●AIM:To evaluate the efficacy and safety of combined intraarterial chemotherapy(IAC)and intravitreal melphalan(IVM)for the treatment of advanced unilateral retinoblastoma.●METHODS:This retrospective study involved 3...●AIM:To evaluate the efficacy and safety of combined intraarterial chemotherapy(IAC)and intravitreal melphalan(IVM)for the treatment of advanced unilateral retinoblastoma.●METHODS:This retrospective study involved 30 consecutive eyes from 30 Chinese patients with advanced unilateral retinoblastoma.All patients were initially treated with IAC combined with IVM.The clinical status and complications were recorded at each visit.●RESULTS:The International Intraocular Retinoblastoma Classification groups were D in 23 eyes and E in 7 eyes.All eyes showed severe cloud vitreous seeds at the first visit.The mean number of IAC cycles and intravitreal injections was 3.2(range,3-4)and 6(range,1-14),respectively.The median follow-up time was 29 mo(range,7-36 mo).Treatment success with regression of the retinal tumor and vitreous seeds was achieved in 29 of 30 eyes(96.7%).Globe salvage was attained in 93.3%(28/30)eyes,and enucleation(n=2)was per formed due to neovascular glaucoma and persistent vitreous hemorrhage.Complications included retinal pigment epithelium(RPE)atrophy(n=13;43%),mild lens opacity(n=7;23%),vitreous hemorrhage(n=5;17%)and rhegmatogenous retinal detachment(n=1;3%).No extraocular tumor extension or metastasis occurred.●CONCLUSION:Combined IAC and IVM is effective and safe for the treatment of advanced unilateral retinoblastoma.展开更多
AIM:To investigate the impact of lag time to metastasis and survival rates among patients with retinoblastoma.METHODS:This retrospective study was conducted with 52 patients from the Department of Ophthalmology and th...AIM:To investigate the impact of lag time to metastasis and survival rates among patients with retinoblastoma.METHODS:This retrospective study was conducted with 52 patients from the Department of Ophthalmology and the Department of Pediatrics of Dr.Sardjito General Hospital,between 1^(st) January 2014 and 31^(st) December 2020.Lag time was defined as the time delay between the first sign of retinoblastoma to the diagnosis of retinoblastoma.The subjects with lag time>one year were included in the case group,while the subjects with lag time<one year were included in the control group.RESULTS:The lag time was significantly correlated with American Joint Committee on Cancer and Intraocular Classification of Retinoblastoma staging of retinoblastoma(P=0.005 and P=0.006,respectively).The lag time was also significantly correlated with both metastasis event[odds ratio(OR):5.06,95%Cl:1.56-16.44,P=0.006]and mortality(OR:4.54,95%Cl:1.37-15.07,P=0.011).The follow-up was continued for 32 subjects for 3y after initial diagnoses.Survival analysis revealed a significant difference among these two groups(P=0.021).Furthermore,lag time was significantly correlated with survival of retinoblastoma(r=-0.53,P=0.046).CONCLUSION:The study highlights the importance of lag time between the onset of first symptoms and the time of retinoblastoma diagnosis which significantly contribute to metastasis and mortality of patients with retinoblastoma.Examinations for the early detection of retinoblastoma should be performed for individuals at-risk to minimize lag time and improve the outcomes.展开更多
Esterase D (EsD) was evaluated in 20 patients with retinoblastoma (RB). The EsD activity of the hemolysates of three unilateral cases was normal and the EsD phenotypes of their tumor cells were zero. In another three ...Esterase D (EsD) was evaluated in 20 patients with retinoblastoma (RB). The EsD activity of the hemolysates of three unilateral cases was normal and the EsD phenotypes of their tumor cells were zero. In another three cases, including one patient with bilateral RB, the EsD was heterozygous, but the tumor cells expressed enzyme from only one of the two EsD alleles. These results provided fresh evidence for Comings' theory of tumorigenesis in which the production of sporadic nonhereditary RB has been explained.展开更多
Background Previous studies had demonstrated hemostatic abnormalities in patients with heart failure (HF) and several studies have shown that abnormal coagulation indices, represented by elevated D-dimer, had prognost...Background Previous studies had demonstrated hemostatic abnormalities in patients with heart failure (HF) and several studies have shown that abnormal coagulation indices, represented by elevated D-dimer, had prognostic significance in patients with compatible or acute decompensated HF. However, the impact of D-dimer on the outcome in patients with end-stage HF remains unclear. Methods A total of 244 consecutive patients with end-stage HF due to idiopathic dilated cardiomyopathy (DCM) were prospectively enrolled from February 2011 to September 2014. D-dimer levels were measured and its prognostic value was assessed. Primary endpoint was all-cause mortality during the follow-up period. Secondary endpoints were stroke, bleeding, occurrence of sustained ventricular tachycardia or ventricular fibrillation, and major adverse cardiovascular events (MACE). Results D-dimer was significantly elevated in the non-survivors (median: 0.8 vs. 1.1 mg/L, P < 0.001). Traditional markers including B-type natriuretic peptide, troponin I, left ventricular ejection fraction, and left ventricular end-diastolic dimension provided limited prognostic value;but the addition of D-dimer refined the risk stratification. The optimal cut-off value of D-dimer to predict all-cause mortality was 0.84 mg/L by receiver operator characteristic analysis. Elevated D-dimer level was independently associated with increased risk of long-term all-cause mortality (HR = 2.315, 95% CI: 1.570–3.414, P < 0.001) and MACE (HR = 1.256, 95% CI: 1.058–1.490, P = 0.009), and the predictive value was independent of age, sex, atrial fibrillation and anticoagulation status. Conclusions Elevated D-dimer level was independently associated with poor long-term outcome in patients with end-stage HF secondary to idiopathic DCM, and the predictive value was superior to that of traditional prognostic markers.展开更多
Thomas Hardy's Tess of the D'Urbervilles tells a tragedy of an innocent girl called Tess, whose fate is dominated by the male power. Angel Clare, as one of the main male characters, has always been neglected. ...Thomas Hardy's Tess of the D'Urbervilles tells a tragedy of an innocent girl called Tess, whose fate is dominated by the male power. Angel Clare, as one of the main male characters, has always been neglected. Exploring Angel's mental process and choices from the perspective of Lacan's mirror stage theory will provide a new interpretation of this novel, and a deeper understanding of the aesthetic value and the purpose of the characterization might be formed, and Hardy's concerns for the gender issues in the Victorian age have also been well presented through the time-transcending character.展开更多
Introduction: Developing countries are characterized by a high maternal mortality rate, particulary related to the management of childbirth. The author describes in this work 588 childbirth labors that took place with...Introduction: Developing countries are characterized by a high maternal mortality rate, particulary related to the management of childbirth. The author describes in this work 588 childbirth labors that took place without any medical supervision. Method: All patients who reached the hospital with a full cervix dilation were included in the study. The outcomes of those childbirth labors without medical supervision were evaluated at the maternal and neonatal level. Results and Discussion: The average age of the patients was 28.1 ± 13 years with 47% nulliparous and 30% pauciparous. These patients represented 14% of all births;59% of the patients had had three and five prenatal consultations. 71% of them came straight from home and had meconium-stained amniotic fluid. The APGAR score was greater than 6 in 94% of newborns, and 66.7 of them weighed between 2500 and 3500 g. Only 0.9% of patients coming from home needed a caesarean section. Conclusion: Home birth is not yet possible in Africa because it is not supervised by professionals who know the risks of childbirth, its complications and recognize the warning signs;however, the results of this preliminary study show that the issue of home childbirth in Côte d’Ivoire can be reconsidered subject to greater involvement of medical staffs.展开更多
目的观察原发性肝癌(primary hepatocellular carcinoma,PHC)与血清25(OH)维生素D水平的相关性。方法抽取2018年8月—2020年8月莆田市第一医院PHC患者50例作为观察组,抽取同时期健康体检者50例作为对照组。检测两组血清25(OH)D3水平以...目的观察原发性肝癌(primary hepatocellular carcinoma,PHC)与血清25(OH)维生素D水平的相关性。方法抽取2018年8月—2020年8月莆田市第一医院PHC患者50例作为观察组,抽取同时期健康体检者50例作为对照组。检测两组血清25(OH)D3水平以及甲胎蛋白(alpha fetoprotein,AFP)水平。结果观察组血清25(OH)D3水平低于对照组,差异有统计学意义(P<0.05)。观察组AFP水平高于对照组,差异有统计学意义(P<0.05)。PHC血清患者25(OH)D3水平与中国肝癌分期(China live cancer staging,CNLC)、淋巴结转移有关,差异有统计学意义(P<0.05)。结论针对PHC患者,其血清25(OH)D3水平主要相关因素为CNLC分期、淋巴结转移,根据血清25(OH)D3水平可为疾病治疗及其预后评估提供依据。展开更多
基金Supported by Shanghai Science and Technology Committee(No.17411952900)Shanghai Shen Kang Hospital Development Center(No.16CR4017A).
文摘●AIM:To evaluate the efficacy and safety of combined intraarterial chemotherapy(IAC)and intravitreal melphalan(IVM)for the treatment of advanced unilateral retinoblastoma.●METHODS:This retrospective study involved 30 consecutive eyes from 30 Chinese patients with advanced unilateral retinoblastoma.All patients were initially treated with IAC combined with IVM.The clinical status and complications were recorded at each visit.●RESULTS:The International Intraocular Retinoblastoma Classification groups were D in 23 eyes and E in 7 eyes.All eyes showed severe cloud vitreous seeds at the first visit.The mean number of IAC cycles and intravitreal injections was 3.2(range,3-4)and 6(range,1-14),respectively.The median follow-up time was 29 mo(range,7-36 mo).Treatment success with regression of the retinal tumor and vitreous seeds was achieved in 29 of 30 eyes(96.7%).Globe salvage was attained in 93.3%(28/30)eyes,and enucleation(n=2)was per formed due to neovascular glaucoma and persistent vitreous hemorrhage.Complications included retinal pigment epithelium(RPE)atrophy(n=13;43%),mild lens opacity(n=7;23%),vitreous hemorrhage(n=5;17%)and rhegmatogenous retinal detachment(n=1;3%).No extraocular tumor extension or metastasis occurred.●CONCLUSION:Combined IAC and IVM is effective and safe for the treatment of advanced unilateral retinoblastoma.
基金Supported in part by funding from the the Teuku Jacobs Foundation Research Fellowship Program(No.#312)。
文摘AIM:To investigate the impact of lag time to metastasis and survival rates among patients with retinoblastoma.METHODS:This retrospective study was conducted with 52 patients from the Department of Ophthalmology and the Department of Pediatrics of Dr.Sardjito General Hospital,between 1^(st) January 2014 and 31^(st) December 2020.Lag time was defined as the time delay between the first sign of retinoblastoma to the diagnosis of retinoblastoma.The subjects with lag time>one year were included in the case group,while the subjects with lag time<one year were included in the control group.RESULTS:The lag time was significantly correlated with American Joint Committee on Cancer and Intraocular Classification of Retinoblastoma staging of retinoblastoma(P=0.005 and P=0.006,respectively).The lag time was also significantly correlated with both metastasis event[odds ratio(OR):5.06,95%Cl:1.56-16.44,P=0.006]and mortality(OR:4.54,95%Cl:1.37-15.07,P=0.011).The follow-up was continued for 32 subjects for 3y after initial diagnoses.Survival analysis revealed a significant difference among these two groups(P=0.021).Furthermore,lag time was significantly correlated with survival of retinoblastoma(r=-0.53,P=0.046).CONCLUSION:The study highlights the importance of lag time between the onset of first symptoms and the time of retinoblastoma diagnosis which significantly contribute to metastasis and mortality of patients with retinoblastoma.Examinations for the early detection of retinoblastoma should be performed for individuals at-risk to minimize lag time and improve the outcomes.
文摘Esterase D (EsD) was evaluated in 20 patients with retinoblastoma (RB). The EsD activity of the hemolysates of three unilateral cases was normal and the EsD phenotypes of their tumor cells were zero. In another three cases, including one patient with bilateral RB, the EsD was heterozygous, but the tumor cells expressed enzyme from only one of the two EsD alleles. These results provided fresh evidence for Comings' theory of tumorigenesis in which the production of sporadic nonhereditary RB has been explained.
文摘Background Previous studies had demonstrated hemostatic abnormalities in patients with heart failure (HF) and several studies have shown that abnormal coagulation indices, represented by elevated D-dimer, had prognostic significance in patients with compatible or acute decompensated HF. However, the impact of D-dimer on the outcome in patients with end-stage HF remains unclear. Methods A total of 244 consecutive patients with end-stage HF due to idiopathic dilated cardiomyopathy (DCM) were prospectively enrolled from February 2011 to September 2014. D-dimer levels were measured and its prognostic value was assessed. Primary endpoint was all-cause mortality during the follow-up period. Secondary endpoints were stroke, bleeding, occurrence of sustained ventricular tachycardia or ventricular fibrillation, and major adverse cardiovascular events (MACE). Results D-dimer was significantly elevated in the non-survivors (median: 0.8 vs. 1.1 mg/L, P < 0.001). Traditional markers including B-type natriuretic peptide, troponin I, left ventricular ejection fraction, and left ventricular end-diastolic dimension provided limited prognostic value;but the addition of D-dimer refined the risk stratification. The optimal cut-off value of D-dimer to predict all-cause mortality was 0.84 mg/L by receiver operator characteristic analysis. Elevated D-dimer level was independently associated with increased risk of long-term all-cause mortality (HR = 2.315, 95% CI: 1.570–3.414, P < 0.001) and MACE (HR = 1.256, 95% CI: 1.058–1.490, P = 0.009), and the predictive value was independent of age, sex, atrial fibrillation and anticoagulation status. Conclusions Elevated D-dimer level was independently associated with poor long-term outcome in patients with end-stage HF secondary to idiopathic DCM, and the predictive value was superior to that of traditional prognostic markers.
文摘Thomas Hardy's Tess of the D'Urbervilles tells a tragedy of an innocent girl called Tess, whose fate is dominated by the male power. Angel Clare, as one of the main male characters, has always been neglected. Exploring Angel's mental process and choices from the perspective of Lacan's mirror stage theory will provide a new interpretation of this novel, and a deeper understanding of the aesthetic value and the purpose of the characterization might be formed, and Hardy's concerns for the gender issues in the Victorian age have also been well presented through the time-transcending character.
文摘Introduction: Developing countries are characterized by a high maternal mortality rate, particulary related to the management of childbirth. The author describes in this work 588 childbirth labors that took place without any medical supervision. Method: All patients who reached the hospital with a full cervix dilation were included in the study. The outcomes of those childbirth labors without medical supervision were evaluated at the maternal and neonatal level. Results and Discussion: The average age of the patients was 28.1 ± 13 years with 47% nulliparous and 30% pauciparous. These patients represented 14% of all births;59% of the patients had had three and five prenatal consultations. 71% of them came straight from home and had meconium-stained amniotic fluid. The APGAR score was greater than 6 in 94% of newborns, and 66.7 of them weighed between 2500 and 3500 g. Only 0.9% of patients coming from home needed a caesarean section. Conclusion: Home birth is not yet possible in Africa because it is not supervised by professionals who know the risks of childbirth, its complications and recognize the warning signs;however, the results of this preliminary study show that the issue of home childbirth in Côte d’Ivoire can be reconsidered subject to greater involvement of medical staffs.
文摘目的观察原发性肝癌(primary hepatocellular carcinoma,PHC)与血清25(OH)维生素D水平的相关性。方法抽取2018年8月—2020年8月莆田市第一医院PHC患者50例作为观察组,抽取同时期健康体检者50例作为对照组。检测两组血清25(OH)D3水平以及甲胎蛋白(alpha fetoprotein,AFP)水平。结果观察组血清25(OH)D3水平低于对照组,差异有统计学意义(P<0.05)。观察组AFP水平高于对照组,差异有统计学意义(P<0.05)。PHC血清患者25(OH)D3水平与中国肝癌分期(China live cancer staging,CNLC)、淋巴结转移有关,差异有统计学意义(P<0.05)。结论针对PHC患者,其血清25(OH)D3水平主要相关因素为CNLC分期、淋巴结转移,根据血清25(OH)D3水平可为疾病治疗及其预后评估提供依据。
