ABSTRACT
Objective To investigate the clinical efficacy and safety of microwave ablation combined with concurrent chemotherapy in treatment of locally advanced pancreatic cancer. Methods Thirty-one patients with locally advanced pancreatic cancer with between August 2013 and April 2016 were divided into two groups according to the different treatments: 15 patients in the control group were treated with gemcitabine monotherapy; 16 patients in the combination group were treated with the same regimen as control group 1-2 weeks after the microwave ablation. The efficacy and side effects of the two groups were compared by chi-square test. Results The effective rates in the combination group and control group were 25.0%(4/16) and 13.3%(2/15), the difference between the two groups was not significant (χ 2=1.034, P=0.247); the local control rates were 68.8%(11/16) and 26.7%(4/15), the difference between the two groups was statistically significant (χ2=6.579, P=0.012). The pain relief rates in the combination group and control group were 87.5%(14/16) and 26.7%(4/15) (χ2=8.146, P=0.004). The 3-, 6-, 9- and 12-month survival rates in the combination group and control group were 100.0%vs. 100.0%(P=1.000), 68.8%vs. 40.0%(P=0.097),56.3%vs.20.0%(P=0.033),50.0%vs.13.3%(P=0.021).In the combination group,9 cases (56.3%)occurred postablation syndrome,the serum amylase of 7 cases(43.8%)increased 1d after ablation,1 case (6.3%) occurred pancreatic fistula. The intraoperative and perioperative death did not occur. The main complications of the two groups were myelosuppression, gastrointestinal reactions and so on. Conclusions Microwave ablation combined with concurrent chemotherapy has a synergistic effect in treatment of locally advanced pancreatic cancer. In disease control rate, pain relief rate and survival of patients, microwave ablation combined with concurrent chemotherapy is better than chemotherapy alone, but the adverse reactions are similar.
ABSTRACT
Objective To investigate the clinical efficacy and safety of microwave ablation combined with concurrent chemotherapy in treatment of locally advanced pancreatic cancer. Methods Thirty-one patients with locally advanced pancreatic cancer with between August 2013 and April 2016 were divided into two groups according to the different treatments: 15 patients in the control group were treated with gemcitabine monotherapy; 16 patients in the combination group were treated with the same regimen as control group 1-2 weeks after the microwave ablation. The efficacy and side effects of the two groups were compared by chi-square test. Results The effective rates in the combination group and control group were 25.0%(4/16) and 13.3%(2/15), the difference between the two groups was not significant (χ 2=1.034, P=0.247); the local control rates were 68.8%(11/16) and 26.7%(4/15), the difference between the two groups was statistically significant (χ2=6.579, P=0.012). The pain relief rates in the combination group and control group were 87.5%(14/16) and 26.7%(4/15) (χ2=8.146, P=0.004). The 3-, 6-, 9- and 12-month survival rates in the combination group and control group were 100.0%vs. 100.0%(P=1.000), 68.8%vs. 40.0%(P=0.097),56.3%vs.20.0%(P=0.033),50.0%vs.13.3%(P=0.021).In the combination group,9 cases (56.3%)occurred postablation syndrome,the serum amylase of 7 cases(43.8%)increased 1d after ablation,1 case (6.3%) occurred pancreatic fistula. The intraoperative and perioperative death did not occur. The main complications of the two groups were myelosuppression, gastrointestinal reactions and so on. Conclusions Microwave ablation combined with concurrent chemotherapy has a synergistic effect in treatment of locally advanced pancreatic cancer. In disease control rate, pain relief rate and survival of patients, microwave ablation combined with concurrent chemotherapy is better than chemotherapy alone, but the adverse reactions are similar.
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A total of 218 patients on chemotherapeutic regimens containing oxaliplatin were randomly divided into experimental (n =120) and control (n =98) groups.The experimental group received an intravenous infusion of lipoic acid plus sodium potassium magnesium calcium and glucose injection.The control group had only normal saline.Overall incidence of neurotoxicity and toxicity grade of peripheral nerve were observed after 4,8 and 12 cycles.Those with neurotoxic symptoms were followed up for 1 year.No significantly statistical difference existed in the incidence of peripheral neurotoxicity after 4,8 cycles (P ＞0.05).After 12 cycles,31 patients in the experimental group had an onset of neurotoxicity of grade3 (n=8,6.7％) &grade4 (n=0) versus21 cases of grade3 (n=21,21.4％) and grade4 (n=5,5.1％) in the control group.Statistically significant differences existed between grades 3 and 4 neurotoxicity (P ＜0.05).After 1 year of follow-up,the incidence of grade 1 of neurotoxicity was 2.5％ (n =3) in the experimental group versus 23.7％ (n =9) in the control group.And the inter-group difference was statistically significant (P ＜ 0.05).Lipoic acid plus sodium potassium magnesium,calcium and glucose injection can effectively prevent the occurrences of acute and chronic peripheral neurotoxicity associated with oxaliplatin.
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Objective To evaluate the expression of Survivin,PTEN in tongue squamous cell carcinoma (TSCC) and the correlation with vascular endothelial growth factor (VEGF) and its clinical significance.Methods The expression of Survivin,PTEN and VEGF of 72 TSCC samples and 15 normal tongue mucosa (NTM) samples were detected by immunohistochemical method.Results The positive expression rate of Survivin,PTEN and VEGF in TSCC were 66.7％(48/72),61.1％(44/72),70.8％(51/72)respectively,while the positive expression rate in NTM were 0,100.0％ (15/15),0.There were statistical significance between the rate in TSCC and NTM respectively (P ＜0.01 ).The expression of Survivin and VEGF in TSCC were positively correlated with TNM stage,histological grade and lymph node metastasis (P＜ 0.05 or ＜ 0.01 ),while the expression of PTEN had negative correlation with them (P＜ 0.05 or ＜ 0.01 ).The expression of Survivin was positively correlated with VEGF expression in TSCC (r=0.6482,P＜0.01),while the expression of PTEN was negatively correleted with VEGF expression (r =-0.4027,P ＜0.01).Conclusions The expression of Survivin and PTEN in TSCC are associated with tumor occurrence and development closely,and are both significantly correlated with VEGF.Joint detection of Survivin,PTEN and VEGF have important reference value in clinical diagnosis,metastasis and prognosis of TSCC.
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Objective To summarize the observation points and nursing experience after minimally invasive ventriculo-atrial shunt. Methods 45 patients after minimally invasive ventficulo-atrial shunt were given preoperative psychological care and preparations, postoperative observation of vital signs, con-sciousness, pupil, with or without intracranial hypertension, inadequate shunt or transitional symptoms, in-fectious symptoms, specific and basic care, awareness of postoperative complications and detailed guidance for discharge and follow-up jobs. Results Half month after shunt 28 cases regained consciousness, 9 cases with alleviated consciousness dysfunction, 8 cases with unchanged consciousness dysfunction, 5 cases with shunt blockage; 3 cases with over-shunt; 5 cases with inadequate shunt, 1 case with blood-borne in-fection, 1 case with shunt exposed, no intracranial infection, air embolism, complications such as endocardi-tis took place. Conclusions Adequate preoperative preparation and close postoperative observation, ef-fective specific care and basic care can increase success rate of ventriculo-atrial shunt and improve the quality of life of patients.