Child ; Evidence-Based Medicine ; Humans ; Kidney Diseases ; therapy

OBJECTIVETo observe the effect of Ganoderma lucidum decoction in treating Russula subnigricans poisoning (RSP) patients.

METHODSThe 14 patients of RSP in the treated group were treated with GLD (GLD, one dose was prepared by 100 g of Ganoderma lucidum decocted with water to 600 ml), on the base of conventional treatment, and 11 patients received conventional therapy in the previous year were taken as control. The clinical efficacy and parameters in them were compared, including the urine N-acetyl-D-glucosaminidase (NAG, which reflects the injury of kidney), the red blood cell and protein in urine, the alanine transaminase (ALT, which reflects the injury of liver), and the aspartate aminotransferase (AST, which reflects the injury of heart).

RESULTSA better clinical cure-markedly improving rate was showed in the treated group as compared with the control group, P < 0.01. In the treated group, red blood cell in urine disappeared after 24 hrs treatment in the majority of patients, urinary protein reduced obviously and the other three parameters reached the peak at the 3rd day then lowered gradually. In the control group, all the parameters increased continuously. Comparison between the parameters at corresponding time in the two groups showed significant difference (P < 0.01), those in the treated group were markedly lower than those in the control group respectively.

CONCLUSIONGLD has good effect in treating RSP, could obviously lower the fatat rate of RSP.

Acetylglucosaminidase ; urine ; Adolescent ; Adult ; Aged ; Alanine Transaminase ; blood ; Aspartate Aminotransferases ; blood ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Mushroom Poisoning ; drug therapy ; Phytotherapy ; Reishi ; chemistry

Objective: To investigate the efficacy of patients with cancer-induced bone pain (CIBP) treated with morphine in combination with dexamethasone through intrathecal pumping injection and its mechanism. Methods: Seventy-six patients with CIBP undergoing implantation of an infusion port with intrathecal catheter were randomly divided into group A (n = 38, intrathecally injected with morphine alone and group B (n = 38, intrathecally injected with morphine in combination with dexamethasone). The pain relief degree by 11-Point Numeric Rating Scale (NRS-11) score, the frequency of breakthrough pain, quality of life and SF-36 scale score were evaluated before treatment and the 1st, 3rd and 7th days after the beginning of intrathecal pumping. On the 7th day after treatment, the concentrations of â-endorphin (â-EP) and motilin in plasma as well as prostaglandin E2 (PGE2), substance P (SP) and calcitonin gene-related peptide (CGRP) in cerebrospinal fluid (CSF) were determined. Results: The pain was relieved significanly in group B, and the frequencies of breakthrough pain per day were less than those in group A on the 1st, 3rd and 7th days after treatment (all P < 0.05); the NRS-11 score was < 2 in two groups after treatment, but there was no significant difference between the two groups (P > 0.05); in group B, the SF-36 scale score and quality of life were both improved significantly on the 3rd and 7th days after treatment as compared with those of group A (all P < 0.05). On the 7th day after treatment, the endorphin level in plasma was not significantly different between the two groups (P > 0.05), but the motilin level in plasma in group B was significantly higher than that in group A (P < 0.05); the PGE2, SP and CGRP levels in CSF in group B were significantly lower than those in group A (all P < 0.05). Conclusion: Intrathecal pumping injection of morphine in combination with dexamethasone can be of great help in decreasing the frequency of breakthrough of CIBP, improving the quality of life, and increasing the motilin level in plasma, but decreasing PGE2, SP and CGRP levels in CSF which may contribute to alleviating the tolerance of morphine, thus enhance the analgesic effect.

Fibrosis can occur in different organs with high incidence rate and great danger. It still lacks effective drugs for prevention of fibrosis. Fluorofenidone is a newly developed drug with anti-fibrotic activity, which provides a new hope for treating the progressive fibrotic diseases. Recent studies have shown that fluorofenidone is a multifunctional small molecule with anti-inflammatory, antioxidative and anti-apoptotic eff ects. It can inhibit the activation and proliferation of myofibroblasts, promote the degradation of extracellular matrix and regulate the cellular signal transmission. Fluorofenidone can be applied to attenuate the progression of renal, hepatic and pulmonary fibrosis.
Apoptosis ; Extracellular Matrix ; Fibrosis ; Humans ; Kidney ; pathology ; Liver Cirrhosis ; Pulmonary Fibrosis ; Pyridones ; pharmacology ; Signal Transduction

Objective: Pembrolizumab and dostarlimab are immune checkpoint inhibitors that target programmed death receptor 1 (PD-1). Combination anti-PD-1 regimens have been shown to exhibit favorable survival benefits when treating advanced endometrial cancer (EC). Which treatment was preferable will need to be confirmed by a cost-effectiveness comparison between them. Methods: Based on patient and clinical parameters from RUBY and NRG-GY018 phase III randomized controlled trials, the Markov model with a 20-year time horizon was established to evaluate the cost-effectiveness of dostarlimab plus chemotherapy (DC), pembrolizumab plus chemotherapy (PC), and chemotherapy alone (C) treatment for patients with mismatch repair-proficient microsatellite-stable (pMMR-MSS) and mismatch repair-deficient microsatellite instability-high (dMMR-MSI-H) advanced EC from the American payers’ perspective. The main results include total cost, life-years (LYs), quality-adjusted lifeyears (QALYs), and the incremental cost-effectiveness ratio (ICER) at a $150,000/QALY of willingness-to-pay. Results: In the pMMR-MSS population, DC, PC, and C produced costs (QALYs) of $99,205 (3.02), $322,530 (3.25), and $421,923 (4.40), resulting in corresponding ICERs of $974,177/ QALY (PC vs. C), $234,527/QALY (DC vs. C), $86,671/QALY (DC vs. PC), respectively; In the dMMR-MSI-H population, DC, PC, and C obtained costs (QALYs) of $120,177 (5.73), $691,399 (8.43), and $708,787 (11.26), yielding ICERs of $266,423/QALY (PC vs. C), $135,165/QALY (DC vs. C), $7,866/QALY (DC vs. PC), respectively. Conclusion In the US, DC was a more cost-effective treatment than PC for patients with advanced EC irrespective of MMR status. However, compared to C, DC was associated with more cost-effectiveness in the dMMR-MSI-H population.

Objective: Pembrolizumab and dostarlimab are immune checkpoint inhibitors that target programmed death receptor 1 (PD-1). Combination anti-PD-1 regimens have been shown to exhibit favorable survival benefits when treating advanced endometrial cancer (EC). Which treatment was preferable will need to be confirmed by a cost-effectiveness comparison between them. Methods: Based on patient and clinical parameters from RUBY and NRG-GY018 phase III randomized controlled trials, the Markov model with a 20-year time horizon was established to evaluate the cost-effectiveness of dostarlimab plus chemotherapy (DC), pembrolizumab plus chemotherapy (PC), and chemotherapy alone (C) treatment for patients with mismatch repair-proficient microsatellite-stable (pMMR-MSS) and mismatch repair-deficient microsatellite instability-high (dMMR-MSI-H) advanced EC from the American payers’ perspective. The main results include total cost, life-years (LYs), quality-adjusted lifeyears (QALYs), and the incremental cost-effectiveness ratio (ICER) at a $150,000/QALY of willingness-to-pay. Results: In the pMMR-MSS population, DC, PC, and C produced costs (QALYs) of $99,205 (3.02), $322,530 (3.25), and $421,923 (4.40), resulting in corresponding ICERs of $974,177/ QALY (PC vs. C), $234,527/QALY (DC vs. C), $86,671/QALY (DC vs. PC), respectively; In the dMMR-MSI-H population, DC, PC, and C obtained costs (QALYs) of $120,177 (5.73), $691,399 (8.43), and $708,787 (11.26), yielding ICERs of $266,423/QALY (PC vs. C), $135,165/QALY (DC vs. C), $7,866/QALY (DC vs. PC), respectively. Conclusion In the US, DC was a more cost-effective treatment than PC for patients with advanced EC irrespective of MMR status. However, compared to C, DC was associated with more cost-effectiveness in the dMMR-MSI-H population.

Objective: Pembrolizumab and dostarlimab are immune checkpoint inhibitors that target programmed death receptor 1 (PD-1). Combination anti-PD-1 regimens have been shown to exhibit favorable survival benefits when treating advanced endometrial cancer (EC). Which treatment was preferable will need to be confirmed by a cost-effectiveness comparison between them. Methods: Based on patient and clinical parameters from RUBY and NRG-GY018 phase III randomized controlled trials, the Markov model with a 20-year time horizon was established to evaluate the cost-effectiveness of dostarlimab plus chemotherapy (DC), pembrolizumab plus chemotherapy (PC), and chemotherapy alone (C) treatment for patients with mismatch repair-proficient microsatellite-stable (pMMR-MSS) and mismatch repair-deficient microsatellite instability-high (dMMR-MSI-H) advanced EC from the American payers’ perspective. The main results include total cost, life-years (LYs), quality-adjusted lifeyears (QALYs), and the incremental cost-effectiveness ratio (ICER) at a $150,000/QALY of willingness-to-pay. Results: In the pMMR-MSS population, DC, PC, and C produced costs (QALYs) of $99,205 (3.02), $322,530 (3.25), and $421,923 (4.40), resulting in corresponding ICERs of $974,177/ QALY (PC vs. C), $234,527/QALY (DC vs. C), $86,671/QALY (DC vs. PC), respectively; In the dMMR-MSI-H population, DC, PC, and C obtained costs (QALYs) of $120,177 (5.73), $691,399 (8.43), and $708,787 (11.26), yielding ICERs of $266,423/QALY (PC vs. C), $135,165/QALY (DC vs. C), $7,866/QALY (DC vs. PC), respectively. Conclusion In the US, DC was a more cost-effective treatment than PC for patients with advanced EC irrespective of MMR status. However, compared to C, DC was associated with more cost-effectiveness in the dMMR-MSI-H population.

Objective To analyze the development and changes of novel coronavirus diseases 2019 (COVID-19) in the six neighboring provinces of Hubei. Methods The COVID-19 epidemic data of Hubei and its six neighboring provinces released by the National Health and Health Commission and local governments from January 11, 2020 to March 22, 2020 was collected. Joinpoint regression model was used to analyze the trend of cumulative confirmed cases, daily new confirmed cases and daily average confirmed cases according to the daily change percentage (DPC) and average daily percentage change (ADPC). Results As of March 22, 2020, a total of 5,036 confirmed cases were reported in the six neighboring provinces of Hubei, among which Henan, Hunan and Anhui ranked the top three, with 1,272, 1,018, and 990 cases, respectively, accounting for 65.13% of the total cases. The inflection points of the cumulative number of confirmed cases in the six provinces were January 24 and February 5, with an average growth rate of 5.27% [ADPC (95% CI) = 5.27% (3.71%, 6.85%), P < 0.05)], which was different from Hubei where the inflection points of the cumulative diagnosis number were February 2 and February 15, with an average growth rate of 10.77 % [ADPC 9995% CI) = 10.77% (9.12%, 12.44%), P < 0.05]. The average number of new cases per day in 28 days, 21 days, 14 days and 7 days from the last case report (February 28, Hunan) was 116.93, 55.48, 12.93 and 1.86, respectively, showing a significant downward trend (DPC 95%CI = -79.04（-88.95, -43.62）%, P<0.05). The peak number of new cases per day in the six neighboring provinces occurred on February 4 (309 cases), and the inflection point was February 5, showing a sharp increase (DPC = 25.53%, P < 0.05), and then a rapid decline (DPC = - 28.46%, P < 0.05). The total case fatality rate of the six provinces was 0.79%, which was lower than that of Hubei (4.65%). Conclusion The measures taken by the six provinces and cities adjacent to Hubei Province in the prevention and control of domestic imported risks are active and effective. It is necessary to summarize and optimize the strategies in time to prevent possible second transmission in the future.

To explore the clinical features of viral encephalitis with acute retinal necrosis syndrome.
 Methods: Clinical symptoms, laboratory tests, treatment and prognosis for 6 patients with viral encephalitis and acute retinal necrosis syndrome, who admitted to Xiangya Hospital from October 2013 to March 2015, were retrospectively analyzed.
 Results: Clinical features of the six cases are similar. Anti-virus treatment and anti-inflammation therapy can improve the prognosis. 
 Conclusion: Viral encephalitis with acute retinal necrosis syndrome is common and the neurological physicians need to strengthen the understanding of this disease.
Anti-Inflammatory Agents ; therapeutic use ; Antiviral Agents ; therapeutic use ; Encephalitis, Viral ; diagnosis ; therapy ; Humans ; Prognosis ; Retinal Necrosis Syndrome, Acute ; diagnosis ; therapy ; Retrospective Studies