Dynamic features of placebo effects addressing persistent insomnia disorder: A meta‐analysis of placebo‐controlled randomized clinical trials

It has been accepted knowledge that placebo effects have been significant in insomnia clinical trials. However, the dynamic features of placebo effects have not been clarified. Our aim was therefore to conduct a meta‐analysis of placebo‐controlled randomized clinical trials to characterize the dynamic features of placebo effects addressing persistent insomnia disorder. We performed a comprehensive literature search for randomized, placebo‐controlled, double‐blind clinical trials evaluating the efficacy of therapeutic regimens addressing persistent insomnia disorder. We pooled separate effect size estimates (Hedge's g) of placebo and regimen conditions across trials for outcome measures, and multilevel mixed‐effects models were used to explore potential sources of heterogeneity. The placebo effects were significant and robust to improve the symptoms of insomnia, and subjective measures were significantly smaller than objective measures (p < .001), but placebo response rates were nearly identical between subjective and objective measures. The overall placebo effects were influenced by publication year (p = .015), treatment duration (p = .010), sample size (p < .001) and therapeutic regimen (p < .001). Placebo effects showed a diphasic feature within treatment duration: initially a decrease and subsequently being stable; a sustained decline trend after withdrawals; and a steady‐to‐upward trend for a mixed therapeutic regimens in a large‐scale period over decades. The dynamic features of placebo effects addressing persistent insomnia disorder may lead to the development and validation of dosing strategies that require less medication exposure to maintain clinical effects.     

Study on the characteristics and mechanisms of nicosulfuron biodegradation by Bacillus velezensis CF57

Nicosulfuron is one of the main sulfonylurea herbicides that have been widely used to protect maize crops. A total of 10 nicosulfuron-degrading strains were isolated from the intestine tract of earthworm Eisenia foetida. Among them, Bacillus velezensis CF57 with the highest degradation efficiency was selected and studied in detail. The degradation characteristics of CF57 showed that it was able to effectively degrade nicosulfuron in a wide range of temperature, pH, and a low inoculation amount, and the response surface analysis revealed that the optimum degradation conditions were 30.8 °C, pH 6.31, and inoculation amount 3.04%. Meanwhile, CF57 could degrade high-concentration nicosulfuron efficiently and posed a broad degradation spectrum of other sulfonylurea herbicides. Furthermore, the localization of degradation enzyme indicated that the nicosulfuron-degrading enzyme was an extracellular fraction. By analyzing the metabolites of nicosulfuron, it could be further determined that the degradation of nicosulfuron by strain CF57 was mainly through the extracellular enzyme, and its possible degradation pathway was mainly derived from the cleavage of the C–N bond of the sulfonylurea bridge. These results may provide new insights into bioremediation of nicosulfuron-contaminated environments and enrich the resources of degrading bacteria of sulfonylurea herbicides.     

海博刀与三角刀在经口内镜下肌切开术中疗效的回顾性队列研究

目的 比较海博刀与三角刀在经口内镜下肌切开术(POEM)中的临床疗效。方法 采用回顾性队列研究设计，纳入2012年6月至2014年7月因贲门失弛缓症在南方医科大学南方医院接受POEM治疗的患者，术中使用海博刀者为海博刀组，使用注射针和三角刀者为三角刀组，比较两组手术相关参数、术后症状缓解及并发症发生率。结果 共纳入57例患者，其中海博刀组25例，三角刀组32例。两组患者基线特征比较差异无统计学意义（P>0.05）。海博刀组平均手术时间短于三角刀组[(55.3±17.7)min比(69.5±9.4)min，P=0.038)]；术中平均器械交换次数少于三角刀组[(4.5±1.5)次比(10.7±1.7)次，P=0.000]。所有患者无严重不良事件发生。在1年的随访中，海博刀组治疗成功率92.0%(23/25)，三角刀组96.9%(31/32)，差异无统计学意义（P=0.576)。结论 海博刀能显著缩短POEM手术时间，并且获得与三角刀相似的治疗成功率。     

光疗治疗银屑病的研究进展

目前治疗银屑病的方法较多,但治疗效果令人满意的方法尚少。光疗是治疗银屑病的一种有效方法,与药物联合应用不仅可以提高疗效,还可减少不良反应的发生。现将近年光疗治疗银屑病的研究进展综述如下。     

Notch-1在木村病中的表达及意义

目的探讨Notch-1在木村病的表达,指导木村病患者的优化治疗。方法通过免疫组化SP方法评估Notch-1蛋白在40例木村病患者组织和15例慢性淋巴结炎组织中的表达,分析Notch-1与木村病临床病理资料及预后的关系。结果 40例木村病患者中,男性患者占92.5%(37/40),7.5%(3/40)为女性患者,发病平均年龄为38岁。肿块的直径范围为1.0⁶.5 cm。Notch-1在复发的11例木村病患者中,63.6%(7/11)高度表达,36.4%(4/11)低度或中度表达。Notch-1表达、嗜酸粒细胞计数、肿块最大直径与复发有统计学差异(P<0.05),年龄、性别、肿块部位、肿块个数与复发无相关性(P>0.05)。结论 Notch-1高表达可能为木村病复发患者的一个有效观察指标,可为预后提供评估途径及指导患者个体优化治疗。