Progression of radiotherapy for brain metastases in non-small cell lung cancer / 国际肿瘤学杂志

Brain metastases are one of the most common distant metastases in patients with non-small cell lung cancer (NSCLC), and the prognosis will be extremely poor. The effect of chemotherapy and operation is limited. As a standard treatment, radiotherapy is widely used in clinical practice. Radiotherapy alone includes whole brain radiotherapy, stereotactic radiotherapy and whole brain radiotherapy combined with stereotactic radiotherapy. With the continuous development of radiotherapy and the progress of gene sequencing, radiotherapy has been combined with targeted drugs, anti-angiogenic drugs and immunodrugs in the treatment of NSCLC brain metastasis, which can improve the survival of patients with NSCLC brain metastasis.

Comparison of 2018 and 2009 FIGO staging system of cervical cancer and analysis of prognostic factors / 国际肿瘤学杂志

Objective:To compare the differences in distribution and prognosis of cervical cancer patients in the 2009 and 2018 editions of International Federation of Gynecology and Obstetrics (FIGO) staging, and to analyze the prognostic factors of cervical cancer patients.Methods:The clinical data of 524 cervical cancer patients admitted to the First Affiliated Hospital of Soochow University from January 2010 to December 2018 were retrospectively analyzed. The cases were staged according to the 2009 and 2018 FIGO staging, and the Kendall τb coefficient was calculated to compare the consistency of the distribution of the two stages. Kaplan-Meier was used for survival analysis, and log-rank test was used to test the difference of prognosis in each stage. Cox-regression was used to analyze the prognostic factors of cervical cancer patients.Results:In the 2009 FIGO edition of staging, 1 case of stage ⅠB1 was reduced to stage ⅠA1 due to the microscopic infiltration depth <5 mm, 51 cases of stage ⅠB1 were raised to stage ⅠB2 due to 2 cm<the maximum diameter of the tumor≤4 cm, and 43 cases of stage ⅠB2 were raised to stage ⅠB3 due to the maximum diameter of the tumor>4 cm. A total of 119 cases raised to stage ⅢC1 due to pelvic lymph node metastasis, and 11 cases raised to stage ⅢC2 due to para-aortic lymph node metastasis. The distribution of cases in the two stages was consistent (τb=0.61, P<0.001). There were statistically significant differences in overall survival (OS) ( χ2=107.13, P<0.001; χ2=93.02, P<0.001; χ2=92.74, P<0.001) and progression-free survival (PFS) ( χ2=91.95, P<0.001; χ2=77.69, P<0.001; χ2=73.27, P<0.001) among patients with different stages of FIGO in 2018 (ⅠA, ⅠB, Ⅱ, ⅢA, ⅢB, ⅢC1, ⅢC2, Ⅳ) and 2009 (ⅠA, ⅠB, Ⅱ, ⅢA, ⅢB, Ⅳ) and patients with different T stages (T 1, T 2, T 3, T 4). There were statistically significant differences in OS ( χ2=20.71, P<0.001) and PFS ( χ2=24.25, P<0.001) in 2018 FIGOⅠB and ⅢC stages, and there was a statistically significant difference in OS between stage ⅢC1 and stage ⅠB2 ( χ2=6.18, P=0.013). Multivariate analysis showed that age ( HR=1.88, 95% CI: 1.08-3.28, P=0.026), pathological type ( HR=2.11, 95% CI: 1.04-4.27, P=0.038), lymph node metastasis ( HR=2.18, 95% CI: 1.34-3.56, P=0.002), parametrial spread ( HR=2.56, 95% CI: 1.52-4.29, P<0.001), maximum tumor diameter ( HR=1.98, 95% CI: 1.18-3.30, P=0.009), squamous cell carcinoma antigen (SCCA) positive after treatment ( HR=4.49, 95% CI: 2.09-9.68, P<0.001) and Hemoglobin (HB) level before treatment ( HR=0.58, 95% CI: 0.35-0.96, P=0.035) were independent risk factors for OS in patients with cervical cancer. According to the 2018 FIGO stage, the 5-year OS rates of patients with stage ⅠB1, ⅠB2, ⅠB3 were 100%, 97.1% and 87.9% respectively, with a statistically significant difference ( χ2=7.79, P=0.020), and there was a statistically significant difference between stage ⅠB1 and ⅠB3 ( χ2=5.55, P=0.019). According to the 2009 FIGO stage, the 5-year OS rates of patients with stage ⅠB1 and ⅠB2 were 95.7% and 84.3% respectively, with a statistically significant difference ( χ2=9.08, P=0.003). For patients with 2018 FIGO stage ⅠB, SCCA positive after treatment ( HR=1 172.50, 95% CI: 10.37-132 554.51, P=0.003) was an independent risk factor for OS, and differentiation degree ( HR=0.09, 95% CI: 0.01-0.81, P=0.032), treatment method ( HR=0.17, 95% CI: 0.04-0.71, P=0.015) and SCCA positive after treatment ( HR=190.68, 95% CI: 14.27-2 547.67, P<0.001) were independent risk factors for PFS. For patients with 2018 FIGO stage ⅠB, stage ( HR=9.56, 95% CI: 2.38-38.32, P=0.001), SCCA positive after treatment ( HR=126.32, 95% CI: 12.36-1 290.60, P<0.001) and lymph node metastasis ( HR=20.07, 95% CI: 3.63-111.11, P=0.001) were independent risk factors for OS, and differentiation degree ( HR=0.11, 95% CI: 0.02-0.63, P=0.013), treatment method ( HR=0.22, 95% CI: 0.06-0.75, P=0.015) and SCCA positive after treatment ( HR=43.83, 95% CI: 7.94-241.84, P<0.001) were independent risk factors for PFS. According to the 2018 FIGO stage, the 5-year OS rates of patients with stage ⅡA and ⅡB were 95.7% and 75.6% respectively, with a statistically significant difference ( χ2=13.96, P<0.001). The 5-year PFS rates of patients with stage ⅡA and ⅡB were 83.1% and 67.1% respectively, with a statistically significant difference ( χ2=7.61, P=0.006). According to the 2009 FIGO stage, the 5-year OS rates of patients with stage ⅡA and ⅡB were 90.9% and 75.0% respectively, with a statistically significant difference ( χ2=8.85, P=0.003). The 5-year PFS rates of patients with stage ⅡA and ⅡB were 75.7% and 66.7% respectively, with a statistically significant difference ( χ2=4.07, P=0.044). For patients with 2018 FIGO stage Ⅱ, pathological type ( HR=20.28, 95% CI: 2.93-140.32, P=0.002) and stage ( HR=4.35, 95% CI: 1.02-18.55, P=0.047) were independent risks factors for OS. For patients with 2009 FIGO stage Ⅱ, pathological type ( HR=5.82, 95% CI: 1.62-20.94, P=0.007) was an independent risk factor for OS, and pathological type ( HR=3.09, 95% CI: 1.22-7.85, P=0.017) and lymph node metastasis ( HR=2.07, 95% CI: 1.22-3.51, P=0.007) were independent risk factors for PFS. For patients with 2018 FIGO stage Ⅲ, maximum tumor diameter ( HR=3.31, 95% CI: 1.45-7.56, P=0.005) and SCCA positive after treatment ( HR=4.67, 95% CI: 1.22-17.86, P=0.024) were independent risk factors for OS, and pathological type ( HR=4.15, 95% CI: 1.47-11.77, P=0.007) and SCCA positive after treatment ( HR=3.96, 95% CI: 1.45-10.86, P=0.007) were independent risk factors for PFS. Conclusion:The 2018 and 2009 FIGO staging have a good distribution consistency in the cervical cancer patients, and the 2018 FIGO stage ⅠB has more advantages in judging the prognosis, but stage ⅢC cannot accurately judge the prognosis. Lymph node metastasis and maximum tumor diameter are more important prognostic factors.

Application of thyroglobulin measurement in fine‐needle aspiration for detecting lymph node metastasis in papillary thyroid carcinoma / 中华超声影像学杂志

Objective To explore the diagnostic value of thyroglobulin measurement with fine‐needle aspiration ( FNA‐Tg ) in detecting papillary thyroid carcinoma ( PTC ) metastatic lymph nodes ,and analyze the impact of different factors on the diagnostic accuracy of FNA‐Tg . Methods One hundred and fifty‐four lymph nodes from 138 patients w ho underwent total thyroidectomy and cervical lymphadenectomy were enrolled . Ultrasonography ,fine needle aspiration cytology ( FNAC) and FNA‐Tg results were acquired in all patients . T he diagnostic value of FNAC ,FNA‐Tg and the combination of the two methods were compared in suspicious PTC metastatic lymph nodes . T he influence of lymph nodes size ,lymph nodes cystic change and serum thyroglobulin antibody( TgAb) on the accuracy of FNAC and FNA‐Tg were analyzed . Results T he sensitivities of FNAC ,FNA‐Tg ,and the combination of the two methods in the diagnosis were 79 .5% , 95 .5% and 97 .7% ,respectively . T he specificities were 100% ,93 .9% and 100% ,respectively . T he size and cystic change of lymph nodes had effects on the accuracy of FNAC( P ＜0 .05) ,w hile they had no effect on the accuracy of FNA‐Tg ( P ＝0 .42 ,0 .67 ) . T he serum TgAb level had no influence on the accuracy of FNAC and FNA‐Tg ( P ＝ 0 .88 ,0 .34 ) . Conclusions FNA‐Tg is sensitive to metastatic lymph nodes in PTC w hich not affected by the lymph nodes size ,the lymph nodes cystic change and serum TgAb level . Application of FNA‐Tg with FNAC can improve the sensitivity of diagnosis ,w hich is important in the diagnosis of PTC metastatic lymph nodes .

A new oleanane type triterpenoid from Viburnum taitoense Hayata / 药学学报

The chemical constituents of Viburnum taitoense Hayata were investigated using column chromatography silica gel and Sephadex LH-20, etc. Seven pentacyclic triterpenoids were isolated and their structures were elucidated by spectral data and physicochemical properties as 3β,6β-dihydroxy olean-11,13(18)-dien-28-acid (1), 3β-hydroxy olean-11,13(18)-diene-28-acid (2), 12-ene-olean-28-acid-3β-palmitate (3), 3β-acetylcocodiol (4), corosolic acid (5), uvaol (6) and ursolic acid (7). Among them, compound 1 is a new oleanane type triterpenoid and its absolute configuration was confirmed by single-crystal X-ray diffraction data. Compounds 2-5 were isolated from this genus for the first time. All the compounds were evaluated for their anti-inflammatory activities in vitro, and compound 5 showed significant inhibitory activity against nitric oxide (NO) production in lipopolysaccharide (LPS)-induced RAW264.7 macrophage cells with an IC50 of 25.52 ± 0.56 μmol·L-1 when compared to the positive control, quercetin (IC50 of 25.46 ± 0.62 μmol·L-1).

Research progress of new oral anticoagulants in nonvalvular atrial fibrillation / 心血管康复医学杂志

Oral anticoagulants has become the cornerstone preventing thromboembolic complications in patients with atrial fibrillation (AF ) who are at high risk for stroke .Advantages of new oral anticoagulants (NOAC ) include greater pharmacokinetic predictability ,less risk of fatal or intracranial hemorrhage compared to vitamin K antago-nists ,fewer drug-food interactions and no long time monitoring of international standardized ratios etc .The present article focused on recent studies of NOAC in AF complicated coronary diseases ,for secondary prevention of stroke and its specific antagonists .

Application of shear wave elastography combined with superb micro-vascular imaging in diagnosing benign and malignant thyroid masses / 中华超声影像学杂志

Objective To investigate the application value of shear wave elastography (SWE) combined with superb micro-vascular imaging (SMI) in differentiating malignant and benign thyroid masses.Methods Seventy-eight patients diagnosed by ultrasound and verified with postoperative pathological analysis were enrolled.Conventional two-dimensional ultrasound was applied to observe the masses.SWE was performed to evaluate the elasticity and the Young's modulus (AveT1) value acquired.ROC curve was drawn to calculate the sensibility and specificity using the cut-off value of AveT1.SMI was applied to define Adler's grading standard according to the degree of blood supply.The sensitivity,specificity and accuracy of SWE and SWE combined with SMI in differentiating malignant and benign thyroid masses were analyzed.Results ①According to pathological analysis,there were 42 benign and 44 malignant masses;②The AveT1 value between malignant and benign groups were all significantly different (P ＜0.01).41.4 kPa was used as the best cut-off value of AveT1.The area under the ROC curve were 0.83 with sensitivity 86.9％ and specificity 88.1％;③There were more masses with the Alder class Ⅱ-Ⅲ in malignant group than those in benign group,and the difference was statistically significant (P ＜0.01);④Quantified with SWE or SWE combined with SMI,the sensitivity were 86.9％ and 91.3％,specificity were 88.1％ and 92.8％,and accuracy were 87.5％ and 94.1 ％,respectively,and the difference was statistically significant (P ＜ 0.01).Conclusions SWE combined with SMI represents an excellent application value in differentiating malignant and benign thyroid masses,which could improve the sensitivity,specificity and accuracy of the diagnosis for thyroid masses using ultrasound.

The established of pediatric-focused adverse drug event triggers based on GTT by using delphi method / 中国药学杂志

OBJECTIVE: To establish pediatric-focused trigger of adverse drug event using Delphi expert consensus method, and provide a reference for clinical to develop ADE active monitoring based on GTT. METHODS: The formed trigger items were adopted to design an expert consultation questionnaire based on GTT white paper, related literatures and by expert pre investigation. Twenty-seven experts from Beijing, Shanghai and so on were chosen to do a two-round Delphi consultation. Trigger items were screened and modified. RESULTS: THE recovery rate of questionnaire were 92.6%, 100%. After two rounds of consultation the authority coefficient (Cr) was 0.81 ± 0.05. The coefficient of variation (CV) was 0.29 ± 0.13.The KendallW was 0.346, respectively(P < 0.001). Finally 36 trigger items were formulated, including 20 laboratory index, 9 antidotes, 4 clinical symptoms and 3 intervention measures. CONCLUSION: It is reasonable, feasible to adopt Delphi expert consensus method as pediatric-focused trigger of adverse drug events, which lays the foundation for the implementation of GTT.

The study of the expression and the prognostic value of Survivin and Ki67 in pancreatic endocrine tumors / 中国应用生理学杂志

<p><b>OBJECTIVE</b>To explore the relationship between the expression of Survivin and Ki67 with prognosis of pancreatic endocrine tumors (PETs).</p><p><b>METHODS</b>Immunohistochemistry for Survivin and Ki67 was performed in 25 cases of normal pancreatic tissues and 81 cases of PETs by tissue microarrays and to observe the expression and evaluate the relationship with prognosis.</p><p><b>RESULTS</b>(1)The expression of Survivin and Ki67 in PETs was significantly higher than that in normal pancreatic tissues (P <0.01); (2)The expression of Survivin and Ki67 in PETs was correlated with tissue grading and the TNM-staging (P < 0.05), but not related with tumor size, location and functional status. In addition, the expression of nuclear Survivin was association with lymph node metastasis (P < 0.05). (3)The high expression of Ki67 was related with the expression of nuclear Survivin, but not related with the expression of cytoplasmic Survivin.</p><p><b>CONCLUSION</b>Survivin and Ki67 were both expressed in PETs, which were closely related to the clinical pathological characteristics. They could be used as new indicators in the evaluation of prognosis of PETs. The expression of Survivin in nucleus had more diagnostic significance than that in cytoplasm, and that could be highly correlated with lymph node metastasis, which would be used as a new marker of poor prognosis.</p>

The effect and mechanism of curcumin derivative B06 on the myocardium from type 2 diabetic rats / 中国应用生理学杂志

<p><b>OBJECTIVE</b>To investigate the protective effect and mechanism of curcumin derivatives B06 on myocardium from type 2 diabetic rats.</p><p><b>METHODS</b>Thirty-five male SD rats were randomly divided into 5 groups, normal control group (NC group), high fat group (HF group), high fat treatment group (FT group), diabetes mellitus group (DM group) and diabetes treatment group (DT group) (n = 7). The late four groups were fed with high fat food, after four weeks of high fat feeding, the rats from DM group and DT group were injected with low dosage of streptozocin intraperitoneally to induce diabetes mellitus, FT group and DT group were gavaged with curcumin derivatives B06 at the dosage of 0.2 mg/kg x d. The blood glucose and lipid were detected biochemically, blood insulin was assayed by ELISA and the insulin resistance index was calculated, the morphology of myocardium was observed by light and transmission electron microscopy, the protein expression of AMP-activated protein kinase alpha (AMPKalpha) and phosphorylated AMP-activated protein kinase alpha (p-AMPKalpha) in myocardium were tested by Western blot.</p><p><b>RESULTS</b>The level of blood glucose, lipid, insulin and the insulin resistance index were increased in HF group and DM group, but they were decreased after the treatment with B06. The expression of AMPKalpha and p-AMPKalpha were decreased, but they became increased after the treatment of B06. There were increased collagen fibers in interstitium and expansion of mitochondria in cytoplasm of myocardium from DM group, but they were ameliorated in B06 treatment group.</p><p><b>CONCLUSION</b>It is suggested that B06 may relieve the damage of myocardium from type 2 diabetic rats and the increased expression of AMPKalpha and p-AMPKalpha may be involved in it.</p>

Levels of TNF-α, IL-6 and IL-10 in bronchoalveolar lavage fluid in children with Mycoplasma pneumoniae pneumonia / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the levels and roles of cytokines TNF-α, IL-6 and IL-10 in bronchoalveolar lavage fluid (BALF) in children with Mycoplasma pneumoniae pneumonia (MPP).</p><p><b>METHODS</b>The levels of TNF-α, IL-6 and IL-10 in BALF were measured using ELISA in children with MPP at acute stage (n=45) and at remission stage (n=30). Twenty children without lung lesions severed as the control group.</p><p><b>RESULTS</b>The TNF-α, IL-6 and IL-10 levels in BALF were higher in children with MPP at acute stage than those in the control group (P<0.05). The levels of TNF-α and IL-6 in BALF at remission stage were reduced to the levels similar to the control group and were significantly lower than those at the acute stage in children with MPP. However, the levels of IL-10 in BALF remained at higher levels at remission stage in children with MPP.</p><p><b>CONCLUSIONS</b>The levels of TNF-α, IL-6 and IL-10 in BALF increase in children with MPP at acute stage, suggesting that the cytokines may be involved in the pathogenesis of MPP.</p>

Regulatory effects of inhaled steroids on expression of matrix metalloproteinase-9 and its inhibitor in asthmatic rats / 中华儿科杂志

<p><b>OBJECTIVE</b>To investigate the role of matrix metalloproteinase-9 (MMP-9) and its tissue inhibitor (TIMP-1) in the pathogenesis of bronchial asthma and assess the effect of steroid treatment on MMP-9 and TIMP-1 levels. Matrix metalloproteinases are a family of zinc and calcium-dependent endopeptidases. Many MMPs such as MMP-1, MMP-2, MMP-3 are associated with asthma, in which MMP-9 is the key factor in asthma. Tissue inhibitor-1 of metalloproteinases is a specific inhibitor of MMP-9; the MMP-9 and TIMP-1 imbalance could lead to airway inflammation and remodeling in lung disease such as asthma.</p><p><b>METHODS</b>Forty Wistar rats were divided into 4 groups randomly: control, asthma model 7 days (7-day group), asthma model 21 days (21-day group) and steroid treatment groups. Asthma model of rats were established by ovalbumin (OVA) sensitization and challenge with mist inhalation. The expression of MMP-9 and TIMP-1 in lung tissues was detected by immunocytochemistry, RT-PCR and Western blotting.</p><p><b>RESULTS</b>(1) By observing the changes of action, tracing respiratory curves, detecting level of serum IgE level and observing the lung tissues sections, the authors demonstrated that the rat asthmatic models were successfully established. (2) The lung tissue sections of the asthma groups stained with hematoxiline and eosin (HE) showed many inflammatory cell infiltrations around the bronchioli and accompanying arterioles, hyperplasia of caliciform cells, broken bronchial mucous membrane and thickening of submucosal layer. The hyperplasia of airway smooth muscle and basement membrane were more significant in asthma model 21-day group than that in 7-day group. These changes were improved after treatment. (3) The expression of MMP-9 in rat's lung tissues: the expression was 2.71 +/- 0.37 in 7-day group, 1.76 +/- 0.27 in 21-day group, 0.88 +/- 0.18 in the treatment group and 0.52 +/- 0.10 in the control group (F = 151.52, P < 0.01). The expression of TIMP-1 in rat's lung tissues was 1.13 +/- 0.19 in the 7-day group, 1.55 +/- 0.24 in 21-day group, 0.77 +/- 0.15 in the treatment group and 0.47 +/- 0.08 in the control group (F = 69.46, P < 0.01). (4) The results of immunocytochemistry and protein expression were consistent with those of RT-PCR.</p><p><b>CONCLUSION</b>The protein and mRNA expression level of MMP-9 and TIMP-1 was high in asthmatic rat's lung tissues. Down-regulation of the expression of MMP-9 and TIMP-1 by steroids may be one of the mechanisms by which airway inflammation and remodeling are inhibited in asthma.</p>