Medical education on oncology is urgently enhanced in China.We analyse a host of questions in medical education on oncology in our country at present,and study didactical methods,goal and task on oncology education.

OBJECTIVETo determine the lamivudine response of HBV genotypes in patients with HBV DNA positive chronic hepatitis.

METHODSClinical data from 235 patients in the original trial were analyzed.

RESULTS135 patients received lamivudine and 100 patients as controls. Almost all patients had HBV genotypes B or C. Antiviral response were 92.9% and 75.9% in lamivudine-treated patients (chi-square = 6.628, P < 0.05) and 9.8% and 8.5% in untreated controls (P > 0.05) with HBV genotype B and C, respectively. The incidences of lamivudine-induced mutation in YMDD motif were 3.6% and 16.5% in HBV genotype B and C, respectively (chi-square = 5.508, P < 0.01). We identified HBV genotype B, elevated pretreatment alanine aminotransferase (ALT) levels, and low pretreatment HBV DNA levels as independent factors associated with antiviral response.

CONCLUSIONHBV genotype B was associated with a higher rate of lamivudine-induced HBV DNA clearance and lower rate of lamivudine-induced YMDD mutation compared with genotype C. HBV genotypes may be an important determinant of lamivudine therapy of chronic hepatitis B.

Adult ; Antiviral Agents ; therapeutic use ; DNA, Viral ; blood ; Female ; Gene Products, pol ; genetics ; Genotype ; Hepatitis B virus ; classification ; genetics ; Hepatitis B, Chronic ; drug therapy ; Humans ; Lamivudine ; therapeutic use ; Male ; Mutation

AIMTo study the regulation mechanism of GP on plasma lipoprotein metabolism and To explore its mechanism of anti-lipoperoxidation in the experimental hyperglycemia rats.

METHODSThe rats were raised with high fat diet for six weeks,and the model of hyperglycemia was then established. After that, those rats were treated with high or low dose of GP and xuezhikang as a masculine comparison for four weeks. Then, those rat were executed, and detected the plasma TC, TG, LDL-C, HDL-C, GSH-Px, at the same time the SOD, CAT and MDA concentration also be mensurated.

RESULTSThe results showed that high and low dose of GP could decrease the concentration of serum LDL-C, cholesterol and triglyceride remarkably and raise the concentration of HDL-C. The activity of GSH-Px, SOD and CAT in GP groups were promoted and the level of MDA was decreased distinctly.

CONCLUSIONThe GP can therapy the abnormity of serum lipid and has obviously anti-lipoperoxidation affection.

Animals ; Cholesterol ; blood ; Cholesterol, LDL ; blood ; Gynostemma ; Hyperlipidemias ; drug therapy ; metabolism ; Lipid Peroxidation ; Lipids ; blood ; Lipoproteins, HDL ; blood ; Male ; Phytotherapy ; Plant Extracts ; therapeutic use ; Rats ; Rats, Wistar ; Triglycerides ; blood

OBJECTIVETo investigate the value of in vivo proton magnetic resonance spectroscopy (MRS) in the assessment of hepatocellular carcinoma (HCC) and monitor its metabolic change shortly after transcatheter arterial chemoembolization (TACE).

METHODSIn this prospective study, 28 consecutive patients with large HCC (> or = 3 cm in diameter) confirmed by fine needle aspiration biopsy were recruited. The 1H MRS of all hepatic lesions and some uninvolved liver parenchyma were performed with 1. 5T whole body MR scanner. Among them, 15 cases were evaluated again about one week after TACE. The main metabolites such as choline and lipid before and after interventional therapy were measured to assess the early response of the tumor.

RESULTSThe technical success rate of 1H MRS in liver was high (33/41, 80%), closely related to breath motion, location of lesion, and size of voxel. In spectra, the choline compound peak of HCC elevated compared with uninvolved liver parenchyma. After TACE, both the amplitude and the area of choline resonance peak significantly descended (choline-to-lipid ratios from 0.352 +/- 0.080 to 0.167 +/- 0.030, P = 0.026; from 0.205 +/- 0.060 to 0.070 +/-0.020, P = 0.042, respectively); yet lipid resonance peak ascended.

CONCLUSIONSIn vivo 1H MRS is technically feasible for the evaluation of large focal hepatic lesions, however, the reproducibility and stability are not as good as routine MR scan. 1H MRS can monitor the early stage metabolic changes of HCC after TACE but limitation like quantification still exists.

Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; administration & dosage ; Carcinoma, Hepatocellular ; diagnosis ; therapy ; Chemoembolization, Therapeutic ; Cisplatin ; administration & dosage ; Doxorubicin ; administration & dosage ; analogs & derivatives ; Female ; Humans ; Liver ; pathology ; Liver Neoplasms ; diagnosis ; therapy ; Magnetic Resonance Spectroscopy ; methods ; Male ; Middle Aged

OBJECTIVETo investigate the efficacy of high dose chemotherapy combined with autologous peripheral blood stem cell transplantation (APBSCT) for the treatment of neural ectodermal solid tumor originated from neural crest in children.

METHODSTwenty-three children at a medium age of 5.8 + or - 3.5 years with neural ectodermal solid tumor originated from neural crest were enrolled. Of the 23 children, 20 with stage IV neuroblastoma (9 were in complete remission, 7 were in partial remission and 4 were in progressive disease), 2 with stage IV primitive neuroectodermal tumor (PNET) in complete remission, and 1 with retinoblastoma in partial remission. Before APBSCT the children received 8.0 + or - 4.3 courses of chemotherapy. During chemotherapy the autologous peripheral blood stem cells were harvested and the tumor excision was performed. Then APBSCT was performed.

RESULTSThe reconstruction of the hematopoietic system was noted in 19 of 20 children with stage IV neuroblastoma 16.5 + or - 0.9 days after transplantation. A follow-up (median 15.8 months) was done in these children. The follow-up showed that the survival rate in children in complete remission before transplantation was 100%, 57% in those in partial remission, and none of children in progressive disease survived (P<0.05). The total survival rate was 67% in children with neuroblastoma. The child with retinoblastoma had complete remission in a 6-months follow-up. The tumors recurred in children with PNET 5 to 8 months after transplantation and all died within one year after transplantation.

CONCLUSIONSHigh dose chemotherapy combined with APBSCT can result in a good outcome in children with neural ectodermal solid tumor originated from neural crest in complete remission before transplantation and can improve the outcome in patients in partial remission before transplantation. However, the children with PNET, even in complete remission before transplantation, do not respond to the therapy.

Antigens, CD34 ; analysis ; Antineoplastic Agents ; therapeutic use ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Humans ; Male ; Neural Crest ; pathology ; Neuroblastoma ; therapy ; Neuroectodermal Tumors, Primitive ; therapy ; Peripheral Blood Stem Cell Transplantation ; Transplantation, Autologous

Stem cell marker LIN28, related closely with SOX2 and OCT4, has been studied as a biomarker for the maintainance of pluripotent cells in several malignancies. Our previous study showed that SOX2 and OCT4 were negative predictors for hepatocellular carcinoma (HCC). However, the predictive value of LIN28 in HCC outcome is still undetermined. We hypothesized that LIN28 may also play a role as a biomarker for HCC. To test this hypothesis, we examined the expression of LIN28 in 129 radically resected HCC tissues using reverse transcription-polymerase chain reaction and analyzed the association of LIN28 expression with clinicopathologic features and prognosis. Our study showed that LIN28 was expressed at a higher frequency in tumor tissues than in non-HCC tissues (45.0% vs. 21.7%, P = 0.020). Moreover, LIN28 expression was significantly increased in cases with large tumor size (P = 0.010). Univariate analysis did not reveal a significant correlation between LIN28 expression and overall survival or recurrence-free survival. For HCC patients who met the Milan criteria, stratified analysis revealed shorter overall survival (P = 0.007) and recurrence-free survival (P < 0.001) in those with detectable LIN28 expression compared to those with no detectable LIN28 expression. Furthermore, multivariate analysis revealed that LIN28 was a negative independent predictor for both overall survival (hazard ratio= 7.093, P = 0.017) and recurrence-free survival (hazard ratio=5.518, P = 0.004) in patients who met the Milan criteria. Taken together, our results suggest that LIN28 identifies low-risk and high-risk subsets of HCC patients meeting the Milan criteria who undergo hepatectomy.
Adult ; Aged ; Carcinoma, Hepatocellular ; metabolism ; pathology ; surgery ; Disease-Free Survival ; Female ; Follow-Up Studies ; Gene Expression Regulation, Neoplastic ; Hepatectomy ; Humans ; Liver Neoplasms ; metabolism ; pathology ; surgery ; Male ; Middle Aged ; Neoplasm Grading ; Neoplasm Staging ; RNA, Messenger ; metabolism ; RNA-Binding Proteins ; genetics ; metabolism ; Survival Rate ; Tumor Burden

OBJECTIVETo observe the feasibility of a segment thoracic esophagus replaced by using a nitinol alloy composite artificial esophagus.

METHODSA nitinol alloy composite artificial esophagus was made of a nitinol tube coated with a silicone membrane with a dacron flange 1 cm proximal to each end. There were ten pigs for the models of experimental animal. The models of experimental animal were established by excised a segment of 7 cm long thoracic esophagus and replaced with the graft. In accordance with the different anastomosis connective way 10 pigs were divided into group I and group II, every group had 5 pigs. In group I monolayer end-to-end anastomosis was used with this prosthesis. In group II monolayer end-to-end anastomosis was used with this prosthesis and above the site of anastomosis adding dacron strip fixed. After operation the operate animals were observed for eating and health. Esophagography and flexible esophagoscopy were performed once a month at the first, second, and third postoperatively month. Three pigs of the grafted prostheses sloughed out spontaneously at different postoperatively period were killed for autopsy and pathologic examination of the neoesophagus.

RESULTSAll pigs had no leakage at the site of anastomosis and survived over 6 months. The longest survival was 20 months. Seven of 10 pigs the grafted prostheses sloughed out spontaneously at 2 to 6 months after the operation (4 in group I and 3 in group II). The grafted prostheses sloughed out spontaneously less than 3 months after operation, marked neoesophageal stenosis in the grafted portion was recognized (3 in group I). They displayed serious difficulty in eating. But the prostheses sloughed out spontaneously more than 3 months after operation, neoesophageal stenosis was increased slightly and the stenosis was only temporary and gradually resolved. (1 in group I, 3 in group II) They lived in good health and without difficulty in eating. Three of 10 pigs the grafted prosthesis still stayed in the grafted place over 10 months (1 in group I, 2 in group II). The neoesophageal had no stenosis. They were perfectly well in eating.

CONCLUSIONSA segment excised pig esophagus replaced with a nitinol alloy composite artificial esophagus is feasible and takes a better result.

Alloys ; Animals ; Artificial Organs ; Biocompatible Materials ; Esophagectomy ; Esophagus ; Female ; Implants, Experimental ; Male ; Prosthesis Design ; Prosthesis Implantation ; Silicone Elastomers ; Swine ; Time Factors ; Titanium

Objective:To compare between laparoscopic and open pancreaticoduodenectomy in the treatment of distal cholangiocarcinoma.Methods:The clinical data of laparoscopic pancreaticoduodenectomy (LPD group, n=101) and open pancreaticoduodenectomy (OPD group, n=99) in patients with distal cholangiocarcinoma who underwent pancreaticoduodenectomy at Hunan people's Hospital from Jan 2015 to Dec 2019 were analyzed retrospectively. The operation time, intraoperative blood loss, number of lymph node dissection, R 0 resection rate, postoperative hospital stay, postoperative complications and overall survival rate were compared between the two groups. Results:The operation time was (475.0±90.7) min and (444.8±63.3) min, the intraoperative blood loss was (350.9±397.9) ml and (546.7±642.9) ml, the postoperative hospital stay was (11.5±4.7) d and (13.3±5.1) d, the differences were statistically significant ( P<0.05).The number of lymph node dissection was 14.8±3.0 and 15.4±2.4, the R 0 resection rate was 93.1% and 96.0%, respectively, and there was no significant difference ( P>0.05). There was no significant difference in the incidence of residual complications ( P>0.05). During the follow-up of 5-64 months, the OS of 1, 3 and 5 years in the two groups were 90.4%, 41.3%, 20.6% and 94.3%, 50.8% and 24.7%, respectively. ( P>0.05). Conclusions:LPD is safe and feasible in the treatment of distal cholangiocarcinoma, and its short-term curative effect, curative effect and long-term overall survival rate are similar to those of OPD.

Objective:To compare the safety and efficacy of laparoscopic versus open pancreaticoduodenectomy.Methods:The clinical data of 989 patients who underwent pancreaticoduodenectomy at Hunan People's Hospital from January 2015 to December 2019 were analyzed retrospectively. There were 349 patients in the laparoscopic pancreaticoduodenectomy (LPD) group and 640 patients in the open pancreaticoduodenectomy (OPD) group. Propensity score matching (PSM) was used to match the baseline data of the two groups at a 1: 1 ratio. Data including operation time, intraoperative bleeding, postoperative hospital stay, bile leakage, pancreatic fistula and wound infection were compared between the two groups.Results:After PSM, there were 345 patients in each of the 2 groups. When the LPD group was compared with the OPD group, there were no significant differences in postoperative mortality, reoperation, intraoperative blood transfusion, pancreatic fistula, bile leakage, abdominal hemorrhage, abdominal abscess, severe complications, and pulmonary complication rates. The number of lymph node dissected, R 0 resection and overall survival rates between the two groups were also not significantly different ( P>0.05). However, the operation time of the LPD group (478.2±91.3) min was significantly longer than that of the OPD group (410.8±62.0) min ( P<0.05). On the other hand, the postoperative hospitalization time (10.8±4.3) d, intraoperative bleeding (322.0±362.6) ml, wound infection rate 1.2% (4/345) in the LPD group were significantly better than those in the OPD group [postoperative hospitalization time (12.5±7.9) d, intraoperative bleeding (478.8±570.2) ml, and wound infection rate 5.8% (20/345)] ( P<0.05) . Conclusion:LPD was safe and feasible, and it achieved similar curative effect as OPD.

BACKGROUNDMutations of the LMNA gene encoding lamin A and C are associated with dilated cardiomyopathy (DCM), conduction system defects and skeletal muscle dystrophy. Here we report a family with a mutation of the LMNA gene to identify the relationship between genotype and phenotype.

METHODSAll 30 members of the family underwent clinical and genetic evaluation. A mutation analysis of the LMNA gene was performed. All of the 12 exons of LMNA gene were extended with polymerase chain reaction (PCR) and the PCR products were screened for gene mutation by direct sequencing.

RESULTSTen members of the family had limb-girdle muscular dystrophy (LGMD) and 6 are still alive. Two patients suffered from DCM. Cardiac arrhythmias included atrioventricular block and atrial fibrillation; sudden death occurred in 2 patients. The pattern of inheritance was autosomal dominant. Mutation c.73C > G (R25G) in exon 1 encoding the globular domains was confirmed in all of the affected members, resulting in the conversion of arginine (Arg) to glycine (Gly).

CONCLUSIONSThe mutation R25G in exon 1 of LMNA gene we reported here in a Chinese family had a phenotype of malignant arrhythmia and mild LGMD, suggesting that patients with familial DCM, conduction system defects and skeletal muscle dystrophy should be screened by genetic testing for the LMNA gene.

Adult ; Cardiomyopathy, Dilated ; genetics ; Exons ; Humans ; Lamin Type A ; genetics ; Muscular Dystrophies, Limb-Girdle ; genetics ; Mutation