OBJECTIVE:To investigate the effect of entecavir plus Ganshuang granule(肝爽颗粒,GSG)on advanced fibrosis and cirrhosis in patients with chronic hepatitis B virus infection.METHODS:One hundred thirty-five patients wer...OBJECTIVE:To investigate the effect of entecavir plus Ganshuang granule(肝爽颗粒,GSG)on advanced fibrosis and cirrhosis in patients with chronic hepatitis B virus infection.METHODS:One hundred thirty-five patients were randomly assigned to one of two cohorts:GSG cohort(n=69)or placebo cohort(n=66).The GSG cohort received entecavir plus GSG and the placebo cohort received entecavir plus placebo for 48 weeks.Liver biopsy was performed at baseline and between weeks 44 and 48 during this placebo-controlled trial.We assessed histological improvement(greater than a two-point decrease using the Knodell in fl ammatory score and no worsening of the Ishak fibrosis score)and fibrosis regression(a decrease of at least one point in the Ishak fibrosis score).RESULTS:There were 95.7% of patients(66/69)in the GSG cohort and 66.7%(44/66)of patients in the placebo cohort who showed necroin t.The mean reduction in flth ammation improvemene Knodell necroinflammatory score was 5.1 and 2.6,respectively.There were 89.9%(62/69)of patients in the GSG cohort and 31.8%(21/66)of patients in the placebo cohort who showed at least a one-point improvement in the Ishak fibrosis score.The mean reduction in the Ishak fibrosis score was 1.7 and 0.4,respectively.CONCLUSION:Patients with advanced fibrosis and cirrhosis caused by chronic hepatitis B showed more improvement in liver histology in a shorter time after treatment with entecavir plus GSG compared with entecavir plus placebo.展开更多
BACKGROUND Computed tomography(CT)technology has been gradually used in the differen-tiation of small mesenchymal tumors of the stomach and intestines from smooth muscle tumours.AIM To explore the value of enhanced CT...BACKGROUND Computed tomography(CT)technology has been gradually used in the differen-tiation of small mesenchymal tumors of the stomach and intestines from smooth muscle tumours.AIM To explore the value of enhanced CT in the differentiation of small mesenchymal tumors of the stomach and intestines from smooth muscle tumours.METHODS Clinical data of patients with gastric mesenchymal or gastric smooth muscle tu-mours who were treated in our hospital from May 2018 to April 2023 were retrospectively analysed.Patients were divided into the gastric mesenchymal tumor group and the gastric smooth muscle tumor group respectively(n=50 cases per group).Clinical data of 50 healthy volunteers who received physical examinations in our hospital during the same period were selected and included in the control group.Serum levels of carcinoembryonic antigen(CEA),alpha-fetoprotein(AFP),carbohydrate antigen 19-9(CA19-9),CA-125 and cytokeratin 19 fragment antigen 21-1 were compared among the three groups.The value of CEA and CA19-9 in the identification of gastric mesenchymal tumours was analysed using the receiver operating characteristic(ROC)curve.The Kappa statistic was used to analyse the consistency of the combined CEA and CA19-9 test in identi-fying gastric mesenchymal tumours.RESULTS CEA levels varied among the three groups in the following order:The gastric mesenchymal tumour group>the control group>the gastric smooth muscle tumour group.CA19-9 levels varied among the three groups in the following order:The gastric mesenchymal group>the gastric smooth muscle group>the control group,the difference was statistically significant(P<0.05).ROC analysis showed that the area under the curve of CEA and CA19-9 was 0.879 and 0.782,respectively.CONCLUSION Enhanced CT has shown value in differentiating small mesenchymal tumors of the stomach and intestines from smooth muscle tumors.展开更多
Objective: to study the application of improved instrument cleaning process in ophthalmic instrument management. Methods: the control group used the traditional cleaning process of ophthalmic surgical instruments, and...Objective: to study the application of improved instrument cleaning process in ophthalmic instrument management. Methods: the control group used the traditional cleaning process of ophthalmic surgical instruments, and the experimental group optimized and improved the cleaning process of traditional ophthalmic surgical instruments. The cleaning quality, passive change times and damage rate were compared between the two groups. Results: the cleaning quality of the equipment after optimization and improvement was significantly higher than that before improvement. The frequency of passive replacement and damage rate of surgical instruments were significantly lower than those before improvement (P < 0.05). Conclusion: after the improvement of ophthalmic surgical instrument cleaning process, the unqualified instruments are significantly reduced, and the number of passive replacement of surgical instruments and damage rate are significantly reduced, indicating that the improved ophthalmic surgical instrument cleaning process is effective and worthy of extensive support.展开更多
Recent advances in systemic and locoregional treatments for patients with unresectable or advanced hepatocellular carcinoma(HCC)have resulted in improved response rates.This has provided an opportunity for selected pa...Recent advances in systemic and locoregional treatments for patients with unresectable or advanced hepatocellular carcinoma(HCC)have resulted in improved response rates.This has provided an opportunity for selected patients with initially unresectable HCC to achieve adequate tumor downstaging to undergo surgical resection,a‘conversion therapy’strategy.However,conversion therapy is a new approach to the treatment of HCC and its practice and treatment protocols are still being developed.Review the evidence for conversion therapy in HCC and develop consensus statements to guide clinical practice.Evidence review:Many research centers in China have accumulated significant experience implementing HCC conversion therapy.Preliminary findings and data have shown that conversion therapy represents an important strategy to maximize the survival of selected patients with intermediate stage to advanced HCC;however,there are still many urgent clinical and scientific challenges for this therapeutic strategy and its related fields.In order to summarize and learn from past experience and review current challenges,the Chinese Expert Consensus on Conversion Therapy for Hepatocellular Carcinoma(2021 Edition)was developed based on a review of preliminary experience and clinical data from Chinese and non-Chinese studies in this field and combined with recommendations for clinical practice.Sixteen consensus statements on the implementation of conversion therapy for HCC were developed.The statements generated in this review are based on a review of clinical evidence and real clinical experience and will help guide future progress in conversion therapy for patients with HCC.展开更多
The BRAF gene is an important signaling molecule in human cells that is involved in the regulation of cell growth,differentiation,and survival.When the BRAF gene mutates,it can lead to abnormal activation of the signa...The BRAF gene is an important signaling molecule in human cells that is involved in the regulation of cell growth,differentiation,and survival.When the BRAF gene mutates,it can lead to abnormal activation of the signaling pathway,which promotes cell proliferation,inhibits cell apoptosis,and ultimately contributes to the occurrence and development of cancer.BRAF mutations are widely present in various cancers,including malignant melanoma,thyroid cancer,colorectal cancer,non-small cell lung cancer,and hairy cell leukemia,among others.BRAF is an important target for the treatment of various solid tumors,and targeted combination therapies,represented by BRAF inhibitors,have become one of the main treatment modalities for a variety of BRAF-mutation-positive solid tumors.展开更多
基金Supported by a Major Science and Technology Special Project for the Prevention and Treatment of HIV/AIDS,Viral Hepatitis and Other Major Infectious Diseases of China Thirteenth 5-year plan(No.2018ZX10732401-003-015)。
文摘OBJECTIVE:To investigate the effect of entecavir plus Ganshuang granule(肝爽颗粒,GSG)on advanced fibrosis and cirrhosis in patients with chronic hepatitis B virus infection.METHODS:One hundred thirty-five patients were randomly assigned to one of two cohorts:GSG cohort(n=69)or placebo cohort(n=66).The GSG cohort received entecavir plus GSG and the placebo cohort received entecavir plus placebo for 48 weeks.Liver biopsy was performed at baseline and between weeks 44 and 48 during this placebo-controlled trial.We assessed histological improvement(greater than a two-point decrease using the Knodell in fl ammatory score and no worsening of the Ishak fibrosis score)and fibrosis regression(a decrease of at least one point in the Ishak fibrosis score).RESULTS:There were 95.7% of patients(66/69)in the GSG cohort and 66.7%(44/66)of patients in the placebo cohort who showed necroin t.The mean reduction in flth ammation improvemene Knodell necroinflammatory score was 5.1 and 2.6,respectively.There were 89.9%(62/69)of patients in the GSG cohort and 31.8%(21/66)of patients in the placebo cohort who showed at least a one-point improvement in the Ishak fibrosis score.The mean reduction in the Ishak fibrosis score was 1.7 and 0.4,respectively.CONCLUSION:Patients with advanced fibrosis and cirrhosis caused by chronic hepatitis B showed more improvement in liver histology in a shorter time after treatment with entecavir plus GSG compared with entecavir plus placebo.
文摘BACKGROUND Computed tomography(CT)technology has been gradually used in the differen-tiation of small mesenchymal tumors of the stomach and intestines from smooth muscle tumours.AIM To explore the value of enhanced CT in the differentiation of small mesenchymal tumors of the stomach and intestines from smooth muscle tumours.METHODS Clinical data of patients with gastric mesenchymal or gastric smooth muscle tu-mours who were treated in our hospital from May 2018 to April 2023 were retrospectively analysed.Patients were divided into the gastric mesenchymal tumor group and the gastric smooth muscle tumor group respectively(n=50 cases per group).Clinical data of 50 healthy volunteers who received physical examinations in our hospital during the same period were selected and included in the control group.Serum levels of carcinoembryonic antigen(CEA),alpha-fetoprotein(AFP),carbohydrate antigen 19-9(CA19-9),CA-125 and cytokeratin 19 fragment antigen 21-1 were compared among the three groups.The value of CEA and CA19-9 in the identification of gastric mesenchymal tumours was analysed using the receiver operating characteristic(ROC)curve.The Kappa statistic was used to analyse the consistency of the combined CEA and CA19-9 test in identi-fying gastric mesenchymal tumours.RESULTS CEA levels varied among the three groups in the following order:The gastric mesenchymal tumour group>the control group>the gastric smooth muscle tumour group.CA19-9 levels varied among the three groups in the following order:The gastric mesenchymal group>the gastric smooth muscle group>the control group,the difference was statistically significant(P<0.05).ROC analysis showed that the area under the curve of CEA and CA19-9 was 0.879 and 0.782,respectively.CONCLUSION Enhanced CT has shown value in differentiating small mesenchymal tumors of the stomach and intestines from smooth muscle tumors.
文摘Objective: to study the application of improved instrument cleaning process in ophthalmic instrument management. Methods: the control group used the traditional cleaning process of ophthalmic surgical instruments, and the experimental group optimized and improved the cleaning process of traditional ophthalmic surgical instruments. The cleaning quality, passive change times and damage rate were compared between the two groups. Results: the cleaning quality of the equipment after optimization and improvement was significantly higher than that before improvement. The frequency of passive replacement and damage rate of surgical instruments were significantly lower than those before improvement (P < 0.05). Conclusion: after the improvement of ophthalmic surgical instrument cleaning process, the unqualified instruments are significantly reduced, and the number of passive replacement of surgical instruments and damage rate are significantly reduced, indicating that the improved ophthalmic surgical instrument cleaning process is effective and worthy of extensive support.
文摘Recent advances in systemic and locoregional treatments for patients with unresectable or advanced hepatocellular carcinoma(HCC)have resulted in improved response rates.This has provided an opportunity for selected patients with initially unresectable HCC to achieve adequate tumor downstaging to undergo surgical resection,a‘conversion therapy’strategy.However,conversion therapy is a new approach to the treatment of HCC and its practice and treatment protocols are still being developed.Review the evidence for conversion therapy in HCC and develop consensus statements to guide clinical practice.Evidence review:Many research centers in China have accumulated significant experience implementing HCC conversion therapy.Preliminary findings and data have shown that conversion therapy represents an important strategy to maximize the survival of selected patients with intermediate stage to advanced HCC;however,there are still many urgent clinical and scientific challenges for this therapeutic strategy and its related fields.In order to summarize and learn from past experience and review current challenges,the Chinese Expert Consensus on Conversion Therapy for Hepatocellular Carcinoma(2021 Edition)was developed based on a review of preliminary experience and clinical data from Chinese and non-Chinese studies in this field and combined with recommendations for clinical practice.Sixteen consensus statements on the implementation of conversion therapy for HCC were developed.The statements generated in this review are based on a review of clinical evidence and real clinical experience and will help guide future progress in conversion therapy for patients with HCC.
基金supported by the Natural Science Foundation of China(grant number 82002456)China Postdoctoral Science Foundation(grant number 2022M723207)+10 种基金the Medical Scientific Research Foundation of Zhejiang Province,China(grant number 2023KY666)Zhejiang Traditional Chinese Medicine Science Fund Project(grant number 2024ZL372)Qiantang Cross Fund Project(grant number 2023-16)National Natural Science Foundation of China of Zhejiang Cancer Hospital Cultivation Project(grant number PY2023006)the Medical Scientific Research Foundation of Zhejiang Province,China(grant number 2024KY812)the Natural Science Foundation of Zhejiang Province(grant number LQ24H160036)Beijing Health Technologies Promotion Program[grant number BHTPP2022041]Peking University Clinical Scientist Training Program and the Fundamental Research Funds for the Central Universities[grant number BMU2024PYJH010]Science Foundation of Peking University Cancer Hospital[grant number PY202333]the Beijing Natural Science Foundation[grant number 7232248]Beijing Hospitals Authority Youth Programme[grant number QML20231902].
文摘The BRAF gene is an important signaling molecule in human cells that is involved in the regulation of cell growth,differentiation,and survival.When the BRAF gene mutates,it can lead to abnormal activation of the signaling pathway,which promotes cell proliferation,inhibits cell apoptosis,and ultimately contributes to the occurrence and development of cancer.BRAF mutations are widely present in various cancers,including malignant melanoma,thyroid cancer,colorectal cancer,non-small cell lung cancer,and hairy cell leukemia,among others.BRAF is an important target for the treatment of various solid tumors,and targeted combination therapies,represented by BRAF inhibitors,have become one of the main treatment modalities for a variety of BRAF-mutation-positive solid tumors.
