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2022 Chinese expert consensus and guidelines on clinical management of toxicity in anti-CD19 chimeric antigen receptor T-cell therapy for B-cell non-Hodgkin lymphoma

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Cancer Biology & Medicine 2023年第2期20卷 129-146页

作者： Ping Li Yang Liu Yun Liang Jian Bo Sujun Gao Yongxian Hu Yu Hu He Huang Xiaojun Huang Hongmei Jing Xiaoyan Ke Jianyong Li Yuhua Li Qifa Liu Peihua Lu Heng Mei Ting Niu Yongping Song Yuqin Song Liping Su Sanfang Tu Jianxiang Wang Depei Wu Zhao Wang Kailin Xu Zhitao Ying Qingming Yang Yajing Zhang Fengxia Shi Bin Zhang Huilai Zhang Xi Zhang Mingfeng Zhao Weili Zhao Xiangyu Zhao Liang Huang Jun Zhu Wenbin Qian Weidong Han Aibin Liang Department of Hematology Shanghai Tongji HospitalTongji University School of MedicineShanghai 200065China Department of Bio-therapeutic Chinese PLA General HospitalBeijing 100853China Department of Hematology The Second Affiliated HospitalCollege of MedicineZhejiang UniversityHangzhou 310009China Department of Hematology Chinese PLA General HospitalBeijing 100853China Department of Hematology The First Hospital of Jilin UniversityChangchun 130012China Center for Bone Marrow Transplantation The First Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhou 310058China Institute of Hematology Union Hospital of Tongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430022China Peking University People’s Hospital&Peking University Institute of Hematology Beijing Key Laboratory of Hematopoietic Stem Cell TransplantationBeijing 100044China Department of Hematology Lymphoma Research CenterPeking University Third HospitalBeijing 100191China Department of Hematology The First Affiliated Hospital of Nanjing Medical UniversityJiangsu Province HospitalNanjing 210029China Department of Hematology Zhujiang HospitalSouthern Medical UniversityGuangzhou 510280China Department of Hematology Nanfang HospitalSouthern Medical UniversityGuangzhou 510515China Lu Daopei Institute of Hematology Beijing 101102China Department of Hematology West China HospitalSichuan UniversityChengdu 610041China The Affiliated Cancer Hospital of Zhengzhou University Zhengzhou 450008China Department of Lymphoma Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education/Beijing)Peking University Cancer Hospital and InstituteBeijing 100142China Department of Hematology Shanxi Cancer HospitalTaiyuan 030013China State Key Laboratory of Experimental Hematology National Clinical Research Center for Blood DiseasesDivision of Pediatric Blood Disease CenterInstitute of Hematology&Blood Disease HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeTianj

Adoptive cellular immunotherapy with chimeric antigen receptor(CAR)T cells has emerged as a novel modality for treating relapsed and/or refractory B-cell non-Hodgkin lymphoma(B-NHL).With increasing approval of CAR T-cell products and advances in CAR T cell therapy,CAR T cells are expected to be used in a growing number of ***,CAR T-cell-associated toxicities can be severe or even fatal,thus compromising the survival benefit from this *** and studying the clinical management of these toxicities are *** contrast to other hematological malignancies,such as acute lymphoblastic leukemia and multiple myeloma,anti-CD19 CAR T-cell-associated toxicities in B-NHL have several distinctive features,most notably local cytokine-release syndrome(CRS).However,previously published guidelines have provided few specific recommendations for the grading and management of toxicities associated with CAR T-cell treatment for ***,we developed this consensus for the prevention,recognition,and management of these toxicities,on the basis of published literature regarding the management of anti-CD19 CAR T-cell-associated toxicities and the clinical experience of multiple Chinese *** consensus refines a grading system and classification of CRS in B-NHL and corresponding measures for CRS management,and delineates comprehensive principles and exploratory recommendations for managing anti-CD19 CAR T-cell-associated toxicities in addition to CRS.

关键词： CAR T-cell therapy B-cell non-Hodgkin lymphoma toxicity cytokine-release syndrome clinical management

The influence of ^(18)F-fluorodeoxyglucose positron emission tomography/computed tomography on the N-and M-staging and subsequent clinical management of intrahepatic cholangiocarcinoma

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Hepatobiliary Surgery and Nutrition 2022年第5期11卷 684-695,I0002-I0007页

作者： Youpei Lin Huanhuan Chong Guohe Song Chenhao Zhang Liangqing Dong Ling Aye Fei Liang Shuaixi Yang Mengsu Zeng Guangyu Ding Shu Zhang Jieyi Shi Aiwu Ke Xiaoying Wang Jian Zhou Jia Fan Qiang Gao Department of Liver Surgery and Transplantation Liver Cancer InstituteZhongshan Hospitaland Key Laboratory of Carcinogenesis and Cancer Invasion(Ministry of Education)Fudan UniversityShanghaiChina Department of Radiology Zhongshan HospitalFudan UniversityShanghaiChina Department of Biostatistics Zhongshan HospitalFudan UniversityShanghaiChina Key Laboratory of Medical Epigenetics and Metabolism Institutes of Biomedical SciencesFudan UniversityShanghaiChina

Background:Intrahepatic cholangiocarcinoma(ICC)is a highly metastatic cancer.^(18)F-fluorodeoxyglucose positron emission tomography/computed tomography(^(18)F-FDG PET/CT)enables sensitive tumor and metastasis *** aim is to evaluate the influence of pre-treatment PET/CT on the N-and M-staging and subsequent clinical management in ICC ***:Between August 2010 and August 2018,660 consecutive ICC patients,without prior anti-tumor treatments nor other malignancies,were *** diagnostic performance of PET/CT on the N-and M-staging was compared with conventional imaging,and the preoperative staging accuracy and treatment re-allocation by PET/CT were retrospectively *** difference was compared between patients receiving PET/CT or not after propensity score ***:Patients were divided into group A(n=291)and group B(n=369)according to whether PET/CT was *** 291 patients with both PET/CT and conventional imaging for staging in group A,PET/CT showed significantly higher sensitivity(83.0%vs.70.5%,P=0.001),specificity(88.3%vs.74.9%,Pclinical treatment strategy in 5.8%(17/291)of ICC patients,with unique roles in different tumor-node-metastasis(TNM)*** tumor-to-non-tumor ratio(TNR)predicted poor overall survival[hazard ratio(HR)=2.17;95%confidence interval(CI):1.49-3.15;P<0.001].Furthermore,patients performing PET/CT had longer overall survival compared with those without PET/CT(HR=0.74;95%CI:0.58-0.93;P=0.011)after propensity score ***:PET/CT was valuable for diagnosing regional lymph node metastasis and distant metastasis in ICC patients,and facilitated accura

关键词： Intrahepatic cholangiocarcinoma(ICC) staging positron emission tomography/computed tomography(PET/CT) clinical management

Impaired motor control after sport-related concussion could increase risk for musculoskeletal injury:Implications for clinical management and rehabilitation

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Journal of Sport and Health Science 2021年第2期10卷 154-161页

作者： Terese L.Chmielewski Justin Tatman Shuhei Suzuki MaryBeth Horodyski Darcy S.Reisman Russell M.Bauer James R.Clugston Daniel C.Herman TRIA Orthopedic Center BloomingtonMN 55431USA ATP Tour Inc. Ponte Vedra BeachFL 32082USA Department of Orthopaedics and Rehabilitation University of FloridaGainesvilleFL 32607USA Department of Physical Therapy University of DelawareNewarkDE 19716USA Department of clinical and Health Psychology University of FloridaGainesvilleFL 32611USA Department of Community Health&Family Medicine University of FloridaGainesvilleFL 32603USA

This review presents a conceptual framework and supporting evidence that links impaired motor control after sport-related concussion(SRC)to increased risk for musculoskeletal *** studies have found that athletes who are post-SRC have higher risk for musculoskeletal injury compared to their counterparts.A small body of research suggests that impairments in motor control are associated with musculoskeletal injury *** control involves the perception and processing of sensory information and subsequent coordination of motor output within the central nervous system to perform a motor *** control is inclusive of motor planning and motor *** sensory information is not accurately perceived or there is interference with sensory information processing and cognition,motor function will be altered,and an athlete may become vulnerable to injury during sport *** with SRC show neuroanatomic and neurophysiological changes relevant to motor control even after meeting return to sport criteria,including a normal neurological examination,resolution of symptoms,and return to baseline function on traditional concussion *** conjunction,altered motor function is demonstrated after SRC in muscle activation and force production,movement patterns,balance/postural stability,and motor task performance,especially performance of a motor task paired with a cognitive task(i.e.,dual-task condition).The clinical implications of this conceptual framework include a need to intentionally address motor control impairments after SRC to mitigate musculoskeletal injury risk and to monitor motor control as the athlete progresses through the return to sport continuum.

关键词： clinical management Concussion Injury Motor control Rehabilitation

Expert Consensus on clinical management of T2DM Combined with Obesity Reversal Treatment in China(2023 Edition)

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Proceedings of Anticancer Research 2023年第6期7卷 40-51页

作者： Gugen Xu Bo Chen Writing Group for Expert Consensus on clinical management of TDM Combined with Obesity Reversal Treatment in China Endocrinology Department Guangdong Second Provincial General HospitalGuangzhou 510310China

With lifestyle changes,the incidence of type 2 diabetes(T2DM)and obesity has significantly increased,becoming major chronic diseases that seriously threaten the health of China’s *** domestic and international guidelines and consensus exist regarding the diagnosis and management of this *** recent years,T2DM treatment has focused more on new tactics that lean towards a patient-centered comprehensive management approach,replacing the traditional glucose-centered ***,an increasing amount of evidence in medicine suggests that the reversal of diabetes is ***,there is currently no expert consensus on the clinical management of T2DM combined with obesity reversal ***,experts and scholars in China with extensive experience in T2DM combined with obesity reversal treatment have been invited to develop this *** content includes early identification and diagnosis of T2DM combined with obesity,definition and mechanisms of diabetes reversal,disease assessment and grading,staging of diabetes and goals of reversal,the 2+N reversal strategy,inpatient system treatment combined with comprehensive outpatient management(including weight control,precise nutrition,scientific exercise,glucose-lowering medication,psychological intervention,rehabilitation therapy,and remote follow-up through online platforms),and evaluation of post-reversal *** aim is to further improve the level of T2DM combined with obesity reversal diagnosis,treatment,and management in China,and to implement the Healthy China strategy.

关键词： Type 2 diabetes mellitus(T2DM) Obesity Reversal treatment clinical management Expert consensus

Advances in Zika virus vaccines and therapeutics:A systematic review

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Asian Pacific Journal of Tropical Medicine 2024年第3期17卷 97-109页

作者： Shiza Malik Khalid Muhammad Omar Ahsan Muhammad Tahir Khan Ranjit Sah Yasir Waheed Bridging Health Foundation Rawalpindi 46000Pakistan Department of Biology College of SciencesUAE University15551Al AinUnited Arab Emirates Department of Medicine Foundation University Medical CollegeFoundation University IslamabadIslamabad 44000Pakistan INTI International University Persiaran Perdana BBN Putra Nilai71800 NilaiNegeri SembilanMalaysia Institute of Molecular Biology and Biotechnology the University of LahoreKM Defence RoadLahore 58810Pakistan Zhongjing Research and Industrialization Institute of Chinese Medicine Zhongguancun Scientific ParkNanyang 473006China Department of Microbiology Tribhuvan University Teaching HospitalInstitute of MedicineKathmandu 44600Nepal Department of Microbiology Dr.D.Y.Patil Medical CollegeHospital and Research CentreDr.D.Y.Patil VidyapeethPune 411018MaharashtraIndia Department of Public Health Dentistry Dr.D.Y.Patil Dental College and HospitalDr.D.Y.Patil VidyapeethPune 411018MaharashtraIndia Gilbert and Rose-Marie Chagoury School of Medicine Lebanese American UniversityByblos 1401Lebanon

Zika virus(ZIKV)is the causative agent of a viral infection that causes neurological complications in newborns and adults *** wide transmission route and alarming spread rates are of great concern to the scientific *** trials have been conducted to develop treatment options for ZIKV *** review highlights the latest developments in the fields of vaccinology and pharmaceuticals developments for ZIKV infection.A systematic and comprehensive approach was used to gather relevant and up-to-date data so that inferences could be made about the gaps in therapeutic *** results indicate that several therapeutic interventions are being tested against ZIKV infection,such as DNA vaccines,subunit vaccines,live-attenuated vaccines,virus-vector-based vaccines,inactivated vaccines,virus-like particles,and mRNA-based *** addition,approved anti-ZIKV drugs that can reduce the global burden are *** many vaccine candidates for ZIKV are at different stages of development,none of them have received Food and Drug Authority approval for use up to *** issue of side effects associated with these drugs in vulnerable newborns and pregnant women is a major obstacle in the therapeutic pathway.

关键词： Zika virus Infection Therapeutics Antiviral agents Vaccines Therapies Treatment Novel therapeutic clinical management

Diabetic foot ulcers:Classification,risk factors and management

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World Journal of Diabetes 2022年第12期13卷 1049-1065页

作者： Xuan Wang Chong-Xi Yuan Bin Xu Zhi Yu Key Laboratory of Acupuncture and Medicine Research of Ministry of Education Nanjing University of Chinese MedicineNanjing 210023Jiangsu ProvinceChina

Diabetic foot ulceration is a devastating complication of diabetes that is associated with infection,amputation,and death,and is affecting increasing numbers of patients with diabetes *** pathogenesis of foot ulcers is complex,and different factors play major roles in different *** refractory nature of foot ulcer is reflected in that even after healing there is still a high recurrence rate and amputation rate,which means that management and nursing plans need to be considered *** importance of establishment of measures for prevention and management of DFU has been ***,a validated and appropriate DFU classification matching the progression is necessary for clinical diagnosis and *** the first part of this review,we list several commonly used classification systems and describe their application conditions,scope,strengths,and limitations;in the second part,we briefly introduce the common risk factors for DFU,such as neuropathy,peripheral artery disease,foot deformities,diabetes complications,and *** on the relationship between the risk factors and DFU progression may facilitate prevention and timely management;in the last part,we emphasize the importance of preventive education,characterize several of the most frequently used management approaches,including glycemic control,exercise,offloading,and infection control,and call for taking into account and weighing the quality of life during the formulation of treatment *** intervention and management of diabetic foot ulcers(DFUs)based on the effective and systematic combination of these three components will contribute to the prevention and treatment of DFUs,and improve their prognosis.

关键词： Diabetes Diabetes foot ulceration Classification Diabetes complications clinical management Lower limb complications

Ferric carboxymaltose for anemia in Crohn’s disease patients at a tertiary center:A retrospective observational cohort study

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World Journal of clinical Cases 2023年第12期11卷 2740-2752页

作者： Natália Souza Nunes Siqueira Livia Bitencourt Pascoal Bruno Lima Rodrigues Marina Moreira de Castro Alan Sidnei Corrêa Martins Dante Orsetti Silva Araújo Luis Eduardo Miani Gomes Michel Gardere Camargo Maria de Lourdes Setsuko Ayrizono Raquel Franco Leal Inflammatory Bowel Disease Research Laboratory GastrocenterColorectal Surgery UnitSchool of Medical SciencesUniversity of Campinas(Unicamp)Campinas 13083-878São PauloBrazil

BACKGROUND Although the gastrointestinal tract is the most affected by Crohn’s disease(CD),the condition triggers other consequent manifestations,and iron deficiency anemia(IDA)is one of the most ***(IV)iron replacement is currently available through several drugs,such as ferric hydroxide sucrose and ferric carboxymaltose(FCM).However,the clinical management of these conditions can be *** To elucidate the drug’s effectiveness,the present study analyzed,through medical records,the clinical and epidemiological data of a cohort of patients with active CD who received IV FCM for the IDA *** This retrospective observational study included 25 patients with active CD,severe anemia,and refractory to previous conventional *** were evaluated two times:During the last treatment with ferric hydroxide sucrose and treatment with *** After treatment with FCM,parameters of IDA assessment significantly improved,serum hemoglobin(Hb)levels increased in 93%of patients(P<0.0001),and in 44%,there was an increase of≥2 g/dL in a single *** addition,86%of the patients showed an increase in serum iron(P<0.0001)and ferritin(P=0.0008)and 50%in transferrin saturation(P=0.01).The serum iron levels at baseline showed a negative association with the ileal and colonic CD and use of biologics and a positive association with patients who developed CD later in life after the age of 40(A3)and with a stenosing(B2)and fistulizing(B3)*** values of Hb and hematocrit after ferric hydroxide sucrose treatment remained similar to those found before *** This study demonstrated that FCM is an important therapeutic strategy for treating IDA in CD patients,achieving satisfactory results in refractory cases.

关键词： Ferric carboxymaltose Iron deficiency anemia Crohn’s disease Inflammatory bowel disease Anemia clinical management

Late presentation of dural tears:Two case reports and review of literature

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World Journal of clinical Cases 2023年第11期11卷 2464-2473页

作者： Chang Xu Rong-Peng Dong Xue-Liang Cheng Jian-Wu Zhao Department of Orthopedics Jilin Provincial Armed Police Corps HospitalChangchun 130000Jilin ProvinceChina Department of Spinal Surgery The Second Hospital of Jilin UniversityChangchun 130012Jilin ProvinceChina

BACKGROUND The late presentation of dural tears(LPDT)has a low incidence rate and hidden symptoms and is easily ignored in clinical *** the disease is not treated in time,a series of complications may occur,including low intracranial pressure headache,infection,pseudodural cyst formation,and sinus ***,we describe two cases of *** SUMMARY Two patients had sudden fever 1 wk after lumbar *** examination showed obvious tenderness in the operation *** patients were confirmed as having LPDT by lumbar magnetic resonance imaging and surgical *** case was caused by continuous negative pressure suction and malnutrition,and the other was caused by decreased dural ductility and low postoperative nutritional *** first symptom of both patients was fever,with occasional *** patients underwent secondary surgery to treat the *** defects were observed and dural sealants were used to seal the dural defects,then drainage tubes were retained for *** the operation,the patients were treated with antibiotics and the patients’surgical incisions healed well,without fever or incision *** recovered and were discharged 1 wk after the *** LPDT is a rare complication of spinal surgery or neurosurgery that has hidden symptoms and can easily be *** it may cause a series of complic-ations,LPDT needs to be actively addressed in clinical practice.

关键词： Late presentation of dural tears Delayed cerebrospinal fluid leakage Dural repair Factors clinical management Case report

Providing higher value care for hepatocellular carcinoma rather than diagnosis:What can current radiologists do?

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World Journal of Gastrointestinal Surgery 2022年第5期14卷 525-527页

作者： Shan Yao Yi Wei Bin Song Department of Radiology West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina

Medical imaging is of great value for the comprehensive evaluation of hepatocellular carcinoma from diagnosis to prognosis,which contributes to optimal clinical management making.

关键词： Hepatocellular carcinoma Medical imaging clinical management