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find Author "LI Ling" 48 results
  • Correlation between Polymorphism in Exon-4 of PC-1 Gene and Type 2 Diabetes Mellitus in Chinese Population: A Meta-Analysis

    Objective To systematically evaluate the correlation between type 2 diabetes mellitus (T2DM) in Chinese population and K121Q polymorphism in exon-4 of plasma cell glycoprotrin-1 (PC-1) gene. Methods The following databases such as CNKI, VIP, CBM, PubMed, EMbase, The Cochrane Library (Issue 3, 2012) and WanFang Data were searched to collect case-control studies on the correlation between T2DM and K121Q polymorphism in exon-4 of PC-1 gene. The retrieval time was from 1980 to 2012. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data and assessed the quality. Then the meta-analysis was conducted by using RevMan 5.0 and Stata 12.0 software, and the publication bias was analyzed by means of Egger’s linear regression. Results A total of 11 studies involving 1 637 T2DM patients and 1 730 healthy volunteers were included. The results of meta-analyses showed that, for Chinese population, the risk of T2DM was higher in those with K/Q genotype than K/K genotype (OR=1.84, 95%CI 1.19 to 2.85, P=0.006), in Q/Q+K/Q genotype than K/K genotype (OR=1.92, 95%CI 1.18 to 3.14, P=0.009), and also in allele Q than allele K (OR=1.83, 95%CI 1.16 to 2.89, P=0.010). Conclusion The K121Q polymorphism in exon-4 of PC-1 gene in Chinese population is significantly associated with T2DM. For the quantity and quality limitation of the included studies, this conclusion has to be further proved by more studies.

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  • Evidence-Based Medicine: Quality, Method, Translation and Innovation ——Theme of the 6th Asia-Pacific Conference on EBM

    Release date:2016-09-07 11:12 Export PDF Favorites Scan
  • Correlation between gender and long-term prognosis of patients with type B acute aortic dissection after endovascular therapy

    Objective To explore the correlation between gender and long-term prognosis of patients with type-B acute aortic dissection (AAD) after endovascular therapy (EVT). Methods From January to December 2012, all patients with type-B AAD undergoing EVT were enrolled by retrospective and observational study. They were divided into male and female groups. Kaplan-Meier analysis was used to analyze the correlation between gender and the cumulative survival rate. Results A total of 131 tyep-B AAD patients who had undergone EVT were selected, including 97 males (74.0%), and 34 females (26.0%). The medium follow-up duration was 2.1 years. Smoking history, cholesterol, white blood cell count, hemoglobin, creatinine and uric acid of the patients in males were higher than those in females (P<0.05); while the difference in other indexes were not significant (P>0.05). The inhospital mortality of male patients was 10 (10.3%), and was 3 (8.8%) in female patients; there was no significant difference between the two groups (P=0.803). Kaplan-Meier analysis showed that there was no significant difference in cumulative survival rate between the two groups (84.5% vs. 82.4%; Logrank test χ2=0.023, P=0.880). Conclusion No correlation between gender and long-term prognosis in patients with type-B AAD after EVT is found.

    Release date:2017-06-22 02:01 Export PDF Favorites Scan
  • Prospects and challenges of exosomes as drug delivery systems

    Exosomes are nanoscale vectors with a diameter of 30~100 nm secreted by living cells, and they are important media for intercellular communication. Recent studies have demonstrated that exosomes can not only serve as biomarkers for diagnosis, but also have great potential as natural drug delivery vectors. Exosomes can be loaded with therapeutic cargos, including small molecules, proteins, and oligonucleotides. Meanwhile, the unique biological compatibility, high stability, and tumor targeting of exosomes make them attractive in future tumor therapy. Though exosomes can effectively deliver bioactive materials to receptor cells, there is a wide gap between our current understanding of exosomes and their application as ideal drug delivery systems. In this review, we will briefly introduce the function and composition of exosomes, and mainly summarize the potential advantages and challenges of exosomes as drug carriers. Finally, this review is expected to provide new ideas for the development of exosome-based drug delivery systems.

    Release date:2020-10-20 05:56 Export PDF Favorites Scan
  • Research progress of different types of stem cells in treatment of ischemic stroke

    ObjectiveTo review the recent research progress of different types of stem cells in the treatment of ischemic stroke.MethodsBy searching the PubMed database, a systematic review had been carried out for the results of applying different types of stem cells in the treatment of ischemic stroke between 2000 and 2020.ResultsStem cells can be transplanted via intracranial, intravascular, cerebrospinal fluid, and intranasal route in the treatment of ischemic stroke. Paracrine and cell replacement are the two major mechanisms of the therapy. The researches have mainly focused on utilization of neural stem cells, embryonic stem cells, and mesenchymal stem cells. Each has its own advantages and disadvantages in terms of capability of migration, survival rate, and safety. Certain stem cell therapies have completed phase one clinical trial.ConclusionStem cells transplantation is feasible and has a great potential for the treatment of ischemic stroke, albeit that certain obstacles, including the selection of stem cells, transplantation strategy, migration ability, survival rate, still wait to be solved.

    Release date:2021-01-29 03:56 Export PDF Favorites Scan
  • Statistical methods in pragmatic randomized controlled trials (I): addressing non-compliance

    In the study of real-world data, the pragmatic randomized controlled trial can provide the optimal evidence for clinical decisions. Although randomization protects against confounding, post-randomization confounding may still arise due to non-compliance. Traditional intention-to-treat analysis will drift apart from true estimation and lead to deviation of clinical decisions. Meanwhile, the alternative traditional methods would subject to bias and confounding. Thus, new methods are required for revolution, i.e., instrument variable method and modern per-protocol analysis. Our study reviews the defects of traditional methods in pragmatic randomized controlled trials, and then refers to two new methods with a detailed discussion of strengths and weaknesses. We aim to provide researches with insights on choosing the statistical methods for pragmatic trial.

    Release date:2021-02-05 02:57 Export PDF Favorites Scan
  • Path analysis of treatment adherence and its influencing factors in chronic kidney disease patients without dialysis

    ObjectiveTo explore the current status of treatment adherence in patients with chronic kidney disease without dialysis and to analyze its influencing factors.MethodsThe patients who visited the Outpatient Department of Nephrology of West China Hospital of Sichuan University from September to December 2020 were taken as the research objects. Self-designed general information questionnaire, treatment adherence questionnaire, physician-patient communication satisfaction, health information seeking behavior questionnaire, and physician-patient concordance questionnaire were used to investigate, and path analysis was used to explore the influencing factors of treatment adherence.ResultsA total of 203 valid questionnaires were obtained. Treatment adherence score was (21.69±2.42) points, self-reported health status was (2.48±0.91) points, physician-patient concordance was (20.39±2.70) points, physician-patient communication satisfaction was (67.73±5.52) points, and health information seeking behavior was (13.17±2.65) points. Health information seeking behavior (r=0.214, P=0.002), physicians-patient concordance (r=0.494, P<0.001), physician-patient communication satisfaction (r=0.229, P=0.001) were positively correlated with treatment adherence. Self-reported health status was negatively correlated with treatment adherence (r=−0.225, P=0.001). Path analysis showed that physicians-patient concordance was the most influencing factor of treatment adherence (total effect=0.474).ConclusionHealth information-seeking behavior and physicians-patient concordance are important factors affecting treatment adherence in chronic kidney disease patients without dialysis. In order to improve treatment adherence of chronic kidney disease patients, healthcare providers can provide various ways to provide information, which can help make more disease-related health knowledge available to patients. Moreover, healthcare workers should also further explore ways to improve the concordance related to reaching agreement between doctors and patients on medical and treatment options.

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  • Survey of Medical Undergraduates’ Satisfactory Degree to Doctor-Patient Communication Education

    Objective To study the current situation of doctor-patient communication education for medical undergraduates, and meanwhile to analyze the students’ satisfactory degree to communication education and its influencing factors, so as to provide sound suggestions to promote the students’ clinical communication abilities. Methods Using simple sampling, 50% of the students who majored in clinical medicine in grade 2006-2009 in West China Medical School of Sichuan University were selected as respondents. The investigation was conducted by face to face talk with a self-designed questionnaire. The data were input using EpiData 3.0 software and the results were analyzed by SPSS 13.0 software. Results A total of 450 questionnaires were distributed, and 404 were validly retrieved (89.78%). Among the respondents, 74.3% of them were satisfied with the current situation of doctor-patient communication education; 75.7% of them begun to know doctor-patient communication education since the stage of learning basic knowledge; 49.8% of them were trained by means of problem-based-learning (PBL); and 65.5% of them were trained with auxiliary standardized patient (SP). “Grade”, “Gender”, “SP used” and “PBL used” were the main factors affecting the satisfactory degree to current doctor-patient communication education (P=0.029, 0.023, 0.012, and 0.029, respectively). Conclusion The medical undergraduates’ satisfactory degree to current doctor-patient communication education is generally high, but it is also affected by various factors. Although doctor-patient communication education has started early, the training system is still problematic and the teaching resources coverage is limited. So in order to make a further systematic, standardized, overall designed education for students’ cognition and communication skills, the medical colleges should open integrated doctor-patient communication curriculum that combines with both PBL and SP auxiliary teaching methods, and covers all the undergraduate learning stage.

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  • Intervention Effects and Safety of Cardiovascular Polypill for the Relevant Risk Factors of Coronary Heart Disease: A Systematic Review

    Objective To systematically review the intervention effects and safety of cardiovascular polypill for the relevant risk factors of coronary heart disease. Methods The randomized clinical trials (RCTs) on polypill in intervening coronary heart disease were searched in PubMed, CENTRAL, ICTRP, CBM, CNKI, WanFang and VIP from their inception to September 2012. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data, and assessed the methodological quality. Then the analysis was conducted. Results A total of 5 RCTs from overseas were included. The descriptive analysis showed that: a) as for blood pressure, polypill was obviously superior to placebo in reducing SBP and DBP with a significant difference, but it didn’t reveal difference compared to the hypotensive drugs used alone; b) as for serum lipid, polypill was obviously superior to placebo in reducing TC, TG and LDL-C with a significant difference, but there was no difference between polypill and standard drug treatment; c) as for glucose, polypill was obviously superior to placebo in reducing glucose with a significant difference; d) as for adverse reaction, such adverse events as cough, bleeding tendency or gastritis, liver and kidney dysfunction were reported in the included studies; e) as for drug compliance, polypill showed no differences compared with either standard treatment or placebo. Conclusion Polypill has intervention effects on the relevant factors of coronary heart disease, such as hypertension and serum lipid, etc. Due to quantity limitation of the included trials, the above conclusion still needs to be further proved by performing more large scale and high quality studies. For lack of adequate evidence, this review does not recommend polypill as a primary care for cardiovascular disease.

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  • Application of adaptive design in clinical trials

    Due to the competition of new drug research and clinical requirement, speeding up drug development and marketing requires faster and more flexible clinical trial design that meets the ethical requirements. Different adaptive designs have emerged in clinical trials of different stages and purposes, for trial efficiency improvement. Adaptive design is more widely used in the field of oncology. Compared with traditional design, adaptive design is more complicated and requires higher level of methodology from researchers. Therefore, implementing adaptive design requires careful consideration and adequate preparation. This paper aims to summarize the design of adaptive methods used in different trial stages so as to provide reference for clinical research designers and implementers.

    Release date:2020-04-30 02:11 Export PDF Favorites Scan
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