CT and MRI fusion based on generative adversarial network and convolutional neural networks under image enhancement / 生物医学工程学杂志

Aiming at the problems of missing important features, inconspicuous details and unclear textures in the fusion of multimodal medical images, this paper proposes a method of computed tomography (CT) image and magnetic resonance imaging (MRI) image fusion using generative adversarial network (GAN) and convolutional neural network (CNN) under image enhancement. The generator aimed at high-frequency feature images and used double discriminators to target the fusion images after inverse transform; Then high-frequency feature images were fused by trained GAN model, and low-frequency feature images were fused by CNN pre-training model based on transfer learning. Experimental results showed that, compared with the current advanced fusion algorithm, the proposed method had more abundant texture details and clearer contour edge information in subjective representation. In the evaluation of objective indicators, Q AB/F, information entropy (IE), spatial frequency (SF), structural similarity (SSIM), mutual information (MI) and visual information fidelity for fusion (VIFF) were 2.0%, 6.3%, 7.0%, 5.5%, 9.0% and 3.3% higher than the best test results, respectively. The fused image can be effectively applied to medical diagnosis to further improve the diagnostic efficiency.

Effect of BiPAP ventilation on respiratory physiology in patients with stable COPD / 中华健康管理学杂志

Objective:To observe the physiological effect of bi-level positive airway pressure (BiPAP) ventilation among stable chronic obstructive pulmonary disease (COPD) patients.Methods:This was a small sample size, exploratory, interventional study. A total of 10 outpatients with stable COPD were included from Department of Pulmonary and Critical Care Medicine of Zhujiang Hospital, Southern Medical University between January 2018 and December 2018. The BiPAP mode of noninvasive mechanical ventilation was adopted. The inspiratory positive airway pressure was gradually increased from 10 cmH 2O (1 cmH 2O=0.098 kPa) to 24 cmH 2O, and each time by 2 cmH 2O. The expiratory positive airway pressure remained unchanged at 4 cmH 2O. Baseline and test data were collected before and during the ventilation for comparison, including total respiratory cycle time (T tot), inspiratory time (T i), inspiratory time (T e), inspiratory tidal volume (V Ti); mouth pressure (P mo), esophageal pressure (P eso), transdiaphragmatic pressure (P di), esophageal pressure time product (PTP es), diaphragm pressure time product (PTP di), root mean square of electromyography of diaphragm (RMS), V e/RMS, inspiratory capacity (IC), the change in end-expiratory lung volume (ΔEELV) and dynamic PEEPi (PEEPi dyn). Results:All the 10 patients completed the trial. Compared to calm breathing, V Ti, V e, P mo, IC, ΔEELV score and V e/RMS increased significantly with increasing pressure levels (all P<0.05); T e only increased significantly at 20-22 cmH 2O pressure levels compared to calm breathing ( P<0.05). P di, PTP es, PTP di, RMS and RMS/RMS max decreased significantly with increasing levels (all P<0.05). PTP es and PTP di converged to 0 and no longer showed significant changes after the 18 cmH 2O pressure level. RMS and RMS/RMS max flattened out at pressure level greater than 16 cmH 2O. T i/T tot only significantly decreased at the 20 cmH 2O pressure level compared to calm breathing. PEEPi dyn showed a tendency to decrease and then increase with increasing pressure levels. Conclusion:BiPAP ventilation, at appropriate pressure levels, significantly relieves pulmonary ventilation disorders and reduces the load of respiratory muscle in patients with stable COPD.

Progress and prospects of international cancer drug clinical research on gastric cancer / 中华胃肠外科杂志

Gastric cancer is a common type of malignant tumor. Recently, a growing number of clinical researches initiated by investigators have provided valuable evidence for clinical practice. Here we review the perioperative treatment of locally advanced gastric cancer, and summarize the optimization of neoadjuvant treatment regimens, the exploration of new combinational treatment models and new adjuvant chemotherapy schemes, and the changes in the status of chemoradiotherapy in adjuvant therapy. At the same time, for the comprehensive treatment of advanced gastric cancer, the advances in the optimization of first-line chemotherapy regimens, emerging immunotherapy and targeted therapy are reviewed as well. Gastric cancer is a highly heterogeneous tumor. For further development of precision medicine represented by targeted therapy and immunotherapy, genetic testing-guided precise molecular subtyping will be the direction.

Value renal CT volumetric texture analysis with machine learning radiomics in assessment of pathological grade of clear cell renal cell carcinoma / 中华放射学杂志

Objective To investigate the value of renal CT volumetric texture analysis with machine learning radiomics in assessment of pathological grade of clear cell renal cell carcinoma(ccRCC). Methods Thirty-four biopsy-confirmed ccRCC subjects who had four-phase CT scanning (NC:non-contrast, CM: Corticomedullary, N: Nephrographic, E: Excretory) were collected retrospectively from June 2013 to October 2017 for the study.Non-rigid registration was performed on multi-phase CT images in reference to CM-phase.Each lesion was segmented on CM-phase CT images using our in-house volumetric image analysis platform,"3DQI".A set of fifty-nine volumetric textures,including histogram,gradient,gray level co-occurrence matrix(GLCM),run-length(RL),moments,and shape,was calculated for each segment lesion in each phase as parameters for the training/testing of Random Forest (RF) classifier. Four groups according to pathological Fuhrman grade on a scaleⅠtoⅣ,these tumors were then divided into low(Ⅰ+Ⅱ) and high grade ( Ⅲ + Ⅳ) groups. Feature selection was performed by Boruta algorithm. A 10-fold cross-validation method was applied to validate the RF performance by receiver operating characteristic (ROC) curves analysis to determine the diagnostic accuracy of the model. Results Subjects were divided into four groups by Fuhrman grade on a scaleⅠtoⅣ:3 cases gradeⅠ,19 cases gradeⅡ,8 cases gradeⅢand 4 cases gradeⅣ.In CM-phase,kurtosis and long-run-emphasis(RLE)were selected the most important textures for ccRCC staging among 59 features. The area under curve (AUC) of ROC was 0.88 (79% sensitivity and 82% specificity)by using kurtosis and RLE textures.The mean values of kurtosis and RLE were(-20.00±22.00)×10-2and(3.00±0.40)×10-2for low group,whereas(31.00±32.00)×10-2and(5.00± 0.02)×10-2for high group.Within the mean±SD range of statistics,radiomics can distinguish between low and high grade tumors.In multi-phase analysis,three most important features were selected among 236(59× 4) textures: kurtosis (CM-phase), GLCM homogeneity I (HOMO 1) (E-phase), and GLCM homogeneity 2 (HOMO2)(E-phase).The mean values of HOMO 1(E-phase)and HOMO 2(E-phase)were(19.00±0.03)× 10-2and(11.00±0.02)×10-2for low group,whereas(22.00±0.03)×10-2and(14.00±0.02)×10-2for high group. The AUC was 0.92(93% sensitivity and 87% specificity)by using these three textures. Conclusion This study has demonstrated that renal CT volumetric texture analysis with machine learning radiomics could preoperative accurately perform cancer staging for ccRCC.

microRNA-1183 Promotes the Proliferation and Metastasis by Suppressing the Expression of CBL-B in Gastric Cancer Cells / 中国医科大学学报

Objective To investigate the effect of microRNA-1183 on proliferation and metastasis on gastric cancer cells and to explore the role of microRNA-1183 and CBL-B signaling pathways in this process. Methods MGC803 cells were transfected with a microRNA-1183 mimic. Real-time PCR detected the expression of microRNA-1183 in gastric cancer cell line MGC803. MTT detected the proliferative effect of microRNA-1183 on MGC803 gastric cancer cells. A Transwell assay detected the effect of microRNA-1183 on the metastasis of MGC803 gastric cancer cells. A dual luciferase reporter assay detected the binding ability between microRNA-1183 and CBL-B. The expression of the protein was tested by Western blotting. Results MTT assay results showed that microRNA-1183 promoted the proliferation of MGC803 cells. Transwell assay results revealed that microRNA-1183 promoted the metastasis of MGC803 cells. The results of BLAST contrast analysis show that CBL-B is one of the target genes of microRNA-1183. Western blotting analysis showed that the mimic microRNA-1183 inhibited the expression of CBL-B. A dual luciferase reporter assay showed that CBL-B was the target gene of microRNA-1183. A CBL-B knockdown promoted the proliferation and metastasis of MGC803 cells. microRNA-1183 promoted the proliferation and metastasis of MGC803 cells by inhibiting the expression of CBL-B. Conclusion microRNA-1183 can inhibit the proliferation and metastasis of gastric cancer cell lines by inhibiting the expression of CBL-B.

Construction,Protein Expression,and Subcellular Localization of Various Kinase Mutant Plasmids of GATA1 / 中国医科大学学报

Objective The GATA1 mutant GATA1 S161A S187A (death type) and GATA1 S161D S187D (activated) eukaryotic expression vectors were constructed using the large primer method,and,to explore their biological function and potential tumor treatment targets,the expression and localization of the fusion protein in cells were confirmed. Methods S161A,S187A,S161D,and S187D mutants were amplified by GFP-GATA1 WT,which served as the template. The recombinant plasmid was cloned into a pEGFP-C1 expression vector and transfected into HEK293 cells by immunoblotting expression of the fusion protein. Results The eukaryotic expression vectors pEGFP-GATA1 S161A S187A and pEGFP-GATA1 S161D S187D were successfully constructed using the high primer PCR method,and expression of the fusion protein was verified. Confocal laser microscopy showed that the fusion protein was mainly located in the nuclei of HEK293 cells. Conclusion A eukaryotic expression vector of a GATA1 mutant was successfully constructed using the large primer method. This work lays the foundation for further studies on the structure and function of the mutant.

Protective effect and mechanism of Sestrin2 in the development of pulmonary alveolar type II epithelial cell injury induced by cigarette smoking / 中国比较医学杂志

Objective To explore the role of Sestrin2 in pulmonary alveolar type II epithelial cell injury induced by cigarette smoking and its mechanism of action. Methods The cell injury model was induced by cigarette smoke extract (CSE)in the human pulmonary alveolar type II epithelial A549 cells. The generation of ROS was detected by DCFDA fluorescence probe. The levels of inflammatory factors TNF-α and IL-8 were determined by ELISA, and the expression of Sestrin2 and the peroxiredoxin,Prx-SO2/3H,was detected by Western blot. In addition,all the events were also measured in the A549 cells which were transfected with Sestrin2 siRNA and treated with azithromycin. Results After the CSE treatment,the expression of Sestrin2 in the A549 cells was decreased, the expression of Prx-SO2/3H was increased, the ROS production,secretion of cytokines TNF-α and IL-8 were increased(P < 0.05). These changes were partly reducedby azithromycin, indicating that azithromycin significantly relieved CSE-induced oxidative stress and inflammatory injury.Silencing of Sestrin2 in the A549 cells result ed in an increase of Prx-SO2/3 H expression, ROS production and the secretionof the cytokines TNF-α and IL-8. However, oxidative stress and inflammatory injury were not alleviated with the addition ofazithromycin in the Sestrin2 siRNA silencing A549 cells. Conclusions Sestrin2 plays an protective role in the pulmonaryalveolar type II epithelial cell injury induced by cigarette smoking through negatively regulating the level of intracellularROS via catalyzing the reduction of the hyperoxidized peroxiredoxin Prx-SO2/3 H.

Mechanistic study of β-tubulin and its interaction with the dopamine D5 receptor, cholecystokinin B receptor, and water-sodium metabolism / 中国比较医学杂志

Objective To examine the role of β-tubulin on the interaction between the cholecystokinin B receptor (CCKBR),dopamine D5 receptor(D5R), and water-sodium metabolism. Methods Normotensive and hypertensive renal proximal tubular cells(RPTC)were equally randomized into three separate groups: a gastrin group, fenoldopam group,and gastrin+nocodazole group. Immunofluorescence was used to determine localization of β-tubulin,CCKBR,and D5R. Western blotting was used to detect CCKBR, D5R, and Na-K-ATP expression. Results Gastrin stimulation in normotensive RPTC increased D5R expression(P < 0.05)and decreased Na-K-ATP expression(P < 0.05). These changes were blocked by a tubulin inhibitor(P < 0.05). However, interaction between CCKBR, D5R, and Na-K-ATP expression was not significantly affected in hypertensive RPTC. Immunofluorescence showed that CCKBR and D5R can induce one another,followed by transport to the plasma membrane, which can prevented by a tubulin inhibitor. Further, tubulin is disordered in hypertensive RPTC,which cannot support intracellular CCKBR and D5R transport. Conclusions tubulin plays a key role in the interaction between CCKBR, D5R, and water-sodium metabolism by improving protein transfer from the cytoplasm to cell membrane.

Advances in Treatments for Small Cell Lung Cancer in Elderly Patients / 中国医科大学学报

Small cell lung cancer (SCLC) accounts for approximately 20％ of lung carcinomas.Nearly 30％ of patients with lung cancer are diagnosed over the age of 70 years and about 10％ over 80 years.Chemotherapy is the cornerstone of treatment for SCLC.However,elderly patients tolerate chemotherapy poorly as compared to their younger counterparts because of age-related progressive reduction in organ functions and the presence of comorbidities.Therefore,the best approach towards the development of active and well-tolerated chemotherapy regimens for elderly patients with SCLC is to design clinical trials that are based specifically on geriatric assessments.This review focuses on the major issues related to the treatment of elderly patients with SCLC.

Role of Akt and SRC Pathways in Exosome?mediated Proliferation of Homologous Lung Adenocarninoma Cells / 中国医科大学学报

Objective To explore the effect of Exosomes isolated from the A549 lung cancer cells on the proliferation of these cells and their ho?mologous tumor cells,HCC827,and the role of the PI3K/Akt and SRC signaling pathways in this process. Methods Exosomes were isolated from the supernatant after density gradient centrifugation of A549 cells. The Exosomes morphology was observed by transmission electron microscopy. The expression of the Exosome?specific proteins was analyzed using Western blotting. Cell proliferation was investigated using the MTT assay. Re?sults The A549?derived Exosomes were 30?100 nm in diameter and had a bilayer membrane.Western blotting showed that CD9 was detected in these Exosomes. The isolated Exosomes promoted the proliferation of the A549 and the HCC827 cells in a dose?and time?dependent manner,ac?companied by the activation of Akt and SRC. Conclusion Exosomes isolated from A549 cells promote the proliferation of the secreting cells and the homologous tumor cells in a dose?and time?dependent manner. The mechanism may be related to the activation of Akt and SRC.

Ethical Reflection on Standardized Management of Intestinal Microbiota Transplantation / 中国医学伦理学

Intestinal microecology is an important and complex biological system necessary for human health.Its disorder is involved in the development of various diseases of human body.The technology of intestinal microbiota transplantation can effectively regulate the intestinal flora,repair the imbalance of the intestinal microecology,and bring a new breakthrough for the treatment of many diseases of gastrointestinal tract and outside gastrointestinal tract.However,there is still no systematic and complete management standard for intestinal microbiota transplantation technology.This paper discussed related content involved in standardized management of intestinal microbiota transplantation technology and reflected the ethical problems involved in standardized management from the perspective of medical ethics,in order to promote the clinical application of intestinal microbiota transplantation technology.

Role of Akt and SRC Pathways in Exosome-mediated Migration of Homologous Lung Adenocarninoma Cells / 中国医科大学学报

Objective To investigate the effect of Exosomes derived from lung cancer cells on the migration of secretory cells and homologous tumor cells and to explore the role of PI3K/Akt and SRC signaling pathways in this process.Methods Exosomes were isolated from the supematant post density gradient centrifugation of A549,lung cancer cells.Morphology of the Exosomes was studied using transmission electron microscopy.Protein expression was analyzed using Western blotting.Cell migration was analyzed by a transwell assay.Results The double-membrane-bound Exosomes appeared as discal-shaped structures,30-100 nm in diameter.Western blotting showed that CD9 was abundant in the Exosomes.The Exosomes promoted the migration of A549 cells and their homologous tumor cells,HCC827 in a dose-dependent manner,accompanied by the activation of Akt and SRC.Conclusion The Exosomes derived from A549 (lung cancer) cells promote the migration of the secreting cells and the homologous tumor cells.The mechanism may be correlated with the activation of Akt and SRC.

The study on the mechanism of platelet in the development of salt-sensitive hypertension via inflammation / 中国比较医学杂志

Objective To investigate the role and mechanism of platelet in the development of salt-sensitive hypertension.Methods 25 Dahl salt-sensitive rats (Dahl SS) were divided into three groups: low-salt diet (0.12% NaCl, LS), high-salt diet (8%NaCl, HS) and high-salt diet + platelet inhibitor (8%NaCl+busulfan, HS+bus).Blood pressures were measured by tail-cuff method.After six weeks, animals were sacrificed.Platelet p-selectin expression, platelet cytosolic Ca2+ concentration, platelet-leukocyte aggregation (PLA) in peripheral blood, and immune cells infiltrated on aortic walls were assessed by flow cytometry, and serum IL-6 level was tested by ELISA in vivo.Platelets purified from SD rats were treated with normal salt (0.9%NaCl) and high salt (1.3%NaCl), then the cytosolic Ca2+ concentration and p-selectin expression of platelet were detected.Results We found that Dahl SS rats with high-salt diet, relative to low-salt diet, presented with high blood pressure and increased the ratio of platelet p-selectin expression, Ca2+ concentration.IL-6 level and PLA in peripheral blood, and the number of infiltrated immune cells on aortic walls were also significantly elevated in high-salt diet group.The whole events were ameliorated by the platelet inhibitor busulfan.Cytosolic Ca2+ concentration and p-selectin expression were also increased in purified platelets treated with high salt than those treated with low salt (P < 0.05).Conclusions Our findings suggest that high salt induced platelet activation with increased Ca2+ concentration may play an important role in the development of salt-sensitive hypertension via vascular inflammation.However, the detailed mechanisms of platelet activation and development of high blood pressure via inflammation induced by high salt intake remain to be determined.

Analysis of Clinical Significance of AKT3 Expression in Gastric Cancer Utilizing TCGA Datasets / 中国医科大学学报

Objective To investigate the prognostic value of AKT3 expression in gastric cancer. Methods AKT3 expression data in The Cancer Genome Atlas(TCGA)datasets and its clinical information were downloaded. Statistically assessed was performed for relationship with clinicopatho?logical factors and prognosis. Gene set enrichment analysis(GSEA)was used to predict the gene sets modulated by AKT3. Results The expres?sion of AKT3 was associated with T stage(P=0.001),TNM stage(P=0.049)and differentiation(P<0.001).High level of AKT3 expression indi?cates poor prognosis(P=0.001). AKT3 could regulate gene sets involving cell adhesion molecule,cytoskeleton regulation,focal adhesion and TGF?βsignaling pathway. Conclusion AKT3 could be used as a potential prognostic marker and a therapeutic target in gastric cancer.

Association of UGT1A1*6 Polymorphisms with Irinotecan-induced Toxicities:A Meta-analysis / 中国医科大学学报

Objective To conduct a meta?analysis of literatures to explore the relationship of UGT1A1*6 gene polymorphism and irinotecan toxici?ty,so as to guide clinical treatment. Methods Papers were searched by PubMed database and manual search. The inclusion and exclusion criteria of studies were formulated and the methodologies quality was assessed,data were extracted and the statistical analysis was made using STATA12.0 software. Results A total of 12 articles were included according to the inclusion and exclusion criteria. Patients with mutated UGT1A1*6 showed an increased risk for neutropenia compared to wild UGT1A1*6(OR=2.37,95%CI 1.58?3.55,P=0.001). Both homozygous and heterozygous muta?tion showed an increased risk for neutropenia compared to wild type and the homozygous mutation(OR=5.09,95%CI 2.74?9.45,P<0.001) showed an even higher risk for neutropenia compared to the heterozygous mutation(OR=2.07,95%CI 1.37?3.13,P=0.001). For severe diarrhea, mutated UGT1A1*6 showed an increased risk compared to wild type(OR=1.48,95%CI 0.86?2.55,P=0.153),though without statistical signifi?cance. The homozygous mutation performed a significantly increased risk(OR=3.51,95%CI 1.33?9.25,P=0.011)and the heterozygous mutation also showed increased risk,however,the difference between them was not statistically significant. Conclusion UGT1A1*6polymorphisms can pre?dict irinotecan toxicity,especially for incidence of neutropenia.

Clinical Analysis of Treatment and Prognosis of Patients with Pain Caused by Malignant Bone Metastasis / 中国医科大学学报

Objective To analyze the clinical features,therapeutic effect and prognosis in patients with bone pain induced by malignant bone me?tastasis as well as the rationality of analgesic application,so as to improve the level of diagnosis and treatment for metastatic bone pain. Methods Totally 123 patients with pain due to malignant bone metastasis received antitumor therapy and analgesic therapy based on standardized three?step guidelines. Their clinical characteristics were retrospectively analyzed. Results The total pain relief rate was 85.4%and the pain was significantly relieved(P<0.05). The DUI value of each narcotic agent was close to 1 and the application of narcotic agents tended to be rational. The Kaplan?Meier survival analysis showed that patients with moderate pain had longer survival time than those with severe pain(P=0.015). The survival rate of patients with significant pain relief after treatment was higher than those unrelieved(P=0.021). The survival rate of patients without visceral me?tastasis was higher than those with visceral metastasis(P=0.000). The COX multivariate analysis indicated that the pain intensity and visceral me?tastasis were independent risk factors influencing patient prognosis. Conclusion Standard treatment can improve symptoms in most patients with bone metastasis and prolong survival time. Opioids have satisfactory analgesic effect for moderate to severe pain and the adverse reactions can be tol?erated.

The Evaluation of Anti-tumor Effect of CTL Induced by Oxidized Mannan-modified Tumor Cells Vaccine / 中国医科大学学报

Objective To study to take the oxidized Mannan?modified 786?0 in renal clear cell carcinom as tumor cells antigen to sensitize Dendrit?ic cells(DC)and to observe the its killing effect on renal clear cell carcinoma of CTLs induced. Methods Getting the peripheral blood mononucle?ar cells from the volunteers,and then to be stimulated to turn to be maturation by GM?CSF and IL?4 in vitro. Taking the clear renal carcinoma cell as the tumor antigen,and then making it to be modified by oxidized Mannan to acquire the tumor cell vaccine.Experimental groups include:blank group:DC?PBS group,control group:control?DC?786?0,experimental group:DC?Ox?Mannose?786?0 group. Taking the flow cytometry to detect the changes of DC phenotype,then taking the ELISA to detect the sencretion levels of supernatant of IL?12 of DC,then taking the CCK to detecte the cytotoxicity of lymphocytes(CTL)induced by DC of these experiment groups. Results Results by flow cytometry:the mature phenotype of DCs sensitized by Ox?Mannose?786?0 group included CD80,CD83,CD86 and HLA?DR expressed significantly higher than the other groups. As well as the secretion levels of IL?12. Meanwhile the cytotoxicity activity of lymphocytes(CTLs)induced by DCs which are sensitized by Ox?Mannose?786?0 increased more significantly than the other groups. Conclusion Glycosylated Antigens can be more effective in sensitizing antigen?presenting cells DC,and stimulating them to be maturation,while the killing effect to tumor cells also have noticeably improved.

Type 2 diabetes mellitus is a prognostic predictor in patients with resectable pancreatic ductal adenocarcinoma / 中国肿瘤临床

Pancreatic ductal adenocarcinoma (PDAC) is one of the most aggressive and lethal human cancers. Cur-rent studies on the relationship between complicated type 2 diabetes mellitus (T2DM) and PDAC prognosis have demonstrated inconsis-tent results. The present study aimed to determine the relationship between complicated T2DM and the clinicopathological characteris-tics of PDAC, and evaluate whether complicated T2DM is a significant predictor for overall survival in patients with resectable PDAC. Methods: In this study, clinicopathological characteristics were observed in 136 patients who underwent surgery for PDAC at the Shengjing Hospital of China Medical University between January 2009 and February 2011. The relationship between complicated T2DM and overall survival of PDAC patients was analyzed using univariate and multivariate analyses. Results:The median age of pa-tients was 60 years (range: 35-80 years). Among the 136 patients, 76(55.9%) were male. The prevalence of complicated T2DM was 27.9%in 136 PDAC cases. Preexisting T2DM was not associated with any of the clinicopathological characteristics (all P>0.05). Uni-variate analysis showed that complicated T2DM (P=0.045), maximum diameter (P=0.011), histological differentiation (P=0.013), pT stage (P=0.034), vessel invasion (P=0.032), and pTNM stage (P=0.030) were significantly associated with the overall survival of PDAC patients. The median overall survival time was 14.2 months for T2DM patients, and 18.8 months for non-T2DM patients. In mul-tivariate analysis, complicated T2DM [hazard ratio (HR), 1.873;95%confidence interval (CI), 1.187-2.954;P=0.007], poorly differenti-ated tumor (HR, 2.647;95%CI, 1.413-4.957;P=0.002), and maximum diameter≥4.0 cm (HR, 1.699;95%CI, 1.094-2.640;P=0.018) were the independent predictors associated with poor overall survival. Conclusion:Complicated T2DM was associated with poor prog-nosis. It could be used as a prognostic predictor in patients with resectable PDAC. If confirmed, these findings may provide a novel ap-proach for individualized adjuvant therapy.

Adjuvant capecitabine and oxaliplatin for gastric cancer after D2 gastrectomy (CLASSIC): Chinese subgroup analysis / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety profile of XELOX (capecitabine/oxaliplatin) in patients with locally advanced gastric cancer who underwent curative D2 resection in China.</p><p><b>METHODS</b>This is a subgroup analysis of Chinese patients in the capecitabine and oxaliplatin adjuvant study in stomach cancer (CLASSIC study), which was a randomised, open-label, multicentre, parallel-group, phase III( study in the Asia-Pacific region. A total of 100 gastric cancer patients who received curative D2 gastrectomy were enrolled in this study and were randomly assigned to either XELOX group (oral capecitabine combined with intravenous oxaliplatin chemotherapy) or the control group (surgery alone). This study aims to compare the 3-year disease-free between the two groups.</p><p><b>RESULTS</b>Subgroup analysis showed that 3-year DFS rate were 78% and 56% in XELOX and control group, respectively. The risk of relapse in XELOX group was reduced by 59% (HR=0.41, 95%CI:0.20-0.85, P=0.013), compared with the control group. The 3-year overall survival rate were 78% and 66% in XELOX and control group, with no statistically significant difference (HR=0.55, 95%CI:0.26-1.16, P=0.110).</p><p><b>CONCLUSION</b>Adjuvant XELOX chemotherapy following D2 gastrectomy may improve the survival in patients with advanced gastric cancer in China.</p>

Advances in study on the therapy for limited-stage small cell lung cancer / 中南大学学报(医学版)

Small cell lung cancer (SCLC) are divided into limited and extensive stage diseases. Limited-stage SCLC (LS-SCLC) is conifned to the ipsilateral hemithorax and within a single radiotherapy region, 30%-40%of patients with SCLC are limited stage. The median ranges of survival for patients with LS-SCLC is from 15 to 20 months. Approximately 20%-40%of patients with LS-SCLC can survive for two years. According to the guidelines, patients with LS-SCLC should be treated with combined concurrent chemoradiotherapy and patients with LS-SCLC achieving a complete remission or patient with stage I disease who have had resection should be offered prophylactic cranial irradiation (PCI). Whereas in SCLC, targeted therapies is still in the early stage and few clinical trial data is available to support its effect.