Over the past decade,nine separate gene therapy clinical trials for advanced Parkinson’s disease(PD)have been launched and completed,involving the dosing of nearly 12-dozen PD volunteers who incurred significant ri...Over the past decade,nine separate gene therapy clinical trials for advanced Parkinson’s disease(PD)have been launched and completed,involving the dosing of nearly 12-dozen PD volunteers who incurred significant risks to hopefully reduce symptoms and gain a better life.展开更多
To analyze the effect of nutritional support on clinical efficacy in patients with end-stage malignant tumors.Sample data collection was conducted from April 2015 to July 2017.54 patients with end-stage malignant tumo...To analyze the effect of nutritional support on clinical efficacy in patients with end-stage malignant tumors.Sample data collection was conducted from April 2015 to July 2017.54 patients with end-stage malignant tumors were enrolled in the study.They were divided into reference group(n=27)and experimental group(n=27)by double-blind method.Conventional treatment was used in the reference group,while nutritional support therapy was used in the experimental group.The treatment effects of the two groups were compared.Post-treatment effect of the experimental group and the reference group was compared using the parameters including total adverse reaction value,cancer-related fatigue score,quality of life,A/G,AS:AL,alkaline phosphatase(ALP),blood urea nitrogen(BUN),anorexia score,ALB,and uric acid(UA).The parameters such as A/G,AS:AL,ALP,BUN,anorexia score,ALB,and UA were also used to compare between pre-and post-treatment.The value of P<0.05 was used to indicate the statistical significance of the test.Conclusion:Nutritional support therapy had a superior effect in patients with end-stage malignant tumors.展开更多
Extracorporeal organ support(ECOS)has made remarkable progress over the last few years.Renal replacement therapy,introduced a few decades ago,was the first available application of ECOS.The subsequent evolution of ECO...Extracorporeal organ support(ECOS)has made remarkable progress over the last few years.Renal replacement therapy,introduced a few decades ago,was the first available application of ECOS.The subsequent evolution of ECOS enabled the enhanced support to many other organs,including the heart[veno-arterial extracorporeal membrane oxygenation(ECMO),slow continuous ultrafiltration],the lungs(veno-venous ECMO,extracorporeal carbon dioxide removal),and the liver(blood purification techniques for the detoxification of liver toxins).Moreover,additional indications of these methods,including the suppression of excessive inflammatory response occurring in severe disorders such as sepsis,coronavirus disease 2019,pancreatitis,and trauma(blood purification techniques for the removal of exotoxins,endotoxins,or cytokines),have arisen.Multiple organ support therapy is crucial since a vast majority of critically ill patients present not with a single but with multiple organ failure(MOF),whereas,traditional therapeutic approaches(mechanical ventilation for acute respiratory failure,antibiotics for sepsis,and inotropes for cardiac dysfunction)have reached the maximum efficacy and cannot be improved further.However,several issues remain to be clarified,such as the complexity and cost of ECOS systems,standardization of indications,therapeutic protocols and initiation time,choice of the patients who will benefit most from these interventions,while evidence from randomized controlled trials supporting their use is still limited.Nevertheless,these methods are currently a part of routine clinical practice in intensive care units.This editorial presents the past,present,and future considerations,as well as perspectives regarding these therapies.Our better understanding of these methods,the pathophysiology of MOF,the crosstalk between native organs resulting in MOF,and the crosstalk between native organs and artificial organ support systems when applied sequentially or simultaneously,will lead to the multiplication of their effects and the minimization of complications arising from their use.展开更多
Liver transplantation and blood purification therapy,including plasmapheresis,hemodiafiltration,and bioartificial liver support,are the available treatments for patients with severe hepatic failure.Bioartificial liver...Liver transplantation and blood purification therapy,including plasmapheresis,hemodiafiltration,and bioartificial liver support,are the available treatments for patients with severe hepatic failure.Bioartificial liver support,in which living liver tissue is used to support hepatic function,has been anticipated as an effective treatment for hepatic failure.The two mainstream systems developed for bioartificial liver support are extracorporeal whole liver perfusion(ECLP)and bioreactor systems.Comparing various types of bioartificial liver in view of function,safety,and operability,we concluded that the best efficacy can be provided by the ECLP system.Moreover,in our subsequent experiments comparing ECLP and apheresis therapy,ECLP offers more ammonia metabolism than HD and HF.In addition,ECLP can compensate amino acid imbalance and can secret bile.A controversial point with ECLP is the procedure is labor intensive,resulting in high costs.However,ECLP has the potential to reduce elevated serum ammonia levels of hepatic coma patients in a short duration.When these problems are solved,bioartificial liver support,especially ECLP,can be adopted as an option in ordinary clinical therapy to treat patients with hepatic failure.展开更多
The outlook for patients with pancreatic cancer has been grim. There have been major advances in the surgical treatment of pancreatic cancer, leading to a dramatic reduction in post-operative mortality from the develo...The outlook for patients with pancreatic cancer has been grim. There have been major advances in the surgical treatment of pancreatic cancer, leading to a dramatic reduction in post-operative mortality from the development of high volume specialized centres. This stimulated the study of adjuvant and neoadjuvant treatments in pancreatic cancer including chemoradiotherapy and chemotherapy. Initial protocols have been based on the original but rather small GITSG study first reported in 1985. There have been two large European trials totalling over 600 patients (EORTC and ESPAC-1) that do not support the use of chemoradiation as adjuvant therapy. A second major finding from the ESPAC-1 trial (541 patients randomized) was some but not conclusive evidence for a survival benefit associated with chemotherapy. A third major finding from the ESPAC-1 trial was that the quality of life was not affected by the use of adjuvant treatments compared to surgery alone. The ESPAC-3 trial aims to assess the definitive use of adjuvant chemotherapy in a randomized controlled trial of 990 patients.展开更多
INTRODUCTIONCancer treatment situation in tumor hospitals inChina has its own unique characteristics which arenot found in other parts of the world. Because ofthe huge population and high incidence rates ofesophageal ...INTRODUCTIONCancer treatment situation in tumor hospitals inChina has its own unique characteristics which arenot found in other parts of the world. Because ofthe huge population and high incidence rates ofesophageal and stomach cancer[1-5], the number ofcancer patients waiting for admission isinconceivably large.展开更多
AIM:rAAV mediated endostatin gene therapy has been examined as a new method for treating cancer.However, a sustained and high protein delivery is required to achieve the desired therapeutic effects.We evaluated the im...AIM:rAAV mediated endostatin gene therapy has been examined as a new method for treating cancer.However, a sustained and high protein delivery is required to achieve the desired therapeutic effects.We evaluated the impact of topoisomerase inhibitors in rAAV delivered endostatin gene therapy in a liver tumor model. METHODS:rAAV containing endostatin expression cassettes were transduced into hepatoma cell lines.To test whether the topoisomerase inhibitor pretreatment increased the expression of endostatin,Western blotting and ELISA were performed.The biologic activity of endostatin was confirmed by endothelial cell proliferation and tube formation assays. The anti-tumor effects of the rAAV-endostatin vector combined with a topoisomerase inhibitor,etoposide,were evaluated in a mouse liver tumor model. RESULTS:Topoisomerase inhibitors,including camptothecin and etoposide,were found to increase the endostatin exPression level in vitro.The over-expressed endostatin, as a result of pretreatment with a topoisomerase inhibitor, was also biologically active.In animal experiments,the combined therapy of topoisomerase inhibitor,etoposide with the rAAV-endostatin vector had the best tumor- suppressive effect and tumor foci were barely observed in livers of the treated mice.Pretreatment with an etoposide increased the level of endostatin in the liver and serum of rAAV-endostatin treated mice.Finally,the mice treated With rAAV-endostatin in combination with etoposide showed the longest survival among the experimental models. CONCLUSION:rAAV delivered endostatin gene therapy in combination with a topoisomerase inhibitor pretreatment is an effective modality for anticancer gene therapy.展开更多
AIM:To assess and compare the efficacy and safety of two triple regimes:A)metronidazole,amoxicillin and omeprazole, which is still widely used in Russia,and B)azithromycin, amoxicillin and omeprazole in healing active...AIM:To assess and compare the efficacy and safety of two triple regimes:A)metronidazole,amoxicillin and omeprazole, which is still widely used in Russia,and B)azithromycin, amoxicillin and omeprazole in healing active duodenal ulcer and H.pylori eradication. METHODS:100 patients with active duodenal ulcer were included in the open,multicentre,randomized study with comparative groups.Patients were randomly assigned to one of the following one-week triple regimes:A) metronidazole 500 mg bid,amoxicillin I g bid and omeprazole 20 mg bid(OAM,n=50)and B)azithromycin 1 god for the first 3 days(total dose 3 g),amoxicillin 1 g bid and omeprazole 20 mg bid(OAA,n=50).Omeprazole 20 mg od was given after the eradication course as a monotherapy for three weeks.The control endoscopy was performed 8 weeks after the entry.H.pyloriinfection was determined in the entry of the study and four weeks after the cessation of treatment by means of histology and CLO-test. RESULTS:97 patients completed the study according to the protocol(1 patient of the OAM group did not come to the control endoscopy,2 patients of the OAA group stopped the treatment because of mild allergic urticaria).Duodenal ulcers were healed in 48 patients of the OAM group(96 %, C190.5-100 %)and in 46 patients of the OAA group(92 %, CI 89.5-94.5 %)(p=ns).H.pyloHinfection was eradicated in 15 out of 50 patients with OAM(30 %,CI 17-43 %)and in 36 out of 50 patients treated with OAA(72 %;CI 59-85 %) (P<0.001)-ITT analysis.CONCLUSION: The triple therapy with omeprazole, amoxicillin and metronidazole failed to eradicate H.pylori'vc\ the majority of patients, which is an essential argument to withdraw this regimen out of the national recommendations. Macrolide with amoxicillin are preferable to achieve higher eradication rates. Azithromycin (1 g od for the first 3 days) can be considered as a successful component of the triple PPI-based regimen.展开更多
AIM: To test the hypothesis to block VEGF expression of SMMC-7721 hepatoma cells may inhibit tumor growth using the rat hepatoma model. METHODS: Amplify the 200 VEGF cDNA fragment and insert it into human U6 gene cass...AIM: To test the hypothesis to block VEGF expression of SMMC-7721 hepatoma cells may inhibit tumor growth using the rat hepatoma model. METHODS: Amplify the 200 VEGF cDNA fragment and insert it into human U6 gene cassette in the reverse orientation transcribing small antisense RNA which could specifically interact with VEGF165, and VEGF121 mRNA. Construct the retroviral vector containing this antisense VEGF U6 cassette and package the replication-deficient recombinant retrovirus. SMMC-7721 cells were transduced with these virus and positive clones were selected with G418. PCR and Southern blot analysis were performed to determine if U6 cassette integrated into the genomic DNA of positive clone. Transfected tumor cells were evaluated for RNA expression by ribonuclease protection assays. The VEGF protein in the supernatant of parental tumor cells and genetically modified tumor cells was determined with ELISA. In vitro and in vivo growth properties of antisense VEGF cell clone in nude mice were analyzed. RESULTS: Restriction enzyme digestion and PCR sequencing verified that the antisense VEGF RNA retroviral vector was successfully constructed.After G418 selection, resistant SMMC-7721 cell clone was picked up. PCR and Southern blot analysis suggested that U6 cassette was integrated into the cell genomic DNA. Stable SMMC-7721 cell clone transduced with U6 antisense RNA cassette could express 200 bp small antisense VEGF RNA and secrete reduced levels of VEGF in culture condition. Production of VEGF by antisense transgene-expressing cells was 65+/-10 ng/L per 10(6) cells, 42045 ng/L per 10(6) cells in sense group and 485+/-30 ng/L per 10(6) cells in the negative control group, (P【 0.05). The antisense-VEGF cell clone appeared phenotypically indistinguishable from SMMC-7721 cells and SMMC-7721 cells transfected sense VEGF. The growth rate of the antisense-VEGF cell clone was the same as the control cells. When S.C. was implanted into nude mice, growth of antisense-VEGF cell lines was greatly inhibited compared with control cells. CONCLUSION: Expression of antisense VEGF RNA in SMMC-7721 cells could decrease the tumorigenicity, and antisense-VEGF gene therapy may be an adjuvant treatment for hepatoma.展开更多
Objective The aim of this study was to investigate changes in nutritional status and related indexes in patients with Nutritional Risk Score(NRS)≥3 gastric cancer after nutritional support treatment.Methods A total o...Objective The aim of this study was to investigate changes in nutritional status and related indexes in patients with Nutritional Risk Score(NRS)≥3 gastric cancer after nutritional support treatment.Methods A total of 50 patients with gastric cancer were divided into two groups according to the different nutritional support treatment they received during postoperative chemotherapy:immune-enhanced enteral nutrition group(n=25)and conventional enteral nutrition group(n=25).Changes in patient’body mass index(BMI),hemoglobin(HB),serum total protein(TP),serum albumin(ALB),and immune indexes(CD3+,CD4+/CD8+,CD3+/CD8+)were monitored before and after chemotherapy.At the same time,the incidence and classification of gastrointestinal adverse reactions after chemotherapy were assessed.Results Compared with the conventional enteral nutrition group,the nutritional and immune indexes in the immune-enhanced enteral nutrition group were significantly improved.After chemotherapy,the incidence of adverse reactions in the digestive tract was relatively lower and the grade was reduced.Conclusion Immune-enhanced enteral nutrition support can significantly improve the nutritional status of patients,improve immune function,increase the susceptibility of cancer patients to chemotherapy,reduce toxicity and adverse effects,and improve the quality of life of tumor patients compared with conventional enteral nutrition support.展开更多
In order to investigate the influence of radiation therapy after the treatment of maxillary implant-supported prostheses, 27 patients received a total of 131 implants in maxilla after oral cancer treatment and/or reco...In order to investigate the influence of radiation therapy after the treatment of maxillary implant-supported prostheses, 27 patients received a total of 131 implants in maxilla after oral cancer treatment and/or reconstructive surgery. Among them, 25 received maxillary implant-supported prostheses. The cumulative survival rates of implants and prostheses were evaluated by the product-limit-estimates method according to Kaplan-Meier. The cumulative survival rate of implants and prostheses in irradiated patients was compared with that in non-irradiated patients by statistical Log-rank test. The results showed that 112 implants were observed after implant loading. The implants cumulative survival rate was approximately 65 % for overall patients. The cumulative prosthesis successful rate was approximately 88 % for all 25 patients. Log-rank test analysis revealed that there was a significant difference in cumulative implants survival rates between non-irradiated and irradiated maxillary bone (P<0. 01). It was concluded that the implants and prostheses in irradiated patients have significantly lower survival rates than in non-irradiated patients.展开更多
The therapeutic effect of herpes simplex virus thymidine kinase/ganciclovir (HSV-tk/GCV) system on hepatocellular carcinoma was studied in this experiment. The tk-containing retroviral recombinants were used to infect...The therapeutic effect of herpes simplex virus thymidine kinase/ganciclovir (HSV-tk/GCV) system on hepatocellular carcinoma was studied in this experiment. The tk-containing retroviral recombinants were used to infect hepatoma cells (BEL-7402) and the cells were treated with ganciclovir (0-1000 microg/ml). The results showed that HSV-tk gene could be efficiently transferred in vitro into hepatoma cells and stably expressed. The growth potential of the tk-containing cells was significantly inhibited by GCV (P展开更多
The latest achievements in the field of pancreas transplantation and stem cell therapy require an effort by the scientific community to clarify the ethical implications of pioneering treatments,often characterized by ...The latest achievements in the field of pancreas transplantation and stem cell therapy require an effort by the scientific community to clarify the ethical implications of pioneering treatments,often characterized by high complexity from a surgical point of view,due to transplantation of multiple organs at the same time or at different times,and from an immunological point of view for stem cell therapy.The fundamental value in the field of organ transplants is,of course,a solidarity principle,namely that of protecting the health and life of people for whom transplantation is a condition of functional recovery,or even of survival.The nature of this value is that of a concept to which the legal discipline of transplants entrusts its own ethical dignity and for which it has ensured a constitutional recognition in different systems.The general principle of respect for human life,both of the donor and of the recipient,evokes the need not to put oneself and one’s neighbor in dangerous conditions.The present ethical reflection aims to find a balance between the latest therapeutic advances and several concepts including the idea of the person,the respect due to the dead,the voluntary nature of the donation and the consent to the same,the gratuitousness of the donation,the scientific progress and the development of surgical techniques,and the policies of health promotion.展开更多
Advances in antiretroviral therapy for both Human Immunodeficiency Virus (HIV) treatment and prevention have increased interest in adherence to HIV treatment. This is because the individual patient and public health b...Advances in antiretroviral therapy for both Human Immunodeficiency Virus (HIV) treatment and prevention have increased interest in adherence to HIV treatment. This is because the individual patient and public health benefits of antiretroviral treatment?(ART) greatly depend on the extent to which people living with HIV (PLHIV) adhere to the prescribed daily dosing regimens. Studies have shown that nonadherence to ART increases drug resistance, morbidity and person-to-person HIV transmission. Public health experts are trying different innovations to enhance ART adherence, including promoting support groups of PLHIV. The purpose of this study was to determine the value of support group participation in enhancing ART adherence. The study used a cross-sectional design to compare ART adherence among PLHIV who participate in support group activities and those who do not. Respondents were adults who were initiated on ART between January 1, 2010 and December 31, 2012. Multistage probability sampling was used to select study sites and respondents. Data was collected using a self-administered questionnaire from 1676 respondents between February and May 2014. Data was analyzed using STATA. Univariate analysis was carried out to generate descriptive statistics, while Chi-square tests were used to examine if there was an association between participation in support group activities and antiretroviral treatment adherence. ART adherence was self-reported by 745/788 (95%) and 814/888 (92%) respondents who had ever and had never participated in support group activities respectively. Among respondents who reported nonadherence to ART, 74/117 (8%) had never participated in support group activities compared to just 43/117 (5%) who participated in support group activities. These findings suggest that PLHIV who participate in support group activities are more likely to adhere to ART than those who do not participate. This implies that there is value in participating in support groups by PLHIV in terms of ART adherence.展开更多
Background: 70% of ovarian cancer cases are diagnosed at an advanced stage (III or IV) of the disease and, in turn, with a high prevalence of peritoneal carcinosis and ascites, which leads to progressive malnutrition ...Background: 70% of ovarian cancer cases are diagnosed at an advanced stage (III or IV) of the disease and, in turn, with a high prevalence of peritoneal carcinosis and ascites, which leads to progressive malnutrition in patients, with the consequent deterioration of their general condition. There is a very important relationship between nutritional status, quality of life, survival, and the ability to tolerate multidisciplinary treatment of peritoneal carcinosis. Methods: A phase II, open-label, single-center, non-randomised clinical trial was conducted that included 36 patients with advanced disease who were administered the nutritional supplement Ocoxin, 30 ml twice a day, beginning one week before chemotherapy (CT) based on carboplatin/paclitaxel, of which they receive three cycles with neoadjuvant intent. Ocoxin treatment was continued during chemotherapy and for three weeks after completion of the last cycle, as well as during any periods for which this treatment was discontinued due to toxicity. The effect of Ocoxin on the quality of life was assessed through the QLQ C30 and QLQ OV28 questionnaires from the start of treatment until the end of the follow-up period. In addition, the Karnofsky Index and nutritional parameters were assessed. Results: There were no significant differences between adverse events versus baseline values, except in leukocytes, lymphocytes, neutrophils, ALT, and AST. There was no deterioration of the QoL scales, except for those related to the effects of chemotherapy and alopecia. Conclusions: Ocoxin as an adjuvant to chemotherapy appears to improve better tolerance to chemotherapy, showed a good safety profile, and improved quality of life. For further information on Ocoxin neoadjuvant therapy benefits, a phase III clinical trial will be needed.展开更多
Requirements for intervention measures for lung cancer have increased in number and difficulty due to the progress of patients and influence of complex groups of symptom.The cure rate for patients with lung cancer has...Requirements for intervention measures for lung cancer have increased in number and difficulty due to the progress of patients and influence of complex groups of symptom.The cure rate for patients with lung cancer has improved with the vigorous development of new technologies in modern medicine.However,their mental health status and physical quality of life have continued to warrant scholarly attention.The field of cognitive behavior therapy(CBT)provides innovative ideas for addressing this issue.Thus,the study reviews the origin and concept of CBT,CBT technology,and effect of its application to patients with lung cancer to provide a feasible reference for intervention on physical and mental adverse symptoms in patients with lung cancer.展开更多
Based on the Traditional Chinese Medicine Inheritance Support System(V2.5),we explored the compatibility rules of moxibustion and auricular point prescriptions in the treatment of urinary retention after anorectal sur...Based on the Traditional Chinese Medicine Inheritance Support System(V2.5),we explored the compatibility rules of moxibustion and auricular point prescriptions in the treatment of urinary retention after anorectal surgery,and further to obtain new prescriptions.Methods:We searched CNKI,Wanfang,VIP and CBM databases for the literature of moxibustion and auricular point therapy for urinary retention after anorectal surgery,collecting complete prescriptions and entering them into the Traditional Chinese Medicine Inheritance Support System(V2.5).The acupoint frequency,association rules,and combination rules were analyzed by data mining method of software integration.Results:126 moxibustion prescriptions were selected,and the acupoints for urinary retention after anorectal surgery in the literature were analyzed,including 10 acupoints with frequency≥6,9 acupoint combinations with frequency≥26,5 acupoints with association rules,6 core acupoint combinations and 3 new prescription.124 auricular point prescriptions were selected,and the relevant acupoints in the literature were analyzed,including 10 acupoints with frequency of use≥18,15 acupoint combinations with frequency≥40,12 acupoint combinations with association rules,6 core acupoint combinations,and 3 new prescriptions.The core points include Qihai(RN6),Sanyinjiao(SP6),Zhongji(RN3),Guanyuan(RN4).The auricular point therapy is more to select the tenderness points and acupoints that have an impact on the urinary system,mainly including“Pangguang”(CO9),“Shenmen”(TF4),“Shen”(CO10),“Sanjiao”(CO17),“Pizhixia”(AT4),“Niaodao”(HX3),“Fei”(CO14),“Jiaogan”(AH6a).Conclusion:Moxibustion for the treatment of urinary retention is mainly based on invigorating“Primordial Qi”and regulating the functions of“Middle Jiao”(refers to the area of the body just below the diaphragm and above the navel that helps produce delicate nutrients).The entropic clustering of complex systems excavated new prescriptions for the treatment of urinary retention after anorectal surgery,providing new ideas for future research and treatment.展开更多
文摘Over the past decade,nine separate gene therapy clinical trials for advanced Parkinson’s disease(PD)have been launched and completed,involving the dosing of nearly 12-dozen PD volunteers who incurred significant risks to hopefully reduce symptoms and gain a better life.
文摘To analyze the effect of nutritional support on clinical efficacy in patients with end-stage malignant tumors.Sample data collection was conducted from April 2015 to July 2017.54 patients with end-stage malignant tumors were enrolled in the study.They were divided into reference group(n=27)and experimental group(n=27)by double-blind method.Conventional treatment was used in the reference group,while nutritional support therapy was used in the experimental group.The treatment effects of the two groups were compared.Post-treatment effect of the experimental group and the reference group was compared using the parameters including total adverse reaction value,cancer-related fatigue score,quality of life,A/G,AS:AL,alkaline phosphatase(ALP),blood urea nitrogen(BUN),anorexia score,ALB,and uric acid(UA).The parameters such as A/G,AS:AL,ALP,BUN,anorexia score,ALB,and UA were also used to compare between pre-and post-treatment.The value of P<0.05 was used to indicate the statistical significance of the test.Conclusion:Nutritional support therapy had a superior effect in patients with end-stage malignant tumors.
文摘Extracorporeal organ support(ECOS)has made remarkable progress over the last few years.Renal replacement therapy,introduced a few decades ago,was the first available application of ECOS.The subsequent evolution of ECOS enabled the enhanced support to many other organs,including the heart[veno-arterial extracorporeal membrane oxygenation(ECMO),slow continuous ultrafiltration],the lungs(veno-venous ECMO,extracorporeal carbon dioxide removal),and the liver(blood purification techniques for the detoxification of liver toxins).Moreover,additional indications of these methods,including the suppression of excessive inflammatory response occurring in severe disorders such as sepsis,coronavirus disease 2019,pancreatitis,and trauma(blood purification techniques for the removal of exotoxins,endotoxins,or cytokines),have arisen.Multiple organ support therapy is crucial since a vast majority of critically ill patients present not with a single but with multiple organ failure(MOF),whereas,traditional therapeutic approaches(mechanical ventilation for acute respiratory failure,antibiotics for sepsis,and inotropes for cardiac dysfunction)have reached the maximum efficacy and cannot be improved further.However,several issues remain to be clarified,such as the complexity and cost of ECOS systems,standardization of indications,therapeutic protocols and initiation time,choice of the patients who will benefit most from these interventions,while evidence from randomized controlled trials supporting their use is still limited.Nevertheless,these methods are currently a part of routine clinical practice in intensive care units.This editorial presents the past,present,and future considerations,as well as perspectives regarding these therapies.Our better understanding of these methods,the pathophysiology of MOF,the crosstalk between native organs resulting in MOF,and the crosstalk between native organs and artificial organ support systems when applied sequentially or simultaneously,will lead to the multiplication of their effects and the minimization of complications arising from their use.
文摘Liver transplantation and blood purification therapy,including plasmapheresis,hemodiafiltration,and bioartificial liver support,are the available treatments for patients with severe hepatic failure.Bioartificial liver support,in which living liver tissue is used to support hepatic function,has been anticipated as an effective treatment for hepatic failure.The two mainstream systems developed for bioartificial liver support are extracorporeal whole liver perfusion(ECLP)and bioreactor systems.Comparing various types of bioartificial liver in view of function,safety,and operability,we concluded that the best efficacy can be provided by the ECLP system.Moreover,in our subsequent experiments comparing ECLP and apheresis therapy,ECLP offers more ammonia metabolism than HD and HF.In addition,ECLP can compensate amino acid imbalance and can secret bile.A controversial point with ECLP is the procedure is labor intensive,resulting in high costs.However,ECLP has the potential to reduce elevated serum ammonia levels of hepatic coma patients in a short duration.When these problems are solved,bioartificial liver support,especially ECLP,can be adopted as an option in ordinary clinical therapy to treat patients with hepatic failure.
文摘The outlook for patients with pancreatic cancer has been grim. There have been major advances in the surgical treatment of pancreatic cancer, leading to a dramatic reduction in post-operative mortality from the development of high volume specialized centres. This stimulated the study of adjuvant and neoadjuvant treatments in pancreatic cancer including chemoradiotherapy and chemotherapy. Initial protocols have been based on the original but rather small GITSG study first reported in 1985. There have been two large European trials totalling over 600 patients (EORTC and ESPAC-1) that do not support the use of chemoradiation as adjuvant therapy. A second major finding from the ESPAC-1 trial (541 patients randomized) was some but not conclusive evidence for a survival benefit associated with chemotherapy. A third major finding from the ESPAC-1 trial was that the quality of life was not affected by the use of adjuvant treatments compared to surgery alone. The ESPAC-3 trial aims to assess the definitive use of adjuvant chemotherapy in a randomized controlled trial of 990 patients.
基金Supported by the Hebei Provincial Scientific Commission, No. 97276162D
文摘INTRODUCTIONCancer treatment situation in tumor hospitals inChina has its own unique characteristics which arenot found in other parts of the world. Because ofthe huge population and high incidence rates ofesophageal and stomach cancer[1-5], the number ofcancer patients waiting for admission isinconceivably large.
基金Supported by a faculty research grant of Yonsei University College of Medicine for 2002,No.2002-06
文摘AIM:rAAV mediated endostatin gene therapy has been examined as a new method for treating cancer.However, a sustained and high protein delivery is required to achieve the desired therapeutic effects.We evaluated the impact of topoisomerase inhibitors in rAAV delivered endostatin gene therapy in a liver tumor model. METHODS:rAAV containing endostatin expression cassettes were transduced into hepatoma cell lines.To test whether the topoisomerase inhibitor pretreatment increased the expression of endostatin,Western blotting and ELISA were performed.The biologic activity of endostatin was confirmed by endothelial cell proliferation and tube formation assays. The anti-tumor effects of the rAAV-endostatin vector combined with a topoisomerase inhibitor,etoposide,were evaluated in a mouse liver tumor model. RESULTS:Topoisomerase inhibitors,including camptothecin and etoposide,were found to increase the endostatin exPression level in vitro.The over-expressed endostatin, as a result of pretreatment with a topoisomerase inhibitor, was also biologically active.In animal experiments,the combined therapy of topoisomerase inhibitor,etoposide with the rAAV-endostatin vector had the best tumor- suppressive effect and tumor foci were barely observed in livers of the treated mice.Pretreatment with an etoposide increased the level of endostatin in the liver and serum of rAAV-endostatin treated mice.Finally,the mice treated With rAAV-endostatin in combination with etoposide showed the longest survival among the experimental models. CONCLUSION:rAAV delivered endostatin gene therapy in combination with a topoisomerase inhibitor pretreatment is an effective modality for anticancer gene therapy.
文摘AIM:To assess and compare the efficacy and safety of two triple regimes:A)metronidazole,amoxicillin and omeprazole, which is still widely used in Russia,and B)azithromycin, amoxicillin and omeprazole in healing active duodenal ulcer and H.pylori eradication. METHODS:100 patients with active duodenal ulcer were included in the open,multicentre,randomized study with comparative groups.Patients were randomly assigned to one of the following one-week triple regimes:A) metronidazole 500 mg bid,amoxicillin I g bid and omeprazole 20 mg bid(OAM,n=50)and B)azithromycin 1 god for the first 3 days(total dose 3 g),amoxicillin 1 g bid and omeprazole 20 mg bid(OAA,n=50).Omeprazole 20 mg od was given after the eradication course as a monotherapy for three weeks.The control endoscopy was performed 8 weeks after the entry.H.pyloriinfection was determined in the entry of the study and four weeks after the cessation of treatment by means of histology and CLO-test. RESULTS:97 patients completed the study according to the protocol(1 patient of the OAM group did not come to the control endoscopy,2 patients of the OAA group stopped the treatment because of mild allergic urticaria).Duodenal ulcers were healed in 48 patients of the OAM group(96 %, C190.5-100 %)and in 46 patients of the OAA group(92 %, CI 89.5-94.5 %)(p=ns).H.pyloHinfection was eradicated in 15 out of 50 patients with OAM(30 %,CI 17-43 %)and in 36 out of 50 patients treated with OAA(72 %;CI 59-85 %) (P<0.001)-ITT analysis.CONCLUSION: The triple therapy with omeprazole, amoxicillin and metronidazole failed to eradicate H.pylori'vc\ the majority of patients, which is an essential argument to withdraw this regimen out of the national recommendations. Macrolide with amoxicillin are preferable to achieve higher eradication rates. Azithromycin (1 g od for the first 3 days) can be considered as a successful component of the triple PPI-based regimen.
基金Project supported by National Natural Science Foundation of China,No.863 Z2001-04
文摘AIM: To test the hypothesis to block VEGF expression of SMMC-7721 hepatoma cells may inhibit tumor growth using the rat hepatoma model. METHODS: Amplify the 200 VEGF cDNA fragment and insert it into human U6 gene cassette in the reverse orientation transcribing small antisense RNA which could specifically interact with VEGF165, and VEGF121 mRNA. Construct the retroviral vector containing this antisense VEGF U6 cassette and package the replication-deficient recombinant retrovirus. SMMC-7721 cells were transduced with these virus and positive clones were selected with G418. PCR and Southern blot analysis were performed to determine if U6 cassette integrated into the genomic DNA of positive clone. Transfected tumor cells were evaluated for RNA expression by ribonuclease protection assays. The VEGF protein in the supernatant of parental tumor cells and genetically modified tumor cells was determined with ELISA. In vitro and in vivo growth properties of antisense VEGF cell clone in nude mice were analyzed. RESULTS: Restriction enzyme digestion and PCR sequencing verified that the antisense VEGF RNA retroviral vector was successfully constructed.After G418 selection, resistant SMMC-7721 cell clone was picked up. PCR and Southern blot analysis suggested that U6 cassette was integrated into the cell genomic DNA. Stable SMMC-7721 cell clone transduced with U6 antisense RNA cassette could express 200 bp small antisense VEGF RNA and secrete reduced levels of VEGF in culture condition. Production of VEGF by antisense transgene-expressing cells was 65+/-10 ng/L per 10(6) cells, 42045 ng/L per 10(6) cells in sense group and 485+/-30 ng/L per 10(6) cells in the negative control group, (P【 0.05). The antisense-VEGF cell clone appeared phenotypically indistinguishable from SMMC-7721 cells and SMMC-7721 cells transfected sense VEGF. The growth rate of the antisense-VEGF cell clone was the same as the control cells. When S.C. was implanted into nude mice, growth of antisense-VEGF cell lines was greatly inhibited compared with control cells. CONCLUSION: Expression of antisense VEGF RNA in SMMC-7721 cells could decrease the tumorigenicity, and antisense-VEGF gene therapy may be an adjuvant treatment for hepatoma.
文摘Objective The aim of this study was to investigate changes in nutritional status and related indexes in patients with Nutritional Risk Score(NRS)≥3 gastric cancer after nutritional support treatment.Methods A total of 50 patients with gastric cancer were divided into two groups according to the different nutritional support treatment they received during postoperative chemotherapy:immune-enhanced enteral nutrition group(n=25)and conventional enteral nutrition group(n=25).Changes in patient’body mass index(BMI),hemoglobin(HB),serum total protein(TP),serum albumin(ALB),and immune indexes(CD3+,CD4+/CD8+,CD3+/CD8+)were monitored before and after chemotherapy.At the same time,the incidence and classification of gastrointestinal adverse reactions after chemotherapy were assessed.Results Compared with the conventional enteral nutrition group,the nutritional and immune indexes in the immune-enhanced enteral nutrition group were significantly improved.After chemotherapy,the incidence of adverse reactions in the digestive tract was relatively lower and the grade was reduced.Conclusion Immune-enhanced enteral nutrition support can significantly improve the nutritional status of patients,improve immune function,increase the susceptibility of cancer patients to chemotherapy,reduce toxicity and adverse effects,and improve the quality of life of tumor patients compared with conventional enteral nutrition support.
文摘In order to investigate the influence of radiation therapy after the treatment of maxillary implant-supported prostheses, 27 patients received a total of 131 implants in maxilla after oral cancer treatment and/or reconstructive surgery. Among them, 25 received maxillary implant-supported prostheses. The cumulative survival rates of implants and prostheses were evaluated by the product-limit-estimates method according to Kaplan-Meier. The cumulative survival rate of implants and prostheses in irradiated patients was compared with that in non-irradiated patients by statistical Log-rank test. The results showed that 112 implants were observed after implant loading. The implants cumulative survival rate was approximately 65 % for overall patients. The cumulative prosthesis successful rate was approximately 88 % for all 25 patients. Log-rank test analysis revealed that there was a significant difference in cumulative implants survival rates between non-irradiated and irradiated maxillary bone (P<0. 01). It was concluded that the implants and prostheses in irradiated patients have significantly lower survival rates than in non-irradiated patients.
文摘The therapeutic effect of herpes simplex virus thymidine kinase/ganciclovir (HSV-tk/GCV) system on hepatocellular carcinoma was studied in this experiment. The tk-containing retroviral recombinants were used to infect hepatoma cells (BEL-7402) and the cells were treated with ganciclovir (0-1000 microg/ml). The results showed that HSV-tk gene could be efficiently transferred in vitro into hepatoma cells and stably expressed. The growth potential of the tk-containing cells was significantly inhibited by GCV (P
文摘The latest achievements in the field of pancreas transplantation and stem cell therapy require an effort by the scientific community to clarify the ethical implications of pioneering treatments,often characterized by high complexity from a surgical point of view,due to transplantation of multiple organs at the same time or at different times,and from an immunological point of view for stem cell therapy.The fundamental value in the field of organ transplants is,of course,a solidarity principle,namely that of protecting the health and life of people for whom transplantation is a condition of functional recovery,or even of survival.The nature of this value is that of a concept to which the legal discipline of transplants entrusts its own ethical dignity and for which it has ensured a constitutional recognition in different systems.The general principle of respect for human life,both of the donor and of the recipient,evokes the need not to put oneself and one’s neighbor in dangerous conditions.The present ethical reflection aims to find a balance between the latest therapeutic advances and several concepts including the idea of the person,the respect due to the dead,the voluntary nature of the donation and the consent to the same,the gratuitousness of the donation,the scientific progress and the development of surgical techniques,and the policies of health promotion.
文摘Advances in antiretroviral therapy for both Human Immunodeficiency Virus (HIV) treatment and prevention have increased interest in adherence to HIV treatment. This is because the individual patient and public health benefits of antiretroviral treatment?(ART) greatly depend on the extent to which people living with HIV (PLHIV) adhere to the prescribed daily dosing regimens. Studies have shown that nonadherence to ART increases drug resistance, morbidity and person-to-person HIV transmission. Public health experts are trying different innovations to enhance ART adherence, including promoting support groups of PLHIV. The purpose of this study was to determine the value of support group participation in enhancing ART adherence. The study used a cross-sectional design to compare ART adherence among PLHIV who participate in support group activities and those who do not. Respondents were adults who were initiated on ART between January 1, 2010 and December 31, 2012. Multistage probability sampling was used to select study sites and respondents. Data was collected using a self-administered questionnaire from 1676 respondents between February and May 2014. Data was analyzed using STATA. Univariate analysis was carried out to generate descriptive statistics, while Chi-square tests were used to examine if there was an association between participation in support group activities and antiretroviral treatment adherence. ART adherence was self-reported by 745/788 (95%) and 814/888 (92%) respondents who had ever and had never participated in support group activities respectively. Among respondents who reported nonadherence to ART, 74/117 (8%) had never participated in support group activities compared to just 43/117 (5%) who participated in support group activities. These findings suggest that PLHIV who participate in support group activities are more likely to adhere to ART than those who do not participate. This implies that there is value in participating in support groups by PLHIV in terms of ART adherence.
文摘Background: 70% of ovarian cancer cases are diagnosed at an advanced stage (III or IV) of the disease and, in turn, with a high prevalence of peritoneal carcinosis and ascites, which leads to progressive malnutrition in patients, with the consequent deterioration of their general condition. There is a very important relationship between nutritional status, quality of life, survival, and the ability to tolerate multidisciplinary treatment of peritoneal carcinosis. Methods: A phase II, open-label, single-center, non-randomised clinical trial was conducted that included 36 patients with advanced disease who were administered the nutritional supplement Ocoxin, 30 ml twice a day, beginning one week before chemotherapy (CT) based on carboplatin/paclitaxel, of which they receive three cycles with neoadjuvant intent. Ocoxin treatment was continued during chemotherapy and for three weeks after completion of the last cycle, as well as during any periods for which this treatment was discontinued due to toxicity. The effect of Ocoxin on the quality of life was assessed through the QLQ C30 and QLQ OV28 questionnaires from the start of treatment until the end of the follow-up period. In addition, the Karnofsky Index and nutritional parameters were assessed. Results: There were no significant differences between adverse events versus baseline values, except in leukocytes, lymphocytes, neutrophils, ALT, and AST. There was no deterioration of the QoL scales, except for those related to the effects of chemotherapy and alopecia. Conclusions: Ocoxin as an adjuvant to chemotherapy appears to improve better tolerance to chemotherapy, showed a good safety profile, and improved quality of life. For further information on Ocoxin neoadjuvant therapy benefits, a phase III clinical trial will be needed.
文摘Requirements for intervention measures for lung cancer have increased in number and difficulty due to the progress of patients and influence of complex groups of symptom.The cure rate for patients with lung cancer has improved with the vigorous development of new technologies in modern medicine.However,their mental health status and physical quality of life have continued to warrant scholarly attention.The field of cognitive behavior therapy(CBT)provides innovative ideas for addressing this issue.Thus,the study reviews the origin and concept of CBT,CBT technology,and effect of its application to patients with lung cancer to provide a feasible reference for intervention on physical and mental adverse symptoms in patients with lung cancer.
文摘Based on the Traditional Chinese Medicine Inheritance Support System(V2.5),we explored the compatibility rules of moxibustion and auricular point prescriptions in the treatment of urinary retention after anorectal surgery,and further to obtain new prescriptions.Methods:We searched CNKI,Wanfang,VIP and CBM databases for the literature of moxibustion and auricular point therapy for urinary retention after anorectal surgery,collecting complete prescriptions and entering them into the Traditional Chinese Medicine Inheritance Support System(V2.5).The acupoint frequency,association rules,and combination rules were analyzed by data mining method of software integration.Results:126 moxibustion prescriptions were selected,and the acupoints for urinary retention after anorectal surgery in the literature were analyzed,including 10 acupoints with frequency≥6,9 acupoint combinations with frequency≥26,5 acupoints with association rules,6 core acupoint combinations and 3 new prescription.124 auricular point prescriptions were selected,and the relevant acupoints in the literature were analyzed,including 10 acupoints with frequency of use≥18,15 acupoint combinations with frequency≥40,12 acupoint combinations with association rules,6 core acupoint combinations,and 3 new prescriptions.The core points include Qihai(RN6),Sanyinjiao(SP6),Zhongji(RN3),Guanyuan(RN4).The auricular point therapy is more to select the tenderness points and acupoints that have an impact on the urinary system,mainly including“Pangguang”(CO9),“Shenmen”(TF4),“Shen”(CO10),“Sanjiao”(CO17),“Pizhixia”(AT4),“Niaodao”(HX3),“Fei”(CO14),“Jiaogan”(AH6a).Conclusion:Moxibustion for the treatment of urinary retention is mainly based on invigorating“Primordial Qi”and regulating the functions of“Middle Jiao”(refers to the area of the body just below the diaphragm and above the navel that helps produce delicate nutrients).The entropic clustering of complex systems excavated new prescriptions for the treatment of urinary retention after anorectal surgery,providing new ideas for future research and treatment.