RESUMEN
OBJECTIVE: To evaluate the efficacy and safety of Qingkailing Injection (, QKL) for treatment of children pneumonia caused by respiratory syncytial virus (RSV). METHODS: Randomized clinical trials (RCTs) comparing QKL with ribavirin injection in the treatment of children pneumonia induced by RSV were searched in PubMed, Science Direct, Cochrane Library, Chinese VIP database, CNKI and Wanfang databases from their inception to March 2014. Meta-analyses were performed using RevMan 5.2 software. The methodological quality of the selected RCTs was evaluated by the Modified Jadad Score. The primary outcome measures were effective rate and the secondary outcomes were relief time of fever and cough. RESULTS: Seven RCTs with 992 cases published from 2008 to 2013 were identified. The meta-analysis results indicated that QKL was more effective in cure rate [risk ratios (RR)=1.32, 95% CI (1.17, 1.50), P<0.01], total effective rate [RR=1.07, 95% CI (1.02, 1.13), P=0.009] and less fever clearance time [mean difference=-0.73, 95% CI (-1.22,-0.23), P=0.004], compared with ribavirin injection in the treatment of RSV-induced children pneumonia. No dead case was reported in all trials. There were 3 trials mentioned adverse events, 2 reported no obvious adverse event occurred while 1 reported adverse events described as skin hypersensitivity, elevation of ALT, a mild abnormal of hepatic and renal function in both QKL and ribavirin group. CONCLUSIONS: QKL was an effective and relatively safe option for the treatment of RSV-induced children pneumonia. These therapeutic effects were promising but need to be interpreted with caution due to variations in the treatment and methodological weakness in the studies.
Asunto(s)
Medicamentos Herbarios Chinos/administración & dosificación , Medicamentos Herbarios Chinos/uso terapéutico , Neumonía/tratamiento farmacológico , Neumonía/virología , Ensayos Clínicos Controlados Aleatorios como Asunto , Infecciones por Virus Sincitial Respiratorio/tratamiento farmacológico , Infecciones por Virus Sincitial Respiratorio/virología , Virus Sincitiales Respiratorios/fisiología , Tos/complicaciones , Tos/tratamiento farmacológico , Medicamentos Herbarios Chinos/efectos adversos , Medicamentos Herbarios Chinos/farmacología , Fiebre/complicaciones , Fiebre/tratamiento farmacológico , Humanos , Inyecciones , Sesgo de Publicación , Infecciones por Virus Sincitial Respiratorio/complicaciones , Ribavirina/uso terapéuticoRESUMEN
BACKGROUND: This pilot study was performed to evaluate the risk of anastomotic leakage (AL) and pelvic autonomic nerve dysfunction, and the effects of (125) I brachytherapy after intraoperative permanent implantation of iodine-125 seeds within the patients with rectal carcinoma. METHODS: In a cohort consisting of 80 rectal cancer patients who received potentially curative resection of rectal carcinoma with implantation of (125) I brachytherapy or radical resection of rectal carcinoma underwent total mesorectal excision. The incidences of AL, fecal incontinence, urinary dysfunction, and sexual dysfunction were calculated for comparison, and risk factors for these complications were analyzed by logistic regression. Rates of tumor recurrence and overall survival were evaluated. RESULTS: Six out of 17 (35.29%) patients in the (125) I implant group and 1 out of 34 (2.94%) patients in the non-implant group were complicated with AL (P = 0.006). The incidences of urinary dysfunction (P = 0.005) and fecal incontinence (P = 0.023) were significantly different between the two groups. Multivariate analyses revealed that (125) I brachytherapy was an independent risk factor for AL (odds ratio, 18.702; 95%CI, 1.802-194.062; P = 0.014) and urinary dysfunction (odds ratio, 4.340; 95%CI, 1.158-16.264; P = 0.029), respectively. At postoperative 2-year, the recurrence rates were 5.56% in the (125) I implant group and 9.09% in the non-implant group (P = 0.029). CONCLUSIONS: Intraoperative implantation of (125) I brachytherapy significantly increases the risk of AL, fecal incontinence, urinary dysfunction, and improves local control and do not improve overall survival after total mesorectal excision.
Asunto(s)
Adenocarcinoma/radioterapia , Adenocarcinoma/cirugía , Braquiterapia/métodos , Radioisótopos de Yodo/uso terapéutico , Radiofármacos/uso terapéutico , Neoplasias del Recto/radioterapia , Neoplasias del Recto/cirugía , Adenocarcinoma/diagnóstico por imagen , Adenocarcinoma/mortalidad , Anciano , Fuga Anastomótica/etiología , Braquiterapia/efectos adversos , Braquiterapia/mortalidad , Incontinencia Fecal/etiología , Femenino , Humanos , Radioisótopos de Yodo/efectos adversos , Estimación de Kaplan-Meier , Modelos Logísticos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Recurrencia Local de Neoplasia , Oportunidad Relativa , Proyectos Piloto , Radiofármacos/efectos adversos , Radioterapia Adyuvante , Neoplasias del Recto/diagnóstico por imagen , Neoplasias del Recto/mortalidad , Estudios Retrospectivos , Factores de Riesgo , Disfunciones Sexuales Fisiológicas/etiología , Factores de Tiempo , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , Enfermedades Urológicas/etiologíaRESUMEN
THE TITLE COMPOUND [SYSTEMATIC NAME: (1S,4S,5R,7S,8S,9R,10R,11S,13S,14S,16S,17R)-N-methyl-8,14-dihy-droxy-1,16-tri-meth-oxy-4-(meth-oxy-methyl-ene)aconitane], C(24)H(39)NO(5), was isolated from the roots of Aconitum carmichaelii Debx., which is known as 'Chuanwu' in Chinese traditional herbal medicine. The mol-ecule has an aconitane carbon skeleton with four six-membered rings and two five-membered rings, including a six-membered N-containing heterocyclic ring. Both five-membered rings adopt envelope conformations. The four six-membered adopt chair conformations. Two intra-molecular O-Hâ¯O hydrogen bonds occur.