ABSTRACT
Network Meta-analysis was used to compare the efficacy and safety of Chinese patent medicines in the treatment of unstable angina pectoris. PubMed, Cochrane Library, CNKI, Wanfang, VIP and other databases were retrieved by computers from the establishment of the databases to June 2020. Randomized controlled trials(RCTs) of Chinese patent medicines for the treatment of unstable angina pectoris were collected. Two investigators independently screened out the literatures, and extracted data according to the inclusion and exclusion criteria. The quality of the included RCTs was evaluated according to the bias risk assessment tool recommended by the Cochrane System Reviewer Manual, and the Stata 13.0 software was used for data analysis and mapping. Through screening, 28 eligible studies were finally included, with the sample size of 2 885 cases, involving 8 Chinese patent medicines. The results of the network Meta-analysis showed that in terms of total effective rate for angina symptom improvement, the order was as follows: Shenshao Capsules > Naoxintong Capsules > Ginkgo Ketone Ester Dripping Pills > Compound Danshen Dripping Pills > Ginkgo Leaf Tablets > Shexiang Baoxin Pills > Tongxinluo Capsules > Yindan Xinnaotong Soft Capsules; in terms of total effective rate for ECG curative effect, the order was as follows: Ginkgo Ketone Ester Dripping Pills>Compound Danshen Dripping Pills > Tongxinluo Capsules > Shenshao Capsules > Shexiang Baoxin Pills > Yindan Xinnaotong Soft Capsules; in terms of hypersensitivity-C-reactive protein curative effect, the order was as follows: Tongxinluo Capsules > Shenshao Capsules > Ginkgo Leaf Tablets>Compound Danshen Dropping Pills> Shexiang Baoxin Pills > Naoxintong Capsules > Yindan Xinnaotong Soft Capsules > Ginkgo Ketone Ester Dropping Pills. Chinese patent medicine combined with conventional therapy can improve the clinical efficacy of unstable angina pectoris. Due to the differences in the quantity and quality of the included studies, the order results of Chinese patent medicines need to be further verified.
Subject(s)
Humans , Angina, Unstable/drug therapy , China , Drugs, Chinese Herbal , Medicine, East Asian Traditional , Network Meta-Analysis , Nonprescription DrugsABSTRACT
This paper was aimed to observe the interventional effect of Sedum sarmentosum total flavanones on hepatic fibrosis and its possible mechanism through the subcutaneous injection of CCl_4 in rats. Sixty male SD rats were randomly divided into normal control group, model group, low-dose, medium-dose, high-dose S. sarmentosum total flavanones groups(100, 200, 400 mg·kg~(-1)) and silymarin group(200 mg·kg~(-1)). The model of liver fibrosis was established by subcutaneous injection of rats with 40% CCl_4. After the modeling, the drug groups were intragastrically administered with corresponding drugs once a day for consecutively five weeks, while the normal group and the model group were given 0.9% sodium chloride solution during the same period. After the experiment, the general conditions of rats and the pathological changes of liver tissues were observed, and the contents of serum ALT, AST, HA and LN were measured. Besides, the expressions of the protein and relevant mRNA of Smad2/3, Smad4 and α-SMA in rats were detected. Compared with model group, S. sarmentosum total flavanones could significantly increase the rats' body weight, inhibit the increase of liver and spleen index in rats of liver fibrosis, reduce the levels of ALT, AST, HA and LN, and alleviate pathological changes. Meanwhile, compared with the model group, the protein expressions of Smad2/3, Smad4 and α-SMA as well as relevant mRNA expressions in S. sarmentosum total flavanones group were obviously decreased, while Smad7 expression was markedly increased. As a result, S. sarmentosum total flavanones could significantly alleviate CCl_4-induced liver fibrosis, and its anti-hepatic fibrosis mechanism may be related to intervention with Smads pathway, so as to inhibit the activation of HSC.
Subject(s)
Animals , Male , Rats , Carbon Tetrachloride , Drugs, Chinese Herbal/therapeutic use , Flavanones/therapeutic use , Hepatic Stellate Cells/drug effects , Liver , Liver Cirrhosis/drug therapy , Rats, Sprague-Dawley , Sedum/chemistry , Signal Transduction , Smad Proteins/metabolismABSTRACT
Objective To observe the curative effect of plasma perfusion (PP) combined with continuous veno-venous hemofiltration (CVVH) on different degrees of paraquat poisoning induced acute lung injury (ALI), and assess its clinical value for treatment of paraquat poisoning. Methods Data of 197 patients with paraquat poisoning hospitalized in our hospital from June 2013 to April 2017 were retrospectively analysed, including 128 cases with mild-to-moderate poisoning (5 mg·h/L≤SIPP≤25 mg·h/L) and 69 cases with severe poisoning (25 mg·h/L<SIPP≤50 mg·h/L). Patients were divided into treatment group and control group according to the treatment of PP and CVVH. The incidence rate and time of irreversible lung injury were compared between the two groups of patients. Results (1) In patients with mild-to-moderate poisoning, the incidence rate of lung injury was significantly lower in treatment group than that of control group (P<0.05). In patients with severe poisoning there was no significant difference in the incidence rate of lung injury between two groups ( P>0.05). (2) There was no significant difference in the occurrence time of irreversible lung injury between two groups of patients with different degrees of poisoning (P>0.05). (3) The blood toxicant concentration of 4.35 mg·h/L and SIPP value 19.35 mg·h/L were used as a critical indicator of prognosis in treatment group. Conclusion Plasma perfusion combined with continuous veno-venous hemofiltration can obviously reduce the incidence of paraquat poisoning of lung injury in mild-to-moderate patients, but which has no obvious influence on the occurrence time.
ABSTRACT
Objective:To observe influence of benazepril combined trimetazidine on blood levels of follistatin-like 1 (FSTL1)and platelet activating factor (PAF)and vascular endothelial function in patients with coronary heart dis-ease (CHD)complicated heart failure (HF).Methods:A total of 120 CHD patients with chronic heart failure were selected from our hospital.They were randomly and equally divided into benazepril group and combined treatment group (received benazepril combined trimetazidine therapy),both groups were treated for six months.Serum Blood levels of N-terminal pro brain natriuretic peptide (NT-proBNP),FSTL1 and PAF,endothelial progenitor cells (EPCs)count and fore brachial artery endothelium dependent diastolic-systolic function (FMD)before and after treatment were measured and compared between two groups.Results:Compared with before treatment,there were significant rise in left ventricular ejection fraction (LVEF),6min walking distance (6MWD),EPCs and FMD,and significant reductions in serum levels of NT-proBNP,FSTL1 and PAF after treatment in two groups,P <0.05 or <0.01;compared with benazepril group,there were significant rise in LVEF [(41.94±9.19)% vs.(46.15±10.04)%], 6MWD [(333.94±58.29)m vs.(383.14±77.84)m],EPCs [(0.059±0.029)pg/ml vs.(0.083±0.014)pg/ml]and FMD [(7.53±2.02)% vs.(8.24±1.42)%],and significant reductions in serum levels of NT-proBNP [(2.74±0.69) ng/ml vs.(2.05±0.34)ng/ml],FSTL1 [(5.38±1.29)ng/ml vs.(4.64±0.84)ng/ml]and PAF [(5.16±0.92)μg/ml vs.(4.20±1.05)μg/ml]in combined treatment group,P <0.05 or <0.01.Conclusion:Benazepril combined trimeta-zidine can effectively reduce blood levels of NT-proBNP,FSTL1 and PAF,and promote vascular endothelial function re-covery in patients with coronary heart disease complicated chronic heart failure.
ABSTRACT
Objective:To observe influence of benazepril combined trimetazidine on blood levels of follistatin-like 1 (FSTL1)and platelet activating factor (PAF)and vascular endothelial function in patients with coronary heart dis-ease (CHD)complicated heart failure (HF).Methods:A total of 120 CHD patients with chronic heart failure were selected from our hospital.They were randomly and equally divided into benazepril group and combined treatment group (received benazepril combined trimetazidine therapy),both groups were treated for six months.Serum Blood levels of N-terminal pro brain natriuretic peptide (NT-proBNP),FSTL1 and PAF,endothelial progenitor cells (EPCs)count and fore brachial artery endothelium dependent diastolic-systolic function (FMD)before and after treatment were measured and compared between two groups.Results:Compared with before treatment,there were significant rise in left ventricular ejection fraction (LVEF),6min walking distance (6MWD),EPCs and FMD,and significant reductions in serum levels of NT-proBNP,FSTL1 and PAF after treatment in two groups,P <0.05 or <0.01;compared with benazepril group,there were significant rise in LVEF [(41.94±9.19)% vs.(46.15±10.04)%], 6MWD [(333.94±58.29)m vs.(383.14±77.84)m],EPCs [(0.059±0.029)pg/ml vs.(0.083±0.014)pg/ml]and FMD [(7.53±2.02)% vs.(8.24±1.42)%],and significant reductions in serum levels of NT-proBNP [(2.74±0.69) ng/ml vs.(2.05±0.34)ng/ml],FSTL1 [(5.38±1.29)ng/ml vs.(4.64±0.84)ng/ml]and PAF [(5.16±0.92)μg/ml vs.(4.20±1.05)μg/ml]in combined treatment group,P <0.05 or <0.01.Conclusion:Benazepril combined trimeta-zidine can effectively reduce blood levels of NT-proBNP,FSTL1 and PAF,and promote vascular endothelial function re-covery in patients with coronary heart disease complicated chronic heart failure.
ABSTRACT
Objective To investigate the feasibility of using low Kv,low iodine contrast Agent concentration (dual low)CT scan techniques in Coronary CTA (CCTA).Methods Seventy-six patients undergoing CCTA were divided into Group A and Group B , randomly.Group A (38 patients)was the dual-low group,which was scanned with tube voltage of 100 kVp,and injected with iso-osmolarity contrast agent visipaque 270 (270 mg I/mL),with iterative reconstruction technique (ASIR 40%).Group B (38 pa-tients)was scanned with 120 kVp,and low osmolarity contrast agent omnipaque 350 (350 mg I/mL)and FBP reconstruction,The images are assessed double-blindly by two experienced radiologists.Five ROIs were placed onto the ascending root of aorta (AO), left main artery(LM),left anterior descending (LAD),left circumflex artery(LCX),right coronary artery (RCA),and the image qualities are evaluated objectively using CT values,noise,signal noise ratio (SNR),contrast noise ratio (CNR),and compared sta-tistically using Paired t-test.The radiation dosages,such as CTDIvol,DLP and ED were also recorded and compared with Paired t-test.Results CTDIvol,DLP and ED of Group A (dual low)decreased 35.7%,38.6% and 38.6% respectively compared with Group B,the iodine intake decreased 22.9%.While the image qualities of the two groups were not significantly different,all images are good enough for diagnosis,with Group A slightly better than Group B in radiologists’scores.Conclusion Voltage 100 kVp, combined with low contrast agent concentration of 270 mg I/mL can fully satisfy the diagnostics need in CCTA,and significantly lower both the radiation dosage and iodine intake.
ABSTRACT
<p><b>OBJECTIVE</b>To compare the long-term efficiency between preoperative radiotherapy or radiochemotherapy followed by lower-anterior resection and abdominoperineal resection (APR) for lower and locally advanced rectal cancer.</p><p><b>METHODS</b>From January 1983 to December 2000, 157 consecutive patients suffering from lower rectal cancer were enrolled in the study, which included 69 cases of clinical stage II and 88 cases of stage III respectively. All patients were divided in to three groups. Patients in group A (n=52) received preoperative radiotherapy with a total dose of 35-45 Gy within 4-5 weeks plus preoperative chemotherapy with 5-fluorouracil (5- FU) followed by lower-anterior resection; patients in group B (n=51) received radiotherapy followed by lower-anterior resection; patients in group C (n=54) received APR only. Clinical data of all patients were reviewed retrospectively.</p><p><b>RESULTS</b>The follow-up rate was 91.7%. The 5- year survival rate was higher in group A (71.1%) than those in group B (47.1%) and group C (42.6%)(P< 0.05). The tumor- free survival rate was higher in group A (61.5%) than those in group B (37.3%) and group C (35.2%)(P< 0.05). The local recurrence rate was 13.5%, 15.7% and 11.1% in group A, B and C respectively, there was no significant difference in recurrence rate among three groups (P> 0.05). The distant metastasis rate was lower in group A (23.1%) than those in group B (49.0%) and group C (46.3%)(P< 0.05), but there was no significant difference in distant metastasis rate between group B and group C.</p><p><b>CONCLUSIONS</b>The combined preoperative radiochemotherapy followed by lower-anterior resection can improve the 5-year survival rate and tumor-free survival rate, and decrease distal metastasis rate.</p>