2013 Volume 15 Issue 6 Published: 28 December 2013
  

  • Select all
    |
  • Efficacy and safety of sitagliptin in patients with type 2 diabetes mellitus: a meta-analysis
    WAN Li-yan;ZHANG Ce;GUO Wei-hong;CUI Jian;LI Hong-mei
    2013, 15(6): 306-8.
    Abstract ( ) PDF ( )
    ObjectiveTo assess the efficacy and safety of sitagliptin in patients with type 2 diabetes mellitus.MethodsPubMed, Embase, the Cochrane Library, and Wanfang Database was searched by using “sitagliptin” as keyword. Randomized controlled trials (RCT), whose endpoints were the level of glycosylated hemoglobin lower than 7% and adverse reactions rates, of sitagliptin in the patients with type 2 diabetes mellitus were collected. The qualities of the RCT which could accord with inclusion criteria were evaluated. The related information was selected and statistically analyzed with RevMan 5.2 software and the odds ratio (OR) and 95% confidence intervals (CI) were calculated.ResultsA total of 25 RCT were entered. Meta-analysis showed the control rate of glycosylated hemoglobin lower than 7% of sitagliptin is better than that of placebo (OR=3.02, 95%CI: 2.48 to 3.67, P=0.00) , worse than that of thiazolidinedione (OR=0.60, 95%CI: 0.41 to 0.88, P=0.01) , and similar to that of merformin (OR=078, 95%CI: 0.51 to 1.19, P=0.25) , glucagon-like peptide (GLP-1) receptor agonists (OR=0.53, 95%CI: 0.15 to 1.92, P=0.34), and sulfonylureas (OR=0.93, 95%CI: 0.58 to 1.48, P=0.76). The adverse reactions rates of sitagliptin was similar with that of placebo (OR=1.11, 95%CI: 0.89 to 1.39, P=0.33) and lower than that of merformin (OR=0.42, 95%CI: 0.32 to 0.55, P=0.00), thiazolidinedione (OR=065, 95%CI: 0.45 to 0.94, P=0.02), GLP-1 receptor agonists (OR=0.45, 95%CI: 024 to 0.83, P=001), and sulfonylureas (OR=0.38, 95%CI: 0.32 to 0.47, P=0.00).ConclusionSitagliptin was effective in lowering the glycosylated hemoglobin level in the patients with type 2 diabetes mellitus and the adverse reaction rate of sitagliptin was lower than those of other antidiabetic drugs.
  • Dipeptidyl-peptidase Ⅳ inhibitors for treatment of type 2 diabetes mellitus: an overview of systematic reviews
    ZHAN Mei;YIN Xi;XU Ting
    2013, 15(6): 314-6.
    Abstract ( ) PDF ( )
    ObjectiveTo evaluate the efficacy and safety of dipeptidyl-peptidase Ⅳ (DPP-4) inhibitors for treatment of type 2 diabetes mellitus.MethodsThe Cochrane Library, PubMed, Embase, Science Citation Index, the Chinese Journal Full-text Database, Chinese Scientific and Technical Periodicals Database, Chinese Biomedical Literature Database, and Wanfang Database were searched from the inception to August 2013. The key words were sitagliptin, vildagliptin, saxagliptin, linagliptin, alogliptin, dipeptidyl-peptidase Ⅳ, systematic reviews, and meta-analysis. According to the inclusion and exclusion criteria, articles for systematic reviews and meta-analysis were selected. Their methodological qualities were evaluated using QQAQ scale and the data were analyzed using descriptive analysis. The main outcomes included the changes in hemoglobin A1c (HbA1c) and homeostasis model assessment of β-cell index (HOMA-β) and incidence of adverse events.ResultsA total of 18 articles were entered in this study. Of them, scores of methodological quality in 89 percent of articles (16 articles) were 6.0-7.0. The effects of DPP-4 inhibitors on HbA1c levels in patients with type 2 diabetes mellitus were evaluated in thirteen articles. The effects of sitagliptin, vildagliptin, saxagliptin, and linagliptin on HbA1c reduction were better than those of the placeboes, but the conclusions were controversial with other oral hypoglycemic drugs. The effects of DPP-4 inhibitors on HOMA-β levels in patients with type 2 diabetes mellitus were evaluated in five articles. Sitagliptin, vildagliptin, and saxagliptin could significantly improve HOMA-β levels compared with the placeboes. The effect of sitagliptin on HOMA-β level improvement was not better than other oral antidiabetic drugs. The incidences of adverse events during the DPP-4 treatments were evaluated in 14 articles. The differences in the incidences of adverse events and hypoglycemia between the treatments with sitagliptin, vildagliptin, saxagliptin, linagliptin and the placeboes were not statistically significant. The incidences of hypoglycemia in treatment with sitagliptin and vidagliptin were lower than those with other oral hypoglycemic drugs. ConclusionDPP-4 inhibitors could control effectively the blood glucose in patients with type 2 diabetes mellitus and the short-term safety was good.
  • Quality analysis of adverse drug reactions reports from Affiliated Hospital of Guiyang Medical College in 2008 to 2012
    YANG Ji-hong;SONG Qi-wen;ZHENG Zhi-chang;SUN Wei-min;CHENG Ming-liang
    2013, 15(6): 320-5.
    Abstract ( ) PDF ( )
    ObjectiveTo analyze existing problems and countermeasures during the reporting work of hospital adverse drug reaction(ADR).MethodsADR reports which were reported by Affiliated Hospital of Guiyang Medical College during the period from January 2008 to December 2012 and received by National Center for ADR Monitoring were collected. Analysis was made to see whether these ADR reports could meet the requirement of “An ADR case” published by National Health and Family Planning Commission in 2011. The monitoring period of drug (new drugs) and outside monitoring period of drug (older drugs) were calculated on approval number respectively listing <5 and ≥5 years.ResultsFour hundred and eighty-five ADR reports were collected. Of them, 242 cases (49.9%) were received from 2012 and 243 cases (50.1%) were received from 2008 to 2011. Significantly increasing ADR reports in number was associated with the implementation of ADR reporting quantitative measures in Guiyang since 2012. Of the 485 ADR reports, there were 107 cases (22.1%) in accordance with the reporting requirement including 22 cases caused by new drugs and 85 cases of new and serious ADR caused by old drugs. The 22 cases caused by new drugs, involving 18 kinds of new drugs, included 5 cases of serious ADR reports and 17 cases of general ADR reports. Old drug-induced ADR reports were 463 cases involving 384 kinds of drugs and, of them, there were 85 cases (18.4%) in accordance with the reporting requirement including 9 cases of new ADR reports and 76 cases of serious ADR reports.ConclusionsThe main existing problem during the reporting work of hospital ADR is low quality of ADR reports. Implementation of ADR reporting quantitative measures played a limited role in improving the reports quality. Subdividing the definition of ADR, making reporting scope clear, perfecting reporting system, implementing feasible institution of new drugs monitoring, and improving reports quality and their usable value are suggested.
  • Bibliometric study on visual disturbance due to voriconazole
    WANG Dong;CAO Jiang;JIANG Xue-wei;BAI Nan;WEN Ke;ZHANG Yong;WANG Jin;WANG Rui
    2013, 15(6): 325-5.
    Abstract ( ) PDF ( )
    ObjectiveTo investigate the research progress and clinical and pathological characteristics of visual disturbances due to voriconazole, in order to provide a reference for clinical safety use of voriconazole.Methods“Voriconazole” or “vfend” + characterized word of visual disturbances, “voriconazole” + “adverse reactions” were selected as the keywords and PubMed, Embase, Web of Science, CNKI and Chinese Medical Citation Index were searched. All literatures about visual disturbances due to voriconazole were selected. The evaluated databases of literatures accepted for bibliometric study was established by Microsoft Excel. The indexes of bibliometrics such as published time of literature, literature′s type, the first author′s country and institution, loaded media, number of papers and citation rates were recorded and analyzed. The clinical and pathological parameters of visual disturbances due to voriconazole such as clinical manifestations, degree of severity, prognosis, mechanism, prevention and treatment were recorded and analyzed.ResultsA total of 119 articles (92 in English and 27 in Chinese) were enrolled in the study, of which 61 were original articles, 36 reviews, 17 case reports, and 5 conference papers. The publication time of first original publication of visual disturbances due to voriconazole in abroad and China were 1999 and 2008, respectively. The area distribution of the first authors of 92 English articles were Europe (33 pieces, 359%), North America (27 pieces, 30.4%), Asia (26 pieces, 28.3%), Oceania (5 pieces, 54%) and South America (1 piece, 1.1%), respectively. The highest cited rates of English and Chinese article were 1542 and 17 times, respectively. Visual disturbances due to voriconazole usually occurred in the first week after administration. Intravenous administration was more easily lead to visual disturbance than oral administration. The main clinical manifestations of visual disturbance were visual disturbances, involuntary vision disorder, visual impairment, visual abnormalities, color change and light flash. Most patients′ vision could recover within 1 to 3 days spontaneously. The mechanism of visual disturbances due to voriconazole might be related to the dysfunction of rod and cone type optical nerve bipolar cells.ConclusionsEurope and Unite State are ahead of China in the research on visual disturbance due to voriconazole. Visual disturbances due to voriconazole is transient and reversible. Voriconazole is relatively safe in clinical practice.
  • Preliminary study on the identification of poisonous mushrooms and confusable edible mushrooms
    XIE Li-jing;TANG Li-ping
    2013, 15(6): 330-6.
    Abstract ( ) PDF ( )
    ObjectiveTo explore whether it would be possible to distinguish the poisonous mushrooms and the confusable edible mushrooms by visualized method and provide the basis for prevention and treatment of mushroom poisoning.MethodsThe types of dangerous poisonous mushrooms were confirmed by literature and experts′ opinions. The macroscopical morphological features were compared between the common poisonous mushrooms and the edible mushrooms. The specimens of mushroom were field-collected and the macroscopical and microcosmic features were identified by traditional morphological method. The visualized identification methods of poisonous mushrooms reported in literature, books and periodicals, and circulated among the people were tested and verified with examples.ResultsFifteen kinds of common and dangerous poisonous mushrooms were selected preliminarily. The macroscopical morphological features were compared between the common poisonous mushrooms and the confusable edible mushrooms according to the professional books, literature and the experience. The results of the above-mentioned comparison proved that it was impossible to distinguish the poisonous mushrooms and the confusable edible mushrooms according to macroscopical morphological features only. The traditional morphological features (including both macroscopical and microcosmic features) of 12 kinds of field-collected mushroom species were identified. The results showed that the identification of mushroom′s type must be completed by the taxonomic professionals according to the macroscopical and microcosmic features. The results of verification showed that none of the 6 kinds of visualized methods which were widely circulated could be used as general identification method of poisonous mushrooms. ConclusionsThere is no simple and general visualized identification method for poisonous mushrooms at present. The stress of control poisonous mushrooms poisoning should be put on the study of identifying technique and the correction of misunderstanding in identification of poisonous mushrooms.
  • Target and mechanism of cardiotoxicity of recombinant human endostatin
    QIN Jing;QIAN Xin-yu;LI Ai-min;LUO Rong-cheng
    2013, 15(6): 336-6.
    Abstract ( ) PDF ( )
    ObjectiveTo explore the target and mechanisms of the cardiotoxicity of recombinant human endostatin (endostar).MethodsThe myocardial cell line H9c2 was used as subjects and the following tests were performed. (1) H9c2 cells were divided into the control group (without drug intervention), intervened groups including 100, 200, and 400 μg/ml endostar co-cultured for 24 h or 48 h, respectively. The apoptosis rate of H9c2 cells in different groups were detected by flow cytometry. (2) The H9c2 cells were divided into the control group and the intervened group of 400 μg/ml endostar co-cultured for 24 h. The changes of ultrastructure of cells were observed by transmission electron microscope. (3) The H9c2 cells were divided into the control group and the intervened groups including 100, 200, and 400 μg/ml endostar co-cultured for 18 h, respectively. The mitochondrial membrane potential was recorded by JC-1 fluorescence probe. (4) The H9c2 cells were divided into the control group and the intervened group of 400 μg/ml endostar co-cultured for 24 h. The release condition of cytochrome C were observed by method of immunocytochemistry. (5) The H9c2 cells were divided into the control group and the intervened groups including 100, 200, and 400 μg/ml endostar co-cultured for 24 h, respectively. The ADP/ATP ratio was detected by the method of chemiluminescence.Results(1) The apoptotic rate of 200 μg/ml endostar co-cultured for 24 h group and the 400 μg/ml endostar co-cultured for 24 h and 48 h groups were higher than that in the control group ［24 h:(16.34±3.72)%, (27.03±3.91)% vs.(6.99±1.72)%; 48 h:(24.89±477)% vs.(6.44±1.81)%; all P＜0.01］. The apoptotic rate of the 200 μg/ml endostar co-cultured for 24 h group was higher than that in the endostar co-cultured for 48 h group［(16.34+3.72)% vs.(11.34±309)%, P＜0.01］. (2) The H9c2 cells′ ultrastructure of control group presented normal. The H9c2 cells in the group of 400 μg/ml endostar co-cultured for 24 h showed pyknotic and fragmental in nuclei, the massed chromatin, intracellular vacuoles, dilation of endoplasmic reticulum, mitochondrial swelling, and appearance of apoptotic body. (3) Compared with the control group, the degree of depolarization of mitochondrial transmembrane potential decreased following of the increasing concentration of endostar in 100, 200, and 400 μg/ml endostar intervened groups. (4) Cytochrome C of the H9c2 cells in the control group mainly distributed in the mitochondria. Cytochrome C of the H9c2 cells in the group of 400 μg/ml endostar co-cultured for 24 h were released from mitochondria to the cytoplasm. (5) ADP/ATP ratio of H9c2 cells in the 200 μg and 400 μg/ml endostar groups were significantly higher than those in the control group(1.14±0.11, 1.31±0.18 vs. 0.98±0.09, all P＜0.01). ConclusionsCardiomyocyte mitochondria may be the target of the cardiotoxicity of endostar. The cardiomyocyte apoptosis evoked via the mitochondrial-dependent pathway is one of the mechanism of myocardial damage.
  • Dipeptidyl-peptidase Ⅳ inhibitors and acute pancreatitis
    LEI Zhao-bao
    2013, 15(6): 342-4.
    Abstract ( ) PDF ( )
    Dipeptidyl-peptidase Ⅳ (DPP-4) inhibitors are a new class of oral hypoglycemic drugs. These drugs can effectively reduce glycated hemoglobin, as well as have a good tolerability and safety. Acute pancreatitis is a rare, but serious adverse reaction of DPP-4 inhibitors. The latent period of DPP-4 inhibitor induced acute pancreatitis is from 14 to 515 days. The symptom includes abdominal pain, and laboratory examination showed that serum amylase, lipase and elastase levels are markedly elevated. The pathological examination showed diffuse edema and necrosis of pancreas and peripancreatic tissue. The mechanism of DPP-4 inhibitors induced acute pancreatitis mainly relates to the allergy and direct toxicity of the drugs or metabolite to pancreas. DPP-4 inhibitor should be used with caution in patients with a history of pancreatitis. Closely monitoring the clinical presentations and the levels of serum amylase, lipase and elastase during treatment with DPP-4 inhibitors is the effective measure to prevent the occurrence and development of acute pancreatitis.
  • Research progress on therapy for extravasation due to chemotherapy drugs for cancer
    XU Yan-gui
    2013, 15(6): 346-4.
    Abstract ( ) PDF ( )
    Extravasation of chemotherapy drugs for cancer could lead to local skin swelling, burning pain, vesicle, phlebitis, and even tissue necrosis. Moreover, surgical debridement and skin-grafting were needed for serious patients. The degree of injury generally includes local inflammatory response phase, venous inflammatory response phase, and tissue necrosis phase. According to the degree of irritation of issue after extravasation, the chemotherapy drugs could be divided into vesicants, stimulants, and non-stimulants. The drug should be stopped immediately once extravasation occurred. Moreover, aspirating endovascular and extravascular drug and early therapy containing cold compress, fomentation, and wet compress with drug should be given to avoid much serious complications. The important measures of preventing extravasation due to chemotherapy drugs for cancer include strengthening safe medication education for patients and their families and mastering correct method of drug use.
  • Acute pancreatitis after administration of sitagliptin
    CAO Fang;WANG Jing-wen;CHANG Ying;WANG Lei;QIAO Yi;WEN Ai-dong
    2013, 15(6): 350-2.
    Abstract ( ) PDF ( )
    A 58-year-old female patient with type 2 diabetes mellitus treated with metformin hydrochloride (0.5 g twice daily)and insulin (subcutaneous of injection insulin 8、8、10 U before three meals respectively and subcutaneous injection of insulin glargine 8 U before sleep). Sitagliptin 100 mg once daily was added to her regimen due to unsatisfactory efficacy. Three weeks later, the patients felt nausea, vomiting and abdominal pain. Laboratory examination showed a serum amylase value of 267 U/L and urine amylase value of 933 U/L. Abdominal ultrasonography revealed seroperitoneum. She was diagnosed as having acute pancreatitis. Sitagliptin and metformin hydrochloride were withdrawn and insulin was continued. Symptomatic treatment such as acid suppression, inhibition of digestive enzyme and fluid supplement were given. Six days later, the patient′s condition improved, the levels of serum amylase and urine amylase were 76 U/L and 288 U/L, respectively.
  • Paroxetine-induced hyponatremia in an elderly patient
    HUANG Yu-ming;QIN Kai-yu;ZHAN Han-qiu;Qi Yan-yun;XU Dong-mei;JIANG Mei-juan;XUE Cheng-lian;GAO Jun-hua;ZHANG Lei
    2013, 15(6): 351-2.
    Abstract ( ) PDF ( )
    A 67-year-old male patient with cerebral infarction and depression received paroxetine 20 mg once daily. Five days later, the patient developed fatigue, apathy and loss of appetite. Laboratory test showed a serum sodium level of 128 mmol/L. His serum sodium level was 136 mmol/L before paroxetine therapy. Paroxetine was discontinued and changed to flupentixol and melitracen, and oral saline was administered. One week later, the level of serum sodium returned to 134 mmol/L and his clinical symptoms were improved. One month later, his serum sodium level was 142 mmol/L.
  • Antisynthetase syndrome suspected as drug-induced myopathy: a case report
    WANG Xue-mei;ZHAO Hong;ZHANG Jun-xia;YANG Ya-jun;CAI Feng-xia;XIE Wen;CAI Hao-dong
    2013, 15(6): 353-2.
    Abstract ( ) PDF ( )
    A 42-year-old man with chronic hepatitis B was treated with combined use of lamivudine 100 mg once daily and adefovir dipivoxil 10 mg once daily. After a month the patient developed muscle aches in his extremities, asthenia and edema in his lower extremities. Laboratory tests showed that creatine kinase and myoglobin were 9368 U/L and ＞4317 μg/L, respectively. Electromyography indicated a myogenic lesion of right deltoid muscle. Rhabdomyolysis was suspected. Lamivudine and adefovir dipivoxil were stopped. The creatine kinase levels decreased and symptoms of muscular weakness improved. One year later, the patient had recurred edema in his lower extremities, abdominal distension and intermittent fever. Creatine kinase and myoglobin were 5546 U/L and ＞1200 μg/L, anti-Jo-1 antibody was positive. The patient was diagnosed with polymyositis and antisynthetase syndrome. He was given treatment with liver-protective, diuretics and neurotrophic agents. Two weeks later, he was given entecavir 0.5 mg once daily. Two months later, he was given glucocorticoid treatment. One month later, the muscle aches and asthenia improved, and his creatine kinase levels dropped to normal.
  • Anaphylactic shock due to ketorolac tromethamine injection
    WANG Xiao-jun;ZHAN Wei-hua;ZHENG Zao-qian
    2013, 15(6): 355-1.
    Abstract ( ) PDF ( )
    A male patient aged 26 years received intramuscular infusion of ketorolac tromethamine 30 mg for abdominal pain. About 5 minutes after injection finish, the patient felt dizziness and weakness. Meanwhile, he developed generalised sweating and syncope. His blood pressure was 65/40 mm Hg and heart rate was 108 beats/min. He was immediately given oxygen inhalation, intravenous infusion of epinephrine, dexamethasone, and metaraminol, and intramuscular promethazine. About 30 minutes later, the patient came to his senses and his symptoms gradually improved with a blood pressure of 105/75 mm Hg and a heart rate of 80 beats/min. Thereafter, no discomfort recurred
  • Cefamandole-induced multiple organ failure
    HE Li-en;QIU Zhi-hong;DONG Zhan-jun
    2013, 15(6): 356-2.
    Abstract ( ) PDF ( )
    A 72-year-old woman received an IV infusion of cefamandole 2.0 g for preventing infection after colonoscopic polypectomy. Two hours after infusion completion, the patient presented with severe abdominal pain and the symptom did not relieve after spasmolysis. At the next 11∶ 00 am, she suddenly developed hypotension (the minimum level of 80/50 mm Hg) and elevated heart rate. Treatments for raising blood pressure and supplying blood volume were given immediately. At 12∶ 30 am, an IV infusion of cefamandole 2.0 g was given again and, after infusion completion, she developed shock and a low blood pressure of 70/30 mm Hg. And she experienced gradually acute kidney injury, acute pulmonary edema, left heart dysfunction, liver damage, hypocytosis, coagulation disorders, and disseminated intravascular coagulation. The patient was admitted to intensive care unit and, after two-week resuscitation, her condition improved. Two months later, her hepatic function, coagulation function, and blood cells returned to normal except abnormal renal function ( a serum creatinine level of 165 μmol/L and a urea nitrogen level of 9.1 mmol/L ).
  • Erythema multiforme-type drug eruption induced by cattle encephalon glycoside and ignotin injection
    ZHANG Ai-wu;WANG Yi
    2013, 15(6): 357-2.
    Abstract ( ) PDF ( )
    A 60-year-old female patient with hypetension received an IV infusion of cattle encephalon glycoside and ignotin injection 6 ml in 0.9% sodium chloride injection 250 ml for fluctuation of blood pressure, dizziness, numbness of the limbs, and blurred vision. About 30 minutes later, the patient developed skin pruritus, red and swollen eyelids, red papules in her chest, urticaria rashes in her head and neck, and chest tightness. The infusion was immediately stopped and symptomatic treatment was given. The next day, her symptoms of skin worsened and gradually developed into erythema multiforme-type drug eruption. An IV infusion of dexamethasone, vitamin C, and calcium gluconate, oral levocetirizine, and calamine lotion for topical application were given for 10 days. And then her erythema completely subsided.
  • Acute laryngeal edema induced by diatrizoate meglumine in a patient after kidney transplantation
    LI Xiang;XU Liang;CAI Ming
    2013, 15(6): 359-2.
    Abstract ( ) PDF ( )
    A 29-year-old male patient after kidney transplantation underwent enhanced CT examination for the transplant renal dysfunction and received intravenous diatrizoate meglumine injection 20 ml (12 g ). Twelve hours later, the patient developed illness and more secretion in throat followed by slight neck swelling. Twenty hours later, his symptom aggravated and dyspnea, dysphagia, and hoarseness appeared. Physical examination showed obvious neck swelling and enlargement and slight generalized edema. Intravenous dexamethasone 10 mg and aerosol inhalation of budesonide 1 mg were given immediately and, in the meantime, he underwent electrocardiographic monitoring and oxygen inhalation. About four hours later, his condition improved and, two days later, the anaphylactic symptoms disappeared.
Office
Journal
Download
More...
Link
More...