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回顾性分析紫杉醇联合表柔比星新辅助化疗方案治疗三阴性乳腺癌的疗效 被引量:34
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作者 郝静 赵鹏飞 《中国临床药理学杂志》 CAS CSCD 北大核心 2013年第7期496-497,500,共3页
目的回顾性分析紫杉醇联合表柔比星新辅助化疗方案治疗三阴性乳腺癌(TNBC)的疗效。方法术前行4个周期紫杉联合表柔比星新辅助化疗方案治疗的乳腺癌患者151例,依据用药情况,47例作为TNBC组,104例作为对照组。比较2组患者反应率及术后远... 目的回顾性分析紫杉醇联合表柔比星新辅助化疗方案治疗三阴性乳腺癌(TNBC)的疗效。方法术前行4个周期紫杉联合表柔比星新辅助化疗方案治疗的乳腺癌患者151例,依据用药情况,47例作为TNBC组,104例作为对照组。比较2组患者反应率及术后远期疗效。结果 2组客观反应率差别无统计学意义(P>0.05);病理完全缓解,TNBC组显著高于对照组(34 vs 16,P<0.05)。2组随访期间死亡患者分别为34,13,但死亡风险无明显差别(HR=1.39,P>0.05)。结论 TNBC组患者更易从新辅助化疗中获完全缓解;但2组远期疗效无明显差别。 展开更多
关键词 三阴性乳腺癌 紫杉醇联合表柔比星新辅助化疗方案 预后 病理 完全缓解 死亡风险
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阿瑞匹坦联合5-HT_3受体拮抗剂和地塞米松预防化疗相关性恶心和呕吐的Meta分析 被引量:29
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作者 黄鲁众 张晓晔 +2 位作者 刘艳 徐兆国 崔国元 《现代肿瘤医学》 CAS 2015年第15期2198-2203,共6页
目的:采用Meta分析方法对阿瑞匹坦联合5-HT3受体拮抗剂和地塞米松预防化疗相关性恶心和呕吐进行系统评价。方法:检索Pubmed、EMbase、Cochrane Library、中国知网CNKI全文数据库、维普数据库、万方数据库和中国生物医学文献数据库,查找2... 目的:采用Meta分析方法对阿瑞匹坦联合5-HT3受体拮抗剂和地塞米松预防化疗相关性恶心和呕吐进行系统评价。方法:检索Pubmed、EMbase、Cochrane Library、中国知网CNKI全文数据库、维普数据库、万方数据库和中国生物医学文献数据库,查找2003年1月至2013年12月公开发表的研究阿瑞匹坦联合5-HT3受体拮抗剂和地塞米松预防化疗相关性恶心和呕吐的临床随机对照试验。按照纳入与排除标准选择文献,质量评估,资料提取,采用Rev Man 5.2软件进行Meta分析。结果:共纳入12篇英文RCT文献,均为高质量研究。Meta分析结果显示,阿瑞匹坦联合5-HT3受体拮抗剂、地塞米松治疗(三联治疗)在预防高、中度致吐性化疗相关性恶心和呕吐的总体完全缓解率[OR=1.91,95%CI(1.68,2.17),P<0.00001]、急性完全缓解率[OR=1.89,95%CI(1.48,2.42),P<0.00001]、迟发性完全缓解率[OR=2.05,95%CI(1.68,2.51),P<0.00001]明显高于5-HT3受体拮抗剂、地塞米松治疗(二联治疗),两组差异有统计学意义。结论:阿瑞匹坦可以显著提高高、中度致吐性化疗的总体、急性和迟发性恶心和呕吐完全缓解率,尤其是在提高迟发性恶心和呕吐完全缓解率更为明显。 展开更多
关键词 阿瑞匹坦 5-HT3受体拮抗剂 化疗相关性恶心和呕吐 完全缓解率 META分析
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高分辨率MRT2WI联合DWI评价直肠癌新辅助治疗后病理学完全缓解 被引量:16
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作者 张晓燕 李晓婷 +4 位作者 史燕杰 王之龙 刘玉良 朱海滨 孙应实 《中国介入影像与治疗学》 CSCD 北大核心 2017年第3期164-168,共5页
目的探讨高分辨率MR T2WI联合DWI预测直肠癌新辅助治疗后病理学完全缓解的效能。方法回顾分析经完整新辅助治疗后接受根治性手术、新辅助治疗前后有完整2次MR影像资料、有明确病理学评价的进展期直肠癌患者364例,计算并比较单独使用高... 目的探讨高分辨率MR T2WI联合DWI预测直肠癌新辅助治疗后病理学完全缓解的效能。方法回顾分析经完整新辅助治疗后接受根治性手术、新辅助治疗前后有完整2次MR影像资料、有明确病理学评价的进展期直肠癌患者364例,计算并比较单独使用高分辨率T2WI、高分辨率MR T2WI联合DWI预测直肠癌病理学完全缓解的效能。结果最终49例患者经病理证实为肿瘤完全缓解。单独使用高分辨率T2WI判断直肠癌是否病理学完全缓解的准确率为82.69%(301/364)、敏感度为40.82%(20/49)、特异度89.21%(281/315)、阳性预测值为37.04%(20/54)、阴性预测值为90.65%(281/310);高分辨率T2WI联合DWI预测直肠癌病理学完全缓解的准确率为87.36%(318/364)、敏感度为65.31%(32/49)、特异度为90.79%(286/315)、阳性预测值为52.46%(32/61)、阴性预测值为94.39%(286/303)。两种方法的敏感度差异有统计学意义(χ~2=4.96,P=0.03)。结论与单独使用高分辨率T2WI比较,高分辨率T2WI联合DWI评价直肠癌新辅助治疗后病理学完全缓解可提高诊断效能。 展开更多
关键词 扩散磁共振成像 直肠肿瘤 病理学 完全缓解
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考虑电动汽车用户响应的微电网运行优化 被引量:16
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作者 刘延博 邱晓燕 邱高 《高压电器》 CAS CSCD 北大核心 2016年第4期163-169,175,共8页
文中针对大规模电动汽车(EVs)接入微电网的分布式能源(DER)出力优化进行了研究。在(EVs)无序充电模型的基础上,提出了基于峰谷负荷的分段电价模型,考虑行驶需求时间共同影响,建立了EVs接入微电网的完全响应行为模型。对负荷进行分类建模... 文中针对大规模电动汽车(EVs)接入微电网的分布式能源(DER)出力优化进行了研究。在(EVs)无序充电模型的基础上,提出了基于峰谷负荷的分段电价模型,考虑行驶需求时间共同影响,建立了EVs接入微电网的完全响应行为模型。对负荷进行分类建模,提出基于响应权重的常规负荷电价响应模型,并建立了基于经济成本权重的综合效益优化模型。在典型微电网中,通过改进遗传算法,在不同调度控制策略下计算得到系统的优化出力结果。通过对比不同模型下的出力结果,验证所提模型的正确性和有效性。 展开更多
关键词 电动汽车 完全响应 经济成本权重 微电网 运行优化
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直肠癌术前放化疗后完全缓解病例的处理 被引量:15
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作者 肖毅 吴斌 +6 位作者 林国乐 牛备战 赵林 张福泉 胡克 仲光熙 邱辉忠 《中国实用外科杂志》 CSCD 北大核心 2008年第5期362-364,共3页
目的探讨直肠癌经术前放化疗后获得完全缓解病例的处理方法。方法对北京协和医院1997—2007年实施术前放化疗的69例直肠癌进行分析。肿瘤平均距肛缘5.0cm,临床分期T3、T4期。所有病人均接受术前放疗(2Gy×25),或辅以5-FU/亚叶... 目的探讨直肠癌经术前放化疗后获得完全缓解病例的处理方法。方法对北京协和医院1997—2007年实施术前放化疗的69例直肠癌进行分析。肿瘤平均距肛缘5.0cm,临床分期T3、T4期。所有病人均接受术前放疗(2Gy×25),或辅以5-FU/亚叶酸钙为基础的同步化疗。放疗结束后4—6周接受全直肠系膜切除(TME)原则的外科手术。结果有2例获得临床完全缓解,因拒绝手术在不同时间内均出现局部复发和远处转移。67例手术病人中病理完全缓解7例(10.15%),术后随访12—38个月均未出现肿瘤复发或疾病进展。结论在目前没有充分循证医学证据的情况下,应谨慎对待术前放化疗后完全缓解的直肠癌病例,不建议采用非手术治疗。 展开更多
关键词 直肠肿瘤 术前放化疗 完全缓解
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Watch and wait approach in rectal cancer:Current controversies and future directions 被引量:13
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作者 Fernando López-Campos Margarita Martín-Martín +9 位作者 Roberto Fornell-Pérez Juan Carlos García-Pérez Javier Die-Trill Raquel Fuentes-Mateos Sergio López-Durán JoséDomínguez-Rullán Reyes Ferreiro AlejandroRiquelme-Oliveira Asunción Hervás-Morón Felipe Couñago 《World Journal of Gastroenterology》 SCIE CAS 2020年第29期4218-4239,共22页
According to the main international clinical guidelines,the recommended treatment for locally-advanced rectal cancer is neoadjuvant chemoradiotherapy followed by surgery.However,doubts have been raised about the appro... According to the main international clinical guidelines,the recommended treatment for locally-advanced rectal cancer is neoadjuvant chemoradiotherapy followed by surgery.However,doubts have been raised about the appropriate definition of clinical complete response(cCR)after neoadjuvant therapy and the role of surgery in patients who achieve a cCR.Surgical resection is associated with significant morbidity and decreased quality of life(QoL),which is especially relevant given the favourable prognosis in this patient subset. Accordingly, therehas been a growing interest in alternative approaches with less morbidity,including the organ-preserving watch and wait strategy, in which surgery isomitted in patients who have achieved a cCR. These patients are managed with aspecific follow-up protocol to ensure adequate cancer control, including the earlyidentification of recurrent disease. However, there are several open questionsabout this strategy, including patient selection, the clinical and radiologicalcriteria to accurately determine cCR, the duration of neoadjuvant treatment, therole of dose intensification (chemotherapy and/or radiotherapy), optimal followupprotocols, and the future perspectives of this approach. In the present review,we summarize the available evidence on the watch and wait strategy in thisclinical scenario, including ongoing clinical trials, QoL in these patients, and thecontroversies surrounding this treatment approach. 展开更多
关键词 Watch and wait Rectal cancer Clinical complete response Organ preservation Dose intensification
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Pathologic complete response confirmed by surgical resection for liver metastases of gastrointestinal stromal tumor after treatment with imatinib mesylate 被引量:11
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作者 Seiji Suzuki Koji Sasajima +8 位作者 Masayuki Miyamoto Hidehiro Watanabe Tadashi Yokoyama Hiroshi Maruyama Takeshi Matsutani Aimin Liu Masaru Hosone Shotaro Maeda Takashi Tajiri 《World Journal of Gastroenterology》 SCIE CAS CSCD 2008年第23期3763-3767,共5页
A 39-year-old male underwent distal gastrectomy for a high grade gastrointestinal stromal tumor(GIST) . Computed tomography(CT) and magnetic resonance imaging(MRI) 107 mo after the operation,revealed a cystic mass(14 ... A 39-year-old male underwent distal gastrectomy for a high grade gastrointestinal stromal tumor(GIST) . Computed tomography(CT) and magnetic resonance imaging(MRI) 107 mo after the operation,revealed a cystic mass(14 cm in diameter) and a solid mass(9 cm in diameter) in the right and left lobes of the liver,respectively. A biopsy specimen of the solid mass showed a liver metastasis of GIST. The patient received imatinib mesylate(IM) treatment,400 mg/day orally. Following the IM treatment for a period of 35 mo,the patient underwent partial hepatectomy(S4 + S5) . The effect of IM on the metastatic lesions was interpreted as pathologic complete response(CR) . Pathologically verified cases showing therapeutic efficacy of IM have been rarely reported. 展开更多
关键词 Gastrointestinal stromal tumor Liver metastasis Imatinib mesylate Pathologic complete response
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基于全响应功率补偿的电压型PWM整流器直接功率控制 被引量:11
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作者 肖雄 张勇军 +2 位作者 王京 尚敬 陈铁柱 《电工技术学报》 EI CSCD 北大核心 2015年第4期113-120,共8页
为提高直流环节的动态响应,抑制功率突变时的母线电压波动,本文在建立双PWM变频调速系统能量平衡数学模型的基础上,将无功电流引入功率调节环,采用输出功率直接反馈,首次提出动态和稳态分步补偿的全响应直接功率控制策略,即以功率为控制... 为提高直流环节的动态响应,抑制功率突变时的母线电压波动,本文在建立双PWM变频调速系统能量平衡数学模型的基础上,将无功电流引入功率调节环,采用输出功率直接反馈,首次提出动态和稳态分步补偿的全响应直接功率控制策略,即以功率为控制量,对稳态所需能量进行实时性补偿,对动态所需能量以n个期望控制周期为单位进行阶段性补偿。实验结果表明,改进后的电压型PWM整流器控制策略显著提高了直流环节的动态响应,且有效抑制直流母线电压波动,实现了对双PWM变频系统能量流动的精确控制和协调性能的提升。 展开更多
关键词 双PWM变频器 能量平衡 输出功率反馈 直接功率控制 全响应
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Arc-length technique for nonlinear finite element analysis 被引量:9
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作者 MEMONBashir-Ahmed 苏小卒 《Journal of Zhejiang University Science》 EI CSCD 2004年第5期618-628,共11页
Nonlinear solution of reinforced concrete structures, particularly complete load-deflection response, requires tracing of the equilibrium path and proper treatment of the limit and bifurcation points. In this regard, ... Nonlinear solution of reinforced concrete structures, particularly complete load-deflection response, requires tracing of the equilibrium path and proper treatment of the limit and bifurcation points. In this regard, ordinary solution techniques lead to instability near the limit points and also have problems in case of snap-through and snap-back. Thus they fail to predict the complete load-displacement response. The arc-length method serves the purpose well in principle, received wide acceptance in finite element analysis, and has been used extensively. However modifications to the basic idea are vital to meet the particular needs of the analysis. This paper reviews some of the recent developments of the method in the last two decades, with particular emphasis on nonlinear finite element analysis of reinforced concrete structures. 展开更多
关键词 Arc-length method Nonlinear analysis Finite element method Reinforced concrete Load-deflection path Document code: A CLC number: TU31 Arc-length technique for nonlinear finite element analysis* MEMON Bashir-Ahmed# SU Xiao-zu (苏小卒) (Department of Structural Engineering Tongji University Shanghai 200092 China) E-mail: bashirmemon@sohu.com xiaozub@online.sh.cn Received July 30 2003 revision accepted Sept. 11 2003 Abstract: Nonlinear solution of reinforced concrete structures particularly complete load-deflection response requires tracing of the equilibrium path and proper treatment of the limit and bifurcation points. In this regard ordinary solution techniques lead to instability near the limit points and also have problems in case of snap-through and snap-back. Thus they fail to predict the complete load-displacement response. The arc-length method serves the purpose well in principle received wide acceptance in finite element analysis and has been used extensively. However modifications to the basic idea are vital to meet the particular needs of the analysis. This paper reviews some of the recent developments of the method in the last two decades with particular emphasis on nonlinear finite element analysis of reinforced concrete structures. Key words: Arc-length method Nonlinear analysis Finite element method Reinforced concrete Load-deflection path
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Ⅱ/Ⅲ期食管癌术前放化疗的影像学评价对预后的影响 被引量:9
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作者 钟胜 吴清泉 +3 位作者 王万伟 陶光州 彭进 朱卫国 《中华放射医学与防护杂志》 CAS CSCD 北大核心 2015年第4期270-273,共4页
目的 回顾性分析Ⅱ/Ⅲ期食管癌术前放化疗后影像学评价对预后的影响.方法 对有完整随访资料的145例Ⅱ/Ⅲ期食管癌术前放化疗患者进行回顾性分析.分析内容包括术后病理完全缓解(pCR)与未达完全缓解(NpCR)、X射线造影完全缓解(xCR)... 目的 回顾性分析Ⅱ/Ⅲ期食管癌术前放化疗后影像学评价对预后的影响.方法 对有完整随访资料的145例Ⅱ/Ⅲ期食管癌术前放化疗患者进行回顾性分析.分析内容包括术后病理完全缓解(pCR)与未达完全缓解(NpCR)、X射线造影完全缓解(xCR)与未完全缓解(NxCR)及实体瘤疗效评价标准(RECIST)完全缓解(rCR)与未完全缓解(NrCR)的总生存率,并进行多因素分析.结果 全部145例患者,pCR率33.8%,xCR率42.8%,rCR率38.6%.pCR患者与NpCR患者1、3、5年总生存率分别为87.8%、79.6%、61.2%与75%、40.6%、24.0%,差异有统计学意义(χ^2=20.215,P<0.05);xCR患者与NxCR患者1、3、5年总生存率分别为80.6%、66.1%、51.6%与75%、44.6%、25.3%,差异有统计学意义(χ^2=8.895,P<0.05);rCR患者与NrCR患者1、3、5年总生存率分别为83.9%、69.6%、53.6%与76.4%、46.1%、25.8%,差异有统计学意义(χ^2=10.862,P <0.05),Cox模型进行多因素分析显示pCR是独立预后因素(HR=0.333,95% CI:0.200 ~0.554,P <0.05).结论 xCR、rCR较NxCR、NrCR明显提高了生存率,可以指导临床进行疗效判断;pCR为独立预后因素,术后pCR依然是食管癌术前同步放化疗疗效判断的金标准. 展开更多
关键词 食管癌 术前放化疗 完全缓解 影像学 预后
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短程放疗联合CAPOX和PD-1单抗用于局部进展期直肠癌全程新辅助治疗的前瞻性多中心随机二期临床研究(TORCH)——单中心初步结果分析 被引量:8
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作者 王雅琪 申丽君 +16 位作者 万觉锋 张慧 王雁 吴显 王靖雯 王人杰 孙轶群 童彤 黄丹 王磊 盛伟琪 张迅 蔡国响 徐烨 蔡三军 章真 夏凡 《中华胃肠外科杂志》 CSCD 北大核心 2023年第5期448-458,共11页
目的对于局部进展期直肠癌(LARC,T3~4或N+M0)患者,全程新辅助治疗(TNT)已被证实可提高肿瘤退缩率,尽早控制远处转移。取得临床完全缓解(cCR)的患者有机会采取等待观察策略,实现器官功能保留(保肛)。相较于常规分割放疗,大分割放疗和免... 目的对于局部进展期直肠癌(LARC,T3~4或N+M0)患者,全程新辅助治疗(TNT)已被证实可提高肿瘤退缩率,尽早控制远处转移。取得临床完全缓解(cCR)的患者有机会采取等待观察策略,实现器官功能保留(保肛)。相较于常规分割放疗,大分割放疗和免疫治疗具有更好的协同作用,有助于增加微卫星稳定(MSS)结直肠癌对免疫治疗的敏感性。因此,本研究旨在探索短程放疗为基础的TNT模式联合免疫治疗,是否能进一步提高LARC患者的肿瘤退缩。方法这是一项前瞻性多中心随机二期临床研究(TORCH研究注册号:NCT04518280)的单中心初步结果分析,纳入肿瘤距肛缘10 cm的LARC患者,随机分为巩固组和诱导组。巩固组先行短程放疗(25 Gy/5 Fx),再进行6程CAPOX化疗(奥沙利铂+卡培他滨)和特瑞普利单抗治疗;诱导组先行2程CAPOX化疗和特瑞普利单抗治疗,再行短程放疗,再行4程上述化疗+免疫治疗,最后行全直肠系膜切除(TME)术,达到cCR的患者可选择等待观察策略。主要研究终点是完全缓解(CR)率,即病理完全缓解率(pCR率)+持续超1年的cCR率。次要研究终点为不良反应发生情况。结果截至2022年9月30日,复旦大学附属肿瘤医院前瞻性入组62例患者(巩固组34例,诱导组28例);中位年龄53(27~69)岁;MSS或错配修复完整(pMMR)型59例(95.2%),仅3例为微卫星高度不稳定(MSI-H)或错配修复缺陷(dMMR);肿瘤Ⅲ期患者55例(88.7%)。肿瘤距肛缘距离≤5 cm者占77.4%(48/62),cT4期者占11.3%(7/62),肿瘤侵犯直肠系膜筋膜者占27.4%(17/62),cN2期者占41.9%(26/62)和肿瘤侵犯壁外血管浸润者占17.7%(11/62)。全部62例患者均完成短程放疗和≥5程的化疗免疫治疗,6程化疗免疫完成率为83.9%(52/62)。疗效评估显示,共29例患者达到了cCR(46.8%,29/62),其中18例采取了等待观察策略。共32例接受了TME手术,其中18例pCR,4例TRG 1分,10例TRG 2~3分。3例MSI-H患者均获得cCR;其中1例术后病理为p 展开更多
关键词 直肠肿瘤 局部进展期 短程放疗 免疫治疗 全程新辅助治疗 肿瘤完全退缩 等待观察 不良反应
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Impact of interval between neoadjuvant chemoradiotherapy and surgery in rectal cancer patients 被引量:9
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作者 Shi-Wen Mei Zheng Liu +9 位作者 Fang-Ze Wei Jia-Nan Chen Zhi-Jie Wang Hai-Yu Shen Juan Li Fu-Qiang Zhao Wei Pei Zheng Wang Xi-Shan Wang Qian Liu 《World Journal of Gastroenterology》 SCIE CAS 2020年第31期4624-4638,共15页
BACKGROUND Epidemiologically,in China,locally advanced rectal cancer is a more common form of rectal cancer.Preoperative neoadjuvant concurrent chemoradiotherapy can effectively reduce the size of locally invasive tum... BACKGROUND Epidemiologically,in China,locally advanced rectal cancer is a more common form of rectal cancer.Preoperative neoadjuvant concurrent chemoradiotherapy can effectively reduce the size of locally invasive tumors and improve disease-free survival(DFS)and pathologic response after surgery.At present,this modality has become the standard protocol for the treatment of locally advanced rectal cancer in many centers,but the optimal time for surgery after neoadjuvant therapy is still controversial.AIM To investigate the impact of time interval between neoadjuvant therapy and surgery on DFS and pathologic response in patients with locally advanced rectal cancer.METHODS A total of 231 patients who were classified as having clinical stage II or III advanced rectal cancer and underwent neoadjuvant chemoradiation followed by surgery at the National Cancer Center/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College from November 2014 to August 2017 were involved in this retrospective cohort study.The patients were divided into two groups based on the different time intervals between neoadjuvant therapy and surgery:139(60.2%)patients were in group A(≤9 wk),and 92(39.2%)patients were in group B(>9 wk).DFS and pathologic response were analyzed as the primary endpoints.The secondary endpoints were postoperative complications and sphincter preservation.RESULTS For the 231 patients included,surgery was performed at≤9 wk in 139(60.2%)patients and at>9 wk in 92(39.8%).The patients’clinical characteristics,surgical results,and tumor outcomes were analyzed through univariate analysis combined with multivariate regression analysis.The overall pathologic complete response(pCR)rate was 27.2%(n=25)in the longer time interval group(>9 wk)and 10.8%(n=15)in the shorter time interval group(≤9 wk,P=0.001).The postoperative complications did not differ between the groups(group A,5%vs group B,5.4%;P=0.894).Surgical procedures for sphincter preservation were performed in 113(48.9%)patients,which wer 展开更多
关键词 Interval time Advanced rectal cancer Disease-free survival Pathologic complete response Neoadjuvant therapy SURGERY COMPLICATION Sphincter preservation
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Nomogram for predicting pathological complete response to neoadjuvant chemotherapy in patients with advanced gastric cancer 被引量:8
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作者 Yong-He Chen Jian Xiao +4 位作者 Xi-Jie Chen Hua-She Wang Dan Liu Jun Xiang Jun-Sheng Peng 《World Journal of Gastroenterology》 SCIE CAS 2020年第19期2427-2439,共13页
BACKGROUND Survival benefit of neoadjuvant chemotherapy(NAC)for advanced gastric cancer(AGC)is a debatable issue.Studies have shown that the survival benefit of NAC is dependent on the pathological response to chemoth... BACKGROUND Survival benefit of neoadjuvant chemotherapy(NAC)for advanced gastric cancer(AGC)is a debatable issue.Studies have shown that the survival benefit of NAC is dependent on the pathological response to chemotherapy drugs.For those who achieve pathological complete response(pCR),NAC significantly prolonged prolapsed-free survival and overall survival.For those with poor response,NAC yielded no survival benefit,only toxicity and increased risk for tumor progression during chemotherapy,which may hinder surgical resection.Thus,predicting pCR to NAC is of great clinical significance and can help achieve individualized treatment in AGC patients.AIM To establish a nomogram for predicting pCR to NAC for AGC patients.METHODS Two-hundred and eight patients diagnosed with AGC who received NAC followed by resection surgery from March 2012 to July 2019 were enrolled in this study.Their clinical data were retrospectively analyzed by logistic regression analysis to determine the possible predictors for pCR.Based on these predictors,a nomogram model was developed and internally validated using the bootstrap method.RESULTS pCR was confirmed in 27 patients(27/208,13.0%).Multivariate logistic regression analysis showed that higher carcinoembryonic antigen level,lymphocyte ratio,lower monocyte count and tumor differentiation grade were associated with higher pCR.Concordance statistic of the established nomogram was 0.767.CONCLUSION A nomogram predicting pCR to NAC was established.Since this nomogram exhibited satisfactory predictive power despite utilizing easily available pretreatment parameters,it can be inferred that this nomogram is practical for the development of personalized treatment strategy for AGC patients. 展开更多
关键词 Advanced gastric cancer Neoadjuvant chemotherapy NOMOGRAM Pathological complete response
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Complete response to preoperative chemoradiotherapy in highly advanced gastric adenocarcinoma 被引量:6
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作者 Hironori Shigeoka Haruhiko Imamoto +5 位作者 Yasumasa Nishimura Taro Shimono Hiroshi Furukawa Hiroshi Imamura Takushi Yasuda Hitoshi Shiozaki 《World Journal of Gastrointestinal Oncology》 SCIE CAS 2010年第6期282-286,共5页
This report presents a case of highly advanced gastric cancer that achieved a histologically complete response (CR) to preoperative chemoradiotherapy with S-1 plus low-dose Cisplatin. A 60-year-old male patient underw... This report presents a case of highly advanced gastric cancer that achieved a histologically complete response (CR) to preoperative chemoradiotherapy with S-1 plus low-dose Cisplatin. A 60-year-old male patient underwent FDG positron emission tomography (PET) during a routine health examination. The patient was found to have swollen paraaortic lymph nodes. Shortly thereafter, he was diagnosed with gastric carcinoma with a type 2 tumor in the antrum with paraaortic lymph node metastases based on FDG-PET, endoscopic examination and abdominal computed tomography. After the completion of chemoradiation therapy (CRT), the tumor and the paraaortic lymph node metastases disappeared. The patient underwent surgery 5 wk after the completion of CRT, including a subtotal gastrectomy with Rouxen-Y reconstruction, D3 lymph node dissection and a left adrenalectomy. No cancer cells were detected in the resected specimen either in the primary lesion or lymph nodes, thus confirming a pathologically CR to CRT (CR grade 3). The patient has been stable and well without any evidence of recurrence for 48 mo after surgery. Such a preoperative CRT regimen might therefore be very effective for treatment of some advanced gastric cancers. 展开更多
关键词 complete response GASTRIC cancer CISPLATIN CHEMORADIATION NEOADJUVANT THERAPY
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MATLAB仿真在一阶RC电路响应教学中的应用 被引量:6
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作者 尚丽 《苏州市职业大学学报》 2017年第1期71-78,共8页
一阶RC电路响应包括零输入响应、零状态响应以及全响应等内容。分析一阶RC电路的理论前提是必须熟练掌握电路的过渡过程、换路定律及初始值的确定等,但是这些理论内容较为抽象,在教学中不易为高职院校的学生理解和掌握。为了使学生易懂... 一阶RC电路响应包括零输入响应、零状态响应以及全响应等内容。分析一阶RC电路的理论前提是必须熟练掌握电路的过渡过程、换路定律及初始值的确定等,但是这些理论内容较为抽象,在教学中不易为高职院校的学生理解和掌握。为了使学生易懂易学,对一阶RC电路的动态响应引入MATLAB仿真技术,选择不同的电阻和电容参数对响应波形进行分析,从而使学生对一阶RC电路响应的动态过程有直观上的认知,有助于更好地理解理论内容,在实际教学中取得较好的效果。 展开更多
关键词 一阶RC电路 动态时域分析 零输入响应 零状态响应 全响应 MATLAB仿真
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乳腺癌新辅助化疗后MR完全缓解与病理不一致的原因分析 被引量:7
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作者 万芸 黄燕 +2 位作者 陈丽君 尚晓静 刘园园 《临床放射学杂志》 北大核心 2021年第10期1888-1894,共7页
目的评估新辅助化疗(NAC)后MR诊断完全缓解(rCR)的乳腺癌患者,分析引起影像-病理不一致的放射学和临床的因素。方法回顾性分析乳腺癌NAC后MR诊断为rCR的65例患者资料,取得术后病理,分析临床、乳腺X线图像及MR图像、病理资料。结果50例患... 目的评估新辅助化疗(NAC)后MR诊断完全缓解(rCR)的乳腺癌患者,分析引起影像-病理不一致的放射学和临床的因素。方法回顾性分析乳腺癌NAC后MR诊断为rCR的65例患者资料,取得术后病理,分析临床、乳腺X线图像及MR图像、病理资料。结果50例患者(50/65,76.9%)术后病理完全缓解(pCR),归入"pCR组";15例患者(15/65,23.1%)术后病理证实有浸润性癌灶残留,归入"假阴性组"。两组患者在年龄、组织学分级、雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体-2(HER-2)、分子分型差异没有统计学意义(P值分别为0.684,0.681,0.256,0.646,0.232,0.128)。22例患者(22/65,33.8%)乳腺X线片存在微钙化,存在微钙化的患者假阴性率(10/22,45.5%)比例高于无微钙化患者(5/43,11.6%),差异有统计学意义(P=0.002)。NAC前动态增强磁共振成像(DCE-MRI)扫描多灶性多中心性乳腺癌患者,NAC后MRI诊断rCR出现假阴性(11/26,42.3%)比例高于单发癌灶患者(4/39,10.3%),差异有统计学意义(P=0.003)。NAC前DCE-MRI扫描42例(42/65,64.6%)癌灶呈肿块强化,23例(23/65,35.4%)癌灶呈非肿块强化,非肿块强化的患者在NAC后MR诊断rCR出现假阴性(9/23,39.1%)比例高于肿块强化患者(6/42,14.3%),差异有统计学意义(P=0.023)。多因素二元Logistic回归分析发现以下因素会增加NAC后MR诊断rCR假阴性的风险:多灶性多中心性癌[OR=1.895(95%CI:1.697~3.799),P=0.037];非肿块强化[OR=1.562(95%CI:1.257~6.387),P=0.034];乳腺X线片内钙化[OR=1.532(95%CI:1.472~4.375),P=0.008]。结论NAC前乳腺癌乳腺X线片内钙化、多灶性多中心性乳腺癌、非肿块强化征象,是引起NAC后MR诊断rCR与病理不一致的重要独立因素。 展开更多
关键词 乳腺癌 新辅助治疗 完全缓解 微钙化 非肿块强化 多灶性多中心性乳腺癌
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Multidisciplinary treatment of rectal cancer in 2014: Where are we going? 被引量:6
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作者 Andrea Vignali Paola De Nardi 《World Journal of Gastroenterology》 SCIE CAS 2014年第32期11249-11261,共13页
In the present review we discuss the recent developments and future directions in the multimodal treatment of locally advanced rectal cancer, with respect to staging and re-staging modalities, to the current role of n... In the present review we discuss the recent developments and future directions in the multimodal treatment of locally advanced rectal cancer, with respect to staging and re-staging modalities, to the current role of neoadjuvant chemo-radiation and to the conservative and more limited surgical approaches based on tumour response after neoadjuvant combined therapy. When initial tumor staging is considered a high accuracy has been reported for T pre-treatment staging, while preoperative lymph node mapping is still suboptimal. With respect to tumour re-staging, all the current available modalities still present a limited accuracy, in particular in defining a complete response. The role of short vs long-course radiotherapy regimens as well as the optimal time of surgery are still unclear and under investigation by means of ongoing randomized trials. Observational management or local excision following tumour complete response are promising alternatives to total mesorectal excision, but need further evaluation, and their use outside of a clinical trial is not recommended.The preoperative selection of patients who will benefit from neoadjuvant radiotherapy or not, as well as the proper identification of a clinical complete tumour response after combined treatment modalities,will influence the future directions in the treatment of locally advanced rectal cancer. 展开更多
关键词 Rectal cancer Cancer staging Cancer restaging Neoadjuvant chemoradiation response Treatment Local control Local excision complete pathologic response Rectal cancer surgery
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First-week clinical responses to dexlansoprazole 60 mg and esomeprazole 40 mg for the treatment of grades A and B gastroesophageal reflux disease 被引量:5
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作者 Chih-Ming Liang Ming-Te Kuo +13 位作者 Pin-I Hsu Chao-Hung Kuo Wei-Chen Tai Shih-Cheng Yang Keng-Liang Wu Hsing-Ming Wang Chih-Chien Yao Cheng-En Tsai Yao-Kuang Wang Jiunn-Wei Wang Chih-Fang Huang Deng-Chyang Wu Seng-Kee Chuah 《World Journal of Gastroenterology》 SCIE CAS 2017年第47期8395-8404,共10页
AIM To compare the one-week clinical effects of single doses of dexlansoprazole and esomeprazole on grades A and B erosive esophagitis.METHODS We enrolled 175 adult patients with gastroesophageal reflux disease(GERD).... AIM To compare the one-week clinical effects of single doses of dexlansoprazole and esomeprazole on grades A and B erosive esophagitis.METHODS We enrolled 175 adult patients with gastroesophageal reflux disease(GERD). The patients were randomized in a 1:1 ratio into two sequence groups to define the order in which they received single doses of dexlansoprazole(n = 88) and esomeprazole(n = 87) for an intention-to-treat analysis. The primary endpoints were the complete symptom resolution(CSR) rates at days 1, 3, and 7 after drug administration.RESULTS Thirteen patients were lost to follow-up, resulting in 81 patients in each group for the per-protocol analysis. The CSRs for both groups were similar at days 1, 3 and 7. In the subgroup analysis, the female patients achieved higher CSRs in the dexlansoprazole group than in the esomeprazole group at day 3(38.3% vs 18.4%, P = 0.046). An increasing trend toward a higher CSR was observed in the dexlansoprazole group at day 7(55.3% vs 36.8%, P = 0.09). In the esomeprazole group, female sex was a negative predictive factor for CSR on post-administration day 1 [OR =-1.249 ± 0.543; 95%CI: 0.287(0.099-0.832), P = 0.022] and day 3 [OR =-1.254 ± 0.519; 95%CI: 0.285(0.103-0.789), P = 0.016]. Patients with spicy food eating habits achieved lower CSRs on day 1 [37.3% vs 21.4%, OR =-0.969 ± 0.438; 95%CI: 0.380(0.161-0.896), P = 0.027]. CONCLUSION The overall CSR for GERD patients was similar at days 1-7 for both the dexlansoprazole and esomeprazole groups, although a higher incidence of CSR was observed on day 3 in female patients who received a single dose of dexlansoprazole. 展开更多
关键词 Dexlansoprazole ESOMEPRAZOLE Oneweek response complete symptom resolution rate Gastroesophageal reflux disease
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Primary squamous cell carcinoma of the rectum: An update and implications for treatment 被引量:5
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作者 Glen R Guerra Cherng H Kong +3 位作者 Satish K Warrier Andrew C Lynch Alexander G Heriot Samuel Y Ngan 《World Journal of Gastrointestinal Surgery》 SCIE CAS 2016年第3期252-265,共14页
AIM: To provide an update on the aetiology, pathogenesis, diagnosis, staging and management of rectal squamous cell carcinoma(SCC).METHODS: A systematic review was conducted according to the preferred reporting items ... AIM: To provide an update on the aetiology, pathogenesis, diagnosis, staging and management of rectal squamous cell carcinoma(SCC).METHODS: A systematic review was conducted according to the preferred reporting items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search of Ovid MEDLINE was performed with the reference list of selected articles reviewed to ensure all relevant publications were captured. The search strategy was limited to the English language, spanning from 1946 to 2015. A qualitative analysis was undertaken examining patient demographics, clinical presentation, diagnosis, staging, treatment and outcome. The quantitaive analysis was limited to data extracted on treatment and outcomes including radiological, clinical and pathological complete response where available. The narrative and quantitative review were synthesised in concert.RESULTS: The search identified 487 articles in total with 79 included in the qualitative review. The quantitative analysis involved 63 articles, consisting of 43 case reports and 20 case series with a total of 142 individual cases. The underlying pathogenesis of rectal SCC while unclear, continues to be defined, with increasing evidence of a metaplasia-dysplasia-carcinoma sequence and a possible role for human papilloma virus in this progression. The presentation is similar to rectal adenocarcinoma, with a diagnosis confirmed by endoscopic biopsy. Many presumed rectal SCC's are in fact an extension of an anal SCC, and cytokeratin markers are a useful adjunct in this distinction. Staging is most accurately reflected by the tumour-nodemetastasis classification for rectal adenocarcinoma. It involves examining locoregional disease by way of magnetic resonance imaging and/or endorectal ultrasound, with systemic spread excluded by way of computed tomography. Positron emission tomography is integral in the workup to exclude an external siteof primary SCC with metastasis to the rectum. While the optimal treatment remains as yet undefined, recent studies hav 展开更多
关键词 SQUAMOUS cell CARCINOMA RECTAL cancer CHEMORADIOTHERAPY Surgery complete response
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Complete response to sorafenib in a patient with recurrent hepatocellular carcinoma 被引量:6
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作者 Hong-bo Huan Wan-Yee Lau +2 位作者 Feng Xia Kuan-sheng Ma Ping bie 《World Journal of Gastroenterology》 SCIE CAS 2014年第39期14505-14509,共5页
Partial hepatectomy is still the treatment of choice aiming at a cure for patients with hepatocellular carcinoma(HCC), provided that the patient can tolerate the treatment. For patients with multiple recurrent HCC aft... Partial hepatectomy is still the treatment of choice aiming at a cure for patients with hepatocellular carcinoma(HCC), provided that the patient can tolerate the treatment. For patients with multiple recurrent HCC after partial hepatectomy which cannot be treated by re-hepatectomy or local ablative therapy, the prognosis is extremely poor. sorafenib is a molecular-targeted agent which has been demonstrated in two global phase III randomized controlled trials to show survival benefit for advanced HCC. Here, we present a 56-yearold patient with HCC who showed complete clinical response after sorafenib was used for tumor recurrence which developed 3 mo after partial hepatectomy. There was no evidence of progression of disease for 60 mo till now after continuous treatment with sorafenib. 展开更多
关键词 Hepatocellular carcinoma Partial hepatectomy SORAFENIB complete response
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