ObjectiveTo systematically review the effectiveness and safety of domestic tirofiban for Chinese population with non ST-elevation acute coronary syndromes (NSTE-ACS) in non-interventional therapy. MethodsWe searched databases including The Cochrane Library (Issue 11, 2013), PubMed, EMbase, CBM, CNKI, VIP and WanFang Data from 1994 to 2014 to collect randomized controlled trials (RCTs) about domestic tirofiban for NSTE-ACS patients in non-interventional therapy. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed methodological quality of included studies. Meta-analysis was then conducted using RevMan 5.2 software. ResultsA total of 23 RCTs were enrolled involving 2 425 patients. The results of meta-analysis showed that:a) the effectiveness of tirofiban in the trial group was significantly better than that in the control group (OR=3.62, 95%CI 2.33 to 5.63, P<0.000 01); b) ST segment down improvement in the trial group was better than that in the control group (WMD=0.39, 95%CI 0.30 to 0.49, P<0.000 01); c) improvement of platelet aggregation in the trial group was better than that in the control group (WMD=27.89, 95%CI 25.45 to 30.34, P<0.000 01); d) the incidences of cardiovascular events of composite endpoints in the trial group were lower than that in the control group (during 36 h:OR=0.20, 95%CI 0.12 to 0.31, P<0.000 01; and after 30 days:OR=0.31, 95%CI 0.23 to 0.42, P<0.000 01); and e) the incidence rate of bleeding in the trial group was higher than that in the control group (OR=1.53, 95%CI 1.09 to 2.15, P=0.02). ConclusionCompared with routine drugs used alone, tirofiban has better therapeutic effects in non-interventional therapy for Chinese population with NSTE-ACS, but the incidence of bleeding is relatively high.
ObjectiveTo summarize and improve the nursing skills of medication for hemodialysis patients. MethodsWe observed and took nursing measures for adverse medication events in 280 hemodialysis patients treated in our dialysis center from July 2013 to December 2013, and actively prevented all kinds of complications caused by medications. ResultsIn this group of patients, 26 had adverse drug events. Five patients with bleeding after central venous catheter indwelling were cured by changing the dressings. One patient had heparin induced thrombocytopenia, and the complication disappeared after the use of non-heparin hemodialysis. One patient had urokinase allergic reaction, and the complication disappeared by cardio-pulmonary resuscitation. One patient had EPO associated pure red cell aplastic anemia, and the patient did not suffer from it any more by changing the EPO. Two patients with high blood pressure recovered to normal by reducing the use of blood for rHuePO. One had allergic reaction for Iron Dextran Injection and was successfully treated by ICU. Six patients with severe reactive hypoglycemia were corrected quickly by intravenous injection of 50% glucose injection. One patient with adverse reaction to levocarnitine was cured by lowering the frequency of medication to one time per week. Two patients had flu-like symptoms after the use of biological agents were cured by stoppage of the medicine. ConclusionAdverse drug effect should be carefully observed, and patients' education and nursing skills of medical workers should be improved to ensure the medication safety of hemodialysis patients.