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Stroke is the primary reason for death and disability worldwide, with few treatment strategies to date. Neurosteroids, which are natural molecules in the brain, have aroused great interest in the field of stroke. Neurosteroids are a kind of steroid that acts on the nervous system, and are synthesized in the mitochondria of neurons or glial cells using cholesterol or other steroidal precursors. Neurosteroids mainly include estrogen, progesterone (PROG), allopregnanolone, dehydroepiandrosterone (DHEA), and vitamin D (VD). Most of the preclinical studies have confirmed that neurosteroids can decrease the risk of stroke, and improve stroke outcomes. In the meantime, neurosteroids have been shown to have a positive therapeutic significance in some post‐stroke complications, such as epilepsy, depression, anxiety, cardiac complications, movement disorders, and post‐stroke pain. In this review, we report the historical background, modulatory mechanisms of neurosteroids in stroke and post‐stroke complications, and emphasize on the application prospect of neurosteroids in stroke therapy.
Background IgA nephropathy (IgAN), characterized by the deposition of IgA, is one of the most common forms of primary glomerulonephritis. Although bibliometrics has been popular in the field of medicine, the bibliometric analysis of research related to IgAN has not been reported in the past 10 years. Therefore, the purpose of this study was to analyze the evolution trend and hotspots of IgAN over the last 10 years. Material/Methods The literature data related to IgAN between 2010 and 2021 were retrieved from the Web of Science Core Collection database, a high-quality digital database that has been broadly accepted among researchers and has become a common tool for retrieving and evaluating different types of publications. VOSviewer 1.6.18 was used to analyze co-authorship, co-occurrence, citation, and co-citation. CiteSpace 5.8.R3 was used to analyze burst keywords. Results According to the inclusion and exclusion criteria, 3664 papers were gathered. The country with the largest number of publications was China. Peking University was the most productive institution. The journal with the highest publications was Nephrology Dialysis Transplantation . The most prolific author was Zhang Hong. The highly cited references mainly investigated the pathology and pathogenesis of IgAN. The most frequent keywords were “IgA nephropathy”, “glomerulonephritis”, and “Oxford classification”. Conclusions Our study provided a comprehensive overview of IgAN research and showed the development status and scientific trend of IgAN through bibliometric analysis from 2010 to 2021. Our results will allow researchers to understand the existing research quickly and get direction for future research.
Background: In this meta-analysis, we compared the clinical efficacy and safety of ipilimumab/nivolumab combination therapy with those of ipilimumab monotherapy for stage III/IV unresectable melanoma. Materials and Methods: A search for randomized controlled trials (RCTs) reported by relevant studies conducted up to May 2021 was performed in the PubMed, Cochrane Library, Embase, CNKI, Wanfang, and VIP databases. Literature screening, data extraction, and quality evaluation were conducted independently by two researchers. The target parameters were complete response (CR), partial response (PR), objective response rate (ORR), time to progression (TTP), overall survival (OS), adverse events (AEs), and AEs in each organ system. Results: Ten articles reporting the results of three RCTs, including 790 subjects, were evaluated. In the pooled results, the CR (risk ratio [RR] = 4.48, 95% confidence interval [CI] [2.73, 7.33]), PR (RR = 2.82, 95% CI [2.09, 3.81]), and ORR (RR=3.31, 95%CI[2.60, 4.20]) were statistically different between the two treatment groups. The CR, PR, and ORR in the combination therapy group were 22.00% (90/409), 36.43% (149/409), and 58.44% (239/409), respectively, versus 4.97% (18/362), 12.98% (47/362), and 17.96% (65/362), respectively, in the monotherapy group. There were significant differences in TTP and OS between the two groups (TTP: hazard ratio [HR] = 0.41, 95% CI [0.35, 0.49]; OS: HR = 0.55, 95% CI [0.45, 0.67]). PFS and OS were longer in the combination therapy group than in the monotherapy group. The incidence of treatment-related AEs (TRAEs) and AEs leading to death (RR = 1.00, 95% CI [0.97, 1.02]; RR = 2.28, 95% CI [0.54, 9.55], respectively) was not significantly different, but the incidence of Grade 3-4 AEs and AEs leading to discontinuation was higher in the combination therapy group than in the monotherapy group (RR = 1.81, 95% CI [1.15, 2.86]); RR = 2.66, 95% CI [2.02, 3.52], respectively). Conclusions: Ipilimumab/nivolumab combination therapy was more effective than ipilimumab monotherapy for patients with stage III/IV unresectable melanoma. Although the incidence of TRAEs did not differ between the two groups, the severity of cases (Grade 3–4 AEs and AEs leading to discontinuation) was lower in the monotherapy group than in the combination therapy group. Additional high-quality studies are needed to verify the efficacy and safety of this drug combination, determine the optimal dosage, and explore additional potential drug combinations.
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