Clinical outcomes of active specific immunotherapy in advanced colorectal cancer and suspected minimal residual colorectal cancer: a meta-analysis and system review

<p>Abstract</p> <p>Background</p> <p>To evaluate the objective clinical outcomes of active specific immunotherapy (ASI) in advanced colorectal cancer (advanced CRC) and suspected minimal residual colorectal cancer (suspected minimal residual CRC).</p> <p>Methods</p> <p>A search was conducted on Medline and Pub Med from January 1998 to January 2010 for original studies on ASI in colorectal cancer (CRC). All articles included in this study were assessed with the application of predetermined selection criteria and were divided into two groups: ASI in advanced CRC and ASI in suspected minimal residual CRC. For ASI in suspected minimal residual CRC, a meta-analysis was executed with results regarding the overall survival (OS) and disease-free survival (DFS). Regarding ASI in advanced colorectal cancer, a system review was performed with clinical outcomes.</p> <p>Results</p> <p>1375 colorectal carcinoma patients with minimal residual disease have been enrolled in Meta-analysis. A significantly improved OS and DFS was noted for suspected minimal residual CRC patients utilizing ASI (For OS: HR = 0.76, P = 0.007; For DFS: HR = 0.76, P = 0.03). For ASI in stage II suspected minimal residual CRC, OS approached significance when compared with control (HR = 0.71, P = 0.09); however, the difference in DFS of ASI for the stage II suspected minimal residual CRC reached statistical significance (HR = 0.66, P = 0.02). For ASI in stage III suspected minimal residual CRC compared with control, The difference in both OS and DFS achieved statistical significance (For OS: HR = 0.76, P = 0.02; For DFS: HR = 0.81, P = 0.03). 656 advanced colorectal patients have been evaluated on ASI in advanced CRC. Eleven for CRs and PRs was reported, corresponding to an overall response rate of 1.68%. No serious adverse events have been observed in 2031 patients.</p> <p>Conclusions</p> <p>It is unlikely that ASI will provide a standard complementary therapeutic approach for advanced CRC in the near future. However, the clinical responses to ASI in patients with suspected minimal residual CRC have been encouraging, and it has become clear that immunotherapy works best in situations of patients with suspected minimal residual CRC.</p

Early transition from insulin to sulfonylureas in neonatal diabetes and follow-up: experience from China

Background: Sulfonylurea therapy can improve glycemic control and ameliorate neurodevelopmental outcomes in patients suffering from neonatal diabetes mellitus (NDM) with KCNJ11 or ABCC8 mutations. As genetic testing results are often delayed, it remains controversial whether sulfonylurea treatment should be attempted immediately at diagnosis or doctors should await genetic confirmation. Objective: This study aimed to investigate the effectiveness and safety of sulfonylurea therapy in Chinese NDM patients during infancy before genetic testing results were available. Methods: The medical records of NDM patients with their follow‐up details were reviewed and molecular genetic analysis was performed. Sulfonylurea transfer regimens were applied in patients diagnosed after May 2010, and glycemic status and side effects were evaluated in each patient. Results: There were 23 NDM patients from 22 unrelated families, 10 had KCNJ11 mutations, 3 harbored ABCC8 mutations, 1 had INS mutations, 4 had chromosome 6q24 abnormalities, 1 had a deletion at chromosome 1p36.23p36.12, and 4 had no genetic abnormality identified. Sixteen NDM infants were treated with glyburide at an average age of 49 days (range 14‐120 days) before genetic confirmation. A total of 11 of 16 (69%) were able to successfully switch to glyburide with a more stable glucose profile. The responsive glyburide dose was 0.51 ± 0.16 mg/kg/d (0.3‐0.8 mg/kg/d), while the maintenance dose was 0.30 ± 0.07 mg/kg/d (0.2‐0.4 mg/kg/d). No serious adverse events were reported. Conclusions: Molecular genetic diagnosis is recommended in all patients with NDM. However, if genetic testing results are delayed, sulfonylurea therapy should be considered before such results are received, even in infants with newly diagnosed NDM

Using Earth Observation for Monitoring SDG 11.3.1-Ratio of Land Consumption Rate to Population Growth Rate in Mainland China

Urban sustainable development has attracted widespread attention worldwide as it is closely linked with human survival. However, the growth of urban areas is frequently disproportionate in relation to population growth in developing countries; this discrepancy cannot be monitored solely using statistics. In this study, we integrated earth observation (EO) and statistical data monitoring the Sustainable Development Goals (SDG) 11.3.1: &ldquo;The ratio of land consumption rate to the population growth rate (LCRPGR)&rdquo;. Using the EO data (including China&rsquo;s Land-Use/Cover Datasets (CLUDs) and the Defense Meteorological Satellite Program/Operational Linescan System (DMSP/OLS) nighttime light data) and census, we extracted the percentage of built-up area, disaggregated the population using the geographically weighted regression (GWR) model, and depicted the spatial heterogeneity and dynamic tendency of urban expansion and population growth by a 1 km &times; 1 km grid at city and national levels in mainland China from 1990 to 2010. Then, the built-up area and population density datasets were compared with other products and statistics using the relative error and standard deviation in our research area. Major findings are as follows: (1) more than 95% of cities experienced growth in urban built-up areas, especially in the megacities with populations of 5&ndash;10 million; (2) the number of grids with a declined proportion of the population ranged from 47% in 1990&ndash;2000 to 54% in 2000&ndash;2010; (3) China&rsquo;s LCRPGR value increased from 1.69 in 1990&ndash;2000 to 1.78 in 2000&ndash;2010, and the land consumption rate was 1.8 times higher than the population growth rate from 1990 to 2010; and (4) the number of cities experiencing uncoordinated development (i.e., where urban expansion is not synchronized with population growth) increased from 93 (27%) in 1990&ndash;2000 to 186 (54%) in 2000&ndash;2010. Using EO has the potential for monitoring the official SDGs on large and fine scales; the processes provide an example of the localization of SDG 11.3.1 in China