Hair follicle stem cells(HFSCs)in the bulge are a multipotent adult stem cell population.They can periodically give rise to new HFs and even regenerate the epidermis and sebaceous glands during wound healing.An increa...Hair follicle stem cells(HFSCs)in the bulge are a multipotent adult stem cell population.They can periodically give rise to new HFs and even regenerate the epidermis and sebaceous glands during wound healing.An increasing number of biomarkers have been used to isolate,label,and trace HFSCs in recent years.Considering more detailed data from single-cell transcriptomics technology,we mainly focus on the important HFSC molecular markers and their regulatory roles in this review.展开更多
AIM: To explore the expression of PlexinA1 in gastric carcinoma and its relationship with tumor angiogenesis and proliferation. METHODS: PlexinA1 mRNA and protein expressions of Semaphorin6D were measured using semi-q...AIM: To explore the expression of PlexinA1 in gastric carcinoma and its relationship with tumor angiogenesis and proliferation. METHODS: PlexinA1 mRNA and protein expressions of Semaphorin6D were measured using semi-quantity reverse transcription PCR and Western blotting in 20 cases of gastric carcinoma and corresponding normal gastric mucosa. PlexinA1, Ki-67 expression and microvessel density (MVD) were detected by immunohistochemistry in 50 cases of gastric carcinoma and 20 cases of normal gastric mucosa. RESULTS: The mRNA and protein expressions of PlexinA1 in gastric carcinoma were significantly higher than that in normal gastric mucosa (0.71 ± 0.37 vs 0.60 ± 0.25, P = 0.0299 < 0.05, and 0.47 ± 0.16 vs 0.21 ± 0.08, P = 0.0000 < 0.01), and MVD within tumor tissues increased significantly with PlexinA1 mRNA expression (r =0.8736, P < 0.01) and PlexinA1 protein expression (r = 0.7286, P < 0.01), and MVD of the PlexinA1 positive staining group (25.25 ± 3.93) was significantly higher than that of the negative group (19.56 ± 1.75), (P < 0.01). Proliferation index of tumor cells within tumor tissues were positively correlated with PlexinA1 mRNA expression (r = 0.5420, P = 0.014 < 0.01) and PlexinA1 protein expression (r = 0.5024, P = 0.024 < 0.05). The proliferation index of the PlexinA1 positive staining group (567.69 ± 125.61) was signifi cantly higher than that of the negative group (369.58 ± 116.88), (P < 0.01). CONCLUSION: PlexinA1 may play an important role in the occurrence and development of gastric carcinoma, and be related to tumor angiogenesis and proliferation.展开更多
Background: Pathologic response is evaluated according to the extent of tumor regression and is used to estimate the efficacy of preoperative treatment. Several studies have reported the association between the pathol...Background: Pathologic response is evaluated according to the extent of tumor regression and is used to estimate the efficacy of preoperative treatment. Several studies have reported the association between the pathologic response and clinical outcomes of colorecal cancer patients with liver metastases who underwent hepatectomy.However, to date, no data from Chinese patients have been reported. In this study, we aimed to evaluate the association between the pathologic response to pre-hepatectomy chemotherapy and prognosis in a cohort of Chinese patients.Patients and methods: In this retrospective study, we analyzed the data of 380 liver metastases in 159 patients.The pathologic response was evaluated according to the tumor regression grade(TRG).The prognostic role of pathologic response in recurrence-free survival(RFS) and overall survival(OS) was assessed using Kaplan-Meier curves with the log-rank test and multivariate Cox models. Factors that had potential influence on pathologic response were also analyzed using multivariate logistic regression and Kruskal-Wallis/Mann-Whitney U tests.Results: Patients whose tumors achieved pathologic response after preoperative chemotherapy had significant longer RFS and OS than patients whose tumor had no pathologic response to chemotherapy(median RFS: 9.9 vs.6.5 months, P = 0.009; median OS: 40.7 vs. 28.1 months, P = 0.040). Multivariate logistic regression and Kruskal-Wallis/Mann-Whitney U tests showed that metastases with small diameter, metastases from the left-side primary tumors,and metastases from patients receiving long-duration chemotherapy had higher pathologic response rates than their control metastases(all P < 0.05). A decrease in the serum carcinoembryonic antigen(CEA) level after preoperative chemotherapy predicted an increased pathologic response rate(P < 0.05). Although the application of targeted therapy did not significantly influence TRG scores of all cases of metastases, the addition of cetuximab to chemotherapy resulted in a higher pathologic response rate when combined with irinotecan-based regimens rather than with oxaliplatin-based regimens.Conclusions: We found that the evaluation of pathologic response may predict the prognosis of Chinese colorectal cancer patients with liver metastases after preoperative chemotherapy. Small tumor diameter, long-duration chemotherapy, left primary tumor, and decreased serum CEA level after chemotherapy are associated with increased pathologic response rates.展开更多
Background:Fluoropyrimidine and oxaliplatin are widely used for patients with colorectal cancer.This phase II study was conducted to evaluate the efficacy and safety of the combination of S-1,oxaliplatin,and leucovori...Background:Fluoropyrimidine and oxaliplatin are widely used for patients with colorectal cancer.This phase II study was conducted to evaluate the efficacy and safety of the combination of S-1,oxaliplatin,and leucovorin(SOL) in the treatment of Chinese patients with metastatic colorectal cancer(mCRC).Methods:Eligible patients with untreated mCRC from four hospitals in China received intravenous oxaliplatin(85 mg/m2) on day 1,oral S-1 twice daily(80-120 mg per day) on day 1-7,and leucovorin twice daily(50 mg per day)simultaneously with S-1,every 2 weeks.Results and discussion:Forty patients were enrolled in our study.In total,296 cycles of SOL were administered.The overall response rate was 50.0%.At a median follow-up of 27 months,progression-free survival and overall surviva were 7.0 months(95%confidence interval[CI]6.0-10.6 months) and 22.2 months(95%CI 15.1-29.3 months),respectively.The most common grade 3/4 non-hematological adverse events were diarrhea(n = 8,20.0%),nausea(n = 3,7.5%),and vomiting(n = 3,7.5%).The most common grade 3/4 hematological toxicities were thrombocytopenia(n = 3,7.5%),neutropenia(n = 1,2.5%),and abnormal alanine transaminase/aspartate transaminase levels(n = 1,2.5%).There was one treatment-related death.Conclusions:The data indicate that the SOL regimen is effective and moderately tolerated in Chinese patients with mCRC.Trial registration:Clinical trial展开更多
There is a lack of high-quality,large-scale,real-world evidence from patients with metastatic colorectal cancer(mCRC),especially in China.It remains unclear whether efforts to improve the quality of care for mCRC woul...There is a lack of high-quality,large-scale,real-world evidence from patients with metastatic colorectal cancer(mCRC),especially in China.It remains unclear whether efforts to improve the quality of care for mCRC would improve patient survival outcomes in real-world practice.On the basis of an intelligent bigdata platform,we established a large-scale retrospective cohort of mCRC patients.We investigated the temporal changes in the systemic and local treatment(resection,ablation,or radiation to liver,lung,or extrahepatic and/or extrapulmonary metastases)patterns of mCRC,and whether these changes were associated with improved overall survival(OS)over time.Between July 2012 and December 2018,3403 eligible patients were included in this research.The median OS was 42.8 months(95%confidence interval(CI),40.7–46.6)for the entire cohort,25.6 months(95%CI,24.7–26.9)for those treated with systemic therapy only,and not reached(95%CI,78.6 months–not reached)for those receiving local therapy.The utility rate of local therapy increased continuously from 37.9%in 2012–2014 to 46.9%in 2017–2018.A dramatic increase in the utility rate of either cetuximab or bevacizumab was observed since 2017(39.9%,43.2%,and 60.3%in 2012–2014,2015–2016,and 2017–2018,respectively).Compared with 2012–2014,the OS of the entire population significantly improved in 2015–2016(hazard ratio(HR)=0.87(95%CI,0.78–0.99);P=0.034),but not for patients receiving systemic therapy only(HR=0.99(95%CI,0.86–1.14);P=0.889),whereas an improved OS was found in 2015–2018 for both the entire population(HR=0.75(95%CI,0.70–0.81);P<0.001)and for patients receiving systemic therapy only(HR=0.83(95%CI,0.77–0.91);P<0.001).In summary,the quality of care for mCRC,as indicated by the utility rate of targeted and local therapies,has been continuously improving over time in this study cohort,which is associated with continuously improving survival outcomes for these patients.展开更多
BACKGROUND Leiomyoma of the uterus is relatively common,but uterine leiomyoma of the greater omentum is rare.CASE SUMMARY Here,we report the case of a 22-year-old woman who presented with a 3 mo history of progressive...BACKGROUND Leiomyoma of the uterus is relatively common,but uterine leiomyoma of the greater omentum is rare.CASE SUMMARY Here,we report the case of a 22-year-old woman who presented with a 3 mo history of progressive abdominal distension and a hypervascular abdominopelvic mass.Due to a high serum concentration of CA125,the preoperative diagnosis was unclear.During surgery,5 L of ascites was removed.An 18.8 cm solid mass,which was pedunculated from the uterine fundus and exhibited complex adhesion to the greater omentum,was removed.The CA125 level was reduced postoperatively,and a pathologic study confirmed that the mass was a leiomyoma that originated in the uterus.CONCLUSION Uterine leiomyoma can share vessels with the greater omentum.This case highlights the difficulty of diagnosing pseudo-Meigs syndrome and the importance of imaging and laboratory examinations.展开更多
1. Objective Among globally known industrial helium-enriched natural gas reservoirs, associated helium is dominantly crust-derived helium(4He), which is generated by the radioactive decay of uranium(U) and thorium(Th)...1. Objective Among globally known industrial helium-enriched natural gas reservoirs, associated helium is dominantly crust-derived helium(4He), which is generated by the radioactive decay of uranium(U) and thorium(Th) in crustal rocks. These rocks with old ages are also defined as helium source rocks.Published accumulation models for helium have revealed that granite is the main and effective helium source rock in the crust(Li YH et al., 2018).展开更多
The impact of maintenance therapy on progression-free survival and overall survival as well as quality of life of Chinese patients with metastatic colorectal cancer has long been under discussion.Recently,some phase I...The impact of maintenance therapy on progression-free survival and overall survival as well as quality of life of Chinese patients with metastatic colorectal cancer has long been under discussion.Recently,some phase III clinical trials have revealed that maintenance therapy can significantly prolong the progression-free survival while maintain an acceptable safety profile.Based on this evidence and common treatment practice in China,we now generated one Expert Consensus on Maintenance Treatment for Metastatic Colorectal Cancer in China to further specify the necessity of maintenance therapy,suitable candidates for such treatment,and appropriate regimens.展开更多
AIM: To investigate the protein and mRNA expression of semaphorin 6D in gastric carcinoma and its significance. METHODS: The protein and mRNA expression of semaphorin 6D was detected by semi-quantitative rever- se tra...AIM: To investigate the protein and mRNA expression of semaphorin 6D in gastric carcinoma and its significance. METHODS: The protein and mRNA expression of semaphorin 6D was detected by semi-quantitative rever- se transcription PCR and Western blotting respectively in 30 cases of gastric carcinoma and normal gastric mucosa. RESULTS: The protein and mRNA expression of semaphorin 6D in gastric carcinoma was significantly higher than that in normal gastric mucosa (0.24 ± 0.06 vs 0.19 ± 0.07, 0.26 ± 0.09 vs 0.20 ± 0.10, P < 0.05). CONCLUSION: Semaphorin 6D may play an important role in the occurrence and development of gastric carcinoma, and is related to tumor angiogenesis.展开更多
AIM: To contrast the effects of various modifications of body fluid volumes on thirst as reported by healthy volunteers. METHODS: Ten male volunteers aged between 19 and 37 years(mean 22 years) underwent four experime...AIM: To contrast the effects of various modifications of body fluid volumes on thirst as reported by healthy volunteers. METHODS: Ten male volunteers aged between 19 and 37 years(mean 22 years) underwent four experiments each, which comprised infusion of 400-800 m L of acetated Ringer's solution and intake of 600 m L of tap water. Half of the experiments were preceded by volume depletion(median 1.7 L) with furosemide. A visual analogue scale(0-100 mm) was used to assess perceived thirst during each experiment. RESULTS: Volume depletion(P < 0.001) and tap water(P < 0.03) both affected thirst by 13 mm per L of fluid, whereas spontaneous diuresis and infusion of Ringer's acetate did not significantly change the thirst rating(multiple regressions). More detailed analyses showed that the volume depletion increased the median(25th-75th percentiles) thirst rating from 28 mm(21-43) to 59 mm(46-72, P < 0.001) while no change occurred in those who were only slightly thirsty(< 30 mm) before the volume depletion began. Ringer's solution alleviated thirst in those who were very thirsty, but tended to increase thirst in the volunteers who were not thirsty before the infusion. Similarly, hydration with tap water decreased thirst(by 24 mm, P < 0.04) in those who were thirsty(> 60 mm) while the others reported no change.展开更多
The purpose of this study was to determine the ion release from four commercially available pit-and-fissure sealants [3M Clinpro, 3M ConciseTM, BeautiSealant （BS）, and GI FX-Ⅱ）]. With each brand, 18 specimens were...The purpose of this study was to determine the ion release from four commercially available pit-and-fissure sealants [3M Clinpro, 3M ConciseTM, BeautiSealant （BS）, and GI FX-Ⅱ）]. With each brand, 18 specimens were prepared. Their fluoride release in de-ionized water was measured by fluoride electrode, while the release of silicate （Si）, aluminum （A1）, sodium （Na）, calcium （Ca）, strontium （Sr）, and phosphorus （P） was measured by inductively coupled plasma atomic emission spectroscopy （ICP-AES） on days 1, 3, 7, 14, 21, and 28. The result showed that fluoride was not released from 3M ConciseTM. GI FX-II displayed the largest fluoride release, which, however, dropped rapidly on day 3.3M Clinpro exhibited less fluoride release than GI FX-II and BS did. At any time during the 28-day experimental period, GI FX-II released more Na than the other sealants （P〈0.001）. BS ranked the second in Na release, and a small amount of Na ions was released from the 3M Clinpro and 3M ConciseTM samples. Al ions were only detected from BS and GI FX-Ⅱ, but not from the 3M Clinpro and 3M ConciseTM. Additionally GI FX-II had the largest Si release among the four brands at any time during the experimental period （P〈0.001）. Ca ions were detected from 3M Clinpro and 3M ConciseTM, but not from GI FX-Ⅱ. BS released more Sr than the other sealants at any time during the experimental period （P〈0.001）. All the samples released similar amounts of P continuously during these 28 days. In conclusion, based on the type and the amount of ion release, BS is the best pit-and-fissure sealant among the four brands.展开更多
Background Pediatric antineutrophil cytoplasmic antibody-associated vasculitis(AAV)is a life-threatening systemic vasculitis featured by liability to renal involvement.However,there are few studies on the risk factors...Background Pediatric antineutrophil cytoplasmic antibody-associated vasculitis(AAV)is a life-threatening systemic vasculitis featured by liability to renal involvement.However,there are few studies on the risk factors and predictive models for renal outcomes of AAV in children.Methods Data from 179 AAV children in multiple centers between January 2012 and March 2020 were collected retrospectively.The risk factors and predictive model of end-stage renal disease(ESRD)in AAV were explored.Results Renal involvement was the most typical manifestation(95.5%),and the crescent was the predominant pathological lesion(84.9%).The estimated glomerular filtration rate(eGFR)was evaluated in 114 patients,of whom 59.6%developed ESRD,and the median time to ESRD was 3.20 months.The eGFR[P=0.006,odds ratio(OR)=0.955,95%confidence interval(CI)=0.924–0.987]and the percentages of global glomerulosclerosis(pGGS;P=0.018,OR=1.060,95%CI=1.010–1.112)were independent risk factors for ESRD of renal biopsy.Based on the pGGS and eGFR at renal biopsy,we developed three risk grades of ESRD and one predictive model.The Kaplan‒Meier curve indicated that renal outcomes were significantly different in different risk grades(P<0.001).Compared with serum creatinine at baseline,the predictive model had higher accuracy(0.86 versus 0.58,P<0.001)and a lower coefficient of variation(0.07 versus 0.92)in external validation.Conclusions Renal involvement is the most common manifestation of pediatric AAV in China,of which more than half deteriorates into ESRD.The predictive model based on eGFR at renal biopsy and the pGGS may be stable and accurate in speculating the risk of ESRD in AAV children.展开更多
Patients carrying mutations in polymerase epsilon/polymerase delta have shown positive responses to immune checkpoint inhibitors.Yet,prospective trials exploring the efficacy in those with polymerase epsilon/polymeras...Patients carrying mutations in polymerase epsilon/polymerase delta have shown positive responses to immune checkpoint inhibitors.Yet,prospective trials exploring the efficacy in those with polymerase epsilon/polymerase delta mutations are still lacking.A phase II clinical trial was initiated to evaluate the efficacy of toripalimab,a humanized IgG4K monoclonal antibody to human PD-1,in patients with advanced solid tumors with unselected polymerase epsilon/polymerase delta mutations but without microsatellite instability-high.A total of 15 patients were enrolled,14 of whom were assessed for treatment efficacy.There was a 21.4%overall response rate,with a disease control rate of 57.1%.The median overall survival and median progression-free survival were 17.9(95%CI 13.5-not reach)months and 2.5(95%CI 1.4-not reach)months,respectively.For patients with exonuclease domain mutations,the objective response rate was 66.7%(2/3),with a disease control rate of 66.7%(2/3).For those with non-exonuclease domain mutations,the rates were 9.1%(1/11)and 54.5%(6/11),respectively.Notably,patients with PBRM1 gene mutations exhibited a high response rate to toripalimab at 75.0%(3/4).This study showed that neither the exonuclease domain mutations nor non-exonuclease domain mutations could fully predict the efficacy of immunotherapy,urging the need for more investigations to clarify potential immune sensitization differences within polymerase epsilon/polymerase delta mutation variants.展开更多
Background：Urolithiasis in pediatric population is a serious problem with the incidence increased these years.In the management of larger stones （diameters 〉2 cm）,percutaneous nephrolithotomy （PCNL） is considere...Background：Urolithiasis in pediatric population is a serious problem with the incidence increased these years.In the management of larger stones （diameters 〉2 cm）,percutaneous nephrolithotomy （PCNL） is considered to be the gold standard.This study aimed to investigate the efficacy and safety of mini-PCNL under total ultrasonography in patients aged 〈3 years.Methods：We reviewed 68 patients （80 renal units） aged 〈3 years between August 2006 and December 2014 in Peking University People＆#39;s Hospital and Beijing Tsinghua Changung Hospital,including 36 renal units with a single stone,6 with staghom stones,14 with upper ureteral stones,and 24 with multiple stones.The mean age of the patients was 24.2 months （range 6-36 months）,and the mean maximum stone diameter was 19.2 mm （range 10-35 mm）.The puncture site selection and tract dilation were guided by Doppler ultrasonography solely.All procedures were performed using 12-16 Fr tracts.Stones were fragrnented using pneumatic lithotripsy and a holmium laser with an 8/9.8 Fr rigid ureteroscope.Results：Fifty-six patients with unilateral stones underwent a single session procedure,and 12 patients with bilateral stones underwent two procedures.The mean time to establish access was 2.8 min （range 1.8-5.0 min）,the mean operative time was 36.5 min （range 20-88 min）,the mean decrease in hemoglobin concentration was 8.9 g/L （2-15 g/L）,and the stone-free rate （SFR） at hospital discharge was 94.0%.The mean postoperative hospital stay was 7.1 days （range 3-13 days）.Postprocedure complications included fever （〉38.5℃） in five patients and reactive pleural effusion in one patient.Blood loss requiring transfusion,sepsis,adjacent organ injury,and kidney loss were not observed.Conclusions：This study indicated that ultrasound-guided mini-PCNL is feasible and safe in patients aged 〈3 years,without major complications or radiation exposure.展开更多
Background: Oxaliplatin, irinotecan, 5-fluorouracil, and l-leucovorin (FOLFIRINOX) has become one of the first-line treatment options for advanced pancreatic cancer (PC). However, the relatively high rate of grade 3 o...Background: Oxaliplatin, irinotecan, 5-fluorouracil, and l-leucovorin (FOLFIRINOX) has become one of the first-line treatment options for advanced pancreatic cancer (PC). However, the relatively high rate of grade 3 or 4 adverse events associated with the standard dosage of FOLFIRINOX limits its widespread use in clinical practice. In this study, we were to evaluate the efficacy and safety of a modified FOLFIRINOX regimen as a first-line chemotherapy for Chinese patients with metastatic PC. Methods: Patients with histologically confirmed primary metastatic pancreatic adenocarcinoma with an Eastern Cooperative Oncology Group (ECOG) performance status score of 0-2 were recruited to receive the modified FOLFIRINOX regimen (intravenous infusion of oxaliplatin, 65 mg/m2;irinotecan, 150 mg/m2;l-leucovorin, 200 mg/ m2;and 5-fluorouracil, 2400 mg/m2, repeated every 2 weeks). The treatment was continued for 12 cycles unless the patient had progressive disease (PD), stable disease (SD) with symptom deterioration, unacceptable adverse events, or requested to terminate the treatment prematurely. The primary endpoint was objective response rate (ORR). Results: Sixty-five patients were enrolled from July 2012 to April 2017 in three institutions, and they all received at least one cycle of chemotherapy, with a median of 8 cycles (range 1-12 cycles). No complete response was observed. Twenty-one (32.3%) patients had partial responses, and 27 (41.5%) had SD. The ORR and disease control rate of the study cohort was 32.3% and 73.8%. The estimated median overall survival and progression-free survival were 11.60 (95% confidence interval [CI] 8.76-14.44) and 5.77 (95% CI 5.00-6.54) months. Major grade 3 or 4 adverse events included neutropenia (12.3%) and diarrhea (6.2%). No treatment-related death was observed. Conclusions: Modified FOLFIRINOX was well-tolerated and might be a promising option as first-line therapy for Chinese patients with metastatic PC.展开更多
基金National Natural Science Foundation of China,No.82173446the Youth Training Program of the Army Medical University,No.2018XQN01.
文摘Hair follicle stem cells(HFSCs)in the bulge are a multipotent adult stem cell population.They can periodically give rise to new HFs and even regenerate the epidermis and sebaceous glands during wound healing.An increasing number of biomarkers have been used to isolate,label,and trace HFSCs in recent years.Considering more detailed data from single-cell transcriptomics technology,we mainly focus on the important HFSC molecular markers and their regulatory roles in this review.
基金Supported by The National Natural Science Foundation of China, No 30570522
文摘AIM: To explore the expression of PlexinA1 in gastric carcinoma and its relationship with tumor angiogenesis and proliferation. METHODS: PlexinA1 mRNA and protein expressions of Semaphorin6D were measured using semi-quantity reverse transcription PCR and Western blotting in 20 cases of gastric carcinoma and corresponding normal gastric mucosa. PlexinA1, Ki-67 expression and microvessel density (MVD) were detected by immunohistochemistry in 50 cases of gastric carcinoma and 20 cases of normal gastric mucosa. RESULTS: The mRNA and protein expressions of PlexinA1 in gastric carcinoma were significantly higher than that in normal gastric mucosa (0.71 ± 0.37 vs 0.60 ± 0.25, P = 0.0299 < 0.05, and 0.47 ± 0.16 vs 0.21 ± 0.08, P = 0.0000 < 0.01), and MVD within tumor tissues increased significantly with PlexinA1 mRNA expression (r =0.8736, P < 0.01) and PlexinA1 protein expression (r = 0.7286, P < 0.01), and MVD of the PlexinA1 positive staining group (25.25 ± 3.93) was significantly higher than that of the negative group (19.56 ± 1.75), (P < 0.01). Proliferation index of tumor cells within tumor tissues were positively correlated with PlexinA1 mRNA expression (r = 0.5420, P = 0.014 < 0.01) and PlexinA1 protein expression (r = 0.5024, P = 0.024 < 0.05). The proliferation index of the PlexinA1 positive staining group (567.69 ± 125.61) was signifi cantly higher than that of the negative group (369.58 ± 116.88), (P < 0.01). CONCLUSION: PlexinA1 may play an important role in the occurrence and development of gastric carcinoma, and be related to tumor angiogenesis and proliferation.
文摘Background: Pathologic response is evaluated according to the extent of tumor regression and is used to estimate the efficacy of preoperative treatment. Several studies have reported the association between the pathologic response and clinical outcomes of colorecal cancer patients with liver metastases who underwent hepatectomy.However, to date, no data from Chinese patients have been reported. In this study, we aimed to evaluate the association between the pathologic response to pre-hepatectomy chemotherapy and prognosis in a cohort of Chinese patients.Patients and methods: In this retrospective study, we analyzed the data of 380 liver metastases in 159 patients.The pathologic response was evaluated according to the tumor regression grade(TRG).The prognostic role of pathologic response in recurrence-free survival(RFS) and overall survival(OS) was assessed using Kaplan-Meier curves with the log-rank test and multivariate Cox models. Factors that had potential influence on pathologic response were also analyzed using multivariate logistic regression and Kruskal-Wallis/Mann-Whitney U tests.Results: Patients whose tumors achieved pathologic response after preoperative chemotherapy had significant longer RFS and OS than patients whose tumor had no pathologic response to chemotherapy(median RFS: 9.9 vs.6.5 months, P = 0.009; median OS: 40.7 vs. 28.1 months, P = 0.040). Multivariate logistic regression and Kruskal-Wallis/Mann-Whitney U tests showed that metastases with small diameter, metastases from the left-side primary tumors,and metastases from patients receiving long-duration chemotherapy had higher pathologic response rates than their control metastases(all P < 0.05). A decrease in the serum carcinoembryonic antigen(CEA) level after preoperative chemotherapy predicted an increased pathologic response rate(P < 0.05). Although the application of targeted therapy did not significantly influence TRG scores of all cases of metastases, the addition of cetuximab to chemotherapy resulted in a higher pathologic response rate when combined with irinotecan-based regimens rather than with oxaliplatin-based regimens.Conclusions: We found that the evaluation of pathologic response may predict the prognosis of Chinese colorectal cancer patients with liver metastases after preoperative chemotherapy. Small tumor diameter, long-duration chemotherapy, left primary tumor, and decreased serum CEA level after chemotherapy are associated with increased pathologic response rates.
文摘Background:Fluoropyrimidine and oxaliplatin are widely used for patients with colorectal cancer.This phase II study was conducted to evaluate the efficacy and safety of the combination of S-1,oxaliplatin,and leucovorin(SOL) in the treatment of Chinese patients with metastatic colorectal cancer(mCRC).Methods:Eligible patients with untreated mCRC from four hospitals in China received intravenous oxaliplatin(85 mg/m2) on day 1,oral S-1 twice daily(80-120 mg per day) on day 1-7,and leucovorin twice daily(50 mg per day)simultaneously with S-1,every 2 weeks.Results and discussion:Forty patients were enrolled in our study.In total,296 cycles of SOL were administered.The overall response rate was 50.0%.At a median follow-up of 27 months,progression-free survival and overall surviva were 7.0 months(95%confidence interval[CI]6.0-10.6 months) and 22.2 months(95%CI 15.1-29.3 months),respectively.The most common grade 3/4 non-hematological adverse events were diarrhea(n = 8,20.0%),nausea(n = 3,7.5%),and vomiting(n = 3,7.5%).The most common grade 3/4 hematological toxicities were thrombocytopenia(n = 3,7.5%),neutropenia(n = 1,2.5%),and abnormal alanine transaminase/aspartate transaminase levels(n = 1,2.5%).There was one treatment-related death.Conclusions:The data indicate that the SOL regimen is effective and moderately tolerated in Chinese patients with mCRC.Trial registration:Clinical trial
基金This study was supported by the grants from the National Natural Science Foundation of China(81930065)the Natural Science Foundation of Guangdong Province(2014A030312015)+1 种基金the Science and Technology Program of Guangdong(2019B020227002)the Science and Technology Program of Guangzhou(201904020046,201803040019,and 201704020228).
文摘There is a lack of high-quality,large-scale,real-world evidence from patients with metastatic colorectal cancer(mCRC),especially in China.It remains unclear whether efforts to improve the quality of care for mCRC would improve patient survival outcomes in real-world practice.On the basis of an intelligent bigdata platform,we established a large-scale retrospective cohort of mCRC patients.We investigated the temporal changes in the systemic and local treatment(resection,ablation,or radiation to liver,lung,or extrahepatic and/or extrapulmonary metastases)patterns of mCRC,and whether these changes were associated with improved overall survival(OS)over time.Between July 2012 and December 2018,3403 eligible patients were included in this research.The median OS was 42.8 months(95%confidence interval(CI),40.7–46.6)for the entire cohort,25.6 months(95%CI,24.7–26.9)for those treated with systemic therapy only,and not reached(95%CI,78.6 months–not reached)for those receiving local therapy.The utility rate of local therapy increased continuously from 37.9%in 2012–2014 to 46.9%in 2017–2018.A dramatic increase in the utility rate of either cetuximab or bevacizumab was observed since 2017(39.9%,43.2%,and 60.3%in 2012–2014,2015–2016,and 2017–2018,respectively).Compared with 2012–2014,the OS of the entire population significantly improved in 2015–2016(hazard ratio(HR)=0.87(95%CI,0.78–0.99);P=0.034),but not for patients receiving systemic therapy only(HR=0.99(95%CI,0.86–1.14);P=0.889),whereas an improved OS was found in 2015–2018 for both the entire population(HR=0.75(95%CI,0.70–0.81);P<0.001)and for patients receiving systemic therapy only(HR=0.83(95%CI,0.77–0.91);P<0.001).In summary,the quality of care for mCRC,as indicated by the utility rate of targeted and local therapies,has been continuously improving over time in this study cohort,which is associated with continuously improving survival outcomes for these patients.
基金Supported by Shanghai Municipal Key Clinical Specialty,No.Shslczdzk06302.
文摘BACKGROUND Leiomyoma of the uterus is relatively common,but uterine leiomyoma of the greater omentum is rare.CASE SUMMARY Here,we report the case of a 22-year-old woman who presented with a 3 mo history of progressive abdominal distension and a hypervascular abdominopelvic mass.Due to a high serum concentration of CA125,the preoperative diagnosis was unclear.During surgery,5 L of ascites was removed.An 18.8 cm solid mass,which was pedunculated from the uterine fundus and exhibited complex adhesion to the greater omentum,was removed.The CA125 level was reduced postoperatively,and a pathologic study confirmed that the mass was a leiomyoma that originated in the uterus.CONCLUSION Uterine leiomyoma can share vessels with the greater omentum.This case highlights the difficulty of diagnosing pseudo-Meigs syndrome and the importance of imaging and laboratory examinations.
基金supported by China Geological Survey Project (DD20221665, DD20230026, DD20230268, DD20230314)National Key Research and Development Program (2021YFA0719003)。
文摘1. Objective Among globally known industrial helium-enriched natural gas reservoirs, associated helium is dominantly crust-derived helium(4He), which is generated by the radioactive decay of uranium(U) and thorium(Th) in crustal rocks. These rocks with old ages are also defined as helium source rocks.Published accumulation models for helium have revealed that granite is the main and effective helium source rock in the crust(Li YH et al., 2018).
文摘The impact of maintenance therapy on progression-free survival and overall survival as well as quality of life of Chinese patients with metastatic colorectal cancer has long been under discussion.Recently,some phase III clinical trials have revealed that maintenance therapy can significantly prolong the progression-free survival while maintain an acceptable safety profile.Based on this evidence and common treatment practice in China,we now generated one Expert Consensus on Maintenance Treatment for Metastatic Colorectal Cancer in China to further specify the necessity of maintenance therapy,suitable candidates for such treatment,and appropriate regimens.
文摘AIM: To investigate the protein and mRNA expression of semaphorin 6D in gastric carcinoma and its significance. METHODS: The protein and mRNA expression of semaphorin 6D was detected by semi-quantitative rever- se transcription PCR and Western blotting respectively in 30 cases of gastric carcinoma and normal gastric mucosa. RESULTS: The protein and mRNA expression of semaphorin 6D in gastric carcinoma was significantly higher than that in normal gastric mucosa (0.24 ± 0.06 vs 0.19 ± 0.07, 0.26 ± 0.09 vs 0.20 ± 0.10, P < 0.05). CONCLUSION: Semaphorin 6D may play an important role in the occurrence and development of gastric carcinoma, and is related to tumor angiogenesis.
文摘AIM: To contrast the effects of various modifications of body fluid volumes on thirst as reported by healthy volunteers. METHODS: Ten male volunteers aged between 19 and 37 years(mean 22 years) underwent four experiments each, which comprised infusion of 400-800 m L of acetated Ringer's solution and intake of 600 m L of tap water. Half of the experiments were preceded by volume depletion(median 1.7 L) with furosemide. A visual analogue scale(0-100 mm) was used to assess perceived thirst during each experiment. RESULTS: Volume depletion(P < 0.001) and tap water(P < 0.03) both affected thirst by 13 mm per L of fluid, whereas spontaneous diuresis and infusion of Ringer's acetate did not significantly change the thirst rating(multiple regressions). More detailed analyses showed that the volume depletion increased the median(25th-75th percentiles) thirst rating from 28 mm(21-43) to 59 mm(46-72, P < 0.001) while no change occurred in those who were only slightly thirsty(< 30 mm) before the volume depletion began. Ringer's solution alleviated thirst in those who were very thirsty, but tended to increase thirst in the volunteers who were not thirsty before the infusion. Similarly, hydration with tap water decreased thirst(by 24 mm, P < 0.04) in those who were thirsty(> 60 mm) while the others reported no change.
文摘The purpose of this study was to determine the ion release from four commercially available pit-and-fissure sealants [3M Clinpro, 3M ConciseTM, BeautiSealant （BS）, and GI FX-Ⅱ）]. With each brand, 18 specimens were prepared. Their fluoride release in de-ionized water was measured by fluoride electrode, while the release of silicate （Si）, aluminum （A1）, sodium （Na）, calcium （Ca）, strontium （Sr）, and phosphorus （P） was measured by inductively coupled plasma atomic emission spectroscopy （ICP-AES） on days 1, 3, 7, 14, 21, and 28. The result showed that fluoride was not released from 3M ConciseTM. GI FX-II displayed the largest fluoride release, which, however, dropped rapidly on day 3.3M Clinpro exhibited less fluoride release than GI FX-II and BS did. At any time during the 28-day experimental period, GI FX-II released more Na than the other sealants （P〈0.001）. BS ranked the second in Na release, and a small amount of Na ions was released from the 3M Clinpro and 3M ConciseTM samples. Al ions were only detected from BS and GI FX-Ⅱ, but not from the 3M Clinpro and 3M ConciseTM. Additionally GI FX-II had the largest Si release among the four brands at any time during the experimental period （P〈0.001）. Ca ions were detected from 3M Clinpro and 3M ConciseTM, but not from GI FX-Ⅱ. BS released more Sr than the other sealants at any time during the experimental period （P〈0.001）. All the samples released similar amounts of P continuously during these 28 days. In conclusion, based on the type and the amount of ion release, BS is the best pit-and-fissure sealant among the four brands.
基金approved by the Ethics Committee of the Children’s Hospital of Chongqing Medical University(approval Number:149/2022)other enrolled centers.This study was registered at the Chinese Clinical Trial Registry(registered number:ChiCTR2000034203).
文摘Background Pediatric antineutrophil cytoplasmic antibody-associated vasculitis(AAV)is a life-threatening systemic vasculitis featured by liability to renal involvement.However,there are few studies on the risk factors and predictive models for renal outcomes of AAV in children.Methods Data from 179 AAV children in multiple centers between January 2012 and March 2020 were collected retrospectively.The risk factors and predictive model of end-stage renal disease(ESRD)in AAV were explored.Results Renal involvement was the most typical manifestation(95.5%),and the crescent was the predominant pathological lesion(84.9%).The estimated glomerular filtration rate(eGFR)was evaluated in 114 patients,of whom 59.6%developed ESRD,and the median time to ESRD was 3.20 months.The eGFR[P=0.006,odds ratio(OR)=0.955,95%confidence interval(CI)=0.924–0.987]and the percentages of global glomerulosclerosis(pGGS;P=0.018,OR=1.060,95%CI=1.010–1.112)were independent risk factors for ESRD of renal biopsy.Based on the pGGS and eGFR at renal biopsy,we developed three risk grades of ESRD and one predictive model.The Kaplan‒Meier curve indicated that renal outcomes were significantly different in different risk grades(P<0.001).Compared with serum creatinine at baseline,the predictive model had higher accuracy(0.86 versus 0.58,P<0.001)and a lower coefficient of variation(0.07 versus 0.92)in external validation.Conclusions Renal involvement is the most common manifestation of pediatric AAV in China,of which more than half deteriorates into ESRD.The predictive model based on eGFR at renal biopsy and the pGGS may be stable and accurate in speculating the risk of ESRD in AAV children.
基金National Natural Science Foundation of China(82321003,81930065,82173128)CAMS Innovation Fund for Medical Sciences(CIFMS)(2019-I2M-5-036)+6 种基金Science and Technology Program of Guangzhou(202206080011)Medical Scientific Research Foundation of Guangdong Province(A2022054)Cancer Innovative Research Program of Sun Yat-sen University Cancer Center(CIRP-SYSUCC-0004)Sun Yat-sen University Clinical Research 5010 Program(84000-31630002)Fundamental Research Funds for the Central Universities,Sun Yat-sen University(22yklj06)Young Talents Program of Sun Yat-sen University Cancer Center(YTP-SYSUCC-0018)CSCO foundation(Y-QL202202-0089).
文摘Patients carrying mutations in polymerase epsilon/polymerase delta have shown positive responses to immune checkpoint inhibitors.Yet,prospective trials exploring the efficacy in those with polymerase epsilon/polymerase delta mutations are still lacking.A phase II clinical trial was initiated to evaluate the efficacy of toripalimab,a humanized IgG4K monoclonal antibody to human PD-1,in patients with advanced solid tumors with unselected polymerase epsilon/polymerase delta mutations but without microsatellite instability-high.A total of 15 patients were enrolled,14 of whom were assessed for treatment efficacy.There was a 21.4%overall response rate,with a disease control rate of 57.1%.The median overall survival and median progression-free survival were 17.9(95%CI 13.5-not reach)months and 2.5(95%CI 1.4-not reach)months,respectively.For patients with exonuclease domain mutations,the objective response rate was 66.7%(2/3),with a disease control rate of 66.7%(2/3).For those with non-exonuclease domain mutations,the rates were 9.1%(1/11)and 54.5%(6/11),respectively.Notably,patients with PBRM1 gene mutations exhibited a high response rate to toripalimab at 75.0%(3/4).This study showed that neither the exonuclease domain mutations nor non-exonuclease domain mutations could fully predict the efficacy of immunotherapy,urging the need for more investigations to clarify potential immune sensitization differences within polymerase epsilon/polymerase delta mutation variants.
文摘Background：Urolithiasis in pediatric population is a serious problem with the incidence increased these years.In the management of larger stones （diameters 〉2 cm）,percutaneous nephrolithotomy （PCNL） is considered to be the gold standard.This study aimed to investigate the efficacy and safety of mini-PCNL under total ultrasonography in patients aged 〈3 years.Methods：We reviewed 68 patients （80 renal units） aged 〈3 years between August 2006 and December 2014 in Peking University People＆#39;s Hospital and Beijing Tsinghua Changung Hospital,including 36 renal units with a single stone,6 with staghom stones,14 with upper ureteral stones,and 24 with multiple stones.The mean age of the patients was 24.2 months （range 6-36 months）,and the mean maximum stone diameter was 19.2 mm （range 10-35 mm）.The puncture site selection and tract dilation were guided by Doppler ultrasonography solely.All procedures were performed using 12-16 Fr tracts.Stones were fragrnented using pneumatic lithotripsy and a holmium laser with an 8/9.8 Fr rigid ureteroscope.Results：Fifty-six patients with unilateral stones underwent a single session procedure,and 12 patients with bilateral stones underwent two procedures.The mean time to establish access was 2.8 min （range 1.8-5.0 min）,the mean operative time was 36.5 min （range 20-88 min）,the mean decrease in hemoglobin concentration was 8.9 g/L （2-15 g/L）,and the stone-free rate （SFR） at hospital discharge was 94.0%.The mean postoperative hospital stay was 7.1 days （range 3-13 days）.Postprocedure complications included fever （〉38.5℃） in five patients and reactive pleural effusion in one patient.Blood loss requiring transfusion,sepsis,adjacent organ injury,and kidney loss were not observed.Conclusions：This study indicated that ultrasound-guided mini-PCNL is feasible and safe in patients aged 〈3 years,without major complications or radiation exposure.
文摘Background: Oxaliplatin, irinotecan, 5-fluorouracil, and l-leucovorin (FOLFIRINOX) has become one of the first-line treatment options for advanced pancreatic cancer (PC). However, the relatively high rate of grade 3 or 4 adverse events associated with the standard dosage of FOLFIRINOX limits its widespread use in clinical practice. In this study, we were to evaluate the efficacy and safety of a modified FOLFIRINOX regimen as a first-line chemotherapy for Chinese patients with metastatic PC. Methods: Patients with histologically confirmed primary metastatic pancreatic adenocarcinoma with an Eastern Cooperative Oncology Group (ECOG) performance status score of 0-2 were recruited to receive the modified FOLFIRINOX regimen (intravenous infusion of oxaliplatin, 65 mg/m2;irinotecan, 150 mg/m2;l-leucovorin, 200 mg/ m2;and 5-fluorouracil, 2400 mg/m2, repeated every 2 weeks). The treatment was continued for 12 cycles unless the patient had progressive disease (PD), stable disease (SD) with symptom deterioration, unacceptable adverse events, or requested to terminate the treatment prematurely. The primary endpoint was objective response rate (ORR). Results: Sixty-five patients were enrolled from July 2012 to April 2017 in three institutions, and they all received at least one cycle of chemotherapy, with a median of 8 cycles (range 1-12 cycles). No complete response was observed. Twenty-one (32.3%) patients had partial responses, and 27 (41.5%) had SD. The ORR and disease control rate of the study cohort was 32.3% and 73.8%. The estimated median overall survival and progression-free survival were 11.60 (95% confidence interval [CI] 8.76-14.44) and 5.77 (95% CI 5.00-6.54) months. Major grade 3 or 4 adverse events included neutropenia (12.3%) and diarrhea (6.2%). No treatment-related death was observed. Conclusions: Modified FOLFIRINOX was well-tolerated and might be a promising option as first-line therapy for Chinese patients with metastatic PC.
