AIM: To evaluate the relationship between hepatocellular carcinoma(HCC) vascularity and grade; to describe patterns and vascular/histopathological variations of post-transplantation recurrence.METHODS: This retrospect...
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AIM: To evaluate the relationship between hepatocellular carcinoma(HCC) vascularity and grade; to describe patterns and vascular/histopathological variations of post-transplantation recurrence.METHODS: This retrospective study included 165 patients(143 men, 22 women; median age 56.8 years, range 28-70.4 years) transplanted for HCC who had a follow-up period longer than 2 mo. Pre-transplantation dynamic computed tomography or magnetic resonance examinations were retrospectively reviewed, classifying HCC imaging enhancement pattern into hypervascular and hypovascular based on presence of wash-in during arterial phase. All pathologic reports of the explanted livers were reviewed, collecting data about HCC differentiation degree. The association between imaging vascular pattern and pathological grade was estimated using the Fisher exact test. All follow-up clinical and imaging data were reviewed for evidence of recurrence. Recurrence rate was calculated and imaging features of recurrent tumor were collected, classifying early and late recurrences based on timing(< or ≥ 2 years after transplantation) and intrahepatic, extrahepatic and both intrahepatic and extrahepatic recurrences based onlocation. All intrahepatic recurrences were classified as hypervascular or hypovascular and the differentiation degree was collected where available. The presence of variations in imaging enhancement pattern and pathological grade between the primary tumor and the intrahepatic recurrence was evaluated and the association between imaging and histopatholgical variations was estimated by using the χ2 test. RESULTS: Of the 163 patients with imaging evidence of viable tumor, 156(95.7%) had hypervascular and 7(4.3%) hypovascular HCC. Among the 125 patients with evidence of viable tumor in the explanted liver, 19(15.2%) had grade 1, 56(44.8%) grade 2, 40(32%) grade 3 and 4(3.2%) grade 4 HCC, while the differentiation degree was not assessable for 6 patients(4.8%). A significant association was found between imaging vascularity and pathologi
目的通过网络meta分析比较不同类型和方式的心理治疗在青少年焦虑障碍患者中的效果。方法检索PubMed, Cochrane CENTRAL, Embase, PsycINFO, Web of Science,CINAHL, ProQuest Dissertations, LILACS, international trial registers以...
目的通过网络meta分析比较不同类型和方式的心理治疗在青少年焦虑障碍患者中的效果。方法检索PubMed, Cochrane CENTRAL, Embase, PsycINFO, Web of Science,CINAHL, ProQuest Dissertations, LILACS, international trial registers以及FDA报道的从建库至2016年6月31日的文献。筛选出比较两种结构化心理治疗或结构化心理治疗与对照组在儿童青少年焦虑障碍患者中效果的随机对照试验。4位研究者分为两组独立地进行数据提取与质量评价。使用随机效应模型的成组meta分析和贝叶斯网络meta分析来整合数据。评价治疗结束和随访结束时的疗效(焦虑症状的改变),耐受性(治疗结束时的失访),以及生活质量和功能改善。短程和长程的随访的疗效同样也被测量。通过GRADE框架评估证据质量对每个网络的贡献。评价治疗结束和随访结束时的疗效(焦虑症状的改变),耐受性(治疗结束时的失访),以及生活质量和功能改善,同时评价短程和长程的随访的疗效。通过GRADE框架评估证据质量对每个网络的贡献。结果共纳入96个临床试验包括6256名参与者,比较了11种心理治疗与4种不同的对照措施。基于GRADE框架,大多数证据被评为低风险或极低风险。疗效结果显示,大多数心理治疗在治疗结束时(SMDs:-1.44到-0.65)和最长随访时(SMDs:-1.84到-1.64)显著优于等待治疗组。然而,只有团体CBT治疗比某些心理治疗和所有对照措施在治疗结束时和短期随访时有显著疗效。耐受性结果显示,阅读疗法比大多数心理疗法和对照措施具有更多的全因失访(ORs:0.06到0.37)。生活质量和功能改善结果显示,只有不同方式的CBT治疗比心理安慰剂治疗和等待治疗组显着有益(SMDs:0.65到2.01)。结论团体CBT是儿童青少年焦虑障碍患者的首选心理治疗。其他类型和方式的心理治疗可作为替代治疗选择。需进一步研究特定的焦虑障碍,特定障碍的心理治疗方法,以及影响疗效的因素。
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