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Objective:To explore the association between different feeding patterns, emotional states, and salivary oxytocin (OT) levels during breastfeeding.Methods:From January to December 2019, 153 pairs of 3-month-old infants and their mothers were recruited from 4 maternal and child health hospitals in Chongqing, Liuzhou, Dalian and Hangzhou in China.Saliva samples were collected from the mothers at the first 5 minutes of feeding, 5 minutes during feeding, and 10 minutes after feeding.Edinburgh postnatal depression scale (EPDS) was used to evaluate maternal depression.Infants were divided into exclusive breastfeeding group and artificial feeding group according to feeding patterns.ELISA of salivary oxytocin was performed by ELISA kits, and the OT levels measured at the 3 time points were converted using linear interpolation.Area under the curve with respect to ground(OTAUCG) was used to represent the total concentration of salivary OT during the mother's breastfeeding.SPSS 25.0 software was used for statistical analysis.Multiple linear regression analysis and two factors analysis of variance were used to explore the association between different feeding methods, emotional state and salivary oxytocin during breastfeeding.Results:The results of the two factors analysis of variance showed that the interaction between feeding pattern and mother's emotion was not significant ( F=2.440, P=0.120), the main effect of mother's emotion was not significant ( F=0.380, P=0.539), and the main effect of feeding style was significant ( F=3.350, P=0.021). The level of OTAUCG under pure breastfeeding ((151 561.47±75 738.11) pg/mL) was higher than that under artificial feeding ((122 269.03±65 029.88) pg/mL), and the difference was statistically significant ( P=0.02). There was no statistically significant difference in OTAUCG levels between mothers with normal emotions ((146 106.37±75 106.76) pg/mL) and mothers with depressed emotions ((129 079.56±67 565.87) pg/mL) ( P=0.221). Multiple stepwise regression analysis showed that artificial feeding had a negative predictive effect on maternal salivary OT levels compared to exclusive breastfeeding( β=-0.211, t=-2.513, P=0.013). Conclusion:Feeding pattern is a factor that affects the mother's salivary OT level, and breastfeeding can improve the mother's OT level.
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Purpose@#The human epidermal growth factor receptor 2 (HER2) is an established therapeutic target for various kinds of solid tumors. HER2 amplification occurs in approximately 1% to 6% of colorectal cancer. In this study, we aimed to assess the efficacy and safety of trastuzumab in combination with chemotherapy in HER2-positive metastatic colorectal cancer (mCRC). @*Materials and Methods@#An open-label, phase II trial (Clinicaltrials.gov: NCT03185988) was designed to evaluate the antitumor activity of trastuzumab and chemotherapy in HER2-positive digestive cancers excluding gastric cancer in 2017. Patients from this trial with HER2-positive, KRAS/BRAF wild-type, unresectable mCRC were analyzed in this manuscript. Eligible patients were treated with trastuzumab (8 mg/kg loading dose and then 6 mg/kg every 3 weeks) and irinotecan (120 mg/m2 days 1 and 8 every 3 weeks). The primary endpoint was the objective response rate. @*Results@#Twenty-one HER2-positive mCRC patients were enrolled in this study. Seven patients (33.3%) achieved an objective res-ponse, and 11 patients (52.4%) had stable disease as their best response. The median progression-free survival (PFS) was 4.3 months (95% confidence interval, 2.7 to 5.9). Four of the 21 patients (19.0%) had grade 3 adverse events, including leukopenia, neutropenia, urinary tract infection, and diarrhea. No treatment-related death was reported. Exploratory analyses revealed that high tumor tissue HER2 copy number was associated with better therapeutic response and PFS. Alterations in the mitogen-activated protein kinase pathway, HER2 gene, phosphoinositide 3-kinase/AKT pathway, and cell cycle control genes were potential drivers of trastuzumab resistance in mCRC. @*Conclusion@#Trastuzumab combined with chemotherapy is a potentially effective and well-tolerated therapeutic regimen in mCRC with a high HER2 copy number.
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Objective:To investigate the expressions of TRIM25 and RIG-Ⅰ in liver cancer tissues and their relationship with the prognosis of patients.Methods:The data of 82 patients with liver cancer who were admitted to the Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University from January 2017 to January 2018 were retrospectively analyzed, and their cancer tissue and paracancerous tissue (>5 cm from the edge of the tumor) specimens were collected. The protein expressions of TRIM25 and RIG-Ⅰ in cancer tissues and paracancerous tissues were detected by immunohistochemistry. The relationship between TRIM25 and RIG-Ⅰ expressions in cancer tissues of patients and clinicopathological features was analyzed. Kaplan-Meier method was used to analyze the overall survival (OS) of patients with different TRIM25 and RIG-Ⅰ expression status.Results:The positive rate of TRIM25 in cancer tissues was higher than that in paracancerous tissues [68.29% (56/82) vs. 21.95% (18/82), P < 0.001], and the positive rate of RIG-Ⅰ in cancer tissues was lower than that in paracancerous tissues [31.71% (26/82) vs. 74.39% (61/82), P < 0.001]. The positive rate of TRIM25 in cancer tissues of poorly differentiated patients was higher than that of highly and moderately differentiated patients ( P < 0.05), and the positive rate of RIG-Ⅰ was lower than that of highly and moderately differentiated patients ( P < 0.05). The positive rate of TRIM25 in cancer tissues of patients with extrahepatic metastasis was higher than that of patients without extrahepatic metastasis ( P < 0.05), but the positive rate of RIG-Ⅰ was lower than that of patients without extrahepatic metastasis ( P < 0.05). The positive rate of TRIM25 in patients with clinical Ⅲ-Ⅳ was higher than that in patients with stage Ⅰ-Ⅱ ( P < 0.05), but the positive rate of RIG-Ⅰ was lower than that in patients with stage Ⅰ-Ⅱ ( P < 0.05). The median follow-up time was 27 months (4-48 months), 2 patients were lost to follow-up. At the end of follow-up in January 2022, the overall survival rate was 43.75% (35/80). The survival rates of patients with TRIM25-positive and TRIM25-negative cancer tissues were 33.33% (18/54) and 65.38% (17/26), respectively. The survival rates of patients with RIG-Ⅰ-positive and RIG-Ⅰ-negative cancer tissues were 64.00% (16/25) and 34.55% (19/55), respectively. Kaplan-Meier analysis showed that the OS of patients with TRIM25-negative cancer tissues was better than that of patients with TRIM25-positive cancer tissues, and the OS of patients with RIG-Ⅰ-positive cancer tissues was better than that of patients with TRIM25-negative cancer tissues, and the differences were statistically significant (both P < 0.05). Conclusions:The expression of TRIM25 is increased and the expression of RIG-Ⅰ is decreased in liver cancer tissues. The expressions of TRIM25 and RIG-Ⅰ in liver cancer tissues are associated with prognosis.
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Oxytocin is a neuropeptide produced primarily in the hypothalamus and plays an important role in the regulation of mammalian birth and lactation. It has been shown that oxytocin has important cardiovascular protective effects. Here we investigated the effects of oxytocin on vascular reactivity and underlying the mechanisms in human umbilical vein endothelial cells (HUVECs) in vitro and in rat aorta ex vivo. Oxytocin increased phospho-eNOS (Ser 1177) and phospho-Akt (Ser 473) expression in HUVECs in vitro and the aorta of rat ex vivo. Wortmannin, a specific inhibitor of phosphatidylinositol 3-kinase (PI3K), inhibited oxytocin-induced Akt and eNOS phosphorylation. In the rat aortic rings, oxytocin induced a biphasic vascular reactivity: oxytocin at low dose (10-9–10-8 M) initiated a vasorelaxation followed by a vasoconstriction at high dose (10-7 M). L-NAME (a nitric oxide synthase inhibitor), endothelium removal or wortmannin abolished oxytocin-induced vasorelaxation, and slightly enhanced oxytocin-induced vasoconstriction. Atosiban, an oxytocin/ vasopressin 1a receptor inhibitor, totally blocked oxytocin-induced relaxation and vasoconstriction. PD98059 (ERK1/2 inhibitor) partially inhibited oxytocin-induced vasoconstriction. Oxytocin also increased aortic phospho-ERK1/2 expression, which was reduced by either atosiban or PD98059, suggesting that oxytocin-induced vasoconstriction was partially mediated by oxytocin/V1aR activation of ERK1/2. The present study demonstrates that oxytocin can activate different signaling pathways to cause vasorelaxation or vasoconstriction. Oxytocin stimulation of PI3K/eNOS-derived nitric oxide may participate in maintenance of cardiovascular homeostasis, and different vascular reactivities to low or high dose of oxytocin suggest that oxytocin may have different regulatory effects on vascular tone under physiological or pathophysiological conditions.
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【Objective】 To explore the quantitative value of key points for ABO blood group initial screening in fixed blood donation sites, so as to provide reference for standardized testing process of sliding method. 【Methods】 Several groups of experiments were carried out to illustrate the optimal conditions, including the serum dosage of monoclonal reagent, red blood cell dosage of blood sample, and reaction time in ABO blood group initial screening, by sliding method, and the quantitative value of key points of sliding method was preliminarily determined. Blood typing tests of 310 blood donor samples including type A, B, O, AB, subtype A and subtype AB were conducted to evaluate the effects of quantitative value of key points in the initial screening procedure. The test tube method would be conducted if the results are inconsistent with the fully automated blood grouping analyzer. The ABO subtypes suspected are identified by serological and molecular biological methods. 【Results】 The quantitative value of key points in initial screening procedure of sliding methods was as follows: 2 drops of reagent serum, 5-10 μL of whole blood and 3 minutes of reaction time. The concordance rate of ABO blood type screening comparison experiment in 310 blood donors was 100%. 【Conclusion】 ABO blood group initial screening by sliding method with quantitative value can effectively standardize the pre-donation blood type screening in fixed blood donation sites, and can meet the requirements of ABO blood group initial screening.
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Objective:To observe the changes of macular microvessels in patients with retinal vein occlusion (RVO) and macular edema (ME) after intravitreal injection of aflibercept (IVA), and analyze its correlation with best corrected visual acuity (BCVA).Methods:A retrospective case study. Thirty patients (30 eyes) with monocular RVO with ME (RVO-ME) who were diagnosed in the clinical examination of Tianjin Eye Hospital from April 2019 to February 2020 were included in the study. Among them, there were 12 males (12 eyes) and 18 females(18 eyes); the average age was 54.30±13.17 years. The average course of disease was3.43±1.97 months. Both eyes were examined by BCVA and optical coherence tomography (OCTA). The on-demand injection was adopted after the first injection in IVA treatment regimen. The macular area 6 mm×6 mm in both eyes was scanned with an OCTA instrument, and the area of the foveal avascular area (FAZ), FAZ circumference (PERIM), and out-of-roundness were measured at baseline and 1, 3, and 6 months after treatment. Index (AI), blood flow density within 300 μm width of FAZ (FD-300), foveal retinal thickness (CMT), superficial retinal capillary plexus (SCP), deep retinal capillary plexus (DCP) blood flow density. The paired t test was used to compare the quantitative parameters of the affected eye and the contralateral healthy eye at baseline; the changes of the quantitative parameters at baseline and 1, 3, and 6 months after treatment were analyzed by repeated measures analysis of variance. Pearson correlation analysis was used to analyze the correlation between BCVA, retinal perfusion, and macular blood supply parameters at 6 months after IVA treatment. Results:At baseline, compared with the contralateral healthy eye, the FAZ area ( t=-4.091), PERIM ( t=-5.098) and AI ( t=-9.093) of the RVO-ME eye were enlarged, and FD-300 ( t=7.237) and overall SCP and DCP blood flow density ( t=8.735, 9.897) decreased, the difference was statistically significant ( P<0.001). Six months after treatment, the BCVA of RVO-ME eyes was significantly increased, CMT decreased, FAZ area expanded, and AI decreased ( t=8.566, 16.739, -6.469, 9.719; P<0.001), the difference was statistically significant. There was no significant change in the blood flow density of FD-300 and overall SCP and DCP, and the difference was not statistically significant ( t=1.017, 1.197, 0.987; P>0.05). Compared with baseline, the FAZ area of RVO-ME eyes gradually expanded at 3 and 6 months after treatment, and the difference was statistically significant ( F=21.979, P<0.001). Correlation analysis results showed that BCVA at 6 months after treatment was positively correlated with the overall SCP and DCP blood flow density at baseline and 6 months after treatment ( r=-0.538, -0.484, -0.879, -0.854; P<0.05). There was a negative correlation with the area of FAZ 6 months after treatment ( r=0.544, P=0.001). The number of ME recurrences was negatively correlated with BCVA and overall SCP and DCP blood flow density 6 months after treatment ( r=0.604, -0.462, -0.528; P<0.05), it was positively correlated with FAZ area ( r=0.379, P=0.043). Conclusion:Within 6 months of IVA treatment in RVO-ME eyes, ME is significantly reduced and visual acuity is improved; SCP blood flow density decreases, and FAZ area expands.
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Objective:To observe the outcome of posterior staphyloma (PS) marginal retinal photocoagulation in pars plana vitrectomy (PPV) for high myopia macular hole retinal detachment eyes accompanied with PS.Methods:From January 2017 to June 2019, 49 patients (49 eyes) with high myopia macular hole retinal detachment accompanied with PS who were undergone PPV operation from Tianjin Eye Hospital were included in this study. There were 13 males (13 eyes) and 36 females (36 eyes). All patients underwent best corrected visual acuities (BCVA) and optical coherence tomography examinations. The standard logarithmic visual acuity chart was used for BCVA examination, and the visual acuity was converted to minimum resolution angle in logarithmic (logMAR) when recorded. The patients were randomly divided into two groups according to surgical options: conventional PPV with internal limiting membrane (ILM) peeling (group A, 24 eyes), PS marginal retinal photocoagulation in PPV with ILM peeling (group A, 25 eyes). The mean preoperative logMAR BCVA of group A and B were 1.87±0.28 and 1.80±0.37, the difference was not statistically significant ( t=0.604, P=0.551). The patients in the group A received 23G PPV, triamcinolone acetonide staining during the operation, the epiretinal membrane was peeled off, indocyanine green assisted staining, the posterior macular ILM was peeled off, and the peripheral retina was examined in detail during the operation. Areas with retinal degeneration were reinforced by laser photocoagulation, and the subretinal fluid was drained through the macular hole and filled with silicone oil. The eyes of the group B were subjected to retinal photocoagulation for 2 to 3 rows at the edge of the PS in addition to the usual surgical procedures. The average follow-up time was 8.34±3.21 months. Surgical outcome were estimated by the average number of operation, retinal reattachment rate, macular hole closure rate and BCVA. The χ2 test or Fisher exact probability was used to compare the count data. Independent sample t test was used to compare the measurement data. Results:Retinal reattachment was obtained in 17 eyes (70.8%, 17/24) and 24 eyes (96.0%, 24/25) in group A and B after first surgery respectively, the difference was statistically significant ( χ2=3.984, P=0.046). Final retinal reattachment was obtained in all 49 eyes. Final macular hole closure was in 15 eyes (62.5%, 15/24) and 19 eyes (76.0%, 19/25) in group A and B, respectively, the difference was not statistically significant ( χ2=1.051, P=0.305). The mean postoperative logMAR BCVA of group A (1.20±0.47) and B (1.08±0.39) were all improved than preoperative BCVA, the differences were all statistically significant ( t=2.899, 5.327; P=0.001, 0.000), the differences of mean postoperative logMAR BCVA between two groups was not statistically significant ( t=0.675, P=0.506). The mean number of operation of group A (2.63±0.88) was more than group B (2.08±0.28), the difference was statistically significant ( t=3.003, P=0.006). Conclusion:In comparison with conventional PPV, combined PS marginal retinal photocoagulation can improve retinal reattachment rate after first surgery, and reduce the number of reoperations.
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Objective: To evaluate the preliminary efficacy and safety of the 5-fluorouracil/leucovorin, irinotecan, and oxaliplatin (FOLF-OXIRI) and capecitabine, irinotecan, and oxaliplatin (CAPIRINOX) regimens as first-line therapy for unresectable advanced colorectal cancer. Methods: Between January 2013 and November 2018, 73 patients with metastatic colorectal cancer (mCRC) were analyzed. All patients received first-line chemotherapy. Of them, 45 patients were administered FOLFOXIRI, and the remaining 28 patients were ad-ministered CAPIRINOX. The clinical outcomes and safety profiles were evaluated according to the objective response rate (ORR), con-version resection rate, and adverse effects. Results: The ORR, median progression-free survival (mPFS), and R0 resection rate in the FOLFOXIRI group were not statistically different from those in the CAPIRINOX group (60% vs. 57.1%, 7.7 months vs. 9.6 months, 24.4% vs . 17.9% , respectively; P>0.05). No treatment-related deaths occurred. The major adverse events were leukopenia, neutropenia, fa-tigue, nausea, vomiting, diarrhea, alopecia, aspartate aminotransferase/alanine aminotransferase elevation, and neurotoxicity. The to-tal rate of grade 3/4 adverse events in the FOLFOXIRI group was 33.3% (15/45), while the total rate of grade 3/4 adverse events in the CAPIRINOX group was 46.4% (13/28). Toxicities between the two groups were not statistically significant (P=0.263). Conclusions: Both the FOLFOXIRI and CAPIRINOX regimens are effective as first-line treatment for metastatic colorectal cancer. The triple-agent chemo-therapy was associated with good efficacy and tolerable toxicity.
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Recently,the immunological checkpoint inhibitors (ICIs) represented by programmed death-1/programmed cell death-ligand 1 antibody have shown dramatic efficacy in advanced gastric adenocarcinoma.Although the overall response rate is not high,great tumor regression and long-term control can be reported in particular population.More interestingly,efficacy and good tolerance are also documented in adjuvant or neoadjuvant treatments of lung cancer or other tumors.However,the rationality and feasibility of ICIs in perioperative treatments for locally advanced gastric cancer are not yet clear.This review will provide basic data for future clinical research and practice.
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Acute abdomen in patients with malignant tumors is called malignant acute abdomen, often seen in the digestive system tumor or abdominal pelvic metastasis of the other primary tumors. Bleeding, perforation, gastrointestinal obstruction, biliary obstruction with infection, acute peritonitis are acute and severe, however, prevention is more important than treatment. For high-risk patients, even if acute abdomen does not occur when the disease is diagnosed, we should make precautions, including actively local treatment of local lymph nodes or primary lesions and careful choice of drugs. Malignant acute abdomen is mainly treated by surgical intervention. However, to seize the opportunity of anti-tumor treatment while actively treating acute abdomen requires multidisciplinary team (MDT), including co-management of diagnostic team, treatment team and support team. Most patients with malignant acute abdomen are in late stage, so the role of medical oncologists can not be ignored in the prevention, intervention and management of malignant acute abdomen. For patients with potentially resectable malignant acute abdomen who are suitable for neoadjuvant therapy and technically unresectable malignant acute abdomen, the opportunity for drug treatment should be sought first. For those presenting with obstruction, bleeding or perforation during radiotherapy or chemotherapy, we should carefully evaluate the response of previous antitumor treatment, the reason of acute abdomen and discuss the option of surgery. Some concomitant medications may also increase the risk of malignant acute abdomen. Here, we discuss the role of medical oncologists in the management of malignant acute abdomen in the MDT setting.
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Humans , Abdomen, Acute , Therapeutics , Gastrointestinal Neoplasms , Therapeutics , Neoadjuvant Therapy , Oncologists , Patient Care TeamABSTRACT
Objective: To explore the significance of next-generation sequencing for the screening of high-risk hereditary gastrointesti-nal cancer patients and the value of high-risk factors in screening. Methods: Twenty-five hereditary high-risk gastrointestinal cancer pa-tients from March 2016 to April 2016 in Peking University Cancer Hospital were enrolled. They received detection of 42 hereditary can-cer syndrome related genes by next-generation sequencing. Results: Out of 25 patients enrolled, 24% (6/25) patients had pathological germline mutations. The expression of mismatch repair protein was absent in 50% (3/6) patients. There were 83% (5/6) patients with family history of malignant tumors and were diagnosed when younger than 50 years. Six patients had hereditary cancer syndrome re-lated gene mutation, 1 patient had MYH gene missense mutation, 1 patient had APC gene deletion mutation, 4 patients had heredi-tary colorectal cancer related gene mutation, including MLH1, MLH3, and TGFBR2 germline missense mutations as well as MSH6 non-sense mutation. Conclusions: Out of 25 patients with high-risk factors of hereditary gastrointestinal cancer, 6 (24%) had pathological germline mutations. Given the high frequency and wide spectrum of mutations, the application of next-generation sequencing for screening of hereditary high-risk gastrointestinal cancer patients has the clinical value for improving the positive rate of diagnosis.
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Polycythemia vera (PV) is a clonal myeloproliferative neoplasms (MPN) deriving from hematopoietic stem cells (HSC), with a median survival of about 14 years. Thrombosis is the major complication affecting the survival of PV patients as well as the most common cause of death in PV patients. For PV patients, thrombosis is the result of the combined effects of various factors, and its pathogenesis is very complicated. There are many factors affecting the incidence of thrombosis in PV patients, including age, history of thrombosis, count of blood cells, platelet activity, treatment modality, JAK2 V617F burden. This paper reviews the factors affecting thrombosis in PV patients.
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Objective The aim of this study was to examine the association between plasma Pentraxin 3(PTX3) levels with acute ischemic stroke and carotid artery atherosclerosis.Methods We enrolled 103 patients with acute ischemic stroke (AIS)and 83 control subjects.The levels of plasma PTX3 were measured by using Enzyme-linked immunosorbent assay (ELISA) at admission and after 7 days treatment in the AIS group.The carotid artery plaques in the AIS group were detected by using Color Doppler Ultrasound.Patients with AIS were divided into two groups according to the stability of carotid artery atherosclerosis plaques.The association between plasma PTX3 levels with acute ischemic stroke and the stability of carotid artery atherosclerosis plaques was examined.Results ① The plasma PTX3 levels were significantly higher in the AIS group than in the control group (P＜0.05).After 7 days standard treatment,the plasma PTX3 levels in AIS group were significantly decreased (P＜0.05),but still higher than those in control group (P＜0.05).Multivariable logistic regression suggested that the plasma PTX3 levels had a close relationship with AIS (OR=15.043,95％CI:3.46～65.45,P＜0.001).② In the AIS group,the plasma PTX3 levels before and after treatment were significantly higher in unstable plaque group than in no plaque and stable plaque group(P＜0.05).Conclusion The plasma PTX3 levels are higher in patients with acute ischemic stroke.The plasma PTX3 levels are significantly higher in AIS group with unstable plaque.The plasma PTX3 levels are closely associated with acute ischemic stroke.
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The cardiovascular disease has become one of the important chronic health problems for humans. At present, the research on the traditional risk factors of cardiovascular disease has been studied from the relevance to the mechanism. In this paper, the recent progress of the traditional risk factors of CVD and the impact mechanism are reviewed in order to provide a basis for the prevention, treatment and nursing of cardiovascular diseases.
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Sub-health status in the occupational population showed high incidence. Thus, it is necessary to improve the occupational groups of sub-health status, improve the health level of occupational groups. Shanghai university of traditional Chinese medicine Shuguang hospital treatment center (hereinafter referred to as disease prevention center), based on traditional Chinese medicine disease theory, did a lot of practices on occupational sub-health groups with Chinese medicine prevention and health care. Since 2014, three-year commitment to the Shanghai action plan project, the hospital has constructed a sub-health platform. This article discussed the experience of construction of sub-health platform for the construction of sub-health management system with Chinese characteristics and provided reference for the construction of sub-health management model.
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Objective To explore the clinical effect of treatment on facial soft tissue depression by autologous fat granule mixed with adipose-derived stem ceils.Methods A lof of 36 patients with facial soft tissue depression from September 2011 to March 2013 in this clinic were as the research objects.The autologous fat granules were harvested from patients' lateral thigh.The autologous fat granules mixed with adipose-derived stem cells (ADSCs) which were harvested by separating and cleaning were injected into facial soft tissue depression.The standard was based on the subjective satisfaction of patients and the physicians' objective assessment;there were two unrelated doctors to reach an objective assessment of the clinical efficacy based on the comparison of preoperative and postoperative photographs.Results A lof of 36 patients were followed up for 5 16 months,low absorption rate of injec ted fat and significant improvement in shape filling areas were observed,and skin texture,pores,spots and wrinkles were significantly improved.Conclusions Autologous fat granule mixed with AD SCs in the treatment of facial soft tissue depression is a minimally injuried,easily-handled,cheap and safe procedure.It is an ideal treatment of facial soft tissue depression.All the patients have no complications such as infection,induration and fat liquefaction.
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AFP-producing gastric cancer(AFPGC) and hepatoid adenocarcinoma of the stomach (HAS) are two special subtypes of gastric cancer. There are both correlation and difference between them. AFPGC is usually identified as primary gastric cancer with serum AFP level more than 20 ng/ml or showed AFP positive staining by immunohistochemistry. The diagnosis of HAS is mainly dependent on the pathological character of hepatocellular carcinoma-like differentiation of gastric cancer. The morbidity of AFPGC and HAS are rather low, especially the incidence of HAS is about 1%. The prognoses of these two subtypes are poorer than that of common gastric adenocarcinoma, due to a high incidence rate of liver metastasis and lymph node metastasis. With the development of next-generation sequencing and other genomic technologies, gastric cancers, including these two rare subtypes, are now being investigated in more detail at the molecular level. Treatment remains the biggest challenge, early diagnosis and radical resection can dramatically improve patients′prognosis. Monitoring serum AFP and abdominal imaging examination during follow-up is important for early detection of liver metastasis. In combination with local treatment methods such as transarterial chemoembolization and radiofrequency ablation of liver may further extend patients′survival time. Targeted therapy owes a great potential value in the future.
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Objective@#This study aimed to review the clinicopathological characteristics and prognosis of advanced gastric cancer patients with elevated serum Alpha-fetoprotein (AFP).@*Methods@#From August 2006 to May 2016, 70patients with advanced gastric cancer were enrolled retrospectively. All these patients had pathologically confirmed gastric adenocarcinoma, had a serum AFP level of more than 20 ng/ml, and received at least first-line treatment. The clinicopathological data and follow-up data were collected for analysis.@*Results@#Liver metastasis was more common in patients with AFP≥1 000 ng/ml, compared with AFP<1 000 ng/ml patients (78.6% vs 57.1%, P=0.064). In patients whose AFP level decreased ≥50% after first-line chemotherapy, the disease control rate and overall survival were both better than those in patients with AFP decreased <50%(96.3% vs 56.7%, P=0.001; 17.2 m vs 8.8 m P=0.007). The overall survival of all these 70 patients ranged from 0.5-50.0 months. 31 patients received chemotherapy only, and 39 patients received combined therapy modality. The overall survival of these two groups were similar(11.0 m and 15.6 m, respectively, P=0.070).@*Conclusions@#Serum AFP-elevated gastric cancer is a special subtype of gastric cancer. It′s a heterogeneous cancer with different clinical outcomes. The extent of decrease of serum AFP level during follow-up may be a sensitive prognostic and predictive biomarker. Liver metastasis were more common in these patients, and combined treatment may improve survival.
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Cardiovascular disease has become a major health problem facing human beings, and it is also the leading cause of death world wide.Now Cardiovascular disease risk factors have been found and many new complex risk factors (such as sleep, atmospheric pollution, social psychological factors, cortisol, C-reactiveprotein, homocysteine, age at menarche etc.) are put forward, which let people have a deeper understanding. In this paper, the recent advances in cardiovascular disease risk factors and influence mechanism are reviewed, so as to provide basis and support for cardiovascular disease in prevention, treatment and nursing.
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Cardiovascular disease has become a major health problem facing human beings, and it is also the leading cause of death world wide.Now Cardiovascular disease risk factors have been found and many new complex risk factors (such as sleep, atmospheric pollution, social psychological factors, cortisol, C-reactiveprotein, homocysteine, age at menarche etc.) are put forward, which let people have a deeper understanding. In this paper, the recent advances in cardiovascular disease risk factors and influence mechanism are reviewed, so as to provide basis and support for cardiovascular disease in prevention, treatment and nursing.