ABSTRACT
Objective To observe the efficacy and side effects of anlotinib combined with paclitaxel and cisplatin as the first-line treatment of advanced esophageal squamous cell carcinoma (ESCC). Methods We retrospectively analyzed 50 cases of advanced esophageal squamous cell carcinoma diagnosed pathologically. Among them, 24 cases were treated with the combination of anlotinib and paclitaxel plus cisplatin (experimental group), and 26 cases were treated with paclitaxel plus cisplatin regimen (control group). The efficacy and adverse reactions were observed and followed up. Results The objective response rates of the experimental and control groups were 83.33% and 53.84% (P < 0.05), the disease control rates were 100% and 96.15% (P > 0.05), mPFS were 10.6 and 9.13 months (P < 0.05), and mOS were 13.4 and 11.8 months (P < 0.05). The common adverse events in the experimental group were hand-foot syndrome (12.5%), hypertension (12.5%), epistaxis (8.33%) and proteinuria (4.16%), all of which were grade Ⅰ-Ⅱ and controllable without affecting the continuity of chemotherapy. Conclusion The combination of anlotinib, paclitaxel and cisplatin as the first-line treatment of advanced esophageal squamous cell carcinoma can improve the curative effect and the adverse effects are endurable.
ABSTRACT
Objective This study aims to explore the risk factors of hemorrhagic transformation (HT),and compare the predictive ability of different predictive models.Methods Retrospective analysis of clinical data of patients with intravenous thrombolysis in our hospital from June 2015 to June 2018.The risk factors were statistically analyzed.The results were fitted into a new predictive model named MODEL.The area under receiver operating characteristic (ROC) curve was used to compare the predictive ability of the MODEL and some traditional methods including the Multicenter Stroke Survey (MSS),and the Totaled Health Risks In Vascular Events Score (THRIVE),and the Glucose at presentation,Race,Age,Sex,systolic blood Pressure at presentation,Severity of stroke at presentation (GRASPS) to HT.Results The results of single factor analysis showed that there were significant differences in the history of hypertension,the history of atrial fibrillation,the systolic pressure before thrombolysis,the National Institute of Health Stroke Scale (NIHSS) score before thrombolysis,the level of plasma total cholesterol (TG),low density lipoprotein cholesterol (LDL-C),apolipoprotein B (Apo B),D dimer (DD),and the platelet distribution width and the sodium ion.Multivariate logistic regression analysis confirmed that the NIHSS score before thrombolysis,the level of plasma LDL-C and DD were independent risk factors for HT.The formation of a new predictive model was logi(p) =0.21 +0.99 × NIHSSscore-0.834 × LDL-C +0.002 × DD,which was defined as predictive mode of MODEL.The four predictive models all had predictive effects on HT.Z test results showed that,compared with the GRASPS,the MODEL and MSS showed a higher predictive power.Conclusions The NIHSS score before thrombolysis,and the level of plasma LDL-C,and DD were independent risk factors for HT after intravenous thrombolysis.MODEL and MSS had better predictive performance.
ABSTRACT
Intravenous thrombolysis is one of the most effective methods for the treatment of acute cerebral infarction.However,secondary hemorrhagic transformation after thrombolysis is a serious complication.Many studies have shown that hypofibrinemia and severe damage to the blood-brain barrier are important causes of this result.Bleeding after thrombolysis is not caused by a single factor.Foreign countries have more predictive research models for hemorrhagic transformation.Various research results have their own advantages and disadvantage.Domestic research is still scarce.This article reviews the pathogenesis,classification and prediction models of hemorrhagic transformation after intravenous thrombolysis.