BACKGROUND Post-intensive care syndrome(PICS)is a term used to describe a constellation of new or worsened dysfunctions in the physical,cognitive,or mental health status of critically ill patients after their discharg...BACKGROUND Post-intensive care syndrome(PICS)is a term used to describe a constellation of new or worsened dysfunctions in the physical,cognitive,or mental health status of critically ill patients after their discharge from the intensive care unit(ICU).These dysfunctions persist beyond the acute phase of illness and have a significant impact on both the patient and their family.Connect,Introduce,Communicate,Ask,Respond,Exit(CICARE)communication advocates that patients should be respected and accepted when receiving medical services.Clinicians should attach importance to the communication mode of feelings,including connection,introduction,communication,ask,response,and exit 6 steps.AIM To assess the impact of CICARE communication on the reduction of anxiety,depression,and post-traumatic stress disorder(PTSD)symptoms in patients transitioning from the ICU to other care settings.METHODS This prospective,randomized,controlled study was performed between October 2021 and March 2023.Intensive Care Unit Memory Tool was used to evaluate patients’ICU memory.The Hospital Anxiety and Depression Scale was employed to determine the presence of anxiety or depression symptoms.Impact of Event Scale-Revised was utilized to assess the presence of PTSD.All data were processed and analyzed using R language software version 4.1.0.The measurement data were expressed as mean±SD,and the t test was used.The count data were analyzed by theχ2 test and expressed as[n(%)].RESULTS In total,248 subjects were included in this study.Among them,206 were successfully followed up for three months after transfer from the ICU,and 42 cases were lost to follow-up.There was no significant difference in the composition of ICU memory between the two groups.The application of the CICARE communication nursing model combined with the motivational psychological intervention nursing model,as well as the adoption of only the motivational psychological intervention nursing model,demonstrated favorable effects on PICS.Both groups of patients showed a reduction in anxiety scores,depression scores,and PTSD scores following the implementation of these two nursing models.However,it is noteworthy that the experimental group exhibited greater improvements compared to the control group.CONCLUSION Our findings suggest that CICARE communication nursing mode may have good influence on relieving PICS.展开更多
BACKGROUND Primary malignant melanoma of the esophagus(PMME)is a rare malignant disease whose clinical and molecular pathological features,origin and pathoge-nesis,diagnosis and treatment have not been elucidated.CASE...BACKGROUND Primary malignant melanoma of the esophagus(PMME)is a rare malignant disease whose clinical and molecular pathological features,origin and pathoge-nesis,diagnosis and treatment have not been elucidated.CASE SUMMARY In this paper,we report a case of a 73-year-old male with PMME.The patient complained of progressive dysphagia accompanied by substantial weight loss.Gastroscopy revealed a purple black bulging-type mass in the lower esophagus with easy bleeding on contact and scattered satellite lesions in the stomach.Histopathological biopsy revealed melanocytes in the esophageal mucosa.Physical examination and multidisciplinary consultation led to diagnostic exclusion of melanoma originating in other organs,such as the skin.Through this case report and literature review,we aimed to describe the clinical and molecular pathological features of PMME and summarize possible pathways of pathoge-nesis as well as cutting-edge therapeutic advances.CONCLUSION PMME is a rare malignancy of the esophagus with a poor prognosis.Clinicians should raise their awareness and be able to identify early lesions.展开更多
AIM: To give the evidence for rationalizing surgical therapy for early gastric cancer with different lymph node status. METHODS: A series of 322 early gastric cancer patients who underwent gastrectomy with more than 1...AIM: To give the evidence for rationalizing surgical therapy for early gastric cancer with different lymph node status. METHODS: A series of 322 early gastric cancer patients who underwent gastrectomy with more than 15 lymph nodes retrieved were reviewed in this study. The rate of lymph node metastasis was calculated. Univariate and multivariate analyses were performed to evaluate the independent factors for predicting lymph node metastasis. RESULTS: No metastasis was detected in No.5, 6 lymph nodes (LN) during proximal gastric cancer total gastrectomy, and in No.10, 11p, 11d during for combined resection of spleen and splenic artery and in No.15 LN during combined resection of transverse colon mesentery. No.11p, 12a, 14v LN were proved negative for metastasis. The global metastastic rate was 14.6% for LN, 5.9% for mucosa, and 22.4% for submucosa carcinoma, respectively. The metastasis in group Ⅱ?was almost limited in No.7, 8a LN. Multivariate analysis identified that the depth of invasion, histological type and lymphatic invasion were independent risk factors for LN metastasis. No metastasis from distal cancer (≤ 1.0 cm in diameter) was detected in group Ⅱ?LN. The metastasis rate increased significantly when the diameter exceeded 3.0 cm. All tumors (≤ 1.0 cm in diameter) with LN metastasis and mucosa invasion showed a depressed macroscopic type, and all protruded carcinomas were > 3.0 cm in diameter. CONCLUSION: Segmental/subtotal gastrectomy plus D1/D1 + No.7 should be performed for carcinoma (≤ 1.0 cm in diameter, protruded type and mucosa invasion).Subtotal gastrectomy plus D2 or D1 + No.7, 8a, 9 is the most rational operation, whereas No.11p, 12a, 14v lymphadenectomy should not be recommended routinely for poorly differentiated and depressed type of submucosa carcinoma (> 3.0 cm in diameter). Total gastrectomy should not be performed in proximal, so does combined resection or D2+/D3 lymphadenectomy.展开更多
AIM:To explore the efficacy of preoperative intravitreal bevacizumab(IVB) injection combined with Ahmed glaucoma valve(AGV) implantation in the treatment of neovascular glaucoma(NVG).METHODS:This retrospective study i...AIM:To explore the efficacy of preoperative intravitreal bevacizumab(IVB) injection combined with Ahmed glaucoma valve(AGV) implantation in the treatment of neovascular glaucoma(NVG).METHODS:This retrospective study included 35 eyes from 35 patients who underwent preoperative IVB and AGV implantation for treatment of NVG. Findings such as intraocular pressure(IOP) number of anti-glaucoma medications, visual acuity(VA), surgical success rates,and complications were recorded.RESULTS:AfterAGVimplantation,IOPwas18.2±4.0mmHg,15.5±3.3 mm Hg and 9.8±2.6 mm Hg at 6, 12 and 36 mo,significantly decreased compared with pre-IOP(P <0.01).The number of anti-glaucoma medications was 0.9 ±0.5,0.8 ±0.9 and 0.8 ±0.6 at 6, 12 and 36 mo, significantly decreased compared to pre-treatment(P <0.01). At last visit, there were 19 eyes with stable VA, 4 with VA improvement, 12 with diminished VA and 3 with complete loss light perception. There were 7 cases that failed during 3-year fellow up period. Cumulative probabilities of valve survival by Kaplan-Meier analysis were 82.9%,74.1% and 71.0% at 12, 24 and 36 mo, respectively. Cox stepwise regression analysis found that the survival time was significant associated with the pre-visual acuity <2/400(P <0.05). Post-operative complications occurred in 8eyes, of which hyphema presented in 2 eyes, choroidal effusion in 2 eyes.CONCLUSION:The procedure of preoperative IVB andAGV implantation should be one of treatments for NVG because of its safety and effectiveness.展开更多
AIM:To explore whether cyclooxygenase 2(COX-2) -765G>C polymorphism is associated with susceptibility of colorectal cancer(CRC)and to evaluate the risk of colorectal cancer in relation to environmental exposures an...AIM:To explore whether cyclooxygenase 2(COX-2) -765G>C polymorphism is associated with susceptibility of colorectal cancer(CRC)and to evaluate the risk of colorectal cancer in relation to environmental exposures and polymorphism. METHODS:We conducted a case-control study of 137 patients with colorectal cancer and 199 cancer- free controls in northeast China.Multivariate logistic regression analysis was performed to calculate the adjusted odds ratio(OR)and 95% confidence interval (95%CI). RESULTS:The-765G>C polymorphism was not independently associated with CRC risk.However,risk associated with the polymorphism differed by smoking and body mass index(BMI).Smoking and BMI associated risks were stronger among those with-765GG genotype, showing that smokers had a 2.682-fold greater risk of CRC than nonsmokers(51/43 vs 68/126,P=0.006). Compared to those with a normal body mass index(BMI 18.5-22.9),those with overweight(BMI 23-24.9)had a 3.909-fold higher risk of CRC(OR=3.909,95% CI= 2.081-7.344;P<0.001),while those with obesity(BMI >25)had a 2.031-fold higher risk of CRC(OR=1.107, 95% CI=1.107-3.726;P=0.022). CONCLUSION:Although COX-2-765G>C polymorphismis not associated with an increased risk of CRC,-765GG genotype appears to be related to an increased risk in the presence of smoking and higher BMI.展开更多
Oxaliplatin-based chemotherapy is used for treating gastric cancer. Autophagy has been extensively implicated in cancer cells; however, its function is not fully understood. Our study aimed to determine if oxaliplatin...Oxaliplatin-based chemotherapy is used for treating gastric cancer. Autophagy has been extensively implicated in cancer cells; however, its function is not fully understood. Our study aimed to determine if oxaliplatin induce autophagy in gastric cancer MGC803 cells and to assess the effect of autophagy on apoptosis induced by oxaliplatin. MGC803 cells were cultured with oxaliplatin. Cell proliferation was measured using MTT assay, and apoptosis was determined by flow cytometry. Protein expression was detected by Western blot. Autophagy was observed using fluorescent microscopy. Our results showed that the rate of apoptosis was 9.73% and 16.36% when MGC803 cells were treated with 5 and 20 μg/mL oxaliplatin for 24 h, respectively. In addition, caspase activation and poly ADP-ribose polymerase (PARP) cleavage were detected. Furthermore, when MGC803 cells were treated with oxaliplatin for 24 h, an accumulation of punctate LC3 and an increase of LC3-II protein were also detected, indicating the activation of autophagy. Phosphorylation of Akt and mTOR were inhibited by oxaliplatin. Compared to oxaliplatin alone, the combination of autophagy inhibitor chlorochine and oxaliplatin significantly enhanced the inhibition of cell proliferation and the induction of cell apoptosis. In conclusion, oxaliplatin-induced protective autophagy partially prevents apoptosis in gastric cancer MGC803 cells. The combination of autophagy inhibitor and oxaliplatin may be a new therapeutic option for gastric cancer.展开更多
AIM: To explore the role of the matrix metalloproteinase-9 (MMP-9) polymorphism in colorectal cancer (CRC) in a northeast Chinese population. METHODS: Genotyping of MMP-9 -1562C>T and 279R>Q polymorphisms was ca...AIM: To explore the role of the matrix metalloproteinase-9 (MMP-9) polymorphism in colorectal cancer (CRC) in a northeast Chinese population. METHODS: Genotyping of MMP-9 -1562C>T and 279R>Q polymorphisms was carried out on blood samples from 137 colorectal cancer patients and 199 controls using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Multivariate logistic regression models were used to calculate adjusted odds ratios (OR) and 95% confidence intervals (95% CI). RESULTS: The distribution of MMP-9 -1562C>T and 279 R>Q genotype was not significantly associated with the risk of CRC. However, the risk of llymph node metastasis of CRC was increased in patients with the -1562T allele (OR = 2.601; 95% CI = 1.160-5.835; P = 0.022). The frequency of MMP-9 279RR + RQ genotype was higher than the QQ genotype among CRC patients younger than sixty years old (OR = 0.102; 95% CI = 0.013-0.812; P = 0.012). CONCLUSION: Our results indicated that the MMP-9-1562C>T polymorphism affects lymph node metastasis of CRC. In addition, the MMP-9 279R allele may lead to a younger age of onset of colorectal cancer.展开更多
A potential strategy for patients with estrogen receptor(ER)-positive breast cancer is necessary to replace neoadjuvant chemotherapy which has limited benefit.Neoadjuvant endocrine therapy(NAE)has been indicated to be...A potential strategy for patients with estrogen receptor(ER)-positive breast cancer is necessary to replace neoadjuvant chemotherapy which has limited benefit.Neoadjuvant endocrine therapy(NAE)has been indicated to be a favorable alternate approach to downstage large or locally advanced breast cancer in ER-positive,human epidermal growth factor receptor 2(HER2)-negative(ER+/HER2-)patients,especially postmenopausal women.Previous studies have demonstrated the efficacy of various endocrine agents in NAE.Aromatase inhibitors(AIs)have proven superiority over tamoxifen as a suitable choice to optimize treatment efficacy.Fulvestrant was recently reported as an effective agent,similar to AIs.Furthermore,the addition of targeted agents exerts synergistic antiproliferative effects with endocrine agents and rapidly improves response rates in both endocrine sensitive and resistant tumors.The neoadjuvant platform provides a unique opportunity to define the appropriate strategy and address the mechanisms of endocrine resistance.In addition,the predictive value of biomarkers and genomic assays in NAE is under investigation to evaluate individual effects and validate biomarker-based strategies.In this review,we discuss the most relevant evidence on the potential of NAE for ER+breast cancer.The current understanding also offers new insights into the identification of the optimal settings and valuable predictive tools of NAE to guide clinical treatment decisions and achieve beneficial therapeutic effects.展开更多
The formation of nerve bundles,which is partially regulated by neural cell adhesion molecule 1(NCAM1),is important for neural network organization during peripheral nerve regeneration.However,little is known about how...The formation of nerve bundles,which is partially regulated by neural cell adhesion molecule 1(NCAM1),is important for neural network organization during peripheral nerve regeneration.However,little is known about how the extracellular matrix(ECM)microenvironment affects this process.Here,we seeded dorsal root ganglion tissue blocks on different ECM substrates of peripheral nerve ECM-derived matrixgel,Matrigel,laminin 521,collagen I,and collagen IV,and observed well-aligned axon bundles growing in the peripheral nerve ECM-derived environment.We confirmed that NCAM1 is necessary but not sufficient to trigger this phenomenon.A protein interaction assay identified collagen VI as an extracellular partner of NCAM1 in the regulation of axonal fasciculation.Collagen VI interacted with NCAM1 by directly binding to the FNIII domain,thereby increasing the stability of NCAM1 at the axolemma.Our in vivo experiments on a rat sciatic nerve defect model also demonstrated orderly nerve bundle regeneration with improved projection accuracy and functional recovery after treatment with 10 mg/m L Matrigel and 20μg/m L collagen VI.These findings suggest that the collagen VI-NCAM1 pathway plays a regulatory role in nerve bundle formation.This study was approved by the Animal Ethics Committee of Guangzhou Medical University(approval No.GY2019048)on April 30,2019.展开更多
BACKGROUND Immunoinflammatory markers such as the peripheral blood neutrophil-tolymphocyte ratio(NLR)and the platelet-to-lymphocyte ratio(PLR)have gained considerable attention as prognostic markers in gastrointestina...BACKGROUND Immunoinflammatory markers such as the peripheral blood neutrophil-tolymphocyte ratio(NLR)and the platelet-to-lymphocyte ratio(PLR)have gained considerable attention as prognostic markers in gastrointestinal stromal tumors(GISTs).AIM To assess the prognostic value of Onodera’s Prognostic Nutritional Index(OPNI)for GISTs.METHODS All patients who had undergone surgical resection for a primary,localized GIST from 2009 to 2016 at our cancer center were initially and retrospectively identified.Recurrence-free survival(RFS)was calculated by the Kaplan-Meier method and compared by the log-rank test.We used multivariate Cox proportional hazard regression models to identify associations with outcome variables.RESULTS A total of 235 GISTs were identified and included for analysis under our inclusion criteria.Univariate and multivariate analyses both identified the OPNI as an independent prognostic marker,and the OPNI was associated with the primary site,tumor size,mitotic index,tumor rupture,necrosis,and modified NIH risk classification.Low OPNI(<51.30;hazard ratio=5.852;95% confidence interval:1.072–31.964;P=0.0414)was associated with worse RFS.The 2-and 5-year RFS rates of the patients with a low OPNI were 92.83% and 76.22%,respectively,whereas 100% and 98.41% were achieved by the patients with a high OPNI.CONCLUSION The preoperative OPNI is a novel and useful prognostic marker for GISTs.展开更多
Objective This study aims to investigate the effect ofω-3 fatty acid immunonutritional therapy on natural killer(NK)cell gene methylation and function in elderly patients with gastric cancer.Methods A total of 70 cas...Objective This study aims to investigate the effect ofω-3 fatty acid immunonutritional therapy on natural killer(NK)cell gene methylation and function in elderly patients with gastric cancer.Methods A total of 70 cases of elderly patients with gastric cancer were randomized into theω-3 fatty acid group and placebo group,according to the type of nutritional support administered.The methylation status of the tumor necrosis factor(TNF)-αgene promoter in peripheral NK cells was detected by methylation specific polymerase chain reaction,and the TNF-αlevel in peripheral NK cells was detected by enzyme-linked immunosorbent assay.Results After 14 days of immunonutritional therapy withω-3 fatty acid or placebo,patients in theω-3 group had significantly higher average NK cell activity(0.27 vs.0.24,P=0.013)and lower percentages of TNF-αgene promoter methylation(25.7%vs.60%,P<0.05)than the placebo group.However,there were no significant differences in the concentration of albumin,prealbumin and TNF-αin serum,and the NK cell count between theω-3 group and placebo group.Conclusion The postoperative application ofω-3 fatty acid may improve the activity of NK cells,which is correlated to the methylation status of the TNF-αgene promoter.展开更多
Objective At present,there is no appropriate system to evaluate the severe complications of liver surgery through the preoperative factors.This study aimed to design and verify a risk assessment system for the predict...Objective At present,there is no appropriate system to evaluate the severe complications of liver surgery through the preoperative factors.This study aimed to design and verify a risk assessment system for the prediction of severe post-operative complications after a hepatectomy based on the preoperative parameters.Methods A retrospective analysis was performed on 1732 patients who had undergone liver surgery.The severity of the complications was graded by Accordion Severity Grading of post-operative complications.The variables were screened by multivariate analysis,and graded scores were assigned to the selected variables.A logistic regression equation was used to form the liver operation risk formula(LORF)for the prediction of severe post-operative complications.The LORF was verified by the receiver operating characteristic(ROC)curve.Results The multivariate correlation analysis revealed the independent influencing factors of the severe post-operative complications of liver surgery were Child-Pugh grade(OR=4.127;P<0.001),medical diseases requiring drug treatment(OR=3.092;P<0.001),the number of liver segments to be removed(OR=2.209;P=0.006),organ invasion(OR=4.538;P=0.024),and pathological type(OR=4.023;P=0.002).The binomial logistic regression model was established to obtain the calculation formula(LORF)of the severe complication risk.The area under the ROC curve(AUC)of the LORF was 0.815.The cut-off value of the expected probability of severe complications was 0.3225(32.25%).Furthermore,in the validation data set,the corresponding AUC of the LORF was 0.829.Conclusion As a novel and simplified assessment system,the LORF could effectively predict the severe post-operative complications of liver surgery through the preoperative factors,and therefore it could be used to evaluate the risk of severe liver surgical complications before surgery.展开更多
BACKGROUND At present,there is no perfect system to evaluate pulmonary complications of liver surgery using perioperative variables.AIM To design and verify a risk assessment system for predicting postoperative pulmon...BACKGROUND At present,there is no perfect system to evaluate pulmonary complications of liver surgery using perioperative variables.AIM To design and verify a risk assessment system for predicting postoperative pulmonary complications(PPCs)after hepatectomy based on perioperative variables.METHODS A retrospective analysis was performed on 1633 patients who underwent liver surgery.The variables were screened using univariate and multivariate analyses,and graded scores were assigned to the selected variables.Logistic regression was used to develop the liver operation pulmonary complication scoring system(LOPCSS)for the prediction of PPCs.The LOPCSS was verified using the receiver operating characteristic curve.RESULTS According to the multivariate correlation analysis,the independent factors which influenced PPCs of liver surgery were age[≥65 years old/<65 years old,odds ratio(OR)=1.926,P=0.011],medical diseases requiring drug treatment(yes/no,OR=3.523,P<0.001),number of liver segments to be removed(≥3/≤2,OR=1.683,P=0.002),operation duration(≥180 min/<180 min,OR=1.896,P=0.004),and blood transfusion(yes/no,OR=1.836,P=0.003).The area under the curve(AUC)of the LOPCSS was 0.742.The cut-off value of the expected score for complications was 5.The incidence of complications in the group with≤4 points was significantly lower than that in the group with≥6 points(2.95%vs 33.40%,P<0.001).Furthermore,in the validation dataset,the corresponding AUC of LOPCSS was 0.767.CONCLUSION As a novel and simplified assessment system,the LOPCSS can effectively predict PPCs of liver surgery through perioperative variables.展开更多
BACKGROUND Latamoxef shows excellent antibacterial activity against anaerobic bacteria such as Bacteroides fragilis.Reports of thrombocytopenic toxicity of latamoxef are limited.This report presents a case of severe t...BACKGROUND Latamoxef shows excellent antibacterial activity against anaerobic bacteria such as Bacteroides fragilis.Reports of thrombocytopenic toxicity of latamoxef are limited.This report presents a case of severe thrombocytopenia possibly induced by latamoxef,an infrequent adverse drug reaction in a young patient with tuberculosis and Crohn's disease in China.CASE SUMMARY We reported a case of severe thrombocytopenia induced by latamoxef in a 28-year-old man with tuberculosis and Crohn's disease.On admission,the patient presented with a cough productive of bloody sputum,a chest computed tomogram suggested scattered mottled,high-density shadows in both lungs.Laboratory tests indicated a platelet count of 140000/μL.Considered a pulmonary bacterial infection,the patient received anti-infection therapy with latamoxef(dose:2.0 g)intravenously Q12h.On the 9th day of treatment,the platelet count decreased to 44000/μL.On the 12th day,scattered purpura and ecchymosis appeared on the patient’s limbs and trunk,and the platelet count decreased to 9000/μL after latamoxef treatment for 15 d.Three days after discontinuation of latamoxef,the platelet count recovered to 157000/μL,and the area of scattered purpura and ecchymosis on the limbs and trunk decreased.The platelet counts remained in the normal range,and no thrombocytopenia was found at follow-up 15 mo after discharge.CONCLUSION For patients treated with latamoxef,platelet counts should be carefully followed,and caregivers should be vigilant for the appearance of scattered ecchymosis.展开更多
BACKGROUND Many clinical studies for the long-term survival or efficacy of capecitabine plus oxaliplatin(XELOX)in colon cancer have already been studied,but its clinical benefit is controversial.AIM To evaluate the lo...BACKGROUND Many clinical studies for the long-term survival or efficacy of capecitabine plus oxaliplatin(XELOX)in colon cancer have already been studied,but its clinical benefit is controversial.AIM To evaluate the long-term efficacy of XELOX regimen in comparison with other adjuvant chemotherapy protocols in colon cancer.METHODS By searching the PubMed,EMBASE and Cochrane databases,a total of 12 randomized controlled trials involving 6698 stageⅢcolon cancer cases(XELOX protocol:n=3298 cases;other adjuvant chemotherapy protocol:n=3268 cases)were included.The parameter outcomes included the overall survival and the disease-free survival.The quality control of selected literature was based on the Jadad scale and the GRADE system.RESULTS In comparison to other adjuvant chemotherapy regimen,XELOX regimen showed a better overall survival(odds ratio=1.29,95% confidence interval:1.15-1.44,P<0.0001)and a better disease-free survival(odds ratio=1.32,95%confidence interval:1.18-1.46,P<0.0001)for colon cancer patients,suggesting the XELOX regimen can be a good option for postoperative treatment of stage III colon cancer.CONCLUSION The XELOX regimen can be a preferred option for adjuvant treatment of stageⅢcolon cancer after surgery.展开更多
Antibody-drug conjugates(ADCs)are a rapidly developing therapeutic approach in cancer treatment that has shown remarkable activity in breast cancer.Currently,there are two ADCs approved for the treatment of human epid...Antibody-drug conjugates(ADCs)are a rapidly developing therapeutic approach in cancer treatment that has shown remarkable activity in breast cancer.Currently,there are two ADCs approved for the treatment of human epidermal growth factor receptor 2-positive breast cancer,one for triple-negative breast cancer,and multiple investigational ADCs in clinical trials.However,drug resistance has been noticed in clinical use,especially in trastuzumab emtansine.Here,the mechanisms of ADC resistance are summarized into four categories:antibodymediated resistance,impaired drug trafficking,disrupted lysosomal function,and payload-related resistance.To overcome or prevent resistance to ADCs,innovative development strategies and combination therapy options are being investigated.Analyzing predictive biomarkers for optimal therapy selection may also help to prevent drug resistance.展开更多
BACKGROUND The combination of programmed cell death protein-1(PD-1)inhibitor and che-motherapy is approved as a standard first-or second-line treatment in patients with advanced oesophageal or gastric cancer.However,i...BACKGROUND The combination of programmed cell death protein-1(PD-1)inhibitor and che-motherapy is approved as a standard first-or second-line treatment in patients with advanced oesophageal or gastric cancer.However,it is unclear whether this combination is superior to chemotherapy alone.AIM To assess the comparative effectiveness and tolerability of combining PD-1 inhibitors with chemotherapy vs chemotherapy alone in patients with advanced gastric cancer,gastroesophageal junction(GEJ)cancer,or oesophageal carcinoma.METHODS We searched the PubMed and Embase databases for studies that compared the efficacy and tolerance of PD-1 inhibitors in combination with chemotherapy vs chemotherapy alone in patients with advanced oesophageal or gastric cancer.We employed either random or fixed models to analyze the outcomes of each clinical trial,en-compassing data on overall survival(OS),progression-free survival(PFS),objective response rate,and adverse events(AEs).RESULTS Nine phase 3 clinical trials(7016 advanced oesophageal and gastric cancer patients)met the inclusion criteria.Our meta-analysis demonstrated that the pooled PD-1 inhibitor+chemotherapy group had a significantly longer OS than the chemotherapy-alone group[hazard ratio(HR)=0.76,95%confidence interval(CI):0.71-0.81];the pooled PFS result was consistent with that of OS(HR=0.67,95%CI:0.61-0.74).The count of patients achieving an objective response in the PD-1 inhibitor+chemotherapy group surpassed that of the chemotherapy-alone group[odds ratio(OR)=1.86,95%CI:1.59-2.18].AE incidence was also higher in the combination-therapy group than in the chemotherapy-alone group,regardless of whether≥grade 3 only(OR=1.30,95%CI:1.07-1.57)or all AE grades(OR=1.88,95%CI:1.39-2.54)were examined.We performed a subgroup analysis based on the programmed death-ligand 1(PD-L1)combined positive score(CPS)and noted extended OS and PFS durations within the CPS≥1,CPS≥5,and CPS≥10 subgroups of the PD-1 inhibitor+chemotherapy group.CONCLUSION In contrast to chemotherapy alone,the combination of PD-1 inhibitor and chemotherapy appears to present a more favorable option for initial or subsequent treatment in patients with gastric cancer,GEJ tumor,or oesophageal cancer.This holds true particularly for individuals with PD-L1 CPS scores of≥5 and≥10.展开更多
Hyperplasia of the mammary glands(HMG)is a noninflammatory and non-tumorous lesion.[1]It is a structural disorder of the mammary glands due to different degrees of hyperplasia and subinvolution of the mammary parenchy...Hyperplasia of the mammary glands(HMG)is a noninflammatory and non-tumorous lesion.[1]It is a structural disorder of the mammary glands due to different degrees of hyperplasia and subinvolution of the mammary parenchyma and stroma.In the literature,HMG is also called mastopathy,fibroadenosis,fibrocystic breast disease,mastalgia,fibrocystic change,benign mammary dysplasia,or sclerosing adenosis.展开更多
With the maturation and advances of image-guided puncture biopsy technology,the proportion of open breast biopsy has gradually decreased.Ultrasound-guided biopsy is convenient in practice and supports real-time visual...With the maturation and advances of image-guided puncture biopsy technology,the proportion of open breast biopsy has gradually decreased.Ultrasound-guided biopsy is convenient in practice and supports real-time visualization.In order to standardize the practice of ultrasound-guided breast and regional lymph node biopsy,and provide a reference for Chinese breast surgeons,based on the version of Consensus statements and operation guidelines on breast lesions and lymph nodes biopsy guided by ultrasound(2019),[1]the Chinese Society of Breast Surgery(CSBrS)has re-evaluated the quality of the evidence of relevant clinical studies referring to the Grading of Recommendations Assessment,Development,and Evaluation(GRADE)handbook and considered domestic medical condition to develop the Clinical Practice Guidelines for Ultrasound-guided Breast Lesions and Lymph Nodes Biopsy:CSBrS Practice Guidelines 2021.展开更多
Nine 5-aryl-2-methyloxazole derivatives were synthesized via gold-catalyzed alkyne oxidation.All of the compounds have been screened for their antiproliferative activities against MCF-7 cell(human breast carcinoma),A5...Nine 5-aryl-2-methyloxazole derivatives were synthesized via gold-catalyzed alkyne oxidation.All of the compounds have been screened for their antiproliferative activities against MCF-7 cell(human breast carcinoma),A549 cell(human lung carcinoma)and Hela cell(human cervical carcinoma)lines in vitro.The results revealed that compounds 1b,1c and 1d exhibited strong inhibitory activities against the MCF-7 cell lines(with IC50values of 4.6,9.7 and 2.2 mmol/L,respectively).展开更多
文摘BACKGROUND Post-intensive care syndrome(PICS)is a term used to describe a constellation of new or worsened dysfunctions in the physical,cognitive,or mental health status of critically ill patients after their discharge from the intensive care unit(ICU).These dysfunctions persist beyond the acute phase of illness and have a significant impact on both the patient and their family.Connect,Introduce,Communicate,Ask,Respond,Exit(CICARE)communication advocates that patients should be respected and accepted when receiving medical services.Clinicians should attach importance to the communication mode of feelings,including connection,introduction,communication,ask,response,and exit 6 steps.AIM To assess the impact of CICARE communication on the reduction of anxiety,depression,and post-traumatic stress disorder(PTSD)symptoms in patients transitioning from the ICU to other care settings.METHODS This prospective,randomized,controlled study was performed between October 2021 and March 2023.Intensive Care Unit Memory Tool was used to evaluate patients’ICU memory.The Hospital Anxiety and Depression Scale was employed to determine the presence of anxiety or depression symptoms.Impact of Event Scale-Revised was utilized to assess the presence of PTSD.All data were processed and analyzed using R language software version 4.1.0.The measurement data were expressed as mean±SD,and the t test was used.The count data were analyzed by theχ2 test and expressed as[n(%)].RESULTS In total,248 subjects were included in this study.Among them,206 were successfully followed up for three months after transfer from the ICU,and 42 cases were lost to follow-up.There was no significant difference in the composition of ICU memory between the two groups.The application of the CICARE communication nursing model combined with the motivational psychological intervention nursing model,as well as the adoption of only the motivational psychological intervention nursing model,demonstrated favorable effects on PICS.Both groups of patients showed a reduction in anxiety scores,depression scores,and PTSD scores following the implementation of these two nursing models.However,it is noteworthy that the experimental group exhibited greater improvements compared to the control group.CONCLUSION Our findings suggest that CICARE communication nursing mode may have good influence on relieving PICS.
文摘BACKGROUND Primary malignant melanoma of the esophagus(PMME)is a rare malignant disease whose clinical and molecular pathological features,origin and pathoge-nesis,diagnosis and treatment have not been elucidated.CASE SUMMARY In this paper,we report a case of a 73-year-old male with PMME.The patient complained of progressive dysphagia accompanied by substantial weight loss.Gastroscopy revealed a purple black bulging-type mass in the lower esophagus with easy bleeding on contact and scattered satellite lesions in the stomach.Histopathological biopsy revealed melanocytes in the esophageal mucosa.Physical examination and multidisciplinary consultation led to diagnostic exclusion of melanoma originating in other organs,such as the skin.Through this case report and literature review,we aimed to describe the clinical and molecular pathological features of PMME and summarize possible pathways of pathoge-nesis as well as cutting-edge therapeutic advances.CONCLUSION PMME is a rare malignancy of the esophagus with a poor prognosis.Clinicians should raise their awareness and be able to identify early lesions.
基金Supported by the National Natural Science Foundation of China, No. 30370640
文摘AIM: To give the evidence for rationalizing surgical therapy for early gastric cancer with different lymph node status. METHODS: A series of 322 early gastric cancer patients who underwent gastrectomy with more than 15 lymph nodes retrieved were reviewed in this study. The rate of lymph node metastasis was calculated. Univariate and multivariate analyses were performed to evaluate the independent factors for predicting lymph node metastasis. RESULTS: No metastasis was detected in No.5, 6 lymph nodes (LN) during proximal gastric cancer total gastrectomy, and in No.10, 11p, 11d during for combined resection of spleen and splenic artery and in No.15 LN during combined resection of transverse colon mesentery. No.11p, 12a, 14v LN were proved negative for metastasis. The global metastastic rate was 14.6% for LN, 5.9% for mucosa, and 22.4% for submucosa carcinoma, respectively. The metastasis in group Ⅱ?was almost limited in No.7, 8a LN. Multivariate analysis identified that the depth of invasion, histological type and lymphatic invasion were independent risk factors for LN metastasis. No metastasis from distal cancer (≤ 1.0 cm in diameter) was detected in group Ⅱ?LN. The metastasis rate increased significantly when the diameter exceeded 3.0 cm. All tumors (≤ 1.0 cm in diameter) with LN metastasis and mucosa invasion showed a depressed macroscopic type, and all protruded carcinomas were > 3.0 cm in diameter. CONCLUSION: Segmental/subtotal gastrectomy plus D1/D1 + No.7 should be performed for carcinoma (≤ 1.0 cm in diameter, protruded type and mucosa invasion).Subtotal gastrectomy plus D2 or D1 + No.7, 8a, 9 is the most rational operation, whereas No.11p, 12a, 14v lymphadenectomy should not be recommended routinely for poorly differentiated and depressed type of submucosa carcinoma (> 3.0 cm in diameter). Total gastrectomy should not be performed in proximal, so does combined resection or D2+/D3 lymphadenectomy.
文摘AIM:To explore the efficacy of preoperative intravitreal bevacizumab(IVB) injection combined with Ahmed glaucoma valve(AGV) implantation in the treatment of neovascular glaucoma(NVG).METHODS:This retrospective study included 35 eyes from 35 patients who underwent preoperative IVB and AGV implantation for treatment of NVG. Findings such as intraocular pressure(IOP) number of anti-glaucoma medications, visual acuity(VA), surgical success rates,and complications were recorded.RESULTS:AfterAGVimplantation,IOPwas18.2±4.0mmHg,15.5±3.3 mm Hg and 9.8±2.6 mm Hg at 6, 12 and 36 mo,significantly decreased compared with pre-IOP(P <0.01).The number of anti-glaucoma medications was 0.9 ±0.5,0.8 ±0.9 and 0.8 ±0.6 at 6, 12 and 36 mo, significantly decreased compared to pre-treatment(P <0.01). At last visit, there were 19 eyes with stable VA, 4 with VA improvement, 12 with diminished VA and 3 with complete loss light perception. There were 7 cases that failed during 3-year fellow up period. Cumulative probabilities of valve survival by Kaplan-Meier analysis were 82.9%,74.1% and 71.0% at 12, 24 and 36 mo, respectively. Cox stepwise regression analysis found that the survival time was significant associated with the pre-visual acuity <2/400(P <0.05). Post-operative complications occurred in 8eyes, of which hyphema presented in 2 eyes, choroidal effusion in 2 eyes.CONCLUSION:The procedure of preoperative IVB andAGV implantation should be one of treatments for NVG because of its safety and effectiveness.
基金Program for New Century Excellent Talents fromUniversity,No.NCET-06-0296
文摘AIM:To explore whether cyclooxygenase 2(COX-2) -765G>C polymorphism is associated with susceptibility of colorectal cancer(CRC)and to evaluate the risk of colorectal cancer in relation to environmental exposures and polymorphism. METHODS:We conducted a case-control study of 137 patients with colorectal cancer and 199 cancer- free controls in northeast China.Multivariate logistic regression analysis was performed to calculate the adjusted odds ratio(OR)and 95% confidence interval (95%CI). RESULTS:The-765G>C polymorphism was not independently associated with CRC risk.However,risk associated with the polymorphism differed by smoking and body mass index(BMI).Smoking and BMI associated risks were stronger among those with-765GG genotype, showing that smokers had a 2.682-fold greater risk of CRC than nonsmokers(51/43 vs 68/126,P=0.006). Compared to those with a normal body mass index(BMI 18.5-22.9),those with overweight(BMI 23-24.9)had a 3.909-fold higher risk of CRC(OR=3.909,95% CI= 2.081-7.344;P<0.001),while those with obesity(BMI >25)had a 2.031-fold higher risk of CRC(OR=1.107, 95% CI=1.107-3.726;P=0.022). CONCLUSION:Although COX-2-765G>C polymorphismis not associated with an increased risk of CRC,-765GG genotype appears to be related to an increased risk in the presence of smoking and higher BMI.
基金supported by National Natural Science Foundation of China (No. 30770993)Specialized Research Fund for the Doctoral Program of Higher Education (No. 20102104120008)+1 种基金Fund for Scientific Research of the First Hospital of China Medical University (No. fsfh1003)Scientific Research Foundation for Doctors in Liaoning Province (No. 20101146)
文摘Oxaliplatin-based chemotherapy is used for treating gastric cancer. Autophagy has been extensively implicated in cancer cells; however, its function is not fully understood. Our study aimed to determine if oxaliplatin induce autophagy in gastric cancer MGC803 cells and to assess the effect of autophagy on apoptosis induced by oxaliplatin. MGC803 cells were cultured with oxaliplatin. Cell proliferation was measured using MTT assay, and apoptosis was determined by flow cytometry. Protein expression was detected by Western blot. Autophagy was observed using fluorescent microscopy. Our results showed that the rate of apoptosis was 9.73% and 16.36% when MGC803 cells were treated with 5 and 20 μg/mL oxaliplatin for 24 h, respectively. In addition, caspase activation and poly ADP-ribose polymerase (PARP) cleavage were detected. Furthermore, when MGC803 cells were treated with oxaliplatin for 24 h, an accumulation of punctate LC3 and an increase of LC3-II protein were also detected, indicating the activation of autophagy. Phosphorylation of Akt and mTOR were inhibited by oxaliplatin. Compared to oxaliplatin alone, the combination of autophagy inhibitor chlorochine and oxaliplatin significantly enhanced the inhibition of cell proliferation and the induction of cell apoptosis. In conclusion, oxaliplatin-induced protective autophagy partially prevents apoptosis in gastric cancer MGC803 cells. The combination of autophagy inhibitor and oxaliplatin may be a new therapeutic option for gastric cancer.
基金Program for New Century Excellent Talents in University, NCET-06-0296
文摘AIM: To explore the role of the matrix metalloproteinase-9 (MMP-9) polymorphism in colorectal cancer (CRC) in a northeast Chinese population. METHODS: Genotyping of MMP-9 -1562C>T and 279R>Q polymorphisms was carried out on blood samples from 137 colorectal cancer patients and 199 controls using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Multivariate logistic regression models were used to calculate adjusted odds ratios (OR) and 95% confidence intervals (95% CI). RESULTS: The distribution of MMP-9 -1562C>T and 279 R>Q genotype was not significantly associated with the risk of CRC. However, the risk of llymph node metastasis of CRC was increased in patients with the -1562T allele (OR = 2.601; 95% CI = 1.160-5.835; P = 0.022). The frequency of MMP-9 279RR + RQ genotype was higher than the QQ genotype among CRC patients younger than sixty years old (OR = 0.102; 95% CI = 0.013-0.812; P = 0.012). CONCLUSION: Our results indicated that the MMP-9-1562C>T polymorphism affects lymph node metastasis of CRC. In addition, the MMP-9 279R allele may lead to a younger age of onset of colorectal cancer.
基金Supported by the National Natural Science Foundation of China,No.81773083
文摘A potential strategy for patients with estrogen receptor(ER)-positive breast cancer is necessary to replace neoadjuvant chemotherapy which has limited benefit.Neoadjuvant endocrine therapy(NAE)has been indicated to be a favorable alternate approach to downstage large or locally advanced breast cancer in ER-positive,human epidermal growth factor receptor 2(HER2)-negative(ER+/HER2-)patients,especially postmenopausal women.Previous studies have demonstrated the efficacy of various endocrine agents in NAE.Aromatase inhibitors(AIs)have proven superiority over tamoxifen as a suitable choice to optimize treatment efficacy.Fulvestrant was recently reported as an effective agent,similar to AIs.Furthermore,the addition of targeted agents exerts synergistic antiproliferative effects with endocrine agents and rapidly improves response rates in both endocrine sensitive and resistant tumors.The neoadjuvant platform provides a unique opportunity to define the appropriate strategy and address the mechanisms of endocrine resistance.In addition,the predictive value of biomarkers and genomic assays in NAE is under investigation to evaluate individual effects and validate biomarker-based strategies.In this review,we discuss the most relevant evidence on the potential of NAE for ER+breast cancer.The current understanding also offers new insights into the identification of the optimal settings and valuable predictive tools of NAE to guide clinical treatment decisions and achieve beneficial therapeutic effects.
基金supported by the National Natural Science Foundation of China,No.31800892(to JLZ)the Natural Science Foundation of Guangdong Province of China,No.2018A030310254(to YY)a grant from Guangzhou Medical University Start-up Project of China,No.B195002002048(to JLZ)。
文摘The formation of nerve bundles,which is partially regulated by neural cell adhesion molecule 1(NCAM1),is important for neural network organization during peripheral nerve regeneration.However,little is known about how the extracellular matrix(ECM)microenvironment affects this process.Here,we seeded dorsal root ganglion tissue blocks on different ECM substrates of peripheral nerve ECM-derived matrixgel,Matrigel,laminin 521,collagen I,and collagen IV,and observed well-aligned axon bundles growing in the peripheral nerve ECM-derived environment.We confirmed that NCAM1 is necessary but not sufficient to trigger this phenomenon.A protein interaction assay identified collagen VI as an extracellular partner of NCAM1 in the regulation of axonal fasciculation.Collagen VI interacted with NCAM1 by directly binding to the FNIII domain,thereby increasing the stability of NCAM1 at the axolemma.Our in vivo experiments on a rat sciatic nerve defect model also demonstrated orderly nerve bundle regeneration with improved projection accuracy and functional recovery after treatment with 10 mg/m L Matrigel and 20μg/m L collagen VI.These findings suggest that the collagen VI-NCAM1 pathway plays a regulatory role in nerve bundle formation.This study was approved by the Animal Ethics Committee of Guangzhou Medical University(approval No.GY2019048)on April 30,2019.
基金Supported by Health Commission of Shanxi Province,No.2020130 and No.2020TD27the Science and Technology Planning Project of Yangzhou City,No.YZ2018092。
文摘BACKGROUND Immunoinflammatory markers such as the peripheral blood neutrophil-tolymphocyte ratio(NLR)and the platelet-to-lymphocyte ratio(PLR)have gained considerable attention as prognostic markers in gastrointestinal stromal tumors(GISTs).AIM To assess the prognostic value of Onodera’s Prognostic Nutritional Index(OPNI)for GISTs.METHODS All patients who had undergone surgical resection for a primary,localized GIST from 2009 to 2016 at our cancer center were initially and retrospectively identified.Recurrence-free survival(RFS)was calculated by the Kaplan-Meier method and compared by the log-rank test.We used multivariate Cox proportional hazard regression models to identify associations with outcome variables.RESULTS A total of 235 GISTs were identified and included for analysis under our inclusion criteria.Univariate and multivariate analyses both identified the OPNI as an independent prognostic marker,and the OPNI was associated with the primary site,tumor size,mitotic index,tumor rupture,necrosis,and modified NIH risk classification.Low OPNI(<51.30;hazard ratio=5.852;95% confidence interval:1.072–31.964;P=0.0414)was associated with worse RFS.The 2-and 5-year RFS rates of the patients with a low OPNI were 92.83% and 76.22%,respectively,whereas 100% and 98.41% were achieved by the patients with a high OPNI.CONCLUSION The preoperative OPNI is a novel and useful prognostic marker for GISTs.
基金This project was supported by the General Project of Natural Science Foundation of Hubei Province(No.2020CFB826).
文摘Objective This study aims to investigate the effect ofω-3 fatty acid immunonutritional therapy on natural killer(NK)cell gene methylation and function in elderly patients with gastric cancer.Methods A total of 70 cases of elderly patients with gastric cancer were randomized into theω-3 fatty acid group and placebo group,according to the type of nutritional support administered.The methylation status of the tumor necrosis factor(TNF)-αgene promoter in peripheral NK cells was detected by methylation specific polymerase chain reaction,and the TNF-αlevel in peripheral NK cells was detected by enzyme-linked immunosorbent assay.Results After 14 days of immunonutritional therapy withω-3 fatty acid or placebo,patients in theω-3 group had significantly higher average NK cell activity(0.27 vs.0.24,P=0.013)and lower percentages of TNF-αgene promoter methylation(25.7%vs.60%,P<0.05)than the placebo group.However,there were no significant differences in the concentration of albumin,prealbumin and TNF-αin serum,and the NK cell count between theω-3 group and placebo group.Conclusion The postoperative application ofω-3 fatty acid may improve the activity of NK cells,which is correlated to the methylation status of the TNF-αgene promoter.
文摘Objective At present,there is no appropriate system to evaluate the severe complications of liver surgery through the preoperative factors.This study aimed to design and verify a risk assessment system for the prediction of severe post-operative complications after a hepatectomy based on the preoperative parameters.Methods A retrospective analysis was performed on 1732 patients who had undergone liver surgery.The severity of the complications was graded by Accordion Severity Grading of post-operative complications.The variables were screened by multivariate analysis,and graded scores were assigned to the selected variables.A logistic regression equation was used to form the liver operation risk formula(LORF)for the prediction of severe post-operative complications.The LORF was verified by the receiver operating characteristic(ROC)curve.Results The multivariate correlation analysis revealed the independent influencing factors of the severe post-operative complications of liver surgery were Child-Pugh grade(OR=4.127;P<0.001),medical diseases requiring drug treatment(OR=3.092;P<0.001),the number of liver segments to be removed(OR=2.209;P=0.006),organ invasion(OR=4.538;P=0.024),and pathological type(OR=4.023;P=0.002).The binomial logistic regression model was established to obtain the calculation formula(LORF)of the severe complication risk.The area under the ROC curve(AUC)of the LORF was 0.815.The cut-off value of the expected probability of severe complications was 0.3225(32.25%).Furthermore,in the validation data set,the corresponding AUC of the LORF was 0.829.Conclusion As a novel and simplified assessment system,the LORF could effectively predict the severe post-operative complications of liver surgery through the preoperative factors,and therefore it could be used to evaluate the risk of severe liver surgical complications before surgery.
文摘BACKGROUND At present,there is no perfect system to evaluate pulmonary complications of liver surgery using perioperative variables.AIM To design and verify a risk assessment system for predicting postoperative pulmonary complications(PPCs)after hepatectomy based on perioperative variables.METHODS A retrospective analysis was performed on 1633 patients who underwent liver surgery.The variables were screened using univariate and multivariate analyses,and graded scores were assigned to the selected variables.Logistic regression was used to develop the liver operation pulmonary complication scoring system(LOPCSS)for the prediction of PPCs.The LOPCSS was verified using the receiver operating characteristic curve.RESULTS According to the multivariate correlation analysis,the independent factors which influenced PPCs of liver surgery were age[≥65 years old/<65 years old,odds ratio(OR)=1.926,P=0.011],medical diseases requiring drug treatment(yes/no,OR=3.523,P<0.001),number of liver segments to be removed(≥3/≤2,OR=1.683,P=0.002),operation duration(≥180 min/<180 min,OR=1.896,P=0.004),and blood transfusion(yes/no,OR=1.836,P=0.003).The area under the curve(AUC)of the LOPCSS was 0.742.The cut-off value of the expected score for complications was 5.The incidence of complications in the group with≤4 points was significantly lower than that in the group with≥6 points(2.95%vs 33.40%,P<0.001).Furthermore,in the validation dataset,the corresponding AUC of LOPCSS was 0.767.CONCLUSION As a novel and simplified assessment system,the LOPCSS can effectively predict PPCs of liver surgery through perioperative variables.
基金Supported by the Special Research Fund of Hospital Pharmacy of Zhejiang Pharmaceutical Society,No. 2019ZYY27Zhejiang Medical and Health Science and Technology Plan,No. 2020KY741 and No. 2021KY910
文摘BACKGROUND Latamoxef shows excellent antibacterial activity against anaerobic bacteria such as Bacteroides fragilis.Reports of thrombocytopenic toxicity of latamoxef are limited.This report presents a case of severe thrombocytopenia possibly induced by latamoxef,an infrequent adverse drug reaction in a young patient with tuberculosis and Crohn's disease in China.CASE SUMMARY We reported a case of severe thrombocytopenia induced by latamoxef in a 28-year-old man with tuberculosis and Crohn's disease.On admission,the patient presented with a cough productive of bloody sputum,a chest computed tomogram suggested scattered mottled,high-density shadows in both lungs.Laboratory tests indicated a platelet count of 140000/μL.Considered a pulmonary bacterial infection,the patient received anti-infection therapy with latamoxef(dose:2.0 g)intravenously Q12h.On the 9th day of treatment,the platelet count decreased to 44000/μL.On the 12th day,scattered purpura and ecchymosis appeared on the patient’s limbs and trunk,and the platelet count decreased to 9000/μL after latamoxef treatment for 15 d.Three days after discontinuation of latamoxef,the platelet count recovered to 157000/μL,and the area of scattered purpura and ecchymosis on the limbs and trunk decreased.The platelet counts remained in the normal range,and no thrombocytopenia was found at follow-up 15 mo after discharge.CONCLUSION For patients treated with latamoxef,platelet counts should be carefully followed,and caregivers should be vigilant for the appearance of scattered ecchymosis.
文摘BACKGROUND Many clinical studies for the long-term survival or efficacy of capecitabine plus oxaliplatin(XELOX)in colon cancer have already been studied,but its clinical benefit is controversial.AIM To evaluate the long-term efficacy of XELOX regimen in comparison with other adjuvant chemotherapy protocols in colon cancer.METHODS By searching the PubMed,EMBASE and Cochrane databases,a total of 12 randomized controlled trials involving 6698 stageⅢcolon cancer cases(XELOX protocol:n=3298 cases;other adjuvant chemotherapy protocol:n=3268 cases)were included.The parameter outcomes included the overall survival and the disease-free survival.The quality control of selected literature was based on the Jadad scale and the GRADE system.RESULTS In comparison to other adjuvant chemotherapy regimen,XELOX regimen showed a better overall survival(odds ratio=1.29,95% confidence interval:1.15-1.44,P<0.0001)and a better disease-free survival(odds ratio=1.32,95%confidence interval:1.18-1.46,P<0.0001)for colon cancer patients,suggesting the XELOX regimen can be a good option for postoperative treatment of stage III colon cancer.CONCLUSION The XELOX regimen can be a preferred option for adjuvant treatment of stageⅢcolon cancer after surgery.
基金the National Natural Science Foundation of China(82072916)the 2018 Shanghai Youth Excellent Academic Leader,the Fudan ZHUOSHI Project,Chinese Young Breast Experts Research project(CYBER-2021-A01).
文摘Antibody-drug conjugates(ADCs)are a rapidly developing therapeutic approach in cancer treatment that has shown remarkable activity in breast cancer.Currently,there are two ADCs approved for the treatment of human epidermal growth factor receptor 2-positive breast cancer,one for triple-negative breast cancer,and multiple investigational ADCs in clinical trials.However,drug resistance has been noticed in clinical use,especially in trastuzumab emtansine.Here,the mechanisms of ADC resistance are summarized into four categories:antibodymediated resistance,impaired drug trafficking,disrupted lysosomal function,and payload-related resistance.To overcome or prevent resistance to ADCs,innovative development strategies and combination therapy options are being investigated.Analyzing predictive biomarkers for optimal therapy selection may also help to prevent drug resistance.
文摘BACKGROUND The combination of programmed cell death protein-1(PD-1)inhibitor and che-motherapy is approved as a standard first-or second-line treatment in patients with advanced oesophageal or gastric cancer.However,it is unclear whether this combination is superior to chemotherapy alone.AIM To assess the comparative effectiveness and tolerability of combining PD-1 inhibitors with chemotherapy vs chemotherapy alone in patients with advanced gastric cancer,gastroesophageal junction(GEJ)cancer,or oesophageal carcinoma.METHODS We searched the PubMed and Embase databases for studies that compared the efficacy and tolerance of PD-1 inhibitors in combination with chemotherapy vs chemotherapy alone in patients with advanced oesophageal or gastric cancer.We employed either random or fixed models to analyze the outcomes of each clinical trial,en-compassing data on overall survival(OS),progression-free survival(PFS),objective response rate,and adverse events(AEs).RESULTS Nine phase 3 clinical trials(7016 advanced oesophageal and gastric cancer patients)met the inclusion criteria.Our meta-analysis demonstrated that the pooled PD-1 inhibitor+chemotherapy group had a significantly longer OS than the chemotherapy-alone group[hazard ratio(HR)=0.76,95%confidence interval(CI):0.71-0.81];the pooled PFS result was consistent with that of OS(HR=0.67,95%CI:0.61-0.74).The count of patients achieving an objective response in the PD-1 inhibitor+chemotherapy group surpassed that of the chemotherapy-alone group[odds ratio(OR)=1.86,95%CI:1.59-2.18].AE incidence was also higher in the combination-therapy group than in the chemotherapy-alone group,regardless of whether≥grade 3 only(OR=1.30,95%CI:1.07-1.57)or all AE grades(OR=1.88,95%CI:1.39-2.54)were examined.We performed a subgroup analysis based on the programmed death-ligand 1(PD-L1)combined positive score(CPS)and noted extended OS and PFS durations within the CPS≥1,CPS≥5,and CPS≥10 subgroups of the PD-1 inhibitor+chemotherapy group.CONCLUSION In contrast to chemotherapy alone,the combination of PD-1 inhibitor and chemotherapy appears to present a more favorable option for initial or subsequent treatment in patients with gastric cancer,GEJ tumor,or oesophageal cancer.This holds true particularly for individuals with PD-L1 CPS scores of≥5 and≥10.
文摘Hyperplasia of the mammary glands(HMG)is a noninflammatory and non-tumorous lesion.[1]It is a structural disorder of the mammary glands due to different degrees of hyperplasia and subinvolution of the mammary parenchyma and stroma.In the literature,HMG is also called mastopathy,fibroadenosis,fibrocystic breast disease,mastalgia,fibrocystic change,benign mammary dysplasia,or sclerosing adenosis.
文摘With the maturation and advances of image-guided puncture biopsy technology,the proportion of open breast biopsy has gradually decreased.Ultrasound-guided biopsy is convenient in practice and supports real-time visualization.In order to standardize the practice of ultrasound-guided breast and regional lymph node biopsy,and provide a reference for Chinese breast surgeons,based on the version of Consensus statements and operation guidelines on breast lesions and lymph nodes biopsy guided by ultrasound(2019),[1]the Chinese Society of Breast Surgery(CSBrS)has re-evaluated the quality of the evidence of relevant clinical studies referring to the Grading of Recommendations Assessment,Development,and Evaluation(GRADE)handbook and considered domestic medical condition to develop the Clinical Practice Guidelines for Ultrasound-guided Breast Lesions and Lymph Nodes Biopsy:CSBrS Practice Guidelines 2021.
基金supported by NSFC (No. 21276068)Department of Science and Technology Foundation of Hunan Province (No. 2010SK2001)Hunan Natural Science Foundation (No. 11JJ5008)
文摘Nine 5-aryl-2-methyloxazole derivatives were synthesized via gold-catalyzed alkyne oxidation.All of the compounds have been screened for their antiproliferative activities against MCF-7 cell(human breast carcinoma),A549 cell(human lung carcinoma)and Hela cell(human cervical carcinoma)lines in vitro.The results revealed that compounds 1b,1c and 1d exhibited strong inhibitory activities against the MCF-7 cell lines(with IC50values of 4.6,9.7 and 2.2 mmol/L,respectively).
