A meta-analysis of randomized controlled trials comparing left with right radial approach for coronary angiography / 中华心血管病杂志

<p><b>OBJECTIVE</b>To compare the efficacy between left radial approach (LRA) and right radial approach (RRA) for coronary angiography (CAG).</p><p><b>METHODS</b>The following databases were searched, including PubMed, Embase, Web of science, Cochrane Library, CBM, VIP, Wanfang databases and CNKI, from creation of database to January 2013. Two reviewers extracted data independently, according to inclusive criteria, exclusion criteria and methods of Cochrane Collaboration. Statistical analysis was performed using Review Manager Software (RevMan 5.1).</p><p><b>RESULTS</b>Eleven trials with 5 442 patients were included in the systematic review. The results of meta-analysis showed that when compared with RRA, LRA did not increase the failure rate of the procedures (OR = 1.04, 95%CI 0.80-1.35, P > 0.05) and amount of contrast medium (mean difference = 2.39, 95%CI -0.30-5.08), P > 0.05). However, LRA was superior to RRA in reducing fluoroscopy time (standardized mean difference = 0.15, 95%CI 0.06-0.24, P < 0.01). In addition, the incidence of severe tortuosity of subclavian artery was significantly lower with LRA (OR = 4.65, 95%CI 1.98-10.88, P < 0.01).</p><p><b>CONCLUSIONS</b>Based on the current evidence, LRA shares similar safety with RRA for CAG and is superior to RRA in certain respects. LRA can thus be used either as an alternative approach or routine approach for CAG.</p>

Role of mitochondrial calpains in apoptosis / 中国药理学通报

Calpains are the family of Ca2+-activated cysteine pro-teases. Although calpains are considered to be cytoplasmic en-zymes, recent research has demonstrated that μ-calpain, m-cal-pain, calpain 10 and their endogenous inhibitor calpastatin are present in the mitochondria and play important roles both in caspase -dependent and-independent pathways in cell death phe-nomena. Calpains exert direct and indirect effects on the caspases and regulators of apoptosis pathway such as Bcl-2, Bax, Bid, promoting the release of Cyt-C, AIF, then result in cellular ap-optosis. To allow pharmacological targeting of these enzymes, thorough knowledge of their patterns of activation and further in-teractions with already known apoptotic pathways is necessary.

A Meta-analysis of alendronate for the prevention and treatment of glucocorticoid-induced osteoporosis / 中华内科杂志

Objective To assess the efficiency and safety of alendronate for the prevention and treatment of glucocorticoid-induced osteoporosis (GIOP).Methods The electronic databases of PubMed,EMBASE,Cochrane Library,Web of Science,Chinese BioMedical Literature Database (CBM) and Wanfang Data were searched for all randomized controlled trials (RCT) of alendronate vs.placebo.Two reviewers independently selected trials for inclusion,assessed trial quality using Jadad's scale and extracted the data.RevMan 5.1 software was used for data synthesis and Meta-analysis.Results Seven studies with 1111 patients were included.Compared with placebo,alendronate significantly increased bone mineral density (BMD) at the lumbar spine[MD ＝3.35,95％CI (2.67-4.02),P =0.000] and the femoral neck[MD =1.90,95％ CI (0.89-2.92),P =0.000] after 12 months of therapy.After 24 months of therapy,alendronate significantly increascd BMD at the lumbar spine [MD =3.91,95％ CI (2.37-5.45),P =0.000],but not at the femoral neck [MD =1.91,95％ CI (-1.15-5.02),P =0.22].Compared with placebo,no significant reduction was found by the use of alendronate in the incidence of vertebral fractures [RR =1.00,95％ CI (0.49-2.07),P =0.99] or nonvertebral fractures[RR ＝ 1.02,95％ CI (0.49-2.14),P =0.95].No difference was shown with the adverse event between the two groups[RR =0.97,95％ CI (0.90-1.05),P =0.47].Conclusions Alendronate is effective for the prevention and treatment of glucocorticoid-induced bone loss at the lumbar spine and the femoral neck with relatively good safety profile.Yet,there is no significant difference between the two groups in reducing the incidence of vertebral fractures and non-vertebral fractures.Large-scale RCT designed to observe whether different lengths of alendronate therapy will influence the efficiency should be conducted in the future and to further explore whether it can reduce the incidence of fractures.