Plasma medicine and wound management: Evaluation of the antibacterial efficacy of a medically certified cold atmospheric argon plasma jet

Objectives: A major problem for wound healing is contamination with bacteria, often resulting in biofilm formation and wound infection, which, in turn, needs immediate intervention such as surgical debridement and through irrigation. A topical treatment with cold atmospheric pressure plasma (CAP) for wound disinfection may present an alternative and less painful approach.Methods: This study investigated the antibacterial effects of a cold atmospheric pressure argon plasma jet (kINPen® MED) as a CAP source, using the three-dimensional Staphylococcus aureus immunocompetent biofilm system hpBIOM in addition to a standard planktonic test. Furthermore, skin cell compatibility was evaluated using a keratinocyte (HaCat) model.Results: CAP treatment (0–240 s) followed by incubation (15, 120 min) within the CAP-treated media showed slight bactericidal efficacy under planktonic conditions but no effect on biofilms. However, indirect CAP treatment of keratinocytes performed under the same conditions resulted in a significant decrease in metabolic activity. Short CAP treatment and exposure time (30 s; 15 min) induced a slight increase in the metabolic activity; however, longer treatments and/or exposure times led to pronounced reductions up to 100%. These effects could partially be reversed by addition of catalase, indicating a dominant role of CAP-generated hydrogen peroxide.Conclusions: These results indicate that plasma treatment does not lead to the desired disinfection or significant reduction in the bacterial burden of Staphylococcus aureus in a wet milieu or in biofilms. Thus, treatment with CAP could not be recommended as a single anti-bacterial therapy for wounds but could be used to support standard treatments.     

Vitamin C metabolism and the common cold

Summary Male and female university students at the commencement of common cold symptoms were given a single dose of 500 mg of vitamin C. Plasma and leucocyte ascorbic acid concentrations were then measured for six hours. Symptom severity was recorded. The test was repeated twenty-three days after the last symptom had disappeared. The ascorbic acid blood response curve had then returned to normal. Significant and similar elevations of plasma ascorbic acid occurred in both sexes in the cold and post-cold tests. The leucocyte response was significantly reduced in the males but was unaffected in the females in the cold test. The regression coefficients between leucocyte and plasma values (P/L regressions) confirmed that ascorbic acid metabolism was less deranged in females than males during the cold test. Administration of ascorbic acid was associated with increases in blood ascorbic acid concentrations during the post-cold period but not during colds. A single dose of 1000 mg raised blood ascorbic acid concentrations in both sexes during their colds. The elevation was higher, and maintained for two hours longer in the females.In vitro incubation of leucocytes in ascorbic acid confirmed that their ascorbic acid load could be increased by approximately 100% while cold symptoms were present. A significant association between cold symptoms and the state of ascorbic acid metabolism was demonstrated by correlating the ratio of toxic to catarrhal symptoms with P/L regressions during colds. When catarrhal symptoms are severe, ascorbic acid passes from the leucocytes into the plasma, and thence into the inflamed respiratory membranes. When toxic symptoms are relatively more severe, ascorbic acid is retained in the cells. The beneficial effect of vitamin C on the common cold is associated with its influence on ascorbic acid metabolism. A sex-linked difference in ascorbic acid metabolism is manifested during the common cold which affects assessment of the effects of vitamin C on the common cold.     

渗透树脂联合冷光美白微创治疗氟斑牙的临床疗效

目的观察渗透树脂联合冷光美白微创治疗氟斑牙的临床效果。方法 32例氟斑牙患者,所有患者均在冷光美白微创治疗基础上联合渗透树脂治疗,用VITA比色板记录治疗前后色阶,评价治疗效果;同时对治疗后患者的牙齿敏感度情况进行记录并分析。结果 32例患者经治疗后,牙面白垩色及黄色斑点基本消失,牙面光滑,牙齿色泽均改善明显,效果满意。其中,显效29例,有效3例,无效0例,显效率为90.63%,总有效率为100.00%。在冷光美白微创治疗过程中, 32例患者均出现牙本质敏感的症状,其中轻度敏感19例,中度敏感13例,所有患者均顺利完成整个治疗过程。然而,经过渗透树脂技术治疗后患者均未出现牙本质敏感的症状。结论渗透树脂联合冷光美白微创治疗氟斑牙效果稳定,符合微创理念,值得临床推广使用。     

Cost utility of chemotherapy and best supportive care in non-small cell lung cancer

Polychemotherapy is the therapeutic option recommended for nonresectable, non-small cell lung cancer (NSCLC). However, the modest gains in survival, and the frequent and often serious adverse effects, associated with chemotherapy should also be considered when deciding on therapy. We therefore performed a cost-utility analysis of chemotherapy and best supportive care in NSCLC. Effectiveness and costs were analysed on 70 patients who were randomised to receive one of 3 treatments: VP (vindesine and cisplatin), CAP (cyclophosphamide, doxorubicin and cisplatin), or best supportive care. Subsequently, an assessment of the value of polychemotherapy and best supportive care was performed by oncology personnel using the time trade-off technique. Polychemotherapy was found to be more effective than best supportive care, but was also more costly and had a lower value score. Because of its cost utility and its higher value, best supportive care should not be discarded as an alternative for the treatment of NSCLC.     

5-HT1A receptors mediate the analgesic effect of rosavin in a mouse model of oxaliplatin-induced peripheral neuropathic pain

Oxaliplatin, a third-generation platinum derivative, is the mainstay of current antineoplastic medications for advanced colorectal cancer therapy. However, peripheral neuropathic complications, especially cold allodynia, undermine the life-prolonging outcome of this anti-cancer agent. Rosavin, a phenylpropanoid derived originally from Rhodiola rosea, exhibits a wide range of therapeutic properties. The present study explored whether and how rosavin alleviates oxaliplatin-induced cold hypersensitivity in mice. In the acetone drop test, cold allodynia behavior was observed from days 3 to 5 after a single injection of oxaliplatin (6 mg/kg, i.p.). Cold allodynia was significantly attenuated following rosavin treatment (10 mg/kg, i.p.). Specific endogenous 5-HT depletion by three consecutive pretreatments with para-chlorophenylalanine (150 mg/kg/day, i.p.) abolished the analgesic action of rosavin; this effect was not observed following pretreatment with naloxone (opioid receptor antagonist, 10 mg/kg, i.p.). Furthermore, 5-HT_1A receptor antagonist WAY-100635 (0.16 mg/kg, i.p.), but not 5-HT₃ receptor antagonist MDL-72222 (1 mg/kg, i.p.), blocked rosavin-induced analgesia. These results suggest that rosavin may provide a novel approach to alleviate oxaliplatin-induced cold allodynia by recruiting the activity of 5-HT_1A receptors.     

社区获得性肺炎患者血浆FIB及CRP的变化及其意义

目的探讨社区获得性肺炎(CAP)患者血浆纤维蛋白原(FIB)及C反应蛋白(CRP)的变化特点及其与病情的关系。方法测定26例合并胸腔积液的CAP患者、40例单纯CAP患者治疗前后血浆FIB和CRP的浓度的变化,并与30例同期健康体检者作比较。结果与健康对照组相比,CAP患者血浆FIB及CRP的浓度明显升高(P<0.01),合并胸腔积液的肺炎患者比单纯肺炎患者FIB及CRP浓度升高更明显(P<0.05);发生胸膜粘连者,血浆FIB较未粘连者升高(P<0.05);治疗后,血浆FIB及CRP浓度明显下降(P<0.01)。结论 CAP患者血浆FIB及CRP升高明显,与病情呈正相关,血浆FIB和CRP的变化可以作为评价疾病严重度和治疗效果的指标。     

Non-Thermal Atmospheric-Pressure Plasma Possible Application in Wound Healing

Non-thermal atmospheric-pressure plasma, also named cold plasma, is defined as a partly ionized gas. Therefore, it cannot be equated with plasma from blood; it is not biological in nature. Non-thermal atmospheric-pressure plasma is a new innovative approach in medicine not only for the treatment of wounds, but with a wide-range of other applications, as e.g. topical treatment of other skin diseases with microbial involvement or treatment of cancer diseases. This review emphasizes plasma effects on wound healing. Non-thermal atmospheric-pressure plasma can support wound healing by its antiseptic effects, by stimulation of proliferation and migration of wound relating skin cells, by activation or inhibition of integrin receptors on the cell surface or by its pro-angiogenic effect. We summarize the effects of plasma on eukaryotic cells, especially on keratinocytes in terms of viability, proliferation, DNA, adhesion molecules and angiogenesis together with the role of reactive oxygen species and other components of plasma. The outcome of first clinical trials regarding wound healing is pointed out.     

Chemotherapy regimens and treatment protocols for laryngeal cancer

Importance of the field: Laryngeal cancer has been the model of curative-intent organ-preserving therapies in clinical oncology. Although the optimal care of patients with laryngeal cancer is truly multidisciplinary, with progressive advances in surgical, radiation, and medical oncology, the development of effective systemic therapies has been a major component of the therapeutic arsenal against laryngeal cancer.

Areas covered in this review: This review will discuss the rapidly evolving roles of chemotherapy in the management of locally advanced and metastatic laryngeal cancer.

What the reader will gain: The reader will gain a historical perspective on this evolution in treatment and will appreciate current treatment challenges and promising future directions in optimizing therapeutic efficacy in functional larynx preservation and in patient survival.

Take home message: The treatment of most patients with laryngeal cancer with systemic therapy represents an opportunity to positively impact functional outcomes with an anatomically and functionally preserved larynx. Future challenges include identification of novel therapies and optimizing therapy protocols for individualized patient care.     

临床药师参与肿瘤科乳腺癌序贯辅助化疗的实践与分析

从临床药师角度分析1例早期乳腺癌患者保乳术后的病情特征、治疗原则,利用药学理论和循证药学,与医师共同讨论治疗方案,并对方案进行评价与调整,从入院到出院实施药物监护计划。临床药师通过病例跟踪分析,可以发现临床药物治疗中需注意的问题,提出合理建议。此举有利于与医护人员形成综合治疗团队。     

肿瘤科临床药师开展药学服务实践总结

目的:通过肿瘤科临床药师开展工作情况,探讨不同专科的临床药师在病区如何深入开展药学服务工作。方法:总结肿瘤科患者药物治疗特点,从患者最需要解决的问题着手,抓住癌性疼痛的处理及肿瘤患者的抗感染治疗,运用实例进行阐述。结果:临床药师对于药物治疗的干预,有效地减轻了癌症患者的疼痛,降低了药品不良反应发生率,促进了临床医师规范使用抗菌药物,提高了治疗效果。结论:总结专科药物治疗特点,着手患者最需要解决的问题是专科临床药师成功实施临床药学服务的重要有效途径。     

Review. Evidence-based complementary oncology. Innovative approaches to optimize standard therapy strategies

Cancer diseases demand diagnostic and therapeutic measures with proven quality, safety and efficacy. The basis for evaluation is clinical studies representing levels I or II (randomized controlled trials (RCT) or epidemiological cohort studies) in accordance with recommendations of the Centre for Evidence-based Medicine, University of Oxford, UK Regarding these claims, surgery, chemo-, radio- and hormone therapy have emerged as the gold standard in the treatment of carcinomas. These therapies have proven their cancer destructive potencies and their curative feasibilities, dependent on the particular cancer entity and stage. Complementary therapies are recommended to support and optimize the scientifically-based cancer standard treatment. Complementary medicine is currently widely debated by the oncological community, because the required scientific proof of safety and effectiveness for most of the therapeutic approaches has not yet been definitively provided. In the past years, basic research and clinical evaluation of defined complementary therapeutic concepts in oncology have been intensified in an attempt to integrate these procedures into evidence-based medicine. Scientifically-based therapies of complementary medicine cannot replace the well studied conventional cancer-destructive therapies such as surgery, chemo-, radio- or hormone therapy. Accordingly, they are by no means "alternative therapies". Complementary approaches in oncology that are recommended as additional to standard cancer destructive therapies claim to optimize this therapy. A great body of data emerging from scientifically sound clinical trials prove that defined complementary procedures are beneficial for the patients.     

人血高密度脂蛋白注射液的研制

目的探索人血高密度脂蛋白 (HDL)注射液的制备方法 ,并对该产品进行质量研究和初步稳定性试验 ,为预防和治疗动脉粥样硬化提供一种新药。方法采用低温乙醇法从经乙肝疫苗免疫的健康人血浆中分离、纯化并采取病毒灭活技术制成HDL注射液 ,同时拟订质量标准并进行检验。结果HDL注射液生产工艺路线合理 ,质量达到拟定标准要求。结论此法可制备出合格的HDL注射液 ,且适合于规模化生产     

ENALAPRIL DECREASES PLASMA NORADRENALINE LEVELS DURING THE COLD PRESSOR TEST IN HUMAN HYPERTENSIVES

1. The effects of the angiotensin-converting enzyme (ACE) inhibitor enalapril on the responses of blood pressure and plasma catecholamine levels to the cold pressor test in human hypertensives were examined. 2. Systolic and diastolic blood pressure decreased significantly after treatment with enalapril (5 mg/day for 4 weeks) as did the resting level of plasma noradrenaline. 3. The cold pressor test induced a rise in blood pressure and plasma noradrenaline levels. After 2 and 4 weeks enalapril treatment, the rises in the plasma noradrenaline level and systolic and diastolic pressure due to cold pressor test were reduced significantly. 4. These results suggest that ACE inhibition has a sympatho-inhibitory effect. One possible explanation is that enalapril reduces angiotensin II formation thus decreasing the activation of release-enhancing angiotensin II receptors on postganglionic sympathetic nerve endings.     

妇科肿瘤术后抗感染治疗的医药合作模式探索和实践

目的:梳理妇科肿瘤术后感染的主要类别以及医生与药师共同优化抗感染治疗的关键点。方法:针对医生与临床药师在妇科肿瘤术后抗感染治疗中进行合作的案例进行深入解析,并总结实践经验。结果:在卵巢癌患者术后发生盆腔淋巴囊肿合并感染、腹泻的案例中,医生对患者的感染和腹泻进行诊断、对淋巴囊肿施行切开引流术,临床药师协助医生调整抗菌药物、判断腹泻原因并对症处理;在宫颈癌术后盆腔感染的案例中,医生及时对患者进行扩张阴道残端、引流等外科操作,临床药师协助医生调整抗菌药物类别、对血药浓度进行监测、对药物剂量进行优化。结论:在妇科肿瘤患者术后抗感染治疗方面进行医药合作可以充分发挥医生和药师各自的专业优势,优化患者的治疗结局。     

Newly developed strategies for multifunctional mitochondria-targeted agents in cancer therapy

The development of multifunctional agents that could be used for simultaneous tumor targeting, imaging and treatment is a major goal in cancer research and is expected to contribute significantly to the realization of personalized oncology. Mitochondria are involved in diverse physiological activities and confer vital roles in cancer development and progression. Increasing efforts are being made to develop cancer treatment strategies based on various mitochondrial targets and novel mitochondrial drug delivery systems. Multifunctional nanostructures or multifunctional chemical compounds further broaden the current concept of tumor targeting and provide alternative solutions for mitochondrially targeted cancer therapy.     

Intravenous/oral sequential therapy in patients hospitalised with community-acquired pneumonia: which patients, when and what agents?

Cost and pharmacoeconomic aspects are becoming more and more important in antibacterial therapy. Nevertheless, antibacterial therapy is curative and initial use of the right antibacterial with high activity and low resistance rates against the relevant pathogens can help to save costs. A new trend in antibacterial therapy is sequential therapy (intravenous/oral) in hospitalised patients with moderate to severe infections. Large studies comparing intravenous therapy with sequential therapy (intravenous/oral) have shown equivalence in clinical and bacteriological outcome. One main indication investigated is community-acquired pneumonia (CAP). CAP requires prompt and effective antibacterial treatment and conventional therapy for patients hospitalised with CAP has typically been parenteral antibacterial therapy for 7 to 10 days. However, clinical evidence shows that in most patients the objective and subjective indicators of infection are substantially improved within the first 2 to 3 days of treatment. Today a large number of clinical trials in patients with CAP have been undertaken and sequential therapy with appropriate antibacterials used in suitable patients has been proven as a treatment option. This demonstrates pharmacoeconomic benefits without compromising antibacterial efficacy. Recommended antibacterials for intravenous/oral sequential therapy in patients with CAP are second- and third- generation cephalosporins, aminopenicillins plus a beta-lactamase inhibitor, and new fluoroquinolones.     

Lacosamide has protective disease modifying properties in experimental vincristine neuropathy

Pain and paresthesias are the most common symptoms of chemotherapy induced painful neuropathy (CIPN). Current treatment and preventive strategies of CIPN are ineffective, and the neuropathy may lead to discontinuation of anti-tumor therapy. Here we used experimental vincristine-induced neuropathy in rats to evaluate the disease modifying potential of lacosamide using a sustained release formulation and the acute treatment effects of a rapid release formulation. Pain behavior was assessed by withdrawal responses to von Frey hairs, acetone drops, the Randall-Selitto device, and to radiant heat. Neuropathy was assessed using electrophysiological recordings. Preventive lacosamide treatment (30 mg/kg subcutaneously b.i.d. for 17 days) was well tolerated, and pharmacokinetic analysis revealed a peak plasma concentration 2 h post-injection with a plasma half-life of approximately 3 h. Rats treated with lacosamide, in contrast to vehicle treated rats, did not develop vincristine-induced cold allodynia. Neurophysiology showed a delayed F-wave latency in vehicle treated rats, which was not present in lacosamide treated animals. We could thus demonstrate a protective disease modifying potency of lacosamide in an animal model of CIPN. Lacosamide may be a promising candidate for preventive treatment of CIPN in patients receiving chemotherapy with vinca alkaloids or platinum drugs.     

NP与CAP方案治疗晚期非小细胞肺癌临床观察

目的比较NP(去甲长春花碱、顺铂)和CAP(环磷酰胺、阿霉素、顺铂)联合化疗方案治疗晚期非小细胞肺癌(NSCLC)的近期疗效和毒副反应。方法统计分析72例接受NP或CAP方案联合化疗的晚期非小细胞肺癌患者的疗效和毒副反应,其中NP方案42例,CAP方案30例。结果NP组42例,有效19例,有效率为45.24%,CAP组30例,有效11例,有效率为36.67%,两者疗效无显著差异(P>0.05),两者毒副反应主要为骨髓抑制及恶心呕吐,均可耐受。结论NP和CAP方案治疗非小细胞肺癌疗效肯定,毒副反应可耐受,可作为一线治疗方案。     

紫杉醇作为一线药物在卵巢癌化疗中的应用

目的 探讨紫杉醇(安泰素)联合铂类药物(TP方案)和国产紫杉醇(紫素)联合铂类药物(PTP方案)以及环磷酰胺加铂类药物和阿霉素(CAP方案)作为一线药物治疗上皮性卵巢癌的疗效及毒性.方法 对1997年7月～2005年12月采用TP、PTP及CAP化疗方案作为一线药物治疗的64例卵巢癌患者进行回顾性分析.TP组27例、PTP组22例、CAP组15例.结果 TP组有效率为81.5%、PTP组有效率为63.6%、CAP有效率为53.3%.三组相比较,TP组和PTP组的一线用药有效率均高于CAP方案(P＜0.05).结论 TP和PTP作为一线用药的疗效均优于CAP,TP与PTP在疗效及副作用上无明显差异(P＜0.05).     

Treatment of community-acquired pneumonia in hospitalised patients

Community-acquired pneumonia (CAP) can be life-threatening. The prognosis is generally poorest in elderly patients and/or those with underlying chronic conditions, but fatalities can occur in all age groups. Current challenges in the clinical management of CAP are discussed, and the criteria for identifying those patients who should be treated in hospital with initial intravenous therapy are considered. Rapid initiation of therapy is important, using an agent that provides coverage against the most likely pathogens--Streptococcus pneumoniae and the atypical organisms. There is an increasing tendency to minimise the duration of intravenous therapy, with an early transition to oral therapy and the rapid return of the patient to the community. The efficacy of oral macrolides in the treatment of CAP is well established. Evidence for the use of intravenous azithromycin to provide effective and well-tolerated, first-line intervention in the hospitalized CAP patient is summarised.