OBJECTIVE: To evaluate the effectiveness of glucocorticoid in the management of olfaction in patients with chronic rhinosinusitis accompanied with nasal polyposis. METHOD: The published studies of the effectiveness of glucocorticoid in the management of chronic rhinosinusitis with nasal polyposis were searched in the Medline, Cochrane, EMBASE, Springer and CNKI databases(from the date of establishment of the databases to December 2014). The trails selection based on inclusion criteria and the quality of the included studies was assessed and meta-analysis was performed with RevMan 5. 3 software. RESULT: A total of 5 trials involving 325 patients were included. The Meta-analysis showed that oral glucocorticoid showed more significant improvement in subjective olfaction scores compared to placebo [SMD = -2.22, 95% CI (-3.94 - -0. 49), P < 0.05], oral glucocorticoid also showed significant improvement in objective olfaction scores compared to placebo [SMD = 0.65, 95% CI (0.28-1.01), P < 0.05]. But subsequent use of nasal glucocorticoid had no impact on subjective and objective olfaction scores [SMD = -2.15, 95% CI (-5.67-1.38), P > 0.05], [SMD = 0.28, 95% CI (-0.08-0.64) P > 0.05]. CONCLUSION According to current evidence, oral glucocorticoid can significantly improve subjective and objective olfaction among patients with CRSwNP, but nasal glucocorticoid cannot improve subjective or objective olfaction dysfunction.
Chronic Disease ; Clinical Trials as Topic ; Glucocorticoids ; therapeutic use ; Humans ; Nasal Polyps ; complications ; drug therapy ; Sinusitis ; complications ; drug therapy ; Smell ; drug effects

Objective:To observe any effect of combining low-frequency transcranial magnetic stimulation (rTMS) with interactive virtual scenario training on the recovery of upper limb motor function after a stroke.Methods:Ninety stroke survivors were randomly divided into a pseudo-rTMS group, an rTMS group and a combination group, each of 30. In addition to basic medication, conventional rehabilitation and nursing care, the pseudo-rTMS, rTMS and combination groups received either sham rTMS treatment, 1Hz rTMS or virtual situational interaction along with 1Hz rTMS 5 days a week for 4 weeks. Before and after the 4 weeks their motor evoked potentials, cortical latency and central motor conduction time were measured, and surface electromyography was applied to the affected biceps brachii and triceps brachii. Meanwhile, the National Institutes of Health Stroke Scale, the Fugl-Meyer upper extremity assessment and the modified Barthel index were employed to assess the degree of neurological deficit, upper extremity motor function and ability in the activities of daily living (ADL).Results:After the 4-week intervention, a significant improvement was observed in all of the outcome measurements with all three groups. At that time the average scores of the rTMS group were significantly better than the pseudo-rTMS group′s averages but the average scores of the combination group were significantly better than those of either of the other two groups.Conclusion:Repeated application of low-frequency transcranial magnetic stimulation combined with virtual scenario interactive training can effectively improve the upper limb motor function and ADL performance of stroke survivors, and relieve the symptoms of neurological deficit. The combined therapy is worthy of application in clinical practice.