Aim:It remains unclear what the best therapeutic option for recurrent glioma patients after Stupp treatment is.Bevacizumab(BVZ)is commonly administered in progression,but it appears that only some patients benefit.It ...Aim:It remains unclear what the best therapeutic option for recurrent glioma patients after Stupp treatment is.Bevacizumab(BVZ)is commonly administered in progression,but it appears that only some patients benefit.It would be useful to find biomarkers that determine beforehand who these patients are.Methods:The protocol included 31 high-risk progressing glioma patients after Stupp treatment who received BVZ 5-10 mg/kg every 14 days and temozolomide(3-19 cycles,150-200 mg five days each 28-day cycle)during a mean of eight cycles of BVZ or until tumor progression or unacceptable toxicity.We analyzed the clinical outcome values of inflammatory indices measured before BVZ administration.Results:Lymphocyte level before BVZ administration was the best independent predictor of overall survival(HR=0.34;95%CI:0.145-0.81;P=0.015).The area under the receiver operating characteristic(ROC)curve was 0.823,with 1.645 being the optimal cut-off value,and 0.80 and 0.85 the sensitivity and specificity values,respectively.Responder and non-responder survival curves were also significantly different,considering the first and second tertiles as cut-off points.The number of BVZ cycles was not related to lymphopenia.Pretreatment neutrophil platelet levels,platelet-to-lymphocyte ratio(PLR),and neutrophil-to-lymphocyte ratio(NLR)did not have independent predictive value.Inflammatory variables were not correlated with each other.However,patients with high NLR and PLR simultaneously(double positive PLR-NLR)showed a worse clinical outcome than the rest(P=0.043).Conclusion:Pretreatment lymphocyte levels and double positive PLR-NLR could be used as non-invasive hematological prognostic markers for recurrent gliomas treated with bevacizumab.A close relationship emerged between inflammation and angiogenesis.展开更多
Objective:To observe the early interventions of traditional Chinese Medicine(TCM)on the conversion time of nucleic acid in patients with coronavirus disease 2019(COVID-19),and find possible underlying mechanisms of ac...Objective:To observe the early interventions of traditional Chinese Medicine(TCM)on the conversion time of nucleic acid in patients with coronavirus disease 2019(COVID-19),and find possible underlying mechanisms of action.Methods:A retrospective cohort study was conducted on 300 confirmed COVID-19 patients who were treated with TCM,at a designated hospital in China.The patients were categorized into three groups:TCM1,TCM2 and TCM3,who respectively received TCM interventions within 7,8–14,and greater than15 days of hospitalization.Different indicators such as the conversion time of pharyngeal swab nucleic acid,the conversion time of fecal nucleic acid,length of hospital stay,and inflammatory markers(leukocyte count,and lymphocyte count and percentage)were analyzed to observe the impact of early TCM interventions on these groups.Results:The median conversion times of pharyngeal swab nucleic acid in the three groups were 5.5,7 and16 d(P<0.001),with TCM1 and TCM2 being statistically different from TCM3(P<0.01).TCM1(P<0.05)and TCM3(P<0.01)were statistically different from TCM2.The median conversion times of fecal nucleic acid in the three groups were 7,9 and 17 d(P<0.001).Conversion times of fecal nucleic acid in TCM1 were statistically different from TCM3 and TCM2(P<0.01).The median lengths of hospital stay in the three groups were 13,16 and 21 d(P<0.001).TCM1 and TCM2 were statistically different from TCM3(P<0.01);TCM1 and TCM3 were statistically different from TCM2(P<0.01).Both leucocyte and lymphocyte counts increased gradually with an increase in the length of hospital stay in TCM1 group patients,with a statistically significant difference observed at each time point in the group(P<0.001).Statistically significant differences in lymphocyte count and percentage in TCM2(P<0.001),and in leucocyte count(P=0.043)and lymphocyte count(P=0.038)in TCM3 were observed.The comparison among the three groups showed a statistically significant difference in lymphocyte percentage on the third day of admission(P=0.044).Conclusion:In this study,it was observed that in COVID-19 patients treated with a combination of Chinese and Western medicines,TCM intervention earlier in the hospital stay correlated with faster conversion time of pharyngeal swab and fecal nucleic acid,as well as shorter length of hospital stay,thus helping promote faster recovery of the patient.The underlying mechanism of action may be related to improving inflammation in patients with COVID-19.展开更多
基金the Agencia Española de Medicamentos y Productos Sanitarios(ref:PLJ-BEV-2016-01)the Hospital Universitario de Gran Canaria Doctor Negrin committee(ref:170007).
文摘Aim:It remains unclear what the best therapeutic option for recurrent glioma patients after Stupp treatment is.Bevacizumab(BVZ)is commonly administered in progression,but it appears that only some patients benefit.It would be useful to find biomarkers that determine beforehand who these patients are.Methods:The protocol included 31 high-risk progressing glioma patients after Stupp treatment who received BVZ 5-10 mg/kg every 14 days and temozolomide(3-19 cycles,150-200 mg five days each 28-day cycle)during a mean of eight cycles of BVZ or until tumor progression or unacceptable toxicity.We analyzed the clinical outcome values of inflammatory indices measured before BVZ administration.Results:Lymphocyte level before BVZ administration was the best independent predictor of overall survival(HR=0.34;95%CI:0.145-0.81;P=0.015).The area under the receiver operating characteristic(ROC)curve was 0.823,with 1.645 being the optimal cut-off value,and 0.80 and 0.85 the sensitivity and specificity values,respectively.Responder and non-responder survival curves were also significantly different,considering the first and second tertiles as cut-off points.The number of BVZ cycles was not related to lymphopenia.Pretreatment neutrophil platelet levels,platelet-to-lymphocyte ratio(PLR),and neutrophil-to-lymphocyte ratio(NLR)did not have independent predictive value.Inflammatory variables were not correlated with each other.However,patients with high NLR and PLR simultaneously(double positive PLR-NLR)showed a worse clinical outcome than the rest(P=0.043).Conclusion:Pretreatment lymphocyte levels and double positive PLR-NLR could be used as non-invasive hematological prognostic markers for recurrent gliomas treated with bevacizumab.A close relationship emerged between inflammation and angiogenesis.
基金supported by Foundation of Shanghai Science and Technology Committee(No.2041195020002)Shanghai Key Laboratory of Traditional Chinese Clinical Medicine(No.14DZ2273200)Shanghai Key Clinical Specialty(No.shslczdzk05101)。
文摘Objective:To observe the early interventions of traditional Chinese Medicine(TCM)on the conversion time of nucleic acid in patients with coronavirus disease 2019(COVID-19),and find possible underlying mechanisms of action.Methods:A retrospective cohort study was conducted on 300 confirmed COVID-19 patients who were treated with TCM,at a designated hospital in China.The patients were categorized into three groups:TCM1,TCM2 and TCM3,who respectively received TCM interventions within 7,8–14,and greater than15 days of hospitalization.Different indicators such as the conversion time of pharyngeal swab nucleic acid,the conversion time of fecal nucleic acid,length of hospital stay,and inflammatory markers(leukocyte count,and lymphocyte count and percentage)were analyzed to observe the impact of early TCM interventions on these groups.Results:The median conversion times of pharyngeal swab nucleic acid in the three groups were 5.5,7 and16 d(P<0.001),with TCM1 and TCM2 being statistically different from TCM3(P<0.01).TCM1(P<0.05)and TCM3(P<0.01)were statistically different from TCM2.The median conversion times of fecal nucleic acid in the three groups were 7,9 and 17 d(P<0.001).Conversion times of fecal nucleic acid in TCM1 were statistically different from TCM3 and TCM2(P<0.01).The median lengths of hospital stay in the three groups were 13,16 and 21 d(P<0.001).TCM1 and TCM2 were statistically different from TCM3(P<0.01);TCM1 and TCM3 were statistically different from TCM2(P<0.01).Both leucocyte and lymphocyte counts increased gradually with an increase in the length of hospital stay in TCM1 group patients,with a statistically significant difference observed at each time point in the group(P<0.001).Statistically significant differences in lymphocyte count and percentage in TCM2(P<0.001),and in leucocyte count(P=0.043)and lymphocyte count(P=0.038)in TCM3 were observed.The comparison among the three groups showed a statistically significant difference in lymphocyte percentage on the third day of admission(P=0.044).Conclusion:In this study,it was observed that in COVID-19 patients treated with a combination of Chinese and Western medicines,TCM intervention earlier in the hospital stay correlated with faster conversion time of pharyngeal swab and fecal nucleic acid,as well as shorter length of hospital stay,thus helping promote faster recovery of the patient.The underlying mechanism of action may be related to improving inflammation in patients with COVID-19.
