To analyse the effectiveness of performing a transverse tibial bone graft in the treatment of patients with diabetic foot. We retrospectively analysed the clinical details of 51 diabetic foot patients in our hospital ...To analyse the effectiveness of performing a transverse tibial bone graft in the treatment of patients with diabetic foot. We retrospectively analysed the clinical details of 51 diabetic foot patients in our hospital from February 2023 to February 2024 and divided them into two groups according to the different treatment modalities, in which the control group received open debridement and the treatment group received transverse tibial bone transfer and compared the differences between the two groups. There were large differences in VAS score, Toronto Clinical Symptom Score, quality of life score, internal lumen diameter, blood flow velocity in the affected limb, perfusion volume, vascular endothelial growth factor, epidermal growth factor and CRP between the two groups after surgery (P < 0.05). Patients with diabetic foot should be treated with transverse tibial bone grafting, which is safer and more effective and can have a significant impact on improving the status of the affected limb, the inflammation and the patient’s quality of life.展开更多
Background::Recently,T-helper 17(Th17)cells have been proved to play an important role in promoting cervical cancer.But,till now,few study has been carried out to understand the involvement of these cells in efficacy ...Background::Recently,T-helper 17(Th17)cells have been proved to play an important role in promoting cervical cancer.But,till now,few study has been carried out to understand the involvement of these cells in efficacy of anti-tumor treatments.This study aimed to investigate the alterations in the percentage of circulating Th17 cells and related cytokines in locally advanced cervical cancer(LACC)patients before and after concurrent chemoradiotherapy(cCRT)and to analyze the correlations between the alterations in Th17 cells and treatment efficacy.Methods::A prospective study with 49 LACC(International federation of gynecology and obstetrics[FIGO]stage IIB-IIIB)patients and 23 controls was conducted.Patients received the same cCRT schedule and were followed up for 3 years.Circulating Th17 cells(CD3+CD8-interleukin[IL]-17+T cells)and related cytokines IL-17,transforming growth factor-β(TGF-β),IL-10,IL-23,IL-6,and IL-22 were detected before and after cCRT.Correlations between alterations of circulating Th17 cells and treatment efficacy were analyzed.Kaplan-Meier analysis was used for overall survival(OS)and progression-free survival(PFS).Results::We found that 40 patients finished the entire cCRT schedule and met the endpoint of this study.The percentage of circulating Th17 cells in the LACC patients was higher than that in the controls,and it significantly decreased after cCRT(P<0.05).After cCRT,patients were divided into two groups based on the average of the Th17 cells declined.The subgroup of patients with a prominent decrease in circulating Th17 cells after cCRT had a higher treatment efficacy and longer PFS and OS times.Compared with the control patients,LACC patients had higher IL-6,IL-10,IL-22,TGF-βlevels and a lower IL-23 level(P<0.05).After cCRT,IL-6,IL-10,IL-17,IL-23 level significantly increased and TGF-βlevel significantly decreased compared with the levels before cCRT(P<0.05).Conclusion::Circulating Th17 cells in the LACC patients(FIGO stage IIB-IIIB)were higher than those in the controls,but they generally decreased after cCRT.A more pronounced decrease in circulating Th17 cells after cCRT was correlated with better therapeutic effect and longer PFS and OS times.展开更多
Background: Helicobacter pylori (H. pylori) infection is a public health concern. In fact, due to bacterial resistance, treatment strategy is a challenge. It is then more recommended to prolong first-line treatment. I...Background: Helicobacter pylori (H. pylori) infection is a public health concern. In fact, due to bacterial resistance, treatment strategy is a challenge. It is then more recommended to prolong first-line treatment. In order to be acceptable, the clinical efficacy of treatment must be higher than 90%. Aim: We aimed to assess the outcome of prolonged first-line treatment among adults. Patients and Methods: The study was cross-sectional among adults and patients were treated for H. pylori eradication for the first time during 10 to 14 days. Recruitment was made from March 2019 in six private polyclinics and two hospitals of the city of Ouagadougou. We used monoclonal antigen (Ag) test on the stool samples for diagnostic and for the patients follow up. Chi squared (X<sup>2</sup>) tests and ANOVA for the comparison of percentages and means were determined using with STATA<sup>® </sup>software program in the bilateral 95% confidence interval for the statistical analysis. Results: In the different medical centers for 19 months, 365 patients were compiled. The sex-ratio was 0.64. The average age was 43.55 years. The treatment efficacy was 92.88%. Treatment efficacy was better with p-value <10<sup>-3</sup> depending on prescriber: gastroenterologist (94.07%), general practitioner (75%);compliance before treatment: excellent (95.88%) or bad (50%);number of consultations: ≥four (94.35%), three (96.32%), two (78.85%). Triple therapies efficacy was 90.81%;p = 0.19. Quadritherapy efficacy was 95%;p = 0.5. Conclusion: This research is a contribution to the advent of national or African recommendations.展开更多
Constructed wetlands (CWs) can achieve a high-quality wastewater treatment and a quality that meets the prescribed standard, defined by legislation on wastewater discharge. A limitation in the application of construct...Constructed wetlands (CWs) can achieve a high-quality wastewater treatment and a quality that meets the prescribed standard, defined by legislation on wastewater discharge. A limitation in the application of constructed wetlands (CWs) is the large area requirement, which limits their application. The subject matter of this research is to check the possibility of improving the efficiency of wastewater treatment and reducing the required area for constructed wetlands (CWs) by using an adequate substrate under the conditions found in Montenegro. In the described experiment, the constructed wetlands (CW) have a vertical flow system and play the role of a secondary wastewater treatment, receiving water from the existing WWTP in Podgorica after the primary treatment. These vertical flow systems reflect experience with the use of similar systems in Slovenija, Austria and Italy. Measurements to date show that the substrate plays an important role and that wastewater treatment efficacy varies significantly with respect to the type of substrate when used under the conditions available in Montenegro.展开更多
Objective To evaluate the clinical efficacy and side effects of sunitinib in treatment of advanced renal cell carcinoma. Methods Forty-five patients with advanced renal cell carcinorna and an average age of 48. 6 yrs ...Objective To evaluate the clinical efficacy and side effects of sunitinib in treatment of advanced renal cell carcinoma. Methods Forty-five patients with advanced renal cell carcinorna and an average age of 48. 6 yrs were treated with sunitinib. of the study group。展开更多
Background: Early excision and grafting has been the preferred method of managing major burns around the world since 1970. Considering the advances in health care and the development of new antibiotics over the past 5...Background: Early excision and grafting has been the preferred method of managing major burns around the world since 1970. Considering the advances in health care and the development of new antibiotics over the past 50 years, delayed grafting as a technique for the management of burns over 15%-20% of total body surface area (TBSA) could have comparable results to that of early excision. This study aims to highlight the outcomes of practicing delayed grafting in burn patients. Methods: A case series analysis was performed of 51 patients who were admitted to the burns unit in Sultan Qaboos Hospital Salalah with over 20% TBSA between January 2014 and December 2019. The patients received prophylactic antibiotics and silver sulphadiazine dressing until the burn eschar had completely separated, followed by grafting. Results: Two patients were lost during the entire duration of the study. The mortality rate was comparable to that of early excision, while the rate of hypertrophic scarring was lower than the range reported by other studies. Conclusion: In the management of patients with over 20% TBSA, delayed grafting after complete separation of eschar is still a valid technique.展开更多
Objective:To analyze the clinical efficacy of hepatic artery chemoembolization in the treatment of advanced liver cancer.Methods:124 patients with advanced liver cancer admitted to our hospital from September 2019 to ...Objective:To analyze the clinical efficacy of hepatic artery chemoembolization in the treatment of advanced liver cancer.Methods:124 patients with advanced liver cancer admitted to our hospital from September 2019 to November 2020 were selected as the research subjects of this paper.The patients with advanced liver cancer were divided into experimental group and control group.The control group was treated with radiofrequency ablation alone,and the experimental group was administered hepatic arterial chemoembolization.The improvement in physical indicators and the incidence of adverse reactions between the two groups were compared.Results:The alpha-fetoprotein(AFP)index and serum total bilirubin(TBIL)index of the experimental group were lower than those of the control group,and the alanine aminotransferase(ALT)index was higher than that of the control group.There were differences in the comparison of liver function indices between the two groups which were statistically significant.After treatment,there were 3 cases of fever,4 cases of vomiting,8 cases of bone marrow transplantation,4 cases of abdominal pain,2 cases of proteinuria,and 1 case of diarrhea occurred in the experimental group;whereas there were 6 cases of fever,8 cases of vomiting,14 cases of bone marrow transplantation,7 cases of abdominal pain,5 cases of proteinuria,and 6 cases of diarrhea occurred in the control group.The difference in incidence of adverse reactions between patients after different treatment interventions was statistically significant.Analyzing the remission rate of tumor diseases in patients,the remission rate of the experimental group was higher than that of the control group,and the difference in the remission rate between the two groups of patients was statistically significant.Conclusion:The implementation of hepatic arterial chemoembolization for patients with advanced liver cancer can promote the improvement of the patient's short-term treatment efficacy,enhance the liver functions of the patient,reduce the incidence of adverse reactions,improve the efficiency of the patient's body rehabilitation,and enhance the quality of life of the patient after treatment.展开更多
Background:In recent years,herbal formulations have assumed an influential part in preventing and treating tumors.Shenqi Yichang granules(SQYCG)have proven effective in the adjuvant treatment of colorectal cancer(CRC)...Background:In recent years,herbal formulations have assumed an influential part in preventing and treating tumors.Shenqi Yichang granules(SQYCG)have proven effective in the adjuvant treatment of colorectal cancer(CRC),but their mechanism has not been elucidated.This study aimed to explore the potential active compounds and mechanisms of SQYCG in the treatment of CRC using network pharmacology and molecular docking.Methods:The active compounds and targets of SQYCG and the CRC genes were found using the Traditional Chinese Medicine Systems Pharmacology,DrugBank,and DisGeNET databases.The intersected targets of disease genes and drug targets were depicted using a Venn diagram.The protein-protein interaction(PPI)network of these targets was obtained by String platform and visualized using Cytoscape.Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analysis were carried using the DAVID database to obtain the core molecular mechanism of SQYCG in CRC treatment.Molecular docking techniques were used to validate the results.Results:A total of 63 compounds and 245 targets were obtained from the herbal prescription after the screening,of which 122 targets crossed with CRC genes.PPI showed that the core regulatory targets include MAPK1,TNF,TP53,JUN,RELA,MAPK14,and MAPK 8.The GO analysis indicated regulation of drug response,apoptotic process,response to hypoxia,angiogenesis,and response to lipopolysaccharide.KEGG pathway enrichment analysis mainly involves TNF,T cell receptor,Toll-like receptor,PI3K-Akt,and MAPK signal pathway.Conclusion:Through network pharmacology,we havedemonstrated that SQYCG has multiple targets,components,and pathways in treating CRC,with anti inflammation and inhibition of cell proliferation being critical components of its mechanism.展开更多
Objective:To examine the efficacy and safety of bathing therapy with Taohong Siwu Decoction(桃红四物汤,TSD) in the treatment of early-stage,mild-moderate diffuse cutaneous systemic sclerosis(dc SSc).Methods:This rando...Objective:To examine the efficacy and safety of bathing therapy with Taohong Siwu Decoction(桃红四物汤,TSD) in the treatment of early-stage,mild-moderate diffuse cutaneous systemic sclerosis(dc SSc).Methods:This randomized,placebo-controlled trial enrolled 148 men and women(18–60 years) with dc SSc(disease duration 12 months) and baseline modified Rodnan skin score(MRSS) 10.Patients were randomized into a TSD group(71 cases bathing with TSD plus oral prednisone) or control group(71 cases bathing with placebo plus oral prednisone).Bathing(40 ℃,30 min) of the upper and lower limbs was carried out once daily for 12 consecutive weeks.The primary outcome measure was MRSS;secondary outcomes were Raynaud's phenomenon(RP) score,quality of life(QOL),physician visual analogue scale(VAS),patient VAS,percent predicted diffusing capacity for carbon monoxide(DLCO),percent predicted forced vital capacity(FVC),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP) level and overall treatment effect.Results:The final analysis included 135 patients(control group,68 cases;TSD group,67 cases).Primary and secondary outcome measures after 2 weeks of treatment showed no improvement(versus baseline) in both groups,with no differences between groups.At 12 weeks,QOL,physician VAS,patient VAS,ESR and CRP were improved in both groups,but MRSS and RP score were improved only in the TSD group(all P<0.05).MRSS,RP score,QOL,physician VAS,patient VAS,ESR and CRP differed significantly between groups(all P<0.05).Meanwhile,the overall treatment effect was significantly higher in the TSD group than in the control group(P<0.05).Adverse events in the two groups were similar(P>0.05).Conclusions:Bathing with TSD plus oral prednisone achieves better outcomes than oral prednisone alone in patients with dcS Sc and is not associated with serious adverse events.展开更多
Transcranial direct current stimulation(tDCS)has been reportedly beneficial for different neurodegenerative disorders.tDCS has been reported as a potential adjunctive or alternative treatment for auditory verbal hallu...Transcranial direct current stimulation(tDCS)has been reportedly beneficial for different neurodegenerative disorders.tDCS has been reported as a potential adjunctive or alternative treatment for auditory verbal hallucination(AVH).This study aims to review the effects of tDCS on AVH in patients with schizophrenia through combining the evidence from randomized clinical trials(RCTs).The databases of PsycINFO(2000–2019),PubMed(2000–2019),EMBASE(2000–2019),CINAHL(2000–2019),Web of Science(2000–2019),and Scopus(2000–2019)were systematically searched.The clinical trials with RCT design were selected for final analysis.A total of nine RCTs were eligible and included in the review.Nine RCTs were included in the final analysis.Among them,six RCTs reported a significant reduction of AVH after repeated sessions of tDCS,whereas three RCTs did not show any advantage of active tDCS over sham tDCS.The current studies showed an overall decrease of approximately 28%of AVH after active tDCS and 10%after sham tDCS.The tDCS protocols targeting the sensorimotor frontal-parietal network showed greater treatment effects compared with the protocols targeting other regions.In this regard,cathodal tDCS over the left temporoparietal area showed inhibitory effects on AVHs.The most effective tDCS protocol on AVHs was twice-daily sessions(2 mA,20-minute duration)over 5 consecutive days(10 sessions)with the anode over the left dorsolateral prefrontal cortex and the cathode over the left temporal area.Some patient-specific and diseasespecific factors such as young age,nonsmoking status,and higher frequencies of AVHs seemed to be the predictors of treatment response.Taken together,the results of tDCS as an alternative treatment option for AVH show controversy among current literatures,since not all studies were positive.However,the studies targeting the same site of the brain showed that the tDCS could be a promising treatment option to reduce AVH.Further RCTs,with larger sample sizes,should be conducted to reach a conclusion on the efficacy of tDCS for AVH and to develop an effective therapeutic protocol for clinical setting.展开更多
Locally recurrent head and neck squamous cell carcinoma(HNSCC)is often unresectable,and a repeat course of radiotherapy is associated with incremental toxicities.Boron neutron capture therapy(BNCT)is a novel targeted ...Locally recurrent head and neck squamous cell carcinoma(HNSCC)is often unresectable,and a repeat course of radiotherapy is associated with incremental toxicities.Boron neutron capture therapy(BNCT)is a novel targeted radiotherapy modality that can achieve a high dose gradient between cancerous and adjacent normal tissues.However,the relationships among the dose resulting from BNCT,tumor response to BNCT,and survival are not completely understood.Recently,a study published in Radiotherapy and Oncology investigated the efficacy of BNCT in the treatment of patients with locally recurrent HNSCC and the factors associated with favorable treatment response and survival.In this article,the findings,strengths and limitations of this study are discussed in depth,and the significance of the study and motivations for future research are highlighted.展开更多
Background:Hypoxic-ischemic encephalopathy(HIE)is a devastating condition affecting around 8.5 in 1000 newborns globally.Therapeutic hypothermia(TH)can reduce mortality and,to a limited extent,disability after HIE.Nev...Background:Hypoxic-ischemic encephalopathy(HIE)is a devastating condition affecting around 8.5 in 1000 newborns globally.Therapeutic hypothermia(TH)can reduce mortality and,to a limited extent,disability after HIE.Nevertheless,there is a need for new and effective treatment strategies.Cell-based treatments using mononuclear cells(MNCs),which can be sourced from umbilical cord blood,are currently being investigated.Despite promising preclinical results,there is currently no strong indicator for the clinical efficacy of the approach.This analysis aimed to provide potential explanations for this discrepancy.Methods:A systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines.Preclinical and clinical studies were retrieved from PubMed,Web of Science,Scopus,and clinicaltrials.gov using a predefined search strategy.A total of 17 preclinical and 7 clinical studies were included.We analyzed overall MNC efficacy in preclinical trials,the methodological quality of preclinical trials,and relevant design features in preclinical versus clinical trials.Results:There was evidence for MNC therapeutic efficacy in preclinical models of HIE.The methodological quality of preclinical studies was not optimal,and statistical design quality was particularly poor.However,methodological quality was above the standard in other fields.There were significant differences in preclinical versus clinical study design including the use of TH as a baseline treatment(only in clinical studies)and much higher MNC doses being applied in preclinical studies.Conclusions:Based on the analyzed data,it is unlikely that therapeutic effect size is massively overestimated in preclinical studies.It is more plausible that the many design differences between preclinical and clinical trials are responsible for the so far lacking proof of the efficacy of MNC treatments in HIE.Additional preclinical and clinical research is required to optimize the application of MNC for experimental HIE treatment.展开更多
Objective To evaluate the efficacy and safety of thalidomide(100 to 200 mg per day)in the treatment of adult refractory Crohn’s disease(CD).Methods From July 2008 to February 2013,29 refractory CD patients were enrol...Objective To evaluate the efficacy and safety of thalidomide(100 to 200 mg per day)in the treatment of adult refractory Crohn’s disease(CD).Methods From July 2008 to February 2013,29 refractory CD patients were enrolled in thalidomide(100 to 200 mg per day)cohort study.The clinical activity was evaluated by展开更多
Patients with high tumor mutational burden(TMB)levels do not consistently respond to immune checkpoint inhibitors(ICIs),possibly because a high TMB level does not necessarily result in adequate infiltration of CD8^(+)...Patients with high tumor mutational burden(TMB)levels do not consistently respond to immune checkpoint inhibitors(ICIs),possibly because a high TMB level does not necessarily result in adequate infiltration of CD8^(+)T cells.Using bulk ribonucleic acid sequencing(RNA-seq)data from 9311 tumor samples across 30 cancer types,we developed a novel tool called the modulator of TMB-associated immune infiltration(MOTIF),which comprises genes that can determine the extent of CD8^(+)T cell infiltration prompted by a certain TMB level.We confirmed that MOTIF can accurately reflect the integrity and defects of the cancer-immunity cycle.By analyzing 84 human single-cell RNA-seq datasets from 32 types of solid tumors,we revealed that MOTIF can provide insights into the diverse roles of various cell types in the modulation of CD8^(+)T cell infiltration.Using pretreatment RNA-seq data from 13 ICI-treated cohorts,we validated the use of MOTIF in predicting CD8^(+)T cell infiltration and ICI efficacy.Among the components of MOTIF,we identified EMC3 as a negative regulator of CD8^(+)T cell infiltration,which was validated via in vivo studies.Additionally,MOTIF provided guidance for the potential combinations of programmed death 1 blockade with certain immunostimulatory drugs to facilitate CD8^(+)T cell infiltration and improve ICI efficacy.展开更多
Pancreatic ductal adenocarcinoma(PDAC)is currently the fourth most common cause of cancer-related deaths in the United States.It has a poor prognosis and remains a difficulty to treat malignancy.Over the past several ...Pancreatic ductal adenocarcinoma(PDAC)is currently the fourth most common cause of cancer-related deaths in the United States.It has a poor prognosis and remains a difficulty to treat malignancy.Over the past several decades,significant efforts have been directed towards developing new approaches to enhance the efficacy of therapeutic regimens for PDAC treatment.In recent years,the measurement of serum carbohydrate antigen 19-9(CA 19-9)has become one of the most validated and extensively used tumour biomarkers for PDAC.In particular,serum CA 19-9 levels have been explored as a validated tool to predict either the signs of disease progression or the response to treatment.However,despite its clinical relevance,the implications on diagnosis or accurately predicting tumour resectability,and monitoring disease symptoms in PDAC patients remains limited.This current review highlights the recent updates on the applicability of CA 19-9,its exploitation,and challenges in predicting the treatment efficacy and responses in PDAC patients.展开更多
文摘To analyse the effectiveness of performing a transverse tibial bone graft in the treatment of patients with diabetic foot. We retrospectively analysed the clinical details of 51 diabetic foot patients in our hospital from February 2023 to February 2024 and divided them into two groups according to the different treatment modalities, in which the control group received open debridement and the treatment group received transverse tibial bone transfer and compared the differences between the two groups. There were large differences in VAS score, Toronto Clinical Symptom Score, quality of life score, internal lumen diameter, blood flow velocity in the affected limb, perfusion volume, vascular endothelial growth factor, epidermal growth factor and CRP between the two groups after surgery (P < 0.05). Patients with diabetic foot should be treated with transverse tibial bone grafting, which is safer and more effective and can have a significant impact on improving the status of the affected limb, the inflammation and the patient’s quality of life.
基金the National Key Research and Development Program of China(No:2016YFC1302904)the National Natural Science Foundation of China(No:81572559)the Key Research Project of Shandong Province(No:2017CXGC1210).
文摘Background::Recently,T-helper 17(Th17)cells have been proved to play an important role in promoting cervical cancer.But,till now,few study has been carried out to understand the involvement of these cells in efficacy of anti-tumor treatments.This study aimed to investigate the alterations in the percentage of circulating Th17 cells and related cytokines in locally advanced cervical cancer(LACC)patients before and after concurrent chemoradiotherapy(cCRT)and to analyze the correlations between the alterations in Th17 cells and treatment efficacy.Methods::A prospective study with 49 LACC(International federation of gynecology and obstetrics[FIGO]stage IIB-IIIB)patients and 23 controls was conducted.Patients received the same cCRT schedule and were followed up for 3 years.Circulating Th17 cells(CD3+CD8-interleukin[IL]-17+T cells)and related cytokines IL-17,transforming growth factor-β(TGF-β),IL-10,IL-23,IL-6,and IL-22 were detected before and after cCRT.Correlations between alterations of circulating Th17 cells and treatment efficacy were analyzed.Kaplan-Meier analysis was used for overall survival(OS)and progression-free survival(PFS).Results::We found that 40 patients finished the entire cCRT schedule and met the endpoint of this study.The percentage of circulating Th17 cells in the LACC patients was higher than that in the controls,and it significantly decreased after cCRT(P<0.05).After cCRT,patients were divided into two groups based on the average of the Th17 cells declined.The subgroup of patients with a prominent decrease in circulating Th17 cells after cCRT had a higher treatment efficacy and longer PFS and OS times.Compared with the control patients,LACC patients had higher IL-6,IL-10,IL-22,TGF-βlevels and a lower IL-23 level(P<0.05).After cCRT,IL-6,IL-10,IL-17,IL-23 level significantly increased and TGF-βlevel significantly decreased compared with the levels before cCRT(P<0.05).Conclusion::Circulating Th17 cells in the LACC patients(FIGO stage IIB-IIIB)were higher than those in the controls,but they generally decreased after cCRT.A more pronounced decrease in circulating Th17 cells after cCRT was correlated with better therapeutic effect and longer PFS and OS times.
文摘Background: Helicobacter pylori (H. pylori) infection is a public health concern. In fact, due to bacterial resistance, treatment strategy is a challenge. It is then more recommended to prolong first-line treatment. In order to be acceptable, the clinical efficacy of treatment must be higher than 90%. Aim: We aimed to assess the outcome of prolonged first-line treatment among adults. Patients and Methods: The study was cross-sectional among adults and patients were treated for H. pylori eradication for the first time during 10 to 14 days. Recruitment was made from March 2019 in six private polyclinics and two hospitals of the city of Ouagadougou. We used monoclonal antigen (Ag) test on the stool samples for diagnostic and for the patients follow up. Chi squared (X<sup>2</sup>) tests and ANOVA for the comparison of percentages and means were determined using with STATA<sup>® </sup>software program in the bilateral 95% confidence interval for the statistical analysis. Results: In the different medical centers for 19 months, 365 patients were compiled. The sex-ratio was 0.64. The average age was 43.55 years. The treatment efficacy was 92.88%. Treatment efficacy was better with p-value <10<sup>-3</sup> depending on prescriber: gastroenterologist (94.07%), general practitioner (75%);compliance before treatment: excellent (95.88%) or bad (50%);number of consultations: ≥four (94.35%), three (96.32%), two (78.85%). Triple therapies efficacy was 90.81%;p = 0.19. Quadritherapy efficacy was 95%;p = 0.5. Conclusion: This research is a contribution to the advent of national or African recommendations.
文摘Constructed wetlands (CWs) can achieve a high-quality wastewater treatment and a quality that meets the prescribed standard, defined by legislation on wastewater discharge. A limitation in the application of constructed wetlands (CWs) is the large area requirement, which limits their application. The subject matter of this research is to check the possibility of improving the efficiency of wastewater treatment and reducing the required area for constructed wetlands (CWs) by using an adequate substrate under the conditions found in Montenegro. In the described experiment, the constructed wetlands (CW) have a vertical flow system and play the role of a secondary wastewater treatment, receiving water from the existing WWTP in Podgorica after the primary treatment. These vertical flow systems reflect experience with the use of similar systems in Slovenija, Austria and Italy. Measurements to date show that the substrate plays an important role and that wastewater treatment efficacy varies significantly with respect to the type of substrate when used under the conditions available in Montenegro.
文摘Objective To evaluate the clinical efficacy and side effects of sunitinib in treatment of advanced renal cell carcinoma. Methods Forty-five patients with advanced renal cell carcinorna and an average age of 48. 6 yrs were treated with sunitinib. of the study group。
文摘Background: Early excision and grafting has been the preferred method of managing major burns around the world since 1970. Considering the advances in health care and the development of new antibiotics over the past 50 years, delayed grafting as a technique for the management of burns over 15%-20% of total body surface area (TBSA) could have comparable results to that of early excision. This study aims to highlight the outcomes of practicing delayed grafting in burn patients. Methods: A case series analysis was performed of 51 patients who were admitted to the burns unit in Sultan Qaboos Hospital Salalah with over 20% TBSA between January 2014 and December 2019. The patients received prophylactic antibiotics and silver sulphadiazine dressing until the burn eschar had completely separated, followed by grafting. Results: Two patients were lost during the entire duration of the study. The mortality rate was comparable to that of early excision, while the rate of hypertrophic scarring was lower than the range reported by other studies. Conclusion: In the management of patients with over 20% TBSA, delayed grafting after complete separation of eschar is still a valid technique.
文摘Objective:To analyze the clinical efficacy of hepatic artery chemoembolization in the treatment of advanced liver cancer.Methods:124 patients with advanced liver cancer admitted to our hospital from September 2019 to November 2020 were selected as the research subjects of this paper.The patients with advanced liver cancer were divided into experimental group and control group.The control group was treated with radiofrequency ablation alone,and the experimental group was administered hepatic arterial chemoembolization.The improvement in physical indicators and the incidence of adverse reactions between the two groups were compared.Results:The alpha-fetoprotein(AFP)index and serum total bilirubin(TBIL)index of the experimental group were lower than those of the control group,and the alanine aminotransferase(ALT)index was higher than that of the control group.There were differences in the comparison of liver function indices between the two groups which were statistically significant.After treatment,there were 3 cases of fever,4 cases of vomiting,8 cases of bone marrow transplantation,4 cases of abdominal pain,2 cases of proteinuria,and 1 case of diarrhea occurred in the experimental group;whereas there were 6 cases of fever,8 cases of vomiting,14 cases of bone marrow transplantation,7 cases of abdominal pain,5 cases of proteinuria,and 6 cases of diarrhea occurred in the control group.The difference in incidence of adverse reactions between patients after different treatment interventions was statistically significant.Analyzing the remission rate of tumor diseases in patients,the remission rate of the experimental group was higher than that of the control group,and the difference in the remission rate between the two groups of patients was statistically significant.Conclusion:The implementation of hepatic arterial chemoembolization for patients with advanced liver cancer can promote the improvement of the patient's short-term treatment efficacy,enhance the liver functions of the patient,reduce the incidence of adverse reactions,improve the efficiency of the patient's body rehabilitation,and enhance the quality of life of the patient after treatment.
基金This work was supported by the National Natural Science Foundation of China(No.82004339)Project of National Clinical Research Base of Traditional Chinese Medicine in Jiangsu Province(No.JD2019SZXYB02,JD2019SZXYB04)+2 种基金Scientific research project of Jiangsu provincial health commission(No.H2019095)Jiangsu science and technology department social development-clinical frontier technology.(No.BE2019767,BRA2019100)and Jiangsu province traditional Chinese medicine leading talent training project(No.SLJ0211).
文摘Background:In recent years,herbal formulations have assumed an influential part in preventing and treating tumors.Shenqi Yichang granules(SQYCG)have proven effective in the adjuvant treatment of colorectal cancer(CRC),but their mechanism has not been elucidated.This study aimed to explore the potential active compounds and mechanisms of SQYCG in the treatment of CRC using network pharmacology and molecular docking.Methods:The active compounds and targets of SQYCG and the CRC genes were found using the Traditional Chinese Medicine Systems Pharmacology,DrugBank,and DisGeNET databases.The intersected targets of disease genes and drug targets were depicted using a Venn diagram.The protein-protein interaction(PPI)network of these targets was obtained by String platform and visualized using Cytoscape.Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analysis were carried using the DAVID database to obtain the core molecular mechanism of SQYCG in CRC treatment.Molecular docking techniques were used to validate the results.Results:A total of 63 compounds and 245 targets were obtained from the herbal prescription after the screening,of which 122 targets crossed with CRC genes.PPI showed that the core regulatory targets include MAPK1,TNF,TP53,JUN,RELA,MAPK14,and MAPK 8.The GO analysis indicated regulation of drug response,apoptotic process,response to hypoxia,angiogenesis,and response to lipopolysaccharide.KEGG pathway enrichment analysis mainly involves TNF,T cell receptor,Toll-like receptor,PI3K-Akt,and MAPK signal pathway.Conclusion:Through network pharmacology,we havedemonstrated that SQYCG has multiple targets,components,and pathways in treating CRC,with anti inflammation and inhibition of cell proliferation being critical components of its mechanism.
基金Supported by the Administration of Traditional Chinese Medicine of Gansu Province in China(No.GZK-2012-66)
文摘Objective:To examine the efficacy and safety of bathing therapy with Taohong Siwu Decoction(桃红四物汤,TSD) in the treatment of early-stage,mild-moderate diffuse cutaneous systemic sclerosis(dc SSc).Methods:This randomized,placebo-controlled trial enrolled 148 men and women(18–60 years) with dc SSc(disease duration 12 months) and baseline modified Rodnan skin score(MRSS) 10.Patients were randomized into a TSD group(71 cases bathing with TSD plus oral prednisone) or control group(71 cases bathing with placebo plus oral prednisone).Bathing(40 ℃,30 min) of the upper and lower limbs was carried out once daily for 12 consecutive weeks.The primary outcome measure was MRSS;secondary outcomes were Raynaud's phenomenon(RP) score,quality of life(QOL),physician visual analogue scale(VAS),patient VAS,percent predicted diffusing capacity for carbon monoxide(DLCO),percent predicted forced vital capacity(FVC),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP) level and overall treatment effect.Results:The final analysis included 135 patients(control group,68 cases;TSD group,67 cases).Primary and secondary outcome measures after 2 weeks of treatment showed no improvement(versus baseline) in both groups,with no differences between groups.At 12 weeks,QOL,physician VAS,patient VAS,ESR and CRP were improved in both groups,but MRSS and RP score were improved only in the TSD group(all P<0.05).MRSS,RP score,QOL,physician VAS,patient VAS,ESR and CRP differed significantly between groups(all P<0.05).Meanwhile,the overall treatment effect was significantly higher in the TSD group than in the control group(P<0.05).Adverse events in the two groups were similar(P>0.05).Conclusions:Bathing with TSD plus oral prednisone achieves better outcomes than oral prednisone alone in patients with dcS Sc and is not associated with serious adverse events.
文摘Transcranial direct current stimulation(tDCS)has been reportedly beneficial for different neurodegenerative disorders.tDCS has been reported as a potential adjunctive or alternative treatment for auditory verbal hallucination(AVH).This study aims to review the effects of tDCS on AVH in patients with schizophrenia through combining the evidence from randomized clinical trials(RCTs).The databases of PsycINFO(2000–2019),PubMed(2000–2019),EMBASE(2000–2019),CINAHL(2000–2019),Web of Science(2000–2019),and Scopus(2000–2019)were systematically searched.The clinical trials with RCT design were selected for final analysis.A total of nine RCTs were eligible and included in the review.Nine RCTs were included in the final analysis.Among them,six RCTs reported a significant reduction of AVH after repeated sessions of tDCS,whereas three RCTs did not show any advantage of active tDCS over sham tDCS.The current studies showed an overall decrease of approximately 28%of AVH after active tDCS and 10%after sham tDCS.The tDCS protocols targeting the sensorimotor frontal-parietal network showed greater treatment effects compared with the protocols targeting other regions.In this regard,cathodal tDCS over the left temporoparietal area showed inhibitory effects on AVHs.The most effective tDCS protocol on AVHs was twice-daily sessions(2 mA,20-minute duration)over 5 consecutive days(10 sessions)with the anode over the left dorsolateral prefrontal cortex and the cathode over the left temporal area.Some patient-specific and diseasespecific factors such as young age,nonsmoking status,and higher frequencies of AVHs seemed to be the predictors of treatment response.Taken together,the results of tDCS as an alternative treatment option for AVH show controversy among current literatures,since not all studies were positive.However,the studies targeting the same site of the brain showed that the tDCS could be a promising treatment option to reduce AVH.Further RCTs,with larger sample sizes,should be conducted to reach a conclusion on the efficacy of tDCS for AVH and to develop an effective therapeutic protocol for clinical setting.
文摘Locally recurrent head and neck squamous cell carcinoma(HNSCC)is often unresectable,and a repeat course of radiotherapy is associated with incremental toxicities.Boron neutron capture therapy(BNCT)is a novel targeted radiotherapy modality that can achieve a high dose gradient between cancerous and adjacent normal tissues.However,the relationships among the dose resulting from BNCT,tumor response to BNCT,and survival are not completely understood.Recently,a study published in Radiotherapy and Oncology investigated the efficacy of BNCT in the treatment of patients with locally recurrent HNSCC and the factors associated with favorable treatment response and survival.In this article,the findings,strengths and limitations of this study are discussed in depth,and the significance of the study and motivations for future research are highlighted.
基金Academy of Medical Sciences(Newton Advanced Fellowship),Grant/Award Number:NAF\R11\1010。
文摘Background:Hypoxic-ischemic encephalopathy(HIE)is a devastating condition affecting around 8.5 in 1000 newborns globally.Therapeutic hypothermia(TH)can reduce mortality and,to a limited extent,disability after HIE.Nevertheless,there is a need for new and effective treatment strategies.Cell-based treatments using mononuclear cells(MNCs),which can be sourced from umbilical cord blood,are currently being investigated.Despite promising preclinical results,there is currently no strong indicator for the clinical efficacy of the approach.This analysis aimed to provide potential explanations for this discrepancy.Methods:A systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines.Preclinical and clinical studies were retrieved from PubMed,Web of Science,Scopus,and clinicaltrials.gov using a predefined search strategy.A total of 17 preclinical and 7 clinical studies were included.We analyzed overall MNC efficacy in preclinical trials,the methodological quality of preclinical trials,and relevant design features in preclinical versus clinical trials.Results:There was evidence for MNC therapeutic efficacy in preclinical models of HIE.The methodological quality of preclinical studies was not optimal,and statistical design quality was particularly poor.However,methodological quality was above the standard in other fields.There were significant differences in preclinical versus clinical study design including the use of TH as a baseline treatment(only in clinical studies)and much higher MNC doses being applied in preclinical studies.Conclusions:Based on the analyzed data,it is unlikely that therapeutic effect size is massively overestimated in preclinical studies.It is more plausible that the many design differences between preclinical and clinical trials are responsible for the so far lacking proof of the efficacy of MNC treatments in HIE.Additional preclinical and clinical research is required to optimize the application of MNC for experimental HIE treatment.
文摘Objective To evaluate the efficacy and safety of thalidomide(100 to 200 mg per day)in the treatment of adult refractory Crohn’s disease(CD).Methods From July 2008 to February 2013,29 refractory CD patients were enrolled in thalidomide(100 to 200 mg per day)cohort study.The clinical activity was evaluated by
基金supported by the National Natural Science Foundation of China(81930065,82173128,82102921,and 82003269)the Cancer Innovation Research Program of Sun Yat-sen University Cancer Center(CIRP-SYSUCC-0004)+5 种基金the Swedish Research Council(VR-MH 2014-46602-117891-30)the CAMS Innovation Fund for Medical Sciences(CIFMS)(2019-I2M-5-036)the Youth Teacher Cultivation Program of Sun Yat-sen UniversityGuangdong Provincial Clinical Medical Research Center for Malignant Tumors(84000-31660002)the China Postdoctoral Science Foundation(2023M744049)the Chih Kuang Scholarship for Outstanding Young Physician-Scientists of Sun Yat-sen University Cancer Center(CKS-SYSUCC-2023001)。
文摘Patients with high tumor mutational burden(TMB)levels do not consistently respond to immune checkpoint inhibitors(ICIs),possibly because a high TMB level does not necessarily result in adequate infiltration of CD8^(+)T cells.Using bulk ribonucleic acid sequencing(RNA-seq)data from 9311 tumor samples across 30 cancer types,we developed a novel tool called the modulator of TMB-associated immune infiltration(MOTIF),which comprises genes that can determine the extent of CD8^(+)T cell infiltration prompted by a certain TMB level.We confirmed that MOTIF can accurately reflect the integrity and defects of the cancer-immunity cycle.By analyzing 84 human single-cell RNA-seq datasets from 32 types of solid tumors,we revealed that MOTIF can provide insights into the diverse roles of various cell types in the modulation of CD8^(+)T cell infiltration.Using pretreatment RNA-seq data from 13 ICI-treated cohorts,we validated the use of MOTIF in predicting CD8^(+)T cell infiltration and ICI efficacy.Among the components of MOTIF,we identified EMC3 as a negative regulator of CD8^(+)T cell infiltration,which was validated via in vivo studies.Additionally,MOTIF provided guidance for the potential combinations of programmed death 1 blockade with certain immunostimulatory drugs to facilitate CD8^(+)T cell infiltration and improve ICI efficacy.
文摘Pancreatic ductal adenocarcinoma(PDAC)is currently the fourth most common cause of cancer-related deaths in the United States.It has a poor prognosis and remains a difficulty to treat malignancy.Over the past several decades,significant efforts have been directed towards developing new approaches to enhance the efficacy of therapeutic regimens for PDAC treatment.In recent years,the measurement of serum carbohydrate antigen 19-9(CA 19-9)has become one of the most validated and extensively used tumour biomarkers for PDAC.In particular,serum CA 19-9 levels have been explored as a validated tool to predict either the signs of disease progression or the response to treatment.However,despite its clinical relevance,the implications on diagnosis or accurately predicting tumour resectability,and monitoring disease symptoms in PDAC patients remains limited.This current review highlights the recent updates on the applicability of CA 19-9,its exploitation,and challenges in predicting the treatment efficacy and responses in PDAC patients.
