三联疗法与序贯疗法根除长期服用非甾体类抗炎药人群幽门螺旋杆菌的疗效观察

目的 观察长期服用非甾体类抗炎药(NSAID)人群采用三联疗法与序贯疗法根除幽门螺旋杆菌(Hp)的疗效.方法 选取于2012年6月至2014年6月期间来我院接受治疗的84例感染Hp的患者作为研究对象.据随机数表法将患者分成观察组和对照组各42例,对照组患者采用三联疗法治疗,观察组患者则采用序贯疗法,观察两种不同治疗方式根除Hp感染的效果.结果 对照组患者治疗后Hp转阴率为76.20%,观察组为80.95%,两组比较差异无统计学意义(P>0.05).两组患者治疗后,对照组不良反应发生率为11.90%,观察组为9.52%,两组比较差异无统计学意义(P>0.05).对照组患者治疗后总有效率为71.43%,观察组为92.86%,两组比较差异有统计学意义(P<0.05).结论 序贯疗法能有效抑制幽门螺旋杆菌对非甾体药物产生耐药性,增强药物药效,同时降低非甾体药物对患者胃部黏膜损害,提高药物有效治愈率,值得广泛使用.     

卵巢微乳头交界性浆液性肿瘤一例及文献复习

卵巢微乳头型浆液性交界性肿瘤（micropapillary serous borderline tumor,MPSC）是卵巢癌中非常罕见的一种病理类型,这种肿瘤不显示破坏性浸润生长,但可能与恶性行为有关,与无微乳头状结构的浆液性病变相比,双侧肿瘤、表面受累的频率更高,且盆腹腔浸润性种植的发生率更高,相当于非浸润性低级别浆液性癌。到目前为止对于MPSC的治疗仍没有明确的诊治规范或指南,微乳头结构对浆液性交界性卵巢肿瘤患者预后的影响目前仍存在争议。结合我院收治的1例伴有腹腔非浸润性种植的MPSC患者,主要对此疾病的治疗加以探讨,已期提高临床医师对本病治疗的进一步认识。     

别嘌呤醇与溴敌隆的协同作用

目的观察别嘌呤醇与溴敌隆的协同作用及其是否可以改善溴敌隆的灭鼠性能。方法使用灌胃和饲喂2种方法观察小白鼠首次出现死亡的时间和摄食系数。结果首次出现死鼠时间，灌胃法：0．0058％溴敌隆为4d，00056％溴敌隆＋0．0058％别嘌呤醇为2d；饲喂法：0．005％溴敌隆为4d，0．002％～0．005％溴敌隆分别与0．04％和0．06％别嘌呤醇合用均为3d。适口性检测结果：0．005％溴敌隆组、0．002％溴敌隆＋0．04％别嘌呤醇组、0．002％溴敌隆＋0．06％别嘌呤醇组的摄食系数分别为1、0．92、1．49。结论别嘌呤醇可以改善溴敌隆的灭鼠性能，使首次出现死鼠的时间提前。当别嘌呤醇浓度大于0．06％时，可使摄食系数提高，     

Evaluation of blood pressure lowering effect by generic and brand-name antihypertensive drugs treatment: a multicenter prospective study in China

Background::Generic drugs are bioequivalent to their brand-name counterparts; however, concerns still exist regarding the effectiveness and safety of generic dr...     

萸黄连的炮制研究进展

萸黄连为“相反为制”改变饮片药性的代表性炮制品之一,首载于《韩氏医通》,炮制方法为吴茱萸汁与净黄连拌匀闷润后炒干即得,即通过吴茱萸制黄连在保留黄连泻火解毒功效的基础上降低了黄连的苦寒之性,使黄连寒而不滞,可清气分湿热,对肝气犯胃、呕吐吞酸等病症有良好疗效。作为相反为制、药汁制的代表品种,萸黄连饮片收录于2020年版《中华人民共和国药典》和多个地方炮制规范中,其炮制工艺研究及优选一直备受关注。现代研究表明,萸黄连除含有小檗碱、药根碱、巴马汀等黄连中的成分外,还含有吴茱萸碱、吴茱萸次碱、柠檬苦素等吴茱萸中的成分,具有抗炎、抗菌、抗肿瘤等药理活性。该文对近20年萸黄连相关的研究报道进行整理归纳,从萸黄连的炮制历史及工艺、药效药性、质量评价和临床应用等方面进行综述,发现萸黄连在各省市炮制规范收载的炮制方法及标准差异较大,主要涉及吴茱萸汁的制备方法、吴茱萸汁的用量和炮制终点的判断标准等方面;此外,不同研究期间萸黄连炮制前后主要成分的变化情况差异较大,推测与萸黄连的炮制工艺和质量标准不同有关。该综述可为完善萸黄连的质量评价体系提供参考。     

Point-of-care hepatitis C screening with direct access referral to improve linkage to care among halfway house residents: a pilot randomised study

INTRODUCTIONLinkage to care among individuals with substance misuse remains a barrier to the elimination of the hepatitis C virus (HCV). We aimed to determine whether point-of-care (PoC) education, screening and staging for liver disease with direct access to hospitals would improve linkage to care among this group.METHODSAll participants were offered PoC education and HCV screening. HCV-positive participants were randomised to standard care (controls) or direct access, which provided a direct pathway to hospitals. Linkage to care was determined by reviewing electronic medical records. Linkage of care cascade was defined as attendance at the specialist clinic, confirmation of viraemia by HCV RNA testing, discussion about HCV treatment and initiation of treatment.RESULTS351 halfway house residents were screened. The overall HCV prevalence was 30.5% (n = 107), with 69 residents in the control group and 38 in the direct access group. The direct access group had a significantly higher percentage of cases linked to specialist review for confirmatory RNA testing (63.2% vs. 40.6%, p = 0.025), HCV treatment discussion (p = 0.009) and treatment initiation (p = 0.01) compared to the controls. Overall, only 12.6% (n = 13) had treatment initiation during follow-up. PoC HCV screening with direct access referral had significantly higher linkage to HCV treatment initiation (adjusted odds ratio 9.13, p = 0.005) in multivariate analysis.CONCLUSIONPoC HCV screening with direct access improves linkage to care and simplifies the HCV care cascade, leading to improved treatment uptake. PoC education, screening, diagnosis and treatment may be an effective strategy to achieving HCV micro-elimination in this population.     

High-Throughput Screening of FDA-Approved Drug Library Reveals Ixazomib Is a Broad-Spectrum Antiviral Agent against Arboviruses

The emergence of significant arboviruses and their spillover transmission to humans represent a major threat to global public health. No approved drugs are available for the treatment of significant arboviruses in circulation today. The repurposing of clinically approved drugs is one of the most rapid and promising strategies in the identification of effective treatments for diseases caused by arboviruses. Here, we screened small-molecule compounds with anti-tick-borne encephalitis virus, West Nile virus, yellow fever virus and chikungunya virus activity from 2580 FDA-approved drugs. In total, 60 compounds showed antiviral efficacy against all four of the arboviruses in Huh7 cells. Among these compounds, ixazomib and ixazomib citrate (inhibitors of 20S proteasome β5) exerted antiviral effects at a low-micromolar concentration. The time-of-drug-addition assay suggested that ixazomib and ixazomib citrate disturbed multiple processes in viruses’ life cycles. Furthermore, ixazomib and ixazomib citrate potently inhibited chikungunya virus replication and relieved virus-induced footpad swelling in a mouse model. These results offer critical information which supports the role of ixazomib as a broad-spectrum agent against arboviruses.     

Can Radiotherapy Empower the Host Immune System to Counterattack Neoplastic Cells? A Systematic Review on Tumor Microenvironment Radiomodulation

Despite the rising evidence in favor of immunotherapy (IT), the treatment of oncological patients affected by so-called “cold tumors” still represents an open issue. Cold tumors are characterized by an immunosuppressive (so-called cold) tumor microenvironment (TME), which favors host immune system suppression, cancer immune-escape, and a worse response to IT. However, the TME is not a static element, but dynamically mutates and can be changed. Radiotherapy (RT) can modulate a cold microenvironment, rendering it better at tumor killing by priming the quiescent host immune system, with a consequent increase in immunotherapy response. The combination of TME radiomodulation and IT could therefore be a strategy for those patients affected by cold tumors, with limited or no response to IT. Thus, this review aims to provide an easy, rapid, and practical overview of how RT could convert the cold TME and why cold tumor radiomodulation could represent an interesting strategy in combination with IT.     

Factors Associated with Pneumocystis jirovecii Pneumonia in Patients with Rheumatoid Arthritis Receiving Methotrexate: A Single-center Retrospective Study

Objective To investigate the risk factors for the development of Pneumocystis jirovecii pneumonia (PCP) in patients with rheumatoid arthritis (RA) undergoing methotrexate (MTX) therapy. Methods This single-center retrospective cohort study included consecutive patients with RA who received MTX for at least one year. The study population was divided into PCP and non-PCP groups, depending on the development of PCP, and their characteristics were compared. We excluded patients who received biologic disease-modifying anti-rheumatic drugs (DMARDs), Janus kinase inhibitors, and anti-PCP drugs for prophylaxis. Results Thirteen patients developed PCP, and 333 did not develop PCP. At the initiation of MTX therapy, the PCP group had lower serum albumin levels, a higher frequency of pulmonary disease and administration of DMARDs, and received a higher dosage of prednisolone (PSL) than the non-PCP group. A multivariate Cox regression analysis revealed that the concomitant use of PSL [hazard ratio (HR) 5.50, p=0.003], other DMARDs (HR 5.98, p=0.002), and serum albumin <3.5 mg/dL (HR 4.30, p=0.01) were risk factors for the development of PCP during MTX therapy. Patients with these risk factors had a significantly higher cumulative probability of developing PCP than patients who lacked these risk factors. Conclusion Clinicians should pay close attention to patients with RA who possess risk factors for the development of PCP during MTX therapy.