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OBJECTIVE：To evaluate therapeutic e fficacy and safety of differen t doses of Secukinumab in the treatment of medium and severe ankylosing spondylitis （AS）， and to provide evidence-based reference for clinical treatment of AS. METHODS： Retrieved from Medline ， PubMed， Cochrane Library， Embase， VIP， CJFD， Wanfang database andpu- ClinicalTrials.gov， during the inception to March 2020， xiaofeng1205@outlook.com randomized controlled trials （RCTs）about different doses of secukinumab （75， 150， 300 mg） versus placebo in the treatment of medium and severe AS were collected. After data extraction of clinical studies met the inclusion criteria ，quality evaluation with Cochrane risk bias evaluation tool 5.1.0，Rev Man 5.3 statistical software was used for Meta-analysis of therapeutic efficacy [in the international society for the evaluation of spondyloarthritis scale ，the proportion of 20％ patients improved （ASAS20）；ASAS40；among 6 routine clinical areas related to AS，the scores of at least 5 areas improved by at least 20％，and there was no patients receiving treatment due to deterioration in other areas （ASAS 5/6）；remission value of Bath ankylosing spondylitis disease activity index （BASDAI）from baseline to 16th week，the proportion of the patients with the international society for the evaluation of ankylosing spondyloarthritis （ASAS PR ） score no higher than 2 in the 4 ASAS fields within the specified time] and safety [the incidence of withdrawal from treatment due to ADR，the incidence of serious ADR ，the incidence of general ADR （nasopharyngitis，headache，diarrhea）]. RESULTS ：A total of 5 RCTs were included ，involving 1 624 patients. Meta-analysis showed that ASAS 20 [total：OR＝2.62，95％CI（2.14，3.20），P＜ 0.000 01；75 mg：OR＝2.63，95％CI（1.28，5.40），P＝0.008；150 mg：OR＝2.58，95％CI（2.01，3.32），P＜0.000 01；300 mg：OR＝2.63，95％CI（1.37，5.06），P＝0.004]，ASAS40 [total：OR＝2.82，95％CI（2.13，3.74），P＜0.000 01；75 mg：OR＝ 3.14，95％CI（1.86，5.31），P＜0.000 1；150 mg：OR＝2.79，95％CI（1.85，4.20），P＜0.000 01；300 mg：OR＝2.73，95％CI （1.33，5.58），P＝0.006]，ASAS5/6 [total：OR＝3.82，95％CI（2.61，5.59），P＜0.000 01；75 mg：OR＝5.59，95％CI（3.29， 9.49），P＜0.000 01；150 mg：OR＝3.45，95％CI（2.08，5.70），P＜0.000 01；300 mg：OR＝3.85，95％CI（1.75，8.47），P＝ 0.000 8]，ASAS PR [total ：OR＝4.69，95％CI（3.07，7.16），P＜0.000 01；75 mg：OR＝5.48，95％CI（2.50，11.99），P＜0.000 1； 150 mg：OR＝3.71，95％CI（2.19，6.29），P＜0.000 01；300 mg：OR＝20.0，95％CI（2.58，155.14），P＝0.004] in trial group was significantly higher than control group ；BASDAI improvement [total ：WMD＝－1.15，95％CI（－1.50，－0.79），P＜0.000 01； 75 mg：WMD＝－1.40，95％CI（－2.08，－0.72），P＜0.000 1；150 mg：WMD＝－1.03，95％CI（－1.52，－0.54），P＜ 0.000 1；300 mg：WMD＝－1.20，95％CI（－2.03，－0.37），P＝0.005] of trial group were significantly higher than those of control group ，with statistical significance. The total incidence of nasopharyngitis in trial group [OR ＝1.77，95％CI（1.22，2.57）， P＝0.003] and 150 mg dose subgroup [OR ＝1.84，95％CI（1.18，2.86），P＝0.007] was significantly higher than control group ， without significant difference in other safety indexes among total and different dose subgroups （P＞0.05）. CONCLUSIONS ：75 mg，150 mg and 300 mg of secukinumab are all effective and well tolerated for medium and severe AS patients ，and 150 mg of secukinumab may increase the incidence of nasopharyngitis.
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Objective To systematically evaluate the safety and efficacy of probiotics in the treatment of severe acute pancreatitis (SAP).Methods The randomized controlled trials (RCTs) for studying probiotics in the treatment of SAP were retrieved from databases,including PubMed,Embase,Cochrane Library,Medline,Chinese Biomedical Literature Database (CBM),Chinese science and technology journal full-text database (VIP),China journal full-text database (CNKI),Wanfang academic journal fulltext database.The methodological quality of included literatures was evaluated,and statistical analysis was performed via RevMan5.3 software.Results A total of 12 pieces of RCT literatures including 910 cases of patients with SAP were included.The results of meta analysis indicated that no statistically significant difference was found in the mortality [RR =0.97,95 ％ CI(0.63,1.49),P=0.88],the incidence rate of multiple organ dysfunction [RR =0.72,95 ％ CI(0.49,1.06),P=0.10] and the incidence rate of pancreas-related infections [RR=0.76,95 ％ CI(0.54,1.07),P=0.12] between the probiotics group and the control group;while there were statistically significant differences in the length of hospital stay [MD =-3.74,95 ％ CI(-6.37,-1.12),P=0.005] and the incidence rate of intestinal ischemia necrosis [RR=11.39,95 ％ CI(1.5,86.4),P =0.02],Conclusion Probiotics could not improve clinical outcomes of patients with SAP,and may increase risk for intestinal ischemic necrosis.However,it could shorten the length of hospital stay.
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Objective To explore the protective effects and mechanism of shenmaisanjie capsule(SMSJC) combined with methimazole on the L?thyroxine? induced hyperthyroid hepatic damage in rats. Methods so rats were divided into 5 groups randomly as normal group,model group,SMSJC group(0.48 g/kg),methimazole group (12 mg/kg)and combination group. With the exception of the normal group ,all rats were administered L?thyroxine (800 μg/kg ,ig) daily for 6 weeks. Rats were sacrificed. Blood and liver samples were collected for detecting thyroid and liver function , histological analysis and hepatic activity of SOD , GSH?Px and MDA content. Results The levels of T3,T4,FT3,FT4,ALT,AST,ALP,TBIL in serum and hepatic MDA content declined significantly. Hepatic activity of SOD ,GSH?Px increased obviously. Liver morphologic changes improved in methimazole group and combination group,whereas no significant difference of serum FT3,FT4,TSH level and liver activities of SOD and GSH?Px was noticed in SMSJC group in comparison to model group. Compared with SMSJC or methimazole mono?therapy ,the effect of combination therapy was obvious. However ,serum TRAb level was not significantly different in five groups of rats. Conclusion SMSJC combined with methimazole plays a protective role on hyperthyroidism hepatic damage induced by L?thyroxine in rat. It is proposed that the effect is association with inhibiting hepatic oxidative stress.
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Objective To observe the effect of Yidutiaogan mixture on rat liver fibrosis induced by CCl4 complex factors. Methods Sixty SD rats were randomly divided into normal control group, model control group, colchicine group (0.2 mg·kg-1), Yidutiaogan mixture low-, medium-, and high-dose groups(2.7, 5.4, 10.8 mL·kg-1) (n=10).Except for normal control group, the other groups were given drinking water containing 10% ethanol, subcutaneous injection of 40%CCl4 in olive oil (3 mL·kg-1,twice weekly), and high-fat diet for 8 weeks as the model control group, and they were given relevant medicine intragastrically once a day during modeling. The rats were sacrificed, and the livers were harvested and stained with Masson staining to observe liver fibrosis. Serum levels of ALT, AST, ALP, ALB, HA, LN, PCⅢ, C-Ⅳ, and the levels of TIMP-1, MMP-1, MMP-2, MMP-13, and TGF-β1 in liver tissue were detected by biochemical assay, radioimmunoassay and ELISA. Results Compared with normal control group, serum levels of ALT, AST, ALP, HA, LN, PCⅢ, and C-Ⅳ were significantly increased in model control group, while serum level of ALB was significantly decreased (P<0.01); the levels of TIMP-1, MMP-2 and TGF-β1 in liver tissue were significantly increased, while the levels of MMP-1 and MMP-13 were significantly decreased (P<0.01).Compared with the model control group, serum levels of ALT, AST, HA, LN, PCⅢ, and C-Ⅳ as well as the levels of TIMP-1, MMP-2, and TGF-β1 in liver tissue were all significantly decreased in Yidutiaogan mixture medium-dose, high-dose, and colchicine groups( P<0.05);serum level of ALB as well as the levels of MMP-1 and MMP-13 in liver tissue were significantly increased(P<0.05).However, there was no statistical significance in above indexes in Yidutiaogan mixture low-dose group(P>0.05). Conclusion Yidutiaogan mixture could be used to prevent experimental hepatic fibrosis through regulating TIMPs/MMPs, suppressing TGF-β1 , reducing deposition of extracellular matrix in liver.
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Objective To observe the effect of Yidutiaogan mixture on rat liver fibrosis induced by CCl4 complex factors. Methods Sixty SD rats were randomly divided into normal control group, model control group, colchicine group (0.2 mg·kg-1), Yidutiaogan mixture low-, medium-, and high-dose groups(2.7, 5.4, 10.8 mL·kg-1) (n=10).Except for normal control group, the other groups were given drinking water containing 10% ethanol, subcutaneous injection of 40%CCl4 in olive oil (3 mL·kg-1,twice weekly), and high-fat diet for 8 weeks as the model control group, and they were given relevant medicine intragastrically once a day during modeling. The rats were sacrificed, and the livers were harvested and stained with Masson staining to observe liver fibrosis. Serum levels of ALT, AST, ALP, ALB, HA, LN, PCⅢ, C-Ⅳ, and the levels of TIMP-1, MMP-1, MMP-2, MMP-13, and TGF-β1 in liver tissue were detected by biochemical assay, radioimmunoassay and ELISA. Results Compared with normal control group, serum levels of ALT, AST, ALP, HA, LN, PCⅢ, and C-Ⅳ were significantly increased in model control group, while serum level of ALB was significantly decreased (P<0.01); the levels of TIMP-1, MMP-2 and TGF-β1 in liver tissue were significantly increased, while the levels of MMP-1 and MMP-13 were significantly decreased (P<0.01).Compared with the model control group, serum levels of ALT, AST, HA, LN, PCⅢ, and C-Ⅳ as well as the levels of TIMP-1, MMP-2, and TGF-β1 in liver tissue were all significantly decreased in Yidutiaogan mixture medium-dose, high-dose, and colchicine groups( P<0.05);serum level of ALB as well as the levels of MMP-1 and MMP-13 in liver tissue were significantly increased(P<0.05).However, there was no statistical significance in above indexes in Yidutiaogan mixture low-dose group(P>0.05). Conclusion Yidutiaogan mixture could be used to prevent experimental hepatic fibrosis through regulating TIMPs/MMPs, suppressing TGF-β1 , reducing deposition of extracellular matrix in liver.
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Objective To analyze the usage of basic drugs in non-primary health care institutions in Luzhou,Sichuan,to comment on the performance of the basic drug system,and to provide reference data for relevant ministries and departments.Methods To collect and to statistically analyze the data of the categories and sales amount of the basic drugs used by three level-3A health care institutions and nine level-2 health care institutions from Jan 1,2010 to Dec 31,2012. Results The purchasing proportion of the basic drugs in the level-3A institutions for 2010,2011,and 2012 are respectively 15.62%,17.84%,20.01%;similarly,the data for the level-2A institutions are respectively 29.35%,32.16%,35.07%;the data for the level-2B institutions are respectively 34.73%,37.05%,40.02%.The sales proportion ofthe basic drugs for the years of2010,2011,and 2012 are respectively 10.43%,12.38%,15.04% for the level-3A institutions,25.08%,27.24%,30.12% for the level-2A institutions,and 29.24%,32.08%,35.03%for the level-2B institutions.Conclusion Non-primary health care institutions should firmly execute the basic drug system, enhance the propaganda of this policy,try to increase the purchasing proportion of the basic drugs,supervise the prescription behavior of the doctors, and optimize the basic drug index in order to use drugs more appropriately and efficiently.
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Objective To explore effects of shuanghuanglian combined with levofloxacin on antibiotic resistance of Staphylococcus Aureus ATCC29213 to levofloxacin. Methods Tissue cage infection model with Staphylococcus aureus was established in rabbits, and the infected animals were given with levofloxacin alone ( group A ) or in combination with shuanghuanglian ( group B) for 5 days respectively. Steady-state concentration of levofloxacin in tissue cage, bacteria recovery and bacterial resistance in tissue cage infection model were studied. Results Steady-state concentration of levofloxacin in tissue cage was not significantly different between group A and group B. The recovery rate of bacteria was significantly lower in group B than in group A (20. 0% vs. 100. 0%). The minimum inhibitory concentration (MIC) was lower in group B than in group A. Conclusion Shuanghuanglian combined with levofloxacin is helpful to reduce antibiotic resistance of Staphylococcus aureus to levofloxacin, indicating that some Chinese traditional medicine combined with antibiotics can reduce antibiotic resistance.
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OBJECTIVE:To establish a HPLC method for the determination of both chloramphenicol and furacillin in compound chloramphenicol auristillae.METHODS:The determination was performed on Tianhe Kromasil C18 column,the mobile phase consisted of methanol-water(60∶40) with flow speed at 1.0ml/min,detection wavelength at 278nm,column temperature at 25℃,and sample size at 20?l.The dexamethasone was used as internal standard.RESULTS:The linear ranges for chloramphenicol and furacillin were 31.75～127?g/ml and 26.25～105?g/ml,respectively;The average recovery rates were 100.4%(RSD=0.89%) and 100.7%(RSD=1.20%),respectively.CONCLUSION:This method is simple in operation,accurate and reliable in determination results and it can be used for the quality control of compound chloramphenicol auristillae.
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OBJECTIVE:To establish UV-spectrophotometry method for the determination of melatonin in the compound melatonin capsules.METHODS:The UV-spectrophotometry was adopted with the detection wavelength at277nm.RESUL_ TS:There was a good linear relationship between melatonin and its absorbability(r=0.9996)within the concentration range of5～25?g/ml.The average recovery was96.49%(RSD=1.21%,n=6).CONCLUSION:The method is accurate,reliable,convenient and stable.
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OBJECTIVE:To establish a HPLC method for the content determination of testosterone propionate in testosterone propionate paints.METHODS:The assaying was conducted on a Kromasil C 18 column with methanol-water solution(80∶20)as mobile phase,the detection wavelength was254nm and the flow rate was1.0ml/min.RESULTS:The linear concentration range of the testosterone propionate was100～400mg/ml(r=0.9997)with average recovery rate at98.5%(RSD=0.55%).CONCLUSION:The method is simple,accurate and reproducible,and it can be used for the quality control of testosterone propionate paints.
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OBJECTIVE:To try to establish a combined serum-pharmacology and electrophysiology method for the study of mechanism of chuanxiong extract in dilatating coronary artery.METHODS:Chuanxiong extract was intragastrically given to rats and mice,then the serum contents of tetramethylpyrazine(TMP)were determined by HPLC,which provided data for electrophysiological study.The action of chuanxiong extract on Ca 2+ -activated K channel(Kca)of smooth muscle of coronary artery in pigs was studied by patch clamp technique.RESULTS:The calibration curve of TMP was linear in the range of0.216～54?g/ml(r=0.9999).The recovery was100.7%～102.4%.The serum concentrations of TMP in rats and mice were(3.56?3.01)and(8.19?6.57)?g/ml respectively.The chuanxiong extract could not markedly activate the Kca of smooth muscle of coronary artery in patch clamp study.CONCLUSION:The established method for TMP determination is feasible and relieable.In order to improve the combined electrophysiology and serum pharmacology technique,high quality medical materials should be adopted and the bioavailability improved.