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BACKGROUND@#Lung cancer has been the leading cause of cancer-related deaths worldwide for many years. This study aimed to investigate the global patterns and trends of lung cancer.@*METHODS@#Lung cancer incidence and mortality were derived from the GLOBOCAN 2020 database. Continuous data from Cancer Incidence in Five Continents Time Trends were used to analyze the temporal trends from 2000 to 2012 using Joinpoint regression, and average annual percent changes were calculated. The association between the Human Development Index and lung cancer incidence and mortality was assessed by linear regression.@*RESULTS@#An estimated 2.2 million new lung cancer cases and 1.8 million lung cancer-related deaths occurred in 2020. The age-standardized incidence rate (ASIR) ranged from 36.8 per 100,000 in Demark to 5.9 per 100,000 in Mexico. The age-standardized mortality rate (ASMR) varied from 32.8 per 100,000 in Poland to 4.9 per 100,000 in Mexico. Both ASIR and ASMR were approximately twice higher in men than in women. The ASIR of lung cancer showed a downward trend in the United States of America (USA) between 2000 and 2012, and was more prominent in men. The age-specific incidence rates of lung cancer for ages of 50 to 59 years showed an upward trend in China for both men and women.@*CONCLUSIONS@#The burden of lung cancer is still unsatisfactory, especially in developing countries like China. Considering the effectiveness of tobacco control and screening in developed countries, such as the USA, there is a need to strengthen health education, accelerate the establishment of tobacco control policies and regulations, and improve early cancer screening awareness to reduce the future burden of lung cancer.
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Male , Humans , Female , Middle Aged , United States , Incidence , Lung Neoplasms/epidemiology , Linear Models , China/epidemiologyABSTRACT
Objective:To evaluate the efficacy and safety of Osimertinib in the second-line and above treatment of elderly patients with advanced lung adenocarcinoma with epidermal grouth factor receptor(EGFR)mutation.Methods:A retrospective analysis of 51 elderly patients with advanced lung adenocarcinoma aged 65 years and over was performed.EGFR gene mutations were detected at baseline.The patients were treated with Osimertinib as second or later-line treatment after disease progression on prior epidermal growth factor receptor tyrosine kinase inhibitor(EGFR-TKI)therapy.Results:The median age of the patients was 72 years old, and the median progression-free survival(PFS)with Osimertinib was 13 months(95% CI: 10.8-15.2 months). Patients with exon 19 deletion(19del)treated with Osimertinib had longer PFS than patients with EGFR 21 exon L858R mutation(12 vs.24 month, P=0.028). In patients with EGFR resistance mutation T790M(T790M-positive), the PFS of patients with 19del combined with T790M(19del / T790M-positive)was better than that of patients with L858R combined with T790M(L858R / T790M-positive)(10 vs.28 months, P=0.029). After Osimertinib treatment, 43.8% of patients had brain or meningeal progression.The most commonly used agents for treatment after resistance to Osimertinib are antiangiogenic drugs.The common adverse reactions of Osimertinib were diarrhea(31.4 %), followed by dry skin with itching(29.4%)and rash(25.5 %). Most adverse reactions were grade 1 to 2, and one patient discontinued the drug intermittently due to grade 3 hematological adverse reactions. Conclusions:Osimertinib is effective and well tolerated in elderly patients with advanced EGFR-mutant lung adenocarcinoma.
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Objective:To analyze the postoperative paravertebral muscle degeneration and its correlations with health related quality of life (HRQL) in patients undergoing minimally invasive surgery-transforaminal lumbar interbody fusion (MIS-TLIF).Methods:The clinical data of the 50 patients were retrospectively analyzed who had undergone single-segmental MIS-TLIF at Department of Spinal Cord Surgery, The People's Hospital of Henan Province from January 2019 to December 2021. The relative volumes of lumbar posterior muscle (LM), the relative volumes of the psoas major (PM), and the rates of fatty degeneration (FD) of the fused segment and its adjacent segments were compared respectively between preoperation, 6 and 12 months postoperation. The correlations were analyzed between the HRQL scores [visual analog scale (VAS) for pain and Oswestry disability index (ODI)] and the relative LM volumes, the relative PM volumes, and the FD rates of the fused segment and its adjacent segments at 12 months postoperation.Results:Compared with the preoperative values, the relative LM volumes and the relative PM volumes of the fused segment and its adjacent segments at 6 and 12 months postoperation were significantly reduced while the FD rates significantly increased. However, the FD rate of the fused segment at 12 months postoperation (20.6% ± 6.1%) was significantly lower than that at 6 months postoperation (29.7% ± 8.2%) ( P < 0.05). The VAS score was strongly negatively or positively correlated with the relative LM volume ( r = -0.819, P < 0.001) and the FD rate ( r = 0.86, P < 0.001) of the fused segment, and moderately negatively correlated with the relative PM volume ( r = -0.435, P = 0.016). The ODI index was moderately negatively correlated with the relative LM volume ( r = -0.512, P = 0.004) and the relative PM volume ( r = -0.402, P = 0.020) of the fused segment, but moderately positively correlated with the FD rate of the fused segment ( r = 0.565, P = 0.001). There was a moderate negative correlation between the ODI index and the relative LM volume of the adjacent segments ( r = -0.478, P = 0.012). Conclusions:After MIS-TLIF, the volume of the paravertebral muscles decreases and the dorsal muscles develop fatty degeneration. The improvement of LM fatty degeneration may be observed by 12-month follow-up in the fused segment, but not in the adjacent segments. The LM volume and the FD rate of the fused segment are the most closely related to the postoperative HRQL.
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BACKGROUND@#Immune checkpoint inhibitors (ICIs) improved survival of partial patients with lung squamous cell carcinoma (LUSC). However, it was still insufficient of data in older patients. This study aimed to investigate the efficacy and toxicity of immunotherapy in patients with LUSC in Chinese population of real world.@*METHODS@#A total of 185 LUSC patients underwent pathological diagnosis were involved from January 2018 to January 2022. Patients were divided into elderly group (age ≥70 years) and younger group (age <70 years). The efficacy of mono-immunotherapy or combined with chemotherapy to chemotherapy in first-line treatment was compared. The expression of programmed cell death ligand 1 (PD-L1) and tumor mutational burden (TMB) were evaluated. Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 was used to evaluate the efficacy, and Common Terminology Criteria for Adverse Events (CTCAE) version 4.03 was used to evaluate immune-related adverse. Kaplan-Meier and Log-rank test was performed. Cox regression was used in prognostic analysis.@*RESULTS@#Combined therapy acquired significantly higher overall response rate (ORR) compared with chemotherapy alone in elderly group (P<0.05), and also in younger group, despite the difference was not significant (P>0.05). The median progression-free survival (mPFS) and median overall survival (mOS) in elderly group were similar with younger group (P>0.05). Both combined group and immunology alone demonstrated prolonged mPFS in first-line compared with chemotherapy in elderly group. And combined group demonstrated significantly prolonged mPFS compared with chemotherapy in younger group (P<0.01). There was no difference of mOS between different regimes in two groups. Elderly LUSC patients had higher PD-L1 positive rate (≥1%) and similar TMB compared with younger group. There was no relationship between mPFS and mOS with the expression of PD-L1 and TMB. Immunology combined with chemotherapy demonstrated better mPFS compared to chemotherapy in first-line therapy with TMB-High (P<0.05), and inferior mPFS with TMB-Low despite the difference was not significant (P>0.05). Cox regression model demonstrated that clinical stage was an independent predictor and prognostic factor. The incidence of immune-related adverse was 58.0% (51/88) and grade 3 or above 25.0% (22/88). The most common grade 3 adverse events were rash, immune-associated pneumonia, and fatigue.@*CONCLUSIONS@#Immunology combined with chemotherapy increased ORR, mPFS and mOS of Chinese patients with LUSC in first-line therapy compared with chemotherapy. There was no difference of efficacy and adverse effects rate between elderly group and younger group. The adverse effects of immunology in elderly patients with LUSC were controllable.
Subject(s)
Aged , Humans , B7-H1 Antigen/analysis , Biomarkers, Tumor , Carcinoma, Non-Small-Cell Lung/pathology , Carcinoma, Squamous Cell/drug therapy , China , Lung/pathology , Lung Neoplasms/pathologyABSTRACT
Objective:Immunologic characteristics of differed between younger and older patients.This study aimed to screen potentially key genes related to tumor-infiltrated immune cells(TIICs)in senile patients with lung adenocarcinoma(LUAD).Methods:In this retrospective study, the gene expression data for the training set were extracted from the Cancer Genome Atlas(TCGA)database, and the GSE72094 data set from Gene Expression Database was selected as the validation set.The 91 LUAD patients aged ≥75 years and 14 matched normal samples were screened for analysis.The components of tumor infiltrated immune cells(TIICs)were estimated by the deconvolution algorithm.Then a weighted gene co-expression network analysis was conducted in the training set so as to identify key genes correlating to TIICs.The GSE72094 dataset was used for validation.Results:In elderly patients with LUAD, the high expressions of IKZF1 and PRKCB were related to autoimmune diseases and T cell receptor signaling pathway.And their gene encoding proteins could interact with various immunomodulatory factors, such as IL2RB, LCK, and CD5.In the high expression group of IKZF1 and PRKCB, the expression levels of immunological checkpoint genes such as PD-L1, PD-1 and CTLA-4 were significantly higher than those of the low expression group(all P<0.01). The results of the validation set showed that CD8 + T cells were significantly correlated with the expression of IKZF1( r=0.75, P<0.01)and PRKCB( r=0.65, P<0.01). Conclusions:The expressions of IKZF1 and PRKCB in the tumor tissues are related to tumor infiltrating CD8 T cells and expression of immune checkpoint genes in elderly patients with LUAD.
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Objective:To investigate clinical features, diagnosis and treatment of angioimmunoblastic T-cell lymphoma(AITL)in middle and old age patients.Methods:This was a retrospective study.A total of 33 middle-aged and elderly patients(a median age of 64 years, range 47~85 years)with AITL admitted to our hospital from May 2008 to March 2017, including 54.5% male(18 cases), were enrolled in this study.Clinical manifestations, pathology, imaging and survival data of patients were collected.The objective response rate(ORR)of patients with different therapeutic regimens was analyzed.The survival analysis was conducted by using the Kaplan-Meier method, the survival rate was analyzed by using the Log-rank method, and multivariate analysis was conducted by using the proportional hazards regression model.Results:The median overall survival(OS)was 26.0 months(8.5-43.5 months). The 1-year, 3-year and 5-year OS rate was 66.7%(22 cases), 45.5%(15 cases)and 24.2%(8 cases), respectively.The ORR of first-line chemotherapy with CHOP-like regimens(cyclophosphamide, doxorubicin, vincristine, prednisone)was 65.5%(19/29)and the incidence of serious adverse reactions was 64.5%(20/31). Single-factor chi-square testing showed that age ≥60 years, Barthel score ≥90, Eastern Cooperative Oncology Group performance status score(ECOG-PS)≥2, anemia, International prognostic index(IPI)score of 4~5, receiving chidamide treatment were influncing factors for the prognosis in middle-aged and elderly patients with AITL( χ2=5.103, 4.306, 6.004, 4.030, 6.348 and 4.080, P<0.05). Cox multivariate analysis showed that age ≥60 years and receiving chidamide treatment were independent prognostic factors affecting the 5-year survival rate of middle-aged and elderly AITL patients( OR=0.313 and 4.964, P<0.05). That the OS was better in the group receiving chidamide treatment than in the group without chidamide treatment( P<0.05). Conclusions:Clinical features of AITL are diverse and lack of specificity.Most patients present with advanced stage AITL at the initial diagnosis.The 5-year OS rate is low.AITL patients aged over 60 years have a poor prognosis.Chidamide can improve the OS rate.
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Objective To investigate the clinical characteristics of advanced lung adenocarcinoma patients with different epidermal growth factor receptor(EGFR) mutation status, and to analysis the efficacy of first line epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) for these patients. Methods The clinical data of 193 advanced lung adenocarcinoma patients with EGFR gene sensitive mutation (exon 19 deletion and exon 21 L858R mutation) were collected in the Beijing Hospital from January 2011 to December 2015.The relationship between EGFR mutation status and objective response rate (ORR), progression free survival (PFS) were analyzed. Results Of the 193 patients, 104 patients expressed exon 19 deletion, 89 patients expressed exon 21 L858R mutation.Compared with the patients with EGFR exon 21 L858R mutation, the patients with EGFR exon 19 deletion were younger, and the patients younger than 60 years old accounted for 47.1 %(49/104),while the L858R point mutation in this age group was 28.1 %(25/89),and the difference was statistically significant (χ2= 7.343, P = 0.007), but there were no significant differences in gender, smoking status, and metastasis site (all P>0.05). The ORR of patients with exon 19 deletion were same to those of patients with exon 21 L858R mutation [71.2 % (47/66) vs. 61.1 % (33/54), χ2= 1.364, P= 0.243]. The median PFS of patients with exon 19 deletion was significantly higher than that of patients with exon 21 L858R mutation (11.0 months vs. 8.6 months, U= 1.984, P = 0.046). Conclusions Lung adenocarcinoma with EGFR exon 19 deletion is associated with longer PFS compared with those with exon 21 L858R mutation. Different mutation status of EGFR can be used as a predictor of PFS in patients with advanced lung adenocarcinoma treated with first-line EGFR-TKI.
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Objective To investigate the imaging features of the elderly patients with GGN and to guide the follow-up.Methods Thirty-four cases of elderly patients with pulmonary GGN were enrolled in this study, including 14 cases of adenocarcinoma in situ(AIS)and 20 cases of invasive adenocarcinoma(IAC).The clinical characteristics of these patients were analyzed and compared.The CT imaging features of burr sign, lobulated sign,pleural retraction sign,vacuole sign and solid component were analyzed by two doctors via blind method.The average diameter,volume,mass,volume doubling time(VDT)and mass doubling time(MDT)of GGN were measured and calculated by software layer by layer overlay model.Results There were no statistically significant differences between the group AIS and group IAC in age,gender,smoking history(P>0.05);The burr sign,lobulated sign,vacuole sign,pleural retraction sign and the average diameter had no significant difference(P>0.05).There were statistically significant difference between the group AIS and group IAC in the solid component incidence(14.3%,65%,P=0.003),volume((714.4+261.8)mm3,(927.2 ±259.7)mm3,t= 2.344,P= 0.025),mass((376.4 ± 144.0)mg,(586.8 ± 182.0)mg,t= 3.600,P=0.001),volume doubling time((1511.1± 1098.2)d,(654.1± 229.0)d,t=-2.876,P=0.012),quality doubling time((1427.4±989.3)d,(540.4±190.7)d,t=-3.312,P=0.005).Conclusion The signs of solid components,volume,mass,VDT,MDT can be used as an important basis for identification of AIS and GGN in the elderly patients.The treatment of the elderly patients with GGN should be based on the basic diseases,life expectancy,surgical risk and imaging features of the elderly patients,so as to give more appropriate treatment strategies for the elderly patients.
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Objective To investigate the imaging features of the elderly patients with GGN and to guide the follow-up.Methods Thirty-four cases of elderly patients with pulmonary GGN were enrolled in this study, including 14 cases of adenocarcinoma in situ(AIS)and 20 cases of invasive adenocarcinoma(IAC).The clinical characteristics of these patients were analyzed and compared.The CT imaging features of burr sign, lobulated sign,pleural retraction sign,vacuole sign and solid component were analyzed by two doctors via blind method.The average diameter,volume,mass,volume doubling time(VDT)and mass doubling time(MDT)of GGN were measured and calculated by software layer by layer overlay model.Results There were no statistically significant differences between the group AIS and group IAC in age,gender,smoking history(P>0.05);The burr sign,lobulated sign,vacuole sign,pleural retraction sign and the average diameter had no significant difference(P>0.05).There were statistically significant difference between the group AIS and group IAC in the solid component incidence(14.3%,65%,P=0.003),volume((714.4+261.8)mm3,(927.2 ±259.7)mm3,t= 2.344,P= 0.025),mass((376.4 ± 144.0)mg,(586.8 ± 182.0)mg,t= 3.600,P=0.001),volume doubling time((1511.1± 1098.2)d,(654.1± 229.0)d,t=-2.876,P=0.012),quality doubling time((1427.4±989.3)d,(540.4±190.7)d,t=-3.312,P=0.005).Conclusion The signs of solid components,volume,mass,VDT,MDT can be used as an important basis for identification of AIS and GGN in the elderly patients.The treatment of the elderly patients with GGN should be based on the basic diseases,life expectancy,surgical risk and imaging features of the elderly patients,so as to give more appropriate treatment strategies for the elderly patients.
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Objective To observe the efficacy and safety of albumin bound paclitaxel in the treatment of retreatment advanced non-small-cell lung cancer (NSCLC).Methods Retreatment NSCLC patients failed from first line regimen or beyond were treated with albumin bound paclitaxel weekly by intravenous dose of 130 mg/m2 on day 1 and day 8,with a 21-day cycle.Efficacy was evaluated every two cycles and side effects were observed during each cycle.Results None of 69 patients achieved complete remission (CR),15 patients (21.7 ％) achieved partial remission (PR),and 23 patients (33.4 ％) achieved stable disease (SD).Objective response rate (ORR) was 21.7 ％,disease control rate (DCR) was 55.1％,and progress free survival (PFS) time was 3.8 months.Efficacy was not correlated with gender,age,histology and lines of previous treatment (all P ＞ 0.05).Main adverse reactions included neutropenia,alopccia and neurotoxicity,which were all tolerable.Conclusion Weekly albumin bound paclitaxel is effective and well tolerated in the treatment of retreatment advanced NSCLC,which can be considered as the second line or beyond regimen.
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Objective:In order to provide policy-makers with basis and reference for improving the operational efficiency of county general public hospitals, this paper studies the changes in overall efficiency, technical efficiency and scale efficiency of 40 county general public hospitals in Fujian province from 2009 to 2014 , as well as how the to-tal factor productivity changes over the time. Methods: After collecting the relevant data of hospital operations from 2009 to 2014, this paper uses CCR, BBC, Malmquist model and other data envelopment analysis (DEA) methods to analyze the data. Results:The vast majority of those 40 county general public hospitals are in decreasing state. The total factor productivity of 40 hospitals from 2009 to 2014 is 1. 019. There are 21 hospitals (52. 5%) that slightly im-proved their productivity, of which 3 hospitals increased their productivity mainly due to technological progress, 3 hospitals due to efficiency increase, and the rest 15 hospitals due to the effect of both technological progress and effi-ciency increase. Conclusions:The operational efficiency of county general public hospitals in Fujian province is gen-erally insufficient, and there are significant differences between operating efficiency of different regions. The efficien-cy of hospitals in mountainous areas had increased, but the efficiency of hospitals in coastal areas had decreased. Therefore, in order to increase investment in county general public hospitals, the government should take differential policy and pay attention to the reasonable control of hospital size, as well as to strengthen the connotation building and attach importance to improving medical service technologies.
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<p><b>OBJECTIVE</b>The aim of this study was to establish a standardized protocol for detection of ALK protein expression and gene fusion in cytologic specimens.</p><p><b>METHODS</b>Lung adenocarcinoma cytologic specimens were collected from seven hospitals in Beijing city. A detection protocol for ALK protein expression and gene fusion was designed according to the results of comparative experiment. Ventana immunohistochemical (IHC) ALK(D5F3) detecting ALK protein expression was performed in 203 prepared formalin-fixed paraffin-embedded (FFPE) cell blocks. ALK gene fusion in 98 EGFR gene wild type cytologic specimens and in 4 bronchoalveolar lavage fluid (BL) samples was detected by quantitative reverse transcription polymerase chain reaction (qRT-PCR). ALK gene fusion in the Ventana IHC ALK (D5F3) positive samples was further tested by fluorescence in situ hybridization (FISH). Six patients with ALK IHC-positive result were followed up to analyze the responses of crizotinib therapy. Comparative experiments: (1) Comparison of the results of 4% neutral buffered formalin fixed for different time (24 h, 48 h, 72 h) on the Ventana IHC ALK (D5F3) staining was conducted in two cases of IHC ALK positive FFPE cell blocks; (2) Comparing qRT-PCR results for ALK fusion in samples from FFPE cell blocks and cytospin prepared slides in 10 cases of lung adenocarcinoma cytologic specimens.</p><p><b>RESULTS</b>Among the specimens examined using the standardized protocol recommended by this study, 229 cases of cytologic specimens met the diagnostic criteria of lung adenocarcinoma. Among them, 207 cases obtained ALK gene test results (by at least one method), with an ALK test ratio of 90.4% (207/229). FFPE cell blocks were successfully prepared in 203 cases, Ventana IHC ALK (D5F3) were successfully performed in all the 203 FFPE cell blocks (100%), and the ALK protein positive detection rate was 10.3% (21/203). ALK fusion was tested in 98 FFPE cytologic samples of EGFR wild types by qRT-PCR, and 96 out of 98 (97.96%) cytologic samples were successfully performed.18 out of 19 IHC ALK-positive cases were verified to be of ALK fusion status by qRT-PCR. The concordance rate was 94.7% (Kappa=0.967, P<0.001) between Ventana IHC ALK (D5F3) and qRT-PCR, and the sensitivity of the Ventana IHC ALK (D5F3) assay compared with qRT-PCR was 100% and the specificity was 98.7%. FISH assay was used to verify the positive cases detected by Ventana IHC ALK (D5F3) staining. Two cases of low tumor cell content FFPE samples obtained indefinite results by FISH test. The six patients with positive ALK protein expression received crizotinib therapy, and 5 paitents got treated effectively. For two ALK IHC positive cases, which were 4% neutral buffered formalin fixed for 72 h, the result of Ventana IHC ALK (D5F3) staining became weakened obviously and uneven. In 10 cases of samples, total RNA was extracted from FFPE cytologic sections and cytospin prepared slides, and the results of qRT-PCR test and ALK gene fusion showed good concordance.</p><p><b>CONCLUSIONS</b>The standardized protocol recommended in this study expands the detection types and quantity of cytologic specimens for ALK protein expression and gene fusion and increased the detection rate. Ventana IHC ALK (D5F3) is a reliable method for detecting ALK protein expression in FFPE cell blocks. The pathologic quality control procedure prior to Ventana IHC ALK (D5F3) is crucial for the accuracy of testing the ALK gene status. When FFPE cell blocks could not be prepared or prepared unsuccessfully from the cytologic specimens, qRT-PCR may be an alternative option for the detection of ALK gene fusion.</p>
Subject(s)
Humans , Adenocarcinoma , Drug Therapy , Genetics , Pathology , Alkaline Phosphatase , Genetics , Metabolism , Gene Fusion , Genes, erbB-1 , Immunohistochemistry , In Situ Hybridization, Fluorescence , Lung Neoplasms , Drug Therapy , Genetics , Pathology , Protein Kinase Inhibitors , Therapeutic Uses , Proteomics , Pyrazoles , Therapeutic Uses , Pyridines , Therapeutic Uses , Sensitivity and SpecificityABSTRACT
<p><b>OBJECTIVE</b>The aim of this study was to establish a standard protocol for detection of EGFR mutations in cytologic specimens.</p><p><b>METHODS</b>287 cytologic samples were collected from the patients who were suspected of having lung cancer at six hospitals in Beijing. A detection protocol for EGFR mutations was designed. Two comparative experiments were carried out for the coincidence in EGFR mutation rates between direct sequencing (Seq) and amplification refractory mutation system (ARMS) methods, and between 40 matched cytologic samples with formaldehyde-fixed paraffin embedded (FFPE) cytologic blocks and cytospin slides.</p><p><b>RESULTS</b>Tumor cells were found in 236 out of 287 cases (82.2%, 236/287) . Among them, there were 31 cases (13.1%, 31/236) of low tumor cell content samples and 205 cases (86.9%, 205/236) of high tumor cell content samples. 180 cases in the high tumor cell content samples (87.8%, 180/205) were diagnosed to be consistent with NSCLC. 25 out of 194 cases were ruled out or indefinite to be diagnosed as NSCLC by immunohistochemistry. By direct sequencing, the mutation rate of EGFR was 27.8% (50/180) in NSCLC samples and 28.2% (50/177) in adenocarcinoma samples (high tumor content samples) . By ARMS, the mutation rate of EGFR was 45.6% (82/180) in NSCLC samples and 46.3% (82/177) in adenocarcinoma samples (high tumor content samples). The EGFR mutation rate in low tumor content samples was 38.7% (12/31) , there was no significant difference in EGFR mutation rates between the groups of low tumor cell content samples and high tumor cell content samples (P = 0.12). The concordance rate of EGFR mutation rates was 100% between scraping tumor cells from slides samples and from FFEP blocks in the 40 matched samples. Forty-eight out of 180 definitive NSCLC patients received Gefitinib therapy. The FPS was 12 months in the gefitinib-treated ARMS⁺ group and 2 months in the ARMS⁻ group (P < 0.001), and the OS was 19 months in the gefitinib-treated ARMS⁺ group and 7 months in the ARMS⁻ group (P = 0.003), but no significant differences were found in the efficacy (PFS and OS) of Gefitinib between Seq⁺ and Seq⁻ groups (P = 0.227, P = 0.510, respectively), and Seq⁺/ARMS⁺ and Seq⁻/ARMS⁺ groups (P = 0.354, P = 0.334, respectively).</p><p><b>CONCLUSIONS</b>The detection protocol for EGFR mutations in cytological specimens introduced in this study is tested to be reliable and feasible. Pathological evaluation and immunohistochemistry are important in the detection procedure of EGFR mutations in cytologic specimens. High sensitivity methods should be selected for detection of EGFR mutations in cytologic samples.</p>
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Humans , Adenocarcinoma , Metabolism , Carcinoma, Non-Small-Cell Lung , Metabolism , Lung Neoplasms , Diagnosis , Epidemiology , Metabolism , Mutation , Mutation Rate , Polymerase Chain Reaction , ErbB Receptors , Genetics , MetabolismABSTRACT
Third-grade class A hospitals undertake three tasks-medical service,scientific research and teaching.scientific research is the motivation for third-grade class A hospitals' continuous development and also an important symbol of their medical and academic level.On the purpose of evaluating overall scientific level of such hospitals this thesis analyze the scientific projects and the outcomes of 34 hospitals by using the method of literature research and questionnaire,extracting advantages for scientific research,seeking their problems and coming up with corresponding strategy.have analyzed the achievements we acquired as well as the problems still existing.According to the reality of Fujian Province,some suggestions are coming up with so as to improve the scientific research.
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<p><b>OBJECTIVE</b>This study aims to determine the fissure morphology, prevalence, and severity of caries in the first permanent molars of 7-year-old to 9-year-old children in the Dalian development area. The study also aims to investigate the relationship between fissure morphology and noncavitated lesions.</p><p><b>METHODS</b>A multi-stage, cluster sampling method was used. Three schools were randomly selected from 20 elementary schools in the Dalian development area. All of the children in the selected schools completed clinical oral examinations. A diagnosis criterion of the International Caries Detection and Assessment System was used to assess the cavitated and noncavitated dental caries in the first permanent molars. Fissure depth and fissure stain were also assessed.</p><p><b>RESULTS</b>The total size of the study sample was 1 160. The prevalence of cavitated caries was 19.1%, and the mean D3-6FT score was 0.31. No significant differences were found between urban and rural subjects, between men and women, and among different age groups. The prevalence and D1-2FT score of noncavitated caries were 42.1% and 0.86, respectively. The D1-2FT score for rural children was significantly higher than that for urban children, and the D1-2FT score for girls were higher than that for boys. No statistical differences were found among different age groups. The prevalence of deep fissures in the first permanent molars was 44.7%. The prevalence of noncavitated caries increased with increasing fissure depth.</p><p><b>CONCLUSION</b>The prevalences of noncavitated caries and deep fissure in the first permanent molar of 7-year-old to 9-year-old children in Dalian were high. Fissure morphology was found to be related to noncavitated caries.</p>
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Child , Female , Humans , Male , China , DMF Index , Dental Caries , Molar , PrevalenceABSTRACT
Objective To observe the safety and efficacy of FOLFOX4 regiment in elderly versus young patients with advanced colorectal cancer. Methods There were 61 patients enrolled in this study, with 28 elderly patients aged 70 years and over, 33 young patients aged less than 70 years.They suffered from advanced/recurrent colorectal cancer and received FOLFOX4 regiment (Oxaliplatin +CF+5-FU). Every 14 days were as a cycle, and the therapeutic safety and efficacy were evaluated after three cycles. Adverse events and response to treatment were compared between the elderly and young patients. Results The main adverse effects were myelosuppression, gastrointestinal disturbance and neurotoxicity. The incidence rate of diarrhea was significantly higher in elderly patients than in young patients, but the most of diarrhea were at grade Ⅰ - Ⅱ. The incidence rates of leucocyte decrease and neutrophil decrease were higher in elderly patients than in young patients (92. 8% vs. 78. 8%, 39.3% vs. 36.3%), but there were no statistically significant differences between them. The incidence rate of neurotoxicity was 46.5% in elderly patients and 36.4% in young patients (P＞0. 05). The recent efficacy rate was 25%, disease control rate was 71.4% and median time-to-progression (TTP) was 6 months in elderly patients and 24.2%, 84.8% and 7 months in young patients (all P＞0.05). Conclusions FOLFOX4 regiment is well-tolerated and effective in both young and elderly patients.
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ObjectiveTo investigate mutations in exons 19, 20 and 21 of epidermal growth factor receptor (EGFR) gene in elderly patients with non-small cell lung cancer (NSCLC). MethodsEGFR gene mutations in exons 19, 20 and 21 were detected by nested PCR amplification and DNA sequencing in 46 elderly patients with non-small cell lung cancer. The relationship between mutations and clinical characteristics of these patients was analyzed. ResultsEGFR gene mutations were found in 56.5% (26/46) patients and 41.3% (19/46)were non-silent mutations. Mutation of exon 19 was detected in 6 cases (13.0%), mutation of exon 20 in 13 cases(28.2%) and that of exon 21 in 14 cases (30.4%). Seven patients among them had double mutations and the rest only had a single mutation. The incidence of EGFR gene mutations was higher in non-smokers than in smokers(P＜ 0.01). Higher EGFR mutation rate in exon 19, 20 and 21 were found in patients with clinical benefit who were treated with tyrosine kinase inhibitor(TKl)(P＜0.05). There was no difference in EGFR mutation rate between 60～69 age group and 70～85 age group. ConclusionsThe data suggest that the characteristics of EGFR gene mutations in elderly patients with NSCLC is the same as in the general NSCLC patients. The forecast informations of TKI treatment can be obtained by gene detection in elderly NSCLC patients.
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To investigate AIDS-related knowledge, attitudes, beliefs and practices (KABPs) among Chinese migrant laborers in east African cities, and to examine the current status of access to AIDS-related healthcare services, we conducted a cross-sectional study in Nairobi, Kenya, and Dar es Salaam, Tanzania. Of 121 male laborer participants who spoke neither English nor Swahili, 109 (90.9%) had an education level of high school or less. The survey revealed that migrants‘ AIDS-related knowledge was poor, e.g., very few (n=4, 3.3%) were aware of the epidemiologic status of HIV in these two cities. Negative attitudes toward people living with HIV⁄AIDS (PLWHA) were widespread, and the majority (n=94, 77.7%) did not make use of AIDS-related healthcare services or education. Although the main information resources on HIV⁄AIDS in China include television (n=94, 77.7%), books and newspapers (n=78, 64.5%) and radio (n=51, 42.1%), these sources were much less common in Nairobi and Dar es Salaam (p&It;0.001 for each). One third (n=44, 36.4%) did not have any information resources in these two cities. These results indicate that Chinese migrant laborers are at risk of HIV infection in the two African cities. Appropriate education for the general population in China and for migrants in these two cities regarding HIV⁄AIDS, along with relevant information resources that are more accessible and useful for migrants in East Africa are therefore needed to minimize the risk of infection.
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Objective: To obtain the antibody against N terminal of 1A6/DRIM, and thereafter get the profile of 1A6/DRIM expression in different cell lines. Methods: The N terminal of 1A6/DRIM (aa 577 714) was cloned into pGEX 4T 3. Multiple antigenic peptides (MAPs)(aa638 661) was synthesized as the antigen with Fmoc/PyBOP method. Rabbits were immunized by injecting the MAPs and the immunized sera were analyzed with ELISA and Western Blot. The Western Blot and immunofluorescence were performed to analyze the expressing profiles of the 1A6/DRIM in different tumor cell lines. Results: The antibody specifically recognized the full length of 1A6/DRIM as a 310 kDa band, which was also recognized by C terminal monoclonal antibody shown by Western Blot. 1A6/DRIM is expressed in multiple tumor cell lines and mainly located in the nuclei. Conclusion: Preparation of the antibody with MAPs is a useful technique when the fusion proteins can not be induced in E coli . The antibody we got via MAPs has supplied a good tool for further studies on the functions of the novel gene 1A6/DRIM.
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Purpose:To study the efficacy and safety of combination of methylprednisolone (MP) and ondansetron (OND) in the prevention of acute and delayed nausea and emesis induced by cisplatin base chemotherapy. Methods:This was a randomized, self cross over study. 47 patients receiving cisplatin based chemotherapy were randomized to enter one of the two following groups:Group 1:the combination of 80mg MP and 8 mg OND were iv injected to the patients before the first cycle of chemotherapy and then 8 mg OND was iv injected to the same patients before the second cycle of chemotherapy (23 cases); Group 2:8mg OND was iv injected to the patients before the first cycle of chemotherapy and then the combination of 80 mg MP and 8mg OND were iv injected to the same patients before the second cycle of chemotherapy (24 cases). The dosage of chemotheraputic agents and the times of anti emesis agents were the same in the two different cycles of chemotherapy for each patient.Results:The complete and partial control of the acute emesis were significantly superior in the combination of MP and OND than in the OND alone(93.6% versus 70.2%, P