1.Curative effect observation of capecitabine combined with intensity modulated radiotherapy for posto-perative mediastinum lymphonode metastasis in esophageal carcinoma
Mingjun LI ; Xuezhang LI ; Guiping LIU ; Yanxing SHENG
Journal of International Oncology 2015;(4):252-254
Objective To evaluate the efficacy and toxicity of capecitabine combined with intensity modulated radiotherapy( IMRT)for postoperative mediastinal lymph node metastasis in esophageal cancer. Methods A total of 62 esophageal cancer patients with postoperative mediastinal lymph node metastases were randomly divided into the irradiation group(A group,31 cases)and the capecitabine combined with IMRT group( B group,31 cases). Both of two groups received IMRT radiotherapy with a total dose of 60-66 Gy, 30-33 times in 6-6. 5 weeks. The patients in B group were treated with capecitabine(1 250mg/ m2 ,2 f/ d, d1-d14,21 d × 2 cycle). Results Group A:there were 7 cases of complete response(CR),12 of partial response(PR),10 of stable disease(SD),and 2 of progressive disease(PD);the effective rate was 61. 3%(19 / 31). Group B:there were 10 cases of CR,16 of PR,4 of SD,and 1of PD;the effective rate was 83. 9%(26 / 31). There was a statistical significance between the effective rates of A group and B group(χ2 = 3. 971, P < 0. 05). Our experiment showed that the rates of grade Ⅱand Ⅲ myelosuppression in group A and group B were 29. 0% and 38. 7%(χ2 = 0. 648,P = 0. 421). The rates of Ⅰ and Ⅱ level radioactive pneumonia in group A and were 19. 4% and 25. 8%(χ2 = 0. 369,P = 0. 544). The different incidence of the two adverse reactions between group A and B had no statistical significance. Conclusion Compared with IMRT alone,IM-RT combined with capecitabine may have better curative efficacy without increasing toxicity to esophageal cancer patients with postoperative mediastinum lymphonode metastasis.
2.Enhanced MR texture analysis in the differential diagnosis of solitary brain metastasis and high-grade glioma
Fei XIONG ; Huibin TAN ; Ying WANG ; Ye WANG ; Guiping SHENG
Chinese Journal of Postgraduates of Medicine 2018;41(12):1121-1124
Objective To investigate the value of enhanced MR texture analysis in the differential diagnosis of single brain metastasis (SBM) and high grade glioma (HGG). Methods The preoperative MRI images of 21 SBM and 23 HGG patients confirmed by pathology were retrospectively analyzed. The T1WI enhanced images were used for texture analysis to obtain the mean, median, entropy, skewness, kurtosis, heterogeneity and other parameters. An independent sample t-test or Mann-Whitney U test was used to statistically analyze the values of the parameters between the two groups, and ROC evaluation parameters were used to identify the diagnostic efficacy of SBM and HGG. Results There were significant differences in entropy and heterogeneity parameters between SBM and HGG: (4.838 ± 0.523 vs. 5.358 ± 0.449, 0.276 ± 0.066 vs. 0.331 ± 0.101), P<0.05. When the cut-off value of entropy was 4.88, the sensitivity of differential diagnosis between SBM and HGG was 47.6%, specificity was 100.0%, and the area under ROC curve was the largest (0.745). Conclusions The entropy value and heterogeneity have certain value in distinguishing SBM and HGG in MRI texture analysis.
3.A multicenter clinical study of risk factors for abdominal pain and distension in sedation-free colonoscopy
Guiping ZHAO ; Shuyue YANG ; Linlin SHAO ; Zheng ZHANG ; Sheng WANG ; Zhen DING ; Li ZHANG ; Runfang LI ; Wenyan LIANG ; Peng LI ; Shutian ZHANG
Chinese Journal of Digestive Endoscopy 2022;39(7):528-533
Objective:To analyze the risk factors for the most common adverse events, i.e. abdominal pain and distension in sedation-free colonoscopy.Methods:This was a multicenter clinical study, in which clinical data of patients including outpatients and inpatients who underwent selective sedation-free colonoscopy at six gastrointestinal endoscopy centers from July 2017 to December 2019 were collected, including patients' general information, complicating diseases, examination time, examination results, and occurrence of adverse events of abdominal pain and distension. Univariate and multivariate logistic regression was performed to analyze the risk factors for adverse events of abdominal pain and distension during sedation-free colonoscopy.Results:A total of 2 394 patients underwent sedation-free colonoscopy, among whom 690 (28.8%) suffered from abdominal pain, and 1 151 (48.1%) experienced abdominal distension. The results of multivariate logistic analysis showed that overweight ( OR=1.33, 95% CI:1.09-1.62, P=0.005), obesity ( OR=1.55, 95% CI:1.14-2.11, P=0.005) and combination of hypertension ( OR=1.58, 95% CI:1.23-2.02, P<0.001) were independent risk factors for abdominal pain during sedation-free colonoscopy, and overweight ( OR=1.40, 95% CI:1.17-1.68, P<0.001) and combination of hypertension ( OR=1.39,95% CI:1.10-1.76, P=0.006) were independent risk factors for abdominal distension during sedation-free colonoscopy. Conclusion:Obesity, overweight and combination of hypertension are independent risk factors for abdominal pain, and overweight and combination of hypertension are independent risk factors for abdominal distension during sedation-free colonoscopy.