Objective To assess the effectiveness and safety of fructose 1,6-diphosphate （FDP） in the treatment of hypoxic ischemic encephalopathy （HIE）patients. Methods Biomedical databases, including MEDLINE （1977 -2004 ）, EMBASE（1989- 2004） ,Cochrane Injuries Group trials register, Cochrane Controlled Trials Register, CBMdisk and CNKI （1994- 2005 ）were searched. Chnical trials were collecte＆Quality assessments of chnical trials were carried out. Randomized controlled trials （RCTs） with mortality and the incidence of cerebral palsy, epilepsy and mental defect were selected for meta-analysis. Results Nine RCTs were included, and all were done in China. None of the 9 RCTs described the method of randomization or allocation concealment. None of the 9 RCTs mentioned wether blindness was use＆ In Jadad score, 5 trials were scored by 2 and 4 trials were 1. Seven trials were included in the meta-analysis of death, which showed that the obsolute risk （OR） [95% confidence interval （CI）] of death following FDP administration was 0. 50 （95% CI 0. 21 to 1.16）. Five RCTs reported the results of follow-up. When intention to treat （ITT） analysis was adopted, the OR of FDP on cerebral palsy was 0. 36 （95% CI 0. 19 to 0. 89）, on epilepsy was 0.74 （95% CI 0. 29 to 1.88）, and on dementia was 0. 21 （95% CI 0. 06 to 0.70）. We didn＇t conduct sensitivity analysis because no RCTs were of high quality. We didn＇t identify clinical trials compared with adverse reactions between the two groups. Conclusions The quality of RCTs on FDP for HIE is poor. Because there were no RCTs of high quality available, we can＇t draw a conlusion. Well-designed RCTs with economic evaluation are urgently needed to evaluate the value of FDP in the treatment of HIE.
ObjectiveTo analyze pathogenic factors and etiological characteristics of suppurative endophthalmitis.MethodsA total of 531 consecutive patients (531 eyes) with suppurative endophthalmitis who were hospitalized in Qingdao Eye Hospital of Shandong Eye Institute from January 2006 to December 2015 were included in the study. Among them, 410 patients with 410 eyes were males (77.2%), 121 patients with 121 eyes were females (22.8%). The average age of the patients was 38.62±15.36 years. The relevant medical records were collected to analyze the pathogenic factors. Samples of aqueous humor, vitreous or other intraocular samples were taken under aseptic conditions for bacterial and fungal culture and in vitro drug sensitivity test.ResultsOcular trauma was the primary pathogenic factor of suppurative endophthalmitis (60.1%), other factors included postoperative endophthalmitis (19.0%), suppurative keratitis-related endophthalmitis (17.1%) and endogenous endophthalmitis (3.8%). Postoperative endophthalmitis mainly occured after cataract surgery. A total of 224 strains of organisms were isolated, among which the predominant organisms isolated were gram-positive bacteria (54.0%) and staphylococcus epidermidis was the most common (25.0%). The other pathogenic organisms were fungi (29.5%) and gram-negative bacteria (16.5%). Among the fungi, aspergillus (10.7%) was the dominant genus, followed by fusarium (9.8%). For gram-positive organisms, susceptibilities were vancomycin 97.4%, gatifloxacin 91.8%, fusidate acid 77.9% and levofloxacin 54.6%. For gram-negative organisms, susceptibilities were gatifloxacin 85.7%, levofloxacin 77.8%, tobramycin 71.4% and ceftazidime 62.5%. For fungal isolates, sensitivities were voriconazole 88.2% and amphotericin B 84.8%.ConclusionsOcular trauma is the main pathogenic factor of suppurative endophthalmitis, followed by postoperative endophthalmitis and suppurative keratitis-related endophthalmitis. Gram-positive bacteria are the major pathogenic organisms, especially staphylococcus epidermidis followed by fungal species, among which aspergillus and fusarium were the dominating pathogenic genus.