Objective To analyze the clinical application, ADR/AE involved systems and manifestations of the six injections containing Houttuynia cordata which are much complicated in their ingredients and pharmacological actions compared with the Houttuynia cordata Injection, and to assess their safety and efficacy, so as to provide references for further deep research. Methods Such databases as MEDLINE (1998 to December 31, 2010), EMBASE (1998 to December 31, 2010), The Cochrane Library (1998 to December 31, 2010), CNKI (1979 to December 31, 2010), CBM (1978 to December 31, 2010), and VIP (1989 to December 31, 2010) were searched to retrieve the case report, series of cases observation, cross-sectional study, and clinical control study. The studies were included according to the inclusive and exclusive criteria, and the data was abstracted to analyze the reason and regularity of ADR/AE. Meta-analyses for efficacy were conducted when the data was feasible. Results a) About ADR/AE: Among the included 132 studies, 118 cases were reported with the ADR/AE. There were 59 studies about the New Houttuyfonate sodium injection, 93 cases with ADR/AE mainly manifested as pain in injection site (41 cases), rash (19 cases), anaphylactic shock (11 cases) and other infusion or allergic reactions (21 cases). There were 69 studies about the Yu Jin injection, 25 cases with ADR/AE manifested as rash (12 cases), anaphylactic shock (four cases), pain in injection site (three cases), and other infusion or allergic reactions (six cases); and b) The good efficacy of the New Houttuyfonate sodium injection and the Yu Jin injection was reported in one cross-sectional study and one RCT respectively, but the limited data was not enough to properly judge the efficacy. Conclusion There are few of clinical studies about these six injections containing Houttuynia cordata, and the irrational use in clinic is serious. Most of the ADR/AE cases are related to irrational use, such as, non-indication use, and arbitrarily change of administration method. The proof for analyzing and evaluating the safety and efficacy of injections containing Houtturnia cordata is insufficient, so strict clinical trials with large sample size are required to support further research.
Femoral nerve blocks (FNB) can provide effective pain relief but result in quadriceps weakness with increased risk of falls following total knee arthroplasty (TKA). Adductor canal block (ACB) is a relatively new alternative providing pure sensory blockade with minimal effect on quadriceps strength. The meta-analysis was designed to evaluate whether ACB exhibited better outcomes with respect to quadriceps strength, pain control, ambulation ability, and complications. PubMed, Embase, Web of Science, Wan Fang, China National Knowledge Internet (CNKI) and the Cochrane Database were searched for RCTs comparing ACB with FNB after TKAs. Of 309 citations identified by our search strategy, 12 RCTs met the inclusion criteria. Compared to FNB, quadriceps maximum voluntary isometric contraction (MVIC) was significantly higher for ACB, which was consistent with the results regarding quadriceps strength assessed with manual muscle strength scale. Moreover, ACB had significantly higher risk of falling versus FNB. At any follow-up time, ACB was not inferior to FNB regarding pain control or opioid consumption, and showed better range of motion in comparison with FNB. ACB is superior to the FNB regarding sparing of quadriceps strength and faster knee function recovery. It provides pain relief and opioid consumption comparable to FNB and is associated with decreased risk of falls.
Extra-adrenal myelolipoma happens in adrenal glands, and the thoracic location is extremely unusual. This is the first study involving 36 of patients with thoracic myelolipoma of English literature by investigating the clinical data, pathologic findings, radiological manifestation, and treatment strategy of all patients. Imageologic diagnosis including computed tomography, magnetic resonance imaging, and positron emission tomography/computed tomography scans is useful to identify the feature of extra-adrenal myelolipoma. Pathologic analysis is an effective method to clarify the diagnosis. In view of the potential progressive enlargement of the lesion, most myelolipomas are removed by surgery, and this operation has frequently been accomplished by using video-assisted thoracic surgery. (C) 2016 Elsevier Inc. All rights reserved.
ObjectivesTo systematically review the safety of traditional Chinese medicine injection based on clinical centralized monitoring studies that have been carried out and listed so far, to understand basic situation of adverse reactions and explore the risk factors of traditional Chinese medicine injections and to provide evidence for clinical rational use of drugs and optimizing centralized monitoring methods. MethodsCFDA, CNKI, VIP, WanFang Data, Sinomed, PubMed and The Cochrane Library databases were electronically searched to collect studies on safety monitoring of listed traditional Chinese medicine injections from inception to February, 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed by using Excel software. ResultsA total of 14 studies involving 14 varieties of injections, 296 200 cases were included. The highest incidence rate of adverse reactions was found in the XueBiJing injection (2.54%). The related factors of ADR extraction were age, sex, drug combined usage, time from administration, allergic history, administration days, indication, dose and distribution of the tube. ConclusionsThe safety of traditional Chinese medicine injection is generally high. Middle and old age is an important factor in the occurrence of ADR. The incidence of ADR is relatively high in the first 6 days of drug use, and the incidence of ADR is more likely to be caused by irrational use of drugs in clinic, and the history of allergy may be related to the occurrence of ADR. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusion.