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Entinostat plus exemestane in hormone receptor-positive (HR+) advanced breast cancer (ABC) previously showed encouraging outcomes. This multicenter phase 3 trial evaluated the efficacy and safety of entinostat plus exemestane in Chinese patients with HR + ABC that relapsed/progressed after ≥1 endocrine therapy. Patients were randomized (2:1) to oral exemestane 25 mg/day plus entinostat (n = 235) or placebo (n = 119) 5 mg/week in 28-day cycles. The primary endpoint was the independent radiographic committee (IRC)-assessed progression-free survival (PFS). The median age was 52 (range, 28-75) years and 222 (62.7%) patients were postmenopausal. CDK4/6 inhibitors and fulvestrant were previously used in 23 (6.5%) and 92 (26.0%) patients, respectively. The baseline characteristics were comparable between the entinostat and placebo groups. The median PFS was 6.32 (95% CI, 5.30-9.11) and 3.72 (95% CI, 1.91-5.49) months in the entinostat and placebo groups (HR, 0.76; 95% CI, 0.58-0.98; P = 0.046), respectively. Grade ≥3 adverse events (AEs) occurred in 154 (65.5%) patients in the entinostat group versus 23 (19.3%) in the placebo group, and the most common grade ≥3 treatment-related AEs were neutropenia [103 (43.8%)], thrombocytopenia [20 (8.5%)], and leucopenia [15 (6.4%)]. Entinostat plus exemestane significantly improved PFS compared with exemestane, with generally manageable toxicities in HR + ABC (ClinicalTrials.gov #NCT03538171).
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Objective@#To analyze of epidemiological and etiological characteristics of 14 norovirus clusters or outbreak in Nan an District, for comprehensive prevention and control measures for norovirus infections in the region.@*Methods@#Data were collected from the emergency public health event management information system of China Disease Prevention and Control Information System, and were analyzed by using descriptive epidemiological method.@*Results@#In 2018, 14 cases of norovirus infection clusters and outbreaks were reported in Nan an District, accounting for 63.64% of the total number of incidents in the region. A total of 268 cases were reported, with an average incidence of 2.19%; the outbreak occurred mainly in November(n=6); kindergartens reported the most outbreak(n=7), followed by primary schools(n=5); the median duration of the outbreak was 2.80 days; and 14 outbreaks were caused by the GII-type genome of norovirus, with the main transmission routes being human-to-hnuman transmission.@*Conclusion@#The prevalence of norovirus outbreaks tends to be higher in schools, it is necessary to strengthen the monitoring of vomiting and diarrhea symptoms in collective units such as schools, and efforts should be promoted for implementation of all levels of prevention and control measures in school.
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OBJECTIVE：To explore the new management model of Good Clinical Practice （GCP）trial drug dispensing . METHODS：Base on the relevant experience of Pharmacy Intravenous Admixture Services （PIVAS）in daytime chemotherapy center（“daytime PIVAS ”for short ）of our hospital ，the nodes and other matters needing attention were discussed in the workflow of confirmation and development of drug dispensing tasks for clinical trials. RESULTS ：After the successful approval of the new clinical trial ，the supervisor of the sponsor and the principal investigator should first confirm whether the drugs involved in the project needed to be centrally dispensed in the daytime PIVAS ，and then submitted the relevant data to PIVAS for filing. Daytime PIVAS pharmacists could participate in trial drug dispensing of relevant projects only after starting training and authorization. After the doctor issued the medical order for the subjects in the hospital information system ，the research nurse took the drugs out of the GCP pharmacy and handed them to the daytime PIVAS drug receiving window. After receiving the drugs ，the pharmacist would check the dispensing ，and then the preparation pharmacist trained and authorized by the project team would mix and dispense the drugs. The reviewed pharmacist would check and label the prepared infusion. In addition ，daytime PIVAS would regularly summarize the feedback information on the trial drug dispensing and fund management in all links of dispensing process ，so as to improve the standardization of the process. CONCLUSIONS ：Daytime PIVAS for clinical trial drug can arrange batches more rationally，ensure smooth and orderly infusion ，and meet different drug stability requirements ，which can improve trial drug dispensing management and further promote the development of drug clinical trial projects in China.
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Poly ADP-ribose polymerase (PARP) inhibitors can block the repair of DNA single-strand breaks, and BRCA mutation can cause the loss of repair function of DNA double-strand damage in breast cancer cells. Therefore, PARP inhibitors are used to treat BRCA-mutant breast cancer by simultaneously blocking the repair of DNA single-strand breaks and DNA double-strand damage, which leads to the failure of DNA repair, resulting in the death of cancer cells. At present, a variety of PARP inhibitors have been developed that primarily inhibit PARP1 and PARP2 subtypes with high sensitivity and specificity. This review summarizes the mechanism of PARP inhibitors in the treatment of breast cancer with BRCA mutation, and states the progress of several reported PARP inhibitors used alone or in combination with commonly used chemotherapeutic agents for the treatment of advanced breast cancer.
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<p><b>OBJECTIVE</b>To identify the properties of nerve fibers of dogs by immunohistochemical staining method.</p><p><b>METHODS</b>Intact bone blocks above the inferior alveolar nerve canal were cut from the medial of the second premolar to the distal of the third premolar of healthy adult Beagle dogs of 18 months, embedded to make hard tissue sections, stained with S100 and neurofilament protein (NFP) antibodies, and finally observed the nerve distribution under the microscope.</p><p><b>RESULTS</b>The distribution of S100 positive tissue in the periodontal ligament of dogs showed the following patterns: bundles of densely gathered rings with different diameters, filaments accompanied by lumens, free endings and deep-dyeing oval lamellasome. The location of NFP positive tissue was similar to that of S100 positive tissue, but the distribution of these NFP positive filaments with various diameters showed largely as bundles, free ending and branches scattering in periodontal membrane.</p><p><b>CONCLUSIONS</b>We may firstly distinguish the structure of the nerve fibers in periodontal ligament of nerve distribution, and then judge the categories of the nerve fibers by S100 immunohistochemistry furtherly according to comparison of the thickness of neural axon by NFP immunohistochemistry, and finally distinct the function and attribute of the nerve fibers in the periodontal ligament of dogs. .</p>
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Animals , Dogs , Bicuspid , Cytoskeleton , Immunohistochemistry , Mandibular Nerve , Nerve Fibers , Nervous System , Neurofilament Proteins , Periodontal LigamentABSTRACT
Objective To evaluate the imaging performance and characteristics of peripheral primitive neuroectodermal tumors (pPNET), in order to raise awareness of the disease and the diagnostic accuracy. Methods Thirteen patients with pPNET who confirmed by puncture or pathology were enrolled in this study. The CT and MRI features were retrospectively analyzed. Four patients received simple routine CT examination, and 9 patients had MRI examination based on X-ray, CT examination. Results The part of body involved was more widely.Two patients occurred in the sinuses, 1 patient in the chest wall, 1 patient in the lung, and 3 patients in the abdominal and pelvic(1 patient involved the pelvic floor through the pelvic wall lesions to basins), 1 patient in the spine, and 5 patients located in the extremities. The characteristics of pPNET by CT and MRI in soft tissue of 8 patients showed single large soft tissue mass, and the biggest was 11.2 cm × 10.6 cm. In bonds and joints of 5 patients, CT and MRI showed wide range of soft tissue mass, mixed internal signal/density with obviously uneven enhancement, significant bone destruction and dissolvable osseous changes, and no obvious tumor bone and calcification. Conclusions Each site has its relative imaging characteristics of pPNET. CT and MRI can show lesions involving the scope, internal structure, with or without adjacent tissue invasion and metastasis, and provide guidance for clinical treatment and selecting treatment regimen. But in the end, it depends on the diagnosis of pathological and immunohistochemical examination.
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Objective To identify the role of autophagy‐related genes in prediction of therapeutic effect of ET regimen neoadju‐vant chemotherapy in breast cancer .Methods Breast cancer tissues were retrospectively collected from 41 cases of breast cancer pa‐tients that treated by ET regimen neoadjuvant chemotherapy with different therapeutic effects .Expressions of Atg3 and Beclin1 ,and the autophagy‐related genes ,were detected by Western blot ,Real‐time PCR and immunohistochemistry in these tissues to observe their expressions before neoadjuvant chemotherapy .Statistical test was used to analyze the relationship between Atg3 ,Beclin1 ex‐pressions and therapeutic effects of ET regimen neoadjuvant chemotherapy .Results Western blot ,Real‐time PCR and immunohis‐tochemistry revealed that expressions of Atg3 and Beclin1 were up‐regulated in 24 breast cancer tissues before neoadjuvant chemo‐therapy ,including 23 cases of complete response(CR) or partial response (PR) (95 .8% ) and 1 case of progressive disease (PD) . Atg3 and Beclin1 were not expressed or lowly expressed in the other 17 cases ,including 3 cases of CR or PR (17 .6% ) and 14 cases of no change and PD .The effective rate of ET regimen neoadjuvant chemotherapy in breast cancer patients with over expression of Atg3 and Beclin1 was significantly higher than those with low expression or without expression of Atg3 and Beclin1 (P<0 .05) . Conclusion Over expression of Atg3 and Beclin1 could be new indicators for therapeutic effect of ET regimen neoadjuvant chemo‐therapy in breast cancer .
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Objective To study the optimal management of the closed-loop management in safe practice of nursing teaching in private hospitals.Method Through analyzing the causes and problems during the teaching of nursing adverse events,the closed-loop management in safe practice of nursing teaching was investigated,including the closed-loop management team,implementation cycle and range,etc.Totally 100 teachers and 220 students were chosen in 27 clinical teaching departments of our hospital during January 2013 and March 2014.The teachers were divided into experimental group (n=50) and the control group (n=50).The closed-loop management model was applied in experimental group while routing management was applied in control group.At the same time,220 students' behavior in experimental group was compared before and after the closed-loop management.Through the evaluation of nursing teaching' safe hidden trouble and questionnaire survey,the nursing teaching of both groups were safe.SAS 9.2 was applied to do statistical analysis and non-parametric Wilcoxon Fisher exact test and x2 test were used.Results The number of teachers' operating key points in experimental group was significantly higher than the control group,with statistically significant differences (46 vs.15) (P=0.000).The safety hazard times of nursing teaching were 38 and 8 respectively before and after the closed loop management,and the difference was statistically significant (P=0.000).In addition,the comparison before the students' implementing the check system,hospital safety index patients and regulation for technical operations and hospital infection was significant after the closedloop management (P＜0.01 for all).Conclusion The full implementation of the closed-loop management,effective tracking and prevention in place,can optimize the safety management of nursing teaching.
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OBJECTIVE@#To evaluate the association between CD24 polymorphism and genetic susceptibility to breast cancer in Chongqing women of Han nationality.@*METHODS@#In the case-control study, single nucleotide polymorphism of CD24 (rs3838646 and rs52812045) was genotyped by Sequenom MassArray®iPLEX GOLD System in 170 patients with breast cancer and 178 healthy controls. Data were analyzed via t test, Chi-square test, and logistic regression analysis.@*RESULTS@#The distribution of CD24 rs3838646 genotype and allelotype had no significant difference between the patients with breast cancer and healthy controls (χ2=3.54, P=0.17; χ2=2.29, P=0.13). Stratified by menstruation status, premenopausal individuals carrying CD24 rs3838646 Del allele significantly reduced the risk (OR=0.51, 95% CI 0.26-1.00, P=0.0485) of breast cancer compared with the individuals carrying CD24 CA/CA genotype. The distribution of CD24 rs52812045 genotypes and allelotypes had no significant difference between the patients with breast cancer and healthy controls (χ2=5.37, P=0.07; χ2=3.05, P=0.08). Compared with C/C homozygotes, CD24 rs52812045 T/T homozygotes had a significantly reduced risk (OR=0.47, 95% CI 0.23-0.95; P=0.04) for breast cancer.@*CONCLUSION@#CD24 polymorphism may be a marker for susceptibility to breast cancer in Han population in southwestern China. CD24 polymorphisms may be associated with a reduced risk of breast cancer in Chinese population. Further studies are needed to confirm these findings.
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Female , Humans , Asian People , Breast Neoplasms , Genetics , CD24 Antigen , Genetics , Case-Control Studies , China , Genetic Predisposition to Disease , Genotype , Polymorphism, Single NucleotideABSTRACT
Objective To provide vessel anatomical materials guidance for endovascular aortic repair,the branches artery of thoracic aortic was studied by CT angiography (CTA).Methods From January 2008 to February 2012,739 adult cases' CTA data were collected,all cases performing thoracic CTA in Wuhan General Hospital of Guangzhou Command.We measured the diameter and/or leugth of the ascending aorta,aortic arch and branches artery of aortic arch,and made an analysis.Results The aortic arch includes standard and variant types.Standard type is common,which accounted for 91.1％ of the total number,while variant type accounted for 8.9％.In the standard aortic arch of patients,the diameter of aortic arch above the opening of coronary artery (CA) was (35.7 ±4.3) mm,the diameter of ascending aortic arch at the opening of brachiocephalic trunk (BCT) was (33.6 ±4.2) mm,the diameter of aortic arch between the BCT and the left common carotid artery (LCCA) was (29.4 ± 5.7) mm,the diameter of aortic arch between the LCCA and the left subclavian artery (LSA) was (27.6 ± 4.2) mm,the diameter of descending aortic at the opening of the LSA was (25.4 ± 4.5) mm,the diameter of the head BCT from aortic arch was (12.9 ±0.9) mm,the diameter of the head LCCA from aortic arch was (8.5 ± 0.7) mm,the diameter of the head LSA from aortic arch was (10.4 ± 1.1) mm,the length of aorta between the CA and the BCT was (53.3 ±12.5) mm,the length of aortic between the BCT and the LCCA was (4.7 ± 1.5) mm,the length of aortic between the LCCA and the LSA was (7.9 ± 2.6) mm,the length between the opening of BCT and the right subclavian artery (RSA) was (41.1 ± 8.2) mm,the length between the opening of LSA and the opening of left vertebral artery was (38.5 ±5.7) mm,the angle between the horizontal of BCT and the LCCA and the sagittal plane was (71.2 ± 7.2) °,the angle between the plane of LCCA and the LSA and the plane of sagittal was (31.1 ± 2.9)°.Conclusions The CT data of the thoracic aorta can be used as reference for production of stents and guide releasing the stents in endovascular repair.
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Clopidogrel was believed to be superior to aspirin by the well-known CAPRIE trial. However, no other large clinical trials demonstrated the same results, but all focused on the combination use of clopidogrel with aspirin, and combination therapy in CREDO was called the "Emperor's New Clothes". However, no one overturned the results of these clinical trials by quantitatively analyzing them. We reviewed ten large-scale clinical trials about clopidogrel. On the basis of results of CAPRIE, CREDO and CHARISMA trials, we re-estimated their minimal sample sizes and their powers by three well-established statistical methodologies. From the results of CAPRIE, we inferred that the minimal sample size should be 85 086 or 84 968 but its power was only 30.70%. A huge gap existed. The same was also true of CREDO and CHARISMA trials. Moreover, in CAPRIE trial, 0 was included in the 95% confidence interval and 1 was included in the 95% confidence interval for the relative risk. There were some paradoxical data in CAPRIE trial. We are led to conclude that the results in CAPRIE, CREDO, and from the subgroup analysis in CHARISMA trials were questionable. These results failed to demonstrate that clopidogrel was superior to aspirin or that clopidogrel used in combination with aspirin was better than aspirin alone. The cost-effectiveness analyses by some previous studies were not reliable.
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Objective To investigate the MSCT(multi-slice computed tomography) manifestation of different kinds of malignant tumor in Renal Sinus.Methods MSCT data of 31 patients with diferent kinds of malignent tumor in Renal Sinus were analyzed retrospectively.Results In our series,15 cases were renal pelvic carcinoma,and central mass in renal sinus with light or middle ehancement were revealed in their MSCT investigation,as well as pelvic filling defect and hydronephrosis to some extent were found in secretory phase of enhanced MSCT.10 cases were renal cell carcinoma with renal sinus invasion,and their MSCT muti-planar reconstruction showed the mass mainly located in renal parenchymal,with dramatical and heterogenous CT enhancement mostly,besides local oppression & latral destruction of pelvic wall were caused by renal pelvic invasion.2 cases leiomyosaocoma in renal sinus were big and had a sharp edge,after adminisration they demonstrated dramatical and heterogenous CT enhancement.3 cases were lymphnode metastasis located in renal sinus or renal gate,appeared as nodular lesion with CT enhancement,and hydronephrosis could be exsisted if renal pelvic were obstructed.1 case were retroperitoneal lymphoma,MSCT muti-planar recon-struction revealed a large retroperitoneal mass derectly invaded into renal sinus,with light or middle homogenous ehancement.Conclusion MSCT has advantages of high speed scan,excellent discrimination,and aplenty post-process technique,and is of diagonotic value to malignant tumor in renal sinus.
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Objective To dectect the expression of CD54 in thyroid tissue of Hashimotos thyroiditis patients,and expression changes of CD54 on thyroid cells interferred by different agents.Methods The thyroid tissues from 41 cases of Hashimotos thyroiditis were collected and 26 normal thyroid tissues served as normal controls.All thyroid tissues were identified by pathological examination.The positive expression rate and area of CD54 were investigated by immunohistochemical method and quantitative analysis of image analysis system in all thyroid tissues.The expression changes of CD54 in the isolated thyroid cells interferred by 100,500,1 000 pg/ml IL-1? or 10 mg/L NaI or 1 000 pg/ml IL-1? and 10 mg/L NaI for 48 h were detected by flow cytometry.Results The positive expression rate of CD54 in Hashimotos thyroiditis tissues was much more than that of control tissues(P
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Purpose;To observe curative effect and side reaction ,histopathology change of dose - dense combinated pharmorubicin with paclitaxel in advanced breast cancer treatment. Methods ;38 patients with advanced breast cancer diagnosed by pathology, which had e-valuation index, pharmorubicin 50mg/m2 ,d1 , intravenous injection,paclitaxel 175mg/m2,d2,intravenous injection,every 2 weeks as 1 course of treatment,after accepted 2 - 4 course of treatment,all patients were evaluated. Results: All patients were followed up,clinical complete remission( CR) 10. 5% , clinical partial remission 71. 1% , total effective rate 81. 6% . effective rate in patents of initial treatment was much higher than that in patients of retreatmen; effective rate in patents of III stage also was much higher than that in patients of IV stage; low leucocyte and Neutropenia appeared III ,IV side reaction,occupying respectively 63.2% and 71. 1% ;7.9% patients febricity owing to low leucocyte were cured by G - CSF and antibiotics,all patients successfully accomplish chemotherapy. Other side reaction,for instance thrombocytopenia.anaemia,nausea and vomiting etc,mostly displayed I , II toxic reaction,but they can be tolerated. After chemotherapy,cancer cells degeneration . cellular necrosis . retrogression and interstitial fibrosis .inflammatory cell infiltration are obviously changed. Conclusion: dose -dense chemotherapy combinated pharmorubicin with paclitaxel in advanced breast cancer treatment, remission rate was much higher and remission rate can be tolerated.
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Objective To study the clinical value of CT function supplied by DSA system. Methods 278 patients were scanned by Innova CT ,which was concomitant with Innova 3100 DSA system, to check fresh blood .In the PTC operation, Innova CT was used to direct the site,degree,deepness of needle. Results Innova CT found intracranial hemorrhage in 4 cases . The fresh blood were checked by helical -CT,too. Innova CT comparing with B type ultrasonograph ,the orientation of needle were more convenient, exact, faster. Conclusion Innova CT could perform CT scan in interventional room to save time for emergence patients. It is a great improvement that gets CT images by DSA system. There is better consistency between Helix CT and Innova CT.
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To study the pharmacokinetics of 5 FU after splenic artery(IA) and auricular vein(IV) infusion, portal vein blood was collected for measurement to appraise the clinical value of treatment with this anti tumor drug via different routes on malignant hepatic neoplasms. 5 FU in portal vein blood was measured with high performance liquid chromatography. The results showed that the concentration of 5 FU in IA group was higher than that in the IV group. The peak concentration of 5 FU in the IA group was higher than that in the IV group by 64%. The area under the curve (AUC) of 5 FU in the IA group was larger than that in the IV group by 42%. It suggested that higher concentration of anti tumor drug in the portal vein could be obtained via splenic artery infusion, and it is valuable for the treatment of malignant hepatic neoplasms.
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Background and purpose:hTERT is indistinct in the effect of neo-adjuvant chemotherapy. Our aim was to detect both expression of hTERT mRNA and protein in breast cancer tissue and their changes after neoadjuvant chemotherapy. Methods:From Feb 2004 to Jun 2007, 53 cases with untreated advanced breast cancer were enrolled. All patients received CEF chemotherapy three cycles. The breast cancer tissue was collected before and after chemotherapy. hTERT mRNA and protein expression were detected by RT-PCR and immunohistochemistry techniques. Results:The positive hTERT mRNA and protein expression in breast cancer tissue before chemotherapy were 77.4% and 73.6% respectively, and after neo-adjuvant chemotherapy were 28.3%,22.6% respectively.The effective rate of the neo-adjuvant chemotherapy of the patients with positive of hTERT expression was higher than those with negative hTERT expression. Conclusion:The chemo-agents altered hTERT gene expression, improved negative rate of hTERT expression. Detecting expression of hTERT gene in breast cancer tissue would be an important index for predicting the effects of neo-adjuvant chemotherapy.
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This paper discusses the importance of the usage and maintenance of image plate(IP)for CR image quality and the life span of IP.
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Objective To observe the effect of sedative drugs applied on uncooperative children in CT examination. Methods 204 samples were divided into groups of baby, infant and preschool children. 20 minutes before CT scan, chloral hydrate and diazepam were taken by those uncooperative children seperately. Drug dosage was calculated according to body weight (kg). Results The effective rate of chloral hydrate were 96.8%(30 cases) in baby group,54.2%(13 cases) in infant group and 53.9%(21eases) in preschool children group, while that of diazepam were 100%(9 cases), 82.6%(19 cases) and 87.2%(68 cases) respectively.Conclusion When approriate sedative drugs were taken by uncooperative children, satisfactory scanning images can be obtained in CT examination