Anatomical classification of adductor magnus perforator flap and its application in head and neck reconstruction / 中华耳鼻咽喉头颈外科杂志

Objective: To investigate the anatomical classification of adductor magnus perforator flap and its application in head and neck reconstruction. Methods: From January 2017 to January 2020, Hunan Cancer Hospital treated 27 cases of oral tumor patients (15 cases of tongue cancer, 9 cases of gingival cancer and 3 cases of buccal cancer), including 24 males and 3 females, aged 31-56 years old. The course of disease was 1-12 months. Secondary soft tissue defects with the sizes of 5.0 cm × 3.5 cm to 11.0 cm × 8.0 cm were left after radical resection of the tumors, and were repaired with free adductor magnus perforator flaps. The flaps based on the origing locations of perforator vessels were divided into three categories: ① intramuscular perforator: vessel originated between the gracilis muscle and the adductor magnus or passed through a few adductor magnus muscles; ② adductor magnus middle layer perforator: vessel run between the deep and superficial layers of adductor magnus; ③ adductor magnus deep layer perforator: vessel run between the deep layer of adductor magnus and the semimembranous muscle. Descriptive analysis was used in this research. Results: Perforator vessels of adductor magnus were found in all cases, with a total of 62 perforator branches of adductor magnus. The anatomical classification of the perforator vessels was as follows: 12 branches for class ①, 31 branches for class ② and 19 branches for class ③. The vascular pedicles of the free adductor major perforator flaps included type ① for 3 cases, type ② for 16 cases and type ③ for 8 cases. All 27 flaps survived and the donor sites were closed directly. In 18 cases, the perforator arteries and the venae comitan were respectively anastomosed with the superior thyroid arteries and veins. In 9 cases, the pedicle arteries and the venae comitan were respectively anastomosed with the facial arteries and veins. Follow up for 12-40 months showed that the appearances of the flaps and the swallowing and language functions of patients were satisfactory, apart from linear scars were left in the donor sites with no significant affect on the functions of thigh. Local recurrence occurred in 3 cases and radical surgeries were performed again followed by repairs with pedicled pectoralis major myocutaneous flaps. Cervical lymph node metastasis occurred in 2 cases and cervical lymph node dissection was performed again. Conclusions: The adductor magnus perforator flap has soft texture, constant perforator vessel anatomy, flexible donor location and harvesting forms, and less damage to the donor site. It is an ideal choice for postoperative reconstruction in head and neck tumors.

Different forms of free radial collateral artery perforator flaps for reconstruction after removal of oral tumors / 中华耳鼻咽喉头颈外科杂志

Objective: To investigate the efficacies of different forms of free radial collateral artery perforator flaps in repairing the defects after oral tumor surgeries. Methods: From May 2016 to March 2021, 28 patients (22 males, 6 females, aged 35-62 years) with oral tumors admitted by Hunan Cancer Hospital received the reconstructive surgeries with the free radial collateral artery perforator flaps after removal of oral tumors, including 24 cases of tongue cancer (11 cases of tongue marginal cancer, 9 cases of tongue belly cancer and 4 cases of tongue cancer involved in the floor of the mouth) and 4 cases of buccal and oral cancer. Four forms of radial collateral artery perforator flaps were used: single perforator flaps for 6 cases, double perforators flaps for 7 cases, flaps without perforator visualization for 10 cases and chimeric perforator myocutaneous flaps for 5 cases. The recipient vessels were the superior thyroid artery and superior thyroid vein, and if second concomitant vein available, it was anastomosed with internal jugular vein in end-to-side fashion. SPSS 20.0 statistical software was used to analyze the data. Results: The mean length of flaps was (9.7±0.4) cm, mean width (4.4±0.3) cm and mean thickness (1.1±0.4) cm. The mean length of the vascular pedicles was (7.1±0.6)cm (6.0-8.0 cm), the mean diameter of the radial accessory arteries was (1.1±0.3)mm (0.8-1.3 mm). Eleven cases(39.3%) had respectively one accompanying vein and 17 cases(60.7%) had respectively two accompanying veins, with the mean diameter of (1.1±0.3) mm (0.8-1.3 mm). All the 28 flaps survived, the donor and recipient wounds healed in one stage, the appearances of the flaps were satisfactory, only linear scars remained in the donor sites, and the upper arm functions were not significantly affected. Follow up for 12-43 months showed that the flaps were soft with partially mucosalization, the reconstructed tongue and buccal cavity were in good shape, and the swallowing and language functions were satisfactory. The swallowing and language functions were retained to the greatest extent in 3 cases with near total tongue resection, although the functions were still significantly affected. There was no local recurrence of the tumor during follow-up. One case had regional lymph node metastasis, and further lymph node dissection and comprehensive treatment were performed, with satisfactory outcomes. Conclusions: The vascular pedicle of the radial collateral artery perforator flap has a constant anatomy, which can be prepared in different forms to improve the safety of the operation and minimize the donor site damage. It is an ideal choice for the repair of small and medium-sized defects after oral tumor surgery.

Research Progress of Small Molecule Anti-angiogenic Drugs in Non-small Cell Lung Cancer / 中国肺癌杂志

Lung cancer is one of the cancers with the highest incidence in the world, and there is no standard treatment plan after second-line progression. Tumor angiogenesis has now been identified as an important therapeutic target for malignant tumors. Small molecule multi-target vascular kinase inhibitors can inhibit tumor angiogenesis by inhibiting angiogenesis-related signal pathways. At present, a lot of clinical trials of small molecule anti-angiogenic drugs for the treatment of non-small cell lung cancer (NSCLC) have been carried out, and some vascular endothelial growth factor receptor-tyrosine kinase inhibitors (VEGFR-TKIs) have been approved for the treatment of advanced NSCLC. Based on the development status of multiple small molecule anti-angiogenic drugs at home and abroad for the treatment of NSCLC, this article summarizes the efficacy and safety studies of multiple VEGFR-TKIs and fibroblast growth factor receptor (FGFR)-TKI single agents or combination treatments [including combined with chemotherapy, epidermal growth factor receptor (EGFR)-TKIs, immunotherapy, and radiotherapy, etc.] for NSCLC, and at the same time discussed the possible existence of VEGFR-TKIs drug resistance mechanisms and efficacy predictors, etc., and prospect the future development trend and potential problems of anti-vascular treatment of NSCLC, and provide new ideas for the follow-up precision and individualized treatment of lung cancer.
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Changes and clinical significance of serum ischemia-modified albumin in patients with coronary heart disease / 中国医师杂志

Objective:To observe the changes and clinical significance of serum ischemia-modified albumin (IMA) level in patients with coronary atherosclerotic heart disease (CHD).Methods:80 patients admitted in our hospital from January 2018 to January 2020 were selected as observation group, and 60 healthy controls were selected as control group. In the observation group, there were 14 patients with silent myocardial ischemia (SMI), 28 patients with angina pectoris(AP), 27 patients with myocardial infarction (AMI) and 11 patients with ischemic cardiomyopathy (ICM). According to the number of different pathological vessels in coronary angiography (CAG), the patients in the observation group were divided into single vessel group (38 cases), two vessels group (29 cases) and three vessels group (13 cases). The serum level of high-sensitivity cardiac troponin T (hs-cTnT), creatine kinase isoenzyme (CK-MB), high sensitivity C-reactive protein (hs-CRP)and IMA among groups was compared. Pearson method was used to analyze the correlation between IMA level and other indicators.Results:The levels of hs-cTnT, hs-CRP, CK-MB and IMA in the observation group were higher than those in the control group ( P<0.05). The levels of hs-cTnT, hs-CRP and IMA were significantly lower at 24 hours after treatment than those at admission; at 72 hours after treatment, the above indexes level was significantly lower ( P<0.05). The level of CK-MB increased 24 hours after treatment ( P<0.05), and decreased 72 hours after treatment ( P<0.05). The levels of hs-cTnT, hs-CRP, CK-MB and IMA in AP group, AMI group and ICM group were higher than those in SMI group ( P<0.05). The levels of CK-MB and IMA in AMI group were significantly higher than those in other groups ( P<0.05). The levels of hs-cTnT, hs-CRP, CK-MB and IMA were higher in the two vessels group and three vessels group than in the single vessel group ( P<0.05). The levels of CK-MB and IMA in the three vessels group were higher than those in the two vessels group ( P<0.05). The correlation analysis showed that serum IMA was positively correlated with hs-cTnT, hs-CRP and CK-MB ( r=0.554, 0.541, 0.521, P<0.05). Conclusions:The abnormal increase of serum IMA in CHD is closely related to myocardial cell injury and inflammatory response. The detection of serum IMA level is conducive to the early diagnosis and condition evaluation of CHD.

Advances of the Correlation between Driver Gene Status and Immunotherapy in Non-small Cell Lung Cancer / 中国肺癌杂志

In recent years, the checkpoint inhibitors targeted programmed cell death 1 (PD-1) and its ligand 1 (PD-1 ligand, PD-L1) achieved landmark significance in treating a variety of cancers including non-small cell lung cancer (NSCLC). However, current immunotherapy is not precise enough, only 15%-20% of the unselected patients can benefit from the therapy, and there is a possibility of hyperprogression (HP). Therefore, how to select the dominant population is crucial. Although many studies have emphasized the importance of PD-L1 and tumor mutation burden (TMB) and other indicators to guide immunotherapy, current PD-L1 expression level and mutation load cannot be used as a decisive and excluded predictive marker based on various obstacles. With the deepening of research, we found that there is a close relationship between lung cancer-driver gene mutation and aberrant activation of PD-1/PD-L1 signal pathways, and the correlation between gene mutation and immunotherapy efficacy has broad research value. This article will revolve around the above issues.
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Advances in the relationship between gene mutation status and cancer-associated ve-nous thrombosis / 中国肿瘤临床

Cancer-associated venous thromboembolic disease (VTE) has become the second leading cause of death among cancer pa-tients. Some scholars have proposed a variety of thrombosis risk models to screen out patients with a higher thrombosis risk and then offer them drug or physical intervention measures to reduce the incidence of cancer-associated VTE. However, with the continuous de-velopment of precision medicine, these conclusions can no longer meet the requirements of medical personnel to explore the prob-lems of cancer-associated VTE. Genetic testing has become the "baseline" test in cancer patients. Common driver genes, such as the epidermal growth factor receptor (EGFR), anaplastic lymphoma kinase (ALK), v-ros UR2 virus oncogene homolog 1 (ROS1), and kirsten ras sarcoma (KRAS), have become the normalcy and are recommended by the guidelines for clinical use. The status of gene mutations in clinical prognosis and treatment is increasingly prominent. This review discusses whether there is a correlation between cancer-as-sociated VTE and gene status and whether we can screen out cancer populations with a higher risk of thrombosis according to gene status, thus providing a theoretical basis for better implementation of prevention management strategies.

Coil selection and application during temporomandibular joint MRI imaging / 医疗卫生装备

Objective To evaluate the clinical application of 15-channel phased-array head coil and 6-channel dS Flex M surface coil in MRI imaging of temporomandibular joint.Methods Totally 50 patients were randomly equally assigned into two groups, of whom, one group used a 15-channel phase-array head coil for MRI scanning, and the other applied a 6-channel dS Flex M surface coil. The same regions of interest were set up to measure and analyze the signal to noise ratio (SNR)and contrast to noise ratio (CNR)of each region respectively.SPSS 19.0 software was used for quantitative analysis. Results The head coil had the SNR and the CNR higher than those of the surface coil.The head coil and Flex surface coil had the imaging diagnosis rates being 95.83% and 91.67% respectively,and there was no significant difference between them(P>0.05). Conclusion Both phase-array head coil and dS Flex M surface coil can be used for temporomandibular joint MRI imaging, and it's suggested that conventional imaging be executed with dS Flex M surface coil and functional imaging be implemented with head coil.

Progress in chemotherapy combined with immunotherapy for advanced non-small cell lung cancer / 中国肿瘤临床

Chemotherapy plays an important role in the treatment of advanced non-small cell lung cancer (NSCLC). However, in recent years, immune checkpoint inhibitors have also been shown to have a good effect against advanced NSCLC. Whether the combination therapy can produce better results has become the focus of attention. This review summarizes the efficacy and safety of the use of death receptor 1 (programmed death 1, PD-1/PD-L1) inhibitors or cytotoxic T lymphocyte-associated protein (cytotoxic T lymphocyte-associated protein 4, CTLA4) inhibitors combined with chemotherapy for the treatment of NSCLC. This article also expounds the mech-anisms of the combination therapy in enhancing curative effect, thereby providing insights into future treatment options for advanced non-small cell lung cancer.

A multicenter clinical study for the comparison of S-1 versus capecitabine in the treatment of advanced breast cancer / 中华肿瘤杂志

Objective@#To investigate the safety, efficacy and prognostic factors of S-1 versus capecitabine in patients with advanced breast cancer (ABC).@*Methods@#From January 1, 2012 to December 31, 2014, 154 ABC patients with pathological diagnosis were separated into two groups: S-1 with or without the 3rd generation chemotherapy drug (group S-1) and capecitabine with or without the 3rd generation chemotherapy drug (Group capecitabine). The efficacy, side effects and prognostic factors were compared between the two groups.@*Results@#There were 70 patients in group S-1 and 84 patients in group capecitabine. The objective response rates (ORR) were 31.4% (22/70) in group S-1 and 28.6% (24/84) in group capecitabine. The disease control rates (DCR) were 74.3% (52/70) and 83.3% (70/84), respectively. There were no significant differences in DCR and ORR between two groups (P>0.05). The DCR of patients treated with capecitabine monotherapy was significantly higher than that of S-1 monotherapy [94.4%(17/18) and 64.0%(16/25), P=0.028]. The median PFS was 7.5 and 8.9 months for the patients in the group S-1 and group capecitabine, with no statistically significant difference (P=0.423). The 1-year survival rates of group S-1 and group capecitabine were 81.4% and 66.7%, respectively, with no significant differences(P=0.020). Univariate analysis showed that ER and/or PR status (P=0.004), T stage (P=0.041), and molecular typing (P=0.046) were associated with PFS. Multivariate analysis showed ER and/or PR status (P=0.034) was an independent prognostic factor related with PFS. The incidence of hemoglobin reduction was 14.3% (10/70) and 36.9% (31/84) in the group S-1 and group capecitabine, and the differences were statistically significant (P=0.002). There was no significant difference in the incidence of leukopenia, neutropenia, thrombocytopenia and hand-foot syndrome between the two groups(P>0.05).@*Conclusions@#S-1 and capecitabine are both effective for advanced breast cancer. Neither ORR nor DCR were significantly different between these two groups. The incidence of gastrointestinal reactions and thrombocytopenia of S-1 was slightly lower than that of capecitabine.

Effect of regulating platelet function on systemic inflammatory response and pul-monary oxygenation function in rats during extracorporeal circulation / 中国免疫学杂志

Objective:To investigate the effect of regulating platelet function on systemic inflammatory response and pulmonary oxygenation function in rats during extracorporeal circulation(ECC).Methods:The rats participating in the ECC model were randomly divided into ECC supplemented platelet group (group MH),ECC supplemented plasma group (group MP),and continuous pump Tirofiban+ECC supplemented platelet group (group TMH),with 8 rats in each group.Rats of the three groups lasted two hours with ECC,observed for two hours after operation.Enzyme linked immunosorbent assay (ELISA) was used to detect inflammatory factors in the plasma and bronchoalveolar lavage fluid of rats in the three groups.The oxygenation index and lung tissue water content were meas-ured.The number of circulating endothelial quantity was measured by flow cytometry,and pathological changes of lung tissue in rats were observed by hematoxylin eosin staining.The effects of regulating platelet function on the levels of systemic inflammatory response, the degree of vascular endothelial damage,the edema degree of lung tissue and pulmonary oxygenation function of ECC rats were analyzed.Results:There was no significant difference in platelet count between group MH and group MP after two hours with ECC(P>0.05),the group TMH was significantly higher than that in group MH and group MP (P<0.05).After two hours with ECC,the oxygenation indexes of the three groups were lower than that at the beginning of ECC(P<0.05).There was no significant difference in lung tissue water content between the three groups(P>0.05);the level of neutrophil elastase(NE) in bronchoalveolar lavage fluid of rats in group MH was lower than that in group TMH(P<0.05),the level of NE in plasma of group TMH was lower than that in group MP (P<0.05).At the end of ECC,there were no statistically significant differences in circulating endothelial quantity of the three groups (P>0.05).Pathological examination of lung tissue showed that the lung interstitium of group MH was thinner than that of other groups,and inflammatory cell infiltration was less.Conclusion:At the early stage of ECC,supplement fresh platelets after platelet sharp decrease can significantly reduce the inflammatory response in the circulation.The protective effect may be related to platelets adhere to the endothelium associated with ECC related inflammatory reactions,and decrease the neutrophils and endothelial tissue adhesion.It is suggested that certain number of platelets with normal adhesion and aggregation function in ECC may reduce inflammatory response and lung injury after operative,and improve prognosis.

Standardized patients applied to the training on neuro-ophthalmology students / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To enhance the doctors` ability of disease diagnosis and treatment by using standardized patients in neuro-ophthalmology teaching.METHODS: Graduated students and visiting students accepting neuro-ophthalmology training courses in Department of Ophthalmology during 2014-2016 were enrolled as the research objects.Two groups were randomized allocated and 20 students each group.One group of students was applied standardized patients teaching method and the other group of students was applied traditional teaching method.A questionnaire and exam after the teaching were evaluated.The data were analyzed by SPSS 20.0.RESULTS: The data of questionnaire included content interest improving,satisfaction for teaching,the key points understanding,theory with practice effective linking,future practice instruction.Comparison questionnaire data between two groups were of statistical significance (P<0.05).The test scores of case analysis of two groups were statistically significant also(P<0.001).CONCLUSION: Standardized patients teaching method is helpful for students` training on the ability of clinical diagnosis and treatment.

Research progress on androgen receptor in triple-negative breast carcinoma / 中国癌症杂志

Triple-negative breast cancers (TNBC) comprise a heterogeneous group of tumors characterized by poor survival and lack of targeted therapeutics. In recent years, androgen receptor (AR) has been demonstrated to play an important role in the genesis and development of TNBC. There has been increased interest in the role of AR in TNBC and AR-targeting has been introduced as a novel therapeutic option for TNBC. This review offers an overview of the relationship between AR expression and TNBC, and provides insights into the novel drugs in the development for targeting this signaling pathway.

Advances in research of rh-endostatin in the treatment of cancer / 国际肿瘤学杂志

Recombinant human endostatin (Endostar) is a broad spectrum molecular targeted drug on anti-angiogenesis that the main evidence-based data is combined chemotherapy treatment of advanced non-small cell lung cancer (NSCLC).In recent years,the researches of recombinant human endostatin used in the treatment of various malignant tumors are on the increase and achieve good effect.In addition,the researches about combined treatment methods,routes of administration,methods of medication are carried out gradually,which will be conducive to the reasonable application in clinical.

Molecular mechanism of tumor associated hypercoagulability / 国际肿瘤学杂志

The process of tumorigenesis,local invasion and distant metastasis will produce a series of molecular changes,these genetic mutation or abnormal expression of molecules play a promoting role in hypercoagulation.At the same time,hypercoagulation also increases the risk of tumor progression.It is important to understand their specific processes and the molecular role,and it can provide theoretical basis for better management of patients,and has significance for developing more effective and security new anti-clotting drugs.

Percutaneous Nucleoplasty Using Coblation Technique for the Treatment of Chronic Nonspecific Low Back Pain: 5-year Follow-up Results / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>This study evaluated the efficacy of percutaneous nucleoplasty using coblation technique for the treatment of chronic nonspecific low back pain (LBP), after 5 years of follow-up.</p><p><b>METHODS</b>From September 2004 to November 2006, 172 patients underwent percutaneous nucleoplasty for chronic LBP in our department. Forty-one of these patients were followed up for a mean period of 67 months. Nucleoplasty was performed at L3/4 in 1 patient; L4/5 in 25 patients; L5/S1 in 2 patients; L3/4 and L4/5 in 2 patients; L4/5 and L5/S1 in 7 patients; and L3/4, L4/5, and L5/S1 in 4 patients. Patients were assessed preoperatively and at 1 week, 1 year, 3 years, and 5 years postoperatively. Pain was graded using a 10-cm Visual Analogue Scale (VAS) and the percentage reduction in pain score was calculated at each postoperative time point. The Oswestry Disability Index (ODI) was used to assess disability-related to lumbar spine degeneration, and patient satisfaction was assessed using the modified MacNab criteria.</p><p><b>RESULTS</b>There were significant differences among the preoperative, 1-week postoperative, and 3-year postoperative VAS and ODI scores, but not between the 3- and 5-year postoperative scores. There were no significant differences in age, sex, or preoperative symptoms between patients with effective and ineffective treatment, but there were significant differences in the number of levels treated, Pfirrmann grade of intervertebral disc degeneration, and provocative discography findings between these two groups. Excellent or good patient satisfaction was achieved in 87.9% of patients after 1 week, 72.4% after 1 year, 67.7% after 3 years, and 63.4% at the last follow-up.</p><p><b>CONCLUSIONS</b>Although previously published short- and medium-term outcomes after percutaneous nucleoplasty appeared to be satisfactory, our long-term follow-up results show a significant decline in patient satisfaction over time. Percutaneous nucleoplasty is a safe and simple technique, with therapeutic effectiveness for the treatment of chronic LBP in selected patients. The technique is minimally invasive and can be used as part of a stepwise treatment plan for chronic LBP.</p>

Comparison of Functional and Radiological Outcomes Between Two Posterior Approaches in the Treatment of Multilevel Cervical Spondylotic Myelopathy / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Posterior cervical decompression is an accepted treatment for multilevel cervical spondylotic myelopathy (CSM). Each posterior technique has its own advantages and disadvantages. In the present study, we compared the functional and radiological outcomes of expansive hemilaminectomy and laminoplasty with mini titanium plate in the treatment of multilevel CSM.</p><p><b>METHODS</b>Forty-four patients with multilevel CSM treated with posterior cervical surgery in Department of Orthopedic Surgery, Beijing Army General Hospital from March 2011 to June 2012 were enrolled in this retrospective study. Patients were divided into two groups by surgical procedure: Laminoplasty (Group L) and hemilaminectomy (Group H). Perioperative parameters including age, sex, duration of symptoms, operative duration, and intraoperative blood loss were recorded and compared. Spinal canal area, calculated using AutoCAD ® software(Autodesk Inc., San Rafael, CA, USA), and neurological improvement, evaluated with Japanese Orthopedic Association score, were also compared.</p><p><b>RESULTS</b>Neurological improvement did not differ significantly between groups. Group H had a significantly shorter operative duration and significantly less blood loss. Mean expansion ratio was significantly greater in Group L (77.83 ± 6.41%) than in Group H (62.72 ± 3.86%) (P < 0.01).</p><p><b>CONCLUSIONS</b>Both surgical approaches are safe and effective in treating multilevel CSM. Laminoplasty provides a greater degree of enlargement of the spinal canal, whereas expansive hemilaminectomy has the advantages of shorter operative duration and less intraoperative blood loss.</p>

A single nucleotide polymorphism in the Epstein-Barr virus genome is strongly associated with a high risk of nasopharyngeal carcinoma / 癌症

<p><b>BACKGROUND</b>Epstein-Barr virus (EBV) commonly infects the general population and has been associated with nasopharyngeal carcinoma (NPC), which has a high incidence in certain regions. This study aimed to address how EBV variations contribute to the risk of NPC.</p><p><b>METHODS</b>Using logistic regression analysis and based on the sequence variations at EBV-encoded RPMS1, a multi-stage association study was conducted to identify EBV variations associated with NPC risk. A protein degradation assay was performed to characterize the functional relevance of the RPMS1 variations.</p><p><b>RESULTS</b>Based on EBV-encoded RPMS1 variations, a single nucleotide polymorphism (SNP) in the EBV genome (locus 155391: G>A, named G155391A) was associated with NPC in 157 cases and 319 healthy controls from an NPC endemic region in South China [P < 0.001, odds ratio (OR) = 4.47, 95% confidence interval (CI) 2.71-7.37]. The results were further validated in three independent cohorts from the NPC endemic region (P < 0.001, OR = 5.20, 95% CI 3.18-8.50 in 168 cases vs. 241 controls, and P < 0.001, OR = 5.27, 95% CI 4.06-6.85 in 726 cases vs. 880 controls) and a non-endemic region (P < 0.001, OR = 7.52, 95% CI 3.69-15.32 in 58 cases vs. 612 controls). The combined analysis in 1109 cases and 2052 controls revealed that the SNP G155391A was strongly associated with NPC (P(combined) < 0.001, OR = 5.27, 95% CI 4.31-6.44). Moreover, the frequency of the SNP G155391A was associated with NPC incidence but was not associated with the incidences of other EBV-related malignancies. Furthermore, the protein degradation assay showed that this SNP decreased the degradation of the oncogenic RPMS1 protein.</p><p><b>CONCLUSIONS</b>Our study identified an EBV variation specifically and significantly associated with a high risk of NPC. These findings provide insights into the pathogenesis of NPC and strategies for prevention.</p>

Significance of standardized treatment for cancer pain / 中国肿瘤临床

Objective:To discuss the significance of standardized treatment for cancer pain, according to the Cancer Pain Treat-ment Specification (2011 Edition) issued by the Ministry of Health, PR China. Methods:Clinical data of 126 patients with cancer pain, who were admitted to the Department of Medical Oncology, The Fourth Hospital of Hebei Medical University, were collected to com-pare the improvement of the Numeric Rating Scale (NRS) score, number of breakthrough pain, and quality of life score after treatment. The relationships between different pain grades, disease entities, and treatment effect were analyzed. The influence factors of pain relief were also analyzed by using Logistic regression analysis. Results:1). Following standardized treatment, the improvement rate of NRS score has shown significant differences in pain grading (P=0.001) and gender (P=0.000). However, no significant differences were ob-served between different diseases (P=0.112). The improvement rate of the life quality score and the number of breakthrough pain had no significant difference after standardized treatment. 2). The grading of cancer pain and the disease entities had little effect on cancer pain relief. 3). The anti-tumor treatment and“no distant metastasis”were the independent factors that brought about the decrease in NRS and quality of life scores.“No distant metastasis”(P=0.046) was the independent factor that reduced the number of pain out-breaks. Conclusion: The standardized treatment positively affects the NRS score, number of breakthrough pain, and quality of life score. Patients who received anti-neoplastic therapy and who had no distant metastasis showed significant treatment effectiveness in pain management.

Meta analysis of brain metastases ideal treatment mode / 国际肿瘤学杂志

Objective To explore the ideal treatment mode of brain metastases by Meta-analysis.Methods Articles were searched for from the databases at home and abroad using English and Chinese keywords.Searching time limited from the databases setting up to December 30,2012.Jadad score was applied to evaluate the qualities of literatures.RevMan5.0 software was applied to perform the Meta-analysis.A totle of 25 articles including 2 750 patients were eligible for the Meta-analysis,which divided into groups with different treatment.Results Compared with monotherapy,combined therapy improved 1-year survival (OR =0.58,95％ CI:0.46 ～0.71,P ＜0.000 01).In combined therapy groups,compared with two methods,three kinds of therapies improved 1-year survival (OR =0.63,95 ％ CI:0.50 ～ 0.80,P =0.000 1).Compared with local therapy only or systemic therapy only,systemic combined local therapy improved 1-year survival (OR =0.68,95％ CI:0.53 ～ 0.86,P =0.001 ; OR =0.59,95％ CI:0.41 ～ 0.86,P =0.006).In systemic combined local therapy groups,three kinds of treatments improved 1-year survival compared with two methods (OR =0.52,95％ CI:0.35 ～ 0.78,P =0.002).Compared with non-molecular targeted therapy,molecular targeted therapy improved 1-year survival (OR =0.76,95％ CI:0.67 ～ 0.87,P ＜ 0.000 1).Conclusion The reasonable treatment for patients with brain metastases is combined treatment with operation,radiotherapy and chemotherapy.There is better curative effect added molecular targeted therapy based on original scheme,if patients have targeted therapy indications.

The expression differences and their signiifcance of the relevant receptors in breast cancer / 中国癌症杂志

ER, PR, HER-2 are signiifcant biological markers in guiding the choice of treatment and evaluating clinical prognosis. As the progression of tumor cells, the expressions of these receptors in recurrent tumors may be different from primary tumors. Nowadays clinicians have realized the necessity of receptor detection in the metastatic lesions. This article summarized the current research status on the above issues.