Systematic evaluation of efficacy and safety of Huangqi Guizhi Wuwu Decoction for preventing oxaliplatin-induced peripheral neurotoxicity / 国际生物医学工程杂志

Objective:To evaluate the efficacy and safety of Huangqi Guizhi Wuwu Decoction for preventing oxaliplatin-induced peripheral neurotoxicity(OIPN).Methods:PubMed, ScienceDirect, EMbase, VIP, CNKI and WanFang Data were searched to collect the randomized controlled trials(RCTs) of Huangqi Guizhi Wuwu Decoction for OIPN from the date of establishment until July 2019. Two reviewers independently evaluated the quality of literature and extracted data. RevMan5.3 software was used for Meta-analysis.Results:Fifteen RCTs (849 patients) were included. The results of Meta-analyses showed statistically significant differences in favor of Huangqi Guizhi Wuwu Decoction group compared with control group for all incidence of OIPN [ RR=0.57, 95% CI(0.40, 0.81), P=0.002] and incidence of serious OIPN [ RR=0.35, 95% CI(0.25, 0.48), P<0.000 01]. No differences were observed in disease control rates between two groups. There was statistically significant differences between Huangqi Guizhi Wuwu Decoction group and mecobalamine group for all incidence of OIPN [ RR=0.51, 95% CI(0.39, 0.66), P<0.000 01] and incidence of serious OIPN [ RR=0.37, 95% CI(0.19, 0.70), P=0.002]. Conclusions:Huangqi Guizhi Wuwu Decoction is more safety and effective than mecobalamine on the prevention of OIPN and did not affect the efficacy of chemotherapy. So Huangqi Guzhi Wuwu decoction can be widely extended to clinical applications.

Correlation between the stenosis degree of aorto-iliac artery and superior mesenteric artery in patients with lower extremity atherosclerotic occlusive disease by CT angiography / 中华危重病急救医学

Objective@#To investigate the correlation between the stenosis degree of superior mesenteric artery (SMA) and each artery within the scope of aorto-iliac artery in patients with lower extremity atherosclerotic occlusive disease (LEAOD).@*Methods@#Images of 70 patients who had undergone the aorta-iliac-femoral arteries CT angiography (CTA) examination and had a definite diagnosis of LEAOD due to intermittent claudication or resting pain admitted to Tianjin Hospital from January to December in 2017 were enrolled. The arteries in the aorta as well as iliac were surface-reconstructed, which were analyzed by advanced vascular analysis (AVA) combined with the original images, including SMA trunk, abdominal aorta (AA), left and right common iliac artery (LCIA, RCIA), left and right internal iliac artery (LIIA, RIIA), left and right external iliac artery (LEIA, REIA). The normal reference plane and the maximal stenosis plane were selected, and the stenosis rate of each artery in the reconstruction range was automatically calculated with software. The patient's imaging data were divided into groups with two methods: ① according to the degree of SMA stenosis, the patients were divided into group Ⅰ (stenosis degree ≤70%) and groupⅡ (stenosis degree > 70%); ② LEAOD patients with different gender were respectively divided into three groups: middle-aged group (45-59 years old), pre-elderly group (60-74 years old) and elderly group (75-89 years old). The comparison between the stenosis degree of SMA and each artery within the scope of aorto-iliac artery was analyzed with Pearson simple correlation analysis.@*Results@#The incidence of SMA stenosis in all LEAOD patients was 100%. Correlation analysis showed that there was no correlation between the stenosis degree of SMA and AA, LCIA, RCIA, LIIA, RIIA, LEIA, or REIA in group Ⅰ (n = 64) and group Ⅱ (n = 6), respectively (r value was -0.021, 0.023, 0.023, -0.137, 0.182, -0.113, 0.141, respectively, in group Ⅰ, and it was 0.020, -0.560, 0.010, 0.306, -0.204, -0.381, 0.393, respectively, in group Ⅱ, all P > 0.05). In 52 male patients, there was no correlation between the stenosis degree of SMA and AA, LCIA, RCIA, LIIA, RIIA, LEIA, or REIA in middle-aged group (n = 16), pre-elderly group (n = 27) and elderly group (n = 9), respectively (r value was -0.032, 0.024, 0.324, 0.146, 0.312, 0.008, 0.344, respectively, in middle-aged group, it was -0.108, -0.116, -0.040, -0.249, -0.082, -0.052, 0.096, respectively, in pre-elderly group, and it was 0.182, 0.311, 0.400, 0.360, 0.688, 0.498, 0.406, respectively, in elderly group, all P > 0.05). In 18 female patients, there was also no correlation between the stenosis degree of SMA and above each artery within the scope of aorto-iliac artery in pre-elderly group (n = 11) and elderly group (n = 6), respectively (the r value was -0.170, 0.040, -0.019, 0.152, 0.508, 0.042, 0.456, respectively, in pre-elderly group, and it was -0.660, 0.008, -0.055, -0.056, -0.213, 0.344, 0.011, respectively, in elderly group, all P > 0.05). The correlation in middle-aged group was not analyzed because there was only 1 patient.@*Conclusions@#Although the atherosclerotic changes in LEAOD patients can affect SMA and aorto-iliac artery at the same time, there was no correlation between the stenosis degree of SMA and each artery within the scope of aorto-iliac artery which may due to the differences in the histological structure and hemodynamics among different arteries. SMA atherosclerotic stenosis and occlusion is a relatively independent disease process for LEAOD.

Correlation between the stenosis degree of aorto-iliac artery and superior mesenteric artery in patients with lower extremity atherosclerotic occlusive disease by CT angiography / 中华危重病急救医学

OBJECTIVE@#To investigate the correlation between the stenosis degree of superior mesenteric artery (SMA) and each artery within the scope of aorto-iliac artery in patients with lower extremity atherosclerotic occlusive disease (LEAOD).@*METHODS@#Images of 70 patients who had undergone the aorta-iliac-femoral arteries CT angiography (CTA) examination and had a definite diagnosis of LEAOD due to intermittent claudication or resting pain admitted to Tianjin Hospital from January to December in 2017 were enrolled. The arteries in the aorta as well as iliac were surface-reconstructed, which were analyzed by advanced vascular analysis (AVA) combined with the original images, including SMA trunk, abdominal aorta (AA), left and right common iliac artery (LCIA, RCIA), left and right internal iliac artery (LIIA, RIIA), left and right external iliac artery (LEIA, REIA). The normal reference plane and the maximal stenosis plane were selected, and the stenosis rate of each artery in the reconstruction range was automatically calculated with software. The patient's imaging data were divided into groups with two methods: (1) according to the degree of SMA stenosis, the patients were divided into group I (stenosis degree ≤70%) and group II (stenosis degree > 70%); (2) LEAOD patients with different gender were respectively divided into three groups: middle-aged group (45-59 years old), pre-elderly group (60-74 years old) and elderly group (75-89 years old). The comparison between the stenosis degree of SMA and each artery within the scope of aorto-iliac artery was analyzed with Pearson simple correlation analysis.@*RESULTS@#The incidence of SMA stenosis in all LEAOD patients was 100%. Correlation analysis showed that there was no correlation between the stenosis degree of SMA and AA, LCIA, RCIA, LIIA, RIIA, LEIA, or REIA in group I (n = 64) and group II (n = 6), respectively (r value was -0.021, 0.023, 0.023, -0.137, 0.182, -0.113, 0.141, respectively, in group I, and it was 0.020, -0.560, 0.010, 0.306, -0.204, -0.381, 0.393, respectively, in group II, all P > 0.05). In 52 male patients, there was no correlation between the stenosis degree of SMA and AA, LCIA, RCIA, LIIA, RIIA, LEIA, or REIA in middle-aged group (n = 16), pre-elderly group (n = 27) and elderly group (n = 9), respectively (r value was -0.032, 0.024, 0.324, 0.146, 0.312, 0.008, 0.344, respectively, in middle-aged group, it was -0.108, -0.116, -0.040, -0.249, -0.082, -0.052, 0.096, respectively, in pre-elderly group, and it was 0.182, 0.311, 0.400, 0.360, 0.688, 0.498, 0.406, respectively, in elderly group, all P > 0.05). In 18 female patients, there was also no correlation between the stenosis degree of SMA and above each artery within the scope of aorto-iliac artery in pre-elderly group (n = 11) and elderly group (n = 6), respectively (the r value was -0.170, 0.040, -0.019, 0.152, 0.508, 0.042, 0.456, respectively, in pre-elderly group, and it was -0.660, 0.008, -0.055, -0.056, -0.213, 0.344, 0.011, respectively, in elderly group, all P > 0.05). The correlation in middle-aged group was not analyzed because there was only 1 patient.@*CONCLUSIONS@#Although the atherosclerotic changes in LEAOD patients can affect SMA and aorto-iliac artery at the same time, there was no correlation between the stenosis degree of SMA and each artery within the scope of aorto-iliac artery which may due to the differences in the histological structure and hemodynamics among different arteries. SMA atherosclerotic stenosis and occlusion is a relatively independent disease process for LEAOD.

Systematic Evaluation of the Efficacy of Glutathione in Preventing Oxaliplatin-induced Peripheral Neuro-toxicity / 中国药房

OBJECTIVE:To systematically evaluate the efficacy and safety of glutathione (GSH) in preventing oxaliplatin-in-duced peripheral neurotoxicity(OIPN),and to provide evidence-based reference in the clinic. METHODS:Randomized controlled trials (RCTs) about therapeutic efficacy of GSH vs. placebo/no any measures (called placbo group) or other drug in preventing OIPN were retrieved from PubMed,EMBase,Cochrane library,CJFD,Wanfang database and VIP. Meta-analysis was performed with Rev Man 5.3 statistical software after data extraction and quality evaluation with Jadad scale. RESULTS:18 RCTs were in-cluded,involving 1200 patients. The results of Meta-analysis showed that:total incidence of oxaliplatin-induced chronic peripheral neurotoxicity (OICPN)[RR=0.71,95%CI(0.59,0.87),P<0.001] and the incidence of severe OICPN [RR=0.50,95%CI(0.42, 0.60),P<0.001] in GSH group were significantly lower than placebo group,with statistical significance;there was statistical signif-icance in the incidence of oxaliplatin-induced acute peripheral neurotoxicity(OIAPN)[RR=0.89,95%CI(0.72,1.09),P=0.25]. The incidence of severe OICPN in GSH group was significantly higher than mecobalamine group,with statistical significance [RR=2.06,95%CI(1.07,3.99),P=0.03]. There was no statistical significance in the incidence of OICPN[RR=1.38,95%CI(0.83,2.31), P=0.21] and severe OICPN [RR=1.91,95%CI(0.85,4.30),P=0.12] between GSH group and Ca+Mg mixture group. CONCLU-SIONS:GSH can effectively prevent the occurrence of OICPN,however,its therapeutic efficacy is equivalent to Ca+Mg mixture and inferior to mecobalamine in preventing severe OICPN.

Network Meta-analysis of 5 Kinds of TCM Injections in the Treatment of Malignant Pleural Effusion / 中国药房

OBJECTIVE:To evaluate therapeutic efficacy of Aidi injection,Compound kushen injection,Kanglaite injection, Elemene injection and Brucea javanica oil emulsion injection in the treatment of malignant pleural effusion(MPE),and to provide evidence-based reference in clinic. METHODS:Retrieved from PubMed,EMBase,Cochrane library,CJFD,Wanfang database and CJFD,RCTs about Aidi injection,Compound kushen injection,Kanglaite injection,Elemene injection and B. javanica oil emulsion injection in the treatment of MPE were collected. Meta-analysis was conducted by using ADDIS 1.16.6 statistical software after data extraction and quality evaluation by modified Jadad scale. RESULTS:A total of 54 RCTs were included,involving 3404 patients. All RCTs were two legs with a total number of 108. Results of network Meta-analysis showed that compared with cisplat-in,Compound kushen injection [OR=2.19,95%CI(1.30,3.76),P<0.05],Elemene injection [OR=3.55,95%CI(2.43,5.32),P<0.05] and B. javanica oil emulsion injection [OR=1.92,95%CI(1.34,2.76),P<0.05] could significantly improve response rate of MPE patients,with statistical significance. Pairwise comparison showed response rate of Elemene injection was significantly higher than that of Aidi injection [OR=0.32,95%CI(0.17,0.56),P<0.05],Kanglaite injection [OR=0.30,95%CI(0.13,0.68),P<0.05] and B. javanica oil emulsion injection [OR=1.85,95%CI(1.10,3.17),P<0.05] in improving response rate. The probability ranking was Elemene injection>Compound kushen injection>B. javanica oil emulsion injection>Aidi injection=Kanglaite injection=cispl-atin. Compared with cisplatin,Aidi injection [OR=0.29,95%CI(0.16,0.54),P<0.05],Compound kushen injection [OR=0.44, 95%CI(0.18,0.96),P<0.05],Elemene injection [OR=0.21,95%CI(0.10,0.44),P<0.05] and B. javanica oil emulsion injection [OR=0.41,95%CI(0.23,0.70),P<0.05] could significantly improve the rate of quality of life improvement in MPE patients,with statistical significance. Pairwise comparison showed the rate of quality of life improvement of Elemene injection in MPE patients was significantly higher than that of Kanglaite injection [OR=4.84,95%CI(1.03,25.01),P<0.05]. The probability ranking was El-emene injection>Aidi injection>Compound kushen injection>B. javanica oil emulsion injection>Kanglaite injection>cisplatin.CONCLUSIONS:All 5 kinds of TCM injection can effective-ly treat MPE and improve the quality of life,among which El-emene injection is mostlikely to be the most effective interven-tion.