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OBJECTIVE To explore the efficacy of Jiaotai pill (JTW) and JTW modified prescriptions (JTW+) plus benzodiazepines (BDZ) for insomnia in China by systematic review and network meta-analysis, especially optimization ratio (m:n) between Coptis chinensis and Cinnamo. METHODS Randomized controlled trials (RCTs) regarding JTW and JTW++BDZ for insomina were comprehensively searched in CNKI, VIP, Wanfang, and PubMed, Cochrane Library, OVID, Embase databases from their inception to December 2017. The risk of bias was assessed by the Cochrane collab?oration's tool and Jadad scale. Systematic review and network meta-analysis were performed to evaluate the relative risk (RR) plus 95％confidence interval (95％CI) or prediction interval (95％PrI), and draw surface under the cumulative rank?ing curves (SUCRA) by Stata 14.0 and RevMan 5.0 software. RESULTS A total of 13 RCTs (1 RCT was omitted by sen?sitivity analysis) with 1040 patients were included. Overall heterogeneity was acceptable, except publication bias. Based on classical meta-analysis, JTW and JTWm:n++BDZ, such as JTW2:1++BDZ, JTW5:1++BDZ, JTW6:1++BDZ, JTW10:1++BDZ, had more efficacy than BDZ. Based on network meta-analysis, JTW and JTWm:n++BDZ, such as JTW2:1++BDZ, JTW6:1++BDZ, JTW10:1++BDZ, had more efficacy than BDZ; meanwhile, SUCRA showed the best rank of JTW/JTW+ (BDZ<JTWm:n++BDZ<JTW) for insomina, as same as that of JTWm:n+(BDZ<JTW5:1++BDZ<JTW10:1++BDZ<JTW2:1++BDZ<JTW6:1++BDZ). CONCLUSION Based on the existing clinical evidence, JTW has efficacy for insomnia, but the optimization ratio between Coptis chinensis and cinnamo of JTWm:n++BDZ for insomnia needs more supports.
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Aim To explore the correlation between elevated plus maze (EPM) and elevated zero maze (EZM),as two type animal models of state anxiety in Kunming mice. Methods The behavior of adult,♂/♀,Kunming mice in EPM and EZM was recorded by sequence,for 5 min,with a one-week inter-trial interval. The following parameters were evaluated:percentage of time in open arms (Otime%) and total entries into open and closed arms(Entries). Subsequently,descriptive analysis,fac-tor analysis,cluster analysis,correlation analysis and consisten-cy test were calculated for these parameters. Results T test showed that, compared with EPM, Otime% of EZM (male/fe-male/both sex) decreased, while Entries (male/both sex) in-creased significantly;Fiedman test showed that Otime% (male/female/both sex) and Entries(female/both sex) of both EPM and EZM had great difference between the 5 repeated fragments;Wilcoxon test showed that, compared with EPM, Otime% of EZM in 1st min (male/female/both sex), 2nd min (male/fe-male/both sex),3rd min (female/both sex) decreased, while the Entries in 1st min (male/both sex), 4th min (male/fe-male/both sex),5th min(both sex) increased markedly. Clus-ter analysis showed that EPM and EZM parameters could be clustered into two groups:EPM group and EZM group(male/fe-male/both sex). Factor analysis indicated that the EPM and EZM parameters could be extracted as two factors: EPM factor and EZM factor (male/female/both sex). Correlation analysis displayed either general(in Otime%) or poor(in Entries) cor-relation(male/female/both sex) between EPM and EZM param-eters. Consistency test displayed general consistency (male/fe-male/both sex) in Otime% between EPM and EZM. Conclu-sions Despite of the similar internal principles to induce state anxiety,the different external environment(structure) results in different behavioral patterns,different structure dimensions,fair correlation and concordance between EPM and EZM, and the stable index of EPM and EZM might be preferred to Otime%.
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Objective: To evaluate the efficacy and safety of Xiyanping Injection in the treatment of viral pneumonia in children. Methods: We searched several databases, including PubMed, CNKI, VIP and Wanfang Data (January- June, 2014). The references of all selected studies were also retrieved to collect the relevantly randomized controlled trials (RCTs) on Xiyanping Injection for viral pneumonia in children. Two authors screened the literatures in accordance with the inclusive criteria, extracted the data and assessed the methodological quality of the included studies. We used RevMan 5.2 software for meta-analysis. Results: Meta-analysis on the 10 included RCTs showed that the effective rates of defervescing and vanishing of the rashes and cough in the Xiyanping Injection group were better than those in the Ribavirin Injection group. There was no significant difference between the two groups in the incidence of adverse drug reaction. Conclusion: The existing research indicated that Xiyanping Injection is a secure and efficient scheme for viral pneumonia in children. Because of the poor quality of present researches, these results should be verified by strictly-designed and large-scale sample RCTs.
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<p><b>OBJECTIVE</b>To rationalize the clinical use and safety are some of the key issues in the surveillance of traditional Chinese medicine injections (TCMIs).</p><p><b>METHOD</b>In this 2011 study, 240 medical records of patients who had been discharged following treatment with TCMIs between 1 and 12 month previously were randomly selected from hospital records. Consistency between clinical use and the description of TCMIs was evaluated. Research on drug use and adverse drug reactions/events using logistic regression analysis was carried out.</p><p><b>RESULT</b>There was poor consistency between clinical use and best practice advised in manuals on TCMIs. Over-dosage and overly concentrated administration of TCMIs occurred, with the outcome of modifying properties of the blood. Logistic regression analysis showed that, drug concentration was a valid predictor for both adverse drug reactions/events and benefits associated with TCMIs.</p><p><b>CONCLUSION</b>Surveillance of rational clinical use and safety of TCMIs finds that clinical use should be consistent with technical drug manual specifications, and drug use should draw on multi-layered logistic regression analysis research to help avoid adverse drug reactions/events.</p>
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , China , Epidemiology , Clinical Trials as Topic , Drug-Related Side Effects and Adverse Reactions , Epidemiology , Drugs, Chinese Herbal , Logistic Models , Retrospective StudiesABSTRACT
<p><b>BACKGROUND</b>Enoxaparin is routinely used for prevention of venous thromboembolism (VTE) after total hip or knee arthroplasty. The purpose of this study was to compare the efficacy and safety of apixaban, a newly oral direct inhibitor of factor Xa versus enoxaparin.</p><p><b>METHODS</b>We performed a meta-analysis of relevant randomized-controlled trials (RCTs) identified in PubMed, Cochrane Library, Embase China Biological Medical Literature database, Countries Journal full-text database, VIP database, and WanFang database. The primary efficacy outcome for our meta-analysis was all VTE and all-cause mortality. The secondary efficacy outcomes included major VTE, non-fatal pulmonary embolism, and mortality. The primary safety outcome was bleeding events, categorized as major, clinically relevant non-major, or minor events.</p><p><b>RESULTS</b>Four RCTs, involving 14 065 patients, were included in our meta-analysis. Compared to enoxaparin, thromboprophylaxis with apixaban was associated with significantly fewer VTE and all-cause mortality (8346 patients, risk ratio (RR): 0.63, 95%CI 0.42 - 0.95) and similar incidence of bleeding events (major bleeding, 11 525 patients, RR 0.76, 95%CI 0.43 - 1.33; clinically relevant non-major bleeding, 11 525 patients, RR 0.83, 95%CI 0.69 - 1.01; and minor bleeding, 11 828 patients, RR 0.93, 95%CI 0.79 - 1.09). However, our meta-analysis revealed similar effects of apixaban with enoxaparin for thromboprophylaxis with regard to the secondary efficacy outcomes.</p><p><b>CONCLUSIONS</b>Apixaban was more effective than recommended dose of enoxaparin and had a similar safety profile for thromboprophylaxis after hip and knee arthroplasty. But more evidence, especially well designed head-to-head RCTs, is needed to confirm the superior efficacy of apixaban.</p>