The efficacy and safety of denosumab and bisphosphonates on glucocorticoid induced osteoporosis patients:a meta-analysis / 中国医师进修杂志

Objective@#In order to evaluate the therapeutic effects and safety of denosumab and bisphosphonates in glucocorticoid induced osteoporosis patients.@*Methods@#Standard studies were obtained by searching CNKI, CBM, VIP, Wanfang, Pubmed, Embase and Cochrane databases.@*Results@#Three RCTs with 869 patients were included in this study. It showed that the mean changes of lumbar spine, total hip and femoral neck bone mineral density (BMD) for patients in denosumab group were increased by 2.47%, 1.43% and 1.07% respectively compared to those of bisphosphonates group.There was no statistically significant difference between patients receiving denosumab and those receiving bisphosphonate in terms of adverse events and serious adverse events.@*Conclusions@#Denosumab has an effective increase for lumbar spine, total hip and femoral neck bone mineral density, and the safety of both is similar.

The efficacy and safety of denosumab and bisphosphonates on glucocorticoid induced osteoporosis patients:a meta-analysis / 中国医师进修杂志

Objective In order to evaluate the therapeutic effects and safety of denosumab and bisphosphonates in glucocorticoid induced osteoporosis patients. Methods Standard studies were obtained by searching CNKI, CBM, VIP, Wanfang, Pubmed, Embase and Cochrane databases. Results Three RCTs with 869 patients were included in this study. It showed that the mean changes of lumbar spine, total hip and femoral neck bone mineral density (BMD) for patients in denosumab group were increased by 2.47%, 1.43% and 1.07% respectively compared to those of bisphosphonates group.There was no statistically significant difference between patients receiving denosumab and those receiving bisphosphonate in terms of adverse events and serious adverse events. Conclusions Denosumab has an effective increase for lumbar spine, total hip and femoral neck bone mineral density, and the safety of both is similar.

Clinical study on osteoporosis and osteoporotic fracture in patients with rheumatic diseases / 中华风湿病学杂志

Objective To investigate the clinical features and related risk factors of osteoporosis and osteoporotic fracture (OPF) in patients with rheumatic diseases (RD),and the fracture predictive values of fracture risk assessment tool fracture risk assessment (FRAX(R))for Han patients.Methods A total of 313 untreated RD patients were included.Each individual BMD was measured at lumbar spine and femoral neck with Dual-energy X-ray absorptionary.Ten-year probability of fracture (％) was calculated by fracture risk assessment tool FRAX(R) of Chinese model.Each individual previous fracture was confirmed by X-ray or CT examination.The associations between BMD,FRAX),previous fracture and age,bone mass index,nationality,erythrocyte sedimentation rate (ESR) and RD types were analyzed.T test or Wilcoxon test was used to compare the difference between groups for statistical analysis.Pearson/Spearman rank order and binary regression were used to analyze the correlations between variables of normal/non-normal and two classification distribution.Results ① The BMD of patients with untreated RD was significantly lower than that of control group (P=0.000).Individuals diagnosed with "osteopenia" in the RD group and control group were accounted for 39.3％ (123/313) and 15.8％ (47/296) respectively.Individuals diagnosed with "osteoporosis" in RD group and control group were accounted for 11.5％ (36/313) and 5.4％ (16/296) respectively.② The next 10-year probability of the hip (Z=-2.28,P=0.02) and major osteoporotic fracture (Z=-1.98,P=0.03) were higher than those of the control group,as well as the actual incidence of OPF (x2=25.11,P=0.00),the difference was statistically significant.③ 27.3％(18/66) and 55.0％(11/20) of the previous OPF patients in RD group and control group achieved the diagnostic criteria of "high risk" of hip fracture.And 12.1％ (8/66) and 35.0％ (7/20) achieved the "high risk" of major osteoporotic fracture.④ Patients with RA,SLE and pSS had significantly increased risk of fracture.Ten-year fracture risks were negatively related to advanced age,female gender and ESR.Conclusion Bone loss and increased fracture risk are prevalent in the early stage of untreated rheumatism patients.RA,SLE plays an important role in low bone mass.The FRAX China model may underestimate 10-year fracture probability of RD patients and controls.Further explore should be done to predict the FRAX China model on different areas and different RDs.

Research on Classifed Punishments on Manufacturers of Unconformity Products in Supervision and Sampling Inspection of Medical Devices / 中国医疗器械杂志

Theories of classified management which are based on risk governance are introduced into the newly revised , but the punishments on the manufacturers of unconformity products are not classified based on the severity and risks caused by the test items. This article analysed the disadvantages of current punishment measures on the manufacturers of unconformity products and the theoretical basis of classified punishments. The feasibility of classified punishments had also been studied and some basis of discretionary punishments was provided under the current regulations.

Association of N-terminal pro-brain natriuretic peptide with the severity of coronary artery disease in patients with normal left ventricular ejection fraction / 中华医学杂志(英文版)

<p><b>UNLABELLED</b>Backround N-terminal pro-brain natriuretic peptide (NT-proBNP) is a reliable predictor in acute coronary artery disease (CAD). Little is known about patients with stable CAD, especially Chinese patients with CAD. The aim of the present study was to investigate the association of NT-proBNP levels with the severity of CAD in patients with normal left ventricular ejection fraction.</p><p><b>METHODS</b>A total of 658 consecutive patients were divided into two groups based on angiograms: CAD group (n = 484) and angiographic normal control group (n = 174). The severity of CAD was evaluated by modified Gensini score, and its relationship with NT-proBNP was analyzed.</p><p><b>RESULTS</b>The prevalence of risk factors such as age, male gender, diabetes mellitus (DM), dyslipidemia, smoking, and family history of CAD in the CAD group were higher than that in the control group. In multivariate regression model analysis, age, gender, and DM were determinants of the presence of CAD. NT-pro BNP was found to be an independent predictor for CAD (OR:1.66 (95% CI: 1.06-2.61), P < 0.05). In a receiver operating characteristic (ROC) curve analysis, an NT-proBNP value of 641.15 pmol/L was identified as a cut-off value in the diagnosis or exclusion of CAD (area under curve (AUC) = 0.56, 95% CI: 0.51-0.61). Furthermore, NT-proBNP was positively correlated with Gensini score (r = 0.14, P < 0.001) in patients with CAD.</p><p><b>CONCLUSION</b>NT-proBNP was an independent predictor for Chinese patients with CAD, suggesting that the NT-proBNP level might be associated with the presence and the severity of CAD.</p>

The detection of serum interferon γ in patients with chronic hepatitis B and its clinical significance / 中国医师进修杂志

Objective To investigate the clinical significance of serum interferon (IFN) γ in patients with chronic hepatitis B (CHB).Methods Two hundred and eighty patients with CHB (CHBgroup) were divided into stabilize group (114 cases) and activity group (166 cases).Sixty healthy people were used as control group.The levels of serum IFN T and alanine aminotransferase (ALT) were measured with enzyme-linked immunosorbent assay.Results The levels of serum IFN γ and ALT in CHB group,stabilize group and activity group were significantly higher than those in control group [(114.54 ± 36.28),(54.21 ± 21.33) and (164.57 ± 41.25) ng/L vs.(26.43 ± 12.01) ng/L; (84.87 ± 45.24),(32.64 ± 15.59)and (93.26 ±41.55) U/L vs.(27.44 ± 11.52) U/L,P＜0.05].The levels of serum IFN γ aad ALT in activity group were significantly higher than those in stabilize group (P＜ 0.05).The level of serum IFN γ in CHB patients was positively related with the level of serum ALT (r =0.504,P ＜ 0.01).After treatment in activity group,there were 126 cases recovery,40 cases no-recovery,the levd of serum IFN γ in recovery patients was significantly lower than that in no-recovery patients [(76.24 ± 31.16) ng/L vs.(169.15 ± 39.46)ng/L,P ＜0.01].Conclusions The high-level expression of IFN T is found in CHB patients,and which maybe play a key role in the pathogenesis and progression of CHB patients.Regulation of immune responses maybe a new way in CHB.