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OBJECTIVE:To systematically evaluate therapeutic efficacy and safety of recombinant mutant human tumor necrosis factor(rmhTNF)versus pleural perfusion of cisplatin in the treatment of malignant pleural effusions,and to provide evidence-based reference in clinic. METHODS:Retrieved from PubMed,Cochrane Library,Web of Science,CJFD,Wanfang database,VIP and CBM,RCTs about rmhTNF(trial group)vs. cisplatin(control group)in the treatment of malignant pleural effusions were included. Meta-analysis was conducted by using Rev Man 5.3 statistical software after quality evaluation and data extraction with Cochrane system evaluator manual 5.3.0. RESULTS:A total of 7 RCTs were included,involving 478 patients. Meta-analysis showed that clinical total response rate of trial group [RR=1.43,95%CI(1.27,1.62),P<0.001] was significantly higher than that of control group,with statistical significance. There was no statistical significance in the incidence of gastrointestinal reaction[RR=1.15,95%CI(0.73,1.80),P=0.55],chest pain[RR=1.12,95%CI(0.73,1.73),P=0.60],fever[RR=0.62,95%CI(0.35,1.08),P=0.09] and myelosuppression[OR=0.94,95%CI(0.57,1.54),P=0.79] between trial group and control group. CONCLUSIONS:Pleural perfusion of rmhTNF is significantly better than cisplatin in the treatment of malignant pleural effusions. The incidences of gastrointestinal reaction,chest pain,fever and myelosuppression induced by rmhTNF were similar to those induced by cisplatin.
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OBJECTIVE:To systematically evaluate the effectiveness of probiotics in adjunctive prevention and treatment of chemotherapy-induced diarrhea(CID),and to provide evidence-based reference in the clinic. METHODS:All relevant randomized controlled trials (RCTs) of probiotics in adjunctive prevention and treatment of CID were collected by searching EMBase,Co-chrane library,PubMed,CJFD,VIP,Wanfang databases and CBM. Meta-analysis were performed with Rev Man 5.2 software af-ter data extraction and quality evaluation by Cochrane Hand book 5.0risk-bias assessment tool. RESULTS:10 RCTs were includ-ed,involving 871 patients. The results of Meta-analysis showed that addition of probiotics on the basis of conventional symptomatic therapy significantly reduced the total rate of diarrhea in cancer patients [OR=0.31,95%CI(0.20,0.49),P<0.001] and Ⅲ-Ⅳ diar-rhea rate[OR=0.09,95%CI(0.03,0.24),P<0.001],improved overall response rate [OR=4.16,95%CI(2.40,7.23),P<0.001] and complete remission rate [OR=2.55,95%CI(1.66,3.90),P<0.001],with statistical significance. The probiotics had little effect onⅠ-Ⅱlevel diarrhea rate[OR=0.86,95%CI(0.48,1.56),P=0.62] and partial remission rate[OR=1.00,95%CI(0.67,1.50),P=1.00],with statistical significance. CONCLUSIONS:The use of probiotics before chemotherapy can effectively prevent the occur-rence of severe CID in cancer patients;in the treatment of CID,the combination of probiotics can also improve therapeutic effica-cy of conventional symptomatic treatment.
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Objective To investigate the radiobiological effects of radiation with different dose rates on human nasopharyngeal carcinoma cell line CNE-2 treated with or without a poly ADP-ribose polymerase (PARP) inhibitor,olaparib.Methods The concentration of olaparib used to treat cells equaled to the inhibition concentration IC10 of olaparib to CNE-2 cells.The CNE-2 cells were divided into acute radiotherapy (RT) group,fractionated radiotherapy (FRT) group,olaparib + RT group,and olaparib + FRT group.All groups were exposed to radiation of 0,1,2,3,5,7,and 10 Gy at a dose rate of 3 Gy/min.The delivery time for each dose point was 4 min in RT and 30 min in FRT.The colony forming assay was used to evaluate the survival of CNE-2 cells at each dose point.The multi-target,single-hit model was used to fit the cell survival curves and the parameters,D0,Dq,and SF2,were calculated.At dose points of 0.1,and 2 Gy,western blot was used to determine the expression of PARP-1 in the RT group and the FRT group and γH2AX in each group.Immunofluorescence was used to evaluate the γH2AX focus formation.A single factor analysis of variance was used to compare the 4 groups,and two two compared with SNK-q test.Results The IC10 value of olaparib to CNE-2 cells was 4.0 μmoL/L.At dose points of 1 and 2 Gy,the PARP-1 expression was significantly higher in the FRT group than in the RT group (P=0.029,0.022),while the γH2AX focus number was significantly smaller in the FRT group than in the other three groups (all P＜0.05);compared with the RT group,the D0,Dq,and SF2 values in the FRT group were increased by 11.67％,15.78％,and 23.61％,respectively;compared with the FRT group,the D0,Dq,and SF2 values in the Olaparib+ FRT group decreased by 11.19％,6.44％,and 13.26％,respectively;there were no significant differences in above indices between the RT group,the Olaparib+RT group,and the Olaparib+FRT group.Conclusions For the same radiation dose,fractionation reduces the relative dose rate and weakens the radiobiological effects.lowdose olaparib can compromise the single strand break repair induced by the decline of the relative dose rate in a fractionated irradiation mode,which promotes the formation of double-strand break and improves the radiobiological effects.
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Objective To evaluate the acute side effects and efficacy of the intraluminal brachytherapy combined with external radiation and synchronous chemotherapy in the treatment of bronchial lung cancer.Methods From June 2001 to June 2003,42 patients with bronchial lung cancer were divided into treatment group and control group randomly.21 lung cancer patients with major airway obstruction were treated by combined intralumihal brachytherapy with external beam radiotherapy and synchronous chemotherapy.Results The overall response rate(CR+PR)in treatment group and control group were 85.7% and 57.1%(P＜0.05).There were no serious complication during the treatment except for irritant cough and leukocytopenia.Conclusion Intraluminal brachytherapy may result in symptom improvement in patients with major airway occlusion of lung cancer.The intraluminal bmchytherapy combined with external beam radiothempy and synchronous chemotherapy is an effective method in treatment of lung cancer.
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Objective To observe the effect of Jisheng injection(JI)in preserving isolated heart of mice.Methods Langendorff' s isolated -perfused mouse heart mod el was established.The isolated hearts were preserved in modified Eu-ro -Collins solution(MECS)and MECS with JI added for 3h,7.5h and8.5h respectively.Cardiac functio n,coronary flow and myocardial water -volume (MWV)were observed after 3h ,7.5h and 8.5h of preservation,heart reactivatio n(HR)rate,coronary flow,MWV and time for HR were also observed.Results After 3h of preservation and 20min,30min or 40min of reperfusion,cardiac function and coronary flow in three M ECS +JI groups and especially in that of large dose were improved as compared with t hose in MECS group;MWV in large -dose and moderate -dose groups was obvi-ously lower than that in MECS group(P
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Objective To evaluate the clinical effect of Tiaoxie Wan(Chinese medicine for regulating the metabolic functions)on the metabolic syndrome.Methods Under the condition without changing their original treatment,the 62 metabolic syndrome patients were administered Tiaoxie Wan for oral taking in succession for 2 months.The blood lipid,glycolated hemoglobin(HbA1C),fasting insulin(FINS),insulin action index(IAI),body mass index(BMI),and the clinical effect of main symptoms were observed.Results After treatment,the symptoms such as dizziness,dry mouth,constipation,abdominal distention,and hot temper with irritability were significantly relieved,the total effective rate was all above 85%.The BMI,blood lipid,and HbA1C were significantly decreased,while the FINS and IAI were significantly increased(P