ABSTRACT
OBJECTIVE To systematically review the efficacy and safety of tranexamic acid （TXA） for hemostasis in cancer patients before and during surgery， and to provide evidence-based reference for clinical drug use. METHODS Retrieved from PubMed， Embase， the Cochrane Library， CNKI， VIP and Wanfang databases， randomized controlled trials （RCTs） about tranexamic acid （trial group） versus 0.9% Sodium chloride injection， Lactated Ringer’s solution， Compound electrolyte solution or placebo （control group） for cancer surgery were electronically searched from the inception to June 9， 2022. After literature screening and data extraction， the quality of included RCTs were evaluated by bias risk assessment tool recommended by Cochrane system evaluator manual 5.1.0. RevMan 5.3 software was used for meta-analysis or descriptive analysis， sensitivity analysis and publication bias analysis. RESULTS A total of 2 032 patients in 22 RCTs were included for meta-analysis. Results of meta-analysis showed that the blood transfusion rate [RR＝0.59， 95%CI （0.50， 0.69）， P＜0.000 01] and the volume of erythrocyte suspension infusion [MD＝－0.53， 95%CI （－0.92， －0.14）， P＝0.007] in trial group were significantly lower than control group； there was no statistical significance in the incidence of thromboembolic events [RR＝0.44， 95%CI （0.16， 1.17）， P＝0.10] or post-operative mortality [RR＝1.27， 95%CI（0.32，5.08）， P＝0.73] between two groups. Results of descriptive analysis showed that the total blood loss and postoperative drainage volume were still controversial between two groups. The results of sensitivity analysis showed that the results were basically stable. The results of publication bias analysis showed that there was little possibility of publication bias in this study. CONCLUSIONS TXA can significantly decrease the blood transfusion， reduce the volume of erythrocyte suspension infusion， whereas does not increase the incidence of thromboembolic events and post-operative mortality in cancer surgery.
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Objective To select and analyze the drug types for treatment of patients with diabetes in the older adults.Methods The clinical data including age,gender,disease duration,drugs (types and frequency) for 320 elderly cases with diabetes were retrospectivly analyzed Results With aging,duration of diabetes had been extended(P＜0.05),but no difference between the sex ratio.The frequency of insulin (32.2％) and metformin (29.7％)were the highest in the selective therapy for senile diabetes patients.But other types of drugs such as alpha glycosidase inhibitor (19.4 ％),sulfonylureas for promoting secrete (10.9 ％) and thiazolidinedione (7.8 ％) also occupied certain proportion.Conclusions The metformin has been widely applied for senile diabetes patients,and it is usually need to be in combination with other drugs and be paied more attention to monitoring in the whole process.
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Objective To understand the compliance of antihypertensive drug use in patients with hypertension.Methods A retrospective analysis was conducted among 218 patients with hypertension to understand their drug use compliancy and influencing factors,including side effect of the drugs,drug type,educational level,economic status and drug use length.Results The factors including disease course,drug type,drug use length and drug side effects,the economy status,educational level,awareness of hypertension related knowledge and psychological reaction could significantly influence the compliance of antihypertensive drug use.Among the patients surveyed,86.67％ of them with poor drug use compliance had only an educational level less than senior high school,77.33％ had poor awareness of hypertension related knowledge.Conclusion The antihypertensive drug use compliance in patients with hypertension is directly related to the outcome of the disease in clinical treatment.It is necessary to take effective measures to improve the treatment compliance and maintain normal blood pressure level of the patients.