RESUMEN
OBJECTIVE: By integrating meta-analysis and network pharmacology strategy, the clinical efficacy of Zhishe Tongluo capsule in the treatment of cerebral infarction was evaluated, and the intervention mechanism was preliminary explored. METHODS: Through meta-analysis, the Chinese and English literature of the randomized controlled trial (RCT) of Zhishe Tongluo capsule in the treatment of cerebral infarction was comprehensively searched. Based on the standard of Na Pai, the quantitative literature was determined and the Review Manager data were statistically analyzed. RESULTS: A total of 10 RCTs literatures were included. These literatures included a total of 1278 subjects, of which 670 were in the treatment group and 608 were in the control group. In terms of indicators of efficiency and adverse reaction rate, the treatment group was better than the control group. There was a statistical difference (P < 0.05); a total of 559 chemical constituents and 2306 potential targets were obtained from the online database. Of these, 201 components, 145 targets, and 185 pathways were closely related to cerebral infarction. CONCLUSIONS: The available evidence indicates that the addition of Zhishe Tongluo capsule to the conventional treatment of Western medicine can improve the clinical efficacy of cerebral infarction and has some advantages in regulating blood lipids and hemorheology, but the overall evidence level is low, which still needs to be further supported by large-scale and multicenter RCTs; intervention of brain infarction by Zhishe Tongluo capsule is a comprehensive result of multicomponent and multi-target interactions. On the basis of the combined meta-analysis and network pharmacology in scientific attempts, it also provides a reference for the clinical evaluation of other drugs and mechanism research.
RESUMEN
OBJECTIVE: To investigate tear film alterations in patients with latent herpes stromal keratitis (HSK). METHODS: Prospective comparative case series study. Twenty-four patients with latent HSK in one eye and 28 age and gender matched healthy individuals were recruited. All subjects were evaluated by subjective symptoms of dry eye, tear film break-up time (BUT) and Schirmer I test (SIT). Laser in vivo confocal microscopic investigation was performed in 12 patients with severe tear film instability (BUT ≤ 5 s). Data distribution and homogeneity of variance was analyzed. Statistical comparisons of the mean values between different groups were performed using Kruskal-Wallis test, Mann-Whitney test or student t-test. RESULTS: Most of latent HSK patients (n = 22/24, 91.7%) had symptoms as dryness, burning sensation, redness and foreign body sensation. Both eyes of patients with latent HSK had hyposecretion (SIT, control eyes (16.2 ± 3.2) mm/5 min; affected eyes (10.4 ± 7.8) mm/5 min; lateral eyes (11.2 ± 8.8) mm/5 min; control and affected, U = 135.0, P < 0.001; control and lateral, U = 155.0, P = 0.001) and decreased tear film stability [BUT, control eyes (12.1 ± 0.7) s, affected eyes (4.3 ± 3.3) s, lateral eyes (9.2 ± 4.4) s; control and affected, U = 28.0, P < 0.001; control and lateral, U = 114.0, P < 0.001] as compared to control group (Kruskal-Wallis nonparametric test). The value of BUT showed significant difference between affected eyes and healthy eyes (U = 90.0, P < 0.001), whereas no difference of the value of SIT was found (U = 273.0, P = 0.757). Abnormal SIT (≤ 10 mm/min) and BUT (≤ 10 s) was presented in 14 (58.3%) and 23 (95.8%) affected eyes, as well as in 14 (58.3%) and 17 (70.8%) lateral eyes, respectively. Laser in vivo confocal microscopy investigation in 12 affected corneas with abnormal tear film showed morphological alterations as corneal epithelial metaplasia with polymorphism and enlarged cells, reflective nuclei, and decreased nucleus/cytoplasm ratio; decreased nerve density in subepithelial plexus and obvious branching and beading, which is similar to those changes caused by dry eye. CONCLUSIONS: Most of latent HSK patients had abnormal tear film. Dry eye related alterations could be found in affected corneas with abnormal tear film by in vivo confocal microscopy.