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| 1 | Outcomes in refractory diffuse large B-cell lymphoma:results fromamulticenter real-world study in China显示文摘Background:Diffuse large B-cell lymphoma(DLBCL)patients refractory to rituximab-based immunochemotherapy have a dismal prognosis.However,the definition of refractory DLBCL remains inconsistent and no large cohort study data is available from Asian countries.To validate the definition and outcomes of refractory DLBCL in China,we conducted a multicenter,retrospective cohort study.Methods:The REtrospective AnaLysis of Treatment REspoNse of refractory DLBCL(REAL-TREND)study was performed using real-world data from 8 centers in China.DLBCL patients with curative intent were included in the REAL-TREND dataset.Overall survival(OS)was estimated using the Kaplan-Meier method and compared by the log-rank test.Due to heterogeneity in response rates among different centers,the response rates of refractory patients were pooled using random-effect models.Multivariate survival analysis was performed using the Cox regression model.Results:A total of 2778 DLBCL patients diagnosed between January,2010 and December,2015 were enrolled to this study.After validating previous definitions,the SCHOLAR-1 study was most suitable to define refractory DLBCL.The estimated 5-year cumulative incidence of refractory patients was 20%(95% confidence Interval[CI]=18%-22%).After the determination of refractory disease,overall response rate and complete remission rate were 30%(95%CI=22%-38%)and 9%(95%CI=4%-15%),respectively.Patients with either no response to immunochemotherapy or relapse within 12 months after stem-cell transplantation had inferior survival with a median OS of 5.9 months(95%CI=5.5-7.1 months)and 2-year OS rate of 16%(95%CI=12%-20%).International prognostic index score 4-5(hazard ratio[HR]=2.22;95%CI=1.47-3.35),central nervous systemrelapse(HR=1.43;95%CI=1.04-1.97),and best response status(HR=2.68;95%CI=1.42-5.03 for partial remission.HR=5.97,95%CI=3.21-11.11 for stable disease/progressive disease)were independent unfavorable prognostic factors.Conclusions:This is the first large-scale Asian cohort study focusing on outcomes of refractory DLBCL.The definition of the SCHOLAR-1 study identifies patients with homogenously inferior survival,thus is appropriate to select refractory DLBCL.Due to poor clinical outcomes in the rituximab era,patients with refractory DLBCL may be potential candidates for novel treatment modalities. | Shuo Wang Li Wang Jianda Hu Wenbin Qian Xi Zhang Yu Hu Qi Zhu Bobin Chen Depei Wu Chung-Chou H.Chang Pengpeng Xu Xiaoyun Zheng Juying Wei Yao Liu Guohui Cui Yong Tang Yan Ma Haiwen Huang Hongmei Yi Weili Zhao | 2021 | Cancer Communications2021，41，3： | 10 |
| 2 | Retrospective study of steroid therapy for patients with autoimmune pancreatitis in a Chinese population显示文摘AIM:To explore the optimal steroid therapeutic strategy for autoimmune pancreatitis(AIP).METHODS:This study was conducted retrospectively in two large institutions in China.Patients with clinically,radiologically and biochemically diagnosed AIP were enrolled.The performed radiological investigations and biochemical tests,the regimen of the given steroid treatment,remission and relapse whether with and without steroid therapy were analyzed.RESULTS:Twenty-eight patients with AIP received steroid treatment,while 40 patients were treated surgically by pancreatoduodenectomy,distal pancreatectomy and choledochojejunostomy,radiofrequency ablation for the enlarged pancreatic head,percutaneous transhepatic biliary drainage and endoscopic biliary drainage.The starting oral prednisolone dose was 30 mg/d in 18(64.3%) patients and 40 mg/d in 10(35.7%) patients administered for 3 wk.The remission rate of AIP patients with steroid treatment(96.4%) was significantly higher than in those without steroid treatment(75%).Maintenance therapy(oral prednisolone dose 5 mg/d) was performed after remission for at least 6-12 mo to complete the treatment course.Similarly,the relapse rate was significantly lower in AIP patients with steroid treatment(28.6%) than in those without steroid treatment(42.5%).Steroid re-treatment was effective in all relapsed patients with or without steroid therapy.CONCLUSION:Steroid therapy should be considered in all patients with active inflammatory phase of AIP.However,the optimal regimen still should be trailed in larger numbers of patients with AIP. | Bin Liu Jing Li Lu-Nan Yan Hao-Ran Sun Tong Liu Zhi-Xiang Zhang | 2013 | World Journal of Gastroenterology2013，19，4： | 10 |
| 3 | Beneficial effect of probiotics supplements in reflux esophagitis treated with esomeprazole: A randomized controlled trial显示文摘BACKGROUND Reflux esophagitis(RE) is a common digestive disorder, and its frequent recurrences cause significant physical pain and are financially burdensome to patients. However, studies on the natural history of treated RE are few. Although proton pump inhibitors(PPIs) as the first-line treatment provide notable symptomatic relief, disordered gut microbiota has been observed among PPI users. Probiotics are commonly administered to patients to regulate the disordered intestinal flora.AIM To evaluate the therapeutic effects in RE patients treated with a combination of esomeprazole and probiotics [Bacillus subtilis(B. subtilis) and Enterococcus faecium(E. faecium)].METHODS One hundred and thirty-four RE patients were randomized into two groups of 67 subjects each. The probiotics group was administered with esomeprazole 20 mg b.i.d. and live combined B. subtilis and E. faecium enteric-coated capsules 500 mg t.i.d. for eight weeks; the placebo group was administered with esomeprazole 20 mg b.i.d. and placebo for eight weeks. Subsequently, 12-wk follow-up was carried out on patients who achieved both endoscopic and clinical cure. Endoscopy,reflux diagnostic questionnaire(RDQ), gastrointestinal symptom rating scale(GSRS), and lactulose hydrogen breath test were performed to evaluate the therapeutic effects. A difference of P < 0.05 was considered statistically significant.RESULTSSixty-six patients in the probiotics group and 64 patients in the placebo group completed the 8-wk treatment. The healing rate and RDQ score had no significant difference between the two groups(P > 0.05). However, the GSRS diarrhea syndrome score was decreased significantly in the probiotics group(P = 0.002),and the small intestinal bacterial overgrowth negative rate in the probiotics group was significantly higher than that in the placebo group(P = 0.002). Of 114 endoscopically and clinically cured patients, 96 completed the follow-up. The logrank test showed that the time to relapse was shorter in the placebo group than in the probiotics group(P = 0.041). Furthermore, the therapy had a significant influence on relapse time, and the risk of relapse in the probiotics group was lower than that in the placebo group at any time point during the 12-wk followup(hazard ratio = 0.52, P = 0.033).CONCLUSION Esomeprazole combined with probiotics(B. subtilis and E. faecium) have a beneficial effect on RE treatment and patient management. | Qing-Hua Sun Hong-Yan Wang Shi-Dong Sun Xin Zhang Han Zhang | 2019 | World Journal of Gastroenterology2019，25，17： | 9 |
| 4 | Everyone has a donor:contribution of the Chinese experience to global practice of haploidentical hematopoietic stem cell transplantation显示文摘Human leukocyte antigen (HLA)-matched donors for hematopoietic stem cell transplantation (HSCT) have long been scarce in China. Haploidentical (haplo) donors are available for the vast majority of patients, but toxicity has limited this approach. Three new approaches for haplo-HSCT originated from Italy, China, and USA in 1990 and have been developed to world-renowned system up to now. The Chinese approach have been greatly improved by implementing new individualized conditioning regimens, donor selection based on non-HLA systems, risk-directed strategies for graft-versus-host disease and relapse, and infection management. Haplo-HSCT has exhibited similar efficacy to HLA-matched HSCT and has gradually become the predominant donor source and the first alternative donor choice for allo-HSCT in China. Registry-based analyses and multicenter studies adhering to international standards facilitated the transformation of the unique Chinese experience into an inspiration for the refinement of global practice.This review will focus on how the new era in which 'everyone has a donor' will become a reality in China. | Meng Lv Yingjun Chang Xiaojun Huang | 2019 | Frontiers of Medicine2019，13，1： | 8 |
| 5 | Decitabine for Relapsed Acute Lymphoblastic Leukemia after Allogeneic Hematopoietic Stem Cell Transplantation显示文摘Relapse after allogeneic hematopoietic stem cell transplantation(allo-HSCT) remains a main question on treatment failure. Current strategies for management that usually include salvage chemotherapy, donor lymphocytic infusion and second transplantation. Our study assessed the efficacy of decitabine(DAC) for treating patients with acute lymphoblastic leukemia(ALL) who relapsed after allogeneic hematopoietic stem cell transplantation(allo-HSCT). We retrospectively analyzed the outcomes of 12 patients with relapsed ALL after allo-HSCT who received DAC therapy. Nine patients received DAC combined with chemotherapy and donor stem cell infusion, and 3 patients received single-agent DAC. Ten of the 12 patients achieved complete remission(CR), 1 achieved a partial remission(PR), and 1 had no response(NR) after treatment at the latest follow-up(LFU), the median survival was 11.2 months(range, 3.8–34, 7 months). The 1-and 2-year overall survival(OS) rates were 50%(6/12) and 25%(3/12), respectively. Five patients were still alive; 4 had maintained CR and 1 was alive with disease. Patients with Philadelphia chromosome-positive ALL had higher survival rate than patients with Philadelphia chromosome-negative ALL(57.1% vs. 20%). No aggravated flares of graft-versus-host disease(GVHD) were observed during DAC treatment. Therefore, DAC may be a promising therapeutic agent for ALL recurrence after allo-HSCT. | 崔杰克 肖音 游泳 石威 李青 罗毅 蒋林 仲照东 | 2017 | Journal of Huazhong University of Science and Technology(Medical Sciences)2017，37，5： | 8 |
| 6 | Liver transplantation and alcoholic liver disease:History,controversies,and considerations显示文摘Alcohol consumption accounts for 3.8% of annual global mortality worldwide, and the majority of these deaths are due to alcoholic liver disease(ALD), mainly alcoholic cirrhosis. ALD is one of the most common indications for liver transplantation(LT). However, it remains a complicated topic on both medical and ethical grounds, as it is seen by many as a 'self-inflicted disease'. One of the strongest ethical arguments against LT for ALD is the probability of relapse. However, ALD remains a common indication for LT worldwide. For a patient to be placed on an LT waiting list, 6 mo of abstinence must have been achieved for most LT centers. However, this '6-mo rule' is an arbitrary threshold and has never been shown to affect survival, sobriety, or other outcomes. Recent studies have shown similar survival rates among individuals who undergo LT for ALD and those who undergo LT for other chronic causes of end-stage liver disease. There are specific factors that should be addressed when evaluating LT patients with ALD because these patients commonly have a high prevalence of multisystem alcohol-related changes. Risk factors for relapse include the presence of anxiety or depressive disorders, short pre-LT duration of sobriety, and lack of social support. Identification of risk factors and strengthening of the social support system may decrease relapse among these patients. Family counseling for LT candidates is highly encouraged to prevent alcohol consumption relapse. Relapse has been associated with unique histopathological changes, graft damage, graft loss, and even decreased survival in some studies. Research has demonstrated the importance of a multidisciplinary evaluation of LT candidates. Complete abstinence should be attempted to overcome addiction issues and to allow spontaneous liver recovery. Abstinence is the cornerstone of ALD therapy. Psychotherapies, including 12-step facilitation therapy, cognitive-behavioral therapy, and motivational enhancement therapy, help support abstinence. Nutritional therapy helps to reverse muscle wasting, weight loss, vitamin deficiencies, and trace element deficiencies associated with ALD. For muscular recovery, supervised physical activity has been shown to lead to a gain in muscle mass and improvement of functional activity. Early LT for acute alcoholic hepatitis has been the subject of recent clinical studies, with encouraging results in highly selected patients. The survival rates after LT for ALD are comparable to those of patients who underwent LT for other indications. Patients that undergo LT for ALD and survive over 5 years have a higher risk of cardiorespiratory disease, cerebrovascular events, and de novo malignancy. | Claudio Augusto Marroni Alfeu de Medeiros Fleck Jr Sabrina Alves Fernandes Lucas Homercher Galant Marcos Mucenic Mario Henrique de Mattos Meine Guilherme Mariante-Neto Ajacio Bandeira de Mello Brandao | 2018 | World Journal of Gastroenterology2018，24，26： | 7 |
| 7 | Abstinence Following a Motivation-Skill-Desensitization-Mental Energy Intervention for Heroin Dependence: A Three-year Follow-up Result of a Randomized Controlled Trial显示文摘The high rate of relapse among heroin users remains a significant public concern in China. In the present study, we utilized a Motivation-Skill-Desensitization-Mental Energy (MSDE) intervention and evaluated its effects on abstinence and mental health. Eighty-nine male heroin users in a drug rehabilitation center were enrolled in the study. The participants in the MSDE intervention group (n=46) received MSDE intervention, which included motivational interviewing, coping skills training, eye movement desensitization and reprocessing, and mindfulness-based psychotherapy. The participants in the control group (h=43) received a series of lectures on skills training. A significant increase in Contemplation Ladder score (P<0.001) and decreases in scores on the Obsessive Compulsive Drug Use Scale (P<0.001), Beck Depression Inventory (P<0.001), and Aggression Questionnaire (P=O.O33) were found immediately after intervention. Compared to the control group, the MSDE intervention group reported significantly higher abstinence rates (P=0.027) and retention rates (P<0.001) at follow-up. Overall, the MSDE intervention, which uses a combined strategy for relapse prevention, could be a promising approach for preventing relapse among heroin users in China. | Jia-yan CHEN Jin-cong YU Jie-pin CAO Yang XIAO Hong GU Rui-lin ZHONG Fang DING Zeng-zhen WANG | 2019 | Current Medical Science2019，39，3： | 5 |
| 8 | Role of anti-angiogenesis therapy in the management of hepatocellular carcinoma: The jury is still out显示文摘As the leading cause of disease-related deaths,cancer is a major public health threat worldwide.Surgical resection is still the first-line therapy for patients with early-stage cancers.However,postoperative relapse and metastasis remain the cause of 90%of deaths of patients with solid organ malignancies,including hepatocellular carcinoma(HCC).With the rapid development of molecular biology techniques in recent years,molecularly targeted therapies using monoclonal antibodies,small molecules,and vaccines have become a milestone in cancer therapeutic by significantly improv-ing the survival of cancer patients,and have opened a window of hope for patients with advanced cancer.Hypervascularization is a major characteristic of HCC.It has been reported that anti-angiogenic treatments,which inhibit blood vessel formation,are highly effective for treating HCC.However,the efficacy and safety of anti-angiogenesis therapies remain controversial.Sorafenib is an oral multikinase inhibitor with antiproliferative and anti-angiogenic effects and is the first molecular target drug approved for the treatment of advanced HCC.While sorafenib has shown promising therapeutic effects,substantial evidence of primary and acquired resistance to sorafenib has been reported.Numerous clinical trials have been conducted to evaluate a large number of molecularly targeted drugs for treating HCC,but most drugs exhibited less efficacy and/or higher toxicity compared to sorafenib.Therefore,understanding the mechanism(s)underlying sorafenib resistance of cancer cells is highlighted for efficiently treating HCC.This concise review aims to provide an overview of anti-angiogenesis therapy in the management of HCC and to discuss the common mechanisms of resistance to anti-angiogenesis therapies. | Hong Sun Man-Sheng Zhu Wen-Rui Wu Xiang-De Shi Lei-Bo Xu | 2014 | World Journal of Hepatology2014，6，12： | 4 |
| 9 | Advances in the development of chimeric antigen receptor-T-cell therapy in B-cell acute lymphoblastic leukemia显示文摘CD19-targeted chimeric antigen receptor T-cell(CAR-T)therapy is effective in refractory/relapsed(R/R)B-cell acute lymphoblastic leukemia(B-ALL).This review focuses on achievements,current obstacles,and future directions in CAR-T research.A high complete remission rate of 68%to 93%could be achieved after anti-CD19 CAR-T treatment for B-ALL.Cytokine release syndrome and CAR-T-related neurotoxicity could be managed.In view of difficulties collecting autologous lymphocytes,universal CAR-T is a direction to explore.Regarding the high relapse rate after anti-CD19 CAR-T therapy,the main solutions have been developing new targets including CD22 CAR-T,or CD19/CD22 dual CAR-T.Additionally,some studies showed that bridging into transplant post-CAR-T could improve leukemia-free survival.Some patients who did not respond to CAR-T therapy were found to have an abnormal conformation of the CD19 exon or trogocytosis.Anti-CD19 CAR-T therapy for R/R B-ALL is effective.From individual to universal CAR-T,from one target to multi-targets,CAR-T-cell has a chance to be off the shelf in the future. | Xian Zhang Jing-Jing Li Pei-Hua Lu | 2020 | Chinese Medical Journal2020，，4： | 4 |
| 10 | Long-term survival after liver transplantation for alcoholic liver disease显示文摘Currently,alcoholic cirrhosis is the second leading indication for liver transplantation in the United States and Europe.The quality of life and survival after a liver transplantation(LT)in patients with alcoholic liver disease(ALD)are similar to those in patients with other cirrhosis etiologies.The alcoholic relapse rate after a LT varies from 10%-50%,and these relapse patients are the ones who present a reduced long-term survival,mainly due to cardiovascular diseases and the onset of de novo neoplasms,including lung and upper aerodigestive tract.Nearly 40%of ALD recipients resume smoking and resume it early post-LT.Therefore,our pre-and post-LT follow-up efforts regarding ALD should be focused not only on alcoholic relapse but also on treating and avoiding other modifiable risk factors such as tobacco.The psychiatric and psychosocial pre-LT evaluation and the post-LT follow-up with physicians,psychiatrists and addiction specialists are important for reversing these problems because these professionals help to identify patients at risk for relapse as well as those patients who have relapsed,thus enabling responsive actions. | Paula Iruzubieta Javier Crespo Emilio Fábrega | 2013 | World Journal of Gastroenterology2013，19，48： | 4 |
| 11 | Induction of clinical response and remission of inflammatory bowel disease by use of herbal medicines:A meta-analysis显示文摘AIM:To evaluate the efficacy and tolerability of herbal medicines in inflammatory bowel disease(IBD)by conducting a meta-analysis.METHODS:Electronic databases were searched for studies investigating efficacy and/or tolerability of herbal medicines in the management of different types of IBD.The search terms were:'herb'or'plant'or'herbal'and'inflammatory bowel disease'.Data were collected from 1966 to 2013(up to Feb).The'clinical response','clinical remission','endoscopic response','endoscopic remission','histological response','histological remission','relapse','any adverse events',and'seriousadverse events'were the key outcomes of interest.We used the Mantel-Haenszel,Rothman-Boice method for fixed effects and DerSimonian-Laird method for random-effects.For subgroup analyses,we separated the studies by type of IBD and type of herbal medicine to determine confounding factors and reliability.RESULTS:Seven placebo controlled clinical trials met our criteria and were included(474 patients).Comparison of herbal medicine with placebo yielded a significant RR of 2.07(95%CI:1.41-3.03,P=0.0002)for clinical remission;a significant RR of 2.59(95%CI:1.24-5.42,P=0.01)for clinical response;a non-significant RR of 1.33(95%CI:0.93-1.9,P=0.12)for endoscopic remission;a non-significant RR of 1.69(95%CI:0.69-5.04)for endoscopic response;a non-significant RR of 0.64(95%CI:0.25-1.81)for histological remission;a non-significant RR of 0.86(95%CI:0.55-1.55)for histological response;a non-significant RR of 0.95(95%CI:0.52-1.73)for relapse;a non-significant RR of 0.89(95%CI:0.75-1.06,P=0.2)for any adverse events;and a non-significant RR of 0.97(95%CI:0.37-2.56,P=0.96)for serious adverse events.CONCLUSION:The results showed that herbal medicines may safely induce clinical response and remission in patients with IBD without significant effects on endoscopic and histological outcomes,but the number of studies is limited to make a strong conclusion. | Roja Rahimi Shekoufeh Nikfar Mohammad Abdollahi | 2013 | World Journal of Gastroenterology2013，19，34： | 4 |
| 12 | Sintilimab for relapsed/refractory extranodal NK/T cell lymphoma: a multicenter, single-arm, phase 2 trial (ORIENT-4)显示文摘This study(ORIENT-4)aimed to assess the efficacy and safety of sintilimab,a humanized anti-PD-1 antibody,in patients with relapsed/refractory extranodal NK/T cell lymphoma(r/r ENKTL).ORIENT-4 is a multicenter,single-arm,phase 2 clinical trial(NCT03228836).Patients with r/r ENKTL who failed to at least one asparaginase-based regimen were enrolled to receive sintilimab 200 mg intravenously every 3 weeks for up to 24 months.The primary endpoint was the objective response rate(ORR)based on Lugano 2014 criteria.Twenty-eight patients with r/r ENKTL were enrolled from August 31,2017 to February 7,2018.Twenty-one patients(75.0%,95%CI:55.1–89.3%)achieved an objective response.With a median follow-up of 30.4 months,the median overall survival(OS)was not reached.The 24-month OS rate was 78.6%(95%CI,58.4–89.8%).Most treatment-related adverse events(TRAEs)were grade 1–2(71.4%),and the most common TRAE was decreased lymphocyte count(42.9%).Serious adverse events(SAEs)occurred in 7(25.0%)patients,and no patient died of adverse events.Sintilimab is effective and well tolerated in patients with r/r ENKTL and could be a novel therapeutic approach for the control of ENKTL in patients. | Rong Tao Lei Fan Yongping Song Yu Hu Wei Zhang Yafei Wang Wei Xu Jianyong Li | 2021 | Signal Transduction and Targeted Therapy2021，6，11： | 4 |
| 13 | Seasonal variations in the onset of ulcerative colitis in Japan显示文摘AIM:To investigate seasonal variations in the onset and relapse of ulcerative colitis(UC)in Japanese patients.METHODS:Between 1994 and 2006,198 Japanese patients diagnosed with UC according to conventional criteria in an academic hospital were enrolled for onset evaluation.Among 265 Japanese patients with UC who were observed for more than 12 mo,165 patients relapsed(239 times)and were enrolled for relapse evaluation.The patients’symptoms were recorded each month for 12 consecutive years.RESULTS:There was monthly seasonality in symptom onset during October and March for UC.The onset of symptoms in UC patients frequently occurred during the winter.Variation in UC onset was observed according to both month(P=0.015)and season(P=0.048).Relapse commonly occurred in October,and variations in relapse were not significant either in month(P=0.52)or season(P=0.12).Upper respiratory inflammation was the main factor responsible for relapse.CONCLUSION:Our results suggest that environmental factors associated with winter and spring seasonality may be responsible for triggering the clinical onset of UC in Japan. | Shigeo Koido Toshifumi Ohkusa Hiroaki Saito Tetsuji Yokoyama Tomoyoshi Shibuya Naoto Sakamoto Kan Uchiyama Hiroshi Arakawa Taro Osada Akihito Nagahara Sumio Watanabe Hisao Tajiri | 2013 | World Journal of Gastroenterology2013，19，47： | 3 |
| 14 | Carbohydrate antigen 19-9 as a novel prognostic biomarker in distal cholangiocarcinoma显示文摘BACKGROUND Distal cholangiocarcinoma(DCC)presents as one of the relatively rare malignant tumors in the digestive system and has a poor long-term prognosis.Curative resection is currently the most appropriate therapy for patients with DCC because of the lack of effective adjuvant therapies.Therefore,it is important to accurately predict the prognosis for formulating a reasonable treatment plan and avoiding unnecessary surgical trauma.AIM To minimize the interference of obstructive jaundice on carbohydrate antigen 19-9(CA19-9)level by adapting CA19-9 toγ-glutamyltransferase(GGT)as an indicator,to determine the strong associations between CA19-9/GGT and postoperative neoplasm recurrence and long-term outcome of DCC.METHODS We enrolled 186 patients who were diagnosed with DCC between January 2010 and December 2019 and performed radical excision with strict criteria as follows in our hospital.Receiver operating characteristic curves were drawn according to preoperative CA19-9/GGT and 1-year survival.Based on this,patients were divided into two groups(group 1,low-ratio,n=81;group 2,high-ratio,n=105).Afterwards,by the way of univariate and multivariate analysis,the risk factors influencing postoperative tumor recrudesce and long-term prognosis of patients with DCC were screened out.RESULTS Optimum cut-off value of CA19-9/GGT was 0.12.Patients in group 2 represented higher CA19-9 and lymphatic metastasis rate accompanied by lower GGT,when compared with group 1(P<0.05).The 1-,3-and 5-year overall survival rates of patients in groups 1 and 2 were 88.3%,59.2%and 48.1%,and 61.0%,13.6%and 13.6%,respectively(P=0.000).Multivariate analysis indicated that CA19-9/GGT,lymphatic metastasis and tumor differentiation were independent risk factors for tumor recurrence and long-term prognosis of DCC.CONCLUSION Elevation of CA19-9/GGT performed better as a biomarker of aggressive carcinoma and predictor of poor clinical outcomes by reducing the effect of obstruction of biliary tract on CA19-9 concentration in patients with DCC. | Tao Jiang Shao-Cheng Lyu Lin Zhou Jing Wang Han Li Qiang He Ren Lang | 2021 | World Journal of Gastrointestinal Surgery2021，13，9： | 3 |
| 15 | Consecutive fecal calprotectin measurements for predicting relapse in pediatric Crohn's disease patients显示文摘BACKGROUND Asymptomatic children with Crohn's disease(CD) require ongoing monitoring to ensure early recognition of a disease exacerbation.AIM In a cohort of pediatric CD patients, we aimed to assess the utility of serial fecal calprotectin measurements to detect intestinal inflammatory activity and predict disease relapse.METHODS In this prospective longitudinal cohort study, children with CD on infliximab therapy in clinical remission were included. Fecal calprotectin levels were assessed at baseline and at subsequent 2-5 visits. Clinical and biochemical disease activity were assessed using the Pediatric Crohn's Disease Activity Index, Creactive protein and erythrocyte sedimentation rate at baseline and at visits over the following 18 mo.RESULTS 53 children were included and eighteen patients(34%) had a clinical disease relapse during the study. Baseline fecal calprotectin levels were higher in patients that developed symptomatic relapse [median(interquartile range), relapse 723μg/g(283-1758) vs 244 μg/g(61-627), P = 0.02]. Fecal calprotectin levels > 250μg/g demonstrated good predictive accuracy of a clinical flare within 3 mo(area under the receiver operator curve was 0.86, 95% confidence limits 0.781 to 0.937).CONCLUSION Routine fecal calprotectin testing in children with CD in clinical remission is useful to predict relapse. Levels > 250 μg/g are a good predictor of relapse in the following 3 mo. This information is important to guide monitoring standards used in this population. | Alice Jane Foster Matthew Smyth Alam Lakhani Benjamin Jung Rollin F Brant Kevan Jacobson | 2019 | World Journal of Gastroenterology2019，25，10： | 3 |
| 16 | Clinical characteristics and outcome of autoimmune pancreatitis based on serum immunoglobulin G4 level:A single-center,retrospective cohort study显示文摘BACKGROUND Autoimmune pancreatitis(AIP)has been linked with elevated immunoglobulin(Ig)G4 levels.The characteristics and outcomes of AIP based on serum markers have not been fully evaluated.AIM To compare clinical features,treatment efficacy,and outcome of AIP based on serum IgG4 levels and analyze predictors of relapse.METHODS A total of 213 patients with AIP were consecutively reviewed in our hospital from 2006 to 2021.According to the serum IgG4 level,all patients were divided into two groups,the abnormal group(n=148)with a high level of IgG4[>2×upper limit of normal(ULN)]and the normal group(n=65).The t-test or Mann-Whitney U test was used to compare continuous variables.Categorical parameters were compared by theχ^(2) test or Fisher’s exact test.Kaplan-Meier curves Zhou GZ et al.Clinical characteristics and outcome of AIP WJG https://www.wjgnet.com 5126 September 21,2023 Volume 29 Issue 35 and log-rank tests were established to assess the cumulative relapse rates.Univariate and multivariate analyses were used to investigate potential risk factors of AIP relapse.RESULTS Compared with the normal group,the abnormal group had a higher average male age(60.3±10.4 vs 56.5±12.9 years,P=0.047);higher level of serum total protein(72.5±7.9 g/L vs 67.2±7.5 g/L,P<0.001),IgG4(1420.5±1110.9 mg/dL vs 252.7±106.6 mg/dL,P<0.001),and IgE(635.6±958.1 IU/mL vs 231.7±352.5 IU/mL,P=0.002);and a lower level of serum complement C3(100.6±36.2 mg/dL vs 119.0±45.7 mg/dL,P=0.050).In addition,a lower number of cases with abnormal pancreatic duct and pancreatic atrophy(23.6%vs 37.9%,P=0.045;1.6%vs 8.6%,P=0.020,respectively)and a higher rate of relapse(17.6%vs 6.2%,P=0.030)were seen in the abnormal group.Multivariate analyses revealed that serum IgG4[(>2×ULN),hazard ratio(HR):3.583;95%confidence interval(CI):1.218–10.545;P=0.020]and IgA(>1×ULN;HR:5.908;95%CI:1.199–29.120;P=0.029)and age>55 years(HR:2.383;95%CI:1.056–5.378;P=0.036)were independent risk factors of relapse.CONCLUSION AIP patients with high IgG4 levels have clinical features including a more active immune system and higher relapse rate.Several factors,such as IgG4 and IgA,are associated with relapse. | Guan-Zhou Zhou Jia-Qi Zeng Lei Wang Miao Liu Ke Meng Zi-Kai Wang Xiu-Li Zhang Li-Hua Peng Bin Yan Fei Pan | 2023 | World Journal of Gastroenterology2023，29，35： | 3 |
| 17 | Long-term Trends and Predictors of Smoking Behaviors among Men Following First-ever Ischemic Stroke显示文摘Continued smoking following stroke is associated with adverse outcomes including increased risk of mortality and secondary stroke. The aim of this study was to examine the long-term trends in smoking behaviors and factors associated with smoking relapse among men who survived their first-ever stroke. Data collection for this longitudinal study was conducted at baseline through face-toface interviews and follow-up was completed every 3 months via telephone, beginning in 2010 and continuing through 2014. Cox proportional hazard regression models were used to identify predictors of smoking relapse behavior. At baseline, 372 male patients were recruited into the study. Totally, 155(41.7%) of these patients stopped smoking for stroke, and 61(39.3%) began smoking again within 57 months after discharge with an increasing trend in the number of cigarettes smoked per day. Exposure to environmental tobacco smoke at places outside of home and work(such as bars, restaurants)(HR, 2.34; 95% CI, 1.04–5.29, P=0.04), not having a spouse(HR, 0.12; 95% CI, 0.04–0.36; P=0.0002) and smoking at least 20 cigarettes per day before stroke(HR, 2.42; 95% CI, 1.14–5.14, P=0.02) were predictors of smoking relapse. It was concluded that environmental tobacco smoke is an important determinant of smoking relapse among men who survive their first stroke. Environmental tobacco smoke should be addressed by smoke-free policies in public places. | 侯利莎 杜旭东 李吉杰 朱萍 闫沛静 詹凤羽 周沐科 朱彩蓉 | 2017 | Journal of Huazhong University of Science and Technology(Medical Sciences)2017，37，3： | 3 |
| 18 | Fecal calprotectin measurement is a marker of shortterm clinical outcome and presence of mucosal healing in patients with inflammatory bowel disease显示文摘AIM To evaluate the utility of fecal calprotectin(FC) in predicting relapse and endoscopic activity during follow-up in an inflammatory bowel disease(IBD) cohort.METHODS All FC measurements that were obtained during a 3-year period from patients with inflammatory bowel disease in clinical remission were identified. Data regarding the short-term(6 mo) course of the disease were extracted from the medical files. Exclusion criteria were defined as:(1) An established flare of the disease at the time of FC measurement,(2) Loss to follow up within 6 mo from baseline FC measurement, and,(3) Insufficient data on file. Statistical analysis was performed to evaluate whether baseline FC measurement could predict the short term clinical relapse and/or the presence of mucosal healing.RESULTS We included 149 [Crohn's disease(CD) = 113, Ulcerative colitis(UC) = 36, male = 77] IBD patients in our study. Within the determined 6-month period post-FC measurement, 47(31.5%) had a disease flare. Among 76 patients who underwent endoscopy, 39(51.3%) had mucosal healing. Baseline FC concentrations were significantly higher in those who had clinical relapse compared to those who remained in remission during follow up(481.0 μg/g, 286.0-600.0 vs 89.0, 36.0-180.8, P < 0.001). The significant predictive value of baseline median with IQR FC for clinical relapse was confirmed by multivariate Cox analysis [HR for 100μg/g: 1.75(95%CI: 1.28-2.39), P = 0.001]. Furthermore, lower FC baseline values significantly correlated to the presence of mucosal healing in endoscopy(69.0 μg/g, 30.0-128.0 vs 481.0, 278.0-600.0, in those with mucosal inflammation, median with IQR, P < 0.001). We were able to extract cut-off values for FC concentration with a high sensitivity and specificity for predicting clinical relapse(261 μg/g with AUC = 0.901, sensitivity 87.2%, specificity 85.3%, P < 0.001) or mucosal healing(174 μg/g with AUC = 0.956, sensitivity 91.9%, specificity 87.2%, P < 0.001). FC was better than CRP in predicting either outcome; nevertheless, having a pathological CRP(> 5 mg/L) in addition to the cutoffs for FC, significantly enhanced the specificity for predicting clinical relapse(95.1% from 85.3%) or endoscopic activity(100% from 87.2%). CONCLUSION Serial FC measurements may be useful in monitoring IBD patients in remission, as FC appears to be a reliable predictor of short-term relapse and endoscopic activity. | Athanasios Kostas Spyros I Siakavellas Charalambos Kosmidis Anna Takou Joanna Nikou Georgios Maropoulos John Vlachogiannakos George V Papatheodoridis Ioannis Papaconstantinou Giorgos Bamias | 2017 | World Journal of Gastroenterology2017，23，41： | 2 |
| 19 | Addiction specialist's role in liver transplantation procedures for alcoholic liver disease显示文摘Although liver transplantation(LT) is performed increasingly for patients with end-stage alcoholic liver disease(ALD), the topic remains controversial. Traditionally, the role of an addiction specialist focused on the screening and identification of patients with a high risk on relapse in heavy alcohol use. These patients were in many cases subsequently excluded from a further LT procedure.Recently, awareness is growing that not only screening of patients but also offering treatment, helping patients regain and maintain abstinence is essential, opening up a broader role for the addiction specialist(team)within the whole of the transplant procedure. Within this context, high-risk assessment is proposed to be an indication of increasing addiction treatment intensity,instead of being an exclusion criterion. In this review we present an overview regarding the state of the art on alcohol relapse assessment and treatment in patients with alcohol use disorders, both with and without ALD.Screening, treatment and monitoring is suggested as central roles for the addiction specialist(team) integrated within transplant centers. | Geert Dom Hendrik Peuskens | 2015 | World Journal of Hepatology2015，7，17： | 2 |
| 20 | Secondary donor-derived CD19 CAR-T therapy is safe and efficacious in acute lymphoblastic leukemia with extramedullary relapse after first autologous CAR-T therapy显示文摘Despite the advancement of treatments,adults with relapsed/refractory(R/R)B-lineage acute lymphoblastic leukemia(B-ALL)have poor prognosis,with an expected five-year overall survival(OS)rate of 10%‒20%(Nguyen et al.,2008;Oriol et al.,2010).Extramedullary relapse of B-ALL is regarded as a highrisk factor generally associated with poor survival,occurring in about 15%to 20%of all relapsed patients(Ding et al.,2017;Sun et al.,2018).The central nervous system(CNS)and the testes are the most common sites of extramedullary relapse of B-ALL.In addition,extramedullary leukemia can appear in the skin,eyes,breasts,bones,muscles,and abdominal organs.The prognosis of relapsed extramedullary B-ALL after allogeneic hematopoietic stem cell transplantation(allo-HSCT)is extremely poor(Spyridonidis et al.,2012;Dahlberg et al.,2019).Conventional chemotherapy or radiation is often ineffective in such patients.At present,there are no optimal treatment strategies for treating extramedullary leukemia after allo-HSCT. | Delin KONG Tingting YANG Jia GENG Ruirui JING Qiqi ZHANG GuoqingWEI He HUANG Yongxian HU | 2022 | Journal of Zhejiang University-Science B(Biomedicine & Biotechnology)2022，23，10： | 2 |
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