Objective To identify the N6-methyladenosine (m6A)-related characteristic genes analyzed by gene clustering and immune cell infiltration in myocardial ischemia-reperfusion injury (MI/RI) after cardiopulmonary bypass through machine learning. Methods The differential genes associated with m6A methylation were screened by the dataset GSE132176 in GEO, the samples of the dataset were clustered based on the differential gene expression profile, and the Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis of the differential genes of the m6A cluster after clustering were performed to determine the gene function of the m6A cluster. R software was used to determine the better models in machine learning of support vector machine (SVM) model and random forest (RF) model, which were used to screen m6A-related characteristic genes in MI/RI, and construct characteristic gene nomogram to predict the incidence of disease. R software was used to analyze the correlation between characteristic genes and immune cells, and the online website was used to build a characteristic gene regulatory network. Results In this dataset, a total of 5 m6A-related differential genes were screened, and the gene expression profiles were divided into two clusters for cluster analysis. The enrichment analysis of m6A clusters showed that these genes were mainly involved in regulating monocytes differentiation, response to lipopolysaccharides, response to bacteria-derived molecules, cellular response to decreased oxygen levels, DNA transcription factor binding, DNA-binding transcription activator activity, RNA polymerase Ⅱ specificity, NOD-like receptor signaling pathway, fluid shear stress and atherosclerosis, tumor necrosis factor signaling pathway, interleukin-17 signaling pathway. The RF model was determined by R software as the better model, which determined that METTL3, YTHDF1, RBM15B and METTL14 were characteristic genes of MI/RI, and mast cells, type 1 helper lymphocytes (Th1), type 17 helper lymphocytes (Th17), and macrophages were found to be associated with MI/RI after cardiopulmonary bypass in immune cell infiltration. Conclusion The four characteristic genes METTL3, YTHDF1, RBM15B and METTL14 are obtained by machine learning, while cluster analysis and immune cell infiltration analysis can better reveal the pathophysiological process of MI/RI.
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.
【摘要】 目的 探讨抗菌药物诱导尖端扭转型室速（torsade de pointes，TDP）的规律及特点，为临床合理用药提供参考。 方法 检索中国期刊全文数据库、维普、万方、中国生物医学文献数据库建库至2011年7月有关抗菌药物致TDP的病例报道，共16例，并进行分析。 结果 16例患者中男3例，女13例；年龄17～88岁，平均54岁。6例患者存在心脏疾病；诱导TDP的抗菌药物包括常用的莫西沙星、司帕沙星、头孢拉定、头孢哌酮、磷霉素、克林霉素、两性霉素B、氟康唑、伊曲康唑以及不常用的红霉素、酮康唑；TDP发生时间为用药后（5.1±6.6） d，多数患者先出现心悸、心电图提示QTc间期延长，进而出现TDP。 结论 临床医师、药师应重视抗菌药物诱导TDP的不良反应。【Abstract】 Objective To investigate the regularity and characteristics of antimicrobial agents-induced torsade de pointes(TDP),and to provide reference for rational use of drugs. Methods A total of 16 reported cases of antimicrobial agents-induced TDP were analyzed. Results The 16 cases including 3 males and 13 females at the age of 17-88 years with the mean age of 54. Six patients suffered from heart disease. The antimicrobial agents included moxifloxacin, sparfloxacin, cefradine, cefoperazone, fosfomycin, clindamycin, amphoterincin B, fluconazole, and itraconazole; which were used frequently, as well as some less frequently-used ones liked erythromycin, ketoconazole. The mean time from medication to onset of TDP was (5.1±6.6) days. Patients usually presented with palpitations at first following by prolonged QTc intervals, and then TDP appeared. Conclusion Clinical physicians and pharmacists should pay attention to antimicrobial agents-induced TDP.
目的 评价卡培他滨+伊立替康与氟尿嘧啶/醛氢叶酸（5-FU/LV）+伊立替康治疗转移性结直肠癌的有效性和安全性。 方法 计算机检索PubMed、CENTRAL、Embase、中国生物医学数据库、中国期刊全文数据库、维普数据库和万方数据库，检索时间均从建库至2011年9月。对符合纳入标准的随机对照试验进行质量评价和Meta分析。 结果 纳入3个随机对照试验，共计419例患者，卡培他滨+伊立替康在中位生存期、完全缓解率[RR=1.58，95%CI（0.27，9.11），P=0.61]、部分缓解率[RR=0.86，95%CI（0.68，1.09），P=0.20]、总有效率[RR=0.88，95%CI（0.71，1.09），P=0.26]上表现出与5-FU/LV+伊立替康相似的效果，安全性方面卡培他滨+伊立替康有较高的Ⅲ/Ⅳ级恶心[RR=1.92，95%CI（1.05，3.54），P=0.04]、腹泻[RR=3.23，95%CI（2.14，4.89），P＜0.000 01]发生风险和较低的Ⅲ/Ⅳ级中性粒细胞减少[RR=0.72，95%CI（0.53，0.98），P=0.04]发生风险。 结论 根据当前现有证据，5-FU/LV+伊立替康可能较卡培他滨+伊立替康更为有利于转移性结直肠癌患者的治疗，但仍需结合临床实际情况进行化疗方案的优选。
【摘要】 目的 探讨非诺贝特致药品不良反应（ADRs）的一般规律和特点。 方法 检索PubMed（1978年-2009年8月）、中国期刊全文数据库CNKI（1980年-2009年8月）、中国生物医学文献数据库CBMDise（1980年-2009年8月）非诺贝特所致ADRs文献，进行统计、分析。 结果 非诺贝特致ADRs多发生在gt;40岁年龄段，与性别无显著关联；64例ADRs主要涉及骨骼肌肉系统、消化系统、泌尿生殖系统、过敏反应，及时处理者预后良好。 结论 临床上应重视非诺贝特所致ADRs，及时处理。【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.
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 assess the effectiveness and safety of irbesartan for hypertensive patients with hyperuricaemia. Methods The databases such as The Cochrane Library (Issue 2, 2010), MEDLINE (by the end of April 2010), SCI (by the end of April 2010), CBM (by the end of April 2010) and CNKI (by the end of April 2010) were searched to collected randomized controlled trails (RCTs) on irbesartan for hypertensive combined with hyperuricaemia. Studies were screened according to the inclusion and exclusion criteria; data were extracted; the methodological quality was evaluated; and meta-analyses were conducted by using RevMan 5.0.0 software. Results Nine studies involving 977 patients were included. The results of meta-analyses showed that compared with the control group, irbesartan was superior in decreasing serum uric acid (SUA) (MD=57.12, 95%CI 16.08 to 98.15, P=0.006); it was similar in controlling blood pressure (Systolic pressure: MD= –0.24, 95%CI –2.19 to 1.71, P=0.81; Diastolic pressure: MD=0.46, 95%CI –1.58 to 2.50, P=0.66), and lower in the incidence rate of adverse reaction (RR=0.07, 95%CI 0.02 to 0.24, P=0.000 1). Conclusion The study suggests that irbesartan is effective and safe to control blood pressure and decrease serum uric acid for hypertensive patients with hyperuricaemia. But because all nine included studies are graded C in quality, the conclusion still needs to be further verified by long-term, large scale and high quality studies.
【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 了解2007年-2008年成都地区17家医院消化系统药物的使用状况。 方法 采用限定日剂量（DDD）的方法，对成都地区2007年-2008年17家医院消化系统用药的销售金额、用药频度（DDDs）等进行统计分析。 结果 2007-2008年成都地区17家医院消化系统用药总金额分别为12 527.89万元和16 446.21万元，居所有药物销售总额的第5位。在金额排序和用药频度排序中，抗溃疡药、肝病用药居于前列。 结论 消化系统药物的应用状态与同期的整体增长保持一致，相比上一年略有上涨。抗溃疡药中的质子泵抑制剂以其优异的性价比，引领着消化系统药物销售额的增长。
Objective To assess the efficacy and safety of mesalazine versus sulfasalazine in the treatment of ulcerative colitis.Methods The literatures were searched from PubMed (1966 to January 2010), the Cochrane Library (1966 to January 2010), EMbase (1974 to January 2010), CNKI (1994 to January 2010), VIP (1989 to January 2010), and CBM (1978 to January 2010). The data were extracted, the quality of studies was evaluated according to The Cochrane Handbook, and meta-analyses were performed using RevMan 5.0 software. Results Sixteen RCTs involving 1 333 patients were included in this study. The results of meta-analyses showed that the total effective rate of the mesalazine group was significantly higher than that of the sulfasalazine group (RR=1.10, 95%CI 1.04 to 1.17, Plt;0.05), and significant differences were noted in the total remission rate (RR=1.82, 95%CI 1.14 to 2.91, Plt;0.05), while there was no significant difference in the relapse rate between the two groups (RR=0.86, 95%CI 0.57 to 1.29, Pgt;0.05). Twelve RCTs reported adverse effects and meta-analyses showed that the incidence of adverse effects was significantly lower in the mesalazine group than in the sulfasalazine group (RR=0.56, 95%CI 0.42 to 0.73, Plt;0.05). Conclusion Analyses show that mesalazine is much more effective and safe in the management of ulcerative colitis than sulfasalazine. However, there is a moderate risk of bias due to methodological quality problems in all 16 included RCTs, so more strictly-designed multi-centered randomized controlled trials with high quality in large-scale are needed to confirm this result.