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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 | Role of percutaneous cerclage wire in the management of subtrochanteric fractures treated with intramedullary nails显示文摘PurposeCerclage 电线申请作为潜在的治疗学的附属物出现了到为 subtrochanteric 破裂钉的 intramedullary。但是它的流行被可能的否定效果的担心在破裂地区生物学上折磨。这研究被打算分析与 cerclage 电线 application.MethodsRetrospective 分析联系的 clinico 放射学的结果和复杂并发症在破裂操作了, intramedullary 在 2012 年 1 月和 2016 年 1 月之间钉的所有 subtrochanteric 上被执行。在排除以后, 48 个病人与 20.8 个月的平均后续是可得到的。长倾斜,有蝴蝶碎片的螺线,螺线楔或弄碎的破裂配置特别地为 cerclage 电线申请被考虑,它被经皮的 cerclage passer 在 21 个病人采用。评价到鸫类 dAubigne-Postel score.ResultsAverage 操作时间以操作时间,血损失,减小的质量,颈柄角度,后续排水量,联合时间,复杂并发症,和最后的功能的评估被做,血损失在 cerclage 组是显著地更高的(p ? | Vivek Trikha Saubhik Das Prabhat Agrawal Arkesh M Sunil Kumar Dhaka | 2018 | Chinese Journal of Traumatology2018，21，1： | 4 |
| 3 | Evaluation of mannitol effect in patients with acute hepatic failure and acute-on-chronic liver failure using conventional MRI,diffusion tensor imaging and in-vivo proton MR spectroscopy显示文摘AIM:To evaluate the effect of an intravenous bolus of mannitol in altering brain metabolites, brain water content, brain parenchyma volume, cerebrospinal fluid (CSF) volume and clinical signs in controls and in patients with acute liver failure (ALF) and acute-on-chronic liver failure (ACLF), by comparing changes in conventional magnetic resonance imaging (MRI), in vivo proton magnetic resonance spectroscopy (PMRS) and diffusion tensor imaging (DTI) before and after its infusion.METHODS: Five patients each with ALF and ACLF in grade 3 or 4 hepatic encephalopathy and with clinical signs of raised intracranial pressure were studied along with five healthy volunteers. After baseline MRI, an intravenous bolus of 20% mannitol solution was given over 10 min in controls as well as in patients with ALF and ACLF. Repeat MRI for the same position was acquired 30 min after completing the mannitol injection. RESULTS: No statistically significant difference was observed between controls and patients with ALF and ACLF in metabolite ratios, DTI metrics and brain volume or CSF volume following 45 min of mannitol infusion. There was no change in clinical status at the end of post-mannitol imaging. CONCLUSION: The osmotic effect of mannitol did not result in significant reduction of brain water content, alteration in metabolite ratios or any change in the clinical status of these patients during or within 45 min of mannitol infusion. | Vivek A Saraswat Sona Saksena Kavindra Nath Pranav Mandal Jitesh Singh M Albert Thomas Ramkishore S Rathore Rakesh K Gupta | 2008 | World Journal of Gastroenterology2008，14，26： | 2 |
| 4 | Intratympanic treatment of hearing loss with novel and traditionalagents显示文摘 | SEIDMAN M D VIVEK P | 2004 | Otolaryngol Clin North Am2004，37，： | 1 |
| 5 | Radiation pneumonitis and pulmonary fibrosis in non - small- cell lung cancer: pulmonary function, prediction, and prevention显示文摘 | Vivek M | 2005 | Int J Radiat Oncol Biol Phys2005，63，： | 1 |
| 6 | Design Guidelines for Wireless SensorNetworks:Communication,Clustering and Aggregation显示文摘 | Vivek M Catherine R | 2004 | AdHoc Networks2004，2，1： | 1 |
| 7 | Antioxidant and antilisterial effect of seed essential oil and organic extracts from Zizyphus jujuba显示文摘 | Sharif M Al-Reza Vivek K Bajpai Sun Chul Kang | | 0，，： | 1 |
| 8 | Use of locking compression plates for long bone nonunions without removing existing in tram edulary nail review of literature and our experience显示文摘 | Biren N Shekhar S Vivek M | 2008 | Trauma2008，65，2： | 1 |
| 9 | Endothelial cell and hepatocyte deaths occur by apoptosis after ischemia-reperfusion in the rat liver 显示文摘 | Vivek K Markus S John F M | 1999 | Tranplantation1999，67，8： | 1 |
| 10 | Fingerprint identification using space in- variant transforms显示文摘 | VIVEK A S MIEHAEL P M | 2002 | Pattern Recognition2002，，23： | 1 |
| 11 | Murine islet allograft tolerance upon blockade of the B-Lymphocyte stimulator,BLyS/BAFF显示文摘 | Parsons RF Yu M Vivek K | 2012 | Transplantation2012，93，7： | 1 |
| 12 | Design guidelines for wireless sensor networks:communication, clustering and aggregation显示文摘 | Vivek M Catherine R | 2004 | Ad Hoc Networks2004，2，1： | 1 |
| 13 | Tooth polishing: Relevance in present day periodontal practice 显示文摘 | Charu M Rhythm B Vivek KB | 2009 | J Indian Soc Periodontol2009，13，1： | 1 |
| 14 | Cardiac cell transplantation:closer to bedside显示文摘 | Osman O Al-radi M Vivek R | 2003 | Ann Thorac Surg2003，75，2： | 1 |
| 15 | Compact analyt- ical threshold-voltage model of nanoscate fully depleted strained-Si on silicon germanium-on insulator (SGOI) MOSFETs 显示文摘 | VIVEK V NAWAL S KUMAR M J | 2007 | IEEE Transactions on Electron Devices2007，54，3： | 1 |
| 16 | Silica-supported Pd catalysts for Heck coupling reactions 显示文摘 | Vivek P Arpad M | 2007 | Tetrahedron2007，63，30： | 1 |
| 17 | Avian metapneumovirus phosphoprotein targeted RNA interference silences the expression of viral proteins and inhibits virus replication 显示文摘 | Shirin M Kuljeet K Vivek K | 2006 | Antiviral Res2006，69，： | 1 |
| 18 | Intratympanic treatment of hearing loss with novel and traditional agents显示文摘 | SEIDMAN M D VIVEK P | 2004 | Otolaryngol Clin North Am2004，37，5： | 1 |
| 19 | Par-4 transcriptionally regulates Bcl-2 through a WT1-binding site on the bcl-2 promoter显示文摘 | Sangeeta K C Sandip K M Vivek M R | 2003 | J Biol Chem2003，278，19： | 1 |
| 20 | Impulse response dynamic stiffness decay in aging general aviation airfield pavements显示文摘 | Vivek K Michael A M Gerald A M | 2012 | Transportation Research Record Journal of the Transportation Research Board2012，2304，： | 1 |
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