Neoadjuvant Treatment of Borderline Resectable Pancreatic Cancer / 肿瘤防治研究

Borderline resectable pancreatic ductal adenocarcinoma accounts for approximately 20% of newly diagnosed pancreatic cancer patients. This type of adenocarcinoma is between resectable and unresectable. It has a high degree of heterogeneity and features in anatomy, biology, and physical condition. The biological characteristics of invasiveness determine that, rather than direct surgery, neoadjuvant therapy should be primarily given to patients to achieve R0 resection and avoid early postoperative recurrence. However, this treatment model is still controversial. According to the latest research on this topic, the full text summarizes the definition of BR-PDAC, resectable evaluation, neoadjuvant treatment selection and evaluation, surgical results after neoadjuvant therapy, and the efficacy of adjuvant therapy after neoadjuvant therapy.

Plasma exchange followed by chemotherapy treatment for multiple-myeloma patients with high viscosity syndrome and renal dysfunction: a clinical analysis / 中国输血杂志

Objective To assess the clinical performance of plasma exchange (PE) followed by chemotherapy treatment for multiple-myeloma patients with high-viscosity syndrome and renal dysfunction.Methods 20 cases of multiple-myeloma patients with high viscous syndrome and various levels of renal dysfunction,were randomly divided into PE-chemotherapy group (the experiment groups) and chemotherapy-only group (the control group).In the experiment groups,the patients received PE via blood cell separators for 3 times (2 600±580 mLeach time,1 day interval) followed by VAD regimens chemotherapy (0.5 mg vincristine continuous intravenous drip for 12 h,adriamycin 10 mg continuous intravenous drip for 12 h and dexamethasone 40 mg qd1-4).In the control group,patients received standard VAD regimen.After 2 cycles of chemotherapy,globulin (GLB),blood sedimentation (ESR) and hemorheology properties were compared between the two groups before and after treatment.Results The symptoms of high viscosity syndrome(gingivial blood/nosebleed,dizziness and extremities numbness)in the treatment group were significantly improved compared with that in the control group (P＜ 0.05).Before and after therapy,the GLB (g/L) were 80.0± 19.6 vs 30.0±10.5 in the treatment group and 85.5±21.5 vs 53.5± 16.0 in the control group (P＜0.05),respectively;the Cr (μmol/L) were 359.0±30.5 vs 105.0±25.0 and 362.0±39.6 vs 190.0±43.0,respectively(P＜0.05);the ESR (mm/h) were 80.0±22.5 vs 12±0.6 and 83.0±23.6 vs 30.0+3.6 (P＜0.05),respectively;the whole blood high shear reductive viscosity were 16.2±2.1 vs 8.5±0.6 and 15.8±2.0 vs 12.8±0.8 (P＜0.05),respectively;the whole blood middle shear reductive viscosity were 19.0±0.5 vs 10.8±0.6 and 20.0±0.6 vs 15.2±0.8 (P＜0.05),respectively;the whole blood low shear reductive viscosity were 50.3±2.9 vs 28.1±1.2 and 52.7±3.5 vs 40.2±3.5(P＜0.05),respectively.Conclusion Plasma exchange treatment combined with sequential chemotherapy presents better clinical performances compared to the chemotherapy-only solution for multiple-myeloma patients with high viscosity syndrome and renal dysfunction.

Clinical study of different bowel preparations on changes of gut flora in patients undergoing colorectal resection / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To compare the impact of traditional and fast bowel preparation on the changes of gut flora in the patients following colorectal resection.</p><p><b>METHODS</b>Sixty patients undergoing colorectal resection from March 2010 to March 2011 in the Nanfang Hospital were randomly divided into the control group(n=27, 3 days of bowel preparation) and the experimental group(n=33, 1 day of bowel preparation). Fresh feces were collected before bowel preparation and on the first defecation after surgery. The postoperative changes in gut flora and septic complications were observed.</p><p><b>RESULTS</b>Gut flora disturbance was found in both groups. The postoperative population of Bifidobacterium and Lactobacillus decreased significantly(P<0.05), and the decrease was more significant in the experimental group compared to the control group(P<0.05), while E.coli and Staphylococcus were much higher than the preoperative level(P<0.05), which was more significant in the control group. The incidence of postoperative infection was 9.1%(3/33) in the experimental group, which was significantly lower than 29.6%(8/27) in the control group(P<0.05).</p><p><b>CONCLUSION</b>Fast bowel preparation is effective in reducing gut flora disturbance and the incidence of postoperative infection.</p>

Different influence of Her-2 expression on the prognosis in node-positive and node-negative breast cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the prognostic significance of Her-2 expression in node-positive and node-negative breast cancer in Chinese women.</p><p><b>METHODS</b>The Her-2 expression in breast cancers from 981 patients was detected by immunohistochemistry with anti-Her-2 (CB11) monoclonal antibody. The survival curves were analyzed by Kaplan-Meier method, and Cox regression model was applied to determine whether this factor is an independent predictor of survival in multivariate analysis.</p><p><b>RESULTS</b>Nineteen point seven percent of the patients showed positive Her-2 expression in their tumors. Patients with Her-2-positive tumors tended to be younger. The high level Her-2 expression was significantly associated with negative estrogen receptor and progesterone receptor status in their tumors (P < 0.05). Among 387 patients with node-positive disease, the 5-year disease-free survival (DFS) rate and 5-year overall survival (OS) rate were significantly lower in patients with Her-2-positive tumors than in patients with Her-2-negative tumors (DFS: 48.8% vs. 66.9%, P = 0.009; OS: 55.2% vs. 76.4%, P = 0.001), and Her-2 expression was an independent unfavorable prognostic factor for OS, but not for DFS in patients with node-positive disease. Among 591 patients with node-negative disease, Her-2 expression was not significantly associated with DFS and OS (P > 0.05).</p><p><b>CONCLUSION</b>Her-2 expression is an important prognostic factor in patients with node-positive disease, but not for patients with node-negative disease in Chinese women.</p>

The early results of breast-conserving therapy in ninety-five patients of primary breast cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To discuss the effects of breast-conserving therapy in Chinese women with early primary breast carcinoma.</p><p><b>METHODS</b>Ninety-five patients with stage I to II primary breast cancer were operated with wide local excision and axillary lymph node dissection. After operation, the radiation therapy was done on the whole breast.</p><p><b>RESULTS</b>Breast conservation surgery was taken successfully in ninety-five patients. Six months after operation, the approval rate for their breast was 100% by themselves. Ninety-two per cent of them were very satisfactory. After a median follow-up of 17 months (range 2 - 51 months), only one patient suffered from ipsilateral breast tumor relapse. The two years local relapse rate was 1.4%. There were no cases of distant relapse and death.</p><p><b>CONCLUSIONS</b>The early results of breast-conserving therapy are satisfactory for stage I to II primary breast cancer. The long-term follow-up is needed for the final outcome.</p>