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Intravenous diltiazem and metoprolol are both commonly used to treat atrial fibrillation (AF) with rapid ventricular rate (RVR) in the emergency department (ED), but the advantages and disadvantages of these drugs cannot be verified. This meta-analysis aimed to assess the efficacy and safety of intravenous diltiazem versus metoprolol for AF with RVR.We systematically searched PubMed, Web of Science, Embase, Cochrane library, the China National Knowledge Infrastructure (CNKI), Wanfang, China Biology Medicine disc (CBM) and the WeiPu (VIP). Meta-analysis was performed using weighted mean difference (WMD), relative risk (RR) and 95% confidence interval (CI). Statistical analysis was performed using Review Manager 5.4.1.Seventeen studies involving 1214 patients in nine randomized controlled trials (RCTs) and eight cohort studies were included in meta-analysis, including 643 patients in the intravenous diltiazem group and 571 patients group in the intravenous metoprolol. The results of the meta-analysis showed that compared with intravenous metoprolol, intravenous diltiazem was found higher efficacy (RR =1.11; 95% CI = 1.06 to 1.16, p0.00001), shorter average onset time (RR = -1.13; 95% CI = -1.97 to -0.28, p = 0.009), lower ventricular rate (RR = -9.48; 95% CI = -12.13 to -6.82, p0.00001), less impact on systolic blood pressure (WMD = 3.76; 95% CI: 0.20 to 7.33, P = 0.04), and no significant difference in adverse events (RR = 0.80, 95% CI = 0.55 to 1.14, P = 0.22) and diastolic blood pressure (WMD = -1.20; 95% CI: -3.43 to 1.04, P = 0.29) was found between intravenous diltiazem and metoprolol.Intravenous diltiazem has higher efficacy, shorter average onset time, lower ventricular rate, less impact on blood pressure, and with no increase in adverse events compared to intravenous metoprolol.

Background: The mortality rate of coronary heart disease (CHD) in China is different from region to region, and there are sex, age and urban-rural differences. This study described trend and distribution of CHD in Hexi corridor of Gansu province from 2006 to 2015. Method: The death data of CHD were obtained using the Death Reporting System of Gansu CDC for 2006-2015. The trend of the death cases of CHD by year, month and its distribution by sex, age and region were studied, and the changing characteristics of epidemiology was analyzed. Results: Overall, The mortality rate of CHD in Hexi corridor showed a decline trend from 2006 to 2015, a tendency that higher in winter and spring, and lowest in summer. The relative mortality of males was higher than that of females ( P < 0.05), increased with age ( P < 0.05), and that of rural areas was higher than that of urban areas ( P < 0.05). The trend analysis of death rate for ten-year showed a marked decline in females, an increase in 18-39 years old, a small change in 40-59 years old, a decrease in over 60 years old, and a downward tendency of urban areas. Further analysis showed that the mortality rate of males were higher than that of females in 18-39 years old and 40-59 years old group and also in urban areas group ( P < 0.05), while no sex difference in over 60 years old group and rural areas group ( P > 0.05). Conclusion: The mortality of CHD in Hexi corridor of Gansu province in China was lower than the national average from 2006 to 2015, but increased gradually in specified population such as in males, young and middle-age, rural areas groups. The prevention and control measures should be strengthened in these special populations.

This paper presents a co-design method of the event generator and the dynamic output feedback controller for a linear time-invariant (LIT) system. The event-triggered condition on the sensor-to-controller and the controller-to-actuator depends on the plant output and the controller output, respectively. A sufficient condition on the existence of the event generator and the dynamic output feedback controller is proposed and the co-design problem can be converted into the feasibility of linear matrix inequalities (LMIs). The LTI system is asymptotically stable under the proposed event-triggered controller and also reduces the computing resources with respect to the time-triggered one. In the end, a numerical example is given to illustrate the effectiveness of the proposed approach.