An Update on the Efficacy and Safety Profile of Clazosentan in Cerebral Vasospasm After Aneurysmal Subarachnoid Hemorrhage: A Meta-Analysis.

OBJECTIVE: The present meta-analysis was conducted to provide an update on the efficacy and safety profile of clazosentan with different doses in aneurysmal subarachnoid hemorrhage (aSAH). METHODS: We performed a comprehensive and electronic search updated to September 2018 of The Cochrane Library, Embase, and PubMed to identify relevant clinical trials. Trials of the effectiveness of clazosentan in treating cerebral vasospasm after aSAH were studied. The main outcomes included new cerebral infarction (NCI), delayed ischemic neurologic deficit (DIND), vasospasm associated with morbidity/mortality, angiographic vasospasm, rescue therapy, and adverse events. We applied RevMan 5.3 software for this meta-analysis to analyze the combined pooled odds ratios (ORs) with 95% confidence intervals (CIs) using a fixed- or random-effects model on the basis of heterogeneity. RESULTS: A total of 5 randomized placebo-controlled trials were included in this meta-analysis. Beneficial outcome was found in patients who received higher doses of clazosentan (>5 mg/h) after aSAH based on decreased incidence of DINDs (OR, 1.76; 95% CI, 1.16-2.69; P = 0.008), NCIs (OR, 2.31; 95% CI, 1.34-3.95; P = 0.002), and angiographic vasospasms (OR, 1.85; 95% CI, 1.19-2.89; P = 0.007). Meanwhile, other parameters, such as vasospasm-related morbidity/mortality, rescue therapy, and adverse events, showed no statistical significance (P > 0.05) between high and low doses of clazosentan. CONCLUSIONS: The significant beneficial outcomes of high-dose clazosentan have been proven in preventing cerebral vasospasm and subsequent cerebral infarction compared with low-dose clazosentan, with a manageable safety profile. However, high doses of clazosentan had no significant effect on rescue therapy and vasospasm-related morbidity/mortality.

Effectiveness of lomustine and bevacizumab in progressive glioblastoma: a meta-analysis.

BACKGROUND: Glioblastomas (GBMs) are the most aggressive type of glial brain tumors. Despite aggressive treatment with surgery and chemoradiation, GBMs invariably relapse and tumors are progressive. Controversy remains on optimal treatment of patients with recurrent GBMs. Data from previous trials have suggested that the addition of bevacizumab (BEV) to lomustine (CCNU) might improve overall survival (OS) as compared with that with monotherapies. The aim of this study was to compare the efficacy of BEV in addition to CCNU versus single-agent therapy in patients with recurrent GBM. METHODS: Electronic databases were searched for eligible literature updated in December 2017. Trials assessing the effectiveness of CCNU and BEV in progressive GBM were included, of which the main outcomes were progression-free survival (PFS) and OS. All the data were pooled with the corresponding 95% confidence intervals (CIs) using RevMan software. Sensitivity and heterogeneity were quantitatively evaluated. RESULTS: Three randomized clinical trials were identified, including 574 patients (combination group: 358, monotherapies group: 216). The combination group treated with BEV and CCNU showed improvement in PFS (OR = 0.49; 95% CI, 0.41-0.59; p < 0.00001). No significant differences were, however, found in patients in terms of the OS (OR = 0.84; 95% CI, 0.68-1.03; p = 0.09). CONCLUSION: Although treatment with CCNU plus BEV prolonged PFS, it did not confer OS advantage over monotherapies in patients with progressive GBM. The encouraging results of the addition of CCNU to BEV warrant investigation in further randomized trials.

[Determination of trace elements in Lophatherum gracile brongn from different habitat by microwave digestion-atomic absorption spectroscopy].

A method of microwave digestion technique was proposed to determine the content of Zn, Fe, Cu, Mn, K, Ca, Mg, Ni, Cd, Pb, Cr, Co, Al, Se and As in Lophatherum gracile brongn of different habitat by atomic absorption spectroscopy. The RSD of the method was between 1.23% and 3.32%, and the recovery rates obtained by standard addition method were between 95.8% and 104.20%. The results of the study indicate that the proposed method has the advantages of simplicity, speediness and sensitivity. It is suitable for the determination of the contents of metal elements in Lophatherum gracile brongn. The experimental results also indicated that different areas' Lophantherum gracile brongn had different trace elements content. The content of trace elements K, Mg, Ca, Fe and Mn beneficial to the human body was rich. The content of the heavy metal trace element Pb in Lophantherum gracile brongn of Hunan province was slightly high. The content of the heavy metal trace element Cu in Lophantherum gracile brongn of Guangdong province and Anhui province is also slightly higher. Beside, the contents of harmful trace heavy metal elements Cd, Cu, Cr, Pb and As in Lophatherum gracile brongn of different habitat are all lower than the limits of Chinese Pharmacopoeia and Green Trade Standard for Importing and Exporting Medicinal Plant and Preparation and National Food Sanitation Standard. These determination results provided the scientific data for further discussing the relationship between the content of trace elements in Lophantherum gracile brongn and the medicine efficacy.

[Simultaneous determination of four glycosylflavones from Lophatherum gracile by RP-HPLC].

OBJECTIVE: To develop a RP-HPLC method for simultaneous determination of orientin, isorientin, vitexin and isovitexin in Lophatherum gracile from different habitat and harvesting time. METHOD: The HPLC method was applied and the chromatographic column was a Waters XBridge C18 column (4.6 mm x 250 mm, 5 microm). The mobile phase consisted of methanol-0.05% acetic acid (35:65). The flow rate was 1.0 mL min(-1) and the detection wavelength was set at 340 nm. The column temperature was set at 25 degrees C. RESULT: Four components were isolated well, the linear relationships were excellent. The mean recoveries and RSD values of orientin, isorientin, vitexin and isovitexin were 103.2%, 2.1%; 101.6%, 2.7%; 98.4%, 2.3%; 99.2%, 1.8%, respectively. CONCLUSION: The HPLC method is simple, sensitive and reliable, and can be used for the quality control of the medicinal material.