ObjectiveTo compare the efficacy and compliance of children children with refractory epilepsy receiving ketogenic diet (KD) in outpatient department with children receiving KD treatment in inpatient department.
MethodsA retrospective study of 44 children with intractable epilepsy receiving the modified classical ketogenic diets in outpatient department from June 2014 to December 2015, who were followed-up during the third, sixth and twelfth month. Records of epileptic seizures and adverse reactions were used to evaluate the efficacy and retention rate of inpatient department KD treatment in children with refractory epilepsy, and compared with 104 children receiving KD treatment in inpatient department at the same period.
ResultsThirty-four of the forty-four children comleted observation after 12-month follow-up, 15 cases had been seizure freedom, 22 cases had more than 50% reduction in seizure frequency, 12 patients had less than 50% reduction in seizure frequency.The total effective rate of the KD therapy in outpatient department was 64.7%, and the retention rate was 71%. 18 of of the 104 children with KD treatment in inpatient department at the same period comleted observation after 12-month follow-up, 3 cases had been seizure freedom, 5 cases had more than 50% reduction in seizure frequency, 13 cases had less than 50% reduction in seizure frequency.The total effective rate of the KD therapy in inpatient department was 27.8%, and the retention rate was 17.3%.
ConclusionThe KD therapy in outpatient department is effective to children with intractable epilepsy, and there is a highly efficacy and compliance of children receiving KD in outpatient department comparing with children receiving KD in inpatient department. Therefore, it's optional to children with refractory epilepsy who can't received KD by inpatient department because of insufficient number of beds.
Objective To assess the efficacy and safety of levoamlodipine besylate for essential hypertension. Methods We searched MEDLINE (1999 to October 2007), EMBASE (1999 to October 2007), The Cochrane Library (Issue 3, 2007), CNKI (1999 to 2007), Wanfang (1999 to 2007), VIP (1999 to 2007) and CBM (1999 to October 2007). The quality of included studies was critically evaluated. Data analyses were performed with The Cochrane Collaboration’ s RevMan 4.2 software. Results A total of 345 articles were retrieved, but only 17 were finally included. Meta-analyses showed that the effective rate in patients receiving levoamlodipine besylate was significantly higher than that in patients receiving indapamide (RD 0.14, 95%CI 0.06 to 0.22, P=0.0004), while no significant differences were noted between the levoamlodipine besylate group and other control groups. The incidence of adverse effects was significantly lower in the levoamlodipine besylate group compared to the indapamide group (RD –0.12, 95%CI –0.21 to –0.03, P=0.01), the amlodipine group (RD –0.06, 95%CI –0.11 to –0.01, P=0.02) and the nitrendipine group (RD –0.27, 95%CI –0.46 to –?0.08, P=0.006). No significant differences were observed between the levoamlodipine besylate group and other control groups. Conclusion Levoamlodipine besylate tends to have better efficacy and safety profiles compared with other antihypertensive drugs. However, most trials included in the review were of poor quality and, so, multi-center large-scale randomized controlled trials of higher quality are needed to confirm this.
ObjectivesTo systematically review the efficacy and safety of doxazosin for ureterolithiasis.MethodsPubMed, EMbase, Web of Science, The Cochrane Library and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) of comparing doxazosin with conservative treatment or tamsulosin for ureterolithiasis from inception to October, 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, RevMan 5.3 software was used to perform meta-analysis.ResultsA total of 15 RCTs involving 1 062 patients were included. The results of meta-analysis showed that: compared with conservative treatment, doxazosin significantly facilitated ureteral stone expulsion (RR=1.62, 95%CI 1.45 to 1.81, P<0.000 01). No statistical significant difference was found in stone-free rate (RR=0.96, 95%CI 0.83 to 1.11, P=0.57), stone expulsion time (SMD=?0.17, 95%CI ?0.52 to 0.19, P=0.35) or pain episode frequency (SMD=0.21, 95%CI ?0.15 to 0.56, P=0.25) between doxazosin and tamsulosin. Treatment-associated serious side effects were rarely reported.ConclusionCurrent evidence shows that doxazosin is an efficient and safe medical expulsion agent for ureterolithiasis management. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.
Cenobamate is one of the latest antiseizure medications (ASMs) developed for the treatment of focal onset seizures in adult patients. Cenobamate is characterized by a peculiar pharmacology. The mechanisms responsible for its anti-seizure activity include enhancement of the inactivated state of voltage-gated sodium channels with blockade of the persistent sodium current and positive allosteric modulation of GABAa receptors at a non-benzodiazepine binding site. Studies showed that cenobamate appears to be an effective treatment for focal epilepsy, showing reductions in seizure frequency, increased responder rates, and high rates of seizure freedom, and is well tolerated and safe. This article reviews the mechanism, pharmacokinetic characteristics, clinical efficacy, and safety of cenobamate as a novel anti-seizure drug
Objective
To investigate the efficacy and influential factors of interventional therapy for post-intubation tracheal stenosis.
Methods
The clinical data of 69 patients with tracheal stenosis after tracheal intubation in the First Affiliated Hospital of Guangzhou Medical University from February 2010 to March 2015 were retrospectively analyzed. The effects of interventional treatment for tracheal stenosis after intubation were evaluated by reviewing the medical records and telephone follow-up for more than 1 year. Multivariate logistic regression model was used to analyze the influential factors.
Results
The study recruited 69 patients with the median age of 44 years. After the interventional treatment, ATS dyspnea score decreased from (2.41±0.76) points to (0.65±0.62) points ( P<0.01), the diameter of airway lumen increased from (4.24±2.05)mm to (10.57±3.14)mm ( P<0.01). The short-term effective rate of interventional therapy was 92.8% (64/69) but the restenosis rate in 1 month, 3 months and 1 year after interventional treatment were 56.5%, 26.1% and 36.2%, respectively. Multivariate logistic regression analysis showed that diabetes (OR=2.819, 95%CI 1.973-4.062）, shortness of breath score >3 points (OR=13.816, 95%CI 5.848-32.641）, trachea stenosis diameter <4.5 mm (OR=7.482, 95%CI 4.015-13.943), tracheal stenosis grade ≥4 (OR=3.815, 95%CI 2.258-6.447), stenosis in the upper trachea (OR=5.173, 95%CI 3.218-8.316) were risk factors of interventional therapy for post-intubation tracheal stenosis.
Conclusions
The general efficacy of interventional treatment for tracheal stenosis after tracheal intubation is poor, and the recurrence rate is still high. The high degree of tracheal stenosis, diabetes mellitus and upper tracheal stenosis are important factors that affect the efficacy of respiratory interventional therapy.
ObjectiveTo investigate the predicting effect of PIK3CA mutations for the efficacy and prognosis of hepatocellular carcinoma (HCC) patients received surgical resection.
MethodsPCR and DNA sequencing were used to detect the PIK3CA mutation status of 79 HCC tissues, its impact on the short and long term effects of the patients were analyzed.
ResultsIn this group of patients, mutation rate of PIK3CA gene exon 9 was 39.24% (31/79), PIK3CA mutation rate correlated with lymph node status and tumor differentiation (P < 0.05). The therapeutic effect of patients with PIK3CA mutation was significantly poor than that of the non-mutated group (P < 0.05). The three-year cumulative survival of patients with PIK3CA mutation (33.33%) was significantly lower than non-mutated group's (60.00%) by Kaplan-Meier (P < 0.05).
ConclusionPIK3CA gene mutation in exon 9 could impact the efficiency of surgical resection in patients with HCC and could predict a poor survival prognosis.
Objective To systematically review the efficacy and safety of abiraterone acetate in the treatment of castration-resistant prostate cancer. Methods CNKI, WanFang Data, VIP, Web of Science, PubMed, EMbase and The Cochrane Library databases were electronically searched to collect randomized controlled trials on abiraterone in the treatment of castration-resistant prostate cancer from inception to December 31st, 2020. Two reviewers independently screened literature, extracted data and evaluated the risk of bias of the included studies. Meta-analysis was then performed using RevMan 5.3 software. Results A total of 25 randomized controlled trials involving 8 654 patients were included. Meta-analysis results showed that the median radiographic progression-free survival (MD=5.81, 95%CI 3.58 to 8.03, P<0.01), PSA response rate (RR=2.77, 95%CI 1.65 to 4.65, P<0.01), median overall survival (MD=6.44, 95%CI 4.54 to 8.33, P<0.01), median time to PSA progression (MD=2.57, 95%CI 1.30 to 3.84, P<0.01), median PSA progressionfree survival (MD=6.74, 95%CI 5.08 to 8.39, P<0.01), testosterone level control (MD=?0.41, 95%CI ?0.68 to ?0.14, P<0.01), PSA level control (MD=?8.06, 95%CI ?13.82 to ?2.31, P<0.01), effective rate (RR=2.94, 95%CI 1.89 to 4.58, P<0.01), complete remission (RR=1.66, 95%CI 1.02 to 2.72, P<0.05), granulocytopenia (RR=0.18, 95%CI 0.07 to 0.45, P<0.01) and KPS score (MD=4.29, 95%CI 4.06 to 4.52, P<0.01) were significantly superior to non-abiraterone treatment group. The incidence of hypertension (RR=2.04, 95%CI 1.62 to 2.57, P<0.01), heart disease (RR=2.27, 95%CI 1.80 to 2.86, P<0.01) and hypokalemia (RR=2.89, 95%CI 1.59 to 5.26, P<0.01) adverse reactions were significantly higher than those in non-abiraterone group. The number of drug withdrawals caused by adverse reactions (RR=1.26, 95%CI 0.98 to 1.61, P>0.05), fluid retention or edema (RR=1.23, 95%CI 0.73 to 2.09, P>0.05), liver function damage (RR=1.66, 95%CI 0.93 to 2.97, P>0.05), fatigue and weakness (RR=0.97, 95%CI 0.73 to 1.29, P>0.05), anemia (RR=0.86, 95%CI 0.64 to 1.16, P>0.05) and elevated blood glucose (RR=1.51, 95%CI 0.96 to 2.36, P>0.05), were not significantly different between the two groups. Conclusion Abiraterone acetate can effectively delay the progression of castration-resistant prostate cancer, prolong the survival period, and improve the quality of life. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
Objective To access the efficacy and safety of different doses of metoprolol for patients with chronic heart failure. Methods We searched databases such as MEDLINE, EMbase, The Cochrane Library, CBM and CMCC. The search was conducted in March 2006. Randomised controlled trials, systematic reviews, and current guidelines of chronic heart failure were reviewed. The efficacy and safety of the high-dose (≥100 mg/d) and low-dose metoprolol (lt;100 mg/d) were compared. Results Only one small-scale, short-term randomised trial met our inclusion criteria. This found that metoprolol 100 mg/d was more effective than 25 mg/d and 50 mg/d. A sub-group analysis of MERIT-HF recommended individualized titration for drug administration. Most guidelines suggested that the administration of metoprolol CR/XL for chronic left ventricular systolic dysfunction should be performed by titrating up to 200 mg/d or the maximum tolerance dose. Patients receiving 100 mg/d might have more adverse events than those receiving a lower dose than this. However, in the long-term, it’s the benefits of high-dose treatment outweighed its risks. Race-related differences in tolerance or dose-related adverse effects were not found. Conclusion We couldn’t determine an optimal dose based on the existing evidence, but a target dose of metoprolol CR/XL 200 mg/d is safe and effective. We are unable to draw any conclusions about the relationship between dose and adverse effects.
Objective To explore the efficacy and safety of bioactive material(combest) which is combinated with bioglass and hyaluronan on burn wound healing．Methods From March to September 2006, 20 patients were treated; including 16 males and 4 females, aging 18-58 years(40 years on average)．The wounds were classified as deep degrees Ⅱ in 7 cases, granulated wounds in 9 cases and graft site wounds in 4 cases. Twenty wounds in one side were repaired with Combest as the test group and 20 wounds in the other side with blank cream as the control group. The wounds in size ranged from 2.0 cm×1.5 cm to 40.0 cm×20.0 cm. The wound healing rate was observed, and the blood test and the indices of hepatic and renal function were determined on the 1st, 3 rd,6 th, 11 th, 16 th and 21 st days of treatment．Results Wound healed within 3 weeks in 11 cases of the test group (3 cases on the 11 st day, 4 on the 16 th day, and 4 on the 21 st day) , but no wound healing was observed within 3 weeks in the control group. The healing size accounted for 2/3 of wounds in 18 cases of the test group and in 1 case of the control group. The excellent and good rates were 95%(18 cases and 1 case) in the test group and 50% (1 case and 9 cases) in the control group, showing significant difference (Plt;0.01). For all patients, no obvious changes were found in the blood test and hepatic or renal function indices. Conclusion Combest combinated with bioglass and hyaluronan is beneficial to the proliferation of the granulation and wound healing with good safety.
Objective To evaluate the effectiveness and safety of kushenin for chronic hepatitis B. Methods We searched The Cochrane Hepato-Bil iary Group Controlled Trials Register (March, 2006), The Cochrane Central Register of Controlled Trials (CENTRAL) (Issue 1, 2006), MEDLINE (1966 to present), EMBASE (1966 to present), OVID (1965 to present), the Chinese Biomedical Database (CBM) (1978 to 2006) and CNKI. Qual ity assessment and data extraction were conducted by two reviewers independently, and disagreement, if any, was resolved by discussion. Meta-analyses were performed for homogeneous studies. Results A total of 56 studies involving 5156 patients met the inclusion criteria. These included 3 randomized controlled trials (RCTs), 7 quasi-RCTs, and 46 other studies that did not report randomization methods. None of the trials enforced allocation concealment and only one trial performed blinding.We conducted subgroup analyses based on the outcome measures and interventions. Compared with interferon,the HBeAg seroconversion rate at 12 months after treatment was lower in patients treated with kushenin (RR=0.72, 95%CI 0.58 to 0.90); compared with lamivudine, a lower HBV DNA seroconversion rate after 12 and 24 weeks of treatment was associated with kushenin (RR=0.48, 95%CI 0.33 to 0.70; RR=0.40, 95%CI 0.26 to 0.63). No significant differences were noted between the kushenin group and the control group for all the other outcome measures. Conclusion Kushenin might be effective in normal izing ALT levels, clearing HBV DNA, achieving virus seroconversion and improving hepatic fibrosis, without any serious adverse effects. However, because the overall effects cannot be pooled for analysis, more evidence is needed to support this finding.
