Research progress on drug treatment and drug resistance mechanism of gastrointestinal stromal tumors / 中国临床药理学与治疗学

Gastrointestinal stromal tumors (GIST) are the most common mesenchymal-derived tumors of the gastrointestinal tract. Tyrosine kinase inhibitors (TKIs) are the cornerstone of GIST therapy, but mutations in resistance genes pose many problems for treatment, especially the heterogeneity of KIT resistance mutations. In recent years, with the release of a number of GIST related drug research and experimental results, the great potential of targeted therapy, immunotherapy and combination therapy to treat GIST in different directions has been revealed, providing more therapeutic directions for GIST. This article will review the experimental research and future direction in recent years.

Application value of psTg combined with lymph node ratio in prognosis of papillary thyroid cancer patients treated with 131I / 中华核医学与分子影像杂志

Objective:To explore the value of pre-ablation stimulated thyroglobulin (psTg) before 131I treatment combined with lymph node ratio (LNR) in predicting 131I treatment response in patients with papillary thyroid cancer (PTC). Methods:From January 2016 to December 2018, 178 PTC patients (47 males, 131 females; age (43.2±12.6) years) treated with 131I in the Affiliated Cancer Hospital of Zhengzhou University were retrospectively analyzed. According to 131I treatment response, patients were divided into excellent response (ER) group and non-ER group. The clinical data of the two groups were compared by χ2 test, independent-sample t test and Mann-Whitney U test. The cut-off values and AUCs of psTg and LNR to predict treatment response were calculated according to the ROC curve. Factors affecting 131I treatment response were analyzed by logistic multivariate regression analysis. Results:There were 118 patients (66.3%, 118/178) in ER group and 60 patients (33.7%, 60/178) in non-ER group, and there were significant differences in N stage ( χ2=11.15, P=0.004), 131I treatment dose ( χ2=12.65, P<0.001), American Thyroid Association (ATA) initial risk stratification ( χ2=15.25, P<0.001), number of metastatic lymph nodes ( χ2=22.63, P<0.001), LNR ( U=1 506.00, P<0.001) and psTg ( U=919.00, P<0.001) between the two groups. The cut-off values of psTg and LNR predicting ER were 3.97 μg/L and 0.29, with the AUC of 0.870 and 0.787 respectively. PsTg (odds ratio ( OR)=10.88, 95% CI: 4.67-25.36, P<0.001) and LNR ( OR=5.30, 95% CI: 1.85-15.23, P=0.002) were independent factors to predict 131I treatment response in PTC patients. When psTg≥3.97 μg/L, LNR ( OR=9.40, 95% CI: 2.06-42.92, P=0.004) was an independent factor affecting 131I treatment response in PTC patients. Conclusions:PsTg and LNR are independent factors affecting 131I treatment response in PTC patients. When psTg≥3.97 μg/L, LNR can be used as a supplementary factor to predict 131I treatment response. The combination of psTg and LNR can better predict 131I treatment response in PTC patients.

Predictive value of psTg on the excellent response to 131I treatment in patients with functional lymph node metastases after papillary thyroid carcinoma surgery / 中华核医学与分子影像杂志

Objective:To explore the predictive value of preablative stimulated thyroglobulin (psTg) level before 131I treatment on the excellent response (ER) to 131I treatment in patients with functional residual lymph node metastasis without distant metastasis after papillary thyroid carcinoma (PTC) surgery. Methods:From March 2011 to June 2015, 72 patients (22 males, 50 females, age: 14-76 (46.5±14.4) years) who were diagnosed with functional lymph node metastasis without distant metastasis at the time of their first 131I treatment after total thyroid bilobectomy + lymph node dissection performed in the Affiliated Cancer Hospital of Zhengzhou University were retrospectively included, and their serum thyroglobulin antibody (TgAb) levels were normal. Patients were divided into ER group and non-ER group according to the treatment response assessment system. Independent sample t test, χ2 test, and Mann-Whitney U test were used to compare the basic clinical characteristics between the two groups, and then multivariate logistic regression was performed. The ROC curve was employed to evaluate the predictive value of psTg and lymph node size in 131I treatment response. Results:The treatment responses of 44 patients were ER, and those of 28 were non-ER. The differences in gender, age, clinical stage, number and location of postoperative metastatic lymph nodes between ER and non-ER groups were not statistically significant ( t=0.82, χ2 values: 0.16-2.60, all P>0.05), while there were significant differences in American Thyroid Association (ATA) initial risk stratification ( χ2=33.38), lymph node size ( U=296.50) and psTg ( U=111.00, all P<0.001). PsTg (odds ratio ( OR)=0.047, 95% CI: 0.004-0.500, P=0.011) and lymph node size ( OR=0.146, 95% CI: 0.032-0.666, P=0.013) were independent factors affecting ER, whereas ATA initial risk stratification was not an independent factor ( OR=0.266, 95% CI: 0.051-1.390, P=0.116). AUCs for psTg and lymph node size were 0.904 and 0.873, respectively. The cut-off value of psTg was 20.05 μg/L with the sensitivity and specificity of 96.4%(27/28) and 75.0%(33/44) respectively, and lymph node size was 0.75 cm with the sensitivity and specificity of 78.6% (22/28) and 81.8% (36/44) respectively. Conclusion:PsTg can be used to predict 131I outcomes in patients with functional lymph node metastases after PTC, and lymph node size also has effect on ER.

Influence of 131I therapy on parathyroid hormone in patients with differentiated thyroid cancer / 中华内分泌代谢杂志

Objective:This study aimed to investigate the influence of 131I therapy on parathyroid hormone (PTH) in differentiated thyroid cancer (DTC) patients. Methods:Clinical data were collected from 353 DTC patients (121 males and 232 females) with normal initial PTH (baseline PTH) and normal serum calcium who received 131I therapy, and tetany, limbs anesthesia, or paresthesia after the 131I therapy were also collected. Comparisons were performed on the changes of PTH, serum calcium, and serum phosphorus before and after 131I therapy. According to gender, age, histology, American Joint Committee on Cancer (AJCC) stages, administered activity, and residual thyroid tissue, further analyses were done for the difference of changes of PTH. Paired t-tests and Pearson χ 2 test were used to conduct statistics. Results:No patients suffered from tetany, limbs anesthesia, or paresthesia, etc. PTH showed a significant decrease [(39.83±16.94)μg/L vs (36.98±16.31)μg/L, P<0.01] after the 131I therapy. Serum calcium also decreased mildly [(2.30±0.12)mmol/L vs (2.27±0.14)mmol/L, P<0.01]. There was no significant difference in changes of PTH in gender, age, histology, AJCC stages, administered activity, and residual thyroid tissue. Conclusions:PTH of DTC patients decreased mildly after 131I therapy, and no hypocalcemia occurred. The change of PTH was not associated with sex, age, histology, AJCC stages, administered activity, and residual thyroid tissue.

Analysis of external exposure dose during 131I treatment for thyroid cancer patient / 中华放射医学与防护杂志

Objective:To explore the existing issues in radiation protection during the treatment of 131I by means of measuring the ambient dose equivalent rate to patients with thyroid cancer and the dose equivalent to the surface of chest of patients during hospitalization. Methods:The ambient dose equivalent rate (peer) was measured by using gamma ray detector for selected 78 patients who received 131I treatment in a hospital 10 min, 1 d, 2 d, 3 d and 5 d after administration with 131I. The measurements were made at distances of 5 cm, 0.5 m and 1 m from the body surface in front, rear, left and right directions. The photoluminescence dosimeter on the chest of the patients was used to measure the effective dose during hospitalization period (6 d). Results:The ambient dose equivalent rate on the surface of chest of patients was up to 4.81 mSv/h 10 min after administration of medicine. The dose equivalent on the surface of chest of patients before discharge ranged 2.6-64.1 μSv/h. The cumulative dose on chest surface during hospitalization was 15.9-58.8 mGy. There was a significant difference in the dose rate at 5 cm from the body surface between 3.7 GBq group and 5.55 GBq group 10 min after medication ( t=-6.11, P<0.05). There was a significant difference in the dose rate at 5 cm from the body surface between male and female groups 10 min after medication ( t=4.52, P < 0.05). There was no significant difference in other groups ( P > 0.05). Conclusions:During the 131I treatment, patients had high level of radiation around them, so it is necessary to strengthen the protection and management of patients and reduce unnecessary exposure to the public.

Neutrophil-lymphocyte-ratio in the prediction of the prognosis of neoadjuvant chemoradiotherapy for locally advanced rectal cancer / 中华普通外科杂志

Objective:To determine whether the neutrophil-lymphocyte-ratio (NLR) a inflammatory factor can predict tumor response to neoadjuvant chemoradiotherapy (CRT) in locally advanced rectal cancer.Methods:Between 2014 and 2019, 205 locally advanced rectal cancer patients underwent CRT before curative surgery. After propensity score matching, 148 patients (74 matched pairs) were enrolled in this study. The hematological parameters were collected and their relationship with tumor response was investigated.Results:After propensity score matching, NLR before CRT in good response group were significantly lower than that in poor response group(2.2±1.0 vs. 2.4±1.2, Z=-2.465, P<0.05), while there was no significant difference in all hematological characteristics between two groups after CRT. The cutoff values of pre-CRT NLR was 3.88 after receiver operating characteristic analysis(AUC=0.618, 95% CI: 0.528-0.708). Multivariate analysis model indicated that pre-CRT NLR≥3.88 was the predictor of poor tumor response ( OR=5.826, 95% CI: 1.299-26.132, P<0.05). Conclusion:The increased NLR before CRT can be regarded as a hematological factor for poor tumor response in locally advanced rectal cancer.

Predictive value of stimulated thyroglobulin before the first 131I ablation for metastasis of differentiated thyroid carcinoma in children and adolescents / 中华核医学与分子影像杂志

Objective@#To investigate the clinical value of pre-ablation stimulated thyroglobulin (psTg) in the prediction of metastasis of differentiated thyroid carcinoma (DTC) in children and adolescents.@*Methods@#The study included 51 children and adolescent patients (20 males, 31 females, age: 8-18(13.5±3.0) years) with DTC who had undergone total thyroidectomy and lymphadenectomy and were going to have the first 131I ablation therapy from March 2012 to December 2017 in the Affiliated Cancer Hospital of Zhengzhou University. Patients′ serum thyroglobulin antibody (TgAb) levels were normal. They were divided into M0 group (without metastasis) and M1 group (with metastasis). The psTg difference between the two groups was compared using Mann-Whitney U test. The receiver operating characteristic (ROC) curves and diagnostic critical point (DCP) of psTg for the metastasis prediction were analyzed.@*Results@#The psTg levels of M0 group (n=20) and M1 group (n=31) were 5.76(3.38, 18.51) μg/L and 280.46(37.66, 470.00) μg/L, respectively, and the difference between the two groups was statistically significant (U=41, P<0.05). The area under the ROC curve of psTg was 0.934 (95% CI: 0.869-0.999) with the sensitivity, specificity and accuracy of 80.6%(25/31), 100%(20/20) and 88.2%(45/51) respectively, with the DCP value of 31.98 μg/L.@*Conclusion@#The psTg value detected before the first 131I treatment has an important predictive value for postoperative metastasis of DTC in children and adolescents.

Beta-adrenergic signaling on neuroendocrine differentiation, angiogenesis, and metastasis in prostate cancer progression / 亚洲男科学杂志(英文版)

Prostate cancer is a complex, heterogeneous disease that mainly affects the older male population with a high-mortality rate. The mechanisms underlying prostate cancer progression are still incompletely understood. Beta-adrenergic signaling has been shown to regulate multiple cellular processes as a mediator of chronic stress. Recently, beta-adrenergic signaling has been reported to affect the development of aggressive prostate cancer by regulating neuroendocrine differentiation, angiogenesis, and metastasis. Here, we briefly summarize and discuss recent advances in these areas and their implications in prostate cancer therapeutics. We aim to provide a better understanding of the contribution of beta-adrenergic signaling to the progression of aggressive prostate cancer.

New progress in joint-preserving treatment of ankle osteoarthritis / 中华创伤骨科杂志

Ankle osteoarthritis (OA),a progressive disease,will develop into its full end-stage in the long run if no appropriate treatment is given.Joint-sacrificing procedures,such as total ankle replacement and ankle arthrodesis,used to be mostly applied for treatment of painful mid-and end-stage ankle OA,leading to adverse effects in functional recovery,complications and treatment costs.In recent years,joint-preserving surgery has emerged as an increasingly common treatment for mid-stage ankle OA at home and abroad.It has become a hot topic in the field of foot and ankle surgery,because it may restore normal biomechanics of the ankle joint,substantially relieve postoperative pain,improve function,and prevent or slow the degeneration process.This paper reviews the new progress in joint-preserving treatment of ankle OA.

Application of ultrasound-guided temporary balloon occlusion in performing cesarean section for patients with pernicious placenta previa: initial results in 13 cases / 介入放射学杂志

Objective To discuss the clinical application of ultrasound-guided temporary balloon occlusion in performing cesarean section for patients with pernicious placenta previa.Methods At Qujing Municipal First People's Hospital,the Interventional Department and Ultrasonography Department assisted the Obstetrics Department to accomplished cesarean section for 13 patients with pernicious placenta previa.The diagnosis of central placenta previa was confirmed by both color ultrasound and MRI in all the 13 patients.Before cesarean section,the balloons were placed in bilateral common iliac arteries or in abdominal aorta,and the balloons were inflated at the same time when the fetus was delivered so as to temporarily obstruct the target vessels.Based on the hemostatic condition,the balloon was timely withdrawn.Results Among the 13 patients,temporary abdominal aorta occlusion was employed in one and temporary bilateral common iliac artery occlusion in 12.Ultrasound-guided occlusion was successfully accomplished in 12 patients,and the average blocking time was ＜15 min.The amount of intraoperative blood loss was 800-1500 ml.Conclusion Ultrasound-guided temporary balloon occlusion before cesarean section is safe with reliable effect in treating pernicious placenta previa,it can remarkably reduce the amount of intraoperative blood loos,and it has no X-ray radiation damage,therefore,this technique is worthy of clinical application.

The clinical application of balloon occlusion technique in treating obstetric hemorrhage / 介入放射学杂志

Objective To discuss the clinical efficacy of balloon occlusion technique in treating pernicious placenta previa.Methods Between January 2015 and March 2016,a total of 16 matcrnal patients with pernicious placenta previa,who were admitted to the Interventional Department of Qujing Municipal First People's Hospital,received balloon occlusion management to assist obstetrician in dealing with placenta previa.Central type of placenta previa with highly suspected placenta implantation were diagnosed in 15 patients by color ultrasound or MRI.Balloon catheters were placed in bilateral internal iliac arteries before cesarean section was carried out,and immediately after the fetus was taken out the balloons were inflated to temporary occlude the targeted arteries.Based on the hemostatic status the balloon catheters were timely retrieved.One patient received emergency temporary balloon occlusion of abdominal aorta,and laparotomy revealed that the placenta had penetrated to the subserosa of uterine anterior wall,and total hysterectomy had to be carried out.Results Successful balloon occlusion was achieved in all 16 patients.The mean blocking time of the artery was 15 minutes and the amount of blood loss was 300-1200 ml.Conclusion In treating pernicious placenta previa,balloon occlusion treatment before cesarean section is safe and reliable,it can significantly reduce the amount of blood loss during surgery,make quick and effective hemostasis,provide a clear surgical field for the performance of cesarean section,and,more important,save the maternal life.This effective technique has fully showed the necessity of multidisciplinary collaboration,including obstetrics,interventional radiology,etc.

Research progress of Hedgehog signaling pathway regulating RANKL expression in osteoblasts / 中国组织工程研究

BACKGROUND: Hedgehog signaling pathway is shown to contribute to the osteogenesis of bone marrow mesenchymal stem cells, and to play an important role in regulating the expression of RANKL in osteoblasts. Nowadays, the definite signal transduction pathway has been revealed gradually.OBJECTIVE: To review the research progress of RANKL in osteoblasts that regulated by hedgehog signaling pathway.METHODS: A computer-based online search in CNKI, Google Scholar and PubMed databases was performed with the key words of Hedgehog, osteoblast, BMSCs, PTHrP, CREB, NFAT, RANKL in English and Chinese, respectively.Literatures related to the expression of RANKL in osteoblasts that regulated by the Hedgehog signaling pathway were included initially and 37 eligible articles were extensively summarized for review.RESULTS AND CONCLUSION: The Hedgehog signaling pathway plays an advanced role in the osteogenic differentiation of bone marrow mesenchymal stem cells, and also upregulates intracellular parathyroid hormone related protein, which activates its downstream signaling molecules cAMP response element binding protein and nuclear factor of activated T cells ulteriorly, to promote the expression of RANKL in osteoblasts and increase the differentiation and formation from osteoclast precursor cells to mature osteoclasts.

Latest research on zirconia implant surface treatment / 中国组织工程研究

BACKGROUND: Recently, zirconia ceramic implants have been reported to be used in clinic. Increasing studies on surface treatment of ziconia implants have been done, in order to promote bone-implant osseointegration and increase the success rate of implantation. There are no recognized surface treatment techniques of zirconia implants as yet.OBJECTIVE: To summarize the research progress in surface treatment techniques of zirconia implants.METHODS: The first author searched the CNKI, PubMed and Web of Science databases for relevant articles published from January 2000 to October 2016. The keywords were zirconia or zirconium, implant, surface treatment in Chinese and English, respectively. The search condition was((zirconia or zirconium) AND implant) AND surface treatment. Here,we reviewed the surface treatment techniques of zirconia implants, and introduced the properties, the surface treatment techniques and commercialization of zirconia implants.RESULTS AND CONCLUSION: Totally 23 papers were included in result analysis. Commonly used surface treatment technologies of zirconia implants include sand blasting, acid etching, sandblast and acid-etching, selective filtration etching, laser, ultraviolet and coating. These technologies all contribute to improving the surface activity of the implant,increasing the roughness, and promoting bone bonding to a certain extent.Because of the very limited experiments,further investigations are required to explore the optimum technique for the surface treatment of zirconia implants.

Advance in research on regulation of sRNAs in bacterial biofilm formation / 军事医学

Small RNAs(sRNAs) play a significant role in the regulation of bacterial growth.When sensing certain environmental cues such as fluctuation of nutrient concentration, temperature, pH, and osmolarity, sRNAs can influence the expression of target genes.The formation of biofilms is initiated by bacteria transitioning from the planktonic to the surface-associated mode of growth, which is a self-produced extracellular matrix composed of proteins, polysaccharides, and DNA.Recent evidences have shown that small RNA plays an important role in the regulation of bacterial biofilm formation.sRNAs have key roles in biofilm formation process by base pairing with target mRNAs or interaction with modulating proteins.This review discussed the regulation mechanism and pathway of sRNAs in bacterial biofilms formation, and summarized three classical regulatory models of sRNAs in bacterial biofilms formation, this review also gives the research status and development direction of sRNAs in bacterial biofilms formation.

Clinical features and prognostic factors of brain metastasis from colorectal cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>The aim of this study was to analyze the clinical features and prognostic factors in patients with brain metastasis from colorectal cancer (CRC).</p><p><b>METHODS</b>Clinical materials of 45 colorectal cancer patients who developed brain metastasis were collected, and the data and follow-up data of those patients were retrospectively analyzed.</p><p><b>RESULTS</b>Most brain metastases were from rectal cancer (64.4%), and 80.0% of the 45 cases had extracranial metastases. The most common extracranial metastatic site was the lung (57.8%), followed by the liver (35.6%). All the brain metastases in patients with liver metastases were supratentorial, while in contrast, 44.8% of the patients without liver metastasis had subtentorial metastasis, showing a significant difference between them (P<0.05). The interval time from diagnosis of CRC to the development of brain metastases in case of Dukes D stage was 12.0 months, significantly shorter than that in the cases of Dukes A stage (24.0 months), B (36.0 months) and C (29.0 months) (P<0.05). The interval time was also shorter in the patients who developed extracranial metastasis within one year than those more than one year (12.0 months vs. 38.0 months)( P<0.05). The median survival time of patients with brain metastasis from colorectal was 6.0 months, with a 1-year survival rate of 21.1% and 2-year survival rate of 3.3% only. Univariate analysis showed that the median survival of patients with a KPS score of ≥70 was 8.0 months, significantly higher than 2.0 months in those with a KPS score of <70 (P<0.05). The median survival of patients with one or two brain metastases was 8.0 months, significantly higher than 4.0 months of those with >2 brain metastases (P<0.05). The median survival time after diagnosis of brain metastasis was 4.0 months for those who received monotherapy (only steroids, only chemotherapy or only radiotherapy), significantly shorter than 10.0 months of patients who received chemoradiotherapy, and 12.0 months of those who underwent surgery (P<0.05). Comparing each two differently treated groups, the survival time of surgery combined with chemotherapy or radiotherapy group was significantly different from that of all of other groups (P<0.05). The median survival time of chemoradiotherapy group was longer than that of monotherapy, but the difference was not significant (P>0.05). Multivariate analysis showed that brain metastases >2 and treatment modality type are independent prognostic factors for survival.</p><p><b>CONCLUSIONS</b>Patients initially diagnosed with a Dukes D stage primary colorectal tumor and occurrence of extracranial metastasis (especially, pulmonary metastasis) within one year are associated to an increased risk of brain metastases and have a shorter survival time. Most brain metastases in patients with liver metastases are supratentorial, while many patients without liver metastasis have subtentorial metastasis. Brain metastases >2 and the type of treatment modality are independent prognostic factors for survival. The prognosis of patients who received chemoradiotherapy is better than those treated only with chemotherapy or radiotherapy. Some subsets of patients may benefit from surgery plus chemotherapy/radiotherapy.</p>

Comparative study of laparoscopic and transabdominal radical hysterectomy's impact on the cellular immunity / 中国内镜杂志

Objective To compare the difference of impact on the cellular immunity between laparoscopic and transabdominal radical hysterectomy. Methods 60 patients with early cervical cancer (Ⅰa2~Ⅱa1), half of them were assigned to do abdominal radical hysterectomy (ARH) and the other half for laparoscopic radical hysterectomy (LRH). Adopt flow cytometry (FCM) detect peripheral blood T lymphocyte subsets, NK cells, CIK cells and T lymphocyte ac-tivation function on one day before surgery, one day, five days, and 28 days after the surgery separately. Compare the changes of immune status. Results After one day, the number of T lymphocyte subsets declined compared with preoperative one day(P <0.05). After five days, each index in LRH group was increased compared with postoperative one day, and the degree of decline is less than the ARH group ( P< 0.05), and recovered faster. After one day, the number of HLA-DR+CD3+in LRH group compared with the preoperative one day declined and HLA-DR+CD8+in-creased, and the degree of change is less than the ARH group, and recovered faster. Conclusions Immune function in patients after laparoscopic group was less changed, and recovered quickly, while the immune function were less inhibited, it may protect patients' immune function better.

Intervention ofFu Liu Zhen plus Moxa-box Moxibustion at Umbilicus in a Community Population of Qi Deficiency and Yang Deficiency / 上海针灸杂志

Objective To observe the action ofFu Liu Zhen (acupuncture at the six abdominal points) plus moxa-box moxibustion at umbilicus on a community population of qi and yang deficiency.Method Two hundred subjects diagnosed with qi deficiency and/or yang deficiency were randomized into a treatment group and a control group, 100 cases in each group. The two groups both received constitution-associated health education, and the treatment group was additionally intervened byFu Liu Zhen plus moxa-box moxibustion at umbilicus, while the control group didn’t receive any other intervention. The Score of Constitution in Traditional Chinese Medicine (TCM) and the number of people of each constitution were observed prior to the intervention, right after the intervention, 6 months after the intervention and 12 months after the intervention.Result In the treatment group, the scores of qi deficiency and yang deficiency after the intervention, 6 months after the intervention and 12 months after the intervention were significantly different from that prior to the intervention (P<0.01). The scores of the corresponding constitution types (qi deficiency, yang deficiency) after the intervention, 6 months after the intervention and 12 months after the intervention were significantly different from that before the intervention (P<0.01). The proportions of subjects with harmonious constitution, qi deficiency, and yang deficiency in the treatment group after the intervention, 6 months and 12 months after the intervention were significantly different from that prior to the intervention (P<0.01). The proportions of subjects with harmonious constitution, qi deficiency, and yang deficiency in the treatment group after the intervention, 6 months and 12 months after the intervention were significantly different from that in the control group (P<0.01).ConclusionFu Liu Zhen plus moxa-box moxibustion at umbilicus can improve the qi-deficiency and yang-deficiency constitutions in the community population.

Comparison of Postoperative Efficacy between Cylindrical Abdominoperineal Resection by Laparoscopy and Traditional Abdominoperineal Resection / 昆明医科大学学报

Objective To evaluate the efficacy between cylindrical abdominoperineal resection(CAPR)by laparoscopy and traditional abdominoperineal resection(APR). Methods A retrospectively analysis was done in the data of patients with low rectal cancer who underwent APR in our department from January 2010 to September 2015. The patients were divided into two groups,including cylindrical abdominoperineal resection by laparoscopy and traditional abdominoperineal resection. The operation time,intraoperative bleeding,the time of intestinal exhaust as well as the postoperative complications of the two groups were compared. Results There were no statistical differences in the intraoperative bleeding,operation time,the time of intestinal exhaust,postoperative intestinal obstruction and pulmonary infection between the two groups(P > 0.05). However,the differences in the rates of perineal incision infection and tumor intestinal perforation between the two groups were statistically significant (P < 0.05). Conclusion CAPR by laparoscopy is safer,more reliable than traditional APR,which can effectively reduce the rates of postoperative incision infection and tumor intestinal perforation of patients.

Clinical decision on a patient with esthesioneuroblastoma / 中国肿瘤临床

Olfactory neuroblastoma is a rare malignant tumor. Although multiple therapeutic modalities including surgery, radio-therapy, or chemotherapy could be used in patients with olfactory neuroblastoma, no standardized treatment has been achieved. This re-view introduces a case of adult olfactory neuroblastoma treated by a multiple disciplinary team in Tianjin Medical University Cancer In-stitute and Hospital. This review also aims to explore a complete set of diagnostic and treatment practices for the benefit of future pa-tients.

Clinical and prognostic analysis of 30 cases of primary central nervous system lymphoma / 中华血液学杂志

<p><b>OBJECTIVE</b>To explore clinical characteristics， treatment and prognosis of primary central nervous system lymphoma(PCNSL).</p><p><b>METHODS</b>Retrospective analysis, Kaplan-Meier analysis and Log-rank test were conducted on 30 PCNSL patients from 2006 to 2014 in our hospital.</p><p><b>RESULTS</b>The median age of this cohort (14 males and 16 females) was 57.4 years old. 18 cases had single tumor, 12 cases multiple. 17 cases presentd with intracranial hypertension and 13 cases focal neurological deficits. 13 cases (62%) were diffuse large B cell lymphoma. About 60% patients received combination therapy including surgery, radiotherapy or chemotherapy. 63.3% complete remission rate (CR) was achieved for all patients. Kaplan-Meier analysis and Log-rank test showed the median overall survival (OS) was 24 months, the rates of 2-year survival, 5-year survival, 6-month progression-free survival(PFS) and 1-year free-progressed survival (PFS) were as of 46.7%, 13.3%, 60.0% and 43.3% respectively. The median OS of 11 patients received whole brain radiotherapy(WBRT)combined with chemotherapy was 48 months. The median OS of 7 patients treated with stereotactic radiosurgery(SRS) combined with chemotherapy had no significant difference when compared to the former (P=0.233). Survive analysis showed that age was prognostic factor for PCNSL patients(P=0.030).</p><p><b>CONCLUSION</b>Diffuse large B cell lymphoma was the main type of PCNSL, single or multiple location, presented with increased intracranial hypertension or focal neurological deficits. Age was the key prognostic factor for patients. Surgery was suitable for patients with supertentorial and superficial tumor or with acute intracranial hypertension syndrome. SRS was a feasible local therapy which alleviated the symptoms and led to less toxicity. PCNSL patients might benefit from multimode therapy.</p>