Objective To assess the safety and efficacy of patients with acute myelogenous leukemia treated with mitoxantrone/arabinosylcytosin versus daunorubicin/arabinosylcytosin.Methods We searched Pubmed,Embase,the Cochrane Library,Chinese biomedicine literature database,Chinese Scientific Journals full-text database,and Chinese Journal full-text database for randomized controlled trials comparing MA regimen with DA regimen.We manually searched key Chinese magazines of related fields.The quality of included studies was evaluated and graded according to Cochrane Reviewer's Handbook.Results Nine randomized controlled trials totaling 608 patients were included.Meta-analysis results were as follows:There was significant difference between MA regimen and DA regimen in total complete remission rate [RR=1.24,95%CI(1.10,1.40)]and effective rate[RR =1.22,95%CI(1.09,1.36)] after the second course of treatment.There was significant difference between MA regimen and DA regimen in heart toxicity incidence [RR=0.54,95%CI(0.29,0.99)],infection incidence [RR=1.56,95%CI(1.29,1.94)],agranulocytosis time [RR=2.70,95%CI(2.09,3.31)].There was no significant difference in nausea and vomitting [RR=0.96,95%CI(0.87,1.07)].Conclusion Current clinical studies might confirm that MA regimen is superior to DA regimen in complete remission rate and effective rate in treating the patient with initial treatment acute myelogenous leukemia.Fewer patients receiving MA regimen experienced heart toxicity incidence compared with patients receiving DA regimen,but more experienced infection and agranulocytosis.They still need to be confirmed by large sample,high quality randomized controlled trials.

Objective To observe the efficacy of percutaneous vertebroplasty (PVP) combined with zoledronic acid in treatment of spinal metastatic carcinoma.Methods Fifty cases of spinal metastatic carcinoma were divided into control group and treatment group by random digits table method with 25 cases each.The control group was given zoledronic acid 4 mg,intervals of 28 d intravenous drip 1 time.The treatment group was given PVP besides zoledronic acid.The visual analog scale score,activity ability score and analgesic usage score after treatment for 3 months were observed and compared.The quality of life was evaluated and the occurrence of relapse of fracture was also recorded.Results After treatment for 3 months,the visual analog scale score,activity ability score and analgesic usage score were (2.00 ± 0.17),(2.12 ± 1.38),(1.47 ± 0.10) scores in treatment group,and (7.84 ± 0.18),(3.21 ± 0.13),(3.30 ± 0.09) scores in control group,and there were significant differences between two groups (P ＜ 0.01 or ＜ 0.05).The occurrence of relapse of fracture was 2 cases (8％,2/25) in treatment group and 9 cases (36％,9/25) in control group,and there was significant difference between two groups (P ＜ 0.05).Conclusions PVP combined with zoledronic acid in treatment of spinal metastatic carcinoma has many advantages such as small incision,short surgery time and rapid relief from pain.It can obviously improve the quality of life,and it is worthy of spreading in the clinic.

Cancer-related fatigue is one of the most common and refractory clinical sympotoms in patients with cancer. Investigators have tried to study the molecular pathogenesis of cancer-related fatigue, and the cytokine has become a research focus. At present, a number of cytokines, including transformation growth factor, tumor necrosis factor, interleukin, proteolytic inducing factors, inflammatory cytokine are proved to be correlated to cancer-related fatigue.

Objective:To investigate the relationship between cancer-related fatigue and cortisol in cancer patients and elucidate the underlying mechanism. Methods:A total of 80 cancer cases were divided into two groups:fatigue group (50 cases with cancer-related fatigue) and non-fatigue group (30 cases without fatigue). The scores were evaluated through the Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF) and the Fatigue Symptom Inventory (FSI) report. Serum specimens were examined through electrochemiluminesence immunoassay and enzyme-linked immunosorbent assay. Serum cholesterol was examined through the CHOD-PAP method, and serum total protein and albumin were determined via the Biuret method. Agarose gel electrophoresis was conducted to determine alpha 2 globulin ratio and to calculate serum alpha 2 globulin concentration. Results: The cortisol level in the fatigue group was significantly lower than that in the non-fatigue group[(119.68±5.34) nmol/L vs. (163.45± 31.49) nmol/L, P<0.05], and the adrenocorticotropic hormone (ACTH) level in the fatigue group was significantly higher than that in the non-fatigue group [(104.50 ± 17.15) ng/L vs. (51.43±13.24) ng/L, P<0.05]. Cortisol negatively correlated with MFSI-SF (r=-0.867, P<0.001) but positively correlated with ACTH (r=0.809, P<0.001). Furthermore, cortisol negatively correlated with FSI (r=-0.747, P<0.001) but positively correlated with ACTH (r=0.70, P<0.001). The levels of serum cholesterol [(1.25±0.70) mmol/L vs. (3.28±0.73) mmol/L, P<0.05], albumin[(18.24 ± 7.03) g/L vs. (37.40 ± 8.05) g/L, P<0.05], and alpha-2 globulin [(2.25±1.07) g/L vs. (5.36±1.09) g/L, P<0.05]were significantly lower in the fatigue group than in the non-fatigue group. Conclusion:The patients with cancer-related fatigue exhibited increased MFSI-SF score, decreased serum cortisol level, and enhanced ACTH level. The low serum cortisol levels caused a disorder in the serum ACTH and cancer-related fatigue of malignant tumor patients. The mechanism underlying the reduction in serum cortisol level correlated with the insufficient amounts of serum cholesterol, the composite material of cortisols, and of serum albumin, particularly alpha-2 globulin, the carrier protein of serum cholesterol.