Antitumor drugs that target the signaling of vascular endothelial growth factor and its receptors have attracted increasing attention with the development of antiangiogenic targeted therapy. Apatinib is a second-generation vascular endothelial growth factor receptor-2 inhibitor and a potent antiangiogenic agent. Apatinib is one of the recent oral molecular targeted anti tumor drugs. Clinical studies have indicated that apatinib exhibits high bioavailability and a tolerable safety profile. A series of large-scale randomized and controlled clinical trials before and after the release of the drug in the market have demonstrated encouraging objective response rate and survival benefit across a broad range of malignancies, including non-small cell lung cancer, breast cancer, and gastric cancer. Apa-tinib was approved and launched in China in 2014 as a subsequent-line treatment for patients with advanced gastric cancer. Apatinib is currently undergoing phase II/III clinical trials for the treatment of numerous cancer types, such as gastric carcinoma, lung cancer, he-patocellular carcinoma, esophageal cancer, and colorectal cancer. These clinical trials are conducted to determine the antitumor activi-ty of apatinib when administrated alone or in combination with other therapies. This review summarizes the latest research progress of apatinib, including antitumor mechanisms, clinical effects on different tumor types, safety profile and adverse effects, drug interac-tions, as well as drug resistance and biomarkers. This article presents a deeper understanding of the clinical application of apatinib in anti tumor treatment, and provides reference for future clinical practice in therapeutic options for cancer patients.

Pancreatic abscess(PA)is the most serious complication of severe acute pancreatitis(SAP),which can lead to systemic and/ or local complications,and even death. PA cannot be resolved automatically after the formation. Once diagnosed,early drainage,anti-infection and nutrition support should be undertaken,the most important is early drainage. In the past,the treatment of PA was mainly based on surgical treatment. With the development of minimally invasive techniques,endoscopic ultrasound(EUS)guided drainage and percutaneous catheter drainage(PCD)offer a new way for the treatment of PA. Preventing and early diagnosis of PA become a challenge in the treatment of SAP. This article reviewed the progress in diagnosis and treatment of SAP complicated with PA.

Objective To study the effect of adjuvant transcatheter arterial chemoembolization (TACE) on intrahepatic recurrence after curative liver resection for primary hepatocellular carcinoma (PHC).Methods 130 PHC patients who underwent curative liver resection from June 2010 to February 2013 were selected and randomly allocated to the study group (n =67) and the control group (n =63).The study group underwent adjuvant TACE for 1 ～ 4 times,and the control group did not receive any adjuvant therapy.On follow-up for 36 months,the postoperative recurrence rates,tumour free survival time and tumor free survival rates of the two groups were compared.Results At 6 months after surgery,the serum AFP level [(379.8 ±91.7) μg/L vs.(414.5 ±84.3) μg/L] and the IGFBP-2 level [(2 855.3 ±727.5) μg/L vs.(3 259.6 ± 894.1) μg/L] in the study group were significantly lower than the control group (P ＜ 0.05).The 1-year cumulative recurrence rate in the study group (10.4％ vs.28.6％) was significantly lower than the control group (P ＜ 0.05).However,the 2-year and 3-year cumulative recurrence rates were not significantly different between the two groups (P ＞ 0.05).The 3-year cumulative tumor free survival rate of the study group (81.0％ vs.73.2％) was significantly higher than the control group (P ＜ 0.05).Patients in the study group with portal vein tumor thrombus had an 1-year cumulative recurrence rate of (12.8％ vs.31.6％) and a 2-year rate of (28.2％ vs.50.0％).In patients with a preoperative AFP ≥400 μg/L,the 1-year cumulative recurrence rates were (8.8％ vs.30.6％).When the tumor diameter was ≥10 cm,the 1-year,2 year and 3-year cumulative recurrence rates were significantly lower than the control group (P ＜ 0.05,11.8％ vs.46.7％),(35.3％ vs.75.3％) and (47.1％ vs.86.7％),respectively.The recurrence rates in patients who had no cancer thrombus,a preoperative AFP ≤400 μg/L and a tumor diameter ＜ 10 cm were not significantly different between the two groups (P ＞ 0.05).The recurrent rates of patients who underwent TACE 1 time and those who did not receive TACE showed no significant difference (P ＞0.05).In patients who had TACE twice,the 1-year (4.3％ vs.28.6％),2-year (15.2％ vs.41.3％) and 3-year (26.1％ vs.49.2) cumulative recurrence rates were significantly lower than patients who did not receive TACE (P ＜ 0.05).In patients who had TACE for more than three times,the cumulative recurrence rate was similar to patients who had TACE twice (P ＞ 0.05).Conclusions Adjuvant TACE helped to reduce PHC recurrence after curative liver resection during the high-risk period for recurrence.A 1-time TACE did not significantly reduce postoperative recurrence rate,and ≥ 3 times TACE did not significantly improve tumor-free survival rates.Adjuvant TACE and the number of TACE should be reasonably carried out based on the indications and pathological characteristics.

Objective To explore the pregnancy outcome of large doses of progesterone conservative treatment in early endometrial cancer and endometrial severe dysplasia and analyze the pregnancy-relating factors.Methods Fifty-eight cases with early endometrial cancer and 33 cases with endometrial severe dysplasia from June 2008 to January 2013 were selected.They were given large doses of oral progesterone,endometrial curettage was used to evaluate the therapy response of endometrium after every 3 months of administration.Individualized maintained treatment was given to patients after achieving complete remissionof the endometrium.Pregnancy outcome and pregnancy-relating factors were analyzed retrospectively.Results All of the 91 patients 87.9％ (80/91) achieved complete response.Of the 61 cases who desired to conceive after complete response,29 of them had 35 pregnancies,the pregnant rate was 47.5 ％ (29/61),and 22 women obtained healthy live birth baby,the fertility rate was 36.1％ (22/61).Age,pre-treatment complications,treatment time and treatment before endometrial biopsy result (endometrial severe atypical hyperplasia or endometrial cancer) was not correlated with pregnancy (P ＞0.05).The pregnant rate of patients who received in vitro fertilization-embryo transfer,ovulation promotion,or no treatment was 13/13,12/29 and 4/19,respectively,and there was significant difference (P ＜0.05).Conclusions Conservative treatment for early endometrial cancer and endometrial severe dysplasia with large doses progesterone could achieve higher response rate.Assisted reproductive technologies could significantly increase the chance of conception.

It has been indicated that the oncogene and anti-oncogene are closely related to the development and progression of cancer.With the development of molecular biology,detection of oncogene and anti-oncogene has become an important approach for clinical warning and diagnosing of cancer.Since the establishment of the molecular model of colon cancer by Fearon and Vogelstein in 1990,the genetics of colorectal cancer has gained major advances in early diagnosis.Early detection of related gene mutations is helpful for the early warning of colorectal cancer,especially for palients with hereditary cancer(the detection rate is fairly high).This review summarizes the progression of study on biomarkers of colorectal cancer.

Anti-Bacterial Agents ; adverse effects ; Humans ; Integrative Medicine ; Kidney Diseases ; chemically induced ; therapy

Objective To explore the characteristics of the bus explosion wounds and their first aid and treatment. Methods The conditions of the 87 victims of two bus explosions and their treatments were analyzed retrospectively. Results Of the 87 victims, 9 died on the spot, 3 died on their way to the hospital, 18 were treated in the outpatient department and discharged after observation for several days, and 57 received hospitalization treatment. All the patients were discharged with full recovery except that 2 with bone defects in 3 limbs had to receive secondary bone transplantation and 2 with tibial nerve injury had to receive secondary nerve plerosis. Conclusions The conditions of victims of the bus explosion are usually severe and complicated. The majority of the patients present compound wounds with high mortality. Pre hospital first aid and classification of the patients should be made properly before the patients are referred to the hospital in batches. Treatment should be arranged in order of severity and urgency.

Objectives To investigate the risk factors of cardiorenal syndrome type 1 (CRS1) in patients with acute myocardial infarction (AMI).Methods The medical date of hospitalized patients with AMI from January,2013 to February,2014 in Hunan Provincial People~ Hospital were reviewed.A total of 265 patients with AMI was divided into CRS1 and non-CRS1 groups.The univariate comparison and multivariate Logistic regression analysis were performed to obtain the CRS1 risk factors.Results In the 265 AMI patients,CRS1 was found in 59 patients (22.3％).Age,history of diabetes,Killip classification,left ventricular ejection fraction (LVFF),baseline serum creatinine,blood urea nitrogen,uric acid,baseline evaluated glomerular filtration rate (eGFR),serum sodium,the left anterior descending artery lesion,emergency percutaneous coronary intervention (PCI),β-blocker,and angiotensin converting enzyme inhibitor/angiotensin receptor antagonist (ACEI/ARB) were statistically different between CRS1 and non-CRS1 groups (all P ＜ 0.05).Multivariate logistic regression showed that age,history of diabetes,Killip classification,reduced LVEF,reduced eGFR,hyponatremia,the left anterior descending artery lesionn,emergency PCI non-undergo,and β-blocker non-use were independent risk factors for CRS1 after AMI.Conclusions CRS1 is a common complication in AMI patients,which is associated with many factors.Our data suggest that patients with AMI should be more comprehensively assessed and monitored,thereby preventing the occurrence of CRS1.

Objective To explore the effects of AKT2 expression in pancreatic cancer cell line Panc-1 on the sensitivity towards to gemcitabine.Methods The expression vector pAKT2 shRNA was constructed and transfected into Panc-1 cells by lipofecton.The mRNA and protein expression levels of AKT2 were detected by RT-PCR and Western blot assays,respectively.The changes of gemcitabine sensitivity after shRNA were examined by the MTT assay.Results The mRNA and protein levels of AKT2 in Panc-1 cells were significantly decreased after the transfection,and the median inhibition concentration of gemcitabine against Panc-1 cells was reduced from (1.96 ± 0.22) mg/L to (0.24±0.03) mg/L.The sensitivity of Panc-1 cells to gemcitabine was increased significantly after pAKT2-shRNA transfection.Conclusion The sensitivity of Panc-1 cells to gemcitabine could be enhanced by pAKT2-shRNA.

Objective To study the effect of RNA interference suppressing the expression of AKT2 on sensitivity of human pancreatic cancer cell line xenograft in nude mice to gemcitabine.Methods The human pancreatic cancer cell implanted tumor mode1 in the nude mice was established.By abdominal cavity administration and intratumoral injection,the mice bearing tumor were treated with gemcitabine in combination with vector of pAKT2-siRNA.Tumor growth of tumor tissues was observed,the AKT2 mRNA and protein expression levels in tumor tissues detected by RT-PCR and immunohistochemistry respectively,and tumor apoptosis measured by Tdt-mediated dUTP nick end labeling(TUNEL).Results In chemotherapy+AKT2-siRNA group the expression of AKT2 mRNA and protein was significantly lower than in control group,chemotherapy group and chemotherapy+blank plasmid group.The tumor weight and tumor volume in chemotherapy+AKT2-siRNA group were significantly reduced as compared with those in other three groups.The inhibition rate and apoptosis rate in chemotherapy+AKT2-siRNA group were significantly higher than those in other three groups.Conclusion Sensitivity of human pancreatic cancer cell line to gemcitabine could be significantly improved by RNA interference suppressing the expression of AKT2.