Objectives To assess the efficacy and safety of statins for adult osteoporosis. Methods We electronically searched The Cochrane Library (Issue 4, 2007), MEDLINE (1990 to November 2007), EMBASE (1990 to November 2007), Current Controlled Trials, The National Research Register, CBM (1990 to November 2007), VIP (1990 to November 2007) and CNKI (1990 to November 2007). We also handsearched some related journals and identified randomized controlled trials of statins versus placebo in adults with osteoporosis. Results Two randomized controlled trials were included. We didn’t perform meta-analysis due to heterogeneity. No significant differences were observed in the changes of bone density at the lumbar spine and total hip from baseline between statins and placebo. However, a significant increase in bone density was found in response to simvastatin at the forearm. Biochemical markers of bone metabolism changes from baseline did not differ significantly between statins and placebo groups. Conclusions The evidence currently available does not support the use of statins in the treatment of osteoporosis. Further randomized, double-blind, placebo-controlled trials are needed in order to define the efficacy and acceptability of statins in the treatment of osteoporosis.
Rheumatoid arthritis is a chronic inflammatory disorder. It is characterized by a chronic polyarthritis that primarily affects the peripheral joints and related periarticular tissues. To a patient with rheumatoid arthritis, we searched the evidence and indentified the best available therapy for him: ① Ibuprofen was used to relieve pain. ② Methopterin ivgtt qw and oral methopterin after the discharge for 12 months. ③ Oral omeprazole 20 mg/d to prevent peptic ulcear. ④ Administration with fish oil and physical exercises after discharge were recommended.
This study aimed to investigate the effect of curcumin (Cur) against human cytomegalovirus (HCMV) in vitro. Human embryonic lung fibroblasts were cultured in vitro. The tetrazolium salt (MTS) method was used to detect the effects of Cur on cell viability. The cells were divided into control group, HCMV group, HCMV + (PFA) group and HCMV + Cur group in this study. The cytopathic effect (CPE) of each group was observed by plaque test, then the copy number of HCMV DNA in each group was detected by quantitative polymerase chain reaction (qPCR), and the expression of HCMV proteins in different sequence was detected by Western blot. The results showed that when the concentration of Cur was not higher than 15 μmol/L, there was no significant change in cell growth and viability in the Cur group compared with the control group (P>0.05). After the cells were infected by HCMV for 5 d, the cells began to show CPE, and the number of plaques increased with time. Pretreatment with Cur significantly reduced CPE in a dose-dependent manner. After the cells were infected by HCMV, the DNA copy number and protein expression gradually increased in a time-dependent manner. Pretreatment with Cur significantly inhibited HCMV DNA copies and downregulate HCMV protein expression levels in a concentration-dependent manner, and the difference was statistically significant (P<0.05). In conclusion, Cur may exert anti-HCMV activity by inhibiting the replication of HCMV DNA and down-regulating the expression levels of different sequence proteins of HCMV. This study provides a new experimental basis for the development of anti-HCMV infectious drugs.
ObjectivesTo systematically review the efficacy of intra-articular injection of sodium hyaluronate for kashin-beck disease. MethodsDatabases including PubMed, EMbase, The Cochrane Library (Issue 1, 2016), CBM, VIP, WanFang Data, and CNKI were electronically searched from inception to January 2016 to collect randomized controlled trials (RCTs) about sodium hyaluronate in the treatment of kashin-beck disease. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then meta-analysis was performed by using RevMan 5.3 software. ResultsA total of 6 RCTs involving 1 276 patients were included. The result of metaanalysis suggested that the sodium hyaluronate group was significantly superior to the control group in clinical effect (OR=5.89, 95% CI 4.10 to 8.47, P < 0.000 01) and the Lequesne index (SMD=-1.66, 95% CI-2.14 to-1.13, P < 0.000 01). ConclusionIntra-articular injection of sodium hyaluronate is helpful in the improvement of kashin-beck disease in clinical effect and the Lequesne index. Due to the limited quality and quantity of the included studies, more high quality studies are need to verify the above conclusion.
Stomach cancer is a malignancy arising from the stomach mucous epithelium. It accounts for 95% of all stomach malignancy cancer. The prevalence of stomach cancer is high in China and the treatment is debated, especially regarding choice of chemotherapy and treatment duration. In order to identify the best treatment and follow-up for patient with stage T2N0M0 stomach sinus cancer, we searched MEDLINE, SUMsearch, The Cochrane Library (Issue 4, 2004), Clinical Evidence (Issue 4, 2003) and CBMdisc (1981 to 2004). A total of 3 systematic reviews, 28 randomized controlled trails, 3 cohort studies and 3 observational studies were identified. We evaluated the quality of included studies.All studies were divided into 5 grades by the levels and grades of recommendation. We drew a conclusion by synthesizing the results of included studies: The primary treatment for the patient was surgery treatment including gastric deuto-total resection and D1 lymph node dissection. There was no evidence supporting chemotherapy use in either systematic or abdominal cavity after surgery. The survival rate was high in 5 years and 10 years, so the follow-up time should not be long and the follow-up infermission should not less than 1 year. Follow-up included the dynamic and delayed MR sequence with Gd-DTPA, the level of serum CA199, endoscope, and stool occult blood test.
Every country has its own clinical guideline to standardize medical care, and China is developing guidehnes too. Viewing the guidehne＇s usage in the world over many years, we find that it hasn＇t achieved good effect. The development of evidence-based medicine brings a primal change to guideline development. The evidence-based clinical guidehnes are arising in the world. We summarized the principle of developing evidence-based guideline according to the experience of Scotland to provide reference for domestic peers.