Purpose:To evaluate the efficacy and toxicity of combination of MabThera and CEOP regimen in the treatment of aggressive B-cell lymphoma. Methods:21 patients diagnosed as aggressive B-cell lymphoma with median age of 48 years old (from 15 to 68 years old),received the treatment of MabThera plus CEOP regimen. This treatment consisted of MabThera 375 mg/m2 intravenously infusion on day 1,cyclophosphamide 750 mg/m 2 ,epirubicin 60 mg/m 2 ,vincristine 2 mg on day3 ,prednisone 40 mg/m 2 orally taken on day 3～7. Results:In all 21 patients,16 (76.2%) complete response and 3 (14.2%) partial response were observed. Thus,the overall response rate was 90.5%. Moreover,of the remaining patients,1(4.8%) achieved stable disease and 1(4.8%) had progressive disease. In the 19 responsive patients,the follow-up duration were from 2 to 15 months. One case of thyroid lymphoma experienced recurrence after 14 months with complete response. Until now,the other responses have been maintained. Only one dose of MabThera infusion related-toxicity was observed in all who received 87 cycles. The hematological toxicities were mainly leucopenia and neutropenia. 5( 23.8% ) experienced 3-4 grade neutropenia. Only 1 patient developed neutropenia fever. The other non-hematological toxicities were 1-2 grade except grade 3 alopecia. Conclusions:The combination of MabThera and CEOP regimen had high efficacy with mild toxicity in the treatment of aggressive B-cell lymphoma,hopefully may become the standard treatment.

300?10~(9)/L. Results:One hundred and six patients were enrolled into this study. Of the 106 patients, 100 patients completed the study and were evaluable for efficacy. The median nadir of platelet was 49(5-76)?10~(9)/L in the control cycle and 69(6-221)?10~(9)/L in the study cycle. Median durations of PLT≤75?10~(9)/L, ≤50?10~(9)/L, and ≤20?10~(9)/L were 7 (0-26), 2 (0-20), and 0 (0-9) days in control cycle versus 3.5 (0-28) (P0.05) days in study cycle, respectively. The median duration of platelet recovery to 80?10~(9)/L was 5 (1-18) days in control cycle versus 2(0-28) days in study cycle (P

Objective To detect the expression levels of multiple serum chemokines including IFN-inducible T cell chemoattractant (ITAC),Fractalkine,macrophage inflammatory protein (MIP)-3α,IL-8,MIP-lα,MIP-1β in patients with lung cancer and explore their association with the clinical characteristics of lung cancer as well as the correlations among these chemokines.Methods Forty newly diagnosed patients with lung cancer and thirty healthy controls were enrolled for detection of the serum levels of 6 kinds of chemokines by Luminex technology.The correlations of clinical characteristics of lung cancer with these chemokines and the correlations among these chemokines were analyzed by SPSS 17.0 software.Results The serum levels [M (QR)] of IL-8,Fractalkine and MIP-3α in patients with lung cancer were 5.16 (4.74),128.45 (141.89),10.31 (8.88) respectively,and 2.01 (0.95),61.46 (74.81),8.08 (5.87) respectively in control group,with significant differences (Z =-4.783,P ＜0.001;Z =-4.046,P ＜0.001;Z =-3.105,P =0.002).The expression of MIP-1β in lung adenocarcinoma was significantly higher than that in squamous carcinoma [18.32 (12.27) vs.13.72 (7.31),Z =-2.212,P =0.027],and of ITAC in squamous carcinoma was significantly higher than that in small cell lung cancer [24.51 (22.48) vs.9.28 (4.85),Z =-2.460,P =0.014].The expressions of MIP-3α and Fractalkine were positively correlated in the two groups (r =0.619,P＜0.001;r=0.766,P＜0.001).Conclusion The expressions of IL-8,Fractalkine and MIP-3α increase significantly in lung cancer patients,and they are may play important roles in metastatic lung cancer.

Purpose:To investigate the efficacy and adverse effects of irinotecan, a novel and potent inhibitor of topoisomerase Ⅰ, for second line treatment of advanced colorectal cancer.Methods:14 patients who previously failed with fluorouracil treatment received single drug irinotecan 300 mg/m 2 intravenously every 3 weeks . All patients had received adjuvant therapy containing fluorouracil. Two patients had received pelvic radiotherapy.Results:Nine patients had received three cycles and five patients completed six cycles . Ten cases had stable disease, and four with progressive disease were observed among the 14 patients. The common treatment related adverse events were cholinergic syndrome (92.9%) ,delayed diarrhea (78.6%) and neutropenia (78.6%) . Grade Ⅲ side effects occurred in several patients: two nausea/ vomiting , two delayed diarrhea and one neutropenia / leucytopenia . Only one patient developed grade Ⅳ diarrhea.Conclusions: Irinotecan is an active drug in the treatment of advanced colorectal cancer with acceptable toxicity.

Objective To evaluate local moderate hypothermia technology on acute brain hemorrhage cases.Methods 100 patients of cerebral hemorrhage were randomly divided into two groups(moderate hypothermia groupand control group). The moderate hypothermia group was 50 cases treated with moderate hypothermia after routine treatment,the control group was 50 cases with routine treatment. The two groups were assessed after treatment for 21 days. Results The group treated via moderate hypothermia therapy showed the nerve function damages relatively lower than the control group(P < 0.05), and the surviving probability and curative ratio were significant higher than the control group(P< 0.05 ). Conclusion The local moderate hypothermia therapy for acute cerebral hemorrhage patient in clinical can significantly improve the never cell function and reduce mortality and disablement.

Objective To investigate the therapeutic effect of the sandwich method (medical glue +gelatin sponge+medical glue) in the repair of spinal dura mater to prevent the cerebrospinal fluid leakage.Methods From February 2007 to June 2011,54 patients with spinal subdural tumors underwent excision of tumor in our hospital.According to manner of repairing spinal dura mater,all patients were classified into two groups:routine group and sandwich group.There were 16 males and 7 females with an average age of 45.2±7.2 years in the routine group,while 19 males and 12 females with an average age of 44.2±6.4 years in sandwich group.In routine group,the spinal dura mater was repaired through running locked suture.In sandwich group,the spinal dura mater was repaired through running locked suture,painting medical glue around the dural incision,covering with gelatin sponge,and painting medical glue on the surface and margin of gelatin sponge successively.Results Compared with the routine group,the total volume of postoperative drainage in sandwich group decreased significantly on the very day,the first day,the second day,and the third day,and the incidence of cerebrospinal fluid leakage decreased significantly.Before discharge,hydrops happened in 3 cases in the routine group,and got well through aspiration,continuous pressure by sandbag,and prone position.Three months after operation,5 cases from the routine group got deep hydrops under the incision and no treatment was applied to them.There was no obvious abnormality in the sandwich group.Conclusion The sandwich method can improve the repair effect of spinal dura mater injury,reduce the volume of postoperative drainage,and decrease the incidence of cerebrospinal fluid leakage

Objective To detect the expression levels of serum ITAC, Fractalkine, IL-8, IL-17A, IL-7 and TNF-α in patients with gastric cancer, and to explore correlation among them, as well as their association with different clinical characteristics.Methods The levels of the 6 kinds of cytokines in serum of 46 gastric cancer patients (gastric cancer group) and 30 healthy people (healthy control group) were detected.Results Compared with those in healthy control group, the levels of serum ITAC, Fractalkine, IL-8, IL-17A, IL-7 and TNF-α in gastric cancer group were significantly increased [22.26 (32.83) pg/ml vs 11.95 (9.99) pg/ml, P =0.001;62.21 (82.23) pg/ml vs 26.47 (50.87) pg/ml, P =0.050;4.50 (10.38) pg/ml vs 2.06 (3.17) pg/ml, P =0.002;0.83 (2.01) pg/ml vs 0.21 (0.85) pg/ml, P=0.013;3.46 (1.90) pg/ml vs 2.11 (1.48) pg/ml, P=0.001;1.21 (1.13) pg/ml vs 0.79 (0.37) pg/ml, P ＜ 0.001].There were correlations between cytokines (all P ＜ 0.05).The level of serum cytokines was no significant difference between gastric cancer patients with lymph node metastasis and those without lymph node metastasis (P ＞ 0.05).Conclusions The high level of serum ITAC, Fractalkine, IL-8, IL-17A, IL-7 or TNF-α may be related to the occurrence and development of gastric cancer.High level of serum IL-8 may be a marker of poor prognosis of gastric cancer, and interaction between the various cytokines also has a certain association with tumorigenesis.

10.3969/j.issn.2095-4344.2013.26.007

Objective:To evaluate the efficacy and toxicity of single-agent bendamustine in patients with indolent B-cell non-Hodgkin's lymphoma (NHL) refractory to rituximab. Methods:Between April 2010 and April 2013, 100 patients with rituximab-refrac-tory indolent B-cell NHL from 8 institutions were enrolled. Bendamustine was administered at 120 mg/m2 on days 1 and 2 every 21 days for 6-8 cycles. The primary endpoint was the overall response rate (ORR). The secondary endpoints included disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and safety. Results:One hundred patients with a median age of 56 (rang-ing from 28 to 74) years were recruited in this clinical study. The total number of chemotherapy was 447 cycles, and the median number was 4 cycles. Ninety-three patients could be evaluated for efficacy. Fifteen patients (16.1%) had complete remission (CR), 52 (55.9%) had partial remission (PR), 22 (23.7%) had stable disease (SD), and 4 (4.3%) had progression disease (PD). The ORR and DCR were 72%and 95.7%, respectively. After a median follow-up of 26.6 months (ranging from 2 to 48.4 months), 59 patients (63.4%) had PD.The median PFS was 8.53 (95%CI:6.518-10.542) months, and PFS rate for 1 year was (40.6±5.3)%. Forty-eight patients (48%) had 3/4 grade adverse events, including leucopenia (26%), neutropenia (24%), and anemia (11%). Conclusion:Single-agent bendamustine produced a high rate of objective responses in patients with rituximab-refractory indolent B-cell NHL and could be one of the new op-tions for second-line treatment of these patients. The most common adverse event is hematologic toxicity.

Objective To develop an SPE‐HPLC method for the determination of methotrexate (M TX) in human plasma to monitor the clinical drug use of M TX ,and to identify the human metabolite of M TX by mass spectrometry .Methods M TX was extracted from human plasma using C18 SPE column and analyzed directly after elution .The separation of MTX was per‐formed on Diamonsil C18 column (150 mm × 4 .6 mm ,5 m) with a gradient mobile phase of methanol and 0 .5% acetic acid solu‐tion (containing 0 .3% triethylamine) at a flow rate of 1 .0 ml/min .The detection wavelength was 306 nm .QLMS and MRM‐IDA‐EPI scan modes were used to obtain the mass spectrum of MTX metabolite .Results The calibration curve of MTX in plasma was linear over the range of 0 .05‐100 μmol/L(r=0 .999 9) .The extraction recovery was above 95% and accuracy was between 97% and 105% .Both intra‐and inter‐day precision were less than 5% .7‐OH MTX was identified to be the metabolite through the analysis of the mass spectrum .Conclusion The method is sensitive ,reproducible ,easy to operate and suits for monitoring the concentration of M TX in clinical practice .