High-dose versus low-dose iron sucrose in individuals undergoing maintenance haemodialysis: a retrospective study.

BACKGROUND: Intravenous iron sucrose is becoming a prevailing treatment for individuals undergoing maintenance haemodialysis, but comparisons of dosing regimens are lacking. The aim of this retrospective review was to evaluate the safety and efficacy of proactively administered high-dose iron sucrose versus reactively administered low-dose iron sucrose in patients undergoing maintenance haemodialysis. METHODS: We analysed the data of 1500 individuals with maintenance haemodialysis who were treated with either high-dose iron sucrose that was proactively administered (Group HD) or low-dose iron sucrose that was reactively administered (Group LD) at the First Affiliated Hospital of Chongqing Medical University from Jan 1, 2008, to Dec 31, 2020. The primary endpoints were the cumulative doses of iron and erythropoiesis-stimulating agent; the secondary endpoints were the events of nonfatal myocardial infarction, nonfatal stroke, hospitalization for heart failure, infection rate, and death from any cause. RESULTS: Of the 2124 individuals, 624 individuals were excluded because they met one or more of the exclusion criteria, thus resulting in 1500 individuals who were eligible for inclusion in the study (Group HD, n = 760 and Group LD, n = 740). The median follow-up for the two cohorts was 32 months (range: 25-36). A significant median difference was detected in the monthly iron dose between the groups (1121 mg [range: 800-1274] in the HD group vs. 366 mg [range: 310-690] in the LD group; p < 0.05). The median dose of an erythropoiesis-stimulating agent was 26,323 IU/month (range: 17,596-44,712) in the HD group and 37,934 IU/month (range: 22,402-59,380) in the LD group (median difference: - 7901 IU/month; 95% CI: - 9632--5013; p = 0.000). A significant difference was detected in the secondary endpoints (266 events in 320 cases in the HD group vs. 344 events in 385 cases in the LD group) (HR: 0.62; 95% CI: 0.51-0.79; p < 0.001). A significant difference was not observed in death from any cause (HR: 0.57; 95% CI: 0.48-1.00; p = 0.361). CONCLUSIONS: For individuals undergoing maintenance haemodialysis, high-dose iron sucrose that was proactively administered may be superior to low-dose iron sucrose that was reactively administered with low doses of erythropoiesis-stimulating agent.

Locust bean gum/gellan gum double-network hydrogels with superior self-healing and pH-driven shape-memory properties.

In this work, we prepared locust bean gum (LBG)/gellan gum (Gg) double network (DN) hydrogels based on pH-sensitive borate-ester bonds in the LBG network and hydrogen-bond-associated double-helix bundles in the Gg network by using two novel natural polysaccharide polymers. The DN hydrogels with optimized Gg and borax concentrations exhibit good mechanical properties (the fracture tensile stress is almost three times that of the LBG single network hydrogel). Because of their unique thermo- and pH-sensitive DN structure, the LBG/Gg DN hydrogels also show excellent self-healing, thermo-processability, and pH-driven shape memory properties. Such novel DN hydrogels demonstrate strong potentiality in many challenging applications such as biomedicine, soft robotics and other fields.

Carboplatin and nab-paclitaxel chemotherapy with or without atezolizumab as front-line management for treatment-naïve metastatic nonsquamous non-small cell lung cancer with PD-L1 staining: a retrospective study.

PURPOSE: The aim of this retrospective review was to compare the efficacy and safety of the atezolizumab plus carboplatin and nab-paclitaxel regimen versus the carboplatin and nab-paclitaxel regimen as front-line management for treatment-naïve, metastatic nonsquamous programmed death-ligand 1 (PD-L1)-positive non-small cell lung cancer (NSCLC) in a selected population. METHODS: Consecutive patients with untreated, metastatic nonsquamous PD-L1-positive NSCLC who initially received the atezolizumab plus carboplatin and nab-paclitaxel (ACN) regimen or carboplatin and nab-paclitaxel (CN) regimen were retrospectively identified in two medical institutions from 2017 to 2020. The co-primary end points were overall survival (OS) and progression-free survival (PFS); secondary end point was the rate of key adverse events (AEs). RESULTS: In sum, 171 patients were retrospectively analysed, 47 of whom were excluded according to the criteria used in this study, leaving 124 patients (ACN: n = 60, median age 64 years [range 46-75]; CN: n = 64, 63 years [47-72]). The median duration of follow-up was 27 months [range 1-37]. At the final follow-up, the median OS was 19.9 months (95% confidence interval [CI], 16.3-22.5) in the ACN group vs. 14.8 months (95% CI 12.5-17.2) in the CN group (hazard ratio [HR] 0.51, 95% CI 0.33-0.77; p = 0.001). A marked distinction in the median PFS was seen (8.5 months [95% CI 6.7-9.4] in the ACN group vs. in the CN group [5.1 months [95% CI 3.6-6.8; HR 0.60; 95% CI 0.38-0.95; p = 0.005]). The rates of the key AEs (neutropenia and anaemia) were greater in the ACN group than in the CN group (all p < 0.05), but these AEs were manageable. CONCLUSION: Among selected populations of individuals with treatment-naïve, metastatic nonsquamous PD-L1-positive NSCLC, atezolizumab combined with carboplatin and nab-paclitaxel chemotherapy might have encouraging anticancer activity, with a tolerable safety profile.

Association of serum cholesterol with Parkinson's disease in a cohort of statin-free individuals.

INTRODUCTION: The role of serum cholesterol in the pathogenesis of Parkinson's disease (PD) remains unclear. The objective of this study was to assess the association between serum cholesterol and PD in a cohort of statin-free newly diagnosed PD patients. METHODS: This retrospective study used fasting lipid profiles obtained from 672 consecutive statin-free newly diagnosed PD individuals and 540 controls. These PD individuals were identified from three medical institutions during 2017-2021, and the controls were identified from three physical examination centers during the same time period. Logistic regressions were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs), with adjustment of age, sex, and tobacco use history. RESULTS: Among 672 PD individuals, 112 were excluded in accordance with the current criteria, leaving 560 PD patients. The multivariate binary logistic regression analysis showed that LDL-C was the only variable contributing to the occurrence of PD (OR 1.39, 95% CI: 1.07-2.31, p < .001) after adjusting for age, sex, and tobacco use history; this association persisted following further adjustment for TC and HDL-C. In the subgroup analysis of the adjusted results of LDL-C after correcting for TC and HDL-C, lower LDL-C was associated with a higher risk of PD. CONCLUSION: Among selected populations of statin-free newly diagnosed PD individuals, low LDL-C might be associated with the occurrence of PD.