Clinical evidence in concurrence of retinitis pigmentosa and glaucoma

Glaucoma is rarely complicated by retinitis pigmentosa （RP）. To provide clinical evidences for this rare situation, we report the concurrence of these two diseases in two children of a Chinese family. In the present two-child Chinese family without positive history, the older sister presented with bilateral sector RP and coexisting chronic angle-closure glaucoma,and the brother with bilateral whole RP but without coexisting glaucoma. Clinical evidences in concurrence of variants of RP and glaucoma because of possible different gene mutations from the same genetic background represent a rare situation, which may provide clues for future researches in molecular pathogenesis of these rare diseases.

THE USE OF TRADITIONAL CHINESE MEDICINE FOR IN VITRO FERTILIZATION IN CHINA: CLINICAL EVIDENCE

In vitro fertilization(IVF),as an important assisted reproductive technology(ART),is chosen by over l,000,000infertile couples each year,which is linked to over 3,000,000babies bom worldwide.However,an IVF cycle may be unsuccessful.The success of IVF is not guaranteed,and patients often have to undergo more than one cycle of treatment before they are successful.IVF treatment

Clinical effects of acupuncture therapy for vascular dementia

OBJECTIVE： To evaluate clinical acupuncture treatment studies for vascular dementia, as well as to collect high-quality evidence related to clinical acupuncture treatment for clinical diagnosis. DATA SOURCES： PubMed database （1966-2010）, Embase database （1986-2010）, Cochrane Library （Issue 1,2010）, Chinese Biomedical Literature Database （1979-2010）, China HowNet database （1979-2010）, VlP Journals Database （1989-2010）, and Wanfang database （1998-2010） were analyzed by computer.

Timing of biliary decompression for acute cholangitis

Severe acute cholangitis(AC)exacerbates the risk of death because of the rapid progression of the disease.The optimal timing of biliary decompression(BD)as a necessary intervention in patients with severe AC is controversial.A recently report titled“Timing of endoscopic retrograde cholangiopancreatography in the treatment of acute cholangitis of different severity”in the World Journal of Gastroenterology that the optimal time of endoscopic retrograde cholangiopancreatography for treating patients with severe AC is≤48 but not≤24 h,providing clinical evidence for selecting the optimal time for implementation of BD.Here,we discuss the controversy over the optimal timing of BD for AC based on guidelines and clinical evidence,and consider that more high-level clinical researches are urgent needed to benefit the management of patients with different severity of AC.

Liver injury induced by COVID 19 treatment–what do we know?

The severity of coronavirus disease 2019(COVID-19)may be correlated with the risk of liver injury development.An increasing number of studies indicate that degrees of hepatotoxicity have been associated with using some medications in the management of COVID-19 patients.However,limited studies have systematically investigated the evidence of drug-induced liver injury(DILI)in COVID-19 patients.An increasing number of studies indicate that degrees of hepatotoxicity have been associated with using some of these medications in the management of COVID-19 patients.Significantly,it was relieved after the cessation of these agents.However,to our knowledge,no studies have systematically investigated the evidence of DILI in COVID-19 patients.In this review,we discussed the association between hepatotoxicity in COVID-19 patients and the drugs used in these patients and possible mechanisms of hepatotoxicity.The currently available evidence on the association of different therapeutic agents with hepatotoxicity in COVID-19 patient was systematically reviewed.

Vocational Rehabilitation after Acquired Brain Injury: A Swedish Study of Benefits and Costs

Purpose: To examine the benefits from a vocational rehabilitation program for patients suffering from Acquired Brain Injury (ABI) in terms of quality of life, and overall health. In addition, to examine the direct societal costs of healthcare interventions related to vocational rehabilitation and indirect societal costs related to production loss. Method: Identified interventions in 45 patients with ABI who were discharged from a vocational rehabilitation program between 2010 and 2011 were documented, classified and translated into costs. Expenses associated with production loss were calculated by comparing sick leave production loss at first contact with the team, with sick leave production loss at discharge. Health related QoL and overall health, was measured at first contact and at discharge by using the EQ5D. Results: For vocational rehabilitation interventions, mean costs were €6303/individual/month. At first contact with the team, mean production loss was estimated to be €4409/individual/month compared;at discharge to be €2446. QoL ratings increased from first contact to discharge, although estimated health did not change. At discharge, significant correlations were found between QoL ratings and estimated health and the extent of production loss

A Summary and Evaluation of Current Evidence for Myocardial Infarction with Chinese Medicine

Objective: To provide evidence-based recommendations for clinical application and provoke thoughts for future researchers by conducting a comprehensive summary and evaluation of the current evidence profile for the role of Chinese medicine(CM) in treating myocardial infarction(MI). Methods: Online databases including Pub Med, EMBase, Cochrane Library, Chinese National Knowledge Infrastructure(CNKI), Chinese Biomedical Medicine(CBM), VIP Journal Integration Platform, and Wanfang database were systematically searched for literatures on CM in treating MI. After screening, studies were categorized into 5 types, i.e. systematic review(SR), randomized controlled trial(RCT), observational study, case report and basic research. General information was abstracted, and the quality levels of these studies and their conclusions were summarized and assessed. Results: A total of 452 studies including 10 SRs, 123 RCTs, 47 observational studies, 28 case reports, and 244 basic researches were selected. Clinical studies centered primarily on herbal decoction and mostly were not rigorously performed. High-quality studies were predominantly on Chinese patent medicines(CPMs) such as Danshen Injection(丹参注射液), Shenmai Injection(参麦注射液), Shengmai Injection(生脉注射液) and Qishen Yiqi Dripping Pills(芪参益气滴丸). The most frequently observed pattern of drug combination was decoction plus injection. Results of SRs and clinical studies showed that CM may reduce mortality, decrease risk of complication, reduce myocardial injury, improve cardiac function and inhibit ventricular remodeling. Findings from basic researches also supported the positive role of CM in reducing infarct size and myocardial injury, promoting angiogenesis, preventing ventricular remodeling and improving cardiac function. According to the current evidence body, CM has proven effects in the prevention and treatment of MI. It is also found that the effects of CPMs vary with indications. For instance, Shenmai Injection has been found to be especially effective for reducing the incidence of acute clinical events, while CPMs with qi-nourishing and bloodcirculating properties have been proven to be effective in inhibiting ventricular remodeling. High quality evidence supports the use of CM injection for acute MI and CPM for secondary prevention. Reports on adverse events and other safety outcomes associated with CM for MI are scarce. Conclusions: Sufficient evidence supported the use of CM as an adjuvant to Western medicine for preventing and treating MI. The choice of drug use varies with disease stage and treatment objective. However, the quality of the evidence body remains to be enhanced.

Quality assessment of clinical guidelines in China： 1993-2010

Background Clinical practice guidelines （CPGs） play an important role in healthcare in China as well as in the world. However, the current status and trends of Chinese CPGs are unknown. The aim of this study was to systematically review the present situation and the quality of Chinese CPGs published in the peer-reviewed medical literature. Methods To identify Chinese CPGs, a systematic search of relevant literature databases （CBM, WANFANG, VIP, and CNKI） was performed for the period January 1978 to December 2010. We used the AGREE II instrument to assess the quality of the included guidelines. Results We evaluated 269 guidelines published in 115 medical journals from 1993 to 2010 and produced by 256 different developers. Only four guidelines （1%） described the systematic methods for searching and selecting the evidence, 14 （5%） guidelines indicated an explicit link between the supporting evidence and the recommendations, only one guideline used the Grading of Recommendations Assessment, Development and Evaluation （GRADE） system. Thirty-one guidelines （12%） mentioned updates and the average frequency of update was 5.5 years; none described a procedure for updating the guideline. From the assessment with the Appraisal of Guidelines for Research and Ecaluation II （AGREE II）, the mean scores were low for the domains ＂scope and purpose＂ （19%） and ＂clarity of presentation＂ （26%） and very low for the other domains （＂rigour of development＂ 7%, ＂stakeholder involvement＂ 8%, ＂applicability＂ 6% and ＂editorial independence＂ 2%）. Conclusions Compared with other studies on the quality of guidelines assessed with the AGREE instrument in other countries, Chinese CPGs received lower scores, which indicates a relatively poor quality of the guidelines. However, there was some increase over time.

Traditional Chinese medicine in COVID-19

COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2(SARSCo V-2)has spread across the globe,posing an enormous threat to public health and safety.Traditional Chinese medicine(TCM),in combination with Western medicine(WM),has made important and lasting contributions in the battle against COVID-19.In this review,updated clinical effects and potential mechanisms of TCM,presented in newly recognized three distinct phases of the disease,are summarized and discussed.By integrating the available clinical and preclinical evidence,the efficacies and underlying mechanisms of TCM on COVID-19,including the highly recommended three Chinese patent medicines and three Chinese medicine formulas,are described in a panorama.We hope that this comprehensive review not only provides a reference for health care professionals and the public to recognize the significant contributions of TCM for COVID-19,but also serves as an evidence-based in-depth summary and analysis to facilitate understanding the true scientific value of TCM.

Transarterial chemoembolization in combination with programmed death-1/programmed cell death-ligand 1 immunotherapy for hepatocellular

Hepatocellular carcinoma(HCC)is one of the most common malignancies worldwide.With the development of systemic therapies,several studies are currently underway,especially those related to the use of programmed death-1/programmed cell death-ligand 1(PD-1/PD-L1)immunotherapy.Moreover,studies on transarterial che-moembolization(TACE)and PD-1/PD-L1 immunotherapy have demonstrated some interesting outcomes.This article reviewed the current clinical evidence on the combination of TACE and PD-1/PD-L1 immunotherapy.Overall,our review summarized that a favorable survival time could be achieved using this combination in most patients.However,complications such as hyperprogression should be taken seriously,and the underlying mechanisms need to be explored.