HPLC fingerprint of Guanxin Shutong Capsule / 中草药

Objective: To establish an HPLC method for fingerprint analysis of Guanxin Shutong Capsule (GSC) for its quality control. Methods: The chromatographic behaviors were obtained by an Agilent TC-C18 column (250 mm × 4.6 mm, 5 μm) with gradient elution using 0.05% phosphoric acid and acetonitrile as the mobile phase. The column temperature was set at 30 ℃ and the flow rate was 1.0 mL/min. The detection wavelength was set at 280 nm. The common mode of HPLC fingerprint for 10 batches of GSC was established with Similarity Evaluation System for Chromatographic Fingerprint of Traditional Chinese Medicine (2009 edition) and the common peaks were identified by reference compounds. Results: Fingerprints of 10 batches of GSC were established and the similarities to the common mode were above 0.95. Totally 45 common peaks were found, and 34 belonged to herbs. Five mutual peaks were from Choerospondias axillaris, 23 mutual peaks were from Salvia miltiorrhiza, and seven mutual peaks were from Syzigium aromaticum. Based on the retention time of reference substances, 13 constituents including gallic acid (peak 1), danshensu (peak 3), protocatechuic acid (peak 5), procatechuic aldehyde (peak 6), ellagic acid (peak 10), rosmarinic acid (peak 16), salvianolic acid A (peak 19), salvianolic acid B (peak 23), eugenol (peak 24), dihydrotanshinone I (peak 30), cryptotanshinone (peak 34), tanshinone I (peak 35), and tanshinone IIA (peak 39) were identified. Conclusion: This method is specific and reliable, which will be conducive to the quality control of GSC.

Cervical disc arthroplasty with ProDisc-C artificial disc: 5-year radiographic follow-up results / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Cervical disc arthroplasty is an alternative surgery to standard cervical decompression and fusion for disc degeneration. Different types of cervical disc prosthesis are used in China. The aim of this study was to evaluate the radiographic outcomes of cervical arthroplasty using the ProDisc-C prosthesis.</p><p><b>METHODS</b>Radiographic evaluation, including static and dynamic flexion-extension lateral images, was performed at baseline and at final follow-up.</p><p><b>RESULTS</b>Twenty six patients who had single-level ProDisc-C arthroplasty were followed up for a mean period of 63 months (56-76 months). The range of motion at the operated level was 9.3°±3.7° at baseline and 7.3°±3.5° at final follow-up, with a significant difference (P < 0.05). Seventeen of 26 levels (65.4%) developed heterotopic ossification: three were classified as grade II, 13 were classified as grade III, and 1 as grade IV, according to McAfee's classification. Forty nine adjacent segments were evaluated by lateral X-ray and 18 (36.7%) segments developed adjacent segment degenerations.</p><p><b>CONCLUSIONS</b>ProDisc-C arthroplasty had acceptable radiographic results at 5-year follow-up. The range of motion was preserved. However, more than 60% of the patients developed heterotopic ossification.</p>

Comparison of adjacent segment degeneration five years after single level cervical fusion and cervical arthroplasty: a retrospective controlled study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Cervical arthroplasty is indicated to preserve cervical motion and prevent accelerated adjacent segment degeneration. Whether accelerated adjacent segment degeneration is prevented in the long term is unclear. This trial compared adjacent segment degeneration in Bryan disc arthroplasty with that in anterior cervical decompression and fusion five years after the surgery.</p><p><b>METHODS</b>We studied patients with single level degenerative cervical disc disease. The extent of adjacent segment degeneration was estimated from lateral X-rays.</p><p><b>RESULTS</b>Twenty-six patients underwent single level Bryan disc arthroplasty and twenty-four patients underwent single level anterior cervical decompression and fusion. All patients were followed up for an average of sixty months. In the Bryan arthroplasty group, nine (17.6%) segments developed adjacent segment degeneration, which was significantly lower than that (60.4%) in the anterior cervical decompression and fusion group. Eleven segments in the Bryan arthroplasty group developed heterotopic ossification according to McAfee's classification and two segments had range of motion less than 2°. In the heterotopic ossification group, four (19.5%) segments developed adjacent segment degeneration, similar to the number in the non-heterotopic ossification group (16.7%). Adjacent segment degeneration rate was 50% in grade IV group but 11.8% in grade II to III.</p><p><b>CONCLUSIONS</b>Adjacent segment degeneration was accelerated after anterior cervical decompression and fusion. However, Bryan disc arthroplasty avoided accelerated adjacent segment degeneration by preserving motion. Patients with grade IV heterotopic ossification lost motion, and the rate of adjacent segment degeneration was higher than that in patients without heterotopic ossification.</p>

Chinese female breast cancer patients show a better overall survival than their male counterparts / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>It is not clear if there is a difference in prognosis between male breast cancer (MBC) and female breast cancer (FBC) patients. The aim of this study was to compare the prognosis of MBC and FBC patients in China and the prognosis of MBC and their corresponding postmenopausal FBC patients.</p><p><b>METHODS</b>Thirty-five MBC patients who were treated at the Sun Yat-sen University Cancer Center between 1969 and 2004 were enrolled in the study. Seventy FBC patients who were matched with the MBC patients for TNM stage, year of diagnosis, and age at diagnosis were simultaneously enrolled in the study. A second group comprising 18 MBC patients and their corresponding 36 matched postmenopausal FBC patients were also enrolled. The whole group and the postmenopausal groups were compared for five- and ten-year survivals.</p><p><b>RESULTS</b>All the factors that could potentially affect prognosis were comparable among the groups except more FBC than MBC patients underwent endocrine therapy and a modified radical mastectomy. The 5- and 10-year survivals in the whole group were 81.6% and 60.3% for men and 90.7% and 73.5% for women (P = 0.02). The 5- and 10-year survival in the postmenopausal group was 82.5% and 100% for men and 66.0% and 85.9% for women (P = 0.159).</p><p><b>CONCLUSIONS</b>Chinese FBC patients had a better prognosis than Chinese MBC patients. However, MBC patients and their corresponding postmenopausal FBC patients had a similar prognosis.</p>

Short-term outcomes of 16 patients with non-small cell lung cancer receiving cetuximab combined with standard chemotherapy in the first and non-first line settings / 南方医科大学学报

<p><b>OBJECTIVE</b>To summarize our experiences with the treatment of non-small cell lung cancer (NSCLC) with cetuximab and compare the therapeutic effects of cetuximab applied in the first line and non-first line settings.</p><p><b>METHODS</b>From October 1, 2006 to December 31, 2009, 16 NSCLC patients were treated with cetuximab combined with standard chemotherapy in Sun Yat-sen University Cancer Center. The short-term efficacy of the therapeutic protocols were analyzed.</p><p><b>RESULTS</b>A total of 115 cycles of cetuximab treatment were administered in these patients with a median of 6 cycles (7.5 in the first line setting and 2 in non-first line setting). In the 10 patients with cetuximab treatment in the first line setting, the ORR was 40.0% (4/10), DCR was 80.0% (8/10), median TTP was 6.5 months (2-19), and median OS was 8.5 months (2-48); in the non-first line setting, these indices were 33.3% (2/6), 33.3% (2/6), 3.5 months (3-4) and 18 months (4-28), respectively. Both ORR and DCR were similar between the first and non-first line settings (P=0.790, P=0.062). Ten of the patients (62.5%) developed acne-like rash within 3 weeks, who had an ORR of 60% (6/10) and DCR of 90% (9/10); the ORR and DCR in patients without acne-like rash were both 10.4% (1/6), showing no significant difference in ORR (P=0.080) but a significant difference in DCR between the two groups (P=0.003). No treatment-associated death or cetuximab-associated discontinuation occurred. Altogether 11 patients (68.8%) developed acne-like rash, which occurred within 3 weeks in 10 cases. Seven patients showed side effects associated with the chemotherapy.</p><p><b>CONCLUSION</b>Cetuximab combined with standard chemotherapy is a good option for Chinese patients with NSCLC and the current data support the application of cetuximab in the first line setting.</p>

Efficacy of cetuximab combined with chemotherapy for patients with advanced colorectal cancer and unclear K-ras status / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To study the efficacy and safety of cetuximab combined with chemotherapy for patients with advanced colorectal cancer (ACRC) and unclear K-ras status.</p><p><b>METHODS</b>Clinical data of 102 ACRC patients, treated by cetuximab combined with chemotherapy in Sun Yat-sen Cancer Center from March 2005 to December 2008, were collected. The cumulative survival rate, objective response rate (ORR), disease control rate (DCR), progression free survival (PFS) of the cases were calculated. The difference in ORR, DCR, PFS and oval survival (OS) between the regimens used as first-line and non-first-line treatment, and between the regimens including oxaliplatin and irinotecan were compared.</p><p><b>RESULTS</b>The overall ORR of cetuximab plus chemotherapy was 43.1%, DCR 73.5%, median PFS 4.0 months, OS 28.5 months, and the 1-year, 3-year, and 5-year survival rate was 89.2%, 50.9% and 27.5%, respectively. The differences in ORR (50.0% vs. 40.0%, P = 0.344), DCR (78.1% vs. 72.9%, P = 0.571) and OS (51.0 months vs. 35.0 months, P = 0.396) between the regimens as first line and as non-first line treatment were not statistically significant. However, the PFS of the regimen as first-line was longer than that as non-first-line treatment (PFS 5.5 months vs. 3.0 months, P = 0.001). The differences in ORR (54.2% vs. 40.0%, P = 0.223), DCR (79.2% vs. 74.7%, P = 0.654), PFS (5.0 months vs. 3.0 months, P = 0.726) and OS (36.0 months vs. 40.0 months, P = 0.759) between cetuximab plus oxliplatin and irinotecan were not statistically significant. The most common side effects of cetuximab plus chemotherapy were acneiform eruption (80.4%, grade 3-4 in 9.8%), neutropenia (66.7%, grade 3-4 in 18.6%), and diarrhea (19.6%, grade 3-4 in 5.9%). No treatment-related death was recorded.</p><p><b>CONCLUSION</b>Patients with advanced colorectal cancer and unclear K-ras treated by cetuximab combined with chemotherapy have good ORR and OS, and the regimen is safe with less adverse events for them. There is no significant difference between the efficacies of regimens as first line and as non-first line treatment, and between cetuximab plus oxliplatin and cetuximab plus irinotecan regimens.</p>

Analysis of prognostic factors in male breast cancer: a report of 72 cases from a single institution / 癌症

<p><b>BACKGROUND AND OBJECTIVE</b>Male breast cancer (MBC) in China usually has been studied retrospectively with small sample size, and studies analyzing the prognostic factors are rare. This study was to investigate the prognostic factors of Chinese patients with MBC based on the data from a single institute with a relatively large sample.</p><p><b>METHODS</b>Clinical data of 72 patients with histopathologically confirmed MBC who received treatment at Sun Yat-sen University Cancer Center between January 1969 and March 2009, were collected. Kaplan-Meier, log-rank test and Cox regression model were used for statistical analysis.</p><p><b>RESULTS</b>The 5-year overall survival rate was 72.4%, and the survival rates for stage I, II, III, and IV were 100%, 74.2%, 57.2%, and 0%, respectively. Univariate analysis showed that the tumor size (P < 0.001), axillary lymph node status (P = 0.001), TNM stage (P = 0.001), operation model (with vs. without: P < 0.001; classic radical resection vs. modified radical resection, P = 0.336) and endocrine therapy(P = 0.02) significantly influenced the survival. Multivariate Cox regression showed that TNM stage (P = 0.035), operation model (P = 0.021) and endocrine therapy (P = 0.019) were independent prognostic factors for MBC.</p><p><b>CONCLUSIONS</b>Early diagnosis and comprehensive treatment strategy consisting of surgery and endocrine treatment is essential to improve the survival of the patients with MBC, and TNM stage, operation and endocrine treatment are the significant prognostic factors for MBC.</p>

The application of cervical spine arthroplasty with Bryan disc and mid-term clinical and radiological follow-up results / 中华外科杂志

<p><b>OBJECTIVE</b>To study the clinical and radiological outcome of Bryan cervical disc replacement and the degenerative status on adjacent segments.</p><p><b>METHODS</b>The data of 26 cases of single level disc replacement with minimal 2 years follow-up were reviewed. CLINICAL OUTCOME was assessed with the JOA 17 score scale and Odom's score. Radiological assessment including range of motion and heterotopic ossification of operated level were recorded. Adjacent level degeneration on X-ray and MRI scan at baseline and at follow-up were compared.</p><p><b>RESULTS</b>(1) CLINICAL OUTCOME: the average JOA score was 16 with 84% improvement ratio at final follow-up in 18 cases of cervical myelopathy. Eight cases of radiculopathy were fully recovered. According to the Odom's criteria 15 cases had an excellent outcome, 7 good, 4 fair, and no case of poor result. (2) On X-ray: The range of motion (ROM) at operated level was 6.9 degrees (2 degrees-12 degrees) at baseline and 7.8 degrees (1 degree-14 degrees) at final follow-up. The heterotopic ossification around the prosthesis was observed in 7 cases and only 1 case lost movement. The average ROM was 5.3 degree in other 6 cases. There was no obvious change of disc height at adjacent levels. (3) On MRI: There was no deterioration of disc degeneration at adjacent levels at final follow-up according to Pfirrmann's classification. There was no further ligamentum flavum impingement into spinal canal observed at adjacent levels but the disc movement slightly increased at both upper and lower adjacent level at final follow-up.</p><p><b>CONCLUSIONS</b>The motion at operated level is preserved after minimal 2 years Bryan disc replacement with satisfied clinical outcome. The deterioration of disc degeneration at adjacent levels may be postponed.</p>