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| 1 | Advanced gastric cancer:Current treatment landscape and future perspectives显示文摘Gastric cancer currently ranks fourth in cancer-related mortality worldwide. In the western world, it is most often diagnosed at an advanced stage, after becoming metastatic at distant sites. Patients with advanced disease(locally advanced or metastatic) have a somber prognosis, with a median overall survival of 10-12 mo, and palliative chemotherapy is the mainstay of treatment. In recent years, novel approaches using inhibition of human epidermal growth factor receptor 2(HER2) have demonstrated significant improvements in progression-free and overall survival, compared with chemotherapy alone, in first-line treatment of patients with overexpression of HER2. In addition, both second-line chemotherapy and treatment with the vascular endothelial growth factor receptor-inhibitor ramucirumab demonstrated significant benefits in terms of overall survival, compared with best supportive care, in randomized studies. Moreover, ramucirumab in combination with chemotherapy demonstrated further significant benefits in terms of progression-free and overall survival, compared with chemotherapy alone, in second-line treatment for patients with metastatic gastric cancer. A recently published molecular classification of gastric cancer is expected to improve patient stratification and selection for clinical trials and provide a roadmap for future drug development. Nevertheless, despite these developments the prognosis of patients with advanced gastric cancer remains poor. In this review we discuss current standards of care and outline major topics of drug development in gastric cancer. | Antonia Digklia Anna Dorothea Wagner | 2016 | World Journal of Gastroenterology2016，22，8： | 108 |
| 2 | 中医药辨证治疗急性加重期慢性阻塞性肺疾病随机对照试验疗效评价指标的系统评价显示文摘目的:在系统评价中医药辨证治疗急性加重期慢性阻塞性肺疾病(AECOPD)随机对照试验临床疗效基础上探讨其疗效评价指标的选择和使用。方法:计算机检索CBM、CNKI、VIP、万方数据库、Cochrane图书馆、PubMed和Embase数据库,收集公开发表中医药辨证治疗AECOPD随机对照试验的临床研究,由两位研究者按照纳入标准独立筛选文献、提取资料后,应用RevMan5.1软件进行Meta分析。结果:共纳入73篇相关文献,Meta分析结果显示中医辨证治疗能提高AECOPD患者的临床疗效和中医证候疗效,改善临床症状、肺功能,提高氧分压,降低二氧化碳分压,降低白细胞计数和CRP水平;疗效评价指标使用较多的有临床疗效、证候疗效、肺功能、血气分析、血常规、C反应蛋白、临床症状体征、中医证候积分等,其余如生活质量、影像学评价、住院时间和6 min步行距离等则相对较少。结论:中医药辨证治疗AECOPD具有较好的临床疗效,但由于纳入研究的质量不高,仍需开展大样本、多中心、方法科学的高质量临床试验;临床疗效评价指标的选用仍不规范,疗效指标的选择应根据临床研究的目的不同而有所侧重,另外还应体现中医药的临床特点。 | 张海龙 王明航 李风雷 王海峰 余学庆 李建生 | 2013 | 中医学报2013，28，6： | 53 |
| 3 | A randomized controlled clinical trial on the treatment of Thymosin-a1 versus interferon-α in patients with hepatitis B显示文摘INTRODUCTIONChronic hepatitis B virus (HBV) infection is a serious problem because of its world wide distribution and possible adverse sequelae ,such as cirrhosis and hepatocellular carcinoma .The World Health Organization estimates that HBV has infected mord than 350 million people worldwide ,and up to 20% of them will become chromic carricrs and will be at significant risk for cirrhosis and HCC .The ultimate goal of the therapy for chronic hepatitis B is to prevent progression to cirrhosis and to prevent development of HCC. | Jing You Lin Zhuang Bao Zhang Tang Wei Bo Yang Su Ying Ding Wu Li Rong Xue Wu Hong Li Zhang Yan Mei Zhang Shao Ming Yan Lu Zhang ~1Department of Infectious Diseases,The First Affiliated Hospital of Kunming Medical College,Kunming 650032,Yunnan Province,China ~2Departrnent of Hepatology,Kunming Third Municipal People’s Hospital,Kunming 650041,Yunnan Province,China | 2001 | World Journal of Gastroenterology2001，7，3： | 48 |
| 4 | Effect of probiotic treatment on cirrhotic patients with minimal hepatic encephalopathy: A meta-analysis显示文摘Background: Minimal hepatic encephalopathy(MHE) is an early and reversible form of hepatic encephalopathy. The documentations on the treatment with probiotics are inconsistent. The present meta-analysis was to verify the role of probiotics in the treatment of cirrhotic patients with MHE.Data sources: Seven electronic databases were searched for relevant randomized controlled trials(RCTs)published until July 2015. The effects of probiotics on serum ammonia, endotoxin, and MHE were evaluated.Results: A total of 14 RCTs(combined n = 1132) were included in the meta-analysis. When probiotics were compared to placebo or no treatment, probiotics were more likely to reduce values in the number connection test(NCT; week 4: MD =-30.25, 95% CI:-49.85 to-10.66), improve MHE(week 4: OR = 0.18,95% CI: 0.07 to 0.47; week 12: OR = 0.15, 95% CI: 0.07 to 0.32), and prevent overt HE progression(week4: OR = 0.22, 95% CI: 0.07 to 0.67) in patients with liver cirrhosis. When probiotics was compared to lactulose, probiotics tended to reduce serum ammonia levels(week 4: MD =-0.33 μmol/L, 95% CI:-5.39 to 4.74; week 8: MD = 6.22 μmol/L, 95% CI:-24.04 to 36.48), decrease NCT(week 8: MD = 3.93, 95% CI:-0.72 to 8.58), improve MHE(week 4: OR = 0.93, 95% CI: 0.45 to 1.91; week 12: OR = 0.73, 95% CI: 0.35 to 1.51) and prevent the development of overt HE(week 4: OR = 0.96, 95% CI: 0.17 to 5.44; week 12:OR = 2.7, 95% CI: 0.50 to 14.64) in patients with liver cirrhosis. However, lactulose appears to be more effective in reducing NCT values as compared to probiotics(week 4: MD = 6.7, 95% CI: 0.58 to 12.82).Conclusion: Probiotics can decrease serum ammonia and endotoxin levels, improve MHE, and prevent overt HE development in patients with liver cirrhosis. | Qing Cao Cheng-Bo Yu Shi-Gui Yang Hong-Cui Cao Ping Chen Min Deng Lan-Juan Li | 2018 | Hepatobiliary & Pancreatic Diseases International2018，17，1： | 25 |
| 5 | Mechanisms of resistance to sorafenib and the corresponding strategies in hepatocellular carcinoma显示文摘Sorafenib, the unique drug as first-line treatment for advanced hepatocellular carcinoma (HCC), has opened a window of hope after searching for effective agents to combat HCC for decades. However, the overall outcomes are far from satisfactory. One of the explanations is the genetic heterogeneity of HCC, which has led to identifying predictive biomarkers for primary resistance to sorafenib, and then applying the concept of personalized medicine, or seeking therapeutic strategies such as combining sorafenib with other anticancer agents. Some of the combinations have demonstrated a better effectiveness than sorafenib alone, with good tolerance. The acquired resistance to sorafenib has also drawn attention. As a multikinase inhibitor, sorafenib targets several cellular signaling pathways but simultaneously or sequentially the addiction switches and compensatory pathways are activated. Several mechanisms are involved in the acquired resistance to sorafenib, such as crosstalks involving PI3K/Akt and JAK-STAT pathways, hypoxia-inducible pathways, epithelial-mesenchymal transition, etc . Based on the investigated mechanisms,some other molecular targeted drugs have been applied as second-line treatment for treat HCC after the failure of sorafenib therapy and more are under evaluation in clinical trials. However, the exact mechanisms accounting for sorafenib resistance remains unclear. Further investigation on the crosstalk and relationship of associated pathways will better our understanding of the mechanisms and help to find effective strategies for overcoming sorafenib resistance in HCC. | Bo Zhai Xue-Ying Sun | 2013 | World Journal of Hepatology2013，5，7： | 24 |
| 6 | Early postoperative feeding in resectional gastrointestinal surgical cancer patients显示文摘Malnutrition is present in the majority of patients presenting for surgical management of gastrointestinal malignancies,due to the effects of the tumour and preoperative anti-neoplastic treatments.The traditional practice of fasting patients until the resumption of bowel function threatens to further contribute to the malnutrition experienced by these patients.Furthermore,the rationale behind this traditional practice has been rendered obsolete through developments in anaesthetic agents and changes to postoperative analgesia practices.Conversely,there is a growing body of literature that consistently demonstrates that providing oral or tube feeding proximal to the anastomosis within 24 h postoperatively,is not only safe,but might be associated with significant benefits to the postoperative course.Early post operative feeding should therefore be adopted as a standard of care in oncology patients undergoing gastrointestinal resections. | Emma J Osland Muhammed Ashraf Memon | 2010 | World Journal of Gastrointestinal Oncology2010，2，4： | 22 |
| 7 | 俯卧位通气对急性呼吸窘迫综合征患者预后影响的荟萃分析显示文摘目的:系统评价俯卧位通气(PPV)对急性呼吸窘迫综合征(ARDS)患者预后的影响。方法检索美国国家医学图书馆PubMed数据库、WebofScience、Cochrane系统评价和临床试验数据库、生物医学与药理学文摘数据库(EMBASE)、中国生物医学文献数据库(CBM)和中国期刊网全文数据库(CNKI)等数据库,系统收集相关随机对照临床试验(RCT)文献。按Cochrane系统评价方法筛选试验、评价质量、提取资料,采用RevMan5.1软件进行Meta分析。结果最终纳入10项临床对照试验,共2187例患者,全部为随机对照试验,研究质量为B或C。荟萃分析结果显示,与对照组比较,PPV可明显提高ARDS患者氧合指数(6h氧合指数比较:MD=28.19,95%CI为12.39~43.98,P=0.0005;4d氧合指数比较:MD=22.34,95%CI为10.77~33.91,P=0.0002;10d氧合指数比较:MD=18.07,95%CI为3.50~32.64,P=0.02)。与对照组比较,PPV能够降低总体死亡率(OR=0.75,95%CI为0.59~0.96,P=0.02),但ICU死亡率(OR=0.74,95%CI为0.51~1.05,P=0.09)、28d死亡率(OR=0.75,95%CI为0.44~1.29,P=0.30)、90d死亡率(OR=0.69,95%CI为0.30~1.60,P=0.39)及6个月死亡率(OR=0.88,95%CI为0.62~1.26,P=0.49)两组比较差异均无统计学意义。PPV组住ICU天数与对照组比较差异有统计学意义(MD=1.43,95%CI为0.38~2.48,P=0.007),而机械通气天数(受访90d)两组比较差异无统计学意义(MD=-0.42,95%CI为-1.56~0.72,P=0.47)。PPV组呼吸机相关肺炎发生率与对照组比较差异无统计学意义(OR=0.83,95%CI为0.62~1.13,P=0.24),压疮发生率PPV组高于对照组(OR=1.36,95%CI为1.06~1.74,P=0.01),意外拔管发生率两组比较差异无统计学意义(OR=0.94,95%CI为0.62~1.42,P=0.75),气胸发生率两组比较差异无统计学意义(OR=0.75,95%CI为0.45~1.25,P=0.27)。结论应用PPV治疗ARDS患者能明显提高氧合指数,降低总死亡率,尤其对于重度ARDS患者,可明显改善预后。 | 范平 石俊 陆杉 姚智渊 袁亮 朱曦 | 2014 | 中国急救医学2014，34，4： | 23 |
| 8 | Can we further optimize therapeutic hypothermia for hypoxic-ischemic encephalopathy?显示文摘Perinatal hypoxic-ischemic encephalopathy is a leading cause of neonatal death and disability.Therapeutic hypothermia significantly reduces death and major disability associated with hypoxic-ischemic encephalopathy;however,many infants still experience lifelong disabilities to movement,sensation and cognition.Clinical guidelines,based on strong clinical and preclinical evidence,recommend therapeutic hypothermia should be started within 6 hours of birth and continued for a period of 72 hours,with a target brain temperature of 33.5 ±0.5℃ for infants with moderate to severe hypoxic-ischemic encephalopathy.The clinical guidelines also recommend that infants be re warmed at a rate of 0.5℃ per hour,but this is not based on strong evidence.There are no randomized controlled trials investigating the optimal rate of rewarming after therapeutic hypothermia for infants with hypoxic-ischemic encephalopathy.Preclinical studies of rewarming are conflicting and results were confounded by treatment with sub-optimal durations of hypothermia.In this review,we evaluate the evidence for the optimal start time,duration and depth of hypothermia,and whether the rate of rewarming after treatment affects brain injury and neurological outcomes. | Anthony Davies Guido Wassink Laura Bennet Alistair J.Gunn Joanne O.Davidson | 2019 | Neural Regeneration Research2019，14，10： | 20 |
| 9 | 0Adipose-derived stem cells: Implications in tissue regeneration显示文摘Adipose-derived stem cells(ASCs) are mesenchymal stem cells(MSCs) that are obtained from abundant adipose tissue, adherent on plastic culture flasks, can be expanded in vitro, and have the capacity to differ-entiate into multiple cell lineages. Unlike bone marrow-derived MSCs, ASCs can be obtained from abundant adipose tissue by a minimally invasive procedure, which results in a high number of cells. Therefore, ASCs are promising for regenerating tissues and organs dam-aged by injury and diseases. This article reviews the implications of ASCs in tissue regeneration. | Wakako Tsuji J Peter Rubin Kacey G Marra | 2014 | World Journal of Stem Cells2014，6，3： | 19 |
| 10 | Herbal traditional Chinese medicine and its evidence base in gastrointestinal disorders显示文摘Herbal traditional Chinese medicine(TCM) is used to treat several ailments, but its efficiency is poorly documented and hence debated, as opposed to modern medicine commonly providinge ffective therapies. The aim of this review article is to present a practical reference guide on the role of herbal TCM in managing gastrointestinal disorders, supported by systematic reviews and evidence based trials. A literature search using herbal TCM combined with terms for gastrointestinal disorders in Pub Med and the Cochrane database identified publications of herbal TCM trials. Results were analyzed for study type, inclusion criteria, and outcome parameters. Quality of placebo controlled, randomized, double-blind clinical trials was poor, mostly neglecting stringent evidence based diagnostic and therapeutic criteria. Accordingly, appropriate Cochrane reviews and meta-analyses were limited and failed to support valid, clinically relevant evidence based efficiency of herbal TCM in gastrointestinal diseases, including gastroesophageal reflux disease, gastric or duodenal ulcer, dyspepsia, irritable bowel syndrome, ulcerative colitis, and Crohn's disease. In conclusion, the use of herbal TCM to treat various diseases has an interesting philosophical background with a long history, but it received increasing skepticism due to the lack of evidence based efficiency as shown by high quality trials; this has now been summarized for gastrointestinal disorders, with TCM not recommended for most gastrointestinal diseases. Future studies should focus on placebo controlled, randomized, double-blind clinical trials, herbal product quality and standard criteria for diagnosis, treatment, outcome, and assessment of adverse herb reactions. This approach will provide figures of risk/benefit profiles that hopefully are positive for at least some treatment modalities of herbal TCM. Proponents of modern herbal TCM best face these promising challenges of pragmaticmodern medicine by bridging the gap between the two medicinal cultures. | Rolf Teschke Albrecht Wolff Christian Frenzel Axel Eickhoff Johannes Schulze | 2015 | World Journal of Gastroenterology2015，21，15： | 19 |
| 11 | Neurotherapeutic potential of erythropoietin after ischemic injury of the central nervous system显示文摘Erythropoietin (EPO) is one of the most successful biopharmaceuticals in history and is used for treating anemia of different origins. However, it became clear that EPO could also work in a neuroprotective, antiapoptotic, antioxidative, angiogenetic and neurotropic way. It causes stimulation of cells to delay cell apoptosis, especially in the central nervous system. In rodent models of focal cerebral ischemia, EPO showed an impressive reduction of infarct size by 30% and improvement of neurobehavioral outcome by nearly 40%. A large animal model dealing with ischemia and reperfusion of the spinal cord showed that EPO could reduce the risk of spinal cord injury significantly. In addition, some clinical studies tested whether EPO works in real live clinical settings. One of the most promising studies showed the innocuousness and improvements in follow-up, outcome scales and in infarct size, of EPO-use in humans suffering from ischemic stroke. Another study ended unfortunately in a negative outcome and an increased overall death rate in the EPO group. The most possible reason was the involvement of patients undergoing simultaneously systemic thrombolysis with recombinant tissue plasminogen activator. An experimental study on rats demonstrated that administration of EPO might exacerbate tissue plasminogen activator-induced brain hemorrhage without reducing the ischemic brain damage. This case shows clearly how useful animal models can be to check negative side effects of a treatment before going into clinical trials. Other groups looked in human trials at the effects of EPO on the outcome after ischemic stroke, relation to circulating endothelial progerdtor cells, aneurysmal subarachnoid hemorrhage, traumatic brain injury, hemoglobin transfusion thresholds and elective first-time coronary artery bypass surgery. Most of the results were pos-让ive, but are based mostly on small group sizes. However, some of the most neglected facts when focusing on experimental setups of ischemia of the central nervous system are issues like age and comorbidities. It might be extremely worthy to consider these points for future projects, because EPO might influence all these factors. | Florian Simon Nicolaos Floros Wiebke Ibing Hubert Schelzig Artis Knapsis | 2019 | Neural Regeneration Research2019，14，8： | 15 |
| 12 | New advances in targeted gastric cancer treatment显示文摘Despite a decrease in incidence over past decades,gastric cancer remains a major global health problem. In the more recent period, survival has shown only minor improvement, despite significant advances in diagnostic techniques, surgical and chemotherapeutic approaches, the development of novel therapeutic agents and treatment by multidisciplinary teams. Because multiple genetic mutations, epigenetic alterations, and aberrant molecular signalling pathways are involved in the development of gastric cancers, recent research has attempted to determine the molecular heterogeneity responsible for the processes of carcinogenesis, spread and metastasis. Currently, some novel agents targeting a part of these dysfunctional molecular signalling pathways have already been integrated into the standard treatment of gastric cancer, whereas others remain in phases of investigation within clinical trials. It is essential to identify the unique molecular patterns of tumours and specific biomarkers to develop treatments targeted to the individual tumour behaviour. This review analyses the global impact of gastric cancer, as well as the role of Helicobacter pylori infection and the efficacy of bacterial eradication in preventing gastric cancer development. Furthermore, the paper discusses the currently available targeted treatments and future directions of research using promising novel classes of molecular agents for advanced tumours. | Daniela Cornelia Lazar Sorina Taban Marioara Cornianu Alexandra Faur Adrian Goldis | 2016 | World Journal of Gastroenterology2016，22，30： | 15 |
| 13 | Value of bevacizumab in treatment of colorectal cancer: A meta-analysis显示文摘AIM:To assess the efficacy and safety of bevacizumab in the treatment of colorectal cancer.METHODS:All randomized controlled trials of bevacizumab for the treatment of colorectal cancer from January 2003 to June 2013 were collected by searching the Cochrane Library, Pub Med, Chinese National Knowledge Infrastructure and Wanfang databases.The primary endpoint was overall survival(OS), and the secondary endpoints were progression-free survival, overall response rate and adverse events.Two reviewers extracted data independently.Statistical analyses were performed with Stata 12.0.The degree of bias was assessed using funnel plots for the effect size of OS at the primary endpoint.RESULTS:Following the inclusion criteria and exclusion criteria, ten studies comprising 6977 cases were finally included, of which nine were considered to be of high quality(4-7 points) and one of low quality(1-3 points).Our meta-analysis revealed the efficacy of bevacizumab in patients with colorectal cancer in terms of OS(HR = 0.848, 95%CI:0.747-0.963), progressionfree survival(HR = 0.617, 95%CI:0.530-0.719), and overall response rate(OR = 1.627, 95%CI:1.199-2.207).Regarding safety, higher rates of grade ≥ 3 hypertension, proteinuria, bleeding, thrombosis, and gastrointestinal perforation were observed in the bevacizumab treatment group(P < 0.05); however, the incidence of serious toxicity was very low.There was no publication bias in the 10 reports included in this meta-analysis.CONCLUSION:The clinical application of bevacizumab in colorectal cancer is effective with good safety. | Chun-Ying Qu Ying Zheng Min Zhou Yi Zhang Feng Shen Jia Cao Lei-Ming Xu | 2015 | World Journal of Gastroenterology2015，21，16： | 15 |
| 14 | New therapeutic options opened by the molecular classification of gastric cancer显示文摘Gastric cancer(GC) is one of the most lethal and aggressive cancers, being the third cause of cancer related death worldwide. Even with radical gastrectomy and the latest generation of molecular chemotherapeutics, the numbers of recurrence and mortality remains high. This is due to its biological heterogeneity based on the interaction between multiple factors, from genomic to environmental factors, diet or infections with various pathogens. Therefore, understanding the molecular characteristics at a genomic level is critical to develop new treatment strategies. Recent advances in GC molecular classification provide the unique opportunity to improve GC therapy by exploiting the biomarkers and developing novel targeted therapy specific to each subtype. This article highlights the molecular characteristics of each subtype of gastric cancer that could be considered in shaping a therapeutic decision, and also presents the completed and ongoing clinical trials addressed to those targets. The implementation of the novel molecular classification system will allow a preliminary patient selection for clinical trials, a mandatory issue if it is desired to test the efficacy of a certain inhibitor to the given target. This will represent a substantial advance as well as a powerful tool for targeted therapy. Nevertheless, translating the scientific results into new personalized treatment opportunities is needed in order to improve clinical care, the survival and quality of life of patients with GC. | Mihaela Chivu-Economescu Lilia Matei Laura G Necula Denisa L Dragu Coralia Bleotu Carmen C Diaconu | 2018 | World Journal of Gastroenterology2018，24，18： | 14 |
| 15 | Five-year long-term outcomes of laparoscopic surgery for colon cancer显示文摘AIM:To perform a meta-analysis to answer whether long-term recurrence rates after laparoscopic-assisted surgery are comparable to those reported after open surgery.METHODS:A comprehensive literature search of the MEDLINE database,EMBASE database,and the Cochrane Central Register of Controlled Trials for the years 1991-2010 was performed.Prospective randomized clinical trials(RCTs)were eligible if they included patients with colon cancer treated by laparoscopic surgery vs open surgery and followed for more than five years.RESULTS:Three studies involving 2147 patients reported long-term outcomes based on five-year data and were included in the analysis.The overall mortality was similar in the two groups(24.9%,268/1075 in the laparoscopic group and 26.4%,283/1072 in open group).No significant differences between laparoscopic and open surgery were found in overall mortality during the follow-up period of these studies[OR(fixed) 0.92,95%confidence intervals(95%CI):0.76-1.12,P=0.41].No significant difference in the development of overall recurrence was found in colon cancer patients,when comparing laparoscopic and open surgery [2147 pts,19.3%vs 20.0%;OR(fixed)0.96,95% CI:0.78-1.19,P=0.71].CONCLUSION:This meta-analysis suggests that laparoscopic surgery was as efficacious and safe as open surgery for colon cancer,based on the five-year data of these included RCTs. | Bai HL Chen B Zhou Y Wu XT. | 2010 | World Journal of Gastroenterology2010，16，39： | 13 |
| 16 | WJSC 6^(th) Anniversary Special Issues(2):Mesenchymal stem cells Neurotrauma and mesenchymal stem cells treatment:From experimental studies to clinical trials显示文摘Mesenchymal stem cell(MSC)therapy has attracted the attention of scientists and clinicians around the world.Basic and pre-clinical experimental studies have highlighted the positive effects of MSC treatment after spinal cord and peripheral nerve injury.These effects are believed to be due to their ability to differentiate into other cell lineages,modulate inflammatory and immunomodulatory responses,reduce cell apoptosis,secrete several neurotrophic factors and respond to tissue injury,among others.There are many pre-clinical studies on MSC treatment for spinal cord injury(SCI)and peripheral nerve injuries.However,the same is not true for clinical trials,particularly those concerned with nerve trauma,indicating the necessity of more well-constructed studies showing the benefits that cell therapy can provide for individuals suffering the consequences of nerve lesions.As for clinical trials for SCI treatment the results obtained so far are not as beneficial as those described in experimental studies.For these reasons basic and pre-clinical studies dealing with MSC therapy should emphasize the standardization of protocols that could be translated to the clinical set with consistent and positive outcomes.This review is based on pre-clinical studies and clinical trials available in the literature from 2010 until now.At the time of writing this article there were 43 and 36 pre-clinical and 19 and 1 clinical trials on injured spinal cord and peripheral nerves,respectively. | Ana Maria Blanco Martinez Camila de Oliveira Goulart Bruna dos Santos Ramalho Júlia Teixeira Oliveira Fernanda Martins Almeida | 2014 | World Journal of Stem Cells2014，6，2： | 11 |
| 17 | The issue of lymphadenectomy during laparoscopic gastrectomy for gastric carcinoma显示文摘Surgical resection remains the mainstay of treatment for gastric cancer.Laparoscopic assisted gastrectomy has failed to gain universal acceptance as an alternative to the open approach for a number of reasons,one of which includes the issue of oncological radicality in terms of lymph node dissection.Nodal status,which is one of the most crucial and independent predictors of patient survival,therefore has been examined both in single institutional trials and also in randomised controlled trials especially on early gastric cancer.The issue of oncological adequacy for laparoscopic lymph node harvesting for advanced gastric cancer remains a contentious issue because of the unique challenges it poses in terms of complexity,safety and time,and also the lack of randomised controlled trials in this area.It is thus imperative that good quality multicentre randomised controlled trials are designed to investigate the benef its of extended lymphadenectomy in the setting of laparoscopic surgery,especially for advanced gastric cancer and its impact on both short and long term survival. | Muhammed Ashraf Memon Nick Butler Breda Memon | 2010 | World Journal of Gastrointestinal Oncology2010，2，2： | 10 |
| 18 | Meta-analysis of aspirin-heparin therapy for un-explained recurrent miscarriage显示文摘Objective This study was designed to evaluate the efficacy and safety of aspirin-heparin treatment for un-explained recurrent spontaneous abortion(URSA). Methods Literatures reporting the studies on the aspirin-heparin treatment of un-explained recurrent miscarriage with randomized controlled trials(RCTs) were collected from the major publication databases. The live birth rate was used as primary indicator, preterm delivery, preeclampsia, intrauterine growth restriction, and adverse reactions(thrombocytopenia) were used as the secondary indicators. The quality of the included studies was evaluated using RCT bias risk assessment tool in the Cochrane Handbook(v5.1.0). Meta-analysis was conducted using RevM an(v5.3) software. Subgroup analyses were conducted with an appropriately combined model according to the type of the treatments if heterogeneity among the selected studies was detected. Results Six publications of RCTs were included in this study. There were a total of 907 pregnant women with diagnosis of URSA, 367 of them were pooled in the study group with aspirin-heparin therapy and 540 women in the control group with placebo, aspirin or progesterone therapy. Meta-analysis showed that the live birth rate in the study group was significantly different from that in the control group [RR = 1.18, 95% CI(1.00-1.39), P=0.04]. Considering the clinical heterogeneity among the six studies, subgroup analysis were performed. Live birth rates in the aspirin-heparin treated groups and placebo groups were compared and no significant difference was found. There were no significant differences found between the two groups in the incidence of preterm delivery [RR=1.22, 95% CI(0.54-2.76), P=0.64], preeclampsia [RR=0.52, 95% CI(0.25-1.07), P=0.08], intrauterine growth restriction [RR=1.19, 95% CI(0.56-2.52), P=0.45] and thrombocytopenia [RR=1.17, 95% CI(0.09-14.42), P=0.90]. Conclusion This meta-analysis did not provide evidence that aspirin-heparin therapy had beneficial effect on un-explained recurrent miscarriage in terms of live birth rate, but it was relatively safe for it did not increase incidence of adverse pregnancy and adverse events. More well-designed and stratified double-blind RCT, individual-based meta-analysis regarding aspirin-heparin therapy are needed in future. | Ling Tong Xian-jiang Wei | 2016 | Chinese Medical Sciences Journal2016，31，4： | 10 |
| 19 | Quality Control and Nonclinical Research on CAR-T Cell Products: General Principles and Key Issues显示文摘Adoptive cell therapy using chimeric antigen receptor T (CAR-T) cells, which is a promising cancer immunotherapy strategy, has been developing very rapidly in recent years. CAR-T cells are genetically modified T cells that can specifically recognize tumor specific antigens on the surface of tumor cells, and then effectively kill tumor cells. At present, exciting results are being achieved in clinical applications of CAR-T cells for patients with hematological malignancies. The research and development of CAR-T cells for various targets and for the treatment of solid tumors have become a hot topic worldwide, so an increasing number of investigational new drug applications (INDAs) and new drug applications (NDAs) of CAR-T cell products are expected to be submitted in future. The quality control and nonclinical research of these products are of great significance in ensuring the safety and effectiveness of these products;however, they also present great challenges and difficulties. This article discusses the general principles of and key issues regarding the quality control and nonclinical research of CAR-T cell products based on their product characteristics and on relevant guidelines for gene and cell therapy products. | Yonghong Li Yan Huo Lei Yu Junzhi Wang | 2019 | Engineering2019，5，1： | 9 |
| 20 | Neo-adjuvant radiotherapy in rectal cancer显示文摘In rectal cancer treatment,attention has focused on the local primary tumour and the regional tumour cell deposits to diminish the risk of a loco-regional recurrence.Several large randomized trials have also shown that combinations of surgery,radiotherapy and chemotherapy have markedly reduced the risk of a locoregional recurrence,but this has not yet had any major influence on overall survival.The best results have been achieved when the radiotherapy has been given preoperatively.Preoperative radiotherapy improves loco-regional control even when surgery has been optimized to improve lateral clearance,i.e.,when a total mesorectal excision has been performed.The relative reduction is then 50%-70%.The value of radiotherapy has not been tested in combination with more extensive surgery including lateral lymph node clearance,as practised in some Asian countries.Many details about how the radiotherapy is performed are still open for discussion,and practice varies between countries.A highly fractionated radiation schedule(5 Gy×5),proven efficacious in many trials,has gained much popularity in some countries,whereas a conventionally fractionated regimen(1.8-2.0 Gy×25-28),often combined with chemotherapy,is used in other countries.The additional therapy adds morbidity to the morbidity that surgery causes,and should therefore be administered only when the risk of loco-regional recurrence is sufficiently high.The best integration of the weakest modality,to date the drugs(conventional cytotoxics and biologicals)is not known.A new generation of trials exploring the best sequence of treatments is required.Furthermore,there is a great need to develop predictors of response,so that treatment can be further individualized and not solely based upon clinical factors and anatomic imaging. | Bengt Glimelius | 2013 | World Journal of Gastroenterology2013，19，46： | 7 |
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