Study on international cooperation mechanism of traditional Chinese medicine in process of Belt and Road / 中草药

Traditional Chinese medicine (TCM) has been the focus and highlight of the ancient Silk Road trade activities since ancient times. Since the Belt and Road Initiative was proposed for the first time in China in 2013, the internationalized development of TCM has made positive progress. Based on the theory of international mobility of production factors, this paper qualitatively analyzes the "five mechanisms" of international cooperation between China and the countries along the routes in the background of the Belt and Road Initiative: The intergovernmental exchange and cooperation mechanism; cooperation mechanism of TCM inheritance and innovation; TCM service trade cooperation mechanism; TCM resources sharing cooperation mechanism; cooperation mechanism of TCM culture and humanities exchanges. A qualitative and quantitative analysis combined with partial equilibrium analysis were used to analyze the welfare effects before and after the production factors of TCM transnational movement, and make a further investigation on the difficulties and challenges faced by the current international cooperation of TCM in China, and put forward the corresponding countermeasures and suggestions.

Comparison of the efficacy of second line EGFR TKIs followed by third line pemetrexed or the reverse sequence in the treatment of advanced lung adenocarcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To compare the efficacy of second-line EGFR-TKIs followed by third-line pemetrexed with second-line pemetrexed followed by third-line EGFR-TKIs in patients with advanced lung adenocarcinoma.</p><p><b>METHODS</b>From March 2007 to August 2008, 83 patients with advanced lung adenocarcinoma who failed standard first-line chemotherapy were included in this study. The patients who received EGFR-TKIs as second-line therapy followed by third-line pemetrexed were designated as group A (n = 45). The patients who received pemetrexed as second-line therapy followed by third-line EGFR-TKIs were designated as group B (n = 38). PFS and MST were estimated with Kaplan-Meier analysis and the difference between groups were compared with Log-rank test.</p><p><b>RESULTS</b>The progression-free survival (PFS) after second-line therapy in the groups A and B was 8.05 months (95% CI, 5.90 to 10.20) and 4.20 months (95% CI, 3.33 to 5.06), respectively (P = 0.001). The PFS after second-line therapy in smokers and non-smokers was 3.69 months (95% CI, 5.00 to 7.59) and 7.12 months (95% CI, 5.51 to 8.38), respectively (P = 0.007). The PFS of male and female patients was 5.56 months (95% CI, 4.02 to 7.10) and 6.85 months (95% CI, 4.98 to 7.58), respectively (P = 0.279). The PFS after third-line therapy in groups A and B was 6.88 months (95% CI, 5.07 to 8.69) and 7.60 months (95% CI, 5.59 to 9.12) respectively, (P = 0.899). The PFS after third-line therapy in smokers and non-smokers was 4.95 months (95% CI, 2.83 to 7.05) and 8.49 months (95% CI, 6.27 to 10.76), respectively (P = 0.050). The PFS after third-line therapy in male and female patients was 5. 96 months (95% CI, 4.02 to 7.91) amd 8.38 months (95% CI, 5.68 to 11.07), respectively (P = 0.176). The MST in groups A and B was 23.60 months (95% CI, 19.23 to 28.00) and 15.58 months (95% CI, 11.85 to 19.32), respectively (P = 0.021). The MST in smokers and non-smokers was 11.99 months (95% CI, 8.55 to 15.49) and 23.18 months (95% CI, 19.33 to 27.02), respectively (P = 0.001). The MST in male and female patients was 17.40 months (95% CI, 13. 19 to 21.61) and 22.74 months (95% CI, 18.29 to 27.19), respectively (P = 0.111).</p><p><b>CONCLUSIONS</b>Second line EGFR TKIs followed by third line pemetrexed regimen improves the PFS and MST compared with the regimen second line pemetrexed followed by third line EGFR TKIs in patients with advanced lung adenocarcinoma. Smoking status is an independent prognostic factor. Survival is not influenced by gender. Prospective clinical trials are needed to confirm these findings.</p>

Efficacy and safety of docetaxol, pemetrexed and EGFR-TKIs as second-line treatment for patients with advanced non-small-cell lung cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To compare the efficacy and safety of docetaxol, pemetrexed and EGFR-TKIs in the second-line treatment for patients with advanced non-small cell lung cancer.</p><p><b>METHODS</b>The clinical data of 170 patients with advanced non-small cell lung cancer who failed standard first-line chemotherapy were reviewed. Those who received docetaxol as second-line therapy were designated as group A (n = 60), those who received pemetrexed as second-line therapy were designated as group B (n = 49), and those who received EGFR-TKIs as second-line therapy were designated as group C (n = 61). PFS and MST were estimated by Kaplan-Meier method and the differences between groups were compared by log-rank test.</p><p><b>RESULTS</b>The response rate in the groups A, B and C group was 15.0% (9/60), 24.5% (12/49) and 36.1% (22/61), respectively. The PFS after second-line therapy in the groups A, B and C was 5.49 months (95%CI: 4.03 - 6.95 months), 5.42 months (95%CI: 4.23 - 6.60 months) and 9.31 months (95%CI: 6.88 - 11.73 months), respectively (P = 0.045). The MST after second-line therapy in the groups A, B and C was 14.89 months (95%CI: 11.23 - 18.55 months), 15.81 months (95%CI: 12.11 - 19.52 months) and 17.47 months (95%CI: 13.38 - 21.56 months), respectively (P = 0.574). Regression analysis showed that the performance status score (PS) and response for second-line treatment are independent prognostic factors in each sub-group, and pathological type is an independent prognostic factor in the group C (P = 0.003).</p><p><b>CONCLUSIONS</b>The safety of the three drugs used as second-line treatment for patients with advanced non-small-cell lung cancer, who failed standard first-line chemotherapy, is comparable, but the EGFR-TKIs group has the highest response rate, and the EGFR-TKIs group has the longest PFS with a statistically significant difference, while there is no significant difference in MST among the three groups. When patients receive second-line treatment, the performance status < 2 and the response rate for second-line treatment are independent prognostic factors. Furthermore, pathological type (adenocarcinoma) is also an independent prognostic factor for EGFR-TKIs as second-line treatment.</p>

Chromosomal analysis of lung cancer by comparative genomic hybridization / 中国癌症杂志

Background and purpose:Lung cancer is thought to be caused by multiple-step carcinogenesis. Identification of the genetic alterations that occur in tumors is an important approach to understanding carcinogenesis. We identified chromosomal abnormality in lung cancer by the molecular cytogenetic techniques of comparative genomic hybridisation(CGH),the technology could help to comprehend the relationship between chromosome abnormality, different patho-types,and clinical features of lung cancer.Methods:CGH was used to detect the global genomic aberration in the fresh cancer tissue cells from 30 patients with lung cancer.Results:Chromosomal abnormality were detected in all of 30 cases with lung cancer,the altofrequent gains in 1p11-p22,5p11-p14,16p 11-P12,19q13, 19p 13,20p12,21q21 and the altofrequent losses in 5q,6p24-pter,9p31-qter,13q21-qter,14q21-qter were found in all three types of lung cancer,the marked differences of chromosomal abnormalities in three types of lung cancer were also found.Conclusions:The cytogenetic aberration exists generally in lung cancer cells,the cytogenetic aberration is the base of the initiation and progression of the lung cancer.There are some different chromosomal abnormalities between different types of lung cancer,which may serve as a marker to differential diagnosos of the three types of lung cancer.As to the progression of malignant neoplastic disease,the complexity of chromosomal abnormality is obviously elevated.Different carcinogenic agents(smoking for example)may induce different chromosomal abnormalities.