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Two reviewers (Pan Yang and Bin Xuan) independently assessed the quality of the included studies by the EPHPP (Effective Public Health Practice Project) Modified scale with minor modifications [22]. The indicators of quality assessment included the following aspects: (1) study design (number of subjects, gender distribution, and inclusion and exclusion criteria), (2) identification of confounding factors (stain and number of cells evaluated), (3) blind analysis (hide sample information when viewing cells under a microscope), and (4) data analysis (Appropriate statistical methods and analysis of cytotoxicity). According to the above four indicators, the literature was evaluated into three grades: strong (three strong ratings and no weak), weak (with two or more weak ratings), and moderate (all remaining cases).

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