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BACKGROUND@#The predictive value of hemoglobin A1c (HbA1c) levels in non-diabetic patients with myocardial infarction undergoing percutaneous coronary intervention (PCI) is still controversial. This study aimed to evaluate whether HbA1c levels were independently associated with adverse clinical outcomes in non-diabetic patients with coronary artery disease (CAD) who had undergone PCI by performing a meta-analysis of cohort studies.@*METHODS@#This meta-analysis included non-diabetic patients with CAD who had undergone PCI. A systematic search for publications listed in the PubMed, Embase, and Cochrane Library databases from commencement to December 2018 was conducted. Studies evaluating the adverse clinical outcomes according to abnormal HbA1c levels in non-diabetic patients diagnosed with CAD who had undergone PCI were eligible. The primary outcomes were long-term all-cause deaths and long-term major adverse cardiac events, and the secondary outcome was short-term all-cause deaths. The meta-analysis was conducted with RevMan 5.3 and Stata software 14.0. Odds ratios (ORs) were pooled using a random or fixed-effects model, depending on the heterogeneity of the included studies. Sub-group analysis or sensitivity analysis was conducted to explore potential sources of heterogeneity, when necessary.@*RESULTS@#Six prospective cohort studies involving 10,721 patients met the inclusion criteria. From the pooled analysis, abnormal HbA1c levels were associated with increased risk for long-term all-cause death (OR 1.39, 95% confidence interval [CI] 1.16-1.68, P = 0.001, I = 45%). Sub-group analysis suggested that abnormal HbA1c levels between 6.0% and 6.5% predicted higher long-term major adverse cardiac event (including all-cause deaths, non-fatal myocardial infarction, target lesion revascularization, target vessel revascularization, recurrent acute myocardial infarction, heart failure requiring hospitalization, and stent thrombosis) risk (OR 2.05, 95% CI 1.46-2.87, P < 0.001, I = 0). Contrarily, elevated HbA1c levels were not associated with increased risk of short-term all-cause death (OR 1.16, 95% CI 0.88-1.54, P = 0.300, I = 0).@*CONCLUSIONS@#An abnormal HbA1c level is an independent risk factor for long-term adverse clinical events in non-diabetic patients with CAD after PCI. Strict control of HbA1c levels may improve patient survival. Further studies in different countries and prospective cohort studies with a large sample size are required to verify the association.
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Objective:To observe the effect of oral administration of dietary fiber (DF) on flatus and defecation promotion and abdominal distension reduce,as well as the impact on exclusive breastfeeding and adverse reactions.Method:A total of 80 pregnant women who received repeated cesarean section at obstetrics department in Shanxi Provincial People's Hospital(2016.12 ～ 2017.03) were randomly divided by computer into two groups.DF group included 40 cases,and the patients took DF (1 bag,15g,with 200ml warm boiled water) 6h after cesarean section in 10min,and repeated it 8 ～ 12 h after operation.Patients in control group only received 200ml warm boiled water at the same point-in-time.The two groups shared the same dietary guidance,nursing and medical treatment.Bowel sound,flatus and defecation conditions as well as the incidence rates of abdominal distension and exclusive breastfeeding were compared between two groups.The adverse reactions after administration of DF were collected.Result:There were 38(97.4 ％)cases that had bowel sound in 12h pro-operation in DF group.There were 25(62.5 ％) cases that had bowel sound in 12h pro-operation in control group.There were 30(76.9 ％) and 12(30.0 ％) cases had first flatus during 24h pro-operation respectively in DF group and in control group.There were 22 (56.4 ％) and 7 (17.5 ％)cases had first defecation ＜48h pro-operation respectively in DF group and in control group.The differences were all statistically significant (P ＜ 0.01).In the comparison of gastrointestinal reaction,there were more cases reported abdominal distension(3,7.7％;12,30.0％) and nausea (3,7.7％ ∶10,25.0 ％),with statistical significances (P ＜ 0.05).There was no statistical significance (1,2.6 ％ ∶ 4,1.0 ％,P ＞ 0.05) in vomiting.Breast feeding rate was no statistical significance (56.％ ∶52.5 ％,P ＞ 0.05).One case of DF group discovered adverse reactions,such as nausea and vomiting.Conclusion:Oral administration of soluble DF significantly promoted the flatus and defecation after repeated cesarean section,however,patients with intestinal irritability need to be paid more attention to the adverse reactions,such as nausea and vomiting.
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Objective To investigate in vivo pharmacokinetics and bioequivalence of Meloxicam Chewable Tablets in healthy Beagle's dogs.Method Twelve healthy adult Beagle's dogs were randomized into two groups.Using the double-preparation,double-cycle,cross-over method and administering orally of testing and reference tablet (2 mg) respectively.The plasma concentration of meloxicam was determinated by RP-HPLC.The 3P97 software was adopted to calculate the pharmacokinetic parameters and evaluate the bioequivalence of two preparations.Results The area under the curves (AUC0-96 h) of the testing tablets and innovator tablets were (2.85±0.64) and (2.79±0.48) μg/mL·h.The peak time (Tmax) was (4.33±0.65) and (4.16±0.71) h.The peak concentration (Cmax) was (0.091±0.017) and (0.086±0.021) μg/mL.The half time (t1/2) was (26.08±3.64) and (26.94± 4.21) h.After the double unilateral t test,there was no statistical significance in the difference of lnAUC and lnCmax between the testing tablets and innovator tablets.Conclusion The testing tablets and innovator tablets are bioequivalent.The relative bioavailability of generic tablet is (98.0±9.76)％.