The emulsion stability of oilfield produced water is related to the oil-water interfacial film strength and the zeta potential of the oil droplets. We investigated the effects of water treatment agents (corrosion inh...The emulsion stability of oilfield produced water is related to the oil-water interfacial film strength and the zeta potential of the oil droplets. We investigated the effects of water treatment agents (corrosion inhibitor SL-2, scale inhibitor HEDP, germicide 1227, and flocculant polyaluminium chloride PAC) on the stability of oilfield produced water. The influence of these treatment agents on oil-water interfacial properties and the mechanism of these agents acting on the oilfield produced water were studied by measuring the interfacial shear viscosity, interfacial tension and zeta electric potential. The results indicated that the scale inhibitor HEDP could increase the oil-water interfacial film strength, and it could also increase the absolute value of the zeta potential of oil droplets. HEDP played an important role in the stability of the emulsion. Polyaluminum chloride (PAC) reduced the stability of the emulsion by considerably decreasing the absolute value of the zeta potential of oil droplets. Corrosion inhibitor SL-2 and germicide 1227 could decrease the oil-water interfacial tension, whereas they had little influence on oil-water interfacial shear viscosity and oil-water interfacial electricity properties.展开更多
The management of diabetes in pregnancy varies depending on whether the condition was first diagnosed during pregnancy (gestational diabetes) or was diagnosed before pregnancy (pregestational diabetes). Little has bee...The management of diabetes in pregnancy varies depending on whether the condition was first diagnosed during pregnancy (gestational diabetes) or was diagnosed before pregnancy (pregestational diabetes). Little has been published comparing the relative efficacy of various oral agents for the treatment of gestational diabetes and the reported experience with the insulin pump in pregnancy for pregestational diabetes remains meager. We conducted a retrospective chart review of women managed in a specialized diabetic clinic to compare the results of treatment of gestational diabetes with oral agents, glyburide and acarbose, to those treated with split-mixed insulin and treatment of pregestational diabetes with either the insulin pump or conventional splitmixed insulin. Gestational diabetics treated with split-mixed insulin were hospitalized significantly more often (p < 0.001) than those treated with oral agents only. The incidence of several important pregnancy complications (growth restriction, preterm labor, preeclampsia, oligohydramnios) did not differ between groups. Pregestational diabetics managed with an insulin pump had comparable glycemic control, as measured by hemoglobin A1c, to those managed with split-mixed insulin. Infant birth weights and Apgar scores were similar in each group. There were no perinatal deaths in either group. Acarbose and glyburide showed comparable efficacy in treating gestational diabetics. In addition, our experience adds to the small number of pregnant women with pregestational diabetes who were managed with an insulin pump that have been reported in the literature.展开更多
The most common and aggressive type of brain tumor is glioblastoma multiforme (GBM). The prognosis for GBM remains poor with a five-year survival rate between 1% and 2%. The prospects for patients with recurrent GBM (...The most common and aggressive type of brain tumor is glioblastoma multiforme (GBM). The prognosis for GBM remains poor with a five-year survival rate between 1% and 2%. The prospects for patients with recurrent GBM (RGBM) are much worse, with the majority dying within 6 months. This publication provides a brief description of the treatment of 11 GBM patients treated with sodium phenylbutyrate (PB) in combination with pazopanib, m-TOR inhibitors, and other agents. The treatment was associated with tolerable side effects and resulted in objective responses in 54.5% of cases (complete response 18.2%, partial response 36.3%) and 27.3% cases of stable disease. The preferable treatment regimen consisted of PB, pazopanib, dasatinib, everolimus, and bevacizumab (BVZ). For various reasons not all patients were compliant with the treatment regimen. In patients who strictly complied with the treatment plan, all responded as CR or PR. Based on preliminary findings, the authors propose further phase I/II clinical trials with PB in combination with pazopanib, dasatinib, everolimus, and BVZ in patients with RGBM who failed standard surgery, radiation therapy and chemotherapy. With proper dose reductions, the treatment appears to be well-tolerated. Molecular profiling of patient subgroups with favorable genomic signatures may help to select patients for future studies.展开更多
Deicing agent is always applied to alleviate urban traffic pressure after snowing in winter,however,such a snow melting agent is extremely harmful for landscape plants.To eliminate or avoid such damages,we have been a...Deicing agent is always applied to alleviate urban traffic pressure after snowing in winter,however,such a snow melting agent is extremely harmful for landscape plants.To eliminate or avoid such damages,we have been actively exploring protection and treatment means.By analyzing the protection of landscape plants before using the deicing agent and the treatment after being damaged by the salt,the paper described how landscaping industry of Beijing handled extreme weather and influence of certain urban environment on landscape plants in a high-efficiency and low-cost way,and then figured out the balance point of normal social life and healthy development of ecological environment.展开更多
A large amount of residue from the water treatment process has gradually accumulated and thus caused serious environmental pollution in waterflood oilfields. The water treatment residue is a grey suspension, with a de...A large amount of residue from the water treatment process has gradually accumulated and thus caused serious environmental pollution in waterflood oilfields. The water treatment residue is a grey suspension, with a density of 1.08 g/cm^3, and mainly contains over 65% of light CaCO3, MgCO3, CaSO4, Fe2S3 and Ca(OH)2. This paper ascertains the effect of water treatment residue on core permeability and its application in oilfields. Coreflooding tests in laboratory were conducted in two artificial cores and one natural core. Core changes were evaluated by cast model image analysis, mercury injection method and scanning electron microscopy (SEM). Fresh water was injected into another natural core, which was plugged with water treatment residue, to determine the effective life. The results indicate that the water treatment residue has a strongly plugging capability, a resistance to erosion and a long effective life, and thus it can be used as a cheap raw material for profile control. In the past 8 years, a total of 60,164 m^3 of water treatment residue has been used for profile control of 151 well treatments, with a success ratio of 98% and an effective ratio of 83.2%. In the field tests, the profile control agent increased both starting pressure and injection pressure of injectors, and decreased the apparent water injectivity coefficient, significantly improving intake profiles and lengthening average service life of injectors. 28,381 tons of additional oil were recovered from these corresponding oil wells, with economic benefits of ¥3,069.55×10^4 (RMB) and a remarkable input-output ratio of 8.6:1.展开更多
To achieve good metabolic control in diabetes and keep long term, a combination of changes in lifestyle and pharmacological treatment is necessary. Achieving near-normal glycated hemoglobin significantly, decreases ri...To achieve good metabolic control in diabetes and keep long term, a combination of changes in lifestyle and pharmacological treatment is necessary. Achieving near-normal glycated hemoglobin significantly, decreases risk of macrovascular and microvascular complications. At present there are different treatments, both oral and injectable, available for the treatment of type 2 diabetes mellitus(T2DM). Treatment algorithms designed to reduce the development or progression of the complications of diabetes emphasizes the need for good glycaemic control. The aim of this review is to perform an update on the benefits and limitations of different drugs, both current and future, for the treatment of T2 DM. Initial intervention should focus on lifestyle changes. Moreover, changes in lifestyle have proven to be beneficial, but for many patients is a complication keep long term. Physicians should be familiar with the different types of existing drugs for the treatment of diabetes and select the most effective, safe and better tolerated by patients. Metformin remains the first choice of treatment for most patients. Other alternative or second-line treatment options should be individualized depending on the characteristics of each patient. This article reviews the treatments available for patients with T2 DM, with an emphasis on agents introduced within the last decade.展开更多
About 130-170 million people, is estimated to be infected with the hepatitis C virus(HCV). Chronic HCV infection is one of the leading causes of liverrelated death and in many countries it is the primaryreason for hav...About 130-170 million people, is estimated to be infected with the hepatitis C virus(HCV). Chronic HCV infection is one of the leading causes of liverrelated death and in many countries it is the primaryreason for having a liver transplant. The main aim of antiviral treatment is to eradicate the virus. Until a few years ago the only treatment strategy was based on the combination of pegylated interferon and ribavirin(PEG/RBV). However, in genotypes 1 and 4 the rates of viral response did not surpass 50%, reaching up to 80% in the rest. In 2011 approval was given for the first direct acting antiviral agents(DAA), boceprevir and telaprevir, for treatment of genotype 1, in combination with traditional dual therapy. This strategy managed to increase the rates of sustained viral response(SVR) in both naive patients and in retreated patients, but with greater toxicity, interactions and cost, as well as being less safe in patients with advanced disease, in whom this treatment can trigger decompensation or even death. The recent, accelerated incorporation since 2013 of new more effective DAA, with pan-genomic properties and excellent tolerance, besides increasing the rates of SVR(even up to 100%), has also created a new scenario: shorter therapies, less toxicity and regimens free of PEG/RBV. This has enabled their almost generalised applicability in all patients. However, it should be noted that most of the scientific evidence available is based on expert opinion, case-control series, cohort studies and phase 2 and 3 trials, some with a reduced number of patients and select groups. Few data are currently available about the use of these drugs in daily clinical practice, particularly in relation to the appearance of side effects and interactions with other drugs, or their use in special populations or persons with the less common genotypes. This situation suggests the need for the generalised implementation of registries of patients receiving antiviral therapy. The main inconvenience of these new drugs is their high cost. This necessitates selection and prioritization of candidate patients to receive them, via strategies established by the various national organs, in accordance with the recommendations of scientific societies.展开更多
Traumatic brain injury is an important global public health problem.Traumatic brain injury not only causes neural cell death,but also induces dendritic spine degeneration.Spared neurons from cell death in the injured ...Traumatic brain injury is an important global public health problem.Traumatic brain injury not only causes neural cell death,but also induces dendritic spine degeneration.Spared neurons from cell death in the injured brain may exhibit dendrite damage,dendritic spine degeneration,mature spine loss,synapse loss,and impairment of activity.Dendritic degeneration and synapse loss may significantly contribute to functional impairments and neurological disorders following traumatic brain injury.Normal function of the nervous system depends on maintenance of the functionally intact synaptic connections between the presynaptic and postsynaptic spines from neurons and their target cells.During synaptic plasticity,the numbers and shapes of dendritic spines undergo dynamic reorganization.Enlargement of spine heads and the formation and stabilization of new spines are associated with long-term potentiation,while spine shrinkage and retraction are associated with long-term depression.Consolidation of memory is associated with remodeling and growth of preexisting synapses and the formation of new synapses.To date,there is no effective treatment to prevent dendritic degeneration and synapse loss.This review outlines the current data related to treatments targeting dendritic spines that propose to enhance spine remodeling and improve functional recovery after traumatic brain injury.The mechanisms underlying proposed beneficial effects of therapy targeting dendritic spines remain elusive,possibly including blocking activation of Cofilin induced by beta amyloid,Ras activation,and inhibition of GSK-3 signaling pathway.Further understanding of the molecular and cellular mechanisms underlying synaptic degeneration/loss following traumatic brain injury will advance the understanding of the pathophysiology induced by traumatic brain injury and may lead to the development of novel treatments for traumatic brain injury.展开更多
Drug treatment remains an active domain in the therapy of male fertility disorders. Although there are only a fewconditions that allow causal treatment, rational approaches are possible in many cases. Best results are...Drug treatment remains an active domain in the therapy of male fertility disorders. Although there are only a fewconditions that allow causal treatment, rational approaches are possible in many cases. Best results are obtained in casesrequiring an anti-inflammatory treatment and in patients with an impaired sperm transport. High-dosage administrationof FSH is a promising new development, aimed particularly at improving the disturbed sperm structures. A careful di-agnostic work-up with elucidation of the underlying disease is essential to achieve a successful therapy.展开更多
Diffuse intrinsic pontine glioma (DIPG) is the most common type of brainstem glioma and one of the most deadly brain tumors. DIPG in young adult patients is a rare disease for which treatment options are limited. Radi...Diffuse intrinsic pontine glioma (DIPG) is the most common type of brainstem glioma and one of the most deadly brain tumors. DIPG in young adult patients is a rare disease for which treatment options are limited. Radiation therapy remains the standard-of-care for newly-diagnosed DIPG, but no established therapies for recurrent disease are available. This paper describes the results of treatment of a young adult patient diagnosed with DIPG that progressed after radiation therapy. Therapy included sodium phenylbutyrate (PB) in combination with the targeted agents: pazopanib, everolimus, erlotinib, and bevacizumab. The patient achieved a rapid partial response, which persisted over a year and five months. The patient opted to discontinue the therapy and thereafter elected chemotherapy, which resulted in a subsequent rapid progression and death within one month. The targeted treatment was associated with minor toxicity that included a Grade 2 skin rash and Grade 1 elevation of transaminases. In conclusion, a combination of PB and currently available targeted drugs may offer extended survival in patients with recurrent DIPG.展开更多
A lead-acid storage battery manufacturing industry in India produces several thousand liters of lead con-taminated acidic wastewater on a daily basis and uses hydrated lime to render the lead-contaminated acidic waste...A lead-acid storage battery manufacturing industry in India produces several thousand liters of lead con-taminated acidic wastewater on a daily basis and uses hydrated lime to render the lead-contaminated acidic wastewater alkaline (pH = 8.0). Alkaline treatment of the acidic wastewater with lime though a cost-effective method, generates copious amount of lead-contaminated gypsum sludge. Other alkali agents such as sodium hydroxide, sodium carbonate and dolomite are also used for alkali treatment of the acid wastewaters. The present paper compares the relative efficiency of hydrated lime and 0.05 M to 1 M NaOH solutions with re-spect to 1) amounts of sludge produced, 2) immobilization of the soluble lead in the acidic wastewater (AWW) and 3) increase in TDS (total dissolved solids) levels upon treatment of AWW with NaOH solutions and lime. The study also performs equilibrium speciation upon alkaline treatment of AWW with lime and NaOH (sodium hydroxide) solutions using the Visual MINTEQ program to understand the chemical reac-tions occurring during treatment process.展开更多
Major advances have been made in the treatment of chronic hepatitis C virus(HCV) infection with the advent of direct-acting antiviral agents(DAAs). China has the most cases of HCV infection worldwide, but none of the ...Major advances have been made in the treatment of chronic hepatitis C virus(HCV) infection with the advent of direct-acting antiviral agents(DAAs). China has the most cases of HCV infection worldwide, but none of the DAAs has been approved in China's Mainland so far, and interferon(IFN)-α-based treatment remains the standard of care. HCV patients without response or with contraindications to IFN-based therapy have no alternative options. However, many patients buy DAAs, especially the generic forms of sofosbuvir, from other countries or areas. Under these circumstances, the use of these drugs may cause many predictable and unpredictable problems in ethics, law and medical practice. Given the obstacles of legal accessibility to DAAs and the potential problems of obtaining and using DAAs in China, the early launching of the DAAs in China or the legalization of buying drugs from areas outside China and using these drugs in China is an urgent issue and needs to be dealt with as soon as possible, in the interest of the patients.展开更多
To observe the safety and effectiveness of a topical herbal agent used to promote fracture healing, a herbal patch containing extracts of three herbs, viz., Flos Carthami, Radix Dipsaci, Rhizoma Rhei and Borneolum Syn...To observe the safety and effectiveness of a topical herbal agent used to promote fracture healing, a herbal patch containing extracts of three herbs, viz., Flos Carthami, Radix Dipsaci, Rhizoma Rhei and Borneolum Syntheticum (an enhancer) was applied on ten subjects with un-displaced fifth metatarsal fractures. Pain scores, foot and ankle function questionnaires and regional swelling were carefully assessed and recorded. Peripheral blood was taken to measure the inflammation cytokines. Assessment checks were performed biweekly to enforce effective patch application and compliance. The results showed that pain improved after two weeks and fracture sites swelling had 20% reduction in thickness when measured with an ultrasonic tool. Foot and ankle functional scores markedly improved after six weeks. Radiological examinations revealed early perfect fracture unions. The topical herbal patch was effective in promoting fracture healing. It was well tolerated by the fracture patients. Larger randomized controlled trials would be indicated.展开更多
The new position statement of the American Diabetes Association and the European Association for the Study of Diabetes on the management of type 2 diabetes mellitus represents a paradigm shift in our understanding of ...The new position statement of the American Diabetes Association and the European Association for the Study of Diabetes on the management of type 2 diabetes mellitus represents a paradigm shift in our understanding of antidiabetic treatment.It emphasises the necessity to individualise management based on patient needs.Glycaemic targets should also be pursued on an individualised basis.New therapeutic combinations are discussed,and the uncertainty surrounding the ideal choice is acknowledged.Above all,it is the mindful and experienced clinician who will implement the best available evidence towards flexible and efficacious treatment.Some areas of uncertainty may ensue,but it is expected that the new position statement will improve patient healthcare and treatment satisfaction.This now remains to be seen in practice.展开更多
The use of injectable agents for the treatment of stress urinary incontinence(SUI)is an option for female patients who are unwilling to undergo surgery,or have concurrent conditions or diseases that render surgical tr...The use of injectable agents for the treatment of stress urinary incontinence(SUI)is an option for female patients who are unwilling to undergo surgery,or have concurrent conditions or diseases that render surgical treatment unsuitable.To be effective for SUI,an injectable agent must be nonimmunogenic,hypoallergenic,biocompatible,permanent,nonerosive,nonmigratory and painless.It must also heal with minimal fibrosis,possess a long-term bulking effect,and be easily stored and handled.Glutaraldehyde cross-linked bovine collagen(Contigen),silicone polymers(Macroplastique),Durasphere,calcium hydroxyapatite(Coaptite),polyacrylamide hydrogel(Aquamid,Bulkamid),Permacol,and stem cell therapy have been used as injectable agents.Patients must be informed that treatment with injectable agents is not as effective as surgical treatment,and that such agents might necessitate additional and repeated administrations in order to achieve the desired therapeutic effect.展开更多
文摘The emulsion stability of oilfield produced water is related to the oil-water interfacial film strength and the zeta potential of the oil droplets. We investigated the effects of water treatment agents (corrosion inhibitor SL-2, scale inhibitor HEDP, germicide 1227, and flocculant polyaluminium chloride PAC) on the stability of oilfield produced water. The influence of these treatment agents on oil-water interfacial properties and the mechanism of these agents acting on the oilfield produced water were studied by measuring the interfacial shear viscosity, interfacial tension and zeta electric potential. The results indicated that the scale inhibitor HEDP could increase the oil-water interfacial film strength, and it could also increase the absolute value of the zeta potential of oil droplets. HEDP played an important role in the stability of the emulsion. Polyaluminum chloride (PAC) reduced the stability of the emulsion by considerably decreasing the absolute value of the zeta potential of oil droplets. Corrosion inhibitor SL-2 and germicide 1227 could decrease the oil-water interfacial tension, whereas they had little influence on oil-water interfacial shear viscosity and oil-water interfacial electricity properties.
文摘The management of diabetes in pregnancy varies depending on whether the condition was first diagnosed during pregnancy (gestational diabetes) or was diagnosed before pregnancy (pregestational diabetes). Little has been published comparing the relative efficacy of various oral agents for the treatment of gestational diabetes and the reported experience with the insulin pump in pregnancy for pregestational diabetes remains meager. We conducted a retrospective chart review of women managed in a specialized diabetic clinic to compare the results of treatment of gestational diabetes with oral agents, glyburide and acarbose, to those treated with split-mixed insulin and treatment of pregestational diabetes with either the insulin pump or conventional splitmixed insulin. Gestational diabetics treated with split-mixed insulin were hospitalized significantly more often (p < 0.001) than those treated with oral agents only. The incidence of several important pregnancy complications (growth restriction, preterm labor, preeclampsia, oligohydramnios) did not differ between groups. Pregestational diabetics managed with an insulin pump had comparable glycemic control, as measured by hemoglobin A1c, to those managed with split-mixed insulin. Infant birth weights and Apgar scores were similar in each group. There were no perinatal deaths in either group. Acarbose and glyburide showed comparable efficacy in treating gestational diabetics. In addition, our experience adds to the small number of pregnant women with pregestational diabetes who were managed with an insulin pump that have been reported in the literature.
文摘The most common and aggressive type of brain tumor is glioblastoma multiforme (GBM). The prognosis for GBM remains poor with a five-year survival rate between 1% and 2%. The prospects for patients with recurrent GBM (RGBM) are much worse, with the majority dying within 6 months. This publication provides a brief description of the treatment of 11 GBM patients treated with sodium phenylbutyrate (PB) in combination with pazopanib, m-TOR inhibitors, and other agents. The treatment was associated with tolerable side effects and resulted in objective responses in 54.5% of cases (complete response 18.2%, partial response 36.3%) and 27.3% cases of stable disease. The preferable treatment regimen consisted of PB, pazopanib, dasatinib, everolimus, and bevacizumab (BVZ). For various reasons not all patients were compliant with the treatment regimen. In patients who strictly complied with the treatment plan, all responded as CR or PR. Based on preliminary findings, the authors propose further phase I/II clinical trials with PB in combination with pazopanib, dasatinib, everolimus, and BVZ in patients with RGBM who failed standard surgery, radiation therapy and chemotherapy. With proper dose reductions, the treatment appears to be well-tolerated. Molecular profiling of patient subgroups with favorable genomic signatures may help to select patients for future studies.
文摘Deicing agent is always applied to alleviate urban traffic pressure after snowing in winter,however,such a snow melting agent is extremely harmful for landscape plants.To eliminate or avoid such damages,we have been actively exploring protection and treatment means.By analyzing the protection of landscape plants before using the deicing agent and the treatment after being damaged by the salt,the paper described how landscaping industry of Beijing handled extreme weather and influence of certain urban environment on landscape plants in a high-efficiency and low-cost way,and then figured out the balance point of normal social life and healthy development of ecological environment.
文摘A large amount of residue from the water treatment process has gradually accumulated and thus caused serious environmental pollution in waterflood oilfields. The water treatment residue is a grey suspension, with a density of 1.08 g/cm^3, and mainly contains over 65% of light CaCO3, MgCO3, CaSO4, Fe2S3 and Ca(OH)2. This paper ascertains the effect of water treatment residue on core permeability and its application in oilfields. Coreflooding tests in laboratory were conducted in two artificial cores and one natural core. Core changes were evaluated by cast model image analysis, mercury injection method and scanning electron microscopy (SEM). Fresh water was injected into another natural core, which was plugged with water treatment residue, to determine the effective life. The results indicate that the water treatment residue has a strongly plugging capability, a resistance to erosion and a long effective life, and thus it can be used as a cheap raw material for profile control. In the past 8 years, a total of 60,164 m^3 of water treatment residue has been used for profile control of 151 well treatments, with a success ratio of 98% and an effective ratio of 83.2%. In the field tests, the profile control agent increased both starting pressure and injection pressure of injectors, and decreased the apparent water injectivity coefficient, significantly improving intake profiles and lengthening average service life of injectors. 28,381 tons of additional oil were recovered from these corresponding oil wells, with economic benefits of ¥3,069.55×10^4 (RMB) and a remarkable input-output ratio of 8.6:1.
文摘To achieve good metabolic control in diabetes and keep long term, a combination of changes in lifestyle and pharmacological treatment is necessary. Achieving near-normal glycated hemoglobin significantly, decreases risk of macrovascular and microvascular complications. At present there are different treatments, both oral and injectable, available for the treatment of type 2 diabetes mellitus(T2DM). Treatment algorithms designed to reduce the development or progression of the complications of diabetes emphasizes the need for good glycaemic control. The aim of this review is to perform an update on the benefits and limitations of different drugs, both current and future, for the treatment of T2 DM. Initial intervention should focus on lifestyle changes. Moreover, changes in lifestyle have proven to be beneficial, but for many patients is a complication keep long term. Physicians should be familiar with the different types of existing drugs for the treatment of diabetes and select the most effective, safe and better tolerated by patients. Metformin remains the first choice of treatment for most patients. Other alternative or second-line treatment options should be individualized depending on the characteristics of each patient. This article reviews the treatments available for patients with T2 DM, with an emphasis on agents introduced within the last decade.
文摘About 130-170 million people, is estimated to be infected with the hepatitis C virus(HCV). Chronic HCV infection is one of the leading causes of liverrelated death and in many countries it is the primaryreason for having a liver transplant. The main aim of antiviral treatment is to eradicate the virus. Until a few years ago the only treatment strategy was based on the combination of pegylated interferon and ribavirin(PEG/RBV). However, in genotypes 1 and 4 the rates of viral response did not surpass 50%, reaching up to 80% in the rest. In 2011 approval was given for the first direct acting antiviral agents(DAA), boceprevir and telaprevir, for treatment of genotype 1, in combination with traditional dual therapy. This strategy managed to increase the rates of sustained viral response(SVR) in both naive patients and in retreated patients, but with greater toxicity, interactions and cost, as well as being less safe in patients with advanced disease, in whom this treatment can trigger decompensation or even death. The recent, accelerated incorporation since 2013 of new more effective DAA, with pan-genomic properties and excellent tolerance, besides increasing the rates of SVR(even up to 100%), has also created a new scenario: shorter therapies, less toxicity and regimens free of PEG/RBV. This has enabled their almost generalised applicability in all patients. However, it should be noted that most of the scientific evidence available is based on expert opinion, case-control series, cohort studies and phase 2 and 3 trials, some with a reduced number of patients and select groups. Few data are currently available about the use of these drugs in daily clinical practice, particularly in relation to the appearance of side effects and interactions with other drugs, or their use in special populations or persons with the less common genotypes. This situation suggests the need for the generalised implementation of registries of patients receiving antiviral therapy. The main inconvenience of these new drugs is their high cost. This necessitates selection and prioritization of candidate patients to receive them, via strategies established by the various national organs, in accordance with the recommendations of scientific societies.
文摘Traumatic brain injury is an important global public health problem.Traumatic brain injury not only causes neural cell death,but also induces dendritic spine degeneration.Spared neurons from cell death in the injured brain may exhibit dendrite damage,dendritic spine degeneration,mature spine loss,synapse loss,and impairment of activity.Dendritic degeneration and synapse loss may significantly contribute to functional impairments and neurological disorders following traumatic brain injury.Normal function of the nervous system depends on maintenance of the functionally intact synaptic connections between the presynaptic and postsynaptic spines from neurons and their target cells.During synaptic plasticity,the numbers and shapes of dendritic spines undergo dynamic reorganization.Enlargement of spine heads and the formation and stabilization of new spines are associated with long-term potentiation,while spine shrinkage and retraction are associated with long-term depression.Consolidation of memory is associated with remodeling and growth of preexisting synapses and the formation of new synapses.To date,there is no effective treatment to prevent dendritic degeneration and synapse loss.This review outlines the current data related to treatments targeting dendritic spines that propose to enhance spine remodeling and improve functional recovery after traumatic brain injury.The mechanisms underlying proposed beneficial effects of therapy targeting dendritic spines remain elusive,possibly including blocking activation of Cofilin induced by beta amyloid,Ras activation,and inhibition of GSK-3 signaling pathway.Further understanding of the molecular and cellular mechanisms underlying synaptic degeneration/loss following traumatic brain injury will advance the understanding of the pathophysiology induced by traumatic brain injury and may lead to the development of novel treatments for traumatic brain injury.
文摘Drug treatment remains an active domain in the therapy of male fertility disorders. Although there are only a fewconditions that allow causal treatment, rational approaches are possible in many cases. Best results are obtained in casesrequiring an anti-inflammatory treatment and in patients with an impaired sperm transport. High-dosage administrationof FSH is a promising new development, aimed particularly at improving the disturbed sperm structures. A careful di-agnostic work-up with elucidation of the underlying disease is essential to achieve a successful therapy.
文摘Diffuse intrinsic pontine glioma (DIPG) is the most common type of brainstem glioma and one of the most deadly brain tumors. DIPG in young adult patients is a rare disease for which treatment options are limited. Radiation therapy remains the standard-of-care for newly-diagnosed DIPG, but no established therapies for recurrent disease are available. This paper describes the results of treatment of a young adult patient diagnosed with DIPG that progressed after radiation therapy. Therapy included sodium phenylbutyrate (PB) in combination with the targeted agents: pazopanib, everolimus, erlotinib, and bevacizumab. The patient achieved a rapid partial response, which persisted over a year and five months. The patient opted to discontinue the therapy and thereafter elected chemotherapy, which resulted in a subsequent rapid progression and death within one month. The targeted treatment was associated with minor toxicity that included a Grade 2 skin rash and Grade 1 elevation of transaminases. In conclusion, a combination of PB and currently available targeted drugs may offer extended survival in patients with recurrent DIPG.
文摘A lead-acid storage battery manufacturing industry in India produces several thousand liters of lead con-taminated acidic wastewater on a daily basis and uses hydrated lime to render the lead-contaminated acidic wastewater alkaline (pH = 8.0). Alkaline treatment of the acidic wastewater with lime though a cost-effective method, generates copious amount of lead-contaminated gypsum sludge. Other alkali agents such as sodium hydroxide, sodium carbonate and dolomite are also used for alkali treatment of the acid wastewaters. The present paper compares the relative efficiency of hydrated lime and 0.05 M to 1 M NaOH solutions with re-spect to 1) amounts of sludge produced, 2) immobilization of the soluble lead in the acidic wastewater (AWW) and 3) increase in TDS (total dissolved solids) levels upon treatment of AWW with NaOH solutions and lime. The study also performs equilibrium speciation upon alkaline treatment of AWW with lime and NaOH (sodium hydroxide) solutions using the Visual MINTEQ program to understand the chemical reac-tions occurring during treatment process.
文摘Major advances have been made in the treatment of chronic hepatitis C virus(HCV) infection with the advent of direct-acting antiviral agents(DAAs). China has the most cases of HCV infection worldwide, but none of the DAAs has been approved in China's Mainland so far, and interferon(IFN)-α-based treatment remains the standard of care. HCV patients without response or with contraindications to IFN-based therapy have no alternative options. However, many patients buy DAAs, especially the generic forms of sofosbuvir, from other countries or areas. Under these circumstances, the use of these drugs may cause many predictable and unpredictable problems in ethics, law and medical practice. Given the obstacles of legal accessibility to DAAs and the potential problems of obtaining and using DAAs in China, the early launching of the DAAs in China or the legalization of buying drugs from areas outside China and using these drugs in China is an urgent issue and needs to be dealt with as soon as possible, in the interest of the patients.
文摘To observe the safety and effectiveness of a topical herbal agent used to promote fracture healing, a herbal patch containing extracts of three herbs, viz., Flos Carthami, Radix Dipsaci, Rhizoma Rhei and Borneolum Syntheticum (an enhancer) was applied on ten subjects with un-displaced fifth metatarsal fractures. Pain scores, foot and ankle function questionnaires and regional swelling were carefully assessed and recorded. Peripheral blood was taken to measure the inflammation cytokines. Assessment checks were performed biweekly to enforce effective patch application and compliance. The results showed that pain improved after two weeks and fracture sites swelling had 20% reduction in thickness when measured with an ultrasonic tool. Foot and ankle functional scores markedly improved after six weeks. Radiological examinations revealed early perfect fracture unions. The topical herbal patch was effective in promoting fracture healing. It was well tolerated by the fracture patients. Larger randomized controlled trials would be indicated.
文摘The new position statement of the American Diabetes Association and the European Association for the Study of Diabetes on the management of type 2 diabetes mellitus represents a paradigm shift in our understanding of antidiabetic treatment.It emphasises the necessity to individualise management based on patient needs.Glycaemic targets should also be pursued on an individualised basis.New therapeutic combinations are discussed,and the uncertainty surrounding the ideal choice is acknowledged.Above all,it is the mindful and experienced clinician who will implement the best available evidence towards flexible and efficacious treatment.Some areas of uncertainty may ensue,but it is expected that the new position statement will improve patient healthcare and treatment satisfaction.This now remains to be seen in practice.
文摘The use of injectable agents for the treatment of stress urinary incontinence(SUI)is an option for female patients who are unwilling to undergo surgery,or have concurrent conditions or diseases that render surgical treatment unsuitable.To be effective for SUI,an injectable agent must be nonimmunogenic,hypoallergenic,biocompatible,permanent,nonerosive,nonmigratory and painless.It must also heal with minimal fibrosis,possess a long-term bulking effect,and be easily stored and handled.Glutaraldehyde cross-linked bovine collagen(Contigen),silicone polymers(Macroplastique),Durasphere,calcium hydroxyapatite(Coaptite),polyacrylamide hydrogel(Aquamid,Bulkamid),Permacol,and stem cell therapy have been used as injectable agents.Patients must be informed that treatment with injectable agents is not as effective as surgical treatment,and that such agents might necessitate additional and repeated administrations in order to achieve the desired therapeutic effect.