Clinical significance and diagnostic value of Golgi-protein 73 in patients with early-stage primary hepatocellular carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To explore the clinical significance and diagnostic value of GP73 in early-stage primary hepatocelluar carcinoma (PHC).</p><p><b>METHODS</b>GP73 levels in 50 healthy controls, 65 cases of liver cirrhosis and 40 early stage PHC were detected by ELISA. The areas under ROC, sensitivities and specificities were also compared. The relationship between GP73 and liver function parameters was analyzed.</p><p><b>RESULTS</b>The median of serum GP73 in early PHC was 291.3 µg/L, significantly higher than that in the cirrhosis group 211.8 µg/L and in the control group 58.3 µg/L (all P<0.01). The sensitivity of GP73 (72.5%) was significantly higher than that of AFP (50.0%), P<0.05. The specificity of GP73 (70.4%) was lower than that of AFP (95.7%), P<0.05. The sensitivity and specificity in combination for diagnosis were 77.5% and 79.1%, and the area under ROC curve in the combining form was 0.838 (95% CI:0.760-0.917). In the early PHC patients, the median of GP73 in the Child C group was 365.2 µg/L, significantly higher than that in the Child B group 310.6 µg/L and Child A group 266.4 µg/L, P = 0.002. In patients with liver cirrhosis, the median of GP73 in the Child B group was 307.3 µg/L, significantly higher than that in the Child A group 176.6 µg/L, P = 0.031. The level of serum GP73 was positively correlated with ALT, AST, negatively with ABL, A/G, and with no significant correlation with AFP, TBLB, DBLB, IBLB, and GGT.</p><p><b>CONCLUSIONS</b>GP73 has a superior sensitivity in detecting early-stage PHC in liver cirrhosis patients. The sensitivity can be further increased by combining with AFP. The changes of GP73 expression may be related with the decline of liver function.</p>

Clinical study of Philadelphia chromosome-positive adult acute lymphoblastic leukemia / 中华血液学杂志

<p><b>OBJECTIVE</b>To study the clinical characteristics, risk factors and therapeutic outcome of Philadelphia chromosome-positive adult acute lymphoblastic leukemia (Ph(+)aALL).</p><p><b>METHODS</b>The clinical data of 117 newly diagnosed adults with Ph(+)ALL in our hospital between January 1995 and December 2009 were retrospectively analyzed. And their prognoses were followed up.</p><p><b>RESULTS</b>There were 117(16.1%) of 727 aALL patients diagnosed as Ph(+)aALL. Among the 117 cases, 64.1% patients were classified as pre-B immunophenotype and 31.3% as common B immunophenotype, 37.5% patients with co-expression of myeloid antigens (CD13 or CD33), and 98.4% patients with positive CD34. The complete remission (CR) rate after 1 or 2 cycles of induction chemotherapy was 62.2% in Ph(+)aALL group versus 82% in Ph(-)aALL group (P = 0.000). The median disease-free survival time of Ph(+) group was 6 months and the median survival time was 9 months. Sole karyotype abnormality subgroup t(9;22) accounted for 53% of all Ph(+)aALL patients and additional karyotype abnormality subgroup, t(9;22) plus other chromosome variation, accounted for 47%. Patients in sole karyotype abnormality subgroup had slightly lower CR rate (59.6% vs 62.5%, P = 0.768), longer median survival time (7 months vs 4 months, P = 0.158), and higher 3-year overall survival rate (27.3% vs 14.4%, P = 0.271). For the myeloid antigen co-expressed patients and the only lymphocytic antigen expressed ones, CR rate was 56.0% and 61.5% (P = 0.750), the median survival time was 5 months and 4 months (P = 0.182), and the 3-year overall survival rate was 16.0% and 15.0% (P = 0.354), respectively. In the imatinib plus combination chemotherapy treatment group, 81.3% patients achieved CR, compared with that of 58.3% in patients treated with only traditional combination chemotherapy (P = 0.083). The median survival time was 9.5 months and 6 months (P = 0.003) in these two subgroup, and 3-year overall survival rate was 52.2% and 10.3% (P = 0.029), respectively. For the patients receiving allo-HSCT after CR and that receiving traditional consolidation chemotherapy, the median survival time was 15 months and 6 months (P = 0.000), and the 3-year overall survival rate was 62.0% and 10.3% (P = 0.000), respectively. For the patients receiving imatinib as consolidation-maintenance treatment and that receiving allo-HSCT, the median survival time was 12 months and 15 months (P = 0.300), and the 3-year overall survival rate was 64.7% and 62% (P = 0.505), respectively.</p><p><b>CONCLUSION</b>Of all adult ALL patients, the Ph(+) subgroup accounted for about 16.1%, which have unfavorable prognosis such as lower CR rate and shorter survival duration under traditional chemotherapy. Neither additional chromosome abnormalities to t(9;22) nor co-expression of myeloid antigen had negative effect on CR rate and survival duration. Addition of imatinib to the therapy was beneficial to improve the CR rate and survival duration. Either receiving imatinib as consolidation-maintenance treatment or allo-HSCT after complete remission can improve long-term survival rate of Ph(+) adult ALL group significantly.</p>

Comparison between therapeutic effects of acupuncture and intravenous injection of amiodarone in the treatment of paroxymal atrial fibrillation and atrial flutter / 中国针灸

<p><b>OBJECTIVE</b>To probe the feasibility of acupuncture in conversion of paroxymal atrial fibrillation and atrial flutter.</p><p><b>METHODS</b>Eighty cases of atrial fibrillation and atrial flutter were randomly divided into 2 groups, a treatment group and a control group, 40 cases in each group. The treatment group were treated with acupuncture at Neiguan (PC 6), Shenmen (HT 7), Danzhong (CV 17) and others, and the control group with intravenous injection of amiodarone. The cardiac rhythms and side effects were observed in the two groups.</p><p><b>RESULTS</b>The total effective rate of 85.0% in the treatment group was better than 67.5% in the control group (P < 0.01). The average conversion time was (39.6 +/- 13.7) min in the treatment group and (50.1 +/- 14.8) min in the control group with a significant difference between the two groups (P < 0.01). No adverse effect was found in the treatment group.</p><p><b>CONCLUSION</b>Acupuncture is a safe and effective therapy for conversion of paroxymal atrial fibrillation and atrial flutter.</p>

Long-term outcome of antireflux surgery for gastroesophageal reflux disease / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the long-term outcomes of various antireflux procedures for gastroesophageal reflux disease (GERD).</p><p><b>METHODS</b>Between November 1988 and January 2004, 129 patients with GERD underwent antireflux procedures. Six kinds of antireflux procedures were performed including Nissen fundoplication, cardiac oblique invagination (COI) procedure, Belsey Mark IV, Toupet, Thal and Dor procedures. One hundred and sixteen patients were followed up. Esophageal manometry study was carried out in 95 patients preoperatively and 51 postoperatively. 24-hour esophageal pH monitoring were carried out in 56 patients preoperatively and 35 postoperatively. Esophagoscopy were performed in all patients before operation and 48 cases after operation.</p><p><b>RESULTS</b>Clinical symptom scores reduced significantly from 4.1 +/- 0.4 before surgery to 1.1 +/- 1.0 after surgery (t = 27.21, P < 0.01). The outcome of surgery showed excellent in 42 cases (36.2%), good in 60 (51.7%), fair in 7 (6.0%), poor in 7 (6.0%). The long-term follow-up showed excellent or good results in 87.9% of patients. There was no significant difference in Nissen fundoplication, COI procedure and Belsey Mark IV.</p><p><b>CONCLUSIONS</b>There are significant differences in symptom score, esophageal manometry, 24-hour esophageal pH monitoring and esophagoscopy pre- and post-operatively. There is no significant difference in Nissen fundoplication, COI procedure and Belsey Mark IV.</p>

Professor Wu Lian-zhong's experience on four needling methods at Fengchi (GB 20) / 中国针灸

The paper introduces the manipulation and different clinical application examines of the 4 needling methods, oblique needling, horizontal needling, deep needling and transversal needling summarized by Prof. Wu Lian-zhong on the basis of many years's clinical work.