Manifestation of leukoencephalopathy in a patient with advanced non-small cell lung cancer following treatment with gefitinib / 中华医学杂志(英文版)

The present case is a patient with advanced non-small cell lung cancer (NSCLC) who developed leukoencephalopathy following radiotherapy and gefitinib treatments. There are rarely reports of such incidences because the median survival period of advanced NSCLC is only ten months. The features of leukoencephalopathy in this case were atypical for radiation leukoencephalopathy, so it was suspected that the leukoencephalopathy was associated with gefitinib.

Impact of smoking status and pathologic type on epidermal growth factor receptor mutations in lung cancer / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Epidermal growth factor receptor (EGFR) mutations in lung carcinomas can make the disease more responsive to the treatment with tyrosine kinase inhibitors. We aimed to evaluate the prevalence of EGFR mutations in a large series of lung carcinomas.</p><p><b>METHODS</b>We examined 1195 consecutive lung cancer patients for EGFR mutations in exons 18, 19, and 21 using direct sequencing of polymerase chain reaction products. A detailed smoking history was obtained. Patients were categorized as never smokers (< 100 lifetime cigarettes), former smokers (quit > 1 year ago), or current smokers (quit < 1 year ago).</p><p><b>RESULTS</b>There were EGFR mutations in 9 (4.5%) of 201 squamous carcinomas, in 1 (2%) of 50 large cell carcinomas, and in 1 (2.3%) of 44 small cell carcinomas that were investigated. Three hundred and twenty-seven mutations were found in the series of 858 adenocarcinomas (38.1%). Among 858 lung adenocarcinomas, we detected EGFR mutations in 250 (48.6%) of 514 never smokers, 39 (33.9%) of 115 former smokers, and 38 (16.6%) of 229 current smokers. Significantly fewer EGFR mutations were found in people who smoked for more than 15 pack-years (P = 0.0002) or stopped smoking less than 15 years ago (P = 0.033) compared with individuals who never smoked.</p><p><b>CONCLUSIONS</b>Adenocarcinoma is the most frequent EGFR mutation pathologic type in lung cancer. The likelihood of EGFR mutations in exons 18, 19 and 21 decreases as the number of pack-years increases. Mutations were less common in people who smoked for more than 15 pack-years or who stopped smoking cigarettes less than 15 years ago. These data can assist clinicians in assessing the likelihood of exons 18, 19, or 21 EGFR mutations in Chinese patients with lung cancer when mutational analysis is not feasible.</p>

Clinical observation of lumbar spinal stenosis treated with deep puncture at Jiaji (EX-B 2) / 中国针灸

<p><b>OBJECTIVE</b>To explore the clinical efficacy on lumbar spinal stenosis treated with deep puncture at Jiaji (EX-B 2) with round-sharp needle.</p><p><b>METHODS</b>One hundred and fifty cases of lumbar spinal stenosis were divided randomly into a deep puncture at Jiaji (EX-B 2) group (deep puncture group) and a conventional needling group, 75 cases in each one. In deep puncture group, the round-sharp needle was used to puncture Jiaji (EX-B 2) deeply to the nerve root in vertebral canal. Additionally, the conventional acupuncture with filiform needle was applied at the acupoints selected according to the symptoms, such as Shenshu (BL 23), Weizhong (BL 40), Zusanli (ST 36) and Zhibian (BL 54), etc. In conventional needling group, acupuncture with filiform needle was adopted at the acupoints as those in deep puncture group. The clinical symptom scores and efficacies of the patients in two groups were observed after 4 weeks treatment and 3 months of follow-up visit separately.</p><p><b>RESULTS</b>After treatment and in follow-up visit, the clinical symptom scores all increased apparently for the patients in two groups (all P < 0.01). The result in deep puncture group was superior to that in conventional needling group (both P < 0.01). In deep puncture group, the total effective rates were 100.0% (75/75) and 96.0 (72/75) after treatment and in follow-up visit respectively, which were all superior to 92.0% (69/75) and 84.0% (63/75) in conventional needling group (both P < 0.05).</p><p><b>CONCLUSION</b>The deep puncture at Jiaji (EX-B 2) with round-sharp needle achieves superior efficacy as compared with the conventional needling therapy in treatment of lumbar spinal stenosis. The prognosis of it is better and the disease is hardly recurred.</p>

Clinical observation on three-combination needling method for treatment of primary trigeminal neuralgia / 中国针灸

<p><b>OBJECTIVE</b>To probe into a better therapy for primary trigeminal neuralgia.</p><p><b>METHODS</b>Eighty-six cases were randomly divided into an observation group (n = 46) and a control group (n = 40). The observation group were treated with the three-combination needling method, i. e. acupuncture, acupoint-injection and fire-needle therapy, and the control group with acupuncture and acupoint-injection. After treatment of 2 courses, their therapeutic effects were assessed.</p><p><b>RESULTS</b>The total effective rate of 93.5% and the cured rate of 60.9% in the observation group were better than 65.0% and 22.5% in the control group, with significant differences (both P < 0.01).</p><p><b>CONCLUSION</b>The three-combination needling method has obvious clinical therapeutic effect on primary trigeminal neuralgia.</p>

Weekly gemcitabine as a radiosensitiser for the treatment of brain metastases in patients with non-small cell lung cancer: phase I trial / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Conventional treatment for non-small cell lung cancer (NSCLC) brain metastases (BM) is whole-brain radiotherapy (WBRT). The efficacy is limited. It might be increased by a potent radiosensitizer such as gemcitabine, which is believed to cross the disrupted blood-brain barrier. The primary objective of this study was to determine the maximum tolerated dose (MTD) of weekly gemcitabine given concurrently with WBRT.</p><p><b>METHODS</b>Patients with BM from NSCLC were included. The dose of WBRT was 3750 cGy (total 15 times, 3 weeks). Gemcitabine was given concurrently with WBRT on days 1, 8 and 15. The starting dose was 400 mg/m(2), escalated by 100 mg/m(2) increments. At least three patients were included per level. Dose limiting toxicity (DLT) was defined as grade 4 hematological or grade 2 neurological toxicity. When two or more patients experience DLT, the MTD was reached.</p><p><b>RESULTS</b>A total of 16 patients were included; 69% had a performance status (PS) 1 (Eastern Cooperative Oncology Group, ECOG). A total of 69% had concurrent active extra cranial diseases. All had more than 3 BM. Up to 600 mg/m(2) (level 3) no neurology toxicity was observed. At 600 mg/m(2) two out of 9 patients developed grade 4 thrombocytopenia. One of the two patients' thrombocytopenia was confused with disseminated intravascular coagulation (DIC). At 700 mg/m(2) two out of 4 patients developed neurotoxicities. One developed grade 3 seizure and cognitive disorder. Another patient developed suspected grade 2 muscle weakness.</p><p><b>CONCLUSIONS</b>The MTD was reached at a dose of 700 mg/m(2). The dose of 600 mg/m(2) would be considered for further study.</p>

Clinical study on round-sharp needle therapy combined with massage for prolapse of lumbar intervertebral disk / 中国针灸

<p><b>OBJECTIVE</b>To search for a better therapy for prolapse of lumbar intervertebral disk.</p><p><b>METHODS</b>One hundred and sixteen cases were randomly divided into a treatment group treated with round sharp needle plus massage, and a control group with filiform needle plus massage, 58 cases in each group. Changes of symptoms and signs were observed before and after treatment.</p><p><b>RESULTS</b>The effective rate was 98.2% in the treatment group and 82.8% in the control group (P < 0.01).</p><p><b>CONCLUSION</b>Round sharp needle combined with massage has a better therapeutic effect on prolapse of lumbar intervertebral disk.</p>