Search

Objective. Several recent reviews of published studies have shown that the eradication of H. pylori infection in patients with ITP improved thrombocytopenia in about half of the cases. However, most included studies were observational case series. We performed the first meta-analysis of randomized trials to gain a better insight into the effect of H. pylori eradication in ITP patients. Methods. A systematic computerized search of the electronic databases including PubMed, EMBASE, Google Scholar, and Cochrane Library (up to December 2017) was conducted. Results. From six studies, a total of 241 patients (125 in eradication group and 116 in control group) were included in the meta-analysis. Patients in the eradication group showed significantly higher overall platelet response rate than those in the control group (odds ratio = 1.93, 95% confidence interval: 1.01–3.71, P=0.05). In the subgroup analysis, however, children in the eradication group failed to show statistically better response rate than those in the noneradication group (odds ratio = 1.80, 95% confidence interval: 0.88–3.65, P=0.11). Conclusions. This meta-analysis indicates that H. pylori eradication has a significant therapeutic effect in patients with ITP. Considering the intrinsic limits in the design and sample size of the included studies, however, large randomized controlled trials are warranted to validate the therapeutic impact of H. pylori eradication in adults as well as children with ITP. [ABSTRACT FROM AUTHOR]

The combination of Artemisia iwayomogi and Curcuma longa radix is frequently prescribed for liver diseases in TKM. However, the synergic effects of the two herbs on nonalcoholic steatohepatitis (NASH) have not yet been studied. Therefore, we investigated the anti-NASH effects of the water extract of A. iwayomogi (AI), C. longa radix (CL), and combination of the two herbs (ACE). Hepatic steatosis and NASH were induced in HepG2 cells by treatment with palmitic acid (PA, for 6 h) with/without pretreatment of ACE (25 or 50 μg/mL), AI (50 or 100 μg/mL), CL (50 or 100 μg/mL), curcumin (5 μg/mL), or scopoletin (5 μg/mL). The PA treatment (200 μM) drastically altered intracellular triglyceride levels, total cholesterol, and expression levels of genes related to lipid metabolism (CD36, SREBP1c, PPAR-γ, and PPAR-α), whereas pretreatment with ACE significantly attenuated these alterations. ACE also protected HepG2 cells from PA- (300 μM-) induced endoplasmic reticulum (ER) stress and apoptosis and attenuated the related key molecules including GRP78, eIF2, and CHOP, respectively. In conclusion, we found synergic effects of A. iwayomogi and C. longa on NASH, supporting the clinical potential for fatty liver disorders. In addition, modulation of ER stress-relative molecules would be involved in its underlying mechanism. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to evaluate the pattern of tailoring and efficacy of several types of pharmacotherapy in male LUTS.Methods: Prospectively 404 male subjects were included who were over 40 years old, had at least 3 months symptom duration, and 12 or higher international prostate symptom score (IPSS). Subjects were treated with several types of pharmacotherapy for 6 months and were evaluated with IPSS/QoL at every follow-up. Subjects were subdivided into storage (44%), nocturia (18.5%), and voiding symptom (37.5%) groups according to the most bothersome symptom.Results: At 6 months, 188 subjects (46.5%) completed the study. The mean age was 64.2±8.5 years, and symptom duration was 30.6±32.6 months. PSA was 2.98±7.96 ng/mL, and prostate size was 32.8±14.2 cc. IPSS continually decreased from baseline (18.7) to last follow-up (10.8). Combination therapy increased from 33.0% to 52.7% at last follow-up (P=.006). However, there was no difference of IPSS changes between combination and monotherapy groups (P>.05). Only antimuscarinic prescription significantly increased from 15.4% to 28.2% (P=.004). Mean number of visits to the clinic was 3.6±1.3 and the number of treatment changes was 0.31±0.47. The nocturia (0.47±0.51) group changed treatment more than voiding group (0.21±0.41, P=.003). However, the voiding group (-9.4) had significantly more improvement than e storage (-6.4) and nocturia (-7.8) groups (P=.011).Conclusions: Male LUTS continually improved over 6 months with customised treatment. Pharmacotherapy for male LUTS should be tailored by symptom type and alteration of symptoms during treatment. [ABSTRACT FROM AUTHOR]

Rhus verniciflua Stoke has been commonly used in traditional medicine to treat gastrointestinal (GI) dysfunction diseases. In order to investigate pharmacological properties of Rhus verniciflua Stoke water extract (RVX) on cisplatin-induced amnesia, RVX (0, 25, 50, or 100 mg/kg) was orally administrated for five consecutive days after a single intraperitoneal injection of cisplatin (6 mg/kg) to SD rat. Cisplatin injection significantly increased the kaolin intake (emesis) but reduced the normal diet intake (anorexia) whereas the RVX treatment significantly improved these abnormal diet behaviors at both the acute and delayed phase. The serotonin concentration and the related gene expressions (5-HT3 receptors and SERT) in small intestine tissue were abnormally altered by cisplatin injection, which were significantly attenuated by the RVX treatment. Histological findings of gastrointestinal tracts, as well as the proteins level of proinflammatory cytokines (TNF-α, IL-6, and IL-1β), revealed the beneficial effect of RVX on cisplatin-induced gastrointestinal inflammation. In addition, RVX significantly improved cisplatin-induced myelosuppression, as evidenced by the observation of leukopenia and by histological examinations in bone marrow. Our findings collectively indicated Rhus verniciflua Stoke improved the resistance of rats to chemotherapy-related adverse effects in the gastrointestinal track and bone marrow. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to evaluate the persistence with solifenacin therapy over a 12-month period in patients with overactive bladder (OAB).Methods: This is a 52-week long, multicenter, prospective, observational study. The subjects were individuals ≥ 18 years old with OAB symptoms for ≥ 3 months, characterised by a total OAB Symptom Score (OABSS) of ≥ 3 and OABSS urgency item score of ≥ 2. Patients were prescribed 5 mg or 10 mg of solifenacin once daily for OAB symptoms. Drug persistence, reasons for discontinuation and factors related to the persistence were evaluated.Results: A total of 1018 patients (329 men, 689 women) with a mean age of 59 years were included. The 52-week drug persistence rate was 22.1%. The drug persistence rates at 12, 24 and 36 weeks were 72.4%, 45.8% and 31.1% respectively. The three most common reasons for discontinuing therapy included symptom improvement in 30.4%, lack of efficacy in 13.4%, and a switch to another antimuscarinic agent in 10.8%. Older patients (odds ratio = 1.02, 95% CI: 1.01-1.04), and female patients (odds ratio = 1.94, 95% CI: 1.37-2.75) were more likely to continue the medication over the 12-month period than were younger, male patients. The number of nocturia episodes was negatively correlated with drug persistence (odds ratio = 0.83, 95% CI: 0.71-0.97).Conclusions: There was low persistence (22%) to solifenacin therapy for OAB symptoms over a 12-month period. Older patients, female patients and those with fewer episodes of nocturia were more persistent to therapy than were others. [ABSTRACT FROM AUTHOR]

Background: We evaluated the vascular complications and success rate of manual compression in achieving hemostasis and access site closure after transfemoral arterial extracorporeal membrane oxygenation (ECMO) decannulation.Methods: Between February 2010 and July 2014, 63 patients who underwent veno-arterial ECMO were retrospectively studied. Patients who developed postprocedural vascular complications after manual compression were identified, and the hemostasis success rate was evaluated.Results: The overall manual compression success rate was 95.2%. Eleven patients (17.5%) developed vascular complications: hematoma (more than 5 cm) occurred in six patients (9.5%) who were treated with repeat manual compression. Retroperitoneal bleeding occurred in one patient, requiring abdominal hematoma evacuation surgery. One patient (1.6%) developed access site bleeding, requiring suturing. One patient (1.6%) developed an arteriovenous fistula (AVF). Two patients (3.2%) had a pseudoaneurysm, of whom one was treated with sclerotherapy in the femoral artery; the other patient and the AVF patient were treated with repeat manual compression. The hematoma rate was significantly higher in patients with an activated partial thromboplastin time (aPTT) >56, and in whom dual antiplatelet drugs were used (OR: 11.55, 95% CI: 1.32-100.92, p = 0.027; OR: 8.17, CI: 1.61-41.46, p = 0.011, respectively).Conclusion: The use of dual antiplatelet drugs and a higher aPTT can lead to an increased risk of post-procedural vascular complications. Therefore, manual compression should be applied cautiously after the correction of coagulopathy factors such as activated clotting time (ACT), aPTT, and platelets. [ABSTRACT FROM AUTHOR]

Al2O3-Ni-P composite powders with Ni-P contents of 10.9, 14.4, and 20.4 wt.% were synthesized via the Ni-P electroless deposition process. The as-received Al2O3-Ni-P composite powders were composed of Ni-P particles and Ni-P coating layer. Some Ni-P particles randomly adhered to the Al2O3 powders, and their particle diameter ranged from 5 nm to 20 nm. The thin Ni-P layer had about 5 nm thick amorphous structure and directly bonded with Al2O3 powders. Using the Ni-P-coated Al2O3 powders, a dense Al2O3-Ni-P composite can be successfully obtained using the hot press process at 1,350°C for 1 hour in an Ar atmosphere under an applied pressure of 30 MPa. The hot-pressed Al2O3-15 wt.% Ni-P composite showed excellent material properties. Its relative density, Vickers hardness, and fracture toughness were comparatively high: about 99.1%, 2,360 Hv, and 6 MPa·m1/2, respectively. The fracture surface of the hot-pressed Al2O3-Ni-P composite showed a semiductile mode due to the mixed intergranular and transgranular fracture mode. In particular, the fracture toughness of the hot-pressed Al2O3-15 wt.% Ni-P composite was strongly enhanced by the combined action of the crack branching and the crack deflection. [ABSTRACT FROM AUTHOR]

Background. This retrospective study aimed to assess the efficacy and toxicities of second-line chemotherapy with irinotecan, leucovorin, and 5-fluorouracil (5-FU) in metastatic gastric cancer (MGC) patients previously treated with docetaxel and S-1 with or without oxaliplatin (DS/DOS). Patients and Methods. We reviewed the data of patients who had previously been treated with first-line DS/DOS and received biweekly irinotecan-based chemotherapy (FOLFIRI/IFL) between October 2004 and November 2011. Results. A total of 209 cycles were administered to 35 patients, with a median of 4 (range, 1–22) cycles each. The overall response rate in 29 response-assessable patients was 17.2%, including 2 complete and 3 partial responses. The median progression-free and overall survivals were 3.81 (95% confidence interval [CI], 1.82–5.80) months and 6.24 (95% CI, 1.44–11.04) months, respectively. The major grade 3/4 toxicity was neutropenia (8.6%). Conclusion. FOLFIRI/IFL chemotherapy showed modest antitumour activity and tolerable toxicities in DS/DOS-treated MGC patients. [ABSTRACT FROM AUTHOR]

We aimed to identify the hepatoprotective effects of Terminalia chebula water extract (TCW) and its corresponding pharmacological actions using C57/BL6 mice model of tert-butylhydroperoxide-(t-BHP-) induced acute liver injury. Mice were orally administered with TCW (0, 50, 100, or 200 mg/kg) or gallic acid (100 mg/kg) for 5 days before t-BHP (2.5 mM/kg) injection. Liver enzymes, histopathology, oxidative stress parameters, antioxidant components, and inflammatory cytokines were examined 18 h after t-BHP injection. t-BHP injection caused dramatic elevation of serum AST, ALT, and LDH level, while TCW pretreatment notably attenuated these elevations. Inflammatory cytokines including TNF-α, IL-1β, and IL-6 were notably increased in hepatic tissues, and then these were efficiently attenuated by TCW pretreatment. t-BHP injection notably increased malondialdehyde, total reactive oxygen species, and nitric oxide in the liver tissue, while it markedly dropped the antioxidant activities including total antioxidant capacity, total glutathione contents, glutathione peroxidase, superoxide dismutase, and catalase. TCW pretreatment remarkably ameliorated these alterations, and these effects were relevant to gene expressions. Histopathological examinations supported the above findings. Collectively, these findings well prove that TCW beneficially prevents acute and severe liver injury and clarify its corresponding mechanisms involved in the inhibition of oxidative stress and inflammatory cytokines. [ABSTRACT FROM AUTHOR]

ABSTRACT Outsourcing database to a third-party data provider is becoming a common practice for data owners to avoid the cost of managing and maintaining the database. Meanwhile, because of the popularity of location-based services, the need for spatial data is increasing dramatically. However, the most important challenge in database outsourcing is how to meet privacy requirements and guarantee the integrity of the query result as well. Unfortunately, most of the existing techniques support either data privacy or integrity on spatial databases. To carry on both privacy and integrity for outsourced spatial data, we propose a spatial transformation scheme that makes use of shearing transformation with rotation shifting. We describe attack models measuring the data privacy of our transformation scheme. Finally, our extensive experiments have demonstrated that our scheme has adequate strength for data privacy by showing outstanding performance against different kinds of attack models and efficiently handles the query integrity of the query result sets. Copyright © 2013 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]