ABSTRACT
OBJECTIVES: To assess the effects of long-term beta blockers in patients with stable angina. METHODS: We reviewed the literature up to June 2010 from CENTRAL, MEDLINE, EMBASE, CBM, and CNKI for randomized controlled trials. The appropriate data were meta-analysed using Revman 5.0. RESULTS: Twenty-six trials including 6108 patients were identified. The treatment with beta blockers has significantly decreased all-cause mortality when compared with no control (OR 0.40, 95% CI 0.20 to 0.79), but has had no statistically differences when compared with placebo (OR 0.92, 95% CI 0.62 to 1.38) and with calcium-channel blocker (CCB) (OR0.84, 95% CI 0.49 to 1.44). This was similar in patients with fatal and non-fatal acute myocardial infarction when compared with placebo (OR 0.82, 95% CI 0.57 to 1.17) or CCB (OR 1.08, 95% CI 0.71 to 1.66); on revascularization and quality of life. The beta blockers reduced the incident of unstable angina compared to no treatment (OR 0.14, 95% CI0.07 to 0.29), but increased unstable angina compared to placebo (OR 3.32, 95% CI 1.50 to 7.36). There was a significant reduction of nitrate consumption when beta blockers were compared with CCBs (OR 1.18, 95% CI 1.54 to 0.82),but not with placebo and trimetazidine. There was no significant difference in angina attack between each group. Side effects in beta blocker were similar with ones in controls. CONCLUSIONS: Beta blockers may decrease the death and unstable angina when compared with no treatment, but no more effective than other anti-anginal agents on prophylaxis of myocardial ischaemia in stable angina patients.
Subject(s)
Adrenergic beta-Antagonists/administration & dosage , Angina, Stable/drug therapy , Adrenergic beta-Antagonists/adverse effects , Aged , Angina, Stable/complications , Angina, Stable/mortality , Angina, Unstable/etiology , Angina, Unstable/prevention & control , Disease Progression , Drug Administration Schedule , Evidence-Based Medicine , Female , Humans , Male , Middle Aged , Myocardial Infarction/etiology , Myocardial Infarction/prevention & control , Odds Ratio , Randomized Controlled Trials as Topic , Risk Assessment , Risk Factors , Time Factors , Treatment OutcomeABSTRACT
OBJECTIVE: To study the expression of vitamin D receptor in bone of immobilized immature rat and explore the relation between disuse osteoporosis (DOP) and the expression of vitamin D receptor (VDR) in bone. METHODS: Rats aging 4 weeks were immobilized by limb-tail fixation for 2 and 4 weeks respectively, and then the wet weight, gray weight, bone mineral density of femurs and tibiae were measured, the histopathological and histomorphological parameters also were detected, which were used to evaluate the effect of immobilization on bone content and bone structure of femurs and tibiae in growing rats. The VDR expression of femurs and tibiae in the growing rats was evaluated by immunohistochemistry and image analysis. RESULTS: The wet weight, gray weight, and bone mineral density of immobilized limbs in the growing rats were all lower than those in age-matched control groups (P < 0.05). There were rare, small and broken bone trabeculae found in the histological films of proximal tibial metaphysis of immobilized limbs, with decreased trabecular area and perimeter (P < 0.05), comparing with the age-macthed control groups. Over-expression of VDR in cellular plasma and nuclear membranes of osteoblasts was also found in the proximal metaphysis of right hind limb in immobilized growing rats. CONCLUSIONS: It is a definite method to establish animal model of DOP in young rats by leg-tail fixation; over-expression of Vitamin D receptors in growing bone of immobilized rat limbs means that the disorder of vittamin D endocrine system may be related to pathogenesis of DOP.
