Malignant serous effusions (MSE) are one complication in patients with advanced cancer. Endostar is a new anti-tumor drug targeting vessels which exerts potent inhibition of neovascularization. This study aimed to systematically evaluate the efficacy and safety of intraperitoneal perfusion therapy of Endostar combined with platinum chemotherapy for malignant serous effusions (MSE).Randomized controlled trials (RCTs) on intraperitoneal perfusion therapy of Endostar combined with platinum chemotherapy for malignant serous effusions were searched in the electronic data of PubMed, EMBASE, Web of Science, CNKI, VIP, CBM and WanFang. The quality of RCTs was evaluated by two independent researchers and a meta-analysis was performed using RevMan 5.3 software.The total of 25 RCTs included in the meta-analysis covered 1,253 patients, and all literature quality was evaluated as "B" grade. The meta-analysis showed that Endostar combined with platinum had an advantage over platinum alone in terms of response rate of effusions (76% vs 48%, RR=1.63, 95%CI: 1.50-1.78, P<0.00001) and improvement rate in quality of life (69% vs 44%, RR=1.57, 95%CI: 1.42-1.74, P<0.00001). As for safety, there was no significant difference between the two groups in the incidences of nausea and vomiting (35% vs 34%, RR=1.01, 95%CI: 0.87-1.18, P=0.88), leucopenia (38% vs 38%, RR=1, 95%CI: 0.87-1.15, P=0.99), and renal impairment (18% vs 20%, RR=0.86, 95%CI: 0.43-1.74, P=0.68).Endostar combined with platinum by intraperitoneal perfusion is effective for malignant serous effusions, and patient quality of life is significantly improved without the incidence of adverse reactions being obviously increased.
Objective
To investigate the relationship between (serum neutrophil gelatinase-associated lipocalin, sNGAL) and cardiovascular events in patients with chronic kidney disease (CKD) .
Methods
300 patients with CKD were divided into two groups according to the level of sNGAL: high sNGAL group (n=158) and low sNGAL group (n=142) . The incidence of cardiovascular events and cumulative survival rate were analyzed by ROC curve, and the correlation between sNGAL and cardiovascular risk factors, cardiovascular events in patients with chronic renal disease was analyzed. Influencing factors of cardiovascular events in CKD patients was analyzed.
Results
There were significant differences in the data about BMI, diabetes proportion, CKD staging, eGFR, hs-CRP, 24h proteinuria, HDL, iPTH, phosphate and blood calcium between the two groups (P<0.05) . The 3-year cumulative survival rate of high sNGAL group (77.2%) was significantly lower than that of low sNGAL group (96.5%) , and the 3-year incidence of cardiovascular events (37.9%) was significantly higher than that of low sNGAL group (9.8%) (P< 0.05) . AUC in diagnosing cardiovascular events in high sNGAL group (0.746) was significantly higher than that in eGFR (0.636) , age (0.504) , serum calcium (0.545) , HDL (0.594) and LDL (0.508, all P<0.05) . There was a significant correlation between sNGAL and eGFR, HDL, BMI, hs-CRP, iPTH and phosphate (P<0.05) . Both univariate and multivariate factors COX showed that sNGAL was a risk factor of cardiovascular events in patients with CKD (P<0.05) , ( (HR=1.976 and 1.588, 95% CI=1.443-2.724 and 1.144-2.143, respectively, P=0.000 and 0.000) ) .
Conclusions
The incidence of cardiovascular events in patients with CKD with high sNGAL is significantly increased. sNGAL is an independent factor of cardiovascular events in patients with chronic renal disease.
Key words:
Chronic renal disease; Neutrophil gelatinase-associated apolipoprotein; Cardiovascular events; prognosis
Abstract Background This research investigates the correlation between serum fibroblast growth factor 23 (FGF23) levels and vascular calcification in individuals undergoing peritoneal dialysis (PD). Methods The study period spanned from January 2021 to August 2023, 220 patients receiving peritoneal dialysis at our hospital were selected as participants. FGF23 concentrations were determined through an enzyme-linked immunosorbent assay (ELISA), and coronary multi-slice spiral computed tomography (CT) and upright abdominal X-ray examinations were conducted to evaluate calcification scores. The relationship between FGF23 levels and vascular calcification in PD patients was analyzed. Results FGF23 levels were significantly positively correlated with coronary artery calcification (CAC), abdominal aortic calcification (AAC), brachial-ankle pulse wave velocity (baPWV), and high-sensitivity C-reactive protein (CRP). When patients were stratified by coronary calcification scores, there was statistical difference in FGF23 levels between the mild-to-moderate calcification group and the non-calcification group, significant differences were observed between the mild-to-moderate calcification group and the severe calcification group, as well as between the non-calcification group and the severe calcification group. Similarly, significant differences in FGF23 levels were observed among groups stratified by abdominal aortic calcification scores, with FGF23 levels significantly increasing with the severity of calcification. The diagnostic efficacy of FGF23 levels in detecting coronary artery calcification was assessed using a receiver operating characteristic (ROC) curve analysis, yielding a sensitivity of 61.35% and a specificity of 73.68%. Similarly, for abdominal aortic calcification, the ROC curve analysis revealed a sensitivity of 58.9% and a specificity of 69.57%. Conclusion The study concludes that serum FGF23 levels are linked to coronary artery calcification in PD patients and can be utilized as a supplementary indicator for diagnosing this condition.
Abstract Background and Aim The relationship between gestational diabetes mellitus (GDM) and peripartum mental disorders is unclear. Hence, the current meta-analysis aimed to systematically evaluate the risk of mental disorders in pregnant women with or without GDM. Methods We searched the PubMed, Cochrane Library, EMBASE, and Web of Science databases for relevant articles published up to October 30, 2021. The random-effects or fixed-effects model was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the prevalence of mental disorders in GDM. Sensitivity and subgroup analyses were conducted to test the robustness of the pooled estimates. Results We analyzed 32 studies involving 1,636,131 pregnant women, and the results demonstrated that GDM significantly increased the prevalence of peripartum depression (antenatal, pooled OR: 1.57, 95% CI: 1.33–1.85, P < 0.05; postpartum, pooled OR: 1.42, 95% CI: 1.18–1.70, P < 0.05), especially in women from Asia (pooled OR: 2.71, 95% CI: 1.98–3.72, P < 0.05). Compared to pregnant women without GDM, women with GDM reported significantly higher anxiety scores (pooled OR: 4.19, 95% CI: 1.21–7.17, P = 0.006) but insignificantly on antenatal stress symptoms while this evidence still needs to be further strengthened. Conclusions GDM significantly increased the prevalence of antenatal and postpartum mental disorders. Further multi-center prospective studies with long-term follow-up are required to verify the association between GDM and mental health.
BACKGROUND Despite significant advancements in the medical treatment of primary hepatocellular carcinoma (PHC) in recent years, enhancing therapeutic effects and improving prognosis remain substantial challenges worldwide. AIM To investigate the expression levels of serum vascular endothelial growth factor (VEGF) and interleukin (IL)-17 in patients with PHC and evaluate their diagnostic value while exploring their relationship with patients’ clinical characteristics. METHODS The study included 50 patients with confirmed PHC who visited Wuhan Hanyang Hospital from January 2021 to January 2022, and 50 healthy individuals from the same period served as the control group. Serum VEGF and IL-17 levels in both groups were measured by Enzyme-Linked Immunosorbent Assay, and their diagnostic value was assessed using receiver operating characteristic (ROC) curves. Pearson correlation analysis was performed to examine the relationship between serum VEGF and IL-17 levels. Pathological data of the PHC patients were analyzed to determine the relationship between serum VEGF and IL-17 levels and pathological characteristics. RESULTS Serum VEGF and IL-17 levels were significantly higher in the study group compared to the control group (P < 0.05). No significant association was observed between serum VEGF and IL-17 levels and gender, age, combined cirrhosis, tumor diameter, or degree of differentiation (P > 0.05). However, there was a significant relationship between clinical TNM stage, tumor metastasis, and serum VEGF and IL-17 levels (P < 0.05). Correlation analysis revealed a positive correlation between serum VEGF and IL-17 (P < 0.05). ROC analysis demonstrated that both serum VEGF and IL-17 had good diagnostic efficacy for PHC. CONCLUSION Serum VEGF and IL-17 levels were significantly higher in PHC patients compared to healthy individuals. Their levels were closely related to pathological features such as tumor metastasis and clinical TNM stage, and there was a significant positive correlation between VEGF and IL-17. These biomarkers may serve as valuable reference indicators for the early diagnosis and treatment guidance of PHC.
Objective To explore clinical relevance of serum type Ⅲ procollagen peptide and Laminin in idiopathic interstitial pneumonia. Methods A composite clinical-radiographic-physiologic(CRP)scoring system was devised,using these 7 variables:dyspnea,chest radiogragh,spirometry,luμg volume,diffusion capacity,resting alveolar-arterial PO 2,and exercise O 2 saturation.29 patients with idiopathic interstitial pneumonia were divided into 2 groups according to CRP scoring system:low score group,high score group.The serum concentrations of type Ⅲ procollagen peptide (PCⅢ)and Laminin were measured in patients and the control group. Result The CRP score determination correlated with the serum concentration of PCⅢ(r=0.5823,P0.01).The PCⅢ of high scores group was significantly higher than that of control group(P0.001),and was significantly higher than that of low scores group(P0.01),but the low scores group wasn’t higher than that of control group(P=0.5823).The CRP score showed a significant correlation with the concentration of LN(r=0.4247,P0.05). Conclusion Serum concentrations of PCⅢ and LN in patients with idiopathic interstitial pneumonia are important and not-hurted index to evaluate with CRP scores system regarded as measure balance.
Abstract Background Peritoneal dialysis has been proven to be a safe and effective mode of renal replacement therapy for patients with end-stage renal disease. The usage of laparoscopic catheter placement technique was increased in recent years. But the advantages and disadvantages between the laparoscopic catheter placement technique and open laparotomy technique were still http://in controversy. The objective of this study is to access the operation-related data and complications of catheter placement for peritoneal dialysis (PD) patients, Then to determine the better method for catheter insertion. Methods We performed a systematic review and meta-analysis on published studies identified by the databases PubMed, EMBASE, Highwire, and the Cochrane Library. Analysis was performed using the statistical software Review Manager Version 5.0. Results We assessed the operation-related data and complications of four randomized controlled trials (RCTs) and ten observational studies. The available data showed that laparoscope prolonged the time for catheter insertion in PD patients, however, the two groups did not significantly differ in hospital stays, early and late complications, including infection, dialysate leaks, catheter migration, pericannular bleeding, blockage and hernia. Conclusions The data showed that Laparoscopic catheter placement had no superiority to open surgery. However, this treatment still needs to be confirmed in a large, multi-center, well-designed RCT.
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