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Objective To evaluate the short-term efficacy,safety and impact on the quality of life of anlotinib in third-line and above treatment for advanced non-small cell lung cancer (NSCLC) patients.Methods All the patients received alotinib 12 mg/d.One cycle was defined as 2 weeks on-treatment followed by 1 week off-treatment until disease progression or treatment intolerance.Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 was used to assess tumor responses.Common Terminology Criteria for Adverse Events (CTCAE) 4.02 was used to assess the adverse events.The European Organization for Research on Treatment of Cancer (EORTC) QLQ-C30 and QLQ-LC13 were used to assess quality of life.Results Among 27 patients in study,no complete response (CR) was found,2 patients (7.4％) achieved partial response (PR),16 patients (59.3％) achieved stable disease (SD),9 patients (33.3％) achieved progressive disease (PD),objective response rate (ORR) was 7.4％,and disease control rate (DCR) was 66.7％.The scores of physical functioning (76.00 ± 10.55 vs.64.44 ± 11.59),emotional functioning (81.67 ± 8.71 vs.76.11 ±6.71) and global health status (48.87 ±7.97 vs.40.56 ± 12.49) of the QLQ-C30 scale after treatment were higher than those before treatment,with statistically significant differences (t =-4.516,P ＜0.001;t=-2.646,P=0.019;t=-3.872,P=0.002).Fatigue (50.37±8.95 vs.40.74±13.86),nausea and vomiting (26.54 ± 16.18 vs.14.20 ± 11.97),loss of appetite [M(QR):33.33 (33.33) vs.33(33.33)] were better than before (t =-2.476,P =0.027;t =-5.036,P ＜0.001;Z =-2.923,P =0.003);pain (28.88 ± 14.23 vs.33.33 ± 13.60) and dyspnea [33.33 (33.33) vs.33.33 (66.67)] scores were lower than before (t =3.674,P =0.003;Z =-3.266,P =0.001).The scores of cough (24.44 ±19.12 vs.45.24 ±20.34),shortness of breath [11.11(22.22) vs.33.33(22.22)] and chest pain [0.00(33.33)vs.33.33 (33.33)] in the QLQ-LC13 scale after treatment were lower than those before treatment,with statistically significant differences (t =4.000,P =0.001;Z =-4.125,P ＜0.001;Z =-1.890,P =0.034);the scores of sore mouth or tongue [0.00(33.33) vs.0.00(0.00)] and hands and feet tingling [33.33(33.33) vs.0.00(0.00)] were higher than before (Z=-2.000,P=0.046;Z=-2.264,P=0.024).Common adverse reactions included hypertension,fatigue,elevated thyroid stimulating hormone,proteinuria,hand-foot syndrome,oral mucositis,hemoptysis,etc,mainly grade 1-2,and they were all improved after the treatments.Conclusion Anlotinib as a third-line and further therapy is positive effected and well tolerated.It can alleviate the clinical symptoms and significantly improve the quality of life of NSCLC patients.
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The effect of different doses of ulinastatin on cellular immunity and hepatorenal functions in patients undergoing laparoscopic colorectal-carcinoma surgery was observed and analyzed. The 200 patients with laparoscopic colorectal-carcinoma surgery in our hospital were selected as research subjects and divided into 4 groups containing equal patients, namely, saline group, 0.5 x 104U/kg ulinastatin group, 1 x 104U/kg ulinastatin group, and 1.5 x 104U/kg
ulinastatin group, which were denoted as group A, group B, group C and group D, respectively. The treatment effect of patients in 4groups was observed and compared. By observing the Narcotrend cerebral state index [NT index], the results showed that NT index at tracheal intubation, pneumoperitoneum beginning, pneumoperitoneum 30min, resection of tumor, end of operation in 4 groups was significantly lower than that at preoperative anesthesia [T0] [p<0.05];
differences in hepatorenal values [AST, ALT, BUN and Cr] among 4 groups at T0 were of no statistical significance [P > 0.05]; each index in T cell subsets in the postoperative third days [T1] was significantly lower than that at T0; indexes of T cell subgroup of group B, C and D at T1 were higher than that of group A at T1 [p<0.05]. For 4 groups, the difference in liver and kidney function indicators at T1 and T0 was of no statistical significance, p>0.05. Different doses of ulinastatin have a certain effect on cellular immunity in patients undergoing laparoscopic colorectal-carcinoma surgery and do not significantly affect hepatorenal function
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Objective To evaluate the short-term clinical results of total hip arthroplasty(THA) through a direct anterior minimally invasive approach aided by lower extremity tractor for hip diseases.Methods Between August 2013 and August 2015,115 patients (138 hips) were admitted for hip diseases.They were 71 men and 44 women,aged from 28 to 77 years (average,59.4 years).Their body mass indexes ranged from 19.7 kg/m2 to 28.9 kg/m2,averaging 24.7 kg/m2.Their hip diseases included avascular necrosis of the femoral head in 56 cases (with an average disease course of 15.7 months),hip osteoarthritis in 35 cases (with an average disease course of 12.6 months),hip dysplasia in 14 cases (with an average disease course of 2.8 years) and inflammatory arthritis in 10 cases (with an average disease course of 6.8 years).All the patients were treated by primary THA through a direct anterior minimally invasive approach and assistance of lower extremity tractor.Results All the 115 patients (138 hips) were followed up for an average of 31.6 months (from 12 to 40 months).Their average length of incision was 9.4 cm,average operative time 115.9 min,average blood loss 210.2 mL,and average hospital stay 7.5 days.Their postoperative imaging results were as follows:the angles of acetabular abduction averaged 41.6° (from 37° to 56°) and the angles of acetabular anteversion 18.1° (from 11° to 23°).Their average Harris hip score one year postoperatively was 91.4 points (from 80 to 96 points).Split fracture of the proximal femur happened in one patient (one hip) (0.7％) intraoperatively;injury to lateral femoral cutaneous never was observed in 6 patients (7 hips) (5.1％).Complications like deep infection,hip dislocation,deep vein thrombosis or prosthetic loosening were not observed during follow-ups.Conclusions THA with assistance of lower extremity tractor through a direct anterior minimally invasive approach can lead to fine short-term clinical results,including quick recovery of hip function and decreased intraoperative and postoperative complications.
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Objective: To investigate the efficacy and safety of using pegylated recombinant human granulocyte-colonystimulating factor (PEG-rhG-CSF) in preventing neutropenia in multiple chemotherapy cycles. Methods: A multicenter, prospective, open-label, singlearmstudy was designed. Patients with malignant tumors, such as lung, ovarian, and colorectal cancers, who received multiple cycles of chemotherapy with the prophylactic use of PEG-rhG-CSF for 2-4 consecutive cycles participated in the study. Results: After the prophylactic use of PEG-rhG-CSF, the incidence of grade IV neutropenia decreased from 4.76% (13/273) in the first cycle to 1.83% (5/273), 1.15% (2/174), and 2.08% (2/96) in subsequent cycles. Meanwhile, the incidence of grade III neutropenia decreased from 11.36% (31/ 273) in the first cycle to 6.23% (17/273), 2.87% (5/174), and 3.13% (3/96) in subsequent cycles. The incidence of febrile neutropenia (FN) during the first cycle was 0.73% (2/273). The duration of FN was 2 days in one case and 5 days in another case. FN was not observed during the second, third, or fourth cycle. After the secondary prophylactic use of PEG-rhG-CSF, the incidence of grade IV neutropenia decreased from 25% (7/28) to 3.57% (1/28), 0% (0/28), and 6.67% (1/15) in subsequent cycles. Meanwhile, the incidence of grade III neutropenia decreased from 71.43% (20/28) to 10.71% (3/28), 14.29% (4/28), and 0% (0/15) in subsequent cycles. The proportion of patients who received antibiotic therapy during the entire chemotherapy period was 10.48% (44/420). Conclusion: The application of PEG-rhG-CSF once per chemotherapy cycle can effectively reduce the occurrence of neutropenia in patients under multiple cycles of chemotherapy treatment with good safety.
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Purpose To clarify the role of KAI1/CD82 in metastasis of nasopharyngeal carcinom and to evaluate the clinical efficacy of KAI1/CD82-expressing EPCs in the prevention of nasopharyngeal carcinoma.Method Umbilical vein-derived EPCs were infected with KAI1/CD82-expressing lenti-virus to get a KAI1/CD82-overexpressing EPC cell line (KAI1/CD82-EPCs).A xenograft mouse model of human nasopharyngeal carcinoma was established,and KAI1/CD82-EPCs were injected through the tail vein.The effect of the KAI1/CD82-EPCs on growth and metastasis of the xenograft was observed.Results Time required for tumor formation was 14.70 ± 3.81,15.05 ±3.85,14.20 ± 3.55 days respectively for the EPCs,EPCs-NC,and KAI1/CD82-EPCs groups,with no significant difference among the three groups (P =0.771).Weight of the xenograft was (1.388 ±0.204) g,(1.487 ±0.223) g,(1.485 ±0.234) g respectively for the EPCs,EPCs-NC,and KAI1/CD82-EPCs groups,with no significant difference (P =0.274).Rate of lung metastasis was 55％,45％ and 10％ for the EPCs,EPCs-NC,and KAI1/CD82-EPC groups,and the difference was significant (P =0.005).Number of metastatic lesions was 34.27 ± 5.35,38.44 ± 9.63,17.50 ± 3.54 for the three groups,and the difference was also significant (P =0.007).Immunohistochemistry indicated positive KAI1/CD82 expression in metastatic lesion of the KAI1/CD82-EPCs group,but no KAI1/CD82 expression in the EPCs group or EPCs-NC group.Conclusion KAI1/CD82-expressing EPCs inhibits lung metastasis of the xenograft mouse model of human nasopharyngeal carcinoma.
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This study aimed to evaluate the efficacy and safety of dexamethasone pretreatment regimen with different doses in the prevention of docetaxel-induced hypersensitivity reaction [HSR]. One hundred and sixty-two patients who had malignant tumors as determined by histology and/or cytology and received docetaxel treatments at least 2 cycles, were randomized into two groups. There were 90 patients in the study group and 72 patients in the control group. In the study group, patients received 4.5mg of oral dexamethasone once a day. Patients in the control group received 8 mg of dexamethasone twice a day. All patients received dexamethasone for 3 days, from the day before docetaxel treatment to the day after docetaxel treatment. The endpoints were hypersensitivity reaction [HSR] and other adverse effects, which were determined according to common terminology criteria for adverse event v3.0 [CTCAE 3.0]. In the study group, 10 patients had HSRs [11.1%]. While in the control group, 7 patients had HSRs [9.7%], and the main clinical symptoms of HSR were rash [3.1%], fever/chill [2.5%], angioedema [1.9%], chest discomfort [1.9%] and hypotension [0.6%]. There was no statistically significant difference between these two groups [P=0.774]. There was no significant difference in the incidence rate of adverse effect between patients in the study group and in the control group. Those adverse effects included neutropenia, decreased hemoglobin, nausea, vomiting, fatigue and fluid retention. Since no significant difference in the HSR incidence between these two groups has been found, 4.5mg of dexamethasone [qd] is as efficient and safe as 8mg [bid]
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Adult , Adolescent , Aged , Female , Humans , Male , Middle Aged , Young Adult , Taxoids/adverse effects , Antineoplastic Agents/adverse effects , Drug Hypersensitivity/drug therapy , ChinaABSTRACT
BACKGROUND:Recent studies have shown that icari n is a good bone-inducing factor that can promote the osteogenic differentiation of mesenchymal stem cel s, providing a new hope for the treatment of bone defects. OBJECTIVE:To review research achievements in pharmacological effects of icari n effects on bone tissue metabolism as wel as its effect to promote osteogenic differentiation of mesenchymal stem cel s. METHODS:The first author retrieved CNKI and PubMed databases for relevant Chinese and English literatures using keywords of“icariin, stem cell, osteogenesis”, respectively. Articles regarding icariin, stem cells, osteogenesis were included, and repetitive studies were excluded. Totally 754 articles were retrieved initially. In accordance with inclusion and exclusion criteria, 41 articles were included in result analysis. RESULTS AND CONCLUSION:As the main ingredient of Herba epimedi , icari n functions as a good osteogenetic growth factor to promote the osteogenic differentiation of bone marrow mesenchymal stem cel s. In recent years, icari n has been shown to promote adipose-, umbilical cord-, and periodontal ligament tissue-derived mesenchymal stem cel s to differentiate into osteoblasts. But such studies are less reported. Until now, mesenchymal stem cel s stil exhibit unsatisfactory osteogenic ability in in vivo experiments. Given this, osteogenetic growth factors contribute to the osteogenic differentiation of mesenchymal stem cel s. Therefore, the use of icari n is expected to provide a good strategy for bone defect repair.
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Obj ectiev The purpose of this study is to assess the impact of bone metastasis on survival in non-small cell lung cancer(NSCLC),Which were treated with gefitinib for more than 6 months,and to identify the prognostic factors of patients with NSCLC presenting bone metastasis .Methods We compared the overall survival(OS), progression-free survival(PFS),1-year2,-year and 3-year survival rates between two cohorts based on bone metastasis ,as well as the prognostic factors in the patients with bone metastasis .Results In total, 76 patients were included in the study ,in which there are44 patients with no bone metastasis and32 patients with bone metastasis.The cohorts were similar in OS (19.000 ±3.317 months vs.26.000 ±2.121 months,P =0.625)as well as PFS (14.000 ±1.843 months vs.16.000 ±1.411 months,P=0.328).The 1-year survival rate was 63.6%in no bone metastasis cohort,but was increased to 96.9%in the other cohort.The survival rates at 2 years(34.1%vs.56.3%,P=0.054)and 3 years(18.2%vs.18.4%,P=0.950)were similar.The univa-riate analysis showed that a worse prognosis was more likely existed in elderly patients ( aged >60 years) and with pulmonary progression ,whereby factors including gender ,pathology s,moking index ,brain metastases ,bone related events and the application of radiotherapy ,bisphosphonates might not be independently associated with the surviv -al late.Analysis of multiple variables indicated a favorable prognosis for patients with no pulmonary progression . Conclusion This retrospective study shows that bone metastasis may not shorten the survival in patients whose pulmonary lesion was controlled by gefitinib .On the contrary ,pulmonary progression may be more likely the cause of death in patients with bone metastasis .Non suggestion is given to discontinue gefitinib when the bone metastasis appears.
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Objective To detect potential proteins which may play a key role in pathogenesis and early diagnosis for Acinetobacter baumannii sepsis,and compare the protein profile of neutrophils of na(i)ve rats with that of rats infected with Acinetobacter baumannii.Methods Using two-dimensional electrophoresis for separation of proteins,we compared the differences of the profile of total proteins from neutrophils of na(i)ve rats with that of rats infected with Acinetobacter baumannii.Differences in the profiles of expressed proteins were observed,and some of the proteins were isolated and verified by line mass spectrometry analysis and Western blot.Results Fifty proteins from the neutrophils of rats with Acinetobacter baumannii sepsis were found to be different from those of naive rats.Forty-one of these proteins were able to be identified successfully using two-dimensional electrophoresis,in which 24 were upregulated,and 17 were downregulated compared with the proteins isolated from neutrophils of na(i)ve rats.Conclusion The protein profile of neutrophils in rats with Acinetobacter baumannii sepsis is significantly different from that of na(i)ve rats.These proteins can be identified by proteomic screening,and may be used as potential markers for early diagnosis and molecular targets for effective treatment of Acinetobacter baumannii sepsis.
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Objective To evaluate the efficacy and safety of low-dose dexamethasone pretreatment regimen in prevention of hypersensitive reaction (HR) related to docetaxel in elderly tumor patients. Methods According to the order for admission and the ratio of 3:2, 91 elderly patients with docetaxel weekly therapy were randomly divided into two groups: experimental group and control group. All patients aged from 65 to 82 years with a median age of 68 years old. There were 54 patients in the experimental group and 37 patients in the control group. In the experimental group, patients received oral dexamethasone 4. 5 mg once daily on 1 day before treatment, the day of treatment and continuing for 3 days after treatment, while patients received 8 mg twice daily in the control group. All patients were scored according to MCIRS by the physician. The side effects were evaluated by NCI-CTCAE3.0. Results Four cases in the experimental group (7.4 %) and three cases in the control group (8. 1%) occurred HR, and there was no significant statistical difference (P=1. 000). Conclusions The low dose dexamethasone is efficient and safe compared with the conventional dose dexamethasone, and there is no significant difference in HR incidence between two groups.
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Hypersensitivity reactions ( HSRs) are the serious problems of taxanes in the clinical appli- cation. These reactions range in severity from mild flushing and itching to bronchospasm, dyspnea and signifi-cant alterations in blood pressure with loss of consciousness or not, and death in some rare cases. Nevertheless, HSRs are often reported only sporadically in clinical trials or as case reports. The vague or inconsistent termi-nology used to describe these reactions may reflect our poor understanding of their pathophysiology. This article will reviews the advancement of taxanes HSRs.
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Delirium is defined as an acute imbalance state in the higher nervous center.It is more of ten been an accompanied syndrome,or may be a complication associated with the diagnosis and treatment of cancer.Delirium occurs frequently in cancer patients,especially in terminal patients.No more attention was paid on it yet.Its clinical feature,diagnosis and treatment were described.
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<p><b>OBJECTIVE</b>To study the distributional feature and clinical characteristics of infectious diarrhea caused by enterohemorrhagic Escherichia coli O157:H7, and to understand its pollution to the environment and the carrier status among livestock and poultry.</p><p><b>METHODS</b>To describing the incidence of diarrhea, to isolate and culture the pathogenic bacteria from samples of the patients with diarrhea and livestock or poultry with methods of microbiology, molecular biology and cytology, and then to determine the toxic factors.</p><p><b>RESULTS</b>In the first epidemic area in Suixian county, Henan province, 35 cases had been found during 17 March and 6 July with 91% of them above age of 60. Of them, 32 were complicated with acute renal failure, including 28 death (death rate: 87.50%). One hundred and seven strains of O157:H7 were isolated from the samples of livestock or poultry and 48 strains were isolated from patients. It was found that 67 strains having toxic gene through microbiological, molecular biological and cytological technologies. Five types of toxic factors were found.</p><p><b>CONCLUSION</b>The main factor causing death was the complicated acute renal failure from diarrhea infected by E. coli O157:H7. The pathogen from livestock or poultry with high carrying rate might infect people through polluted water, food flies and close contacts. The outbreak of acute hemolytic uremic syndrome in Suixian county was caused by Enterohemorrhagic Escherichia coli O157:H7 infection.</p>
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Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Acute Kidney Injury , China , Epidemiology , Diarrhea , Epidemiology , Disease Outbreaks , Escherichia coli Infections , Epidemiology , Escherichia coli O157ABSTRACT
To summary the complications of somatic, psychological and societal in cancer survivor. To study and solve these problems. It would be significant to improve survivor's quality of life.