Tranexamic acid for subarachnoid hemorrhage: A systematic review and meta-analysis.

BACKGROUND: The efficacy of tranexamic acid for subarachnoid hemorrhage remains controversial. Thus, we conduct this meta-analysis to explore the efficacy of tranexamic acid for subarachnoid hemorrhage. METHODS: PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched. Randomized controlled trials (RCTs) assessing the effect of tranexamic acid on subarachnoid hemorrhage were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. This meta-analysis was performed using the random-effect model. RESULTS: Five RCTs and 2359 patients were included in the meta-analysis. Overall, compared with control intervention for subarachnoid hemorrhage, tranexamic acid was associated with significantly reduced risk of rebleeding (Odd ratio [OR] =0.62; 95% confidence interval [CI] =0.41 to 0.93; P = 0.02), but had no influence on mortality (OR = 0.94; 95% CI = 0.75 to 1.18; P = 0.61), poor outcome (OR = 0.95; 95% CI = 0.61 to 1.48; P = 0.82), hydrocephalus (OR = 1.17; 95% CI = 0.94 to 1.46; P = 0.17) or delayed cerebral ischemia (OR = 1.26; 95% CI = 0.78 to 2.04; P = 0.34). CONCLUSIONS: Tranexamic acid may be effective to reduce the risk of rebleeding in patients with subarachnoid hemorrhage.

Exploration of Lasmiditan 200 mg Versus 100 mg for the Treatment of Migraine: A Meta-analysis Based on Aggregate Data.

OBJECTIVES: Lasmiditan holds important potential in treating migraine, but its ideal dose remains elusive. This meta-analysis is conducted based on aggregate data and aims to compare the efficacy of lasmiditan 200 mg versus 100 mg for acute treatment of migraine attack. METHODS: PubMed, Embase, Web of Science, EBSCO, and Cochrane Library databases were systematically searched, and we included the randomized controlled trials comparing the efficacy of lasmiditan 200 mg versus 100 mg for migraine patients. This meta-analysis was conducted using the random-effect model or fixed-effect model based on the heterogeneity. The primary outcome was pain free at 2 hours. Secondary outcomes included pain relief at 2 hours, pain free at 24 hours, most bothersome symptom free at 2 hours, and adverse events. RESULTS: Seven randomized controlled trials and 6515 patients were included in this meta-analysis. Compared with lasmiditan 100 mg for migraine patients, lasmiditan 200 mg was able to significantly improve pain free at 2 hours (odd ratio [OR], 1.28; 95% confidence interval [CI], 1.14-1.44; P < 0.0001) and pain free at 24 hours (OR, 1.35; 95% CI, 1.14-1.60; P = 0.0005), but showed no effect on pain relief at 2 hours (OR, 1.00; 95% CI, 0.90-1.12; P = 0.98) or most bothersome symptom free at 2 hours (OR, 0.93; 95% CI, 0.83-1.03; P = 0.17). Lasmiditan 200 mg was associated with the increase in adverse events compared with lasmiditan 100 mg (OR, 1.28; 95% CI, 1.15-1.43; P < 0.0001). CONCLUSIONS: Lasmiditan 200 mg is more effective to improve pain free at 2 hours and 24 hours than lasmiditan 100 mg for the acute treatment of migraine patients.

Direct conversion of chitin derived N-acetyl-D-glucosamine into 3-acetamido-5-acetylfuran in deep eutectic solvents.

3-Acetylamino-5-acetylfuran (3A5AF) is an important nitrogen-containing fine chemical with broad application prospects and high research value. Herein, we report a novel method for the conversion of N-acetyl-d-glucosamine (NAG) to 3A5AF in the choline chloride-based deep eutectic solvents (DESs). The catalytic activities of various DESs have been smoothly screened, and DES 2 (choline chloride/PEG-200/boronic acid = 1/1/0.5) displayed the best catalytic performance. In the absence of any additional solvent, catalyst and additive, product 3A5AF was obtained in 18.3% yield after reacting at 180 °C for 15 min under atmospheric condition. In addition, DES 2 showed a good reusability. The possible reaction pathway was elucidated on the basis of the results of LC-MS and 13C NMR spectra. This study provided a new perspective for the application of DES in the conversion of chitin biomass.

The Efficacy and Safety of Adjuvant Lomustine to Chemotherapy for Recurrent Glioblastoma: A Meta-analysis of Randomized Controlled Studies.

INTRODUCTION: Lomustine is regarded as 1 common anti-vascular endothelial growth factor agent. The efficacy of adjuvant lomustine to chemotherapy remains controversial for recurrent glioblastoma. We conduct this meta-analysis to explore the influence of adjuvant lomustine on treatment efficacy of recurrent glioblastoma. METHODS: We have searched PubMed, EMBASE, Web of Science, EBSCO, and Cochrane library databases through August 2019 and included randomized controlled trials assessing the efficacy and safety of adjuvant lomustine for recurrent glioblastoma. RESULTS: Four randomized controlled trials are included in the meta-analysis. Overall, compared with the control group for recurrent glioblastoma, adjuvant lomustine has no substantial effect on objective response (risk ratio [RR], 1.32; 95% confidence interval [CI], 0.91 to 1.93; P = 0.15), complete response (RR, 1.76; 95% CI, 0.26-11.90; P = 0.56), progressive response (RR, 1.32; 95% CI, 0.88-1.99; P = 0.18), median progression-free survival (standard mean difference [SMD], 0.73; 95% CI, -0.65 to 2.11; P = 0.30), or median overall survival (SMD, 0.26; 95% CI, -0.30-0.83; P = 0.36), but results in the increase in 6-month progression-free survival (SMD, 1.71; 95% CI, 0.38-3.04; P = 0.01). There is no increase in grade ≥3 adverse events after adjuvant lomustine treatment (RR, 1.55; 95% CI, 0.84-2.89; P = 0.16) compared with control intervention. CONCLUSIONS: Adjuvant lomustine to other chemotherapy may provide no obvious benefits for the treatment of recurrent glioblastoma.

Valorization of chitin biomass into N-containing chemical 3-acetamido-5-acetylfuran catalyzed by simple Lewis acid.

3-Acetamido-5-acetylfuran(3A5AF) is a nitrogen-containing fine chemical and has broad application prospects and high research value. Herein, we report a mild and efficient method for the synthesis of 3A5AF from N-acetyl-d-glucosamine (NAG). The influence of solvent, temperature and additive on the catalytic performance was also studied. The Lewis acids with high catalytic efficiency have been smoothly screened. The highest yield (41.57%) of 3A5AF was obtained in the presence of B2O3 and MgCl2·6H2O at 180 °C for 60 min under normal atmospheric conditions. The reaction pathway was explored by LC-MS, 1H NMR, 13C NMR and FT-IR spectra. Compared with the microwave method and hydrothermal method, the optimized reaction condition was relatively mild. Moreover, the catalyst MgCl2·6H2O is low-cost and environmentally friendly.

Upregulation of CPNE3 suppresses invasion, migration and proliferation of glioblastoma cells through FAK pathway inactivation.

Glioblastoma (GBM) is a deadly brain tumor with a bleak prognosis. In recent years, the copine III (CPNE3) protein was discovered to be associated to metastasis across various types of malignancies. Nevertheless, its function has not been well documented in glioma. This study characterizes CPNE3 expression in GBM along with its impact and underlying molecular mechanism with regards to cellular migration, invasion and proliferation. Immunohistochemistry was used to characterizes CPNE3 expression in the glioma tissues. Then, knockdown of CPNE3 expression was used to analyze the role of CPNE3 in GBM cell viability, migration, invasion. Western blot analysis was performed to measure the protein levels of FAK signaling pathway. We found that GBM tissues had higher CPNE3 expressions as compared to those in normal brain tissues. CPNE3 silencing in GBM cells impaired the migratory, invasive and proliferative abilities of GBM cells that can be attributed to inactivation of the FAK signaling pathway. Collectively, these findings highlight the role of CPNE3 as a new biomarker, offering deeper insights into its carcinogenic role in GBM.

The efficacy and safety of radiotherapy with adjuvant temozolomide for glioblastoma: A meta-analysis of randomized controlled studies.

The efficacy of radiotherapy with adjuvant temozolomide for glioblastoma remains controversial. We conduct a systematic review and meta-analysis to explore the influence of radiotherapy with adjuvant temozolomide on treatment efficacy for glioblastoma.We search PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through November 24, 2019 for randomized controlled trials (RCTs) assessing the efficacy and safety of adjuvant temozolomide to radiotherapy for glioblastoma. This meta-analysis is performed using the random-effect model.Five RCTs are included in the meta-analysis. Overall, compared with radiotherapy for glioblastoma, adjuvant temozolomide is associated with substantially improved overall survival (HR = 0.63; 95% CI = 0.52-76; P < 0.00001) and 2-year survival rate (3.25 = 1.76; 95% CI = 2.13-4.94; P < 0.00001), with no increase in adverse events (RR = 0.76; 95% CI = 0.40-1.45; P = 0.41). However, adjuvant temozolomide appears to increase the incidence of haematological complications than only radiotherapy (RR = 3.58; 95% CI = 1.10-11.59; P = 0.03).Adjuvant temozolomide to radiotherapy may provide better efficacy for the treatment of glioblastoma.