complication following primary total hip arthroplasty(THA),associated with significant morbidity,mortality,and healthcare costs.The choice of femoral fixation method-cemented vs uncemented-may influence the risk of postoperative periprosthetic fracture.While uncemented stems have gained popularity due to perceived advantages in younger patients and bone preservation,emerging evidence suggests potential differences in fracture risk between fixation methods,particularly in elderly and osteoporotic populations.AIM To conduct a systematic review and meta-analysis comparing the risk of PFFs between cemented and uncemented femoral fixation in primary THA.METHODS Following the PRISMA 2020 guidelines,we performed a comprehensive search of PubMed,EMBASE,and the Cochrane Library databases up to October 2025.We included comparative studies reporting periprosthetic fracture rates following primary THA with cemented vs uncemented femoral fixation.The primary out-come was the incidence of PFFs.Data were pooled using a random-effects model.Risk of bias was assessed using the Cochrane RoB 2.0 tool for randomized controlled trials and the Methodological Index for Non-Randomized Studies for observational studies.Publication bias was evaluated using funnel plot analysis and Egger’s test.RESULTS A total of 27 studies were included in the qualitative synthesis,of which three comparative studies,encompassing 2650 patients(772 cemented,1878 uncemented),provided extractable data for quantitative meta-analysis of periprosthetic fracture incidence.The pooled analysis demonstrated a trend towards a lower risk of periprosthetic fractures in the cemented group compared to the uncemented group(risk ratio=0.46;95%confidence interval:0.14-1.49;P=0.19);however,this finding was not statistically significant.Substantial heterogeneity was observed among the included studies(I2=93.1%,P<0.001).Funnel plot analysis was limited by the small number of studies but did not suggest significant publication bias.CONCLUSION This meta-analysis suggests that cemented femoral fixation in primary THA may be associated with a lower risk of PFFs compared to uncemented fixation,although this finding did not reach statistical significance and was based on limited,heterogeneous data.The choice of fixation method should be individualized based on patient age,bone quality,activity level,and surgeon experience.Cemented fixation may be particularly advantageous in elderly patients and those with poor bone stock.Further high-quality randomized controlled trials with adequate followup are needed to provide definitive evidence. 展开更多
关键词 Periprosthetic femoral fracture Total hip arthroplasty Primary total hip arthroplasty Cemented fixation Uncemented fixation Meta-analysis Fracture prevention
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Semaglutide in patients with obesity and heart failure with preserved ejection fraction:A systematic review and meta-analysis 认领 引用 被引量：1
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作者 Maneeth Mylavarapu Ogechukwu Obi +8 位作者 Yozahandy Abarca Husna Fatima Prarath Roshni Noor Ul Huda Yuliya Lysak Asad Gandapur Samantha Contreras Vazquez Muhammad Areeb Siddiqui Adetola Mowo-Wale 《World Journal of Cardiology》 2026年第3期123-133,共11页
BACKGROUND Obesity-related heart failure in patients is often associated with a high symptom burden.However,no treatments have been proven to specifically target obesity-related heart failure with preserved ejection f... BACKGROUND Obesity-related heart failure in patients is often associated with a high symptom burden.However,no treatments have been proven to specifically target obesity-related heart failure with preserved ejection fraction(HFpEF).AIM To evaluate the efficacy of semaglutide in patients with obesity and HFpEF.METHODS Per the PRISMA guidelines,studies reporting clinical outcomes of semaglutide in patients with obesity and HFpEF were included.The outcomes included percentage weight change and adjudicated heart failure events.Both random and common effects models were used for the data analysis.The random intercept logistic regression model was used to compute the proportions,and the Peto method was used to compute the odds ratios(OR).A P≤0.05 was considered significant.RESULTS In total,three studies with 1463 patients with obesity and HFpEF were included in the study.The mean age of the patients was 68.8±3.47 years.50.7%of the patients were females.Patients who received semaglutide had statistically higher odds of achieving 10%(OR=6.35;95%CI:1.54-26.21;P<0.00001)and 15%(OR=9.44;95%CI:2.91-30.60;P<0.0001)weight reductions compared to those who received placebo.Additionally,patients who received semaglutide had lower odds of adjudicated heart failure event(OR=0.29;95%CI:0.14-0.58;P=0.0005)when compared to patients on placebo.CONCLUSION Our study demonstrates that semaglutide is significantly effective in reducing weight and potentially lowering the risk of heart failure events.This suggests that semaglutide could be a promising therapeutic option for managing obesity-related HFpEF. 展开更多
关键词 Semaglutide Heart failure with preserved ejection fraction Obesity Weight-loss Glucagon-like peptide-1 receptor agonists Meta-analysis
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Comparative effectiveness of electroacupuncture and conventional acupuncture for rheumatoid arthritis pain:A network meta-analysis with emphasis on placebo control validity 认领 引用
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作者 Shan Wang Ye-hua Xue +2 位作者 Li-bing Liang Kun-peng Li Cai-qin Wu 《Journal of Integrative Medicine》 SCIE CAS CSCD 2026年第1期57-64,共8页
Background:Acupuncture is recognized as an alternative therapy for rheumatoid arthritis(RA)pain,but its efficacy evaluations are often confounded by variability in sham acupuncture techniques.The accurate selection of... Background:Acupuncture is recognized as an alternative therapy for rheumatoid arthritis(RA)pain,but its efficacy evaluations are often confounded by variability in sham acupuncture techniques.The accurate selection of sham acupuncture controls,which are administered at either therapeutic acupuncture points or non-acupuncture points,is crucial for the validity of assessment outcomes.Objective:To assess the efficacy of acupuncture in treating RA pain and identify the most effective acupuncture methods.Search strategy:Databases including MEDLINE,Embase,Pub Med,Cochrane Library,Scopus,Web of Science,China National Knowledge Infrastructure Database,Chinese Science and Technology Journal Database,and Wanfang Database were searched from inception to October 11,2024.Keywords included‘‘rheumatoid arthritis,”‘‘acupuncture,”‘‘electroacupuncture,”and‘‘pain.”Inclusion criteria:Randomized controlled trials(RCTs)in adults with RA that assessed pain using a visual analog scale and joint swelling by swollen joint count.Eligible trials compared electroacupuncture,conventional acupuncture,or sham acupuncture,against standard pain medication.Data extraction and analysis:Two reviewers independently extracted data on study design,participant characteristics,interventions and outcomes.Risk of bias was evaluated using the Cochrane Risk of Bias2 tool,and evidence certainty was assessed via the confidence in network meta-analysis framework.A frequentist network meta-analysis with random-effect models was conducted,and standardized mean difference(SMD)and 95%confidence interval(CI)were reported.Results:Ten RCTs involving 704 participants were analyzed.Electroacupuncture(SMD:–1.42;95%CI:[–1.87,–0.98])and conventional acupuncture(SMD:–1.11;95%CI:[–1.49,–0.73])outperformed conventional therapy and non-acupoint sham needling.Surface under cumulative ranking curve showed that electroacupuncture was most effective for pain reduction(97.7%),followed by conventional acupuncture(75.1%),non-acupoint sham(29.1%),same-acupoint sham(28.6%),and conventional therapy(19.5%).Conclusion:Electroacupuncture demonstrated the highest efficacy for RA pain relief.Same-acupoint sham acupuncture may underestimate acupuncture's true effect and is not recommended as a placebo control.Non-acupoint sham acupuncture is a more valid control for future trials. 展开更多
关键词 Electroacupuncture Acupuncture Rheumatoid arthritis Pain Systematic review Meta-analysis
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EEG Spectral Analysis of Tinnitus Sound Therapy:Meta-Analysis 认领 引用
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作者 Xueyan Wang Sisi Liu +3 位作者 Yanjun Jia Bowen Chen He Qin Xin Li 《Journal of Otology》 CSCD 2026年第2期106-112,共7页
Background Chronic subjective tinnitus affects 15–20%of adults globally,with 3–5%experiencing severe quality-of-life impairment.Sound therapy(ST)is a core intervention,but its neuromodulatory mechanisms remain incom... Background Chronic subjective tinnitus affects 15–20%of adults globally,with 3–5%experiencing severe quality-of-life impairment.Sound therapy(ST)is a core intervention,but its neuromodulatory mechanisms remain incompletely characterized due to the lack of objective biomarkers.Methods Following PRISMA guidelines,we systematically searched PubMed,Web of Science,Embase,and other databases(1977-2025)for randomized controlled trials(RCTs)investigating ST effects on EEG spectral power in tinnitus patients.Inclusion criteria required pre/post-ST EEG data in delta(0.5-4 Hz)and alpha(8-14 Hz)bands.Two independent reviewers extracted data and assessed bias using Cochrane tools.Standardized mean differences(SMDs)with 95%confidence intervals(CIs)were pooled via fixedandom-effects models.Results Two RCTs(n=71 patients)met inclusion criteria.Post-ST,the intervention group showed non-significant trends toward increased delta(SMD=0.11,95%CI:[-0.40,0.62],P=0.67)and alpha(SMD=0.09,95%CI:[-0.41,0.60],P=0.72)power.Between-group analyses revealed greater alpha enhancement in customized ST versus controls(SMD=0.40,95%CI:[-0.12,0.91],P=0.13;I2=39%).Alpha changes demonstrated moderate consistency across studies(I2=39%,P=0.19).Conclusion ST induces measurable delta/alpha power modulation,suggesting enhanced inhibitory neurotransmission and attentional regulation.While statistical significance was limited by sample size,these trends support EEG as a tool for objective treatment monitoring.We propose a“dual-band synergistic neuromodulation”framework:ST concurrently suppresses pathological hyperexcitability and potentiates slow-wave inhibition.Standardized EEG protocols and longitudinal validation are critical for advancing precision tinnitus therapeutics. 展开更多
关键词 tinnitus sound therapy electroencephalography meta-analysis neuromodulation biomarkers
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