目的:系统评价阿托伐他汀对稳定期慢性阻塞性肺疾病(COPD)患者肺功能、肺动脉压及相关指标的影响,为临床提供循证参考。方法:计算机检索Cochrane图书馆、PubMed、EMBase、中国期刊全文数据库、中文科技期刊数据库,收集阿托伐他汀联合常...目的:系统评价阿托伐他汀对稳定期慢性阻塞性肺疾病(COPD)患者肺功能、肺动脉压及相关指标的影响,为临床提供循证参考。方法:计算机检索Cochrane图书馆、PubMed、EMBase、中国期刊全文数据库、中文科技期刊数据库,收集阿托伐他汀联合常规基础方案(试验组)对比单纯常规基础方案(对照组)治疗稳定期COPD的随机对照试验(RCT),提取资料并按照Cochrane系统评价员手册5.1.0评价质量后,采用Rev Man 5.3统计软件进行Meta分析。结果:共纳入7项RCT,合计371例患者。Meta分析结果显示,试验组患者第1秒用力呼气容积[MD=0.07,95%CI(0.04,0.09),P<0.001]、第1秒用力呼气容积占预计值百分比[MD=6.18,95%CI(2.23,10.12),P=0.002]、6分钟步行距离[MD=55.31,95%CI(36.44,74.18),P<0.001]均显著高于/长于对照组,肺动脉收缩压[MD=-6.78,95%CI(-11.62,-1.94),P=0.006]、平均肺动脉压[MD=-6.61,95%CI(-7.26,-5.96),P<0.001]、圣乔治呼吸问卷评分[MD=-13.21,95%CI(-23.90,-2.52),P=0.02]均显著低于对照组,差异均有统计学意义;两组患者第1秒用力呼气容积占用力肺活量比值[MD=3.73,95%CI(-2.08,9.55),P=0.21]和高敏C反应蛋白水平[MD=0.29,95%CI(-1.37,1.95),P=0.73]比较,差异均无统计学意义。结论:阿托伐他汀用于稳定期COPD患者可以显著改善患者肺功能和肺动脉压,提高患者生活质量。展开更多
Objective： To examine the variations in the prevalence of skin reactions and the association between skin reactions and efficacy of summer acupoint application treatment （SAAT） on chronic pulmonary disease （CPD）....Objective： To examine the variations in the prevalence of skin reactions and the association between skin reactions and efficacy of summer acupoint application treatment （SAAT） on chronic pulmonary disease （CPD）. Methods： A total of 2,038 patients with CPD were enrolled at 3 independent hospitals （defined as Groups A, B and C, respectively） in China. All patients were treated by SAAT, as applying a herbal paste onto the acupoints of Fengmen （BL 12） and Feishu （BL 13） on the dog days of summer, according to the lunar calendar, in 2008. Ten days after treatment, skin reaction data （no reaction, itching, stinging, blistering, and infection） were obtained via face-to-face interviews. Patients were retreated in the same hospital one year later, thereby allowing doctors to assess treatment efficacy based on the patients＇ symptoms, the severity of the spirometric abnormalities, and the concomitant medications used. Results： A large number of patients （85.3%） displayed reactive symptoms; however, the marked associations between reactive symptoms and age or gender were not observed. An increased number of patients from Group B （99.3%） and Group C （76.5%） displayed reactive symptoms due to the increased mass of crude Semen Sinapis Albae. The effective rate of SPAT was as high as 90.4% for patients of Group B, which was followed by Group A （70.9%） and Group C （42.2%）. Using stratified analyses, a convincing association between reactive symptoms and therapeutic efficacy was observed for patients with asthma [itching： odds ratio （OR）=2,17, 95% confidence interval （CI）： 1.49 to 3.14; blistering： OR=0.43, 95% Ch 0.25 to 0.73; and no reaction： OR=0.56, 95% CI： 0.35 to 0.90]. However, the same tendency was not observed for patients with chronic bronchitis and chronic obstructive pulmonary disease. Conclusions： SAAT can induce very mild skin reactions for patients with CPD, among which patients with asthma displayed a strong association between skin reactions 展开更多
The pathogenesis of the two inflammatory bowel disease(IBD) phenotypes ulcerative colitis(UC) and Crohn' s disease(CD) has remained elusive,thus frustrating attempts at defining a cure.IBD often presents as a comp...The pathogenesis of the two inflammatory bowel disease(IBD) phenotypes ulcerative colitis(UC) and Crohn' s disease(CD) has remained elusive,thus frustrating attempts at defining a cure.IBD often presents as a complex inflammatory process wherein colon lesions(UC) or widespread ulceration and fissure(CD) might be accompanied by ancillary extra-intestinal manifestations involving the eye,skin,joints or liver,but also by full-blown "autoimmune" disorders from psoriasis and multiple sclerosis to rheumatoid arthritis;attempts at unraveling a link or a hierarchical order in these entities have proven almost fruitless.More recently,the input of genetics has suggested that the IBDs might be multiorgan inflammatory processes,elicited by a large number of low-penetrance susceptibility genes,with environmental factors needed to induce full-blown disease.At a noteworthy exception to this rule,the description of the nucleotide-oligomerization domain(NOD) gene mutations in CD came at the beginning of the 2000s:the NOD-LRR are part of a highly conserved microbial sensor system which respond to bacterial peptidoglycans by mounting an inflammatory response.At least in Caucasian patients,the prevalently loss-of-function mutation of NOD permitted to unexpectedly define CD as an immune deficiency state,and upon its recent description in apparently unrelated disorders such as the Blau syndrome(a granulomatous pediatric syndrome),and perhaps in psoriasis and chronic obstructive pulmonary disorders,has contributed to revolutionize our view of IBD and CD in particular.The latter affection,together with psoriasis and chronic pulmonary disease can now be included into a newly identified category named "barrier organ disease",wherein a barrier organ is defined as a large mucosal or epithelial surface with an abundant metagenomic microbial population and an underneath reactive tissue,the whole structure being in contact with the outer environment and capable to react to it.Personalized treatments and empowerment of research across different展开更多
文摘目的:系统评价阿托伐他汀对稳定期慢性阻塞性肺疾病(COPD)患者肺功能、肺动脉压及相关指标的影响,为临床提供循证参考。方法:计算机检索Cochrane图书馆、PubMed、EMBase、中国期刊全文数据库、中文科技期刊数据库,收集阿托伐他汀联合常规基础方案(试验组)对比单纯常规基础方案(对照组)治疗稳定期COPD的随机对照试验(RCT),提取资料并按照Cochrane系统评价员手册5.1.0评价质量后,采用Rev Man 5.3统计软件进行Meta分析。结果:共纳入7项RCT,合计371例患者。Meta分析结果显示,试验组患者第1秒用力呼气容积[MD=0.07,95%CI(0.04,0.09),P<0.001]、第1秒用力呼气容积占预计值百分比[MD=6.18,95%CI(2.23,10.12),P=0.002]、6分钟步行距离[MD=55.31,95%CI(36.44,74.18),P<0.001]均显著高于/长于对照组,肺动脉收缩压[MD=-6.78,95%CI(-11.62,-1.94),P=0.006]、平均肺动脉压[MD=-6.61,95%CI(-7.26,-5.96),P<0.001]、圣乔治呼吸问卷评分[MD=-13.21,95%CI(-23.90,-2.52),P=0.02]均显著低于对照组,差异均有统计学意义;两组患者第1秒用力呼气容积占用力肺活量比值[MD=3.73,95%CI(-2.08,9.55),P=0.21]和高敏C反应蛋白水平[MD=0.29,95%CI(-1.37,1.95),P=0.73]比较,差异均无统计学意义。结论:阿托伐他汀用于稳定期COPD患者可以显著改善患者肺功能和肺动脉压,提高患者生活质量。
基金Supported by the National Key Technology Research and Development Program for the Eleventh Five-Year Plan of China(No.2008BAI53B061)
文摘Objective： To examine the variations in the prevalence of skin reactions and the association between skin reactions and efficacy of summer acupoint application treatment （SAAT） on chronic pulmonary disease （CPD）. Methods： A total of 2,038 patients with CPD were enrolled at 3 independent hospitals （defined as Groups A, B and C, respectively） in China. All patients were treated by SAAT, as applying a herbal paste onto the acupoints of Fengmen （BL 12） and Feishu （BL 13） on the dog days of summer, according to the lunar calendar, in 2008. Ten days after treatment, skin reaction data （no reaction, itching, stinging, blistering, and infection） were obtained via face-to-face interviews. Patients were retreated in the same hospital one year later, thereby allowing doctors to assess treatment efficacy based on the patients＇ symptoms, the severity of the spirometric abnormalities, and the concomitant medications used. Results： A large number of patients （85.3%） displayed reactive symptoms; however, the marked associations between reactive symptoms and age or gender were not observed. An increased number of patients from Group B （99.3%） and Group C （76.5%） displayed reactive symptoms due to the increased mass of crude Semen Sinapis Albae. The effective rate of SPAT was as high as 90.4% for patients of Group B, which was followed by Group A （70.9%） and Group C （42.2%）. Using stratified analyses, a convincing association between reactive symptoms and therapeutic efficacy was observed for patients with asthma [itching： odds ratio （OR）=2,17, 95% confidence interval （CI）： 1.49 to 3.14; blistering： OR=0.43, 95% Ch 0.25 to 0.73; and no reaction： OR=0.56, 95% CI： 0.35 to 0.90]. However, the same tendency was not observed for patients with chronic bronchitis and chronic obstructive pulmonary disease. Conclusions： SAAT can induce very mild skin reactions for patients with CPD, among which patients with asthma displayed a strong association between skin reactions
文摘The pathogenesis of the two inflammatory bowel disease(IBD) phenotypes ulcerative colitis(UC) and Crohn' s disease(CD) has remained elusive,thus frustrating attempts at defining a cure.IBD often presents as a complex inflammatory process wherein colon lesions(UC) or widespread ulceration and fissure(CD) might be accompanied by ancillary extra-intestinal manifestations involving the eye,skin,joints or liver,but also by full-blown "autoimmune" disorders from psoriasis and multiple sclerosis to rheumatoid arthritis;attempts at unraveling a link or a hierarchical order in these entities have proven almost fruitless.More recently,the input of genetics has suggested that the IBDs might be multiorgan inflammatory processes,elicited by a large number of low-penetrance susceptibility genes,with environmental factors needed to induce full-blown disease.At a noteworthy exception to this rule,the description of the nucleotide-oligomerization domain(NOD) gene mutations in CD came at the beginning of the 2000s:the NOD-LRR are part of a highly conserved microbial sensor system which respond to bacterial peptidoglycans by mounting an inflammatory response.At least in Caucasian patients,the prevalently loss-of-function mutation of NOD permitted to unexpectedly define CD as an immune deficiency state,and upon its recent description in apparently unrelated disorders such as the Blau syndrome(a granulomatous pediatric syndrome),and perhaps in psoriasis and chronic obstructive pulmonary disorders,has contributed to revolutionize our view of IBD and CD in particular.The latter affection,together with psoriasis and chronic pulmonary disease can now be included into a newly identified category named "barrier organ disease",wherein a barrier organ is defined as a large mucosal or epithelial surface with an abundant metagenomic microbial population and an underneath reactive tissue,the whole structure being in contact with the outer environment and capable to react to it.Personalized treatments and empowerment of research across different
