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991.
《Clinical gastroenterology and hepatology》2020,18(6):1336-1345
De-escalation of immunomodulators and biologic agents in inflammatory bowel disease is frequently discussed with patients and must weigh the risk of continued medical therapy with the risk of disease recurrence. Risk factors for disease flare after withdrawal of inflammatory bowel disease medications such as disease activity at de-escalation, disease prognostic features, and prior course of disease have been identified predominately in retrospective studies, allowing for risk stratification of patients. This review evaluates the published literature regarding therapeutic de-escalation and provides a framework for physicians to apply this to clinical practice. Prospective trials are underway and planned, which should provide further insight into this treatment paradigm and better inform patient selection for this strategy. 相似文献
992.
《Vaccine》2016,34(24):2663-2670
Human metapneumovirus (HMPV) is a major cause of morbidity and mortality from acute lower respiratory tract illness, with most individuals seropositive by age five. Despite the presence of neutralizing antibodies, secondary infections are common and can be severe in young, elderly, and immunocompromised persons. Preclinical vaccine studies for HMPV have suggested a need for a balanced antibody and T cell immune response to enhance protection and avoid lung immunopathology. We infected transgenic mice expressing human HLA-A*0201 with HMPV and used ELISPOT to screen overlapping and predicted epitope peptides. We identified six novel HLA-A2 restricted CD8+ T cell (TCD8) epitopes, with M39–47 (M39) immunodominant. Tetramer staining detected M39-specific TCD8 in lungs and spleen of HMPV-immune mice. Immunization with adjuvant-formulated M39 peptide reduced lung virus titers upon challenge. Finally, we show that TCD8 from HLA-A*0201 positive humans recognize M39 by IFNγ ELISPOT and tetramer staining. These results will facilitate HMPV vaccine development and human studies. 相似文献
993.
目的:探究G蛋白信号调节因子-13(RGS13)在结直肠癌(CRC)进展中的作用。方法:使用TCGA数据库和实时荧光定量聚合酶链反应(RT-qPCR)在mRNA水平分析CRC组织和细胞中RGS13 的表达量,使用免疫组织化学染色(IHC)和蛋白质印迹法(Western blot)在蛋白水平进一步分析。用ATP细胞活力检测实验、软琼脂克隆集落形成实验和细胞迁移侵袭实验检测RGS13对CRC细胞增殖、迁移和侵袭的影响,并通过Western blot、RT-qPCR等实验探究其下游分子机制。结果:RGS13在CRC组织与细胞系中低表达(P <0.01),RGS13 表达越低,患者的无病生存期越短(P =0.017)。RGS13 的下调可显著促进CRC细胞的增殖、迁移与侵袭(P <0.01),表明RGS13在CRC进展中发挥抑癌作用。机制上,RGS13通过下调Wnt/β-catenin信号通路中β-catenin的蛋白水平,进而降低癌基因c-Myc、MMP7 和CCND1等的表达水平(P <0.01),发挥对CRC的抑制作用。结论:RGS13可能通过下调β-catenin发挥抑制CRC进展的重要作用。 相似文献
994.
《The Journal for Nurse Practitioners》2021,17(7):776-780
The primary care literature lacks information on mast cell activation disease (MCAD) and, more specifically, mast cell activation syndrome, yet it affects approximately 17% of the population. Because many providers remain unaware of MCAD, this article provides a primer on mast cell diseases, including triggers, signs and symptoms, diagnosis, treatment, and resources for patients and providers. Primary care nurse practitioners are uniquely positioned and qualified to identify patients with multiple, diffuse complaints and chronic, multisystem symptoms—the hallmark of MCAD—and refer them for further diagnosis and treatment to reduce debilitating symptoms. 相似文献
995.
996.
《Journal of thoracic oncology》2021,16(11):1909-1924
IntroductionWe report the final overall survival (OS) analyses of atezolizumab-carboplatin-paclitaxel (ACP [experimental arm]) and OS data with approximately 39.8 months of median follow-up with atezolizumab-bevacizumab-carboplatin-paclitaxel (ABCP) versus bevacizumab-carboplatin-paclitaxel (BCP) in chemotherapy-naive patients with metastatic nonsquamous NSCLC in the phase 3 IMpower150 study (NCT02366143).MethodsIn this randomized, open-label study (N = 1202), coprimary end points included investigator-assessed progression-free survival and OS in intention-to-treat (ITT) wild-type (WT; no EGFR or ALK alterations) patients. Secondary and exploratory end points included OS in ITT and programmed death-ligand 1 (PD-L1) subgroups defined by the VENTANA SP142 and SP263 immunohistochemistry assays.ResultsAt the final analysis with ACP versus BCP (data cutoff: September 13, 2019; minimum follow-up: 32.4 mo), ACP had numerical, but not statistically significant, improvements in OS (ITT-WT: median OS = 19.0 versus 14.7 mo; hazard ratio = 0.84; 95% confidence interval: 0.71–1.00). OS benefit was sustained with ABCP versus BCP (ITT-WT: 19.5 versus 14.7 mo; hazard ratio = 0.80; 95% confidence interval: 0.67–0.95). Exploratory analyses in the SP142-defined PD-L1 subgroups revealed longer median OS with ABCP and ACP versus BCP in PD-L1–high and PD-L1–positive subgroups; in the PD-L1–negative subgroups, median OS was similar with ACP and ABCP versus BCP. Safety was consistent with that in earlier analyses (data cutoff: January 22, 2018).ConclusionsAt the final IMpower150 OS analysis, ACP had numerical, but not statistically significant, OS improvement versus BCP. Updated data with an additional 20 months of follow-up revealed continued OS improvement with ABCP versus BCP in all patients. 相似文献
997.
目的调查本科实习护生的患者安全态度现状,并分析影响因素,为开展患者安全教育提供参考。方法采用中文版安全态度问卷(C-SAQ)对重庆市某医学院校的225名本科实习护生进行问卷调查,采用SPSS 20.0软件进行数据分析。结果实习护生患者安全态度总均分为(3.75±0.54)分,安全态度6个维度的平均分由高到低依次为管理感知、工作满意、压力感知、团队合作、安全氛围和工作条件。多元线性回归分析结果表明,每周工作时间短、接受过患者安全教育、实习期间未发生过护理差错的本科实习护生患者安全态度更积极(P<0.05)。结论本科实习护生的患者安全态度处于中等水平。实习医院应将患者安全教育融入并贯穿于临床护理实践培养过程中,减轻实习护生的工作压力,重点关注经历过护理差错的护生,进而提高实习护生的患者安全态度。 相似文献
998.
Emily L. Marshall Samuel Guajardo Emily Sellers Matthew Gayed Zheng Feng Lu Joshua Owen Brian Funaki Osman Ahmed 《Journal of vascular and interventional radiology : JVIR》2021,32(3):429-438
PurposeTo evaluate the radiation dose differences for intraprocedural computed tomography (CT) imaging between cone-beam CT and angio-CT acquired during transarterial radioembolization (TARE) therapies for hepatocellular carcinoma.Materials and MethodsA retrospective cohort of 22 patients who underwent 23 TARE procedures were selected. Patients were imaged in both cone-beam CT and angio-CT rooms as a part of their conventional treatment plan. Effective dose contributions from individual CT acquisitions as well as the cumulative dose contributions from procedural 3D imaging were evaluated. Angiography dose contributions were omitted. Cone-beam CT images were acquired on a C-arm Philips Allura system. Effective doses were evaluated by coupling previously published conversion factors (effective dose per dose-area product) to patient’s dose-area product meter readings after the procedure. Angio-CT images were acquired on a hybrid Canon Infinix-i Aquilion PRIME system. Effective doses from angio-CT scans were estimated using Radimetrics. Comparisons of a single patient’s dose differential between the 2 technologies were made.ResultsThe mean effective dose from a single CT scan was 6.42 mSv and 5.99 mSv in the cone-beam CT room and the angio-CT room, respectively (P = .3224), despite the greater field of view and average craniocaudal scan coverage in angio-CT. The mean effective dose summed across all CTs in a procedure was 12.89 mSv and 34.35 mSv in the cone-beam CT room and the angio-CT room, respectively (P = .0018).ConclusionsThe mean effective dose per CT scan is comparable between cone-beam CT and angio-CT when considered in direct comparison for a single patient. 相似文献
999.
1000.
Dylan J. Martini Subir Goyal Yuan Liu Sean T. Evans T. Anders Olsen Katherine Case Benjamin L. Magod Jacqueline T. Brown Lauren Yantorni Greta Anne Russler Sarah Caulfield Jamie M. Goldman Bassel Nazha Wayne B. Harris Haydn T. Kissick Viraj A. Master Omer Kucuk Bradley C. Carthon Mehmet Asim Bilen 《The oncologist》2021,26(10):e1742-e1750