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Lung cancer is the most common malignant tumor. As the first-generation oral small-molecule tyrosine kinase inhibitor independently developed in China, apatinib can block many kinds of signaling pathways with high selectivity, and play an anti-tumor effect by inhibiting tumor angiogenesis, and the adverse reactions are controllable. More and more studies have shown that apatinib can be used for the second-line and beyond treatment of patients with advanced non-small cell lung cancer. This article reviews the mechanisms and clinical studies of apatinib in treatment of lung cancer.
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Objective To explore the optimum sentinel lymph node (SLN) mapping method in gastric cancer. Methods The clinical data of 59 patients who were confirmed with gastric cancer at Guangzhou General Hospital of Guangzhou Military Command from January 2004 to August 2008 were retrospectively analysed. Patent blue V dye was used in 20 patients (group A), technetium-99m sulfur colloid was used in 20 patients (group B),and a combination of patent blue V dye and technetium-99m sulfur colloid were used in 19 patients (group C).The number of SLNs detected, and accuracy and false-negative rate of SLNs in diagnosing regional lymph node metastasis were analysed by t test and chi-square test. Results The numbers of SLNs detected in groups A, B and C were 38 (1.9 per case), 31 (1.6 per case) and 56 (2.9 per case), respectively. In group C, 46 SLNs were screened out by patent blue V dye and technetium-99m sulfur colloid simultaneously, six SLNs were only detected by patent blue V dye and four only by technetium-99m sulfur colloid. There was a significant difference in the number of SLNs detected among the three groups (t = 4.35, P ＜ 0. 05 ). The number of SLNs detected in group C was significantly greater than that in groups A and B (t = 4. 21, 3. 54, P ＜ 0.05 ). The accuracy and false-negative rate of SLNs in diagnosing regional lymph node metastasis were 95% (19/20) and 5% (1/20) in group A, 90% (18/20) and 10% (2/20) in group B, and 100% (19/19) and 0 in group C. The accuracy was significantly higher (x2 = 163.01, P ＜ 0.05) and the false-negative rate was significantly lower in group C compared with those in groups A and B (x2 = 170. 14, P ＜ 0. 05). Conclusion A combination of dye and radioactive tracer is a favorable method for detecting SLNs in gastric cancer.
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Objective To assess the analgesic effect of continuous infusion of 0.2% ropivacaine with epidural catheter placed at T11-12 or L2-3 after abdominal hysterectomy. Methods Eighty ASA Ⅰ -Ⅱ patients undergoing elective abdominal hysterectomy were randomly divided into 4 groups with 20 patients in each group : in group Al and A2 the epidural catheter was placed at T11-12 and in group Bl and B2 at L2-3 . After surgery two infusion pumps were used. The first pump was used for continuous epidural infusion of 0.2% ropivacaine in the 4 groups. The second pump was used for patient controlled intravenous analgesia (PCIA) with 0.08% lornoxicam in group Al and Bl or with 0.1% morphine in group A2 and B2. The PCIA bolus dose was 1 ml with a lockout time of 5 min. The analgesic effect (assessed using VAS) and the consumption of lomoxicam / morphine were compared among the four groups. Results The ropivacaine consumption was 192 mg during the 24 h after operation in the 4 groups. The lornoxicam and morphine consumption were (3.9?2.8) mg and (4.6?3.5) mg in group Al and A2 with the epidural catheter placed at T11-12 and (7.7?2.5) mg and (7.8?2.4) mg in group B2 and B2 with catheter placed at L2-3.The consumption of lomoxicam or morphine was significantly less with epidural catheter placed at T11-12 than that with epidural catheter at L2-3 (P
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Objective To compare the analgesic and side effects of patient-controlled intravenous analgesia(PCIA) with lornoxicam and morphine supplemented by continuous epidural infusion of 0.2% ropivacaine. Methods Sixty ASA I - II patients undergoing elective hysterectomy under epidural anesthesia were randomly divided into two groups: lornoxicam group (L, n = 30) and morphine group (M, n=30). For postoperative analgesia both groups received continuous epidural infusion of 0.2% ropivacaine 4 ml'h . In group L the patients received PICA with 0.008% lornoxicam and in group M 0.001% morphine. The bolus dose was 1 ml, lock-out interval 5 min and maximal amount within 1 h was 12 ml in both groups. If the patient still felt pain after pressing PCA pump 12 times, an additional epidural bolus of 0.2% ropivacaine 5 ml and morphine 0. 5mg was given. The clinical effects were assessed by (1) VAS score of pain( 0 = no pain, 10 = severe pain), (2) Bruggrmann comfort score (0 = persistent pain, 4 = no pain at coughing), (3) modified Bromage score, (4)patients satisfaction, (5) the number of pressing of PCIA pump by the patient (D1 ) at 30 min, 1,4,8,12,16,20,24h and the number of bolus dose delivered (D2), (5) the time when the patient passed gas and (7) complications such as nausea and vomiting and respiratory depression.Results The demographic data were comparable between the two groups. The amount of ropivacaine consumed was 192 mg in both groups.The amount of lornoxicam consumed was (3.4 +2.8) mg in group L and the amount of morphine consumed was (4.7 + 3.5) mg in group M. There was no statistically significant difference in VAS and Bruggrmann comfort score between the two groups. There were less side-effects in group L which were also milder as compared with those in group M.Conclusion The results suggest that continuous epidural infusion of 0.2% ropivacaine combined with lornoxicam in PCIA can provide better analgesia and reduce drug consumption in PICA. The efficacy of analgesia providedby lornoxicam is similar to morphine but lornoxicam causes less side-effects than morphine.
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Objective To investigate the analgesic efficacy and safety of continuous epidural infusion of 0.2% levobupivacaine in patients after lower abdominal surgery.Methods Sixty ASA Ⅰ - Ⅱ patients undergoing lower abdominal gynecologic operation under epidural anesthesia were randomly divided into two groups : group L levobupivacaine (n = 30) and group R ropivacaine ( n = 30) . An epidural catheter was placed at L2-3 . After operation the catheter was connected through a 3-way Stopcock to a Graseby 9 500 infusion pump for continuous infusion of 0.2% levobupivacaine or 0.2% ropivacaine at a rate of 4 ml?h-1 and a Graseby 3300 infusion pump for PCEA with 0.01% morphine (bolus dose = 2ml, lockout interval = 10 min, total dose limit = 16 ml?4 h-1) (1) VAS score (0 = no pain, 100 = severe pain). (2) the ratio of the number of attempts calculated (D1) to the number of successfully delivered doses (D2) (D1/D2), (3) modified Bromage Motor scale score, (4) Bruggmann comfort scale (BCS), (5) Ramsay sedation score and (6) the severity of side effects were recorded 0, 2,4, 8, 12, 20 and 24h after operation.Results The demographic data (age, body weight, height) and duration of operation were comparable between the two groups. The analgesia was satisfactory in both groups. VAS scores were significantly lower in levobupivacaine group than that in ropivacaine group at 8 and 24 h after operation ( P