Hepatocellular carcinoma(HCC) is the fifth most common form of human cancer worldwide and the third most common cause of cancer-related deaths. The strategies of various treatments for HCC depend on the stage of tumor...Hepatocellular carcinoma(HCC) is the fifth most common form of human cancer worldwide and the third most common cause of cancer-related deaths. The strategies of various treatments for HCC depend on the stage of tumor,the status of patient's performance and the reserved hepatic function. The Barcelona Clinic Liver Cancer(BCLC) staging system is currently used most for patients with HCC. For example,for patients with BCLC stage 0(very early stage) and stage A(early stage) HCC,the curable treatment modalities,including resection,transplantation and radiofrequency ablation,are taken into consideration. If the patients are in BCLC stage B(intermediate stage) and stage C(advanced stage) HCC,they may need the palliative transarterial chemoembolization and even the target medication of sorafenib. In addition,symptomatic treatment is always recommended for patients with BCLC stage D(end stage) HCC. In this review,we will attempt to summarize the historical perspective and the current developments of systemic therapies in BCLC stage B and C in HCC.展开更多
Background： Antihypertensive drugs have been linked to new-onset osteoporotic fracture （NOF）, and different classes of antihypertensive drugs may alter the risk for the development of NOF; however, the classic effe...Background： Antihypertensive drugs have been linked to new-onset osteoporotic fracture （NOF）, and different classes of antihypertensive drugs may alter the risk for the development of NOF; however, the classic effect of different antihypertensive drugs on the development of NOF in the elderly has not been well studied during long-term follow-up. Methods： In this study, we investigated the association between different classic antihypertensives and the development of NOF in the elderly. This was a longitudinal cohort study performed using data from claim forms submitted to the Taiwan Bureau of National Health Insurance in Central Taiwan, China including case patients with NOF aged 65–80 years from January 2002 to December 2012 and non-NOF controls. Prescriptions for antihypertensives before the index date were retrieved from a prescription database. We estimated the hazard ratios （HR s） of NOF associated with antihypertensive use. Non-NOF controls served as the reference group. Results： A total of 128 patients with NOF were identified from among 1144 patients with hypertension during the study period. The risk of NOF after adjusting age, sex, comorbidities, and concurrent medications was higher among the users of angiotensin-converting enzyme （ACE） inhibitors （HR, 1.64; 95% confidence interval [CI], 1.01–2.66） than among nonusers. Patients who took calcium channel blockers （CCBs） （HR, 0.70; 95% CI, 0.49–0.99） were at a lower risk of developing NOF than nonusers. Loop diuretics, thiazide diuretics, angiotensin receptor blocker, beta-blocker, and alpha-blocker were not associated with the risk of NOF. Conclusions： Elderly with hypertension who take CCBs are at a lower risk of NOF and that the use of ACE inhibitors was associated with a significantly increased risk of developing NOF during the 11-year follow-up.展开更多
文摘Hepatocellular carcinoma(HCC) is the fifth most common form of human cancer worldwide and the third most common cause of cancer-related deaths. The strategies of various treatments for HCC depend on the stage of tumor,the status of patient's performance and the reserved hepatic function. The Barcelona Clinic Liver Cancer(BCLC) staging system is currently used most for patients with HCC. For example,for patients with BCLC stage 0(very early stage) and stage A(early stage) HCC,the curable treatment modalities,including resection,transplantation and radiofrequency ablation,are taken into consideration. If the patients are in BCLC stage B(intermediate stage) and stage C(advanced stage) HCC,they may need the palliative transarterial chemoembolization and even the target medication of sorafenib. In addition,symptomatic treatment is always recommended for patients with BCLC stage D(end stage) HCC. In this review,we will attempt to summarize the historical perspective and the current developments of systemic therapies in BCLC stage B and C in HCC.
文摘Background： Antihypertensive drugs have been linked to new-onset osteoporotic fracture （NOF）, and different classes of antihypertensive drugs may alter the risk for the development of NOF; however, the classic effect of different antihypertensive drugs on the development of NOF in the elderly has not been well studied during long-term follow-up. Methods： In this study, we investigated the association between different classic antihypertensives and the development of NOF in the elderly. This was a longitudinal cohort study performed using data from claim forms submitted to the Taiwan Bureau of National Health Insurance in Central Taiwan, China including case patients with NOF aged 65–80 years from January 2002 to December 2012 and non-NOF controls. Prescriptions for antihypertensives before the index date were retrieved from a prescription database. We estimated the hazard ratios （HR s） of NOF associated with antihypertensive use. Non-NOF controls served as the reference group. Results： A total of 128 patients with NOF were identified from among 1144 patients with hypertension during the study period. The risk of NOF after adjusting age, sex, comorbidities, and concurrent medications was higher among the users of angiotensin-converting enzyme （ACE） inhibitors （HR, 1.64; 95% confidence interval [CI], 1.01–2.66） than among nonusers. Patients who took calcium channel blockers （CCBs） （HR, 0.70; 95% CI, 0.49–0.99） were at a lower risk of developing NOF than nonusers. Loop diuretics, thiazide diuretics, angiotensin receptor blocker, beta-blocker, and alpha-blocker were not associated with the risk of NOF. Conclusions： Elderly with hypertension who take CCBs are at a lower risk of NOF and that the use of ACE inhibitors was associated with a significantly increased risk of developing NOF during the 11-year follow-up.
