Several studies have investigated the association between CYP2C19 polymorphism and clinical outcomes of patients treated with clopidogrel, but few have noticed the difference in association between Westerners and Asia...Several studies have investigated the association between CYP2C19 polymorphism and clinical outcomes of patients treated with clopidogrel, but few have noticed the difference in association between Westerners and Asians. We searched MEDLINE, EMBASE and Cochrane Library database and conducted a systematic review and meta-analysis. Thirty-six studies involving 44 655 patients with coronary artery disease（CAD） treated with clopidogrel were included, of which more than 68% had undergone percutaneous coronary intervention（PCI）. The primary outcome of our interest was the recurrence of major adverse cardiovascular events（MACE） in those CAD patients. Firstly, we found that the distribution of reduced-function CYP2C19 allele varied between Westerners and Asians. Among Asians, 1 and 2 reduced-function CYP2C19 mutant allele carriers accounted for 42.5% and 10%, respectively. While among Westerners, 1 and 2 reduced-function CYP2C19 mutant allele carriers accounted for 25.5% and 2.4%, respectively. Secondly, the impact of CYP2C19 polymorphism on clinical outcomes of patients treated with clopidogrel varied with races. Among Asians, only 2 reduced-function CYP2C19 mutant allele carriers had the reduced effect of clopidogrel. And the reduced effect was significant only after the 30 th day of treatment. While among Westerners, both 1 and 2 reduced-function CYP2C19 allele carriers had the reduced effect, and it mainly occurred within the first 30 days. Thirdly, the safety of clopidogrel was almost the same among races. Reduced-function allele non-carriers had higher risk for total bleeding but did not have higher risk for major bleeding. It is suggested that CYP2C19 polymorphism affects the efficacy of clopidogrel differently among Westerners and Asians.展开更多
目的:分析2008-2012年国际粪菌移植文献概貌,了解粪菌移植研究现状。方法:从时间、国家、机构、来源期刊和写作体裁等方面分析PubMed和EMBASE数据库收录的近5年粪菌移植相关论文,并采用共词分析法分析了高频主题词。结果:粪菌移植文献近...目的:分析2008-2012年国际粪菌移植文献概貌,了解粪菌移植研究现状。方法:从时间、国家、机构、来源期刊和写作体裁等方面分析PubMed和EMBASE数据库收录的近5年粪菌移植相关论文,并采用共词分析法分析了高频主题词。结果:粪菌移植文献近5年数量有所增长。美国在粪菌肺移植研究领域具有领先优势,加拿大、英国、澳大利亚、荷兰也有开展和研究,我国粪菌移植研究几乎空白。相关研究机构中,美国机构占58.33%。发文量2篇以上的作者,有7位来自美国。刊载粪菌移植研究论文最多的期刊是American Journal of Gastroenterology。临床粪菌移植研究高频主题词涉及艰难梭菌、伪膜性肠炎、复发、治疗结果等。结论:近5年来国际临床粪菌移植文献量逐年上升,美国是粪菌移植研究大国,粪菌移植对复发性艰难梭菌相关肠炎、治疗结果是临床主要关注点,粪便供者的选择、粪便剂型的制备、给药方式等是临床次级关注点。展开更多
Background Agitation is very common in patients with acute stage schizophrenia, and injection of antipsychotics and clonazepam is widely used. Network meta-analysis of these comparisons among three injection treatment...Background Agitation is very common in patients with acute stage schizophrenia, and injection of antipsychotics and clonazepam is widely used. Network meta-analysis of these comparisons among three injection treatments has been seldom reported.Aim To compare the efficacy and safety of various injections for agitation symptoms in Chinese patients with schizophrenia.Methods Searches were made in PubMed, Embase and Web of Knowledge, Cochrane Library, Wanfang data, CNKI, SinoMed and VIP databases up to 18 February 2018. Standard search strategies were performed by two reviewers according to the Cochrane Review Group. The Consolidated Standards of Reporting Trials statement was used to assess the methodological quality of the studies. STATA was used to perform meta-analysis. The Cochrane Grades of Recommendation, Assessment, Development and Evaluation(GRADE) was used to assess the strength of evidence.Results A total of 15 studies were included in the network meta-analysis. There were 11 studies comparing ziprasidone with haloperidol, and four studies comparing haloperidol with clonazepam. The results showed that ziprasidone is more effective than haloperidol and clonazepam(sucra: 77.2, 72.8 and 0) in the treatment of agitation symptoms. There was the effect size(standardised mean difference(SMD)) in the three groups: haloperidol: SMD=2.278, 95% CI 1.836 to 2.719; ziprasidone: SMD=2.536, 95% CI 2.082 to 2.990; and clonazepam: SMD=1.360, 95% CI 0.127 to 2.593. The acceptability was assessed by the incidence of excessive sedation, which showed that ziprasidone and haloperidol were similar with both being superior to clonazepam(sucra: 0.3, 0.7 and 99.0). Ziprasidone had significantly less adverse effects than haloperidol in effects of extrapyramidal system(EPS)(z=5.01, p<0.001). There were no statistically significant differences between haloperidol and ziprasidone in tachycardia and abnormal ECG(z=1.69, p=0.091; z=0.87, p=0.386; respectively). Based on GRADE, the strength of the evidence for primary outcome was ‘mediu展开更多
The aim of this study was to summarize the efficacy and tolerability of rotigotine in the treatment of primary restless legs syndrome（RLS）. Pub Med, EMBASE, and Cochrane Central Register of Controlled Trials（CENTRA...The aim of this study was to summarize the efficacy and tolerability of rotigotine in the treatment of primary restless legs syndrome（RLS）. Pub Med, EMBASE, and Cochrane Central Register of Controlled Trials（CENTRAL） were searched for English-language randomized controlled trials（RCTs） that assessed the effectiveness of rotigotine for RLS. The pooled mean change from baseline in International RLS（IRLS） Study Group Rating Scalescore and relative risk（RR） of response based on the Clinical Global Impression-Improvement（CGI-I） scale score were applied to evaluate the outcomes. The pooled proportions of adverse events（AEs） were also estimated. Six RCTs were included. The meta-analysis showed a favorable effectiveness of rotigotine versus placebo on RLS [mean change on IRLS score： mean difference（MD）=–4.80; 95% confidence interval（CI）： –5.90 to –3.70; P〈0.00001 and RR of response on CGI-I was 2.19; 95% CI： 1.86 to 2.58, P〈0.00001]. The most common AEs were application site reactions, nausea, headache and fatigue. In general, rotigotine was well-tolerated in patients with primary RLS. Based on the findings from the meta-analysis, rotigotine was more significantly efficacious in the treatment of RLS than placebo. Nevertheless, long-term studies and more evidence of comparisons of rotigotine with other dopamine agonists are needed.展开更多
Reports of BRCA2 genetic mutations on the prognosis of familial breast cancer（BC） patients have been contradictory. True difference in survival,if it exists,would have important implications for genetic counseling a...Reports of BRCA2 genetic mutations on the prognosis of familial breast cancer（BC） patients have been contradictory. True difference in survival,if it exists,would have important implications for genetic counseling and in treatment of hereditary BC. The purpose of this study was to compare overall survival rate（OSR） among BRCA2 mutation carriers,non-carriers and sporadic BC patients. We searched the PUBMED and EMBASE databases and retrieved 4529 articles using keywords that included breast cancer,BRCA,prognosis and survival. Nine articles were selected for systematic review and among them 6 were included in our meta-analysis. We used the fixed and random effect models to calculate the summary odds ratio（OR） and corresponding 95% confidence interval（CI）. BRCA2 mutation carriers had significantly higher long-term OSR than non-carriers（OR=0.69 [95% CI=0.5–0.95]）,while both short-term and long-term OSR of BRCA2 mutation carriers did not differ from those of patients with sporadic disease（OR=1.11 [95% CI=0.74–1.65]; 0.85 [95% CI=0.38–1.94],respectively）. For BC-specific survival rate（BCSSR）,BRCA2 mutation carriers had a similar BCSSR to the non-carriers（OR=0.61 [95% CI=0.28–1.34]）. There was no significant difference in disease-free survival（DFS） between BRCA2 mutation carriers and patients with sporadic disease. Our results suggest that BRCA2 mutation increases long-term OSR in hereditary BC,which reminds us a new prospect of management of the disease.展开更多
Studies examining the association of hemochromatosis（HFE） gene polymorphisms and susceptibility to alcoholic liver disease（ALD） yielded inconsistent results. Thus, we performed a metaanalysis to investigate whethe...Studies examining the association of hemochromatosis（HFE） gene polymorphisms and susceptibility to alcoholic liver disease（ALD） yielded inconsistent results. Thus, we performed a metaanalysis to investigate whether the variations in HFE gene increase the risk of ALD. The studies published up to Feb. 2014 were identified by searching Pub Med/MEDLINE, ISI Web of Science, EMBASE and China National Knowledge Infrastructure databases, which was complemented by screening the references of the retrieved studies. For all genotypes and alleles, the odds ratios（ORs） with 95% confidence intervals（CIs） according to the heterogeneity were pooled using fixed-effect model. Sixteen studies with 1933 cases and 9874 controls were included for this meta-analysis. C282Y/C282 Y, C282Y/wild type, H63D/wild type and C282Y/H63 D were found not to be associated with susceptibility to ALD, but increased risk of H63D/H63D（OR： 1.52, 95% CI： 1.05–2.22, P=0.029） was observed for ALD when compared to total control. Comparison of ALD patients with alcoholics without liver damage revealed a significant association of D allele, as well as a marginal association of H63D/wild type with ALD, while H63D/H63 D was not significantly associated with ALD although increased value of OR was obtained. The presence of Y allele and other genotypes yielded insignificant findings when ALD patients were compared with alcoholics without liver damage. No evident publication bias or significant heterogeneity among studies was detected in this meta-analysis. In conclusion, our metaanalysis showed a marginal higher prevalence of H63 D variant in ALD but did not support an increased risk of C282 Y mutation.展开更多
Chinese Journal of Gastroenterology (ISSN 1008-7125),founded in June,1996,is a national academic journal being designed to present the latest basic scientific and clinical researches of gastroenterology in China.It is...Chinese Journal of Gastroenterology (ISSN 1008-7125),founded in June,1996,is a national academic journal being designed to present the latest basic scientific and clinical researches of gastroenterology in China.It is published monthly currently by the Editorial Board of Chinese Journal of Gastroenterology.展开更多
印刷本荷兰《医学文摘》(EM)颇受大家的欢迎,而它最近几年的变化亦引起广泛的重视。因此本文着重论述这些变化并探讨其可能发展的趋向。这里我们试以 EM 第6分册(内科学分册)1987年第61卷、1990年第69卷和1991年第71卷各累积主题索引(CU...印刷本荷兰《医学文摘》(EM)颇受大家的欢迎,而它最近几年的变化亦引起广泛的重视。因此本文着重论述这些变化并探讨其可能发展的趋向。这里我们试以 EM 第6分册(内科学分册)1987年第61卷、1990年第69卷和1991年第71卷各累积主题索引(CUM SUBJECTINDEX)里的 crohn disease 为例。展开更多
基金supported by grants from National Natural Science Foundation of China(Nos.81371311 and 81101905)New Century Excellent Talents in University of China(No.NCET-10-0406)
文摘Several studies have investigated the association between CYP2C19 polymorphism and clinical outcomes of patients treated with clopidogrel, but few have noticed the difference in association between Westerners and Asians. We searched MEDLINE, EMBASE and Cochrane Library database and conducted a systematic review and meta-analysis. Thirty-six studies involving 44 655 patients with coronary artery disease（CAD） treated with clopidogrel were included, of which more than 68% had undergone percutaneous coronary intervention（PCI）. The primary outcome of our interest was the recurrence of major adverse cardiovascular events（MACE） in those CAD patients. Firstly, we found that the distribution of reduced-function CYP2C19 allele varied between Westerners and Asians. Among Asians, 1 and 2 reduced-function CYP2C19 mutant allele carriers accounted for 42.5% and 10%, respectively. While among Westerners, 1 and 2 reduced-function CYP2C19 mutant allele carriers accounted for 25.5% and 2.4%, respectively. Secondly, the impact of CYP2C19 polymorphism on clinical outcomes of patients treated with clopidogrel varied with races. Among Asians, only 2 reduced-function CYP2C19 mutant allele carriers had the reduced effect of clopidogrel. And the reduced effect was significant only after the 30 th day of treatment. While among Westerners, both 1 and 2 reduced-function CYP2C19 allele carriers had the reduced effect, and it mainly occurred within the first 30 days. Thirdly, the safety of clopidogrel was almost the same among races. Reduced-function allele non-carriers had higher risk for total bleeding but did not have higher risk for major bleeding. It is suggested that CYP2C19 polymorphism affects the efficacy of clopidogrel differently among Westerners and Asians.
文摘目的:分析2008-2012年国际粪菌移植文献概貌,了解粪菌移植研究现状。方法:从时间、国家、机构、来源期刊和写作体裁等方面分析PubMed和EMBASE数据库收录的近5年粪菌移植相关论文,并采用共词分析法分析了高频主题词。结果:粪菌移植文献近5年数量有所增长。美国在粪菌肺移植研究领域具有领先优势,加拿大、英国、澳大利亚、荷兰也有开展和研究,我国粪菌移植研究几乎空白。相关研究机构中,美国机构占58.33%。发文量2篇以上的作者,有7位来自美国。刊载粪菌移植研究论文最多的期刊是American Journal of Gastroenterology。临床粪菌移植研究高频主题词涉及艰难梭菌、伪膜性肠炎、复发、治疗结果等。结论:近5年来国际临床粪菌移植文献量逐年上升,美国是粪菌移植研究大国,粪菌移植对复发性艰难梭菌相关肠炎、治疗结果是临床主要关注点,粪便供者的选择、粪便剂型的制备、给药方式等是临床次级关注点。
基金Shanghai Municipal Hospital's Emerging Frontier Technology Joint Research Project(SHDC12012109)Shanghai Open Project of Key Laboratory of Severe Psychiatry(13dz2260500)
文摘Background Agitation is very common in patients with acute stage schizophrenia, and injection of antipsychotics and clonazepam is widely used. Network meta-analysis of these comparisons among three injection treatments has been seldom reported.Aim To compare the efficacy and safety of various injections for agitation symptoms in Chinese patients with schizophrenia.Methods Searches were made in PubMed, Embase and Web of Knowledge, Cochrane Library, Wanfang data, CNKI, SinoMed and VIP databases up to 18 February 2018. Standard search strategies were performed by two reviewers according to the Cochrane Review Group. The Consolidated Standards of Reporting Trials statement was used to assess the methodological quality of the studies. STATA was used to perform meta-analysis. The Cochrane Grades of Recommendation, Assessment, Development and Evaluation(GRADE) was used to assess the strength of evidence.Results A total of 15 studies were included in the network meta-analysis. There were 11 studies comparing ziprasidone with haloperidol, and four studies comparing haloperidol with clonazepam. The results showed that ziprasidone is more effective than haloperidol and clonazepam(sucra: 77.2, 72.8 and 0) in the treatment of agitation symptoms. There was the effect size(standardised mean difference(SMD)) in the three groups: haloperidol: SMD=2.278, 95% CI 1.836 to 2.719; ziprasidone: SMD=2.536, 95% CI 2.082 to 2.990; and clonazepam: SMD=1.360, 95% CI 0.127 to 2.593. The acceptability was assessed by the incidence of excessive sedation, which showed that ziprasidone and haloperidol were similar with both being superior to clonazepam(sucra: 0.3, 0.7 and 99.0). Ziprasidone had significantly less adverse effects than haloperidol in effects of extrapyramidal system(EPS)(z=5.01, p<0.001). There were no statistically significant differences between haloperidol and ziprasidone in tachycardia and abnormal ECG(z=1.69, p=0.091; z=0.87, p=0.386; respectively). Based on GRADE, the strength of the evidence for primary outcome was ‘mediu
文摘The aim of this study was to summarize the efficacy and tolerability of rotigotine in the treatment of primary restless legs syndrome（RLS）. Pub Med, EMBASE, and Cochrane Central Register of Controlled Trials（CENTRAL） were searched for English-language randomized controlled trials（RCTs） that assessed the effectiveness of rotigotine for RLS. The pooled mean change from baseline in International RLS（IRLS） Study Group Rating Scalescore and relative risk（RR） of response based on the Clinical Global Impression-Improvement（CGI-I） scale score were applied to evaluate the outcomes. The pooled proportions of adverse events（AEs） were also estimated. Six RCTs were included. The meta-analysis showed a favorable effectiveness of rotigotine versus placebo on RLS [mean change on IRLS score： mean difference（MD）=–4.80; 95% confidence interval（CI）： –5.90 to –3.70; P〈0.00001 and RR of response on CGI-I was 2.19; 95% CI： 1.86 to 2.58, P〈0.00001]. The most common AEs were application site reactions, nausea, headache and fatigue. In general, rotigotine was well-tolerated in patients with primary RLS. Based on the findings from the meta-analysis, rotigotine was more significantly efficacious in the treatment of RLS than placebo. Nevertheless, long-term studies and more evidence of comparisons of rotigotine with other dopamine agonists are needed.
文摘Reports of BRCA2 genetic mutations on the prognosis of familial breast cancer（BC） patients have been contradictory. True difference in survival,if it exists,would have important implications for genetic counseling and in treatment of hereditary BC. The purpose of this study was to compare overall survival rate（OSR） among BRCA2 mutation carriers,non-carriers and sporadic BC patients. We searched the PUBMED and EMBASE databases and retrieved 4529 articles using keywords that included breast cancer,BRCA,prognosis and survival. Nine articles were selected for systematic review and among them 6 were included in our meta-analysis. We used the fixed and random effect models to calculate the summary odds ratio（OR） and corresponding 95% confidence interval（CI）. BRCA2 mutation carriers had significantly higher long-term OSR than non-carriers（OR=0.69 [95% CI=0.5–0.95]）,while both short-term and long-term OSR of BRCA2 mutation carriers did not differ from those of patients with sporadic disease（OR=1.11 [95% CI=0.74–1.65]; 0.85 [95% CI=0.38–1.94],respectively）. For BC-specific survival rate（BCSSR）,BRCA2 mutation carriers had a similar BCSSR to the non-carriers（OR=0.61 [95% CI=0.28–1.34]）. There was no significant difference in disease-free survival（DFS） between BRCA2 mutation carriers and patients with sporadic disease. Our results suggest that BRCA2 mutation increases long-term OSR in hereditary BC,which reminds us a new prospect of management of the disease.
基金supported by the National Natural Science Foundation of China(Nos.81472979 and 81402673)
文摘Studies examining the association of hemochromatosis（HFE） gene polymorphisms and susceptibility to alcoholic liver disease（ALD） yielded inconsistent results. Thus, we performed a metaanalysis to investigate whether the variations in HFE gene increase the risk of ALD. The studies published up to Feb. 2014 were identified by searching Pub Med/MEDLINE, ISI Web of Science, EMBASE and China National Knowledge Infrastructure databases, which was complemented by screening the references of the retrieved studies. For all genotypes and alleles, the odds ratios（ORs） with 95% confidence intervals（CIs） according to the heterogeneity were pooled using fixed-effect model. Sixteen studies with 1933 cases and 9874 controls were included for this meta-analysis. C282Y/C282 Y, C282Y/wild type, H63D/wild type and C282Y/H63 D were found not to be associated with susceptibility to ALD, but increased risk of H63D/H63D（OR： 1.52, 95% CI： 1.05–2.22, P=0.029） was observed for ALD when compared to total control. Comparison of ALD patients with alcoholics without liver damage revealed a significant association of D allele, as well as a marginal association of H63D/wild type with ALD, while H63D/H63 D was not significantly associated with ALD although increased value of OR was obtained. The presence of Y allele and other genotypes yielded insignificant findings when ALD patients were compared with alcoholics without liver damage. No evident publication bias or significant heterogeneity among studies was detected in this meta-analysis. In conclusion, our metaanalysis showed a marginal higher prevalence of H63 D variant in ALD but did not support an increased risk of C282 Y mutation.
文摘Chinese Journal of Gastroenterology (ISSN 1008-7125),founded in June,1996,is a national academic journal being designed to present the latest basic scientific and clinical researches of gastroenterology in China.It is published monthly currently by the Editorial Board of Chinese Journal of Gastroenterology.
