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Objective:To compare the efficacy and safety of 10 kinds of oral Chinese patent medicines combined with chemotherapy in the treatment of gastric cancer in a network Meta-analysis. Method:PubMed，Embase，Web of Science，Cochrane Library，CNKI，China biomedical literature service system，VIP，Wanfang database were retrieved to obtain Chinese and English literatures published before March 1，2020. The randomized controlled trials（RCTs） and data were screened and extracted. The quality of the included literatures was also evaluated. The pair-work Meta-analysis was conducted by Revman 5.3 software， and the Meta-analysis were conducted by ADDIS 1.16.7 software. Result:A total of 41 randomized controlled trials were eventually involved. All of them were two-arm，including 10 oral Chinese patent medicines，Cinobufotalin，Jinlong capsule，Pingxiao capsule，Shenyi capsule，Xihuang pill （or capsule），Xiaoaiping tablet，Yangzheng Xiaoji capsule，Zhenqi Fuzheng granule combined with chemotherapy for gastric cancer. The effective rate for treating cancer was significantly higher than that of chemotherapy alone （<italic>P</italic><0.05）. Zhenqi Fuzheng+chemotherapy was the best choice； the KPS improvement rate of Cinobufacin，Shenyi capsule，Yangzheng Xiaoji capsule，Zhenqi Fuzheng granule combined with chemotherapy in the treatment of gastric cancer was significantly increased（<italic>P</italic><0.05）. Shenyi capsule combined with chemotherapy might be the best regimen. The incidence rate of leukocyte decline was significantly lower in the treatment of gastric cancer（<italic>P</italic><0.05）. The combination of Zhenqi Fuzheng granule and chemotherapy was the best choice. Traditional Chinese medicine could not reduce the incidence of neurotoxicity（<italic>P></italic>0.05）. Cinobufufacin，Yangzheng Xiaoji capsule and Zhenqi Fuzheng granule combined with chemotherapy could increase CD4<sup>+</sup>/CD8<sup>+ </sup>in patients with gastric cancer， which was significantly higher than that of chemotherapy alone（<italic>P</italic><0.05）. Conclusion:All kinds of oral Chinese patent medicines can play a significantly role in the treatment of gastric cancer. Zhenqi Fuzheng granule，angzheng Xiaoji capsule and Shenyi capsule combined with chemotherapy are more effective in treating gastric cancer.
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<p><b>BACKGROUND</b>Long-term use of antiplatelet agents, statins, beta-blockers and angiotensin-converting enzyme inhibitors are proven therapies for secondary prevention in acute coronary syndrome. However, little is known of physicians' opinion about their use in China.</p><p><b>METHODS</b>In 2010, standard questionnaires were posted to chief cardiologists in 1397 geographically diverse and representative sample of tertiary and secondary hospitals in China, collecting information about their opinions on the recommended treatments for acute coronary syndrome.</p><p><b>RESULTS</b>A total of 1009 (72%) cardiologists responded with a valid questionnaire. Of them, 77% reported routine use of all the four main secondary preventive treatments, with little difference between secondary and tertiary hospitals (75% vs. 79%, P = 0.16). Of the cardiologists reporting routine or selective use of aspirin, beta-blockers, statins and angiotensin-converting enzyme inhibitors, 94%, 85%, 73% and 86% would recommend indefinite use respectively. For all the 4 treatments combined, only 63.5% reported indefinite use at the same time, with no significant difference between secondary and tertiary hospitals (62% vs. 65%, P = 0.17), nor between hospitals with or without fast track for primary percutaneous coronary intervention (66% vs. 61%, P = 0.50).</p><p><b>CONCLUSIONS</b>Although Chinese cardiologists seem well informed about the value of main secondary preventive treatments for acute coronary syndrome, there is still gap in their understanding of the need for combined and prolonged use of these treatments.</p>
Subject(s)
Humans , Acute Coronary Syndrome , China , Coronary Disease , Physicians , Secondary Prevention , Methods , Surveys and QuestionnairesABSTRACT
<p><b>OBJECTIVE</b>This study investigated current use of ACEI/ARB among high risk patients with coronary heart disease (CHD) in China and factors affecting ACEI/ARB use in these patients.</p><p><b>METHODS</b>This cross-sectional survey was performed between June to December 2007 and May to November 2009 in 51 hospitals from 14 cities. The characteristics of patients with established CHD were collected by electronic questionnaire.</p><p><b>RESULTS</b>Only 45.8% high risk CHD patients were taking ACEI/ARB and the ACEI/ARB medication decreased significantly with time after initial CHD diagnosis. ACEI/ARB was taken in 46.1% CHD patients complicated with diabetes mellitus and in 56.3% CHD patients complicated with hypertension. Logistic regression analysis showed that comorbid hypertension was the strongest factor associated with ACEI/ARB use. In addition, male gender, history of myocardial infarction (MI), PCI and the time after initial CHD diagnosis were independent factors affecting the use of ACEI/ARB. Captopril was the most commonly prescribed ACEI in this cohort.</p><p><b>CONCLUSION</b>ACEI/ARB is underused in secondary prevention among high risk CHD patients in China. It remains a major challenge for healthcare professionals and policy makers to make efforts on narrowing the gap between evidence and practice.</p>
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Angiotensin-Converting Enzyme Inhibitors , Therapeutic Uses , China , Epidemiology , Coronary Disease , Drug Therapy , Epidemiology , Cross-Sectional Studies , Risk Factors , Treatment OutcomeABSTRACT
<p><b>BACKGROUND</b>Well designed randomized trials and meta-analyses have clearly shown that statins reduce the risk of major vascular events, including ischemic stroke, in a wide range of patients and their routine use is recommended for patients at an increased cardiovascular risk. Survivors of a first ischemic stroke are at a risk of recurrence and of other vascular events and statins are generally recommended to reduce this risk. This study investigated how widely statins were being used for such patients in China.</p><p><b>METHODS</b>Totally 6422 patients with a history of ischemic stroke were identified by reviewing medical records at 51 highest-ranking hospitals in 14 cities in China, and invited to attend a screening clinic to assess eligibility for a randomized trial. Their current statin and other drug uses were recorded alongside clinical and demographic characteristics. Univariate chi-square test and multivariate Logistic regression were used to determine the factors associated with treatment.</p><p><b>RESULTS</b>Only 24% of these patients reported currently taking a statin. The most important predictor of statin use among these patients was prior history of coronary heart disease. History of diabetes or hypertension, as well as treated in university affiliated hospitals is related to increased use. The status had improved significantly during a 2-year period. Atorvastatin (40%) and simvastatin (39%) were the most commonly used.</p><p><b>CONCLUSIONS</b>In China, statins are still underused for secondary prevention among survivors of ischemic stroke. Reasons for this poor use need to be understood in order to increase use of these evidence based therapies.</p>
Subject(s)
Aged , Female , Humans , Male , Middle Aged , China , Hydroxymethylglutaryl-CoA Reductase Inhibitors , Therapeutic Uses , Stroke , Drug TherapyABSTRACT
<p><b>BACKGROUND</b>Despite considerable improvements in the care of patients with cardiovascular disease in various populations over the last few decades, there are still limited data about long-term treatment patterns among patients with various atherosclerotic vascular conditions in China, especially the use of statin therapy.</p><p><b>METHODS</b>Between June 2007 and October 2009, 16 860 patients aged 50 - 80 years with established history of atherosclerotic vascular disease (coronary heart disease (CHD), atherosclerotic cerebrovascular disease (CVD), or peripheral arterial disease (PAD)) from 51 hospitals in 14 cities of China were screened for a large randomized trial. Detailed information about current use of statins and various other treatments was recorded and analyzed by prior disease history, adjusting for various baseline characteristics.</p><p><b>RESULTS</b>Among the 16 860 patients, the mean age was 63 years and 74% were male. Overall, 78% of the patients had documented CHD, 40% had CVD, 5% had PAD and 21% reported more than one condition. The median time from initial diagnosis of vascular disease to screening was 18 months. At screening, the proportions who took various treatments were 83% for antiplatelet agents, 49% for beta-blockers, 47% for statins and 28% for angiotensin-converting enzyme inhibitors. The proportion treated with statin was much higher in CHD than in CVD or PAD patients (61% vs. 10% vs. 22% respectively) and decreased significantly with time from initial diagnosis. Simvastatin (mainly 20 mg) and atorvastatin (mainly 10 mg) each accounted for about 40% of total statin use.</p><p><b>CONCLUSIONS</b>In urban China, there is still significant underuse of various proven secondary preventive therapies, with particularly low use of statins in patients with ischaemic stroke.</p>