ObjectiveTo research on the advances of stress ulcer drug prophylaxis.
MethodsGuidelines for stress ulcer prophylaxis in and out of China were searched and analyzed. Risk factors for stress ulcer, recommended prevention drugs and safety of medicines were summarized.
ResultsThe risk factors for stress ulcer included mechanical ventilation, coagulopathy, severe sepsis, multiple organ failure, shock, severe head injury, burns, major trauma, older than 65 and drug use. The recommended prevention drugs included proton pump inhibitors, H2-receptor antagonist and misoprostol, which played a role in the reduction of bleeding in intensive care units. However, recommended drugs had little function in the reduction of bleeding in general patients outside the intensive care units, which was even not recommended or supported in the clinical literature. Related adverse effects of these drugs also needed careful consideration.
ConclusionExistence of risk factors for stress ulcer does not necessarily indicate the use of preventive drugs. Drug prophylaxis is used only for critically ill patients. This view summarized by the author provides a reference for physicians and pharmacists.
Objective To systematically review the effectiveness and safety of erlotinib for the elderly with Non-small-cell lung cancer (NSCLC). Methods Databases including The Cochrane Library, PubMed, EMbase, CBM, VIP, CNKI and WanFang Data were electronically searched for relevant randomized controlled trails (RCTs). Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality. Then, meta-analysis was performed using RevMan 5.0 software. Results Totally 5 studies were included. The results of meta-analysis showed that, the objective response rate and stable disease rate was similar between the erlotinib group and the control group with no significant difference (RR=0.99, 95%CI 0.34 to 2.93, P=0.99; RR=1.17, 95%CI 0.95 to 1.43, P=0.14). The incidences of Grade Ⅲ-Ⅳ neutropenia and thrombocytopenia were lower in the erlotinib group than those in the control group (OR=0.12, 95%CI 0.03 to 0.52, P=0.005; OR=0.19, 95%CI 0.04 to 0.91, P=0.04); and the incidences of nausea and vomiting as wel as liver impairments were alike between the two groups (OR=0.93, 95%CI 0.12 to 7.08, P=0.95; OR=0.80, 95%CI 0.24 to 2.68, P=0.71); the incidences of diarrhea and skin rashes in the erlotinib group were higher (OR=5.96, 95%CI 1.28 to 27.88, P=0.02; OR=6.77, 95%CI 1.52 to 30.10, P=0.01). Conclusion Current evidence shows that, erlotinib is effective and safe in treating the elderly with NSCLC with better effects and no serious adverse reaction. However, due to the limited quantity and quality of the included studies, more high quality studies with large sample size and long-term follow-up are still needed to verify the above conclusion.
ObjectiveTo assess the methods, processes and evaluation criteria of burn models in rats.
MethodsDatabases including MEDLINE, EMbase, CBM, CNKI, VIP and WanFang Data were electronically searched from inception to February 2016. The animal studies of burn models development in rats were included. Two reviewers independently screened literatures, extracted data, assessed the quality of included studies, and analyzed the outcomes.
ResultsFifteen studies including 38 burn groups were identified. The results indicated:(1) depth of burn:50.00% burn models were partial thickness burn (II°), and 21.05% were full thickness burn (III°). (2) methods of induction:80.00% burn models were developed through high temperature liquid or solid tools. (3) burn sites:93.33% burns were on the back of rats. (4) induction temperature:66.67% induction temperature was between 80℃ and 100℃. (5) induction time:86.67% induction time was between 3 seconds and 100 seconds. (6) anesthesia:40.00% rats were anesthetized with intraperitoneal injection of pentobarbital sodium. (7) skin preparation:60.00% studies reported the skin was prepared by physical and chemical methods. (8) housing post surgery:13.33% studies reported the housing temperature post surgery. (9) intervention post surgery:13.33% studies reported antishock treatment. (10) assessment criteria:almost all studies evaluated the depth of burn through the macroscopic and microcosmic assessment.
ConclusionBased on current animal studies, most burn models in rats are partial thickness and full thickness burn on the back of rats. Burn is inducted mainly by 80℃ to 100℃ hot liquid or solid tools within 30 seconds, according with skin preparation, anesthesia, antishock or analgesia management. The depth of burn is evaluated by the macroscopic and microcosmic assessment. However, there is no standard for the methods, processes, assessment and reporting of development of burn model in rats.
