结直肠癌肝转移个体化综合性治疗的研究进展

结直肠癌是临床上常见的消化道恶性肿瘤,近年来其发病率逐渐上升.肝脏是结直肠癌最常见的转移部位,并且肝转移是结直肠癌患者死亡的主要原因.结直肠癌肝转移患者通过手术治疗、新辅助治疗、分子靶向治疗、肝动脉导管化疗栓塞治疗、射频消融治疗等个体化综合治疗后,疾病进展可得到控制,并可改善生活质量,延长生存时间.本文就结直肠癌伴肝转移的个体化综合性治疗最新进展进行综述.     

个体化综合治疗——结直肠癌患者的新希望

结直肠癌是当前世界上发病率和死亡率最高的恶性肿瘤之一。据世界卫生组织(WHO)统计,2002年全世界新诊断结直肠癌患者为102万例,占全球癌症发病率第3位,死亡52.9万例,占死亡率第4位。在欧美国家结直肠癌死亡率位居肿瘤患者死亡的第2位。2006年仅美国新增结直肠癌患者15.4万,当年全美约有5.2万人死于该病。目前结直肠癌仍以2%的速度递增。在     

结直肠癌的内科治疗及进展

结直肠癌是胃肠道系统中最为常见的恶性肿瘤,在欧美等西方国家其死亡率位居第二.在我国,人民生活水平的提高和饮食结构的变化,结直肠癌的发病率呈逐年上升的趋势,尤其是近年更以4%的速度迅猛增长,它已成为严重危害广大人民生命健康的恶性肿瘤之一.     

结直肠癌治疗进展

结直肠癌（colorectal cancer,CRC）是最常见恶性肿瘤之一,在我国消化道肿瘤中排第3位,且其发病率呈逐年上升的趋势。近年来,随着腔镜技术的发展、靶向药物的应用,减少了结直肠癌的复发率、转移发生率和病死率,提高了患者生活质量和生存率。     

复方苦参注射液联合化疗治疗晚期结直肠癌近期疗效及安全性的Meta分析

<正>结直肠癌(ACRC)是消化道常见恶性肿瘤之一,发病率居消化道恶性肿瘤第三位(仅次于胃癌及食管癌),死亡率居恶性肿瘤第五位[1]。近年来,我国结直肠癌的发病率有逐年上升的趋势,有报道称结直肠的发病率在我国沿海发达地区已经达到或接近高发国家的水平[2]。目前结直肠癌最主要的治疗仍然是     

直肠癌治疗的现状

众所周知,结直肠癌是常见的消化道恶性肿瘤,尽管人们对结直肠癌的发生、发展做了很多研究,也采取了不少预防干预措施,但结直肠癌的发病率还是呈现出逐年上升的趋势。在我国,结直肠癌的发病在全身恶性肿瘤中排第3～4位,欧美国家则更高,达第2位。结直肠癌中直肠癌约占50％～60％。随着对结直肠癌的生长和转移规律的深入研究,     

结直肠癌的腹腔镜手术治疗

结直肠癌是我国常见的恶性肿瘤之一,发病率呈上升趋势;结直肠癌根治术后的5年生存率徘徊在50%(直肠癌)和70%(结肠癌)左右。目前结直肠癌的诊治仍强调早期诊断和以手术为主的综合治疗。     

晚期结直肠癌的药物治疗进展

结直肠癌是最常见的恶性肿瘤之一.国内结直肠癌的发病率和病死率在近30年明显升高,药物治疗是转移复发或局部晚期结直肠癌的主要治疗手段之一.研究证明药物治疗能延长患者生存并改善生活质量,新一代药物可使中位生存期延长到20 个月.本文就近年来药物治疗进展作一综述.     

放射性粒子植入治疗结直肠癌的研究进展

结直肠癌是常见的恶性肿瘤之一,我国结直肠癌的发病率和病死率呈逐年上升趋势。结直肠癌的治疗以手术治疗为主,辅以放疗、化疗等,但疗效欠佳,术后5年生存率低,仅为50%左右。近年来,放射性粒子植入治疗结直肠癌,因其对肿瘤的良好治疗效果,成为治疗结直肠癌的重要手段之一。在此综述放射性粒子植入治疗结直肠癌的研究进展。     

碘-125粒子靶向种植治疗在直肠癌治疗中的应用

直肠癌是常见的恶性肿瘤之一.在欧美等发达国家,每20人中就有一人最终患结直肠癌.虽然我国发病率较低,但随着经济的发展、人们生活水平的提高和膳食结构的改变,直肠癌的发病率有逐年上升趋势,尤其在大中城市,这种趋势更加明显.然而,受传统观念的影响和医疗条件的限制,我国直肠癌患者的早期就诊率低,误诊率高,中、晚期病例较多,手术切除率低,预后差,临床治疗的难度大.     

Efficacy of sunitinib in patients with metastatic renal cell carcinoma: initial experience in two Chinese centers

Background The advent of targeted therapy has proved a milestone in the history of metastatic renal cell carcinoma treatment, and several guidelines now recommend sunitinib as first- or second-line treatment. But little is known about its efficacy in Asian patients. The aim of this article was to evaluate the efficacy of sunitinib monotherapy in patients with metastatic renal cell carcinoma treated at two Chinese centers. Methods One hundred and forty-one patients with metastatic renal cell carcinoma were included in the study. Of them, 119 patients received single-agent sunitinib as first-line therapy and the remaining 22 patients received it as second-line therapy. One hundred and twenty patients received sunitinib in a dosage of 50 mg orally once daily on a 4-2 schedule （4 weeks on treatment, 2 weeks off）, while 21 patients received 37.5 mg/day continuously until either disease progression or unacceptable toxicity occurred. The overall response rate, survival outcomes, and safety were evaluated. Results Over a median follow-up time of 23 months （16 cycles; range 2-45 months）, complete responses, partial responses, and stable disease lasting two cycles or longer were achieved in 2.8%, 24.1%, and 60.3% of patients respectively （objective response rate 26.9%; overall benefit 87.2%）. The median progression-free survival was 14.2 months （range 3-39 months）. During the study, 53 patients died and the median survival time was 13.5 months （range 7-25 months）. Dose modification or treatment interruption due to adverse events was required in 36.9% of the patients. The most common adverse events were hand-foot syndrome （71.4%）, thrombocytopenia （68.8%）, hypertension （47.1%）, and fatigue （46.3%）. Conclusion Sunitinib had a favorable efficacy/tolerability profile in Chinese patients with metastatic renal cell carcinoma.     

The role of central nervous system on hypoglycemia and the feasibility of the brain theory in traditional Chinese medicine on treatment of diabetes mellitus

The central nervous system （CNS） plays a key regulatory role in glucose homeostasis. In particular, the brain is important in initiating and coordinating protective counterregulatory responses when blood glucose levels fall. This may due to the metabolic dependency of the CNS on glucose, and protection of food supply to the brain. In healthy subjects, blood glucose is normally maintained within a relatively narrow range. Hypoglycemia in diabetic patients can increase the risk of complications, such as heart disease and diabetic peripheral neuropathy. The clinical research finds that the use of traditional Chinese medicine （TCM） has a positive effect on the treatment of hypoglycemia. Here the authors reviewed the current understanding of sensing and counterregulatory responses to hypoglycemia, and discuss combining traditional Chinese and Western medicine and the theory of iatrogenic hypoglycemia in diabetes treatment. Furthermore, the authors clarify the feasibility of treating hypoglycemia on the basis of TCM theory and CNS and have an insight on its clinical practice.     

TGF-β1 Precursor and CD8 Are Potential Prognostic and Predictive Markers in Operated Breast Cancer简

The transforming growth factor β1（TGF-β1） and CD8-positive T cells are two important immune factors that function at opposite directions. The purpose of this study was to verify the relationship between the two factors and their associations with long-term effects of adjuvant chemotherapy or endocrine therapy in breast cancer. Expression of TGF-β1 precursor and CD8 was immunohistochemically detected on surgically-obtained tumor samples of 130（stageⅠ–Ⅲ） invasive breast carcinomas from Chinese subjects, who were followed up for a mean time of 112 months. Interstitial CD8-positive cells and TGF-β1 precursor-positive cells adjacent to tumor nests were counted. Infiltration of CD8-positive lymphocytes into tumor nests and TGF-β1 precursor expression in tumor cells were observed and survival analysis was performed. Our results showed that density of interstitial CD8-positive lymphocytes was an independent adverse prognostic factor for distant disease-free survival（DDFS）（HR=8.416, 95% CI=1.636–43.292, P=0.011） in hormone receptor-positive patients who were on adjuvant endocrine therapy. For breast cancer patients who did not receive adjuvant chemotherapy, those without infiltration of CD8-positive cells into tumor nests had a shorter overall survival（OS） than their counterparts with CD8-positive cell infiltration into tumor nests（Log-Rank, P=0.003）. But OS of patients without infiltration of CD8-positive cells into tumor nests was significantly prolonged by adjuvant chemotherapy（Log-Rank, P=0.013） and paralleled that of patients with CD8-positive cell infiltration. Although OS was shorter in the tumor cell TGF-β1 precursor（t-TGF-β1-pre）-positive patients than in the negative patients in patients without recieiving chemotherapy（P=0.053）, OS of t-TGF-β1-pre-positive patients was significantly prolonged by adjuvant chemotherapy（P=0.035） and was longer than that of t-TGF-β1-pre-negative patients. Analysis showed that t-TGF-β1-pre was an independent positive prognostic factor for DDFS（HR=0.392 95% CI=0.157–0.978, P=0.045） in patients who received adjuvant chemotherapy. This study suggested that density of interstitial CD8-positive lymphocytes was of prognostic value in hormone receptor-positive patients who received adjuvant endocrine therapy. Our study verified that adverse immunologic signatures consisting of absence of CD8-positive cells in tumor nests or expression of TGF-β1 precursor in tumor cells in breast cancer were associated with worse prognosis and significantly improved long-term survival with adjuvant chemotherapy, respectively.     

Chinese herbal medicine Xinfeng Capsule in treatment of rheumatoid arthritis： study protocol of a multicenter randomized controlled trial

BACKGROUND： Rheumatoid arthritis （RA）, as a common systemic inflammatory autoimmune disease, affects approximately 1 in 100 individuals. Effective treatment for RA is not yet available because current research does not have a clear understanding of the etiology and pathogenesis of RA. Xinfeng Capsule, a patent Chinese herbal medicine, has been used in the treatment of RA in recent years. Despite its reported clinical efficacy, there are no large-sample, multicenter, randomized trials that support the use of Xinfeng Capsule for RA. Therefore, we designed a randomized, double-blind, multicenter, placebo-controlled trial to assess the efficacy and safety of Xinfeng Capsule in the treatment of RA. METHODS AND DESIGN： This is a 12-week, randomized, placebo-controlled, double-blind, multicenter trial on the treatment of RA. The participants will be randomly assigned to the experimental group and the control group at a ratio of 1：1. Participants in the experimental group will receive Xinfeng Capsule and a pharmaceutical placebo （imitation leflunomide）. The control group will receive leflunomide and an herbal placebo （imitation Xinfeng Capsule）. The American College of Rheumatology （ACR） Criteria for RA will be used to measure the efficacy of the Xinfeng Capsule. The primary outcome measure will be the percentage of study participants who achieve an ACR 20% response rate （ACR20）, which will be measured every 4 weeks after randomization. Secondary outcomes will include the ACR50 and ACR70 responses, the side effects of the medications, the Disease Activity Score 28, RA biomarkers, quality of life, and X-rays of the hands and wrists. The first four of the secondary outcomes will be measured every 4 weeks and the others will be measured at baseline and after 12 weeks of treatment. DISCUSSION： The result of this trial will help to evaluate whether Xinfeng Capsule is effective and safe in the treatment of RA. TRIAL REGISTRATION： This trial has been registered in ClinicalTrials.gov. The identifier is N CT01774877.     

Effects of the aqueous extract of Schizandra chinensis fruit on ethanol withdrawal-induced anxiety in rats

Background We previously demonstrated that the aqueous extract of the Schizandra chinensis fruit （AESC） ameliorated Cd-induced depletion of monoamine neurotransmitters in the brain through antioxidant activity.In the present study,we investigated the effect of AESC on anxiety-like behavior and the levels of norepinephrine and 3-methoxy-4-hydroxyphenylglycol （a metabolite of norepinephrine） in different brain regions during ethanol withdrawal in rats.Methods Male Sprague-Dawley rats were treated with 3 g/kg of ethanol （20％,w/v） or saline by daily intraperitoneal injection for 28 days followed by three days of withdrawal.During withdrawal,rats were given AESC （100 mg.kg 1.d-1 or 300 mg.kg 1·d1,P.O.） once a day for three days.Thirty minutes after the final dose of AESC,the anxiogenic response was evaluated using an elevated plus maze,and the plasma corticosterone levels were examined by radioimmunoassay.Meanwhile,the concentrations of norepinephrine and 3-methoxy-4-hydroxy-phenylglycol in the hypothalamic paraventricular nucleus and hippocampus were also measured by high performance liquid chromatography.Results Rats undergoing ethanol withdrawal exhibited substantial anxiety-like behavior,which was characterized by both the decrease in time spent in the open arms of the elevated plus maze and the increased level of corticosterone secretion,which were greatly attenuated by doses of AESC in a dose-dependent manner.The high performance liquid chromatography analysis revealed that ethanol withdrawal significantly increased norepinephrine and 3-methoxy-4-hydroxy-phenylglycol levels in the hypothalamic paraventricular nucleus,while not significantly altering them in the hippocampus.Similar to the results from the elevated plus maze test,the AESC significantly inhibited the elevation of norepinephrine and its metabolite in the hypothalamic paraventricular nucleus in a dose-dependent manner.Conclusions These results suggest that AESC attenuates anxiety-like behavior induced by ethanol withdrawal through modulation of the hypothalamic norepinephrine system in the brain.     

HER2突变非小细胞肺癌患者的临床特征和疗效

1文献来源 Mazieres J, Peters S, Lepage B, et al. Lung cancer that harbors an HER2 mutation ： Epidemiologic characteristics and therapeutic perspectives [ J ]. J Clin Oncol, 2013,31 （16） ： 1997- 2003.     

Risk factors for perioperative major cardiac events in Chinese elderly patients with coronary heart disease undergoing noncardiac surgery

Background Few studies have investigated perioperative major adverse cardiac events (MACEs) in elderly Chinese patients with coronary heart disease (CHD) undergoing noncardiac surgery.This study examin...     

Antioxidant and Antigenotoxic Activity of Bioactive Extracts from Corn Tassel简

This study is designed to evaluate antioxidant and antigenotoxic activities of corn tassel extracts（CTTs）. The major bioactive components of CTTs include flavonoid, saponin and polysaccharide. The antioxidant properties of the three bioactive components of CTTs were investigated by Ferric Reducing Antioxidant Property（FRAP） and 1, 1-diphenyl-2-picrylhydrazyl（DPPH） assays. The activities of the extracts were determined by assessing the inhibition of mutagenicity of the direct-acting mutagen fenaminosulf, sodium azide, and indirect-acting mutagen 2-aminofluorene using the Ames test（strains TA98 and TA100）. The results showed that the extraction rates of flavonoid, saponin, and polysaccharide from the dried corn tassels were 1.67%, 2.41% and 4.76% respectively. DPPH and FRAP assay strongly demonstrated that CTTs had antioxidant properties. CTTs at doses of 625, 1250 and 2500 μg per plate reduced 2-aminofluorene mutagenicity by 12.52%, 28.76% and 36.49% in Salmonella typhimurium TA98 strain assay respectively and by 10.98%, 25.27% and 37.83%, at the same doses in Salmonella typhimurium TA100 assay system, respectively. 3-[4, 5-dimethylthiazol-2-yl]-2, 5-diphenyltetrazolium bromide（MTT） assay showed that the different concentrations of CTTs inhibited the proliferation of MGC80-3 cells in a dose-dependent manner（P0.01）. It is concluded that these integrated approaches to antioxidant and antigenotoxicity assessment may be useful to study corn tassel as a natural herbal material.