OBJECTIVETo evaluate the efficacy of antioxidants in the treatment of non-alcoholic fatty liver.

METHODSThe Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE or PUBMED (1978-2011), EMBASE (1978-2011), ISI, OVID Database (1978-2011), CNKI Net and WANFANG database (1978-2011) were searched for relevant randomized controlled trials, with also manual search of the bibliographies of the retrieved articles. The data were synthesized to assess the histological response of the patients (hepatic steatosis, inflammation and fibrosis) and hepatic biochemical changes after the treatments (alanine aminotransferase responses).

RESULTSFourteen trials involving 1284 patients were included in the Meta-analysis. The quality of the trials was inconsistent. The data were extracted for meta-analysis or descriptive analysis, which did not yield sufficient evidence that antioxidants could improve hepatic steatosis, inflammation, fibrosis or alanine aminotransferase responses.

CONCLUSIONSThe current data do not support a positive therapeutic effect of antioxidants on nonalcoholic fatty liver, and antioxidants are therefore not recommended in the clinical treatment of the condition.

Antioxidants ; therapeutic use ; Fatty Liver ; drug therapy ; Humans ; Non-alcoholic Fatty Liver Disease ; Randomized Controlled Trials as Topic ; Treatment Outcome

Objective To investigate the clinical features of pneumocystis pneumonia (PCP) in patients with chronic kidney disease. Methods Clinial data of 21 cases of the primary and secondary kidney diseases complicated with PCP,excluding renal transplantation,were analyzed retrospectively. Results Twenty-one cases consisted of 6 cases of primary renal diseases and 15 eases of secondary renal diseases.Twenty patients (95.2%) were receiving immunesuppressive therapy at the PCP onset.Main manifestations were fever,progressive dyspnea,cough with no or seldom sputum.Twenty patients presented obvious hypoxemia and 12 of them were type I respiratory failure.X-ray and CT imaging of 20 patients revealed diffuse pulmonary interstitial shadows or ground glass opacities in both lungs.All the patients were treaed with trimethoprim-sulfamethoxazole.Eleven patients died accounting for 52.3%.Compared with the survivors,elder age (60.91±15.08 vs 44.50±14.83,P＜0.05),lower blood oxygen pressure at onset [(48.11±19.05)mm Hg vs (65.91±13.13)mm Hg,P＜0.01],higher percentage of respirator application and other secondary lung infection were found in dead patients.No PCP relapsed after average 16-month follow-up in the survival patients. Conclusions PCP is a severe complication with high mortality during immunosuppressive therapy in patients with chronic renal disease.Early diagnosis and proper treatment are important to improve prognosis.