Objective To investigate the effects of celecoxib-poly lactide-co-glycolide microparticles (CEL-PLGA-MS) on rat retina after intravitreal injection. Methods A total of 32 male Brown Norway rats were randomly divided into CEL-PLGA-MS group and celecoxib group, 16 rats in each group. The rats in CEL-PLGA-MS group were divided into four dosage group, four rats in each group, which received intravitreal injection of PLGA with celecoxib at the concentration of 40, 80, 160, 320 mu;mol/L, respectively. The rats in celecoxib group were divided into four dosage group, four rats in each group, which received intravitreal injection of celecoxib at the concentration of 40, 80, 160, 320 mu;mol/L, respectively. Phosphate buffer solution (PBS) was injected in two rats as PBS control group. Two rats as normal control group received no treatment. The difference of retinal thickness among groups was measured by optical coherence tomography (OCT). The morphological and histological change of retina was evaluated under light microscope and transmission electron microscope. Results There was no difference of retinal thickness between normal control group and PBS control group (F=0.12,P＞0.05). At the first week after injection, the retinal thickness of CEL-PLGA-MS group and celecoxib group were thicker than that in normal control group and PBS control group (F=9.62, 46.13;P＜0.01). The retinal thickness of celecoxib group was thicker than that in CEL-PLGA-MS group (F=165.15,P＜0.01). The retinal thickness was estimated equal among 40, 80, 320 mu;mol/L dosage groups in CEL-PLGA-MS group (F=4.79,P＜0.01). The retinal thickness of 160, 320 mu;mol/L dosage group were thicker than that in 40, 80 mu;mol/L dosage group in celecoxib group (F=28.10,P＜0.01). At the second week after injection, there was no difference of retinal thickness between CEL-PLGA-MS and celecoxib group (F=3.79,P＞0.05); the retinal thickness of CEL-PLGA-MS and celecoxib group became thinner gradually compare to the first week after injection (F=7.28, 103.99; P＜0.01). At the fourth week after injection, the retinal thickness of celecoxib group was thicker than that in CEL-PLGA-MS group (F=19.11,P＜0.01). The retinal thickness of CEL-PLGA-MS group was approximately the same to normal control group and PBS control group (F=2.02,P＞0.05). The retinal thickness of celecoxib group was thicker than that in normal control group and PBS control group. No considerable abnormality of the retina was seen by light microscope and the retinal thickness corresponded with the values measured by OCT at the first week after injection. The abnormal structures of the retina were seen in 160, 320 mu;mol/L dosage group of celecoxib group and inner changed evidently by the transmission electron microscope. Disordered arrangement of microfilaments, dilated microtubule and some mitochondria vacuolation were observed in 320mu;mol/L dosage group of celecoxib group. Others changed slightly. Conclusions CEL-PLGA-MS has less toxicity on the retina than free-celecoxib after intravitreal injection. The safety of intravitreal injection with CEL-PLGA-MS is better than celecoxib.
ObjectivesTo systematically review the efficacy of living preparation of lactobacillus for bacterial vaginosis (BV) during pregnancy.MethodsPubMed, Web of Science, Medline (OVID), CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect randomized controlled trials (RCTs) of living preparation of lactobacillus for BV during pregnancy from inception to September 30th, 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies, then, meta-analysis was performed by RevMan 5.3 software.ResultsA total of 21 RCTs involving 2 930 patients were included. The results of meta-analysis indicated that: living preparation of lactobacillus was superior to metronidazole in effective rate (RR=1.05, 95%CI 1.02 to 1.07, P=0.000 4), premature delivery rate (RR=0.49, 95%CI 0.32 to 0.73, P=0.000 4), premature rupture of membrane rate (RR=0.54, 95%CI 0.38 to 0.77, P=0.000 7), infant of low-birth weight rate (RR=0.45, 95%CI 0.22 to 0.94, P=0.03) and puerperal infection rate (RR=0.60, 95%CI 0.39 to 0.94, P=0.03).ConclusionsThe current evidence shows that, living preparation of lactobacillus is superior to metronidazole for BV during pregnancy, and the incidence of adverse pregnancy outcomes (preterm delivery, premature rupture of membranes, low birth weight, puerperal infection) after treatment is lower. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify above conclusions.
The human sclera accounts for 95% of the surface of the eyeball, providing ample contact area which is suitable for targeted trans-scleral ocular drug delivery. Currently there are several tans-scleral sustained-release strategies, including intra-scleral delivery, episcleral delivery, as well as tans-scleral iontophoresis. Different devices and methods have their own advantages and disadvantages, for example, intra-scleral delivery is somehow invasive, and episcleral delivery device needs to be made thin to prevent erosion of conjunctiva, iontophoresis needs to be frequently repeated as of its short-term effect. With the development of bio-material engineering technology, episcleral microfilm could become an ideal drug delivery route for posterior segment ocular diseases.
ObjectiveTo systematically review the efficacy of discharge preparation service in elderly patients with chronic diseases.MethodsCNKI, WanFang Data, VIP, Web of Science, The Cochrane Library, PubMed and EMbase databases were electronically searched to collect randomized controlled trails (RCTs) on the discharge preparation service for elderly patients with chronic diseases from January, 2000 to January, 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 7 RCTs, involving 884 patients were included. The results of meta-analysis showed that: after the hospitalization preparation service, the incidence of acute complication (RR=0.38, 95%CI 0.15 to 0.98, P=0.04), patient compliance behavior (SMD=0.54, 95% CI 0.25 to 0.83, P=0.000 3), exercise capacity (SMD=2.65, 95%CI 0.25 to 5.04, P=0.03), and nursing satisfaction (SMD=0.71, 95%CI 0.10 to 1.33, P=0.02) significantly improved. However, there were no significant differences in emergency hospital admission for acute complications (RR=0.25, 95%CI 0.06 to 1.11, P=0.07), self-care ability (SMD=2.18, 95%CI ?1.02 to 5.38, P=0.18), activity of daily living (ADL) (SMD=0.56, 95%CI ?0.47 to 1.59, P=0.28).ConclusionsThe current evidence shows that after implementation of the discharge preparation service, the incidence of acute complication, compliance behavior, exercise ability, and service satisfaction of the elderly patients with chronic diseases are significantly improved. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify above conclusion.
ObjectivesTo systematically review the efficacy of dyclonine and lidocaine for preparation before gastroscopy.MethodsPubMed, CNKI, CBM, VIP and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) of dyclonine vs. lidocaine for preparation before gastroscopy from inception to December 31st, 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed by using RevMan 5.3 software.ResultsA total of 11 RCTs were included. The results of meta-analysis showed that: dyclonine could improve anesthetic effect (RR=1.38, 95%CI 1.31 to 1.47, P<0.000 01), and was more capable to remove bubble (RR=1.40, 95%CI 1.28 to 1.52,P<0.000 01), and had superior textures (RR=1.43, 95%CI 1.18 to 1.74,P=0.000 3).ConclusionsOral dyclonine can improve the visual definition of gastric mucosa and anesthetic effect, and has superior textures. Thus, dyclonine can be regarded as a recommended option prior to gastroscopy. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.
ObjectiveTo observe the effectiveness and safety of pseudomonas aeruginosa preparation in treating refractory seroma after breast cancer surgery.MethodsA total of 76 patients with refractory seroma after breast cancer surgery who underwent surgery from October 2018 to August 2019 in our hospital were selected. The subjects were randomly divided into two groups. The patients in the control group (n=36) adopted negative pressure drainage connected with indwelling needle in the lower position of the seroma chamber; on the basis, patients in the experimental group (n=400) were injected with pseudomonas aeruginosa preparation into the seroma chamber. The drainage time, total drainage volume, recurrence rate, and incidence of complications of the two groups were compared.ResultsThere were 4 cases in the experimental group and 3 cases in the control group were lost followed-up, so only 69 cases enrolled in data analysis. The drainage time, total drainage volume, and the recurrence rate of the experimental group were all shorter or less than those of the control group (P<0.05). But there was no significant difference in the incidence of complications between the experimental group and the control group (P>0.05), such as fever, inflamed skin, and infection of incision.ConclusionPseudomonas aeruginosa preparation is an effective treatment for refractory seroma after breast cancer surgery, which can shorten the drainage time and promote wound healing.
Objective To analyze the effects and recurrence rate of single miconazole and the miconazole plus living preparation of lactobacillus for the treatment of the uncomplicated vulvovaginal candidiasis. Methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 4, 2008) MEDLINE (1966 to January 2009); PubMed (1966 to January 2009); EMbase (1966 to January 2009); CNKI (1966 to January 2009), and the Chinese Biomedicine Database (CBM) (1966 to January 2009) to identify randomized controlled trials of single miconazole versus the miconazole plus living preparation of lactobacillus.The quality of the included trials was assessed. RevMan 5 software was used to conduct meta–analysis. Results Eight trials involving 5 156 patients were included in the effect analysis. Meta-analysis showed miconazole plus with living preparation of lactobacillus was better compared with just miconazole (RR=0.96, 95%CI 0.92 to 1.00, Z=2.12, P=0.03; RR=0.92, 95%CI 0.85 to 0.99, Z=2.17, P=0.03).Seven trials involving 4 852 patients were included in recurrence rate analysis. Meta-analysis showed miconazole plus living preparation of lactobacillus had lower recurrence rate compared with single miconazole (RR=3.72, 95%CI 1.94 to 7.13, Z=3.97, Plt;0.000 1; RR=12.85, 95%CI 8.27 to 19.96, Z=11.37, Plt;0.000 01). Conclusion Currently available evidence shows that the effect in the combined group is better, and the recurrence rate is lower.
ObjectiveTo explore the clinical application of electronic crossmatch technique in the preparation of blood in operation.
MethodsBetween January 2012 and December 2012, in the donor and the application operation preparation of blood in patients with ABO/RhD, blood type was detected and antibody was screened. The donors with correct blood type and negative antibody and the patients with accordant results of two blood identification and negative antibody underwent electronic cross-matching by electronic cross-matching rules, and completed the blood preparation program. At the same time, the patients underwent traditional blood cross-matching method for preparation to ensure the blood compatibility and to compare the advantages and disadvantages of the two kinds of preparing methods.
ResultsIn 7721 blood samples, 7647 samples matched the electronic cross-matching rules; no incompatibility of ABO/RhD was found using electronic cross-matching by computer system. Also, no incompatibility was found using cross-matching by traditional serum method in 7647 blood samples; the average time was 10 minutes, while 100% occupation of blood preparation for operation was found.
ConclusionElectronic cross-matching techniques for preparing operation can save manpower and material resources, and also may optimize the operation process, improve the work efficiency and the safety of blood transfusion.
Objective We searched and reviewed medical evidence to find the guide of bowel preparation we should choose before large bowel preparation. Method Firstly, we put forward clinical questions. Secondly, we searched medical evidence from PubMed, MEDLINE, EMbase, Cochrane Library, Science and ACP in recent 10 years. And then we reviewed the results. Results We finally identified 17 literatures including 2 system reviews, 6 meta-analyses and 9 randomized control trials which included 4 multicentre randomized clinical trials. Most of literature suggested that there was no evidence showing the benefit of mechanical bowel preparation (MBP). No MBP before large bowel surgery would not increase rate of anastomotic leakage. On the contrary, MBP may increase the percentage of anastomotic leakage and wound infection. Considering the research with the clinical situation, we produced a new method of simplified MBP to treat the patient. It reached the predictive effect. Conclusion No evidence of systematic review and meta-analysis supports the benefit of BMP. The new simplified bowel preparation before surgery in West China Hospital was worthy to test.
ObjectiveTo observe the clinical efficacy of dexamethasone intravitreal implant (DEX) in the treatment of active non-infectious uveitis macular edema (NIU-ME).MethodsA retrospective observational study. From February 2018 to February 2019, 23 patients (26 eyes) were included in the study who were diagnosed with NIU-ME at the Department of Ophthalmology, Central Theater Command General Hospital and received intravitreal DEX treatment. Among 23 patients, there were 8 males (8 eyes) and 15 females (18 eyes); the average age was 46.9 years; the average course of disease was 9.2±2.4 months. All the affected eyes underwent BCVA and intraocular pressure examination; at the same time, OCT was used to measure the central retinal thickness (CMT) of the macula. Snellen visual acuity chart was used for visual inspection. The average BCVA of the affected eye was 0.281±0.191, the average intraocular pressure was 16.2±0.8 mmHg (1 mmHg=0.133 kPa), and the average CMT was 395.4±63.7 μm. Among the 23 patients, 8 patients had middle uveitis and 15 patients had posterior uveitis. Seven patients had received intravenous infusion of methylprednisolone, 5 patients had been treated with methylprednisolone combined with immunosuppressive agents, and 11 patients had not received any treatment. All the affected eyes were treated with DEX intravitreal injection. Patients received repeated visual acuity, intraocular pressure and OCT examination with follow-up after injection. During the follow-up period, patients with recurrence of edema or poor efficacy, systemic methylprednisolone and intravitreal reinjection of DEX, triamcinolone acetonide or methotrexate should be considered based on the patient's own conditions. We observed the changes of BCVA, intraocular pressure and CMT before and after injection in the affected eyes, and analyzed the variance of a single repeated measurement factor. At the same time, we observed the occurrence of ocular adverse reactions and systemic complications.ResultsAfter treatment 1.2±0.4, 3.3±0.3, 6.7±1.1, 9.2±1.1, 12.2±0.6 months, the BCVA of the affected eyes were 0.488±0.296, 0.484±0.266, 0.414± 0.247, 0.411±0.244 and 0.383±0.232; CMT was 280.2±42.7, 271.0±41.4, 292.5±42.9, 276.2±40.5, 268.4±26.6 μm, respectively. Compared with before treatment, the BCVA and CMT of the all eyes increased after treatment, and the difference was statistically significant (F=30.99, 5 196.92; P＜0.000). Among 23 eyes completed a 12-month follow-up, 13 eyes (56.5%) received 2 injections, 3 eyes (13.0%) received 3 injections, and other 7 eyes (30.4%) received only 1 injection. After treatment 1.2±0.4 months, 5 patients (6 eyes) with intraocular pressure＞25 mmHg gradually returned to normal after treatment with two eye drops for lowering intraocular pressure; 1 patient (2 eyes) with intraocular pressure＞40 mmHg, the intraocular pressure gradually returned to normal after 3 kinds of eye drops for lowering intraocular pressure.ConclusionIntravitreal injection of DEX in the treatment of NIU-ME can improve the visual acuity of the affected eye and reduce CMT.
