Efficacy and safety of rituximab in children and adolescents with mature B-cell non-Hodgkin's lymphoma: a Meta analysis / 中国当代儿科杂志

OBJECTIVES@#To study the efficacy and safety of rituximab combined with chemotherapy in the treatment of children and adolescents with mature B-cell non-Hodgkin's lymphoma (B-NHL) through a Meta analysis.@*METHODS@#The databases including PubMed, Embase, the Cochrane Library, ClinicalTrials.gov, Web of Science, China National Knowledge Infrastructure, Wanfang Data, and Weipu were searched to obtain 10 articles on rituximab in the treatment of mature B-NHL in children and adolescents published up to June 2022, with 886 children in total. With 3-year event-free survival (EFS) rate, 3-year overall survival (OS) rate, complete remission rate, mortality rate, and incidence rate of adverse reactions as outcome measures, RevMan 5.4 software was used for Meta analysis, subgroup analysis, sensitivity analysis, and publication bias analysis.@*RESULTS@#The rituximab+chemotherapy group showed significant increases in the 3-year EFS rate (HR=0.38, 95%CI: 0.25-0.59, P<0.001), 3-year OS rate (HR=0.29, 95%CI: 0.14-0.61, P=0.001), and complete remission rate (OR=3.72, 95%CI: 1.89-7.33, P<0.001) as well as a significant reduction in the mortality rate (OR=0.31, 95%CI: 0.17-0.57, P<0.001), as compared with the chemotherapy group without rituximab. There was no significant difference in the incidence rate of adverse reactions between the two groups (OR=1.28, 95%CI: 0.85-1.92, P=0.24).@*CONCLUSIONS@#The addition of rituximab to the treatment regimen for children and adolescents with mature B-cell non-Hodgkin's lymphoma can bring significant survival benefits without increasing the incidence of adverse reactions.

Clinical features and prognosis of children with Burkitt's lymphoma: an analysis of 62 cases / 中国当代儿科杂志

OBJECTIVES@#To study the clinical features and chemotherapy response of Burkitt's lymphoma (BL) in children and the influence of rituximab on the prognosis of children with BL.@*METHODS@#A retrospective analysis was performed for the medical data of 62 children with BL, including clinical features, therapeutic efficacy, and prognostic factors. The Cox regression model was used to identify the factors associated with poor prognosis in children with BL. According to whether rituximab was used, the children with advanced (stage III/IV) BL were divided into two groups: chemotherapy plus rituximab and chemotherapy alone. The prognosis was compared between the two groups.@*RESULTS@#For these 62 children, the median age of onset was 5 years (range 1-14 years), and there were 58 boys (94%) and 4 girls (6%). The primary site was abdominal cavity in 41 children (66%), and head and neck in 16 children (26%). There were 1 child with stage I BL (2%), 8 with stage II BL (13%), 33 with stage III BL (53%), and 20 with stage IV BL (32%). The median follow-up time was 29 months, with progression/recurrence observed in 15 children (24%), and the 3-year overall survival (OS) rate and event-free survival (EFS) rate were 82.8%±5.2% and 77.3%±5.8%, respectively. For the children with stage III/IV BL, there was a significant difference in the 3-year the OS rate between the chemotherapy plus rituximab group (16 children) and the chemotherapy alone group (30 children) (93.3%±6.4% vs 65.6%±9.9%, P=0.042), while there was no significant difference in the 3-year EFS rate between the two groups (86.2%±9.1% vs 61.8%±10.1%, P>0.05). The Cox regression analysis showed that central nervous system involvement, lactate dehydrogenase >1 000 U/L, and early incomplete remission were the factors associated with poor prognosis (P<0.05).@*CONCLUSIONS@#Chemotherapy combined with rituximab can improve the prognosis of children with stage III/IV BL. Central nervous system involvement, elevated lactate dehydrogenase level, and early incomplete remission may indicate a poor prognosis in children with BL.

Exploration and thoughts on perioperative treatment of advanced gastric cancer / 中华胃肠外科杂志

Perioperative treatment is critical to improve the outcomes of patients with advanced gastric cancer. There are three therapeutic modes of perioperative treatment for resectable gastric cancer: neoadjuvant chemotherapy+ D1/D2 surgery+ adjuvant chemotherapy, D0/D1 surgery+ adjuvant radiochemotherapy, and D2 surgery+ adjuvant chemotherapy. Over the decades, a large number of clinical studies had been conducted to optimize the perioperative treatment mode of gastric cancer, including the postoperative radiotherapy and chemotherapy, and perioperative chemotherapy, and to explore the feasibility of preoperative radiochemotherapy, targeted therapy, and immunotherapy in advanced gastric cancer. After nearly 20 years of development and exploration, although the perioperative treatment mode for advanced gastric cancer has become standardized, there are still some core issues that need to be solved urgently, including the selection of population for perioperative treatment, the limitation of efficaly evaluation criteria, insufficient emphasis on laparoscopic exploration before neoadjuvant treatment, and lack of exploration in esophagogastric junction cancer. We should fully integrate the current clinical research data into clinical practice, adopt a multidisciplinary diagnosis and treatment mode, and follow the principles of standardized diagnosis and treatment based on a multi-dimensional analysis of patient characteristics, and formulate the most reasonable treatment strategy to ultimately benefit patients.

Effect of Reinforcing Qi and Activating Blood Recipe on Ventricular Remodeling in Rats with Chronic Heart Failure and Mechanisms Involved / 中国实验方剂学杂志

Objective::To observe the intervention effect of Yiqi Huoxue recipe (YQHX) on ventricular remodeling in rats with chronic heart failure, in order to explore its mechanism. Method::Among 40 male SD rats, 10 were randomly selected as the sham operation group. The left anterior descending coronary artery ligation was performed to construct the chronic heart failure(CHF) rat model. After modeling, they were randomly divided into model group, captopril group(13.5 mg·kg-1·d-1) and YQHX group (20 g·kg-1·d-1), and orally given the corresponding drugs. After 8 weeks of intervention, cardiac tissues were collected, body mass and heart mass were weighed, and echocardiography were performed to detect the changes in cardiac structure. Masson staining was performed to determine the myocardial interstitial collagen volume fraction. Western blot was used to detect the expression levels of mitochondrial fusion protein optic atrophy 1 (Opa1) and cleavage protein dynamic-related protein 1 (Drpl). The quantitative real-time fluorescence polymerase chain reaction(Real-time PCR)was applied to detect the expressions of Wnt/β-catenin pathway-related factors such as lipoprotein receptor-related protein 6 (LRP6), glycogen synthase kinase-3β (GSK-3β) and β-catenin. Result::Compared with the sham group, the left ventricular wall of the model group was significantly thickened (P<0.05), the cardiac cavity was significantly enlarged, and the content of collagen in the myocardial interstitium was increased (P<0.01). The expression level of Opal decreased, the expression level of Drp1 increased (P<0.05), the mRNA expression level of LRP6, GSK-3, and β-catenin increased (P<0.01). Compared with the model group, YQHX group can reduce ventricular wall thickening, heart chamber enlargement, myocardial interstitial collagen content, up-regulate the low expression of Opa1, but down-regulate the high expressions of Drpl, LRP6, GSK-3β, β-catenin(P<0.05, P<0.01). Conclusion::YQHX can effectively alleviate ventricular remodeling and improve mitochondrial energy metabolism in rats with CHF. The mechanism may be related to the inhibition of Wnt/β-catenin related factors.

Distinction of Cells Infected with Respiratory Syncytial Virus by Matrix Assisted Laser Desorption/Ionization Mass Spectrometry / 分析化学

Respiratory syncytial virus (RSV),which is a major cause of lower respiratory tract infections during infancy and childhood,is also an important pathogen for immunosuppression in elder and diseased areas.In order to research the pathogenesis of RSV,the matrix assisted laser desorption/ionization mass spectrometry (MALDI-MS)was used to explore the difference between uninfected cells and virus-infected cells.The result showed that,in the molecular weight range of 5000~10000 Da,there are three component peaks expressed with significant difference in both normal group and infection group.One of the three components was up-regulated (m/z 6154.25) and the other two were down-regulated (m/z 7658.47 and 9259.82) after RSV infection.This result proved the obvious differences between the infected cells and untreated cells.The differential expression may provide a feasible method for RSV disease diagnosis and pathology research,and also provide scientific evidences for research on development of RSV therapeutic drugs.

Serosa-penetration in human T4aN0M0 gastric carcinoma correlates with worse prognosis after D2 gastrectomy / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>In both the seventh edition of the International Union Against Cancer (UICC) staging system for gastric cancer and the 14th edition of the Japanese Gastric Cancer Association (JGCA) system, T(4a) is defined as "Tumor perforates serosa (visceral peritoneum) without invasion of adjacent structures." The aim of this study was to investigate the differences in prognosis between patients with serosa-penetrating and serosa-invading T(4a)N(0)M(0) gastric carcinomas.</p><p><b>METHODS</b>Data were collected from 221 patients with T(4a)N(0)M(0) gastric carcinoma who underwent D2 resection at our cancer center between January 1990 and December 2008. The cohort included 42 patients with serosa-penetrating tumors and 179 patients with serosa-invading tumors. The average follow-up time was 85.5 months. Spearman's rank correlation, Kaplan-Meier plots, and Cox proportional hazards regression models were used to analyze the data.</p><p><b>RESULTS</b>The 5-year survival rate of patients with serosa-penetrating and serosa-invading gastric cancers were 31% and 62% respectively (P < 0.05). The relapse rates after D2 radical surgery were 16.2% in patients with serosa-invading gastric cancer versus 59.5% in those with serosa-penetrating tumors (P < 0.05). Peritoneal dissemination and distant organ/lymph node metastatic rates were 76.0% and 24.0% respectively in patients with penetrating tumors, versus 44.8% and 55.2% respectively in patients with invading tumors (P < 0.05). Multivariate analysis showed that penetration of the serosa was an independent prognostic indicator of overall survival.</p><p><b>CONCLUSIONS</b>Our findings provide a basis for the concept that serosa-penetrating T(4a)N(0)M(0) gastric carcinoma represents a more aggressive cancer than serosa-invading T(4a)N(0)M(0) gastric carcinoma. Serosa penetration is an independent factor for poor prognosis of patients with gastric carcinoma.</p>

Comparison of two types of digestive tract reconstruction after total gastrectomy in patients with gastric carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the influence of two different types of digestive tract reconstruction on the life quality, nutritional status and tolerance to adjuvant chemotherapy after total gastrectomy in patients with gastric carcinoma.</p><p><b>METHODS</b>The clinical data of a total of 107 patients treated in our department from January 2005 to december 2008 were analyzed retrospectively. Among them, 49 patients underwent digestive tract reconstruction with functional jejunal interposition (FJI group) and 58 patients underwent Roux en-Y jejunal P-type anastomosis (PR group) after total gastrectomy. 79 of 107 (73.8%) patients received postoperative adjuvant chemotherapy with XELOX regimen. The digestive complications and tolerance to chemotherapy were assessed respectively.</p><p><b>RESULTS</b>Neither severe complications nor surgery-related or chemotherapy-related death were observed among the 107 patients. There were statistical differences in the incidence rate of emaciation, dumping syndrome and retention syndrome between the FJI and PR groups (P < 0.05), but no significant statistical difference in incidence rate of reflux esophagitis (P > 0.05). 28 of 40 (70.0%) patients in the FJI group completed all six cycles of chemotherapy, while 12 (30.0%) patients interrupted the treatment due to chemotherapy-related toxicity. 39 patients in the PR group received chemotherapy, 19 (48.7%) of them completed 6 cycles of chemotherapy but 20 (51.3%) patients interrupted. There was a significant difference in the incidence rate of grade III/IV chemotherapeutic toxicity and completion rate of chemotherapy (P < 0.05).</p><p><b>CONCLUSIONS</b>Both functional jejunal interposition and Roux-Y operation are reasonable and safe procedures of digestive tract reconstruction. The incidence rates of emaciation, dumping syndrome and retention syndrome are lower in the patients with FJI, showing a better tolerance to adjuvant chemotherapy than Roux en-Y jejunal p type anastomosis.</p>

Correlation analysis between loss of heterozygosity at chromosome 18q and prognosis in the stage-II colon cancer patients / 癌症

<p><b>BACKGROUND AND OBJECTIVE</b>Colorectal cancer is one of the most common malignant cancers in the world. Although the clinicopathologic staging is the golden criterion for the prognosis at present, the optimum prognostic criteria for colorectal cancer should be a combination of the clinicopathologic staging and the molecular markers. However, there are currently no molecular markers available for the prognosis of colorectal cancer. Several tumor-suppressor genes associated with colorectal cancer have been mapped at the 18q21-23 region. In this study we detected the frequency of loss of heterozygosity (LOH) at chromosome 18q and investigated the relationship between LOH and clinicopathologic features and its prognostic value for patients with stage II colon cancer.</p><p><b>METHODS</b>A total of 106 samples of tumor tissues and corresponding normal mucosa from patients with sporadic stage-II colon cancer were included in this study. All the samples were formalin-fixed and paraffin-embedded. DNA was extracted from tumor tissues and LOH of D18S474, D18S55, D18S58, D18S61 and D18S64 at chromosome 18q was analyzed using polymerase chain reaction (PCR), polyacrylamide gel-electrophoresis, and DNA sequencing method. Multivariate analysis for association between LOH and prognosis in colon cancer patients was performed with Cox proportional hazards regression model.</p><p><b>RESULTS</b>The median follow-up time was 68 months. For 106 patients, 5-year survival rate was 83.6%, which was associated with age and gross tumor type (P = 0.011 and 0.034, respectively). Among 102 patients who were eligible for LOH information, the overall frequency of LOH is 49.0% (50/102), and that of LOH at 5 microsatellite loci of D18S474, D18S55, D18S58, D18S61, and D18S64 was 30.2% (26/86), 23.4% (18/77), 28.6% (20/70), 35.0% (28/80), and 20.8%(15/72), respectively. The occurrence of LOH was significantly associated with tumor location and histopathologic grade (P = 0.023, 0.016 and 0.005, respectively). LOH was more frequent on the left-side, poorly-differentiated adenocarcinoma, and nonmucinous colon cancers. The occurrence of 18q-LOH was significantly associated with 5-year overall survival rate and disease free survival rate (P = 0.008 and 0.006, respectively). The occurrence of 18q-LOH at the loci of D18S474 and D18S61 was significantly associated with 5-year overall survival rate (P = 0.010 and 0.005, respectively). The multivariate analysis showed that only the occurrence of 18q-LOH was significantly associated with prognosis (P = 0.021).</p><p><b>CONCLUSIONS</b>There is a high occurrence of LOH at the loci of 18q. The expression of LOH is significantly associated with tumor location and histopathologic grade. The occurrence of 18q-LOH is an independent poor prognostic factor for the patients with stage-II colon cancer.</p>

Prognosis of 980 patients with gastric cancer after surgical resection / 癌症

<p><b>BACKGROUND AND OBJECTIVE</b>Although surgery is the only possible means to cure gastric cancer, the prognosis is often discrepant. The American Joint Committee on Cancer / International Union against Cancer (AJCC/UICC) published the TNM classification of Malignant Tumors (seventh edition) for gastric cancer recently. This study aimed to use this new edition staging system to investigate the prognostic factors for gastric cancer.</p><p><b>METHODS</b>The clinicopathologic data of 980 patients with gastric cancer treated by surgical resection in our hospital between January 2000 and December 2006 were analyzed retrospectively. The overall survival rate was determined by using Kaplan-Meier method and log-rank test was used to determine significance. The prognosis was analyzed using univariate analysis and multivariate analysis with the Cox proportional hazards model. The 6th and 7th edition AJCC/UICC TNM staging systems were used to compare the survival outcomes for the cohort of patients.</p><p><b>RESULTS</b>The overall 1-, 3-, 5-year survival rates for the whole group were 82.5%, 58.7%, and 52.6%. The 5-year survival rates for patients with pTNM stage I, II, III, and IV disease classified by the 7th edition staging system were 93.2%, 72.4%, 39.1%, and 5.2%, respectively. In both univariate analysis and Cox multivariate analysis, age, tumor site, tumor size, histological type, resection type, radical resection, lymphatic/venous invasion, depth of invasion, nodal status, metastasis, retrieved lymph nodes, metastatic lymph node ratio, and adjuvant chemotherapy were prognostic factors with these patients.</p><p><b>CONCLUSION</b>Compared with the 6th edition system, the new edition of TNM staging system for gastric cancer can accurately predict the survival after operation.</p>

Relationship between the number of lymph node detection and prognosis in stage II gastric cancer after D(2) dissection / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the relationship between the lymph node count and prognosis in stage II gastric cancer.</p><p><b>METHODS</b>Retrospective analysis was performed for the 268 cases with gastric cancer who underwent parallel D(2) dissection between January 1990 and December 2006 in the Sun Yat-Sen Cancer Center. The Japanese Gastric Cancer Association(JGCA) 13th edition of pathological staging system was used to define stage II gastric cancer. Patients were followed up until December 2008. The Kaplan-Meier method and chi-square test were used for data analysis. All the data were analyzed using SPSS16.0 for Windows.</p><p><b>RESULTS</b>The average number of detected lymph nodes was 17.3+/-1.2. There were 109 patients with detected lymph node <15. The 1-, 3-, and 5-year survival rates were 92.7%, 67.8%, and 50.9%, respectively. The number of detected lymph node was > or =15 in 159 cases, and the 1-, 3-, and 5-year survival rates were 96.9 %, 81.0%, and 66.4%, respectively. The difference between two groups was statistically significant (P=0.003). Further analysis of the 199 cases with no lymph node metastasis (pN(0) group) showed that there were 95 cases with lymph nodes <15, and the 1-, 3-, and 5-year survival rates were 92.6%, 70.4%, and 55.9%, respectively. There were 104 patients with > or =15 lymph nodes, and the 1-, 3-, and 5-year survival rates were 97.1%, 84.4%, and 66.8%, respectively. The difference was also statistically significant (P=0.049). There were 69 cases with lymph node metastasis (PN(1) group), and the 1-, 3-, and 5-year survival rates of 14 patients with lymph nodes <15 were 92.9%,57.1%, and 34.3%, respectively. Comparing two groups, the survival rate was significantly different (P=0.034). There were 55 patients with > or =15 lymph nodes, and the 1-, 3-, and 5-year survival rates were 96.4%, 73.4%, and 63.8%. The difference was statistically significant (P=0.036).</p><p><b>CONCLUSION</b>In patients with stage II gastric cancer as defined by the JGCA 13th edition, the survival rate is better in patients with more than 15 detected lymph nodes as compared to those with less than 15.</p>

Long-term results of surgical treatment of stomach cancer: clinical experience of forty years from Sun Yat-sen University Cancer Center / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the approaches to improve therapeutic effect of stomach cancer by analysis of the long-term results of surgical treatment of this disease.</p><p><b>METHODS</b>Prognostic factors of stomach cancer were analyzed by Cox multivariate regression model based on clinical data of 2561 stomach cancer cases who underwent surgical treatment from 1964 to 2004 at Sun Yat-sen University Cancer Center. Survival rates were calculated by life table method.</p><p><b>RESULTS</b>Gastrectomy was performed for 1950 cases with resectability of 76.1%, among which there were 1192 cases of curative resection (46.5%) and 758 cases of non-curative resection (29.6%). The other 611 cases of palliative operation included bypass procedures and laparotomy. Operative mortality of all cases was 0.8% and morbidity was 5.1%. For all cases the 1-, 3- and 5-year survival rate was 52.4%, 38.6% and 35.5%, respectively. The stage-specific 5-year survival rate was 86.8% (Stage I), 58.7% (Stage II), 28.4% (Stage III) and 7.6% (Stage IV), respectively. The 5-year survival after curative resection in the period of 40 years was 45.5%, and increased to 52.7% in the last two decades and 61.8% in recent decade. Stage-specific case proportion during the earlier two decades was 1.4% (Stage I), 10.6% (Stage II), 23.1% (Stage III) and 64.9% (Stage IV), respectively, and that during the recent two decades was 9.3%, 18.5%, 35.3% and 36.8%, respectively. The 5-year survival rate of cases during the earlier two decades was 18.0% and increased to 37.5% during the recent two decades. Multivariate analysis indicated that main prognostic factors of stomach cancer included TNM staging, curative resection and multidisciplinary treatment.</p><p><b>CONCLUSIONS</b>Early detection and curative resection were the most important measures to improve therapeutic effect of stomach cancer. A surgery-predominant multidisciplinary treatment individualizing biological characteristics of tumor, staging of disease and tumor site will contribute to improvement of therapeutic effect of stomach cancer.</p>