Objective To review the efficacy and safety of Kushenin combined with Adefovir Dipivoxil for Chronic Hepatitis B (CHB). Method Randomized controlled trails of Kushenin combined with Adefovir Dipivoxil for CHB were gathered from PubMed, CBMdisc (1978 to 2009), and CSJD (1989 to 2009), while other relative researches were searched manually; every research was evaluated, and then analyzed with RevMan 5.0.0 software. Result Ten randomized controlled trials were included; among total 855 patients, 436 were in trial group and the other 419 were in control group. As the Meta-analysis showed, the therapeutic effect of kushenin combined with Adefovir Dipivoxil was better than that of Adefovir Dipivoxil in aspects of improving the negative rate of serum ALT (RR=1.28, 95%CI 1.17 to 1.40), the negative rate of serum HBV-DNA (RR=1.27, 95%CI 1.13 to 1.42), the negative rate of serum HBeAg (RR=1.80, 95%CI 1.32 to 2.44), and the conversion rate of HBeAg and anti-HBe (RR2.06, 95%CI 1.43 to 2.95). Conclusion Kushenin combined with Adefovir Dipivoxil in treating CHB can improve the conversion rate of HBeAg and anti-HBe and further take better therapeutic effect.
Objective To assess the effectiveness and safety of Tongxinluo Capsule in the treatment of vertebrobasilar artery insufficiency. Methods The Cochrane Library, MEDLINE, VIP and CNKI were searched. Two authors independently collected data, including randomized controlled trials that met the inclusion criteria. They evaluated the quality of these trials and performed meta-analysis using The Cochrane Collaboration’s RevMan 5.0. Results Eleven studies involving 1157 participants were included. All the included studies were inadequate at reporting randomization, concealment of allocation and blinding. Meta-analysis based on the included studies showed that Tongxinluo Capsule with Danshen was better than Danshen alone in vertebrobasilar artery insufficiency (RR= 1.35, 95%CI 1.24 to 1.48) and blood flow velocity of vertebrobasilar artery (WMD=3.60, 95%CI 2.44 to 4.77 and WMD=3.46, 95%CI 1.89 to 5.04). Tongxinluo Capsule with simple basic therapy was better than simple basic therapy alone in vertebrobasilar artery insufficiency (RR=1.21, 95%CI 1.11 to 1.31) and blood flow velocity of vertebrobasilar artery (WMD=3.85, 95%CI 2.19 to 5.51). Conclusion Tongxinluo Capsule is an effective and safe drug for vertebrobasilar artery insufficiency. However, due to the limited quantity and quality of the included studies, we can not draw a firm conclusion about the effectiveness of Tongxinluo Capsule compared to the simple basic therapy or Danshen. The results suggest that further and larger-scale trials using Tongxinluo Capsule for vertebrobasilar artery insufficiency are needed.
Objective To evaluate the effectiveness and safety of different doses of interferon alfa (INF-α) in the treatment of chronic hepatitis C (CHC). Methods Such databases as MEDLINE, EMbase, CENTRAL, CBM, CNKI, VIP and WanFang Data were searched to collect the randomized controlled trials (RCTs) on different doses of INF-α in the treatment of CHC published before August, 2012. According to the inclusion and exclusion criteria, two reviewers independently screened literature, extracted data and evaluated the quality of the included studies, and then meta-analysis was performed using RevMan 5.0 software. Results A total of 13 RCTs involving 1 442 patients were included. The results of meta-analysis on different doses of INF-α showed that, a) There was no significant difference in the complete response rate between the 3 MU dose group and the 1 MU dose group (RR=0.83, 95%CI 0.52 to 1.32, P=0.43), but there was significant difference in the sustained response rate between those 2 groups (RR=1.89, 95%CI 1.00 to 3.59, P=0.05); and b) No significant differences were found in the complete response rate among the 3 MU dose group, the 6 MU dose group, and the 1 MU dose group. Conclusion INF-α in dose of 3 MU, 3 times daily, is effective in treating CHC, but it would not rule out that higher dose takes more effective action. When INF-α is used to treat CHC, an individualized medication should be applied according to patients’ tolerance and economic status.
Objective To assess the effectiveness of exemestane in the treatment of postmenopausal women with breast cancer. Methods We searched The Cochrane Library, PubMed, CBMdisc, and CNKI to identify randomized controlled trials (RCTs) that met the inclusion and exclusion criteria. Two reviewers extracted the data and evaluated the quality of included trials, respectively. Meta-analysis was performed using RevMan 5.0 software. Results A total of 12 RCTs involving 6 166 participants were included, and the results of meta-analyses showed that: (1) When used in neoadjuvant endocrine therapy after operation, exemestane was more effective in progression-free survival than tamoxifen; (2) When used in rescue therapy, exemestane was more effective in objective response than tamoxifen, but not more effective than letrozole or anastrozole; (3) When used in new neoadjuvant endocrine therapy before operation, exemestane was not more effective than letrozole, and there was too little research about it. Conclusions The current evidence shows that exemestane has certain short-term therapeutic effect, but its long-term therapeutic effect is unknown. More high-quality clinical trials are expected for further study.
Objective
To evaluate the effect of physician-nurse-pharmacist collaboration on cardiovascular disease risk factors in diabetes patients.
Methods
Randomized controlled trails (RCTs) on collaboration among physicians, nurses and pharmacists for reducing cardiovascular disease risk factors in diabetes patients were collected from Cochrane Central Register of Controlled Trials, Medline (Ovid SP), Embase, China Knowledge Resource Integrated Database, VIP and WanFang. We screened the retrieved studies according to the inclusion and exclusion criteria, evaluated the quality of included studies, and then performed meta-analysis with the Cochrane Collaboration’s Revman 5.3.0 software.
Results
Seven RCTs were included. The results of meta-analysis showed that the change in glycosylated hemoglobin A1c, systolic blood pressure, diastolic blood pressure and low density lipoprotein-cholesterol were significantly reduced in the collaboration group than in usual care group [SMD=–0.39, 95%CI (–0.56, –0.21),P<0.000 1;SMD=–0.30, 95%CI (–0.43, –0.18),P<0.000 01;SMD=–0.37, 95%CI (–0.64, –0.11),P=0.006;SMD=–0.11, 95%CI (–0.16, –0.06),P<0.000 1].
Conclusions
Collaboration among physicians, nurses and pharmacists is effective for reducing cardiovascular disease risk factors in diabetes patients. But its long-term efficacy still needs to be confirmed by performing higher quality, large sample RCTs with long-term follow-up.
ObjectiveTo systematically review the thromboembolic risk of Janus Kinase (JAK) inhibitors. MethodsWe searched PubMed, Embase, Cochrane Library, and Web of Science databases from inception to March 2025. Quality was assessed using Cochrane Risk of Bias-2. Stata 15 software was used for network meta-analysis. ResultsA total of 68 randomized controlled trials with a sample size of 39 059 were included. Findings did not show a significant difference between JAK inhibitors and placebo, methotrexate, tumor necrosis factor -α inhibitor, apremilast, otilimab in the risk of thromboembolism. ConclusionJAK inhibitors do not increase thromboembolism risk. To clarify the long-term safety of JAK inhibitors, future large-scale real-world studies with long-term follow-up are needed, especially in patients at risk of thromboembolism.
【摘要】 目的 探討非諾貝特致藥品不良反應(ADRs)的一般規律和特點。 方法 檢索PubMed(1978年-2009年8月)、中國期刊全文數據庫CNKI(1980年-2009年8月)、中國生物醫學文獻數據庫CBMDise(1980年-2009年8月)非諾貝特所致ADRs文獻,進行統計、分析。 結果 非諾貝特致ADRs多發生在gt;40歲年齡段,與性別無顯著關聯;64例ADRs主要涉及骨骼肌肉系統、消化系統、泌尿生殖系統、過敏反應,及時處理者預后良好。 結論 臨床上應重視非諾貝特所致ADRs,及時處理。【Abstract】 Objective To analyse the clinical features, correlation factors, preventions and cures of (adverse drug reactions, ADRs) caused by fenofibrate. Methods The cases of ADRs caused by fenofibrate were collected and analyzed from Pubmed (1978 - August 2009), CNKI (1980 - August 2009) and CBMDise (1980 - August 2009). Results Fenofibrate-induced ADRs were mostly seen in patients over 40 years old, but which was independent for sex. Totally, 64 ADRs were involved in the skeletal musculature system, digestive system, urinogenital system, and allergic response. The prognosis was favorable. Conclusion More attention should be given to patients with fenofibrate and ADRs should be treated as soon as possibile.