Objective To evaluate the effectiveness and safety of ramelteon for chronic insomnia in adults. Methods The following databases as CENTRAL, PubMed, EMbase, ISI, CNKI, CBMdisc, VIP and WanFang Data were searched from the date of their establishment to November 2010. The randomized controlled trials (RCTs) meeting the inclusion criteria were included. The data extraction and quality assessment were conducted according to the methods of Cochrane Reviewers’ Handbook recommend by The Cochrane Collaboration, and meta-analysis was performed with RevMan5.0 software. Results A total of 5 RCTs involving 1 772 patients were included. The results of meta-analyses showed that: a) Effectiveness: In the effectiveness, ramelteon was superior to placebo in latency to persistent sleep (MD=18.36, 95%CI 11.55 to 25.18, Plt;0.000 01), total sleep time (MD= –15.47, 95%CI –22.50 to –8.43, Plt;0.000 1), sleep efficiency (MD= –3.39, 95%CI –5.32 to –1.46, P=0.000 6), sleep quality (MD=0.14, 95%CI 0.03 to 0.25, P=0.01) after one week treatment and latency to persistent sleep (MD=13.02, 95%CI 6.01 to 20.03, P=0.000 3) except for wake after sleep onset (MD= –8.79, 95%CI –17.24 to –0.35, P=0.04) after one month treatment. b) Safety: significant differences were only found in the female prolactin (MD=5.50, 95%CI 2.02 to 8.98, P=0.002) and male free testosterone (MD=15.30, 95%CI 0.62 to 29.98, P=0.04) between the two groups, rather than in all the other hormones concentration, rebound insomnia, withdrawal syndrome, next-day residual effects and incidence rate of adverse reactions. Conclusion Ramelteon has marked effects on adults’ chronic insomnia after 1-week treatment, but its effect is not obvious after 1-month treatment. The adverse reactions are mostly the somnolence, rising of male free testosterone and female prolactin concentration.
目的：了解2007年成都地区17家医院间心血管系统药物的使用状况。方法：采用限定日剂量(DDD)的方法，对成都地区2007年17家医院中心血管系统用药的销售金额、用药频度(DDDs)等进行统计分析。结果：2007年成都地区17家医院心血管系统用药总金额为13 753.86万元，占所有药物销售总额的9.05%。在金额排序和用药频度排序前列中，主要包括中药制剂、钙离子拮抗剂等，中药制剂类产品也销售状况良好。结论：中药制剂发挥巨大作用，依从性好、不良反应发生率低、疗效确切的药物已成为临床医师治疗心血管疾病的首选。
Objective To assess the effectiveness of exemestane in the treatment of postmenopausal women with breast cancer. Methods We searched The Cochrane Library, PubMed, CBMdisc, and CNKI to identify randomized controlled trials (RCTs) that met the inclusion and exclusion criteria. Two reviewers extracted the data and evaluated the quality of included trials, respectively. Meta-analysis was performed using RevMan 5.0 software. Results A total of 12 RCTs involving 6 166 participants were included, and the results of meta-analyses showed that: (1) When used in neoadjuvant endocrine therapy after operation, exemestane was more effective in progression-free survival than tamoxifen; (2) When used in rescue therapy, exemestane was more effective in objective response than tamoxifen, but not more effective than letrozole or anastrozole; (3) When used in new neoadjuvant endocrine therapy before operation, exemestane was not more effective than letrozole, and there was too little research about it. Conclusions The current evidence shows that exemestane has certain short-term therapeutic effect, but its long-term therapeutic effect is unknown. More high-quality clinical trials are expected for further study.
Objective To evaluate the efficacy and safety of low-dose versus standard-dose cyclosporine immunosuppressive therapy in kidney transplant recipients. Methods We searched MEDLINE, EMbase, SCI, CBM and The Cochrane Library from the establishment to December 2009 to screen randomized controlled trials (RCTs) of low-dose versus standard-dose cyclosporine immunosuppressive therapy in kidney transplant recipients. Quality assessment and meta-analyses were performed for the included studies. Results A total of 6 RCTs involving 1551 patients were identified, among which 4 RCTs were graded A and two were graded B. The meta-analyses indicated that there were no significant differences between the two groups at the end of 6-month and 12-month follow-up in the acute rejection rate at a RR 1.07, 95%CI 0.69 to 1.65 and a RR 1.06, 95%CI 0.71 to 1.57, respectively. There were no significant differences between the two groups at the end of 6-month and 12-month follow-up in the patients’ death rate at a RR 0.64, 95%CI 0.20 to 2.03 and a RR 0.61, 95%CI 0.30 to 1.24, respectively. There were no significant differences between the two groups in renal function and safety. Conclusion Based on the current evidence, compared with standard-dose CsA, low-dose CsA has the same effect and safety for the short-term results, but the long-term results need to be further studied.
目的 评价卡培他滨+伊立替康与氟尿嘧啶/醛氢叶酸（5-FU/LV）+伊立替康治疗转移性结直肠癌的有效性和安全性。 方法 计算机检索PubMed、CENTRAL、Embase、中国生物医学数据库、中国期刊全文数据库、维普数据库和万方数据库，检索时间均从建库至2011年9月。对符合纳入标准的随机对照试验进行质量评价和Meta分析。 结果 纳入3个随机对照试验，共计419例患者，卡培他滨+伊立替康在中位生存期、完全缓解率[RR=1.58，95%CI（0.27，9.11），P=0.61]、部分缓解率[RR=0.86，95%CI（0.68，1.09），P=0.20]、总有效率[RR=0.88，95%CI（0.71，1.09），P=0.26]上表现出与5-FU/LV+伊立替康相似的效果，安全性方面卡培他滨+伊立替康有较高的Ⅲ/Ⅳ级恶心[RR=1.92，95%CI（1.05，3.54），P=0.04]、腹泻[RR=3.23，95%CI（2.14，4.89），P＜0.000 01]发生风险和较低的Ⅲ/Ⅳ级中性粒细胞减少[RR=0.72，95%CI（0.53，0.98），P=0.04]发生风险。 结论 根据当前现有证据，5-FU/LV+伊立替康可能较卡培他滨+伊立替康更为有利于转移性结直肠癌患者的治疗，但仍需结合临床实际情况进行化疗方案的优选。
Objective To assess the effectiveness and safety of Tongxinluo Capsule in the treatment of vertebrobasilar artery insufficiency. Methods The Cochrane Library, MEDLINE, VIP and CNKI were searched. Two authors independently collected data, including randomized controlled trials that met the inclusion criteria. They evaluated the quality of these trials and performed meta-analysis using The Cochrane Collaboration’s RevMan 5.0. Results Eleven studies involving 1157 participants were included. All the included studies were inadequate at reporting randomization, concealment of allocation and blinding. Meta-analysis based on the included studies showed that Tongxinluo Capsule with Danshen was better than Danshen alone in vertebrobasilar artery insufficiency (RR= 1.35, 95%CI 1.24 to 1.48) and blood flow velocity of vertebrobasilar artery (WMD=3.60, 95%CI 2.44 to 4.77 and WMD=3.46, 95%CI 1.89 to 5.04). Tongxinluo Capsule with simple basic therapy was better than simple basic therapy alone in vertebrobasilar artery insufficiency (RR=1.21, 95%CI 1.11 to 1.31) and blood flow velocity of vertebrobasilar artery (WMD=3.85, 95%CI 2.19 to 5.51). Conclusion Tongxinluo Capsule is an effective and safe drug for vertebrobasilar artery insufficiency. However, due to the limited quantity and quality of the included studies, we can not draw a firm conclusion about the effectiveness of Tongxinluo Capsule compared to the simple basic therapy or Danshen. The results suggest that further and larger-scale trials using Tongxinluo Capsule for vertebrobasilar artery insufficiency are needed.