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5% at diagnosis to 2.9% after 17 months of pembrolizumab treatment. Other peripheral blood lineages did not decrease, and pembrolizumab treatment was continued without any adverse events. This is the first report demonstrating the effectiveness of pembrolizumab in an MPN patient with JAK2V617F mutation.The second-generation proteasome inhibitor carfilzomib produces superior outcomes in relapsed or refractory multiple myeloma (MM). We conducted a single-arm trial of twice-weekly carfilzomib (27 mg/m2)-dexamethasone (Kd27) for relapsed and refractory MM in China. Kd27 was administered in 28-day cycles to 123 patients previously treated with ≥ 2 other regimens, including treatment with bortezomib and an immunomodulatory drug, and refractory to their most recent therapy. Overall response rate (ORR) was the primary endpoint; progression-free survival (PFS) and overall survival (OS) were key secondary endpoints. Primary analysis was conducted when all patients received ≥ 6 cycles of Kd27 or discontinued Kd27. Median age was 60 years; median number of prior regimens was 4; 74% were refractory to proteasome inhibitors and immunomodulatory drugs. ORR was 35.8% (95% CI 27.3-44.9), median PFS was 5.6 (95% CI 4.6-6.5) months, and median OS was 16.6 (95% CI 12.2-NE) months. Grade ≥ 3 adverse events (AEs) occurred in 76.4% of patients. Epacadostat solubility dmso Grade ≥ 3 AEs of interest included hypertension (13.8%), acute renal failure (3.3%), cardiac failure (0.8%), ischemic heart disease (0.0%), and peripheral neuropathy (0.0%); 5.7% of patients discontinued carfilzomib due to AEs. Carfilzomib-dexamethasone produced a clinically meaningful response without new safety findings in Chinese patients with previously treated MM.Trial registration NCT03029234.Increasing evidence suggests that COVID-19 may be associated with venous thromboembolism, and much data exists regarding high incidence of venous thrombosis in critical COVID-19 patients. However, evidence on this complication in less severe patients is not widely available. The aim of this study was to investigate the incidence of deep-vein thrombosis (DVT) in patients with moderate-to-severe COVID-19, to assess the prevalence of DVT with duplex ultrasound, and to compare patients with DVT and those without it using lung computerized tomography (CT), clinical information and lab data. The subjects of this study were 75 consecutive patients (aged 27-92 y, median-63 y; 36 males and 39 females) with moderate-to-severe COVID-19. DVT was found in 15 patients (20%). The vast majority of those with DVT (13 patients, 86.7%) had thrombi in calf veins and 2 (13.3%) had ileofemoral thrombosis. High incidence of DVT (20%) is observed even in patients with moderate-to-severe COVID-19. These patients require early anticoagulation therapy as part of their treatment. Such therapy may be continued after hospital discharge and these patients may also require follow-up vein ultrasonography after recovery to rule out DVT.High-dose methotrexate (HD-MTX) therapy is widely used in patients with acute lymphoblastic leukemia (ALL) and lymphoma. However, some patients experience delayed MTX elimination, which requires treatment suspension or dose reduction to avoid organ damage. This single-center retrospective analysis reviewed the clinical data of 88 children with ALL or non-Hodgkin lymphoma who received a total of 269 courses of HD-MTX therapy between April 2008 and April 2019. HD-MTX was defined as MTX administration at 2.0, 3.0, or 5.0 g/m2 over a 24-h period, and delayed MTX elimination was defined as a serum MTX concentration ≥ 1.0 µmol/L at 48 h after the start of HD-MTX. Clinical factors were compared between courses with and without delayed MTX elimination. MTX elimination was delayed in 21 of the 269 courses (7.8%). Multivariate analysis showed that first HD-MTX course (OR 4.04), lower urine volume per BSA on the first day of HD-MTX administration ( 3.0 g/m2, OR 10.8), and lower urine volume per BSA on the next day of starting HD-MTX ( less then  2,107 mL/m2, OR 3.43) were independent risk factors for delayed MTX elimination.Laparoscopic colectomy has become the standard practice for colorectal cancer surgery. A variety of techniques are described for anastomosis including extracorporeal and intracorporeal techniques. Intracorporeal anastomosis may be associated with better cosmesis and post-operative recovery. However, the review by Reddavid et al. (J Gastrointest Surg 242389-2392, 2020) describing an intracorporeal stapled technique for ileo-colonic anastomosis has several issues. First, the technique for forming intracorporeal anastomoses is not novel and has been previously reported. The conversion rate to open surgery does not relate to anastomosis technique but the difficulty of dissection and tumour stage. Furthermore, performing the technique requires an additional trocar adding to expense. Moreover, utilizing multiple sutures which close the enterostomy prior to stapling does not stand scrutiny when the defect has already been closed. The additional staple firing is a risky strategy particularly if the stapler splits. Thus, it is vital that new techniques promoted to trainees and residents have a sound technical and evidence base, avoid unnecessary expense or risk technical failure.The robotic system has overcome some laparoscopic shortcomings, such as stereoscopic 3D-magnified vision, a stable camera and flexible and tremor filtering manipulation. Therefore, robotic surgery has made many steps forward gaining more diffusion in the field of general surgery and this trend was associated with a decrease in laparoscopic surgery. Although the safety and effectiveness of robotic surgical systems in most procedures has been confirmed, some difficult procedures have not been widely performed but rather limited to a few highly specialized centers. This study describes the worldwide diffusion of robotic surgery in their respective fields in terms of hepatectomy, gastrectomy, esophagectomy, colectomy and pancreatectomy, respectively. The worldwide diffusion of robotic surgery is uneven, which may be related to the local economic strength, government health care policies, and surgeons' preference for minimally invasive surgery of various countries and regions. In the future, with the gradual decrease of cost of robotic surgical systems, and the standardization of surgical procedures, as well as the coverage of medical insurance, we believe that robotic surgery will become the gold standard procedure in general surgery.

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