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Entinostat plus exemestane in hormone receptor-positive (HR+) advanced breast cancer (ABC) previously showed encouraging outcomes. This multicenter phase 3 trial evaluated the efficacy and safety of entinostat plus exemestane in Chinese patients with HR + ABC that relapsed/progressed after ≥1 endocrine therapy. Patients were randomized (2:1) to oral exemestane 25 mg/day plus entinostat (n = 235) or placebo (n = 119) 5 mg/week in 28-day cycles. The primary endpoint was the independent radiographic committee (IRC)-assessed progression-free survival (PFS). The median age was 52 (range, 28-75) years and 222 (62.7%) patients were postmenopausal. CDK4/6 inhibitors and fulvestrant were previously used in 23 (6.5%) and 92 (26.0%) patients, respectively. The baseline characteristics were comparable between the entinostat and placebo groups. The median PFS was 6.32 (95% CI, 5.30-9.11) and 3.72 (95% CI, 1.91-5.49) months in the entinostat and placebo groups (HR, 0.76; 95% CI, 0.58-0.98; P = 0.046), respectively. Grade ≥3 adverse events (AEs) occurred in 154 (65.5%) patients in the entinostat group versus 23 (19.3%) in the placebo group, and the most common grade ≥3 treatment-related AEs were neutropenia [103 (43.8%)], thrombocytopenia [20 (8.5%)], and leucopenia [15 (6.4%)]. Entinostat plus exemestane significantly improved PFS compared with exemestane, with generally manageable toxicities in HR + ABC (ClinicalTrials.gov #NCT03538171).
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The outbreak of 2019 novel coronavirus disease (COVID-19) is spreading rapidly. In order to prevent cluster outbreaks, the government strengthened the management and control of personnel mobility, which had a great impact on the examination and treatment of breast cancer patients. This paper discusses how to realize scientific health management of breast cancer patients outside the hospital based on the existing epidemic situation, characteristics of breast cancer patients and public health safety factors. The breast cancer patients should synthetically consider the epidemic prevention situation of inhabitance, the disease stage and previous therapeutic schedule to decide the next therapeutic schedule. If necessary, after professional discussion and communication between doctors and patients online or offline, the hospital visiting time should be delayed through seeking alternative treatment schemes, and psychological counseling for patients should be paid attention to at the same time.
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Objective@#We aimed to examine the feasibility and toxicity of EC-T dose-dense regimen and to demonstrate the suitable dose of epirubicin in a Chinese early-stage breast cancer population with high recurrence risk.@*Methods@#370 patients with early-stage breast cancer at high risk of recurrence were treated with EC-T dose-dense adjuvant chemotherapy and prophylactic administration of recombinant human granulocyte stimulating factor (G-CSF). The incidence of delayed chemotherapy, drug reduction and adverse reactions were retrospectively analyzed.@*Results@#370 patients completed the planned eight cycles of chemotherapy, 50 patients experienced chemotherapy delay, and 90 had chemotherapy dose reductions. Overall, 61.1% of the patients experienced grade 3 or 4 hematology toxicities, 4.1% of the patients experienced grade 3 gastrointestinal toxicity, 16.3% experienced grade 3 or 4 liver malfunction, and 1.9% experienced grade 3 alopecia. In the multivariate analysis, pretreatment epirubicin levels were associated with comprehensive and hematology toxicity risk (OR=1.268, P=0.046; OR=1.244, P=0.036). With G-CSF support, the probability of grade 3-4 dose limiting toxicity, i. e. neutropenia, abnormal liver function, and gastrointestinal adverse effects did not increase as the epirubicin dose level increased(P>0.05). However, there were no statistically significant associations between epirubicin grade and treatment delay (P=0.814) or dose reduction (P=0.282).@*Conclusions@#EC-T dose-dense chemotherapy shows tolerable toxicity. High dose level is not a limiting factor for this regimen. With G-CSF support, epirubicin 85-90 mg/m2 is appropriate tolerance dose for Chinese early breast cancer patients with high recurrence risk.
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Objective@#To explore the clinical application effect of the orbital periorbital perforator flap pedicled with zygomatic artery to repair the defect of eyelid ectropion and the defect after tumor resection.@*Methods@#(1)Perfused 10 fresh cadavers gelatin lead oxidate with one-time arteriography and CT spiral scanning, and imported DICOM data into Mimics 17.0 for rapid body mapping and three-dimensional reconstruction, and observed the source of zygomatic orbital artery and distribution rules of perforating branches. (2)From July 2012 to July 2017, 18 clinical cases were repaired by orbital periorbital perforator flap pedicled with zygomatic artery, the flap was cut with the same width as the defect width, and the length of the flap was 2 to 3 times the defect length, with an area of 0.3 cm × 1.5 cm to 2.0 cm × 3.0 cm.@*Results@#The zygomatic orbital artery originated from the superficial temporal artery, extending up to about the midpoint of the line between the anterior ear and the lateral canthus.The clinical application of the orbital periorbital flap with the perforating branch of the zygomatic orbital artery in 18 cases survived and healed well. After 1 month to 2 years of follow-up, the color, texture and shape function recovered well.@*Conclusions@#The orbital periorbital flap with the perforating branch of the zygomatic orbital artery is a good method for reconstruction of ectropion and palpebral defect due to its reliable movement and the arterial arch connected with the orbicularis suborbicularis.
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Theδ13 C values of volatile organic compounds ( VOCs) in various emission sources and ambient air were analyzed by using thermal desorption coupled with gas chromatography and isotope ratio mass. The lowest sample concentration and peak shape quality needed for high precision and accurate analysis were investigated. Fuel evaporation ( gasoline and diesel) , vehicle exhaust, solvent evaporation, dining fumes and ambient air of different functional zones of Xiamen city were collected using Tenax TA tube, and the significant differences in δ13 C values of VOCs between these sources were observed. The δ13 C value of gasoline exhaust ( 97 # ) was heavier (-25 . 84‰) than that of dining fumes (-30 . 26‰) and theδ13 C values of fuel evaporation were heavier than that of vehicle exhaust after combustion. The average δ13 C value of atmospheric VOCs in Xiamen was at the level of -27 . 03‰ to -25 . 40‰, which was close to the δ13 C value of the evaporation and exhaust of gasoline and diesel, indicating that the VOCs in the atmosphere of Xiamen was highly influenced by transportation related sources.
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Analytical technique on oxygen isotope composition of phosphate in soil has important applications in biogeochemical research. As the composition of the soil is complex with multiple oxygen sources, a liable phosphate enrichment and purification technology is important for phosphate oxygen isotope research. Here we presented a protocol on the analysis of the δ18 Op of inorganic phosphate in soil, and phosphate was purified with multiple mineral precipitations and finally precipitated as silver phosphate. The efficiency of NH4 OH purification method was examined and the purity of the product was verified through XRD and element analysis. The result showed that treatment of the Ag3 PO4 sample by recrystallizing with ammonia could remove the impurity efficiently without significantly modifying oxygen isotope compositions. The validity of sample processing and reliability of isotope analyses were confirmed by processing a KH2 PO4 standard in parallel with soil P sample. The analytical result of three soil types indicated that this method provided good precision of 0. 2‰. The differences of δ18 Op between three soils groups are significant ( From 15. 2‰ to 19. 5‰) and can be used to tracing P sources.
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Objective To investigate the relationship between serum thyrotrophin(TSH)and dyslipidemia in subclinical hypothyroid and euthyroid subjects. Methods An epidemiological study on diabetes and thyroid diseases was performed in Dadong community, Shenyang city, in 2007. 110 subjects with subclinical hypothyroidism(SCH)and 1 240 euthyroid subjects were enrolled in the study. Neither history of thyroid diseases nor administration of thyroid-related and lipid-regulating medicines were reported in these subjects. The levels of serum thyroid hormones, lipids, fasting plasma glucose(FPG), and insulin were determined. Results (1)Patients with SCH had significantly lower HDL-C levels than those who were euthyroid.(2)According to the guideline of treatment of adult dyslipidemia in China, the lipid profiles were each categorized. Mean TSH levels were higher in subjects in the dyslipidemia subclass than subjects in the normal subclass. The differences were significant in high LDL-C subclass in overweight individuals. In euthyroid overweight women, mean TSH levels were significantly higher in high LDL-C subclass. In the euthyroid population, TSH was positively associated with total cholesterol in overweight population. The association was not modified by the homestasis model assessment for insulin resistance(HOMA-IR)values.(3)TSH was associated positively with serum triglycerides and negatively with serum HDL-C in women. TSH was positively associated with total cholesterol in overweight population and positively associated with total cholesterol and LDL-C in overweight women after adjustment for age, sex, and body mass index. Conclusion Raised serum TSH seems to be a risk factor of dyslipidemia in subclinical hypothyroid and euthyroid subjects, which is independent of insulin sensitivity.
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Objective To verify the criteria proposed by National Academy of Clinical Biochemistry(NACB)guidelines in investigating the factors that affect serum TSH determination, and to determine the reference range of serum TSH in iodine-sufficient areas of China. Methods In 2007, 5 348 inhabitants were enrolled from 3 iodine-sufficient areas of Liaoning Province, and were asked to fulfill the questionnaire. Serum TSH, thyroid peroxidase antibody(TPOAb), and thyroglobulin antibody(TgAb)were determined, and thyroid ultrasonography was carried out. Results The distribution of TSH levels was skewed in healthy people and closely fit the curve of Gaussian distribution after logarithmic transformation. The levels of TSH in subjects of 12-19 years of age were significantly higher than those of other age groups(P＜0.01), and no significant difference was found among the latter groups. TSH level in females [(1.68±1.90)mIU/L] was higher than in males[(1.45±1.92)mIU/L, P＜0.01]. The reference range of TSH was 0.43-4.74 mIU/L in males, and 0.48-5.39 mIU/L in females. Family history of thyroid disease, abnormal thyroid ultrasonography, and positive thyroid antibodies were the factors that influenced TSH level. Conclusion The reference range of serum TSH in iodine-sufficient areas of China is established.
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This study investigated the relationship between serum thyrotrophin levels and dyslipidemia in subclinical hypothyroid and euthyroid subjects. A total of 110 subjects with subclinical hypothyroidism and 1,240 euthyroid subjects enrolled in this study. Patients with subclinical hypothyroidism had significantly lower high density lipoprotein cholesterol (HDL-C) levels than those who were euthyroid. The lipid profiles were each categorized and mean thyrotrophin levels were higher in subjects in the dyslipidemia subclasses than subjects in the normal subclasses. Thyrotrophin was positively associated with serum triglyceride and negatively associated with serum HDL-C in women. Thyrotrophin was also positively associated with total cholesterol (TC) in the overweight population along with TC and LDL-C in overweight women. In the euthyroid population, thyrotrophin was positively associated with TC in the overweight population. In conclusion, serum thyrotrophin was correlated with dyslipidemia in subclinical hypothyroid and euthyroid subjects; the correlation was independent of insulin sensitivity.
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Cholesterol/blood , Cholesterol, HDL/blood , Dyslipidemias/blood , Insulin Resistance , Lipids/blood , Thyrotropin/blood , Triglycerides/bloodABSTRACT
BACKGROUND: Many study results proved that electroacupuncture can cause change of endogenous opioid peptide system.OBJECTIVE: To observe the change of blood sugar and blood lipoprotein (a) in rats with diabetes mellitus after electroacupuncture therapy and probe into the effect of opioid peptide system in the treatment for diabetes with electroacupuncture.DESIGN: Randomized controlled trial with experimental animals as the subjects.SETTING: The experiment was conducted in the Department of Pathophysiology, Medical College of Shandong University.MATERIALS: The experiment was completed in the Department of Pathophysiology, Medical College of Shandong University from July 2004 to December 2004. Totally 140 male Wistar rats were involved.METHODS: Ten Wistar rats were collected randomly as the blank control group. The other 130 rats were given 20 g/L streptozotocin 50 mg/kg intraperitoneally and the rats in blank control group were given the same volume of saline intraperitoneally. Three weeks later, the tails were cut off and the blood sugar was measured 2 hours after food intake. The rats with obvious rapid sugar tolerance were given foods with high calories for 28 days as the model rats. There were 64 rats were successful models and they were classified into 3 groups randomly, namely model control group( n = 20), electroacupuncture therapy(n=22) and electroacupuncture with naloxone groups( n = 22) . The blood sugar and blood lipoprotein(a) were detected after treatment for the diabetic rats with streptozotocin.MAIN OUTCOME MEASURES: Blood sugar level and blood lipoprotein(a) of each rat after the final therapy.RESULTS: Totally 74 rats entered the result analysis. Electroacupuncture therapy could reduce the blood sugar and blood lipoprotein(a) of diabetes mellitus rats, while rats with naloxone injection before therapy were insensitive to electroacupuncture. [The blood sugar value were(13.91 ± 3.79),( 10.33 ± 2.36), (12.96 ± 2.23)mmol/L in the model control group, electroacupuncture therapy group, electroacupuncture with naloxone group respectively; while the level of blood lipoprotein(a) were(13.75 ±2.69),( 10.81 ± 2.96), (13.01 ± 3.23)mg/L respectively].CONCLUSION: Electroacupuncture therapy can reduce the level of blood sugar and the risk of atherosclerosis in rats with diabetes mellitus. Although the mechanism can not be explained through the meridian theory, according to the experimental result that blood sugar and blood lipoprotein(a) were no longer intervened by electroacupuncture therapy after injecting naloxone, it is presumed that electroacupuncture therapy can exert its intervention effect on blood sugar and blood lipoprotein(a)through opiate system.
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Objective To explore the relationship between serum thyrotropin and the components of metabolic syndrome.Methods A total of 1534 adult inhabitants in Dadong district of Shenyang were asked to fulfill the questionnaires and have physical examination and oral glucose tolerance test(OGTT).The vein blood was drawn to measure thyrotropin(TSH),fasting plasma glucose(FPG),OGTT 2hPG,fasting insulin,triglyceride(TG) and high density lipoprotein cholesterol(HDL-C).Results Serum TSH in the MS group was higher than in the Non-MS group(2.54 vs 2.22 mU/L,P