Influencing factors of self-management behavior in cancer patients based on a theoretical domain framework / 浙江大学学报·医学版

OBJECTIVES@#To explore the factors that influence self-management behavior in cancer patients based on the theoretical domain framework.@*METHODS@#Studies in Chinese and English about factors influencing self-management behavior in cancer patients were searched from Wanfang database, CNKI, VIP, SinoMed, PubMed, Embase, CINAHL, Web of Science Core Collection, Cochrane library and Medline from inception to June 2022. Two investigators independently identified, extracted data, and collected characteristics and methodology of the studies. Factors were analyzed with Nvivo12, and the theoretical domain framework was mapped to the theoretical domain. Then the secondary node was generalized by theme analysis. Finally, the specific influencing factors were summarized and analyzed.@*RESULTS@#Thirty-four studies were included for analysis. A total of 194 factors were mapped to 13 theoretical domains, and 31 secondary nodes were summarized. Theoretical domains environmental context and resources, social/professional role and identity, and beliefs about consequences were the most common factors. Knowledge, age, self-efficacy, disease stage, social support, gender, economic status and physical status were the most influential factors for self-management in cancer patients.@*CONCLUSIONS@#The influencing factors of self-management of cancer patients involve most of the theoretical domains, are intersectional, multi-source and complex.

Predictive value of multimodal magnetic resonance imaging based radiomics model for micro-satellite instability of rectal cancer / 中华消化外科杂志

Objective:To investigate the predictive value of multimodal magnetic resonance imaging (MRI) based radiomics model for microsatellite instability (MSI) of rectal cancer.Methods:The retrospective cohort study was conducted. The clinicopathological data of 117 patients with rectal cancer who were admitted to 2 medical centers, including 74 in Ningbo Urology & Nephrology Hospital and 43 in the First Affiliated Hospital of Zhejiang University School of Medicine, from January 2020 to December 2022 were collected. There were 73 males and 44 females, aged (63±5)years. Based on random number table, all 117 patients were divided into the training dataset of 70 cases and the test dataset of 47 cases with a ratio of 7:3. All patients underwent pelvic MRI exami-nation. Observation indicators: (1) construction of radiomics prediction model and analysis of charac-teristics; (2) analysis of factors influencing MSI of rectal cancer in the training dataset; (3) construc-tion and evaluation of the prediction model for MSI of rectal cancer. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M( Q1, Q3), and compari-son between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test. Univariate analysis was conducted using the one way ANOVA and multivariate analysis was conducted using the Logistic regression model with forward method. The receiver operating characteristic curve was drawn, and the area under the curve (AUC), decision curve, calibration curve and Delong test were used to evaluate the predictive ability of prediction model. Results:(1) Construction of radiomics prediction model and analysis of characteristics. Five thousand five hundred and eighty radiomics features were finally extracted from the 117 patients. Based on the feature selection using the maximum correlation minimum redundancy method, and the least absolute shrinkage and selection operator fitting algorithm, 9 radiomics features were finally selected. The radiomics prediction model was constructed based on calculation of the radiomics score. (2) Analysis of factors influencing MSI of rectal cancer in the training dataset. Results of multivariate analysis showed that platelet count was an independent influencing factor for MSI of rectal cancer [ odds ratio=1.13, 95% confidence interval ( CI) as 1.06-1.21, P<0.05]. (3) Construction and evaluation of the prediction model for MSI of rectal cancer. The clinical prediction model and clinical-radiomics combined prediction model were constructed based on the results of multivariate analysis. The AUC of clinical prediction model, radiomics prediction model, clinical-radiomics combined prediction model in the training dataset was 0.94 (95% CI as 0.86-0.98), 0.96 (95% CI as 0.88-0.99), 0.99 (95% CI as 0.93-1.00), respectively, with the sensitivity and specificity as 90.7%, 91.2%, 96.9% and 85.0%, 88.9%, 94.3%. Results of Delong test showed that there was a significant difference in the predictive performance between the clinical-radiomics combined prediction model and the clinical prediction model ( Z=2.20, P<0.05), and there was no significant difference between the radiomics prediction model and the clinical-radiomics combined prediction model or the clinical prediction model ( Z=1.94, 0.60, P>0.05). The AUC of clinical prediction model, radiomics prediction model, clinical-radiomics combined prediction model in the test dataset was 0.97 (95% CI as 0.88-1.00), 0.86 (95% CI as 0.73-0.95), 0.97(95% CI as 0.87-1.00), respectively, with the sensitivity and specificity as 99.3%, 95.8%, 99.3% and 85.7%, 73.9%, 90.5%. Results of Delong test showed that there was a significant difference in the predictive performance between the clinical-radiomics combined prediction model and the radiomics prediction model ( Z=2.21, P<0.05), and there was no significant difference between the clinical prediction model and the clinical-radiomics combined prediction model or the radiomics prediction model ( Z=0.17, 1.82, P>0.05). Results of calibration curve showed that clinical prediction model, radiomics prediction model, clinical-radiomics combined prediction model had good ability in predicting the MSI status of rectal cancer. Results of decision curve showed that compared to clinical prediction model and radiomics prediction model, clinical-radiomics combined prediction model had greatest net gain in predicting the MSI of rectal cancer. Conclusion:The prediction model based on 9 radiomics features after selecting can effectively predict the MSI status of rectal cancer, and the clinical-radiomics combined prediction model has a better prediction efficiency.

Atp6i deficient mouse model uncovers transforming growth factor-β1 /Smad2/3 as a key signaling pathway regulating odontoblast differentiation and tooth root formation / 国际口腔科学杂志·英文版

The biomolecular mechanisms that regulate tooth root development and odontoblast differentiation are poorly understood. We found that Atp6i deficient mice (Atp6i-/-) arrested tooth root formation, indicated by truncated Hertwig's epithelial root sheath (HERS) progression. Furthermore, Atp6i deficiency significantly reduced the proliferation and differentiation of radicular odontogenic cells responsible for root formation. Atp6i-/- mice had largely decreased expression of odontoblast differentiation marker gene expression profiles (Col1a1, Nfic, Dspp, and Osx) in the alveolar bone. Atp6i-/- mice sample RNA-seq analysis results showed decreased expression levels of odontoblast markers. Additionally, there was a significant reduction in Smad2/3 activation, inhibiting transforming growth factor-β (TGF-β) signaling in Atp6i-/- odontoblasts. Through treating pulp precursor cells with Atp6i-/- or wild-type OC bone resorption-conditioned medium, we found the latter medium to promote odontoblast differentiation, as shown by increased odontoblast differentiation marker genes expression (Nfic, Dspp, Osx, and Runx2). This increased expression was significantly blocked by anti-TGF-β1 antibody neutralization, whereas odontoblast differentiation and Smad2/3 activation were significantly attenuated by Atp6i-/- OC conditioned medium. Importantly, ectopic TGF-β1 partially rescued root development and root dentin deposition of Atp6i-/- mice tooth germs were transplanted under mouse kidney capsules. Collectively, our novel data shows that the prevention of TGF-β1 release from the alveolar bone matrix due to OC dysfunction may lead to osteopetrosis-associated root formation via impaired radicular odontoblast differentiation. As such, this study uncovers TGF-β1 /Smad2/3 as a key signaling pathway regulating odontoblast differentiation and tooth root formation and may contribute to future therapeutic approaches to tooth root regeneration.

Exploration and practice on interdisciplinary studies in universities: The case of Xi′an Jiaotong University / 中华医学科研管理杂志

Objective:Under the background of extensive interdisciplinary studies, this article aims to provide references for other domestic universities by analyzing the current situation and exploration of universities to promote the development of interdisciplinary studies.Methods:Taking Xi′an Jiaotong University as a typical case, it was summarized from three aspects: background, specific measures, and results.Results:Measures such as strengthening top-level design, improving organizational management systems, consolidating research platforms, establishing cross-funds, and strengthening talent training modes, were adopted by Xi′an Jiaotong University to promote the development of interdisciplinary studies from all aspects of structure, system, human resources, financial resources, and incentive mechanisms. It has promoted the depth and extension of the school's science, engineering, medicine, literature, and other disciplines, improved academic influence, and serving national and regional development.Conclusions:Interdisciplinary studies is a systematic project that requires the cooperation of the government, universities, medical institutions, industry, and academia to create a policy and institutional environment for multidisciplinary collaboration, truly allowing disciplines to move from mechanical integration to knowledge fusion. Therefore, in the process of interdisciplinary development in universities, it is necessary to straighten out the guiding concepts and basic principles of interdisciplinarity, grasp the characteristics of interdisciplines, and focus on promoting the discipline structure, supporting systems, talent training, funding, and incentive mechanisms.

Analysis of interdiscipline of medicine and engineering supported by National Natural Science Foundation in comprehensive university: Taking Xi′an Jiaotong University as an example / 中华医学科研管理杂志

Objective:Take Xi′an Jiaotong University as an example, to analyze the funding status of the National Natural Science Foundation of the Comprehensive University in the field of medicine-Engineering integration, with a view to revealing the general picture of interdiscipline of medicine and engineering research of Xi′an Jiaotong University, and gaining a glimpse of the development of the interdiscipline of medicine and engineering research in universities.Methods:Descriptive statistics were used to analyze the basic situation of the National Natural Science Foundation of China approved in the field of medicine-Engineering integration.Results:A total number of 692 projects were funded in the field of medicine-Engineering integration, with a total funding of 420 million yuan. Funding types are mainly general projects, followed by Youth Science Foundation projects. The number of key and major projects is small, but it is of great significance to the growth of the funding amount. The Department of Medical Science and the Department of Engineering Science are the departments with the largest total number of funding projects and funding amounts. In terms of funding disciplines, the core disciplines of imaging medicine and biomedical engineering, mechanical design and manufacturing, mechanics, biomaterials, imaging and tissue engineering, optics and optoelectronics, and oncology have been formed.Conclusions:The research shows that the interdiscipline of medicine and engineering research of Xi′an Jiaotong University has continued to grow, attracting scholars in science, engineering, medicine, management and other fields to participate, forming an advantageous discipline group. For the development of the integration of medicine and engineering in domestic universities, it is recommended to strengthen the top-level design, increase support for young people, and pay attention to the advanced layout of key and major projects.

The effects of deep-learning image reconstruction algorithm on image quality of lower extremity CT angiography with low kV and reverse flow direction scanning / 中华放射学杂志

Objective:To investigate impacts of a deep learning image reconstruction (DLIR) algorithm on image quality of lower extremity CTA with low kVp and reverse flow direction scanning.Methods:From January 2021 to March 2021, fifty patients with suspected lower extremities diseases and received lower extremity CTA with low kVp and reverse flow direction scanning in Union Hospital affiliated to Fujian Medical University were retrospectively collected in this study. Six groups of CT images were reconstructed at the thickness of 0.625 mm using two algorithms including ASIR-V of three blending ratios (ASIR-V 20%, ASIR-V 50% and ASIR-V 80%) and DLIR of three strengths (DLIR-H, DLIR-M and DLIR-L). Regions of interest (ROIs) were placed on proximal abdominal aorta (AA), distal AA, left and right common iliac arteries, left and right femoral arteries (upper segment), left and right superficial femoral arteries (middle segment), left and right popliteal arteries. The CT value and SD value were measured for each group; the signal-noise ratio (SNR) and contrast-noise ratio (CNR) were calculated. The lower extremity CTA was divided into four segments, and the subjective evaluation was independently performed on noise and sharpness using 4 points scales by two radiologists. One-way analysis of variance was utilized to evaluate the differences in subjective scoring and objective parameters among the six groups.Results:For all arteries segments, with the increase of blending ratios for ASIR-V and reconstruction strength of DLIR, the SD values were reduced while SNR and CNR were increased (all P<0.05). Among the six groups, DLIR-H and ASIR-V80% images had lowest SD as well as highest SNR and CNR (all P<0.05). In comparison to ASIR-V20% and ASIR-V50% images, DLIR-H images showed lower SD, higher SNR and CNR values (all P<0.05). There were no statistical differences between ASIR-V80% and DLIR-H images in SD, SNR and CNR values (all P>0.05). Subjective scoring results showed that the DLIR-H images displayed the best noise performance for the entire lower extremity arteries from AA to the foot artery, and the sharpness scores of DLIR-H images were also significantly higher than ASIR-V80% (all P<0.05). Conclusion:DLIR can significantly reduce the image noise and improve the image quality in CTA for abdominal aorta to lower extremity arteries. DLIR-H showed the greatest noise reduction ability and the best effect balancing noise and sharpness, providing highest image quality.

Health-related behaviors preventing COVID-19 and associated factors in primary school students in Wuhan / 中国学校卫生

Objective@#To understand the level of health behaviors related to prevention and control of Corona Virus Disease 2019, COVID-19 among primary school students in Wuhan during the epidemic, and to provide a basis for further targeted health education and promotion.@*Methods@#Stratified random sampling was used to select 12 primary schools in Wuhan. Relying on the "questionnaire star", the head teacher of the selected school sent the questionnaire link to students through the QQ or WeChat group, and all students participated in the survey voluntarily.@*Results@#A total of 8 569 valid questionnaires were collected. The rate of prevention and control of COVID-19 among primary school students in Wuhan was 39.3%. Among them, wearing masks, hand hygiene and other healthy behavior accounted for 53.4%, 42.0% and 75.2%, respectively. Multivariate logistic regression analysis showed that girl, grade 3-4 and 5-6, higher maternal education (>graduate degree) were more likely to have overall health behaviors in the prevention and control of COVID-19, and the OR values were 1.13(95%CI=1.04-1.24), 1.18(95%CI=1.06-1.31) 1.58(95%CI=1.41-1.75) and 1.62(95%CI=1.00-2.62)(P<0.05), respectively. Compared with fathers whose occupations were state agencies, managers of enterprises and institutions, students whose fathers’ occupations were professional technicians and ordinary employees were less likely to have level of overall health behaviors in the prevention and control of COVID-19, and the OR values were 0.78(95%CI=0.61-0.99) and 0.72(95%CI=0.58-0.90)(P<0.05), respectively.@*Conclusion@#The level of health behaviors of primary school children in Wuhan against COVID-19 was not high and targeted health education and promotion should be provided.

Efficacy and safety of domestic dasatinib as second-line treatment for chronic myeloid leukemia patients in the chronic phase / 中华血液学杂志

Objective@#To investigate the efficiency and safety of domestic tyrosine kinase inhibitor (TKI) dasatinib (Yinishu) as second-line treatment for patients with chronic myeloid leukemia in chronic phase (CML-CP).@*Methods@#A retrospective analysis of clinical data of CML-CP patients who received domestic dasatinib as second-line treatment in the CML collaborative group hospitals of Hubei province from March 2016 to July 2018 was performed. The optimal response rate, the cumulative complete cytogenetic response (CCyR), the cumulative major molecular responses (MMR), progression free survival (PFS), event free survival (EFS) and adverse effects (AEs) of the patients were assessed at 3, 6 and 12 months of treatment.@*Results@#A total of 83 CML-CP patients were enrolled in this study. The median follow-up time was 23 months. The optimal response rates at 3, 6 and 12 months in 83 CML-CP patients treated with dasatinib were 77.5% (54/71), 72.6% (61/75) and 60.7% (51/69), respectively. By the end of follow-up, the cumulative CCyR and MMR rates were 65.5% (55/80) and 57.1% (48/73), respectively. The median time to achieving CCyR and MMR was 3 months. During follow-up time, the PFS rate was 94.0% (79/83) and the EFS rate was 77.4% (65/83). The most common non-hematological AEs of dasatinib were edema (32.5%), rash itching (18.1%) and fatigue (13.3%). The common hematological AEs of dasatinib were thrombocytopenia (31.3%), leukopenia (19.3%) and anemia (6.0%).@*Conclusion@#Domestic dasatinib was effective and safe as the second-line treatment of CML-CP patients and it can be used as an option for CML-CP patients.

Overexpression of Oct4B1 induces epithelial mesenchymal transition in colorectal cancer SW480 cells / 中国免疫学杂志

Objective:To investigate whether the overexpression of Oct4B1 gene induces epithelial mesenchymal transition in human colorectal cancer SW480 cells and its possible mechanism.Methods: Experimental group(SW480-Oct4B1):Transfection of SW480 cell lines in colorectal cancer with Oct4B1 overexpression plasmid;Control group(SW480-Oct4B1):negative control plasmid with G418 resistance.Stably transfected cell lines were obtained by G418 culture medium.The two groups were compared with:①Detection of Oct4B1 gene expression in stably transfected cell lines by RT-qPCR;②Scratches and Transwell assays were used to estimate migration and invasion;③Detection of EMT related markers E-cadherin,N-cadherin and Vimentin protein expression by Western blot assay;④Detection of Twist gene and protein expression by RT-PCR and Western blot assays.Results: The transient transfection was confirmed by RT-qPCR and the stable transfected cell lines were obtained from two groups of cells transfected with G418 culture medium.Compared with the control group:①RT-qPCR revealed increased expression of Oct4B1 gene in the experimental group(P<0.01);②Cell migration and invasion were significantly increased(P<0.01);③Epithelial marker:the expression of E-cadherin protein was significantly decreased (P<0.01),interstitial marker:the expression of N-cadherin and Vimentin protein was significantly increased (P<0.01);④Twist mRNA and protein expression were significantly increased(P<0.01).Conclusion: Overexpression of Oct4B1 gene can induce epithelial mesenchymal transition in human colorectal cancer SW480 cells,its molecular mechanism may be related to the promotion of Twist expression.

Meta-analysis of extralevator abdominoperineal excision for rectal cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy of extralevator abdominoperineal excision (ELAPE) of rectal cancer.</p><p><b>METHODS</b>PubMed, Cochrane Library and Embase database were searched for clinical studies comparing the ELAPE and abdominoperineal excision (APE) for rectal cancer between 2007 and 2016. Two reviewers independently screened the articles and extracted the data. The Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of the observational studies and the score more than 5 points was the inclusion criteria. Cochrane Handbook for Systematic Reviews of Interventions v5.1.0 was used to evaluate the quality of the randomized controlled trials (RCT). Intra-operative perforation rate, circumferential resection margin (CRM) involvement, local recurrence rate, perineal wound complications were brought into meta-analysis by Review Manager 5.3 software.</p><p><b>RESULTS</b>A total of 556 articles were retrieved and 12 articles were enrolled finally, including 11 observational studies and 1 RCT study. All the 12 articles were high quality (scores of all observational studies were more than 11 points, RCT study accorded with 6 criteria of the quality evaluation). A total of 3 788 patients were enrolled, including 2 141 cases of ELAPE and 1 647 cases of APE. Meta-analysis revealed that intra-operative perforation rate of ELAPE was lower than APE (RR=0.52, 95%CI:0.34-0.79, P=0.002). There were no significant differences between two groups in CRM involvement (RR=0.72, 95%CI:0.49-1.07, P=0.10), local recurrence rate (OR=0.55, 95%CI:0.24-1.29, P=0.17) and perineal wound complications (RR=0.94, 95%CI:0.58-1.53, P=0.800).</p><p><b>CONCLUSIONS</b>Compared with APE, ELAPE reduces the intra-operative perforation rate, and does not increase the perineal wound complications, but it has no advantages in decreasing the CRM involvement and local recurrence rate.</p>

Correlation between oral chemotherapy adherence and illness perception in colorectal cancer patients:a longitudinal study / 中华护理杂志

Objective To explore the correlation of oral chemotherapy adherence and illness perception among colorectal cancer patients at different stages of chemotherapy in order to provide evidence for improving oral chemotherapy adherence among colorectal cancer patients in clinical practice.Methods A prospective longitudinal study was employed.Convenience sampling was used to recruit 132 cases of colorectal cancer patients.Data of general information,oral chemotherapy adherence and illness perception were collected by questionnaire.Results At different stages of chemotherapy,patient's score of oral chemotherapy adherence were 7.24±1.15,6.97±1.43,6.95± 1.17;patients' illness perception scores were 40.12±9.47,39.91±8.65,37.01±6.83.Oral chemotherapy adherence was negatively correlated with illness perception (r=-0.225,P＜0.05;r=-0.279,P＜0.01;r=-0.277,P＜0.01).Conclusion Higher level of patient's illness perception was related to worse oral chemotherapy adherence.Nurses should instruct patients to understand the disease and the treatment correctly,to reduce the adverse impact on patients' life and emotion,and to improve patients' compliance with oral chemotherapy.

Oral chemotherapy adherence in cancer patients / 中国实用护理杂志

Adherence refers to the extent to which a patient′s behavior coincides with medical advice without missing a dose or overdosing and taking drugs at the right time. Good adherence could assure the effect of the therapy and reduce neoplasm metastasis and recurrence as well. In this article, status of oral chemotherapy adherence in cancer patients, impact factors and measurement tools had been reviewed. Adherence of oral chemotherapy in cancer patients and measurement tools of oral chemotherapy adherence needed further study. Besides, nursing should also focus on impact factors of the adherence of cancer patients during the oral chemotherapy, and take effective interventions to improve the adherence, so as to ensure the effect of chemotherapy, and improve the survival rate of cancer patients.

Expression and significance of Oct4 B1 in colorectal cancer stem cells / 中国免疫学杂志

Objective:To investigate the expression and its possible role of Oct4B1 subtype of Embryonic stem cell transcription factor Oct4 in colorectal cancer stem cells. Methods: 3D microspheres were cultured by suspension culture to human colorectal cancer cell line SW480 cells. The 3D microspheres and SW480 cells were used as the research objects. Whether 3D microspheres were enriched cancer stem cells,we used the methods of cell differentiation experiments,soft agar cloning experiments,and the expression levels of cancer stem cells markers CD133,CD44 detected by flow cytometry. The expression levels of Oct4B1 mRNA were detected by RT-qPCR. Results:3D microspheres could differentiate into normal cancer cells. Compared with the parental SW480 cells,in vitro colony formation was significantly enhanced(P<0. 01),the percentage of positive cells of CD133 and CD44 were significantly increased ( P < 0. 01 ), the expression levels of Oct4B1 mRNA were obviously higher ( P < 0. 01 ) in 3D microspheres. Conclusion: Oct4B1 subtype of Embryonic stem cell transcription factor Oct4 in 3D microspheres enriched human colorectal cancer stem cells,which may be involved in the regulation of colorectal cancer stem cells.

Therapeutic effect of carvedilol combined valsartan on patients with chronic heart failure / 心血管康复医学杂志

Objective:To explore therapeutic effect of carvedilol combined valsartan on patients with chronic heart failure (CHF).Methods:A total of 98 CHF patients were selected from our hospital from Feb 2012 to Dec 2014. According to random number table,they were randomly and equally divided into control group (received valsartan therapy) and combined treatment group (received valsartan combined carvedilol therapy).Therapeutic effect and incidence rate of adverse reactions were compared between two groups.Results:There were no significant differ- ence in all cardiac function indexes before treatment between two groups (P>0.05 all).After treatment,compared with control group,there were significant reductions in HR [(95±14)beats/min vs.(74±16)beats/min],left ventricular end-diastolic dimension (LVEDd)[(74.9±2.9)mm vs.(50.9±1.7)mm],left ventricular end-sys- tolic dimension (LVESd)[(64.9±3.8)mm vs.(45.7±2.0)mm],left ventricular end-diastolic volume (LV- EDV)[(198.7±60.5)ml vs.(165.9±52.3)ml]and left ventricular end-systolic volume (LVESV)[(148.9± 62.7)ml vs.(111.4±51.7)ml];and significant rise in left ventricular ejection fraction (LVEF)[(34.2±6.5)%vs.(56.9±10.1)%]and stroke volume (SV)[(68.4±5.1)ml vs. (81.5±6.0)ml]in combined treatment group,P<0.05 or <0.01.Total effective rate of combined treatment group was significantly higher than that of valsartan group (91.8% vs.71.4%),P<0.01.There were all no apparent adverse reactions in both groups.Con-clusion:The therapeutic effect of valsartan combined carvedilol is significant and its safety is good in patients with chronic heart failure.

Effect of Zoledronic acid combined with chemotherapy on bone metastases of senile lung cancer / 重庆医学

Objective To investigate clinical therapeutic effect of zoledronic acid combined with chemotherapy to senile lung cancer with bone metastases.Methods Totally 80 cases of senile lung cancer patients with bone metastasis were randomly divided into control group and combined group,40 cases in each group.Limitation of activity to the situation,release of bone pain,adverse e-vents and side effects were observed.Serum Ca2+ concentration,alkaline phosphatase (AKP)levels and the levels of serum inflam-matory cytokines TNF-α,IL-1βwere detected.Results Limitation of activities and pain of patients with combined treatment was significantly ameliorated compared to control group (P <0.05).Serum Ca2+ ,AKP and TNF-α,IL-1β levels were significantly de-creased in patients with combined group in time-dependent manner,and which were significantly lower than control group.Bone ad-verse events and side effects in patients with combined treatment were significantly lower than in patients with control group.Con-clusion Zoledronic acid combined with chemotherapy can enhance the efficacy of chemotherapy,effectively relieve the limitation of activities and pain symptoms and reduce the incidence of bone adverse events and adverse reactions.The effect may be related to the decrease of serum calcium and the inflammatory cytokines.

Clinical Observation of TACE Combined with HIFU in the Treatment of Middle and Advanced Primary He-patocellular Carcinoma / 中国药房

OBJECTIVE To observe therapeutic efficacy and safety of transcatheter arterial chemoembolization (TACE) com-bined with high intensity focused ultrasound (HIFU) in the treatment of middle and advanced primary hepatocellular carcinoma (HCC). METHODS:76 patients with middle and advanced primary HCC were randomly divided into treatment group(36 cases) and control group(40 cases). Control group was given TACE alone,and treatment group was additionally given HIFU 2-3 weeks after TACE. Clinical efficacy,the content of alpha-fetoprotein(AFP)before and after operation,survival rate,survival period and ADR were compared between 2 groups. RESULTS:The efficiency rate and total effective rate of treatment group were 61.1% and 94.4%,which were significantly higher than those of control group(35.0%,77.5%),with statistical significance(P0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Com-pared with TACE alone,TACE combined with HIFU in the treatment of middle and advanced primary HCC can improve long-term survival rate and the short-term efficacy,with good safety.

Comparison of safety and long-term outcomes of laparoscopic versus open radical resection for rectal cancer / 中华消化外科杂志

Objective To compare the safety and the long-term outcomes of laparoscopic and open radical resection for rectal cancer. Methods The clinical data of 602 patients who received radical resection at the Second Affiliated Hospital of Fujian Medical University from January 2000 to December 2008 were retrospectively analyzed.All patients were divided into the laparoscope group (324 patients) and the open group (278 patients).The numbers of dissected lymph nodes,lengths of proximal and distal resection margins,local recurrence rate,distal metastasis rate,overall survival rates and disease-free survival rates of the 2 groups were compared.All data were analyzed by the independent t test,chi-square test or Fisher exact probability. The survival rates were calculated by the life table method and were analyzed by the Wilcoxon (Gehan) test.Results The number of lymph nodes dissected in the laparoscope group and the open group were 21 ± 8 and 21 ± 9,with no significant difference between the 2 groups (t =1.120,P ＞0.05).The lengths of proximal resection margin were ( 15.1 ±1.3 )cm in the laparoscope group and (15.0 ±0.8)cm in the open group,with no significant difference between the2groups (t =1.452,P ＞0.05).The lengths of distal resection margin were (4.0 ± 1.6)cm in the laparoscope group and (3.3 ± 1.4) cm in the open group,with a significant difference between the 2 groups ( t =5.587,P ＜ 0.05 ).The overall local recurrence rate was 5.6％ (34/602),and no tumor recurrence was detected in the incision and port-site.The local reccurence rates were 6.2％ (20/324) in the laparoscope group and 5.0％(14/278) in the open group,with no significant difference between the 2 groups (x2 =0.363,P ＞ 0.05 ).The overall distal metastasis rate was 11.5％ (69/602),and the distal metastasis rates were 11.1％ (36/324) in the laparoscope group and 11.9％ (33/278) in the open group,with no significant difference between the 2 groups (x2 =0.085,P ＞0.05).The 3- and 5-year survival rates were 87.8％ and 83.0％ in the laparoscope group,and 84.9％ and 79.3％ in the open group,with no significant difference between the 2 groups (P ＞0.05).The 3- and 5-year tumor-free survival rates were 79.4％ and 69.2％ in the laparoscope group,and 79.7％ and 73.1％ in the open group,with no significant difference between the 2 groups ( P ＞ 0.05 ).The follow-up rate was 81.2％ (489/602).Forty-nine patients died,including 20 patients in the laparoscope group and 29 patients in the open group.Conclusion Laparoscopic radical resection for rectal cancer is reliable in the oncological efficacy,and is possible to achieve the similar long-term outcomes as that of open surgery.

Effects of 'Living High-Training Low' on the Proliferative Capacity of Endothelial Progenitor Cells from Peripheral Blood of Rats / 中国运动医学杂志

Objective We investigated if the proliferative capacity of endothelial progenitor cells was affected by hypoxia and exercise. Methods Twenty four male Sprague-Dawley rats were randomly and averagely divided into 4 groups: (1) living at low altitude (LL), (2) living and training at low altitude (LLTL), (3) living at high altitude (LH), and (4) living at high altitude and training at low altitude (LHTL). Eight-week incremental treadmill exercise and hypoxic simulation were used to establish LHTL animal model. Mononuclear cells from peripheral blood were obtained by density gradient centrifugation 12 hours by the end of 8-week experiment. The cells were suspended in conditioned medium 199 for culturing in vitro. Their phenotypes were confirmed by uptake of acetylated LDL and binding of fluoresce in isothiocyanate (FITC)-labeled Ulex europaeus agglutinin 1 (UEA-1) lectin. Inverted microscopic observation was used to identify the morphological changes in endothelial progenitor cells and measure the cell count. Results Adherent cells and early CFUs in groups LLTL, LH and LHTL increased more obviously than in group LL(P0.05). Conclusion Proliferative capacity of endothelial progenitor cells can be promoted by both hypoxic stimulation and exercise, and the promotion is more significant if combination of hypoxia and exercise was employed simultaneously.