Objective To analyze the outcomes and prognostic factors in patients with esophageal cancer after concurrent chemoradiotherapy.Methods A total of 135 patients with esophageal squamous cell carcinoma were enrolled in the clinical study from January 2008 to June 2015.The patients were treated with two-dimensional radiotherapy (56 patients) or three-dimensional radiotherapy (79 patients).The radiotherapy was delivered at a total dose of 60-64 Gy (1.8-2.0 Gy per fraction).The concurrent chemotherapy regimen consisted of fluorouracil plus cisplatin or paclitaxel plus cisplatin and was performed on days 1 and day 29 of radiotherapy.The Kaplan-Meier method was used to calculate overall survival (OS)and progression-free survival (PFS) rates,the log-rank test was used for survival difference analysis and univariate prognostic analysis,and the Cox model was used for multivariate prognostic analysis.Results The 1-,3-,and 5-year sample sizes were 96,31,16,respectively.The 1-,3-,and 5-year OS rates were 74.0％,39.0％,and 28.6％,respectively;the median OS time was 25 months.The 1-,3-,and 5-year PFS rates were 57.3％,27.3％,and 16.6％,respectively;the median PFS time was 15 months.The univariate analysis indicated that clinical stage,radiotherapy method,and M stage were prognostic factors for OS and PFS (P =0.006,0.000,and 0.032;P=0.017,0.004,and O.000).The multivariate analysis showed that clinical stage and radiotherapy method were independent prognostic factors for OS and PFS (P=0.006 and 0.000;P =0.033 and 0.023).Conclusions For non-surgical treatment of patients with esophageal cancer,concurrent chemoradiotherapy is a preferred strategy and has proven to be effective and tolerable.

Breast Neoplasms ; chemistry ; Female ; Humans ; Immunohistochemistry ; methods ; standards ; In Situ Hybridization, Fluorescence ; methods ; standards ; Receptor, ErbB-2 ; analysis ; Stomach Neoplasms ; chemistry

OBJECTIVE: To investigate the inhibitiom effect of PTEN(gene of phosphate and tension homology deleted on chromsome ten) combined with adriamycin on proliferation, migration and invasion of non-Hodgkin lymphoma cell line Raji in vitro. METHODS: Cell proliferation was determined by MTT in Raji cells response to adriamycin with different concentrations. Transwell assay was performed to evaluate the effects of adriamycin and PTEN on migration and invasion of Raji cells. RT-qPCR was conducted to measure the expression of PTEN in Raji cells after adriamycin treatment. RESULTS: Adriamycin significantly inhibited the proliferation of Raji cells in a concentration dependent manner (r=-0.925, P<0.001). Adriamycin inhibited invasion and migration in Raji cells. Moreover, adriamycin promoted the expression of PTEN. Overexpression of PTEN markedly suppressed invasion and migration in Raji cells. The combination of adriamycin and PTEN strikingly decreased the proliferation, invasion and migration of Raji cells. CONCLUSION: Adriamycin and PTEN would inhibite the proliferation, invasion and migration of Raji cells. PTEN drastically enhances the inhibition of adriamycin on the proliferation, migration and invasion of Raji cells.

ObjectiveTo evaluate the clinical efficacy and toxicity of gefitinib combined with Zhenqi Fuzheng capsule in treatment of senile non-small-cell lung cancer (NSCLC) at the middle and late stages. Methods88 patients with NSCLC at Ⅲ b-Ⅳ were randomly divided into combined drugs group ( gefitinib combined Zhenqi Fuzheng capsule,n =46 cases) and single drug group (gefitinib,n=42 cases).After treatment for 60 d,the short-term efficacy,side effects and quality of life were observed and evaluated. The objective response and survival rate were assessed after following up for 2 years. Results The short-term efficacy rate in the combined drugs group (19.6 ％ ) was higher than single drug group (11.9 ％ ),but there was no significant difference between the two groups (x2=0.096,P＞0.05).The rate of Karnofsky score in improvement and stableness was 71.7％ in combined drugs group and 50.0％ in single drug group,and quality of life improved after combined drugs compared with single drug treatment (x2 =4.376,P＜0.05).The adverse effects in combined drugs group was some lower than in single drug group with no statistical significance.There was no differences in the survival rates of 2 years between the two groups(x2 =0.556,P＞0.05). ConclusionsThe gefitinib combined Zhenqi Fuzheng capsule in treatment of middle-and late-stage NSCLC is worthy to be popularized due to positive efficacy,less side effects and higher quality of life.

·AIM: To detect the effect of CTGF on the apoptosis in the diabetic retina with small interfering RNAs (siRNA) targeting with CTGF. ·METHODS: A total of 60 rats were divided into six groups including control group, diabetic 4,8,12,16 weeks group, and interference group. Diabetic rats were induced by STZ intra-peritoneal. At 4, 8, 12, 16 weeks after diabetic setting up, retinas were obtained from control, diabetic rats and diabetic animals treated by intravitreal injection of CTGFsiRNA to suppress the expression of CTGF mRNA. Retinal cells apoptosis was detected by Tunnel staining and mRNA expression of CTGF was analyzed by RT-PCR.·RESULTS: The levels of CTGF and the apoptosis in the retinas of diabetic rats were significantly higher than those in the controls. Apoptosis occurred at 4 weeks after a diabetic model setting up, became serious with the diabetes developing, while CTGF elevated at 8 weeks. The cell apoptosis counts increased to 25.8cells/mm2 at 24 weeks of diabetes. SiRNA-mediated inhibition of CTGF mRNA resulted in a significant decrease in apoptosis. Significant correlations were found between CTGF and apoptosis in the retina.·CONCLUSION: These results suggest that CTGF might be involved in retinal cells apoptosis which is a characteristic of early diabetic retina. siRNA targeting CTGF seems to have the advantage of ameliorating retinal cells lost.

Objective To explore the value of B-type natriuretic peptide (BNP) predicting cardiac events after noncardiac surgery in the aged patients. Methods The level of BNP， the score of Goldman analysis and the cardiac risk grade of ACC/AHA guideline were analyzed in 274 aged patients for cardiac outcome after noncardiac surgery. Results Preoperative BNP concentration>100 pg/ml，score of Goldman≥13，and the high or moderate risk grade by ACC/AHA guideline were related with cardiac events. There was no significant difference in the index such as sensitivity，specificity, accuracy，positive predictive value and negative predictive value for cardiac events between BNP level and cardiac risk grade. Compared with the score of Goldman, BNP was more sensitive （100% vs 55.6%）and negatively predictive （100% vs 96.3%） for cardiac events. Conclusion The risk of cardiac events after noncardiac surgery could be predicted with the level of BNP before operation in the aged patient.

OBJECTIVETo investigate the advantages and disadvantages of dual-color silver-enhanced in-situ hybridization (DSISH) and fluorescence in-situ hybridization (FISH) for determination of HER2 gene status in gastric carcinoma and to evaluate the feasibility of DSISH.

METHODSEighty cases of primary gastric or gastroesophageal junction adenocarcinomas diagnosed and treated surgically from January to March, 2009 at the West China Hospital were enrolled in the study. Automated immunohistochemistry (IHC) staining, FISH and automated DSISH were carried out to detect the HER2 status, respectively, and the concordance of the three techniques was then evaluated.

RESULTSDSISH and FISH failed initially, but repeated detection was successful in 5 cases. Gene amplification was detected in 12/13 IHC 3+ cases in DSISH and in 11/13 IHC 3+ cases in FISH. In 6 IHC 2+ cases, the amplification rate was both 1/6; in 18 IHC 1+ cases, the amplification rate was both 2/18. No amplification was observed in 43 IHC 0 cases. Only one of the 80 cases showed discrepancy, and therefore the overall concordance between FISH and DSISH was 98.8% (κ = 0.958, P < 0.01).

CONCLUSIONSDSISH represents a novel approach for the determination of HER2 status in gastric carcinoma, and the overall concordance between DSISH and FISH is excellent. Despite their advantages and disadvantages, DSISH is more feasible and practical for routine application in surgical pathology.

Adenocarcinoma ; genetics ; Esophagogastric Junction ; Gene Amplification ; Genes, erbB-2 ; Humans ; In Situ Hybridization ; methods ; In Situ Hybridization, Fluorescence ; Sensitivity and Specificity ; Silver ; Stomach Neoplasms ; genetics

There are many therapies to treat the trismus, such as durg therapy, occulusal splints, pulsing electromagnetic fields, medical iontophoresis, laser, acupuncture. But there are no objective criterias about the most effective methods. The patient with trismus after extraction was cured by using comprehensive rehabilitation including physical therapy (ultrashort wave electrotherapy, medical iontophoresis, middle frequency electrical therapy), traditional Chinese manipulation, functional training, muscular and joints traction. The patient recovered completely with satisfactory. Thus this method had the advantage of painless, noninvasive and non-stimulation with well clinical practice.
Humans ; Lasers ; Trismus

[Objective]To evaluate the expression of enhancer of zeste homolog 2(EZH2),Ki-67 and intratumoral microvaseu?lar density(iMVD)in human colorectal cancer(CRC),and discuss their relationship with the biological behavior and prognosis.[Methods]The expression of EZH2,Ki-67 and iMVD(labeled by CD34 protein)was measured with immunohistochemical MaxVision method in CRC patients followed up over 5 years.[Results]Positive expression rates of EZH2,Ki-67 and iMVD were 40.91%(45/110),57.27%(63/110)and 46.36%(51/110),respectively. EZH2 expression was positively correlated with distant metastasis(P=0.024). Ki-67 expression was positively correlated with tumor size,infiltration depth,AJCC stage and differentiation(P=0.033~0.015). The iMVD expression was positively correlated with infiltration depth ,AJCC stage and differentiation (P=0.016~0.034). Spearman correlation analysis showed that EZH2 expression was positively correlated with Ki-67 expression(r=0.195,P=0.041), whereas negatively correlated with iMVD expression. Ki-67 expression had a positive correlation with iMVD(r=0.213,P=0.025). Multivariate analysis suggested that the EZH2 expression was an adverse independent factor for survivals of CRC patients(HR 1.965, 95%CI:1.019-3.789,P=0.044 for OS).[Conclusion]EZH2 expression was significantly correlate with the proliferation of tumor cells and may plays an important role in the metastasis and prognosis of CRC.

Objective: To compare the performance of Miseq and Ion Torrent PGM platforms and library construction method for next-generation sequencing (NGS) technology for formalin-fixed and paraffin-embedded (FFPE) samples. Methods: A total of 204 FFPE cancer samples including 100 non-small cell lung cancers at the First Affiliated Hospital of Zhejiang University, and 104 colorectal cancers at West China Hospital of Sichuan University were retrospectively selected from January 2013 to December 2016. By using the same samples, DNA was extracted, and the same amount of DNA was used for library construction with the same kit, and sequenced on Miseq and Ion Torrent PGM respectively, after passing the quality control. Any discordant mutations between two platforms were validated by amplified refractory mutation system-polymerase chain reaction (ARMS-PCR) method and Sanger sequencing. Results: A total of 204 FFPE samples were included and 197 samples were successfully analyzed by both platforms. The number of reads generated by the samples on Miseq platform sequencing was higher than PGM platform (median 391 634 vs. 298 030, P<0.01). Alignment with human reference genome showed that the mapping rate of Miseq platform was higher than PGM platform (median 100.0% vs. 99.7%, P<0.01). The median sequence depth of samples on Miseq was higher than PGM platform (median 853× vs. 698×, P<0.01). A total of 236 mutations were detected by two platforms, of which 221 were detected on both platforms, with a 93.6% concordance. Miseq platform detected 11 mutations not detected on PGM platform, while PGM platform detected 4 more mutations not detected on Miseq platform. With validation by ARMS-PCR and Sanger sequencing, Miseq platform was more reliable for low-frequency mutations. The main reasons for the discordant mutations between two platforms were that mutation frequency on undetected platform was lower than mutation reporting range (5%) and FFPE samples were stored for a long time. Conclusions Compared with PGM, Miseq platform shows higher sequencing quality in terms of the number of reads, alignment results and coverage depth, and the test results are more reliable. In clinical practice, the appropriate platform should be chosen based on sample size and actual throughput requirements to aid in the molecular characterization of tumors.