OBJECTIVE:To systematically review the efficacy and safety of escitalopram versus paroxetine in treatment of se-nile patients with depression in China,and provide evidence-based reference for clinical treatment. METHODS:Retrieved from CJFD,VIP,Wanfang database,CBM database,randomized controlled trials(RCT)of escitalopram(test group)versus paroxetine (control group) in the treatment of senile patients with depression in China were collected. After quality evaluation and data ex-tract,Meta-analysis was performed by using Rev Man 4.2 statistics software. RESULTS:A total of 14 RCT were included,involv-ing 1 148 patients. Results of Meta-analysis showed there was no significant difference in the cure rate[OR=1.20,95%CI(0.93, 1.53),P=0.16],significant effective rate[OR=1.23,95%CI(0.94,1.61),P=0.12],the incidences of headache[OR=0.81,95%CI (0.40,1.65),P>0.05],the incidences of tachycardia [OR=0.37,95%CI(0.09,1.52),P>0.05],the incidences of insomnia [OR=1.26,95%CI(0.33,4.82),P>0.05] and the incidences of tremor [OR=0.31,95%CI(0.04,2.24),P>0.05] between test group and control group;the incidences of xerostomia[OR=0.50,95%CI(0.31,0.80),P<0.05],the incidences of nausea[OR=0.49,95%CI (0.36,0.66),P<0.05],the incidences of sweating [OR=0.31,95%CI(0.15,0.62),P<0.05],the incidences of constipation[OR=0.31,95%CI(0.15,0.64),P<0.05],the incidences of dizziness[OR=0.38,95%CI(0.20,0.72),P<0.05] and the incidences of an-orexia[OR=0.45,95%CI(0.21,0.99),P<0.05] in test group were significantly lower than control group,there were significant dif-ferences in 2 groups. CONCLUSIONS:The efficacy of escitalopram and paroxetine is similar in the treatment of senile patients with depression,however,the safety of escitalopram is better than paroxetine. Due to the limit of methodological quality and sam-ple size,it remains to be further verified with more rigorously designed and long-term follow-up of large-scale RCT.

Objective:To evaluate the efficacy and safety of rosuvastatin and atorvastatin in the treatment of the patients with primary hyperlipidemia in China.Methods:The related literatures in CNKI,VIP,Wanfang medicine network,PubMed/MEDLINE,CBM and Chinese dissertations full text database were retrievaled by computer from the establishment time of database to December 31,2015. Two researchers according to the inclusion and exclusion criteria independently selected the studies and extracted the data and assessed the quality of the literatures.The Revman 5.0 software was used to perform Meta analysis of all effect indicators in various groups.Results:A total of 7 randomized controlled trial (RCT)were included,and there was no significant abnormality in bias evaluation. 8 weeks after treatment, the total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C)and high density lipoprotein cholesterol (HDL-C)levels of the patients in 5 mg rosuvastain group and 10 mg atorvastatin group had no significant differences between before and after treatment (P >0.05);the HDL-C levels of the patients in 10 mg rosuvastatin group and 10 mg atorvastatin group had significant differences between before and after treatment (P < 0.05),but the TG,TC,and LDL-C levels had no significant differences (P >0.05);the TG,TC,LDL-C and HDL-C levels of the patients in 5 mg and 10 mg rosuvastatin groups had no significant differences between before and after treatment (P > 0.05).12 weeks after treatment,there were no significant differences in the TC and LDL-C levels between 10 mg rosuvastatin group and 10 mg atorvastatin group (P >0.05),but there were significant differences in the TG and HDL-C levels (P <0.01).The incidence of adverse reactions of the patients in three groups had no significant differences (P >0.05).Conclusion:5 mg rosuvastatin and 10 mg atorvastatin in the treatment of the patients with primary hypercholesterolemia have similar lipid-lowering effect;with the the increase of the treatment time and the dose,10 mg rosuvastatin can obviously reduce the TG level and increase the HDL-C level of the patients,and the incidence of adverse reactions of two kinds of doses of rosuvastatin has no obvious difference.

The hybrid PET/MR has been gradually applied in clinical practice.However,the hybrid PET/MR is a com plex advanced technique,and it brings to the new challenges,especially regarding the workflow and scan protocols.The guidelines for hybrid PET/MR in brain imaging include information related to the indications and contraindications,preparation before examination,procedures of examination (PET imaging,conventional MRI brain imaging and special MRI imaging for brain disease),application of radiopharmaceutical and MRI contrast-enhanced agent.The purpose of the guidelines is to offer a framework that would be practical and helpful for clinical PET/MR brain imaging.In PET tracers,the guidelines only limit to the 18 F-FDG.

Objective To study the value of 18F-fluoro-deoxy-D-glucose positron emission tomography-computed tomography (18F-FDG PET/CT) in diagnosis of patients suspected with gastric malignant tumors. Methods Ten women and fourteen men, with a mean age of (56±15) years (ranged from 28 to 83 years) suspected of gastric malignant tumors were enrolled from May 2007 to July 2007. According to the results of the first time endoscopy and biopsy, patients were divided into gastric cancer group (n=9) and suspected group(n= 15). 18F-FDG PET/CT whole body scan was performed in gastric cancer group for assistant operation and suspected group for further diagnosis. The results of PET/CT for suspected group were all confirmed by the endoscopy later. The final diagnosis was based on pathology and follow-up. The sensitivity, specificity, positive predictive value and negative predictive value of 18F-FDG PET/CT in diagnosis of gastric malignant tumors were analyzed, as well as the tumor staging before operation. Results The malignant tumor was found in 16 out of 24 patients who received 18F-FDG PET/CT scan, including 9 in gastric cancer group and 7 in suspected group. Sixteen tumors originated from stomach,and 1 infiltrated the liver, pancreas and omentum. Liver (1 case) and lung (1 case) metastases were found. Three lesions limited in intestine and 13 had positive lymph nodes. Two patiens in suspected group were not diagnosed by PET/CT, one was negative and the other, who suspected as gastric cancer by PET/CT, was pathologicaly confirmed as benign gastrointestinal stromal tumor. The sensitivity, specificity, positive predictive value and negative predictive value of 18F-FDG PET/CT in diagnosis of gastric malignant tumors were 16/17, 6/7, 16/17 and 6/7, respectively. Six patients of stage Ⅲ and Ⅳ were all detected. Conclusions 18F-FDG PET/CT whole body scan is not only a feasible, safe, noninvasive and promising diagnostic tool in detecting and differentiating gastric cancer from benign tumor, but also can assist the management of disease.

Objective To assess the value of hemofiltration in the prevention of contrast induced nephropathy(CIN) post percutaneous coronary intervention(PCI) in severe chronic kidney disease stages(CKD) patients. Methods We evaluated 30 CKD patients who underwent PCI followed by bedside hemofiltration. We measured serum creatinine levels before PCI, 24 hours, 72 hours, and one week after PCI, and calculated creatinine clearance(CrCl) according to Cockcroft and Gault equation.We observed the incidence of CIN, and the short term clinical efficacy of hemofiltralion. Results The average age of the 30 patients was (72.87 ± 8.71) years old, with 21 (70%) male patients. The stages of CKD among the patients included CKD 3 (3 patients, 10%), CKD 4 (20 patients, 66.7%) and CKD 5 (7 patients, 23.3%). The average duration of hemofiltration was (7.5±4.1) hours. Serum creatinine before PCI, 24 hours, 72 hours and 1 week after PCI was (498.7±143.7)μmol/L, (353.2±128.0)μmol/L, (450.0±132.2)μmol/L, (488.0±145.7)μmol/L respectively,and CrCl was (20.3±10.2) ml/min, (36.5±14.3) ml/min, (28.3±10.4) ml/min, (21.0±10.3) ml/min respectively. There was no CIN. Mean follow-up was (3.1 ± 2.6) months. There was no new cardiovascular events, and no new patients need to rely on long term hemodialysis. Conclusions For patients with severe renal insufficiency, hemofiltration may reduce the incidence of CIN, It is an alternative preventive measures to prevent CIN.

Objective To evaluate the clinical effect of transcatheter closure with Amplatzer duct occluder offers in infants with patent ductus arteriosus(PDA).Methods Thirty-seven PDA infants underwent transcatheter closure of PDA at(8.7 ? 3.3)months and weight of(8.6 ? 3.5)kg.A lateral view aortogram was made to determine the morphology and the narrowest diameter of the ductus and selected the size of the device.Occluder was implanted using the anterograde venous approach.Follow-up evaluations were made with chest X-ray and echocardiogram at 24 hours and 1,6 and 12 months after implantation.Results The narrowest diameter of the ducts measured by angiographically was(3.3 ? 1.5)mm.Ninteen patients(54.29%) achieved immediate complete occlusion.On color Doppler the closure rates at 1 month after implant were 34 cases(97.14%).No residual shunt exsisted in all implanted patients at 6 and 12 months follow-up.Procedure time at(57 ? 43)minutes and fluoroscopy time(23.0?14.9)minutes.Conclusions Percutaneous PDA closure with the Amplatzer duct occluder decice is an safety and effective method for the treatment of PDA in infants,but caution shall be exercised to the anatomic characteristics in the infant age group in solving clinical complications.

Objective To investigate the expression of normal epithelial cell-specific-1(NES1) gene in normal gastric epithelial cells and different gastric cancer cell lines and the effects of 5-aza-2-de- oxycytidine(5-aza-dC)on the expression of NES1 gene.Methods Expression of NES1 mRNA in five gastric cancer cell lines(MKN-28,SGC-7901,AGS,MKN-45 and HGC-27)and normal human gastric epithelial cells were detected by real-time PCR.After treatment with 5-aza-dC,a DNA methyltransferase inhibitor,the expression of NES1 mRNA in gastric cancer cell lines was detected by real-time PCR. DNA methylation status of NES1 gene was assayed by methylation-specific PCR(MSP).Results The expression of NES1 mRNA was decreased in all gastric cancer cell lines.A strong correlation between ex on 3 hypermethylation and loss of NES1 mRNA expression in gastric cancer cell lines was noted.5-aza dC treatment of NES1-nonexpressing tumor cell lines resulted in a dose-dependent induction(SGC-7901, MKN-45,MKN-28 and AGS)and increase (HGC-27) of NES1mRNA expression in gastric cancer cells. Conclusions The study suggested that hypermethylation was a responsible factor for tumor-specific loss of NES1 gene expression in gastric cancer cells.Treatment of gastric cancer cell lines with a demethylating agent led to reexpression of NES1 suggesting an important role of hypermethylation in loss of NES1 gene expression.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Diarrhea ; virology ; Female ; Humans ; Male ; Middle Aged ; Oligonucleotide Array Sequence Analysis ; methods ; Young Adult

Paracetamol was used as a model drug in this study to investigate the synergetic effects of lipid coating and beta-cyclodextrin (beta-CD) inclusion for masking the bitter taste of poorly soluble drugs. To control the concentration as low as possible of the free drug which produced a bitter taste, a kinetic model was established to calculate the drug distribution theoretically among the free drug in medium, lipid coated particles and molecular inclusion on the basis of the preparation and characterization of the lipid microspheres, so as to select the proper amount of beta-CD. Finally, the synergetic drug delivery systems were prepared and characterized by 1H nuclear magnetic resonance (1H NMR), molecular simulation and the electronic tongue. As a result, the drug release rate constant (k) of the lipid microspheres coated with octadecanol was determined as 0.001 270 s(-1). Then, the synergetic drug delivery systems were prepared with the ratio of 6.74 : 1 (w/w) for beta-CD and paracetamol. The chemical shift values for the fingerprint peaks of paracetamol all increased and hydrogen bonds were formed between the oxygen on the phenolic hydroxyl group, the nitrogen on the imino in paracetamol and the hydrogens on the hydroxyl groups in beta-CD. The results tested by the electronic tongue indicated that the paracetamol, lipid microspheres, beta-CD inclusion and their mixture showed different taste characteristics, with the bitterness order of the synergetic drug delivery systems approximately lipid microspheres < beta-CD inclusion < paracetamol, which confirmed the synergetic taste masking effects of lipid coating and beta-CD molecular inclusion. In summary, the synergetic taste masking was jointly achieved through the retard of the drug release by the lipid coating and the inclusion of the free paracetamol by beta-CD through hydrogen bonds.
Acetaminophen ; administration & dosage ; chemistry ; Administration, Oral ; Drug Delivery Systems ; Electrical Equipment and Supplies ; Electrochemical Techniques ; instrumentation ; methods ; Hydrogen Bonding ; Kinetics ; Lipids ; chemistry ; Microspheres ; Solubility ; Taste ; drug effects ; beta-Cyclodextrins ; chemistry

Objective To evaluate the effectiveness of biofeedback in preventing chronic daily headaches. Methods One hundred patients experiencing daily headaches were randomly divided into a biofeedback group ( n=50) and a drug therapy group (n=50). The patients in the drug therapy groupwere administered a predetermined course of medication. Those in the biofeedback group were given 30 minutes of biofeedback therapy twice a week for 8 weeks, followed by 10 months of intensive therapy once a month. The headache frequency, duration of headache at-tacks, days of using acute pain medication and any other adverse events were recorded 3, 6 and 12 months after the treatment. Results The patients in the biofeedback group had significantly less-frequent headaches, shorter headache attacks and fewer days of using acute pain medications. Conclusion Compared to drug therapy, biofeed-back can prevent chronic daily headachesmore safely and effectively.