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Percent free prostate-specific antigen is effective to predict prostate biopsy outcome in Chinese men with prostate-specific antigen between 10.1 and 20.0 ng ml^-1

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Asian Journal of Andrology 2015年第6期17卷 1017-1021,I0012页

作者： Rui Chen Li-Qun Zhou Xiao-Bing Cai Li-Ping Xie Yi-Ran Huang Da-Lin He Xu Gao Chuan-Liang Xu Qiang Ding Qiang wei Chang-Jun Yin Shan-Cheng Ren Fu-Bo Wang Ye Tian Zhong-Quan Sun Qiang Fu Lu-Lin Ma Jun-Hua Zheng Zhang-Qun Ye Ding-Wei Ye Dan-Feng Xu Jian-Quan Hou Ke-Xin Xu Jian-Lin Yuan Xin Gao Chun-Xiao Liu Tie-Jun Pan Ying-Hao Sun Department of Urology Shanghai Changhai Hospital Second Military Medical University Shanghai 200433 China ~Department of Urology Peking University First Hospital Institute of Urology Peking University National Urological Cancer Center Beijing 100034 China Department of Health Care PLA Headquarters of the General Staff Guard Bureau Beijing 100017 China Department of Urology First Affiliated Hospital School of Medicine Zhejiang University Hangzhou 310003 Zhejiang China Department of Urology Renji Hospital Shanghai Jiao Tong University School of Medicine Shanghai 200127 China Department of Urology First Affiliated Hospital of Medical School Xi'an:liaotong University Xi'an 710061 China Department of Urology Huashan Hospital Fudan University Shanghai 200040 China Department of Urology West China Hospital Sichuan University Chengdu 610041 Sichuan China state key laboratory of Reproductive Medicine Department of Urology The First Affiliated Hospital of Nanjing Medical University Nanjing 210029 China Department of Urology Beijing-Friendship Hospital Capital Medical University Beijing 100050China Department of Urology Huadong Hospital Fudan University Shanghai 20040 China Department of Urology Shanghai :Jiao Tong University Affiliated Sixth People's Hospital Shanghai 200233 China Department of Urology Peking University Third Hospital Beijing 100083 China Department of Urology Tenth People's Hospital Tongji University Shanghai 200072 China Department of Urology Tongji Hospital TongjJ Medical College Huazhong University of Science and TechnologyWuhan 430030 China Fudan University Shanghai Cancer Center Department of Oncology Shanghai 200032 China Department of Urology Shanghai ChangzhengHospital Second Military Medical University Shanghai 200003 China Department of Urology The First Affiliated Hospital of Soochow University Suzhou 215006 China Department of Urology Peking University People's Hospital Beijing 100044 China Department of Urology Xiji

Percent free prostatic-specific antigen （%fPSA） has been introduced as a tool to avoid unnecessary biopsies in patients with a serum PSA level of 4.0-10.0 ng ml^-1, however, it remains controversial whether %fPSA is effective in PSA range of 10.1-20.0 ng ml^-1 in both Chinese and Western population. In this study, the diagnostic performance of %fPSA and serum PSA in predicting prostate cancer （PCa） and high-grade PCa （HGPCa） was analyzed in a multi-center biopsy cohort of 5915 consecutive Chinese patients who underwent prostate biopsy in 22 hospitals across China from January 1, 2010 to December 31, 2013. The indication for biopsy was PSA〉4.0 ng ml^-1 or/and suspicious digital rectal examination. Total and free serum PSA determinations were performed by three types of electrochemiluminescence immunoassays with recalibration to the World Health Organization standards. The diagnostics accuracy of PSA, %fPSA and %fPSA in combination with PSA （%fPSA ＋ PSA） was determined by the area under the receivers operating characteristic curve （AUC）. %fPSA was more effective than PSA in men aged ≥60 years old. The AUC was 0.584 and 0.635 in men aged ≥60 years old with a PSA of 4.0-10.0 ng ml^-1 and 10.1-20.0 ng ml^-1, respectively. The AUC of %fPSA was superior to that of PSA in predicting HGPCa in patients ≥60 years old in these two PSA range. Our results indicated that %fPSA is both statistically effective and clinical applicable to predict prostate biopsy outcome in Chinese patients aged ≥60 years old with a PSA of 4.0-10.0 ng ml^-1 and 10.1-20.0 ng ml^-1.

关键词： Chinese population diagnosis percent free prostate-specific antigen prostate cancer prostate carcinoma tumor antigen prostate-specific antigen

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Cyclooxygenase-2 and the inflammogenesis of breast cancer

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World Journal of Clinical oncology 2014年第4期5卷 677-692页

作者： Randall E Harris Bruce C Casto Zachary M Harris The Ohio state University Comprehensive Cancer Center The Ohio State University College of Medicine Columbus OH 43210-1351 United States College of Medicine and College of Public Health Center of Molecular Epidemiology and Environmental Health The Ohio State University Medical Center Columbus OH 43210-1351 United States

Cohesive scientific evidence from molecular, animal, and human investigations supports the hypothesis that constitutive overexpression of cyclooxygenase-2(COX-2) is a ubiquitous driver of mammary carcinogenesis, and reciprocally, that COX-2 blockade has strong potential for breast cancer prevention and therapy. key findings include the following:(1) COX-2 is constitutively expressed throughout breast cancer development and expression intensifies with stage at detection, cancer progression and metastasis;(2) essential features of mammary carcinogenesis(mutagenesis, mitogenesis, angiogenesis, reduced apoptosis, metastasis and immunosuppression) are linked to COX-2-driven prostaglandin E2(PGE-2) biosynthesis;(3) upregulation of COX-2 and PGE-2 expression induces transcription of CYP-19 and aromatase-catalyzed estrogen biosynthesis which stimulates unbridled mitogenesis;(4) extrahe-patic CYP-1B1 in mammary adipose tissue converts paracrine estrogen to carcinogenic quinones with mutagenic impact; and(5) agents that inhibit COX-2 reduce the risk of breast cancer in women without disease and reduce recurrence risk and mortality in women with breast cancer. Recent sharp increases in global breast cancer incidence and mortality are likely driven by chronic inflammation of mammary adipose and upregulation of COX-2 associated with the obesity pandemic. The totality of evidence clearly supports the supposition that mammary carcinogenesis often evolves as a progressive series of highly specific cellular and molecular changes in response to induction of constitutive overexpression of COX-2 and the prostaglandin cascade in the "inflammogenesis of breast cancer".

关键词： Breast Cancer Cyclooxygenase-2 Nonsteroidal anti-inflammatory drugs Inflammogenesis Estrogen Aromatase

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Epidemiological and Clinical Characteristics of COVID-19 in Adolescents and Young Adults

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The Innovation 2020年第1期1卷 2-14,1页

作者： Jiaqiang Liao Shibing Fan Jing Chen Jianglin Wu Shunqing Xu Yuming Guo Chunhui Li Xianxiang Zhang Chuansha Wu Huaming Mou Chenxi Song Feng Li Guicheng Wu Jingjing Zhang Lian Guo Huawen Liu Jinglong Lv Lixin Xu Chunhui Lang key laboratory of Environment and Health Ministry of Education&Ministry of Environmental Protectionand State Key Laboratory of Environmental HealthSchool of Public HealthTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubei 430030People’s Republic of China Department of Neurosurgery Chongqing University Three Gorges Hospital&Chongqing Three Gorges Central HospitalNO.165 Xincheng RoadWanzhouChongqing 404000People’s Republic of China Department of Rheumatology Chongqing University Three Gorges Hospital&Chongqing Three Gorges Central HospitalNO.165 Xincheng RoadWanzhouChongqing404000People’s Republic of China Chongqing University Three Gorges Hospital&Chongqing Three Gorges Central Hospital NO.165 Xincheng RoadWanzhouChongqing 404000People’s Republic of China School of Public Health and Management Binzhou Medical UniversityYantaiShandongChina Department of Epidemiology and Biostatistics School of Public HealthZhengzhou UniversityZhengzhouChina Department of Epidemiology and Preventive Medicine School of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia Fuwai Hospital National Center for Cardiovascular DiseasesChinese Academyof Medical Sciences and Peking Union Medical CollegeA167Beilishi RoadXicheng DistrictBeijing 100037China Department of Endocrinology Chongqing University Three Gorges Hospital&Chongqing Three Gorges Central HospitalNO.165 Xincheng RoadWanzhouChongqing 404000People’s Republic of China Department of oncology Chongqing University Three Gorges Hospital&Chongqing Three Gorges Central HospitalNO.165 Xincheng RoadWanzhouChongqing 404000People’s Republic of China Department of Hematology Chongqing University Three Gorges Hospital&Chongqing Three Gorges Central HospitalNO.165 Xincheng RoadWanzhouChongqing404000People’s Republic of China Department of Clinical Nutrition Chongqing University Three Gorges Hospital&Chongqing Three Gorges Central HospitalNO.165 Xincheng RoadWanzhouChongqing 404000People’s Republic

BACKGROUND Adolescents and young adults might play a key role in the worldwide spread of Coronavirus Disease 2019(COVID-19)because they are more likely to be involved in overseas study,business,work,and ***,the epidem... 详细信息

关键词： Clinical clinical likely

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A glimpse into the psychological status of E.N.T inpatients in China: A cross-sectional survey of three hospitals in different regions

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2019年第2期5卷 95-104页

作者： Jun Tian Li Li Chun-Lei Tao Rong-Ying Hao Fu-Hui Huang Xiao-Hui Ge San-Mei Zhang Department of Otolaryngology Head and Neck Surgery The First HospitalShanxi Medical UniversityTaiyuanShanxi ProvinceChina Department of Otolaryngology Head and Neck Surgery Hospital of Renmin University of ChinaBeijingChina Department of Otolaryngology Head and Neck Surgery Heze Medical CollegeShandong ProvinceChina Department of Otolaryngology Head and Neck Surgery Beijing Chaoyang HospitalCapital Medical UniversityBeijingChina Department of Otolaryngology Head and Neck Surgery Beijing Anzhen HospitalCapital Medical UniversityBeijingChina Department of Medical oncology Shanxi Dayi HospitalShanxi Academy of Medical ScienceTaiyuanShanxi ProvinceChina

Objective:To determine whether E.N.T inpatients have a higher prevalence of mental illness than the general population and whether certain diseases are more likely to be associated with mental illness than other ***:This cross-sectional survey was conducted in the E.N.T departments of three hospitals in different cities in *** psychological status of all consecutive adult inpatients was assessed within 1-2 days following hospital admission using the Symptom Checklist-90 (SCL90),Zung Self-Rating Depression Scale (SDS) and Zung Self-Rating Anxiety Scale (SAS).Inpatients from the general surgery and pneumology departments at the same hospital were enrolled and surveyed as control ***:The 439 patients enrolled in the final analysis accounted for 88.0% of all E.N.T inpatients during the study *** these patients,16.4% were in an anxious state and 79.5%were in a depressive *** overall anxiety (41.7 ± 9.7) and depression (55.9± 29.2) scores were much higher than Chinese norm (29.8 ± 10.0 and 33.5 ± 8.6,respectively),and significant differences were observed (t =20.89,P < 0.01 and t =13.12,P < 0.01,respectively).Although 18.7% of the E.N.T patients were psychiatric distress,these patients scored lower on the SCL-90 than the Chinese ***,the patients in the E.N.T department had a higher prevalence of anxiety and depression than those in the general surgery department but a similar prevalence to those in the respiratory ***:Psychological distress,particularly anxiety and depression,are widespread in patients with otolaryngological ***,the identification and treatment of cooccurring psychiatric disorders in this high risk and clinically challenging group of patients are urgent in China.

关键词： Otorhinolaryngology SCL-90 Anxiety Depression VAS

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COVID-19-associated gastrointestinal and liver injury:clinical features and potential mechanisms

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Signal Transduction and Targeted Therapy 2020年第1期5卷 308-315页

作者： Peijie Zhong Jing Xu Dong Yang Yue Shen Lu Wang Yun Feng Chunling Du Yuanlin Song Chaomin Wu Xianglin Hu Yangbai Sun Department of Musculoskeletal Surgery Fudan University Shanghai Cancer Center200032 ShanghaiChina Department of oncology Shanghai Medical CollegeFudan University200032 ShanghaiChina Department of Gastroenterology and Hepatology Huaihe Hospital of Henan University475000 KaifengChina Clinical Medical College Southwest Medical University646000 LuzhouChina Department of Endocrinology and Metabolism Zhongshan HospitalFudan University200032 ShanghaiChina Department of Pulmonary and Critical Care Medicine Zhongshan HospitalFudan University200032 ShanghaiChina Department of Gastroenterology and Hepatology Zhongshan HospitalFudan University200032 ShanghaiChina Department of Gastroenterology and Hepatology Shanghai General HospitalShanghai Jiao Tong University School of Medicine200080 ShanghaiChina Department of Pulmonary and Critical Care Medicine QingPu Branch of Zhongshan Hospital Affiliated to Fudan University201700 ShanghaiChina Department of Surgery Training Base Fudan University Shanghai Cancer Center200032 ShanghaiChina

Coronavirus disease-2019(COVID-19)is caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).The infection is spreading globally and poses a huge threat to human *** common respiratory symptoms,some patients with COVID-19 experience gastrointestinal symptoms,such as diarrhea,nausea,vomiting,and loss of ***-CoV-2 might infect the gastrointestinal tract through its viral receptor angiotensin-converting enzyme 2(ACE2)and there is increasing evidence of a possible fecal–oral transmission *** addition,there exist multiple abnormalities in liver ***-19-related liver injury may be due to drug-induced liver injury,systemic inflammatory reaction,and hypoxia–ischemia reperfusion *** direct toxic attack of SARS-CoV-2 on the liver is still *** review highlights the manifestations and potential mechanisms of gastrointestinal and hepatic injuries in COVID-19 to raise awareness of digestive system injury in COVID-19.

关键词： gastrointestinal injuries respiratory

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Therapeutic options for HER-2 positive breast cancer: Perspectives and future directions

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World Journal of Clinical oncology 2014年第3期5卷 440-454页

作者： Gonzalo Recondo Jr Enrique Dìaz Canton Màximo de la Vega Martin Greco Gonzalo Recondo Sr Matias E Valsecchi Centro de Educación Médica e Investigaciones Clínicas (CEMIC) 4102 Buenos AiresArgentina Fundaleu Fundación para Combatir la LeucemiaServicio de Oncología Clínica4102 Buenos AiresArgentina Medical oncology HIMGHuntingtonWV 25705United States

During the last 15 years we have witnessed an unprecedented expansion in the drugs developed to target human epidermal growth factor receptor-2(HER-2) positive breast cancer. Trastuzumab, pertuzumab, adotrastuzumab emtansine and lapatinib are currently food and drug administration(FDA)-approved for the treatment of breast cancer patients with HER-2 overexpressed. However, given the amount of information gathered from years of uninterrupted clinical research, it is essential to have periodic updates that succinctly recapitulate what we have learnt over these last years and help us to apply that information in our daily practice. This review will pursue that objective. We will summarize the most relevant and updated informationrelated to the state of the art management of HER-2 positive breast cancer in all the clinical scenarios including the adjuvant, neoadjuvant and metastatic settings. But we will also critically appraise that literature in order to highlight some key clinical concepts that should not be overlooked. Lastly, this review will also point out some of the most promising strategies that are currently being tested and may soon become available.

关键词： Breast cancer Human epidermal growth factor receptor-2 Trastuzumab Pertuzumab Adotrastuzumab Lapatinib

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International consensus statement on robotic pancreatic surgery

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Hepatobiliary Surgery and Nutrition 2019年第4期8卷 345-360页

作者： Rong Liu Go Wakabayashi Chinnusamy Palanivelu Allan Tsung Kehu Yang Brian KPGoh Charing Ching-Ning Chong Chang Moo Kang Chenghong Peng Eli Kakiashvili Ho-Seong Han Hong-Jin Kim Jin He Jae Hoon Lee Kyoichi Takaori Marco Vito Marino Shen-Nien Wang Tiankang Guo Thilo Hackert Ting-Shuo Huang Yiengpruksawan Anusak Yuman Fong Yuichi Nagakawa Yi-Ming Shyr Yao-Ming Wu Yupei Zhao Department of Hepatopancreatobiliary Surgical oncology Chinese People’s Liberation Army(PLA)General HospitalBeijing 100853China Center for Advanced Treatment of Hepatobiliary and Pancreatic Diseases Ageo Central General HospitalAgeoJapan Division of Gastrointestinal Surgery and Minimal Access Surgery GEM Hospital and Research CentreCoimbatoreIndia Division of Surgical oncology Gastrointestinal Disease Specific Research GroupThe Ohio State University Wexner Medical Center Department of SurgeryColumbusOHUSA Evidence-Based Medicine Center School of Basic Medical SciencesLanzhou UniversityLanzhou 730000China Department of Hepatopancreatobiliary and Transplant Surgery Singapore General HospitalSingapore Department of Surgery Division of Hepatobiliary and Pancreatic SurgeryPrince of Wales Hospitalthe Chinese University of Hong KongHong KongChina Division of HBP Surgery Yonsei University College of MedicinePancreatobiliary Cancer CenterYonsei Cancer CenterSeverance HospitalSeoulKorea Pancreatic Disease Centre Ruijin HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghai 200025China Department of General Surgery Galilee Medical CenterNahariyaIsrael Department of Surgery Seoul National University College of MedicineSeoul National University Bundang HospitalSeoulKorea Department of Surgery Yeungnam University HospitalDaeguKorea Department of Surgery The Johns Hopkins HospitalBaltimoreMDUSA Division of Hepatobiliary&Pancreas Surgery Department of SurgeryAsan Medical CenterSeoulKorea Department of Surgery Kyoto University HospitalShogoinSakyo-KuKyotoJapan Department of General Surgery Azienda OspedalieraOspedali Riuniti Villa Sofia-CervelloPalermoItaly Division of General and Digestive Surgery Department of SurgeryKaohsiung Medical University HospitalKaohsiung Department of General Surgery Gansu Provincial HospitalLanzhou 730030China Department of General Visceral and Transplantation SurgeryHeidelberg University HospitalHeidelbergGermany Division of General Surge

The robotic surgical system has been applied to various types of pancreatic surgery. However, controversies exist regarding a variety of factors including the safety, feasibility, efficacy, and cost-effectiveness of robotic surgery. This study aimed to evaluate the current status of robotic pancreatic surgery and put forth experts' consensus and recommendations to promote its development. Based on the WHO Handbook for Guideline Development, a Consensus Steering Group* and a Consensus Development Group were established to determine the topics, prepare evidence-based documents, and generate recommendations. The GRADE Grid method and Delphi vote were used to formulate the recommendations. A total of 19 topics were analyzed. The first 16 recommendations were generated by GRADE using an evidence-based method (EBM) and focused on the safety, feasibility, indication, techniques, certification of the robotic surgeon, and cost-effectiveness of robotic pancreatic surgery. The remaining three recommendations were based on literature review and expert panel opinion due to insufficient EBM results. Since the current amount of;evidence was low/meager as evaluated by the GRADE method, further randomized controlled trials (RCTs) are needed in the future to validate these recommendations.

关键词： Robotic surgery consensus statement pancreatectomy pancreaticoduodenectomy pancreatic enucleation

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Modulation of the immune response by heterogeneous monocytes and dendritic cells in lung cancer

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World Journal of Clinical oncology 2021年第11期12卷 966-982页

作者： Iwona Kwiecień Elżbieta Rutkowska Agata Raniszewska Piotr Rzepecki Joanna Domagała-Kulawik Department of Internal Medicine and Hematology Laboratory of Hematology and Flow CytometryMilitary Institute of MedicineWarsaw 04-141Poland Department of Internal Medicine and Hematology Military Institute of MedicineWarsaw 04-141Poland Department of Internal Medicine Pulmonary Diseases and AllergyMedical University of WarsawWarsaw 02-091Poland

Different subpopulations of monocytes and dendritic cells(DCs)may have a key impact on the modulation of the immune response in *** this review,we summarize the monocyte and DCs heterogeneity and their function in the context of modulating the immune response in *** of monocytes may play opposing roles in cancer,depending on the tumour growth and progression as well as the type of *** can have pro-tumour and anti-tumour functions and can also differentiate into monocyte-derived DCs(moDCs).MoDCs have a similar antigen presentation ability as classical DCs,including cross-priming,a process by which DCs activate CD8 T-cells by crosspresenting exogenous *** play a critical role in generating anti-tumour CD8 T-cell *** have plastic characteristics and show distinct phenotypes depending on their mature state and depending on the influence of the tumour *** and other DC subsets have been attracting increased interest owing to their possible beneficial effects in cancer *** review also highlights key strategies deploying specific DC subpopulations in combination with other therapies to enhance the anti-tumour response and summarizes the latest ongoing and completed clinical trials using DCs in lung cancer.

关键词： Lung cancer Dendritic cell Monocyte Tumour microenvironment Cancer immunotherapy Dendritic-cell vaccination

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从抗TNF抗体的CDR肽库中获得拮抗TNF的短肽

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中国生物化学与分子生物学报 2003年第5期19卷 547-551页

作者：段招军朱建高谢志萍严斌侯云德病毒生物技术国家工程研究中心北京金迪克生物技术研究所北京100052 Department of Radiation oncology 中国疾病预防控制中心病毒病预防控制所病毒基因工程国家重点实验室北京100052

为设计来自抗体的短肽 ,以抗肿瘤坏死因子 (TNF)嵌合抗体 (cA2 )CDRs为模板 ,在其两侧各加 3个随机氨基酸残基 ( X3 CDR X3 ) ,构建了 6个以CDR为基础的肽库 .经过 3轮亲和选择 ,挑取单克隆 ,进一步经ELISA检测TNF阳性噬菌体克隆 ,分离... 详细信息

为设计来自抗体的短肽 ,以抗肿瘤坏死因子 (TNF)嵌合抗体 (cA2 )CDRs为模板 ,在其两侧各加 3个随机氨基酸残基 ( X3 CDR X3 ) ,构建了 6个以CDR为基础的肽库 .经过 3轮亲和选择 ,挑取单克隆 ,进一步经ELISA检测TNF阳性噬菌体克隆 ,分离得到 7个ELISA阳性较好的噬菌体肽克隆 ,分别命名为CDR2L1、CDR2L2、CDR2L3、CDR1L1、CDR2H1、CDR3H1、CDR3H 2 .应用MTT方法 ,检测 7个克隆对TNF生物学活性的拮抗作用 .结果显示 :来自CDR2L ,CDR3H肽库中的CDR2L2、CDR2L3,CDR3H2噬菌体肽具有明显的拮抗TNF诱导L92 9细胞的细胞毒作用 ,其中以CDR2L2噬菌体肽的拮抗活性最强 .而来源于CDR1L ,CDR2H肽库的CDR1L1和CDR2H1噬菌体肽和来自CDR2L ,CDR3H肽库中的CDR2L1和CDR3H1噬菌体肽没有明显的拮抗TNF作用 .研究结果初步表明 :从cA2抗体CDR肽库中筛选得到的噬菌体CDR模拟肽具有亲本抗体相似的结合活性和生物学效应 ,从而为开发已知抗体 (特别是治疗用抗体 )

关键词：肿瘤坏死因子多肽拮抗剂噬茵体呈现互补决定区

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A modified clinicopathological tumor staging system for survival prediction of patients with penile cancer

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Cancer Communications 2018年第1期38卷 726-735页

作者： Zai-Shang Li Antonio Augusto Ornellas Christian Schwentner Xiang Li Alcides Chaux Georges Netto Arthur LBurnett Yong Tang JiunHung Geng Kai Yao Xiao-Feng Chen Bin Wang Hong Liao Nan Liu Peng Chen Yong-Hong Lei Qi-Wu Mi Hui-Lan Rao Ying-Ming Xiao Qi-Lin Wang Zi-Ke Qin Zhuo-Wei Liu Yong-Hong Li Zi-Jun Zou Jun-Hang Luo Hui Li Hui Han Fang-Jian Zhou Department of Urology Shenzhen People’s HospitalThe Second Clinical College of Jinan UniversityShenzhen 518060GuangdongP.R.China Sun Yat-sen University Cancer Center State Key Laboratory of Oncology in South ChinaCollaborative Innovation Center of Cancer MedicineGuangzhou 510060GuangdongP.R.China Department of Urology Sun Yat-sen University Cancer Center651 Dongfeng RoadEast Guangzhou 510060GuangdongP.R.China Department of Urology Brazilian National Institute of Cancer and Hospital Mário KröeffRio de Janeiro 20230-130Brazil Section of Urology National Institute of CancerRio de JaneiroBrazil Department of Urology Diakonie Klinikum Stuttgart70174 StuttgartGermany Urological Department Urological InstituteWest China Hospital of Sichuan UniversityChengdu 610041SichuanP.R.China Department of Scientific Research Norte University1001-1925 AsunciónParaguay Department of Pathology Johns Hopkins UniversityBaltimoreMD 21218USA Department of Urology Johns Hopkins UniversityBaltimoreMD 21218USA Department of Urology Affiliated Cancer Hospital of Guangxi Medical UniversityNanning 530021GuangxiP.R.China Department of Urology Kaohsiung Medical University HospitalKaohsiungTaiwan 807China Department of Urology The First People’s Hospital of ChenzhouChenzhou 423000HunanP.R.China Department of Urology Cancer Center of Guangzhou Medical UniversityGuangzhou 510000GuangdongP.R.China Department of Urology Sichuan Cancer HospitalChengdu 610041SichuanP.R.China Department of Urology Oncological Surgery Chongqing Cancer Hospital&Institute&Cancer CenterChongqing 400040China Department of Urology Affiliated Tumor Hospital of Xinjiang Medical UniversityUrumqi 830011XinjiangP.R.China Department of Urology Yunnan Provincial Tumor HospitalThe Third Affiliated Hospital of Kunming Medical UniversityKunming 650118YunnanP.R.China Department of Urology Dongguan People’s HospitalDongguan 523059GuangdongP.R.China Department of Pathology Sun Yat-sen University Cancer CenterGuangzhou 510060Guangdo

Background:The 8th American Joint Committee on Cancer tumor-node-metastasis(AJCC-TNM)staging system is based on a few retrospective single-center *** aimed to test the prognostic validity of the staging system and to determine whether a modified clinicopathological tumor staging system that includes lymphovascular emboliza-tion could increase the accuracy of prognostic prediction for patients with stage T2-3 penile ***:A training cohort of 411 patients who were treated at 2 centers in China and Brazil between 2000 and 2015 were staged according to the 8th AJCC-TNM staging *** internal validation was analyzed by bootstrap-corrected C-indexes(resampled 1000 times).Data from 436 patients who were treated at 15 centers over four conti-nents were used for external ***:A survivorship overlap was observed between T2 and T3 patients(P=0.587)classified according to the 8th AJCC-TNM staging *** embolization was a significant prognostic factor for metastasis and survival(all P<0.001).Based on the multivariate analysis,only lymphovascular embolization showed a significant influ-ence on cancer-specific survival(CSS)(hazard ratio=1.587,95%confidence interval=1.253-2.011;P=0.001).T2 and T3 patients with lymphovascular embolization showed significantly shorter CSS than did those without lymphovascu-lar embolization(P<0.001).Therefore,a modified clinicopathological staging system was proposed,with the T2 and T3 categories of the 8th AJCC-TNM staging system being subdivided into two new categories as follows:t2 tumors invade the corpus spongiosum and/or corpora cavernosa and/or urethra without lymphovascular invasion,and t3 tumors invade the corpus spongiosum and/or corpora cavernosa and/or urethra with lymphovascular *** modified staging system involving lymphovascular embolization showed improved prognostic stratification with significant differences in CSS among all categories(all P<0.005)and exhibited higher accur

关键词： Penile neoplasms Lymph node metastasis Staging Lymph node excision Prognosis

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