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Levels of evidence and grades of recommendation supporting European society for medical oncology clinical practice guidelines

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Oncology Research 2024年第5期32卷 807-815页

作者： MARKO SKELIN BRUNA PERKOV-STIPIČIN SANJA VUŠKOVIĆ MARINAŠANDRK PLEHAČEK ANE BAŠIĆ DAVIDŠARČEVIĆ MAJA ILIĆ IVAN KREČAK Pharmacy Department General Hospital ofŠibenik-Knin CountyŠibenikCroatia Faculty of Medicine University of RijekaRijekaCroatia Undergraduate Study in Nursing University of Applied SciencesŠibenikCroatia Department of Oncology University Hospital Center ZagrebZagrebCroatia Pharmacies Joukhadar Sveta NedeljaCroatia Pharmacies Prima Pharme ZagrebCroatia Pharmacy Department General Hospital ZadarZadarCroatia Pharmacy Department General Hospital PulaPulaCroatia Department of Internal Medicine General Hospital ofŠibenik-Knin CountyŠibenikCroatia

Background:The European Society for Medical Oncology(ESMO)guidelines are among the most comprehensive and widely used clinical practice guidelines(CPGs)***,the level of scientific evidence supporting ESMO CPG recommendations has not been systematically *** study assessed ESMO CPG levels of evidence(LOE)and grades of recommendations(GOR),as well as their trends over time across various cancer ***:We manually extracted every recommendation with the Infectious Diseases Society of America(IDSA)classification from each *** examined the distribution of LOE and GOR in all available ESMO CPG guidelines across different topics and cancer ***:Among the 1,823 recommendations in the current CPG,30%were classified as LOEⅠ,and 43%were classified as GOR ***,there was a slight decrease in LOEⅠ(−2%)and an increase in the proportion of GOR A(+1%)in the current CPG compared to previous *** proportion of GOR A recommendations based on higher levels of evidence such as randomized trials(LOEⅠ–Ⅱ)shows a decrease(71%vs.63%,p=0.009)while recommendations based on lower levels of evidence(LOEⅢ–Ⅴ)show an increase(29%vs.37%,p=0.01)between previous and current *** the current versions,the highest proportion of LOEⅠ(42%)was found in recommendations related to pharmacotherapy,while the highest proportion of GOR A recommendations was found in the areas of pathology(50%)and diagnostic(50%)*** variability in LOEⅠand GOR A recommendations and their changes over time was observed across different cancer ***:One-third of the current ESMO CPG recommendations are supported by the highest level of *** well-designed randomized clinical trials are needed to increase the proportion of LOEⅠand GOR A recommendations,ultimately leading to improved outcomes for cancer patients.

关键词： ESMO guidelines Clinical practice guidelines Level of evidence Grade of recommendation

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Biological characteristics and clinical management of uveal and conjunctival melanoma

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Oncology Research 2024年第8期32卷 1265-1285页

作者： SNJEŽANA KAŠTELAN ANA DIDOVIĆPAVIČIĆ DARIA PAŠALIĆ TAMARA NIKUŠEVA-MARTIĆ SAMIRČANOVIĆ PETRA KOVAČEVIĆ SUZANA KONJEVODA School of Medicine University of ZagrebZagreb10000Croatia Department of Ophthalmology Clinical Hospital DubravaZagreb10000Croatia Department of Ophthalmology Zadar General HospitalZadar23000Croatia Department of Medical Chemistry Biochemistry and Clinical ChemistrySchool of MedicineUniversity of ZagrebZagreb10000Croatia Department of Biology and Genetics School of MedicineUniversity of ZagrebZagreb10000Croatia School of Medicine University of SplitSplit21000Croatia Department of Health Studies University of ZadarZadar23000Croatia

Uveal and conjunctival melanomas are relatively rare tumors;nonetheless,they pose a signiﬁcant risk of mortality for a large number of affected *** pathogenesis of melanoma at different sites is very similar,however,the prognosis for patients with ocular melanoma remains unfavourable,primarily due to its distinctive genetic proﬁle and tumor *** of considerable advances in understanding the genetic characteristics and biological behaviour,the treatment of uveal and conjunctival melanoma remains a formidable *** enhance the prospect of success,collaborative efforts involving medical professionals and researchers in theﬁelds of ocular biology and oncology are *** data show a lack of well-designed randomized clinical trials and limited beneﬁts in current forms of treatment for these *** advancements in the development of effective melanoma therapeutic strategies,all current treatments for uveal melanoma(UM)and conjunctival melanoma(CoM)remain unsatisfactory,resulting in a poor long-term *** trials offer hope for positive outcomes in advanced and metastatic tumors.A more comprehensive understanding of the genetic and molecular abnormalities involved in the development and progression of ocular melanomas opens the way for the development of personalized therapy,with various potential therapeutic targets currently under *** comprehension of the molecular pathogenesis of UM and CoM and their speciﬁcities may aid in the development of new and more effective systemic therapeutic agents,with the hope of improving the prognosis for patients with metastatic disease.

关键词： Uveal melanoma Conjunctival melanoma Genetic characteristics Immune checkpoint inhibitors Target molecular inhibitors

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Chinese expert consensus on the clinical application of drugcoated balloon(2^(nd) Edition)

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Journal of Geriatric Cardiology 2024年第2期21卷 135-152页

作者： The Expert Writing Committee of the Chinese Expert Consensus on Clinical Applications of Drug-Coated Balloon(2^(nd)Edition) Jun-Bo GE Yun-Dai CHEN 不详 Zhongshan hospital Fudan University Chinese PLA general hospital

Percutaneous coronary interventions have progressed through the era of plain balloon dilation, bare-metal stent insertion to drug-eluting stent treatment, which has significantly reduced the acute occlusion and restenosis rates of target vessels and improved patient prognosis, making drug-eluting stents the mainstream interventional treatment for coronary artery disease. In recent years, drug-coated balloons(DCBs) have become a new treatment strategy for coronary artery disease, and the drugs used in the coating and the coating technology have progressed in the past years. Without permanent implant, a DCB delivers antiproliferative drugs rapidly and uniformly into the vessel wall via the excipient during a single balloon dilation. Many evidence suggests that DCB angioplasty is an effective measure for dealing with in-stent restenosis and de novo lesions in small coronary *** more clinical studies are published, new evidence is emerging for the use of DCB angioplasty in a wide range of coronary diseases, and the indications are expanding internationally. Based on the latest research from China and elsewhere, the Expert Writing Committee of the Chinese Expert Consensus on Clinical Applications of Drug-Coated Balloon has updated the previous DCB consensus after evidence-based discussions and meetings in terms of adequate preparation of in-stent restenosis lesions, expansion of the indications for coronary de novo lesions, and precise guidance of DCB treatment by intravascular imaging and functional evaluation.

关键词： balloon drugs dealing

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Exosomes derived from microglia overexpressing miR-124-3p alleviate neuronal endoplasmic reticulum stress damage after repetitive mild traumatic brain injury

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Neural Regeneration Research 2024年第9期19卷 2010-2018页

作者： Yan Wang Dai Li Lan Zhang Zhenyu Yin Zhaoli Han Xintong Ge Meimei Li Jing Zhao Shishuang Zhang Yan Zuo Xiangyang Xiong Han Gao Qiang Liu Fanglian Chen Ping Lei Department of Geriatrics Tianjin Medical University General HospitalTianjinChina Tianjin Geriatrics Institute Tianjin Medical University General HospitalTianjinChina Tianjin Neurological Institute Tianjin Medical University General HospitalTianjinChina

We previously reported that miR-124-3p is markedly upregulated in microglia-derived exosomes following repetitive mild traumatic brain ***,its impact on neuronal endoplasmic reticulum stress following repetitive mild traumatic brain injury remains *** this study,we first used an HT22 scratch injury model to mimic traumatic brain injury,then co-cultured the HT22 cells with BV2 microglia expressing high levels of *** found that exosomes containing high levels of miR-124-3p attenuated apoptosis and endoplasmic reticulum ***,luciferase reporter assay analysis confirmed that miR-124-3p bound specifically to the endoplasmic reticulum stress-related protein IRE1α,while an IRE1αfunctional salvage experiment confirmed that miR-124-3p targeted IRE1αand reduced its expression,thereby inhibiting endoplasmic reticulum stress in injured ***,we delivered microglia-derived exosomes containing miR-124-3p intranasally to a mouse model of repetitive mild traumatic brain injury and found that endoplasmic reticulum stress and apoptosis levels in hippocampal neurons were significantly *** findings suggest that,after repetitive mild traumatic brain injury,miR-124-3 can be transferred from microglia-derived exosomes to injured neurons,where it exerts a neuroprotective effect by inhibiting endoplasmic reticulum ***,microglia-derived exosomes containing miR-124-3p may represent a novel therapeutic strategy for repetitive mild traumatic brain injury.

关键词： apoptosis C/EBP homologous protein endoplasmic reticulum stress exosome inositol-requiring enzyme 1α microglia miR-124-3p neuron repetitive mild traumatic brain injury X-box binding protein 1

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World Journal of Emergency Medicine 2024年第4期15卷 256-262页

作者： Jie Er Janice Soo Yuan Helen Zhang Gek Hsiang Lim Fatimah Lateef Department of Emergency Medicine Singapore General HospitalSingapore 168753Singapore Health Services Research Unit Singapore General HospitalSingapore168753Singapore

BACKGROUND:This study aimed to review bicycle-related injuries during the COVID-19 pandemic to assist with reinforcement or implementation of new policies for injury ***:This is a retrospective descriptive analysis of injuries sustained during cycling for patients 18 years old and above who presented to Singapore general hospital from January to June *** records were reviewed and *** analyses were used to summarize patient characteristics,and differences in characteristics subgrouped by triage acuity and discharge status were ***:The study included 272 patients with a mean age of 43 years and a male predominance(71.7%).Most presented without referrals(88.2%)and were not conveyed by ambulances(70.6%).Based on acuity category,there were 24(8.8%)Priority 1(P1)patients with 7 trauma activations,174(64.0%)and 74(27.2%)P2 and P3 patients *** most common injuries were fractures(34.2%),followed by superficial abrasion/contusion(29.4%)and laceration/wound(19.1%).Thirteen(4.8%)patients experienced head injury and 85 patients(31.3%)were documented to be wearing a *** majority occurred on the roads as traffic accidents(32.7%).Forty-two patients(15.4%)were admitted with a mean length of stay of 4.1 d and 17(6.3%)undergone surgical *** of 214(78.7%)discharged patients,no re-attendances or mortality were *** the subgroup analysis,higher acuity patients were generally older,with higher proportions of head injuries leading to ***:Our study highlights significant morbidities in bicycle-related *** is also a high proportion of fractures in the young healthy male *** prevention is paramount and we propose emphasizing helmet use and road user safety.

关键词： Cycling Injuries Emergency department

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Psychological Status and Warfarin Therapy in Patients after Valve Replacement during the COVID-19 Pandemic:A Cross-sectional Study

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当代医学科学（英文） 2024年第4期44卷 686-691页

作者： Xiao-yan CHEN Sheng HE Zhen TAN Feng GAO Hui JIANG Lu CHEN Li YANG Yu-shan LIU Si-yi HE Department of Cardiovascular Surgery The General Hospital of Western Theater CommandChengdu 610083China Department of Digestive Medicine The General Hospital of Western Theater CommandChengdu 610083China Department of general Surgery The General Hospital of Western Theater CommandChengdu 610083China

Objective:The standardization of warfarin anticoagulant therapy is the key to lifelong treatment for patients after heart valve *** present study explored the possible risk factors for anxiety and depression during the coronavirus disease 2019(COVID-19)pandemic and analyzed the influence of psychological state on medication ***:Eligible patients received a web-based questionnaire survey via the Wenjuanxing platform during outpatient *** was evaluated by the Self-Rating Depression Scale(SDS).Anxiety was evaluated by the Self-Rating Anxiety Scale(SAS).Medication adherence was evaluated by the Morisky ***:A total of 309 patients(aged 52.2±11.4 years)were included in the present *** SDS score of all included patients was 36.9±9.4 points,of which 11(3.6％)patients were diagnosed as having *** SAS score of all included patients was 43.1±9.3 points,of which 71(23％)patients were diagnosed as having *** patients(2.3％)had both anxiety and *** regression analysis revealed that only monthly income was an independent influencing factor for *** anxiety,patients who underwent repeated operations had a 2.264-fold greater risk,and patients who received combination medication had a 2.140-fold greater *** bleeding events and coagulation disorders could be observed in patients with anxiety,depression or *** anxiety occurred,patients showed worse medication ***,depression had no significant effect on medication ***:During the COVID-19 pandemic,the detection rate of mental illnesses such as anxiety and depression was high,which seriously affected the medication safety of *** of its influencing factors will provide a reference for further standardized regulation of warfarin anticoagulant therapy after valve replacement.

关键词： COVID-19 Warfarin anxiety depression valve replacement

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Magnetic resonance-guided focused ultrasound for essential tremor:a prospective,single center,single-arm study

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Neural Regeneration Research 2024年第9期19卷 2075-2080页

作者： Rui Zong Xuemei Li Chunyu Yin Jianfeng He Dekang Zhang Xiangbing Bian Lichao Huang Jiayou Zhou Zhipei Ling Lin Ma Xin Lou Longsheng Pan Xinguang Yu Seniro Department of Neurosurgery The First Medical Center of the PLA General HospitalBeijingChina Clinics of Cadre Department of OutpatientThe First Medical Center of the PLA General HospitalBeijingChina Department of Radiology The First Medical Center of the PLA General HospitalBeijingChina

The safety and effectiveness of magnetic resonance-guided focused ultrasound thalamotomy has been broadly established and validated for the treatment of essential *** 2018,the first magnetic resonance-guided focused ultrasound system in Chinese mainland was installed at the First Medical Center of the PLA general *** prospective,single center,open-label,single-arm study was part of a worldwide prospective multicenter clinical trial(*** Identifier:NCT03253991)conducted to confirm the safety and efficacy of magnetic resonance-guided focused ultrasound for treating essential tremor in the local *** 2019 to 2020,10 patients with medication refractory essential tremor were recruited into this open-label,single arm *** treatment efficacy was determined using the Clinical Rating Scale for *** was evaluated according to the incidence and severity of adverse *** of the subjects underwent a unilateral thalamotomy targeting the ventral intermediate *** the baseline assessment,the estimated marginal mean of the Clinical Rating Scale for Tremor total score was 58.3±3.6,and this improved after treatment to 23.1±6.4 at a 12-month follow-up assessment.A total of 50 adverse events were recorded,and 2 were defined as *** most common intraoperative adverse events were nausea and *** most frequent postoperative adverse events were paresthesia and equilibrium *** of the adverse events were mild and usually disappeared within a few *** findings suggest that magnetic resonance-guided focused ultrasound for the treatment of essential tremor is effective,with a good safety profile,for patients in Chinese mainland.

关键词： efficacy essential tremor magnetic resonance-guided focused ultrasound(MRgFUS) movement disorder safety stereotactic therapy thalamotomy ventral intermediate nucleus

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Hematochezia due to rectal invasion by an internal iliac artery aneurysm: A case report

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World Journal of Clinical Cases 2024年第11期12卷 1980-1989页

作者： Fang Li Bin Zhao Yong-Qiang Liu Guo-Qing Chen Rong-Feng Qu Chao Xu Zhui Long Jin-Song Wu Mao Xiong Wei-Hang Liu Li Zhu Xiao-Ling Feng Lei Zhang Department of general Surgery Chongqing General HospitalChongqing 401147China

BACKGROUND This case report presents the rare occurrence of hematochezia due to an internal iliac artery aneurysm leading to an arterioenteric fistula,expanding the differential diagnosis for gastrointestinal *** emphasizes the importance of considering vascular origins in cases of atypical hematochezia,particularly in the absence of common gastrointestinal causes,and highlights the role of imaging and multidisciplinary management in diagnosing and treating such unusual *** SUMMARY A 75-year-old man with a history of hypertension presented with 12 d of hematochezia,experiencing bloody stools 7-8 times per *** computed tomography(CT)scans revealed an aneurysmal rupture near the right internal iliac artery with suspected hematoma *** levels progressively decreased to 7 g/*** arterial angiography and iliac arterycovered stent placement were performed,followed by balloon *** initial stabilization,minor rectal bleeding and abdominal pain persisted,leading to further diagnostic *** identified a neoplasm and potential perforation at the proximal *** exploratory laparotomy confirmed the presence of a hematoma and an aneurysm invading the rectal wall,necessitating partial rectal resection,intestinal anastomosis,and *** recovery was successful,with no further bleeding incidents and normal follow-up CT and colonoscopy results after six *** In cases of unusual gastrointestinal bleeding,it is necessary to consider vascular causes for effective diagnosis and intervention.

关键词： Iliac artery aneurysm Hematoma Rectum Hematochezia Case report

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Prognostic nutritional index in predicting survival of patients with gastric or gastroesophageal junction adenocarcinoma: A systematic review

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World Journal of Gastrointestinal Oncology 2024年第2期16卷 514-526页

作者： Stylianos Fiflis Grigorios Christodoulidis Menelaos Papakonstantinou Alexandros Giakoustidis Stergos Koukias Paraskevi Roussos Marina Nektaria Kouliou Konstantinos Eleftherios Koumarelas Dimitrios Giakoustidis First Department of Surgery General Hospital PapageorgiouThessaloniki 56429Greece Department of general Surgery University Hospital of LarissaLarissa 41110Greece

BACKGROUND Gastric cancer is the third most common cause of cancer related death *** with or without chemotherapy is the most common approach with curative intent;however,the prognosis is poor as mortality rates remain *** indexes have been proposed in the past few years in order to estimate the survival of patients undergoing *** preoperative nutritional status of gastric cancer patients has recently gained attention as a factor that could affect the postoperative course and various indexes have been *** aim of this systematic review was to assess the role of the prognostic nutritional index(PNI)in predicting the survival of patients with gastric or gastroesophageal adenocarcinoma who underwent gastrectomy with curative *** To investigate the role of PNI in predicting the survival of patients with gastric or gastroesophageal junction *** A thorough literature search of PubMed and the Cochrane library was performed for studies comparing the overall survival(OS)of patients with gastric or gastroesophageal cancer after surgical resection depending on the preoperative PNI *** PRISMA algorithm was used in the screening process and finally 16 studies were included in this systematic *** review protocol was registered in the International Prospective Register of Systematic Reviews(PRO) RESULTS Sixteen studies involving 14551 patients with gastric or esophagogastric junction adenocarcinoma undergoing open or laparoscopic or robotic gastrectomy with or without adjuvant chemotherapy were included in this systematic *** patients were divided into high-and low-PNI groups according to cut-off values that were set according to previous reports or by using receiver operating characteristic curve analysis in each individual *** 5-year OS of patients in the low-PNI groups ranged between 39%and 70.6%,while in the high-PNI groups,it ranged between 54.9%and 95.8%.In most of the included st

关键词： Prognostic nutritional index Gastric adenocarcinoma Gastroesophageal junction cancer Prognosis Overall survival

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A rare case of hepatic vein-portal vein fistula with hepatolithiasis presenting as cholangiocarcinoma

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Hepatobiliary & Pancreatic Diseases International 2024年第5期23卷 538-540页

作者： Wei Li Wen Lin Le Xiao general Surgery Center The General Hospital of Western Theater CommandChengdu 610083China

To the Editor: We sincerely applaud the work by Tang et al., in which they described caudate lobe-sparing subtotal hepatectomy as treatment for intrahepatic arterioportal fistulas [ 1 ]. Compared to intrahepatic arterioportal fistulas, portal vein-hepatic vein fistulas are rarely reported. Patients typically lack clinical symptoms such as hyperammonemia, cholestatic jaundice, and hypoglycemia, unless the shunt becomes relatively large [ 2, 3 ]. Herein, we describe partial hepatectomy as a treatment for cases of left portal vein-middle hepatic vein fistulas.

关键词： hepatic clinical

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