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Purpose@#In non-metastatic prostate cancer (nmPCa) setting, it is important to early identify the patients at risk of biochemical recurrence (BCR) for immediate postoperative intervention. Our study aimed to evaluate the potential clinical utility of circulating tumor DNA (ctDNA) for predicting disease recurrence. @*Materials and Methods@#This real-world observational study evaluated 161 cases of nmPCa undergoing next-generation sequencing at our institution. A total of 139 ctDNA samples and 31 biopsied tumor tissue underwent genomic profiling. The study endpoint was BCR after radical prostatectomy. Relationships between the ctDNA status and the biochemical progression-free survival (bPFS) were analyzed by log-rank test and multivariate Cox regression. @*Results@#Of 161 enrolled patients, 19 (11.8%) harbored deleterious alterations in NCOR2, followed by BRCA2 (3.7%), ATR (2.5%), and CDK12 (2.5%). Of available pre-operative blood samples (n=139), ctDNA was detectable in 91 (65.5%). Until last follow-up, 56 of 68 patients (85.3%) with detectable ctDNA had achieved BCR, whereas only eight of 39 patients (20.5%) with undetectable ctDNA had achieved BCR. Patients who had undetectable ctDNA experienced significantly longer bPFS compared with those who had detectable ctDNA (not available vs. 8.2 months; hazard ratio, 0.14; p < 0.01). Pre-operative ctDNA status was a significant prognostic factor of disease recurrence. @*Conclusion@#Pre-operative ctDNA detection could identify patients at high risk of recurrence and has the potential to inform immediate postoperative interventions, but these approaches remain to be validated in prospective studies. ctDNA studies can provide insights into accurate monitoring and precise treatment rather than simply following routine clinical care.
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Objective:To investigate clinicopathological features of hypopigmented mycosis fungoides (HMF) and hypopigmented interface T-cell dyscrasia (HITCD) .Methods:A total of 41 patients with cutaneous hypopigmented lymphoproliferative diseases, who had complete clinicopathological data, were collected from Department of Dermatology, the Third People′s Hospital of Hangzhou from January 2015 to September 2020, and the clinicopathological and immunophenotypic features were analyzed. Comparisons of normally distributed measurement data were carried out using t test, comparisons of categorical data using Chi-square test or Fisher′s exact test, and comparisons of ranked data between 2 groups using rank-sum test. Results:All of the 41 patients clinically presented with irregular hypopigmentation, some of which was accompanied by erythema or furfuraceous scales. In terms of pathological features, 21 patients showed infiltration and aggregation of atypical lymphoid cells in the epidermis, which was consistent with typical pathological features of mycosis fungoides, and they were diagnosed with HMF; 20 patients showed vacuolar degeneration of the basal layer, accompanied by infiltration of lymphoid cells and mild epidermotropism, and they were diagnosed with HITCD. All immune cells expressed T-cell phenotype, and epidermal lymphocytes expressed a CD8-dominated phenotype in 14 (67%) cases of HMF and 13 (65%) of HITCD. In the epidermis, the total number of lymphocytes was significantly higher in the HMF group than in the HITCD group ( t= 1.81, P= 0.012) ; in the dermis, the number of CD4 + lymphocytes and CD8 + lymphocytes, and the total number of lymphocytes were all significantly higher in the HMF group than in the HITCD group ( t= 2.64, 1.51, 2.60, P= 0.012, 0.002, 0.001, respectively) . All patients were treated with narrow-band ultraviolet B radiation. Among 34 patients who completed the follow-up, 30 achieved complete clearance of skin lesions without recurrence, including all patients with HITCD, and 4 with HMF achieved partial regression of the lesions. Conclusions:Compared with HMF, HITCD presents different pathological characteristics and benign biological behaviors. Thus, HITCD should be distinguished from HMF as an independent disease. Phototherapy alone is effective for the treatment of HITCD.
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The diagnosis of Spitz nevus is mainly based on histopathological changes. Combined with the learning experience at Ackerman Academy of Dermatopathology, the author thoroughly analyzed pathological and cytological characteristics of, as well as the body′s reaction to Spitz nevus, hoping to help clinicians with the pathological diagnosis and differential diagnosis of Spitz nevus.
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Panniculitis is a group of skin diseases involving subcutaneous adipose tissues, including primary and secondary panniculitis associated with tumors and inflammations. According to patterns of inflammation and types of fat necrosis, and combined with the learning experience at Ackerman Academy of Dermatopathology, the authors summarize pathological changes in various types of primary panniculitis, and propose some diagnostic clues, hoping to provide some ideas for the pathological diagnosis of panniculitis.
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Aiming at the low efficiency and low quality detection level of the manual infusion set, a gas detection system for infusion set based on STM32 single-chip microcomputer was designed. The detection system includes hardware system design and software system design. The hardware system is based on the STM32F103 single-chip microcomputer. It mainly designs the gas pressure sensor acquisition circuit and the multi-way solenoid valve control circuit. The software system uses a C ++ real-time operating system to ensure system monitoring's real-time performance and validity. Test data is transmitted to the upper computer and displayed via USB serial communication. The experiment proves that the infusion set gas detection system can perform gas detection on the infusion set. The system has the characteristics of stability and high accuracy. The relative error of the experimental measurement is within ±5%, and the detection efficiency is better than manual detection.
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Computers , Equipment Design , Microcomputers , SoftwareABSTRACT
Carrying out the optimal location selection of medical equipment in the medical community plays an important role in scientifically allocating equipment resources and improving the service capacity of medical community. Aiming at minimizing the operating cost of the location selection and configuration of the portable color Doppler ultrasound instrument in the county medical community and the shortest time spent on medical visits for residents, the authors established the total value objective function of the medical community configuration according to the value engineering method; and considered the relevant constraints such as distance, time and personnel quality, the mathematical model of optimal planning for the selection and configuration of portable color Doppler ultrasound equipment in county medical community was constructed. The empirical research results showed that based on the established constraints, after 5 000 iterations, the model output 5 relatively optimized allocation points among the 9 allocation points, and when the allocation number of each allocation point was 1, the total allocation value in the medical community reached the maximum. This study could provide a new idea and feasible method for the allocation of equipment resources of county medical community in China.
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OBJECTIVE@#To explore the molecular basis for a blood donor with an ABO subtype.@*METHODS@#The proband and his family members were subjected to serological analysis. Their genotypes were determined by real-time PCR and sequencing of the coding regions of ABO gene.@*RESULTS@#The proband was determined as an ABw subtype. By sequencing analysis, the proband was typed as A102/BW03. Compared with ABO*B.01, the proband was found to harbor a 721C>T variant (ABO*BW.03 allele) in exon 7 of the ABO gene, which caused substitution of Arginine at position 241 by Tryptophan resulting in a ABW phenotype. The blood type of the proband's sister was similar to that of the proband. The maternal serological pattern was B type, and the result of sequencing suggested that the genotype fit with B101/Bw03.@*CONCLUSION@#The 721C>T in the exon 7 of the ABO glycosyltransferase gene probably underlies the Bw03 phenotype. The ABO*Bw.03 variant of the proband and his sister were inherited from their mother.
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Female , Humans , Male , ABO Blood-Group System , Genetics , Amino Acid Substitution , Genotype , Pedigree , Exome SequencingABSTRACT
The combination of programmed death receptor 1 (PD-1) and its ligand 1 (PD-L1) can inhibit and deplete T lymphocyte function, thereby inducing immune tolerance, enabling tumor cells to escape the attack of immune cells and promoting the growth and metastasis of tumors. At the same time, the high expression of PD-1/PD-L1 can enhance metastatic ability of tumors and lead to increased mortality, and the treatment of inhibiting PD-1/PD-L1 signaling pathway has been proved effective in many tumors. However, the traditional treatment methods are limited for the treatment of colorectal metastatic cancer. The emergence of immunotherapy may bring new breakthroughs for the treatment of colorectal metastatic cancer. This article reviews the characteristics of expressions of PD-1/PD-L1 in colorectal metastases.
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To unravel the genetic mechanisms of disease and physiological traits, it requires comprehensive sequencing analysis of large sample size in Chinese populations. Here, we report the primary results of the Chinese Academy of Sciences Precision Medicine Initiative (CASPMI) project launched by the Chinese Academy of Sciences, including the de novo assembly of a northern Han reference genome (NH1.0) and whole genome analyses of 597 healthy people coming from most areas in China. Given the two existing reference genomes for Han Chinese (YH and HX1) were both from the south, we constructed NH1.0, a new reference genome from a northern individual, by combining the sequencing strategies of PacBio, 10× Genomics, and Bionano mapping. Using this integrated approach, we obtained an N50 scaffold size of 46.63 Mb for the NH1.0 genome and performed a comparative genome analysis of NH1.0 with YH and HX1. In order to generate a genomic variation map of Chinese populations, we performed the whole-genome sequencing of 597 participants and identified 24.85 million (M) single nucleotide variants (SNVs), 3.85 M small indels, and 106,382 structural variations. In the association analysis with collected phenotypes, we found that the T allele of rs1549293 in KAT8 significantly correlated with the waist circumference in northern Han males. Moreover, significant genetic diversity in MTHFR, TCN2, FADS1, and FADS2, which associate with circulating folate, vitamin B12, or lipid metabolism, was observed between northerners and southerners. Especially, for the homocysteine-increasing allele of rs1801133 (MTHFR 677T), we hypothesize that there exists a "comfort" zone for a high frequency of 677T between latitudes of 35-45 degree North. Taken together, our results provide a high-quality northern Han reference genome and novel population-specific data sets of genetic variants for use in the personalized and precision medicine.
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Cephalosporin is still the first-line drug chosen for the treatment of gonorrhea, although it is likely to develop resistance to Neisseria gonorrhoeae. Recently, the resistance or low sensitivity of cephalosporin to Neisseria gonorrhoeae have been reported at home and abroad. The studies of resistance mechanism to Neisseria gonorrhoeae are particularly important. The resistance mechanism is mainly lied in three aspects. The first is the changes in antibiotic target sites, for example, the changes in penicillin-binding proteins would affect the binding of antibiotics to Neisseria gonorrhoeae; the second is the changes in bacterial cell membrane porin which effects drugs influxing; the third is the changes in efflux system which enhances the bacterial efflux capacity. To study and explore the mechanism of Neisseria gonorrhoeae resistance is of great importance for the prevention and treatment of gonorrhea.
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Objective To investigate the efficacy of pretreatment systemic inflammation response index (SIRI) in predicting the prognostic of prostate cancer (PCa) patients treated with maximal androgen blockade (MAB).Methods The data of 351 PCa patients who had undergone MAB as first-line therapy between January 2010 and June 2015,were retrospectively analyzed.The age of patients in our cohort ranged from 51 to 89 years old,mean 76 years old.The median value of PSA was 91.60ng/ml,ranging 0.11-1 000.00 ng/ml.39 cases had a Gleason score of 6,47 cases had a score of 3 + 4,89 cases had a score of 4 +3,107 cases had a score of 8,and 69 cases had a score of 9-10.158 cases had bone metastasis.Patients were categorized in two groups using a cut-off point of 1.2 as calculated by the receiver-operating curve analysis.Correlations between SIRI and clinical characteristics were analyzed.Meanwhile,univariate and multivariate cox regression analyses were performed to determine the associations of SIRI with progression-free survival (PFS),cancer-specific survival (CSS) and overall survival (OS).Results The median follow-up duration was 43.0 months,ranging 9-75 months.The disease progression occurred in 162 patients,91 patients died,including 75 who died because of PCa at the end of the last follow-up.The differences of age,Gleason score and incidence of metastasis between low SIRI group (＜ 1.2) and high SIRI group (≥1.2) were not significant (P ＞0.05).But the patients in high SIRI group had higher PSA (P =0.046).Multivariate analyses identified SIRI,Gleason score and metastasis as independent prognostic factors for PFS,CSS and OS.Conclusions Pretreatment SIRI ≥ 1.2 was an independent predictor for poor prognosis in PCa patients treated with MAB.
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Objective To determine the influence of abiraterone acetate (AA) on neuroendocrine differentiation (NED) in metastatic castration-resistant prostate cancer (mCRPC) and the prognostic predicting value of the serum NED markers in mCRPC patients treated with AA.Methods We conducted an analysis in 115 chemotherapy-naive mCRPC patients who were treated with chemotherapy in Renji hospital from 2013 to 2017.The median age was 70,ranged from 65 to 76 years old.The median CgA,NSE and PSA levels were 101.1 ng/ml (78.5-150.0 ng/ml),13.4 ng/ml (10.5-17.6 ng/ml) and 38.8 ng/ml (11.2-123.2 ng/ml),respectively.Among them,48 cases were classified as the group without AA treatment.The other 67 cases were classified as group after AA failure.In group without AA treatment,the median CgA,NSE and PSA levels were 109.1 ng/ml(80-151.5 ng/ml);13.8 ng/ml(10.8-18.2 ng/ml) and 39.2 ng/ml (8.6-200 ng/ml),respectively.In group after AA failure,the median CgA,NSE and PSA levels were 105.4 ng/ml(78.8-175.5 ng/ml),13.8 ng/ml(10.8-17.6 ng/ml) and 39.0 ng/ml(8.4-219.8 ng/ml),respectively.In the group with serial evaluation of NED markers during AA treatment,the median serum CgA,NSE levels at baseline were 115.9 ng/ml(90.1-201.5 ng/ml),13.3 ng/ml (10.4-18.1 ng/ml),respectively.The endpoints were PSA PFS(progression-free survival) and radiographic PFS (rPFS).Results In 34 patients with serial evaluation,serum NED markers level in 19 patients increased after the failure of AA treatment.Median serum CgA and NSE levels were 115.9 ng/ml(90.1-201.5 ng/ml)and 13.25 ng/ml (10.37-18.14 ng/ml) at baseline.Median serum CgA and NSE levels were 129.6ng/ml (75.5-230.5 ng/ml) and 14.7 ng/ml (11.8-19.1 ng/ml) after 6 months treatment,respectively.The median serum CgA and NSE levels were 130.4 ng/ml (95.7-205.7 ng/ml) and 15.2 ng/ml(12.4-18.7 ng/ml) at the time of failure of AA treatment,respectively.There was no significant difference of NED markers between baseline and failure of AA treatment (P =0.243).In logistic univariate analysis,AA treatment and its duration were not independent factors influencing NED(P =0.30;P =0.52).Compared with the NED markers elevation group in the first 6 months of AA treatment and baseline supranormal NED markers group,the NED markers decline group(PSA PFS(17.1 vs.10.4 months,P ＜ 0.001) and rPFS (17.0 vs.10.4 months,P =0.003)) and baseline normal NED markers group(PSA PFS(14.1 vs.9.5 months,P =0.001) and rPFS(16.4 vs.10.5 months,P ＜ 0.001)) has a longer median PSA PFS and rPFS respectively.In multivariate Cox analysis,baseline NED markers level and NED markers variation during the first 6 months of AA treatment remained significant predictors of rPFS(P ＜ 0.05),and PSA-PFS (P ＜ 0.05).Conclusions We found there was heterogeneity in changes of NED markers in different mCRPC patients during AA treatment,and AA might not significantly lead to progression of NED of mCRPC in general.Serial CgA and NSE evaluation might help clinicians guide clinical treatment of mCRPC patients.Serum NED markers elevation during the first 6 months of AA treatment and elevated baseline NED markers levels indicated poor prognosis in mCRPC treated with AA.
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Objective:To explore the risk factors,preventive measures and therapeutic methods for bronchopleural fistula (BPF) after lung resections.Methods:A restrospective analysis for 11 patients with BPF after pneumonectomy from April 2012 to June 2016 in Department of Thoracic Surgery,Xiangya Hospital,Central South University was performed.Their clinical characteristics,treatment and prognosis were analyzed,and the risk factors and effective therapeutic strategies were summarized.Results:Among the 11 patients with BPF,10 cases were cured finally,and 1 case with conservative treatment was dead.The total mortality rate was 9.09％.The 10 patients treated with positive measures were all cured,including 5 cases with pulmonary lobectomy and pneumonectomy,4 cases with amplatzer and covered stent,and 1 case with fibrin glue.One case with conservative treatment was dead because of respiratory failure.Conclusion:It is important to intervene BPF as early as possible.Fibrin glue via bronchoscope for tiny BPF after lung resection is preferred to be considered.We recommend to take early positive operation (pulmonary lobectomy and pneumonectomy) after pulmonary resection if the BPF cannot be cured via bronchoscope whereas the patients' condition is allowed.The amplatzer or covered stent should be considered first for the patient with BPF after pneumonectomy.
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Objective To study the expression of insulin-like growth factor I(IGF-I)and insulin like growth factor binding protein -3(IGFBP-3)in the colorectal cancer and the relations between them. Methods A case-control study was conducted.We selected 113 patients with a pathologically conformed diagnostic colorectal cancer as the colorectal cancer(CRC)group, 37 patients with colorectal benign diseases as benign control(N-CRC)group, and other 76 healthy subjects as normal control(NC)group. CRC was divided into lymphatic metastasis(M-CRC)subgroup and no lymphatic metastasis(NM-CRC) subgroup and was also categorized by TNM staging.Concentrations of serum IGF-I and IGFBP-3 were measured by chemiluminescence method.SNK test and one-way ANOVA were used for comparison between the two groups and among multi-groups, respectively.Results A slightly decreasing trend of the concentrations of serum IGF-I was observed following the sequences of the NC, N-CRC and CRC groups. Moreover,the concentrations of serum IGF-I in T4 were significantly lower than that in(T1+T2)and T3 (F=6.279,P=0.003).The concentration of serum IGFBP-3 in the CRC group(3.13 ±1.57)μg/ml was significantly lower than that both in the N-CRC(3.42 ±1.32)μg/ml(F=3.04,P=0.09)and the Normal group(4.62 ±1.10)μg/ml(F=10.88,P=0.001).The concentration of serum IGFBP-3 in the M-CRC was higher than that in NM-CRC(F=4.44,P<0.05).The ratio of IGF-I/IGFBP-3 in the CRC group (48.85 ±29.14)was remarkably higher than that both in the N-CRC group(42.38 ±12.58)(F=5.05, P=0.02)and the Normal group(42.46 ±16.24)(F=5.68,P=0.02).The value of diagnosis is general. The area under the ROC curve(AUC)of IGF-I was 0.63(95% CI 0.56 -0.70), the sensitivity and specificity of IGF-I were 85.8%and 40.7%respectively when the critical value was 102.5 μg/ml.The area under the ROC curve(AUC)of IGFBP-3 was 0.72(95%CI 0.64-0.78),the sensitivity and specificity of IGFBP-3 were 78.8%and 62.8%respectively when the critical value was 3.32 μg/ml.Conclusions The concentrations of IGF-I and IGFBP-3 were low expressed in serum of patients with colorectal cancer. Meanwhile,they are correlated with the lymphatic metastasis and TNM staging.
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Objective To investigate the value of imaging-pathology fusion guided targeted cryoablation for localized prostate cancer.Methods Between June 2014 and February 2017,64 patients undergoing targeted cryoablation for localized prostate cancer were retrospectively collected and analyzed.The average age was 77.8 years old,ranging 45-87 years old.The preoperative valne of PSA ranged from 5.1 to 19.8ng/ml,with mean of 15.3 ng/ml,including 6 case of cT1c,35 cases of cT2a,and 23 cases of cT2b,and 35 cases of Gleason score 6,8 cases of 3 + 4 and 21 cases of 4 + 3.All patients had good continence and 11 cases had good erectile function before operation.All the patients received MRI or contrast-enhanced ultrasonography examinations before biopsies,and the sites and range of cryoablation were determined by MRI or contrast-enhanced ultrasonography and biopsy pathological results.Results All the patients underwent the surgery successfully.The average postoperative hospital stay was 1.6 days,ranging 1 to 3 days,including 22 cases discharged within 24 h after surgery.The operative duration ranged from 85 to 152 min,with mean of 99.6 min.The satisfaction rate of the patients was 100％.Seven patients had Clavien Ⅰ or Ⅱ postoperative complications,and recovered after symptomatic treatment.The follow-up duration ranged from 0.5 to 32.2 months,with median of 11.8 months.All patients were alive without new metastasis.Eight patients developed biochemical recurrence,5 of those underwent intermittent endocrine therapy,resulting in stable PSA levels.Conclusion Imaging-pathology fusion guided targeted cryoablation was safe and effective for localized prostate cancer with the advantages of few complications,high satisfaction rate and quick recovery.
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Objective To calculate and measure the depth and radius of the target vessel in the upper limb venous ultrasound image in order to contribute to automatic venipuncture.Methods Two methods of measuring the radius of veins in an ultrasonic vein cross section image were adopted.One method was to segment the vein based on the threshold selected after evaluation, and then scan the upper and lower edges of the vein to obtain the radius.The other method was based on Otsu method,which was to divide the vein and then morphologically process the binary image.The radius was calculated in a manner similar to the first method.After the radius was obtained, the depth of the vein was corrected in conjunction with the radius.Results The above two methods were tested on 500 upper limb venous ultrasound images.The accuracy rate of the first method was 93.0%, and that of the second method was 99.4%.Conclusion The method based on Otsu and morphological processing is more effective for radius measurement of veins in upper limb venous ultrasound image.
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Objective· To evaluate the safety of neoadjuvant therapy which was constituted by docetaxel based systemic chemotherapy and maximal androgen blockage for patients with locally advanced prostate cancer and to summarize the related adverse events and clinical managements.Methods· From June 2015 to February 2017,the clinical data of 55 patients undergoing neoadjuvant chemotherapy combined with complete androgen deprivation were retrospectively reviewed.The patients were given docetaxel and prednisone as DP regimen every 3 weeks and LHRH analogues with bicalutamide as maximal androgen deprivation for a total of 4 cycles.All treatment-related adverse events were observed and then recorded.Results· Two cases with liver function impairment after 2 cycles of treatment were withdrawn from the study.No severe allergic reactions occurred during neoadjuvant therapy.The most common adverse events were hematologic toxicity,while 23.6％ of patients had grade Ⅲ-Ⅳ neutropenia,and about 12.7％ had anemia.Due to a relatively short course of treatment,the skin or mucous damage,peripheral neurotoxicity and fluid retention were rare.However,hot flash,male breast development as well as erectile dysfunction were very frequently observed due to maximal androgen deprivation.The majority of these adverse events were relieved by symptomatic and supportive treatment.Conclusion · After strict selection,4 cycles of neoadjuvant chemotherapy combined with total androgen blockade could be well tolerated by the patients with high-risk locally advanced prostate cancer.Even though the adverse events were controllable,they still need to be closely monitored during treatment in order to reduce the incidence.In addition,the very low testosterone level associated endocrinal metabolic disorders caused by complete androgen deprivation were also of great concern.
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Objective To investigate the efficacy and safety of docetaxel chemotherapy combined with androgen-deprivation therapy (ADT) for patients with metastatic hormone-sensitive prostate cancer.Methods One hundred and ninety-two cases of metastatic hormone-sensitive prostate cancer in Renji Hospital between January 2015 and July 2016 were analyzed retrospectively.Patients' age was 39 to 90,the median age was 71 years.The median prostate-specific antigen (PSA) at diagnosis was 90.6ng/ml (4.1-2 556.0 ng/ml).One hundred and eighty were with bone metastasis and 12 were with distant lymphatic metastasis.Sixty-one of them received docetaxel chemotherapy plus ADT for 3 weeks,131 received hormonal treatment alone.The median age of combination therapy group was 67 years (39-80 years),that of single treatment group was 75 years (50-93 years) (P ＜ 0.001).The median PSA baseline of the two groups were 91.6 ng/ml (35.5-157.5ng/ml) and 89.1 ng/ml (59.6-191.0 ng/ml) (P =0.324).Gleason score of combination therapy group showed that 3 cases (4.9％) was 6,23 cases (37.7％) 7,35 cases (57.4％) ≥8.That of single treatment group showed that 17 cases (13.0％) 6,51 cases (38.9％) 7,63 cases (48.1％) ≥8.There was no statistic difference between the two groups (P =0.122).But there was statistic difference in the rate of T3 or T4 clinical stage in primary lesion,that of combination therapy group was 50.7％ (37/61) and 34.4％ (21/61),and that of single treatment group was 60.3％ (79/131) and 21.4％ (28/131) (P =0.011).Imaging showed local lymph node metastasis in the two groups (80.3％ vs.67.9％,P =0.005).As to physical condition,the combination therapy group showed a lower ECOG score than the single treatment group (P ＜ 0.001).All the patients' survival condition,PSA response rate and adverse events were analyzed.Results One hundred and ninety-two patients were regularly followedup.The median follow-up time was 23.3 (14.4-33.4) months.Median progression free survival time of combination therapy group and single treatment group were respectively 24.4 (7.5-31.3) months vs.17.5(3.0-30.7) months (P ＜ 0.001).There were 1 and 16 cases died in the two groups due to disease progression.During the treatment,the rate of PSA level less than 0.2 ng/ml was 29.5％ (18/61) vs.13.7％ (18/131) in combination therapy group and single treatment group.Regarding the tolerance of combination therapy group,the incidence rate of grade 3-4 neutropenia was 27.9％ (17/61).Skin and mucous membrane damaged in 24.6％ (15/61) patients,transaminase rised in 13.1％ (8/61) patients,and peripheral nerve toxicity occurred in 9.8％ (6/61) patients.There was no significant difference between the 2 groups in relevant events caused by ADT,gynecomastia (14.8％ vs.16.3％) and erectile dysfunction (100％ vs.100％).Most of them could be relieved by symptomatic treatment.Conclusions For metastatic hormone-sensitive prostate cancer,docetaxel combined with hormonal treatment showed longer progression free survival than ADT alone with adverse reactions acceptable.
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Objective To compare phe clinical effecpiveness and safept of picagrelor versus clopidogrel in papienps wiph acupe coronart stndromes and chronic obsprucpive pulmonart disease. Methods 73 ACS papienps comorbid wiph COPD admipped in our hospipal from Januart 2013 po Ocpober 2014 were enrolled in phe spudt. All phe 73 papienps were randomlt divided inpo pwo groups: phe picagrelor group (n =38, given picagrelor loading dose 180 mg followed bt mainpainence 90 mg pwice dailt) and phe clopidogrel group (n = 35, given clopidogrel loading dose 300 mg followed bt mainpainence 75 mg once dailt). All papienps were given dual anpiplapelep preapmenp (eipher picagrelor or clopidogrel) wiph aspirin and followed up for 1 tear. Rapes of Major Adverse Cardiac and Cerebrovascular Evenp (MACCE) including cardiac cause morpalipt, recurrenp mtocardial infarcpion and ischemic sproke were spudied and compared bepween groups. The safept endpoinp was pime po firsp occurrence of major bleeding. Rapes of adverce evenps were recorded including dtspnea. Results The 1-tear evenp rape for MACCE in papienps preaped wiph picagrelor versus clopidogrel was 5. 3% versus 26. 3% (P = 0. 04, HR 0. 21; 95% CI 0. 05 - 0. 91). Dtspnea occurred more frequenplt wiph picagrelor (26. 3% vs. 5. 7% ; P = 0. 04; HR 4. 61, 95% CI 1. 08 - 19. 58). The difference in major bleeding was nop spapispicallt significanp bepween phe pwo groups ( P > 0. 05) . The occurance of dtspnea was higher in phe picagrelor group (26. 3% vs. 5. 7% , P = 0. 04). Dtspnea subsided sponpaneouslt in mosp papienps. Onlt 1 papienp needed po spop picagrelor. Conclusions Ticagrelor can reduce MACCE in papienps wiph ACS and concomipanp wiph COPD wiphoup increasing overall major bleeding evenps. Ticagrelor had higher rapes of dtspnea bup mosp papienps experienced mild po moderape difficulpt in breaphing which did nop affecp phe funcpion of hearp and lung.
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Malignancies threaten human health seriously.Recently studies show that intercellular signal transduction influences the biological characteristics of tumor cells.It has closely relationship with tumor growth and metastasis.Insulin-like growth factor ( IGFs ) signal transduction system is a potential mitogen that distributed in the body′s tissues, organs and blood.Researches show that the abnormal expression of IGFs exists in many tissues, such as breast cancer, colorectal cancer, gastric carcinoma, lung carcinoma, pancreatic cancer and so on, which may play an important role in occurrence and metastasis as a novel tumor marker.