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OBJECTIVE： To evaluate immunomodulatory drugs （IMiDs） in the treatment of deep venous thrombosis （DVT） in patients with multiple myeloma （MM） systematically， and to provide reference for safe drug use in clinic. METHODS： Retrieved and collected randomized controlled trials （RCTs） about the risk of DVT in MM patients treated with IMiDs from PubMed， Web of Science， Cochrane library， CJFD， Wanfang database， VIP， www.ClinicalTrials.gov during database and Dec. 31， 2018. Meta-analysis was conducted for the incidence and relative risk of DVT （RR） by using Stata 12.0 statistical software. Evidence was evaluated and graded by using GRADE system. RESULTS： A total of 11 RCTs were included， involving 3 365 patients （including 3 drugs）. Results of Meta-analysis showed that the incidence of DVT was 7.3％ [95％CI （4.5％， 10.2％）] during IMiDs in the treatment of MM. Compared with conventional chemotherapy， IMiDs had a higher risk of DVT in MM patients [RR＝3.57，95％CI（2.42，5.27）， P＜0.01]. Subgroup analysis in different treatment stage showed that after IMiDs treatment for MM patients at induction stage， the risk of DVT increased by 386％ compared with conventional chemotherapy plan [RR＝4.86， 95％CI （2.85， 8.30）， P＜0.01]， which evidence was moderate. Compared with conventional chemotherapy plan， there was no significant difference in the risk of DVT among MM patients treated with IMiDs at maintenance stage [RR＝2.40， 95％CI （0.70， 8.27）， P＝0.16] and relapse stage [RR＝2.01， 95％CI （0.74， 5.46）， P＝0.17]. The incidence of severe DVT caused by thalidomide and lenalidomide were 11％ [95％CI （9％， 13％）] and 3％ [95％CI （2％， 4％）]. CONCLUSIONS： The current evidence suggests that patients with MM treated with IMiDs are at a high risk of serious DVT， and clinical medication should be cautious.
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Objective To investigate the effects and probable mechanism ofShenfu injection on the oxidaitve damage of H2O2-induced PC12 cells.Methods PC12 cells were cultured and exposed to 100μmol/L H2O2 for 1 h to establish the oxidative damage model. The protective effect ofShenfu injection was observed by the cell survival rate measured by colorimetric MTT assay, and the leakage rate of lactic dehydrogense (LDH). Western blot methods were used to detect the expression of NF-κB signaling pathway.Results Compared with the model group,Shenfu injection at 5, 10, 20 ml/L could improve the PC12 cells survival rate (83.11% ± 2.59 %, 87.99% ± 0.59%, 85.26% ± 1.07%vs. 73.82% ± 1.82%;P<0.01 orP<0.05), decrease the LDH leakage rate (32.75% ± 4.10%, 28.52% ± 1.14%, 35.79% ± 1.62%vs. 64.34% ± 3.18%;P<0.01 or P<0.05). Western blot results showed thatShenfu injection could protect the PC12 cells from oxidaitve damage by suppressing the p-p65/p65 (1.30 ± 0.10, 1.17 ± 0.06, 1.37 ± 0.15 vs. 1.70 ± 0.10;P<0.01 orP<0.05), p-IκBα/IκBα (1.07 ± 0.12, 1.00 ± 0.10, 1.03 ± 0.06 vs. 1.17 ± 0.06; P<0.01 orP<0.05).ConclusionShenfu injection has a obvious antioxidant effect on PC12 cells in vitro.