The management of locally advanced esophageal carcinoma has been changed in recent years.More and more evidence confirmed the role of neoadjuvant chemoradiation plus surgery in the treatment of locally advanced esophageal cancer.Further research should be focused on how to target the particular population sensitive to chemoradiation.This article summarizes current knowledge of related literature on combined therapy of locally advanced esophageal cancer and serves as a background for the setup of a national standarized strategy for the treatment of locally advanced esophageal carcinoma.

Carcinoma, Squamous Cell ; diagnosis ; therapy ; China ; Combined Modality Therapy ; Esophageal Neoplasms ; diagnosis ; therapy ; Esophagectomy ; methods ; Esophagoscopy ; Humans ; Neoplasm Staging ; Practice Guidelines as Topic ; standards ; Research

Antineoplastic Agents ; therapeutic use ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; surgery ; Chemotherapy, Adjuvant ; Combined Modality Therapy ; Humans ; Lung Neoplasms ; drug therapy ; surgery ; Molecular Targeted Therapy ; Neoadjuvant Therapy

Objective To observe the consistency of MRI imaging and pathological examination.To discuss the value of MRI imaging in assessing the curative effect of neoadjuvant chemotherapy in breast cancer.Methods 98 patients with breast cancer were selected as research subjects.All patients received six cycles of neoadjuvant chemotherapy,and underwent surgical treatment after the end of chemotherapy.All of them were performed with MRI examination before and after 6 cycles of chemotherapy.The evaluation of MRI in assessing the neoadjuvant chemotherapy and postoperative efficacy of breast cancer were compared for the consistency.Results The total effective rate by pathological examination of 98 cases of breast cancer after 6 cycles of neoadjuvant chemotherapy was 71 .4%,and the effective rate by MRI examination was 74.5%,and two evaluation results were basically consistent.The sensitivity, specificity and accuracy of MRI to assess the complete response (CR)patients after chemotherapy were 87.3%, 67.1 % and 78.2%,respectively,which of the partial response(PR)patients were 92.5%,59.7% and 85.9%, respectively.The tumor shrinkage of 22 patients was reduced towards the heart,with 23 branches reduced according to the MRI image.The average gap between MRI measured maximum tumor diameter and pathological examination results was (0.42 ±0.27)cm.Conclusion The evaluation of MRI in assessing the neoadjuvant chemotherapy was consistent with the pathology results,which could be used for clinical treatment and surgery program,worthy of clinical application.

Objective To investigate diagnosis value of abnormal distribution of electrophysiological parame -ters in Guillain-Barre syndrome .Methods 40 cases of Guillain-Barre syndrome were chosen as an object of study ,all patients electrophysiological examination .Record limbs on both sides ,upper and lower extremities and proximal and distal motor nerve distal latency ( DML ) , motor conduction velocity ( MCV ) , compound muscle action potential (CMAP)and sensory conduction velocity (SCV) were recorded.Results F wave latency mildly abnormal ,moderately abnormal and severe abnormalities were 18.3 %,6.2 %and 5.3%,totaling 29.8%,F-wave occurrence rate mildly abnormal,moderately abnormal and severe abnormalities were 9.3 %9.8%and 15.6%,totaling 66.9%.Abnormal sensory conduction velocity was 57.5%,motor conduction velocity anomaly was 75.7%, there was a statistically sig-nificant difference between the two groups (χ2 =5.34,P<0.05).bilateral tibial nerve tests showed mild ,moderate and severe in patients with H-reflex abnormality rates were 78.0%,80.9%and 100.0%,among the three comparison (Uc=1.47,P>0.05).3 proximal and distal motor nerve severe damage rates were 48.3 percent and 74.5 percent, the difference was statistically significant (χ2 =9.86,P <0.05).Severe upper limb proximal nerve damage was 51.4%,significantly lower than 71.6%of the distal upper extremity ,lower extremity proximal nerve severe damage to 44.2 %,significantly lower than the 81.6% of distal lower extremity between them were statistical difference (χ2 =8.86,12.43,all P<0.05).Conclusion Electrophysiological parameters detection Guillain-Barre syndrome has a high value,which can be accurate response in patients with neurological damage .

The prevalence of esophageal cancer in China is significant. Surgery remains to be the mainstay treatment for esophageal cancer. Standardized surgical procedure and radical lymph node dissection is the base of multimodality treatment, which is also related to the success of the treatment and prognosis. At present, synchronized preoperative chemoradiation is recommended for operable esophageal cancer. Use of preoperative radiation is not associated with increased difficulty in performing surgery or increased complications. Preoperative chemotherapy alone is not recommended. NCCN recommends 5-fluorouracil-based adjuvant therapy administered synchronously with radiation. In China, postoperative synchronized chemoradiation is recommended for II(B-III) esophageal cancer. Large-scale, multi-center, prospective controlled clinical trials are warranted to determine the optimal combination of therapeutic alternatives to benefit patients the most.
Combined Modality Therapy ; Esophageal Neoplasms ; therapy ; Humans

Medical Oncology ; trends

Tamoxifen has shown definitive effect when used as the adjuvant hormonal treatment in women with estrogen-receptor-positive breast cancer. However, long-term use of Tamoxifen can induce fatty liver disease. It has been proposed that tamoxifen may act throught mechanisms such as inducing triacylglycerol accumulation in mitochondria, abnormal fatty acid oxidation, and antagonizing actions of estrogen on hepatic lipid metabolism. Therefore, it is necessary to monitor lipid profile and liver function, conduct regular ultrasonography and CT examination in patients receiving tamoxifen treatment. Replacing tamoxifen with toremifene oraromatase inhibitors, or using lipid-lowering medicines may help prevent tamoxifen-induced fatty liver disease.

BACKGROUND:As the latest generation of ultrahigh molecular weight polyethylene, vitamin E-stabilized ultrahigh molecular weight polyethylene has been widely put into use of various kinds of joint replacement. However, wear debris and osteolysis caused by that are stil the vital factor influencing the clinical curative effect. OBJECTIVE:To discuss and summarize the material characteristics and application progress of vitamin E-stabilized ultrahigh molecular weight polyethylene, and to seek the theoretical basis which can guide us to launch vitamin E-stabilized ultrahigh molecular weight polyethylene clinical y. METHODS:The first author retrieved the CNKI and Medline databases by computer. The keywords were“ultra-high molecular weight polyethylene, vitamin E-stabilized, joint replacement, application”in English. RESULTS AND CONCLUSION:Total y 92 articles were retrieved. According to the inclusion and exclusion criteria, 46 articles were included in result analysis. The results show that vitamin E-stabilized ultrahigh molecular weight polyethylene can not only enhance the physicochemical property of prosthesis, but also can integrate with free radicals to increase antioxidant rate of prothesis in order to prolong the long-term curative effect of prosthesis. However, it is stil lack of vast of clinical cases and fol ow-up as evidence. In case of that, long-term clinical efficacy remains to be assessed.