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71.
Baoan Hong Lin Cai Jiangyi Wang Shengjie Liu Jingcheng Zhou Kaifang Ma Jiufeng Zhang Bowen Zhou Xiang Peng Ning Zhang Kan Gong 《Clinical genitourinary cancer》2019,17(2):97-104.e1
Background
Programmed death ligand-1 (PD-L1) is a potential predictive biomarker for immunotherapy in several malignancies. However, the expression level and clinical significance of PD-L1 in von Hippel–Lindau (VHL)-associated hereditary clear-cell renal cell carcinoma (ccRCC) remain unclear.Patients and Methods
Surgical specimens were recruited from 129 patients with sporadic ccRCC and 26 patients with VHL-associated hereditary ccRCC. The PD-L1 expression level was assessed using immunohistochemistry. Correlations between PD-L1 expression and clinicopathological features were analyzed.Results
In sporadic ccRCC, the positive expression rate of PD-L1 was 47.3% (61/129). Positive PD-L1 expression was correlated with advanced tumor T stage (P = .011), higher Fuhrman nuclear grade (P = .022), poor disease-free survival (P = .037), and sex (P = .025). In the VHL-associated hereditary ccRCC, positive PD-L1 expression rate was 34.6% (9/26), lower than that in sporadic ccRCC. Positive PD-L1 was correlated with higher Fuhrman nuclear grade (P = .008), but not with sex, age, tumor stage, or the onset age of VHL-associated tumors.Conclusion
Positive PD-L1 expression was correlated with the aggressive clinicopathological features in sporadic and VHL-associated hereditary ccRCC. Whether PD-L1 expression level in ccRCC is related to the effectiveness of programmed death-1/PD-L1 checkpoint inhibitor immunotherapy needs to be further investigated. 相似文献72.
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Victoria L. Zhou Frances S. Shofer Nikita G. Desai Ilona S. Lorincz Nikhil K. Mull David H. Adler John C. Greenwood 《The Journal of emergency medicine》2019,56(2):127-134
Background
The resuscitation and critical care unit is a novel emergency department–intensive care unit designed to provide early critical care to emergency department patients for ≤24 h.Objectives
This study sought to identify clinical variables associated with short intensive care unit (ICU) stays in patients with diabetic ketoacidosis (DKA), who commonly require ICU-level care.Methods
We conducted a retrospective, single-center, cross-sectional study of DKA patients ≥18 years of age who presented to an academic, urban hospital emergency department over 16 months. Patient demographics and clinical variables extracted from medical records were compared between prolonged ICU stay patients of ≥24 h versus short ICU stay patients (SSPs) of <24 h. ICU care was defined as treatment in the resuscitation and critical care unit or inpatient ICU.Results
One hundred sixty-eight emergency department visits with a primary diagnosis of DKA were analyzed. There were 53 prolonged ICU stay patients, 58 SSPs, and 57 patients required no ICU time. SSPs had significantly higher initial serum bicarbonate (13.0 vs. 9.0 mEq/L, p = 0.01) and shorter anion gap closure time (9.8 vs. 14.4 hours, p = 0.003). Medication nonadherence was a significantly more frequent precipitant in SSPs (67.2% vs. 47.2%, p = 0.03). Initial anion gap, glucose, beta-hydroxybutyrate, and severity of illness scores were not significantly different between groups. After multivariate logistic regression adjusting for variables significant from univariate analysis, higher initial bicarbonate (p = 0.04) and medication nonadherence (p = 0.03) remained significantly associated with SSPs.Conclusions
Patients with DKA with short ICU stays have higher initial bicarbonate levels and are more likely to have medication nonadherence than patients requiring prolonged critical care. These variables may identify patients with DKA who are best treated in an emergency department–intensive care unit to potentially reduce inpatient ICU use. 相似文献75.
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目的 系统综述冠心病血瘀证基因组学研究的方法和内容。方法 计算机检索Medline、Cochrane Central Register of Controlled Trials、中国知网、万方数据库,查找冠心病血瘀证基因组学的临床研究,按照制定的纳入排除标准,由2名研究人员独立筛选文献,任何分歧通过协商一致或通过第3名研究人员来解决。结果 最终纳入34项研究,其中与冠心病血瘀证密切相关的基因组学研究类型包括基因多态性、差异基因的表达、基因的甲基化修饰,涉及的生物学功能有血管内皮损伤、血液流变学改变、炎症反应与免疫调节、血管平滑肌增殖、血脂水平等,采用的技术方法有聚合酶链式反应(Polymerase chain reaction,PCR)、飞行时间质谱技术(Time-of-flight mass spectrometry,TOF-MS)、基因芯片杂交测序(Gene Chip)等。结论 基因组学研究可阐明冠心病血瘀证的生物学基础,为冠心病血瘀证的病机演变提供更好的依据,更有助于从分子水平实现个体化治疗,从而进一步提高临床疗效。 相似文献
80.
目的 了解食管癌术后康复期患者营养状况及生命质量的变化趋势及相关关系。方法 以四川省肿瘤专科医院行食管癌手术治疗的75例患者为研究对象,在患者术后1个月、3个月和6个月时运用患者主观整体营养评估量表进行营养评估,采用肿瘤生命质量测评量表和食管癌患者补充量表进行生命质量评定。结果 食管癌患者术后随时间的延长营养不良发生率由73.4%下降至33.5%。生活质量各维度评分在各评估时间点差异均有统计学意义(P<0.05),功能领域和症状领域在术后1个月与术后3个月、术后6个月比较有统计学意义(P<0.05),术后3个月与术后6个月比较差异无统计学意义(P>0.05)。患者营养状态与躯体、角色、情绪及社会功能呈负相关(P<0.05),与吞咽困难、进食、反流、梗阻、食欲减退、咳嗽症状呈正相关(P<0.05)。结论 食管癌术后1个月患者营养状况及生命质量较差,随时间推移逐渐好转。医护人员应根据患者在不同时间点营养状况及生命质量的变化特点,制定规范化和个体化的延续护理方案,以促进患者术后康复、提高生命质量。 相似文献