简介:Rheumatoidarthritis(RA)isasystemic,autoimmunediseasethatpresentwithintra-articularandextra-articularmanifestations.AuditorysystemmaybeinvolvedduringthecourseofRAdiseaseduetonumbersofpathologies.ThelinkbetweenhearingimpairmentandRAhasbeendiscussedinthepreviousliterature.InthisstudyweprovideanupdateontheclinicalaspectofhearingimpairmentinRA.WesuggesttotesthearinginallnewlydiagnosedRApatientsatdiagnosisaswellasregularlyduringthecourseofdisease.
简介:
简介:Objective:EvaluatingtheauditoryfunctioninpatientswithchronichepatitisCtreatedwithsofosbuvirandribavirin.Methods:Thisstudyinvolved80patientswithchronichepatitisCwhoagreedtoreceivesofosbuvirandribavirin.Allparticipantsweresubjectedtobaselineotologicalandaudiologicalassessmentjustbeforetreatment.Theaudiologicalassessmentincludedstandardpuretoneaudiometry,extendedhighfrequencyaudiometry,immitancemetryandotoacousticemissions(OAEs)(transientanddistortionproduct).Accordingtobaselinehearingthresholdmeasurements,thestudypopulationwasdividedinto2groups.Group1included42patientswithnormalhearingsensitivity(250e8000Hz),andGroup2included38patientswithsensorineuralhearingloss.After24weeksoftherapy,otologicalandaudiologicalassessmentswererepeatedandcomparedbetweenthetwogroupsandbeforeandaftertherapy.Results:Post-treatmenthearingthresholdevaluationshowednosignificantdifferencefrompretreatmentevaluationatalltestedfrequencies.Therewasnostatisticallysignificantdifferencebetweenpreandpost-treatmentotoacousticemissionsresults.Conclusion:TherapywithsofosbuvirandribavirininchronichepatitisChasnonoticeableeffectsoncochlearfunctions.
简介:Objective:Hepatocellularcarcinoma(HCC)isacommonmalignancyassociatedwithhighmorbidityandmortalityratesworldwide.EarlydiagnosisplaysanimportantroleintheimprovementofHCCprognosis.Methods:Inthisstudy,weconductedacomprehensiveanalysisofHCCDNAmethylationandgeneexpressiondatasetsinTheCancerGenomeAtlas(TCGA),toidentifyaprognosticsignatureforHCCdiagnosisandsurvivalprediction.First,weidentifieddifferentialmethylationCpG(dmCpG)sitesinHCCsamplesandcomparedthemwiththoseinadjacentnormallivertissues;thiswasfollowedbyunivariateanalysisandSureIndependenceScreening(SIS)inthetrainingset.Therobustnessoftheidentifiedprognosticsignaturewasevaluatedusingthetestingset.ToexplorethebiologicalprocessesinvolvedinHCCprogression,wealsoperformedfunctionalenrichmentanalysisforoverlappinggenesbetweengenescontainingdmCpGsites(DMGs)anddifferentialexpressiongenes(DEGs)inHCCpatients,usingdatafromtheDatabaseforAnnotation,Visualization,andIntegratedDiscovery(DAVID).Results:Asaresult,weidentifiedfiveCpGsitesthatweresignificantlyassociatedwithHCCsurvivalthroughunivariateanalysisandSIS.Univariateanalysisofclinicalcharacteristicsidentifiedageandriskfactors(includingalcoholconsumptionandsmoking)asindependentfactorsthatindicatedHCCsurvival.Multivariateanalysisindicatedthattheintegratedprognosticsignature(weightedcombinationofthefiveCpGsites)thattookageandriskfactorsintoconsiderationresultedinmoreaccuratesurvivalprediction.Conclusions:ThisstudyprovidesanovelsignatureforpredictingHCCsurvival,andshouldbehelpfulforearlyHCCdiagnosisandpersonalizedtreatment.
简介:
简介:BackgroundThrombocytopeniaisacommoncomplicationofIABP.Untilnow,thereisnounifiedconclusionsabouttheincidence,characteristics,riskfactorsandtheprognosisofIABPrelatedthrombocytopenia.MethodsInthisstudy,thedataofpatientswithACSundergoingPCIandIABPwereretrospectivelyanalyzed.Allenrolledpatientsweredividedintothrombocytopeniagroupandnon-thrombocytopeniagroupaccordingtotheoccurrenceofthrombocytopeniaafterinsertionofIABP.Thebaselinedataofthetwogroupswerecompared,andthepossibleriskfactorsofthrombocytopeniaandtheirimpactonprognosiswereanalyzedbychi-squaretestandlogisticregressionanalysis.ResultsSixty-twopatientswereenrolledinthisstudy.TherateofIABPassociatedthrombocytopeniawas25.8%(16/62)ofallpatients.OlderagewasanindependentriskfactorofIABPassociatedthrombocytopenia(OR:3.625;95%confidenceinterval:1.016-12.935;P=0.047).TheincidenceofTIMIbleedingeventswashigherinthrombocytopeniagroup[75.0%(12/16)vs.43.5%(20/46),P=0.042].Therateofin-hospitaldeathwassimilarbetweenthetwogroups[18.8%(3/16)vs.17.4%(8/46),P=1.0].ConclusionIABPassociatedthrombocytopeniaoccursin25.8%ofpatientswithACSundergoingPCIandcorrelateswithincreasedTIMIbleedingevents.OlderagemaypredictIABPassociatedthrombocytopenia.
简介:AIMTodeterminewhetherthenumberofexaminedlymphnodes(LNs)iscorrelatedwiththeoverallsurvivalofgallbladdercarcinoma(GBC)patients.METHODSPatientswerecollectedfromtheSurveillanceEpidemiologyandEndResultsdatabase(2004-2013)andcategorizedbythenumberofLNsintosixgroups:1LN,2LNs,3LNs,4LNs,5LNs,and≥6LNs.SurvivalcurvesforoverallsurvivalwereplottedwithaKaplan-Meieranalysis.Thelog-ranktestwasusedforunivariatecomparisons.RESULTSInacohortof893patients,themediannumberofexaminedLNswastwofortheentirecohort.Thesurvivalforthe1LNgroupwassignificantlypoorerthanthoseofthestageⅠandⅡdiseasegroupsandfortheentirecohort.BydichotomizingthenumberofLNsfrom1to6,wefoundthattheminimumnumberofLNsthatshouldbeexaminedwasfourforstageⅠ,fourorfiveforstageⅡ,andsixforstageⅢAdisease.Therefore,fortheentirecohort,thenumberofexaminedLNsshouldbeatleastsix,whichisexactlyconsistentwiththeAmericanJointCommitteeonCancercriteria.CONCLUSIONTheexaminationofhighernumbersofLNsisassociatedwithimprovedsurvivalafterresectionsurgeryforN0GBC.TheguidelinesforGBCsurgery,whichrecommendthatsixLNsbeexaminedatleast,arestatisticallyvalidandshouldbeappliedinclinicalpracticewidely.
简介:第二等的绿内障的长期的结果在回顾的学习包括了的一系列中国patients.METHODSThe与Ahmed绿内障阀门(AGV)由于眼色素层炎对待培植的AIMTo报告从经历了AGV培植的有uveitic绿内障的56个病人的67只眼睛。治疗的成功被定义为完成压力(IOP)从基线IOP在6和21公里Hg之间铺平与或没有另外的反绿内障药或最少20%减小的intraocular的病人。主要结果大小包括了IOP,在1点的绿内障药的数字,3,6,12,24,36,48并且在外科以后的60mo,外科的复杂并发症,最后的改正最好的视觉尖酸(BCVA),吗视觉地(VF)和网膜的神经纤维层(RNFL).RESULTSThe平均数后续是53.3灡?潬桲硥獩??
简介:Objective:Anlotinibhydrochlorideisamultitargettyrosinekinaseinhibitorthattargetsvascularendothelialgrowthfactorreceptor,fibroblastgrowthfactorreceptor,platelet-derivedgrowthfactorreceptor,c-Kit,andc-MET;therefore,itexhibitsbothantitumorandanti-angiogeneticactivities.AphaseIIItrialhasshownthatanlotinibimprovedprogression-freesurvival(PFS)andoverallsurvival(OS)inpatientswithadvancednon-smallcelllungcancer(NSCLC),whopresentedwithprogressivediseaseorintoleranceafterstandardchemotherapy.Thisstudyaimedtoanalyzethecharacteristicsofpatientsreceivinganlotinibtreatmenttodeterminethedominantpopulationswhoarefitforthetreatment.Methods:DatawerecollectedfromMarch2015toJanuary2017fromarandomized,double-blind,placebo-controlled,multicenter,phaseIIItrialofanlotinib(ALTER0303).Atotalof437patientswereenrolledandrandomlyallocated(2:1)totheanlotinibandplacebogroups.Kaplan–Meieranalysisandlog-ranktestwereperformedtocomparePFSandOS.Coxproportionalhazardsmodelwasadoptedformultivariateprognosticanalysis.Results:Multivariateanalysisindicatedthathighpost-therapeuticperipheralbloodgranulocyte/lymphocyteratioandelevatedalkalinephosphataselevelswereindependentriskfactorsforPFS.Meanwhile,elevatedthyroid-stimulatinghormone,bloodglucose,andtriglyceridelevels;hypertension;andhand–footsyndromewereindependentprotectivefactorsofPFS.Highposttherapeuticperipheralbloodgranulocyte/lymphocyteratio,anEasternCooperativeOncologyGroup(ECOG)score≥2,andthesumofthemaximaltargetlesionlengthatbaselinewereindependentriskfactorsofOS,andhypertriglyceridemiawasanindependentprotectivefactorofOS.Conclusions:ThisstudypreliminarilyexploredthepossiblefactorsthataffectedPFSandOSafteranlotinibtreatmentinpatientswithadvancedrefractoryNSCLC,andthebaselinecharacteristicsofthetherapeuticallydominantpopulationswere
简介:Objective:Tocreateanomogramtopredicttheincidenceoflymphnodemetastasis(LNM)inearlygastriccancer(EGC)patientsandtoexternallyvalidatethenomogram.Methods:Toconstructthenomogram,weretrospectivelyanalyzedaprimarycohortof272EGCpatients.Univariateanalysisandabinarylogisticregressionwereperformed.AnomogrampredictingtheincidenceofLNMinEGCpatientswascreated.Thediscriminationabilityofthenomogramwasmeasuredusingtheconcordanceindex(c-index),andthenomogramwasalsocalibrated.Then,anotherprospectivecohortof81patientswasanalyzedtovalidatethenomogram.Results:Intheprimarycohort,LNMwaspathologicallyconfirmedin37(13.6%)patients.Inmultivariateanalysis,thepresenceofanulcer,themaximumlesiondiameterobservedviagastroscopy,thethicknessofthelesionobservedviaendoscopicultrasonography,andthepresenceofenlargedlymphnodesoncomputedtomography(CT)wereindependentriskfactorsforLNM.Anomogramwasthencreatedbasedontheregressionmodelwiththec-indexof0.905,andthecalibrationcurveofthenomogramfellapproximatelyontheideal45-degreeline.Thecut-offscoreofthenomogramwas110,andthesensitivity,specificity,positivepredictiveandnegativepredictivevaluesofthenomogramintheprimarycohortwere81.1%,86.0%,47.6%and96.7%,respectively,andintheprospectivevalidationcohortwere75.0%,91.0%,60.0%and95.5%,respectively.Thecalibrationcurveoftheexternalvalidationcohortwasalmostonthe45-degreeline.Conclusions:WedevelopedaneffectivenomogrampredictingtheincidenceofLNMforEGCpatients.
简介:AIMTo评估热门non-steroidal的预防管理的功效在糖尿病的病人的有斑点的浮肿追随者奔流外科上的反煽动性的药(NSAID),并且在NSAID的类型之间比较(ketorolactromethamine0.4%并且nepafenac0.1%).METHODSGroup(控制)1作为一个安慰剂组接待了人工的眼泪代用品,(nepafenac)组2收到了热门nepafenac(ketorolac)0.1%,和组3收到了热门ketorolactromethamine0.4%。病人们在完成一个以后手术后地被检查为评估似胞的有斑点的浮肿(CME)的星期,一个月,二个月和三月间隔开发。主要学习结果在与光连贯地形学(10月)测量的中央有斑点的厚度(CMT)正在完成最好改正的视觉尖酸(BCVA)和变化76个病人的.RESULTSEighty眼睛在这研究被包括。BCVA在第三个月显示出统计上重要的差别手术后列在后面在上面在控制组和NSAID组(P=0.04)之间。在开始从的所有情况中的CMT有增加手术后第一个星期直到第三个月。CMT显示出控制组和NSAID组之间的统计上重要的差别从手术后第一个月直到第三个月(P=0.008,0.027,0.004)。在BCVA和外科手术前的10月CMT.CONCLUSIONProphylacticnepafenac和ketorolac组之间没有统计上重要的差别,手术后的NSAID可以在在跟随奔流外科的糖尿病的眼睛减少CME的频率和严厉有一个角色。
简介:AspatientsinEastAsiaage,theprevalenceofage-relatedandchronicdisease,includingnonvalvularatrialfibrillation,mayincrease.Althoughwarfarinhasbeentheprimarychoiceofanticoagulantforthepreventionofstrokeandsystemicembolicevents,theuseofdirectoralanticoagulants(DOACs)isincreasing.DOACsdonotrequiremonitoringoftheinternationalnormalizedratiotodeterminetheoptimaldose,andhavealowerpotentialforfoodanddruginteractions,improvedbenefit-riskprofiles,andaquickeronsetandoffsetofactionrelativetowarfarin.Thepivotalphase3trialsforeachoftheDOACs–dabigatran,rivaroxaban,apixaban,andedoxaban–includedatleastsomeEastAsianpatients.Additionally,severalclinicaltrialswereconductedspecificallyforEastAsianpatients.ThisreviewdiscussespatternsandpredictorsofanticoagulantuseinEastAsianpatientswithnonvalvularatrialfibrillation,summarizescurrentguidelinerecommendationsforEastAsianpatients,detailstheprimaryresultsdemonstratingthesafetyandefficacyofDOACsinEastAsianpatientsrelativetonon–EastAsianpatients,providesreal-worlddatasupportingthephase3testingresults,andaddressestheclinicalprofileofDOACsinEastAsianpopulations,includingpatientsathighriskofstroke.
简介:
简介:Objective:Epidermalgrowthfactorreceptor(EGFR)activationwasreportedtoupregulateprogrammeddeath-ligand1(PD-L1)expressioninlungcancercellsandsubsequentlycontributetoimmuneescape,indicatingitscriticalroleinEGFR-drivenlungtumors.ThisstudycharacterizedPD-L1expressioninpatientswithsurgicallyresectedEGFR-mutantnon-smallcelllungcancer(NSCLC).TheeffectofPD-L1expressiononclinicaloutcomeswasalsoinvestigatedinadvancedEGFR-mutantNSCLCtreatedwithEGFR-tyrosinekinaseinhibitors(TKIs).Methods:Intotal,73patientswithsurgicallyresectedNSCLCandEGFRmutationswereidentified.PD-L1expressionandCD8+tumor-infiltratinglymphocyte(TIL)densitywereassessedbyimmunohistochemistry.AliteraturereviewofpublicationsthatassessedthepredictiveandprognosticvalueofPD-L1expressioninadvancedEGFR-mutantNSCLCpatientstreatedwithEGFRTKIswasperformed.Results:Nineteen(26.0%)patientswerepositiveforPD-L1expression,whichwassignificantlyassociatedwithconcomitantKRASmutation(P=0.020)andmarginallyassociatedwithhigherCD8+TILsdensity(P=0.056).PositivePD-L1expressionwasassociatedwithmarkedlyinferioroverallsurvival(OS)inmultivariateanalysis(P=0.032).ThecombinationofPD-L1andCD8+TILsexpressioncouldbeusedtostratifythepopulationintothreegroupswithdistinctprognoses.Ameta-analysisofsixpublicationsshowedthatpositivePD-L1expressionwasnotassociatedwithOS[hazardratio(HR)=0.90;95%confidenceinterval(CI),0.42–1.38]orprogression-freesurvival(HR=1.03;95CI,0.73–1.33)inadvancedEGFR-mutantNSCLCpatientsreceivingEGFR-TKIs.Conclusions:PD-L1expressiontendedtocorrelatewithCD8+TILexpression,concomitantKRASmutation,andpoorsurvivalinsurgicallyresectedEGFR-mutantNSCLC.PD-L1expressionwasneitherthepredictivenortheprognosticfactorinadvancedEGFR-mutantNSCLCpatientstreatedwithEGFR-TKIs.