Management and outcomes of gastric leak after sleeve gastrectomy: results from the 2010-2020 national registry / 中华医学杂志(英文版)

BACKGROUND@#Management of gastric leak after sleeve gastrectomy (SG) is challenging due to its unpredictable outcomes. We aimed to summarize the characteristics of SG leaks and analyze interventions and corresponding outcomes in a real-world setting.@*METHODS@#To retrospectively review of 15,721 SG procedures from 2010 to 2020 based on a national registry. A cumulative sum analysis was used to identify a fitting curve of gastric leak rate. The Kaplan-Meier method and log-rank tests were performed to calculate and compare the probabilities of relevant outcomes. The logistic regression analysis was conducted to determine the predictors of acute leaks.@*RESULTS@#A total of 78 cases of SG leaks were collected with an incidence of 0.5% (78/15,721) from this registry (6 patients who had the primary SG in non-participating centers). After accumulating 260 cases in a bariatric surgery center, the leak rate decreased to a stably low value of under 1.17%. The significant differences presented in sex, waist circumference, and the proportion of hypoproteinemia and type 2 diabetes at baseline between patients with SG leak and the whole registry population ( P = 0.005, = 0.026, <0.001, and = 0.001, respectively). Moreover, 83.1% (59/71) of the leakage was near the esophagogastric junction region. Leakage healed in 64 (88.9%, 64/72) patients. The median healing time of acute and non-acute leaks was 5.93 months and 8.12 months, respectively. Acute leak (38/72, 52.8%) was the predominant type with a cumulative reoperation rate >50%, whereas the cumulative healing probability in the patients who required surgical treatment was significantly lower than those requring non-surgical treatment ( P = 0.013). Precise dissection in the His angle area was independently associated with a lower acute leak rate, whereas preservation ≥2 cm distance from the His angle area was an independent risk factor.@*CONCLUSIONS@#Male sex, elevated waist circumference, hypoproteinaemia, and type 2 diabetes are risk factors of gastric leaks after SG. Optimizing surgical techniques, including precise dissection of His angle area and preservation of smaller gastric fundus, should be suggested to prevent acute leaks.

Value of comprehensive geriatric assessment in clinical management of breast cancer in elderly patients / 中华老年医学杂志

Comprehensive geriatric assessment(CGA), one of the core approaches of geriatrics, is a strategy and option for the management of common clinical problems in the elderly.It has a guiding role in surgery, radiotherapy, chemotherapy, endocrine therapy and anti-tumor clinical research for elderly breast cancer patients, and can be used to evaluate treatment tolerance, monitor intervention effects, adjust treatment plans and strategies, and improve patients' quality of life and life satisfaction.This article reviewed the clinical application of CGA in elderly patients with breast cancer.

A real world study on the relationship between drug resistance of targeted therapy and prognosis of HER-2-positive advanced breast cancer / 中华肿瘤杂志

Objective: To explore the effect of primary and acquired resistance to anti-human epidermal growth factor receptor 2 (HER-2) on the overall survival of patients with HER-2 positive advanced breast cancer. Methods: The clinical characteristics of HER-2 positive patients with advanced breast cancer admitted to Cancer Hospital of Chinese Academy of Medical Sciences from January 1998 to December 2018 were collected, and their neoadjuvant/adjuvant and advanced three-line chemotherapy were summarized. Among them, targeted drugs for HER-2 included trastuzumab, pertuzumab, T-DM1, RC48-ADC, lapatinib, pyrotinib, allitinib, sipatinib, seratinib. Based on the duration of benefit from anti HER-2 treatment, the patients were divided into two groups: primary anti HER-2 resistance group and acquired anti HER-2 resistance group. In this study, the overall survival (OS) was used as the main end point. Kaplan-Meier analysis and Cox proportional risk regression model were used to analyze the effects of different drug resistance mechanisms on the overall survival. Results: The whole group of 284 patients were included. The median age of recurrence and metastasis was 48 years old, 155 (54.6%) were hormone receptor (HR) positive and 129 (45.4%) were HR negative, 128 cases (45.1%) were premenopausal and 156 cases (54.9%) were postmenopausal, 277 cases (97.5%) had a score of 0-1 in ECoG PS and 7 cases (2.5%) had a score of more than 2 in the first diagnosis of relapse and metastasis. There were 103 cases (36.3%) in the primary drug resistance group and 181 cases (63.7%) in the secondary drug resistance group. The median overall survival time of the two groups was 24.9 months and 40.4 months, respectively, with statistical significance (P<0.001). Conclusion: Primary resistance to HER-2 is one of the factors of poor prognosis in HER-2 positive breast cancer, and its mechanism needs to be further explored.

Efficacy and survival outcomes of dose-dense carboplatin plus paclitaxel as neoadjuvant chemotherapy for triple-negative breast cancer / 中华肿瘤杂志

Objective: To evaluate the efficacy and survival outcomes of dose-dense (biweekly) carboplatin plus paclitaxel (PC) as neoadjuvant chemotherapy (NAC) in triple-negative breast cancer (TNBC), and to explore an optimal neoadjuvant chemotherapy regimen for TNBC. Methods: Patients diagnosed as TNBC(cT1-4N0-3M0) in Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Between January 2008 and September 2018 who received dose-dense PC and standard 3-weekly PC as NAC were 1∶1 matched using propensity score matching (PSM) to compare the efficacy, safety and survival outcomes. Results: One hundred of TNBC patients were enrolled (50 patients were divided in dose-dense group, 50 patients in standard group). The objective response rate (ORR) of dose-dense group and standard group were both 90.0% (45/50). The grade 3-4 neutropenia in dose-dense group was less than that of standard group (32.7% vs. 68.0%, P=0.001), while the rate of ALT/AST elevation in dose-dense group was higher than that of standard group (57.1% vs. 32.0%, P=0.012). The pathological complete response (pCR) rates were 34.0% (17/50) in dose-dense group and 38.0% (19/50) in standard group, without statistically significance (P=0.677). The median follow-up time was 55 months (3-150 months). The 5-year recurrence-free survival (RFS) in dose-dense group and standard group were 83.5% and 75.2%, respectively the 5-year overall survival (OS) in dose-dense and standard group were 87.9% and 84.5% the difference were not statistically significant (P=0.322 and 0.647, respectively). Patients with residual disease (tumor size≥1 cm or lymph node positive) had poor prognosis, the 5-year RFS and OS were 59.3% and 68.5%, respectively. Conclusions: Dose-dense PC has similar efficacy with standard 3-weekly PC and has a good safety profile. Since dose-dense regimen can shorten the duration of therapy, it can be an alternative in TNBC.

One Case of Hand-foot Syndrome Recurrence Induced by Sequential Paclitaxel Liposome for Injection with Doxorubicin Hydrochloride Liposome Injection and Literature Review / 中国药房

OBJECTIVE：To investigate the role of clinical pharmacists in the diagnosis and treatment of liposome-induced hand-food syndrome （HFS），and to provide reference for rational use of liposome preparation in clinic. METHODS ：One case of elderly female patient with breast cancer ，admitted to our hospital suffered from HFS （grade 2）after treated with Doxorubicin hydrochloride liposome ；after successful therapy ，the patient had skin symptoms （grade 3）again due to Paclitaxel liposome ，and clinical pharmacist judged the recurrence of HFS. For symptomatic treatment ，stopping the treatment and external use of hormone was suggested ，and whole-process pharmaceutical care was provided. The pathogenesis ，differential diagnosis ，risk factors and therapeutic drugs of HFS were summarized based on literature review and 2 case reports in the database. RESULTS ：The physicians adopted the suggestion of clinical pharmacists ；the patient ’s symptoms improved significantly on the third day and disappeared after 1 week. Combined with literature analysis and 2 case reports ，doxorubicin liposome metabolized more slowly than non liposomes in palms and soles of feet ，resulting in accumulation of doxorubicin in sweat duct and stratum corneum ，aggravating skin damage and leading to HFS. Sequential paclitaxel in liposome form may also lead to the accumulation in eccrine duct ，further caused skin damage and induced HFS. CONCLUSIONS ：Clinical pharmacists actively participate in the diagnosis and treatment of ADR ， which is conducive to the rehabilitation of patients. At same time ，combination or sequential of Paclitaxel liposome with PLD should be avoided ，as it can lead to ADR as HFS.

Research progress on pregnancy risks and timing following bariatric surgery / 国际外科学杂志

The number of women of childbearing age having overweight or obesity problems keeps increasing globally. Besides diabetes, hypertension and other chronic conditions, these women may develop metabolic disorders of sex hormones, manifested by irregular menstruation, infertility and obstetric complications. Bariatric surgery offers prominent weight loss and improves obesity-related conditions. Women patients also benefit from elevated chances of pregnancy postoperatively. However, the timing of pregnancy for obese women after surgery has impact on the effects of weight loss surgery, pregnancy complications, delivery outcomes and long-term prospects of mother and child. This article reviews the clinical studies on the timing of pregnancies after bariatric surgery, weight loss results, as well as risks and outcomes.

Effects of the mulberry leaf extract on depression-like behavior in mice / 国际药学研究杂志

Objective: To investigate the antidepressant effect and mechanism of the extract of mulberry leaf(EML). Methods: Male BALB/c mice were randomly assigned to receive EML(100, 200 and 400 mg/kg)or vehicle for 7 days or single administration by intragastric(ig)route. The effect of EML on spontaneous activity in mice was evaluated using the open field test. The anti-depressant activity of EML was evaluated using the tail suspension test and forced swimming test. After single ig administration of EML (100, 200 and 400 mg/kg), the effects of EML on the function central monoaminergic nervous system were evaluated using the 5-hydroxy-L-tryptophan(5-HTP)induced head-twitch test, yohimbine toxicity potentiation test and reserpine test in mice. Results: In the behavioral despair model, the continuous administration of EML(100 mg/kg)for 7 days significantly reduced the immobility time in the tail suspension test and forced swimming test. Compared with the vehicle group, the inhibitory rates of immobility time were 35.5% and 41%(P<0.05, P<0.01)in the tail suspension test and forced swimming test, respectively. The single treatment with EML(400 mg/kg)also significantly reduced the immobility time in the tail suspension and forced swimming test, and the inhibitory rates of immobility time were 29.1% and 35.3%, respectively(P<0.05). The results of spontaneous activity test showed that EML had no excitatory or inhibitory effect on the central nervous system in mice. In the 5-HTP induced head-twitch test in mice, the single treatment with EML(100 mg/kg)significantly increased the number of head-twitches in mice. In the yohimbine toxicity potentiation test, the single treatment with EML(100, 200 and 400 mg/kg)had no significant effect on the mortality rate in yohimbin-treated mice. In the reserpine test, compared with the model group, the single treatment with EML(400 mg/kg)antagonized reserpine induced ptosis (P<0.05)and had no significant effect on the decrease in rectal temperature and akinesia. Conclusion: EML showed antidepressant effect, and the action mechanism was likely related to the enhancement of the function of serotonergic nervous system.

Functional roles of sodium-calcium exchange in autorhythmicity and action potential of murine fetal cardiomyocytes at early developmental stage / 生理学报

The aim of the present paper was to study the role of sodium calcium exchanger (NCX) in the generation of action potentials (APs) in cardiomyocytes during early developmental stage (EDS). The precisely dated embryonic hearts of C57 mice were dissected and enzymatically dissociated to single cells. The changes of APs were recorded by whole-cell patch-clamp technique before and after administration of NCX specific blockers KB-R7943 (5 μmol/L) and SEA0400 (1 μmol/L). The results showed that, both KB-R7943 and SEA0400 had potent negative chronotropic effects on APs of pacemaker-like cells, while such effects were only observed in some ventricular-like cardiomyocytes. The negative chronotropic effect of KB-R7943 on ventricular-like cardiomyocytes was accompanied by shortening of AP duration (APD), whereas such an effect of SEA0400 was paralleled by decrease in velocity of diastolic depolarization (Vdd). From embryonic day 9.5 (E9.5) to E10.5, the negative chronotropic effects of KB-R7943 and SEA0400 on ventricular-like APs of embryonic cardiomyocytes gradually disappeared. These results suggest that, in the short-term development of early embryo, the function of NCX may experience developmental changes as evidenced by different roles of NCX in autorhythmicity and APs generation, indicating that NCX function varies with different conditions of cardiomyocytes.

Feasibility and toxicity of EC-T dose-dense adjuvant chemotherapy: A real world study in Chinese early-stage breast cancer patients with high recurrence risk / 中华肿瘤杂志

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.

Data analysis of bariatric & metabolic surgery quality control from 2012 to 2018 in Shanghai / 中国实用外科杂志

OBJECTIVE: To learn the latest developments of Shanghai's bariatric & metabolic surgery and the differences with east Asian countries according to the transverse and vertical comparison. METHODS: Through data reporting mechanism of the Shanghai Quality Control Center of General Surgery,the bariatric & metabolic surgery data were regularly collected and summarized. RESULTS: The number of hospitals developed from 11 in 2012 to 14 in 2018,and the overall surgery cases showed a progressive growth. In 2017, nineteen hospitals and 798 surgical cases had reached the highest level while decreased in 2018. The study showed that mean surgical time decreased to 112±14.8 min with no severe complication. The proportion of patients with type 2 diabetes pre-surgery decreased from 53.4% in 2014 to 30.9%in 2018. The proportion of sleeve gastrectomy(SG) increased from 68.4% in 2014 to 94.1% in 2018, which had become the most commonly bariatric surgical procedure. CONCLUSION: The amount of Shanghai metabolic and bariatric surgery increases year by year from 2012 to 2018, while increased little in 2017-2018,patients tend to be younger,mainly with obesity. The SG has become the main procedure performed in Shanghai.

Clinical outcome of receptor expression discordance between primary and metastatic breast cancer / 中华肿瘤杂志

Objective@#To investigate the clinical outcome of expression discordance of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER-2) in primary breast cancer and the corresponding metastatic lesions.@*Methods@#A retrospective analysis was performed on 178 breast cancer patients with metastasis confirmed by the National Cancer Center & Cancer Hospital, Chinese Academy of Medical Sciences in the past 6 years. The data of expressions of ER, PR and HER-2 in primary and metastatic breast cancer, the metastatic sites, disease progression were collected and the relationships of the expression discordance of receptors with prognosis were analyzed.@*Results@#The discordance rates of ER, PR and HER-2 between the primary tumor and the metastatic sites were 27.0%, 39.8% and 18.7%, respectively. The discordance rates of ER, PR and HER-2 of patients with locoregional recurrence were 21.9%, 36.6% and 12.7%, respectively, while those of patients with distant metastases were 31.3%, 42.7% and 23.8%. The median progression free survivals (PFS) of ER+/+、ER+/-、ER-/+、ER-/- of primary tumor and metastatic sites were 17.7 months, 10.3 months, 14.0 months and 9.0months, respectively (P=0.025). The median PFS of PR+/+, PR+/-, PR-/+, PR-/- were 23.0 months, 10.7 months, 14.0 months and 9.2months, respectively (P=0.002). The median PFS of HER-2+/+, HER-2+/-, HER-2-/+, HER-2-/- were 14.9 months, 15.2 months, 12.3 months and 14.0 months, respectively, without significant differences (P=0.588).@*Conclusions@#This study confirms that expression discordances of ER, PR and HER-2 between primary breast cancer and the corresponding metastatic lesions are dramatic, especially in the patients with distant metastasis. The unstable levels of ER and PR seem to be significantly associated with prognosis of breast patients.

An overview oflncRNA involved in articular cartilage injury and repair / 医学研究生学报

Long noncoding RNAs (lncRNAs) are important regulators for a variety of biological process. miRNAs appear to be important modulators of chondrogenesis and osteoarthritis (OA). LncRNAs are widely involved in the regulation of proliferation and apoptosis of chondrocytes as sponge of microRNAs. In this review, we discuss the role of lncRNA in cartilage repairation from the aspects of cartilage injury, chondrocyte proliferation and chondrocyte apoptosis. These findings will promote the development of novel molecular drugs which regulate the balance of cartilage injury and repairation.

Comparison of exosome extracting methods from human umbilical cord mesenchymal stem cells / 中国组织工程研究

BACKGROUND: Cell-free stem cell therapy has been an issue of concern, but there is no conclusion on how to extract high-quality exosomes. OBJECTIVE: To extract exosomes from human umbilical cord mesenchymal stem cells by using three different methods, and then to screen the optimal method. METHODS: Exosomes were extracted from human umbilical cord mesenchymal stem cells by using the Total Exosome Isolation test kit, Exo Quick test kit and differential ultracentrifugation method, respectively. Then, transmission electron microscopy was used for morphological observations, BCA was utilized to quantify the protein, and western blot assay was applied to detect surface markers CD9, CD81 and CD63. RESULTS AND CONCLUSION: Extraction of exosomes was completed by all the three methods, and round or oval membranous vesicles were observed under the transmission electron microscope. The protein content and purity of exosomes was highest in the differential ultracentrifugation group, followed by the Exobiology Quick kit group, and lowest in the Total Exosome Isolation kit group, and there were significant differences among the three groups (P < 0.05). Under the same protein concentration, surface specific markers, CD81, CD63 and CD9, were expressed highest in the differential ultracentrifugation group, followed by the Exobiology Quick kit group, and lowest in the Total Exosome Isolation kit group. The operating time was significantly lower in the Exobiology Quick kit group compared with the other two groups (P < 0.05). To conclude, despite a longer operating time, the differential ultracentrifugation method is a rational method to extract enough exosomes with relative high purity.

Efficacy evaluation of laparoscopic Roux-en-Y gastric bypass on patients ≥60 years three years after / 中华内分泌外科杂志

Objective To evaluate the treatment outcome of laparoscopic Roux-en-Y gastric bypass on old patients (≥60 years old) 3 years after surgery.Methods The clinical data of 116 patients who underwent LRYGB from Jan.2011 to Mar.2014 were retrospectively examined.Patients were divided in two group:group≥ 60 years comprised of 46 patients,group ＜60 years comprised of 70 patients.Preoperative and postoperative weight,blood glucose,blood lipid,hypertension and complication were evaluated,and the efficacy on the two groups was compared.Results The average age of group≥60 years was (63.1±2.5)years and the mean duration of diabetes was (11.3±4.8) years.Mean weight decreased from (81.8±12.7)kg to (64.6±11.7)kg (P＜0.01),mean BMI decreased from (30.5±3.8) kg/m2 to (24.0±4.1) kg/m2 (P＜0.01),glycosylated hemoglobin(HbA1c) decreased from (9.0±2.0)％ to (7.06±126)％ (P＜0.01),and the remission of diabetes was 45.7％.Significant difference was also found in weight,BMI,EWL％,FBG,PBG,HbA1c,HOMA-IR,Ch,TG,LDL-C,hypertension at 3 years after surgery (P＜0.05),but HDL-C level was similar after the operation.There was no significant difference between group≥60 years and group ＜60 years(P＞0.05) except HbA1c(P＜0.05).The incidence of postoperative complicationswasnot statistically significant(P＞0.05).Conclusions LRYGB is a safe and effective treatment for old patients with obesity and T2DM.The remission rate of T2DM 3 years after surgery was similar between the 2 groups.

Chicken RNA-binding protein T-cell internal antigen-1 contributes to stress granule formation in chicken cells and tissues

T-cell internal antigen-1 (TIA-1) has roles in regulating alternative pre-mRNA splicing, mRNA translation, and stress granule (SG) formation in human cells. As an evolutionarily conserved response to environmental stress, SGs have been reported in various species. However, SG formation in chicken cells and the role of chicken TIA-1 (cTIA-1) in SG assembly has not been elucidated. In the present study, we cloned cTIA-1 and showed that it facilitates the assembly of canonical SGs in both human and chicken cells. Overexpression of the chicken prion-related domain (cPRD) of cTIA-1 that bore an N-terminal green fluorescent protein (GFP) tag (pntGFP-cPRD) or Flag tag (pFlag-cPRD) induced the production of typical SGs. However, C-terminal GFP-tagged cPRD induced notably large cytoplasmic granules that were devoid of endogenous G3BP1 and remained stable when exposed to cycloheximide, indicating that these were not typical SGs, and that the pntGFP tag influences cPRD localization. Finally, endogenous cTIA-1 was recruited to SGs in chicken cells and tissues under environmental stress. Taken together, our study provide evidence that cTIA-1 has a role in canonical SG formation in chicken cells and tissues. Our results also indicate that cPRD is necessary for SG aggregation.

Clinical value of heat shock protein-90α on diagnosis, prediction of treatment response, and monitoring of relapse in breast cancer / 中国肿瘤临床

To explore the prognostic value of heat shock protein-90α (HSP-90α) plasma levels on breast cancer and non-breast malignant tumors, monitoring the response of chemotherapy, and the predictive value of cancer recurrence and metastasis. Methods: A total of 615 female patients were enrolled between June 2016 and September 2016 in Cancer Hospital, Chinese Academy of Medical Sciences, who were divided into the examination (n=389) and control (n=216) groups. The former group consisted of static (n=289) and dynamic (n=110) groups, which were analyzed by stages, histological and molecular type, and so on. The latter group in-cluded healthy people (n=103), and those with breast benign tumors (n=51) and non-breast malignant tumors (n=62). In all the plasma samples, HSP-90α was detected using a double-antibody enzyme-linked immunosorbent assay. The receiving-operating characteristic curve was used to analyze the effectiveness of plasma HSP-90α in the diagnosis of breast cancer. Wilcoxon＇s rank test and the Kruskal-Wallis test were used to analyze the association between clinical characteristics and levels of plasma HSP-90α. Results: The levels of plasma HSP-90α were significantly higher in patients with breast cancer than in healthy controls (P<0.001). When the cut-off value was set as 59.7 ng/mL for the diagnosis of breast cancer and 43.22 ng/mL for disease recurrence, the areas under the curve were 0.834 and 0.877, sensitivities were 90.3% and 95.7%, and specificities were 78.6% and 74.5%, respectively. The levels of plasma HSP-90α sig-nificantly decreased after achieving a response to neoadjuvant chemotherapy or surgery (P<0.05). Conclusions: Plasma HSP-90α has good clinical value in the diagnosis and monitoring of response and recurrence in breast cancer.

Genetic polymorphisms of autophagy-related gene 5 (ATG5) rs473543 predict different disease-free survivals of triple-negative breast cancer patients receiving anthracycline- and/or taxane-based adjuvant chemotherapy / 癌症

BACKGROUND@#Autophagy plays a crucial role in chemotherapy resistance of triple-negative breast cancer (TNBC). Hence, autophagy-related gene 5 (ATG5), an essential molecule involved in autophagy regulation, is presumably associated with recurrence of TNBC. This study was aimed to investigate the potential influence of single-nucleotide polymorphisms in ATG5 on the disease-free survival (DFS) of early-stage TNBC patients treated with anthracycline- and/or taxane-based chemotherapy.@*METHODS@#We genotyped ATG5 SNP rs473543 in a cohort of 316 TNBC patients treated with anthracycline- and/or taxane-based chemotherapy using the sequenom's MassARRAY system. Kaplan-Meier survival analysis and Cox proportional hazard regression analysis were used to analyze the association between ATG5 rs473543 genotypes and the clinical outcome of TNBC patients.@*RESULTS@#Three genotypes, AA, GA, and GG, were detected in the rs473543 of ATG5 gene. The distribution of ATG5 rs473543 genotypes was significantly different between patients with and without recurrence (P = 0.024). Kaplan-Meier survival analysis showed that patients carrying A allele of ATG5 rs473543 had an increased risk of recurrence and shorter DFS compared with those carrying the variant genotype GG in rs473543 (P = 0.034). In addition, after adjusting for clinical factors, multivariate Cox regression analyses revealed that the AA/GA genotype of rs473543 was an independent predictor for DFS (hazard risk [HR], 1.73; 95% confidence interval [CI], 1.04-2.87; P = 0.034). In addition, DFS was shorter in node-negative patients with the presence of A allele (AA/GA) than in those with the absence of A allele (P = 0.027).@*CONCLUSION@#ATG5 rs473543 genotypes may serve as a potential marker for predicting recurrence of early-stage TNBC patients who received anthracycline-and/or taxane-based regimens as adjuvant chemotherapy.

Characteristics and adjuvant medical treatment for elderly women with breast cancer / 中国肿瘤临床

The optimal treatment of elderly women with breast cancer still faces many difficulties. Life expectancy, comorbidity, and functional status influence clinical decision and survival. Standard adjuvant medical treatments should not be withheld from healthy older patients with reasonable life expectancies. In this study, adjuvant medical treatment literatures for elderly breast cancer patients, including endocrine therapy, chemotherapy, and HER2-targeted therapy, were reviewed, focusing on efficacy and toxicity of drugs for elderly women.

Clinical Efficiency and Safety of the First-line CHOP Regimen Containing PLD Applied to Treat Aged Patients with Advanced DLBCL / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To explore the clinical efficiency and safety of CHOP regimen containing pegylated liposomal doxorubicin (PLD) for the aged patients with advanced diffuse large B-cell lymphoma (DLBCL).</p><p><b>METHODS</b>Fifty aged patients with advanced DLBCL treated in our hospital from February 2010 to February 2014 were selected and divided into two groups. Out of 50 cases, 25 cases received standard CHOP regimen (sCHOP group), other 25 cases received CHOP regimen containing PLD at dose of 30 mg/m2 (PLD+CHOP). These patients were followed up for 18 months, and the total effective rate, the survival rate and the adverse reaction rate were compared between these two groups.</p><p><b>RESULTS</b>After receiving different treatments, the survival rate of patients on 6, 12 and 18 months in PLD+CHOP group was 88.0%, 80.0% and 76.0%, respectively, and the survival rate of 18 month was significantly higher than that in the sCHOP group (P<0.05); The total effective rate in the PLD+CHOP group was statistically higher than that in the sCHOP group (P<0.05); and all the incidences of non-hematological toxicity, peripheral sensory neuropathy, lung infection, gastrointestinal reaction and hepatotoxicity were not statistically different between two groups (P>0.05), while the incidence of cardiac toxicity including acute myocardial infarction, congestive heart failure, atrioventricular block (AV block) and paroxysmal atrial tachycardia significantly decreased in the PLD+CHOP group (P<0.05).</p><p><b>CONCLUSION</b>The efficiency of CHOP regimen containing PLD for the aged patients with advanced DLBCL has been confirmed to be significant, and its cardiac toxicity is low, thus being worth to be popularized and applied for the treatment of advanced diffuse large B-cell lymphoma.</p>

Effects of Roux-en-Y gastric bypass and sleeve gastrectomy on morbidly obesity / 中华内分泌外科杂志

Objective To evaluate the effects of laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy on weight control in morbidly obese patients.Methods 48 patients with morbidly obesity underwent obese surgery (laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy) from Dec.2013 to Dec.2015,and 1-year follow-up study.The general situation of obesity and biochemical indicators were compared and analyzed.Results There were 20 cases in gastric bypass group and 28 cases in sleeve gastrectomy group.The excess weight loss percentage(％EWL)was 73±0.04 in gastric bypass group and 59±0.05 in sleeve gastrectomy group(P=-0.03).There was no statistical difference in weight change between the two groups.Low density lipoprotein cholesterol (LDL) level in gastric bypass group was significantly lower than that in sleeve gastrectomy group at 1 year after surgery (2.42±0.16 vs 3.29±0.20,P=0.006),while folic acid level was significantly higher than that in sleeve gastrectomy group(15.58±1.99 vs 7.59±1.59,P=0.022).Conclusions The one-year follow up shows there is no significant difference in the efficacy of weight control between the two groups.Gastric bypass group may be superior to gastrectomy group in nutrition indexes.However,it is just a short-term postoperative efficacy in morbidly obese patients,long-term weight control effects and obesity related diseases control need to be further explored.