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ObjectiveThis article aims to investigate the association between hypertension and the risk of GSD by conducting a national multicenter study， a systematic review， and a meta-analysis. MethodsThe study was conducted in three stages. In the first stage， subjects were recruited for health examination in four hospitals in Chengdu， Tianjin， Beijing， and Chongqing， China， from 2015 to 2020， and the multivariate logistic regression analysis was used to investigate the association between hypertension and the risk of GSD in each center. In the second stage， Embase， PubMed， Wanfang Data， VIP， and CNKI databases were searched for related studies published up to May 2021， and a meta-analysis was conducted to further verify such association. In the third stage， the random effects model was used for pooled analysis of the results of the multicenter cross-sectional study and the findings of previous literature. ResultsA total of 633 948 participants were enrolled in the cross-sectional study， and the prevalence rate of GSD was 7.844%. The multivariate logistic regression analysis showed that hypertension was positively associated with the risk of GSD（P<0.05）. Subgroup analysis showed that there was no significant difference in the association between hypertension and GSD between individuals with different sexes， ages， and subtypes of GSD. A total of 80 articles were included in the systematic review and the meta-analysis， and the results showed that the risk of GSD was increased by 1.022 times for every 10 mmHg increase in diastolic pressure and 1.014 times for every 10 mmHg increase in systolic pressure. ConclusionHypertension significantly increases the risk of GSD， and the findings of this study will provide a basis for the etiology of GSD and the identification of high-risk groups.
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OBJECTIVE To evalu ate relat ed researches about the cost- benefit of pharmaceutical care in medical institutions with cost- benefit analysis，in order to provide evidence-based basis for related policy decisions and provide methodological reference for the cost- benefit evaluation of pharmaceutical care in the future. METHODS Retrieved from PubMed ，Embase，the Cochrane Library ，CBM，Wanfang database ，VIP and CNKI ，cost-benefit analysis was used to evaluate the researches about the cost-benefit of pharmaceutical care in medical institutions. Two researchers independently screened the research and extracted data according to the “Consolidated Health Economic Evaluation Reporting Standards Checklist ”. The quality of included studies was scored and evaluated systematically. RESULTS A total of 46 studies from 17 countries were included. Most of them came from the United States （21.74％），China（19.57％）and France （8.70％）. Average score of 46 literature was 14.30，of which 1 literature was excellent ，5 literature were good ，25 literature were qualified and 14 literature were unqualified. There were 25 research protocols of prospective study type ；the type of pharmaceutical care involved mostly was pharmaceutical monitoring （60.87％）， followed by prescription review （23.91％），medication reconciliation （8.70％）and outpatient pharmacy （6.52％）were less. The median cost-benefit ratio of pharmaceutical care was 5.05 （3.08，11.28）. CONCLUSIONS Pharmaceutical care shows good economic value ，and pharmacists have played an important role in saving medical resources ，but the design level and report quality of the existing studies need to be improved.
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BackgroundThe present study aim to comprehensively report the epidemiological and clinical characteristics of the COVID-19 patients and to develop a multi-feature fusion model for predicting the critical ill probability. MethodsIt was a retrospective cohort study that incorporating the laboratory-confirmed COVID-19 patients in the Chongqing Public Health Medical Center. The prediction model was constructed with least absolute shrinkage and selection operator (LASSO) logistic regression method and the model was further tested in the validation cohort. The performance was evaluated by the receiver operating curve (ROC), calibration curve and decision curve analysis (DCA). ResultsA total of 217 patients were included in the study. During the treatment, 34 patients were admitted to intensive care unit (ICU) and no developed death. A model incorporating the demographic and clinical characteristics, imaging features and laboratory findings were constructed to predict the critical ill probability and it was proved to have good calibration, discrimination ability and clinic use. ConclusionsThe prevalence of critical ill was relatively high and the model may help the clinicians to identify the patients with high risk for developing the critical ill, thus to conduct timely and targeted treatment to reduce the mortality rate.
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OBJECTIVE：To evaluate the preventive effect of dexmedetomidine （DEX）on adverse drug reactions induced by carboprost tromethamine used in cesarean section ，and to provide evidence-based reference for rational drug use of cesarean section. METHODS：Retrieved from PubMed ，Cochrane library ，Embase，CNKI，CBM，Wanfang database and VIP during inception to June of 2019，randomized controlled trials about DEX （trial group ）versus normal saline （control group ）in the prevention of adverse drug reactions induced by carboprost tromethamine in cesarean section were collected. After data extraction of included literatures and quality evaluation with modified Jadad scale ，Meta-analysis was performed by using Rev Man 5.3 statistical software. RESULTS ：A total of 11 RCTs with 714 patients were included in this study. Results of Meta-analysis showed that the incidence of nausea [OR ＝0.09，95％CI（0.06，0.14），P＜0.000 01]，vomiting [OR ＝0.09，95％CI（0.05，0.15），P＜0.000 01]， facial flushing [OR ＝0.15，95％CI（0.10，0.22），P＜0.000 01]，chest distress [OR ＝0.12，95％CI（0.08，0.18），P＜0.000 01]， hypertension [OR ＝0.06，95％CI（0.04，0.11），P＜0.000 01] and tachycardia [OR ＝0.17，95％CI（0.12，0.25），P＜0.000 01] in trial group were significantly lower than control group ，with statistical significance. CONCLUSIONS ：DEX can reduce adverse drug reactions such as nausea and vomiting caused by carboprost tromethamine used in cesarean section.
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OBJECTIVE：To study the potential ris k of Chinese patent medicine for the treatment of stable chronic obstructive pulmonary disease （COPD），and to provide reference for the safety of clinical drug use. METHODS ：Retrieved from Chinese journal full-text database ，CBM，Wanfang database and VIP ，using“stable”“Chronic obstructive pulmonary disease ”“COPD” “Chinese patent medicine ”as retrieval words ，relative literatures about Chinese patent medicine in the treatment of stable COPD were retrieved ，and retrieval time limitation was from their establishment to Sept. 2019. The type and components of Chinese patent medicine were collected. The potential risk of Chinese patent medicine was analyzed in terms of the contraindications of traditional Chinese medicines ，the interaction between traditional Chinese medicines and chemical medicines ，and its effects on stable COPD with other common chronic diseases. RESULTS ：Eleven related studies covering 29 kinds of Chinese patent medicines for the treatment of stable COPD were included in this study. There were several incompatibility between two Chinese patent medicines containing Aconitum carmichaelii and eleven Chinese patent medicines containing “Pinellia ternata ，Trichosanthes kirilowii ， Bolbostemma paniculatum ，Ampelopsis japonica ，Bletilla striata ”as an ancient rule of traditional Chinese medicine incompatibility “Eighteen antagonisms ”and“Nineteen mutual ”inhibitors. Meanwhile ，it should be avoided that four Chinese patent medicines containing ephedra combined with β2 receptor agonists or theophylline. Moreover ，oral antibiotics and 14 kinds of Chinese patent medicine containing licorice would reduce the curative effect. In addition ，patients with stable COPD who also had hypertension ， hyperlipidemia or diabetes should be careful to use Chinese patent medicines containing ingredients such as Glycyrrhiza uralensis ， A. carmichaelii ，Ephedra sinica ，Citrus aurantium ，Cornus officinalis ，Fritillaria cirrhosa ，Panax ginseng （Panax notoginseng ）. CONCLUSIONS：There are many potential risks （such as combined use ，compatibility）in the use of Chinese patent medicines for stable COPD. It is suggested to comprehensively evaluate the patient ’s previous medical history and medication before using Chinese patent medicines ，so as to provide scientific guide for clinical rational medication.
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OBJECTIVE： To evaluate the clinical efficacy and economics of α-lipoic acid injection alone or combined with Mecobalamin injection versus Mecobalamin injection in the adjunctive treatment of diabetic peripheral neuropathy （DPN）. METHODS： Retrieved from PubMed， Cochrane Library， Embase， CNKI， VIP， CBM and Wanfang database， using “mecobalamin” “α-lipoic acid” and“diabetic peripheral neuropathy”as Chinese retrieval words， “Thioctic acid” “α-lipoic acid” “Methylcobal” “Mecobalamin” “Diabetic peripheral neuropathy” as English retrieval words， relevant randomized controlled trials （RCTs） were collected during the date of database establishment to Aug. 30th， 2018. Meta-analysis was conducted for total response rate. From the perspective of health care providers， cost-effectiveness analysis was used for economic evaluation and sensitivity analysis was conducted by a 15％ fluctuation of cost and total response rate. RESULTS： Totally 13 RCTs were included， involving 1 131 patients. The results of Meta-analysis showed that the total response rate of two-drug combination therapy in the treatment of DPN was higher than that of mecobalamin alone [RR＝1.41， 95％CI（1.28， 1.55）， P＜0.000 01]； that of α-lipoic acid injection alone in the treatment of DPN was higher than that of mecobalamin injection alone [RR＝1.35， 95％CI（1.25，1.47）， P＜0.000 01]， with statistical significance. Results of cost-effectiveness analysis showed that the cost-effectiveness ratio （CER） of Mecobalamin injection was 211.38 yuan， and CER of two-drug combination and α-lipoic acid injection alone were 1 484.42 and 1 383.49 yuan， respectively. The incremental cost-effectiveness ratio （ICER） were 4 589.52 and 4 638.82 yuan， which were all lower than per capita GDP in 2017. Sensitivity analysis showed that the cost-effectiveness analysis results kept stable. CONCLUSIONS： Compared with Mecobalamin injection， α-lipoic acid injection combined with Mecobalamin injection in the adjunctive treatment of DPN show high total response rate and economics.
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OBJECTIVE:To prepare risperidone injectable biodegradable implants and study its in vitro release. METHODS: Polylactide-co-glycolide copolymer(PLGA)was chosen for carrier and N-Methyl pyrolidone(NMP)as solvent to prepare risperidone injectable biodegradable implants. The percentage of accumulative drug release within 30 days,the change in molecular weight of copolymer and superficial opening diameters of copolymer in function time were observed. RESULTS:Drug release curve of risperidone injectable biodegradable implants for 30 days was stable with small burst. The percentage of accumulative drug release was 89.01% and the percentage of burst accounted for 13.8% at the first 24 hours. The average molecular weight of copolymer decreased to about 10 000 from 43 000 after 30 days and the size of the superficial openings became larger and larger. CONCLUSION:Risperidone injectable biodegradable implants can release continuously and stably in vitro for 30 days.