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

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

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

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

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

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

Continuous Wear of Hydrogel Contact Lenses for Therapeutic Use

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

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

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

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

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

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

Controversies regarding transplantation of mesenchymal stem cells

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

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

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

High-intensity focused ultrasound extracorporeal ablation of liver tissuesin rabbits

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The role of drug utilization evaluation in medical sciences

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

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

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

疾病干预的新靶点:嘌呤与嘧啶受体

内源性核苷、核苷酸通过嘌呤与嘧啶受体 (P受体 ) ,参与机体组织器官多种功能的调节。在肿瘤、细胞凋亡、局部缺血、伤口愈合、骨质疏松、药物毒性、炎症及痛觉等病理状态下 ,P受体的内源性配体核苷与核苷酸发挥保护作用 ,P1。

核苷类药物在乙型肝炎后肝硬化治疗中的应用与疗效

目的观察分析核苷类药物应用在乙型肝炎后肝硬化治疗中的临床疗效。方法从乙型肝炎后肝硬化患者中抽取90例,随机分为A、B、C3组,分别使用不同的核苷类药物进行治疗,A组为拉米夫定,B组为阿德福韦酯,C组为恩替卡韦,对比观察其实验室指标变化。结果所有患者在治疗1年后其HBV病毒DNA载量明显低于治疗前,且C组患者的降低程度及HBeAg转阴率明显高于另外两组患者,不良反应明显低于另外两组,差异有统计学意义(P<0.05)。结论对乙型肝炎后肝硬化患者使用核苷类药物进行治疗,能够有效降低患者体内病毒载量,其中恩替卡韦的临床治疗效果尤为突出,且不良反应较少,更为安全可靠,具有进一步推广应用的价值。

多次抗病毒治疗无效的慢性乙型肝炎患者停用抗病毒药物后的联合治疗

目的对于干扰素治疗无效、核苷类似物耐药后停用抗病毒药物治疗的慢性乙型肝炎患者,探讨其停药的后果及再联合应用核苷类似物长期治疗的必要性。方法先后用干扰素α-2b、核苷类似物抗病毒治疗均无效的42例慢性乙型肝炎患者,其自动停用抗病毒药物一段时间后,再联用拉米夫定(100mg/d)(或替比夫定600mg/d、恩替卡韦0.5mg/d)与阿德福韦酯(10mg/d),观察再治疗前后5年患者临床症状体征、生化指标、病毒学、B超半定量肝纤维化积分改变情况。结果 42例患者在抗病毒治疗停止后一段时间内均出现不同程度肝功能损害、生化改变以及肝纤维化积分增加,19%出现肝功能失代偿。而患者采用联合抗病毒治疗后肝功能生化指标正常或好转,病情缓解稳定,生活质量改善,HBV DNA下降>2log10/mL,肝纤维化积分下降。结论慢性乙型肝炎患者干扰素治疗无效、核苷类似物耐药后,停用抗病毒药物会加剧病情进展风险,坚持联合抗病毒治疗可能阻止或延缓病情进展。

高效抗逆转录病毒治疗对人类免疫缺陷病毒感染者骨代谢的影响

目的：评价长期不同高效抗逆转录病毒治疗（HAART）方案对HIV感染者骨代谢的影响及发生时间。方法：选取2012年1月至2016年5月在浙江大学医学院附属第一医院进行HAART的82例HIV感染者的临床资料，按照HAART方案中含替诺福韦（tenofovirdisoproxil）或叠氮胸苷（azidothymidine）的不同分为替诺福韦组（41例）和叠氮胸苷组（41例），分析两组在服药后6、12、18、24、30个月患者肾小球滤过率（GFR）和血钙、血磷、血ALP浓度变化趋势，比较两组的差异。结果：两种方案均能提高患者CD4＋T细胞数，差异无统计学意义（P〉0．05）。相比治疗前，替诺福韦组患者在治疗6个月时GFR[（120．71±62．85）mL／min与（110．08±39．18）mL／min]、血磷浓度[（1．25±0．19）mmoL／L与（1．22±0．21）mmol／L]差异均无统计学意义（均P〉0．05），而血钙浓度[（2．32±0．12）mmol／L与（2．25±0．17）mmol／L]、血ALP浓度[99．0（79．5～124．0）U／L与80．0（60．5～96．0）U／L]增加均有统计学意义（均P〈0．05）；随着治疗时间延长，GFR、血钙浓度、血磷浓度逐渐下降，血ALP浓度继续升高。替诺福韦组患者在治疗30个月后比治疗前血钙浓度[（2．16±0．15）mmol／L与（2．25±0．17）mmol／L]、血磷浓度[（1．06±0．17）mmol／L与（1．22±0．21）mmol／L]、GFR[（98．13±30．43）mL／min与（110．08±39．18）mL／min]减少、血ALP浓度[110．0（98．5～120．5）U／L与80．0（60．5～96．0）U／L]增加均有统计学意义（均P〈0．05）。叠氮胸苷组患者随HAART时间延长血钙浓度、血ALP浓度增加，GFR减少，差异均有统计学意义（均P〈0．05），而血磷浓度变化差异无统计学意义（P〉0．05）。与叠氮胸苷组比较，替诺福韦组GFR、血钙浓度、血磷浓度减少和血ALP浓度增加更明显。结论：我国目前的免费抗病毒治疗药物对患者疗效显著，含替诺福韦的HAART方案会影响患者的骨代谢，导致GFR、血钙和血磷浓度减少，血ALP浓度增加。临床治疗过程中要密切监测，及时干预和尽早调整方案。

核苷(酸)类似物治疗乙型肝炎慢加急性肝衰竭患者疗效观察

目的:探讨核苷类似物对乙型肝炎慢加急性肝功能衰竭患者临床转归的影响。方法:本研究回顾性分析了2011年1月至2012年8月我院收治的51例慢性乙型肝炎慢加急性肝功能衰竭患者,分为2组,对照组(拒绝接受核苷类似物,n=12)和治疗组(核苷类似物治疗组,n=39,分别给予拉米夫定、恩替卡韦、替比夫定),比较两组患者病毒学指标以及血清转氨酶,胆红素和MELD评分的变化;综合评估患者临床转归。结果:结束住院治疗时,治疗组20例病情明显好转,表现为血清转氨酶以及胆红素明显下降,MELD评分降低,疗效明显优于对照组(χ2=4.48,P<0.05);但3种药物(拉、恩、替)之间疗效无明显差异(P均>0.05)。结论:使用强效快速类核苷类似物能显著延缓乙型肝炎慢加急性肝功能衰竭病情进展。

联合核苷类药物治疗干扰素应答不佳的慢性乙型肝炎时机选择及疗效研究

目的:探讨干扰素治疗HBeAg阳性慢性乙型肝炎时,联合核苷(酸)类药物的不同时机对治疗应答的影响。方法:观察干扰素治疗患者分别在治疗起始时联合阿德福韦酯、12周应答不佳者及24周应答不佳者联合拉米夫定最终各组疗效。结果:48周时及停药后24周时,起始时联合阿德福韦酯治疗组及12周应答不佳者联合拉米夫定组患者的病毒转阴率、ALT复常率、HBeAg转阴率均高于对照组(P<0.05),而HBeAg转换率并未有明显提高(P>0.05)。结论:治疗起始干扰素联合阿德福韦酯或根据12周应答情况加用拉米夫定治疗均能一定程度提高治疗应答率。

盐酸吉西他滨配伍卡铂治疗非小细胞肺癌50例临床观察

目的:观察国产盐酸吉西他滨(泽菲)配伍卡铂治疗非小细胞肺癌(NSCLC)的近期疗效及毒副作用。方法:初治NSCLC病例50例,以28d为1周期。采用第1、8天泽菲1.0g/m2,维泵静脉推注,第1天卡铂按AUC=5～6静脉滴注,连用两个周期后评价疗效及毒副作用。结果:全组50例,有效率为44.0%(22/50),主要毒副作用为胃肠反应(Ⅲ～Ⅳ级是6.0%)和血液学毒性,Ⅲ～Ⅳ级白细胞下降和血小板下降分别为10.0%和2.0%。结论:泽菲配伍卡铂治疗NSCLC有较好疗效,毒副作用小,患者耐受性好。

乙型重型肝炎抗病毒治疗的经验与证据

乙型重型肝炎病情重,病死率高。肝移植是有效的治疗方法,但费用高、等待时间长,限制其在临床的应用。目前治疗仍以内科综合治疗及人工肝治疗为主,抗病毒治疗日益受到重视。本文对近年来国内外乙型重型肝炎的抗病毒治疗资料进行汇总,分析、总结了抗病毒治疗的理论基础、原则与时机及拉米夫定、恩替卡韦等药物的使用经验。建议对存在HBV复制证据的重型肝炎患者进行抗病毒治疗,同时重视其安全性。