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| 1 | 帕博利珠单抗单用或与放疗联用治疗转移性非小细胞肺癌:两个随机试验的汇总分析显示文摘背景放疗可以提高整个机体对免疫治疗的应答。在Ⅱ期PEMBRO-RT研究和Ⅰ/Ⅱ期MDACC研究中,患有转移性非小细胞肺癌(NSCLC)的患者被随机分配入组,接受免疫治疗(帕博利珠单抗)+放疗联合疗法,或免疫治疗单一疗法。当上述2个研究单独分析时,联合疗法组显示出潜在获益。由于每个研究的样本量较小,缓解率和结局并未显示出统计学意义,然而却有显著的临床获益。因此,本研究进行汇总分析,来判断放疗是否会改善转移性NSCLC患者的免疫治疗应答。方法PEMBRO-RT和MDACC研究纳入标准:患者年龄≥18岁,患有转移性NSCLC,且有≥1处未经放疗照射的病灶,以便进行射野外应答监测。PEMBRO-RT研究纳入曾接受过化疗患者,MDACC研究纳入曾接受过治疗或新诊断患者。2个研究中的患者均未接受过免疫治疗。在PEMBRO-RT研究中患者被等比例随机分配入组,并根据吸烟状态进行分层(分为<10年组和≥10年组)。MDACC研究的患者根据放疗计划可行性被等比例随机分配入2个受试组。由于联合治疗组的干预本质,每个研究中的放疗均不适用盲法。在2个研究中,不论是否进行放疗,均静脉滴入帕博利珠单抗(每3周200 mg)。在PEMBRO-RT研究中,在放疗(24 Gy 3次分割照射)结束后1周给予第1剂帕博利珠单抗。在MDACC研究中,在第1次放疗(50 Gy 4次分割照射或45 Gy 15次分割照射)同时给予帕博利珠单抗。仅检测未经照射病灶的应答。本研究的终点为最佳射野外(远隔)应答率(ARR)、最佳射野外疾病控制率(ACR)、12周时ARR、12周时ACR、无进展生存期(PFS)和总生存期(OS)。2个研究的意向治疗(ITT)人群均纳入分析。PEMBRO-RT研究(NCT02492568)和MDACC研究(NCT02444741)均在ClinicalTrials.gov上注册。发现纳入148例患者,76例接受帕博利珠单抗治疗,72例接受帕博利珠单抗+放疗治疗。所有患者随访时间中位数为33个月[四分位距(IQR):32.4~33.6]。148例患者中124例(84%)组织学特征为非鳞癌,111例(75%)患者曾经接受过化疗。组间没有基线特征差异,包括PD-L1表达状态和转移灶体积。最常见的照射部位为肺转移灶(39%,28/72)、胸腔内淋巴结(21%,15/72)和非原发灶(17%,12/72)。帕博利珠单抗组和联合治疗组的最佳ARR分别为19.7%(15/76)和41.7%(30/72),OR=2.96,95%CI:1.42~6.20,P=0.0039;最佳ACR分别为43.4%(33/76)和65.3%(47/72),OR=2.51,95%CI:1.28~4.91,P=0.0071;PFS中位数分别为4.4(IQR:2.9~5.9)和9.0个月(IQR:6.8~11.2),HR=0.67,95%CI:0.45~0.99,P=0.045;OS中位数分别为8.7(IQR:6.4~11.0)和19.2个月(IQR:14.6~23.8),OR=0.67,95%CI:0.54~0.84,P=0.0004。在汇总分析中没有发现新的安全问题。解读帕博利珠单抗免疫疗法+放疗显著提高转移性NSCLC患者的应答和改善治疗结局。这些结果需要在三期临床试验中进行验证。 | 陈大卫(翻译) 于金明(校对) Willemijn S M E Theelen Vivek Verma Brian P Hobbs Heike M U Peulen Joachim G J V Aerts Idris Bahce Anna Larissa N Niemeijer Joe Y Chang Patricia M de Groot Quynh-Nhu Nguyen Nathan I Comeaux George R Simon Ferdinandos Skoulidis Steven H Lin Kewen He Roshal Patel John Heymach Paul Baas James W Welsh | 2021 | 中华肿瘤防治杂志2021，28，24： | 49 |
| 2 | Management of distal humeral coronal shear fractures显示文摘Coronal shear fractures of the distal humerus are rare,complex fractures that can be technically challenging to manage. They usually result from a low-energy fall and direct compression of the distal humerus by the radial head in a hyper-extended or semi-flexed elbow or from spontaneous reduction of a posterolateral subluxation or dislocation. Due to the small number of soft tissue attachments at this site, almost all of these fractures are displaced. The incidence of distal humeral coronal shear fractures is higher among women because of the higher rate of osteoporosis in women and the difference in carrying angle between men and women. Distal humeral coronal shear fractures may occur in isolation, may be part of a complex elbow injury, or may be associated with injuries proximal or distal to the elbow. An associated lateral collateral ligament injury is seen in up to 40% and an associated radial head fracture is seen in up to 30% of these fractures. Given the complex nature of distal humeral coronal shear fractures, there is preference for operative management. Operative fixation leads to stable anatomic reduction, restores articular congruity, and allows initiation of early range-of-motion movements in the majority of cases. Several surgical exposure and fixation techniques are available to reconstruct the articular surface fol owing distal humeral coronal shear fractures. The lateral extensile approach and fixation with countersunk headless compression screws placed in an anterior-to-posterior fashion are commonly used. We have found a two-incision approach(direct anterior and lateral) that results in less soft tissue dissection and better outcomes than the lateral extensile approach in our experience. Stiffness, pain, articular incongruity, arthritis, and ulnohumeral instability may result if reduction is non-anatomic or if fixation fails. | Shahram S Yari Nathan L Bowers Miguel A Craig Lee M Reichel | 2015 | World Journal of Clinical Cases2015，3，5： | 15 |
| 3 | Anticoagulation with direct thrombin inhibitors during extracorporeal membrane oxygenation显示文摘Use of extracorporeal membrane oxygenation to support patients with critical cardiorespiratory illness is increasing.Systemic anticoagulation is an essential element in the care of extracorporeal membrane oxygenation patients.While unfractionated heparin is the most commonly used agent,unfractionated heparin is associated with several unique complications that can be catastrophic in critically ill patients,including heparin-induced thrombocytopenia and acquired antithrombin deficiency.These complications can result in thrombotic events and subtherapeutic anticoagulation.Direct thrombin inhibitors(DTIs)are emerging as alternative anticoagulants in patients supported by extracorporeal membrane oxygenation.Increasing evidence supports DTIs use as safe and effective in extracorporeal membrane oxygenation patients with and without heparininduced thrombocytopenia.This review outlines the pharmacology,dosing strategies and available protocols,monitoring parameters,and special use considerations for all available DTIs in extracorporeal membrane oxygenation patients.The advantages and disadvantages of DTIs in extracorporeal membrane oxygenation relative to unfractionated heparin will be described. | Barry Burstein Patrick M Wieruszewski Yan-Jun Zhao Nathan Smischney | 2019 | World Journal of Critical Care Medicine2019，8，6： | 12 |
| 4 | PIV measurements of turbulent jets issuing from triangular and circular orifice plates显示文摘The present study experimentally investigated the near-field flow mixing characteristics of two turbulent jets issuing from equilateral triangular and circular orifice plates into effectively unbounded surroundings,respectively.Planar particle image velocimetry(PIV) was applied to measure the velocity field at the same Reynolds number of Re=50,000,where Re = UeDe /with Ue being the exit bulk velocity and the kinematic viscosity of fluid,D e the equivalent diameters.The instantaneous velocity,mean velocity,Reynolds stresses were obtained.From the mean velocity field,the centreline velocity decay rate and half-velocity width were derived.Comparing the mixing characteristics of the two jets,it is found that the triangular jet has a faster mixing rate than the circular counterpart.The triangular jet entrainments with the ambient fluid at a higher rate in the near field.This is evidenced by a shorter unmixed core,faster Reynolds stress and centreline turbulence intensity growth.The primary coherent structures in the near field are found to break down more rapidly in the triangular jet as compared to the circular jet.Over the entire measurement region,the triangular jet maintained a higher rate of decay and spread.Moreover,all components of Reynolds stress of the triangular jet appear to reach their peaks earlier,and then decay more rapidly than those of the circular jet.In addition,the axis-switching phenomenon is observed in the triangular jet. | XU MinYi ZHANG JianPeng MI JianChun NATHAN G J KALT P A M | 2013 | Science China(Physics,Mechanics & Astronomy)2013，56，6： | 7 |
| 5 | Stem cells:An eventual treatment option for heart diseases显示文摘Stem cells are of global excitement for various diseases including heart diseases. It is worth to understand the mechanism or role of stem cells in the treatment of heart failure. Bone marrow derived stem cells are commonly practiced with an aim to improve the function of the heart. The majority of studies have been conducted with acute myocardial infarction and a few has been investigated with the use of stem cells for treating chronic or dilated cardiomyopathy. Heterogeneity in the treated group using stem cells has greatly emerged. Ever increasing demand for any alternative made is of at most priority for cardiomyopathy. Stem cells are of top priority with the current impact that has generated among physicians. However,meticulous selection of proper source is required since redundancy is clearly evident with the present survey. This review focuses on the methods adopted using stem cells for heart diseases and outcomes that are generated so far with an idea to determine the best therapeutic possibility in order to fulfill the present demand. | Joseph C Bilgimol Subbareddy Ragupathi Lakshmanan Vengadassalapathy Nathan S Senthil Kali-muthu Selvakumar M Ganesan Sadananda Rao Manjunath | 2015 | World Journal of Stem Cells2015，7，8： | 6 |
| 6 | 临床实践指南应当包含治疗负担显示文摘医疗方案的实施需要花费大量时间和精力,给慢性病患者带来巨大负担。然而,临床实践指南高度重视的是得到某些临床结果(如呼吸急促减少或存活率增加),传统指南的建议也是从同样角度提出的。最近的指南会考虑患者的价值观以及指南建议行为的可接受性和可行性,但对治疗负担没有明确规定。这使患者很难根据自己的价值观和能力对治疗做出明智的决定。 | Claudia C Dobler Nathan Harb Catherine A Maguire Carol L Armour Courtney Coleman M Hassan Murad 邓璇(译) 莫云凌(校) | 2019 | 英国医学杂志中文版2019，22，3： | 3 |
| 7 | Hepatocellular Carcinoma: Current Management and Perspectives for the Future显示文摘 | Nuh N. Rahbari Arianeb Mehrabi Nathan M. Mollberg Sascha A. Müller Moritz Koch Markus W. Büchler Jürgen Weitz | 2011 | Annals of Surgery2011，，3： | 3 |
| 8 | Orthopaedic care provided by the 14th combat support hospital in support of humanitarian and disaster relief after hurricane Maria in Puerto Rico显示文摘On September 20,2017 Hurricane Maria,a category 4 hurricane,made landfall on the eastern coast of Puerto Rico.This was preceded by Hurricane Irma,a category 5 hurricane,which passed just off the coast 13 d prior.The destruction from both Hurricane Irma and Maria precipitated a coordinated federal response which included the Federal Emergency Management Agency(FEMA)and the United States military.The United States Army dispatched the 14^th Combat Support Hospital(CSH)to Humacao,a city on the eastern side of the island where Maria made landfall.The mission of the 14^th CSH was to provide medical humanitarian aid and conduct disaster relief operations in support of the government of Puerto Rico and FEMA.During the 14^th CSH deployment to Puerto Rico,1157 patients were evaluated and treated.Fifty-seven operative cases were performed to include 23 orthopaedic cases.The mean age of the orthopaedic patients treated was 45.7 years(range 13-76 years).The most common operation was irrigation and debridement of open contaminated and/or infected wounds.Patients presented a mean 10.8 d from their initial injury(range 1-40 d).Fractures and infections were the most common diagnoses with the greatest delay in treatment from the initial date of injury.The deployment of the 14^th CSH to Puerto Rico was unique in its use of air transport,language and local customs encountered,as well as deployment to a location outside the continental United States.These factors coupled with the need for rapid deployment of the 14^th CSH provided valuable experience which will undoubtedly enable future success in similar endeavors. | Nathan Lanham Kyle Bockelman Fernando Lopez Marc M Serra Bradford Scanlan | 2020 | World Journal of Orthopedics2020，11，2： | 2 |
| 9 | Metastatic recurrence to a solitary lymph node four years after hepatic lobectomy for primary hepatocellular carcinoma显示文摘This report describes a patient that developed recurrent metastatic hepatocellular carcinoma(HCC) to a suprapancreatic lymph node four years after being treated for primary HCC via complete left hepatectomy. Metastatic HCC was proven by pathologic confirmation. The report addresses the role of surgical resection as a treatment modality for recurrent HCC to solitary lymph nodes. The role of biological chemotherapy as adjuvant treatment is also addressed. | Michael L Caparelli Nathan J Roberts Timothy S Braverman Robert M Stevens Edward R Broun Shyam Allamaneni | 2016 | World Journal of Hepatology2016，8，23： | 2 |
| 10 | A randomised comparison of parecoxib versus placebo for pain management following minor day stay gynaecological surgery显示文摘 | Luscombe K S McDonnell N J Muchatuta N A Paech M J Nathan E A | 2010 | Anaesthesia and Intensive Care2010，，1： | 2 |
| 11 | Evidence That the Diabetes Gene Encodes the Leptin Receptor: Identification of a Mutation in the Leptin Receptor Gene in db / db Mice显示文摘 | Hong Chen Olga Charlat Louis A Tartaglia Elizabeth A Woolf Xun Weng Stephen J Ellis Nathan D Lakey Janice Culpepper Karen J More Roger E Breitbart Geoffrey M Duyk Robert I Tepper Jay P Morgenstern | 1996 | Cell1996，，3： | 2 |
| 12 | Mechanisms of long-distance seed dispersal显示文摘 | Nathan R Schurr F M Spiegel O | 2008 | Trends in Ecology and Evolution2008，23，： | 1 |
| 13 | Quality of an urban community:a framework for understanding the relationship between quality and physical form显示文摘 | Smith T Nelischer M Nathan Perkins | 1997 | Landscape and Urban Planning1997，39，： | 1 |
| 14 | Electroanatomic versus fluoroscopic mapping for catheter ablation procedures: a prospec- tive randomized study显示文摘 | Sporton S Earley M Nathan A | 2004 | J Cardiovasc Electrophysiol2004，15，： | 1 |
| 15 | Management of hyperglycaemia in type 2 diabetes mellitus: a consensus algorithm for the initiation and adjustment of therapy显示文摘 | Nathan D M Buse J B Davidson M B | 2008 | Diabetologia2008，16，51： | 1 |
| 16 | A study of the prevalence of sexually transmitted infections and related conditions in pregnant women attending a sexual health service显示文摘 | Bareny O J Nathan M | 2005 | Int J STD AIDS2005，16，5： | 1 |
| 17 | On-road measurement of fine particle and nitrogen oxide emissions from light-and heavy-duty motor vehicles显示文摘 | KIRCHSTETTER W Thomas HARLEY A Robert KREISBERG M Nathan | 1999 | Atmospheric Environment1999，33，18： | 1 |
| 18 | The use of extracorpo- real membrane oxygenation, high-frequency oscillatory ventilation, and surfactant for the management of intraoperative acute pulmonary hemorrhage in tetralogy of fallot 显示文摘 | Nathan M Kalyanaraman M Blank J | 2011 | J Cardiothorac Vasc Anesth2011，25，2： | 1 |
| 19 | Development of the asthma control test: a survey for assessing asthma control显示文摘 | Nathan RA Sorkness CA Kosinski M | 2004 | Al- lergy Clin lmmunol2004，113，1： | 1 |
| 20 | Management of hyperglycaemiain type 2 diabetes mellitus: a consensus algorithm for the initiation andadjustment oftherapy显示文摘 | Nathan D M Buse J B Davidson M B | 2008 | Diabetologia2008，51，1： | 1 |
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