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Objective:To evaluate the effect of venous excess ultrasound score (VExUS Score) in the acute kidney injury(AKI) in Patients with sepsis, so as to reduce the risk of disease and improve the prognosis of patients.Methods:This experiment was a single-center prospective cohort study. Include septic patients with AKI who were admitted to the Department of Emergency Intensive Care Unit of the First Affiliated Hospital of Anhui Medical University from February 2022 to February 2023, Those with inadequate window, inferior vena cava (IVC) thrombus, age<18 years and known case of cirrhosis with portal hypertension were excluded from the study. Patients underwent ultrasound examination with serial determination till AKI resolved or patient is initiated on dialysis.Results:Totally 86 patients were enrolled for the study. The mean age was (60.43±15.48) with 50 (58.1%) males. Mean sequential organ failure assessment (SOFA) score was (6.23±1.87). 38 patients (44.2%) were in AKI stage 1, while 24 patients (27.9%) were in AKI stage 2 and stage 3 each. 52 patients (60.5%) had VExUS grade Ⅲ. Resolution of AKI injury showed significant correlation with improvement in VExUS grade ( p value 0.003). Similarly, there was significant association between changes in VExUS grade and fluid balance ( p value 0.005). There was no correlation between central venous pressure (CVP), left ventricular function, and right ventricular function with change in VExUS grade. Conclusions:The study shows a significant correlation between the VExUS Score and AKI staging, With improvement in kidney function, there is decline in the VExUS grade as well. Moreover VExUS Score might reliably demonstrate venous congestion and aid in the clinical decision to perform fluid removal.
摘要
Sesquiterpenoids are natural compounds composed of 15 carbon atoms, which can be divided into sesquiterpene alcohols, ketones, lactones, aldehydes, and carboxylic acids according to oxygen groups. These compounds are widely distributed in nature, and their physiological activities are diverse. For example, many sesquiterpenes with potential anticancer effects have been found for anti-tumor effects, including cytotoxicity, antioxidant, immune regulation, cell proliferation, and so on. In addition, some sesquiterpenoids have good application prospects in antibacterial, anti-inflammatory, and anti-cardiovascular diseases. Malignant tumors, inflammation, bacterial diseases, and cardiovascular diseases are the main diseases that cause human death, and natural products have unique advantages in the treatment of these diseases. Therefore, the development of new drugs that are easy to promote has become a new research hotspot. In this paper, the sesquiterpenes extracted from the natural components of Chinese herbs and plants with anti-tumor, anti-inflammatory, antibacterial, and anti-cardiovascular activities, such as Xanthium, Atractylodes, Convolvulus, Acanthium, Ligularia, Artemisia, Ligularia, Ligularia, Labiaceae Mint, Acanthophyllum, Turmeria, Ginger, and other Chinese herbs and plants, were discussed. The biological activities and related mechanisms of this compound were reviewed, which provided a reference for further research and clinical application of sesquiterpenes.
摘要
Human epidermal growth factor receptor 2 (HER2) -positive breast cancer is prone to metastasis and has a poor prognosis. In the context of the booming development of anti-HER2 targeted therapy, HER2-positive breast cancer has reduced recurrence and metastasis and improved prognosis. However, there are still some HER2-positive breast cancer patients who cannot benefit from anti-HER2-targeted therapy and continue to develop recurrent metastasis. Neoadjuvant therapy, surgical treatment, and the full range of adjuvant and palliative therapies enable HER2-positive breast cancer to benefit from them. Scholars from home and abroad have explored the treatment of HER2-positive breast cancer and have achieved some results. In this article, we review the current status and development of HER2-positive breast cancer treatment.
摘要
Objective:To investigate the biological characteristics of proliferation, apoptosis, migration and invasion of radiation-induced polyploid cervical cancer HeLa cells, and to analyze the potential facilitation of polyploid HeLa cells in cervical cancer recurrence after radiotherapy.Methods:HeLa cells were irradiated by 6 MV-X ray with 7 Gy and 14 Gy, the cells were cultured until the third day, and then they were recorded as 7 Gy group and 14 Gy group respectively. The unirradiated HeLa cells were recognized as the control group. The cell morphology was checked under optical microscope. Flow cytometry was used to determine cell ploidy. MTT assay was applied to detect cell proliferation. Flow cytometry by AnnexinⅤ-FITC/PI double labeling was used to detect apoptosis. The ability of migration and invasion was detected by Transwell assay. The expression levels of STAT3 signal pathway-related proteins were analyzed by Western blotting.Results:Compared with the control group, the volume of HeLa cells in 7 Gy group and 14 Gy group increased significantly. The percentages of polyploid HeLa cell subsets in the control group, 7 Gy group and 14 Gy group were (6.33±1.26) %, (21.13±0.50) % and (46.07±1.68) % respectively, with a statistically significant difference ( F=780.47, P<0.001) . The absorbance values in the control group, 7 Gy group and 14 Gy group of polyploidy HeLa cells were 0.21±0.01, 0.23±0.02, 0.16±0.01 at 24 h, 0.37±0.03, 0.38±0.06, 0.21±0.00 at 48 h, 0.66±0.02, 0.55±0.01, 0.28±0.01 at 72 h, and there were statistically significant differences ( F=31.62, P=0.001; F=20.10, P=0.002; F=708.52, P<0.001) . Further pairwise comparison showed that the proliferation abilities of polyploidy HeLa cells of the 14 Gy group at 24, 48 and 72 h were significantly lower than those of the control group and the 7 Gy group (all P<0.05) . The proportions of apoptotic cell subset in the control group, 7 Gy group and 14 Gy group were (3.67±1.16) %, (3.07±0.81) %, (3.83±0.91) %, the proportions of early apoptotic subset were (2.33±0.35) %, (2.13±0.61) %, (2.23±0.32) %, and the proportions of late apoptotic subset were (1.33±0.81) %, (0.93±0.31) %, (1.60±0.60) % respectively. There were no statistically significant differences ( F=0.52, P=0.620; F=0.15, P=0.864; F=0.92, P=0.450) . The migrated numbers of cells in the control group, 7 Gy group and 14 Gy group were 297.40±26.53, 121.33±15.16, 18.40±4.79, and the invaded numbers were 195.67±20.26, 63.60±6.91, 9.47±3.23 respectively, with statistically significant differences ( F=647.28, P<0.001; F=213.94, P<0.001) . Compared with the control group, the migration and invasion abilities of polyploid HeLa cells in the 7 Gy and the 14 Gy groups were significantly decreased, and the migration and invasion abilities of polyploid HeLa cells in the 14 Gy group were significantly lower than those in the 7 Gy group (all P<0.001) . The expression levels of P-STAT3 (Tyr 705) and Bcl-2 in radiation-induced polyploidy HeLa cells were higher than those in the control group, and the expression levels were further increased with the increase of radiation dose. Compared with the control group, the expression levels of Survivin and Mcl-1 in polyploid HeLa cells in the 14 Gy group were up-regulated (both P<0.05) . There was no significant difference in Bcl-xL expression among the three groups ( F=0.52, P=0.618) . Conclusion:The proliferation, migration and invasion abilities of polyploid HeLa cells are reduced by radiation, and the proportion of apoptotic subset is not significantly changed, but the activation of STAT3 signaling pathway is accompanied by up-regulation of downstream anti-apoptotic related proteins, which is favorable for the polyploid tumor cells to be the potential risk factor of recurrent cervical cancer after radiotherapy.
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Online courses are an indispensable part of medical teaching in the new era. Online courses have good prospects, although also with certain problems in practice. As an important basic medical course, medical genetics has both basic theoretical knowledge and clinical cases, involving basic principles and the latest developments. A single online course or offline teaching model cannot meet the needs of subject development and training a new generation of medical professionals. Therefore, actively exploring the online and offline hybrid teaching model is one of the important topics in the current medical teaching reform.
Subject(s)
Genetics, Medical摘要
Objective@#To assess the association of JAG2 gene single nucleotide polymorphisms with the occurrence of nonsyndromic cleft lip with or without cleft palate (NSCLP) among northwest Chinese population.@*Methods@#A case-control study was carried out on 301 NSCLP patients and 304 healthy controls. An iMLDR™ genotyping technique was used to detect three single nucleotide polymorphisms (SNPs) [rs741859 (T/C), rs11621316 (A/G) and rs1057744(C/T)] of the JAG2 gene. Allelic and genotypic frequencies and haplotypic distribution among the two groups were compared.@*Results@#A significant difference was found in the frequency of C and T alleles for rs741859 between the two groups. The CT genotype of rs741859 could significantly reduce the risk for NSCLP to 65% (P < 0.05) and the risk for cleft lip with or without cleft palate (CL/P) to 62% (P < 0.05). rs11621316 and rs1057744 are in the same linkage disequilibrium (LD) region with a high degree of linkage (r2 > 0.8), whose distribution difference between the two groups was not statistically significant (P > 0.05).@*Conclusion@#The CT genotype of the JAG2 gene rs741859 may confer a protective effect for NSCLP among northwest Chinese population.
摘要
OBJECTIVE@#To assess the association of JAG2 gene single nucleotide polymorphisms with the occurrence of nonsyndromic cleft lip with or without cleft palate (NSCLP) among northwest Chinese population.@*METHODS@#A case-control study was carried out on 301 NSCLP patients and 304 healthy controls. An iMLDR(TM) genotyping technique was used to detect three single nucleotide polymorphisms (SNPs) [rs741859 (T/C), rs11621316 (A/G) and rs1057744(C/T)] of the JAG2 gene. Allelic and genotypic frequencies and haplotypic distribution among the two groups were compared.@*RESULTS@#A significant difference was found in the frequency of C and T alleles for rs741859 between the two groups. The CT genotype of rs741859 could significantly reduce the risk for NSCLP to 65% (P 0.8), whose distribution difference between the two groups was not statistically significant (P> 0.05).@*CONCLUSION@#The CT genotype of the JAG2 gene rs741859 may confer a protective effect for NSCLP among northwest Chinese population.
Subject(s)
Humans , Case-Control Studies , China , Cleft Lip , Genetics , Cleft Palate , Genetics , Gene Frequency , Genotype , Jagged-2 Protein , Genetics , Polymorphism, Single Nucleotide摘要
Objective:To study the migration of polyploid tumor cells induced by docetaxel, the characteristics of epithelial-mesenchymal transition, and the killing effect of immune cells on them, in order to explore the potential role of polyploid tumor cells in tumor recurrence.Methods:The human non-small cell lung cancer A549 cells were treated with 1 μmol/L docetaxel for 24 h, and the cells were collected as Doc 1 d group. After drug removal, the cells were cultured in fresh and complete medium for 3 or 5 days, then the cells were collected as Doc 3 d group or Doc 5 d group respectively. The A549 cells were treated with DMSO for 24 h as control group. Immunofluorescence staining was used to detect cell morphology, flow cytometry was used to analyze cell ploidy, scratch test was used to detect cell migration, Western blotting was used to detect the expression of epithelial-mesenchymal transition related proteins, and lactate dehydrogenase release method was used to evaluate the killing activity of cytokine-induced killer (CIK) cells.Results:Compared with the control group, most of the cells in the Doc 1 d group, Doc 3 d group and Doc 5 d group were apoptotic, a few of the surviving cells were significantly larger, and the nucleus was polynuclear. The proportions of polyploid cell subset (DNA content > 4N) in the control group, Doc 1 d group, Doc 3 d group and Doc 5 d group were (1.93±0.55)%, (22.97±2.37)%, (51.30±12.51)% and (67.87±8.31)% respectively, and the difference among the four groups was statistically significant ( F=26.521, P<0.001). The proportion of polyploid cell subset in Doc 1 d group, Doc 3 d group and Doc 5 d group was significantly higher than that in the control group (all P<0.001). With the prolongation of withdrawal time, the proportion of polyploid cell subset in Doc 3 d group and Doc 5 d group was significantly higher than that in Doc 1 d group ( P=0.009; P=0.004). After 24 h and 48 h culture, the wound healing rates of the control group were both 100%, and the wound healing rates of the Doc 3 d group were (39.10±2.12)% and (46.13±5.32)% respectively, with no significant difference ( t=2.126, P=0.051). Compared with the control group at 24 h and 48 h, the cell migration abilities of Doc 3 d group were significantly lower ( t=49.756, P<0.001; t=30.825, P<0.001). Compared with the control group, the expression of E-cadherin protein decreased gradually in the Doc 1 d group, Doc 3 d group and Doc 5 d group, the expression of Vimentin protein increased gradually, and the expressions of Snail protein and N-cadherin protein did not change significantly. The killing efficiencies of CIK cells against the cells of the control group, Doc 3 d group and Doc 5 d group were (27.27±1.91)%, (17.87±2.35)%, (9.47±0.51)% respectively, and the difference was statistically significant ( F=11.294, P<0.001). The killing efficiency of Doc 3 d group and Doc 5 d group was significantly lower than that of the control group ( P=0.004; P<0.001). The killing efficiency of Doc 5 d group was significantly lower than that of Doc 3 d group ( P=0.003). Conclusion:The migration ability of polyploid tumor cells induced by docetaxel is weakened, but epithelial-mesenchymal transition is likely to occur, and the killing effect of immune cells on them is reduced.
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Objective:To survey the application of an intelligent consultation system for common eye diseases and evaluate its applicational effectiveness on an internet hospital platform.Methods:A cross-sectional study was performed in Zhongshan Ophthalmic Centre of Sun Yat-sen University.Natural language processing technology was applied to develop the intelligent consultation system for common eye diseases.Its efficiency and quality were evaluated.The survey data were collected from February 1 to 29, 2020 to analyze the demographic information, consultation time, consultation category, consultation content, service satisfaction.This study protocal was approved by an Ethic Committee of Zhongshan Ophthalmic Centre of Sun Yat-sen University(2020KYPJ095).Results:The intelligent consultation system for common eye diseases was developed and successfully deployed in Internet Hospital of Zhongshan Ophthalmic Center.The repeatability and accuracy of the intelligent consultation system were 100.0% and 99.8%, respectively.During February 1 to 29, 2020, the intelligent consultation system served 6 462 patients, including 3 082 males(47.7%) and 3 380 females(52.3%). The average age of patients was 32.3 years old.Total of 1 135(17.6%) patients used the intelligent guidance consultation, and 5 375(82.4%) patients used the intelligent outpatient consultation.The intelligence consultation system was applied by 223 patients per day with a maximum of 74 patients per hour.The survey showed that 25.6% and 36.4% of the patients felt very satisfied and relatively satisfied with the efficiency of the intelligent consultation service, respectively; 24.3% and 37.8% of the patients were very satisfied and relatively satisfied with the quality of the intelligent consultation service, respectively.Conclusions:Intelligent consultation system for common eye diseases can meet the needs of patients because of its high repeatability and accuracy.Patients are satisfied with the service efficiency and quality of the intelligent consultation system, which avoids the risk of cross infection and releases the burden of medical staff.
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Objective:To investigate the clinical significance of the serum platelet-derived growth factor BB (PDGF-BB) level in the diagnosis and treatment monitoring of non-small cell lung cancer (NSCLC) patients.Methods:Serum samples of 111 NSCLC patients in Xuzhou Cancer Hospital of Jiangsu Province and 105 healthy controls from Outpatients Department of Nanjing Yian Medical Examination Center between October 2014 and December 2017 were collected. Luminex assay was used to determine PDGF-BB level in serum samples of NSCLC patients and the healthy controls as well as patients after platinum chemotherapy. Receiver operating characteristic curve (ROC) was used to evaluate the diagnostic value of serum PDGF-BB level in patients with NSCLC, and the relationship of serum PDGF-BB level with clinicopathological features of NSCLC patients and platinum chemotherapy and effect was analyzed.Results:Compared to the healthy controls, serum PDGF-BB level was decreased in NSCLC patients [(54±24) ng/ml vs. (125±61) ng/ml, t = 11.09, P < 0.01], and the area under the ROC of serum PDGF-BB level on the diagnosis of NSCLC was 0.890. There were no significant differences in serum PDGF-BB level among NSCLC patients with different gender, age or lymph node metastasis (all P > 0.05); the serum PDGF-BB level in patients with high TNM stage was lower than that in patients with low TNM stage, and the serum PDGF-BB level in patients with low differentiation degree was lower than that in patients with high differentiation degree (all P < 0.05). Serum PDGF-BB level was continued to decrease in NSCLC patients after treatment with platinum-based chemotherapy. Conclusion:Serum PDGF-BB level of NSCLC patients is decreased, and it has a certain clinical significance in the early diagnosis of NSCLC.
摘要
Objective: To investigate the Effects of entinostat on the expression of NKG2D ligands in the non-small cell lung cancer (NSCLC) cell lines, A549 and HCC-827, and to detect the effect of entinostat-mediated NK cell killing of A549 and HCC-827 cells. Meth-ods: The effect of entinostat on A549 and HCC-827 cell proliferation was measured by MTT assay. Flow cytometry was used to detect the expression of NKG2D ligands. mRNA levels of the ligands were detected by RT-PCR . The level of soluble MICA in cell culture super-natant was evaluated by ELISA. The cytotoxicity of NK cells against A549 and HCC-827 cell lines (treated with entinostat) was assessed using lactate dehydrogenase release assay. Results: Entinostat showed a time-and dose-dependent inhibition effect on the prolifera-tion of A549 and HCC-827 cell lines. The expression of NKG2D ligands and mRNA transcription levels of MICA and MICB were en-hanced after treatment with 0.5, 1μmol/L entinostat for 48 h. The soluble MICA level in A549 cell culture supernatant was increased by 1μmol/L entinostat. The sensitivity of HCC-827 cells to NK cells was enhanced upon treatment with 0.5, 1μmol/L entinostat. Con-clusions: entinostat enhanced the killing effect of NK cells on non-small cell lung cancer cells by up-regulating the expression of NKG2D ligands. This provides a new method and theory for the treatment of NSCLC.
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Endocrine therapy is the main treatment of hormone receptor-positive advanced breast cancer.How to reverse the endocrine resistance and the new endocrine therapy have become the focus of attention in the tumor community.The study of cyclin dependent kinase (CDKs) has developed rapidly,and the selective cdk4/6 inhibitors can significantly extend the progression-free survival of patients with endocrine resistance to breast cancer,which has been approved for standard treatment for advanced breast cancer.
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Objective To focus on CT classification and clinical significance for minimal lung adenocarcinoma(MIA),to improve the knowledge of this kind of lung adenocarcinoma.Methods 51 cases of MIA confirmed by histopathology were retrospectively evaluated in our hospital,which were analyzed and classified by CT manifestation.Results Of the 51 patients,according to CT features ,lesions were divided into three types:pure ground-glass nodule (pGGN)(34 cases),mixed ground-glass nodule(mGGN)(8 cases),Part-solid GGN (9 cases).The maximum diameter of pGGN ranged from 0.62-2.41 cm (1.01 cm±0.36 cm),the overall density was uniform and the CT value-plus ranged from 150-512 HU (266 HU±81 HU).mGGN showed scattered punctate or rounded,oval shaped high density in GGN in lung window,which was not visible in mediastinal window.Part-solid GGN showed solid component in both lung window and mediastinal window and the longest average diameter of the solid component ranged from 0.02-0.49 cm(0.2 cm±0.16 cm).While no statistical differences were found between the three types in shape,margin,air bronchogram,pleural retraction,vessel dilatation, but lobular,burr and pleural retraction were observed more frequently in Part-solid GGN and mGGN than that in pGGN.In addition, 50% of lobulation were deep lobulation,which was showed statistical difference between pGGN and mGGN/Part-solid GGN groups. Conclusion MIA has multiple CT manifestations,the morphology and size of solid component plays an important role in the diagnosis of MIA. For pGGN,lesion size and CT value-plus should be considered when diagnosing MIA.
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<p><b>OBJECTIVE</b>To assess the influence of assisted reproductive technology(ART) on the incidence of fetal chromosomal abnormalities by analyzing spontaneous abortions during the first trimester following natural conception(NC) or assisted reproductive technology(ART).</p><p><b>METHODS</b>Three hundred and fourteen chorionic villus samples of women with first trimester spontaneous abortion were collected. Cell culture and G-banding karyotyping analysis were carried out, which included 125 cases by in vitro fertilization(IVF), 87 cases by intracytoplasmic sperm injection(ICSI) and 102 cases by natural conception(NC).</p><p><b>RESULTS</b>Chromosomal aberrations were found in 167(53.2%) of the 314 cases. No significant difference was found in the spectrum of karyotypic abnormalities between NC and ART groups. The incidence of chromosomal abnormalities has increased along with the maternal age. Compared with the fresh embryo-transfer(ET) group, frozen-thawed embryo transfer(FET) group showed a slightly lower incidence of chromosomal abnormalities, albeit with no statistical significance(47.3% vs. 53.8%, P>0.05).</p><p><b>CONCLUSION</b>Fetal chromosomal abnormalities are the main cause for spontaneous abortion during the first trimester regardless the ways of conception. Their incidence is associated with maternal age. FET is relatively safe as well as fresh ET. ART is a relatively safe treatment which does not increase the rate of fetal chromosomal abnormalities.</p>
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Objective To explore the feasibility of novel nano-particle HIF-1 α@Fe3 O4 labeled pancreatic cancer PANC1 cells as well as the changes of signal intensity in 3.0T MRI scan.Methods Pancreatic cancer PANC1 cells were cultured in hypoxia condition,and hypoxia-inducible-factor-1 α(HIF-1 α) and stem cell markers CD133,Oct-4,Sox-2 were detected by Western blot assay.Cells cultured under hypoxia for 24 h were collected and then co-incubated with 5,15 and 45 μg/ml HIF-1α@Fe3O4 for 24 h.The number of HIF-1 α@Fe3O4 labeled PANC1 cells and cell survival rate were detected,and the signal intensity of T2 WI image for PANC1 cells was measured by a 3.0T MRI system.Results In hypoxia condition,HIF-1 α level was obviously increased compared with that of normoxic culture,which was further increased with the increase of hypoxia time(all P < 0.05).Stem-cell markers CD133,Oct-4 and Sox-2 was positively correlated with HIF-1α level.Co-cultured with different concentrations of HIF-1α@Fe3O4 for 24 h,blue-stained iron particles in cytoplasm of PANC1 cells was dosage-dependently increased,and the peak was at the concentration of 45 μg/ml,which could reach 100%.The survival rate of the PANC1 cells cultured in normoxic condition,the unlabeled and labeled in hypoxic condition group were(87.0 ± 2.1) %,(84.7 ± 2.7) % and (85 ± 3.8) %,respectively,and the difference was not statistically significant (P > 0.05).In 3.0T MRI scan,T2 WI signal intensity in unlabeled group and 5,15 and 45 μg/ml labeled group was 1.017 ± 0.046,0.793 ± 0.041,0.447 ± 0.032 and 0.240 ± 0.031,and the difference was not statistically significant (F =80.0,P > 0.05).Conclusions Hypoxia condition could promote and maintain the stemness in PANC1 cells.HIF-1α@Fe3O4 probe could successfully label HIF-1α highly expressed PANC1 cells during hypoxia condition,and a significant decrease in T2WI signal intensity can be detected by a 3.0T MRI system.
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Objective@#To explore the clinical characteristics, therapeutic methods and effects of blood blister-like aneurysms (BBA) of the supraclinoid segment of the internal carotid artery (ICA).@*Methods@#A total of 40 patients with BBAs of the ICA treated at Department of Neurosurgery of West China Hospital between January 2010 and January 2016 were retrospectively reviewed. There were 14 males and 26 females with the mean age of 44.7 years (ranging from 25 to 64 years). There were 38 patients presented with subarachnoid hemorrhage (SAH), and 2 patients were found incidentally with unruptured aneurysms in regular examination. Surgical treatment was performed in 22 patients, including direct clipping, clipping over wrapping and trapping. Endovascular treatment with single or multiple stents and coiling was performed in 18 patients. Clinical outcomes were assessed with modified Rankin Scale. The patients were followed up with CT angiography.@*Results@#Direct clipping of BBA was performed in 18 patients, clipping over wrapping in 3 patients and trapping of ICA in 1 patient. Intraoperative rupture occurred in 5 patients. Postoperative cerebral infarction developed in 6 cases, 4 patients died. Single stent-assisted coiling was performed in 8 cases, and multiple stents with coiling in 10 patients. Procedure-related hemorrhage occurred in 2 patients, postoperative massive cerebral infarction developed in 1 patient with stent-assisted coiling. The follow-up time was 26.8 months (ranging from 6 to 72 months), among the patients with surgery, good results (modified Rankin Scale 0-2) were achieved in 16 patients; one patient was score 3, and the other was 4. In endovascular group, 15 patients had good results and one with mRS 4. Follow-up angiography revealed recurrence of BBA in 2 patients treated with stent and coiling, which was retreated with coiling. No recurrence was found in surgical group.@*Conclusions@#BBA of the supraclinoid ICA is a specific and complicated intracranial aneurysm with high risk and complications no matter the treatment is surgical or endovascular, take proper operation methods could achieve satisfactory results.
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In recent years,tumor immunotherapy has attracted more attention because of its remarkable curative effect in patients with advanced cancer,but often accompanied by immune related adverse events.Understanding the immune related adverse reaction rate,possible mechanism and adverse reaction evaluation criteria and treatment principle of the immune checkpoint inhibitors such as Ipilimumab,Nivolumab and Pembrolizumab,has important significance for the treatment of malignant tumor.
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Breast cancer stem cells (CSCs) are the main causes leading to the failure of treatment of breast cancer and play important roles in the progression of breast cancer and drug resistance, which are closely related to the therapeutic resistance of radiotherapy and chemotherapy, and endocrine therapy.The metastatic potential and therapeutic resistance of CSCs are associated with epithelial mesenchymal transition and Hedgehog, Wnt, interleukin-6/signal transduction and tanscriptional activation factor 3, transforming growth factor-β and other signaling pathways.While some of the targeted drugs targeting these signaling pathways are undergoing clinical transformation, which is expected to provide new approach for the clinical treatment of breast cancer.
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Objective:This study evaluates the relationship between carcino-embryonic antigen (CEA) and carbohydrate antigen 153 (CA153) continuous and remarkable reduction after chemotherapy and no-imaging progression in patients with advanced breast can-cer. Methods: Medical records of 93 patients who received chemotherapy in the Oncology Department of the General Hospital of Shenyang Military Command were included in the retrospective analysis. A total of 188 CEA and CA153 serum data were collected from response evaluations that included 105 CEA cases and 139 CA153 cases. Predictive validity of serum CEA and CA153 was as-sessed for diagnosing no-imaging progression. Results:CEA was continuously reduced by 10%, with sensitivity of 54.1%and specificity of 95%. CA153 was continuously reduced by 40%, with sensitivity of 19.1%and specificity of 96.6%. Conclusion:Serum CEA and CA153 could be considered as response evaluation tools when they are continuously reduced by at least 10%and 40%, respectively.
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<p><b>OBJECTIVE</b>To explore the safety and efficacy of pegylated recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) in preventing chemotherapy-induced neutropenia in patients with breast cancer and non-small cell lung cancer (NSCLC), and to provide the basis for clinical application.</p><p><b>METHODS</b>According to the principle of open-label, randomized, parallel-group controlled clinical trial, all patients were randomized by 1∶1∶1 into three groups to receive PEG-rhG-CSF 100 μg/kg, PEG-rhG-CSF 6 mg, or rhG-CSF 5 μg/kg, respectively. The patients with breast cancer received two chemotherapy cycles, and the NSCLC patients received 1-2 cycles of chemotherapy according to their condition. All patients were treated with the combination chemotherapy of TAC (docetaxel+ epirubicin+ cyclophosphamide) or TA (docetaxel+ epirubicin), or the chemotherapy of docetaxel combined with carboplatin, with a 21 day cycle.</p><p><b>RESULTS</b>The duration of grade 3-4 neutropenia in the PEG-rhG-CSF 100 μg/kg and PEG-rhG-CSF 6 mg groups were similar with that in the rhG-CSF 5 μg/kg group (P>0.05 for all). The incidence rate of grade 3-4 neutropenia in the PEG-rhG-CSF 100 μg/kg group, PEG-rhG-CSF 6 mg group, and G-CSF 5 μg/kg group were 69.7%, 68.4%, and 69.5%, respectively, with a non-significant difference among the three groups (P=0.963). The incidence rate of febrile neutropenia in the PEG-rhG-CSF 100 μg/kg group, PEG-rhG-CSF 6 mg group and G-CSF 5 μg/kg group were 6.1%, 6.4%, and 5.5%, respectively, showing no significant difference among them (P=0.935). The incidence rate of adverse events in the PEG-rhG-CSF 100 μg/kg group, PEG-rhG-CSF 6 mg group and G-CSF 5 μg / kg group were 6.7%, 4.1%, and 5.5%, respectively, showing a non-significant difference among them (P=0.581).</p><p><b>CONCLUSIONS</b>In patients with breast cancer and non-small cell lung cancer (NSCLC) undergoing TAC/TA chemotherapy, a single 100 μg/kg injection or a single fixed 6 mg dose of PEG-rhG-CSF at 48 hours after chemotherapy show definite therapeutic effect with a low incidence of adverse events and mild adverse reactions. Compared with the continuous daily injection of rhG-CSF 5 μg/kg/d, a single 100 μg/kg injection or a single fixed 6 mg dose of PEG-rhG-CSF has similar effect and is more advantageous in preventing chemotherapy-induced neutropenia.</p>