Objective To analyze the effects and recurrence rate of single miconazole and the miconazole plus living preparation of lactobacillus for the treatment of the uncomplicated vulvovaginal candidiasis. Methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 4, 2008) MEDLINE (1966 to January 2009); PubMed (1966 to January 2009); EMbase (1966 to January 2009); CNKI (1966 to January 2009), and the Chinese Biomedicine Database (CBM) (1966 to January 2009) to identify randomized controlled trials of single miconazole versus the miconazole plus living preparation of lactobacillus.The quality of the included trials was assessed. RevMan 5 software was used to conduct meta–analysis. Results Eight trials involving 5 156 patients were included in the effect analysis. Meta-analysis showed miconazole plus with living preparation of lactobacillus was better compared with just miconazole (RR=0.96, 95%CI 0.92 to 1.00, Z=2.12, P=0.03; RR=0.92, 95%CI 0.85 to 0.99, Z=2.17, P=0.03).Seven trials involving 4 852 patients were included in recurrence rate analysis. Meta-analysis showed miconazole plus living preparation of lactobacillus had lower recurrence rate compared with single miconazole (RR=3.72, 95%CI 1.94 to 7.13, Z=3.97, Plt;0.000 1; RR=12.85, 95%CI 8.27 to 19.96, Z=11.37, Plt;0.000 01). Conclusion Currently available evidence shows that the effect in the combined group is better, and the recurrence rate is lower.
Objective To investigate the effects of celecoxib-poly lactide-co-glycolide microparticles (CEL-PLGA-MS) on rat retina after intravitreal injection. Methods A total of 32 male Brown Norway rats were randomly divided into CEL-PLGA-MS group and celecoxib group, 16 rats in each group. The rats in CEL-PLGA-MS group were divided into four dosage group, four rats in each group, which received intravitreal injection of PLGA with celecoxib at the concentration of 40, 80, 160, 320 mu;mol/L, respectively. The rats in celecoxib group were divided into four dosage group, four rats in each group, which received intravitreal injection of celecoxib at the concentration of 40, 80, 160, 320 mu;mol/L, respectively. Phosphate buffer solution (PBS) was injected in two rats as PBS control group. Two rats as normal control group received no treatment. The difference of retinal thickness among groups was measured by optical coherence tomography (OCT). The morphological and histological change of retina was evaluated under light microscope and transmission electron microscope. Results There was no difference of retinal thickness between normal control group and PBS control group (F=0.12,P＞0.05). At the first week after injection, the retinal thickness of CEL-PLGA-MS group and celecoxib group were thicker than that in normal control group and PBS control group (F=9.62, 46.13;P＜0.01). The retinal thickness of celecoxib group was thicker than that in CEL-PLGA-MS group (F=165.15,P＜0.01). The retinal thickness was estimated equal among 40, 80, 320 mu;mol/L dosage groups in CEL-PLGA-MS group (F=4.79,P＜0.01). The retinal thickness of 160, 320 mu;mol/L dosage group were thicker than that in 40, 80 mu;mol/L dosage group in celecoxib group (F=28.10,P＜0.01). At the second week after injection, there was no difference of retinal thickness between CEL-PLGA-MS and celecoxib group (F=3.79,P＞0.05); the retinal thickness of CEL-PLGA-MS and celecoxib group became thinner gradually compare to the first week after injection (F=7.28, 103.99; P＜0.01). At the fourth week after injection, the retinal thickness of celecoxib group was thicker than that in CEL-PLGA-MS group (F=19.11,P＜0.01). The retinal thickness of CEL-PLGA-MS group was approximately the same to normal control group and PBS control group (F=2.02,P＞0.05). The retinal thickness of celecoxib group was thicker than that in normal control group and PBS control group. No considerable abnormality of the retina was seen by light microscope and the retinal thickness corresponded with the values measured by OCT at the first week after injection. The abnormal structures of the retina were seen in 160, 320 mu;mol/L dosage group of celecoxib group and inner changed evidently by the transmission electron microscope. Disordered arrangement of microfilaments, dilated microtubule and some mitochondria vacuolation were observed in 320mu;mol/L dosage group of celecoxib group. Others changed slightly. Conclusions CEL-PLGA-MS has less toxicity on the retina than free-celecoxib after intravitreal injection. The safety of intravitreal injection with CEL-PLGA-MS is better than celecoxib.
Objective To observe the effect of Fufang XueShuanTong (FXST) on prevention for retinal microangiopathy of diabetic rats. Methods Take the normal male Wistar rats as normal control group; take the streptozotocin (STZ) Wistar rats as diabetic model group. And then the diabetic model group was divided into two groups: diabetic control group (without other treatment) and FXST treatment group (with FXST at dose 900 mg/kg, by the way of given medicine from esophagus to stomach, 1 time/day, experimental period was 20 weeks). When all the animals had been raised for 20 weeks, not only retinal digesting preparations were used, the endothelium/pericyte ratio (E/P ratio) and micro-vascular changes were observed by microscope, vascular relative area were measured by image system，but also the thickness of capillary basement membrane, the ultrastructural changes of endothelium and pericyte were observed by transmission electron microscope. Results On the 20th week, retinal digesting preparations showed that acellular capillaries, irregular vessel nets, segmental expansion, segmental stricture even occlusion, pericyte number decreased obviously, E/P ratio increased, vascular relative area increased and ghosts of pericytes etc in diabetic control group. Compared to diabetic control group, the retinal changes of FXST treatment group was lighter, the E/P ratio and vascular relative area were closer to normal control group. Transmission electron microscopy results showed that thickness of basement membrane was increased in DM group, vascular changes was light in FXST treated group. Conclusions FXST can prevent the changes of micrangium in diabetic rats effectively. （Chin J Ocul Fundus Dis，2008，24：272-275）
Objective To analyze the effectiveness and effect on pregnant outcome about living preparation of lactobacillus versus metronidazole in the treatment of bacterial vaginosis in pregnancy. Methods We searched PubMed, The Cochrane Library, VIP, CNKI, Wangfang, CBM, FMJS, and FEBMT to identify randomized controlled trials (RCT) of living preparation of lactobacillus versus metronidazole for bacterial vaginosis in pregnancy. The quality of the included trials was assessed. RevMan 5.0.24 software was used for meta-analysis. Results Eight trials involving 1 687 patients were included. The results of meta-analysis showed: no significant difference was found in the effectiveness between the two groups (RR=1.04, 95%CI 1.00 to 1.08, P=0.08); living preparation of lactobacillus had lower recurrence rate and lower premature delivery rate compared with metronidazole (RR=0.16, 95%CI 0.06 to 0.43, P=0.0004; RR=0.56, 95%CI 0.33 to 0.94, P=0.03); no significant differences were found in premature rupture of membrane, puerperal infection, infant of low-birth weight, infant infection, and infant jaundice between the two groups. Conclusion The effectiveness about living preparation of lactobacillus versus metronidazole for bacterial vaginosis in pregnancy is similar, but living preparation of lactobacillus has lower recurrence rate and lower premature delivery rate, the others of effect on pregnant outcome are similar.
Objective We searched and reviewed medical evidence to find the guide of bowel preparation we should choose before large bowel preparation. Method Firstly, we put forward clinical questions. Secondly, we searched medical evidence from PubMed, MEDLINE, EMbase, Cochrane Library, Science and ACP in recent 10 years. And then we reviewed the results. Results We finally identified 17 literatures including 2 system reviews, 6 meta-analyses and 9 randomized control trials which included 4 multicentre randomized clinical trials. Most of literature suggested that there was no evidence showing the benefit of mechanical bowel preparation (MBP). No MBP before large bowel surgery would not increase rate of anastomotic leakage. On the contrary, MBP may increase the percentage of anastomotic leakage and wound infection. Considering the research with the clinical situation, we produced a new method of simplified MBP to treat the patient. It reached the predictive effect. Conclusion No evidence of systematic review and meta-analysis supports the benefit of BMP. The new simplified bowel preparation before surgery in West China Hospital was worthy to test.
Objective To investigate the effect and clinical significance of 3 d and 1 d bowel preparation method for colorectal carcinoma surgery on preoperative gut mucosal barrier function. Methods Plasma levels of D-lactate (D-LAC), diamine oxidase (DAO) and endotoxin (ET) were measured at 2 h before operation in 3 d bowel preparation group (50 cases) and 1 d bowel preparation group (50 cases), 25 cases of inguinal hernia were included as control group. D-LAC, DAO and ET were detected by using enzymatic spectrophotometric assay, spectrophotometric assay and limulus lysate test with azo chromogenic substrate, respectively. Results Preoperative plasma levels of D-LAC, DAO and ET in 3 d bowel preparation group were (10.25±1.43) mg/L, (5.82±0.80) U/ml and (10.11±1.41) ng/L respectively. In 1 d bowel preparation group the corresponding values were (10.19±1.35) mg/L, (5.80±0.81) U/ml and (9.82±1.35) ng/L respectively. There were no significant differences between 3 d and 1 d bowel preparation group (Pgt;0.05), compared with hernia group, 1 d and 3 d bowel preparation group were also no statistically significant differences (Pgt;0.05). Conclusions There are no significant preoperative gut mucosal barrier function damages in patients with 1 d and 3 d bowel preparation for colorectal carcinoma surgery, 1 d bowel preparation for colorectal carcinoma surgery can be performed in colorectal carcinoma patients, and 3 d bowel preparation can be used for certain special colorectal carcinoma patients.
Objective To study the current clinical application and advancement of microbioecological preparation. Methods Literatures about microbioecological preparation published in China and abroad were collected and reviewed. Results The microbioecological preparation has been widely used at present. It is used to rebuild a balanced microbial population in human body, particularly in intestinal, to promote the stability of internal environment, control dysbacteriosis and to treat a variety of gastrointestinal diseases associated with ectopic microbial population. Conclusion Although microbioecological preparation has been widely used in clinical settings, its effect yet should be further supported and evaluated both by large sample research in randomized double-blind control trails and evidence-based medicine.
ObjectiveTo explore the clinical application of electronic crossmatch technique in the preparation of blood in operation. MethodsBetween January 2012 and December 2012, in the donor and the application operation preparation of blood in patients with ABO/RhD, blood type was detected and antibody was screened. The donors with correct blood type and negative antibody and the patients with accordant results of two blood identification and negative antibody underwent electronic cross-matching by electronic cross-matching rules, and completed the blood preparation program. At the same time, the patients underwent traditional blood cross-matching method for preparation to ensure the blood compatibility and to compare the advantages and disadvantages of the two kinds of preparing methods. ResultsIn 7721 blood samples, 7647 samples matched the electronic cross-matching rules; no incompatibility of ABO/RhD was found using electronic cross-matching by computer system. Also, no incompatibility was found using cross-matching by traditional serum method in 7647 blood samples; the average time was 10 minutes, while 100% occupation of blood preparation for operation was found. ConclusionElectronic cross-matching techniques for preparing operation can save manpower and material resources, and also may optimize the operation process, improve the work efficiency and the safety of blood transfusion.
ObjectiveTo evaluate the safety and efficacy of Chaihu drop-pill in the treatment of common cold (wind-heat syndrome). MethodsA multi-center, double blind, double dummy, randomized controlled trial was conducted. A total of 479 patients with common cold (wind-heat syndrome) diagnosed between February and August, 2011, were randomly divided into two groups:the trial group (n=359) and the control group (n=120). The trial group received Chaihu drop-pill and Yinchai granule analogue three times a day, while the control group received Yinchai granule and Chaihu drop-pill analogue. The therapeutic courses of both groups were 3 days. Clinical symptoms, syndromes, and adverse effects were observed before and after the treatment. Furthermore, blood, urine and stool test, hepatorenal function test and electrocardiogram were also carried out before and after treatment. ResultsAfter treatment, the healing rates of the trial group and the control group were 32.4%, 20.2% (for full analysis set) and 32.6%, 20.5% (for per protocol set), and the overall response rates were 96.3%, 87.4% (for full analysis set) and 96.5%, 87.2% (for per protocol set). There were significant differences between the two groups (P<0.01). No adverse effects were found in the trial. ConclusionChaihu drop-pill is effective and safe in the treatment of common cold (wind-heat syndrome).
ObjectiveTo determine the benefits and harms of mechanical bowel preparation(MBP) in elective colorectal surgery. MethodsCochrane systematic evaluation was used to search through Cochrane libraries of clinical comparative trials, PubMed, Embase, Cancer Lit, and the Chinese BioMedical Literature on disc. The quality of literatures was independently evaluated and cross-checked by two evaluators, indicator for assessment including anastomotic leak, overall surgical site infection(SSI), extra-abdominal septic complications, wound infections, reoperation or second intervention rate, and death. The results were analysed with RevMan 5.1 software. ResultsFourteen RCTs were included in this analysis with a total number of 5 373 patients. Comparing with no MBP for elective colorectal surgery, the study results showed that MBP had not reduce any postoperative complications when concerning anastomotic leak[OR(95% CI), 1.08(0.82-1.43);P=0.56];overall SSI[OR(95% CI), 1.26(0.94-1.68);P=0.12];extra-abdominal septic complications[OR(95% CI), 0.98(0.81-1.18);P=0.81];wound infections[OR(95% CI), 1.21(1.00-1.46);P=0.05];reoperation or second intervention rate[OR(95% CI), 1.11(0.86-1.45);P=0.42], and death[OR(95% CI), 0.97(0.63-1.48);P=0.88]. ConclusionNo evidence supporting the use of MBP in patients undergoing elective colorectal surgery. MBP should be omitted in routine clinical practice.