Concurrent administration of aqueous Azadirachta indica (neem) leaf extract with DOCA-salt prevents the development of hypertension and accompanying electrocardiogram changes in the rat

The effect of concurrent administration of Azadirachta indica leaf extract with DOCA-salt was investigated in the development of hypertension.Over 5-6 week old, inbred male Wistar rats with a starting weight of 190 g were given either: (1) twice weekly subcutaneous (s.c.) injections of vehicle (soyabean oil, 0.25 mL per animal) for the first 2 weeks, plus normal drinking water (controls); (2) twice weekly (s.c.) injections (weeks 1 and 2 only) of 15 mg/kg DOCA dissolved in vehicle, plus drinking water containing 1.0% NaCl and 0.03% KCl (DOCA-salt group); or (3) 20 mg/kg of aqueous neem extract daily, in addition to the DOCA-salt treatment (DOCA-salt-neem group). All groups (8-12 animals) received normal rat pellets ad libitum and their BP was measured weekly. Terminally, the animals were anaesthetized and ECGs recorded using s.c. pins in a lead II configuration.The mean arterial pressure was significantly lower (p < 0.05) in the control (97 +/- 3.7 mmHg) and DOCA-salt-neem (87 +/- 3.4 mm Hg) groups than in the DOCA-salt group (115 +/- 7.1 mm Hg). PR and RR intervals and the duration of the QRS complex were shorter (p < 0.05) in the DOCA-salt group than in the control and DOCA-salt-neem groups. Amplitude of the QRS complex was increased (p < 0.05) in the DOCA-salt group compared with both the DOCA-salt-neem and the control groups.Daily administration of 20 mg/kg neem-leaf extract concurrently with DOCA-salt for 5 weeks, prevents the development of hypertension and the accompanying alterations in the ECG patterns seen in DOCA-salt treated rats.     

Different prognosis of patients with esophageal carcinoma with M1a and regional node involvement

Background and purposeBased on the 6th edition of the American Joint Commission on Cancer (AJCC) staging system for esophageal squamous cell carcinoma (ESCC), M1a node involvement was classified as regional node involvement in the revised 7th/8th edition. However, the clinical significance of M1a node involvement is unclear. Thus, we analyzed the prognostic value of M1a node involvement in patients with ESCC after definitive concurrent chemoradiotherapy (CCRT).Materials and methodsIn total, 188 patients with ESCC had M0 disease according to the 7th/8th edition AJCC. We reclassified 31 (16.5%) of these patients as having M1a disease according to the 6th edition. After definitive CCRT, we compared baseline characteristics between the two groups and analyzed the rates of responders and recurrence. Finally, we compared prognoses according to overall survival (OS), disease-specific OS, and disease-free survival (DFS).ResultsAmong 31 patients reclassified to have M1a disease, 21 (67.7%) had supraclavicular lymph node metastasis and 10 (32.3%) had celiac lymph node metastasis. The number of responders was significantly lower for M1a disease based on univariate (p = 0.004) and multivariate (p = 0.011) analyses. Significantly lower survival rates were observed in individuals with M1a disease (median OS, 16.4 vs. 42.7 months; 5-year OS, 10.8% vs. 41.2%).ConclusionsM1a node involvement should be differentiated from regional node involvement.     

The predictive value of metabolic response to preoperative radiochemotherapy in locally advanced rectal cancer measured by PET/CT

Background  To evaluate the value of positron emission tomography using fluorodeoxyglucose and computer tomography scan (FDG-PET/CT) for prediction of histopathological response of preoperative radiochemotherapy (RCTX) in patients with rectal carcinoma. Methods  Thirty patients with uT3 rectal carcinoma were examined by FDG-PET/CT at baseline, 14 days after initiation, and after completion of preoperative RCTX. The FDG decreases seen with PET scanning from baseline to day 14 (early metabolic response) and after completion of therapy (late metabolic response) were compared with histopathological tumor response. One patient denied surgery after RCTX. Results  The mean (±SD) reduction of tumor FDG uptake in histopathologically responding compared to non-responding tumors was −44.3% (±20.1%) versus −29.6% (±13.1%) (p = 0.085) at day 14 and −66.0% (±20.3%) versus −48.3% (±23.4%) (p = 0.040) after completion of RCTX. Best differentiation of histopathological tumor response was achieved by a cut-off value of 35% reduction of initial FDG uptake at day 14 and 57.5% after completion of therapy. Applying the cut-off values as a criterion for metabolic response, histopathological response was predicted with a sensitivity of 74% (14/19) at day 14 and 79% (15/19) after completion of therapy. The positive predictive value for early metabolic response was 82% (14/17) and for late metabolic response was 83% (15/18). Histopathological evidence of accumulated peritumoral inflammation cells was associated with a minor FDG decrease in five histopathologically responding patients, and influenced the results with negative predictive values of 58% (7/12) and 64% (7/11) at the early and late time points, respectively. Conclusions  Metabolic response to a preoperative RCTX using FDG-PET/CT in rectal cancer patients can be correlated with histopathological response, but FDG uptake of peritumoral inflammation cells limited the results and led to false negative results.     

同步放化疗治疗中晚期宫颈癌的临床疗效观察

目的：探讨同步放化疗治疗中晚期宫颈癌的临床疗效和安全性。方法：120例中晚期宫颈癌患者随机分为观察组和对照组各60例,观察组采用同步放化疗治疗,对照组采用单纯放疗,比较二者的近期临床效果和安全性。结果：观察组近期治疗总有效率为93.33%,高于对照组的78.33%,差异有统计学意义（P〈0.05）;观察组患者2年生存率为80.00%,高于对照组的58.33%,差异具有统计学意义（P〈0.05）;观察组不良反应发生率高于对照组,差异有统计学意义（P〈0.05）,但均能耐受。结论：同步放化疗治疗中晚期宫颈癌具有较高的近期临床疗效和2年生存率,不良反应可逆,值得临床推广。     

放疗联合奈达铂每周用药治疗局部中晚期鼻咽癌的临床观察

 目的：观察放疗同步奈达铂每周给药治疗局部中晚期鼻咽癌的近期疗效及毒副反应。方法：将局部中晚期鼻咽癌随机分为治疗组和对照组,治疗组在放疗同时予以单药奈达铂（NDP）40 mg?m-2,每周1次,共7次,对照组为顺铂（DDP） 40 mg?m-2,每周1次,共7次,均在放疗d 1用药。两组放疗方法相同,剂量相似,放疗结束后均予4周期TP方案(紫杉醇+顺铂)化疗。结果：放疗结束后3月评价近期疗效,NDP组和DDP组鼻咽部病灶完全消退率分别为88.9%和92.6%;颈部淋巴结完全消退率分别为92.6%和96.3%,两组比较差异无统计学意义（P>0.05）;NDP组胃肠道反应发生率（7.1%）显著低于DDP组（64.3%）（P<0.05）;两组白细胞下降发生率分别为57.1%和53.8%,差异无统计学意义（P>0.05）,血小板下降发生率NDP组（42.9%）较DDP组（17.9%）高,差异有统计学意义（P<0.05）。结论：放疗联合NDP每周给药治疗局部中晚期鼻咽癌与联合DDP相比,近期疗效相当,但NDP治疗组有较少的胃肠道反应发生,其毒副反应主要是骨髓抑制所致的血小板减少。       

同期放化疗治疗晚期鼻咽癌的疗效分析

目的分析同期放化疗对晚期鼻咽癌患者的治疗效果及不良反应。方法 2002年9月—2005年7月收治符合入选条件的鼻咽癌初诊患者79例,随机分为观察组和对照组,观察组接受同期放化疗治疗,对照组接受单纯放射治疗,收集2组患者疗效和不良反应数据并分析统计。结果观察组鼻咽缓解率(87.2%)优于对照组(67.5%),颈部淋巴结缓解率(87.2%)亦优于对照组(65.0%),2组比较差异均有统计学意义(P<0.05)。5年生存率和无瘤生存率观察组均优于对照组(P<0.05)。2组远处转移率无显著性差异(P>0.05),而在转移时间上,观察组晚于对照组(P<0.05)。观察组在恶心呕吐、血液毒性、口腔黏膜不良反应方面重于对组照(P<0.01),而皮肤反应基本相同(P>0.05)。结论对于晚期鼻咽癌,同期放化疗治疗较单纯放射治疗具有更佳的治疗效果,极大地延迟患者的转移时间,但其增加了一定的不良反应,仍需进一步改进。     

局部晚期鼻咽癌诱导化疗加同步放化疗与单纯同步放化疗的比较分析

目的 观察局部晚期鼻咽癌（NPC）顺铂加5-氟尿嘧啶（PF）诱导化疗后同步调强放疗（IMRT）与单纯顺铂同步IMRT的疗效和副反应. 方法 73例NPC随机分为A、B两组,A组37例,PF诱导化疗1周期,顺铂20 mg/m2,dl-5,5-Fu 500 mg/m2,d1-5,休息2周,然后顺铂同步IMRT,顺铂同步方法为40 mg/m2,每周1次,共6次;B组36例,单纯顺铂同步IMRT,顺铂40 mg/m2,每周1次,共6次,评价两种方案治疗开始后3月的近期疗效、1和2年总生存率（OS）、无疾病进展生存率（PFS）及副反应. 结果 A、B组近期有效率分别为97.3％和97.2％;A组1、2年OS和PFS分别为100％和94.6％,97.3％和86.5％;B组1、2年OS和PFS分别为100％和91.7％,100％和83.3％.两组近期疗效和1、2年生存率无统计学差异.A组血液学毒性较B组明显. 结论 PF诱导同步与单纯顺铂同步放疗方案的疗效相似,单纯顺铂同步方案的血液学毒性较低.     

The prognostic value of circumferential resection margin in esophageal squamous cell carcinoma after concurrent chemoradiation therapy and surgery

BackgroundDespite the significant advances in surgical techniques and multimodality treatments for esophageal cancer, the overall survival remains unsatisfactory. During the past years, efforts were made to determine the prognostic factors that would help in identifying patients suitable for surgery or guiding adjuvant therapy. Positive circumferential resection margins (CRMs) in esophageal cancer have been previously linked with poor prognosis, but their impact on survival remains controversial in patients treated by a multimodality protocol. The aim of our study was to examine the significance of tumor involvement of CRM in patients with esophageal squamous cell carcinoma after concurrent chemoradiation therapy followed by esophagectomy.MethodsBetween 2000 and 2010, 94 esophageal squamous cell carcinoma patients who received preoperative concurrent chemoradiation therapy followed by surgery were enrolled in our study. We focused on the CRM, which was defined microscopically as clear (negative) or involved (positive). Univariate and multivariate survival analyses were performed with overall survival as the endpoint.ResultsOur cohort was predominantly male (94.7%) with a median age of 57 years. All of them received concurrent chemoradiation therapy followed by esophagectomy. Overall, 17 patients (18.1%) had positive CRM. Kaplan–Meier survival analysis demonstrated that the 5-year overall survival of patients with clear and involved CRM is 60.1% and 11.8%, respectively (log rank p < 0.001). Multivariate analysis with the Cox proportional hazard model demonstrated that CRM involvement is a significant prognostic factor for overall survival (p < 0.001).ConclusionIn patients with esophageal squamous cell carcinoma who underwent trimodality treatment, CRM involvement is a significant risk factor predicting survival. Additional effort is required to achieve a clear CRM in esophageal cancer treatment.