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OBJECTIVE： To conduct methodology/reporting quality reevaluation for Meta-analysis/systematic evaluation of anti-TNF-α monoclonal antibody in the treatment of ulcerative colitis. METHODS： Retrieved from the Cochrane library， PubMed， Embase， CBM， Wanfang database and CNKI during data base establishment to Nov. 2018， Meta-analysis/systematic evaluations of anti-TNF-αmonoclonal antibody in the treatment of ulcerative colitis were collected. After data extraction of literatures that meet the inclusion criteria， methodological quality and reporting quality of included studies were evaluated by using AMSTAR scale and the PRISMA statement. RESULTS： Fourteen literatures of Meta-analysis/systematic evaluation were included. The average score of AMSTAR methodology quality （full score of 11 points） was 6.89， with medium methodological quality. PRISMA score （full score of 27 points） ranged from 15 to 26.5. CONCLUSIONS： Meta-analysis/systematic evaluations of anti-TNF-α monoclonal antibody for ulcerative colitis have poor methodological and reporting quality.
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Objective To observe the influences on prognoses and airway acid and base levels while using anti-inflammatory and anti-reflux therapies combined with "Hezhong Fuzheng massage" for treatment of infants with gastric volvulus (GV) and gastroesophageal reflux (GER)-induced pneumonia in order to provide evidence for clinical diagnosis and treatment of such infant disease. Methods Sixty infants 1-6 months old admitted to the Department of Integrated Traditional Chinese and Western Medicine of Wuhan Children's Hospital from January 2013 to December 2015 were diagnosed as pneumonia combined with GV and GER by the chest radiograph and radiography of upper gastrointestinal tract (UGT) with iodine, and according to difference in diagnostic methods, they were divided into an observation 1 group (30 cases) and an observation 2 group (30 cases). In observation 1 group, 24-hour pH value in upper digestive tract especially the distal esophagus was dynamically monitored, while in observation 2 group, 24-hour multichannel intraluminal impedance (MII) combined with pH monitoring of esophagus was carried out. Furthermore, two control groups were set up, each 30 cases; after radiography of the UGT with iodine, the control 1 group was diagnosed as GV and GER without pneumonia and control 2 group was diagnosed as only simple GV. Treatment of infant pneumonia was carried out in accordance with the guidelines for the management of community-acquired pneumonia in children; the treatment of GV and GER included postural, dietary, prokinetic and Hezhong Fuzheng massage [acupoint selection and massage was undertaken in 5 steps: push from the palmar crease to Banmen (rectilinear pushing manipulation) 300 times, push abdominal Yin and Yang (finger-pushing massage) 200 times, palpate the abdomen (clockwise) 100 times, poking of Tianshu 100 times, poke alternately bilateral Zusanli 100 times. Once-daily massage, (15±2) minutes each time, for consecutive 7 days]. The results of pH monitoring of the distal esophagus in observation 1 group was recorded; All GER data concerning pH monitoring of observation 2 group and the results of esophagus multi-channel intra-luminal impedance combined with pH monitoring in control group were compared. After 7 days of continuous treatment, the clinical efficacy of pneumonia and GV, hospitalization time, prognosis and the changes of sputum pH before and after treatment in the two observation groups were compared. Results In two observation groups, the main type of 60 cases with GV was organoaxial volvulus, accounting for 91.67% (55 cases), and more than 60% patients exhibited sputum pH <7.0. The distal esophagus 24-hour pH dynamic monitoring in observation 1 group showed that there were 26 cases with acid reflux (86.67%), 4 cases with GER negative (13.33%), the proportion of pH < 4 in GER negative patients was significantly lower than that in moderate acid reflux patients [3.35% (0.77% - 8.08%) vs. 26.23% (15.19% - 42.87%), P < 0.05], the number of long reflux (> 5 minutes) in GER negative patients was significantly reduced than that in mild acid reflux patients [times: 2 (0-5) vs. 7 (2-15), P < 0.05], the longest time of reflux in GER negative patients was significantly shorter than that in either mild or moderate acid reflux patients [minutes: 5.9 (2.5-10.0) vs. 19.2 (5.9-51.0), 41.6 (16.9-121.0), both P < 0.05]. The 24-hour MII-pH monitoring of esophagus in observation 2 group showed that there were 30 cases with pathological reflux, mainly mild acid reflux accounting for 90%, in which the percentage of proximal reflux events was 46.07% in the total reflux events. The numbers of acid reflux and proximal reflux in the observation 2 group were significantly higher than those in the control 1 and 2 groups [1 305 (37.72%) vs. 795 (25.69%) and 136 (18.89%), 1 594 (46.07%) vs. 687 (22.20%) and 154 (21.39%), both P < 0.05]; there were no significant differences in total effective rate (100% vs. 100%, P > 0.05) and hospitalization time (days: 7.58±1.09 vs. 7.67±1.12, P > 0.05) between the two observation groups. Conclusions For the diagnosis of infant pneumonia combined with GV and GER, the first selection of chest radiograph and radiography of the UGT with iodine can identify the severity of pneumonia, whether it is complicated with GV and its classification, and whether GER exists at the same time. The estimation of 24-hour pH dynamic monitoring of the acid reflux in the upper digestive tract especially the distal esophagus is consistent with that of the 24-hour MII-PH monitoring of esophagus. Moreover, 24-hour MII-PH monitoring of esophagus can also identify non-acid reflux, resulting in the GER diagnosis more accurate. Since the proximal reflux ratio of infants with GV combined with GER and pneumonia is relatively high and easy to cause cough and aspiration. attention should be paid on early diagnosis and timely intervention to such patients. The sputum acidity test can reflect the airway acid-base level and its manipulation is simple, so by that the real time disease situation can be estimated, and aspiration of sputum also can help the treatment. The therapeutic schedule formulated by our group can elevate the therapeutic effect, improve the airway acid-base environment and benefit prognosis.
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Objective To observe the clinical characteristics of infants with pertussis syndrome and the influence of gastroesophageal reflux (GER) on pertussis syndrome in small infants, and provide experience for improving curative effect. Methods ① The clinical data of 807 infants with pertussis syndrome treated at Wuhan Children's Hospital from January 2015 to June 2017 were retrospectively analyzed, in which their clinical characteristics including symptoms, signs and related physical and chemical examinations were summarized. ② Prospective randomized controlled trials were performed at the Children's Hospital of Wuhan from June 2017 to June 2018, there were 120 infants with ages < 6 months diagnosed as pertussis syndrome and simultaneously accompanied by gastric volvulus (GV) and GER, and they were randomly divided into a study group and a control group according to the date sequence of definite diagnosis, 60 cases in each group. The control group was given conventional medical treatment, while in the study group, additionally the infants received massage to restore gastric proper position and anti-reflux therapy. The clinical efficacies of two groups were observed. Results ① Retrospective analysis showed that clinically, pertussis syndrome commonly occurred in infants of ages < 6 months, accounting for 88.30% (713 cases); all cases had spastic cough, and 60.00% (484 cases) infants' coughing was severer at night. In laboratory examinations, 83.27% (672 cases) of the infants had elevated platelets (PLT), 25.03% (202 cases) had abnormal myocardial zymograms, and 70.38% (568 cases) had elevated white blood cells (WBC). In the pathogen examination, only were pathogens found in 34.8% infants, mainly single pathogen infection, accounting for 86.12%. Chest radiographs suggested 71.50% of infants with pneumonia, and 73.00% of infants with GER, among which 77.92% of infants were accompanied by GV. ② The prospective study showed that in the treatment of infants with pertussis syndrome accompanied by GV and GER, manual massage should be used timely to correct GV and simultaneously anti-reflux therapy should be given, in the aspects of time required to improve cough symptoms (days: 5.36±1.40 vs. 6.59±1.56, P < 0.01) and shortening of the hospital stay (days: 6.50±1.41 vs. 8.09±1.63, P < 0.01) in the study group were superior to those in the control group; the case of respiratory failure in the study group was lower than that in the control group [2 cases vs. 8 cases, P < 0.05]. Conclusions In pertussis syndrome, lymphocytes occupy the main proportion of WBC elevation that is an important differential criterion between pertussis syndrome and infantile pneumonia with gastric volvulus and gastroesophageal reflux. PLT elevation in pertussis syndrome suggests that attention should be paid to the elevation as that might be related to the disease prognosis. It is necessary to further investigate whether the positive pathogen discovered in the course of pertussis syndrome is a pathogenic one, and attention should also be paid to the medical examination of GV and GER in the small infants with pertussis syndrome, since early proper intervention to correct GV and GER can significantly improve their clinical efficacies.
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Objective To investigate the effect of COX￣2 inhibitor celecoxib on radiosensitity of irradiation￣resistant cell line CNE￣2R of nasopharyngeal carcinoma and the potential mechanism. Methods Via exposing to a series of X￣ray (2, 4, 6, 8 Gy, 3 times for each dose), radio￣resistant cell subline CNE￣2R was established from human nasopharyngeal carcinoma cell CNE￣2.Radiosensitivity was detected by clone formation assay.CNE￣2R and CNE￣2 cell lines were exposed to 25, 50, 75 μmol.L-1 celecoxib, respectively.Western blotting was used to detect the protein expression of COX￣2.Clone formation assay was performed to measure the survival fraction of CNE￣2 and CNE￣2R after radiotherapy alone or radiotherapy combined with 30 μmol.L-1 celecoxib treatment.Flow cytometry was used to measure influence of radiotherapy alone or radiotherapy combined with 30 μmol.L￣1celecoxib treatment on cell apoptosis.Number of residual γ￣H2AX foci was observed by immunofluorescence assay. Results The colony forming assay demonstrated that the values of SF2, D0 , Dq , and N of CNE￣2R cell subline [(0.81±0.05), (2.15±0.07) Gy, (2.94±0.08) Gy, (3.91±0.07), respectively] was significant higher than those of CNE￣2 cell line [(0.61±0.08), (1.47±0.06) Gy, (1. 68 ± 0. 10) Gy, (3. 13 ± 0. 05), respectively]. The expression of COX￣2 protein was significantly downregulated with increasing celecoxib concentration.Surviving fraction was decreased in both CNE￣2 and CNE￣2R cell lines after irradiation.After radiotherapy combined with celecoxib, apoptosis rates of CNE￣2 and CNE￣2R cell lines [(13.10±0.63)%, (5.30±0.75)%] were higher than those of the corresponding control groups [(4.90±0.71)%, (1.82±0.82)%].Celecoxib increased radiosensitivity in nasopharyngeal carcinoma CNE￣2R and CNE￣2 cell lines.The number of residual γ￣H2AX foci after irradiation was increased by celecoxib pretreatment.The difference was statistically significant (P<0.05). Conclusion Celecoxib can enhance radiosensitivity of radio￣resistant cell subline CNE￣2R of human nasopharyngeal carcinoma in vitro.
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OBJECTIVE：To establish a method for determination of baicalin in QiLiKeGanKang oral liquid.METHODS：The RP-HPLC method was employed taking Nova-pak C18 column as fixed phase and methanol-water-phosphoric acid(45∶ 55∶ 0.2)as mobile phase.Detection wavelength was 280 nm.RESULTS：The detection ranges were 0.179μ g～1.434μ g.The average recovery of baicalin was 101.35％ (RSD=2.40％，n=5).CONCLUSION：This HPLC method is convenient，rapid，accurate and could be used for quality control in the production of QiLiKeGanKang oral liquid.
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Objective Review the epidemiology, injuries and assessments for body impairment on the injured children and teenagers in road traffic accidents (RTAs). Methods The data of 256 cases of assessment for body impairment of the injured children and teenagers in RATs was studied retro spectively. Results Boys were injured more than girls, mainly 6-18 years of age. RATs occurred mostly in 10-12a.m and 4-6p.m. The types of vehicles were mostly car and wagon. The commonest accidents were injury of pedestrians. The sites of injures were mainly head and extremities, the commonest injures were fracture, contusion and wound, the degree of internal organ injuries was relatively slight, the fracture of lower extremities was far more often than the upper extremities. Most of the injuries were assessed to be of medial injury. In most of the cases the rate of disability was evaluated to be lighe (33.2%), in which Ⅸ , Ⅹ grade were the commonest. Conclusion The criterion of assessment for body impairment of the injured in RTAs should be broadened properly, some special items for children and teenagers should be added.