目的:研究药物性肝损伤的诱发药物、临床特点,分析保肝药应用的合理性,为临床药师进一步指导临床用药提供依据.方法:回顾性分析我院2018—2021年诊断为药物性肝损伤患者的临床特征及保肝药的应用.结果:共纳入83例患者,其中男性39例(46.98％),女性44例(50.57％),18～44岁病例较多,共32例(38.55％);43例(51.81％)无明显临床症状,其余患者临床症状与一般肝损伤无差异.引起药物性肝损伤排名前三位的药物为中药(24例,28.92％),抗肿瘤药(12例,14.46％),抗感染药物(10例,12.05％);药物性肝损伤最常见的分型为肝细胞损伤型(38例,81.92％);40例患者的Roussel Uclaf因果关系评估法(RUCAM)评分结果为可能(48.19％);严重程度分级1级68例(81.93％);治疗后74例(89.16％)好转.81例患者(97.59％)应用保肝药,9例患者预防性应用保肝药,其余患者为治疗性应用,26例患者联合应用3种及以上保肝药.应用的药物以多烯磷脂酰胆碱注射液、注射用还原谷胱甘肽、甘草酸制剂为主,极少数患者应用糖皮质激素.结论:引起药物性肝损伤种类较多,临床表现缺乏特异性.用药期间应监测肝功能,尽早发现并及时干预.临床药师应熟悉药物性肝损伤的临床特征和防治措施,掌握药物治疗的方案,在DRGs改革的背景下提供专业的用药指导.

Objective:To systematically evaluate the effect of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) combined with intra-aortic balloon pumping (IABP) on the mortality of patients with cardiogenic diseases.Methods:Systematic searches were conducted in PubMed, the Cochrane Library, Embase, Web of Science, Wanfang data, CNKI and CBM to collect articles about using VA-ECMO combined with IABP to treat patients with cardiogenic diseases published up to April 2022. Two reviewers independently screened articles, extracted data and evaluated quality, and then the meta-analysis was performed using Stata 17 software.Results:A total of 15 528 patients were enrolled in 84 studies, of which 8 520 patients received VA-ECMO combined with IABP (experimental group) and 7 008 patients only received VA-ECMO (control group). Meta-analysis showed that as compared with the control group, the 30-d mortality/inpatient mortality [relative risk (RR) = 0.86, 95% confidence interval (CI) (0.83, 0.89), Z = 8.64, P < 0.000 01] and the incidence of neurological complications [RR = 0.70, 95%CI (0.54, 0.90), Z = 2.78, P = 0.005] decreased remarkably, and the success rate of weaning from ECMO [RR = 1.35, 95%CI (1.28, 1.42), Z = 11.89, P < 0.000 01] increased obviously in the experimental group. Subgroup analysis showed that the 30-d mortality/inpatient mortality in patients with heart-related mixed diseases [RR = 0.85, 95%CI (0.81, 0.90), Z = 5.99, P < 0.000 01] and in patients with acute coronary syndrome (ACS) [RR = 0.68, 95%CI (0.63, 0.74), Z = 9.21, P < 0.000 01] and the incidence of mixed neurological complications [RR = 0.58, 95%CI (0.40, 0.84), Z = 2.90, P = 0.004] were much lower, and the success rate of weaning from ECMO in patients with postcardiotomy [RR = 1.22, 95%CI (1.10, 1.34), Z = 3.88, P = 0.000 1] and heart-related mixed diseases [RR = 1.45, 95%CI (1.37, 1.53), Z = 12.51, P < 0.000 01] were much higher in the experimental group than those in the control group.Conclusion:Compared with VA-ECMO alone, VA-ECMO combined with IABP can reduce 30-d mortality/inpatient mortality in patients with heart-related mixed diseases and ACS, increase the success rate of weaning from ECMO in patients with postcardiotomy and heart-related mixed diseases, and reduce mixed neurological complications.

Objective To systematically evaluate the risk factors for the prognosis of extracorporeal membrane oxygenation in the treatment of acute respiratory distress syndrome.Methods The databases of PubMed,EMbase,Web of Science,Cochrane and CNKI were searched by computer to screen the related studies on the prognosis of ECMO in the treatment of ARDS.The retrieval time was from the establishment of the database to March 2022.Two researchers independently screened the literature,extracted the data and evaluated the included literature.The quality of the included literature was evaluated according to the bias risk assessment tool(NOS scale)of RCT,and the Revman5.4 statistical software provided by Cochrane International Collaboration was used for meta-analysis.Results A total of 31 literatures were included,including 5585 patients.The results of meta-analysis showed that immune dysfunction(OR=2.63,95％CI:1.84-3.76,P<0.000 01),mechanical ventilation time before ECMO(MD=2.19,95％CI:1.48-2.90,P<0.000 01),lactic acid concentration(MD=0.82,95％CI:0.32-1.31,P=0.001),SAPSⅡ score(MD=6.36,95％CI:4.01-8.71,P<0.000 01),APACHEⅡ score(MD=2.99,95％CI:1.88-4.11,P<0.000 01),SOFA score(MD=1.28,95％CI:0.92-1.64,P<0.000 01)and ECMO time(MD=1.93,95％CI:1.31-2.55,P<0.000 01)were negatively correlated with death.Conclusion Immune dysfunction,mechanical ventilation time before ECMO,lactic acid concentration,SAPSⅡ score,APACHEⅡ score,SOFA score and ECMO time are risk factors for the prognosis of ECMO in ARDS patients.

Objective To evaluate the prognostic value of improved national early warning score（INEWS） in critically ill patients.Methods The 24 h basic vital signs,related biochemical indexes and state of consciousness of 733 patients admitted to the Pulmonary and Critical Care Department of The First Affiliated Hospital of Xi’an Medical College from January 2016 to December 2019 were collected for INEWS scoring,acute physiology and chronic health evaluation score（APACHEⅡ score） and British national early warning score（NEWS score）.According to the discharge outcome,the patients were assigned into survival group and death group.The differences in related indexes and scores between the two groups were compared to study the relationship between score and mortality,the receiver operating characteristic curve（ROC curve） was drawn to compare the area under ROC curve（AUC） and cutoff value（Cut-off value）,and the survival curves of INEWS score of the two groups were compared to predict mortality.Results In total,733 patients were enrolled in the study,including 468 males,265 females,572 in the survival group and 161 in the death group,with survival rate of 78.04% and mortality rate of 21.96%.The INEWS,APACHEⅡ,and NEWS scores in the death group were 18（14,25）,10（7,12）,11（8,13）,respectively,all higher than those in the survival group [11（1,16）,7（5.25,9）,8（6,10）];the differences were statistically significant（P＜0.05）.The AUCs and 95% CIs of INEWS,APACHEⅡ and NEWS were 0.74,0.76,0.70,and（0.69,0.78）,（0.72,0.81）,（0.65,0.75）,respectively.The Youden index of INEWS was 10.5 points with a specificity of 85.3%,and a sensitivity of 50.3%.Survival analysis results showed that when Youden index ≥ 10.5 points,about the hospitalized mortality rate of ICU patients was much higher than that of the patients with INEWS ＜10.5 points;the difference was statistically significant（P＜0.001）.Conclusion The INEWS can be used to predict the prognosis in critically ill patients.Score of 10.5 or higher indicates high mortality,thus INEWS can provide more convenient prognostic evaluation indicators of ICU patients for medical workers.

经鼻高流量氧疗(HFNC)是一种新兴的氧疗方式,它通过鼻塞导管直接将一定氧浓度的空氧混合高流量气体输送给患者.这种给氧方式具有流量高、氧浓度精确以及加温、湿化等特点,近些年用于很多呼吸衰竭等危重患者的抢救和治疗.然而,经鼻高流量氧疗治疗失败可能导致呼吸功能进一步恶化并增加死亡率,因此早期识别经鼻高流量氧疗失败的危险因素,避免延时插管,对这类患者合理应用经鼻高流量氧疗具有重要意义.本文将对近年来经鼻高流量治疗呼吸系统疾病失败危险因素的相关研究进行综述,以期为临床治疗此类患者提供帮助.

目的:研究吡嗪酰胺用于治疗结核相关疾病引起高尿酸血症的影响因素.方法:采用回顾性研究,利用医院信息系统(HIS)调取咸阳市第一人民医院2016年1月1日至2020年12月31日使用吡嗪酰胺片患者的病历资料,利用单因素分析及Lo-gistic回归模型进行多因素分析.结果:纳入病例510例,298例发生了高尿酸血症,发生率为58.43％.单因素分析结果显示,发生高尿酸血症组与未发生高尿酸血症组的性别、年龄、体重和用药前血尿酸水平的差异均有统计学意义(P<0.05).Logistic多因素回归分析显示,男性较女性发生高尿酸血症的风险高(OR=1.827,95％CI:1.235～2.704,P<0.05);<60岁的患者较≥60岁的患者易发生高尿酸血症(OR=0.512,95％CI:0.346～0.758,P<0.05);用药前血尿酸水平282～420μmol·L-1较用药前血尿酸水平<282μmol·L-1的患者更易发生高尿酸血症(OR=4.126,95％CI:2.465～6.908,P<0.05).结论:性别、年龄、用药前血尿酸水平是吡嗪酰胺相关高尿酸血症的影响因素.

Objective:To explore whether SpO2/FiO2 can be used as a reliable noninvasive testing indicators for predicting clinical outcome in patients with ARDS.Methods:This was a retrospective study of 221 ARDS patients enrolled in the Department of Respiratory Critical Care of our hospital from January 2016 to December 2019. SpO2, PaO2, pH, FiO2 and APACHE Ⅱ score within 24 hours of admission were collected. The relationship between SpO2/FiO2 and PaO2/FiO2 was analyzed by using linear regression methods. Receiver operator characteristic curve (ROC) were plotted to compare the area under the SpO2/FiO2, PaO2/FiO2 and APACHE Ⅱ score ROC curves (AUC).Results:PaO2/FiO2 and SpO2/FiO2 were highly correlated (R2=0.641, P＜0.001), AUC of PaO2/FiO2, SpO2/FiO2, APACHE Ⅱ score that predicted hospital mortality in patients with ARDS was 0.586 (95%CI: 0.498-0.674, P=0.051), 0.644 (95%CI: 0.503-0.681, P＜0.05), 0.782 (95%CI: 0.717-0.846, P＜0.05), respectively.Conclusion:SpO2/FiO2 can be a substitute for PaO2/FiO2 as a reliable noninvasive indicator for predicting clinical outcome in ARDS patients.

The dynamic changes of pulmonary ventilation and gas exchange were common in pulmonary pathophysiology.Although related detection methods as chest X-ray, CT, magnetic resonance imaging (MRI) had certain effect in the evaluation and treatment of pulmonary diseases, which can′t still fully assess the function of pulmonary ventilation, pulmonary interstitial oxygen absorption, gas exchange, etc., especially having certain limitations in the diagnosis for local lesions.However, hyperpolarized 129Xe MRI uniquely images technology characterised by non-invasiveness and no ionizing radiation.Meanwhile, It has not only a unique application role for chronic obstructive pulmonary disease, idiopathic pulmonary fibrosis, ect., but also a good practical value for expressing pulmonary ventilation, evaluating airway microstructure, exploring gas exchange, and assessing local pulmonary lesion.This article reviews the application of hyperpolarized 129Xe MRI uniquely images in pulmonary diseases.

摘要：目的 调查群众对“网约护士”的接纳度及其影响因素，为进一步推广互联网+护理服务模式提供理论依据。 方法 采用便利抽样法对716名群众进行有关“网约护士”的接纳度及其影响因素的调查分析。结果 36.50%表示完全可以接受“网约护士”，仅有2.50%的群众对“网约护士”接受度较差。不同年龄、学历、居住地的群众，对“网约护士”的接纳度不同（P<0.05）。护士的职业技能及专业性、相关配套制度、居家就医的安全性是影响群众接受“网约护士”的主要因素。结论 群众对“网约护士”的认知度和了解度偏低，但对于“网约护士”的接受程度较高。管理者应在国家大力发展养老事业的政策下，重视“网约护士”的发展，充分利用互联网+护理服务模式，为群众提供高质量、有保障的就医服务和专业护理。

体外膜肺氧合(ECMO)技术目前在临床中应用的越来越广泛，为严重心肺功能衰竭等重症患者带来了生存的希望。但ECMO治疗过程中存在各种并发症，其中出血这类凝血功能障碍问题严重影响ECMO治疗后患者的预后。近年来，凝血相关指标与ECMO治疗出血风险之间的关系成为研究热点，深入探讨凝血相关指标与ECMO治疗出血风险之间的关系，可帮助指导临床决策，减少出血相关并发症的发生，改善患者的预后。

目的 探讨硫辛酸致胰岛素自身免疫综合征(IAS)的临床特点,为临床安全用药提供依据.方法 检索国内外数据库收集硫辛酸致IAS的病例报告类文献,提取相关数据(性别、国籍、年龄、原发疾病、联用药物、IAS发生时间及相关实验室检查、主要症状、临床干预措施及转归)进行描述性统计分析,同时对相关厂家药品说明书进行查阅分析.结果 纳入分析的21例患者,男性4例,女性17例;年龄32～77岁,平均57.71岁;11例患者合并其他药品,其中5例患者合并使用胰岛素或胰岛素促泌剂格列齐特,患者使用二甲双胍或阿卡波糖为5例;4例患者在用药过程中发生IAS,12例患者为停用硫辛酸后发生IAS;患者低血糖发作时血糖平均为2.46 mmol/L;21例患者血清胰岛素均高于正常水平且胰岛素自身抗体(IAA)均为阳性.对14例患者进行基因型检测,中国、日本和韩国患者基因型均为HLA-DRB1*0406,非东亚患者基因型分别为HLA-DRB1*0403或HLA-DRB1*0415.21例患者均停用硫辛酸,其中6例患者停药后未干预患者好转,9例患者同时给予糖皮质激素治疗,1例患者给予二氮嗪,1例患者给予糖皮质激素后仍未改善最终给予血浆置换治疗,21例患者均好转.结论 糖尿病患者使用硫辛酸时发生低血糖症状应警惕硫辛酸所致IAS,临床用药过程中应加强用药监护,同时相关企业应完善药品说明书,确保患者安全用药.

Objective The aim of this study was to investigate the short-term efficacy of Heye Tiaozhi Shugan, a kind of herbal medicine, decoction in dealing with patients with nonalcoholic fatty liver diseases（NAFLD）. Methods 56 patients with NAFLD were recruited in our hospital between April 2019 and April 2021, and were randomly divided into control and observation group, with 28 patients in each group. All patients were supervised for health education, like exercise and diet guidance. The patients in the control group were treated with polyene phosphatidylcholine and glycyrrhizinic acid tables, and those in the observation group were treated with the herbal medicine at base of medication in the control. The regimen lasted for 12 weeks. The TCM syndrome scores were evaluated, and serum total cholesterol（TC）, triglyceride（TG）, low density lipoprotein cholesterol（LDL-C） and high density lipoprotein cholesterol（HDL-C） levels were assayed. Results At the end of three month treatment, the hypochondriac pain, depression, poor appetite, abdominal distension and loose stool scores as obtained by TCM evaluation were（1.0±0.3）,（0.8±0.2）,（0.7±0.2）,（0.7±0.2） and（1.0±0.1）, significantly lower than [（1.4±0.7）,（1.3±0.3）,（1.3±0.3）,（1.2±0.3） and（1.4±0.3）, P ＜ 0.05] in the control; serum TG and LDL-C levels in the observation group were（1.8±0.5）mmol/L and（2.7±0.6）mmol/L, significantly lower than [（2.4±0.8）mmol/L and（3.9±0.8）mmol/L, respectively, P＜0.05], while serum HDL-C level was（1.8±0.6）mmol/L, significantly higher than [（1.1±0.4）mmol/L, P＜0.05] in the control; serum alanine aminotransferase, aspartate aminotransferase, gamma glutamine transferase and alkaline phosphatase levels in the observation group were（46.1±8.9）U/L,（31.9±9.0）U/L,（38.7±11.2）U/L and（66.1±12.2）U/L, all significantly lower than [（55.7±9.4）U/L,（44.3±10.7）U/L,（49.7±12.5）U/L and（74.4±14.7）U/L, respectively, P＜0.05]. Conclusion The Heye Tiaozhi Shugan decoction, a herbal medicine compound, in treatment of NAFLD patients with special TCM syndrome, could improve blood lipid metabolism, and needs further investigation.

目的:运用品管圈工具,提高我院药品不良反应(ADR)监测上报水平.方法:统计我院ADR监测上报数据,分析品管圈活动前影响我院ADR病例报告质量的原因,运用品管圈对我院ADR监测上报工作进行干预和改进.结果:柏拉图分析结果显示,对医护人员培训不到位、上报耗时、奖惩制度未落实、与医护缺乏沟通为我院ADR监测上报水平较低的原因.结合我院实际情况拟定对策并实施,包括ADR监测相关知识的培训及指导、简化院内报告系统与优化上报流程、加强与医护人员的沟通协作、落实奖惩制度等.品管圈活动后我院ADR病例报告质量合格率和上报数量均有较大提升,且效果维持较好.结论:通过品管圈活动,规范了我院ADR上报流程,落实了奖惩制度,提高了医护人员上报ADR的积极性和主动监测意识,我院ADR监测上报水平得到了提升.

Objective:To investigate the inhibitory effects of rosmarinic acid (RA) on high glucose-induced angiogenesis of human retinal microvascular endothelial cells (HRMEC) and nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) inflammasome pathway-related proteins.Methods:The HRMEC were divided into control group, high glucose group, high glucose+ low concentration RA group, high glucose+ medium concentration RA group, and high glucose+ high concentration RA group, and were cultured in vitro with conventional medium, 30 mmol/L D-glucose medium, 30 mmol/L D-glucose+ 25 μmol/L RA medium, 30 mmol/L D-glucose+ 50 μmol/L RA medium and 30 mmol/L D-glucose+ 100 μmol/L RA medium accordingly.The 3-(4, 5-dimethyl-2-thiazolyl)-2, 5-diphenyl-2H-tetrazolium bromide (MTT) assay was used to detect the cell proliferation.Transwell assay was performed to detect the cell migration.Matrigel assay was employed to determine the tube formation ability of cells.Western blot was utilized to detect the expression levels of NLRP3, apoptosis-associated speck like protein (ASC) and cysteinyl aspartate-specific protease-1 (Caspase-1). Enzyme-linked immunosorbent assay (ELISA) kit was used to detect the concentrations of interleukin (IL)-1β and IL-18 in supernatant of cell culture. Results:The cell proliferation rate, the number of migrated cells and the number of formed tubes were (100.00±0.92)%, 37.67±9.02 and 45.00±4.58 in the control group, (163.56±1.46)%, 117.33±7.23 and 95.00±9.54 in the high glucose group, (152.29±2.90)%, 78.67±4.04 and 84.67±1.53 in the high glucose+ low concentration RA group, (147.72±2.22)%, 65.33±4.16 and 71.00±3.61 in the high glucose+ medium concentration RA group, (132.47±0.74)%, 52.67±6.81 and 60.00±1.00 in the high glucose+ high concentration RA group, respectively.There were statistically significant differences in cell proliferation rate, the number of migrated cells and formed tubes among all groups ( F=537.07, 64.63, 45.58; all at P<0.001). Compared with the control group, the cell proliferation rate, the number of migrated cells and formed tubes were significantly increased in the high glucose group, high glucose+ low concentration RA group, high glucose+ medium concentration RA group and high glucose+ high concentration RA group, showing statistical significances (all at P<0.05). Compared with the high glucose group, the cell proliferation rate, the number of migrated cells and formed tubes were significantly decreased in the different concentrations RA groups (all at P<0.05). With the increase of RA concentration, the cell proliferation rate, the number of migrated cells and formed tubes were decreased, and there were statistical differences among high glucose+ low/medium/high concentrations RA groups (all at P<0.05). There were significantly differences in the relative expression levels of NLRP3, ASC and Caspase-1 proteins in cells and the concentrations of IL-1β and IL-18 in cell culture supernatant among all the five groups ( F=145.12, 422.82, 463.79, 2 019.96, 33 406.97; all at P<0.001). Compared with the control group, the relative expression levels of NLRP3, ASC and Caspase-1 proteins as well as the concentrations of IL-1β and IL-18 in cell culture supernatant were significantly increased in the high glucose group, high glucose+ low concentration RA group, high glucose+ medium concentration RA group and high glucose+ high concentration RA group (all at P<0.05). Compared with the high glucose group, the expression levels of NLRP3, ASC and Caspase-1 proteins as well as the concentrations of IL-1β and IL-18 were decreased in the different concentrations RA groups, and the differences were statistically significant (all at P<0.05). With the increase of RA concentration, the expression levels of NLRP3, ASC and Caspase-1 proteins as well as the concentrations of IL-1β and IL-18 were decreased, and there were statistically significant differences among high glucose+ low/medium/high concentrations RA groups (all at P<0.05). Conclusions:RA can inhibit proliferation, migration and tube formation of HRMEC induced by high glucose, and inhibit high glucose-induced activation of NLRP3 inflammasome signaling pathway.

目的 通过回顾性分析肺癌患者的临床、实验室及随访资料,探讨淋巴细胞绝对计数(ALC)与肺癌侵袭性及患者预后的关系.方法 收集98例确诊为肺癌且未接受过任何抗肿瘤治疗患者的临床资料,分析ALC与肺癌侵袭性及患者预后的关系.结果 根据外周血ALC平均值将患者分为对照组(ALC≥1.29×109/L,n=48)及研究组(ALC<1.29×109/L,n=50).与研究组相比,对照组具有较低的TNM临床分期、较少的远处转移及较长的总生存期(OS).结论 与肺癌ALC低者相比,ALC高者肿瘤侵袭性低且生存期较长.ALC可作为肺癌患者预后的一个独立预测指标.

2019年12月,新型冠状病毒肺炎(corona virus dis-ease 2019, COVID-19)在武汉暴发,并迅速向全国及世界蔓延.截止2020年2月28日,全国共报道79251确诊病例,2835死亡病例[1].由于国家采取了有效措施,医护人员逆风前行驰援武汉,目前疫情有了缓解的趋势.回顾从2003年SARS发生以来,H1N1、H7N9以及此次新型冠状病毒肺炎的发生及其流行病学特点,为正确认识新型冠状病毒肺炎提供科学依据.

目的 探讨迷迭香酸联合槲皮素对人肝癌HepG2细胞增殖、侵袭力的影响,并探讨其可能的机制.方法 以不同浓度迷迭香酸(12.5、25.0、50.0和100.0μmol/L)和槲皮素(12.5、25.0、50.0和100.0μmol/L)单药及二者联合用药处理HepG2细胞36 h,用四甲基偶氮唑盐微量酶反应比色法(MTT法)检测细胞增殖,划痕实验检测细胞迁移能力,蛋白质印迹法检测凋亡相关蛋白E-钙黏蛋白(E-cad)及N-钙黏蛋白(N-cad)的表达情况.结果 槲皮素和迷迭香酸单药均能使细胞活力降低,二者联合用药对细胞活力抑制率更加显著,且呈剂量依赖性(P<0.05).25μmol/L迷迭香酸组及25μmol/L槲皮素组划痕愈合距离分别为(11.35±2.37)mm、(11.46±3.86)mm,均能抑制细胞的迁移;两者联合用药组划痕愈合距离为(4.36±0.56)mm,抑制细胞迁移效果更加明显(F=6.73,P=0.003).槲皮素组及迷迭香酸组中E-cad蛋白相对表达量为(1.02±0.10)及(1.25±0.14),N-cad蛋白相对表达量为(0.98±0.05)及(0.73±0.02),与之相比二者联合用药可显著上调E-cad[(1.42±0.06),F=5.28,P=0.02]及下调N-cad[(0.61±0.07),F=3.28,P=0.03]的表达.结论 槲皮素联合迷迭香酸能抑制HepG2细胞增殖及凋亡,其作用主要是通过上调E-cad及下调N-cad的表达来实现的.

目的:使用还原铁粉、活性炭、氯化钠和蛭石等自发热材料,研究自发热医学美容材料最佳发热配比.方法:按L16(45)五因素四水平正交试验表设计实验,对最高温度、平均温度、启动时间及持续时间进行综合评分,评分结果采用正交设计软件进行数据分析,研究自发热材料应用于医学美容材料的最佳发热配比.结果:自发热医学美容材料的配比综合评分影响程度D>E>A>C>B(即蛭石>水>还原铁粉>氯化钠>活性炭),最佳配比为A4B2C4D2E4,即还原铁粉:活性炭:氯化钠:蛭石:水=8:4:5:2:5.结论:按正交设计法得到的最佳配比可制成自发热面膜.该面膜接触空气后缓慢反应散发热量,适合医学美容治疗需要.

We used wanfang, CNKI and VIP database to amalyze the scientific literatures on integrated traditional Chinese and Western medicine in the treatment of Herpes Simplex Keratitis (HSK) published between 2005 and 2018.Randomized controlled trials (RCT) were collected, quality evaluation was performed and the data were analyzed using Revman 5.3 software.According to the inclusion criteria, the statistical data of methodological quality evaluation, Meta-analysis, funnel map analysis, heterogeneity test and bias risk were carried out through the system Revman 5.3 statistical software.15 RCTs were included, involving 1 521 patients.The results of Meta-analysis showed that the of combination of traditional Chinese and Western medicine group for herpes simplex keratitis had the higher total effective rate[OR=5.23, 95％, CI (3.51, 7.80) , P<0.000 01], the lower recurrence rate[OR=0.32, 95％ CI (0.22, 0.45) , P<0.000 01] and the shorter cure time[MD=-5.40, 95％ CI (-6.41, -4.40) , and P<0.000 01] than that of western medicine alone, the difference was statistically significant.The curative effect of combination of traditional Chinese and Western medicine in treating herpes simplex keratitis is better than that of western medicine alone.It has a good clinical application prospect.

AIM:To investigate the role of cellular autophagy in the expression of IL-1β and IL-6 by retinal pigment epithelium(RPE)cells under hypoxia.METHODS: A cultured human RPE cell line was randomly divided into the hypoxia group, 3-methyladenine(3-MA)+ hypoxia group, chloroquine(CQ)+ hypoxia group and the control group. Cells incubated in a hypoxic incubator were set as the hypoxia group. After culture for 24h, western blot was used to analyze the relative expression of autophagy-associated key proteins in each group, including microtubule associated protein 1 light chain 3B(LC3B), Beclin-1 and p62. Then, ELISA was applied to detect the concentration of IL-1β and IL-6 in the cell culture supernatants.RESULTS: The concentration of IL-1β and IL-6 in the hypoxia group was significantly higher than that in the control group 3-MA+hypoxia group and CQ+ hypoxia group(all P<0.01). The relative expression of LC3B-II/I and Beclin-1 in the hypoxia group was significantly higher than that in the control group and 3-MA+hypoxia group. The relative expression of LC3B-II/I in the hypoxia group was significantly lower than that in the CQ+ hypoxia group(all P<0.01). The relative expression of p62 in the hypoxia group was significantly lower than that in the control group, 3-MA+hypoxia group and CQ+ hypoxia group(all P<0.01).CONCLUSION: Hypoxia can enhance the expression of LC3B-II/I and Beclin-1 in RPE cells, weaken the expression of p62, and promote the secretion of IL-1β and IL-6. Autophagy inhibitors 3-MA and CQ can reduce the expression of IL-1βand IL-6 in RPE cells.