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Objective:To evaluate the efficacy and adverse reaction caused by Capecitabine compared with S-1 as maintenance treat-ments for patients with advanced gastric cancer (AGC) after first-line induction chemotherapy. Methods:A total of 130 AGC patients who did not suffer disease progression after first-line chemotherapies, including XELOX (four to six cycles), SOX (four to six cycles), and mFOLFOX6 regimen (six to eight cycles), were randomized into three groups. The Capecitabine group (Cap) received maintenance che-motherapy with Capecitabine (1 000 mg/m2 twice daily for 14 days, 21 days/cycle), while the S-1 group (S1) received S-1 (40, 50, or 60 mg according to the body surface area and orally administered twice a day for 14 days, 21 days/cycle). The control group was consid-ered as the observation group. Patients with maintenance treatments received drugs until disease progression or observation of intol-erant toxicity. Results:A total of 44, 33, and 53 patients received XELOX, SOX, and mFOLFOX6 regimens, respectively. The overall DCR was 63.1%. Among the 82 patients, 35, 28, and 19 belonged to the Cap, S1, and observation groups, respectively. The comparison be-tween the efficacy of treatments in the Cap and S1 groups did not show statistically significant differences (P=0.678). The median time of progression was 8.5 months in the Cap group and 9.0 months in the S1 group (P>0.05). Both groups showed better responses than the observation group, which demonstrated a median progression of 6.0 months (P<0.001). The median overall survivals were 14.5, 15.0, and 14.0 months in the Cap, S-1, and observation groups, respectively (P=0.188). The most common adverse effects observed among the patients with maintenance treatments included myelo-suppression, gastrointestinal reaction, fatigue, hand-foot syndrome, and stomatitis. No death occurred in relation to the therapy. Conclusion:The effectiveness of Capecitabine and S-1 as maintenance chemotherapies in AGC patients after the first-line induction chemotherapy are similar, and both can prolong the time of disease pro-gression with low toxicity.
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Objective:To compare the survival of resected gastric cancer patient treated with oxaliplatin, 5-fluorouracil, and leu-covorin (FOLFOX6) with those treated with oxaliplatin and capecitabine (XELOX). Methods:A total of 147 resected gastric cancer pa-tients accepted the treatment. Among them, 99 were treated with FOLFOX6 and 48 were treated with XELOX. Adverse events and sur-vival rates of the two groups were compared. Results:Incidence of leukopenia and hepatic dysfunction in the FOLFOX6 group was sig-nificantly higher than that of the XELOX group (P0.05) between the two groups. After 1, 3, and 5 years, disease-free and overall survivals between the two groups were not significantly differ-ent (P>0.05). Conclusion:The effects of FOLFOX6 and XELOX adjuvant chemotherapies on long-term survival of resected gastric cancer patients were found to have no significant difference.
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Objective To investigate the relationship between maternal exposure to airborne inhalable particulate matters (PM10) in the first trimester of pregnancy and the risk of fetal congenital deformity.Methods Relationship between exposure to airborne PM10 during the 1st,2nd,3rd and 1-3 months of gestation and the risk of fetal anomalies in 203 pregnant women with deformed fetuses,which paralleled to normal pregnant women with discrepancy of conception date ＜30 days (control),were retrospectively analyzed by a case-control study from May 14,2007 to April 30,2012 in Fujian Medical University and Fuzhou General Hospital.Multivariate Logistic regression adjusted for potential confounders including maternal age,gravidity and parity was performed for data analysis.Results According to the inclusion and exclusion criteria,178 pregnant women with deformed fetuses and 356 controlled cases were enrolled.The average levels of PM10 exposed in pregnant women Withfetal cardiovascular anomalies during 1-3 months of gestation were significantly higher than in the controls [(73.80±11.55) μg/m3 vs (70.49±10.83) μg/m3] (t=2.066,P=0.040),but PM10 exposure in the 1st,2nd and the 3rd month of pregnancy were comparable between the observed and control groups [(74.00±17.34) μg/m3 vs (71.70±15.39) μg/m3,t=0.992,P=0.322;(75.15±16.80) μg/m3 vs (71.38±15.66) μg/m3,t=1.625,P=0.106; (70.28±15.84) μg/m3 vs (69.41± 15.84) μg/m3,t=0.383,P=0.702].There were no significant differences of PM10 exposure levels when compared between facial-cervical anomalies,neurologic anomalies and total anomalies and their corresponding controls (P＞0.05).Each increased quartile of the PM10 exposure levels was associated with an elevated risk of fetal cardiovascular anomalies by 1.218 folds (OR =2.218,95 ％ CI:1.232-3.994,P=0.008).Paired multivariate Logistic regression analysis revealed,a positive correlation between PM10 levels at 1-3 months of gestation and fetal cardiovascular anomalies (OR =1.106,95％CI:1.035-1.183,P =0.003).Conclusions Maternal exposure to PM10 in the first trimester of pregnancy possibly exerts negative effects on fetal cardiovascular anomalies.
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Objective To investigate subacute exposure of airborne particulate matter (PM) on pregnancy and fetal development in female mice. Methods Forty female and forty male ICR adult mice group (A), small (B) , middle (C) , large (D) or overdose (E) PM challenge groups (n = 8 - 11), and were administered with 30 μl of phosphate buffered solution (A) or resuspended standard PM SRM 1649a at 0.09 (B), 0.52 (C), 1.85 (D) or 69.2 (E) μg/μl, once per trid from d 0 till d 19 of pregnancy via instillation onto the base of the tongue. Fetal mice were harvested by cesarean section at the time when spontaneous delivery occurred. Body weight of the pregnant mice, gestational days, intrauterine survival and growth, hepatic and pneumonic histopathological changes of the fetal mice were investigated. Lung/body and liver/body weight ratios were calculated. Expressions of mRNA and protein of CYP1A1 in the fetal lung and CYP1 A2 in the fetal liver were assayed. Results (1) All of the pregnant mice survived pregnancy throughout the entire experiment. Body weight of the pregnant mice was not significantly different among all the groups at gestational d 1 and 7 (P ＞ 0.05), but significantly lower in group E [(41.8 ± 5.8) and (48.9 ± 8.9) g] than in group A [(45.9 ± 1.8) and (56.2 ± 4.9) g] at gestational d 14 and 18 (P ＜0.05). The gestational days were significantly decreased in group E [(19.3 ± 1.3) d] when compared with group A [(20.5 ± 0.7) d; P ＜ 0.05] and were not significantly different among groups A, B, C and D (P ＞ 0.05). Lung/body and liver/body weight ratios of the fetal mice were significantly increased in group E [(1.21 ±0.18) and (4.68 ±0.21)%] as compared with groups A, B, C and D (P＜0.05). (2)Mortality rates of the fetuses were significantly higher in group E (23.0%) than in groups A (0.8%), B (0.9%), C (1.7%) and D (3.7%) (P ＜ 0.05), but were not significantly different among groups A,B, C and D (P ＞ 0.05) despite of an increasing tendency. (3) Pathological changes in the liver and lung of the fetuses were conspicuous in group E. The fetal liver injury was histopathologically evidenced by deranged tissue structure, degenerated parenchyma of hepatic cells, and mildly stained cytoplasm. Adipose degeneration was represented by clear-boundary intracytoplasmic vacuoles in most of the liver cells, and cell pyknosis with heavily stained cytoplasm was observed in some of the liver cells. Inflammatory cell infiltration and focal necrosis were occasionally found in the hepatic tissue. The fetal lung exhibited bronchiole with narrow lumina, vascular engorgement in the submucosal layer, interstitial and alveolar edema, thickened alveolar septum, granulocyte and lymphocyte infiltrations within the pulmonary alveoli and around the bronchioles. The above pathological changes were lesser in groups C and D, and were not or least found in groups A and B. (4) Protein expressions of CYP1A1 in the fetal lung and CYP1A2 in the fetal liver were significantly increased in group E (1.20 ± 0.40 and 2.55 ± 0.89) when compared with group A (0.77 ±0.36 and 2.08 ±0.31) (P ＜ 0.05). mRNA expressions of CYP1A1 in the fetal lung were significantly increased in groups C (0.36 ±0.12), D (0.41 ±0.08) and E (0.43 ±0.11) compared with group A (0.21 ±0.10), and significantly increased in groups D and E compared with group B (0.28 ±0.10,P＜0.05). mRNA expressions of CYP1 A2 in the fetal liver were significantly increased in groups C (0.37 ±0.13), D (0.36 ±0.14) and E (0.43 ±0.16) compared with group A (0.21 ±0.03), and significantly increased in group E compared with group B (0.24± 0.11, P ＜ 0.05). Conclusions PM elicited embryotoxigenicity and resulted in adverse pregnancy outcomes in mice by intrauterine exposure of overdose PM. The expressions of cancer-related genes CYP1A1 and CYP1A2 were up-regulated in organs after the middle- and large-dose subacute exposure of PM, which may have a potential role on the future development.
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Objective To evaluate the preventive effect of compound matrine injection on hepatic lesion caused by chemotherapy. Methods 178 patients after gastric and colorectal cancer resection were enrolled into three groups randomly. 56 patients in group A received MFOLFOX6 regimen treatment only, 62 patients in group B received both normal treatment and combined compound matrine injection,60 patients in group C received both normal treatment and glutathione. The change of liver function were observed. Results There was no the hepatotoxicity of Ⅲ-Ⅳ degree in all groups;the incidence of bilirubin and transaminase increasing in group B and C was significantly lower than that group A(P ＜0.05), but the incidence of ALP/GGT increasing showing no significant difference among the three groups; 72.7 % of the incidence of hepatic lesion in group A happened firstly before the seventh cycle,it was 27.3 % and 33.3 % respectively in group B and group C, the time of the emerging of hepatotoxicity in group B and C was markedly delayed than that group A (P ＜0.05); there was not significant difference between group B and group C in both bilirubin and transaminase increasing and the time of the emerging of hepatotoxicity (P ＞0.05). Conclusion Compound matrine injection can prevent and postpone the happening of hepatic lesion caused by adjuvant chemotherapy after digestive tract cancer resection, The result is equal to glutathione. Compound matrine injection also has antineoplastic effects, so the clinical superiority is more obvious.
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Objective To summarize the clinical diagnosis and treatments of 55 reflux laryngitis (RL) pa-tients, and to study the relationship between gastroesophageal reflux disease (GERD) and RL. Methods The pa-tients went through the following diagnostic process consisting of the collection of medical history, laryngoscopy, gastroscope, X-ray barium meal examination, vocal evaluation, therapy of anti-acid and anti-reflux. Results The laryngeal manifestations of RL mainly consisted of laryngeal discomfort or foreign body sensation (89. 1%), chronic cough (36.4 % ), hoarseness (20 % ), laryngeal pain (18. 2 %), even severe aspiration or laryngismus (10.9%) and so on. With the laryngoscopy we could see congestion in arytenoids area (67.3%), swelling or pachynsis of a mucosal fold in interarytenoid area (43.6%), edema of true or false vocal cord(40%), a little dropsy staying in piriform sinus (32.70% ), contact ulcer or granuloma on posterior extremity of a vocal cord (20 % ), artificial sulcus under vocal cords (16.4 %). RL patients might have mild voice disorder, among whom 65.5 percent displayed ten-sion dysphonia. Fundamental frequency (F0), jitter, shimmer and normalized noise energy (NNE) of RL patients increased. Compared with the controls, there were significant differences (P<0. 05) except for the F0 of female pa-tients. The manifestation and physical symptoms were improved or disappeared after the treatment with proton pump inhibitor (PPI). Conclusion RL is one of the important manifestations of GERD out of digestive tract. Typi-cal RL manifestation is mainly a pathological process in the postero-glottis. Clinically, PPI can be used as not only a treatment but also a tentative diagnosis of RL.
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Objective To investigate the abnormality of electrocardiography (ECG) of patients with neoplasms after different chemotherapy. Methods The abnormality of ECG data in 632 patients with neoplasms after different chemotherapy in our hospital was analyzed. Results The changes of ST-T was found in 352 cases (55.70 %), arrhythmia in 197 cases (31.2 %), low QRS in 91 cases (14.4 %), cardiac infarction in 2 cases (0.32 %). Conclusion Different chemotherapy can induce abnormality of ECG, especially combined with anthracycline. Pay attention to potential cardiotoxicity of chemotherapeutics and do regular examination of ECG is very important.
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OBJECTIVE@#To study the expression and prognostic significance of cyclooxygenase-2 (Cox-2) in supraglottic laryngeal squamous cell carcinomas (SGLSCC) and identify the relationship between Cox-2 and angiogenesis and the roles of Cox-2 in SGLSCC as a biological marker.@*METHOD@#Eighty-eight primary SGLSCC patients received surgical treatment were studied by immunohistochemical staining, and reverse transcription-polymerase chain reaction (RT-PCR) technique.@*RESULT@#The percentage of Cox-2-positive cells was 94.3% (83/88) in SGLSCC whereas there was no immunostaining in the all cells of normal mucosa of paracarcinoma. Cox-2 expression was higher in well-differentiated tumors compared with poorly-differentiated SGLSCC. The relative concentration of Cox-2 mRNA was 141.871 +/- 20.5435 in SGLSCC and 17.031 +/- 2.2597 in normal paracarcinoma mucosa (P 0.05). Cox's regression analysis indicated that Cox-2 intensity were significantly independent prognostic factors (P < 0.01).@*CONCLUSION@#Cox-2 expression maybe relate to the carcinogenesis and progress in tumors especially in well-differentiated ones; The changes of Cox-2 expression are synchronous with MVD. Cox-2 intensity is a significantly independent prognostic factor. So Cox-2 may be an effective target of prevention, therapy and prognostic evaluation for laryngeal carcinoma and other head and neck squamous cell carcinomas (HNSCC).