prognosis assessment

预后评估
  • 文章类型: Journal Article
    建立基于基线炎症和营养指标的简单评分系统,以预测鼻咽癌(NPC)患者的长期预后。回顾性分析1024例新诊断的非转移性NPC患者的临床资料。收集总共15个治疗前炎症和营养标志物作为候选变量。使用接收器工作特征(ROC)曲线来确定每个参数的最佳截止点。采用Kaplan-Meier法和Cox回归分析进行生存分析。此外,通过将每个独立的预后因素分为1,计算每位患者的炎症营养风险评分(INRS).多因素Cox回归分析显示,血清白蛋白(ALB)、全身免疫炎症指数,单核细胞计数(M)是OS的独立预后因素(P<0.05)。生存分析显示,较高的INRS与预后恶化有关。高风险组患者的OS短于低风险组。在训练组中,3-,5-,低危组与高危组的8年OS率分别为92.5%和87.8%,87.4%对75.1%,分别为84.6%和62.2%,分别为(P<0.05)。在验证组中,3-,5-,低风险组的8年OS率与高危人群分别为95.0%和86.4%,92.1%对82.2%,分别为89.5%和74.3%,分别为(P<0.05)。进一步亚组分析显示,在局部晚期患者中,高危组和低危组的OS差异有统计学意义(P<0.05)。ROC曲线表明,与TNM分期和血清EBV-DNA水平相比,INRS对NPC患者的长期生存具有相似的预测价值。预处理ALB,M,和SIRI是影响鼻咽癌患者长期生存的独立预后因素。基于这三个因素构建的INRS可作为NPC的长期预后指标。
    To develop a simple scoring system based on baseline inflammatory and nutritional markers to predict the long-term prognosis of patients with nasopharyngeal carcinoma (NPC). Conducted a retrospective analysis of clinical data from 1024 newly diagnosed non-metastatic NPC patients. A total of 15 pre-treatment inflammatory and nutritional markers were collected as candidate variables. Receiver operating characteristic (ROC) curves were used to determine the optimal cutoff points for each parameter. Survival analysis was performed using Kaplan-Meier method and Cox regression analysis. Besides, the Inflammation Nutrition Risk Score (INRS) was calculated for each patient by assigning each independent prognostic factor a score of 1. Multivariate Cox regression analysis showed that serum albumin (ALB), systemic immune-inflammation index, and monocyte count (M) were independent prognostic factors for OS (P < 0.05). Survival analysis showed that higher INRS was associated with a worsened prognosis. Patients in the high-risk group had shorter OS than in the low-risk group. In the training group, the 3-, 5-, and 8-years OS rates for the low-risk group versus high-risk group were 92.5% versus 87.8%, 87.4% versus 75.1%, and 84.6% versus 62.2%, respectively (P < 0.05). In the validation group, the 3-, 5-, and 8-years OS rates for the low-risk group vs. high-risk group were 95.0% versus 86.4%, 92.1% versus 82.2%, and 89.5% versus 74.3%, respectively (P < 0.05). Further subgroup analysis showed a significant difference in the OS between the high-risk group and low-risk group in patients with locally advanced disease (P < 0.05). The ROC curve demonstrated that INRS had a similar predictive value for long-term survival in NPC patients compared to TNM staging and serum EBV-DNA levels. Pretreatment ALB, M, and SIRI are independent prognostic factors for long-term survival in patients with NPC. INRS constructed based on these three factors can serve as a long-term prognostic indicator for NPC.
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  • 文章类型: Journal Article
    肝细胞生长因子(HGF)及其受体,c-Met,在发生中起重要作用,发展,和胃癌(GC)的治疗。本文就HGF/c-Met信号通路在GC中的作用及其潜在的靶向治疗机制作一综述。作为世界范围内最常见的恶性肿瘤之一,GC具有复杂的发病机制和有限的治疗选择。因此,深入了解GC的分子机制对于开发新的治疗方法非常重要。HGF/c-Met信号通路在细胞增殖中发挥重要作用,迁移,和侵袭的GC细胞而成为新的治疗靶点。本文综述了HGF/c-Met在GC中的作用,并讨论了靶向该信号通路的靶向治疗策略。为GC的治疗提供新的思路和方向。
    Hepatocyte growth factor (HGF) and its receptor, c-Met, play important roles in the occurrence, development, and treatment of gastric cancer (GC). This review explored the function of the HGF/c-Met signaling pathway in GC and its potential targeted therapeutic mechanisms. As one of the most common malignant tumors worldwide, GC has a complex pathogenesis and limited therapeutic options. Therefore, a thorough understanding of the molecular mechanism of GC is very important for the development of new therapeutic methods. The HGF/c-Met signaling pathway plays an important role in the proliferation, migration, and invasion of GC cells and has become a new therapeutic target. This review summarizes the current research progress on the role of HGF/c-Met in GC and discusses targeted therapeutic strategies targeting this signaling pathway, providing new ideas and directions for the treatment of GC.
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  • 文章类型: English Abstract
    一些结直肠癌患者即使在接受了根治性切除术的手术治疗后仍面临高复发率和不良预后。确定潜在的生化标志物和治疗靶标,以评估接受结直肠癌根治术的患者的预后,对于改善其临床预后至关重要。最近,据报道,T细胞免疫球蛋白和粘蛋白结构域蛋白3(Tim-3)及其配体半乳糖凝集素9(galectin-9)在各种肿瘤引起的免疫功能障碍中起着至关重要的作用,如结直肠癌。然而,他们的表情,生物学功能,结直肠癌的预后价值尚不清楚。本研究旨在探讨Tim-3和galectin-9表达水平与结直肠癌根治术患者临床病理特征及预后的关系。
    选择2018年2月至2019年3月在成都市第五人民医院接受结直肠癌根治术的患者171例。进行免疫组织化学以评估患者的癌组织样品和癌旁组织样品中Tim-3和半乳糖凝集素-9的表达水平。相应地分析Tim-3和半乳糖凝集素-9表达水平与患者的基线临床参数之间的关系。进行Kaplan-Meier分析以评估Tim-3和galectin-9表达水平与结直肠癌患者的无复发生存期(RFS)和总生存期(OS)之间的关联。进行Cox回归分析以确定与患者不良预后相关的因素。
    免疫组织化学结果显示,在70.18%(120/171)和32.16%(55/171)中观察到Tim-3和galectin-9的高表达水平,分别,结肠直肠癌组织,而低表达水平分别为29.82%(51/171)和67.84%(116/171),分别。此外,结直肠癌组织中Tim-3的表达得分明显高于癌旁组织,galectin-9在癌旁组织中的表达评分低于癌旁组织(P<0.05)。进一步分析发现Tim-3和galectin-9的表达与肿瘤浸润深度有关,血管浸润,临床分期(P<0.05)。在14-63个月的随访期间,171例患者中有7例失访。在剩下的患者中,49例和112例分别出现Tim-3和galectin-9异常低表达,而115例和52例分别高表达Tim-3和galectin-9。Kaplan-Meier生存分析显示,结直肠癌组织中Tim-3高表达患者的RFS和OS明显低于低表达患者(RFS:log-rank=22.66,P<0.001;OS:log-rank=19.71,P<0.001)。相反,半乳糖凝集素-9低表达患者的RFS和OS显著低于高表达患者(RFS:log-rank=19.45,P<0.001;OS:log-rank=22.24,P<0.001).多因素Cox分析表明TNM分期为Ⅲ期(HR=2.26,95%CI:1.20-5.68),Tim-3的高表达(HR=0.80,95%CI:0.33-0.91),半乳糖凝集素-9低表达(HR=1.80,95%CI:1.33~4.70)是影响患者RFS和OS的独立危险因素(P<0.05)。
    在结直肠癌组织中观察到Tim-3和半乳糖凝集素-9的异常表达。Tim-3的高表达和半乳糖凝集素-9的低表达与不良临床病理特征和预后密切相关。它们被确定为可能引发患者不良预后事件的独立影响因素。这些发现表明Tim-3和半乳糖凝集素-9具有作为新的治疗靶标和临床指标的潜力。
    UNASSIGNED: Some colorectal cancer patients still face high recurrence rates and poor prognoses even after they have undergone the surgical treatment of radical resection. Identifying potential biochemical markers and therapeutic targets for the prognostic evaluation of patients undergoing radical resection of colorectal cancer is crucial for improving their clinical outcomes. Recently, it has been reported that the T cell immunoglobulin and mucin domain protein 3 (Tim-3) and its ligand galactose lectin 9 (galectin-9) play crucial roles in immune dysfunction caused by various tumors, such as colorectal cancer. However, their expressions, biological functions, and prognostic value in colorectal cancer are still unclear. This study aims to investigate the relationship between Tim-3 and galectin-9 expression levels and the clinicopathological characteristics and prognosis of patients undergoing radical resection of colorectal cancer.
    UNASSIGNED: A total of 171 patients who underwent radical resection of colorectal cancer at Chengdu Fifth People\'s Hospital between February 2018 and March 2019 were selected. Immunohistochemistry was performed to assess the expression levels of Tim-3 and galectin-9 in the cancer tissue samples and the paracancerous tissue samples of the patients. The relationship between Tim-3 and galectin-9 expression levels and the baseline clinical parameters of the patients was analyzed accordingly. Kaplan-Meier analysis was performed to assess the association between Tim-3 and galectin-9 expression levels and the relapse-free survival (RFS) and the overall survival (OS) of colorectal cancer patients. Cox regression analysis was conducted to identify factors associated with adverse prognosis in the patients.
    UNASSIGNED: The immunohistochemical results showed that the high expression levels of Tim-3 and galectin-9 were observed in 70.18% (120/171) and 32.16% (55/171), respectively, of the colorectal cancer tissues, whereas the low expression levels were 29.82% (51/171) and 67.84% (116/171), respectively. Furthermore, the expression score of Tim-3 was significantly higher in colorectal cancer tissues than that in the paracancerous tissues, while the expression score of galectin-9 was lower than that in the paracancerous tissues (P<0.05). Further analysis revealed that the expression of Tim-3 and galectin-9 was associated with the depth of tumor infiltration, vascular infiltration, and clinical staging (P<0.05). During the follow-up period of 14-63 months, 7 out of 171 patients were lost to follow-up. Among the remaining patients, 49 and 112 cases presented abnormally low expression of Tim-3 and galectin-9, respectively, whereas 115 and 52 cases presented high expression of Tim-3 and galectin-9, respectively. Kaplan-Meier survival analysis demonstrated that patients with high Tim-3 expression in colorectal cancer tissues had significantly lower RFS and OS than those with low expression did (RFS: log-rank=22.66, P<0.001; OS: log-rank=19.71, P<0.001). Conversely, patients with low galectin-9 expression had significantly lower RFS and OS than those with high expression did (RFS: log-rank=19.45, P<0.001; OS: log-rank=22.24, P<0.001). Cox multivariate analysis indicated that TNM stage Ⅲ (HR=2.26, 95% CI: 1.20-5.68), high expression of Tim-3 (HR=0.80, 95% CI: 0.33-0.91), and low expression of galectin-9 (HR=1.80, 95% CI: 1.33-4.70) were independent risk factors affecting RFS and OS in patients (P<0.05).
    UNASSIGNED: Aberrant expression of Tim-3 and galectin-9 is observed in colorectal cancer tissues. High expression of Tim-3 and low expression of galectin-9 are closely associated with adverse clinico-pathological characteristics and prognosis. They are identified as independent influencing factors that may trigger adverse prognostic events in patients. These findings suggest that Tim-3 and galectin-9 have potential as new therapeutic targets and clinical indicators.
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  • 文章类型: Journal Article
    作为消化系统恶性肿瘤的主要组成部分,起源于肝和胆管的肿瘤严重危害公众健康。驱动蛋白(KIF)是分子马达,可实现有丝分裂和减数分裂所必需的微管依赖性细胞内运输。通常,KIFs的稳定性对于维持细胞增殖和遗传稳态至关重要。然而,异常的KIF活动可能会破坏这种动态稳定性,导致不受控制的细胞分裂和肿瘤启动。在这项工作中,我们对KIFs在肝细胞和胆管癌变中的具体作用进行了全面的总结,指的是异常信号转导和预后评估的潜力。此外,还讨论了KIFs靶向抑制剂的当前临床应用,包括它们的功效优势,与药物敏感性或耐药性的关系,联合化疗或其他靶向药物的可行性,以及相应的临床试验。总之,异常激活的KIFs通过多种机制参与肿瘤进展的调控,并与肿瘤预后密切相关。同时,针对KIFs的抑制剂还进行了有希望的肿瘤靶向治疗策略,值得在肝胆管癌(HBC)中进一步研究。
    As a major component of the digestive system malignancies, tumors originating from the hepatic and biliary ducts seriously endanger public health. The kinesins (KIFs) are molecular motors that enable the microtubule-dependent intracellular trafficking necessary for mitosis and meiosis. Normally, the stability of KIFs is essential to maintain cell proliferation and genetic homeostasis. However, aberrant KIFs activity may destroy this dynamic stability, leading to uncontrolled cell division and tumor initiation. In this work, we have made an integral summarization of the specific roles of KIFs in hepatocellular and biliary duct carcinogenesis, referring to aberrant signal transduction and the potential for prognostic evaluation. Additionally, current clinical applications of KIFs-targeted inhibitors have also been discussed, including their efficacy advantages, relationship with drug sensitivity or resistance, the feasibility of combination chemotherapy or other targeted agents, as well as the corresponding clinical trials. In conclusion, the abnormally activated KIFs participate in the regulation of tumor progression via a diverse range of mechanisms and are closely associated with tumor prognosis. Meanwhile, KIFs-aimed inhibitors also carry out a promising tumor-targeted therapeutic strategy that deserves to be further investigated in hepatobiliary carcinoma (HBC).
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  • 文章类型: Journal Article
    背景:这项研究旨在确定ESCA中的代谢亚型,探索它们与免疫景观的关系,并建立代谢指标进行准确的预后评估。
    方法:临床,SNP,和RNA-seq数据来自TCGA数据库中的80例ESCA患者,RNA-seq数据来自GSE19417数据集.选择与总生存期(OS)和无进展生存期(PFS)相关的代谢基因,并进行了k均值聚类。免疫相关途径,免疫浸润,使用生物信息学算法预测对免疫疗法的反应。进行加权基因共表达网络分析(WGCNA)以鉴定与共表达模块相关的代谢基因。最后,使用患者组织样本和ESCA细胞系进行细胞培养和功能分析,以验证鉴定的基因及其作用.
    结果:根据代谢基因的表达谱鉴定了分子亚型,单因素生存分析显示163个代谢基因与ESCA预后相关。共有聚类分析将ESCA样本分为三种不同的亚型,MC1预后最差,MC3预后最好。这些亚型在免疫细胞浸润方面也表现出显著差异,MC3的得分最高。此外,MC3亚型对免疫疗法的反应最差,而MC1亚型最敏感。WGCNA分析确定了与代谢指数相关的基因模块,SLC5A1、NT5DC4和MTHFD2作为预后标志物出现。基因和蛋白质表达分析验证了MTHFD2在ESCA中的上调。MTHFD2促进ESCA的进展,可能是ESCA的潜在治疗靶点。
    结论:确定的代谢指数和确定的代谢基因为ESCA的预后评估和个性化治疗干预提供了潜力,强调ESCA中靶向代谢-免疫相互作用的重要性。MTHFD2促进ESCA的进展,可能是ESCA的潜在治疗靶点。
    BACKGROUND: This study aimed to identify metabolic subtypes in ESCA, explore their relationship with immune landscapes, and establish a metabolic index for accurate prognosis assessment.
    METHODS: Clinical, SNP, and RNA-seq data were collected from 80 ESCA patients from the TCGA database and RNA-seq data from the GSE19417 dataset. Metabolic genes associated with overall survival (OS) and progression-free survival (PFS) were selected, and k-means clustering was performed. Immune-related pathways, immune infiltration, and response to immunotherapy were predicted using bioinformatic algorithms. Weighted gene co-expression network analysis (WGCNA) was conducted to identify metabolic genes associated with co-expression modules. Lastly, cell culture and functional analysis were performed using patient tissue samples and ESCA cell lines to verify the identified genes and their roles.
    RESULTS: Molecular subtypes were identified based on the expression profiles of metabolic genes, and univariate survival analysis revealed 163 metabolic genes associated with ESCA prognosis. Consensus clustering analysis classified ESCA samples into three distinct subtypes, with MC1 showing the poorest prognosis and MC3 having the best prognosis. The subtypes also exhibited significant differences in immune cell infiltration, with MC3 showing the highest scores. Additionally, the MC3 subtype demonstrated the poorest response to immunotherapy, while the MC1 subtype was the most sensitive. WGCNA analysis identified gene modules associated with the metabolic index, with SLC5A1, NT5DC4, and MTHFD2 emerging as prognostic markers. Gene and protein expression analysis validated the upregulation of MTHFD2 in ESCA. MTHFD2 promotes the progression of ESCA and may be a potential therapeutic target for ESCA.
    CONCLUSIONS: The established metabolic index and identified metabolic genes offer potential for prognostic assessment and personalized therapeutic interventions for ESCA, underscoring the importance of targeting metabolism-immune interactions in ESCA. MTHFD2 promotes the progression of ESCA and may be a potential therapeutic target for ESCA.
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  • 文章类型: Journal Article
    急性胰腺炎(AP)是一种潜在的危及生命的胰腺炎性疾病,临床管理取决于疾病的严重程度。诊断,严重性预测,AP的预后评估通常涉及成像技术的使用,比如计算机断层扫描,磁共振成像,还有超声波,和评分系统,包括Ranson,急性生理学和慢性健康评估II,以及AP分数中严重程度的床边指数。计算机断层扫描由于其高灵敏度和特异性而被认为是AP的金标准成像模式。而磁共振成像和超声可以提供有关胆道梗阻和血管并发症的更多信息。评分系统利用临床和实验室参数将AP患者分类为轻度,中度,或严重类别,指导治疗决策,例如重症监护室入院,早期肠内喂养,抗生素的使用。尽管成像技术和评分系统在AP管理中发挥着核心作用,这些方法在准确性方面有局限性,再现性,实用性和经济性。人工智能(AI)的最新进展提供了新的机会,通过分析大量的临床和成像数据来提高其性能。人工智能算法可以分析大量的临床和成像数据,确定评分系统模式,并预测临床病程。基于AI的模型在预测AP的严重程度和死亡率方面显示出了有希望的结果,但在广泛临床应用之前还需要进一步验证和标准化.此外,了解这三种技术之间的相关性将有助于开发新的方法,敏感,并专门用于诊断,严重性预测,并通过优势互补对AP进行预后评估。
    Acute pancreatitis (AP) is a potentially life-threatening inflammatory disease of the pancreas, with clinical management determined by the severity of the disease. Diagnosis, severity prediction, and prognosis assessment of AP typically involve the use of imaging technologies, such as computed tomography, magnetic resonance imaging, and ultrasound, and scoring systems, including Ranson, Acute Physiology and Chronic Health Evaluation II, and Bedside Index for Severity in AP scores. Computed tomography is considered the gold standard imaging modality for AP due to its high sensitivity and specificity, while magnetic resonance imaging and ultrasound can provide additional information on biliary obstruction and vascular complications. Scoring systems utilize clinical and laboratory parameters to classify AP patients into mild, moderate, or severe categories, guiding treatment decisions, such as intensive care unit admission, early enteral feeding, and antibiotic use. Despite the central role of imaging technologies and scoring systems in AP management, these methods have limitations in terms of accuracy, reproducibility, practicality and economics. Recent advancements of artificial intelligence (AI) provide new opportunities to enhance their performance by analyzing vast amounts of clinical and imaging data. AI algorithms can analyze large amounts of clinical and imaging data, identify scoring system patterns, and predict the clinical course of disease. AI-based models have shown promising results in predicting the severity and mortality of AP, but further validation and standardization are required before widespread clinical application. In addition, understanding the correlation between these three technologies will aid in developing new methods that can accurately, sensitively, and specifically be used in the diagnosis, severity prediction, and prognosis assessment of AP through complementary advantages.
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  • 文章类型: Journal Article
    对病假客户进行基于证据的工作残疾预后评估(WDPE)对于医生来说是一项艰巨的任务。目的是开发一种工作方法,以支持医生进行基于证据的WDPE并提高WDPE质量。
    干预映射(IM)补充了行为改变轮(BCW)的元素,以指导开发工作方法的项目计划。这种方法允许与其他框架的组合,例如,行为改变理论。在各种生态层面上分析了WDPE质量挑战,例如,个人(即,医生),人际关系(即,客户)和组织层面,最终形成问题的多层次逻辑模型。导致这个问题的决定因素,例如,缺乏医生对执行循证WDPE的知识,已确定。制定了性能目标,以促进WDPE质量的期望变化。从绩效目标和决定因素(例如,知识),变化的目标是衍生出来的。为了实现这些变化目标,适当的干预功能(例如,教育)和政策类别(例如,服务提供)被确定,允许制定干预措施。行为改变技术(例如,对行为结果的反馈)被选择来服务于干预功能,以实现所需的变化。这导致了干预计划的概念化。
    介绍了干预措施“可预测”。它由基于证据的WDPE的逐步工作方法(SWM)组成。SWM提供了重要方面的概述(例如,医疗状况,客户\'对重返工作岗位的信心)在个人客户\'WDPE中考虑。SWM帮助医生识别关键的功能限制,发现并评估基于证据的信息,权衡所有相关的预后方面,它支持医生以基于证据的WDPE得出结论,为个人客户量身定制。干预“可预测”是设计的,其中还包括一个教育计划和一个支持性软件工具,以实现SWM。
    IM与BCW元素的结合指导了基于证据的WDPE的SWM的开发。SWM将通过数字工具支持的医生教育计划提供。SWM,教育计划和数字工具已准备好在实践中实施和评估干预措施。\"
    Performing evidence-based work disability prognosis evaluation (WDPE) of clients on sick leave is a difficult task for physicians. The aim was to develop a working method to support physicians in performing evidence-based WDPE and to improve WDPE quality.
    Intervention Mapping (IM) supplemented with elements of the Behavior Change Wheel (BCW) guided project planning for developing the working method. This approach allowed combination with other frameworks and, e.g., behavior change theories. WDPE quality challenges were analyzed on various ecological levels, e.g., the individual (i.e., the physician), interpersonal (i.e., the client) and organizational level, culminating into a multilevel logic model of the problem. Determinants that contributed to this problem, e.g., lack of physicians\' knowledge on performing evidence-based WDPE, were identified. Performance objectives were formulated that could contribute to a desired change in WDPE quality. From the performance objectives and determinants (e.g., knowledge), change objectives were derived. In order to achieve these change objectives, suitable intervention functions (e.g., education) and policy categories (e.g., service provision) were identified, allowing the formulation of intervention components. Behavior change techniques (e.g., feedback on outcomes of a behavior) were selected to serve the intervention functions to deliver the desired change. This led to the conceptualization of an intervention plan.
    The intervention \"Prognosable\" is presented. It consists of a stepwise working method (SWM) for evidence-based WDPE. The SWM offers an overview of important aspects (e.g., medical condition, clients\' confidence in return-to-work) to consider in individual clients\' WDPE. The SWM helps physicians to identify crucial functional limitations, find and appraise evidence-based information, weigh all relevant prognostic aspects and it supports physicians to conclude with an evidence-based WDPE, tailored to the individual client. The intervention \"Prognosable\" was designed, which also includes an educational program and a supportive software tool to enable implementation of the SWM.
    IM combined with BCW elements guided the development of a SWM for evidence-based WDPE. The SWM will be delivered through an educational program for physicians supported by a digital tool. The SWM, educational program and digital tool are ready to be implemented and evaluated in practice as the intervention \"Prognosable.\"
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  • 文章类型: Systematic Review
    Extracellular vesicles (EVs) carrying functional cargoes are emerging as biomarkers and treatment strategies in multiple liver diseases. Nevertheless, the potential of EVs in liver failure remains indistinct. In this systematic review, we comprehensively analyzed the potential of EVs as biomarkers of liver failure and the therapeutic effects and possible mechanisms of EVs for liver failure.
    We conducted a systematic review by comprehensively searching the following electronic databases: PubMed, Web of Science, Embase and Cochrane Central Register of Controlled Trials from inception to March 2022. The used text words (synonyms and word variations) and database-specific subject headings included \"Extracellular Vesicles\", \"Exosomes\", \"Liver Failure\", \"Liver Injury\", etc.
    A total of 1479 studies were identified. After removing 680 duplicate studies and 742 irrelevant studies, 57 studies were finally retained and analyzed. Fourteen studies revealed EVs with functional cargoes could be used to make the diagnosis of liver failure and provide clues for early warning and prognostic assessment of patients with liver failure. Forty-three studies confirmed the administration of EVs from different sources alleviated hepatic damage and improved survival through inhibiting inflammatory response, oxidative stress as well as apoptosis or promoting hepatocyte regeneration and autophagy.
    EVs and their cargoes can be used not only as superior biomarkers of early warning, early diagnosis and prognostic assessments for liver failure, but also as potentially effective treatment options for liver failure. In the future, large-scale studies are urgently needed to verify the diagnostic, predictive and therapeutic value of EVs for liver failure.
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  • 文章类型: Journal Article
    UNASSIGNED:评估与多发性骨髓瘤(MM)患者血浆中循环游离DNA(cfDNA)的水平和完整性有关的临床研究。
    UNASSIGNED:收集56例新诊断的MM患者和60例健康志愿者的血浆样本。ALU247片段和ALU115片段作为靶基因,定量聚合酶链反应(qPCR)用于评估患者和健康对照组的血浆。分析了MM中的cfDNA水平,和ALU247/ALU115比值用于计算cfDNA的完整性。分析cfDNA水平和完整性与原发性MM患者临床特征的相关性,并评估其在疗效监测和预后评估中的价值。
    UNASSIGNED:原发性MM患者血浆ALU247和ALU115的浓度以及cfDNA的完整性明显高于健康对照组(P<0.05)。ALU247片段浓度与杜里鲑鱼(D-S)显着相关,国际分期系统(ISS),修订后的国际分期系统(R-ISS)阶段(P<0.05)。经过三个疗程的诱导化疗,两组患者的ALU247、ALU115和cfDNA完整性水平均低于化疗前(P<0.05)。患者CR的疗效,sCR,VGPR分为≥非常好的部分反应(VGPR)组(n=38),而对PR和SD有疗效的患者分为未经证实:MM患者的CfDNA水平显著升高,ALU247片段浓度与多种临床特征显著相关,对疗效监测和预后评估具有重要的临床价值。
    UNASSIGNED: To evaluate the clinical research related to the level and integrity of circulating free DNA (cfDNA) in the plasma of patients with multiple myeloma (MM).
    UNASSIGNED: The plasma samples of 56 patients with newly diagnosed MM and 60 healthy volunteers were collected. ALU247 fragment and ALU115 fragment were used as target genes, and quantitative polymerase chain reaction (qPCR) was used to assess the plasma of the patient and healthy control groups. The cfDNA level in MM was analyzed, and the ALU247/ALU115 ratio was used to calculate the integrity of cfDNA. The correlation between the cfDNA level and integrity and the clinical characteristics of patients with primary MM was analyzed, and their value in efficacy monitoring and prognostic evaluation was evaluated.
    UNASSIGNED: The plasma concentrations of ALU247 and ALU115 and the integrity of cfDNA in patients with primary MM were significantly higher than those in the healthy controls (P<0.05). The ALU247 fragment concentration was markedly correlated with the Durie-Salmon (D-S), International Staging System (ISS), and Revised-International Staging System (R-ISS) stages (P<0.05). After three courses of induction chemotherapy, the levels of ALU247, ALU115, and cfDNA integrity in both groups were lower than those before chemotherapy (P<0.05). Patients with curative effects of CR, sCR, and VGPR were classified into the ≥ very good partial response (VGPR) group (n=38), while those with curative effects of PR and SD were allocated into the UNASSIGNED: CfDNA levels were significantly elevated in MM patients, and the ALU247 fragment concentration was remarkably correlated with multiple clinical features and had important clinical value for efficacy monitoring and prognostic assessment.
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  • 文章类型: Journal Article
    这项工作旨在回顾内皮功能障碍在自体和异基因造血细胞移植(HCT)后早期出现的主要并发症中的作用。内皮损伤作为窦性阻塞综合征(SOS)的病理生理基础已得到证实。然而,越来越多的证据表明内皮功能障碍与其他并发症有关,如急性移植物抗宿主病(aGVHD)和移植相关血栓性微血管病(TA-TMA)。此外,HCT相关内皮病不仅限于HCT设置,因为有越来越多的证据表明它与其他细胞疗法引起的并发症有关。我们还回顾了主要HCT并发症的发生率和危险因素,以及内皮受累和其他相关途径在其发展中的生物学证据。此外,我们涵盖了关于内皮病生物标志物在预测中的潜在用途的最新技术,早期诊断,以及HCT并发症的随访,并总结了目前对内皮和其他相关途径的知识点,这些途径被描述为预防和治疗HCT并发症的潜在目标。最后,我们还对正在出现并可能对HCT后患者的生存和生活质量产生潜在影响的内皮聚焦治疗策略进行了综述.
    This work aims to review the role of endothelial dysfunction underlying the main complications appearing early after autologous and allogeneic hematopoietic cell transplantation (HCT). The endothelial damage as the pathophysiological substrate of sinusoidal obstruction syndrome (SOS) is well established. However, there is growing evidence of the involvement of endothelial dysfunction in other complications, such as acute graft-versus-host disease (aGVHD) and transplant-associated thrombotic microangiopathy (TA-TMAs). Moreover, HCT-related endotheliopathy is not only limited to the HCT setting, as there is increasing evidence of its implication in complications derived from other cellular therapies. We also review the incidence and the risk factors of the main HCT complications and the biological evidence of the endothelial involvement and other linked pathways in their development. In addition, we cover the state of the art regarding the potential use of the biomarkers of endotheliopathy in the prediction, the early diagnosis, and the follow-up of the HCT complications and summarize current knowledge points to the endothelium and the other linked pathways described as potential targets for the prevention and treatment of HCT-complications. Lastly, the endothelium-focused therapeutic strategies that are emerging and might have a potential impact on the survival and quality of life of post-HCT-patients are additionally reviewed.
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