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ABSTRACT OBJECTIVE:To systematically evaluate the efficacy and safety of echinococcins in the prevention of invasive candidiasis,and to provide evidence-based reference for clinical treatment. METHODS:Retrieved from PubMed,Embase, Medline,Cochrane library,CJFD,VIP and Wanfang database,randomized controlled trials(RCTs)about the effectiveness and safety of echinococcins (trial group) versus conventional fungal drugs (amphotericin B and triazole antifungal agents,control group)in the prevention of invasive candidiasis were collected during database establishment to Jul. 2019. After data extraction of clinical studies met inclusion criteria and quality evaluation with Cochrane system evaluator manual 5.0.2,Meta-analysis was performed for breakthrough invasive fungal infection rate,fungal infection mortality rate,all-cause mortality rate and the incidence of drug withdrawal due to adverse reactions by using Rev Man 5.2 statistical software. RESULTS:Totally 7 RCTs were included, involving 3 219 patients. Results of Meta-analyses indicated that the incidence of breakthrough invasive fungal infection [OR=0.58, 95%CI(0.40,0.85),P=0.004],fungal infection mortality rate[OR=0.68,95%CI(0.51,0.92),P=0.01] and the incidence of drug withdrawal due to adverse reactions [OR=0.52,95%CI(0.40,0.67),P<0.001] in trial groups were significantly lower than control group,with statistical significance. There was no statistical significance in the all-cause mortality rate [OR=0.84,95%CI(0.67, 1.05),P=0.13]. CONCLUSIONS:Compared with amphotericin B and triazole antifungal agents,echinococcins used for the prevention of invasive candidiasis can reduce the incidence of breakthrough invasive fungal infection,fungal infection mortality rate and the incidence of drug withdrawal due to adverse reactions
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BACKGROUND: To repair bone defect, histocompatibility, growing characteristics, biodegradation and repairing mechanism of nanometer need to be further studied in clinic. OBJECTIVE: To observe the growing characteristics and histocompatibility of nano-hydroxyapatite (Nano-HA) for repairing jaw defect of rabbits.DESIGN: Randomized grouping animal study.SETTING: Beijing Jishuitan Hospital and Stomatology College of Jiamusi University.MATERIALS: A total of 24 New Zealand rabbits, either gender, weighing 2.5-3.5 kg, were provided by Animal Experimental Center of Jiamusi University. The animal experiment had got confirmed consent from local ethic committee. Nano-HA was provided by Material Engineering College of Jiamusi University and dealt with routine hyperthermia/hypertension sterilization. In addition, hydroxyapatite was provided by Wuhan Industry University, and the diameter was 1.0-2.0 μm.METHODS: The experiment was carried out in the Experimental Animal Center of Jiamusi University from November 2001 to May 2006. All rabbits were randomly divided into experimental group and control group with 12 in each group. Bone defect in the diameter of 1.0 cm was produced on body of mandible. Nano-HA was used to repair the bone defect of rabbits in the experimental group, while hydroxyapatite was used to repair the bone defect of rabbits in the control group. At 1, 4, 8 and 12 weeks after operation, all rabbits were sacrificed. In addition, medical imaging analysis system was used to analyze generative quantity of tissue in the two groups; meanwhile, histological quality and quantity were also analyzed so as to observe histocompatibility and newborn osteogenesis. MAIN OUTCOME MEASURES: Histocompatibility and newborn osteogenesis.RESULTS: With the time passing by, the amount of repairing materials was decreased because of the combination with newborn tissue into bone in bone defect-repaired region in the experimental group. When it was closed to normal bone, the amount was stable. However, bony callus was not able to grow in materials in the control group. Results of correlation analysis demonstrated that materials were negatively straight-line correlation with newborn bone (r = -0.912 0, P < 0.01). During the repairing procedure of bone defect, newborn bone was closely correlative with Nano-HA; while, with the increase of newborn bone, the amount of repairing materials was decreased because of the combination with newborn tissue into bone.CONCLUSION: Nano-HA can combine with newborn bone tissue so as to rapidly generate bone, while it has an excellent biocompatibility.