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Development and validation of a predictive model for endocervical curettage in patients referred for colposcopy:A multicenter retrospective diagnostic study in China

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Chinese Journal of Cancer Research 2022年第4期34卷 395-405页

作者： Peng Xue Bingrui Wei samuel seery Qing Li Zichen Ye Yu Jiang Youlin Qiao Department of Epidemiology and Biostatistics School of Population Medicine and Public HealthChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China Faculty of Health and Medicine Division of Health ResearchLancaster UniversityLancasterLA14YWUnited Kingdom Diagnosis and Treatment for Cervical Lesions Center Shenzhen Maternity and Child Healthcare HospitalShenzhen 518028China

Objective:This study aimed to develop a nomogram that can predict occult high-grade squamous intraepithelial lesions or worse(HSIL+)and determine the need for endocervical curettage(ECC)in patients referred for ***:This retrospective multicenter study included 4,149 patients who were referred to any one of six tertiary hospitals in China for colposcopy between January 2020 and November 2021 because of abnormal screening *** data were extracted from the medical *** and multivariate logistic regression analyses were performed to identify factors that could predict HSIL+on *** were randomly assigned to a training set or to an internal validation set for performance and comparability *** model was externally validated and tested in patients from two additional *** nomogram was assessed in terms of discrimination and calibration and subjected to decision curve ***:HSIL+was found on ECC in 38.8%(n=388)of *** predictive nomogram included age group,cytology,human papillomavirus(HPV)status,visibility of the cervix and colposcopic *** nomogram had good overall discrimination,which was internally validated[area under the receiver-operator characteristic(AUC),0.839;95%confidence interval(95%CI),0.773-0.904].In terms of external validation,the AUC was 0.843(95%CI,0.773-0.912)for the consecutive sample and 0.843(95%CI,0.783-0.902)for the comparative *** analysis suggested good consistency between predicted and observed *** curve analysis suggested this nomogram would be clinically useful with almost the entire range of threshold ***:This internally and externally validated nomogram can be easily applied and incorporates multiple clinically relevant variables that can be used to identify patients with occult HSIL+who need ECC.

关键词： Cervical cancer colposcopy endocervical curettage nomogram

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Speckle-tracking echocardiography for detecting myocardial dysfunction in sepsis and septic shock patients:A single emergency department study

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World Journal of Emergency Medicine 2022年第3期13卷 175-181页

作者： Xuan Fu Xue Lin samuel seery Li-na Zhao Hua-dong Zhu Jun Xu Xue-zhong Yu Emergency Department State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijing 100730China Department of Cardiology Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China Faculty of Health and Medicine Division of Health ResearchLancaster UniversityLancaster LAI 4YWUnited Kingdom

BACKGROUND:Septic cardiomyopathy(SCM)occurs in the early stage of sepsis and septic shock,which has implications for treatment strategies and ***,myocardial involvement in the early stages of sepsis is difficult to ***,we assess subclinical myocardial function using laboratory tests and speckle-tracking echocardiography(STE).METHODS:Emergency department patients diagnosed with sepsis or septic shock were included for *** with other causes of acute or pre-existing cardiac dysfunction were *** echocardiography(TTE),including conventional echocardiography and STE,were performed for all patients three hours after initial *** for laboratory tests were taken around the time of ***:Left ventricular functions of 60 patients were analyzed,including 21 septic shock patients and 39 sepsis *** was no significant difference in global longitudinal strain(GLS),global circumferential strain(GCS),or global radical strain(GRS)between patients with sepsis and septic shock(all with P>0.05).However,GLS and GCS were significantly less negative in patients with abnormal troponin levels or in patients with abnormal left ventricular ejection fraction(LVEF)values(all with P<0.05).There were also moderate correlations between GLS and levels of cTnI(r=0.40,P=0.002)or N-terminal pro-B-type natriuretic peptide(NT-proBNP)(r=0.44,P=0.001)in sepsis and septic shock ***:Myocardial dysfunction,e.g.,lower LVEF or less negative GLS in patients with sepsis or septic shock,is more affected by myocardial *** could be incorporated into mainstream clinical practice as a supplementary LVEF parameter,especially for those with elevated troponin levels.

关键词： Sepsis Septic shock Speckle-tracking echocardiography Global longitudinal strain Global circumferential strain

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Lymphoepithelioma-like carcinoma of the upper urinary tract: A systematic review of case reports

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World Journal of Clinical Cases 2020年第4期8卷 771-781页

作者： Shi-Cong Lai samuel seery Wei Zhang Ming Liu Guan Zhang Jian-Ye Wang Department of Urology Beijing HospitalNational Center of GerontologyBeijing 100730China Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences Beijing 100730China School of Humanities and Social Sciences Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China Department of Pathology Beijing HospitalNational Center of GerontologyBeijing 100730China Department of Urology China-Japan Friendship HospitalBeijing 100029China

BACKGROUND Lymphoepithelioma-like carcinomas(LELCs)are rare,malignant epithelial tumors,generally considered a subtype of squamous cell *** are undifferentiated and can occur in multiple tissues,although LELCs in the urinary tract are extremely *** such,evidence does not provide clinicians with guidelines for the best *** though this is a rare disease,it is associated with high morbidity and ***,we must learn to differentiate LELC types and identify risk factors for early *** To develop an evidence base to guide clinicians treating primary LELCs of the upper urinary tract(UUT-LELC).METHODS We performed a systematic review of all reports on UUT-LELC from the first published case in 1998 until October 2019,according to the PRISMA.A database was then developed by extracting data from previously published reports in order to analyze interactions between clinical characteristics,pathological features,interventions and *** was analyzed using Kaplan–Meier estimates,which were compared using log rank *** A total of 28 previously published cases were identified for *** median age was 72 years with a male to female ratio of 4:*** type LELCs were most common with 48.3%(n=14),followed by 37.9%(n=11)predominant LELCs and 3.4%(n=1)focal ***-Barr virus testing was negative in all *** patients received radical nephroureterectomy(RNU)-based ***-three patients survived with no evidence of further metastasis,although six died before the median 18 mo follow-up *** analysis suggests pure histological subtypes,and patients who receive complete tumor resection have more favorable *** always in cancer care,early identification generally increases the probability of interventional *** The most effective treatment for UUT-LELC is RNU-based *** cases are few in number,case reporting must be enhanced and publishing enco

关键词： Lymphoepithelioma-like carcinoma Prognosis Radical nephroureterectomy Upper urinary tract Systematic review Case report

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Rare primary lymphoepithelioma-like carcinoma of the renal pelvis

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World Journal of Clinical Cases 2020年第9期8卷 1752-1755页

作者： Shi-Cong Lai samuel seery Tong-Xiang Diao Jian-Ye Wang Ming Liu Department of Urology Beijing HospitalBeijing 100730China National Center of Gerontology Beijing 100730China Institute of Geriatric Medicine Chinese Academy of Medical SciencesBeijing 100730China Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences Beijing 100730China School of Humanities and Social Sciences Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China Peking University Fifth School of Clinical Medicine Beijing 100730China

Lymphoepithelioma-like carcinoma(LELC)is a rare,malignant epithelial tumour which can arise within the upper urinary *** letter adds to a previous systematic review and cumulative analysis of 28 published upper urinary tract-LELC cases which provided insight into this disease;however,the current evidence does not provide clinicians with clear guidelines due to its ***,the aim was to report a new case of renal pelvis LELC presented in our *** this instance,we were able to report treatment experience and longterm follow-up *** patient presented with hypertension and haemturia which initiated further *** ultrasound identified an hypechoic mass,no malignant cells were detected using cytological *** magnetic resonance imaging identified a slightly enhanced mass in the left renal pelvis with no evidence of lymph node *** tumor biopsy suggested the existence of urothelial carcinoma,hence,laparoscopic radical left nephroureterectomy with bladder cuff excision was *** patientpractitioner consultations,we decided to adopt a"watch and wait"approach after radical nephroureterectomy rather than administering ***,we would encourage clinicians to record and publish cases to garner insight into this type of malignant disease.

关键词： Lymphoepithelioma-like carcinoma Prognosis Radical nephroureterectomy Upper urinary tract Treatment Case report

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Efficacy and safety of lenvatinib for patients with advanced hepatocellular carcinoma: A retrospective, real-world study conducted in China

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World Journal of Gastroenterology 2020年第30期26卷 4465-4478页

作者： Dong-Xu Wang Xu Yang Jian-Zhen Lin Yi Bai Jun-Yu Long Xiao-Bo Yang samuel seery Hai-Tao Zhao Department of Liver Surgery Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China Department of Humanities Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China

BACKGROUND Lenvatinib has become an indispensable part of treatment regimens for patients with advanced hepatocellular carcinoma(aHCC).Several recent real-world studies appear to have confirmed this;however,there are etiological *** necessitates further real-world studies of lenvatinib across diverse populations,such as in *** To investigate the efficacy and safety of lenvatinib in a Chinese HCC patient population under real-world *** This is a retrospective and multiregional study involving patients with aHCC receiving lenvatinib *** was assessed using the Response Evaluation Criteria in Solid Tumors version *** characteristics and adverse events(AEs)were recorded throughout the entire *** In total,54 HCC patients treated with lenvatinib monotherapy were included for final *** objective response rate was 22%(n=12)with a progressionfree survival(PFS)of 168 d;however,AEs occurred in 92.8%of *** analysis showed that the Barcelona Clinic Liver Cancer stage[hazard ratio(HR)0.465;95%CI:0.23-0.93;P=0.031],portal vein tumor thrombus(HR 0.38;95%CI:0.15-0.94;P=0.037)and Child-Pugh classifications(HR 0.468;95%CI:and specificity(83.3%)of decreasing serum biomarkers including alphafetoprotein were calculated in order to predict tumor size *** sequencing also provided insights into potential gene mutation signatures related to the effect of *** Our findings confirm previous evidence from the phase III REFLECT *** majority of patients in this Chinese sample were suffering from concomitant hepatitis B virus-related ***,further analysis suggested that baseline characteristics,changes in serum biomarkers and gene sequencing may hold the key for predicting lenvatinib *** large-scale prospective studies that incorporate more basic medical science measures should be conducted.

关键词： Lenvatinib Real-world study Hepatocellular carcinoma Efficacy Safety Treatment

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Oncological impact of different distal ureter managements during radical nephroureterectomy for primary upper urinary tract urothelial carcinoma

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World Journal of Clinical Cases 2020年第21期8卷 5104-5115页

作者： Shi-Cong Lai Peng-Jie Wu Jian-Yong Liu samuel seery Sheng-Jie Liu Xing-Bo Long Ming Liu Jian-Ye Wang Department of Urology Beijing HospitalNational Center of GerontologyInstitute of Geriatric MedicineChinese Academy of Medical SciencesBeijing 100730China Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences Beijing 100730China School of Humanities and Social Sciences Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China

BACKGROUND The current standard surgical treatment for non-metastatic upper urinary tract urothelial carcinoma(UTUC)is radical nephroureterectomy(RNU)with bladder cuff excision(BCE).Typically,BCE techniques are classified in one of the following three categories:An open technique described as intrasvesical incision of the bladder cuff,a transurethral incision of the bladder cuff(TUBC),and an extravesical incision of the bladder cuff(EVBC)*** though each of these management techniques are widely used,there is no consensus about which surgical intervention is superior,with the best oncologic *** To investigate the oncological outcomes of three BCE methods during RNU for primary UTUC *** We retrospectively analyzed the data of 248 primary UTUC patients,who underwent RNU with BCE between January 2004 to December *** were analyzed according to each BCE *** extracted included patient demographics,perioperative parameters,and oncological *** analyses were performed using chi-square and log-rank *** Cox proportional hazards regression model was utilized to identify independent predictors.P<0.05 was considered statistically *** Of the 248 participants,39.9%(n=99)underwent intrasvesical incision of the bladder cuff,38.7%(n=96)EVBC,and 21.4%(n=53)*** a median followup of 44.2 mo,bladder recurrence developed in 17.2%,12.5%,and 13.2%of the cases,***-specific deaths occurred in 11.1%,5.2%,and 7.5%of patients,***-Meier survival curves with a log-rank test highlighted no significant differences in intravesical recurrence-free survival,cancer-specific survival,and overall survival among these approaches with P values of 0.987,0.825,and 0.497,*** analysis showed that the lower ureter location appears to have inferior intravesical recurrence-free survival(P=0.042).However,cancer-specific survival and overall survival were independently influe

关键词： Bladder cuff excision Prognosis Upper urinary tract urothelial carcinoma Radical nephroureterectomy Technique Survival

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