Objective The influence of anti-tuberculosis (TB) treatment history on tuberculous lymphadenitis (TBLN) diagnosis is unclear. Therefore, this study aims to evaluate the diagnostic methods, including histology, mic...Objective The influence of anti-tuberculosis (TB) treatment history on tuberculous lymphadenitis (TBLN) diagnosis is unclear. Therefore, this study aims to evaluate the diagnostic methods, including histology, microbiology, and molecular tests, used for TBLN. Methods In this study, suspected patients with TBLN and having different anti-T8 treatment background were enrolled. All the samples were tested simultaneously by histology, ZiehI-Neelsen (ZN) staining, mycobacterial culture (culture), Xpert MTB/RIF (xpert), real-time PCR, and high-resolution melting curve PCR (HRM). Thereafter, the performance of these methods on samples with different anti-TB treatment background was assessed. Results In our study, 89 patients were prospectively included 82 patients with TBLN and 7 with other diseases. The overall sensitivities of Xpert, real-time PCR, histology, ZN staining, and culture were 86.6%, 69.5%, 58.5%, 43.9%, and 22.0%, respectively. The anti-TB treatment history revealed dramatic influences on the sensitivity of culture (P 〈 0.0001). In fact, the treatment that lasted over 3 months also influenced the sensitivity of Xpert (P 〈 0.05). However, the treatment history did not affect the performance of remaining tests (P 〉 0.05). For rifampicin drug susceptibility test (DST), the anti-T8 treatment showed only significant influence on the success rate of culture DST (P = 0.001), but not on those of Xpert and HRM tests (P 〉 0.05). Conclusion Other tests as welt as culture should be considered for patients with TBLN having retreatment history or over 1-month treatment to avoid false negative results.展开更多
AIM: To compare two different anti-vascular endothelial growth factor(anti-VEGF) treatment regimens'-a priori pro re nata(PRN) and PRN regimen following^(th)e loading phaseanatomical and functional results in neov...AIM: To compare two different anti-vascular endothelial growth factor(anti-VEGF) treatment regimens'-a priori pro re nata(PRN) and PRN regimen following^(th)e loading phaseanatomical and functional results in neovascular agerelated macular degeneration(n AMD) patients. METHODS: Totally 544 n AMD patients followed and treated with aflibercept(n=135) and ranibizumab(n=409)at 9 different centers between 2013 and 2015 were enrolled into^(th)is retrospective multicenter study. Patients with initial best corrected visual acuity(BCVA) interval of 1.3-0.3(log MAR) and a minimum follow-up of 12 mo were included. Patients under two different regimens-a priori pro re nata(1+PRN) or 3 consecutive intravitreal injections followed by a PRN regimen(3+PRN)-were compared in BCVA at 3^(th), 6^(th) and 12^(th) months, and in central macular^(th)ickness(CMT) at 6^(th) and 12^(th) months. The total study group, intravitreal ranibizumab(IVR) and intravitreal aflibercept(IVA) groups were evaluated separately. RESULTS: The mean CMT decreased in^(th)e 1+PRN(n=101) regimen from 407 to 358 and 340 μm and in^(th)e 3+PRN(n=443) group from 398 to 318 and finally to 310 μm at months 6 and 12, respectively. Anatomically,^(th)e CMT reduction at 6^(th) month(48.5 vs 76.4;P<0.05) was statistically significant in favor of 3+PRN group. BCVA changed in 1+PRN group from 0.77 to 0.78, 0.75 and 0.75;in 3+PRN group from 0.81 to 0.69, 0.72, and 0.76 at months 3, 6, and 12, respectively. Visual gain was statistically better in 3+PRN group at 3^(th) month(-0.01 vs 0.12;P<0.001). In IVR group, CMT reduction was in greater in 3+PRN at 6^(th)(44 vs 72) and 12^(th) month(61 vs 84), but statistically insignificant. The 3+PRN group revealed statistically better visual results at 3^(th) month(-0.02 vs 0.11, P<0.05). In IVA group, although statistically insignificant, CMT reduction(61 vs 89, 6^(th) month;85 vs 97, 12^(th) month) and visual gain(0.02 vs 0.16;0.02 vs 0.14;0.05 vs 0.11) was found in favor of 3+PRN group at all visits.CONCLUSION: The loading dose of anti-VEGF treatments in n AMD leads to significantly better anatomical and functional results, regardless of the agent, specially in early follow-up interval.展开更多
Objective:To assess the effectiveness and adverse drug reactions of all-oral regimens for patients with multidrug-resistant tuberculosis.Methods:This retrospective study was conducted at 10 Programmatic Management of ...Objective:To assess the effectiveness and adverse drug reactions of all-oral regimens for patients with multidrug-resistant tuberculosis.Methods:This retrospective study was conducted at 10 Programmatic Management of Drug Resistant Tuberculosis sites in Punjab province of Pakistan.Patients receiving treatment for drug resistant tuberculosis from July 2019 to December 2020 with at least interim result i.e.6th month culture conversion or final outcomes(cured,complete,lost to follow-up,failure,death)available,were included in the study.Data was extracted from electronic data management system.For the reporting and management of adverse drug events,active tuberculosis drug safety monitoring and management was implemented across all sites.All the data was analyzed using SPSS version 22.Results:Out of 947 drug resistant tuberculosis patients included in this study,579(68%)of the patients had final outcomes available.Of these,384(67.9%)successfully completed their treatment.Out of 368(32%)patients who had their interim results available,all had their 6th month culture negative.Combining new medications was thought to result in serious adverse outcomes such as QT prolongation.However,this study did not record any severe adverse events among patients.Conclusions:All-oral regimens formulation guided by overall treatment effectiveness resulted in treatment outcomes comparable to those obtained with traditional injectable treatment.展开更多
Recently, the paper by Wang et at published in World Journal of Gastroenterology has given rise to great interest of many researchers. It is well known that hepatoma is one of the lethal diseases with a high incidence...Recently, the paper by Wang et at published in World Journal of Gastroenterology has given rise to great interest of many researchers. It is well known that hepatoma is one of the lethal diseases with a high incidence in the world, especially in Asia. Radiotherapy is the main treatment modality of hepatoma in clinical practice. Unfortunately, intrinsic radiosensitivity of cancer cells is not fully understood, though a large number of papers on it are now available. Yang and colleagues 21 have developed the premature chromosome condensation technique for clinical radiotherapy of hepatoma. A precise and quick measurement of cell radiosensitivity can detect the highrisk results after exposure to a large dose.展开更多
Background: The Philippines has a burden of drug-resistant tuberculosis (DR-TB). One of the key challenges in the programmatic management of DR-TB (PMDT) is the high rate of loss to follow-up (38% in the 2010 cohort)....Background: The Philippines has a burden of drug-resistant tuberculosis (DR-TB). One of the key challenges in the programmatic management of DR-TB (PMDT) is the high rate of loss to follow-up (38% in the 2010 cohort). An urgent need for a shorter, more tolerable, less expensive treatment regimen exists. The aim of the operational study is to determine the efficacy and safety of the short treatment regimen among drug resistant TB. Methods: This is a prospective single-arm cohort study evaluating the effectiveness and safety of a shorter 9 - 11-month treatment regimen (9MTR) for rifampicin-resistant/multi-drug resistant TB (RR/MDR-TB) in 10 PMDT facilities. All eligible consenting adult patients with rifampicin-resistant TB were enrolled and received the standardized 9-month treatment regimen (9MTR), including injectables, with a follow-up after 12 months of treatment completion. Results: A total of 329 patients were enrolled from July 2015 to December 2016. At the 6th month post-enrollment, 256 (77.8%) of them had culture-negative test results. The end-of-treatment success rate was 74.1% (224 [68.0%] were cured and 20 [6.1%] completed the treatment). On the other hand, 10 (3.0%) died, 41 (12.5%) lost to follow-up, 33 (10.0%) withdrawn, 1 (0.3%) treatment failure. In the 12th month after 9MTR completion, among the 244 patients with successful treatment, 198 (81.1%) had culture-negative results, while there were 46 patients whose culture tests were not done. One patient developed TB relapse with fluoroquinolone resistance. The majority of the adverse events were mild that occurred mostly during the first 6 months of treatment. Conclusion: The 9-month treatment regimen had a high treatment success rate with a favorable safety profile. The loss to follow-up was reduced;however, it was still a challenge. The introduction of the 9MTR via operational research had a major impact on building national capacity and infrastructure for the programmatic adoption of a new regimen. Ten PMDT centers received training and experience, created diagnostic pathways, and active drug safety monitoring and management were built.展开更多
Objective To evaluate the outcome of combination of intensive preconditioning regimen allo - HSCT with imatinib for treatment of Ph chromosome positive acute lymphocyte leukemia ( ALL) . Methods Between 2009 and 2010,...Objective To evaluate the outcome of combination of intensive preconditioning regimen allo - HSCT with imatinib for treatment of Ph chromosome positive acute lymphocyte leukemia ( ALL) . Methods Between 2009 and 2010,8 patients diagnosed as Ph + ALL received展开更多
Introduction: The key to successful elimination of tuberculosis (TB) is treatment of cases with optimum chemotherapy. Irrational anti-TB drug use over time has led to drug-resistant TB. The treatment of MDR-TB with se...Introduction: The key to successful elimination of tuberculosis (TB) is treatment of cases with optimum chemotherapy. Irrational anti-TB drug use over time has led to drug-resistant TB. The treatment of MDR-TB with second line drugs is long, complex and costly, and has a considerable rate of adverse effects. The level of ADR reporting is low in Ethiopia due to different factors. This Study conducted in a selected treated area in Addis Ababa, Ethiopia and helped the health care centers to understand the prevalence of ADR related MDR-TB and be aware of those adverse effects in order to detect them early and be prepared to take proper steps when they occur. Aim of the Study: To determine the prevalence and risk factor of adverse drug reactions associated treatments of Multidrug Resistant tuberculosis. Method: This was a cross sectional study, which was conducted between March 2012 and February 2013 at St. Peter TB specialized hospital and AHRI/ALERT. 73 MDR TB patients, who were on MDR TB treatments, enrolled to the study. Adverse Drug Reactions associated MDR TB treatments were assessed by patient history review and questionnaire. Chemistry laboratory was used to test renal function, thyroid function, liver enzyme and potassium level. Result: In 72 patients, at least two ADRs were found. The mean age of the study population (Mean ± SD) was 28 ± 8.8. In this study the most commonly found adverse drug reactions (ADRs) were: Anorexia 83.3%, Nausea and vomiting 82%, Gastritis 64%, Arteralgia 47%, Skin rash and itching 45%, Headache 29.2%, Depression 22.2% and Blurred vision 19.4%. Using binary logistic regression model older age (COR 8.71, 95% [CI] 1.06 - 71.9), alcoholism (COR 4.05, 95% [CI] 1.05 - 15.6), smoking (COR 0.24, 95% [CI] 0.06 - 0.87) and concomitant drug intake (COR 0.14, 95% [CI] 0.03 - 0.76) were independent predictors for ADRs. Conclusion: The prevalence of ADRs related MDR TB treatments is high. To minimize ADR occurrence, ADR predictors should be integrated into the clinical pathway. Monitoring of liver function, renal function, TSH and level of potassium during MDR TB treatment, helps to avoid complication caused by therapy and increase the adherence to the treatment.展开更多
Objective:To explore the efficacy of intermittent preventive treatment in pregnancy(IPTp)with sulfadoxine and pyrimethamine(SP)against sensitive parasites.Methods:A pharmacological model was used to investigate the ef...Objective:To explore the efficacy of intermittent preventive treatment in pregnancy(IPTp)with sulfadoxine and pyrimethamine(SP)against sensitive parasites.Methods:A pharmacological model was used to investigate the effectiveness of the previous recommended at least two-dose regimen,currently recommended three-dose regimen and 4,6,8-weekly regimens with specific focus on the impact of various nonadherence patterns in multiple transmission settings.Results:The effectiveness of the recommended three-dose regimen is high in all the transmission intensities,i.e.>99%,98%and 92%in low,moderate and high transmission intensities respectively.The simulated 4 and 6 weekly IPTp-SP regimens were able to prevent new infections with sensitive parasites in almost all women(>99%)regardless of transmission intensity.However,8 weekly interval dose schedules were found to have 71%and 86%protective efficacies in high and moderate transmission areas,respectively.It highlights that patients are particularly vulnerable to acquiring new infections if IPTp-SP doses are missed.Conclusions:The pharmacological model predicts that full adherence to the currently recommended three-dose regimen should provide almost complete protection from malaria infection in moderate and high transmission regions.However,it also highlights that patients are particularly vulnerable to acquiring new infections if IPTp doses are spaced too widely or if doses are missed.Adherence to the recommended IPTp-SP schedules is recommended.展开更多
920622 Electrophysiological effects of ne-ferine on ischemic ventricular tachyarrhy-thmias.GUO Zhibing(郭治彬), et al. 1st AffiliHosp, Jiangxi Med Coll, Nanchang, 330006.Chin J Cardiol 1992; 20(2): 119-122. The electr...920622 Electrophysiological effects of ne-ferine on ischemic ventricular tachyarrhy-thmias.GUO Zhibing(郭治彬), et al. 1st AffiliHosp, Jiangxi Med Coll, Nanchang, 330006.Chin J Cardiol 1992; 20(2): 119-122. The electrophysiological effects of neferine(Nef, 8mg/kg, i. v. )on ischemic ventriculartachyarrhythmias in both normal and展开更多
970216 Epirubicin containing regimens in advancedmalignant tumors——a report of 516 cases. SUN Yan(孙燕), et al. Instit and Cancer Hosp. PUMC,CAMS. Beijing 100021. Chin J Intern Med 1997; 36(3): 183-186. Objective: T...970216 Epirubicin containing regimens in advancedmalignant tumors——a report of 516 cases. SUN Yan(孙燕), et al. Instit and Cancer Hosp. PUMC,CAMS. Beijing 100021. Chin J Intern Med 1997; 36(3): 183-186. Objective: To study the effects of epirubicin contain-展开更多
1.Introduction Tuberculosis(TB),caused by Mycobacterium tuberculosis,remains a leading cause of death among infectious diseases worldwide.Latent tuberculosis infections(LTBI)contribute to the global burden of TB disea...1.Introduction Tuberculosis(TB),caused by Mycobacterium tuberculosis,remains a leading cause of death among infectious diseases worldwide.Latent tuberculosis infections(LTBI)contribute to the global burden of TB disease.TB preventive treatment(TPT)is a key intervention to achieve the End TB Strategy targets.The World Health Organization recommends LTBI treatment regimens,including 6 or 9 months of once-daily isoniazid(INH,H),4 months of once-daily rifampin(RIF,R),3 months of once-weekly rifapentine(RPT,P)plus INH(3HP),3 months of once-daily RIF plus INH,or 1 month of daily RPT plus INH(1HP).Clinicians and individuals with LTBI may be reluctant to implement TPT due in part to concerns regarding adherence to the long treatment duration and drug toxicity of the currently recommended LTBI treatment regimens.Shorter,better-tolerated,and cost-effective TPT regimens are highly desirable.Rifapentine is a long-acting rifamycin,and rifamycin-based regimens are now the preferred LTBI treatment because they have similar or better efficacy and higher completion rates due to their shorter duration.Based on our experiences with TPT practice among Chinese people with silicosis,we found that the 3HP regimen was not well tolerated due to an unexpectedly high frequency of adverse events(AEs)(70.4%)and grade 3 or 4 AEs(7.9%),especially the high incidence of flu-like systemic drug reactions(SDRs)(10.8%).展开更多
Background:Rapid initiation of antiretroviral therapy(ART)is recommended by guidelines,however,real-world studies of same-day initiation of ART in China are limited,and an optimal treatment regimen has yet to be ident...Background:Rapid initiation of antiretroviral therapy(ART)is recommended by guidelines,however,real-world studies of same-day initiation of ART in China are limited,and an optimal treatment regimen has yet to be identified.The study aims to provide a realistic reference for rapid initiation of ART.Methods:We retrospectively analyzed the clinical data of treatment-naïve people with human immunodeficiency virus(PWHs)who were diagnosed and prescribed same-day ART initiation from January 1,2021 to December 31,2022 at Chongqing Public Health Medical Center.PWHs voluntarily chose an ART regimen that divided them into two groups:National Free Antiretroviral Treatment Program(NFATP)-recommended regimens group(2 nucleoside reverse transcriptase inhibitors+non-nucleoside reverse transcriptase inhibitors/protease inhibitors)and bictegravir/emtricitabine/tenofovir alafenamide(BIC/FTC/TAF)group.The primary endpoint was the virological outcome of the two groups for same-day ART initiation at 24 weeks and 48 weeks.The secondary endpoints included changes in CD4 counts,maintenance of the original ART regimen at 48 weeks,and lipid levels and renal function at 48 weeks.Results:A total of 255 PWHs were included in the study,including 131(51.4%)in the NFATP group and 124(48.6%)in the BIC/FTC/TAF group.The overall virological suppression rates at 24 weeks and 48 weeks were 78.2%(165/211)and 95.4%(207/217),respectively.At 24 weeks,the virologic suppression rate in the NFATP group was lower than that in the BIC/FTC/TAF group(65.3%[66/101]vs.90.0%[99/110],P<0.001).The median increase in the CD4 count was 198.0(126.0-300.0)cells/μL at 24 weeks,with 182.0(108.0-245.0)cells/μL in the NFATP group and 219(132.0-316.0)cells/μL in the BIC/FTC/TAF group(P=0.035).At 48 weeks,there was no significant difference in the virological suppression rate or CD4 count between the groups.The 48-week initial ART regimen retention rates and treatment retention rates were significantly higher in the BIC/FTC/TAF group than in the NFATP group(91.1%(113/124)vs.71.8%(94/131),99.2%(118/119)vs.93.0%(120/129),respectively).In terms of safety,there were no significant changes from baseline in levels of creatinine,estimated glomerular filtration rate(eGFR),or lipids in either group at 48 weeks.Conclusions:ART initiation on the day of diagnosis is effective,safe,and feasible,with satisfactory rates of virologic suppression,48-week initial ART regimen retention rates,and treatment retention rates in treatment-naïve PWHs.In our study,the early virologic suppression rate,CD4 cell counts,and treatment retention of the BIC/FTC/TAF regimens were significantly better than those of the NFATP regimens.展开更多
基金supported by the grants from the National Natural Science Foundation of China(Grant Number:81572077)Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special(Grant Number:XMLS201506,ZYLX201304)+3 种基金Beijing Health System Training Program for High Level Technique Talents(Grant Number:2014-3-082)the Capital Health Research and Development of Special(Grant Number:2014-4-2161)Beijing Municipal Administration of Hospitals’Ascent Plan(Grant Number:DFL20151501)the Key Project of Department of Science and Technology Beijing,China(Grant Number:D141107005214003,D141107005214004)
文摘Objective The influence of anti-tuberculosis (TB) treatment history on tuberculous lymphadenitis (TBLN) diagnosis is unclear. Therefore, this study aims to evaluate the diagnostic methods, including histology, microbiology, and molecular tests, used for TBLN. Methods In this study, suspected patients with TBLN and having different anti-T8 treatment background were enrolled. All the samples were tested simultaneously by histology, ZiehI-Neelsen (ZN) staining, mycobacterial culture (culture), Xpert MTB/RIF (xpert), real-time PCR, and high-resolution melting curve PCR (HRM). Thereafter, the performance of these methods on samples with different anti-TB treatment background was assessed. Results In our study, 89 patients were prospectively included 82 patients with TBLN and 7 with other diseases. The overall sensitivities of Xpert, real-time PCR, histology, ZN staining, and culture were 86.6%, 69.5%, 58.5%, 43.9%, and 22.0%, respectively. The anti-TB treatment history revealed dramatic influences on the sensitivity of culture (P 〈 0.0001). In fact, the treatment that lasted over 3 months also influenced the sensitivity of Xpert (P 〈 0.05). However, the treatment history did not affect the performance of remaining tests (P 〉 0.05). For rifampicin drug susceptibility test (DST), the anti-T8 treatment showed only significant influence on the success rate of culture DST (P = 0.001), but not on those of Xpert and HRM tests (P 〉 0.05). Conclusion Other tests as welt as culture should be considered for patients with TBLN having retreatment history or over 1-month treatment to avoid false negative results.
文摘AIM: To compare two different anti-vascular endothelial growth factor(anti-VEGF) treatment regimens'-a priori pro re nata(PRN) and PRN regimen following^(th)e loading phaseanatomical and functional results in neovascular agerelated macular degeneration(n AMD) patients. METHODS: Totally 544 n AMD patients followed and treated with aflibercept(n=135) and ranibizumab(n=409)at 9 different centers between 2013 and 2015 were enrolled into^(th)is retrospective multicenter study. Patients with initial best corrected visual acuity(BCVA) interval of 1.3-0.3(log MAR) and a minimum follow-up of 12 mo were included. Patients under two different regimens-a priori pro re nata(1+PRN) or 3 consecutive intravitreal injections followed by a PRN regimen(3+PRN)-were compared in BCVA at 3^(th), 6^(th) and 12^(th) months, and in central macular^(th)ickness(CMT) at 6^(th) and 12^(th) months. The total study group, intravitreal ranibizumab(IVR) and intravitreal aflibercept(IVA) groups were evaluated separately. RESULTS: The mean CMT decreased in^(th)e 1+PRN(n=101) regimen from 407 to 358 and 340 μm and in^(th)e 3+PRN(n=443) group from 398 to 318 and finally to 310 μm at months 6 and 12, respectively. Anatomically,^(th)e CMT reduction at 6^(th) month(48.5 vs 76.4;P<0.05) was statistically significant in favor of 3+PRN group. BCVA changed in 1+PRN group from 0.77 to 0.78, 0.75 and 0.75;in 3+PRN group from 0.81 to 0.69, 0.72, and 0.76 at months 3, 6, and 12, respectively. Visual gain was statistically better in 3+PRN group at 3^(th) month(-0.01 vs 0.12;P<0.001). In IVR group, CMT reduction was in greater in 3+PRN at 6^(th)(44 vs 72) and 12^(th) month(61 vs 84), but statistically insignificant. The 3+PRN group revealed statistically better visual results at 3^(th) month(-0.02 vs 0.11, P<0.05). In IVA group, although statistically insignificant, CMT reduction(61 vs 89, 6^(th) month;85 vs 97, 12^(th) month) and visual gain(0.02 vs 0.16;0.02 vs 0.14;0.05 vs 0.11) was found in favor of 3+PRN group at all visits.CONCLUSION: The loading dose of anti-VEGF treatments in n AMD leads to significantly better anatomical and functional results, regardless of the agent, specially in early follow-up interval.
文摘Objective:To assess the effectiveness and adverse drug reactions of all-oral regimens for patients with multidrug-resistant tuberculosis.Methods:This retrospective study was conducted at 10 Programmatic Management of Drug Resistant Tuberculosis sites in Punjab province of Pakistan.Patients receiving treatment for drug resistant tuberculosis from July 2019 to December 2020 with at least interim result i.e.6th month culture conversion or final outcomes(cured,complete,lost to follow-up,failure,death)available,were included in the study.Data was extracted from electronic data management system.For the reporting and management of adverse drug events,active tuberculosis drug safety monitoring and management was implemented across all sites.All the data was analyzed using SPSS version 22.Results:Out of 947 drug resistant tuberculosis patients included in this study,579(68%)of the patients had final outcomes available.Of these,384(67.9%)successfully completed their treatment.Out of 368(32%)patients who had their interim results available,all had their 6th month culture negative.Combining new medications was thought to result in serious adverse outcomes such as QT prolongation.However,this study did not record any severe adverse events among patients.Conclusions:All-oral regimens formulation guided by overall treatment effectiveness resulted in treatment outcomes comparable to those obtained with traditional injectable treatment.
文摘Recently, the paper by Wang et at published in World Journal of Gastroenterology has given rise to great interest of many researchers. It is well known that hepatoma is one of the lethal diseases with a high incidence in the world, especially in Asia. Radiotherapy is the main treatment modality of hepatoma in clinical practice. Unfortunately, intrinsic radiosensitivity of cancer cells is not fully understood, though a large number of papers on it are now available. Yang and colleagues 21 have developed the premature chromosome condensation technique for clinical radiotherapy of hepatoma. A precise and quick measurement of cell radiosensitivity can detect the highrisk results after exposure to a large dose.
文摘Background: The Philippines has a burden of drug-resistant tuberculosis (DR-TB). One of the key challenges in the programmatic management of DR-TB (PMDT) is the high rate of loss to follow-up (38% in the 2010 cohort). An urgent need for a shorter, more tolerable, less expensive treatment regimen exists. The aim of the operational study is to determine the efficacy and safety of the short treatment regimen among drug resistant TB. Methods: This is a prospective single-arm cohort study evaluating the effectiveness and safety of a shorter 9 - 11-month treatment regimen (9MTR) for rifampicin-resistant/multi-drug resistant TB (RR/MDR-TB) in 10 PMDT facilities. All eligible consenting adult patients with rifampicin-resistant TB were enrolled and received the standardized 9-month treatment regimen (9MTR), including injectables, with a follow-up after 12 months of treatment completion. Results: A total of 329 patients were enrolled from July 2015 to December 2016. At the 6th month post-enrollment, 256 (77.8%) of them had culture-negative test results. The end-of-treatment success rate was 74.1% (224 [68.0%] were cured and 20 [6.1%] completed the treatment). On the other hand, 10 (3.0%) died, 41 (12.5%) lost to follow-up, 33 (10.0%) withdrawn, 1 (0.3%) treatment failure. In the 12th month after 9MTR completion, among the 244 patients with successful treatment, 198 (81.1%) had culture-negative results, while there were 46 patients whose culture tests were not done. One patient developed TB relapse with fluoroquinolone resistance. The majority of the adverse events were mild that occurred mostly during the first 6 months of treatment. Conclusion: The 9-month treatment regimen had a high treatment success rate with a favorable safety profile. The loss to follow-up was reduced;however, it was still a challenge. The introduction of the 9MTR via operational research had a major impact on building national capacity and infrastructure for the programmatic adoption of a new regimen. Ten PMDT centers received training and experience, created diagnostic pathways, and active drug safety monitoring and management were built.
文摘Objective To evaluate the outcome of combination of intensive preconditioning regimen allo - HSCT with imatinib for treatment of Ph chromosome positive acute lymphocyte leukemia ( ALL) . Methods Between 2009 and 2010,8 patients diagnosed as Ph + ALL received
文摘Introduction: The key to successful elimination of tuberculosis (TB) is treatment of cases with optimum chemotherapy. Irrational anti-TB drug use over time has led to drug-resistant TB. The treatment of MDR-TB with second line drugs is long, complex and costly, and has a considerable rate of adverse effects. The level of ADR reporting is low in Ethiopia due to different factors. This Study conducted in a selected treated area in Addis Ababa, Ethiopia and helped the health care centers to understand the prevalence of ADR related MDR-TB and be aware of those adverse effects in order to detect them early and be prepared to take proper steps when they occur. Aim of the Study: To determine the prevalence and risk factor of adverse drug reactions associated treatments of Multidrug Resistant tuberculosis. Method: This was a cross sectional study, which was conducted between March 2012 and February 2013 at St. Peter TB specialized hospital and AHRI/ALERT. 73 MDR TB patients, who were on MDR TB treatments, enrolled to the study. Adverse Drug Reactions associated MDR TB treatments were assessed by patient history review and questionnaire. Chemistry laboratory was used to test renal function, thyroid function, liver enzyme and potassium level. Result: In 72 patients, at least two ADRs were found. The mean age of the study population (Mean ± SD) was 28 ± 8.8. In this study the most commonly found adverse drug reactions (ADRs) were: Anorexia 83.3%, Nausea and vomiting 82%, Gastritis 64%, Arteralgia 47%, Skin rash and itching 45%, Headache 29.2%, Depression 22.2% and Blurred vision 19.4%. Using binary logistic regression model older age (COR 8.71, 95% [CI] 1.06 - 71.9), alcoholism (COR 4.05, 95% [CI] 1.05 - 15.6), smoking (COR 0.24, 95% [CI] 0.06 - 0.87) and concomitant drug intake (COR 0.14, 95% [CI] 0.03 - 0.76) were independent predictors for ADRs. Conclusion: The prevalence of ADRs related MDR TB treatments is high. To minimize ADR occurrence, ADR predictors should be integrated into the clinical pathway. Monitoring of liver function, renal function, TSH and level of potassium during MDR TB treatment, helps to avoid complication caused by therapy and increase the adherence to the treatment.
基金funded by the Bill and Melinda Gates Foundation(grant No.37999.01)the Medical Research Council(grant No.G110052)supported by the Liverpool School of Tropical Medicine
文摘Objective:To explore the efficacy of intermittent preventive treatment in pregnancy(IPTp)with sulfadoxine and pyrimethamine(SP)against sensitive parasites.Methods:A pharmacological model was used to investigate the effectiveness of the previous recommended at least two-dose regimen,currently recommended three-dose regimen and 4,6,8-weekly regimens with specific focus on the impact of various nonadherence patterns in multiple transmission settings.Results:The effectiveness of the recommended three-dose regimen is high in all the transmission intensities,i.e.>99%,98%and 92%in low,moderate and high transmission intensities respectively.The simulated 4 and 6 weekly IPTp-SP regimens were able to prevent new infections with sensitive parasites in almost all women(>99%)regardless of transmission intensity.However,8 weekly interval dose schedules were found to have 71%and 86%protective efficacies in high and moderate transmission areas,respectively.It highlights that patients are particularly vulnerable to acquiring new infections if IPTp-SP doses are missed.Conclusions:The pharmacological model predicts that full adherence to the currently recommended three-dose regimen should provide almost complete protection from malaria infection in moderate and high transmission regions.However,it also highlights that patients are particularly vulnerable to acquiring new infections if IPTp doses are spaced too widely or if doses are missed.Adherence to the recommended IPTp-SP schedules is recommended.
文摘920622 Electrophysiological effects of ne-ferine on ischemic ventricular tachyarrhy-thmias.GUO Zhibing(郭治彬), et al. 1st AffiliHosp, Jiangxi Med Coll, Nanchang, 330006.Chin J Cardiol 1992; 20(2): 119-122. The electrophysiological effects of neferine(Nef, 8mg/kg, i. v. )on ischemic ventriculartachyarrhythmias in both normal and
文摘970216 Epirubicin containing regimens in advancedmalignant tumors——a report of 516 cases. SUN Yan(孙燕), et al. Instit and Cancer Hosp. PUMC,CAMS. Beijing 100021. Chin J Intern Med 1997; 36(3): 183-186. Objective: To study the effects of epirubicin contain-
基金supported by National Natural Science Foundation of China(82271794,82302533)Shanghai Municipal Science and Technology Major Project(HS2021SHZX001).
文摘1.Introduction Tuberculosis(TB),caused by Mycobacterium tuberculosis,remains a leading cause of death among infectious diseases worldwide.Latent tuberculosis infections(LTBI)contribute to the global burden of TB disease.TB preventive treatment(TPT)is a key intervention to achieve the End TB Strategy targets.The World Health Organization recommends LTBI treatment regimens,including 6 or 9 months of once-daily isoniazid(INH,H),4 months of once-daily rifampin(RIF,R),3 months of once-weekly rifapentine(RPT,P)plus INH(3HP),3 months of once-daily RIF plus INH,or 1 month of daily RPT plus INH(1HP).Clinicians and individuals with LTBI may be reluctant to implement TPT due in part to concerns regarding adherence to the long treatment duration and drug toxicity of the currently recommended LTBI treatment regimens.Shorter,better-tolerated,and cost-effective TPT regimens are highly desirable.Rifapentine is a long-acting rifamycin,and rifamycin-based regimens are now the preferred LTBI treatment because they have similar or better efficacy and higher completion rates due to their shorter duration.Based on our experiences with TPT practice among Chinese people with silicosis,we found that the 3HP regimen was not well tolerated due to an unexpectedly high frequency of adverse events(AEs)(70.4%)and grade 3 or 4 AEs(7.9%),especially the high incidence of flu-like systemic drug reactions(SDRs)(10.8%).
基金supported by grants from the first batch of the Key Public Health Key Discipline Construction Project(Junior College)the Chongqing Kewei Traditional Chinese Medicine Technology Innovation and Application Development Project(No.2021ZY4265).
文摘Background:Rapid initiation of antiretroviral therapy(ART)is recommended by guidelines,however,real-world studies of same-day initiation of ART in China are limited,and an optimal treatment regimen has yet to be identified.The study aims to provide a realistic reference for rapid initiation of ART.Methods:We retrospectively analyzed the clinical data of treatment-naïve people with human immunodeficiency virus(PWHs)who were diagnosed and prescribed same-day ART initiation from January 1,2021 to December 31,2022 at Chongqing Public Health Medical Center.PWHs voluntarily chose an ART regimen that divided them into two groups:National Free Antiretroviral Treatment Program(NFATP)-recommended regimens group(2 nucleoside reverse transcriptase inhibitors+non-nucleoside reverse transcriptase inhibitors/protease inhibitors)and bictegravir/emtricitabine/tenofovir alafenamide(BIC/FTC/TAF)group.The primary endpoint was the virological outcome of the two groups for same-day ART initiation at 24 weeks and 48 weeks.The secondary endpoints included changes in CD4 counts,maintenance of the original ART regimen at 48 weeks,and lipid levels and renal function at 48 weeks.Results:A total of 255 PWHs were included in the study,including 131(51.4%)in the NFATP group and 124(48.6%)in the BIC/FTC/TAF group.The overall virological suppression rates at 24 weeks and 48 weeks were 78.2%(165/211)and 95.4%(207/217),respectively.At 24 weeks,the virologic suppression rate in the NFATP group was lower than that in the BIC/FTC/TAF group(65.3%[66/101]vs.90.0%[99/110],P<0.001).The median increase in the CD4 count was 198.0(126.0-300.0)cells/μL at 24 weeks,with 182.0(108.0-245.0)cells/μL in the NFATP group and 219(132.0-316.0)cells/μL in the BIC/FTC/TAF group(P=0.035).At 48 weeks,there was no significant difference in the virological suppression rate or CD4 count between the groups.The 48-week initial ART regimen retention rates and treatment retention rates were significantly higher in the BIC/FTC/TAF group than in the NFATP group(91.1%(113/124)vs.71.8%(94/131),99.2%(118/119)vs.93.0%(120/129),respectively).In terms of safety,there were no significant changes from baseline in levels of creatinine,estimated glomerular filtration rate(eGFR),or lipids in either group at 48 weeks.Conclusions:ART initiation on the day of diagnosis is effective,safe,and feasible,with satisfactory rates of virologic suppression,48-week initial ART regimen retention rates,and treatment retention rates in treatment-naïve PWHs.In our study,the early virologic suppression rate,CD4 cell counts,and treatment retention of the BIC/FTC/TAF regimens were significantly better than those of the NFATP regimens.