Oxaliplatin or irinotecan containing chemotherapeutic regimen is the standard treatment for metastatic colorectal cancer (mCRC), which achieves more than 20 months of overall survival. The addition of cetuximab or bevacizumab to the chemotherapy further improves the outcome. The major achievement for the therapy of mCRC in 2008 is the correlation between K-ras status and the efficacy of anti-EGFR therapy. Data from three randomized clinical trials CRYSTAL,OPUS and CELIM have demonstrated that the analysis of K-ras status can help select patients who may benefit from anti-EGFR antibody treatment. The addition of cetuximab to either oxaliplatin or irinotecan containing regimens can benefit mCRC patients with wild-type K-ras tumors, which shows the great superiority of cetuximab in the first-line treatment of mCRC.

Small cell lung cancer (SCLC) are divided into limited and extensive stage diseases. Limited-stage SCLC (LS-SCLC) is conifned to the ipsilateral hemithorax and within a single radiotherapy region, 30%-40%of patients with SCLC are limited stage. The median ranges of survival for patients with LS-SCLC is from 15 to 20 months. Approximately 20%-40%of patients with LS-SCLC can survive for two years. According to the guidelines, patients with LS-SCLC should be treated with combined concurrent chemoradiotherapy and patients with LS-SCLC achieving a complete remission or patient with stage I disease who have had resection should be offered prophylactic cranial irradiation (PCI). Whereas in SCLC, targeted therapies is still in the early stage and few clinical trial data is available to support its effect.

Objective To compare the clinical results of radial head resection with those of open reduction and internal fixation in treatment of Mason type- Ⅲ comminuted fracture of radial head. Methods 58 cases of Mason type- Ⅲ radial head fracture were treated in our department from January, 1983 to July, 2005. 28 cases had resection of the fractured redial head, while the other 30 cases had open reduction and internal fixation. The outcomes were assessed on the basis of pain, motion, strength, radiographic findings, and elbow functional rating score. Results The resection group had a mean follow- up of 5.5 years (2 to 6), while the internal fixation group had 10 years (3 to 13). The average pain VAS (visual analog scale) score was 18.7 (11 to 25) for the resection group and 23.5 (17 to 25) for the fixation group with a P value of 0.0023. The elbow extension averaged - 12.4? in the resection group and - 5.8? in the fixation group (P0.05) , but the decrease of elbow extension and forearm rotation differed statistically between the 2 groups (P

OBJECTIVEThis study was conducted to investigate the correlation between anemia and postoperative chemotherapy in elderly cancer patients.

METHODSOne hundred and fifty-seven elderly patients ( age ≥ 60) with pathologically confirmed breast, lung and digestive tract cancers, who had HGB ≥ 120 g/L and ECOG scores 0-2, were included in this study. We reviewed their clinicopathological data and analyzed the correlation of anemia in breast cancer patients after 1, 3 or 5 cycles and lung cancer patients after 1, 2 or 3 cycles of postoperative chemotherapy.

RESULTSAmong the 157 cases, the overall proportion of anemia was 31.8% (50/157) , with 18.8% in male and 47.2% in female patients (P < 0.001). After three cycles of chemotherapy, the proportion of anemia was 57.9% in lung cancer, 34.5% in breast cancer, 26.3% in gastric cancer and 9.3% in colorectal cancer patients (P < 0.001). The proportion of anemia during 5 cycles chemotherapy (three cycles in lung cancer) was gradually increasing. In the lung cancer patients, anemia was observed in 66.7% of patients who received vinorelbine plus cispiatin regimen and 25.0% of cases who received vinorelbine regimen chemotherapy (P = 0.044).

CONCLUSIONSIn most elderly patients with normal hemoglobin level and in good conditions, the chemotherapy-related anemia is mild and less frequent. Age should not limit the adjuvant chemotherapy in elderly cancer patients. Attention should be paid to the possibility of anemia in elderly female lung cancer patients receiving multiple cycle platinum-based chemotherapy regimens.

Aged ; Anemia ; chemically induced ; epidemiology ; Antineoplastic Agents ; adverse effects ; Breast Neoplasms ; drug therapy ; Chemotherapy, Adjuvant ; Cisplatin ; adverse effects ; Colorectal Neoplasms ; drug therapy ; Female ; Humans ; Lung Neoplasms ; drug therapy ; Male ; Middle Aged ; Stomach Neoplasms ; drug therapy ; Vinblastine ; adverse effects ; analogs & derivatives

Objecitive The research was in order to explore the roles of MMP-2,MMP-3 and MMP 9 which played in the gastric cancer cell metastasis,and make a further study of the clinical signifance.Methods Both SGC-7901 and GES-1 were cultured in vivo.The migra-tion were examined by Wound-healing and the Transwell assay.The expression of MMP-2,MMP-3 and MMP 9 in the medium were detected by ELISA.The positive rate of MMP-3 in the gastric cancer,gastritis and normal was used the IHC,and the serum of MMP-2,MMP-3 and MMP-9 were also examined by ELISA.Results Both Wound-healing and Transwell assay showed that the migration of SGC-7901 cells was more quicker than the GES-1.Comparing to GES-1,the MMP-2,MMP-3 and MMP-9 were higher in the SGC-7901.The immunohistochemical results showed that the positive rate of MMP-3 in the gastric cancer patients was 84.4%,it was higher than the latter.The serum levels of MMP-2 MMP-3 and MMP-9 were also significantly higher than others.Conclusion The migration of gastric cancer cells was depended on the MMP-2,MMP-3 and MMP-9.The 3 proteins can be used for the diagnosis of gastric cancer patients,and it also avail to make the judgment the prognosis of patients with gastric carcinoma.

Objective To evaluate the effects of combined induction therapy of interferon(IFN) and chemotherapy on survival of the patients with small cell lung cancer(SCLC)by meta-analysis.Methods Search all of clinical trials for addition of IFN to initial chemotherapy and single chemotherapy for induction therapy in SCLC patients in MEDLINE、EMBASE and COCHRANE Library.The references of related studies and education books of ASCO and ESMO meeting were handsearched.The quality of included trials was evaluated.Data were extracted by two reviewers independently with a designed extraction form.Revman 4.2.7 software was used for data analysis.Results The addition of IFN increased 1-year survival and response rate,but both of the results had no significant statistical difference.Conclusion IFN-chemotherapy induction treatment might not influence survival and response rate of patients with NSCLC.To resolve the problem,a series of controlled,prospective,randomized,double-blind,well-designed,multi-center trials should be performed.

Objective To study the toxic effects of Rotenone on glutamate transporter and glutamine synthetase in rat brain.Methods The glutamate levels in the striatum of SD rats were detected by high performance liquid chromatography(HPLC),the expression of glutamate tansporter mRNA and proteins were detected by RT-PCR and Western blotting and the activity of glutamine synthetase was determined by using GS detect kit.Results Rotenone was shown to increase the release of glutamate in rat striatum,the expression of glutamate/aspartate transporter(GLAST)mRNA and protein decreased significantly in 0.6 mg/kg and 1.2 mg/kg Rotenone intoxicated groups,but the expression of GLT-1 and the activity of GS enhanced obviously.Conclusion Down-regulation of GLAST may be responsible for increased Glu level in rat brain induced by Rotenone,but the increased expression of GLT-1 and GS activity may represent a protective mechanism of the brain cells by limiting the neurotoxicity of Glu.

Objective To observe the clinical effects of Naloxone and Methylprednisolone(MPS) on therapy of severe bronchiolitis. Methods 98 cases of severe bronchihtis were randomly divided into 2 groups,the Naloxone/MPS treating group and the control group,the later only give regular treatment. Results The Naloxone/MPS treating group scored significantly lower at the time of 48 hours and 5 days(P＜0.001),according to cough,dyspnia and other respiratory symptoms,and the efficacy of Naloxone/MPS treatment is appreciately higher than control(P＜0.01). Conclusion Naloxone and MPS therapy shows remarkable clinical beneficial effects on severe bronchiolitis.

Objective To verify the validity and feasibility of national early warning score (NEWS) in evaluation of death risk in elderly patients with critical illness,in order to find out which scoring method is more suitable for elderly critical illness patients.Methods A prospective case-control study was conducted.The critical illness patients aged over 60 years old with the length of hospital stay over 24 hours,and admitted to Department of Emergency of Qingdao Municipal Hospital from January to December 2015 were enrolled.The clinical data including in emergency and the actual outcome of patients were collected,and the patients were divided into death group and survival group according to 30-day outcome.Patients in the two groups were assessed by using NEWS and risk classification according to the first results of vital signs monitoring.Multivariate logistic regression model was used to analyze the relationship between the NEWS classification and the risk of death in elderly critical ill patients.Results 1 950 emergency elderly patients with critical illness were enrolled,with 78 cases (4.0％) dead within 30 days and 1 872 survived (96.0％).Compared with the survival group,patients in death group were older (years:79.8 ± 10.8 vs.75.3 ± 8.9,t =4.335,P ＜0.001),and had higher acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score (22.9± 4.6 vs.18.2 ± 4.8,t =8.487,P ＜ 0.001),lower Glasgow coma scale (GCS) score (12.2 ± 4.5 vs.13.4 ± 5.2,t =-2.007,P =0.045),higher incidence of respiratory system diseases (29.5％ vs.17.9％,x 2 =12.742,P =0.013),higher NEWS score (11.2 ± 5.5 vs.3.9 ± 2.7,t =22.063,P ＜ 0.001),as well as higher proportion of patients with NEWS classification of high risk and very high risk (65.4％ vs.15.8％,x 2 =263.125,P ＜ 0.001).With the increase of NEWS risk classification,mortality rate was also increased,and the mortality rate in the patients with low,medium,high and very high risk were 0.81％ (9/1 108),3.63％ (18/496),5.83％ (13/223),30.89％ (38/123),respectively,with statistically significant difference (x 2 =179.741,P ＜ 0.001).It was showed by logistic regression analysis that the NEWS score of elderly patients with critical illness were positively correlated with 30-day death.The 30-day death risk of patients with middle risk,high risk and very high risk was 4.600,9.052 and 54.598 folds of the patients with low risk respectively.Conclusion NEWS score can be used to assess the risk of death in emergency elderly patients with critical illness.NEWS risk classification can quantify and classify the risk of death in the elderly patients with critical illness.