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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.

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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.