OBJECTIVE To systematically evaluate the effectiveness and safety of safflower yellow for injection(SYI)in acute ischemic stroke(AIS).METHODS Computer searches were conducted on CNKI,Wanfang Database,VIP.com,Chinese Biomedical Literature Database,PubMed,Embase,Web of Science and Cochrane Library for randomized controlled trials(RCTs)of SYI combined with conventional Westem medicine treatment as experimental group(EG)and conventional Western medicine treatment as control group(CG).The Cochrane risk of bias assessment tool was used to evaluate the methodological quality of included studies.Statistical analysis was performed using R4.3.1 software.RESULTS A total of 29 RCTs were included.Meta-analysis results showed that compared with the CG group,the total effective rate of the EG group was higher(P＜0.000 1),the patients'NIHSS,Barthel,IL-8,IL-6,plasma viscosity,and hematocrit indexes were improved(P＜0.05);while in terms of NO and FIB indexes,there was no statistically significant difference between the two groups(P＞0.05).In terms of safety,the total incidence of adverse drug reactions in the EG group was lower than that in the CG group(P=0.001 8).The results of sensitivity analysis and publication bias analysis showed that except for the fact that the incidence of adverse reactions reversed to a point had no statistically significant difference between the two groups(P=0.173 4),the results obtained in the study were basically stable,and the possibility of publication bias was small.CONCLUSION Compared with conventional treatment,SYI combined with conventional treatment is generally more effective in terms of effectiveness and does not increase the risk of adverse reactions.
Rheumatoid arthritis (RA) is a chronic, systemic, abnormal inflammatory immune response. It is characterized by the involvement of the synovium and multiple organs and the destruction of joints and articular cartilage. In the past 30 years, several promising novel compounds and antibodies have been developed for the treatment of RA. The introduction of new drugs and precision medicine for all forms of RA raises several issues related to access to novel treatments by patients, optical regimen selection, cost-effectiveness, prognosis monitoring and outcome surveillance, particularly with regard to the development of low drug response rates, drug resistance and adverse side effects. Tremendous attention has been given to the identification of optimized drug combinations for the treatment of RA, particularly in early high-risk vulnerable and early individuals. Addressing these issues requires novel therapeutic approaches with new mechanisms and the establishment of accurate guidelines for drug selection, drug recombination, and non-chemical therapeutic efforts. In this study, we reviewed the most exciting recently established or ongoing novel drugs and approaches according to the clinical trial database maintained by the United States National Library of Medicine and discussed the trends in RA drug development and challenges in the treatment, providing a reference significant for the accurate treatment of RA and the research direction in the future.
The liver cancer has microenvironmental features such as low pH, M2 tumor-associated macrophage enrichment, low oxygen, rich blood supply and susceptibility to hematotropic metastasis, high chemokine expression, enzyme overexpression, high redox level, and strong immunosuppression, which not only promotes the progression of the disease, but also seriously affects the clinical effectiveness of traditional therapeutic approaches. However, nanotechnology, due to its unique advantages of size effect and functionalized modifiability, can be utilized to develop various responsive nano-drug delivery system (NDDS) by using these characteristic signals of the liver cancer microenvironment as a source of stimulation, which in turn can realize the intelligent release of the drug under the specific microenvironment, and significantly increase the concentration of the drug at the target site. Therefore, researchers have designed a series of stimuli-responsive NDDS based on the characteristics of the liver cancer microenvironment, such as hypoxia, weak acidity, and abnormal expression of proteases, and they have been widely investigated for improving anti-tumor therapeutic efficacy and reducing the related side effects. This paper provides a review of the current application and progress of NDDS developed based on the response and regulation of the microenvironment in the treatment of liver cancer, compares the effects of the microenvironment and the NDDS, and provides a reference for building more advanced NDDS.
OBJECTIVE To review systematically the population pharmacokinetic（PPK） study of levetiracetam（LEV） and explore the affecting factors of LEV pharmacokinetic parameters. METHODS The PPK studies using nonlinear mixed effect model method were collected by searching CNKI, Wanfang, VIP, Embase and PubMed. RESULTS A total of 17 studies were included, among which 15 studies characterized LEV pharmacokinetics as a one-compartment model structure. The two most frequently identified significant covariates influencing LEV pharmacokinetics included weight and renal function. For model verification, only 4 studies used external evaluation. CONCLUSION Pharmacokinetic variability of LEV is dependent on the weight and renal function. The generalizability of these PPK models should be externally assessed. Existing studies are insufficient to evaluate the pharmacokinetic behavior of LEV in special populations such as enhanced renal clearance, neonatal and gestational epilepsy patients using PPK method, and further research is needed.
目的 探讨和分析碘对比剂致对比剂相关性脑病(contrast-associated encephalopathy,CAE)的发生情况和特点,为临床安全用药提供参考.方法 检索建库至2022年2月收录在PubMed、Embase、中国知网、万方和维普期刊数据库有关碘对比剂致CAE的病例报道并对其进行整理和分析.结果 共纳入80篇文献合计110例患者,男67例(60.9％),女43例(39.1％),平均(65.2±13.4)岁,其中≥60岁80例(72.7％).CAE的发生时间主要集中在术中至术后24 h内(81.8％),其临床表现以皮质盲最为常见(25.5％),其次是烦躁(23.6％)和意识障碍(20.0％),经水化和糖皮质激素等对症治疗后整体(97.3％)预后良好.结论 虽然CAE较为罕见且预后良好,但在患者应用过程中及之后的至少24 h内仍应密切关注,尤其是对于存在高危因素的患者,一旦出现CAE的相关症状应及时予以水化等对症处理,避免引起不可逆的损害.
