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. 相似文献
Introduction:Traditional open discectomy and intervertebral fusion surgery is the common strategy for lumbar disc herniation (LDH). However, it has the disadvantages of long recovery time and severe paravertebral soft tissue injury. Zina percutaneous screw fixation combined with endoscopic lumbar intervertebral fusion (ZELIF), as a novel minimally invasive surgical technique for LDH, has the advantages in quicker recovery, less soft tissue destruction, shorter hospital stays and less pain. We report a novel technique of ZELIF under intraoperative neuromonitoring (INM) for the treatment of LDH.Patient concerns:A 51-year-old male presented to our hospital with left lower extremity pain and numbness for 1 year.Diagnosis:Lumbar disc herniation (LDH).Interventions:This patient was treated with Zina percutaneous screw fixation combined with endoscopic neural decompression, endplate preparation, and intervertebral fusion through Kambin''s triangle. Each step of the operation was performed under INM.Outcomes:The follow-up period lasted 12 months; the hospitalization lasted 4 nights; the blood loss volume was 65 ml, and the time of operation was 266 min. INM showed no neurological damage during the surgery. No surgical complications, including neurological deterioration, cage migration, non-union, instrumentation failure or revision operation, were observed during the follow-up period. Visual Analogue Scale (VAS) score reduced from 7 to 1; the Oswestry Disability Index (ODI) decreased from 43 to 14; the EQ-5D score was 10 preoperatively and 15 at the final follow-up visit; the Physical Component Summary of the 36-Item Short Form Health Survey (SF-36) was 48 preoperatively and 49 at the last follow up visit; the SF-36 Mental Component Summary was 47 before surgery and decreased to 41 postoperatively.Conclusion:ZELIF under INM may represent a feasible, safe and effective alternative to endoscopic intervertebral fusion and percutaneous screw fixation, for decompressing the lumbar''s exiting nerve root directly with minimal invasion in selected patients. 相似文献
Digestive Diseases and Sciences - Bile acid diarrhoea or BAD is a common but little recognised cause of chronic diarrhoea. Few of these patients in China have been diagnosed due to a lack of... 相似文献
Humans and animals suffer a health threat to soybean allergy. The impaired mechanism of the intestinal barrier by food/feed allergen glycinin has not been clear. The effects of epithelial metabolic activity, permeability, integrity, and the tight junction (TJ) expression induced by glycinin were conducted using porcine intestinal epithelial cells (IPEC-J2) model in this study. The results showed the decreased metabolic activity (R2 = 0.964, p < 0.001) and the increased alkaline phosphatase activity (R2 = 0.528, p = 0.002) linearly correlated with glycinin levels (0–4 mg/mL). The trans-epithelial electrical resistance values declined stimulated by 4 mg/mL glycinin treatment in a time-dependent manner (0, 6, 12, or 24 h, p = 0.018), and also descended after 12 or 24 h glycinin treatment in dose-dependence (0, 0.5, 1, 2, or 4 mg/mL, p < 0.001). The glycinin-induced TJ expression of claudin-3, occludin, and ZO-1 were reduced (p < 0.05). 相似文献
Several well‐controlled polystyrene‐block‐poly(styrene‐alt‐maleic anhydride) (PS‐b‐P(St‐alt‐MA)) functionalized block copolymers (BCs) and their sodium salt ionomers with different block ratios and molecular weights are synthesized through two‐step reversible addition–fragmentation chain transfer (RAFT) polymerization. The atomic force microscopy (AFM) images and differential scanning calorimetry (DSC) results reveal that the prepared BCs and their ionomers microphase separate into various nanostructures depending on the block ratios. By taking advantage of the formation of amphiphilic nanostructures via the microphase, the block ionomers serve as nucleation agents to improve the crystallization rate of poly(ethylene terephthalate) (PET). The crystallization behavior of PET upon the addition of block ionomers is investigated isothermally and non‐isothermally by DSC. The results show that the block ionomers can effectively accelerate the crystallization rate of PET, which strongly depends on the molecular weights and block ratios