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Objective To evaluate the effect of MRS-assisted stereotactic radiosurgery (SRS) for small recurrent high grade glioma (HGG).Methods A total of 54 patients with recurrent HGG were selected,the tumor diameter was less than 3 cm,the patients were divided into the conventional MRI group of 26 cases,and MRI+MRS group of 28 cases.The target region of the conventional MRI group was defined as the enhanced and short T1,long T2 area;MRI+MRS group was defined as the region of Cho/NAAindex (CNI) ≥1.6 in the surrounding short T1,long T2 and enhanced area.All the patients were followed up at least 12 months,analysed their therapeutic effect.Results Compared with the conventional MRI group,MRS+MRI group margin dose increased (19.46 Gy vs.13.58 Gy),the average diameter of target were smaller (2.6 cm vs.3.0 cm),progression-free survival was longer (6.8 months vs.5.6 months),the 1-year survival rate was higher (78.6％ vs.50.0％),and the occurrence rate of brain edema was lower (5 vs.17),the difference was statistically significant (P＜0.05).Conclusion MRI+-MRS assisted SRS helps to accurately identify the scope of HGG,its short term effect was superior.
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Traditional Chinese surgical treatment "suture-dragging" therapy is based on medical thread therapy and tight seton drainage in combination of minimal invasive surgical principle. It can preserve the integrity of anal sphincter musculature involved in fistulous tract or abscess and maintain anal function. This article not only describes in detail about the operation points and mechanisms of "suture-dragging" therapy of anorectal fistula, but also reviews the application and modification of anorectal disease.
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Humans , Abscess , Drainage , Rectal Fistula , Suture Techniques , SuturesABSTRACT
Objective:As a promising strategy,tumor vaccine is at the forefront of novel approaches to tumor treatment.Since tumor antigens derived from self proteins are often less immunogenic alone,they must be administered with a potent immunostimulatory adjuvant to induce robust T-cell response.IFA was widely used and considered to be one of the most effective adjuvant available for con-sistently producing high titer antibodies to diverse antigens.However,IFA-containing tumor vaccines do not produce positive results.The reasons are unclear.Methods:BALB/c mice were s.c.injected with one single dose of IFA.At indicated days, spleen cells were collected and detected for CD11b+cells.MTT method was used to analyze the effect of CD11b+cells on T cell proliferation.ELISA method was used to determine the influence of CD11b+cell on IFN-γ-secreting ability of T cells.Results:In the spleen of mice treated with IFA,the proportion of CD11b+cell was augmented.IFA-induced CD11b+cells inhibit the proliferation and tumor antigen-induced IFN-γ-secreting ability of T cells.Conclusion:This finding may help to understand the low therapeutic efficacy of cancer vaccines recently observed in some clinical trials using Freund′s adjuvant and underscores the necessity of adjuvant selection for active immuno-therapy.
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Background: Basic principles of clinical trials of nonpharmacologic treatment are similar to those of pharmacologic treatment, but its some special characteristics should be discussed. Objective: To explore the design characteristics of clinical surgery trial through the example of tunnel thread-drawing therapy for simple anal fistula. Design, setting, participants and interventions: The clinical trial was designed as a prospective, controlled, randomized multicenter trial. The patients came from Longhua Hospital, Yueyang Hospital of Integrated Traditional Chinese and Western medicine, and Affiliated Hospital of Jianxi University of Traditional Chinese Medicine. Stratified random was performed according to the subtype of anal fistula including low and high anal fistula. Full analysis set was applied to analyze the baseline data, and per protocol set was used in efficacy and safety analysis. The intervention was tunnel thread-drawing method. Classical therapy of thread-drawing method was employed as positive control. Main outcome measures: The primary outcomes were course of recovery and cure rate. Quality of life score was used as secondary outcome and anal maximum constriction pressure was considered as safety outcome. Results: Optimal efficiency testing method was used to estimate sample size. A total of 244 subjects were recruited and 236 subjects completed the trial. There was no significant difference in the cure rate of the low and high anal fistula between the treatment group and control group. There was a significant difference in the course of recovery in the patients with low and high anal fistula between treatment group and control group (P0.05). The trial showed that the tunnel thread-drawing therapy was significantly more effective than classical method for improving the anal sphincter function and patient satisfaction with treatment in the patients with high anal fistula. However the other items of quality of life in the two groups did not show significant difference. There was no any adverse event report in each group. There was no significant difference in the anal maximum constriction pressure in the treatment group before and after the operation. Conclusion: The trial shows that the tunnel thread-drawing therapy for simple anal fistula can shorten the course of recovery and improve the patients' quality of life. The training about surgical intervention and clinical implementation program is important in clinical surgery trial. Blind is absolutely difficult to implement and placebo cannot be used in this kind of trial.
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The thread-dragging therapy, as a new external treatment of traditional Chinese medicine, could eliminate pathogenic factors and restore the vital qi by promoting qi and activating blood circulation to advance tissue repair in treating refractory sinus tracts or fistulae. This article reviewed its origin and development, and introduced its use in treating refractory sinus tracts or fistulae.
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Objective To evaluate the efficacy and adverse reactions of Navelbine(NVB)in the treatment of recurrent and metastatic breast cancer.Methods 34 patients with recurrent and metastatic breast cancer were treated with Navelbine in this clinical study,and 16 patients were treated by the NP(DDP+NVB)regimen,12 patients by the NA(ADM+NVB)regimen,6 patient by single-agent NVB.34 patients received above regimens for two cycles(3～4 week a cycle).Result The overall response rate(CR+PR)was 35.3%,clinical benefit rate(CR+PR+SD≥6 months)44.1%,disease contrrol rate(CP+PR+SD)58.8%,the median time to failure 3.4 months(range:0.7～11 months),the median time to progression(TTP)3 months(range:0.8～11 months),and the median duration of response(CP+PR)5 months(range:2～11 months).The main side effect of the therapies is bone marrow depression,and the grade Ⅲ～Ⅳ leucopenia is 35.3%.Conclusion Single Navelbine and Navelbine plus DDP(or ADM)are effective and well tolerated treatments in patients with recurrent and metastatic breast cancer.