Cost yield of different treatment strategies against Clonorchis sinensis infection

Background Clonorchiasis is attributed to the ingestion of raw freshwater fish harboring Clonorchis sinensis. Morbidity control is targeted through the administration of antihelminthics. This study modelled the cost yield indicated by effectiveness and utility of different treatment strategies against clonorchiasis. Methods About 1000 participants were enrolled from each of 14 counties selected from four provincial-level administrative divisions namely Guangxi, Guangdong, Heilongjiang and Jilin in 2017. Fecal examination was adopted to detect C. sinensis infection, while behavior of ingesting raw freshwater fish was enquired. Counties were grouped into four categories based on prevalence, namely low prevalence group (< 1%), moderate prevalence group (1–9.9%), high prevalence group (10–19.9%) and very high prevalence group (≥ 20%), while population were divided into three subgroups, namely children aged below 14 years old, adult female and adult male both aged over 14 years old. The average of cost effectiveness indicated by the cost to treat single infected cases with C. sinensis and of cost utility indicated by the cost to avoid per disability-adjusted life years (DALYs) caused by C. sinensis infection was calculated. Comparisons were performed between three treatment schedules, namely individual treatment, massive and selective chemotherapy, in which different endemic levels and populations were considered. Results In selective chemotherapy strategy, the cost to treat single infected case in very high prevalence group was USD 10.6 in adult male, USD 11.6 in adult female, and USD 13.2 in children. The cost increased followed the decrease of endemic level. In massive chemotherapy strategy, the cost per infected case in very high prevalence group was USD 14.0 in adult male, USD 17.1 in adult female, USD 45.8 in children, which were also increased when the endemic level decreased. In individual treatment strategy, the cost was USD 12.2 in adult male, USD 15.0 in adult female and USD 41.5 in children in very high prevalence group; USD 19.2 in adult male, USD 34.0 in adult female, and USD 90.1 in children in high prevalence group; USD 30.4 in adult male, USD 50.5 in adult female and over USD 100 in children in moderate prevalence group; and over USD 400 in any population in low prevalence group. As to cost utility, the differences by treatment strategies, populations and endemic levels were similar to those in cost effectiveness. Conclusions Both cost effectiveness and cost utility indicators are highly impacted by the prevalence and population, as well as the treatment schedules. Adults especially men in the areas with a prevalence over 10% should be prioritized, in which selective chemotherapy was best and massive chemotherapy was also cost effective. In moderate endemic areas, the yield is not ideal, but selective chemotherapy for adult male may also be adopted. In low endemic areas, all strategies were high costly and new strategies need to be developed. Graphical Abstract

An unusual variation in the termination of facial artery in south Indian population: A human cadaveric case report

The facial artery is an important artery of the face, prone to many variations. Identification of these variations is of utmost importance in clinical practice, especially rhinoplastic and orofacial surgeries and also super selective chemotherapy procedures. In this case report, we report a bilateral facial artery variation encountered in a male cadaver during routine dissection. Instead of terminating as the angular artery, the facial artery terminated as the superior labial artery, giving the lateral nasal artery as a smaller branch, much closer to the midline than normal. A prominent pre-masseteric branch was noticed along with smaller branches from the infraorbital artery which offered possible compensation for the short facial artery. The case reported is a type II variation according to Bayram classification, and a type C variation as per Loukas classification. This variation is very rare and should be kept in mind while performing any surgical procedures of the face.

Design, Synthesis, and Biological Evaluation of Camptothecin Loaded Biotinylated Cellulose Nanowhiskers as Anticancer Agents

Objective: Using biotinylated cellulose nanowhiskers (CNWs), we designed and synthesized a Glutathione (GSH) sensitive- Camptothecin (CPT) prodrug for selective CPT delivery (compound 12). Methods: CPT-biotin (compound 9), was synthesized by direct conjugation of CPT to the biotin via GSH sensitive linkage to evaluate the role of CNWs in compound 12. The chemical structures of the synthesized prodrugs were confirmed by FT-IR, 1H NMR, 13C NMR, and ESI-MS, while the nanoparticles were characterized by DLS and TEM. Results: The in-vitro drug release assay demonstrated that only 18.6% of CPT was released from the nano conjugate under GSH stimulation at micromolar level (100 μM), while 83.1% accumulative release rate was achieved under GSH stimulation at millimolar level (10 mM). The in-vitro cytotoxicity assay (MTT assay) demonstrated that compound 9showed higher inhibition ratios on biotin positive cells, MCF-7, and HepG2, and lower cytotoxicity on biotin negative, CHO. Compound 12 showed good activity against MCF-7, HepG2, and much lower cytotoxicity on CHO. Conclusion: This work demonstrates CPT-biotinylated cellulose nanowhiskers for selective chemotherapy and may have the potential to be used for cancer targeting.

Safe and Efficient Molybdenum Disulfide Platform for Cooperative Imaging-Guided Photothermal-Selective Chemotherapy: A Preclinical Study

Background The striking imbalance between the ever-increasing amount of nanomedicines and low clinical translation of products has become the focus of intense debate. For clinical translation, the critical issue is to select the appropriate agents and combination regimen for targeted diseases, not to prepare increasingly complex nanoplatforms. Methods Herein, a safe and efficient platform, α-tocopheryl succinate (α-TOS) married 2D molybdenum disulfide, was devised by a facile method and applied for cooperative imaging-guided photothermal-selective chemotherapy of ovarian carcinoma. Results The photothermal efficiency (65.3%) of the platform under safe near-infrared irradiation is much higher than that of other photothermal materials reported elsewhere. Moreover, the covalently linked α-TOS renders platform with selective chemotherapy for cancer cells. Remarkably, with these excellent properties, the platform can be used to completely eliminate the solid tumor by safe photothermal therapy, and then kill the residual cancer cells by selective chemotherapy to prevent tumor recurrence. More significantly, barely side effects occurred in the whole treatment process. The excellent efficacy and safety benefits in vivo lead to the prominent survival rate of 100% over 91 days. Conclusion Overall, the safe and efficient platform might be a candidate of clinical nanomedicines for multimode theranostics. This study demonstrates an innovative thought in precise nanomedicine regarding the design of next generation of cancer theranostic protocol for potential clinical practice.

Self-Assembled Nanoparticles Formed via Complementary Nucleobase Pair Interactions between Drugs and Nanocarriers for Highly Efficient Tumor-Selective Chemotherapy

We report a significant breakthrough in the development of complementary hydrogen-bonded drug-carrier systems, namely the construction of self-assembled nanoparticles with desirable functionalities conferred by the presence of stable complementary uracil–adenine...

Regional Chemotherapy Infusion Via the Bronchial Artery in Combined Treatment of Non-Small Cell Lung Cancer

Introduction. Chemotherapy in the form of endovascular infusion or its combination with radiotherapy is a method for treating non-small cell lung cancer (NSCLC), which raises heated discussions among specialists. This study is aimed at assessing the early results of combined treatment of NSCLC patients with selective chemotherapy infusion via the bronchial artery.Materials and methods. A retrospective analysis of treatment results for 24 patients with central pulmonary cancer hospitalized in the Shymkent Oncological Centre (Kazakhstan) during 2016–2019 was carried out. The average age of the patients was 46.4 ± 11.3 years. According to the histological study, 19 and 5 patients were diagnosed with squamous cell lung cancer and undifferentiated carcinoma, respectively. The patients were recognized as surgically incurable; three courses of neoadjuvant polychemotherapy via selective catheterization of the bronchial artery and regional intra-arterial administration of drugs were prescribed according to the DR scheme: Docetaxel 75 mg/m2 , Cisplatin 75 mg/m2 .Results and discussion. Upon completion of three courses of selective chemotherapy, 20 (83.3%) patients showed the possibility of surgical treatment: 15 patients underwent extended pulmonectomy, 5 patients underwent extendedcombined pulmonectomy with pericardial resection with intrapericardial, separate processing of the vessels of the lung root. After the surgical stage, all patients received radiation therapy to the mediastinal area at a single tumour dose of 2 Gy and a total radiation dose of 45–50 Gy. According to an analysis of the mortality and survival rates, 28-day mortality comprised 5% (1 patient, whose death occurred as a result of acute cardiovascular failure); one-year survival rate was 91.6%.Conclusions. Preliminary results of our study show that selective chemotherapy via the bronchial artery increases the frequency of surgical interventions and the overall survival of patients with inoperable pulmonary cancer.