Short-course preoperative radiotherapy with immediate surgery versus long-course chemoradiation with delayed surgery in the treatment of rectal cancer: A systematic review and meta-analysis

BackgroundLong-course chemoradiotherapy (LCRT) with delayed surgery or short-course radiotherapy (SCRT) with immediate surgery is probably the most frequent regimen in the treatment of rectal cancer. Debate is still going on whether SCRT or LCRT is more effective. So we performed this meta-analysis to evaluate the safety and efficacy of SCRT with immediate surgery versus LCRT with delayed surgery for the management of rectal cancer.MethodsLiterature were searched from PubMed, Embase, Web of science, Cochrane Library up to May, 2014. Quality of the randomized controlled trials (RCTs) was evaluated according to the Cochrane's risk of bias tool of RCT. RevMan 5.3 was used for statistical analysis. Pooled risk ratio (RR) and 95% confidence interval (CI) were calculated. Subgroup analysis and sensitivity analysis were employed to explore heterogeneity.Results16 trials were included in the qualitative systematic review. 12 trials were included in meta-analyses. 4 of them were RCTs; other 8 were non-RCTs. Meta-analysis demonstrated that there were no significant differences in overall survival (OS), disease free survival (DFS), local recurrence rate (LRR), distant metastasis rate (DMR), sphincter preservation rate, R0 resection rate and late toxicity. Compared with SCRT, LCRT obviously increased pCR rate [RR = 0.15, 95%CI (0.08, 0.28), P = 0.003], while LCRT obviously increased the grade 3–4 acute toxicity [RR = 0.13, 95%CI (0.06, 0.28), P < 0.00001].ConclusionsSCRT with immediate surgery is as effective as LCRT with delayed surgery for treatment of rectal cancer in terms of OS, DFS, LRR, DMR, Sphincter preservation rate, R0 resection rate and late toxicity. Though LCRT increased pCR rate, LCRT also increased acute toxicity compared with SCRT. SCRT is a better choice in centers with a long waiting list or lack of medical resources.     

Triterpenes from Astilbe chinensis

Six new triterpenes, 3β,6β-dihydroxyurs-12-en-27-oic acid (1), 3β,6β,24-trihydroxyurs-12-en-27-oic acid (2), 3β,6β,7α-trihydroxyurs-12-en-27-oic acid (3), 3β-acetoxy-6β-hydroxyurs-12-en-27-oic acid (4), 3β,6β,24-trihydroxyolean-12-en-27-oic acid (5), and 3β,6β,7α-trihydroxyolean-12-en-27-oic acid (6), were isolated from the rhizomes of Astilbe chinensis. Their structures were elucidated on the basis of 1D- and 2D-NMR analyses and HR-MS experiments. The isolated compounds exhibited significant cytotoxic activities against the SK-N-SH and HL-60 cell lines.     

Anti-inflammatory Effects of Z-Ligustilide Nanoemulsion

The Z-ligustilide (LIG) was studied for its anti-inflammatory activities with prepared LIG nanoemulsions (LIGNE). Healthy male adult Wistar rats were used in the study. Endotoxin-induced uveitis (EIU) was induced by a footpad injection of 200 μg lipopolysaccharide. EIU rats were administered orally with saline, LIG (20 mg/kg/day), and LIGNE (20 mg LIG /kg/day), respectively. Twenty-four hours later, rats were euthanized, and blood was collected from either right marginal ear vein to estimate inflammatory cells and inflammatory mediators. The drug dissolution profiles of LIGNE in both phosphate buffer pH 6.8 and 0.1 N HCl showed complete dissolution within 20 min. Pharmacokinetic studies suggested a significant increase (P?<?0.0001) in the C _pmax and AUC_{0→24 h} were observed in the LIGNE group when compared with the LIG group. LIGNE significantly reduced the levels of tumor necrosis factor alpha, interleukin 1 beta, vascular endothelial growth factor alpha, and interleukin-17. The anti-inflammatory animal testing revealed that LIGNE led to an improvement in oral bioavailability.     

多西他赛对比奥沙利铂联合卡培他滨治疗晚期胃癌的临床观察

目的探讨多西他赛(TXT)联合卡培他滨(希罗达,Xeloda)对比奥沙利铂(LOHP)联合希罗达(Xeloda)治疗晚期胃癌的临床疗效和不良反应。方法选取我院收治的49例晚期胃癌患者,随机分为两组。A组24例患者采用TXT联合Xeloda治疗方案。B组25例采用LOHP联合Xeloda治疗方案。结果 A,B两组有效率、中位无进展生存期分别为(CR+PR)54.17%、(CR+PR)56%;(PFS)6.1个月(95%CI:5.36~9.84)、PFS 6.3个月(95%CI:5.12~9.46),两组均无明显差异(P>0.05)。结论 TXT联合Xeloda治疗晚期胃癌的临床疗效与LOHP联合Xeloda治疗晚期胃癌的临床疗效基本接近,不良反应可以耐受。     

Comparison of MPL-ANN and PLS-DA models for predicting the severity of patients with acute pancreatitis: An exploratory study

ObjectiveAcute pancreatitis (AP) is a common inflammatory disorder that may develop into severe AP (SAP), resulting in life-threatening complications and even death. The purpose of this study was to explore two different machine learning models of multilayer perception-artificial neural network (MPL-ANN) and partial least squares-discrimination (PLS-DA) to diagnose and predict AP patients' severity.MethodsThe MPL-ANN and PLS-DA models were established using candidate markers from 15 blood routine parameters and five serum biochemical indexes of 133 mild acute pancreatitis (MAP) patients, 167 SAP (including 88 moderately SAP) patients, and 69 healthy controls (HCs). The independent parameters and combined model's diagnostic efficiency in AP severity differentiation were analyzed using the area under the receiver operating characteristic curve (AUC).ResultsThe neutrophil to lymphocyte ratio (NLR) is the most useful marker in 20 parameters for screening AP patients [AUC = 0.990, 95% confidence interval (CI): 0.984–0.997, sensitivity 94.3%, specificity 98.6%]. The MPL-ANN model based on six optimal parameters exhibited better diagnostic and predict performance (AUC = 0.984, 95% CI: 0.960–1.00, sensitivity 92.7%, specificity 93.3%, accuracy 93.0%) than the PLS-DA model based on five optimal parameters (AUC = 0.912, 95% CI: 0.853–0.971, sensitivity 87.8%, specificity 84.4%, accuracy 84.8%) in discriminating MAP patients from SAP patients.ConclusionThe results demonstrated that the MPL-ANN model based on routine blood and serum biochemical indexes provides a reliable and straightforward daily clinical practice tool to predict AP patients' severity.     

Homozygous familial hypercholesterolemia in China: Genetic and clinical characteristics from a real-world,multi-center,cohort study

BackgroundThere is a lack of large-scale data on the clinical and genotype characteristics of homozygous familial hypercholesterolemia (HoFH) patients in Asia.ObjectiveTo define the characteristics of phenotypic and genetic HoFH probands from mainland China.MethodsWe collected data from patients with suspected HoFH from ten clinical hospitals across mainland China from 2003 to 2019. Clinical data and DNA testing were obtained in all patients. The Kaplan-Meier method was used to generate survival curves, and the groups were compared with the log-rank test.ResultsA total of 108 unrelated probands with suspected HoFH (mean age 14.9 years) were included. The three most common variants were W483X (c.1448 G>A), A627T (c.1879 G>A), H583Y (c.1747 C>T). The majority (64.8%) were compound heterozygotes (n = 70), 23 (21.3%) were true HoFH patients. True HoFH showed higher LDL-C levels compared to compound HoFH (16.8±3.6 mmol/L vs. 15.0±3.1 mmol/L, P = 0.022). During follow-up, only 21.2% patients exhibited an LDL-C reduction of more than 50%. Kaplan-Meier analysis showed that the true HoFH probands had significantly worse survival rates compared to other genotype probands (13-year survival; 20.3% vs. 76.7%, respectively; P = 0.016). In addition, true HoFH shows that 2.8-fold (P = 0.022) increase any death and 3.0-fold (P = 0.023) increase cardiovascular death risk in relative to other FH.ConclusionsThis report shows that HoFH has devastating consequences, and that patients are often only diagnosed after they have been exposed to severely elevated LDL-C for years. Systematic screening and early intensive treatment are an absolute requirement for these young individuals with HoFH.     

鼻内镜术后不同冲洗液冲洗鼻腔的效果对比

目的:观察鼻渊通窍颗粒稀释液与生理盐水对鼻内镜术后鼻腔冲洗的效果。方法:临床纳入进行功能性内窥镜鼻窦手术患者90例,研究组给予鼻渊通窍颗粒稀释液,对照组给予生理盐水。每周定期对患者进行鼻内窥镜的检查,观察两组患者4周内鼻腔症状以及术腔清洁、囊泡形成、肉芽生成等体征变化情况。结果:两组术后4周冲洗治疗结果表明,两者均有治疗作用,且治疗效果相当,但鼻渊通窍颗粒稀释液冲洗在术后第2周时对术腔痂皮脱落、黏膜水肿、鼻分泌物减少、囊泡形成治疗作用较生理盐水冲洗要好,差异有显著性(P<0.05);研究组治疗4周,总有效率为93.33%,对照组有效率为91.11%,差异无显著性(P>0.05)。结论:鼻渊通窍颗粒稀释液能够有效清洁术后的鼻腔,具有减轻鼻腔黏膜水肿、囊泡再生以及促进黏膜功能恢复等作用。     

氟伐他汀对2型糖尿病患者血脂影响的研究

目的:探讨氟伐他汀对2型糖尿病患者血脂的影响。方法:选择187例2型糖尿病患者,根据随机数字表法分为观察组(87例)和对照组(60例),对照组常规降血糖治疗,观察组加用氟伐他汀治疗。对比治疗效果。结果:观察组总胆固醇水平、三酰甘油水平、低密度脂蛋白胆固醇水平、颈动脉中层厚度、粥样斑块面积及脑血管事件发生率均明显低于对照组,P<0.05)。结论:氟伐他汀可有效调节2型糖尿病患者的血脂水平。