Background In the latter of 20th century, a global growth in allergic diseases has been witnessed, accompanying with spring-out of therapeutic drugs. However, trials did not clarify the comparative effectiveness and pharmaceutical economics of these agents. Severe adverse drug effects have been reported increasingly in the last few years. These made it difficult for clinical practice and selection of national essential drugs. Objective To assess astemizole, loratadine, cetirizine and tefenadine for allergic rhinitis (AR) and urticaria in terms of effectiveness, heart-related drug adverse effects and pharmaceutical economics. Search strategy Cochrane Library, Medline, Embase and Chinese Biomedical Database will be searched. Additional database should be searched for safety and economic studies. Selection Criteria The publication languages are restrained to English and Chinese. 1) Effectiveness: high-quality randomized controlled trials (RCTs) and systematic Reviews (SRs)/ meta-analysis for AR and uritcaria are included, with comparisons restrained to among these four drugs; 2) Safety: a hierarchy of evidences of these four drugs for allergic diseases are included. 3) Economical evaluation: cost-effectiveness and cost-utility assessment of these four drugs for AR and urticaria should be included. Methods of review data extraction sheet and quality appraisal table are separately designed. QUOROM STATEMENT and Jadad Scale are applied, respectively, to SRs and RCTs. Two reviewers independently select the studies, appraise the quality and extract the data. Any disagreement is solved by discussion. Data analysis Fixed effect model is first applied. Sensitivity analysis is employed to study the heterogeneity between trials. Randomized effect model is alternatively used when compromised.
目的 提高对外源性过敏性肺泡炎的认识。 方法 回顾分析2011年10月报道1例外源性过敏性肺泡炎（过敏性肺炎）患者的诊断及治疗经过，总结其临床特征、诊疗要点及预后评价。 结果 患者数次误诊后最终诊断为外源性过敏性肺泡炎，予脱离变应原及激素治疗后痊愈，随访半年无复发。结论 该病临床表现无特异性，需结合患者病史、临床症状、血清学检查、影像学表现，甚至肺泡灌洗液及肺活检综合判断；脱离变应原为该病治疗的最根本、最重要措施；对于病情严重患者，短期全身性使用糖皮质激素可缩短病程或改善症状。
The protocol of rational use of oral H1 receptor antagonists in children: a clinical practice guideline primarily introduces key methods, processes and precautions of the guideline to standardize and guarantee the formulation of this evidence-based guideline. Referring to the World Health Organization Guidelines Development Manual, the guideline will be conducted according to the following steps, which involves the establishment of project group; registration (IPGRP-2020CN110); declaration of interest and funding support; identification of the clinical issues and outcomes; evidence retrieval, assessment, synthesis and utilization; investigation of patients’ preferences and values; development, external review and revision of recommendations; guideline release, dissemination and update.
Neuromyelitis optica spectrum disorders (NMOSDs) are a class of immune-mediated inflammatory demyelinating diseases of the central nervous system that mainly involve the optic nerve and spinal cord. As an important environmental factor, the gut microbiota may play an important role in the occurrence and development of NMOSDs. Previous studies have shown that the structure and number of intestinal flora in NMOSDs patients are different from those of normal healthy people. The altered intestinal flora may cross-react with central nervous system autoantigens, induce T cell differentiation, and affect short-chain fatty acids, etc. The metabolite secretion pathway triggers the occurrence of NMOSDs. The summary of the changes of gut microbiota in patients with NMOSDs and the possible underlying mechanisms by summarizing the literature, aim to provide more effective treatments for the prevention and treatment of NMOSDs in the future.
Oral H1-antihistamines are one of the most commonly prescribed drug categories in the treatment of allergic diseases in children. However, its rational application still lacks sufficient evidence and pharmaceutical guidance, making its clinical use risky. Based on the best available evidence, expert experience, and the willingness of patients' families, the guideline development panel developed this guideline, using the grading of recommendations assessment, development and evaluation (GRADE) approach. The guidelines developed 19 recommendations in 8 domains, covering the therapeutic status of oral H1-antihistamines in pediatric allergic diseases, age range, dose, duration of treatment, adjustment in the presence of hepatic and renal insufficiency, drug interactions, adverse effects and adherence. As a result, this guideline helped to standardize and guide the rational use of oral H1-antihistamines in pediatric allergic diseases.