Objective To summarize the genotypes associated with Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) induced by methazolamide and to provide references for the diagnosis and treatment of SJS and TEN induced by methazolamide. Methods Databases including PubMed, EMbase, CNKI, and WanFang Data were electronically searched from database inception to September 2021. Two reviewers independently screened literature and extracted data, and then a systematic review was performed. Results A total of 18 studies involving 49 patients were included. HLA genetic testing was performed on 37 patients. HLA-B*59:01 was detected in 27 patients, HLA-C*01:02 was detected in 15 patients, and 14 patients carried both genes. Statistical analysis showed that the positive rate of HLA-B*59:01 was 73% (95% CI 0.58 to 0.88) and that of HLA-C*01:02 was 40.5% (95%CI 0.24 to 0.57). The latent time until the symptoms were observed was 14.08 ± 8.77 days, and the mean dosage of methazolamide administered was 88.95±39.45 mg/d. Glucocorticoid and immunoglobulin were the main treatments prescribed. Conclusion Methazolamide can cause SJS and TEN. As the presence of HLA-B*59:01 or HLA-C*01:02 has been reported as a genetic risk factor for these adverse drug reactions, the implementation of genetic screening can effectively reduce their occurrence. Glucocorticoid and immunoglobulin, anti-infectives, should be administered to control the symptoms.
ObjectiveTo observe the prognosis index in acute arsenic trihydride poisoning patients in order to provide references for early clinical treatment. MethodsWe retrospectively analyzed the clinical data of 20 acute arsenic trihydride poisoning patients treated between July 2010 and January 2014. The patients were divided into death group and survival group according to survival situation 90 days later. The length of time from onset to treatment, urine arsenic concentration, blood routine, hepatic and renal function, electrolyte, myocardial enzyme, arterial blood gas analysis were observed by single factor analysis, and the positive indexes were analyzed by logistic regression analysis to seek the potential influencing factors for survival. ResultsCompared with the survival group, the length of time from onset to treatment, urine arsenic, serum total bilirubin, creatinine, creatine kinase of the death group were significantly higher (P<0.05), while the value of pH, HCO3-, BE of the survival group were significantly lower (P<0.05). Logistic regression analysis revealed that these indexes remarkably affected patients' survival rate. ConclusionTherapeutic time window, extent of damage of heart, liver, kidney and acid-base imbalance are closely associated with the survival rate of arsenic trihydride poisoning patients, and timely treatment for above factors can be useful for improving prognosis.
ObjectiveTo systematically evaluate the effect of hyperbaric oxygen therapy on delayed encephalopathy caused by carbon monoxide poisoning.MethodsChina National Knowledge Infrastructure, Wanfang Data, CQVIP data, China Biology Medicine Database, PubMed, Embase, and Cochrance Library were searched by computer for randomized controlled trials on hyperbaric oxygenation for delayed encephalopathy caused by carbon monoxide poisoning which were published in English or Chinese from the dates of establishment of the databases to March 31st, 2019. After literature including, excluding, and screening, RevMan 5.2 software was used to conduct a meta-analysis.ResultsA total of 25 studies were included, including 1 797 patients, 924 in the hyperbaric oxygen therapy group (the trial group) and 873 in the control group. The clinical effective rate [relative risk (RR)=1.24, 95% confidence interval (CI) (1.19, 1.30), P<0.000 01], the normal rate of electroencephalogram [RR=2.10, 95%CI (1.18, 3.75), P=0.01], the Mini-Mental State Examination score [standard mean difference (SMD)= 3.19, 95%CI (2.06, 4.32), P<0.000 01], and the Activities of Daily Living score [SMD=1.46, 95%CI (1.02, 1.90), P<0.000 01] were all higher in the trial group than those in the control group.ConclusionHyperbaric oxygen therapy for delayed encephalopathy caused by carbon monoxide poisoning can improve symptoms.
In order to explore the histochemical changes in retina after intravitreal injection of gentamycin,a histochemical quantitative analysis of cytochrome oxidase(CYO)and acetylcholinesterase(ACHE)was performed with a computerized image analysis system and was compared with that of morphological study.The results showed that CYO decreased significantly in 100mu;g dosage group.With increasing intravitreal gentamycin dosage or observed days,CYO decreased gradually in all rabbits.In 100~500mu;g dosage groups,ACHE changed mildly at 3 days of injection.It decreased significantly at 7 days.However,it was destroyed completely in 1000~3000mu;g dosage groups at 3 days. （Chin J Ocul Fundus Dis,1994,10:232-235）
Objectives To analyze the effect of improved oven for defluorination in coal-burning endemic fluorosis areas in China, and to provide evidence for the prevention and control of fluorosis. Methods Electronic databases including CNKI, CBM, VIP and CDMD-D (1989 to 2005), were searched. We also checked the reference lists of relevant articles. We selected relevant articles according to the predefined inclusion and exclusion criteria. The methodological quality was assessed . Data on room heat preservation and the effect of improved oven for defluorination were collected in the surveillance spots of Three Gorges Reservoir. Correlation analyses were conducted between the improved oven and its effect parameters. Results Twelve articles of low quality met the selection criteria, of which 9 were graded C and 3 were graded D in terms of the methodological quality. A negative correlation was found between the decreasing rate of normal oven use and the decreasing rate of dental fluorosis as well as of urine fluorine (Pearson correlation coefficient r = – 0.87, – 0.63, Plt;0.01, lt;0.05, respectively). Analysis also revealed a positive correlation between room heat preservation and the decreasing rate of dental fluorosis as well as of normal oven use (the two Spearman correlation coefficients and P values were the same: r = –1.00, Plt;0.01). Conclusion High-quality studies on the effect of improved oven for defluorination in China are not available. Based on the current evidence, the improved oven for defluorination and the correct use, maintenance and house rebuilding for heat preservation may help to prevent fluorosis.
Objective To formulate an optimal treatment for patients with acute organophosphorus pesticide poisoning through the evidence-based approach. Methods Based on the clinical questions raised from a real-life patient of acute organophosphorus pesticide poisoning (OP poisoning) in Emergency ICU (EICU), we searched ACP journal club (1991-April, 2006), The Cochrane Library (Issue 1, 2006), MEDLINE (1966-May 2006) and Chinese Biological Medical Database(1978-May 2006) for systematic reviews , clinical randomized controlled trials, cohort and case-control studies using the keywords of “organophosphorus compounds, poisoning, insecticides, oximes, cholinesterase reactivators, and intermediate syndrome”. The quality of the included studies was assessed. Results One Cochrane systematic review and one meta-analysis were included. These two studies concluded that there was no clear evidence on the benefits of oximes for acute organophosphorus pesticide poisoning. Based on the current evidence, integrated with clinical expertise and the patients’ values, the oximes were not used for this patient, only low-dose atropine was administered with other supportive therapies. After one week of treatment, the patient was discharged since her vital signs were stable and clinical symptoms were relieved. Conclusions The appropriate management for acute organophosphorus pesticide poisoning has been formulated with the approach of evidence-based medicine. Large-scale, methodologically-sound trials are required.