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Introduction: Previous studies suggested that sevelamer carbonate is well tolerated with a favorable efficacy and safety profile in both dialysis and nondialysis patients in Europe; however, the efficacy remains controversial, and few studies have examined sevelamer carbonate therapy in other ethnic nondialysis CKD patients. This study assessed the efficacy and safety of sevelamer carbonate in Chinese nondialysis CKD patients with hyperphosphatemia. Methods: The multicenter, randomized, double-blind, parallel-group, placebo-controlled, and phase 3 clinical trial enrolled 202 Chinese nondialysis CKD patients with serum phosphorus ≥1.78 mmol/L. Patients were randomly assigned 1:1 to receive sevelamer carbonate (2.4-12 g per day) or placebo for 8 weeks. The primary outcome was the change in serum phosphorous between baseline and week 8. Results: Totally 482 Chinese patients were screened and 202 were randomized (sevelamer carbonate, n = 101; placebo, n = 101). The mean serum phosphorous decreased significantly in patients treated with sevelamer carbonate compared with placebo (-0.22 ± 0.47 vs. 0.05 ± 0.44 mmol/L, p < 0.0001). Significantly (p < 0.0001), decreases of serum total cholesterol, low-density lipoprotein cholesterol, and calcium-phosphorus (Ca × P) product levels from baseline to week 8 were shown in sevelamer carbonate group compared with placebo group. Serum intact parathyroid hormone was not significantly changed in the sevelamer carbonate group (p = 0.83). Patients in the sevelamer carbonate group experienced similar adverse events as the placebo group. Conclusion: Sevelamer carbonate is an effective and well-tolerated phosphate binder in advanced nondialysis CKD Chinese patients with hyperphosphatemia.
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ß-Elemene, a compound extracted from Chinese herb Curcuma wenyujin, has been demonstrated with antitumor effects in various cancers, including glioblastoma (GBM), a primary brain tumor with high morbidity and mortality. In this study, we reported a bisamino derivative of ß-Elemene, 2, 2'-((1R, 3R, 4S)-4-methyl-4-vinylcyclohexane-1, 3-diyl) bis(prop-2-en-1-amine) (compound 1), displayed a better anti-GBM effect than ß-Elemene with lower concentration. GBM cell lines (C6 and U87) were treated with compound 1 and subsequently analyzed by several assays. Compound 1 significantly inhibited the migration of C6 and U87 cells based on wound healing assay, transwell assay and inverted migration assay. Furthermore, colony formation assay, immunostaining and flow cytometry assays revealed that compound 1 significantly inhibited the proliferation of GBM cells. In addition, compound 1 induced the apoptosis of GBM cells. Mechanistically, we found Yes-associated protein (YAP) was down-regulated in compound 1-treated GBM cells, and the overexpression of YAP partially rescued the anti-GBM effects of compound 1. Finally, compound 1 suppresses the GBM growth in xenograft model through inactivation YAP signaling. Taken together, these results reveal that a novel derivative of ß-Elemene, compound 1, exhibits more potent anti-GBM activity than ß-Elemene through inactivating YAP signaling pathway, which will provide novel strategies for the treatment of GBM.
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BACKGROUND: This study aimed to evaluate the effects of standard rescue procedure (SRP) in improving severe trauma treatments in China. METHODS: This study was conducted in 12 hospitals located in geographically and industrially different cities in China. A standard procedure on severe trauma rescue was established as a general rule for staff training and patient treatment. A regional network (system) efficiently integrating prehospital rescue, emergency room treatments, and hospital specialist treatments was built under the rule for information sharing and improving severe trauma treatments. Treatment outcomes were compared between before and 1 year after the implementation of the SRP. RESULTS: The outcomes of a total of 74,615 and 12,051 trauma cases were collected from 12 hospitals before and after the implementation of the SRP. Implementation of the SRP led to efficient cooperation and information sharing of different treatment services. The emergency response time, prehospital transit time, emergency rescue time, consultation call time, and mortality rate of patients were 24.24 ± 4.32 min, 45.69 ± 3.89 min, 6.38 ± 1.05 min, 17.53 ± 0.72 min, and 33.82% ± 3.87% (n = 441), respectively, before the implementation of the standardization and significantly reduced to 10.11 ± 3.21 min, 22.39 ± 4.32 min, 3.26 ± 0.89 min, 3.45 ± 0.45 min, and 20.49% ± 3.11%, separately (n = 495, P < 0.05) after that. CONCLUSIONS: Staff training and SRP can significantly improve the efficiency of severe trauma treatments in China.
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Serviços Médicos de Emergência/normas , Ferimentos e Lesões , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , China , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
OBJECTIVE: To systematically assess the clinical efficacy of bone morphogenetic proteins in the treatment of open tibial fractures. METHODS: Based on the principles and methods of Cochrane systematic reviews, the Cochrane Library, PubMed, EMBASE, Chinese Bio-medicine Database, China Journal Full-text Database, VIP database were searched from their establishment to April 2012 in whatever language. Related journals were handsearched as well. Randomized controlled trials (RCTs) of bone morphogenetic protein for the treatment of open tibial fractures were included. The quality of the included trials according to the Cochrane Handbook for Systematic Reviews of Interventions Version was assessed. The Cochrane Collaboration's software RevMan 5.1 was used for meta-analysis. RESULTS: Three RCTs totaling 851 patients were included. The results showed that bone morphogenetic protein had no significant differences in fracture healing [RR = 1.16, 95% CI (0.95,1.41), P = 0.15], but lower secondary interventions incidence rate [RR = 0.72, 95% CI (0.58, 0.89), P = 0.003]. There were no significant differences between the two groups in the incidence of adverse events of infection [RR = 1.31, 95% CI (0.94, 1.81), P = 0.11] and pain [RR = 0.92, 95% CI (0.79, 1.08), P = 0.30]. CONCLUSION: Bone morphogenetic protein has certain advantages in treating open tibial fractures. It needs more high-quality articles to assess the long-term effect of different courses of treatments. The above conclusion still needs more high-quality randomized controlled trails to be verified owing to the limitations of the number and quality of systematic review included studies.
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Proteínas Morfogenéticas Ósseas/uso terapêutico , Fraturas da Tíbia/tratamento farmacológico , Adulto , Feminino , Humanos , Masculino , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
OBJECTIVE: To evaluate the clinical effectiveness of pulsed electromagnetic field therapy in the treatment of knee osteoarthritis. METHODS: Based on the principles and methods of Cochrane systematic reviews, the authors searched the Cochrane Library (2012, 2 issue), PubMed (1966 to February, 2012), EMBASE (1974 to February, 2012), Chinese Biomedicine Database (1978 to February, 2012), China Journal Full-text Database (1979 to February, 2012), VIP database (1989 to February, 2012), as well as search engine Google Scholar. Randomized controlled trials (RCTs) of pulsed electromagnetic field therapy to treat knee osteoarthritis were included. The authors assessed the quality of the included trials according to the Cochrane Handbook for Systematic Reviews of Interventions Version. The Cochrane Collaboration's software RevMan 5.1 was used for meta-analysis. RESULTS: Five RCTs totaling 331 patients were included. The results showed that compared with placebo control treatment, pulsed electromagnetic field therapy had little clinical benefit in relieving the pain of knee osteoarthritis [WMD=0.12, 95%CI (-0.46,0.69)], reducing morning stiffness time [WMD=0.08, 95%CI (-0.05, 0.21)] and improving the knee function [WMD=-1.16, 95%CI (-4.36, 2.05)]. There were no significant differences between the two groups. CONCLUSION: The effects of Pulsed electromagnetic field therapy for treating knee osteoarthritis need more powerful trails to be confirmed. The above conclusions still need more high-quality randomized controlled trails to be verified owing to the limitations of the number and the quality of systematic review included studies.
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Campos Eletromagnéticos , Osteoartrite do Joelho/terapia , Humanos , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
OBJECTIVE: To observe the effect of autologous bone marrow stem cell (BMSC) transplantation via the renal artery on renal function recovery following renal ischemic-reperfusion (I/R) injury in rabbits. METHODS: BMSCs were collected and isolated from rabbits. Twenty-eight rabbits were subjected to renal pedicle clamping for 105 min and randomized subsequently into transplantation group and control group. BMSCs or saline were injected into the kidney via the renal artery, respectively. Before and 1, 3, 5, 7, 14, 21, and 28 days after I/R injury the venous blood was collected to measure the serum levels of SCr and BUN, and the renal tissue was sampled for pathological observation. RESULTS: One and 3 days after I/R injury, serum Cr and BUN levels increased significantly to the highest level in both groups. On the 7th day serum Cr and BUN levels in the transplantation group were lower than those in control group and remained so till the end of the experiment. On the 28th day, the levels of serum Cr (90.1+/-11.1 micromol/L) and BUN (8.0+/-1.5 mmol/L) in the transplantation group were significantly lower than those in the control group (135.6+/-32.5 micromol/L and 10.9+/-2.5 mmol/L, respectively, P<0.05). Pathological observation of the renal tissue revealed renal tubular epithelial cell degeneration, necrosis and abscission. CONCLUSION: BMSC transplantation can accelerate renal function repair after acute tubular necrosis resulting from I/R injury, and decrease serum Cr and BUN levels in early stage following the injury.