目的筛选、提取并归纳乳腺癌幸存者睡眠障碍非药物预防及管理的相关最佳证据,为乳腺癌幸存者进行睡眠管理提供相关实践依据。方法采用PIPOST模式构建循证问题。根据循证检索资源的“6S”模型,使用计算机对PubMed、BMJ Best Practice、JB...目的筛选、提取并归纳乳腺癌幸存者睡眠障碍非药物预防及管理的相关最佳证据,为乳腺癌幸存者进行睡眠管理提供相关实践依据。方法采用PIPOST模式构建循证问题。根据循证检索资源的“6S”模型,使用计算机对PubMed、BMJ Best Practice、JBI循证卫生保健中心、NICE、Web of Science、美国临床肿瘤学会(ASCO)、中国知网、万方等数据库进行文献检索,检索内容包括临床指南、专家共识、系统评价、随机对照试验、临床决策以及证据总结等。结果共计纳入文献13篇,其中包含临床指南2篇,专家共识2篇,系统评价3篇,随机对照试验6篇。最终从睡眠障碍筛查与评估、体育活动建议、正念训练治疗、认知行为干预、中医治疗以及睡眠卫生健康教育等6个维度总结了27条最佳证据。结论本研究总结的27条最佳证据能为乳腺癌幸存者进行睡眠管理提供实践依据,将证据与临床实际相结合有助于制定系统化、全面化、个体化的睡眠管理方案。展开更多
目的运用网络药理学和分子对接探讨清热药作用机制。方法检索TCMSP、TCMID、NPASS数据库获取5类清热中药活性成分,检索DrugBank、NPASS数据库收集对应靶点,使用UniProt数据库规范靶点名称。使用STRING数据库构建交集靶点蛋白相互作用网...目的运用网络药理学和分子对接探讨清热药作用机制。方法检索TCMSP、TCMID、NPASS数据库获取5类清热中药活性成分,检索DrugBank、NPASS数据库收集对应靶点,使用UniProt数据库规范靶点名称。使用STRING数据库构建交集靶点蛋白相互作用网络,采用Cytoscape3.9.1软件筛选核心靶点。使用在线软件DAVID进行GO功能、KEGG通路及疾病富集分析,使用Metascape数据库分析特有靶点。使用Discovery Studio 4.5.0软件对清热药共有成分与核心靶点进行分子对接。结果获得清热泻火药活性成分297个、清热燥湿药活性成分609个、清热解毒药活性成分1196个、清热凉血药活性成分224个、清虚热药活性成分为389个,对应靶点分别为117、241、402、87和260个;获得共有活性成分7个,对应靶点196个。GO功能、KEGG通路及疾病富集分析显示,清热药可能通过调节外源代谢过程、单碳代谢过程中的代谢途径对乳腺癌和肿瘤发挥治疗作用。分子对接结果表明,清热药发挥抗肿瘤、抗乳腺癌的核心化学成分可能为棕榈酸、槲皮素、亚油酸。结论清热类中药可通过多途径发挥治疗作用,其中,清热泻火药、清热燥湿药、清热解毒药的生物过程及信号通路较为相似,均可通过调节外源代谢过程、单碳代谢过程、葡萄糖醛酸基转移酶活性的负调控、细胞葡萄糖醛酸化的负调控、雌激素代谢过程、细胞葡萄糖醛酸化中的新陈代谢类信号通路发挥治疗乳腺癌的作用。展开更多
BACKGROUND Although the past decade has seen remarkable advances in treatment options for hepatocellular carcinoma(HCC),the dismal overall prognosis still envelops HCC patients.Several comparative trials have been con...BACKGROUND Although the past decade has seen remarkable advances in treatment options for hepatocellular carcinoma(HCC),the dismal overall prognosis still envelops HCC patients.Several comparative trials have been conducted to study whether transarterial chemoembolization(TACE)could improve clinical outcomes in patients receiving sorafenib for advanced HCC;however,the findings have been inconsistent.AIM To study the potential synergies and safety of sorafenib plus TACE vs sorafenib alone for treating advanced HCC,by performing a systematic review and metaanalysis.METHODS This study was conducted following the PRISMA statement.A systematic literature search was conducted using the Cochrane Library,Embase,PubMed,and Web of Science databases.Data included in the present work were collected from patients diagnosed with advanced HCC receiving sorafenib plus TACE or sorafenib alone.Data synthesis and meta-analysis were conducted using Review Manager software.RESULTS The present study included 2780 patients from five comparative clinical trials(1 was randomized control trial and 4 were retrospective studies).It was found that patients receiving sorafenib plus TACE had better prognoses in terms of overall survival(OS),with a combined hazard ratio(HR)of 0.65[95%confidence interval(95%CI):0.46–0.93,P=0.02,n=2780].Consistently,progression free survival(PFS)and time to progression(TTP)differed significantly between the sorafenib plus TACE arm and sorafenib arm(PFS:HR=0.62,95%CI:0.40–0.96,P=0.03,n=443;TTP:HR=0.73,95%CI:0.64-0.83,P<0.00001,n=2451).Disease control rate(DCR)was also significantly increased by combination therapy(risk ratio=1.36,95%CI:1.02-1.81,P=0.04,n=641).Regarding safety,the incidence of any adverse event(AE)was increased due to the addition of TACE;however,no significant difference was found in grade≥3 AEs.CONCLUSION The combination of sorafenib with TACE has superior efficacy to sorafenib monotherapy,as evidenced by prolonged OS,PFS,and TTP,as well as increased DCR.Additional high-quality trials are essential to further validate the clinical benefit of this combination in the treatment of advanced HCC.展开更多
文摘目的筛选、提取并归纳乳腺癌幸存者睡眠障碍非药物预防及管理的相关最佳证据,为乳腺癌幸存者进行睡眠管理提供相关实践依据。方法采用PIPOST模式构建循证问题。根据循证检索资源的“6S”模型,使用计算机对PubMed、BMJ Best Practice、JBI循证卫生保健中心、NICE、Web of Science、美国临床肿瘤学会(ASCO)、中国知网、万方等数据库进行文献检索,检索内容包括临床指南、专家共识、系统评价、随机对照试验、临床决策以及证据总结等。结果共计纳入文献13篇,其中包含临床指南2篇,专家共识2篇,系统评价3篇,随机对照试验6篇。最终从睡眠障碍筛查与评估、体育活动建议、正念训练治疗、认知行为干预、中医治疗以及睡眠卫生健康教育等6个维度总结了27条最佳证据。结论本研究总结的27条最佳证据能为乳腺癌幸存者进行睡眠管理提供实践依据,将证据与临床实际相结合有助于制定系统化、全面化、个体化的睡眠管理方案。
文摘目的运用网络药理学和分子对接探讨清热药作用机制。方法检索TCMSP、TCMID、NPASS数据库获取5类清热中药活性成分,检索DrugBank、NPASS数据库收集对应靶点,使用UniProt数据库规范靶点名称。使用STRING数据库构建交集靶点蛋白相互作用网络,采用Cytoscape3.9.1软件筛选核心靶点。使用在线软件DAVID进行GO功能、KEGG通路及疾病富集分析,使用Metascape数据库分析特有靶点。使用Discovery Studio 4.5.0软件对清热药共有成分与核心靶点进行分子对接。结果获得清热泻火药活性成分297个、清热燥湿药活性成分609个、清热解毒药活性成分1196个、清热凉血药活性成分224个、清虚热药活性成分为389个,对应靶点分别为117、241、402、87和260个;获得共有活性成分7个,对应靶点196个。GO功能、KEGG通路及疾病富集分析显示,清热药可能通过调节外源代谢过程、单碳代谢过程中的代谢途径对乳腺癌和肿瘤发挥治疗作用。分子对接结果表明,清热药发挥抗肿瘤、抗乳腺癌的核心化学成分可能为棕榈酸、槲皮素、亚油酸。结论清热类中药可通过多途径发挥治疗作用,其中,清热泻火药、清热燥湿药、清热解毒药的生物过程及信号通路较为相似,均可通过调节外源代谢过程、单碳代谢过程、葡萄糖醛酸基转移酶活性的负调控、细胞葡萄糖醛酸化的负调控、雌激素代谢过程、细胞葡萄糖醛酸化中的新陈代谢类信号通路发挥治疗乳腺癌的作用。
基金Supported by Sichuan Science and Technology Project,No.2021YJ0138Research Subject of Sichuan Provincial Health Commission,No.19PJ007Chengdu Science and Technology Project,No.2021-YF05-01788-SN.
文摘BACKGROUND Although the past decade has seen remarkable advances in treatment options for hepatocellular carcinoma(HCC),the dismal overall prognosis still envelops HCC patients.Several comparative trials have been conducted to study whether transarterial chemoembolization(TACE)could improve clinical outcomes in patients receiving sorafenib for advanced HCC;however,the findings have been inconsistent.AIM To study the potential synergies and safety of sorafenib plus TACE vs sorafenib alone for treating advanced HCC,by performing a systematic review and metaanalysis.METHODS This study was conducted following the PRISMA statement.A systematic literature search was conducted using the Cochrane Library,Embase,PubMed,and Web of Science databases.Data included in the present work were collected from patients diagnosed with advanced HCC receiving sorafenib plus TACE or sorafenib alone.Data synthesis and meta-analysis were conducted using Review Manager software.RESULTS The present study included 2780 patients from five comparative clinical trials(1 was randomized control trial and 4 were retrospective studies).It was found that patients receiving sorafenib plus TACE had better prognoses in terms of overall survival(OS),with a combined hazard ratio(HR)of 0.65[95%confidence interval(95%CI):0.46–0.93,P=0.02,n=2780].Consistently,progression free survival(PFS)and time to progression(TTP)differed significantly between the sorafenib plus TACE arm and sorafenib arm(PFS:HR=0.62,95%CI:0.40–0.96,P=0.03,n=443;TTP:HR=0.73,95%CI:0.64-0.83,P<0.00001,n=2451).Disease control rate(DCR)was also significantly increased by combination therapy(risk ratio=1.36,95%CI:1.02-1.81,P=0.04,n=641).Regarding safety,the incidence of any adverse event(AE)was increased due to the addition of TACE;however,no significant difference was found in grade≥3 AEs.CONCLUSION The combination of sorafenib with TACE has superior efficacy to sorafenib monotherapy,as evidenced by prolonged OS,PFS,and TTP,as well as increased DCR.Additional high-quality trials are essential to further validate the clinical benefit of this combination in the treatment of advanced HCC.
