Rimexolone控制白内障术后眼内炎症的Meta分析

目的：目的：对1％rimexolone滴眼液控制白内障手术相关性眼内炎症的疗效进行系统评价。方法：对两项多中心随机双盲对照临床研究进行Eeta分析。根据前瞻治疗分析模型对资料进行提取。通过计算机治疗3效应和比值来评估1％rimexolone滴眼液的治疗的治疗效果。并按照固定效应模型对两项研究的结果进行合并。结果：总计对357例患者进行有效性分析。在治疗结束时,炎症消失,治疗失败的合并比值比分别为3．28[95％CI2．10,5．11]0．13[95％CI0．05,0．33],前房炎症的合并治疗效应为－1．30[95％（CI－1．67,－0．93]。Rimexolone治疗相关副作用发生率为7．5％,而安慰剂高达33．3％,两组的眼内压改变没有显著性差异。结论：1％rimexolone滴眼液是一种既安全又有效的控制手术相关性眼内炎症的药物。     

Arthroscopic surgery for degenerative tears of the meniscus: a systematic review and meta-analysis

Background:

Arthroscopic surgery for degenerative meniscal tears is a commonly performed procedure, yet the role of conservative treatment for these patients is unclear. This systematic review and meta-analysis evaluates the efficacy of arthroscopic meniscal débridement in patients with knee pain in the setting of mild or no concurrent osteoarthritis of the knee in comparison with nonoperative or sham treatments.

Methods:

We searched MEDLINE, Embase and the Cochrane databases for randomized controlled trials (RCTs) published from 1946 to Jan. 20, 2014. Two reviewers independently screened all titles and abstracts for eligibility. We assessed risk of bias for all included studies and pooled outcomes using a random-effects model. Outcomes (i.e., function and pain relief) were dichotomized to short-term (< 6 mo) and long-term (< 2 yr) data.

Results:

Seven RCTs (n = 805 patients) were included in this review. The pooled treatment effect of arthroscopic surgery did not show a significant or minimally important difference (MID) between treatment arms for long-term functional outcomes (standardized mean difference [SMD] 0.07, 95% confidence interval [CI] −0.10 to 0.23). Short-term functional outcomes between groups were significant but did not exceed the threshold for MID (SMD 0.25, 95% CI 0.02 to 0.48). Arthroscopic surgery did not result in a significant improvement in pain scores in the short term (mean difference [MD] 0.20, 95% CI −0.67 to 0.26) or in the long term (MD −0.06, 95% CI −0.28 to 0.15). Statistical heterogeneity was low to moderate for the outcomes.

Interpretation:

There is moderate evidence to suggest that there is no benefit to arthroscopic meniscal débridement for degenerative meniscal tears in comparison with nonoperative or sham treatments in middle-aged patients with mild or no concomitant osteoarthritis. A trial of nonoperative management should be the first-line treatment for such patients.Arthroscopic meniscal débridement is one of the most commonly performed procedures in orthopedic surgery. More than 700 000 such procedures are performed each year in the United States, and more than 4 million are performed each year worldwide, with substantial economic and social burdens.^1–6 Many patients who undergo arthroscopic meniscal débridement have concurrent osteoarthritis, and orthopedic surgeons are often challenged to determine the true cause of patients’ symptoms: the meniscal tear, osteoarthritis or a combination of both.⁷Although 2 well-designed randomized controlled trials (RCTs)^8,9 have shown a lack of efficacy for arthroscopic surgery in patients with severe and advanced knee arthritis, many patients present with degenerative meniscal tears and mild or minimal concurrent osteoarthritis.¹⁰ Patients with degenerative meniscal tears in the setting of mild osteoarthritis may experience functional improvement or pain relief with arthroscopic surgery,^11–14 but the role of conservative treatment is unclear.^15–17 Arthroscopic surgery involves the potential for complications, which must be weighed against the prognosis for relief from presenting symptoms.^6,18The objective of this systematic review and meta-analysis was to evaluate the efficacy of arthroscopic meniscal débridement in comparison with nonoperative or sham treatments in patients with degenerative meniscal tears and knee pain with regard to function and pain relief in the short term (< 6 mo) and long term (< 2 yr).     

Hand-assisted laparoscopic surgery versus laparoscopic right colectomy: a meta-analysis

Objective

The objective of this study is to systematically assess the clinical efficacy of hand-assisted laparoscopic surgery (HALS) and laparoscopic right colectomy (LRC).

Methods

The randomized controlled trials (RCTs) and non-RCTs were collected by searching electronic databases (Pubmed, Embase, and the Cochrane Library). The outcomes included intraoperative outcomes, postoperative outcomes, postoperative morbidity, and oncologic outcomes. Meta-analysis was performed using of RevMan 5.3 software.

Results

A total of five studies involving 438 patients were finally included, with 202 cases in HALS group and 236 cases in LRC group. Results of meta-analysis showed that there was no statistical difference between HALS and LRC in terms of conversion rate, length of hospital stay, reoperation rate, postoperative morbidity, and oncologic outcomes. The operative time was 6.5 min shorter in HALS group; however, it was not a clinically significant difference. Although the incision length was longer in HALS, it did not influence the postoperative recovery.

Conclusions

HALS can be considered an alternative to LRC which combines the advantages of open as well as laparoscopic surgery.

     

Iris recognition as a biometric method after cataract surgery

Background

Biometric methods are security technologies, which use human characteristics for personal identification. Iris recognition systems use iris textures as unique identifiers. This paper presents an analysis of the verification of iris identities after intra-ocular procedures, when individuals were enrolled before the surgery.

Methods

Fifty-five eyes from fifty-five patients had their irises enrolled before a cataract surgery was performed. They had their irises verified three times before and three times after the procedure, and the Hamming (mathematical) distance of each identification trial was determined, in a controlled ideal biometric environment. The mathematical difference between the iris code before and after the surgery was also compared to a subjective evaluation of the iris anatomy alteration by an experienced surgeon.

Results

A correlation between visible subjective iris texture alteration and mathematical difference was verified. We found only six cases in which the eye was no more recognizable, but these eyes were later reenrolled. The main anatomical changes that were found in the new impostor eyes are described.

Conclusions

Cataract surgeries change iris textures in such a way that iris recognition systems, which perform mathematical comparisons of textural biometric features, are able to detect these changes and sometimes even discard a pre-enrolled iris considering it an impostor. In our study, re-enrollment proved to be a feasible procedure.

     

Pseudoexfoliation syndrome and cataract surgery by phacoemulsification

Pseudoexfoliation syndrome is a systemic age-related disease in which abnormal extracellular material is produced and accumulates in many ocular tissues. Its ocular manifestations involve all of the structures of the anterior segment as well as conjunctiva and orbital structures. The presence of pseudoexfoliation should alert the physicians to the increased risks associated during and after cataract surgery. Increasing awareness of this condition are important in the detection and preoperative determination of patients inclined to be at greater risk for complications during surgery. Data regarding the rate of complications during phacoemulsification suggest a lower complication rate than with exstracapsular extraction but still greater than in eyes without pseudoexfoliation. Despite the existence of a higher number of intraoperative and postoperative complications, experience with the phacoemulsification technique together with the improvement of the apparatus and instruments used enable similar results to obtained in eyes with pseudoexfoliation syndrome as in eyes without this pathology.     

Fertilization success and UV ornamentation in blue tits Cyanistes caeruleus: correlational and experimental evidence

Cases where less ornamented males are favored through sexualselection are rare among birds. Here we show, based on datafrom 3 consecutive breeding seasons, that male blue tits withless ultraviolet (UV)-ornamented crown feathers sire more offspring.This pattern was mainly driven by the higher success of older,less UV-ornamented males at siring extrapair offspring. Thereason behind this relationship is unclear although we hypothesizethat being less UV-ornamented may enable adult males to intrudeinto nearby territories by mimicking juveniles. To test causality,we experimentally manipulated male crown coloration creating2 groups, one with higher (UV(+) treatment) and one with lowerUV reflectance (UV(–) treatment). Contrary to our expectations,UV(–) males were less likely to sire extrapair offspringthan UV(+) males. The treatment had no effect on the likelihoodof losing paternity in a male's own nest. Because the experimentalevidence does not support the observational data, a direct effectof male crown color on extrapair success cannot be confirmed.However, potential pitfalls of this and other such color manipulationexperiments, like fading of treatment with time and mismatchesbetween behavior and coloration, call for new improved manipulationtechniques and detailed behavioral observations to conclusivelytest for the effect of blue tit crown coloration on male extrapairsuccess.     

Comparison of efficacy of eight treatments for plantar fasciitis: A network meta-analysis

The objective of this network meta-analysis (NMA) was to assess the pain relief performance of eight different plantar fasciitis therapies, including nonsteroidal anti-inflammatory medications, corticosteroid injections (CSs), autologous whole blood, platelet-rich plasma (PRP), extracorporeal shockwave therapy (ESWT), ultrasound therapy (US), botulinum toxin A (BTX-A), and dry needling (DN). Published prospective or randomized controlled trials (RCTs) as for the above eight therapies were identified by searching CNKI, PubMed, and Embase. Mean difference (MD) and 95% credible intervals (CrIs) of visual analogue scale (VAS) were used to evaluate multiaspect comparisons. The ranking result was obtained by utilizing surface under cumulative ranking curve (SUCRA). Node-splitting plots were conducted to assess the consistency between direct and indirect evidence. Egger’s test and funnel plots were performed to examine publication bias. Forty-one trials with a total of 2,889 cases were involved in this NMA. In terms of 1-month VAS, only ESWT turned out to be of better efficacy than placebo (MD = −3.3; CrI: [−5.3, −1.1]). No statistically significant difference was found between pair-wise comparisons concerning 2-month VAS. ESWT also demonstrated better efficacy as for 3-month results (MD = −2.7; CrI: [−4.2, −1.3]). Besides, CSs was significantly better than placebo as well in 3-month results (MD = −2.1; CrI: [−4.1, −0.19]). With regard to 6-month VAS results, ESWT performed better than placebo (MD = −3.0; CrI: [−5.0, −0.51]). According to the SUCRA, ESWT ranked the first as for all seven outcomes. ESWT might be the optimal treatment. In addition, BTX-A and PRP were considered as suboptimal.     

Effects of nestling condition on UV plumage traits in blue tits: an experimental approach

Intraspecific sexual and social communications are among themost important factors shaping costly color traits in birds.Condition capture models assume that only animals in superiorcondition can develop and maintain a colorful plumage. Althoughthere is good evidence that carotenoid-based components of plumagecolors show condition dependence, the situation is more controversialwith the underlying UV-reflecting structural component. We conducteda brood size manipulation in blue tits (Parus caeruleus) toinvestigate condition-dependent effects on plumage colorationin male and female offspring. Carotenoid chroma and UV reflectanceof the yellow breast plumage showed condition-dependent expressionin male and female fledglings. However, only males that wereraised in reduced broods had higher UV reflectance in the UV/bluetail feathers, whereas female tail coloration did not differbetween treatments. Our data suggest that there is a sex-specificeffect on the blue but not the yellow plumage and that thisis related to differences in the signaling function of bothplumage traits. Although sexual selection may already act onmale nestlings to develop colorful tail feathers for the nextbreeding season, the UV/yellow breast feathers are molted duringthe postjuvenile molt, and their signaling value is likely tobe important for both sexes during the extended postfledglingphase.     

A meta-analysis of the interactive effects of UV and drought on plants

Interactions between climate change and UV penetration in the biosphere are resulting in the exposure of plants to new combinations of UV radiation and drought. In theory, the impacts of combinations of UV and drought may be additive, synergistic or antagonistic. Lack of understanding of the impacts of combined treatments creates substantial uncertainties that hamper predictions of future ecological change. Here, we compiled information from 52 publications and analysed the relative impacts of UV and/or drought. Both UV and drought have substantial negative effects on biomass accumulation, plant height, photosynthesis, leaf area and stomatal conductance and transpiration, while increasing stress-associated symptoms such as MDA accumulation and reactive-oxygen-species content. Contents of proline, flavonoids, antioxidants and anthocyanins, associated with plant acclimation, are upregulated both under enhanced UV and drought. In plants exposed to both UV and drought, increases in plant defense responses are less-than-additive, and so are the damage and growth retardation. Less-than-additive effects were observed across field, glasshouse and growth-chamber studies, indicating similar physiological response mechanisms. Induction of a degree of cross-resistance seems the most likely interpretation of the observed less-than-additive responses. The data show that in future climates, the impacts of increases in drought exposure may be lessened by naturally high UV regimes.     

岩羊和矮岩羊头骨形态特征比较

本文报道了岩羊和矮岩羊的头骨形态学资料,涉及头骨特征描述和一些形态学指标测定,被测定的指标主要有上颊齿列基长、眼窝长、乳突间距、眶间距、颧宽、枕颅高、枕髁宽、脑颅最大宽、眶下孔距、上颌臼齿外宽、角基最窄、最小角尖距、角尖距、最大角间距、角基周长、角基长径、角基短径、角外侧长,应用判别分析和单变量分析对岩羊和矮岩羊头骨的测量值进行统计与分析,以探讨这两个种头骨之间的形态差异。结果表明：（1）岩羊和矮岩羊头骨在形态上十分相似,但矮岩羊的头骨细长,脑颅狭窄,角直且朝上翘,角内侧具一明显角棱,亦较直,角基部狭窄,老年个体角基部愈合;岩羊的脑颅宽大,角粗大而长,向两侧分开,弯曲度较大,内侧角棱弯曲呈长S型,角尖朝向后方,角基部较宽,不愈合在一起。（2）岩羊和矮岩羊头骨的18项形态测量指标中乳突间距、眶间距、颧宽、脑颅最大宽、上颌臼齿外宽、角基周长、角基长径差异极显著（P〈0.01）,枕颅高、枕髁宽、眶下孔距、角尖距、最大角间距、角基短径、角外侧长差异显著（P〈0.05）;典型判别的正确率：岩羊为100%,矮岩羊为83.3%,交互验证法检验的结果,判别正确率：岩羊100%,矮岩羊为83.3%。这两个判别函数可以从角上区别岩羊和矮岩羊。