国产小牛血去蛋白提取物眼用凝胶对角膜屈光术后角膜上皮修复的Meta分析

目的:系统评价国产小牛血去蛋白提取物眼凝胶对准分子激光角膜屈光手术后角膜上皮修复的临床疗效和安全性。方法:计算机检索Pubmed、Embase、Cochrane Library、维普中文科技期刊数据库、中国知网、万方数据库,查找国内外采用国产小牛血去蛋白提取物眼凝胶治疗准分子激光角膜屈光手术患者上皮修复的随机对照试验(RCT),检索时限2007-01/2016-12。由2位研究成员根据纳入与排除标准独立筛选文献、提取资料和评价质量后,采用Review Manager 5.3软件进行Meta分析。结果:最终纳入7个RCT,共计患者1042眼,其中治疗组523眼,对照组519眼。Meta分析结果显示:准分子激光角膜屈光术后应用国产小牛血去蛋白提取物眼凝胶在临床疗效、症状评分、角膜愈合时间方面均优于对照组,其差异均有统计学意义:临床疗效:OR=1.81,95%CI(1.39~2.35),P<0.001;准分子激光术后角膜损伤症状评分WMD=-0.33,95%CI(-0.45^-0.21),P<0.001;角膜愈合时间WMD=-1.26,95%CI(-1.56^-0.97),P<0.001。结论:应用国产小牛血去蛋白提取物眼凝胶可使准分子激光屈光术后患者不适症状减轻、角膜上皮恢复快、治疗有效率提高。受纳入研究质量和数量所限,上述结论尚需进一步开展严格设计的随机双盲对照试验加以验证。

Clinical characteristics and prognosis of community-acquired pneumonia in autoimmune disease-induced

BACKGROUND:Community-acquired pneumonia(CAP)in autoimmune diseases(AID)-induced immunocompromised host(ICH)had a high incidence and poor prognosis.However,only a few studies had determined the clinical characteristics of these patients.Our study was to explore the characteristics and predictors of mortality in CAP patients accompanied with AID-induced ICH.METHODS:From 2013 to 2018,a total of 94 CAP patients accompanied with AID-induced ICH,admitted to Emergency Department of Zhongshan Hospital,Fudan University,were enrolled in this study.Clinical data and the risk regression estimates of repeated predictors were evaluated by generalized estimating equations(GEEs)analysis.An open-cohort approach was used to classify patient's outcomes into the survival or non-survival group.RESULTS:The hospital mortality of patients with CAP occurring in AID-induced ICH was 60.64%.No significant differences were found with respect to clinical symptoms and lung images between survival and non-survival groups,while renal insufficiency and dysfunction of coagulation had higher proportions in non-survival patients(P<0.05).Both noninvasive ventilation(NIV)and invasive mechanical ventilation(IMV)were performed more frequently in non-survival group(P<0.05).By the multivariate GEEs analysis,the repeated measured longitudinal indices of neutrophilto-lymphocyte ratio(NLR)(odds ratio[OR]=1.055,95%confidence interval[95%CI]1.025–1.086),lactate dehydrogenase(LDH)(OR=1.004,95%CI 1.002–1.006)and serum creatinine(s Cr)(OR=1.018,95%CI 1.008–1.028),were associated with a higher risk of mortality.CONCLUSION:The CAP patients in AID-induced ICH had a high mortality.A significant relationship was demonstrated between the factors of NLR,LDH,s Cr and mortality risk in these patients.

Effects of dexmedetomidine + propofol intervention during general anesthesia induction on endotracheal intubation

Objective:To investigate the effects of dexmedetomidine + propofol intervention during general anesthesia induction on endotracheal intubation.Methods: A total of 218 patients receiving tracheal intubation general anesthesia in the hospital between January 2017 and December 2017 were divided into the control group (n=109) and the dexmedetomidine group (n=109) by random number table method. Control group underwent routine propofol anesthesia induction and dexmedetomidine group underwent dexmedetomidine anesthesia induction on the basis of propofol. The differences in the severity of inflammatory response and stress response were compared between the two groups of patients after general anesthesia induction (T0), 1 min after endotracheal intubation (T1), 5 min after endotracheal intubation (T2) and 10 min after endotracheal intubation (T3).Results:At T0, there was no statistically significant difference in serum levels of inflammatory factors and stress hormones between the two groups. At T1, T2 and T3, serum inflammatory factors CRP, IL-1, IL-6, IL-8 and TNF-α levels of dexmedetomidine group were lower than those of control group;serum stress hormones ACTH, Cor, NE, AngⅠ and AngⅡ levels were lower than those of control group. Conclusion: Dexmedetomidine + propofol general anesthesia induction can effectively reduce the inflammatory stress response caused by endotracheal intubation.

Effect of multimodal analgesia+preemptive analgesia on the postoperative recovery of elderly patients with hip replacement

Objective: To study the effect of multimodal analgesia + preemptive analgesia on the postoperative recovery of elderly patients with hip replacement, and observe its effect on the postoperative pain-related neurotransmitters, inflammatory factors and stress response. Methods: Elderly patients who received hip replacement in the hospital between February 2015 and December 2016 were selected and randomly divided into preemptive analgesia group, multimodal analgesia group and combined analgesia group. Serum levels of pain-related neurotransmitters, inflammatory factors and stress response molecules were detected before surgery as well as 6 h and 24 h after surgery. Results: Serum SP, PGE2, NO, 5-HT, ICAM-1, hs-CRP, IL-6, IL-10, Cor, NE and MDA levels of three groups of patients 6 h and 24 h after surgery were significantly higher than those before surgery, and serum SP, PGE2, NO, 5-HT, ICAM-1, hs-CRP, IL-6, IL-10, Cor, NE and MDA levels of combined analgesia group 6 h and 24 h after surgery were significantly lower than those of preemptive analgesia group and multimodal analgesia group. Conclusion: Multimodal analgesia + preemptive analgesia can be more effective than multimodal analgesia and preemptive analgesia in reducing postoperative pain, inflammatory response and stress response in elderly patients with hip replacement.

Research progress of the relationship between abnormal vestibular reflexes and adolescent idiopathic scoliosis

Adolescent idiopathic scoliosis (AIS) is an agnogenic structural scoliosis occurring in adolescence, and the main diagnostic criteria is coronal Cobb angle >10°in total spine X-ray. Studies have shown that AIS may be associated with abnormal postural reflexes, vestibular system is an important component of postural reflexes and its mechanism in the occurrence and development of scoliosis has received wide attention in recent years. In the study, the research progress on the role of abnormal vestibular reflexes in the pathogenesis of AIS was mainly introduced to help the clinicians better understand the pathogenesis of AIS and provide new ideas for AIS study.

Microglia polarization in ischemic stroke:complex mechanisms and therapeutic interventions

Stroke is the second leading cause of death and the third leading contributor to the loss of disability-adjusted life-years.The fatality rate of all stroke patients ranges from 15%to 50%at 1 month to 5 years after stroke.Ischemic stroke is the most common type of stroke and accounts for 87%of all stroke cases.

Experimental quantum simulation of dynamic localization on curved photonic lattices

Dynamic localization,which originates from the phenomena of particle evolution suppression under an externally applied AC electric field,has been simulated by suppressed light evolution in periodically curved photonic arrays.However,experimental studies on their quantitative dynamic transport properties and application for quantum information processing are rare.Here we fabricate one-dimensional and hexagonal two-dimensional arrays both with sinusoidal curvatures.We successfully observe the suppressed single-photon evolution patterns,and for the first time,to the best of our knowledge,measure the variances to study their transport properties.For onedimensional arrays,the measured variances match both the analytical electric-field calculation and the quantum walk Hamiltonian engineering approach.For hexagonal arrays as anisotropic effective couplings in four directions are mutually dependent,the analytical approach suffers,whereas quantum walk conveniently incorporates all anisotropic coupling coefficients in the Hamiltonian and solves its exponential as a whole,yielding consistent variances with our experimental results.Furthermore,we implement a nearly complete localization to show that it can preserve both the initial injection and the wave packet after some evolution,acting as a memory of a flexible time scale in integrated photonics.We demonstrate a useful quantum simulation of dynamic localization for studying their anisotropic transport properties and a promising application of dynamic localization as a building block for quantum information processing in integrated photonics.