目的 評估光動力療法聯合曲安奈德治療滲出型老年性黃斑變性（AMD）的臨床療效及對患者生活質量的影響。 方法 將2007年12月－2010年12月就診的35例（38只眼）滲出型AMD患者采用隨機數字表法隨機分為兩組，治療組18例（20只眼）采用光動力療法聯合玻璃體腔內注射曲安奈德治療，對照組17例（18只眼）單用光動力療法。評估患者視力和眼底影像學改變，同時也評估對患者生活質量的影響。兩組均隨訪12個月。 結果 隨訪12個月后，光動力療法聯合曲安奈德治療組視力不變者8例9只眼，占45.0%；視力提高者9例10只眼，占50.0%；視力下降者1例1只眼，占5.0%。吲哚青綠血管造影結果顯示，脈絡膜新生血管（CNV）滲漏停止7例7只眼，占35.0%；持續滲漏或滲漏增加者1例1只眼，占5.0%；滲漏減少者11例12只眼，占60.0%。光動力療法治療組視力不變者6例6只眼，占33.3%；視力提高者4例5只眼，占27.8%；視力下降者7例7只眼，占38.9%。吲哚青綠血管造影結果顯示，CNV滲漏停止3例3只眼，占16.7%；持續滲漏或滲漏增加者5例6只眼，占33.3%；滲漏減少者9例9只眼，占50.0%。聯合治療組與單用光動力療法組在視力改變方面差異有統計學意義（χ2=4.67，P=0.03），在吲哚青綠血管造影結果方面差異有統計學意義（χ2=3.35，P=0.01）。中文譯本低視力者生存質量量表評估生活質量治療組平均得分（102.02 ± 16.20）分，對照組平均得分為（91.27 ± 11.81）分，兩組比較差異有統計學意義（P＜0.05）。 結論 光動力療法聯合曲安奈德治療滲出型AMD療效優于單用光動力療法。
Objective To investigate the plasma levels of soluble Fas receptor ( sFas) , soluble Fas ligand ( sFas-L) and matrix metalloproteinase-7 ( MMP-7) and their correlation with disease severity as well as the prognosis of septic patients.Methods The plasma levels of sFas, sFas-L, sFas / sFas-L ratio and MMP-7 were measured by enzyme-linked immunosorbent assay and compared between32 patients with sepsis and 24 age and sex matched healthy controls. Based on the 28-day outcome, the patients were divided into a survival group and a death group. The difference in sFas, sFas-L, sFas/ sFas-L ratio and MMP-7 between the survival group and the death group were compared.Results Compared with the healthy control group, the concentration of plasma sFas, sFas-L and MMP-7 were significantly increased in the septic patients ( P lt; 0. 01) . Elevated plasma sFas and sFas-L were both positive correlated with the APACHEⅡ score and SOFA score. Although a modest negative correlation was found between plasma MMP-7 and APACHEⅡ score and SOFA score, but this correlation did not reach statistical significance ( P gt;0. 05) . The septic patients who died had significantly higher sFas-L level and lower sFas / sFas-L ratio as compared with those who survived ( P lt;0. 05) . Conclusion Plasma sFas, sFas-L and MMP-7 are associated with the disease severity and can serve as potential markers for predicting the outcome in septic patients.
ObjectiveTo analyze the incidence and risk factors of tuberculosis in the city of Mianyang based on data from active cases.MethodsFrom March 2018 to April 2019, 199 182 residents were selected for the study. Data were collected using a questionnaire, digital radiography (DR), physical examination and laboratory tests. The incidence of tuberculosis was estimated, and multivariate logistic regression was used to identify factors associated with the disease.ResultsThroughout the process, 103 residents were diagnosed with active tuberculosis, corresponding to an incidence of 51.71 per 100 000. Risk of tuberculosis was significantly higher among individuals who were over age 60 (OR=1.74, 95%CI 1.11 to 2.73, P=0.02), males (OR=4.39, 95%CI 2.74 to 7.04, P<0.001), medical workers (OR=11.18, 95%CI 2.99 to 41.84, P<0.001), and those with a history of tuberculosis (OR=16.43, 95%CI 8.10 to 33.33, P<0.001). Conversely, individuals with higher levels of education were associated with lower risk of tuberculosis: compared to those with primary school or less, those with a junior high school education had an OR of 0.53 (95%CI 0.30 to 0.88, P=0.02); high school/technical school had an OR of 0.36 (95%CI 0.15 to 0.92, P=0.03); junior college or above had an OR of 0.23 (95%CI 0.06 to 0.88, P=0.04).ConclusionsAnalyzing tuberculosis epidemiology based on active cases can help detect the disease as well as control or even prevent epidemics. Individuals who are more senior, males, medical workers, with a history of tuberculosis, and those with lower levels of education may be at higher risk of the disease. These results may improve screening efforts and allow timely intervention.
ObjectivesTo conduct an overview of systematic reviews (SRs) on Tuina from 2013 to 2017, and to explore recent research improvements on Tuina.MethodsPubMed, Web of Science, The Cochrane Library, SpringerLink e-book database, CNKI, VIP, WanFang Data and CBM databases were searched to collect SRs including randomized controlled clinical trials on Tuina from January 1st, 2013 to December 31st, 2017. Two reviewers independently screened literature, extracted data, and used AMSTAR 2 tool and PRISMA statement to assess methodology quality and reporting quality of included studies, respectively. The R 3.4.3 software was used to analyze data.ResultsA total of 8 SRs studies were included in the overview. The studied diseases involved radiculopathy cervical spondylotic, myelopathy cervical spondylotic, constipation, child anorexia, child diarrhea and external humeral epicondylitis. The results of above SRs showed that massage might be superior to other interventions in clinical efficacy, curative effects or total effective rate. However, due to the low quality of included studies of SRs, further evidence from high-quality clinical studies is required to verify above conclusions. For the results of AMSTAR 2 assessment, all 8 SRs were rated as very low quality. The quantity of items accomplished for each SR ranged from 7 to 13, 2 SRs had low methodological quality (percentage of accomplishment or partial accomplishment <50.0%) and 6 SRs with high methodological quality (percentage of accomplishment or partial accomplishment ≥50.0%). All 8 SRs did not report item 2 "Whether to declare research methods", item 10 "Whether reports have included funding sources for each study" and item 11 "Whether reports used the correct statistical method". The results of PRISMA assessment showed that all SR had good quality of reporting. The accomplished items number of each SR ranged from 22 to 26. However, there were defects in item 5(0), item 16(25.0%) and item 23(25.0%). All SRs did not report item 5 "Whether to declare research program".ConclusionsThis study finds that Tuina has supportive evidence-based medical evidence for treating anorexia, cervical spondylosis and other diseases, however, the SRs of Tuina are yet needed to be improved in terms of standardized degree. Therefore, establishing a reporting consolidated standard for evidence-based medicine on Tuina in order to improve the quality of clinical studies so as to provide clinicians with high-quality evidence is the focus of our further research.