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1帕博利珠单抗(pembrolizumab)与化疗治疗微卫星不稳定性高/错配修复缺陷型转移性结直肠癌的比较:KEYNOTE-177的3期研究显示文摘背景:KEYNOTE-177 (NCT02563002)是一项3期随机、开放标签的临床研究,评估了帕博利珠单抗与标准化疗±贝伐珠单抗或西妥昔单抗作为微卫星不稳定性高/错配修复缺陷(MSI-H/d MMR)型转移性结直肠癌患者一线治疗的效果和安全性。本次公布了终期PFS分析的结果。方法:共有307名由当地医疗机构评判的MSI-H/d MMR且ECOG PS评分为0或1的转移性结直肠癌患者按1:1比例随机分组接受治疗,治疗方案为一线帕博利珠单抗(200 mg,Q3W,最长治疗时限为2年),或为研究者所选择的化疗方案,包括m FOLFOX6或FOLFIRI Q2W±贝伐珠单抗或西妥昔单抗(随机选择化疗方案)。治疗终止于出现PD、无法耐受的毒性、患者/研究者决定退出治疗或完成35个周期治疗(仅对于帕博利珠单抗而言)。确诊PD后,接受化疗组患者可转入帕博利珠单抗组并接受最长为35个周期的治疗。主要终点是PFS (RECIST v1.1,中心审查)和OS。主要的次要终点包括ORR (RECIST v1.1,中心审查)和安全性。该中期分析的数据截止日期是2020年2月19日。该研究仍将继续随访评估OS。结果:截止数据纳入时,153名患者被随机分至帕博利珠单抗组,154名患者被随机分至化疗组。帕博利珠单抗组的中位随访为28.4个月(0.2~48.3个月),化疗组为27.2个月(0.8~46.6个月)。帕博利珠单抗组PFS优于化疗组(中位时间16.5个月vs. 8.2个月;HR=0.60,95%CI:0.45~0.80,P=0.0002)。帕博利珠单抗组的12个月和24个月PFS率分别为55.3%和48.3%,化疗组则相应分别为37.3%和18.6%。帕博利珠单抗组与化疗组经确认的ORR分别为43.8%与33.1%;帕博利珠单抗组与化疗组中位持续反应时间分别为未达到(2.3+~41.4+个月)和10.6个月(2.8~37.5+个月)。帕博利珠单抗组3~5级与治疗相关的不良事件(AE)发生率为22%,化疗组为66%。化疗组中有1例患者因治疗相关的AE死亡。结论:与化疗相比,帕博利珠单抗作为MSI-H/d MMR型转移性结直肠癌的一线治疗可提供具有临床意义和统计学意义的PFS获益,同时观察到较少的与治疗相关的AE,应该成为这类患者的新的标准治疗方案。陈功 ANDRé T SHIU K K KIM T W 2020结直肠肛门外科2020,26,6:15
2Post-infectious irritable bowel syndrome:Mechanistic insights into chronic disturbances following enteric infection显示文摘Irritable bowel syndrome(IBS)is a commonly encountered chronic functional gastrointestinal(GI)disorder.Approximately 10%of IBS patients can trace the onset of their symptoms to a previous a bout of infectious dysentery.The appearance of new IBS symptoms following an infectious event is defined as post-infectiousIBS.Indeed,with the World Health Organization estimating between 2 and 4 billion cases annually,infectious diarrheal disease represents an incredible international healthcare burden.Additionally,compounding evidence suggests many commonly encountered enteropathogens as unique triggers behind IBS symptom generation and underlying pathophysiological features.A growing body of work provides evidence supporting a role for pathogen-mediated modifications in the resident intestinal microbiota,epithelial barrier integrity,effector cell functions,and innate and adaptive immune features,all proposed physiological manifestations that can underlie GI abnormalities in IBS.Enteric pathogens must employ a vast array of machinery to evade host protective immune mechanisms,and illicit successful infections.Consequently,the impact of infectious events on host physiology can be multidimensional in terms of anatomical location,functional scope,and duration.This review offers a unique discussion of the mechanisms employed by many commonly encountered enteric pathogens that cause acute disease,but may also lead to the establishment of chronic GI dysfunction compatible with IBS.Jennifer K Beatty Amol Bhargava Andre G Buret 2014World Journal of Gastroenterology2014,20,14:12
3Effect of technical parameters on transjugular intrahepatic portosystemic shunts utilizing stent grafts显示文摘AIM: To assess the effect of technical parameters on outcomes of transjugular intrahepatic portosystemic shunt(TIPS) created using a stent graft.METHODS: The medical records of 68 patients who underwent TIPS placement with a stent graft from 2008 to 2014 were reviewed by two radiologists blinded to the patient outcomes.Digital Subtraction Angiographic images with a measuring catheter in two orthogonal planes was used to determine the TIPS stent-to-inferior vena cava distance(SIVCD),hepatic vein to parenchymal tract angle(HVTA),portal vein to parenchymal tract angle(PVTA),and the accessed portal vein.The length and diameter of the TIPS stent and the use of concurrent variceal embolization were recorded by review of the patient's procedure note.Data on re-intervention within 30 d of TIPS placement,recurrence of symptoms,and survival were collected through the patient's chart.Cox proportional regression analysis was performed to assess the effect of these technical parameters on primary patency of TIPS,time to recurrence of symptoms,and all-cause mortality.RESULTS: There was no significant associationbetween the SIVCD and primary patency(P = 0.23),time to recurrence of symptoms(P = 0.83),or allcause mortality(P = 0.18).The 3,6,and 12-mo primary patency rates for a SIVCD ≥ 1.5 cm were 82.4%,64.7%,and 50.3% compared to 89.3%,83.8%,and 60.6% for a SIVCD of < 1.5 cm(P = 0.29).The median time to stenosis for a SIVCD of ≥ 1.5 cm was 19.1 mo vs 15.1 mo for a SIVCD of < 1.5 cm(P = 0.48).There was no significant association between the following factors and primary patency: HVTA(P = 0.99),PVTA(P = 0.65),accessed portal vein(P = 0.35),TIPS stent diameter(P = 0.93),TIPS stent length(P = 0.48),concurrent variceal embolization(P = 0.13) and reinterventions within 30 d(P = 0.24).Furthermore,there was no correlation between these technical parameters and time to recurrence of symptoms or all-cause mortality.Recurrence of symptoms was associated with stent graft stenosis(P = 0.03).CONCLUSION: TIPS stent-to-caval distance and other parameters have no significant effect on primary patency,time to recurrence of symptoms,or all-cause mortality following TIPS with a stent-graft.Brice Andring Sanjeeva P Kalva Patrick Sutphin Rajiv Srinivasa Alvin Anene Marc Burrell Yin Xi Anil K Pillai 2015World Journal of Gastroenterology2015,21,26:7
4Irritable bowel syndrome subtypes differ in body awareness, psychological symptoms and biochemical stress markers显示文摘AIM: To elucidate the differences in somatic, psycho-logical and biochemical pattern between the subtypes of irritable bowel syndrome (IBS). METHODS: Eighty IBS patients, 30 diarrhoea pre-dominant (D-IBS), 16 constipation predominant (C-IBS) and 34 alternating IBS (A-IBS) underwent physi-otherapeutic examinations for dysfunctions in body movements and awareness and were compared to an apparently healthy control group (AHC). All groups an-swered questionnaires for gastrointestinal and psycho-logical symptoms. Biochemical variables were analysed in blood. RESULTS: The D-IBS group showed less body aware-ness, less psychological symptoms, a more normal sense of coherence and psychosocial rating as well as higher C-peptide values. C-IBS had a higher degree of body dysfunction and psychological symptoms, as well as the lowest sense of coherence compared to controls and D-IBS. They also demonstrated the most elevated prolactin levels. A-IBS had the lowest degree of body disturbance, deteriorated quality of life and affected bi-ochemical pattern. All subtypes had higher pain scores compared to controls. In addition they all had signifi -cantly increased triglycerides and elevated morning cortisol levels, however, without statistical signifi cance compared with the controls.CONCLUSION: IBS subtypes showed different pro-files in body awareness, somatic and psychological symptoms and in biochemical variables. D-IBS differed compared to the other groups by lowered body aware-ness, less psychological symptoms and a higher sense of coherence and elevated C-peptide values. C-IBS and A-IBS subtypes suffered more from depression and anxiety, associated with a lower quality of life. These differences may be important and will be taken into account in our treatment of these patients.Elsa M Eriksson Kristina I Andrén Henry T Eriksson Gran K Kurlberg 2008World Journal of Gastroenterology2008,14,31:7
5Feasibility study of computed vs measured high b-value(1400 s/mm2) diffusion-weighted MR images of the prostate显示文摘AIM: To evaluate the impact of computed b = 1400 s/mm2(C-b1400) vs measured b = 1400 s/mm2(M-b1400) diffusion-weighted images(DWI) on lesion detection rate, image quality and quality of lesion demarcation using a modern 3T-MR system based on a small-field-of-view sequence(sFOV). METHODS: Thirty patients(PSA: 9.5 ± 8.7 ng/mL; 68 ± 12 years) referred for magnetic resonance imaging(MRI) of the prostate were enrolled in this study. All measurements were performed on a 3T MR system.For DWI, a single-shot EPI diffusion sequence(b = 0, 100, 400, 800 s/mm2) was utilized. C-b1400 was cal-culated voxelwise from the ADC and diffusion images. Additionally, M-b1400 was acquired for evaluation and comparison. Lesion detection rate and maximum lesion diameters were obtained and compared. Image quality and quality of lesion demarcation were rated accord-ing to a 5-point Likert-type scale. Ratios of lesion-to-bladder as well as prostate-to-bladder signal intensity(SI) were calculated to estimate the signal-to-noise-ratio(SNR). RESULTS: Twenty-four lesions were detected on M-b1400 images and compared to C-b1400 images. C-b1400 detected three additional cancer suspicious lesions. Overall image quality was rated significantly better and SI ratios were significantly higher on C-b1400(2.3 ± 0.8 vs 3.1 ± 1.0, P < 0.001; 5.6 ± 1.8 vs 2.8 ± 0.9, P < 0.001). Comparison of lesion size showed no significant differences between C- and M-b1400(P = 0.22). CONCLUSION: Combination of a high b-value extrap-olation and sFOV may contribute to increase diagnostic accuracy of DWI without an increase of acquisition time, which may be useful to guide targeted prostate biopsies and to improve quality of multiparametric MRI(mMRI) especially under economical aspects in a pri-vate practice setting.Leonardo K Bittencourt Ulrike I Attenberger Daniel Lima Ralph Strecker Andre de Oliveira Stefan O Schoenberg Emerson L Gasparetto Daniel Hausmann 2014World Journal of Radiology2014,6,6:5
6Epidemiologic characteristics of Helicobacter pylori infection in southeast Hungary显示文摘BACKGROUND Epidemiologic studies have revealed a decrease in the prevalence of Helicobacter pylori(H.pylori)infection in Western Europe.AIM To obtain data regarding the prevalence of H.pylori in Csongrád and Békés Counties in Hungary,evaluate the differences in its prevalence between urban and rural areas,and establish factors associated with positive seroprevalence.METHODS One-thousand and one healthy blood donors[male/female:501/500,mean age:40(19–65)years]were enrolled in this study.Subjects were tested for H.pylori IgG antibody positivity via enzyme-linked immunosorbent assay.Subgroup analysis by age,gender,smoking habits,alcohol consumption,and urban vs nonurban residence was also performed.RESULTS The overall seropositivity of H.pylori was 32%.It was higher in males(34.93%vs 29.2%,P=0.0521)and in rural areas(36.2%vs 27.94%,P=0.0051).Agricultural/industrial workers were more likely to be positive for infection than office workers(38.35%vs 30.11%,P=0.0095)and rural subjects in Békés County than those in Csongrád County(43.36%vs 33.33%,P=0.0015).CONCLUSION Although the prevalence of H.pylori infection decreased in recent decades in Southeast Hungary,it remains high in middle-aged rural populations.Generally accepted risk factors for H.pylori positivity appeared to be valid for the studied population.Lenke Bálint Andrea Tiszai Gábor Kozák Ilona Dóczi Veronika Szekeres Orsolya Inczefi Georgina Ollé Krisztina Helle Richárd Róka András Rosztóczy 2019World Journal of Gastroenterology2019,25,42:5
7Correlation between water diffusion and adhesion loss: Study of an epoxy primer on steel显示文摘Elise Legghe Emmanuel Aragon Léna?k Bélec André Margaillan Denis Melot 2009Progress in Organic Coatings2009,,3:2
8Phytoplankton functional groups as indicators of human impacts along the River Loire (France)显示文摘András Abonyi Maria Leit?o Anne Marie Lan?on Judit Padisák 2012Hydrobiologia2012,,1:2
9Relationship between diabetes mellitus and cataract in Hungary显示文摘AIM:To examine the coexistence of diabetes mellitus(DM)and cataract in Hungary.The effects of DM on the cataract surgical results were also in the focus of analysis.METHODS:Statistical data analysis of the results of the Rapid Assessment of Avoidable Blindness with Diabetic Retinopathy(RAAB+DR)module conducted in Hungary in 2015.This cross-sectional,population-based,national survey included 3523 people aged 50 years and over.Participants of the survey were examined on-site.Visual acuity,main cause for visual impairment(using direct and indirect ophthalmoscopes),in case of best corrected visual acuity(BCVA)≤0.5 and blood glucose level(random test with glucometer)were examined.RESULTS:The prevalence of cataract was 23.4%,and DM was 20.0%.The occurrence of cataract steadily increased with age.Among the examined participants with DM,the prevalence of cataract was significantly(P=0.012)higher(+35%)than that in non-diabetic subjects(29.5%vs 21.8%).Following aging(OR=15.2%,P<0.001),DM proved to be the most independent influencing risk factor(OR=49.9%,P<0.001).The presence of DM was neither an influencing factor for complications of cataract surgery,nor for postoperative visual acuity.CONCLUSION:DM appears to be one of the main risk factors for developing cataract.Other risk factors,such as age,sex and environment also play an influencing role.Diabetes does not seem to affect the occurrence of cataract surgical complications.Anita Pék Dorottya Szabó Gábor LászlóSándor Gábor Tóth András Papp Zoltán Zsolt Nagy Hans Limburg János Németh 2020International Journal of Ophthalmology(English edition)2020,13,5:2
10Splenic and portal venous obstruction in chronic pancreatitis显示文摘Pr. Pierre Bernades André Baetz Philippe Lévy Jacques Belghiti Yves Menu Fran?ois Fékété 1992Digestive Diseases and Sciences1992,,3:2
11Bone marrow cells produce nerve growth factor and promote angiogenesis around transplanted islets显示文摘AIM:To clarify the mechanism by which bone marrow cells promote angiogenesis around transplanted islets.METHODS: Streptozotocin induced diabetic BALB/ c mice were transplanted syngeneically under the kidney capsule with the following: (1) 200 islets (islet group: n=12), (2) 1-5×106 bone marrow cells (bone marrow group: n=11), (3) 200 islets and 1-5×106 bone marrow cells (islet + bone marrow group: n= 13), or (4) no cells (sham group:n=5). All mice were evaluated for blood glucose, serum insulin, serum nervegrowth factor (NGF) and glucose tolerance (GTT) up to postoperative day (POD) 14. Histological assessment for insulin, von Willebrand factor (vWF) and NGF was performed at POD 3, 7 and 14.RESULTS: Blood glucose level was lowest and serum insulin was highest in the islet + bone marrow group. Serum NGF increased in islet, bone marrow, and islet + bone marrow groups after transplantation, and there was a significant difference (P=0.0496, ANOVA) between the bone marrow and sham groups. The number of vessels within the graft area was signif icantly increased in both the bone marrow and islet + bone marrow groups at POD 14 as compared to the islet alone group (21.2 ± 3.6 in bone marrow, P=0.01, vs islet group, 22.6 ± 1.9 in islet + bone marrow, P = 0.0003, vs islet group, 5.3 ± 1.6 in islet-alone transplants). NGF was more strongly expressed in bone marrow cells compared with islets. CONCLUSION: Bone marrow cells produce NGF and promote angiogenesis. Islet co-transplantation with bone marrow is associated with improvement of islet graft function.Naoaki Sakata Nathaniel K Chan John Chrisler Andre Obenaus Eba Hathout 2010World Journal of Gastroenterology2010,16,10:2
12A new and rapid colorimetric determination of aeetylcholin esterase activity显示文摘Ellman G L Kiane C K Andres V 1961Biochem Pharmacoogyl1961,,7:1
13Update of nutrient-deficiency ane- mia in elderly patients 显示文摘Andres E Federici L Serraj K 2008Eur J Intern Med2008,19,7:1
14Transcription of the gene coding for subunit 9 of ATP synthase in rice mitochondria 显示文摘Kaleikau E K Andre C P Walbot V 1993Plant Mol Biol1993,22,:1
15A new and rapid colorimetric determination of acetylcholinesterase activity 显示文摘Ellman G L Courtney K D Andres V 1961Biochemical Pharmacology1961,7,:1
16Characterization of gold-titania catalysts via oxidation of propylene to propyleneoxide 显示文摘Stangland E E Stavens K B Andres R P etal 2000Journal of Catalysis2000,191,:1
17Systematic Method for Rating Soil Quality of Conventional, Organic, and Integrated Apple Orchards in Washington State 显示文摘COVER J D REGANOLD J P ANDRES P K 2000Agriculture Ecosystems and Environment2000,80,:1
18A new and rapid colorimetric determination of acetylcholinesterase activity显示文摘Ellman G L Courtney K D Andres Jr V 1961Biochem Pharmacol1961,7,2:1
19Comparison of metabo- litelevels and water diffusion between cortical and subcortical strokes as monitored by MRI and MRS显示文摘Martin L Abdesslem K Andre D 2001Investigative Radiol2001,36,:1
20Wireless power transfer via strongly coupled magnetic resonances 显示文摘Andre K Aristeidis K Robert M 2007Sci- ence2007,317,6:1
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