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Objective To study the accuracy of lactic dehydrogenase (LDH) in the diagnosis of pneumocystis pneumonia (PCP). Methods The data of this systemic review was retrieved from the PubMed, China Biology Medicine disc, Wanfang, Weipu and China National Knowledge Infrastructure (CNKI) databases from establishment till to October 31st, 2017. Case-control studies about the diagnosis of PCP were enrolled. Enrolled studies were required that patients in case group ware PCP and patients in control group were lung diseases other than PCP. The QUADAS tool was used to evaluate the quality of studies. The RevMan 5.3 software was used to draw a forest plot. The StataMP 14 software was used to make subgroup analyses by drawing receiver operator characteristic (SROC) curves for the whole group, the acquired immune deficiency syndrome (AIDS) group, and the not all-AIDS group, and calculating their diagnostic odds ratio (DOR) and 95% confidential interval (95%CI). Results Thirteen studies, all in English, were included. There were 825 patients in the case group, in which 650 patients were AIDS. There were 1 341 patients in control group, in which 888 patients were AIDS and most of them were Pulmonary Kaposi Sarcoma, bacterial pneumonia, pulmonary tuberculosis etc. Although there were different positive values of LDH in different studies, from 200 U/L to 598 U/L, sensitivities were good, especially in AIDS patients all values were above 80% (80%-100%). The specificities had big fluctuations, from 6% to 85%, which made them poor. The DOR (95%CI) of LDH in PCP diagnosis of all patients, AIDS patients and not-all AIDS patients were 6.73 (3.19-14.21), 9.17 (3.79-22.18) and 5.07 (1.30-19.80) respectively. Conclusions The sensitivity of LDH in the diagnosis of PCP is high, especially in AIDS group. In practice if LDH is negative, there should be more evidences to support the treatment of PCP.
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Objective To investigate the clinical outcomes of percutaneous kyphoplasty (PKP) for treatment of vertebral compression fractures in perimenpausal women.Methods A total of 53 perimenopausal patients (70 vertebrae) undergone PKP for vertebral compression fractures from January 2007 to May 2014 were analyzed retrospectively by case-control study.Thirty-six patients had single vertebral fractures and 17 two-level vertebral fractures.The fracture segments included 5 T11 vertebrae,14 T12 vertebrae,30 L1 vertebrae,12 L2 vertebrae and 9 L3 vertebrae.Ratio of vertebral compression was 10％-30％.According to treatment difference,the patients were divided into PKP group and non-operation group.In PKP group,there were 30 patients with age range of 44-54 years (mean,51.0 years),and the fracture segments included 13 T11 vertebrae,11 T12 vertebrae,17 L1 vertebrae,7 L2 vertebrae,3 L3 vertebrae.In non-operation group,there were 23 patients with age range of 44-54 years (mean,50.5 years),and the fracture segments included 2 T11 vertebrae,3 T12 vertebrae,13 L1 vertebrae,5 L2 vertebrae,6 L3 vertebrae.Visual analogue scale (VAS),Oswesty disability index (ODI),vertebral compression rate,Cobb angle and bone mineral density change were compared preoperatively,2 weeks,6 months and 3 years after operation.Results All patients were followed up for 6-36 months.VAS and ODI were improved compared with preoperative status in two groups at 2 weeks,6 months and 3 years (P ＜ 0.01).VAS and ODI in PKP group were significantly decreased at 2 weeks and 6 months compared with non-operation group (P ＜ 0.01).The Cobb angle and vertebral compression rate in non-operation group were improved at 6 months compared with those in preoperative status (P ＜ 0.05),and a consistent increase was noted at 3 years,but the difference was not statistically significant (P ＞ 0.05).The Cobb angle and vertebral compression rate in PKP group were reduced at 6 months compared with preoperative status (P ＜ 0.05),and an increase was noted at 3 years,but the difference was not statistically significant (P ＞ 0.05).The Cobb angle and vertebral compression rate in PKP group did not increase at 6 months and 3 years,but they had significant increase in non-operation group (P ＜ 0.05).The body mass index in non-operation group decreased at different degrees at 6 months and 3 years,compared with preoperative status (P ＜ 0.05),while the body mass index reduction in PKP group had no statistically significant difference (P ＞ 0.05).The body mass index reduction in PKP group was less than that in non-operation group at 3 years (P ＜0.01).The body mass index reduction in PKP group was slow and had no statistically significant difference compared with preoperative status (P ＞ 0.05).The body mass index reduction in non-operation group was fast and had significant decrease compared with preoperative status (P ＜ 0.05).Conclusion PKP can relieve pain for vertebral compression fractures in perimenopausal women in short term and long term,and PKP can also improve spinal kyphosis and prohibit the decline of bone mineral density.
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BACKGROUND: Stellate ganglion block has the ability to improve the imbalance of the autonomic nervous system in perimenopausal syndrome. Lumbosacral plexus is an automatic nervous block, and exerts similar effects with stellate ganglion block. OBJECTIVE: To investigate the effect of lumbosacral plexus block on the serum level of hormones and histology of the ovary in rabbits, thus providing a new treatment strategy for perimenopausal syndrome. METHODS: This was a randomized controlled animal experiment, which was finished at the Animal Center of Guiyang Medical Unversity, China. The healthy rabbits were randomly divided into experimental and control groups, and underwent lumbosacral plexus block by injecting 0.5 mg of vitamin B12, 100 mg of lidocaine and 10 mL of normal saline into the psoas compartment, and the same volume of normal saline, respectively. The effect of lumbosacral plexus block on the serum levels of hormones (estradiol, gonadotropin releasing hormone, follicle-stimulating hormone and luteinizing hormone) at rabbit proestrus, estrus and metaestrus were observed, respectively. The pathological changes of the ovary in a complete estrus cycle were observed. The relationship between the treatment time of lumbosacral plexus block and the levels of hormones was investigated after 1, 3 and 6 complete estrus cycles. The experimental followed the national guidelines for the Care and Use of Laboratory Animals, and Consensus author guidelines on animal ethics and welfare by the International Association for Veterinary Editors (IAVE), and prepared in accordance with the Animal Research: Reporting of In Vivo Experiments Guidelines (ARRIVE Guidelines). RESULTS AND CONCLUSION: Lumbosacral plexus block can increase the serum level of estrogen, reduce the serum levels of follicle-stimulating hormone and luteinizing hormone, and regulate the hypothalamic-pituitary-ovary axis function. Presumably, it may be used as a treatment method or adjuvant therapy of perimenopausal syndrome. Future experiments are needed to explore the effect of lumbosacral plexus block on the serum levels of hormones in a rabbit after oophorectomy to determine whether it exhibits the same effect on ovarian failure.
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<p><b>OBJECTIVE</b>To systematically evaluate the efficacy of intranasal antihistamine in the treatment of allergic rhinitis.</p><p><b>METHODS</b>The randomized controlled trials (RCT) about intranasal antihistamines for the treatment of allergic rhinitis between January 1985 and January 2014 were searched in OVID, PubMed, EMBASE, CNKI, WanFang Data and Cochrane Library. Two reviewers independently screened the literatures, extracted the data, and evaluated the methodological quality, then meta-analysis was performed by using RevMan 5.1 software.</p><p><b>RESULTS</b>A total of thirteen RCTs were included. The results of meta-analysis showed that the efficacy of intranasal antihistamine group was superior to the placebo group in total nasal symptom scores (TNSS), the difference was significant[WMD = -1.96, 95%CI (-2.06;-1.85), P < 0.01], and individual nasal symptom scores (blocked nose, rhinorrhea, and sneezing) [WMD = -0.18, 95%CI (-0.28;-0.08); WMD = -0.45, 95%CI (-0.52;-0.38); WMD = -0.41, 95%CI (-0.58;-0.24), all P < 0.01], with significant differences. There was no significant difference between the intranasal antihistamine group and the corticosteroid group in TNSS [WMD = -1.51, 95%CI (-3.51;0.49), P = 0.14], but the intranasal antihistamines group was superior to the corticosteroid group in individual nasal symptom scores (blocked nose, rhinorrhea, and sneezing) [WMD = -0.23, 95%CI (-0.40;-0.06); WMD = -0.35, 95%CI (-0.65;-0.05); WMD = -0.25, 95%CI (-0.42;-0.08), all P < 0.05], with significant differences. The intranasal antihistamine group was superior to the oral antihistamines group in TNSS [WMD = -0.88, 95%CI (-1.51;-0.25), P < 0.01].</p><p><b>CONCLUSION</b>Intranasal antihistamine is effective in the control of nasal symptoms in AR patients.</p>