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Colorectal cancer is one of the most common malignant tumors, and its morbidity and mortality increase year by year. In recent years, some patients with colorectal cancer have benefited from precision targeted therapies, but the overall prognosis is still unsatisfactory. Treatment of homologous recombination deficiency represented by BRCA1/2 has become a hot research direction at present. With the wide application and exact curative effect of poly (adenosine diphosphate-ribose) polymerase (PARP) inhibitors in ovarian cancer, breast cancer, pancreatic cancer and other malignant tumors, PARP inhibitors are also gradually being used in colorectal cancer. This review summarizes the current research progress of PARP inhibitors in treatment of colorectal cancer.
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Background/Aims@#We aimed to study the clinical characteristics, treatment modality, and the prognosis of synchronous multiple primary esophageal squamous cell carcinomas (SMPESCC). @*Methods@#A total of 117 SMPESCC cases were evaluated retrospectively from 2010 to 2015. @*Results@#The most common locations of SMPESCC were mid- and lower thoracic segments (n = 208, 84.9%). The 1-, 2-, and 3-year overall survival rates were 53.8%, 30.8%, and 15.4%, respectively; the median survival time (MST) was 12.5 months. With definitive radiotherapy and surgery, respectively, the MST of stage I/II patients were 34.2 and 26.7 months, of stage III patients were 8.3 and 13.2 months (p = 0.163), and of stage IV patients were and 8 and 12.6 months (p = 0.379). Clinical stage, family history of cancer, and Karnofsky performance status were independent prognostic factors for the whole cohort by Cox multivariate regression analysis (hazard ratio [HR] = 0.859, p < 0.001; HR = 0.579, p = 0.032; and HR = 0.586, p = 0.013). @*Conclusions@#Although the prognosis of SMPESCC is poor, stage I/II patients can achieve long-term survival with aggressive treatment, especially those with a Karnofsky performance score 90 or higher and who have no family history of cancer. Definitive radiotherapy could achieve a similar survival rate to definitive surgery at different clinical stages.
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Colorectal cancer is the most common gastrointestinal malignant tumor. Advances of targeted therapy and immunotherapy have significantly improved the prognosis of patients with colorectal cancer. In recent years, with the concept of precision medicine, molecular classification of colorectal cancer based on molecular pathology has been widely accepted. Patients with BRAF, HER2, MET, PIK3CA, MEK, BRAC1, BRAC2 and other rare driver gene mutations have been gradually paid attention. This article reviews the treatment advances in colorectal cancer with rare driver gene mutations.
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Multiple primary esophageal carcinoma (MPEC) is a special type of esophageal carcinoma, including multiple sites in esophagus and carcinomas in esophagus and other organs that mostly occurs in the head and neck as well as stomach.With the great advance of researches,knowledge and diagnostic technique, the diagnosis rate of MPEC has been improved.The biological behavior, clinical characteristics, and prognosis of MPEC differ from esophageal cancer alone.This paper summarizes the research progress of MPEC.
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Objective To investigate the effect of fentanyl citrate combined with psychological intervention on the treatment of elderly patients with inguinal hernia tension-free repair. Methods From May 2015 to May 2017, 110 elderly cases with inguinal hernia tension-free repair were divided into two groups, the control group and the observation group according to the different nursing intervention mode . The control group were received routine nursing intervention combined with midazolam. The observation group were given fentanyl citrate and routine nursing care combined with psychological intervention. The effect and safety in the two groups were recorded and compared. Results The curative effect in the observation group was remarkable, and the indexes during the operation were better than those in the control group. The incidence of adverse reactions was lower than that in the control group, and the nursing satisfaction was higher than that in the control group, the difference was statistically significant (P<0.05). Conclusion The effect is remarkable which Fentanyl citrate combined with routine nursing and psychological intervention were used on the treatment of elderly patients with inguinal hernia tension-free repair, the body indexes are stable, has less adverse reaction and high nursing satisfaction, is worthy of clinical application.
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Objective To investigate the Preventive effect of sodium hyaluronate gel on postoperative adhesion of hysteroscopic intrauterine adhesions. Methods 84 cases of IUA patients undergoing hysteroscopy were retrospectively selected,and divided into two groups according to the different ways of prevention and control of IUA,42 cases in each group.The control group was treated with Foley balloon catheter after operation,the study group was treated with sodium hyaluronate gel prevention on the based of control group.The clinical signs of the patients before and after treatment one,two and three months were observed,the therapeutic effects and complication were compared between two groups. Results After treatment one,two and three months,the adhesion type score and the score scale of study group, were significantly decreased,and lower than the control group,the difference was statistically significant (P<0.05).The total effective rate of the study group was 90.48%,which was significantly higher than that of the control group (83.33%),the difference was statistically significant (P<0.05).In the course of treatment,the complication rate of the two groups was 11.90% (5/42),there was no significant difference between the two groups in the incidence of complications. Conclusion Hyaluronic acid sodium gel on hysteroscopic intrauterine adhesions in patients with postoperative adhesions have a significant preventive effect,can improve the treatment efficiency and clinical signs,and with high security.
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Objective To examine the clinical characteristics,treatment,and prognosis of patients with synchronous head and neck and esophageal cancer (SHNEC).Methods The clinical data of 30 SHNEC patients treated in the Department of Radiotherapy of the First Affiliated Hospital of China Medical University from 2010 to 2014 were retrospectively reviewed.The patients were followed up and survival was calculated using the Kaplan-Meier method.Differences between survival curves were analyzed by the log-rank test,and prognostic analysis was performed using the Cox regression model.At the same and different time,the comprehensive diagnosis were 24 cases and 6 cases.21 patients were treated with radiochemotherapy, 9 patients were treated by surgery and radiotherapy±chemotherapy.Results SHNEC was frequently found in elderly men with heavy drinking and smoking habits.Hypopharyngeal cancer with middle esophageal cancer was most common among the patients;of the 30 patients,23(77%) had hypopharyngeal cancer,and 12(40%) had hypopharyngeal cancer with middle esophageal cancer.The median survival time of the patients was 20 months,and the 1-and 2-year overall survival (OS) rates were 83% and 37%,respectively.Univariate analysis showed that the stage of esophageal cancer,heavy smoking and drinking habits,and a family history of cancer were significantly associated with patient prognosis (P=0.009,0.044,0.012).In addition,the Cox analysis also demonstrated that the stage of esophageal cancer (HR=3.53,P=0.008),heavy smoking and drinking habits (HR=2.33,P=0.049),and a family history of cancer (HR=2.78,P=0.026) were independent prognostic factors.Conclusions Hypopharyngeal and middle esophageal cancer is the most common type of SHNEC,and the stage of esophageal cancer and heavy smoking and drinking habits are significantly associated with the prognosis of SHNEC patients.In addition,patients with stage Ⅰ and Ⅱ esophageal cancer can also achieve acceptable survival after receiving radiotherapy-based comprehensive treatment.
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Objective To study the effects and security of umbilical cord mesenchymal stem cells transPlantation (UC-MSCs) for Patients with refractory systemic luPus erythematosus(SLE). Methods Forty Patients with refractory SLE were divided into two grouPs at random.All of Patients were treated for glucocorticoid and CTX, then Patients of the 2 grouP were transPlanted for UC-MSCs.All of Patients were observed before and 2 weeks after treatment,1 month,2 months,3 months,6 months,9 months and 12 months of clinical manifestations and laboratory Parameters . Results 2 weeks after treatment, 60%of the 1 grouP were SLEDAI<10 scores, and the 2 grouPs were 90%. There was statistically significant difference between the two grouPs (χ2=7.619, P=0.006). 1 year after treatment, PLT,ALB and C3 of the 2 grouPs were more than the 1 grouPs(P<0.05). SLEDAI,U-Pro,ESR and Hs-CRP of the 1 grouPs were more than the 2 grouPs(P<0.05). WBC,Cr and C4 of the two grouPs had not statistically significant difference(P﹥0.05). The recurrence rate of the 1 grouPs was 45%. Of the 2 grouPs was 15%.There was statistically significant difference between the two grouPs (χ2=4.286, P=0.038). Conclusion It is effective and safe for refractory SLE to transPlant UC-MSCs after using glucocorticoid and CTX. Further observation is required to evaluate long term efficacy and adverse reaction of UC-MSCs.
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OBJECTIVE To investigate the risk factors of hospital infection among parturients to put forward prevention measures.METHODS The infection cases among parturients in our hospital 2005-2007 were analyzed by retrospective survey.RESULTS The first three infections sites were upper respiratory tract(29.79%);surgical incision(28.72%) and urinary tract(21.28%).The main factor for upper respiratory tract infetion was the traditional postnatal recovering modality.Surgical incision infections were mainly perineum ones.Catheterization after the caesarean operation led to urinary tract infection.CONCLUSIONS Postnatal recovery by scientific modality,aseptic operation and strict infection management are the keys to preventing obstetrical infections.