Objective To evaluate the clinical toxicity and efficacy of S-1 combined with γ-ray body stereotactic radiation therapy in treatment of locally advanced pancreatic cancer.Methods Forty-five patients with locally advanced pancreatic cancer were randomly divided into two groups.The combination group received γ-ray stereotactic body radiation therapy which was given isodose curve of 50 ％-60 ％,tumor encircling dose of 3.0-4.5 Gy per fraction depended on dimension of tumors,9-12 fractions.Combined with S-1 40 mg/m2,2 times/d,for consecutive twenty-one days for four courses.The control group was given γ-ray stereotactic body radiation therapy only.Toxicities and effects were evaluated according to the criteria of WHO and RTOG.Results The CR rates in combination group and control group were 30.4 ％ (7/23) and 13.6 ％ (3/22),the response rates were 91.3 ％ (21/23) and 63.6 ％ (14/22) (x2 =4.980,P =0.026).The rates of gastrointestinal tract side reaction in combination group and control group were 82.6 ％ and 68.2 ％ (x2 =1.267,P =0.260),myelosuppression in combination group and control group were 78.3 ％ and 63.6 ％ (x2 =1.171,P =0.279).The rate of Ⅲ-Ⅳ grade myelosuppression in combination group were higher than that in control group (x2 =4.874,P =0.027).The median progression-free survival (PFS) rates of two groups were 8 months and 6 months respectively (x2 =1.357,P ＞ 0.05),the median survival period were 17 months and 14 months (x2 =1.017,P ＞ 0.05),1 year survival rates were 60.9 ％ and 54.5 ％ respectively (x2 =0.184,P ＞ 0.05).Conclusions S-1 combined with body gamma system treatment can improve local control rate and effective rate for inoperable patients with local advanced pancreatic carcinoma,and the adverse reactions are well tolerated.This method can be used as locally advanced pancreatic cancer chemoradiation safe and effective choice.

Background Neovascular glaucoma is a type of refractory glaucoma.Biological amnion combined with glaucoma valve implantation is a primary therapy and its long-term effectiveness is noticeable. Objective The goal of this Survey was to evaluate the effectiveness of biological amnion combined with glaucoma valve implantation for neovascular glaucoma and compare the clinical outcome with simple glaucoma valve implantation. Methods This was a retrospective observational case series.The clinical data of 44 eyes of 44 patients received biological amnion combined with glaucoma valve implantation for neovascular glaucoma and 43 eyes of 43 patients received simple glaucoma valve implantation for neovascular glaucoma were retrospectively analyzed and compared.The age,sex and disease-cause were matched between these two groups.Patients were followed-up for 24 months after operation.Surgery success was identified as the intraocular pressure(IOP)<21 mmHg after operation.Written informed consent was obtained from each patient prior to the operation.Results The IOP was<21 mmHg throughout the follow-up duration in both groups.No significant difierence was found in the IOP value in 1 week after operation between two groups(t=-5.34,P=0.60).However,IOP values were lower in biological amnion combined with glaucoma valve implantation group in 3,12 and 24 months after operation than those of simple glaucoma valve implantation(t=6.64,t=5.00,t=7.81,P<0.01).Operation successful rates in biological amnion combined with glaucoma valve implantation group were 97.73％.93.18％。90.24％and 82.05％in 1 week,3 months,12 months and 24 months respectively after operation.and those in simple glaucoma valve implantation were 95.35％,71.43％,65.00％and 60.53％in corresponding time points,showing considerably significant differences between two groups (χ2=7.06,χ2=7.47,χ2=4.37,P<0.05).There was no significant difference in Ihe number of eyes with complication between the two groups(P>0.05). Conclusion The biological amnion combined with glaucoma valve implantation surgery may be more effective and safe for the treatment of neovascular glaucoma than with glaucoma va]ve only.

?AIM: To evaluate the effect for refractory glaucoma by using Ex - Press miniature implantation with deep sclerectomy.?METHODS: Thirty eyes in 24 patients with refractory glaucoma were treated by Ex- Press miniature ( P50 ) implantation with deep sclerectomy. The patients’ symptom, intraocular pressure ( IOP ) , visual acuity and complications were analyzed in a 12mo follow-up period.?RESULTS: During the follow-up period, all patients’ ocular pain was reduced. The mean IOP before operation and at the last follow-up time were 51. 15 ± 2. 60mmHg (1kPa=7. 5mmHg) and 15. 11 ± 2. 51mmHg, respectively, there was significant difference (P<0. 05). Postoperative visual acuity was improved in 8 eyes, had no significant change in 22 eyes. After operation, hyphema of anterior chamber appeared in 2 eye ( 7%) , which were obsorbed after 1wk.? CONCLUSION: Ex - Press miniature implantation combined with deep sclerectomy surgery is a relatively effective and safe treatment for the patients with refractory glaucoma. This method can significantly degrade the IOP, lessen ocular pain and reduce the complications risk.

AIM: To evaluate the efficacy and tolerability of one-site versus two-site phacotrabeculectomy in the treatment of patients with coexisting cataract and glaucoma. METHODS: A comprehensive literature meta-analysis was performed according to the Cochrane Collaboration methodology to identify controlled clinical trials comparing one-site with two-site phacotrabeculectomy. The studies meeting the predefined criteria were reviewed systematically by meta-analysis. Efficacy estimates were measured by standardised mean difference (SMD) for the percentage intraocular pressure (IOP) reduction from baseline to end point, odds ratio (OR) for the percentage having a best-corrected visual acuity (BCVA) of 0.5 or better after surgery and relative risk (RR) for complete success rates. Tolerability estimates were measured by RR for adverse events. All of outcomes were reported with 95% confidence interval (CI). Data were synthesised by Stata 10.1 for Windows. RESULTS: Two-site phacotrabeculectomy was associated with numerically greater, and significant efficacy than one-site in lowering IOP(SMD,-0.19;95% CI, -0.33 to -0.04; P=0.01). Numerically greater, but nonsignificant proportions of two-site patients than one-site patients had a BCVA of 0.5 or better (OR, 0.65; 95% CI, 0.30 to 1.39; P=0.26).Numerically greater, but nonsignificant proportions of two-site patients than one-site patients achieved the target IOP without anti-glaucoma medication at the end point (RR, 0.94; 95% CI, 0.84 to 1.04; P=0.22). Furthermore, there was no significant difference in adverse events between two surgical procedures.CONCLUSION: The efficacy of two-site phacotrabeculectomy appears to be superior to one-site phacotrabeculectomy. One-site and two-site phacotrabeculectomy are similarly tolerable in postoperative adverse events.

·AIM: To study the expressive variation of Nogo-A on rat retina in the process of chronic ocular hypertension. · METHODS: Thirty-six healthy adult male Wistars were randomly divided into control group (6 rats) and chronic hypertension group (30 rats). Chronic hypertension was created by cauterizing the superficial scleral veins. Immunohistochemistry technique was used to evaluate the expressive varieties of Nogo-A at different time points during the course of chronic ocular hypertension. · RESULTS: The success of the model was indicated by over 40% of increase in the IOP as compared with normal rats. Compared with control group, as time passed chronic hypertension group gradually had detectable morphology changes in the retina. At the 21st day of chronic ocular hypertension, retinas became thinner and the quantity of retinal ganglion cell (RGC) decreased (P<0.05). Assoicated with the morphological changes, the expression of Nogo-A was strongly increased (P<0.05).CONCLUSION: Myelin associated protein Nogo-A plays a part in the process of chronic ocular hypertension.

AIM: To study the effects of geranylgeranylacetone(GGA) on the expression of heat shock protein70(HSP70) on retinal ganglion cells(RGC) in rats with chronic intraocular pressure(IOP) elevation.METHODS: Seventy Wistars were divided into blank control group(10 rats), chronic hypertension group(30 rats) and GGA group(30 rats). Chronic hypertension was created by cauterizing the superficial scleral veins. 800mg/(kg·d)GGA was given by oral daily after cauterization. Immunohistochemistry was used respectively to observe the changes of expression of HSP70 in the model rats and GGA interference rats at different time points during the course of chronic IOP elevation.RESULTS: The successful model was identified as the IOP over 40% of normal rats. The retinal thickness was significantly reduced in model group and model+ GGA group compared with normal rats from 21 days through 28 days after cauterization(P<0.05), and that of model rats was obviously decreased in comparison with model+ GGA rats(P<0.05). The number of ganglion cells was significantly decreased in model rats and model+ GGA rats compared with normal rats from 21 days and 28 days. The stronger expression intensity(IOD) value was seen for HSP70 in the model+ GGA rats by immunochemistry(P<0.01).CONCLUSION: Systemic administration of GGA protects retina from chronic IOP elevation by regulating the expression of HSP70.

AIM:To compare one-site vs two-site phacotrabe-culectomy in chronic angle-closure glaucoma (CACG) coexisting with cataract.METHODS:This prospective, randomized study included 41 eyes with CACG. One-site approach was performed in 21 eyes and two-site procedure in 20 eyes. Intraocular pressure (IOP), best-corrected visual acuity (BCVA), the number of antiglaucoma medications and complications were observed. All patients were followed up for 9 months.RESULTS:There were no significant differences between the two groups preoperatively. IOP decreased from 22.7±4.9mmHg and 23.7±4.7mmHg preoperatively in one-and two-site groups to 18.0±1.2mmHg and 16.7±1.1mmHg 9 months after operation respectively(P<0.05). There were no significant differences in mean IOP between the two groups at any time (P>0.05). Decrease of the number of antiglaucoma medications and BCVA improvement were similar in both groups 9 months after surgery (P>0.05).There were no significant differences in complications between the two surgical procedures.CONCLUSION:There were no significant differences between the two groups in clinical efficacy and complications.

Objective:To investigate the efficacy of stereotactic body radiation therapy with gamma-knife (γ-SBRT) combined with targeted drug sorafenib and hyperthermia for the treatment of recurrent and metastatic hepatocellular carcinoma. Methods:A total of 71 patients with recurrent and metastatic hepatocellular carcinoma were admitted from August 2007 to December 2009. Among these patients, 39 were treated with γ-SBRT and hyperthermia (group 1); 19 were treated with γ-SBRT combined with sorafenib and hyperthermia (group 2). Results: The total efficacy rate after a three-month treatment was 83.1% (59/71). In group 1, the following results were obtained:one-and three-year local control rates of 41.0%(16/39) and 18%(7/39), respectively;one-and three-year overall survival (OS) rates of 41.2% and 17.9%, respectively; and one- and three-year progression-free survival (PFS) rates of 38.4% and 15.4%, respectively. In group 2, the following results were obtained:one-and three-year local rates of 56.3%(18/32) and 28.1%(9/32), respectively;one-and three-year OS rates of 62.5%and 28.1%, respectively;and one-and three-year PFS rates of 59.4%and 25.0%, respectively. Significant differences in OS and PFS were observed between the two groups. Conclusion:The combination ofγ-SBRT with targeted drug sorafenib and hyperthermia can be used effectively to treat recurrent and metastatic hepatocellular carcinoma. Adverse reactions are mild, and patients can tolerate this treatment.

Objective To evaluate biodistribution and pharmacokinetics pattern of ~(131)I-labeled rch24which is the region-grafted (humanized) anti-carcinoembryonic antigen (CEA) monoclonal antibody in nude mice. Methods Nude mice bearing cancer xenografts received intravenous injections of ~(131)I- rch24, then blood, plasma, heart, liver, spleen, lung, kidney, tumor and other tissues were taken at different time point for determination the concentration of radioactivity and calculate the T/NT value. Nude mice were packeted randomly to four group of high, medium, low dose and continuous administration, blood drug concentration was detected by ELISA method at the different intervals. Then, draw the concentration-time curve and calculate the pharmacokinetics paramete. Results After administration, radioactivity of the tumour was significantly enhanced whereas radioactivity of normal tissues decreased gradually. For single administration, at the dose of low to medium, pharmacokinetics pattern was linearity -kinetics whereas for high dose group,pharmacokinetics paramete shown some behavior of non-linearity-kinetics. Conclusion Our results suggest that the ~(131)I-labeled region-grafted (humanized) anti-CEA monoclonal antibody rch24 exhibit a considerable targeting activity so as to ~(131)I radioisotopes can be concentrated specifically in tumor. The pharmacokinetics pattern of this medicine was different at different dose.

Thirty SHRs were obtained randomly to hypertension, model group, captopril group and Qingre jiangya capsule group. Ten Wistar rats were used as control group. The hippocampus tissue was removed to explore the damage of spontaneously hypertensive rats (SHR) and the protective effect of Qingre jiangya capsule after continuously administered for 14 days. And then the data were processed by principal component analysis (PCA) and partial least squares discriminant analysis (PLS-DA). The research results revealed captopril group was significantly different from the other three groups. The classification of other three groups is also very clear after captopril group removed. This suggested that Qingre jiangya capsule could improve the overall metabolism compared with captopril. Four metabolites were identified: dimethylglycine, glycerophosphocholine, aldosterone and noradrenaline. Hypertension hippocampus damage may mainly be expressed in tyrosine metabolism, aldosterone-regulated sodium, vascular smooth muscle contraction reabsorption, and Qingre jiangya capsule could reverse the hippocampus tissue damage of SHR.
Animals ; Capsules ; pharmacology ; Drugs, Chinese Herbal ; pharmacology ; Hippocampus ; drug effects ; Hypertension ; drug therapy ; Male ; Rats ; Rats, Inbred SHR ; Rats, Wistar