Hepatocellular carcinoma (HCC) is a leading cause of cancer-related death worldwide.The recurrence of HCC after curative treatments is currently a major hurdle.Identification of subsets of patients with distinct progn...Hepatocellular carcinoma (HCC) is a leading cause of cancer-related death worldwide.The recurrence of HCC after curative treatments is currently a major hurdle.Identification of subsets of patients with distinct prognosis provides an opportunity to tailor therapeutic approaches as well as to select the patients with specific sub-phenotypes for targeted therapy.Thus,the development of gene expression profiles to improve the prediction of HCC prognosis is important for HCC management.Although several gene signatures have been evaluated for the prediction of HCC prognosis,there is no consensus on the predictive power of these signatures.Using systematic approaches to evaluate these signatures and combine them with clinicopathologic information may provide more accurate prediction of HCC prognosis.Recently,Villanueva et al developed a composite prognostic model incorporating gene expression patterns in both tumor and adjacent tissues to predict HCC recurrence.In this commentary,we summarize the current progress in using gene signatures to predict HCC prognosis,and discuss the importance,existing issues and future research directions in this field.展开更多
Background Primary percutaneous intervention （PPCI） is the treatment of choice for ST elevation myocardial infarction （STEMI） but robust evidence in the very elderly is lacking. We compared PPCI outcomes between d...Background Primary percutaneous intervention （PPCI） is the treatment of choice for ST elevation myocardial infarction （STEMI） but robust evidence in the very elderly is lacking. We compared PPCI outcomes between different age quartiles （quartile I 〈 60 years, quartile 2 〉 60 to 〈 70 years, quartile 3 〉 70 to 〈 80 years, quartile 4 〉 80 years）. Methods Retrospective observational analysis of our Morriston Tertiary Cardiac Center （Abertawe Bro Morgannwg University Health Board） patients from 2005 to 2010 with STEMI who underwent PPCI. Resnlts Of 434 patients, 57 （13%） were in quartile 4 （〉 80 years）. In older age quartiles, patients were less likely to receive a drug eluting stent （DES, P = 0.001） or glycoprotein IlbAIIa inhibitor （GPI, P 〈 0.0001）. Increase in age was associated with reduced time to survival （13-coefficient： -0.192, t： -3,70, 95%CI： --4.91 to -1.50, P 〈 0.0001） as was the presence of cardiogenic shock 03-coefficient： -0.194, t = 3.77, 95%CI： -5.26 to -1.65, P 〈 0.0001）. Use of GPI was associated with increased time to survival （p-coefficient： 0.138, t = 2.82, 95%CI： 1.58-8.58, P = 0.005） but older age quartiles were less likely to receive GPI （P 〈 0.0001）. In-hospital mortality （1.8% quartile 1, 3.6% quartile 2, 10.9% quartile 3 and 12.3% quartile 4, P = 0.002） and 1-year mortality （5.4% quartile 1, 5.5% quartile 2, 16.8% quartile 3 and 24.6% quartile 4, P 〈 0.0001, respectively） was significantly higher in older age quartiles. Conclusions Increased short term and intermediate term mortality is seen in the very elderly after PPCI. Age and cardiogenic shock were prognostic factors. Intervention should not be based on age alone and awareness regarding prognostic factors can help improve management.展开更多
Objective To evaluate the predictive factors of refractory glaucoma treated with diode laser transscleral cyclophotocoagulation(TSCP) in a midterm observation.Methods Fifty-four consecutive patients(54 eyes) with refr...Objective To evaluate the predictive factors of refractory glaucoma treated with diode laser transscleral cyclophotocoagulation(TSCP) in a midterm observation.Methods Fifty-four consecutive patients(54 eyes) with refractory glaucoma were enrolled and underwent TSCP(power of 1.5-2.0 W,exposure time of 2 seconds and 20-50 applications).Patients were regularly followed up for 12 months.Intraocular pressure(IOP) was measured before TSCP treatment and at each follow-up visit.Patients were divided into the sensitive and insensitive groups according to the effect of a single treatment of TSCP on IOP.The success rate was defined as the percentage of eyes achieving an IOP between 5 and 21 mm Hg following TSCP therapy at their final follow up visit.Difference of age between the sensitive and insensitive groups was evaluated with Independent-samples T test and that of gender distribution of two groups was evaluated with Fisher's exact test.The success rate of different types of glaucoma to TSCP was calculated.Results A total of 32 patients were sensitive to TSCP(sensitive group) and 22 patients were insensitive to TSCP(insensitive group).The success rates of female(77.8%,14/18) and cases being over 50 years(71.4%,20/28) were higher than those of male(50.0%,18/36) and ones being under 50 years(46.2%,12/26)(all P>0.05).The age of the sensitive and insensitive groups was 56.0±15.5 and 46.4±15.4 years,respectively(P=0.029).The age(P=0.029) and gender distribution(P=0.046) of the two groups had significant difference.The success rate of neovascular glaucoma,primary angle-closure glaucoma,primary open angle glaucoma,traumatic glaucoma,uveitic glaucoma,and secondary glaucoma after silicone oil injection to TSCP was 57.1%,100.0%,50.0%,20.0%,81.8%,and 0%,respectively.Conclusion Age,gender,and type of glaucoma appear to be associated with effect of TSCP on IOP control.展开更多
基金Supported by The National Outstanding Youth Fund,No.81025015Key Project Fund,No.91129301Creative Research Group Fund of the National Natural Science Foundation of China,No.30921006
文摘Hepatocellular carcinoma (HCC) is a leading cause of cancer-related death worldwide.The recurrence of HCC after curative treatments is currently a major hurdle.Identification of subsets of patients with distinct prognosis provides an opportunity to tailor therapeutic approaches as well as to select the patients with specific sub-phenotypes for targeted therapy.Thus,the development of gene expression profiles to improve the prediction of HCC prognosis is important for HCC management.Although several gene signatures have been evaluated for the prediction of HCC prognosis,there is no consensus on the predictive power of these signatures.Using systematic approaches to evaluate these signatures and combine them with clinicopathologic information may provide more accurate prediction of HCC prognosis.Recently,Villanueva et al developed a composite prognostic model incorporating gene expression patterns in both tumor and adjacent tissues to predict HCC recurrence.In this commentary,we summarize the current progress in using gene signatures to predict HCC prognosis,and discuss the importance,existing issues and future research directions in this field.
文摘Background Primary percutaneous intervention （PPCI） is the treatment of choice for ST elevation myocardial infarction （STEMI） but robust evidence in the very elderly is lacking. We compared PPCI outcomes between different age quartiles （quartile I 〈 60 years, quartile 2 〉 60 to 〈 70 years, quartile 3 〉 70 to 〈 80 years, quartile 4 〉 80 years）. Methods Retrospective observational analysis of our Morriston Tertiary Cardiac Center （Abertawe Bro Morgannwg University Health Board） patients from 2005 to 2010 with STEMI who underwent PPCI. Resnlts Of 434 patients, 57 （13%） were in quartile 4 （〉 80 years）. In older age quartiles, patients were less likely to receive a drug eluting stent （DES, P = 0.001） or glycoprotein IlbAIIa inhibitor （GPI, P 〈 0.0001）. Increase in age was associated with reduced time to survival （13-coefficient： -0.192, t： -3,70, 95%CI： --4.91 to -1.50, P 〈 0.0001） as was the presence of cardiogenic shock 03-coefficient： -0.194, t = 3.77, 95%CI： -5.26 to -1.65, P 〈 0.0001）. Use of GPI was associated with increased time to survival （p-coefficient： 0.138, t = 2.82, 95%CI： 1.58-8.58, P = 0.005） but older age quartiles were less likely to receive GPI （P 〈 0.0001）. In-hospital mortality （1.8% quartile 1, 3.6% quartile 2, 10.9% quartile 3 and 12.3% quartile 4, P = 0.002） and 1-year mortality （5.4% quartile 1, 5.5% quartile 2, 16.8% quartile 3 and 24.6% quartile 4, P 〈 0.0001, respectively） was significantly higher in older age quartiles. Conclusions Increased short term and intermediate term mortality is seen in the very elderly after PPCI. Age and cardiogenic shock were prognostic factors. Intervention should not be based on age alone and awareness regarding prognostic factors can help improve management.
文摘Objective To evaluate the predictive factors of refractory glaucoma treated with diode laser transscleral cyclophotocoagulation(TSCP) in a midterm observation.Methods Fifty-four consecutive patients(54 eyes) with refractory glaucoma were enrolled and underwent TSCP(power of 1.5-2.0 W,exposure time of 2 seconds and 20-50 applications).Patients were regularly followed up for 12 months.Intraocular pressure(IOP) was measured before TSCP treatment and at each follow-up visit.Patients were divided into the sensitive and insensitive groups according to the effect of a single treatment of TSCP on IOP.The success rate was defined as the percentage of eyes achieving an IOP between 5 and 21 mm Hg following TSCP therapy at their final follow up visit.Difference of age between the sensitive and insensitive groups was evaluated with Independent-samples T test and that of gender distribution of two groups was evaluated with Fisher's exact test.The success rate of different types of glaucoma to TSCP was calculated.Results A total of 32 patients were sensitive to TSCP(sensitive group) and 22 patients were insensitive to TSCP(insensitive group).The success rates of female(77.8%,14/18) and cases being over 50 years(71.4%,20/28) were higher than those of male(50.0%,18/36) and ones being under 50 years(46.2%,12/26)(all P>0.05).The age of the sensitive and insensitive groups was 56.0±15.5 and 46.4±15.4 years,respectively(P=0.029).The age(P=0.029) and gender distribution(P=0.046) of the two groups had significant difference.The success rate of neovascular glaucoma,primary angle-closure glaucoma,primary open angle glaucoma,traumatic glaucoma,uveitic glaucoma,and secondary glaucoma after silicone oil injection to TSCP was 57.1%,100.0%,50.0%,20.0%,81.8%,and 0%,respectively.Conclusion Age,gender,and type of glaucoma appear to be associated with effect of TSCP on IOP control.
