RESUMEN
Objective: To evaluate the efficacy and safety of hepatic arterial infusion chemotherapy (HAIC) combined with lenvatinib and tislelizumab in the treatment of unresectable intrahepatic cholangiocarcinoma (ICC). Methods: The clinical data of 12 patients with unresectable ICC who received HAIC combined with lenvatinib and tislelizumab in the First Affliated Hospital of Soochow University from October 2021 to April 2023 were retrospectively analyzed. HAIC included gemcitabine plus oxaliplatin; this regimen was combined with lenvatinib and tislelizumab within 3-7 days after its initial administration. Relevant laboratory examinations were performed before each cycle of HAIC, and enhanced computed tomography/magnetic resonance imaging examinations were performed every 6-9 weeks. Tumor response to treatment was evaluated using the modified Response Evaluation Criteria in Solid Tumors. The objective response rate, disease control rate, progression-free survival, overall survival, and treatment-related adverse reactions of patients with ICC were statistically analyzed. Results: The objective response rate to HAIC combined with lenvatinib and tislelizumab was 6/12; the disease control rate was 8/12; the median progression-free survival was 11.8 months; and the median overall survival was 14.2 months. Three patients had grade â £ adverse reactions (increased alanine aminotransferase and aspartate aminotransferase thrombocytopenia), while three patients had grade â ¢ adverse reactions (increased total bilirubin, alanine aminotransferase, and aspartate aminotransferase). The remaining patients had grade â -â ¡ adverse reactions. There were no serious complications related to interventional surgery. Conclusions: Use of HAIC (gemcitabine plus oxaliplatin) combined with lenvatinib and tislelizumab in the treatment of unresectable ICC may be safe and feasible. Preliminary clinical studies have shown that this combination can improve the survival and prognosis of patients with ICC.
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Anticuerpos Monoclonales Humanizados , Protocolos de Quimioterapia Combinada Antineoplásica , Neoplasias de los Conductos Biliares , Colangiocarcinoma , Compuestos de Fenilurea , Quinolinas , Humanos , Colangiocarcinoma/tratamiento farmacológico , Quinolinas/administración & dosificación , Quinolinas/uso terapéutico , Anticuerpos Monoclonales Humanizados/administración & dosificación , Anticuerpos Monoclonales Humanizados/uso terapéutico , Estudios Retrospectivos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Compuestos de Fenilurea/administración & dosificación , Compuestos de Fenilurea/uso terapéutico , Neoplasias de los Conductos Biliares/tratamiento farmacológico , Masculino , Femenino , Infusiones Intraarteriales , Gemcitabina , Desoxicitidina/análogos & derivados , Desoxicitidina/administración & dosificación , Persona de Mediana Edad , Oxaliplatino/administración & dosificación , Oxaliplatino/uso terapéutico , Arteria Hepática , Anciano , Resultado del TratamientoRESUMEN
Objective: To analyse the efficacy and safety of dupilumab in the treatment of moderate to severe atopic dermatitis (AD). Methods: The clinical data of moderate to severe AD patients who received dupilumab therapy in the Department of Dermatology, Xiangya Hospital, Central South University from August 2020 to November 2022 were retrospectively analyzed. The efficacy was evaluated by Eczema Area and Severity Index (EASI), SCORing Atopic Dermatitis (SCORAD), Numerical Rating Scale (NRS), Patient Oriented Eczema Measure (POEM), and Dermatology Quality of Life Index (DLQI) before treatment and 2, 4, 16 and 24 weeks after treatment. Adverse events that occurred during treatment were recorded. Repeated Measures ANOVA and Generalized Estimating Equations were used to compare changes in scores and changes in laboratory indices at different time points before and after treatment. Results: The age of 259 patients was (35.4±25.9) years, the duration of AD was 4.00 (2.00, 9.00) years, and 64.1% (166 patients) were men patients. The scores of EASI, SCORAD, POEM, DLQI and NRS at 2, 4, 16 and 24 weeks after treatment with dupilumab were significantly lower than those before treatment (all P<0.001). The proportions of EASI50, EASI75, and EASI90 were 91.0% (101/111), 71.2% (79/111), and 40.5% (45/111) at 16 weeks, and 95.0% (76/80), 80.0% (64/80) and 45.0% (36/80) at 24 weeks, respectively. Basal total IgE levels (P=0.005) and EOS counts (P<0.001) at Week 24 were significantly lower than those before treatment. Adverse events occurred in 54 patients (20.9%), mainly manifested as intractable erythema of the face and neck (5.0%, 13 patients) and conjunctivitis (1.9%, 5 patients). Conclusions: Dupilumab can effectively improve the rash area, rash severity and itchiness of moderate to severe atopic dermatitis, improve the quality of life of patients, and reduce the incidence of adverse effects.
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Anticuerpos Monoclonales Humanizados , Dermatitis Atópica , Calidad de Vida , Índice de Severidad de la Enfermedad , Humanos , Dermatitis Atópica/tratamiento farmacológico , Anticuerpos Monoclonales Humanizados/uso terapéutico , Anticuerpos Monoclonales Humanizados/efectos adversos , Adulto , Masculino , Femenino , Estudios Retrospectivos , Resultado del Tratamiento , Persona de Mediana Edad , Adulto JovenRESUMEN
OBJECTIVE: Recently, numerous studies have yielded inconsistent results regarding the effect of metformin on esophageal cancer risk in type 2 diabetes mellitus patients. The purpose of this study is to systematically assess this effect using meta-analysis. METHODS: We searched clinical studies on metformin and esophageal cancer risk in PubMed, Embase, and the Cochrane Library. After literature screening, a series of meta-analyses were conducted using RevMan 5.3 software. The pooled hazard ratio (HR) and the corresponding 95% confidence interval (CI) were used as the effect size. RESULTS: Five eligible studies (four cohort studies and one case-control study) were included for our meta-analysis using a random-effect model. The analysis showed that metformin could not reduce esophageal cancer risk in type 2 diabetes mellitus patients (HR 0.88, 95% CI 0.60-1.28, P > 0.05). Subgroup analyses by geographic location showed that metformin significantly reduced esophageal cancer risk in Asian patients with type 2 diabetes mellitus (HR 0.59, 95% CI 0.39-0.91, P = 0.02), without heterogeneity between studies (P = 0.80 and I2 = 0%). CONCLUSIONS: Overall, our systematic review and meta-analysis demonstrate that metformin does not reduce esophageal cancer risk in type 2 diabetes mellitus patients. However, a significant reduction in esophageal cancer risk in Asian populations remains to be clarified.
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Diabetes Mellitus Tipo 2/tratamiento farmacológico , Neoplasias Esofágicas/prevención & control , Hipoglucemiantes/farmacología , Metformina/farmacología , Pueblo Asiatico , Estudios de Casos y Controles , Intervalos de Confianza , Diabetes Mellitus Tipo 2/etnología , Neoplasias Esofágicas/etnología , Humanos , Modelos de Riesgos Proporcionales , Estudios Prospectivos , Sesgo de Publicación , Estudios Retrospectivos , RiesgoRESUMEN
OBJECTIVE: This study aimed to evaluate the effect of four exercise modalities on patients with nonalcoholic fatty liver disease (NAFLD). MATERIALS AND METHODS: Databases of CNKI, Wanfang, VIP, Web of Science, PubMed, Cochrane Library, Medline, and Embase were searched for relevant studies. The literature search was restricted to those published between January 2010 and June 2021. Randomized controlled trials of exercise interventions on NAFLD were collected. Data were presented as statistical graphics using ADDIS 1.16.5 and R-Studio 4.1. RESULTS: Seventeen controlled studies analyzing 1627 patients with NAFLD were included. Patients were divided into the control group (n=688), aerobic training group (AT, n=554), resistance training group (RT, n=232), high-intensity interval training group (HIIT, n=53), and aerobic training with resistance training group (AT+RT, n=100). Results of the statistical analysis showed that the combined exercise intervention had the most significant effect on the total serum cholesterol of patients' mean difference [MD=0.47(0.23, 0.73), p<0.05]. Levels of alanine aminotransferase and aspartate aminotransferase were improved, but no significant difference was found in their levels in the four groups of exercise intervention. The intervention effect of the four exercises on blood lipid and liver enzymes in patients with NAFLD was in the order of AT+RT > HIIT > RT > AT > control. CONCLUSIONS: Exercise interventions are recommended as stand-alone or adjunctive therapy. For patients with NAFLD who can tolerate various exercises, priority should be given to AT+RT exercise 4-5 times per week. The exercise intensity should be 50%-70% of the maximum heart rate and performed for >3 months to improve the effectiveness of the exercise supervision intervention.
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Terapia por Ejercicio , Enfermedad del Hígado Graso no Alcohólico/terapia , Teorema de Bayes , Humanos , Metaanálisis en Red , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
The aim of this work was to study oxidative stress and the compensating mechanisms implicated in severe thermal injury using the burned rat model. Results showed that after thermal injury glutathione (GSH) level was decreased, oxidized glutathione (GSSG) and the ratio of GSSG/GSH increased both at 24 and 48 h in the liver. The activities of GSH-reductase (GSH-Rx) in the liver and GSH-peroxidase (GSH-Px) both in the liver and erythrocytes increased at 24 h and then decreased at 48 h. The level of alpha-tocopherol in plasma was reduced at 24 h. Lipid peroxide levels increased both at 24 and 48 h in the liver. The serum zinc level decreased, reaching a minimum at 12h, whereas liver zinc level was elevated and reached the maximum at 12 h. After severe thermal injury enhancement of metallothionein (MT) expression has been discovered for the first time. MT content in the liver increased both at 24 and 48 h. Expression of MT-I mRNA was activated at 3 h and reached the top at 24 h postburn. The conclusion is that severe thermal injury gives rise to oxidative stress and dramatic enhancement of MT expression could be one of the important compensative mechanisms of natural defense system postburn.
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Quemaduras/metabolismo , Hígado/metabolismo , Metalotioneína/biosíntesis , Estrés Oxidativo , Animales , Quemaduras/sangre , Modelos Animales de Enfermedad , Glutatión/sangre , Glutatión Reductasa/análisis , Glutatión Reductasa/sangre , Hígado/química , Masculino , Metalotioneína/análisis , Ratas , Ratas Wistar , Factores de Tiempo , Zinc/análisis , Zinc/sangre , alfa-Tocoferol/análisisRESUMEN
m-Nisoldipine caused a concentration-dependent depression of the contractile response and 45Ca influx evoked by KCl in isolated rat thoracic aorta. The IC50 value for contraction and 45Ca influx were 0.69 (95% confidence limits 0.32-1.5) nmol.L-1 and 0.35 (95% confidence limits 0.06-2.0) nmol.L-1, respectively. There was a positive correlation between the inhibition of KCl-evoked contraction and 45Ca influx (r = 0.996). m-Nisoldipine (0.1-10 mumol.L-1) did not influence the 45Ca influx into resting cells and failed to inhibit noradrenaline (1.0 mumol.L-1)-evoked contraction and 45Ca influx. The results suggest that the relaxant effect of m-nisoldipine on rat aorta may be closely related to the blockade of Ca2+ entry through a potential-dependent calcium channel.