RESUMO
BACKGROUND: As patients aged 75 years and older are often underrepresented in randomized clinical trials, the external validity of clinical trials-based recommendations in older gastric patients was still controversial. The aim of this study is to explore the recommended treatment strategy for locally advanced gastric cancer in elderly patients. METHODS: We designed our study to specifically evaluate the cancer-specific survival (CSS) of four subgroups of patients according to four different treatment modalities: adjuvant radiation (RT), surgery only, RT only and no surgery/no RT by analyzing the Surveillance, Epidemiology, and End Results (SEER)-registered database. Kaplan-Meier methods were adopted and multivariable Cox regression models were built for the analysis of survival outcomes and risk factors. RESULTS: The 5-year CSS was 43.8 % in adjuvant RT, 28.5 % in surgery only, 14.9 % in RT only and 1.4 % in no surgery/no RT, which had significant difference in univariate log-rank test (P < 0.001) and multivariate Cox regression (P < 0.001). Moreover, we observed significant survival benefits in adjuvant RT group in all age categories, including age 75-79 years, age 80-84 years and age ≥85 years (all P < 0.001). CONCLUSIONS: Surgery and adjuvant RT may be the recommended treatment strategy in elderly patients with locally advanced gastric cancer, especially for patients medically fit for the combined modality therapy.
Assuntos
Adenocarcinoma/terapia , Neoplasias Gástricas/terapia , Adenocarcinoma/mortalidade , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Análise Multivariada , Guias de Prática Clínica como Assunto , Modelos de Riscos Proporcionais , Programa de SEER , Neoplasias Gástricas/mortalidade , Resultado do TratamentoRESUMO
A method of determining the contents of K, Na, Ca, Mg, P, Zn, Al, Ba, Co, Cu, Ni, Sr, Cr and Ti, fourteen elements, in urine of Xinjiang Kuitun fluorine poisoning and arsenic-fluoride poisoning patients was developed. The operation conditions of ICP-AES, and the lowest test concentration, precision and linear ranges were studied. The relative standard deviation of the method was 0.24%-2.47% (n=10), the average recoveries were 90.4%-00.5%. The contents of K and Na in urine of fluorine poisoning and arsenic-fluoride poisoning patients were higher than those of healthy contrast group. The contents of Ba, Co, Cu, Ni and Cr in the urine of arsenic-fluoride poisoning patients were higher than those of fluorine poisoning patients and healthy contrast group (P < 0.05). The contents of P, Ca, Mg, Zn, Al, Sr and Ti do not have statistic significance (P > 0.05). The method was sensitive, simple and accurate. The experiment data was reliable.
Assuntos
Intoxicação por Arsênico/urina , Intoxicação por Flúor/urina , Metais/urina , Fósforo/urina , Espectrofotometria Atômica , Adulto , Idoso , Idoso de 80 Anos ou mais , Intoxicação por Arsênico/diagnóstico , Cálcio/urina , China , Cromo/urina , Elementos Químicos , Feminino , Intoxicação por Flúor/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Potássio/urina , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Sódio/urina , Estrôncio/urina , Titânio/urinaRESUMO
OBJECTIVE: To understand the differentially expressed genes in human T lymphocytes induced by arsenic trioxide (As(2)O(3)) and to explore mechanism of its immunotoxicity and immune suppression. METHODS: Human Jurkat T cell line was treated by arsenic trioxide (5 micromol/L, 24 h) in vitro, as a sample model. Then, the differentially expressed genes were cloned and the subtractive cDNA library from Jurkat T cell line was constructed by suppression subtractive hybridization (SSH). Polymerase chain reaction (PCR) and sequencing techniques were applied to identify positive clones. RESULTS: The forward subtracted cDNA library contained differentially expressed genes from Jurkat T cell line induced by arsenic trioxide was constructed, including 29 different gene fragments and only replicated one in the subtracted cDNA library identified by PCR and sequencing analysis. These gene sequences were 95%-100% analogous to the genes in public database (GenBank/EMBL). The cDNA library contained oxidative metabolic genes in mitochondria (triose phosphate dehydrogenase, NADH4, pyrophosphate synthase, 16S rRNA ribosome, succinate-CoA ligase and ATP synthase 6); transcriptional and translation genes poly (A) binding protein, t-RNA-guanine transglycoslase, ribosomal protein L23, ribosomal protein S15A, eukaryotic translation initiation factor 3, Rab interaction protein 5, splicing factor-arginine serine rich 5, and ADP-ribosylation factor-like 6 interacting protein), oxide stress related genes (ferritin high chain and high-mobility group protein 2); protein activating and signaling pathway related genes (casein kinase, serine kinase 2 and phosphatidylinositol-four-phosphate adaptor protein-1-associated protein); cell differentiation and apoptosis associated genes (NB4 cell apoptosis related protein and myeloid differentiation primary response protein) and five genes with unknown function (KIAA0092, CGI-147protein, GCI-35, nucleolar phosphoprotein Nopp34 and Mus muscular partial mRNA for hypothetical protein), as well as a novel gene unmatched to the sequence in GenBank. CONCLUSIONS: The forward subtracted cDNA library contained differentially expressed genes from Jurkat T cell line induced by arsenic trioxide was successfully constructed. And, genes not involved in previous research on arsenic were found. Results of analysis for these genetic function suggested that there should be many genes involved in process of T lymphocytes apoptosis or injury induced by arsenic trioxide and that there should still be many genes associated with arsenic that were not reported in the past.
Assuntos
Arsenicais/farmacologia , Biblioteca Gênica , Células Jurkat/efeitos dos fármacos , Óxidos/farmacologia , Antineoplásicos/farmacologia , Trióxido de Arsênio , Clonagem Molecular , DNA Complementar/química , DNA Complementar/genética , Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos , Humanos , Células Jurkat/metabolismo , Hibridização de Ácido Nucleico/métodos , Análise de Sequência de DNARESUMO
A lymphocyte cDNA library of normal human was constructed in order to obtain specific gene and prepare lymphocyte gene chips to detect the relative genes between psychiatric diseases and immunity. The lymphocyte was abstracted from fresh normal human blood and cultured in vitro. Total RNA of lymphocyte was extracted from the cultured cells and then mRNA was extracted further. Moreover,single-strand cDNA and double-strand cDNA were synthesized in turn. The double-strand cDNAs were ligated to SalI and NotI adaptor,which were later ligated to arms of gammaZipLox. Ligated-cDNAs were packed in vitro, and then infected E. coli Y1090. Titering the phage and amplifying the library. The lymphocyte cDNA library consisted of 2.6 x 10(6) recombinants with the length of 1-5 kb and the cloning efficiency was 5 x 10(12) recombinants/g cDNA. The amplified library was 3 x 10(7) recombinants/microl in concentration and the number of bacteriophage plagues was the most suitable in density after it was diluted to 10(-6) in concentration. The constructed cDNA library of normal human lymphocyte would be helpful to further detecting target genes and preparing gene chips etc.