For patients with papillary thyroid microcarcinoma, thyroidectomy plus prophylactic central neck dissection is a safe and efficient procedure and it results in lower recurrence rate. Since the evidences are of low quality (non-randomized studies), further randomized trials are needed.
Background
The future of combined immunotherapy (a PD-1/PD-L1 plus a CTLA-4 antagonist) is very bright. However, besides improving efficacy, combined therapy increases treatment-related adverse events (TRAEs). Also, the clinical application is limited in some solid tumors.
Methods
This paper purports to investigate the TRAEs for the combined immunotherapy aiming for a more appropriate utilization of immune checkpoint inhibitors (ICIs) in clinical practice through a meta-analysis.
Results
A total of 17 eligible studies covering 2626 patients were selected for a meta-analysis based on specified inclusion and exclusion criteria. The incidence rates of any grade and grade 3 or higher TRAEs were 88% (95%CI, 84–92%) and 41% (95%CI, 35–47%), respectively. The overall incidence of any grade TRAEs leading to discontinuation of treatment was 20% (95%CI, 16–24%). The incidence rate of treatment related deaths was 4.3‰ (95%CI, 1.4‰-8.4‰). Analysis showed that NIVO1 + IPI3 cohort had higher incidences of grade 3 or higher TRAEs (RR = 1.77, 95%CI, 1.34–2.34,
p
< 0.0001) and any grade TRAEs leading to discontinuation of treatment (RR = 1.81, 95%CI, 1.08–3.04,
P
= 0.02), compared with NIVO3 + IPI1 regimen.
Conclusions
The combined therapy had high TRAEs. The TRAEs, especially grade 3 or higher, led to discontinuation of the treatment. Furthermore, the incidence of treatment-related deaths was rare. Moreover, the NIVO3 + IPI1 regimen, regardless of efficacy, is more recommended because of better tolerance and lower adverse events.
Electronic supplementary material
The online version of this article (10.1186/s12885-019-5785-z) contains supplementary material, which is available to authorized users.
The mechanism of enhancing the capacity of the LiFePO 4 cathodes in lithium ion batteries by the addition of a small amount of vanadium, which locate on the lithium site and induce lithium vacancies in the crystal structure, is reported in this article. As a result, the capacity increases from 138 mAh/g found for pristine LiFePO 4 to 155 mAh/g for the V-added compound, and the conductivity increases from 4.75 × 10 −4 S/cm for the LiFePO 4 without V addition to 1.9 × 10 −2 S/cm for the V-added compound. A possible model to facilitate the enhancement of conductivity and capacity is described with evidence supported by X-ray powder diffraction, X-ray absorption spectroscopy, and neutron powder diffraction data.
Background
In theory, proximal gastrectomy with double-tract reconstruction (PG-DT) was superior to total gastrectomy (TG) in hematologic and nutritional outcomes. However, its clinical effects in proximal early gastric cancer (EGC) have been controversial.
Methods
The purpose of this study was to investigate the outcomes of laparoscopic proximal gastrectomy with double-tract reconstruction (LPG-DT) for proximal EGC. For this systematic review and meta-analysis, we searched for articles published before December of 2018 in the following databases: PubMed, Web of Science, EBSCO, Medline, and Cochrane Library.
Results
The results showed no significant difference in the anastomotic stenosis (OR = 0.91, 95%CI = 0.33–2.50,
p
= 0.85) and reflux esophagitis (OR = 1.87, 95%CI = 0.62–5.65,
p
= 0.27) between LPG-DT and laparoscopic total gastrectomy (LTG). The vitamin B12 supplementation rate in the LPG-DT group was lower than the LTG group (OR = 0.06, 95%Cl = 0.01–0.59,
p
= 0.02).
Conclusions
Due to comparable clinical effect, PG-DT is comparable to TG for patients with proximal EGC. In addition, LPG-DT not only appears superior to TG in terms of preventing vitamin B12 deficiency, but also does not increase the risk of anastomotic stricture and reflux esophagitis.
Electronic supplementary material
The online version of this article (10.1186/s12893-019-0584-7) contains supplementary material, which is available to authorized users.
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