ABSTRACT
<p><b>OBJECTIVE</b>To compare the effects of neoadjuvant chemotherapy and adjuvant chemotherapy on the prognosis of patients with locally advanced gastric cancer using propensity score matching method.</p><p><b>METHODS</b>Clinical data of patients with locally advanced gastric cancer undergoing open D2 radical gastrectomy between January 2012 and December 2014 at the Affiliated Tumor Hospital of Zhengzhou University were analyzed retrospectively. Sixty-five patients receiving neoadjuvant chemotherapy (NAC) were allocated into the NAC group and 1243 patients receiving postoperative adjuvant chemotherapy (AC) were allocated into the AC group.</p><p><b>INCLUSION CRITERIA</b>(1) age ranged from 18 to 75 years old, and biopsy specimen was confirmed as adenocarcinoma; (2) all the operative procedures were open D2 radical gastrectomy;(3)image examinations showed no distant metastasis or other unresectable factors.</p><p><b>EXCLUSION CRITERIA</b>no open D2 radical gastrectomy, undergoing laparoscopic surgery, neoadjuvant chemotherapy course <2 cycles, without adjuvant chemotherapy, history of other malignancies, severe complications, incomplete data. SOX (tegafur-gimeracil-oteracil plus oxaliplatin) or XELOX (capecitabine plus oxaliplatin) was used as neoadjuvant and postoperative adjuvant chemotherapy regimen. One-to-two propensity score matching was performed to balance the covariance between two groups. Survival was analyzed using the Kaplan-Meier method. Differences between the curves were tested using log-rank test.</p><p><b>RESULTS</b>After balancing the covariates including gender, age, tumor location, degree of differentiation, clinical stage, chemotherapy regimen, chemotherapy course and surgical approach, 195 patients were enrolled, including 65 patients of the NAC group and 130 patients of the AC group. The number of harvested lymph nodes in NAC and AC group was 22.3±4.6 and 22.6±5.1 respectively, without statistically significant difference(t=1.125, P=0.263). Pathological response assessment for NAC group showed TRG0 in 6 cases, TRG1 in 8 cases, TRG2 in 17 cases, TRG3 in 34 cases; sensitive (TRG 0 to 2) in 31 cases (47.7%), non-sensitive in 34 cases (52.3%). The 3-year progression-free survival rate of NAC and AC group was 73.6%(95%CI: 62.8-84.3) and 69.9%(95%CI:62.1-77.7) respectively, which was not significantly different(P=0.361). The 3-year overall survival rate of NAC and AC group was 80.0%(95%CI:70.2-89.8) and 74.6%(95%CI:67.2-82.0) respectively, which was not significantly different as well(P=0.387). Subgroup analysis revealed that the 3-year progression-free survival rate and 3-year overall survival rate of sensitive patients in NAC group were 83.3%(95%CI:70.0-96.6) and 87.1%(95%CI:75.3-98.9) respectively, which were significantly higher than 62.4%(95%CI:46.1-78.7, P=0.037) and 70.2%(95%CI:54.7-85.7, P=0.033) of non-sensitive patients in NAC group, and those in AC group(P=0.044 and P=0.040).</p><p><b>CONCLUSIONS</b>Effects of neoadjuvant chemotherapy and postoperative adjuvant chemotherapy on the prognosis of patients with locally advanced gastric cancer are similar. Patients who are sensitive to neoadjuvant chemotherapy have better prognosis. It may be beneficial to improve prognosis that some appropriate patients with locally advanced gastric cancer are screened for neoadjuvant chemotherapy.</p>
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Objective To evaluate the efficacy of embryo thymus transplantation in the treatment of lupus-like BXSB mice,study the pathogenesis of SLE in BXSB mice and the therapeutic effect of embryo thymus transplantation.Methods The embryonic thymus of CB57L mice was transplanted to50day-old male BXSB mice.Levels of proteinuria,ANA,blood urea nitrogen(BUN),blood creatinine and the deposits of immunoglobulin(Ig)in the glomerulus were detected regularly for5months,and the number of mice died of SLE was observed.Results The levels of proteinuria,ANA,BUN,blood creatinine of the5,6,7month old mice in embryo thymus transplantation group were lower than that of5month old mice in control group.The efficacy of treatment in embryo thymus transplantation group were similar to that of dexamethasone treatment group,and the SLE-caused death was reduced in these two groups.However,the embryo thymus transplantation seemed not to reduce the deposits of lg in glomerulus significantly,the deposits of lg in the glomerulus were similar in all three groups.Conclusions Embryo thymus transplantation could improve renal functions and reduce the titer of ANA.Its efficacy is similar to that of dexamethasone.Embryo thymus transplantation has a short term therapeutic effect in the treatment of lupus-like BXSB mice.The deficiency of thymus in the BXSB mice may play an important role in the pathogenesis of lupus-like mice.Embryo thymus transplantation may be a valuable approach to treat SLE.
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Objective To investigate the clinical significance of human telomerase RNA component (hTR) and human telomerase reverse transcriptase(hTERT) mRNA expression in cutaneous squamous cell carcinoma(SCC) and Bowen′s disease(BD). Methods Expressions of hTR and hTERT mRNA were detected by in situ hybridization technique in 30 cases of cutaneous SCC and 30 cases of BD. Results Weak expressions of hTR and hTERT mRNA were observed in BD, with positivity rates of 23.33% and 16.67%, respectively. Expressions of hTR and hTERT mRNA were found in 86.67% and 93.33%, respectively, in cutaneous SCC. hTR and hTERT mRNA were positive in 82.35% and 88.24%, respectively, of stage I and II of cutaneous SCC, without strong positive signals in those patients. hTR and hTERT mRNA were positive in 92.31% and 100%, respectively, of stage III and IV of cutaneous SCC, with strong positivity rates of 69.23% and 76.92% in those patients. Expressions of hTR and hTERT mRNA in skin tumors were gradually increased which positively linked with phenotypic progression and degree of dysplasia. Conclusion The strong expression of hTR and hTERT mRNA in the skin tumor suggest the presence of cutaneous squamous cell carcinoma.