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Atrial fibrillation in the elderly

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Journal of Geriatric Cardiology 2019年第1期16卷 49-53页

作者： Pablo Díez-Villanueva Fernando Alfonso Department of Cardiology Hospital Universitario de la Princesa

Atrial fibrillation(AF)is the most common arrhythmia in elderly population,with age being one of the most important factors involved in its pathogenesis.Conduction disturbances may be present on the surface electrocardiogram before AF onset in some patients.Once this arrhythmia is diagnosed,antithrombotic therapy is mandatory in most cases,as this is the only treatment that has demonstrated to improve survival.Age increases both the risk of thromboembolic and bleeding complications,while benefits from anticoagulant therapy outweigh that from bleeding in most scenarios,also in very elderly patients.However,elderly patients with AF are often undertreated.Non-vitamin K antagonist oral anticoagulants have emerged as an alternative to vitamin K antagonists,with significant less adverse events and better profile in terms of efficacy and safety.Other conditions related to age should be carefully evaluated in these patients(including frailty,comorbidity and polypharmacy)to ensure an individualized clinical and therapeutic approach.

关键词： Atrial fibrillation Antithrombotic therapy Frailty Non-vitamin K antagonist oral anticoagulants The elderly

Evidence on neuroprotective properties of coenzyme Q10 in the treatment of glaucoma

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Neural Regeneration Research 2019年第2期14卷 197-200页

作者： Alessio Martucci Carlo Nucci Ophthalmology Unit Department of Experimental Medicine University of Rome Tor Vergata

Glaucoma, the leading cause of visual impairment and irreversible blindness worldwide, is a multifactorial, progressive optic neuropathy characterized by loss of retinal ganglion cells, alterations of the optic nerve head, and specific visual field defects. Clinical evidence shows that intraocular pressure is the major risk factor of the treatable disease. However, in some patients, glaucoma develops and continues to progress despite normal intraocular pressure values, suggesting that other risk factors are involved in the disease. Consequently, neuroprotective treatments, focused on preventing retinal ganglion cells death by acting on different therapeutic strategies but not focused on intraocular pressure reduction, has therefore become of great interest. In this contest, coenzyme Q10, showing evidence in slowing or reversing pathological changes typical of the disease, has been proposed as a potential neuroprotective agent in glaucoma. In this review, we describe the possible mechanisms of action of coenzyme Q10 and the recent evidence in literature regarding the neuroprotective activity of the molecule.

关键词： glaucoma neuroprotection retinal ganglion cells coenzyme Q10 intraocular pressure mitochondrion oral administration neurodegenerative diseases

Analysis on oral medication rules of traditional Chinese medicine prescriptions for prevention of COVID-19

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Chinese Herbal Medicines 2021年第4期13卷 502-517页

作者： Dong-yang Wu Xiao-tao Hou Zhong-shang Xia Er-wei Hao Jin-ling Xie Jing-yan Liang Qiu-ming Liang Zheng-cai Du Jia-gang Deng Guangxi Key Laboratory of Efficacy Study on Chinese Materia Medica Guangxi University of Chinese MedicineNanning 530001China Collaborative Innovation Center for Research on Functional Ingredients of Agricultural Residues Guangxi University of Chinese MedicineNanning 530200China Guangxi Key Laboratory of TCM Formulas Theory and Transformation for Damp Diseases Guangxi University of Chinese MedicineNanning 530200China China-ASEAN Joint Laboratory for International Cooperation in Traditional Medicine Research Guangxi University of Chinese MedicineNanning 530200China Qinzhou Hospital of Traditional Chinese Medicine Qinzhou 535099China

Objective:To analyze the medication rules of traditional Chinese medicine(TCM)preventive oral prescriptions for COVID-19.Methods:The preventive oral prescriptions for COVID-19 published by national and provincial health and wellness committees,administrations of TCM,medical institutions at all levels,medical masters and Chinese medicine experts were collected to establish a database,manual screening was carried out according to the inclusion and exclusion criteria,and frequency statistics,association rule analysis.The mutual information method,entropy hierarchical clustering and other methods were improved through Excel and the TCM inheritance auxiliary platform V2.5 to mine the rules and characteristics of medication.Results:The selected 157 prescriptions contained a total of 130 TCMs.The top five TCMs with the highest use frequency were Glycyrrhizae Radix et Rhizoma(86),Astragali Radix(80),Lonicerea Japonicae Flos(70),Atractylodis Macrocephalae Rhizoma(62),Saposhnikoviae Radix(60).In accordance with TCM efficacy classification,most of them were medicines for qi-tonifying(279),followed by medicines for clearing heat and drying dampness(163),dispelling pathogenic wind-cold(126),resolving dampness(111),as well as dispelling pathogenic wind-heat(99).The characteristics of four-natures of the selected medicines are as follows:most of them were cold(59),followed by warm(38)and mild(21).In terms of fivetaste,most of them were sweet(26)and acrid-and-bitter(24),followed by sweet-and-bitter(20),bitter(20)and acrid(15).For the meridian attribution,the five-zang organs and six-fu organs were all involved,most of them attributed to lung meridian(80),followed by stomach meridian(57)and spleen meridian(40).Based on association rule analysis,12 commonly used medicine combinations with two or three TCMs were found.The commonly used medicinal pairs included Astragali Radix and Saposhnikoviae Radix(51),Astragali Radix and Atractylodis Macrocephalae Rhizoma(46),Atractylodis Macrocephalae Rhizoma and Saposhnikoviae Radix(43),Astrag

关键词： COVID-19 medication rule oral preventive prescriptions

oral delivery of insulin with Desmodium gangeticum root aqueous extract protects rat hearts against ischemia reperfusion injury in streptozotocin induced diabetic rats

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Asian Pacific Journal of Tropical Medicine 2010年第2期3卷 94-100页

作者： Gino A.Kurian Jose Paddikkala School of Chemical and Biotechnology SASTRA UniversityThirumalaisamudramThanjavurTamil NaduIndia613402 Department of Plant Biotechnology Amala Cancer Research CenterAmalanagarTrichurKeralaIndia

Objective:To evaluate the effect of insulin administered via oral route with the help of aqueous extract of Desmodium gangeticum(DG) root in rendering cardio protection against ischemia reperfusion injury in diabetic rats.Methods:Diabetes mellitus was induced in rats by theβ-cell toxin,streptozotocin(STZ,60 mg/kg).Isolated rat(IR) heart was used to investigate the effect of insulin mixed DG pretreatment on ischemia reperfusion injury.Mitochondrial respiratory enzymes and microsomal enzymes were used to assess the metabolic recovery of myocardium. Cardiac marker enzymes were used to find the functional recovery,which were compared with that of the STZ treated IR rats.Results:Compared with IR control group,rat treated with insulin mixed DG showed a significant functional and metabolic recovery of myocardium from the insult of ischemia reperfusion.Even though orally administered insulin mixed DG displayed a slow but prolonged hypoglycemic effect,the cardio protection it provided was more significant than when it was given intra peritoneal.Furthermore the above result indicates that insulin mixed DG can overcome the barriers in the gastrointestinal tract and be absorbed.Conclusions:The above results indicate the efficacy of insulin mixed DG in protecting the heart from ischemia reperfusion induced injury in diabetic rats.Furthermore the study gives additional information that herbal extracts can be used to transport insulin across the membrane and found to be a feasible approach for developing the oral delivery of insulin,as well as other peptide drugs.

关键词： Desmodium gangeticum Insulin oral delivery Myocardial ischemia reperfusion

New oral pharmacotherapeutic agents for venous thromboprophylaxis after total hip arthroplasty

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World Journal of Orthopedics 2014年第3期5卷 188-203页

作者： Garrett B Aikens Jacob R Osmundson Michael P Rivey Department of Pharmacy Central Alabama Veterans Health Care SystemMontgomeryAL 36109United States Department of Pharmacy Practice Auburn University Harrison School of Pharmacy Auburn University AuburnAL 36849United States Department of Pharmacy Practice University of Montana Skaggs School of PharmacyMissoulaMT 59812United States Department of Pharmacy Community Medical CenterMissoulaMT 59804United States

Patients undergoing total hip arthroplasty(THA)are at high risk for developing venous thromboembolism and,therefore,require short term prophylaxis with antithrombotic agents.Recently,target specific oral anticoagulants(TSOA)including the direct thrombin inhibitor,dabigatran,and the factorⅩa inhibitors rivaroxaban,apixaban,and edoxaban have been approved for THA thrombopropylaxis in various countries.The TSOAs provide a rapid acting,oral alternative to parenteral agents including low-molecular weight heparins(LMWH)and fondaparinux;and compared to warfarin,they do not require routine laboratory monitoring and possess much fewer drug-drug interactions.Based on phaseⅢclinical studies,TSOAs have established themselvesas an effective and safe option for thromboprophylaxis after THA compared to LMWH,particularly enoxaparin,but require additional evaluation in specific populations such as the renally impaired or elderly.The ability to monitor and reverse these TSOAs in the case of bleeding complications or suspected sub-or supra-therapeutic anticoagulation is of importance,but remains investigational.This review will focus on the drug-specific characteristics,efficacy,safety,and economic impact of the TSOAs for thromboprophylaxis following THA,as well as the aspects of therapeutic monitoring and anticoagulation reversal in the event of bleeding complications or a need for urgent reversal.

关键词： oral Thromboprophylaxis Venous thromboembolism Hip Arthroplasty

Portal vein thrombosis in cirrhosis: Why a well-known complication is still matter of debate

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World Journal of Gastroenterology 2019年第31期25卷 4437-4451页

作者： Mariella Faccia Maria Elena Ainora Francesca Romana Ponziani Laura Riccardi Matteo Garcovich Antonio Gasbarrini Maurizio Pompili Maria Assunta Zocco Department of Internal Medicine and Gastroenterology Fondazione Policlinico Universitario A.Gemelli IRCCSCatholic University

Portal vein thrombosis(PVT)represents a well-known complication during the natural course of liver cirrhosis(LC),ranging from asymptomatic cases to lifethreating conditions related to portal hypertension and hepatic decompensation.Portal flow stasis,complex acquired hypercoagulable disorders and exogenous factors leading to endothelial dysfunction have emerged as key factors for PVT development.However,PVT occurrence remains unpredictable and many issues regarding its natural history,prognostic significance and treatment are still elusive.In particular although spontaneous resolution or disease stability occur in most cases of PVT,factors predisposing to disease progression or recurrence after spontaneous recanalization are not clarified as yet.Moreover,PVT impact on LC outcome is still debated,as PVT may represent itself a consequence of liver fibrosis and hepatic dysfunction progression.Anticoagulation and transjugular intrahepatic portosystemic shunt are considered safe and effective in this setting and are recommended in selected cases,even if the safer therapeutic option and the optimal therapy duration are still unknown.Nevertheless,their impact on mortality rates should be addressed more extensively.In this review we present the most debated questions regarding PVT,whose answers should come from prospective cohort studies and large sample-size randomized trials.

关键词： Portal vein thrombosis Liver cirrhosis Hypercoagulability Anticoagulation Direct oral anticoagulants

Efficacy of Topical Tacrolimus for Erosive oral Lichen Planus: A Meta-analysis

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Chinese Medical Sciences Journal 2015年第4期30卷 210-217页

作者： Chun-lan Gu Ji-zhi Zhao Jie Zhang Hai-tao Dong Department of Stomatology Peking Union Medical College Hospital Chinese Academy of Medical Sciences & Peking Union Medical College

Objective To assess the efficacy and safety of topical tacrolimus for erosive oral lichen planus(EOLP). Methods Literatures published up to December 2013 were searched from Pub Med, Embase, CENTRAL, Chinese Bio Medical Literature Database(CBM), and System for Information on Grey Literature in Europe(SIGLE). All randomized controlled trials(RCTs) of topical tacrolimus for EOLP which compared with other interventions or a placebo were considered in this Meta-analysis. Two researchers collected data independently. The assessment of methodological quality was based on Cochrane Handbook and the materials were analyzed with the software Revman 5.2.5. The primary outcome measures were the symptoms(e.g. pain, discomfort) complained by patients. The secondary outcome measures included the improvement rate of clinical signs assessed by the investigators and the incidence of adverse effects(e.g. clinical candidiasis). Results A total of 9 RCTs involving 476 patients were finally included. The pooled odds ratio(OR) of clinical improvement for topical tacrolimus vs. topical corticosteroids was 1.19 [95% confidence interval(CI): 0.64-2.22, I2: 44%]. Regarding to 0.1% tacrolimus and 0.03% tacrolimus, the pooled OR were 1.87(95 % CI: 0.60-5.82) and 1.47(95 % CI: 0.14-16.04) respectively in subgroup analysis. No serious adverse events were reported in topical tacrolimus group. Conclusions There was no evidence to support that topical tacrolimus for EOLP was more effective and safer than topical corticosteroids in this Meta-analysis. Clinical assessment criteria should be established and accepted by clinicians and researchers before further RCTs are undertaken.

关键词： tacrolimus corticosteroids oral lichen planus Meta-analysis

Porphyromonas gingivalis and digestive system cancers

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World Journal of Clinical Cases 2019年第7期7卷 819-829页

作者： Ying Zhou Guang-Hua Luo Comprehensive Laboratory the Third Affiliated Hospital of Soochow University

Porphyromonas gingivalis(P. gingivalis) is an anaerobic gram-negative bacterium that colonizes in the epithelium and has been strongly associated with periodontal disease. Recently, various degrees of associations between P.gingivalis and digestive system cancers, including oral squamous cell carcinoma in the oral cavity, oesophageal squamous carcinoma in the digestive tract, and pancreatic cancer in pancreatic tissues, have been displayed in multiple clinical and experimental studies. Since P. gingivalis has a strong association with periodontal diseases, not only the relationships between P. gingivalis and digestive system tumours but also the effects induced by periodontal diseases on cancers are well-illustrated in this review. In addition, the prevention and possible treatments for these digestive system tumours induced by P. gingivalis infection are also included in this review. At the end, we also highlighted the possible mechanisms of cancers caused by P. gingivalis. One important carcinogenic effect of P. gingivalis is inhibiting the apoptosis of epithelial cells,which also plays an intrinsic role in protecting cancerous cells. Some signalling pathways activated by P. gingivalis are involved in cell apoptosis, tumourigenesis,immune evasion and cell invasion of tumour cells. In addition, metabolism of potentially carcinogenic substances caused by P. gingivalis is also one of the connections between this bacterium and cancers.

关键词： Porphyromonas gingivalis oral squamous cell carcinoma Oesophageal squamous cell carcinoma Pancreatic cancer Periodontal diseases

oral biomaterials for intestinal regulation

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Engineered Regeneration

Engineered Regeneration 2021年第1期2卷 116-132页

作者： Cheng Zhao Lijun Cai Hanxu Chen Hui Tan Dewen Yan Department of Endocrinology Shenzhen Second People’s HospitalHealth Science Center of Shenzhen UniversityShenzhen 518035China Department of Gastroenterology Nanjing Drum Tower HospitalThe Affiliated Drum Tower Hospital of Nanjing University Medical SchoolNanjing 210002China State Key Laboratory of Bioelectronics School of Biological Science and Medical EngineeringSoutheast UniversityNanjing 210096China Department of Neurosurgery Health Science CenterThe First Affiliated Hospital of Shenzhen UniversityShenzhen Second People’s HospitalShenzhen 518035China

Intestinal diseases have always been a highly focused concern since recorded.Although endless efforts have been devoted,the underlying pathogenesis of alimentary canal disease remains mysterious and effective therapies are still in development.Intriguingly,the emerging of biomedical engineering has sprung up to unveil the enigmas of alimentary canal diseases,thus ameliorating the therapies and relieving the sufferings of patients.In this review,we present a comprehensive and deep-going perception into therapies of digestive disease with the assistance of biomaterials,involving the constructions of biomaterials and their mechanisms in digestive disease therapy.This review aims at conveying fundamentals of biomaterials in treating alimentary canal diseases,a critical analysis of their current applications and challenges,and a perspective on their future development.It is believed that this review will facilitate the communications between material science and medical fields.

关键词： oral Biomaterials Intestine Drug delivery