Meta-analysis of clinical effect and safety of Loratadine combined with Diclofenac sodium eye drops on allergic conjunctivitis / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate the clinical effects and safety of Loratadine combined with Diclofenac sodium eye drops in the treatment of allergic conjunctivitis by system review.METHODS:Using “Loratadine” “Diclofenac sodium” and “allergic conjunctivitis” as keywords, a randomized controlled trial of Loratadine combined with diclofenac sodium in the treatment of allergic conjunctivitis was searched in Embase, Cochrane library, Pubmed, CNKI, Wanfang database, VIP and SionMed. The retrieval time is from the establishment of the database to July 2021. The risk bias tool provided by the Cochrane cooperation scale was used to assess the risk bias of included studies of RCTs. The publication bias of the included studies was assessed by the Egger's test. Meta-analysis of clinical efficiency, incidence of adverse effects, ocular itch score, and discharge score were using RevMan 5.3. Descriptive analysis were performed on the results with high heterogeneity.RESULTS:A total of 19 articles were included, all of which were Chinese literatures, including 1 931 patients(2 044 eyes). The control group was treated with Loratadine, and the experimental group was treated with Loratadine combined with Diclofenac sodium eye drops. The Meta-analysis showed that the clinical effect of experimental group was better than control group(<i>OR</i>=4.43, 95%<i>CI</i>:3.26-6.03,<i>P</i><0.00001).The incidence of adverse reaction was lower than control group(<i>OR</i>=0.32, 95%<i>CI</i>:0.2-0.52,<i>P</i><0.00001). The Score of ocular itching(<i>MD</i>=-0.36, 95%<i>CI</i>:-0.39 to -0.33,<i>P</i><0.00001)and discharge(<i>MD</i>=-0.24,95%<i>CI</i>: -0.31 to -0.18,<i>P</i><0.00001)in experimental group was lower than control group. All the studies on hyperemia and edema of conjunctiva, conjunctival papilla or follicle proliferation and foreign body sensation in patients with allergic conjunctivitis showed that the experimental group could significantly reduce the above symptoms(all <i>P</i><0.05). Egger's test was performed on the total effective rate, the incidence of adverse reaction. The results showed that there was publication bias in the total effective. Trim and fill method showed that the publication bias did not affect the results.CONCLUSION: On the basis of the oral Loratadine, combined with Diclofenac sodium eye drops has a certain clinical efficacy in the treatment of allergic conjunctivitis, which can improve the clinical symptoms such as ocular itching, foreign body sensation, hyperemia and edema of conjunctiva, and the incidence of adverse reactions is low, which can provide evidence-based basis for the drug treatment of allergic conjunctivitis in the future. However, due to the low intensity of the included research evidence, more multicenter, randomized double-blind clinical trials are needed in the future, so that to improve the evidence intensity.

Glycyrrhizic acid: a potential drug against COVID-19 / 药学学报

Pneumonia caused by SARS-CoV-2 has seriously threatened human life and health worldwide and caused a large number of deaths. Viral infection and acute inflammation are important causes of death, so it is particularly important to combine antiviral therapy with anti-inflammatory therapy. Glycyrrhizic acid, the main component of the glycyrrhizic root extract, has a wide range of pharmacological effects as well as high efficiency and low toxicity, its preparation has been widely used in the treatment of chronic hepatitis and other diseases. Glycyrrhizic acid can regulate the expression and release of a variety of cytokines and play a significant anti-inflammatory effect. At the same time, glycyrrhizic acid also showed significant inhibition towards a variety types of viruses. Therefore, the potential application of glycyrrhizic acid as COVID-19 treatment should be explored.

Meta-analysis of clinical effect of subconjunctival injection of vitamin C on corneal ulcer / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate the clinical effects of subconjunctival injection of vitamin C in the treatment of corneal ulcer by using Meta-analysis.<p>METHODS: Using “vitamin C” and “corneal ulcer” as keywords, the randomized controlled trials(RCT)of subconjunctival injection of vitamin C in Embase, Cochrane library, Pubmed, CNKI and Wanfang database in the treatment of corneal ulcer was searched. Relevant reference published before February 2021. The risk bias tool provided by the Cochrane cooperation scale was used to assess the risk bias of included studies of RCTs. The publication bias of the included studies were assessed by the Egger's test with Stata software. Meta-analysis was performed with RevMan 5.3.<p>RESULTS: A total of 32 eligible articles were included, all of which were Chinese literatures, with a total of 4 514 patients. The control group was treated with routine treatment, and the experimental group was treated with subconjunctival injection of vitamin C combined with routine treatment. The Meta-analysis showed that the experimental group was better than control group(<i>OR</i>=4.61, 95%<i>CI</i>:3.70, 5.74). The recurrence rate was lower than control group(<i>OR</i>=0.24, 95%<i>CI</i>: 0.18, 0.31). The cure time in experimental group was shorter than control group(<i>MD</i>= -6.29, 95%<i>CI</i>: -7.08, -5.51), 32 studies do not adequately report adverse drug reactions(ADR). Egger's test was performed on the total effective rate, recurrence rate and cure time. The results showed that there was publication bias in the total effective rate and cure time. Trim and fill method showed that the publication bias did not affect the results.<p>CONCLUSION: Subconjunctival injection of vitamin C is feasible in the treatment of corneal ulcer. The clinical effect, cure time and recurrence rate were better than routine treatment. However, due to the low intensity of the included research evidence, more multicenter, randomized double-blind clinical trials are needed to improve the evidence intensity of vitamin C in the treatment of corneal ulcer.

Etiologic and epidemiologic analysis of hand, foot, and mouth disease in Guangzhou city: a review of 4,753 cases

OBJECTIVES: This study aimed to review etiological and epidemiological data for hand, foot, and mouth disease (HFMD) cases that occurred between 2008 and 2010 in Guangzhou City, to help develop and implement precautionary measures applicable for future outbreaks. METHODS: The characteristics of 4,753 HFMD episodes were retrospectively reviewed in 4,636 patients reported between 2008 and 2010 by the Guangdong Women and Children's Hospital, which is the national enterovirus monitoring agent and the designated hospital in China for treating severe HFMD. RESULTS: Out of 4,753 incident episodes reviewed, 525 patients were hospitalized; 60% were males. Most patients (93.8%) were children under 5 years old, with a median age at onset of 2.4 years. HFMD incidence peaked in April/May and September/October. From the total, 1,067 (22.4%) infections were positive for human enterovirus 71 (HEV71), 1,094 (23.0%) were positive for coxsackievirus A16 (CA16), and 941 (19.8%) were positive for other common enteroviruses. In contrast, 1,666 (35.0%) cases were negative to HEV71, CA16, and other common enteroviruses. Cross-correlation coefficients demonstrated associations between the number of cases, seasonal temperatures, and humidity. Among hospitalized cases, HEV71 was positive in 261 (24.5%), and 42 (3.9%) critical cases were positive for HEV71. CONCLUSION: Seasonal fluctuations and HEV71 and CA16 were the two key factors influencing the Guangzhou HFMD epidemic. The infection predominantly affected children younger than 5 years old.

The protective effect of N-acetylcysteine magnesium against liver cirrhosis with portal hypertension in rat / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To study the effects of acetylcysteine magnesium on the vasoactive substances and hepatic fibrosis indexes in liver cirrhosis and portal hypertension of rats.</p><p><b>METHODS</b>The rat liver cirrhosis model was made with 12 microg/kg dimethylnitrosamines. Then acetylcysteine magnesium was injected respectively with 25, 50, and 100 mg x kg(-1) dose daily into abdominal cavity. After 8 weeks treatment, pathological section, TGF-beta1, NO, TNOS and iNOS of hepatic tissue were detected to assess the effect of acetylcysteine magnesium against cirrhosis portal hypertension.</p><p><b>RESULTS</b>After the DMNA modeling was completed, the HE and Sweet reticulocyte staining of liver pathological section showed that cirrhosis of the liver was in the III-IV phase, the infiltration of lymphocytes and formation of pseudolobuli in liver were alleviated in three acetylcysteine magnesium treatment groups (low, medium, and high dose), and the degree of liver fiber sclerosis in three groups was significantly lower than control group. Compared with control group, TGF-beta1, NO, TNOS and iNOS were significantly reduced in all treatment groups (P < 0.05).</p><p><b>CONCLUSION</b>Acetylcysteine magnesium is probably a distinctive antioxidant which can remove various free radical in body and modulate ligand-dependent signal transduction and the growth of cell. It also have protection in the liver cirrhosis and portal hypertension of rats induced by dimethylnitrosamine.</p>

Clinical experience of 3T intraoperative magnetic resonance imaging integrated neurosurgical suite in Shanghai Huashan Hospital / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Intraoperative magnetic resonance imaging (iMRI) dates back to the 1990s and has been successfully applied in neurosurgery but they were low-field iMRI (< 1.0T). This paper reports the clinical experience with a 3T iMRI-integrated neurosurgical suite in Huashan Hospital, Shanghai, China.</p><p><b>METHODS</b>From September 2010 through March 2012, 373 consecutive patients underwent neurological surgery under guidance with 3T iMRI. A retrospective analysis was conducted regarding clinical efficiency.</p><p><b>RESULTS</b>All surgery in the 373 patients was safe. The ratio of gross total resection for cerebral gliomas (n = 161) was increased from 55.90% to 87.58%. The ratio of benefit in extent of resection was 39.13%. One hundred and fifty eight of the 161 glioma patients accomplished follow-up at 3 months postoperatively. Twenty of 161 patients (12.42%) suffered from early motor deficit after surgery. Late motor deficit was however observed in five of 158 patients (3.16%). Twenty-one of 161 patients (13.04%) had early speech deficit and late speech deficit was only observed in six of 158 patients (3.80%). The ratio of gross total resection for pituitary adenomas (n = 49) was increased from 77.55% to 85.71%. The ratio of benefit in extent of resection was 10.2%. There were no iMRI-related adverse events even for patients who underwent awake craniotomy.</p><p><b>CONCLUSION</b>The 3T iMRI integrated neurosurgical suite provides high-quality intraoperative structural and functional imaging for real-time tumor resection control and accurate functional preservation, resulting in an improvement in maximal safe brain surgery.</p>

Preliminary application of 3.0 T intraoperative magnetic resonance imaging neuronavigation system in China / 中华外科杂志

<p><b>OBJECTIVE</b>To report the preliminary experience in clinical application of 3.0 T intraoperative magnetic resonance imaging (iMRI) neuronavigation system in China.</p><p><b>METHODS</b>From September 2010 to March 2011, a consecutive series of 122 patients with intracranial lesions underwent operations in guidance with 3.0 T iMRI. A retrospective analysis was conducted regarding clinical efficiency.</p><p><b>RESULTS</b>Among 122 procedures, the numbers of intraoperative scanning were 2 - 4 times with an average of 2.6. The qualities of images were excellent. Due to the discovery and further possibility of resection of residual tumors, the ratio of gross total resection was increased from 71.7% to 90.0% in cerebral gliomas (n = 60), while from 75.9% to 93.1% in macroadenomas (n = 29). There were 6.7% of all patients occurred postoperative paralysis, but only 3.3% of patients had persistent paralysis at 1 - 2 months follow-up. There was no iMRI-related adverse event occurred. During the same period, more than 2500 patients underwent diagnostic MRI scanning.</p><p><b>CONCLUSIONS</b>3.0 T iMRI neuronavigation system provides high-quality intraoperative structural, functional and metabolic images for real time tumor resection control and accurate functional preservation, resulting in an improvement in maximal safe brain surgery. The system is cost-effective.</p>

Awake craniotomy and intraoperative language cortical mapping for eloquent cerebral glioma resection: preliminary clinical practice in 3.0 T intraoperative magnetic resonance imaging integrated surgical suite / 中华外科杂志

<p><b>OBJECTIVES</b>To evaluate preliminary clinical experience for combining awake craniotomy and intraoperative language brain mapping within the integrated 3.0 T intraoperative magnetic resonance imaging (iMRI) suite.</p><p><b>METHODS</b>From December 2010 to April 2011, 11 right hand-dominant patients with left glioma were involved in, or adjacent to, eloquent cortex was carried out awake craniotomies with cortical stimulation within an integrated 3.0 T iMRI suite. Aphasia battery of Chinese was used to test the language function before the operation. During the procedure, after the occipital, temporal, and supraorbital nerves were blocked by the anesthesiologists, the head was fixed with a custom high-field MRI-compatible head holder. The skull and dura was opened as usual and language brain mapping was then performed. Language testing followed a set protocol: counting numbers from 1 to 50, naming objects, reading single words. Resection of the tumor was guided by neuronavigation system and continued until eloquent areas were encountered or the margin of assessment was reached. An interdissection MRI was acquired to evaluate the glioma removal in a movable MRI scanner after minimal draping. Meanwhile, adverse effects caused by electrical stimulation and iMRI were recorded. The follow-up speech tests were assessed on 7th day and 1 month at least after the operation.</p><p><b>RESULTS</b>The combined use of 3.0 T iMRI and awake craniotomy was performed safely in all patients. No adverse effects were reported. The duration of surgery was prolonged by 2 to 4 h. The patients' perception of iMRI during surgery was favorable. First-look MRI studies led to further resection attempts in 6/11 cases as well as a 3/11 increase in the number of gross-total resections. One week after surgery, baseline language function worsened in 4 cases. However, no patients had a persistent language deficit one month after surgery.</p><p><b>CONCLUSIONS</b>Awake craniotomy and direct cortical electrical stimulation can be performed safely and effectively within a 3.0 T iMRI suite. The combination of high-field iMRI and awake craniotomy may facilitate safe removal of eloquent glioma.</p>

Current status of cerebral glioma surgery in China / 中华医学杂志(英文版)

The treatment of gliomas is highly individualized. Surgery for gliomas is essentially for histological diagnosis, to alleviate mass effect, and most importantly, to favor longer survival expectancy. During the past two decades, many surgical techniques and adjuvants have been applied to glioma surgery in China, which lead to a rapid development in the field of cerebral glioma surgery. This article broadly and critically reviewed the existing studies on cerebral glioma surgery and to portrait the current status of glioma surgery in China. A literature search was conducted covering major innovative surgical techniques and adjuvants for glioma surgery in China. The following databases were searched: the Pubmed (January 1995 to date); China Knowledge Resource Integrated Database (January 1995 to date) and VIP Database for Chinese Technical Periodicals (January 1995 to date). A selection criterion was established to exclude duplicates and irrelevant studies. The outcome measures were extracted from included studies. A total of 3307 articles were initially searched. After excluded by abstracts and full texts, 69 studies conducted in the mainland of China were included and went through further analysis. The philosophy of surgical strategies for cerebral gliomas in China is undergoing tremendous change. Nowadays Chinese neurosurgeons pay more attention to the postoperative neurofunctional status of the patients. The aim of the glioma surgery is not only the more extensive tumor resection but also the maximal safety of intervention. The well balance of longer overall survival and higher quality of life should be judged with respect to each individual patient.

Effect of vascular endothelial growth factor small interfering RNA (siRNA) on retinal microvascular endothelial cells under hypoxia condition in vitro / 中华儿科杂志

<p><b>OBJECTIVE</b>To explore VEGF siRNA's effect on the immature fetal retinal microvascular endothelial cells in vitro.</p><p><b>METHOD</b>The fresh retinal micrangium was primarily cultured to obtain microvascular endothelial cells. CoCl2 was used to simulate oxygen-deficient conditions. siRNA directed against human VEGF was designed and chemically synthesized. There were 3 groups in our experiment: VEGF siRNA group, hypoxia control group, and negative siRNA control group. The fetal retinal micrangium vascular endothelial cells were transfected by using liposome. The expression levels of VEGF mRNA and protein were evaluated by RT-PCR and Western blotting 24, 48, 72 h after transfection, cell proliferation was evaluated by MTT method.</p><p><b>RESULT</b>The expression levels of VEGF mRNA decreased by 21.05%, 79.67%, and 90.48% 24 h, 48 h, and 72 h after transfection as compared to those in hypoxia control group, the expression level of VEGF protein had decreased by 14.58%, 66.97%, and 81.61% as compared to those in hypoxia control group. The siRNA could decrease cell proliferation under hypoxia too, the multiplication rate after 12, 24, 48, and 72 h decreased by 15.0%, 42.9%, 78.3% and 65.9%.</p><p><b>CONCLUSION</b>VEGF siRNA could down-regulate the expression of VEGF in immature fetal retinal microvascular endothelial cells and suppressed cell proliferation. Application of siRNA to inhibit expression of VEGF may be a hopeful way to prevent and cure ROP.</p>

Study on the changes of incidence rates on birth defects through hospital based surveillance program in Guangdong province during 1997-2007 / 中华流行病学杂志

Objective To analyze the tendency of hospital based surveillance incidence rates of birth defects in Guangdong province to provide reference evidence for related intervention program. Methods Data from hospital based birth defects surveillance of Guangdong province during 1997-2007 were analyzed retrospectively. Results The overall surveillance rates of birth defects in Guangdong province showed an increasing trend form 98.9 per 10 000 birth in 1997 to 244.2 per 10 000 birth in 2007. Among the frequently seen birth defects, the rate of congenital heart diseases increased sharply, but the rates of congenital talipes equinovarus, polydactyly, cleft lip with/without cleft palate showed a slight increasing trend.It seemed that there was a significant difference between different maternal age interval and gender of the infants. Mother's illness, drug use, and exposure to environment harmful factors in early pregnancy stage, high maternal age, negative bearing history were the suspect risk factors for birth defects. Conclusion The increasing trend of surveillance rate of birth defects seemed to be comprehensively affected by the factors as: method being adopted, target and extension of birth defects surveillance, technology used for diagnosis, kinds of risk factor,and quality control on surveillance programs.

Ultrafiltration Applied in Low Flow Venovenous Extracorpareal Membrane Oxygenation in Sheep / 实用儿科临床杂志

0.05.Conclusions The UF effectively removed BUN in sheep with low flow VV-ECMO.The application of UF didn't cause blood shunt in ECMO.The low flow VV-ECMO effectively eliminated carbon dioxide and rerformed oxygenation.

Early Stage Syphilis: Clinical and Pathological Analysis of 1200 Cases / 中华医院感染学杂志

OBJECTIVE To study the clinic feature and cause of misdiagnosis of early stage syphilis and evaluate the significance of histopathology in the diagnosis of the disease. METHODS Totally 1 200 early syphilis cases were analyzed.The serologic test for syphilis was performed.Thirty five of them were performed with histopathological examination. RESULTS The primary syphilis was found to be commonly misdiagnosed as chancroid,genital herpes,scabies nodules and ulcus vulvae acutum.For secondary syphilis,macular syphilide and maculopapular syphilide were easily misdiagnosed as pityriasis rosea or dermatitis.The papulosquamous syphilide was commonly misdiagnosed as psoriasis.The condyloma latum was commonly misdiagnosed as condyloma acuminatum. CONCLUSIONS The serologic test is important in diagnosis of primary syphilis.The histopathologic test plays a role in diagnosis of primary syphilis,condyloma latum and papulosquamous syphilide,but of limited value in diagnosis of macular syphilide.

Exploration of Effective Methods on Improvement of Medical College Students' Experimental Skills in Physics / 中华医学教育探索杂志

The author analyzes the problems existing in medical students' experimental skills in physics and points out the countermeasures.