Efficacy and safety of riociguat in the treatment of chronic thromboembolic pulmonary arterial hypertension: A meta-analysis

Background:Riociguat is a novel soluble guanylate cyclase stimulator, and has been widely used for the treatment of pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension (CTEPH). Some studies found that riociguat had better effects on CTEPH and proved to be safe, but the results were not utterly consistent. Therefore, the purpose of this study was to comprehensively evaluate the efficacy and safety of riociguat in the treatment of CTEPH.Methods:Randomized controlled trials on riociguat for the treatment of CTEPH were searched through such electronic databases as PubMed, Embase, Cochrane Library, Web of Science, China national knowledge internet, and Wanfang. The outcomes included exercise capacity, pulmonary hemodynamics, and side effects. The fixed-effects or random-effects models were used to analyze the pooled data, and heterogeneity was assessed by the I² test.Results:Four studies involving 520 patients were included in this meta-analysis. Compared with the placebo group, riociguat significantly improved the hemodynamic indexes and increased 6-min walking distance (P < .0001, standardized mean difference (SMD) = −0.24, 95%CI −0.35 to −0.12; P < .00001, SMD = 0.52, 95%CI 0.33 to 0.71), and decreased the Borg dyspnea score (P = .002, SMD = −0.31, 95%CI −0.51 to −0.12). In addition, riociguat could also significantly reduce the living with pulmonary hypertension scores and increase the EQ-5D scores (P = .01, SMD=−0.23, 95%CI −0.42 to −0.05; P < .00001, SMD = 0.47, 95%CI 0.27 to 0.66), but there was no significant difference in the change level of N-terminal pro-hormone B-type natriuretic peptide in patients with riociguat (P = .20, SMD = −0.24, 95%CI −0.61 to −0.13). The common adverse events of riociguat were dyspepsia and peripheral edema, and no other serious adverse reactions were observed.Conclusions:We confirmed that riociguat had better therapeutic effects in improving the hemodynamic parameters and exercise capacity in patients with CTEPH without inducing serious adverse events. This will provide a reasonable medication regimen for the treatment of CTEPH.     

Augmentation in patients with restless legs syndrome receiving pramipexole therapy: a retrospective study in a single center from China

Sleep and Breathing - Augmentation is a major complication of long-term pramipexole treatment of restless legs syndrome (RLS). However, there have been no studies on augmentation in Chinese...     

放射医学实验室废水管理

报道我院放射医学系大楼放射性实验区废水管理的基本原则、处理系统、监测、排放和~(147)Pm 废水的凝聚沉降处理。     

正常妊娠妇女及习惯性流产患者IL—2、IL—10mRNA的表达差异

目的 检测正常妊娠妇女、习惯性流产患者外周血单个核细胞（PBMC）内T辅助细胞亚型（Th1)细胞因子白细胞介素-2（IL-2）、T辅助细胞2亚型（Th2)细胞因子白细胞介素10（IL-10）mRNA表达水平的差异。方法 用半定量逆转录-聚合酶链反应（RT-PCR）的方法检测10例正常非孕妇女,10例正常妊娠妇女,10例习惯性流产患者PBMC内IL-2、IL10mRNA的表达水平。结果 同正常非孕对照相比,正常妊娠妇女IL-10mRNA明显升高,习惯性流产患者IL-10mRNA降低,IL-2mRNA明显升高;同正常妊娠妇女相比,习惯性流产患者IL-2mRNA及IL-10mRNA均明显降低。结论 正常妊娠分泌IL-10升高,当孕妇分泌IL-10降低而分泌IL-2升高时,可能会导致习惯性流产的发生。     

TRH对失血性休克狗脑脊液和血浆ir－β－EP含量的影响

采用狗重度失血性休克模型，同时动态测定了休克及应用促甲状腺素释放激素（ＴＲＨ）后，狗脑脊液（ＣＳＦ）和血浆的β－内啡肽样免疫活性物质（ｉｒ－β－ＥＰ）含量变化。结果显示：失血性休克时ＣＳＦ和血浆ｉｒ－β－ＥＰ含量明显升高，与休克严重程度显著相关。提示中枢神经系统和外周血循环中的β－ＥＰ共同参与失血性休克的病理生理过程。静脉滴注ＴＲＨ后，ＣＳＦ和血浆中的ｉｒ－β－ＥＰ均降到休克前水平，与对照组比较相差显著。ＴＲＨ抑制了下丘脑和垂体释放β－ＥＰ，可能是ＴＲＨ拮抗失血性休克的机理之一。     

rt—PA治疗下肢深静脉血栓形成

观察重组组织型型纤溶酶原激活剂的临床应用效果、摸索其治疗规律。方法对８例下肢深静脉全形成患者进行静脉溶栓治疗。经患肢静脉给予ｒｔ／ＰＡ总量５０－１００ｍｇ，以治前后症状，体征，数字减影血管造影或血管多普勒彩超评价治疗效果。