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Objective:To study the efficacy of different systemic chemotherapy regimens as first-line and second-line therapy and to determine the prognostic factors for patients with advanced biliary tract cancer.Methods:The clinical data of patients with advanced biliary tract cancer who underwent systemic chemotherapy in Cancer Hospital of Chinese Academy of Medical Sciences from January 2011 to December 2018 were studied. The efficacy of chemotherapy on objective response rate (ORR) and disease control rate (DCR) were evaluated. Potential prognostic factors for survival were studied using the Cox proportional hazards models.Results:Of 151 patients enrolled into this study, there were 75 males and 76 females, with ages ranging from 31 to 77 years (median 58 years). Two treatment protocols were used: (1) 104 patients received a gemcitabine-based regimen (combined with platinums or fluorouracils) or a combination of platinums and fluorouracils, while (2) 47 patients received a combination of albumin-bound paclitaxel and S-1. The corresponding ORR for each group were 15.4%(16/104) and 27.6%(13/47), respectively, and the DCR were 65.4%(68/104) and 72.3%(34/47), respectively. Of 58 evaluable patients who received chemotherapy as a second-line therapy, 31 patients received the regimen containing gemcitabine, platinums or fluorouracils with an ORR of 3.2% (1/31) and a DCR of 35.5%(11/31); a total of 18 patients received the taxanes-based regimen with an ORR of 11.1%(2/18) and a DCR of 38.9%(7/18); 9 patients received the irinotecan-based regimen with an ORR of 22.2%(2/9) and a DCR of 44.4%(4/9). Univariate analysis showed positive liver metastasis and elevated carbohydrate antigen (CA)19-9 level to be significantly correlated with worse survival outcomes ( HR=1.540, 95% CI: 1.019-2.328, P=0.040 and HR=1.892, 95% CI: 1.123-3.188, P=0.017). Conclusion:For patients with advanced biliary tract cancer, in addition to the conventional regimens containing gemcitabine, platinums and fluorouracils, the combination of albumin-bound paclitaxel and S-1 was shown to be an effective chemotherapeutic regimen for these patients. Second-line chemotherapy was insufficient and ineffective, and an irinotecan-based regimen deserves to be further investigated. Liver metastasis and elevated CA19-9 level were worse prognosis after chemotherapy for patients with advanced biliary tract cancer.
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Aortic dissection is one of the most common vascular emergent disease. Thoracic endovascular aortic repair (TEVAR) therapy which created the new era of treatment of Stanford type B aortic dissection (TBAD) has gradually replaced the surgical treatment and becomes the gold standard for treatment of TBAD. Aortic remodeling after TEVAR is the key factor to evaluate the mid-term survival rate and successful treatment of the aortic dissection victims. However, there are few studies on aortic remodeling and lack of unified criteria to evaluate it. This article was to summarize the domestic and abroad research advances which focused on the morphological changes, the regularity, and the evaluation criteria of aorta remodeling after TEVAR.
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As an oral chemotherapy drug, capecitabine is safe, effective and easy to use, has been widely used in the treatment of esophageal cancer, gastric cancer, colorectal cancer, breast cancer, ovarian cancer and other solid tumor.The chemotherapy scheme is mainly for 3 weeks, each cycle of capecitabine for 14 days, and 7 days off.As a modification to conventional chemotherapy, the biweekly scheme with capecitabine showed low toxicity and well tolerated by patients, short hospitalization time and other characteristics, it is worth of application in clinical.
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As national strategic resources,traditional Chinese medicine (TCM) resource is the material basis for the pharmaceutical industry and health services.The high-efficiency utilization of TCM resource is a major strategic issue that realize the resource conservation and environment friendly recycling economy,guarantee the sustainable development of medicine.But currently,on one hand,the wild TCM resource was seriously damaged and in a serious shortage of stock,the cultivation variety was degenerated,the tending of endangered medicinal materials and the development of alternative varieties were faced many problems.On the other hand,the limited resources cannot be effectively utilized,which results in the waste of resources.Therefore,two ecological restricted resources,poria cocos and Chinese gall,were studied for comprehensive utilization of resources to explore the comprehensive exploitation and utilization of TCM resource as well as the pattern of sustainable development.We suggested that TCM resource should be taken into account as a whole for comprehensive utilization.We should especially pay attention to basic research for the sustainable development of TCM resource,discovery of bioactive substance,excavation and transformation for functional components,the use of biotechnology,the product development,the formation and extension of industry chain.So as the comprehensive exploitation and utilization of TCM resources and sustainable development would be realized.
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Cardiovascular diseases are closely related to proliferation , injury and apoptosis of the cells in the cardiovascular system .For instance , endothelial cells play an important role in the pathogenic process of hypertension and atherosclerosis , and smooth muscle cells and monocytes/macrophages involve in the formation of atherosclerotic plaque . Recently, it has been confirmed that long noncoding RNA (lncRNA) regulates proliferation, apoptosis, injury, autophagy and differentiation of the cells by a series of regulatory mechanisms , thus participating in the development and progression of cardiovascular diseases .This article is to review the recent research progress on the function of lncRNAs and their regu -latory roles in the cardiovascular diseases at cellular and molecular levels .
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Endothelialcellsarethecellsliningtheinnersurfacesofbloodvessels.Theybuildupasinglecell layer and play an important role in the regulation of vascular functions and the maintenance of homeostasis .The activation or injury of endothelial cells is associated with multiple diseases , including hypertension , atherosclerosis, cancer, diabe-tes, etc.Recent studies have found that microparticles are involved in the process of endothelial cell injury , thus playing a part in the development of many diseases .miRNAs enfolded in the microparticles have become importance in recent years . Moreover , recent studies also found that the concentration of the miRNAs enfolded in the microvesicles is higher than that of the miRNAs in the plasma , which means that the microparticles are the main form of miRNAs present in peripheral circula -tory system.This article is to review the recent research progress in microparticle-encapsulated miRNAs and their regulatory effect on endothelial cell injury .
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Objective To screen the potent permeation enhancers used in transcutaneous immunization with inactivated highly pathogenic avian influenza vaccine. Methods Five different permeation enhancers, ethanol, propylene glycol, dimethyl sulfoxide, ratinoic acid, oleic acid, were used to treat the skin of BALB/c mice before transcutaneous immunization. Sera were collected before the flist transcutaneous immunization and every two weeks post immunization. The titers of influenza virus-specific humoral IgG and IgA were assayed in serum, lung and nasal lavages by ELISA. The titers of hemagglutination inhibition ( HAI), IFN-γand IL-4 produced by splenic lymphocytes were also detected. Except that, clinical symptom of the skin in different time points and skin pathological changes were observed. Results The serum IgG titers, HAI titers and the influenza virus-specific lgA and IgG in lung and nasal lavages in the groups of HA +CT + DMSO, HA + CT + RA and HA + CT + OA were significantly higher than those of HA and HA + CT groups( P ＜0.05). Moreover, the numbers of splenic lymphocytes producing IFN-γ and IL-4 were increased in the above three groups than those in control groups. In addition, no evident clinical symptoms were observed, but stratum corneum of the skin in different groups showed different changes. Conclusion DMSO,RA and OA are potent permeation enhancers in mouse model inoculated with inactivated high pathogenic avian influenza vaccine transcutaneously.
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Background and purpose:Irinotecan plus fuorouracil/Leucovorin has become the standard regimen as the first-line in treating advanced colorectal cancer.We investigated the clinical response and side-effects of the first-line treatment with Irinotecan plus fuorouracil/ leucovorin(FOLFIRI) for advanced colorectal cancer.Methods:From may 2001 to march 2005,37 patients with advanced colorectal cancer were treat with irinotecan 180mg/m~(2) i.v.on day 2,and fuorouracil 400 mg/m~(2),bolus on day 1,2 and 1200 mg/m~(2),civ.44hour;leucovorin 200 mg/m~(2) i.v.on day 1,2,two weeks per cycle.Results:The response rate was 41.7%.Incidence of III/IV Grade myelosuppression was 35.1%/8.1%,and 4 patients suffered from febrile neutropenia.Incidence of III Grade delayed diarrhea was 8.1%.Conclusions:The first-line chemotherapy with a combination of irinotecan and fuorouracil/ leucovorin is effictive and well tolerated by patients with advanced colorectal cancer.