目的 评价卡培他滨+伊立替康与氟尿嘧啶/醛氢叶酸（5-FU/LV）+伊立替康治疗转移性结直肠癌的有效性和安全性。 方法 计算机检索PubMed、CENTRAL、Embase、中国生物医学数据库、中国期刊全文数据库、维普数据库和万方数据库，检索时间均从建库至2011年9月。对符合纳入标准的随机对照试验进行质量评价和Meta分析。 结果 纳入3个随机对照试验，共计419例患者，卡培他滨+伊立替康在中位生存期、完全缓解率[RR=1.58，95%CI（0.27，9.11），P=0.61]、部分缓解率[RR=0.86，95%CI（0.68，1.09），P=0.20]、总有效率[RR=0.88，95%CI（0.71，1.09），P=0.26]上表现出与5-FU/LV+伊立替康相似的效果，安全性方面卡培他滨+伊立替康有较高的Ⅲ/Ⅳ级恶心[RR=1.92，95%CI（1.05，3.54），P=0.04]、腹泻[RR=3.23，95%CI（2.14，4.89），P＜0.000 01]发生风险和较低的Ⅲ/Ⅳ级中性粒细胞减少[RR=0.72，95%CI（0.53，0.98），P=0.04]发生风险。 结论 根据当前现有证据，5-FU/LV+伊立替康可能较卡培他滨+伊立替康更为有利于转移性结直肠癌患者的治疗，但仍需结合临床实际情况进行化疗方案的优选。
【摘要】 目的 了解2007年-2008年成都地区17家医院抗肿瘤药物的使用情况。 方法 以销售金额、用药频度（DDDs）对2007年、2008年成都地区17家医院抗肿瘤药物消耗数据进行分类统计、综合分析、对比。 结果 2008年成都地区17家医院抗肿瘤药物用药金额增长幅度较大，各亚类抗肿瘤药物中其它类抗肿瘤药物类、植物来源的抗肿瘤药、抗代谢药金额排序依次占前3位。销售金额前100位药物中，肿瘤药物占据8位，大多数是其它类抗肿瘤药物，且其用药频度也靠前。 结论 抗肿瘤药物用药金额和用药量都将快速增长，其中其它类抗肿瘤药物和植物来源的抗肿瘤药的发展尤被看好。【Abstract】 Objective To evaluate the situation of antineoplastics used in Chengdu area from 2007 to 2008. Methods The consumption data of antineoplastics used in 17 hospitals of Chengdu area in 2007 and 2008 were classified, and the consumption sum and defined daily doses (DDDs) were analyzed. Results The total consumption sum of antineoplastics in 2008 increased sharply. Other antineoplastics, herbal-sourced antineoplastics and antimetabolism drugs ranked in the first three places. Among the top drugs in terms of consumption sum, antineoplastics took 8 places. Conclusion The consumption sum and DDDs of antineoplastics, especially other antineoplastics and herbal-sourced antineoplastics, will increase rapidly.
Objective To assess the effectiveness and safety of Tongxinluo Capsule in the treatment of vertebrobasilar artery insufficiency. Methods The Cochrane Library, MEDLINE, VIP and CNKI were searched. Two authors independently collected data, including randomized controlled trials that met the inclusion criteria. They evaluated the quality of these trials and performed meta-analysis using The Cochrane Collaboration’s RevMan 5.0. Results Eleven studies involving 1157 participants were included. All the included studies were inadequate at reporting randomization, concealment of allocation and blinding. Meta-analysis based on the included studies showed that Tongxinluo Capsule with Danshen was better than Danshen alone in vertebrobasilar artery insufficiency (RR= 1.35, 95%CI 1.24 to 1.48) and blood flow velocity of vertebrobasilar artery (WMD=3.60, 95%CI 2.44 to 4.77 and WMD=3.46, 95%CI 1.89 to 5.04). Tongxinluo Capsule with simple basic therapy was better than simple basic therapy alone in vertebrobasilar artery insufficiency (RR=1.21, 95%CI 1.11 to 1.31) and blood flow velocity of vertebrobasilar artery (WMD=3.85, 95%CI 2.19 to 5.51). Conclusion Tongxinluo Capsule is an effective and safe drug for vertebrobasilar artery insufficiency. However, due to the limited quantity and quality of the included studies, we can not draw a firm conclusion about the effectiveness of Tongxinluo Capsule compared to the simple basic therapy or Danshen. The results suggest that further and larger-scale trials using Tongxinluo Capsule for vertebrobasilar artery insufficiency are needed.
Objective To evaluate the efficacy and safety of low-dose versus standard-dose cyclosporine immunosuppressive therapy in kidney transplant recipients. Methods We searched MEDLINE, EMbase, SCI, CBM and The Cochrane Library from the establishment to December 2009 to screen randomized controlled trials (RCTs) of low-dose versus standard-dose cyclosporine immunosuppressive therapy in kidney transplant recipients. Quality assessment and meta-analyses were performed for the included studies. Results A total of 6 RCTs involving 1551 patients were identified, among which 4 RCTs were graded A and two were graded B. The meta-analyses indicated that there were no significant differences between the two groups at the end of 6-month and 12-month follow-up in the acute rejection rate at a RR 1.07, 95%CI 0.69 to 1.65 and a RR 1.06, 95%CI 0.71 to 1.57, respectively. There were no significant differences between the two groups at the end of 6-month and 12-month follow-up in the patients’ death rate at a RR 0.64, 95%CI 0.20 to 2.03 and a RR 0.61, 95%CI 0.30 to 1.24, respectively. There were no significant differences between the two groups in renal function and safety. Conclusion Based on the current evidence, compared with standard-dose CsA, low-dose CsA has the same effect and safety for the short-term results, but the long-term results need to be further studied.
Objective To evaluate the efficacy and safety of vildagliptin vs. placebo for patients with type 2 diabetes.Methods The following databases as The Cochrane Library (Issue 2, 2010), PubMed (1978 to September, 2010), EMbase (1974 to September, 2010), CNKI (1978 to September, 2010), VIP (1989 to September, 2010) and CBM (1978 to September, 2010) were searched to collect the randomized controlled trials (RCTs) of vildagliptin vs. placebo in treating type 2 diabetes. Two reviewers screened the trials according to the inclusion and exclusion criteria, extracted the data, assessed the quality in accordance with the Cochrane Collaboration, and conducted meta-analyses with RevMan 5.0 software. Results A total of 13 studies were included. The results of meta-analyses showed that the vildagliptin given as monotherapy led to greater reduction in HbA1c compared with the placebo (MD= –0.76, 95%CI –0.94 to –0.58, Plt;0.000 01), but it was inferior to the placebo in losing weight (MD=0.68, 95%CI 0.29 to 1.07, P=0.000 6). When the vildagliptin was given as monotherapy, there was no statistical difference in the incidence of overall adverse events (AEs) (OR=1.00, 95%CI 0.83 to 1.21, P=0.98) and hypoglycaemia (OR=1.03, 95%CI 0.65 to 1.65, P=0.89). When the vildagliptin was combined with other oral antihyperglycemic drugs or insulin, it produced greater reduction in level of HbA1c (MD= –0.76, 95%CI –0.94 to –0.58, Plt;0.000 01), and there was no statistically significant difference between vildagliptin and placebo in weight loss (MD=0.40, 95%CI –0.25 to 1.05, P=0.23), AEs (OR=0.95, 95%CI 0.76 to 1.18, P=0.62) and hypoglycaemia (OR=1.11, 95%CI 0.49 to 2.53, P=0.80). Conclusion The vildagliptin treatment for type 2 diabetes is effective and safe. A long-term study in large scale with high quality is required to confirm its long-term outcomes.
Objective To assess the effectiveness and safety of cyclosporine A (CsA) for aplastic anemia (AA) in China. Methods Randomized controlled trails (RCTs) of CsA for AA were collected from CBMdisc (1978 to 2008), CNKI (1979 to 2008), and VIP (1989 to 2008). Other relevant journals were also hand searched. The methodological quality of included studies was evaluated, and data analyses were performed with The Cochrane Collaboration’s software RevMan 4.2.0. Results A total of 19 RCTs were included. As for the total effective rate and complete remission rate, significant differences were noted between CsA + androgen vs. androgen alone, CsA + androgen combination vs. androgen combination, as well as CsA + androgen + other drugs vs. androgen + other drugs [total effective rate: RRs and 95%CIs were 1.48 (1.28 to 1.70), 1.67 (1.17 to 2.39), and 1.51 (1.09 to 2.08); complete remission rate: RRs and 95%CIs were 2.06 (1.33 to 3.19), 3.52 (1.19 to 10.39), and 1.54 (1.00 to 2.38)]. Conclusion According to the domestic evidence, treatment with CsA for AA may improve the total effective rate and complete remission rate. However, more high quality clinical trials are expected for further study.
Objective To review the efficacy and safety of Kushenin combined with Adefovir Dipivoxil for Chronic Hepatitis B (CHB). Method Randomized controlled trails of Kushenin combined with Adefovir Dipivoxil for CHB were gathered from PubMed, CBMdisc (1978 to 2009), and CSJD (1989 to 2009), while other relative researches were searched manually; every research was evaluated, and then analyzed with RevMan 5.0.0 software. Result Ten randomized controlled trials were included; among total 855 patients, 436 were in trial group and the other 419 were in control group. As the Meta-analysis showed, the therapeutic effect of kushenin combined with Adefovir Dipivoxil was better than that of Adefovir Dipivoxil in aspects of improving the negative rate of serum ALT (RR=1.28, 95%CI 1.17 to 1.40), the negative rate of serum HBV-DNA (RR=1.27, 95%CI 1.13 to 1.42), the negative rate of serum HBeAg (RR=1.80, 95%CI 1.32 to 2.44), and the conversion rate of HBeAg and anti-HBe (RR2.06, 95%CI 1.43 to 2.95). Conclusion Kushenin combined with Adefovir Dipivoxil in treating CHB can improve the conversion rate of HBeAg and anti-HBe and further take better therapeutic effect.
Objective To assess the efficacy and safety of mesalazine versus sulfasalazine in the treatment of ulcerative colitis.Methods The literatures were searched from PubMed (1966 to January 2010), the Cochrane Library (1966 to January 2010), EMbase (1974 to January 2010), CNKI (1994 to January 2010), VIP (1989 to January 2010), and CBM (1978 to January 2010). The data were extracted, the quality of studies was evaluated according to The Cochrane Handbook, and meta-analyses were performed using RevMan 5.0 software. Results Sixteen RCTs involving 1 333 patients were included in this study. The results of meta-analyses showed that the total effective rate of the mesalazine group was significantly higher than that of the sulfasalazine group (RR=1.10, 95%CI 1.04 to 1.17, Plt;0.05), and significant differences were noted in the total remission rate (RR=1.82, 95%CI 1.14 to 2.91, Plt;0.05), while there was no significant difference in the relapse rate between the two groups (RR=0.86, 95%CI 0.57 to 1.29, Pgt;0.05). Twelve RCTs reported adverse effects and meta-analyses showed that the incidence of adverse effects was significantly lower in the mesalazine group than in the sulfasalazine group (RR=0.56, 95%CI 0.42 to 0.73, Plt;0.05). Conclusion Analyses show that mesalazine is much more effective and safe in the management of ulcerative colitis than sulfasalazine. However, there is a moderate risk of bias due to methodological quality problems in all 16 included RCTs, so more strictly-designed multi-centered randomized controlled trials with high quality in large-scale are needed to confirm this result.
Objective To identify the N6-methyladenosine (m6A)-related characteristic genes analyzed by gene clustering and immune cell infiltration in myocardial ischemia-reperfusion injury (MI/RI) after cardiopulmonary bypass through machine learning. Methods The differential genes associated with m6A methylation were screened by the dataset GSE132176 in GEO, the samples of the dataset were clustered based on the differential gene expression profile, and the Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis of the differential genes of the m6A cluster after clustering were performed to determine the gene function of the m6A cluster. R software was used to determine the better models in machine learning of support vector machine (SVM) model and random forest (RF) model, which were used to screen m6A-related characteristic genes in MI/RI, and construct characteristic gene nomogram to predict the incidence of disease. R software was used to analyze the correlation between characteristic genes and immune cells, and the online website was used to build a characteristic gene regulatory network. Results In this dataset, a total of 5 m6A-related differential genes were screened, and the gene expression profiles were divided into two clusters for cluster analysis. The enrichment analysis of m6A clusters showed that these genes were mainly involved in regulating monocytes differentiation, response to lipopolysaccharides, response to bacteria-derived molecules, cellular response to decreased oxygen levels, DNA transcription factor binding, DNA-binding transcription activator activity, RNA polymerase Ⅱ specificity, NOD-like receptor signaling pathway, fluid shear stress and atherosclerosis, tumor necrosis factor signaling pathway, interleukin-17 signaling pathway. The RF model was determined by R software as the better model, which determined that METTL3, YTHDF1, RBM15B and METTL14 were characteristic genes of MI/RI, and mast cells, type 1 helper lymphocytes (Th1), type 17 helper lymphocytes (Th17), and macrophages were found to be associated with MI/RI after cardiopulmonary bypass in immune cell infiltration. Conclusion The four characteristic genes METTL3, YTHDF1, RBM15B and METTL14 are obtained by machine learning, while cluster analysis and immune cell infiltration analysis can better reveal the pathophysiological process of MI/RI.
【摘要】 目的 评价舒林酸治疗结直肠息肉的有效性和安全性。 方法 计算机检索PubMed、Cochrane Iibrary、Embase、SCI、CNKI、万方、维普、CBM数据库。按Cochrane系统评价的方法评价纳入研究质量，并进行Meta分析。 结果 共纳入7个随机对照试验（RCT），共235例患者。Meta分析结果显示舒林酸治疗腺瘤性息肉病（FAP）在有效率、息肉消失率方面与安慰剂比较，差异无统计学意义（Pgt;0.05）；治疗散发性结肠腺瘤性息肉病（SCAP）在有效率、息肉消失率、腺瘤直径变化方面与安慰剂比较，差异有统计学意义（Plt;0.05）；舒林酸的不良反应多为消化道症状，与安慰剂比较差异有统计学意义（Plt;0.05）。 结论 系统评价结果显示舒林酸对于家族性FAP的疗效尚不确切，而对SCAP有一定的疗效。【关键词】结直肠息肉；舒林酸；有效性；不良反应；系统评价【Abstract】 Objective To assess the efficacy and safety of sulindac on colorectal polyps. Methods The literatures were searched from several databases including PubMed,Cochrane Iibrary,SCI,CNKI,Wanfang,VIP,and CBM. The quality of the researches was evaluated according to Cochrane systematic reviews, and the Meta analysis was performed. Results Seven RCT were enrolled with a total of 235 patients. Meta analysis showed that there was no significant difference in the effective rate and polyps disappearance rate of FAP between the two groups (Pgt;0.05). There were significant differences in the effective rate, polyps disappearance rate and size of adenomas between the two groups (Plt;0.05); the most common adverse event was the symptoms of digestive tract which differed much from that in the placebo group (Plt;0.05). Conclusion The therapeutic effect of sulindac on FAP is not sure, but it is effective on SCAP.