ABSTRACT
BACKGROUND@#The global pandemic coronavirus disease 2019 (COVID-19) has become a major public health problem and presents an unprecedented challenge. However, no specific drugs were currently proven. This study aimed to evaluate the comparative efficacy and safety of pharmacological interventions in patients with COVID-19.@*METHODS@#Medline, Embase, the Cochrane Library, and clinicaltrials.gov were searched for randomized controlled trials (RCTs) in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)/SARS-CoV. Random-effects network meta-analysis within the Bayesian framework was performed, followed by the Grading of Recommendations Assessment, Development, and Evaluation system assessing the quality of evidence. The primary outcome of interest includes mortality, cure, viral negative conversion, and overall adverse events (OAEs). Odds ratio (OR) with 95% confidence interval (CI) was calculated as the measure of effect size.@*RESULTS@#Sixty-six RCTs with 19,095 patients were included, involving standard of care (SOC), eight different antiviral agents, six different antibiotics, high and low dose chloroquine (CQ_HD, CQ_LD), traditional Chinese medicine (TCM), corticosteroids (COR), and other treatments. Compared with SOC, a significant reduction of mortality was observed for TCM (OR = 0.34, 95% CI: 0.20-0.56, moderate quality) and COR (OR = 0.84, 95% CI: 0.75-0.96, low quality) with improved cure rate (OR = 2.16, 95% CI: 1.60-2.91, low quality for TCM; OR = 1.17, 95% CI: 1.05-1.30, low quality for COR). However, an increased risk of mortality was found for CQ_HD vs. SOC (OR = 3.20, 95% CI: 1.18-8.73, low quality). TCM was associated with decreased risk of OAE (OR = 0.52, 95% CI: 0.38-0.70, very low quality) but CQ_HD (OR = 2.51, 95% CI: 1.20-5.24) and interferons (IFN) (OR = 2.69, 95% CI: 1.02-7.08) vs. SOC with very low quality were associated with an increased risk.@*CONCLUSIONS@#COR and TCM may reduce mortality and increase cure rate with no increased risk of OAEs compared with standard care. CQ_HD might increase the risk of mortality. CQ, IFN, and other antiviral agents could increase the risk of OAEs. The current evidence is generally uncertain with low-quality and further high-quality trials are needed.
Subject(s)
Humans , COVID-19 , Medicine, Chinese Traditional , Network Meta-Analysis , Pandemics , SARS-CoV-2ABSTRACT
Idiopathic orbital inflammatory pseudotumor(IOIP) is a common orbital disease.It is a nonspecific inflammatory process,and the etiology is still unknown.IOIP occurs at any position of orbit.The clinical manifestation varies according to the anatomic involvement and the degree of inflammation progress.IOIP can clinically mimic many other orbital diseases,especially serious type of this disease can present similar clinical characteristics as the malignant tumor,so it is comprehensive to make a clinical diagnosis.Currently,the diagnosis of IOIP is allowed based on the differentiation from an exclusion of other diseases by a thorough medical history and clinical manifestations,and then acquire some assistant information by radiologic evaluation and laboratory tests and observe the response to steroid treatment.The final diagnosis still requires histopathological examination.
ABSTRACT
The pathogenic basis of degenerative retinal diseases is structural and functional abnormality of neuron of retina.The irreversible damage of visual function is the unfortunate results of degenerative retinal diseases,and some effective treating approach to these blindness eye diseases is still in expectation.In recent years,stem cells replacement therapy is increasingly developed and is a prospective way for degenerative retinal diseases.But some formidable challenges for successfully grafting cells to the retina are waiting for further solving,such as migration,survival,and differentiation of the stem cells etc.Recent studies showed that retinal tissue engineering technique may be a good alternation to address all the problems mentioned above.The current advances in stem cell and tissue engineering retina researches,including selectable seed cells,appropriate scaffold materials and transferring method in vivo,are reviewed in this paper.