Background Because limited comparative data are available,we decided to compare 2-year major clinical outcomes between beta-blockers (BB) with angiotensin converting enzyme inhibitors (ACEI) and BB with angiotensin re...Background Because limited comparative data are available,we decided to compare 2-year major clinical outcomes between beta-blockers (BB) with angiotensin converting enzyme inhibitors (ACEI) and BB with angiotensin receptor blockers (ARB) therapy in patients with non-ST-segment elevation myocardial infarction (NSTEMI) after percutaneous coronary intervention (PCI) with drug-eluting stents (DES).Methods A total 11,288 NSTEMI patients who underwent PCI with DES were enrolled and they were divided into two groups,the BB with ACEI group (n = 7600) and the BB with ARB group (n = 3688).The major clinical endpoint was the occurrence of major adverse cardiac events (MACE) defined as all-cause death,recurrent myocardial infarction (re-MI),total revascularization [target lesion revascularization (TLR),target vessel revascularization (TVR),non-TVR] rate during the 2-year follow-up period.Results After propensity score-matched (PSM) analysis,two PSM groups (3317 pairs,n = 6634,C-statistic = 0.695) were generated.Although the cumulative incidences of all-cause death,cardiac death,TLR,and non-TVR were similar between the two groups,MACE (HR = 0.832,95% CI: 0.704?0.982,P = 0.030),total revascularization rate (HR = 0.767,95% CI: 0.598?0.984,P = 0.037),and TVR rate (HR = 0.646,95% CI: 0.470?0.888,P = 0.007) were significantly lower in the BB with ACEI group after PSM.Conclusions In this study,we suggest that the combination of BB with ACEI may be beneficial for reducing the cumulative incidences of MACE,total revascularization rate,and TVR rather than the BB with ARB after PCI with DES in NSTEMI patients.展开更多
Objective To evaluate the differences in 24-hour ambulatory blood pressure (BP) in older patients with hypertension treated with the five major classes of antihypertensive drugs,as monotherapy or dual combination ther...Objective To evaluate the differences in 24-hour ambulatory blood pressure (BP) in older patients with hypertension treated with the five major classes of antihypertensive drugs,as monotherapy or dual combination therapy,to improve daytime and nighttime BP control. Methods We enrolled 1920 Chinese community-dwelling outpatients aged ≥ 60 years and compared ambulatory BP values and ambulatory BP control (24-hour BP < 130/80 mmHg;daytime mean BP < 135/85 mmHg;and nighttime mean BP < 120/70 mmHg),as well as nighttime BP dip patterns for monotherapy and dual combination therapy groups. Results Patients’ mean age was 71 years,and 59.5% of patients were women. Calcium channel blockers (CCBs) constituted the most common (60.3% of patients) monotherapy,and renin–angiotensin system (RAS) blockers combined with CCBs was the most common (56.5% of patients) dual combination therapy. Monotherapy with beta-blockers (BB) provided the best daytime BP control. The probabilities of having a nighttime dip pattern and nighttime BP control were higher in patients receiving diuretics compared with CCBs (OR = 0.52,P = 0.05 and OR = 0.41,P = 0.007,respectively). Patients receiving RAS/diuretic combination therapy had a higher probability of having controlled nighttime BP compared with those receiving RAS/CCB (OR = 0.45,P = 0.004). Compared with RAS/diuretic therapy,BB/CCB therapy had a higher probability of achieving daytime BP control (OR = 1.27,P = 0.45). Conclusions Antihypertensive monotherapy and dual combination drug therapy provided different ambulatory BP control and nighttime BP dip patterns. BB-based regimens provided lower daytime BP,whereas diuretic-based therapies provided lower nighttime BP,compared with other antihypertensive regimens.展开更多
Current trends in chiral analysis of pharmaceutical drugs are focused on faster separations and higher separation efficiencies, Core-shell or superficially porous particles （SPP） based chiral stationary phases （CSP...Current trends in chiral analysis of pharmaceutical drugs are focused on faster separations and higher separation efficiencies, Core-shell or superficially porous particles （SPP） based chiral stationary phases （CSPs） provide reduced analysis times while maintaining high column efficiencies and sensitivity. In this study, mobile phase conditions suitable for chiral analyses with electrospray ionization LC-MS were systematically investigated using vancomycin as a representative CSP. The performance of a 2.7 μm SPP based vancomycin CSP （SPP-V） 10 cm ×0.21 cm column was compared to that of a corresponding 5 μm fully porous particles based analogue column. The results demonstrated that the SPP-V column provides higher efficiencies, 2-5 time greater sensitivity and shorter analysis time for a set of 22 basic pharma- ceutical drugs. The SPP-V was successfully applied for the analysis of the degradation products of racemic citalopram whose enantiomers could be selectively identified by MS.展开更多
The objective of the study is to systematically evaluate the efficacy of four Chinese patent medicines in combination with angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARB) in the treat...The objective of the study is to systematically evaluate the efficacy of four Chinese patent medicines in combination with angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARB) in the treatment of early diabetic nephropathy (DN). Retrospectively, previously published randomized controlled trials (RCTs) of four different Chinese patent medicines combined with ACEI or ARB in the treatment of patients with early DN were searched overall from databases. The data were analyzed by R, Generate Mixed Treatment Comparisons and STATA softwares. A total of 78 RCTs were finally included. Network meta-analysis showed that the total effective rate of the Jinshuibao capsule-ACEI/ARB combination group and Huangkui capsule-ACEI/ARB combination groups were better than the others;Jinshuibao capsule-ACEI/ARB combination group reduced the 24-h urinary protein excretion (24-h UTP), urine microalbumin excretion rate (UAER), serum creatinine (Scr), and glycosylated hemoglobin (HbAlc) values. The Huangkui capsule-ACEI/ARB combination demonstrated a better reduction of (blood urea nitrogen [BUN]). Reduced incidences of adverse effects were only observed on treatment with Bailing capsule-ACEI/ARB combination. In early DN, combination of Jinshuibao capsule-ACEI/ARB provided the highest effective rate;moreover, it could reduce the24-h values of UTP, UAER, Scr, and HbAlc;Huangkuai capsule-ACI/ARB combination group showed a good effect on reducing BUN. Bailing capsule-ACEI/ARB combination group had reduced the incidences of adverse reactions.展开更多
目的：系统评价β受体阻滞剂治疗阵发性心房颤动的有效性及安全性。方法计算机检索2001年1月—2014年9月Cochrane图书馆临床对照试验数据库、Pubmed、万方数据、中国学术期刊全文数据库、维普数据库（ VIP）等，收集β受体阻滞剂治疗阵...目的：系统评价β受体阻滞剂治疗阵发性心房颤动的有效性及安全性。方法计算机检索2001年1月—2014年9月Cochrane图书馆临床对照试验数据库、Pubmed、万方数据、中国学术期刊全文数据库、维普数据库（ VIP）等，收集β受体阻滞剂治疗阵发性房颤的临床随机对照试验（ RCT），由2名评价者按纳入、排除标准独立选择、提取资料，并交叉核对、评估质量方法学，使用RevMan 5,．0软件进行Meta分析。结果共纳入26项研究3368例患者。（1）联合应用β-受体阻滞剂治疗阵发性房颤时疗效优于胺碘酮（OR＝1．97，95％CI 1．49～2．61， P ＜0．05）、稳心颗粒（OR＝1．37，95％CI 0．69～4．81， P ＜0．05）及ACEI（OR＝2．29，95％CI 1．53～3．43， P ＜0．05），总有效率治疗组高于对照组（OR＝2．06，95％CI 1．73～2．45， P ＜0．05）；（2）致胃肠道不良反应率：联合应用β受体阻滞剂明显低于单独应用胺碘酮（OR＝0．39，95％CI 0．22～0．69， P ＜0．05）及稳心颗粒（OR＝0．24，95％CI 0．06～0．88， P ＜0．05），与ACEI药物无明显差异（OR＝0．50；95％CI 0．24～1．06， P ＞0．05），总体致胃肠道不良反应率低于对照组（OR＝0．48，95％CI 0．35～0．66， P ＜0．05）。致心律失常不良反应率低于单独应用稳心颗粒（OR＝0．23，95％CI 0．06～0．96， P ＜0．05），与胺碘酮（OR＝0．59，95％CI 0．35～1．00， P ＝0．05）及ACEI（OR＝0．62，95％CI 0．37～1．04， P ＞0．05）比较无明显差异；总体致心律失常不良反应率治疗组低于对照组（ OR＝0．60，95％CI 0．46～0．79；P ＜0．05）。结论β受体阻滞剂在治疗阵发性房颤方面具有较好的临床疗效，且不良反应发生率较低。展开更多
目的系统评价β受体阻滞剂(β-R)治疗婴幼儿血管瘤有效性和安全性。方法计算机检索Cochrane图书馆、Pub Med、EMBASE、Web of Science、中国生物医学文献数据库、中国知网、维普数据库,收集β-R治疗婴幼儿血管瘤的RCT文献,检索时限为建...目的系统评价β受体阻滞剂(β-R)治疗婴幼儿血管瘤有效性和安全性。方法计算机检索Cochrane图书馆、Pub Med、EMBASE、Web of Science、中国生物医学文献数据库、中国知网、维普数据库,收集β-R治疗婴幼儿血管瘤的RCT文献,检索时限为建库至2014年11月。由2位研究者按照纳入与排除标准筛选文献,提取数据和评价纳入文献的方法学质量,采用Rev Man 5.3软件进行Meta分析。结果 17篇RCT进入Meta分析,共纳入1 097例患儿(β-R组585例,对照组512例)。1普萘洛尔治疗有效率高于泼尼松(OR=6.15,95%CI:1.69~22.40,P=0.006);低于激光(OR=0.13,95%CI:0.02~0.67,P=0.02);高于Sr-Y敷贴、维生素E、安慰剂等其他干预措施(OR=22.64,95%CI:9.16~55.96,P<0.000 01);与噻吗洛尔治疗有效率差异无统计学意义(OR=0.64,95%CI:0.31~1.35,P=0.24)。2噻吗洛尔+激光治疗有效率与激光差异无统计学意义(OR=1.80,95%CI:0.14~23.37,P=0.65);噻吗洛尔有效率高于空白对照(OR=21.80,95%CI:7.10~66.90,P<0.05)。3普萘洛尔与其他干预措施(Sr-Y敷贴、维生素E、安慰剂)的总体不良事件发生率差异无统计学意义(OR=2.10,95%CI;0.67~6.58,P=0.20),普萘洛尔的不良事件发生率低于泼尼松(OR=0.20,95%CI:0.06~0.65,P=0.007);高于噻吗洛尔(OR=5.74,95%CI:2.30~14.36,P=0.000 2)。β-R对患儿的心率、甲状腺功能及肝肾功能无明显影响。结论β-R治疗婴幼儿血管瘤疗效优于传统的泼尼松,不良事件发生率低于泼尼松。在不同的β-R中,噻吗洛尔体现出与普萘洛尔相近的疗效和较低不良反应的趋向,有待补充研究证实。展开更多
基金supported by Research of Korea Centers for Disease Control and Prevention (2016-ER6304-02)
文摘Background Because limited comparative data are available,we decided to compare 2-year major clinical outcomes between beta-blockers (BB) with angiotensin converting enzyme inhibitors (ACEI) and BB with angiotensin receptor blockers (ARB) therapy in patients with non-ST-segment elevation myocardial infarction (NSTEMI) after percutaneous coronary intervention (PCI) with drug-eluting stents (DES).Methods A total 11,288 NSTEMI patients who underwent PCI with DES were enrolled and they were divided into two groups,the BB with ACEI group (n = 7600) and the BB with ARB group (n = 3688).The major clinical endpoint was the occurrence of major adverse cardiac events (MACE) defined as all-cause death,recurrent myocardial infarction (re-MI),total revascularization [target lesion revascularization (TLR),target vessel revascularization (TVR),non-TVR] rate during the 2-year follow-up period.Results After propensity score-matched (PSM) analysis,two PSM groups (3317 pairs,n = 6634,C-statistic = 0.695) were generated.Although the cumulative incidences of all-cause death,cardiac death,TLR,and non-TVR were similar between the two groups,MACE (HR = 0.832,95% CI: 0.704?0.982,P = 0.030),total revascularization rate (HR = 0.767,95% CI: 0.598?0.984,P = 0.037),and TVR rate (HR = 0.646,95% CI: 0.470?0.888,P = 0.007) were significantly lower in the BB with ACEI group after PSM.Conclusions In this study,we suggest that the combination of BB with ACEI may be beneficial for reducing the cumulative incidences of MACE,total revascularization rate,and TVR rather than the BB with ARB after PCI with DES in NSTEMI patients.
基金supported by a grant from the Chinese Ministry of Sciences and Technology (2016YFC1300100)
文摘Objective To evaluate the differences in 24-hour ambulatory blood pressure (BP) in older patients with hypertension treated with the five major classes of antihypertensive drugs,as monotherapy or dual combination therapy,to improve daytime and nighttime BP control. Methods We enrolled 1920 Chinese community-dwelling outpatients aged ≥ 60 years and compared ambulatory BP values and ambulatory BP control (24-hour BP < 130/80 mmHg;daytime mean BP < 135/85 mmHg;and nighttime mean BP < 120/70 mmHg),as well as nighttime BP dip patterns for monotherapy and dual combination therapy groups. Results Patients’ mean age was 71 years,and 59.5% of patients were women. Calcium channel blockers (CCBs) constituted the most common (60.3% of patients) monotherapy,and renin–angiotensin system (RAS) blockers combined with CCBs was the most common (56.5% of patients) dual combination therapy. Monotherapy with beta-blockers (BB) provided the best daytime BP control. The probabilities of having a nighttime dip pattern and nighttime BP control were higher in patients receiving diuretics compared with CCBs (OR = 0.52,P = 0.05 and OR = 0.41,P = 0.007,respectively). Patients receiving RAS/diuretic combination therapy had a higher probability of having controlled nighttime BP compared with those receiving RAS/CCB (OR = 0.45,P = 0.004). Compared with RAS/diuretic therapy,BB/CCB therapy had a higher probability of achieving daytime BP control (OR = 1.27,P = 0.45). Conclusions Antihypertensive monotherapy and dual combination drug therapy provided different ambulatory BP control and nighttime BP dip patterns. BB-based regimens provided lower daytime BP,whereas diuretic-based therapies provided lower nighttime BP,compared with other antihypertensive regimens.
基金supported by the Robert A.Welch Foundation(Y0026)the French National Center for Scientific Research(ISA-CNRS-UMR5280)
文摘Current trends in chiral analysis of pharmaceutical drugs are focused on faster separations and higher separation efficiencies, Core-shell or superficially porous particles （SPP） based chiral stationary phases （CSPs） provide reduced analysis times while maintaining high column efficiencies and sensitivity. In this study, mobile phase conditions suitable for chiral analyses with electrospray ionization LC-MS were systematically investigated using vancomycin as a representative CSP. The performance of a 2.7 μm SPP based vancomycin CSP （SPP-V） 10 cm ×0.21 cm column was compared to that of a corresponding 5 μm fully porous particles based analogue column. The results demonstrated that the SPP-V column provides higher efficiencies, 2-5 time greater sensitivity and shorter analysis time for a set of 22 basic pharma- ceutical drugs. The SPP-V was successfully applied for the analysis of the degradation products of racemic citalopram whose enantiomers could be selectively identified by MS.
基金the National Natural Scienceof China (youth science fund project 81603570)。
文摘The objective of the study is to systematically evaluate the efficacy of four Chinese patent medicines in combination with angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARB) in the treatment of early diabetic nephropathy (DN). Retrospectively, previously published randomized controlled trials (RCTs) of four different Chinese patent medicines combined with ACEI or ARB in the treatment of patients with early DN were searched overall from databases. The data were analyzed by R, Generate Mixed Treatment Comparisons and STATA softwares. A total of 78 RCTs were finally included. Network meta-analysis showed that the total effective rate of the Jinshuibao capsule-ACEI/ARB combination group and Huangkui capsule-ACEI/ARB combination groups were better than the others;Jinshuibao capsule-ACEI/ARB combination group reduced the 24-h urinary protein excretion (24-h UTP), urine microalbumin excretion rate (UAER), serum creatinine (Scr), and glycosylated hemoglobin (HbAlc) values. The Huangkui capsule-ACEI/ARB combination demonstrated a better reduction of (blood urea nitrogen [BUN]). Reduced incidences of adverse effects were only observed on treatment with Bailing capsule-ACEI/ARB combination. In early DN, combination of Jinshuibao capsule-ACEI/ARB provided the highest effective rate;moreover, it could reduce the24-h values of UTP, UAER, Scr, and HbAlc;Huangkuai capsule-ACI/ARB combination group showed a good effect on reducing BUN. Bailing capsule-ACEI/ARB combination group had reduced the incidences of adverse reactions.
文摘目的：系统评价β受体阻滞剂治疗阵发性心房颤动的有效性及安全性。方法计算机检索2001年1月—2014年9月Cochrane图书馆临床对照试验数据库、Pubmed、万方数据、中国学术期刊全文数据库、维普数据库（ VIP）等，收集β受体阻滞剂治疗阵发性房颤的临床随机对照试验（ RCT），由2名评价者按纳入、排除标准独立选择、提取资料，并交叉核对、评估质量方法学，使用RevMan 5,．0软件进行Meta分析。结果共纳入26项研究3368例患者。（1）联合应用β-受体阻滞剂治疗阵发性房颤时疗效优于胺碘酮（OR＝1．97，95％CI 1．49～2．61， P ＜0．05）、稳心颗粒（OR＝1．37，95％CI 0．69～4．81， P ＜0．05）及ACEI（OR＝2．29，95％CI 1．53～3．43， P ＜0．05），总有效率治疗组高于对照组（OR＝2．06，95％CI 1．73～2．45， P ＜0．05）；（2）致胃肠道不良反应率：联合应用β受体阻滞剂明显低于单独应用胺碘酮（OR＝0．39，95％CI 0．22～0．69， P ＜0．05）及稳心颗粒（OR＝0．24，95％CI 0．06～0．88， P ＜0．05），与ACEI药物无明显差异（OR＝0．50；95％CI 0．24～1．06， P ＞0．05），总体致胃肠道不良反应率低于对照组（OR＝0．48，95％CI 0．35～0．66， P ＜0．05）。致心律失常不良反应率低于单独应用稳心颗粒（OR＝0．23，95％CI 0．06～0．96， P ＜0．05），与胺碘酮（OR＝0．59，95％CI 0．35～1．00， P ＝0．05）及ACEI（OR＝0．62，95％CI 0．37～1．04， P ＞0．05）比较无明显差异；总体致心律失常不良反应率治疗组低于对照组（ OR＝0．60，95％CI 0．46～0．79；P ＜0．05）。结论β受体阻滞剂在治疗阵发性房颤方面具有较好的临床疗效，且不良反应发生率较低。
文摘目的系统评价β受体阻滞剂(β-R)治疗婴幼儿血管瘤有效性和安全性。方法计算机检索Cochrane图书馆、Pub Med、EMBASE、Web of Science、中国生物医学文献数据库、中国知网、维普数据库,收集β-R治疗婴幼儿血管瘤的RCT文献,检索时限为建库至2014年11月。由2位研究者按照纳入与排除标准筛选文献,提取数据和评价纳入文献的方法学质量,采用Rev Man 5.3软件进行Meta分析。结果 17篇RCT进入Meta分析,共纳入1 097例患儿(β-R组585例,对照组512例)。1普萘洛尔治疗有效率高于泼尼松(OR=6.15,95%CI:1.69~22.40,P=0.006);低于激光(OR=0.13,95%CI:0.02~0.67,P=0.02);高于Sr-Y敷贴、维生素E、安慰剂等其他干预措施(OR=22.64,95%CI:9.16~55.96,P<0.000 01);与噻吗洛尔治疗有效率差异无统计学意义(OR=0.64,95%CI:0.31~1.35,P=0.24)。2噻吗洛尔+激光治疗有效率与激光差异无统计学意义(OR=1.80,95%CI:0.14~23.37,P=0.65);噻吗洛尔有效率高于空白对照(OR=21.80,95%CI:7.10~66.90,P<0.05)。3普萘洛尔与其他干预措施(Sr-Y敷贴、维生素E、安慰剂)的总体不良事件发生率差异无统计学意义(OR=2.10,95%CI;0.67~6.58,P=0.20),普萘洛尔的不良事件发生率低于泼尼松(OR=0.20,95%CI:0.06~0.65,P=0.007);高于噻吗洛尔(OR=5.74,95%CI:2.30~14.36,P=0.000 2)。β-R对患儿的心率、甲状腺功能及肝肾功能无明显影响。结论β-R治疗婴幼儿血管瘤疗效优于传统的泼尼松,不良事件发生率低于泼尼松。在不同的β-R中,噻吗洛尔体现出与普萘洛尔相近的疗效和较低不良反应的趋向,有待补充研究证实。
