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Background
Nasopharyngeal carcinoma (NPC) is a type of neoplasm that is highly prevalent in East Asia and Africa with Epstein-Barr virus (EBV), genetic, and dietary factors implicated as possible aetiologic factors. Previous studies suggested the association of certain cytokines with the invasion and metastatic properties of NPC. The present study examined the roles of EBV latent membrane protein-1 (LMP1), interleukin-6 (IL-6), interleukin-10 (IL-10), transforming growth factor-beta 1 (TGF-β1) and laminin in the regulation of matrix-metalloproteinases (MMPs) and vascular endothelial growth factor (VEGF) in NPC. The effects of these factors on bmi-1, an oncogene, and ngx6, a tumour suppressor gene, were also investigated. 相似文献87.
Paulsson AK McMullen KP Peiffer AM Hinson WH Kearns WT Johnson AJ Lesser GJ Ellis TL Tatter SB Debinski W Shaw EG Chan MD 《中国神经肿瘤杂志》2013,(1):52-52
PURPOSE: We investigate the patterns of failure in the treatment of glioblastoma(GBM) based on clinical target volume(CTV) margin size,dose delivered to the site of initial failure,and the use of temozolomide and intensity-modulated radiotherapy(IMRT).METHODS: Between August 2000 and May 2010,161 patients with GBM were treated with radiotherapy with or without concurrent temozolomide.Patients were treated with CTV expansions that ranged from 5 to 20 mm using a shrinking field technique.Patterns of failure and time to progression and overall survival were compared based on CTV margin,use of temozolomide,and use of IMRT.Kaplan Meier analysis was used to estimate survival times,and χ test was used for comparison of cohorts.RESULTS: For patients treated with 5-,10-,and 15-to 20-mm CTV,79%,77%,and 86% experienced failures in the 60 Gy volume,respectively.Forty-eight percent,55%,and 66% of patients with 5-,10-,and 15-to 20-mm CTV experienced failures in the 46 Gy volume,respectively.There was no statistical difference between patients treated with 5-,10-,15-to 20-mm margins with regard to 60 Gy failure(P=0.76),46 Gy failure(P=0.51),or marginal failure(P=0.73).Eighty percent of patients receiving temozolomide experienced failures in the 60 Gy volume.There was no increased likelihood of marginal failures in patients receiving IMRT(P =0.97).CONCLUSIONS: Modern treatment techniques including use of concurrent temozolmide,limited CTV margin size,and IMRT have not greatly changed the patterns of failure of GBM. 相似文献
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Hans J Kreder Paul Grosso Jack I Williams Susan Jaglal Tami Axcell Eugene K Wal David J G Stephen 《Canadian journal of surgery》2003,46(1):15-22
INTRODUCTION: Because of rationing of the limited pool of health care resources, access to total knee arthroplasty (TKA) is limited, but investigation of variables that predict complications, length of hospital stay, cost and outcomes of TKA may allow us to optimize the available resources. The objective of this study was to examine the effect of various factors on complication rates after TKA in patients managed in Ontario. METHODS: Patients who had undergone an elective TKA between 1993 and 1996, as captured in the Canadian Institute for Health Information (CIHI) database, formed the study cohort. The CIHI dataset was used to obtain information regarding in-hospital complications, hospital length of stay, revision rates, infection rates and mortality. Generalized estimating linear or logistic regression equations were used to model outcomes as a function of age, gender, comorbidity, diagnosis and provider volume. RESULTS: During the study period, 14,352 patients in Ontario underwent TKA. Mortality at 3 months was associated with patient age, gender and comorbidity. There was no association between provider volume and mortality or the infection rate. Higher revision rates at 1 and 3 years were significantly associated with lower patient age and low hospital volume (p < 0.05). Hospitals in which fewer than 48 TKA procedures were done per year (< 40th percentile) had 2.2-fold greater 1-year revision rates than hospitals performing more than 113 TKAs annually (> 80th percentile). Complications during admission were associated with increased patient age and comorbidity, and higher hospital volume. Longer hospital stay was associated with female gender, increasing patient comorbidity and age, and lower provider volume. Surgeons who performed fewer than 14 TKAs annually (< 40th percentile) kept patients in hospital an average of 1.4 days longer than surgeons performing more than 42 TKAs annually (> 80th percentile). CONCLUSIONS: Patient variables significantly affect the rate of complications. Age, sex and comorbidity were significant predictors of complications, length of hospital stay and mortality after TKA. Although low surgeon volume was related to longer hospital stay, there was no association between surgeon volume and complication rates. The increased early revision rate for low-volume hospitals demands further study. 相似文献
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Pulmonary arterial hypertension (PAH) is a life-threatening disease of varied etiologies. Although PAH has no curative treatment, a greater understanding of pathophysiology, technological advances resulting in early diagnosis, and the availability of several newer drugs have improved the outlook for patients with PAH. Sildenafil is one of the therapeutic agents used extensively in the treatment of PAH in children, as an off-label drug. In 2012, the United States Food and Drug Administration (USFDA) issued a warning regarding the of use high-dose sildenafil in children with PAH. This has led to a peculiar situation where there is a paucity of approved therapies for the management of PAH in children and the use of the most extensively used drug being discouraged by the regulator. This article provides a review of the use of sildenafil in the treatment of PAH in children.KEY WORDS: Child, phosphodiesterase (PDE)-5 inhibitor, Pulmonary hypertension therapy 相似文献