Objective To estimate the effects of N-acetylcystein (NAC) combined with conventional treatment on the patients with stable COPD. Methods Literatures published between January 1995 and September 2010 were searched in the databases including PubMed, CHEST, CNKI, CBM, VIP and WANGFANG for collecting the randomized control trials (RCTs) of NAC combined with the conventional treatment versus the conventional treatment on patients with stable COPD. The studies were screened according to the inclusive and exclusive criteria, the data were extracted, the quality was assessed and the meta-analysis was conducted with RevMan 5.0 software. Results A total of seven RCTs including 404 patients with stable COPD were enrolled. The meta-analysis demonstrated that, a) the short-term usage of NAC could improve PaO2 (SMD=0.05 mmHg, 95%CI –0.23 to 0.32) and PaCO2 (SMD= –0.29 mmHg, 95%CI –0.76 to 0.17) without significant differences compared with the control group; and b) the NAC could significantly improve FEV1 (SMD=1.11L, 95%CI 0.69 to 1.50) and clinical symptoms (RR=17.32, 95%CI 7.11 to 42.18), and reduce the frequency of acute exacerbation (RR=0.20, 95%CI 0.07 to 0.54) with significant differences. Conclusion The NAC used in a short-term can significantly improve arterial blood gas (ABG) and pulmonary function, and it can improve clinical symptoms and reduce the frequency of acute exacerbation. But for the possibility of moderate bias due to lower quality of the included studies and unclear implementation of RCTs, this conclusion should be cautiously applied in clinic with patients’ conditions in considered and it has to be verified with more large-scale and high-quality RCTs.
ObjectiveTo investigate the correlation between intima-media thickness (IMT) of carotid artery in color ultrasonography and the heart rate variability. MethodsA retrospective analysis was performed in 64 patients from West China Hospital of Sichuan University between March and May 2013. Carotid intima-media thickness was measured with color ultrasonography and dynamic electrocardiogram, and the heart rate variability was assayed at the same time. ResultsIMT in the cardiovascular disease group, combination group, coronary heart disease group and hypertension group was significantly thicker than the control group (P<0.05). The differences of SDNN and SDANN were statistically significant (P<0.05) between the combination group and the control group. There were 23 cases with IMT ≥ 1.0 mm in the cardiovascular disease group including 8 cases in the combination group, 10 cases in the coronary heart disease group and 5 cases in the hypertension group. IMT in those groups were all significantly higher than that in the control group with only 2 cases having IMT ≥ 1.0 mm (P<0.05). There were 18 cases with SDNN<100 ms in the cardiovascular disease group including 7 cases in the combination group, 6 cases in the coronary heart disease group and 5 cases in the hypertension group, but there was no statistically significant difference compared with that in the control group with only 11 cases (P>0.05). Negative correlation was found between IMT and SDNN, SDANN in the cardiovascular diseases group (r=-0.574, -0.544; P<0.01) and negative correlation was found between IMT and SDANN in the control group (r=-0.392, P<0.05). ConclusionThe carotid artery lesions and autonomic nerve especially sympathetic nerve dysfunction are obvious in patients with cardiovascular diseases and there is a negative correlation between them.