【摘要】 目的 報道1例靜脈滴注胺碘酮致肝腎功能不全患者。 方法 2010年10月收治1例擴張性心肌病患者，治療過程中使用胺碘酮注射液，導致嚴重的肝腎功能不全。系統查閱中國期刊全文數據庫及外文數據庫Pubmed、Embase建庫至2011年8月關于胺碘酮致肝腎功能不全的相關文獻，進行靜脈胺碘酮致肝腎功能不全的可能性評估，探索胺碘酮靜脈滴注致肝功能不全的的作用機制。 結果 根據查閱文獻結果分析，此患者靜脈注射胺碘酮致肝功不全的可能性高，Naranjo概率評分分別為7分。 結論 提出臨床醫師和臨床藥師應進行胺碘酮靜脈的藥學監護，高度的重視胺碘酮相關的不良反應，從而及時識別和防治胺碘酮所致肝腎功能不全，減少其不良預后。【Abstract】 Objective To report a case of hepatic and renal insufficiency induced by intravenous injection with amiodarone, and to evaluate the possibility of the adverse drug reaction. Methods A patient with dilated cardiomyopathy was admitted in October, 2010. During the procedure, the use of amiodarone hydrochloride injection made the patient suffer from liver and kidney dysfunction. We retrieved the literatures about liver and kidney toxicity of amiodarone from CNKI, Pubmed, and Embase (from the establishment of the databases to November 2011). We also ssessed the possibility of the adverse drug reaction, discussed the mechanism of amiodarone-induced hepatic insufficiency. Results According to the literature, There was a great possibility of hepatic insufficiency induced by amiodarone, and the total score of the Naranjo probability score was 7. Conclusion It is important to pay more attention to the pharmaceutical care of amidarone to timely recognize and effectively prevent or treat hepatic and renal insufficiency induced by intravenous injection with amiodarone.
【摘要】 目的 探討非諾貝特致藥品不良反應（ADRs）的一般規律和特點。 方法 檢索PubMed（1978年-2009年8月）、中國期刊全文數據庫CNKI（1980年-2009年8月）、中國生物醫學文獻數據庫CBMDise（1980年-2009年8月）非諾貝特所致ADRs文獻，進行統計、分析。 結果 非諾貝特致ADRs多發生在gt;40歲年齡段，與性別無顯著關聯；64例ADRs主要涉及骨骼肌肉系統、消化系統、泌尿生殖系統、過敏反應，及時處理者預后良好。 結論 臨床上應重視非諾貝特所致ADRs，及時處理。【Abstract】 Objective To analyse the clinical features, correlation factors, preventions and cures of (adverse drug reactions, ADRs) caused by fenofibrate. Methods The cases of ADRs caused by fenofibrate were collected and analyzed from Pubmed (1978 - August 2009), CNKI (1980 - August 2009) and CBMDise (1980 - August 2009). Results Fenofibrate-induced ADRs were mostly seen in patients over 40 years old, but which was independent for sex. Totally, 64 ADRs were involved in the skeletal musculature system, digestive system, urinogenital system, and allergic response. The prognosis was favorable. Conclusion More attention should be given to patients with fenofibrate and ADRs should be treated as soon as possibile.
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.
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 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.
【摘要】 目的 了解2007年-2008年成都地區17家醫院抗腫瘤藥物的使用情況。 方法 以銷售金額、用藥頻度（DDDs）對2007年、2008年成都地區17家醫院抗腫瘤藥物消耗數據進行分類統計、綜合分析、對比。 結果 2008年成都地區17家醫院抗腫瘤藥物用藥金額增長幅度較大，各亞類抗腫瘤藥物中其它類抗腫瘤藥物類、植物來源的抗腫瘤藥、抗代謝藥金額排序依次占前3位。銷售金額前100位藥物中，腫瘤藥物占據8位，大多數是其它類抗腫瘤藥物，且其用藥頻度也靠前。 結論 抗腫瘤藥物用藥金額和用藥量都將快速增長，其中其它類抗腫瘤藥物和植物來源的抗腫瘤藥的發展尤被看好。【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 irbesartan for hypertensive patients with hyperuricaemia. Methods The databases such as The Cochrane Library (Issue 2, 2010), MEDLINE (by the end of April 2010), SCI (by the end of April 2010), CBM (by the end of April 2010) and CNKI (by the end of April 2010) were searched to collected randomized controlled trails (RCTs) on irbesartan for hypertensive combined with hyperuricaemia. Studies were screened according to the inclusion and exclusion criteria; data were extracted; the methodological quality was evaluated; and meta-analyses were conducted by using RevMan 5.0.0 software. Results Nine studies involving 977 patients were included. The results of meta-analyses showed that compared with the control group, irbesartan was superior in decreasing serum uric acid (SUA) (MD=57.12, 95%CI 16.08 to 98.15, P=0.006); it was similar in controlling blood pressure (Systolic pressure: MD= –0.24, 95%CI –2.19 to 1.71, P=0.81; Diastolic pressure: MD=0.46, 95%CI –1.58 to 2.50, P=0.66), and lower in the incidence rate of adverse reaction (RR=0.07, 95%CI 0.02 to 0.24, P=0.000 1). Conclusion The study suggests that irbesartan is effective and safe to control blood pressure and decrease serum uric acid for hypertensive patients with hyperuricaemia. But because all nine included studies are graded C in quality, the conclusion still needs to be further verified by long-term, large scale and high quality studies.
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.
目的 評價卡培他濱+伊立替康與氟尿嘧啶/醛氫葉酸（5-FU/LV）+伊立替康治療轉移性結直腸癌的有效性和安全性。 方法 計算機檢索PubMed、CENTRAL、Embase、中國生物醫學數據庫、中國期刊全文數據庫、維普數據庫和萬方數據庫，檢索時間均從建庫至2011年9月。對符合納入標準的隨機對照試驗進行質量評價和Meta分析。 結果 納入3個隨機對照試驗，共計419例患者，卡培他濱+伊立替康在中位生存期、完全緩解率[RR=1.58，95%CI（0.27，9.11），P=0.61]、部分緩解率[RR=0.86，95%CI（0.68，1.09），P=0.20]、總有效率[RR=0.88，95%CI（0.71，1.09），P=0.26]上表現出與5-FU/LV+伊立替康相似的效果，安全性方面卡培他濱+伊立替康有較高的Ⅲ/Ⅳ級惡心[RR=1.92，95%CI（1.05，3.54），P=0.04]、腹瀉[RR=3.23，95%CI（2.14，4.89），P＜0.000 01]發生風險和較低的Ⅲ/Ⅳ級中性粒細胞減少[RR=0.72，95%CI（0.53，0.98），P=0.04]發生風險。 結論 根據當前現有證據，5-FU/LV+伊立替康可能較卡培他濱+伊立替康更為有利于轉移性結直腸癌患者的治療，但仍需結合臨床實際情況進行化療方案的優選。
【摘要】 目的 評價舒林酸治療結直腸息肉的有效性和安全性。 方法 計算機檢索PubMed、Cochrane Iibrary、Embase、SCI、CNKI、萬方、維普、CBM數據庫。按Cochrane系統評價的方法評價納入研究質量，并進行Meta分析。 結果 共納入7個隨機對照試驗（RCT），共235例患者。Meta分析結果顯示舒林酸治療腺瘤性息肉病（FAP）在有效率、息肉消失率方面與安慰劑比較，差異無統計學意義（Pgt;0.05）；治療散發性結腸腺瘤性息肉病（SCAP）在有效率、息肉消失率、腺瘤直徑變化方面與安慰劑比較，差異有統計學意義（Plt;0.05）；舒林酸的不良反應多為消化道癥狀，與安慰劑比較差異有統計學意義（Plt;0.05）。 結論 系統評價結果顯示舒林酸對于家族性FAP的療效尚不確切，而對SCAP有一定的療效。【關鍵詞】結直腸息肉；舒林酸；有效性；不良反應；系統評價【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.