The International Federation of Gynecology and Obstetrics (FIGO) 2000 scoring system classifies gestational trophoblastic neoplasia (GTN) patients into low- and high-risk groups, so that single- or multi-agent chemotherapy can be administered accordingly. However, a number of FIGO-defined low-risk patients still exhibit resistance to single-agent regimens, and the risk factors currently adopted in the FIGO scoring system possess inequable values for predicting single-agent chemoresistance. The purpose of this study is therefore to evaluate the efficacy of risk factors in predicting single-agent chemoresistance and explore the feasibility of simplifying the FIGO 2000 scoring system for GTN.
Methods
The clinical data of 578 GTN patients who received chemotherapy between January 2000 and December 2018 were retrospectively reviewed. Univariate and multivariate logistic regression analyses were carried out to identify risk factors associated with single-agent chemoresistance in low-risk GTN patients. Then, simplified models were built and compared with the original FIGO 2000 scoring system.
Results
Among the eight FIGO risk factors, the univariate and multivariate analyses identified that pretreatment serum human chorionic gonadotropin (hCG) level and interval from antecedent pregnancy were consistently independent predictors for both first-line and subsequent single-agent chemoresistance. The simplified model with two independent factors showed a better performance in predicting single-agent chemoresistance than the model with the other four non-independent factors. However, the addition of other co-factors did improve the efficiency. Overall, simplified models can achieve favorable performance, but the original FIGO 2000 prognostic system still features the highest discrimination.
Conclusions
Pretreatment serum hCG level and interval from antecedent pregnancy were independent predictors for both first-line and subsequent single-agent chemoresistance, and they had greater weight than other non-independent factors in predicting single-agent chemoresistance. The simplified model composed of certain selected factors is a promising alternative to the original FIGO 2000 prognostic system, and it shows comparable performance.
Objective： Some animal models apply morphine in the drinking water to generate addiction, but related reports are not free of conflicting results. Accordingly, this study aimed to figure out if chronic consumption of morphine in the drinking water can induce morphine addiction in Wistar rats. Methods： For 3 weeks, the animals received a daily morphine dose of 35 mg/kg by offering a calculated volume of sugar water （5% sucrose） with morphine （0. l mg/ml） to each rat; animals receiving just sugar water served as controls. Immediately after the treatment phase, the tail immersion test was used to check for morphine tolerance, and all animals were then kept on tap water for one week （withdrawal phase）. Afterwards, all rats were allowed to choose their drinking source by offering two bottles, containing sugar water without and with morphine, simultaneously for two days （preference phase）. Results： While the chronic consumption of morphine led to a reduction in body weight and to morphine tolerance, the morphine-treated Wistar rats did not show any preference for the opiate-containing sugar water. Conclusion： Body weight loss and tolerance do not reveal a condition of drug craving, and current animal models should be re-evaluated regarding their potential to establish morphine addicted animals. 相似文献
In this work,the dynamic properties of composite cemented clay under a wide range of strains were studied considering the effect of different mixing ratio and the change of confining pressures through dynamic triaxial test. A simple and practical method to estimate the dynamic elastic modulus and damping ratio is proposed in this paper and a related empirical normalized formula is also presented. The results provide useful guidelines for preliminary estimation of cement requirements to improve the dynamic properties of clays. 相似文献
Study on the action mechanism of inflammatory mediators generated by the severe acute pancreatitis(SAP) in mul-tiple organ injury is a hotspot in the surgical field.In clinical practice,the main complicated organ dysfunctions are shock,res-piratory failure,renal failure,encephalopathy,with the rate of hepatic diseases being closely next to them.The hepatic injury caused by SAP cannot only aggravate the state of pancreatitis,but also develop into hepatic failure and cause patient death.Its complicated pathogenic mechanism is an obstacle in clinical treatment.Among many pathogenic factors,the changes of vasoac-tive substances,participation of inflammatory mediators as well as OFR(oxygen free radical),endotoxin,etc.may play important roles in its progression. 相似文献
Objective:The purpose of this study was to investigate the effects of a zinc-substituted nano-hydroxyapatite(Zn-HA) coating,applied by an electrochemical process,on implant osseointegraton in a rabbit model.Methods:A Zn-HA coating or an HA coating was deposited using an electrochemical process.Surface morphology was examined using field-emission scanning electron microscopy.The crystal structure and chemical composition of the coatings were examined using an X-ray diffractometer(XRD) and Fourier transform infrared spectroscopy(FTIR).A total of 78 implants were inserted into femurs and tibias of rabbits.After two,four,and eight weeks,femurs and tibias were retrieved and prepared for histomorphometric evaluation and removal torque(RTQ) tests.Results:Rod-like HA crystals appeared on both implant surfaces.The dimensions of the Zn-HA crystals seemed to be smaller than those of HA.XRD patterns showed that the peaks of both coatings matched well with standard HA patterns.FTIR spectra showed that both coatings consisted of HA crystals.The Zn-HA coating significantly improved the bone area within all threads after four and eight weeks(P<0.05),the bone to implant contact(BIC) at four weeks(P<0.05),and RTQ values after four and eight weeks(P<0.05).Conclusions:The study showed that an electrochemically deposited Zn-HA coating has potential for improving bone integration with an implant surface. 相似文献
Objective:This study deals with the effect of phosphoric acid etching and conditioning on enamel micro-tensile bond strengths(μTBSs)of conventional and resin-modified glass ionomer cements(GICs/RMGICs).Methods:Forty-eight bovine incisors were prepared into rectangular blocks.Highly-polished labial enamel surfaces were either acid-etched,conditioned with liquids of cements,or not further treated(control).Subsequently,two matching pre-treated enamel surfaces were cemented together with one of four cements[two GICs:Fuji I(GC),Ketac Cem Easymix(3M ESPE);two RMGICs:Fuji Plus(GC),RelyX Luting(3M ESPE)]in preparation forμTBS tests.Pre-treated enamel surfaces and cement-enamel interfaces were analyzed by scanning electron microscopy(SEM).Results:Phosphoric acid etching significantly increased the enamelμTBS of GICs/RMGICs.Conditioning with the liquids of the cements produced significantly weaker or equivalent enamelμTBS compared to the control.Regardless of etching,RMGICs yielded stronger enamelμTBS than GICs.A visible hybrid layer was found at certain enamelcement interfaces of the etched enamels.Conclusions:Phosphoric acid etching significantly increased the enamelμTBSs of GICs/RMGICs.Phosphoric acid etching should be recommended to etch the enamel margins before the cementation of the prostheses such as inlays and onlays,using GICs/RMGICs to improve the bond strengths.RMGICs provided stronger enamel bond strength than GICs and conditioning did not increase enamel bond strength. 相似文献
