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Objective@#To investigate the effect of omeprazole on plasma concentration, efficacy and adverse reactions of capecitabine in patients with colon cancer.@*Methods@#Seventy-two patients with colon cancer treated with capecitabine were analysed retrospective. The patients treated with capecitabine combined with omeprazole were identified as experimental group and the capecitabine treatment alone as control group.The differences of blood concentration and the side effects of capecitabine between these two groups were compared.@*Results@#The plasma concentration of 5-Fluorouracilum in experimental group was (126.25±50.59) μg/ml, without significant difference of (123.09±56.70) μg/ml in control group (P=0.121). The incidence of Ⅲ to Ⅳ degree bone marrow suppression, nausea, vomiting, diarrhea and hand-foot syndrome in experimental group were 13.8%, 0%, 0% and 19.4%, respectively. In control group, the incidence of Ⅲ to Ⅳ degree bone marrow suppression, nausea, vomiting, diarrhea and the hand-foot syndrome were 11.1%, 0%, 0% and 19.4%, respectively, without significant difference of experimental group (P>0.05). The incidence of acid reflux and heartburn in the control group was 72.2%, significantly higher than 44.4% of the experimental group (P<0.05). The objective response rate (ORR) and progression-free survival time (PFS) in these two groups were 30.6% and 33.3%, and 8.0 month and 8.5 month, respectively, without significant difference (P>0.05).@*Conclusion@#The intravenous omeprazole attenuates reflux and heartburn of colon cancer patients treated with capecitabine, without affecting its plasma concentration and side effects and has no impact on the PFS of these patients.
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Objective@#To analyze the diagnosis treatment and methods for pancreatic pseudoaneurysms complicated with pancreatitis.@*Methods@#The diagnostic methods, treatments and clinical effects of 11 patients with pancreatic pseudoaneurysms complicated with pancreatitis from January 2006 to December 2014 were retrospectively analyzed in Shengjing hospital.@*Results@#Two cases of pancreatic pseudoaneurysms were diagnosed by endoscopic ultrasonography(EUS). Eight cases were diagnosed with contrast-enhanced computed tomography. One case was diagnosed by angiography. Ten patients received endovascular embolization, and nine of them were successfully treated. Rebleeding occurred in one patient 28 days after embolization, and was successfully treated by repeated embolization. One patient was successfully treated by surgery.@*Conclusion@#Contrast-enhanced computed tomography and angiography are the current main methods to diagnose pancreatic pseudoaneurysms. With the wide use of EUS in the diagnosis of pancreatic disease, EUS becomes an option for diagnosis of pancreatic pseudoaneurysm. Traditionally, pancreatic pseudoaneurysm is treated by surgery. With the advancement of endovascular techniques, endovascular treatment has become the first-line treatment. Further studies with a large sample size are needed to establish the better diagnostic methods and treatments for pancreatic pseudoaneurysm.
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Objective To analyze the diagnosis treatment and methods for pancreatic pseudoaneurysms complicated with pancreatitis. Methods The diagnostic methods,treatments and clinical effects of 11 patients with pancreatic pseudoaneurysms complicated with pancreatitis from January 2006 to December 2014 were retrospectively analyzed in Shengjing hospital. Results Two cases of pancreatic pseudoaneurysms were diagnosed by endoscopic ultrasonography(EUS). Eight cases were diagnosed with contrast-enhanced computed tomography. One case was diagnosed by angiography. Ten patients received endovascular embolization,and nine of them were successfully treated. Rebleeding occurred in one patient 28 days after embolization,and was successfully treated by repeated embolization. One patient was successfully treated by surgery. Conclusion Contrast-enhanced computed tomography and angiography are the current main methods to diagnose pancreatic pseudoaneurysms. With the wide use of EUS in the diagnosis of pancreatic disease,EUS becomes an option for diagnosis of pancreatic pseudoaneurysm. Traditionally, pancreatic pseudoaneurysm is treated by surgery. With the advancement of endovascular techniques, endovascular treatment has become the first-line treatment. Further studies with a large sample size are needed to establish the better diagnostic methods and treatments for pancreatic pseudoaneurysm.
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Purpose To investigate the expression of Beclin1, LC3 and mTOR in colorectal cancer ( CRC) and their significance. Methods Immunohistochemistry, Western blot and real-time PCR were employed to detect the expression of Beclin1, LC3 and mTOR in CRC. Results The positive expression rate of Beclin1, LC3 and mTOR in 242 cases of CRC was 90. 50%, 87. 19% and 46. 28%, respectively, which were higher than that in adjacent tissues ( P0. 05). The expres-sion of LC3 was positively correlated with Beclin1 and negatively correlated with mTOR in colorectal cancer (rs =0. 593, P0. 05). Kaplan-Meier survival analysis re-vealed that the five-year survival rate of patients without nodal metastasis, positive expression of Beclin1, LC3 and negative expression of mTOR was higher than those with nodal metastasis, negative expression of Beclin1 and LC3, and positive expression of mTOR. Cox survival analysis results revealed that LC3, mTOR and lymphnode metastasis were independent prognostic factors. The results of IHC, real-time PCR and Western blot in fresh CRC tissues indicated that the expression of Beclin1, LC3 and mTOR in colorectal cancer was significantly higher than that in adjacent tissues (P<0. 05). Conclusions The aberrant expression of Beclin1, LC3 and mTOR may be associated with the development and progression of colorectal cancer. The simultaneous detection of Beclin1, LC3 and mTOR genes in colorectal cancer may be helpful for the evaluation of the progressive degree and the judgment of prognosis.
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Objective To compare the clinical efficacy of neoadjuvant chemotherapy plus vaginal intracavitary irradiation,neoadjuvant chemotherapy alone and vaginal intracavitary irradiation alone followed by radical hysterectomy in patients with stage Ⅰ b2 and Ⅱ a2 bulkly cervical carcinoma.Methods Between January 2000 and December 2009,224 patients with stage Ⅰ b2 and Ⅱ a2 bulkly cervical carcinoma ( tumor diameter ＞ 4 cm) received neoadjuvant therapy combined surgery in Cancer Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences were respectively analyzed,and they were divided into 3 groups according to the preoperative neoadjuvant therapy,the neoadjuvant chemotherapy combined vaginal intracavitary irradiation group (chemotherapy combined irradiation group,n =86 ),the neoadjuvant chemotherapy alone group ( chemotherapy group,n =48 ),the vaginal intracavitary irradiation alone group ( irradiation group,n =90).The efficacy,postoperative risk factors,postoperative adjuvant therapy and survival were compared among the 3 groups.Results Among the chemotherapy combined irradiation group,chemotherapy group and irradiation group,the response rate (RR) were respectively 62％ (53/86),42％(20/48) and 37％ ( 33/90 ),and there was significant difference ( P =0.003 ).The comparison of deep stromal invasion,lymph node metastases,lympho-vascular space involvement(LVSI) and other risk factors among the 3 groups,which showed that there were no statistically significant differences ( P ＞ 0.05 ).In chemotherapy combined irradiation group,the percentage of stromal invasion ≥ 1/2 was lower than that in chemotherapy group [ 53％ ( 46/86 ) vs.73％ ( 35/48 ),P =0.027 ],and the percentage of lymph node metastases was significantly lower than irradiation group [ 17％ ( 15/86)vs.29％ (26/90),P =0.046],and the risk factors-free rate was significantly higher than chemotherapy group [ 44％ (38/86)vs.25％ ( 12/48 ),P =0.028 ].Among the chemotherapy combined irradiation group,chemotherapy group and irradiation group,the percentage of postoperative radiation therapy were respectively 47％ (40/86),67％ (32/48)and 62％ (56/90),and the differences were statistically significant (P =0.035).The five-year disease free survival (DFS) was 79％,75％ and 78％,respectively.The five-year overall survival (OS) was respectively 81％,78％ and 81％ among 3 groups,and there were no statistically significant differences (P ＞ 0.05).Among 224 patients,the five-year DFS of the patients with 0,1 and ≥ 2 risk factors after surgery were 90％,75％ and 57％,and OS were 95％,82％ and 65％,and there were no statistically significant differences( P ＜ 0.01,respectively).Of patients without postoperative risk factors,the five-year OS in those without receiving postoperative radiation therapy was 96％,while 89％ in received postoperative radiation therapy patients,there were no statistically significant differences ( P =0.263 ).Conclusion There are no differences of DFS and OS among the neoadjuvant chemotherapy combined vaginal intracavitary irradiation group,the neoadjuvant chemotherapy alone group and the vaginal intracavitary irradiation alone group patients with stage Ⅰ b2 and Ⅱ a2.Patients without risk factors after neoadjuvant therapies have better prognosis.