Clinical observation of chemotherapy combined with camrelizumab in patients with inoperable microsatellite stable type colorectal cancer / 中国药房

OBJECTIVE To evaluate the clinical efficacy and safety of XELOX chemotherapy （oxaliplatin+capecitabine） combined with antiangiogenic agent （apatinib） and immunotherapy （camrelizumab） in patients with inoperable metastatic colorectal cancer （CRC）of microsatellite stable （MSS） type. METHODS Clinical medical records of 40 patients with inoperable metastatic CRC of MSS type treated in Lishui People’s Hospital from January 2020 to January 2021 were retrospectively collected. According to the treatment plan， the patients were divided into control group （20 cases） and observation group （20 cases）. Control group was given XELOX+apatinib regimen， while observation group was given XELOX+apatinib+camrelizumab regimen. Every 3 weeks was a treatment cycle， and the treatment lasted for 2 consecutive cycles. The objective response rate （ORR）， disease control rate （DCR）， progression-free survival （PFS）， overall survival （OS） and adverse events （AEs） were recorded for all patients. RESULTS The ORR and DCR of observation group were 65.0% and 85.0%， respectively； and the ORR and DCR of control group were 35.0% and 75.0%， respectively， with no statistical significance between 2 groups （P＞0.05）. The median PFS of observation group and control groups were 16.0 months and 8.0 months， respectively； and the median OS were 19.0 months and 12.5 months， respectively， with statistical significance between 2 groups （P＜0.05）. Each patient in both groups had at least one AEs， and the incidences of reactive skin capillary hyperplasia and hyperthyroidism in observation group （40.0%， 20.0%） were significantly higher than those in control group （both were 0） （P＜0.05）. The incidence of nausea and vomiting in control group （90%） was significantly higher than observation group （10%） （P＜0.05）. There were 14 cases （70.0%） of patients with grade 3 or above AEs in observation group， and only 5 cases （25.0%） in control group， with statistical significance between 2 groups （P＜0.05）. However， no severe AEs that could not be tolerated or fatal occurred in the two groups， which could be alleviated after drug withdrawal or treatment. CONCLUSIONS The efficacy of XELOX chemotherapy combined with apatinib and camrelizumab in inoperable metastatic CRC patients of MSS type is comparable to that of XELOX chemotherapy combined with apatinib， but it has certain advantages in ORR， PFS and OS， and controllable safety.

Expression of SPNS2 in colorectal cancer tissues and its clinical significance / 中国肿瘤临床

Objective: To investigate the expression and clinical significance of sphingosine-1-phosphate transporter 2 (spinster homolog 2, SPNS2) in colorectal cancer. Methods: Colorectal cancer and adjacent normal tissues were collected from 133 patients undergoing colorectal cancer resection in Anhui Provincial Hospital from January 2010 to June 2013. The expression of SPNS2 protein was detected by immunohistochemistry. RT-qPCR was performed on the cancer tissues and adjacent normal tissues of 29 patients with colorectal cancer from February 2018 to June 2018. The relationship between the expression of SPNS2 in cancer tissues and clinicopathological features of colorectal cancer patients was analyzed using χ2test. The relationship between the expression of SPNS2 and prognosis of patients with colorectal cancer was analyzed based on univariate and multivariate analysis. Results: Immunohistochemistry results indicated that the expression of SPNS2 in colorectal cancer tissues was higher than that in adjacent normal tissues (81.20% vs. 22.60%, χ2=69.136, P<0.001). The results of RT-qPCR indicated that the expression of SPNS2 mRNA in colorectal cancer tissues was significantly higher than that in the corresponding adjacent normal tissues (t=3.974, P<0.001). The overexpression of SPNS2 protein was closely related to tumor differentiation, lymph node metastasis (pN), tumor size, and depth of invasion (Tx); this difference was statistically significant (P<0.001). The survival time of patients with negative SPNS2 expression was significantly longer than that of patients with positive expression (χ2=13.080, P<0.001). Univariate and Cox multivariate analyses showed that abnormal expression of SPNS2 affects the overall survival of colorectal cancer patients and is an independent influencing factor for patient prognosis. Conclusions: The positive expression of SPNS2 in colorectal cancer is related to the occurrence and development of colorectal cancer. SPNS2 can be used as a new colorectal tumor marker to evaluate the prognosis of patients, monitor the invasion and metastasis of postoperative tumors, and serve as a new target for diagnosis and treatment.

Effects of tripterygium wilfordii polyglycoside tablets on expression of CD4+/CD8+ and CD4+ CD25+ Treg in elderly patients with relapsing refractory immune thrombocytopenic purpura / 中国基层医药

Objective To explore the mechanism of tripterygium wilfordii polyglycoside tablets for elderly patients with relapsing refractory immune thrombocytopenic purpura (ITP),and to seek the theoretical basis for Chinese medicine treatment of this disease.Methods The clinical data of 79 patients with relapsing refractory ITP were retrospectively analyzed.According to whether the combined use of tripterygium wilfordii polyglycoside,they were divided into the control group (35 cases) and the observation group (44 cases).The control group was treated with platelet and tranexamic acid,sulfasalazine,sulforaphane sodium,hemagglutinin and other symptomatic hemostasis treatment.The observation group in symptomatic hemostasis support on the basis of treatment with tripterygium wilfordii polyglycoside tablets.The CD4+/CD8+ ratio and CD4+ CD25+ Treg expression were compared between the two groups.Results The CD4+/CD8+ ratio,CD4+ CD25+ Treg and platelet count in the control group before treatmentwere (0.96 ± 0.36),(1.21 ± 0.67) ％,(13.14 ± 6.92) × 109/L,respectively,which of the observation group were (0.92 ± 0.37),(1.19 ± 0.59) ％,(11.51 ± 6.21) × 109/L,respectively,there were no statistically significant differences between the two groups (all P ＞ 0.05).The CD4+/CD8+ ratios in peripheral blood of the observation group at 2 weeks,3 weeks and 4 weeks after treatmentwere (1.04 ±0.56),(1.55 ±0.34),(1.59 ±0.41),respectively,there were statistically significant differences between the two groups (t =9.994,9.797,all P ＜ 0.05).The CD4+ CD25+ Treg proportions in the observation group at 2 weeks,3 weeks and 4 weeks after treatmentwere (1.01 ± 0.61) ％,(1.06:±:0.57) ％,(5.92 ± 0.65) ％,respectively,there was statistically significant difference between the 4 weeks after treatment and before treatment(t =5.378,P ＜ 0.05).The CD4+/CD8+ ratios in the peripheral blood of the control group were (1.01 ±0.60),(0.89 ±0.50) and (0.96 ±0.51),respectively,and the CD4+ CD25+ Treg in control group at 2 weeks,3 weeks and 4 weeks after treatment proportions were (0.99 ±0.72)％,(1.15 ±0.66)％,(1.22 ±0.56)％,respectively,there were no statistically significant differences between before and after treatment (all P ＞0.05).There were statistically significant differences in the CD4+/CD8+ ratio and CD4+ CD25+ Treg expression between the observation group and control group at 4 weeks after treatment (t =8.589,P ＜ 0.01;t =2.369,P ＜ 0.05).There was no statistically significant difference in the platelet count between the two groups(P ＞ 0.05),but the symptoms of bleeding of the observation group was lighter at 3 weeks after treatment.Conclusion Tripterygium wilfordii polyglycoside improves the expression of CD4+/CD8+ and CD4+ CD25+ Treg in peripheral blood of elderly patients with relapsed or refractory ITP.It is an ideal drug for the treatment of relapsed and refractory ITP in the elderly,it is worth further study.

Expressions of Maspin and Ki67 in extranodal nasal type NK/T-cell lymphoma and the significance / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To analyze the expression of Maspin and Ki67 in EN-NK/TCL and the significance.@*METHOD@#The expressions of Maspin and Ki67 were detected by immunohistochemistry in 34 cases of EN-NK/TCL and 11 cases of chronic sinusitis.@*RESULT@#Maspin was low expressed in EN-NK/TCL, Ki67 was highly expressed in EN-NK/TCL. Negative correlation was found between the expression of Maspin and Ki67 in EN-NK/TCL.@*CONCLUSION@#The combined examination of Maspin and Ki67 has important significance in the diagnosis in EN-NK/ TCL.

Clinical observation of multi-target therapy in children with lupus nephritis / 中华风湿病学杂志

Objective To explore the efficacy of mycophenolate mofetil-based induction or maintenance therapy for children with lupus nephritis combined with Calcineurin inhibitors (cyclosporine A/tacrolimus) for resistant cases.Methods the clinical data were analyzed for 10 patients treated with multi-target therapy (Glucocorticoid + Mycophenolate mofetile+ Cyclosporine A/Tacrolimus) in Department of Nephrology and Rheumatology from January 2005 to December 2011.Calcineurin inhibitor (Cyclosporine A/Tacrolimus) was added when Mycophenolate mofetil-based induction or maintenance protocol was not satisfactory.The data was analyzed by repeated measures data of ANOVA.Results The SLEDAI score (10.9±3.8 vs 7.9±2.6),24 hours urinary protein quantification [(4.0±2.0) vs (2.2±1.8) g] and ESR [(78±10) vs (54±8) mm/l h] were decreased significantly (P＜0.01),while serum albumin [(29±8) vs (34±8) g/L] and complement C3 level [(0.41±0.20) vs (0.70±0.30) g/L] were increased significantly (P＜0.05).The complete remission rate (CR) was 70％ and the response rate was 90％ in the first 6 month,and the CR was 90％ in the last month.Except 1 case withdrawal,the follow-up period for 9 cases was 24 months.Adverse reactions were rare,1 case had lung in-fection,1 case had hyperglycemia and 1 case had transaminase elevation,which disappeared after mana-gement.Conclusion Mycophenolate mofetil combined with Calcineurin inhibitors (cyclosporine A/tacrolimus) is effective for treating lupus nephritis,the dose of induction or maintenance period is low,and adverse reactions are rare.

Progress of childhood rheumatic diseases associated with interstitial lung disease / 国际儿科学杂志

Rheumatic disease is a kind of autoimmune disease,which can damage all of tissues and organ,the respiratory system is commonly involved.Interstitial lung disease(ILD) is the most prevalent respiratory manifestation.ILD of unknown etiology in immunocompetent patients is rare in children,but it can increase the mortality obviously.Therefore,we should improve the knowledge of rheumatic diseases-ILD,earlier diagnosis and treatment are very important for the life quality of children.

Macrophage migration inhibitory factor in children with hematologic malignancy complicated with sepsis / 中国小儿急救医学

ObjectiveTo assess the relationship between serum macrophage migration inhibitory factor (MIF) and sepsis in children with hematologic malignancy.Methods( 1 ) An observational study was performed in a university pediatric intensive care unit.Forty-one children were enrolled in our study,and were divided into two groups:sepsis group (27 cases) and non sepsis group ( 14 cases).(2) Serum samples were taken in the both two groups in 24 h after they were admitted in hospital.Clinical and laboratory parameters,including the levels of serum MIF,cortisol,corticotropin releasing hormone ( CRH),and ferritin were measured and compared between the two groups.Multiple linear regression analysis was used to assess the relationship between MIF and CRH,cortisol and pediatric critical illness score (PCIS).ResultsThe level of MIF was significantly elevated in the sepsis group[ (5 022.71 ± 3 915.82) pg/ml] than that of non sepsis group[ ( 1 722.81 ± 1 738.53) pg/ml] (P =0.001 ).Multiple linear regression analysis showed that CRH as well as PCIS were the correlative factors of MIF( t =- 2.830,P =0.009; t =2.852,P =0.009 ).The higher CRH concentration,the lower PCIS score,and the higher MIF was.ConclusionThe level of serum MIF could reflect the severity of children with hematologic malignancy complicated with sepsis.The higher MIF concentration,the lower PCIS score,then the disease is more serious.To some extent,serum MIF is related with the adrenocortical function of sepsis children.

Progress in the therapy of glucocorticoid to pediatric ALI/ARDS / 国际儿科学杂志

Pediatric acute lung injury/acute respiratory distress syndrome (ALI/ARDS)refers to a special syndrome with high mortality, acute progressive respiratory failure with loss of epithelial and endothelial integrity induced by severe stress reaction and/or inflammation reaction because of pulmonary and/or extrapulmonary diseases.Corticosteroids are routinely used in patients with ALI/ARDS for many years. Corticosterioids play an important role in every link of the therapy of ALI/ARDS because of the effect of anti-fibrosis and anti-inflammation, but it is unclear why the effect of treatment is very different in individual. The use of corticosteroid in the treatment of ALI/ARDS has been subject of great controversy and debate over the years. Recent researches indicate that the effect of glucocoticoids treatment is related with the number and affinity of the receptor for glucocorticoids.

Spindle cell rhabdomyosarcoma in adults:a clinicopathologic study of nine cases / 临床与实验病理学杂志

Purpose To study the clinicopathological features, immunophenotype and differential diagnosis of spindle cell rhabdomyosarcoma in adults (SRMS).Methods The clinical,pathologic and immunohistochemical features were evaluated in 9 cases of SRMS in adults.Results Nine cases of SRMS in adults were retrieved from the pathological archive of this hospital. 7 cases were male and 2 were female. Patients age ranged from 20 to 80 years (median,45 years). The head and neck region,including the right mandible, pharyngeal portion, nasopharynx, and left maxillary,was the most commonly affected area, accounting for 44% of the cases, followed by forearm, waist, thigh, leg and testis(1 case each). Tumor size varied from 2 to 14 cm (median 5.9 cm).Histologically, all the tumors were mainly composed of cellular bands and fascicles of atypical spindlE-shaped tumor cells with a variable number of spindled or polygonal rhabdomyoblasts.In addition, focal areas reminiscent of interstitial sclerosing were presented in 2 cases, and pseudovascular structures were noted in 2 cases, loosely myxoid stroma were detected in 1 case and small solid areas with mild pleomorphic tumor cells were present, but lacking bizarre pleomorphic rhabdomyoblasts. Immunohistochemically, the tumor cells were positive for vimentin, desmin, CD99 and MyoD1; Myogenin and MSA were positive in most of the cases (6/9 and 7/9 each); The remaining antibodies(S-100, CD34,CK and HMB-45) were all negative. Follow-up information was available in all the cases, ranged from 6 months to 4 years, revealed paravenous metastases of the peritoneal cavity in one patient with testis tumor and liver metastases in one patient with leg tumour. 4 patients developed local recurrences and 2 patients died of the disease.Conclusions SRMS is a rare neoplasm in adults,and most commonly occurs in male with preferential involvement in the head and neck region. It appears a more aggressive clinical course in adults. Morphologically, SRMS in adults should be differentiated from other spindle cell tumors.

Expression and clinical significance of MMP-2 and MMP-9 protein in human gastric carcinoma / 肿瘤研究与临床

Objective To study the expression and clinical significance of MMP-2 and MMP-9 protein and their relationships in human gastric carcinoma. Methods MMP-2 and MMP-9 protein expression were examined by two-step immunohistochemistry in 96 cases of human gastric carcinoma and paracancerous normal tissue. Results The expression rate of MMP-2 and MMP-9 in gastric carcinoma tissue was 72.9 %(70/96)and 66.7 %(64/96) respectively, which was significantly higher than those in the normal tissue (30.2 % and 31.3 % respectively, P<0.001). The expression of MMP-2 and MMP-9 was significantly correlated with site, depth invaded,TNM stage and lymph node metastasis of gastric carcinoma (P <0.05), and not with age, sex, size, histological differentiation of gastric carcinoma(all P>0.05). Conclusion There are close relationships between the expressions of MMP-2, MMP-9 in gastric carcinoma and pathological characteristics in clinic metastasis and prognosis. They may be used as important indexes to judge the biological behavior and prognosis of gastric carcinoma.

Vocational education requirement analysis on medicine industry development in Jiangsu province / 中华医学教育探索杂志

From the medicinal economy development in Jiangsu province and medicinal high vocational characteristics, the article analyses how to make higher vocational education adapt to the continued developing requirements and how to open up medicinal personnel training pattern . The text also introduces the experience in vocational education reformation in Xuzhou vocational college of pharmaceutics.

A methods of early identification in severe acute pancreatitis / 医学研究生学报

Objective:To study the diagnosis values in severe acute pancreatitis (SAP) by means of the detection of C-reactive protein (CRP) and coagulation function in the early period of acute pancreatitis (AP). Methods:Seventy-two patients with AP accepted early detection of C-reactive protein (CRP),prothrombin time (PT),international normalized ratio(INR),activated partial thromboplastin time (APTT),fibrinogen (FIB ),CT scan and enhanced CT,and the evaluation on the CT severity index (CTSI). Results:There were significant differences in the levels of CRP,PT,INR,APTT,FIB and the CTSI scores between severe AP (SAP) and mild AP (MAP) (P

Primary lymphoma of bone:A clinicopathologic and immunohistochemical observation / 临床与实验病理学杂志

Purposes　To observe the clinicopathologic and immunohistochemical features of primary lymphoma of bone(PLB). Methods　Eight cases of PLB were investigated by light microscopy and immunohistochemical staining. Results　The mean age of eight cases of PLB was 51 years. Radiographs of all cases showed the lytic lesions or osteoporosises; All the cases were diffuse non-Hodgkins lymphomas(NHL), including 4 large cell lymphomas (centroblastic, CB), 2 centrocytic(CC), one mixed cell (CB-CC ) and one lymphoplasmacytic (LP); Immunohistochemical features revealed 6 cases of B-cell, 2 T-cell. Conclusions　The peak incidence for PLB is in the 5th decade with the radiologic appearance of lytic lesions or osteoporosises. All tumors are the diffuse NHL, including mainly large cell lymphomas and immunophenotypic features of B-cell lymphomas. Immunohistochemistry is helpful in the differential diagnosis of PLB.

Pituitary adenoma: A clinicopathologic analysis of 180 cases / 临床与实验病理学杂志

To study the histogenesis, biological behaviour, classification of pituitary adenoma and the relationship between the symptoms of hormonal hypersecretion and the hormone test in pituitary adenoma. MethodsOne hundred and eighty cases of pituitary adenoma were investigated by clinicopatholgic analysis, and GH, PRL, ACTH, TSH, FSH, LH were examined in 110 cases by ABC immunocytochemical methods. ResultsForty percent of the patients were found to have the identical results between the clinical symptoms and hormonal test. Female patients were more than male ones, and the difference was satistically significant. The results showed that PRL and GH adenoma were often found in the cases by immunocytochemical method,and mixed GH-PRL adenoma were often found in the cases with multihormono-adenoma. ConclusionThe classification is practical and easy to operate, which combines the immunohistochemical examination of pituipary adenoma with the morphology and function.