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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 | Predictors of spine deformity progression in adolescent idiopathic scoliosis: A systematic review with meta-analysis显示文摘AIM: To evaluate published data on the predictors of progressive adolescent idiopathic scoliosis(AIS) in order to evaluate their efficacy and level of evidence. METHODS: Selection criteria:(1) study design: randomized controlled clinical trials, prospective cohort studies and case series, retrospective comparative and none comparative studies;(2) participants: adolescents with AIS aged from 10 to 20 years; and(3) treatment: observation, bracing, and other. Search method: Ovid MEDLINE, Embase, the Cochrane Library, Pub Medand patent data bases. All years through August 2014 were included. Data were collected that showed an association between the studied characteristics and the progression of AIS or the severity of the spine deformity. Odds ratio(OR), sensitivity, specificity, positive and negative predictive values were also collected. A metaanalysis was performed to evaluate the pooled OR and predictive values, if more than 1 study presented a result. The GRADE approach was applied to evaluate the level of evidence.RESULTS: The review included 25 studies. All studies showed statistically significant or borderline association between severity or progression of AIS with the following characteristics:(1) An increase of the Cobb angle or axial rotation during brace treatment;(2) decrease of the rib-vertebral angle at the apical level of the convex side during brace treatment;(3) initial Cobb angle severity(> 25o);(4) osteopenia;(5) patient age < 13 years at diagnosis;(6) premenarche status;(7) skeletal immaturity;(8) thoracic deformity;(9) brain stem vestibular dysfunction; and(10) multiple indices combining radiographic, demographic, and physiologic characteristics. Single nucleotide polymorphisms of the following genes:(1) calmodulin 1;(2) estrogen receptor 1;(3) tryptophan hydroxylase 1;(3) insulin-like growth factor 1;(5) neurotrophin 3;(6) interleukin-17 receptor C;(7) melatonin receptor 1B, and(8) Scoli Score test. Other predictors included:(1) impairment of melatonin signaling in osteoblasts and peripheral blood mononuclear cells(PBMC);(2) G-protein signaling dysfunction in PBMC; and(3) the level of platelet calmodulin. However, predictive values of all these findings were limited, and the levels of evidence were low. The pooled result of brace treatment outcomes demonstrated that around 27% of patents with AIS experienced exacerbation of the spine deformity during or after brace treatment, and 15% required surgical correction. However, the level of evidence is also low due to the limitations of the included studies.CONCLUSION: This review did not reveal any methods for the prediction of progression in AIS that could be recommended for clinical use as diagnostic criteria. | Andriy Noshchenko Lilian Hoffecker Emily M Lindley Evalina L Burger Christopher MJ Cain Vikas V Patel Andrew P Bradford | 2015 | World Journal of Orthopedics2015，6，7： | 4 |
| 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 | Fusion neutron and ion emission from deuterium and deuterated methane cluster plasmas显示文摘 | K W Madison P K Patel D Price A Edens, M Allen, T E Cowan, J Zweiback, T Ditmire | | 0，，： | 2 |
| 5 | 3,6-Disubtituted fluorane containing 4 (3H)-quinazolinon-3-yl, diethyl amino groups and their application in reversible thermochromic materials显示文摘 | PATEL R G PATEL M P PATLE R G | 2005 | Dyes and Pigments2005，66，1： | 1 |
| 6 | TLR2 agonist ameliorates established allergic airway inflammation by promoting Th1 response and not via regulatory T cells显示文摘 | PATEL M XU D KEWIN P | 2005 | J Immunol2005，174，12： | 1 |
| 7 | Flow-based multiadsorbate ellipsometric porosimetry for the characterization of mesoporous Pt- TiO2 and Au-TiO2 nanocomposites显示文摘 | May R A Patel M N Johnston K P | 2009 | Langmuir2009，25，8： | 1 |
| 8 | 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 |
| 9 | Accelerated thermal ageing studies on nitrile rubber o-rings显示文摘 | Morrell P R Patel M Skinner A R | 2003 | Polymer Testing2003，22，： | 1 |
| 10 | Platelet derived growth factor B and epithelial mesenchymal transition of peritoneal mesothelial cells显示文摘 | Patel P West-Mays J Kolb M | 2010 | Matrix Biol2010，29，2： | 1 |
| 11 | 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 |
| 12 | Removal of arsenic from groundwater by granular titanium dioxide adsorbent显示文摘 | Pena M E Korfiatis G P Patel M | 2005 | Water Res2005，39，11： | 1 |
| 13 | Phytosterols and vascular disease显示文摘 | PATEL M D THOMPSON P D | 2006 | Atherosclerosis2006，186，1： | 1 |
| 14 | Soluble monomeric P - selectin containing only the lectin and epidermal growth factor domains binds to P - selectin glycoprotein ligand - 1 on leukocytes 显示文摘 | MEHTA P PATEL K D LAUE T M | 1997 | Blood1997，90，6： | 1 |
| 15 | Adsorption of As (Ⅴ) and As (Ⅲ) by nanocrystalline titanium dioxide显示文摘 | Pena M E Korfiatis G P Patel M | 2005 | Water Research2005，39，11： | 1 |
| 16 | Cardiac T2* Magnetic Resonance for Prediction of Cardiac Complications in Thalassemia Major显示文摘 | P Kirk M Roughton J B. Porter J M. Walker M A. Tanner J Patel D Wu J Taylor M A. Westwood L J. Anderson D J. Pennell | 2009 | Circulation2009，，20： | 1 |
| 17 | Novel human SR-BI antibodies prevent infection and dissemination of HCV in vitro and in humanized mice显示文摘 | Lacek K Vercauteren K Grzyb K Naddeo M Verhoye L Slowikowski M P Fafi-Kremer S Patel A H Baumert T F Folgori A Leroux-Roels G Cortese R Meuleman P Nicosia A | 2012 | J Hepatol2012，57，1： | 1 |
| 18 | An analysis of deep vein thrombosis in 1277 consecutive neurosurgical patients undergoing routine weekly ultrasonography显示文摘 | Patel A P Kohz M T Sansur C A | 2013 | J Neurosurg2013，118，3： | 1 |
| 19 | The maize epicuticular wax layer provides UV protection显示文摘 | Long L M Patel H P Cory W C | 2002 | Functional Plant Biology2002，30，1： | 1 |
| 20 | C-reactive protein and its relation to cardiovascular risk factor: a population based cross sectional study 显示文摘 | Mendall M A patel P Ballam L | 1996 | Bri Med J1996，312，7038： | 1 |
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