ABSTRACT
Objective:To study the combined use of neoadjuvant chemotherapy and immunotherapy in patients with borderline resectable pancreatic cancer.Methods:The clinical data of patients with pancreatic cancer who were planned to undergo perioperative treatment before surgical treatment at the Fifth Medical Center of PLA General Hospital from January 2019 to June 2021 were retrospectively studied. Of 22 patients with pancreatic cancer, there were 10 males and 12 females, aged (56.0±10.2) years old. Preoperative treatment with chemotherapy (nab-paclitaxel and S-1, AS) and immunotherapy regimen before surgery were given. The baseline characteristics, treatment efficacy, surgical pathology and prognosis were analyzed.Results:Of 22 patients who were treated with neoadjuvant chemotherapy combined with programmed death-1 (PD-1) monoclonal antibody, 11 patients (50%) had tumors in the head, neck and uncinated process of pancreas. On radiographic assessment, one patient achieved CR (4.5%, 1/22), 9 patients PR (40.9%, 9/22), and 11 patients SD (50.0%, 11/22). All patients subsequently underwent R 0 resection. The postoperative pTNM staging showed 91% (20/22) of patients were in stage IA-IIB, 31.8% (7/22) of patients had pT2, 63.6% (14/22) had N0, and 1 patient had pCR. Thirteen patients (54.2%, 13/22) received postoperative adjuvant therapy. The median recurrence-free survival (RFS) was 6.4 months and the median time to progression (TTP) was 12.8 months. The median overall survival of patients was not reached. Postoperative pathology TNM staging IIA to III ( HR=3.63, 95% CI: 1.18-11.20, P=0.025) and postoperative pathology T2-3 stage ( HR=2.02, 95% CI: 1.01-5.05, P=0.049) were significantly associated with RFS. Postoperative pathology TNM stages IIA to III ( HR=2.39, 95% CI: 1.04-5.50, P=0.041) and postoperative pathology T2-3 stage ( HR=2.53, 95% CI: 1.26-5.09, P=0.009) were significantly associated with TTP. Conclusion:AS combined with PD-1 monoclonal antibody showed good efficacy as a neoadjuvant therapy for patients with borderline-resectable pancreatic cancer.
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Objective: In order to have more direction to treat senile diseases,the feature of diseases and the principle of medication are investigated.Methods: Through combining the experiences of prevention and cure of senile diseases,we can conclude and analyze from its characteristics of imbalance of YIN and YANG,clumsy of reaction,deterioration of entrails,inclusion of excess and deficiency et al.Results: Aiming its physiological and pathological feature,we propose the standpoint that we should limit reinforcing and reducing,protect gastric-qi and prescribe containing minerals.Conclusion: It has evident specificity when we diagnose and prescribe for the aged,and can not equate that to the young.
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BACKGROUND: Dyslipidemia is the important risk of cardiac cerebral vascular diseases, such as arthrosclerosis and coronary heart disease, etc.OBJECTIVE: To observe the clinical therapeutic effects of tiaozhi zengshou tang (herbal decoction) on intervention of dyslipidemia.DESIGN: Randomized, group controlled observation.SETTING: Department of Oncology, Department of Chinese Medicine and Department of Cardiology of General Hospital of Chinese PLA.PARTICIPANTS: Totally 120 cases from inpatients with dyslipidemia in Department of Chinese Medicine and Department of Cardiology of General Hospital of Chinese PLA and outpatients in Clinic of Blood lipid from February 2002 to January 2004.METHODS: Totally 120 cases of dyslipidemia were randomized into 3 groups. In Chinese herb group (43 cases), tiaozhi zengshou tang (herbal decoction) was prescribed, one dose/d, taking separately before breakfast and dinner. In western drug group (40 cases), pravastatin sodium was prescribed, 10 mg/tablet, 1 tablet/d, taking orally before sleep at night. Integrative group (37 cases) both pravastatin sodium and herbal decoction were prescribed, the dosage, composition and administration were same as previous. The treatment lasted 8 weeks, and then, the therapeutic effects on changes of blood lipid and harmful effects were observed.MAIN OUTCOME MEASURES: Comparisons of therapeutic effects and harmful effects among groups.RESULTS: 120 cases were employed in the experiment, but 27 of those were dropped out due to loss of contact and absent re-visiting in time. Total parison of therapeutic effects among groups: The effective rates in Chinese herb group and western drug group were similar (81%, 80%, P ＞ 0.05),changes of blood lipid series before and after treatment in each group: In Chinese herb group, triglyceride (TG) (2.59t1.64) mmol/L was reduced to (1.56±0.72) mmol/L, serum total cholesterol (TC) (5.30±1.71) mmol/L was reduced to (4.35±0.85) mmol/L (P ＜ 0.01) and HDL-Cholesterol (HDL-Ch)(1.32±0.37) mmol/L was increased to (1.50±0.22) mmol/L (P ＜ 0.05). In western drug group, TG (2.84±1.50) mmol/L was reduced to (2.04±0.98) mmol/L,serum TC (5.50±1.22) mmol/L was reduced to (4.71±0.89) mmol/L (P ＜ 0.05,P ＜ 0.01) and APoA1 (1.24±0.21) g/L was increased to (1.49±0.15) g/L (P ＜ 0.01). In integrative group, the therapeutic effects were significant in re ducing TG, TC, LDL-Ch and APoB and increasing APoA1 and HDL-Ch harmful effects in Chinese herb group were less than western drug group (1 case, 7 cases).CONCLUSION: Tiaozhi zengshou tang provides definitely clinical therapeutic effects in dyslipidemia and presents low incident of harmful effects.