Medicine
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Apatinib (Jiangsu HengRui Medicine Co. Ltd), a vascular endothelial growth factor receptor 2 (VEGFR-2) tyrosine kinase inhibitor, has been proven to be safe and to significantly prolong survival in advanced chemotherapy-refractory gastric cancer. This study aimed to assess and compare the efficacy and safety of apatinib combined with chemotherapy with that of chemotherapy alone as second- or higher-line treatment in patients with advanced and metastatic gastric or those with metastatic gastroesophageal junction adenocarcinoma (mGC). ⋯ Moreover, the incidence of Grade 3 to 4 hand-foot syndrome, proteinuria, and hypertension was significantly different between the 2 groups. Combined therapy (P = .040) and metastatic sites <2 (P = .008) were the independent prognostic factors for disease progression. Compared with chemotherapy alone, the addition of apatinib to chemotherapy could better improve PFS and DCR with an acceptable safety profile for mGC refractory to 1 or more line of prior chemotherapy.
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Hepatocellular carcinoma (HCC) is one of the most prevalent cancers worldwide. However, the precise mechanisms of the development and progression of HCC remain unclear. The present study attempted to identify and functionally analyze the differentially expressed genes between HCC and cirrhotic tissues by using comprehensive bioinformatics analyses. ⋯ The present study identified a series of key genes and pathways that may be involved in the tumorigenicity and progression of HCC, providing a new understanding of the underlying molecular mechanisms of carcinogenesis in HCC.
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Observational Study
High preoperative C-reactive protein level is a risk factor for acute exacerbation of interstitial lung disease after non-pulmonary surgery.
Several studies have investigated the incidence of and risk factors for acute exacerbation (AE) in patients with interstitial lung disease (ILD) after lung resection surgery. However, the incidence and risk factors for AE-ILD after non-pulmonary surgery are not known. The aim of this study was to investigate the incidence of and risk factors for AE-ILD after non-pulmonary surgery. ⋯ In multivariate analysis, only a high CRP level (odds ratio 2.556, 95% confidence interval 1.110-5.889, P = .028) was identified as an independent risk factor for AE-ILD after non-pulmonary surgery. The risk of AE-ILD should be kept in mind in patients with ILD and a high CRP level before non-pulmonary surgery. These patients should also be monitored carefully for development of AE-ILD after surgery.
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The aim of this study was to investigate the relationships between uterine size and volume and clinical pregnancy rate. This longitudinal study was conducted among patients undergoing assisted reproduction technology (ART) treatment at the Reproductive Medicine Center from January 2010 to May 2017, all of whom provided informed consent to participate in the study. The uterine size, for all patients, was measured by transvaginal ultrasonography before ovarian stimulation. ⋯ Compared with those with a uterine volume of 30 to 49 mL (referent), patients with a uterine volume ≥70 mL had a lower clinical pregnancy rate. The patients with an optimal uterine length, width, anteroposterior diameter, and volume had a higher clinical pregnancy rate than those with suboptimal uterine measurements. Uterine sizes and volumes that were too large reduced the clinical pregnancy rate.
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Case Reports
PICC insertion in the sitting position for a patient with congestive heart failure: A case report.
A peripherally inserted central catheter (PICC) is typically inserted with the patient in the supine position. Here, we placed a PICC in a patient in the sitting position, in order to treat congestive heart failure. ⋯ The technique of inserting a PICC in the sitting position is simple and feasible. This approach may be useful for patients in whom central venous access is needed, but the supine position cannot be achieved.