BACKGROUND: Penehyclidine is a newly developed anticholinergic agent. We aimed to investigate the role of penehyclidine in acute organophosphorus pesticide poisoning (OP) patients. METHODS: We searched the Pubmed, Cochrane library, EMBASE, Chinese National Knowledge Infrastructure (CNKI), Chinese Biomedical literature (CBM) and Wanfang databases. Randomized controlled trials (RCTs) recruiting acute OP patients were identified for meta-analysis. Main outcomesincluded cure rate, mortality rate, time to atropinization, time to 60% normal acetylcholinesterase (AchE) level, rate of intermediate syndrome (IMS) and rate of adverse drug reactions (ADR). RESULTS: Sixteen RCTs involving 1,334 patients were identified. Compared with the atropine-or penehyclidine-alone groups, atropine combined with penehyclidine significantly increased the cure rate (penehyclidine+atropine vs. atropine, 0.97 vs. 0.86, RR 1.13, 95% CI [1.07–1.19]; penehyclidine+atropine vs. penehyclidine, 0.93 vs. 0.80, RR 1.08, 95% CI [1.01–1.15]) and reduced the mortality rate (penehyclidine+atropine vs. atropine, 0.015 vs. 0.11, RR 0.17, 95% CI [0.06–0.49]; penehyclidine+atropine vs. penehyclidine, 0.13 vs. 0.08, RR 0.23, 95% CI [0.04–1.28]). Atropine combined with penehyclidine in OP patients also helped reduce the time to atropinization and AchE recovery, the rate of IMS and the rate of ADR. Compared with a single dose of atropine, a single dose of penehyclidine also significantly elevated the cure rate, reduced times to atropinization, AchE recovery, and rate of IMS. CONCLUSION Atropine combined with penehyclidine benefits OP patients by enhancing the cure rate, mortality rate, time to atropinization, AchE recovery, IMS rate, total ADR and duration of hospitalization. Penehyclidine combined with atropine is likely a better initial therapy for OP patients than atropine alone.

Objective: To analyze the correlation between WT1 gene polymorphism and multiple myeloma (MM) susceptibility in 168 patients. Methods: One hundred and sixty eight MM patients, who were hospitalized in our hospital and Hebei Provincial People&#39;s Hospital from January 2013 to December 2017, were researched in this study. There were 121 males (72%) and 47 females(28%) with a median age of 62.4 years old (36~83 years old). Polymorphism of WT1 gene of the samples was detected and analyzed by SSP-PCR and SBT-PCR. Results: Eleven WT1 alleles were detected in MM patients, WT1*010 and WT1*012 alleles occupied a higher frequency in MM group (WT1*010: OR=6.13, 95%CI:3.5~10.75, PC<0.000; WT1*012: OR=2.06, 95%CI:1.23~1.44, PC<0.051). STR genotype frequency of WT1*A5 markedly increased (OR=1.62, 95%CI:1.18~2.23, PC<0.05). Genotype frequency of WT1*010/010 also obviously increased (OR=6.28, 95%CI:1.81～21.76, PC<0.05). Conclusion: WT1 allele is highly polymorphic in MM patients and homozygote WT1*010/010 is a susceptible genotype of MM, indicating that the occurrence and development of MM are related to the polymorphism of WT1 gene.

Oral lichen planus (OLP), a common and chronic disorder, has no effective treatment or cure because its etiology is complicated and has until now remained unclear. Therefore, effectively controlling the activity of the disease and preventing its recurrence are two primary purposes of clinical treatment for OLP. The available evidence supports the notion that topical steroids are the preferred drug for treating this disease. However, some cases have poor clinical curative responses to steroids or other medicines, mainly because of drug resistance and other factors. Therefore, scholars have explored new drugs and methods with the aim of achieving more effective and safe treatment effects. The current research evidence indicates that glucocorticoid remains the front-line drug for OLP treatment. Topical tacrolimus, pimecrolimus and retinoic acid combined with glucocorticoid can be used as alternative therapies, especially in cases with glucocorticoid drug resistance. The systemic application of glucocorticoid or immunosuppressive agents, such as methotrexate, mycophenolate mofetil, and sulfoxide, should be limited to extensive, refractory cases or those with lesions involving regions outside the oral cavity. Surgery and cryotherapy can be applied in a specific, limited range of lesions. Some previous randomized controlled clinical studies have had limitations, including a small sample size, short treatment and clinical follow-up periods, a lack of reliable questionnaires and differences in evaluation standards. Therefore, future studies should include the following: randomized controlled clinical studies with large sample sizes that offer reliable evidence of a curative effect; assessments of treatment outcomes should be extended as long as possible; the follow-up period should be long enough to assess the recurrence rate; and the methods and standards used to evaluate treatment effects should be standardized.