Medicine
-
The human epidermal growth factor receptor 2 (HER2) is amplified in approximately 20% of breast cancers, and HER2 receptor targeting therapy is associated with a significant improvement in disease-free and overall survival. In several clinical trials, the pathologic complete response (pCR) rate was significantly increased with combined pertuzumab and trastuzumab treatment in HER2-amplified breast cancer. Although the efficacy and safety of anti-HER2 dual blockade therapy has been reported, the markers that predict the response are still unclear. ⋯ The patients who experienced a pCR had a median HER2/CEP17 ratio of 7.08 (range, 3.16-10.40) and average HER2 copy number of 17.00 (range, 5.85-37.50). The patients who did not experience a pCR had a median ratio of 4.70 (range, 1.06-9.00) and median HER2 copy number of 12.00 (range, 5.85-20.95) (P = .030, P = .174), respectively.pCR was highly correlated with HER2/CEP17 ratio in neoadjuvant anti-HER2 dual blockade. This suggests that the HER2/CEP17 ratio can be used as a predictive marker for pCR in neoadjuvant trastuzumab and pertuzumab therapy.
-
Epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKIs) have become the preferred therapy as first-line treatment of non-small cell lung cancer patients harboring sensitizing EGFR mutations. However, the prognostic indicators are limited. The present study aimed to assess the prognostic value of immune-inflammation factors, fibrinogen-albumin ratio index (FARI), neutrophil to lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR) in EGFR-Mutant lung adenocarcinoma patients receiving first-generation EGFR-TKIs treatment.194 patients were included in this retrospective analysis. ⋯ In multivariate analysis, PLR (hazard ratios [HR] 1.692; 95% CI 1.054-2.715; P = .029) and FARI (HR 1.496; 95% CI 1.031-2.172; P = .034) were independent prognostic factors for PFS. While only ECOG PS status (HR 2.052; 95% CI 1.272-3.310; P = .003) was independently correlated with OS. FARI is independently associated with PFS in EGFR-Mutant lung adenocarcinoma patients receiving first-line EGFR-TKIs treatment.
-
To investigate the frequency and degree of azole antifungal agents that influence the anticoagulant activity of warfarin to reduce the potential bleeding risk and provide a reference for rational administration of warfarin in clinics. Patients with an abnormal international normalized ratio (INR; INR ≥ 4.5) and treated with warfarin plus azole antifungal agents were screened from February 2011 to July 2016, and their data were extracted. Thirty-two patients treated with warfarin plus azole antifungal agents were included. ⋯ The combination of FLCZ and voriconazole will enhance the anticoagulant effect of warfarin. Therefore, it is recommended to detect the genotype of CYP2C9 in patients and evaluate the interaction between the 2 drugs to adjust the warfarin dose. It is also recommended to closely monitor INR within 1 week of the addition of azole antifungal agents.
-
This study compared implant outcomes following maxillary sinus floor augmentation (MSFA) in edentulous patients with a residual alveolar bone height ≤3 mm. Four techniques were evaluated: 1-stage bone-added osteotome sinus floor elevation procedure (BAOSFE) with simultaneous implant placement; 2-stage BAOSFE with delayed implant placement; 1-stage lateral window sinus floor elevation with simultaneous implant placement; and 2-stage lateral window sinus floor elevation with delayed implant placement. Patients were followed for 18 to 72 months (mean: 52.5 months) after prosthesis placement. ⋯ However, the bone height gain of 1st sinus lifting with 2-stage BAOSFE was significantly lower than the 2-stage lateral window procedure (P < .01). There was no prosthesis failure. The favorable implant outcomes suggest these 1-stage and 2-stage MSFA procedures should be considered as alternative treatment options for patients with extremely atrophic posterior maxilla.
-
By observing and analyzing the success rate of Tai'an City central hospital TOLAC and VBNC and various indicators after delivery, we make sure whether TOLAC is safe and feasible to be promoted in Tai'an area. Between January and December 2017, data of 144 cases undergoing TOLAC, 152 cases undergoing VBNC, 152 cases undergoing RCS and 142 case undergoing PCS in Tai'an City Central Hospital were retrospectively analyzed. The success rate of vaginal delivery, labor time, 24 hours postpartum hemorrhage, hospital stay, Apgar score of newborns and puerperal morbidity were observed. ⋯ There were statistically significant differences in amount of 24 hours postpartum hemorrhage (P < .001), hospital stay (P < .001) and puerperal morbidity (P = .018), but no difference in Apgar score of newborns (P = .228) between the VBAC group and RCS group. There were significant differences in operation time (P = .011), amount of 24 hours hemorrhage (P = .001), hospital stay (P = .001) and puerperal morbidity (P = .041), but no significant difference in Apgar score of newborns (P = .300) between the RCS and PCS groups. The TOLAC is as safe and feasible as VBNC, and more favorable to the safety of mother and fetus than RCS in Tai'an area.