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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 | Outcomes of liver transplantation in patients with hepatorenal syndrome显示文摘Hepatorenal syndrome(HRS) plays an important role in patients with liver cirrhosis on the wait list for liver transplantation(LT). The 1 and 5-year probability of developing HRS in cirrhotic with ascites is 20% and 40%, respectively. In this article, we reviewed current concepts in HRS pathophysiology, guidelines for HRS diagnosis, effective treatment options presently available, and controversies surrounding liver alone vs simultaneous liver kidney transplant(SLKT) in transplant candidates. Many treatment options including albumin, vasoconstrictors, renal replacement therapy, and eventual LT have remained a mainstay in the treatment of HRS. Unfortunately, even after aggressive measures such as terlipressin use, the rate of recovery is less than 50% of patients. Moreover, current SLKT guidelines include:(1) estimation of glomerular filtration rate of 30 m L/min or less for 4-8 wk;(2) proteinuria > 2 g/d; or(3) biopsy proven interstitial fibrosis or glomerulosclerosis. Even with these updated criteria there is a lack of consistency regarding longterm benefits for SLKT vs LT alone. Finally, in regards to kidney dysfunction in the post-transplant setting, an estimation of glomerular filtration rate < 60 mL /min per 1.73 m2 may be associated with an increased risk of patients having long-term end stage renal disease. HRS is common in patients with cirrhosis and those on liver transplant waitlist. Prompt identification and therapy initiation in transplant candidates with HRS may improve post-transplantation outcomes. Future studies identifying optimal vasoconstrictor regimens, alternative therapies, and factors predictive of response to therapy are needed. The appropriate use of SLKT in patients with HRS remains controversial and requires further evidence by the transplant community. | Rohan M Modi Nishi Patel Sherif N Metwally Khalid Mumtaz | 2016 | World Journal of Hepatology2016，8，24： | 8 |
| 3 | 固定低剂量三联抗高血压药物与常规治疗对斯里兰卡轻度至中度高血压患者血压控制的疗效差异:一项随机临床试验显示文摘控制不良的高血压是全球领先的公共卫生问题,需要新的治疗策略。该研究评估低剂量三联抗高血压药物治疗是否能达到比常规治疗更好的血压控制。研究者纳入2016年2月至2017年5月在斯里兰卡11所城市医院诊所就诊的需要开始抗高血压治疗(未治疗的患者)或接受单药治疗的患者,进行低剂量三联降压与常规治疗比较的随机、开放性试验,随访至2017年10月。 | Web-ster R Salam A de Silva HA Selak V Stepien S Rajapakse S Amarasekara S Amarasena N Billot L de Silva AP Fernando M Guggilla R Jan S Jayawardena J Maulik PK Mendis S Munasinghe J Naik N Prabhakaran D Ranasinghe G Thom S Tisserra N Senaratne V Wijekoon S Wijeyasingam S Rodgers A Patel A 刘莉 叶鹏 | 2018 | 中华高血压杂志2018，26，12： | 7 |
| 4 | Clinical application of concentrated bone marrow aspirate in orthopaedics:A systematic review显示文摘AIM To examine the evidence behind the use of concentrated bone marrow aspirate(c BMA) in cartilage, bone, and tendon repair; establish proof of concept for the use of cB MA in these biologic environments; and provide the level and quality of evidence substantiating the use of cB MA in the clinical setting.METHODS We conducted a systematic review according to PRISMA guidelines. EMBASE, MEDLINE, and Web of Knowledge databases were screened for the use of cB MA in the repair of cartilage, bone, and tendon repair. We extracted data on tissue type, cB MA preparation, cB MA concentration, study methods, outcomes, and level of evidence and reported the results in tables and text.RESULTS A total of 36 studies met inclusion/exclusion criteria and were included in this review. Thirty-one of 36(86%) studies reported the method of centrifugation and preparation of cB MA with 15(42%) studies reporting either a cell concentration or an increase from baseline. Variation of c BMA application was seen amongst the studies evaluated. Twenty-one of 36(58%) were level of evidence Ⅳ, 12/36(33%) were level of evidence Ⅲ, and 3/36(8%) were level of evidence Ⅱ. Studies evaluated full thickness chondral lesions(7 studies), osteochondral lesions(10 studies), osteoarthritis(5 studies), nonunion or fracture(9 studies), or tendon injuries(5 studies). Significant clinical improvement with the presence of hyaline-like values and lower incidence of fibrocartilage on T2 mapping was found in patients receiving cB MA in the treatment of cartilaginous lesions. Bone consolidation and time to bone union was improved in patients receiving cB MA. Enhanced healingrates, improved quality of the repair surface on ultrasound and magnetic resonance imaging, and a decreased risk of re-rupture was demonstrated in patients receiving cB MA as an adjunctive treatment in tendon repair. CONCLUSION The current literature demonstrates the potential benefits of utilizing c BMA for the repair of cartilaginous lesions, bony defects, and tendon injuries in the clinical setting. This study also demonstrates discrepancies between the literature with regards to various methods of centrifugation, variable cell count concentrations, and lack of standardized outcome measures. Future studies should attempt to examine the integral factors necessary for tissue regeneration and renewal including stem cells, growth factors and a biologic scaffold. | Arianna L Gianakos Li Sun Jay N Patel Donald M Adams Frank A Liporace | 2017 | World Journal of Orthopedics2017，8，6： | 5 |
| 5 | Caloric restriction attenuates Aβ-deposition in Alzheimer transgenic models显示文摘 | PATEL N V GORDON M N CONNOR K E | 2005 | Neurobiol Aging2005，26，： | 1 |
| 6 | 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 |
| 7 | Identification of a 52 kb deletion downstream of the SOST gene in patients with van Buchem disease显示文摘 | BALEMANS W PATEL N EBELING M | 2002 | J Med Genet2002，39，2： | 1 |
| 8 | DNA replication licensing factors and aneuploidy are linked to tumor cell cycle state and clinical outcome in penile carcinoma显示文摘 | Kayes O J Loddo M Patel N | 2009 | Clin Cancer Res2009，15，23： | 1 |
| 9 | Regulation of carbonic-anhydrase activity,inorganic-carbon uptake and photosynthetic biomass yield in Chlamydomonas reinhardtii显示文摘 | Patel B N Merrett M J 1986 | 1986 | Planta1986，169，： | 1 |
| 10 | 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 |
| 11 | Characterisation of bacterially expressed structural protein E2 of hepatitis C virus显示文摘 | Yurkova M S Patel A H Fedorov A N | 2004 | Protein Expression and Purification2004，37，1： | 1 |
| 12 | Liquid chromato- graphy tandem mass spectrometry assay for the simultaneous determination of venlafaxine and O- desmethylvenlafaxine in human plasma and its application to a bioequivalence study显示文摘 | PATEL BN SHARMA N SANYAL M et ol | 2008 | J Pharm Biomed Anal2008，47，3： | 1 |
| 13 | Combination of the superior and inferior pedicle'continuities'for anastomosis of an SIEA flap to a contralateral DIEP flap in double-pedicled abdominal free flaps:a further modification of the Hamdi classification显示文摘 | Mohan A T Patel N G Malata C M | 2014 | J Plast Reconstr Aesthet Surg2014，67，10： | 1 |
| 14 | Surgical management of localized amyloidosis显示文摘 | KENNEDY T L PATEL N M | 2000 | Laryngoscope2000，110，： | 1 |
| 15 | New symptomatic vertebral compression fractures within a year following vertebroplasty inosteoporotic women显示文摘 | Syed M Patel N Jan S | 2005 | AJNR2005，26，： | 1 |
| 16 | Interactive im age-guided surgery of the spine-use of the ISG/ElektaViewing Wand to aid intraoperative localization of a sacral osteoblastoma显示文摘 | Patel N Sanderman DR Cobby M | 1997 | Brit J Neurosurg1997，11，1： | 1 |
| 17 | Can higher doses of oxybutynin improve efficacy in neurogenic bladder? 显示文摘 | Bennett N O'Leary M Patel AS | 2004 | Urol2004，171，21： | 1 |
| 18 | Dimensional changes of alginate dental impression materials 显示文摘 | Nallamuthu N Braden M Patel MP | 2006 | J Mater Sci Mater Med2006，17，12： | 1 |
| 19 | Dimensional changes of alginate dental impression materials 显示文摘 | Nallamuthu N Braden M Patel MP | 2006 | J Mater Sci Mater Med2006，17，12： | 1 |
| 20 | LC-MS-ESI for the determination of loratadine and descarboethoxyloratadine in hu- man plasma显示文摘 | PATEL BN SHARMA N SANYAL M | 2010 | J Chromatogr Sci2010，48，1： | 1 |
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