AIM To consolidate the present evidence of effectiveness in renal functioning and graft survival following early introduction of mammalian target of rapamycin(m TOR) inhibitors with or without calcineurin inhibitors(C...AIM To consolidate the present evidence of effectiveness in renal functioning and graft survival following early introduction of mammalian target of rapamycin(m TOR) inhibitors with or without calcineurin inhibitors(CNIs) in renal transplant recipients.METHODS We analysed the current literature following PROSPERO approval describing the role of immunosuppressive agent, m TOR inhibitors as an alternative to CNI within six months of renal transplant by searching the Pub Med, EMBASE, Cochrane, Crossref, and Scopus using Me SH terms. RESULTS Six articles of early withdrawal of CNI and introduction of m TOR-inhibitors within six months of renal transplantation were sought. Glomerular filtration rate(GFR) and serum creatinine were significantly better in m TOR inhibitor group with equivalent survival at 12 mo, even though Biopsy Proven Acute rejection was significantly higher in m TOR-inhibitor group. CONCLUSION The evidence reviewed in this meta-analysis suggests that early introduction m TOR-inhibitors substantial CNI minimization. The m TOR inhibitors such as everolimus and sirolimus, due to their complementary mechanism of action and favourable nephrotoxicity profile; better glomerular filtration, lower serum creatinine with equivalent survival. Having said that, due to the higher rejection rate, may influence the use of these regimens to patients with moderate to high immunological risk patients.展开更多
BACKGROUND The T-cell costimulation blocking agent belatacept has been identified as a possible substitute for calcineurin inhibitors,however,no consensus has been established against its use over the standard care ag...BACKGROUND The T-cell costimulation blocking agent belatacept has been identified as a possible substitute for calcineurin inhibitors,however,no consensus has been established against its use over the standard care agent Tacrolimus.AIM To evaluate the effectiveness of belatacept based maintenance immunosuppressive regimens in comparison to tacrolimus in renal transplantion.METHODS We did extensive search of all the available literature comparing the role of belatacept to tacrolimus in renal transplant recipients by searching the PubMed,Embase,Cochrane,Crossref,Scopus,clinical trials registry on October 5,2020.RESULTS The literature search identified four randomized controlled trials(n=173 participants)comparing belatacept with tacrolimus.There was no significant difference in estimated renal function at 12 mo[mean difference 4.12 mL/min/1.73 m^(2),confidence interval(CI):-2.18 to 10.42,P=0.20].Further,belatacept group was associated with significant increase in biopsy proven acute rejection[relative risk(RR)=3.27,CI:0.88 to 12.11,P=0.08]and worse 12 mo allograft survival(RR=4.51,CI:1.23 to 16.58,P=0.02).However,incidence of new onset diabetes mellitus was lower with belatacept at 12 mo(RR=0.26,CI:0.07 to 0.99,P=0.05).CONCLUSION The evidence reviewed in this meta-analysis suggested that belatacept-based maintenance immunosuppression regimens were associated with an increased risk allograft loss in renal transplant recipients with equivalent renal functioning against standard tacrolimus;however,observed significantly reduced new onset diabetes mellitus after transplantation incidence and lower serum low density lipid profile levels in belatacept group.In addition,the adaptation of belatacept in renal transplantation has been forestalled by increased rates of rejection and resistance owing to development of various effector memory T cells through,parallel differentiation and immunological plasticity.展开更多
Several kinds of novel azobenzene-containing polyelectrolytes with special molecular design have been developed from acryloyl chloride or epoxy based precursor polymers. The acryloyl chloride based precursor polymer, ...Several kinds of novel azobenzene-containing polyelectrolytes with special molecular design have been developed from acryloyl chloride or epoxy based precursor polymers. The acryloyl chloride based precursor polymer, poly(acryloyl chloride), was prepared by free radical polymerization of acryloyl chloride. The azo polyelectrolytes were prepared by an esterification reaction between the precursor polymer and corresponding azo chromophores containing a reactive hydroxyl group, followed by hydrolysis of the unreacted acyl chloride groups. The epoxy based precursor polymer was prepared by the reaction between 1,4-cyclohexanedimethanol diglycidyl ether and aniline, and postfunctionalized by azo coupling reaction to form azo polymers containing chromophores with ionizable groups. The polyelectrolytes were characterized by elemental analysis, H-1-NMR, IR and UV-Vis spectroscopy. The photodynamic and photoresponsive properties, as well as self-assembly of these azo polyelectrolytes are reported in this paper([1]).展开更多
Polyserotonin was enzymatically synthesized using Horseradish peroxidase(HRP)as the catalyst.This novel conjugated polymer exhibited good fluorescent properties with significantly higher Stokes shift than its monomer....Polyserotonin was enzymatically synthesized using Horseradish peroxidase(HRP)as the catalyst.This novel conjugated polymer exhibited good fluorescent properties with significantly higher Stokes shift than its monomer.The enzymatic polymerization eliminated the need for extensive purification of the product(typically necessary for the removal of residual metal catalyst)allowing the product to be naturally fluorescent as synthesized.The reaction was monitored using UV-Vis spectrophotometry and the polymers were characterized using Fluorescence,Fourier Transform Infrared Spectroscopy(FTIR)and Thermogravimetry.The possibility of using polyserotonin for the detection of nitro-aromatic compounds,including 2,4-dinitrotoluene(DNT)and trinitrotoluene(TNT),through fluorescence quenching at parts per million levels in solution has also been demonstrated.展开更多
Bacterial infections are a major cause for impulsive deaths in human beings.Bacterial infections of the respiratory,gastrointestinal and central nervous system account for the majority of cases of sudden casualties.Re...Bacterial infections are a major cause for impulsive deaths in human beings.Bacterial infections of the respiratory,gastrointestinal and central nervous system account for the majority of cases of sudden casualties.Readily available drugs are getting ineffective by each passing day as the mutation is very fast in these pathogenic microbes resulting in drug resistance.The growing resistance of bacteria necessitates the development of new and effective compounds of desired characteristics that could bar the rapid development of bacterial cell inside of the host body.Along with cellular resistance for clinical antibiotics,co-bacterial infections during microbial attacks(viz.virus,fungus,protozoans etc.)also demand for some novel antibacterial drugs having high efficacy and minimal side effects on human body.These antibiotics should also be compatible with remedies ongoing for core microbial infections.So,in demand of search for effective antibacterial moieties,the scope of transition metal complexes as drug gives a good signal against the pathogenic bacteria by inhibiting their growth.The action of metal complexes on bacterial cell may be due to impremiablity,enzymatic interruptions,ribosomal interactions,disturbance in the path of protein synthesis,denaturing of genetic materials etc.inside the cell.Metals in complexes may interrupt the lipophilisity through the bacterial cell wall.Inclusion of metal ions in organic moieties behaving as ligand delocalizeπ-electrons upon the entire chelate ring and this chelation results in overlapping of ligand orbital and partial sharing of(+)ve charge of metal ion with donor atoms.These structural modifications in metal and organic lone pair donor species are the supposed reasons for their enhanced antimicrobial activities against pathogenic microbes.The present review focuses on the impact of recently synthesized,well characterized mono and binuclear transition metal complexes of Cu ions that have the potential to be the drug of the decade in medicinal inorganic chemistry for treating the bacterial diseases.展开更多
Purpose: Liver is the most frequently injured organ in abdominal trauma. Today non-operative management (NOM) is considered as the standard of care in hemodynamically stable patients, with or without the adjunct of an...Purpose: Liver is the most frequently injured organ in abdominal trauma. Today non-operative management (NOM) is considered as the standard of care in hemodynamically stable patients, with or without the adjunct of angioembolisation (AE). This systematic review assesses the incidence of complications in patients who sustained liver injuries and were treated with simple clinical observation. Given the differences in indications of treatment and severity of liver trauma and acknowledging the limitations of this study, an analysis of the results has been done in reference to the complications in patients who were treated with AE. Methods: A systematic literature review searched "liver trauma" , "hepatic trauma" , "conservative management" , "non operative management" on MEDLINE (via PubMed), Cochrane Central Register of Controlled Trials databases, EMBASE, and Google Scholar, to identify studies published on the conservative management of traumatic liver injuries between January 1990 and June 2020. Patients with traumatic liver injuries (blunt and penetrating) treated by NOM, described at least one outcome of interests and provided morbidity outcomes from NOM were included in this study. Studies reported the outcome of NOM without separating liver from other solid organs;studies reported NOM complications together with those post-intervention;case reports;studies including less than 5 cases;studies not written in English;and studies including patients who had NOM with AE as primary management were excluded. Efficacy of NOM and overall morbidity and mortality were assessed, the specific causes of morbidity were investigated, and the American Association for the Surgery of Trauma classification was used in all the studies analysed. Statistical significance has been calculated using the Chi-square test. Results: A total of 19 studies qualified for inclusion criteria were in this review. The NOM success rate ranged from 85% to 99%. The most commonly reported complications were hepatic collection (3.1%), followed by bile leak (1.5%), with variability between the studies. Other complications included hepatic haematoma, bleeding, fistula, pseudoaneurysm, compartment syndrome, peritonitis, and gallbladder ischemia, all with an incidence below 1%. Conclusion: NOM with simple clinical observation showed an overall low incidence of complications, but higher for bile leak and collections. In patients with grade III and above injuries, the incidence of bile leak, collections and compartment syndrome did not show a statistically significant difference with the AE group. However, the latter result is limited by the small number of studies available and it requires further investigations.展开更多
文摘AIM To consolidate the present evidence of effectiveness in renal functioning and graft survival following early introduction of mammalian target of rapamycin(m TOR) inhibitors with or without calcineurin inhibitors(CNIs) in renal transplant recipients.METHODS We analysed the current literature following PROSPERO approval describing the role of immunosuppressive agent, m TOR inhibitors as an alternative to CNI within six months of renal transplant by searching the Pub Med, EMBASE, Cochrane, Crossref, and Scopus using Me SH terms. RESULTS Six articles of early withdrawal of CNI and introduction of m TOR-inhibitors within six months of renal transplantation were sought. Glomerular filtration rate(GFR) and serum creatinine were significantly better in m TOR inhibitor group with equivalent survival at 12 mo, even though Biopsy Proven Acute rejection was significantly higher in m TOR-inhibitor group. CONCLUSION The evidence reviewed in this meta-analysis suggests that early introduction m TOR-inhibitors substantial CNI minimization. The m TOR inhibitors such as everolimus and sirolimus, due to their complementary mechanism of action and favourable nephrotoxicity profile; better glomerular filtration, lower serum creatinine with equivalent survival. Having said that, due to the higher rejection rate, may influence the use of these regimens to patients with moderate to high immunological risk patients.
文摘BACKGROUND The T-cell costimulation blocking agent belatacept has been identified as a possible substitute for calcineurin inhibitors,however,no consensus has been established against its use over the standard care agent Tacrolimus.AIM To evaluate the effectiveness of belatacept based maintenance immunosuppressive regimens in comparison to tacrolimus in renal transplantion.METHODS We did extensive search of all the available literature comparing the role of belatacept to tacrolimus in renal transplant recipients by searching the PubMed,Embase,Cochrane,Crossref,Scopus,clinical trials registry on October 5,2020.RESULTS The literature search identified four randomized controlled trials(n=173 participants)comparing belatacept with tacrolimus.There was no significant difference in estimated renal function at 12 mo[mean difference 4.12 mL/min/1.73 m^(2),confidence interval(CI):-2.18 to 10.42,P=0.20].Further,belatacept group was associated with significant increase in biopsy proven acute rejection[relative risk(RR)=3.27,CI:0.88 to 12.11,P=0.08]and worse 12 mo allograft survival(RR=4.51,CI:1.23 to 16.58,P=0.02).However,incidence of new onset diabetes mellitus was lower with belatacept at 12 mo(RR=0.26,CI:0.07 to 0.99,P=0.05).CONCLUSION The evidence reviewed in this meta-analysis suggested that belatacept-based maintenance immunosuppression regimens were associated with an increased risk allograft loss in renal transplant recipients with equivalent renal functioning against standard tacrolimus;however,observed significantly reduced new onset diabetes mellitus after transplantation incidence and lower serum low density lipid profile levels in belatacept group.In addition,the adaptation of belatacept in renal transplantation has been forestalled by increased rates of rejection and resistance owing to development of various effector memory T cells through,parallel differentiation and immunological plasticity.
基金This work was supported by National Natural Foundation of China (No. 59873013).
文摘Several kinds of novel azobenzene-containing polyelectrolytes with special molecular design have been developed from acryloyl chloride or epoxy based precursor polymers. The acryloyl chloride based precursor polymer, poly(acryloyl chloride), was prepared by free radical polymerization of acryloyl chloride. The azo polyelectrolytes were prepared by an esterification reaction between the precursor polymer and corresponding azo chromophores containing a reactive hydroxyl group, followed by hydrolysis of the unreacted acyl chloride groups. The epoxy based precursor polymer was prepared by the reaction between 1,4-cyclohexanedimethanol diglycidyl ether and aniline, and postfunctionalized by azo coupling reaction to form azo polymers containing chromophores with ionizable groups. The polyelectrolytes were characterized by elemental analysis, H-1-NMR, IR and UV-Vis spectroscopy. The photodynamic and photoresponsive properties, as well as self-assembly of these azo polyelectrolytes are reported in this paper([1]).
文摘Polyserotonin was enzymatically synthesized using Horseradish peroxidase(HRP)as the catalyst.This novel conjugated polymer exhibited good fluorescent properties with significantly higher Stokes shift than its monomer.The enzymatic polymerization eliminated the need for extensive purification of the product(typically necessary for the removal of residual metal catalyst)allowing the product to be naturally fluorescent as synthesized.The reaction was monitored using UV-Vis spectrophotometry and the polymers were characterized using Fluorescence,Fourier Transform Infrared Spectroscopy(FTIR)and Thermogravimetry.The possibility of using polyserotonin for the detection of nitro-aromatic compounds,including 2,4-dinitrotoluene(DNT)and trinitrotoluene(TNT),through fluorescence quenching at parts per million levels in solution has also been demonstrated.
文摘Bacterial infections are a major cause for impulsive deaths in human beings.Bacterial infections of the respiratory,gastrointestinal and central nervous system account for the majority of cases of sudden casualties.Readily available drugs are getting ineffective by each passing day as the mutation is very fast in these pathogenic microbes resulting in drug resistance.The growing resistance of bacteria necessitates the development of new and effective compounds of desired characteristics that could bar the rapid development of bacterial cell inside of the host body.Along with cellular resistance for clinical antibiotics,co-bacterial infections during microbial attacks(viz.virus,fungus,protozoans etc.)also demand for some novel antibacterial drugs having high efficacy and minimal side effects on human body.These antibiotics should also be compatible with remedies ongoing for core microbial infections.So,in demand of search for effective antibacterial moieties,the scope of transition metal complexes as drug gives a good signal against the pathogenic bacteria by inhibiting their growth.The action of metal complexes on bacterial cell may be due to impremiablity,enzymatic interruptions,ribosomal interactions,disturbance in the path of protein synthesis,denaturing of genetic materials etc.inside the cell.Metals in complexes may interrupt the lipophilisity through the bacterial cell wall.Inclusion of metal ions in organic moieties behaving as ligand delocalizeπ-electrons upon the entire chelate ring and this chelation results in overlapping of ligand orbital and partial sharing of(+)ve charge of metal ion with donor atoms.These structural modifications in metal and organic lone pair donor species are the supposed reasons for their enhanced antimicrobial activities against pathogenic microbes.The present review focuses on the impact of recently synthesized,well characterized mono and binuclear transition metal complexes of Cu ions that have the potential to be the drug of the decade in medicinal inorganic chemistry for treating the bacterial diseases.
文摘Purpose: Liver is the most frequently injured organ in abdominal trauma. Today non-operative management (NOM) is considered as the standard of care in hemodynamically stable patients, with or without the adjunct of angioembolisation (AE). This systematic review assesses the incidence of complications in patients who sustained liver injuries and were treated with simple clinical observation. Given the differences in indications of treatment and severity of liver trauma and acknowledging the limitations of this study, an analysis of the results has been done in reference to the complications in patients who were treated with AE. Methods: A systematic literature review searched "liver trauma" , "hepatic trauma" , "conservative management" , "non operative management" on MEDLINE (via PubMed), Cochrane Central Register of Controlled Trials databases, EMBASE, and Google Scholar, to identify studies published on the conservative management of traumatic liver injuries between January 1990 and June 2020. Patients with traumatic liver injuries (blunt and penetrating) treated by NOM, described at least one outcome of interests and provided morbidity outcomes from NOM were included in this study. Studies reported the outcome of NOM without separating liver from other solid organs;studies reported NOM complications together with those post-intervention;case reports;studies including less than 5 cases;studies not written in English;and studies including patients who had NOM with AE as primary management were excluded. Efficacy of NOM and overall morbidity and mortality were assessed, the specific causes of morbidity were investigated, and the American Association for the Surgery of Trauma classification was used in all the studies analysed. Statistical significance has been calculated using the Chi-square test. Results: A total of 19 studies qualified for inclusion criteria were in this review. The NOM success rate ranged from 85% to 99%. The most commonly reported complications were hepatic collection (3.1%), followed by bile leak (1.5%), with variability between the studies. Other complications included hepatic haematoma, bleeding, fistula, pseudoaneurysm, compartment syndrome, peritonitis, and gallbladder ischemia, all with an incidence below 1%. Conclusion: NOM with simple clinical observation showed an overall low incidence of complications, but higher for bile leak and collections. In patients with grade III and above injuries, the incidence of bile leak, collections and compartment syndrome did not show a statistically significant difference with the AE group. However, the latter result is limited by the small number of studies available and it requires further investigations.
