简介：AbstractGlioblastoma (GBM) is the most common primary malignancy of the central nervous system in adults. The prognosis for late-stage glioblastoma (World Health Organization grade IV astrocytic glioma) is very poor. Novel treatment options are sought after and evaluated by clinicians and researchers, and remarkable advances have been made in surgical techniques, radiotherapy, and chemotherapy. However, the treatment of glioblastoma remains extremely difficult and it can extend the lives of patients by only a few months. There has been notable progress in the field of immunotherapy, particularly with the use of tumor vaccines, for treating glioblastoma; especially peptide vaccines and cell-based vaccines such as dendritic cell vaccines and tumor cell vaccines. However, the results of the current clinical trials for vaccination are not satisfactory. This article reviews the progress in the development of vaccines for glioblastoma.

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简介：AbstractGastric cancer (GC) is one of the most common malignant tumors worldwide. Its incidence ranks the 5th among all malignant tumors globally, and it is the 3rd leading cause of death among patients with cancer. Surgical treatment is the first choice in clinical practice. However, targeted therapy, immunotherapy, and other treatment methods have also become research hotspots at home and abroad with the development of individualized precision therapy in recent years, besides traditional radiotherapy and chemotherapy. At present, targeted therapy and immunotherapy are methods used for treating GC, and they have important clinical application value and prospects. This study aimed to review the research progress of targeted therapy and immunotherapy for GC, focusing on its mechanism of action and related important clinical trials, hoping to provide references for the clinical treatment of GC.

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简介：摘要BACKGROUND AND OBJECTIVESpasticity is a common sequala of the upper motor neuron lesions. For instance, it often occurs in the first 4 weeks after stroke and is seen in more than one-third of stroke survivors after 12 months. In recent years, extracorporeal shock wave therapy (ESWT) has been recognized as a safe and effective method for reducing muscle spasticity. Possible/relevant mechanisms include nitric oxide production, motor neuron excitability reduction, induction of neuromuscular transmission dysfunction, and direct effects on rheological properties. There are two types of ESWT, focused and radial, with the radial type more commonly applied for treating muscle spasticity. Concerning the optimal location for applying ESWT, the belly muscles and myotendinous junction seem to produce comparable results. The effects of ESWT on spasticity are known to last at least four to six weeks, while some studies report durations of up to 12 weeks. In this review, the authors will focus on the current evidence regarding the effectiveness of ESWT in spasticity, as well as certain technical parameters of ESWT, e．g., the intensity, frequency, location, and number of sessions. The pertinent literature has been reviewed, with an emphasis on post-stroke upper limbs, post-stroke lower limbs, cerebral palsy, and multiple sclerosis. In short, while ESWT has positive effects on parameters such as the modified Ashworth scale, mixed results have been reported regarding functional recovery. Of note, as botulinum toxin injection is one of the most popular and effective pharmacological methods for treating spasticity, studies comparing the effects of ESWT and botulinum toxin injections, and studies reporting the results of their combination, are also reviewed in this paper.

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简介：AbstractDue to the coronavirus disease 2019 (COVID-19) pandemic, the development of antiviral drugs has attracted increasing attention. Clinical antiviral drugs show weak solubility, low bioavailability, adverse side effects, or only limited targets. With the advancement of nanotechnology and material science, biosafety nanomaterials have been constructed for drug delivery systems of antiviral disease therapy, such as liposomes, polymers, gold nanoparticles, and graphene. These nanodrug systems can either deliver synthesized antiviral drugs siRNA/miRNA and small molecular compounds, deliver bioactive large molecular drug proteins and mRNA, or show antiviral activity by themselves. Nanodelivery systems could effectively enhance the efficiency of antiviral drugs by increasing drug loading and host cell uptake with a small size and high specific surface area. This review focused on the biosafety nanomaterials used for antiviral therapy and discussed the options for the design of antiviral drugs in the future.

简介：摘要Background and objectiveCloser monitoring and treatment is vital for pregnant carbon monoxide (CO) poisoning cases due to fetal poisoning component. Permanent damage can occur in both the mother and the baby. It may cause stillbirth even though no serious clinical symptoms occur in the mother. Hyperbaric oxygen (HBO) treatment is advised for all pregnant patients regardless of their clinical symptoms. Pregnant CO poisoning patients that received HBO treatment and their fetal status were evaluated in this study.MethodsPregnant patients poisoned with CO treated in the same hyperbaric clinic were evaluated. Pregnant patients that received HBO treatment in a multiplace chamber were evaluated in terms of clinical status, demographic structure, laboratory tests, fetal effects and progress of the fetus until birth and 6 months postpartum.ResultsA total number of 32 pregnant cases were treated. COHb values were over 20% (min 6.9- max 40.2) in 23 patients, 11 patients had a history of syncope. All patients took HBO treatment under 2.4 ATA pressure for 120 min. 3 patients received more than 1 session of HBO treatments due to fetal stress; all other cases took 1 session of HBO treatment. No spontaneous abortus occurred in early follow-ups; only 4 babies were born prematurely. 2 of the babies were lost in the early phases after birth, due to causes non-related to CO poisoning complications (cyanotic heart disease, necrotizing enterocolitis). No significant difference were observed in the comparison of laboratory results of patients with syncope and of those who did not have syncope and comparison of patients with COHb value higher than 20% and patients with COHb value lower than 20% (P>0.05)．ConclusionHBO is not advisable for pregnant patients except for CO poisoning. In this study it is observed that HBO treatment under 2.4 ATA pressure for 120 min has no harmful effects on the mother and the fetus. It is observed that continuation of HBO treatment in the cases with fetal distress findings has beneficial effects. COHb levels and syncope were shown to have no significant effect on clinical symptoms and on blood tests.

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简介：摘要Carbon monoxide (CO) poisoning is the leading cause of poisoning-related deaths globally. The currently available therapy options are normobaric oxygen (NBO) and hyperbaric oxygen (HBO). While NBO lacks in efficacy, HBO is not available in all areas and countries. We present a novel method, extracorporeal hyperoxygenation therapy (EHT), for the treatment of CO poisoning that eliminates the CO by treating blood extracorporeally at elevated oxygen partial pressure. In this study, we proof the principle of the method in vitro using procine blood: Firstly, we investigated the difference in the CO elimination of a hollow fibre membrane oxygenator and a specifically designed batch oxygenator based on the bubble oxygenator principle at elevated pressures (1, 3 bar). Secondly, the batch oxygenator was redesigned and tested for a broader range of pressures (1, 3, 5, 7 bar) and temperatures (23, 30, 37 ℃). So far, the shortest measured carboxyhemoglobin half-life in the blood was 21.32 min. In conclusion, EHT has the potential to provide an easily available and effective method for the treatment of CO poisoning.

简介：AbstractIntroduction:Bowen’s disease is a squamous cell carcinoma in situ. It is more common on the head and neck, less common on the nail units in which it usually involves the second to fourth fingers of both hands. Here, we report a case of Bowen’s disease involving the left fifth finger of a 78-year-old Chinese woman.Case presentation:The patient was treated with nine sessions of topical 5-aminolevulinic acid-photodynamic therapy (5-ALA-PDT), with a one-week interval between sessions. The 5-ALA cream was applied to the lesion and the region surrounding its marginal diameter by 0.5 cm. After 3-4 hours, the lesion was irradiated with 635 ± 10 nm red light at an intensity of 80 mw/cm2 for 20 minutes. An excellent result with a topical 5-ALA-PDT was reached.Discussion:PDT involves the application of a combination of a photosensitizing drug and light to cause selective damage to the target tissue. PDT is more appropriate than surgical excision for lesions located in sites with poor healing ability.Conclusion:PDT appears to be effective, safe and has a better cosmetic outcome in the treatment of Bowen’s disease of the finger unit.

简介：AbstractObjective:Skin diseases are common and striking features of patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and may vary considerably by ethnic and geographic regions and by the influence of highly active antiretroviral therapy (HAART). However, little information exists regarding the cutaneous manifestations of patients with HIV/AIDS in Bangladesh. This study was performed to elucidate the spectrum of cutaneous disorders in patients with HIV/AIDS in the era of HAART.Materials:This descriptive cross-sectional study was carried out in Chittagong Medical College Hospital, Bangladesh from January 2017 and December 2020. Diagnosed case of HIV/AIDS for HAART therapy and all cases of HIV/AIDS who are already on HAART therapy were included in this study. Descriptive statistical analysis was carried out by using frequencies and percentages.Results:Of 40 patients with HIV/AIDS, 22 (55.0%) were male and 18 (45.0%) were female. The patients ranged in age from 8 to 60 years, with a mean age of 38 ± 0.966 years. Among all age groups, the highest 19 (47.5%) patients were in the 31- to 40-year age group. Most of the patients were migrant workers [22/40 (55.0%)] with low socioeconomic status [32/40 (80.0%)], and the most common transmission mode was heterosexual activity [36/40 (90.0%)]. Most of the patients [32/40 (80.0%)] had mucocutaneous disorders, 30/40 (75.0%) had infective dermatoses, and 21/40 (52.5%) had non-infective inflammatory dermatoses. Eight of forty (20.0%) patients presented with three or more skin disorders. The most common infective dermatoses were fungal infections [15/40 (37.5%)], followed by viral infections [8/40 (20.0%)], bacterial infections [4/40 (10.0%)], and scabies [3/40 (7.5%)]. The most common non-infective dermatosis was generalized pruritus [6/40 (15.0%)], followed by prurigo simplex [4/40 (10.0%)], psoriasis [4/40 (10.0%)], eczema [3/40 (7.5%)], pruritic papular eruption [1/40 (2.5%)], seborrheic dermatitis [1/40 (2.5%)], urticaria [1/40 (2.5%)], and xerosis [1/40 (2.5%)]. Patients treated with HAART had decreased rates of oral candidiasis and herpes simplex but increased rates of drug reactions [19/40 (47.5%)]. The most common drug eruption following HAART was a morbilliform rash [11/40 (27.5%)], and the most common offending agent was nevirapine. The prevalence of mucocutaneous disorders was higher in patients with a CD4 cell count of <200 cells/mm3.Conclusions:A wide range of mucocutaneous disorders is observed in Bangladeshi patients with HIV/AIDS, and HAART has an impact on the spectrum of HIV/AIDS-associated mucocutaneous disorders. Skin and mucocutaneous disorders are seen at every stage of HIV/AIDS and are the initial presentation in most patients in Bangladesh. There is a need for increased attention to the diagnosis and treatment of skin diseases affecting the quality of life of patients with HIV/AIDS.

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简介：摘要IntroductionHyperbaric oxygen (HBO) therapy may be a useful treatment to prevent the development of delayed neuropsychiatric sequelae (DNS) in patients with acute carbon monoxide (CO) poisoning. However, there is no clear consensus regarding the optimal number of HBO therapy sessions in patients with CO poisoning. Here, we compared the development of DNS after 3 and > 3 sessions of HBO therapy in patients with acute CO poisoning.MethodsThis prospective observational study recruited 299 patients with CO poisoning. Demographic and clinical information were obtained, including comorbidities, vital signs, and symptoms. Patients were divided into two groups according to whether they received 3 or > 3 sessions of HBO therapy (3 HBO vs. >3 HBO). A propensity score-matching process was used to balance potential prognostic factors in both groups.ResultsOf the 299 patients with acute CO poisoning enrolled in this study, 183 (59.0%) were included in the analysis. Patients were excluded for the following reasons: age < 18 years, not underwent HBO therapy, discharged against medical advice, and loss to follow-up. The overall rate of DNS development was 17.5%. The >3 HBO group had a higher incidence of DNS development compared to the 3 HBO group (36.3% vs. 16.3%; P＝0.09). Propensity score-matching analysis revealed similar incidences of DNS (31.3% vs. 28.1%, respectively; P>0.99)．ConclusionThere is a critical need to determine the optimal number of HBO therapy sessions for patients with acute CO poisoning. This study showed no difference in DNS development after 3 and > 3 sessions of HBO therapy.

简介：摘要Background and purposeCarbon monoxide (CO) is a gas product of combustion, considered highly poisonous. Prolonged CO exposure is responsible for more than half of fatal poisonings and is also one of the leading causes of poisoning in Western countries. We aimed to compare the effectiveness of therapy with hyperbaric oxygen (HBO) versus normobaric oxygen (NBO) in the setting of carbon monoxide poisoning (COP).MethodsWe independently searched the National Library of Medicine′s Medline (PubMed™), ScienceDirect™，and Scielo™ for any relevant studies published from 1989 to 2017, using the following keywords: hyperbaric therapy, hyperbaric oxygenation, normobaric therapy, carbon monoxide poisoning, carboxyhemoglobin, Haldane effect. We analyzed the studies that suggested the effectiveness of HBO or NBO. Also，we searched for studies related to COP; including history，epidemiology (risk factors，incidence，demographics)，pathophysiology, clinical manifestations, diagnosis, and treatment.ResultsSixty-eight articles were found, sixteen of which dealt with either HBO or NBO or both. Twelve suggested HBO as the treatment of choice in COP; four studies indicated that NBO was an adequate treatment due to its cost-effectiveness and availability in the emergency department (ED). HBO has been shown in several studies to be effective in moderate to high-risk COP situations, being the therapy of choice to avoid sequelae, especially neurologically.ConclusionNBO can be considered as a reasonable alternative due to its cost-effectiveness. The availability and understanding of different therapeutic interventions are critical in the management of patients with COP in ED and the Critical Care unit.

简介：摘要Background and aimIn Multiple Sclerosis (MS) spasticity worsen patient′s quality of life. Botulinum NeuroToxin TypeA (BoNT-A) is extensively used in focal spasticity, frequently combined with physical therapies. Radial extracorporeal shock waves (rESW) were already used in association with BoNT-A. Considering that loss of efficacy and adverse events are determinants of BoNT-A treatment interruption, this study aimed to evaluate the possibility to prolong BoNT-A′s effect by using rESW in MS focal spasticity.MethodsSixteen MS patients with spasticity of triceps surae muscles were first subjected to BoNT-A therapy and, four months later, to 4 sections of rESWT. Patients were evaluated before, 30, 90 days after the end of the treatments, by using Modified Ashworth Scale (MAS), Modified Tardieu Scale (MTS) and kinematic analysis of passive and active ankle ROM.ResultsBoNT-A determined a significant reduction of spasticity evaluated by MAS with a reduction of positive effects after 4months (P<0.05); MTS highlighted the efficacy only 90 days after injection (P<0.05). rESWT decreased MAS values at the end and 30 days later the treatment (P<0.01); MTS values showed instead a prolonged effect (P<0.01). BoNT-A determined a gain of passive and active ankle ROM, persisting along with treatment and peaking the maximum value after rESWT (P<0.05).ConclusionsrESWT can prolong BoNT-A effect inducing significant reduction of spasticity and improvement in passive and active ankle ROM in MS patients. The use of rESWT following BoNT-A injection is useful to avoid some limitations and to prolong the therapeutic effects of BoNT-A therapy.

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