AIM: To determine whether the association of β-blockers with endoscopic treatment is superior to endoscopic treatment alone for the secondary prophylaxis of oesophageal variceal bleeding. METHODS: Randomised controll...AIM: To determine whether the association of β-blockers with endoscopic treatment is superior to endoscopic treatment alone for the secondary prophylaxis of oesophageal variceal bleeding. METHODS: Randomised controlled trials comparing sclerotherapy (SCL) with SCL plus β-blockers (BB) or banding ligation (BL) with BL plus BB were identif ied.Main outcomes were overall and 6, 12 and 24 mo rebleeding rates, as well as overall and 6, 12 and 24 mo mortality. Two statistical methods were used: Yusuf-Peto, and Der Simonian and Laird. Inter-trial heterogeneity was systematically taken into account. RESULTS: Seventeen randomised controlled trials were included, 14 with SCL and 3 with BL. Combination β-blocker and endoscopic treatment signif icantly reduced rebleeding rates at 6, 12 and 24 mo and overall [odds ratio (OR): 2.20, 95% conf idence interval (CI): 1.69-2.85, P<0.0001] compared to endoscopic treatment alone. Mortality at 24 mo was signif icantly lower for the combined treatment group (OR: 1.83, 95% CI:1.16-2.90, P= 0.009), as well as overall mortality (OR: 1.43, 95% CI:1.03-1.98, P= 0.03). CONCLUSION: Combination therapy should thus be recommended as the fi rst line treatment for secondary prophylaxis of oesophageal variceal bleeding.展开更多
Background β-blocker (BB) therapy is a cornerstone for the treatment of coronary heart disease (CHD).The evidence of the benefit from long-term BB therapy in diabetic patients with stable CHD is scarce.This meta-anal...Background β-blocker (BB) therapy is a cornerstone for the treatment of coronary heart disease (CHD).The evidence of the benefit from long-term BB therapy in diabetic patients with stable CHD is scarce.This meta-analysis summarizes the evidence relating to the BB therapy in diabetic patients with stable CHD.Methods A meta-analysis was performed according to PRISMA and MOOSE guidelines for reporting of systematic reviews of observational studies.PubMed,Embase,and Cochrane central were searched and two authors independently screened studies for eligibility.The quality of studies was assessed with the Newcastle Ottawa scale.The primary outcome of interest was all-cause mortality,cardiovascular (CV) mortality and major adverse cardiovascular events (MACE) in diabetic patients with and without BB therapy.A generic inverse variance model was used to pool odds ratio or hazards ratio from included studies to calculate the overall effect estimate.The significance threshold was set at P-value < 0.05.Heterogeneity was assessed by I2.Results Four non-randomized studies with 9515 participants were selected for the analyses.Four studies were post-hoc analyses of randomized controlled trials,and one article was an analysis of a nationally representative survey.In a fixed effects model,BB therapy in diabetic patients with stable CHD was found to be associated with increased risk of CV mortality,and MACE (27% and 32% respectively;P-value < 0.05) and was not associated with a reduction in all-cause mortality (HR 1.12;95% CI: 0.94–1.33;P-value = 0.22).Conclusion BB therapy in diabetic patients with stable CHD appears to be linked to higher mortality.Large randomized trials are needed in this population to confirm these findings.展开更多
Currently, nonselective β-blockers (NSBBs) are commonly used for the prevention of variceal bleeding in liver cirrhosis. The beneficial effects of NSBBs are primarily attributed to the reduction in cardiac...Currently, nonselective β-blockers (NSBBs) are commonly used for the prevention of variceal bleeding in liver cirrhosis. The beneficial effects of NSBBs are primarily attributed to the reduction in cardiac output by blockade of β1 receptors and vasoconstriction of the splanchnic circulation by the blockade of β2 receptors. The prognostic value of occlusive portal vein thrombosis (PVT) in cirrhotic patients has been increasingly recognized. The most important risk factor for the development of PVT in liver cirrhosis is the decreased portal vein inflow velocity. Collectively, we propose that the use of NSBBs potentially increases the development of portal vein thrombosis by reducing portal vein inflow velocity. The hypothesis should be confirmed by prospective cohort studies, in which cirrhotic patients without prior PVT treated with and without NSBBs are enrolled, and the development of PVT during follow-up is compared between the two groups. Additionally, subgroup analyses should be performed according to the dosage of NSBBs and the reduction of portal inflow velocity after use of NSBBs.展开更多
Aim： To investigate the effect of substituting β-blockers with nebivolol on the erectile function of patients suffering from essential hypertension. Methods： Forty-four young and middle-aged men （31-65 years） wit...Aim： To investigate the effect of substituting β-blockers with nebivolol on the erectile function of patients suffering from essential hypertension. Methods： Forty-four young and middle-aged men （31-65 years） with essential hypertension visited our outpatient clinic and took β-blocker treatment （atenolol, metoprolol or bisoprolol） for more than 6 months. All the patients completed a questionnaire regarding erectile function （International Index for Erectile Function）. Patients were then switched to an equipotent dose of nebivolol for 3 months and, at the end of this time period, filled out the same questionnaire. Results： Twenty-nine out of the 44 （65.9%） patients who took p-blockers （atenolol, metoprolol or bisoprolol） had exhibited erectile dysfunction （ED）. Their systolic and diastolic blood pressure did not change significantly with the treatment switch. In 20 out of these 29 （69%） patients, a significant improvement in the erectile function score was exhibited after 3 months of nebivolol administration, and in 11 of these 20 patients, erectile function was normalized. Conclusion： Nebivolol seems to have a beneficial effect on ED （possibly due to increased nitric oxide availability）; however, further prospective, randomized, placebo-controlled studies are needed to confirm the beneficial effects of nebivolol. （Asian J Androl 2006 Mar; 8： 177-182）展开更多
Objective To develop a rapid,simple and sensitive chemiluminescence method for the determination of three β-blockers (bisoprolol,atenolol and propranolol). Methods The chemiluminescence of cerium (Ⅳ)-sulfite system ...Objective To develop a rapid,simple and sensitive chemiluminescence method for the determination of three β-blockers (bisoprolol,atenolol and propranolol). Methods The chemiluminescence of cerium (Ⅳ)-sulfite system was obviously sensitized by adding anyone of three β-blockers in acid media. A new chemiluminescence method was set up by combining with flow-injection technique and used to determine the three β-blockers. Results Good linear ranges were obtained at the concentrations of 2.0×10-7g/mL-4.0×10-5g/mL,1.0×10-7g/mL-3.0×10-5g/mL and 7.0×10-7g/mL-1.0×10-5g/mL,respectively,with the detection limits of 5.0×10-8g/mL,7.0×10-8g/mL and 5.0×10-8g/mL (S/N=3),respectively,and the relative standard deviations for 11 times consecutive injections of 1.0×10-6g/mL bisoprolol,atenolol and propranolol were 3.57%,2.21% and 2.26%,respectively. Conclusion The developed method is sensitive,accurate,rapid and of low cost. And it can be applied to determine bisoprolol,atenolol and propranolol in pharmaceutical preparations.展开更多
A high performance liquid chromatography-linear ion trap mass spectrometry method using isotope dilution technique has been developed for the simultaneous determination of 23 β2-agonists and 5 β-blockers in animal m...A high performance liquid chromatography-linear ion trap mass spectrometry method using isotope dilution technique has been developed for the simultaneous determination of 23 β2-agonists and 5 β-blockers in animal muscle tissues. Pork and chicken muscle samples were acid hydrolyzed and extracted with 5% trichloracetic acid in water, and then cleaned up using MCX solid phase extraction (SPE) cartridge. Methanol and 0.1% formic acid were used as mobile phases for gradient elution. A Waters AtlantisT3 column was used for separation. ESI positive ion scan mode was used with selective reaction monitoring. 9 β2-Agonists labeled by the deuterium isotope were used as internal standards for quantification. The linear ranges of 23 β2-agonists and 5 β-blockers were 5-200 μg/L, the coefficient of correlation was not less than 0.995, and the limit of detection for each compound in the muscle tissue was below 0.2 μg/kg. The recoveries of each compound in the spiked samples at three levels 5, 10, 20 μg/kg were in the range of 47.3%-123.7%, and the relative standard deviations were in the range of 3.2%-25.7%. The developed method is sensitive and specific for the determination of β2-agonists and β-blockers in pork and chicken muscle samples.展开更多
Objective: To evaluate the association between hypertension and β-blocker (BB) use and antepartum depression risk. Patients and Methods: We conducted a retrospective cohort study of women who delivered within our int...Objective: To evaluate the association between hypertension and β-blocker (BB) use and antepartum depression risk. Patients and Methods: We conducted a retrospective cohort study of women who delivered within our integrated health system between 2009 and 2015, and completed an Edinburgh Postnatal Depression Scale (EPDS) during pregnancy. Increased depression risk was defined as EPDS score ≥ 10, or an affirmative answer to question ten, endorsing self-harm. Antepartum hypertension was determined by blood pressure measurements and provider ICD-9 codes. Regression analyses examined the independent associations of BB use and hypertension on antepartum depression risk. Results: Of 9192 deliveries during the study time frame, 5% were hypertensive. Within the hypertensive group, 103 (22%) used a single agent BB (BB Group), 325 (68%) required no antihypertensive medication (No-Med Group), and 48 (10%) used a non-BB single agent or multi-agent therapy (All-Other Group). After adjusting for covariates, compared to normotensive pregnancies, antepartum hypertension was significantly associated with both EPDS score ≥ 10 (adjusted odds ratio [aOR] 1.61, 95% confidence interval [CI] 1.17 - 2.21) and endorsement of self-harm (aOR 1.76, 95% CI 1.05 - 2.95). In further analyses of depression risk in hypertensive pregnancies, there was no difference between the BB Group and No-Med Group (EPDS score ≥ 10, aOR 1.22, 95% CI 0.56 - 2.63;self-harm, aOR 0.84, 95% CI 0.32 - 2.21), or between the All-Other Group and No-Med Group (EPDS ≥ 10, aOR 1.42, 95% CI 0.57 - 3.54;self-harm, aOR 1.04, 95% CI 0.29 - 3.74). Conclusion: Women with antepartum hypertension have increased risk for depression and thoughts of self-harm. β-Blocker use is not associated with further increased risk.展开更多
Objective:The goal of this study was to see if travoprost and β-blockers improved MDA and SOD expression as well as neuroprotection in glaucoma mice.Methods:One hundred healthy SPF SD rats were randomly allocated int...Objective:The goal of this study was to see if travoprost and β-blockers improved MDA and SOD expression as well as neuroprotection in glaucoma mice.Methods:One hundred healthy SPF SD rats were randomly allocated into five groups:travoprost and β-blocker group,travoprost group,β-blocker group,model group and blank group,with 20 rats in each group.We created a glaucoma mouse model in which the blank group and the model group received the same volume of saline,the β-blocker group received β-blocker,the travoprost group received travoprost,and the travo Prost and β-blocker groups received travo Prost and βreceptor blockers.Retinal cell apoptosis level,intraocular pressure level,MDA and SOD levels were measured after drug administration.Results:The results showed that the levels of intraocular pressure,the apoptosis rate of optic nerve,SOD and MDA of retina in travoprost and β-blocker group,travoprost group,β-blocker group and model group were greater than those in blank group(P<0.05).In comparison to the model group,the intraocular pressure level,optic nerve apoptosis rate,and retinal MDA level in the travoprost and β-blocker group continued to fall,while the retinal SOD level was considerably elevated(P<0.05).The continuous application of travoprost and β-blocker resulted in a constant drop in intraocular pressure,optic nerve apoptosis rate and MDA level in the retina,whereas the SOD level was dramatically elevated(P<0.05).Conclusion:In glaucoma mice,travoprost in combination with a β-blocker can greatly increase MDA expression,SOD and neuroprotection.展开更多
文摘AIM: To determine whether the association of β-blockers with endoscopic treatment is superior to endoscopic treatment alone for the secondary prophylaxis of oesophageal variceal bleeding. METHODS: Randomised controlled trials comparing sclerotherapy (SCL) with SCL plus β-blockers (BB) or banding ligation (BL) with BL plus BB were identif ied.Main outcomes were overall and 6, 12 and 24 mo rebleeding rates, as well as overall and 6, 12 and 24 mo mortality. Two statistical methods were used: Yusuf-Peto, and Der Simonian and Laird. Inter-trial heterogeneity was systematically taken into account. RESULTS: Seventeen randomised controlled trials were included, 14 with SCL and 3 with BL. Combination β-blocker and endoscopic treatment signif icantly reduced rebleeding rates at 6, 12 and 24 mo and overall [odds ratio (OR): 2.20, 95% conf idence interval (CI): 1.69-2.85, P<0.0001] compared to endoscopic treatment alone. Mortality at 24 mo was signif icantly lower for the combined treatment group (OR: 1.83, 95% CI:1.16-2.90, P= 0.009), as well as overall mortality (OR: 1.43, 95% CI:1.03-1.98, P= 0.03). CONCLUSION: Combination therapy should thus be recommended as the fi rst line treatment for secondary prophylaxis of oesophageal variceal bleeding.
文摘Background β-blocker (BB) therapy is a cornerstone for the treatment of coronary heart disease (CHD).The evidence of the benefit from long-term BB therapy in diabetic patients with stable CHD is scarce.This meta-analysis summarizes the evidence relating to the BB therapy in diabetic patients with stable CHD.Methods A meta-analysis was performed according to PRISMA and MOOSE guidelines for reporting of systematic reviews of observational studies.PubMed,Embase,and Cochrane central were searched and two authors independently screened studies for eligibility.The quality of studies was assessed with the Newcastle Ottawa scale.The primary outcome of interest was all-cause mortality,cardiovascular (CV) mortality and major adverse cardiovascular events (MACE) in diabetic patients with and without BB therapy.A generic inverse variance model was used to pool odds ratio or hazards ratio from included studies to calculate the overall effect estimate.The significance threshold was set at P-value < 0.05.Heterogeneity was assessed by I2.Results Four non-randomized studies with 9515 participants were selected for the analyses.Four studies were post-hoc analyses of randomized controlled trials,and one article was an analysis of a nationally representative survey.In a fixed effects model,BB therapy in diabetic patients with stable CHD was found to be associated with increased risk of CV mortality,and MACE (27% and 32% respectively;P-value < 0.05) and was not associated with a reduction in all-cause mortality (HR 1.12;95% CI: 0.94–1.33;P-value = 0.22).Conclusion BB therapy in diabetic patients with stable CHD appears to be linked to higher mortality.Large randomized trials are needed in this population to confirm these findings.
文摘Currently, nonselective β-blockers (NSBBs) are commonly used for the prevention of variceal bleeding in liver cirrhosis. The beneficial effects of NSBBs are primarily attributed to the reduction in cardiac output by blockade of β1 receptors and vasoconstriction of the splanchnic circulation by the blockade of β2 receptors. The prognostic value of occlusive portal vein thrombosis (PVT) in cirrhotic patients has been increasingly recognized. The most important risk factor for the development of PVT in liver cirrhosis is the decreased portal vein inflow velocity. Collectively, we propose that the use of NSBBs potentially increases the development of portal vein thrombosis by reducing portal vein inflow velocity. The hypothesis should be confirmed by prospective cohort studies, in which cirrhotic patients without prior PVT treated with and without NSBBs are enrolled, and the development of PVT during follow-up is compared between the two groups. Additionally, subgroup analyses should be performed according to the dosage of NSBBs and the reduction of portal inflow velocity after use of NSBBs.
文摘Aim： To investigate the effect of substituting β-blockers with nebivolol on the erectile function of patients suffering from essential hypertension. Methods： Forty-four young and middle-aged men （31-65 years） with essential hypertension visited our outpatient clinic and took β-blocker treatment （atenolol, metoprolol or bisoprolol） for more than 6 months. All the patients completed a questionnaire regarding erectile function （International Index for Erectile Function）. Patients were then switched to an equipotent dose of nebivolol for 3 months and, at the end of this time period, filled out the same questionnaire. Results： Twenty-nine out of the 44 （65.9%） patients who took p-blockers （atenolol, metoprolol or bisoprolol） had exhibited erectile dysfunction （ED）. Their systolic and diastolic blood pressure did not change significantly with the treatment switch. In 20 out of these 29 （69%） patients, a significant improvement in the erectile function score was exhibited after 3 months of nebivolol administration, and in 11 of these 20 patients, erectile function was normalized. Conclusion： Nebivolol seems to have a beneficial effect on ED （possibly due to increased nitric oxide availability）; however, further prospective, randomized, placebo-controlled studies are needed to confirm the beneficial effects of nebivolol. （Asian J Androl 2006 Mar; 8： 177-182）
基金supported by Xi'an Jiaotong University (08140012)
文摘Objective To develop a rapid,simple and sensitive chemiluminescence method for the determination of three β-blockers (bisoprolol,atenolol and propranolol). Methods The chemiluminescence of cerium (Ⅳ)-sulfite system was obviously sensitized by adding anyone of three β-blockers in acid media. A new chemiluminescence method was set up by combining with flow-injection technique and used to determine the three β-blockers. Results Good linear ranges were obtained at the concentrations of 2.0×10-7g/mL-4.0×10-5g/mL,1.0×10-7g/mL-3.0×10-5g/mL and 7.0×10-7g/mL-1.0×10-5g/mL,respectively,with the detection limits of 5.0×10-8g/mL,7.0×10-8g/mL and 5.0×10-8g/mL (S/N=3),respectively,and the relative standard deviations for 11 times consecutive injections of 1.0×10-6g/mL bisoprolol,atenolol and propranolol were 3.57%,2.21% and 2.26%,respectively. Conclusion The developed method is sensitive,accurate,rapid and of low cost. And it can be applied to determine bisoprolol,atenolol and propranolol in pharmaceutical preparations.
基金support from the National Natural Science Foundation of China (Grant No. 20837003)the National Key Technology R&D Program of the 11th Five Year Plan (Grant Nos. 2006BAK02A27 & 2006BAK01A02-5)
文摘A high performance liquid chromatography-linear ion trap mass spectrometry method using isotope dilution technique has been developed for the simultaneous determination of 23 β2-agonists and 5 β-blockers in animal muscle tissues. Pork and chicken muscle samples were acid hydrolyzed and extracted with 5% trichloracetic acid in water, and then cleaned up using MCX solid phase extraction (SPE) cartridge. Methanol and 0.1% formic acid were used as mobile phases for gradient elution. A Waters AtlantisT3 column was used for separation. ESI positive ion scan mode was used with selective reaction monitoring. 9 β2-Agonists labeled by the deuterium isotope were used as internal standards for quantification. The linear ranges of 23 β2-agonists and 5 β-blockers were 5-200 μg/L, the coefficient of correlation was not less than 0.995, and the limit of detection for each compound in the muscle tissue was below 0.2 μg/kg. The recoveries of each compound in the spiked samples at three levels 5, 10, 20 μg/kg were in the range of 47.3%-123.7%, and the relative standard deviations were in the range of 3.2%-25.7%. The developed method is sensitive and specific for the determination of β2-agonists and β-blockers in pork and chicken muscle samples.
文摘Objective: To evaluate the association between hypertension and β-blocker (BB) use and antepartum depression risk. Patients and Methods: We conducted a retrospective cohort study of women who delivered within our integrated health system between 2009 and 2015, and completed an Edinburgh Postnatal Depression Scale (EPDS) during pregnancy. Increased depression risk was defined as EPDS score ≥ 10, or an affirmative answer to question ten, endorsing self-harm. Antepartum hypertension was determined by blood pressure measurements and provider ICD-9 codes. Regression analyses examined the independent associations of BB use and hypertension on antepartum depression risk. Results: Of 9192 deliveries during the study time frame, 5% were hypertensive. Within the hypertensive group, 103 (22%) used a single agent BB (BB Group), 325 (68%) required no antihypertensive medication (No-Med Group), and 48 (10%) used a non-BB single agent or multi-agent therapy (All-Other Group). After adjusting for covariates, compared to normotensive pregnancies, antepartum hypertension was significantly associated with both EPDS score ≥ 10 (adjusted odds ratio [aOR] 1.61, 95% confidence interval [CI] 1.17 - 2.21) and endorsement of self-harm (aOR 1.76, 95% CI 1.05 - 2.95). In further analyses of depression risk in hypertensive pregnancies, there was no difference between the BB Group and No-Med Group (EPDS score ≥ 10, aOR 1.22, 95% CI 0.56 - 2.63;self-harm, aOR 0.84, 95% CI 0.32 - 2.21), or between the All-Other Group and No-Med Group (EPDS ≥ 10, aOR 1.42, 95% CI 0.57 - 3.54;self-harm, aOR 1.04, 95% CI 0.29 - 3.74). Conclusion: Women with antepartum hypertension have increased risk for depression and thoughts of self-harm. β-Blocker use is not associated with further increased risk.
文摘Objective:The goal of this study was to see if travoprost and β-blockers improved MDA and SOD expression as well as neuroprotection in glaucoma mice.Methods:One hundred healthy SPF SD rats were randomly allocated into five groups:travoprost and β-blocker group,travoprost group,β-blocker group,model group and blank group,with 20 rats in each group.We created a glaucoma mouse model in which the blank group and the model group received the same volume of saline,the β-blocker group received β-blocker,the travoprost group received travoprost,and the travo Prost and β-blocker groups received travo Prost and βreceptor blockers.Retinal cell apoptosis level,intraocular pressure level,MDA and SOD levels were measured after drug administration.Results:The results showed that the levels of intraocular pressure,the apoptosis rate of optic nerve,SOD and MDA of retina in travoprost and β-blocker group,travoprost group,β-blocker group and model group were greater than those in blank group(P<0.05).In comparison to the model group,the intraocular pressure level,optic nerve apoptosis rate,and retinal MDA level in the travoprost and β-blocker group continued to fall,while the retinal SOD level was considerably elevated(P<0.05).The continuous application of travoprost and β-blocker resulted in a constant drop in intraocular pressure,optic nerve apoptosis rate and MDA level in the retina,whereas the SOD level was dramatically elevated(P<0.05).Conclusion:In glaucoma mice,travoprost in combination with a β-blocker can greatly increase MDA expression,SOD and neuroprotection.
