In recent years, tumor-nfiltrating lymphocytes (TILs) have been reported to be effective for tumors in experimental and clinical research. In order to increase the therapeutical effect, we modified some steps of Rosen...In recent years, tumor-nfiltrating lymphocytes (TILs) have been reported to be effective for tumors in experimental and clinical research. In order to increase the therapeutical effect, we modified some steps of Rosenberg's approach a. cold digestion with collagenase at 4C for 24 hours; b. sedimentation instead of centrifugation; c. elimination of tumor cells before the cultivation procedure. Compared with the original approach, the proliferation, activity and cytotoxicity of TILs obtained by the modified procedure were much improved. TILs' expansion-old was greater than that with the original approach. Cytotoxicity against rumor cells was more potent. Increased TILs' subsets were CD3 and CD8 cells. Meanwhile, we took tumor cells from tumor tissues to test their in vitro chemosensitivities to different drugs in order to select highly sensitive antitumor drugs for treatment of cases with advanced tumors. According to the design of using highly active TILs and highly sensitive drugs (H & H therapy), preliminary clinical results of 50 cases showed higher response rates than those in treatment with TIL / IL2, LAK / 1L2 and TIL+IL2+CTX. Less toxic side effects were observed in 14 patients.展开更多
This article explains how two AI systems have been incorporated into the everyday operations of two Singapore public healthcare nation‐wide screening programs.The first example is embedded within the setting of a nat...This article explains how two AI systems have been incorporated into the everyday operations of two Singapore public healthcare nation‐wide screening programs.The first example is embedded within the setting of a national level population health screening program for diabetes related eye diseases,targeting the rapidly increasing number of adults in the country with diabetes.In the second example,the AI assisted screening is done shortly after a person is admitted to one of the public hospitals to identify which inpatients—especially which elderly patients with complex conditions—have a high risk of being readmitted as an inpatient multiple times in the months following discharge.Ways in which healthcare needs and the clinical operations context influenced the approach to designing or deploying the AI systems are highlighted,illustrating the multiplicity of factors that shape the requirements for successful large‐scale deployments of AI systems that are deeply embedded within clinical workflows.In the first example,the choice was made to use the system in a semi‐automated(vs.fully automated)mode as this was assessed to be more cost‐effective,though still offering substantial productivity improvement.In the second example,machine learning algorithm design and model execution trade-offs were made that prioritized key aspects of patient engagement and inclusion over higher levels of predictive accuracy.The article concludes with several lessons learned related to deploying AI systems within healthcare settings,and also lists several other AI efforts already in deployment and in the pipeline for Singapore's public healthcare system.展开更多
文摘In recent years, tumor-nfiltrating lymphocytes (TILs) have been reported to be effective for tumors in experimental and clinical research. In order to increase the therapeutical effect, we modified some steps of Rosenberg's approach a. cold digestion with collagenase at 4C for 24 hours; b. sedimentation instead of centrifugation; c. elimination of tumor cells before the cultivation procedure. Compared with the original approach, the proliferation, activity and cytotoxicity of TILs obtained by the modified procedure were much improved. TILs' expansion-old was greater than that with the original approach. Cytotoxicity against rumor cells was more potent. Increased TILs' subsets were CD3 and CD8 cells. Meanwhile, we took tumor cells from tumor tissues to test their in vitro chemosensitivities to different drugs in order to select highly sensitive antitumor drugs for treatment of cases with advanced tumors. According to the design of using highly active TILs and highly sensitive drugs (H & H therapy), preliminary clinical results of 50 cases showed higher response rates than those in treatment with TIL / IL2, LAK / 1L2 and TIL+IL2+CTX. Less toxic side effects were observed in 14 patients.
文摘This article explains how two AI systems have been incorporated into the everyday operations of two Singapore public healthcare nation‐wide screening programs.The first example is embedded within the setting of a national level population health screening program for diabetes related eye diseases,targeting the rapidly increasing number of adults in the country with diabetes.In the second example,the AI assisted screening is done shortly after a person is admitted to one of the public hospitals to identify which inpatients—especially which elderly patients with complex conditions—have a high risk of being readmitted as an inpatient multiple times in the months following discharge.Ways in which healthcare needs and the clinical operations context influenced the approach to designing or deploying the AI systems are highlighted,illustrating the multiplicity of factors that shape the requirements for successful large‐scale deployments of AI systems that are deeply embedded within clinical workflows.In the first example,the choice was made to use the system in a semi‐automated(vs.fully automated)mode as this was assessed to be more cost‐effective,though still offering substantial productivity improvement.In the second example,machine learning algorithm design and model execution trade-offs were made that prioritized key aspects of patient engagement and inclusion over higher levels of predictive accuracy.The article concludes with several lessons learned related to deploying AI systems within healthcare settings,and also lists several other AI efforts already in deployment and in the pipeline for Singapore's public healthcare system.
