Klavsenkearney5876
Ultrathin bronchoscope (UTB) with a 3.0-mm outer diameter and a 1.7-mm working channel currently appeared as a potential tool for better biopsy and diagnosis of peripheral pulmonary lesions (PPLs) by accessing more distal bronchus. However, published research is primarily limited to diagnosis value of UTB for PPLs with fluoroscopy, the value of UTB compared with thin bronchoscope (TB) without fluoroscopy guidance has not been determined yet.
We design a prospective, randomized, controlled, non-inferior, multicenter study aiming to evaluate the diagnostic value and safety of UTB for PPLs with the guidance of virtual bronchoscopic navigation (VBN) combined with endobronchial ultrasound (EBUS) without fluoroscopy by comparing to TB. The study aims to enroll 578 patients presenting for evaluation of PPLs at five clinical sites in China. Subjects will be randomized to UTB-VBN-EBUS group, TB-VBN-EBUS-guide sheath (GS) group, and TB-VBN-EBUS-non-GS group. Primary endpoint is the diagnostic yield of PPLs. The total examination time, duration of finding lesions, the proportion of lesions visible by radial EBUS, factors affecting the diagnostic yield, difference in the bronchus level reached with the bronchoscope, difference in diagnostic yield, and complication rate will be determined as secondary endpoints. The primary endpoint will be followed-up at least 6-month post-procedure and 1-month post-procedure for safety endpoint.
Study enrollment began in March 2021. Our preliminary experience reveals that UTB is a powerful tool in the diagnosis of PPLs even without fluoroscopy. The results of the current study will compensate the limitations of the previous research, further provide evidence of UTB in diagnosing PPLs without fluoroscopy.
ClinicalTrials.gov NCT04571476. Registered on 30 September 2020.
ClinicalTrials.gov NCT04571476. Registered on 30 September 2020.
A hormonal role in the development of non-small cell lung cancer (NSCLC) has been well documented, and the classic estrogen receptors (ERs)-ERα and ERβ have been extensively investigated over the past decade. The expression of ERβ was found to be high and display biological activity in NSCLC, but anti-estrogen therapy targeting this receptor has shown limited efficacy for the disease. The third estrogen receptor, G protein-coupled estrogen receptor 1 (GPER1/GPR30), was recently found to be highly expressed in NSCLC. Herein, we aimed to investigate the expression profile of GPER1 and correlate it with clinicopathological factors as well as postoperative prognosis in NSCLC.
We examined GPER1 and ERβ expression using immunohistochemistry among 183 NSCLC cases, including 132 lung adenocarcinoma (LUAD) with identified epidermal growth factor receptor (EGFR) mutation status and 51 squamous cell carcinoma (SCC) patients. We then conducted correlation analysis between the expression of GPER1 and clinicopathologicprognosis in NSCLC.
This study revealed that GPER1 is aberrantly highly expressed and presents a unique GPER1 expression profile in NSCLC. The n/cGPER1 expression was significantly associated with EGFR mutation status, tumor stage, lymph node metastasis, and poor postoperative prognosis in NSCLC.
Short-term hospital readmissions for acute heart failure lead to the rise of health care budget and all-cause death. Elderly patients with acute or decompensated heart failure are often admitted to different wards (either the geriatric department or other departments). The diagnosis for readmission, cost and length of hospital stay in different wards are not well known.
A retrospective study was conducted examining senile patients admitted to the hospital over a 1-year period. Data related to demographic information, comorbidities, ejection fraction (EF), brain natriuretic peptide (BNP) levels, costs, and discharge disposition were collected from electronic medical record.
A total of 3,922 cases were enrolled in this study. There were 1,316 patients with heart failure who were re-hospitalized, among which, 893 were admitted to the geriatric department. The top 3 diagnosis for re-hospitalization for more than 7 days in the geriatric department were pneumonia (38.5%), blood pressure fluctuations (19.4%), ifferent department. Those rehospitalized with pneumonia may benefit from geriatric department.
Our study identified a higher readmission rate in senile acute decompensated heart failure patients. Pneumonia was listed as the top 1 diagnosis for longer hospital stay in different department. Those rehospitalized with pneumonia may benefit from geriatric department.
This study aimed to summarize the available data on the association between the severity of (COVID-19) and routine blood indicators, inflammatory, biochemical parameters and coagulation parameter.
A literature search was conducted of PubMed, EMBASE, and Web of Sciences, CNKI, WanFang database providing relevant data. Random-effects meta-analysis was used to pool effect sizes.
In patients with severe symptoms, interleukin-6, [IL-6; standardized mean difference (SMD) =1.15, 95% confidence interval (95% CI) 1.01, 1.29, P<0.001, n=1,121], interleukin-10 (IL-10; SMD =0.92, 95% CI 0.75, 1.08, P<0.001, n=782), interleukin-4 (IL-4; SMD =0.2, 95% CI 0.01, 0.39, P=0.04, n=500), procalcitonin (PCT; SMD =1.16, 95% CI 0.99, 1.33, P<0.001, n=734), C-reactive protein (CRP; SMD =1.42, 95% CI 1.27, 1.57, P<0.001, n=1,286), serum amyloid A (SAA; SMD =2.82, 95% CI 2.53, 3.11, P<0.001, n=502) neutrophil count (SMD =0.63, 95% CI 0.44, 0.82, P<0.001, n=558), alanine aminotransferase (ALT; SMD =2.72, 95% CI CI 0.16, 0.23, P<0.001, n=156), creatinine (SMD =2.29, 95% CI 1.87, 2.7, P<0.001, n=213), and neutrophil counts (SMD =2.77, 95% CI 2.38, 3.16, P<0.001, n=260) in patients with COVID-19 in the death group were significantly higher than that in patients in the survival group, while the lymphocyte count was significantly lower.
In summary, current evidence show that those laboratory indicators are associated with the severity of COVID-19 and thus could be used as prognostic risk stratification of patients with COVID-19.
In summary, current evidence show that those laboratory indicators are associated with the severity of COVID-19 and thus could be used as prognostic risk stratification of patients with COVID-19.
Lung adenocarcinoma (LUAD) is a subtype of lung cancer with high morbidity and mortality. While genotyping is an important determinant for the prognosis of LUAD patients, there is a paucity of studies on gene set-based expression (GSE) typing for LUAD. This current study used GSE methodology to perform gene typing of LUAD patients.
Clinical and genomic information of the LUAD patients were downloaded from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases. Patients with LUAD were clustered into different molecular subtypes depending on the clinical and gene set expression characteristics. 3,3cGAMP The survival rate and silhouette widths were compared between each molecular subtype. Differences in survival rate between gene sets were analyzed using Kaplan-Meier survival curves. Cox regression and Lasso regression were used to establish the prognostic gene set model based on the TCGA database, and the results were validated using the GEO dataset.
A total of 10 hub genes were finally identiftients with LUAD can be clustered into three subtypes based on the expression of gene sets. These findings contribute to understanding the pathogenesis and molecular mechanisms in LUAD, and may lead to potential individualized pharmacogenetic therapy for patients with LUAD.
Patients with LUAD can be clustered into three subtypes based on the expression of gene sets. These findings contribute to understanding the pathogenesis and molecular mechanisms in LUAD, and may lead to potential individualized pharmacogenetic therapy for patients with LUAD.
The effect of empagliflozin on the cardiovascular outcome is consistent in heart failure with reduced ejection fraction (HFrEF) patients regardless of the presence or absence of diabetes. More evidence is needed regarding the cost-effectiveness of empagliflozin in HFrEF patients. This study sought to evaluate the economic outcomes of adding empagliflozin to the standard treatment for HFrEF patients from the perspective of the Chinese healthcare system, and thus to provide information for decision makers.
Based on the EMPEROR-Reduced clinical trial and other published literature data, the direct medical costs and quality-adjusted life years (QALYs) of patients with HFrEF over a 15-year study period were simulated by a Markov model, and the incremental cost-effectiveness ratio (ICER) was calculated. The price of empagliflozin referred to the data released by Menet, the hospitalization expenses and utility values were derived from published studies in China. A one-way sensitivity analysis and probabilistic shina.
At a willingness-to-pay threshold of $31,510.57, adding empagliflozin to standard treatment is a very cost-effective option for HFrEF patients with or without diabetes in China.
This study sought to compare and evaluate the clinical efficacy and safety of Y-type coronary artery bypass grafting (CABG) and sequential CABG. However, the prognosis and complication rate of the two treatments are different. Therefore, we need to systematically compare the efficacy and safety of the two surgical schemes.
A total of 112 patients who underwent Y-type CABG and 113 patients who underwent sequential CABG were selected from January 2020 to December 2020. The patients undergoing Y-type CABG of the great saphenous vein (SV) were classified as the experimental group, and those undergoing sequential anastomosis were classified as the control group. The intraoperative blood flow at each anastomotic site of the venous sequential CABG, left ventricular ejection fraction (LVEF), and left ventricular diastolic diameter (LVEDD) at the end of 3 months, 6 months, and 1 year after surgery, the incidence rate of major adverse cardiovascular events, and coronary angiography (CAG) after readmissions due to se of great significance for improving the postoperative mid-term survival rate of patients.
Large SV Y-type CABG can improve postoperative left heart function and reduce the incidence of postoperative adverse events, which may be of great significance for improving the postoperative mid-term survival rate of patients.
Platelets play a vital role in the neoplastic process. Platelet parameters are hence an important source of information concerning ongoing neoplastic disease. The aim of the study is to assess the impact of selected platelet parameters on the survival of patients with non-small cell lung cancer (NSCLC).
The study included 532 (174 female and 358 male) patients aged 36-84 years (mean age 63.6 years) operated on due to NSCLC, staged IA-IIIA. Before the operation, all patients received a blood morphology test. The following parameters were subjected to statistical analysis platelet count, mean platelet volume (MPV) parameter, platelet distribution width (PDW) parameter, platelet-to-lymphocyte ratio (PLR) and systemic immune-inflammation (SII) index. These findings were compared with the clinical data of the patients, and the probability of overall survival was analyzed.
The univariate analysis revealed a correspondence between PDW, MPV, PLR and SII index and patient survival. The multivariate analysis including patient clinical data found the following factors to have negative prognostic value for patients operated on due to NSCLC male sex, advancement stage of neoplastic disease and Charlson Comorbidity Index (CCI) above 4, and PLR >144.