Activiteit

ker in LT.

To develop and validate a conversion table between the MMSE and the MoCA using Rasch analysis in older adults undergoing selective surgery and examine its diagnostic accuracy in detecting cognitive impairment.

Cross-sectional study.

Older patients [N=129; age 66.0 (4.6) years, education 7.7 (3.5) years] undergoing elective surgery were recruited from December 2017 to June 2018. All participants completed the MMSE and MoCA and 113 of them completed a battery of neuropsychological tests. Common person linking based on Rasch analysis was performed to develop the conversion table. The conversions were validated by calculating the intraclass correlation coefficient (ICC), score differences between actual and converted scores, and root mean squared error of the difference (RMSE). The diagnostic accuracy of the conversions for detecting cognitive impairment was also tested.

The MoCA [person measure 1.3 (1.1) logits] was better targeted to the patients than the MMSE [person measure 3.2 (1.3) logits]. ConversiMMSE based on Rasch analysis is now possible for surgical setting and clinical research.

HBV-specific T cell receptor (HBV-TCR) engineered T cells have the potential for treating hepatocellular carcinoma (HCC) relapses after liver transplantation, but their efficacy can be hampered by the concomitant immunosuppressive treatment required to prevent graft rejection. Our aim is to molecularly engineer TCR-T cells that could retain their polyfunctionality in such patients while minimising the associated risk of organ rejection.

We first analysed how immunosuppressive drugs can interfere with the in vivo function of TCR-T cells in liver transplanted patients with HBV-HCC recurrence receiving HBV-TCR T cells, and in vitro in the presence of clinically relevant concentrations of immunosuppressive Tacrolimus (TAC) and Mycophenolate Mofetil (MMF). Immunosuppressive Drug Resistant Armored (IDRA) TCR-T cells of desired specific (HBV or EBV) were then engineered by concomitantly electroporating mRNA encoding specific-TCRs and mutated variants of calcineurin B (CnB) and inosine-5′-monophosphate dehydrogenpressive effects of TAC and MMF. This finding has important clinical applications for the treatment of HBV-HCC relapses and other pathologies occurring in organ transplanted patients.

To determine the incidence and risk factors associated with peripherally inserted central catheter-related thrombosis (PICC-RT) in patients with lung cancer.

A retrospective cross-sectional design.

Patients with lung cancer receiving PICC insertion during 1 March 2014-31 May 2019 at a tertiary hospital in Shanghai, China were enrolled (N=748). Symptomatic PICC-RT was confirmed by Doppler ultrasonography in the presence of clinical symptoms and signs. Univariate and multivariate logistic regression analyses were performed to identify risk factors of symptomatic PICC-RT.

Among the patients (mean age, 60.7years; males, 67.1%), 55 (7.35%) had symptomatic PICC-RT. Based on the multivariate analysis, history of smoking [OR 2.49 (1.13-5.46), p<.05], use of Carboplatin [OR 2.23 (1.19-4.17), p<.05] or Docetaxel [OR 7.23 (1.65-31.56), p<.05], PICC size [OR 3.52 (1.78-6.99), p<.001], and level of D-dimer [OR 5.32 (2.39-11.83), p<.001] were significant risk factors of PICC-RT.

Several modifiable ver appropriate interventions against modifiable risk factors to reduce the risk of PICC-RT.Integrated behavioral responses to emotionally salient stimuli require the concomitant activation of descending neural circuits that integrate physiological, affective, and motor responses to stress. Our previous work interrogated descending circuits in the brainstem and spinal cord that project to motor and sympathetic targets. 4-Hydroxynonenal in vivo The hypothalamic paraventricular nucleus (PVN), a key node of this circuitry, integrates multiple motor and sympathetic responses activated by stress. The present study sought to determine whether descending projections from the PVN to targets in muscle and adrenal gland are differentially organized in rats with inborn differences in emotionality and stress responsivity. We utilized retrograde transsynaptic tract-tracing with unique pseudorabies virus (PRV) recombinants that were injected into sympathectomized gastrocnemius muscle and adrenal gland in two rat models featuring inborn differences in emotional behavior. Our tract-tracing results revealed a significant decrease in the number of PVN neurons with poly-synaptic projections to the gastrocnemius in male Wistar Kyoto [WKY] rats (versus Sprague Dawley rats) and selectively bred Low Novelty Responder [bLR] rats (versus selectively bred High Novelty Responder [bHR] rats). These neuroanatomical differences mirrored behavioral observations showing that both WKY and bLR rats display marked inhibition of emotional motor responses in a variety of settings relative to their respective controls. Our findings suggest that, in male rodents, PVN poly-synaptic projections to skeletal muscle may regulate emotional motor and coping responses to stress. More broadly, perturbations in PVN motor circuitry may play a role in mediating psychomotor disturbances observed in depression or anxiety-related disorders.

Withdrawal of treatment is a common therapeutic problem in patients with long-standing remission of inflammatory bowel disease.

To evaluate the relapse rate in patients with quiescent inflammatory bowel disease after cessation of biologic or immunomodulator therapy.

We searched five databases for studies evaluating disease relapse after withdrawal of monotherapy or a drug from combination therapy in Crohn’s disease or ulcerative colitis. In meta-analysis, risk ratios (RR) were calculated with 95% confidence intervals (CI).

Ten randomised controlled trials (587 patients) were included in the meta-analysis, and another nine studies in systematic review. Withdrawal of immunomodulator monotherapy resulted in a significantly higher risk of relapse within 24months of follow-up compared to ongoing therapy in Crohn’s disease, but not in ulcerative colitis (RR=2.06, CI 1.53-2.77 and RR=1.39, CI 0.85-2.26, respectively). Trial sequential analysis indicated that further studies with similar design are unlikely to change the significant association on relapse rates after withdrawing immunomodulator monotherapy in patients with Crohn’s disease.