ObjectiveTo investigate the protective effect and the regulation mechanism of oxaloacetate (OAA) on myocardial ischemia reperfusion injury in rats. MethodsSixty rats, weight ranged from 200 to 250 grams, were randomly divided into 6 groups:a negative control group, a sham operation control group, a model control group, an OAA pretreatment myocardial ischemia-reperfusion model group (three subgroups:15 mg/kg, 60 mg/kg, 240 mg/kg). We established the model of myocardial ischemia reperfusion of rats and recorded the internal pressure of left ventricle (LVSP), the maximal rate of left ventricular pressure change (±dp/dtmax) and left ventricular end diastolic pressure (LVEDP). We restored reperfusion 180 minutes after ligating the left anterior descending coronary artery 30 minutes and determinated cardiac troponin Ⅰ (cTn-I), lactate dehydrogenase (LDH), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px). We took out heart tissues, stained it and calculated the infarcted size. We used the Western blot to detect the expression of NF-E2 related factor 2 (Nrf2), Kelch-like ECH-associated protein-1 (Keap1) and heme oxygenase-1 (HO-1). ResultsCompared with the sham operation group, heart function indexes in the negative control group had no significant difference (P>0.05). But in the model control group there was a decrease (P<0.05) And the serum levels of LDH, cTn-I, and myocardial infarcted size were significantly increased (P<0.01). Compared with the model control group, heart function indexes in the OAA pretreatment groups improved, the serum LDH, cTn-I activity, and infarct size decreased (P<0.05), SOD and GSH-Px activity increased (P<0.05). And these results were statistically different (P<0.01) in the high dose OAA pretreatment groups. Compared with the model control group, the expression of Keap1 in the OAA pretreatment group was down-regulated (P<0.001) while total Nrf2, nucleus Nrf2 and its downstream HO-1 was up-regulated (P<0.001), which suggested that OAA enhanced antioxidant capacity by (at least in part) Keap1-Nrf2 pathway, resulting in reducing myocardial damage and protecting myocardium after acute myocardial ischemia reperfusion injury. ConclusionOxaloacetate can provide protective effects on myocardial ischemia reperfusion injury through down-regulating the expression of Keap1 and up-regulating the expression of Nrf2 and its downstream peroxiredoxins to improve antioxidant capacity.
Objective To evaluate the diagnostic accuracy of enzyme immunoassay (EIA) for chlamydia trachomatis (CT). Methods The diagnosis trials on EIA for CT were searched in the databases such as PubMed (1966 to Dec. 2011), The Cochrane Library (Issue 12, 2011), EMbase (1974 to Dec. 2011), CNKI (1994 to Dec. 2011), VIP (1989 to Dec. 2011) and CBM (1978 to Dec. 2011), meanwhile the manual and other retrieves were also conducted. Two reviewers evaluated the quality of the included trials according to the quality assessment of diagnostic accuracy studies (QUADAS), and then meta-analysis was performed using Meta Analyst and RevMan 5.0 software. Results A total of 17 trials involving 9 461 participants were included. The results of meta-analysis showed that the weighted sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and the area under SROC curve were 0.847 (95%CI 0.571 to 0.995), 0.964 (95%CI 0.890 to 0.994), 25.972 (95%CI 18.587 to 36.293), 0.156 (95%CI 0.114 to 0.212), 228.875 (95%CI 127.136 to 412.028), and 0.953, respectively. Conclusion EIA for CT has higher sensitivity and specificity, so EIA is recommended for preliminary screening CT and diagnosing the highly suspected cases or the patients without obvious signs and symptoms.
The resistance of non-small cell lung cancer (NSCLC) to epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) has been brought into focus. COX-2 signal pathway was found to be closely related to EGFR signal pathway by recent researches, and there has been a growing interest to focus the researches on whether COX-2 pathway inhibition improves the efficacy of EGFR-TKIs in treating advanced NSCLC. In this review, we will illustrate recent advances of combined inhibition of EGFR and COX-2 signal pathways in NSCLC therapy.
Objective To evaluate the diagnostic value of ELISA using AgB in cystic echinococcosis (CE). Methods Such databases as PubMed, EMbase, The Cochrane Library, EBSCO, CBM, CNKI, WanFang Data and MedaLink were retrieved on computer, and the relevant journals were also manually searched to collect the trials on ELISA using AgB in diagnosis of CE. The retrieval time was from inception to July 5th, 2012. Two reviewers independently screened the literature, extracted the data and assessed the quality according to QUADAS. Then the meta-analysis was conducted by using Meta-Disc 1.4 software. Results A total of 8 studies were included, and there were 562 CE patients diagnosed by gold standard, 434 suspected cases and 303 healthy people. There were no threshold effects among those 8 studies (the spearman’s correlation coefficient of log sensitivity to log 1-specificity was 0.527, P=0.400 1). The meta-analysis of DerSimonia-Laird showed that, the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio was 0.76 (95%CI 0.73 to 0.79), 0.84 (95%CI 0.82 to 0.86), 5.20 (95%CI 3.59 to 7.55), 0.26 (95%CI 0.18 to 0.35), 23.93 (95%CI 12.35 to 46.39), respectively. And the AUC of SROC was 0.889 7 (Q=0.820 4). Conclusion ELISA using natural AgB and rAgB has greater diagnostic value in detecting CE.
Objective To systematically review the resistance of pseudomonas aeruginosa to quinolone in China. Methods Such databases as CNKI, WanFang Data, CBM, VIP, PubMed, EMbase and The Cochrane Library were electronically searched from inception to December 2012, for relevant studies on the resistance mechanism of pseudomonas aeruginosa to quinolone. Two reviewers independently screened literature according to inclusion and exclusion criteria. Then, meta-analysis was performed using RevMan 5.0 software. Results Totally 19 studies were included, involving 723 strains of quinolone-resistant pseudomonas aeruginosa. The statistical results showed that, in the areas to the north of Huai River, the detection rates of gyrA, gyrB, parC and parE were 88.0%, 13.3%, 31.4% and 16.7%, respectively; and in the areas to the south of Huai River, they were 64.6%, 50.0%, 35.4% and 16.7%, respectively. The detection rates of plasmid mediated resistant genes aac (6’)-Ib-cr was 0 (0/66) in the areas to the north of Huai River, and 39% (25/64) in the areas to the south of Huai River. The outer membrane protein expression rate of active efflux system was 68.1%. Conclusion In China, gyrA gene mutation and the active efflux system mainly account for pseudomonas aeruginosa’s resistance to quinolone. DNA topoisomerase IV abnormalities and plasmid mediated resistance is the secondary mechanism.
Objective To systematically review the diagnostic value of anti-HCV in serum tested by the third-generation enzyme-linked immunosorbent assay (ELISA 3) in patients with hepatitis C. Methods Such databases as PubMed, MEDLINE, EMbase, The Cochrane Library (Issue 1, 2013), EBSCO, CBM, CNKI, VIP and WanFang Data were electronically and comprehensively searched for relevant studies on the diagnostic value of anti-HCV in serum tested by ELISA 3 in patients with hepatitis C from inception to January 1st, 2013. Relevant journals were also manually retrieved. QUADAS items were used to evaluate the quality of the included studies. Then meta-analysis was performed using Meta-Disc 1.4 software to calculate pooled effect size in sensitivity (SEN), specificity (SPE), likelihood ratio (±LR), diagnostic odds ratio (DOR) and summary receiver operating characteristic curve (SROC curve), and area under the curve (AUC) as well. Results Finally, nine studies were included, involving 1 182 patients with hepatitis C diagnosed by the gold standard and 4 764 patients with non-hepatitis C diseases. The results of meta-analysis using random model showed (SEN=0.96, 95%CI 0.95 to 0.97; SPE=0.96, 95%CI 0.96 to 0.97; +LR=42.21, 95%CI 10.23 to 174.23; –LR=0.02, 95%CI 0.01 to 0.09; DOR=1 635.89, 95%CI 372.37 to 7 186.83; AUC=0.996 5). Conclusion Anti-HCV in serum tested by ELISA 3 has fairly high value in the diagnosis of patients with hepatitis C.
Objective To assess the efficacy and safety of low-dose urokinase plus conventional treatment versus conventional treatment alone in patients with unstable angina. Methods We searched the database PubMed, EMBASE, The Cochrane Library, SCI, CBM, CNK, VIP and Wanfang database on line by computer, and handsearched relevant professional journals by two independent screening and extract information. The quality of the included documents was evaluated by the criterion of Cochrane handbook 4.2.6. The cochrane collaboration’s Revman 4.2.10 software was used for data analyses. Results A total of 19 randomized controlled trials were included (2 273 patients) Meta-analyses showed that the low-dose urokinase group was better than the conventional treatment group in efficiency [OR= 4.18, 95%CI (3.24, 5.41)] and ECG [OR= 2.81, 95%CI (2.04, 3.88)], and there were no differences between the two groups in cardiovascular outcomes [OR= 0.74, 95%CI (0.44,1.24)], mucocutaneous bleeding [OR= 1.43, 95%CI (0.90, 2.28)], gums bleeding [OR= 1.88, 95%Cl (0.46, 7.70)] and microscopic hematuria [OR= 3.82, 95%CI (0.77, 18.92)]. Conclusion The low dose urokinase group is higher efficient than the conventional treatment group. As the samples of the included studies are small and their quality is low, more randomized, double-blind, high-quality and big- sample trials are required.
Objective To assess the efficacy and safety of fibfinogen-depleting agents (snake venom extracts) in the treatment of acute ischemic stroke. Method A systematic review of all the relevant randomized controlled trails (RCTs) was performed. RCTs were identified from the Cochrane Stroke Group’s Specialized Trials Register, additional electronic and handsearching, and personal contract with pharmaceutical companies. We included all completed and unconfounded truly or quasi-randomized trials in patients with ischemic stroke comparing fibrinogen depleting agents for analysis. Results Ten completed and one ongoing RCTs have been identified so far. Up to 1998, only three trials using ancrod (182 patients) met the inclusion criteria. Ancrod was associated with a significant reduction in early deaths (5.6% vs. 16%; odds ratio [OR], 0.33; 95% confidence interval [CI], 0.13 to 0.85; 2P=0.02) suggesting that treatment of 100 patients would avoid about 10 early deaths. The frequency of asymptomatic intracranial hemorrhage shown by computed tomography was similar between ancrod-treated and control groups (7.6% vs. 9.6%; OR 0.78; 95%CI 0.26 to 2.33; 2P=0.65). No major intracranial or extracranial hemorrhages or recurrent ischemic strokes occurred in the ancord-allocated patients. There were nonsignificant trends in favor of ancrod in death from any cause (OR 0.57; 95%CI 0.27 to 1.23; 2P=0.15) and death or disability (OR 0.52; 95%CI 0.26 to 1.03; 2P=0.06) at the end of trial follow-up. Up to 2000, other two trials published results. This review will be updated with new trial results soon, which will provide more data. Conclusions There were too few patients and outcome events to draw reliable conclusions from the present data. Although ancrod-like agents appeared promising, their routine use cannot be recommended at the moment. Future trials should test simpler fixed-dose regimens to allow better generalizability.
Objective To assess the effect of different thrombolytic agents, and different regimens in acute ischaemic stroke. Methods A systematic review of all the relevant randomized controlled trials (RCTs) was performed. RCTs were identified from the Cochrane Stroke Group trials register, Embase (1980 to 1997), handsearching Japanese and Chinese journals, and personal contact with pharmaceutical companies. We included randomised and quasi-randomised trials in patients with confirmed acute ischaemic stroke comparing different doses of a thrombolytic agent, or different thrombolytic agent, or the same agent given by different routes. Results Eight trials involving 1 334 patients were included. Concealment of allocation was generally adequate. All the trials were conducted in Japan. Different doses (of tissue plasminogen activator or urokinase) were compared in six trials. Different agents (tissue plasminogen activator versus urokinase,or tissue-cultured urokinase versus conventional urokinase) were compared in three trials. Few data were available for functional outcomes. A higher dose of thrombolytic therapy was associated with a five-fold increase in fatal intracranial haernorrhages (odds ratio 5.02, 95% confidence interval 1.56 to 16.18). There was a non-significant trend towards more early deaths or clinically significant intracranial haemorrhages in higher dose group. No difference in late deaths or extra-cranial haemorrhages was shown between low and higher doses. However, very few of these events occurred. No difference was shown between the different thrombolytic agents tested. Conclusions There is not enough evidence to conclude whether lower doses of thrombolytic agents might be safer or more effective than higher doses in acute ischaemic stroke. It is not possible to conclude whether one agent might be better than another, or which route of administration might be best.
Objective To assess the effectiveness and safety of collagenase for intervertebral disk hernia, to facilitate the rational selection of the most appropriate therapy. Methods We searched the following electronic databases: Medline (1966 to May 2006), EMbase (1966 to May 2006), The Cochrane Library (Issue 2, 2006), CRD (Center for Reviews and Dissemination, York University), CBM (1978 to May 2006), CNKI (1994 to 2006), and VIP (1989 to 2006). RCTs or quasi-RCTs were included. RevMan 4.2 was used for statistical analysis. Results Six RCTs and one quasi-RCT involving 829 participants were included. One study showed that the short-term effective rate was similar between chemonucleolysis (CNL) and percutaneous laser dise decompression (PLDD), but the long-term effective rate of PLDD was superior to that of CNL (RR 0.35, 95%CI 0.13 to 0.96). One study revealed that the short- and long-term effective rate of CNL were higher than those of placebo (Plt;0.05). Two studies comparing collagenase vs chymopaain were heterogeneous: one indicated that chymopapain was superior to collagenase according to ITT analysis (Plt;0.05); but the other revealed no significant difference among the high- and low-dose collagenase groups and chymopapain group (Pgt;0.05). One trial showed that the effective rate between collagenase and automated percutaneous lumbar discectomy (APLD) was not significantly different (Pgt;0.05). The overall results of CNL vs Triamcinolone Acetonide showed no significant difference, but significant difference was found among patients with different types of intervertebral disk hernia. One study showed that CNL was superior to Prednisolone. Three studies reported adverse effects, mainly involving pain, neurologic deficit, cauda equina syndrome and allergic reaction amongst others. Conclusions No adequate evidence shows which therapy is more effective for intervertebral disk hernia. More high-quality trials are required.