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OBJECTIVE To establish the ion mobility mass spectrometry method for simultaneous determination of epiberberine， berberine， coptisine， palmatine， calycosin-7-glucoside， 3，5-O-dicaffeoylquinic acid， 4，5-O-dicaffeoylquinic acid and chlorogenic acid in Jinqi jiangtang tablets. METHODS Ion mobility mass spectrometry method was used. The determination was performed on Waters ACQUITY UPLC HSS T3 （2.1 mm×50 mm， 1.8 μm） with mobile phase consisted of 0.1% formic acid solution-acetonitrile （gradient elution） at the flow rate of 0.3 mL/min. The column temperature was 40 ℃， and the injection volume was 5 μL. The contents of 8 components in Jinqi jiangtang tablets were determined by scanning detection under positive and negative ion modes with an electric spray ion source， and setting ion mobility mass parameters according to the peak response of each component. RESULTS The results showed that the linear relationship of the eight components was good within their respective ranges （r≥0.999）； RSDs of precision， repeatability and stability （24 h） tests were not more than 4.0%； average recoveries were 94.6%-101.2% ， RSDs were 2.6%-3.9% （n＝9）. The contents of the above eight components in three batches of Jinqi jiangtang tablets were 3.060-3.545， 24.50-26.74， 2.795-4.149， 1.437-2.501， 0.204-0.242， 0.950-1.281， 2.272-2.828， 7.314- 7.960 mg/g， respectively. CONCLUSIONS The established method has high sensitivity and good reproducibility， and can provide reference for the quality control of the preparation.
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Objective To investigate the clinical efficacy of aprepitant in the treatment of cisplatin based chemotherapy in-duced nausea and vomiting.Methods The tumor patients treated with cisplatin(80 mg/m2)chemotherapeutic regimen in Affiliated Shantou Hospital of Sun Yat-Sen University from December 1,2014 to December 1,2016 were selected,61 cases still had vomiting after using granisetron and dexamethasone for routinely stopping vomiting,the patients with aprepitant and dexamethasone for fur-ther stopping vomiting served as the aprepitant group,while the patients with granisetron and dexamethasone as the granisetron group.Then the complete response(CR)rates within 24,24-72,>72-144 h were observed in the two groups.Results The CR rates within 24 h in the aprepitant group and granisetron group were 66.67% and 51.61% respectively,the difference was not sta-tistically significant(P=0.232),which at 24-72 h were 80.00% and 54.84% respectively,the aprepitant group was significantly better than the granisetron group(P=0.036),which at >72-144 h were 86.67% and 64.52% respectively,the aprepitant group was better than the granisetron group(P=0.045).The comparison of adverse reactions between the two antiemetic drugs found that constipation,diarrhea,urticaria,fatigue and anxiety had no significant difference(P>0.05),the occurrence rate of total adverse reactions in the aprepitant group was 23.33%,which in the granisetron group was 25.81%,the difference between the two groups was not statistically significant(P>0.05).Conclusion Aprepitant combined with dexamethasone has better effect for treating hy-peremetic chemotherapy drug cisplatin chemotherapy caused nausea and vomiting with good tolerance.
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Objective To compare of clinical effect between radiotherapy and chemoradiotherapy and investigate the prognostic factors in elderly patients with esophageal squamous cell cancer.Methods 229 elderly patients with esophageal squamous cell cancer who received radiotherapy and chemoradiotherapy from January 2009 to December 2013 were retrospective analyzed.The Local control rate and survival rate were calculated by Kaplan-Meier method,and the short effect and long term effect between radiotherapy and chemoradiotherapy were compared.Cox regression model was used for invariant analysis and multivariate analysis.Results The follow up time was 15.3months.The short effect of radiotherapy group was not better than that of chemoradiotherapy group,with CR 35.6％ vs 45.8％,RR 61.0％ vs 53.0％,SD 2.7％ vs 0 and PD 0.7％ vs 1.2％ (P=0.211).The 1-,2-,3-year local control rates of radiotherapy group were significantly poorer than that of chemoradiotherapy group,with 82.8 ％,60.5 ％ and 52.7％ vs 89.5％,85.4％ vs 80.9％,respectively (P=0.009).However,there were no significance difference between the 1-,2-,3-year survival rates of radiotherapy group and chemoradiotherapy group,with 66.4％,29.5％,17.1％ vs.65.9％,40.3 ％,30.8 ％,respectively (P =0.071).In invariant analysis,T stage,N stage,clinical stage and radiotherapy dose (＜ 60 Gy,60 ～66 Gy,＞66 Gy) were related with the prognosis of esophageal carcinoma.The COX regression model showed that T stage,N stage and radiotherapy dose were independent prognostic factors that effected survival rate.Conclusion In elderly patients with esophageal squamous cell cancer,chemoradiotherapy can improve the local control rates,but not benefit the survival rate.T stage,N stage and radiotherapy dose were independent prognostic factors that effected survival rate,which could provided evidence for prognosis judgement and clinical practice.
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Objective To improve the non?surgical N staging system for esophageal carcinoma ( EC) . Methods A retrospective analysis was performed in 501 patients newly diagnosed with esophageal squamous cell carcinoma who received radiotherapy in our hospital from 2009 to 2013. The impacts of the supraclavicular lymph nodes and mediastinal lymph nodes on the overall survival ( OS) rate were analyzed. The original non?surgical N staging system was improved and the proposed N staging system was evaluated. The OS rates were calculated using the Kaplan?Meier method and analyzed using the log?rank test. The univariate and multivariate analyses were performed using the log?rank test and Cox regression model, respectively. Results The 3?and 5?year sample sizes were 404 and 205, respectively. In all patients, the 1?, 3?, and 5?year OS rates were 64?9%, 26?5%, and 18?3%, respectively;the 1?, 3?, and 5?year distant metastasis?free ( DMF) rates were 86?2%, 68?9%, and 67?3%, respectively;the 1?, 3?, and 5?year local control rates were 72?7%, 53?1%, and 43?6%, respectively. The univariate analysis showed that the incidence, 3?year OS rate, and 3?year DMF rate of supraclavicular lymph node metastases in patients with cervical and upper?thoracic EC were significantly higher than those in patients with middle?thoracic and lower?thoracic EC ( 25?7% vs. 14?2%, P=0?034;24?2% vs. 11?5%, P=0?016;84?8% vs. 69?2%, P=0?007) . The multivariate analysis also showed that the number of metastatic lymph nodes was an independent prognostic factor for the OS and DMF rates in patients ( P= 0?000;P= 0?007 ) . Conclusions It is reasonable to classify upper?thoracic EC with supraclavicular lymph node metastasis into stage N1 diseases. The proposed N staging system with the factor of the number of metastatic lymph nodes is more scientific and objective than the original N staging system.
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Objective To observe the clinical characteristic and prognosis of primary lung cancer patients with venous thromboembolism (VTE).Methods 589 primary lung cancer patients were selected and divided into VTE group(n =49) and non VTE group(n =540).49 cases with VTE were divided into pulmonary thromboembolism (PTE) group(n =15),including single PTE and PTE combined with deep venous thrombosis(DVT) and DVT group (n =34).Single factor and multiple logistic regression analysis were performed to determine the factors influencing primary lung cancer patients with VTE.Clinical manifestation,time of onset and prognosis of patients with VTE were analyzed.Results 49 patients with VTE included 10 patients(20.4％) with single PTE,34 patients(69.4％) with single DVT and 5 PTE patients combined with DVT(10.2％).D-dimer(OR =1.560,95％ CI =1.018 ～ 2.392,x2 =4.161,P =0.041),interleukin-1 (IL-1,OR =1.846,95％ CI =1.054-3.234,x2 =4.594,P =0.033),tumor necrosis factor (TNF OR =1.486,95％ CI =1.014-2.178,x2 =4.126,P =0.042),adenocarcinoma (OR =2.854,95％CI=1.217-6.695,x2 =5.812,P=0.016) and phase Ⅲ-Ⅳ(OR =2.198,95％CI=1.122-4.305,x2 =5.272,P =0.022) were the factors influencing primary lung cancer patients with VTE.Chest tightness,coughing,accelerated heart rate,swelling and pain in lower limb were common clinical manifestations of primary lung cancer patients with VTE.Most patients with VTE occurred within 3 months after a diagnosis of primary lung cancer.There was no significant difference in the time of onset between PTE group and DVT group(P ＞0.05).As of July 2014,31 cases (63.2％) died,12 cases (24.5 ％) survived,and 6 cases (12.2％) lost in 49 patients with VTE.The median survival time of 49 patients with VTE was 9.5 months.The median survival time of PTE group was 5.8 months,while DVT group was 15.2 months,but no significant difference between them (P ＞ 0.05).Conclusion Increased D-dimer,increased IL-1,increased TNF,adenocarcinoma and phase Ⅲ-Ⅳ could increase the risk of primary lung cancer patients with VTE.There were little typical.clinical symptoms in most patients with VTE,which occurred with in 3 months after a diagnosis of primary lung cancer.They had high mortality and needed to take early diagnosis and treatment through auxiliary examination.
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Objective To evaluate the clinical effectiveness and the major toxic effect of radiotherapy combined with docetaxol and cisplatin respectively in the treatment of locally advanced non-small cell lung cancer (NSCLC).Methods 98 patients with locally advanced NSCLC were randomly divided into two groups.All of the patients were treated with 3D-CRT.One group was treated combined with docetaxel,20mg/m2,every week,totally 6 times.The other group was treated combined with cisplatin,30mg/m2,every week,totally 6 times.The total dose was 60 ～66Gy,2Gy/F,5 times each week for 5 ～7 weeks.The clinical effect and the major toxic effect between two groups were compared.Results The median survival time in group that treated with docetaxol was 17.2 months,median progression-free survival time was 13.5 months,and the 1,2 and 3-year survival rates of the patients were 78.6％,35.7％ and 19.5％ respectively.The median survival time in group that treated with cisplatin was 16 months,median progression-free survival time was 16.5 months,and the 1,2 and 3-year survival rates of the patients were 74％,34％ and 20％ respectively.The differences between two group were not stetisticelly significant( P ＞0.05 ).However,the side effect of the stomach and intestine and late radiation complication in group treated with docetaxol were slighter than those in group treated with cisplatin.Conclusion The clinical effect of radiotherapy combined with docetaxol in the treatment of locally advanced NSCLC was equal to radiotherapy combined with cisplatin.But radiotherapy combined with docetaxol has a slighter and acceptable toxic effect,which was worth the clinical application.
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Objective To evaluate the effects and toxic side-effects of radiotherapy combined with xeloda or carboplatin respectively for locally advanced esophagus carcinoma.Methods 74 cases with locally advanced esophagus carcinoma were randomly allocated into two groups.One group received radiotherapy combined with Xeloda,500mg at a time,twice a day,taken orally from the beginning of radiotherapy till end of treatment.The second group received radiotherapy combined with Carboplatin by intravenous drip at 100mg a day,for 5 days,from the first week of radiotherapy.Results The overall response rate in the radiotherapy combined with Xeloda group was 91.4％ and 89.7％ in the radiotherapy combined with Carboplatin group.The difference between the two groups was not statistically significant(P ＞0.05 ).Kaplan-Meier survival analysis showed no statistically significant differences in survival between the two groups.The toxic side-effects of gastrointestinal tract,reaction myelosuppression and late radiation reaction were notably alleviated in the Xeloda group compared with the Carboplatin group.Conclusion Compared with Carboplatin,Xeloda combined with radiotherapy had less toxic side-effects for treatment of advanced esophagus carcinoma,with an equal local control rate,which worthy of clinical application.
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Objective To evaluate the efficacy of zoledronic acid combined with radiotherapy for bone meta-static cancer. Methods 71 cases with bone metastatic cancer were randomly divided into observation group (40 ca-ses) and control group (31 cases). The observation group was treated with zoledronic acid, 4 mg intravenously and local radiotherapy. The control group was treatd by radiotherapy alone. Results Pain relief was noted in 90% pa-tients in the observation group and 83.9% in the control group, respectively. The statistical difference was not signif-icant(P > 0.05). After the treatment had finished 3 months pain alleviation situation:Pain relief was noted in 87.5% patients in the observation group and 67.7% in the control group, respectively. The difference between the two groups was significant(χ2 =4.09, P =0.043). No serious radiotherapy and serious adverse drug reactions was found. Conclusion Zoledronic acid combined with radiotherapy was superior to radiotherapy alone for metastatic cancer bone pain relief, analgesic effect maintain a longer time.
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Objective To compare the efficacy and side effect of radiotherapy and radiotherapy combined with chemotherapy for esophageal carcinoma. Methods 90 patients with esophageal carcinoma were randomly divided into tow groups: control group 45 patients and combined therapy group 45 patients. Radiotherapy was performed on the control group, radiotherapy combined with chemotherapy which consisted of Carboplatin, 5-Fluorouracil and Hydroxycamptothecine were carried out the combined group. The two groups were under the same technical conditions and radiation dose. Three radiation fields were performed on both two groups at 200 cGy each time. The total radiation dose were 6 400 ~ 6 800 cGy. Results The local tumor control rate of combined group were higher than control group markedly. The acute gastrointestinal tract reaction and myetlosuppression were more serious than the control group. However, the late radiation reaction were not significance between the two groups. The main late reaction were radiation esophageal stricture and lung fibrosis. Conclusion Radiotherapy combined with chemotherapy is able to enhance the local control rate, 1 year and 3 years survival rate for esophageal carcinoma, but the acute side effect also increased and the late reaction were not increased.