Systemic treatment for unresectable hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is most commonly found in the context of liver cirrhosis and,in rare cases,in a healthy liver.Its prevalence has risen in recent years,particularly in Western nations,due to the increasing frequency of nonalcoholic fatty liver disease.Advanced HCC has a poor prognosis.For many years,the only proven therapy for unresectable HCC (uHCC) was sorafenib,a tyrosine kinase inhibitor.Recently,the synergistic effect of an immune checkpoint inhibitor,atezolizumab,and bevacizu...     

Mebendazole treatment for intestinal nematode infection.

A total of 270 cases with intestinal nematode infection were selected as study subjects,amongthem 156 cases received 2％ mebendazole oral suspension 400 mg/day(200mg,bid)for three days forhe treatment of ascariasis,trichuriasis,and hookworm infection,200 mg/day(200mg,qd)for 3 daysfor the treatment of enterobiasis;114 cases received levamizole for the same treatment as a controlgroup.Before and after the treatment,all the patients'feces were examined by Kato's method.The     

What is the best treatment for prediabetes?

Worldwide, along with the increasing prevalence of obesity, the number of people with prediabetes is increasing. The diagnostic criteria for prediabetes include impaired fasting glucose, impaired glucose tolerance, and metabolic syndrome. The presence of two or more of these three criteria renders a person at high risk for future diabetes. The treatment goal of prediabetes is to prevent future development of type 2 diabetes and diabetes-related cardiovascular complications. The treatment approach is twofold: glycemic control and control of cardiovascular risk factors, mainly hypertension and hyperlipidemia. Intensive lifestyle modification is the mainstay of treatment in low-risk patients. When lifestyle modification fails and in high-risk patients, medications such as metformin and/or acarbose are recommended. For high-risk patients and those who progress despite intensive lifestyle modification, thiazolidinediones are also recommended. The goals for cardiovascular risk factor control are similar to those for patients with diabetes.     

Levalbuterol for asthma: A better treatment?

The purpose of this review is to determine whether the proinflammatory actions identified in vitro for (S)-albuterol provide a clinically significant therapeutic advantage for levalbuterol over racemic albuterol. Clinical trials evaluating the bronchodilation in chronic and acute asthma provide conflicting evidence. Older trials suggested an advantage for levalbuterol; however, the newer trials have failed to confirm those advantages. Although (S)-albuterol produces increased bronchial hyperresponsiveness in vitro and in animal models, this has not been consistently confirmed in clinical trials; however, the heterogeneity of the trials precludes definitive conclusions. Current clinical trials do not provide evidence of a substantial advantage of levalbuterol over racemic albuterol although the data are insufficient to determine whether subsets of the patient population might benefit from single isomer therapy.     

Surgical treatment for hepatocellular carcinoma and secondary hypersplenism

BACKGROUND: Hepatocellular carcinoma (HCC) is a common disease with high mortality and serious effect on the life quality of patients. Operation is still the most effective treatment. Currently, in China, patients with HCC are often complicated by hepatitis B related liver cirrhosis and secondary hypersplenism. This study was undertaken to evaluate the effect and indications of synchronous hepatectomy and splenectomy for HCC patients with hypersplenism. METHODS: The clinical records and treating processes of 24 patients with HCC and hypersplenism during the period of January 1991 to July 2004 were analyzed retrospectively. RESULTS: Sixteen patients underwent hepatectomy and splenectomy, including extensive devascularizasion around the cardia (9 patients). Seven patients were treated with microwave ablation and splenectomy plus extensive esophagogastric devascularization. One patient underwent hepatectomy combined with microwave ablation and splenectomy plus extensive esophagogastric devascularization. There were no deaths during the operation. During the first week after operation, the symptoms of hypersplenism disappeared and the platelet (Plt) and white blood cell (WBC) counts were significantly elevated (Plt: 247×109/L vs. 45.9×109/L, WBC: 13.0×109/L vs.3.3×109/L,P<0.01). CONCLUSIONS: Synchronous splenectomy can increase the safety of hepatectomy in selected patients with HCC and secondary hypersplenism by reducing bleeding complications. Splenectomy enhances patients' immunity against tumor in a long period as well.     

Pathogenesis of coeliac disease:implications for treatment

INTRODUCTIONCoeliac disease(CD)is an enteropathy,characterised by villousatrophy,which occurs in genetically susceptible individuals.It affectsmainly the proximal small intestine,and is caused by an intolerance tocereal storage proteins found in wheat,barley and rye.Due to earlierdiagnosis,and the recognition of‘silent’or‘latent’forms of thedisease,the very severe symptoms that were seen previously are notvery common now.Malabsorption,with steatorrhoea and weightloss,occur less frequently.Anaemia,vitamin deficiencies,complications of pregnancy and associated autoimmune diseases,suchas insulin dependent diabetes mellitus or thyroid disease are often the