【摘要】 目的 了解2007年-2008年成都地区17家医院抗肿瘤药物的使用情况。 方法 以销售金额、用药频度（DDDs）对2007年、2008年成都地区17家医院抗肿瘤药物消耗数据进行分类统计、综合分析、对比。 结果 2008年成都地区17家医院抗肿瘤药物用药金额增长幅度较大，各亚类抗肿瘤药物中其它类抗肿瘤药物类、植物来源的抗肿瘤药、抗代谢药金额排序依次占前3位。销售金额前100位药物中，肿瘤药物占据8位，大多数是其它类抗肿瘤药物，且其用药频度也靠前。 结论 抗肿瘤药物用药金额和用药量都将快速增长，其中其它类抗肿瘤药物和植物来源的抗肿瘤药的发展尤被看好。【Abstract】 Objective To evaluate the situation of antineoplastics used in Chengdu area from 2007 to 2008. Methods The consumption data of antineoplastics used in 17 hospitals of Chengdu area in 2007 and 2008 were classified, and the consumption sum and defined daily doses (DDDs) were analyzed. Results The total consumption sum of antineoplastics in 2008 increased sharply. Other antineoplastics, herbal-sourced antineoplastics and antimetabolism drugs ranked in the first three places. Among the top drugs in terms of consumption sum, antineoplastics took 8 places. Conclusion The consumption sum and DDDs of antineoplastics, especially other antineoplastics and herbal-sourced antineoplastics, will increase rapidly.
【摘要】 目的 探讨非诺贝特致药品不良反应（ADRs）的一般规律和特点。 方法 检索PubMed（1978年-2009年8月）、中国期刊全文数据库CNKI（1980年-2009年8月）、中国生物医学文献数据库CBMDise（1980年-2009年8月）非诺贝特所致ADRs文献，进行统计、分析。 结果 非诺贝特致ADRs多发生在gt;40岁年龄段，与性别无显著关联；64例ADRs主要涉及骨骼肌肉系统、消化系统、泌尿生殖系统、过敏反应，及时处理者预后良好。 结论 临床上应重视非诺贝特所致ADRs，及时处理。【Abstract】 Objective To analyse the clinical features, correlation factors, preventions and cures of (adverse drug reactions, ADRs) caused by fenofibrate. Methods The cases of ADRs caused by fenofibrate were collected and analyzed from Pubmed (1978 - August 2009), CNKI (1980 - August 2009) and CBMDise (1980 - August 2009). Results Fenofibrate-induced ADRs were mostly seen in patients over 40 years old, but which was independent for sex. Totally, 64 ADRs were involved in the skeletal musculature system, digestive system, urinogenital system, and allergic response. The prognosis was favorable. Conclusion More attention should be given to patients with fenofibrate and ADRs should be treated as soon as possibile.
Objective To assess the effectiveness of exemestane in the treatment of postmenopausal women with breast cancer. Methods We searched The Cochrane Library, PubMed, CBMdisc, and CNKI to identify randomized controlled trials (RCTs) that met the inclusion and exclusion criteria. Two reviewers extracted the data and evaluated the quality of included trials, respectively. Meta-analysis was performed using RevMan 5.0 software. Results A total of 12 RCTs involving 6 166 participants were included, and the results of meta-analyses showed that: (1) When used in neoadjuvant endocrine therapy after operation, exemestane was more effective in progression-free survival than tamoxifen; (2) When used in rescue therapy, exemestane was more effective in objective response than tamoxifen, but not more effective than letrozole or anastrozole; (3) When used in new neoadjuvant endocrine therapy before operation, exemestane was not more effective than letrozole, and there was too little research about it. Conclusions The current evidence shows that exemestane has certain short-term therapeutic effect, but its long-term therapeutic effect is unknown. More high-quality clinical trials are expected for further study.
Objective To assess the effectiveness and safety of Tongxinluo Capsule in the treatment of vertebrobasilar artery insufficiency. Methods The Cochrane Library, MEDLINE, VIP and CNKI were searched. Two authors independently collected data, including randomized controlled trials that met the inclusion criteria. They evaluated the quality of these trials and performed meta-analysis using The Cochrane Collaboration’s RevMan 5.0. Results Eleven studies involving 1157 participants were included. All the included studies were inadequate at reporting randomization, concealment of allocation and blinding. Meta-analysis based on the included studies showed that Tongxinluo Capsule with Danshen was better than Danshen alone in vertebrobasilar artery insufficiency (RR= 1.35, 95%CI 1.24 to 1.48) and blood flow velocity of vertebrobasilar artery (WMD=3.60, 95%CI 2.44 to 4.77 and WMD=3.46, 95%CI 1.89 to 5.04). Tongxinluo Capsule with simple basic therapy was better than simple basic therapy alone in vertebrobasilar artery insufficiency (RR=1.21, 95%CI 1.11 to 1.31) and blood flow velocity of vertebrobasilar artery (WMD=3.85, 95%CI 2.19 to 5.51). Conclusion Tongxinluo Capsule is an effective and safe drug for vertebrobasilar artery insufficiency. However, due to the limited quantity and quality of the included studies, we can not draw a firm conclusion about the effectiveness of Tongxinluo Capsule compared to the simple basic therapy or Danshen. The results suggest that further and larger-scale trials using Tongxinluo Capsule for vertebrobasilar artery insufficiency are needed.
目的 评价卡培他滨+伊立替康与氟尿嘧啶/醛氢叶酸（5-FU/LV）+伊立替康治疗转移性结直肠癌的有效性和安全性。 方法 计算机检索PubMed、CENTRAL、Embase、中国生物医学数据库、中国期刊全文数据库、维普数据库和万方数据库，检索时间均从建库至2011年9月。对符合纳入标准的随机对照试验进行质量评价和Meta分析。 结果 纳入3个随机对照试验，共计419例患者，卡培他滨+伊立替康在中位生存期、完全缓解率[RR=1.58，95%CI（0.27，9.11），P=0.61]、部分缓解率[RR=0.86，95%CI（0.68，1.09），P=0.20]、总有效率[RR=0.88，95%CI（0.71，1.09），P=0.26]上表现出与5-FU/LV+伊立替康相似的效果，安全性方面卡培他滨+伊立替康有较高的Ⅲ/Ⅳ级恶心[RR=1.92，95%CI（1.05，3.54），P=0.04]、腹泻[RR=3.23，95%CI（2.14，4.89），P＜0.000 01]发生风险和较低的Ⅲ/Ⅳ级中性粒细胞减少[RR=0.72，95%CI（0.53，0.98），P=0.04]发生风险。 结论 根据当前现有证据，5-FU/LV+伊立替康可能较卡培他滨+伊立替康更为有利于转移性结直肠癌患者的治疗，但仍需结合临床实际情况进行化疗方案的优选。
【摘要】 目的 评价肾移植术后他克莫司（TAC）低剂量对比常规剂量干预的疗效和安全性。 方法 检索MEDLINE、EMbase、SCI、CBM、Cochrane图书馆，纳入肾移植术后TAC低剂量对比常规剂量免疫抑制治疗的随机对照试验（RCT）。检索时间从各个数据库建库至2009年12月，对纳入研究进行方法学质量评价和Meta分析。 结果 纳入3个RCT，其中A级研究2个，B级研究1个。分析结果显示:两组急性排斥反应发生率比较，无统计学意义[RR=1.39， 95%CI(0.64， 3.01)]；肾小球滤过率、受者/移植物生存率和纳入分析的安全性指标差异均无统计学意义。 结论 基于当前临床证据，肾移植术后TAC低剂量与常规剂量干预相比，近期疗效和安全性相似；远期结果尚需进一步研究探讨。【Abstract】 Objective To evaluate the effect and safety of low-dose versus standard-dose tacrolimus immunosuppressive therapy on kidney transplant recipients. Methods MEDLINE, EMbase, SCI, CBM and the Cochrane library were searched and randomized controlled trials (RCT) of low-dose versus standard-dose tacrolimus immunosuppressive therapy in kidney transplant recipients were gathered. The search was updated in December 2009. Quality assessment and meta-analysis were performed. Results A total of three RCT were identified, two of which were graded A and one was graded B. The analysis results indicated that RR (95%CI) value of the acute rejection rate was 1.39 (0.64, 3.01); glomerular filtration rate, patient/graft survival rate, and safety analysis were not significant different between the two groups. Conclusion Based on the evidence currently, compared to standard-dose TAC, Low-dose TAC has the same effect and safety results, but further study are needed to get the long term results.
Objective To explore the effects of utilization of new partogram on the progress of labor and intervention in the labor. Methods We reviewed nulliparous women who had vaginal delivery at our hospital from January 1st, 2015 to December 31st, 2017. They were divided into control group (group A) (n=200; the old labor standard was used during this time) and observation group (the new labor standard was used at the same time). The observation group was sub-divided into group B (n=100, the duration of dilatation of cervix from 0 to 3 centimeters greater than or equal to 16 hours after parturition), group C1 [n=100; the second-stage duration (t) was greater than or equal to 2 hours, and less than 3 hours), and group C2 (n=100; t was greater than or equal to 3 hours). We compared the differences in intervention at the stages of labor such as using oxytocin to strengthen the contractions, artificial rupture of membranes, using phloroglucinol to soften the cervix, urinary catheterization, and manual rotation of fetal head among the groups. We also compared the differences in fetal presentation position, head tumor, fetal position, cephalopelvic disproportion and progress of the drop when the dilatation of cervix get to 10 centimeters among the groups. Results In the comparison among group A, B, C1 and C2 in rates of using oxytocin to strengthen the contractions, using phloroglucinol to soften the cervix, urinary catheterization and manual rotation of fetal head, the differences were statistically significant between group C2 and the other groups (P<0.008 5). The differences among group C1, C2 and A were statistically significant in duration of the first stage of labor (P<0.05). The same result was found between group B and A in duration of the second stage of labor (P<0.05). In the comparison of the different ratios of fetal presentation position between group A and C1, and group A and C2, when the dilatation of cervix get to 10 centimeters, the differences were significant (P<0.017), except at +1 position. The differences in whether the fetal presentation was producing head tumor and occipital anterior position among group A, C1, and C2 were statistically significant (P<0.017), but there was no difference between group A and C1 (P>0.017) in occipital anterior position. In the comparison of the different progress of the drop when the dilatation of cervix had got to 10 centimeters, 0–1 hours: the differences were statistically significant among group A, C1, and C2 (P<0.05) ; 1–2 hours: the difference was statistically significant between groups C1 and C2 (P<0.05). In group C1, there was a statistically significant difference between 0–1 hour and 1–2 hours (P<0.05). In group C2, there was no statistically significant difference among 0–1 hour, 1–2 hours and 2–3 hours (P>0.05). Conclusions According to the new labor standard, the rates of intervention in the labor would not increase, but when the second-stage duration is greater than or equal to 3 hours, the frequency would increase. We should deal with the abnormal factors affecting labor in time, and try to control the duration in 3 hours.
【摘要】 目的 报道1例静脉滴注胺碘酮致肝肾功能不全患者。 方法 2010年10月收治1例扩张性心肌病患者，治疗过程中使用胺碘酮注射液，导致严重的肝肾功能不全。系统查阅中国期刊全文数据库及外文数据库Pubmed、Embase建库至2011年8月关于胺碘酮致肝肾功能不全的相关文献，进行静脉胺碘酮致肝肾功能不全的可能性评估，探索胺碘酮静脉滴注致肝功能不全的的作用机制。 结果 根据查阅文献结果分析，此患者静脉注射胺碘酮致肝功不全的可能性高，Naranjo概率评分分别为7分。 结论 提出临床医师和临床药师应进行胺碘酮静脉的药学监护，高度的重视胺碘酮相关的不良反应，从而及时识别和防治胺碘酮所致肝肾功能不全，减少其不良预后。【Abstract】 Objective To report a case of hepatic and renal insufficiency induced by intravenous injection with amiodarone, and to evaluate the possibility of the adverse drug reaction. Methods A patient with dilated cardiomyopathy was admitted in October, 2010. During the procedure, the use of amiodarone hydrochloride injection made the patient suffer from liver and kidney dysfunction. We retrieved the literatures about liver and kidney toxicity of amiodarone from CNKI, Pubmed, and Embase (from the establishment of the databases to November 2011). We also ssessed the possibility of the adverse drug reaction, discussed the mechanism of amiodarone-induced hepatic insufficiency. Results According to the literature, There was a great possibility of hepatic insufficiency induced by amiodarone, and the total score of the Naranjo probability score was 7. Conclusion It is important to pay more attention to the pharmaceutical care of amidarone to timely recognize and effectively prevent or treat hepatic and renal insufficiency induced by intravenous injection with amiodarone.
Objective To assess the effectiveness and safety of cyclosporine A (CsA) for aplastic anemia (AA) in China. Methods Randomized controlled trails (RCTs) of CsA for AA were collected from CBMdisc (1978 to 2008), CNKI (1979 to 2008), and VIP (1989 to 2008). Other relevant journals were also hand searched. The methodological quality of included studies was evaluated, and data analyses were performed with The Cochrane Collaboration’s software RevMan 4.2.0. Results A total of 19 RCTs were included. As for the total effective rate and complete remission rate, significant differences were noted between CsA + androgen vs. androgen alone, CsA + androgen combination vs. androgen combination, as well as CsA + androgen + other drugs vs. androgen + other drugs [total effective rate: RRs and 95%CIs were 1.48 (1.28 to 1.70), 1.67 (1.17 to 2.39), and 1.51 (1.09 to 2.08); complete remission rate: RRs and 95%CIs were 2.06 (1.33 to 3.19), 3.52 (1.19 to 10.39), and 1.54 (1.00 to 2.38)]. Conclusion According to the domestic evidence, treatment with CsA for AA may improve the total effective rate and complete remission rate. However, more high quality clinical trials are expected for further study.
【摘要】 目的 探讨二甲双胍致不良反应的一般规律和特点。 方法 检索1994年-2011年中国期刊全文数据库中二甲双胍所致不良反应个案报道的文献，得到符合条件的文献29篇共33例，进行统计分析。 结果 33例不良反应主要表现为内分泌系统（48.5%），皮肤及附件（18.2%），变态反应（15.2%），消化系统（9.1%），神经系统（6.1%）等。 结论 临床上应重视二甲双胍引起的不良反应，用药时应加强对患者的监护，以减少严重药物不良反应的发生。【Abstract】 Objective To investigate the characteristics and the general pattern of the adverse drug reactions (ADR) induced by metformin. Methods The ADR induced by metformin reported in domestic medical journals during 1994-2008 were retrieved by means of CNKI. A total of 29 related literatures involving 33 cases, and a related database was established for statistical analysis. Results The main clinical manifestation represented as endocrine system (48.5%), lesion of skin and its appendants (18.2%), allergic reactions (15.2%), digestive system (9.1%), nervous system (6.1%) and so on. Conclusion It is necessary to pay attention to ADR induced by metformin and strengthen observation during medication in order to reduce serious ADR.