Therapeutic approaches to brain metastases from non-small cell lung cancer ( NSCLC ) include corticosteroids, anticonvulsants, surgery, radiotherapy and chemotherapy. In recent years, molecular targeted therapy such as the epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKI) has become a new option. This article discussed the roles of surgery, brain radiation, chemotherapy, targeted therapy , and other new directions in the treatment of patients with brain metastases from NSCLC.

Objective To investigate the association of interferon (IFN) γ gene polymorphisms and risk and prognosis of HPV cervical infection.Methods PCR-ASP was used for detectiug IFN-γ rs2430561 polymorphism in 179 HPV positive patients and 328 HPV negative normal controls.Results The frequency of A allele of 63.7％ (228/358) was significantly higher than the frequency of T allele of 36.3％ (130/358) in HPV positive group (P =0.045).The frequencies were 41.3％ (74/179) in AA genotype and 14.0％ (25/179) in TT genotype,women carrying AA genotype increased the risk of HPV infection compare with those with TT genotype (OR =1.784,95％ CI:1.031-3.088,P =0.039).During follow-up,the rate of HPV positive again in AA genotype was 83.8％ (62/74),while TT genotype was 20.0％ (5/25).In the analysis of Kaplan-Meier,the cumulative HPV negative rates of AA,TA and TT genotype exhibited significantly different (P =0.008).The cumulative HPV negative rate of AA genotype was the lowest (1.1％-5.9％).Conclusions IFN-γ rs2430561 polymorphisms confer the susceptibility to HPV infection.Women with AA genotype exhibited higher risk of infection and inclined to be continuous status and recurrence after HPV infection.

OBJECTIVETo observe the impact of tonifying Qi traditional Chinese medicines contained in Yiqi Qingwen Jiedu mixture on mRNA expression of lung inflammatory cytokines and pulmonary pathological injury of mice infected by influenza virus, in order to discuss the mechanism of tonifying Qi traditional Chinese medicines against pulmonary immune inflammatory injury of infected mice.

METHODIn different time phases after mice were infected with influenza virus FM1, the RT-PCR method was adopted to observe the impact of tonifying Qi traditional Chinese medicines contained in Yiqi Qingwen Jiedu mixture on five inflammatory cytokines TNF-α, IL-1, IL-6, IL-10 and IFN-γ, and the changes in pulmonary pathological injury of mice with viral pneumonia after intervention with tonifying qi traditional Chinese medicines.

RESULT(1) Tonifying Qi traditional Chinese medicines significantly reduced the mRNA expression of TNF-α at 1-5 d and IL-1 mRNA expression at 7 d, may increase IL-1 mRNA expression in mouse lung at 3 d, significantly reduced IL-6 mRNA expression in mouse lung and increased IL-10 mRNA expression at 3-7 d, and significantly increased IFN-γ mRNA expression at 1 d. (2) Tonifying Qi traditional Chinese medicines could significantly inhibited and repaired pulmonary immune inflammatory injury of mice infected by FM1, which was most remarkable at 3-7 d after the infection with influenza virus FM1.

CONCLUSIONTonifying Qi traditional Chinese medicines contained in Yiqi Qingwen Jiedu mixture could resist pulmonary immune inflammatory injury and repair inflammatory injury by regulating the mRNA expression of imbalance inflammatory cytokines of organisms infected with influenza virus.

Animals ; Drugs, Chinese Herbal ; administration & dosage ; Humans ; Influenza A virus ; drug effects ; immunology ; Influenza, Human ; drug therapy ; genetics ; immunology ; Interferon-gamma ; genetics ; immunology ; Interleukin-1 ; genetics ; immunology ; Interleukin-10 ; genetics ; immunology ; Interleukin-6 ; genetics ; immunology ; Lung ; immunology ; virology ; Male ; Mice ; Mice, Inbred BALB C ; Tumor Necrosis Factor-alpha ; genetics ; immunology

ObjectiveTo systematically evaluate the efficacy and safety of Rimegepant in the treatment of acute migraine. MethodsThe databases of CNKI， Wanfang and VIP database， PubMed， Embase， Cochrane Library， ClinicalTrials were searched to collect relevant literature on the treatment of Rimegepant in acute migraine. The pain freedom and Most Bothersome Symptom （MBS） freedom 2 hours after medication were the primary outcome indicators， and the other 11 indicators including pain relief 2 hours after medication were the secondary outcome indicators. The Meta-analysis was performed using RevMan 5.3， and the quality of evidence was evaluated using GRADE Profiler 3.6 for outcome indicators. ResultsA total of 4 randomized controlled studies involving 3 827 patients， including 1 840 patients in the experimental group and 1 987 patients in the control group. Meta-analysis results showed that， in terms of effectiveness， compared with the control group， the proportion of patients in the Rimegepant group who were painless 2 hours after medication （RR=1.67， 95 % CI： 1.44~1.94， P<0.01）， MBS free 2 hours after medication （RR=1.37， 95% CI： 1.24~1.51， P<0.01） and pain relief （RR=1.33， 95% CI： 1.25~1.41， P<0.01）， pain relief lasting 2~24 hours after medication （RR=1.59， 95% CI： 1.46~1.74， P<0.01）， pain relief lasting 2~48 hours after medication （RR=1.57， 95% CI： 1.42~1.74， P<0.01）， painless 2~24 hours after medication （RR=2.27， 95% CI： 1.62~3.20， P<0.01）， painless 2~48 hours after medication （RR=2.14， 95% CI： 1.52~3.02， P<0.01）， and no fear of light （RR=1.47， 95% CI： 1.32~1.64， P<0.01） and no fear of sound 2 hours after medication （RR=1.40， 95% CI： 1.19~1.64， P<0.01） was higher， the differences were statistically significant. In terms of safety， the proportion of patients with nausea （RR=1.70， 95% CI： 0.95~3.02， P=0.07）， urinary tract infection （RR=1.81， 95% CI： 0.84~3.91， P=0.13）， dizziness （RR=1.14， 95% CI： 0.49~2.63， P=0.77） or elevated transaminase （RR=0.76， 95% CI： 0.45~1.27， P=0.29） showed no statistically significant differences between the Rimegepant group and the control group. Based on GRADE criteria， evidence for Rimegepant in the treatment of acute migraine was of high or moderate quality. ConclusionRimegepant is effective for acute migraine， and the toxic effects are tolerable.

BACKGROUNDTransient sublethal ischemia is known as ischemic preconditioning, which enables cells and tissues to survive subsequent prolonged lethal ischemic injury. Ischemic preconditioning exerts neuroprotection through phosphatidylinositol 3-kinase (PI3K)/Akt pathway. Cbl-b belongs to the Casitas B-lineage lymphoma (Cbl) family, and it can regulate the cell signal transduction.The roles of ubiquitin ligase Cbl-b and PI3K/Akt pathway and the relationship between them in oxygen-glucose deprivation preconditioning (OGDPC) in PC12 cells were investigated in the present study.

METHODSOxygen and glucose deprivation (OGD) model in PC12 cells was used in the present study. The 3-(4, 5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, nuclear staining with Hoechst 33258, and Western blotting were applied to explore the roles of Cbl-b and PI3K/Akt pathway and the relationship between them in OGDPC in PC12 cells.

RESULTSCell viability was significantly changed by OGD and OGDPC. OGD significantly decreased cell viability compared with the control group (P < 0.05), and preconditioning could rescue this damage was demonstrated by the increase of cell viability (P < 0.05). The expression of Cbl-b was significantly increased after OGD treatment. However, the activation of Akt and GSK3β was greatly inhibited. Preconditioning could inhibit the increase of Cbl-b caused by OGD and increase the activation of Akt and GSK3β. LY294002, a specific inhibitor of PI3K, could effectively inhibit the increase of Akt and GSK3β after preconditioning treatment. It partly inhibited the decrease of Cbl-b expression after preconditioning treatment.

CONCLUSIONUbiquitin ligase Cbl-b and PI3K/Akt pathway are differently involved in OGDPC in PC12 cells.

Adaptor Proteins, Signal Transducing ; genetics ; metabolism ; Animals ; Cell Survival ; Glucose ; deficiency ; Ischemic Preconditioning ; Oxygen ; metabolism ; PC12 Cells ; Phosphatidylinositol 3-Kinase ; genetics ; metabolism ; Proto-Oncogene Proteins c-akt ; genetics ; metabolism ; Proto-Oncogene Proteins c-cbl ; genetics ; metabolism ; Rats ; Signal Transduction ; physiology

OBJECTIVETo investigate the inhibitory effect of the small interfering RNA targeting mdm2 gene on the growth of osteosarcoma cells.

METHODSPGCsilencerTM-mdm2 siRNA was constructed and transfected into the osteosarcoma cell line U2OS cells. The inhibitory effects on mdm2 were determined by RT-PCR and Western blot analysis. The cell growth activity was determined by MTT assay, and the cell apoptosis was examined by flow cytometry. The therapeutic effects of simdm2 was assessed on the nude mouse model of transplanted tumor.

RESULTSThe simdm2 plasmid was successfully constructed. After simdm2 being transfected into the U2OS cells, the expressions of mdm2 gene and protein were significantly inhibited. The ability of cell growth activity decreased greatly and cell apoptosis occurred apparently. There was no significant difference between the negative control group and non-transfected group. The growth of xenograft tumor in simdm2 transfected nude mice was inhibited and the expressions of mdm2 gene and protein were down-regulated remarkably.

CONCLUSIONsiRNA targeting mdm2 gene inhibits the mdm2 expression in osteosarcoma U2OS cells and the growth of osteosarcoma in nude mice.

Animals ; Apoptosis ; Bone Neoplasms ; metabolism ; pathology ; Cell Line, Tumor ; Cell Proliferation ; Female ; Humans ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Neoplasm Transplantation ; Osteosarcoma ; metabolism ; pathology ; Plasmids ; Proto-Oncogene Proteins c-mdm2 ; genetics ; metabolism ; RNA Interference ; RNA, Small Interfering ; genetics ; Transfection ; Tumor Burden

OBJECTIVETo analysis the clinical effects of free patellar implantation in treating the defect of the knee joint after the excision of giant cell tumor in the distal femur and the proximal tibia.

METHODSIf the giant cell tumor in the distal femur and the proximal tibia invaded the articular surface, we resected the condyle of femur or tibia including the tumor, dissociated the patella and placed it in the condyle horizontally to repair the articular surface. The cruciate ligament was reserved in all the patients. The condyle of femur or tibia was replaced by the anterior surface or the articular surface of the patella respectively. The implanted patella was fixed by the screw to the contralateral condyle, and the remaining defect was filled by autogenous cancellous illium.

RESULTSNine patients were followed up 3 to 121 months, the average was 65 months. None of them recurred or metastated. The excellent and good rate of the functional evaluation of knee joints was 88.9%.

CONCLUSIONAfter resecting the condyle of femur or tibia including the tumors which invade the articular surface, we find that free patellar implantation is a suitable way to repair the defect of the knee.

Adult ; Bone Neoplasms ; surgery ; Female ; Femoral Neoplasms ; surgery ; Follow-Up Studies ; Giant Cell Tumor of Bone ; surgery ; Humans ; Knee Joint ; surgery ; Male ; Patella ; transplantation ; Tibia ; surgery ; Transplantation, Homologous ; Treatment Outcome

Gastrointestinal stromal tumor (GIST) represents the most common intramural mesenchymal tumor of the gastrointestinal tract, but the synchronous occurrence of GIST in the stomach and gynecological cancer is rare. We present a unique case of a 56-year-old female patient who was diagnosed with the synchronous development of GIST and an isolated parenchymal splenic metastasis of ovarian cancer. She underwent a wide local excision of gastric lesions with splenectomy. A morphological (histological and immunohistochemical) study established a spindle-cell type of gastrointestinal tumor that expressed CD117, and a parenchymal recurrence of ovarian papillary serous adenocarcinoma. The patient has remained alive and disease-free for 30 months since the last operation. A small GIST concomitant with an isolated parenchymal splenic metastasis of ovarian cancer is rarely encountered. The coexistence of GIST with other malignancies constitutes an intriguing oncologic model. Surgeons are advised to be alert against possible primary GIST accompanying other neoplasms.
Female ; Gastrointestinal Stromal Tumors ; diagnostic imaging ; secondary ; Humans ; Middle Aged ; Ovarian Neoplasms ; complications ; Radiography ; Splenic Neoplasms ; secondary

OBJECTIVETo assess the effect of Qingfei Quyu Decoction (QQD) in preventing radiation pneumonitis in esophageal carcinoma patients by concurrent using it with chemoradiotherapy.

METHODSA total of 120 patients with mid-late stage esophageal carcinoma were randomly assigned to the treatment group (60 cases) and the control group (60 cases). All patients received concurrent radiochemotherapy. Patients in the treatment group additionally took QQD, one dose per day for 8 successive weeks. The incidence of radiation pneunonitis was compared between the two groups. The improvement rates of short-term benefit rate, Karnofsky performance scale (KPS), and body weight (BW) improvement rate were calculated between the two groups. The 1-and 2-year overall survival rates were compared between the two groups.

RESULTSThe incidence of radiation pneunonitis was 8.93% (15/56) in the treatment group and 18.64% (11/59) in the control group (P < 0.05). The short-term benefit rate was 92.86% (52/56) in the treatment group and 69.49% (41/59) in the control group (P < 0.05). Besides, the KPS and BW improvement rate were higher in the treatment group [89.29% (50/56) and 83.05% (49/59) ] than in the control group [80.36% (45/56) and 66.10% (39/59)] (P < 0.05). The 1-and 2-year overall survival rate were 66.07% and 35.71% in the treatment group, higher than those of the control group (61.02% and 30.51%; P > 0.05).

CONCLUSIONConcurrent using QQD with chemoradiotherapy for treating esophageal carcinoma patients could lower the incidence of radiation pneumonitis, attenuate the degree of radiation induced lung injury, improve clinical benefit rate, and elevate their QOL.

Carcinoma, Squamous Cell ; Chemoradiotherapy ; adverse effects ; Drugs, Chinese Herbal ; therapeutic use ; Esophageal Neoplasms ; drug therapy ; radiotherapy ; Humans ; Radiation Pneumonitis ; prevention & control ; Survival Rate

Vimentin, a kind of type Ⅲ intermediate filament protein, is the major component of cytoskeleton of stromal cells. Increasing researches have demonstrated that vimentin is over-expressed in muiltple tumor tissues, and is closely related with the occurrence, development, invasion and metastasis of tumors. However, correlated studies including cervical neoplasm, endometrial neoplasm and ovarian neoplasm start comparatively late with inconsistent conclusions, thus, a lot of mechanisms need to be further investigated. This paper reviews the expressions and the clinical significances of vimentin in 3 kinds of gynecological malignant tumors.