A comparative study to evaluate the effect of various postoperative treatment protocols on dry eye and patient satisfaction after phacoemulsification

Purpose: Foreign body sensation and irritation are common after cataract surgery, as is the exacerbation of dry eye disease if present. This study compared postoperative dry eye treatments and patient satisfaction. Methods: Age-related cataract patients undergoing phacoemulsification were recruited and were divided randomly into 4 postoperative treatment groups: Group A: Antibiotic + Steroids; Group B: Antibiotic + Steroids + Mydriatic; Group C: Antibiotic + Steroids + Mydriatic + Non-steroidal Ant- inflammatory drugs (NSAIDs); Group D: Antibiotic + Steroids + Mydriatic + NSAID + Tear substitute. Patients were assessed at 1, 3, and 5 weeks post-operatively for uncorrected distance and near vision, best corrected visual acuity (BCVA) for distance and near, Schirmer’s-1 test, and Tear Film Break-Up Time test. At each visit, patients were assessed for dry eye-related subjective parameters using Ocular Surface Disease Index questionnaire. Results: Study participants numbered 163. (87 male and 76 female patients). No statistically significant difference was present in visual acuity for near and distance. The mean values of Schirmer’s test and TFBUT were better in group D patients at each postoperative visit, with significant differences noted in comparison with other groups. The patient response to pain and dry eye symptoms was superior in groups C and D, with group D producing the best results. Compared to group A, patients in groups C and D were more satisfied with their vision and surgery. Conclusion: The addition of tear substitutes to steroids and NSAIDs has been associated with decreased dry eye-related symptoms and a better subjective feeling of vision, although no significant difference was noted in vision measured objectively

Pharmacokinetics/pharmacodynamics-guided rational application of antibiotics / 中国小儿急救医学

Pharmacokinetics/pharmacodynamics study fully considers the relationship among pathogens, hosts and drugs, which reflects the relationship between bactericidal effects and adverse drug reactions and the change of drug concentrations, which is of much value to the rational use of antimicrobial agents and delaying antimicrobial resistance.This review discussed design and optimization of dosing regimens for anti-infective therapy base on theory of pharmacokinetics/pharmacodynamics.

Efficacy and safety of secukinumab in patients with psoriatic arthritis: A meta-analysis of different dosing regimens

The appropriate dosing regimens of secukinumab for psoriatic arthritis (PsA) are not well defined. We performed a meta-analysis to evaluate the efficacy and safety of different dosing regimens of secukinumab in the treatment of PsA. A systematic search was conducted using major electronic databases to identify relevant randomized controlled trials (RCTs) comparing secukinumab 300 mg versus secukinumab 150 mg in patients with PsA. Meta-analysis was performed using Review Manager software (version 5.3). Six studies with a total of 1141 patients were included. At week 24, secukinumab 300 mg was associated with a higher American College of Rheumatology 20% response (ACR 20), ACR 50, PASI 75 response rate, and dactylitis resolution rate than secukinumab 150 mg, especially in the anti-TNF-IR subgroup. At week 52, secukinumab 300 mg was associated with a higher psoriasis area and severity index (PASI) 75 and PASI 90 response rate than secukinumab 150 mg. There was no significant difference between secukinumab 300 mg and secukinumab 150 mg in the risk of any adverse events (AEs) and serious AEs at either week 24 or week 52. Secukinumab 300 mg was significantly more effective than 150 mg, especially for patients with PsA who have failed TNF therapy, and it was well tolerated.

Impact of antitumor regimens on the outcomes of cancer patients with COVID-19: a pooled analysis / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Since the outbreak of coronavirus disease 2019 (COVID-19), which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) discovered in December 2019, the disease has emerged as a global pandemic (Shi et al., 2020; World Health Organization, 2020). Several studies have shown a higher incidence of COVID-19, as well as related poor outcomes in patients with malignancies as compared with those without them (Liang et al., 2020; Tian et al., 2020). The impact of cancer on COVID-19 may be attri‑buted to the use of antitumor treatments that may disturb the host response to SARS-CoV-2 infection (Wang et al., 2020), while the current studies on this topic have drawn controversial conclusions. Some implied that anticancer treatments might elevate the risk of death (García-Suárez et al., 2020; Liu et al., 2020). On the contrary, others pointed out that this association is not significant (Brar et al., 2020; Lee et al., 2020a). Although previous systematic reviews have investigated this important issue (Wang and Huang, 2020), the heterogeneity of findings is obvious and the general conclusion has remained unclear. Considering this ambiguity, it is difficult for clinicians to make therapeutic decisions when facing patients with both cancer and COVID-19; therefore, a high-quality and accurate evaluation of the impact of anticancer treatments on COVID-19 patients is necessary. Accordingly, we conducted a pooled analysis with the original data of each patient for the first time to provide a comprehensive perspective into the association between anticancer regimens and the outcomes of cancer patients with COVID-19.

Feeding ecology of blue rock pigeon (Columba livia) in the three districts of Punjab, Pakistan / Ecologia de alimentação do pombo-da-rocha-azul (Columba livia) nos três distritos de Punjab, Paquistão

Abstract Present paper provides information on the feeding regimens of the two genders of the blue-rock pigeon (Columba livia Linn.) in the sampled habitats of the three districts viz. Rawalpindi, Faisalabad and Bahawalpur of the Punjab province, Pakistan. This feral pigeon, considered ubiquitous species, inhabits both the grasslands and clumped environments to establish their roosts and nests. The study explored about comparable feeding proportions from three major habitats of the pigeons which were captured with medium sized mist-nets. For Rawalpindi in the winter season, the Zea mays was one of the predominant food item (30.6%) for males, and other ranked major food contents were (26.7%, 22.4% and 20.2%), and fairly similar feeding proportions were also recorded for the females (50.4%, 33.3%, 36.4% and 23.9%) for Carthamus oxyacantha, Hordeum vulgare, Triticum aestivum and Zea mays respectively. Evidently, no significant deviations in the existing food crops for the three sites for the feral pigeon were detected, which strongly suggested that the, modes of feeding habits among the sustainable roosts and nests which were closely located to food crops, exerted negligible impacts during intermittent pigeon foraging movements in the diurnal conditions.

Resumo O presente artigo fornece informações sobre os regimes de alimentação dos dois sexos do pombo-da-rocha-azul (Columba livia Linn.) nos habitats amostrados dos três distritos, a saber: Rawalpindi, Faisalabad e Bahawalpur, da província de Punjab, Paquistão. Este pombo-doméstico, considerado espécie onipresente, habita tanto as pastagens quanto os ambientes agrupados para estabelecer seus poleiros e ninhos. O estudo explorou proporções comparáveis ​​de alimentação de três grandes habitats dos pombos que foram capturados com redes de neblina de tamanho médio. Para Rawalpindi no inverno, Zea mays foi um dos itens alimentares predominantes (30,6%) para os machos, e outros alimentos classificados como principais foram (26,7%; 22,4% e 20,2%), e proporções bastante semelhantes foram registradas para as fêmeas (50,4%, 33,3%, 36,4% e 23,9%) para Carthamus oxyacantha, Hordeum vulgare, Triticum aestivum e Zea mays, respectivamente. Evidentemente, não foram detectados desvios significativos nas culturas alimentares existentes nos três locais para o pombo-doméstico, sugerindo fortemente que os modos de alimentação entre os poleiros e ninhos sustentáveis, que estavam estreitamente localizados em culturas alimentares, exerceram impactos não significativos durante os períodos intermitentes dos movimentos de forrageamento dos pombos-domésticos nas condições diurnas.

Review On Wound Healing Therapeutic Regimens In Ayurveda

Wound healing is type of tissue repair involving number of processes. These processes influenced by both systemic factors and local factors. Nutrition, metabolic status, circulatory status, hormone levels are the main systemic factors which influence wound healing. In addition to these, infection, mechanical factors, foreign bodies, size, location and type of wound are also influence the wound healing process. Various kinds of complications are occurred when wound is not properly healed. In Ayurveda, the term Vrana is equated to wound of modern parlance and the drugs having both Vranashodhana (wound cleansing) and Vranaropana (wound healing) properties play an important role in wound management. Considering this, single and compound formulations having Vranashodhana and Vranaropana properties are compiled from classical texts and compendia. Clinical trials on wound management through are Ayurvedic drugs/regimen reviewed and presented.

A Summary of Health Preserving Thoughts of Confucianism, Buddhism, Taoism and Medicine (Ⅰ) / 中国实验方剂学杂志

Traditional health preservation thoughts of four major schools (Confucianism, Buddhism, Taoism and medicine) were systematically summarized. The proposed health-preserving ideas of physical health maintenance by Confucianism (self-cultivation, moderation and harmony), mental health maintenance by Buddhism (keeping still and in deep meditation, insight, kindness and help), health preservation by Taoism (following the nature, enhancing spirit and energy) and life protecting by medicine (dredging collaterals, Qi and blood, possessing both the form and the spirit), and the health-preserving methods under the guidance of such ideas have important guiding value for current industry of traditional health care.

Salvage treatment for refractory or relapsed acute myeloid leukemia: a 10-year single-center experience

OBJECTIVES: The outcomes of refractory and relapsed acute myeloid leukemia (AML) patients in developing countries are underreported, even though the similar classic regimens are widely used. METHODS: We conducted a retrospective comparison of "MEC" (mitoxantrone, etoposide, and cytarabine) and "FLAG-IDA" (fludarabine, cytarabine, idarubicin, and filgrastim) in adults with first relapse or refractory AML. RESULTS: In total, 60 patients were included, of which 28 patients received MEC and 32 received FLAG-IDA. A complete response (CR) rate of 48.3% was observed. Of the included patients, 16 (27%) died before undergoing bone marrow assessment. No statiscally significant difference in CR rate was found between the two protocols (p=0.447). The median survival in the total cohort was 4 months, with a 3-year overall survival (OS) rate of 9.7%. In a multivariable model including age, fms-like tyrosine kinase 3 (FLT3) status, and stem-cell transplantation (SCT), only the last two indicators remained significant: FLT3-ITD mutation (hazard ratio [HR]=4.6, p<0.001) and SCT (HR=0.43, p=0.01). CONCLUSION: In our analysis, there were no significant differences between the chosen regimens. High rates of early toxicity were found, emphasizing the role of supportive care and judicious selection of patients who are eligible for intensive salvage therapy in this setting. The FLT3-ITD mutation and SCT remained significant factors for survival in our study, in line with the results of previous studies.

Role of long-acting insulin analogues in the management of type 1 diabetes in children and adolescent / 中华内分泌代谢杂志

A recent national wide epidemiological study showed that the incidence of type 1 diabetes mellitus ( T1DM) was increased among children and adolescents in China. However, the glycemic control was not optimal, leading to high incidence of complications. Previous studies demonstrated that inappropriate insulin regimen was a major cause of sub-optimal glycemic control. Basal-bolus regimen recommended by international pediatric guidelines, significantly improved glycemic control with increased hypoglycemia risk. Given that basal insulin largely contributed to efficacy and safety profiles of base-bolus regimen, long-acting insulin analogues, such as insulin glargine ( 100U) , have ideal efficacy, safety profiles, especially lower hypoglycemia risk compared with neutral protamine Hagedorn ( NPH) . Therefore,long-acting insulin analogues is a good choice for basal-bolus regimen treatment in children and adolescents with T1DM.

Pharmacokinetics/Pharmacodynamics models of veterinary antimicrobial agents

Misuse and abuse of veterinary antimicrobial agents have led to an alarming increase in bacterial resistance, clinical treatment failure, and drug residues. To address these problems, consistent and appropriate dosage regimens for veterinary antimicrobial agents are needed. Pharmacokinetics/Pharmacodynamics (PK/PD) models have been widely used to establish rational dosage regimens for veterinary antimicrobial agents that can achieve effective prevention and treatment of bacterial diseases and avoid the development of bacterial resistance. This review introduces building methods for PK/PD models and describes current PK/PD research progress toward rational dosage regimens for veterinary antimicrobial agents. Finally, the challenges and prospects of PK/PD models in the design of dosage regimens for veterinary antimicrobial agents are reviewed. This review will help to increase awareness of PK/PD modeling among veterinarians and hopefully promote its development and future use.

The evaluation of immunosuppressive regimens in kidney transplant Mongolian recipients / Эрүүл мэндийн лаборатори

Background@#However kidney transplantation has being performed in Mongolia since 2006, because of pre-transplant sensitization, ABO incompatibility, hepatitis B and C virus activation many patients are taken kidney transplantation in abroad. The transplantation centers use own immunosuppressive regimens.@*Objective@#Our aim was to assess the immunosuppressive regimens efficacy and toxicity in kidney transplant Mongolian recipients.@*Methods@#We analyzed data from 96 adult kidney transplant recipients who had taken kidney transplantation in different transplant centers from August 2006 through January 2014. There were 3 kinds of regimens Group I Simulect induction with standard triple /FK506/CyA+MMF/AZA+steroid/, Group II Campath-1H induction with CNI monotherapy and Group III Campath-1H induction with standard triple /FK506/CyA+MMF/AZA+steroid/. We retrospectively collected the post-transplant first two years serum creatinine. The study was performed in 2014. The questionnaire was taken and blood samples collected for determination of tacrolimus through level and for other laboratory tests. The primary end point was the first two years serum creatinine, the secondary end points included rejection episodes, blood through level of tacrolimus and some laboratory findings. @*Results@#The post-transplant first two years serum creatinine levels were significantly different in 3 groups. Group III showed similar results compared to Group I. There was not enough data of biopsy proven acute rejection episodes however group II said more rejections occurred. However participants said that rejection occurred in 15 (15.6%) biopsy was done only 3 (3.1%) cases. Blood through level of tacrolimus was significantly different in three groups. Some laboratory findings showed different between three groups. @*Conclusions@#A regimen of Campath-1H induction with CNI monotherapy (Group II) may be advantageous for short-term renal function and cost effective but there were more rejection complications and increased creatinine. The regimen of Campath-1H induction 11 with standard triple (Group III) may be advantageous for long-term renal function, allograft survival, but there should consider about infection complications and polycythemia. Simulect induction with standard triple could be best choice but transplantations were performed in experienced centers. The study enrolled few cases and cases which were performed at the beginning of transplant program so many things could influence on the result. The study was compared beginner transplant center with experienced centers. Longitudinal cohort study needed in the future.

Use of modified Richards model to predict isothermal and non-isothermal microbial growth

Abstract Mathematical models are often used to predict microbial growth in food products. An important class of these models involves the adaptation of classical sigmoid functions, such as the Gompertz and logistic functions. This study aimed to validate the use of the modified Richards model in various situations, which have not previously been tested. The model was obtained through solving a system of two differential equations and could be applied to both isothermal and non-isothermal environments. To test and validate this model, we used published datasets containing data for the growth of Pseudomonas spp. in fish products. The results obtained after fitting the model showed that it could be effectively used to describe and predict the Pseudomonas growth curves under various temperature regimens. However, the influence of the shape parameter on the growth curve is an issue that needs further evaluation.

Pattern of management of febrile neutropenia among breast cancer patients treated with different chemotherapeutic regimens

Background: Breast cancer is one of the common malignancies in females. Chemotherapy with Adriamycin and Cyclophosphamide (AC) followed by the Docetaxel (AC-T, Regimen-I), AC followed by Docetaxel and Carboplatin (AC-T+Cr, Regimen-II) and AC followed by Docetaxel and Trastuzumab (AC-T+Tr, Regimen-III) are commonly given for treatment. These cause myelosuppression and febrile neutropenia and need necessary interventions.Methods: This is a prospective open labelled observational comparative study to evaluate the antibiotic usage needed to treat sepsis following febrile neutropenia among breast cancer patients undergoing chemotherapy with regimen I, II and III. All patients received prophylactic Pegfilgrastim / Filgrastim. Antibiotics used and days in intensive care unit (ICU) in all the 8 cycles of chemotherapy were recorded. 38 patients in Regimen I, 40 patients in Regimen II and 46 patients in Regimen III completed the study and were included in the statistical analysis.Results: In regimen II, following cycle 2 of chemotherapy, none of the patients needed antibiotic therapy. Antibiotic use was maximum, following cycle 1of chemotherapy in regimen I and III, maximum number of antibiotics prescribed were 7. Number of days of ICU care needed for regimen II patients following 3rd cycle of chemotherapy was 3.5±3.5 days. No ICU care was needed for regimen III patients, following cycles 2, 3 and for regimen II following cycle 7.Conclusions: Febrile neutropenia produced by chemotherapy were effectively treated with intravenous antibiotics in ICU for an average of 2-3 days. No mortality was associated with febrile neutropenia and all patients were recovered.

Pulsed Versus Continuous Cyclosporine Regimens for Maintenance Therapy in Psoriasis: A Comparative Study / 대한피부과학회지

BACKGROUND: Psoriasis is a chronic recurrent disease requiring long-term treatment; therefore, special attention is warranted when prescribing cyclosporine A (CsA) for patients diagnosed with psoriasis. Various forms of maintenance therapy have been suggested to reduce the incidence of adverse events associated with CsA use. OBJECTIVE: We aimed to compare the efficacy and safety of the three aforementioned CsA therapies for management of patients with psoriasis. METHODS: Patients fulfilling our selection criteria were selected for the study. CsA therapy (2.5∼5 mg/kg/day) was administered for 12 weeks, and patients who showed remission following this treatment were administered maintenance therapy. Patients with successful induction of response were randomly assigned to three treatment groups. Group A was the continuous regimen group (2∼3 mg/kg/day). Group B was the pulsed regimen group (4 mg/kg/day for 4 days, 3 days of discontinuation). Group C was the weekend regimen group (5 mg/kg/day for 2 days, 5 days of discontinuation). Patients were followed up on an outpatient basis at 4-week intervals to monitor treatment effects. RESULTS: In each group, the Psoriasis Area and Severity Index (PASI) and body surface area (BSA) values decreased in a similar fashion from visit 1 to visit 4 and at the time of the final visit 7. In each group, dermatology life quality index (DLQI) values showed statistically significant differences between pre- and post-treatment states; however, no inter-group differences were observed. Although adverse events such as elevated blood pressure and serum creatinine levels were slightly higher in the intermittent group, there was no significant inter-group difference. CONCLUSION: The pulsed regimen did not show a major difference in treatment effects compared to the everyday use group. We propose that the patient's age, presence of underlying diseases, lifestyle patterns, and convenience of use should be considered while determining the type of regimen administered to a patient.

Feeding ecology of blue rock pigeon (Columba livia) in the three districts of Punjab, Pakistan

Abstract Present paper provides information on the feeding regimens of the two genders of the blue-rock pigeon (Columba livia Linn.) in the sampled habitats of the three districts viz. Rawalpindi, Faisalabad and Bahawalpur of the Punjab province, Pakistan. This feral pigeon, considered ubiquitous species, inhabits both the grasslands and clumped environments to establish their roosts and nests. The study explored about comparable feeding proportions from three major habitats of the pigeons which were captured with medium sized mist-nets. For Rawalpindi in the winter season, the Zea mays was one of the predominant food item (30.6%) for males, and other ranked major food contents were (26.7%, 22.4% and 20.2%), and fairly similar feeding proportions were also recorded for the females (50.4%, 33.3%, 36.4% and 23.9%) for Carthamus oxyacantha, Hordeum vulgare, Triticum aestivum and Zea mays respectively. Evidently, no significant deviations in the existing food crops for the three sites for the feral pigeon were detected, which strongly suggested that the, modes of feeding habits among the sustainable roosts and nests which were closely located to food crops, exerted negligible impacts during intermittent pigeon foraging movements in the diurnal conditions.

Resumo O presente artigo fornece informações sobre os regimes de alimentação dos dois sexos do pombo-da-rocha-azul (Columba livia Linn.) nos habitats amostrados dos três distritos, a saber: Rawalpindi, Faisalabad e Bahawalpur, da província de Punjab, Paquistão. Este pombo-doméstico, considerado espécie onipresente, habita tanto as pastagens quanto os ambientes agrupados para estabelecer seus poleiros e ninhos. O estudo explorou proporções comparáveis de alimentação de três grandes habitats dos pombos que foram capturados com redes de neblina de tamanho médio. Para Rawalpindi no inverno, Zea mays foi um dos itens alimentares predominantes (30,6%) para os machos, e outros alimentos classificados como principais foram (26,7%; 22,4% e 20,2%), e proporções bastante semelhantes foram registradas para as fêmeas (50,4%, 33,3%, 36,4% e 23,9%) para Carthamus oxyacantha, Hordeum vulgare, Triticum aestivum e Zea mays, respectivamente. Evidentemente, não foram detectados desvios significativos nas culturas alimentares existentes nos três locais para o pombo-doméstico, sugerindo fortemente que os modos de alimentação entre os poleiros e ninhos sustentáveis, que estavam estreitamente localizados em culturas alimentares, exerceram impactos não significativos durante os períodos intermitentes dos movimentos de forrageamento dos pombos-domésticos nas condições diurnas.

Clinical Dosage Regimens of Voriconazole Evaluated by Monte Carlo Simulation / 中国药房

OBJECTIVE:To provide reference for clinical individual medication of voriconatole. METHODS:The distribution of MIC of voriconazole to Aspergillus fumigatus and Candida albicans were summarized as well as the pharmacokinetic parameters of voriconazole in different populations. Using probability of target attainment(PTA)and cumulative fraction of response(CFR)as indexes,crystal ball software 11.1.2.4 was used for Monte Carlo simulation of different dosage regimens of same population and same dosage regimen of different populations. RESULTS:For children with impaired immunity,when the drug doses of were 4,6 mg/kg and MIC was lower than 0.125 mg/L,PTA was higher than 90%;when the drug doses was increased to 8 mg/kg and MIC was lower than 0.125 mg/L,PTA was higher than 90%. For different populations receiving same dosage regimens(4 mg/kg),MIC of teenagers with impaired immunity was lower than 0.25 mg/L and those of healthy adults,patients underwent hematopoietic stem cell transplantation and adults with impaired immunity were all lower than 0.5 mg/L,PTA was higher than 90%. CFR to A. fumigatus were 42.53%,58.41%,77.74%,70.16%,89.40%,93.72%,95.42% and CFR to C. albicans were 96.68%,97.13%,97.94%, 97.54%,98.07%,98.28%,98.35%among children with impaired immunity receiving different drug doses(4,6,8 mg/kg)and dif-ferent populations receiving drug dose of 4 mg/kg(teenagers with impaired immunity,healthy adults,patients underwent hemato-poietic stem cell transplantation,adults with impaired immunity). CONCLUSIONS:Various dosage regimens of different popula-tions included in this study could effectively control C. albicans infection. It is necessary to increase the drug dose of children and teenagers with impaired immunity in order to meet the needs of A. fumigatus infection treatment.

Effects of Different Regimens of Tranexamic Acid on Perioperative Bleeding and Postoperative Compliance of Simultaneous Bilateral Total Knee Arthroplasty / 中国药房

OBJECTIVE:To observe the effects of different regimens of tranexamic acid on perioperative bleeding and postoper-ative compliance of simultaneous bilateral total knee arthroplasty(TKA). METHODS:A total of 70 patients undergoing simultane-ous bilateral TKA in our hospital were randomly divided into control group and observation group,with 35 cases in each group. Control group was given Tranexamic acid injection 15 mg/kg 30 min before surgery. Observation group was given Tranexamic acid injection 15 mg/kg,30 min before surgery and 30 min before suturing incision. The operation duration,total blood loss,intraopera-tive blood loss,postoperative drainage as well as the levels of FIB,PT,APTT before trectment and 3 d after surgery,the occur-rence of postoperative compliance and ADR were observed and compared between 2 groups. RESULTS:There was no statistical significance in operation duration,intraoperative blood loss and rate of ADR between 2 groups (P>0.05). The total blood loss, postoperative drainage and the incidence of complications of observation group were significantly lower than those of control group,with statistical significance(P0.05). CONCLUSIONS:The application of tranexamic acid 30 min before simultaneous bilateral TKA and 30 min before the end of surgery can reduce perioperative bleeding and postoperative venous thromboembolism with good safety.

Efficacy and prognostic analysis of ICE regimen for 84 patients with relapsed/refractory diffuse large B-cell lymphoma / 上海交通大学学报（医学版）

Objective · To evaluate the efficacy and prognostic factors of ifosfamide-cisplatin-etoposide (ICE) chemotherapy as salvage regimen for patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL).Methods · A retrospective analysis was performed on 84 relapsed/refractory DLBCL patients who were treated with ICE salvage regimen at Ruijin Hospital (Shanghai Jiao Tong University School of Medicine,China) from July 2004 to June 2016.Overall survival (OS) was analyzed by Kaplan-Meier method and multivariate Cox proportional hazards models.Results· Of the 84 patients who were treated with ICE regimen,37 (44.0％) patients had responses,including 26 (31.0％) achieving complete remission.The median number of cycles per patient was 3 (range 1-6 cycles).The 1-year and 2-year OS rates were 49.5％ and 30.0％,respectively.The median OS time was 12.2 months.On univariate analysis,patients with early progression/recurrence (P=0.041) and a high-intermediate/high risk according to the international prognostic index (IPI) (P=0.024) and NCCN-IPI (P=0.002) had poorer outcomes.While improved outcome was found in patients in complete remission after chemotherapy (P=0.000).The multivariate analysis revealed that the intermediate-high/high risk according to NCCN-IPI was an independent risk factor,and remission after chemotherapy was an independent prognostic factor for prolonging survival.Conclusion· The ICE regimen can be used as an effective salvage therapy for patients with relapsed/refractory DLBCL.

Effectiveness of Triple Therapy Regimens in the Eradication of Helicobacter Pylori in Patients with Uninvestigated Dyspepsia in Ekiti State, Nigeria.

Aim and Objective: The term dyspepsia has been used inconsistently by healthcare professionals to describe different patterns of upper gastrointestinal symptoms. It denotes a symptom and does not itself represent a disease. In this study, we seek to determine the effectiveness of common triple therapy regimens in use in the eradication of H. pylori in this environment and to compare it what is obtained worldwide. Materials and Methods: One hundred and four Consecutive adult patients, aged 18 to 50 years presenting newly with uninvestigated dyspepsia and without alarm symptoms at General Outpatient Clinics of the Ekiti State University Teaching Hospital, Ado-Ekiti and the Federal Medical Centre, Ido-Ekiti, Nigeria were randomized into five treatment groups in the study. Approval was obtained from Ethical Committees of the two study centres. Treatment outcome was computed using frequency table. Results: The mean age of the studied population was 37.8±12.98 years. 32.7% were males while 67.3% were females. Most prevalent symptom for uninvestigated dyspepsia was abdominal discomfort 100 (96.2%), this was followed by early satiety, abdominal fullness and vomiting with 32 (30.8%), 26 (25%) and 13 (12.5%) of the participants respectively. 76.0% were positive for H. pylori infection by Urea Breath Test Heliprobe® System with highest prevalence of H. Pylori infection within age group 31-45 years (36.7%). Rabeprazole-Clarithromycin-Metronidazole group (RCM) had the highest eradication rate per protocol [77.8%], followed in descending order by Rabeprazole-Amoxil- Levofloxacin group (RAL) [53.3%], Omeprazole-Tinidazole-Clarithromycin “ulcer kit” (OTC) [44.4%], Rabeprazole-Amoxil- Metronidazole group (RAM) [44.4%] and Rabeprazole-Amoxil-Clarithromycin (RAC) [30.0%]. Conclusion: This study showed there is difference in eradication rates of popularly known triple therapy regimens. This may be due to geographical differences in antibiotics resistant pattern to H. pylori. Further study is suggested to find out the national sensitivity pattern to the commonly used triple therapy regimens in Nigeria.

The evaluation of immunosuppressive regimens in kidney transplant Mongolian recipients / Эрүүл мэндийн лаборатори

Background:However kidney transplantation has being performed in Mongolia since 2006, because of pre-transplant ensitization, ABO incompatibility, hepatitis B and C virus activation many patients are taken kidney transplantation in abroad. The transplantation centers use own immunosuppressive regimens.Objective:Our aim was to assess the immunosuppressive regimens efficacy and toxicity in kidney transplant Mongolian recipients.Material and Methods:We analyzed data from 96 adult kidney transplant recipients who had taken kidney transplantation in different transplant centers from August 2006 through January 2014. There were 3 kinds of regimens Group I Simulect induction with standard triple /FK506/CyA+MMF/AZA+steroid/, Group II Campath-1H induction with CNI monotherapy and Group III Campath-1H induction with standard triple /FK506/CyA+MMF/AZA+steroid/. We retrospectively collected the post-transplant first two year serum creatinine. The study was performed in 2014. The questionnaire was taken and blood samples collected for determination of tacrolimus through level and for other laboratory tests. The primary end point was the first two years serum creatinine, the secondary end points included rejection episodes, blood through level of tacrolimus and some laboratory findings.Results:The post-transplant first two years serum creatinine levels were significantly different in 3 groups. Group III showed similar results compared to Group I. There was not enough data of biopsy proven acute rejection episodes however group II said more rejections occurred. However participants said that rejection occurred in 15 (15.6%) biopsy was done only 3 (3.1%) cases. Blood through level of tacrolimus was significantly different in three groups. Some laboratory findings showed different between three groups.Conclusion:A regimen of Campath-1H induction with CNI monotherapy (Group II) may be advantageous for short-term renal function and cost effective but there were more rejection complications and increased creatinine. The regimen of Campath-1H induction with standard triple (Group III) may be advantageous for long-term renal function, allograft survival, but there should consider about infection complications and polycythemia. Simulect induction with standard triple could be best choice but transplantations were performed in experienced centers. The study enrolled few cases and cases which were performed at the beginning of transplant program so many things could influence on the result. The study was compared beginner transplant center with experienced centers. Longitudinal cohort study needed in the future.