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Objective To evaluate the efficacy and safety of gefitinib combined with concurrent thoracic radiotherapy in the treatment of local - advanced non - small cell lung cancer with sensitive EGFR mutations. Methods From June 2015 to December 2016,fifty-six eligible patients in Chongqing Three Gorges Central Hospital were randomly assigned into two groups by one to one ratio,with 28 cases in each group.A group received treatment of gefitinib combined with concurrent thoracic radiotherapy, and B group adopted concurrent chemoradiotherapy. The toxic effects were recorded and all patients were followed up as defined by the study protocol.Primary study endpoints included:severe toxic effects,objective response rate and disease control rate,progression free survival and overall survival.Results Twenty-six patients in A group completed the study,and the severe toxic effects were as followed:interstitial pneumonia(3/26),radiation esophagitis(4/26),myelosuppression,skin rashes and gastrointestinal disruption. Twenty- eight patients in B group completed the study, and the severe toxicity included: interstitial pneumonia (4/26),radiation esophagitis(3/26),myelosuppression,skin rashes and gastrointestinal disruption.No toxicity higher than gradeⅢdeveloped in both two groups,and there were no statistically significant differences in incidence rates of interstitial pneumonia and radiation esophagitis between the two groups ( all P >0. 05 ). Moreover, there were no statistically significant differences in ORR and DCR between the two groups( ORR:61.5% vs.39.3% ,P=0.102;DCR:84. 6% vs. 71. 4% , P =0. 505 ). A group showed the benefit over B group in PFS ( 12. 45 months vs. 10.35 months,P=0.036).However,OS didn＇t reach and needed further follow-up.Conclusion The modality of gefitinib combined with concurrent thoracic radiotherapy in the treatment of local -advanced non -small cell lung cancer with sensitive EGFR mutations is safe and effective,and it yet needs further follow-up.
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Objective To observe the clinical curative effecand safety of ordinary intensity modulated and simplified intensi-ty modulated radiotherapy technique combined with transcathetearterial chemoembolization (TACE) fotreating primary hepaticancer(PHC) .MethodTotally 85 caseof Phwere randomly divided into the observation group (n=43) and the control group (n=42) .The observation group adopted the sequential therapy of TACE combined with the simplified intensity modulated radio-therapy(sIMRT) and the control group adopted the sequential therapy of TACE combined with the conventional intensity-modula-ted radiation therapy (cIMRT) .The shorterm curative effect,progresfree survival (PFS) ,overall survival (OS) ,and toxicity and adverse reactionwere observed in the two group.Result85 casewere followed up according to the requirement,2 casein the control group did noparticipated in the effecevaluation due to the unfinished radiotherapy projec.There were no statistically significandifferencebetween the two groupin the shorterm effect(55 .81% v.52 .50% ) ,PFS(25 .51 weekv.28 .06 weeks) and OS(78 .82 weekv.83 .22 weeks) (P＞0 .05) .The main toxicity and adverse reactionwere similain the two group,each i-tem had no statistical difference between the two group(P>0 .05) .Conclusion sIMRcan obtain the curative effecand progno-sisimilato cIMRwithouincreasing the toxicity and adverse reaction,and reducethe trend developing radioactive livedam-age ,which can be used athe routine replace mode of intensity modulated radiotherapy projecof PHC.
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Objective To compare the difference of pregnancy outcomes between women who had a history of recurrent spontaneous abortion ( RSA) and women who were primigravida. Methods A case-control study was carried out. A total of 98 cases with a history of RSA and giving birth in the First Affiliated Hospital of Guangzhou University of Chinese Medicine from January of 2010 to September of 2014 served as the case group, while 98 primigravida giving birth at the same period in the same hospital were randomly selected as controls. The information collection form was designed following literature review before the research. All of the available data, including maternal demographic, reproductive information, medical history and present pregnancy outcomes, were collected from in-patient medical records. The number of valid information forms in case group was 91 and was 94 in control group after excluding the forms with incomplete data. The data was analyzed with SPSS 16.0 software. Results Univariate analysis results showed that maternal age, marital status, distribution of ABO blood groups, the history of infertility, clinical manifestation of threaten abortion, miscarriage treatment during pregnancy, medication of Zishen Yutai Pills for preventing miscarriage, time of delivery, adverse pregnancy outcome, and newborn sex were statistically significant different between the two groups ( P<0.05) . Logistic regression analysis results showed that there were significant differences in 5 factors between the two groups. Maternal age ( OR=1.466, 95%CI=1.267-1.698) , medication of Zishen Yutai Pills for preventing miscarriage ( OR=4.484, 95%CI=1.073-18.519) , and adverse pregnancy outcome ( OR=8.850, 95%CI=2.994-26.316) were the risk factors of RSA. Set blood type O as the classification reference, blood type A was a protective factor ( OR=0.259, 95%CI=0.088-0.765). And newborn sex was another protective factor of RSA ( OR=0.336, 95%CI=0.139-0.813). Conclusion Older women or women with blood type O are more likely to suffer from RSA than women with blood type A. Comparing with primigravida, women who had a history of RSA are more willing to accept medication of Zishen Yutai Pills for miscarriage, and women giving birth of a boy are more likely to have RSA and thereatened abortion, having high risk of adverse pregnancy outcomes particularly for the increase of gestational diabetes incidence.
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Objective To explore the effects of glutamine (Gln) on tumor necrosis factor-alpha (TNF-α),interleukin-6(IL-6),and interleukin-10 (IL-10) in rats with severe acute pancreatitis (SAP).Methods 54 Sprague-Dawley rats were randomly divided into 3 groups ( n =18 for each group):Gln treatment group ( Gln),SAP model group (SAP),and negative control group (NC).SAP was induced by injection of 4％ sodium taurocholate through common bile duct with a fine needle and the puncture hole in the bile duct was closed by medical sealant glue.Sham operation was performed in the rats of NC group.Rats in Gln group received Gln injection and rats in SAP group and NC group received normal saline instead of Gln.Ascites volume and blood amylase were measured at 3,6 and 12 hours after injection and plasma cytokines were detected by enzyme-linked immunosorbent assay (ELISA).Gross and histological changes of pancreas were evaluated by a scoring system.Results The ascites volume,serum amylase level,gross and histological scores,TNF-α level,and IL-6 level were significantly higher in SAP group than in NC group at each time point(P＜0.05).IL-10 level was significantly higher in SAP group than in NC group at 3 hour point(P＜0.05).The ascites volume,serum amylase level,and gross and histological scores were significantly lower in Gln group than in SAP group at the time point of 3 hour and 6 hour after injection( P ＜ 0.05 ).Level of TNF-α and IL-6 was significantly lower in Gln group than in SAP group at each time point( P ＜0.05 ).IL-10 level was lower in Gln group than in SAP group at 3 hour point( P ＜0.05 ).Conclusion Gln is effective in SAP treatment by decreasing the serum level of proinflammatory cytokine and ameliorating the pathological damage of pancreatic tissues in rats.
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Objective To improve the establishment of severe acute pancreatitis model in rat. Methods 36 Sprague-Dawley rats were randomly divided into experiment or shame operation group(n=18,each). Severe acute pancreatitis was induced by injection of 4% sodium taurocholate through puncturing common bile duct with a fine needle, puncture hole was closed by medical sealant glue. Ascites volume and blood amylase were measured at 3, 6 and 12 hours after injection. Gross and histological changes of pancreas were evaluated by a scoring system. Results Pancreatic changes in the experiment group was hemorrhagic and necrosis.The ascites volume(8.52±1.05)ml,serum amylase activity(5247.17±547.07)u/L, gross and histological scores(13.6±3.92) in experiment group was significantly higher than ascites volume(1.21±0.32)ml,serum amylase activity(1289.5±176.67)u/L, gross and histological scores((0.83±0.58) in shame operation group at every time point(P<0.05). Conclusions Combined injection through common bile duct and medical sealant glue in the experiment can minimize the trauma and simplize the procedure. This method produces a reliable model with high success rate and it is an ideal severe acute pancreatitis animal model.