Medicine
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Multicenter Study
Predictive impact of clinical factors on chemosensitivity in advanced high-grade serous ovarian carcinoma according to chemotherapy response score.
The use of neoadjuvant chemotherapy (NAC) as a first-line therapy for advanced high-grade serous ovarian carcinoma (HGSOC) has increased. However, several studies have reported NAC-induced platinum resistance. This study aimed to evaluate the predictive impact of clinical factors on chemotherapy response score (CRS) and to select patients who would respond well to NAC. ⋯ Germline breast cancer susceptibility gene 1/2 mutation was a predictor of CRS3 and a good prognostic factor for the survival rate. Simultaneous metastasis to distant lymph nodes and solid organs is a predictor of CRS1. CRS inversely correlated with PFS and overall survival.
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Inflammatory bowel disease (IBD), encompassing Crohn disease and ulcerative colitis, is a group of persistent and recurrent gastrointestinal disorders. Despite the prevalence of these conditions, no studies have been conducted to examine the connection between altered human blood cell phenotypes and the underlying mechanisms of IBD pathogenesis. By utilizing summary statistics from genome-wide association studies, we executed a systematic two-sample Mendelian randomization (MR) investigation on 91 genetically determined blood cell perturbation traits in relation to 3 separate IBD phenotypes. ⋯ The forward MR analysis identified 7 human blood cell perturbation phenotypes associated with various IBD outcomes, while the reverse MR analysis revealed that 9 human blood cell perturbation phenotypes were influenced by various IBD phenotypes. The study has uncovered human blood cell perturbation phenotypes associated with various IBD diseases, contributing to a deeper understanding of the pathogenesis of IBD. It also provides new insights for early clinical diagnosis, disease activity monitoring, immune surveillance, prognosis assessment, and personalized treatment.
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Gastric cancer (GC) is one of the most prevalent malignant tumors in the world and has an extremely poor prognosis. Regulator of calcineurin 1 (RCAN1), a known tumor suppressor in various cancers, has an undefined role in the proliferation and metastasis of GC. Primary tumor and paired normal gastric tissues were collected from 77 patients with GC for evaluating the mRNA levels of 3 RCAN1 transcripts. ⋯ Downregulated expression of RCAN1.4 was found to be an independent prognostic factor of overall survival in GC patients, with a hazard ratio of 2.485 and a significant P-value of .023 in multivariate Cox analysis. The concordance index of nomogram to predict overall survival was 0.788, based on RCAN1.4 level, tumor stage and lymph node metastasis status. In conclusion, our findings suggest that RCAN1.4 is a novel prognostic marker for gastric cancer, targeting RCAN1.4 may provide a promising therapeutic strategy in GC management.
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Stanford type B aortic dissection involving the left subclavian artery (LSA) poses significant clinical challenges. The Castor single-branch stent graft and in situ fenestration are commonly used techniques, but the better endovascular treatment remains debated. This study evaluates the clinical effects of the Castor single-branched stent graft versus in situ fenestration in treating Stanford type B aortic dissection involving the LSA. ⋯ Follow-up showed similar 30-day postoperative mortality (1/41 vs 0/34, P = 1.00), stent patency (33/34 vs 39/41, P = .67), and stent migration rates (0/34 vs 1/41, P = 1.00). However, the endoleak rate was significantly higher in the in situ fenestration group (11/41 vs 1/34, P = .01). Both the Castor single-branch stent graft and the in situ fenestration technique effectively protect and reconstruct the LSA in Stanford type B aortic dissection, with the Castor single-branch stent graft showing higher technical success and fewer complications, indicating better clinical potential.
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Comparative Study
Comparison of clinical outcomes between conventional and underwater endoscopic mucosal resection for duodenal neuroendocrine tumors.
Duodenal neuroendocrine tumors are relatively rare subepithelial tumors that arise from cells of the neuroendocrine system. Small duodenal neuroendocrine tumors can be treated endoscopically because of their low potential for metastasis. This study aimed to evaluate the clinical outcomes of conventional and underwater endoscopic mucosal resection for duodenal neuroendocrine tumors. ⋯ The median follow-up period was 39.5 months (interquartile range: 19.5-57.3 months). There was no local recurrence or distant metastasis during the follow-up period. Underwater endoscopic mucosal resection is a safe and effective treatment option for small duodenal neuroendocrine tumors and is the preferred treatment option for flat-type duodenal neuroendocrine tumors.