ABSTRACT
OBJECTIVE:To evaluate the effectiveness of mifepristone in the treatment of abnormal uterine bleeding in Chinese women during perimenopause period,and to provide evidence-based reference in clinic.METHODS:Retrieved from CJFD,SinoMed,VIP,Wanfang database,randomized controlled trials (RCTs) about mifepristone in the treatment of abnormal uterine bleeding in Chinese women during perimenopause period were collected,data extraction was conducted for clinical studies meeting inclusion criteria.Meta-analysis was conducted by using Stata 8.0 statistical software after quality evaluation with Cochrane manual 5.1.0.RESULTS:A total of 49 RCTs were included,involving 5 082 patients.Meta-analysis showed that the response rate of mifepristone high-dose group (12.5 mg/d)was significantly higher than that of mifepristone low-dose group (≤ 6.5 mg/d)[OR=2.13,95％ CI(1.53,2.97),P＜0.001],and response rate of mifepristone group was significantly higher than that of progesterone drug group [OR=6.05,95％CI(3.92,9.34),P＜0.001].There was no statistical significance in response rate between mifepristone group and estrogen drug group [OR=1.52,95％ CI (0.45,5.16),P=0.499].CONCLUSIONS:Mifepristone is better than progesterone drug and similar to hormone drug in the treatment of abnormal uterine bleeding during perimenopause period.High-dose of mifepristone is better than low-dose of mifepristone in the treatment of abnormal uterine bleeding during perimenopause period.
ABSTRACT
OBJECTIVE:To provide reference for safe use of sunitinib in clinic. METHODS:Using"sunitinib""ADR"as re-trieval words,retrieved from PubMed,VIP,CNKI and Wanfang database during Jan. 2006-Mar. 2017,case reports and case series reports about sunitinib-induced ADR were collected and screened. In retrospective study,general information of patients,disease in-formation,involved organs or systems,clinical manifestations,ADR association evaluation and outcomes were analyzed statistical-ly. RESULTS:A total of 57 literatures were included,involving 66 cases,among which there were 15 new ADR. There were 34 male(51.52％)and 32 female(48.48％),with ratio of 1.06:1. Average age of patients was(63.4±10.5)years old. Sunitinib was mainly used for suprarenal epithelioma, accounting for 65.15％;followed by gastrointestinal stromal tumors, accounting for 21.21％. The incidence of ADR was the highest during 8-14 d(27.27％)and 22-28 d(22.73％)of medication. Organs/systems in-volved in ADR mostly were endocrine system(accounting for 25.76％). Main clinical manifestation was hypothyroidism,followed by diseases of skin and subcutaneous tissue(21.21％),diseases of the blood lymphatic system(16.67％)which mainly manifested as hand foot syndrome and thrombocytopenia (mainly being 4 degree bone marrow suppression). There were 9 cases of definite causal relationship and 57 cases of probable causal relationship. Fourteen cases of sunitinib-induced ADR were recovered after drug withdrawal(21.21％);27 cases were recovered after drug withdrawal and drug therapy(40.91％);17 cases had sequel after sur-gery,prolonging disease course and therapy (25.76％);there were 8 death cases (12.12％). CONCLUSIONS:Sunitinib-induced ADR involve various organs/systems,and there are fatal cases. In the process of clinical medication,we should strengthen the ob-servation and monitoring,timely ADR disposal to guarantee the safety of patients.
ABSTRACT
OBJECTIVE:To explore the assessment indicators of the accessibility of essential medicines to comprehensively evaluate the accessibility of essential medicinesand its coverage of medicine supply security and service quality and the improve-ment of the implementation of the new Healthcare reform. METHODS:Retrieved from Chinese and English Literature and the World Health Organization(WHO),theoretical analysis was conducted for the covering the core elements of essential medicines to explore construction ideas and content of essential medicines evaluation index system with international suitability,index appropri-ateness and operability. RESULTS&CONCLUSIONS:A series of medicine policy evaluation guide established by WHO is current-ly the main basis of the accessibility of essential medicines evaluation around the world,however,there are certain limitations for these indicators.According to the concept put forward by WHO and the related organizations,the core elements of the accessibility of essential medicines include:availability,affordability,supply system,sustainable financing,medicine quality and appropriate use.