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1A life support-based comprehensive treatment regimen dramatically lowers the in-hospital mortality of patients with fulminant myocarditis: a multiple center study显示文摘Fulminant myocarditis(FM) has unacceptable high mortality. This study aimed to evaluate the therapeutic efficacy of a life support-based comprehensive treatment regimen(LSBCTR), a completely novel treatment regimen, for FM. A total of 169 FM patients recruited from January 2008 to December 2018 were divided into two groups: patients receiving LSBCTR(81 cases),which includes(i) mechanical life support(positive pressure respiration, intra-aortic balloon pump with or without extracorporeal membrane oxygenation),(ii) immunomodulation therapy using sufficient doses of glucocorticoids and immunoglobulins, and(iii) application of neuraminidase inhibitors, and those receiving conventional treatment(88 cases). The endpoints were in-hospital death and heart-transplantation. Of all the population, 44 patients(26.0%) died in hospitals. Inhospital mortality was 3.7%(3/81) for LSBCTR group and 46.6%(41/88) for traditional treatment(P<0.001). Early application of LSBCTR, mechanical life support, neuraminidase inhibitors, and immunomodulation therapy significantly contributed to reduction in in-hospital mortality. This study describes a novel treatment regimen for FM patients that dramatically reduces inhospital mortality. Its generalization and clinical application will efficiently save lives although further optimization is needed.This study offers an insight that virus infection induced inflammatory waterfall results in cardiac injury and cardiogenic shock and is the therapeutic target.Sheng Li Shengyong Xu Chenze Li Xiao Ran Guanglin Cui Mengying He Kun Miao Chunxia Zhao Jiangtao Yan Rutai Hui Ning Zhou Yan Wang Jiangang Jiang Jing Zhang Daowen Wang 2019Science China(Life Sciences)2019,62,3:43
2Outcomes of furazolidone-and amoxicillin-based quadruple therapy for Helicobacter pylori infection and predictors of failed eradication显示文摘AIM To evaluate the outcomes of furazolidone-and amoxicillin-based quadruple therapy for treatment of Helicobacter pylori(H. pylori) infection and identify predictors of failed eradication.METHODS Patients with H. pylori infection treated with furazolidone, amoxicillin, bismuth, and proton pump inhibitor therapy(January 2015 to December 2015) who received the ^(13)C-urea breath test > 4 wk after treatment were evaluated. Demographic and clinical data including prior H. pylori treatment attempts, medication adherence, alcohol and cigarette consumption during therapy, and treatment-related adverse events were recorded by reviewing medical records and telephone surveys. H. pylori eradication rates for overall and subgroups were evaluated. Multivariate analysis was performed to identify independent predictors of failed H. pylori eradication.RESULTS Of the 992 patients treated and retested for H. pylori infection, the overall eradication rate was 94.5% [95% confidence interval(CI): 94.1%-95.9%]. H. pylori eradication rate of primary therapy was 95.0%(95%CI: 93.5%-96.5%), while that of rescue therapy was 91.3%(95%CI: 86.8%-95.8%). Among the 859 patients who completed the study protocol, 144(17%) reported treatment-related adverse events including 24(3%) leading to premature discontinuation. On multivariate analysis, poor medication adherence [adjusted odds ratio(AOR) = 6.7, 95%CI: 2.8-15.8], two or more previous H. pylori treatments(AOR = 7.4, 95%CI: 2.2-24.9), alcohol consumption during therapy(AOR = 4.4, 95%CI: 1.5-12.3), and possibly smoking during therapy(AOR = 1.9, 95%CI: 0.9-4.3) were associated with failed H. pylori eradication. CONCLUSION Furazolidone-and amoxicillin-based quadruple therapy for H. pylori infection in an area with a high prevalence of clarithromycin resistance demonstrated high eradication rates as primary and rescue therapies with a favorable safety profile. Patient education targeting abstinence from alcohol during therapy and strict medication adherence may further optimize H. pylori eradication.Ya-Wen Zhang Wei-Ling Hu Yuan Cai Wen-Fang Zheng Qin Du John J Kim John Y Kao Ning Dai Jian-Min Si 2018World Journal of Gastroenterology2018,24,40:18
3Chinese expert consensus statement on the diagnosis and treatment of fulminant myocarditis显示文摘Fulminant myocarditis is primarily caused by infection with any number of a variety of viruses. It arises quickly, progresses rapidly, and may lead to severe heart failure or circulatory failure presenting as rapid-onset hypotension and cardiogenic shock,with mortality rates as high as 50%–70%. Most importantly, there are no treatment options, guidelines or an expert consensus statement. Here, we provide the first expert consensus, the Chinese Society of Cardiology Expert Consensus Statement on the Diagnosis and Treatment of Fulminant Myocarditis, based on data from our recent clinical trial(NCT03268642). In this statement, we describe the clinical features and diagnostic criteria of fulminant myocarditis, and importantly, for the first time,we describe a new treatment regimen termed life support-based comprehensive treatment regimen. The core content of this treatment regimen includes(i) mechanical life support(applications of mechanical respirators and circulatory support systems,including intraaortic balloon pump and extracorporeal membrane oxygenation),(ii) immunological modulation by using sufficient doses of glucocorticoid, immunoglobulin and(iii) antiviral reagents using neuraminidase inhibitor. The proper application of this treatment regimen may and has helped to save the lives of many patients with fulminant myocarditis.Daowen Wang Sheng Li Jiangang Jiang Jiangtao Yan Chunxia Zhao Yan Wang Yexin Ma Hesong Zeng Xiaomei Guo Hong Wang Jiarong Tang Houjuan Zuo Li Lin Guanglin Cui Section of Precision Medicine Group of Chinese Society of Cardiology,Editorial Board of Chinese Journal of Cardiology &Working Group of Adult Fulminant Myocarditis 2019Science China(Life Sciences)2019,62,2:18
4Antiviral therapies for chronic hepatitis C virus infection with cirrhosis显示文摘Patients who are infected with hepatitis C virus(HCV) and also have advanced fibrosis or cirrhosis have beenrecognized as 'difficult-to-treat' patients during an era when peginterferon and ribavirin combination therapy is the standard of care. Recent guidelines have clearly stated that treatment should be prioritized in this population to prevent complications such as decompensation and hepatocellular carcinoma. Recent advances in the treatment of chronic hepatitis C have been achieved through the development of direct-acting antiviral agents(DAAs). Boceprevir and telaprevir are first-generation DAAs that inhibit the HCV NS3/4A protease. Boceprevir or telaprevir, in combination with peginterferon and ribavirin, improved the sustained virological response rates compared with peginterferon and ribavirin alone and were tolerated in patients with HCV genotype 1 infection without cirrhosis or compensated cirrhosis. However, the efficacy is lower especially in prior non-responders with or without cirrhosis. Furthermore, a high incidence of adverse events was observed in patients with advanced liver disease, including cirrhosis, in real-life settings. Current guidelines in the United States and in some European countries no longer recommend these regimens for the treatment of HCV. Next-generation DAAs include second-generation HCV NS3/4A protease inhibitors, HCV NS5 A inhibitors and HCV NS5 B inhibitors, which have a high efficacy and a lower toxicity. These drugs are used in interferon-free or in interferon-based regimens with or without ribavirin in combination with different classes of DAAs. Interferon-based regimens, such as simeprevir in combination with peginterferon and ribavirin, are well tolerated and are highly effective especially in treatmentnave patients and in patients who received treatment but who relapsed. The efficacy is less pronounced in nullresponders and in patients with cirrhosis. Interferonfree regimens in combination with ribavirin and/or two or more DAAs could be used for treatment-nave, treatment-experienced and even for interferon-ineligible or interferon-intolerant patients. Some clinical trials have demonstrated promising results, and have shown that the efficacy and safety were not different between patients with and without cirrhosis. There are also promising regimens for genotypes other than genotype 1. Interferonis contraindicated in patients with decompensated cirrhosis, and further studies are needed to establish the optimal treatment regimen for this population. In the future, interferon-free and ribavirin-free regimens with high efficacy and improved safety are expected for HCVinfected patients with advanced liver diseases.Shingo Nakamoto Tatsuo Kanda Hiroshi Shirasawa Osamu Yokosuka 2015World Journal of Hepatology2015,7,8:17
5Predictive and prognostic value of serum AFP level and its dynamic changes in advanced gastric cancer patients with elevated serum AFP显示文摘AIM To investigate predictive and prognostic value of serum alpha-fetoprotein(AFP) level and its dynamic changes in patients with advanced gastric cancer with elevated serum AFP(AFPAGC).METHODS One hundred and five patients with AFPAGC were enrolled in the study, and all of them underwent at least one cycle of systemic chemotherapy at our institute and had serum AFP ≥ 20 ng/m L at diagnosis or recurrence. Clinicopathologic features, serum AFP level at diagnosis and changes during treatment, first-line chemotherapy regimens, efficacy and toxicity, and survival information were collected. A Person's χ~2 or Fisher's exact test was used to measure the differences between variables. Survival prognostic factors were investigated using the Kaplan-Meier method and Cox regression.RESULTS Median serum AFP level was 161.7 ng/m L(range, 22.9-2557110 ng/m L). Objective response rates(ORR) was significantly lower in the AFP ≥ 160 ng/m L group than in the AFP < 160 ng/m L group(30.4% vs 68.3%, P < 0.001). ORR to doublet regimens was significantly lower in the AFP ≥ 160 ng/m L group, whereas ORR to triplet regimens was similar between the two groups. Liver metastasis rate was significantly higher in the AFP ≥ 160 ng/m L group than in the AFP < 160 ng/m L(69.8% vs 50.0%, P < 0.001). Overall survival(OS) in the two cohorts did not show any significant difference(P = 0.712). Dynamic changes of AFP were consistent with response to chemotherapy, and median OS of patients with a serum AFP decline ≥ 50% and those with a serum AFP decline < 50% was 17.5 m and 10.0 m, respectively(P = 0.003). Hepatic(P = 0.005), peritoneal(P < 0.001), non-regional lymph node metastasis(P < 0.001), and portal vein tumor thrombus(PVTT)(P = 0.042) were identified as independent prognostic factors for AFPAGC. CONCLUSION Real-time examination of AFP has great predictive and prognostic value for managing AFPAGC. For those with markedly elevated AFP, triplet regimens may be a better choice.Ya-Kun Wang Lin Shen Xi Jiao Xiao-Tian Zhang 2018World Journal of Gastroenterology2018,24,2:17
6Toripalimab combined with lenvatinib and GEMOX is a promising regimen as first-line treatment for advanced intrahepatic cholangiocarcinoma:a single-center,single-arm,phase 2 study显示文摘Advanced intrahepatic cholangiocarcinoma(ICC)has a dismal prognosis.Here,we report the efficacy and safety of combining toripalimab,lenvatinib,and gemcitabine plus oxaliplatin(GEMOX)as first-line therapy for advanced ICC.Thirty patients with pathologically confirmed advanced ICC received intravenous gemcitabine(1 g/m2)on Days 1 and 8 and oxaliplatin(85 mg/m2)Q3W for six cycles along with intravenous toripalimab(240 mg)Q3W and oral lenvatinib(8 mg)once daily for one year.The expression of programmed death-ligand 1(PD-L1)and genetic status was investigated in paraffin-embedded tissues using immunohistochemistry and whole-exome sequencing(WES)analysis.The primary endpoint was the objective response rate(ORR).Secondary outcomes included safety,overall survival(OS),progression-free survival(PFS),disease control rate(DCR)and duration of response(DoR).As of July 1,2022,the median follow-up time was 23.5 months,and the ORR was 80%.Twenty-three patients achieved partial response,and one achieved complete response.Patients(21/30)with DNA damage response(DDR)-related gene mutations showed a higher ORR,while patients(14/30)with tumor area positivity≥1(PD-L1 staining)showed a trend of high ORR,but without significant difference.The median OS,PFS,and DoR were 22.5,10.2,and 11.0 months,respectively.The DCR was 93.3%.Further,56.7%of patients experienced manageable grade≥3 adverse events(AEs),commonly neutropenia(40.0%)and leukocytopenia(23.3%).In conclusion,toripalimab plus lenvatinib and GEMOX are promising first-line regimens for the treatment of advanced ICC.A phase-III,multicenter,double-blinded,randomized study to validate our findings was approved by the National Medical Products Administration(NMPA,No.2021LP01825).Guo-Ming Shi Xiao-Yong Huang Dong Wu Hui-Chuan Sun Fei Liang Yuan Ji Yi Chen Guo-Huan Yang Jia-Cheng Lu Xian-Long Meng Xin-Ying Wang Lei Sun Ning-Ling Ge Xiao-Wu Huang Shuang-Jian Qiu Xin-Rong Yang Qiang Gao Yi-Feng He Yang Xu Jian Sun Zheng-Gang Ren Jia Fan Jian Zhou 2023Signal Transduction and Targeted Therapy2023,8,4:12
7Acute respiratory distress syndrome and lung injury: Pathogenetic mechanism and therapeutic implication显示文摘To review possible mechanisms and therapeutics for acute lung injury(ALI) and acute respiratory distress syndrome(ARDS). ALI/ARDS causes high mortality. The risk factors include head injury, intracranial disorders, sepsis, infections and others. Investigations have indicated the detrimental role of nitric oxide(NO) through the inducible NO synthase(i NOS). The possible therapeutic regimen includes extracorporeal membrane oxygenation, prone position, fluid and hemodynamic management and permissive hypercapnic acidosis etc. Other pharmacological treatments are anti-inflammatory and/or antimicrobial agents, inhalation of NO, glucocorticoids, surfactant therapy and agents facilitating lung water resolution and ion transports. β-adrenergic agonists are able to accelerate lung fluid and ion removal and to stimulate surfactant secretion. In con-scious rats, regular exercise training alleviates the endotoxin-induced ALI. Propofol and N-acetylcysteine exert protective effect on the ALI induced by endotoxin. Insulin possesses anti-inflammatory effect. Pentobarbital is capable of reducing the endotoxin-induced ALI. In addition, nicotinamide or niacinamide abrogates the ALI caused by ischemia/reperfusion or endotoxemia. This review includes historical retrospective of ALI/ARDS, the neurogenic pulmonary edema due to head injury, the detrimental role of NO, the risk factors, and the possible pathogenetic mechanisms as well as therapeutic regimen for ALI/ARDS.Chain-Fa Su Shang Jyh Kao Hsing I Chen 2012World Journal of Critical Care Medicine2012,1,2:12
8China's treatment regimen for fulminant myocarditis is bringing wonderful achievement to the world显示文摘Fulminant myocarditis is characterized by acute and severe inflammation with injury of myocardium globally. It has a fulminant course and high in-hospital mortality rate of up to50%-70%. It onsets rapidly after viral infection and progresses to hypotension.Jing Zhang Weijian Hang Rutai Hui Qiong Zhao Shashank S.Desai 2019Science China(Life Sciences)2019,62,2:8
9Short-term effects of chemotherapy-surgery-chemotherapy regimen on clinically inoperable advanced ovarian cancer显示文摘Neoadjuvantchemotherapyhasbenappliedtocasesofclinicalyinoperableadvancedovariancarcinoma,ortocasesinwhichmasivemacroscopicres...酆豫增 孙廷慰 1998Chinese Medical Journal1998,,8:5
10Primary pulmonary rhabdomyosarcoma in an adult:a case report and review of the literature显示文摘Primary pulmonary rhabdomyosarcoma (RMS)is one of the most common soft-tissue malignancies in children, but is rare in persons aged >45 years (Triche,1997; Ferrari et al., 2003). RMS is considered to result from the malignant transformation of primitive mesenchymal cells.Gui-yi JI Hui MAO 2013Journal of Zhejiang University-Science B(Biomedicine & Biotechnology)2013,14,9:5
11Guidelines and controversies in the management of diabetic ketoacidosis – A mini-review显示文摘Diabetic ketoacidosis(DKA) is a complication seen in patients with both type 1 and type 2 diabetes. Due to its large, growing economic impact with associated morbidity, closer look at proper management is im-portant. Factors involved in appropriate management involves fluid resuscitation, insulin regimen, and elec-trolyte replacement including types of fluid and insulin treatment. The caveat with generalized protocol is application to special populations such as renal or heart failure patients the sequelae of complications due to pathophysiology of the disease processes. This leads to complications and longer length of stay in the hospital, therefore, possibly increased cost and resource utilization during the hospitalization. This review takes a closer look at current guidelines of DKA management and resource utilization, the drawbacks of current management protocols and the cost associated with it. Therefore, a need for amendment to existing protocol or initiation of a newer guideline that properly manages DKA should incorporate special populations and appropriate regimen of fluid resuscitation, insulin therapy and electrolyte management.Tasnim Islam Khalid Sherani Salim Surani Abhay Vakil 2018World Journal of Diabetes2018,9,12:5
12Is Acupuncture Actually Not Effective for Polycystic Ovary Syndrome?--Analysis of the Trial Published in JAMA显示文摘In recent years, acupuncture has been applied to treat more and more patients suffering from polycystic ovary syndrome(PCOS). On June 27, 2017 a paper titled 'Effect of acupuncture and clomiphene in Chinese women with polycystic ovary syndrome: a randomized clinical trial' was published in Journal of the American Medical Association(JAMA). The results did not support acupuncture as an effective therapy for improving the live births in PCOS. The aim of this article was to analyze the therapeutic regimen and design of the clinical trial. The primary outcome and the conclusion of the paper were discussed as well. There are 5 doubts in the paper.(1) The therapeutic regimen decided by trigger points in the paper was different from that of the traditional Chinese acupuncture.(2) The live birth as the primary outcome was limited during the PCOS recovery.(3) In addition the period of the treatment was too short to reflect the therapeutic effect.(4) Although there was no significant difference between active acupuncture and control acupuncture, the conclusion that acupuncture was not effective for PCOS was not confirmed because the control acupuncture plus clomiphene was also more effective than that of clomiphene alone.(5) The proposal and the statistics were not in accordance with the one planned before. Therefore the result was worth to be discussed so as to provide some suggestions and references for improving the clinical research of acupuncture.GANG Wei-juan JING Xiang-hong 2017Chinese Journal of Integrative Medicine2017,23,12:4
13A systematic review of SARS-CoV-2 vaccine candidates显示文摘Advanced natural killer/T cell lymphoma(NKTL)has demonstrated poor prognosis with currently available therapies.Here,we report the efficacy of anti-programmed death 1(PD-1)antibody with the P-GEMOX(pegaspargase,gemcitabine,and oxaliplatin)regimen in advanced NKTL.Nine patients underwent six 21-day cycles of anti-PD-1 antibody(day 1),pegaspargase 2000 U/m2(day 1),gemcitabine 1 g/m2(days 1 and 8)and oxaliplatin 130 mg/m2(day 1),followed by anti-PD-1 antibody maintenance every 3 weeks.Programmed death-ligand 1(PD-L1)expression and genetic alterations were determined in paraffin-embedded pretreatment tissue samples using immunohistochemistry and next-generation sequencing(NGS)analysis.Responses were assessed using 18F-fluorodeoxyglucose positron emission tomography(18FDG-PET)and computed tomography or magnetic resonance imaging.Eight patients exhibited significant responses,comprising of seven complete remissions and one partial remission(overall response rate:88.9%).After a median follow-up of 10.6 months,6/9 patients(66.7%)remained in complete remission.The most common grade 3/4 adverse events were anemia(33.3%),neutropenia(33.3%),and thrombocytopenia(33.3%);all of which were manageable and resolved.Immunochemotherapy produced a high response rate in patients with positive PD-L1 expression(5/6,83.3%).NGS analysis suggested that STAT3/JAK3/PD-L1 alterations and ARID1A mutation were associated with immunochemotherapy efficacy.Mutation in DDX3X and alteration in epigenetic modifiers of KMT2D,TET2,and BCORL1 might indicate a poor response to immunochemotherapy.In conclusion,the anti-PD-1 antibody plus P-GEMOX regimen demonstrated promising efficacy in advanced NKTL.PD-L1 expression combined with specific genetic alterations could be used as potential biomarkers to predict therapeutic responses to immunochemotherapy.Yetian Dong Tong Dai Yujun Wei Long Zhang Min Zheng Fangfang Zhou 2020Signal Transduction and Targeted Therapy2020,5,1:4
14Preoperative rapid suppression of viral load by elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide regimen in human immunodeficiency virus-positive fracture patients significantly reduces postoperative complications显示文摘To the Editor:There are 1.25 million people living with human immunodeficiency virus(HIV)(PLWH)in China,with more than 135,000 newly diagnosed cases in 2018.[1]HIV-positive patients who suffer a fracture have extremely high complication rates following operations,and medical staff frequently experience occupational exposure during the perioperative period.Therefore,surgeons are often worried about operating on HIV-positive patients.To ensure the safety of surgeons and reduce patients’postoperative complications,we attempted to maximally suppress the viral load(VL)prior to operation.Previous studies have shown that PLWH demonstrated high uptake of highly active antiretroviral therapy(HAART)and rapid VL suppression.[2]In recent years,more rapid VL suppression has been observed with newly introduced antiretroviral drugs,for example,a combination of the integrase strand transfer inhibitor(INSTI),in a single-tablet regimen(STR)containing elvitegravir,cobicistat,emtricitabine,and tenofovir alafenamide(E/C/F/TAF)(150/150/200/10 mg).[3]Studies have shown that STRs have more reliable virus suppression success rates than multiple-tablet regimens(MTRs).[4]Generally,patients prefer freely available HAART drugs that are available nationally,containing tenofovir disoproxil fumarate,lamivudine,and efavirenz(TDF/3TC/EFV)(400/300/600 mg).In this study,we compared the preoperative effect of E/C/F/TAF and TDF/3TC/EFV regimens in the treatment for HIV-positive patients to reduce VL and improve the immune function in 7 and 10 days.Rui Ma Qiang Zhang Yao-Shen Zhang Biao Xu Zhi-Wen Tong Chang-Song Zhao Ru-Gang Zhao 2020Chinese Medical Journal2020,,23:3
15Autologous peripheral blood stem cell transplantation as front-line therapy for myeloma with double-hit and triple-hit in a real-world study显示文摘Multiple myeloma(MM)is a plasmocytic malignancy which accounts for approximately 10%of all hematologic malignancies.In 2016,over 16,500 new cases were diagnosed in China,and approximately 10,300 patients died of the disease.[1]In novel-agent era,some patients had a poor prognosis with a median overall survival(OS)of<2 years although they received the therapy regimen containing novel agents and autologous peripheral blood stem cell transplantation(APBSCT)as front-line therapy.Stratification for Myeloma and Risk-Adapted Therapy 3.0(mSMART 3.0)from Mayo Clinic is a risk-stratification guideline revised in 2020.[2]This risk-stratification guideline proposed a novel point of view as having two of the above genetic abnormalities to be named as doublehit MM and having any three or more as triple-hit MM.Guang-Zhong Yang Guo-Rong Wang Yan-Chen Li Yin Wu Wen Gao Wen-Ming Chen 2021Chinese Medical Journal2021,,16:3
16Drug Resistance to HIV-1 Integrase Inhibitors among Treatment-naive Patients in Jiangsu, China显示文摘Integrase strand transfer inhibitors (In STIs) have been widely used in recent years because of their high genetic barrier to resistance.The World Health Organization (WHO) has recommended dolutegravir(DTG)-containing regimens as the preferred first-and second-line antiretroviral therapy (ART) regimens for people living with human immunodeficiency virus(HIV)[1].YIN Yue Qi LU Jing ZHOU Ying SHI Ling En YUAN De Fu CHEN Jian Shuang XU AN Yan HU Hai Yang ZHANG Zhi XU Xiao Qin FU Geng Feng WANG Bei 2021Biomedical and Environmental Sciences2021,34,5:2
17Drug resistance mutation profiles of the drug-nave and first-line regimen-treated HIV-1-infected population of Suzhou, China显示文摘Little is known about the prevalence of drug-resistant mutations in HIV-1-positive individuals in Suzhou, China. To elucidate the transmitted drug resistance(TDR) and acquired drug resistance mutation(ADR) profiles, we collected blood specimens from 127 drug-naive and 117 first-line drugtreated HIV-1-infected individuals sampled from 2014 to 2016 in Suzhou. We successfully amplified po/fragments from 100 drug-naive and 20 drug-treated samples. We then determined the drugresistant mutations to protease(PR) and reverse-transcriptase(RT) inhibitors according to the Stanford drug resistance database. Overall, 11 and 13 individuals had transmitted(drug-naive group) and acquired(treated group) resistance mutations, respectively. Six transmitted drugresistant mutations were found, including two mutations(L33F and L76V) in the protease region and four(K70N/E and V179D/E) in the RT region. Only L76 V was a major mutation, and K70N/E and V179D/E are known to cause low-level resistance to RT inhibitors. All 13 treated participants who had major drug resistance mutations demonstrated intermediate to high resistance to efavirenz and nevirapine, and six had a treatment duration of less than three months. No major mutations to RT inhibitors were found, implying that the epidemic of transmitted resistance mutations was not significant in this area. Our results suggest that more frequent virus load and drug resistance mutation tests should be conducted for individuals receiving antiretroviral treatment, especially for newly treated patients. Our research provides insights into the occurrence of HIV-1 drug resistance in Suzhou and will help to optimize the treatment strategy for this population.Tingting Li Feng Qian Ting Yuan Weilu Xu Li Zhu Jinlong Huang Haiyan Wang Yueping Zhu Yinling Wang Xiaohong Li Saihong Gu Zhuqing Tan Hui Chen Xiangrong Luo Wei Zhu Weniuan Lu Ping Xu Ming Li Yuying Chen Yong Gao Rongge Yang Chuanwu Zhu Binlian Sun 2017Virologica Sinica2017,32,4:2
18Assessment of in vitro sensitivity of Plasmodium vivax fresh isolates显示文摘Objective:To compare the applicability of the SYBK Grcen-Ⅰ assay with the standard schizont maturalion assay,for determination of sensitivity of Plasmodium vivax(P.vivax) to chloroquine and a new antifolale WR 99210.Methods:The study was conducted at Mae Tao Clinic for migrant workers,Tak Province during April 2009 to July 2010.A total of 64 blood samples(1 mL blood collected into sodium heparinized plastic tube) were collected from patients with monoinfection with P.vivax malaria prior to treatment with standard regimen of a 3-day chloroquine. In vitro sensitivity of P.vivax isolates was evaluated by schizont maturation inhibition and SYBR Green-Ⅰ assays.Results:A total of 30 out of 64 blood samples collected from patients with P.vivax malaria were successfully analyzed using both the microscopic schizont maturation inhibition and SYBR Green-I assays.The failure rates of the schizont maturation inhibition assay(50%) and the SYBR Green-I assay(54%) were similar(P=0.51).The median IC_(10)s,IC_(50)s and IC_(90)s of both chloroquine and WR99210 were not significantly different from the clinical isolates of P.vivax tested.Based on the cut-off of 100 nM,the prevalences of chloroquine resistance determined by schizont maturation inhibition and SYBR Green-I assays were 19 and 11 isolates,respectively.The strength of agreement between the two methods was very poor for both chloroquine and WR992I0.Conclusions:On the basis of this condition and its superior sensitivity,the microscopic method appears better than the SYUK Green-I Green assay for assessing in vitro sensitivity of fresh P.vivax isolates to antimalarial drugs.Poonuch Muhamad Wanna Chacharoenkul Kanchana Rungsihirunrat Ronnatrai Ruengweerayut Kesara NaBangchang 2011Asian Pacific Journal of Tropical Biomedicine2011,1,1:2
19Effects of silver nanoparticles with different dosing regimens and exposure media on artificial ecosystem显示文摘Due to the wide use of silver nanoparticles(AgNPs) in various fields, it is crucial to explore the potential negative impacts on the aquatic environment of AgNPs entering into the environment in different ways. In this study, comparative experiments were conducted to investigate the toxicological impacts of polyvinylpyrrolidone-coated silver nanoparticles(PVP-AgNPs) with two kinds of dosing regimens, continuous and one-time pulsed dosing, in different exposure media(deionized water and XiangJiang River water). There were a number of quite different experimental results(including 100% mortality of zebrafish,decline in the activity of enzymes, and lowest number and length of adventitious roots) in the one-time pulsed dosing regimen at high PVP-AgNP concentration exposure(HOE)compared to the three other treatments. Meanwhile, we determined that the concentration of leached silver ions from PVP-AgNPs was too low to play a role in zebrafish death. Those results showed that HOE led to a range of dramatic ecosystem impacts which were more destructive than those of other treatments. Moreover, compared with the continuous dosing regimen, despite the fact that higher toxicity was observed for HOE, there was little difference in the removal of total silver from the aquatic environment for the different dosing regimens. No obvious differences in ecological impacts were observed between different water columns under low concentration exposure. Overall, this work highlighted the fact that the toxicity of Ag NPs was impacted by different dosing regimens in different exposure media, which may be helpful for assessments of ecological impacts on aquatic environments.Jingwen Zeng Piao Xu Guiqiu Chen Guangming Zeng Anwei Chen Liang Hu Zhenzhen Huang Kai He Zhi Guo Weiwei Liu Jing Wu Jiangbo Shi 2019Journal of Environmental Sciences2019,31,1:2
20Cilostazol for secondary stroke prevention:systematic review and meta-analysis显示文摘Background Stroke is one of the leading causes of death worldwide.Cilostazol,an antiplatelet and phosphodiesterase 3 inhibitor,has not been clearly established for ischaemic stroke use.We aim to determine the efficacy and safety of cilostazol for secondary stroke prevention.Methods MEDLINE,EMBASE,Cochrane Library,Web of Science and ClinicalTrials.gov were searched from inception to 25 September 2020,for randomised trials comparing the efficacy and safety of cilostazol monotherapy or dual therapy with another antiplatelet regimen or placebo,in patients with ischaemic stroke.Version 2 of the Cochrane risk-of-bias tool for randomised trials(RoB 2)was used to assess study quality.This meta-analysis was reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)statement.Results Eighteen randomised trials comprising 11429 participants were included in this meta-analysis.Most trials possessed low risk of bias and were of low heterogeneity.Cilostazol significantly reduced the rate of ischaemic stroke recurrence(risk ratio,RR=0.69,95%CI 0.58 to 0.81),any stroke recurrence(RR=0.64,95%CI 0.54 to 0.74)and major adverse cardiovascular events(RR=0.67,95%CI 0.56 to 0.81).Cilostazol did not significantly decrease mortality(RR=0.90,95%CI 0.64 to 1.25)or increase the rate of good functional outcome(Modified Rankin Scale score of 0–1;RR=1.07,95%CI 0.95 to 1.19).Cilostazol demonstrated favourable safety profile,significantly reducing the risk of intracranial haemorrhage(RR=0.46,95%CI 0.31 to 0.68)and major haemorrhagic events(RR=0.49,95%CI 0.34 to 0.70).Conclusions Cilostazol demonstrated superior efficacy and safety profiles compared with traditional antiplatelet regimens such as aspirin and clopidogrel for secondary stroke prevention but does not appear to affect functional outcomes.Future randomised trials can be conducted outside East Asia,or compare cilostazol with a wider range of antiplatelet agents.Choon Han Tan Andrew GR Wu Ching-Hui Sia Aloysius ST Leow Bernard PL Chan Vijay Kumar Sharma Leonard LL Yeo Benjamin YQ Tan 2021Stroke & Vascular Neurology2021,6,3:2
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