Effect of PEG-rhG-CSF in Preventing Chemotherapy-induced Neutropenia in Locally Advanced Non-small Cell Lung Cancer Patients at Nutritional Risk / 肿瘤防治研究

Objective To explore the efficacy and safety of polyethylene glycol recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) in preventing chemotherapy-induced neutropenia in locally advanced non small cell lung cancer (NSCLC) patients at nutritional risk. Methods A total of 337 locally advanced NSCLC patients at nutritional risk were selected. They were randomly divided into three groups: 112 cases in the non-prophylactic drug group (control group), 112 cases in the prophylactic use of rhG-CSF treatment group (rhG-CSF group), and 113 cases in the prophylactic use of PEG-rhG-CSF treatment group (PEG-rhG-CSF group). The incidence and duration of neutropenia after chemotherapy and the ratio of CD4+/CD8+T cells in peripheral blood were observed. Results The incidences of neutropenia in the control group, rhG-CSF group, and PEG-rhG-CSF group were 67.97%, 41.57%, and 38.98% (P < 0.05), respectively. The incidences of grade Ⅲ-Ⅳ neutropenia in the three groups were 22.39%, 14.25%, and 11.14% (P < 0.05); moreover, the incidence of febrile neutropenia in the three groups was 3.55%, 1.84%, and 1.21% (P < 0.05); in addition, the ratios of CD4+/CD8+T cells in peripheral blood were 1.27±0.44, 1.41±0.52, and 1.49±0.42 (P < 0.05). The duration of grade Ⅲ-Ⅳ neutropenia and the time required for the neutrophil value to reach 2.0×109/L from the lowest value in the PEG-rhG-CSF group were lower than those in the control and rhG-CSF groups (P < 0.05). Conclusion The PEG-rhG-CSF preventive treatment used in the course of chemoradiotherapy in locally advanced NSCLC patients at nutritional risk can reduce the incidence of neutropenia and improve immunologic function. PEG-rhG-CSF preventive treatment is worthy of clinical recommendation.

Clinical research of transurethral turning holmium laser enucleation of the prostate in the treatment of benign prostatic hyperplasia / 中华泌尿外科杂志

Objective To compare the efficacy and safety of turning holmium laser enucleation of the prostate (THoLEP) and transurethral holmium laser enucleation of the prostate (HoLEP) in the treatment of benign prostatic hyperplasia (BPH).Methods A retrospective analysis of 532 patients with BPH surgery from January 2016 to December 2017 was performed,including 289 cases of transurethral resection of holmium laser enucleation (THoLEP) and 43 cases of transurethral holmium laser enucleation (HoLEP).Cases with incomplete data were excluded.Finally,100 patients were enrolled and divided into THoLEP group and HoLEP.The mean ages of patients in the THoLEP group and the HoLEP group were (74.6 ± 8.2) years and (75.3 ± 7.7) years,respectively.The prostate weights were (52.3 ± 23.1) g and (52.6 ± 22.7) g,respectively.International prostate symptom scores (IPSS) were (22.8 ± 1.3) and (23.1 ± 1.6),and the quality of life score (QOL) scores were (4.4 ± 0.5) and (4.3 ± 0.8),respectively.The rate of mximum flow rate (Qmax) was (5.9 ± 2.7) ml/s and (6.3 ± 2.8) mL/s,respectively.The residual urine volume was (149.3 ± 8.7) ml and (145.3 ± 9.7) ml,respectively.There was no significant difference between the two groups (P ＞ 0.05).Results Compared with HoLEP group,THoLEP group showed shorter operation time [(44 ± 13) min vs.(61 ± 15) min,P ＜ 0.05] and less intraoperative bleeding [(101.6 ± 13.2) ml vs.(119.9 ± 18.0) ml,P ＜ 0.05].The weight of the resected tissue in the THoLEP group was slightly larger than that in the HoLEP group,however the difference was not statistically significant [(30.5 ± 9.5) g vs.(28.7 ± 8.5) g] (P ＞ 0.05).The incidence of transient urinary incontinence in THoLEP group was less than that in HoLEP group [2 and 4 cases,P ＜ 0.05].There were no cases of urinary incontinence in both groups after 3 months,and no permanent urinary incontinence in both groups.THoLEP was slightly better than HoLEP group,but the difference was not statistically significant (P ＞0.05).Conclusions Compared with HoLEP,THoLEP has similar short-term results,and has more advantages in shortening the operation time,reducing intraoperative bleeding and transient urinary incontinence.It is a safer and effective method for the treatment of benign prostatic hyperplasia.

Detection and clinical significance of apoptosis related protein in local advanced rectal cancer patients with preoperative neoadjuvant therapy / 中华外科杂志

<p><b>OBJECTIVE</b>To discuss the mechanism of rectal cancer apoptosis induced by preoperative chemoradiotherapy and evaluate its effect by detection of apoptosis related proteins in locally advanced colorectal cancer patients who had received preoperative chemoradiation.</p><p><b>METHODS</b>To detect Bcl-XL and Bax expression in rectal cancer before and after chemoradiotherapy by EnVision method, combined with patients clinical and pathological index, statistically analysis and evaluation their relationship and clinical significance.</p><p><b>RESULTS</b>Patients with or without tumor shrinkage after preoperative chemoradiotherapy was 13 cases and 21 cases. While the positive rate of Bcl-XL in rectal cancer before and after chemoradiotherapy were 58.8% (20/34) and 52.9% (18/34), respectively. There were significant difference between Bcl-XL change before and after chemoradiation with tumor size, tumor cells shrinkage and operation pattern. The positive rate of Bax in rectal cancer before and after chemoradiotherapy were 32.4% (11/34) and 44.1% (15/34), respectively. There were no significant difference between Bax change before and after chemoradiotherapy with tumor cells shrinkage. There were statistically significant difference between Bax ratio (χ(2) = 9.607, P = 0.048) before and after chemoradiation while there were no significant difference between Bcl-XL/Bax ratio before and after chemoradiation with tumor shrinkage. According to layered analysis with preoperative therapy, there were statistically significant difference (χ(2) = 13.964, P = 0.007) between Bcl-XL change with operation pattern while the same of significant difference between Bax change with tumor infiltration and tumor shrinkage (χ(2) = 10.806 and 10.455, both P < 0.05).</p><p><b>CONCLUSIONS</b>Preoperative chemoradiation can influence rectal cancer cell's apoptosis and treatment effect by changing Bcl-XL and Bax expression. Bcl-XL downregulation and Bax upregulation have shown important function in colorectal cancer cell apoptosis which induced by preoperative chemoradiation, it can also improve the effection of chemoradiation in rectal cancer.</p>

Diagnosis and treatment of basaloid squamous cell carcinoma of the esophagus / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the histopathological features of basaloid squamous cell carcinoma of the esophagus, and to explore the ways of its diagnosis, differential diagnosis and treatment.</p><p><b>METHODS</b>The clinical data and pathological features of 23 cases of esophageal basaloid squamous cell carcinoma were reviewed and analyzed retrospectively.</p><p><b>RESULTS</b>The tumors were mainly located at the middle third segment of the esophagus. The 1-,2- and 3-year survival rates were 60.9%, 21.7% and 0, respectively.</p><p><b>CONCLUSION</b>The basaloid squamous cell carcinoma of the esophagus is highly malignant with poor prognosis. Radical resection combined with radiotherapy and chemotherapy is required.</p>