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Objective:To evaluate the efficacy and safety of camrelizumab combined with albumin paclitaxel in second-line treatment of advanced esophageal squamous cell carcinoma (ESCC).Methods:Seventy-two patients with advanced or metastatic ESCC who had failed first-line treatment admitted to the Department of Oncology of the Affiliated Hospital of West Anhui Health Vocational College from May 12, 2019 to August 20, 2020 were enrolled. The patients were given camrelizumab combined with albumin paclitaxel (the experimental group, n=45) or second-line chemotherapy (docetaxel or irinotecan, the control group, n=27) according to patients′ preference. Besides, the objective response rate (ORR), disease control rate (DCR), incidence of adverse events, overall survival (OS) and progress free survival (PFS) were assessed. Results:The ORR of the experimental group and the control group were 26.7% (12/45) and 7.4% (2/27) respectively, with a statistically significant difference ( χ2=3.996, P=0.046). The DCR of the two groups were 48.9% (22/45) and 29.6% (8/27) respectively, with no statistically significant difference ( χ2=2.575, P=0.109). In terms of adverse events, the experimental group was better tolerated, and the incidence of grade 3 or above adverse events was lower [28.9% (13/45) vs. 55.6% (15/27)], which was 48% lower than that of the control group, with a statistically significant difference ( χ2=5.049, P=0.025). One patient in the control group had a treatment-related death. The median OS was 8.9 months (95% CI: 7.9-9.8) in the experimental group and 6.5 months (95% CI: 5.6-7.3) in the control group, with a statistically significant difference ( χ2=5.068, P=0.024). The median PFS was 2.2 months (95% CI: 1.6-2.7) in the experimental group and 1.8 months (95% CI: 1.5-2.0) in the control group, with a statistically significant difference ( χ2=4.799, P=0.028). Conclusion:Camrelizumab combined with albumin paclitaxel in second-line treatment of advanced ESCC patients has proven efficacy and tolerable safety, which may be a potential second-line treatment for advanced ESCC.
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Objective@#To compare the efficacy of goal-activity-motor environment (GAME) therapy and neurodevelopmental therapy (NDT) in the early intervention of high-risk infants with cerebral palsy (IHRCP), and to provide scientific evidence-based medical basis for early intervention of IHRCP.@*Methods@#A total of 62 cases of IHRCP were enrolled in the Children′s Neurological Rehabilitation Center of the First Affiliated Hospital of Anhui Medi-cal University from June 2017 to December 2018.They were divided into GAME group (32 cases) and NDT group (30 cases) according to the admission order.Gross Motor Function Scale (GMFM), Fine Motor Function Measure (FMFM) and Gesell Development Scale (GDS) were used for detection and comparison.The differences among the gross motor, the fine motor score and the developmental quotient (DQ) between two groups before treatment, 9 months after treatment and 12 months after treatment, and the normalization rate and the incidence of cerebral palsy between the two groups at 12 months of age were compared.@*Results@#(1) Motor function was as follows: at 9 months[GAME: (32.63±15.83) scores, (30.03±15.88) scores], [NDT: (33.37±15.61) scores, (29.67±12.54) scores] and at 12 months[GAME: (40.56±15.79) scores, (36.31±14.98) scores], [NDT: (40.47±15.50) scores, (36.73±14.58) scores] after treatment, and GMFM and FMFM scores in GAME and NDT groups were significantly higher than those before treatment[GAME: (27.56±14.24) scores, (21.75±11.35) scores], [NDT: (26.93±14.96) scores, (21.30±10.67) scores], and the differences were significant (all P<0.01), but there was no significant difference between the 2 groups (all P> 0.05). (2) DQ had no significant difference in DQ between GAME group(63.59±10.83) and NDT group (61.59±7.96) before treatment (P>0.05). The total DQ at 9 months, 12 months, the total DQ of GAME group (73.67±12.00, 81.59±13.03) was significantly higher than that of NDT group (66.05±9.54, 75.17±1.92) (all P<0.05). Among them, the improvement of GAME in speech (79.84±16.56, 83.19±17.05) at 9 months and 12 months, and adaptive ability(78.63±16.37, 85.78±13.60) were significantly higher than that of NDT group(71.63±13.36, 72.53±12.77), (68.20±14.97, 77.43±12.10), and the differences were significant (all P<0.05). (3) Prognosis was as follows: at 12 months after treatment, 25 cases in GAME group and 23 cases in NDT group developed into normal children, there was no significant difference in the normalization rate between the 2 groups (P>0.05); the incidence of cerebral palsy was present in 6 cases in GAME group and 5 cases in NDT group, and there was no significant difference between the 2 groups (P>0.05).@*Conclusions@#GAME therapy and NDT had significant effects on both gross and fine exercise of IHRCP, and the efficacy of the two methods is similar.Both GAME therapy and NDT can equally promote IHRCP development into normal infants and reduce the incidence of cerebral palsy.
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Objective To compare the efficacy of goal_activity_motor environment( xAmE)therapy and neurodevelopmental therapy(NDT)in the early intervention of high_risk infants with cerebral palsy(IHRCP),and to provide scientific evidence_based medical basis for early intervention of IHRCP. Methods A total of 62 cases of IHRCP were enrolled in the Children＇s Neurological Rehabilitation Center of the First Affiliated Hospital of Anhui medi_cal University from June 2017 to December 2018. They were divided into xAmE group(32 cases)and NDT group(30 cases)according to the admission order. xross motor Function Scale(xmFm),Fine motor Function measure(FmFm) and xesell Development Scale(xDS)were used for detection and comparison. The differences among the gross motor, the fine motor score and the developmental quotient( D匝)between two groups before treatment,9 months after treat_ment and 12 months after treatment,and the normalization rate and the incidence of cerebral palsy between the two groups at 12 months of age were compared. Results ( 1 )motor function was as follows:at 9 months[ xAmE:(32. 63 ± 15. 83)scores,(30. 03 ± 15. 88)scores],[NDT:(33. 37 ± 15. 61)scores,(29. 67 ± 12. 54)scores]and at 12 months[xAmE:(40. 56 ± 15. 79)scores,(36. 31 ± 14. 98)scores],[NDT:(40. 47 ± 15. 50)scores,(36. 73 ± 14. 58)scores]after treatment,and xmFm and FmFm scores in xAmE and NDT groups were significantly higher than those before treatment[xAmE:(27. 56 ± 14. 24)scores,(21. 75 ± 11. 35)scores],[ NDT:(26. 93 ± 14. 96)scores, (21. 30 ± 10. 67)scores],and the differences were significant( all P<0. 01),but there was no significant difference between the 2 groups(all P> 0. 05).(2)D匝 had no significant difference in D匝 between xAmE group(63. 59 ± 10. 83)and NDT group(61. 59 ± 7. 96)before treatment(P>0. 05). The total D匝 at 9 months,12 months,the total D匝 of xAmE group(73. 67 ± 12. 00,81. 59 ± 13. 03)was significantly higher than that of NDT group(66. 05 ± 9. 54, 75. 17 ± 1. 92)(all P<0. 05). Among them,the improvement of xAmE in speech(79. 84 ± 16. 56,83. 19 ± 17. 05)at 9 months and 12 months,and adaptive ability(78. 63 ± 16. 37,85. 78 ± 13. 60)were significantly higher than that of NDT group(71. 63 ± 13. 36,72. 53 ± 12. 77),(68. 20 ± 14. 97,77. 43 ± 12. 10),and the differences were significant( all P<0. 05).(3)Prognosis was as follows:at 12 months after treatment,25 cases in xAmE group and 23 cases in NDT group developed into normal children,there was no significant difference in the normalization rate between the 2 groups( P>0. 05);the incidence of cerebral palsy was present in 6 cases in xAmE group and 5 cases in NDT group,and there was no significant difference between the 2 groups(P>0. 05). Conclusions xAmE therapy and NDT had significant effects on both gross and fine exercise of IHRCP,and the efficacy of the two methods is similar. Both xAmE therapy and NDT can equally promote IHRCP development into normal infants and reduce the incidence of cerebral palsy.
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[ ABSTRACT] AIM:To explore the mechanisms of fluctuant high blood glucose-induced apoptosis of hepatocytes. METHODS:SD rats were randomly divided into normal control group ( N) , stable high blood glucose group ( S) , fluctu-ant high blood glucose group ( F) and insulin group ( I) .Diabetic rats were induced by intraperitoneal injection of strepto-zotocin (65 mg/kg) , and the fluctuant high blood glucose animal model was induced by intraperitoneal injection of ordinary insulin and glucose at different time points every day.The blood glucose fluctuation patterns of the animals in F group with-in 12 weeks were similar every day and no significant difference of the HbA1c concentration was observed compared with S group, indicating that the fluctuant hyperglycemia was successfully established in F group.The activity of superoxide dis-mutase ( SOD) and glutathione peroxidase ( GSH-Px) , and the content of malondialdehyde ( MDA) and nitric oxide ( NO) in the homogenate of the liver tissues were detected by colorimetry.The mRNA and protein levels of JNK, p-JNK, Bax and Bcl-2 were examined by RT-PCR and Western blot.RESULTS:After 12 weeks, the increases in the intakes of food and water, the urine output, and the abnormal liver function were observed in S group, I group and F group.Compared with N group, the MDA level was increased, the content of NO and the activity of SOD and GSH-Px were decreased, and up-regu-lation of JNK mRNA and p-JNK and Bax proteins, and down-regulation of Bcl-2 were also found in S group, I group and F group.The above effects were more obviously showed in F group.CONCLUSION:Oxidative stress activates JNK-MAPK signaling pathway, which is involved in fluctuant high glucose-induced apoptosis of hepatocytes.
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Objective To explore in vitro cytotoxic activities of DCIKs against hepatocarcinoma cells by co-culturing cytokine-induced killer cells (CIKs) with dendritic cells (DCs) derived from peripheral blood of patients with hepatocellular carcinoma (HCC).Methods Peripheral blood mononuclear cells (PBMCs) were isolated from 23 patients with HCC and cultured with cytokines to induce DCs and CIKs.DCIKs were induced by co-culturing CIKs with DCs.After 14 days of co-culture,the phenotypes of DCIKs and CIKs were analyzed by flow cytometry,and their in vitro cytotoxic activities against SMCC-7721 and HepG2 hepatocarcinoma cells were measured by MTT assay.Levels of IL-12,IL-4 and IFN-γ in the supernatants of cell culture were detected by enzyme-linked immunosorbent assay (ELISA).Results High expressions of CD3+CD8+ and CD3+CD56+ were observed on DCIKs.The percentages of effector cells,cytotoxic activity and cytokine secretion were all significantly increased with DCIKs as compared with those CIKs without DC co-culture (P＜0.05).Conclusion Co-culture of CIKs with DCs can enhance the differentiation of effector cells and the cytolytic activities of CIKs against hepatocarcinoma cells in vitro.Immunotherapy with DCIKs may be a promising strategy for the treatment of patients with HCC.
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Objective To investigate the change of surface molecules and cytokine expressions of dendritic cells (DC) stimulated with recombinant proteins Com1 and heat shock protein B (HspB) of Coxiella burnetii (Cb).MethodsThe DC cultured for 5 d were stimulated with 20 μg/mL recombinant protein Com1,20μg/mL HspB or 6 μg/mL E.coli lipopolysaccharide (LPS).Twentyfour hours later,the surface mature marker,CD83,and activation-associated markers of T lymphocytes,CD58,CD54,CD40,CD80 and CD86,and expression levels of interleukin (IL)-10 and IL-12 of DC were detected by fluorescence activated cell sorter (FACS).Multiple comparisons were performed by using Student-Newman-Keuls test.ResultsCom1 could induce DC maturation efficiently in vitro.Human monocyte-derived DC exhibited significantly higher expression levels of surface molecules including CD83,CD54,CD58,CD80,CD86,and CD40,which were all ＞80％.CD83 expression induced by Com1 was similar with that induced by 1E.coli LPS,while CD54 and CD86 expressions were slightly higher than those induced by E.coli LPS,and expressions of other molecules were significantly higher than those induced by E.coli LPS (all P＜0.05).After Com1 stimulation,intracellular IL-12 level increased to 9 ％ from zero.HspB could not induce DC maturation in vitro.The intracellular IL-10 level was 6％ after HspB stimulation.DC pulsed with Com1 and HspB exhibited intracellular IL-12 level of zero and IL-10 level of ＜2％.Conclusion Com1 but not HspB can efficiently activate DC and Com1-activated DC can drive T cells toward Th1 cell development due to a high level of IL-12 production.