BACKGROUND:Contrast agents help to improve visibility in magnetic resonance(MR)imaging.However,owing to the large interstitial spaces of the liver,there is a reduction in the natural contrast gradient between lesions ...BACKGROUND:Contrast agents help to improve visibility in magnetic resonance(MR)imaging.However,owing to the large interstitial spaces of the liver,there is a reduction in the natural contrast gradient between lesions and healthy tissue.This study was undertaken to evaluate the efficacy and safety of the liverspecific MR imaging contrast agent gadoxetate disodium(GdEOB-DTPA)in Chinese patients.METHODS:This was a single-arm,open-label,multicenter study in patients with known or suspected focal liver lesions referred for contrast-enhanced MR imaging.MR imaging was performed in 234 patients before and after a single intravenous bolus of Gd-EOB-DTPA(0.025 mmol/kg body weight).Images were evaluated by clinical study investigators and three independent,blinded radiologists.The primary efficacy endpoint was sensitivity in lesion detection.RESULTS:Gd-EOB-DTPA improved sensitivity in lesion detection by 9.46%compared with pre-contrast imaging for the average of the three blinded readers(94.78%vs 85.32%for Gd-EOB-DTPA vs pre-contrast,respectively).Improvements in detection were more pronounced in lesions less than 1cm.Gd-EOB-DTPA improved diagnostic accuracy in lesion classification.CONCLUSIONS:This open-label study demonstrated that Gd-EOB-DTPA improves diagnostic sensitivity in liver lesions,particularly in those smaller than 1 cm.Gd-EOB-DTPA also significantly improves the diagnostic accuracy in lesion classification,and furthermore,Gd-EOB-DTPA is safe in Chinese patients with liver lesions.展开更多
AIM:To determine the mechanism of the radiationinduced biological effects of 125I seeds on pancreatic carcinoma cells in vitro.METHODS:SW1990 and PANC-1 pancreatic cancer cell lines were cultured in DMEM in a suitable...AIM:To determine the mechanism of the radiationinduced biological effects of 125I seeds on pancreatic carcinoma cells in vitro.METHODS:SW1990 and PANC-1 pancreatic cancer cell lines were cultured in DMEM in a suitable environment.Gray’s model of iodine-125(125I)seed irradiation was used.In vitro,exponential phase SW1990,and PANC-1cells were exposed to 0,2,4,6,and 8 Gy using 125I radioactive seeds,with an initial dose rate of 12.13c Gy/h.A clonogenic survival experiment was performed to observe the ability of the cells to maintain their clonogenic capacity and to form colonies.Cell-cycle and apoptosis analyses were conducted to detect the apoptosis percentage in the SW1990 and PANC-1 cells.DNA synthesis was measured via a tritiated thymidine(3H-Td R)incorporation experiment.After continuous low-dose-rate irradiation with 125I radioactive seeds,the survival fractions at 2 Gy(SF2),percentage apoptosis,and cell cycle phases of the SW1990 and PANC-1 pancreatic cancer cell lines were calculated and compared.RESULTS:The survival fractions of the PANC-1 andSW1990 cells irradiated with 125I seeds decreased exponentially as the dose increased.No significant difference in SF2 was observed between SW1990 and PANC-1 cells(0.766±0.063 vs 0.729±0.045,P<0.05).The 125I seeds induced a higher percentage of apoptosis than that observed in the control in both the SW1990and PANC-1 cells.The rate of apoptosis increased with increasing radiation dosage.The percentage of apoptosis was slightly higher in the SW1990 cells than in the PANC-1 cells.Dose-dependent G2/M cellcycle arrest was observed after 125I seed irradiation,with a peak value at 6 Gy.As the dose increased,the percentage of G2/M cell cycle arrest increased in both cell lines,whereas the rate of DNA incorporation decreased.In the 3H-Td R incorporation experiment,the dosimetry results of both the SW1990 and PANC-1cells decreased as the radiation dose increased,with a minimum at 6 Gy.There were no significant differences in the dosimetry results of the two cell lines when they were exposed to the same dose of radiation.CONCLUSION:The pancreatic cancer cell-killing effects induced by 125I radioactive seeds mainly occurred via apoptosis and G2/M cell cycle arrest.展开更多
There is considerable potential for integrating transarterial chemoembolization(TACE),programmed death-(ligand)1(PD-[L]1)inhibitors,and molecular targeted treatments(MTT)in hepatocellular carcinoma(HCC).It is necessar...There is considerable potential for integrating transarterial chemoembolization(TACE),programmed death-(ligand)1(PD-[L]1)inhibitors,and molecular targeted treatments(MTT)in hepatocellular carcinoma(HCC).It is necessary to investigate the therapeutic efficacy and safety of TACE combined with PD-(L)1 inhibitors and MTT in real-world situations.In this nationwide,retrospective,cohort study,826 HCC patients receiving either TACE plus PD-(L)1 blockades and MTT(combination group,n=376)or TACE monotherapy(monotherapy group,n=450)were included from January 2018 to May 2021.The primary endpoint was progression-free survival(PFS)according to modified RECIST.The secondary outcomes included overall survival(OS),objective response rate(ORR),and safety.We performed propensity score matching approaches to reduce bias between two groups.After matching,228 pairs were included with a predominantly advanced disease population.Median PFS in combination group was 9.5 months(95%confidence interval[CI],8.4-11.0)versus 8.0 months(95%CI,6.6-9.5)(adjusted hazard ratio[HR],0.70,P=0.002).OS and ORR were also significantly higher in combination group(median OS,19.2[16.1-27.3]vs.15.7 months[13.0-20.2];adjusted HR,0.63,P=0.001;ORR,60.1%vs.32.0%;P<0.001).Grade 3/4 adverse events were observed at a rate of 15.8%and 7.5%in combination and monotherapy groups,respectively.Our results suggest that TACE plus PD-(L)1 blockades and MTT could significantly improve PFS,OS,and ORR versus TACE monotherapy for Chinese patients with predominantly advanced HCC in real-world practice,with an acceptable safety profile.展开更多
Background and Aims:The recognition of transarterial chemoembolization(TACE)failure/refractoriness among Chinese clinicians remains unclear.Using an online survey conducted by the Chinese College of Interventionalists...Background and Aims:The recognition of transarterial chemoembolization(TACE)failure/refractoriness among Chinese clinicians remains unclear.Using an online survey conducted by the Chinese College of Interventionalists(CCI),the aim of this study was to explore the recognition of TACE failure/refractoriness and review TACE application for hepatocellular carcinoma(HCC)treatment in clinical practice.Methods:From 27 August 2020 to 30 August 2020 during the CCI 2020 annual meeting,a survey with 34 questions was sent by email to 264 CCI clinicians in China with more than 10 years of experience using TACE for HCC treatment.Results:A total of 257 clinicians participated and responded to the survey.Most participants agreed that the concept of“TACE failure/refractoriness”has scientific and clinical significance(n=191,74.3%).Nearly half of these participants chose TACE-based combination treatment as subsequent therapy after so-called TACE failure/refractoriness(n=88,46.1%).None of the existing TACE failure/refractoriness definitions were widely accepted by the participants;thus,it is necessary to re-define this concept for the treatment of HCC in China(n=235,91.4%).Most participants agreed that continuing TACE should be performed for patients with preserved liver function,presenting portal vein tumor thrombosis(n=242,94.2%)or extrahepatic spread(n=253,98.4%),after the previous TACE treatment to control intrahepatic lesion(s).Conclusions:There is an obvious difference in the recognition of TACE failure/refractoriness among Chinese clinicians based on existing definitions.Further work should be carried out to re-define TACE failure/refractoriness.展开更多
Importance:Transarterial chemoembolization(TACE)has been associated with a wide range of practice variations for hepatocellular carcinoma(HCC)between the East and the West.This considerable ambiguity may lead to the h...Importance:Transarterial chemoembolization(TACE)has been associated with a wide range of practice variations for hepatocellular carcinoma(HCC)between the East and the West.This considerable ambiguity may lead to the heterogeneous quality in treatment and have a negative impact on the role of TACE in the overall multidisciplinary HCC treatment system.Objective:It may be a good start to establish a guideline worldwide to have this consensus from experts who represent east and west,although it does not cover all aspects of TACE.Evidence Review:An international expert panel on TACE is convened to cluster the expert’s opinions and summary a standard consensus.This panel committee consist of leading physicians in TACE on HCC from USA,France,Japan,Singapore,Korea,China,and so on.The first-round face-to-face consensus meeting was held during in Nanjing,China in October 2019.The second-round conference for revision of the consensus was held during the Annual Meeting of Chinese College of Interventionalists in August 2020 by a hybrid format of a Webinar and roundtable meeting.After several on-line revisions,the final manuscript was approved by all members of the panel in June 2021.Findings:The consensus statements were organized into the following categories:patients’selection,performing the procedure,TACE outcomes,repeat TACE,TACE failure/refractory,and TACE-based combination treatments.Conclusions and Relevance for Reviews:More and more evidences have showed the better outcomes with strategy of combined TACE with other local therapies such as ablations.The most-recently developing strategy of combined TACE with PD-1/PD-L1 plus tyrosine kinase inhibitor(TKI)agents has shined a light to the HCC patients,especially to those with high risk of tumor recurrence after treatment or TACE failure/refractory.展开更多
Dear Editor,Approximately 500 million individuals suffer from hearing loss worldwide. The number of hearing-impaired individuals is estimated to increase to 900 million by 2050. The etiology of hearing loss is complex.
The present study aimed to establish a prognostic nomogram to stratify high-risk patients with Coronavirus Disease 2019(COVID-19)who progressed from the nonsevere condition on admission to severe during hospitalizatio...The present study aimed to establish a prognostic nomogram to stratify high-risk patients with Coronavirus Disease 2019(COVID-19)who progressed from the nonsevere condition on admission to severe during hospitalization.This multicenter retrospective study included patients with nonsevere COVID-19 on admission from Jan 10,2020 to Feb 7,2020.In the training cohort,independent risk factors associated with disease progression were identified by univariate and multivariate analyses.The prognostic nomogram was established and then validated externally using C-index.The study included 351 patients(293 and 58 in the training and validation cohorts,respectively),with 27(9.2%)and 5(8.6%)patients progressed,respectively.In the training cohort,older age(OR 1.036,95%Cl 1.000-1.073),more lobes involved on chest CT(OR 1.841,95%Cl 1.117-3.035),comorbidity present(OR 2.478,95%Cl 1.020-6.018),and lower lymphocyte count(OR 0.081,95%Cl 0.019-0.349)were identified as independent risk factors.The prognostic nomogram was established in the training cohort with satisfied external prognostic performance(C-index 0.906,95%Cl 0.806-1.000).In conclusion,older age,comorbidity present,more lobes involved on chest CT,and lower lymphocyte count are independent risk factors associated with disease progression during hospitalization for patients with nonsevere COVID-19.展开更多
基金supported by a grant from Bayer HealthCare/Bayer Schering Pharma AG
文摘BACKGROUND:Contrast agents help to improve visibility in magnetic resonance(MR)imaging.However,owing to the large interstitial spaces of the liver,there is a reduction in the natural contrast gradient between lesions and healthy tissue.This study was undertaken to evaluate the efficacy and safety of the liverspecific MR imaging contrast agent gadoxetate disodium(GdEOB-DTPA)in Chinese patients.METHODS:This was a single-arm,open-label,multicenter study in patients with known or suspected focal liver lesions referred for contrast-enhanced MR imaging.MR imaging was performed in 234 patients before and after a single intravenous bolus of Gd-EOB-DTPA(0.025 mmol/kg body weight).Images were evaluated by clinical study investigators and three independent,blinded radiologists.The primary efficacy endpoint was sensitivity in lesion detection.RESULTS:Gd-EOB-DTPA improved sensitivity in lesion detection by 9.46%compared with pre-contrast imaging for the average of the three blinded readers(94.78%vs 85.32%for Gd-EOB-DTPA vs pre-contrast,respectively).Improvements in detection were more pronounced in lesions less than 1cm.Gd-EOB-DTPA improved diagnostic accuracy in lesion classification.CONCLUSIONS:This open-label study demonstrated that Gd-EOB-DTPA improves diagnostic sensitivity in liver lesions,particularly in those smaller than 1 cm.Gd-EOB-DTPA also significantly improves the diagnostic accuracy in lesion classification,and furthermore,Gd-EOB-DTPA is safe in Chinese patients with liver lesions.
基金Supported by Natural Science Foundation of China,No.81271682(partly)grants from Science and Technology Commission of Shanghai Municipality,No.11JC1407400(partly)+1 种基金the project of Luwan District Science and Technology Commission of Shanghai,No.LKW1104(partly)the project of Medical Key Specialty of Shanghai Municipality,No.ZK2012A20(partly)
文摘AIM:To determine the mechanism of the radiationinduced biological effects of 125I seeds on pancreatic carcinoma cells in vitro.METHODS:SW1990 and PANC-1 pancreatic cancer cell lines were cultured in DMEM in a suitable environment.Gray’s model of iodine-125(125I)seed irradiation was used.In vitro,exponential phase SW1990,and PANC-1cells were exposed to 0,2,4,6,and 8 Gy using 125I radioactive seeds,with an initial dose rate of 12.13c Gy/h.A clonogenic survival experiment was performed to observe the ability of the cells to maintain their clonogenic capacity and to form colonies.Cell-cycle and apoptosis analyses were conducted to detect the apoptosis percentage in the SW1990 and PANC-1 cells.DNA synthesis was measured via a tritiated thymidine(3H-Td R)incorporation experiment.After continuous low-dose-rate irradiation with 125I radioactive seeds,the survival fractions at 2 Gy(SF2),percentage apoptosis,and cell cycle phases of the SW1990 and PANC-1 pancreatic cancer cell lines were calculated and compared.RESULTS:The survival fractions of the PANC-1 andSW1990 cells irradiated with 125I seeds decreased exponentially as the dose increased.No significant difference in SF2 was observed between SW1990 and PANC-1 cells(0.766±0.063 vs 0.729±0.045,P<0.05).The 125I seeds induced a higher percentage of apoptosis than that observed in the control in both the SW1990and PANC-1 cells.The rate of apoptosis increased with increasing radiation dosage.The percentage of apoptosis was slightly higher in the SW1990 cells than in the PANC-1 cells.Dose-dependent G2/M cellcycle arrest was observed after 125I seed irradiation,with a peak value at 6 Gy.As the dose increased,the percentage of G2/M cell cycle arrest increased in both cell lines,whereas the rate of DNA incorporation decreased.In the 3H-Td R incorporation experiment,the dosimetry results of both the SW1990 and PANC-1cells decreased as the radiation dose increased,with a minimum at 6 Gy.There were no significant differences in the dosimetry results of the two cell lines when they were exposed to the same dose of radiation.CONCLUSION:The pancreatic cancer cell-killing effects induced by 125I radioactive seeds mainly occurred via apoptosis and G2/M cell cycle arrest.
基金The study was supported by National Key Research and Development Program(2018YFA0704100,2018YFA0704104)National Natural Science Foundation of China(81827805,82130060)Jiangsu Provincial Special Program of Medical Science(BE2019750).The funding sources had no role in the writing of the report,or decision to submit the paper for publication.
文摘There is considerable potential for integrating transarterial chemoembolization(TACE),programmed death-(ligand)1(PD-[L]1)inhibitors,and molecular targeted treatments(MTT)in hepatocellular carcinoma(HCC).It is necessary to investigate the therapeutic efficacy and safety of TACE combined with PD-(L)1 inhibitors and MTT in real-world situations.In this nationwide,retrospective,cohort study,826 HCC patients receiving either TACE plus PD-(L)1 blockades and MTT(combination group,n=376)or TACE monotherapy(monotherapy group,n=450)were included from January 2018 to May 2021.The primary endpoint was progression-free survival(PFS)according to modified RECIST.The secondary outcomes included overall survival(OS),objective response rate(ORR),and safety.We performed propensity score matching approaches to reduce bias between two groups.After matching,228 pairs were included with a predominantly advanced disease population.Median PFS in combination group was 9.5 months(95%confidence interval[CI],8.4-11.0)versus 8.0 months(95%CI,6.6-9.5)(adjusted hazard ratio[HR],0.70,P=0.002).OS and ORR were also significantly higher in combination group(median OS,19.2[16.1-27.3]vs.15.7 months[13.0-20.2];adjusted HR,0.63,P=0.001;ORR,60.1%vs.32.0%;P<0.001).Grade 3/4 adverse events were observed at a rate of 15.8%and 7.5%in combination and monotherapy groups,respectively.Our results suggest that TACE plus PD-(L)1 blockades and MTT could significantly improve PFS,OS,and ORR versus TACE monotherapy for Chinese patients with predominantly advanced HCC in real-world practice,with an acceptable safety profile.
基金This study was supported by the National Natural Science Foundation of China(No.81901847,81520108015 and 81827805)the Clinical Innovation Center of Medical Imaging and Interventional Radiology(No.YXZXA2016005)+2 种基金the Natural Science Foundation of Jiangsu Province(No.BK20190177)and the Suzhou Science and Technology Youth Plan(No.KJXW2018003)Funding sources had no involvement in the financial support for the conduct of the research and preparation of the article。
文摘Background and Aims:The recognition of transarterial chemoembolization(TACE)failure/refractoriness among Chinese clinicians remains unclear.Using an online survey conducted by the Chinese College of Interventionalists(CCI),the aim of this study was to explore the recognition of TACE failure/refractoriness and review TACE application for hepatocellular carcinoma(HCC)treatment in clinical practice.Methods:From 27 August 2020 to 30 August 2020 during the CCI 2020 annual meeting,a survey with 34 questions was sent by email to 264 CCI clinicians in China with more than 10 years of experience using TACE for HCC treatment.Results:A total of 257 clinicians participated and responded to the survey.Most participants agreed that the concept of“TACE failure/refractoriness”has scientific and clinical significance(n=191,74.3%).Nearly half of these participants chose TACE-based combination treatment as subsequent therapy after so-called TACE failure/refractoriness(n=88,46.1%).None of the existing TACE failure/refractoriness definitions were widely accepted by the participants;thus,it is necessary to re-define this concept for the treatment of HCC in China(n=235,91.4%).Most participants agreed that continuing TACE should be performed for patients with preserved liver function,presenting portal vein tumor thrombosis(n=242,94.2%)or extrahepatic spread(n=253,98.4%),after the previous TACE treatment to control intrahepatic lesion(s).Conclusions:There is an obvious difference in the recognition of TACE failure/refractoriness among Chinese clinicians based on existing definitions.Further work should be carried out to re-define TACE failure/refractoriness.
基金The study was supported by Jiangsu Provincial Special Program of Medical Science(BE2019750)National Natural Science Foundation of China(81827805)and National Key Research and Development Program(2018YFA0704100,2018YFA0704104).
文摘Importance:Transarterial chemoembolization(TACE)has been associated with a wide range of practice variations for hepatocellular carcinoma(HCC)between the East and the West.This considerable ambiguity may lead to the heterogeneous quality in treatment and have a negative impact on the role of TACE in the overall multidisciplinary HCC treatment system.Objective:It may be a good start to establish a guideline worldwide to have this consensus from experts who represent east and west,although it does not cover all aspects of TACE.Evidence Review:An international expert panel on TACE is convened to cluster the expert’s opinions and summary a standard consensus.This panel committee consist of leading physicians in TACE on HCC from USA,France,Japan,Singapore,Korea,China,and so on.The first-round face-to-face consensus meeting was held during in Nanjing,China in October 2019.The second-round conference for revision of the consensus was held during the Annual Meeting of Chinese College of Interventionalists in August 2020 by a hybrid format of a Webinar and roundtable meeting.After several on-line revisions,the final manuscript was approved by all members of the panel in June 2021.Findings:The consensus statements were organized into the following categories:patients’selection,performing the procedure,TACE outcomes,repeat TACE,TACE failure/refractory,and TACE-based combination treatments.Conclusions and Relevance for Reviews:More and more evidences have showed the better outcomes with strategy of combined TACE with other local therapies such as ablations.The most-recently developing strategy of combined TACE with PD-1/PD-L1 plus tyrosine kinase inhibitor(TKI)agents has shined a light to the HCC patients,especially to those with high risk of tumor recurrence after treatment or TACE failure/refractory.
基金supported by the National Natural Science Foundation of China (81520108015)。
文摘Dear Editor,Approximately 500 million individuals suffer from hearing loss worldwide. The number of hearing-impaired individuals is estimated to increase to 900 million by 2050. The etiology of hearing loss is complex.
基金the National Natural Science Foundation of China(81827805,81520108015,81671743,81901847,81971573)the Natural Science Foundation of Jiangsu Province(BK20190177)+2 种基金the Suzhou Science and Technology Youth Plan(KJXW2018003)the Clinical Key Diseases Diagnosis and Therapy Special Project of Health and Family Planning Commission of Suzhou(LCZX201801)the High-level Health Personnel"Six-one"Project of Jiangsu Province(LGY2016035).
文摘The present study aimed to establish a prognostic nomogram to stratify high-risk patients with Coronavirus Disease 2019(COVID-19)who progressed from the nonsevere condition on admission to severe during hospitalization.This multicenter retrospective study included patients with nonsevere COVID-19 on admission from Jan 10,2020 to Feb 7,2020.In the training cohort,independent risk factors associated with disease progression were identified by univariate and multivariate analyses.The prognostic nomogram was established and then validated externally using C-index.The study included 351 patients(293 and 58 in the training and validation cohorts,respectively),with 27(9.2%)and 5(8.6%)patients progressed,respectively.In the training cohort,older age(OR 1.036,95%Cl 1.000-1.073),more lobes involved on chest CT(OR 1.841,95%Cl 1.117-3.035),comorbidity present(OR 2.478,95%Cl 1.020-6.018),and lower lymphocyte count(OR 0.081,95%Cl 0.019-0.349)were identified as independent risk factors.The prognostic nomogram was established in the training cohort with satisfied external prognostic performance(C-index 0.906,95%Cl 0.806-1.000).In conclusion,older age,comorbidity present,more lobes involved on chest CT,and lower lymphocyte count are independent risk factors associated with disease progression during hospitalization for patients with nonsevere COVID-19.
