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Objective To study the therapeutic efficacy and toxicity of Bevacizumab combined with Chemotherapy in patients with advanced and metastatic cancer.Methods Fifty-nine patients of advanced metastatic cancer (Forty-two patients of refractory metastatic colorectal cancer and 17 advanced adenocarcinoma) were treated with normalized chemotherapy combined with Bevacizumab.Patients with refractory metastatic colorectal cancer were treated with Bevacizumab combined with FOLFIRI or FOLFOX4,and patients with advanced adenocarcinoma of NSCLC were treated with Bevacizumab in combination with docetaxel and cisplatin for 4-6 cycles,Bevacizumab was used until progressive disease (PD).During treatment,adverse effect were assessed with Common Toxicity Criteria V3.0 developed by National Cancer Institute.Results Among the 42 patients of metastatic colorectal cancer,27 were treated with First-line 1 with complete remission (CR),13 partial response(PR),4 stable disease(SD) and 9 PD,the effective rate (ER) was 51.9％ ( 5/15 ),disease control rate(DCR) was 66.7％ (18/27);Fifteen patients were treated with second-line PR,of which 5 PRD,4 SD,6 PD.ER was 33.3％ (5/15),and DCR was 60.0％ (9/15).The effective rate were slightly higher in the First-line treatment group than that in the second-line treatment group,however,the difference was not statistically significant (x2=1.335,P=0.248 ).Among the 17 patients of NSCLC,of which 1 CR,7 PR,5 SD,4 PD.RR was 47.1％ (8/17),and DCR was 76.5％ (13/17).The major toxicities were one grade 3 hemoptysis observed in one patient,grade 3 thrombosis was observed in one patient.Other common adverse effects,were epistaxis,hemoptysis,hypertension and proteinuria,which were not severe and could be well tolerated.Conclusion Bevacizumab Combined with Chemotherapy was effective in short term for the patients with advanced and metastatic cancerMost patients could tolerate the side effects.Further studies should be done to prove the long-term effects.
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Mammalian target of rapamycin (mTOR) is an atypical serine / threonine protein kinase,and belongs to the phosphatidylinositol kinase-related kinase (PIKK) family.mTOR plays an important role in tumor cell growth,apoptosis and tumor angiogenesis. Molecular therapy targeted mTOR has become a hot research topiccurrently.
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In this study, the colonization and distribution of Helicobacter pylori (Hp) in patients with chronic gastric diseases were investigated and the relationship between the periodontal initial treatment and presence of Hp in oral cavity was examined to better understand the connection between Hp infection and chronic diseases. Primers for PCR amplification were designed according to ureC gene and cagA genes of Hp. Specimens were harvested from different sites of 96 patients with chronic gastric diseases and the specimens of dental plaques, gargles and dorsal mucosa were tested for Hp. The 96 patients were treated by bismuth triple therapy and among them, 52 subjects were additionally given periodontal initial therapy. The eradication rate of gastric Hp and oral Hp detection rate were determined 4 weeks and 1 year after the treatment. The results showed that the detection rates of oral specimens were in the order of dental plaques (82.3%), gargles (51.1%) and scrapings of dorsal mucosa of tongue (37.5%). One year after bismuth triple therapy or the triple therapy in combination with periodontal initial treatment, the eradication rate of gastric Hp was significantly higher in the combination treatment group than in group treated by the triple therapy alone (62.8% vs. 32.4%, P<0. 05). Moreover, the Hp detection rate was significantly lower in the combination group than in the group treated only with the triple therapy. We are led to conclude that Hp is present at various parts of oral cavity, oral Hp might be an important source of gastric Hp and the triple therapy plus periodontal initial treatment can enhance the long-term eradication rate of gastric Hp in patient with both chronic gastric diseases and chronic periodontitis.
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Objective To evaluate the etiology and clinical features of jejunoileum bleeding.Methods Seventy-two patients admitted in 7 hospitals of Shangdong province for jejunoileum bleeding from January 1998 to December 2008 were enrolled in the study. There were 46 males and 26 females with mean age of 47 years (ranged 13-85 years). The jejunoileum bleeding was confirmed by means of endoscopy, images or surgery. The causes, diagnostic methods and major clinical manifestations were retrospectively analyzed. Results The most frequent cause of jejunoileum bleeding was tumor (42/72,58.3 %), followed by enteritis (9/72, 12.5 %), diverticulum ( 7/72, 9. 7%), angiopathy (7/72,9.7%), Crohn's disease (3/72,4.2%). Differences were significant in constituent ratio of cause of jejunoileum hemorrhage between male and female and between jejunum and ileum (P＜0.05).Hematochezia or hematochezia with abdominal pain was the first presentation. The jejunoileum bleeding in 54. 2% patients was diagnosed by laparotomy, 23. 6% by capsule endoscopy, 9.7% by selective angiography, 6.9% by small bowel series and enteroclysis, 2.8% by colonoscopy and 2.8% by push enteroscopy. The complications of jejunoileum bleeding were anemia, intestinal obstruction,peritoneal metastasis, shock, ankylenteron and intestinal perforation. Conclusions Intestinal tumor is the most common cause in jejunoileum bleeding, especially in jejunum. Whereas the enteritis,diverticulum and angiopathy were often found in ileum. The capsule endoscopy and push enteroscopy are recommended in diagnosis of jejunoileum bleeding.
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Purpose:To investigate the effect of Flk-1、LR P and MDR1 genes in the carcinogenesis and development of lung cancer. Methods:The expression of Flk-1、LRP and MDR1 geneproteins in primary lung tumors were studied immunohistochemically. Results:of the 70 lung cancers, 29 cases (49.2%) were positive for MDR1 expression in NSCLCs and 2cases (18.2%) in small cell lung carcinoma(S CLC); 41cases (69.5%)had overexpression of LRP in NSCLCs and 3cases (27.3%) in S CLCs, there was a statistically significant correlation (P