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Can patients with mild non-neoplastic lesions diagnosed at baseline screening be safely exempt from surveillance: evidence from multicenter community-based cohorts

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Science China Life Sciences 2025年第1期68卷 263-271页

作者： Siyi He Zhiyi Zhang Guohui Song Zhenhai Wang Chunyun Dai Shipeng Yan Kun Jiang Bingbing Song He Li Maomao Cao Dianqin Sun Fan Yang Xinxin Yan Shaoli Zhang Yi Teng Qianru Li Changfa Xia Wanqing Chen office of Cancer Screening National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical College Department of Gastroenterology Gansu Wuwei Tumor Hospital Cixian Cancer Institute Linzhou Cancer Hospital Center for Disease Control and Prevention of Sheyang County Department of Cancer Prevention and Control Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of MedicineCentral South University Luoshan Center for Disease Control and Prevention office for Cancer Control and Research Affiliated Cancer Hospital of Harbin Medical University

Surveillance recommendations for gastric cancer（GC） in current guidelines focused on advanced precancerous lesions and were based on precise diagnosis of severity/extent of baseline lesions. We aimed to develop a less endoscopy-related equipment-dependent risk-stratification tool, and assessed whether mild-precursor-lesion patients can be safely exempt from surveillance. In the multicenter communitybased cohort, 75,051 participants receiving baseline endoscopy were enrolled during 2015–2017 and followed-up until 2021. Cumulative incidence rates（CIRs） of GC for precancerous-conditions were calculated by Kaplan-Meier method and compared by Log-rank tests. Mixedeffects Cox regression models were used to detect potential factors for progression towards GC. A risk score was calculated as counts of selected factors. An independent cohort, including 26,586 participants was used for external validation. During a median follow-up of 6.25 years, CIRs of GC were 0.302%, 0.436%, and 4.756% for normal group, non-neoplastic（atrophic gastritis/intestinal metaplasia） and neoplastic lesions（low-grade/high-grade dysplasia）, respectively(Ptrend<0.001). Four predictors, including male, ≥60 years, smoking, and limited vegetable consumption, were selected for risk-stratification. High-risk patients（≥3 risk factors） with non-neoplastic lesions showed higher GC risks（adjusted HR=7.73, 95%CI: 4.29–13.92）, and their four-year CIR reached the one-year CIR of neoplastic lesions. Further categorizing non-neoplastic lesions by histological grade, both patients with moderate-to-severe lesions（aHR=3.07, 95%CI: 1.67–5.64） and high-risk patients with mild lesions（aHR=7.29, 95%CI: 3.58–14.86） showed higher risks. Consistent trends were observed in validation cohort. High-risk mild-precursor-lesion patients should receive surveillance within 3–5 years after baseline screening. Our study provides evidence on supplementing current guideline recommendations.

关键词： stomach neoplasms precancerous conditions cancer screening cumulative incidence risk stratification

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Cilostazol and isosorbide mononitrate for the prevention of progression of cerebral small vessel disease:baseline data and statistical analysis plan for the Lacunar Intervention Trial-2(LACI-2)(ISRCTN14911850)

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Stroke & Vascular Neurology 2023年第2期8卷 134-143页

作者： Philip M Bath Iris Mhlanga Lisa J Woodhouse Fergus Doubal Katherine Oatey Alan A Montgomery Joanna M Wardlaw LACI-Trial Investigators Stroke trials Unit University of NottinghamNottinghamUK Centre for clinical Brain Sciences UK Dementia Research Institute CentreUniversity of EdinburghEdinburghUK Edinburgh clinical trials Unit University of EdinburghEdinburghUK Nottingham clinical trials Unit University of NottinghamNottinghamUK

Background Cerebral small vessel disease(SVD)causes lacunar strokes(25%of all ischaemic strokes),physical frailty and cognitive impairment and vascular and mixed *** is no specific treatment to prevent progression of *** The LACunar Intervention Trial-2 is an investigator-initiated prospective randomised open-label blinded-endpoint phase II feasibility study assessing cilostazol and isosorbide mononitrate for preventing SVD *** aimed to recruit 400 patients with clinically evident lacunar ischaemic stroke and randomised to cilostazol,isosorbide mononitrate,both or neither,in addition to guideline secondary ischaemic stroke prevention,in a partial factorial *** primary outcome is feasibility of recruitment and adherence to medication;key secondary outcomes include:drug tolerability;recurrent vascular events,cognition and function at 1 year after randomisation;and safety(bleeding,falls,death).Data are number(%)and median(IQR).Results The trial commenced on 5 February 2018 and ceased recruitment on 31 May 2021 with 363 patients randomised,with the following baseline characteristics:average age 64(56.0,72.0)years,female 112(30.9%),stroke onset to randomisation 79.0(27.0,244.0)days,hypertension 267(73.6%),median blood pressures 143.0(130.0,157.0)/83.0(75.0,90.0)mm Hg,current smokers 67(18.5%),educationally achieved end of school examinations(A-level)or higher 118(32.5%),modified Rankin scale 1.0(0.0,1.0),National Institutes Health stroke scale 1.0(1.4),Montreal Cognitive Assessment 26.0(23.0,28.0)and total SVD score on brain imaging 1.0(0.0,2.0).This publication summarises the baseline data and presents the statistical analysis *** The trial is currently in follow-up which will complete on 31 May 2022 with results expected in October *** registration number ISRCTN14911850.

关键词： nitrate initiated prevention

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Blood pressure management in acute stroke

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Stroke & Vascular Neurology 2016年第2期1卷 72-82页

作者： Jason P Appleton Nikola Sprigg Philip M Bath Stroke trials Unit Division of Clinical NeuroscienceUniversity of NottinghamNottinghamUK

Blood pressure(BP)is elevated in 75%or more of patients with acute stroke and is associated with poor *** to modulate BP in acute stroke has long been *** the loss of normal cerebral autoregulation,theoretical concerns are twofold:high BP can lead to cerebral oedema,haematoma expansion or haemorrhagic transformation;and low BP can lead to increased cerebral infarction or perihaematomal *** evidence from multiple large,high-quality,randomised trials is increasing our understanding of this challenging area,such that BP lowering is recommended in acute intracerebral haemorrhage and is safe in ischaemic *** we review the evidence for BP modulation in acute stroke,discuss the issues raised and look to on-going and future research to identify patient subgroups who are most likely to benefit.

关键词： Blood acute cerebral

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Antithetical impacts of deleterious LRP1B mutations in non-squamous and squamous NSCLCs on predicting benefits from immune checkpoint inhibitor alone or with chemotherapy over chemotherapy alone: retrospective analyses of the POPLAR/OAK and CHOICE-01 trial

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Science China Life Sciences 2025年第1期68卷 249-262页

作者： Jinliang Wang Wenyong Zhou Yu Xu Jianchun Duan Qiaoxia Zhou Guoqiang Wang Leo Li Chunwei Xu Wenxian Wang Shangli Cai Zhijie Wang Jie Wang Department of Oncology The Fifth Medical Center of Chinese PLA General Hospital Department of Thoracic Surgery Shanghai Chest HospitalSchool of MedicineShanghai Jiao Tong University Burning Rock Biotech CAMS Key Laboratory of Translational Research on Lung Cancer State Key Laboratory of Molecular OncologyDepartment of Medical OncologyNational Cancer Center/National Clinical Research Center for ancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical College Institute of Basic Medicine and Cancer (IBMC) Chinese Academy of Sciences Department of clinical Trial The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital)

In non-small cell lung cancers,the non-squamous and squamous subtypes（nsqNSCLC and sqNSCLC） exhibit disparities in pathophysiology,tumor immunology,and potential genomic correlates affecting responses to immune checkpoint inhibitor（ICI）-based *** our inhouse training cohort（n=85）,the presence of the LRP1B deleterious mutation（LRP1B-del） was associated with longer and shorter progression-free survival（PFS） on ICIs alone in nsqNSCLCs and sqNSCLCs,respectively(Pinteraction=0.008).These results were validated using a larger public ICI cohort(n=208,Pinteractionclinical utility of LRP1B-del in guiding treatment choices for nsqNSCLCs and sqNSCLCs,emphasizing the necessity for a detailed analysis based on pathological subtypes when investigating biomarkers for cancer therapeutics.

关键词： non-squamous NSCLC squamous NSCLC LRP1B deleterious mutations predictive biomarker immune checkpoint inhibitor

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Recombinant streptokinase vs phenylephrine-based suppositories in acute hemorrhoids, randomized, controlled trial(THERESA-3)

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World Journal of Gastroenterology 2014年第6期20卷 1594-1601页

作者： Francisco Hernández-Bernal Georgina Castellanos-Sierra Carmen M Valenzuela-Silva Karem M Catasús-lvarez Roselin Valle-Cabrera Ana Aguilera-Barreto Pedro A López-Saura Center for Genetic Engineering and Biotechnology "Juan B. Zayas" Hospital National Center for the Coordination of clinical trials

AIM: To compare the efficacy and safety of recombinant streptokinase (rSK) and phenylephrine-based suppositories in acute hemorrhoidal disease.

关键词： Streptokinase Suppository Phenylephrine Thrombolysis Hemorrhoids Randomized clinical trial

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Pre-treatment platelet counts as a prognostic and predictive factor in stage Ⅱ and Ⅲ rectal adenocarcinoma

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World Journal of Gastrointestinal Oncology 2017年第1期9卷 42-49页

作者： Morgan Steele Ioannis A Voutsadakis clinical trials Unit Sault Area Hospital Division of Medical Oncology Department of Internal Medicine Sault Area Hospital Division of clinical Sciences Northern Ontario School of Medicine

AIM To investigate if pre-treatment platelet counts could provide prognostic information in patients with rectal adenocarcinoma that received neo-adjuvant treatment. METHODS Platelet number on diagnosis of stage II and III rectal cancer was evaluated in 51 patients receiving neoadjuvant treatment and for whom there were complete follow-up data on progression and survival, as well as pathologic outcome at the time of surgery. Pathologic responses on the surgical specimen of patients with lower platelet counts(150-300 × 10~9/L) were compared with these of patients with higher platelet counts(> 300 × 10~9/L) by the χ~2 test. Overall and progression free survival Kaplan-Meier curves of the two groups were constructed and compared with the Log-Rank *** A significant difference was present between the two groups in regards to pathologic response with patients with lower platelet counts being more likely to exhibit a good or complete response to neo-adjuvant treatment than patients with higher platelet counts(P = 0.015). Among other factors evaluated, there was also a significant difference between the carcinoembryonic antigen(CEA) at presentation of patients that exhibited a good or complete response and those that had no response or a minimal to moderate response. Patients with a good or complete response were more likely to present with a CEA of less than 5 μg/L(P = 0.00066). There was no significant difference in overall and progression free survival between the two platelet count groups(Log-Rank tests P = 0.42 and P = 0.35, respectively).CONCLUSION In this retrospective analysis of stage II and III rectal cancer patients, platelet counts at the time of diagnosis had prognostic value for neo-adjuvant treatment pathologic response. Pre-treatment CEA also held prognostic value in regards to treatment effect.

关键词： Rectal cancer Platelets Prognosis Treatment response neo-adjuvant Chemoradiation

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Kelp Fucoidans Facilitate Vascular Recanalization via Inhibiting Excessive Activation of Platelet in Deep Venous Thrombosis Model of Mouse

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Journal of Ocean University of China 2024年第2期23卷 550-556页

作者： SUN Taohua LIU Jie YAN Taishan CHEN Anjin ZHANG Fang Department of clinical Drug trials Qingdao Municipal HospitalQingdao 266100China Department of Pharmacy Qingdao Municipal HospitalQingdao 266100China

This study was carried out explore the mechanism underlying the inhibition of platelet activation by kelp fucoidans in deep venous thrombosis(DVT)*** the control and sham mice,the walls of deep vein were regular and smooth with intact intima,myometrium and *** blood vessel was wrapped with the tissue and there was no thrombosis in the *** the DVT model,the wall was uneven with thicken intima,myometrium and *** treated with fucoidans LF1 and LF2,the thrombus was dissolved and the blood vessel was *** with the control group,the ROS content,ET-1 and VWF content and the expression of PKC-βand NF-κB in the model were significantly higher(P<0.05);these levels were significantly reduced following treatments with LF2 and *** with H_(2)O_(2)treated-HUVECs,combined LF1 and LF2 treatment resulted in significant decrease in the expression of PKC-β,NF-κB,VWF and TM protein(P<0.05).It is clear that LF1 and LF2 reduces DVT-induced ET-1,VWF and TM expressions and production of ROS,thus inhibiting the activation of PKC-β/NF-κB signal pathway and the activation of coagulation system and ultimately reducing the formation of venous thrombus.

关键词： kelp fucoidans LF1 LF2 deep vein thrombosis platelet

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Effect of arotinolol on right ventricular function in patients with dilated cardiomyopathy

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Journal of Geriatric Cardiology 2007年第3期4卷 170-173页

作者： Hong Yang Li Xu Yongkang Tao Zhimin Xu Xiuqing Du Naqiang Lu Kefei Dou Jinglin Zhao Xianqi Yuan Yanfen Zhao Rongfang Shi Chaomei Fan Key Laboratory of clinical trials Research in Cardiovascular Drugs Ministry of HealthClinical Pharmacology CenterCardiovascular Institute and Fuwai Hospital CAMS and PUMCBeijing 100037China Key Laboratory of Clinical Trials Research in Cardiovascular DrugsMinistry of HealthClinical Pharmacology CenterCardiovascular Institute and Fuwai Hospital CAMS and PUMCBeijing 100037China Key Laboratory of Clinical Trials Research in Cardiovascular DrugsMinistry of HealthClinical Pharmacology CenterCardiovascular Institute and Fuwai Hospital CAMS and PUMCBeijing 100037China Key Laboratory of Clinical Trials Research in Cardiovascular DrugsMinistry of HealthClinical Pharmacology CenterCardiovascular Institute and Fuwai Hospital CAMS and PUMCBeijing 100037China Beijing Nuclear Industry Hospital Beijing 100042China. Beijing Nuclear Industry Hospital Beijing 100042China. Key Laboratory of Clinical Trials Research in Cardiovascular DrugsMinistry of HealthClinical Pharmacology CenterCardiovascular Institute and Fuwai Hospital CAMS and PUMCBeijing 100037China Key Laboratory of Clinical Trials Research in Cardiovascular DrugsMinistry of HealthClinical Pharmacology CenterCardiovascular Institute and Fuwai Hospital CAMS and PUMCBeijing 100037China Key Laboratory of Clinical Trials Research in Cardiovascular DrugsMinistry of HealthClinical Pharmacology CenterCardiovascular Institute and Fuwai Hospital CAMS and PUMCBeijing 100037China Key Laboratory of Clinical Trials Research in Cardiovascular DrugsMinistry of HealthClinical Pharmacology CenterCardiovascular Institute and Fuwai Hospital CAMS and PUMCBeijing 100037China Key Laboratory of Clinical Trials Research in Cardiovascular DrugsMinistry of HealthClinical Pharmacology CenterCardiovascular Institute and Fuwai Hospital CAMS and PUMCBeijing 100037China Key Laboratory of Clinical Trials Research in Cardiovascular DrugsMinistry of HealthClinical Pharmacology CenterCardiovascular Institute and Fuwai Hospital CAMS and PUMCBeijing 100037Ch

Objective Dilated cardiomyopathy(DCM) is generally considered to be accompanied by both left and right ventricular dysfunction,but most studies only analyze the left ventricular function. In this study,we evaluated the effect of arotinolol on right ventricular function in patients with DCM. Methods Right ventricular ejection fraction(RVEF) and right ventricular diameter(RVD) were measured by two-dimensional echocardiography(2-DE) in 33 DCM patients;RVEF measured by first-pass radionuclide angiography(FPRA) was compared with that by 2-DE. Results The treatment with arotinolol for one year resulted in a reduction in the right ventricular diameter(baseline,23.0 ± 8.3 mm vs after one-year treatment,20.7 ± 5.4 mm;P=0.004 ) and an associated increase in ejection fraction(baseline,36.9 ± 10.3% vs after one-year treatment,45.8 ± 9.6%;P < 0.001 ) ;there is a high correlation between the 2-DE method and radionuclide ventriculographic method. The correlation coefficient is 0.933(P<0.001) . Conclusion Arotinolol therapy could not only improve left ventricular function,but also improve right ventricular function in DCM patients.

关键词： dilated cardiomyopathy arotinolol right ventricular function

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Action observation as a tool for neurorehabilitation to moderate motor deficits and aphasia following stroke

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Neural Regeneration Research 2012年第26期7卷 2063-2074页

作者： Denis Ertelt Ferdinand Binkofski Center for clinical trials University of Luebeck University Hospital Schleswig-Holstein-Campus Luebeck Cognitive Neurology Department of NeurologyRWTH Aachen University Hospital

The mirror neuron system consists of a set of brain areas capable of matching action observation with action execution. One core feature of the mirror neuron system is the activation of motor areas by action observation alone. This unique capacity of the mirror neuron system to match action perception and action execution stimulated the idea that mirror neuron system plays a crucial role in the understanding of the content of observed actions and may participate in procedural learning. These features bear a high potential for neurorehabilitation of motor deficits and of aphasia following stroke. Since the first articles exploring this principle were published, a growing number of follow-up studies have been conducted in the last decade. Though, the combination of action observation with practice of the observed actions seems to constitute the most powerful approach. In the present review, we present the existing studies analyzing the effects of this neurorehabJlitative approach in clinical settings especially in the rehabilitation of stroke associated motor deficits and give a perspective on the ongoing trials by our research group. The data obtained up to date showed significant positive effect of action observation on recovery of motor functions of the upper limbs even in the chronic state after stroke, indicating that our approach might become a new standardized add-on feature of modern neurorehabilitative treatment schemes.

关键词： mirror neuron system motor system procedural learning stroke neurorehabilitation aphasia paresis motor deficits aphasic deficits stroke

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Maintaining clarity:Review of maintenance therapy in nonsmall cell lung cancer

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World Journal of clinical Oncology 2014年第2期5卷 103-113页

作者： Kristen R Dearing Ashish Sangal Glen J Weiss Department of clinical Research Cancer Treatment Centers of America Department of Medicine Cancer Treatment Centers of America CRAB-clinical trials Consortium

The purpose of this article is to review the role of maintenance therapy in the treatment of advanced nonsmall cell lung cancer(NSCLC). A brief overview about induction chemotherapy and its primary function in NSCLC is provided to address the basis of maintenance therapies foundation. The development of how maintenance therapy is utilized in this population is discussed and current guidelines for maintenance therapy are reviewed. Benefits and potential pitfalls of maintenance therapy are addressed, allowing a comprehensive review of the achieved clinical benefit that maintenance therapy may or may not have on NSCLC patient population. A review of current literature was conducted and a table is provided comparing the results of various maintenance therapy clinical trials. The table includes geographical location of each study, the number of patients enrolled, progression free survival and overall survival statistics, post-treatment regimens and if molecular testing was conducted. The role of molecular testing in relation to therapeutic treatment options foradvanced NSCLC patients is discussed. A treatment algorithm clearly depicts first line and second line treatment for management of NSCLC and includes molecular testing, maintenance therapy and the role clinical trials have in treatment of NSCLC. This treatment algorithm has been specifically tailored and developed to assist clinicians in the management of advanced NSCLC.

关键词： Maintenance therapy clinical trials Nonsmall cell lung cancer Molecular aberrations Progression-free survival Overall survival

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