Pancreatic cancer is one of the most aggressive and difficult cancers to treat.Despite numerous research efforts,limited success has been achieved in the therapeutic management of patients with this disease.In the cur...Pancreatic cancer is one of the most aggressive and difficult cancers to treat.Despite numerous research efforts,limited success has been achieved in the therapeutic management of patients with this disease.In the current review,we focus on one component of morphogenesis signaling,Hedgehog(Hh),with the aim of developing novel,effective therapies for the treatment of pancreatic cancer.Hh signaling contributes to the induction of a malignant phenotype in pancreatic cancer and is responsible for maintaining pancreatic cancer stem cells.In addition,we propose a novel concept linking Hh signaling and tumor hypoxic conditions,and discuss the effects of Hh inhibitors in clinical trials.The Hh signaling pathway may represent a potential therapeutic target for patients with refractory pancreatic cancer.展开更多
Synchronous gastric cancer and primary small intestinal lymphoma are extremely rare. A 49-year-old woman was referred to our hospital with a history of upper abdominal pain for two weeks and was diagnosed with synchro...Synchronous gastric cancer and primary small intestinal lymphoma are extremely rare. A 49-year-old woman was referred to our hospital with a history of upper abdominal pain for two weeks and was diagnosed with synchronous cancer. During hospitalization, the patient underwent laparoscopic distal gastrectomy + resection of bilateral ovaries + partial resection of both small intestine and descending colon. Pathological examination revealed a synchronous cancer consisting of early gastric cancer with poorly differentiated adenocarcinoma located in mucosa, with lymph node metastasis (3+/29) (T1N1M0, stage IB); and diffuse large B cell lymphoma of small intestine involving descending colon and bilateral ovaries, with lymph node metastasis (2+/5) (Ann Arbor IIE). The patient recovered well, without any obvious complications and was discharged on post-operative day 7. The patient received six cycles of chemotherapy after operation. She has been doing well with no evidence of recurrence for 13 mo.展开更多
Objective:To explore the mechanism of anticancer prescription in treatment of gastric cancer based on network pharmacology and molecular docking.Methods:By searching TCMSP database,the active components and correspond...Objective:To explore the mechanism of anticancer prescription in treatment of gastric cancer based on network pharmacology and molecular docking.Methods:By searching TCMSP database,the active components and corresponding targets of anticancer prescriptions were screened out.GeneCards,PharmGkb,OMIM,DrugBank and TTD database were used to collect action targets of gastric cancer.And Venny 2.1 software was used to screen drug-disease co-action targets.Then,String and Cytoscape software were used to analyze and construct PPI network,and Cytonca plug-in was used to cany out topology analysis to select the core targets.ClueGO plugin was used for GO function enrichment analysis and KEGG pathway analysis.Finally,the AutoDock software was used to conduct molecular docking between the core target and the main active ingredients of the anticancer prescription.Results:Sixty-four active compounds,159 common targets and 12 core targets of anti-cancer prescriptions were screened out,which involved 2373 GO functions and 172 KEGG pathways.Finally,the core target proteins MAPKI TP53 and JUN were screened and molecularly docked with 8 major active components.Among them,theflavonoid quercetin and luteolin had the best binding activity with MAPK1,Quercetin baicalin also had high binding activity with FOS.Conclusion:The preliminary study showed that flavonoids were an important active ingredient in the anti-cancer prescription,which mainly treated gastric cancer through multiple targets and multiple pathways,such as the effect of MAPK1 on chemical carcinogenesis in reaction with drugs,bacterial and viral infection and cell apoptosis.展开更多
AIM: To evaluate the safety and feasibility of laparoscopic abdominoperineal resection compared with the open procedure in multimodality management of rectal cancer.METHODS: A total of 106 rectal cancer patients who u...AIM: To evaluate the safety and feasibility of laparoscopic abdominoperineal resection compared with the open procedure in multimodality management of rectal cancer.METHODS: A total of 106 rectal cancer patients who underwent open abdominoperineal resection(OAPR) were matched with 106 patients who underwent laparoscopic abdominoperineal resection(LAPR) in a 1 to 1 fashion, between 2009 and 2013 at Fudan University Shanghai Cancer Center. Propensity score matching was carried out based on age, gender, pathological staging of the disease and administration of neoadjuvant chemoradiation. Data regarding preoperative staging, surgical technique, pathologicalresults, postoperative recovery and complications were reviewed and compared between the LAPR and OAPR groups. Perineal closure around the stoma and pelvic floor reconstruction were performed only in OAPR, not in LAPR. Therefore, abdominoperineal resection procedure-specific surgical complications including parastomal hernia and perineal wound complications were compared between the open and laparoscopic procedure. Regular surveillance of the two cohorts was carried out to gather prognostic data. Diseasefree survival was analyzed using Kaplan-Meier estimate and log-rank test. Subgroup analysis was performed in patients with locally advanced disease treated with preoperative chemoradiation followed by surgical resection. RESULTS: No significant difference was found between the LAPR group and the OAPR group in terms of clinicopathological features. The operation time(180.8 ± 47.8 min vs 172.1 ± 49.2 min, P = 0.190), operative blood loss(93.9 ± 60.0 m L vs 88.4 ± 55.2 m L, P = 0.494), total number of retrieved lymph nodes(12.9 ± 6.9 vs 12.9 ± 5.4, P = 0.974), surgical complications(12.3% vs 15.1%, P = 0.549) and pathological characteristics were comparable between the LAPR and OAPR group, respectively. Compared with OAPR patients, LAPR patients showed significantly shorter postoperative analgesia(2.4 ± 0.7 d vs 2.7 ± 0.6 d, P < 0.001), earlier first flatus(57.3 ± 7.9 h vs 63.5 ± 9.2 h, P < 0.001), shorter urinary drainage time(6.5 ± 3.4 d vs 7.8 ± 1.3 d, P < 0.001), and shorter postoperative admission(11.2 ± 4.7 d vs 12.6 ± 4.0 d, P = 0.014). With regard to APR-specific complications(perineal wound complications and parastomal hernia), there were no significant differences between the two groups. Similar results were found in the 26 pairs of patients administered neoadjuvant chemoradiation in subgroup analysis. During the follow-up period, no port site recurrences were observed. CONCLUSION: Laparoscopic abdominoperineal resection for multidisciplinary management of rectal cancer is safe, and is associated with earlier recovery and shorter admission time in combination with neoadjuvant chemoradiation.展开更多
AIM:To evaluate the safety and clinical application of high-intensity focused ultrasound(HIFU)therapy for unresectable pancreatic cancer(PC).METHODS:Thirty PC patients(16 cases in stage III and 14 cases in stage IV)wi...AIM:To evaluate the safety and clinical application of high-intensity focused ultrasound(HIFU)therapy for unresectable pancreatic cancer(PC).METHODS:Thirty PC patients(16 cases in stage III and 14 cases in stage IV)with visualized pancreatic tumors were admitted for HIFU therapy as an optional local therapy in addition to systemic chemotherapy or chemoradiotherapy.Informed consent was obtained.This study began at the end of 2008 and was approved by the ethics committee of our hospital[Institutional Review Board(IRB):890].The HIFU device used was the FEP-BY02(Yuande Bio-Medical Engineering,Beijing,China).RESULTS:The mean tumor size after HIFU therapy changed to 30.9±1.7 mm from 31.7±1.7 mm at pre-therapy.There were no significant changes in tumor size,mean number of treatment sessions(2.7±0.1 mm),or mean total treatment time(2.4±0.1 h).The rate of symptom relief effect was 66.7%.The effectiveness of primary lesion treatment was as follows:complete response,0;partial response,4;stable disease,22;progressive disease,4.Treatment after HIFU therapy included 2 operations,24 chemotherapy treatments,and 4 best supportive care treatments.Adverse events occurred in 10%of cases,namely pseudocyst formation in 2 cases and mild pancreatitis development in 1.However,no severe adverse events occurred in this study.CONCLUSION:We suggest that HIFU therapy is safe and has the potential to be a new method of combination therapy for PC.展开更多
The effect of chemotherapy on peritoneal carcinomatosis(PC) of gastric cancer remains unclear.Recently,the intraperitoneal(IP) administration of taxanes [e.g.,paclitaxel(PTX) and docetaxel(DOC)] during the perioperati...The effect of chemotherapy on peritoneal carcinomatosis(PC) of gastric cancer remains unclear.Recently,the intraperitoneal(IP) administration of taxanes [e.g.,paclitaxel(PTX) and docetaxel(DOC)] during the perioperative period has shown promising results.Herein,we summarized the rationale and methodology for using IP chemotherapy with taxanes and reviewed the clinical results.IP administered taxanes remain in the IP space at an extremely high concentration for 48-72 h.The drug directly infiltrates peritoneal metastatic nodules from the surface and then produces antitumor effects,making it ideal for IP chemotherapy.There are two types of perioperative IP chemotherapy with taxanes: neoadjuvant intraperitoneal and systemic chemotherapy and sequential perioperative intraperitoneal chemotherapy(SPIC).In SPIC,patients receive neoadjuvant IP chemotherapy and the same regimen of IP chemotherapy after cytoreductive surgery(CRS) until disease progression.Usually,a taxane dissolved in 500-1000 m L of saline at ordinary temperature is administered through an IP access port on an outpatient basis.According to phase Ⅰ?studies,the recommended doses(RD) are as follows: IP DOC,45-60 mg/m2; IP PTX [without intravenous(IV) PTX],80 mg/m2; and IP PTX(with IV PTX),20 mg/m2.Phase Ⅱ studies have reported a median survival time of 14.4-24.6 mo with a 1-year overall survival of 67%-78%.A phase Ⅲ study comparing S-1 in combination with IP and IV PTX to S-1 with IV cisplatin started in 2011.The prognosis of patients who underwent CRS was better than that of those who did not; however,this was partly due to selection bias.Although several phase Ⅱ studies have shown promising results,a randomized controlled study is needed to validate the effectiveness of IP chemotherapy with taxanes for PC of gastric cancer.展开更多
Endoscopic submucosal dissection(ESD) is now widely accepted as a strategy to treat superficial esophageal neoplasms.The rate of adverse events,such as perforation,has been decreasing with the improvement of devices a...Endoscopic submucosal dissection(ESD) is now widely accepted as a strategy to treat superficial esophageal neoplasms.The rate of adverse events,such as perforation,has been decreasing with the improvement of devices and techniques.In this paper,we report a case of esophageal cancer that had a diverticulum under cancerous epithelium.The diverticulum was not detected during preoperative examination,and led to perforation during the ESD procedure.Our case shows that,although rare,some diverticula can exist underneath the mucosal surface without obvious depression.If there is any sign of hidden diverticula during ESD,surgeons should proceed with caution or,depending on the case,the procedure should be discontinued to avoid adverse events.展开更多
We report two cases of solitary mediastinal lymph node recurrence after colon cancer resection. Both cases had para-aortic lymph node metastasis at the time of initial surgery and received adjuvant chemotherapy for 4 ...We report two cases of solitary mediastinal lymph node recurrence after colon cancer resection. Both cases had para-aortic lymph node metastasis at the time of initial surgery and received adjuvant chemotherapy for 4 years in case 1 and 18 mo in case 2. The time to recurrence was more than 8 years in both cases. After resection of the recurrent tumor, the patient is doing well with no recurrence for 6 years in case 1 and 4 mo in case 2. Patients should be followed up after colon cancer surgery considering the possibility of solitary mediastinal lymph node recurrence if they had para-aortic node metastasis at the time of initial surgery.展开更多
During the last decade, we have seen tremendous progress in the therapy of lung cancer. Discovery of actionable mutations in EGFR and translocations in ALK and ROS1 have identified subsets of patients with excellent t...During the last decade, we have seen tremendous progress in the therapy of lung cancer. Discovery of actionable mutations in EGFR and translocations in ALK and ROS1 have identified subsets of patients with excellent tumor response to oral targeted agents with manageable side effects. In this review, we highlight treatment options including corresponding clinical trials for oncogenic alterations affecting the receptor tyrosine kinases MET, FGFR, NTRK, RET, HER2, HER3, and HER4 as well as components of the RAS-RAF-MEK signaling pathway.展开更多
Objective:To construct a nomogram model for predicting the prognosis of colorectal cancer patients based on preoperative fibrinogen(Fbg),platelet to albumin ratio(PAR)and carbohydrate antigen 199(CA199).Methods:In thi...Objective:To construct a nomogram model for predicting the prognosis of colorectal cancer patients based on preoperative fibrinogen(Fbg),platelet to albumin ratio(PAR)and carbohydrate antigen 199(CA199).Methods:In this retrospective study,we included 323 patients who underwent colorectal cancer(CRC)surgery in our hospital.The preoperative test indexes and relevant clinicopathological data of the patients were collected.According to the cut-off value of Fbg and PAR calculated from the receiver operating characteristic(ROC)curve,they were divided into the high and low expression groups.Univariate and multivariate Cox proportional hazards models were used to screen independent prognostic factors which were used to construct a nomogram.Results:According to ROC curve,the cut-off values of Fbg and PAR were 2.80 and 6.05.Multivariate Cox regression analysis showed that Fbg,PAR,CA199,TNM stage and grade were independent risk factors affecting the prognosis of patients(P<0.05).Fbg,PAR,and CA199 jointly built the risk score that was included into the nomogram.The area under the curve(AUC)in the ROC of the training and verification set was greater than 0.6.The calibration curve and ideal curve fit well.Conclusion:The nomogram based on Fbg,PAR and CA199 has well accuracy and can provide individualized prediction for the overall survival of CRC patients.展开更多
Objective: To study the tr eatment of postope rative gast ropa resis in pa ti ents with gast ric cancer. Methods: 18 patients with gast ropa resis afte r gast ric cance r sur gery were divided into two gr oups, includ...Objective: To study the tr eatment of postope rative gast ropa resis in pa ti ents with gast ric cancer. Methods: 18 patients with gast ropa resis afte r gast ric cance r sur gery were divided into two gr oups, including 10 pa ti ents in the obse rva tion group and 8 pati ents in the cont rol group. The observation group was treated with traditional Chinese medicine combined with warm acupuncture and moxibustion, and the control group was treated with western medicine. Results: After 7 days tr eatment, the re was significant diffe rence in cure r ate and total effective rate between the two groups (P < 0.01), and the treatment group was obviously superior to the control group. Conclusion: Traditional Chinese medicine combined with warm acupuncture is effective in the treatment of postoperative gastroparesis of gastric cancer.展开更多
On 3,September,2015,China signed more than 20 cooperation agreements,six of which were about oil and gas. This is a breakthrough since the 400 billion natural gas supply deal which was signed in May 2014. These great ...On 3,September,2015,China signed more than 20 cooperation agreements,six of which were about oil and gas. This is a breakthrough since the 400 billion natural gas supply deal which was signed in May 2014. These great achievements are inseparable from the continuous efforts of the new generation of collective leadership and multi- level and all- dimensional cooperation under the background of "China dream". This paper aims to discuss the stimulative factors of the developments and breakthroughs from the aspects of the internal efforts between the two governments and external influences of international environment. Lastly,the paper explores the great significance of energy cooperation between China and Russia to the realization of "China dream".展开更多
To investigate the level of telomerase activation (TA) and telomerase catalytic subunit (hEST 2) gene mRNA in patients with non small cell lung cancer, and determine whether they are associated with tumor cell apopt...To investigate the level of telomerase activation (TA) and telomerase catalytic subunit (hEST 2) gene mRNA in patients with non small cell lung cancer, and determine whether they are associated with tumor cell apoptosis, stage, and clinical outcome Methods Primary tumor specimens from 58 patients untreated with chemotherapy and 10 cases of histologically benign and adjacent lung tissue were analyzed TA and hEST 2 were measured by means of a modified telomerase repeat amplification protocol (TRAP) assay and in situ hybridization (ISH), respectively Terminal deoxynucleotidyl transferase (TdT) mediated biotin dUTP nick end labeling (TUNEL) was used to evaluate apoptotic cells Reverse transcription polymerase chain reaction (RT PCR) was used to detect bcl 2 mRNA expression Results TA and hEST 2 were detected in 45 (77 6%) and 43 (74 1%) of 58 tumor specimens, respectively, and not detected in specimens of adjacent and benign lung tissue One case expressed hEST 2 as a weak positive Statistically significant positive association was found between the level of TA and hEST 2( r =0 85, P =0 001) TA and hEST 2 were associated with tumor stage, but not associated with tumor grade, gender and patient age Positive rate of bcl 2 mRNA was 38 (65 5%) of 58 tumor specimens The mean apoptotic index in the bcl 2 positive group (9 5±1 3) was lower than that in the bcl 2 negative one (19 8±2 1, P <0.05), suggesting that apoptotic index may be inversely associated with bcl 2 expression ( r =-0 48, P =0 041) Bcl 2 expression in the TA and hEST 2 positive group (92 1% and 89 4%) was higher than that in the negative one (50 0% and 45 0%, P =0 043 and P =0 032, respectively) The apoptotic index was lower in the TA or hEST 2 positive group (8 2±1 4, 10 7±1 1) than in the negative one (20 5±1 6, 24 2±2 1, P <0 05) A statistically significant inverse association was found between TA or hEST 2 and apoptotic index ( r =-0 45, P =0 02 and r = -0 51, P =0 001, respectively) Positive correlation was also detected between TA or hEST 2 and bcl 2 expression ( r =0 86, P =0 01 and r =0 73, P =0 024, respectively) The level of hEST 2 mRNA and apoptotic index were associated with clinical outcome in a multivariate cox regression analysis Conclusions High TA and hEST 2 were frequently detected in primary non small cell lung cancer untreated with chemotherapy, having high bcl 2 expression and a low tumor cell apoptotic rate This suggests that both TA and hEST 2 are correlated with the deregulation of apoptosis hEST 2 and apoptotic index have prognostic significance in patients with non small cell lung cancer展开更多
基金Supported by The Japan Society for the Promotion of Science,Kakenhi Grant,No.24390303
文摘Pancreatic cancer is one of the most aggressive and difficult cancers to treat.Despite numerous research efforts,limited success has been achieved in the therapeutic management of patients with this disease.In the current review,we focus on one component of morphogenesis signaling,Hedgehog(Hh),with the aim of developing novel,effective therapies for the treatment of pancreatic cancer.Hh signaling contributes to the induction of a malignant phenotype in pancreatic cancer and is responsible for maintaining pancreatic cancer stem cells.In addition,we propose a novel concept linking Hh signaling and tumor hypoxic conditions,and discuss the effects of Hh inhibitors in clinical trials.The Hh signaling pathway may represent a potential therapeutic target for patients with refractory pancreatic cancer.
基金Supported by Major Science and Technology Projects of Zhejiang Province,China,No.2012C13014-4Traditional Chinese Medicine Science and Technology Program of Zhejiang Province,China,No.2012ZA087
文摘Synchronous gastric cancer and primary small intestinal lymphoma are extremely rare. A 49-year-old woman was referred to our hospital with a history of upper abdominal pain for two weeks and was diagnosed with synchronous cancer. During hospitalization, the patient underwent laparoscopic distal gastrectomy + resection of bilateral ovaries + partial resection of both small intestine and descending colon. Pathological examination revealed a synchronous cancer consisting of early gastric cancer with poorly differentiated adenocarcinoma located in mucosa, with lymph node metastasis (3+/29) (T1N1M0, stage IB); and diffuse large B cell lymphoma of small intestine involving descending colon and bilateral ovaries, with lymph node metastasis (2+/5) (Ann Arbor IIE). The patient recovered well, without any obvious complications and was discharged on post-operative day 7. The patient received six cycles of chemotherapy after operation. She has been doing well with no evidence of recurrence for 13 mo.
文摘Objective:To explore the mechanism of anticancer prescription in treatment of gastric cancer based on network pharmacology and molecular docking.Methods:By searching TCMSP database,the active components and corresponding targets of anticancer prescriptions were screened out.GeneCards,PharmGkb,OMIM,DrugBank and TTD database were used to collect action targets of gastric cancer.And Venny 2.1 software was used to screen drug-disease co-action targets.Then,String and Cytoscape software were used to analyze and construct PPI network,and Cytonca plug-in was used to cany out topology analysis to select the core targets.ClueGO plugin was used for GO function enrichment analysis and KEGG pathway analysis.Finally,the AutoDock software was used to conduct molecular docking between the core target and the main active ingredients of the anticancer prescription.Results:Sixty-four active compounds,159 common targets and 12 core targets of anti-cancer prescriptions were screened out,which involved 2373 GO functions and 172 KEGG pathways.Finally,the core target proteins MAPKI TP53 and JUN were screened and molecularly docked with 8 major active components.Among them,theflavonoid quercetin and luteolin had the best binding activity with MAPK1,Quercetin baicalin also had high binding activity with FOS.Conclusion:The preliminary study showed that flavonoids were an important active ingredient in the anti-cancer prescription,which mainly treated gastric cancer through multiple targets and multiple pathways,such as the effect of MAPK1 on chemical carcinogenesis in reaction with drugs,bacterial and viral infection and cell apoptosis.
文摘AIM: To evaluate the safety and feasibility of laparoscopic abdominoperineal resection compared with the open procedure in multimodality management of rectal cancer.METHODS: A total of 106 rectal cancer patients who underwent open abdominoperineal resection(OAPR) were matched with 106 patients who underwent laparoscopic abdominoperineal resection(LAPR) in a 1 to 1 fashion, between 2009 and 2013 at Fudan University Shanghai Cancer Center. Propensity score matching was carried out based on age, gender, pathological staging of the disease and administration of neoadjuvant chemoradiation. Data regarding preoperative staging, surgical technique, pathologicalresults, postoperative recovery and complications were reviewed and compared between the LAPR and OAPR groups. Perineal closure around the stoma and pelvic floor reconstruction were performed only in OAPR, not in LAPR. Therefore, abdominoperineal resection procedure-specific surgical complications including parastomal hernia and perineal wound complications were compared between the open and laparoscopic procedure. Regular surveillance of the two cohorts was carried out to gather prognostic data. Diseasefree survival was analyzed using Kaplan-Meier estimate and log-rank test. Subgroup analysis was performed in patients with locally advanced disease treated with preoperative chemoradiation followed by surgical resection. RESULTS: No significant difference was found between the LAPR group and the OAPR group in terms of clinicopathological features. The operation time(180.8 ± 47.8 min vs 172.1 ± 49.2 min, P = 0.190), operative blood loss(93.9 ± 60.0 m L vs 88.4 ± 55.2 m L, P = 0.494), total number of retrieved lymph nodes(12.9 ± 6.9 vs 12.9 ± 5.4, P = 0.974), surgical complications(12.3% vs 15.1%, P = 0.549) and pathological characteristics were comparable between the LAPR and OAPR group, respectively. Compared with OAPR patients, LAPR patients showed significantly shorter postoperative analgesia(2.4 ± 0.7 d vs 2.7 ± 0.6 d, P < 0.001), earlier first flatus(57.3 ± 7.9 h vs 63.5 ± 9.2 h, P < 0.001), shorter urinary drainage time(6.5 ± 3.4 d vs 7.8 ± 1.3 d, P < 0.001), and shorter postoperative admission(11.2 ± 4.7 d vs 12.6 ± 4.0 d, P = 0.014). With regard to APR-specific complications(perineal wound complications and parastomal hernia), there were no significant differences between the two groups. Similar results were found in the 26 pairs of patients administered neoadjuvant chemoradiation in subgroup analysis. During the follow-up period, no port site recurrences were observed. CONCLUSION: Laparoscopic abdominoperineal resection for multidisciplinary management of rectal cancer is safe, and is associated with earlier recovery and shorter admission time in combination with neoadjuvant chemoradiation.
基金Supported by The cancer research project group of Tokyo Medical University
文摘AIM:To evaluate the safety and clinical application of high-intensity focused ultrasound(HIFU)therapy for unresectable pancreatic cancer(PC).METHODS:Thirty PC patients(16 cases in stage III and 14 cases in stage IV)with visualized pancreatic tumors were admitted for HIFU therapy as an optional local therapy in addition to systemic chemotherapy or chemoradiotherapy.Informed consent was obtained.This study began at the end of 2008 and was approved by the ethics committee of our hospital[Institutional Review Board(IRB):890].The HIFU device used was the FEP-BY02(Yuande Bio-Medical Engineering,Beijing,China).RESULTS:The mean tumor size after HIFU therapy changed to 30.9±1.7 mm from 31.7±1.7 mm at pre-therapy.There were no significant changes in tumor size,mean number of treatment sessions(2.7±0.1 mm),or mean total treatment time(2.4±0.1 h).The rate of symptom relief effect was 66.7%.The effectiveness of primary lesion treatment was as follows:complete response,0;partial response,4;stable disease,22;progressive disease,4.Treatment after HIFU therapy included 2 operations,24 chemotherapy treatments,and 4 best supportive care treatments.Adverse events occurred in 10%of cases,namely pseudocyst formation in 2 cases and mild pancreatitis development in 1.However,no severe adverse events occurred in this study.CONCLUSION:We suggest that HIFU therapy is safe and has the potential to be a new method of combination therapy for PC.
文摘The effect of chemotherapy on peritoneal carcinomatosis(PC) of gastric cancer remains unclear.Recently,the intraperitoneal(IP) administration of taxanes [e.g.,paclitaxel(PTX) and docetaxel(DOC)] during the perioperative period has shown promising results.Herein,we summarized the rationale and methodology for using IP chemotherapy with taxanes and reviewed the clinical results.IP administered taxanes remain in the IP space at an extremely high concentration for 48-72 h.The drug directly infiltrates peritoneal metastatic nodules from the surface and then produces antitumor effects,making it ideal for IP chemotherapy.There are two types of perioperative IP chemotherapy with taxanes: neoadjuvant intraperitoneal and systemic chemotherapy and sequential perioperative intraperitoneal chemotherapy(SPIC).In SPIC,patients receive neoadjuvant IP chemotherapy and the same regimen of IP chemotherapy after cytoreductive surgery(CRS) until disease progression.Usually,a taxane dissolved in 500-1000 m L of saline at ordinary temperature is administered through an IP access port on an outpatient basis.According to phase Ⅰ?studies,the recommended doses(RD) are as follows: IP DOC,45-60 mg/m2; IP PTX [without intravenous(IV) PTX],80 mg/m2; and IP PTX(with IV PTX),20 mg/m2.Phase Ⅱ studies have reported a median survival time of 14.4-24.6 mo with a 1-year overall survival of 67%-78%.A phase Ⅲ study comparing S-1 in combination with IP and IV PTX to S-1 with IV cisplatin started in 2011.The prognosis of patients who underwent CRS was better than that of those who did not; however,this was partly due to selection bias.Although several phase Ⅱ studies have shown promising results,a randomized controlled study is needed to validate the effectiveness of IP chemotherapy with taxanes for PC of gastric cancer.
文摘Endoscopic submucosal dissection(ESD) is now widely accepted as a strategy to treat superficial esophageal neoplasms.The rate of adverse events,such as perforation,has been decreasing with the improvement of devices and techniques.In this paper,we report a case of esophageal cancer that had a diverticulum under cancerous epithelium.The diverticulum was not detected during preoperative examination,and led to perforation during the ESD procedure.Our case shows that,although rare,some diverticula can exist underneath the mucosal surface without obvious depression.If there is any sign of hidden diverticula during ESD,surgeons should proceed with caution or,depending on the case,the procedure should be discontinued to avoid adverse events.
基金Supported by Department of Surgery,Osaka Medical Center for Cancer and Cardiovascular Disease,Osaka 537-8511,Japan
文摘We report two cases of solitary mediastinal lymph node recurrence after colon cancer resection. Both cases had para-aortic lymph node metastasis at the time of initial surgery and received adjuvant chemotherapy for 4 years in case 1 and 18 mo in case 2. The time to recurrence was more than 8 years in both cases. After resection of the recurrent tumor, the patient is doing well with no recurrence for 6 years in case 1 and 4 mo in case 2. Patients should be followed up after colon cancer surgery considering the possibility of solitary mediastinal lymph node recurrence if they had para-aortic node metastasis at the time of initial surgery.
文摘During the last decade, we have seen tremendous progress in the therapy of lung cancer. Discovery of actionable mutations in EGFR and translocations in ALK and ROS1 have identified subsets of patients with excellent tumor response to oral targeted agents with manageable side effects. In this review, we highlight treatment options including corresponding clinical trials for oncogenic alterations affecting the receptor tyrosine kinases MET, FGFR, NTRK, RET, HER2, HER3, and HER4 as well as components of the RAS-RAF-MEK signaling pathway.
基金National Natural Science Foundation of China(No.81872275)High Level Health Talents of Jiangsu Provincial Health Commission(No.LGY2018017)Applied Basic Research Project of Changzhou Science and Technology Bureau(No.CJ20220006)。
文摘Objective:To construct a nomogram model for predicting the prognosis of colorectal cancer patients based on preoperative fibrinogen(Fbg),platelet to albumin ratio(PAR)and carbohydrate antigen 199(CA199).Methods:In this retrospective study,we included 323 patients who underwent colorectal cancer(CRC)surgery in our hospital.The preoperative test indexes and relevant clinicopathological data of the patients were collected.According to the cut-off value of Fbg and PAR calculated from the receiver operating characteristic(ROC)curve,they were divided into the high and low expression groups.Univariate and multivariate Cox proportional hazards models were used to screen independent prognostic factors which were used to construct a nomogram.Results:According to ROC curve,the cut-off values of Fbg and PAR were 2.80 and 6.05.Multivariate Cox regression analysis showed that Fbg,PAR,CA199,TNM stage and grade were independent risk factors affecting the prognosis of patients(P<0.05).Fbg,PAR,and CA199 jointly built the risk score that was included into the nomogram.The area under the curve(AUC)in the ROC of the training and verification set was greater than 0.6.The calibration curve and ideal curve fit well.Conclusion:The nomogram based on Fbg,PAR and CA199 has well accuracy and can provide individualized prediction for the overall survival of CRC patients.
文摘Objective: To study the tr eatment of postope rative gast ropa resis in pa ti ents with gast ric cancer. Methods: 18 patients with gast ropa resis afte r gast ric cance r sur gery were divided into two gr oups, including 10 pa ti ents in the obse rva tion group and 8 pati ents in the cont rol group. The observation group was treated with traditional Chinese medicine combined with warm acupuncture and moxibustion, and the control group was treated with western medicine. Results: After 7 days tr eatment, the re was significant diffe rence in cure r ate and total effective rate between the two groups (P < 0.01), and the treatment group was obviously superior to the control group. Conclusion: Traditional Chinese medicine combined with warm acupuncture is effective in the treatment of postoperative gastroparesis of gastric cancer.
基金supported by Development Research Center of Oil and Gas,Sichuan,China
文摘On 3,September,2015,China signed more than 20 cooperation agreements,six of which were about oil and gas. This is a breakthrough since the 400 billion natural gas supply deal which was signed in May 2014. These great achievements are inseparable from the continuous efforts of the new generation of collective leadership and multi- level and all- dimensional cooperation under the background of "China dream". This paper aims to discuss the stimulative factors of the developments and breakthroughs from the aspects of the internal efforts between the two governments and external influences of international environment. Lastly,the paper explores the great significance of energy cooperation between China and Russia to the realization of "China dream".
基金This research was supported by grants from the Bejjing Natural Science Faundation(Na 7992005)and Postdoctoral Foundation fram the Nati an al Committee of Education.
文摘To investigate the level of telomerase activation (TA) and telomerase catalytic subunit (hEST 2) gene mRNA in patients with non small cell lung cancer, and determine whether they are associated with tumor cell apoptosis, stage, and clinical outcome Methods Primary tumor specimens from 58 patients untreated with chemotherapy and 10 cases of histologically benign and adjacent lung tissue were analyzed TA and hEST 2 were measured by means of a modified telomerase repeat amplification protocol (TRAP) assay and in situ hybridization (ISH), respectively Terminal deoxynucleotidyl transferase (TdT) mediated biotin dUTP nick end labeling (TUNEL) was used to evaluate apoptotic cells Reverse transcription polymerase chain reaction (RT PCR) was used to detect bcl 2 mRNA expression Results TA and hEST 2 were detected in 45 (77 6%) and 43 (74 1%) of 58 tumor specimens, respectively, and not detected in specimens of adjacent and benign lung tissue One case expressed hEST 2 as a weak positive Statistically significant positive association was found between the level of TA and hEST 2( r =0 85, P =0 001) TA and hEST 2 were associated with tumor stage, but not associated with tumor grade, gender and patient age Positive rate of bcl 2 mRNA was 38 (65 5%) of 58 tumor specimens The mean apoptotic index in the bcl 2 positive group (9 5±1 3) was lower than that in the bcl 2 negative one (19 8±2 1, P <0.05), suggesting that apoptotic index may be inversely associated with bcl 2 expression ( r =-0 48, P =0 041) Bcl 2 expression in the TA and hEST 2 positive group (92 1% and 89 4%) was higher than that in the negative one (50 0% and 45 0%, P =0 043 and P =0 032, respectively) The apoptotic index was lower in the TA or hEST 2 positive group (8 2±1 4, 10 7±1 1) than in the negative one (20 5±1 6, 24 2±2 1, P <0 05) A statistically significant inverse association was found between TA or hEST 2 and apoptotic index ( r =-0 45, P =0 02 and r = -0 51, P =0 001, respectively) Positive correlation was also detected between TA or hEST 2 and bcl 2 expression ( r =0 86, P =0 01 and r =0 73, P =0 024, respectively) The level of hEST 2 mRNA and apoptotic index were associated with clinical outcome in a multivariate cox regression analysis Conclusions High TA and hEST 2 were frequently detected in primary non small cell lung cancer untreated with chemotherapy, having high bcl 2 expression and a low tumor cell apoptotic rate This suggests that both TA and hEST 2 are correlated with the deregulation of apoptosis hEST 2 and apoptotic index have prognostic significance in patients with non small cell lung cancer
