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OBJECTIVE: To evaluate therapeutic efficacy and safety of orlistat versus metformin in reducing body weight of overweight or obese patients, and to provide evidence-based reference.METHODS: Retrieved from PubMed, Embase, Ovid, Web of Science, Cochrane Library, Chinese Journal Full-text Database, Wanfang database and VIP, RCTs about orlistat alone or combined with metformin (trial group) versus metformin alone (control group) in reducing body weight, BMI and the incidence of ADR of overweight or obese patients were collected. Meta-analysis was performed by using Rev Man 5. 3 statistical software after data extraction and quality evaluation with modified Jadad scale. RESULTS: A total of 9 RCTs were included, involving 502 patients. The results of Meta-analysis showed that, when orlistat combined with metformin, the reduction of BMI in trial group was significantly better than control group, with statistical significance [SMD= -0. 74, 95%CI (- 1. 22,-0. 26),P=0. 002]. There was no statistical significance in the reduction of body weight [SMD= -0. 04, 95%CI (-0. 27,0. 20), P=0. 76] or the incidence of ADR [RR=1. 07, 95%CI (0. 68, 1. 68), P=0. 78] between 2 groups. CONCLUSIONS: Both orlistat and metformin can reduce body weight with good safety. Combined use of these two drugs can reduce body weight more significantly.
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Objective To study the alterations of renal function in patients with acute ischemic stroke and diabetes and to analyze the risk factors of contrast-induced nephropathy (CIN) after digital subtraction angiography (DSA).Methods Eight hundred and seventy-one cerebral infarction patients with diabetes who underwent DSA were selected in the Third Affiliated Hospital of Chongqing Medical University and Nanjing Brain Hospital Affiliated to Nanjing Medical University from August 2012 to August 2016.The patients were divided into diabetic group (n =178) and non-diabetic group (n =693).The alterations of renal function and the incidence rate of CIN were observed between two groups 3 days after DSA.Univariate analysis and multi-factor Logistic regression analysis were used to analyze the independent risk factors of CIN.Results The levels of estimated glomerular filtration rate (eGFR,ml · min-1 · 1.73 m-2) in diabetic group at 1,2 and 3 days after DSA(81.94 ±9.38,75.36 ±8.21,84.43 ±9.72) were lower than that in non-diabetic group (84.62 ± 10.06,79.08 ±9.84,87.62 ± 10.15,t =3.213,4.645,3.772,all P < 0.05).The levels of serum creatinine (Scr) and cystatin (CysC) in diabetic group at 1,2 and 3 days after DSA (Scr:85.63 ±9.83,92.37 ±10.07,83.43 ±9.07;CysC:1.08 ±0.12,1.35 ±0.14,0.95 ±0.10) were higher than that in non-diabetic group (Scr:81.36 ± 8.98,87.84 ± 9.85,80.31 ± 8.64,t =5.548,5.448,4.253;CysC:0.97 ±0.11,1.21 ±0.12,0.88 ±0.09;t =11.677,13.400,9.043;all P < 0.05).The incidence rate of CIN in diabetic group (25.84% (46/178)) was higher than that in nondiabetic group (7.07% (49/693),x2 =51.358,P =0.001).Multi-factor Logistic regression analysis showed allergies,plasma brain natriuretic peptide,heart failure,the original renal insufficiency,NIHSS score,contrast agent dosage,preoperative eGFR,preoperative Scr and preoperative CysC were the independent risk factors of CIN in cerebral infarction patients with diabetes.Conclusions The renal function decreased significantly and the incidence rate of CIN was high in cerebral infarction patients with diabetes after DSA.Allergies,plasma brain natriuretic peptide,heart failure,the original renal insufficiency,contrast agent dosage,preoperative eGFR,preoperative Scr and preoperative CysC were the independent risk factors of CIN in cerebral infarction patients with diabetes.
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When mature adipocytes are subjected to an in vitro dedifferentiation strategy referred to as ceiling culture, these mature adipocytes can revert to dedifferentiated fat (DFAT) cells. DFAT cells have many advantages compared with adipose-derived stem cells (ASCs) and bone marrow mesenchymal stem cells (BMSCs). For example, DFAT cells are homogeneous and could be obtained from donors regardless of their age. Furthermore, DFAT cells also have the same multi-lineage potentials and low immunogenicity as ASCs. As an excellent source of seed cells for tissue engineering and stem cell transplantation, DFAT cells have better prospects in the treatment of many clinical diseases, such as bone defects, neurological diseases, ischemic heart disease and kidney disease. It is necessary to make more intensive studies of DFAT cells. This article summarizes progresses in the immunological characteristics, differentiation ability and potential clinical applications of DFAT cells.
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Humanos , Adipocitos , Biología Celular , Desdiferenciación Celular , Diferenciación Celular , Células Cultivadas , Trasplante de Células Madre , Ingeniería de TejidosRESUMEN
<p><b>OBJECTIVE</b>To investigate the relationship between the 3 polymorphic loci of endothelin receptor type A (EDNRA) gene and intracranial aneurysms.</p><p><b>METHODS</b>Three EDNRA gene polymorphisms (rs5335, rs6842241, and rs6841581) were genotyped using polymerase chain reaction-restriction fragment length polymorphism analysis. The genotype and allele frequencies were calculated in the patients and the control group to analyze the association between the gene and the size of aneurysms.</p><p><b>RESULTS</b>No significant difference was found in the distribution of the EDNRA gene genotypes or allele frequencies between the patients and the control subjects. Only GG genotype of rs6841581 was found to significantly correlate with the size of aneurysms.</p><p><b>CONCLUSION</b>EDNRA gene rs6841581 has significant associations with the size of intracranial aneurysms, indicating a possible role of EDNRA in the genetic mechanisms of intracranial aneurysms and subarachnoid hemorrhage.</p>