OBJECTIVE:To evaluate clinical efficacy and toxicities of oxaliplatin or irinotecan combined with 5-FU/LV for advanced colorectal cancer. METHODS:RCTs were retrieved from PubMed database and CHKD and Metaanalysis was carried out using Review Manager version 4.2.2 software. RESULTS:Six studies were enrolled. The oxaliplatin group was superior to irinotecan group in the overall response rate(RR=0.82,95%CI ranged from 0.74 to 0.91). The incidence rate of neutropenia in irinote-can group was lower than in oxaliplatin group(RR=0.79,95%CI ranged from 0.69 to 0.90)while the incidence of nausea/vomiting and diarrhea in irinotecan group was higher than in oxaliplatin group(RR=1.85,95%CI ranged from 1.42 to 2.40;RR=1.75, 95%CI ranged from 1.41 to 2.17). CONCLUSION:The scheme oxaliplatin combined with 5-FU/LV in the treatment of advanced colorectal cancer is superior to the scheme irinotecan combined with 5-FU/LV.

Objective To explore the radiosensitivity of berberine on esophageal cancer cells under hypoxia condition.Methods MTT assay and clonogenic survival assay were used to evaluate the effect of berberine on proliferation inhibition and radiosensitivity of esophageal cancer cells,respectively.Immunofluorescence was employed to examine the expression of HIF-1.The change of cell cycle distribution and cell apoptosis was assayed by flow cytometry.The expression of HIF-1 was measured by Western blot.DNA damage was detected by γ-H2AX Foci counting.Results With a clear dose and time effect,berberine inhibited cell proliferation and enhanced cell radiosensitivity(t =3.69,P＜0.05)with a sensitizing enhancement ratio(SER)of 1.42.Berberine caused a dose-dependent decrease in HIF-1 protein expression and also significantly increased the cell apoptosis in ECA-109 population(t=4.74,P＜0.05).Compared with the radiation alone group,berberine enhanced X-ray induced DNA double chain breaks(DSB).Conclusions Berberine can increase the radiosensitivity of esophageal cell line ECA-109,which may be associated with decrease of HIF-1 expression and induction of apoptosis in ECA-109 cells.

Objective To evaluate the diagnostic and therapeutic significance of serum free light chain (sFLC) in primary systemic(AL) amyloidosis. Methods Twenty-five patients with AL amyloidosis,including 18 men and 7 women with a mean age of 54(47-77) years old, were enrolled from October, 2005to May, 2010. sFLC was measured by immunoturbidimetric assay. The type of monoclonal light chain was judged upon sFLC κ/λ and its sensibility was compared with serum immunofixation and immunohistochemical analysis. Four patients were treated with M (T)D (melphalan/thalidomideand, dexamethasone), one with VD (velcade and dexamethasone) and four with high-dose melphalan followed by autologous stem cell support. The changes of sFLC were serially determined before and after treatment. Results Among the 25 patients with AL amyloidosis, two were κ light chains of precursor protein and 23 were λ light chains. Mean plasma cell in bone marrow was 3.5% (0-15%). Nineteen (76%) patients had abnormal elevated sFLC and abnormal κ/λ ratios, and 17(68% ) patients with immunofixation positive. The sFLC test had similar sensitivity as serum immunofixation (P = 0. 727 ). Twenty-one (84%) patients were shown to have either κor λ immunoreactive amyloid deposits on biopsied tissues. The sFLC test combined with serum immunofixation allowed the M protein to be detected in 22 (88%) patients. The positive rates of immunohistochemical analysis combined with sFLC test and/or serum immunofixation were 96%. Four patients with hematologic response showed obvious improvement in visceral organ involvement, but illness of 5 patients without hematologic response kept stable or progressed. Conclusions sFLC test is a sensitive qualitative and quantitative method to detect M protein. Preliminary data show the patients with obvious sFLC level decrease and/or κ/λ recovery to normal may have a high percentage of improved organs function. sFLC is critical index in diagnosing AL amyloidosis, which might help efficacy assessment.

OBJECTIVETo explore the feature of primary light chain amyloidosis patients treated with high-dose melphalan with auto peripheral blood stem cell transplantation (auto-PBSCT) and bortezomib plus dexamethasone (VD).

METHODSThirty-eight patients diagnosed from September 2004 to September 2012 were analyzed retrospectively, including 15 cases received auto-PBSCT, 23 cases exposed with VD.

RESULTSThe median follow-up duration for the patients was 34 months (range, 1-112 months), including auto-PBSCT group of 38 months (range, 5-112 months) and VD group of 31 months (range, 1-108 months). The organ response rate in all the patients was 39.5% (15/38), and the organ response rate between these two groups has no significant difference [33.3% (5/15) vs 43.5% (10/23), P=0.532]. However, the median time of organ response was significant difference [6 (3-10) months vs 3 (1-6) months, respectively (P=0.032)]. The 3-year overall survival (OS) rates in the two groups were 72.0% and 66.9%, and their average survival were 84.7 months and 75.9 months, respectively (P=0.683). In the patients with auto-PBSCT, the occurrence of III-IV grade of bone marrow suppression (P<0.001), fever (P<0.001), nausea and infection (P=0.006) were obviously higher than those with VD, but there was no statistically significant difference in pulmonary infection (P=0.069) and bloodstream infection (P=0.059).

CONCLUSIONSThe preliminary results have presented that primary light chain amyloidosis patients treated with auto-PBSCT or VD had similar organ response rate and survival. However, more adverse events occurred in the group of auto-PBSCT.

Amyloidosis ; therapy ; Bortezomib ; therapeutic use ; Dexamethasone ; therapeutic use ; Humans ; Immunoglobulin Light-chain Amyloidosis ; Melphalan ; therapeutic use ; Myeloablative Agonists ; therapeutic use ; Peripheral Blood Stem Cell Transplantation ; Retrospective Studies

Objective To explore the clinical characteristics and prognostic factors of primary gastric lymphoma.Methods Clinical data of 78 primary gastric lymphoma patients treated between September 2012 and January 2017 in our hospital were analyzed retrospectively.Results 1-year and 3-year survival rate were 86％ and 68％ respectively.Univariate analysis showed that the four factors including the level of serum lactate dehydrogenase (x2 =35.088,P =0.000),Musshoff stage (x2 =29.930,P =0.000),pathology types (x2 =6.077,P =0.014),IPI score (x2 =21.337,P =0.000) were associated with the prognosis.Multivariate analysis showed that Musshoff stage was an independent risk factor for the prognosis when stage Ⅰ,stage Ⅱ (OR =1.075,95％ CI:0.060-19.107,P =0.961) were compared with stageⅢ (OR =11.994,95％ CI:1.042-138.083,P =0.046),or stage Ⅳ (OR =13.165,95％ CI:1.476-117.417,P =0.021).Conclusions Musshoff stage is an independent factor for the prognosis,surgical treatment can not prolong survival and chemotherapy is the therapy of choice.

Objective To optimize the treatment plan for dermatitis medicamentosa in a patient with abnormal liver function associated with infection.Methods The culprit medication for drug eruption was identified by reviewing the patient′s liver and kidney function, routine blood count, therapeutic drugs, allergic history, by analyzing the characteristics of the compounding medication, combined with literature search on drug eruption diagnosis and treatments.Following the antihistamines and glucocorticoid use guidelines, the treatment plan was optimized by selecting appropriate antihistamines and glucocorticoids based on their metabolism and excretion pathway.Results The rash was poorly controlled after clinical pharmacist′s initial recommendation to use chlorpheniramine (intramuscular injection) and cetirizine (oral).The clinical pharmacist further suggested dexamethasone intravenous drip.The patient recovered well with the combination therapy of antihistamines and glucocorticoid.Conclusion When drug eruption occurred, clinical pharmacists should evaluate patient′s disease and medications comprehensively, provide timely and accurate pharmaceutical care to patients.

Objective To investigate the influence of depression on glycemic control in the patients with type 2 diabetes mellitus(T2DM).Methods The Zung self-rating depression scale(SDS) was used to assess depression.A total of 276 cases of T2DM were divided into the group A(SDS standard score ≥53 points) and B(SDS standard score ＜53points).The levels of HbA1c,FPG,HOMA-IR,etc.were compared between the two groups,and the influencing factors of glycemic control in T2DM patients were analyzed.Results In the patients with T2DM,the SDS standard score was correlated with HbA1c(r=0.26,P＜0.05).The multivariate regression analysis showed that the SDS standard score was still correlated with HbA1c (β =0.30,t =5.1,P＜ 0.05).The HbA1c level in the group A was higher than that in the group B(t=3.685,P＜0.05);after correcting the factors of sex,age and education,the HbA1c level in the group A was still higher than that in the group B(F=47.8,P＜0.05).Conclusion The depression mood is adverse to glycemic control in T2DM patients.

Humans ; Multiple Myeloma ; Paresis

Humans ; Immunophenotyping ; Leukemia, Large Granular Lymphocytic ; classification ; complications ; Receptors, Antigen, T-Cell, gamma-delta ; beta-Thalassemia ; complications

Objective: To analyze the longitudinal change of serum total cholesterol concentration in 733 rural residents in Shanxi province. Methods: Based on the residents of five rural areas in Shanxi province who participated in China nutrition and health survey in 2002, a follow-up survey was conducted in 2015. Fasting venous blood of the participants was collected and serum TC concentration was tested by cholesterol oxidase method. Results: Of 733 participants, 332 were male and 401 were female. In 2002 baseline survey, the age of the participants was (42.6±9.5) years old, 76.2% of male and 83.8% of female had junior middle school education or below. Proportion of smoking were 65.7% and 1.2%, drinking were 26.8% and 4.0%, obesity were 6.3% and 12.0%, and central obesity were 27.1% and 31.9%, respectively in male and female. The follow-up age of participants in 2015 was (55.8±9.5) years old, proportion of smoking changed to 48.2% and 1.5%, drinking were 49.7% and 3.0%, obesity increased to 11.8% and 18.2% and central obesity increased to 41.6% and 53.6%, respectively in male and female. The overall serum TC level increased from (3.82±0.89) mmol/L to (4.72±0.97) mmol/L with an average increase of 27.2%, which increased from (3.84±0.94) mmol/L to (4.54±0.93) mmol/L in male with an average increase of 22.7%, and increased from (3.81±0.84) mmol/L to (4.86±0.98) mmol/L in female with an average increase of 30.9%. The serum TC levels in 18-, 30-, 40-, and 50-59 years old group increased from (3.42±0.83), (3.72±0.77), (3.90±0.83) and (4.00±1.03) mmol/L to (4.38±1.01), (4.79±0.92), (4.73±0.99) and (4.76±0.96) mmol/L, with average increase range of 31.4%, 32.1%, 25.2% and 22.6%, respectively. The mean serum TC levels between two years all had statistically significant difference among groups of gender, age, education, marital status, family history of cardiovascular disease, smoking, drinking, BMI and waist circumference after paired t-test and ANOVA analysis (P<0.01). Conclusion The longitudinal serum TC level of rural residents in Shanxi province increased rapidly.