1.Perioperative anesthesia management in patients with anti-N-methyl-D-aspartate receptor encephalitis complicated with ovarian teratoma
Mengya PANG ; Haofeng LIAO ; Mian GE
Journal of Chinese Physician 2019;21(2):167-171
Objective To improve the understanding of perioperative anesthesia management in patients with anti-N-methyl-D-aspartate receptor encephalitis combined with a history of ovarian teratoma.Methods Case information of 10 patients with anti-N-methyl-D-aspartate receptor encephalitis with a history of ovarian teratoma admitted to the Third Affiliated hospital of Sun yat-sen University from July 2014 to November 2018 were retrospectively analyzed.Results A total of 10 patients received treatment,8 improved after treatment,2 had poor prognosis,and their families required discharge.All patients received endotracheal intubation under general anesthesia.Conclusions Anesthesiologists should pay attention to perioperative anesthesia management of patients with anti-N-methyl-D-aspartate receptor encephalitis complicated with ovarian teratoma,including preoperative evaluation,anesthesia methods and drug selection,intraoperative and postoperative management.
2.Analysis of the therapeutic efficacy of transcatheter arterial chemoembolization com-bined with systemic treatment in unresectable hepatocellular carcinoma
Wenli LI ; Yangfeng DU ; Guosheng YUAN ; Mengya ZANG ; Peilin ZHU ; Rong LI ; Yongru CHEN ; Kaiyan SU ; Qi LI ; Xiaoyun HU ; Huajin PANG ; Jinzhang CHEN
Chinese Journal of Clinical Oncology 2023;50(22):1135-1141
Objective:To investigate the efficacy and safety of different transcatheter arterial chemoembolization(TACE)-based regimens in patients with unresectable hepatocellular carcinoma(uHCC)and explore the optimal timing for combining TACE with tyrosine kinase inhibit-ors(TKIs)and immune checkpoint inhibitors(ICIs).Methods:A retrospective analysis was conducted on data from 555 patients with uHCC who underwent TACE-based treatment between April 2016 and December 2021 in Nanfang Hospital,Southern Medical University.The pa-tients were assigned into the following four groups according to different treatment regimens:TACE group(n=317),TACE combined with TKIs group(TACE+TKIs,n=66),TACE combined with ICIs group(TACE+ICIs,n=33),and TACE combined with TKIs+ICIs group(TACE+TKIs+ICIs,n=139).Subgroup analysis was performed within the TACE+TKIs+ICIs group,with patients being assigned into"pre-TACE"and"post-TACE"groups based on the timing of the combination therapy.Univariate and multivariate Cox regression analyses were conducted to identify pro-gnostic factors influencing overall survival(OS).Results:The TACE+TKIs+ICIs group showed the longest OS(21.9 months,95%confidence in-terval[CI]:17.2-26.6,P=0.030)and progression-free survival(PFS)(8.3 months,95%CI:7.3-9.3,P=0.004)compared to those in the other three groups.In the subgroup analysis,the"post-TACE"group had longer OS than the"pre-TACE"group(26.8 months vs.19.2 months,P = 0.011).The objective response rate(ORR)was 32.8%,41.1%,42.4%,and 52.5%(P=0.001)and the disease control rate(DCR)was 59.6%,71.2%,69.7%,and 82.7%(P<0.001)in the TACE,TACE+TKIs,TACE+ICIs,and TACE+TKIs+ICIs groups,respectively.The adverse events were similar to those reported in previous studies.Cox regression analysis revealed that tumor number,extrahepatic metastasis,and treatment regimen were independent factors influencing OS in patients(all P<0.05).Conclusions:TKIs or ICIs can improve OS and PFS in patients with uHCC receiving TACE,and the combination of TKIs+ICIs with TACE achieves better beneficial outcomes.The greatest OS was observed when the combination therapy TKIs+ICIs was initiated within 3 months after the first TACE procedure.