Purpose: To evaluate the efficacy and toxicity of combination chemotherapy with paclitaxel and oxaliplatin (two new drugs) in patients with locally advanced and(or) metastatic gastric adenocarcinoma ( M/AGC). Methods: Between May 2001 and May 2002, 30 patients (22 male and 8 female) with a median age of 58 years (range35-80) were consecutively enrolled in this study. Oxaliplatin and paclitaxel were administered as a two-hour infusion every one or two weeks, respectively, and DDP or FUDR were infused in abdominal cavity every one week. Results: Thirty patients were evaluable for activity, with 2 complete and 17 partial responses, objective response rate( RR): 63% ( 95% CI: 46% -80%). Twenty-three of thirty patients (77%) experienced WHO grade Ⅰ-Ⅳ bone marrow suppression, which was the most common and serious toxicity. WHO Grade Ⅰ-Ⅲ side effect ( non-hematological toxicity) of gastrointestinal tract, liver, peripheral neuropathy, kidney , mucositis and heart occurred in 40%, 30%, 13%, 10%, 10% and 7% of patients, respectively. No patients withdrew because of treatment-related toxicity. Conclusions: Our data suggest that the combination of paclitaxel and oxaliplatin has promising therapeutic activity in patients with advanced gastric cancer. This regimen shows good efficacy and an acceptable safety profile in M/AGC patients, and may prove to be a suitable alternative regimen in this indication, especially for the patients with bad function of the heart , liver and kidney or old, physically weak patients.

Purpose:To explore the relationship between the infection of Helicobacter pylori (Hp), cell apoptosis and the expression of EGFR,VEGF in gastric mucosa and the gastrocarcinogenesis in Changle city, where has a high incidence of gastric carcinomas. Methods:The status of Hp infection was detected by the serum Hp antibody detection and the Hp special staining. The in situ TUNEL method was used in the apoptosis index (AI) detection. The immunohistochemical method (with S P kit) was used in the detection of the EGFR, VEGF expression. Results:The present infection rate of Hp in the series of the gastrocarcinogenesis was 74.4%, and was highest in the objects with chronic atrophic gastritis and/or intestinal metaplasia (CAG IM, 92.5%) . The AI was highest in the subjects with CAG IM, and lowest in the subjects with chronic superficial gastritis (CSG), the data were 0.357 and 0.179 respectively. The expression rate of EGFR was highest in the subjects with CAG IM, and lowest in the subjects with CSG, the data were 51.35% and 75% respectively. The expression rate of VEGF was highest in the subjects with GC, and lowest in the subjects with AH, the data were 65% and 35% respectively ( P

Objective To evaluate the sensitivity, repeatability and accuracy of microarray digital PCR system in detecting JAK2 V617F mutation, which was closely related to myeloproliferative neoplasms (MPN).Methods All of the 31 MPN patients with JAK2 V617F mutation, including 18 cases of polycythemia vera(PVs),11 primary thrombocythemias (ETs) and 2 primary myelofibrosis (PMFs), were collected from Huashan Hospital, Fudan University during 2014 -2015, while 10 normal controls and 6 cases with abnormal increased hemoglobin were involved.Human erythroleukemia cell line ( HEL ) and colorectal cancer cell SW480 were used as the mutant and the wild type control, respectively.The sensitivity of microarray digital PCR were verified by detecting the gradient diluted mutation standard harboring 30%, 10%, 1%, 0.1%and 0.01%mutant allele burden, respectively .Repeatability was evaluated by detecting 1%and 10% mutated samples for 5 times, respectively.MGB probe real time PCR was selected as the reference method to verify the accuracy of the digital PCR.Results With digital PCR, the accurate quantitation of JAK2 V617F mutation was achieved down to 0.1%, which is approximate to 0.16 copies per microliter.The results obtained from the two kinds of technique showed a high correlation by linear regression analysis (R2 =0.998 3).The results of repeated samples showed CVs as 17.18% for 1%mutant allele burden and 7.50%for 10%.Among all cases, the 31 patients known mutated were detected as positive and 10 controls as negative by both digital PCR and Real time PCR.In another 6 cases, 2 were found JAK2 V617F mutation of low allele burdens of 0.37% and 0.18% by digital PCR but detected as negative by real time PCR.Conclusions Microarray digital PCR offers a higher sensitivity and better repeatability than real time PCR which could help detect rare JAK2 V617F mutations in MPNs accurately.