乳腺导管原位癌仅局部切除不行放疗是否可行：一项美国东部肿瘤协作组的研究结果

1文献来源 Hughes LL, Wang M, Page DL, et al. Local excision alone without irradiation for ductal carcinoma in situ of the breast： A trial of the eastern cooperative oncology group [J]. J Clin Oneol, 2009, 27（32） ：5319-5324.     

儿童及青少年急性淋巴细胞白血病依据风险调节治疗可降低治疗负荷并提高生存率

1 文献来源 Moricke A, Reiter A, Zimmermann M, et al. Risk-adjusted therapy of acute lymphoblastic leukemia can decrease treatment burden and improve survival： Treatment results of 2 169 unselected pediatric and adolescent patients enrolled in the trial ALL-BFM 95 [J]. Blood,2008,111（9）：4477-4489.     

1.GENERAL DIAGNOSIS

1.1.Physical method of diagnosis930613 The DSA manifestations of collateral circula-tion in malignant tumors of the liver.SHI Zhonghua,WANG ZhengyanCancer Hosp,CAMS,Beijing,100021,Chin J Radiol 1993;27(7):446—449.Thirty two cases of malignant tumors of the liver     

浙江中医药大学童培建教授早期干预股骨头坏死新疗法在骨研究顶级杂志在线发表

浙江中医药大学骨伤研究所（浙江省骨伤研究所）副所长、浙江中医药大学附属第一医院骨伤科主任童培建教授团队于2014年10月27日在骨研究领域国际顶级杂志Journal of Boneand Mineral Research（《骨与矿物质研究杂志》，2013年IF：6．589）在线发表研究论文“Combination Treatment of Biomechanical Support and Targeted Intra-arterial Infusion of Peripheral Blood Stem Cells mobilized by granulocyte-colony stimulating factor for the Osteonecrosis of the Femoral Head： a randomised controlled clinical trial”（J Bone Miner Res. 2014 Oct 2？. DOI： 10. 1002/jbmr. 2390.）。     

在传统IA诱导方案基础上加用洛莫司汀可改善老年原发性AML患者的预后

1文献来源 Pigneux A, Harousseau JL, Witz F, et al. Addition of Lomustine to Idarubicin and Cytarabine improves the outcome of elderly patients with De Novo acute myeloid leukemia： A report from the GOELAMS[J]. J Clin Oncol, 2010,28（18）：3028-3034.     

A review on pharmacological significance of genus Jatropha (Euphorbiaceae)

<正>A number of herbs belonging to the genus Jatropha of Euphorbiaceae family are noted for their medicinal benefits.The genus Jatropha is one of the prospective biodiesel yielding crops.The plants which have been so far explored include J.curcas,J.gossypifolia,J.glandulifera,J.multifida and J.podagrica.Although, the plants of this genus are widely distributed,there is an exiguity of scientific literature proclaiming the medicinal benefits of the plants belonging to genus Jatropha.The present paper is a pragmatic approach to accrue the findings on this very significant genus.     

吉西他滨单药与吉西他滨和卡培他滨联合化疗对进展期胰腺癌患者疗效的随机Ⅲ期研究

1文献来源 David C randomized Gemcitabine , Ian C, Deborah DS, et al. Phase III comparison of Gemcitabine versus plus Capecitabine in patients with advanced pancreatic cancer [J]. J Clin Oncol,2009,27（33）：5513-5518.     

手术方式及术后同期放化疗对胃癌复发模式的影响

1文献来源 Dikken JL,Jansen E,Cats A,et al.Impact of the extent of surgery and postoperative chemoradiotherapy on recurrence patterns in gastriccancer[J].J Clin Oncol,2010,28（30）：615-616.     

Expression of chemokine receptors CCR3, CCR5 and CXCR3 on CD4^＋ T cells in CBA/J×DBA/2 mouse model,selectively induced by IL-4 and IL-10, regulates the embryo resorption rate

Background Chemokines and their receptors have been a research focus in transplantation immunology. Chemokines and their receptors play a role in lymphocyte recruitment and differentiation process. This study aimed to observe whether IL-4 and IL-10 may regulate the expression of chemokine receptors CCR3, CCR5 and CXCR3 on CD4^＋ T cells in CBA/J×DBA/2 mouse model and to explore the role of CCR3, CCR5, CXCR3 in immune tolerance in pregnancy. Methods The mouse model of spontaneous abortion （CBA/J×DBA/2） and the normal pregnant mouse model （CBA/J×BALB/c） were used. CBA/J×DBA/2 mice were injected with IL-4 （CBA/J×DBA/2-IL-4）, IL-4 and IL-10 （CBA/J×DBA/2-IL-4＋IL-10）, or normal saline （CBA/J×DBA/2-NS） as a control. The expression of CCR3, CCR5 and CXCR3 on CD4^＋ T cells from mouse peripheral blood was measured by the double-labelled FCM method, and the embryo resorption rate was also examined. Results The embryo resorption rate in the CBA/J×DBA/2 group without any treatment was significantly higher than that in the CBA/J×BALB/c group （17.9% vs 3.7%, P 〈0.01）. The embryo resorption rate in the CBA/J×DBA/2 group immunized with IL-4 or IL-4 together with IL-10 was significantly decreased, compared with that in the control and NS groups respectively. CCR3 expression on CD4^＋ T cells in the CBA/J×DBA/2 group without any treatment was significantly lower than that in the CBA/J×BALB/c group （0.3738±0.3575 vs 1.2190±0.2772, P 〈0.01）; both CCR5 （3.0900±1.5603 vs 1.2390±0.6361, P〈0.01） and CXCR3 （2.4715±0.9074 vs 0.9200±0.5585, P 〈0.01） expressions on CD4^＋ T cells of the CBA/J×DBA/2 group without any treatment were significantly higher than those of the CBA/J×BALB/c group. Significant up-regulation of CCR3 and down-regulation of CXCR3 were found in the CBA/J×DBA/2 group treated with IL-4 （CCR3： 2.0360±0.6944, CXCR3： 1.3510±0.5263, P〈0.01） or IL-4 and IL-10 （CCR3： 1.8160±1.0947, CXCR3：1.0940±0.7168, P〈0.01）. Because of the CCR5, IL-4 and IL-10 （1.9400±0.8504 vs 3.0900±1.5603, P 〈0.05）, but IL-4 alone （2.5310±1.3595 vs 3.0900±1.5603, P 〉0.05） treatment significantly decreased the expression of CCR5 in CBA/J×DBA/2. Conclusions The abnormal expression of CCR3, CCR5 and CXCR3 on CD4^＋ T cells may play an important role in the pathogenesis of spontaneous abortion. The pregnancy immune tolerance may be induced through selective induction of CCR3, CCR5 and CXCR3 expressions by IL-4 together with IL-10.     

Hold a dialectical view towards creatine kinase

To the editor： The diagnosis of juvenile dermatomyositis （JDM） is much more challenging when lacking the cutaneous naanifestations as well as muscular biomarkers. Here we report an interesting case of J DM.     

晚期霍奇金淋巴瘤一线化疗方案的疗效比较

1文献来源 Federico M, Luminari S, Iannitto E, et al.ABVD compared with BEACOPP compared with CEC for the initial treatment of patients with advanced Hodgkin＇s lymphoma： Results from the HD2000 Gruppo Italiano per lo Studio dei Linfomi Trial [J]. J Clin Oncol, 2009,27（5）：805-811.     

BEACOPP在PET中期评价阳性晚期霍奇金淋巴瘤患者的疗效分析

1文献来源 Gallamini A, Patti C, Viviani S, et al. Early chemotherapy intensification with BEACOPP in advanced stage Hodgkin lymphoma patients with a interim-PET positive after two ABVD courses [J]. Br J Haematol, 2011,152（5） ：551-560.     

ABVD和BEACOPP方案治疗进展期霍奇金淋巴瘤,孰优孰劣?

众所周知，霍奇金淋巴瘤（Hodgkin lymphoma， HL ）是起源于淋巴造血组织的恶性肿瘤。在我国， HL的发病率不似欧美国家之高，但该病却是最早可被治愈的肿瘤之一，并被视为药物治疗恶性肿瘤之典范。     

ABVD与BEACOPP方案在计划行大剂量挽救性化疗霍奇金淋巴瘤患者中疗效比较

1文献来源 Viviani S, Zinzani PL, Rambaldi A, et al. ABVD versus BEACOPP for Hodgkin＇s lymphoma when high-dose salvage is planned [J]. N Engl J Med, 2011,365（3） ：203-212.     

Primary Hodgkin disease of the spine could mimic eosinophilic granuloma initially

Primary Hodgkin disease （HD） of bone is rare. The recognition on it is relatively confined. Bothcases arising-in male adults were suspected to be Potts disease （spinal tuberculosis） on imaging, and pathologic misdiagnosed initially. The clinical situations rapidly aggravated. The pathomorphology was remarkable malignant changed. They shared similar process in clinical, radiological and diagnostic process and could be representative. We retrospectively analyzed correlative results of them and review points of distinction from other disease entities that might be confused with it.     

Comparison of Dose-dense ABVD and Standard ABVD in the Treatment of Early Unfavorable and Advanced Hodgkin’s Lymphoma: A Retrospective Analysis

This retrospective analysis compared standard regimen of doxorubicin, bleomycin, vin- blastine, and dacarbazine （ABVD） with the dose-dense ABVD regimen （ABVD-21） in terms of effi- cacy and toxicity. Patients who had early-stage unfavorable or advanced Hodgkin＇s lymphoma （HL） according to German Hodgkin Study Group criteria from March 1999 to February 2011 were ana- lyzed for treatment response, long-term survival and hematological toxicity. There were 85 patients in the ABVD-21 group and 118 patients in the ABVD group respectively. The complete remission rates aider completion of treatment were 92.9% and 90.7% for ABVD-21 and ABVD, respectively. During a median follow-up period of 62 months, no significant difference was found in projected 10-year progression-free survival （PFS） and overall survival （OS） rates （84.7% and 94.1% respectively for ABVD-21; 81.4% and 91.5% for ABVD）. Subgroup analyses showed that ABVD-21 was signifi- cantly better than ABVD for patients with IPS〉3 in terms of PFS and OS rates. Grade 3 to 4 leuko- penia （51.8% vs. 28.8%, P=0.001） and neutropenia （57.6% vs. 39.0%, P=0.009） were more common with ABVD-21. We were led to conclude that dose-dense ABVD did not result in better tumor con- trol and overall survival than did ABVD for early-stage unfavorable HL. However, patients at high risk, for example, with IPS〉3, may benefit from dose-dense ABVD.     

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.     

Saffron （Crocus sativus L.） and major depressive disorder： a meta-analysis of randomized clinical trials

Due to safety concerns and side effects of many antidepressant medications, herbal psychopharmacology research has increased, and herbal remedies are becoming increasingly popular as alternatives to prescribed medications for the treatment of major depressive disorder （MDD）. Of these, accumulating trials reveal positive effects of the spice saffron （Crocus sativus L.） for the treatment of depression. A comprehensive and statistical review of the clinical trials examining the effects of saffron for treatment of MDD is warranted. OBJECTIVE： The purpose of this study was to conduct a meta-analysis of published randomized controlled trials examining the effects of saffron supplementation on symptoms of depression among participants with MDD. SEARCH STRATEGY： We conducted electronic and non-electronic searches to identify all relevant randomized, double-blind controlled trials. Reference lists of all retrieved articles were searched for relevant studies. INCLUSION CRITERIA： The criteria for study selection included the following： （1） adults （aged 18 and older） with symptoms of depression, （2） randomized controlled trial, （3） effects of saffron supplementation on depressive symptoms examined, and （4） study had either a placebo control or antidepressant comparison group. DATA EXTRACTION AND ANALYSIS： Using random effects modeling procedures, we calculated weighted mean effect sizes separately for the saffron supplementation vs placebo control groups, and for the saffron supplementation vs antidepressant groups. The methodological quality of all studies was assessed using the Jadad score. The computer software Comprehensive Meta- analysis 2 was used to analyze the data. RESULTS： Based on our pre-specified criteria, five randomized controlled trials （n = 2 placebo controlled trials, n = 3 antidepressant controlled trials） were included in our review. A large effect size was found for saffron supplementation vs placebo control in treating depressive symptoms （M ES = 1.62, P 〈 0.001）, revealing that saffron supplementation significantly reduced depression symptoms compared to the placebo control. A null effect size was evidenced between saffron supplementation and the antidepressant groups （M ES = -0.15） indicating that both treatments were similarly effective in reducing depression symptoms. The mean Jadad score was 5 indicating high quality of trials. CONCLUSION： Findings from clinical trials conducted to date indicate that saffron supplementation can improve symptoms of depression in adults with MDD. Larger clinical trials, conducted by research teams outside of Iran, with long-term follow-ups are needed before firm conclusions can be made regarding saffron＇s efficacy and safety for treating depressive symptoms.