ObjectiveTo explore the effect of different doses of low molecular weight heparin (LMWH) on the patency rate of cuffed central venous catheter used by patients for hemodialysis therapy.MethodsFrom June 2012 to January 2018, patients who received long-term hemodialysis in 363 Hospital with cuffed central venous catheter were enrolled in this retrospective study. According to the dose of LMWH used in hemodialysis, they were divided into below 60 U/kg group and greater than or equal to 60 U/kg group. The general parameters, frequency of urokinase use, bleeding events, severe coagulation in dialysis line and occurrence of catheter dysfunction were collected and compared between two groups.ResultsA total of 48 cases were enrolled. Of these, the doses of LMWH of 31 cases were below 60 U/kg and 17 cases were greater than or equal to 60 U/kg. There was no significant difference between the two groups in terms of age, sex, diabetes, hemoglobin, platelets, albumin, low-density lipoprotein cholesterol, or hypersensitive C-reactive protein parameters (P>0.05). Between the below 60 U/kg group and the greater than or equal to 60 U/kg group, there was no statistically significant difference in the incidence of catheter dysfunction (16.1% vs. 29.4%; χ2=0.507, P=0.476) or the incidence of bleeding events (1.77 vs. 2.81 times per 1 000 catheter-days; χ2=1.500, P=0.221). The frequency of urokinase used in the two group were 27.89 and 36.18 times per 1 000 catheter-days, respectively (χ2=5.927, P=0.015) and the frequency of severe coagulation were 6.88 and 2.30 times per 1 000 catheter-days, respectively (χ2=5.140, P=0.023). The differences were statistically significant.ConclusionThe lower dose of LMWH used in hemodialysis for preventing extra-corporeal circuit thrombosis does not result in the decrease of the patency rate of cuffed central venous catheter.
Objective For the dispute on the superiority of the pemetrexed compared with the docetaxel for treating advanced non-small-cell lung cancer (NSCLC), this study is conducted to evaluate the efficacy and safety of pemetrexed versus docetaxel for patients with NSCLC. Methods Such databases as The Cochrane Library, PubMed, EMBASE, SCI, CBM, CNKI, and VIP were searched to collect the randomized controlled trials (RCTs) about pemetrexed versus docetaxel for the treatment of NSCLC published before November of 2010. Two reviewers independently screened the studies, extracted the data and assessed the methodology quality. RevMan 5.0 software was used for meta-analyses. Results Five studies involving 847 patients were included. The results of meta-analyses showed that, in the aspect of efficacy, there was no significant difference between the two groups in the effective rate (OR=1.09, 95%CI 0.7 to 1.70), the disease control rate (OR=0.99, 95%CI 0.75 to 1.31), and the one-year survival rate (OR=1.11, 95%CI 0.56 to 2.18); in the aspect of safety, compared with docetaxel, pemetrexed could reduce the neutropenia (OR=0.09, 95%CI 0.05 to 0.15), the febrile neutropenia (OR=0.13, 95%CI 0.06 to 0.29) and the alopecia (OR=0.20, 95%CI 0.12 to 0.33), but no significant difference was found in haemoglobin (OR=1.45, 95%CI 0.23 to 9.06), thrombocytopenia (OR=1.46, 95%CI 0.59 to 3.59), nausea and vomiting (OR=1.23, 95%CI 0.53 to 2.83) and fatigue and debilitation (OR=0.73, 95%CI 0.40 to 1.30). Conclusion As the current evidence shows, pemetrexed has similar efficacy to docetaxel for advanced NSCLC patients, but it has fewer side effects of neutropenia, febrile neutropenia and alopecia.