ABSTRACT
To find antibacterial candidate compounds, eighteen novel sulfonamide derivatives containing a fused-ring were designed and synthesized on the basis of previous studies, with structures confirmed by 1H NMR, 13C NMR and MS. Antibacterial activities of the products were evaluated by the agar dilution method. The results show that these derivatives have different degrees of inhibitory activity on the tested bacteria, with the compounds IIi and IIr the most potent. The MIC of IIi for S. aureus, E. coli and MRSA was 8, 32 and 16 μg·mL-1, respectively, and the MIC of the IIr was 8, 64 and 32 μg·mL-1, respectively. The anti-MRSA activities of the two compounds is significant and is worthy of further structural optimization and study.
ABSTRACT
Objective To analyze the effectiveness and safety of chest pain centers in the management of patients with acute chest pain.Methods The clinical data of 315 patients with acute chest pain who presented to the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine from January 2012 to December 2016 were retrospectively analyzed.The chest pain center of our hospital was established in December 2014.A total of 123 patients with acute chest pain who were treated before the establishment of the chest pain were included as the control group.From December 2014 to December 2016,192 patients with chest pain were admitted and included as the observation group.The percentages of acute myocardial infarction and patients receiving emergency intervention(percutaneous coronary intervention,PCI),the door-to-balloon(D to B)time,average length of hospital stay and rates adverse events between the two groups were compared.Results The percentages of acute myocardial infarction among patients with acute chest pain was 75.6％in the control group and 82.3％in the observation group(P=0.027).The emergency PCI rate was 83.9％in the control group and 92.4％in the observation group(P=0.001).The door-to-balloon time was(64.12±34.76)min in the control group and(58.08±16.26)min in the observation group(P=0.025).The average length of hospital stay was(10.09±4.03)days for the control group,and(7.41±3.78)days for the observation group(P=0.025).There was no statistical difference in the incidence of recurrent myocardial infarction between the 2 groups(P＞0.05).The rates of sudden cardiac death,heart failure,cardiogenic shock and adverse events were all significantly higher in the control group(all P＜0.05).Conclusions The establishment of chest pain center provides safer and more effective treatment to patients with acute chest pain.
ABSTRACT
Clopidogrel was believed to be superior to aspirin by the well-known CAPRIE trial. However, no other large clinical trials demonstrated the same results, but all focused on the combina-tion use of clopidogrel with aspirin, and combination therapy in CREDO was called the "Emperor's New Clothes". However, no one overturned the results of these clinical trials by quantitatively ana-lyzing them. We reviewed ten large-scale clinical trials about clopidogrel. On the basis of results of CAPRIE, CREDO and CHARISMA trials, we re-estimated their minimal sample sizes and their powers by three well-established statistical methodologies. From the results of CAPRIE, we inferred that the minimal sample size should be 85 086 or 84 968 but its power was only 30.70%. A huge gap existed. The same was also true of CREDO and CHARISMA trials. Moreover, in CAPRIE trial, 0 was included in the 95% confidence interval and 1 was included in the 95% confidence interval for the relative risk. There were some paradoxical data in CAPRIE trial. We are led to conclude that the results in CAPRIE, CREDO, and from the subgroup analysis in CHARISMA trials were questionable. These results failed to demonstrate that clopidogrel was superior to aspirin or that clopidogrel used in combination with aspirin was better than aspirin alone. The cost-effectiveness analyses by some pre-vious studies were not reliable.