Prognostic factors affecting the success of conversion chemotherapy in patients with unresectable liver metastases from initially colorectal cancer / 中华胃肠外科杂志

Objective: To investigate the factors affecting the success of conversion therapy in patients with initially unresectable colorectal cancer liver metastases (CRLM) in order to provide evidence-based medical evidence for formulating individualized treatment strategies for patients. Methods: A retrospective case-control study was used in this study. Clinical data of 232 patients with initially unresectable CRLM receiving first-line systemic treatment in Sun Yat-sen University Cancer Center from January 2013 to January 2020 were collected, including 98 patients of successful conversion and 134 patients of failed conversion as control. Conversion therapy scheme: 38 patients received FOLFOXIRI regimen chemotherapy (irinotecan, oxaliplatin, calcium folinate and fluorouracil), 152 patients received FOLFOX regimen (oxaliplatin, calcium folinate and fluorouracil), 19 patients received FOLRIRI regimen (irinotecan, calcium folinate and fluorouracil), 23 patients received systemic chemotherapy combined with fluorouridine hepatic artery infusion chemotherapy; 168 patients received targeted therapy, including 68 of bevacizumab and 100 of cetuximab. Logistics analysis was used to compare the factors affecting the success of conversion therapy. The Kaplan-Meier method was used to calculate progression-free survival (PFS), and the Log-rank test was used for survival comparison. Results: Among 232 patients, 98 patients had successful conversions and 134 patients had failed conversions with a successful conversion rate of 42.2%, meanwhile 30 patients underwent simple hepatectomy and 68 underwent hepatectomy combined with intraoperative radiofrequency ablation. After first-line chemotherapy, 111 patients (47.8%) were partial remission, 57 patients (24.6%) were stable disease, and 64 patients (27.6%) were progression disease. During the median follow-up of 18.8 (1.0-87.9) months, 148 patients were dead or with tumor progression. The median PFS time of patients with successful conversion was longer than that of patients with failed conversion (31.0 months vs. 9.9 months, P<0.001). Univariate analysis found that the bilobar distribution of liver tumors (P=0.003), elevated baseline carcinoembryonic antigen (CEA) levels (P=0.024), tumor invasion of the portal vein (P=0.001), number of metastatic tumor>8 (P<0.001), non-FOLFOXIRI (P=0.005), and no targeted therapy (P=0.038) were high risk factors for the failed conversion therapy. The results of multivariate logistics analysis indicated that the number of metastatic tumor >8 (OR=2.422, 95%CI: 1.291-4.544, P=0.006), portal vein invasion (OR=2.727, 95%CI: 1.237-4.170, P=0.008) were the independent risk factors for failed conversion therapy, while FOLFOXIRI regimen (OR=0.300, 95%CI: 0.135-0.666, P=0.003) and targeted drugs (OR=0.411, 95%CI: 0.209-0.809, P=0.010) were independent protective factors for successful conversion therapy. Conclusions: The number of metastatic tumor and portal vein invasion are key factors that affect the outcomes of conversion therapy for initially unresectable CRLM. If a patient can tolerate chemotherapy, a combination program of three-drug and targeted therapy is preferred for the active conversion therapy.

Progress in diagnosis and treatment of gastroparesis after colon cancer surgery / 中华胃肠外科杂志

At present, comprehensive treatment dominated by surgical procedures is an important measure for colon cancer to obtain the chance of cure. Surgical intervention, while removing the tumor, carries the risk of postoperative gastroparesis (PG) . Because of the low incidence rate and insignificant early clinical symptoms, early stage PG is often overlooked clinically. However, PG can increase the risk of malnutrition, delay postoperative antitumor treatment, and increase the risk of tumor recurrence and metastasis. This review focuses on the mechanisms, clinical risk factors, preventive measures, and advances in treatment of PG due to colon cancer. Aim to increase the clinician's adequate attention to PG in colon cancer and from a surgical point to reduce the risk of gastroparesis in colon cancer by optimizing the surgical strategy.

Clinical characteristics, cytogenetic and molecular findings in patients with disorders of sex development / 华中科技大学学报（医学）（英德文版）

The clinical characteristics of patients with disorders of sex development (DSD), and the diagnostic values of classic cytogenetic and molecular genetic assays for DSD were investigated. In the enrolled 56 cases, there were 9 cases of 46,XY DSD, 6 cases of Turner syndrome (TS), one case of Super female syndrome, 25 cases of Klinefelter syndrome, 14 cases of 46,XX DSD, and one case of autosomal balanced rearrangements with hypospadias. The diagnosis of sex was made through physical examination, cytogenetic assay, ultrasonography, gonadal biopsy and hormonal analysis. PCR was used to detect SRY, ZFX, ZFY, DYZ3 and DYZ1 loci on Y and X chromosomes respectively. The DSD patients with the same category had similar clinical characteristics. The karyotypes in peripheral blood lymphocytes of all patients were identified. PCR-based analysis showed presence or absence of the X/Y-linked loci in several cases. Of the 9 cases of 46,XY DSD, 6 were positive for SRY, 9 for ZFX/ZFY, 9 for DYZ3 and 8 for DYZ1 loci. Of the 6 cases of TS, only 1 case with the karyotype of 45,X,/46,XX/46,XY was positive for all 5 loci. Of the 25 cases of Klinefelter syndrome, all were positive for all 5 loci. In one case of rare Klinefelter syndrome variants azoospermia factor (AZF) gene detection revealed the loss of the AZFa+AZFb region. In 14 cases of 46,XX DSD, 7 cases were positive for SRY, 14 for ZFX, 7 for ZFY, 7 for ZYZ3, and 5 for DYZ1. PCR can complement and also confirm cytogenetic studies in the diagnosis of sex in cases of DSD.

Clinical characteristics, cytogenetic and molecular findings in patients with disorders of sex development / 华中科技大学学报（医学）（英德文版）

The clinical characteristics of patients with disorders of sex development (DSD), and the diagnostic values of classic cytogenetic and molecular genetic assays for DSD were investigated. In the enrolled 56 cases, there were 9 cases of 46,XY DSD, 6 cases of Turner syndrome (TS), one case of Super female syndrome, 25 cases of Klinefelter syndrome, 14 cases of 46,XX DSD, and one case of autosomal balanced rearrangements with hypospadias. The diagnosis of sex was made through physical examination, cytogenetic assay, ultrasonography, gonadal biopsy and hormonal analysis. PCR was used to detect SRY, ZFX, ZFY, DYZ3 and DYZ1 loci on Y and X chromosomes respectively. The DSD patients with the same category had similar clinical characteristics. The karyotypes in peripheral blood lymphocytes of all patients were identified. PCR-based analysis showed presence or absence of the X/Y-linked loci in several cases. Of the 9 cases of 46,XY DSD, 6 were positive for SRY, 9 for ZFX/ZFY, 9 for DYZ3 and 8 for DYZ1 loci. Of the 6 cases of TS, only 1 case with the karyotype of 45,X,/46,XX/46,XY was positive for all 5 loci. Of the 25 cases of Klinefelter syndrome, all were positive for all 5 loci. In one case of rare Klinefelter syndrome variants azoospermia factor (AZF) gene detection revealed the loss of the AZFa+AZFb region. In 14 cases of 46,XX DSD, 7 cases were positive for SRY, 14 for ZFX, 7 for ZFY, 7 for ZYZ3, and 5 for DYZ1. PCR can complement and also confirm cytogenetic studies in the diagnosis of sex in cases of DSD.

Clinical observation on catgut implantation at Shu- and Mu-acupoints for treatment of premature ovarian failure / 中国针灸

<p><b>OBJECTIVE</b>To observe clinical therapeutic effect of catgut implantation at Shu- and Mu-acupoints of liver, spleen and kidney on premature ovarian failure.</p><p><b>METHODS</b>One hundred and thirty-two cases of premature ovarian failure were randomly divided into a catgut implantation group and a medication group, 66 cases in each group. The catgut implantation group were treated by catgut implantation at She- and Mu-acupoints of liver, spleen and kidney, and the medication group were treated with oral administration of Estradiol Valerate 2 mg, qd, for 20 days, and 10 days later, Medroxyprogesterone Acetate 4 mg was added, b. i. d, for 10 days, averaging 6 months of medication. The therapeutic effects and changes of serum follicle-stimulating hormone (FSH) and estradiol (E2) were observed in the two groups.</p><p><b>RESULTS</b>After treatment, serum FSH and E2 significantly improved in the two groups (P<0.01), with the serum E2 in the catgut implantation group increased more significantly than that in the medication group (P<0.01). The cured rate and the total effective rate were 84.9% and 97.0% in the catgut implantation group and 31.8% and 84.8% in the medication group, the cured rate in the catgut implantation group being better than that in the medication group (P<0.05). Ten month later, the therapeutic effect in the catgut implantation group was kept.</p><p><b>CONCLUSION</b>Catgut implantation at Shu- and Me-acupoints of liver, spleen and kidney has a good therapeutic effect on premature ovarian failure with no side effect.</p>

Comparative observation on acupuncture and western medicine for treatment of minimal brain dysfunction / 中国针灸

<p><b>OBJECTIVE</b>To compare the therapeutic effects of acupuncture and western medicine on minimal brain dysfunction (MBD) and to search for a clinically effective therapy for MBD.</p><p><b>METHODS</b>Sixty-eight cases were randomly divided into an acupuncture group and a western medicine group, 34 cases in each group. The acupuncture group were treated by acupuncture at Dazhui (GV 14) and Shenque (CV 8), and the western medicine group by taking Haloperidol orally. One month constituted one course. After treatment, the total effective rate and scores of Connell's scale for diagnosis and behavior of MBD were compared between the two groups.</p><p><b>RESULTS</b>The total effective rate and the score after treatment were 97.1% and 10 +/- 0.37 in the acupuncture group and 82.4% and 15 +/- 0.93 in the western medicine group, with a very significant difference between the two groups (P < 0.01, P < 0.000 5), the acupuncture group being better than the western medicine group. Follow-up survey for 2-10 months showed the effects of the acupuncture group still were kept.</p><p><b>CONCLUSION</b>Acupuncture at Dazhui (GV 14) and Shenque (CV 8) can effectively cure MBD.</p>