Effect evaluation of surgical plus radio(chemo)therapy and non-surgery chemoradiotherapy treatment strategies for advanced tonsillar squamous cell carcinoma / 中华耳鼻咽喉头颈外科杂志

Objective: Using propensity score matching method(PSM) to investigate the clinical effect of surgical plus radio(chemo)therapy and non-surgery chemoradiotherapy treatment strategies for advanced tonsillar squamous cell carcinoma. Methods: A retrospective analysis was conducted on the clinical data of 324 patients diagnosed with advanced tonsillar squamous cell carcinoma and treated in Peking Union Medical College Hospital from 2000 to 2018, confirmed by pathology and without distant metastasis. Survival analysis was performed using Kaplan-Meier estimates, the Cox proportional hazards model, and propensity score matching(PSM). Results: Of the 324 patients, 102 were treated with non-surgery chemoradiotherapy treatment strategies and 222 with surgical plus radio(chemo)therapy treatment. Cox multivariate analysis showed that the non-surgery treatment group had a favorable prognosis than the surgical treatment group, however, these outcomes were not significantly different [overall survival(OS): adjusted Hazard Ratios(aHR): 0.92, 95% confidence interval(CI): 0.60-1.42; disease-specific survival(DSS): aHR: 0.71, 95%CI: 0.43-1.20; disease-free survival(DFS): aHR: 0.82, 95%CI: 0.53-1.28]. The new patient cohort consisted of 102 subpairs after PSM. There were no significant differences between two groups(OS: aHR: 0.85, 95%CI: 0.51-1.40; DSS: aHR: 0.62, 95%CI: 0.35-1.11; DFS: aHR: 0.80, 95%CI: 0.49-1.33). Conclusion: Our findings indicate that patients with non-surgical treatment do not have significantly better survival outcomes compared to surgical treatment group, while non-surgical treatment has advantages in improving the quality of life of patients, so comprehensive treatment based on radiotherapy and chemotherapy may be recommended for advanced tonsillar squamous cell carcinoma.

β3-adrenoceptor impacts apoptosis in cultured cardiomyocytes via activation of PI3K/Akt and p38MAPK / 华中科技大学学报（医学）（英德文版）

β3-adrenoceptor (β3-AR) has been shown to promote myocardial apoptosis. However, the exact physiological role and importance of this receptor in the human myocardium, and its underlying mode of action, have not been fully elucidated. The present study aimed to determine the effects of β3-AR on the promotion of myocardial apoptosis and on norepinephrine (NE) injury. We analyzed NE-induced cardiomyocyte (CM) apoptosis by using a TUNEL and an annexin V/propidium iodide apoptosis assay. Furthermore, we investigated the NE-induced expression of the apoptosis marker genes Akt and p38MAPK, their phosphorylated counterparts p-Akt and p-p38MAPK, caspase-3, Bcl-2, and Bax. In addition, we determined the effect of a 48-h treatment with a β3-AR agonist and antagonist on expression of these marker genes. β3-AR overexpression was found to increase CM apoptosis, accompanied by an increased expression of caspase-3, bax/bcl-2, and p-p38MAPK. In contrast, the β3-blocker reduced apoptosis of CMs and the associated elevated Akt expression. We identified a novel and potent anti-apoptosis mechanism via the PI3K/Akt pathway and a pro-apoptosis pathway mediated by p38MAPK.

β3-adrenoceptor impacts apoptosis in cultured cardiomyocytes via activation of PI3K/Akt and p38MAPK / 华中科技大学学报（医学）（英德文版）

β3-adrenoceptor (β3-AR) has been shown to promote myocardial apoptosis. However, the exact physiological role and importance of this receptor in the human myocardium, and its underlying mode of action, have not been fully elucidated. The present study aimed to determine the effects of β3-AR on the promotion of myocardial apoptosis and on norepinephrine (NE) injury. We analyzed NE-induced cardiomyocyte (CM) apoptosis by using a TUNEL and an annexin V/propidium iodide apoptosis aβsay. Furthermore, we investigated the NE-induced expreβsion of the apoptosis marker genes Akt and p38MAPK, their phosphorylated counterparts p-Akt and p-p38MAPK, caspase-3, Bcl-2, and Bax. In addition, we determined the effect of a 48-h treatment with a β3-AR agonist and antagonist on expression of these marker genes. β3-AR overexpression was found to increase CM apoptosis, accompanied by an increased expression of caspase-3, bax/bcl-2, and p-p38MAPK. In contrast, the β3-blocker reduced apoptosis of CMs and the associated elevated Akt expression. We identified a novel and potent anti-apoptosis mechanism via the PI3K/Akt pathway and a pro-apoptosis pathway mediated by p38MAPK.

Anti-angiogenic mechanism of cordycepin on rhesus macaque choroid - retinal endothelial cell line cultured in high glucose condition / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the angiogenesis effect and protective mechanism of cordycepin on rhesus macaque choroid- retinal endothelial ( RF/ 6A) cell line cultured in high glucose condition. METHODS: Cultured RF/ 6A cells were divided into normal control group, high glucose group and high glucose (HG) + different concentration cordycepin groups (HG+ 10μ g/ mL group, HG+ 50μ g/ mL group, HG+ 100μ g/mL group). The cell proliferation was assessed using cholecystokinin octapeptide dye after treated for 48h. The cell migration was investigated by a Transwell assay. The tube formation was measured on Matrigel. Furthermore, the impact of cordycepin on high glucose - induced activation of VEGF and VEGF receptor 2 (VEGFR-2) was tested by Western blot analysis. RESULTS: Compared with normal control group, cell viability markedly increased in high glucose group ( P CONCLUSION: Cordycepin can suppress the proliferation, migration and tubu formation of RF/ 6A in high glucose condition, might via inhibiting expression of VEGF and VEGFR-2.

Expression of nerve growth factor and hypoxia inducible factor-1α and its correlation with angiogenesis in non-small cell lung cancer / 华中科技大学学报（医学）（英德文版）

In order to investigate the expression of nerve growth factor (NGF) and hypoxia inducible factor-1α (HIF-1α) and its correlation with angiogenesis in non-small cell lung cancer (NSCLC), paraffin-embedded tissue blocks from 20 patients with NSCLC were examined. Twenty corresponding para-cancerous lung tissue specimens were obtained to serve as a control. The expression of NGF, HIF-1α, and vascular endothelial growth factor (VEGF) in the NSCLC tissues was detected by using immunohistochemistry. The microvascular density (MVD) was determined by CD31 staining. The results showed that the expression levels of NGF, HIF-1α and VEGF in the NSCLC tissues were remarkably higher than those in the para-cancerous lung tissues (P<0.05). There was significant difference in the MVD between the NSCLC tissues (9.19±1.43) and para-cancerous lung tissues (2.23±1.19) (P<0.05). There were positive correlations between NGF and VEGF, between HIF-1α and VEGF, and between NGF and HIF-1α in NSCLC tissues, with the spearman correlation coefficient being 0.588, 0.519 and 0.588, respectively. In NSCLC tissues, the MVD had a positive correlation with the three factors (P<0.05). Theses results suggest that NGF and HIF-1α are synergically involved in the angiogenesis of NSCLC.

Expression of nerve growth factor and hypoxia inducible factor-1α and its correlation with angiogenesis in non-small cell lung cancer / 华中科技大学学报（医学）（英德文版）

In order to investigate the expression of nerve growth factor (NGF) and hypoxia inducible factor-1α (HIF-1α) and its correlation with angiogenesis in non-small cell lung cancer (NSCLC), paraffin-embedded tissue blocks from 20 patients with NSCLC were examined. Twenty corresponding para-cancerous lung tissue specimens were obtained to serve as a control. The expression of NGF, HIF-1α, and vascular endothelial growth factor (VEGF) in the NSCLC tissues was detected by using immunohistochemistry. The microvascular density (MVD) was determined by CD31 staining. The results showed that the expression levels of NGF, HIF-1α and VEGF in the NSCLC tissues were remarkably higher than those in the para-cancerous lung tissues (P<0.05). There was significant difference in the MVD between the NSCLC tissues (9.19±1.43) and para-cancerous lung tissues (2.23±1.19) (P<0.05). There were positive correlations between NGF and VEGF, between HIF-1α and VEGF, and between NGF and HIF-1α in NSCLC tissues, with the spearman correlation coefficient being 0.588, 0.519 and 0.588, respectively. In NSCLC tissues, the MVD had a positive correlation with the three factors (P<0.05). Theses results suggest that NGF and HIF-1α are synergically involved in the angiogenesis of NSCLC.

Prevention and treatment of skin complications following BAHA implantation / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To discuss the skin complications of 16 cases received bone-anchored hearing aid (BAHA) implantations, and the clinical experience for prevention and treatment skin complications following BAHA.</p><p><b>METHODS</b>Retrospective review 16 patients who received BAHA implantation from December 2010 to March 2013, and summarize the complications and treatment.</p><p><b>RESULTS</b>Four patients (1/4) suffered from skin complications. According to Holgers classification, two patients (1/8) had a Holgers Grade 1-2 skin reaction and cured by local application of antibiotics. Two patients (1/8) experienced Holgers Grade 3 skin reaction received revision surgeries for excessive soft tissue growth. One patient replaced the BAHA abutment with a longer 9.0mm one.</p><p><b>CONCLUSIONS</b>Infection and skin overgrowth around the abutment was the common complications of BAHA implantation. Standardize the peri-operative managements, and clean the skin regularly would prevent the skin complication. Additional surgical intervention should be applied timely in the cases of severe complications.</p>

The isolation and identification of novel duck reovirus / 病毒学报

The virus strains were isolated from the liver and spleen of the dead young ducks characterized with symptoms of hemorrhagic-necrotic hepatitis. These isolates could cause the death of muscovy duck-embryo and chick-embryo. 1-day-old birds infected with these isolates had the same character with clinically dead birds and the virus could be isolated from artificially infected birds. These isolates could proliferate in MDEF and result in CPE. The virus could proliferate in the cytoplasm in order of crystals and arranged in the latlic-like. The viron was shown spherical, icosahedron, cubic symmetry, no-envelope, with double-layered capsid, about 70 nm in diameter by electron microscopy. The genome segments of the virus were consisted of L1-3, M1-3 and S1-4, which were similar to that of avian reovirus (ARV). Compared to 68.2%, 69.3% - 70.1%, respectively. The system evolution analysis showed that S3 gene coding sigmaB protein was placed in different branch of MDRV and ARV, indicating that S3 gene of the virus was different from ARV and MDRV. The main clinical symptoms and lesions of ducklings caused by the virus were different from the diseases caused by MDRV and ARV. It was concluded that the virus was a Novel duck reovirus belonging to Orthoreovirus genus of the Reoviridae family.

Protective effect of vitamin D3 on ocular structure in diabetic rat / 中华实验眼科杂志

BackgroundResearch demonstrated that vitamin D3 mediated by its receptor has the potent nonclassical effects,including immunomodulatory,antiinflammatory,and neuroprotective properties,and it can enhance the secretion and sensitivity of insulin and therefore down-regulate hyperglycemia and attenuate the corneal edema.ObjectiveThe present study was to investigate the protective effect of vitamin D3on ocular structure in experimental diabetic rat.Methods Twenty-two healthy SPF C57BL/6 rats were randomly divided into vitamine D3 group (8 rabbits),diabetic control group ( 11 rabbits) and normal control group ( 3 rabbits).2％ streptozotocin ( STZ,175 mg/kg)was intraperitoneally injected to create the diabetic models in the rats of the vitamine D3 group and diabetic control group.Blood glucose was examined for 3 times in the third day after STZ injection,and the rats with the blood glucose concentration ＞16.7 mmol/L was identified as the successful diabetic models.After modeling,the rat tail blood was collected for the monitoring of blood glucose.Two weeks after modeling,vitamine D3 was intraperitoneally injected in each week for 5 times.The fundus was examined using direct ophtalmoscope,and the eyeballs were obtained under the excessive anesthesia for the measurement of thickness of the central cornea,retina and choroids by histopathological examination once a week for 7 weeks after administration of vitamin D3.The administration of the animals complied with the Statement of ARVO.ResultsThe corneal edema appeared with the corneal thickness of (339.14± 11.13) μm in the first week and gradually attenuated with time elapse after modeling in the diabetic group ( F =382.446,P =0.000).The corneal thickness values were significantly decreased from the second week through the seventh week in the vitamin D3 group compared with diabetic control group(P＜0.05).The atrophy of the corneal epithelium was found from the fifth week to the seventh week in diabetic control group,but that in vitamin D3 group was slight (P＜0.05).The gradually thinning of the choroids was seen from the first week to the seventh week in the diabetic control group ( F =437.411,P =0.000 ),however,the thickness values in the vitamin D3 group were significantly increased in comparison with the diabetic control group in various time points (P＜0.05).The retina thickness was gradually reduced during the seven-week duration in the diabetic control group (F =91.859,P =0.000),but no significant change was identified in retina thickness in the vitamin D3 group(P＞0.05).ConclusionsVitamin D3 has prevent and therapeutic effects on experimental diabetic oculopathy.

KRAS and BRAF gene mutations in correlation with clinicopathologic features of colorectal carcinoma in Chinese / 中华病理学杂志

<p><b>OBJECTIVE</b>To retrospectively analyze KRAS and BRAF gene mutation features in Chinese colorectal cancer (CRC) and their clinicopathologic relationship.</p><p><b>METHODS</b>557 colorectal cancer cases were collected, including 325 colon cancer and 232 rectal cancer. PCR amplification and DNA sequencing were used to detect mutations in exon 2 of KRAS gene and exon 15 of BRAF gene mutation.</p><p><b>RESULTS</b>(1) KRAS mutation was found in 40.4% (225/557) colorectal cancer. The most common mutation locations were in codon 12(79.1%, 178/225) and codon 13 (20.4%, 46/225). The most common mutation types were GGT > GAT (G12D) (37.8%, 85/225), GGT > GTT(G12V) (20.0%, 45/225) in codon 12 and GGC > GAC (G13D) in codon 13 (19.6%, 44/225). These three point mutations accounted 77.3% (174/225) in total KRAS gene mutation cases. All cases showed only one of point mutation types. (2) Among 557 CRC cases, KRAS mutation was significantly higher in female (46.2%, 92/199) than in man (37.2%, 133/358; P < 0.05). KRAS gene codon 13 mutation was higher in right colon cancer (11.3%, 12/106) than that in left colon cancer (4.8%, 6/124), but it didn't show any statistical significance (P > 0.05). (3) BRAF gene mutation was 5.1% (10/197) in colorectal cancer and 8/10 were the point mutation of GTG > GAG (V600E). Eight colorectal cancer cases with GTG > GAG (V600E) were not showing KRAS gene mutation. Both two cases with mutation on codon 600 (GTG > ATG, V600M) and codon 606 (GGG > AGT, G606S) showed codon 12 mutation of KRAS gene. (4) BRAF (V600E) gene mutation was higher in female (8.5%, 6/71) than that in male (1.6%, 2/126; P = 0.05); BRAF mutation in colon cancer (8.3%, 6/72) was higher than that in rectum cancer (2.1%, 2/94), but hadn't statistical significance (P > 0.05).</p><p><b>CONCLUSIONS</b>(1) Codon 12, 13 in KRAS gene and codon 600 in BRAF gene are the most common mutation points in Chinese colorectal cancer. KRAS and BRAF mutations are mutually exclusive. (2) KRAS and BRAF gene mutation is higher in female than that in male, suggesting that RAS-RAF-MAPK signal pathway is probably related to hormones directly or indirectly. (3) There is a trend that codon 13 mutation in KRAS and codon 600 mutation in BRAF in right colon cancer are higher than that in left colon cancer, respectively, however, which needs more cases to be further verified.</p>

The rescue modalities and etiology of acute organic solvent poisoning / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the rescue modalities and etiology of acute organic solvent poisoning.</p><p><b>METHODS</b>A total of 776 cases of acute organic solvent poisoning were analyzed retrospectively. The kinds of organic solvents, the modes of exposure, the characteristics of poisoning and the methods of treatment were analyzed.</p><p><b>RESULTS</b>Poisoning was due to occupational exposure to organic solvents in 87.4%, the other was exposed in daily life. The total number of organic solvents harming the patients was 55. The most common three of the organic solvent poisoning were halogenated hydrocarbons poisoning, hydrocarbons poisoning, amino- and nitro-hydrocarbons poisoning. The accidents of mass poisoning were increasing in numbers recently, especially the acute halogenated hydrocarbons poisoning.</p><p><b>CONCLUSION</b>To know the numerous poisonings responsible for acute solvent poisoning is essential for enhancing the pre-hospital care, emergency treatment and following treatment. Also, extensive clinical knowledge and numerous biologic laboratory tests are needed to improve the diagnosis and rescue of acute solving poisoning. Effect of therapeutic plasma exchange treatment on sever acute poisoning is with a positive attitude.</p>

Efficacy in patients with outer and middle ear deformities of using bone-anchored hearing aids / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and satisfaction of bone-anchored hearing aids (BAHA) in patients with outer and middle ear deformities.</p><p><b>METHODS</b>Seven patients with bilateral microtia and aural atresia, and three patients with unilateral microtia and bilateral middle ear malformation were fitted with soft-band BAHA for a few months, followed by receiving unilateral BAHA implantation. Mean pure-tone thresholds and speech audiometry tests results were compared among patients without hearing aid, with soft-band BAHA, and with implanted BAHA. Scores from the BAHA users' questionnaires and Glasgow children's benefit inventory (GCBI) were used to measure patient satisfaction and subjective health benefit.</p><p><b>RESULTS</b>The mean pure-tone thresholds of the patients were (64.8 ± 5.9) dBHL for those without hearing aid, (30.2 ± 3.7) dBHL for those with soft-band BAHA, and (20.3 ± 3.9) dBHL for those with implanted BAHA. The average decline in pure-tone threshold was (36.2 ± 8.0) dBHL for those with soft-band BAHA, and an additional decline of (12.2 ± 3.4) dBHL was achieved with implanted BAHA. The average gains in speech discrimination scores (SDS) were (3.00 ± 1.07)% for those without hearing aids and (89.39 ± 5.83)% for those with implanted BAHA in sound field of 45dBHL. SDS were (57.55 ± 10.30)% for those without hearing aids and (91.19 ± 4.16)% for those with implanted BAHA in sound field of 65dBHL. The average gains in SDS were (88.21 ± 6.86)% and (38.04 ± 7.56)% tested with 45dBHL and 65dBHL respectively. Sound reception thresholds (SRT) without hearing aids were (63.1 ± 5.9) dBHL and (24.7 ± 3.5) dBHL for those with implanted BAHA. The average gains in SRT was (39.6 ± 6.2) dBHL. The BAHA application questionnaire demonstrated excellent patient satisfaction. The general benefit score was 35.59 ± 14.35.</p><p><b>CONCLUSION</b>BAHA remains one of the most reliable methods of auditory rehabilitation and improves quality of life for patients with ear deformities.</p>

Detection of epidermal growth factor receptor mutations in non-small-cell lung carcinoma by direct sequencing and correlations with clinicopathological characteristics and sample types / 中华病理学杂志

<p><b>OBJECTIVE</b>To retrospectively analyze epidermal growth factor receptor (EGFR) gene mutation frequencies and distribution characteristics in Chinese patients with non-small-cell lung carcinoma (NSCLC) by direct gene sequencing.</p><p><b>METHODS</b>Clinical samples from 443 NSCLC patients were obtained for EGFR gene mutation analysis, including 299 surgical specimens, 59 core biopsies and 85 fine needle aspiration and pleural effusion cytology specimens. All samples were processed from paraffin embedded blocks and microdissection was performed to enrich tumor cells. PCR based direct gene sequencing was used to investigate tyrosine kinase domain coding region involving exon 18 through 21.</p><p><b>RESULTS</b>(1) Among 443 samples, 193 mutations were detected in 189 patients (42.7%) and 4 patients possessed two mutations involving two different exons in their tumor samples. The percentage of mutations involving exon 18 to 21 were 2.0% (4/193), 48.7% (94/193), 6.7% (13/193) and 42.5% (82/193) respectively. (2) There was no significant correlation of EGFR mutation with age, however, mutation rate (50.9%, 54/106) of exon 21 in patients over median age 57 was higher than that of the younger patients (32.2%, 28/87; P<0.01). (3) EGFR mutation rate was remarkably higher in female patients (53.5%, 107/200) than in male patients (33.7%, 82/243; P<0.01). (4) Mutation rate in adenocarcinomas (46.5%, 161/346) was much higher than in squamous cell carcinomas (13.3%, 4/30) and poorly differentiated carcinomas (24.1%, 7/29; P<0.01, P<0.05), while the adenosquamous carcinomas shared a mutation rate similar to that of adenocarcinoma (7/13, P>0.05). (5) In surgical samples, core biopsies and cytological samples, the EGFR mutation detection rates were 49.5% (148/299), 35.6% (21/59) and 23.5% (20/85) respectively. The fine needle aspiration and cytological samples showed much lower EGFR mutation detection rates (23.5%, 20/85) than that of surgical samples (49.5%, 148/299; P<0.01).</p><p><b>CONCLUSIONS</b>(1) Direct gene sequencing is a reliable and effective method for the detection of EGFR mutations in NSCLC, particularly for unknown EGFR mutations. (2) EGFR mutations are more frequent in female patients and patients with adenocarcinoma NSCLC, involving mainly exon 19 and 21. (3) The mutation distribution in exons of EGFR gene appears age-related. (4) Detection rate of EGFR mutation varies in different sample types. Small biopsy and fine needle aspiration specimens are valuable materials for analyzing EGFR mutation in NSCLC, although rare false negativity may occur using such samples.</p>

Treatment strategies and indications for interventional management of pseudoaneurysms / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Pseudoaneurysms (PAs) are common vascular abnormalities predominantly arising from a disruption in the integrity of the arterial wall. The potential complications of PAs are usually unpredictable and carry high rates of morbidity and mortality. This paper presents our experience with various treatment strategies for PAs.</p><p><b>METHODS</b>Fifty-four patients with 55 PAs were diagnosed by non-invasive imaging examination. The etiology of PAs included trauma (33/55), infection (5/55), iatrogenic (6/55), and idiopathic (11/55). Different procedures including ultrasound (US)-guided compression, endovascular treatment, and surgery were performed depending on the location of PAs, size of the sac and neck, and characteristics of the donor artery. The methods of endovascular treatment included embolization of parent artery, the PA sac, or implantation of a stent-graft. Follow-up was performed using US or CT and ranged from 1 day to 24 months (average 16.7 months).</p><p><b>RESULTS</b>In all 54 patients, 3 patients with superficial PAs were treated by US-guided compression, while 44 patients with 45 PAs located in the head and neck (n = 20), viscera (n = 10) or extremities (n = 15) were treated by endovascular treatment. Nine patients with PAs located in the head and neck (n = 2) or extremities (n = 7) were treated by surgery. Among them, one patient underwent endovascular treatment combined with surgery and 1 was treated by surgery after unsuccessful US-guided compression. In the 3 patients treated with US-guided compression, 2 were successfully treated while the remaining patient required additional surgery. Primary technical success of endovascular management was 97.7% (43/44) and the cure rate was 95.5% (42/44). In the surgery group, 4 patients recovered well, 1 patient was cured by endovascular treatment combined with surgery, 2 cases underwent amputation, 1 patient died of multi-organ failure and 1 patient was paralysed.</p><p><b>CONCLUSIONS</b>Minimally invasive interventional techniques are established treatment methods for PA with favorable success rates and minimal morbidity. The therapeutic options should be tailored to the location, size and rupture risk of PA, condition of the donor artery and existing comorbidity.</p>

Evaluation of efficacy and safety of platinum-based doublet chemotherapy for advanced non-small cell lung cancer patients aged 70 years or over / 肿瘤

Objective: To evaluate the efficacy and safety of platinum-based doublet chemotherapy for patients aged ≥70 years old with advanced non-small cell lung cancer (NSCLC). Methods: One hundred and sixty-seven patients with NSCLC at stage III/IV were divided into three groups: patients aged ≥70 years old receiving platinum-based doublet chemotherapy (group A), patients aged ≥70 years old receiving best supportive care (group B) and patients aged <70 years old receiving platinum-based doublet chemotherapy (group C). At least two cycles of chemotherapy were required. The short-term response and the adverse effects were observed. All patients were followed up, and the progression-free survival (PFS) and the overall survival (OS) were calculated. Results: There were no significant differences in short-term response rate (33.3% vs 35.5%, P=0.811), median PFS (124 d vs 140 d, P=0.122) and median survival (337 d vs 367 d, P=0.173) between group A and group C. The median PFS and median survival of group B were 87 d and 218 d, respectively, which were both shorter than those of group A and group C (P<0.05). The one-year survival rate (42% vs 53%) and the rate of Eastern Cooperative Oncology Group performance status (ECOG PS) score improvement (41% vs 48%) after chemotherapy between group A and group C were not significantly different, but the group B had a lower one-year survival rate (15%) and a lower ECOG PS score improvement rate (13%) as compared with group A and group C (P<0.05). The incidence rates of grade III/IV leukopenia and nausea/vomiting were similar in group A and group C. Conclusion: The elderly patients (≥70 years old) with advanced NSCLC, whose ECOG PS score was ≤2, may benefit from the platinum-based doublet chemotherapy, and the short-term response, survival and the improvement in life quality of these patients were similar to the patients younger than 70 years old with advanced NSCLC receiving the same chemotherapy. The side effects of chemotherapy occurred in the elderly and non-elderly patients were also similar. Copyright© 2011 by TUMOR.

XPC Lys939Gln polymorphism is associated with the decreased response to platinum based chemotherapy in advanced non-small-cell lung cancer / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Platinum-based chemotherapeutics are the most common regimens for advanced non-small-cell lung cancer (NSCLC) patients, and genetic factors are thought to represent important determinants of drug efficacy. We prospectively assessed the status of the XPC Ala499Val and Lys939Gln gene polymorphisms and investigated whether these SNPs can predict the response to cisplatin/carboplatin-based regimens in advanced NSCLC patients in a Chinese population.</p><p><b>METHODS</b>The treatment outcomes of 96 advanced NSCLC patients who were treated with platinum-based chemotherapy were evaluated. The polymorphic status of xeroderma pigmentosum group C (XPC) gene was genotyped by the 3-D polyacrylamide gel-based DNA microarray method.</p><p><b>RESULTS</b>The distributions of XPC Lys939Gln genotypes differed significantly between the response group (complete + partial responses) and the non-response group (stable + progressive disease; P = 0.022). The heterozygous A/C genotype carriers had a poorer response rate than the wild A/A genotype carriers in stage III (OR, 0.074; 95%CI, 0.008 - 0.704; P = 0.023). The XPC Ala499Val polymorphisms were not associated with response to platinum-based chemotherapy.</p><p><b>CONCLUSION</b>Polymorphisms of the XPC gene, Lys939Gln, may be a predictive marker of treatment response for advanced NSCLC patients in stage III.</p>

Immunoglobulin heavy chain gene rearrangement study in difficult cases of B-cell lymphoproliferative disorder / 中华病理学杂志

<p><b>OBJECTIVE</b>To evaluate the ancillary diagnostic value of IgH gene rearrangements in those B-cell lymphoproliferative disorder cases whom are difficult in making a final diagnosis.</p><p><b>METHODS</b>IgH gene clonal rearrangements were retrospectively analyzed in a total of 77 diagnostically difficult B-cell lympho-proliferative patients. Standardized BIOMED-2 system IgH gene clonality assay kit targeting FR1, FR2, FR3 was used, followed by heteroduplex-polyacrylamide gel electrophoresis (PAGE) and silver nitrate staining.</p><p><b>RESULTS</b>The final diagnoses of the 77 cases were: 12 cases of reactive lymphoid hyperplasia, 20 cases of atypical lymphoid hyperplasia or suspicious lymphoma, and 45 cases of B-cell lymphoma. Detection rates of at least one positive reaction were 2/12, 11/20 (55%), 36/45 (80%) in the three groups, respectively. In B-cell lymphomas, the clonality detection rate of FR1, FR2 and FR3 was 60% (27/45), 60% (27/45) and 56% (25/45), respectively. The type distribution were: 20 marginal zone lymphomas, including 18 extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue, 7 diffuse large B-cell lymphomas, 7 follicular lymphomas, 1 mantle-cell lymphoma, 1 Burkitt's lymphoma, 4 plasma cell neoplasms and 5 unclassified B-cell lymphomas. Rearrangements of FR1, FR2 or FR3 were not detected in 9 (20%) of the B cell lymphoma cases, nevertheless, one of them had developed liver lesion later, and was confirmed finally to be B cell lymphoma. Fourteen patients of reactive lymphoid hyperplasia with positive IgH gene clonal rearrangements, and atypical lymphoid hyperplasia had follow-up history available. Four of them were diagnosed as lymphoid malignancies upon further biopsy, and in three of them, clonal IgH gene rearrangements were detected.</p><p><b>CONCLUSIONS</b>B-cell lymphoproliferative disorder requiring a detection of clonal IgH gene rearrangement for making a final diagnosis. Combined detections of three IgH FR1, FR2 and FR3 rearrangements provide important ancillary diagnostic value in confirming suspected B-cell lympho-proliferative disorders. It is important to take an additional biopsy or to follow-up those patients who that have a detectable IgH gene clonal rearrangement but without apparent morphological evidence of lymphoma. For cases with a negative IgH gene rearrangements, it might be necessary to perform clonality analysis for other forms of gene rearrangements including IgH or IgK and IgL in order to further improve the detection sensitivity.</p>

Surgical management of tumor in the conjunctive area among neck, thorax and axilla / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the surgical management of tumors in the conjunctive area among the neck, thorax and axilla and its efficacy.</p><p><b>METHODS</b>From Oct. 1999 to March 2006, eleven cases with benign tumors in the area between the neck, thorax and axilla were collected and analysed. Among them, five neurilemmoma, three neurofibroma, two chondroma and one meningioma, respectively. CT scans showed that the neck, thorax and axilla were affected simultaneously more or less. In this group, direct invasion to the vertebra was found in 4 cases, and spinal compression in one patient. After the disarticulation and displacement of the clavicle, the tumor was removed with the structures of importance in the neck, thorax and axilla under direct views. A bypass was constructed between the axillary vein and the medial end of the subclavian vein.</p><p><b>RESULTS</b>All these tumors were completely removed, injury of vertebral artery was encounter in two cases, and immediate repair was successfully carried out. No other serious complications were found in this group. During the follow-up period from 3 months to 3 years and 5 months, local recurrence was found in no patient.</p><p><b>CONCLUSIONS</b>Benign tumors in the area between neck, thorax and axilla could be successfully dissected and removed with displacement of the medial portion of the clavicle.</p>

Diagnosis and surgical management of metastatic diseases in retropharyngeal space / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the symptoms and surgical management results of metastatic disease in the retropharyngeal space.</p><p><b>METHODS</b>Six patients with malignant tumors were collected, in which enlarged lymph nodes presented both in neck and retropharyngeal space. They consisted of two supraglottic carcinoma (T3N2MO), one thyroid carcinoma (TXN2MO), one nasal melanoma (TXN2MO), one oropharyngeal carcinoma (T2N2M0) and one hypopharyngeal carcinoma (T3N2MO). The enlarged nodes in the retropharyngeal space were measured with CT and (or) MRI, which ranged from 1.5-2.5 cm in diameter. Based on the control of the primary and neck disease, the mass in the retropharyngeal space was dissected and sent for pathologic exam separately.</p><p><b>RESULTS</b>Metastasis in the retropharyngeal space was pathologically proved in all of them, along with the involved internal jugular lymph nodes of 3/15, 3/17, 4/19, 5/19, 6/20, and 6/23, respectively. No serious complications occurred, such as fistula and central nerve damage. The patient with hypopharyngeal carcinoma died of lung metastasis 2 years after operation. The one suffering nasal malignant melanoma was out of follow-up in the 14th months. The patient with oropharyngeal carcinoma locally relapsed in the 18th months and died at the 24th months postoperatively. The rest was alive with tumor free within the follow-up period from 2 to 4 years.</p><p><b>CONCLUSIONS</b>CT or Mifi are the mainstay of diagnosis of the metastatic disease in the retropharyngeal space and can he surgically controlled with safety.</p>

Expressions of wildtype-RET and RET/PTC rearrangements in sporadic adult papillary thyroid carcinoma and their clinicopathologic correlation / 中华病理学杂志

<p><b>OBJECTIVE</b>To evaluate the expressions of wildtype-RET (WT-RET) and RET/PTC in sporadic adult papillary thyroid carcinoma and to investigate their clinicopathologic correlation.</p><p><b>METHODS</b>Sixty-six papillary thyroid carcinomas (PTC) and thirty-six control cases with frozen and paraffin-embedded tissues were analyzed for the expressions of WT-RET and oncogene RET/PTC1 or RET/PTC3 by nested RT-PCR.</p><p><b>RESULTS</b>(1) 62 percent (41/66) of PTC patients were above 40 years of age. Thirty-eight percent (25/66) of the tumors showed lymphocytic thyroiditis. Lymph node and distant metastasis were seen in 59% (39/66) and 7.6% (5/66) respectively. (2) Forty-five cases (68.1%) of PTCs expressed RET tyrosine kinase domain (RET-TK). Simultaneous expressions of RET-BP and TK were seen in nineteen PTCs (28.8 %). One of eight adenomas (12.5 %) expressed wild-type RET (WT-RET). (3) Fourteen PTCs (21.2%) expressed RET/PTC, including five cases expressing RET/PTC1 and nine cases expressing RET/PTC3. Six cases (9%) expressed both RET/PTC and WT-RET. (4) Statistic analysis did not show any correlation between the expression of WT-RET or RET/PTC and clinicopathologic parameters.</p><p><b>CONCLUSIONS</b>The expression of RET/PTC was specific to PTC. However, its prevalence was low and, therefore, of limited diagnostic utility. The expression patterns of WT-RET in PTC and adenoma suggest that there are different molecular mechanisms in activating RET proto-oncogene in thyroid tumors.</p>