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The paper dilates upon purpose and meaning of the building of multipath remote consultation platform based on medical alliance,introduces its building scheme,which includes implementation method,technology roadmap and technology feasibility analysis,compares the domestic and overseas situations in the area and discusses its future.
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It is unanimously accepted that stroke is a highly heterogeneous disorder.Different subtypes of ischemic stroke may have different risk factors,clinical features,and prognoses.The aim of this study was to evaluate the risk factors,clinical characteristics,and prognoses of different subtypes of ischemic stroke defined by the Trial of ORG10172 in Acute Stroke Treatment (TOAST) criteria.We prospectively analyzed the data from 530 consecutive patients who were admitted to our hospital with acute ischemic stroke within 7 days of stroke onset during the study period.Standardized data assessment was used and the cause of ischemic stroke was classified according to the TOAST criteria.Patients were followed up till 30 and 90 days after stroke onset.It was found that large-artery atherosclerosis was the most frequent etiology of stroke (37.4％),and showed the highest male preponderance,the highest prevalence of previous transient ischemic attack,and the longest hospital stay among all subtypes.Small artery disease (36.4％) was associated with higher body mass index,higher plasma triglycerides,and lower plasma high-density lipoprotein cholesterol than cardioembolism.Cardioembolism (7.7％),which was particularly common in the elderly (i.e.,individuals aged 65 years and older),showed the highest female preponderance,the highest prevalence of atrial fibrillation,the earliest presentation to hospital after stroke onset,the most severe symptoms on admission,the maximum complications associated with an adverse outcome,and the highest rate of stroke recurrence and mortality.Our results suggest that ischemic stroke should be regarded as a highly heterogeneous disorder.Studies involving risk factors,clinical features,and prognoses of ischemic stroke should differentiate between etiologic stroke subtypes.
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It is unanimously accepted that stroke is a highly heterogeneous disorder.Different subtypes of ischemic stroke may have different risk factors,clinical features,and prognoses.The aim of this study was to evaluate the risk factors,clinical characteristics,and prognoses of different subtypes of ischemic stroke defined by the Trial of ORG10172 in Acute Stroke Treatment (TOAST) criteria.We prospectively analyzed the data from 530 consecutive patients who were admitted to our hospital with acute ischemic stroke within 7 days of stroke onset during the study period.Standardized data assessment was used and the cause of ischemic stroke was classified according to the TOAST criteria.Patients were followed up till 30 and 90 days after stroke onset.It was found that large-artery atherosclerosis was the most frequent etiology of stroke (37.4％),and showed the highest male preponderance,the highest prevalence of previous transient ischemic attack,and the longest hospital stay among all subtypes.Small artery disease (36.4％) was associated with higher body mass index,higher plasma triglycerides,and lower plasma high-density lipoprotein cholesterol than cardioembolism.Cardioembolism (7.7％),which was particularly common in the elderly (i.e.,individuals aged 65 years and older),showed the highest female preponderance,the highest prevalence of atrial fibrillation,the earliest presentation to hospital after stroke onset,the most severe symptoms on admission,the maximum complications associated with an adverse outcome,and the highest rate of stroke recurrence and mortality.Our results suggest that ischemic stroke should be regarded as a highly heterogeneous disorder.Studies involving risk factors,clinical features,and prognoses of ischemic stroke should differentiate between etiologic stroke subtypes.
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Antibody-drug conjugate (ADC) is a new class of therapeutics composed of a monoclonal antibody and small cytotoxin moieties conjugated through a chemical linker. ADC molecules bind to the target antigens expressed on the tumor cell surfaces guided by the monoclonal antibody component. The binding ADC molecules can be internalized and subsequently the toxin moieties can be released within the tumor cells via chemical and/or enzymatic reactions to kill the target cells. The conjugation combines the merits of both components, i.e., the high target specificity of the monoclonal antibody and the highly potent cell killing activity of the cytotoxin moieties. However, such complexities make the pharmacokinetic and metabolic studies of ADCs highly challenging. The major challenges should include characterization of absorption, distribution, metabolism and excretion, investigation of underlying mechanisms, assessment of pharmacokinetic- pharmacodynamic relationship, and analytical method development of ADC drugs. This review will discuss common pharmacokinetic issues and considerations, as well as tools and strategies that can be utilized to characterize the pharmacokinetic and metabolic properties of ADCs.
Subject(s)
Humans , Antibodies, Monoclonal , Pharmacokinetics , Cytotoxins , Pharmacokinetics , Immunoconjugates , Pharmacokinetics , Neoplasms , Drug TherapyABSTRACT
<p><b>OBJECTIVE</b>To evaluate the efficacy and safty of photoselective vaporization of prostate (PVP) in the treatment of benign prostatic hyperplasia with obstruction within 5 years.</p><p><b>METHODS</b>From December 2004 to December 2009, there were 782 cases have been except for neurogenic bladder dysfunction and prostate cancer, who received PVP surgical treatment of BPH. The surgical conditions and postoperative follow-up data were recorded and the follow-up cut-off time for surgery after 5 years.</p><p><b>RESULTS</b>A total of 782 patients with BPH who underwent PVP were included in this retrospective study. The operation in 740 cases was successfully completed at one time. But in other 42 cases, the twice operation was performed. The mean operation time was (85 ± 38) minutes, and the mean energy delivery was (355 ± 124) kJ. The mean catheterization and postoperative hospitalization time was (2.3 ± 1.7) days and (5.2 ± 2.6) days, respectively. No severe intraoperative complications were observed. The mean follow-up was (44.1 ± 19.3) months. The shortest follow-up was 6 months. The longest follow-up was 5 years. Complete follow-up data were available for 398 of the 782 patients. Of the 398 patients followed up for 5 years, the mean international prostate symptom score after 5 years was 12.8 ± 6.9, quality of life score was 2.2 ± 1.6, maximal flow rate was (14.5 ± 2.4) ml/s, and residual urine volume was 58 ml (M50). The retreatment rate because of BPH was 2.3% (9/398). Urethral stricture and bladder neck contracture were observed in 1.5% and 0.5% of the patients, respectively.</p><p><b>CONCLUSIONS</b>PVP has demonstrated remarkably consistent results for objective and subjective voiding parameters. Its late complication is rare and retreatment rate is low.</p>
Subject(s)
Aged , Humans , Male , Follow-Up Studies , Lasers, Solid-State , Prostatic Hyperplasia , General Surgery , Retrospective Studies , Transurethral Resection of Prostate , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To discuss the feasibility of estimating energy consumption of green laser in photoselective vaporization of prostate (PVP) based on the preoperative volume of prostate.</p><p><b>METHODS</b>From January 2005 to January 2007, 260 patients with benign prostatic hyperplasia (BPH) had been treated with PVP. Preoperative prostatic volume and post-two-weeks-operative prostatic volume of each patient were measured by transrectal ultrasound (TRUS). Energy consumption and emission time of green laser were recorded during the operation. Then we calculated the amount of energy consumption needed in vaporizing one gramme prostatic tissue, evaluated the correlation of energy consumption and preoperative volume of prostate by means of correlation-regression analysis, and established its regression equation.</p><p><b>RESULTS</b>The amount of energy consumption needed in vaporizing one gramme prostatic tissue was (6.9 ± 0.6)kJ. The correlation of energy consumption and preoperative volume of prostate was significantly positive linear correlated. Its regression equation was: Energy Consumption (kJ) = 4.7 x Preoperative Volume of Prostate (cm³) - 14.1.</p><p><b>CONCLUSION</b>It is feasible to estimate energy consumption of green laser in PVP based on preoperative volume of prostate.</p>
Subject(s)
Aged , Aged, 80 and over , Humans , Male , Middle Aged , Feasibility Studies , Laser Therapy , Prostate , Pathology , Prostatic Hyperplasia , Pathology , General Surgery , Transurethral Resection of Prostate , MethodsABSTRACT
OBJECTIVE@#To evaluate the reliability and clinical practicability of cefoxitin disk diffusion test in the detection of methicillin-resistant staphylococcus (MRS) heterogenic drug-resistant strains.@*METHODS@#Three hundred and ten strains of staphylococcus isolated from clinics were detected by the oxacillin disk diffusion test, the cefoxitin disk diffusion test as well as the oxacillin agar dilution test according to the standard operation procedures of NCCLS, and the detection of mecA gene of staphylococcus was used as a criterion. The sensitivities and specitivities of the 4 methods were compared.@*RESULTS@#By the detection of mecA gene, the ratio for MRSA was 57.1%(113/198) and the ratio for MRCNS was 62.5%(70/112). Both the sensitivity and specificity of cefoxitin disk diffusion test in the detection of MRS were 100%, and those in the detection of MRCNS were 98.6% and 100%.@*CONCLUSION@#Cefoxitin disk diffusion test is reliable, simple and convenient, and it can be used as a conventional method for the detection of MRS in clinical laboratories.