AIM: To evaluate the efficacy and safety of Traditional Chinese Medicine (TCM) in the treatment of Helicobacter pylori (H pylori) infection. METHODS: We electronically and manually searched electronic databases, refer...AIM: To evaluate the efficacy and safety of Traditional Chinese Medicine (TCM) in the treatment of Helicobacter pylori (H pylori) infection. METHODS: We electronically and manually searched electronic databases, references lists and conferences compilations, and included all randomized clinical trials comparing the treatment of H pylori using TCM with proton pump inhibitor or colloidal bismuth subcitratebased triple therapy as controls. The Jadad score was used to assess trial quality, H pylori eradication rate and the incidence of side effects were taken as outcome measurements, and heterogeneity analysis, meta-analysis and funnel plot analysis were conducted. RESULTS: Sixteen trials were included. The Jadad scores of all the trials were not more than 2. Clinical heterogeneity and substantial statistical heterogeneity existed among the trials (P = 0.001, I 2 = 59%) and meta-analysis was not conducted. The average eradication rates following TCM and triple therapy were 72% and 78% and the incidence of side effects were 2% and 29%, respectively. The funnel plot was obviously asymmetric. CONCLUSION: Available evidence is not convincing enough to show that TCM has the same efficacy as triple therapy in H pylori treatment. TCM may be safer than triple therapy. TCM should not be recommended as monotherapy in H pylori infection.展开更多
Pseudomonas aeruginosa is an opportunistic pathogen that contributes to high morbidity and mortality. MexAB-OprM is the main efflux pump among the Resistance-Nodulation-Division family multi-drug effiux systems, which...Pseudomonas aeruginosa is an opportunistic pathogen that contributes to high morbidity and mortality. MexAB-OprM is the main efflux pump among the Resistance-Nodulation-Division family multi-drug effiux systems, which contribute greatly to the multidrug resistance of P. aeruginosa. Effiux pump inhibitors （EPIs） of MexAB-OprM could enhance the activity of the antibiotics effiuxed by MexAB-OprM, and thus they might be useful in the clinic as antibacterial synergistic agents. In this work, a new EPI of MexAB-OprM, KL-0153, was discovered by screening of a small molecular library. Its inhibition of MexAB-OprM was confirmed by assays of synergistic activity and EB accumulation. The activity of KL-0153 was shown to be synergistic with antibiotics effiuxed by MexAB-OprM when they were tested against strains expressing MexAB-OprM, especially so for the strains that express MexAB-OprM at high levels. KL-0153 showed more activity than the positive drug carbonyl cyanide m-chlorophenylhydrazone in the EB accumulation assay. It cannot be neglected that KL-0153 has significant liver and kidney toxicity. However, KL-0153 may be a lead comoound for the research and development of new tvoes of EPIs.展开更多
In the present study,we aimed to systematically evaluate the efficacy of the combination therapy of prokinetics and proton pump inhibitors(PPIs)in patients with gastroesophageal reflux disease(GERD),and to provide an ...In the present study,we aimed to systematically evaluate the efficacy of the combination therapy of prokinetics and proton pump inhibitors(PPIs)in patients with gastroesophageal reflux disease(GERD),and to provide an evidence-based reference for clinical use.The pertinent randomized controlled trials(RCTs)were retrieved from Pub Med and Embase.The quality of included studies was evaluated using the"risk of bias"tool for RCTs using the Rev Man 5.3.Related data were extracted according to the preset data collection forms.Meta-analysis was performed using Rev Man 5.3 and Stata 12.0 statistical software.Mean difference(MD)was used to describe the continuous variables,and relative ratio(RR)was used for classification variables.A total of 13 RCTs involving 1388 patients were included.Results of the meta-analysis showed that compared with PPI monotherapy,the combination therapy significantly improved the total response rate(RR=1.15,95%confidence interval(CI):(1.07,–1.24),P<0.001),gastroesophageal reflux disease questionnaire(GERD-Q)score(MD=–1.38,95%CI:(–2.12,–0.64),P<0.001),the frequency scale for the symptoms of gastroesophageal reflux(FSSG)score(MD=2.11,95%CI:(1.68,2.54),P<0.001)and visual analogue scale(MD=–0.69,95%CI:(–0.93,–0.45),P<0.001).However,the endoscopic response(RR=1.08,95%CI:(0.99,1.18),P=0.10)and symptomatic response(RR=1.22,95%CI:(0.94,1.59),P=0.13)were not significantly different between the two groups.For patients with GERD,the combination therapy could markedly improve the total response rate(symptomatic response and/or endoscopic response)and quality of life,while no benefits were found in symptomatic and endoscopic response.In view of the small number of participants included and some confounding factors in this study,the conclusion made in this study needs to be further confirmed by including a large number of participants and performing high-quality RCTs.展开更多
文摘AIM: To evaluate the efficacy and safety of Traditional Chinese Medicine (TCM) in the treatment of Helicobacter pylori (H pylori) infection. METHODS: We electronically and manually searched electronic databases, references lists and conferences compilations, and included all randomized clinical trials comparing the treatment of H pylori using TCM with proton pump inhibitor or colloidal bismuth subcitratebased triple therapy as controls. The Jadad score was used to assess trial quality, H pylori eradication rate and the incidence of side effects were taken as outcome measurements, and heterogeneity analysis, meta-analysis and funnel plot analysis were conducted. RESULTS: Sixteen trials were included. The Jadad scores of all the trials were not more than 2. Clinical heterogeneity and substantial statistical heterogeneity existed among the trials (P = 0.001, I 2 = 59%) and meta-analysis was not conducted. The average eradication rates following TCM and triple therapy were 72% and 78% and the incidence of side effects were 2% and 29%, respectively. The funnel plot was obviously asymmetric. CONCLUSION: Available evidence is not convincing enough to show that TCM has the same efficacy as triple therapy in H pylori treatment. TCM may be safer than triple therapy. TCM should not be recommended as monotherapy in H pylori infection.
文摘Pseudomonas aeruginosa is an opportunistic pathogen that contributes to high morbidity and mortality. MexAB-OprM is the main efflux pump among the Resistance-Nodulation-Division family multi-drug effiux systems, which contribute greatly to the multidrug resistance of P. aeruginosa. Effiux pump inhibitors （EPIs） of MexAB-OprM could enhance the activity of the antibiotics effiuxed by MexAB-OprM, and thus they might be useful in the clinic as antibacterial synergistic agents. In this work, a new EPI of MexAB-OprM, KL-0153, was discovered by screening of a small molecular library. Its inhibition of MexAB-OprM was confirmed by assays of synergistic activity and EB accumulation. The activity of KL-0153 was shown to be synergistic with antibiotics effiuxed by MexAB-OprM when they were tested against strains expressing MexAB-OprM, especially so for the strains that express MexAB-OprM at high levels. KL-0153 showed more activity than the positive drug carbonyl cyanide m-chlorophenylhydrazone in the EB accumulation assay. It cannot be neglected that KL-0153 has significant liver and kidney toxicity. However, KL-0153 may be a lead comoound for the research and development of new tvoes of EPIs.
文摘In the present study,we aimed to systematically evaluate the efficacy of the combination therapy of prokinetics and proton pump inhibitors(PPIs)in patients with gastroesophageal reflux disease(GERD),and to provide an evidence-based reference for clinical use.The pertinent randomized controlled trials(RCTs)were retrieved from Pub Med and Embase.The quality of included studies was evaluated using the"risk of bias"tool for RCTs using the Rev Man 5.3.Related data were extracted according to the preset data collection forms.Meta-analysis was performed using Rev Man 5.3 and Stata 12.0 statistical software.Mean difference(MD)was used to describe the continuous variables,and relative ratio(RR)was used for classification variables.A total of 13 RCTs involving 1388 patients were included.Results of the meta-analysis showed that compared with PPI monotherapy,the combination therapy significantly improved the total response rate(RR=1.15,95%confidence interval(CI):(1.07,–1.24),P<0.001),gastroesophageal reflux disease questionnaire(GERD-Q)score(MD=–1.38,95%CI:(–2.12,–0.64),P<0.001),the frequency scale for the symptoms of gastroesophageal reflux(FSSG)score(MD=2.11,95%CI:(1.68,2.54),P<0.001)and visual analogue scale(MD=–0.69,95%CI:(–0.93,–0.45),P<0.001).However,the endoscopic response(RR=1.08,95%CI:(0.99,1.18),P=0.10)and symptomatic response(RR=1.22,95%CI:(0.94,1.59),P=0.13)were not significantly different between the two groups.For patients with GERD,the combination therapy could markedly improve the total response rate(symptomatic response and/or endoscopic response)and quality of life,while no benefits were found in symptomatic and endoscopic response.In view of the small number of participants included and some confounding factors in this study,the conclusion made in this study needs to be further confirmed by including a large number of participants and performing high-quality RCTs.
