Association between muscle mass and quality of life in Shaanxi adults / 中华流行病学杂志

Objective: To investigate the association between muscle mass and quality of life in adults in Shaanxi adults. Methods: The data in this analysis were part of the baseline survey of the Regional Ethnic Cohort Study in Northwest China from June 2018 to May 2019 in Shaanxi Province. The participants' quality of life, including physical component summary (PCS) and mental component summary (MCS), was assessed by the 12-Item Short Form Survey, and the Body Fat Determination System measured muscle mass. A logistic regression model with adjustment for confounding factors was established to analyze the association between muscle mass and quality of life in different genders. Further, sensitivity and subgroup analyses were conducted to explore its stability. Finally, a restricted cubic spline was employed to investigate the dose-response relationship between muscle mass and quality of life in different genders. Results: A total of 20 595 participants were included, with an average age of 55.0, and 33.4% were male. After controlling for potential confounders, compared with the Q1 group, the risk of low PCS was reduced by 20.6% (OR=0.794, 95%CI: 0.681-0.925) and the risk of low MCS was lower reduced by 20.1% (OR=0.799, 95%CI: 0.689-0.926) in female Q5 groups. Compared with the Q1 group, the risk of low PCS was reduced by 24.4% (OR=0.756, 95%CI: 0.644-0.888) in the male Q2 group. However, no significant association between muscle mass and MCS in males has been found. In females, restricted cubic spline analysis showed a significant linear dose-response relationship between muscle mass and PCS and MCS. Conclusions: There is a positive association between muscle mass and quality of life in Shaanxi adults, especially females. With the increase in muscle mass, the physical and mental functions of the population continue to improve.

Efficacy of erlotinib after the failure of gefitinib in patients with metastasis of non-small cell lung cancer with unknown EGFR mutation status / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy of erlotinib in patients with metastasis of non-small cell lung cancer who had benefits from initial gefitinib treatment but finally demonstrated resistance, especially in those of unknown EGFR mutation status, and to compare the efficacy of erlotinib between patients who received erlotinib immediately after gefitinib failure and those who received chemotherapy before erlotinib.</p><p><b>METHODS</b>Forty Chinese patients who had been treated with erlotinib (150 mg daily) after gefitinib (250 mg daily) failure were evaluated retrospectively. All of these patients had achieved gefitinib treatment for at least three months with response of partial remission or stable disease. Among them, 16 patients shifted to erlotinib immediately after progression (Group G-E), and the other 24 patients inserted chemotherapy between gefitinib and erlotinib (Group G-C-E).</p><p><b>RESULTS</b>In the whole group, the disease control rate (DCR) of erlotinib was 52.5% (21/40) while the objective response rate (RR) was only 10.0% (4/40). The RR of the group G-E was 6.2% and the group G-C-E was 12.5%, and the DCR was 56.2% and 50.0% in the two groups, respectively, both without significant differences (P = 0.638 and P = 0.755). There was no correlation between the efficacy of erlotinib and that of initial gefitinib in both group G-E and group G-C-E (P = 0.365 and P = 0.658). The median progression-free survival (PFS) and overall survival (OS) for the erlotinib treatment were 3.0 and 12.0 months in the 40 patients. Statistically no significant difference was observed in PFS (4 months in the group G-E and 2 months in the group G-C-E, P = 0.768) and OS (12 months in both Groups, P = 0.510).</p><p><b>CONCLUSIONS</b>Erlotinib can be considered either immediately after gefitinib failure or following the insertion of chemotherapy after gefitinib failure in progressive non-small cell lung cancer patients who initially benefited from gefitinib.</p>

Clinical study on curing the cervical spondylotic radiculopathy with the methods of Blade needle closed loosing and reduction with traction at the same time / 中国骨伤

<p><b>OBJECTIVE</b>To observe the effects of curing the cervical spondylotic radiculopathy with the methods of Blade needle closed loosing and reduction with traction at the same time.</p><p><b>METHODS</b>From May 2006 to May 2009, 65 patients with cervical spondylotic radiculopathy were divided into treatment group and control group according the random number table produced by SAS Software. There were 18 males and 17 females in the treatment group,age in range from 42 to 73 years old with an average of (61.3 +/- 6.4) years, course of disease was from 8 to 42 months with an average of (23.8 +/- 13.8) months, preoperatively cervical functional score was from 4 to 17 scores with the mean of (11.45 +/- 3.31) scores. And in the control group, including 14 males and 16 females, aged from 44 to 76 years old with an average of (62.4 +/- 8.8) years, course of disease was from 7 to 43 months with an average of (24.4 +/- 16.8) months, preoperatively cervical functional score was from 4 to 18 scores with the mean of (11.40 +/- 3.24) scores. The patients of treatment group were treated with Blade needle closed loosing the specific pain point on the neck and shoulder, then immediately underwent traction and reduction after operation. And the patients of control group were treated with traditional traction. The cervical functional score were compared between the two groups at 10, 20, 180 d after treatment, including pain of neck and shoulder, limitation of motion of neck, tenderness of neck, numbness and muscle weakness of upper limb.</p><p><b>RESULTS</b>(1) At the 10th day after treatment, the total score of treatment group was (15.43 +/- 3.46) scores, which was obviously higher than that of control group's (13.17 +/- 3.18) scores (P < 0.01). In different symptoms, treatment group also was better than that of control group (P < 0.05), so as in the tenderness of neck, and especially in the limitation of motion of neck and muscle weakness of upper limb decreased obviously (P < 0.01). (2) At the 20th day after treatment, the total score of treatment group was (18.00 +/- 2.94) scores, which was obviously better than that of control group's (15.90 +/- 2.89) scores (P < 0.01). In different symptoms, treatment group also was better than that of control group (P < 0.05), so as in the pain of neck and shoulder, numbness and muscle weakness of upper limb (P < 0.05), and especially in the limitation of motion of neck, tenderness of neck decreased obviously (P < 0.01). (3) At the 180th day after treatment, the total score of treatment group was (16.63 +/- 3.32) scores, which was obviously better than that of control group's (12.67 +/- 3.42) scores (P < 0.01); In different symptoms, treatment group also was better than that of control group (P < 0.05), so as in the numbness of upper limb (P < 0.05), and especially in the pain of neck and shoulder, muscle weakness of upper limb, limitation of motion of neck, tenderness of neck decreased obviously (P < 0.01).</p><p><b>CONCLUSION</b>Compared with method of traditional traction, Blade needle closed loosing and traction in treating cervical spondylotic radiculopathy can significantly obtain clinical effects,which can quickly improve symptoms, relieve pain of neck and shoulder, limitation of motion of neck, tenderness of neck, numbness and muscle weakness of upper limb.</p>

Classification and regression tree analysis of 154 patients with cancer of unknown primary / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To explore the prognostic factors and their impact on survival of patients with cancer of unknown primary (CUP).</p><p><b>METHODS</b>The clinical and follow up data of 154 CUP patients referred to the Cancer Hospital & Institute, Chinese Academy of Medical Sciences from January 1, 2003 to December 31, 2007 were analyzed. Multivariate analysis of survival was performed using recursive partitioning referred to as classification and regression tree (CART) analysis.</p><p><b>RESULTS</b>The median survival for 154 eligible consecutive CUP patients was 18.2 months, and the 5-year survival rate was 1.3%. CART was performed with an initial split on age of 34, and 5 terminal subgroups were formed. The median survival of the 5 subsets ranged from 5.5 months (younger than 34 years old subgroup) to 61.8 months for patients at age of 34 to 60, with one or two organ sites involved, and non-adenocarcinoma histology subsets.</p><p><b>CONCLUSIONS</b>CART can be used to identify previously unappreciated patient subsets and is a useful method for dissecting complex clinical situations and identifying homogeneous patient populations in clinical practice and future clinical trials.</p>

A randomized phase II trial of docetaxel and doxorubicin in treatment for patients with non-small-cell lung cancer who have failed previous platinum-based chemotherapy / 中华肿瘤杂志

<p><b>OBJECTIVE</b>The aim of this study was to evaluate the efficacy, toxicity and safety of doxorubicin combined with domestically produced docetaxel versus with taxotere, and to investigate whether these two regimens result in similar outcomes in the treatment for non-small-cell lung cancer (NSCLC) patients who failed previous platinum-based chemotherapy.</p><p><b>METHODS</b>Eighty-eight NSCLC patients were enrolled into this clinical phase II trial. The patients randomly received either domestic docetaxel (study arm) or taxotere (control arm) at a dose of 70 mg/m2 on D2, while doxorubicin at a dose of 40 mg/m2 on D1 was administered in both groups. It was repeated every 3 weeks, totally for three cycles. No granulocyte colony-stimulating factor was used to prevent granulocytopenia. The response rate and toxicity were evaluated using World Health Organization toxicity scale and Karnofsky performance status scale.</p><p><b>RESULTS</b>Of the 88 patients, 81 were evaluable in terms of efficacy. There was no complete responder in this series. The response rate (RR) was 17.1% in the study arm versus 7.5% in the control arm, and the clinical benefit rate (CBR) was 80.5% in the study group versus 72.5% in the control group. The most frequent grade 3 or 4 toxicities were neutropenia, leucopenia and gastrointestinal symptoms. Other toxicities such as alopecia and vomiting were mild and generally well tolerated. No fluid retention was noticed.</p><p><b>CONCLUSION</b>The administration of doxorubicin 40 mg/m2 on D1 combined with domestic docetaxel 70 mg/m2 on D2 is proved to be as effective and tolerable as with taxotere. The domestic drug docetaxel may be considered as an alternative for patients with non-small-cell lung cancer who failed previous platinum-based chemotherapy.</p>

Docetaxel in the treatment of advanced breast cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy, toxicity and safety of an new domestic docetaxel in the treatment of pretreated advanced breast cancer.</p><p><b>METHODS</b>Fourty-four breast cancer patients who had failed in first-line chemotherapy were included in this trial. They received docetaxel as the second-line chemotherapy. Docetaxel was administered alone at a dose of 70 mg/m2 every 3 weeks. The use of granulocyte colony-stimulating factor to prevent granulocytopenia was not permitted. The response rate and toxicity were evaluated by World Health Organization toxicity scale and performance status by Karnofsky scale.</p><p><b>RESULTS</b>Of the 41 evaluable patients, 4 achieved complete response and 14 partial remission, with a response rate and clinical benefit rate of 43.9% and 85.4%, respectively. Grade 3 or grade 4 neutropenia developed in 42.9%, alopecia in 7.1% and vomiting in 4.8% of these patients. Fluid retention was not observed in this series.</p><p><b>CONCLUSION</b>Three-week administration of docetaxel alone at a dose of 70 mg/m2 is effective and tolerable. It provides an alternative for the pretreated advanced breast cancer patients.</p>