ObjectiveTo use the evidence map system to search and sort out the clinical research on the prevention and treatment of hyperlipidemia with proprietary Chinese medicine, and to understand the distribution of evidence in this field. MethodsThe literature on the treatment of hyperlipidemia with proprietary Chinese medicines was retrieved from CNKI, WanFang Data, VIP, SinoMed, PubMed, Cochrane Library, Embase and Web of Science databases from inception to December 2022. The distribution characteristics of evidence were analyzed and presented by means of text and graph. ResultsA total of 865 articles were included and 79 kinds of proprietary Chinese medicines were obtained. The Xuezhikang tablets or capsules were the most frequently used. In recent years, the number of published articles showed a downward trend, and the literature quality was generally low. Most of the research intervention programs only used Chinese patent medicine, and the sample size of a single study was mostly 60-100 patients, and the study course was 4-8 weeks. Clinical studies did not highlight the characteristics of traditional Chinese medicine, and only 12.7% of the studies limited the syndrome type of traditional Chinese medicine in the study population. In terms of the selection of outcome indicators, more attention was paid to blood lipid levels and safety indicators, while less attention was paid to indicators such as traditional Chinese medicine syndrome scores. ConclusionThe results show that Chinese patent medicine has certain advantages in the prevention and treatment of hyperlipidemia, but there are some deficiencies in the reports of methodology and clinical characteristics, and the overall quality of the research is low.
Objective To evaluate the diagnostic value of serum neuron specific enolase (NSE) in patients with small cell lung cancer. Methods We searched MEDLINE, EMBASE, The Cochrane Library and other databases (1966 to March 2007) to collect studies which evaluated the diagnostic value of NSE in patients with small cell lung cancer. The heterogeneity of included studies was tested by the Cochrane Collaboration’s software RevMan 4.2. The Summary Receiver Operating Characteristic (SROC) curve and meta-analyses were performed by MetaDisc. Results Fifteen studies involving 4221 patients (672 SCLC and 3549 NSCLC patients, all diagnosed by the gold standard) were included. Meta-analyses showed that the heterogeneity among studies was high (P=0.000 2, I2=66.1%), the pooled sensitivity was 0.67 (95%CI 0.64 to 0.71) and the pooled specificity was 0.91 (95%CI 0.90 to 0.92). Subgroup analyses indicated that 4 of the studies which used the reagent supplied by The Academy of Military Medical Sciences (P=0.33, I2=13.4%, AUC= 0.9672, SE=0.0393) and another 4 which used the reagent supplied by Roche (P=0.23, I2=29.9%, AUC=0.8311, SE=0.0836) had no heterogeneity. Conclusion NSE could be regarded as one of the reference tests in patients with small cell lung cancer, but more high quality trials are required.
Objective To assess the clinical efficacy and safety of paclitaxel in the first-line and second-line treatment of patients with small cell lung cancer (SCLC). Methods We searched The Cochrane Library, MEDLINE, EMBASE, CBM, CNKI, VIP and etc to collect all clinical controlled trials involving the addition of paclitaxel to chemotherapy in SCLC patients. Two reviewers evaluated the quality of included trials independently. The Cochrane Collaboration’s software RevMan 4.2.2 was used for meta-analyses. Results Nine trials involving 1675 SCLC patients were included. Five trials were randomized controlled trials, and all trails didn’t mention the blinding methods. Meta analyses indicated that the PET arm (paclitaxel+cisplatin+etoposide) had a similar response rate compared with the EP arm (etoposide+cisplatin) (OR1.35, 95%CI 0.98 to 1.85). The incidences of severe thrombocytopenia (OR 1.68, 95%CI 1.12 to 2.52) and lethal toxicity (OR 4.00, 95%CI 1.77 to 9.04) were higher in the PET arm than those in the EP arm, but the incidence of severe leukocytopenia was lower in the PET arm (OR 0.50, 95%CI 0.37 to 0.68). A total of 54 treatment-related deaths were reported. Conclusion In the first-line treatment of SCLC, the combination of paclitaxel, carboplatin and etoposide improved the progression-free survival, but the combination of paclitaxel and EP did not improve the survival and was more toxic than EP alone. Paclitaxel as the second-line treatment showed some therapeutic effect. Due to the poor quality and small sample size of included trials, more well-designed multi-center randomized controlled trials should be performed.
Objective To investigate the adverse drug reactions (ADRs) of patients with SARS in Xiao Tang Shan Hospital. Methods We developed and distributed Drug Use Handbook and established ADRs monitoring group to guide resaonable drug use. We followed up the process and collected clinical report on ADRs. We retrospectively analyzed the data on ADRs by the classification and grade of ADRs according to WHO and Hospital Information Sysytem (HIS) of Chinese PLA General Hospital. Results We collected 193 (87 males and 106 females) patients with ADRs among 680 SARS patients with incidence rate of ADRs of 28.38%. The ADRs incidence rate was higher in females and elders. Critical SARS patients and SARS patients with diabetes were more susceptible to ADRs. Large dosage and combination of drugs may induce ADRs. Steroids may be a main cause of ADRs. The ADRs incidence rate induced by injection was higher than that induced by all kinds of oral drugs. ADRs mainly happened in hematological, endocrine and digestive systems. Conclusion SARS patients are prescribed many kinds of medications. Large dosage of so many medications may lend to high incidence rate of ADRs. Steroid should be cautiously used in the treatment of SARS.
Objective To study the medication usage in patients with severe acute respiratory syndrome (SARS). Methods The information of the medications of 680 patients with SARS in Xiao Tang Shan Hospital was collected by HIS system and classified by using computer model on the basis of disease factor. The usage time and cases, and cost of these medications were calculated. The defined daily dose (DDD) and drug utilization index (DUI) were analyzed. Results A number of 359 drugs in 17 categories were applied to 680 patients with SARS. Most cases used antibacterial agents, the DDDs of immunomodulator and vitamins were the highest, the usage duration of vitamins and infusion fluids were the longest among 17 kinds of the drugs. The cost of methylpredni-solone injection was the highest. The mortality rate, kinds of drugs and frequency of drugs were higher in type C, type D and serious SARS patients than that of type A and common SARS patients. Conclusions Many kinds of medications have been prescribed to SARS patients. The dosages of these medication are very high, especially glucocorticoids, immuneomodulator and nutrient agents. The computer model on the basis of disease factor is probably valid, rapid and easy to standardize.