双膦酸盐类药物对前列腺癌生存及骨转移影响的Meta分析

目的:分析双膦酸盐类药物对前列腺癌患者总生存期(OS)及骨转移的影响,为探讨双膦酸盐类药物改善前列腺癌预后提供依据。方法:采用计算机并配合手工检索中国知网、万方数据库、维普数据库、Web of Science、PubMed、Embase及Cochrane Library,搜索截止时间为2024年1月,检索文章为公开发表的关于双膦酸盐类药物辅助治疗前列腺癌的所有随机对照试验。主要观察指标包括患者OS、风险比(HR)及其95%置信区间(95%CI),次要指标为骨转移引起的骨痛和骨相关事件(SREs)等不良事件的发生率。使用Revman、Stata软件进行Meta分析。结果:共纳入10项随机对照试验。Meta分析结果显示,双膦酸盐辅助治疗组和安慰剂组之间的OS结果为阴性(HR=-0.07,95%CI:-0.21~0.07,P=0.331);SREs发生率无明显改变(OR=0.88,95%CI:0.69~1.13,Z=-0.993,P>0.05),差异均无统计学意义。结论:双膦酸盐类药物无法延缓前列腺癌患者的病情进展和延长生存期,也无法降低骨转移所致SREs等不良事件的发生率。

壮族泌尿系结石患者的发病影响因素及结石成分特点

目的探讨壮族泌尿系结石患者的发病影响因素,并分析其结石成分特点。方法选取184例壮族泌尿系结石患者作为结石组,取100例壮族健康体检者作为对照组。比较两组研究对象的一般特征、血液代谢指标及24 h尿液代谢指标。采用二元Logistic回归模型分析壮族泌尿系结石患者发病的影响因素。分析结石组患者的结石成分,并比较不同结石成分的泌尿系结石患者代谢异常的发生率。结果结石组的血清肌酐、血清尿酸、尿草酸、尿尿酸、尿钙水平均高于对照组,24 h尿量及尿枸橼酸水平均低于对照组(均P<0.05)。二元Logistic回归模型分析结果显示,血清尿酸、尿尿酸、尿钙水平是壮族泌尿系结石患者发病的危险因素,而24 h尿量是其保护因素(均P<0.05)。结石组患者的结石以草酸钙结石、无水尿酸结石为主;草酸钙结石患者的高钙尿症、高草酸尿症发生率均高于其他结石成分的患者,无水尿酸结石患者的高尿酸尿症发生率均高于其他结石成分的患者(均P<0.05)。结论血清尿酸、尿尿酸、尿钙水平是壮族泌尿系结石患者发病的危险因素,而24 h尿量是其保护因素。壮族泌尿系结石患者的结石以草酸钙结石、无水尿酸结石为主,泌尿系结石的形成与机体代谢异常密切相关。

Allogeneic hematopoietic stem cell transplantation for patients with acute leukemia

Objective： The purposes of this study were to assess the efficacy of allogeneic hematopoietic stem cell transplantation （HSCT） for acute leukemia （AL） and analyze the factors affecting the prognosis of these patients. Methods： The clinical and follow-up data of 93 AL patients （median age, 30 years） undergoing allogeneic HSCT in Xiangya Hospital over the past 12 years were collected, and the potential factors affecting the efficacy and prognosis of allogeneic HSCT patients were determined. Results： Hematopoietic reconstitution was achieved in 90 patients. At the last follow-up, the incidences of severe acute graft versus host disease （aGvHD） and extensive chronic GvHD （cGvHD） were 14.0% and 20.0%, the 3-year cumulative incidence of transplantation related mortality （TRM） and relapse rate were 16.8%±6.1% and 21.3%±6.7%, and the estimated 3-year overall survival （OS） and disease-free survival （DFS） of the patients were 64.6%±5.4% and 56.5%±5.5%, respectively. Univariate analysis indicated that age older than 40 years, HLA mismatch, and severe lung infection within the first 100 days after transplantation were risk factors for severe aGvHD, age older than 40 years, HLA mismatch, severe lung infection within the first 100 days after transplantation, and severe aGvHD were risk factors for TRM, high-risk AL and lack of cGvHD were risk factors for relapse （all P〈0.05）. Survival estimation showed that HLA mismatch, severe lung infection occurring within the first 100 days post-transplantation, high-risk AL severe aGvHD and lack of cGvHD were risk factors associated with poor prognosis （all P〈0.05）. Further multivariate analyses revealed that severe lung infection within the first 100 days post-transplantation, severe aGvHD and lack of cGvHD were independent risk factors for unfavorable outcomes （all P〈0.05）. Conclusions： Allogeneic HSCT can improve the DFS of AL patients, and severe lung infection within the first 100 days post-transplantation, severe aGvHD and lack of cGvHD are independent risk factors affecting the prognosis.