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Introduction

In the phase II/III KEYNOTE-010 study (ClinicalTrials.gov, NCT01905657), pembrolizumab significantly prolonged overall survival over docetaxel in patients with previously treated, programmed death ligand 1–expressing (tumor proportion score ≥ 1%), advanced NSCLC. Health-related quality of life (HRQoL) results are reported here.

Methods

Patients were randomized 1:1:1 to pembrolizumab 2 or 10 mg/kg every 3 weeks or docetaxel 75 mg/m2 every 3 weeks. HRQoL was assessed using European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLC) Core 30 (C30), EORTC QLQ–Lung Cancer 13 (LC13), and EuroQoL-5D. Key analyses included mean baseline-to-week-12 change in global health status (GHS)/quality of life (QoL) score, functioning and symptom domains, and time to deterioration in a QLQ-LC13 composite endpoint of cough, dyspnea, and chest pain.

Results

Patient reported outcomes compliance was high across all three instruments. Pembrolizumab was associated with better QLQ-C30 GHS/QoL scores from baseline to 12 weeks than docetaxel, regardless of pembrolizumab dose or tumor proportion score status (not significant). Compared with docetaxel, fewer pembrolizumab-treated patients had “deteriorated” status and more had “improved” status in GHS/QoL. Nominally significant improvement was reported in many EORTC symptom domains with pembrolizumab, and nominally significant worsening was reported with docetaxel. Significant prolongation in true time to deterioration for the QLQ-LC13 composite endpoint emerged for pembrolizumab 10 mg/kg compared to docetaxel (nominal two-sided p = 0.03), but not for the 2-mg/kg dose.

Conclusions

These findings suggest that HRQoL and symptoms are maintained or improved to a greater degree with pembrolizumab than with docetaxel in this NSCLC patient population.  相似文献   
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目的 探讨γ干扰素诱导蛋白30(IFI 30)、程序性死亡因子配体1(PD-L1)在人脑胶质瘤中的表达及与病人预后的关系。方法 选择2015年5月~2019年5月手术切除的103例人脑胶质瘤组织和瘤旁组织,采用免疫组织化学染色检测IFI 30、PD-L1表达情况。随访24个月,记录无进展生存期和总生存期。结果 胶质瘤组织IFI 30、PD-L1高表达率[分别为70.87%(73/103)、68.93%(71/103)]明显高于瘤旁组织[分别为19.42%(20/103)、21.36%(22/103);P<0.001]。胶质瘤组织IFI 30表达水平与PD-L1表达水平呈明显正相关(r=0.583,P<0.05)。随访24个月,生存75例,死亡28例;多因素logistic回归分析显示,IFI 30高表达、PD-L1高表达是增加病人死亡风险的独立危险因素(P<0.05)。生存曲线分析显示,IFI 30高表达组2年累积生存率(64.52%)和2年累积无进展生存率(65.56%)均明显低于低表达组(分别为82.25%、89.45%;P<0.05)。PD-L1高表达组2年累积生存率(61.78%)和2年累积无进展生存率(60.14%)均明显低于低表达组(分别为88.52%、79.86%;P<0.05)。结论 人脑胶质瘤组织IFI 30、PD-L1呈高表达,与病人不良预后密切相关。  相似文献   
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IntroductionAlthough peak C-reactive protein (CRP) levels are correlated with the prognosis of some diseases, there have been no reports regarding the association between peak CRP levels and mortality in patients with bacteremia. The present study aimed to determine the association between peak CRP levels and prognosis in patients with bacteremia.MethodsThis retrospective cohort study was conducted in a single tertiary hospital and included patients with bacteremia admitted to the emergency department from November 2012 to March 2017. Cox regression analysis was performed to examine the association between peak CRP levels and 30-day mortality. We also performed propensity score adjustment using potential confounding factors.ResultsOne hundred fifty-nine patients were included in the study. Peak CRP levels were significantly higher in the β-hemolytic streptococci (P = 0.001) and Streptococcus pneumoniae (P = 0.003) groups. The C-statistic of the multivariate logistic regression model for the propensity score was 0.88. For 30-day mortality, peak CRP levels >20 mg/dL did not show significance in the Cox regression analysis (hazard ratio, 0.866; 95% confidence interval, 0.489–1.537; P = 0.62). Even after propensity score adjustment, no significance was noted (hazard ratio, 0.865; 95% confidence interval, 0.399–1.876; P = 0.71).ConclusionsPeak CRP levels were not an independent predictor of mortality in patients with bacteremia in the emergency department. Clinicians should consider that patients with extremely high peak CRP levels do not necessarily have high mortality and vice versa.  相似文献   
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仙草消毒液为含 3 0 %乙醇的植物消毒剂 ,其中包括五味子、细辛、丁香等成分 ,p H6.0 1。为了解其杀灭微生物效果及其毒性 ,进行了载体定量杀菌试验及毒性试验。结果 ,1∶ 1的水稀释液对金黄色葡萄球菌作用2分钟 ,1∶ 2的稀释液对金黄色葡萄球菌作用 8分钟 ,以其原液对白色念珠菌作用 2 min,平均杀灭率均大于99.90 %。小牛血清对其杀灭效果有影响 ,原液经 5 4℃存放 14天 ,杀菌效果无明显变化。以其原液对雌、雄小鼠经口 LD50 >5 0 0 0 mg/Kg,对大耳白兔一次眼、皮肤刺激试验平均积分指数为 0 ,微核试验阴性 ,蓄积毒性试验为弱蓄积毒性  相似文献   
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The CD30 is a surface molecule expressed by Th2-type lymphokine-producing T cells upon activation. CD30-expressing activated T cells release a soluble form of the molecule, which can be detectable both in vitro and in vivo. In the present study, high levels of soluble CD30 were found in peripheral blood and synovial fluid from patients with RA. However, CD30+ CD3+ cells, either CD4+ or CD8+, were significantly present in synovial fluid, but not in peripheral blood, of RA patients. Serum values of soluble CD30 were higher in active than inactive RA patients and directly correlated with rheumatoid factor serum titres. These data strongly support an involvement of CD30+ T cells in the immune processes of rheumatoid synovitis, and may suggest a relationship between Th2-type cytokine-secreting T cells and the pathological response in RA.  相似文献   
9.
鼻息肉上皮细胞凋亡与bcl-2的表达及意义   总被引:4,自引:0,他引:4  
梁传余  田爱民 《四川医学》2003,24(12):1214-1216
目的 了解细胞的凋亡和癌基因bcl 2在鼻息肉的发病机制中的作用。方法 应用免疫组织化学的方法检测 45例鼻息肉细胞凋亡早期蛋白 (M3 0 )和bcl 2的表达 ,用下鼻甲粘膜作自身对照。结果 鼻息肉上皮和下鼻甲粘膜上皮的M3 0指数分别为 0 482± 0 3 2 ;1 0 62± 0 5 47,其差别有统计学意义 (P <0 0 1)。bcl 2阳性细胞在鼻息肉表层上皮和腺上皮均有表达 ,在下鼻甲中未见表达 ,其指数为 14 5 1± 4 46。结论 鼻息肉的发病机制及其生长过程与上皮细胞的增殖和凋亡的失平衡有关。bcl 2的表达可能是鼻息肉上皮凋亡抑制的原因 ,在鼻息肉上皮细胞增殖和凋亡失平衡的过程中起重要作用  相似文献   
10.
Soluble CD30 in pediatric patients with atopic dermatitis   总被引:9,自引:1,他引:8  
Atopic dermatitis (AD) is a chronic, inflammatory skin disease in which a pathogenetic role of Th2 cells has been supposed. This study investigated the presence of soluble CD30 (sCD30), an activation marker of T-cell clones able to produce Th2-type cytokines, in sera from pediatric patients affected by AD ( n =25) with no symptoms of asthma or rhinitis. The severity of the disease was graded by both the SCORAD and Costa et al. clinical scoring systems. Serum levels of sCD30 were significantly higher in patients with AD in respect to both normal donors ( n =20) and urticaria patients ( n = 10), and a positive correlation between serum sCD30 and clinical score was found ( r =0.508; P =0.01) when AD patients were evaluated by Costa et al.'s method. Furthermore, a significant association ( r -=0.443; P =0.027) between sCD30 and serum levels of the soluble interleukin (IL)-2 receptor (sIL-2R) was observed in AD. The presence of high amounts of sCD30 in atopic patients seems to confirm the role of this molecule as an activation marker useful for in vivo evaluation of a Th2 immune response, and the correlation observed with both clinical score and sIL-2R levels indicates the role of sCD30 as an additional marker of disease activity in pediatric patients with AD.  相似文献   
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