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【流行的乳腺癌局部治疗方案对受控临床试验以外的生存的影响：印度北部一家专业乳腺部门的经验。】
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DOI：10.1007/s00268-006-0037-1
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BACKGROUND & AIMS: BACKGROUND:This study aimed at analyzing different treatments of breast cancer (BC) prevalent in the region, their effect on patients' survival, and discusses the most suitable method within available resources. METHODS:The study was set up at a tertiary care hospital in north India. We retrospectively reviewed data of 473 female BC patients who attended the departments of Surgical Oncology and Radiotherapy from January 1997 to December 1999. Patients with cTNM stage IV and inoperable stage III were included; those who defaulted or were lost to follow-up were excluded. Out of 473 patients, 372 were selected. The selected patients were divided into groups on the basis of place and type of local treatment they received: (1) local excision only, (2) standard breast conservation therapy (BCT), (3) total mastectomy (TM) + axillary lymph node dissection + radiotherapy (RT), and (4) modified radical mastectomy (MRM) + RT. Data regarding recurrence and survival were analyzed in December 2005. Minimum follow-up was 6 years. RESULTS:Overall recurrence rates were significantly higher in patients operated elsewhere (P <0.0001). Of 194 operated at our Breast Unit, 25 (14.6%) of 171 MRM patients and none of 23 BCT had recurrence. Of 178 patients operated elsewhere, 44 (100%), 6 (42.9%), 41 (41%), and 8 (40%) developed recurrence in groups 1, 2, 3, and 4 respectively. Overall survival was significantly better in patients with MRM at our unit versus TM outside (93.6% vs. 80%). CONCLUSIONS:Several types of treatment from improper local excision alone, BCT, TM, to a carefully done MRM are prevalent here. Properly done, MRM yields significant local control with survival benefit and appears to remain the gold standard in management of our BC patients.背景与目标： 背景：本研究旨在分析该地区流行的乳腺癌（BC）的不同治疗方法，它们对患者生存的影响，并在可用资源范围内讨论最合适的方法。
方法：该研究是在印度北部的一家三级保健医院进行的。我们回顾性回顾了1997年1月至1999年12月就诊于外科肿瘤和放射治疗科的473例女性BC患者的数据。那些违约或失去随访的人被排除在外。在473名患者中，选择了372名。根据所接受的局部治疗的位置和类型将选定的患者分为几类：（1）仅局部切除，（2）标准乳房保留疗法（BCT），（3）全乳房切除术（TM）腋窝淋巴结清扫术放射疗法（RT）和（4）改良根治性乳房切除术（MRM）RT。有关复发和生存的数据于2005年12月进行了分析。最低随访时间为6年。
结果：在其他地方手术的患者的总体复发率显着更高（P <0.0001）。在我们的乳房科进行的194例手术中，171例MRM患者中有25例（占14.6％），而23例BCT均未复发。在178例在其他地方手术的患者中，分别在第1、2、3和4组中复发了44例（100％），6例（42.9％），41例（41％）和8例（40％）复发。我们单位的MRM患者的总生存期明显优于室外TM（93.6％vs. 80％）。
结论：从单独的不当局部切除，BCT，TM到精心制作的MRM的几种治疗方法在这里很普遍。正确完成后，MRM可以产生明显的局部控制并具有生存获益，并且似乎仍然是我们BC患者治疗的金标准。 -
2 Are success and survival rates of early implant placement higher than immediate implant placement?
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【早期植入植入物的成功率和存活率是否高于立即植入植入物？】
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DOI：10.1016/j.ijom.2012.10.014
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BACKGROUND & AIMS: :Immediate placement refers to the placement of an implant into a tooth socket at the time of extraction; early placement refers to the placement of an implant after substantial gingival healing, but before any clinically significant bone fill occurs within the socket. This study evaluated the success and survival rates of implants following immediate and early placement. 50 implants were placed in 36 patients. 26 immediate (group I) and 24 early placements (group II) were performed. Pain or tenderness with function, mobility, radiographic bone loss from initial surgery and exudate history were evaluated. Mean vertical bone loss in the immediate placement group was 0.55 mm and 0.80 mm in the early placement group. The survival rate for the immediate placement group was 96.16% with 51.6 months follow-up and in the early placement group was 100% with 61.9 months follow-up. The results of this study suggest that although the success and survival rates of early placed implants were a little higher and the follow up period was longer than immediately placed implants, the difference was not remarkable. In conclusion, both implant insertion techniques are safe and reliable procedures with considerably high survival rates.背景与目标： ：立即放置是指拔出时将植入物放置在牙槽中；早期放置是指在基本的牙龈愈合之后但在窝内发生任何临床上显着的骨填充之前的植入物放置。这项研究评估了立即和早期放置后植入物的成功率和存活率。在36例患者中放置了50个植入物。进行了26例即刻（I组）和24例早期放置（II组）。评估疼痛或压痛以及功能，活动性，初次手术的影像学骨丢失和渗出液病史。立即放置组的平均垂直骨丢失为0.55 mm，早期放置组为0.80 mm。立即安置组的生存率为96.16％，随访时间为51.6个月，早期安置组的生存率为100％，随访时间为61.9个月。这项研究的结果表明，尽管早期放置的植入物的成功率和存活率比立即放置的植入物更高，并且随访时间更长，但差异并不明显。总之，两种植入物插入技术都是安全可靠的方法，具有很高的生存率。 -
【切除无名静脉原发性平滑肌肉瘤后的长期生存一例报告。】
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BACKGROUND & AIMS: :Leiomyosarcoma of the innominate vein is a rare but usually lethal disease. We report the case of a 50-year-old woman, undergoing a curative resection of the tumor. She is alive and free of disease at 88-month follow-up. Surgical excision remains the current optimal treatment able to provide a chance of cure. KEY WORDS: Late survival, Venous leiomyosarcoma.背景与目标： 无名静脉平滑肌肉肉瘤是一种罕见但通常致命的疾病。我们报道了一名50岁妇女的病例，该患者正在接受肿瘤的根治性切除。在88个月的随访中，她还活着并且没有疾病。手术切除仍然是目前能够提供治愈机会的最佳治疗方法。关键词：晚期生存，静脉平滑肌肉肉瘤。
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【在2002年至2012年期间治疗的瑞典肾细胞癌患者的总生存期：RENCOMP研究的更新以及同步转移和老年人群的亚组分析。】
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DOI：10.1016/j.urolonc.2017.05.013
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BACKGROUND & AIMS: BACKGROUND:This retrospective study investigated overall survival (OS) and factors influencing OS in Swedish patients with metastatic renal cell carcinoma (mRCC) during the pre- (2002-2005), early (2006-2008), and late (2009-2012) targeted therapy (TT) era. METHODS:Three national Swedish registries identified patients with mRCC. Median OS was estimated using the Kaplan-Meier method. Multivariate analysis was performed using Cox proportional hazards regression. Subgroup analysis was conducted for patients with synchronous metastases (M1) and the elderly (aged≥75y). RESULTS:A total of 4,217 patients with mRCC were identified, including 1,533 patients with M1 and 1,275 elderly patients. For patients with mRCC diagnosed in 2002 to 2005, 2006 to 2008, and 2009 to 2012, median OS was 10.0, 13.0, and 18.0 months. Similarly, median OS improved in the M1 and elderly populations. Elderly patients were less likely to be prescribed TT (≥75 vs.<75y): 18.3 vs. 63.5% (in 2006-2008) and 28.6% vs. 55.9% (in 2009-2012). Diagnosis of mRCC in 2009 to 2012, nephrectomy and TT prescription were associated with improved OS in the total mRCC, M1, and elderly populations. CONCLUSION:This real-world study showed continued significant improvement in mRCC OS during the late TT era, including in M1 and elderly populations. TT should be considered for all patients with mRCC based on tolerability, regardless of age.背景与目标： 背景：这项回顾性研究调查了瑞典转移性肾细胞癌（mRCC）患者在治疗前（2002-2005），早期（2006-2008）和晚期（2009-2012）的总体生存率（OS）和影响OS的因素。靶向治疗（TT）时代。
方法：瑞典的三个国家登记册确定了mRCC患者。中位数操作系统是使用Kaplan-Meier方法估算的。使用Cox比例风险回归进行多变量分析。对同步转移患者（M1）和老年人（年龄≥75岁）进行亚组分析。
结果：共鉴定出4,217例mRCC患者，其中1,533例M1患者和1,275例老年患者。对于2002年至2005年，2006年至2008年以及2009年至2012年诊断为mRCC的患者，中位OS为10.0、13.0和18.0个月。同样，M1和老年人口的OS中位数有所改善。老年患者接受TT的可能性较小（≥75 vs. <75y）：18.3 vs. 63.5％（在2006-2008年）和28.6％vs. 55.9％（在2009-2012年）。 2009年至2012年对mRCC的诊断，肾切除术和TT处方与总mRCC，M1和老年人口的OS改善相关。
结论：这项真实世界的研究表明，在TT时代后期，包括M1和老年人群，mRCC OS持续显着改善。对于所有mRCC患者，无论年龄大小，均应考虑TT。 -
【上皮干样细胞中增高的脂肪生成赋予乳腺导管原位癌的生存优势。】
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DOI：10.1038/onc.2012.519
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BACKGROUND & AIMS: :Upregulation of lipogenesis is a hallmark of cancer and blocking the lipogenic pathway is known to cause tumor cell death by apoptosis. However, the exact role of lipogenesis in tumor initiation is as yet poorly understood. We examined the expression profile of key lipogenic genes in clinical samples of ductal carcinoma in situ (DCIS) of breast cancer and found that these genes were significantly upregulated in DCIS. We also isolated cancer stem-like cells (CSCs) from DCIS.com cell line using cell surface markers (CS24(-)CD44(+)ESA(+)) and found that this cell population has significantly higher tumor-initiating ability to generate DCIS compared with the non-stem-like population. Furthermore, the CSCs showed significantly higher level of expression of all lipogenic genes than the counterpart population from non-tumorigenic breast cancer cell line, MCF10A. Importantly, ectopic expression of SREBP1, the master regulator of lipogenic genes, in MCF10A significantly enhanced lipogenesis in stem-like cells and promoted cell growth as well as mammosphere formation. Moreover, SREBP1 expression significantly increased the ability of cell survival of CSCs from MCF10AT, another cell line that is capable of generating DCIS, in mouse and in cell culture. These results indicate that upregulation of lipogenesis is a pre-requisite for DCIS formation by endowing the ability of cell survival. We have also shown that resveratrol was capable of blocking the lipogenic gene expression in CSCs and significantly suppressed their ability to generate DCIS in animals, which provides us with a strong rationale to use this agent for chemoprevention against DCIS.背景与目标： ：脂肪生成的上调是癌症的标志，已知阻断脂肪生成途径会通过凋亡导致肿瘤细胞死亡。然而，尚不清楚脂肪生成在肿瘤起始中的确切作用。我们检查了乳腺导管原位癌（DCIS）临床样品中关键脂肪形成基因的表达谱，发现这些基因在DCIS中显着上调。我们还使用细胞表面标记（CS24（-）CD44（）ESA（））从DCIS.com细胞系中分离了癌干样细胞（CSCs），发现与该细胞相比，该细胞群具有更高的产生DCIS的肿瘤启动能力与非茎状种群。此外，CSCs显示所有脂肪形成基因的表达水平均高于非致瘤性乳腺癌细胞系MCF10A的对应群体。重要的是，MCF10A中脂生成基因的主要调控因子SREBP1的异位表达显着增强了干细胞样脂质的生成，并促进了细胞的生长以及乳球的形成。此外，SREBP1表达显着提高了来自MCF10AT的CSC细胞的存活能力，MCF10AT是另一种能够在小鼠和细胞培养物中产生DCIS的细胞系。这些结果表明，通过赋予细胞存活能力，脂肪生成的上调是DCIS形成的先决条件。我们还表明，白藜芦醇能够阻断CSC中脂肪基因的表达，并显着抑制其在动物体内生成DCIS的能力，这为我们提供了使用该药物化学预防DCIS的强大理由。
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【血液透析开始前合并症的进展是事件患者生存的重要预测指标。】
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DOI：10.1093/ndt/gfs512
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BACKGROUND & AIMS: BACKGROUND:Most studies investigate the association between the baseline Romano-Charlson comorbidity index (CCI) and survival on hemodialysis (HD). Few consider the effect of progression in the CCI score (CCIp) on patient survival before HD initiation. That is CCIp = CCI-1 - CCI-3, where CCI(-1) is the CCI score in the first year before HD initiation, and CCI-3 is the CCI score in the third year before HD initiation. The present study investigated whether CCIp affects the survival of incident HD patients. METHODS:Using the National Health Insurance (NHI) Research Database of Taiwan, we recruited 7391 adult incident HD patients in the year 2006 for this historical cohort study. We followed the cohort until the end of 2007. Using the Romano-Charlson method, each comorbidity was assigned a score of 1, 2, 3 or 6. The scores were then summed to produce a total score (CCI), which predicts mortality. The log-rank test and a Cox regression model were used to analyze the association between CCIp and survival, and the risk markers of survival. RESULTS:Diabetes, ulcers, congestive heart failure, chronic pulmonary disease and cerebrovascular disease were the most common comorbid conditions. The median CCI-3 was 2 (interquartile range 0-3). The overall survival rate in 1 year was 82.8%. In incident patients with a CCI-3 score of <3, the rate was 85.1%, and in patients with a CCI-3 score of ≥ 3, the rate was 76.8%. Each increase of one point in the CCI-3 score (HR = 1.69, 95% CI 1.42-2.01) and the CCIp (HR = 1.22, 95% CI 1.17-1.27) affected survival in HD patients. CONCLUSIONS:The CCI-3 and CCIp before HD initiation are valuable predictors of survival in incident patients.背景与目标： 背景：大多数研究调查了基线罗曼诺-查尔森合并症指数（CCI）与血液透析生存率（HD）之间的关联。很少有人考虑开始HD之前CCI评分（CCIp）的进展对患者生存的影响。那就是CCIp = CCI-1-CCI-3，其中CCI（-1）是HD启动前第一年的CCI得分，而CCI-3是HD启动前第三年的CCI得分。本研究调查了CCIp是否会影响HD患者的生存。
方法：利用台湾国家健康保险（NHI）研究数据库，我们在2006年招募了7391名成人事件高清患者进行这项历史性队列研究。我们追踪了该队列直到2007年底。使用Romano-Charlson方法，为每个合并症分配了1、2、3或6分。然后将这些总和相加得出总分（CCI），该总分可预测死亡率。使用log-rank检验和Cox回归模型来分析CCIp和生存之间的关联以及生存的风险标记。
结果：糖尿病，溃疡，充血性心力衰竭，慢性肺部疾病和脑血管疾病是最常见的合并症。中位数CCI-3为2（四分位间距0-3）。 1年总生存率为82.8％。在CCI-3得分<3的事件患者中，该比率为85.1％，在CCI-3得分≥3的患者中，该比率为76.8％。 CCI-3评分（HR = 1.69，95％CI 1.42-2.01）和CCIp（HR = 1.22，95％CI 1.17-1.27）每增加1分，都会影响HD患者的生存率。
结论：HD开始前的CCI-3和CCIp是事件患者生存的重要预测指标。 -
【血清甲胎蛋白的半衰期：肝细胞癌肝切除术后复发和生存的早期预后指标。】
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DOI：10.1097/SLA.0b013e318273be70
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BACKGROUND & AIMS: OBJECTIVE:To explore the prognostic value of the postsurgical half-life (HL) of serum alpha-fetoprotein (AFP). BACKGROUND:There is still a paucity of early surrogate indicators of clinical endpoints after liver resection of hepatocellular carcinoma (HCC). METHODS:The analysis was based on cohorts of 225 (exploration set) and 117 (validation set) treatment-naïve HCC patients undergoing curative liver resection. We defined 3 categories of AFP HL: early complete resolution of AFP, normal HL, and prolonged HL if the HL exceeded 7 days. Overall, probabilities of recurrence and survival were estimated and compared across the AFP HL categories. RESULTS:In the exploration cohort, 48 patients (21.3%) achieved early AFP complete resolution, 116 (51.6%) had normal HL, and 61 (27.1%) had prolonged HL. Long AFP HL was significantly associated with early postoperative recurrence (P < 0.001), as was microvascular invasion. Early recurrence within 2 years of resection was observed in 59% of the patients with prolonged AFP HL compared with only 29.3% of those with normal AFP HL (P < 0.001). A log-rank test followed by multivariate Cox analysis identified an independent function of prolonged AFP HL in predicting shorter recurrence-free survival and overall survival time after HCC resection (hazard ratios, 2.81 and 3.58; P < 0.001). When AFP HL analysis was applied to the validation cohort, the association between prolonged AFP HL and survival endpoints (hazard ratio, 11.63 and 16.39; P < 0.001) was confirmed.背景与目标： 目的：探讨血清甲胎蛋白（AFP）的术后半衰期（HL）的预后价值。
背景：肝切除肝细胞癌（HCC）后仍缺乏临床终点的早期替代指标。
方法：该分析基于225例（探索组）和117例（验证组）未进行过根治性肝切除的未接受治疗的HCC患者的分析。我们定义了AFP HL的3个类别：AFP的早期完全消退，正常HL和如果HL超过7天则延长HL。总体而言，估计并比较了AFP HL类别中复发和存活的可能性。
结果：在探索队列中，有48例（21.3％）的患者达到了AFP的早期完全缓解，HL正常的116例（51.6％），HL延长的61例（27.1％）。长期AFP HL与微血管浸润与术后早期复发显着相关（P <0.001）。 AFP HL延长的患者中有59％的患者在切除后2年内出现了早期复发，而AFP HL正常的患者中只有29.3％（P <0.001）。对数秩检验和随后的多元Cox分析确定了AFP HL延长在预测肝癌切除术后较短的无复发生存期和总生存期方面具有独立的功能（危险比，2.81和3.58； P <0.001）。当将AFP HL分析应用于验证队列时，证实了延长的AFP HL与生存终点之间的关联（危险比：11.63和16.39； P <0.001）。 -
【阿霉素扩张型心肌病的心脏移植生存结果。】
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DOI：10.1016/j.amjcard.2012.10.048
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BACKGROUND & AIMS: :In 2015, there will be an estimated 11.3 million cancer survivors. With an increasing population of cancer survivors, it is imperative to understand the treatment options available and outcomes for chemotherapy-related cardiomyopathy. Anthracycline-based chemotherapy causes heart failure in approximately 5% of patients. Orthotopic heart transplantation (OHT) is an option for cancer survivors in complete remission who develop end-stage heart failure. We examined retrospective OHT data collected from the United Network of Organ Sharing from 1987 to 2011. The primary aim was to characterize the survival in patients with either the primary diagnosis of "dilated cardiomyopathy: Adriamycin" (DCA) versus "all other" causes of cardiomyopathy. The secondary aim was to define the differences in the primary cause of death and to describe the temporal relationship of DCA OHT. The United Network of Organ Sharing database identified 453 OHTs for the diagnosis of DCA and 51,312 OHTs for all other causes of cardiomyopathy. The DCA group was significantly younger with a greater percentage of women. After adjusting for age, gender, and history of malignancy, the 10-year survival curves showed that patients with DCA have an improved survival compared to those with all other causes of cardiomyopathy (hazard ratio 1.28, p = 0.026). No difference was found in the primary cause of death between the 2 groups. A statistically significant increasing temporal trend was seen in the number of OHTs for the diagnosis DCA. In conclusion, patients who undergo OHT for DCA have favorable 10-year survival, making OHT a good therapeutic option for end-stage heart failure due to anthracyclines. Additionally, no increased risk of cancer-related deaths was found in the DCA group, demonstrating that recurrent malignancy does not affect long-term survival. The temporal trends demonstrated that DCA remains a significant problem for cancer survivors.背景与目标： ：2015年，估计将有1,130万癌症幸存者。随着癌症幸存者人数的增加，必须了解可用的治疗方案和化疗相关性心肌病的预后。基于蒽环类的化学疗法在大约5％的患者中引起心力衰竭。原位心脏移植（OHT）是完全缓解并发展为晚期心力衰竭的癌症幸存者的一种选择。我们检查了从1987年至2011年从器官共享联合网络收集的回顾性OHT数据。主要目的是鉴定患有“扩张型心肌病：阿霉素”（DCA）的主要诊断与“其他所有”原因的患者的生存特征。心肌病。第二个目的是确定主要死亡原因的差异，并描述DCA OHT的时间关系。器官共享网络联合会确定了用于诊断DCA的453个OHT，以及所有其他引起心肌病的原因的51,312个OHT。 DCA组明显年轻，女性比例更高。在对年龄，性别和恶性肿瘤病史进行调整后，10年生存曲线显示DCA患者的生存率比所有其他原因的心肌病患者高（危险比1.28，p = 0.026）。两组之间的主要死亡原因均未发现差异。诊断DCA的OHT数量出现了统计上显着增加的时间趋势。总之，接受OHT进行DCA治疗的患者具有良好的10年生存期，这使OHT成为治疗因蒽环类药物所致晚期心力衰竭的良好治疗选择。此外，在DCA组中未发现与癌症相关的死亡风险增加，表明复发性恶性肿瘤不会影响长期生存。时间趋势表明，DCA对于癌症幸存者仍然是一个重大问题。
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【在同种异体BMT中，验证院内护理伙伴支持对患者生存的积极影响：一项前瞻性研究。】
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DOI：10.1038/bmt.2012.208
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BACKGROUND & AIMS: :This prospective study validates the finding from retrospective research that having an inpatient lay care-partner (CP) is associated with better survival following allogeneic BMT. Compared with patients without a CP (n=76), patients with a CP (n=88) have significantly better OS (P=0.017) and relapse-free survival (RFS) (P=0.020). Four-year and median survivals were 42% and 36 months among patients with CPs, compared with 26% and 10 months among those without CPs. Four-year survival and median RFS were 39% and 25 months among those with CPs, compared with 23% and 7 months among those without CPs. Further, better survival and RFS were associated with CP visit duration of >3 h per day (P=0.005 and P=0.007, respectively) and with CP frequency of visits >75% of inpatient days (P=0.004 and P=0.010, respectively). A CP support program should encourage not only presence of a CP but also duration and frequency of CP visits associated with better patient survival.背景与目标： ：这项前瞻性研究证实了回顾性研究的发现，即同种异体BMT可使住院的专业护理伙伴（CP）与更好的生存率相关。与没有CP的患者（n = 76）相比，具有CP的患者（n = 88）的OS（P = 0.017）和无复发生存率（RFS）（P = 0.020）明显更好。 CPs患者的四年和中位生存期分别为42％和36个月，而没有CPs的患者则为26％和10个月。有CP的患者的四年生存率和中位RFS分别为39％和25个月，而没有CP的患者为23％和7个月。此外，更好的生存率和RFS与CP访视持续时间每天> 3 h（分别为P = 0.005和P = 0.007）以及CP访视频率>住院天数的75％相关（P = 0.004和P = 0.010，分别）。 CP支持计划不仅应鼓励CP的存在，还应鼓励CP探访的持续时间和频率，以提高患者的生存率。
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10 CD11c expression in chronic lymphocytic leukemia revisited, related with complications and survival.
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【CD11c在慢性淋巴细胞性白血病中的表达被重新审视，与并发症和生存有关。】
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DOI：10.1111/ijlh.12695
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BACKGROUND & AIMS: INTRODUCTION:Chronic lymphocytic leukemia (CLL) is a disorder of mature but dysfunctional monoclonal B cells. Microenvironment, antigenic stimulation and genetical mutations are demonstrated in etiopathogenesis. We aimed to evaluate the expression of CD11c in patients with CLL and its possible clinical significance. METHODS:Data of 259 patients with CLL between 2010 and 2016 in Trakya University Faculty of Medicine, including age at diagnosis, sex, whole blood count, stage, percentage of CLL cells in bone marrow, line of treatments, development of Richter's transformation and secondary tumors, autoimmune complications, IgG level, prognostic cytogenetic analysis, and length of survival were recorded from files. RESULTS:151 patients were male (58.3%) and 108 were male (41.7%). Mean age was 70 (21-92) years. CD11c was observed to be positive (>%20) in 103 patients (39.8%). Development of Richter's transformation, secondary tumors and ITP was significantly frequent in patients with CD11c positivity (P values .000, .003, .000 respectively). Also, IgG levels were significantly lower in this group (P = .000). Hemoglobin level, RAI stage and bone marrow CLL infiltration percentage were statistically related with CD11c (P values .036, .037, .000 respectively). Finally, CD11c was statistically related (in positive group 70 months, negative group 79 months, P = .001). CONCLUSION:CD11c, expressed not only in Hairy cell leukemia but also in dendritic cells, macrophages and monocytes is a differentiation marker for inflammation. Prolonged inflammation in the microenvironment of CLL cells may cause a susceptibility to autoimmune disorders and secondary tumors in CLL, in this way, an increase in mortality.背景与目标： 简介：慢性淋巴细胞性白血病（CLL）是一种成熟但功能失调的单克隆B细胞疾病。微环境，抗原刺激和遗传突变已在病因学中得到证实。我们旨在评估CD11c在CLL患者中的表达及其可能的临床意义。
方法：特拉基亚大学医学院2010年至2016年间259例CLL患者的数据，包括诊断年龄，性别，全血细胞计数，分期，骨髓CLL细胞百分比，治疗方法，里氏转化的发展和继发性从文件中记录肿瘤，自身免疫并发症，IgG水平，预后细胞遗传学分析和生存期。
结果：男性151例，占58.3％；男性108例，占41.7％。平均年龄为70（21-92）岁。在103例患者中（39.8％）观察到CD11c阳性（>）。 CD11c阳性患者中Richter转化，继发性肿瘤和ITP的发生非常频繁（分别为P值.000，.003，.000）。此外，该组的IgG水平显着降低（P = .000）。血红蛋白水平，RAI分期和骨髓CLL浸润百分比与CD11c具有统计学相关性（P值分别为.036，.037和.000）。最后，CD11c具有统计学相关性（阳性组70个月，阴性组79个月，P = .001）。
结论：CD11c不仅在毛细胞白血病中表达，而且在树突状细胞，巨噬细胞和单核细胞中表达，是炎症的分化标志。 CLL细胞微环境中的长时间炎症可能会导致自身免疫性疾病和CLL中继发性肿瘤的易感性，从而增加死亡率。 -
【对转移到区域烧伤中心的患者进行的结果分析：转移状态不会影响生存。】
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DOI：10.1016/j.burns.2006.04.001
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BACKGROUND & AIMS: BACKGROUND:Optimal burn care is provided at specialized burn centers. Given the geographic location of these centers, many burn patients receive initial treatment at local emergency departments prior to transfer. The purpose of this study was to determine whether patients transferred from other facilities have worse outcomes than those admitted directly from the field. STUDY DESIGN:A retrospective cohort study was performed comparing the outcomes of patients admitted to our burn center directly from the field with patients requiring transfer from a preliminary care facility. The outcomes of interest were mortality, length of stay, length of stay/TBSA burned, number of operations and hospital charges. Poisson regression or Cox proportional hazards model was used to evaluate differences in outcomes after adjusting for potential confounders. RESULTS:From 2000 to 2003 a total of 1877 patients were admitted to our burn center and 953 (51%) were transferred from a preliminary care facility. No difference (p<0.05) was found in length of stay, number of operations, hospital charges and mortality between the two cohorts. CONCLUSIONS:This study demonstrates that patients transferred to a regional burn center from local hospitals have equivalent mortality, length of stay and hospital charges as those admitted directly from the field.背景与目标： 背景：在专门的烧伤中心提供最佳的烧伤护理。考虑到这些中心的地理位置，许多烧伤患者在转移之前会先在当地急诊科接受初步治疗。这项研究的目的是确定从其他机构转移来的患者是否比直接从现场接受的患者具有更差的结局。
研究设计：进行了一项回顾性队列研究，比较了直接从现场进入我们烧伤中心的患者与需要从初级保健机构转诊的患者的结局。感兴趣的结果是死亡率，住院时间，住院时间/ TBSA烧伤，手术次数和医院费用。泊松回归或Cox比例风险模型用于评估潜在混杂因素后评估结局的差异。
结果：从2000年到2003年，共有1877名患者被收录到我们的烧伤中心，其中953名（51％）从初级护理机构转入了治疗。两组的住院时间，手术次数，住院费用和死亡率均无差异（p <0.05）。
结论：这项研究表明，从当地医院转移到区域烧伤中心的患者的死亡率，住院时间和住院费用与直接从现场接受的患者相同。 -
【胃癌和结直肠癌肝转移之间生存期的比较。】
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BACKGROUND & AIMS: BACKGROUND/AIM:The outcome after hepatectomy and non-surgical treatment of liver metastases from gastric and colorectal malignancies are reported.
METHODOLOGY:Between April 1988 and March 1994, 176 patients with metastatic liver cancer were treated at the First Department of Surgery, Kyoto Prefectural University of Medicine Hospital.
RESULTS:All patients received multi-disciplinary treatment, and 51 underwent hepatectomy. The survival after hepatectomy for metastatic liver cancer from a colorectal primary was better than that for gastric cancer. The survival after hepatic arterial infusion (HAI) therapy for metastases from gastric cancer was better than that for colorectal cancer.
CONCLUSION:Surgical resection may be the best treatment for liver metastases from colorectal cancer. HAI may be a better option for liver metastases from gastric cancer.
背景与目标： BACKGROUND / AIM ：报道了肝切除和非手术治疗胃和大肠恶性肿瘤肝转移后的结果。
方法：于1988年4月至1994年3月，京都府立医科大学附属医院第一外科收治了176例转移性肝癌患者。
结果：所有患者均接受了多学科治疗，其中51例患者接受了多学科治疗。进行了肝切除术。肝切除术后原发于结直肠癌的转移性肝癌的生存率要好于胃癌。胃癌转移的肝动脉输注（HAI）治疗后的存活率优于结直肠癌。
结论：手术切除可能是结直肠癌肝转移的最佳治疗方法癌症。 HAI可能是胃癌肝转移的更好选择。
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【在全膝关节置换术中股骨植入物的屈曲是否会增加膝盖的屈曲：一项随机对照试验。】
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DOI：10.1016/j.knee.2012.10.028
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BACKGROUND & AIMS: INTRODUCTION:Prosthetic and operative modifications in total knee arthroplasty (TKA) have been proposed to maximise post-operative knee flexion as it is essential in routine functional activities. METHODS:We performed a double blind randomised controlled trial to compare clinical outcomes of primary cruciate-retaining TKA for osteoarthritis with the femoral component implanted in either 4° flexion in the sagittal plane (F) or in a neutral position (C). The primary outcome of knee flexion and secondary outcomes knee extension, quadriceps strength, WOMAC, SF-12v2, timed stand test, stair climb test and satisfaction were assessed at 1 year. Knee flexion and extension were also assessed intra-operatively. Implant flexion was measured from true lateral radiographs. RESULTS:Thirty-nine participants (40 knees) were recruited, 20 knees per group. Three subjects from the control group and two from the flexed group were lost to 1 year follow-up but numbers were sufficient to satisfy the sample size calculation. Significant differences were found between the groups in knee flexion (F: 113.6±8.8° pre-operative, 122.4±6.0° intra-operative, 110.2±7.5° 1 year, C: 117.4±11.7°, 117.4±7.6°, 103.5±10.7°. p=0.031) and mental component score of the SF12-v2 (F 53.3±13.2, C 61.1±7.3, p=0.009) but there were no significant differences in other outcomes and patients were equally satisfied. CONCLUSION:Flexing the femoral implant in this cruciate retaining TKA system provided a significant difference in knee flexion compared to a neutral position. The improvement appears to occur predominantly at surgery and was not associated with a clinical or functional benefit at 1 year. (ACTRN12606000325505). LEVEL OF EVIDENCE:Level 1; randomised controlled trial.背景与目标： 简介：已经提出对全膝关节置换术（TKA）进行假体和手术修改，以最大程度地提高术后膝关节屈曲度，因为它是常规功能活动中必不可少的。
方法：我们进行了一项双盲随机对照试验，比较了在骨矢状面（F）或中性位（C）中以4°屈曲度植入股骨组件的原发性保留骨关节炎的TKA的临床结局。在1年时评估膝关节屈曲的主要结果和膝关节伸展，次股四头肌力量，WOMAC，SF-12v2，定时站立测试，爬楼梯测试和满意度的主要结果。术中还评估了膝盖的屈伸性。从真实的侧位X线照片测量植入物的弯曲度。
结果：招募了39名参与者（40膝），每组20膝。对照组的三名受试者和屈肌训练的三名受试者失去了1年的随访，但数量足以满足样本量的计算。两组之间的膝关节屈曲有显着差异（F：术前113.6±8.8°，术中122.4±6.0°，10.2±7.5°1年，C：117.4±11.7°，117.4±7.6°，103.5± SF12-v2的10.7°。p = 0.031）和精神成分评分（F 53.3±13.2，C 61.1±7.3，p = 0.009），但其他结局无显着差异，患者也同样满意。
结论：在这种十字形保持的TKA系统中弯曲股骨植入物与中立位置相比，在膝关节屈曲方面有显着差异。改善似乎主要发生在手术上，并且在1年时与临床或功能获益无关。 （ACTRN12606000325505）。
证据级别：1级；随机对照试验。 -
【通过人工植入人工耳蜗消除了面部神经刺激。】
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DOI：10.1097/01.mao.0000235374.85739.c6
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BACKGROUND & AIMS: HYPOTHESIS:Perimodiolar intracochlear electrodes with contacts facing towards the modiolus have limited current flow towards the outer wall of the cochlea and therefore, may reduce the occurrence of facial nerve stimulation (FN) in cochlear implant subjects. BACKGROUND:Facial nerve stimulation is a well-known complication in cochlear implant treatment especially in the group of subjects with otosclerosis. The possible explanation of this side effect is a change of the electrical properties of the otosclerotic bone leading to leakage current and resulting in facial nerve stimulation. METHODS:Four CI subjects who had been implanted with a Nucleus Mini22 device with a Nucleus Straight electrode between 9 to 12 years ago suffered from severe FN stimulation. Electrode contacts had to be switched off so that they could only use 4, 11, 13, and 15 electrodes of their usual set of 22. The switch off resulted in deteriorating speech understanding over time. Therefore, all subjects were reimplanted with a Nucleus 24R device with a Contour electrode. Preoperatively, the threshold of FN stimulation was obtained on all electrodes subjectively. Intraoperatively, FN stimulation thresholds were measured objectively with both, the old and the new device and were compared. NRT and SRT thresholds were also obtained with the reimplanted device to assure effective electrical stimulation of the auditory nerve. RESULTS:In all four cases the postoperative fitting demonstrated no FN stimulation on all electrodes up to maximum comfortable level. The insertion of the Contour electrode array was complete in three cases, in one case the array could only be inserted partially similarly to the situation before the reimplantation. Speech perception tests showed a significant improvement in all subjects with the new device. CONCLUSION:Electrodes with modiolar facing contacts and perimodiolar position like the Nucleus Contour electrode reduce the possibility of facial nerve stimulation significantly due to more focused electrical stimulation.背景与目标： 假设：耳蜗周围的耳蜗内电极面向耳蜗，电流流向耳蜗外壁的电流有限，因此可以减少人工耳蜗植入对象面部神经刺激（FN）的发生。
背景：面神经刺激是耳蜗植入治疗中众所周知的并发症，尤其是在耳硬化症患者群体中。这种副作用的可能解释是耳硬化骨的电特性发生变化，导致漏电流并导致面神经刺激。
方法：4名在9至12年前之间植入带有Nucleus直电极的Nucleus Mini22装置的CI受试者遭受了严重的FN刺激。必须关闭电极触点，以便它们只能使用其通常的22组电极中的4、11、13和15个电极。断开会导致语音理解随着时间的流逝而变差。因此，所有受试者均被植入带有轮廓电极的Nucleus 24R装置。术前，主观地在所有电极上获得FN刺激的阈值。术中用新旧设备客观测量FN刺激阈值，并进行比较。 NRT和SRT阈值也可以通过重新植入的设备获得，以确保对听神经进行有效的电刺激。
结果：在所有四种情况下，术后佩戴均未显示在最大舒适度下所有电极上均未受到FN刺激。在三种情况下，轮廓电极阵列的插入均已完成，在一种情况下，只能与再植入前的情况部分相似地插入阵列。语音感知测试显示，使用新设备后，所有受试者的感觉都有明显改善。
结论：具有模块化的面对面接触和电极周围位置的电极（如Nucleus Contour电极）可通过更加集中的电刺激显着降低面部神经刺激的可能性。 -
【Bcl-x和免疫系统中生存的调节。】
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DOI：10.1007/BF02786359
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BACKGROUND & AIMS: A variety of experimental models indicate that programmed cell death, or apoptosis, of lymphocytes is a key mechanism in the homeostatic regulation of immunity. Apoptosis is important in early B- and T-cell development to delete cells with nonfunctional antigen receptors, and is also critical for censoring self-reactive cells at the immature lymphocyte stage and at various stages after lymphocytes reach maturity. In this article we focus on the role of the apoptosis regulatory gene bcl-x in controlling survival during lymphocyte development and following B- and T-cell activation. Interesting parallels are observed for bcl-x expression between the B- and T-lineages. The available data also indicate that bcl-x and bcl-2 are expressed in reciprocal patterns during the lifespan of a lymphocyte, suggesting unique regulatory roles for these two survival proteins.
背景与目标： 多种实验模型表明，淋巴细胞程序性死亡或凋亡是免疫稳态调节的关键机制。凋亡在早期B细胞和T细胞发育中很重要，以删除具有非功能性抗原受体的细胞，对于检查未成熟淋巴细胞阶段和淋巴细胞成熟后各个阶段的自反应性细胞也至关重要。在本文中，我们重点研究凋亡调控基因bcl-x在控制淋巴细胞发育以及B细胞和T细胞活化过程中的存活中的作用。在B谱系和T谱系之间观察到bcl-x表达有趣的相似之处。现有数据还表明，bcl-x和bcl-2在淋巴细胞的生命周期中以相互表达的方式表达，表明这两种存活蛋白具有独特的调节作用。
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