Renal safety evaluation of aspirin plus edaravone in patients with ischaemic stroke: a retrospective cohort study.

BACKGROUND AND OBJECTIVE: Aspirin combined with edaravone is more effective than aspirin or edaravone alone in the treatment of ischaemic stroke. Aspirin is defined as a nephrotoxic drug while the renal safety of edaravone is controversial. We aimed to evaluate whether edaravone will increase the nephrotoxicity of aspirin in patients with ischaemic stroke. DESIGN: A propensity score-matched retrospective cohort study. SETTING: A tertiary hospital in China. PARTICIPANTS: Patients with ischaemic stroke were treated with aspirin from February 2007 to May 2018. PRIMARY AND SECONDARY OUTCOME MEASURES: Acute kidney injury (AKI, diagnosed by the Acute Kidney Injury Network), decreased estimated glomerular filtration rate (eGFR,>10%), gastrointestinal bleeding and in-hospital adverse outcomes (defined as dying or giving up treatment in our hospital). RESULTS: We included 3061 patients, and 986 pairs were successfully matched. Of the 986 pairs of patients included, the incidence of AKI between the aspirin group and the combination group showed no significant difference (7.71% vs 6.29%, p=0.217). While the incidence of eGFR decline (24.75% vs 16.94%, p<0.001) was significantly lower in the combination group. The protective effect was significant in patients with baseline eGFR >30 mL/min/1.73 m2, especially in eGFR 60-90 mL/min/1.73 m2. In patients with different complications, the incidence of AKI showed no significant differences in patients with chronic kidney injury, hypertension, anaemia, age above 75 years, except in patients with cardiovascular disease (OR, 2.82; 95% CI 1.50 to 5.29; p<0.001). However, the incidence of gastrointestinal bleeding (1.22% vs 2.84%, p=0.011) and in-hospital adverse outcomes (3.25% vs 7.00%, p<0.001) were significantly higher in the combination group. CONCLUSIONS: Our study indicated that edaravone in patients with ischaemic stroke didn't increase the nephrotoxicity of aspirin, and even had a protective effect on mild renal deterioration. Nevertheless, there is a need to be cautious when patients are in bad pathophysiological conditions and at high risk of bleeding.

Safety and Efficacy of Low Molecular Weight Heparin for Thromboprophylaxis in the Elderly: A Network Meta-Analysis of Randomized Clinical Trials.

Background: Given their changing pathophysiology, elderly patients carry a high risk of embolism and bleeding events; hence, use of appropriate anticoagulants is very important. Low molecular weight heparin (LMWH) is one of the most widely used anticoagulants although LMWHs differ in their anti-Xa, antithrombin, and anticoagulant activities. To date, no study has directly compared the safety and efficacy of different LMWHs in the elderly. We aimed to compare such differences by conducting a network meta-analysis. Methods: We searched the Pubmed, Embase, and Cochrane databases for randomized controlled trials (RCTs) of LMWHs that included patients ≥60 years old up to July 22, 2020. Safety outcomes included venous thromboembolism (VTE) or VTE-related death, deep thrombus embolism, and pulmonary embolism. Safety outcomes were clinically relevant bleeding, major bleeding, minor bleeding, and all-cause death. We calculated relative ratios (RR) and 95% confidence intervals (CI) for all outcomes. The cumulative ranking probabilities (SUCRA) were conducted to rank the comparative effects and safety of all LMWHs. Results: We included 27 RCTs (30,441 elderly), comprising five LMWHs. LMWH was more effective than placebo in preventing VTE or VTE-related death (RR 0.36, 95% CI 0.25-0.53) but less effective than a novel oral anticoagulant (RR 1.59, 95% CI 1.33-1.91) and safer than acenocoumarol regarding risk of clinically relevant bleeding (RR 0.67, 95% CI 0.49-0.90). However, indirect comparison of efficacy and safety of the five LMWHs showed no significant difference in our network analysis, and the subgroup analyses (such as in patients with deep venous thrombosis, cardiac disease, or age >65 years old) supported the results. The SUCRA showed that tinzaparin performed best in preventing VTE or VTE-related death (SUCRA 68.8%, cumulative probability 42.3%) and all-cause death (SUCRA 84.2%, cumulative probability 40.7%), whereas nadroparin was predominant in decreasing the risk of clinically relevant bleeding (SUCRA 84.8%, cumulative probability 77.0%). Conclusions: On present evidence, there are no significant differences in the efficacy and safety of different LMWHs for the elderly. According to the rank probability analysis, nadroparin seems to be safer for the elderly with a high risk of bleeding, whereas tinzaparin is more effective for those with low bleeding risk.

Highly sensitive analysis of substituted aniline compounds in water samples by using oxidized multiwalled carbon nanotubes as an in-tube solid-phase microextraction medium.

An automated on-line method for the determination of the substituted aniline compounds was developed using in-tube solid-phase microextraction coupling to high-performance liquid chromatography (HPLC). In this work, oxidized multiwalled carbon nanotubes (MWCNTs-COOH) coated on the outer surface of the fused-silica tube and inserted in the polyether ether ketone (PEEK) tubing, which was fixed directly on the six-port injection valve to substitute for the sample loop. The extraction procedure was performed by a constant flow pump frequently driving the sample solution through the PEEK tubing and the analytes were adsorbed onto MWCNTs-COOH materials when the six-port valve set to load position. After extraction, the valve switched to inject position and the extracted analytes were desorbed by mobile phase in dynamic mode. High extraction capacity was achieved for the investigated analytes and great improvement of the limits of detection was obtained in comparison with other methods. The calibration plots were linear (r(2)> or =0.9949) over the concentration range of 1.04-104ngmL(-1) for 4-nitroaniline, 1.02-102ngmL(-1) for 2-nitroaniline, 1.68-168ngmL(-1) for 2-chloroaniline and 1.09-109ngmL(-1) for 2,4-dichloroaniline. The detection limit ranged from 0.04ngmL(-1) to 0.13ngmL(-1) (at S/N=3). The possibility of applying the established method to water samples analysis was also studied.

QSPR prediction of GC retention indices for nitrogen-containing polycyclic aromatic compounds from heuristically computed molecular descriptors.

Gas chromatographic retention indices of nitrogen-containing polycyclic aromatic compounds (N-PACs) have been predicted by quantitative structure-property relationship (QSPR) analysis based on heuristic method (HM) implemented in CODESSA. In order to indicate the influence of different molecular descriptors on retention indices and well understand the important structural factors affecting the experimental values, three multivariable linear models derived from three groups of different molecular descriptors were built. Moreover, each molecular descriptor in these models was discussed to well understand the relationship between molecular structures and their retention indices. The proposed models gave the following results: the square of correlation coefficient, R(2), for the models with one, two and three molecular descriptors was 0.9571, 0.9776 and 0.9846, respectively.

Separation procedures for the pharmacologically active components of rhubarb.

Rhubarb, as an important Chinese medicine, has many functions owing to containing anthraquinone derivatives. The analysis of anthraquinone derivatives in Chinese rhubarb is reviewed. The analytical techniques include high performance liquid chromatography, capillary electrophoresis, thin-layer chromatography and so on. The main operation parameters in every technique were given. The structures of anthraquinone derivatives and the classification of Chinese rhubarb were summarized too.

[Studies on quantitative structure-retention relationships for sulfides on stationary phases of different polarities].

Multiple linear regression (MLR) based on forward stepwise multiple regression techniques was used for predicting gas chromatographic retention index of sulfides after calculating their quantum-chemical parameters. The correlative quantitative model between the retention index (IR) of sulfides on four stationary phases of different polarities and their quantum chemical parameters was built. The results proved the strong predictive power of the models. The root-mean-square error (RMS) of the regression equation was less than 4%.