Molecular targeted therapy for advanced hepatocellular carcinoma

Systemic anticancer therapy for hepatocellular carcinoma (HCC) is limited by intrinsic drug resistance and accompanying liver dysfunction. However, recent advances in molecular targeted therapy (MTT) have shed light on the treatment of advanced HCC. A recent randomized, placebo-controlled trial demonstrated that sorafenib, a multi-target tyrosine kinase inhibitor, prolonged overall survival and time-to-progression in patients with advanced HCC. This breakthrough highlights the potential of MTT targeting hepatocarcinogenic pathways, such as the Raf/MAPK/ERK pathway, angiogenic pathways and the EGFR signaling pathway. This review discusses the current status and the potential of developing novel MTTs for advanced HCC.     

半乳糖-半乳糖胺检测法在大肠癌筛选中的应用

应用半乳糖-半乳糖胺检测法对118份直肠粘液标本作了检查。在30例大肠癌病人中其阳性率达90％,在65例肠粘膜正常人中,其阴性率达92.3％;另外20例大肠息肉病人中,其阳性率为15％,3例溃疡性结肠炎病人中阳性率为66.7％。结果表明:该法有较高的敏感性(90％)和特异性(92.3％),方法简便,结果易重复,在大肠癌普查中具有较大的应用潜力;在大肠息肉和溃疡结肠性炎中也有一定的阳性率,提示该法可用于某些大肠癌癌前状态恶变的监测。     

Alterations of plasma antioxidants and mitochondrial DNA mutation in hair follicles of smokers

The effects of long-term smoking on mitochondrial DNA (mtDNA) deletions in hair follicles were investigated in subjects with different antioxidant capacity. Twenty-two male smokers with a smoking index of greater than 5 pack-years and without any known systemic diseases were recruited for this study. Forty healthy nonsmoking males were included as controls. We found that the concentrations of ascorbate and alpha-tocopherol and the activities of glutathione S-transferase (GST) and glutathione peroxidase in blood plasma were significantly decreased in smokers. The levels of glutathione and protein thiols in whole blood and the incidence of a 4,977 bp deletion of mtDNA (dmtDNA) in hair follicles were significantly increased in smokers. A significantly higher incidence of the 4,977 bp dmtDNA was found in smokers with plasma GST activity less than 5.66 U/l (OR = 7.2, P = 0.020). Using multiple covariate ANOVA and logistic regression, we found that age and low plasma GST activity were the only two risk factors for the 4,977 bp dmtDNA. These results suggest that smoking depletes antioxidants and causes mtDNA deletions and that plasma GST may play an important role in the preservation of the mitochondrial genome in tissue cells of smokers.     

Nonminimum phase non-Gaussian autoregressive processes

The structure of non-Gaussian autoregressive schemes is described. Asymptotically efficient methods for the estimation of the coefficients of the models are described under appropriate conditions, some of which relate to smoothness and positivity of the density function f of the independent random variables generating the process. The principal interest is in nonminimum phase models.     

Andrographolide mitigates cardiac apoptosis to provide cardio‐protection in high‐fat‐diet‐induced obese mice

Excessive intake of high fat diet (HFD) and associated obese conditions are critical contributors of cardiac diseases. In this study, an active metabolite andrographolide from Andrographis paniculata was found to ameliorate HFD‐induced cardiac apoptosis. C57/BL6 mouse were grouped as control (n = 9), obese (n = 8), low dose (25 mg/kg/d) andrographolide treatment (n = 9), and high dose (50 mg/kg/d) andrographolide treatment (n = 9). The control group was provided with standard laboratory chow and the other groups were fed with HFD. Andrographolide was administered through oral gavage for 1 week. Histopathological analysis showed increase in apoptotic nuclei and considerable cardiac‐damages in the obese group signifying cardiac remodeling effects. Further, Western blot results showed increase in pro‐apoptotic proteins and decrease in the proteins of IGF‐1R‐survival signaling. However, feeding of andrographolide significantly reduced the cardiac effects of HFD. The results strongly suggest that andrographolide supplementation can be used for prevention and treatment of cardiovascular disease in obese patients.     

中药止痛膏在癌性疼痛控制中的应用研究

[目的]研究中药止痛膏在癌性疼痛控制中的疗效。[方法]住院肿瘤病人71例,随机分为两组。实验组36例,采用中药止痛膏外敷止痛;对照组35例,口服奥施康定止痛。观察两组病人镇痛前后镇痛评分、血压、脉搏变化,以及使用奥施康定情况及使用中药止痛膏病人的主观感受。[结果]两组病人镇痛前后镇痛评分、血压、脉搏变化比较差异无统计学意义,实验组病人使用镇痛药物剂量明显减少,主观感觉较好。[结论]中药止痛膏外敷能有效缓解癌性疼痛,减少镇痛药物的使用。     

煮散剂与汤剂在肺炎喘嗽中的疗效比较和成本分析

目的比较儿科煮散剂与饮片汤剂对小儿肺炎喘嗽的临床疗效和经济成本分析,探讨中药煮散剂的成本优势。方法对2010年10月至2013年3月广东省中西医结合医院儿科病房收治的300例肺炎喘嗽患儿按风寒闭肺、风热闭肺、痰热闭肺3种证型随机分配到煮散剂组和饮片组,比较3种证型各自方剂不同剂型口服给药对患儿临床症状、体征的影响,观察煮散剂与饮片的疗效差异,探讨煮散剂口服给药的安全性。同时,对煮散剂与饮片进行临床经济成本对比评价。结果煮散剂组在小儿肺炎喘嗽3种证型中的临床疗效与饮片汤剂组比较差异无统计意义（P〉0．05）,但煮散剂组在中药经济成本上明显少于饮片组。结论通过对小儿肺炎喘嗽3种证型的临床观察及对比,煮散剂在有效性、安全性方面与饮片剂型无明显差异,但在经济成本土明显优于饮片汤剂型。     

一次根管治疗术与两次根管治疗术术后短期临床疗效的比较

目的比较一次根管治疗术与两次根管治疗术术后短期临床疗效,并分析不同因素对疗效的影响。方法将96例需行根管治疗的患者随机分成2组,分别进行一次根管治疗术（一次治疗组）和两次根管治疗术（两次治疗组）,并在术后的1、3d和1周进行随访,记录其疼痛情况,术后3个月行影像学检查,评估分析其短期疗效。结果一次治疗组和两次治疗组在术后短期疼痛和影像学检查方面的差异均无统计学意义;患者的性别及患牙术前根尖周指数（PAI）对根管治疗的术后疗效有一定影响,而患者年龄、患牙解剖牙位、患牙牙髓情况（未出现根尖周病损）的差异对根管治疗术术后疗效影响意义不大。结论一次性根管治疗在术后短期的疼痛发生率较低,在临床可根据实际情况推广应用;患者性别及术前PAI会影响根管治疗的术后疗效。     

Differentiation of soft tissue benign and malignant peripheral nerve sheath tumors with magnetic resonance imaging

PURPOSE: The objective of this study was to differentiate the magnetic resonance (MR) imaging appearance of benign peripheral nerve sheath tumors (PNSTs) from that of malignant PNSTs. MATERIALS AND METHODS: Twenty-six patients who underwent MR imaging and had a histologic diagnosis of benign (schwannoma, n=16; neurofibroma, n=1) or malignant (n=9) PNST were retrospectively reviewed. The size, location, shape, margin, and signal intensities of the tumors on precontrast and gadolinium-enhanced MR imaging were analyzed. In each patient, the presence or absence of split fat, target, and fascicular signs was determined. RESULTS: The mean size of the benign PNSTs (3.4 cm, S.D.=2.5 cm) was significantly smaller than that of the malignant tumors (8.2 cm, S.D.=3.1 cm) (P<.001). Seventeen (65.4%) of the 26 tumors were spindle shaped or ovoid (12 benign and 5 malignant tumors). Contiguity with specific nerves was identified in 15 (88.2%) of the 17 benign PNSTs but in none of the malignant tumors (P<.05). Well-defined margins were noted in all 17 benign PNSTs but in only 3 (33.3%) of the 9 malignant tumors (P<.001). Five (55.6%) of the 9 malignant PNSTs but none of the benign tumors showed signal intensity change in adjacent soft tissue (P<.05). There was no significant difference in signal intensity between the benign and malignant tumors on T(1)-weighted, T(2)-weighted, and contrast-enhanced MR images. The split fat and target signs were present more frequently in the benign PNSTs than in the malignant PNSTs (P<.05).Conclusions: Benign and malignant PNSTs are often spindle shaped. Recognition of contiguity with adjacent nerves, a well-defined margin, and the presence of the split fat sign may suggest benignity. Imaging features suggestive of malignancy can be a larger size and an infiltrative margin.