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1帕博利珠单抗治疗伴脑转移NSCLC患者的一项非随机、开放Ⅱ期试验的长期随访结果和生物标志物分析显示文摘背景与目的我们开展了一项帕博利珠单抗用于伴未治疗脑转移的非小细胞肺癌(non-small cell lung cancer,NSCLC)或黑色素瘤患者的疗效和安全性的II期试验,旨在评估程序性死亡受体1(programmed cell death 1,PD-1)抑制剂在中枢神经系统(central nervous system,CNS)中的疗效。中期结果已发表,现报道对NSCLC队列的更新分析结果。方法这是一项开放性、单中心、II期试验。纳入标准:年龄≥18岁,诊断为晚期NSCLC并伴有≥1个5 mm-20 mm脑转移病灶,既往从未治疗或之前放疗后进展,无神经系统症状,不需要激素治疗且美国东部肿瘤协作组(Eastern Cooperative Oncology Group,ECOG)<2分。患者每2周接受一次帕博利珠单抗(10 mg/kg)治疗。队列1为程序性死亡配体1(programmed cell death ligand 1,PD-L1)≥1%的患者,队列2为PD-L1<1%或未评估的患者。主要终点是脑转移患者缓解比例。所有经治患者均纳入疗效与安全性终点的分析。该研究已结束入组,并于Clinicaltrials.gov登记注册,注册号为NCT02085070。结果2014年3月31日-2018年5月21日,共42例患者接受治疗。中位随访时间为8.3个月(IQR:4.5个月-26.2个月)。队列1的37例患者中11例有脑转移缓解[29.7%(95%CI:15.9%-47.0%)]。队列2未观察到缓解。治疗相关的3级-4级不良事件(adverse events,AEs)包括2例肺炎、1例全身症状、1例结肠炎、1例肾上腺皮质功能不全、1例高血糖症和1例低钾血症。6例(14%)患者发生了治疗相关的严重不良事件,包括肺炎、急性肾损伤、低钾血症和肾上腺皮质功能不全。没有观察到治疗相关死亡病例。结论帕博利珠单抗治疗PD-L1≥1%的NSCLC伴脑转移患者有效,且对所有纳入的未经治疗的脑转移患者安全。需要进一步探索免疫治疗用于NSCLC合并CNS转移。Sarah B GOLDBERG Kurt A SCHALPER Scott N GETTINGER Amit MAHAJAN Roy S HERBST Anne C CHANG Rogerio LILENBAUM Frederick H WILSON Sacit Bulent OMAY James B YU Lucia JILAVEANU Thuy TRAN Kira PAVLIK Elin ROWEN Heather GERRSH Annette KOMLO Richa GUPTA Hailey WYATT Matthew RIBEIRO Yuval KLUGER Geyu ZHOU Wei WEI Veronica L CHANG Harriet M KLUGER 董晓荣(翻译/校对) 2021中国肺癌杂志2021,24,9:34
2皮质下小血管病诊断的共识声明显示文摘血管性认知损害是用于描述一组涉及大血管和小血管的散发性和遗传性异质性疾病的诊断术语。皮质下小血管病可导致腔隙性梗死和进行性白质损害。被称为宾斯旺格病(Binswanger's disease, BD)的进行性白质损害患者构成了从单纯血管性疾病到合并神经变性病变的疾病谱。BD患者是一个相对同质性的亚组,存在缺氧缺血、腔隙性梗死和炎症,它们协同作用破坏血脑屏障和髓鞘。通过临床、脑脊液、神经心理学和影像学检查获得的多模式疾病标记物能促进该亚组患者的鉴别。本共识声明确定了一系列基于基础病理学改变的潜在生物学标记物,这将有助于诊断以及将来协作性治疗试验的患者选择。Gary A Rosenberg Anders Wallin Joanna M Wardlaw Hugh S Markus Joan Montaner Leslie Wolfson Costantino Iadecola Berislav V Zlokovic Anne Joutel Martin Dichgans Marco Duering Reinhold Schmidt Amos D Korczyn Lea T Grinberg Helena C Chui Vladimir Hachinski 王训师 张劼 陈涵丰 俞娅美 徐子奇 罗本燕 2016国际脑血管病杂志2016,24,6:18
3Retrograde-viewing device improves adenoma detection rate in colonoscopies for surveillance and diagnostic workup显示文摘AIM:To determine which patients might benefit most from retrograde viewing during colonoscopy through subset analysis of randomized,controlled trial data.METHODS:The Third Eye Retroscope Randomized Clinical Evaluation(TERRACE) was a randomized,controlled,multicenter trial designed to evaluate the efficacy of a retrograde-viewing auxiliary imaging device that is used during colonoscopy to provide a second video image which allows viewing of areas on the proximal aspect of haustral folds and flexures that are difficult to see with the colonoscope's forward view.We performed a post-hoc analysis of the TERRACE data to determine whether certain subsets of the patient population would gain more benefit than others from use of the device.Subjects were patients scheduled for colonoscopy for screening,surveillance or diagnostic workup,and each underwent same-day tandem examinations with standard colonoscopy(SC) and Third Eye colonoscopy(TEC),randomized to SC followed by TEC or vice versa.RESULTS:Indication for colonoscopy was screening in 176/345 subjects(51.0%),surveillance after previous polypectomy in 87(25.2%) and diagnostic workup in 82(23.8%).In 4 subjects no indication was specified.Previously reported overall results had shown a net additional adenoma detection rate(ADR) with TEC of 23.2% compared to SC.Relative risk(RR) of missing adenomas with SC vs TEC as the initial procedure was 1.92(P = 0.029).Post-hoc subset analysis shows additional ADRs for TEC compared to SC were 4.4% for screening,35.7% for surveillance,55.4% for diagnostic and 40.7% for surveillance and diagnostic combined.The RR of missing adenomas with SC vs TEC was 1.11(P = 0.815) for screening,3.15(P = 0.014) for surveillance,8.64(P = 0.039) for diagnostic and 3.34(P = 0.003) for surveillance and diagnostic combined.Although a multivariate Poisson regression suggested gender as a possibly significant factor,subset analysis showed that the difference between genders was not statistically significant.Age,bowel prep quality and withdrawal time did not significantly affect the RR of missing adenomas with SC vs TEC.Mean sizes of adenomas detected with TEC and SC were similar at 0.59 cm and 0.56 cm,respectively(P = NS).CONCLUSION:TEC allows detection of significantly more adenomas compared to SC in patients undergoing surveillance or diagnostic workup,but not in screening patients(ClinicalTrials.gov Identifier:NCT01044732).Peter D Siersema Amit Rastogi Anke M Leufkens Paul A Akerman Kassem Azzouzi Richard I Rothstein Frank P Vleggaar Alessandro Repici Giacomo Rando Patrick I Okolo Olivier Dewit Ana Ignjatovic Elizabeth Odstrcil James East Pierre H Deprez Brian P Saunders Anthony N Kalloo Bradley Creel Vikas Singh Anne Marie Lennon Daniel C DeMarco 2012World Journal of Gastroenterology2012,18,26:6
4Colonoscopy surveillance for high risk polyps does not always prevent colorectal cancer显示文摘AIM To determine the frequency and risk factors for colorectal cancer(CRC) development among individuals with resected advanced adenoma(AA)/traditional serrated adenoma(TSA)/advanced sessile serrated adenoma(ASSA). METHODS Data was collected from medical records of 14663 subjects found to have AA, TSA, or ASSA at screening or surveillance colonoscopy. Patients with inflammatory bowel disease or known genetic predisposition for CRC were excluded from the study. Factors associated with CRC developing after endoscopic management of high risk polyps were calculated in 4610 such patients who had at least one surveillance colonoscopy within 10 years following the original polypectomy of the incident advanced polyp. RESULTS84/4610(1.8%) patients developed CRC at the polypectomy site within a median of 4.2 years(mean 4.89 years), and 1.2%(54/4610) developed CRC in a region distinct from the AA/TSA/ASSA resection site within a median of 5.1 years(mean 6.67 years). Approximately, 30%(25/84) of patients who developed CRC at the AA/TSA/ASSA site and 27.8%(15/54) of patients who developed CRC at another site had colonoscopy at recommended surveillance intervals. Increasing age; polyp size; male sex; right-sided location; high degree of dysplasia; higher number of polyps resected; and piecemeal removal were associated with an increased risk for CRC developmentat the same site as the index polyp. Increasing age; right-sided location; higher number of polyps resected and sessile endoscopic appearance of the index AA/TSA/ASSA were significantly associated with an increased risk for CRC development at a different site. CONCLUSION Recognition that CRC may develop following AA/TSA/ASSA removal is one step toward improving our practice efficiency and preventing a portion of CRC related morbidity and mortality.Mohamad A Mouchli Lidia Ouk Marianne R Scheitel Alisha P Chaudhry Donna Felmlee-Devine Diane E Grill Shahrooz Rashtak Panwen Wang Junwen Wang Rajeev Chaudhry Thomas C Smyrk Ann L Oberg Brooke R Druliner Lisa A Boardman 2018World Journal of Gastroenterology2018,24,8:5
5Gas chromatography/plasma spectrometry-an important analytical tool for elemental speciation studie显示文摘Jorgelina C A Wuilloud Rodolfo G Wuilloud Anne P Vonderheide 2004Spectrochimica Aeta Part B: A- tomic Spectroscopy2004,59,6:1
6The influence of changes in tidal asymmetry on residual sediment transport in the Western Scheldt显示文摘Annelies B A Wang Z B Amos C 2010Continental Shelf Research2010,31,2:1
7Influence of pH and high pressure on the thermal inactivation kinetics of horseradish peroxidase显示文摘Lemos M A Oliveria J C Anne van Loey 1999Food Biotechnology1999,13,1:1
8Numerical modelling of inhibited electrical discharges in air显示文摘Larsson A Anne B C Gallimberti I 1998J Phys D: Appl Phys1998,31,2:1
9Avian perching deterrents on ultrasonic sensors at airport wind-shear alert systems 显示文摘MICHAEL L A ANN C G 2004Wildlife Soc Bu112004,32,3:1
10The Dioscorea genus: a review of bioactive steroid saponins显示文摘Marc S Anne C M Marie A L 2007J Nat Med2007,,61:1
11Diagnosis of tuberculosis by DNA amplification in clinical practice evaluation 显示文摘Anne Brio - Noel Christine A Corinne C 1991Lancet1991,338,8763:1
12Time slot management in attended home de- livery显示文摘Niels A Ann C 2011Transportation Science2011,45,3:1
13An innovative approach to enhance dermatology competencies for advanced practice nurses: Service-learning with a migrant farm worker health clinic显示文摘Elizabeth A Ann C Maeve H 2014J Nurs Educ2014,53,12:1
14Influence of pH and high pressure on the thermal inactivation kinetics of horseradish peroxidase显示文摘Lemos M A Oliveria J C Anne van Loey 1999Food Biotechnology1999,13,1:1
15早期乳腺癌最佳辅助化疗方案与人类表皮生长因子受体2阳性乳腺癌辅助靶向治疗选择:依据 ASCO 对 CCO临床实践指南的改编显示文摘目的研究加拿大安大略癌症治疗中心(CCO)关于早期乳腺癌最佳辅助化疗方案,包括人类表皮生长因子受体2(HER2)阳性乳腺癌辅助靶向治疗方案,并对其进行改编。方法按照美国临床肿瘤协会(ASCO)对其他组织临床实践指南改编的策略和程序,对CCO临床实践指南的严谨性与内容适用性进行回顾。结果基于对CCO临床实践指南内容的回顾,ASCO小组认为,CCO临床实践指南在整体上清晰全面,以最确切的科学证据为基础,为患者提供可接受的治疗选项。推荐关于辅助化疗方案的决定,应考虑到基线复发风险、毒性、利益可能性和宿主因素(如合并症)。对于高风险HER2阴性的身体状况良好的人群,蒽环类和紫杉烷治疗方案是标准治疗方案。4个周期的多西他赛和环磷酰胺治疗方案是可接受的非蒽环类治疗方案。对于高风险HER2阳性患者,推荐蒽环类与紫杉烷序贯疗法联合曲妥单抗或多西他赛、卡铂、曲妥单抗进行6个周期的治疗。对于低风险、非淋巴结转移、HER2阳性人群,推荐每周一次的紫杉醇和曲妥单抗连续进行12个周期的替代治疗。曲妥单抗应持续使用1年。不应采用铂复合盐对三阴性人群进行常规的辅助管理,除非出现有效的生存数据加以支持。Neelima Denduluri Mark R Somerfield Andrea Eisen Jamie N Holloway Arti Hurria Tari A King Gary H Lyman Ann H Partridge Melinda L Telli Maureen E Trudeau Antonio C Wolff 本刊编辑部 2016中国全科医学2016,19,18:1
16Extraction and analysis of low concentrations of DDT,DDE and DDD in small volumes of sediment pore water显示文摘Anne M C Patricia A K Robert A H 1996Chemosphere1996,33,7:1
17DNA-linked Metal Nanosphere Materials: Structural Basis for the Optical Properties显示文摘Anne A L George C S 2000J Phys Chem B2000,104,3:1
18Meta-Analysis of Calcium Supplementation for the Prevention of Postmenopausal Osteoporosis显示文摘Beverley S George W Ann C Nicole Z Vivian R Lauren G Zulma O Joan P Jonathan A Peter T Gordon G 2002Endocrine Reviews2002,23,4:1
19Resilience: Promoting well-being through recovery, sustainability, and growth显示文摘ALEX J Z ANNE A MARY C D 2010Research in Human Development2010,7,3:1
20Classical swine fever virus is genetically stable in vitro and in vivo 显示文摘Vanderhallen H Mittelhozer C hofm ann M A 1999Arch Virol1999,,:1
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