Design,delivery and efficacy testing of therapeutic nucleic acids used to inhibit hepatitis C virus gene expression in vitro and in vivo

Despite major achievements in the treatment ofchronic hepatitis C with the combination ofinterferons and the nucleoside analog ribavirin themajority of patients with chronic hepatitis C virus(HCV) infection cannot be treated effectively.Toimprove this response rate we used antisensetechnologies to inhibit HCV translation as possibleadditional option for experimental treatment.Antisense oligodeoxynucleotides(ODN) are

Pharmacological Monitoring of Capecitabine in a Gastric Cancer Patient with Hyperbilirubinemia

Objective: To examine therapeutic drug monitoring in managing hyperbilirubinemia caused by capecitabine in patients with gastric adenocarcinoma with extensive liver metastases. Results: The initial liver function tests showed an elevation of transaminases (aspartate amino transferase 615 UI/l, alanine aminotransferase 385.9 UI/l), hyperbilirubinemia (total bilirubin at 246.1 μmol/l), and alkaline phosphatase at 694.6 UI/l. We initiated capecitabine based combination chemotherapy, and the clinical pharmacist conducted a full-course medication monitoring of the patient’s treatment including design of individualized dosing regimens and monitoring of bilirubin, infection, cancer pain, parenteral nutrition support and adverse events. After 21 days of supervision by clinical pharmacist and clinicians, the patient’s bilirubin and transaminase decreased progressively, with aspartate aminotransferase, total bilirubin and alkaline phosphatase falling back to 57 UI/l, 69.8 μmol/l, 307.2 UI/l, respectively. The patient’s condition improved significantly at the time of discharge, with the jaundice subsided, and the bloating relieved. Conclusion: Due to adverse reactions, capecitabine requires medication monitoring during use. The relationship between effectiveness and adverse effects is controversial. Adverse reactions should not be the sole criterion for the use of drugs. Clinical pharmacists can improve the safety and effectiveness of patients’ medications and promote rational drug use by monitoring patients, which may be useful to help the doctors identify the high-risk patients for taking efficient treatment strategy decisions.

Therapeutic and Medicinal Uses of <i>Aloe vera</i>: A Review

The plant Aloe vera is used in Ayurvedic, Homoeopathic and Allopathic streams of medicine, and not only tribal community but also most of the people for food and medicine. The plant leaves contains numerous vitamins, minerals, enzymes, amino acids, natural sugars and other bioactive compounds with emollient, purgative, anti-microbial, anti inflammatory, antioxidant, aphrodisiac, anti-helmenthic, antifungal, antiseptic and cosmetic values for health care. This plant has potential to cure sunburns, burns and minor cuts, and even skin cancer. The external use in cosmetic primarily acts as skin healer and prevents injury of epithelial tissues, cures acne and gives a youthful glow to skin, also acts as extremely powerful laxative.

Blastocystis hominis as a cause of chronic diarrhea in low-resource settings:A systematic review

BACKGROUND Blastocystis hominis(B.hominis),an anaerobic unicellular protist parasite,is known for its diverse clinical manifestations upon infecting the human gastrointestinal tract.Although globally distributed,it is particularly prevalent in developing nations.Examining the symptoms and treatment outcomes of B.hominis infection in low-resource settings holds immense significance,providing healthcare practi-tioners with valuable insights to enhance patient care.AIM To synthesize existing evidence on the symptomatology and treatment outcomes of B.hominis infection in low-resource settings.METHODS Following the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines,a systematic review was conducted.The search spanned electronic databases including PubMed,Scopus,and Google Scholar.After a comprehensive screening process,a thorough examination of the papers,adhering to inclusion and exclusion criteria,and data extraction from eligible studies was conducted.The findings underwent summarization through simple descriptive analysis.RESULTS The search yielded 1200 papers,with 17 meeting inclusion criteria.Chronic diarrhea due to B.hominis infection was reported in only two studies,while abdominal pain,diarrhea,flatulence,constipation,and nausea/vomiting emerged as the most commonly documented symptoms.Recovery rates after one week of treatment ranged from 71.8%to 100%,and after two weeks,from 60%to 100%.CONCLUSION In low-resource settings,chronic diarrhea resulting from B.hominis infection is infrequent.Common symptoms include abdominal pain,diarrhea,flatulence,constipation,and nausea/vomiting.Post-treatment,clinical outcomes are notably favorable,supporting the recommendation for treatment.Metronidazole is advocated as the first-line agent,with consideration for switching to a second-line option in cases of treatment failure or poor response.

Continuous Wear of Hydrogel Contact Lenses for Therapeutic Use

Purpose: To investigate the efficacy and complications of continuous wear of etafilcon A for therapeutic use. Materials and Methods: The subjects were 228 eyes of 219 outpatients prescribed contact lens (CL) for one week of continuous therapeutic wear during 10 years. The reason for prescription of CLs, the primary disease, the duration of CL wear and the complications were assessed retrospectively. Results: The predominant reason for prescription of CLs was relief of pain or a foreign-body sensation (62.3%) and protection of the corneal epithelium (20.6%). The primary disease was post-penetrating keratoplasty (36.8%), followed by corneal epithelial erosion (14.5%), post-lamellar keratoplasty (14.0%) and bullous keratopathy (12.2%). The average duration of wearing single lens was 6.5 ± 3.2 days. The average duration of wearing CLs in total was 9.2 ± 10.7 months. The most frequent problem associated with continuous wear of CLs was their dropping out of CLs (12.3%). The complications associated with CLs included conjunctivitis with papillary hyperplasia, corneal erosion and superficial punctate keratitis, but corneal ulcer and corneal infiltrates were not found. Conclusion: Serious complications were not shown changing the lenses every week to keep to the prescribed time limit for continuous therapeutic wear, even if corneal epithelial barrier function is impaired.

Comparison of long-lasting therapeutic effects between succimer and penicillamine on hepatolenticular degeneration

AIM To compare the long term effect of succimer (Suc) with that of penicillamine (Pen) in treating hepatolenticular degeneration (HLD). METHODS One hundred and twenty patients with HLD were divided into 2 groups. Group A ( n =60) received Suc 750mg , po. bid. Group B ( n =60) received Pen 250mg , po. qid. The period of maintenance treatment varied from 6 months to 3 years, averaging 1 5 years. Symptoms and therapeutic effects were evaluated by modified Goldstein scale. RESULTS The total effectiveness of group A in two different periods of treatment were 80% and 85% respectively, higher than those of group B (58% and 59% respectively) ( P <0 05). Suc also had obvious curative effects for the patients who failed in the use of Pen. There were fewer side effect in group A than in group B ( P <0 05). Suc and Pen could increase urinary copper excretion effectively and continually. CONCLUSION Suc is more effective and safer than Pen. Clinically, it can replace Pen as first choice drug for long term maintenance therapy of HLD.

Functional dyspepsia of ulcer-dysmotility type:clinical incidence and therapeutic strategy

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Therapeutic role of template-based lymphadenectomy in urothelial carcinoma of the upper urinary tract

Lymphadenectomy for urothelial carcinoma of the upper urinary tract has attracted the attention of physicians. The mapping study of lymphatic spread has shown that a relatively wide area should comprise the regional nodes for tumors of the right renal pelvis or the right upper two-thirds of the ureter. A prospective study showed that an anatomical templatebased lymphadenectomy significantly improved patient survival in tumors of the renal pelvis. This benefit was more evident for patients with p T2 stage tumors or higher. The risk of regional node recurrence is significant reduced by template-based lymphadenectomy,which is likely to be associated with improved patient survival. The removal of lymph node micrometastases is assumed to be the reason for therapeutic benefit following lymphadenectomy. The number of resected lymph nodes can be used to assess the quality of lymphadenectomy,but not to determine the extent of lymphadenectomy. The guidelines currently recommend lymphadenectomy for patients with muscle-invasive disease,even though the current recommendation grades are still low. The present limitation of lymphadenectomy is the lack of standardization of the extent of lymphadenectomy and the randomized trials. Further studies are warranted to collect the evidence to support lymphadenectomy.

Controversies regarding transplantation of mesenchymal stem cells

Mesenchymal stem cells(MSCs)have tantalized regenerative medicine with their therapeutic potential,yet a cloud of controversies looms over their clinical tran-splantation.This comprehensive review navigates the intricate landscape of MSC controversies,drawing upon 15 years of clinical experience and research.We delve into the fundamental properties of MSCs,exploring their unique immuno-modulatory capabilities and surface markers.The heart of our inquiry lies in the controversial applications of MSC transplantation,including the perennial debate between autologous and allogeneic sources,concerns about efficacy,and lingering safety apprehensions.Moreover,we unravel the enigmatic mechanisms surro-unding MSC transplantation,such as homing,integration,and the delicate balance between differentiation and paracrine effects.We also assess the current status of clinical trials and the ever-evolving regulatory landscape.As we peer into the future,we examine emerging trends,envisioning personalized medicine and innovative delivery methods.Our review provides a balanced and informed perspective on the controversies,offering readers a clear understanding of the complexities,challenges,and potential solutions in MSC transplantation.

Clinacanthus nutans:a review of the medicinal uses,pharmacology and phytochemistry

Clinacanthus nutans Lindau is known as snake grass belonging to the Acanlhaceae family.This plant has diverse and potential medicinal uses in traditional herbal medicine for treating skin rashes,insects and snake bites,lesions caused by herpes simplex virus,diabetes,and gout in Malaysia.Indonesia.Thailand and China.Phylochemieal investigations documented the varied contents of bioaclive compounds from litis plant namely flavonoids,glycosides,glycoglyeerolipids.cerebrosides and monoacylmonogalatosylglycerol.The pharmacological experiment proved that various types of extracts and pure compounds from this species exhibited a broad range of biological properties such as anti-inflammatory,antiviral,antioxidant,and anti-diabetic activities.The lindings of toxicity study showed that extracts from this plant did not show any toxicity thus it can be used as strong therapeutic agents for specific diseased conditions.However,further experiments on chemical components and their mode of action showing biological activities are required to elucidate the complete phytochemical profile and assess to confirm their suitability tor future drugs.This review summarizes the medicinal uses,phytochemistry and pharmacology of this plant in order to explore its therapeutic potential and gaps necessitating for prospected research work.

High-intensity focused ultrasound extracorporeal ablation of liver tissuesin rabbits

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The role of drug utilization evaluation in medical sciences

Background:Drug utilization evaluation(DUE)is defined by the World Health Organization(WHO)and focuses on the medical,social,and economic consequences of pharmaceutical marketing,distribution,prescribing,and usage in society.The WHO recommends a physician to every 1000 people.According to the recent data from the Health Ministry in 2019,in which 1.16 million doctors are of active population with just 80%,or 0.9 million,practicing.As a result,a ratio of 0.68 doctors for every 1000 people,which is much below as per the WHO reports.This article describes history,types,WHO guidelines,need and purpose of DUE.Objective:The main aim of this paper is to provide information about the rational use of medication in outpa­tient and inpatient department with special emphasis of DUEs.It also provides awareness directly to healthcare professionals,researchers,academicians,pharmacist and nurses to reduce the irrationality of medicines.Methods:The method used to compile this review information gathered from websites,Google scholar,PubMed,Research gate,and studies published on DUE from July 20 to Oct 22 were included as source of information.Results:We studied more than 35 published study on DUE,that reveals most of the physicians prescribed branded drugs not generic drugs,but WHO prescribing indicator allows to prescribe generic drugs in the hospital pharmacy to maintain better inventory control.It may also help to prevent pharmacist misunderstanding during dispensing.Conclusion:The use of generic prescription names avoids the possibility of medication product duplication and lowers patient costs.It is important to remember that incorrect medication prescriptions have impact on both patients and their family members.WHO indicators identify irrational prescribing behaviours to make therapy more rational and cost-effective.

USE OF CELL-BASED BIOASSAY FOR THE QUALITY CONTROL OF BOTANICAL THERAPEUTICS

The single most important factor in modernization efforts of traditional oriental medicines is the limited understanding of active compounds responsible for claimed therapeutic effects.Indeed,the unknown identity of biologically active molecules generates major difficulties associated with botanical therapeutics in general.This includes management of raw materials,poor understanding of

卡培他滨和替吉奥作为晚期胃癌一线诱导化疗后维持治疗的临床观察

目的:观察对比卡培他滨和替吉奥在晚期胃癌一线诱导化疗后维持治疗的疗效和不良反应。方法:收集2010年1月至2016年1月北京大学深圳医院诊治的130例晚期胃癌患者,经XELOX或SOX方案诱导治疗4~6个周期,或m FOLFOX6方案诱导治疗6~8个周期,疗效评价无疾病进展(progressive disease,PD)的患者,分为卡培他滨维持治疗组(1 000 mg/m^2,2次/d,口服,d1~14,21 d为1个周期);替吉奥维持治疗组:1)体表面积≤1.25 m^2,40 mg/次;2)体表面积1.25~1.5 m^2,50 mg/次;3)体表面积≥1.5 m^2,60 mg/次,2次/d,早晚口服,d1~14,21 d为1个周期,或观察组维持化疗持续到PD或出现不能耐受不良反应为止。结果:130例患者中采用XELOX、SOX和m FOLFOX6方案治疗的例数分别为44、33和53例,总体疾病控制率(disease control rate,DCR)为63.1%。82例患者中采用卡培他滨、替吉奥维持治疗和观察的例数分别为35、28和19例。卡培他滨组与替吉奥维持治疗组的疗效无显著性差异(P=0.678)。卡培他滨组、替吉奥组的疾病进展时间(time to progress,TTP)分别为8.5个月和9.0个月(P>0.05),均优于观察组的6.0个月(P<0.001)。卡培他滨组、替吉奥组和观察组的总生存期(overall survival,OS)无显著性差异(14.5 vs.15.0 vs.14.0,P=0.188)。维持化疗患者不良反应主要以骨髓抑制、胃肠道反应、疲乏、手足综合征和口腔炎等为主,无治疗相关死亡。结论:卡培他滨和替吉奥作为晚期胃癌一线诱导化疗后维持治疗疗效相当,均可延长患者TTP,不良反应较轻。

草酸铂联合卡培他滨—线化疗后卡培他滨维持治疗晚期胃癌

目的:探讨晚期胃癌草酸铂/卡培他滨一线化疗后继续卡培他滨维持化疗的疗效与不良反应方法:62例初治晚期胃癌患者,采用草酸铂/卡培他滨化疗;最多6个周期化疗后疗效评价无疾病进展的患者中,32例进行卡培他滨维持化疗(2 000mg/m^2/d,d1～14,21d重复),维持化疗持续到疾病进展或出现不能耐受毒性为止。结果:62例患者共接受315个周期初始化疗,均可评价疗效,总有效率51.6%。初始化疗后49例疗效评价无疾病进展,其中17例随访观察,32例继续卡培他滨维持化疗维持化疗组总有效率和疾病控制率分别为28.1%、78.1%,均好于随访观察组(总有效率和疾病控制率分别为0、47.1%,P<0.05)维持化疗组中位疾病进展时间7.9个月,较对照观察组5.7个月延长(P<0.05),中位生存时间分别为14.9个月和13.4个月(P>0.05)主要不良反应有恶心、呕吐、腹泻、骨髓抑制、手足综合征等,经对症台疗后均好转,无治疗相关死亡。结论:草酸铂/卡培他滨一线化疗后卡培他滨维持治疗晚期胃癌可增加有效率、延长疾病进展时间,并有延长总生存期的趋势。

周剂量多西他赛联合卡培他滨治疗晚期胃癌的疗效观察

目的观察周剂量多西他赛联合卡培他滨治疗晚期胃癌的疗效及不良反应。方法多西他赛每次剂量25mg·m-2,d1、d8、d15,卡培他滨每日2000mg·m-2,分2次口服,d1～d14,28天为1周期,连用2周期以后评价疗效。结果 40例晚期胃癌患者均可评价疗效,其中完全缓解0例(0%),部分缓解18例(45.0%),病情稳定16例(40.0%),病情进展6例(15.0%),总有效率为45.0%,中位疾病无进展时间(TTP)为6.35月。不良反应多为骨髓抑制、胃肠道反应、手足综合征,严重不良反应主要为白细胞下降(35%)。结论周剂量多西他赛联合卡培他滨治疗晚期胃癌近期疗效好,严重不良反应少,患者耐受性高,可改善患者的生存质量。

卡培他滨在Ⅲ期结直肠癌一线化疗后维持治疗的临床分析

目的评估卡培他滨在Ⅲ期结直肠癌一线化疗后维持治疗的有效性及安全性。方法回顾性分析213例Ⅲ期结直肠癌术后患者的临床及随访资料。以上患者术后接受8周期奥沙利铂联合卡培他滨（XELOX）方案化疗，然后分组：A组（n=76）维持组，B组（n=137）非维持组。比较两组3年无瘤生存率（DFS）、5年总生存率（OS）以及A组维持化疗前后临床不良反应发生率。结果中位随访时间45月。A组3年DFS为62．0％，B组为51．3％（HR=0．6168，95％CI：0．4173—0．9118，P=0．0305），差异有统计学意义。A组5年OS为70．2％，B组为54．5％（HR=0．6502，95％CI：0．4150～1．1090，P=0．0498），差异有统计学意义。A组维持化疗前后的不良反应多数是Ⅰ／Ⅱ级，严重Ⅲ／Ⅳ级不良反应少见。A组和B组两组之间的Ⅰ／Ⅱ级和Ⅲ／Ⅳ级不良反应发生率比较差异无统计学意义（P〉0．05）。结论结直肠癌一线化疗后加单药卡培他滨维持治疗可显著延长患者3年DFS和5年OS，且耐受良好。

希罗达联合唑来膦酸治疗乳腺癌多发骨转移疗效观察

目的:观察评价希罗达(卡培他滨)联合唑来膦酸治疗乳腺癌多发骨转移的效果及安全性。方法:采用随机对照研究,56例乳腺癌多发骨转移分为治疗组与对照组,治疗组28例给予希罗达片口服化疗联合唑来膦酸治疗。对照组28例单纯给予希罗达治疗。对两组进行治疗并比较和分析治疗结果。结果:两组治疗的有效率、临床获益率分别为57.1%、75.0%和46.4%、60.7%;两组近期疗效、生存质量改善及毒副反应比较,无统计学差异(P>0.05)。治疗组骨痛缓解率及骨转移灶修率分别是82.1%和75.0%,高于对照组(42.8%和46.4%),差异有统计学意义(P<0.05)。结论:希罗达联合唑来膦酸治疗乳腺癌多发骨转移具有协同效应,较单用希罗达近期疗效好,骨痛缓解、骨转移灶修复明显。

卡培他滨单药维持治疗晚期转移性乳腺癌疗效观察

目的观察和评价卡培他滨单药维持化疗治疗晚期转移性乳腺癌的临床疗效、生活质量改善和不良反应。方法 54例经病理学检查确诊的晚期转移性乳腺癌患者分为实验组30例,在以卡培他滨为主的两药联合化疗完成后,给予卡培他滨单药维持,剂量1 250 mg/m2,每天早、晚餐后30分钟口服,连服14天,21天为1周期,每2周期评价疗效,病灶进展则停药;对照组24例进行随访观察。结果实验组30例患者均可评价疗效,CR 0例,PR9例,SD 16例,PD 5例,有效率为30.0%,疾病控制率(CR+PR+SD)为83.3%(25/30),TTP、中位生存期及1年、2年生存率分别为6.1月、11.7月和56.7%、36.7%。对照组TTP、中位生存期及1年、2年生存率分别为5.4月、10.6月和54.1%、33.3%。实验组生活质量改善者占63.3%(19/30)。实验组常见的不良反应为手足综合征(60.0%)、皮肤色素沉着(46.7%)、腹泻(13.3%)、恶心、呕吐(13.3%)、口腔发炎(6.7%)、白细胞减少(20.0%)及血小板减少(10.0%),均能够耐受。结论卡培他滨单药维持化疗治疗晚期转移性乳腺癌,可延长患者生存时间,改善生活质量,不良反应轻,值得临床进一步研究。

卡培他滨单药治疗蒽环类和紫杉醇类耐药的晚期乳腺癌25例

为了观察卡培他滨单药治疗蒽环类和紫杉醇类耐药晚期乳腺癌的临床疗效和毒副作用，对以蒽环类及紫杉醇类为基础的化疗方案耐药的晚期乳腺癌25例，应用卡培他滨2500ms／（m^2·d），口服14d，21d为1个周期，观察临床疗效和毒副反应。结果：共化疗112个周期，肿瘤缓解率24％（6／25），临床受益率56％（14／25），中位肿瘤进展时间3、9个月（1～17个月），中位生存期10个月（2．5～〉24个月）。Ⅲ、Ⅳ度毒副反应有：Ⅲ度手足综合征3例（12％），Ⅲ度白细胞下降2例（8％），Ⅲ度腹泻1例（4％），Ⅳ度恶心、呕吐1侧（4％）。初步研究结果提示，卡培他滨单药化疗蒽环类和紫杉醇类耐药的晚期乳腺癌，疗效确切、毒副反应轻、应用方便。