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.
【摘要】 目的 评价肾移植术后他克莫司（TAC）低剂量对比常规剂量干预的疗效和安全性。 方法 检索MEDLINE、EMbase、SCI、CBM、Cochrane图书馆，纳入肾移植术后TAC低剂量对比常规剂量免疫抑制治疗的随机对照试验（RCT）。检索时间从各个数据库建库至2009年12月，对纳入研究进行方法学质量评价和Meta分析。 结果 纳入3个RCT，其中A级研究2个，B级研究1个。分析结果显示:两组急性排斥反应发生率比较，无统计学意义[RR=1.39， 95%CI(0.64， 3.01)]；肾小球滤过率、受者/移植物生存率和纳入分析的安全性指标差异均无统计学意义。 结论 基于当前临床证据，肾移植术后TAC低剂量与常规剂量干预相比，近期疗效和安全性相似；远期结果尚需进一步研究探讨。【Abstract】 Objective To evaluate the effect and safety of low-dose versus standard-dose tacrolimus immunosuppressive therapy on kidney transplant recipients. Methods MEDLINE, EMbase, SCI, CBM and the Cochrane library were searched and randomized controlled trials (RCT) of low-dose versus standard-dose tacrolimus immunosuppressive therapy in kidney transplant recipients were gathered. The search was updated in December 2009. Quality assessment and meta-analysis were performed. Results A total of three RCT were identified, two of which were graded A and one was graded B. The analysis results indicated that RR (95%CI) value of the acute rejection rate was 1.39 (0.64, 3.01); glomerular filtration rate, patient/graft survival rate, and safety analysis were not significant different between the two groups. Conclusion Based on the evidence currently, compared to standard-dose TAC, Low-dose TAC has the same effect and safety results, but further study are needed to get the long term results.
目的 评价酚妥拉明治疗小儿毛细支气管炎的疗效和安全性。 方法 计算机检索Cochrane图书馆，Medline（1950年－2013年），Embase（1980年－2013年），中国生物医学文献数据库（1978年－2013年）、中国知网（1979年－2013年）、万方（1986年－2013年）、维普（1989年－2013年），收集酚妥拉明联合常规方法对比仅用常规方法治疗小儿毛细支气管炎的随机对照试验（RCT），由两名研究者根据纳入与排除标准筛选文献、提取资料并评价质量后，采用RevMan 5.1软件进行Meta分析。 结果 共纳入13个RCT，1 186例患儿。Meta分析结果显示：在常规治疗基础上加用酚妥拉明，其总有效率[RR=1.30，95%CI（1.15，1.46），P＜0.000 1]、平均住院时间[MD=?2.15 d，95%CI（?2.78，?1.53） d，P＜0.000 01]、啰音消失的平均时间[MD=?1.62 d，95%CI（?2.02，?1.23） d，P＜0.000 01]，憋喘消失的平均时间[MD=?2.39 d，95%CI（?4.64，?0.13）d，P=0.04]差异有统计学意义，而气促消失的平均时间差异无统计学意义[MD=?0.62 d，95%CI（?1.31，0.07）d，P=0.08]。 结论 在常规治疗基础上加用酚妥拉明治疗小儿毛细支气管炎时，其疗效疗效优于仅采用常规治疗，在缓解啰音、憋喘等临床症状上起效更快。而在安全性方面证据不足，需要进一步的研究。
Objective To assess the effectiveness and safety of cyclosporine A (CsA) for aplastic anemia (AA) in China. Methods Randomized controlled trails (RCTs) of CsA for AA were collected from CBMdisc (1978 to 2008), CNKI (1979 to 2008), and VIP (1989 to 2008). Other relevant journals were also hand searched. The methodological quality of included studies was evaluated, and data analyses were performed with The Cochrane Collaboration’s software RevMan 4.2.0. Results A total of 19 RCTs were included. As for the total effective rate and complete remission rate, significant differences were noted between CsA + androgen vs. androgen alone, CsA + androgen combination vs. androgen combination, as well as CsA + androgen + other drugs vs. androgen + other drugs [total effective rate: RRs and 95%CIs were 1.48 (1.28 to 1.70), 1.67 (1.17 to 2.39), and 1.51 (1.09 to 2.08); complete remission rate: RRs and 95%CIs were 2.06 (1.33 to 3.19), 3.52 (1.19 to 10.39), and 1.54 (1.00 to 2.38)]. Conclusion According to the domestic evidence, treatment with CsA for AA may improve the total effective rate and complete remission rate. However, more high quality clinical trials are expected for further study.
Objective To find out the beneficial and harmful effectiveness of tacrolimus (TAC) compared with cyclosporine A (CSA) for simultaneous pancreas-kidney transplant (SPKT) recipients. Methods Randomized controlled trials (RCTs) of TAC versus CSA for SPKT recipients were collected from The Cochrane Library, MEDLINE, EMbase, SCI, and CBM database. Bias risk assessment and meta-analysis were performed based on the methods recommended by the Cochrane Collaboration. Results Five RCTs including 342 recipients were included. Pooled data of pancreas survival favored TAC (RR=1.15, 95%CI 1.04 to 1.27; RD=0.11, 95%CI 0.03 to 0.19). However, there were no significant differences of acute rejection (RR=0.81, 95%CI 0.58 to 1.12), patient survival (RR=1.00, 95%CI 0.94 to 1.05), kidney survival (RR=1.02, 95%CI 0.95 to 1.09), and infection (RR=1.00, 95%CI 0.83 to 1.20). Conclusion Based on the recent evidence, TAC results in higher episodes of pancreas survival compared with CSA after SPKT. Treating 100 patients with TAC instead of CSA would increase pancreas survival in 11 recipients.
Objective To collect and analyze the data of emergency medicine supply for both Wenchuan and Lushan earthquakes victims in the West China Hospital, so as to provide evidence for scientifically and efficiently carrying out the logistical support for emergency rescue medicines supply, and improving the coping capacity for those similar public health emergencies. Methods Both medicine constituent ratios and DDDs were taken as evaluation indexes, and the data were input by Excel software. Then the following items were analyzed: the use and cost of emergency medicine for victims admitted in the hospital from one day to one month after earthquake, as well as, the acceptance, allocation and use of the donation medicines for both Wenchuan and Lusan earthquakes. Results During the first month after Lushan earthquake, the victims used 26 categories of medicines involving 455 drug specifications in the West China Hospital. The dosage and DDDs of therapeutic medicines were higher than those of ancillary medicines. The donation medicines for Lushan earthquake accepted by the hospital were in 8 categories involving 16 drug specifications, and they were all used to rescue the victims in the hospital. Based on the hospital emergency medicine supply system oriented by the information of victim’s medicine use, the drug specification and total drug cost of the donation medicines for Lushan earthquake decreased by 90.91% and 89.73%, respectively, indicating a more accurate and efficient system compared with those for Wenchuan earthquake. Conclusion The implementation of the hospital emergency medicine supply system oriented by the information of victim’s medicine use is helpful to improve the time efficiency and pertinence of earthquake medical rescue.
目的 评价参附注射液治疗老年人心力衰竭疗效和安全性。 方法 计算机检索Cochrane图书馆，Medline（1950年－2013年10月），Embase（1980年－2013年10月），中国知网（1979年1月－2013年10月）、万方（1986年1月－2013年10月）、维普（1989年1月－2013年10月）数据库，全面收集参附注射液联用西药常规治疗（试验组）与西药常规治疗疗效（对照组）比较的随机对照试验（RCT），分别由2名研究者根据纳入与排除标准，独立筛选文献、提取资料并评价文献质量，采用Revman 5.1软件进行Meta分析。 结果 共纳入8个研究559例患者，研究质量均为C级。Meta分析结果显示：与对照组比较，试验组临床疗效明显提高、症状改善[RR=1.20，95%CI（1.11，1.29），P＜0.000 01]，左室舒张末期内径减小明显[MD=5.90，95%CI（3.97，7.84），P＜0.000 01]、6 min步行试验距离增加[MD=62.48，95%CI（43.12，81.84），P＜0.000 01]，但左室射血分数两组差异无统计学意义[MD=4.79，95%CI（－0.07，9.65），P=0.05]。 结论 参附注射液与西药常规治疗联用能进一步提高老年心力衰竭患者的临床疗效，且安全性较好。
Objective To analyze the scientific research output of West China Hospital of Sichuan University from 2015 to 2020, so as to evaluate the effectiveness of new scientific research management model. Methods From January 2018, a series of management measures were introduced, including improving research incentive policies, integrating and supporting resources, constructing a scientific quantitative research performance evaluation system, and establishing an information-based research service model. The changes of scientific research output before (2015-2017) and after (2018-2020) the implementation of the management measures were analyzed to evaluate the quality and effectiveness of the management model. Results A total of 10141 high-quality research papers were seized and 2311 research projects were approved. After the implementation of the measures, the absolute number of papers published and projects approved increased significantly. In terms of high-quality papers published after the implementation of the measures, the increase rate reached 46.80%, among which the number of interdisciplinary papers increased by 116.05%, the number of reviews increased by 96.13%, the numbers of papers published in Area 2 and Area 1 increased by 114.67% and 75.00%, respectively, and the number of co-author papers increased by over seven times. In terms of scientific research projects approved after the implementation of the measures, the number of projects approved by the National Natural Science Foundation of China (NSFC) increased by 21.03%, and the number of provincial and ministerial projects increased by 110.17%, with the people in charge becoming younger. The number of principal investigators of NSFC increased by 1.67 times. The number of projects managed by intermediate and undetermined professional titles increased by 64.71% and 68.63%, respectively. The number of projects approved by youth and general fund increased by 30.26% and 14.16% respectively. The number of people in charge of provincial and ministerial projects increased by 1.45 times. The number of projects managed by deputy senior and intermediate titles increased by 1.64 times and 1.54 times, respectively. Key research and development projects, key projects, international cooperation projects, and basic application projects saw a significant increase. Conclusions After the implementation of management measures, the number and overall level of research papers have been improved, and the cross-cooperation between clinical and basic research has been gradually started. The number of projects approved increased significantly, and the project leaders tended to be younger. The high-quality cultivation and continuous growth of scientific research talents achieved initial results.