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Blood Lymphocytes as a Prognostic Factor for Stage III Non-Small Cell Lung Cancer with Concurrent Chemoradiation. 血淋巴细胞作为同期化疗的 III 期非小细胞肺癌的预后因素
Pub Date : 2024-01-01 Epub Date: 2024-01-25 DOI: 10.4068/cmj.2024.60.1.40
Yong-Hyub Kim, Yoo-Duk Choi, Sung-Ja Ahn, Young-Chul Kim, In-Jae Oh, Taek-Keun Nam, Jae-Uk Jeong, Ju-Young Song

We aimed to identify blood lymphocytes as a prognostic factor for survival in patients with locally advanced stage III non-small cell lung cancer (NSCLC) treated with concurrent chemoradiotherapy (CCRT). This is a secondary study of 196 patients enrolled in the Korean Radiation Oncology Group 0903 phase III clinical trial to evaluate the prognostic significance of circulating blood lymphocyte levels. The median total lymphocyte count (TLC) reduction ratio during CCRT was 0.74 (range: 0.29-0.97). In multivariate analysis, patient age (p=0.014) and gross tumor volume (GTV, p=0.031) were significant factors associated with overall survival, while TLC reduction (p=0.018) and pretreatment neutrophil-to-lymphocyte ratio (NLR; p=0.010) were associated with progression-free survival (PFS). In multivariate logistic regression analysis, pretreatment NLR, GTV, and heart V20 were significantly associated with TLC reduction. Immunohistochemical analysis of programmed death ligand 1 and CD8 expression on T cells was performed on 84 patients. CD8 expression was not significantly associated with the pretreatment lymphocyte count (p=0.673), and PDL1 expression was not significantly associated with OS or PFS. Univariate analysis revealed that high CD8 expression in TILs was associated with favorable OS and was significantly associated with favorable PFS (p=0.032). TLC reduction during CCRT is a significant prognostic factor for PFS, and heart V20 is significantly associated with TLC reduction. Thus, in the era of immunotherapy, constraining the volume of the radiation dose to the whole heart must be prioritized for the better survival outcomes.

我们旨在确定血液淋巴细胞是影响接受同期化疗放疗(CCRT)的局部晚期 III 期非小细胞肺癌(NSCLC)患者生存期的预后因素。本研究对韩国放射肿瘤学组 0903 III 期临床试验的 196 例患者进行了二次研究,以评估循环血淋巴细胞水平的预后意义。CCRT期间总淋巴细胞计数(TLC)减少率的中位数为0.74(范围:0.29-0.97)。在多变量分析中,患者年龄(p=0.014)和肿瘤总体积(GTV,p=0.031)是与总生存期相关的重要因素,而总淋巴细胞减少率(p=0.018)和治疗前中性粒细胞与淋巴细胞比率(NLR,p=0.010)与无进展生存期(PFS)相关。在多变量逻辑回归分析中,治疗前的 NLR、GTV 和心脏 V20 与 TLC 减少显著相关。对84名患者的T细胞上的程序性死亡配体1和CD8表达进行了免疫组化分析。CD8 表达与治疗前淋巴细胞计数无明显相关性(P=0.673),PDL1 表达与 OS 或 PFS 无明显相关性。单变量分析显示,TIL 中 CD8 高表达与良好的 OS 相关,与良好的 PFS 显著相关(p=0.032)。CCRT期间TLC减少是PFS的重要预后因素,而心脏V20与TLC减少显著相关。因此,在免疫疗法时代,为了获得更好的生存结果,必须优先考虑限制整个心脏的放射剂量体积。
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引用次数: 0
Atorvastatin on Treatment of Nonalcoholic Fatty Liver Disease Patients. 治疗非酒精性脂肪肝患者的阿托伐他汀
Pub Date : 2024-01-01 Epub Date: 2024-01-25 DOI: 10.4068/cmj.2024.60.1.13
Zahra Eslami, Samaneh Sadat Aghili, Amir Ghaleh Ghafi

Non-alcoholic fatty liver disease (NAFLD) is a condition in which excess fat builds up in the liver, often related to obesity and insulin resistance, which can lead to inflammation and scarring of the liver tissue. While efforts have been made to develop effective treatments for NAFLD, the need for pharmaceutical interventions remains unmet. Large clinical trials investigating the association between statin use and NAFLD are scarce, leading to contradictory results. Statins play a crucial role in cholesterol synthesis in the liver. Several studies have demonstrated that statins possess anti-inflammatory, anti-thrombotic, and anti-fibrotic properties. These properties make statins potentially useful in preventing the progression of NAFLD from simple steatosis to more severe forms like non-alcoholic steatohepatitis (NASH) and fibrosis. The results indicate that statin use is associated with a lower prevalence of NASH and fibrosis and may have a preventive effect on NAFLD.

非酒精性脂肪肝(NAFLD)是一种肝脏内脂肪堆积过多的疾病,通常与肥胖和胰岛素抵抗有关,可导致肝组织炎症和瘢痕形成。虽然人们一直在努力开发治疗非酒精性脂肪肝的有效方法,但对药物干预的需求仍未得到满足。调查他汀类药物的使用与非酒精性脂肪肝之间关系的大型临床试验很少,导致结果相互矛盾。他汀类药物在肝脏合成胆固醇的过程中发挥着至关重要的作用。多项研究表明,他汀类药物具有抗炎、抗血栓形成和抗纤维化的特性。这些特性使他汀类药物在预防非酒精性脂肪肝从单纯的脂肪变性发展为非酒精性脂肪性肝炎(NASH)和纤维化等更严重的非酒精性脂肪肝方面具有潜在的作用。研究结果表明,他汀类药物与较低的非酒精性脂肪性肝炎和纤维化发病率有关,可能对非酒精性脂肪性肝病有预防作用。
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引用次数: 0
Gallic Acid Inhibits Proliferation and Migration of Smooth Muscle Cells in a Pig In-Stent Restenosis Model. 没食子酸抑制猪支架内再狭窄模型中平滑肌细胞的增殖和迁移
Pub Date : 2024-01-01 Epub Date: 2024-01-25 DOI: 10.4068/cmj.2024.60.1.32
Han Byul Kim, Young Joon Hong, Seung Hun Lee, Hae Jin Kee, Munki Kim, Youngkeun Ahn, Myung Ho Jeong

In-stent restenosis (ISR) develops primarily due to neointimal hyperplasia. Gallic acid (GA) has anti-inflammatory, antioxidant, and cardioprotective effects. This study sought to investigate the effects of GA on neointimal hyperplasia and proliferation and migration of vascular smooth muscle cells (VSMCs) in a pig ISR model. In vitro proliferation and migration experiments were confirmed, after VSMCs were treated with platelet-derived growth factor (PDGF-BB) and GA (100 µM) using a 3-(4,5-dimethylthiazol)-2,5-diphenyltetrazolium bromide (MTT) assay and a scratch wound assay for 24 hours and 48 hours. A bare metal stent (BMS) was implanted in the pig coronary artery to induce ISR with overdilation (1.1-1.2:1), and GA (10 mg/kg/day) was administered for 4 weeks. At the 4-week follow-up, optical coherence tomography (OCT) and histopathological analyses were performed. GA decreased the proliferation of VSMCs by PDGF-BB for 24 hours (89.24±24.56% vs. 170.04±19.98%, p<0.001) and 48 hours (124.87±7.35% vs. 187.64±4.83%, p<0.001). GA inhibited the migration of VSMCs induced by PDGF-BB for 24 hours (26.73±2.38% vs. 65.38±9.73%, p<0.001) and 48 hours (32.96±3.04% vs. 77.04±10.07%, p<0.001). Using OCT, % neointimal hyperplasia was shown to have significantly decreased in the GA group compared with control vehicle group (28.25±10.07% vs. 37.60±10.84%, p<0.001). GA effectively reduced neointimal hyperplasia by inhibiting the proliferation and migration of VSMCs in a pig ISR model. GA could be a potential treatment strategy for reducing ISR after stent implantation.

支架内再狭窄(ISR)的发生主要是由于新内膜增生。没食子酸(GA)具有抗炎、抗氧化和保护心脏的作用。本研究旨在探讨没食子酸对猪 ISR 模型中新内膜增生以及血管平滑肌细胞(VSMC)增殖和迁移的影响。用 3-(4,5-二甲基噻唑)-2,5-二苯基溴化四氮唑(MTT)测定法和划痕伤口测定法对 VSMC 进行 24 小时和 48 小时的体外增殖和迁移实验。在猪冠状动脉中植入裸金属支架(BMS),以过度扩张(1.1-1.2:1)诱导 ISR,并连续 4 周服用 GA(10 毫克/千克/天)。在4周的随访中,进行了光学相干断层扫描(OCT)和组织病理学分析。在 PDGF-BB 的作用下,GA 可使 VSMC 增殖 24 小时(89.24±24.56% vs. 170.04±19.98%,p
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引用次数: 0
Gestational Transient Thyrotoxicosis Can Lead to Hypokalemic Periodic Paralysis. 妊娠期一过性甲亢可导致低钾血症性周期性麻痹
Pub Date : 2024-01-01 Epub Date: 2024-01-25 DOI: 10.4068/cmj.2024.60.1.95
Jin Woo Jeong, Tae Yang Yu
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引用次数: 0
Comparative Study on the Immunogenicity of COVID-19 mRNA Vaccines in Patients Receiving Adjuvant and Palliative Chemotherapy. COVID-19 mRNA 疫苗在接受辅助化疗和姑息化疗患者中的免疫原性比较研究
Pub Date : 2024-01-01 Epub Date: 2024-01-25 DOI: 10.4068/cmj.2024.60.1.69
Hyun-Woo Choi, Younggon Jung, Uh Jin Kim, Sang-Cheol Lee, Jung Hye Kwon, Hyeonjong Kim, Sarah Kim, Yoonjung Lee, Hyun-Jung Shim, Sang-Hee Cho, Ik-Joo Chung, Eu Chang Hwang, Seung Ji Kang, Woo Kyun Bae, Seung-Jung Kee

This study was conducted to investigate potential differences in vaccine efficacy between patients undergoing palliative chemotherapy and receiving adjuvant chemotherapy. Additionally, the study proved the influence of vaccination timing on vaccine efficacy during active chemotherapy. Anti-receptor-binding domain (RBD) IgG binding antibody assays and surrogate neutralizing antibody assays were performed after BNT162b2 or mRNA-1273 vaccination in 45 solid cancer patients (23 adjuvant and 22 palliative chemotherapy) and in 24 healthy controls before vaccination (baseline), at every two to four weeks after the first (post-dose 1) and the second vaccination (post-dose 2). The levels of anti-RBD IgG and neutralizing antibodies increased significantly from baseline through post-dose 1 to post-dose 2 in all three groups. At the post-dose 1, the anti-RBD IgG and neutralizing antibody levels were significantly lower in cancer patients than in healthy controls. However, by post-dose 2, the seropositivity of anti-RBD IgG and neutralizing antibodies uniformly reached 100% across all groups, with no significant disparity in antibody levels among the three groups. Moreover, the antibody titers were not significantly different between patients with a vaccine and chemotherapy interval of more than 14 days or those with less than 14 days. This study demonstrated that after second doses of mRNA COVID-19 vaccines, humoral immune responses in patients receiving chemotherapy were comparable to those of healthy controls, regardless of whether the purpose of the anti-cancer treatment was palliative or adjuvant. Furthermore, the timing of vaccination did not affect the level of humoral immunity after the second vaccination.

本研究旨在调查接受姑息化疗和接受辅助化疗的患者在疫苗疗效方面的潜在差异。此外,该研究还证明了疫苗接种时机对积极化疗期间疫苗疗效的影响。在接种 BNT162b2 或 mRNA-1273 疫苗后,对 45 名实体瘤患者(23 名辅助化疗患者和 22 名姑息化疗患者)和 24 名健康对照者进行了抗受体结合域(RBD)IgG 结合抗体测定和替代中和抗体测定。所有三组的抗 RBD IgG 和中和抗体水平从基线到剂量后 1 再到剂量后 2 都显著增加。在剂量 1 后,癌症患者的抗 RBD IgG 和中和抗体水平明显低于健康对照组。然而,在剂量 2 后,各组抗 RBD IgG 和中和抗体的血清阳性率均达到 100%,三组间抗体水平无明显差异。此外,疫苗接种与化疗间隔时间超过 14 天或少于 14 天的患者之间的抗体滴度也无明显差异。这项研究表明,无论抗癌治疗的目的是姑息治疗还是辅助治疗,接受化疗的患者在接种第二剂 mRNA COVID-19 疫苗后,其体液免疫反应与健康对照组相当。此外,接种疫苗的时间并不影响第二次接种后的体液免疫水平。
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引用次数: 0
MiR-4492, a New Potential MicroRNA for Cancer Diagnosis and Treatment: A Mini Review. MiR-4492,一种用于癌症诊断和治疗的新型潜在 MicroRNA:微型综述。
Pub Date : 2024-01-01 Epub Date: 2024-01-25 DOI: 10.4068/cmj.2024.60.1.21
Aida Alizamir, Mohammad Amin Amini, Ashkan Karbasi, Mehdi Beyrami

There is no doubt that the incidence of cancer sufferers is rising in the world, and it is estimated that in the next several decades, the number of people suffering from malignancies or the cancer rate will double. Diagnostic and therapeutic targeting of noncoding RNAs (ncRNAs), especially microRNAs (miRNAs) and long noncoding RNAs (lncRNAs), represent an excellent approach for cancer diagnosis and treatment, as well as many other diseases. One of the latest miRNAs is miR-4492, upregulating some genes in tumor tissues including ROMO1, HLA-G, NKIRAS2, FOXK1, and UBE2C. It represents an attractant example of a miRNA acting at multiple levels to affect the same malignancy hallmark. Based on the studies, miR-4492 plays a key role in several cancers such as, breast cancer, bladder cancer, osteosarcoma, glioblastoma multiforme, hepatocellular carcinoma, colorectal cancer, and ovarian cancer. Putting it all together, identifying the precise mechanisms of miR-4492 in the pathogenesis of cancer, could pave the way to find better diagnostic and therapeutic strategies for cancer sufferers. For this reason, it might be a novel potential diagnostic biomarker and therapeutic target for neoplasms.

毫无疑问,全球癌症发病率正在上升,据估计,在未来几十年内,恶性肿瘤患者人数或癌症发病率将翻一番。以非编码 RNA(ncRNA),特别是微小 RNA(miRNA)和长非编码 RNA(lncRNA)为诊断和治疗靶标,是诊断和治疗癌症以及许多其他疾病的绝佳方法。最新的 miRNA 之一是 miR-4492,它能上调肿瘤组织中的一些基因,包括 ROMO1、HLA-G、NKIRAS2、FOXK1 和 UBE2C。它是 miRNA 在多个水平上影响同一恶性肿瘤特征的一个引人入胜的例子。根据研究,miR-4492 在乳腺癌、膀胱癌、骨肉瘤、多形性胶质母细胞瘤、肝细胞癌、结直肠癌和卵巢癌等多种癌症中发挥着关键作用。综上所述,确定 miR-4492 在癌症发病机制中的确切机制,可以为癌症患者找到更好的诊断和治疗策略铺平道路。因此,miR-4492 可能是一种新型的潜在肿瘤诊断生物标志物和治疗靶点。
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引用次数: 0
Early Gastric Cancer Concurrent with Gastritis Cystica Profunda Resembling Advanced Cancer. 早期胃癌并发类似晚期癌症的深部糜烂性胃炎
Pub Date : 2024-01-01 Epub Date: 2024-01-25 DOI: 10.4068/cmj.2024.60.1.87
Yasuka Eriksson, Manabu Nakamoto, Hitoshi Orita, Takumi Miyahira, Hajime Aoyama, Akira Hokama
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引用次数: 0
Spinal Cord Infarction due to Aortic Atherosclerosis. 主动脉粥样硬化导致脊髓梗死
Pub Date : 2024-01-01 Epub Date: 2024-01-25 DOI: 10.4068/cmj.2024.60.1.91
Mi-Yeon Eun, Hung Youl Seok
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引用次数: 0
Bile Leak from the Cystic Duct during Endoscopic Retrograde Cholangiopancreatography. 内镜逆行胰胆管造影术中胆汁从胆囊管漏出。
Pub Date : 2024-01-01 Epub Date: 2024-01-25 DOI: 10.4068/cmj.2024.60.1.93
Yusaku Kajihara
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引用次数: 0
Clinical Outcome after Everolimus-Eluting Stent Implantation for Small Vessel Coronary Artery Disease: XIENCE Asia Small Vessel Study. 小血管冠状动脉疾病植入依维莫司洗脱支架后的临床效果:XIENCE 亚洲小血管研究》。
Pub Date : 2024-01-01 Epub Date: 2024-01-25 DOI: 10.4068/cmj.2024.60.1.78
Doo Sun Sim, Dae Young Hyun, Young Joon Hong, Ju Han Kim, Youngkeun Ahn, Myung Ho Jeong, Sang Rok Lee, Jei Keon Chae, Keun Ho Park, Young Youp Koh, Kyeong Ho Yun, Seok Kyu Oh, Seung Jae Joo, Sun Ho Hwang, Jong Pil Park, Jay Young Rhew, Su Hyun Kim, Jang Hyun Cho, Seung Uk Lee, Dong Goo Kang

There are limited data on outcomes after implantation of everolimus-eluting stents (EES) in East Asian patients with small vessel coronary lesions. A total of 1,600 patients treated with XIENCE EES (Abbott Vascular, CA, USA) were divided into the small vessel group treated with one ≤2.5 mm stent (n=119) and the non-small vessel group treated with one ≥2.75 mm stent (n=933). The primary end point was a patient-oriented composite outcome (POCO), a composite of all-cause death, myocardial infarction (MI), and any repeat revascularization at 12 months. The key secondary end point was a device-oriented composite outcome (DOCO), a composite of cardiovascular death, target-vessel MI, and target lesion revascularization at 12 months. The small vessel group was more often female, hypertensive, less likely to present with ST-elevation MI, and more often treated for the left circumflex artery, whereas the non-small vessel group more often had type B2/C lesions, underwent intravascular ultrasound, and received unfractionated heparin. In the propensity matched cohort, the mean stent diameter was 2.5±0.0 mm and 3.1±0.4 mm in the small and non-small vessel groups, respectively. Propensity-adjusted POCO at 12 months was 6.0% in the small vessel group and 4.3% in the non-small vessel group (p=0.558). There was no significant difference in DOCO at 12 months (small vessel group: 4.3% and non-small vessel group: 1.7%, p=0.270). Outcomes of XIENCE EES for small vessel disease were comparable to those for non-small vessel disease at 12-month clinical follow-up in real-world Korean patients.

有关东亚小血管冠状动脉病变患者植入依维莫司洗脱支架(EES)后疗效的数据十分有限。共有1600名患者接受了XIENCE EES(雅培血管公司,美国加利福尼亚州)治疗,他们被分为使用一个≤2.5毫米支架的小血管组(119人)和使用一个≥2.75毫米支架的非小血管组(933人)。主要终点是以患者为导向的综合结果(POCO),即12个月内全因死亡、心肌梗死(MI)和任何重复血管再通的综合结果。关键的次要终点是以设备为导向的综合结果(DOCO),即12个月时心血管死亡、靶血管心肌梗死和靶病变血管再通的综合结果。小血管组患者多为女性、高血压患者,较少出现ST段抬高的心肌梗死,更多接受左侧环状动脉治疗,而非小血管组患者多为B2/C型病变,接受血管内超声检查,并接受非分叶肝素治疗。在倾向匹配队列中,小血管组和非小血管组的平均支架直径分别为 2.5±0.0 毫米和 3.1±0.4 毫米。经倾向调整后,12 个月时小血管组的 POCO 为 6.0%,非小血管组为 4.3%(P=0.558)。12 个月时的 DOCO 无明显差异(小血管组:4.3%,非小血管组:1.7%,p=0.270)。在真实世界的韩国患者中,XIENCE EES治疗小血管疾病的疗效在12个月的临床随访中与治疗非小血管疾病的疗效相当。
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引用次数: 0
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Chonnam medical journal
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