ABSTRACT
Non-small cell lung cancer is recognized as the deadliest cancer across the globe. In some areas, it is more common in women than even breast and cervical cancer. Its rise, vaulted by smoking habits and increasing air pollution, has garnered much attention and resource in the medical field. The first lung cancer treatments were developed more than half a century ago. Unfortunately, many of the earlier chemotherapies often did more harm than good, especially when they were used to treat genetically unsuitable patients. With the introduction of personalized medicine, physicians are increasingly aware of when, how, and in whom, to use certain anti-cancer agents. Drugs such as tyrosine kinase inhibitors, anaplastic lymphoma kinase inhibitors, and monoclonal antibodies possess limited utility because they target specific oncogenic mutations, but other drugs that target mechanisms universal to all cancers do not. In this review, we discuss many of these non-oncogene-targeting anti-cancer agents including DNA replication inhibitors (
ABSTRACT
Non-small cell lung cancer is a prevalent and rapidly-expanding challenge to modern medicine. While generalized medicine with traditional chemotherapy yielded comparatively poor response rates and treatment results, the cornerstone of personalized medicine using genetic profiling to direct treatment has exalted the successes seen in the field and raised the standard for patient treatment in lung and other cancers. Here, we discuss the current state and advances in the field of personalized medicine for lung cancer, reviewing several of the mutation-targeting strategies that are approved for clinical use and how they are guided by patient genetic information. These classes include inhibitors of tyrosine kinase (TKI), anaplastic lymphoma kinase (ALK), and monoclonal antibodies. Selecting from these treatment plans and determining the optimal dosage requires in-depth genetic guidance with consideration towards not only the underlying target genes but also other factors such as individual metabolic capability and presence of resistance-conferring mutations both directly on the target gene and along its cascade(s). Finally, we provide our viewpoints on the future of personalized medicine in lung cancer, including target-based drug combination, mutation-guided drug design and the necessity for data of population genetics, to provide rough guidance on treating patients who are unable to get genetic testing.
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OBJECTIVE:To observe clinical efficacy and safety of Xianlinggubao combined with alendronate sodium in the treatment of osteoporosis. METHODS:112 patients with osteoporosis were randomly divided into treatment group and control group with 56 cases in each group. Both group were given routine treatment as calcium carbonate,vitamin D and life style. Control group were given alendronate sodium 10 mg orally,qd;treatment group was additionally given Xianlinggubao capsule 1.5 g,bid, on the basis of control group. Both groups received 12 weeks of treatment. The levels of S-Ca,S-P,24 h urinary calcium(U-Ca), alkaline phosphatase(ALP),osteocalcin,IL-6,bone mineral density(BMD)of L2-4 lumbar spine and femoral neck were observed in 2 groups before and after treatment. Clinical efficacy and toxic reaction were compared. RESULTS:There was no statistical sig-nificance in the levels of S-P and S-Ca between 2 groups after treatment(P>0.05);the level of ALP、osteocalcin、BMD increased in treatment group after treatment,the level of U-Ca and IL-6 decreased compared to before treatment,and the treatment group was better than the control group,with statistical significance(P<0.05). Total effective rate of treatment group(92.86%)was sig-nificantly higher than that of control group (73.21%),with statistical significance (P<0.05). No obvious toxic side effects was found in 2 groups. CONCLUSIONS:Xianlinggubao combined with alendronate sodium shows significant therapeutic efficacy for patients with osteoporosis with good safety.
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Objective To explore the common causes and associated risk factors for unintentional injuries among inpatient children from Yuying Children's Hospital of Wenzhou Medical College during 2007～2008.Methods This retrospective study involved 2 672 children of 0～18 years of age treated for unintentional injuries in Yuying Children's Hospital of Wenzhou Medical Collge from 2007 to 2008.Statistical evluation included x2 analysis and computation of relative risk(RR)with a 95％ confidence interval(CI).Results The top five types of unintentional injury were falls from one level to another(e.g.from playground equipment,chair,bed,stationary vehicle,and so on.)or falls on same level(e.g.from slipping,tripping,stumbling,collision,and so on)(30.84％),traffic accident(25.15％),falls from height(e.g.from balcony,bridge,building,window,and so on)(11.56％),foreign body ingestion/inhalations(6.89％),open wounds including cut,lacerarion and puncture wound(6.51％).The types of unintentional injury were not uniform among different age groups(x2 =602.12,P ＜0.01).Boys had a higher incidence of injury than did girls with a ratio of 2.34∶ 1.Unintentional injury rates varied considerably by age(x2 =583.90,P ＜0.01).The most prevalent age group was 1～4 years old.The most common body part injuried was the extremity region(54.00％).20.40％ of cases had injuried to the neck and head,15.27％ had thorax and abdomen injuries,3.78％ had vertebral column injuries and 1.87％ had pelvis injuries.Significant differences existed in injuried body site among different age children(x2 =315.21,P ＜0.01).The discharge departments were traumatic department(42.07％),hand surgery and spinal department(22.16％),department of otorhinolaryngology(6.89％),orthopaedic department(6.32％),neurosurgical department(5.84％),and the other discharge departments included pediatric surgical department,chest surgery department,stomatology department,ophthalmic department,pediatric intensive care unit and pediatric internal department.The number and rate of unintentional injury were the highest in summer(July-September),accounting for 28.63％.The estimated days and cost of unintentional injuries were 1 1.72 d and 9 617.96 yuan RMB each child,respectively.Conclusion Injury prevention efforts should include consideration of the substantial differences in the leading causes of unintentional injuries,in regard to sex,age and type of injury.Unintentional injuries lead to a threat to health and well-being and waste a majory source of medical spending in China for children and youth 0 to 18 years age.Making efforts to prevent child injury and establishing a complete emergency medical system are very important.