Publications by authors named "Jiarong Lan"

7 Publications

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Real-world comparison of direct-acting oral anticoagulants and vitamin K antagonists in chronic kidney disease: a systematic review and meta-analysis.

Expert Rev Hematol 2021 May 5:1-10. Epub 2021 May 5.

Department of Nephrology, Changxing People's Hospital, Huzhou, Zhejiang Province, P.R. China.

: No clear clinical guidelines exist on anticoagulant use for chronic kidney disease (CKD) patients. We compared the efficacy and safety of direct-acting oral anticoagulants (DOACs) vs. vitamin K antagonists (VKA) in patients with CKD by pooling data from real-world observational studies.: This systematic review searched PubMed, Embase, and CENTRAL databases and pooled multivariable-adjusted hazard ratios (HR) of outcomes.: Fifteen studies were included. Our results indicated a small but significant reduction in the risk of all-cause mortality (p = 0.01), stroke or systemic embolism (p = 0.03), and major bleeding (p = 0.01) with DOAC as compared to VKA. In subgroup analysis based on the severity of CKD, no difference in the risk of stroke or systemic embolism was noted in any subgroups. The risk of mortality was reduced only in patients with moderate-severe or severe CKD and the risk of major bleeding was reduced only in patients with moderate-severe or moderate CKD.: DOACs are associated with only a modest reduction in stroke or systemic embolism, major bleeding, and mortality when compared to VKA in CKD patients. Reduction in mortality and major bleeding with DOAC may only be seen in moderate-to-severe CKD patients.
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http://dx.doi.org/10.1080/17474086.2021.1920012DOI Listing
May 2021

Short- and long-term treatment with angiotensin-converting enzyme inhibitors or calcium channel blockers for the prevention of diabetic nephropathy progression: A meta-analysis.

Exp Ther Med 2021 Jan 4;21(1):14. Epub 2020 Nov 4.

Endocrinology Department, Huzhou Hospital of Traditional Chinese Medicine Affiliated Zhejiang University of Traditional Chinese Medicine, Huzhou, Zhejiang 313000, P.R. China.

Treatments with angiotensin-converting enzyme (ACE) inhibitors or calcium channel blockers (CCBs) may delay the development of albuminuria in patients with early diabetic nephropathy. However, evidence in the literature has not been consistent. The present meta-analysis aimed to compare the short- and long-term therapeutic effects of ACE inhibitors and CCBs (when used separately) for preventing the progression of nephropathy in patients with diabetes mellitus. A comprehensive search of various databases was performed from inception until March 2015 for studies in the Chinese and English languages. Randomized controlled trials (RCTs) comparing the efficacy of ACE inhibitors with that of CCBs in patients with early diabetic nephropathy were considered. A total of 12 RCTs were included with a total of 947 patients. ACE inhibitors were indicated to be more effective in reducing the albumin excretion rate than CCBs after short-term treatments (<6 months) [mean difference (MD), 32.35; 95% confidence interval (CI), 31.62-33.07; P<0.00001]. There was no difference in serum creatinine values after treatment with either drug (MD, 8.7; 95% CI, -21.5-38.91; P=0.57). Data from six studies were used to compare long-term treatment effects (≥1 year). In terms of progression to normoalbuminuria, a marginal difference was obtained between the two drugs with better outcomes with ACE inhibitors [odds ratio (OR), 0.70; 95% CI, 0.49-1.00; P=0.05]. There was no statistically significant difference between ACE inhibitors and CCBs regarding the progression from microalbuminuria to macroalbuminuria (OR, 1.78; 95% CI, 0.82-3.87; P=0.15). In conclusion, the present study indicated that the antiproteinuric efficacy of CCBs may be less than that of ACE inhibitors after short-term treatment in patients with DN. However, both types of drugs are equally effective in reducing the progression of microalbuminuria to macroalbuminuria in the long term.
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http://dx.doi.org/10.3892/etm.2020.9446DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7678606PMC
January 2021

Effectiveness of hypoxia-induced factor prolyl hydroxylase inhibitor for managing anemia in chronic kidney disease: a systematic review and meta-analysis.

Eur J Clin Pharmacol 2021 Apr 7;77(4):491-507. Epub 2020 Nov 7.

Department of Nephrology, Changxing People's Hospital, Huzhou, 313100, Zhejiang, China.

Purpose: To meta-statistically compare the efficiency of hypoxia-induced factor prolyl hydroxylase inhibitor on hemoglobin, ferritin, hepcidin rate, and adverse events.

Methods: A systematic identification of literature was performed according to PRISMA guidelines on 4 academic databases: MEDLINE, Scopus, EMBASE, and CENTRAL. A meta-analysis evaluating the influence of hypoxia-induced factors was performed for patients undergoing/not undergoing hemodialysis. The analysis evaluated the efficacy of hypoxia-induced factors on hemoglobin, ferritin, hepcidin rate, and the number of adverse events.

Results: Out of 1052 records, 15 articles including 2045 patients (mean age 62.1 ± 5.4 years) were included in this review. The systematic review presents a 1a level of evidence supporting the use of hypoxia-induced factor for mediating anemia in patients with chronic kidney disease. The meta-analysis reveals medium to large beneficial effects of the hypoxia-induced factor on hemoglobin rate for patients receiving (0.72) and not receiving (1.04) hemodialysis. Moreover, the administration of hypoxia-induced factors was reported to reduce ferritin rate and the hepcidin rate, and the number of adverse events in patients with chronic kidney disease.

Conclusion: The current meta-analysis recommends the use of hypoxia-induced factor prolyl hydroxylase inhibitor for managing anemia in chronic kidney disease.
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http://dx.doi.org/10.1007/s00228-020-03037-1DOI Listing
April 2021

Comparison of Irbesartan and Benazepril Hydrochloride on Urine Protein Reduction in Chronic Glomerulonephritis.

J Coll Physicians Surg Pak 2020 Sep;30(9):1000-1001

Department of Nephrology, Huzhou Hospital of Traditional Chinese Medicine Affiliated Zhejiang University of Traditional Chinese Medicine, China.

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http://dx.doi.org/10.29271/jcpsp.2020.09.1000DOI Listing
September 2020

Associations of Leptin Receptor and Peroxisome Proliferator-Activated Receptor Gamma Polymorphisms with Polycystic Ovary Syndrome: A Meta-Analysis.

Ann Nutr Metab 2019 14;75(1):1-8. Epub 2019 Aug 14.

Department of Gynecology, Huzhou First People's Hospital, Huzhou, China,

Background: Previous studies on associations of leptin receptor (LEPR) and peroxisome proliferator-activated receptor gamma (PPARG) polymorphisms with polycystic ovary syndrome (PCOS) yielded conflicting results.

Objectives: In this meta-analysis, we aimed to better analyze the relationship between LEPR/PPARG polymorphisms and PCOS in a larger pooled population.

Methods: We performed a systematic search of PubMed, Web of Science, Embase and CNKI. We calculated pooled ORs and 95% CIs to estimate associations between LEPR/PPARG polymorphisms and PCOS.

Results: Totally, 33 eligible studies were included. A significant association with susceptibility to PCOS was observed for LEPR rs1137101 polymorphism under recessive genetic model (p = 0.002, OR 1.88, 95% CI 1.26-2.78, I2 = 42%) and for PPARG rs1801282 polymorphism under dominant (p = 0.007, OR 1.20, 95% CI 1.05-1.36, I2 = 49%), overdominant (p = 0.02, OR 0.85, 95% CI 0.74-0.97, I2 = 48%), and allele (p = 0.006, OR 1.18, 95% CI 1.05-1.33, I2 = 47%) genetic models in overall population. Further subgroup analyses by ethnicity revealed that LEPR rs1137101 and PPARG rs3856806 polymorphisms were both significantly associated with susceptibility to PCOS in Asians. No any positive results were detected in overall and subgroup analyses.

Conclusions: Our meta-analysis suggested that LEPR rs1137101, PPARG rs1801282, and rs3856806 polymorphisms were all significantly associated with individual susceptibility to PCOS in certain populations.
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http://dx.doi.org/10.1159/000500996DOI Listing
June 2020

CCDN1 rs603965 polymorphism may serve as a genetic biomarker of brain tumor: A meta-analysis of 5,769 subjects.

Mol Genet Genomic Med 2019 06 10;7(6):e00655. Epub 2019 Apr 10.

Department of Neurosurgery, Ningbo No. 1 Hospital, Ningbo, Zhejiang, China.

Introduction: Some studies already tried to assess the associations between cyclin D1 (CCND1) polymorphisms and brain tumor. However, the results of these studies were not consistent. Thus, we performed the present meta-analysis to explore the relationship between CCND1 polymorphisms and brain tumor in a larger pooled population.

Methods: PubMed, Web of Science, Embase, and CNKI were searched for related articles. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to assess the potential associations.

Results: Totally nine studies with 5,769 subjects were analyzed. A significant association with brain tumor susceptibility was observed for the rs603965 polymorphism in GG versus GA + AA (dominant comparison, p = 0.003, OR = 0.72, 95% CI 0.57-0.89, I  = 64%), AA versus GG + GA (recessive comparison, p = 0.004, OR = 1.46, 95% CI 1.13-1.88, I  = 67%), and G versus A (allele comparison, p = 0.0004, OR = 0.77, 95% CI 0.66-0.89, I  = 66%) in overall population. Further subgroup analyses by ethnicity yielded similar positive results in both Asians and Caucasians. Moreover, in stratified analyses by type of disease, we noticed that the rs603965 polymorphism was significantly associated with the susceptibility to glioma, but such positive results were not detected in pituitary adenoma or meningioma. Additionally, a significant association with tumor grade was also observed for the rs603965 polymorphism in G versus A (allele comparison, p = 0.02, OR = 0.74, 95% CI 0.59-0.95, I  = 26%).

Conclusions: Our findings suggested that CCND1 rs603965 polymorphism may serve as a potential genetic biomarker of brain tumor, especially for glioma.
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http://dx.doi.org/10.1002/mgg3.655DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6565547PMC
June 2019

Meta-analysis of the effect and safety of berberine in the treatment of type 2 diabetes mellitus, hyperlipemia and hypertension.

J Ethnopharmacol 2015 Feb 10;161:69-81. Epub 2014 Dec 10.

Cincinnati Children׳s Hospital Medical Center, Cincinnati, OH 45229, USA.

Ethnopharmacological Relevance: Berberine, extracted from Coptis Root and Phellodendron Chinese, has been frequently used for the adjuvant treatment of type 2 diabetes mellitus, hyperlipidemia, and hypertension in China. Safety and efficacy studies in terms of evidence-based medical practice have become more prevalent in application to Chinese Herbal Medicine. It is necessary to assess the efficacy and safety of berberine in the treatment of type 2 diabetes mellitus, hyperlipidemia and hypertension by conducting a systematic review and meta-analysis of available clinical data.

Materials And Methods: We searched the English databases PubMed, ScienceDirect, Cochrane library, EMbase, etc., and Chinese databases including China biomedical literature database (CBM), Chinese Technology Journal Full-text Database, Chinese journal full text database (CNKI), and Wanfang digital periodical full text database. Relevant studies were selected based on the inclusion and exclusion criteria. Meta-analysis was performed with RevMan5.0 software after data extraction and the quality of studies assessment.

Results: Twenty-seven randomized controlled clinical trials were included with 2569 patients. There are seven subgroups in our meta-analysis: berberine versus placebo or berberine with intensive lifestyle intervention versus intensive lifestyle intervention alone; berberine combined with oral hypoglycemic versus hypoglycemic alone; berberine versus oral hypoglycemic; berberine combined with oral lipid lowering drugs versus lipid lowering drugs alone; berberine versus oral lipid lowering drugs; berberine combined with oral hypotensor versus hypotensive medications; berberine versus oral hypotensive medications. In the treatment of type 2 diabetes mellitus, we found that berberine with lifestyle intervention tended to lower the level of FPG, PPG and HbA1c than lifestyle intervention alone or placebo; the same as berberine combined with oral hypoglycaemics to the same hypoglycaemics; but there was no statistical significance between berberine and oral hypoglycaemics. As for the treatment of hyperlipidemia, berberine with lifestyle intervention was better than lifestyle intervention, berberine with oral lipid lowering drugs was better than lipid lowering drugs alone in reducing the level of TC and LDL-C, and raising the level of HDL-C. In the comparative study between berberine and oral lipid lowering drugs, there was no statistical significance in reducing the level of TC and LDL-C, but berberine shows better effect in lowering the level of TG and raising the level of HDL-C. In the treatment of hypertension, berberine with lifestyle intervention tended to lower the level of blood pressure more than the lifestyle intervention alone or placebo did; The same occurred when berberine combined with oral hypotensor was compared to the same hypotensor. Notably, no serious adverse reaction was reported in the 27 experiments.

Conclusion: This study indicates that berberine has comparable therapeutic effect on type 2 DM, hyperlipidemia and hypertension with no serious side effect. Considering the relatively low cost compared with other first-line medicine and treatment, berberine might be a good alternative for low socioeconomic status patients to treat type 2 DM, hyperlipidemia, hypertension over long time period. Due to overall limited quality of the included studies, the therapeutic benefit of berberine can be substantiated to a limited degree. Better methodological quality, large controlled trials using standardized preparation are expected to further quantify the therapeutic effect of berberine.
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http://dx.doi.org/10.1016/j.jep.2014.09.049DOI Listing
February 2015