ObjectiveTo systematically review the efficacy and safety of indacaterol compared with tiotropium in the treatment of chronic obstructive pulmonary disease (COPD).MethodsWe electronically searched databases including PubMed, EMbase, The Cochrane Library, CNKI, VIP and WanFang Data to collect randomized controlled trials (RCTs) about indacaterol versus tiotropium for COPD patients from inception to November 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.1 software.ResultsA total of 10 RCTs involving 10 415 patients were included, 5 686 patients were in tiotropium group and 4 729 patients in tiotropium group. The results of meta-analysis showed that there was no significant difference between both groups for improving trough forced expiratory volume in one second pulmonary function (FEV1) (MD=0.00, 95%CI –0.03 to 0.03, P=0.79). In the subgroup analysis, it was found that indacaterol had a significant advantage over tiotropium in improving FEV1 over the first 2 weeks (MD=–0.05, 95%CI –0.10 to 0.00, P=0.03). As to the transition dyspnoea index, indoruterol was superior to tiotropium (RR=1.09, 95%CI 1.05 to 1.14, P<0.000 1). Although there was no significant difference of two groups in the St George's respiratory questionnaire score (SGRQ) (MD=–0.48, 95%CI –1.42 to 0.47, P=0.32), indoruterol could significantly improve it among patients whose SGRQ score was greater than or equal 4 than tiotropium (RR=1.13, 95%CI 1.05 to 1.22, P=0.002). Indoruterol had lower overall incidence of adverse reactions (RR=1.05, 95%CI 1.01 to 1.09, P=0.01) , but there was no significant difference between two groups in severe adverse events (RR=1.02, 95%CI 0.89 to 1.16, P=0.81).ConclusionIndacaterol and tiotropium are similar in improving lung function in COPD patients, however, the indacaterol is better than tiotropium in TDI and SGRQ. There is no significant difference for the serious adverse reactions in two groups. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
Objective To understand the current situation of the care burden of primary caregiver of patients with oral diquat poisoning, analyze its influencing factors, and analyze the mediating effect of psychological resilience in social support and care burden, so as to provide a theoretical basis for further clinical intervention. Methods The primary caregivers of patients with oral diquat poisoning who received treatment at Qilu Hospital of Shandong University between October 2019 and October 2021 were selected. The general information questionnaire, Zarit Burden Interview (ZBI), Connor-davidson Resilience Scale (CD-RISC), and Social Support Revalued Scale (SSRS) were used to investigate the primary caregivers of patients with oral diquat poisoning. The influencing factors of the care burden on primary caregivers were analyzed. Results A total of 218 patients and their primary caregivers were included. The age of the primary caregivers, whether they were an only child, physical condition, educational level, economic income, daily care time, patient’s condition, and patient’s urinary concentration of diquat were the influencing factors of ZBI. The SSRS score of the primary caregiver was 26.97±10.21, the CD-RISC score was 56.95±26.64, and the ZBI score was 52.95±16.06. The burden of care was negatively correlated with social support (r=−0.369, P<0.05), the burden of care was negatively correlated with psychological resilience (r=−0.467, P<0.05), and social support was positively correlated with psychological resilience (r=0.288, P<0.05). The role of psychological resilience in the influence of social support and care burden was partly mediated, accounting for 41.905%. Conclusions The level of social support and psychological resilience of the primary caregivers is low, and the burden of care is heavy. Psychological resilience plays an intermediary role in the social support and care burden of the primary caregivers of patients with oral diquat poisoning. Clinical staff can carry out targeted intervention to improve the level of social support and psychological resilience and reduce the care burden.
Objective To systematically evaluate the effectiveness and safety of mepolizumab in treating eosinophilic asthma. Methods Databases including PubMed, Embase, ISI Web of Science, Cochrane CENTRAL, MEDLINE, VIP and CNKI were searched to collect randomized controlled trials (RCTs) about mepolizumab for eosinophilic asthma from inception to October 2016. The references of these articles and relevant conference information were also manually retrieved. Meta-analysis was performed by RevMan 5.1 software after two researchers independently selected the literatures, extracted data and evaluated the quality according to the inclusion and exclusion criteria. Results A total of 9 RCTs involving 2273 patients were included. Compared with the control group, the acute exacerbation rate of asthma was decreased significantly in the mepolizumab treatment group [RR=0.67, 95%CI (0.53, 0.85), P=0.0009], eosinophil count in blood was significantly reduced [MD=–0.22, 95%CI (–0.29, –0.15), P<0.00001], eosinophil count in sputum was also significantly reduced [MD=–6.37, 95%CI (–9.68, –3.06), P<0.0002], and the proportion of patients with increased asthma-related quality of life (ACQ) score was higher significantly. The overall incidence of adverse reactions was similar between two groups [RR=0.90, 95%CI (0.71, 1.14), P=0.39]. The incidence of serious adverse reactions of mepolizumab treatment was superior to that of placebo [RR=0.45, 95%CI (0.23, 0.89), P=0.02]. The overall incidence of cardiovascular events was comparable between placebo and mepolizumab treatment [RR=0.95, 95%CI(0.40, 2.22), P=0.90]. Mepolizumab treatment may have a role in improving lung function, but the effect was not obvious. Conclusion Mepolizumab treatment can reduce the number of eosinophils in blood and sputum, reduce the exacerbation rate, and improve the quality of life of asthmatic patients with better safety.