ObjectiveTo analyze the CT features of immune checkpoint inhibitor-related pneumonia (CIP) and improve the diagnostic accuracy of CIP. MethodsAmong patients with malignant tumor treated with immune checkpoint inhibitors, those who developed pneumonia and rule out other causes of disease were identified. Chest CT Imaging were reviewed to assess special signs, distribution characteristics, severity of pneumonia and radiographic patterns of CIP. ResultsA total of 28 patients were enrolled, including 26 males and 2 females. CT features include ground-glass opacity, centrilobular nodularity, reticular opacity, consolidation, traction bronchiectasis, honeycomb, etc. The lesions predominant involved peripheral lung zone (17/28), lower lung zone (18/28) and posterior lung zone (18/28), with a diffuse distribution (23/28). In most cases the disease involved both lungs (23/28), and a few involved unilateral or single lobe. The most common affected lobes were the lower lobe of the right lung (25/28) and the lower lobe of the left lung (20/28), followed by the upper lobe of the right lung (18/28). Mean pneumonia severity score was 5.5, standard deviation was 3.8, and range was 1 - 15. The most common radiographic patterns of CIP were nonspecific interstitial pneumonia (11/28) and hypersensitivity pneumonia (10/28). The second was organizing pneumonia (6/28). ConclusionsThe CT manifestations of CIP have certain specificity. Combined with the history of drug treatment and clinical symptoms of patients, the early and correct diagnosis can be obtained.
Objective To determine the effectiveness and safety of autologous platelet-rich gel in the management of diabetic foot ulcer. Methods We searched Cochrane Central Register of Controlled Trails (CENTRAL), MEDLINE or PubMed, EMbase, OVID Database, Chinese Biological Medicine Database (CBMDisc), CNKI, Chinese VIP Database and WANFANG Database. We also handsearched the bibliographies of retrieved articles and correlated proceedings. The systematic review was conducted using the method recommended by the Cochrane Collaboration. Results Four trials involving 216 patients were included. Meta-analyses showed (1) Diabetic foot ulcer healing rate: Autologous platelet-rich gel was superior to the standard care (Plt;0.000 01); (2) Diabetic foot ulcer reduction rate: Autologous platelet-rich gel was superior to the standard care (P=0.000 3); (3) Diabetic foot ulcer healing time: Autologous platelet-rich gel was superior to the standard care (Plt;0.000 01); (4) Complications: No patient in these trials had complications. Conclusions The limited current evidence shows that autologous platelet-rich gel is safe and effective in the short-term treatment for diabetic foot ulcer.
Objective To evaluate the effectiveness and safety of probiotic agents for ulcerative colitis. Methods We searched electronically the Cochrane Central Register of Controlled Trials (Issue 1, 2007), MEDLINE (1978 to 2007), EMBASE (1978 to 2007), OVID Database (1978 to 2007), Chinese Biological Medicine Database (CBM Disc) (1978 to 2007), CNKI (1979 to 2007), Chinese VIP Database (1989 to 2007) and Wanfang Database (1978 to 2007). We also checked the reference lists of retrieved articles and hand-searched 4 kinds of important journals to identify randomized controlled trials of probiotic agents for ulcerative colitis. Meta-analyses were conducted with The Cochrane Collaboration’s RevMan 4.2 software. Results Thirteen trials involving 1146 patients were included. Meta-analyses showed that probiotic agents were not superior to aminosalicylates for the clinical remission rate (OR 0.93, 95% CI 0.53 to 1.66; P=0.82); but the combination of probiotic agents and aminosalicylates were superior to aminosalicylates alone (OR 2.69, 95% CI 1.57 to 4.61; P=0.0003). In terms of the clinical relapse, the rate for probiotic agents was superior to that for placebo (OR 0.03, 95% CI 0.00 to 0.15; Plt;0.0001); but not superior to aminosalicylates (OR 0.95, 95% CI 0.65 to 1.38; P=0.79). The combination of probiotic agents and aminosalicylates was not superior to aminosalicylates alone (OR 0.57, 95% CI 0.24 to 1.32; P=0.19). As for the incidence of adverse effects, probiotic agents were not superior to aminosalicylates (OR 0.85, 95% CI 0.43 to 1.70; P=0.65); and the combination of probiotic agents and aminosalicylates was not superior to aminosalicylates alone (OR 0.30, 95% CI 0.06 to 1.54; P=0.15). Conclusion Probiotic agents are not superior to aminosalicylates based on the evidence in this review, but the combination of probiotic agents and aminosalicylates is superior to aminosalicylates alone in maintaining remission. Probiotic agents are superior to placebo but not superior to aminosalicylates, and the combination of probiotic agents and aminosalicylates is not superior to aminosalicylates alone in preventing relapse. Probiotic agents have good tolerability. However, all these findings should be interpreted with caution and more clinical trials are needed.