Inflammatory bowel diseases(IBD)are chronic diseases with a relapsing-remitting disease course necessitating lifelong treatment.However,non-adherence has been reported in over 40%of patients,especially those in remiss...Inflammatory bowel diseases(IBD)are chronic diseases with a relapsing-remitting disease course necessitating lifelong treatment.However,non-adherence has been reported in over 40%of patients,especially those in remission taking maintenance therapies for IBD. The economical impact of non-adherence to medical therapy including absenteeism,hospitalization risk, and the health care costs in chronic conditions,is enormous.The causes of medication non-adherence are complex,where the patient-doctor relationship, treatment regimen,and other disease-related factors play key roles.Moreover,subjective assessment might underestimate adherence.Poor adherence may result in more frequent relapses,a disabling disease course, in ulcerative colitis,and an increased risk for colorectal cancer.Improving medication adherence in patients is an important challenge for physicians.Understanding the different patient types,the reasons given by patients for non-adherence,simpler and more convenient dosage regimens,dynamic communication within the health care team,a self-management package incorporating enhanced patient education and physician-patient interaction,and identifying the predictors of nonadherence will help devise suitable plans to optimize patient adherence.This editorial summarizes the available literature on frequency,predictors,clinical consequences,and strategies for improving medical adherence in patients with IBD.展开更多
AIM： To investigate the efficacy of combination treatment of IFN-α and lamivudine compared to lamivudine monotherapy, after 24 mo of administration in HBeAgnegative hepatitis B patients. METHODS： Fifty consecutive ...AIM： To investigate the efficacy of combination treatment of IFN-α and lamivudine compared to lamivudine monotherapy, after 24 mo of administration in HBeAgnegative hepatitis B patients. METHODS： Fifty consecutive patients were randomly assigned to receive IFN-α-2b （5 MU thrice per week, n = 24） plus lamivudine （100 mg daily） or lamivudine only （n = 26） for 24 mo. Patients were followed up for further 6 mo. The primary outcome was the proportion with sustained virological response （undetectable serum HBV DNA concentrations） and or sustained biochemical response （transaminase levels within normal range） at 30 mo （6 mo after the end of therapy）. Secondary end-points were timed from initial virological （biochemical） response to VBR （BBR, respectively） and the emergence of YMDD mutants across the two arms. RESULTS： Five of twenty-four （21%） patients in the combination arm vs 3/26 （12%） in the lamivudine arm had sustained response （i.e., normal serum transaminase levels and undetectable HBV DNA by PCR assay） 6 mo after treatment discontinuation. A reduction in the emergence of YMDD mutants and in the development of virological breakthroughs was observed in patients receMng combination treatment （10% vs46% , P= 0.01 and 14% vs46% , P= 0.03, respectively）. Time from initial virologic response to virologic breakthrough （VBR） was greater among initial responders receiving combination treatment compared to those receiving lamivudine （22.9 mo vs 15.9 mo, respectively; P = 0.005）.CONCLUSION： Our results demonstrate that IFN-α plus lamivudine combination therapy does not increase the sustained response, compared to lamivudine. However, combination therapy reduces the likelihood of VBR due to YMDD mutants and prolongs the time period until the breakthrough development.展开更多
Background To document the pharmacotherapy of chronic heart failure （CHF） and to evaluate the adherence to treatment guidelines in Australian population. Methods The pharmacological management of 677 patients （fema...Background To document the pharmacotherapy of chronic heart failure （CHF） and to evaluate the adherence to treatment guidelines in Australian population. Methods The pharmacological management of 677 patients （female 46.7%, 75.5 ±11.6 years） with CHF was retrospectively analyzed. Results The use of angiotensin converting enzyme （ACE） inhibitors/angiotensin receptor blockers （ARB） and β-blockers were 58.2 % and 34.7 %, respectively. Major reasons for non-use of ACE inhibitors/ARBs were hyperkalemia and elevated serum creatinine level. For patients who did not receive β-blockers, asthma and chronic obstructive pulmonary disease were the main contraindications. Treatment at or above target dosages for ACE inhibitors/ARBs and β-blockers was low for each medication （40.3% and 28.9%, respectively）. Conclusions Evidenced-based medical therapies for heart failure were under used in a rural patient population. Further studies are required to develop processes to improve the optimal use of heart failure medications.展开更多
Over the last decade, the standard of care for the treat- ment of chronic hepatitis C has been the combination of pegylated-interferon-alfa （PEG-IFN） and ribavirin （RBV） which results in sustained virological resp...Over the last decade, the standard of care for the treat- ment of chronic hepatitis C has been the combination of pegylated-interferon-alfa （PEG-IFN） and ribavirin （RBV） which results in sustained virological response （SVR） rates of 75%-85% in patients with genotypes 2 or 3 but only of 40%-50% in patients with genotype 1. Cur- rently, there are rapid and continuous developments of numerous new agents against hepatitis C virus （HCV）, which are the focus of this review. Boceprevir and tela- previr, two first-generation NS3/4A HCV protease inhibi- tors, have been recently licensed in several countries around the world to be used in combination with PEG- IFN and RBV for the treatment of genotype 1 patients. Boceprevir or telaprevir based triple regimens, com- pared with the PEG-IFN/RBV combination, improve the SVR rates by 25%-31% in treatment-naTve genotype 1 patients, by 40%-64% in prior relapsers, by 33%-45% in prior partial responders and by 24%-28% in prior null responders. At the same time, the application of response-guided treatment algorithms according to the on-treatment virological response results in shortening of the total therapy duration to only 24 wk in 45%-55% of treatment-na＇ive patients. There are, however, several challenges with the use of the new triple combinations in genotype 1 patients, such as the need for immediate results of HCV RNA testing using sensitive quantitative assays, new and more frequent adverse events （anemia and dysgeusia for boceprevir; pruritus, rash and anemia for telaprevir）, new drug interactions and increasing dif- ficulties in compliance. Moreover, the SVR rates are still poor in very difficult to treat subgroups of genotype 1 patients, such as null responders with cirrhosis, while there is no benefit for patients who cannot tolerate PEG- IFN/RBV or who are infected with non-1 HCV genotype. Many newer anti-HCV agents of different classes and numerous combinations are currently under evaluation with encouraging results. Preliminary data suggest that the treatment of chronic HCV patients with well toler- ated combinations of oral agents without PEG-IFN is feasible and may lead to a universal HCV cure over the next 5-10 years.展开更多
AIM： To investigate the use of high dose consensusinterferon in combination with ribavirin in former iv drug users infected with hepatitis C. METHODS： We started, before pegylated （PEG）interferons were available, ...AIM： To investigate the use of high dose consensusinterferon in combination with ribavirin in former iv drug users infected with hepatitis C. METHODS： We started, before pegylated （PEG）interferons were available, an open-label study to investigate the efficacy and tolerability of high dose induction therapy with consensus interferon （CIFN） and ribavirin in treatment of naiive patients with chronic hepatitis C. Fifty-eight patients who were former iv drug users, were enrolled receiving 18 μg of CIFN daily for 8 wk, followed by 9 μg daily for up to wk 24 or 48 and 800 mg of ribavirin daily. End point of the study was tolerability and eradication of the virus at wk 48 and sustained virological response at wk 72. RESULTS： More than 62% of patients responded to the treatment with CIFN at wk 24 or 48, respectively, showing a negative qualitative PCR [genotype 1 fourteen patients （56%）, genotype 2 five （50%）, genotype 3 thirteen （87%）, genotype 4 four （50%）]. Forty-eight percent of genotype 1 patients showed sustained virological response （SVR） six months after the treatment. CONCLUSION： CIFN on a daily basis is well tolerated and side effects like leuko- and thrombocytopenia are moderate. End of therapy （EOT） rates are slightly lower than the newer standard therapy with pegylated interferons. CIFN on a daily basis might be a favourable therapy regimen for patients with GTI and high viral load or for non-responders after failure of standard therapy.展开更多
Objective:To evaluate the antiviral activity of the alcohol extract of Styela plicata on DHBV (duck hepatitis B virus) in vivo. Methods: Guangzhou-Sheldrake ducklings congenitally infected with DHBV were assigned to r...Objective:To evaluate the antiviral activity of the alcohol extract of Styela plicata on DHBV (duck hepatitis B virus) in vivo. Methods: Guangzhou-Sheldrake ducklings congenitally infected with DHBV were assigned to receive the alcohol extract of Styela plicata or lamivudine for 30 consecutive days. The DHBV DNA of sera was detected by RT-PCR. and the histological analysis of duckling liver was evaluated. Results:Thirty days after therapy,histological analysis of duckling liver showed that the ducklings receiving the alcohol extract of Styela plicata or lamivudine exhibited catabatic status in the degree of liver cell degeneration and inflammation compared with the ducklings receiving normal diet. DHBV DNA of sera from alcohol extract of Styela plicata-treated ducklings and lamivudine-treated ducklings all produced significantly lower levels compared with ducklings receiving normal diet (P<0. 01 ). Although these treatment groups all exhibited a rebound phenomenon 10 d after withdrawal of medication, they still exhibited a significant lower level of serum DHBV DNA compared with the control group responded to normal diet (P<0. 05, P<0. 01). Conclusion:Styela plicata may be an effective antiviral medicine in treating chronic hepatitis B. The data of this experiment will be valuable in studying the therapeutic role and the potential therapeutic mechanism of Styela plicata.展开更多
Several case reports deal with the relationship between hepatitis C virus （HCV） infection and pulmonary or he- patic sarcoidosis. Most publications describe interferon m-induced sarcoidosis. However, HCV infection p...Several case reports deal with the relationship between hepatitis C virus （HCV） infection and pulmonary or he- patic sarcoidosis. Most publications describe interferon m-induced sarcoidosis. However, HCV infection per se is also suggested to cause sarcoqdosis. The present case report describes a case of biopsy-verified lung and liver sarcoidosis and HCV infection, and the out- come of antiviral therapy. In March 2009, a 25-year-old man presented with moderately elevated liver enzymes without any clinical symptoms. The patient was posi- tive for HCV antibodies and HCV RNA of genotype lb. Four months later the patient became dyspnoic and pulmonary sarcoidosis was diagnosed by lung biopsy and radiography. A short course of corticosteroid treat- ment relieved symptoms. Three months later, liver biopsy showed noncaseating granulomas consisting of epithelioid histiocytes and giant cells with a small amount of peripheral lymphocyte infiltration, without any signs of fibrosis. Chronic HCV infection with co- existence of pulmonary and hepatic sarcoidosis was diagnosed. Antiviral therapy with peginterferon ~ and ribavirin at standard doses was started, which lasted 48 wk, and sustained viral response was achieved. A second liver biopsy showed disappearance of granulo- mas and chest radiography revealed normalization of mediastinal and perihilar glands. The hypothesis that HCV infection perse may have triggered systemic sar- coidosis was proposed. Successful treatment of HCV infection led to continuous remission of pulmonary and hepatic sarcoidosis. Further studies are required to un- derstand the relationship between systemic sarcoidosis and HCV infection.展开更多
Inflammatory bowel disease （IBD） results from the interaction between an individual＇s immune response and precipitant environmental factors, which generatean anomalous chronic inflammatory response in thosewho are ...Inflammatory bowel disease （IBD） results from the interaction between an individual＇s immune response and precipitant environmental factors, which generatean anomalous chronic inflammatory response in thosewho are genetically predisposed. Various feeding practices have been implicated in the origin of IBD based on epidemiological observations in developed countries, but we do not have solid evidence for the etiological role played by specific food types. IBD is associated with frequent nutritional deficiencies, thepattern and severity of which depends on the extent,duration and activity of the inflammation. Nutritional support allows these deficiencies in calories, macro and micronutrients to be rectified. Enteral nutrition is also aprimary therapy for IBD, especially for Crohn＇s disease,as it allows the inflammatory activity to be controlled,kept in remission, and Drevents or delays the need forsurgery. Nutritional support is especially important in childhood IBD as an alternative to pharmacological treatment. This report discusses the complex relationship between diet and IBD.展开更多
Treatment of hepatitis C, even when absolutely necessary, is almost impossible when interferon cannot be administered for any reason. We report a 65-year-old patient with chronic hepatitis C virus (HCV) infection and ...Treatment of hepatitis C, even when absolutely necessary, is almost impossible when interferon cannot be administered for any reason. We report a 65-year-old patient with chronic hepatitis C virus (HCV) infection and fibrosis, who was unable to receive interferon because of systemic hypersensitivity. The patient was desensitized successfully through gradual incremental exposure to interferon, and HCV infection was eradicated after a complete course of treatment, with no further allergic reactions. This case report that describes successful eradication of hepatitis C in a patient with advanced liver disease after desensitization to interferon revealed that desensitization may not necessarily damage the therapeutic efficacy of the drug.展开更多
Inflammatory Bowel Disease （IBD） was a chronic inflammatory disease of the digestive tract especially in small and large intestines that induced by indomethacin. Potency of ethanol and ethyl acetate extract from bro...Inflammatory Bowel Disease （IBD） was a chronic inflammatory disease of the digestive tract especially in small and large intestines that induced by indomethacin. Potency of ethanol and ethyl acetate extract from brown seaweed （Sargassum duplicatum Bory） against indomethacin induced jejunum damage was evaluated in Rattus norvegicus. Control rats induced by corn oil orally. IBD rats induced by indomethacin of 15 mg/kg body weight （bw） orally and incubated for 7 days. Therapy rats were treated orally by brown seaweed extract of 100 mg/kg bw respectively for seven days. Based on phytochemistry test, Sargassum duplicatum Bory extract contains flavonoids, phlorotanin, and alkaloid. The result of preparative Thin Layer Chromatography （TLC） and Infra Red （IR） spectrum of extract spots showed the same result （function group similarity） with gallic acid standard as polyphenol. Sargassum duplicatum Bory extract decreased Malondialdehid （MDA） level （54.20%） significantly using Thiobarbituric Acid （TBA） assay, repaired ZO-1 and occludin protein expressions by immunohistochemistry and repaired jejunum damage by histological observation.展开更多
As China is accelerating into an aging society,the coexistence of multiple diseases,multiple drugs,and the decline of body function are serious problems faced by elderly patients.Therefore,it is imperative to carry ou...As China is accelerating into an aging society,the coexistence of multiple diseases,multiple drugs,and the decline of body function are serious problems faced by elderly patients.Therefore,it is imperative to carry out the comprehensive prevention and control of chronic diseases,strengthen the health guidance and comprehensive intervention of common and chronic diseases of the elderly,and strengthen the health management of elderly patients.Collaborative drug therapy management(CDTM)is a drug treatment management mode that emerged in pharmaceutical services under the situation of new medical reform,aiming to expand the role of pharmacists in the medical team and improve the quality of hospital medical service.Although CDTM has shown some favorable effects in managing chronic diseases in the elderly population,the popularization of CDTM in China is limited by the differences in supporting facilities,management mode,and pharmacist’s abilities in hospitals.By exploring the CDTM mode for elderly patients with chronic diseases,we provided a reference for further promoting the CDTM services and laid a good foundation for displaying pharmacist value and the realization of real pharmaceutical care.展开更多
Hepatitis D virus(HDV)infection is associated with severe liver-related morbidity and mortality.The prevalence of HDV is rising especially among people who abuse drugs and immigrants from endemic areas.Reliable diagno...Hepatitis D virus(HDV)infection is associated with severe liver-related morbidity and mortality.The prevalence of HDV is rising especially among people who abuse drugs and immigrants from endemic areas.Reliable diagnostic assays with enhanced sensitivity and specificity are essential for screening at-risk populations.Until recently,interferon has been the only treatment for hepatitis D.Its efficacy is,however,limited and it is associated with significant side effects.A number of novel antiviral agents that target various stages of the HDV life cycle show promising results.They are currently in different phases of clinical development.This review focuses on the changing epidemiology,novel therapeutic agents,and updated management of chronic hepatitis delta.展开更多
文摘Inflammatory bowel diseases(IBD)are chronic diseases with a relapsing-remitting disease course necessitating lifelong treatment.However,non-adherence has been reported in over 40%of patients,especially those in remission taking maintenance therapies for IBD. The economical impact of non-adherence to medical therapy including absenteeism,hospitalization risk, and the health care costs in chronic conditions,is enormous.The causes of medication non-adherence are complex,where the patient-doctor relationship, treatment regimen,and other disease-related factors play key roles.Moreover,subjective assessment might underestimate adherence.Poor adherence may result in more frequent relapses,a disabling disease course, in ulcerative colitis,and an increased risk for colorectal cancer.Improving medication adherence in patients is an important challenge for physicians.Understanding the different patient types,the reasons given by patients for non-adherence,simpler and more convenient dosage regimens,dynamic communication within the health care team,a self-management package incorporating enhanced patient education and physician-patient interaction,and identifying the predictors of nonadherence will help devise suitable plans to optimize patient adherence.This editorial summarizes the available literature on frequency,predictors,clinical consequences,and strategies for improving medical adherence in patients with IBD.
文摘AIM： To investigate the efficacy of combination treatment of IFN-α and lamivudine compared to lamivudine monotherapy, after 24 mo of administration in HBeAgnegative hepatitis B patients. METHODS： Fifty consecutive patients were randomly assigned to receive IFN-α-2b （5 MU thrice per week, n = 24） plus lamivudine （100 mg daily） or lamivudine only （n = 26） for 24 mo. Patients were followed up for further 6 mo. The primary outcome was the proportion with sustained virological response （undetectable serum HBV DNA concentrations） and or sustained biochemical response （transaminase levels within normal range） at 30 mo （6 mo after the end of therapy）. Secondary end-points were timed from initial virological （biochemical） response to VBR （BBR, respectively） and the emergence of YMDD mutants across the two arms. RESULTS： Five of twenty-four （21%） patients in the combination arm vs 3/26 （12%） in the lamivudine arm had sustained response （i.e., normal serum transaminase levels and undetectable HBV DNA by PCR assay） 6 mo after treatment discontinuation. A reduction in the emergence of YMDD mutants and in the development of virological breakthroughs was observed in patients receMng combination treatment （10% vs46% , P= 0.01 and 14% vs46% , P= 0.03, respectively）. Time from initial virologic response to virologic breakthrough （VBR） was greater among initial responders receiving combination treatment compared to those receiving lamivudine （22.9 mo vs 15.9 mo, respectively; P = 0.005）.CONCLUSION： Our results demonstrate that IFN-α plus lamivudine combination therapy does not increase the sustained response, compared to lamivudine. However, combination therapy reduces the likelihood of VBR due to YMDD mutants and prolongs the time period until the breakthrough development.
文摘Background To document the pharmacotherapy of chronic heart failure （CHF） and to evaluate the adherence to treatment guidelines in Australian population. Methods The pharmacological management of 677 patients （female 46.7%, 75.5 ±11.6 years） with CHF was retrospectively analyzed. Results The use of angiotensin converting enzyme （ACE） inhibitors/angiotensin receptor blockers （ARB） and β-blockers were 58.2 % and 34.7 %, respectively. Major reasons for non-use of ACE inhibitors/ARBs were hyperkalemia and elevated serum creatinine level. For patients who did not receive β-blockers, asthma and chronic obstructive pulmonary disease were the main contraindications. Treatment at or above target dosages for ACE inhibitors/ARBs and β-blockers was low for each medication （40.3% and 28.9%, respectively）. Conclusions Evidenced-based medical therapies for heart failure were under used in a rural patient population. Further studies are required to develop processes to improve the optimal use of heart failure medications.
文摘Over the last decade, the standard of care for the treat- ment of chronic hepatitis C has been the combination of pegylated-interferon-alfa （PEG-IFN） and ribavirin （RBV） which results in sustained virological response （SVR） rates of 75%-85% in patients with genotypes 2 or 3 but only of 40%-50% in patients with genotype 1. Cur- rently, there are rapid and continuous developments of numerous new agents against hepatitis C virus （HCV）, which are the focus of this review. Boceprevir and tela- previr, two first-generation NS3/4A HCV protease inhibi- tors, have been recently licensed in several countries around the world to be used in combination with PEG- IFN and RBV for the treatment of genotype 1 patients. Boceprevir or telaprevir based triple regimens, com- pared with the PEG-IFN/RBV combination, improve the SVR rates by 25%-31% in treatment-naTve genotype 1 patients, by 40%-64% in prior relapsers, by 33%-45% in prior partial responders and by 24%-28% in prior null responders. At the same time, the application of response-guided treatment algorithms according to the on-treatment virological response results in shortening of the total therapy duration to only 24 wk in 45%-55% of treatment-na＇ive patients. There are, however, several challenges with the use of the new triple combinations in genotype 1 patients, such as the need for immediate results of HCV RNA testing using sensitive quantitative assays, new and more frequent adverse events （anemia and dysgeusia for boceprevir; pruritus, rash and anemia for telaprevir）, new drug interactions and increasing dif- ficulties in compliance. Moreover, the SVR rates are still poor in very difficult to treat subgroups of genotype 1 patients, such as null responders with cirrhosis, while there is no benefit for patients who cannot tolerate PEG- IFN/RBV or who are infected with non-1 HCV genotype. Many newer anti-HCV agents of different classes and numerous combinations are currently under evaluation with encouraging results. Preliminary data suggest that the treatment of chronic HCV patients with well toler- ated combinations of oral agents without PEG-IFN is feasible and may lead to a universal HCV cure over the next 5-10 years.
文摘AIM： To investigate the use of high dose consensusinterferon in combination with ribavirin in former iv drug users infected with hepatitis C. METHODS： We started, before pegylated （PEG）interferons were available, an open-label study to investigate the efficacy and tolerability of high dose induction therapy with consensus interferon （CIFN） and ribavirin in treatment of naiive patients with chronic hepatitis C. Fifty-eight patients who were former iv drug users, were enrolled receiving 18 μg of CIFN daily for 8 wk, followed by 9 μg daily for up to wk 24 or 48 and 800 mg of ribavirin daily. End point of the study was tolerability and eradication of the virus at wk 48 and sustained virological response at wk 72. RESULTS： More than 62% of patients responded to the treatment with CIFN at wk 24 or 48, respectively, showing a negative qualitative PCR [genotype 1 fourteen patients （56%）, genotype 2 five （50%）, genotype 3 thirteen （87%）, genotype 4 four （50%）]. Forty-eight percent of genotype 1 patients showed sustained virological response （SVR） six months after the treatment. CONCLUSION： CIFN on a daily basis is well tolerated and side effects like leuko- and thrombocytopenia are moderate. End of therapy （EOT） rates are slightly lower than the newer standard therapy with pegylated interferons. CIFN on a daily basis might be a favourable therapy regimen for patients with GTI and high viral load or for non-responders after failure of standard therapy.
基金Supported by the grants from the Social Development Program of Department of Science and Technology of Guangdong Province (2004B30101009).
文摘Objective:To evaluate the antiviral activity of the alcohol extract of Styela plicata on DHBV (duck hepatitis B virus) in vivo. Methods: Guangzhou-Sheldrake ducklings congenitally infected with DHBV were assigned to receive the alcohol extract of Styela plicata or lamivudine for 30 consecutive days. The DHBV DNA of sera was detected by RT-PCR. and the histological analysis of duckling liver was evaluated. Results:Thirty days after therapy,histological analysis of duckling liver showed that the ducklings receiving the alcohol extract of Styela plicata or lamivudine exhibited catabatic status in the degree of liver cell degeneration and inflammation compared with the ducklings receiving normal diet. DHBV DNA of sera from alcohol extract of Styela plicata-treated ducklings and lamivudine-treated ducklings all produced significantly lower levels compared with ducklings receiving normal diet (P<0. 01 ). Although these treatment groups all exhibited a rebound phenomenon 10 d after withdrawal of medication, they still exhibited a significant lower level of serum DHBV DNA compared with the control group responded to normal diet (P<0. 05, P<0. 01). Conclusion:Styela plicata may be an effective antiviral medicine in treating chronic hepatitis B. The data of this experiment will be valuable in studying the therapeutic role and the potential therapeutic mechanism of Styela plicata.
基金Supported by A grant from the Estonian Science Foundation,No.7650a grant from the University of Tartu,No. SF0180081s07
文摘Several case reports deal with the relationship between hepatitis C virus （HCV） infection and pulmonary or he- patic sarcoidosis. Most publications describe interferon m-induced sarcoidosis. However, HCV infection per se is also suggested to cause sarcoqdosis. The present case report describes a case of biopsy-verified lung and liver sarcoidosis and HCV infection, and the out- come of antiviral therapy. In March 2009, a 25-year-old man presented with moderately elevated liver enzymes without any clinical symptoms. The patient was posi- tive for HCV antibodies and HCV RNA of genotype lb. Four months later the patient became dyspnoic and pulmonary sarcoidosis was diagnosed by lung biopsy and radiography. A short course of corticosteroid treat- ment relieved symptoms. Three months later, liver biopsy showed noncaseating granulomas consisting of epithelioid histiocytes and giant cells with a small amount of peripheral lymphocyte infiltration, without any signs of fibrosis. Chronic HCV infection with co- existence of pulmonary and hepatic sarcoidosis was diagnosed. Antiviral therapy with peginterferon ~ and ribavirin at standard doses was started, which lasted 48 wk, and sustained viral response was achieved. A second liver biopsy showed disappearance of granulo- mas and chest radiography revealed normalization of mediastinal and perihilar glands. The hypothesis that HCV infection perse may have triggered systemic sar- coidosis was proposed. Successful treatment of HCV infection led to continuous remission of pulmonary and hepatic sarcoidosis. Further studies are required to un- derstand the relationship between systemic sarcoidosis and HCV infection.
文摘Inflammatory bowel disease （IBD） results from the interaction between an individual＇s immune response and precipitant environmental factors, which generatean anomalous chronic inflammatory response in thosewho are genetically predisposed. Various feeding practices have been implicated in the origin of IBD based on epidemiological observations in developed countries, but we do not have solid evidence for the etiological role played by specific food types. IBD is associated with frequent nutritional deficiencies, thepattern and severity of which depends on the extent,duration and activity of the inflammation. Nutritional support allows these deficiencies in calories, macro and micronutrients to be rectified. Enteral nutrition is also aprimary therapy for IBD, especially for Crohn＇s disease,as it allows the inflammatory activity to be controlled,kept in remission, and Drevents or delays the need forsurgery. Nutritional support is especially important in childhood IBD as an alternative to pharmacological treatment. This report discusses the complex relationship between diet and IBD.
文摘Treatment of hepatitis C, even when absolutely necessary, is almost impossible when interferon cannot be administered for any reason. We report a 65-year-old patient with chronic hepatitis C virus (HCV) infection and fibrosis, who was unable to receive interferon because of systemic hypersensitivity. The patient was desensitized successfully through gradual incremental exposure to interferon, and HCV infection was eradicated after a complete course of treatment, with no further allergic reactions. This case report that describes successful eradication of hepatitis C in a patient with advanced liver disease after desensitization to interferon revealed that desensitization may not necessarily damage the therapeutic efficacy of the drug.
文摘Inflammatory Bowel Disease （IBD） was a chronic inflammatory disease of the digestive tract especially in small and large intestines that induced by indomethacin. Potency of ethanol and ethyl acetate extract from brown seaweed （Sargassum duplicatum Bory） against indomethacin induced jejunum damage was evaluated in Rattus norvegicus. Control rats induced by corn oil orally. IBD rats induced by indomethacin of 15 mg/kg body weight （bw） orally and incubated for 7 days. Therapy rats were treated orally by brown seaweed extract of 100 mg/kg bw respectively for seven days. Based on phytochemistry test, Sargassum duplicatum Bory extract contains flavonoids, phlorotanin, and alkaloid. The result of preparative Thin Layer Chromatography （TLC） and Infra Red （IR） spectrum of extract spots showed the same result （function group similarity） with gallic acid standard as polyphenol. Sargassum duplicatum Bory extract decreased Malondialdehid （MDA） level （54.20%） significantly using Thiobarbituric Acid （TBA） assay, repaired ZO-1 and occludin protein expressions by immunohistochemistry and repaired jejunum damage by histological observation.
文摘As China is accelerating into an aging society,the coexistence of multiple diseases,multiple drugs,and the decline of body function are serious problems faced by elderly patients.Therefore,it is imperative to carry out the comprehensive prevention and control of chronic diseases,strengthen the health guidance and comprehensive intervention of common and chronic diseases of the elderly,and strengthen the health management of elderly patients.Collaborative drug therapy management(CDTM)is a drug treatment management mode that emerged in pharmaceutical services under the situation of new medical reform,aiming to expand the role of pharmacists in the medical team and improve the quality of hospital medical service.Although CDTM has shown some favorable effects in managing chronic diseases in the elderly population,the popularization of CDTM in China is limited by the differences in supporting facilities,management mode,and pharmacist’s abilities in hospitals.By exploring the CDTM mode for elderly patients with chronic diseases,we provided a reference for further promoting the CDTM services and laid a good foundation for displaying pharmacist value and the realization of real pharmaceutical care.
文摘Hepatitis D virus(HDV)infection is associated with severe liver-related morbidity and mortality.The prevalence of HDV is rising especially among people who abuse drugs and immigrants from endemic areas.Reliable diagnostic assays with enhanced sensitivity and specificity are essential for screening at-risk populations.Until recently,interferon has been the only treatment for hepatitis D.Its efficacy is,however,limited and it is associated with significant side effects.A number of novel antiviral agents that target various stages of the HDV life cycle show promising results.They are currently in different phases of clinical development.This review focuses on the changing epidemiology,novel therapeutic agents,and updated management of chronic hepatitis delta.
