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Georgian Med News 2021 Mar(312):88-92

Tbilisi State Medical University, Department of Paediatric Neurology, Georgia.

Epilepsy is one of the most common neurological disorder affecting up to 1% of the world population. It is a heterogeneous disorder and includes genetic, structural, metabolic causes, sometimes reason is unknown. In recent 20 years inflammation has been considered as a possible etiologic factor in angiogenesis and epileptogenesis in experimental models but there is still lack of evidence if inflammation could be seen in clinical cases of children with different forms of epilepsy. Read More

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Georgian Med News 2021 Mar(312):52-56

NJSC "Medical University of Karaganda", Kazakhstan.

The new cardiovascular events development remains the main factors limiting its long-term effectiveness despite technological progress and the widespread use of percutaneous coronary intervention (PCI). Objective - to assess the effect of clinical and genetic factors on the development of complication after percutaneous coronary intervention with double antiplatelet therapy (DAT). Case-control. Read More

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COVID-19 infection in severe Alpha 1-antitrypsin deficiency: Looking for a rationale.

Respir Med 2021 Apr 30;183:106440. Epub 2021 Apr 30.

Centre for Diagnosis of Inherited Alpha-1 Antitrypsin Deficiency, Laboratory of Biochemistry and Genetics, Institute for Respiratory Disease, Department of Internal Medicine and Therapeutics, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.

The clinical manifestations of COVID-19 are heterogeneous: 46.4% of patients admitted into hospital reported to have at least one comorbidity. Comorbidities such as COPD, diabetes, hypertension and malignancy predispose patients with Covid-19 to adverse clinical outcomes. Read More

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Comparison in detection of prodromal Parkinson's disease patients using original and updated MDS research criteria in two independent cohorts.

Parkinsonism Relat Disord 2021 Apr 30;87:48-55. Epub 2021 Apr 30.

Department of Neurology, P. J. Safarik University, Trieda SNP 1, 04011, Kosice, Slovak Republic; Department of Neurology, University Hospital L. Pasteur, Rastislavova 43, 04190, Kosice, Slovak Republic.

Introduction: MDS research criteria for prodromal Parkinson's disease (pPD) were published in 2015 and updated in 2019. We aimed to determine the difference in pPD patient detection rates in two cohorts recruited via gastrointestinal symptoms (PARCAS study) and the presence of a probable REM sleep behaviour disorder (PDBIOM study) using the original and updated criteria.

Methods: We evaluated all risk and prodromal markers, except genetic testing, plasma urate and physical inactivity, in both cohorts and DaT scan, diabetes mellitus type II and cognitive deficit in the PARCAS cohort. Read More

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Benign cystic mesothelioma: A case report on the presentation of an unusual tumor.

Int J Surg Case Rep 2021 Apr 30;82:105918. Epub 2021 Apr 30.

King Hamad University Hospital, Bahrain.

Introduction: Benign cystic mesothelioma of the peritoneum is a rare, benign abdominal tumor. It can present with vague signs and symptoms and is often found on imaging or incidentally during surgery.

Presentation Of Case: We report the case of a 30-year-old man presenting with acute abdominal pain that radiated to the right iliac fossa. Read More

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Hypoxic acclimation improves cardiac redox homeostasis and protects heart against ischemia-reperfusion injury through upregulation of O-GlcNAcylation.

Redox Biol 2021 Apr 30;43:101994. Epub 2021 Apr 30.

Laboratory of Mitochondria and Metabolism, Department of Anesthesiology, National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, 610041, China; Laboratory of Anesthesia and Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, 610041, China. Electronic address:

Ischemia-reperfusion (I/R) injury is detrimental to cardiovascular system. Alteration in glucose metabolism has been recognized as an important adaptive response under hypoxic conditions. However, the biological benefits underlying this metabolic phenotype remain to be elucidated. Read More

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Alpelisib in combination with everolimus ± exemestane in solid tumours: Phase Ib randomised, open-label, multicentre study.

Eur J Cancer 2021 May 5;151:49-62. Epub 2021 May 5.

Institut Gustave Roussy, Villejuif, France.

Background And Purpose: Combined mTORC1 inhibition with everolimus (EVE) and phosphatidylinositol 3-kinase catalytic subunit p110α blockade with alpelisib (ALP) has demonstrated synergistic efficacy in preclinical models and supports testing the combination of ALP and EVE in the clinical setting. The primary objective was to determine the maximum tolerated dose (MTD)/recommended dose for expansion (RDE) of ALP in combination with EVE and in combination with EVE and exemestane (EXE) and subsequently assess safety, preliminary efficacy and effect of ALP on the pharmacokinetics of EVE and determine the magnitude of the drug-drug interaction.

Patients And Methods: Dose escalation phases were conducted in patients with advanced solid tumours and in postmenopausal women with hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) advanced breast cancer (ABC). Read More

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Early warning of infection in patients undergoing hematopoietic stem cell transplantation using heart rate variability and serum biomarkers.

Transplant Cell Ther 2021 May 5. Epub 2021 May 5.

Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; Ottawa Hospital Research Institute, Ottawa, ON, Canada; Departments of Critical Care Medicine and Surgery, The Ottawa Hospital, Ottawa, ON, Canada.

Background: Early warning of infection is critical to reduce risk of deterioration and mortality, especially in neutropenic patients following hematopoietic stem cell transplantation (HCT). Given that heart rate variability (HRV) is a sensitive and early marker for infection and serum inflammatory biomarkers can have high specificity for infection, we hypothesized their combination may be useful for accurate early warning of infection.

Purpose: Develop and evaluate a composite predictive model utilizing continuous HRV with daily serum biomarker measurements to provide risk stratification of future deterioration in HCT patients. Read More

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The Financial Impact of the COVID-19 Pandemic on Neurosurgery Practice in Spring 2020.

World Neurosurg 2021 May 5. Epub 2021 May 5.

Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, TX USA. Electronic address:

Background: The COVID-19 pandemic has changed healthcare delivery across the United States. However, few analyses are specifically dedicated to quantifying the financial impact of the pandemic on practicing neurosurgeons. The authors present a survey analysis to address this need. Read More

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Clinical validation of Whole Genome Sequencing for cancer diagnostics.

J Mol Diagn 2021 May 5. Epub 2021 May 5.

Hartwig Medical Foundation, Science Park 408, 1098 XH Amsterdam, the Netherlands; Center for Molecular Medicine and Oncode Institute, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands.

Whole genome sequencing (WGS) using fresh frozen tissue and matched blood samples from cancer patients is becoming in reach as the most complete genetic tumor test. With a trend towards the availability of small biopsies and the need to screen an increasing number of (complex) biomarkers, the use of a single all-inclusive test is preferred over multiple consecutive assays. To meet high-quality diagnostics standards, we optimized and clinically validated WGS sample and data processing procedures resulting in a technical success rate of 95. Read More

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Intravenous tranexamic acid reduce postoperative drainage and pain after open elbow arthrolysis: A randomized controlled trial.

J Shoulder Elbow Surg 2021 May 5. Epub 2021 May 5.

Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, P. R. China. Electronic address:

Background: Open elbow arthrolysis (OEA), which has become an established treatment for post-traumatic elbow stiffness (PTES), requires complete release of contracture tissue and wide excision of ectopic bone, which results in extensive bleeding. The aim of the present study is to evaluate the efficacy of intravenous tranexamic acid (TXA) on postoperative drainage, calculated blood loss and early clinical outcomes in patients undergoing OEA.

Methods: A double-blind, randomized, placebo-controlled trial including 96 patients undergoing OEA was undertaken. Read More

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MUSIC INTERVENTIONS IN PEDIATRIC ONCOLOGY: systematic review and meta-analysis.

Complement Ther Med 2021 May 5:102725. Epub 2021 May 5.

Pediatrics Department of the University of São Paulo, Av. Dr Enéas Carvalho Aguiar No. 647, Cerqueira Cesar, São Paulo, CEP: 05403-901, Brazil. Electronic address:

Background: Pain is a disagreeable and distressing feeling that affects human beings in multi-dimensional ways. A number of non-pharmacological interventions have had varying degrees of success in treating cancer-related pain, such as breathing and relaxation techniques, and music therapy, which have been identified as beneficial therapies for alleviating pain and anxiety.

Objective: Identify the therapeutic effects of music interventions in psychological and physiological terms and on the quality of life of children undergoing cancer treatment. Read More

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Lack of Conclusive Evidence of the Benefit of Biologic Augmentation in Core Decompression for Nontraumatic Osteonecrosis of the Femoral Head: A Systematic Review.

Arthroscopy 2021 May 5. Epub 2021 May 5.

Department of Orthopaedics, Balgrist University Hospital, Forchstrasse 340, 8008 Zurich, Switzerland.

Purpose: To assess whether biologic augmentation in addition to core decompression (CD), compared to CD alone, improves clinical and radiographic outcomes in the treatment of nontraumatic osteonecrosis of the femoral head (ONFH). Our hypothesis was that biologic augmentation would reduce the progression of osteonecrosis and therefore also the rate of conversion to THA.

Methods: A systematic review was performed in accordance with the Preferred Reporting Items of Systematic Reviews and Meta-analysis (PRISMA) statement. Read More

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Identification of distinct clinical subphenotypes in critically ill patients with COVID-19.

Chest 2021 May 5. Epub 2021 May 5.

Center for Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Pulmonary, Allergy and Critical Care Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.

Background: Subphenotypes have been identified in patients with sepsis and acute respiratory distress syndrome (ARDS), and are associated with different outcomes and response to therapies.

Research Question: Can unique subphenotypes be identified among critically ill patients with coronavirus disease 2019 (COVID-19)?

Study Design: & Methods: Using data from a multicenter cohort study that enrolled critically ill patients with COVID-19 from 67 hospitals across the United States, we randomly divided centers into Discovery and Replication cohorts. We utilized latent class analysis independently in each cohort to identify subphenotypes based on clinical and laboratory variables. Read More

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Deep phenotyping of the Cdhr1 mouse validates its use in pre-clinical studies for human CDHR1-associated retinal degeneration.

Exp Eye Res 2021 May 5:108603. Epub 2021 May 5.

Nuffield Laboratory of Ophthalmology, Department of Clinical Neurosciences, Oxford University, West Wing, John Radcliffe Hospital, Oxford, OX3 9DU, UK; Oxford Eye Hospital, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Headley Way, Oxford, OX3 9DU, UK. Electronic address:

Purpose: To validate the Cdhr1 mouse as a model for human CDHR1-associated retinal degeneration, which may present as cone-rod dystrophy or geographic atrophy.

Methods: Deep phenotyping of Cdhr1(n = 56) and C57BL6J wildtype control mice (n = 45) was undertaken using in vivo multimodal retinal imaging and dark- and light-adapted electroretinography (ERG) over 15 months to evaluate rod- and cone-photoreceptor responses and retinal morphology.

Results: Cdhr1 retinas exhibited outer retinal thinning on optical coherence tomography (OCT) at 1-month versus C57BL6J (mean 14. Read More

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ENB-guided microwave ablation combined with uniportal VATS for multiple ground glass opacities.

Ann Thorac Surg 2021 May 5. Epub 2021 May 5.

Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China. Electronic address:

Background: An increasing number of patients are being diagnosed with multiple ground glass opacities (GGOs), but a consensus on the treatment of these patients is still lacking. The aim of this study was to investigate the safety and feasibility of a novel technique, electromagnetic navigation bronchoscopy (ENB)-guided microwave ablation combined with uniportal video-assisted thoracoscopic surgery (Uni-VATS), in patients with multiple GGOs.

Methods: The clinical, radiographic, surgical, and pathological data of patients with multiple GGOs who underwent ENB-guided microwave ablation combined with Uni-VATS from October 2018 to December 2019 were reviewed. Read More

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Maternal haemodynamics during labour epidural analgesia with and without adrenaline.

Scand J Pain 2021 May 10. Epub 2021 May 10.

Department of Anaesthesia, Akershus University Hospital, Lørenskog, Norway.

Objectives: Labour is one of the most painful experiences in a woman's life. Epidural analgesia using low-concentration local anaesthetics and lipophilic opioids is the gold standard for pain relief during labour. Pregnancy in general, particularly labour, is associated with changes in maternal haemodynamic variables, such as cardiac output and heart rate, which increase and peak during uterine contractions. Read More

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Epidemiology of Tongue Squamous Cell Carcinoma: A Retrospective Cohort Study.

Oral Dis 2021 May 8. Epub 2021 May 8.

Clinical Research Division, National Cancer Institute, Rio de Janeiro (RJ), Brazil.

Objective: Analyze the epidemiological profile and the specific survival of patients diagnosed with tongue squamous cell carcinoma at the National Cancer Institute (INCA).

Materials And Methods: Hospital Cancer Registry System Data and Mortality Information from 2007 to 2009 were retrieved in a retrospective cohort study of patients diagnosed with tongue squamous cell carcinoma. Specific survival was estimated using the Kaplan-Meier method. Read More

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Statin therapy and the incidence of thromboembolism and vascular events following liver transplantation.

Liver Transpl 2021 May 8. Epub 2021 May 8.

Mayo Clinic Arizona, Phoenix, AZ, USA.

Statin therapy may reduce the risk of venous thromboembolism (VTE), which may impact solid organ transplant outcomes. We evaluated the incidence of VTE and other complications after liver transplantation stratified by hyperlipidemia status and statin use using a retrospective cohort study approach from a high-volume liver transplant center. We reviewed all primary orthotopic liver transplant (OLT) records from January 2014-December 2019 from our center. Read More

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Pattern and localization of perineural invasion predict poor survival in oral tongue carcinoma.

Oral Dis 2021 May 8. Epub 2021 May 8.

Department of Clinical Specialistic and Dental Sciences, Marche Polytechnic University, Ancona, Italy.

Background: Survival rate for oral tongue squamous cell carcinoma (OTSCC) is still poor and, despite Tumor-Node-Metastasis staging system has been recently updated, patients included under the same stage still show difference in prognosis. Perineural invasion (PNI) emerged to be an indicator of tumour aggressive behavior and unfortunate events. In this study we investigate the clinic and prognostic value of PNI in a cohort of OTSCC patients. Read More

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The effect of experimental and clinical musculoskeletal pain on spinal and supraspinal projections to motoneurons and motor unit properties in humans: a systematic review.

Eur J Pain 2021 May 8. Epub 2021 May 8.

Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom.

Background And Objective: Numerous studies have examined the influence of pain on spinal reflex excitability, motor unit behaviour and corticospinal excitability. Nevertheless, there are inconsistencies in the conclusions made. This systematic review sought to understand the effect of pain on spinal and supraspinal projections to motoneurons and motor unit properties by examining the influence of clinical or experimental pain on the following three domains: H reflex, corticospinal excitability and motor unit properties. Read More

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Remnant cholesterol predicts progression of diabetic nephropathy and retinopathy in type 1 diabetes.

J Intern Med 2021 May 8. Epub 2021 May 8.

From the, Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland.

Background: We aimed to assess whether remnant cholesterol concentration and variability predict the progression of diabetic nephropathy (DN) and severe diabetic retinopathy (SDR) in type 1 diabetes.

Methods: This observational prospective study covered 5150 FinnDiane Study participants. Remnant cholesterol was calculated as total cholesterol - LDL cholesterol - HDL cholesterol and variability as the coefficient of variation. Read More

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24-hour fluid administration in emergency department patients with suspected infection; a multicenter, prospective, observational study.

Acta Anaesthesiol Scand 2021 May 8. Epub 2021 May 8.

Research Center for Emergency Medicine, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital, Denmark.

Background: To describe 24-hour fluid administration in emergency department (ED) patients with suspected infection.

Methods: A prospective, multicenter, observational study conducted in three Danish hospitals, January 20-March 2, 2020. We included consecutive adult ED-patients with suspected infection (drawing of blood culture and/or intravenous antibiotic administration within 6 hours of admission). Read More

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Nephroplex: a kidney-focused NGS panel highlights the challenges of PKD1 sequencing and identifies a founder BBS4 mutation.

J Nephrol 2021 May 8. Epub 2021 May 8.

Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.

Background: Genetic testing of patients with inherited kidney diseases has emerged as a tool of clinical utility by improving the patients' diagnosis, prognosis, surveillance and therapy.

Methods: The present study applied a Next Generation Sequencing (NGS)-based panel, named NephroPlex, testing 115 genes causing renal diseases, to 119 individuals, including 107 probands and 12 relatives. Thirty-five (poly)cystic and 72 non (poly)cystic individuals were enrolled. Read More

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Medulloblastoma recurrence and metastatic spread are independent of colony-stimulating factor 1 receptor signaling and macrophage survival.

J Neurooncol 2021 May 8. Epub 2021 May 8.

Division of Hematology/Oncology, Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, WA, USA.

Purpose: Tumor infiltration by immunosuppressive myeloid cells or tumor-associated macrophages (TAMs) contributes to tumor progression and metastasis. In contrast to their adult counterparts, higher TAM signatures do not correlate with aggressive tumor behavior in pediatric brain tumors. While prominent TAM infiltrates exist before and after radiation, the degree to which irradiated macrophages and microglia support progression or leptomeningeal metastasis remains unclear. Read More

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Systematic review and meta-analysis of cervical metastases in oral maxillary squamous cell carcinoma.

Cancer Rep (Hoboken) 2021 May 8:e1410. Epub 2021 May 8.

University of Sydney, Camperdown, New South Wales, Australia.

Background: Management of the node-negative neck in oral maxillary squamous cell carcinoma (SCC), encompassing the hard palate and upper alveolar subsites of the oral cavity, is controversial, with no clear international consensus or recommendation regarding elective neck dissection in the absence of cervical metastases.

Aim: To assess the occult metastatic rate in patients with clinically node negative oral maxillary SCC; both as an overall metastatic rate, and a comparison of patients managed with an elective neck dissection at index surgery, compared to excision of the primary with clinical observation of the neck.

Methods And Results: A systematic review was performed by two independent investigators for studies relating to oral maxillary SCC and analysed according to PRISMA criteria. Read More

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Safety and efficacy of autologous whole cell vaccines in hematologic malignancies: A systematic review and meta-analysis.

Hematol Oncol 2021 May 8. Epub 2021 May 8.

Cancer Therapeutics Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada.

Autologous cell vaccines use a patient's tumor cells to stimulate a broad antitumor response in vivo. This approach shows promise for treating hematologic cancers in early phase clinical trials, but overall safety and efficacy remain poorly described. We conducted a systematic review assessing the use of autologous cell vaccination in treating hematologic cancers. Read More

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Exposure to stressful and traumatic life events in hoarding: Comparison to clinical controls.

J Clin Psychol 2021 May 8. Epub 2021 May 8.

Anxiety Treatment and Research Clinic, St. Joseph's Healthcare, Hamilton, Ontario, Canada.

Background: Individuals with hoarding report stressful and traumatic life events at an elevated rate compared with those with obsessive-compulsive disorder and healthy controls, but have not been compared with other clinical groups. This study compared rates of traumatic life events between those with clinically significant hoarding, anxiety disorders, or posttraumatic stress disorder (PTSD), hypothesizing that rates would be higher in the hoarding and PTSD groups than the anxiety group.

Methods: Rates of traumatic and stressful events were compared across groups. Read More

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Using Pressure Mapping to Optimize Hospital-Acquired Pressure Injury Prevention Strategies in the Burn Intensive Care Unit.

J Burn Care Res 2021 May 8. Epub 2021 May 8.

Department of Plastic & Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, Maryland, USA.

Although prior studies have demonstrated the utility of real-time pressure mapping devices in preventing pressure ulcers, there has been little investigation of their efficacy in burn intensive care unit (BICU) patients, who are at especially high risk for these hospital-acquired injuries. This study retrospectively reviewed clinical records of BICU patients to investigate the utility of pressure mapping data in determining the incidence, predictors and associated costs of hospital-acquired pressure injuries. Of 122 patients, 57 (47%) were studied prior to implementation of pressure mapping and 65 (53%) were studied after implementation. Read More

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[Factors affecting survival prognosis of advanced gastric cancer and establishment of a nomogram predictive model].

Nan Fang Yi Ke Da Xue Xue Bao 2021 Apr;41(4):621-627

Department of Oncology, Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine, Foshan 528200, China.

Objective: To explore the factors affecting the survival of patients with advanced gastric cancer and establish a reliable predictive model of the patients' survival outcomes.

Objective: We retrospectively collected the clinical data from patients with advanced gastric cancer treated in our department between January, 2015 and December, 2019. Univariate survival analysis was carried out using Kaplan-Meier method followed by multivariate Cox regression analysis to identify the factors associated with the survival outcomes of the patients. Read More

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