Chinese Medicine Prolongs Overall Survival of Chinese Patients with Advanced Gastric Cancer: Treatment Pattern and Survival Analysis of a 20-Year Real-World Study.

OBJECTIVE: To describe the treatment patterns and survival status of advanced gastric cancer (AGC) in China in the past two decades, and objectively evaluate the impact of standardized Chinese medicine (CM) treatment on the survival of AGC patients. METHODS: This multicenter registry designed and propensity score analysis study described the diagnosis characteristics, treatment-pattern development and survival status of AGC from 10 hospitals in China between January 1, 2000 and July 31, 2021. Overall survival (OS) was evaluated between non-CM cohort (standard medical treatment) and CM cohort (integrated standard CM treatment ≥3 months). Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were performed to adjust any difference in average outcomes for bias. RESULTS: A total of 2,001 patients histologically confirmed locally advanced and/or metastasis stomach and gastroesophageal junction adenocarcinoma were enrolled. Among them, 1,607 received systemic chemotherapy, 215 (10.74%) accepted molecular targeted therapy, 44 (2.2%) received checkpoint inhibitor therapy, and 769 (38.43%) received CM. Two-drug regimen was the main choice for first-line treatment, with fluoropyrimidine plus platinum as the most common regimen (530 cases, 60.09%). While 45.71% (16 cases) of patients with HER2 amplification received trastuzumab in first-line. The application of apatinib increased (33.33%) in third-line. The application of checkpoint inhibitors has increased since 2020. COX analysis showed that Lauren mixed type (P=0.017), cycles of first-line treatment >6 (P=0.000), CM (P=0.000), palliative gastrectomy (P=0.000), trastuzumab (P=0.011), and apatinib (P=0.008) were independent prognostic factors for the OS of AGC. After PSM and IPTW, the median OS of CM cohort and non-CM cohort was 18.17 and 12.45 months, respectively (P<0.001). CONCLUSIONS: In real-world practice for AGC in China, therapy choices consisted with guidelines. Two-drug regimen was the main first-line choice. Standardized CM treatment was an independent prognostic factor and could prolong the OS of Chinese patients with AGC. (Registration No. NCT02781285).

The correlation between periodontitis and uncontrolled hypertension is mediated by inflammatory markers: results from a cross-sectional study of urban elderly population in southeast China.

BACKGROUND: Periodontal diseases is considered the most important global oral health burden according to the world health organization (WHO) (Oral health. https://www.who.int/news-room/fact-sheets/detail/oral-health#Overviewth (who.int). Accessed 21 Sep 2023). It is a common local inflammatory disease associated with hypertension, this study aims to explore the relationship between periodontitis and uncontrolled hypertension and whether inflammation indication such as white blood cell (WBC) count or neutrophil count is a mediator of this relationship. METHODS: One thousand four hundred eighty-eight elders attending annual physical and oral examinations in Zhejiang province were included in this study. The staging of Periodontitis was classified as none, mild-moderate and severe. Participants are categorized into two groups based on blood pressure: hypertensive( positive high blood pressure( HBP) history or underwent HBP medication or blood pressure( BP) ≥ 140/90 mmHg) and uncontrolled hypertensive (systolic blood pressure( SBP) ≥ 140 mmHg or distolic blood pressure( DBP) ≥ 90 mmHg). Peripheral blood samples were collected, information on hypertension history and potential confounders (age, sex, smoking, alcohol consumption, exercise frequency, diabetes) was collected in questionnaires. The correlation between periodontitis and hypertension was investigated using logistics regression analyses, mediation analysis was assessed for the effect of inflammation on hypertension. RESULTS: The study population includes 1,488 participants aged 55-90 years. Odds of uncontrolled hypertension increased significantly along with periodontitis in the regression models both in unadjusted model (odds ratio( OR): 1.407, 95% confidence intervals( CI): 1.037 ~ 1.910) and fully adjusted model (OR: 1.950, 95% CI: 1.127 ~ 3.373). Mediation analysis confirmed that WBC and neutrophic count function as a full mediator of the association between periodontitis and uncontrolled hypertension either in the unadjusted or the adjusted model. CONCLUSIONS: In a study of urban elderly population in southeast China, periodontitis is found to be significantly associated with uncontrolled hypertension, such relation is mediated by WBC and neutrophil count. Periodontitis can increase the difficulty of controlling hypertension. Promotion of periodontal health strategies in the dental setting could help reduce the burden of hypertension and its complications.

Modified Nuss procedure for the treatment of pectus excavatum: Experience of 259 patients.

BACKGROUND: Pectus excavatum is not rare in China. Many treatments for this disease have proved to have many shortcomings. Nuss procedure has been a ground-breaking technology, but it also has some disadvantages. Hence, this study was conducted to review our experience in the use of modified Nuss procedure in our hospital. METHODS: Data from 259 patients suffered from pectus excavatum between August 2020 and August 2021 who were treated with modified Nuss procedure was analyzed retrospectively. RESULT: Age was from 3 to 37 years. The average was 15.54 years. The male was 213 cases and the female was 46 cases. The time patients or their family members found pectus excavatum varied. 10 cases had been repaired previously when patients were admitted in our hospital. The clinical symptoms also varied. Each case had an improvement in Haller index. The average of the postoperative hospitalization was 3.97 days. Most cases were inserted 1 bar. Complication rate was also very low. All patients or their parents or their guardians were satisfied with the appearance of the chest wall after operation. There was no death in the whole observation period. CONCLUSION: From our experience, this modified Nuss procedure have obtained optimistic outcomes with more minimal invasion and low complication rate. This surgical method may be applied to many other hospitals in the future.

Correlation between periodontitis and prostate-specific antigen levels in the elderly Chinese male population.

BACKGROUND: The comparison of prostate-specific antigen (PSA) levels among older individuals with different periodontal statuses has not been fully investigated. Here we aimed to explore the correlation between the staging and grading of periodontitis and PSA levels in an elderly Chinese male population, which may lead to a biopsy recommendation and prevent prostate cancer as early as possible. METHODS: The study included 996 individuals aged ≥ 55 years who participated in routine postretirement physical examinations. Periodontal data included probing depth and gingival recession on four sites/tooth and on two diagonal quadrants (1-3 or 2-4) while excluding third molars, and clinical attachment loss was calculated. Periodontal status was classified as none, mild-moderate or severe periodontitis according to the Centers for Disease Control and Prevention and the American Academy of Periodontology case definition. Blood samples, oral health status and sociodemographic characteristics were collected by using general and oral examinations and questionnaires. Linear and logistic regressions were used to estimate the correlation between periodontitis severity and PSA levels, respectively. RESULTS: A total of 479 men had mild-moderate periodontitis and 355 had severe periodontitis; 162 men were periodontally healthy individuals. After adjusting for potential confounders, PSA levels were significantly lower in the individuals without periodontitis than in those with mild-moderate (P = 0.04) or severe (P = 0.03) periodontitis. However, PSA levels did not significantly correlate with periodontitis severity (P = 0.06). Although the ORs of elevated PSA were not significant, individuals with PSA ≥ 4.0 ng/mL were more likely to have periodontitis. CONCLUSIONS: In a sample of an elderly Chinese male population, after adjusting for possible confounders, serum PSA levels in individuals with periodontitis were significantly higher than those in individuals without periodontitis, but serum PSA did not significantly correlate with periodontitis severity.

circBIRC6 contributes to the development of non-small cell lung cancer via regulating microRNA-217/amyloid beta precursor protein binding protein 2 axis.

BACKGROUND: Circular RNAs (circRNAs) are considered to be important regulators in cancer biology. In this study, we focused on the effect of circRNA baculoviral inhibitor of apoptosis protein (IAP) repeat containing 6 (circBIRC6) on non-small cell lung cancer (NSCLC) progression. METHODS: The NSCLC and adjacent non-tumor tissues were collected at Shanghai Ninth People's Hospital. Quantitative real-time polymerase chain reaction was conducted for assessing the levels of circBIRC6, amyloid beta precursor protein binding protein 2 (APPBP2) messenger RNA (mRNA), baculoviral IAP repeat containing 6 mRNA (BIRC6), and microRNA-217 (miR-217). Western blot assay was adopted for measuring the protein levels of APPBP2, E-cadherin, N-cadherin, and vimentin. Colony formation assay, transwell assay, and flow cytometry analysis were utilized for evaluating cell colony formation, metastasis, and apoptosis. Dualluciferase reporter assay and RNA immunoprecipitation assay were carried out to determine the interaction between miR-217 and circBIRC6 and APPBP2 in NSCLC tissues. The murine xenograft model assay was used to investigate the function of circBIRC6 in tumor formation in vivo. Differences were analyzed via Student's t test or one-way analysis of variance. Pearson's correlation coefficient analysis was used to analyze linear correlation. RESULTS: CircBIRC6 was overexpressed in NSCLC tissues and cells. Knockdown of circBIRC6 repressed the colony formation and metastasis and facilitated apoptosis of NSCLC cells in vitro and restrained tumorigenesis in vivo. Mechanically, circBIRC6 functioned as miR-217 sponge to promote APPBP2 expression in NSCLC cells. MiR-217 inhibition rescued circBIRC6 knockdown-mediated effects on NSCLC cell colony formation, metastasis, and apoptosis. Overexpression of miR-217 inhibited the malignant phenotypes of NSCLC cells, while the effects were abrogated by elevating APPBP2. CONCLUSIONS: CircBIRC6 aggravated NSCLC cell progression by elevating APPBP2 via sponging miR-217, which might provide a fresh perspective on NSCLC therapy.

[Real-time transrectal ultrasound-guided seminal vesiculoscopy for the treatment of azoospermia secondary to ejaculatory duct obstruction].

OBJECTIVE: To evaluate the effect of real-time transrectal ultrasound-guided seminal vesiculoscopy (TRUS-SVS) in the treatment of azoospermia secondary to ejaculatory duct obstruction. METHODS: This retrospective study included 40 cases of azoospermia secondary to bilateral ejaculatory ducts obstruction treated by TRUS-SVS from June 2016 to June 2018 after failure to enter the vesiculoscope through the ejaculatory duct or prostatic utricle. We analyzed the success rate of surgery, operation time, postoperative complications, treatment results, and application value of TRUS-SVS. RESULTS: Real-time TRUS-SVS was successfully performed in 36 (90.0%) of the cases, 33 through bilateral and the other 3 through unilateral seminal vesicle, with a mean operation time of (32.8 ± 16.6) min. Thirty-seven of the cases were followed up for 6－15 (mean 9.3) months, of which sperm were found in 31 at 1－3 months and in 25 at 3－12 months, and pregnancies achieved in 9 cases within 12 months after surgery. No serious complications as retrograde ejaculation, urinary incontinence and rectal injury were observed postoperatively, except 2 cases of epididymitis and 2 cases of hematuria, which were all cured. CONCLUSIONS: For the patients who failed in seminal vesiculoscopy through the ejaculatory duct or prostatic utricle, real-time TRUS-SVS is a recommended procedure with the advantages of a high success rate, less damage to the prostate and rectum, and benefit to the improvement of semen quality.

Comprehensive analysis of tumor microenvironment and identification of an immune signature to predict the prognosis and immunotherapeutic response in lung squamous cell carcinoma.

BACKGROUND: Tumor mutation burden (TMB) and immune microenvironment are important determinants of prognosis and immunotherapeutic efficacy for cancer patients. The aim of the present study was to develop an immune signature to effectively predict prognosis and immunotherapeutic response in patients with lung squamous cell carcinoma (LUSC). METHODS: TMB and immune microenvironment characteristics were comprehensively analyzed by multi-omics data in LUSC. The immune signature was further constructed and validated in multiple independent datasets by LASSO Cox regression analysis. Next, the value of immune signature in predicting the response of immunotherapy was evaluated. Finally, the possible mechanism of immune signature was also investigated. RESULTS: A novel immune signature based on 5 genes was constructed and validated to predict the prognosis of LUSC patients. These genes were filamin-C, Rho family GTPase 1, interleukin 4-induced gene-1, transglutaminase 2, and prostaglandin I2 synthase. High-risk patients had significantly poorer survival than low-risk patients. A nomogram was also developed based on the immune signature and tumor stage, which showed good application. Furthermore, we found that the immune signature had a significant correlation with immune checkpoint, microsatellite instability, tumor infiltrating lymphocytes, cytotoxic activity scores, and T-cell-inflamed score, suggesting low-risk patients are more likely to benefit from immunotherapy. Finally, functional enrichment and pathway analyses revealed several significantly enriched immune-related biological processes and metabolic pathways. CONCLUSIONS: In the present study, we developed a novel immune signature that could predict prognosis and immunotherapeutic response in LUSC patients. The results not only help identify LUSC patients with poor survival, but also increase our understanding of the immune microenvironment and immunotherapy in LUSC.

MicroRNA­92a promotes non­small cell lung cancer cell growth by targeting tumor suppressor gene FBXW7.

MicroRNA (miRNA/miR)­92a has been identified as being significantly downregulated in non­small cell lung cancer (NSCLC) tissues using a miRNA array. However, its biological function and molecular mechanisms in NSCLC have not been fully elucidated. The aim of the present study was to determine the role of miR­92a in NSCLC and the mechanisms by which it affects NSCLC cells. The expression levels of miR­92a in NSCLC tissues and cell lines were analyzed using reverse transcription­quantitative PCR. Cell viability and cell apoptosis were determined using an MTT assay and flow cytometry, respectively. It was observed that miR­92a was significantly upregulated in NSCLC tissues and cell lines. Inhibition of miR­92a significantly suppressed viability of NSCLC cells, with concomitant downregulation of key proliferative genes, such as proliferating cell nuclear antigen and Ki­67. miR­92a downregulation induced apoptosis of NSCLC cells, as evidenced by flow cytometry and apoptosis­related protein detection. Luciferase assays confirmed that miR­92a could directly bind to the 3'­untranslated region of tumor suppressor F­box/WD repeat­containing protein 7 (FBXW7) and suppress its translation. Furthermore, small interfering RNA­mediated FBXW7 inhibition partially attenuated the tumor suppressive effect of an miR­92a inhibitor on NSCLC cells. Collectively, these findings demonstrated that miR­92a might function as an oncogene in NSCLC by regulating FBXW7. In conclusion, miR­92a could serve as a potential therapeutic target in NSCLC treatment.

Biodegradable Nanoprodrugs: "Delivering" ROS to Cancer Cells for Molecular Dynamic Therapy.

Biodegradable nanoprodrugs, inheriting the antitumor effects of chemotherapy drugs and overcoming the inevitable drawback of side effects on normal tissues, hold promise as next-generation cancer therapy candidates. Biodegradable nanoprodrugs of transferrin-modified MgO2 nanosheets are developed to selectively deliver reactive oxygen species to cancer cells for molecular dynamic therapy strategy. The nanosheets favor the acidic and low catalase activity tumor microenvironment to react with proton and release nontoxic Mg2+ . This reaction simultaneously produces abundant H2 O2 to induce cell death and damage the structure of transferrin to release Fe3+ , which will react with H2 O2 to produce highly toxic ·OH to kill tumor cells.

MicroRNAs as biomarkers for human glioblastoma: progress and potential.

Glioblastoma multiforme (GBM) is the most common malignant glioma. Despite innovative research efforts in tumor therapy, the outcome for most diagnosed patients remains poor; therefore, early diagnosis of GBM is the most effective method for achieving better patient outcomes. In recent years, combined research efforts including cellular, molecular, genetic, and bioinformatics methods have been used to investigate GBM, and the results show that variations in miRNA expression occur in GBM tissues and biological fluids. Some highly stable miRNAs circulate in the blood and cerebrospinal fluid (CSF) of both healthy individuals and diagnosed patients, thus raising the possibility that miRNAs may serve as novel diagnostic markers. In addition, increased understanding of the miRNA and mRNA interactions involved in GBM progression may lead to discovering predictive biomarkers, some of which are clinically relevant for targeted therapy and predicting prognosis. However, as this field is relatively new, some studies have yielded conflicting results. To progress in the field, different advanced techniques must be combined, including bioinformatics methods and molecular and cellular techniques. In addition, we must overcome the various challenges in non-invasive GBM biomarker detection. Here, we discuss the progress and potential of miRNAs as biomarkers for GBM and related signaling pathways. Studying the clinical relevance and applicability of these biomarkers may alter GBM patient diagnosis and treatment.

The roles of ARHGAP10 in the proliferation, migration and invasion of lung cancer cells.

Lung cancer is a leading cause of cancer-related mortalities worldwide. In the present study, a comparison of To determine the roles of ARHGAP10 in the proliferation, migration and invasion of lung cancer cells expression levels between normal lung tissues and lung cancer tissues were compared using immunoblotting, and CCK-8 and Transwell assays. Lung cancer tissues had a decreased ARHGAP10 mRNA expression level compared to the adjacent normal tissues. The ectopic expression of ARHGAP10 significantly suppressed the migration, invasion and proliferation of lung cancer cells. Gene set enrichment analysis revealed that metastasis and Wnt signaling pathways were negatively correlated with ARHGAP10 expression. Immunoblotting analysis revealed that ARHGAP10 overexpression inhibited metastasis [matrix metalloproteinase (MMP)-2, MMP-9 and VEGF] and the expression of Wnt pathway-related proteins (ß-catenin and c-Myc). Moreover, the stimulation effects of lithium chloride, a GSK3ß inhibitor, on the accumulation of ß-catenin were notably suppressed by ARHGAP10 overexpression. Collectively, ARHGAP10 acts to suppress tumor within lung cancer by affecting metastasis and Wnt signaling pathways. The results therefore suggest that ARHGAP10 is a potentially attractive target for the treatment of lung cancer.

Cisplatin and photodynamic therapy exert synergistic inhibitory effects on small-cell lung cancer cell viability and xenograft tumor growth.

Lung cancer is the leading cause of cancer death worldwide. Small-cell lung cancer (SCLC) is an aggressive type of lung cancer that shows an overall 5-year survival rate below 10%. Although chemotherapy using cisplatin has been proven effective in SCLC treatment, conventional dose of cisplatin causes adverse side effects. Photodynamic therapy, a form of non-ionizing radiation therapy, is increasingly used alone or in combination with other therapeutics in cancer treatment. Herein, we aimed to address whether low dose cisplatin combination with PDT can effectively induce SCLC cell death by using in vitro cultured human SCLC NCI-H446 cells and in vivo tumor xenograft model. We found that both cisplatin and PDT showed dose-dependent cytotoxic effects in NCI-H446 cells. Importantly, co-treatment with low dose cisplatin (1 µM) and PDT (1.25 J/cm2) synergistically inhibited cell viability and cell migration. We further showed that the combined therapy induced a higher level of intracellular ROS in cultured NCI-H446 cells. Moreover, the synergistic effect by cisplatin and PDT was recapitulated in tumor xenograft as revealed by a more robust increase in the staining of TUNEL (a marker of cell death) and decrease in tumor volume. Taken together, our findings suggest that low dose cisplatin combination with PDT can be an effective therapeutic modality in the treatment of SCLC patients.

Identification and analysis of the mechanism underlying heat-inducible expression of rice aconitase 1.

Respiratory metabolism is an important though poorly understood facet of plant adaptation to stress. Posttranslational modification of aconitase, a component of the tricarboxylic acid cycle (TCA), may be involved in stress tolerance. However, such stress-related transcriptional regulation and its mechanism remain unknown. In this study, we found that expression of the rice Aconitase gene OsACO1 is induced in a time-dependent manner by heat but not other typical abiotic stresses. To analyze the transcriptional regulation mechanism underlying the response to heat, the OsACO1 promoter (POsACO1) was isolated and characterized in transgenic rice. Using qualitative and quantitative analyses, we found that the expression of the GUS reporter gene responded to heat in different tissues and at different stages of development when driven by POsACO1. A series of 5' distal deletions of POsACO1 was generated to delineate the region responsible for heat-induced gene expression. Transient expression analyses in tobacco leaves identified a 322-bp minimal region between -1386 and -1065 as being essential and sufficient for heat-induced expression by POsACO1. We screened for known heat response-related cis-elements in this 322-bp region; however, sequences correlating with heat-induced gene expression were not identified in POsACO1. Therefore, truncations and successive mutagenesis analyses were performed in this 322-bp region. By comparing the activities of promoter fragments and their derivatives, our results indicated that the heat response element resided in a 9-bp region between -1132 and -1124, a sequence that contains a W-box motif. Additional site-directed mutagenesis analyses eliminated the heat response activity of POsACO1 via the W-box element, and an electrophoretic mobility shift assay (EMSA) indicated the binding of POsACO1 by factors in the nuclear extracts of heat-stressed rice seedlings in a W-box-dependent manner. Our results illustrate the expression pattern of a key component of the TCA response to abiotic stress and establish a putative regulatory pathway in the transcriptional modulation of rice respiratory metabolism genes in response to heat.

Survival benefit of traditional chinese herbal medicine (a herbal formula for invigorating spleen) in gastric cancer patients with peritoneal metastasis.

Objective. We evaluated the efficiency of traditional Chinese herbal medicine (a compound herbal formula for invigorating spleen) as a complementary and alternative therapy for gastric cancer patients with peritoneal metastasis. Methods. Between 2001 and 2012, 93 gastric cancer patients with peritoneal metastasis were enrolled in this study. The effect of traditional Chinese herbal medicine on their long-term outcome was investigated. Kaplan-Meier method was used to assess the difference in survival time, and Cox proportional hazards regression analysis was performed to identify independent prognostic factors. Result. First-line palliative chemotherapy plus traditional Chinese herbal medicine was performed in 47 patients and the other 46 patients received chemotherapy alone. The overall survival was different between patients with and without traditional Chinese herbal medicine (12.0 versus 10.5 months; P = 0.046). According to the Cox proportional hazard model, first-line chemotherapy cycle (hazards ratio [HR] = 0.527; 95% CI = 0.323~0.860) and TCHM (hazards ratio [HR] = 0.644; 95% CI = 0.481~0.992) were selected as independent prognostic factors for survival. Conclusion. The results suggest that traditional Chinese herbal medicine could improve the prognosis of the gastric cancer patients with peritoneal metastasis.

Survival benefit of traditional Chinese herbal medicine (a herbal formula for invigorating spleen) for patients with advanced gastric cancer.

BACKGROUND: Traditional Chinese herbal medicine (TCHM) is widely used for advanced gastric cancer (AGC) in China. In this study, the authors analyzed the prognostic factors of selected patients with AGC, and further studied the efficacy of TCHM (a herbal formula for invigorating spleen, formerly named Wei Chang' An) on AGC. METHODS: Patients with uncured AGC were prospectively enrolled. All patients were enrolled to either the TCHM group or non-TCHM group. TCHM was administered orally to the patients in the TCHM group for 3 months or more. Cox regression analysis was performed to determine survival trends adjusted for clinical and demographic factors. Kaplan-Meier curves were used to assess the differences in survival time. RESULTS: There were a total of 399 eligible patients with histologically confirmed adenocarcinoma of the stomach from 2001 to 2009. In the overall group, Cox regression analysis suggested that histological type (P = .016), radiotherapy (P = .000), cycle of chemotherapy (P = .000), and TCHM (P = .000) were independent prognostic factors. In a stratification analysis of stage for 213 patients who received 3 or more cycles of chemotherapy, there was a significant increase in median overall survival from 14.0 (non-TCHM group) to 20.0 (TCHM group) months (hazard ratio [HR] = 0.538, 95% confidence interval [CI] 0.385-0.750, P = .000). Among 186 patients who did not receive chemotherapy, but best supportive care, there was a significant increase in median overall survival from 7.0 (non-TCHM group) to 14.8 (TCHM group) months (HR = 0.443, 95% CI = 0.299-0.657, P = .000). CONCLUSIONS: TCHM has an important potential value for improving the prognosis of patients with AGC.

[Survival time of advanced gastric cancer patients treated with integrated traditional Chinese and Western medicine therapy].

BACKGROUND: Advanced gastric cancer has a low survival rate while traditional Chinese medicine (TCM) therapy has effects in inhibiting tumor growth, lengthening survival time and improving the quality of life. OBJECTIVE: To analyze the effects of integrated traditional Chinese and Western medicine therapy on the survival time and quality of life of advanced gastric cancer patients. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: A total of 95 advanced gastric cancer patients were enrolled and divided into comprehensive group (48 cases) and control group (47 cases). The patients in the comprehensive group from the First Department of Oncology, Longhua Hospital, were treated with TCM therapy and chemotherapy based on the gastric cancer treatment guidelines made by the First Department of Oncology of Longhua Hospital, and the patients in the control group from Renji Hospital and Ruijin Hospital in Shanghai were treated with chemotherapy only. MAIN OUTCOME MEASURES: The survival time in the two groups were observed and compared. The Karnofsky score, body weight, the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30) score, response rate and chemotherapy-related adverse events in the comprehensive group were observed. RESULTS: The estimated median survival time in the comprehensive group was 16.12 months, longer than 9.64 months in the control group (P<0.05). The scores of function and symptom of EORTC QLQ-C30 in the comprehensive group decreased, while the overall health status increased, and the results indicated that the quality of life of the patients in the comprehensive group was improved. In the comprehensive group, the body weight after treatment was higher than that before treatment (P=0.037), while there was no difference in Karnofsky scores between that before and after treatment (P=0.061). All the patients in the comprehensive group were assessable. The complete response rate was 0, 3 cases had a partial response, 34 cases had stable disease, and 11 cases had disease progression. The overall response rate was 6.25% (3/48), and the disease control rate was 77.08% (37/48). No patient withdrew because of severe adverse events and there was no chemotherapy-related death. CONCLUSION: Integrated traditional Chinese and Western medicine can prolong the survival time and improve the quality of life of advanced gastric cancer patients, and enhance the comprehensive effects.

Totally endoscopic atrial-septal defect repair through 3 ports.

BACKGROUND: The standard techniques of laparoscopic surgery were first used in the late 1980s, and this method rapidly developed into a safe and effective procedure that became the standard of care. Cardiac surgery has been the last surgical specialty to completely embrace endoscopic techniques. Our working hypothesis was that atrial-septal defect (ASD) repairs can be performed by using a totally 2-dimensional endoscope view through 3 ports with results that are similar to those obtained with traditional surgical techniques. METHODS: From May 2000 to May 2006, we performed totally endoscopic ASD repairs through 3 ports in 238 patients. Femorofemoral cardiopulmonary bypass and transthoracic clamp techniques were used. RESULTS: The operation was performed successfully in 234 patients (98%). In 4 patients the port was enlarged to a 5-cm incision. Neither conversion to median sternotomy incision nor reoperation was necessary in any patients. Mean operation time was 2.2 +/-0.8 hours; mean cardiopulmonary bypass and aortic cross-clamp times were 66 +/- 19 minutes and 25 +/- 8 minutes, respectively. No in-hospital deaths occurred. Major postoperative complications occurred in 13 patients (5%). Echocardiographic examinations performed at the time of discharge revealed no residue leaks. Mild mitral valve regurgitation was observed in 2 patients and mild tricuspid valve regurgitation in 4 patients. Patients reported satisfaction with cosmetic results and levels of postoperative discomfort. CONCLUSIONS: Totally endoscopic ASD repair through 3 ports is technically feasible and safe.

[Thoracoscopic cardiac surgical procedures: a report of 674 cases].

OBJECTIVE: To evaluate the efficacy and safety of thoracoscopic cardiac surgical procedures under extracorporeal circulation. METHODS: From May 2000 to May 2006, 674 patients received thoracoscopic cardiac surgery under extracorporeal circulation. These procedures included atrial septal defect occlusion for 238 patients, ventricular septal defect occlusion for 380 patients and mitral valve replacement for 56 patients. Thirty degree thoracoscopes and femoral extracorporeal circulation were used. The aorta was cross-clamped and the myocardium was protected by coronary perfusion with cold crystal or blood cardioplegia. RESULTS: The operation succeed in 645 patients (96%, 645/674). Enlarging the incision was performed in 28 patients. Operation time was from 1.8 h to 5.6 h with the mean of (2.8 +/- 1.2) h. Cardiopulmonary bypass time was from 56 min to 198 min with the mean of (78 +/- 2.3) min. Aortic cross-clamp time was from 8 min to 96 min with the mean of (31 +/- 19) min. The volume of chest drainage was (140 +/- 46) ml. None but one postoperative death occurred, the mortality was 0.15%. Postoperative complications occurred in 48 cases (7%), including bleeding in 8 patients, leakage in 5 patients (reoperation in 2 patients) and hemo-pneumothorax in 33 patients. One patient died postoperatively from cerebral hemorrhage (0.15%, 1/647). CONCLUSION: Thoracoscopic cardiac surgical procedures for atrial septal defect occlusion, ventricular septal defect occlusion and mitral valve replacement is feasible and safe.