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Objective To evaluate the efficacy and toxicity of induction chemotherapy with nedaplatin and docetaxel plus concurrent intensity?modulated radiotherapy ( IMRT) with nedaplatin or cisplatin in the treatment of locally advanced nasopharyngeal carcinoma (NPC). Methods A total of 223 patients with pathologically diagnosed locally advanced NPC in five treatment centers from 2011 to 2012 were randomly divided into two groups. In the test group, one hundred and thirteen patients received two cycles of induction chemotherapy with docetaxel (65 mg/ m2 on day 1) and nedaplatin (80 mg/ m2 on day 1) plus concurrent IMRT with nedaplatin (40 mg/ m2 on day 1). In the control group, 110 patients received two cycles of induction chemotherapy with the same regimens plus concurrent IMRT with cisplatin (40 mg/ m2 on day 1). The survival rates were calculated with the Kaplan?Meier method and the differences in the survival rates between the two groups were analyzed using the log?rank test. Comparison of the incidence rates of adverse reactions between the two groups was made by the chi?square test. Results The follow?up rate was 99?? 1%.The response rates at 3 months after treatment in the two groups were both 100%. The 2?year local recurrence?free, regional recurrence?free, distant metastasis?free, and overall survival rates were 94?? 0%, 94?? 2%, 88?? 2%, and 90?? 3%, respectively, in the test group, versus 93?? 4%, 94?? 1%, 86?? 7%, and 87?? 3% in the control group ( P= 0?? 757、 0?? 478、 0?? 509、 0?? 413). The incidence rates and severity of leucopenia, neutropenia, and thrombocytopenia were significantly higher in the test group than in the control group ( P= 0?? 027 , 0?? 028 , 0?? 035 ) . The incidence rates and severity of hemoglobin reduction and nausea /vomiting were significantly lower in the test group than in the control group (P= 0?? 000,0?? 023). There were no significant differences in the incidence rates of mucositis and xerostomia between the two groups ( P=0?? 483,0?? 781). Conclusions The short?term efficacy of induction chemotherapy with nedaplatin and docetaxel plus concurrent IMRT with nedaplatin is similar to that with cisplatin in the treatment of locally advanced NPC. The mild gastrointestinal reactions can be tolerated by patients. However, the severe myelosuppression should be closely monitored during the treatment.
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Objective To investigate the clinical efficacy of gastrectomy and simple repair in the treatment of acute gastric perforation.Methods 132 patients with acute gastric perforation were randomly divided into the control group and observation group by random number table,66 cases in each group.The control group received gastrectomy,the observation group was given simple repair treatment.The clinical efficacy,clinical indicators and ulcer recurrence Visick grading of patients in two groups were observed.Results The total effective rate of the observation group (87.9％) was significantly higher than that in the control group(71.3％) (x2 =5.634,P ＜ 0.05).The operative time,bed time,gastrointestinal function recovery time and hospitalization time in the observation group were (38.76 ± 6.23) min,(4.26 ± 1.67) d,(28.68 ± 4.74) h,(11.52 ± 2.32) d,those in the control group were (72.13 ± 10.78) min,(10.01 ± 2.21) d,(45.61 ± 5.69) h,(25.65 ± 3.95) d,there were statistically significant differences between the two groups(t =21.773,25.058,18.572,16.863,all P ＜ 0.01).The relapse rate in the observation group (4.6％) was significantly lower than that in the control group (15.2 ％) (x2 =4.181,P ＜ 0.05).Conclusion The simple repair in the treatment of acute gastric perforation has significant effect,it can effectively reduce the value of clinical parameters and the recurrence rate of patients,which has important clinical application value.
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<p><b>OBJECTIVE</b>To investigate chemical constituents contained in Salvia castanea.</p><p><b>METHOD</b>The compounds were separated and purified by silica gel, macroporous resin, RP-C18 and Sephadex LH-20 column chromatography. The structures were identified on the basis of physicochemical property and spectral data.</p><p><b>RESULT</b>Nineteen compounds were separated and identified as tanshinone II(A) (1) , tanshinone II(B) (2), hydroxytanshinone II(A) (3), tanshinone I(4), dihydrotanshinone I(5), cryptotanshinone (6) , neotanshinone A(7) , neotanshinone B(8) , tanshinoldehyde(9), przewaquinone A(10), przewaquinone B(11), sugiol(12), caffeic acid(13), rosmarinci acid(14), ethylrosmarinate(15), lithospermic acid(16), pro-lithospermic acid ( 17) , protocatechualdehyde (18), and danshensu(19).</p><p><b>CONCLUSION</b>Compounds 2, 3, 7-13 and 15-19 were separated from S. castanea for the first time.</p>
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Cromatografia , Métodos , Medicamentos de Ervas Chinesas , Química , Medicina Tradicional Chinesa , Salvia , QuímicaRESUMO
Objective To detect the ERCC1 expression in nasopharyngeal cancer(NPC),to analyze its relationship with concurrent chemo-radiotherapy.Methods The biopsy specimens were obtained through nasopharyngeal endoscopy from patients with NPC in the Fourth Affiliated Hospital of Guangxi Medical University from January 2008 to December 2008.The ERCC1 expression in the cancer tissue was detected using MaxVision immunohistochemistry.Eight weeks after the chemo-radiotherapy,MRI was performed,The MRI results were used to assess the efficacy according to RECIST 1.1 standard,with sensitive group including complete relief (CR) and partial relief (PR) and insensitive group including stable disease(SD) and progress disease (PD).MRI was re-performed every three months with follow-up 3 years.The relationships between ERCC1 expression and concuTent chemo-radiotherapy in the short-term sensitivity and overall survival in patients with nasopharyngeal cancer were analyzed.Results 76 cases were collected.All cases were evaluable for the short-term sensitivity,and only 72 cases were evaluable for progression-free rate and overall survival (OS).In 76 short-term curative effect evaluable cases,CR was 56 cases (73.68 ％),PR was 11 cases (14.47 ％),SD was 3 cases (3.95 ％),PD was 6 cases (7.89 ％),respectively.RR (effective efficiency) was 88.16 ％ and DCR (disease control rate) was 92.1％.The positive rate of ERCC1 expression was 42.1％ (32/76),with 37.3 ％ (24/67) in the sensitive group (CR+PR) and 88.8 ％ (8/9) in the non-sensitive group (SD+PD).RR and DCR in the negative ERCC1 expression group were higher (97.7 ％,97.7 ％) than those in the positive expression group (75 ％,81.3 ％,x2 =7.119,P ＜ 0.05).Of 72 case,twelve month progression-free survival (PFS) rate was 91.7 ％ (66/72),with 95.5 ％ (39/41) in the negative ERCC1 expression group and 87.1％ (27/31) in the ERCC 1 positive group,and there was no significant difference between the 2 groups (x 2 =0,623,P =0.430).Of 72 cases,one year OS rate was 93.0 ％ (67/72),two years OS rate was 84.7 ％ (61/72),three years OS rate was 72.2 ％(52/72).Of 31 ERCC1 positive cases one year OS rate was 90.6 ％(28/31),two years OS rate was 77.4 ％ (27/31),and three years OS rate was 61.3 ％ (19/31).Of 41 ERCC1 negative eases one year OS rate was 95.5 ％(39/41),two years OS rate was 90.2 ％ (37/41),and three years OS rate was 82.9 ％ (34/41).The ERCC1 expression demonstrated significant correlation with the short-term sensitivity and OS (x2 =4.192,P =0.041).Conclusion The ERCC1 expression in NPC has negative correlation with the chemo-radiotherapy and short-term sensitivity,which may predict the chemo-radio therapy sensitivity in NPC.The ERCC1 expression in NPC has significant correlation with OS.It may predict the prognosis of NPC.
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Objective To evaluate the treatment efficacy,toxicities and prognostic factors of nasopharyngeal carcinoma ( NPC ) treated with intensity modulated radiation oncology ( IMRT ).Methods Between January 2006 and August 2008,300 patients with pathologically diagnosed NPC from 6 center received IMRT.The number of patients with stage Ⅰ,Ⅱ,Ⅲ and Ⅳa+b disease (UICC/AJCC 2002 staging system) were 6,45,141 and 108,respectively.The prescription doses were as follows:70-74 Gy/30f toplanning target volume of primary nasopharynx tumor ( PTVRλ),68-70 Gy/30f to planning target volume of positive lymphnode (ptvnd),60-64 Gy/30f to higher risk region (PTV1),50-54 Gy/30f to lower risk region (PTV2).Patients with stage Ⅲ and Ⅳa+b disease also received cisplatin-based chemotherapy.Cox method was used for Multivariate analysis.ResultsThe follow-up rate was 99.7％.The 4-year rate of local control,regional control,metastasis-free survival (DMFS),disease-free survival (DFS) and overall survival (OS) was 94.0％,95.5％,87.4％,80.8％,86.1％,respectively.Mucositis was the most severe acute toxicity,with 18.0％grade 1,48.7％grade 2,33.3％grade 3.No patient suffered from grade 4mucositis.Xerostomia was the most common late toxicity,with 12.0％ grade 0,75.7％ grade 1,12.3％grade 2.No grade 3-4 xerostomia was observed.There were 18,15 and 42 patients failed in local,regional and distant metastasis,respectively.Multivariate analysis showed that N stage was the only prognostic factor for OS (x2 =5.17,P=0.023),DMFS (x2 =6.91,P=0.009) and DFS (x2 =8.15,P=0.004) in these patients.ConclusionsIMRT can improve the treatment efficacy of NPC.The acute and late toxicities were tolerated.Distant metastasis becomes the main treatment failure.N stage is a significant prognostic factors.
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Intensity-modulated radiation therapy (IMRT)is a more advanced radiotherapy technique than routine radiotherapy,and has been effectively utilized in the treatment of nasopharyngeal carcinoma (NPC).Rradiotherapy alone has disappointing effect to local advanced cases.Nevertheless,chemoradiotherapy provides long term survival.Chemoradiotherapy is becoming the standard therapeutic regimen for local advanced NPC.But different ways of chemomdiotherapy such as induction,concurrent,adjuvant chemotherapy still need to be defined.
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Background and purpose:It has been shown that chemotherapy could improve the quality of life and prolongation of survival time of the patients with advanced gastric cancer. There is still no standard chemotherapy regimen for advanced and metastatic gastric cancer, and regimens with high efficacy and safety are scare. Toxicities are considered to be limiting factors and in? uence the quality of life in the patients with advanced gastric cancer. The purpose of this study was to investigate the effi cacy and toxicity of docetaxel(DOC) in combination with oxaliplatin(OXA) as fi rst-line treatment in advanced gastric cancer and try to fi nd a regimen that would be more tolerable without deterioration of treatment response. Methods:48 patients with advanced gastric cancer were treated with docetaxel 35 mg/m2, ivgtt, d1,d8 combined with oxaliplatin 130 mg/ m2,ivgtt,d1 ;repeated every 3 weeks (one cycle) ,The effect was evaluated after two cycles. The effi cacy and toxicity were evaluated according to WHO standard. Results:48 patients could be evaluated for clinical response. Complete response in 3 pts and partial response in 24 pts were observed with an overall response rate of 56.25%, median time to progression (MTTP) was 5.6 months and median overall survival (MST) was 11.8 months. The most common toxicities were bone marrow suppression, peripheral neuritis, nausea and vomiting. All of them are reversible. Conclusion:Combining weekly docetaxel and oxaliplatin is an effective and well tolerated alternative treatment in advanced gastric cancer and has yielded promising results.
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Background and purpose:Extraovarian peritoneal serous papillary carcinoma(EPSPC) originats from peritoneum with rare incidence, sometimes may affect the surface of ovary and have multi-focal lesions, whose standard therapy have not been established. In this study, we preliminarily reviewed the clinical characteristics, treatment and prognosis of EPSPC in 11 cases. Methods:The clinical characteristics of 11 cases with EPSPC were first retrospectively analyzed. All the patients underwent cytoreduction surgery followed by chemotherapy. Finally, short-term and long-term effi cacy, time to progression (TTP) and overall survival were evaluated by RECIST, respectively. Results:Abdominal pain, distention and ascites were the most common presenting symptoms, but tumors could be palpable in only 18.2% of the patients. The positive rate of ascites, abdomen B ultrasound,MRI scan and ascending CA125 level in the plasma and ascites was 100%,45.5%,100%,72.7%,81.2%,respectively. The successful rate of cytoreduction surgery was 45.5% for the EPSPC. After chemotherapy, the cases of complete remission, partial remission, stable disease and progression disease were 1(11.1%,1/9),3(33.3%,3/9),2(22.2%,2/9) and 3(33.3%,4/9), respectively. TTP was 5-14 months for all the patients and the median TTP was 8.6 months. The 1,2,3-year overall survival was 72.7%,18.2%,0%, respectively and the median overall survival was 14.6 months. Conclusions: Ascite, abdomen MRI scan and CA125 level are the most meaningful factor to diagnose EPSPC. EPSPC is a carcinoma of poor prognostic with non-specific clinical characteristics, low successful rate of cytoreduction surgery and is chemotherapy-resistent.
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OBJECTIVE: To compare the advantages and disadvantages of two procedures: Roux-Y with enterostomy and Roux-Y with spur valve in the treatment of biliary atresia. METHODS: Twenty-four patients with biliary atresia underwent hepatic portoenterostomy with percutaneous jejunal enterostomy (Group A) and 24 patients underwent Roux-Y with antireflux spur valve (Group B). Clinical data were reviewed retrospectively. RESULTS: Ten patients remained alive in the Group A. Among them, 9 survived without jaundice, the oldest one being 9-years old. One of the 9 patients had portal hypertension. The remaining one who survived with jaundice and portal hypertension was 8-years old at follow up. Ten patients in the Group B remained alive. Of them, 8 survived without jaundice and 2 with jaundice. CONCLUSIONS: Two surgical procedures had similar effects in preventing reflux cholangitis, while spur valve has the benefit of quitting cutaneous enterostomy.
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Objective To optimize the shaping process of Biyuan dropping pills.Methods With the hardness,tailing degree,spherical degree and coefficient of heavy variation of the dropping pills as the scoring indexes,the proportion of extract and matrix,temperature of extract and refrigerant liquid,internal diameter of the dropper,dropping speed were observed.Orthogonal design was applied to optimize the proportion of extract and matrix,temperature of extract and refrigerant liquid,drops distance on the basis of the preliminary experiments.Results The optimal conditions were: semi-synthesized fatty acid ester and extract at the proportion of 4 ∶1 were heated in a water bath and were completely stirred for melting;the pills were dropped into the 65 %alcohol (10 ℃) at temperature 40 ℃at the constant rate of 60 drops per minute;the diameter (internal)of the dropping tip is 2.0 mm .Conclusion The experimental results provide evidences for shaping process of Biyuan dropping pills in the manufacturing scale.
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In this study,we have observed the effects of extract from mussel ( Mytilus edulis Linnaeus ) on experimental hyperlipidemia in rats.The results showed that the extract from mussel could reduce the levels of total cholesterol and triglyceride in blood serum of the experimental hyperlipidemic rats.
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0.05)。The median time to progression (mTTP)was 5.8 months in XELOX group and 5.7 months in FOLFOX4 group. The median survival time (MST) was 10.0 months in XELOX group and 9.8 months in FOLFOX4 group, The toxicities were well tolerated,The incidence of grade Ⅲ+Ⅳ nausea and vomiting was significantly lower in XELOX group than in FOLFOX4 group (P0.05).Conclusions:Both of the two regimens were feasible, well tolerated and effective in treatment of advanced gastric cancer。XELOX regimen may be safer than FOLFOX4 regimen,especially in elderly patients or patients with ECOG PS of 1 to 2.
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0.05).The median time to progression (mTTP) was 7.8 months in HCPTOX group and 7.9 months in FOLFOX4 group, respectively. The median survival time (MST) was 13.1 months in HCPTOX group and 13.3 months in FOLFOX4 group, respectively. The toxicities were well tolerated.The incidence of grade Ⅲ+Ⅳ nausea and vomiting was significantly lower in HCPTOX group than in FOLFOX4 group (?2=4.538,P0.05). Conclusion:Both of the two regimens were feasible, well tolerated and effective in treatment of metastatic colorectal cancer.HCPTOX regimen might be safer than FOLFOX4 regimen,especially in elderly patients or patients with ECOG PS of 1 to 2.
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Objective To study the effects of different factors on the salvianolic acid B stability in water solution and to provide the experimental data for production and application of salvianolic acid B. Methods Effects of salvianolic acid B concentration, pH value, temperature, and holding period on salvianolic acid B stability in water solution were studied by the salvianolic acid B changes determined by HPLC in orthogonal design test. Results The most stable condition of salvianolic acid B is that the concentration is 1 mg/mL, pH value is 2, the temperature is 20℃ , and the holding period is one day. Conclusion Salvianolic acid B should be kept in the conditions of higher concentration, lower pH value, lower temperature, and shorter period in solution to ensure its stability.
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Objective To evaluate factors influencing long-term survival of biliary atresia patients receiving Kasai procedure and the prevention and treatment of surgical complications.Methods Among 97 biliary atresia patients undergoing Kasai or Suruga operation from Mar 1989 to Mar 1999, 35 cases have survived over five years.These 35 cases were classified intraoperatively into type Ⅱ (4 cases) and type Ⅲ (31 cases).Procedures included hepaticojejunostomy (12 cases), Suruga operation (hepaticojejunostomy with a jejunal fistula in 21 cases), hepaticocystomy (2 cases).Six patients underwent second hepaticojejunostomy because of porta hepatis obstruction.Results (1) Eighteen patients suffered from early cholangiolitis, and four cases developed late cholangiolitis, 5-8 years after closing the ascending stoma.(2) Five cases presented upper digestive tract hemorrhage caused by portal hypertension.(3) All patients were followed up from 5 to 15 years with 2 deaths.Conclusion Conventional surgical procedures still take important part in treating biliary atresia before liver transplantation is popularized.Factors influencing long term survival of patients receiving Kasai′s operation include age at operation, pathological classification of extrahepatic bile duct, with or without cholangitis after operation, and portal hypertension.
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Objective: To study the influences of steam distillation (SD) on the isomerization of the essential oils of Angelica sinensis (Oliv.) Diel. Methods: SD、GC、GC-MS. Results: The duration of the extraction of essential oils of Angelica sinensis (Oliv.) Diels. by SD was about 14 h, and the yield of (Z)-ligustilide was about 67.1 percent of total (Z)-ligustilide. During the SD, it produced some new components in the essential oils, for example 4-hydroxy-3-methylacetophenone, 2,4,5-benzaldehyde,2,4,5-trimethyl-et al. Conclusion: The results suggested that the extraction of essential oils of Angelica sinensis (Oliv.) Diels. by SD had some disadvantages.