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Early anticoagulation in patients with stroke and atrial fibrillation is associated with fewer ischaemic lesions at 1 month: the ATTUNE study

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Stroke & Vascular Neurology 2024年第1期9卷 30-37,I0034页

作者： Angelos Sharobeam Longting Lin Christina Lam Carlos Garcia-Esperon Yash Gawarikar Ronak Patel Matthew Lee-Archer Andrew Wong Michael Roizman Amanda Gilligan Andrew Lee Kee Meng Tan Susan Day Christopher Levi Stephen M Davis Mark Parsons Bernard Yan Melbourne Brain Centre at Royal Melbourne Hospital ParkvilleVictoriaAustralia University of New South Wales South Western Sydney Clinical School LiverpoolNew South WalesAustralia Department of Neurology John Hunter HospitalNewcastleNew South WalesAustralia Department of Neurology Calvary Public HospitalCanberraAustralian Capital TerritoryAustralia Department of Neurology Northern Hospital EppingEppingVictoriaAustralia Department of Neurology Royal Brisbane and Women's HospitalHerstonQueenslandAustralia The University of Queensland School of Medicine HerstonQueenslandAustralia Neurosciences Clinical Institute Epworth HealthcareRichmondVirginiaAustralia Department of Neurology Austin HealthUniversity of MelbourneHeidelbergVictoriaAustralia Flinders University College of Medicine and Public Health AdelaideSouth AustraliaAustralia Department of Neurology Gold Coast University HospitalSouthportQueenslandAustralia The University of Sydney Northern Clinical School St LeonardsNew South WalesAustralia Department of Neurology and Neurophysiology Liverpool HospitalLiverpoolNew South WalesAustralia

Background The optimal time to commence anticoagulation in patients with atrial fibrillation(AF)after ischaemic stroke or transient ischaemic attack(TIA)is unclear,with guidelines differing in recommendations.A limitation of previous studies is the focus on clinically overt stroke,rather than radiologically obvious diffusion-weighted imaging ischaemic lesions.We aimed to quantify silent ischaemic lesions and haemorrhages on MRI at 1month in patients commenced on early(lesions and more haemorrhages in the early anticoagulant group at 1-month MRI.Methods A prospective multicentre,observational cohort study was performed at 11 Australian stroke centres.Clinical and MRI data were collected at baseline and follow-up,with blinded imaging assessment performed by two authors.Timing of commencement of anticoagulation was at the discretion of the treating stroke physician.Results We recruited 276 patients of whom 208 met the eligibility criteria.The average age was 74.2 years(SD±10.63),and 79(38%)patients were female.Median National Institute of Health Stroke Scale score was 5(IQR 1–12).Median baseline ischaemic lesion volume was 5mL(IQR 2–17).There were a greater number of new ischaemic lesions on follow-up MRI in patients commenced on anticoagulation≥4days after index event(17%vs 8%,p=0.04),but no difference in haemorrhage rates(22%vs 32%,p=0.10).Baseline ischaemic lesion volume of≤5mL was less likely to have a new haemorrhage at 1month(p=0.02).There was no difference in haemorrhage rates in patients with an initial ischaemic lesion volume of>5mL,regardless of anticoagulation timing.Conclusion Commencing anticoagulationlesions at 1month in AF patients.There is no increased rate of haemorrhage with early anticoagulation.These results suggest that early anticoagulation after mild-to-moderate acute ischaemic stroke associated with AF might be safe,but randomised controlled s

关键词： patients lesions ischaemic

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The activity and immune dynamics of PD-1 inhibition on high-risk pulmonary ground glass opacity lesions:insights from a single-arm,phase II trial

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Signal Transduction and Targeted Therapy 2024年第5期9卷 2202-2214页

作者： Bo Cheng Caichen Li Jianfu Li Longlong Gong Peng Liang Ying Chen Shuting Zhan Shan Xiong Ran Zhong Hengrui Liang Yi Feng Runchen Wang Haixuan Wang Hongbo Zheng Jun Liu Chengzhi Zhou Wenlong Shao Yuan Qiu Jiancong Sun Zhanhong Xie Zhu Liang Chenglin Yang Xiuyu Cai Chunxia Su Wei Wang Jianxing He Wenhua Liang Department of Thoracic Surgery and Oncology the First Affiliated Hospital of Guangzhou Medical UniversityGuangzhou Institute of Respiratory HealthState Key Laboratory of Respiratory DiseaseNational Clinical Research Center for Respiratory DiseaseGuangzhouChina Medical Department Genecast Biotechnology Co.LtdWuxiChina Department of Radiation Oncology the First Affiliated Hospital of Guangzhou Medical UniversityGuangzhouChina Department of Respiratory Medicine the First Affiliated Hospital of Guangzhou Medical UniversityGuangzhou Institute of Respiratory HealthState Key Laboratory of Respiratory DiseaseNational Clinical Research Center for Respiratory DiseaseGuangzhouChina Department of Cardiothoracic Surgery Affiliated Hospital of Guangdong Medical UniversityZhanjiangChina Department of Thoracic Surgery National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital&Shenzhen HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeShenzhenChina Department of VIP Inpatient Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South ChinaSun Yat-sen UniversityGuangzhouChina Department of Medical Oncology Shanghai Pulmonary HospitalSchool of MedicineTongji UniversityShanghaiChina

Immune checkpoint inhibitors targeting the programmed cell death-1(PD-1)protein significantly improve survival in patients with advanced non-small-cell lung cancer(NSCLC),but its impact on early-stage ground-glass opacity(GGO)lesions remains unclear.This is a single-arm,phase II trial(NCT04026841)using Simon’s optimal two-stage design,of which 4 doses of sintilimab(200 mg per 3 weeks)were administrated in 36 enrolled multiple primary lung cancer(MPLC)patients with persistent high-risk(Lung-RADS category 4 or had progressed within 6 months)GGOs.The primary endpoint was objective response rate(ORR).T/B/NK-cell subpopulations,TCR-seq,cytokines,exosomal RNA,and multiplexed immunohistochemistry(mIHC)were monitored and compared between responders and non-responders.Finally,two intent-to-treat(ITT)lesions(pure-GGO or GGO-predominant)showed responses(ORR:5.6%,2/36),and no patients had progressive disease(PD).No grade 3-5 TRAEs occurred.The total response rate considering two ITT lesions and three non-intent-to-treat(NITT)lesions(pure-solid or solid-predominant)was 13.9%(5/36).The proportion of CD8^(+)T cells,the ratio of CD8^(+)/CD4^(+),and the TCR clonality value were significantly higher in the peripheral blood of responders before treatment and decreased over time.Correspondingly,the mIHC analysis showed more CD8^(+)T cells infiltrated in responders.Besides,responders’cytokine concentrations of EGF and CTLA-4 increased during treatment.The exosomal expression of fatty acid metabolism and oxidative phosphorylation gene signatures were down-regulated among responders.Collectively,PD-1 inhibitor showed certain activity on high-risk pulmonary GGO lesions without safety concerns.Such effects were associated with specific T-cell re-distribution,EGF/CTLA-4 cytokine compensation,and regulation of metabolism pathways.

关键词： lesions metabolism doses

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Hepatic cystic lesions mimicking liver abscess on imaging: A report oftwo cases

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Hepatobiliary & Pancreatic Diseases International 2024年第1期23卷 86-89页

作者： Yun-Wen Jiang Yong-Hong Yu Tian-An Jiang Shu-Yuan Tian Department of Ultrasound Medicine Tongde Hospital of Zhejiang ProvinceHangzhou 310012China Department of Ultrasound Medicine the First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China

Hepatic cystic lesions include congenital dysplasia,inflammatory cystic lesions,neoplastic cystic lesions and parasitic cystic lesions.As different treatment modalities can be chosen for these lesions,differential diagnosis is particularly important[1].Clinical features or imaging findings of cystic lesions of the liver are typical;for instance,liver abscess often shows thick-walled enhancement on contrast-enhanced CT.

关键词： lesions Hepatic cystic

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Effect of negative remodeling of the side branch ostium on the efficacy of a two-stent strategy for distal left main bifurcation lesions:an intravascular ultrasound study

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Journal of Geriatric Cardiology 2024年第5期21卷 506-522页

作者： Yi XU Tian XU Jia-Cong NONG Xiao-Han KONG Meng-Yao ZHAO Zhi-Jing GAO Yi-Fei WANG Wei YOU Pei-Na MENG Yu-He ZHOU Xiang-Qi WU Zhi-Ming WU Mei-En ZHAN Yan-Qing WANG De-Feng PAN Fei YE Department of Cardiology Nanjing First HospitalNanjing Hospital Affiliated to Nanjing Medical UniversityNanjing Medical UniversityNanjingChina Department of Cardiology Clinical Medicine School of Nanjing UniversityNanjingChina Department of Cardiology Tianchang People’s HospitalTianchangChina Department of Cardiology the Affiliated Hospital of Xuzhou Medical UniversityXuzhouChina

OBJECTIVES To investigate whether negative remodeling(NR)detected by intravascular ultrasound(IVUS)of the side branch ostium(SBO)would affect in-stent neointimal hyperplasia(NIH)at the one-year follow-up and the clinical outcome of target lesion failure(TLF)at the long-term follow-up for patients with left main bifurcation(LMb)lesions treated with a two-stent strategy.METHODS A total of 328 patients with de novo true complex LMb lesions who underwent a 2-stent strategy of percutaneous coronary intervention(PCI)treatment guided by IVUS were enrolled in this study.We divided the study into two phases.Of all the patients,48 patients who had complete IVUS detection pre-and post-PCI and at the 1-year follow-up were enrolled in phase I analysis,which aimed to analyze the correlation between NR and in-stent NIH at SBO at the 1-year follow-up.If the correlation was confirmed,the cutoff value of the remodeling index(RI)for predicting NIH≥50%was analyzed next.The phase II analysis focused on the incidence of TLF as the primary endpoint at the 1-to 5-year follow-up for all 328 patients by grouping based on the cutoff value of RI.RESULTS In phase I:according to the results of a binary logistic regression analysis and receiver operating characteristic(ROC)analysis,the RI cutoff value predicting percent NIH≥50%was 0.85 based on the ROC curve analysis,with a sensitivity of 85.7%,a specificity of 88.3%,and an AUC of 0.893(0.778,1.000),P=0.002.In phase II:the TLR rate(35.8%vs.5.3%,Plesions with a 2-stent strategy,and NR with RI≤0.85 is linked to percent NIH area≥50%at the 1-year follow-up and more TLF at the 5-year follow-up.

关键词： lesions remodeling intravascular

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Comprehensive overview of genotype distribution and prevalence of human papillomavirus in cervical lesions

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Gynecology and Obstetrics Clinical Medicine 2024年第1期4卷 37-47页

作者： Yuhong Ye Terel Jones Tiannan Wang Xianxu Zeng Yang Liu Chengquan Zhao Department of Pathology the First Affiliated HospitalFujian Medical UniversityFuzhouFujianChina Department of Pathology Magee-Womens HospitalUniversity of Pittsburgh Medical CenterPittsburghPennsylvaniaUSA Department of Pathology University of Southern CaliforniaLos AngelesCaliforniaUSA Department of Pathology The Third Affliated Hospital of Zhengzhou UniversityZhengzhouHenanChina Departments of Medicine and Bioengineering University of PittsburghPittsburghPennsylvaniaUSA Department of Bioengineering University ofllinois Urbana-ChampaignUrbanaIlinoisUSA

Acrosscervical squamousandgl and ular lesions,a spectrum of human papillomavirus(HPV)genotypes has been identified.This review aims to provide a comprehensive summary detailing the distribution and profile of HPV genotypes detected in cervical lesions,leveraging insights from histological and cytological findings.High-risk HPV(HR-HPV)genotypes exhibit varying degrees of oncogenic potential,with HPV16 and HPV18 identified as the most prevalent and oncogenic types.Thedistribution of HR-HPVgenotypes varies among different degrees of the cervical lesions and varies between squamous andglandular neoplasia.HPV16 is predominantly associated with severe lesions(precancers and carcinomas),while HPV18 demonstrates a significantly higher prevalence in endocervical as compared with squamous neoplasia.The distribution of HR-HPV in severe squamous lesions is complex,involving many HR-HPV genotypes in addition to HPV16,while the distribution of HR-HPV genotypes in endocervical glandular lesions is mainly limited in HPV18 and HPV16.Large datasets from China have identified the three mostcommon HR-HPVgenotypes in this population as stratified by diagnostic category:HPV52,HPV16,HPV58 in histologically negative cases and cervical intraepithelial neoplasia 1(CIN1);HPV16,HPV52,HPV58 in CIN2/3;HPV16,HPV58,HPV52 or HPV18 in squamous cell carcinoma(SCC);HPV16,HPV18 and HPV52 in endocervical adenocarcinoma in situ(AIS),invasiveadenocarcinoma,as well asmixedsquamous and glandular lesions.HPV33 is the fourth most common HPVtype in CIN2/3and SCC,whileHPV45occursmore commonly in AIS and adenocarcinoma,compared with squamous lesions.The prevalence and distribution of multiple HR-HPV coinfections vary across different cervical diseases.The clinical significance and pathogenesis of these multiple HR-HPV infections remain uncertain,although recent two large studies demonstrate that multiple HR-HPV infections are not associated with cumulatively higher risk of high-grade cervical squamous lesiondevelopment,suggestingcompetitiveand/or cooperative

关键词： cervical lesions prevalence

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Transcriptomic analysis reveals that NIBAN1 overexpression is associated with BRAF^(V600E)mutation and increases the aggressiveness of thyroid cancer

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Genes & Diseases 2024年第4期11卷 16-19页

作者： Paula Diana Thaise Nayane Ribeiro Carneiro Janete Maria Cerutti Reginaldo Massanobu Kuroshu Gianna Maria Griz Carvalheira Division of Genetics Department of Morphology and GeneticsEscola Paulista de MedicinaUniversidade Federal de Sao PauloSao PauloRua Botucatu740Edificio Leitaoda Cunha1AndarSao PauloSP04023900Brazil Genetic Bases of Thyroid Tumors Laboratory Division of GeneticsDepartment of Morphology and GeneticsEscola Paulista de MedicinaUniversidade Federal de Sao PauloPedro de Toledo 66911AndarSao PauloSP 04039-032Brazil Institute of Science and Technology Universidade Federal de Sao PauloAv Cesare Mansueto Giulio Lattes1201Eugenio deMelloSaoJose dos CamposSP12247-014Brazil

NIBAN1 overexpression has been reported in a widerange of thyroid carcinoma subtypes,and in other cancers,while it is not expressed in thyroid benign lesions and normal thy-roid.1-3 However,the mechanism associated with its expression and prognostic value remains unclear.In this study,six independent cohorts were enrolled,in which NIBAN1 expression was evaluated.A total of 583patients with thyroid tumors,326 patients with skin cancers,293 patients with colorectal carcinoma,and 189 patients with lung carcinoma were analyzed.

关键词： BRAF lesions BAN

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Drug-coated balloons for the treatment of ostial left anterior descending or ostial left circumflex artery lesions:a patientlevel propensity score-matched analysis

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Journal of Geriatric Cardiology 2023年第10期20卷 716-727,I0001-I0005页

作者： Liang PAN Wen-Jie LU Zhan-Ying HAN San-Cong PAN Xi WANG Ying-Guang SHAN Meng PENG Xiao-Fei QIN Guo-Ju SUN Pei-Sheng ZHANG Jian-Zeng DONG Chun-Guang QIU Department of Cardiovascular Medicine the First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina Department of Cardiology Jincheng People’s HospitalJinchengChina Department of Cardiology the Fifth Affiliated Hospital of Zhengzhou UniversityZhengzhouChina

BACKGROUND Controversy exists as to the optimal treatment approach for ostial left anterior descending(LAD)or ostial left circumflex artery(LCx)lesions.Drug-coated balloons(DCB)may overcome some of the limitations of drug-eluting stents(DES).Therefore,we investigated the security and feasibility of the DCB policy in patients with ostial LAD or ostial LCx lesions,and compared it with the conventional DES-only strategy.METHODS We retrospectively enrolled patients with de novo ostial lesions in the LAD or LCx who underwent interventional treatment.They were categorized into two groups based on their treatment approach:the DCB group and the DES group.The treatment strategies in the DCB group involved the use of either DCB-only or hybrid strategies,whereas the DES group utilized crossover or precise stenting techniques.Two-year target lesion revascularization was the primary endpoint,while the rates of major adverse cardiovascular events,cardiac death,target vessel myocardial infarction,and vessel thrombosis were the secondary endpoints.Using propensity score matching,we assembled a cohort with comparable baseline characteristics.To ensure result analysis reliability,we conducted sensitivity analyses,including interaction,and stratified analyses.RESULTS Among the 397 eligible patients,6.25%of patients who were planned to undergo DCB underwent DES.A total of 108 patients in each group had comparable propensity scores and were included in the analysis.Two-year target lesion revascularization occurred in 5 patients(4.90%)and 16 patients(16.33%)in the DCB group and the DES group,respectively(odds ratio=0.264,95%CI:0.093–0.752,P=0.008).Compared with the DES group,the DCB group demonstrated a lower major adverse cardiovascular events rate(7.84%vs.19.39%,P=0.017).However,differences with regard to cardiac death,non-periprocedural target vessel myocardial infarction,and definite or probable vessel thrombosis between the groups were non-significant.CONCLUSIONS The utilization of the DCB approach signifies an innovative and dis

关键词： lesions balloon treatment

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Venoarterial extracorporeal membrane oxygenation for refractory cardiogenic shock induced by adrenal lesions:a case report and review of the literature

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World Journal of Emergency Medicine 2023年第4期14卷 325-328页

作者： Liping Zhou Xiaoye Mo Guoqing Huang Ping Wu Changshou She Shanshan Hu Ben Liu Zhen Zhao Ning Yang Department of Emergency Medicine Xiangya HospitalCentral South UniversityChangsha 410008China

The adrenal gland secretes a variety of hormones that regulate physiological functions,and adrenal lesions can lead to insidious or sudden onset diseases that are easily misdiagnosed.Recently,several young patients with unknown sudden and refractory cardiogenic shock or cardiac arrest(CA)were successfully treated in our emergency department by the application of venoarterial extracorporeal membrane oxygenation(VA-ECMO).These life-threatening conditions were finally determined to be caused by adrenal lesions,which highlight the bridging role of VA-ECMO.[1]

关键词： adrenal lesions arterial

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The first experience of multi-gripper robot assisted percutaneous coronary intervention in complex coronary lesions

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老年心脏病学杂志:英文版 2023年第8期20卷 608-611页

作者： Pan LI Liang ZHANG Bo LI Wei-Po CHEN Wei-Sheng CHEN Zhi-Fu GUO Bi-Li ZHANG Department of Cardiology Changhai HospitalNaval Medical UniversityShanghaiChina Department of Cardiology Shanghai 411 HospitalChina RongTong Medical Healthcare Group Co.Ltd.ShanghaiChina

With advances in the field of interventional cardiology,percutaneous coronary intervention(PCI)has become one of the main treatment methods for patients with coronary artery disease in clinical practice.^([1])Routine interventional therapy is performed under fluoroscopic guidance,and interventional cardiologists are therefore often exposed to radiation.As a result,the risks of cancer,cataract,hair loss and loss of skin pigmentation will be significantly incre-ased after long-term radiation exposure.

关键词： coronary percutaneous lesions

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Diagnostic value of combination of rapid on-site evaluation and radial endobronchial ultrasound for peripheral pulmonary infectious lesions

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Chinese Medical Journal 2022年第23期135卷 2869-2871页

作者： Min Li Jiaqi Cao Qian He Ming Zhang Qianqian Xu Wenya Su Chunlai Feng Department of Respiratory and Critical Care Medicine The Third Affiliated Hospital of Soochow UniversityChangzhouJiangsu 213003

Peripheral pulmonary lesions(PPLs)are surrounded by lung parenchyma and invisible under an endoscope.The detection rate of PPLs by routine bronchoscopy is low.Radial endobronchial ultrasound(R-EBUS)can overcome those limitations,as it can locate peripheral bronchial lesions through a characteristic ultrasound signal.Rapid on-site evaluation(ROSE)is a real-time rapid cytological interpretation technology accompanied by tissue sampling.ROSEis helpful in improving the diagnostic rate of R-EBUS for PPLs,especially lung cancer.[1]However,the utility of ROSE during R-EBUS for peripheral pulmonary infectious lesions(infectious PPLs)is unclear.This study aimed to analyze the diagnostic value and safety of R-EBUS combined with ROSE in infectious PPLs.The study was approved by the Ethics Committee of the Third Affiliated Hospital of Soochow University(No.2019-017).The informed consent form was signed by the patient or his or her authorized legal representative.

关键词： lesions routine legal

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