OBJECTIVETo explore the pattern of abnormal skeletal development in girls with idiopathic precocious puberty (IPP) and the therapeutic effect of Chinese herbs for nourishing yin and purging fire (CH).

METHODSMeasurement of bone age, bone mineral content (BMC) and bone density (BD) were performed and levels of serum gla-protein (BGP), insulin-like growth factor 1 (IGF-1) and insulin-like growth factor binding protein 3 (IGFBP3) were determined in girls with IPP at various stages of pubertal development. Data were compared with those collected from matched girls, and the correlativity between various parameters and the extent of the disease were analyzed to explore the pattern. Thirty-eight girls out of them were treated with CH and the therapeutic effect was observed.

RESULTSThe bone age of the IPP girls was ahead of time obviously (P < 0.05), levels of BMC, BD and serum BGP, IGF-1 were significantly higher than the levels in the healthy girls of matched age (P < 0.05). And the degree of these changes were markedly positive correlated with the severity of disease (P < 0.05). After being remitted with CH treatment, the advanced bone age was apparently alleviated, and above-mentioned abnormal criteria were lowered significantly (P < 0.05).

CONCLUSIONThe skeletal development of the girls with IPP was accelerated and the skeletal maturity were ahead of time, the more serious the condition of disease, the more obvious the acceleration and the advanced bone age. CH could decelerate skeletal development and delay the skeletal maturity of IPP patients.

Age Determination by Skeleton ; Bone Development ; Child ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Insulin-Like Growth Factor I ; metabolism ; Osteocalcin ; blood ; Phytotherapy ; Puberty, Precocious ; blood ; drug therapy

OBJECTIVETo investigate the clinical significance of plasmic L-plastin level in patients with colorectal cancer.

METHODSFrom March 2008 to March 2009, plasma samples were collected from 40 patients and 40 healthy controls. Plasmic L-plastin level was measured by ELISA kit and was compared to TIMP-1.

RESULTSPlasmic L-plastin level in patients with colorectal cancer was higher than that in healthy adults (1.662±0.386 vs. 0.485±0.085 μg/L, P<0.01). The sensitivity of L-plastin in the diagnosis of colorectal cancer was 67.5%, and the specificity was 80.6%. The Youden index was 0.481 and AUC was 0.772 (P<0.01). Plasmic L-plastin levels were associated with the tumor size (P=0.006), serosal penetration (F=4.687, P<0.05) and lymphatic metastasis (P<0.01). Compared to plasmic TIMP-1 level, L-plastin showed the same capability in indicating the depth of tumor. The specificity of L-plastin was better in indicating lymphatic metastasis (86% vs. 58%, χ2=4.2, P<0.05).

CONCLUSIONSPlasmic L-plastin level may serve as a potential marker in colorectal cancer.

Aged ; Case-Control Studies ; Colorectal Neoplasms ; blood ; diagnosis ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Male ; Membrane Glycoproteins ; blood ; Microfilament Proteins ; blood ; Middle Aged ; Sensitivity and Specificity ; Tissue Inhibitor of Metalloproteinase-1 ; blood

OBJECTIVEThe aim of this study was to evaluate the effect of anastrozole, a new generation aromatase inhibitor, on the lipid metabolism in postmenopausal Chinese women with early breast cancer, and observe the adverse reactions as well.

METHODSPostmenopausal women with early breast cancer patients took anastrozole 1 mg per day. The lipid profiles of total cholesterol, triglyceride, low density lipoprotein, and high density lipoprotein were assessed before taking the drug, 3 months, 6 months after taking medication, and later once a year, until the end of medication or follow-up. Patients taking lipid-lowering drugs were excluded. The adverse reactions during the process of taking medication was followed-up by telephone.

RESULTSTwo hundred and eighty-five postmenopausal breast cancer patients took part in the trial from Jan. 2003 to Jun. 2009. All patients had completed primary surgery and demonstrated a postmenopausal status. ER or PR positivity was confirmed by histopathology. Taking the medication from a minimum of one year to a maximum of 5 years, with a median time of 3.61 years. During the medication time, anastrozole significantly increased the levels of low density lipoprotein-cholesterol after 6 months of treatment, continuing to 5 years, from (3.08 ± 0.90) mmol/L to (3.59 ± 0.59) mmol/L, with a maximal increase of 18.2% higher than that before medication. Anastrozole significantly increased the levels of total cholesterol and high density lipoprotein-cholesterol after 1 years of treatment. Anastrozole significantly reduced the levels of triglycerides after 1 years of treatment. Anastrozole showed no significant effect on serum lipids in the patients with pre-existing hyperlipidemia. A more significant effect on blood lipids was observed in patients aged ≥ 60-years than that in patients less than 60 years of age. The rate of other adverse events were similar to that reported in foreign patients.

CONCLUSIONSFor the postmenopausal patients with breast cancer, taking anastrozole may lead to an abnormal lipid metabolism. Anastrozole significantly increases the levels of low density lipoprotein-cholesterol, total cholesterol and high density lipoprotein-cholesterol, and significantly reduces the level of triglycerides. The rate of other adverse events were similar to that reported in foreign patients. it is suggested that the blood lipid levels should be regularly assessed in patients with long-term anastrozole treatment. The rate of other adverse events similar to that reported with foreign patients, and patients tolerate this treatment well.

Age Factors ; Aged ; Aged, 80 and over ; Antineoplastic Agents, Hormonal ; therapeutic use ; Aromatase Inhibitors ; therapeutic use ; Breast Neoplasms ; blood ; complications ; drug therapy ; surgery ; Chemotherapy, Adjuvant ; Cholesterol ; blood ; Cholesterol, HDL ; blood ; Cholesterol, LDL ; blood ; Female ; Follow-Up Studies ; Humans ; Hyperlipidemias ; blood ; complications ; Lipid Metabolism ; drug effects ; Lipids ; blood ; Middle Aged ; Neoplasm Staging ; Nitriles ; therapeutic use ; Postmenopause ; Triazoles ; therapeutic use ; Triglycerides ; blood

Objective To evaluate the feasibility of different kinds of surgeries to treat hypopharyngeal carcinoma and investigate the methods to conduct one-stage repair after hypopharyngeal carcinoma removal. Methods Thirty nine cases of hypopharyngeal carcinoma were treated from May 2000 to Mar 2007, of which 27 were originated from pyriform sinus, 8 from postcricoid and 4 from posterior pharyngeal wall. One-stage reconstruction for hypopharyngeal and esophageal defect was done with simple and less-damaged hypopharyngeal plasty by local sewing, infrahyoid muscle flap, pectoralis major flap and supplement of esophagus by stomach. Results The defect of 18 cases was repaired by sternohyoid muscle flap, including 13 from pyriform sinus, 4 from root of tongue and 1 from posterior pharyngeal wall. Seven were repaired by substitute of esophagus by stomach, 5 by local sewing, 4 by cervical flap and 2 by pectoralis major myocutaneous flap. All the patients were successfully followed up during the survival days. Half of the cases suffered from slight deglutitory disorder after operation and recovered soon, while 2 cases were still with worse deglutitory function. All the cases were recovered with laryngeal function, and 21 cases were decannulated with normal respiration and voice, and 18 with cannula. Thirteen cases survived for more than 3 years after operation and 5 cases more than 5 years, while 14 cases died within 1 year. Thirteen cases were carried out another operations for local recurrence or metastases of lymph nodes, one of whom experienced 6 operations. The estimated 3-year survival was 43.3% (13/30), and 5-year survival was 37.5%(3/8). Conclusion Hypopharyngeal carcinoma with different site and stage can be treated by different methods, and one-stage reconstruction can be done to repair the defect of pharynx and esophagus with satisfactory functional restoration and prognosis.

Objective To discuss the clinical diagnostic value of 16-slice spiral computed tomography angiography (CTA) for intracranial aneurysm. Methods Seventy-four patients with suspected intracranial aneurysm were examined with 16-slice spiral CTA. The post-processing techniques including multiplanar reconstruction (MPR), curved planar reformation (CPR), maximum intensity projection (MIP), volume rendering (VR) and virtual endoscopy (VE) were used, and their diagnostic accuracy was evaluated and compared with the results of digital subtraction angiography (DSA) and operation. Results A total of 77 aneurysms were detected by 16-slice spiral CTA in 65 patients. Among them, 55 patients had single aneurysm, 9 patients had double aneurysms, and only 1 patient had 4 aneurysms. The smallest diameters of aneurysm were 2.0 and 1.5 mm, and the largest were 49 and 8.5 mm at body and neck, respectively. The coincidence of aneurysms confirmed by operation and those detected by 16-slice spiral CTA was 94.74%. There were no significant difference in the sensitivity and the accordance rate of diagnosis between DSA and 16-slice spiral CTA (P>0.05). Conclusions 16-slice spiral CTA clearly showed the location, axis pointing, neck, parent artery ofa aneurysm, as well as the spatial relationship with the surrounding structures. The accuracy of 16-slice spiral CTA is higherin the diagnosis of intracranial aneurysm. It can be used as the first and effective choice for diagnosis of acute intracranial aneurysm.

OBJECTIVETo assess and compare the Human Papillomavirus (HPV) detection efficiency and the potential clinical utility of PCR sequencing-based technology.

METHODSFour HPV consensus primer sets (GP5+/6+, MGP, MY09/11, and PGMY09/11) were used in order to amplify a broad spectrum of HPV types for HPV infection in 325 cervical samples and the PCR products were sequenced afterwards for the HPV genotyping.

RESULTSThe HPV-positive rate was 75.4%, of which 35.5% harbored more than one HPV genotype. A total of 36 different genotypes was found, with HPV 16 (24.1%) being the most prevalent, followed by HPV 58 (13.3%) and HPV 52 (9.6%). There were substantial to almost perfect agreements between different primer sets regarding HPV detection efficiency, with the kappa value varying from 0.751 to 0.925, MGP, and PGMY09/11 were the most effective in detecting multiple infections (P < 0.001). With each of the primer sets, a board range of HPV types could be identified, though there were several differences for a few genotypes.

CONCLUSIONThe substantial agreement between PCR-sequencing and HC2 for the detection of high-risk HPV (kappa=0.761) indicated that PCR-sequencing is also suitable for routine HPV screening.

Adult ; Aged ; Alphapapillomavirus ; genetics ; isolation & purification ; Female ; Genotype ; Humans ; Middle Aged ; Papillomavirus Infections ; virology ; Polymerase Chain Reaction ; methods ; Young Adult

OBJECTIVETo investigate the safety and tolerance of adjuvant dose-dense chemotherapy with paclitaxel and epirubicin for high-risk breast cancer.

METHODSFrom January 2004 to December 2006, 101 patients with high-risk breast cancer after surgical resection were enrolled into this study. The patients were divided into two groups: dose-dense and regular groups. Each patient received 6 cycles of chemotherapy with intravenous administration of paclitaxel (175 mg/m2, on D3) and epirubicin (60 mg/m2, on Dl and D2). The dose-dense group had repeated treatment every two weeks, while the regular group repeated it every three weeks. G-CSF was used in a dose of 3 microg/kg on D5-D9 during each cycle in the dose-dense group. While in the regular group, it was used only under the condition that grade II neutropenia occurred.

RESULTSThe toxicity could be evaluated in 101 patients. Major grade II-IV toxicities included: neutropenia, nausea, vomiting and alopecia. The incidence of grade III-IV neutropenia was 16.0% in the dose-dense group versus 54.9% in the regular group (P = 0.000); postponing of chemotherapy was 2.4% versus 6.0% (P = 0.027). Ninety-eight patients completed the chemotherapy as planed. After a median follow-up of 24 months, the median DFS and OS were not reached. The relapse-free rate and survival rate were 89.8% and 100% in the dose-dense group, which were 87.8% and 93.9% in the regular group. The relapse-free rate of the high-risk patients in the dose-dense group was 86.8% versus 81.3% in the regular group, and the corresponding survival rate was 100% versus 90.6%.

CONCLUSIONAdjuvant dose-dense chemotherapy with paclitaxel and epirubicin is safe, tolerable and promising for high-risk breast cancer.

Adult ; Antineoplastic Combined Chemotherapy Protocols ; administration & dosage ; adverse effects ; therapeutic use ; Breast Neoplasms ; drug therapy ; pathology ; surgery ; Chemotherapy, Adjuvant ; Epirubicin ; administration & dosage ; adverse effects ; Female ; Follow-Up Studies ; Granulocyte Colony-Stimulating Factor ; administration & dosage ; therapeutic use ; Humans ; Lymphatic Metastasis ; Mastectomy ; methods ; Middle Aged ; Nausea ; chemically induced ; Neoplasm Recurrence, Local ; Neoplastic Cells, Circulating ; Neutropenia ; chemically induced ; Paclitaxel ; administration & dosage ; adverse effects ; Survival Rate ; Vomiting ; chemically induced ; Young Adult

OBJECTIVEEndobronchial metastases (EBM) secondary to extrapulmonary solid malignant tumors are rare but may occur. The most common extrathoracic malignancies associated with EBM are colorectal, renal and breast cancer. This study aimed to evaluate the clinicopathological aspects of EBM from breast cancer and the prognosis of the patients.

METHODSClinicopathological data of 11 cases diagnosed as EBM from breast cancer treated in our hospital from 2003 to 2010 were re-evaluated. Their symptoms, recurrence interval, radiological features, histopathological properties, and prognosis were assessed.

RESULTSEleven cases were diagnosed by bronchoscopic bronchial biopsy. The median interval from diagnosis of breast cancer was 57 months (range: 11 - 189 mo). All patients had other proven metastases when the EBM was diagnosed. The most frequently observed symptoms were cough (8 cases). Interestingly, two patients were asymptomatic. Hilar mass (5 cases) was a common radiological finding. No disaccordance between the hormone receptor status in the primary and metastatic lesions in these patients was found. The median survival after EBM diagnosis was 21 months (range: 6 - 36) with four patients still alive and one of these four patients was surviving more than 7 years.

CONCLUSIONSOn average, EBM is diagnosed about 5 years after the diagnosis of breast cancer, which is a relatively long lead time, but the median survival time is short, as 21 months in our group. The treatment plan must be individualized, because in some cases, long-term survival can be expected.

Adult ; Antineoplastic Agents ; therapeutic use ; Breast Neoplasms ; drug therapy ; pathology ; radiotherapy ; surgery ; Bronchial Neoplasms ; drug therapy ; secondary ; Carcinoma, Ductal, Breast ; drug therapy ; pathology ; radiotherapy ; secondary ; surgery ; Chemotherapy, Adjuvant ; Female ; Follow-Up Studies ; Humans ; Lymphatic Metastasis ; Mastectomy, Modified Radical ; Middle Aged ; Nitriles ; therapeutic use ; Radiotherapy, Adjuvant ; Retrospective Studies ; Survival Analysis ; Triazoles ; therapeutic use

Anthracycline-Taxane chemotherapy is widely used in neoadjuvant treatment for breast cancers. However, there is limited data reported in patients with triple negative breast cancer (TNBC). Here, we evaluated the pathologic responses and survival of neoadjuvant epirubicin and taxanes chemotherapy in patients with locally advanced TNBC to provide some useful information for clinical practice. A total of 43 patients with locally advanced TNBC were enrolled in this study. Patients were administered with epirubicin 75 mg/m(2) plus paclitaxel 175 mg/m(2) or docetaxel 75 mg/m(2) every 3 weeks for at least 2 cycles. The primary endpoint was pathologic complete response (pCR), which was defined as no residual invasive cancer, or only carcinoma in situ in both the excised breast and axillary lymph node, while relapse-free survival (RFS) and overall survival (OS) were secondary endpoints. Thirty-nine (90.7%) patients were at clinical stages IIB-IIIC. Thirty-seven (86%) completed 4-6 cycles of preoperative chemotherapy, and objective response rate (ORR) was 81.4% (35/43). Forty-two patients underwent radical surgery subsequently. The pCR rate was 14.3% (6/42). The most common adverse events in neoadjuvant chemotherapy were nausea/vomiting (88.4%, 38/43) and neutropenia (88.4%). After a median follow-up period of 34.0 months, 3-year RFS and OS rate was 53.6% and 80.1%, respectively. All events of recurrence and death occurred in non-pCR patients, in whom the 3-year RFS and OS rates were 44.3% and 76.6%, respectively. This study suggest that neoadjuvant chemotherapy with epirubicin plus taxanes has a relatively low pCR rate and high early recurrence risk in locally advanced TNBC, which indicates the necessity for more efficacious treatment. Further study is needed to validate these results.
Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; administration & dosage ; Chemoradiotherapy, Adjuvant ; methods ; Disease-Free Survival ; Epirubicin ; administration & dosage ; Female ; Humans ; Male ; Middle Aged ; Neoadjuvant Therapy ; methods ; Neoplasm Recurrence, Local ; pathology ; prevention & control ; Neoplasm, Residual ; pathology ; prevention & control ; Paclitaxel ; administration & dosage ; Taxoids ; administration & dosage ; Treatment Failure ; Treatment Outcome ; Triple Negative Breast Neoplasms ; drug therapy ; pathology

OBJECTIVETo evaluate the efficacy, safety and survival of combination of carboplatin plus paclitaxel as neoadjuvant chemotherapy (NACT) for patients with locally advanced triple-negative breast cancer (TNBC), and explore an optimal regimen for TNBC.

METHODSPatients with core needle biopsy confirmed pathological diagnosis of IIA ∼ IIIC invasive breast cancer, negative for estrogen and progesterone receptors and HER2 by immunohistochemistry, and with indication for NACT were eligible in this study. The biopsy tumor tissues were tested for CK5/6, CK14, EGFR and Ki67. The patients received paclitaxel 175 mg/m(2) on day 1, carboplatin at an area under the curve 5 mg×min/ml on day 2 of every 21 days. The clinical response was evaluated every 2 cycles according to Standard RECIST 1.0 criteria and surgery was done after four to six cycles. Pathological complete remission (pCR) was defined if absence of invasive tumor in the breast and axillary lymph nodes samples or residual carcinoma in situ only.

RESULTSOverall, thirty-one patients were enrolled from January 2008 to November 2010. The median age was 51 years and 83.9% of the patients were diagnosed as stage IIB to IIIC diseases. 30 Patients completed chemotherapy as planed while one patient changed regimen due to paclitaxel allergy. Twenty-eight patients could be evaluated for clinical efficacy, of which CR, PR, SD, PD were achieved in 4, 20, 3 and 1 women, respectively. The objective response rate was 85.7%. The expression rate of CK5/6, CK14 and EGFR were 88.9% (24/27), 59.3% (16/27) and 63% (17/27), respectively. Among 27 patients who received modified radical mastectomy or breast-conserving surgery, 11 patients obtained pCR, with a pCR rate of 40.7% (95%CI 22.2% - 59.3%). Five of six CK5/6- and CK14-positive patients achieved pCR. All the 31 patients could be evaluated for toxicity according to the NCI-CTC v3.0 criteria. The major toxicities were neutropenia (93.5%), vomiting (45.2%) and ALT/AST increase (32.3%), and grade 3-4 toxicities accounted for 74.2%, 3.2%, 0, respectively. Until December 2011, at a median follow-up of 28.9 months (range 5 - 47.9), eight patients developed recurrence including 5 patients died. Among 11 patients with pCR, one suffered from lung metastasis at 45 months after diagnosis and survived with tumor until now. The other ten were alive and disease free. The 3-year DFS and OS were 62% and 74.7%, respectively.

CONCLUSIONSAs a neoadjuvant treatment for triple-negative breast cancer, carboplatin plus paclitaxel regimen achieves notable higher objective response rate and pCR rate compared with the anthracycline plus paclitaxel regimen reported in the literature, and is well tolerable. It is an optimized regimen for TNBC.

Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Biopsy, Large-Core Needle ; Breast Neoplasms ; drug therapy ; metabolism ; pathology ; Carboplatin ; administration & dosage ; Carcinoma, Ductal, Breast ; drug therapy ; metabolism ; pathology ; Chemotherapy, Adjuvant ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Lung Neoplasms ; secondary ; Middle Aged ; Neoadjuvant Therapy ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Neutropenia ; chemically induced ; Paclitaxel ; administration & dosage ; Receptor, ErbB-2 ; metabolism ; Receptors, Estrogen ; metabolism ; Receptors, Progesterone ; metabolism ; Remission Induction ; Survival Rate ; Young Adult