Correction to:Cheng FS,Pan D,Chang B,Jiang M,Sang LX.Probiotic mixture VSL#3:An overview of basic and clinical studies in chronic diseases.World J Clin Cases 2020;8:1361-1384.We are the team of Min Jiang and Li-Xuan S...Correction to:Cheng FS,Pan D,Chang B,Jiang M,Sang LX.Probiotic mixture VSL#3:An overview of basic and clinical studies in chronic diseases.World J Clin Cases 2020;8:1361-1384.We are the team of Min Jiang and Li-Xuan Sang from the First Affiliated Hospital,China Medical University.Now we solemnly declare that the studies mentioned in this article[1]evaluated the probiotic formulation known as VSL#3 before January 31,2016.The probiotic formulation is now commonly referred to as De Simone Formulation.In addition,the product currently known as VSL#3 is not the same as De Simone Formulation.De Simone Formulation is now available as Visbiome in the United States and Vivomixx in Europe.展开更多
BACKGROUND Target therapy is licensed by United States Food and Drug Administration on certain cancers.Both sorafenib and lenvatinib are tyrosine kinase inhibitor and indicated on radioactive iodine(RAI)-refractory di...BACKGROUND Target therapy is licensed by United States Food and Drug Administration on certain cancers.Both sorafenib and lenvatinib are tyrosine kinase inhibitor and indicated on radioactive iodine(RAI)-refractory differentiated thyroid cancer(DTC).Lenvatinib is more effective in cancers'control than sorafenib,but causes more nephrotoxicity than sorafenib does.This case is the second published case about the serial adaptions from lenvatinib to sorafenib for improving the proteinuria and,meanwhile,achieving the therapeutic goal.CASE SUMMARY A 56-year-old man suffered from bilateral edematous lower extremities after 1-mo prescription of lenvatinib of 20 mg/d for RAI-refractory DTC.Aside from this symptom,he also developed hypertension.His laboratory showed grade-3 proteinuria(estimated 24-h urine protein:9993 mg),hypoalbuminemia and hypercholesterolemia.Anti-vascular endothelial growth factor(VEGF)therapyinduced nephrotic syndrome was impressed.After reduced dosage of lenvatinib of 10 mg/d and related symptomatic drugs,limited improvement was observed in both adverse effects and caner control.Under this condition,we substituted sorafenib of 400 mg/d for lenvatinib of 10 mg/d.After a 5-mo prescription,not only hypertension and peripheral edema were greatly improved,but also proteinuria was improved from grade three to grade one(estimated 24-h urine protein:962 mg).At the same time the cancer control was achieved,judged from computed tomography and laboratory evidence[thyroglobulin(Tg)before prescription of sorafenib:354.7 ng/m L;Tg after prescription of sorafenib:108.9 ng/m L].CONCLUSION Adaption from lenvatinib to sorafenib is a feasible method to improve the antiVEGF therapy-induced nephrotic syndrome and achieve the therapeutic goal at the same time.展开更多
Aim: To evaluate the safety and effectiveness of a pilot program to control perioperative blood glucose in patients with diabetes. Methods: A pre-post intervention study was conducted in a 280-bed hospital in Spain. I...Aim: To evaluate the safety and effectiveness of a pilot program to control perioperative blood glucose in patients with diabetes. Methods: A pre-post intervention study was conducted in a 280-bed hospital in Spain. In the year 2008 we implemented perioperative insulin protocols aimed at blood glucose values from 80 to 180 mg/dL. Surgical patients with diabetes admitted on year 2009 (intervention group) were compared with a control group of patients with diabetes admitted for surgery on year 2007, matched 1:1 by traditional wound class. Results: We analyzed 96 patients. Implemented protocols were followed in 48% of patients intra-operatively and 75% of patients postoperatively. Patients in the intervention group had reductions in blood glucose at surgery 150 +/- 61 mg/dL vs. 172 +/- 53 mg/dL;p = 0.05), greater proportion of target glucose values throughout hospitalization (67% vs. 55%;p = 0.07), and reductions in the incidence of nosocomial infections after controlling for confounders (Odds Ratio: 0.20;95% Confidence intervals: 0.06 - 0.72;p = 0.014) when they were compared with the control group: The incidence of hypoglycemia was similar between two groups (0.12% vs. 0.10%, p = 0.867), respectively. Conclusion: Although our protocol needs improvements to increase implementation it was useful to control blood glucose safely and for reducing nosocomial infections.展开更多
Food must supply a balance of nutrients to support both brain and body.The human brain makes us uniquely human.Essential fatty acids are part of the metabolic pathways that define tissue structure and function.Omega-6...Food must supply a balance of nutrients to support both brain and body.The human brain makes us uniquely human.Essential fatty acids are part of the metabolic pathways that define tissue structure and function.Omega-6(O6)linoleic acid(LA6)has long been known to be required for skin structure,and as a precursor for inflammatory,thrombotic,immune,and other signaling molecules.Omega-3(O3)alpha-linolenic acid(ALA3)and particularly its long chain product docosahexaenoic acid(DHA3)has a key structural role in the brain,retina,and related neural tissue.In the 20 th century western world,inexpensive,high quality oils primarily from LA6-rich/O3-poor vegetable seed oils became dominant fats produced by the food industry.Provision of LA6-rich/O3-poor oils as the sole source of fat in the diets of pregnant animals causes O3 deficiency and poor brain development,primarily because high LA6 antagonizes metabolism of all O3,creating an artificial metabolic demand for O3.Data developed over the last 2~3 decades show that provision of low LA6 combined with preformed DHA3 optimizes brain function.Recent studies emphasize the importance of nutrition to support brain development,with newer findings showing particular importance of fatty acid balance in malnourished children.The World Health Organization(WHO)through the Codex Alimentarius(“Code for Food”)is increasingly recognizing the primacy of brain health and in part on that basis recently acted to recommend balanced fat for Ready-to-Use-Therapeutic Foods used to treat children with severe acute malnutrition.Similar principles are likely to be important in older persons.Industry now has the tools to adjust the composition of oils to support brain health throughout the life cycle.展开更多
OBJECTIVE: To evaluate the therapeutic effectiveness and safety of Jinying capsule on pelvic inflammatory disease(PID) in patients with symptoms identified as the pattern of damp and heat accumulation in terms of Trad...OBJECTIVE: To evaluate the therapeutic effectiveness and safety of Jinying capsule on pelvic inflammatory disease(PID) in patients with symptoms identified as the pattern of damp and heat accumulation in terms of Traditional Chinese Medicine(TCM).METHODS: We conducted a double-blinded, multicenter, randomized, placebo-controlled clinical trial which included 155 patients diagnosed with PID and identified as symptom pattern of damp and heat accumulation. They were randomly divided into experimental group(n = 78) and control group(n = 77) according to a random number table. The treatment lasted for a period of 28 d. The experimental group was given Jinying capsules and oral levofloxacin plus oral metronidazole for first 7 d.They continued with Jinying capsules and levofloxacin placebo and metronidazole placebo for another 7 d. For the remaining 14 d, they continued with Jinying capsules only. Whereas, the control group was treated with oral levofloxacin and metronidazole and Jinying capsule placebo for the first 14 d in the same way as the experimental group and then continued with Jinying capsule placebo only for the remaining 14 d. The clinical efficacy was assessed using McCormack scale, TCM symptom pattern scores, physicochemical indexes including white blood cell and erythrocyte sedimentation rate, C-reaction protein, smear of vaginal discharge,and pelvic ultrasound.RESULTS: Comparing McCormack scale between both groups after treatment, the difference in curative effect between both groups was significant (P = 0.0269). The cure rate of the experimental group and control group is 76.32% and 59.46% respectively at week 4. Comparing TCM symptom pattern scores between both groups before and after treatment, the differences in total effective rate were both significant(P < 0.05). The curative effect rate of experimental group is 2.63% and 13.70% of the control group at week 1(P = 0.0131), and73.33% of the experimental group and 56.94% of the control group at week 4(P = 0.0369). No significant differences were found between the two groups on the Physicochemical indexes(all P >0.05). No adverse events or reactions occurred in the experimental groups.CONCLUSION: Jinying capsule can reduce the dosage of antibiotics needed for PID treatment, and improve the symptoms in PID patients.展开更多
OBJECTIVE:To observe the effects of the Yiqi Qingdu prescription(益气清毒方)on intermediate-stage and advanced non-small-cell lung cancer(NSCLC).METHODS:In total,300 patients with intermediate-stage or advanced NSCLC ...OBJECTIVE:To observe the effects of the Yiqi Qingdu prescription(益气清毒方)on intermediate-stage and advanced non-small-cell lung cancer(NSCLC).METHODS:In total,300 patients with intermediate-stage or advanced NSCLC were randomly and equally divided into three groups using computer-generated random numbers as follows:Western medicine(WM),Chinese medicine(CM),and integrated Traditional Chinese and Western Medicine(IM).After 3 months of treatment,the overall response rate(ORR);disease control rate(DCR);symptom score(SS);Karnofsky performance status(KPS);adverse event score;counts of CD3^(+),CD4^(+),and CD8^(+)cells;CD4^(+)/CD8^(+)ratio;and carcinoembryonic antigen(CEA)level were compared among the groups.RESULTS:The ORRs were 30.36%,20.24%,and 7.87%in the IM,CM,and WM groups,respectively,whereas the DCRs were 85%,75%,and 73%,respectively.Compared to the CM group,the ORR was significantly higher in the WM and IM groups,whereas the DCR was significantly higher in the IM group(all P<0.05).SS was obviously higher in the WM group than in the other two groups(both P<0.01).KPS was significantly lower in the WM group after treatment(P=0.005).The mean number of adverse events was significantly lower in the CM(2.2±1.3)and IM(2.4±1.3)groups than in the WM group(4.6±1.7,both P<0.05).CD3^(+)cell counts were significantly decreased in the WM group(P=0.031).In the IM group,CD8^(+)cell counts were increased after treatment,whereas the CD4^(+)/CD8^(+)ratio was decreased(both P<0.01).Compared with the WM group,CD3^(+)(P=0.01),CD4^(+)(P=0.044),and CD8^(+)(P=0.009)cell counts were significantly higher in the IM group,whereas the CD4^(+)/CD8^(+)ratio was significantly lower(P=0.011).Relative to the CM group,CD8^(+)cell counts were significantly higher(P=0.001)and the CD4^(+)/CD8^(+)ratio was significant ly lower in the IM group(P=0.001).CEA levels were significantly increased in the CM group(P=0.023).CONCLUSION:The Yiqi Qingdu prescription can improve the outcomes of WM in patients with NSCLC.展开更多
OBJECTIVE:To investigate the therapeutic effect of Sishen Wan(四神丸,SSW)on ulcerative colitis(UC)induced by dinitrobenzene sulfonic acid and its effect on toll-like receptor 2/interleukin-1 receptor-associated kinase...OBJECTIVE:To investigate the therapeutic effect of Sishen Wan(四神丸,SSW)on ulcerative colitis(UC)induced by dinitrobenzene sulfonic acid and its effect on toll-like receptor 2/interleukin-1 receptor-associated kinase-4/nuclear factor-κB(TLR2/IRAK4/NF-κB)signaling pathway in colonic tissue.METHODS:In this study,120 Sprague–Dawley rats were randomly divided into blank and model groups.The experimental UC model in rats was established by subcutaneous injection of hydrocortisone+senna gavage for 21 d+dinitrobenzene sulfonic acid(DNBS)/ethanol solution enema.The successful model rats were randomly divided into the model group;mesalazine(0.36 g/kg)group;and high-,medium-,and low-dose SSW(24,12,and 6 g/kg)groups.The model and blank groups were gavaged with equal volumes of distilled water once a day for 21 d.The general condition of the rats was observed,and the body mass,fecal properties,and occult blood were recorded for calculating the disease activity index(DAI)score.The colonic tissue of the rats was collected,and its general morphology and pathological form were noted for obtaining the colonic mucosal injury index(CMDI)score.Hematoxylin-eosin staining was used to view the pathological changes of the colon tissue in each group,apoptosis of the cells was detected using terminal deoxynucleotidyl transferase-mediated d UTP nick-end labeling staining,and quantitative real-time polymerase chain reaction was used to measure the expressions of TLR2,myeloid differentiation primary response gene 88(My D88),IRAK4,and NF-κB p65 mRNA in the colon tissue.The expressions of TLR2,My D88,IRAK4,and NF-κB p65 protein were detected using western blotting and immunohistochemistry assay,and the levels of interleukin-1β(IL-1β)and tumor necrosis factor-α(TNF-α)in the colon tissue were determined using enzyme linked immunosorbent assay.RESULTS:Compared with the blank group,the general condition of the model group was relatively poor.The DAI and CMDI scores of the model group increased significantly(P<0.01),the glands and intestinal mucosa disappeared partially,and several inflammatory cells infiltrated and gathered in the mucosal layer and base layer of the rats in the model group.Furthermore,the cell apoptosis and expression levels of TLR2,My D88,IRAK4,and NF-κB p65 mRNA and protein in the colon tissue of rats in the model group increased significantly(P<0.01).The levels of IL-1βand TNF-αincreased significantly in the colon tissue of rats in the model group(P<0.01).After treatment with SSW,compared with the model group,the general condition of the UC rats improved.Moreover,the DAI and CMDI scores of the UC rats decreased significantly(P<0.05),and the pathological changes in the colon tissue of the UC rats tended to be normal.The cell apoptosis and expression levels of TLR2,My D88,IRAK4,and NF-κB p65 mRNA and protein in the colon tissue of the UC rats decreased gradually(P<0.01),and the levels of IL-1βand TNF-αdecreased significantly(P<0.01).CONCLUSION:SSW can improve the general condition and alleviate the intestinal mucosal injury of UC model rats.Additionally,SSW can inhibit the TLR2/IRAK4/NF-κB signaling pathway,but further studies are required to confirm it.展开更多
OBJECTIVE:To evaluate the effectiveness of electroacupuncture(EA)for female stress urinary incontinence(SUI).METHODS:We searched 12 databases electronically from inception to November 2018 without language restriction...OBJECTIVE:To evaluate the effectiveness of electroacupuncture(EA)for female stress urinary incontinence(SUI).METHODS:We searched 12 databases electronically from inception to November 2018 without language restrictions.We included randomized controlled trials(RCTs)involving women with SUI,but excluded other types of urinary incontinence or studies that were not RCTs.Two independent reviewers extracted study characteristics,with disagreements resolved by consensus.Data were pooled and expressed as mean difference(MD)for continuous outcomes and relative risk(RR)for dichotomous outcomes,with 95%confidence intervals(CI).This study was registered with the International Prospective Register of Systematic Reviews(number CRD42018089734).RESULTS:We found very low to high level evidence that EA improved the effective rate(RR=2.03,95%CI:1.40,2.95;P=0.0002)and reduced urine leakage as measured by the 1-hour pad test(MD=3.33,95%CI:0.89,5.77;P=0.008),International Consultation on Incontinence Questionnaire Short Form score(MD=3.14,95%CI:2.42,3.85;P<0.00001),and 72-hour incontinence episodes(MD=1.17,95%CI:0.56,1.78;P=0.0002)compared with sham electroacupuncture(SA),pelvic floor muscle training,and medication.CONCLUSION:The effectiveness and safety of EA for key outcomes for women with SUI are statistically significantly better than those of SA,but most available evidence is very low or low quality.More well-designed RCTs are needed to confirm these findings.展开更多
Background:Since 2015,the Global Technical Strategy(GTS)for Malaria 2016–2030 has been adopted by the World Health Organization(WHO)as a comprehensive framework to accelerate progress for malaria elimination in endem...Background:Since 2015,the Global Technical Strategy(GTS)for Malaria 2016–2030 has been adopted by the World Health Organization(WHO)as a comprehensive framework to accelerate progress for malaria elimination in endemic countries.This strategy sets the target of reducing global malaria incidence and mortality rates by 90% in 2030.Here it is sought to evaluate Brazil’s achievements towards reaching the WHO GTS milestone in 2030.Considering the total number of new malaria cases in 2015,the main research question is:will Brazil reach the malaria elimination goal in 2030?Methods:Analytical strategies were undertaken using the SIVEP-malaria ofcial databases of the Brazilian Malaria Control Programme for the Brazilian Amazon region from 2009 to 2020.Spatial and time-series analyses were applied for identifying municipalities that support the highest numbers of malaria cases over the years.Forecast analysis was used for predicting the estimated number of new cases in Brazil in 2025–2050.Results:Brazil has signifcantly reduced the number of new malaria cases in 2020 in comparison with 2015 in the states of Acre(−56%),Amapá(−75%),and Amazonas(−21%);however,they increased in the states of Pará(156%),Rondônia(74%),and Roraima(362%).Forecast of the predicted number of new malaria cases in 2030 is 74,764(95%CI:41,116–141,160)in the Brazilian Amazon.Conclusions:It is likely that Brazil will reduce the number of new malaria cases in the Brazilian Amazon in 2030 in relation to that in 2015.Herein forecast shows a reduction by 46%(74,754 in 2030 forecast/137,982 in 2015),but this reduction is yet far from the proposed reduction under the WHO GTS 2030 milestone(90%).Stable and unbeatable transmission in the Juruá River Valley,Manaus,and Lábrea still support endemic malaria in the Brazilian Amazon.Today’s cross-border malaria is impacting the state of Roraima unprecedently.If this situation is maintained,the malaria elimination goal(zero cases)may not be reached before 2050.An enhanced political commitment is vital to ensure optimal public health intervention designs in the post-2030 milestones for malaria elimination.展开更多
文摘Correction to:Cheng FS,Pan D,Chang B,Jiang M,Sang LX.Probiotic mixture VSL#3:An overview of basic and clinical studies in chronic diseases.World J Clin Cases 2020;8:1361-1384.We are the team of Min Jiang and Li-Xuan Sang from the First Affiliated Hospital,China Medical University.Now we solemnly declare that the studies mentioned in this article[1]evaluated the probiotic formulation known as VSL#3 before January 31,2016.The probiotic formulation is now commonly referred to as De Simone Formulation.In addition,the product currently known as VSL#3 is not the same as De Simone Formulation.De Simone Formulation is now available as Visbiome in the United States and Vivomixx in Europe.
文摘BACKGROUND Target therapy is licensed by United States Food and Drug Administration on certain cancers.Both sorafenib and lenvatinib are tyrosine kinase inhibitor and indicated on radioactive iodine(RAI)-refractory differentiated thyroid cancer(DTC).Lenvatinib is more effective in cancers'control than sorafenib,but causes more nephrotoxicity than sorafenib does.This case is the second published case about the serial adaptions from lenvatinib to sorafenib for improving the proteinuria and,meanwhile,achieving the therapeutic goal.CASE SUMMARY A 56-year-old man suffered from bilateral edematous lower extremities after 1-mo prescription of lenvatinib of 20 mg/d for RAI-refractory DTC.Aside from this symptom,he also developed hypertension.His laboratory showed grade-3 proteinuria(estimated 24-h urine protein:9993 mg),hypoalbuminemia and hypercholesterolemia.Anti-vascular endothelial growth factor(VEGF)therapyinduced nephrotic syndrome was impressed.After reduced dosage of lenvatinib of 10 mg/d and related symptomatic drugs,limited improvement was observed in both adverse effects and caner control.Under this condition,we substituted sorafenib of 400 mg/d for lenvatinib of 10 mg/d.After a 5-mo prescription,not only hypertension and peripheral edema were greatly improved,but also proteinuria was improved from grade three to grade one(estimated 24-h urine protein:962 mg).At the same time the cancer control was achieved,judged from computed tomography and laboratory evidence[thyroglobulin(Tg)before prescription of sorafenib:354.7 ng/m L;Tg after prescription of sorafenib:108.9 ng/m L].CONCLUSION Adaption from lenvatinib to sorafenib is a feasible method to improve the antiVEGF therapy-induced nephrotic syndrome and achieve the therapeutic goal at the same time.
基金Fundacion Mutua Madrilena para la Investigacion Sanofi-Aventis Laboratories
文摘Aim: To evaluate the safety and effectiveness of a pilot program to control perioperative blood glucose in patients with diabetes. Methods: A pre-post intervention study was conducted in a 280-bed hospital in Spain. In the year 2008 we implemented perioperative insulin protocols aimed at blood glucose values from 80 to 180 mg/dL. Surgical patients with diabetes admitted on year 2009 (intervention group) were compared with a control group of patients with diabetes admitted for surgery on year 2007, matched 1:1 by traditional wound class. Results: We analyzed 96 patients. Implemented protocols were followed in 48% of patients intra-operatively and 75% of patients postoperatively. Patients in the intervention group had reductions in blood glucose at surgery 150 +/- 61 mg/dL vs. 172 +/- 53 mg/dL;p = 0.05), greater proportion of target glucose values throughout hospitalization (67% vs. 55%;p = 0.07), and reductions in the incidence of nosocomial infections after controlling for confounders (Odds Ratio: 0.20;95% Confidence intervals: 0.06 - 0.72;p = 0.014) when they were compared with the control group: The incidence of hypoglycemia was similar between two groups (0.12% vs. 0.10%, p = 0.867), respectively. Conclusion: Although our protocol needs improvements to increase implementation it was useful to control blood glucose safely and for reducing nosocomial infections.
基金US National Institutes of Health(R01s AT007003,GM103437,GM71534,EY10208,GM49209)Unorthodox Philanthropy+3 种基金Open Philanthropythe Hickey Family Foundationthe Children’s Discovery InstituteWiley Companies。
文摘Food must supply a balance of nutrients to support both brain and body.The human brain makes us uniquely human.Essential fatty acids are part of the metabolic pathways that define tissue structure and function.Omega-6(O6)linoleic acid(LA6)has long been known to be required for skin structure,and as a precursor for inflammatory,thrombotic,immune,and other signaling molecules.Omega-3(O3)alpha-linolenic acid(ALA3)and particularly its long chain product docosahexaenoic acid(DHA3)has a key structural role in the brain,retina,and related neural tissue.In the 20 th century western world,inexpensive,high quality oils primarily from LA6-rich/O3-poor vegetable seed oils became dominant fats produced by the food industry.Provision of LA6-rich/O3-poor oils as the sole source of fat in the diets of pregnant animals causes O3 deficiency and poor brain development,primarily because high LA6 antagonizes metabolism of all O3,creating an artificial metabolic demand for O3.Data developed over the last 2~3 decades show that provision of low LA6 combined with preformed DHA3 optimizes brain function.Recent studies emphasize the importance of nutrition to support brain development,with newer findings showing particular importance of fatty acid balance in malnourished children.The World Health Organization(WHO)through the Codex Alimentarius(“Code for Food”)is increasingly recognizing the primacy of brain health and in part on that basis recently acted to recommend balanced fat for Ready-to-Use-Therapeutic Foods used to treat children with severe acute malnutrition.Similar principles are likely to be important in older persons.Industry now has the tools to adjust the composition of oils to support brain health throughout the life cycle.
文摘OBJECTIVE: To evaluate the therapeutic effectiveness and safety of Jinying capsule on pelvic inflammatory disease(PID) in patients with symptoms identified as the pattern of damp and heat accumulation in terms of Traditional Chinese Medicine(TCM).METHODS: We conducted a double-blinded, multicenter, randomized, placebo-controlled clinical trial which included 155 patients diagnosed with PID and identified as symptom pattern of damp and heat accumulation. They were randomly divided into experimental group(n = 78) and control group(n = 77) according to a random number table. The treatment lasted for a period of 28 d. The experimental group was given Jinying capsules and oral levofloxacin plus oral metronidazole for first 7 d.They continued with Jinying capsules and levofloxacin placebo and metronidazole placebo for another 7 d. For the remaining 14 d, they continued with Jinying capsules only. Whereas, the control group was treated with oral levofloxacin and metronidazole and Jinying capsule placebo for the first 14 d in the same way as the experimental group and then continued with Jinying capsule placebo only for the remaining 14 d. The clinical efficacy was assessed using McCormack scale, TCM symptom pattern scores, physicochemical indexes including white blood cell and erythrocyte sedimentation rate, C-reaction protein, smear of vaginal discharge,and pelvic ultrasound.RESULTS: Comparing McCormack scale between both groups after treatment, the difference in curative effect between both groups was significant (P = 0.0269). The cure rate of the experimental group and control group is 76.32% and 59.46% respectively at week 4. Comparing TCM symptom pattern scores between both groups before and after treatment, the differences in total effective rate were both significant(P < 0.05). The curative effect rate of experimental group is 2.63% and 13.70% of the control group at week 1(P = 0.0131), and73.33% of the experimental group and 56.94% of the control group at week 4(P = 0.0369). No significant differences were found between the two groups on the Physicochemical indexes(all P >0.05). No adverse events or reactions occurred in the experimental groups.CONCLUSION: Jinying capsule can reduce the dosage of antibiotics needed for PID treatment, and improve the symptoms in PID patients.
基金Supported by Xiong Monian National Famous and Senior Chinese Medicine Experts Inheritance Studio Construction Project(No.47[2013],the Personnel and Education Department of the State Administration of Traditional Chinese Medicine promulgated)Key R&D projects in Jiangxi Province:lung cancer prevention and treatment,health preservation technology and products based on the method of"Tonifying Qi and Cleaning Toxin"(No.20171BBG70113)。
文摘OBJECTIVE:To observe the effects of the Yiqi Qingdu prescription(益气清毒方)on intermediate-stage and advanced non-small-cell lung cancer(NSCLC).METHODS:In total,300 patients with intermediate-stage or advanced NSCLC were randomly and equally divided into three groups using computer-generated random numbers as follows:Western medicine(WM),Chinese medicine(CM),and integrated Traditional Chinese and Western Medicine(IM).After 3 months of treatment,the overall response rate(ORR);disease control rate(DCR);symptom score(SS);Karnofsky performance status(KPS);adverse event score;counts of CD3^(+),CD4^(+),and CD8^(+)cells;CD4^(+)/CD8^(+)ratio;and carcinoembryonic antigen(CEA)level were compared among the groups.RESULTS:The ORRs were 30.36%,20.24%,and 7.87%in the IM,CM,and WM groups,respectively,whereas the DCRs were 85%,75%,and 73%,respectively.Compared to the CM group,the ORR was significantly higher in the WM and IM groups,whereas the DCR was significantly higher in the IM group(all P<0.05).SS was obviously higher in the WM group than in the other two groups(both P<0.01).KPS was significantly lower in the WM group after treatment(P=0.005).The mean number of adverse events was significantly lower in the CM(2.2±1.3)and IM(2.4±1.3)groups than in the WM group(4.6±1.7,both P<0.05).CD3^(+)cell counts were significantly decreased in the WM group(P=0.031).In the IM group,CD8^(+)cell counts were increased after treatment,whereas the CD4^(+)/CD8^(+)ratio was decreased(both P<0.01).Compared with the WM group,CD3^(+)(P=0.01),CD4^(+)(P=0.044),and CD8^(+)(P=0.009)cell counts were significantly higher in the IM group,whereas the CD4^(+)/CD8^(+)ratio was significantly lower(P=0.011).Relative to the CM group,CD8^(+)cell counts were significantly higher(P=0.001)and the CD4^(+)/CD8^(+)ratio was significant ly lower in the IM group(P=0.001).CEA levels were significantly increased in the CM group(P=0.023).CONCLUSION:The Yiqi Qingdu prescription can improve the outcomes of WM in patients with NSCLC.
基金Supported by the National Natural Science Foundation of China:to Explore the Immune Mechanism of Treating Ulcerative Colitis by Regulating Treg/Th17 Cell Imbalance by Warming the Kidney and Invigorating the Spleen through Intestinal Flora(No.81960826)
文摘OBJECTIVE:To investigate the therapeutic effect of Sishen Wan(四神丸,SSW)on ulcerative colitis(UC)induced by dinitrobenzene sulfonic acid and its effect on toll-like receptor 2/interleukin-1 receptor-associated kinase-4/nuclear factor-κB(TLR2/IRAK4/NF-κB)signaling pathway in colonic tissue.METHODS:In this study,120 Sprague–Dawley rats were randomly divided into blank and model groups.The experimental UC model in rats was established by subcutaneous injection of hydrocortisone+senna gavage for 21 d+dinitrobenzene sulfonic acid(DNBS)/ethanol solution enema.The successful model rats were randomly divided into the model group;mesalazine(0.36 g/kg)group;and high-,medium-,and low-dose SSW(24,12,and 6 g/kg)groups.The model and blank groups were gavaged with equal volumes of distilled water once a day for 21 d.The general condition of the rats was observed,and the body mass,fecal properties,and occult blood were recorded for calculating the disease activity index(DAI)score.The colonic tissue of the rats was collected,and its general morphology and pathological form were noted for obtaining the colonic mucosal injury index(CMDI)score.Hematoxylin-eosin staining was used to view the pathological changes of the colon tissue in each group,apoptosis of the cells was detected using terminal deoxynucleotidyl transferase-mediated d UTP nick-end labeling staining,and quantitative real-time polymerase chain reaction was used to measure the expressions of TLR2,myeloid differentiation primary response gene 88(My D88),IRAK4,and NF-κB p65 mRNA in the colon tissue.The expressions of TLR2,My D88,IRAK4,and NF-κB p65 protein were detected using western blotting and immunohistochemistry assay,and the levels of interleukin-1β(IL-1β)and tumor necrosis factor-α(TNF-α)in the colon tissue were determined using enzyme linked immunosorbent assay.RESULTS:Compared with the blank group,the general condition of the model group was relatively poor.The DAI and CMDI scores of the model group increased significantly(P<0.01),the glands and intestinal mucosa disappeared partially,and several inflammatory cells infiltrated and gathered in the mucosal layer and base layer of the rats in the model group.Furthermore,the cell apoptosis and expression levels of TLR2,My D88,IRAK4,and NF-κB p65 mRNA and protein in the colon tissue of rats in the model group increased significantly(P<0.01).The levels of IL-1βand TNF-αincreased significantly in the colon tissue of rats in the model group(P<0.01).After treatment with SSW,compared with the model group,the general condition of the UC rats improved.Moreover,the DAI and CMDI scores of the UC rats decreased significantly(P<0.05),and the pathological changes in the colon tissue of the UC rats tended to be normal.The cell apoptosis and expression levels of TLR2,My D88,IRAK4,and NF-κB p65 mRNA and protein in the colon tissue of the UC rats decreased gradually(P<0.01),and the levels of IL-1βand TNF-αdecreased significantly(P<0.01).CONCLUSION:SSW can improve the general condition and alleviate the intestinal mucosal injury of UC model rats.Additionally,SSW can inhibit the TLR2/IRAK4/NF-κB signaling pathway,but further studies are required to confirm it.
文摘OBJECTIVE:To evaluate the effectiveness of electroacupuncture(EA)for female stress urinary incontinence(SUI).METHODS:We searched 12 databases electronically from inception to November 2018 without language restrictions.We included randomized controlled trials(RCTs)involving women with SUI,but excluded other types of urinary incontinence or studies that were not RCTs.Two independent reviewers extracted study characteristics,with disagreements resolved by consensus.Data were pooled and expressed as mean difference(MD)for continuous outcomes and relative risk(RR)for dichotomous outcomes,with 95%confidence intervals(CI).This study was registered with the International Prospective Register of Systematic Reviews(number CRD42018089734).RESULTS:We found very low to high level evidence that EA improved the effective rate(RR=2.03,95%CI:1.40,2.95;P=0.0002)and reduced urine leakage as measured by the 1-hour pad test(MD=3.33,95%CI:0.89,5.77;P=0.008),International Consultation on Incontinence Questionnaire Short Form score(MD=3.14,95%CI:2.42,3.85;P<0.00001),and 72-hour incontinence episodes(MD=1.17,95%CI:0.56,1.78;P=0.0002)compared with sham electroacupuncture(SA),pelvic floor muscle training,and medication.CONCLUSION:The effectiveness and safety of EA for key outcomes for women with SUI are statistically significantly better than those of SA,but most available evidence is very low or low quality.More well-designed RCTs are needed to confirm these findings.
文摘Background:Since 2015,the Global Technical Strategy(GTS)for Malaria 2016–2030 has been adopted by the World Health Organization(WHO)as a comprehensive framework to accelerate progress for malaria elimination in endemic countries.This strategy sets the target of reducing global malaria incidence and mortality rates by 90% in 2030.Here it is sought to evaluate Brazil’s achievements towards reaching the WHO GTS milestone in 2030.Considering the total number of new malaria cases in 2015,the main research question is:will Brazil reach the malaria elimination goal in 2030?Methods:Analytical strategies were undertaken using the SIVEP-malaria ofcial databases of the Brazilian Malaria Control Programme for the Brazilian Amazon region from 2009 to 2020.Spatial and time-series analyses were applied for identifying municipalities that support the highest numbers of malaria cases over the years.Forecast analysis was used for predicting the estimated number of new cases in Brazil in 2025–2050.Results:Brazil has signifcantly reduced the number of new malaria cases in 2020 in comparison with 2015 in the states of Acre(−56%),Amapá(−75%),and Amazonas(−21%);however,they increased in the states of Pará(156%),Rondônia(74%),and Roraima(362%).Forecast of the predicted number of new malaria cases in 2030 is 74,764(95%CI:41,116–141,160)in the Brazilian Amazon.Conclusions:It is likely that Brazil will reduce the number of new malaria cases in the Brazilian Amazon in 2030 in relation to that in 2015.Herein forecast shows a reduction by 46%(74,754 in 2030 forecast/137,982 in 2015),but this reduction is yet far from the proposed reduction under the WHO GTS 2030 milestone(90%).Stable and unbeatable transmission in the Juruá River Valley,Manaus,and Lábrea still support endemic malaria in the Brazilian Amazon.Today’s cross-border malaria is impacting the state of Roraima unprecedently.If this situation is maintained,the malaria elimination goal(zero cases)may not be reached before 2050.An enhanced political commitment is vital to ensure optimal public health intervention designs in the post-2030 milestones for malaria elimination.
