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| 1 | 帕博利珠单抗单用或与放疗联用治疗转移性非小细胞肺癌:两个随机试验的汇总分析显示文摘背景放疗可以提高整个机体对免疫治疗的应答。在Ⅱ期PEMBRO-RT研究和Ⅰ/Ⅱ期MDACC研究中,患有转移性非小细胞肺癌(NSCLC)的患者被随机分配入组,接受免疫治疗(帕博利珠单抗)+放疗联合疗法,或免疫治疗单一疗法。当上述2个研究单独分析时,联合疗法组显示出潜在获益。由于每个研究的样本量较小,缓解率和结局并未显示出统计学意义,然而却有显著的临床获益。因此,本研究进行汇总分析,来判断放疗是否会改善转移性NSCLC患者的免疫治疗应答。方法PEMBRO-RT和MDACC研究纳入标准:患者年龄≥18岁,患有转移性NSCLC,且有≥1处未经放疗照射的病灶,以便进行射野外应答监测。PEMBRO-RT研究纳入曾接受过化疗患者,MDACC研究纳入曾接受过治疗或新诊断患者。2个研究中的患者均未接受过免疫治疗。在PEMBRO-RT研究中患者被等比例随机分配入组,并根据吸烟状态进行分层(分为<10年组和≥10年组)。MDACC研究的患者根据放疗计划可行性被等比例随机分配入2个受试组。由于联合治疗组的干预本质,每个研究中的放疗均不适用盲法。在2个研究中,不论是否进行放疗,均静脉滴入帕博利珠单抗(每3周200 mg)。在PEMBRO-RT研究中,在放疗(24 Gy 3次分割照射)结束后1周给予第1剂帕博利珠单抗。在MDACC研究中,在第1次放疗(50 Gy 4次分割照射或45 Gy 15次分割照射)同时给予帕博利珠单抗。仅检测未经照射病灶的应答。本研究的终点为最佳射野外(远隔)应答率(ARR)、最佳射野外疾病控制率(ACR)、12周时ARR、12周时ACR、无进展生存期(PFS)和总生存期(OS)。2个研究的意向治疗(ITT)人群均纳入分析。PEMBRO-RT研究(NCT02492568)和MDACC研究(NCT02444741)均在ClinicalTrials.gov上注册。发现纳入148例患者,76例接受帕博利珠单抗治疗,72例接受帕博利珠单抗+放疗治疗。所有患者随访时间中位数为33个月[四分位距(IQR):32.4~33.6]。148例患者中124例(84%)组织学特征为非鳞癌,111例(75%)患者曾经接受过化疗。组间没有基线特征差异,包括PD-L1表达状态和转移灶体积。最常见的照射部位为肺转移灶(39%,28/72)、胸腔内淋巴结(21%,15/72)和非原发灶(17%,12/72)。帕博利珠单抗组和联合治疗组的最佳ARR分别为19.7%(15/76)和41.7%(30/72),OR=2.96,95%CI:1.42~6.20,P=0.0039;最佳ACR分别为43.4%(33/76)和65.3%(47/72),OR=2.51,95%CI:1.28~4.91,P=0.0071;PFS中位数分别为4.4(IQR:2.9~5.9)和9.0个月(IQR:6.8~11.2),HR=0.67,95%CI:0.45~0.99,P=0.045;OS中位数分别为8.7(IQR:6.4~11.0)和19.2个月(IQR:14.6~23.8),OR=0.67,95%CI:0.54~0.84,P=0.0004。在汇总分析中没有发现新的安全问题。解读帕博利珠单抗免疫疗法+放疗显著提高转移性NSCLC患者的应答和改善治疗结局。这些结果需要在三期临床试验中进行验证。 | 陈大卫(翻译) 于金明(校对) Willemijn S M E Theelen Vivek Verma Brian P Hobbs Heike M U Peulen Joachim G J V Aerts Idris Bahce Anna Larissa N Niemeijer Joe Y Chang Patricia M de Groot Quynh-Nhu Nguyen Nathan I Comeaux George R Simon Ferdinandos Skoulidis Steven H Lin Kewen He Roshal Patel John Heymach Paul Baas James W Welsh | 2021 | 中华肿瘤防治杂志2021，28，24： | 49 |
| 2 | 中心和外周动脉脉搏波传导速度测量的重复性:社区动脉粥样硬化风险研究显示文摘通过脉搏波传导速度(pulsewavevelocity,PwV)检测动脉硬化程度是当前对高血压和心血管病风险评估和分层所日渐常用的方式。颈股动脉脉搏波传导速度(catroidfemoralarteryPWV,cfPWV)是一项公认的测定中心动脉硬化程度的方式。 | Meyer ML Tanaka H Palta P Patel MD Camplain R Couper D Cheng S Al Qunaibet A Poon AK Heiss G 陈云 叶鹏 | 2016 | 中华高血压杂志2016，24，5： | 6 |
| 3 | Risk-adjustment in hepatobiliarypancreatic surgery显示文摘AIM: The present study evaluates the performance of the POSSUM, the American Society of Anesthetists (ASA),APACHE and Childs classification in predicting mortality and morbidity in hepatopancreaticobiliary (HPB) surgery.We describe especially the limitations and advantages of risk in stratifying the patients.METHODS: We investigated 177 randomly chosen patients undergoing eledive complex HPB surgery in a single institution with a total of 71 pre-operative and intra-operative risk factors.Primary endpoint was in-hospital mortality and morbidity.Ordered logistic regression analysis was used to identify individual predictors of operative morbidity and mortality.RESULTS: The operative mortality in the series was 3.95% .This compared well with the p-POSSUM and APACHE predicted mortality of 4.31% and 4.29% respectively. Postoperative complications amounted to 45% with 24 (13.6%)patients having a major adverse event. On multivariate analysis the pre-operative POSSUM physiological score (OR = 1.18,P = 0.009) was superior in predicting complications compared to the ASA (P = 0.108), APACHE (P = 0.117)or Childs classification (P = 0.136). In addition, serum sodium, creatinine, international normalized ratio (INR),pulse rate, and intra-operative blood loss were independent risk factors. A combination of the POSSUM variables and INR offered the optimal combination of risk factors for risk prognostication in HPB surgery.CONCLUSION: Morbidity for elective HPB surgery can be accurately predicted and applied in everyday surgical practice as an adjunct in the process of informed consent and for effective allocation of resources for intensive and high-dependency care facilities. | Hemant M Kocher Paris P Tekkis Palepu Gopal Ameet G Patel Simon Cottam Irving S Benjamin | 2005 | World Journal of Gastroenterology2005，11，16： | 3 |
| 4 | Reliability of ultrasound ovarian-adnexal reporting and data system amongst less experienced readers before and after training显示文摘BACKGROUND The 2018 ovarian-adnexal reporting and data system(O-RADS)guidelines are aimed at providing a system for consistent reports and risk stratification for ovarian lesions found on ultrasound.It provides key characteristics and findings for lesions,a lexicon of descriptors to communicate findings,and risk characterization and associated follow-up recommendation guidelines.However,the ORADS guidelines have not been validated in North American institutions or amongst less experienced readers.AIM To evaluate the diagnostic accuracy and inter-reader reliability of ultrasound ORADS risk stratification amongst less experienced readers in a North American institution with and without pre-test training.METHODS A single-center retrospective study was performed using 100 ovarian/adnexal lesions of varying O-RADS scores.Of these cases,50 were allotted to a training cohort and 50 to a testing cohort via a non-randomized group selection process in order to approximately equal distribution of O-RADS categories both within and between groups.Reference standard O-RADS scores were established through consensus of three fellowship-trained body imaging radiologists.Three PGY-4 residents were independently evaluated for diagnostic accuracy and inter-reader reliability with and without pre-test O-RADS training.Sensitivity,specificity,positive predictive value,negative predictive value(NPV),and area under the curve(AUC)were used to measure accuracy.Fleiss kappa and weighted quadratic(pairwise)kappa values were used to measure inter-reader reliability.Statistical significance was P<0.05.RESULTS Mean patient age was 40±16 years with lesions ranging from 1.2 to 22.5 cm.Readers demonstrated excellent specificities(85%-100%pre-training and 91%-100%post-training)and NPVs(89%-100%pre-training and 91-100%post-training)across the O-RADS categories.Sensitivities were variable(55%-100%pre-training and 64%-100%post-training)with malignant ORADS 4 and 5 Lesions pre-training and post-training AUC values of 0.87-0.95 and 0.94-098,respectively(P<0.001).Nineteen of 22(86%)misclassified cases in pre-training were related to mischaracterization of dermoid features or wall/septation morphology.Fifteen of 17(88%)of posttraining misclassified cases were related to one of these two errors.Fleiss kappa inter-reader reliability was‘good’and pairwise inter-reader reliability was‘very good’with pre-training and post-training assessment(k=0.76 and 0.77;and k=0.77-0.87 and 0.85-0.89,respectively).CONCLUSION Less experienced readers in North America achieved excellent specificities and AUC values with very good pairwise inter-reader reliability.They may be subject to misclassification of potentially malignant lesions,and specific training around dermoid features and smooth vs irregular inner wall/septation morphology may improve sensitivity. | Prayash Katlariwala Mitchell P Wilson Yeli Pi Baljot S Chahal Roger Croutze Deelan Patel Vimal Patel Gavin Low | 2022 | World Journal of Radiology2022，14，9： | 2 |
| 5 | Relative expression of immunolocalized connexins 40 and 43 correlates with human atrial conduction properties显示文摘 | Kanagaratnam P Rothery S Patel P | 2002 | J Am Coll Cardiol2002，39，1： | 2 |
| 6 | Transbronchial needle aspiration guidance with CT fluoroscopy显示文摘 | White C S Weiner E A Patel P | 2000 | Chest2000，118，4： | 1 |
| 7 | GH6 characterization of a Neocallimastix patriciarum cellulase cDNA (celA) homologous to Trichoderma reesei cellobiohydrolase II 显示文摘 | DENMAN S XUE G P PATEL B | 1996 | Appl Environ Microbiol1996，62，6： | 1 |
| 8 | Oral tonsils (ectopic oral tonsillar tissue)显示文摘 | PATEL K ARIYARATNAM S SLOAN P | 2004 | Dent Update2004，31，： | 1 |
| 9 | Pulmonary embolism:optimization of small pulmonary artery visualization at multi-detector row CT显示文摘 | Patel S Kazerooni E A Cascade P N | 2003 | Radiology2003，227，2： | 1 |
| 10 | International Journal of Powder Metallurgy显示文摘 | Joshi P B Krishnan P S Patel R H | 1998 | 34(4):63-741998，34，4： | 1 |
| 11 | Parameteters Related to Clothing Comfort-A New Approach for Measuring Moisture Transport Through Fabrics显示文摘 | Sreenivasan S Patel G S Nachane R P | 1990 | Indian Journal of Fabrics & Textile Research1990，，9： | 1 |
| 12 | Delta opioid receptor stimulation mimics ischemic preconditioning in human heart muscle显示文摘 | BELL S P SACK M N PATEL A | 2000 | J Am Coll Cardiol2000，36，7： | 1 |
| 13 | Voltammetric sensor for barbituric acid based on a solgel derivated molecularly imprinted polymer brush grafted to graphite electrode显示文摘 | PATEL A K SHARMA P S PRASAD B B | 2009 | International Journal of Pharmaceutics2009，371，1： | 1 |
| 14 | Identification of a gene,MLL,that spans the breakpoint in 11q23 translocations associated with human leukemias显示文摘 | Ziemin-Van Der Poel S McCabe NR Gill HJ Espinosa R 3rd Patel Y Harden A Rubinelli P Smith SD LeBeau MM Rowley JD | | 0，，： | 1 |
| 15 | Dexmedetomidine providescortical neuroprolection : impact on anaesthetic-induced neu-roapoptosis in the rat developing brain 显示文摘 | Sanders RD Sun P Patel S | 2010 | Acta AnaesthesiolScand2010，54，6： | 1 |
| 16 | Group faultlines: A review, integration, and guide to future research 显示文摘 | Thatcher S M B Patel P C | 2012 | Journal of Management2012，38，4： | 1 |
| 17 | A prospective doubleblind randon ized controlled trial comparing the suitability of KTP laser tonsillectomy with conventional dissection tonsillectomy for day case surgery 显示文摘 | Kothari P Patel S Brown P | 2002 | Clinotelarygo La LLIED Sci2002，27，： | 1 |
| 18 | A conditional immortal clonal stem line from human cortical neuroepithelium for the treatment ofischemic stroke 显示文摘 | Pollock K Stroemer P Patel S | 2006 | Exp Neurol2006，199，： | 1 |
| 19 | Dexmedetomidine pro- vides cortical neuroprotection: Impact on anaesthetic-induced neuroapoptosis in the rat developing brain 显示文摘 | SANDERS R D SUN P PATEL S | 2010 | Acta Anaesthesiol Scand2010，54，6： | 1 |
| 20 | Determinants of left ventricular mass and hypertrophy in hemodialysis patients assessed by cardiac magnetic resonance imaging显示文摘 | Patel R K Oliver S Mark P B | 2009 | Clin J Am Soc Nephrol2009，4，9： | 1 |
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