Mycobacterium vaccae as Adjuvant Therapy to Anti-Tuberculosis Chemotherapy in Never-Treated Tuberculosis Patients: A Meta-Analysis

OBJECTIVE: To evaluate the effectiveness and safety of heat-killed M. vaccae added to chemotherapy of never-treated tuberculosis (TB) patients. METHODS: The databases of Medline, Embase, Biosis, Cochrane Central Register of Controlled Trials, SCI, CBM, VIP and CNKI were searched. Randomized controlled trials (RCT) and Controlled clinical trials (CCT) comparing M. vaccae with or without a placebo-control injection as adjuvant therapy in the chemotherapy of never-treated TB patients were included. Two reviewers independently performed data extraction and quality assessment. Data were analyzed using RevMan 5.0 software by The Cochrane Collaboration. RESULTS: Fifty four studies were included. At the end of the follow-up period, Pooled RR (Risk Ratio) and its 95% CI of sputum smear conversion rate were 1.07 (1.04, 1.10) in TB patients without complications, 1.17 (0.92, 1.49) in TB patients with diabetes mellitus, 1.02 (0.94, 1.10) in TB patients with hepatitis B, and 1.46 (0.21, 10.06) in TB patients with pneumosilicosis. In elderly TB patients the RR was 1.22 (1.13, 1.32). Analysis of each time point during the follow-up period showed that M. vaccae could help to improve the removal of acid-fast bacilli from the sputum, and promote improvement of radiological focal lesions and cavity closure. Compared with the control group, the differences in levels of immunological indicators of Th1 such as IL-2 and TNF-α were not statistical significant (P = 0.65 and 0.31 respectively), and neither was that of IL-6 produced by Th2 (P = 0.52). An effect of M. vaccae of prevention of liver damage was found in TB patients with hepatitis B (RR 0.20 and 95% CI (0.12, 0.33). No systemic adverse events were reported. CONCLUSION: Added to chemotherapy, M. vaccae is helpful in the treatment of never-treated TB patients in terms of improving both sputum conversion and X-ray appearances

Gender differences in stability of the instantaneous patterns of body surface potentials during ventricular repolarisation

Women have a higher risk of developing torsade de pointes under QT-prolonging conditions. The electrophysiological differences between the sexes that could account for this are largely unknown. The objective of the work was to evaluate gender differences in repolarisation potentials using a method that is independent of the specific electrical properties of the thorax. 1410 normal recordings from the Glasgow 12-lead ECG database and 52 normal ECG maps obtained separately in Milan were analysed. The average difference between 1 and the correlation coefficient of the instantaneous pattern at the peak of T with that at every other instant is called the early repolarisation deviation index (ERDI) for J-T peak and the late repolarisation deviation index (LRDI) for T peak-T end. In standard ECG recordings, the ERDI was 0.42±0.22 in females compared with 0.19±0.16 in males (p<10−6). The LRDI was higher in males under the age of 50. In body surface maps, the ERDI was 0.32±0.21 in females against 0.16±0.17 in males (p<0.01), and the LRDI was non-significantly higher in males. The pattern of instantaneous body surface potentials showed gender differences during repolarisation with a method that is independent of the electrical properties of the thorax