Evaluation of the efficacy of cevimeline in improving the clinical symptoms of patients with primary Sjögren′s syndrome / 口腔疾病防治

Objective@# To investigate the clinical efficacy of cevimeline as a pharmacotherapeutic approach to stimulating gland activity in improving the symptoms and signs of primary Sjögren syndrome (pSS).@*Methods@#Sixty-three patients diagnosed with pSS who attended the Affiliated Huai'an Hospital of Xuzhou Medical University from January 2018 to September 2019 were included in this trial. They were randomly assigned to the therapeutic group and control group. All patients were recalled at baseline and after 2 weeks, 3 months and 6 months. Measurement of salivary and lacrimal flow as well as evaluation of subjective symptoms was performed at the follow-up. @*Results@# Fifty-eight patients completed the trial and were included in the statistical analysis. There was a significant difference between the two groups in the measurement of salivary and lacrimal flow at the second week and third month (P < 0.05). Improvement in subjective symptoms of oral, ocular and gland was detected at the third month (P < 0.05). At the sixth month, compared with the control group, only the salivary gland symptom score of the treatment group was statistically significant (P < 0.05). @*Conclusion@#Cevimeline has good specificity and safety and can increase salivary and lacrimal flow and improve subjective symptoms of pSS in a short time.

The Effects of Stress on Intraocular Pressure and Lacrimal Secretion

PURPOSE: To evaluate the effects of psychosocial stress on intraocular pressure and lacrimal secretion. METHODS: Twenty normal adult volunteers (40 eyes) who had no history of systemic or ocular disease such as dry eye syndrome or glaucoma were recruited from clinical research participants. Heart rate, intraocular pressure and lacrimal secretion were measured after the Trier Social Stress Test (TSST) which induces psychosocial stress. The same measurements were taken 1 week later and the recorded measurements were considered as the control group. RESULTS: Heart rate was elevated significantly after the TSST, indicating psychosocial stress was induced by the TSST. Compared to stress resolution status, intraocular pressure and lacrimal secretion were increased after the TSST (p = 0.027, p = 0.011). Elevation of intraocular pressure and lacrimal secretion was statistically significant in males (p = 0.031, p = 0.007), but not significant in females (p = 0.336, p = 0.554). CONCLUSIONS: Psychosocial stress can increase intraocular pressure and lacrimal secretion.

Clinical Characteristic of Lacrimal Ductal Cyst

PURPOSE: Through 13 cases of lacrimal ductal cysts which were diagnosed by clinical or histopathological findings, we investigated the clinical characteristic and the effect of cyst excision on lacrimal secretion. METHODS: As a primary treatment, cyst excisions(6 cases), marsupialzations(4 cases), and needle aspirations(3 cases) were performed and their results were compared. Pre-and postoperative lacrimal secretion tests(Schirmer I & BST) were performed on 10 cases which underwent cyst excision either primarily or secondarily(due to recurrences). A biochemical analysis of cyst fluid and serum IgA level was also done on 7 cases. RESULT: There were no recurrences on 6 surgically excised cases, but 1 out of 4 cases with marsupia-lizations and all 3 cases with needle aspirations recurred and underwent cyst excisions secondarily. Two out of 10 surgically excised cases showed reduced value of postoperative lacrimal secretion tests. Cyst fluid IgA levels were higher than that of serum in all 7 cases. CONCLUSION: The higher cyst IgA level may signify the presence of an active secretory precess within cyst walls. A complete cyst excision seems to be the best treatment choice for the prevention of recurren-ces and marsupialization is also considered as an alternative treatment modality. The cyst excision itself does not seem to affect lacrimal secretion.