OBJECTIVE: To assess the efficacy and safety of glucocorticoid in initial treatment of sudden hearing loss with intratympanic (IT) and systemic ways. METHOD: We searched the database of PubMed, Cochrane, Embase,CBM, CNKI, VIP, Wanfang systematically. Literatures were screened according to the preestablished inclusion and exclusion standards,and all the RCT literatures associated with intratympanic and systemic glucocorticoid in the initial treatment of sudden hearing loss before may 2015 were collected. All the data, which meet the inclusion standards, were analyzed by using Meta-analysis software. RESULT: Among all the qualified literatures, 11 randomized controlled trials were included. A total of 1298 cases were involved, including 521 cases with intratympanic administration, 410 with IV-therapy, and 201 with oral therapy. Meta analysis results showed that there was significant difference of the total effective rate and improvement rate between the intratympanic and systemic administration. Intratympanic injection (P > 0.05) was more effective than systemic administration. There was no significant difference between intratympanic group and oral group (RR = 1.15, 95% CI: 0.92-1.42, P > 0.05). A significant difference of the effective rate occurred between intratympanic group and IV therapy group (RR = 1.17, 95% CI: 1.02-1.34, P < 0.05). The major complications of intratympanic were pain, dizziness/vertigo, which occurred more frequently than systemic therapy group; The major complications of systemic therapy group were hyperglycaemia, loss of appetite and insomnia. CONCLUSION This study shows that the intratympanic (IT) glucocorticoid for sudden deafness is more effective than the systemic administration. But it was not the first choice in clinical treatment. Further studies are warranted.
Administration, Oral ; Glucocorticoids ; administration & dosage ; therapeutic use ; Hearing Loss, Sudden ; drug therapy ; Humans ; Hyperglycemia ; Injection, Intratympanic ; Randomized Controlled Trials as Topic ; Steroids ; administration & dosage ; therapeutic use ; Treatment Outcome

Objective To investigate the efficacy of microbubble-enhanced sonothrombolysis on platelet-rich thrombi (PRT) and erythrocyte-rich thrombi (ERT) in different ages.Methods PRT and ERT in different ages were prepared both in vitro and in vivo of common carotid artery in rats.All the participants were divided into 8 groups with 4 in vitro and another 4 in vivo experiment,including PRT 3 h,PRT 24 h,ERT 3 h,ERT 24h in vitro groups and PRT 3 h,PRT 24 h,ERT 3 h,ERT 24 h in vivo groups.Microbubble-enhanced sonothrombolysis was carried out in both in vitro and in vivo experiments,and the ultrasonic images were collected.The components of PRT and ERT were identified by histopathological examination.The percentage increase of luminal cross sectional area and lytic ratio in vitro,and the recanalization rate and mean blood flow velocity of common carotid artery in vivo were mainly analyzed.Results After sonothrombolysis,both in vitro and in vivo experiment showed there was no statistically significant difference of the percentage increase of luminal cross sectional area ([121.12 ± 13.21]％ vs [130.09 ± 15.34]％),lytic ratio ([39.83± 7.09]％ vs [42.14±5.17]％),recanalization rate (83.33％ vs 91.67％) and blood flow velocity of common carotid artery ([0.21±0.02]m/s vs [0.22±0.01]m/s) between PRT 3 h group and ERT 3 h group (both P＞0.05).PRT 24 h group compared with EPR 24 h group,PRT 24 h group compared with PRT 3 h group,as well as ERT 24 h group compared with ERT 3 h group,the percent increase of luminal cross sectional area,lytic ratio,recanalization rate and blood flow velocity of common carotid artery reduced (all P＜0.05).Conclusion The efficacy of microbubble-enhanced sonothrombolysis on PRT and ERT in vitro and in vivo of of rat common carotid artery model decrease with the increase of thrombus age,especially for the PRT.

Objective To analyze serum levels of C1q in children with nephrotic syndrome (NS),and investigate the clinical significance and the relationship among the altered serum C1q levels and other lipid/lipoprotein and renal function parametersin children with NS inacute and remission phases.Methods Serum levels of C1q were measured in 78 NS children with acute phase,in 64NS children with remission and in 77 healthy control children.The other lipid/lipoprotein and renal function parameters were also analyzed in these children,including TP,ALB,TC,TG,LDL-C,HDL-C,Urea,Cr and Uric.Results Compared with the healthy control children [173.00(161.00～185.00)mg/L],children with NS inacute [203.50(183.75 ～ 223.75) mg/L] and remission phases [185.00 (161.00 ～ 202.00) mg/L] all had a significantly increasedserum levels of C1q.Compared with NS children in remission,those in acute phase showed a significantly increased C1q (P＜0.001).In all the NS children,the serum levels of C1q were positively correlated with the levels of TC (r=0.483,P＜0.001),TG (r=0.423,P＜0.001) and LDL-C (r=0.450,P＜0.001),while negatively correlated with the levels of TP (r=-0.276,P=0.001 ＜0.01) and ALB (r=-0.410,P＜0.001).Multiple linear regression analyses showed that serum levels of C1q were independently associated with serum TG levels (β=9.235,P＜0.001;adjusted R2 =0.215) after adjustment of other related factors.Conclusion Serum levels of C1q were significantly increased in NS children in association with their conditions and the levels of lipid/lipoprotein parameters,and may be function as anovel parameter for assessing the development of NS.

Atropine is one of the useful methods that can slow down myopia progression.The effect of atropine has been proved by clinical researches, among which, various concentrations of atropine from 0.01% to 1% are all effective on control myopia progression for children, and atropine 0.01% has been verified to have the best balance between efficiency and side effects.Though many hypotheses and theories have been proposed to explain the mechanism of atropine, no community agreement has been reached among global scientists.Researches have shown that the possible receptors of atropine include M1-M5 acetylcholine families, γ-aminobutyric acid (GABA) receptors, dopamine receptors, ZENK gene and α 2-adrenergic receptors, which are located on retina and posterior sclera.The inhibitory effect of atropine on myopia progression might be achieved through cholinergic, G-protein and GABA signaling pathway.The target site of action of atropine is located on retinal pigment epithelium, choroid and scleral collagen.The effects of topical application of atropine combined with orthokeratology are better than wearing orthokeratology only.The mechanism, site of action and most relevant clinical researches of atropine of various concentrations were reviewed in this article.

Objective To systematically evaluate the clinical outcomes of patients with multivessel diseases treated by fractional flow reserve (FFR) guided percutaneous coronary intervention (PCI) or other forms of treatment .Methods Some keywords inclu-ding FFR or fractional flow reserve ,percutaneous coronary intervention or PCI ,multivessel coronary artery disease were used to search randomized control trails(RCT) ,which compared outcomes of patients with multivessel disease treated by FFR guided PCI with other forms of treatment ,in Chinese and English database including CNKI ,VIP ,Wanfang ,Pubmed ,EMBASE and the web of science .The quality of included studies was evaluated by Jadad quality score and all the data was analyzed by stata 10 .0 .Results A total of 7 english literatures accumulating 2024 cases in experimental group and 7 284 cases in control group were included in this study .Compared with other forms of treatment ,patients with multivessel diseases treated by FFR-guided PCI had significantly low-er risk of myocardial infarction (RR=0 .72 ,P=0 .008) .Although the risk of death and major adverse cardiovascular events were al-so be reduced ,there were no statistically significant difference .Conclusion FFR-guided PCI is an effective treatment for multivessel disease ,but it is still needs further verification for the application in Chinese population .

Objective To study movement process of circulating tumor cells (CTCs) in the blood and mechanism of CTC capture by CellCollector, and reveal relationship between the detected CTC numbers and the actual CTC concentration in the body. Methods Based on Fluent and EDEM software, the unidirectional fluid-solid interaction method was applied to establish a two-phase flow model, including the hemodynamic model and the CTC transport model, and capture simulations under different CTC concentration conditions were conducted. Results The number of CTCs captured by CellCollector was significantly positively correlated with the CTC concentration in the body. When the CTC concentration was low, CTCs could only be captured in several time intervals, and the capture had a certain contingency; as the concentration increased, the uniformity of CTC capture over time became better, and the total number of captures also increased. Conclusions Through the fitting of simulation results, analytical quantitative relationship between the captured CTC number and the CTC concentration in the body is preliminarily given, which provides theoretical basis and mechanical explanation for the clinical use of CellCollector.

Ma-huang Lian-yao Chi-xiao-dou Tang is one of the three formulas for typhoid jaundice.But it has not received much attention,and the source of Lian-yao in the formula is unknown and the status and role are difficult to identify.In this paper,we first analyzed the functions of Ephedra and the symptoms of the whole formula.The formula was mainly used to"clear damp-heat"in order to remove jaundice.On this basis,it is proved that Lian-yao is the root of Forsythia,not"Qiao-gen".Today,the use of Forsythia instead of Lian-yao has the same effect.Then,the indispensable and important position of Forsythia in the formula was analyzed.It also pointed out some valuable directions for the medicinal use and research and development of Forsythia based on its wide range of effects but the lack of main symptoms.This paper provides insights for in-depth theoretical and practical research on Forsythiae Fructus.

Background It has been reported that orthokeratology has the effects of slowing down myopia progression and axial elongation.However,the affecting mechanism of orthokeratology wearing on ocular peripheral refraction is still not elucidated.Objective This study was to observe and compare the changes of ocular peripheral refraction and relative peripheral refraction (RPR) in low to moderate myopic eyes of children after wearing orthokeratology lens and spectacles for 6 months.Methods A randomized controlled clinical trial was carried out after approval of Ethic Committee of Beijing Tongren Hospital and informed consent of guardians of the children.One hundred myopic children aged (ll.0±1.9) years were recruited in Beijing Tongren Hospital from June 2014 to January 2015,with the diopter of-0.50 to-6.00 D.The subjects were randomized into orthokeratology group and spectacles group by the process PLAN PROC of software SAS 9.1.3,50 for each group.The subjects in the orthokeratology group wore orthokeratology lens for 6 months and those in the spectacles group wore spectacles for the same period.An infrared open-field autorefractor was employed to measure the refraction at central 0°,temporal 15°,temporal 30°,nasal 15°and nasal 30° radial lines before and after wearing lens for the assessment and comparison of the changes of peripheral refraction and RPR.Results There was no significant difference in spherical equivalent between the orthokeratology group and the spectacles group before wearing lens ([-3.35±1.31] D versus [-3.01± 1.15] D,P =0.20).The peripheral refraction values in the orthokeratology group were (-2.28 ± 1.60),(-3.28±1.41),(-3.40±1.23),(-3.38±1.12) and (-2.09±1.29)D at nasal 15°and nasal30°,central,temporal 15° and temporal 30°radial lines before wearing lens,and reduced by (0.29±1.67),(0.85±1.66),(0.92±1.76) and (0.66±1.66) D at nasal 30°,nasal 15°,central and temporal 15° after wearing lens,respectively,with significant differences at nasal 15°,central and temporal 15°(all at P＜0.05).The peripheral refraction values in the spectacles group were (-1.88±1.30),(-2.66±1.18),(-2.89±1.27) and (-1.94±1.31)D at nasal 15°,nasal 30°,temporal 15 ° and temporal 30°,radial lines before wearing lens and increased by (-0.25±0.80),(-0.43 ±0.67),(-0.32±0.64) and (-0.22±0.75)D after wearing lens,respectively,with significant differences between before and after wearing lens (all at P＜0.05).The RPR shifted from hyperopia defocus to myopia defocus before and after wearing lens in temporal 15° and 30° radial lines in the orthokeratology group,and at various radial lines in the spectacles group,the RPR showed gradually worsening of hyperopia defocus.Conclusions Long-term wearing of orthokeratology results in a hyperopia shifting in myopic children by exposing the peripheral retina towards relative myopia defocus,whereas wearing spectacles leads to a relative hyperopia defocus on retina.Thus,orthokeratology may slow down the myopia progression.

Objective To investigate the influencing factors for recompensation in patients with first-time decompensated hepatitis B cirrhosis. Methods A total of 438 patients with first-time decompensated hepatitis B cirrhosis who attended The Affiliated Hospital of Xuzhou Medical University from September 1, 2011 to December 31, 2019 were enrolled, and all patients received comprehensive treatment including antiviral therapy. According to the outcome at the end of follow-up, the patients were divided into recompensation group and persistent decompensation group, and the independent influencing factors for recompensation were analyzed. Long-term survival rate was compared between the patients with different states of compensation. The Mann-Whitney U test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data. A multivariate Cox proportional-hazards regression model analysis was used to investigate the influencing factors for recompensation. The Kaplan-Meier method was used to plot survival curves, and the log-rank test was used for comparison. Results Among the 438 patients with decompensated hepatitis B cirrhosis, 199 (45.4%) achieved recompensation after antiviral therapy. There were significant differences between the recompensation group and the persistent decompensation group in sustained virologic response (SVR) ( χ 2 =72.093, P < 0.001), single or multiple complications ( χ 2 =9.834, P =0.002), presence or absence of gastrointestinal bleeding ( χ 2 =6.346, P =0.012), serum creatinine (SCr) ( Z =-1.035, P =0.011), blood sodium concentration ( Z =-1.606, P =0.019), hemoglobin ( Z =1.455, P =0.006), and alanine aminotransferase (ALT) level ( Z =-2.194, P < 0.001). Baseline ALT level (odds ratio [ OR ]=1.002, 95% confidence interval [ CI ]: 1.000-1.003, P =0.009), SVR ( OR =5.760, 95% CI : 3.634-9.129, P < 0.001), and SCr ( OR =0.990, 95% CI : 0.981-1.000, P =0.047) were independent influencing factors for recompensation. The recompensation group had a significantly higher 5-year survival rate than the persistent decompensation group (87.9% vs 72.0%, χ 2 =9.886, P =0.025). Conclusion After comprehensive treatment, including antiviral therapy, approximately 45.4% of patients can achieve recompensation.Patients with elevated baseline ALT and achieved SVR were more likely to achieve recompensation, patients with elevated baseline serum creatinine had difficulty achieving recompensation, and patients with recompensation had a better long-term prognosis than patients with persistent decompensation.

This study was performed to evaluate the oncological and reproductive outcomes of childbearing-age women treated with fertility-sparing surgery (FSS) for non-epithelial ovarian tumors in China. One hundred and forty eight non-epithelial ovarian tumor women treated with FSS between January 1, 2000 and August 31, 2015 from two medical centers in China were identified. Progression-free survival (PFS) was 88.5%, whereas overall survival (OS) was 93.9%. Univariate analysis suggested that delivery after treatment is related to PFS (P = 0.023), whereas histology significantly influenced OS. Cox regression analysis suggested that only histology was associated with PFS and OS (P < 0.05). Among the 129 women who completed adjuvant chemotherapy (ACT), none developed amenorrhea. Among the 44 women who desired pregnancy, 35 (79.5%) successfully had 51 gestations including 35 live births without birth defects. Non-epithelial ovarian tumors can achieve fulfilling prognosis after FSS and chemotherapy. Histology might be the only independent prognostic factor for PFS and OS. FSS followed by ACT appeared to have little or no effect on fertility. Meanwhile, postoperative pregnancy did not increase the PFS or OS. Use of gonadotropin-releasing hormone agonist was not beneficial for fertility.
Adolescent ; Adult ; Chemotherapy, Adjuvant ; adverse effects ; Child ; China ; Female ; Humans ; Infertility, Female ; etiology ; prevention & control ; Neoplasm Staging ; Organ Sparing Treatments ; Ovarian Neoplasms ; drug therapy ; surgery ; Pregnancy ; Pregnancy Rate ; Prognosis ; Retrospective Studies ; Survival Analysis ; Young Adult