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Objective:To explore the clinical application and long-term safety of hydroxychloroquine sulfate (HCQ) in the treatment of rheumatic diseases.Methods:A multi-center cross-sectional study was conducted between August 2017 and August 2018 in a random sample of eleven medical institutions of rheumatology and immunology in China. Patients who took HCQ for more than 3 months were enrolled into this study. The cumulative dose and long-term side effects of HCQ were recorded. The changes of laboratory indexes before and after treatment with HCQ were analyzed. Categorical variables were presented with counts and proportions, and evaluated by Chi-square test. Continuous parametric data were presented as Mean±standard deviation, and evaluated by Student's t test or Mann-Whitney U test. P-values less than 0.05 were considered statistically significant. Results:A total of 886 patients with rheumatic diseases were enrolled into this study, including 505 cases with systemic lupus erythematosus (57.0%), 210 cases with rheumatoid arthritis (23.7%), 80 cases with Sj?gren's syndrome (9.0%), 57 cases with undifferentiated connective tissue disease (6.4%), 12 cases of systemic vasculitis (1.4%), 10 cases of mixed connective tissue disease (1.1%), 7 cases of myositis (0.8%) and 5 cases with systemic sclerosis (0.6%). The most common long-term side effects of HCQ was skin or mucous lesions (12.4%) and vision problems (8.0%). Other adverse reactions included problems of digestive system (3.0%), nervous system (2.1%), musculoskeletal system (1.1%) and cardiovascular system (0.9%). 140 cases (15.8%) had stopped taking HCQ during the treatment. More than half of them decided to stop taking medicine by themselves. Fifty-four patients (6.1%) stopped using HCQ due to side effects while 24 of them took it again, and another 12 patients (1.4%) stopped the drug due to remission of illness. Patients were divided into three groups according to the cumulative dose of HCQ: less than 500 g, 500-1 000 g and more than 1 000 g respectively. There was significant difference in the incidence of long-term side effects among the three groups ( χ2=6.382, P=0.041). The last group (more than 1 000 g) suffered the highest incidence of long-term adverse reactions (37.1%). No severe adverse drug reactions were observed in this study. Conclusion:Hydroxychloroquine is widely used in the treatment of rheumatic diseases. The incidence of long-term side effects is 20.4%, is 6.1% lead to drug withdrawal, which are especially related to the cumulative doses. It should be adjusted properly according to the clinical application.
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Objective To evaluate the effect of Tandospirone citrate in the treatment of Alzheimer's disease with depression and anxiety disorder. Methods A total of 122 patients with Alzheimer's disease with depression and anxiety were enrolled at the Second Hospital of Jinhua City from January 2015 to December 2016.They were randomly divided into the Lorazepam group(n=61) and the Tandospirone citrate(ADHA)(n= 61).The behavioral pathology in Alzheimer's disease (BEHAVE-AD),self-care ability scale(ADL),Hamilton anxiety scale(HAMA)and Hamilton depression scale(HAMD)were evaluated in the two groups after three weeks of treatment.The BEHAVE-AD,ADL,HAMA,and HAMD scores and the incidence of adverse reactions were compared between the two groups before and after treatment. Results Baseline scores of BEHAVE-AD, ADL,HAMA and HAMD were not significantly different between the two groups(all P> 0.05). However,post-treatment scores of BEHAVE-AD,ADL,HAMA and HAMD were significantly lower than pre-treatment scores(all P< 0.05),and were more significantly decreased in the Tandospirone citrate group(all P<0.05).Furthermore,the incidence of adverse reactions was significantly lower in the Tandospirone citrate group than that in the Lorazepam group(6.5% vs.19.7%,P< 0.05). Conclusions Compared with Lorazepam,Tandospirone citrate is clinically more effective for Alzheimer's disease complicated with anxiety and depressive disorder.
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Objective To investigate efficacy in Alpmstadil and Shenkang on regulating renal function and lipids in patients with chronic renal failure (CRF).Methods Ninety-eight cases of CRF patients were collected for the study,and 1:1 randomized,double-blind experiment grouping principles were used in the current study.All cases were divided into study group and the control group (49 cases of each group).The two group were given the high quality low protein,low fat low salt diet,inftion control,diuretic swelling,correct acidosis,buck,correction of electrolyte imbalance and other conventional treatment.The patients in study group on the basis of conventional therapy were given 20 g Alprostadil injection + 100 ml saline,intravenous infusion of 1times/d,and 100 ml Shenkang injection +300 ml 5％ glucose the solution,intravenous infusion of 1 times/d.While patients of control grrup on the basis of conventional therapy plus 200 mg Ligustrazine + 250 ml 5％Glucose Injection,intravenous infusion of 1times/d.Two groups were treated for 14 d.Before and after treatment,renal function,lipid metabolism,adverse drug reactions were observed and determined.Results There was no significant difference in term of renal function between two groups before treatment(P ＞ 0.05).After treatment,the levels of serum creatinine,blood urea nitrogen,24 h-Urine protein and creatinine clearance(Ccr) in study group were (313.7 ±66.2) mmol/L,(15.3 ±2.9) mmol/L,(1.24 ±0.45) g/24 h and (35.7 ±5.4) mmol/L respectively,significant different from those in control group ((358.4 ± 53.9) mmol/L,(18.4 ± 3.0) mmol/L,(1.57 ±0.39) g/24 h and (28.4 ±4.3) mmol/L;t =3.754,7.864,5.873,4.312,P ＜0.05).There was no significant difference in term of blood fat between two groups before treatment (P ＞ 0.05).In study group,the levels of glycerin trilaurate,cholesterol total,high density hpoprotein cholesterol,low density lipoprotein cholesterol were significantly different than those in the control group ((2.12 ± 1.26) mmol/L vs.(2.32 ± 1.34) mmol/L,(4.91 ± 1.43) mmol/vs.(5.35 ± 1.31) mmol/L,(1.39 ± 0.43) mmol/L vs.(1.23±0.37) mmol/L,(2.39 ± 0.68) mmol/L vs.(2.73 ± 0.88) mmol/L; t =3.876,4.661,5.387,8.543 ; P ＜ 0.05) after treatment.There were no adverse drug reactions in both groups.Conclusion Combined usage of alprostadil and shenkang injection could significantly improve the patient's renal function,lipid metabolism disorders and shows no significant adverse reactions,suggesting that it is worthy of clinical application and promotion.