Metastatic colorectal cancer is a major cause of cancer-related mortality. Surgical resection of all known metastatic disease can be curative in selected patients. The majority of patients,however,require systemic chemotherapy as optimal palliative treatment for their disease. For years,effective treatment for advanced colorectal cancer was limited to fluorouracil. In the 1990s,two additional agents,irinotecan and oxaliplatin,were found to have activity against advanced colorectal cancer. Recently,new molecular targeted agents,bevacizumab and cetuximab,were for the first time demonstrated efficacy. Herein,we review recent developments in treatment for metastatic colorectal cancer and implication for optimal treatment in these patients.

Multidrug resistance (MDR) is the most common cause in the failure of cancer chemotherapy. Drug transporters play an important role in multidrug resistance in cancer. Activation of drug pumps which belong to ATP-binding cassette (ABC) transporters leads to the efflux of drug via cell membrane.Three subgroups of ABC transporters are involved in the transport of cytotoxic drugs.These transporters include ABCB subgroup,ABCC subgroup and ABCG subgroup. In this review,the author discussed the recent research advances in the ABC transporters associated with MDR.

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

Mucosa-associated lymphoid tissue lymphomas are a distinct subgroup of non-Hodgin's lymphoma with a particular clinicopathologic behavior.It is the most common type of extranodal low-grade B cell lymphoma.This type of lymphoma tends to appear in patients with a history of autoimmune disease or chronic inflammatory disorders.These indolent lesions usually remain localized for long periods and often respond to local therapy.The most common site of MALT lymphoma is the stomach.This article reviews clinical features and management of MALT lymphoma,emphasizing on gastric MALT lymphoma.

ObjectiveTo compare the clinical efficacies between bloodletting cupping plus acupuncture and acupuncture alone in treating hypertension.MethodSixty patients with primary hypertension were randomized into a treatment group and acontrol group, 30 cases in each group. The treatment group was intervened by bloodletting cupping plus acupuncture, while the controlgroup was by acupuncture. The clinical symptoms, blood pressure, and hemorheological parameters were observed before and after intervention.ResultThe clinical symptoms were improved in both groups after intervention, and the total effective rate was 76.7%in the treatment group versus 63.3% in the control group; the blood pressure dropped in both groups, and the differences were statistically significant between the two groups (P<0.05); the treatment group was superior to the control group in improving the whole blood viscosity and erythrocyte sedimentation rate(P<0.01).ConclusionBloodletting cupping is effective in treating primary hypertension; regarding the short-term therapeutic efficacy, bloodletting cupping plus acupuncture can produce a more significant effect than acupuncture alone in improving the blood pressure, whole blood viscosity, and erythrocyte sedimentation rate in primary hypertension patients.

OBJECTIVE:To summarize the clinical effect of compound glycyrrhizin(CG)on SARS.METHODS:The clin?ical data of73patients with clinically diagnosed SARS(37cases were treated by CG)were prospectively analysed.RESULTS:After CG treatment,the symptoms of dry cough,chest distress and dyspnea improved quickly and the elevated serum level of aminotransferase decreased.The maximal dosages of corticosteroids used in CG group and control group were(354.3?219.8)mg/d and(430?262.6)mg/d,respectively.The average time to occurrence of antibody,duration for reduction of corticosteroid dosage and duration of hospital stay were shorter in CG group than those in control group.There was no significant difference in titer value of antibody between two groups.CG had little effects on WBC,blood sugar and electrolytes.CONCLUSION:CG may be a promising drug against SARS with less side effect.

OBJECTIVE:To summerize the characteristics and variability of chest X-ray manifestations in SARS patients treated with compound glycyrrhizin.METHODS:60cases of SARS were equally divided into2groups:groupⅠreceiving compound glycyrrhizin,groupⅡ(as control)receiving conventional treatment.The appearing time,site,scope and dynamic changes of the pulmonary lesions on chest radiograms were compared between2groups.RESULTS:The average period from peak to50%improvement of lesion in X-ray manifestations was shorter in groupⅠthan that in groupⅡ.In restoration stage,more patients had their X-ray findings absorbed in groupⅠcompared with the patients in groupⅡ.Compound glycyrrhizin had little influence on WBC,blood sugar and electrolytes.CONCLUSION:Glycyrrhizin may be a promising drug against SARS with less side effects.

Objective Serum miRNA has been regarded as a potential biomarker for diagnosis, therapeutic evaluation and prognostic prediction in cancer patients. This study aims to explore the clinical significance of the expression level of metastasis- related microRNA (miR- 18b) in the serum in AFP- negative (≤ 20 ng/ml) hepatocellular carcinoma(HCC) patients receiving radiofrequency ablation (RFA). Methods A total of 131 HCC patients with negative serum AFP, who were encountered during the period from January 2007 to January 2011 at authors’ hospital, were enrolled in this study. Radiofrequency ablation (RFA) of the lesions was carried out in all patients. Serum samples were collected before RFA. Forty - three healthy individuals were selected for control. The expression level of serum miR - 18b was deternmined by using quantitative real- time PCR method in all the patients and the healthy individuals. The correlations of the expression level of serum miR - 18b with clinico - pathological factors, postoperative recurrence, overall cirrhosis (P = 0.035), tumor diameter (P < 0.01) and tumor differentiation (P = 0.020). During the follow-up period, 79 patients (60.3%) developed recurrent tumors, and the expression level of serum miR- 18b in them was dramatically higher than that in the patients showing no recurrence (3.26 ± 1.28 vs. 2.42 ± 0.86, P <0.01). The incidence of recurrence after RFA, especially distant intrahepatic metastasis, in patients with higher expression level of serum miR- 18b was strikingly higher than that in patients with lower expression level of serum miR- 18b (72.3% vs. 48.5%, P = 0.005). Kaplan- Meier survival analysis indicated that both overall survival rate and recurrence- free survival rate of patients with higher expression level of serum miR-18b were significantly lower than those of patients with lower expression level of serum miR- 18b. Conclusion The expression level of serum miR - 18b is significantly elevated in AFP - negative HCC patients. The expression level of serum miR- 18b might be used as an ideal biomarker for monitoring tumor recurrence as well as for predicting prognosis after RFA.

Objective To evaluate the treatment effect and security of transcatheter arterial chemoembolization(TACE)combined with sorafinib for intermediate-advanced hepatocellular carcinoma.Methods From July 2008 to November 2010,the treatment effects of two groups of patients with advanced hepatocellular carcinoma were retrospectively analyzed and compared,including 44 patients treated by sorafenib combined with TACE(test group)and the other 44 patients treated only with TACE(control group).To assess the treatment effect based on mRECIST,the time for patients' tumor progression(TTP),overall survival(OS)time and adverse events were recorded.Survival rate were analyzed using KaplanMeier method and Log-rank analysis in SPSS 18.0.Results Till January 2011,24 patients(54.5％)survived and 20 patients(include patients lost to visit)died(45.5％)among the test group,13 patients survived(29.5 ％)and 31 patients(include patients lost to visit)died(70.5 ％)among the control group.No complete remission condition was observed in all patients.Among the test group,1 patient got partial remission,24 ones remain stable and 19 patients got progression.While among the control group,conditions remained stable in 21 patients and progressed in rest 23 ones.The disease control rate(DCR)in the test group and control group were 56.8％(25/44)and 47.7％(21/44)respectively,with no statistical significance(x2 =0.729,P =0.393).The median overall survival time(mOS)of test group and control group were 21.0(95 ％ CI:14.9-27.1)months and 10.0(95 ％ CI:6.4-13.6)months respectively,and the difference reached statistical significance(x2 =7.436,P =0.006).The median time to tumor progression(mTTP)of test group and control group was 1 1.0(95％ CI:8.7-13.3)and 6.0(95％ CI:3.9-8.1)months respectively,and the difference had statistical significance(x2 =10.437,P =0.001).The adverse events of test group mainly included hand-foot skin reaction,loss of appetite,fever,fatigue and diarrhea.The adverse events of control group mainly included fever,loss of appetite,nausea,vomiting and fatigue.The incidences of hand-foot skin reaction,baldness,diarrhea were significantly higher in test group than those in the control group(P ＜0.05).In most patients,these side effects were mild-to-moderate,and alleviated remarkablely after symptomatic treatment.Conclusions Compared with TACE alone,TACE combined with sorafenib can prolong the OS and TTP significantly for the patients with intermediate-advanced hepatocellular carcinoma.However,the DCR of the two groups has no statistical significance.

OBJECTIVE: To explore the significance of hMSH2 aberrant expression in patients with sporadic colorectal cancer in Xinjiang Uygur Autonomous Region. METHODS: Clinicopathological parameters and postoperative samples of 327 patients with sporadic colorectal cancer were collected in Xinjiang Uygur Autonomous Region. Immunohistochemistry PV-9000 two-step method was performed to measure hMSH2 expression in the postoperative pathologic specimens. Prognostic value of hMSH2 expression was evaluated. RESULTS: Thirty-five (10.7%) patients showed aberrant nuclear staining of hMSH2 expression. The patients with aberrant expression of hMSH2 showed better prognosis than the normal expression group, with significant difference (P<0.05). CONCLUSION In Xinjiang, aberrant hMSH2 expression can be regarded as an independent prognostic factor in patients with sporadic colorectal cancer.
Colorectal Neoplasms ; genetics ; metabolism ; Humans ; Immunohistochemistry ; MutS Homolog 2 Protein ; genetics ; metabolism ; Prognosis