Objective To observe the distribution of cornea Q value in adult myopia,and its relationship with age,sex,eye and refraction.Design Prospective case series.Participants Consecutive 510 patients (1020 eyes) of myopia of adults.Methods Cornea Q values were obtained with OrbscanⅡz Anterior Segment Analysis System in all subjects of adult myopia.Normal distribution test of Q value and correlation analysis with sphere,cylinder,sex,and age were performed.Main Outcome Measures Q value of cornea,corre- lation coefficient.Results In 1020 eyes of adult myopia,the mean Q value was-0.27?0.16 (range from-0.86 to 0.25) with near nor- mal distribution.The difference of Q value between right eyes and left eye was not statistically significant (P=0.675).The Q value be- tween male (-0.26?0.15) and female(-0.27?0.17) was not statistically difference(P=0.697).No significant relation was found Q value with either sphere (r=0.057,P=0.068) or cylinder (r=0.044,P=0.156).Mean Q value of below 20 years old was maximal,-0.24,while over 40 years old was minimal,-0.36,and the difference were statistically significant (P=0.000).Conclusions Q value of cornea has negative shift with the increase of age,especially in over 40 years old.Q value of cornea has no relationship with left or right eyes,sex and refraction,but it is highly customized.

OBJECTIVETo develop quality of life questionnaire of Chinese medicine for postoperative patients with colorectal cancer (QLQ-CMPPCC), thus comprehensively and objectively evaluating the clinical efficacy of Chinese medicine and pharmacy in treating postoperative patients with colorectal cancer (CC).

METHODSThe theoretical structure model of the questionnaire was addressed in combined with basic theories of Chinese medicine according to the principle of WHO quality of life (QOL). The primary questionnaire was developed using methods of structuralization policy making after we extensively retrieve various universal and specific questionnaires for CC cancer patients at home and abroad. The 205 CC patients were tested by questionnaire. The items were screened using experts grading method, item selection analysis, dispersion trends of standard deviation, t-test, correlation coefficient method, factor analysis,and Cronbach's alpha.

RESULTSThe QLQ-CMPPCC was developed containing four domains of physical, psychological, independence, and social functions, involving 20 aspects and 54 items. Of them, non-fistula patients answered 43 items and fistula patients answered 46 items. One item covered the general QOL evaluation.

CONCLUSIONSQLQ-CMPPCC showed Chinese medical features. It comprehensively reflected the connotation of QOL for postoperative CC patients. It could be taken as a tool for evaluating Chinese medical efficacy for postoperative CC patients.

Colorectal Neoplasms ; surgery ; Humans ; Medicine, Chinese Traditional ; methods ; Postoperative Period ; Quality of Life ; Surveys and Questionnaires ; Treatment Outcome

OBJECTIVETo evaluate the effect of thoracic radiation therapy (TRT) on patients with extensive stage small-cell lung cancer (SCLC).

METHODSOne hundred and fifty-four patients with extensive stage SCLC treated in our department between January 2003 and December 2006 were enrolled in this study. Eighty nine patients received chemotherapy and thoracic radiation therapy (ChT/TRT), and 65 patients were treated with chemotherapy alone (ChT without TRT). The chemotherapy was CE (carboplatin and etoposide), PE (cisplatin and etoposide) or CAO (CTX, ADM and VCR) regimens. The total dose of thoracic irradiation was 40-60 Gy with 1.8 - 2.0 Gy per fraction.

RESULTSFor the whole group, the median survival time (MST) was 13.7 months, the 2-year and 5-year overall survival rates were 27.9% and 8.1%, respectively. The MST, overall survival rates at 2 years and 5 years in the ChT/TRT group and ChT without TRT group were 17.2 months, 36.0%, 10.1% and 9.3 months, 16.9%, 4.6%, respectively (P = 0.001). The median progression-free survival (PFS) for all patients was 8.0 months, the 2-year and 5-year PFS were 13.6% and 8.2%, respectively. The median PFS, 2-year and 5-year PFS in the ChT/TRT group and ChT without TRT group were 10.0 months, 17.4%, 10.5% and 6.2 months, 9.8%, 4.9%, respectively (P < 0.001). The incidence of intra-thoracic local failure was 29.6% in the ChT/TRT group and 70.0% in the ChT/without TRT group (P = 0.000).

CONCLUSIONSChemotherapy plus thoracic radiation therapy can improve the overall survival, progress free survival and reduce local regional failure rate in patients with extensive stage SCLC compared with that by chemotherapy alone.

Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Carboplatin ; therapeutic use ; Cisplatin ; administration & dosage ; Combined Modality Therapy ; Disease-Free Survival ; Etoposide ; administration & dosage ; Humans ; Lung Neoplasms ; drug therapy ; radiotherapy ; Prognosis ; Small Cell Lung Carcinoma ; drug therapy ; radiotherapy ; Survival Rate

OBJECTIVETo study the prognostic implications of hematopoietic cell transplantation-specific comorbidity index (HCT-CI) on non-relapse mortality (NRM) and overall survival (OS) in patients underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT).

METHODSClinical data of 161 cases received allo-HSCT from July 2003 to November 2010 were analyzed retrospectively. The prognostic significance of HCT-CI, age, sex, conditioning regimens, disease status before transplantation, graft source and the degree of HLA matches for NRM and OS was conducted by COX regression model. The prognostic impact of HCT-CI on NRM and OS was performed in all patients under different disease status before transplantation.

RESULTSOf the 161 cases with allo-HSCT, 3-year NRM and OS were 26.4% and 61.4% respectively. NRM at 3 years in patients with HCT-CI score 0, 1-2 and ≥3 were 14.9%, 24.5% and 52.7% respectively. And OS at 3 years were 68.9%, 64.6% and 34.7% respectively. There were significant differences between HCT-CI score 0 and ≥3 groups for NRM and OS (P<0.01). High-risk disease status before transplantation (NRM: RR=3.35, P<0.01;OS: RR=3.53, P<0.01) and HCT-CI score≥3 (NRM: RR=6.85, P<0.01;OS: RR=3.77, P<0.01)were independent risk factors by COX regression model. In the subgroup analysis according to disease status, high score of HCT-CI was associated with poor OS (P<0.01) and high NRM (P<0.01) in patients with low-risk, but not in those with high-risk disease status.

CONCLUSIONHCT-CI score and disease status before transplantation are independent risk factors for patients received allo-HSCT. HCT-CI score have prognostic implication for NRM and OS in patients with low-risk disease status, but not in high-risk group.

Adolescent ; Adult ; Child ; Child, Preschool ; Comorbidity ; Female ; Hematopoietic Stem Cell Transplantation ; adverse effects ; mortality ; Humans ; Leukemia ; epidemiology ; Male ; Middle Aged ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors ; Transplantation, Homologous ; Young Adult

This study was purposed to analyze the clinical characteristics and prognostic factors in patients with primary gastrointestinal non-Hodgkin's lymphoma (PGI-NHL). The pathological data of 101 PGI-NHL patients admitted in our hospital in the past 15 years were analyzed retrospectively. The results showed that 101 patients with PGI-NHL accounted for 14.49% of NHL in the same period, there were 64 males, 37 females, the range of ages was from 18 to 87 years old, median age was 61 years old; in disease distribution, the stomach PGI-NHL accounted for 58.42%, intestine PGI-NHL accounted for 39.60%, multiple GI involvements (MGI) accounted for 1.98%; in pathological type, diffuse large B cell lymphoma (DLBCL) accounted for 66.34%, mucosa-associated lymphoid tissue (MALT) lymphoma accounted for 17.82%, mantle cell lymphoma (MCL) accounted for 3.96%, enteropathy-associated T cell lymphoma (EATL) accounted for 7.92%, extra-nodal nasal type NK/T cell lymphoma accounted for 1.98%, follicular lymphoma (FL) accounted for 0.99%, small lymphocyte lymphoma (SLL) accounted for 0.99%. Eighty-nine out of 101 patients were followed up (49 cases live, 40 cases dead), data of the 12 patients were lost; the median survival time was 29 months (1 - 173). The three-year OS and five-year OS were 58.4% and 52.6% respectively. Univariate analysis revealed that the factors affecting OS included sex (P = 0.004), lesion site (P = 0.002), tumor size (P = 0.011), clinical Lugano staging for gastrointestinal non-Hodgkin's lymphoma (P = 0.003), IPI score (P = 0.000), pathological cell phenotype (P = 0.001), and pathological type (P = 0.006), their differences were statistically significant (P < 0.05). Multivariate Cox regression analysis indicated that clinical Lugano staging for gastrointestinal non-Hodgkin's lymphoma, IPI score, pathological type were independent prognostic risk factors affecting OS. It is concluded that clinical Lugano staging for gastrointestinal non-Hodgkin's lymphoma, IPI score and pathological type are independent risk factors affecting OS.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Gastrointestinal Neoplasms ; diagnosis ; mortality ; pathology ; Humans ; Lymphoma, Non-Hodgkin ; diagnosis ; mortality ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Survival Rate ; Young Adult

OBJECTIVETo investigate the efficacy and treatment outcome of different induction regimens, and different post-remission therapies for adult acute promyelocytic leukemia (APL).

METHODSThe outcome of 73 patients with newly diagnosed APL were retrospectively analyzed. According to the induction regimens, the patients were divided into three groups: chemotherapy-only (14 cases group I), all-trans retinoic acid (ATRA) or combined with chemotherapy (33 cases group II), and ATRA combined with arsenic trioxide (As(2)O(3)) (26 cases group III). The complete remission (CR) rate and the time to CR (TTC) were analyzed. After CR, the patients were divided into 2 groups for post-remission therapies: one with sequential treatment of chemotherapy/ATRA/As(2)O(3) and the other with alternative treatment of chemotherapy/ATRA. The overall survival (OS), disease free survival (DFS) and relapse rate were compared between these two groups. Patients induced CR with both ATRA and As(2)O(3), and then sequentially treated with chemotherapy/ATRA/As(2)O(3) (group A), and those induced CR with ATRA or As(2)O(3) alone and then with non-chemotherapy/ATRA/As(2)O(3) sequentially (group B) were also analyzed and compared for CR, OS and DFS.

RESULTS(1) For induction treatment, the CR rate in ATRA and As(2)O(3) combination group was 100%, in ATRA combined with chemotherapy group was 78.8%, and in chemotherapy-only group was 57.1% (P = 0.030). The median TTC in ATRA with As(2)O(3) combination group was 26 (13 - 40) days being the shortest among the three groups. (2) For the post-remission treatment, 3-year OS rates in group I and group II were (95.7 ± 4.3)% and (68.6 ± 11.2)% (P < 0.05), and 3-year DFS rates were (79.0 ± 9.5)%, and (32.9 ± 15.5)%, respectively (P < 0.01). The relapse rate was 14.8% in group I, and 50.0% in group II (P = 0.011). (3) The CR, 3-year OS and DFS rates in group A were all 100%. The CR rate in ATRA or As(2)O(3) alone induced group was 72.9%, and 3-year OS was (72.3 ± 9.1)% (P < 0.05).

CONCLUSIONSFor adult APL induction with ATRA and As(2)O(3) combination can obtain a higher CR rate, and shorter TTC. The post-remission treatment with sequential chemotherapy, ATRA and As(2)O(3) results in a lower relapse rate, and significantly improves OS and DFS. The ATRA and As(2)O(3) combination induction with the sequential post-remission therapy is the best strategy for APL treatment.

Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Disease-Free Survival ; Humans ; Leukemia, Promyelocytic, Acute ; drug therapy ; Remission Induction ; Tretinoin ; therapeutic use

OBJECTIVEThis study was aimed to investigate whether incorporation of rituximab into high-dose chemotherapy with autologous peripheral blood stem cell transplantation (auto-PBSCT)could improve the survival of patients with diffuse large B-cell lymphoma (DLBCL), and evaluate the safety of this regimen.

METHODSTwenty-five patients (age, 17 - 61 yrs) with DLBCL were treated with a sequential chemotherapy for remission induction, intensive chemotherapy for mobilization of stem cells, and high-dose chemotherapy followed by auto-PBSCT. Among 25 patients, 22 cases were at IV Ann Arbor stage, 60% cases with B symptom, and 10 cases with intermediate-high risk and 2 cases with high risk when evaluated by International Prognostic Index (IPI). The high-dose chemotherapy included BEAM regimen for 21 patients, and TBI conditioning regimen for 4 patients. Each patient received infusion of rituximab at a dose of 375 mg/m(2) for 2 times, each at peripheral blood stem cell mobilization and peripheral stem cell infusion.

RESULTS20 patients achieved complete remission (CR) before transplantation. After high-dose chemotherapy and auto-PBSCT, 92% patients achieved CR. At a median follow-up of 45 months, the estimated 3-year overall survival (OS) and progression-free survival (PFS) were 78.9% and 75.9%, respectively, for all patients; while those were 87.4% and 82.4% for patients achieved CR before auto-PBSCT. Multivariate analysis by Cox regression revealed that failure to achieving CR before auto-PBSCT was an independent prognostic factor affecting OS, while factor affecting PFS was IPI scores. Rituximab was generally well tolerated with few side-effects.

CONCLUSIONOur results suggested that the addition of rituximab to high-dose chemotherapy followed by auto-PBSCT was effective and safe for patients with DLBCL.

Adolescent ; Adult ; Aged ; Antibodies, Monoclonal, Murine-Derived ; therapeutic use ; Combined Modality Therapy ; Female ; Humans ; Lymphoma, Large B-Cell, Diffuse ; therapy ; Male ; Middle Aged ; Peripheral Blood Stem Cell Transplantation ; Rituximab ; Transplantation, Autologous ; Young Adult

The study was aimed to investigate the incidences and risk factors of acute and chronic graft-versus-host diseases (GVHD) and to clarify their effects on relapse and survival of recipients after allogeneic hematopoietic stem cell transplantation (allo-HSCT). The clinical data of 100 cases of allo-HSCT were retrospectively analyzed. The incidences and risk factors of aGVHD and cGVHD, relapse and survival were studied. The results showed that 31 cases developed aGVHD of II - IV grade (34.4%) and 14 cases developed aGVHD of III - IV grade (17.7%). HLA matched or mismatched did not show significant difference in the development of aGVHD of II - IV grade (p > 0.05). Previous occurrence of aGVHD was the risk factor for cGVHD (HR = 2.303, p = 0.088). The female was a favorable factor for cGVHD (HR = 0.401, p = 0.055). The relapse rate was lower in patients who developed cGVHD. The development of aGVHD of II - IV grade was the risk factor for overall survival (p < 0.05). The mortality of patients with aGVHD of III - IV grade and mortality of patients with aGVHD of 0 - I grade were 81.0% and 35.7% respectively, there was very significant difference between them (p = 0.000). In conclusion, till now GVHD and graft-versus-leukemia (GVL) effect can not be separated. The positive effect of GVL could be counteracted by GVHD-related mortality. It is necessary to prevent and control the development of severe aGVHD. The development of local cGVHD may be beneficial to the long-term disease-free survival of patients after allo-HSCT.
Adolescent ; Adult ; Child ; Child, Preschool ; Disease-Free Survival ; Female ; Graft vs Host Disease ; etiology ; mortality ; Hematopoietic Stem Cell Transplantation ; adverse effects ; mortality ; Humans ; Incidence ; Male ; Middle Aged ; Recurrence ; Retrospective Studies ; Risk Factors ; Young Adult

OBJECTIVETo evaluate the image of SPECT/PET (18)F-FDG in monitoring response to therapy for lymphoma patients.

METHODSA retrospective study was performed in 83 SPECT/PET studies for 70 patients with lymphoma from 1998 to 2008 in our hospital. The risk factors for survival rate were analyzed by univariate analysis.

RESULTSForty patients received SPECT/PET after 2 - 4 cycles of chemotheraphy, the median PFS in patients with positive and negative group were 5.5 months and 15.5 months, 2-year PFS were 12.5% and 66.8%; the median OS were 12.5 months and 17 months, and 1-year OS were 28.8% and 94.1%, respectively, all being of significant difference between two groups (P = 0.003). Forty-three patients performed posttreatment SPECT/PET, the median PFS in patients with positive and negative group were 10 months and 23 months, the 2-year PFS were 23.3% and 83.2%; the median OS were 17 months and 27 months and the 2-year OS were 60.0% and 100% respectively, all being of significant difference (P = 0.001).

CONCLUSIONSPECT/PET has significant value in monitoring response to therapy and predicting prognosis for patients with lymphoma.

Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Fluorodeoxyglucose F18 ; Humans ; Lymphoma ; Prognosis ; Retrospective Studies ; Tomography, Emission-Computed, Single-Photon ; Treatment Outcome

This study was purposed to investigate the role of NK-alloreactivity and donor-inhibiting or activating KIR gene in predicting prognosis under unmanipulated allogeneic blood and marrow transplantation. A modified polymerase chain reaction sequence specific primers (PCR-SSP) method was used to typing KIR and HLA genotype of donors and recipients. The relationship between donor activating or inhibitory KIR and recipient HLA genotypes on event free survival (EFS), cumulative incidence of malignant relapse and transplant-related mortality (TRM) were investigated retrospectively in 67 patients undergoing hematopoietic stem cell transplantation. The results showed that no effect of 'KIR/HLA mismatched' was detected on acute graft-versus-host disease (aGVHD) and relapse. The EFS of KIR/HLA mismatched group was lower, especially KIR2DL1/HLA-C2 mismatched group (44.8% vs 69.2%, P = 0.043). However, EFS was better for the presence of donor-activating KIR2DS2 (81.3% vs 52.6%, P = 0.052), and the relapse rate was significantly lower for the presence of this genotype (7.7% vs 34.2%, P = 0.05). EFS was worse in patients homozygous for group 1 HLA-C (C1) when donor carries the activating KIR2DS1 (KIR2DS1 positive/HLA-C2-negative group, P = 0.028), and the incidence of aGVHD in this group was significantly higher than that in any other groups (P = 0.028). In multivariate analysis, advanced disease stage, more than two donor-activating KIR, donor KIR2DS2-negative genotype were associated with an reduced disease-free survival (HR = 3.34, 2.19, 3.18;and P = 0.005, 0.053, 0.066). Donor KIR2DS2-negative genotype were also associated with an increased risk of relapse (HR = 6.72, 9.43; and P = 0.019, 0.047). And donor KIR2DS1 positive/recipient HLA-C2 negative group was the only risk factor of TRM (HR = 3.27, 95% CI 1.78 - 9.06, P = 0.023). It is concluded that missing ligand for the donor inhibitory KIR has weak effect on the outcome of unmanipulated HSCT. The activating KIR play an important role in the EFS, relapse and TRM after HSCT. Donor KIR2DS1-positive/recipient HLA-C2-negative group and donor KIR2DS1 gene negative predict poor prognosis. Analysis of KIR genotype and its ligand is important for the selection of best donor and prognostic evaluation in unmanipulated allogeneic HSCT.
Adolescent ; Adult ; Child ; Child, Preschool ; DNA Fingerprinting ; Female ; Genotype ; HLA Antigens ; genetics ; Hematopoietic Stem Cell Transplantation ; methods ; mortality ; Humans ; Male ; Middle Aged ; Prognosis ; Receptors, KIR ; genetics ; metabolism ; Retrospective Studies ; Survival Rate ; Transplantation, Homologous ; Young Adult