الملخص
Objective:To evaluate the efficacy of oral pyrotinib in treatment of patients with human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer in the real world, and to explore its influencing factors.Methods:The clinical data of 148 patients with HER2-positive metastatic breast cancer treated with oral pyrrolitinib in Shanxi Cancer Hospital from September 2018 to December 2020 were retrospectively analyzed. The efficacy was evaluated according to the efficacy evaluation criteria for solid tumors, version 1.1, and the adverse effects were graded according to the National Cancer Institute common terminology criteria of adverse effects, version 4.0. The Kaplan-Meier method was used to draw progression-free survival (PFS) curves, the patients were stratified by different clinical characteristics, and log-rank test was used for univariate analysis of PFS; the multivariate analysis of PFS was performed using Cox proportional hazards model.Results:The objective response rate (ORR) of 148 patients was 71.6% (106/148), and the disease control rate (DCR) was 89.2% (132/148). The overall median PFS time was 11.0 months (95% CI 10.1-11.9 months), and the median PFS of 19 patients with brain metastases was 10.0 months (95% CI 7.4-12.6 months). The differences in PFS between patients stratified by disease-free interval (DFI), the number of metastatic site and Eastern Cooperative Oncology Group (ECOG) score were statistically significant (all P < 0.05), but the difference in PFS between patients with negative and positive hormone receptor was not statistically significant ( P > 0.05). Multivariate Cox regression analysis showed that DFI (>1 year vs. ≤1 year: HR = 5.254, 95% CI 0.728-37.933, P = 0.046) and ECOG score (≥2 points vs. 0-1 point: HR = 2.454, 95% CI 1.261-4.788, P = 0.008) were independent influencing factors of PFS. The most common ≥grade 3 adverse effects were diarrhea (31 cases, 20.9%) and hand-foot syndrome (38 cases, 25.8%). Conclusions:The pyrotinib has definite efficacy and good safety in the treatment of HER2-positive metastatic breast cancer in the real world, especially for patients with DFI > 1 year and ECOG score 0-1 point, the efficacy and safety are particularly good.
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【Objective】 To establish a comprehensive performance appraisal system, in order to promote blood collection, preparation and supply. 【Methods】 The performance reform leading group headed by the central leader was set up to manage the overall work, with performance reform office set up to formulate the central performance reform plan and the target assessment plan. The operation effectiveness was evaluated by comparing the index changes in blood collection, preparation and supply. 【Results】 Compared with before the implementation of performance (from 2018 to 2019, a total of 24 months), except for the total monthly collection of street whole blood, the per person of street monthly blood collection and the total and per person monthly collection of apheresis platelets were significantly increased (P<0.05) during the process of blood collection. The total and per person monthly preparation of cryoprecipitates and virus inactivates plasma were significantly increased (P<0.05) during the process of blood preparation. The total and per person monthly supply of apheresis platelets, cryoprecipitates and virus inactivates plasma were significantly increased (P<0.05) during the process of blood supply. 【Conclusion】 The adjustment and implementation of performance reform program optimized the performance salary distribution system, and the formulation and implementation of target assessment program significantly promoted blood collection, preparation and supply.
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Objective:To evaluate the effects of propofol on glucose-regulated protein 78 (GRP78)-activating transcription factor-4 (ATF4)-CCAAT/enhancer binding protein (C/EBP) homologous protein (CHOP) signaling pathway during apoptosis in gastric cancer cells.Methods:MGC-803 cells were cultured to the logarithmic phase and divided into 2 groups ( n=15 each) using the random number table method: control group (group C) and propofol group (group P). The cells in group C were cultured under normal conditions of 37 ℃ and 5% CO 2. In group P, propofol (final concentration 5 μg/ml) was added when the cells were attached to the wall and grown to 70%-90% confluence.At 24 h after propofol was added, the apoptosis rate of cells was determined by flow cytometry, the expression of GRP78, ATF4 and CHOP mRNA was detected by quantitative polymerase chain reaction, and the expression of GRP78, ATF4 and CHOP was determined by Wester blot, respectively. Results:Compared with group C, the apoptosis rate was significantly increased, and expression of GRP78, ATF4, CHOP and its mRNA was up-regulated in group P ( P<0.05). Conclusion:The mechanism by which propofol accelerates apoptosis is related to activating GRP78-ATF4-CHOP signaling pathway in gastric cancer cells.
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Objective To evaluate the incidental irradiation to the axillary levels Ⅰ,Ⅱ and Ⅲduring the whole breast radiotherapy after breast conserving surgery(BCS)without axillary lymph node dissection(ALND)in breast cancer(BC)patients.Methods A retrospective analysis was performed on the consecutive 42 cases of T1-2N0M0stage BC patients with sentinel lymphnode biopsy(SLNB)and BCS but without ALND.The axillary lymph nodes of Ⅰ,Ⅱ and Ⅲ were delineated according to RTOG atlas guideline.Three radiotherapy plans including conventional tangential field(CTF),three-dimensional conformal radiotherapy(3D-CRT)and forward-planned intensity-modulated radiotherapy(IMRT)for whole breast irradiation were devised for each case.The Prescription dose was 50 Gy per 25 fractions.Doses to axillary levels(Ⅰ-Ⅲ)were evaluated.Results The mean doses delivered to axillary by the three techniques(CTF,3D-CRT and IMRT)were(40.1 ±6.8),(35.4 ±8.3),(32.9 ±7.0)Gy for level Ⅰ(F=10.269,P<0.05),(33.2 ±7.1),(30.6 ±6.7),(30.4 ±7.0)Gy for level Ⅱ(P>0.05)and(9.6 ±6.8),(6.4 ±4.5),(5.2 ±3.7)Gy for level Ⅲ(F =8.377,P <0.05),respectively.V50(volume receiving 50 Gy)for the three techniques were 21.3%,27.6%,9.6%for level Ⅰ(F=13.161,P<0.05),12.9%,15.9%,8.3%for level Ⅱ(F=2.750,P<0.05)and 0.4%,0.1%and 0%for level Ⅲ(P>0.05),respectively.Conclusions The doses coverage to axillary levelsⅠ-Ⅲwere all limited in the three techniques.Therefore,it is necessary to assess the risk of axillary lymph node metastasis adequately to develop individualized radiotherapy plans.
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Objective To investigate the effect of POSTN protein on the proliferation of chondrocytes of tibial plateau in old rats.Methods Cartilage cells collected from the tibial plateau of old rats were cultured in vitro to the third generation.Then the cells were divided into 3 groups:POSTN group,PBS group and POSTN antibody group.The proliferations of the three groups at 24 h,48 h and 72 h were determined by EDU method.The expression of Notch1 protein was detected by immunohistochemistry in all groups at the same time.Female 20-month-old Sprague-Dawley rats were randomly divided into 3 groups:POSTN protein injection group,Phosphate Buffered Saline (PBS) injection group and POSTN antibody injection group.Twelve weeks after the operation,related reagents were injected 3 times consecutively at day 1,day 3,day 5 and EDU was injected into joints at day 1.At 2 weeks after injection,the rats were killed and the knee tibial plateau was taken to observe the proliferation of the cartilage cells.Results At 24 h,there were differences between the three groups O(F=27.32,P=0.017).The proliferation rates of POSTN group [(23±8)%] and PBS group [(21±10)%] were higher than that of POSTN antibody group (16±5)(P=0.003,P=0.011).At 48 h,there were differences between the three groups (F=35.34,P<0.01).The proliferation rate of POSTN group [(36±11)%] was higher than that of the other groups [(22±6)%],(18±6)%(P=0.021,P<0.01).At 72h,there were differences between the three groups (F=52.62,P=0.000).The proliferation rate of POSTN group [(56±17)%] was the highest one,the proliferation rate of PBS group [(31±8)%] was the medium,and the POSTN antibody group [(26±7)%] was the lowest one (all P<0.05).As for Notch1 protein expression in chondrocytes,there were differences between the three groups (F=26.72,P<0.01).The Notch1 protein was the most frequently expressed in POSTN protein-injection group and the least in the anti-POSTN group.In rats,the proliferation rate of the chondrocytes in the medial tibia plateau of the knee of POSTN protein injection group [(36±14)%],which was the highest,and that of the POSTN antibody injection group [(10 ±4)%] was the lowest (all P<0.05).Conclusion POSTN protein can promote the proliferation of chondrocytes knee OA rats.POSTN antibody injection has been shown to induce the proliferation of chondrocytes.The POSTN protein may promote the proliferation of chondrocytes by activating the Notch signaling pathway.
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Objective To investigate the effect of M-CSF and GM-CSF on migration and expression of VEGF-A in breast cancer cell line 4T1.Methods Real-time PCR was used to detect VEGF-A mRNA expression in 4T1 cells treated by 5 ng/ml or 10 ng/ml M-CSF or GM-CSF.Ability of migration and metastasis of 4T1 cells were analyzed by scratch and Transwell assays.Results The relative expression of VEGF-A mRNA at 12 h and 24 h in 4T1 cells treated by 5 ng/ml or 10 ng/ml M-CSF were 17.81±2.49 and 17.48± 5.43,5.15±2.59 and 5.45±4.28,respectively,while those treated by GM-CSF were 9.77±2.39 and 7.61±2.80,6.53±2.41 and 6.30±2.89,respectively.M-CSF and GM-CSF can promote the expression of VEGF-A in 4T1 cells (P < 0.05).The relative expression of VEGF-A was higher in 4T1 cells treated for 12 h than that for 24 h (P < 0.01).M-CSF,GM-CSF and VEGF-A can promote metastasis of 4T1 cells (all P < 0.05),whereas no gross migration of 4T1 cells was showed by VEGF-A treatment.Conclusion M-CSF and GM-CSF can promote the migration and expression of VEGF-A in breast cancer cell line 4T1.
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Nucleobindin2protein(NUCB2)isanewlydiscoveredneuropeptideprecursorprotein, which has a comprehensive cytology function and is expressed in the hypothalamus nucleus and many peripheral tissues.There aren′t many studies about its signaling pathway,where neuroendocrine regulation,cell survival growth,tumor suppressor,cytokine secretion were found to involve in it.Besides,it has also been confirmed that breast cancer,lung cancer,ovarian cancer and prostate cancer are closely related to NUCB2.Therefore, several downstream pathways of NUCB2 may be related to the formation and progression of tumor.Further stud-ies are still needed to clarify the signal pathways of NUCB2 to provide a reliable basis for clinical cancer preven-tion.
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Objective Brain metastasis(BM) is unusual in colorectal carcinoma(CRC) patients.This study was to evaluate the characteristics and prognosis of brain metastasis of colorectal carcinoma patients.Methods Twenty-eight consecutive CRC patients underwent surgical resection for BM between January 2001 and December 2008.The clinical data were analyzed by univariate (logrank) and Cox regression test.Results The median age at BM diagnosis from CRC was 57 years(41-75 years).Median survival after neurosurgical intervention was 9.4 months.The 1-year and 5-year survival rates were 28.9%and 7.1%,respectively.Seventeen patients(61%)had concurrent systemic metastasis.All patients were symptomatic with neurologic deficits and symptoms.On multivariate analysis,gender,infratentorial location of lesions and characteristics of primary CRC had no significant impact on survival.Two factors were signitlcandy associated with better survival:single brain metastases and absence of extracranial metastases.Perioperative mortality was zero.There were no difference of survival among patients undergoing resection alone and resection combined with whole brain radiotherapy (WBRT) or stereotactic radiosurgery(SRS). Conclusions Brain metastases from colorectal cancer is an evil omen of poor prognosis of CRC patients.Sursical resection of symptomatic brain metastases from colorectal cancer is relatively safe and provides the opportunity for prolonged survival.
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OBJECTIVE To survey hepatitis B virus(HBV) contamination on hands of laboratory staffs and to evaluate the protection efficacy against HBV infection by wearing gloves.METHODS Samples from used gloves and gloves-protected hands were carried out according to the methods stipulated in the Technical Guidelines for Disinfection.All samples were divided into 3 groups:gloves worn for 1h,gloves worn for 3h and gloves-protected hands,each group had 202 cases.To detect HBsAg and HBV DNA by microparticle enzyme immunoassay(MEIA) and fluorescence quantitative polymerase chain reaction(FQ-PCR),respectively.RESULTS HBsAg polluted rates of gloves worn for 1h,gloves worn for 3h and gloves-protected hands were 22.77%,34.65% and 2.48%,respectively;HBV DNA polluted rates of gloves worn for 1h,gloves worn for 3h and gloves-protected hands were 27.72%,41.58% and 2.48%,respectively.The HBsAg and HBV DNA polluted rates of gloves worn for 3h were higher than those of gloves worn for 1h,the difference was significant between them(P
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Objective To explore the relationship between te lomerase activity and bile duct carcinoma and its significance in clinical diag nosis. Methods Telomerase activities were examined in 23 cases of bile duct carcinoma, 5 cases of carcinoma adjacent tissues and 5 cases of nor mal bile duct tissues respectively with telomerase PCR-ELISA method. Results Telomerase activity was detected in 18 of 23 cases (78.3%) of b ile duct carcinoma, and was not found in 5 cases of carcinoma adjacent tissues a nd 5 cases of normal bile duct tissues. The detection rate of telomerase activit y had no correlation with patients' age, sex, tumor site and size but significan tly correlated to metastasis of tumor (P<0.05). Conclusion The level of telomerase activity was significantly higher in bile duct carcino ma and may be served as one of the clinical marker for malignant neoplasm becaus e of its spsecificity.
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Objective To explore the adjustment of interleukin II combining lifein for CD+4 T lymphocyte, Th1 and Th2 of patients with malignant tumor. Methods CD+4 T lymphocyte were measured by flow cytometer. Th1 lymphocyte and Th2 lymphocyte were measured by ELISA. Thirty- eight patients with malignant tumor were enrolled in the study. Interleukin II were administered at the dose of 500 000 U, i.h Qd, from day 1 to day 5. Lifein were administered at the dose of 10mg/d, i.m Qd, from day 6 to day 21 or form day 6 to day 27. The count of CD+4 T lymphocyte, Th1 lymphocyte and Th2 lymphocyte were studied before treatment, 2 weeks and 1 month after treatment. Conduct ANOYA using SPSS software. Results The expression of CD+4 T lymphocyte in patients as with increase tendency. The counts of Th1 lymphocyte, Th2 lymphocyte and Th1/Th2 were not significantly different after treatment. Conclusions The dose of this treatment could enhance the count of CD+4 T, but it could not adjust the count of Th1 lymphocyte, Th2 lymphocyte. The target of treatment about interleukin II combining lifein for patients with malignant tumor is CD+4 T lymphocyte's other subsets.