目的系统评价生物制剂治疗类风湿关节炎相关间质性肺病(RA-ILD)的有效性和安全性,为临床治疗提供循证依据。方法在PubMed、Cochrane Library、Embase、Web of Science、中国知网、万方、维普、中国生物医学文献数据库中检索关于生物制...目的系统评价生物制剂治疗类风湿关节炎相关间质性肺病(RA-ILD)的有效性和安全性,为临床治疗提供循证依据。方法在PubMed、Cochrane Library、Embase、Web of Science、中国知网、万方、维普、中国生物医学文献数据库中检索关于生物制剂治疗RA-ILD的研究,采用R软件进行meta分析。结果共纳入10项研究,其中关于利妥昔单抗(RTX)及阿巴西普(ABA)的研究各4项,肿瘤坏死因子α(TNF-α)抑制剂的研究2项。Meta分析结果显示:接受RTX治疗的患者,治疗后用力肺活量占预计值百分比(FVC%pred)较治疗前显著增加[WMD=9.58,95%CI(3.91,15.25),P<0.05];而治疗前后一氧化碳弥散量占预计值百分比(DLCO%pred)的差异无统计学意义[WMD=8.90,95%CI(-1.06,18.86),P>0.05]。接受ABA治疗的患者,治疗前后FVC%pred[WMD=-1.10,95%CI(-3.83,1.63),P>0.05]和DLCO%pred[WMD=0.65,95%CI(-2.24,3.53),P>0.05]的差异均无统计学意义;治疗后患者肺高分辨率CT的好转、稳定、恶化合并率分别为16%[95%CI(12%,22%)]、69%[95%CI(57%,79%)]、19%[95%CI(14%,24%)]。接受TNF-α抑制剂治疗的患者,治疗后的FVC%pred与治疗前相比未出现明显下降。RTX的总体不良事件合并发生率为33%[95%CI(21%,45%)],与不良事件相关的死亡的合并发生率为7%[95%CI(2%,16%)]。结论生物制剂(RTX、ABA、TNF-α抑制剂)具有稳定或改善RA-ILD患者肺功能和影像学表现的作用,是治疗RA-ILD有效且安全的方法。展开更多
Two new Zn(Ⅱ) and Cd(Ⅱ) coordination complexes, [Zn(ppda)(idz)]n(1) and [Cd(mpda)(mbib)]n(2)(H2 ppda = 1,4-phenylenediacetic acid, H2 mpda = 1,3-phenylenediacetic acid, idz = imidazole, mbib = 1,3-bis(imidazol-1-ylm...Two new Zn(Ⅱ) and Cd(Ⅱ) coordination complexes, [Zn(ppda)(idz)]n(1) and [Cd(mpda)(mbib)]n(2)(H2 ppda = 1,4-phenylenediacetic acid, H2 mpda = 1,3-phenylenediacetic acid, idz = imidazole, mbib = 1,3-bis(imidazol-1-ylmethyl)benzene), have been synthesized by using Zn(Ⅱ)/Cd(Ⅱ) salt and phenylenediacetic acid in the presence of different imidazole ligands under hydrothermal conditions, and characterized by elemental analysis, IR spectroscopy, single-crystal X-ray crystallography and thermogravimetric analysis. Complex 1 crystallizes in orthorhombic system, Iba2 space group. The carboxylic acid ligands form a 2 D helical layer with Zn(Ⅱ) ions, and such layers are expanded into a 3 D network structure by the force of C–H…π. Complex 2 crystallizes in monoclinic system, P21/n space group. Complex 2 shows a 3 D framework with two Cd(Ⅱ) ions as nodes of a dual-core unit, which can be considered to be 6-connected net and regarded as a rare(44,510,7) topology network with self-interlacing. The structural diversities indicate that rigid and flexible imidazole ligands play dominating roles in modulating the formation of structures of these crystalline materials. Moreover, the luminescent properties of two complexes are investigated in solid state.展开更多
文摘目的系统评价生物制剂治疗类风湿关节炎相关间质性肺病(RA-ILD)的有效性和安全性,为临床治疗提供循证依据。方法在PubMed、Cochrane Library、Embase、Web of Science、中国知网、万方、维普、中国生物医学文献数据库中检索关于生物制剂治疗RA-ILD的研究,采用R软件进行meta分析。结果共纳入10项研究,其中关于利妥昔单抗(RTX)及阿巴西普(ABA)的研究各4项,肿瘤坏死因子α(TNF-α)抑制剂的研究2项。Meta分析结果显示:接受RTX治疗的患者,治疗后用力肺活量占预计值百分比(FVC%pred)较治疗前显著增加[WMD=9.58,95%CI(3.91,15.25),P<0.05];而治疗前后一氧化碳弥散量占预计值百分比(DLCO%pred)的差异无统计学意义[WMD=8.90,95%CI(-1.06,18.86),P>0.05]。接受ABA治疗的患者,治疗前后FVC%pred[WMD=-1.10,95%CI(-3.83,1.63),P>0.05]和DLCO%pred[WMD=0.65,95%CI(-2.24,3.53),P>0.05]的差异均无统计学意义;治疗后患者肺高分辨率CT的好转、稳定、恶化合并率分别为16%[95%CI(12%,22%)]、69%[95%CI(57%,79%)]、19%[95%CI(14%,24%)]。接受TNF-α抑制剂治疗的患者,治疗后的FVC%pred与治疗前相比未出现明显下降。RTX的总体不良事件合并发生率为33%[95%CI(21%,45%)],与不良事件相关的死亡的合并发生率为7%[95%CI(2%,16%)]。结论生物制剂(RTX、ABA、TNF-α抑制剂)具有稳定或改善RA-ILD患者肺功能和影像学表现的作用,是治疗RA-ILD有效且安全的方法。
基金Supported by the Natural Scientific Research Foundation of Shaanxi Provincial Education Office(16JK1864)the Collaborative Innovation Project of Shaanxi Provincial Science and Technology Office(2016XT-24)the Natural Science Foundation of Yan’an University(YD2014-06)
文摘Two new Zn(Ⅱ) and Cd(Ⅱ) coordination complexes, [Zn(ppda)(idz)]n(1) and [Cd(mpda)(mbib)]n(2)(H2 ppda = 1,4-phenylenediacetic acid, H2 mpda = 1,3-phenylenediacetic acid, idz = imidazole, mbib = 1,3-bis(imidazol-1-ylmethyl)benzene), have been synthesized by using Zn(Ⅱ)/Cd(Ⅱ) salt and phenylenediacetic acid in the presence of different imidazole ligands under hydrothermal conditions, and characterized by elemental analysis, IR spectroscopy, single-crystal X-ray crystallography and thermogravimetric analysis. Complex 1 crystallizes in orthorhombic system, Iba2 space group. The carboxylic acid ligands form a 2 D helical layer with Zn(Ⅱ) ions, and such layers are expanded into a 3 D network structure by the force of C–H…π. Complex 2 crystallizes in monoclinic system, P21/n space group. Complex 2 shows a 3 D framework with two Cd(Ⅱ) ions as nodes of a dual-core unit, which can be considered to be 6-connected net and regarded as a rare(44,510,7) topology network with self-interlacing. The structural diversities indicate that rigid and flexible imidazole ligands play dominating roles in modulating the formation of structures of these crystalline materials. Moreover, the luminescent properties of two complexes are investigated in solid state.
