Computerized tomography-guided therapeutic percutaneous puncture catheter drainage-combined with somatostatin for severe acute pancreatitis: An analysis of efficacy and safety

BACKGROUND Severe acute pancreatitis(SAP),a condition with rapid onset,critical condition and unsatisfactory prognosis,poses a certain threat to human health,warranting optimization of relevant treatment plans to improve treatment efficacy.AIM To evaluate the efficacy and safety of computerized tomography-guided the-rapeutic percutaneous puncture catheter drainage(CT-TPPCD)combined with somatostatin(SS)in the treatment of SAP.METHODS Forty-two SAP patients admitted to The Second Affiliated Hospital of Fujian Medical University from June 2020 to June 2023 were selected.On the basis of routine treatment,20 patients received SS therapy(control group)and 22 patients were given CT-TPPCD plus SS intervention(research group).The efficacy,safety(pancreatic fistula,intra-abdominal hemorrhage,sepsis,and organ dysfunction syndrome),abdominal bloating and pain relief time,bowel recovery time,hospital stay,inflammatory indicators(C-reactive protein,interleukin-6,and pro-calcitonin),and Acute Physiology and Chronic Health Evaluation(APACHE)II score of both groups were evaluated for comparison.RESULTS Compared with the control group,the research group had a markedly higher total effective rate,faster abdominal bloating and pain relief and bowel recovery,INTRODUCTION Pancreatitis,an inflammatory disease occurring in the pancreatic tissue,is classified as either acute or chronic and is associated with high morbidity and mortality,imposing a socioeconomic burden[1,2].The pathogenesis of this disease involves early protease activation,activation of nuclear factor kappa-B-related inflammatory reactions,and infiltration of immune cells[3].Severe acute pancreatitis(SAP)is a serious condition involving systemic injury and subsequent possible organ failure,accounting for 20%of all acute pancreatitis cases[4].SAP is also characterized by rapid onset,critical illness and unsatisfactory prognosis and is correlated with serious adverse events such as systemic inflammatory response syn-drome and acute lung injury,threatening the health of patients[5,6].Therefore,timely and effective therapeutic inter-ventions are of great significance for improving patient prognosis and ensuring therapeutic effects.Somatostatin(SS),a peptide hormone that can be secreted by endocrine cells and the central nervous system,is in-volved in the regulatory mechanism of glucagon and insulin synthesis in the pancreas[7].It has complex and pleiotropic effects on the gastrointestinal tract,which can inhibit the release of gastrointestinal hormones and negatively modulate the exocrine function of the stomach,pancreas and bile,while exerting a certain influence on the absorption of the di-gestive system[8,9].SS has shown certain clinical effectiveness when applied to SAP patients and can regulate the severity of SAP and immune inflammatory responses,and this regulation is related to its influence on leukocyte apoptosis and adhesion[10,11].Computerized tomography-guided therapeutic percutaneous puncture catheter drainage(CT-TPPCD)is a surgical procedure to collect lesion fluid and pus samples from necrotic lesions and perform puncture and drainage by means of CT image examination and precise positioning[12].In the research of Liu et al[13],CT-TPPCD applied to pa-tients undergoing pancreatic surgery contributes to not only good curative effects but also a low surgical risk.Baudin et al[14]also reported that CT-TPPCD has a clinical success rate of 64.6%in patients with acute infectious necrotizing pan-creatitis,with nonfatal surgery-related complications found in only two cases,suggesting that this procedure is clinically effective and safe in the treatment of the disease.In light of the limited studies on the efficacy and safety of SS plus CT-TPPCD in SAP treatment,this study performed a relevant analysis to improve clinical outcomes in SAP patients.

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

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

奥曲肽与生长抑素治疗肝硬化合并上消化道出血疗效对比研究

目的:探讨生长抑素与奥曲肽对肝硬化上消化道出血患者的临床治疗效果及对血流动力学影响。方法:172例肝硬化上消化道出血患者随机分为对照组与观察组,每组为86例,观察组实施奥曲肽治疗,对照组采用生长抑素治疗。结果:对照组治疗后总有效率为74.42%,观察组93.02%,两组差异有统计学意义(P<0.05);治疗后两组肝功能和肝纤维化指标均下降,但观察者明显高于对照组,差异有统计学意义(P<0.05);治疗后观察组门静脉血流量、脾静脉血流量明显较对照组低,差异有统计学意义(P<0.05)。结论:肝硬化上消化道出血采取奥曲肽治疗安全性高,可有效改善血流动力学。

急性坏死性胰腺炎生长抑素和生长激素联合治疗对多器官损伤的保护作用

目的研究生长抑素和生长激素联合应用防治急性坏死性胰腺炎（ANP）的全身炎症反应综合征和多器官功能障碍综合征及其治疗策略．方法经胰胆管逆行注射35g／L牛磺胆酸钠2．5mL／kg建立鼠ANP模型．测定血清IL-8，IL-6，TNFα,淀粉酶、内毒素和清蛋白．胰腺、肝、心、肺和肾病理观察及细胞超微结构观察，TNFαmRNA分子转录水平的RT－PCR分析及TNFα的免疫组化原位观察，探讨生长抑素和生长激素治疗作用．结果ANP的发生和发展伴有炎性递质的明显升高，与ANP和MODS的发展呈正相关．生长抑素和生长激素对抑制炎性递质的释放和TNFarnRNA过度表达有协同作用，同时亦表明肝脏在ANP中对预防宿主多器官衰竭有重要作用结论TNFαmRNA的高度表达在ANP的进展中至关重要，生长抑素和生长激素的联合治疗时防治ANP的MODS的发生和防治有重要作用.

生长抑素在肠梗阻治疗中的应用体会

目的探讨生长抑素在肠梗阻治疗中的应用效果。方法回顾性分析2005年1月至2010年12月本科收治114例肠梗阻患者,其中常规治疗(对照组)58例,常规治疗基础上加生长抑素(治疗组)56例,治疗组生长抑素(每天6 mg静脉微泵滴注维持72 h)比较两组治疗前后的临床症状及体征改善情况、胃肠减压量、中转急诊手术率。结果治疗组临床症状明显改善,与对照组相比,48 h腹痛和腹胀的缓解率分别为76.8%、56.9%(P<0.05);肛门恢复排气排便比率分别为78.5%、58.6%(P<0.05);胃肠减压量明显少于对照组,分别为(212±125)mL/d、(517±134)mL/d(P<0.05),急诊手术率明显低于对照组,分别为10.7%、44.8%(P<0.05)。结论在常规治疗基础上应用生长抑素治疗肠梗阻能加快症状缓解,提高保守治疗的成功率,降低急诊手术率。

脾虚证大鼠组织和血浆中SS,CCK,Mot含量的变化

目的 探讨胃肠激素在脾虚证发病中的作用。 方法 采用放射免疫分析法测定实验性脾虚证大鼠不同造模时间(7d,14d)胃窦、十二指肠、空肠、下丘脑及血浆中胃动素(Mot)、生长抑素(SS)、缩胆囊素(CCK)含量并与正常对照组和四君子汤预防组比较。 结果 脾虚早期(7d):SS在血浆、下丘脑中含量升高(106.5±13.9和143.1±8.5 vs 85.2±4.3和136.9±40.9)(P<0.01,P<0.05),外周组织中含量下降(27.5±1.6,22.7±1.2和19.5±2.4 vs 91.4±9.6,50.7±5.6和55.5±6.8,P<0.01);CCK(88.1±5.2,59.2±3.5,79.1±8.7,68.5±4.7和6.9±0.2)和Mot(76.4±8.0,51.2±1.9,37.2±7.3,63.2±2.2和99.8±6.5 vs 73.0±2.4,43.1±2.3,63.1±7.1,59.2±6.7,3.8±0.1和53.2±9.3,35.6±3.0,29.5±7.6,46.6±7.0,82.7±9.3)在组织和血浆中含量均升高(P<0.01,P<0.05),脾虚晚期(14d):SS在下丘脑(98.3±28.7)、血浆(68.2±2.6)中含量下降,外周组织中含量(119.3±5.2,98.4±9.2和88.2±2.8)升高(P<0.01);Mot在组织(32.5±5.6,27.9±1.8,21.62±6.2和32.3±5.1,P<0.01)和血浆(64.5±5.4,P<0.05)中含量均下降,CCK在下丘脑(84.1±1.5,P<0.01)及胃窦(54.2±6.4,P<0.01)组织中含量升高,在血浆(2.8±0.4)和肠道组织(43.2±2.3,36.5±3.3,P<0.01)

生长抑素联合白蛋白注射液治疗急性胰腺炎临床疗效及安全性研究

目的:探讨生长抑素联合白蛋白注射液治疗急性胰腺炎(SAP)的临床效果及安全性。方法:将符合纳入排除标准的120例SAP患者均分为两组,对照组在常规治疗基础上加用生长抑素进行治疗;试验组则加用生长抑素与白蛋白注射液进行联合治疗。记录两组腹胀、腹痛消退时间、血清淀粉酶水平恢复时间及住院时间;测定两组患者治疗前后血清白蛋白、血小板活化因子(PAF)、C反应蛋白(CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α);对比两组并发症及不良反应发生情况。结果:试验组临床总有效率为95.00%,对照组81.67%,两组间差异存在统计学意义(P<0.05)。与对照组比,试验组腹痛腹胀消失、血清淀粉酶水平恢复及平均住院时间均明显缩短(P<0.05),血清白蛋白上升及血清炎症因子PAF、CRP、IL-6、TNF-α水平下降程度更明显(P<0.05),胰腺脓肿及胰腺假性囊肿发生率均明显减少(P<0.05);但两组急性肾衰竭、腹腔感染发病率及不良反应发生率间差异无统计学意义(P>0.05)。结论:与单独使用生长抑素相比,生长抑素与白蛋白注射液联合治疗SAP效果更好,可更好的抑制机体炎症因子释放,改善患者局部血流动力学,预防并发症发生,且安全性良好。

内镜套扎术联合生长抑素治疗食管曲张静脉破裂出血的疗效评价

目的评价内镜套扎术联合生长抑素治疗食管曲张静脉破裂出血的近期与远期疗效。方法64例门脉高压急性食管曲张静脉破裂出血患者均行内镜套扎术,术后分成单纯套扎组和套扎联合生长抑素组观察疗效。结果短期止血率两组均达93%,术后再出血率及再出血时间间隔两组有显著性差异(P<005)。结论内镜套扎术联合生长抑素治疗食管曲张静脉破裂出血的远期效果比单纯套扎好,表现为再出血率低和再出血时间间隔延长。

加倍剂量生长抑素治疗食管胃底静脉曲张破裂出血的疗效分析

目的评价不同剂量生长抑素治疗食管胃底静脉曲张破裂出血(esophagogastric variceal bleeding,EVB)患者的临床效果。方法选取2013年1月-2015年12月海南省人民医院急诊ICU及消化内科收治的102例肝硬化合并EVB患者,根据随机数字表法将患者分为标准剂量组(A组)和加倍剂量组(B组),各51例。依据患者就诊时Child-Pugh分级对A、B两组依次再分为A1组(Child-Pugh A级)、A2组(Child-Pugh B级)、A3组(Child-Pugh C级)及B1组(Child-Pugh A级)、B2组(Child-Pugh B级)、B3组(Child-Pugh C级)。A组给予生长抑素首剂250μg静脉注射后,再用生长抑素250μg/h持续泵入,持续5 d。B组给予生长抑素首剂500μg静脉注射后,再用生长抑素500μg/h持续泵入,持续5 d。比较A组和B组、A1组和B1组、A2组和B2组、A3组和B3组的首次止血成功率、再出血率、治疗有效率、死亡率。结果 B组的首次止血成功率、治疗有效率高于A组,再出血发生率低于A组(P<0.05)。B2组的首次止血成功率、治疗有效率高于A2组,再出血发生率低于A2组(P<0.05)。结论对于EVB患者,加倍剂量生长抑素治疗是有效的;尤其是对于Child-Pugh B级患者,可以明显提高止血成功率及降低再出血率。