Objective: This study aimed to investigate the effects and side effects of Jinlong Capsule with concurrent three-dimen-sional conformal radiotherapy for advanced primary hepatic carcinoma. Methods: A total of 85 patients with inoperable primary hepat-ic carcinoma were randomly divided into a research group and a control group. Forty-two cases in the control group were treated with three-dimensional conformal radiotherapy alone, whereas 45 cases in the research group were treated with three-dimensional conformal radiotherapy and Jinlong Capsule oral administration. All cases were irradiated with 6 MV X-rays, 2 Gy per day, 5 days a week to a to-tal dose of 60 Gy in 6 weeks. Jinlong Capsule (1 g) was administered orally three times daily until disease progression for at least one year. The short-term therapeutic effect and adverse events were evaluated for 2 months after treatment. The long-term therapeutic effect was assessed at the end of follow-up. Results: The objective response rate of the research group was significantly higher than that of the control group at 74.4% and 47.6%, respectively (P=0.011). The disease control rates were 97.7% and 85.3% (P=0.030) for the re-search and control groups, respectively. No obvious difference was found between the complete response rates of the two groups, 20.9% and 14.3% (P=0.422). The 1- and 3-year overall survival rates of the research group (74.4% and 34.9%) were significantly high-er than those of the control group (66.7% and 16.7%) at P=0.046. The 1- and 3-year progression free survival rates of the research group (74.4% and 27.9%) were significantly higher than those of the control group (61.9% and 9.5%) at P=0.038. The main adverse events were grade 1–2 bone marrow suppression, abdominal distension, nausea, vomiting, and transaminase elevation. No obvious dif-ference was observed between the adverse events in the two groups. Conclusion: The short- and long-term effects of the combination therapy of Jinlong Capsule and three-dimensional conformal radiotherapy on primary hepatocellular carcinoma were significantly high-er than those of three-dimensional conformal radiotherapy alone. The patients also tolerated the adverse effects.

Purpose To compare the therapeutic effects of CO2 laser resection and traditional split laryngeal surgery on the early laryn-geal cancer, and to examine relationship between the expression of p27 and PTEN and clinical prognosis in early laryngeal squamous cell carcinoma. Methods 85 patients who underwent CO2 laser resection surgery and 46 patients who underwent split laryngeal surger-y were selected and the occurrence rates after surgery were observed. SP immunohistochemical method was uesd to detect the expression of p27 and PTEN in tumor resection marginal and their surgical margine tissues. Clinical data were collected and all patients were fol-lowed up. Results In the more than two-year follow-up study, 14 of 85 patients in CO2 laser treatment group ( recurrent group) pres-ented with local recurrence and the recurrence rate was 16. 5%, while 6 of 46 patients in split laryngeal surgery group presented with local recurrence and the recurrent rate was 13. 0%. There was no statistical significance in recurrence rate between the two groups ( P> 0. 05). 10 of all the none recurrent patients did not follow the doctor’s advice to quit smoking after the operation, while 12 in the recurrent patients did not, the difference between the two groups was statistically significant (P<0. 01). The positive rate of p27 and PTEN in laryngeal carcinoma tissues and the cancer adjacent tissues ( negative surgical margin tissues ) was 43. 5% ( 57/131 ) , 80. 2% (105/131) and 48. 9% (64/131), 83. 2% (109/131), respectively, with a significant difference (P<0. 01). The positive rate of p27 and PTEN in laryngeal carcinoma tissues of the recurrent group and non recurrent group was 20. 0% (4/20), 47. 7% (53/111) and 10. 0% (2/20), 55. 9% (62/111), respectively, with a significant difference (P<0. 05). While the positive rate of p27 and PTEN in tumor resection marginal tissues of the recurrence group and non recurrence group was 50. 0% ( 10/20 ) , 85. 6% ( 95/111) and 40. 0% (8/20), 91. 0% (101/111), the difference was also statistically significant (P<0. 01). Conclusions There was no statistically significant difference in tumor recurrence rate between CO2 laser surgery and traditional split laryngeal surgery. Postoper-ative recurrence is closely related to resume smoking. The recurrence rate of p27 and/or PTEN negative patients was higher than that of the opposite ones which should be followed up closely after treatment.

Objective To evaluate the efficacy and survival rate of neoadjuvant chemotherapy with docetaxe and pirarubicin in triple negative breast cancer (TNBC).Methods Total 51 breast cancer patients were divided into TNBC group (n =26,including 16 of stage Ⅱ and 10 of stage Ⅲ patients) and non-TNBC group (n =25,including 14 of stage Ⅱ and 11 of stage Ⅲ patients).All patients received a median of 4 treatment cycles with TAC regimen [docetaxe 75 mg/m2 on day 1,pirarubicin 40 mg/m2 on day 1 and cyclophosphamide (CTX) 500 mg/m2 on day 1 of each 21 day cycle].The efficacy of treatment and survival rate of two groups were evaluated.Results In TNBC group,9 out of 26 (34.62 ％) patients achieved clinical complete response (cCR),and 14 (53.85 ％) had partial response (cPR).Overall,88.46 ％ of TNBC patients had clinical response and 26.92 ％ (7/26) showed pathology complete response (pCR).In non-TNBC group,6 (24.00 ％) patients reached cCR and 8 (32.00 ％) showed cPR.The overall response rate was of 56.00 ％,and 4 (16.00 ％) patients achieved pCR.The overall 3-year survival rates in TNBC and non-TNBC groups were 73.08 ％ and 88.00 ％,respectively,indicating a poorer prognosis of TNBC.The 5-year survival rates of TNBC patients with and without pCR were 88.89 ％ and 47.06 ％,respectively.Conclusion TAC regimen improves the prognosis for locally advanced TNBC,indicating that the neoadjuvant chemotherapy is effective and safe for TNBC patients.

Purpose To study the expression of p53, p21 and Cdk1/p34cdc2 in the laryngeal cancer and its margin tissues and to ex-plore their relationship with local recurrence of laryngeal cancer. Methods A total of 85 patients with early laryngeal cancer were se-lected randomly during 2004 to 2010 in Tangshan Union Hospital, Hebei, China. SP immunohistochemical method was used to detect the expression of p53, p21 and Cdk1/p34cdc2 in the tumor and margin tissues. Pathological data were collected for follow-up. Results In more than 2 years of follow-up study, 14 of 85 patients with laryngeal cancer presented with recurrence (recurrent group), while 71 patients without recurrence (none recurrent group). The positive rate of p53 protein in laryngeal cancer and its margin tissues was 60. 0% and 36. 5%, respectively, the positive rate of p21 protein in laryngeal cancer and its margin tissues was 38. 8% and 21. 2%, respectively. The positive rate of Cdk1/ p34cdc2 in laryngeal cancer and its margin tissues was 70. 6% and 29. 4%, respectively. p53 protein in the surgical margin of the recurrent group and non recurrent group was 71. 4% and 29. 6% (P = 0. 003), that of p21 was 50. 0% and 15. 5%, (P =0. 004) and Cdk1/ p34cdc2 was 57. 1% and 23. 9% (P =0. 013), respectively. There was no correlation between expression of p53 with p21 protein and Cdk1/ p34cdc2 protein(P > 0. 05). Conclusion p53, p21 and Cdk1/ p34cdc2 may be involved in the occurrence, development and recurrence of laryngeal squamous cell carcinoma. Overexpression of p53, p21 and Cdk1/ p34Cdc2 in the surgical margin is closely related to local recurrence of laryngeal cancer.

Objective To investigate the in vitro effects of quercitrin on the proliferation and the cytotoxicity of human γδT cells.Methods Peripheral blood mononuclear cells (PBMCs) were isolated from healthy subjects and cultured with isopentenyl pyrophosphate and IL -2 to induce human γδT cells.The hu-manγδT cells were cultured with quercitrin at various concentrations for 48 hours.CCK-8 kits were used to analyze the in vitro proliferation and cytotoxic activities of γδT cells.Flow cytometry was performed to meas-ure the expression of granzyme B and perforin in γδT cells.The expression of p-ERK, p-Akt and Bcl-2 at protein level were detected by Western blot .Results The percentage of human γδT cells in PBMCs was in-creased from (2.96±1.83)%to (88.94±2.36)%after 10 days of culture.The quercitrin at concentrations of 10 to 80 μg/ml could promote the growth of γδT cells and up-regulate the expression of granzyme B , per-forin, p-ERK, p-Akt and Bcl-2 in a dose dependent manner .The cytolytic activities of γδT cells against co-lonic carcinoma cells ( HCT116 ) were enhanced by quercitrin .Conclusion Quercitrin could promote the proliferation of γδT cells and enhance the expression of granzyme B and perforin at certain concentrations in vitro.ERK1/2 and Akt signal transduction systems might be involved in the process .

Purpose To explore the relationship between expression of PCNA and COX-2 in the early laryngeal cancer with negative surgical margins and the local recurrence of tumor. Methods Totally 63 patients with early laryngeal cancer were enrolled in this stud-y, CO2 laser surgery was adopted as treatment, the expression of PCNA and COX-2 was detected in the resected tumor tissue and surgi-cal margins, and the survival and tumor recurrence were also observed. Results The positive rate of the expression of PCNA and COX-2 in the 63 patients with early laryngeal cancer tumor tissues were 73. 02% and 71. 43%, while that in the cutting edge were 33. 33% and 30. 16%, respectively. The expression of PCNA and COX-2 in tumor tissue and cutting edge were of all positive in 41 cases and 13 cases, and the positive rate was 65. 08% and 20. 63%, respectively. In the all followed-up patients, 17 cases were detected of local recurrence, the recurrence rate was 26. 98%, and the recurrence rate in the patients with PCNA positive was 71. 43%, while in the patients with COX-2 positive was 73. 68% (P<0. 05). The combined detection of PCNA and COX-2 positive recurrence rate was significantly higher than that of single positive (P<0. 05). Conclusion PCNA and COX-2 in the early laryngeal cancer with negative surgical margins are important biological markers for the evaluation of prognosis of laryngeal cancer patients, and to formulate the subse-quent treatment regimen. The combined detection of two proteins is more reliable for postoperative management.

Purpose To investigate the relationship between HPV infection and p53,p16,EGFR expression and prognosis in patients with salivary adenoid cystic carcinoma (ACC).Methods Totally 76 cases of adenoid cystic carcinoma specimens were selected,PCR-reverse dot blot hybridization was used to detect infection of HPV and SP immunohistochemical method was adopted to detect the expression of p53,p16,EGFR,Cdc2 in tumor tissues.Clinical data were collected and all the patients were followed up.The Kaplan-Meier method was used to estimate median overall survival and the Log-rank test to compare survival curves.Cox regression model was used for multivariate analyses.Results Infection rate of HPV in adenoid cystic carcinoma tissues was 0(0/76).The expression rate of p53,p16,EGFR,Cdc2 protein in adenoid cystic carcinoma tissues were 76.3％ (58/76),57.9％ (44/76),60.5％ (46/76) and 64.5％ (49/76)respectively.There was no correlation of the expression of p53,p16,EGFR and Cdc2 with gender,age,tumor location,TNM stage and histological type of patient.Kaplan-Meier survival analysis showed that EGFR-positive patients had shorter median overall survival rate (OS) than the negative ones (x2 =19.111,P ＜ 0.001).EGFR-positive patients had shorter median progression-free survival rate (PFS)than the negative ones (x2 =6.621,P ＜ O.01).Cdc2 positive patients had shorter median OS than the negative ones (x2 =3.870,P ＜ 0.05).Cdc2 positive patients had shorter median PFS than the negative ones (x2 =6.755,P ＜0.01).Cox regression analysis showed that expression of EGFR and Cdc2 was independent risk factors for the prognosis of patients with salivary gland ACC (relativerisk=13.417,13.075,P＜0.001).Conclusion There is no HPV infection detected in adenoid cystic carcinoma tissues.p53,p16,EGFR and Cdc2 are positively expressed in most salivary adenoid cystic carcinoma,p16 is unsuitable as a surrogate for HPV infection status of patient with ACC.Expression of EGFR and Cdc2 is independent risk factors in the prognosis of patients with salivary gland ACC.For the EGFR or Cdc2 positive patients should be followed up closely.

ObjectiveTo evaluate the efficacy and clinical safety of sodium glycididazole (CMNa)in thoracic esophageal squamous carcinoma.Methods From June 1,2008 to October 13,2009,66pathologically proved thoracic esophageal squamous carcinoma (stage Ⅱa-Ⅲ,stage Ⅳ with metastases only in supraclavicular lymph nodes,by AJCC 6th ed) were randomized into radiotherapy plus CMNa (A) or radiotherapy plus placebo (B) group.Radiotherapy was given by conventional schedule:1.8-2.0 Gy per fraction,5 times per week to a total dose of 66 Gy/6.6-7.2w.CMNa was given intravenously 800 mg/m2 3 times a week in solution of 100 ml saline within 30 minutes.Radiotherapy was started 30-60 minutes after completion of infusion.Patients of Group B received placebo in saline solution.A total of 66 patients were enrolled ( Group A:32 ; Group B:34 ),and four patients were unanalyzable,remaining 31 patients in each Group.Baseline factors were balanced.ResultsFollow-up rate was 97％.Group A vs.Group B:the overall response rate was 93.5％ vs.67.7％ ( x2 =6.61,P =0.01 ),2-year overall survival was 39.9％ vs.29.9％ ( x2 =0.62,P =0.433 ),2-year cancer specific survival was 43.1％ vs.26.8％ ( x2 =0.30,P =0.878),and 2-year progression-free survival was 30.1％ vs.27.9％ ( x2 =0.02,P =0.586).No severe side effects observed.All patients tolerated CMNa infusion well.Conclusions CMNa is tolerable and effective as a hypoxic radiosensitizer,and its combination with radiotherapy can improve short term effect.However,survival is not improved within our follow-up period.

Objective To evaluate the long-term clinical efficacy and toxicities of combined intracavitary hyperthermia and radiotherapy fur locally advanced uterine cervical cancer. Methods 310 patients with locally advanced uterine cervical cancer were assigned into intracavitary hyperthermia + radiotherapy group(TRT, 181 patients) and external-beam radiotherapy + traditional intracavitary radiation group (RT,129 patients). The external-beam radiotherapy were given with 60Co γ-my or 6-8 MV X-ray in traditional fractionation. In TRT group,radiotherapy was 40 Gy using the anterior-posterior pelvic fields and additional 20-25 Gy using the lateral fields. Hyperthermia was delivered by the 915 MHz microwave hyperthermia device within 15-60 min after external radiotherapy for 10-12 times(40 min each time,1-2 times per week). The temperature of tumor surface was 46-47℃. In the RT group, the external-beam radiotherapy of 40 Gy was delivered using the anterior-posterior pelvic fields. The intracavity radiotherapy of radium was delivered before 1989 ,with 50 mg radium in the vagina and 30 mg in uterine cavity for 24 hours ,weekly for 3 times to a total dose of 7200 mg·h. After 1989,intraeavity radiotherapy of 192Ir was delivered to a total dose of 30-36 Gy to point A in 5-6 Gy fractions,2 fractions per week. Results The 5-year survival of patients in TRT group and RT group was 67.4% versus 52.1% for stage Ⅱ disease (χ2=7.55,P=0.006), and 60.0% vemus32.3% forstage Ⅲ (χ2=7.06,P=0.007) . The 10-year survival was46.5% versus42.6% for stage Ⅱ (χ2=3.90,P=0.058), and 43.7% versus 20.6% for stage Ⅲ(χ2=17.28,P=0.000). Cox regression analysis showed that the tumor stage(P=0.023) and intracavitary hyperthermia( P=0.019) were prognostic factors. According to the RTOG criteria, the rate of mild to moderate late side effects of rectum and bladder in TRT and RT group was 17.7% and 33.1%, respectively (χ2=9.18, P=0.002). Rectovaginal fistula was developed in5 patients(3.9% ) in RT group and I patient (0.6%) in TRT group(χ2= 4.38,P=0.036). Conclusions The long-term survival of patients with stage Ⅲ uterine cervical cancer is better of TRT group than RT group. The TRT is well tolerated and the late toxicity rate is obviously low. It is necessary to carry out large randomized clinical trials to confirm these outcomes.

Objective To discuss the diagnostic value of peritoneal effusion detection by emergency-ultrasound in patients with closed abdominal injury. Method From August 2006 to June 2009,212 patients with closed abdominal injury were studied to evaluate peritoneal effusion detection by emergency ultrasound. Results of 212 patients,peritoneal effusion frequency rate was 78.8%( 167/212), meanwhile,abdominal paracentesis confirmation ratio was only 46.2%(98/212). In the follow-up, 13 patients with injuried hollow viscera and 1 patient with rupture of kidney showed peritoneal effusion. The volume of abdominal fluid was increasing in 17 patients,which needed to be managed by surgery. The accuracy rates were respectively 78.3%( 112/143) and 36.1%(13/36) in the solid organs and the hollow organs. Conclusion During the course of diagnosis and treatment in closed abdominal injury,peritoneal effusion monitoring by ultrasound should be used routinely, which can help to decrease the rate of misdiagnosis and avoid delayed treatment.