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Objective To evaluate the efficacy and safety of XELOX regimen combined with hepatic artery chemoembolization in the treatment of gastric cancer with liver metastasis.Methods 50 cases of gastric cancer with liver metastasis were randomly divided into two groups,the experimental group (25 cases) received chemotherapy regimen of XELOX first:Xeloda tablets 1 000 mg/m2,orally,twice a day,days1-14;Oxaliplatin 130 mg/m2,intravenous drip,day 1.Hepatic artery chemoembolization was performed one a week later,and a cycle consists of 4 weeks.The control group (25 cases) received chemotherapy regimen of XELOX,3 weeks as a cycle.All patients were evaluated for efficacy and toxicity every 2 cycles.Results In the experimental group,the overall response rate was 56％,the tumor control rate was 80％,the increase rate of Karnofsky was 60％,and 10 patients got chance of tumor resection.In the control group,the overall response rate was 32％,the tumor control rate was 52％,the increase rate of Karnofsky was 48％,and 6 patients got chance of operation.The overall response rate,tumor control rate,surgical treatment rate and the increase rate of Karnofsky in the experimental group were significantly different from those in the control group (P ＜0.05).The median total survival time was 12.5 months in the experimental group and 10.5 months in the control group (P ＜0.05).There was no significant difference in toxicity and side effects between the two groups.Conclusion XELOX regimen combined with hepatic artery chemoembolization is effective and safe in the treatment of gastric cancer with liver metastasis.
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Objective To evaluate efficacy and safety of intravenous chemotherapy combined with TACE in the treatment of gastric cancer with hepatic metastasis.Methods In this study 60 gastric cancer patients with hepatic metastasis were divided into two groups randomly,the trial group (30 cases) took intravenous chemotherapy consisted of docetaxel 60 mg/m2 intravenous drip d1,oxaliplatin 80 mg/m2 intravenous drip d1 followed by 5-fiuorouracil 500 mg/m2 intravenous drip d1-5 after TACE.The control group (30 cases) took the same chemotherapy protocol and one treatment cycle covering 4 weeks.Results The overall response rate in trial group was 53％ and the increase rate of Karnofsky was 70％ while that was 37％ and 40％ respectively in the control group (P ＜ 0.05).The median overall survival of trial group was 13 months and which was 8 months in the control group (P ＜ 0.05),meanwhile the toxicities and side reactions of trial group didn't increase notably.Conclusions Intravenous chemotherapy combined with TACE is safe and more effective in the treatment of gastric cancer with hepatic metastasis.
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Objective To investigate the values of the APACHE O,APACHE-Ⅲ,Ranson and Balthazar CT(CTSI) scoring systems in predicting prognosis of severe acute pancreatitis.Methods Data were collected prospectively from 321 consecutive patients who were admitted into our hospital from 2005-01-01 to 2011-01-01 with acute pancreatitis (AP).The sensitivity,specificity and accuracy of the APACHE-O,APACHE-Ⅱ,Ranson,Balthazar CT scoring systems at different cut-off levels were calculated.The receiver-operating curves (ROC) for the prediction of severe AP in the early period were calculated using the APACHE-O,APACHE-Ⅱ,Ranson and Balthazar CT scores in different cut-off levels on hospital admission.The area under the curve (AUC) was used to compare the predictive accuracy.Using ROC curves,the values in predicting systemic complications,local complications and morbidities were also compared.Results At a cut-off point of 7,the APACHE O had a sensitivity of 95.4％,a specificity of 76.6％ and an overall accuracy of 79.4％.The Youden's index and the AUC of the APACHE-O score were 0.720 and 0.736,respectively.At a cut-off point of 8,the APACHE-Ⅱ had a sensitivity of 90.4％,a specificity of 81.0％ and an overall accuracy of 842.6％.The Youden's index and the AUC of the APACHE-Ⅱ were 0.714 and 0.699,respectively.At a cut-off point of 3,the Ranson had a sensitivity of 75.0％,a specificity of 78.1％ and an overall accuracy of 77.6％,respectively.The Youden’s index and the AUC of the Ranson were 0.531 and 0.703,respectively.At a cut-off point of 5,the CTSI had a sensitivity of 82.7％,a specificity of 91.4％ and an overall accuracy of 90.0％,respectively.The Youden's index and the AUC of the CTSI were 0.741 and 0.777,respectively.The CTSI system was the best in predicting local complications with a Youden’s index of 0.766,and an AUC of 0.777,respectively. At a cut-off point of 5,the CTSI had a sensitivity of 85.4％,a specificity of 91.2％ and an overall accuracy of 90.3％,respectively.The APACHE-O system was the best in predicting systematic complications with a Youden’s index of 0.789 and an AUC of 0.779,respectively.At a cut -off point of 8,the CTSI had a sensitivity of 91.1 ％,a specificity of 87.8％ and an overall accuracy of 88.2％,respectively.The CTSI system was the best in predicting local complications with a Youden’s index 0.952 and an AUC of 0.847,respectively.At a cut-off point of 8,the CTSI had a sensitivity of 100％,a specificity of 95.2％,and an overall accuracy of 95.3％,respectively.Conclusions The results suggested that the CTSI is the most useful system in predicting local complications and morbidities of severe AP in the early period.The APACHE-O is most useful in predicting systemic complications of severe AP.
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Objective To explore relationship between telomerase and canceration of colorectal adenoma.Methods Telomerase activity was measured by hybridization-in-situ in 30 colorectal adenoma,30 normal colorectal mucosa ,30 colorectal adenoma canceration tissues and normal close adenoma.Results The expression of telomerase in colorectal adenoma canceration was 86.6%(strong positive 73.3%, weak positive 13.3%);60% in close adenoma tissues(strong positive 6.7%, weak positive 53.3%),10% in normal colorectal adenoma(strong positive 3.3%, weak positive6.7%),0% in normal colorectal mucosa.Conclusions Telomerase plays a critical role in colorectal adenoma canceration and is a internal factor.It is a sign of canceration tendency(not malignant transformation) in canceration.