Objective To evaluate the accuracy of stoke volume variation (SVV) determined using FloTrac/Vigileo and Picco-plus technologies in prone position for assessment of the blood volume in the patients undergoing spine surgery,Methods Forty-three ASA physical status Ⅰ-Ⅲ patients of both sexes,aged ＞ 18 yr,weighing 40-100 kg,scheduled for elective posterior approach to lumbar spinal fusion or scoliosis surgery were studied.After induction of anesthesia,a volume expansion was performed in supine and prone positions.Hydroxyethyl starch 130/0.4 sodium chloride injection 5 ml/kg was rapidly infused intravenously over 10 min to carry out the test for fluid responsiveness.Picco-plus and FloTrac/Vigileo systems were simultaneously applied in every subject to measure SVV (SVVP and SVVF).Positive fluid responsiveness was defined as the changing rate of stroke volume index ≥ 10％ as measured by using Piccoplus system.The patients were divided into response group (Rs group) and non-response group (NRs group) according to the changing rate of stroke volume index ≥ 10％ and ＜ 10％.The receiver operating characteristic (ROC) curve for SVV was plotted,and the diagnostic threshold,area under the ROC curve and 95％ confidence interval (CI) were calculated.Results Forty-one patients were included for analysis in this study.In supine position,the area under the ROC curve for SVV in predicting the fluid responsiveness was 0.740 (95％ CI:0.568-0.913),the diagnostic threshold was 12％,and the sensitivity and specificity in determining fluid responsiveness were 86％ and 54％,respectively,for SVVF,and the area under the ROC curve was 0.637 for SVVP.In prone position,the area under the ROC curve was 0.451 for SVVF,and 0.634 for SVVP.Compared with Rs group,the baseline value of SVVFwas significantly lower,and no significant change was found in the other hemodynamic parameters before volume expansion in supine position in NRs group.There was no significant difference in the hemodynamic parameters before volume expansion in prone position between the two groups.Conclusion SVV determined by using FloTrac/Vigileo and Picco-plus systems in prone position can not accurately assess the blood volume in the patients undergoing spine surgery.

Objective To investigate the expression discordances of estrogen receptor ( ER), progesterone receptor (PR), human epidermal growth factor receptor2 ( HER?2) and Ki?67 in primary and metastatic breast cancer specimens and explore the clinical significances. Methods Biopsies of metastatic lesions were performed in 203 patients with breast cancer recurrence and metastasis indicated by physical examination and／or imaging examination. We confirmed pathological properties and assessed the expressions of ER, PR, HER?2 and Ki?67 in primary and metastatic lesions, their relationships with prognosis were also analyzed. Results Biopsy failed in 3 patients, the pathology and immunohistochemitry results of metastatic lesions were not obtained. One person was diagnosed as tuberculosis and another was primary lung cancer. Among the 198 cases of primary and metastatic lesions, the discordance rates of ER, PR, HER?2 and Ki?67 were 27.3%, 34.3%, 11.8% and 15.1%, respectively.The expressions of ER, HER?2 and Ki?67 were not significantly different between the primary and metastatic lesions, however, the expressions of PR were more likely to turn negative in the metastases (P＜0.001). The disease?free survival (DFS) of patients with ER, PR positive, HER?2 negative and low expression of Ki?67 in metastatic lesion was much longer ( P＜0.05). Conclusions The expressions of ER, PR, HER?2 and Ki?67 in metastatic lesions are associated with the prognosis of breast cancer patients.Their expression discordances between primary and metastatic lesions can guide the treatment and evaluate the risks of recurrence and prognosis.

Objective To investigate the expression discordances of estrogen receptor ( ER), progesterone receptor (PR), human epidermal growth factor receptor2 ( HER?2) and Ki?67 in primary and metastatic breast cancer specimens and explore the clinical significances. Methods Biopsies of metastatic lesions were performed in 203 patients with breast cancer recurrence and metastasis indicated by physical examination and／or imaging examination. We confirmed pathological properties and assessed the expressions of ER, PR, HER?2 and Ki?67 in primary and metastatic lesions, their relationships with prognosis were also analyzed. Results Biopsy failed in 3 patients, the pathology and immunohistochemitry results of metastatic lesions were not obtained. One person was diagnosed as tuberculosis and another was primary lung cancer. Among the 198 cases of primary and metastatic lesions, the discordance rates of ER, PR, HER?2 and Ki?67 were 27.3%, 34.3%, 11.8% and 15.1%, respectively.The expressions of ER, HER?2 and Ki?67 were not significantly different between the primary and metastatic lesions, however, the expressions of PR were more likely to turn negative in the metastases (P＜0.001). The disease?free survival (DFS) of patients with ER, PR positive, HER?2 negative and low expression of Ki?67 in metastatic lesion was much longer ( P＜0.05). Conclusions The expressions of ER, PR, HER?2 and Ki?67 in metastatic lesions are associated with the prognosis of breast cancer patients.Their expression discordances between primary and metastatic lesions can guide the treatment and evaluate the risks of recurrence and prognosis.

Cancer is the most cause death of among adolescents and young adults (AYAs).Psychological distress caused by cancer affects AYAs' effective coping abilities of disease,physical symptoms and treatment.This paper mainly introduces the related concepts,screening tools and intervention progress of psychological distress of AYAs cancer patients to deepen the understanding of these among clinical professionals and provide reference for implement effective interventions to patients.

Objective:To demonstrate the clinical efficiency and safety of palbociclib combined with endocrine therapy in the treatment of hormone receptor (HR) positive and human epidermal growth factor receptor 2 (HER-2) negative advanced breast cancer patients.Methods:A total of 95 breast cancer patients with HR-positive/HER-2 negative underwent palbociclib combined with endocrine in Jiangsu Cancer Hospital from Octorber, 2018 to Novermber, 2020 were retrospectively recruited. The short-term and long-term efficacy and adverse reactions were summarized. The primary end point was progressive free survival (PFS) and the second end points were disease control rate (DCR), objective response rate (ORR), clinical benefit rate (CBR). Log rank test and Cox proportional hazards regression model were used to analyze the influencing factors of PFS in patients.Results:The ORR, DCR and CBR of 95 patients were 29.5%, 88.4% and 72.6%, respectively. The total median PFS for palbociclib plus endocrine therapy was 10.4 months. The univariate analysis showed that visceral metastasis, the line number of palbociclib treatment and the sensitivity of endocrine therapy were associated with the PFS of patients who received palbociclib combined with endocrine ( P<0.05). The multivariate Cox regression analysis showed that the sensitivity of endocrine therapy and visceral metastasis were the independent influencing factors of PFS in patients receiving palbociclib combined with endocrine therapy. Compared with patients with visceral metastasis, HR of patients with non-visceral metastases was 3.118 (95% CI: 1.405-7.236). Compared with endocrine therapy sensitive patients, the HR of patients with primary and secondary resistance to endocrine therapy were 4.455 (95% CI: 1.380-14.385) and 1.4566 (95% CI: 0.488-4.346), respectively. The main adverse reaction was hematological toxicity. The leukopenia, neutrophilsand thrombocytopenia were main manifestations, which incidence rates were 78.9% (75/95), 85.3% (81/95) and 72.6% (69/95), respectively and the incidence rates of grade 3 to 4 of these manifestations were 27.4% (26/95), 51.6% (49/95) and 20.0% (19/95), respectively. Conclusion:Among patients with HR-positive/HER-2 negative advanced breast cancer, the treatment of palbociclib combined with endocrine drugs has yielded good clinical effects and the toxicity is manageable.

Objective:To demonstrate the clinical efficiency and safety of palbociclib combined with endocrine therapy in the treatment of hormone receptor (HR) positive and human epidermal growth factor receptor 2 (HER-2) negative advanced breast cancer patients.Methods:A total of 95 breast cancer patients with HR-positive/HER-2 negative underwent palbociclib combined with endocrine in Jiangsu Cancer Hospital from Octorber, 2018 to Novermber, 2020 were retrospectively recruited. The short-term and long-term efficacy and adverse reactions were summarized. The primary end point was progressive free survival (PFS) and the second end points were disease control rate (DCR), objective response rate (ORR), clinical benefit rate (CBR). Log rank test and Cox proportional hazards regression model were used to analyze the influencing factors of PFS in patients.Results:The ORR, DCR and CBR of 95 patients were 29.5%, 88.4% and 72.6%, respectively. The total median PFS for palbociclib plus endocrine therapy was 10.4 months. The univariate analysis showed that visceral metastasis, the line number of palbociclib treatment and the sensitivity of endocrine therapy were associated with the PFS of patients who received palbociclib combined with endocrine ( P<0.05). The multivariate Cox regression analysis showed that the sensitivity of endocrine therapy and visceral metastasis were the independent influencing factors of PFS in patients receiving palbociclib combined with endocrine therapy. Compared with patients with visceral metastasis, HR of patients with non-visceral metastases was 3.118 (95% CI: 1.405-7.236). Compared with endocrine therapy sensitive patients, the HR of patients with primary and secondary resistance to endocrine therapy were 4.455 (95% CI: 1.380-14.385) and 1.4566 (95% CI: 0.488-4.346), respectively. The main adverse reaction was hematological toxicity. The leukopenia, neutrophilsand thrombocytopenia were main manifestations, which incidence rates were 78.9% (75/95), 85.3% (81/95) and 72.6% (69/95), respectively and the incidence rates of grade 3 to 4 of these manifestations were 27.4% (26/95), 51.6% (49/95) and 20.0% (19/95), respectively. Conclusion:Among patients with HR-positive/HER-2 negative advanced breast cancer, the treatment of palbociclib combined with endocrine drugs has yielded good clinical effects and the toxicity is manageable.

As new evidence emerges, treatment strategies toward the functional cure of chronic hepatitis B are evolving. In 2019, a panel of national hepatologists published a Consensus Statement on the functional cure of chronic hepatitis B. Currently, an international group of hepatologists has been assembled to evaluate research since the publication of the original consensus, and to collaboratively develop the updated statements. The 2.0 Consensus was aimed to update the original consensus with the latest available studies, and provide a comprehensive overview of the current relevant scientific literatures regarding functional cure of hepatitis B, with a particular focus on issues that are not yet fully clarified. These cover the definition of functional cure of hepatitis B, its mechanisms and barriers, the effective strategies and treatment roadmap to achieve this endpoint, in particular new surrogate biomarkers used to measure efficacy or to predict response, and the appropriate approach to pursuing a functional cure in special populations, the development of emerging antivirals and immunomodulators with potential for curing hepatitis B. The statements are primarily intended to offer international guidance for clinicians in their practice to enhance the functional cure rate of chronic hepatitis B.

As new evidence emerges, treatment strategies toward the functional cure of chronic hepatitis B are evolving. In 2019, a panel of national hepatologists published a Consensus Statement on the functional cure of chronic hepatitis B. Currently, an international group of hepatologists has been assembled to evaluate research since the publication of the original consensus, and to collaboratively develop the updated statements. The 2.0 Consensus was aimed to update the original consensus with the latest available studies, and provide a comprehensive overview of the current relevant scientific literatures regarding functional cure of hepatitis B, with a particular focus on issues that are not yet fully clarified. These cover the definition of functional cure of hepatitis B, its mechanisms and barriers, the effective strategies and treatment roadmap to achieve this endpoint, in particular new surrogate biomarkers used to measure efficacy or to predict response, and the appropriate approach to pursuing a functional cure in special populations, the development of emerging antivirals and immunomodulators with potential for curing hepatitis B. The statements are primarily intended to offer international guidance for clinicians in their practice to enhance the functional cure rate of chronic hepatitis B.

As new evidence emerges, treatment strategies toward the functional cure of chronic hepatitis B are evolving. In 2019, a panel of national hepatologists published a Consensus Statement on the functional cure of chronic hepatitis B. Currently, an international group of hepatologists has been assembled to evaluate research since the publication of the original consensus, and to collaboratively develop the updated statements. The 2.0 Consensus was aimed to update the original consensus with the latest available studies, and provide a comprehensive overview of the current relevant scientific literatures regarding functional cure of hepatitis B, with a particular focus on issues that are not yet fully clarified. These cover the definition of functional cure of hepatitis B, its mechanisms and barriers, the effective strategies and treatment roadmap to achieve this endpoint, in particular new surrogate biomarkers used to measure efficacy or to predict response, and the appropriate approach to pursuing a functional cure in special populations, the development of emerging antivirals and immunomodulators with potential for curing hepatitis B. The statements are primarily intended to offer international guidance for clinicians in their practice to enhance the functional cure rate of chronic hepatitis B.

Genetics ; Laboratories ; Technology ; standards ; United States