【Abstract】ObjectiveTo study the effects of endothelin (ET) and Xuesaitong injection on hepatic, renal and myocardial tissues after bile duct ligation (BDL) in rabbits. MethodsSeventytwo rabbits were randomly divided into three groups: BDL group (24 rabbits), BDL+Xuesaitong injection group (24 rabbits), and sham operation group (24 rabbits). Each group was subdivided into four subgroups of postoperative 3, 6, 9 and 12 d (6 rabbits in each subgroup). Automatic biochemical analysis equipment was used to detect the levels of serum TBIL, ALT, BUN and Crea. The levels of ET in plasma, hepatic, renal and myocardial tissues were measured with radioimmunological method. ResultsThe levels of ET in plasma, hepatic, renal and myocardial tissues in both BDL group and BDL+Xuesaitong injection group were higher than those of sham operation group (P＜0.01). The levels of ET in plasma and tissues of BDL+Xuesaitong group were lower than those in BDL group (P＜0.05). ConclusionObstructive jaundice can lead to an increase of ET in plasma, hepatic, renal and myocardial tissues, the level of ET increases with the time of obstruction. Xuesaitong injection may play a protective role in the injury of hepatic, renal and myocardial tissues after obstruction by decreasing the level of ET in plasma and tissues.
Objective To evaluate the effectiveness and safety of donepezil in the treatment of senile vascular dementia. Methods The databases such as the Chinese Journal Full-text Database, Chinese Biomedical Literature Database, Chinese Scientific Journals Full-text Database, Chinese Biomedicine Database, PubMed and The Cochrane Library were searched by computer, and the related journals and conference proceedings were also manually searched to include randomized controlled trials (RCTs) on donepezil in the treatment of senile vascular dementia. Studies were screened according to the inclusion and exclusion criteria, data were extracted, the methodological quality of the included studies was assessed according to Jadad score criterion, and meta-analyses were performed by using RevMan 5.0 software. Results Among 25 studies (3586 patients) included, eight described the randomization methods, and three described the double blind methods. The results of meta-analyses showed, compared with the placebo group, donepezil was superior in improving vascular dementia patients’ cognition level (three studies, MD= –1.25, 95%CI –1.61 to –0.88, Plt;0.000 01), intellectual spirit level (two studies, MD=0.66, 95%CI 0.35 to 0.97, Plt;0.000 1), dementia level (three studies, MD= –0.74, 95%CI –1.16 to –0.31, P=0.004), and viability level (two studies, MD= –0.74, 95%CI –1.16 to –0.31, P=0.000 6). In improving the intellectual spirit level, donepezil was superior to piracetam (seven studies, MD=3.25, 95%CI 2.15 to 4.35, Plt;0.000 01), Xuesaitong (two studies, MD=6.12, 95%CI 4.02 to 8.22), Huperzine A (three studies, MD=2.45, 95%CI 1.14 to 3.76, P=0.000 2), and vitamin (two studies, MD=4.00, 95%CI 2.73 to 5.27, Plt;0.000 01). For improving the viability level, donepezil was superior to piracetam (five studies, MD= –3.86, 95%CI –4.83 to –2.89, Plt;0.000 01), Xuesaitong (two studies, MD= –5.49, 95%CI –7.18 to –3.80, Plt;0.000 01), Huperzine A (two studies, MD= –0.78, 95%CI –4.23 to –2.66, P=0.66), vitamin (three studies, MD= –5.88, 95%CI –8.29 to –3.48, Plt;0.000 01), and nimodipine (one study, MD= –7.09, 95%CI –10.81 to –3.37, P=0.000 2). In improving the dementia level (HDS Scale), donepezil was superior to piracetam (one study, MD=5.80, 95%CI 2.78 to 8.82, P=0.000 2), Xuesaitong (one study, MD=3.95, 95%CI 2.32 to 5.58, Plt;0.000 01), vitamin (one study, MD=3.91, 95%CI 0.94 to 6.88, P=0.010), and almitrine (one study, MD=3.37, 95%CI 1.10 to 5.64, P=0.004). Conclusion Current evidence shows that donepezil is likely to be more effective in the treatment of vascular dementia than placebo, piracetam, Xuesaitong, Huperzine A and vitamin. However, for the limited evidence and lower methodological quality of the included studies, this conclusion still needs to be verified with more high-quality RCTs.