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Objective@#To investigate the short-term efficacy and adverse events of chemotherapy combined with androgen-deprivation therapy in high-volume metastatic hormone sensitive prostate cancer.@*Methods@#From March 2015 to August 2017, 55 patients with high-volume metastatic hormone sensitive prostate cancer were enrolled at Department of Urology, Fudan University Shanghai Cancer Center receiving chemotherapy combined with androgen-deprivation therapy. The age was 65(8) years (M(QR)) (range: 46 to 79 years). Patients were enrolled in the study for continuous androgen-deprivation therapy (medical or surgical castration), combined with docetaxel 75 mg/m2 intravenous injection on the first day, repeated every 21 days (6 cycles). Endpoints included overall survival, progression-free survival of prostate cancer, prostate specific antigen (PSA) response rate, and adverse events.@*Results@#The follow-up time was 21.2(11.7) months. The PSA value before chemotherapy was 144.9(415.3) μg/L. The days in patients undergoing androgen deprivation therapy before chemotherapy was 14(23) days. Four patients (7.3%) presented 0 in Eastern Cooperative Oncology Group scoring system and 51 patients(92.7%) presented 1. Thirty-nine patients (70.9%) completed more than 6 cycles of combined chemotherapy, 17 patients (30.9%) showed PSA<0.2 μg/L at 6 months after treatment, and 14 patients (25.5%) showed PSA<0.2 μg/L at 12 months after treatment. Twenty-eight patients (50.9%) had grade 3 to 4 neutropenia and 1 patient (1.8%) developed infectious neutropenia and died. Nausea and vomit occurred in 16 patients (29.1%). Twelve patients (21.8%) underwent dose adjustment due to adverse events in blood system.@*Conclusions@#The short-term effect was confirmed in high-volume metastatic hormone sensitive prostate cancer using chemotherapy combined androgen-deprivation therapy, and the long-term effect remains to be seen. Myelosuppression during chemotherapy requires close attention, and taking timely examination is recommended.
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Background and purpose:Liquid biopsy is a kind of blood, urine and other non-solid biologi-cal tissue sampling analysis, mainly for malignant tumor diagnosis, monitoring and predicting its prognosis. In this research, we optimized the extraction of miRNA in urine, established a standardized means of liquid biopsy, screened and verified the miRNA markers in patients with bladder cancer.Methods:From Jan. 2014 to Sept. 2015, we used miRNA microarray in six patients with bladder cancer and six healthy controls. Samples of 78 cases of bladder cancer and 23 healthy controls were tested by real-time fluorescent quantitative polymerase chain reaction (RTFQ-PCR) to verify the relationship between miRNA markers in liquid biopsy and clinical pathological parameters. The diagnostic value of miRNA markers was also analyzed and compared.Results:We screened 10 miRNAs differential expression in urine. Combined with previous literature, we selected 20 miRNAs to verify their expression levels in bladder cancers and healthy controls. miR-509-5p/miR-124 ratio in the urine was found higher in patients with bladder cancer than in healthy controls (P<0.0001). With the rise of miR-509-5p/miR-124 ratio in urine, tumor stage and grade were also increased (P=0.003). When the cutoff was set at 0.41, the diagnostic sensitivity and specificity of miR-509-5p/miR-124 ratio were 73.1% and 82.6%, respectively. The AUC of miR-509-5p/miR-124 ratio to detect bladder cancer was 0.864, higher than that of urinary exfoliated cells (P=0.0002).Conclusion:We optimized the extraction of miRNAs in urine,established a standardized liquid biopsy of miRNA markers. The miR-509-5p/miR-124 ratio could be an ideal diagnos-tic marker for bladder cancer.
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Background and purpose:It has been demonstrated that radical prostatectomy for patients with oligometastatic prostate cancer may contribute to improving local control of prostate cancer and overall survival by several retrospective studies. Perioperative complications play an important role in determining whether radical prostatectomy is appropriate for patients with oligometastatic prostate cancer. This study aimed to discuss the recurrence rate and the sever-ity of perioperative complications, and the primary curative effect of radical prostatectomy on oligometastatic prostate can-cer patients.Methods:A total number of 247 patients who received radical prostatectomy were recruited in the study from Jul. 2015 to Jan. 2016, including 25 patients with oligometastatic prostate cancer and 222 patients with localized prostate cancer. Patients with perioperative complications in both groups were graded with the Clavien-Dindo grading system. The proportion of PSA decline and the rates and severity of perioperative complications were analyzed in both groups.Results:The cases of prostate specific antigen (PSA) decline in the oligometastatic group were 21 (84.0%), lower than the localized group with 212 cases (95.5%). There were 6 cases (24.0%) with postoperative complications in the oligometastatic group, including serious complications (Ⅲ or above) 1 case (4.0%), and 49 cases (22.1%) with postoperative complications in the localized group, including serious complications (Ⅲ or above) 7 cases (3.2%). The differences between the groups reached no statistical significance (P>0.05).Conclusion:Radical prostatectomy for patients with oligometastatic prostate cancer could be safe, effective, and appropriate, the risk of perioperative complications should not be one of the limiting factors.
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Objective To investigate the influence of dexmedetomidine by continuous intravenous infu-sion on the recovery process of patients undergoing laparoscopic radical hysterectomy surgery under general anes-thesia.Methods Eighty patients,ASAⅠ~Ⅱ,scheduled for laparoscopic radical hysterectomy surgery under general anesthesia,were randomized into group C and group D.Normal saline and dexmedetomidine at the dose of 0.6μg.kg-1 .h-1 were injected into different groups from 10 mins before the operation to 20 mins before the end of operation respectively.Heart rate(HR),mean arterial pressure(MAP) were recorded at following five time points:before anesthesia(T1),10 mins before extubation(T2),extubation(T3),5 mins after extubation(T4), 10 mins after exbubation(T5).The recovery time,cough reflex score,sedation-agitation scale(SAS),Ramsay score,the occurrence rate of untoward effect and the dosage of medication were observed.The observational indi-ces were analyzed by using t-test,chi-square test,repeated measures data of ANOVA or the Mann-Whitney u test method.Results Compared with group C,during the recovery process,MAP and HR in group D was more stable.Ramsay score in group D was higher(P<0.05).The SAS in group D was lower(P<0.05).The sedation-agitation scale in group D was lower(P<0.05).The occurrence rate of agitation and tachycardia was lower in group D(P<0.05).But the occurrence rate of bradycardia was higher(P<0.05).Meanwhile,usage amount of sevoflurane was lower in group D(P<0.05).Conclusion Dexmedetomidine continuous intravenous infusion re-duced the untoward effect of extubation,did not extend extubation time,and kept more stable haemodynamics.
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<p><b>OBJECTIVE</b>To diagnose a neonate presenting with multiple dysmorphic features, Cri-du-chat signs and hypoglycemia and to correlate the phenotype with the genotype.</p><p><b>METHODS</b>The patient was diagnosed with conventional cytogenetics and real-time fluorescence quantitative PCR (QF-PCR). The phenotype was then correlated with the genotype through a review of literature.</p><p><b>RESULTS</b>The neonate was diagnosed with a partial 13q trisomy (q12 → qter) and partial 5p monosomy (p15 →pter).</p><p><b>CONCLUSION</b>A rare diagnosis has been established with combined cytogenetic and molecular genetic techniques. QF-PCR has a broad application in genetic diagnosis.</p>
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Female , Humans , Infant, Newborn , Male , Chromosomes, Human, Pair 13 , Genetics , Chromosomes, Human, Pair 5 , Genetics , Cri-du-Chat Syndrome , Diagnosis , Genetics , Cytogenetics , Infant, Newborn, Diseases , Diagnosis , Genetics , Trisomy , Diagnosis , GeneticsABSTRACT
Objective In order to get reference data for diagnosis of clinical genetic disease through analyzing chromosome ab‐normality types and rates in 885 patients who ask for cytogenetics consultation in recent years .Methods 324 newborns who asked for cytogenetics consultation because of high risk factors in down′s screening during pregnancy or found abnormality in physical ex‐amination after birth and 561 patients with history of spontaneous abortion ,infertility or fetal death ,growth or mental retardation , sexual abnormality were examined for karyotype analysis .Results 116 cases of chromosome abnormal karyotypes were detected , count for 13 .11% ,among which ,40 cases(34 .48% ) are chromosomal aberration .Chromosome abnormality types and rates are dif‐ferent in patients with different type of diseases .Conclusion Abnormalities in chromosome numbers and sex chromosome abnor‐mality account for the main causes of growth and mental retardation ,abnormalities of sexual differentiation and development ;but for couples suffered from spontaneous abortion ,polymorphism and structure abnormalities takes up the highest portion .
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Objective To validate the Memorial Sloan-Kettering Cancer Center(MSKCC)score model and evaluate the clinical efficacy of vascular endothelial growth factor(VEGF)-targeted agents in the treatment of advanced renal cell carcinoma(RCC)in China.Methods Three hundred and forty-five patients with advanced RCC and average age of 57(17-90)years were treated with VEGF-targeted agents.There were 306 cases of clear cell RCC,20 cases of papillary RCC,4 cases of chromophobe RCC,5 cases of renal collecting duct carcinoma,3 cases of medullary carcinoma and 7 cases of unclassified RCC.The main metastatic lesions were located at lung,bone and lymph nodes.Of them,205 cases were given the treatment of sorafenib 400 mg bid without off treatment,while 140 cases received sunitinib treatment in repeated six week cycles consisting of four weeks of sunitinib 50 mg daily followed by two weeks off treatment.Overall survival(OS)was estimated by the Kaplan-Meier method.Log-rank test and Harrell concordance index analysis were used to validate the MSKCC score model.Results The median follow-up period were 23(1-68)months in the whole group.The OS was 33 months,and survival rates at 1,2,3 year were 77.6％,59.3％,46.6％,respectively.According to the MSKCC score model,the patients were segregated into three risk categories: the favorable-risk group(no prognostic factors;n =169;49.0％),in which median OS(mOS)was 46 months and 2 year OS was 75.8％;the imtermediate-risk group(one or two prognostic factors;n =150;43.5％),in which mOS was 24 months and 2 year OS was 47.7％;and the poorrisk group(three to five prognostic factors;n =26;7.5％),in which mOS was 8 months and 2 year OS was 10.1％(log-rank P ＜ 0.01).The concordance index was 0.687.Conclusions VEGF-targeted agents are effective in Chinese advanced RCC patients.The MSKCC score model can be incorporated into judging individualizing tumor prognosis and communicating about the treatment options with patients who are using VEGF-targeted agents.
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Background and purpose: Platelet to lymphocyte ratio (PLR) is an important factor reflected systematic inflammation. The clinical value of PLR has not been confirmed. The present study was to explore the value of preoperative PLR in predicting clinical stage and prognosis in upper tract urothelial carcinoma. Methods:Patients who underwent surgical therapy with postoperative pathology upper tract urothelial carcinoma without metastasis from Jan. 2007 to Mar. 2012, were collected. Following up was done by telephone and clinic work, 150 vs 1 was taken as the threshold value of PLR, and the association of PLR with tumor stage, whether suffered bladder cancer as comorbidity, recurrent or metastasis, overall survival, tumor lesion, preoperative hematuria, gender and age was analyzed. We further analyzed the association difference of disease free survival (DFS) time and overall survival (OS) time between different PLR groups. Results:Fifty-one cases of UTUC were collected, and the postoperative mean following up time is 21 (9–51) months. Twenty cases recurred or metastasis and 9 cases died. The mean DFS time was 15 (2–51) months,and the mean OS time was 21 (9–51) months. One-factor analysis of variance showed that preoperative PLR was associated with tumor stage, overall survival rate, hematuria and gender, and the P value were 0.028, 0.008, 0.045, 0.036 respectively. High PLR group was intended to be non-organ confined disease, the sensitivity was 57%and the specificity was 74%. Survival analysis by Kaplan-Meier method showed there is no statistical difference in DFS between high and low PLR groups (P=0.155). But OS time in high PLR group was significantly less than that in low PLR group (P=0.006). Cox regression confirmed that only tumor stage is an independent prognostic factor of OS (P=0.029). Conclusion:PLR has potential clinical value in predicting advanced stage disease and Cox regression confirmed that only tumor stage is an independent prognostic factor of OS.
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Objective To analyze prognosic factors for patients with hormone refractory prostate cancer (HRPC) after chemotherapy of docetaxel/mitoxantrone plus prednisone and to explore the relationship between prostate specific antigen (PSA) parameters and prognosis. Methods Data from 68 patients with CRPC after chemotherapy were collected and analyzed retrospectively.The median age of these patients were 65 years old with 28 cases of biopsy Gleason score ＜ 8 and 35 cases of ≥ 8.The median serum PSA at diagnosis,nadir and pre-chemotherapy baseline were 142 ng/ml,0.5 ng/ml and 33.0 ng/ml,respectively.There were 38 patients in docetaxel group and 30 in mitoxantrone group.PSA doubling time ( PSADT),progression free survival (PFS) and overall survival (OS) was calculated.Chi square test was used in analysis of chemotherapy effect and Cox proportional hazards regression model was applied to identify the predictors for PFS and OS.The median value of continuous variable as cutoff point was used to divide patients into two groups to compare.Risk ratio and 95％ confidence interval (CI) was calculated. Results 38 (55.9％)patients experienced effective chemotherapy. The effective rate were 33％ and 74％ for PSADT ＜ 1.6 months and ≥ 1.6 months group,85％ and 49％ for M0 and M1 stage group,and 69％ and 40％ for docetaxel and mitoxantrone group,(P ＜ 0.05).The median PFS was (3.5 ± 0.5) months for all patients,which were (2.7 ±0.4) months and (5.9 ±0.6) months for patients with PSADT ＜ 1.6 months and ≥ 1.6 months group,(5.0 ± 0.6) months and (2.7 ± 0.5 ) months for patients with docetaxel and mitoxantrone group,and (5.7 ± 0.8) months and ( 3.4 ± 0.6) months for patients with Gleason score ＜ 8 and ≥ 8 group (P ＜0.05).26 case died in the end and the median OS was (28.3 ± 2.6) months for these patients,which were (15.7 ± 3.4) months and (31.6 ± 1.2) months for patients with PSADT ＜ 1.6 months and ≥1.6 months group,(29 ± 4.1 ) months and (28 ± 3.2) months for patients with docetaxel and mitoxantrone group,and (28.7 ± 2.6) months and (24.3 ± 5.6) months for patients with Gleason score ＜ 8 and ≥ 8 group (P ＜ 0.05). Conclusions The effective rate of chemotherapy was related with PSADT,chemotherapy strategy and M stage.PSADT,chemotherapy strategy and Gleason score may be independent predictors for patients with HRPC taking chemotherapy.Patients with PSADT ≥ 1.6 months,docetaxel chemotherapy and Gleason score ＜ 8 will have longer PFS and OS.
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Objective To evaluate the clinical efficacy and side effects of sunitinib in the treatment of advanced renal cell carcinoma. Methods Forty-five patients with advanced renal cell carcinoma and an average age of 48.6 yrs were treated with sunitinib. Among the study group, 25 were male and 20 were female. In group one, patients received sunitinib treatment in repeated six week cycles consisting of four weeks of sunitinib 50 mg daily followed by two weeks off treatment (schedule 4/2). In group two, a single daily dose of sunitinib 37.5 mg was administrated to 20 patients without off treatment. A CT scan was used to evaluate the treatment efficacy after each cycle and the side effects were recorded accordingly. Results Clinical efficacy could be evaluated in 40 patients. Of these, two achieved complete response, eight achieved partial response, 27 were stable and the remaining eight experienced disease progression with four patients dying during the study period. The side effects of sunitinib in group one and in group two included hypertension 32% (8/25) and 10% (2/20), P=0.02; liver function impairment 32% (8/25) and 20% (4/20), P=0.011; hand-foot skin reaction 68% (17/25) and 60% (12/20), respectively. The incidence of major side effects of sunitinib were different in Chinese patients than from what had been previously reported in studies conducted in US and Europe. Generally, most of the sunitinib side effects were easy to manage. Conclusions There weredifferences between the two groups of Chinese patients treated with different sunitinib protocols. The protocol of sunitinib 37.5mg daily without off-treatment was better than the protocol of sunitinib 50mg daily (schedule 4/2) in regard to liver function impairment and hypertension.
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Objective To investigate the efficacy of Sunitinib in treating metastatic non-clear cell renal cell carcinoma (RCC).Methods Twenty-two metastatic non-clear cell subtype renal cell carcinoma patients with a median age of 46 years (29 -76 years) were treated with Sunitinib.Fourteen cases were found have metastasis post radical nephrectomy,and the remaining eight cases with metastasis received cytoreductive surgery.Pathological diagnosis showed 12 papillary RCCs,one chromophobe RCC,three collecting duct RCCs,and six unclassified RCCs.The metastatic lesions were located in the lung,lymph nodes,adrenal gland,bone,liver,and thyroid gland.The patients were given the treatment of sunitinib 50 mg qd four weeks on and two weeks off.The median time of treatment was 11 months (4.5 - 24 months).Results The objective control rate was 73％.Three papillary RCC and one chromophobe RCC reached partial remission (PR) and 12 cases maintained stable disease (SD) for more than 12 weeks.And the remaining six cases progressed (PD).Conclusions Sunitinib has definitive efficacy in metastatic papillary RCC,chromophobe RCC,collecting duct RCC and unclassified RCC.Metastatic lesions in lungs and lymph nodes might be more sensitive to Sunitinib.
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Objective To evaluate the efficacy of sorafenib in treating metastatic renal cell carcinoma with sarcomatoid feature.Methods Fourteen patients with metastatic renal cell carcinoma and previous nephrectomy were treated with sorafenib single agent.The average age was 61 years(45-77years).All patients were pathologically confirmed with sarcomatoid features in the primary tumors and the percentage of sarcomatoid element was recorded from 20% to 100%.Eight cases were diagnosed as clear cell carcinoma with sarcomatoid feature,2 cases papillary renal cell carcinoma (RCC) with sarcomatoid feature,and 4 cases with pure sarcomatoid RCC.The metastatic lesions were located at lung,lymph node,adrenal gland,bone,and liver.The median time of treatment was 8 months (3-19 months).Results Two cases who just had lymph node metastasis reached partial remission.Their percentages of sarcomatoid lesion were 100% and 20%.Seven cases maintained stable disease for more than 12 weeks and the last 5 cases progressed.To Jul 2009,9 patients progressed and the median progression free survival was 6 months(0-19 months).No significant correlation was seen between both objective response rate and progression free survival and the percentage of sarcomatoid element.Conclusions Although sorafenib has some effect in advanced renal cell carcinoma with sarcomatoid feature,the prognosis of these patients is relatively poor.The percentage of sarcomatoid element does not seem to correlate with the treatment efficacy.
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Objective To investigate the efficacy of sorafenib in treating metastatic non-clear cell renal cell carcinoma(RCC).Methods Twenty-one patients with metastatic non-clear cell subtype renal cell carcinoma were treated with sorafenib.Thirteen cases were male,8 were female,with a median age of 45 years(25-76 years).Metastasis occurred in 12 cases after radical nephrectomy,and the other 9 cases received cytoreductive surgery.Pathological diagnosis showed 15 papillary RCCs,1 chromophobe RCC,and 5 unclassified RCCs.The metastatic lesions were located at lung,lymph node,adrenal gland,bone,liver,and thyroid gland.The patients were given the treatment of sorafenib 400 mg bid,or sorafenib 400 mg bid in combination with interferon-α 3 MIU,IH.5 days per week,and the median time of treatment was 8 months (2-21 months).Results Three cases (14.3%)with 1 papillary RCC,1 chromophobe RCC,and 1 unclassified RCC reached partial remission(PR) and 13 cases (61.9%) maintained stable disease (SD) for more than 12 weeks.And the rest 5 cases(23.8%) progressed(PD).To Jul 2009,13 cases progressed and the median progression free survival was 7 months(0-21 months).Conclusions Sorafenib has definitive efficacy in metastatic papillary RCC,chromophobe RCC,and unclassified RCC.Metastatic lesions in lungs and Lymph nodes might be more sensitive to sorafenib.
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Objective To investigate the efficacy and toxicity of sorafenib dose escalation in treating patients with advanced renal cell carcinoma who progressed after rutine dosage of sorafenib.Methods Twenty-four patients with advanced renal cell carcinoma who progressed after 4-22 months' rutine sorafenib treatment(400 mg bid po.) received dose escalation therapy.Nineteen cases were male,5 were female,with the average age of 52 years.Ten cases added their doses to 600 mg bid,and 14 cases escalated to 800 mg bid.Results Four cases(16.7%) progressed after one month's treatment of sorafenib dose escalation,and quited the study.In the other 20 cases,1(4.2%) reached partial remission with a tumor shrinkage of 42.5% and 19(79.2%) maintained stable disease for more than 12 weeks.To Jul 2009,another 10 cases progressed,and the median progression free survival(PFS) for the PR and SD patients was 7 months(3-14 months).The disease control rate was 79.2%,and the median PFS was 5 months(0-14 months) for the entire group of 24 cases.Common toxicities after dose escalation of sorafenib were similar to those of rutine dosage.Although the grade of hand-foot reaction,diarrhea,fatigue,and neutropenia were more severe,no grade 4 toxicities were observed during the treatment.Grade of toxicities would decrease when the time of treatment prolonged.Conclusions Sofafenib dose escalation is a feasible and effective treatment for the patients with advanced renal cell carcinoma who failed to rutine dosage of sorafenib.The disease control rate of this therapy is relatively high.The toxicities do not increase much,and could be well tolerated by most patients.
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Objective To discuss the application of pelvic lymph node dissection during radical prostatectomy.Methods The data of 239 patients with prostate cancer which had been done radical prostatectomy and pelvic lymph node dissection were retrospectively reviewed,with the patients'median age of 68 (48-79) years.148 patients(61.9%) had either a Gleason score of>7 or a PSA of>20 ng/ml.All patients were diagnosed as clinical localized prostate cancer preoperatively.The extent of pelvic lymph node dissection included bilateral obturator fossa and region of the external iliac artery.Patients with positive lymph nodes were advised to receive maximal androgen blockade therapy and were followed up until biochemical recurrence.Results It took an average operation time of 20(15-35)min with the average blood loss of 20(5-45) ml for bilateral lymphadenectomy. There was no injury of big vessels and nerves. The total number of lymph node dissected was 1-23 with a median of 7.The median postoperative hospital stay was 16 days.The time of drainage was 4-36 days with a median of 7 days.74.5%(178 cases)of patients had drainage less than 8 days and 9.4%(20 cases)patients were more than 14 days. Positive nodes were found in 29 cases with the positive rate of 12.1%. The median number of positive lymph nodes was 1.Early postoperative complications related to pelvic lymphadenectomy included deep venous thrombosis,lymphocele,lymph leakage,pelvic infection. Patients with positive lymph nodes had a median progression free time of 10 months.Conclusions Pelvic lymph node dissection could detect lymph node metastasis which might be difficult to find through other means. It could facilitate the accurate staging of prostate cancer and bring potential benefits to patients. It does not significantly prolong the operation time and the incidence of complications should decrease gradually with the improvement of the surgeons'experience and surgical techniques.
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Objective To analyze the predictive factors of anti-androgen withdrawal in the treatment of androgen independent prostate cancer. Methods 347 cases of advanced metastatic prostate cancer in our prostate cancer database were filtered. All the cases were treated with maximal androgen blockade and had full pathological and clinical information. 237 cases developed to the androgen independent stage during the maximal androgen blockade treatment. Among them, 90 cases were treated with anti-androgen withdrawal. This 90 cases were followed up and the last follow-up date was 30 September 2009. The Logistic regression of univariate and multivariate analysis were used to find the predictive factors for the effectiveness of anti-androgen withdrawal, which including baseline PSA, Gleason score, clinical stage, way of castration, kind of anti-androgen, PSA nadir during maximal androgen blockade, time to PSA nadir, PSAV at the time of AIPC, PSADT at the time of AIPC, the effective duration of maximal androgen blockade, age at the time of AIPC and PSA at the initiation of anti-androgen withdrawal. Results Of the 90 cases treated with anti-androgen withdrawal, 3 cases were excluded for analysis because of the incomplete information. Among the 87 cases, 17 cases were effective with the anti-androgen withdrawal treatment while the other 70 cases were ineffective. At the last follow-up, 3 cases were still effective. The median effective duration of anti-androgen withdrawal was 4 months. The univariate analysis indicated that PSAV at the time of AIPC (P=0.033), PSADT at the time of AIPC (P=0.009) and PSA at the initiation of anti-androgen withdrawal (P=0.002)were predictive factors. The multivariate analysis indicated that PSAV (P=0.042) and PSADT at the time of AIPC (P= 0.036) were independent predictive factors for the effectiveness of anti-androgen withdrawal. Conclusions Among the androgen independent advanced metastatic prostate cancer patient, there were about 19. 5% cases effective with the anti-androgen withdrawal treatment and the median effective duration was 4 months. PSAV and PSADT at the time of AIPC were independent predictive factors for the effectiveness of anti-androgen withdrawal.
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Objective To find the predictive factors that related to the effect of hormonal therapy and the survival of advanced metastatic prostate cancer. Methods Three hundred and Sixty-four cases of metastatic prostate cancer were treated with hormonal therapy in Cancer Hospital Fudan University in Shanghai from December 1996 to March 2008. The patients were followed up to the 31 March 2008 and the median follow-up time was 24 months. Two hundred and fifty cases have progressed into the stage of hormonal independent. The statistic software used in this study was SPSS 15. 0. Cumulative survival was analyzed by Kaplan-Meier method. Cox regression was used for univa-riate and multivariate analysis. Log-rank method was used for the significance test. The statistical difference was accepted when the P-value was lower than 0. 05. Results The effective rate of hormonal therapy for advanced metastatic prostate cancer was 98%. The median time of progression free survival of hormonal therapy was 20 months, and the one-year, two-year, three-year progression free survival rate was 69%, 39%, 27%, respectively. The survival analysis indicated that baseline PSA level more than 20ng/ml, with visceral organ metastasis, the PSA nadir more than Ing/ml during hormonal therapy, the time from the start of hormonal therapy to the PSA nadir less than 5 months were poor prognostic factors of progression free survival. Conclusions The baseline PSA level, clinicalstage, the PSA nadir during hormonal therapy and the time form the start of hormonal therapy to the PSA nadir could be the factors that predict the progression free survival time during hormonal therapy.
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Diamond-like carbon(DLC)films age characterized by hish wear resistance,low friction coefficients and chemical inertness,and thus hish-corrosion resistance.The properties of DLC can further be modified by incorporating other elements in the films,such as N,F,AS,and so on,to adjust them for specific applications.These properties make the films good candidates as biocompatible coatings for biomedical devices and implants.The review gives an overview of the biomedical chagacteristics of diamond-like carbon films and their potential apphcafions.
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<p><b>OBJECTIVE</b>To explore the expression of integrin alpha 6 in hepatic sinusoidal capillaration.</p><p><b>METHODS</b>The rat hepatic fibrosis model was established by injection of carbon tetrachloride subcutaneously. Then the expression of laminin and integrin alpha 6 subunit was observed by immunohistochemistry and dot immuno-blotting.</p><p><b>RESULTS</b>We observed sinusoidal capillaration formed by deposition of laminin along sinusoids in Disse interspace by immunohistochemistry staining. In normal rat the expression of integrin alpha 6 was restricted to portal vascular endothelial cells and bile duct epithelial cell membranes. No expression was observed in sinusoidal endothelial cell membranes. When capillaration integrin alpha 6 was detected in a continuous pattern along the sinusoids, the content of integrin alpha 6 was significantly higher in fibrotic liver tissues than in normal liver tissues as measured by dot immuno-blotting (P<0.05).</p><p><b>CONCLUSIONS</b>During fibrogenesis, laminin continuously accumulate in liver tissues and form basement membrane resulting in sinusoidal capillaration, and then induce the expression of integrin alpha 6 on SEC membranes.</p>
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Animals , Male , Rats , Antigens, CD , Carbon Tetrachloride , Immunoblotting , Immunohistochemistry , Integrin alpha6 , Laminin , Metabolism , Liver , Metabolism , Pathology , Liver Cirrhosis, Experimental , Metabolism , Pathology , Rats, Wistar , Time FactorsABSTRACT
<p><b>OBJECTIVE</b>To investigate the effects of genistein, a tyrosine protein kinase inhibitor, on the fenestrae, proliferation and nitric oxide (NO) synthesis of the liver sinusoidal endothelial cells from CCl(4)-induced hepatic fibrosis rats in vitro.</p><p><b>METHODS</b>By in situ collagenase perfusion and two-step percoll gradient centrifugation, SECs were isolated and cultured from normal and CCl(4)-treated Wistar rats. The fenestrae of SECs were observed by the scanning electron microscopy, and the SECs cell proliferation was determined by the MTT assay. The concentrations of NO in the cultured medium of SECs were detected indirectly by measurement of nitrates and nitrites (the stable products of NO) using the nitrate reduction method.</p><p><b>RESULTS</b>Scanning electron microscopic studies revealed that the number of fenestrae in SECs from all stage of hepatic fibrotic rats was decreased markedly as compared with the SECs from normal controls; however, no obvious changes in the fenestrae of SECs were observed after treated with genistein (100 mumol/L) for 24 hours. After treated with 100 mumol/L genistein for 24 hours, the cell proliferation rates of SECs from all stages of hepatic fibrosis were decreased significantly was compared with the control group (P<0.05). The synthesis of NO by SECs from all stages of hepatic fibrosis was markedly lower than those of normal controls. Treatment with 100 mumol/L genistein for 24 hours could increase the synthesis of NO by SECs from the early stage (stage I) of fibrosis; however, this effect of genistein was not observed in SECs from stage II or III of fibrosis at this concentration.</p><p><b>CONCLUSIONS</b>The results suggest that genistein may play an important role in regulating the function of SECs.</p>