Comparison of selegiline and levodopa combination therapy versus levodopa monotherapy in the treatment of Parkinson's disease: a meta-analysis.

BACKGROUND: Selegiline or levodopa treatment has been suggested as a therapeutic method for Parkinson's disease (PD) in many clinical trial reports. However, the combined effects of two drugs still remain controversial. The aim of this report was to evaluate the clinical efficacy and safety of selegiline plus levodopa (S + L) combination therapy in the treatment of PD compared to that of L monotherapy, to provide a reference resource for rational drug use. METHODS: Randomized controlled trials (RCTs) of S + L for PD published up to September, 2018 were searched. Mean difference (MD), odds ratio (OR), and 95% confidence interval (CI) were calculated and heterogeneity was assessed with the I2 test. Sensitivity analysis was also performed. The outcomes measured were as follows: the unified Parkinson's disease rating scale (UPDRS) scores, modified Webster score, adverse events and mortality. RESULTS: Fourteen RCTs with 2008 participants were included. Compared with L monotherapy, the pooled effects of S + L combination therapy on UPDRS score were (eleven trials; MD - 7.00, 95% CI - 8.35 to - 5.65, P < 0.00001) for total UPDRS score (nine trials; MD - 5.74, 95% CI - 7.71 to - 3.77, P < 0.00001) for motor UPDRS score (seven trials; MD - 1.61, 95% CI - 2.18 to - 1.04, P < 0.00001) for activities of daily living UPDRS score (three trials; MD - 0.38, 95% CI - 0.61 to - 0.14, P = 0.002) for mental UPDRS score. The Webster score showed significant decrease in the S + L combination therapy compared to L monotherapy (four trials; MD - 5.71, 95% CI - 7.11 to - 4.32, P < 0.00001). Compared with L monotherapy, S + L combination therapy did not increase the number of any adverse events significantly in PD patients (ten trials; OR 1.58, 95% CI 0.83-3.00, P = 0.16). CONCLUSIONS: S + L combination therapy is superior to L monotherapy for the improvement of clinical symptoms in PD patients. Moreover, the safety profile of S + L combination therapy is comparable with that of L monotherapy.

Roles of Probiotic Supplementation in the Prevention and Treatment of Asthma:A Systematic Review / 中国医学科学院学报

To systematically review the effects of probiotic supplementation on the prevention and treatment of asthma. A computerized literature search was conducted in CNKI,CBM,VIP,Wanfang,PubMed,Embase,Cochrane Library,and Web of Science from their inception to February,2019 to collect all relevant studies. Cochrane Collaboration's risk of bias tool was used to assess the methodological quality of the included studies. Twelve studies were included in the systematic review of the value of probiotics in asthma prevention. The results showed that probiotic supplementation was not significantly associated with a lower risk of asthma (=0.95,95%=0.82-1.11) or wheeze (=0.99,95%=0.88-1.11). Subgroup analyses based on interventions did not show significant differences. Six studies were included in the systematic review of the role of probiotics in asthma treatment. The results showed that probiotic supplementation improved pulmonary function and asthma control in asthmatic patients. However,more studies are needed to validate this effect. Moreover,further studies are needed to clarify the effect of probiotics on the immune markers and the use of asthmatic drugs in asthmatic patients. Based on the currently available literature,probiotic supplementation can not prevent asthma or wheeze. However,it may improve pulmonary function and asthma control in asthmatic patients,although further studies are needed.

Risk Factors of Asthma Attack in An Open Cohort / 中国医学科学院学报

Objective To investigate the risk factors of asthma attack.Methods In this open cohort study,74 492 initially healthy subjects aged 20 years or more in a longitudinal multi-center health management cohort in Shandong province from January 2007 to December 2015 were enrolled in this study. These subjects had no baseline bronchial asthma or other chronic airway disease and did not migrate to other provinces in the past 10 years. All subjects were followed up till 2016,and the asthma attack and its influencing factors were analyzed. The baseline data including sociodemographic data,smoking history,disease histories,and family disease histories were collected and analyzed by Poisson regression analysis.Results The regression analysis showed that age between 40 and 50 years(RR=3.3,95%CI=1.8-6.0),female(RR=1.6,95%CI=1.1-2.3),nasal polyps(RR=9.5,95%CI=2.3-39.6),pneumonia(RR=6.5,95%CI=3.7-11.2),bronchitis(RR=8.7,95%CI=5.1-14.7),and chronic obstructive pulmonary disease(RR=6.6,95%CI=3.1-13.8) significantly increased the risk of asthma attack.Conclusion Age,gender,and previous histories of certain respiratory tract diseases increase the risk of asthma attack.