ObjectiveTo investigate the clinical manifestations, diagnosis, treatment and prognosis of Rosai-Dorfman disease (RDD) in nasal cavity and nasopharynx. MethodsWe retrospectively analyzed the clinical data of 4 patients with extranodal RDD admitted to the Department of Otolaryngology, Head and Neck Surgery of our hospital between November 2009 and August 2013. ResultsAll patients received complete surgical removal of the lesions. Histopathological examination showed that large histocytes had an abundant foamy cytoplasm containing ingested lymphocytes as a result of emperipolesis, and were strongly positive for S-100 and CD68 on immunohistochemical analysis, but negative for CD1a. All patients were followed up for 28 to 45 months (averaging 35 months), and no recurrence was observed during the follow-up period. ConclusionRDD is a rare disease, and the exact etiology and pathogenesis of RDD are not fully understood. There is no unified treatment plan recommended, and complete surgical removal of the lesions is an effective method. Minimally invasive surgery may be a good choice for treatment of this disease.
ObjectiveTo systematically review the effects of adherence therapy in improving medication adherence and clinical outcomes in psychosis patients. MethodsWe searched databases including PubMed, EMbase, The Cochrane Library (Issue 10, 2015), EBSCO, CBM, CNKI, VIP, and WanFang Data from inception to Oct. 2015, to collect randomized controlled trials (RCTs) about adherence therapy for patients with psychosis. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.2 software. ResultsA total of 13 RCTs involving 1 244 patients were included. The results of metaanalysis showed that adherence therapy could improve attitude towards medication adherence (MD=3.12, 95%CI 1.26 to 4.98, P=0.001), behavioral adherence (SMD=0.54, 95%CI 0.21 to 0.88, P=0.001), function (SMD=0.42, 95%CI 0.28 to 0.56, P=0.000 01) and insight of diseases (SMD=0.34, 95%CI 0.15 to 0.54, P=0.000 7) in patients with psychosis. But regarding psychotic symptoms, hospital stay, medical costs and adverse drug reactions, adherence therapy did not show benefit (all P values >0.05). ConclusionCurrent evidence shows that adherence therapy could improve medication adherence, function and insight towards diseases in patients with psychosis. Due to the limited quantity and quality of included studies, more large-scale, multi-center, and high quality RCTs are needed to verify the above conclusion.