Background Hot flashes are common symptoms afflicting perimenopausal women. A stellate ganglion block (SGB) is believed to be an effective treatment for hot flashes; however, more evidence is needed to evaluate its safety and efficacy in relieving perimenopausal hot flashes. Objective To investigate the efficacy and safety of SGB for the treatment of perimenopausal hot flashes. Methods A randomized controlled trial was conducted at Shanxi Bethune Hospital. Forty perimenopausal women with hot flashes were recruited from April 2022 to November 2022 and randomly assigned to receive either 6 consecutive SGB treatments or 6 consecutive saline placebo treatments. The primary outcome was the change in hot flash symptom score from baseline to 12 weeks after treatment. The secondary outcomes were the change in hot flash symptom score from baseline to 12 weeks after treatment and the post-treatment Kupperman Index (KI) and Pittsburgh Sleep Quality Index (PSQI) scores. Results Of the 40 randomized subjects, 35 completed the study. All the variables were significantly improved. During 12 weeks of follow-up, the hot flash scores, Kupperman Menopause Scale scores, and Pittsburgh Sleep Quality Scale scores decreased significantly. Two subjects in the SGB treatment group experienced transient hoarseness, and the incidence of related adverse events was 10%. No related adverse events occurred in the control group. Conclusion Compared to the control treatment, SGB treatment was a safe and effective nonhormone replacement therapy that significantly relieved perimenopausal hot flashes and effectively improved sleep quality. Additional studies are needed to assess the long-term efficacy of this therapy.
Objectives To assess the performance of the M ilan, S hanghai F udan and H angzhou criteria based on a preoperative evaluation in patients undergoing liver transplantation ( LT ) for hepatitis B ‐related hepatocellular carcinoma ( HCC ). Methods Using a prospectively collected database, the data of consecutive patients with hepatitis B ‐related HCC undergoing LT at the Department of Liver Surgery of Ren Ji Hospital, School of Medicine, Shanghai Jiaotong University from J anuary 2005 to D ecember 2009 were reviewed. Overall survival and tumor recurrence rates of patients fulfilling the M ilan, S hanghai F udan and H angzhou criteria were compared using log–rank test. Results Altogether 148 patients were enrolled in the study, among whom 88 fulfilled the M ilan criteria and 24 and 39 were beyond M ilan but within the S hanghai F udan or H angzhou criteria, respectively. After a median follow‐up of 44 months, survival rates did not differ among the three groups ( P = 0.8780). Recurrence rates were significantly higher for newly eligible patients by the S hanghai F udan or H angzhou criteria compared with those within the M ilan criteria. Conclusions The M ilan criteria should be used as the preferred criteria for the selection of hepatitis B ‐related HCC for LT. Considering the high tumor recurrence rates and donor scarcity, a moderate expansion of the Milan criteria must be performed cautiously until high‐quality clinical trials are conducted.
Objective
To investigate the role of ATRX and P53 gene mutations in the classification of diffuse glioma in Chinese.
Methods
A total of 89 cases of diffuse astrocytoma (IDH mutation) or diffuse astrocytoma (IDH wild type) and all levels of oligodendroglioma from 2016 to 2017 were collected, and detected the expression of ATRX protein and over expression of P53 protein by immunohistochemistry, and analyzed their expression in different types of diffuse gliomas.
Results
The ratio of ATRX loss expression in diffuse astrocytoma (IDH mutation) (17/24) was higher than that in oligodendrogliomas (3/16), P<0.01; the ratio of P53 over expression in diffuse astrocytoma (IDH mutation) (15/24) was higher than that in oligodendrogliomas (1/16), P<0.01; the ratio of ATRX loss expression in diffuse astrocytoma (IDH mutation) (71%, 17/24) was higher than that in diffuse astrocytoma (IDH wild) (41%, 20/49), P<0.05.
Conclusions
ATRX and P53 mutation is one of the molecular genetic characteristics of diffuse astrocytoma (IDH mutation), which may be contributed to diagnose diffuse astrocytoma.
Key words:
Diffuse glioma; Tumor suppressor protein P53; Alpha thalassemia/mental retardation syndrome-X
Results of the test were validated in 72% of the patients.They were confirmed by histology in 14%, by another imaging technique (MRI, Bone scintigraphy or CT) in 23.2%, by another 18F-Ch-PET in 5% and with a biochemical response after a specific treatment in 48% of them.Result of the test was discordant in 9%.According to this data, 18F-Ch-PET has a Sensibility and Specificity of 97% and 81% respectively.Conclusion 18F-Ch-PET seems to be a very useful diagnostic test for restaging recurrent PCa in selected group of patients, allowing all relapse sites to be evaluated at once.It can also modify treatment management in an important percentage, identifying which ones can be offered a potential curative treatment.In our series, like in previous literature, PSA level, PSAvel and PSAdt are strong predictive factors for positive 18F-Ch-PET.
s:Objective To assess the value of 12 lead dynamic electrocardiography (Holter) in the diagnosis of coronary artery disease (CAD) in the elderly.Method 100 patients with suspected CAD undergoing both 12 lead Holter and coronary angiography were analyzed.Results The overall sensitivity, specificity, positive and negative predicted values and accuracy in detecting CAD with 12 lead Holters were 63.8%, 79.2%, 73.2%, 71.2% and 72%, respectively. The sensitivity was 100% in identifying triple vessel and left main coronary artery (LMCA) stenosis, whereas the sensitivity in detecting LAD, LCX and RCA stenosis (65.8%,70.6% and 75%, respectively) was not significantly different.Conclusion 12 lead Holter does not have a high level sensitivity and specificity in detecting CAD in the elderly ,but the sensitivity in diagnosing triple vessel disease and LMCA stenosis is high. 12 lead Holter has some value in clinical application.
Abstract Objective The present study has compared the long-term outcomes between performing wedge resection (WR) and microwave ablation (MWA) as first-line treatment of stage I non–small cell lung cancer (NSCLC) patients with tumors adjacent to the pericardium. Materials and Methods Between January 2014 and December 2018, a total of 223 consecutive patients with T1N0 NSCLC underwent first-line treatment by WR ( n = 155) or image-guided lung MWA ( n = 68). This study has compared the progression-free survival (PFS) and overall survival (OS) rates between the two treatments before and after propensity score matching. Subgroup analysis of these outcomes was conducted based on the distance from the pericardium. Results The median follow-up time was 47 months. Propensity matching yielded 56 pairs of patients. In the two matched groups, the PFS rates in the WR group at 3 and 5 years were 66.0% and 56.0% and 54.0% and 36.0%, respectively, in the MWA group ( P = 0.029). Meanwhile, the corresponding OS rates for the WR group at 3 and 5 years were 81.0% and 72.0% and 60.0% and 55.0% in the MWA group, respectively ( P = 0.031). Subgroup analysis, done according to the treatment modality, indicated that local tumor recurrence and PFS for NSCLCs that were close but not contiguous to the pericardium were different from those contiguous to the pericardium ( P = 0.018 and P = 0.025, respectively). Conclusion WR provided better long-term tumor control and OS compared to MWA for stage I NSCLC adjacent to the pericardium as a first-line treatment. MWA can be considered as an alternative option for high-risk and inoperable patients, particularly for tumors that were not contiguous to the pericardium.
The objective of this study is to establish and validate a radiomics nomogram for prediction of local tumor progression (LTP) after microwave ablation (MWA) for recurrent colorectal liver metastases (CRLM) after hepatic resection. We included 318 consecutive recurrent CRLM patients (216 of training while 102 of validation cohort) with contrast-enhanced computerized tomography images treated with MWA between January 2014 and October 2018. Support vector machine-generated radiomics signature was incorporated together with clinical information to establish a radiomics nomogram. Our constructed radiomics signature including 15 features (first-order intensity statistics features, shape and size-based features, gray level size zone/dependence matrix features) performed well in assessing LTP for both cohorts. With regard to its predictive performance, its C-index was 0.912, compared to the clinical or radiomics models only (c-statistic 0.89 and 0.75, respectively) in the training cohort. In the validation cohort, the radiomics nomogram had better performance (area under the curve = 0.89) compared to the radiomics and clinical models (0.85 and 0.69). According to decision curve analysis, our as-constructed radiomics nomogram showed high clinical utility. As revealed by survival analysis, LTP showed worse progression-free survival (3-year progression-free survival 42.6% vs 78.4%, P < .01). High-risk patients identified using this radiomics signature exhibited worse LTP compared with low-risk patients (3-year LTP 80.2% vs 48.6%, P < .01). A radiomics-based nomogram of pre-ablation computerized tomography imaging may be the precious biomarker model for predicting LTP and personalized risk stratification for recurrent CRLM after hepatic resection treated by MWA.
Background The role of p16 INK4a as a surrogate marker for screening human papillomavirus (HPV) in esophageal squamous cell carcinoma (ESCC) remains controversial. Methods A comprehensive search of EMBASE, PubMed, China National Knowledge Infrastructure and China Biology Medicine was performed from inception to December 27, 2015. A random-effects model was applied to the pooled odds ratios (ORs) with 95% confidence intervals (CIs). Results Ten studies were identified (985 cases). The pooled results showed no significant relationship between p16 INK4a expression and HPV infection in ESCC based on overall HPV types (OR: 1.79, 95% CI: 0.69-4.66, p = 0.235). Subgroup analysis by HPV detection method showed no statistical significance in either the polymerase chain reaction (PCR) (OR: 1.65, 95% CI: 0.83-3.30, p = 0.154) or in situ hybridization (ISH) group (OR: 2.58, 95% CI: 0.03-268.14, p = 0.689). The pooled OR of the sensitivity analysis ranged from 1.27 (95% CI: 0.58-2.84) to 2.32 (95% CI: 0.95-5.64). Of these studies, 6 involved only high-risk human papillomavirus types (HR-HPV), HPV16 or HPV18. However, similar observations were made for HR-HPV (OR = 1.31, 95% CI: 0.26-6.59, p = 0.741). Subgroup analysis again showed no statistical significance in the PCR group (OR: 0.95, 95% CI: 0.25-3.64, p = 0.940) and ISH group (OR: 2.58, 95% CI: 0.03-268.14, p = 0.689). Sensitivity analysis showed that the pooled OR ranged from 0.69 (95% CI: 0.21-2.22) to 1.89 (95% CI: 0.33-10.86). Conclusions p16 INK4a is not a reliable screening marker of HPV infection in ESCC. Further multicenter, large-sample and well-matched prospective studies are still required to illuminate the possible etiological roles of HPV in ESCC.
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