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Impact of tumour histological subtype on chemotherapy outcome in advanced oesophageal cancer

World Journal of Gastrointestinal Oncology 2017年第8期9卷 333-340页

作者： Michael Davidson Ian Chau David Cunningham Komel Khabra Timothy Iveson Tamas Hickish Matthew Seymour Naureen Starling royal Marsden hospital NHS Foundation Trust London and Surrey Southampton University hospital NHS Trust and Salisbury hospital NHS Foundation Trust Department of Haematology and Oncology Bournemouth University and Poole Hospital NHS Trust St James’s Institute of Oncology St James’s Hospital

To investigate the impact of histology on outcome in advanced oesophageal cancer treated with first-line fluoropyrimidine-based chemotherapy. METHODSIndividual patient data were pooled from three randomised phase III trials of fluoropyrimidine-based chemotherapy ± platinum/anthracycline in patients with advanced, untreated gastroesophageal adenocarcinoma or squamous cell carcinoma (SCC) randomised between 1994 and 2005. The primary endpoint was overall survival of oesophageal cancer patients according to histology. Secondary endpoints were response rates and a toxicity composite endpoint. RESULTSOf the total 1836 randomised patients, 973 patients (53%) were eligible (707 patients with gastric cancer were excluded), 841 (86%) had adenocarcinoma and 132 (14%) had SCC. There was no significant difference in survival between patients with adenocarcinoma and SCC, with median overall survivals of 9.5 mo vs 7.6 mo (HR = 0.85, 95%CI: 0.70-1.03, P = 0.09) and one-year survivals of 38.8% vs 28.2% respectively. The overall response rate to chemotherapy was 44% for adenocarcinoma vs 33% for SCC (P = 0.01). There was no difference in the frequency of the toxicity composite endpoint between the two groups. CONCLUSIONThere was no significant difference in survival between adenocarcinoma and SCC in patients with advanced oesophageal cancer treated with fluoropyrimidine-based chemotherapy despite a trend for worse survival and less chemo-sensitivity in SCC. Tolerance to treatment was similar in both groups. This analysis highlights the unmet need for SCC-specific studies in advanced oesophageal cancer and will aid in the design of future trials of targeted agents.

关键词： Oesophageal cancer Adenocarcinoma Chemotherapy Squamous pooled analysis

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Systemic treatment of hepatocellular carcinoma:Past,present and future

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World Journal of Hepatology 2017年第18期9卷 797-807页

作者： Esther Una Cidon Department of Medical Oncology Royal Bournemouth HospitalBournemouth BH7 7DWUnited Kingdom

Hepatocellular carcinoma(HCC) is a common neoplasia which represents the second leading cause of cancer related death. Most cases occur in developing countries, but its incidence is rising in Western countries due to hepatitis C. Although hepatitis therapies have evolved and the HCC screening has increased in several areas, 40% present with advanced disease which is only amenable for palliative systemic treatment. HCC continues posing a challenge, in part due to the inherent chemoresistance of this neoplasia, the pharmacologic challenges due to an ill liver, difficulty in assessing radiological responses accurately, etc. Traditional chemotherapy have shown some responses without clear survival benefit, however, sorafenib demonstrated advantages in survival in advanced HCC when liver function is kept and recently immunotherapy seems to be a promising approach for some patients. This article will briefly expose the most relevant systemic treatment modalities to offer a general view from the past to the future.

关键词： Hepatocellular carcinoma Alphafetoprotein Sorafenib Nivolumab MEK

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Recent advances in detecting premalignant pancreatic cysts

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Journal of Cancer Metastasis and Treatment 2023年第1期9卷 274-284页

作者： Mustafa Jalal Sebastine A.Gbadegesin Sazgar Ibrahim Nadeem Tehami Department of Gastroenterology Royal Bournemouth HospitalCastle Lane EastBournemouth BH77DWUK Department of Gastroenterology Sheffield Teaching HospitalsSheffield S57AUUK Department of Surgery Hawler Teaching HospitalErbilIraq Department of Surgery Hawler Medical UniversityP.O.BOX 178ErbilIraq Department of Gastroenterology and Hepatology Southampton General HospitalSouthamptonTremona RoadSouthampton SO166YDUK

The incidental discovery of pancreatic cysts in asymptomatic patients is on the rise due to the widespread use of cross-sectional *** challenge in the management of pancreatic cysts is in distinguishing those with malignant potentials,like mucinous pancreatic cysts,from non-mucinous cysts that have negligible malignant ***,it can be difficult to identify mucinous cysts that harbour high-grade dysplasia or early *** review focuses on the recent advances in detecting pancreatic cancer and cysts with premalignant potential.

关键词： Pancreatic cysts mucinous cyst neoplasm IPMN endoscopic ultrasound pancreatic cancer

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Medium-term mortality after hip fractures and COVID-19:A prospective multicentre UK study

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Chinese Journal of Traumatology 2022年第3期25卷 161-165页

作者： Gareth Chan Ashish Narang Arash Aframian Zaid Ali Joseph Bridgeman Alastair Carr Laura Chapman Henry Goodier Catrin Morgan Chang Park Sarah Sexton Kapil Sugand Thomas Walton Michael Wilson Ajay Belgaumkar Kieran Gallagher Koushik Ghosh Charles Gibbons Joshua Jacob Andrew Keightley Zuhair Nawaz Khaled Sarraf Christopher Wakeling William Kieffer Benedict Rogers Brighton&Sussex University hospitals NHS Trust Brighton&Sussex Medical SchoolFainter CampusBrighton UK Surrey&Sussex Healthcare NHS Trust Canada&venueRedhillUK Chelsea&Westminster hospital NHS Foundation Trust LondonUK Ashford&St frier's Hospital NHS Foundation TrustChertseyUK Western Sussex hospitals NHS Foundation Trust(Sr Richard's Hospital)ChichesterUK poole general hospital&the royal bournemouth hospital froleUK Imperial College Healthcare NHS Trust LondonUK Western Sussex hospitals NHS Foundation Trust(Worthing hospital) WorthingUK royal Surrey hospital NHS Foundation Trust GuildfordUK Frimley Health NHS Foundation Trust FrimleyUK

Purpose:The COVID-19 pandemic has caused 1.4 million deaths globally and is associated with a 3-4 times increase in 30-day mortality after a fragility hip fracture with concurrent COVID-19 ***,death from COVID-19 infection occurs between 15 and 22 days after the onset of symptoms,but this period can extend up to 8 *** study aimed to assess the impact of concurrent COVID-19 infection on 120-day mortality after a fragility hip ***:A multi-centre prospective study across 10 hospitals treating 8%of the annual burden of hip fractures in England between 1st March and 30th April,2020 was *** whose surgical treatment was payable through the National Health Service Best Practice Tariff mechanism for"fragility hip fractures"were included in the ***'120-day mortality was assessed relative to their perioperative COVID-19 *** analysis was performed using SPSS version ***:A total of 746 patients were included in this study,of which 87(11.7%)were COVID-19 *** rates at 30-and 120-day were significantly higher for COVID-19 positive patients relative to COVID-19 negative patients(p<0.001).However,mortality rates between 31 and 120-day were not significantly different(p=0.107),16.1%and 9.4%respectively for COVID-19 positive and negative patients,odds ratio 1.855(95%CI 0.865-3.978).Conclusion:Hip fracture patients with concurrent COVID-19 infection,provided that they are alive at day-31 after injury,have no significant difference in 120-day *** the growing awareness and concern of "long-COVID"and its widespread prevalence,this does not appear to increase mediumterm mortality rates after a hip fracture.

关键词： Hip fractures Femoral fractures COVID-19 Coronavirus Mortality

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在无法开展血运重建的地区综合医院对病情不稳定患者行冠状动脉造影是否安全?

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世界核心医学期刊文摘(心脏病学分册) 2006年第3期 55-56页

作者： Jokhi P.P. Critoph C. Rozkovec A. 欧翔 Department of Cardiology Royal Bournemouth Hospital Castle Lane East Bournemouth BH7 7DW United Kingdom

Background: Patients admitted to hospital with unstable angina or non-ST segment elevation myocardial infarction have a high risk of death, re-infarction or re-hospitalisation within the next 6 months. International guidelines recommend an early interventional strategy in moderate-to high-risk patients with pre-discharge coronary angiography. In the UK, such patients admitted to district hospitals have traditionally been transferred to tertiary centres for investigation and treatment. Due to the large numbers involved and scarcity of tertiary centre beds, this results in long delays before transfer. The objective of this study was to determine whether diagnostic cardiac catheterisation in moderate-to high-risk patients could be safely performed in hospitals without on-site revascularisation and whether this strategy led to earlier discharge times. Methods: A retrospective audit was undertaken of all patients undergoing inpatient coronary angiography to a large district general hospital(DGH) after admission with a clinical diagnosis of unstable angina or non-ST elevation myocardial infarction over a 12-month period from April 2002 to March 2003. The main outcome measures were complications arising from coronary angiography and number of bed-days saved by allowing earlier discharge. Results: 142 patients with non-ST elevation ACS who met ‘ high risk’ criteria underwent inpatient angiography locally. Significant luminal coronary disease was present in 76% of patients but 49% were treated medically and discharged early. 32% of patients required transfer for percutaneous intervention(PCI) and 19% were referred directly for surgery. There was a high revascularisation rate(43% ) even in patients who did not have elevated troponin levels on admission. No patients died or sustained a myocardial infarction as a result of angiography, and morbidity was minimal. Patients waited an average of 3 days for an angiogram locally, but transfer time to a tertiary centre was 9 days for

关键词：冠状动脉造影冠脉造影心血管造影血运重建患者

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Genetic mechanisms of critical illness in Covid-19

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四川生理科学杂志 2020年第4期42卷 455-455页

作者： Erola Pairo-Castineira Roslin Institute University of Edinburgh Edinburgh UK MRC Human Genetics Unit Institute of Genetics and Molecular Medicine University of Edinburgh Western General Hospital Edinburgh UK Genomics England London UK Centre for Inflammation Research The Queen’s Medical Research Institute University of Edinburgh Edinburgh UK Centre for Genomic and Experimental Medicine Institute of Genetics and Molecular Medicine University of Edinburgh Western General Hospital Edinburgh UK Edinburgh Clinical Research Facility Western General Hospital University of Edinburgh Edinburgh UK Intensive Care National Audit & Research Centre London UK Institute for Molecular Bioscience The University of Queensland Brisbane Queensland Australia Biostatistics Group School of Life Sciences Sun Yat-sen University Guangzhou China The Crick Institute London UK Intensive Care Unit Royal Infirmary of Edinburgh Edinburgh UK School of Life Sciences Westlake University Hangzhou China Westlake Laboratory of Life Sciences and Biomedicine Hangzhou China Wellcome Centre for Human Genetics University of Oxford Oxford UK Department of Medicine University of Cambridge Cambridge UK Department of Intensive Care Medicine Guy’s and St Thomas’ NHS Foundation Trust London UK School of Immunology and Microbial Sciences King’s College London London UK NIHR Health Protection Research Unit for Emerging and Zoonotic Infections Institute of Infection Veterinary and Ecological Sciences University of Liverpool Liverpool UK MRC-University of Glasgow Centre for Virus Research Institute of Infection Immunity and Inflammation College of Medical Veterinary and Life Sciences University of Glasgow Glasgow UK William Harvey Research Institute Barts and the London School of Medicine and Dentistry Queen Mary University of London London UK Centre for Tropical Medicine and Global Health Nuffield Department of Medicine University of Oxford Oxford UK Clinical Research Centre at St Vincent’s University hospital Un

Host-mediated lung inflammation is present,1 and drives mortality,2 in critical illness caused by *** genetic variants associated with critical illness may identify mechanistic targets for therapeutic development.3 Here we report the results of the GenOMICC(Genetics Of Mortality In Critical Care)genome-wide association study(GWAS)in 2244 critically ill Covid-19 patients from 208 UK intensive care units(ICUs).We identify and replicate novel genome-wide significant associations,on chr12q24.13(rs10735079,p=1.65[Formula:see text]10-8)in a gene cluster encoding antiviral restriction enzyme activators(OAS1,OAS2,OAS3),on chr19p13.2(rs2109069,p=2.3[Formula:see text]10-12)near the gene encoding tyrosine kinase 2(TYK2),on chr19p13.3(rs2109069,p=3.98[Formula:see text]10-12)within the gene encoding dipeptidyl peptidase 9(DPP9),and on chr21q22.1(rs2236757,p=4.99[Formula:see text]10-8)in the interferon receptor gene *** identify potential targets for repurposing of licensed medications:using Mendelian randomisation we found evidence in support of a causal link from low expression of IFNAR2,and high expression of TYK2,to life-threatening disease;transcriptome-wide association in lung tissue revealed that high expression of the monocyte/macrophage chemotactic receptor CCR2 is associated with severe *** results identify robust genetic signals relating to key host antiviral defence mechanisms,and mediators of inflammatory organ damage in *** mechanisms may be amenable to targeted treatment with existing ***-scale randomised clinical trials will be essential before any change to clinical practice.

关键词： lung drugs critical

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Seasonal and geographical distribution of bacillary dysentery(shigellosis)and associated climate risk factors in Kon Tum Province in Vietnam from 1999 to 2013

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Infectious Diseases of Poverty 2017年第1期6卷 1012-1022页

作者： Hu Suk Lee TTHa Hoang Phuc Pham-Duc Mihye Lee Delia Grace Dac Cam Phung Vu Minh Thuc Hung Nguyen-Viet International Livestock Research Institute(ILRI) Room 301-302B1 BuildingVan Phuc Diplomatic Compound298 Kim Ma StreetBa Dinh DistrictHanoiVietnam Department of Bacteriology National Institute of Hygiene and EpidemiologyHanoiVietnam Center for Public Health and Ecosystem Research Hanoi University of Public HealthHanoiVietnam Medical Microbiology Department The Royal Bournemouth HospitalBournemouthUK ILRI NairobiKenya Thanh Do University HanoiVietnam

Background:Bacillary dysentery(BD)is an acute bacterial infection of the intestine caused by Shigella spp.,with clinical symptoms ranging from fever to bloody diarrhoea to abdominal cramps to *** Vietnam,enteric bacterial pathogens are an important cause of diarrhoea and most cases in children under 5 years of age are due to Shigella *** serogroups *** and *** are considered to be the most *** main objective of this study was to,for the first time,assess the seasonal patterns and geographic distribution of BD in Vietnam,and to determine the climate risk factors associated with the incidence of BD in Kon Tum Province,where the highest rate of bacillary dysentery was observed from 1999 to ***:The seasonal patterns and geographic distribution of BD was assessed in Vietnam using a seasonaltrend decomposition procedure based on *** addition,negative binomial regression models were used to determine the climate risk factors associated with the incidence of BD in Kon Tum Province,from 1999 to ***:Overall,incidence rates of BD have slightly decreased over time(except for an extremely high incidence in 2012 in the north of Vietnam).The central regions(north/south central coast and central highlands)had relatively high incidence rates,whereas the northwest/east and Red River Delta regions had low incidence ***,seasonal plots showed a high peak in the mid-rainy reason and a second smaller peak in the early or late rainy *** incidence rates significantly increased between May and October(“wet season”)across the *** Kon Tum Province,temperature,humidity,and precipitation were found to be positively associated with the incidence of ***:Our findings provide insights into the seasonal patterns and geographic distribution of BD in Vietnam and its associated climate risk factors in Kon Tum *** study may help clinicians and the general public to better understand the timings of outbr

关键词： Shigella Bacillary dysentery Incidence rate Seasonality Wet season Eco-regions Central regions Vietnam

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