2.Pemetrexed and platinum as first-line chemotherapy for advanced lung adenocarcinoma:an observation of recent therapeutic effects and a safety profile
Xiaoxian YE ; Ying YUAN ; Hong SHEN
Chinese Journal of Clinical Oncology 2013;(21):1324-1327
Objective:The recent therapeutic effects and safety profile of pemetrexed plus cisplatin as first-line chemotherapy in advanced lung adenocarcinoma were evaluated. Methods:A total of 41 chemotherapy-naive locally advanced or metastatic non-small cell lung cancer patients, who were diagnosed with adenocarcinoma by pathological examination, were included. All patients received 500 mg/m2 pemetrexed on day 1. A total dose of 75 mg/m2 cisplatin was divided into three daily doses administered over 3 d. Treat-ments were repeated every three weeks. The therapeutic efficiency and safety profile were evaluated every two treatment cycles. Re-sults:All 41 patients were eligible for the evaluation of therapeutic efficiency. Seventeen patients showed partial response, 20 patients showed stable disease, and four patients showed disease progression. The overall response rate (ORR) was 41.5%and the disease con-trol rate (DCR) was 90.3%. Subgroup analysis showed that the ORR in males was significantly higher than that in females (63.1%vs. 22.7%, P=0.009). The median progression-free survival of all patients was 11.0 months, whereas the median overall survival was 12.6 months. The intracranial lesions of six patients with brain metastases were well controlled after chemotherapy and palliative whole brain radiotherapy. The ORR and DCR for these patients were 83.3%and 100.0%, respectively. In terms of safety, only 4.8%of the pa-tients showed gradesⅢandⅣneutropenia, nausea, or vomiting. Conclusion:Pemetrexed plus cisplatin is an effective and well-tolerat-ed regimen as first-line therapy for patients with lung adenocarcinoma. According to subgroup analysis, efficacy in males was signifi-cantly better than that in females. Good efficacy was observed in patients with brain metastases treated with chemotherapy and pallia-tive whole brain radiotherapy. No additional adverse effects were observed.
3.Clinical analysis of 10 children with Wegener granulomatosis
Lin YUAN ; Zhi CHEN ; Guiju ZHANG ; Ying SHEN
Journal of Clinical Pediatrics 2009;(11):1054-1057
Objective To investigate the characteristics of Wegener granulomatosis in children and to improve its recognition. Methods Ten pediatric patients with Wegener granulomatosis were studied retrospectively by clinical manifestations, serum examination, pathological data, treatment, etc. Results All children had clinical evidence of upper respiratory tract and lungs involvement; kidney lesion occurred in 6 cases(6/10); joints, skin, eyes and nervous system were also involved with different degree, cANCA (PR3) showed positive in 8 cases; Pathological examination (1 kidney sample, 2 nasal mucosa samples, 2 skin samples) showed granulomatous vasculitis and crescents were found in renal biopsy; 7 cases were treated with corticosteroid plus cyclophosphamide, 1 case was treated with corticosteroid plus methotrexate, and improvement were seen in all of them. Conclusions Wegener granulomatosis in children have diverse clinical manifestations and clinical diagnosis is difficult. The upper and lower respiratory tract and kidney are most commonly involved organs. ANCA inspection is characteristic. Treatment with corticosteroid and immunosuppressive can achieve good outcome.
4.The evaluation of early lactate clearance rate in respect of prognosis in patients with severe COPD
Zhi YUAN ; Huahao SHEN ; Gengsheng ZHANG ; Yinghuo YING
Chinese Journal of Emergency Medicine 2011;20(7):742-745
Objective To investigate the clinical significance of early lactate clearance rate in respect of the prognosis of patients with severe chronic obstructive pulmonary disease (COPD) . Methods A total of 108 COPD patients with respiratory failure were studied prospectively. The patients were divided into survival group ( n = 82) and the death group ( n = 26) , and the survival group further divided into the conventional treatment subgroup ( n = 55 ) and the invasive ventilation subgroup ( n = 27 ) . Arterial blood lactate, arterial gas analysis, APACHE Ⅱ score and the 6-hour clearance rate were measured before and 6 hours after treatment in 3 groups. The high lactate clearance rate group (n =71 ) was defined as a lactate clearance rate > 10% , and the low lactate clearance rate group (n = 37) with a lactate clearance rate < 10%. The correlation between 6-hour lactate clearance rate and prognosis in patients was analyzed. Results Compared the survival patients in invasive ventilation group with the death group, there were no statistical differences in arterial blood lactate, pH value, PaCO2, PaO2, oxygenation index and APACHE Ⅱ score before the treatment. The 6-hour lactate clearance rate in survival patients in conventional treatment group or invasive ventilation group was significantly higher than that in the death group (t =31.2, P<0. 01; t =34.6, P<0. 01, respectively), while there were no statistical differences in APACHE Ⅱ score and pH value between these 3 groups. Between the conventional ventilation treatment group and the invasive ventilation treatment group, there was no statistical difference in 6-hour lactate clearance rate ( P > 0. 05 ) . There was no statistical difference in APACHE Ⅱ score between before treatment and after treatment in 3 groups. Mortality in high lactate clearance rate group (4. 2% ) was significantly lower than that in low lactate clearance rate group (62. 2% ) (x2 = 121.9, P < 0. 01 ) .Conclusions The early (6h) lactate clearance rate could be used as a marker for evaluating the severity,therapeutic efficacy and prognosis of patients with severe COPD.
5.Clinicopathologic study on gastric mini-cancer
Hong SHEN ; Wensheng PAN ; Ying YUAN ; Shu ZHENG
Chinese Journal of General Surgery 2009;24(4):269-272
objective To investigate the clinicopathological features of mini-cancer of the stomach. Method In this study,out of 296 early gastric cancer cases there were 34 cases of early gastric cancer in which tumor diameter was≤10 mm,among those there were 5 cases with tumor size≤2 mm and 29 cases of the size 2~10 mm. Result Mini-cancer accunted for 2% of all early gastric cancers in this series:All these mini-cancers were of intramucosal cancer(100%),while that took up to 45%in control group in which tumors were between≥2 mm and≤10 mm:Tumors were high or moderately differentiated pathologically in 100%of mini-cancers and 55%in control group.None of mini-cancer patients had lymph node metastasis,however,1 of 29 patients in control group had lymph node metastasis.Both groups had no blood vessel and lymphatic vessel invasion:The differentiation concordance rate between superficial lesions and invasive fronts in mini-cancer was 100%,higher than 86%in control group. Conclusion Gastric mini-cancer is usually of high differentiation,low tumor invasion and low rate of lympy node metastasis than control group.Endoscopic therapy is applicable for most gastric mini-cancers.
6.Progress of plasma exchange in treatment of nervous system diseases
Lin YUAN ; Zhi CHEN ; Guiju ZHANG ; Ying SHEN
International Journal of Pediatrics 2010;37(1):95-97
Plasma exchange is a commonly used blood purification method, h includes plasma exchange,double filtration plasmapheresis and immunoadsorption.Many nervous system diseases have the antibody. Guillian-Barre syndrome is caused by antibodies of the nervous system demyelinafing disease; Myasthenia grads is caused by the acetylcholinc receptor antibodies. CIDP also has autoimmune-mediated mechanism. Plasma exchange can be apphed effectively to remove antibodies, and to quickly improve the patient' s clinical symptoms and shorten the course of disease.
7.In vitro dissolution rate of Liuwei Wuling tablet based on biological potency and integrated dissolution.
Juan ZHENG ; Ling CHENG ; Cheng-ying SHEN ; Juan-juan LI ; Ling QIU ; Gang SHEN ; Jin HAN ; Hai-long YUAN
China Journal of Chinese Materia Medica 2015;40(22):4395-4399
To explore the feasibility of chemical and biological method in evaluation of the in vitro dissolution rate of Liuwei Wuling tablet (LWT), this experiment investigated the inhibitory effect of LWT dissolving solutions on LX-2 hepatic stellate cells in 0.1% SDS dissolution medium in different dissolving periods. From these results, the cumulative dissolution rate of LWT was obtained based on the cell inhibitory rate. The dissolution rates of deoxyschizandrin, phillyrin, and Specnuezhenide were determined by HPLC method. A novel approach of self-defined weighting coefficient had been created to establish the integrated dissolution rate model. Then f2 similar factor method was used to evaluate the relevance of these two methods. The results showed that f2 values for deoxyschizandrin, phillyrin, Specnuezhenide, and the integrated dissolution were 61, 43, 61 and 75 respectively, indicating that the dissolution of multi-component integration could fully reflect the biological potency of the whole recipe. The dissolution evaluation method for multicomponent integration based on biological activity is expected to be one of the effective means for in vitro dissolution test of LWT.
Chromatography, High Pressure Liquid
;
Drugs, Chinese Herbal
;
chemistry
;
Kinetics
;
Quality Control
;
Solubility
;
Tablets
;
chemistry
8.Influence of stir-baked with sand on active ingredients, diarrhea and hepatoprotection of Herpetospermum caudigerum.
Juan-juan LI ; Gang SHEN ; Rong-li YIN ; Cheng-ying SHEN ; Ling CHENG ; Ling QIU ; Jin HAN ; Hai-long YUAN
China Journal of Chinese Materia Medica 2015;40(2):236-239
To study the influence of stir-baked with sand on active ingredients, diarrhea and hepatoprotection of Herpetospermum caudigerum, the contents of herperione and herpetin in H. caudigerum before and after stir-baking with sand were analyzed by HPLC. The effect of stir-baked with sand on diarrhea of H. caudigerum TL was evaluated using the mean stool rate (MSR) and mean diarrheal index ( MDI) and the influence of stir-baked with sand on hepatoprotective effect of H. caudigerum TL was examined using a mouse model of CCl4-induced liver injury based on the analysis of serum ALT and AST activities. The results of HPLC analysis showed the content of herperione in H. caudigerum after stir-baking with sand decreased by 40.9% (P < 0.01) and the content of herpetin had no change. Pharmacodynamic results showed that the MSR and MDI of high-dose and middle-dose group of H. caudigerum TL after stir-baking with sand were significantly lower than that of high-dose and middle-dose group of H. caudigerum TL without stir-baking with sand; The high-dose and middle-dose of H. caudigerum TL with/without stir-baking with sand significantly alleviated liver injury as indicated by the decreased levels of serum ALT and AST, but the ALT and AST levels of high-dose and middle-dose group of H. caudigerum TL after stir-baking with sand were higher than that of H. caudigerum TL without stir-baking with sand. The results revealed that the stir-baking with sand could effectively relieve diarrhea effect of H. caudigerum TL, while it also reduces the hepatoprotection of H. caudigerum TL.
Animals
;
Chromatography, High Pressure Liquid
;
Cooking
;
Cucurbitaceae
;
chemistry
;
Diarrhea
;
chemically induced
;
Female
;
Liver
;
drug effects
;
Male
;
Mice
;
Protective Agents
;
pharmacology
9.Mutation analysis of GATA4 gene in Han Chinese patients with atrioventricular septal defect
Li ZHANG ; Jie SHEN ; Lang YUAN ; Xiaowei LI ; Ying GUO ; Min HUANG ; Fen LI
Journal of Clinical Pediatrics 2011;(10):901-905
Objective To analyze the mutations of GATA4 gene in Han Chinese patients with atrioventricular septal defect(AVSD)and investigate the association between GATA4 gene and pathogenesis. Methods Ninety-four Han Chinese patients with AVSD were recruited,including 23 patients with Down syndrome and 71 patients without. One hundred healthy age-matched Han children were used as the control. Blood samples were drawn. Encoding region and flanking introns of GATA4 gene were amplified using polymerase chain reaction. The mutations were detected by DNA fragment sequences analysis. Results Three novel missense mutations(c.106C > G,p.P36A;c.259C > T, p.P87S;c.504C > A,p.D168E)of the GATA4 gene were identified in three patients with complete AVSD without Down syndrome,and a fourth novel missense mutation(c.1079A > G,p.E360G)was noted in a patient with complete AVSD and Down syndrome. A polymorphism of the GATA4 gene(c.G99T,p.A33A)from six patients was detected. Conclusions The GATA4 gene might be involved in the etiology of AVSD by functional changes resulting from gene mutation. The low incidence of GATA4 gene mutations in patients with AVSD with or without Down syndrome might suggest that AVSD is a polygenetic disorder.
10.Relationship between sex hormone binding globulin and metabolic syndrome in elderly males
Xiaona PANG ; Jiping SHEN ; Ying YUAN ; Xuan SUN ; Xiaoyun ZHA ; Yu HU
Chinese Journal of Endocrinology and Metabolism 2013;(4):318-321
To investigate the relationship between sex hormone binding globulin (SHBG) and metabolic syndrome in elderly males in Shanghai,all the subjects (≥ 60 years old,male) underwent measurements of weight,height,waist and hip circumferences,and blood pressures,serum levels of fasting plasma glucose,total cholesterol,triglyceride,high density lipoprotein-cholesterol (HDL-C),and low density lipoprotein-cholesterol were determined (Hitachi,7600),while the levels of serum insulin,total testosterone,and SHBG were determined by using chemiluminescence methods.Free testosterone was calculated by using the Vermeulen equation.Metabolic syndrome was defined according to the criteria of the Chinese Diabetes Society (CDS 2004).The SHBG level in the metabolic syndrome group was significantly lower than that in non-metabolic syndrome group [(40.50 ± 26.16) nmol/L vs (47.80± 20.34) nmol/L,P<0.01].With increasing number of metabolic syndrome components,the level of SHBG became lowered progressively.The subjects were divided into four subgroups according to SHBG Quartiles.From Quartile 1 to Quartile 4,body mass index,waist-hip ratio,diastolic blood pressure,fasting plasma glucose,triglyceride,fasting insulin,homeostasis model assessment for insulin resistance(HOMA-IR),free testosterone,free androgen index,and free testosterone percentage became progressively lowered,while age and HDL-C became raised (P<0.05).SHBG was correlated significantly with age,body mass index,waist-hip ratio,diastolic blood pressure,fasting plasma glucose,HDL-C,and triglyceride.Age,HDL-C,and body mass index remained independently associated with SHBG in the multivariate regression analysis.In a logistic regression taking metabolic syndrome as the dependent variable,SHBG and HOMA-IR were included in the final model with statistical significance.Lowered SHBG is a risk factor of metabolic syndrome in elderly males.SHBG may be an independent predictor of metabolic syndrome,but the mechanism of how SHBG is involved in the metabolic syndrome needs to be further studied.