Drug selection for simultaneous treatment of tuberculosis combined with hepatitis C virus infection / 中华肝脏病杂志

Clinically, patients with tuberculosis (TB) combined with hepatitis C virus (HCV) infection often require simultaneous treatment. Consequently, when anti-HCV and TB drugs are used in combination drug-drug interactions (DDIs), anti-TB drug-induced hepatotoxicity, and liver disease states need to be considered. This paper focuses on discussing the metabolic mechanisms of commonly used anti-TB and HCV drugs and the selection options of combined drugs, so as to provide rational drug use for TB patients combined with HCV infection.

Discussion on the treatment of 106 cases of Kaposiform hemagioendothelioma / 中华整形外科杂志

Objective@#To compare the curative effect of non-surgical treatment, early operation and advanced operation on the Kaposiform hemagioendothelioma (KHE). To explore the optimal treatment for KHE.@*Methods@#The 106 cases of KHE patients admitted by our hospital from January 2004 to December 2016 were selected as the study subjects. The age is the minimum 1d and the maximum 43 years, median age 94.5 d. According to different treatment methods, they were divided into non-surgical treatment and surgical treatment: according to the onset of the disease and the day of the operation, the early operation was performed less than three months since the onset of the disease, and the advanced operation more than 3 months. Efficacy evaluation criteria: The recovery meant that the tumor disappeared or mostly disappeared, the platelets returned to normal, and there was no recurrence more than half a year after treatment. " Effective" indicated that tumors were shrunken significantly and the platelet counting rose significantly. " Ineffective" indicated that the tumor was not shrunken or continued to increase and platelet counting did not rise or continued to decrease.The three groups of patients were followed up, and the efficacy of the three groups after treatment and the changes of platelet counting before and after treatment on day 1, 7 and 14 were compared. The two groups of early and late treatment were compared for operative and postoperative conditions.@*Results@#All patients were followed up for 6-23 months, 24 cases were effective, 12 cases were ineffective, and 5 cases died. After 7 days of treatment, the platelet counting of the three groups were 68 (31, 157)×109/L in the non-surgical treatment group, (294.75±150.59)×109/L in the early operation group, (221.48±148.71)×109/L in the late operation group, with statistical significance (P < 0.05). After 14 days of treatment, the platelet counting of the three groups were 78 (25.51, 54.5) in the non-surgical treatment group, 281 (234, 356)×109/L in the early operation group, and in the late operation group (219.67±140.95)×109/L, with statistical significance (P < 0.05). After at least half a year of follow-up, the total effective rate of clinical efficacy in the three groups was the non-surgical treatment group 62.07%, the early operation group 96.34% and the late operation group 81.82%; the difference was statistically significant between two groups (P < 0.05); There was significant difference between the early operation group and the late operation group in the amount of bleeding and operation time, the time of platelet counting and the total hospitalization time (P< 0.05).@*Conclusions@#Early surgical treatment of Kaposiform hemangioendothelioma is superior to late-operative and non-surgical treatment.Surgical treatment will be the preferred option for treatment of Kaposiform hemangioendothelioma, and examinations should be operated to potential patients for early diagnosis.

Weathering the storm: COVID-19 infection in patients with hematological malignancies / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

The Coronavirus disease 2019 (COVID-19) is an emerging infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Within a matter of months, this highly contagious novel virus has led to a global outbreak and is still spreading rapidly across continents. In patients with COVID-19, underlying chronic diseases and comorbidities are associated with dismal treatment outcomes. Owing to their immunosuppressive status, patients with hematological malignancies (HMs) are at an increased risk of infection and have a worse prognosis than patients without HMs. Accordingly, intensive attention should be paid to this cohort. In this review, we summarize and analyze specific clinical manifestations for patients with coexisting COVID-19 and HMs. Furthermore, we briefly describe customized management strategies and interventions for this susceptible cohort. This review is intended to guide clinical practice.

Weathering the storm: COVID-19 infection in patients with hematological malignancies / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

The coronavirus disease 2019 (COVID-19) is an emerging infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Within a matter of months, this highly contagious novel virus has led to a global outbreak and is still spreading rapidly across continents. In patients with COVID-19, underlying chronic diseases and comorbidities are associated with dismal treatment outcomes. Owing to their immunosuppressive status, patients with hematological malignancies (HMs) are at an increased risk of infection and have a worse prognosis than patients without HMs. Accordingly, intensive attention should be paid to this cohort. In this review, we summarize and analyze specific clinical manifestations for patients with coexisting COVID-19 and HMs. Furthermore, we briefly describe customized management strategies and interventions for this susceptible cohort. This review is intended to guide clinical practice.

Image characteristics and early diagnosis of renal pelvic carcinoma:report of 69 cases / 重庆医学

Objective To analyze the typical clinical manifestations and imaging characteristics of renal pelvic carcinoma.Methods The clinical data in 69 cases of renal pelvic carcinoma verified by postoperative pathology in this department of the hospital from July 2013 to November 2016 were retrospectively summarized to analyze its typical clinical manifestations,imaging features and treatment regimens.Results All the cases were hospitalized due to hematuria and presented gross hematuria.The detectable rate of B-ultrasonic examination was 71.43 ％,which of computed tomography urography(CTU) was 84.21％ and which of intravenous urography(IVU) + kidney ureter bladder(KUB) was 70.27 ％,which of retrograde pyelography(RP) was 90.32 ％,which of flexible ureteroscope(FU) was 91.67 ％,the pathological detection rate of biopsy tissue by this method was 58.33 ％ and detection rate of fluorescence in situ hybridization was 79.07 ％.Sixty-nine cases all were performed the retroperitoneal laparoscopy combined with hypogastric incision renal pelvic carcinoma radical operation,postoperative pathological examination verified renal pelvis carcinoma.Conclusion Flexible ureteroscope examination has the highest definite diagnosis rate of renal pelvic carcinoma,but the pathological positive rate of biopsy tissue by this method is not ideal;the definite diagnosis rate of RP and CTU were secondary,urinary system B-ultrasonic examination,FISH and KUB+IVP can serve as the preliminary screening and postoperative re-examination means of renal pelvic carcinoma.

Practice of Clinical Pharmacist Participating in the Treatment of One Patient with Severe Intracranial Infection / 中国药师

Objective:To investigate the role of clinical pharmacist in the treatment of patients with severe infection. Methods:Clinical pharmacist participated in the consultations for a patient with severe intracranial infection after craniocerebral operation in neurosurgery. According to the conditions of the patient and the results of antibiotic susceptive test,clinical pharmacist made an individualized medication for the patient,and the regimen included cefoperazone/ sulbactam,meropenem, vancomycin and Angong Niuhuang Wan. Results:The intracranial infection in the patient was improved gradually and controlled finally. Conclusion:Based on self professional knowledge,clinical pharmacist can participate in the clinical treatment of patients with severe infection,and assist doctors to develop treatment regimen in order to improve treatment effects. It will help clinical pharmacist preferably blend in clinical treatment team.

Treatment outcomes of functional dyspepsia patients with Helicobacter pylori infection: A comparison between sequential treatment regimen and conventional triple therapy / 第二军医大学学报

Objective: To compare the eradication rates of H. pylori infection between a new sequential treatment regimen and conventional triple therapy in functional dyspepsia patients, and to assess the symptom improvement of functional dyspepsia. Methods: One hundred and thirty functional dyspeptic patients with H. pylori infection were randomly divided into 2 groups. Patients in sequential treatment group received 10-day sequential therapy: omeprazole (40 mg daily) plus amoxicillin (1 g twice daily) for the first 5 days, followed by omeprazole (20 mg), clarithromycin (500 mg) and tinidazole (500 mg) twice daily for the another 5 days; patients in triple therapy group received standard 7-day treatment: omeprazole (20 mg), clarithromycin (500 mg) and amoxicillin (1 g) twice daily for 7 days. H. pylori statuses were assessed by rapid urease test and 14C-urea breath test at base line level 4 weeks and one year after treatment, and symptom scores in various H. pylori statuses were evaluated. Results: The eradication rates of H. pylori in the sequential treatment group was 83.58% (56/67) by intention-to-treat(TTI) analysis and 91.80% (56/61) by per-protocol (PP) analysis, and the numbers in the triple therapy group were 65.08% (41/63) and 69.49% (41/59), respectively, which were significantly lower than those in the sequential treatment group (P<0.05). The symptom scores of patients with H. pylori eradicated after treatment were 4.88±1.76 before treatment and 2.18±0.83 one year after treatment (P<0.05); the scores of patients whose H. pylori was not eradicated after treatment was 4.99±1.66 before treatment and 3.89±1.56 one year later; there was no significant difference between the 2 numbers. Conclusion: Sequential treatment regimen has a better H. pylori eradication effect for functional dyspepsia patients positive of H. pylori than standard triple therapy; the symptom of dyspepsia can be greatly improved after H. pylori eradication.

The glycemic control in Chinese type 2 diabetic out-patients receiving oral antidiabetic agents and the efficacy and safety of optimized modified-release gliclazide treatment / 中华内分泌代谢杂志

Objective To evaluate the current state of glycemie control in Chinese patients with type 2 diabetes mellitus who have received oral antidiabetic agents in the out-patient clinic,and the efficacy and safety of optimized regiments of gliclazide modified-release tablets (Diamicron MR, SERVIER, Tianjin) in patients with failed glycemic control (HbA1c 6.5%). Methods The patients with type 2 diabetes were enrolled from 54 hospitals in more than 20 cities and received long-term (more than 3 months) oral antidiabetic agents. HbA1c was measured and the success rate of HbA1c reduction was evaluated. The patients who failed to achieve glycemic control (HbA1c 6. 5%) and received daily multiple-dosing insulin secretagogues were provided with the optimized treatment regimen, consisting of replacing daily multiple-dosing insulin secretagogues with single-dosing gliclazide sustained-release tablets. Clinical efficacy and safety were evaluated after three months treatment. Results The survey of glycemic control revealed that the mean HbA1c of 5 586 patients with diabetes mellitus was (7.97±2.89)% ,and the success rate (HbA1c≤6.5%) was 14. 1%. Further more, HbA1c decreased from (8.23±4.00)% before optimization to (6.86±2.24)% after optimization with the average decrement of 1.37% (P<0. 001) and the success rate was raised to 34. 1%. The gliclazide modified-release tablets were well tolerated by most patients, only 2.6% of whom were reported to experience unconfirmed hypoglycemia. Conclusion The success rate of glycemic control was low in Chinese out-patients with type 2 diabetes mellitus receiving oral antidiabetic agents in the clinic. The optimized regimen of gliclazide modified-release tablets taken once daily can down-regulate glycemic levels and increase the success rate of HbA1c reduction,and thus plays efficiently and safely a key role in the optimized management of type 2 diabetes mellitus.

Cost-Effectivness Analysis on 4 Treatment Regimens for Hypertension / 中国药房

OBJECTIVE:To compare the costs and effectiveness of4treatment regimens for hypertension.METHODS:212cases of hypertension were randomly divided into4groups,group A treated with amlodipine,group B treated with fosino?pril,group C treated with candesartan cilexetil,and group D treated with losartan;the curative effects in each group were ob?served and cost-effectiveness analyses were made.RESULTS:The effective rate in group C was markedly higher than those in other3groups(P

Optimization of Treatment Regimen in Traditional Chinese Medicine Clinical Research / 中华中医药杂志

TCM clinical investigators should attach importance to buildup of research basis in order to ensure the feasibility and normalization of clinical regimen,definite curative effect of treatment regimen and enhance consistency among different researchers and repeatability of clinical regimen.Syndrome,therapeutic method and prescription should be consistent,the addition or subtraction of the medicinal or the dosage should be reasonable.Reduce the use of rare or invaluable medicinal to avoid the restrictions of herb resource,drug cost and animal protection.When transforming decoction to capsule,granule,dripping pill and compound granule,the preliminary test in clinic to recur the curative effect of the decoction is necessary.The application of a single medicinal,the single target area of a medicinal or active ingredient of a single medicinal in a prescription should be based on the preliminary work experience.Meanwhile the county-level producing area of the processed medicinal should be explicit,in order to ensure the quality and efficacy of the processed medicinal.This article also discussed the key point of treatment regimen optimization of acupuncture and massage.

Cost-minimization Analysis on 2 Drug Therapeutic Regimens for Children Pneumonia / 中国药房

0.05),but the total expenses and antibiotic cost of the medical treatment in group B were obviously lower than those in group A(P