OBJECTIVE:To make a systematic review on the efficacy and safety of canagliflozin in the treatment of type 2 dia-betes,and to provide evidence-based reference for clinical treatment. METHODS:Retrieved from Cochrane Library,PubMed,EM-Base,CBM and Wanfang database,randomized controlled trials (RCT) of canagliflozin (test group) versus placebo (control group)in the treatment of type 2 diabetes were collected,and Meta-analysis was performed by using Rev Man 5.2 statistical soft-ware after extracting data and evaluating quality. RESULTS:A total of 7 RCTs were included,involving 2 188 patients. The results of Meta analysis indicated that glycosylated hemoglobin levels [WMD=-0.82,95%CI(-0.99,-0.65),P<0.001],the proportion of HbA1c<7%[RR=2.51,95%CI(1.98,3.19),P<0.001],fasting plasma glucose levels [WMD=-32.91,95%CI(-39.65,-26.17), P<0.001] in test group were significantly better than those of control group,the incidence of genital tract infections was significant-ly higher than control group [RR=3.76,95%CI(2.23,6.35),P<0.001];however,compared with control group,there was no sig-nificant difference in the incidence of hypoglycemia [RR=1.13,95%CI(0.40,3.20),P=0.81] and urinary tract infections[RR=1.19,95%CI(0.82,1.73),P=0.36]. CONCLUSIONS:Canagliflozin is safe and effective in the treatment of type 2 diabetes,and it needs to be noticed with genital tract infections during the clinical use. Due to the limitation of methodology,large-scale and poly-centric RCT are required for further validation of the conclusions.

Objective To study the clinical therapeutic effect of combination of Naodekang capsule and western medicine for treatment of patients with mental disorders after bilateral cerebral frontal lobes contusion and laceration.Methods A prospective study was conducted. Sixty-two patients with mental disorders after bilateral frontal lobes contusion and laceration hospitalized from June 2012 to January 2014 in the Department of Neurosurgery in Liangzhou Hospital, Wuwei City, Gansu Province were enrolled. According to random principle, they were divided into combined traditional Chinese and western medicine treatment group (32 cases) and western medicine treatment control group (30 cases). Conventional symptomatic therapy was given to both groups. In the western medicine control group, based on the above conventional treatment, antipsychotic drug risperdal (risperidone) was given, the beginning dosage was 4 mg daily and gradually reduced to 1 mg daily. In combined traditional Chinese and western medicine group, beside the conventional therapy, oral Naodekang capsules and oral risperdal were given. The ingredients of the capsule included: Astragalus 60 g, Radix Paeoniae Rubra 15 g, Rhizoma Chuanxiong 25 g, Angelica 15 g, Earthworm 10 g, Semen Persicae 10 g, Safflower 15 g, Salvia miltiorrhiza 15 g, Rhizoma Gastrodiae 15 g, Uncaria 10 g, Bupleurum 20 g, Pueraria 15 g, Rhizoma Acori Tatarinowii 15 g; the patients took once 3 capsules, three times a day, and risperdal 2 mg per day at the beginning and gradually reduced to 1 mg daily. Before treatment and after treatment for 2, 6 and 12 weeks, the brief psychiatric rating scale (BPRS) score was applied to evaluate the clinical therapeutic effect on the situation of patients' improvement of symptoms; in the two groups, the clinical curative effects were observed and when the psychiatric symptoms were controlled, the mean dosage of antipsychotic western medicine used daily in each patient was calculated.Results After treatment, the BPRS scores in the two groups were lower than those before treatment, from 6 weeks after treatment, the degree of descent in the BPRS score in the combined treatment group was more significant than that in the western medicine group (38.68±7.81 vs. 54.05±6.75,P < 0.05), and the descent was persistent until 12 weeks after treatment (15.46±8.51 vs. 23.98±8.03,P < 0.05). The cure rate of the combined group was markedly higher than that in western medicine group [84.4% (27/32) vs. 76.6% (23/30),P < 0.05]. When the psychiatric symptoms were controlled, the dosage of antipsychotic western drug used in each patient in the combined group was less than that in western medicine group (mg/d: 1.5±0.1 vs. 2.8±0.2,P < 0.05).Conclusion The westernconventional therapy combined with traditional Chinese medicine Naodekang capsule for treatment of mental disorders after bilateral cerebral frontal lobes contusion and laceration has relatively good therapeutic effect.

Objective To observe and analyze the morbidity and risk factors of postoperative delirium in the patients un-dergoing cardiac surgery.Methods From March 2017 to March 2018, 478 patients who need cardiac surgery were selected from our hospital.According to the postoperative results evaluated with Confusion Assessment Method(CAM), they were divid-ed into delirium group(54 patients)and control group(424 patients).Morbidity and risk factors of postoperative delirium were analyzed.Results Delirium occurred in 54 patients of 478 patients and morbidity of postoperative delirium was 11.3％.Psy-chomotor excitement is the most common clinical presentations , followed by attention impairment and a reduced level of con-sciousnes.Single factor analysis result showed that delirium was associated with advanced age (≥65 years) , hypertension, pre-vious cerebral vascular event(previous cerebral infarction, previous brain heamorhage), intraoperative blood loss, mechanical ventilation time, intensive care unit duration time.The multiple-logistic regression analysis indicated that the perioperative risk factors of delirium included advanced age, cerebrovascular accident history and ICU duration time.Conclusion The patients with advanced age, hypertension, previous cerebral vascular event(previous cerebral infarction, previous brain heamorhage) are the high risk groups for delirium after cardiac surgery.Advanced age, hypertension, previous cerebral vascular event(previ-ous cerebral infarction, previous brain heamorhage) are risk factors for delirium in patients undergoing cardiac surgery.