目的评价拉米夫定(LAM)联合阿德福韦酯(ADV)与恩替卡韦(ETV)单药对慢性乙型肝炎初治患者的疗效。方法计算机检索Cochrane图书馆、MEDLINE、Web of Science、CNKI全文数据库、万方中文期刊全文数据库、维普数据库,并追查了所有纳入文献...目的评价拉米夫定(LAM)联合阿德福韦酯(ADV)与恩替卡韦(ETV)单药对慢性乙型肝炎初治患者的疗效。方法计算机检索Cochrane图书馆、MEDLINE、Web of Science、CNKI全文数据库、万方中文期刊全文数据库、维普数据库,并追查了所有纳入文献的参考文献。检索年限均从建库到2012年3月6日。纳入LAM联合ADV与ETV单药对慢性乙型肝炎初治患者疗效比较。用Cochrane协作网专用软件Rev Man 5.1进行统计分析。结果共有4项符合纳入标准的研究被纳入。Meta分析显示,在ALT复常率方面,12、24周时ETV单药组略高于联合组[OR=0.52,95%CI(0.28,0.97),Z=2.04,P=0.04]、[OR=0.45,95%CI(0.22,0.95),Z=2.11,P=0.04],但36、48周后两组无明显差异[OR=0.96,95%CI(0.24,3.94),Z=0.05,P=0.96]、[OR=0.66,95%CI(0.28,1.59),Z=0.93,P=0.35]。HBV DNA阴转率方面12、24、36、48周、18、24、30个月两组间均无明显差异(P=0.22、P=0.30、P=0.86、P=0.31、P=0.93、P=0.84、P=0.83)。48周的HBeAg阴转率两组无差异[OR=0.93,95%CI(0.29,2.95),Z=0.13,P=0.90]。结论 LAM联合ADV对慢性乙型肝炎初治患者其抗病毒疗效与ETV相似,但其长期疗效和安全性仍然有待研究。展开更多
After spinal cord injury （SCl）, re-establishing functional circuitry in the damaged central nervous system （CNS） faces multiple challenges including lost tissue volume, insufficient intrinsic growth capacity of ad...After spinal cord injury （SCl）, re-establishing functional circuitry in the damaged central nervous system （CNS） faces multiple challenges including lost tissue volume, insufficient intrinsic growth capacity of adult neurons, and the inhibitory environment in the damaged CNS. Several treatment strategies have been developed over the past three decades, but successful restoration of sensory and motor functions will probably require a combination of approaches to address different aspects of the problem. Degradation of the chondroitin sulfate proteoglycans with the chondroitinase ABC （ChABC） enzyme removes a regeneration barrier from the glial scar and increases plasticity in the CNS by removing perineuronal nets. Its mechanism of action does not clash or overlap with most of the other treatment strategies, making ChABC an attractive candidate as a combinational partner with other methods. In this article, we review studies in rat SCI models using ChABC combined with other treatments including cell implantation, growth factors, myelin-inhibitory molecule blockers, and ion channel expression. We discuss possible ways to optimize treatment protocols for future combinational studies. To date, combinational therapies with ChABC have shown synergistic effects with several other strategies in enhancing functional recovery after SCI. These combinatorial approaches can now be developed for clinical application.展开更多
文摘目的评价拉米夫定(LAM)联合阿德福韦酯(ADV)与恩替卡韦(ETV)单药对慢性乙型肝炎初治患者的疗效。方法计算机检索Cochrane图书馆、MEDLINE、Web of Science、CNKI全文数据库、万方中文期刊全文数据库、维普数据库,并追查了所有纳入文献的参考文献。检索年限均从建库到2012年3月6日。纳入LAM联合ADV与ETV单药对慢性乙型肝炎初治患者疗效比较。用Cochrane协作网专用软件Rev Man 5.1进行统计分析。结果共有4项符合纳入标准的研究被纳入。Meta分析显示,在ALT复常率方面,12、24周时ETV单药组略高于联合组[OR=0.52,95%CI(0.28,0.97),Z=2.04,P=0.04]、[OR=0.45,95%CI(0.22,0.95),Z=2.11,P=0.04],但36、48周后两组无明显差异[OR=0.96,95%CI(0.24,3.94),Z=0.05,P=0.96]、[OR=0.66,95%CI(0.28,1.59),Z=0.93,P=0.35]。HBV DNA阴转率方面12、24、36、48周、18、24、30个月两组间均无明显差异(P=0.22、P=0.30、P=0.86、P=0.31、P=0.93、P=0.84、P=0.83)。48周的HBeAg阴转率两组无差异[OR=0.93,95%CI(0.29,2.95),Z=0.13,P=0.90]。结论 LAM联合ADV对慢性乙型肝炎初治患者其抗病毒疗效与ETV相似,但其长期疗效和安全性仍然有待研究。
文摘After spinal cord injury （SCl）, re-establishing functional circuitry in the damaged central nervous system （CNS） faces multiple challenges including lost tissue volume, insufficient intrinsic growth capacity of adult neurons, and the inhibitory environment in the damaged CNS. Several treatment strategies have been developed over the past three decades, but successful restoration of sensory and motor functions will probably require a combination of approaches to address different aspects of the problem. Degradation of the chondroitin sulfate proteoglycans with the chondroitinase ABC （ChABC） enzyme removes a regeneration barrier from the glial scar and increases plasticity in the CNS by removing perineuronal nets. Its mechanism of action does not clash or overlap with most of the other treatment strategies, making ChABC an attractive candidate as a combinational partner with other methods. In this article, we review studies in rat SCI models using ChABC combined with other treatments including cell implantation, growth factors, myelin-inhibitory molecule blockers, and ion channel expression. We discuss possible ways to optimize treatment protocols for future combinational studies. To date, combinational therapies with ChABC have shown synergistic effects with several other strategies in enhancing functional recovery after SCI. These combinatorial approaches can now be developed for clinical application.
