Background:Peptic ulcer bleeding(PUB)represents the leading etiology of acute upper gastrointestinal bleeding.Currently,endoscopy within 24 hours after admission is recommended for patients with acute upper gastrointestinal bleeding,but the optimal timing remains uncertain.Aims:To investigate the impact of endoscopic timing on the prognosis of patients with PUB.Methods:A retrospective analysis was conducted on PUB patients presenting with gastrointestinal bleeding symptoms who underwent gastroscopy within 24 hours after admission at Huizhou First Hospital from January 2019 to December 2022.According to the endoscopic timing after admission,patients were divided into urgent endoscopy group(≤8 hours after admission)and early endoscopy group(8-24 hours after admission).The 30-day rebleeding rate,rate of adverse in-hospital outcomes,length of hospital stay,hospitalization cost,and blood transfusion rate were compared between the two groups.Results:A total of 608 PUB patients were enrolled.The 30-day rebleeding rate was 6.6%.No significant differences in 30-day rebleeding rate,rate of adverse in-hospital outcomes,length of hospital stay and blood transfusion rate were found between the urgent endoscopy group and early endoscopy group(all P>0.05).However,hospitalization cost was significantly higher in urgent endoscopy group(P=0.002).In 376 patients with high-risk ulcer,the 30-day rebleeding rate was 10.4%.High-risk ulcer patients receiving urgent endoscopy demonstrated significantly lower 30-day rebleeding rate(7.3%vs.13.7%,P=0.042)and rate of adverse in-hospital outcomes(4.1%vs.10.4%,P=0.019),while there were no significant differences in length of hospital stay,hospitalization cost,and blood transfusion rate between the two subgroups(all P>0.05).Conclusions:Urgent endoscopy within 8 hours after admission does not reduce the 30-day rebleeding rate and rate of adverse in-hospital outcomes in patients with PUB.However,patients with high-risk ulcer may benefit from urgent endoscopy within 8 hours after admission.

Background:Peptic ulcer bleeding(PUB)represents the leading etiology of acute upper gastrointestinal bleeding.Currently,endoscopy within 24 hours after admission is recommended for patients with acute upper gastrointestinal bleeding,but the optimal timing remains uncertain.Aims:To investigate the impact of endoscopic timing on the prognosis of patients with PUB.Methods:A retrospective analysis was conducted on PUB patients presenting with gastrointestinal bleeding symptoms who underwent gastroscopy within 24 hours after admission at Huizhou First Hospital from January 2019 to December 2022.According to the endoscopic timing after admission,patients were divided into urgent endoscopy group(≤8 hours after admission)and early endoscopy group(8-24 hours after admission).The 30-day rebleeding rate,rate of adverse in-hospital outcomes,length of hospital stay,hospitalization cost,and blood transfusion rate were compared between the two groups.Results:A total of 608 PUB patients were enrolled.The 30-day rebleeding rate was 6.6%.No significant differences in 30-day rebleeding rate,rate of adverse in-hospital outcomes,length of hospital stay and blood transfusion rate were found between the urgent endoscopy group and early endoscopy group(all P>0.05).However,hospitalization cost was significantly higher in urgent endoscopy group(P=0.002).In 376 patients with high-risk ulcer,the 30-day rebleeding rate was 10.4%.High-risk ulcer patients receiving urgent endoscopy demonstrated significantly lower 30-day rebleeding rate(7.3%vs.13.7%,P=0.042)and rate of adverse in-hospital outcomes(4.1%vs.10.4%,P=0.019),while there were no significant differences in length of hospital stay,hospitalization cost,and blood transfusion rate between the two subgroups(all P>0.05).Conclusions:Urgent endoscopy within 8 hours after admission does not reduce the 30-day rebleeding rate and rate of adverse in-hospital outcomes in patients with PUB.However,patients with high-risk ulcer may benefit from urgent endoscopy within 8 hours after admission.

Mesenchymal-epithelial transition factor (MET) gene mutation is a large class of mutations commonly seen in non-small cell lung cancer (NSCLC). MET mutation includes subtypes such as MET exon 14 skipping mutation (METex14m) and MET amplification (METamp). For advanced NSCLC with METex14m, Savolitinib has a high sensitivity as a member of tyrosine kinase inhibitors (TKIs). METamp is a relatively rare genetic mutation type which can serve as a driver gene to mediate primary and later acquired drug resistance of epidermal growth factor receptor (EGFR)-TKIs. For advanced NSCLC with secondary METamp, EGFR-TKIs combined with MET-TKIs are usually used in clinical treatment, while the optimal treatment strategy for advanced NSCLC with primary METamp has not yet been determined. For locally advanced NSCLC patients with positive driver gene mutations such as EGFR, anaplastic lymphoma kinase (ALK) fusion and METex14m, there have been relevant cases reported that neoadjuvant targeted therapy could achieve a good prognosis, but there have been no cases of neoadjuvant targeted therapy for locally advanced NSCLC patients with METamp. This report describes a case of a locally advanced NSCLC patient with dual driver gene mutations (EGFR L858R combined with primary METamp), the tumor did not shrink after 1 month of Gefitinib monotherapy, but significantly subsided after 4 months of Savolitinib monotherapy. After radical surgery, the pathological results proved pathological complete response (pCR) of the tumor, and the patient had a good response to postoperative continual Savolitinib treatment, with no recurrence nor metastasis observed to date. This case reports the feasibility and effectiveness of neoadjuvant targeted therapy for locally advanced NSCLC with primary METamp, aiming to provide effective reference for perioperative treatment of locally advanced NSCLC with primary METamp.
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Humans ; Acrylamides/therapeutic use* ; Carcinoma, Non-Small-Cell Lung/pathology* ; Gene Amplification ; Lung Neoplasms/pathology* ; Protein Kinase Inhibitors/therapeutic use* ; Proto-Oncogene Proteins c-met/genetics* ; Triazines

Background:Peptic ulcer bleeding(PUB)is the main cause of acute upper gastrointestinal bleeding.Currently,endoscopic examination within 24 hours is recommended for patients with acute upper gastrointestinal bleeding,but the optimal timing within 24 hours remains uncertain.Aims:To study the impact of endoscopic timing on the prognosis of patients with PUB.Methods:A retrospective analysis was conducted on patients who presented to Huizhou First Hospital with symptoms of gastrointestinal bleeding(hematemesis,melena,and bloody stools)from 2019 to 2022 and were diagnosed with PUB by gastroscopy within 24 hours.Their basic clinical data were collected.According to the endoscopic timing after admission,they were divided into urgent endoscopy group(≤8 hours after admission)and emergent endoscopy group(8-24 hours after admission).The 30-day rebleeding rate,the rates of adverse in-hospital outcomes,hospitalization costs,length of hospital stay,and blood transfusion rates were compared between the two groups.Results:A total of 608 patients were included in this study.The 30-day rebleeding rate was 6.6%.No significant differences in the 30-day rebleeding rate(5.3%vs.7.5%,P=0.275),the rate of adverse in-hospital outcomes in was(3.8%vs.7.2%,P=0.071),length of hospital stay and blood transfusion rate were found between the urgent endoscopy group emergent endoscopy group The hospitalization cost in the urgent endoscopy group was significantly higher than that in the emergent endoscopy group(P=0.002).There were 376 patients with high-risk ulcers.The 30-day rebleeding rate was 10.4%and the rate of adverse in-hospital outcomes was 7.2%.The 30-day rebleeding rate(7.3%vs.13.7%,P=0.042),the rate of adverse in-hospital outcomes(4.1%vs.10.4%,P=0.019)in the urgent endoscopy group were significantly lower than those in the emergent endoscopy group.There were no significant differences in hospitalization cost,length of hospital stay,and blood transfusion rate between the two groups.Conclusions:Urgent endoscopy within 8 hours after admission in patients with PUB does not reduce the 30-day rebleeding rate and the rate of adverse in-hospital outcomes.However,patients with high-risk ulcers seem more likely to benefit from emergency endoscopy within 8 hours.

Objective:To systematically evaluate the efficacy and safety of carfilzomib in treating relapsed and/or refractory multiple myeloma (RRMM) in the real world.Methods:Relevant databases at home and abroad were searched (up to April 2023), and the literature on real-world studies of carfilzomib in the treatment of RRMM was collected. The quality of the literature was evaluated with the methodological index for non-randomized studies (MINORS) scale. Research data on the effectiveness and safety in RRMM patients treated with carfilzomib were extracted. The effectiveness indicators included the overall response rate (ORR), median progression-free survival (PFS), and overall survival (OS). The safety indicators included the incidence of adverse events (AEs) and the rate of treatment termination due to AEs, etc. Stata 13.0 software was used for meta-analysis of single proportions, and the occurrence of major adverse events was analyzed by descriptive statistics.Results:A total of 12 studies were entered, including 2 615 patients. The quality evaluation results showed that all of the 12 studies were with high quality. The meta-analysis of single proportions showed that ORR of carfilzomib in the treatment of RRMM was 75%[95% confidence interval ( CI): 68%-82%], the incidence of ≥ grade 3 AEs was 46% (95 %CI: 44%-49%), and the incidence of treatment termination due to AEs was 14% (95 %CI: 10%-19%). AEs with an incidence of >5% included thrombocytopenia, anemia, neutropenia, infection, hypertension, liver injury, and kidney injury. Conclusions:In the real world, the efficacy of carfilzomib in the treatment of RRMM is lower than that in clinical trials. The occurrence of infection during carfilzomib treatment and drug toxicity to the hematological system, cardiovascular system, liver, and kidney need to be paid attention to.

Objective:To systematically evaluate the efficacy and safety of carfilzomib in treating relapsed and/or refractory multiple myeloma (RRMM) in the real world.Methods:Relevant databases at home and abroad were searched (up to April 2023), and the literature on real-world studies of carfilzomib in the treatment of RRMM was collected. The quality of the literature was evaluated with the methodological index for non-randomized studies (MINORS) scale. Research data on the effectiveness and safety in RRMM patients treated with carfilzomib were extracted. The effectiveness indicators included the overall response rate (ORR), median progression-free survival (PFS), and overall survival (OS). The safety indicators included the incidence of adverse events (AEs) and the rate of treatment termination due to AEs, etc. Stata 13.0 software was used for meta-analysis of single proportions, and the occurrence of major adverse events was analyzed by descriptive statistics.Results:A total of 12 studies were entered, including 2 615 patients. The quality evaluation results showed that all of the 12 studies were with high quality. The meta-analysis of single proportions showed that ORR of carfilzomib in the treatment of RRMM was 75%[95% confidence interval ( CI): 68%-82%], the incidence of ≥ grade 3 AEs was 46% (95 %CI: 44%-49%), and the incidence of treatment termination due to AEs was 14% (95 %CI: 10%-19%). AEs with an incidence of >5% included thrombocytopenia, anemia, neutropenia, infection, hypertension, liver injury, and kidney injury. Conclusions:In the real world, the efficacy of carfilzomib in the treatment of RRMM is lower than that in clinical trials. The occurrence of infection during carfilzomib treatment and drug toxicity to the hematological system, cardiovascular system, liver, and kidney need to be paid attention to.

Background:Peptic ulcer bleeding(PUB)is the main cause of acute upper gastrointestinal bleeding.Currently,endoscopic examination within 24 hours is recommended for patients with acute upper gastrointestinal bleeding,but the optimal timing within 24 hours remains uncertain.Aims:To study the impact of endoscopic timing on the prognosis of patients with PUB.Methods:A retrospective analysis was conducted on patients who presented to Huizhou First Hospital with symptoms of gastrointestinal bleeding(hematemesis,melena,and bloody stools)from 2019 to 2022 and were diagnosed with PUB by gastroscopy within 24 hours.Their basic clinical data were collected.According to the endoscopic timing after admission,they were divided into urgent endoscopy group(≤8 hours after admission)and emergent endoscopy group(8-24 hours after admission).The 30-day rebleeding rate,the rates of adverse in-hospital outcomes,hospitalization costs,length of hospital stay,and blood transfusion rates were compared between the two groups.Results:A total of 608 patients were included in this study.The 30-day rebleeding rate was 6.6%.No significant differences in the 30-day rebleeding rate(5.3%vs.7.5%,P=0.275),the rate of adverse in-hospital outcomes in was(3.8%vs.7.2%,P=0.071),length of hospital stay and blood transfusion rate were found between the urgent endoscopy group emergent endoscopy group The hospitalization cost in the urgent endoscopy group was significantly higher than that in the emergent endoscopy group(P=0.002).There were 376 patients with high-risk ulcers.The 30-day rebleeding rate was 10.4%and the rate of adverse in-hospital outcomes was 7.2%.The 30-day rebleeding rate(7.3%vs.13.7%,P=0.042),the rate of adverse in-hospital outcomes(4.1%vs.10.4%,P=0.019)in the urgent endoscopy group were significantly lower than those in the emergent endoscopy group.There were no significant differences in hospitalization cost,length of hospital stay,and blood transfusion rate between the two groups.Conclusions:Urgent endoscopy within 8 hours after admission in patients with PUB does not reduce the 30-day rebleeding rate and the rate of adverse in-hospital outcomes.However,patients with high-risk ulcers seem more likely to benefit from emergency endoscopy within 8 hours.

Objective:To systematically evaluate the efficacy and safety of ixazomib in patients with relapsed or refractory multiple myeloma (RRMM) in the real world.Methods:Relevant databases at home and abroad were searched (up to April 2022), and the literature on real-world studies of ixazomib in the treatment of RRMM was collected. The quality of the literature was evaluated with the methodological index for non-randomized studies (MINORS) scale. Data such as the effectiveness rate and incidence of adverse events in RRMM patients treated with ixazomib were extracted. The effectiveness indicators included the overall response rate (ORR), very good partial response or better (≥VGPR) rate and median progression-free survival (PFS). The safety indicators included the incidence of adverse events (AEs) and the rate of treatment termination due to AEs, etc. Stata 13.0 software was used for meta-analysis of single proportions, and the occurrence of major adverse events was analyzed by descriptive statistics.Results:A total of 12 studies were entered, including 1 006 patients. The quality evaluation results showed that all of the 12 studies were with high quality. The meta-analysis of single proportions showed that ORR of ixazomib in the treatment of RRMM was 65%[95% confidence interval ( CI): 58%-72%], ≥VGPR rate was 32% (95% CI: 25%-38%), the median PFS was 21.73 (95% CI: 14.37-29.08) months, the incidence of ≥ grade 3 AEs was 39% (95% CI: 24%-55%), and the incidence of treatment termination due to AEs was 6% (95% CI: 3%-10%). AEs with an incidence of ≥10% included neutropenia, thrombocytopenia, infection, anemia, diarrhea, fatigue, peripheral neuropathy, rashes, and bone pain. Conclusion:In the real world, the efficacy of ixazomib in the treatment of RRMM is lower than that in clinical trials, but the safety is similar.

Objective:To systematically evaluate the efficacy and safety of ixazomib in patients with relapsed or refractory multiple myeloma (RRMM) in the real world.Methods:Relevant databases at home and abroad were searched (up to April 2022), and the literature on real-world studies of ixazomib in the treatment of RRMM was collected. The quality of the literature was evaluated with the methodological index for non-randomized studies (MINORS) scale. Data such as the effectiveness rate and incidence of adverse events in RRMM patients treated with ixazomib were extracted. The effectiveness indicators included the overall response rate (ORR), very good partial response or better (≥VGPR) rate and median progression-free survival (PFS). The safety indicators included the incidence of adverse events (AEs) and the rate of treatment termination due to AEs, etc. Stata 13.0 software was used for meta-analysis of single proportions, and the occurrence of major adverse events was analyzed by descriptive statistics.Results:A total of 12 studies were entered, including 1 006 patients. The quality evaluation results showed that all of the 12 studies were with high quality. The meta-analysis of single proportions showed that ORR of ixazomib in the treatment of RRMM was 65%[95% confidence interval ( CI): 58%-72%], ≥VGPR rate was 32% (95% CI: 25%-38%), the median PFS was 21.73 (95% CI: 14.37-29.08) months, the incidence of ≥ grade 3 AEs was 39% (95% CI: 24%-55%), and the incidence of treatment termination due to AEs was 6% (95% CI: 3%-10%). AEs with an incidence of ≥10% included neutropenia, thrombocytopenia, infection, anemia, diarrhea, fatigue, peripheral neuropathy, rashes, and bone pain. Conclusion:In the real world, the efficacy of ixazomib in the treatment of RRMM is lower than that in clinical trials, but the safety is similar.

Overactive bladder (OAB) is the most bothersome symptom in lower urinary tract symptoms (LUTS). Current pharmacologic treatment aims to inhibit detrusor contraction; however, shows unsatisfied efficacy and high discontinuation rate. LIM kinases (LIMKs) promote smooth muscle contraction in the prostate; however, their function in the bladder smooth muscle remains unclear. Here, we studied effects of the LIMK inhibitors on bladder smooth muscle contraction and proliferation both