Objective To explore the effect of related factors on survival of patients with unresectable pancreatic cancer aged 70 years and over. Methods Fifty-seven patients with unresectable locally advanced or metastatic pancreatic cancer aged 70 years and over were enrolled.Their survival time were analyzed with SPSS 13.0 by taking account of gender, age, smoking history,alcohol history, pancreatic disease history, diabetes mellitus history, Eastern Collaborative Oncology Group (ECOG) scoring, chemotherapy, radiotherapy, CEA and CA199 levels. Results Gender,ECOG scoring, chemotherapy and radiotherapy had relationship with overall survival. The median survival time was 8.9 months and one-year survival rate was 28.1%. The median survival was (10.7±5.4) months in male group and (5.5±2.3) months in female group (P=0.000). The median survival was(10.1±5.8) months in patients with ECOG 0～1 group and(7.3±3.8)months in patients with ECOG 2 group (P=0.040). The median survival was(7.76±5.27) months in nochemotherapy group and(11.5±5.0)months in chemotherapy group (P=0.038). The median survival was(8.87±5.36)months in no radiotherapy group and (13.7±3.8) months in radiotherapy group (P=0.048). Conclusions The patients who have better ECOG performance status and receive chemotherapy or radiotherapy show better survival.

Objective To investigate the effects of environmental endocrine disruptors-phytoestrogen soybean isoflavone on serum glucose and lipid in rats with orchiectomy.Methods Fifty-four healthy clean male Wistar rats aged 7 weeks were randomly divided into 6 groups,9 in each group,according to their weight and named as the groups of SHAM,ORCH,L-SI,M-SI,H-SI and EC.The rats were injected intraperitoneally with 1.5% sodium pentobarbital according to 40 mg/kg,and they were either shamoperated or orchiectomized.The rats were fed on high fat diet for 4 weeks.There was 1,3,9 g soybean isoflavone and 0.45 mg estrobene per kilogram high fat diet in L-SI,M-SI,H-SI and EC respectively.At the 2nd and 4th week,serum insulin,fasting blood glucose and lipid (TG,TC,HDL and LDL) were detected.Results The weights of rats with orchiectomy was significantly decreased compared with sham-operated rats,and compared with the EC group,the weights of other groups'rats were significantly higher.The weight was decreased along with the increase of the dose of soy isoflavone.At the end of 4 weeks,SIF significantly decreased serum glucose compared with ORCH,and the insulin level was significantly increased in M-SI and H-SI group.SIF and estrogen could significantly decrease TC,but they did not have obvious effect on LDL.SIF could not improve HDL level in rats with orchiectomy.Even though there was no statistic difference,the TG levels of SIF groups were deceased.Conclusion SIF can decrease serum glucose level via raising insulin level in rats with orchiectomy.SIF can decrease serum TC level significantly and regulate TG level while there is no influence on HDL and LDL.

ObjectiveTo investigate mutations in exons 19, 20 and 21 of epidermal growth factor receptor (EGFR) gene in elderly patients with non-small cell lung cancer (NSCLC). MethodsEGFR gene mutations in exons 19, 20 and 21 were detected by nested PCR amplification and DNA sequencing in 46 elderly patients with non-small cell lung cancer. The relationship between mutations and clinical characteristics of these patients was analyzed. ResultsEGFR gene mutations were found in 56.5% (26/46) patients and 41.3% (19/46)were non-silent mutations. Mutation of exon 19 was detected in 6 cases (13.0%), mutation of exon 20 in 13 cases(28.2%) and that of exon 21 in 14 cases (30.4%). Seven patients among them had double mutations and the rest only had a single mutation. The incidence of EGFR gene mutations was higher in non-smokers than in smokers(P＜ 0.01). Higher EGFR mutation rate in exon 19, 20 and 21 were found in patients with clinical benefit who were treated with tyrosine kinase inhibitor(TKl)(P＜0.05). There was no difference in EGFR mutation rate between 60～69 age group and 70～85 age group. ConclusionsThe data suggest that the characteristics of EGFR gene mutations in elderly patients with NSCLC is the same as in the general NSCLC patients. The forecast informations of TKI treatment can be obtained by gene detection in elderly NSCLC patients.

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Objective:To investigate clinical features, diagnosis and treatment of angioimmunoblastic T-cell lymphoma(AITL)in middle and old age patients.Methods:This was a retrospective study.A total of 33 middle-aged and elderly patients(a median age of 64 years, range 47~85 years)with AITL admitted to our hospital from May 2008 to March 2017, including 54.5% male(18 cases), were enrolled in this study.Clinical manifestations, pathology, imaging and survival data of patients were collected.The objective response rate(ORR)of patients with different therapeutic regimens was analyzed.The survival analysis was conducted by using the Kaplan-Meier method, the survival rate was analyzed by using the Log-rank method, and multivariate analysis was conducted by using the proportional hazards regression model.Results:The median overall survival(OS)was 26.0 months(8.5-43.5 months). The 1-year, 3-year and 5-year OS rate was 66.7%(22 cases), 45.5%(15 cases)and 24.2%(8 cases), respectively.The ORR of first-line chemotherapy with CHOP-like regimens(cyclophosphamide, doxorubicin, vincristine, prednisone)was 65.5%(19/29)and the incidence of serious adverse reactions was 64.5%(20/31). Single-factor chi-square testing showed that age ≥60 years, Barthel score ≥90, Eastern Cooperative Oncology Group performance status score(ECOG-PS)≥2, anemia, International prognostic index(IPI)score of 4~5, receiving chidamide treatment were influncing factors for the prognosis in middle-aged and elderly patients with AITL( χ2=5.103, 4.306, 6.004, 4.030, 6.348 and 4.080, P<0.05). Cox multivariate analysis showed that age ≥60 years and receiving chidamide treatment were independent prognostic factors affecting the 5-year survival rate of middle-aged and elderly AITL patients( OR=0.313 and 4.964, P<0.05). That the OS was better in the group receiving chidamide treatment than in the group without chidamide treatment( P<0.05). Conclusions:Clinical features of AITL are diverse and lack of specificity.Most patients present with advanced stage AITL at the initial diagnosis.The 5-year OS rate is low.AITL patients aged over 60 years have a poor prognosis.Chidamide can improve the OS rate.

BACKGROUNDTo study the efficacy and long-term survival of high-dose chemotherapy supported by autologous peripheral blood stem cell transplantation (APBSCT) in the treatment of small cell lung cancer (SCLC)..

METHODSSeven patients with pathologically confirmed SCLC were enrolled into the study, including 6 patients who had achieved CR or PR after conventional chemotherapy, and 1 patient who underwent surgical treatment and 6 cycles of conventional postoperative chemotherapy. All patients received a high-dose chemotherapy regimen of cyclophosphamide 6 g/m², etoposide 1.2 g/m², carboplatin 1.2 g/m² following APBSCT. Six of 7 patients received local radiotherapy after the procedure, however, another patient over 60 years did not receive local radiotherapy because of pneumonia complication. All patients were consecutively followed up and median follow-up duration was 27 (25-82) months.

RESULTSSurvival of the 7 patients was longer than 2 years. Three patients were still alive for more than 5 years after treatment, and the longest one up to 82 months. Three patients died and their survival time was 26, 27 and 27 months respectively.

CONCLUSIONSHigh-dose chemotherapy supported by APBSCT combined with local radiotherapy may be helpful to prolong survival and improve prognosis for SCLC, especially to those patients with limited disease, relatively younger age and better performance status, and responding to conventional chemotherapy.

Objective To compare the efficiency of intra-articular injection of tranexamic acid (TXA) and autolo-gous transfusion drain on the blood loss after total knee arthroplasty (TKA). Methods A total of 124 patients (124 knees) with varus knee osteoarthritis, who were performed TKA,were retrospectively analyzed. Patients included 24 males and 100 females. The mean age was(65.03±6.84)years. Due to the blood loss control method, patients were divided into two groups including TXA application group (test group, n=49) and autologous transfusion drain group (control group, n=75). The data of blood routine examination, blood loss and blood transfusion after TKA were analyzed. Results The blood transfusion rates were 10.20%(5/49) in test group and 17.33%(13/75) in control group 7 days after TKA surgery. There was no signifi-cant difference between two groups (P>0.05). There were significant differences in red blood cell (RBC), hemoglobin (Hb) and haematocrit (HCT) between groups and effects of interaction in the two groups (P＜0.01). There were significantly higher values of RBC, Hb and HCT at 1, 3 and 7 days after surgery in test group than those of control group (P＜0.05).The total blood loss 1 and 3 days after TKA was significantly lower in test group than that of control group (P＜0.05). There was no sig-nificant difference in the blood loss 7 days after surgery between two groups (P>0.05). Conclusion The single dose intra-articular injection of tranexamic acid is a safe and effective procedure for hemostasis after TKA.

Objective To evaluate the clinical efficacy of the intratympanic inflation by tympanum inflatable balloon for patients with Meniere’s disease(MD) .Methods A total of 36 confirmed cases (according to the listening stage) of Ⅱ - Ⅲ period of MD patients were randomly divided into two groups :experimental group and control group ,18 cases of matched group ,who were staged before preoperation by hearing ,Ⅱ period (average threshold 25~40 dB HL) 6 cases ,Ⅲ period (41~70 dB HL) 12 cases ,were treated by intratympanic methylprednisolone per‐fusion after putting tympanostomy tube under endotoscope ,then once every 3 days perfusion with a total of three times .There were 18 cases of experimental group staged before preoperation by hearing ,Ⅱ period (average thresh‐old 25~40 dB HL) in 5 cases ,Ⅲ period (41~70 dB HL) 13 cases treated by using tympanum inflatable balloon in the tympanum under endotoscope .Two groups were given conventional improved microcirculation and nutritional therapy .Results In 18 cases of patients in experimental group ,for the 18 to 24 months follow -up after treatment ,6 cases of vertigo were fully controlled (grade A) ,10 cases of vertigo basically controlled (grade B) ,2 cases of vertigo partly controlled (grade C) .Vertigo effective control rate was 88 .89% (16/18) .After 18 to 24 months treatment ,two groups of 36 patients with tinnitus and pure tone average threshold had no obvious change .In 18 ca‐ses of patients in the matched group ,during the 18 to 24 months follow -up after treatment ,3 cases of vertigo were fully controlled (grade A) ,7 cases of vertigo basically controlled (grade B) ,8 cases of vertigo partly controlled (grade C) .Vertigo effective control rate was 55 .56% (10/18) .The experimental vertigo basic control rates were higher than the control group (χ2 = 4 .985 ,P<0 .05) .The activitives in the two groups had improved significantly . No obvious differences were found between two groups .Conclusion With the intratympanic gasing by tympanum in‐flatable balloon for patients of Ⅱ - Ⅲ Menier’s disease ,control rates was high and motile ability were improved , but tinnitus and hearing improvement was not obvious .

Objective:To investigate the characteristics of gene mutations in colorectal cancer(CRC)patients by using next-generation generation sequencing(NGS).Methods:Blood and tissue samples were collected from 90 CRC patients admitted to Beijing Hospital between August 5, 2016 and December 29, 2020.Analysis of driver gene mutations was performed by using a 1021-gene NGS panel.Results:There were 43 tissue samples and 83 blood samples.Also, 36 patients had both tissue and blood samples.The frequency rates of KRAS and BRAF mutations were 51.2%(22/43)and 20.9%(9/43)in tissue samples, and 3 rare concomitant KRAS/ BRAF mutations were detected.The frequency rates of KRAS and BRAF mutations were 26.5%(22/83)and 10.8%(9/83)in blood samples.In patients with tissue and blood samples, the rates of KRAS and BRAF mutations were 52.8%(19/36)and 10.8%(8/36). Conclusions:The rate of KRAS mutations in tissue samples from colorectal cancer patients is similar to rates reported in the literature, but the rate of BRAF mutation and the rate of rare KRAS and BRAF co-mutations are higher than those reported from other countries.

Objective To investigate influencing factors of disability after craniocerbral injury caused by road traffic accident.Methods We collected 486 cases with craniocerebral injury caused by traffic accident,and conducted analysis.Factors related to disability were found by univariate analysis,and multivariate logistic regression analysis was conducted to filter the most important factors.Results Degrees of brain injury,drunk driving,age and types of accident were the major influencing factors.Drunk driving and age were positively related with disability grade while the degree of brain injury and type of accident were negatively related.Concuusiorn It is helpful to reduce disability and the burden on society by taking intervening measures on the related factors of disability after brain injury in road traffic accident.