Clinical significance of survivin in the diagnosis and prognosis of endometrial carcinoma

Objective： To investigate the clinical significance of survivin in endometrial carcinoma and to investigate the relationship between the expression of survivin and Ki-67. Methods： Immunohistochemical S-P （streptavidin-biotin-peroxidase complex）method was performed to detect the expression of survivin and Ki-67 antigen in 15 cases of normal endometrium, 21 cases of endometrial simple and complex hyperplasia, 22 cases of endometrial atypical hyperplasia, and 61 cases of endometrial carcinoma. Results： Survivin was hardly detected in some normal endometrium in the proliferative phase and in the secretory phase. However, the level of survivin expression in atypical hyperplasia endometrium（72.73%）was higher than that in normal en- dometrium （7.14%）（P 〈 0.05）, including simple and complex hyperplasia （42.38%）（P 〈 0.01 ）, and was lower than that in endometrial carcinoma（90.17%）（P 〈 0.05）. Moreover, significant correlation was present between the expression of survivin and the characteristics of endometrial carcinoma, including clinical stage, histological grade and the presence of invasion to myometrium （P 〈 0.05）. In addition, Ki-67 antigen expression was positively correlated with survivin expression in all specimen. Ki-67 labeled indexes （LIs）in hyperplasia endometrium were significantly lower than those in atypical hyperplasia endometrium and endometrial carcinoma （P 〈 0.01 ）, while there was no significant difference in Ki-67 LIs between atypical hyperplasia endometrium and endometrial carcinoma（P 〉 0.05）. There was no significant relationship between Ki-67 LIs and the characteristics of endometrial carcinoma, including histological grade, clinical stage or the invasion to myometrium（P 〉 0.05）. Conclusion： Survivin may participate in the onset and progression of endometrial carcinoma through inhibiting apoptosis and promoting proliferation. Survivin expression is correlated with the malignant degree and prognosis of tumor. Ki-67 is also associated with carcinogenesis and progression of endometrial carcinoma. The results suggest that survivin could be a diagnostic and prognostic marker for endometrial carcinoma and might provide pathways to treat the patients with recurrent or refractory or rudimental endometrial carcinoma.     

Visual function and morphological changes in the macular area of patients with type 2 diabetes mellitus after intensive insulin therapy

Background Intensive insulin therapy has been found to lessen the progress of diabetic retinopathy （DR） to some extent,while it has also been implicated to be responsible for decrease of DR.We investigated visual function and morphological changes in the macular area in short-term follow-up of patients with type 2 diabetes mellitus after intensive insulin therapy.Methods This was a prospective clinical study of nonproliferative DR patients （102 eyes,120 patients） undergoing intensive insulin therapy.The Contrast Glare Tester （Takagi CGT-1000） was used to examine contrast sensitivity （CS） and Heidelberg Retina Tomograph （HRT） Ⅱ and Stratus Model 3000 OCT were used to observe the changes of morphology in the macular area.Follow-up times were pre-intensive therapy,3 and 6 months post-intensive therapy.Results CS at low and middle frequencies was higher at 3 and 6 months post-therapy compared with pre-therapy （P 〈0.05）.Significant differences in CS at low frequency were found between 6 and 3 months post-therapy （P 〈0.05）.Macular edema index was lower in the first,second,and third rings of the macular area after intensive therapy compared with pre-therapy （P 〈0.05）.Compared with 3 months post-therapy,the macular edema index was lower in the first,second,and third rings of the macular area at 6 months post-therapy （P 〉0.05）.No significant differences in the thickness of the first,second,and third rings of the macular area were detected between 3 and 6 months post-therapy and pre-therapy （P〉0.05）.Conclusion CS and macular edema indexes were significantly improved in nonproliferative diabetic retinopathy patients after intensive insulin therapy,but thickness of the macular area was unchanged.     

益气养阴粥缓解胃癌患者化疗相关症状的作用：一项单病例随机对照试验

Objective: To investigate the efficacy of dietary therapy of qi-yin-reinforcing porridge for the alleviation of clinical symptoms during FOLFOX chemotherapy. Methods: A single-case randomized controlled study was carried out. Fourteen patients with gastrointestinal tumors accepting FOLFOX chemotherapy were enrolled using self-crossover control design. On days 1–7 of chemotherapy, the dietary therapy experimental group and the placebo control group were given dietary therapy of qi-yin-reinforcing porridge and dextrin-prepared porridge which had the same appearance, smell, color and taste as the qi-yin-reinforcing porridge, respectively. Fourteen clinical symptoms, including debility, vomiting and nausea, etc. were observed. Results: Ten patients completed the study and were estimable. The qi-yin-reinforcing porridge demonstrated certain efficacy in alleviating clinical symptoms of patients with gastrointestinal tumors during the period of chemotherapy. Better effect of alleviating debility was found in the dietary therapy experimental group than in the placebo control group, and the difference was statistically significant (Z=2.27, P=0.02). No statistically significant difference was found between the experimental group and the control group with respect to the effect of alleviating the other 13 clinical symptoms including anorexia, nausea, vomiting, dry stool, loose stool, etc. and body weight (P>0.05). Conclusion: Dietary therapy of qi-yin-reinforcing porridge shows an additional benefit in alleviating debility of patients during chemotherapy and deserves clinical use and popularization.     

Diagnosis and Management of Intractable Hemoptysis by Bronchoscopic Intervention

Objective： To investigate the efficacy of bronchoscopic intervention therapy in the diagnosis and management of intractable hemoptysis. Methods： 106 patients with intractable hemoptysis and in whom clinical medicine, bronchial artery embolization failed to stop the bleeding were analyzed. Results： Therapy was very effective in 58 cases （54.7%）; somewhat effective in 41 cases （38.7%）; and ineffective in 7 cases （6.6%）. Conclusion： Bronchoscopic intervention therapy is safe, convenient and an efficacious method for hemoptysis.     

Clinical observation on the efficacy of Xiaoshui decoction (消水方) combined with intrapleural perfusion of cisplatin in treating malignant pleural effusion

Objective： To observe the clinical efficacy of Xiaoshui decoction （XSD,消水方） combined with intrapleural perfusion of cisplatin in the treatment of malignant pleural effusion. Methods： Fifty-one patients with malignant pleural effusion were randomly assigned to two groups. The treated group patients） received oral administration of XSD combined with intrapleural perfusion of cisplatin, and control group （25 patients） was only treated with intrapleural perfusion of cisplatin. The effects of 26 he he short-term efficacy, quality of life scores and clinical symptom scores of malignant pleural effusion were evaluated. Results： The short-term efficacy in the treated group and the control group was 72.0% and 58.3%, respectively, and no significant difference was found （P〉0.05）. In contrast, the quality of life in the treated group was significantly improved compared to that of the control group （P〈0.05）, and so was the symptom remission （P〈0.05）. Conclusions： The combined therapy of XSD and intrapleural perfusion of cisplatin did not show obvious improvement in short-term efficacy, but the therapy remarkably alleviated the symptoms and improved the quality of life of patients.     

TP化疗方案联合康莱特治疗宫颈癌的效果及对血清CYFRA21-1、CK19水平的影响

Objective: To study the effect of TP chemotherapy regimen combined with Kanglaite in the treatment of cervical carcinoma and its effect on the serum level of CYFRA21-1 and CK19. Methods: 74 patients with cervical carcinoma were admitted in our hospital from October 2015 to May 2017 and were randomly divided into observation group and control group according to random digital table method, 60 cases in each group. The control group was treated with TP chemotherapy and the observation group was treated with TP chemotherapy regimen combined with Kanglaite. The clinical efficacy, the quality of life, serum CYFRA21-1 and CK19 levels and adverse reactions were compared between the two groups before and after treatment. Results: After treatment, the clinical effective rate(83.78%) in the observation group was significantly higher than that of control group (62.16%), u=4.390,P=0.036, with statistical significance(P<0.05). The KPS scores of the two groups were significantly decreased, and the KPS scores in the observation group were significantly higher than those in the control group(u=6.538,P=0.000). After treatment, the serum levels of CYFRA21-1 and CK19 were significantly decreased in both groups, and the levels in the observation group were significantly lower than those in the control group (u = 6.659, 8.647, P=0.000). The adverse reactions were mainly myelosuppression, gastrointestinal reaction and phlebitis. The incidences of myelosuppression and gastrointestinal reaction of grade III-IV in the observation group were significantly lower than that in the control group, while the incidence of phlebitis was significantly higher in the observation group than in the control group ((u = 2.160, 2.000, 4.16, P = 0.030, 0.045, 0.041, respectively). Conclusion: The effect of TP chemotherapy regimen combined with Kanglaite on cervical carcinoma is significantly. It can effectively reduce serum CYFRA21-1 and CK19 levels, improve the quality of life and safety, which is worth popularizing in clinical application.     

Chemotherapy with or without gefitinib in patients with advanced non-small-cell lung cancer: a meta-analysis of 6844 patients

Background Gefitinib is widely used in patients with advanced non-small-cell lung cancer （NSCLC）, in whom chemotherapy had failed. Previous trials reported inconsistent findings regarding the efficacy of gefitinib on overall survival （OS） and progression free survival （PFS）. This study was to evaluate the effects of chemotherapy plus gefitinib versus chemotherapy alone on survival of patients with NSCLC. Methods We systematically searched Medline, EmBase, the Cochrane Central Register of Controlled Trials, reference lists of articles, and proceedings of major meetings for relevant literature. Randomized controlled trials （RCTs） comparing chemotherapy with and without gefitinib in the treatment of patients with advanced NSCLC were included in our analysis. The primary endpoints were OS and PFS. Results Of 182 relevant studies, 12 were included in the final analysis, which consisted of 6844 patients with NSCLC. Overall, we noted that gefitinib therapy had an 8% improvement in the OS as compared to the gefitinib-free therapy, but this difference was not statistically significant （HR, 0.92; 95% CI： 0.85-1.00; P=0.051）. Furthermore, gefitinib therapy had significantly longer PFS compared to gefitinib-free therapy （HR, 0.72; 95% CI 0.60-0.87, P=0.001）. Patients receiving gefitinib therapy also had a more frequent objective response rate （ORR） than the control arm （OR, 2.51; 95% CI, 1.67- 3.78, P 〈0.001）. Rashes, diarrhea, dry skin, pruritus, paronychia, and abnormal hepatic function were more frequent in the gefitinib therapy group. Conclusions Treatment with gefitinib had a clear effect on PFS and ORR, and it might contribute considerably to the OS. Furthermore, there was some evidence of benefit for gefitinib therapy among patients with adenocarcinoma.     

Efficacy and Effect of SI17 Therapy on Pancreatic Polypeptide in Vascular and Tension-Type Headache

Background and purpose:Vascular and tension-type headache is most commonly encountered,andSI17 therapy has been tested to treat headache with good results.The efficacy of SI17 therapy forvascular and tension-type headache was compared and the effect of SI17 therapy on pancreaticpolypeptide(PP)was studied.Materials and methods:29 cases of vascular headache(20 cases in acuteattack during the trial)and 27 cases of tension-type headache(19 cases in acute attack)were enrolledin the study.Plasma PP level before and 4th day after treatment was measured by radioimmunoassay.Results:SI17 therapy is better for the treatment of vascular headache.Vascular headache with higherPP level and tension-type headache with normal PP level had good therapeutic results.Conclusion:The clinical efficacy is better for vascular headache with the increase of vagus tension and for tension-type headache with normal vagus tension.     

Effect and mechanism of ginsenoside Rg3 on postoperative life span of patients with non-small cell lung cancer

Objective： To explore the effect and mechanism of ginsenoside Rg3 （Shenyi Capsule, 参一胶囊） on the postoperative life span of patients with non-small cell lung cancer （NSCLC）. Methods： The prospective, randomized, controlled method was adopted. One hundred and thirty- three patients with NSCLC were randomly assigned to 3 groups： Shenyi Capsule group （43 cases）, combined therapy group （Shenyi Capsule plus chemotherapy, 46 cases）, and chemotherapy group （44 cases）. The survival rates, immune function and the correlation between vascular endothelial growth factor （VEGF） expression and clinical effect were analyzed in the three groups. Results： （1） The 1-year survival rate in the Shenyi group, the combined group and the chemotherapy group was 76.7% （33/43）, 82.6% （38/46）, and 79.5% （35/44）, respectively; the 2-year survival rate was 67.4% （29/43）, 71.7% （33/46）, and 70.5% （31/44）, respectively; and the 3-year survival rate was 46.5% （20/43）, 54.3% （25/46）, and 47.7% （21/44）, respectively. There was no significant difference among the 3 groups （P〉0.05）. （2） NK cells were increased to different degrees and the ratio of CD4/CD8 was normal in the Shenyi Capsule group and the combined group, while the ratio of CD4/CD8 was disproportional in the chemotherapy group. （3） In the chemotherapy group, the 3-year survival rate was lower in patients with positive expression of VEGF than in patients with negative expression （37.0% vs 64.7%, χ^2=17.9, P〈0.01）, but no significant statistical difference was shown in the other two groups （53.6% vs 55.6%, P〉0.05; 44.4% vs 50.0%, P〉0.05）. Conclusion： Shenyi Capsule, especially in combination with chemotherapy, can improve the life span of patients with NSCLC after operation. The mechanism might be correlated with improving the immune function and anti-tumor angiogenesis.     

化疗联合恩度治疗ERCC1阳性晚期 NSCLC的临床疗效

目的：探讨化疗联合恩度在核苷酸切除修复交叉互补基因1（ERCC1）阳性晚期非小细胞肺癌（NSCLC）中的临床疗效。方法选取2012年6月至2013年6月在该院经组织学确诊的Ⅳ期NSCLC患者301例,根据ERCC1的表达将患者分为单纯化疗组和化疗联合恩度组,比较不同治疗方案的疗效及患者的生存率。结果在301例NSCLC患者中,ERCC1阳性患者166例,阳性率为55．1％。在所有接受治疗的患者中,ERCC1阳性患者治疗的效果低于 ERCC1阴性患者;但与单纯化疗组相比,化疗联合恩度组能够显著提高ERCC1阳性患者的治疗效果,且其中位生存时间和疾病进展时间也显著延长（ P＜0．05）。结论化疗联合恩度治疗可有效增加NSCLC患者的疗效。     

非小细胞肺癌生存素的表达及与淋巴结转移相关性分析

目的 研究生存素（Survivin）蛋白在非小细胞肺癌（NSCLC）组织中的表达及其与淋巴结转移和预后的关系。方法用免疫组化方法检测82例NSCLC组织中生存素的表达，分析其与年龄、性别、癌的组织学类型、组织分化程度、淋巴结转移、临床复发和手术后生存期长短的关系。结果82例NSCLC组织中生存素阳性率为52％。生存素表达与淋巴结转移呈正相关（P=0．001，r=0．237），与患者三年生存率呈负相关（P=0．019，r=-0．265）。生存素表达与年龄、性别、癌组织学类型、组织分化程度和临床分期均无关（P〉0．05）。结论生存素蛋白的表达与NSCLC的淋巴结转移和预后密切相关。其高表达提示非小细胞肺癌患者预后不良。     

重组人血管内皮抑制素联合TP方案治疗晚期非小细胞肺癌的临床观察

目的观察YH-16联合紫杉醇和顺铂(TP)治疗晚期非小细胞肺癌(NSCLC)的近期疗效和安全性,同时探讨循环血管内皮细胞(CECs)与该方案疗效的相关性。方法比较观察组和对照组治疗晚期NSCLC的近期疗效及毒副反应,采用流式细胞学法检测治疗前后外周血CECs数量。结果观察组和对照组有效率(CR+PR)分别为62.50%和22.22%(P=0.035);临床受益率分别为87.50%和50.00%(P=0.030);两组Ⅲ～Ⅳ级白细胞减少发生率分别为31.25%和33.33%;Ⅲ～Ⅳ级血小板减少发生率分别为25.00%和27.78%;恶心、呕吐发生率分别为56.24%和50.00%,差异无统计学意义(P0.05)。结论 YH-16联合TP疗效优于单独应用TP,不增加毒副反应,CECs可能是一个较好的预测化疗联合抗血管生成治疗疗效的标志。     

恩度注射液联合NP方案治疗晚期NSCLC临床研究

目的：评价恩度（endostar YH-16）联合长春瑞滨和顺铂（NP）治疗晚期非小细胞肺癌（NSCLC）的疗效和安全性。方法：选择非小细胞肺癌患者486例,分为恩度注射液联合化疗组322例及单纯化疗组164例。研究的目标是有效率（RR）、临床受益率（CBR）、肿瘤进展时间（TTP）、生活质量（QOL）及安全性。结果：试验组和对照组的总RR分别为35.4%和19.5%（P=0.0003）,总CBR分别为73.3%和64.0%（P=0.035）,总的中位TTP分别为6.3个月和3.6个月（P=0.0000）。试验组的临床症状缓解率较对照组略高,有统计学差异（P=0.015）。试验组与对照组不良反应的发生率差异均无统计学意义。结论：YH-16与NP方案联合,能明显提高晚期NSCLC的RR及中位TTP,且安全性较好,具有较好的临床前景。     

重组人血管内皮抑制素联合化疗治疗117例晚期恶性肿瘤

目的采用重组人血管内皮抑制素(恩度)联合经典化疗方案治疗临床分期Ⅲ期以上的恶性肿瘤,观察用药后的疗效及毒副作用。方法经过病理组织切片检查确诊为恶性肿瘤的患者117例,采用恩度联合无交叉耐药的化疗药物方案治疗,联合用药2周期后评价疗效与不良反应,评估患者治疗开始到无疾病进展时间的生活质量。结果 117例患者在完成联合治疗后按照有关标准进行有效性与安全性评价,其中完全缓解12例,部分缓解30例,疾病稳定58例,疾病进展17例;客观有效率为35.8%,疾病控制率为85.4%。结论晚期恶性肿瘤患者低下的生活质量得以改善和稳定,且恩度联合化疗使用的毒性低,值得临床上推广应用,但远期疗效仍需进一步观察。     

重组人血管内皮抑素联合化疗治疗肺外中晚期恶性肿瘤的临床研究

目的评价重组人血管内皮抑素(恩度Endostar,-16)联合化疗治疗肺外中晚期恶性肿瘤的疗效及安全性。方法经病理或细胞学证实的肺外中晚期恶性肿瘤82例,其中研究组41例,接受恩度联合常规方案化疗(恩度15 mg/d,静滴4h,1～14d,间歇7 d重复,21d为1个周期);对照组41例,单纯接受常规方案化疗。2组至少用2个周期后进行近期疗效、临床受益率、疾病进展时间、生存率和生活质量,毒副反应的比较和评价。结果研究组41例中有40例可以评价客观疗效,对照组41例均可评价。研究组和对照组有效率分别为30.00%(12/40)和9.76%(4/41,P=0.02),临床受益率分别为72.50(29/40)和36.60%(15/41,P=0.04),疾病进展时间分别为7.63月和4.76个月(P=0.00),1年生存率分别为80.00%(32/40)和68.29%(28/41,P=0.23),2年生存率分别为25.00%(10/40)和9.76%(4/41,P=0.07),生活质量(QOL)改善稳定率分别为80.00%(32/40)和51.22%(21/41,P=0.006)。2组毒副反应相似,主要为骨髓抑制和恶心、呕吐,多为Ⅰ～Ⅱ度。结论重组人血管内皮抑素联合化疗,具有良好的临床疗效,与化疗药物有协同作用,可改善肺外中晚期恶性肿瘤患者的生活质量,提高局部控制率,延长疾病进展时间,且毒性低、安全性好,具有较好的临床应用前景。     

外周血中血管内皮细胞数量与胶质瘤的关系

目的探讨外周血中循环血管内皮细胞（circulating endothelial cells,CECs）与胶质瘤的关系。方法流式细胞法检测59例初诊胶质瘤患者外周血中的CECs的水平。结果治疗前后循环血管内皮细胞数量变化与胶质瘤患者的性别、年龄、病理类型、肿瘤负荷无关;治疗前后循环血管内皮细胞数量变化在不同疗效、肿瘤进展时间（time to progress,TTP）、1年生存率组有差异。结论提示循环血管内皮细胞是评价胶质瘤近期和远期疗效的指标。     

转移性乳腺癌上皮特异性细胞粘附分子(EpCAM)mRNA阳性循环肿瘤细胞检测及其临床价值

目的:以上皮特异性细胞粘附分子(epithelial cellular adhesion molecule,EpCAM)为标志,用实时定量PCR的方法检测转移性乳腺癌循环肿瘤细胞(circulating tumor cells,CTCs)。方法:以实时定量PCR的方法检测47例转移性乳腺癌患者及20例健康志愿者EpCAM mRNA的表达,并与原发灶病理特征、转移部位、疗效和疾病进展时间(time to progression,TTP)做相关分析。结果:化疗前和第1周期化疗后转移性乳腺癌患者的EpCAM mRNA阳性率分别37.8%和42.6%,20例健康志愿者均为阴性。转移性乳腺癌患者生存分析显示,第1周期化疗后,EpCAMmRNA阳性的患者与EpCAM mRNA阴性的患者相比,中位TTP明显缩短,分别为7.1个月和11.1个月(P=0.013)。亚组分析显示,一线和二线化疗的患者,TTP存在明显差别(P=0.018),而三线及三线以上化疗的患者TTP无明显差别(P=0.471)。结论:转移性乳腺癌中,EpCAM mRNA的阳性率约为40%。第1周期化疗后,EpCAMmRNA阳性的患者中位TTP明显缩短。     

食管鳞癌放疗前后外周血survivin检测的临床意义

目的:研究食管鳞癌(esophagus squamous cell carcinoma,ESCC)患者放疗前后外周血循环肿瘤细胞(circulating tumor cells,CTCs)标记生存素(survivin) mRNA的表达及其临床意义?方法:收集72例ESCC患者根治性放疗前后外周血,应用巢式RT-PCR检测survivin mRNA的表达,分析其与临床病理特征?放疗疗效及两年无进展生存期(progerssion-free survival,PFS)的关系?结果:放疗前后survivin mRNA阳性者分别占54.2%(39/72)与38.9%(28/72),差异无统计学意义(P = 0.066),放疗前后survivin mRNA阳性均与淋巴结转移相关(P值分别为0.012和0.005),放疗后survivin mRNA阳性提示放疗疗效不佳(P = 0.030)?生存分析表明放疗前后survivin mRNA阳性与PFS减少有关 (P值分别为0.040和 < 0.001),Cox回归模型证实放疗后survivin mRNA阳性?KPS评分和规范化后续化疗是独立预后指标?结论:放疗后外周血survivin mRNA阳性有望成为ESCC根治性放疗疗效评估和预后判断的有效分子标记?     

恩度联合化疗治疗晚期实体恶性肿瘤的临床观察

目的观察重组人血管内皮抑制素（恩度）联合化疗方案对多种恶性实体肿瘤的疗效及安全性。方法晚期恶性肿瘤患者41例接受恩度联合化疗的方案治疗。恩度用法：15mg／d,加入生理盐水250mL中静滴,维持3．4h,持续14d,间歇7d,21d为1个周期。化疗1个周期后按照NCICTC3．0版标准评价不良反应。化疗2个周期后开始按照RESIST标准评价近期疗效,参照KPS评分评价生活质量。结果41例患者平均接受了4．2个化疗周期。其中,部分缓解12例,稳定15例,进展14例,总有效率为29．3％,临床获益率为65．9％,生活质量改善70．7％。受累器官越多恩度联合化疗的效果越低（P〈0．05）。二线治疗的疗效优于一线治疗（P〈0．05）。在使用过程中未发生严重的毒副作用。结论恩度联合化疗可以改善晚期恶性肿瘤患者的生活质量,也较为安全。