ObjectiveTo systematically review the safety and immunogenicity of quadrivalent HPV vaccine among healthy population. MethodsDatabases including PubMed, EMbase, CBM, The Cochrane Library (Issue 9, 2013), CNKI, Web of Science and WanFang Data were searched for randomized controlled trials (RCTs) about safety and immunogenicity of quadrivalent HPV vaccine from inception to October 2013. Meanwhile handwork retrieval was also conducted and references of included literature were retrieved. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed methodological quality of included studies. Meta-analysis was then conducted using RevMan 5.2 software. ResultsA total of 9 studies were finally included consisting of 8 RCTs and involving 39 688 patients. The result of meta-analysis showed that:a) for safety, the incidence of injection adverse reaction (swelling and red spots) in vaccine group was higher than that in placebo group (RR=1.22, 95%CI 1.13 to 1.32, P<0.000 01); while the incidences of systemic adverse reaction (RR=1.03, 95%CI 0.99 to 1.07, P=0.1) and serious adverse reaction (RR=1.06, 95%CI 0.75 to 1.50, P=0.74) were alike between the two groups; and b) for immunogenicity, the serum antibody seroconversion rates in the vaccine group (including subtypes of HPV6, HPV11 HPV16 and HPV18) were all higher than those in the placebo group, with significant differences. ConclusionCompared with placebo, quadrivalent HPV vaccine has relatively high incidences of adverse reaction and high-degree immunogenicity, which can be widely used in the prevention of relevant diseases of human papillomavirus infection among adolescents. The main adverse reaction is local dysfunction, which is well tolerated, so the vaccine can be safely used. Due to limited quantity and quality of the included studies, the above conclusion should be verified by further conducting more large-scale, multicentre, high quality RCTs.
Objective To investigate the effect of continuous positive airway pressure (CPAP) on sleep disorder and neuropsychological characteristics in patients with early Alzheimer’s disease (AD) combined with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods A total of forty-two early AD patients with OSAHS were randomly divided into a CPAP combined treatment group (20 cases) and a simple medicine treatment group (22 cases). The changes of neurocognitive function were assessed by Montreal Cognitive Assessment (MoCA), Mini-mental State Examination (MMSE) and Hopkins Verbal Learning Test-revised (HVLT). Patient Health Questionnaire-9 (PHQ9) was used to evaluate the depression mood changes. The sleep characteristics and respiratory parameters were evaluated by polysomnography. The changes of the patients’ sleep status were assessed by Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI). The changes of sleep status, cognitive function and mood in the CPAP combined treatment group were compared before and three months after CPAP treatment, and with the simple medicine treatment group. Results After three months of CPAP treatment, the ESS, PSQI and PHQ9 scores in the CPAP combined treatment group were significantly decreased compared with those before treatment, whereas MoCA, MMSE and HVLT (total scores and recall ) in the CPAP combined treatment group were increased compared with those before treatment (P<0.05). After CPAP treatment, the respiratory parameters apnea hypopnea index in the CPAP combined treatment group was significantly lower than that before treatment (P<0.05), and the minimum blood oxygen saturation was significantly higher than that before treatment (P<0.05). However, the sleep characteristics and parameters did not show statistically significant changes compared with those before treatment (P>0.05). The ESS, PSQI and PHQ9 scores were significantly reduced in the CPAP combined treatment group compared with the simple medicine treatment group (P<0.05), while there was no statistically significant changes of cognitive scores between the two groups (P>0.05). Conclusions The degree of low ventilation and hypoxia is alleviated, and the daytime sleepiness and depression is improved in early AD patients with OSAHS after three-month continuous CPAP treatment. Cognitive function is significantly improved, whereas there is no significant change in sleep structure disorder.