Evaluation Of Short-term Efficacy Research Articles

The Level of Poly-IgA Immune Complexes in the Short-Term Efficacy Evaluation and Disease Activity Monitoring of IgA Nephropathy (IgAN)

The Level of Poly-IgA Immune Complexes in the Short-Term Efficacy Evaluation and Disease Activity Monitoring of IgA Nephropathy (IgAN)

Application Value of Gastroenterography Combined With CT in the Evaluation of Short-Term Efficacy and Prognosis in Patients With Esophageal Cancer Radiotherapy.

PurposeTo observe the application value of gastroenterography combined with CT in the evaluation of short-term efficacy and prognosis in patients with esophageal cancer radiotherapy.MethodsFrom January 2013 to December 2020, the clinical data of 207 patients with esophageal cancer treated by radiotherapy in our hospital were collected retrospectively. All patients received gastroenterography and CT examination before and after radiotherapy, and the patients were followed-up for 1 year, and the evaluation value of their short-term efficacy and prognosis was observed.ResultsAfter radiotherapy, the length diameter, short diameter, and volume of the lymph node were lower than those before radiotherapy (p < 0.05), but the maximum tube wall thickness had no significant difference (p > 0.05). The length diameter, short diameter, and volume of the lymph node, and the maximum tube wall thickness in the good efficacy group and the good prognosis group were lower, and the objective response rate in the good prognosis group was higher (p < 0.05). The area under the curve (AUC) of the length diameter, short diameter, and volume of the lymph node to evaluate the short-term efficacy of patients with esophageal cancer was 0.738, 0.705, and 0.748, respectively, and the AUC to evaluate the prognosis of patients with esophageal cancer was 0.751, 0.776, and 0.791, respectively.ConclusionGastroenterography combined with CT has a good application value in the evaluation of short-term efficacy and prognosis in patients with esophageal cancer radiotherapy.

Comparative Evaluation of Short-term Clinical Safety and Efficacy of COVID-19 Vaccines - Covishield and Covaxin

Background: Many candidate vaccines against COVID-19 are competing for their clinical safety and efficacy but few have got approval from the competent authorities. However, people are still concerned about their use. Objectives: To assess the clinical safety of COVID-19 vaccines, Covishield and Covaxin using the incidence of self-reported and solicited local and systemic adverse events and efficacy by collecting data on the occurrence of confirmed COVID-19 infection after vaccination and to compare the clinical safety and efficacy of both the vaccines. Method: This study was conducted as an online survey using a self-administered questionnaire, among the individuals who were vaccinated in the months of February, March and April 2021. The participants were categorised into two groups, based on the type of vaccine they received as Covishield and Covaxin. The two groups did not differ in terms of age and gender. Results: The proportion of participants who had adverse events after the first dose of vaccination was significantly high with Covishield (37.2%) compared to Covaxin (17.4%). But the proportion of participants who developed adverse events after the second dose was not significantly different between Covishield and Covaxin (16.1% with Covishield and 23.8% with Covaxin). The incidence of COVID-19 infection after vaccination was similar in both the groups (4.5% in Covishield group and 5.7% in Covaxin group, p = 0.5, Chi-square test). Conclusion: The findings from this study gives real-world data that both Covishield and Covaxin are equally effective in preventing COVID-19 infection and have an acceptable safety profile.

Evaluation of immediate and short-term efficacy of DualStim therapy with and without intracavernosal umbilical cord-derived Wharton's jelly in patients with erectile dysfunction: Study protocol for a randomized controlled trial

IntroductionErectile dysfunction (ED) affects a significant portion of the United States population and causes negative psychological burdens that affects men and their partner's quality of life and satisfaction. Extracorporeal shock therapy (ESWT) utilizing focused ESWT and radial ESWT in Low-intensity shock wave therapy has been used to treat ED with some success. Wharton's Jelly (WJ) is a biologic substance with large amounts of stem cells, growth factors, cytokines and extracellular components. The use of combined focused and radial ESWT (DualStim therapy) with injected WJ have potential uses in ED that may have advantages over current treatments. MaterialsA randomized, single-blinded, controlled clinical trial will be conducted to evaluate the efficacy and safety of DualStim therapy and intracavernosal injection of WJ in moderate to severe ED. A total of 60 patients with moderate to severe ED will be enrolled and treated with DualStim therapy with intracavernosal injection of WJ or saline for a period of 7 weeks. The International Index of Erectile Function – Erectile Function score will be used to gauge the treatment related changes in relation to the subject's baseline. The scores will be recorded at baseline and compared to follow-ups 1,3 and 6 months post-treatment. Any adverse events or severe adverse events will be recorded in the corresponding case report forms. Sexual Encounter Profile, as well as the Global Assessment Questionnaire and the Erection Hardness Score will be used to determine the sexual activity improvement from baseline leading to optimal penetration at follow-ups 1,3 and 6 months post-treatment. DiscussionThis clinical trial is one of the first studies to determine the immediate and short-term efficacy of DualStim therapy, with and without intracavernosal injection of formulated umbilical cord-derived WJ to improve and/or restore erectile function in patients with moderate to severe ED. This study will also provide insight into the safety and efficacy of WJ. We anticipate clinically significant improvement in patients suffering from moderate and severe ED treated with DualStim therapy with WJ compared to their baseline and DualStim with saline.

Short-term Efficacy Evaluation of Emergency Interventional Therapy for Patients with Acute Myocardial Infarction

Short-term Efficacy Evaluation of Emergency Interventional Therapy for Patients with Acute Myocardial Infarction

Positron Emission Tomography-Based Short-Term Efficacy Evaluation and Prediction in Patients With Non-Small Cell Lung Cancer Treated With Hypo-Fractionated Radiotherapy.

BackgroundPositron emission tomography is known to provide more accurate estimates than computed tomography when staging non–small cell lung cancer. The aims of this prospective study were to contrast the short-term efficacy of the two imaging methods while evaluating the effects of hypo-fractionated radiotherapy in non-small cell lung cancer, and to establish a short-term efficacy prediction model based on the radiomics features of positron emission tomography.MethodsThis nonrandomized-controlled trial was conducted from March 2015 to June 2019. Thirty-one lesions of 30 patients underwent the delineation of the regions of interest on positron emission tomography and computed tomography 1 month before, and 3 months after hypo-fractionated radiotherapy. Each patient was evaluated for the differences in local objective response rate between the two images. The Kaplan Meier method was used to analyze the local objective response and subsequent survival duration of the two imaging methods. The 3D Slicer was used to extract the radiomics features based on positron emission tomography. Least absolute shrinkage and selection operator regression was used to eliminate redundant features, and logistic regression analysis was used to develop the curative-effect-predicting model, which was displayed through a radiomics nomogram. Receiver operating characteristic curve and decision curve were used to evaluate the accuracy and clinical usefulness of the prediction model.ResultsPositron emission tomography-based local objective response rate was significantly higher than that based on computed tomography [70.97% (22/31) and 12.90% (4/31), respectively (p<0.001)]. The mean survival time of responders and non-responders assessed by positron emission tomography was 28.6 months vs. 11.4 months (p=0.29), whereas that assessed by computed tomography was 24.5 months vs. 26 months (p=0.66), respectively. Three radiomics features were screened to establish a personalized prediction nomogram with high area under curve (0.94, 95% CI 0.85–0.99, p<0.001). The decision curve showed a high clinical value of the radiomics nomogram.ConclusionsWe recommend positron emission tomography for evaluating the short-term efficacy of hypo-fractionated radiotherapy in non-small cell lung cancer, and that the radiomics nomogram could be an important technique for the prediction of short-term efficacy, which might enable an improved and precise treatment.Registration number/URLChiCTR1900027768/http://www.chictr.org.cn/showprojen.aspx?proj=46057

An initial trial of quantitative evaluation of autoimmune pancreatitis using shear wave elastography and shear wave dispersion in transabdominal ultrasound

Background/ObjectivesWe aimed to examine therapeutic efficacy and prognosis prediction of autoimmune pancreatitis (AIP) using shear wave elastography (SWE) and shear wave dispersion (SWD) in transabdominal ultrasound (US). MethodsThe subjects were 23 patients with diffuse type 1 AIP who underwent SWE and SWD, and 34 controls with a normal pancreas. Elasticity and dispersion were defined as the pancreatic elastic modulus (PEM) and dispersion slope, respectively. PEM and dispersion slope were compared between AIP and control cases, and the short-term therapeutic effect and long-term prognosis were examined. ResultsPEM (30.9 vs. 6.6 kPa, P < 0.001) and dispersion slope (15.3 vs. 13.0 (m/sec)/kHz, P = 0.011) were significantly higher in AIP cases than in controls. Among the 17 AIP patients followed-up in two weeks after treatment, these parameters were 12.7 kPa and 10.5 (m/sec)/kHz with median decrease rate of 37.2% and 32.8%, respectively, which were significantly higher than the change in the size of pancreatic parenchyma (14.4%, P = 0.026). Fourteen of these subjects were followed up for >12 months, during which 2 had relapse; diabetes improved in 5 and worsened in 2; in 60% of cases, the pancreatic parenchyma was atrophied. The % change in PEM after two weeks was tended to be higher in non-atrophy cases. ConclusionSWE and SWD measurement in US may be useful for quantitative assessment of AIP and evaluation of short-term treatment efficacy.

Short-term efficacy evaluation of laparoscopic purse-string forceps gastrectomy of upper and middle gastric cancer

目的： 总结腹腔镜荷包钳法胃上中部癌根治手术的应用经验，评价其临床应用价值、可行性及安全性。 方法： 回顾性分析2016年7月至2018年12月期间，于新乡医学院第一附属医院胃肠外科接受腹腔镜荷包钳法胃上中部癌根治手术的35例患者的临床资料。完成胃系膜的切除及淋巴结清扫后，在腹腔镜下采用荷包钳法制作食管荷包，放置抵钉座，以管型吻合器完成食管空肠（食管胃）吻合。观察手术结果，统计切口长度、手术时间、手术失血量、淋巴结清扫数目、食管切缘距肿瘤上缘距离、术后首次排气时间、术后并发症发生情况和术后病理结果。 结果： 35例患者均顺利完成腹腔镜荷包钳法胃上中部癌根治术，无中转开腹病例。全胃切除术26例，近端胃切除术9例；腹部切口长度为（4.0±1.1） cm。手术时间（290.0±74.6） min，术中失血量为（111.4±43.2） ml，清扫淋巴结（32.2±10.4）枚，食管切缘距肿物上缘距离为（2.6±0.5） cm。所有病例食管切缘均为阴性。术后首次排气时间为（2.9±0.9） d。全组并发症发生率为17.1%（6/35），其中吻合口相关并发症发生率为5.7%（2/35）。腹部切口均一期愈合，无切口感染；术后发生肺部感染4例，吻合口漏2例，均经非手术治疗治愈；无吻合口狭窄发生；近端胃切除病例中9例均有反酸表现，2例出现进食后上腹胀、纳差表现，均经药物治疗后缓解。余患者均顺利康复。 结论： 腹腔镜荷包钳法胃上中部癌根治手术安全可行。.

Etiological analysis and short-term efficacy evaluation of acute liver failure in children

Objective: To explore etiology, optimize the search direction of etiology, and short-term efficacy evaluation of acute liver failure in children. Methods: Children with acute liver failure who were diagnosed in the First Affiliated Hospital of Zhengzhou University from November 2011 to November 2019 were collected. Gender difference, age, living environment, etiological factors on the seasonal onset and different etiological profile of short-term prognosis were statistically analyzed. Chi-square test or Fisher's exact probability method was used to compare the rate and the constituent ratio between groups. Results: Among the 236 cases, 114 (48.31%) had unknown etiology and 122 (51.69%) had definite etiology. In the definite etiology group, 38 (16.10%), 27 (11.44%), 22 (9.32%), 15 (6.36%), 17 (7.20%), and 3 (1.27%) cases were related to drugs/toxicants, infection, congenital/vascular/biliary diseases, genetic metabolic diseases, tumor-related, and autoimmune diseases. In addition, the overall etiological distribution did not change statistically with factors such as gender, age, and seasonal onset (P > 0.05), while the difference in different living environments was statistically significant (P < 0.05). Different initial-diagnosed departments had different etiological rates, with liver transplantation department being the highest (78.26%), and pediatrics department the lowest (26.09%). In 122 children with definite etiology, there was no significant difference in gender ratio between the different etiology groups (P>0.05), but there were significant differences in age, living environment and seasonal onset (P < 0.05). Among them, congenital development/vascular/biliary tract and infectivity were the main factors in children < 3 years old, and drug/toxin-related factors were the main factors in children > 3 years old. Most of the rural children had drug/toxin and infection-related etiology, while most of the urban children had tumor and drug/toxin-related etiology. In summer and autumn, drug/toxicant correlation was dominant, while in winter and spring, infection correlation was dominant. In the unknown etiology group, the clinical cure + improvement rate between the medical treatment group and the surgical treatment group was not statistically significant (37.50% vs. 20.00%, P > 0.05), while in the definite etiology group, the above differences were statistically significant (43.96% vs. 83.87%, P < 0.05). Among the different etiology groups, the congenital/vascular/biliary group had the best short-term efficacy (72.72%, 16/22), followed by the drug/toxicity-related group (60.53%, 23/38), and the tumor-related group had the worst (23.53%, 4/17). Conclusion: The definite etiology of acute liver failure in about half of children is still vague. The population distribution of children with definite etiology is related to age, living environment and season, but not to gender. However, the different ages, different living environments, and different seasonal onsets have definite etiology, and the short-term clinical efficacy of the treatment is significantly improved after the definite etiology is identified.

Short-term efficacy evaluation of laparoscopic spleen-preserving splenic hilus lymphadenectomy and left epigastrium mesogastric excision for advanced proximal gastric cancer based on mesangial anatomy

Objective: To investigate short-term efficacy of laparoscopic spleen-preserving splenic hilus lymphadenectomy and left epigastrium mesogastric excision for advanced proximal gastric cancer based on mesangial anatomy. Methods: A case series study was carried out. Case inclusion criteria: (1) patient was confirmed as gastric adenocarcinoma by gastroscopic biopsy before operation; (2) locally advanced gastric cancer was confirmed by abdominal CT before operation; (3) no distant metastases such as liver, lung, and posterior peritoneal lymph nodes, and no tumor directly invading the pancreas, spleen, liver, and colon were verified by superficial lymph node ultrasound, chest and abdominal CT before operation;(4) total gastrectomy or proximal gastrectomy plus D2 lymphadenectomy were performed, and R0 resection was confirmed by postoperative pathology. Exclusion criteria: (1) intraperitoneal dissemination or distant metastasis was found during laparoscopic exploration; (2) No.10 lymph nodes were significantly enlarged or fused into clusters; (3) pathological diagnostic data were incomplete. According to above criteria, the clinicopathological data of 36 patients who underwent laparoscopic spleen-preserving No.10 lymphadenectomy and left epigastrium mesogastric excision based on interspace anatomy for advanced proximal gastric cancer in The First Affiliated Hospital of Zhengzhou University from June 2017 to March 2018 were retrospectively collected and analyzed. The intraoperative conditions, postoperative recovery and complications of patients were analyzed. Results: In 36 patients, the mean age was (59.8±8.0) years, the mean BMI was (23.9±3.5) kg/m(2), and 8 cases (22.2%) received preoperative chemotherapy. All the patients underwent successfully the laparoscopic spleen-preserving splenic hilus lymphadenectomy and left epigastrium mesogastric excision. In the examination of postoperative resected specimens, it was found that the mesangial boundary of the upper and posterior part of the stomach was smooth, indicating the efficiency of complete mesangial resection. No case was converted to open operation. The mean time of lymph node dissection and mesangial resection was (34.2±11.4) minutes. The mean blood loss during operation was (44.8±21.3) ml. The mean number of lymph node dissection per patient was 45.6±17.6. The mean number of No. 11p+11d lymph node dissection was 3.1± 2.8 per patient, and 7 patients were pathologically positive with metastasis rate of 19.4% (7/36). The mean number of No.10 lymph node dissection was 2.9±2.5 per patient, and 2 patients were pathologically positive with metastasis rate of 5.6% (2/36). The time to postoperative flatus was (3.8±0.6) days, time to removal of nasogastric was (1.9±0.7) days, time to the first intake of fluid was (3.0±0.4) days, time to removal of drainage tube was (6.0±1.2) days. Postoperative mean hospital stay was (12.8±4.0) days. One case (2.7%) developed pulmonary embolism and 1 case (2.7%) developed gastroplegia after operation. The morbidity of postoperative complication was 5.6% (2/36). No operative site infection, postoperative bleeding and death within postoperative 30-day were observed. All the 36 patients were followed up and the median follow-up was 18 months (12-28 months). Seven patients died of tumor relapse and metastasis (3 cases died within postoperative 1 year) and another 1 case developed colonic cancer 17 months after operation. Conclusion: Laparoscopic spleen-preserving splenic hilus lymphadenectomy and left epigastrium mesogastric excision for advanced proximal gastric cancer based on mesangial anatomy is safe and feasible.

Safety and Efficacy Evaluation of Traditional Chinese Medicine (Qingre-Lishi-Yishen Formula) Based on Treatment of Regular Glucocorticoid Combined with Cyclophosphamide Pulse in Children Suffered from Moderately Severe Henoch-Schonlein Purpura Nephritis with Nephrotic Proteinuria.

Objective At present, the most appropriate management of Henoch–Schonlein purpura nephritis (HSPN) with nephrotic-range proteinuria still remains controversial; thus, the purpose of this study is to evaluate safety and efficacy of traditional Chinese medicine (TCM), Qingre-Lishi-Yishen Formula (QLYF), integrated with regular oral glucocorticoid and cyclophosphamide intravenous pulse therapeutic regimen in children suffered from moderately severe HSPN with nephrotic proteinuria. Methods From 1 January 2012, to 1 January 2016, totally 150 hospitalized children suffered from HSPN with nephrotic proteinuria were included. All were treated with glucocorticoid and cyclophosphamide, and 100 of them were treated with integrative traditional Chinese decoction QLYF. Patients were followed up for 2 years. Rate of adverse event occurrence, short-term clinical effects, long-term clinical effects, and TCM therapeutic evaluation were all compared. Results Total adverse event rate was lower in the QLYF group (χ2 = 5.357, p = 0.022); rates of respiratory infection, urinary infection, poor appetite, hepatotoxity, cardiotoxicity, and neutropenia were all decreased in patients who received QLYF (p = 0.022); rates of respiratory infection, urinary infection, poor appetite, hepatotoxity, cardiotoxicity, and neutropenia were all decreased in patients who received QLYF (p = 0.022); rates of respiratory infection, urinary infection, poor appetite, hepatotoxity, cardiotoxicity, and neutropenia were all decreased in patients who received QLYF (p = 0.022); rates of respiratory infection, urinary infection, poor appetite, hepatotoxity, cardiotoxicity, and neutropenia were all decreased in patients who received QLYF (p = 0.022); rates of respiratory infection, urinary infection, poor appetite, hepatotoxity, cardiotoxicity, and neutropenia were all decreased in patients who received QLYF (p = 0.022); rates of respiratory infection, urinary infection, poor appetite, hepatotoxity, cardiotoxicity, and neutropenia were all decreased in patients who received QLYF (Conclusion Compared with merely using regular oral glucocorticoid plus cyclophosphamide pulse therapeutic regimen, the therapeutic regimen that integrates QLYF with the abovementioned western medicine might be a safe means to decrease the occurrence rate of adverse events and improve short-term and long-term clinical effects in children who suffered from moderately severe HSPN with nephrotic proteinuria.

Application of cystatin C and β2-microglobulin in the assessment of condition and short-term efficacy of multiple myeloma

Objective To explore the application value of serum cystatin C (Cys-C) and β2-microglobulin (β2-MG) in the diagnosis and short-term efficacy evaluation of multiple myeloma (MM). Methods A total of 450 patients with MM admitted to Anqing Hospital of Chinese People′s Liberation Army Navy and Jinhua Central Hospital of Zhejiang Province from October 2016 to October 2018 were selected as subjects (MM group), according to the Durie-Salmon staging criteria, including 150 patients in stage Ⅰ, Ⅱ and Ⅲ. A total of 150 healthy subjects were selected as the control group. The levels of Cys-C and β2-MG in the serum of the subjects were determined. The differences of Cys-C and β2-MG levels between the two groups and the MM patients with different Durie-Salmon stages were compared. The differences of Cys-C and β2-MG levels between the patients with different short-term efficacy were compared. The receiver operating characteristic (ROC) curve was used to analyze the value of the two indicators in the evaluation of MM efficacy, and the correlation between Cys-C and β2-GM was analyzed. Logistic regression analysis was used to analyze the multiple factors affecting the clinical efficacy of MM patients. Results The levels of Cys-C and β2-MG in the serum of the patients with MM were (2.11±0.78) mg/L and (6.07±3.08) g/L respectively, and those in the control group were (0.75±0.20) mg/L and (1.78±0.59) g/L, with significant differences (t=33.848, P<0.001; t=28.084, P<0.001). The Cys-C levels of Durie-Salmon stage Ⅰ, Ⅱ and Ⅲ patients were (0.99±0.21) mg/L, (1.36±0.17) mg/L and (3.07±1.02) mg/L respectively, and the difference was statistically significant (F=44.157, P<0.001). The β2-MG levels in the serum of patients with stage Ⅰ, Ⅱ and Ⅲ were (2.57±0.75) g/L, (4.66±1.43) g/L, (8.63±2.26) g/L respectively, and the difference was statistically significant (F=57.285, P<0.001). In all the patients, 338 patients were effective, accoun-ting for 75.11%, and 112 patients were ineffective, accounting for 24.89%. The levels of Cys-C and β2-MG in the serum of the effective MM patients were (1.28±0.23) mg/L and (2.82±0.78) g/L, and those of ineffective patients were (2.97±0.77) mg/L and (6.22±1.92) g/L, with statistically significant differences (t=35.874, P<0.001; t=26.633, P<0.001). The sensitivity of serum Cys-C for predicting short-term efficacy was 83.0%, the specificity was 76.6%, and those of serum β2-MG were 89.3% and 73.6%. The area under curve (AUC) of the serum Cys-C was 0.813 (95%CI: 0.764-0.862), and the AUC of serum β2-MG was 0.865 (95%CI: 0.825-0.906), with a statistically significant difference (Z=2.490, P=0.011). Spearman correlation analysis showed a positive correlation between serum Cys-C and β2-MG (r=0.539, P=0.041). Logistic regression analysis showed that both β2-MG (95%CI: 2.386-5.144, P<0.001) and Cys-C (95%CI: 2.367-9.702, P<0.001) were independent factors affecting the short-term efficacy of MM. Multivariate analysis showed that β2-MG (95%CI: 3.549-13.739, P=0.001) was an independent factor affecting the efficacy of MM. Conclusion The levels of serum Cys-C and β2-M in MM patients are significantly higher than those in healthy people, and they show an increasing trend with the progression of MM disease, which can be used as markers for the pathological staging diagnosis of MM patients. The short-term efficacy of the patients can be evaluated by using the two indicators, and the clinical significance in efficacy evaluation of β2-MG is slightly better than that of Cys-C. Key words: Multiple myeloma; Diagnosis; Treatment outcome; Cystatin-C; β2-microglobulin

Effect of whole-course nutrition management on patients with esophageal cancer undergoing concurrent chemoradiotherapy: A randomized control trial.

Malnutrition is the most common complication of patients with esophageal cancer and can lead to poor prognosis and death. Good nutritional status has been shown to help improve patient outcomes and reduce complications. In the absence of specific evidence on the effect of nutrition in patients with esophageal cancer, the purpose of this study was to investigate the effect of whole-course nutrition management on the prognosis and complications of chemoradiotherapy in patients with esophageal cancer through a randomized controlled trial. A total of 96 patients with esophageal cancer treated with concurrent chemoradiation were randomized to an intervention group (treated with whole-course nutrition management from the Nutrition Support Team) and a control group (treated with the general nutritional method) for approximately 6 wk. Dietary surveys and body measurements were conducted at baseline and every day thereafter. Patient-generated Subjective Global Assessment score, blood index, quality of life, and psychological condition were assessed at baseline and every week before discharge. Complications (e.g., radiation esophagitis, myelosuppression, and skin symptoms), completion rates of therapy, short-term efficacy evaluation, as well as clinical outcomes were measured. A total of 85 patients completed the study (intervention group = 45; control group = 40). There were significant differences in the changes of serum albumin and total protein between the two groups throughout the trial (P < 0.05). Complications (e.g., radioactive esophagitis, skin symptom of complications) and quality of life were statistically different before and after the intervention (P < 0.05). The difference in the change of other indicators was not statistically significant. Whole-course nutrition management can improve the nutritional status of patients with esophageal cancer treated with concurrent chemoradiotherapy, reduce the severity of radiation esophagitis and radiation skin reactions, improve the quality of life, and relieve depressive symptoms.

Effect of Whole-course Nutrition Management on Patients with Esophageal Cancer Undergoing Concurrent Chemoradiotherapy: A Randomized Control Trial (P05-031-19)

ObjectivesMalnutrition is the most common complication of patients with esophageal cancer, and can lead to poor prognosis and death. It has been shown that good nutritional status can help improve patient outcomes and reduce complications. In the absence of specific evidence of the effect of nutrition on patients with esophageal cancer, the purpose of this study was to investigate the effect of total nutrition management on the prognosis and complications of patients with esophageal cancer through a randomized controlled trial. Methods96 patients with esophageal cancer concurrent chemoradiation were randomized to observation group (treated by whole-nutrition management from the Nutrition Support Group (NST)) and control group (treated by the general nutritional method) for 6 weeks approximately. Dietary survey, Patient-Generated Subjective Global Assessment (PG-SGA), body measurement, blood index, quality of life survey and psychological condition survey were assessed at baseline and every week/at the end of the study. Complications, the completion rates of therapy, short-term efficacy evaluation as well as clinical outcomes were measured before discharge. ResultsA total of 85 subjects completed the study (observation group = 45, control group = 40). There were significantly different in the changes in serum albumin, prealbumin, and total protein between two groups throughout the trial (P < 0.05). Radioactive esophagitis, skin symptom of the complications, the roles, emotional functions, social functions, and general health status in the quality of life were statistically different before and after the intervention (P < 0.05). The difference in the change of other indicators was not statistically significant. ConclusionsWhole-course nutrition management can improve the nutritional status of patients with concurrent chemoradiotherapy of esophageal cancer, reduce the severity of radiation esophagitis and radiation skin reactions, improve the quality of life and relieve their depressive symptoms. Funding SourcesWu Jieping Medical Foundation Special Fund for Clinical Research of 2017.

Evaluation of short-term efficacy of radiofrequency ablation for hepatocellular carcinoma by dynamic three-dimensional contrast-enhanced ultrasound

Evaluation of short-term efficacy of radiofrequency ablation for hepatocellular carcinoma by dynamic three-dimensional contrast-enhanced ultrasound

Evaluation of short-term efficacy of extraspinal cementoplasty for bone metastasis: A monocenter study of 31 patients

ObjectiveTo study the effect on pain of per-cutaneous cementoplasty for painful extraspinal bone metastasis. Method43 patients with extraspinal bone metastasis were included between April 2006 and October 2014 in this retrospective monocenter study. The primary endpoint was pain level measured on a 0–10 numeric rating scale at week 1 after cementoplasty as compared with pre-cementoplasty. Secondary endpoints were long-term pain level and impact on quality of life and disability. ResultsMean pain score was 4.2 (SD ±3.6) before cementoplasty and 1.09 (SD ±2.4) at week 1 (p = 0.005) (n = 31 patients). At 22 months after cementoplasty, quality of life and disability improved (according to the patient global assessment) for 47.6% and 52.2% of patients (n = 21patients). We did not find a predictor of good response. Cement leakage was the most common adverse event. ConclusionPercutaneous cementoplasty of extraspinal bone metastasis is a rapidly efficient treatment with few adverse events. Its efficacy persists over time, with a benefit for disability and quality of life. Although this technique is only palliative, it should be considered in this situation.

Clinical application of barium radiography and computed tomography-based short-term outcome evaluation criteria in esophageal cancer

Objective To explore and improve the feasibility and prognostic value of barium radiography and computed tomography (CT)-based evaluation criteria in evaluation of the short-term efficacy of radiotherapy for esophageal cancer, and to provide a basis for clinical application. Methods The short-term treatment outcomes of 529 patients with esophageal carcinoma receiving three-dimensional radiotherapy from 2004 to 2015 were evaluated by the 2013 version of barium radiography and CT-based evaluation criteria. The local control (LC) and survival rates were calculated using the Kaplan-Meier method. The log-rank test was used for data analysis and univariate prognostic analysis. The agreement between two evaluation criteria was measured by the Kappa coefficient. Results According to the results of the survival analysis in all the patients using the evaluation criteria for short-term treatment outcomes, the 3-, 5-, 7-, and 9-year LC rates were 78.6%, 69.8%, 69.8%, and 63.4% in the complete response (CR) group (n=52), and 56.4%, 47.9%, 46.2%, and 42.4% in the partial response (PR) group (n=409), respectively; the 3-, 5-, 7-, and 9-year overall survival (OS) rates were 62.7%, 49.1%, 39.8%, and 39.8% in the CR group, and 29.5%, 21.6%, 20.6%, and 19.5% in the PR group, respectively; the median OS time was 50, 17, and 5 months in the CR group, PR group, and non-response group (n=12), respectively (P=0.000). According to CT measurements, the short diameter of residual metastatic lymph node after radiotherapy was between 0.37-3.40 cm (median value=0.82 cm). All patients were divided into groups based on the short diameter of residual metastatic lymph node after radiotherapy with a gradient of 0.5 cm. Patients with short diameters of residual metastatic lymph node of ≤1.00 cm had a significantly higher OS rate than those with short diameters of residual metastatic lymph node of>1.00 cm (P=0.000). The lymph node volume of 1.00 cm3 in the original criteria was replaced by the short diameter of residual metastatic lymph node of 1.00 cm after radiotherapy and treatment outcomes were re-evaluated using the new criteria. The CR group still had significantly higher LC and OS rates than the PR group (P=0.000). There was a good agreement between the two evaluation criteria (Kappa=0.863). Conclusions The barium radiography and CT-based evaluation criteria for short-term treatment outcomes can accurately evaluate the short-term outcomes and predict prognosis in patients with esophageal carcinoma. Replacing the volume in the original criteria with the short diameter of residual metastatic lymph node after radiotherapy achieves similar results in prognostic prediction. Key words: Esophageal neoplasms/radiotherapy; Treatment outcome; Prognosis

Long-term efficacy of stapled transanal rectal resection for obstructed defecation syndrome

To evaluate the long-term efficacy of stapled transanal rectal resection (STARR) in treating obstructed defecation syndrome(ODS). Clinical data of 95 female patients with ODS undergoing STARR at Department of Colorectal Surgery, Rocket Army General Hospital from February 2010 to August 2012 were analyzed retrospectively. The Cleveland constipation scoring system (CSS), Longo ODS scoring system and severe symptoms score(SSS) were used to evaluate the degree and intensity of clinical symptoms. Patient satisfaction was assessed by visual analogue scale (VAS). Clinical symptoms at postoperative 12-month were defined as short-term efficacy, and at the end of follow up (≥48 months) were defined as long-term efficacy. The mean age was 54.5 (29 to 79) years and the median follow-up was 65 (48 to 78) months. Eighty (84.2%) and 44 (46.3%) patients completed the short-term and long-term efficacy evaluation respectively. At the end of follow up, compared with the baseline levels before operation, the CSS score (14.69 vs. 6.02), ODS score (16.51 vs. 5.73) and SSS score (14.64 vs. 5.14) were significantly decreased (all P<0.01), but the VAS score (3.96 vs. 7.20, P<0.01) was significantly increased. A total of 10 patients (22.7%) developed symptomatic recurrence. The self-reported definitive satisfaction was excellent in 10 (22.7%) patients, fairly good in 17(38.6%), good in 9(20.5%), and poor in 8(18.2%). The total effective rate was 81.8%(36/44). Long-term efficacy of STARR in the treatment of ODS is good, but the rate of symptomatic recurrence is relatively high.

Significance of miR-145 expression in peripheral blood in short-term efficacy evaluation of radiotherapy for esophageal carcinoma

Objective To investigate the relationship between the expression level of microRNA-145 (miR-145) in peripheral blood and clinicopathological characteristics of esophageal cancer patients and eva-luate its significance in short-term efficacy of radiotherapy. Methods A total of 52 patients with esophageal cancer diagnosed in Affiliated Hospital of Qingdao University were collected, and all of the patients received radiotherapy alone. The relative expression level of miR-145 in peripheral blood was detected by using the method of reverse transcriptase polymerase chain reaction (RT-PCR) before radiotherapy. The correlations between the expression of miR-145 and pathological characteristics as well as short-term efficacy of radiotherapy were analyzed. Results In the 52 patients, the relative expression of miR-145 [M(QR)] in peripheral blood of clinical stage Ⅰ-Ⅱ was 3.14 (1.44), higher than that of stage Ⅲ-Ⅳ [1.71 (0.48)], and the difference was statistically significant (Z=-3.002, P=0.003). The expression level of miR-145 was not related with the age (Z=-0.403, P=0.687), gender (Z=-1.179, P=0.238) and history of drinking (Z=-0.389, P=0.697). The expression levels of miR-145 in complete response (CR), partial response (PR) and no change (NC) groups were 3.27 (1.64), 1.83 (1.26) and 1.40 (2.51), respectively, and the difference was statistically significant (H=6.567, P=0.038). Conclusion The expression level of miR-145 in peri-pheral blood is significantly correlated with the clinical stage of esophageal cancer. Its expression level is positively correlated with the short-term efficacy of esophageal cancer radiotherapy. High expression of miR-145 shows a better short-term efficacy of radiotherapy. Key words: Esophageal neoplasms; Radiotherapy; MicroRNAs; Prognosis

Evaluation of Short-Term Efficacy of Concurrent Chemoradiotherapy in Primary Fallopian Tube Carcinoma by Diffusion-Weighted Imaging: A Retrospective Study

Background: This study aims to evaluate the short-term efficacy of concurrent chemoradiotherapy (CCRT) in primary fallopian tube carcinoma (PFTC) using magnetic resonance diffusion-weighted imaging (MR-DWI). Patients and Methods: Total abdominal irradiation was performed for 61 PFTC patients after surgery, and paclitaxel and carboplatin were used for CCRT. According to the response evaluation criteria in solid tumors (RECIST1.1), patients were divided into a sensitive (n = 36) and a resistant group (n = 25). Pearson correlation analysis was conducted to assess the correlations of tumor regression rate with apparent diffusion coefficient (ADC)_pre, ADC_post, and ∆ADC_post. The efficacy of CCRT in PFTC using MR-DWI was evaluated by ROC curve, logistic regression analysis, Kaplan-Meier survival curve, and Cox regression model. Results: The ADC_pre in both the sensitive and the resistant group was negatively associated with the tumor regression rate (r = -0.508), while the ADC_post (r = 0.454) and ∆ADC_post (r = 0.769) were positively associated with the tumor regression rate (all p < 0.05). Histopathological type, FIGO stage, lymphatic metastasis, tumor regression rate, ADC_pre, ADC_post, and ∆ADC_post were confirmed as key factors for CCRT in PFTC (all p < 0.05). Conclusion: Our retrospective study demonstrates the predictive value of MR-DWI in CCRT for PFTC patients.