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We accurately reconstruct the Local Field Potential time series obtained from anesthetized and awake rats, both before and during CO 2 euthanasia. We apply the Eigensystem Realization Algorithm to identify an underlying linear dynamical system capable of generating the observed data. Time series exhibiting more intricate dynamics typically lead to systems of higher dimensions, offering a means to assess the complexity of the brain throughout various phases of the experiment. Our results indicate that anesthetized brains possess complexity levels similar to awake brains before CO 2 administration. This resemblance undergoes significant changes following euthanization, as signals from the awake brain display a more resilient complexity profile, implying a state of heightened neuronal activity or a last fight response during the euthanasia process. In contrast, anesthetized brains seem to enter a more subdued state early on. Our data-driven techniques can likely be applied to a broader range of electrophysiological recording modalities.
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Algoritmos , Encéfalo , Animales , Encéfalo/fisiología , Ratas , Vigilia/fisiología , Eutanasia , Masculino , Eutanasia Animal/métodos , Dióxido de CarbonoRESUMEN
Fibromyalgia is a chronic, widespread pain disorder that is strongly represented across the affective and cognitive dimensions of pain, given that the underlying pathophysiology of the disorder is yet to be identified. These affective and cognitive deficits are crucial to understanding and treating the fibromyalgia pain experience as a whole but replicating this multidimensionality on a preclinical level is challenging. To understand the underlying mechanisms, animal models are used. In this scoping review, we evaluate the current primary animal models of fibromyalgia regarding their translational relevance within the affective and cognitive pain realms, as well as summarize treatments that have been identified preclinically for attenuating these deficits.
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1. This study focused on the relationship between MITF mRNA expression and plumage colour in quail and the effect of promoter methylation on the expression of MITF mRNA.2. The CDS region of MITF mRNA was cloned by RT-PCR, followed by DNA sequencing. The RT-qPCR method was used to analyse the expression levels of MITF mRNA in dorsal skin tissue in Korean quail and Beijing white quail. The promoter region of the MITF gene was cloned, and the CpG island was predicted by the CpGplot program. The methylation levels of the CpG island were analysed using BS-PCR technology.3. Quail MITF mRNA contains a 1,476 bp complete ORF, which encodes a 492 amino acid residue protein. The MITF protein has no signal peptide or transmembrane region. The expression of MITF mRNA in dorsal tissue of Korean quail was significantly higher than that in Beijing white quail (p < 0.01). Abundant cis-elements and a 346 bp CpG island were found in the promoter region of the MITF gene. The average methylation level of the CpG island was 22 (22%) in Korean quail, and 46 (30%) in Beijing white quail (p < 0.05).4. The hypermethylation of the MITF gene promoter region in Beijing white quail resulted in a decrease in expression level, which was related to white feather colour.
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Coturnix , Islas de CpG , Metilación de ADN , Plumas , Factor de Transcripción Asociado a Microftalmía , Pigmentación , Regiones Promotoras Genéticas , Animales , Factor de Transcripción Asociado a Microftalmía/genética , Factor de Transcripción Asociado a Microftalmía/metabolismo , Plumas/química , Coturnix/genética , Coturnix/metabolismo , Coturnix/fisiología , Pigmentación/genética , Proteínas Aviares/genética , Proteínas Aviares/metabolismo , ARN Mensajero/metabolismo , ARN Mensajero/genética , Expresión Génica , Secuencia de Bases , Secuencia de Aminoácidos , MasculinoRESUMEN
Modern Bai Jiu(liquor) was called Shao Jiu in ancient times.By consulting ancient books, it was found that there was a distillation and preparation process of Shao Jiu before the Ming Dynasty, but due to its high toxicity, the scope of application was limited, and there were few records of its medicinal use.However many records of its medicinal use was found in the Compendium of Materia Medica(«¼).By comparing the medical books that recorded Shao Jiu in previous dynasties, it is found that the Compendium of Materia Medica comprehensively records the relevant cognition and application of the medicinal use of Shao Jiu for the first time. The book lists in detail the causes of the toxicity of Shao Jiu and the methods to avoid it, comprehensively expounds its characteristics, efficacy and indications, lists a variety of ways to use it, skillfully uses Shao Jiu to treat syphilis sores, and proposes that high-concentration Shao Jiu can be used as a solvent for medical liquor.The record of Shao Jiu in the Compendium of Materia Medica had a profound impact on the medical liquor of later generations.The use of Shao Jiu in the Qing Dynasty continued to expand, and the types of medicinal liquor were also constantly enriched. The record of Shao Jiu in the Compendium of Materia Medica can also provide a reference for the medicinal use of modern liquor.
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Materia Medica , Libros , China , Medicina Tradicional ChinaRESUMEN
OBJECTIVES: There emerges increasing doubt regarding whether the policy composite indicators are applicable to the COVID-19 pandemic. A few early studies demonstrate that the association between some composite indicators of policy preparedness and the risk of COVID-19 is statistically insignificant, and the relation between any composite indicators and recovery process (e.g., vaccination coverage) remains unexplored. To examine the relation between composite indicators and pandemic risk (as well as the vaccination coverage) with robustness, this study applies different policy preparedness indicators by using data from multi-sources. STUDY DESIGN: A cross-sectional analysis was performed. METHOD: Regression analysis is adopted to examine the relation between four policy preparedness indicators (i.e., [1] International Health Regulations core capacity index, [2] Global Health Security Index, [3] epidemic preparedness index, and [4] World Governance Index) and COVID-19-confirmed cases/death/vaccination coverage at different time points. The linear regression is performed, and the spatial distribution of indicators are illustrated. RESULTS: Countries with higher ranking in policy preparedness indexes can experience less severity of pandemic risk (e.g., confirmed cases and mortality) and faster recovery process (e.g., higher vaccination coverage). However, slight disparity in effectiveness exists across different indicators. CONCLUSION: Results show that the policy preparedness indicators have predictive value of the confirmed cases, mortality, and vaccination coverage of COVID-19 pandemic, given sufficiently long-time span is observed.
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OBJECTIVE: Coronavirus disease 2019 (COVID-19) was first discovered in December 2019, and since then rapidly spread worldwide. Our study aimed to investigate the early indicators of death in patients suffering from severe and critical COVID-19. PATIENTS AND METHODS: A retrospective cohort study was conducted on patients with severe and critical COVID-19, admitted to the Seventh Hospital of Wuhan. Clinical information was collected from electronic medical records according to standardized data collection tables. Patients were divided into non-survival and survival groups based on the disease outcome. Using univariate and multivariate logistic regression analysis, and calculating odds ratios (OR) and 95% confidence intervals (CI), independent risk factors for death in severe and critically ill COVID-19 patients were identified. RESULTS: The median age of 162 patients (57.4% males) was 67.5 years old. Patients in the non-survival group had significantly higher white blood cell count, decreased lymphocyte count, anemia and thrombocytopenia compared to patients in the survival group (p < 0.05). A 28-day mortality rate of the study cohort was 31.5%. Multivariate logistic regression analysis showed that underlying heart disease, lymphocyte count < 1.0 × 109/L, glomerular filtration rate < 66, lactate > 2.2 mmol/L, higher Sequential Organ Failure Assessment (SOFA) score, lower oxygenation index (OR 1.748; 95% CI 1.024-2.984; p=0.041) and higher "multi-lobar infiltration, hypo lymphocytosis, bacterial co-infection, smoking history, hypertension and age" (MuLBSTA) score (OR 1.601; 95% CI 1.062-2.415; p=0.025) were risk factors associated with death in patients with severe and critical COVID-19. CONCLUSIONS: Underlying heart disease, lymphocyte count, glomerular filtration rate, lactate, oxygenation index, SOFA score, and MuLBSTA score were associated with the risk of death in severe and critical COVID-19 patients.
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COVID-19 , Cardiopatías , Masculino , Humanos , Anciano , Femenino , Estudios Retrospectivos , Ácido Láctico , Análisis de los Gases de la SangreRESUMEN
Objective: To understand the knowledge, attitude, and current status of vaccination of herpes zoster vaccination among urban residents aged 25 years and above in China. Methods: In August to October 2022, a convenience sampling method was used to survey residents aged 25 years and above at 36 community centers in 9 cities across China. Questionnaires were used to collect basic information, knowledge, and attitude toward herpes zoster and its vaccination, as well as vaccination status and reasons for non-vaccination among residents. Results: A total of 2 864 urban residents were included in the study. The total score of residents' cognition of herpes zoster and its vaccine was 3.01±2.08, and the total score of their attitude was 18.25±2.76. Factors such as being male (ß=-0.45, P<0.001), older than 40-59 years (ß=-0.34, P=0.023) or ≥60 years (ß=-0.68, P<0.001), married (ß=-0.69, P=0.002) were negatively associated with knowledge score. The educational level of high school or secondary school (ß=0.44, P=0.036), college (ß=0.65, P=0.006), bachelor's degree and above (ß=1.20, P<0.001), annual net household income ≥120 000 Yuan in 2021 (ß=0.42, P=0.020), having urban employee medical insurance (ß=0.62, P=0.030), having public or commercial medical insurance (ß=0.65, P=0.033), and having a history of chickenpox (ß=0.29, P=0.025) were positively associated with knowledge scores. Being male (ß=-0.38, P=0.008) and not remembering a history of chickenpox (ß=-0.49, P=0.012) were negatively associated with attitude scores. Annual net household income in 2021 was between 40 000-80 000 Yuan (ß=0.44, P=0.032) or between 80 000-120 000 Yuan (ß=0.62, P=0.002) or ≥120 000 Yuan (ß=0.93, P<0.001), and a history of herpes zoster (ß=0.59, P=0.004) were positively associated with attitude scores. Of the 2 864 residents surveyed, only 29 (1.01%) had received the herpes zoster vaccine, with a vaccination rate of 1.70% for those aged 50 years and above, with the main reason for non-vaccination being lack of knowledge about the herpes zoster vaccine, followed by the high price. 42.67% of the population said they would consider getting the herpes zoster vaccine in the future. Conclusion: Low knowledge of herpes zoster and its vaccine, positive attitudes towards the preventive effects of herpes zoster and its vaccine, and extremely low vaccination rates among the urban population in China call for multiple measures to strengthen health education and vaccination recommendations for residents, especially for the elderly, low-education and low-income populations.
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Varicela , Vacuna contra el Herpes Zóster , Herpes Zóster , Anciano , Masculino , Humanos , Femenino , Conocimientos, Actitudes y Práctica en Salud , Población Urbana , Herpes Zóster/prevención & control , ChinaRESUMEN
OBJECTIVE: To decipher the underlying mechanisms of nitroglycerin (NTG)-induced migraine electrophysiologically. BACKGROUND: Migraine is a recurrent primary headache disorder with moderate to severe disability; however, the pathophysiology is not fully understood. Consequently, safe and effective therapies to alleviate migraine headaches are limited. Local field potential (LFP) recording, as a neurophysiological tool, has been widely utilized to investigate combined neuronal activity. METHODS: We recorded LFP changes simultaneously from the anterior cingulate cortex, posterior nucleus of the thalamus, trigeminal ganglion, and primary visual cortex after NTG injection in both anesthetized and freely moving rats. Additionally, brain coherence was processed, and light-aversive behavior measurements were implemented. RESULTS: Significant elevations of LFP powers with various response patterns for the delta, theta, alpha, beta, and gamma bands following NTG injection were detected in both anesthetized and freely moving rats; however, a surge of coherence alternations was exclusively observed in freely moving rats after NTG injection. CONCLUSION: The multi-region LFP signatures and brain coherence alternations in response to NTG-induced migraine attacks were determined. Furthermore, the results of behavior measurements in the freely moving group indicated that NTG induced the phenomenon of photophobia in our study. All these findings offer novel insights into the interpretation of migraine mechanisms and related treatments.
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Trastornos Migrañosos , Nitroglicerina , Ratas , Animales , Nitroglicerina/efectos adversos , Hiperalgesia/inducido químicamente , Trastornos Migrañosos/inducido químicamente , Trastornos Migrañosos/tratamiento farmacológico , Encéfalo , Modelos Animales de EnfermedadRESUMEN
The aim of this work was to evaluate the relationships among respiratory syncytial virus infection, T cell immune response and intestinal flora. Peer-reviewed papers published in English were collected through extensive searches performed in PubMed, Web of Science, Google Scholar, and China National Knowledge Infrastructure databases. The articles were reviewed to extract relevant information on the immune responses of Th1/Th2 and Treg/Th17 to respiratory syncytial virus infection in the body. RSV (Respiratory syncytial virus, RSV) infection leads to imbalance between Th1/Th2 and Treg/Th17 immune cells, resulting in Th2 or Th17 dominant immune responses, which can generate immune disorder and aggravate clinical symptoms. Intestinal micro-organisms play very important roles in maintaining stable immune environment, stimulating immune system maturation and balancing Th1/Th2 and Treg/Th17 immune systems in children. In our review of various papers from around the world, we speculated that the steady state of intestinal bacteria was disturbed after children got infected with RSV, resulting in intestinal flora disorder. Then, the imbalance between Th1/Th2 and Treg/Th17 immune cells was increased. Both intestinal flora disorder and RSV infection could cause cellular immunity imbalance of Th1/Th2 or Treg/Th17, eventually leading to disease deterioration and even a vicious cycle. Normal intestinal flora can maintain immune system stability, regulate the dynamic balance of Th1/Th2 and Treg/Th17 and prevent or mitigate adverse consequences of RSV infection. Because probiotics can improve intestinal barrier function and regulate immune response, they can effectively be used to treat children with recurrent respiratory tract infections. Using conventional antiviral therapy strategy supplemented with probiotics in the treatment of clinical RSV infection may be better for the body.
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Microbioma Gastrointestinal , Infecciones por Virus Sincitial Respiratorio , Niño , Humanos , Animales , Ratones , Células Th2 , Virus Sincitiales Respiratorios , Inmunidad Celular , Ratones Endogámicos BALB CRESUMEN
AIM: To evaluate the utility of contrast-enhanced magnetic resonance angiography (CE-MRA) for identifying prostatic artery (PA) anatomy in patients with benign prostatic hyperplasia (BPH) before PA embolisation (PAE), using digital subtraction angiography (DSA) as the reference standard. MATERIALS AND METHODS: A total of 176 patients underwent pelvic CE-MRA at 3 T. DSA was performed within the following 7 days. Two interventional radiologists compared the CE-MRA findings with DSA findings to assess the anatomy of the PAs. The rates of correct identification of the origins and collaterals of the PAs by CE-MRA were calculated. The utility for predicting the optimal X-ray tube angle obliquity for visualising the origins of the PAs by CE-MRA was evaluated. An exact McNemar's test was used to compare the detection rates of the PAs and the collaterals with DSA versus CE-MRA. A two-sided p-value of <0.05 was considered statistically significant. RESULTS: Of the 376 PAs identified by DSA, CE-MRA correctly identified the origins of 369 vessels (98.1%), with a 1.9% false-negative rate and no false-positive results. Of the 57 total collaterals identified by DSA, CE-MRA identified 50 vessels correctly (87.7%), with a 12.3% false-negative rate and no false-positive results. No significant differences were observed between CE-MRA and DSA in the identification of the PA origins (p=0.824) and the collaterals (p=0.327). The optimal degree for an oblique projection to visualise the origins of the PAs could be predicted accurately (100%) by pre-procedural CE-MRA. CONCLUSION: CE-MRA before PAE can reliably predict the PA anatomy and facilitate procedural planning.
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Hiperplasia Prostática , Masculino , Humanos , Hiperplasia Prostática/diagnóstico por imagen , Angiografía por Resonancia Magnética/métodos , Angiografía de Substracción Digital/métodos , Medios de Contraste , Próstata/diagnóstico por imagen , Próstata/irrigación sanguínea , Sensibilidad y EspecificidadRESUMEN
This study aimed to investigate the value of combining the detection of serum tumor markers, namely, carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 199, CA 242, and CA 50, with fecal occult blood (FOB) testing in the diagnosis of colorectal cancer (CRC). One hundred patients with CRC who were diagnosed and treated at the First Hospital of Jiaxing, Zhejiang Province, China, between January 2019 and April 2020 were enrolled as the case group, and 200 healthy people who underwent a physical examination at the hospital during the same period were recruited as the control group. The concentrations of CEA, CA199, CA242, and CA50 in serum were measured alongside FOB indicators. Compared with the control group, the concentrations of CEA, CA199, CA242, and CA50 in the case group were significantly higher, and they were related to age, tumor differentiation, tumor stage, and other clinicopathological features (P<0.05). The diagnostic performance of the combination of four tumor markers for CRC was significantly better than when using a single marker (four-combined test: AUC (area under the curve) AUC=0.80), and the diagnostic performance was further improved after adding the fecal occult blood test test (FOBT) results (five-combined test: AUC=0.90). The combined detection of the five indexes was found to be effective for the early diagnosis of CRC (AUC=0.87). We concluded that the detection of serum tumor markers CEA, CA199, CA242, and CA50 combined with an FOBT could significantly improve the sensitivity and accuracy of a CRC diagnosis and contributed to an early diagnosis and appropriate treatment.
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Neoplasias Colorrectales , Neoplasias Pancreáticas , Humanos , Sangre Oculta , Antígeno Carcinoembrionario , Biomarcadores de Tumor , Neoplasias Colorrectales/diagnóstico , Neoplasias Pancreáticas/diagnóstico , Antígeno CA-19-9RESUMEN
Objective: To analyze the influence of intrinsic motivation on work burnout and the mediating effects of work stress. Methods: In 2020, questionnaire survey was conducted in 1 655 gastroenterologists working in 28 provinces of China. Mediation model was used to analyze the mediating effects of work stress in the relationship between intrinsic motivation and burnout. Resutls 1655 valid questionnaires were collected, including 1 132 women and 523 men, with an average age of 39.26. Intrinsic motivation was related to reduced level of burnout, including emotional exhaustion, dehumanization and low sense of accomplishment (ß=-2.06, -1, 77 and-4.20;P<0.001). Job stress partially mediated the negative correlation between intrinsic motivation and job burnout in three dimensions, accounting for 40%, 15% and 5% (ß=-1.58, -0.36 and-0.21;P<0.05), respectively. In female physicians, the intrinsic motivation was more directly related to the reduction of burnout, especially in the dimension"emotional exhaustion"(direct effect accounting for 62% in female gastroenterologists and 46% in male). Conclusions: Enhancing the intrinsic motivation of gastroenterologists can directly reduce burnout and indirectly reduce burnout by alleviating work stress. In the same work environment, female physicians' intrinsic motivation had a greater and more direct effect on reducing burnout.
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Agotamiento Profesional , Gastroenterólogos , Estrés Laboral , Femenino , Masculino , Humanos , Adulto , Satisfacción en el Trabajo , Gastroenterólogos/psicología , Motivación , Agotamiento Profesional/psicología , Agotamiento Psicológico , Encuestas y CuestionariosRESUMEN
Chemotherapy is one of the most commonly used clinical treatments among the currently available cancer therapies. However, the phenomenon of Multidrug resistance (MDR) has become a challenge in the treatment process, weakening the impact of chemotherapy. Extensive research on elucidating the development of cancer MDR has identified the following mechanisms that play a critical role in the development of several MDR reversal agents: abnormal expression of cell membrane transporters, adaptation of cancer cells to the microenvironment, regulation of hypoxia, repair of DNA damage and reduction of apoptosis, the enhancement of the EMT process, the existence of cancer stem cells (CSCs), and the abnormal activation of key signaling pathways. However, they failed to demonstrate significant efficacy due to severe side effects during their clinical trials. Traditional Chinese medicines (TCMs) are known to play an important anti-cancer role since they have low toxicity, high efficacy, and safety and can reverse MDR. TCMs reversal agents can be divided into Chinese medicine monomers, synthetic monomers, analogs, or derivatives. Several studies have shown that TCMs can effectively overcome cancer MDR and can be effectively used for treating cancer patients.
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Resistencia a Medicamentos , Neoplasias , Medicina Tradicional China , Quimioterapia , Resistencia a Múltiples MedicamentosRESUMEN
Pain can be ignited by noxious chemical (e.g., acid), mechanical (e.g., pressure), and thermal (e.g., heat) stimuli and generated by the activation of sensory neurons and their axonal terminals called nociceptors in the periphery. Nociceptive information transmitted from the periphery is projected to the central nervous system (thalamus, somatosensory cortex, insular, anterior cingulate cortex, amygdala, periaqueductal grey, prefrontal cortex, etc.) to generate a unified experience of pain. Local field potential (LFP) recording is one of the neurophysiological tools to investigate the combined neuronal activity, ranging from several hundred micrometers to a few millimeters (radius), located around the embedded electrode. The advantage of recording LFP is that it provides stable simultaneous activities in various brain regions in response to external stimuli. In this study, differential LFP activities from the contralateral anterior cingulate cortex (ACC), ventral tegmental area (VTA), and bilateral amygdala in response to peripheral noxious formalin injection were recorded in anesthetized male rats. The results indicated increased power of delta, theta, alpha, beta, and gamma bands in the ACC and amygdala but no change of gamma-band in the right amygdala. Within the VTA, intensities of the delta, theta, and beta bands were only enhanced significantly after formalin injection. It was found that the connectivity (i.t. the coherence) among these brain regions reduced significantly under the formalin-induced nociception, which suggests a significant interruption within the brain. With further study, it will sort out the key combination of structures that will serve as the signature for pain state.
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Amígdala del Cerebelo/fisiopatología , Ondas Encefálicas/fisiología , Giro del Cíngulo/fisiopatología , Dolor Nociceptivo/fisiopatología , Área Tegmental Ventral/fisiopatología , Animales , Modelos Animales de Enfermedad , Desinfectantes/farmacología , Fenómenos Electrofisiológicos , Formaldehído/farmacología , Inflamación/inducido químicamente , RatasRESUMEN
Chemotherapy is one of the most commonly used clinical treatments among the currently available cancer therapies. However, the phenomenon of Multidrug resistance (MDR) has become a challenge in the treatment process, weakening the impact of chemotherapy. Extensive research on elucidating the development of cancer MDR has identified the following mechanisms that play a critical role in the development of several MDR reversal agents: abnormal expression of cell membrane transporters, adaptation of cancer cells to the microenvironment, regulation of hypoxia, repair of DNA damage and reduction of apoptosis, the enhancement of the EMT process, the existence of cancer stem cells (CSCs), and the abnormal activation of key signaling pathways. However, they failed to demonstrate significant efficacy due to severe side effects during their clinical trials. Traditional Chinese medicines (TCMs) are known to play an important anti-cancer role since they have low toxicity, high efficacy, and safety and can reverse MDR. TCMs reversal agents can be divided into Chinese medicine monomers, synthetic monomers, analogs, or derivatives. Several studies have shown that TCMs can effectively overcome cancer MDR and can be effectively used for treating cancer patients.
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Resistencia a Antineoplásicos , Medicina Tradicional China , Neoplasias/tratamiento farmacológico , HumanosRESUMEN
The North China Medical College typically represented medical colleges for traditional Chinese medicine in the 1930s when many of them were set up. It was based on the principles of centring on traditional Chinese medicine, following western medicine and integrated medicine in teaching. This led to the emergence of a great number of people with a high level of traditional Chinese medicine and strong belief in it. In terms of the textbooks and handouts for western medicine, compared to similar textbooks in other medical colleges, such as the Medical College of Xie He, at that time, the textbooks in the North China Medical College covered a variety of perspectives and categories. It was found that 20 textbooks for western medicine in the North China Medical College were designed reasonably in content and were simple and applicable in teaching. More importantly, it contained some traditional Chinese medicine in different degrees, with its typical characteristics. The course design and textbook compilation provided references for the teaching in contemporary medical universities.
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Medicina , Humanos , Universidades , China , Medicina Tradicional ChinaRESUMEN
Alzheimer's disease (AD) is an irreversible degenerative illness of the central nervous system with characteristic histological alterations, known as amyloid plaques and neurofibrillary tangles (NFT). Aggregation of plaques and tangles in the brain induces neurotoxicity and synaptic dysfunction, eventually contributing to neuronal cell death and neurodegeneration. Recent studies have revealed that COVID-19 has a great impact on the development of AD, directly or indirectly, by facilitating the accumulation of amyloid plaques, causing altered functional brain integrity or increasing the phosphorylation rate of tau protein. As two important bioactive components of Ginkgo biloba extract (GbE), ginkgolides and bilobalide (BB) have been reported to show neuroprotective effects in AD via multiple mechanisms such as anti-excitotoxicity, anti-inflammatory and anti-oxidative activities. Intriguingly, ginkgolides and BB also seem to demonstrate antiviral properties against COVID-19 by inhibiting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) main protease. Herein, we review studies on the neuroprotective and antiviral mechanisms of ginkgolides and bilobalide, as well as their therapeutic potential against AD and COVID-19.
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Enfermedad de Alzheimer , Bilobálidos , COVID-19 , Humanos , Enfermedad de Alzheimer/tratamiento farmacológico , Placa Amiloide/tratamiento farmacológico , SARS-CoV-2 , Ginkgólidos/farmacología , Ginkgólidos/uso terapéutico , Extractos Vegetales/farmacología , Ginkgo bilobaRESUMEN
AIM: To investigate the safety and efficacy of transarterial chemoembolisation (TACE) with bleomycin for hepatocellular carcinoma (HCC) unresponsive to doxorubicin. MATERIALS AND METHODS: A randomised controlled trial was undertaken of HCC patients resistant to TACE with doxorubicin to assess the survival benefits of the experimental group (TACE with bleomycin) compared with the control group (TACE with doxorubicin). One hundred and seventy patients were allocated randomly between December 2015 and December 2017, and 80 patients of each group were analysed. The modified response evaluation criteria in solid tumours (mRECIST) was used to evaluated the tumour response every 4-6 weeks. The primary endpoint was median progression-free survival (mPFS) and median overall survival (mOS). Safety was assessed by post-procedure complications. RESULTS: The study was completed in October 2018. Objective response rate (ORR) of the experimental group was 27.5% (22/80), mPFS and mOS was 5.8 and 8.1 months. ORR of the control group was 7.5% (6/80), mPFS and mOS was 2.9 and 4 months. The ORR were significantly different between two groups (χ2 = 0.348, p<0.05). The differences of mPFS and mOS between the two groups were statistically significant (χ2 = 2.865, p<0.05 and χ2 = 0.926, p<0.05, respectively). There were no significant difference in post-procedure complications (p>0.05) and no major complications occurred. CONCLUSION: It is suggested that TACE with bleomycin is a safe and effective method for HCC and bleomycin can be a second-line chemotherapeutic agent for the HCC patients unresponsive to TACE with doxorubicin.