期刊文献+
共找到22,637篇文章
< 1 2 250 >
每页显示 20 50 100
Novel pharmacological therapy in type 2 diabetes mellitus with established cardiovascular disease: Current evidence 预览
1
作者 Leonardo Pozo Fatimah Bello +4 位作者 Andres Suarez Francisco E Ochoa-Martinez Yamely Mendez Chelsea H Chang Salim Surani 《世界糖尿病杂志:英文版(电子版)》 2019年第5期291-303,共13页
Cardiovascular diseases (CVDs) remain the leading cause of death in the world and in most developed countries. Patients with type 2 diabetes mellitus (T2DM) suffer from both microvascular and macrovascular diseases an... Cardiovascular diseases (CVDs) remain the leading cause of death in the world and in most developed countries. Patients with type 2 diabetes mellitus (T2DM) suffer from both microvascular and macrovascular diseases and therefore have higher rates of morbidity and mortality compared to those without T2DM. If current trends continue, the Center for Disease Control and Prevention estimates that 1 in 3 Americans will have T2DM by year 2050. As a consequence of the controversy surrounding rosiglitazone and the increasing prevalence of diabetes and CVDs, in 2008 the Food and Drug Administration (FDA) established new expectations for the evaluation of new antidiabetic agents, advising for pre and, in some cases, post-marketing data on major cardiovascular events. As a direct consequence, there has been a paradigm shift in new antidiabetic agents that has given birth to the recently published American Diabetes Association/European Association for the Study of Diabetes consensus statement recommending sodium-glucose cotransporter-2 inhibitors (SGLT2i) and glucagon like peptide-1 receptor agonists (GLP-1RA) in patients with T2DM and established CVD. As a result of over a decade of randomized placebo controlled cardiovascular outcome trials, the aforementioned drugs have received FDA approval for risk reduction of cardiovascular (CV) events in patients with T2DM and established CV disease. SGLT2i have been shown to have a stronger benefit in patients with congestive heart failure and diabetic kidney disease when compared to their GLP-1RA counterparts. These benefits are not withstanding additional considerations such as cost and the multiple FDA Black Box warnings. This topic is currently an emerging research area and this mini-review paper examines the role of these two novel classes of drugs in patients with T2DM with both confirmed, and at risk for, CVD. 展开更多
关键词 Type 2 diabetes mellitus Glucagon-like-peptide 1 AGONISTS Sodium-glucose cotransporter-2 inhibitor CARDIOVASCULAR disease Major ADVERSE CARDIOVASCULAR event
在线阅读 免费下载
Complementary parametric probit regression and nonparametric classification tree modeling approaches to analyze factors affecting severity of work zone weather-related crashes 预览
2
作者 Ali Ghasemzadeh Mohamed M. Ahmed 《现代交通学报:英文版》 2019年第2期129-140,共12页
Identifying risk factors for road traffic injuries can be considered one of the main priorities of transportation agencies. More than 12,000 fatal work zone crashes were reported between 2000 and 2013. Despite recent ... Identifying risk factors for road traffic injuries can be considered one of the main priorities of transportation agencies. More than 12,000 fatal work zone crashes were reported between 2000 and 2013. Despite recent efforts to improve work zone safety, the frequency and severity of work zone crashes are still a big concern for transportation agencies. Although many studies have been conducted on different work zone safety-related issues, there is a lack of studies that investigate the effect of adverse weather conditions on work zone crash severity. This paper utilizes probit–classification tree, a relatively recent and promising combination of machine learning technique and conventional parametric model, to identify factors affecting work zone crash severity in adverse weather conditions using 8 years of work zone weatherrelated crashes (2006–2013) in Washington State. The key strength of this technique lies in its capability to alleviate the shortcomings of both parametric and nonparametric models. The results showed that both presence of traffic control device and lighting conditions are significant interacting variables in the developed complementary crash severity model for work zone weather-related crashes. Therefore, transportation agencies and contractors need to invest more in lighting equipment and better traffic control strategies at work zones, specifically during adverse weather conditions. 展开更多
关键词 ADVERSE WEATHER Work zone Safety CRASH characteristics PROBIT model Decision tree
在线阅读 下载PDF
How to Protect Physician Whistleblower—Patient Advocates—From Retaliation to Benefit Patients:A Legal Analysis Regarding Summary Suspension,Retaliation,Peer Review and Remedies 预览
3
作者 Gil Mileikowsky MD Bartholomew Lee 《美中法律评论:英文版》 2019年第1期21-33,共13页
Public safety provides new statutory protections for whistleblowers:Legislation enacted in order to address medical error and failures of hospital quality systems has paradoxically created mechanisms that are used to ... Public safety provides new statutory protections for whistleblowers:Legislation enacted in order to address medical error and failures of hospital quality systems has paradoxically created mechanisms that are used to silence physicians and other caregivers who seek to protect patient safety by reporting breaches of professional quality and integrity.The laws enacted to protect patients can be and are currently misused to silence whistleblowers through punitive legal proceedings against patient safety advocates.Summary suspensions,deprivation of due process,and transfer of adjudicative authority to the hands of the institutions that most require oversight undermines transparency and patient advocacy.A modest set of statutory amendments,prophylactic and remedial,especially to prevent premature reporting of summary suspensions,can counteract these inequities and rebalance the House of Medicine so as to protect both patients and those who would seek to ensure their safety,so it may do no harm. 展开更多
关键词 PATIENT safety preventable adverse events due process SHAM peer review RETALIATION against WHISTLEBLOWER NPDB blacklisting Health Care Quality Improvement Act healthcare cost
在线阅读 下载PDF
Comparing the effects of depression,anxiety,and comorbidity on quality-of-life,adverse outcomes,and medical expenditure in Chinese patients with acute coronary syndrome
4
作者 Kun Xia Le-Feng Wang +5 位作者 Xin-Chun Yang Hong-Yan Jiang Li-Jing Zhang Dao-Kuo Yao Da-Yi Hu Rong-Jing Ding 《中华医学杂志:英文版》 SCIE CAS CSCD 2019年第9期1045-1052,共8页
Background:Depression and anxiety have been correlated with elevated risks for quality-of-life (QOL),adverse outcomes,and medical expenditure in patients with acute coronary syndrome (ACS).However,the relevant data ar... Background:Depression and anxiety have been correlated with elevated risks for quality-of-life (QOL),adverse outcomes,and medical expenditure in patients with acute coronary syndrome (ACS).However,the relevant data are lacking for Chinese ACS populations,especially regarding different effects of major depression,anxiety,and comorbidity.The objective of this study was to evaluate the dynamic changes of depression and/or anxiety over 12 months and examine the effects of depression,anxiety,and comorbidity on QOL,adverse outcomes,and medical expenditure in Chinese patients with ACS.Methods:For this prospective longitudinal study,a total of 647 patients with ACS were recruited from North China between January 2013 and June 2015.Among them,531 patients (82.1%) completed 12-month follow-ups.Logistic regression model was utilized for analyzing the association of baseline major depression,anxiety,and comorbidity with 12-month all-cause mortality,cardiovascular events,QOL,and health expenditure.Results:During a follow-up period of 12 months,7.3% experienced non-fatal myocardial infarction (MI) and 35.8% cardiac rehospitalization.Baseline comorbidity,rather than major depression/anxiety,strongly predicted poor 12-month QOL as measured by short-form health survey-12 (odds ratio [OR]:1.77,95% confidence interval [CI]:1.22–2.52,P = 0.003).Regarding 12-month non-fatal MI and cardiac re-hospitalization,baseline anxiety (OR:2.83,95% CI:1.33–5.89,P<0.01;OR:4.47,95% CI:1.50–13.00,P<0.01),major depression (OR:2.58,95% CI:1.02–6.15,P<0.05;OR:5.22,95% CI:1.42–17.57,P<0.03),and comorbidity (OR:6.33,95% CI:2.96–13.79,P<0.0001,OR:14.08,95% CI:4.99–41.66,P<0.0001) were all independent predictors,and comorbidity had the highest predictive value.Number of re-hospitalization stay,admission frequency within 12 months and medical expenditure within 2 months were the highest in patients with ACS with comorbidity.Conclusions:Major depression and anxiety may predict 12-month non-fatal MI and cardiac re-hospitalization.However,comorb 展开更多
关键词 Acute CORONARY syndrome Major DEPRESSION ANXIETY COMORBIDITY ADVERSE outcome
Parallel ADR Detection Based on Spark and BCPNN
5
作者 Li Sun Shan Sun +2 位作者 Tianlei Wang Jiyun Li Jingsheng Lin 《清华大学学报自然科学版(英文版)》 EI CAS CSCD 2019年第2期195-206,共12页
Adverse Drug Reaction (ADR)is one of the major challenges to the evaluation of drug safety in the medical field.The Bayesian Confidence Propagation Neural Network (BCPNN)algorithm is the main algorithm used by the Wor... Adverse Drug Reaction (ADR)is one of the major challenges to the evaluation of drug safety in the medical field.The Bayesian Confidence Propagation Neural Network (BCPNN)algorithm is the main algorithm used by the World Health Organization to monitor ADRs.Currently,ADR reports are collected through the spontaneous reporting system.However,with the continuous increase in ADR reports and possible use scenarios,the efficiency of the stand-alone ADR detection algorithm will encounter considerable challenges.Meanwhile,the BCPNN algorithm requires a certain number of disk I/O,which leads to considerable time consumption.In this study, we propose a Spark-based parallel BCPNN algorithm,which speeds up data processing and reduces the number of disk I/O in BCPNN,and two optimization strategies.Then,the ADR data collected from the FDA Adverse Event Reporting System are used to verify the performance of the proposed algorithm and its optimization strategies. Experiments show that the parallel BCPNN can significantly accelerate data processing and the optimized algorithm has a high acceleration rate and can effectively prevent memory overflow.Finally,we apply the proposed algorithm to a dataset provided by a real medical consortium.Experiments further prove the performance and practical value of the proposed algorithm. 展开更多
关键词 ADVERSE Drug Reaction (ADR) Bayesian CONFIDENCE Propagation Neural Network (BCPNN) PARALLEL SPARK
Recent advances in endoscopic retrograde cholangiopancreatography in Billroth Ⅱ gastrectomy patients:A systematic review 预览
6
作者 Tae Young Park Tae Jun Song 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第24期3091-3107,共17页
BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP)in patients with Billroth Ⅱ gastrectomy has been considered a challenging procedure due to the surgically altered gastrointestinal anatomy.However,there ... BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP)in patients with Billroth Ⅱ gastrectomy has been considered a challenging procedure due to the surgically altered gastrointestinal anatomy.However,there has been a paucity of comparative studies regarding ERCP in Billroth Ⅱ gastrectomy cases because of procedure-related morbidity and mortality and practical and ethical limitations.This systematic and comprehensive review was performed to obtain a recent perspective on ERCP in Billroth Ⅱ gastrectomy patients.AIM To systematically review the literature regarding ERCP in Billroth Ⅱ gastrectomy patients.METHODS A systematic review was performed on the literature published between May 1975 and January 2019.The following electronic databases were searched:PubMed,EMBASE,and Cochrane Library.The outcomes of successful afferent loop intubation and successful selective cannulation and occurrence of adverse events were assessed.RESULTS A total of 43 studies involving 2669 patients were included.The study designs were 36(83.7%)retrospective cohort studies,4(9.3%)retrospective comparative studies,2(4.7%)prospective comparative studies,and 1(2.3%)prospective cohort study.Of a total of 2669 patients,there were 1432 cases(55.6%)of sideviewing endoscopy,664(25.8%)cases of forward-viewing endoscopy,171(6.6%)cases of balloon-assisted enteroscopy,169(6.6%)cases of anterior obliqueviewing endoscopy,64(2.5%)cases of dual-lumen endoscopy,31(1.2%)cases of colonoscopy,and 14(0.5%)cases of multiple bending endoscopy.The overall success rate of afferent loop intubation was 91.3%(2437/2669),and the overall success rate of selective cannulation was 87.9%(2346/2437).A total of 195 cases(7.3%)of adverse events occurred.The success rates of afferent loop intubation and the selective cannulation rate for each type of endoscopy were as follows:side-viewing endoscopy 98.2%and 95.3%;forward-viewing endoscopy 97.4%and 95.2%;balloon-assisted enteroscopy 95.4%and 97.5%;oblique-viewing endoscopy 94.1%and 97.5%;and dual-lumen endosco 展开更多
关键词 Endoscopic RETROGRADE CHOLANGIOPANCREATOGRAPHY Therapeutic ENDOSCOPE BILLROTH operation ADVERSE event Systematic review
在线阅读 免费下载
Facing a new challenge: the adverse effects of antibiotics on gut microbiota and host immunity
7
作者 Sheng Zhang De-Chang Chen 《中华医学杂志:英文版》 SCIE CAS CSCD 2019年第10期1135-1138,共4页
Mammals have existed on Earth for millions of years. During this long period, mammals and their gut commensal microbes have coevolved and coadapted, forming a complex and inseparable interrelationship called "sup... Mammals have existed on Earth for millions of years. During this long period, mammals and their gut commensal microbes have coevolved and coadapted, forming a complex and inseparable interrelationship called "superorganisms." On the one hand, the food and gut environment play an important role in shaping the composition and function of gut microbiota. 展开更多
关键词 ADVERSE effects GUT MICROBIOTA HOST immunity
Adverse Respiratory Events Increase Post-anesthesia Care Unit Stay in China:A 2-year Retrospective Matched Cohort Study 预览
8
作者 Shang-kun LIU Gang CHEN +2 位作者 Bi YAN Jiao HUANG Hui XU 《当代医学科学(英文)》 SCIE CAS 2019年第2期325-329,共5页
Despite growing attention to patients,safety worldwide,no data were available on the impact of adverse respiratory events(AREs)on post-anesthesia care and post-operation care in China.This study evaluated the occurren... Despite growing attention to patients,safety worldwide,no data were available on the impact of adverse respiratory events(AREs)on post-anesthesia care and post-operation care in China.This study evaluated the occurrence of AREs,the impact of AREs on length of stay(LOS)in post-anesthesia care unit(PACU)and postoperative time in hospital,and PACU cost and in patient healthcare costs.A retrospective,matched-cohort study was conducted by prospectively collecting the data of 159 AREs in PACU during 2016-2017 in an university hospital in China.Records were reviewed by pre-trained,qualified nurses and/or anesthesiologists.The incidence and the impact of AREs were analyzed.The LOS in PACU and postoperative time in hospital and the costs in PACU and inpatient healthcare costs were also obtained.Results showed that there were 253 AREs involving 156 patients.Hypoxia(n=141,55.73%)and respiratory depression(n=70,27.67%)were the most common AREs.Measurement data including body mass index(BMI)(22.85±4.36 vs.22.32±3.83),duration of procedure(138.47±77.33 min vs.137.44±72.33 min),duration of anesthesia(176.35±82.66 min vs.174.61±78.08 min),LOS(16.53±10.65 days vs.16.57±9.56 days),inpatient healthcare costs($9465.57±9416.33 vs.$8166.51±5762.01),and postoperative LOS(11.26±8.77 days vs.11.9±8.30 days)showed no significant differences between ARE and matched groups(P<0.05).Duration(81.65±54.79 min vs.38.89±26.09 min)and costs($31.99±17.80 vs.$18.72±8.39)in PACU were significantly different in ARE group from those in matched group(P<0.001).Proportion of patients with prolonged stay in PACU was significantly higher in ARE group than in matched group(18.59%vs.1.28%),with an odds ratio(after matching)of 17.58(95%CI=4.11 to 75.10;P<0.001).The AREs that occurred during the immediate postoperative period in PACU increased the incidence rate of prolonged stay,delayed the PACU stay,and increased the costs in PACU,resulting in the need of higher levels of postoperative care than anticipated,but the postoperative LOS and inpati 展开更多
关键词 ADVERSE RESPIRATORY EVENTS post-anesthesia care unit POSTOPERATIVE coniplications
在线阅读 下载PDF
张大宁从虚、瘀、湿、逆论治慢性肾功能衰竭经验
9
作者 樊威伟 张大宁(指导) 《中医杂志》 CSCD 北大核心 2019年第11期916-919,共4页
张大宁认为,慢性肾功能衰竭的基本病机为虚、瘀、湿、逆四个方面,虚证有脾肾气(阳)虚和肝肾阴虚两种;湿证有湿困、水湿之不同,共同造成湿浊内蕴;逆证主要为浊毒上逆;瘀证则贯穿于疾病始终。该病为本虚标实之证,而以肾气衰败、肾虚血瘀为... 张大宁认为,慢性肾功能衰竭的基本病机为虚、瘀、湿、逆四个方面,虚证有脾肾气(阳)虚和肝肾阴虚两种;湿证有湿困、水湿之不同,共同造成湿浊内蕴;逆证主要为浊毒上逆;瘀证则贯穿于疾病始终。该病为本虚标实之证,而以肾气衰败、肾虚血瘀为本,湿浊内阻、浊毒犯逆为标,即虚、瘀、湿、逆相互夹杂为其病机。总体治疗原则为补肾活血以治本、祛湿降逆以治标,临证做到整体局部相结合、理证治病相结合、多种治法相结合。 展开更多
关键词 慢性肾功能衰竭 湿 名医经验 张大宁
Botulinum toxin injections after surgery for Hirschsprung disease:Systematic review and meta-analysis 预览
10
作者 Danielle Roorda Zarah AM Abeln +2 位作者 Jaap Oosterlaan Lodewijk WE van Heurn Joep PM Derikx 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第25期3268-3280,共13页
BACKGROUND A large proportion of patients with Hirschsprung disease experience persistent obstructive symptoms after corrective surgery.Persistent obstructive symptoms may result in faecal stasis that can develop into... BACKGROUND A large proportion of patients with Hirschsprung disease experience persistent obstructive symptoms after corrective surgery.Persistent obstructive symptoms may result in faecal stasis that can develop into Hirschsprung-associated enterocolitis,a potential life-threatening condition.Important treatment to improve faecal passage is internal anal sphincter relaxation using botulinum toxin injections.AIM To give an overview of all empirical evidence on the effectiveness of botulinum toxin injections in patients with Hirschsprung disease.METHODS A systematic review and meta-analysis was done by searching PubMed,EMBASE and the Cochrane Library,using entry terms related to:(1)Hirschsprung disease;and(2)Botulinum toxin injections.14 studies representing 278 patients met eligibility criteria.Data that were extracted were proportion of patients with improvement of obstructive symptoms or less enterocolitis after injection,proportion of patients with adverse effects and data on type botulinum toxin,mean dose,average age at first injection and patients with associated syndromes.Random-effects meta-analysis was used to aggregate effects and random-effects meta-regression was used to test for possible confounding factors.RESULTS Botulinum toxin injections are effective in treating obstructive symptoms in on average 66%of patients[event rate(ER)=0.66,P=0.004,I2=49.5,n=278 patients].Type of botulinum toxin,average dose,average age at first injections and proportion of patients with associated syndromes were not predictive for this effect.Mean 7 duration of improvement after one botulinum toxin injections was 6.4 mo and patients needed on average 2.6 procedures.There was a significant higher response rate within one month after botulinum toxin injections compared to more than one month after Botulinum toxin injections(ER=0.79,vs ER=0.46,Q=19.37,P<0.001).Botulinum toxin injections were not effective in treating enterocolitis(ER 0.58,P=0.65,I2=71.0,n=52 patients).There were adverse effects in on average 17%of patients(E 展开更多
关键词 HIRSCHSPRUNG disease BOTULINUM toxin Internal anal SPHINCTER OBSTRUCTIVE symptoms ENTEROCOLITIS ADVERSE effects
在线阅读 免费下载
Mining potential adverse drug reactions of Houttuynia cordata Thunb from "real world" cases 预览
11
作者 Wei-Xiu Fan Li-Ting Yu Li-Ping Yang 《TMR食疗与健康管理》 2019年第3期78-88,共11页
Objective: Search the "real world" case reports of Houttuynia cordata Thunb (HCT)-associated adverse drug reactions (ADRs) to systematically mine potential ADRs of HCT and further investigate whether HCT con... Objective: Search the "real world" case reports of Houttuynia cordata Thunb (HCT)-associated adverse drug reactions (ADRs) to systematically mine potential ADRs of HCT and further investigate whether HCT contained preparations could cause aristolochic acid nephropathy or cancer. Methods: PubMed, EMBASE, Science Direct, Scopus, Web of Science, and CNKI, Wanfang, VIP, Sinomed databases were searched from databases setup to 1st January 2019. All case reports using HCT contained preparations were pooled according to inclusion and exclusion criteria. 15 items in case reportes including basic informations of studies/patients, characters/treaments of ADRs were extracted and analyzed. Results: A total of 346 case reports (441 patients) on the use of different preparations of HCT were finally pooled, among which 89 articles (117 patients) just presented efficacy reports without ADRs and 257 articles (324 patients) on the HCT-related ADRs were further analyzed.① HCT in vivo injections were recorded in 265 articles (338 patients) including 249 ADR reports (315 patients) and 16 efficacy reports (23 patients). As for the ADRs reports, allergic reaction was the major ADRs with different symptoms and onset time. The worst consequences were anaphylactic shock (116/315) and death (11/315), followed by dyspnea (228/315), change of complexion (181/315), heart of abnormality (180/315), chest tightness (147/315), cyanosis (142/315) and so on. The fast onset time was 10 seconds and the most ADRs happened in 30 minutes. Dexamethasone was the mainly medication to treat ADRs.② Oral HCT agents were descripted in 75 articles (94 patients) including 8 ADR reports (9 patients) and 67 efficacy reports (85 patients). Among the 8 ADR reports, 8 patients used Chinese patent medications contained HCT and only 1 patient used HCT decoction. The ADRs almost manifested as skin symptoms, including rubella, macula, rash and urticaria.③ HCT external preparations reported in 6 articles (9 patients), none of those presented any ADRs symptoms.④ No 展开更多
关键词 Houttuynia Cordata In VIVO INJECTIONS ORAL AGENTS ADVERSE drug REACTIONS
在线阅读 下载PDF
Adverse events related to colonoscopy:Global trends and future challenges 预览
12
作者 Su Young Kim Hyun-Soo Kim Hong Jun Park 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第2期190-204,共15页
Colonoscopy is a widely used method for diagnosing and treating colonic disease.The number of colonoscopies is increasing worldwide,and concerns about associated adverse events are growing.Large-scale studies using bi... Colonoscopy is a widely used method for diagnosing and treating colonic disease.The number of colonoscopies is increasing worldwide,and concerns about associated adverse events are growing.Large-scale studies using big data for post-colonoscopy complications have been reported.A colon perforation is a severe complication with a relatively high mortality rate.The perforation rate,as reported in large studies(≥50,000 colonoscopies)published since 2000,ranges from 0.005-0.085%.The trend in the overall perforation rate in the past 15 years has not changed significantly.Bleeding is a more common adverse event than perforation.Recent large studies(≥50,000 colonoscopies)have reported postcolonoscopy bleeding occurring in 0.001-0.687%of cases.Most studies about adverse events related to colonoscopy were performed in the West,and relatively few studies have been conducted in the East.The incidence of post-colonoscopy complications increases in elderly patients or patients with inflammatory bowel diseases.It is important to use a unified definition and refined data to overcome the limitations of previous studies.In addition,a structured training program for endoscopists and a systematic national management program are needed to reduce post-colonoscopy complications.In this review,we discuss the current trends in colonoscopy related to adverse events,as well as the challenges to be addressed through future research. 展开更多
关键词 COLONOSCOPY ADVERSE EVENTS PERFORATION BLEEDING Post-colonoscopy
在线阅读 免费下载
Meta-analysis on Efficacy of Yiqi Huoxue Chinese Drugs in the Treatment of Coronary Heart Disease after Coronary Revascularization 预览
13
作者 Yaonan DU Chenwei SONG +1 位作者 Areyi JIAERKEN Xiaofeng WANG 《药用植物研究(英文版)》 2019年第3期69-76,共8页
[Objectives] To make a systematic evaluation on the therapeutic efficacy and safety of Yiqi Huoxue traditional Chinese drugs combined with western medicine in treatment of coronary heart disease( CHD) after coronary r... [Objectives] To make a systematic evaluation on the therapeutic efficacy and safety of Yiqi Huoxue traditional Chinese drugs combined with western medicine in treatment of coronary heart disease( CHD) after coronary revascularization. [Methods] The literatures were retrieved from China Knowledge Infrastructure( CNKI),Chinese science and technology journal full-text database( VIP database,VIP),Wanfang Data,the Chinese biomedical Database,Pub Med,Embase,and the Cochrane Library. The retrieval time was set to the creation of the database to January 2017. The randomized controlled trial( RCT) was conducted on the comparison between Yiqi Huoxue Chinese drugs combined with western medicine and the western medicine alone in the treatment of CHD after coronary revascularization. The literature information was extracted and the methodological quality of the included literature was evaluated according to the bias risk assessment tool developed by the Cochrane Collaboration. Meta-analysis was performed with the aid of Rev Man 5. 3 software. Coronary artery restenosis rate,angina pectoris treatment efficiency,left ventricular ejection fraction( LVEF),left ventricular end-diastolic volume( LVEDV),B-type natriuretic peptide( BNP),6-minute walk test( 6 MWT),and adverse reactions were analyzed. [Results] A total of 29 articles were included,a total of2 518 patients,the literature quality was low. Meta-analysis results showed that compared with the treatment by western medicine alone,Yiqi Huoxue Chinese drugs combined with western medicine could further reduce coronary restenosis rate[RR = 0. 45,95% CI( 0. 34,0. 60),P <0. 000 01],improve the angina pectoris treatment efficiency[RR = 1. 13,95% CI( 1. 05,1. 21),P = 0. 000 5],raise LVEF[WMD = 4. 25,95% CI( 3. 46,5. 04),P < 0. 000 01],reduce LVEDV[WMD =-10. 41,95% CI(-17. 88,-2. 95),P = 0. 006],decrease the plasma BNP level[WMD =-32. 32,95% CI(-44. 92,-19. 72),P < 0. 000 01],and increase 6 MWT distance(WMD = 62. 25,95% CI( 21. 71,102. 78),P = 0. 003)[Conclusions]Yiqi Huoxue Chinese d 展开更多
关键词 CORONARY heart disease Yiqi Huoxue CHINESE DRUGS CORONARY revascularization META-ANALYSIS LEFT VENTRICULAR end fraction LEFT VENTRICULAR end-diastolic volume B-type natriuretic peptide 6-minute walk test Adverse reactions
在线阅读 免费下载
Not all arrestins are created equal:Therapeutic implications of the functional diversity of the β-arrestins in the heart 预览
14
作者 Anastasios Lymperopoulos Shelby L Wertz +3 位作者 Celina M Pollard Victoria L Desimine Jennifer Maning Katie A McCrink 《世界心脏病学杂志:英文版(电子版)》 2019年第2期47-56,共10页
The two ubiquitous,outside the retina,G protein-coupled receptor(GPCR)adapter proteins,β-arrestin-1 and-2(also known as arrestin-2 and-3,respectively),have three major functions in cells:GPCR desensitization,i.e.,rec... The two ubiquitous,outside the retina,G protein-coupled receptor(GPCR)adapter proteins,β-arrestin-1 and-2(also known as arrestin-2 and-3,respectively),have three major functions in cells:GPCR desensitization,i.e.,receptor decoupling from G-proteins;GPCR internalization via clathrin-coated pits;and signal transduction independently of or in parallel to G-proteins.Bothβ-arrestins are expressed in the heart and regulate a large number of cardiac GPCRs.The latter constitute the single most commonly targeted receptor class by Food and Drug Administration-approved cardiovascular drugs,with about onethird of all currently used in the clinic medications affecting GPCR function.Sinceβ-arrestin-1 and-2 play important roles in signaling and function of several GPCRs,in particular of adrenergic receptors and angiotensin II type 1 receptors,in cardiac myocytes,they have been a major focus of cardiac biology research in recent years.Perhaps the most significant realization coming out of their studies is that these two GPCR adapter proteins,initially thought of as functionally interchangeable,actually exert diametrically opposite effects in the mammalian myocardium.Specifically,the most abundant of the two β-arrestin-1 exerts overall detrimental effects on the heart,such as negative inotropy and promotion of adverse remodeling post-myocardial infarction(MI).In contrast,β-arrestin-2 is overall beneficial for the myocardium,as it has anti-apoptotic and antiinflammatory effects that result in attenuation of post-MI adverse remodeling,while promoting cardiac contractile function.Thus,design of novel cardiac GPCR ligands that preferentially activateβ-arrestin-2 overβ-arrestin-1 has the potential of generating novel cardiovascular therapeutics for heart failure and other heart diseases. 展开更多
关键词 Adverse remodeling β-arrestin Biased signaling CARDIAC MYOCYTE CARDIAC fibroblast CONTRACTILITY Functional divergence G protein-coupled receptor HEART failure Hormone Myocardial infarction Signal transducer
在线阅读 免费下载
Systematic evaluation of Kang-ai injection combined with chemotherapy versus chemotherapy alone in the treatment of ovarian cancer 预览
15
作者 Meng-Xi Gao Ai-Ying Zhang +2 位作者 Tian-Tian Gai Wei Fan Yan Wang 《TMR药物联合治疗》 2019年第1期19-30,共12页
Objective:This study was conducted to evaluate the clinical efficacy and safety of Kang-ai injection combined with chemotherapy in the treatment of ovarian cancer.Methods:the databases of VIP,CNKI,WanFang,CBM,Pub Med,... Objective:This study was conducted to evaluate the clinical efficacy and safety of Kang-ai injection combined with chemotherapy in the treatment of ovarian cancer.Methods:the databases of VIP,CNKI,WanFang,CBM,Pub Med,Cochrane Library and EMBASE were searched to collect the randomized controlled trials(RCTs)of Kang-ai injection,combined with chemotherapy versus chemotherapy alone for the treatment of ovarian cancer.The retrieval time was from the database setup to December 20,2018.After two researchers independently screened the researches,extracted data and evaluated the risk of the included studies,the RevMan 5.3 software was used for analysis.A total of 8 RCTS were included.Results:Results showed that patients in Kang-ai injection combined with chemotherapy group were superior to the conventional chemotherapy group patients in total effective rate[RR=1.31,95%CI(1.11,1.54),P=0.001],quality of life[RR=1.69,95%CI(1.35,2.13),P<0.001],leukopenia[RR=0.63,95%CI(0.51,0.77),P<0.001],nausea and vomiting[RR=0.41,95%CI(0.24,0.70),P=0.001],decreased hemoglobin[RR=0.50,95%CI(0.28,0.88),P=0.002],and thrombocytopenia[RR=0.45,95%CI(0.24,0.85),P=0.01].Conclusion:Kang-ai injection combined with chemotherapy for ovarian cancer is better than chemotherapy alone in improving total effective rate and quality of life,reducing the incidence of adverse reactions.Limited by the number and quality of included studies,the above conclusions are yet to be verified by more high-quality studies. 展开更多
关键词 Kang-ai INJECTION CHEMOTHERAPY Ovarian cancer Total efficiency Quality of life ADVERSE reactions
在线阅读 下载PDF
Long-lasting discussion: Adverse effects of intraoperative blood loss and allogeneic transfusion on prognosis of patients with gastric cancer 预览
16
作者 Koki Nakanishi Mitsuro Kanda Yasuhiro Kodera 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第22期2743-2751,共9页
Gastrectomy with radical lymph node dissection is the most promising treatment avenue for patients with gastric cancer. However, this procedure sometimes induces excessive intraoperative blood loss and requires periop... Gastrectomy with radical lymph node dissection is the most promising treatment avenue for patients with gastric cancer. However, this procedure sometimes induces excessive intraoperative blood loss and requires perioperative allogeneic blood transfusion. There are lasting discussions and controversies about whether intraoperative blood loss or perioperative blood transfusion has adverse effects on the prognosis in patients with gastric cancer. We reviewed laboratory and clinical evidence of these associations in patients with gastric cancer. A large amount of clinical evidence supports the correlation between excessive intraoperative blood loss and adverse effects on the prognosis. The laboratory evidence revealed three possible causes of such adverse effects: anti-tumor immunosuppression, unfavorable postoperative conditions, and peritoneal recurrence by spillage of cancer cells into the pelvis. Several systematic reviews and meta-analyses have suggested the adverse effects of perioperative blood transfusions on prognostic parameters such as all-cause mortality, recurrence, and postoperative complications. There are two possible causes of adverse effects of blood transfusions on the prognosis: Anti-tumor immunosuppression and patient-related confounding factors (e.g., preoperative anemia). These factors are associated with a worse prognosis and higher requirement for perioperative blood transfusions. Surgeons should make efforts to minimize intraoperative blood loss and transfusions during gastric cancer surgery to improve patients’ prognosis. 展开更多
关键词 Gastric cancer Blood loss PROGNOSIS TRANSFUSION ADVERSE effect IMMUNOSUPPRESSION Mortality RECURRENCE COMPLICATION
在线阅读 免费下载
皮下免疫和舌下免疫治疗特应性皮炎的临床疗效和安全性分析
17
作者 吕静 刘娟娟 +4 位作者 柯丹 陈征 邓抒琴 喻云 江阳 《实用皮肤病学杂志》 2019年第3期143-147,共5页
目的评价标准化尘捕变应原疫苗皮下免疫疗法(subcutaneous immunotherapy,SCIT)和舌下免疫疗法Csublingual immunotherapy,SLIT)治疗中国重度特应性皮炎(atopic dermatitis,AD)的临床疗效和安全性。方法150例中-重度AD患者分为两组,分... 目的评价标准化尘捕变应原疫苗皮下免疫疗法(subcutaneous immunotherapy,SCIT)和舌下免疫疗法Csublingual immunotherapy,SLIT)治疗中国重度特应性皮炎(atopic dermatitis,AD)的临床疗效和安全性。方法150例中-重度AD患者分为两组,分别采用SCIT和SLIT的免疫治疗方案。随访6个月~2年,观察免疫治疗过程中的局部和全身不良反应发生情况,所有患者在治疗结束后均进行AD评分(scoring atopic dermatitis index,SCORAD)和有效率的评价。结果临床疗效判断,两组相比差异有统计学意义(P<0.05)。两组治疗前后血清slgE比较差异无统计学意义(P>0.05)。SCIT组所有患者在免疫治疗的不同阶段均出现局部反应,SLπ组有4例(5.5%)出现局部反应,两组患者的局部不良反应均较轻微,可耐受并自行缓解。两组全身不良反应的发生率差异无统计学意义(x^2=0.0038,P>0.05〕。结论尘瞒过敏的AD患者采用皮下注射或舌下含服途径进行特异性免疫治疗均有良好的临床疗效,两组有效率相比差异无统计学意义,两种治疗方式的全身不良反应发生率无明显差异,但局部不良反应发生率SCIT高于SLIT,差异有统计学意义。 展开更多
关键词 皮炎 特应性 皮下免疫 舌下免疫 临床疗效 不良反应
Comparison of outcomes between complete and incomplete congenital duodenal obstruction 预览
18
作者 Stefan Gfroerer Till-Martin Theilen +2 位作者 Henning C Fiegel Anoosh Esmaeili Udo Rolle 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第28期3787-3797,共11页
BACKGROUND Congenital duodenal obstruction (CDO) can be complete (CCDO) or incomplete (ICDO). To date there is no outcome analysis available that compares both subtypes. AIM To quantify and compare the association bet... BACKGROUND Congenital duodenal obstruction (CDO) can be complete (CCDO) or incomplete (ICDO). To date there is no outcome analysis available that compares both subtypes. AIM To quantify and compare the association between CCDO and ICDO with outcome parameters. METHODS We retrospectively reviewed all patients who underwent operative repair of CCDO or ICDO in our tertiary care institution between January 2004 and January 2017. The demographics, clinical presentation, preoperative diagnostics and postoperative outcomes of 50 patients were compared between CCDO (n = 27;atresia type 1-3, annular pancreas) and ICDO (n=23;annular pancreas, web, Ladd′s bands). RESULTS In total, 50 patients who underwent CDO repair were enrolled and followed for a median of 5.2 and 3.9 years (CCDO and ICDO, resp.). CCDO was associated with a significantly higher prenatal ultrasonographic detection rate (88% versus 4%;CCDO vs ICDO, P<0.01), lower gestational age at birth, lower age and weight at operation, higher rate of associated congenital heart disease (CHD), more extensive preoperative radiologic diagnostics, higher morbidity according to Clavien-Dindo classification and comprehensive complication index (all P≤0.01). The subgroup analysis of patients without CHD and prematurity showed a longer time from operation to the initiation of enteral feeds in the CCDO group (P<0.01). CONCLUSION CCDO and ICDO differ with regard to prenatal detection rate, gestational age, age and weight at operation, rate of associated CHD, preoperative diagnostics and morbidity. The degree of CDO in mature patients without CHD influences the postoperative initiation of enteral feeding. 展开更多
关键词 Congenital DUODENAL obstruction DUODENAL ATRESIA DUODENAL STENOSIS PRENATAL ultrasonographic detection rate Clinical presentation Preoperative diagnostics ADVERSE events Outcome
在线阅读 免费下载
Safety of intrathecal injection of Wharton's jelly-derived mesenchymal stem cells in amyotrophic lateralsclerosis therapy 预览
19
作者 Monika Barczewska Mariusz Grudniak +5 位作者 Stanislaw Maksymowicz Tomasz Siwek Tomasz Oldak Katarzyna Jezierska-Wozniak Dominika Gladysz Wojciech Maksymowicz 《中国神经再生研究:英文版》 SCIE CAS CSCD 2019年第2期313-318,共6页
Animal experiments have confirmed that mesenchymal stem cells can inhibit motor neuron apoptosis and inflammatory factor expression and increase neurotrophic factor expression. Therefore, mesenchymal stem cells have b... Animal experiments have confirmed that mesenchymal stem cells can inhibit motor neuron apoptosis and inflammatory factor expression and increase neurotrophic factor expression. Therefore, mesenchymal stem cells have been shown to exhibit prospects in the treatment of amyotrophic lateral sclerosis. However, the safety of their clinical application needs to be validated. To investigate the safety of intrathecal injection of Wharton's jelly-derived mesenchymal stem cells in amyotrophic lateral sclerosis therapy, 43 patients (16 females and 27 males, mean age of 57.3 years) received an average dose of 0.42 × 106 cells/kg through intrathecal administration at the cervical, thoracic or lumbar region depending on the clinical symptoms. There was a 2 month interval between two injections. The adverse events occurring during a 6-month treatment period were evaluated. No adverse events occurred. Headache occurred in one case only after first injection of stem cells. This suggests that intrathecal injection of Wharton's Jelly-derived mesenchymal stem cells is well tolerated in patients with amyotrophic lateral sclerosis. This study was approved by the Bioethical Committee of School of Medicine, University of Warmia and Mazury in Olsztyn, Poland (approval No. 36/2014 and approval No. 8/2016). This study was registered with the ClinicalTrials.gov (identifier: NCT02881476) on August 29, 2016. 展开更多
关键词 amyotrophic lateral sclerosis STEM CELLS THERAPY intrathecal injections Wharton's jelly-derived mesenchymal STEM CELLS adverse events safety cerebrospinal fluid neural regeneration
在线阅读 下载PDF
In silico design of novel proton-pump inhibitors with reduced adverse effects
20
作者 Xiaoyi Li Hong Kang +5 位作者 Wensheng Liu Sarita Singhal Na Jiao Yong Wang Lixin Zhu Ruixin Zhu 《医学前沿:英文版》 CAS CSCD 2019年第2期277-284,共8页
The development of new proton-pump inhibitors (PPIs) with less adverse effects by lowering the pKa values of nitrogen atoms in pyrimidine rings has been previously suggested by our group. In this work, we proposed tha... The development of new proton-pump inhibitors (PPIs) with less adverse effects by lowering the pKa values of nitrogen atoms in pyrimidine rings has been previously suggested by our group. In this work, we proposed that new PPIs should have the following features:(1) number of ring II = number of ring I+ 1;(2) preferably five, six, or seven-membered heteroatomic ring for stability;and (3) 1<pKa1<4. Six molecular scaffolds based on the aforementioned criteria were constructed, and R groups were extracted from compounds in extensive data sources. A virtual molecule dataset was established, and the pKa values of specific atoms on the molecules in the dataset were calculated to select the molecules with required pKa values. Drug-likeness screening was further conducted to obtain the candidates that significantly reduced the adverse effects of long-term PPI use. This study provided insights and tools for designing targeted molecules in silico that are suitable for practical applications. 展开更多
关键词 proton-pump INHIBITOR ADVERSE effect PHARMACOLOGICAL MECHANISM toxicological MECHANISM PKA calculation
上一页 1 2 250 下一页 到第
使用帮助 返回顶部 意见反馈