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Objective:To retrospectively summarize the clinicopathological features of epithelioid glioblastoma (Ep-GBM) and to explore new treatment for Ep-GBM.Methods:The clinical data of 13 patients with Ep-GBM,who were treated in our department from March 2016 to July 2017,were retrospectively analyzed.The clinicopathological features were summarized and the efficacy was evaluated.Results:The positive rate of BRAFV600E mutant and INI-1 was 76.9％ (10/13) and 80％ (8/10),respectively,while the median Ki-67 index was 30％.Meningeal metastases occurred in 9 cases (69.7％) during the course.The median follow-up time was 12 (6-25) months,and the median progression-free time was 8.6 (2.2-16.5) months.Three patients died and the 1-year overall survival rate was 54％.Conclusion:Ep-GBM has a high degree of malignancy and is prone to spread to leptomeninges.INI-1 expression and BRAFV600E mutation are common for Ep-GBM.BRAF inhibitor might be a potential therapeutic drug for it.
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Objective To assess the impact of additional cycles of temozolomide on the survival of glio-blastoma(GBM)patients after 6 months of maintenance temozolomide(TMZ)following concurrent TMZ chemo-therapy and radiation therapy. Methods Data of 51 GBM patients from 2009 to 2015 were retrospectively studied and the therapeutic effect was assessed according to whether receiving long-term treatment with TMZ. Results Sev-enteen of fifty-one GBM patients received 8 or more cycles and prolonged treatment improved progression-free sur-vival(P=0.011)and overall survival(P=0.004). Conclusions Extended use of TMZ is safe to GBM patients , which may improve response OS and PFS compared to conventional regimen. Prospective studies in larger popula-tions are needed to better-define the population to whom it can be proposed and its optimal duration.
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Objective To investigate the relevance between relapse and course of treatment in genotype 1 chronic hepatitis C (CHC)pa-tients with slow virologic response.Methods Totally 157 genotype 1 CHC inpatients or outpatients were selected from the Third People′s Hospital of Jiaozuo and the People′s Hospital of Jiaozuo from April 2010 to March 2013.The patients were treated with interferon α-1b in conjunction with ribavirin.At 6 months of the initial treatment,5 1 patients with slow virologic response were randomly divided into groups A (24 cases)and B (27 cases),which received continued treatment for another 6 and 12 months,respectively.A 1 -year follow-up of pa-tients was performed after withdrawal of treatment.Adverse reactions in patients receiving the antiviral therapy were assessed.Furthermore, group comparisons were performed on the clearance rate of hepatitis C virus (HCV)RNA and normalization rate of alanine aminotransferase (ALT)at withdrawal of treatment,as well as the CHC relapse rate and ALT normalization rate at 6 months and 1 year after withdrawal of treatment.Continuous data were compared using t test,and categorical data were compared usingχ2 test.Results The rate of adverse reac-tions in patients receiving antiviral therapy had no significant difference between groups A and B (P>0.05 ).At withdrawal of treatment, there were no significant differences between groups in terms of HCV RNA clearance rate (95.65%vs 92.59%)and ALT normalization rate (95.65% vs 88.89%)(χ2 =0.02 and 0.13,respectively,both P>0.05).At 6 months and 1 year after withdrawal of treatment,the CHC relapse rate in group B was significantly lower than that in group A (20.00% vs 50.00%,χ2 =4.69,P 0.05;72.00% vs 50.00%,χ2 =2.40,P>0.05).Conclusion To extend the 6 -month course of treatment can significantly reduce the relapse following slow virologic response in patients with genotype 1 CHC.
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Objective To explore the new preservation method of cornea by evaluating the structure and function of rabbit's endothelia on the condition of whole-eye preservation with aqueous removed and recipient's serum tamponaded. Methods Forty New Zealand big white rabbits (80 eyes) were random divided into two groups, 40 eyes in group A (control group) and 40 eyes in group B (experimental group). The vitality of endothelial cell on the condition of tow corneal preservation methods which were the moist chamber preservation (group A) and the whole-eye preservation with aqueous removed and recipient's serum tamponaded (group B) was compared. At the 2nd day, the 5th day, the 7th day, the 10th day, the vitality of endothelial cell was appraised through ultra-microstructure by scanning electron microscope and the trpan biuealizarin red stain. The corneal thickness was measured, and corneal endothelial cells density was calculated, and cell size was observed by image analysis system. Result In group B, the corneas remained transparent for 7 days , and the rate of vitality was 90% for7 days and that was over 80% for 10 days. In group A, the corneas remained transparent for 2 days, and the endothelial cell losing and dying were found after 5 days. Cell vitality, cell density and cell size had no statistical difference between Group B for 7 days and group A for 2 days. (all P＞0. 05). In group A, at the 5th day, the 7th day ,the 10th day, the average corneal thickness were (0.64 ± 0.04) mm, (0. 79 ± 0. 03) mm , (1.06 ± 0. 03) mm. In the group B, at the 5th day, the 7th day ,the l0th day, the average corneal thickness were (0. 55 ±0.03)mm, (0.65 ±0. 02) mm , (0. 85 ± 0. 05) mm. The average corneal thickness had significant difference between group A and group B (all P ＜ 0. 05). Conclusion Recipient serum had the function with supporting the structure and function of rabbit's corneal endothelial cell, and it could prolong the storage time with the moist chamberstorage at the same time.
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Objective To seek the evidence-based medicine (EBM) evidences of curative effects of intravitreous injection with triamcinolone acetonide (TA) for macular edema. Methods All articles of intravitreous injection TA for macular edema published in English or Chinese were picked up from databases of MEDLINE and CNKI and then evaluated according to EBM standard. The data in accord with research standard were selected by using excluding and including criteria, and classified according to the appraisal standard of clinical therapeutic documents. Results In the selected papers, none in gradeⅠevidence; 1 in gradeⅡevidence; 7 in grade Ⅲ evidence; 24 in grade Ⅳ evidence; and 19 in gradeⅤevidence. Forty-two papers reported that intravitreous injection with TA had significant effect for macular edema within 3 months, and the improvement of visual acuity was recorded in these papers. Regression of macular edema was recorded in 23 papers. Among 20 papers, side-effect was found in 93 eyes (31.41%) and the serious side-effect in 4 eyes (1.35%). Conclusions Intravitreous injection with TA has some curative effects for macular edema in short term, but the quality of current study has not been encouraging. There are no grade I document and lack of the study of validity in long term and essentiality and validity of retreatment. The special attention should be payed on the increasing persistency of efficacy and preventing the serious side-effects in the future investigation.