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Objective:To investigate the clinical efficacy and safety of deep hyperthermia combined with sintilimab and nab-PC (albumin-bound paclitaxel + carboplatin) regimen in the treatment of advanced squamous non-small cell lung cancer (NSCLC) with driver gene negative and programmed death-1 receptor ligand 1 (PD-L1) expression positive.Methods:A prospective case-control study was performed. A total of 84 advanced squamous NSCLC patients with driver gene negative and PD-L1 expression positive in Hebei Seventh People's Hospital from January 2020 to December 2022 were collected, and all patients were divided into the observation group and the control group according to the random number table method, with 42 cases in each group. The control group was given the treatment of sintilimab combined with nab-PC regimen, and the observation group was given deep hyperthermia on the basis of the control group. After 4 consecutive cycles of treatment, the short-term efficacy of the two groups was compared. The levels of serum tumor markers [carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCCA), cytokeratin fragment 19 (CYFR21-1)], and the positive expression rates of immunohistochemistry markers [p40, p63, and cytokeratin 5/6 (CK5/6)] before and after treatment were compared between two groups. Functional Assessment of Cancer Therapy-Lung cancer module (FACT-L) scores, the adverse reactions and the long-term survival of the two groups were compared.Results:There were 26 males and 16 females in the observation group, and the age was (59±11) years; there were 22 males and 15 females in the control group, and the age was (58±11) years. The objective remission rate and the disease control rate were 71.43% (30/42), 90.48% (38/42), respectively in the observation group, and 50.00% (21/42), 80.95% (34/42), respectively in the control group; the objective remission rate in the observation group was higher than that in the control group, and the difference was statistically significant ( χ2 = 4.04, P = 0.044); and there was no statistically significant difference in the disease control rate of both groups ( χ2 = 1.56, P = 0.212). The levels of serum CEA, SCCA and CYFRA21-1, and the positive expression rates of p40, p63, and CK5/6 in the two groups after treatment were lower than those before treatment (all P < 0.05); and the scores of physiological status, functional status, additional concern in FACT-L scores and the total score of the scale after treatment were higher than those before treatment (all P < 0.05). There were no statistically significant differences in the incidence of adverse reactions including thrombocytopenia, neutropenia, leukopenia, anemia, fever of the two groups (all P > 0.05). The median progression-free survival (PFS) time was 6.5 months (95% CI: 3.82-12.75), 5.1 months (95% CI: 3.14-12.26),respectively in the observation group and the control group, and the difference in the median PFS time was statistically significantly of both groups ( χ2 = 4.21, P = 0.040). The median overall survival (OS) time was 12.9 months (95% CI: 6.25-15.46), 9.7 months (95% CI: 4.74-13.02), respectively in the observation group and the control group, and the difference in the median OS time was statistically significantly of both groups ( χ2 = 4.43, P = 0.035). Conclusions:Deep hyperthermia combined with sintilimab and nab-PC regimen in the treatment of advanced squamous NSCLC with driver gene negative and PD-L1 expression positive can effectively reduce the serum tumor markers levels and positive expression rate of immunohistochemical markers, improve the quality of life of patients, and increase the short-term and long-term efficacy.
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The 83rd American Diabetes Association(ADA) Academic Conference was held from 23 to 26 June, 2023 in San Diego, U. S.A, in a combined online and offline format. The conference featured various aspects, including diabetes epidemiology, diabetes complications, and advances in the treatment of diabetes and related metabolic diseases. This article provides an overview of Banting awards and research advancements in diabetes and other metabolic diseases.
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Objective:Clinicopathological characteristics of neuroendocrine neoplasms are highly heterogeneous based on variable origins.Our study aims to explore the clinical features of rectal neuroendocrine neoplasm (RNEN).Methods:Patients with histologically diagnosed rectal neuroendocrine neoplasms were retrospectively analyzed between January 2012 and December 2020. Epidemiological characteristics, clinical manifestations, complete blood count, endoscopy findings, and pathological features were recorded and analyzed. T-test was used for measurement data analysis, Chi-square test was performed for classification data analysis, and Binary logistic regression was applied for analyzing risk factors of metastasis.Results:Among 172 patients, the male to female ratio was 107 to 65 with an average age of (52±12) years (16-77 years). Altered bowel habit was the most common initial symptom (58/172, 33.7%), followed by abdominal pain (36/172, 20.9%) and loss of body weight (27/172, 15.7%). One hundred and sixty-one cases were neuroendocrine tumors, 9 were neuroendocrine carcinomas and 2 were mixed neuroendocrine-non-neuroendocrine neoplasms. Most endoscopic presentations were polypoid lesions (147/172, 85.5%), mainly limited to mucosa (48/172, 27.9%) and submucosa (96/172, 55.8%). Twenty-nine patients developed lymph node invasion or distant metastasis at diagnosis. There were statistical difference of neutrophil-to-lymphocyte ratios (NLR) among groups with different tumor size (<10 mm vs. 10-20 mm vs.>20 mm, mean NLR 1.79±0.55 vs. 2.27±1.23 vs. 2.95±0.66, P<0.01. Compared with non-metastatic group, the metastatic group presented higher NLR(2.61±0.81 vs. 1.89±0.80, P<0.01). Tumor size (<10 mm vs. 10-20 mm vs.>20 mm, OR 1.00 vs. 2.10 vs. 5.25×10 9, P =0.001), invasion to bowel wall (mucosa vs. submucosa vs. muscularis vs. serosa invasion, OR 1.00 vs. 3.26 vs. 14.11 vs. 39.42, P=0.008), and NLR (NLR<2.25 vs. NLR≥2.25, OR 1.00 vs. 5.19, P =0.024) were risk factors for metastasis. Conclusion:Metastasis of RNEN is related with tumor size, degree of bowel invasion and NLR. High NLR is a poor prognostic factor of RNEN.
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Objective:To preliminarily understand the living habits, medication taking and treatment status including the therapeutic regimen, compliance and short-term efficacy of patients with chronic atrophic gastritis and erosion in Beijing area.Methods:From April to September in 2019 at Peking Union Medical College Hospital, Peking University Third Hospital and Peking University Shougang Hospital, the outpatients with chronic atrophic gastritis and erosion diagnosed with endoscopy within two weeks before visiting were prospectively included in this non-interventional observation study. Chi square test was used for statistical analysis.Results:A total of 277 patients with chronic atrophic gastritis and erosion had complete follow-up data, of which male patients accounted for 49.8% (138/277). The common initial symptoms of patients with chronic atrophic gastritis and erosion included acid reflux, abdominal distension, epigastric pain and postprandial distension, which accounted for 60.3% (167/277), 59.6% (165/277) , 58.8% (163/277) and 52.3% (145/277), respectively. For treatment, 36.8% (102/277) of the patients only received lifestyle instruction without medication. Among the patients with medication treatment, the short-term efficacy of gastric mucosal protectants+ proton pump inhibitor+ gastro-kinetic agent for abnominal distension, postprandial distention, acid reflux and nausea was highest as compared with other therapeutic regimen, and the differences were statistically significant ( χ2=25.18, 19.49, 13.75, 8.84, all P<0.05). Conclusions:Chronic gastritis with erosion may be caused by a combination of multiple factors, and the symptoms of which lack specific. If necessary, gastroscopy may help the diagnosis. Individualized treatment strategies based on the symptoms of patients is needed for treatment.
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Hepatic encephalopathy (HE) can cause a wide spectrum of neurological or psychological impairment. The high incidence of HE after transjugular intrahepatic portosystemic shunt (TIPS) severely restricts its use in the treatment of portal hypertension. The progress of pathogenesis, risk factors and management of post-TIPS HE were mainly reviewed in this article.
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[Summary] The clinical data of 3 inpatients clinically diagnosed as Gitelman syndrome ( GS ) were collected. The genomic DNA was isolated from the peripheral blood and the primers were designed to amplify all the exons and flanking introns in the SLC12A3 and CLCNKB genes by PCR. Direct sequencing of PCR products in the two genes was performed in all patients. Three patients manifested with recurrent hypokalemia, hypomagnesemia, hypocalciuria, hypochloremic metabolic alkalosis, but normal blood pressure. Gene sequencing results showed that one novel mutation p. L891V was identified in SLC12A3 gene in case 2. Seven and 12 types of polymorphic loci in the CLCNKB gene were found in case 1 and case 3, respectively. However, mutations were not found in the SLC12A3 and CLCNKB gene.
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Objective To observe the incidence of oculocardiac reflex in cataract surgery and investigate the corresponding measures.Methods One hundred cataract patients with surgical treatment were enrolled in this study,observed the occurrence of oculocardiac reflex in different surgical procedures and taked active preventive measures and first aid.Results The incidence of oculocardiac reflex was 20％(20/100),which the intraoperative effective measures can significantly reduce the incidence of oculocardiac reflex.Conclusion In cataract surgery,the incidence of oculocardiac reflex is not high,but the anesthesiologist must be prepared to work effectively with doctors completed surgery to avoid adverse consequences resulting from oculocardiac reflex.
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Objective To analyze the changes in number and biological ability of endothelial progenitor cells (EPCs) from peripheral blood of SLE patients. Methods Mononuclear cells (MNCs) were isolated by Ficoll density gradient centrifugation from peripheral blood of 20 female SLE patients and 20 healthy female controls. EPCs were identified by double staining using antibodies to CD34 and CD133, or antibodies to CD133 and vascular endothelial growth factor receptor 2 (VEGFR2). Phycoerythrin (PE) conjugated antiCD34, fluorescein isothiocyanate (FITC) conjugated anti-CD133 and APC conjugated anti-VEGFR2 antibodies were used in a three color flow cytometric analysis to determine the percentage of EPCs in peripheral MNCs.The proliferation and migration ability of EPCs were measured by MTT assay and modified millicell chamber assay, respectively. The adhesion activity of EPCs was evaluated by counting the number of adherent cells.Results The percentage and proliferation rate of EPCs in peripheral MNCs from female SLE patients were significantly lower than those from the healthy controls(4.49% ± 1.66% vs 20.81% ± 4.14%, 23.11% ± 3.16%vs 35.65% ± 1.74%, both P ＜ 0.01 ). The migration and adhesion ability of EPCs from SLE patients was impaired compared with those from the healthy controls (12.00 ± 2.12 vs 23.60 ± 3.0 cells/field, 22.43 ± 4.43vs 36.43 ± 3.69 cells/filed, both P ＜ 0.01 ). Conclusion There is a decrease in the number and an impairment in biological ability of EPCs in SLE patients.