e16147 Background: Recent studies have assessed the efficacy of some therapeutics in advanced hepatocellular carcinoma. Our aim is to perform a meta-analysis to compare the efficacy of Camrelizumab and Apatinib combination therapy versus Apatinib only in treatment of advanced hepatocellular carcinoma. Methods: We searched PubMed, WOS, Embase and Scopus databases. Inclusion criteria were clinical trials and cohort studies that evaluated the efficacy of Camrelizumab and Apatinib combination therapy or Apatinib only in treatment of advanced hepatocellular carcinoma. We excluded case reports, conference abstracts, editorials and animal studies. CMA software (version 3) was used to perform the meta-analysis. Continuous outcomes were presented as (mean and SD) and dichotomous outcomes as event ratio(ER), with 95% confidence interval (CI). Results: After complete screening, 12 studies were finally included in our study. 4 studies for combination of Camerlizumab and Apatinib while 8 studies investigated the role of Apatinib in patients with advanced hepatocellular carcinoma. The total number of patients included in the study is 844; 172 in combination group and 672 in Apatinib group. By indirect comparison, combination therapy is associated with a relatively better pooled survival rate (ER = 0.532, 95% CI [0.446, 0.615]) compared to Apatinib only therapy (ER = 0.262, 95% CI [0.218, 0.313]). Combination therapy was also associated with higher pooled rates of disease control (ER = 0.755, 95% CI [0.683, 0.815]) compared with Apatinib only (ER = 0.683, 95% CI [0.644, 0.720]). While the Combination therapy was associated with lower pooled rate of stable disease (ER = 0.13, 95% CI [0.339, 0.491]) than Apatinib (ER = 0.531, 95% CI [0.492, 0.570]). The overall survival time was significantly higher in combination therapy (Mean = 14.375, 95% CI [14.101, 14.649]) compared to the pooled mean survival time from Apatinib only therapy (Mean = 10.390, 95% CI [9.925, 10.855]). Conclusions: This study showed that Camrelizumab and Apatinib combination therapy is associated with increased survival rate, disease control and overall survival time in advanced hepatocellular carcinoma patients compared with Apatinib only. It revealed also that combination therapy is associated with lower stable disease than Apatinib only. Further multicenter clinical trials are needed to support our results.
BackgroundSystemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory disease (1), characterized by the production of autoantibodies, and formation of immune complexes due to the polyclonal activation of T and B lymphocytes that result in tissue and organ damage (2). During inflammation, neutrophils and macrophages release serine proteases to cleave progranulin (PGRN) into granulin (GRN), which exert their pro-inflammatory effects that counteract the anti-inflammatory effects of intact PGRN (3). Insulin-like growth factor-2 (ILGF-2) binds to insulin-like growth factors (IGFs) with high affinity (4). Although reports suggest that IGFBP-2 is a reliable biomarker of renal deterioration, it is still needed to confirm that it has high sensitivity and specificity in discriminating kidney disease caused by SLE from other origins.ObjectivesThe aim of this study was to explore whether PGRN and ILGF-2 can be used as useful markers not only for accurate diagnosis of patients with active lupus nephritis (LN) but also for prediction of the disease activity in these patients.MethodsTwenty-five patients with systemic lupus erythematosus, twenty-five patients with chronic renal failure and twenty-five age- and sex-matched healthy volunteers were enrolled in the study. Routine laboratory investigations and measurement of serum PRGN and IGFBP-2 levels were done.ResultsOur results showed that the mean age of SLE, CRF and control groups 31.12±12.34, 38.7±9.4 and 32.96±13.66 respectively with no significant difference between the three groups. There was female predominance in the three groups. Disease duration was 4.78±4.26 in SLE patients.The mean of SLEDAI score was 15.04±7.54. All renal biopsy results were class 2, 3, and 5 with a percentage of 32%, 24%, and 44% respectively.Table 1.Levels of PRGN and ILGF-2 in SLE, CRF and control groupsSLECRFControlPP1P2P3 PRGN, pg/ml2558.92±1170.771814.6±330.281052±276<0.001**<0.001**<0.001**<0.001**ILGF-2, ng/ml26.44±11.556.14±2.253.3±1.7<0.001**<0.001**<0.001**0.148P: Comparison between all groups. P1: comparison between SLE and CRF. P2: comparison between SLE and control. P3: comparison between CRF and control.Table 2.Levels of PRGN and ILGF-2 in relation to SLEDAI score, renal SLEDAI, and Renal biopsyPRGN pg/mlILGF-2 ng/ml SLEDAI score Moderate1945.6±30026.8±11.7 High2072.1±545.520.1±5 Very high4269.2±1106.837.6±12.6 P value0.002**0.006**Renal SLEDAI Inactive2251.2±84123.3±8.9 Active2764.1±133528.6±12.9 P value0.3110.196Renal biopsy Class 22199.31±854.8524.38±13.31 Class 32244.17±767.9723.75±7.01 Class 42992.14±1453.9329.41±12.41 P value0.2700.540SLEDAI: Systemic Lupus Erythematosus Disease Activity Index. *Statistically significant difference (p<0.05) **Statistically significant difference (p<0.01).ConclusionsPGRN and ILGF-2 are significantly elevated in SLE than CRF and control and were associated with SLEDAI. Hence they are considered specific to LN.References Rahman A, Isenberg DA. (2008) Systemic lupus erythematosus. N Engl J Med 358:929–939.Kotzin BL. (1996) Systemic lupu...
Irrigation management and pattern of nitrogen application associated with soil compaction are critical factors in wheat growth. This study aimed to evaluate the effect of irrigation regimes and patterns of nitrogen fertilizer placement in presence of soil compacted layer on some wheat growth parameters. Germination percentage, plant height, pike length, 10-spike weight, total yield and grain yield were measured. Sandy loam lysimeter (0.60 x 1.0 and 0.55 m deep) experiments were conducted in a split-plot design with three replications in the experimental agricultural station of Assiut
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