Background and purpose:The prognosis of high grade gliomas remains poor, and multidisciplinary treatment strategy has been much investigated recently. This study was to explore the efficacy of Temozolomide as first-line treatment combined with radiotherapy and followed by adjuvant chemotherapy for the treatment of newly diagnosed high grade gliomas. Methods:18 patients who had been pathologically proven to be high grade gliomas were enrolled into the study. The patients received 40 Gy/20fractions for the whole brain and followed by 20Gy/10fractions as a boost to tumor bed. All of the patients were given daily oral temozolomide 75mg/ m2 during radiotherapy. 4 weeks after radiotherapy, all of the patients received 6 cycles of Temozolomide, each cycle lasted 5 days with 28 days interval between each cycles. 150 mg/m2 of temozolomide was given for the first cycle for five days,followd by 200 mg/m2 of drug for the rest of the cycles if no significant drug related toxicities were observed. Results:Median follow-up was 12.5 months, 11 cases had either recurrence or progression, 5 of them died from the disease. The median time for disease progression-free survival was 9.8 months (95% CI, 6.1~9.8months), the median time for overall survival was 14 months (95% CI, 8.5 ~ 19.5months), 1-year overall survival rate was 55.6% ,6-month progression-free survival rate was 81.8%. there were no severe temozolomide related toxicities. Conclusion: Concurrent temozolomide with radiotherapy and followed by 6 cycles of temozolomide in the treatment of high grade gliomas had better clinical efficacy, the patients tolerated the strategy well and no severe toxicities were observed.

Objective To compare the efficacy and safety of mesalazine oral plus enema or only oral admin-istration in the treatment of ulcerative colitis .Methods 114 patients with ulcerative colitis were selected , and they were randomly divided into the observation group and treatment group according to random number table , with 57 cases in each group .The observation group was given mesalazine oral treatment ,and the treatment group was given mesalazine oral plus enema .The changes of CRP ,Fid,MPV after treatment were compared between the two groups .The situation of mucosa under colonoscopy , effective rate and the incidence of adverse reactions were compared between the two groups.Results After treatment,the CRP,Fid levels in the treatment group were lower than those in the observation group [(3.17 ±1.48)mg/L vs.(6.14 ±2.53)mg/L,(2.14 ±0.17)g/L vs.(2.91 ±0.27)g/L],the MPV in the treatment group was higher than that in the observation group [(10.93 ±0.59) fL vs.(10.21 ± 1.21)fL],the differences were statistically significant (t=7.650,18.220,4.038,all P<0.05).The total remission rate of the treatment group was higher than that of the observation group (100.00%vs.78.95%) (χ2 =13.412,P<0.001).The total effective rate of treatment group was higher than that of the observation group (89.47% vs .75.44%) (χ2 =3.881,P=0.049).The incidence rate of adverse reactions in the treatment group was lower than that in the observation group (3.51%vs.26.32%) (χ2 =11.683,P=0.001).Conclusion Mesalazine oral plus enema in the treatment of ulcerative colitis has good effect ,minor adverse reactions,high safety,which is worthy of clinical application .

Objective To investigate the clinical efficacy and safety of mesalazine combined with Clostridium butyricum tablets in the treatment of colitis gravis.Methods From January 2016 to December 2016, a total of 120 patients with colitis gravis in the Second Hospital of Qinhuangdao were selected in the research .According to different treatment methods,the patients were divided into observation group and control group ,with 60 cases in each group.The control group was given mesalazine , and the observation group was given mesalazine combined with Clostridium butyricum tablets.All the patients were treated for 2 months.The changes of cytokine levels and C -reactive protein were observed.The therapeutic effects and adverse drug reactions were compared between the two groups . Results The total effective rate of the observation group was significantly higher than that in the control group (91.66%vs.78.33%),and there was statistically significant difference between the two groups ( χ2＝4.183,P＝0.041).The level of IL-10 in the observation group was significantly higher than that in the control group [(110.05 ± 2.61)pg/L vs.(98.35 ±2.42)pg/L,t＝25.462,P＜0.05].The IL-18 level in the observation group was significantly lower than that in the control group [(97.74 ±2.82) pg/L vs.(120.86 ±3.21) pg/L,t＝41.914,P＜0.05].The level of C-reactive protein in the observation group was lower than that in the control group [(8.02 ±1.97) mg/L vs.(6.33 ±3.82)mg/L,t＝14.976,P＜0.05].The incidence rate of adverse reactions of the observation group was significantly lower than that of the control group ( 5.00% vs.25.00%, χ2＝9.412, P ＝0.002 ).Conclusion Mesalazine combined with Clostridium butyricum tablets in the treatment of colitis gravis has obvious curative effect , and can effectively improve the levels of cytokines and C -reactive protein and with high safety.

Objective To explore the prognostic values of telomerase reverse transcriptase promoter (TERTp) mutation and 1p/19q co-deletion in newly-diagnosed O6-methylguanine-DNA methyltransferase (MGMT) promoter un-methylated/isocitrate dehydrogenase (IDH) wild-type glioblastoma multiform (GBM). Methods A total of 82 patients pathologically newly-diagnosed MGMT promoter un-methylated/IDH wild-type GBM, admitted to our hospitals from March 2016 to November 2018, were included in this study. TERTp mutations (TERTp wild-type and TERTp mutation [C228 mutation and C250 mutation]) in GBM specimens were detected by PCR sequencing, 1p/19q co-deletion in GBM specimens was detected by fluorescence in situ hybridization (FISH), and clinical data, adverse reactions and prognoses of patients with different molecular typing were compared. Results There were 33 patients in the TERTp wild type group with mean age of 48 years, and 49 patients in the TERTp mutation group with mean age of 59 years; the difference of age was significant (P<0.05); there were no statistical differences in gender distribution, Karnofsky performance status (KPS) scores, tumor sites and surgical resection degrees between the two groups (P>0.05). There were 8 patients with 1p/19q co-deletion and 74 patients without 1p/19q co-deletion; no significant differences in above clinical parameters were noted between the two groups. There were no statistically significant differences in the incidences of bone marrow suppression, digestive tract response and fatigue, disease progression rate, or survival rate between patients from TERTp wild type group and TERTp mutation group, and between patients with 1p/19q co-deletion and patients without 1p/19q co-deletion (P>0.05). No significant differences in above clinical parameters, disease progression rate, and survival rate were noted between patients with C228 mutation and C250 mutation (P>0.05). Conclusion TERTp typing and 1p/19q co-deletion status do not have prognostic value in newly-diagnosed MGMT un-methylated/IDH wild-type GBM patients; patients with TERTp mutations have older age than wild-type patients; patients with C250 mutation trend to have higher survival rate than those with C228 mutation.