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Survival and clinical outcomes in patients with metastatic epidural spinal cord compression after spinal surgery:a prospective,multicenter,observational cohort study

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Chinese Journal of Cancer 2016年第4期35卷 157-159页

作者： Anick Nater Michael G.Fehlings Department of Surgery Division of NeurosurgeryUniversity of Toronto Division of Neurosurgery Toronto Western HospitalUniversity Health Network

Background:High quality studies have been challenging to undertake in patients with metastatic epidural spinal cord compression.Nonetheless,in the article "Survival and Clinical Outcomes in Surgically Treated Patients With Metastatic Epidural Spinal Cord Compression:Results of the Prospective Multicenter AOSpine Study" recently published in the Journal of Clinical Oncology,our team provided convincing evidence that spinal surgery improves overall quality of life in patients with this potentially devastating complication of cancer.Considering that metastatic spinal lesions treated with surgery have the highest mean cost among all oncological musculo-skeletal issues,it is essential to provide high quality data to optimize the therapeutic approaches and cost-effective use of health care resources.Main body:Although the AOSpine Study provided high quality prospective data,it was primarily limited by the lack of non-operative controls and the relatively small sample size.Given the dearth of medical equipoise and the fundamental difference between patients deemed to be adequate surgical candidates and those who are not amenable to operative intervention,conducting a randomized controlled trial in this patient population was not felt to be ethically or medically feasible.Consequently,the optimal option to overcome limitations of both the lack of controls and the relatively small sample size is through collection of large prospective datasets through rigorously developed and maintained registries.Conclusions:With the alarming increase in the incidence of cancer in China and China's parallel growing cancer control efforts,China would offer a fantastic platform to set up a national metastatic spinal lesion registry.Such registry would not only enhance metastatic epidural spinal cord compression translational research but also optimize patient care.

关键词： Metastatic epidural spinal cord compression Prospective study Cohort study Surgery Clinical outcomes

Culture-expanded mesenchymal stromal cell therapy: does it work in knee osteoarthritis? A pathway to clinical success

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Cellular & Molecular Immunology 2023年第6期20卷 626-650页

作者： Grffn Copp Kevin P.Robb Sowmya Viswanathan Osteoarthritis Research Program Division of Orthopedic SurgerySchroeder Arthritis InstituteUniversity Health NetworkTorontoONCanada Krembil Research Institute University Health NetworkTorontoONCanada institute of Biomedical Engineering University of TorontoTorontoONCanada Department of Medicine Division of HematologyUniversity of TorontoTorontoONCanada

Osteoarthritis(OA)is a degenerative multifactorial disease with concomitant structural,inflammatory,and metabolic changes that fluctuate in a temporal and patient-specific manner.This complexity has contributed to refractory responses to various treatments.MsCs have shown promise as multimodal therapeutics in mitigating OA symptoms and disease progression.Here,we evaluated 15 randomized controlled clinical trials(RCTs)and 11 nonrandomized RCTs using culture-expanded MSCs in the treatment of knee OA,and we found net positive effects of MSCs on mitigating pain and symptoms(improving function in 12/15 RCTs relative to baseline and in 11/15 RCTs relative to control groups at study endpoints)and on cartilage protection and/or repair(18/21 clinical studies).We examined MsC dose,tissue of origin,and autologous vs.allogeneic origins as well as patient clinical phenotype,endotype,age,sex and level of OA severity as key parameters in parsing MSC clinical effectiveness.The relatively small sample size of 610 patients limited the drawing of definitive conclusions.Nonetheless,we noted trends toward moderate to higher doses of MsCs in select OA patient clinical phenotypes mitigating pain and leading to structural improvements or cartilage preservation.evidence from preclinical studies is supportive of MsC anti-inflammatory and immunomodulatory effects,but additional investigations on immunomodulatory,chondroprotective and other clinical mechanisms of action are needed.We hypothesize that MsC basal immunomodulatory"fitness"correlates with OA treatment efficacy,but this hypothesis needs to be validated in future studies.We conclude with a roadmap articulating the need to match an OA patient subset defined by molecular endotype and clinical phenotype with basally immunomodulatory"ft"or engineered-to-be-fit-for-OA MsCs in well-designed,data-intensive clinical trials to advance the field.

关键词： MSC Osteoarthritis Cell therapy mesenchymal stromal cell RCT

Genetic variables of the glutamatergic system associated with treatment-resistant depression:A review of the literature

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World Journal of Psychiatry 2022年第7期12卷 884-896页

作者： Estela Saez Leire Erkoreka Teresa Moreno-Calle Belen Berjano Ana Gonzalez-Pinto Nieves Basterreche Aurora Arrue Department of Psychiatry Barrualde-Galdakao Integrated Health OrganizationOsakidetza-Basque Health ServiceGaldakao 48960Spain Mental health network Group Biocruces Bizkaia Health Research InstituteBarakaldo 48903Spain Department of Neurosciences University of the Basque Country UPV/EHULeioa 48940Spain Department of Psychiatry Araba Integrated Health OrganizationOsakidetza-Basque Health ServiceCIBERSAMVitoria-Gasteiz 01004Spain Severe Mental Disorders Group Bioaraba Health Research InstituteVitoria-Gasteiz 01009Spain Zamudio Hospital Bizkaia Mental Health NetworkOsakidetza-Basque Health ServiceZamudio 48170Spain Integrative Research Group in Mental health Biocruces Bizkaia Health Research InstituteBarakaldo 48903Spain Neurochemical Research Unit Bizkaia Mental Health NetworkOsakidetza-Basque Health ServiceBarakaldo 48903Spain

Depression is a common,recurrent mental disorder and one of the leading causes of disability and global burden of disease worldwide.Up to 15%-40%of cases do not respond to diverse pharmacological treatments and,thus,can be defined as treatment-resistant depression(TRD).The development of biomarkers predictive of drug response could guide us towards personalized and earlier treatment.Growing evidence points to the involvement of the glutamatergic system in the pathogenesis of TRD.Specifically,the N-methyl-D-aspartic acid receptor(NMDAR)andα-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor(AMPAR),which are targeted by ketamine and esketamine,are proposed as promising pathways.A literature search was performed to identify studies on the genetics of the glutamatergic system in depression,focused on variables related to NMDARs and AMPARs.Our review highlights GRIN2B,which encodes the NR2B subunit of NMDAR,as a candidate gene in the pathogenesis of TRD.In addition,several studies have associated genes encoding AMPAR subunits with symptomatic severity and suicidal ideation.These genes encoding glutamatergic receptors could,therefore,be candidate genes for understanding the etiopathogenesis of TRD,as well as for understanding the pharmacodynamic mechanisms and response to ketamine and esketamine treatment.

关键词： Genetics N-methyl-D-aspartic acid receptor α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor Treatment-resistant depression Ketamine Esketamine

Statin-induced Liver Injury Patterns: A Clinical Review

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Journal of Clinical and Translational Hepatology 2022年第3期10卷 543-552页

作者： Leon D.Averbukh Alla Turshudzhyan David C.Wu George Y.Wu Department of Medicine Division of Gastroenterology-HepatologyAllegheny Health NetworkPittsburghPAUSA Department of Medicine Division of Gastroenterology-HepatologyUniversity of Connecticut Health CenterFarmingtonCTUSA

Since their introduction in 1987,hydroxymethyl glutaryl coenzyme A reductase(HMG-CoA)inhibitors,more commonly known as statins,have become some of the most widely prescribed medications in the world.Though generally considered to be safe and well tolerated,statins have been associated with several side effects including mild liver dysfunction manifested by increases in aminotransferases.Rarely,statins have been noted to induce more serious hepatic injury,including liver injury with autoimmune features.Current literature supports statin induced liver injury presenting in either hepatocellular or cholestatic patterns,though with the former being the prevailing pattern of injury.Fortunately,severe liver injury is uncommon with statin use and is generally reversible without any intervention other than offending statin cessation.When evaluating cases of suspected statininduced liver injury,a complete medical history,laboratory tests including a complete metabolic panel,autoimmune markers,and viral panel,as well as hepatic imaging,are crucial for a complete causality analysis with validated tools such as Roussel Uclaf Causality Assessment Method.The aim of this review is to review the current evidence for statininduced liver injury and cholestasis.

关键词： Drug-induced liver injury Statin Cholestatic liver injury Hepatocellular liver injury Cholestasis Autoimmune hepatitis

Epidemic Features of COVID-19 and Potential Impact of Hospital Strain During the Omicron Wave—Australia,2022

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China CDC weekly 2023年第7期5卷 165-169,I0001-I0006页

作者： Jingli Yang Hannah McClymont Liping Wang Sotiris Vardoulakis Wenbiao Hu School of Public health and Social Work Queensland University of TechnologyBrisbaneAustralia College of Earth and Environmental Sciences Lanzhou UniversityLanzhou CityGansu ProvinceChina Division of Infectious Diseases Chinese Center for Diseases Control and PreventionBeijing MunicipalityChina National Centre for Epidemiology and Population health College of Health and MedicineThe Australian National UniversityCanberraAustralia healthy Environments And Lives(HEAL)National Research network Australia

Summary What is already known about this topic?Hospitals have experienced a surge in admissions due to the increasing number of Omicron cases.Understanding the epidemiological features of coronavirus disease 2019(COVID-19)and the strain it places on hospitals will provide scientific evidence to help policymakers better prepare for and respond to future outbreaks.What is added by this report?The case fatality rate of COVID-19 was 1.4 per 1,000 persons during the Omicron wave.

关键词： Impact COV policy

Traditional Chinese Medicine guidelines for coronavirus disease 2019

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Journal of Traditional Chinese Medicine 2020年第6期40卷 891-896页

作者： Liang Ning Ma Yanfang Wang Jingya Li Huizhen Wang Xiaohui Jiao Liwen Liu Bin Ma Yan Zhao Chen Luo Xufei Zhao Siya Lu Meng Cao Jin Hu Wenpin Zhang Hairong Liu Guoxiu Lu Cheng Liu Mengyu Li Li Han Xuejie Liu Yuqi Wang Liying Zhao Xueyao Wei Dongfeng Bai Jing Sun Mingyu Yang Yong Wu Xiaodan Chen Yaolong Shi Nannan Wang Yanping Wang Yongyan Institute of Basic Research in Clinical Medicine China Academy of Chinese Medical SciencesBeijing 100700China evidence-Based Medicine Center School of Basic Medical SciencesLanzhou UniversityLanzhou 730000China School of Public health Lanzhou UniversityLanzhou 730000China Beijing University of Chinese Medicine Beijing 100029China Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine Shanghai 201203China Chinese GRADE Center Lanzhou 730000China Lanzhou University an Affiliate of the Cochrane China NetworkLanzhou 730000China Key Laboratory of evidence Based Medicine and Knowledge Translation of Gansu Province Lanzhou UniversityLanzhou 730000China

OBJECTIVE:To summarize the evidence from Traditional Chinese Medicine(TCM)practice in the treatment of coronavirus disease 2019(COVID-19)and provide timely clinical practice guidance.METHODS:The guidelines were developed in accordance with the World health Organization rapid guideline process.The evidence on TCM for COVID-19 from published guidelines,direct and indirect published clinical evidence,first hand clinical data,and expert experience and consensus were collected.The grading of recommendations assessment,development and evaluation(GRADE)method was used to grade the evidence and make the recommendations.RESULTS:Based on the available evidence,the guidelines recommended 17 Chinese medicines for COVID-19:2 Chinese herbal granules,7 Chinese patent medicines,and 8 Chinese herbal injections.CONCLUSION:As the literature search was conducted on March,any subsequent versions of these guidelines require an up-to-date literature review.We hope that the evidence summary in these guidelines will be helpful in global efforts to address COVID-19.

关键词： COVID-19 Medicine Chinese traditional Practice guideline

Mucosal imaging in colon polyps:New advances and what the future may hold

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World Journal of Gastroenterology 2022年第47期28卷 6632-6661页

作者： Edward John Young Arvinf Rajandran Hamish Lachlan Philpott Dharshan Sathananthan Sophie Fenella Hoile Rajvinder Singh Department of Gastroenterology Lyell McEwin HospitalNorthern Adelaide Local Health NetworkElizabeth Vale 5031South AustraliaAustralia Faculty of health and Medical Sciences University of AdelaideAdelaide 5000South AustraliaAustralia

An expanding range of advanced mucosal imaging technologies have been developed with the goal of improving the detection and characterization of lesions in the gastrointestinal tract.Many technologies have targeted colorectal neoplasia given the potential for intervention prior to the development of invasive cancer in the setting of widespread surveillance programs.Improvement in adenoma detection reduces miss rates and prevents interval cancer development.Advanced imaging technologies aim to enhance detection without significantly increasing procedural time.Accurate polyp characterisation guides resection techniques for larger polyps,as well as providing the platform for the“resect and discard”and“do not resect”strategies for small and diminutive polyps.This review aims to collate and summarise the evidence regarding these technologies to guide colonoscopic practice in both interventional and non-interventional endoscopists.

关键词： Colonoscopy Colorectal cancer Mucosal imaging Chromoendoscopy Polyp surveillance Polyp characterization

Increased mutant KRAS gene dosage drives pancreatic cancer progression: evidence for wild-type KRAS as a tumor suppressor?

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Hepatobiliary Surgery and Nutrition 2018年第5期7卷 403-405页

作者： Oliver A. Kent Princess Margaret Cancer Centre University Health Network Toronto Medical Discovery Tower Toronto Canada

RAS genes are most commonly associated with gain-of function mutations that promote oncogenic behavior. Activating mutations in KRAS occur in 90–95% cases of pancreatic ductal adenocarcinoma (PDAC) a deadly and highly metastatic disease. Currently the fourth leading cause of cancer death in the United States, PDAC presents with a dismal 5-year survival rate of less than 5% (1).

关键词： KRAS dosage cancer

Sclerosing Mucoepidermoid Cancer: A Unique Entity

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Open Journal of Endocrine and Metabolic Diseases 2024年第5期14卷 107-114页

作者： Ashima Mittal Christina Dimech Farhad Hasan Gayatri Jaiswal Division of Endocrinology Allegheny Health Network Pittsburgh Pennsylvania USA

Sclerosing mucoepidermoid thyroid cancer (SMECE) is a rare entity with less than 100 cases reported in the literature. Previously considered to have an indolent course, however, recent evidence has reported an aggressive nature ranging from local invasion to distant metastasis. We present a 66-year-old Caucasian female with SMECE who initially presented neck compressive symptoms. A thyroid ultrasound (US) revealed a solid hypoechoic mass replacing the left thyroid lobe. Fine needle aspiration cytology (FNAC) of the nodule resulted in suspicion of Papillary Thyroid Cancer, Bethesda category 5. The patient underwent total thyroidectomy and surgical pathology showed SMECE. Post-therapy whole-body scan following treatment with 150 mCi I-131 showed no residual or metastatic disease. SMECE is more common in females, between the third to eighth decade of life. Preoperative diagnosis may not be accurate given variable cytopathologic features. Differential diagnoses include primary squamous cell carcinoma of the thyroid, squamous differentiation of other thyroid malignancies, anaplastic thyroid cancer and nodular sclerosing variety of Hodgkin’s lymphoma. Due to its rarity, treatment of SMECE has ranged from thyroid surgery without or with radioactive iodine therapy, to surgery and external beam radiation and even chemotherapy.

关键词： Sclerosing Mucoepidermoid Cancer Papillary Thyroid Cancer Thyroid Cancer