1.Clinical features and prognosis of hepatocellular carcinoma: A single-center study of 850 cases
Meng REN ; Yi YANG ; Ziming LI ; Renqian ZHANG ; Yufeng SHI ; Junxiu TAO
Journal of Clinical Hepatology 2024;40(10):2019-2026
ObjectiveTo investigate the clinical features and prognosis of hepatocellular carcinoma (HCC). MethodsMedical records were collected from 850 HCC patients who were admitted to Hubei Provincial Hospital of Traditional Chinese Medicine from December 2014 to May 2022, and their clinical and prognostic features were analyzed. The chi-square test were used for comparison of categorical data between groups; the Kaplan-Meier method was used to calculate survival time and survival rate, and the log-rank test was used for comparison of survival time based on baseline features. ResultsAmong the 850 HCC patients, male patients accounted for 82.6%, and the median age at initial diagnosis was 58.0 (49.0, 66.0) years, with the highest proportion of patients aged 50 — 69 years (59.8%). The patients with HBV infection accounted for the highest proportion of 77.4%; at initial diagnosis, 49.2% of the patients had portal vein tumor thrombus, and 20.2% of the patients had extrahepatic metastasis, among which pulmonary metastasis accounted for the highest proportion of 44.2% (76/172). The patients with Barcelona Clinic Liver Cancer (BCLC) stage A (0), B, C, and D HCC accounted for 20.4%, 22.5%, 41.5%, and 15.6%, respectively. There was a significant difference in the distribution of BCLC stages between different groups based on sex (χ2=16.631, P=0.001), age (χ2=24.261, P=0.019), place of residence (χ2=39.776, P<0.001), presence or absence of viral hepatitis (χ2=8.338, P=0.040), and presence or absence of regular antiviral therapy before initial diagnosis (χ2=26.140, P<0.001). Follow-up was performed for 489 patients till death, with a median survival time of 19.99 months (95% confidence interval [CI]: 14.86 — 25.12), and the 1-, 3-, 5-, and 10-year cumulative survival rates were 60.7%, 39.9%, 29.4%, and 22.7%, respectively. There was a significant difference in survival time between different groups based on age (χ2=13.452, P=0.009), history of viral hepatitis (χ2=6.123, P=0.013), regular antiviral therapy before initial diagnosis (χ2=15.505, P<0.001), comorbidity with type 2 diabetes (χ2=9.820, P=0.002), the number of tumors (χ2=57.713, P<0.001), maximum tumor diameter (χ2=41.862, P<0.001), portal vein tumor thrombus (χ2=293.909, P<0.001), extrahepatic metastasis at initial diagnosis (χ2=118.329, P<0.001), BCLC stage (χ2=465.638, P<0.001), surgical resection (χ2=78.86, P<0.001), local treatment (χ2=36.216, P<0.001), immune checkpoint inhibitor treatment and/or anti-tumor angiogenesis therapy (χ2=7.182, P=0.007), traditional Chinese medicine decoction treatment (χ2=30.050, P<0.001), and comprehensive treatment regimens (χ2=13.221, P=0.004). Progression-free survival (PFS) was recorded for 259 patients (30.5%), with a median PFS of 10.98 months (95%CI: 8.54 — 13.42). ConclusionHCC patients exhibit epidemiological characteristics in terms of sex, age, place of residence, presence or absence of viral hepatitis, regular antiviral therapy before initial diagnosis, tumor characteristics, treatment modality, and prognosis, with a low early detection rate and a short overall survival time, and therefore, it is urgent to perform early screening, early diagnosis, and early treatment.
2.Efficacy and safety of flurbiprofen cataplasms versus loxoprofen sodium cataplasms in knee osteoarthritis: a randomized controlled trial.
Dong LI ; Yinchu CHENG ; Ping YUAN ; Ziyang WU ; Jiabang LIU ; Jinfu KAN ; Kun ZHANG ; Zhanguo WANG ; Hui ZHANG ; Guangwu ZHANG ; Tao XUE ; Junxiu JIA ; Suodi ZHAI ; Zhenpeng GUAN
Chinese Medical Journal 2023;136(18):2187-2194
BACKGROUND:
Clinical trial evidence is limited to identify better topical non-steroidal anti-inflammatory drugs (NSAIDs) for treating knee osteoarthritis (OA). We aimed to compare the clinical efficacy and safety of flurbiprofen cataplasms (FPC) with loxoprofen sodium cataplasms (LSC) in treating patients with knee OA.
METHODS:
This is an open-label, non-inferiority randomized controlled trial conducted at Peking University Shougang Hospital. Overall, 250 patients with knee OA admitted from October 2021 to April 2022 were randomly assigned to FPC and LSC treatment groups in a 1:1 ratio. Both medications were administered to patients for 28 days. The primary outcome was the change of pain measured by visual analog scale (VAS) score from baseline to day 28 (range, 0-10 points; higher score indicates worse pain; non-inferiority margin: 1 point; superiority margin: 0 point). There were four secondary outcomes, including the extent of pain relief, the change trends of VAS scores, joint function scores measured by the Western Ontario and McMaster University Osteoarthritis Index (WOMAC), and adverse events.
RESULTS:
Among 250 randomized patients (One patient without complete baseline record in the flurbiprofen cataplasms was excluded; age, 62.8 ± 10.5 years; 61.4% [153/249] women), 234 (93.6%) finally completed the trial. In the intention-to-treat analysis, the decline of the VAS score for the 24-h most intense pain in the FPC group was non-inferior, and also superior to that in the LSC group (differences and 95% confidence interval, 0.414 (0.147-0.681); P <0.001 for non-inferiority; P = 0.001 for superiority). Similar results were observed of the VAS scores for the current pain and pain during exercise. WOMAC scores were also lower in the FPC group at week 4 (12.50 [8.00-22.50] vs . 16.00 [11.00-27.00], P = 0.010), mainly driven by the dimension of daily activity difficulty. In addition, the FPC group experienced a significantly lower incidence of adverse events (5.6% [7/124] vs . 33.6% [42/125], P <0.001), including irritation, rash and pain of the skin, and sticky hair uncovering pain.
CONCLUSIONS
This study suggested that FPC is superior to LSC for treating patients with knee OA in pain relief, joint function improvement, and safety profile.
Humans
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Female
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Middle Aged
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Aged
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Osteoarthritis, Knee/drug therapy*
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Flurbiprofen/therapeutic use*
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Anti-Inflammatory Agents, Non-Steroidal/therapeutic use*
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Pain/drug therapy*
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Treatment Outcome
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Double-Blind Method