Research on the hierarchical supervision of national science and technology programs from the perspective of science and technology ethics / 中华医学科研管理杂志

Objective:This paper analyzed the current situation and issues of ethical supervision of science and technology projects supported by central financial funds and proposed countermeasures to improve project management.Methods:Considering the practical management experience of a key special project during the 13th Five-Year Plan period, this article investigated ethical supervision issues in various stages including guideline preparation, review and approval, process management, and final acceptance, and proposed four levels of review for ethical oversight according to the characteristics of the research projects and the degree of ethical risks involved.Results:Firstly, lower-risk projects should still be reviewed by the Institutional Ethics Committee, and the project implementation unit should primarily assume responsibility for ethical supervision and follow-up on the review. Second, in addition to the review by the Institutional Ethics Committee, the Project Management Institution should strengthen ethical supervision and take risk control measures at different nodes for sensitive projects and higher ethical risk projects. Third, projects with large ethical controversies and high-risk projects should be reviewed by the National Science and Technology Ethics Committee and a public participation discussion mechanism for major ethical issues should be established. Finally, it is suggested to conduct prospective ethical studies for cutting-edge new technologies and new fields.Conclusions:In the process of managing science and technology program projects, strengthening ethical oversight in the management of science and technology projects should both standardize relevant scientific and technological research activities and not impede the growth of scientific and technological innovation. In view of the differences in ethical risks that may be involved in different projects, hierarchical examination, and supervision measures should be taken to effectively guarantee the smooth implementation of science and technology planning projects.

The differential diagnosis of pulmonary infiltrates in cancer patients during the outbreak of the 2019 novel coronavirus disease / 中华肿瘤杂志

Objective@#To investigate the principles of differential diagnosis of pulmonary infiltrates in cancer patients during the outbreak of novel coronavirus (2019-nCoV) by analyzing one case of lymphoma who presented pulmonary ground-glass opacities (GGO) after courses of chemotherapy.@*Methods@#Baseline demographics and clinicopathological data of eligible patients were retrieved from medical records. Information of clinical manifestations, history of epidemiology, lab tests and chest CT scan images of visiting patients from February 13 to February 28 were collected. Literatures about pulmonary infiltrates in cancer patients were searched from databases including PUBMED, EMBASE and CNKI.@*Results@#Among the 139 cancer patients underwent chest CT scans before chemotherapy, pulmonary infiltrates were identified in eight patients (5.8%), five of whom were characterized as GGOs in lungs. 2019-nCoV nuclear acid testing was performed in three patients and the results were negative. One case was a 66-year-old man diagnosed as non-Hodgkin lymphoma and underwent CHOP chemotherapy regimen. His chest CT scan image displayed multiple GGOs in lungs and the complete blood count showed decreased lymphocytes. This patient denied any contact with confirmed/suspected cases of 2019-nCoV infection and without fever and other respiratory symptoms. Considering the negative result of nuclear acid testing, this patient was presumptively diagnosed as viral pneumonia and an experiential anti-infection treatment had been prescribed for him.@*Conclusions@#The 2019 novel coronavirus disease (COVID-19) complicates the clinical scenario of pulmonary infiltrates in cancer patients. The epidemic history, clinical manifestation, CT scan image and lab test should be combined consideration. The 2019-nCoV nuclear acid testing might be applicated in more selected patients. Active anti-infection treatment and surveillance of patient condition should be initiated if infectious disease is considered.

Efficacy and safety of vandetanib on advanced medullary thyroid carcinoma: single center result from a phase Ⅲ study / 中华耳鼻咽喉头颈外科杂志

Objective@#There is no effective therapy for patients with advanced medullary thyroid carcinoma (MTC). Vandetanib,a novel multitargeted receptor tyrosine kinase inhibitor, has previously shown antitumor activity in phase Ⅱ studies of patients with advanced MTC. This study was to evaluate the efficacy and the safety of vandetanib on advanced MTC.@*Methods@#This study was an open, international multi-center phase Ⅲ clinical trial and the study number was NCT01298323. The single-center study was a sub-group analysis of the international study, which was conducted on 9 pathologically confirmed advanced MTC patients by Cancer Hospital Chinese Academy of Medical Sciences between March 2012 and October 2017. Vandetanib (300 mg) was orally administered daily till death or withdrawal. The efficacy was evaluated according to RECIST criteria and the adverse events were evaluated according to NCI criteria.@*Results@#The objective response rate was 3/9,and the disease control rate was 4/9. The median progression-free survival was 44 months. All patients who had the elevated levels of calcitonin (CTN) and carcino-embryonic antigen (CEA) before treatment began to show the decreases in the level of CTN and CEA after 3 months and later showed again the increases in the levels of both tumor markers with tumor progression. By ROC curve analysis, CTN was of statistically significance(P<0.05, 95%CI 0.558-0.834), but CEA was not(P>0.05). Adverse events were generally mild (grade 1 or 2),including hypertension (9 cases),skin rash (9 cases), and diarrhea (6 cases). Two patients developed grade 3 elevation of serum glutamate pyruvate transaminase and one patient developed grade 3 elevation of drug-related bowel disease. No grade 4 drug-related adverse event occurred.@*Conclusions@#Vandetanib is effective and well tolerated for patients with locally advanced or metastatic MTC who have no chance for surgery. This indicates the increase of CTN is clinically relevant to disease progression, but the number of patients are extremely low, and, therefore further research is needed. Long-term use of vandetanib may cause resistance.

Retrospective analysis of the clinical features and prognostic factors of 370 patients with advanced-stage diffuse large B-cell lymphoma / 中华肿瘤杂志

Objective@#The clinical features and prognosis of diffuse large B-cell lymphoma (DLBCL) were analyzed to optimize the treatment.@*Methods@#We retrospectively collected the clinical data of patients with advanced-stage DLBCL from January 2006 to December 2012 in National Cancer Center/Cancer Hospital. The demographic characteristics, clinical stage, histological diagnosis, treatment and prognostic characteristics of these patients were analyzed.@*Results@#A total of 370 patients with median age of 55 years old were recruited in the study. The male-to-female ratio was 1.3∶1. Among the 361 patients who underwent therapy, 280 cases received chemotherapy alone, 65 cases received chemoradiotherapy, and 16 cases received chemotherapy combined with autologous hematopoietic stem cell transplantation (AHSCT). The median follow-up period was 89 months, the 5-year overall survival (OS) rate of the entire cohort was 42.9%. The 5-year OS rate of chemotherapy alone, chemoradiotherapy and chemotherapy combined with AHSCT were 36.8%, 58.5%, 87.5%, respectively. The 5-year OS rate were significantly different between chemoradiotherapy and chemotherapy alone (P=0.001), and between chemotherapy combined with AHSCT and chemoradiotherapy (P=0.040). Univariate analysis showed that the age, Eastern Cooperative Oncology Group performance status (ECOG PS) score, Ann Arbor stage, B symptom, bulky disease, number of extranodal sites, Ki-67 index, lactate dehydrogenase (LDH), β2-microglobulin (β2-MG), international prognostic index (IPI), therapeutic manner and chemotherapy combined with rituximab were significantly associated with the prognosis of advanced DLBCL patients (all P<0.05). Multivariate analysis demonstrated that the age >60 years, Ann Arbor stage IV, with B symptom, with bulky disease, ECOG PS≥1, Ki-67 index > 90%, CD5 expression, up-regulation of serum LDH and β2-MG, and chemotherapy without rituximab were related with the poor prognosis of patients with advanced-stage DLBCL (all P<0.05).@*Conclusions@#Chemotherapy combined with rituximab can improve the outcome of patients with advanced-stage DLBCL. The age, stage, B symptom, bulky disease, ECOG PS score, Ki-67 index, CD5 expression, LDH, β2-MG and chemotherapy combined with rituximab are associated with the prognosis of these patients.

Analysis on establishment of ISO9001 quality management system in project management institutions / 中华医学科研管理杂志

Objective To identify the importance of ISO9001 in project management and explore the procedure of establishing it,to provide reference for further practice.Methods According to prior studies,the formation procedure of this quality management system was described in detail.Results Quality management system could improve project management in multiple aspects,such as explicit regulation,orderly implementation,effective supervision,timely feedback and effective reform.Conclusions As the unique national project management institution on medical science and health,it is crucial to establish a institutionalized,standardized and international scientific research management system,especially on medical science and health field.

Advances on bacteria-associated hemophagocytic syndrome / 中国小儿急救医学

Bacteria-associated hemophagocytic syndrome( BAHS) is a rare and life-threatening he-matological system disease. Various bacteria can cause BAHS,but the prognosis is better than other types of hemophagocytic syndrome. This article described the etiology,pathogenies,diagnostic criteria,treatment and prognosis of BAHS,in order to raise awareness of the disease.

Study on the immunization status and its influencing factors among workers from the polio network laboratories in China / 中华流行病学杂志

Objective To Investigate the immune status and influencing factors of provincial polio network laboratory (PNL) workers in China so as to provide evidence for the development of related strategies to protect personnel working at the PNLs.Methods All the practitioners from the PNLs at the provincial centers for disease control,were selected as objects for this study,from October to December,2016,under a questionnaire survey.Information on status of immunity and influencing factors was collected,with SAS software,trend chi-square used for statistics analysis.Results A total of 77 workers were involved in this survey,with 60 (78％) of them completed the polio-based immune program but the rest 17 (22％) remained records unclear.66 people (about 86％) remembered clearly that they had received vaccination when engaging in the polio-lab work,but the rest 11 (14％) with only partial vaccination records.We also noticed that the Influencing factors realted to vaccination status were:age (x2 =2.48,P＜0.05),title (x2 =2.51,P＜0.05),years of employment (P＜0.000 1),education (x2 =0.74,P=0.46) and gender (x2 =0.46,P=0.50).Conclusion Immune status of the Chinese provincial PNL practitioners appeared fairly good as 86％ of all the workers had received polio-related vaccination,with 41％ of them completed a 3-time inoculation program,when started working in this field.

Study on the immunization status and its influencing factors among workers from the polio network laboratories in China / 中华流行病学杂志

Objective To Investigate the immune status and influencing factors of provincial polio network laboratory (PNL) workers in China so as to provide evidence for the development of related strategies to protect personnel working at the PNLs.Methods All the practitioners from the PNLs at the provincial centers for disease control,were selected as objects for this study,from October to December,2016,under a questionnaire survey.Information on status of immunity and influencing factors was collected,with SAS software,trend chi-square used for statistics analysis.Results A total of 77 workers were involved in this survey,with 60 (78％) of them completed the polio-based immune program but the rest 17 (22％) remained records unclear.66 people (about 86％) remembered clearly that they had received vaccination when engaging in the polio-lab work,but the rest 11 (14％) with only partial vaccination records.We also noticed that the Influencing factors realted to vaccination status were:age (x2 =2.48,P＜0.05),title (x2 =2.51,P＜0.05),years of employment (P＜0.000 1),education (x2 =0.74,P=0.46) and gender (x2 =0.46,P=0.50).Conclusion Immune status of the Chinese provincial PNL practitioners appeared fairly good as 86％ of all the workers had received polio-related vaccination,with 41％ of them completed a 3-time inoculation program,when started working in this field.

Duration of filgrastim prophylaxis for chemotherapy-induced neutropenia and its predictors / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To analyze the duration of preventive filgrastim administration as support for chemotherapy and its affecting factors.</p><p><b>METHODS</b>Single institutional data from a phase Ⅱ clinical trial and a phase Ⅲ clinical trial of pegylated filgrastim were combined. In the two randomized cross-over trials, patients with previously untreated cancer received two cycles of chemotherapy of the same regimen. In the study group, the patients received a single subcutaneous injection of 100 μg/kg pegylated filgrastim, and in the control group, they received daily subcutaneous injections of 5 μg/kg filgrastim.</p><p><b>RESULTS</b>In 53 chemotherapy cycles, the median duration of filgrastim administration was (9.57±2.10)d. 83.0% (44/53) of them received filgrastim for 7-11 days. Patients with baseline absolute neutrophil count of <4×10(9)/L or body mass index less than 22 received a longer filgrastim prophylaxis(P<0.05). RESULTS of multivariate analysis showed that the baseline absolute neutrophil count is associated with the time of filgrastim administration(P=0.019). The most common adverse event of rhG-CSF was skeletal pain, generally mild and no treatment-related death occurred.</p><p><b>CONCLUSIONS</b>The median duration of filgrastim support for chemotherapy was 10 days. Patients with lower baseline neutrophil count require a longer filgrastim prophylaxis.</p><p><b>TRIAL REGISTRATION</b>: ClinicalTrials.gov identifier, NCT01285219.</p>

Retrospective analysis of the clinical features and prognostic factors of 126 patients with primary gastric diffuse large B-cell lymphoma / 中国肿瘤临床

Objective:Primary gastric diffuse large B-cell lymphoma (PGLBCL) is a highly common subtype of extranodal non-Hodgkin lymphoma. We analyzed the disease's clinical features and prognosis to guide better treatment. Methods:We retrospectively collect-ed data from PGLBCL cases seen from January 1999 to March 2012 in one cancer center. We then analyzed the demographic character-istics, clinical stage, histological diagnosis, complications, treatment, and prognostic characteristics of such patients. Results:A total of 126 patients with median age of 49 years old (range:16-81 years) were included in the study. The male-to-female ratio was 68:58. A to-tal of 96 patients were pathologically diagnosed with pure diffuse large B-cell lymphoma (DLBCL), 27 with mucosa-assouated lymphoid (MALT) component, and 3 with plasmacytoid differentiation. Meanwhile, 90%of the patients were in the early stage of the disease. For the early-stage patients, treatment strategy included surgery+chemotherapy ± radiotherapy for 38 cases, chemoradiotherapy for 39 cases, chemotherapy alone for 37 cases, and surgery alone for 1 case. Under a median follow up of 48 months, the 4-year progres-sion free survival (PFS) and overall ourvival (OS) rate of the whole group were 75.6%and 82.7%, respectively. PFS rates for early and advanced stage patients were 77%and 41.7%(P=0.005), respectively. For the early-stage patients treated with chemotherapy alone, chemoradiotherapy, and surgery with therapy, the PFS rates were 67.3%, 77.8%, and 77.8%(P=0.588), respectively. The patients with international prognostic index (IPI) score of 0, 1, and>1 achieved PFS of 85.4%, 74.4%, and 55.6%(P=0.011), respectively. The PFS rates were 81.2%and 66.1%(P=0.018) for stagesⅠandⅡ, respectively, and 86.6%and 63.3%(P=0.006) for the normal and elevated LDH levels, respectively. The pathological type of pure DLBCL or a MALT component, GCB or non-GCB origin, and age more than 60 years old were not associated with prognosis. Conclusion:The majority of the PGLBCL patients were in the early stage of disease, but the outcome of early-stage disease was favorable. Surgery did not improve outcomes. Univariate analysis demonstrated that IPI score>1, stageⅡdisease, and elevated LDH levels were associated with poor prognosis in the early-stage patient.

Therapeutic efficacy of first-line CHOP or CHOP-like chemotherapy on patients with advanced staged angioimmunoblastic T-cell lymphoma / 白血病·淋巴瘤

Objective To evaluate the efficacy of first-line CHOP or CHOP-like regimen on patients with advanced staged angioimmunoblastic T-cell lymphoma (AITL).Methods Between Aug 2006 and Sep 2014,twenty-nine AITL patients who were newly diagnosed without prior treatment were included in study.The clinical features,efficacy and survival were analyzed retrospectively.Results Median age of these patients was 59 years old.All patients had stage Ⅲ/Ⅳ disease.17 (58.6 ％) cases presented with B symptoms.26 (89.7 ％) cases had an international prognostic index (IPI) score ≥2,and 20 (69.0 ％) cases had elevated LDH,9 (31.0 ％) cases had ≥2 extranodal involvements.The median follow-up time was 20 months.Overall response rate was 69.0 ％ (20/29).Five (17.2 ％) patients achieved complete remission (CR+CRu),15 (51.7 ％) patients achieved partial remission,and 3 (10.3 ％) patients had stable disease (SD),6 (20.7 ％) patients had progressive diseases(PD).Median progression-free survival (PFS) was 6 months.1-and 2-year PFS rates were 39.0 ％ and 20.0 ％.1-,2-and 5-year overall survival (OS) rates for all patients were 76.8 ％,53.4 ％ and 17.1％,respectively.PFS was significantly better in chemotherapy-sensitive patients (P ＜ 0.001).The responses to chemotherapy had a tendency of affecting the OS,but it failed to reach statistical significance (P ＞ 0.05).Conclusions The CHOP or CHOP-like regimen maybe induce unfavorable efficacy in AITL patients.Further therapeutic options are required to improve the outcome.

Efficacy and safety evaluation of gemcitabine combined with ifosfamide in patients with advanced nasopharyngeal carcinoma after failure of platinum-based chemotherapy / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of gemcitabine combined with ifosfamide (GI regimen)in patients with recurrent or metastatic nasopharyngeal carcinoma after failure of platinum-based chemotherapy.</p><p><b>METHODS</b>The clinical data of 27 nasopharyngeal carcinoma patients, who received GI regimen between April 2005 and March 2014 after failure of prior platinum-based chemotherapy, were retrospectively reviewed,and relevant prognostic factors were explored.</p><p><b>RESULTS</b>All patients were evaluable for efficacy and toxicity. No patient achieved complete response (CR). Partial response (PR) was achieved in ten patients, stable disease (SD) in thirteen patients, progressive disease (PD) in four patients, with a response rate of 37.0% and an overall disease control rate (PR+SD) of 85.2%. For ten PR patients, the median duration of response was 5.5 months. The median progression-free survival of the whole group was 6.7 months, and the Kaplan-Meier estimate of median overall survival was 17.4 months. The 1-year survival rate was 72.6%. Toxicity was mainly hematological: Grade III or IV anemia, neutropenia and thrombocytopenia were found in 3.7%, 37.0% and 18.5% of all patients, respectively. Univariate and multivariate analyses indicated that dose intensity of gemcitabine was a significant prognostic factor for PFS, whereas salvage treatment after failure of GI regimen was a significant prognostic factor for OS.</p><p><b>CONCLUSIONS</b>Gemcitabine and ifosfamide combination is effective and well tolerated by patients with advanced nasopharyngeal carcinoma pretreated with platinum-based chemotherapy. Further clinical study is warranted.</p>

Autologous peripheral blood stem cell mobilization following dose-adjusted cyclophosphamide, doxorubicin, vincristine, and prednisolone chemotherapy alone or in combination with rituximab in treating high-risk non-Hodgkin's lymphoma / 癌症

<p><b>BACKGROUND</b>The regimen of cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) is an efficient treatment of non-Hodgkin's lymphoma (NHL). This study aimed to assess the efficacy and toxicity of dose-adjusted CHOP alone or in combination with rituximab (R-CHOP) by examining the stem cell mobilization in NHL patients. Factors affecting the collection of CD34+ cells were also explored.</p><p><b>METHODS</b>Our retrospective study included 39 patients eligible for autologous stem cell transplantation: 14 patients who expressed CD20 and were financially eligible received R-CHOP for autologous peripheral blood stem cell (APBSC) mobilization; the remaining 25 patients received CHOP.</p><p><b>RESULTS</b>The median CD34+ cell yield was 7.01×10(6) cells/kg body weight (range 1.49-28.39×10(6) cells/kg body weight), with only two patients failing to meet the target CD34+ cell harvest of ≥2.0×10(6) cells/kg body weight. The median number of apheresis procedures per patient was 1 (range 1-3). The APBSC mobilization yield of the CHOP group appeared to be higher than that of the R-CHOP group (P=0.005), whereas the success rate was similar between groups. R-CHOP elevated the complete response (CR) rate in B cell lymphoma patients as compared with CHOP (P=0.01). No significant differences in toxicity or engraftment were observed between the two groups.</p><p><b>CONCLUSION</b>The present study demonstrated that dose-adjusted CHOP chemotherapy effectively mobilized APBSCs in NHL patients and that the addition of rituximab to dose-adjusted CHOP chemotherapy elevated the CR rate for patients with B-cell lymphoma.</p>

Efficacy analysis of pegylated filgrastim as prophylaxis for chemo-therapy-induced neutropenia / 中国肿瘤临床

Objective:To compare the efficacy of a single injection of pegylated filgrastim with daily doses of filgrastim as pro-phylaxis for chemotherapy-induced neutropenia in Chinese cancer patients. Methods:Single-institution data from a phase 2 study and a phase 3 trial on pegylated filgrastim were combined to analyze the efficacy and safety parameters. In the two randomized crossover tri-als, patients with previously untreated cancers received two cycles of chemotherapy with identical regimen. In the study cycle, the pa-tients received a single subcutaneous injection of pegylated filgrastim (100 μg/kg), whereas those in the control cycle received daily subcutaneous injections of filgrastim (5μg/kg). Results:Among the 56 patients enrolled, 53 were evaluable for efficacy. These patients received one cycle with pegylated filgrastim prophylaxis and one cycle with filgrastim support each. Results indicated that 94.3%(50/53) of the cycles with pegylated filgrastim or filgrastim support did not develop grade 4 neutropenia. Moreover, febrile neutropenia did not occur in the cycles. The incidence rates of antibiotic administration were 7.5%(4/53) and 3.8%(2/53) in the pegylated filgrastim and filgrastim cycles, respectively (P=0.678). The median duration of filgrastim administration was 10 days (3-14 days). Generally, the safety profile of pegylated filgrastim is similar to that of filgrastim, including skeletal pain, pain at the injection site, palpitation, fever, and fatigue. Conclusion:A single dose of pegylated filgrastim demonstrated comparable efficacy with 10 consecutive doses of filgras-tim as prophylaxis for chemotherapy-induced neutropenia.

Clinical features and prognostic analysis of mantle cell lymphoma patients / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To analyze the clinical features, therapeutic outcome and prognostic factors of mantle cell lymphoma (MCL).</p><p><b>METHODS</b>Clinical data of a total of 68 patients with MCL admitted from August 2003 to June 2013 in our department were retrospectively analyzed.</p><p><b>RESULTS</b>Of all the patients, the median age was 58.5 years, with marked male predominance (2.8:1), 59 patients (86.8%) were in Ann Arbor stage III/IV. 56 cases (82.4%) primarily showed lymph node involvement, 49 cased showed extranodal involvement and 19 cases (38.8%) had bone marrow involvement. Patients were followed up for 4 to 122 months with a median follow up time of 35 months. The 3- and 5-year overall survival (OS) rates were 78.5% and 64.1%, respectively. The 2- and 3-year progression-free survival (PFS) rates were 41.3% and 23.7%, respectively, and the median time to progression was 20.0 months. The overall response rate (ORR) of CHOP regimen was superior to that of intense regimens (P = 0.036). Univariate analysis showed that stage III/IV,IPI score of 3-5, expression of Ki-67 higher than 30%, elevated LDH, elevated β2-MG, blastic variant, more than 5 lymph nodes involved, and failure to chemotherapy were the negative factors. Multivariate analysis showed that Ki-67 index, LDH and the response to chemotherapy were independent factors affecting survival.</p><p><b>CONCLUSIONS</b>Most patients with MCL were elderly males with advanced stage and usually had bone marrow involvement. Although ORR of CHOP regimen is superior to intense regimens, the prognosis of MCL remains poor.</p>

Efficacy analysis of different follow-up methods in detecting first recurrence of lymphoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>This study aimed to evaluate the value of different follow-up methods for the detection of first recurrence in lymphoma patients in first complete remission (CR), and to find reasonable long-term follow-up strategies.</p><p><b>METHODS</b>We retrospectively analyzed 277 lymphoma patients who achieved CR after first-line therapies and subsequently relapsed. All patients were divided into routine surveillance imaging group (group A) and irregular imaging follow-up visit group (group B). To compare the two groups of patients with tumor burden (tumor diameter and number of tumor invasion areas) at the time of relapse, and the number of imaging scans before the relapse. To analyze the main ways of finding lymphoma relapse in the two groups.</p><p><b>RESULTS</b>Among a total of 277 patients, there were 187 patients in the group A and 90 patients in the group B. The tumor recurrence occurred in 120 cases (43.3%) within the first year, and 76 patients (27.4%) in the second year. At the time of diagnosis of recurrence, the average maximum diameter of tumors in the groups A and B were (3.2 ± 2.2) cm and (3.8 ± 2.9) cm, respectively (P = 0.123). The two groups showed slight difference in number of tumor invasion areas (P = 0.050). At the time of diagnosis of recurrence, there were 3 of 121 patients (2.5%) with maximum diameter of tumors more than 8 cm in the group A and 6 of 49 cases (12.2%) in the group B (P = 0.018). In the group A, the patients had in average 4.9 times of imaging scans before recurrence, significantly more than the 0.22 times in the group B (P < 0.001). Among all patients, the diagnosis of recurrence was based on imaging scans only in 59 patients (21.3%).</p><p><b>CONCLUSIONS</b>Most lymphoma patients do not benefit from routine surveillance imaging to detect the tumor recurrence. It indicates that we should not rely solely on imaging examinations at follow-up visits, and should pay more attention on clinical signs and symptoms.</p>

Efficacy and safety evaluation of gemcitabine combined with oxaliplatin in lymphoma patients after failure of multiple chemotherapy regimens / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of gemcitabine combined with oxaliplatin (GEMOX) in lymphoma patients after failure of multiple chemotherapy regimens.</p><p><b>METHODS</b>The clinical data of 27 lymphoma patients, who received GEMOX regimen after failure of two or more prior chemotherapy regimens, were retrospectively reviewed. The predictive factors related to the clinical efficacy of GEMOX regimen were explored.</p><p><b>RESULTS</b>The efficacy could be evaluated in 24 patients. Complete response was obtained in 4 patients (16.7%), partial response in 7 patients (29.1%), stable disease in 6 patients (25.0%), and progressive disease in 7 patients (29.1%), with an overall response rate of 45.8%. Among the eleven CR and PR patients, four patients were with diffuse large B cell lymphoma, four patients with Hodgkin's lymphoma, one with peripheral T cell lymphoma, one with mantle cell lymphoma and one with gastric mucosa-associated lymphoid tissue lymphoma. The median PFS time of the whole group was 8 months (95%CI, 1.6-14.4 months). For 11 CR and PR patients who had response to the GEMOX regimen, the median PFS time was 19 months (95%CI, 11.1-26.8 months). Major adverse response was hematologic toxicity. Among them, grade III or IV neutropenia appeared in 16 patients (59.3%), and grade III or IV thrombocytopenia appeared in 11 patients (40.7%). The sensitivity to the last chemotherapy was related to the efficacy of GEMOX regimen. The response rate was 83.3% in patients who had response to the last chemotherapy, and only 31.2% in the patients who failed to the last chemotherapy (P = 0.001).</p><p><b>CONCLUSIONS</b>GEMOX regimen can get a better response rate in lymphoma patients after failure of multiple chemotherapy regimens, and with a good tolerance and acceptable safety. Some patients can get long-term survival. Patients sensitive to the last chemotherapy are more likely to benefit from GEMOX regimen.</p>

Contamination with minimal residual disease in autologous peripheral stem cell collected from Non-Hodgkin's lymphoma patients treated with high-dose therapy / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To detect the contaminating minimal residual disease (MRD) in autologous peripheral blood stem cells (APBSC) and evaluate its impact on the prognosis of non-Hodgkin's lymphoma NHL patients.</p><p><b>METHODS</b>Minimal residual disease was detected in 72 APBSC samples from 33 NHL patients through PCR or PCR combined with DNA single-strand conformation polymorphism analysis (SSCP) with the BCL-2/IgH, clonal rearrangement of IgH and TCR gamma gene as markers. Minimal residual disease was also monitored in bone marrow samples collected pre-, post-induction chemotherapy and post-transplantation.</p><p><b>RESULTS</b>MRD was positive in 17/72 (23.6%) APBSC samples. The incidence of positive MRD in bone marrow pre-, post-induction chemotherapy and post-transplantation was 44.0% (11/25), 28.1% (9/32) and 11.5% (3/26) respectively. Six (66.6%) of 9 patients with positive MRD in pre-mobilization bone marrow, compared with 2 (8.7%) of 23 patients with negative MRD in bone marrow, were positive in contamination (P < 0.01). The estimated overall 3-year post-transplantation survival rate for patients with positive and negative MRD in their APBSC would be 71.4% and 71.2% respectively, and the estimated 3-year disease free survival rates of 25.0% and 61.5% respectively (P = 0.53).</p><p><b>CONCLUSION</b>APBSC collected from NHL patients after mobilization by chemotherapy combined with colony stimulating factor may be contaminated by lymphoma cells. The presence of minimal residual disease in bone marrow at mobilization may increase the incidence of APBSC contamination.</p>

The treatment and prognosis of patients with phyllodes tumor of the breast / 中国普通外科杂志

ObjectiveTo study the treatment and prognosis of the breast phyllodes tumors.MethodsKG1Clinical data, and the results of follow-up in 203 cases of breast phyllodes tumors were analyzed using Logistic analysis and Cox regression in SPSS statistic software.ResultWT5”BZLocal recurrence and tumor mortality were in direct proportion to the pathologic grade of the tumor. There was a direct proportion between local recurrence and tumor infiltration; and between tumor caused-mortality and tumor mitosis and necrosis.Mitotic activity and tumor necrosis were the independent prognostic factors. After surgical resection 21 1% of patients with benign tumor, 45 2% of patients with borderline tumor, 64 3% of patients with malignant tumor suffered recurrence. The 5-year survival rate was 100% in patients with benign phyllodes tumor, 92 0% with borderline tumor, and 33 3% with malignance.KG2Conclusion Local excision is not the appropriate treatment for phyllodes tumor. Patients with benign or borderline phyllodes tumor should undergo wide local excision including a margin of uninvolved tissue, and that with local recurrent borderline and malignant phyllodes tumor receive mastectomy.

Anti-ulcer actions on Shuangpu Powder / 中成药

AIM: To study the anti-ulcer actions of the clinic experience prescription Shuangpu Powder and to provide experimental basis for further application. METHODS: Four kinds of experimental rodent ulcer models including aqueous extract excitability ulcer in rats,pyloric ligational ulcer in rats,hydrochloric acid-alcohol induced ulcer in rats and indomethacin induced ulcer in mice were used to observe its actions of anti-ulcer of Shuangpu Powder. RESULTS: The results showed that the Shuangpu Powder significantly decreased ulcer formation induced by stress,pylorus ligation,hydrochloric acid-alcohol and indomethacin. CONCLUSION: Shuangpu Powder has obvious anti-ulcer actions.