Efficacy and Safety of Individualized Antiplatelet Therapy in Patients with Coronary Artery Disease ：A Meta-analysis / 中国药房

OBJECTIVE： To evaluate efficacy and safety of individualized antiplatelet therapy in patients with coronary artery disease （CAD） systematically according to the results of laboratory examination， and to provide reference for individualized antiplatelet therapy in clinic. METHODS： Retrieved from PubMed， Embase and the Cochrane library during the establishment of database to Feb. 2018， RCTs about individualized antiplatelet therapy vs. routine antiplatelet therapy in CAD patients based on the results of laboratory examination were collected. Meta-analysis was conducted for the incidence of main adverse cardiovascular adverse events （MACE）， all-cause death， cardiovascular death， myocardial infarction， stent thrombosis， stroke and severe bleeding by using Rev Man 5.3 statistical software after data extraction and quality evaluation with Cochrane system evaluator manual 5.2.0. Subgroup analysis was carried out for different races， laboratory testing methods and intervention courses. RESULTS： Totally 7 RCTs involving 8 615 patients were included. Results of Meta-analysis showed that compared with routine antiplatelet therapy， there was no significant difference in the incidence of MACE [RR＝0.93， 95％CI （0.74， 1.16）， P＝0.51]， all-cause death [RR＝0.89， 95％CI （0.56， 1.41）， P＝0.61]， cardiovascular death [RR＝0.68， 95％CI （0.36， 1.25）， P＝0.21]， myocardial infarction [RR＝1.03， 95％CI （0.92， 1.16）， P＝0.56]， stent thrombosis [RR＝0.52， 95％CI （0.22， 1.24）， P＝0.14]， stroke [RR＝1.03， 95％CI （0.65， 1.63）， P＝0.90]， and severe bleeding [RR=0.78，95％CI （0.53， 1.14）， P＝0.20] based on the results of laboratory examination. Subgroup analysis showed according to CYP2C19 genotype， individualized medication could reduce the incidence of MACE [RR＝0.29， 95％CI （0.14， 0.64）， P＝0.002] and all-cause death [RR＝0.11， 95％CI （0.01， 0.87）， P＝0.04]， and trials with intervention duration of 6 months could significantly decrease the incidence of all-cause death [RR＝0.11， 95％CI （0.01， 0.87）， P＝0.04]， there were no significant difference between 2 groups in other subgroup analysis. CONCLUSIONS： Compared with routine antiplatelet therapy， individualized antiplatelet therapy based on the results of laboratory examination cannot reduce the incidence of MACE and bleeding event risk in real-world patients with CAD. Although subgroup analysis show that individualized medication on the basis of CYP2C19 genotype can significantly reduce the incidence of MACE and cardiovascular death. But more large-scale samples and high-quality studies are needed to confirm this conclusion.

Meta-analysis of laboratory index of Tripterygium Glycosides Tablets in treatment of rheumatoid arthritis / 中国中药杂志

The aim of this study was to systematically evaluate the clinical efficacy of Tripterysium Glycosides Tablets( TGT) alone or in combination with methotrexate( MTX) in the treatment of rheumatoid arthritis( RA) based on the laboratory index criteria and to provide a basis for the clinical application of TGT against RA. Six databases including CNKI,Wan Fang,VIP,PubMed,EMbase and Cochrane were retrieved for randomized controlled trials( RCT) about TGT alone or combination with MTX in the treatment of RA.Then risk assessment tools were used for quality evaluation of the studies,and data extraction and analysis were conducted by using Rev Man 5.3 software for Meta-analysis. A total of 1 709 articles were retrieved,and finally 25 studies were included,with a total sample size of 2 507 cases. Meta-analysis results showed that between TGT alone and TGT alone,MDESR=-2. 66,95%CI[-8.17,2.86],P = 0.35; MDCRP=-2.38,95%CI[-9.01,4.24],P = 0.48; between TGT combined with MTX and MTX alone,MDESR= 8.74,95%CI[6.72,10.76],P<0.000 01; MDCRP= 5.37,95%CI[3.71,7.03],P<0.000 01; SMDRF= 1.05,95%CI[0.51,1.60],P = 0.000 1.The effect of TGT on decreasing CRP and ESR in RA patients was similar to the MTX. In addition,TGT combined with MTX were more effective in decreasing CRP,ESR,RF than MTX alone. However,due to the potential bias in the included studies,more and high-quality randomized controlled trials would be needed to improve the level of evidence.

Clinical evaluation of xinqin granule combined with loratadine in treatment of allergic rhinitis and its effects on serum EOS, CSF and TNF-α / 中国生化药物杂志

Objective To study clinical evaluation of xinqin granule combined with loratadine in treatment of allergic rhinitis and its effects on serum eosinophil(EOS),colony stimulating factor(CSF)and tumor necrosis factor(TNF)-α.Methods 90 patients of allergic rhinitis who received therapy from January 2014 to November 2016 in our hospital were selected.According to random number table,those patients were divided into the observation group(n=45)and the control group(n=45).The control group was treated with loratadine,while the observation group was combined with xinqin granule.Then the serum EOS,CSF and TNF-α,symptom score,clinical efficacy and adverse reactions were compared.Results After treatment,the serum levels of EOS,CSF and TNF-αin the observation group were significantly lower than that of the control group(P<0.05); the symptom score in the observation group was significantly lower than that of the control group(P<0.05); the total effective rate in the observation group was significantly higher than that of the control group[93.33％(42/45)vs.73.33％(33/45)](P<0.05); there was no significant difference in the incidence of adverse reactions between the two groups.Conclusion Xinqin granule combined with loratadine is well for allergic rhinitis,which can effectively reduce serum levels of EOS,CSF,TNF-α,relieve clinical symptoms,it's worthy of application and promotion.

Analysis on the laboratory determination results of 502 patients with hand-foot-mouth disease / 国际检验医学杂志

Objective To analyze the laboratory determination results of hand-foot-mouth disease(HFMD)and explore its sig-nificance.Methods Pharyngeal swab specimens were collected from 502 children with HFMD(severe case:104 cases and mild case:398 cases).Specific RNA of enterovirus primer(EV),enterovirus71 (EV71)and coxsackievirus A16(CA16)were detected by real-time fluorescence polymerase chain reaction(RT-PCR).Simultaneously,white blood cell (WBC),direct bilirubin(DBIL),alanine transarninase(ALT),creatine kinase MB isoenzyme(CK-MB)and lactic dehydrogenase (LDH )were determined,and the results were analyzed.Results Among the 502 children,384 cases were positive for EV,262 cases were positive for EV71,and 39 cases were positive for CA16.The positive rates were 76.49%,52.19% and 7.76%,respectively.In the 104 HFMD severe cases,EV71 positive rate was 92.31%(96/104).There were clearly more boys than girls.The age distribution was mainly in the group under 3-year-old(402 cases,80.08%).In the group under 3-year-old,there were 97 severe cases(93.27%),and the EV71 positive rate was 92.78%(90/97).Serum levels of WBC,DBIL,ALT,CK-MB and LDH were higher in severe HFMD group than in mild group(P <0.05).Conclusion The HFMD occurred mostly at the children under 3-year-old.The HFMD appeared is mainly related to the EV infection,and EV71 is the main pathogen causing the severe cases of HFMD.

The analysis of laboratory indexes in type 2 diabetes mellitus patients with hypoglycemia / 国际检验医学杂志

Objective To analyze the laboratory indexes related to type 2 diabetes mellitus(T2DM ) and to explore whether hy‐poglycemia would aggravate the injury of body and development of complication .Methods 27 cases of patients with T2DM from Jan .to Jun .2014 were enrolled in hypoglycemia group ,and 80 patients of diabetes mellitus without hypoglycemia were enrolled in non‐hypoglycemia group .The laboratory indexes were compared between the two groups ,and the relationship between incidence rate of hypoglycemia and levels of glycosylated hemoglobin (HbAc1) were also analyzed ..Results The age ,course of the disease , levels of alanine aminotransferase (ALT ) and serum creatinine (SCr) and urinary protein excretion (Upro ) in the hypoglycemia group were higher than those in the non‐hypoglycemia group ,there were statistical significant differences (P0 .05) .The levels of creatine kinase(CK) ,high sensitivity C‐reactive protein(hs‐CRP) and fibrinogen(FIB) in pa‐tients with T2DM after developing hypoglycemia were higher than those in patients before developing hypoglycemia ,while superox‐ide dismutase(SOD) was lower ,there were statistical significant differences (P0 .05) ,at the same time the risk of hypoglycemia tended to be higher in patients with near‐normal level of HbA1c than patients with poor HbA1c control .Conclusion The older , long course of disease and near‐normal levels of HbA1c controled in patients with T2DM may be prone to develop hypoglycemia . Hypoglycemia could aggravate the body injury and speed up the development of complications of T 2DM .

The clinical analysis of hypoplastic myelodysplastic syndrome / 肿瘤研究与临床

Objective To study the clinical features, laboratory index and therapy of hypoplastic myelodysplastic syndrome. Methods 8 patients with hypoplastic MDS by using the method of bone marrow smear and bone marrow biopsy were studied. T lymphocyte subsets were analyzed by flow cytometry. 8 patients were treated with personalized therapy. Results All the patients of this group had hypoplastic bone marrow with more than two parts, bone marrow hypocellularity and characteristics of ineffective hematopoiesis. The analysis of T lymphocyte subsets showed that 5 of 8 patients had abnormal CD+4/CD+8 ratios. After personalized treatment, there were 2 obvious remission cases, 3 partial remission cases, 2 progression cases and 1 inefficacy case. Conclusion Hypoplastic MDS is characterized by bone marrow hypocellularity and ineffective hematopoiesis, which showed immunological abnormalities. Personalized therapeutic strategy may prolong survival in patients with hypoplastic MDS.