Objective To analyse the clinical characteristics,therapeutic modalities and prognosis of pulmonary large cell neuroendocrine carcinoma(LCNEC). Methods The clinical data of 14 patients with pulmonary LCNEC confirmed by surgery were retrospectively reviewed. Results No case was correctely diagnosed before surgery.The immunohistochemical amalysis of the specimens revealed the characters of endocrine carcinoma.Twelve cases received adjuvant chemotherapy of platinum agents,but recurrence or metastasis was found in 8 of them several months after surgery.The median survival time was 19 months.The 1-year,2-year and 3-year survival rate were 85.7%(12/14),21.4%(3/14) and not more than 14.3%(2/14),respectively.The statistical analysis showed that the stage,lymph node metastasis and postoperative adjuvant chemotherapy may have impacts on the prognosis of pulmonary LCNEC. Conclusion Pulmonary LCNEC is a carcinoma with poor prognosis,high tendency of invasion and metastasis.The stage of disease,lymph node metastasis,and adjuvant chemotherapy may be related to the prognosis.

Objective To study the expression and prognostic significance of neuroendocrine differentiation markers chromogranin A(CgA)and synaptophysin(SYN) in patients with resectable non-small cell lung cancer(NSCLC).Methods From January 2000 to January 2003,123 patients with NSCLC who received operations were investigated.The resected specimens and clinical data were collected.Immunohistochemical Elivison method was used to detecte the expression of CgA and SYN.Kaplan-Meier survival curve and Cox proportional hazard model multivariate analysis were applied for the prognostic factors. Results The positive expression rates of CgA and SYN were 22%,17.9%,respectively.The expression of SYN was associated with histological differentiation(P=0.001).No significant association was found between NSCLC with neuroendocrine differentiation(NSCLC-ND) and sex,age,smoke index,TNM Stage and pathology classification.No evidence showed the patients with positive expression of CgA or SYN could be tolerant with more cycles of chemotherapy(P=0.406).Kaplan-Meier survival curve indicated the survival had a relation with the expression of CgA and SYN.It was revealed by Cox analysis that SYN(P=0.001),TNM stage(P=0.02)and the maximal diameter of tumor(P=0.049) were independent prognostic factors. Conclusion The patients with NSCLC-ND had a poorer prognosis.SYN may be one of the prognostic factors in patients with NSCLC.

Background Porcine fibrin sealant kit has been widely used in surgery for clotting and woundssealing.It is thought to be a substitution for inert gas and silicone oil in vitrectomy.But whether it produce toxic effect on retina or not after intravitreal injection is still studying.Objective This study aimed to investigate the retinal toxicity of porcine fibrin sealant kit following intraocular application.Methods Vitrectomy was performed on bilateral eyes of 15 pigmented rabbits.Porcine fibrin sealant kit of 0.5 ml was intravitreally injected in the lateral eyes of the rabbits as the experimental group,and equal volume of BSS was used at the same way in contralateral eye as control group.The inflammatory response of eye was observed under the slit lamp and ophthalmoscopy in 1 day,3,7,15,30 days after injection.Schi(o)tz tonometer was used to measure intraocular pressure(IOP) in 1 day,3,7 days,and retinal function was evaluated by electroretinogram (ERG) before operation and 30 days after operation.B-ultrasonic examination was carried out 30 days after surgery.Animals were sacrificed and eyeballs were obtained for retinal histopathological and ultrastructural examination in 30 days after operation.Results Complications appeared in 7 eyes of the experimental group,including cataract in 3 eyes,proliferation vitreoretinopathy and retinal detachment in 5 eyes,endophthalmitis in 1 eye,however,the cataract in 2 eyes and retina injury in 2 eyes were found in 15 control eyes.On the 30 days after injection,no inflammation was found in the 8 eyes without complication in the experimental group and 11 eyes in the control group.The IOP change was insignificant in different groups and various time points (Fgroup =0.008,P =0.929 ;Ftime =3.600 P =0.075).No significant difference was found in a-wave amplitude between groups and various time points(Fgroup =0.728,P =0.405 ; Ftime =0.516,P =0.482),and so was the b-wave amplitude (Fgroup =0.222,P =0.644 ; Ftime =0.057,P =0.814).On the 30th day after operation,arrangement of the retina was regular and no tissue edema and inflammatory cell infiltration were seen in both groups under the light microscope.Transmission electron microscope revealed that the ultrastructures of retinal cells,photoreceptor and retinal pigment cell were normal with the clear subcellular organelle,intact cellular membrane structure and mitochondria in both groups.Conclusions Domestic porcine fibrin sealant kit does not produce toxic effect on retina after intravitreal injection in rabbit.

Cinobufacino injection is purified from water extraction of the skin of Bufo bufo gargarizans, which has been widely used for various cancers in clinic with significant anti-tumor effects. Bufadienolides were regarded as the main active constituents of cinobufacino injection in previous reports. In present study, 6 bufadienolides were isolated and purified from Cinobufacino injection. Their structures were identified as 3-epi-ψ-bufarenogin (1), ψ-bufarenogin (2), 3-epi-arenobufagin (3), arenobufagin (4), 3-epi-gamabufotalin (5), and 3-oxo-arenobufagin (6), separately. Among them, 1 and 3 were new compounds, 5 and 6 were new natural products. Compounds 1, 2 and compounds 3, 4 were two pairs configuration isomers at C-3, separately.
Animals ; Bufanolides ; chemistry ; isolation & purification ; Bufo bufo ; Injections ; Skin ; chemistry

OBJECTIVETo evaluate the effect of Feiji Recipe (FJR) on quality of life (QOL) of patients with non-small cell lung cancer (NSCLC).

METHODSOne hundred and two patients with NSCLC were randomly assigned into 2 groups. The 61 patients in the combined treated group were given FJR and chemotherapy and the 41 patients in the control group were treated with chemotherapy alone. They were observed for two treatment courses with QOL estimated by EORTC QLQ-C43 questionnaire and FACT-L questionnaire, the two international questionnaires as the tools for measurement, and referred to the traditional evaluating indexes of clinical efficiency.

RESULTSQOL in the combined treated group was improved after treatment with the improvement of scores in all domains, including functional and symptom sub-domain, while it in the control group deprived significantly, showing significant difference between the two groups (P < 0.05). Similar results were also shown in the evaluation of physical performance by Eastern Cooperative Oncology Group (ECOG) and Karnovfsky performance scoring. The gastrointestinal reaction and myelo-suppression were slighter in the combined treated group than those in the control group (P < 0.05), and no significant difference was shown between the response rate of the two groups (P > 0.05).

CONCLUSIONFJR can improve QOL of patients with NSCLC, reduce the adverse reaction of chemotherapy, and improve patients' physical performance.

Adolescent ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Health Status Indicators ; Humans ; International Cooperation ; Lung Neoplasms ; drug therapy ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Phytotherapy ; Quality of Life ; Surveys and Questionnaires

Objective To summarize the domestic design for placebo acupuncture and the placebo effect and explore an ideal design for placebo acupuncture.Method Three large Chinese databases CNKI, Wan Fang and Vip were searched to systematically review the application of placebo acupuncture in randomized controlled trials published at home in recent 5 years (2011.01—2016.11).Results and conclusions A total of 48 articles were included according the inclusion and exclusion criteria. An analysis was made of the kinds of diseases for acupuncture study, the methods of designing placebo acupuncture, the effects of placebo acupuncture and comparisons with foreign placebo acupuncture. Pain syndrome and insomnia were the main kinds of diseases for acupuncture study, accounting for 10 and 8 articles respectively. Acupuncture needles were the main kind of needles for placebo acupuncture, accounting for 66.6%. Sites beside acupoints were the main positions selected for placebo acupuncture, accounting for 58.3%. Not penetrating the skin predominated in the depth of needle insertion, accounting for 37.5%. The kinds of needles for placebo acupuncture were fewer than abroad. The effects of placebo acupuncture were not superior to those of acupuncture.

BACKGROUNDHyperparathyroidism (HPT) occurs at an early age and has a high disability rate. Unfortunately, confirmed diagnosis in most patients is done at a very late stage, when the patients have shown typical symptoms and signs, and when treatment does not produce any desirable effect. It has become urgent to find a method that would detect early bone diseases in HPT to obtain time for the ideal treatment. This study evaluated the accuracy of high field magnetic resonance imaging (MRI) combined with spiral computed tomography (SCT) scan in detecting early bone diseases in HPT, through imaging techniques and histopathological examinations on an animal model of HPT.

METHODSEighty adult rabbits were randomly divided into two groups with forty in each. The control group was fed normal diet (Ca:P = 1:0.7); the experimental group was fed high phosphate diet (Ca:P = 1:7) for 3, 4, 5, or 6-month intervals to establish the animal model of HPT. The staging and imaging findings of the early bone diseases in HPT were determined by high field MRI and SCT scan at the 3rd, 4th, 5th and 6th month. Each rabbit was sacrificed after high field MRI and SCT scan, and the parathyroid and bones were removed for pathological examination to evaluate the accuracy of imaging diagnosis.

RESULTSParathyroid histopathological studies revealed hyperplasia, osteoporosis and early cortical bone resorption. The bone diseases in HPT displayed different levels of low signal intensity on T(1)WI and low to intermediate signal intensity on T(2)WI in bone of stage 0, I, II or III, but showed correspondingly absent, probable, osteoporotic and subperiosteal cortical resorption on SCT scan.

CONCLUSIONHigh field MRI combined with SCT scan not only detects early bone diseases in HPT, but also indicates staging, and might be a reliable method of studying early bone diseases in HPT.

Animals ; Bone Diseases ; diagnosis ; pathology ; Calcium ; blood ; Female ; Hyperparathyroidism ; complications ; Magnetic Resonance Imaging ; methods ; Male ; Osteoporosis ; diagnosis ; Phosphorus ; blood ; Rabbits ; Tomography, Spiral Computed ; methods

OBJECTIVETo assess the therapeutic efficacy of treating advanced non-small cell lung cancer (NSCLC) in the aged by Chinese medicine (CM) adopting the international questionnaire of quality of life (QOL).

METHODS91 aged patients with advanced NSCLC were randomly assigned to three groups. There were 31 in the CM group (Group I), 30 in the chemotherapy group (Group II), and 30 in the CM and chemotherapy combination group (Group III). Oral administration of CM decoction and intravenous dripping of Chinese patent medicine was given to those in Group I. Patients in Group II received chemotherapeutic protocol alone. Patients in Group III received chemotherapeutic protocol while orally taking CM decoction. Twenty-eight days were taken as one therapeutic course, and two courses in total. Assessment was performed using European Organization for Research and Treatment of Lung Cancer Quality of Life Questionnaire LC-43 (EORTC QLQ-LC43) before treatment, the 10th day of the second therapeutic course, and the 28th day of the second therapeutic course, respectively.

RESULTSAfter two therapeutic courses of treatment, compared with Group II, better effects were obtained in Group I and Group III in the aspects of the physical function, roles function, emotional functions, social functions, general health state, and short breath, cough, fatigue, insomnia, poor appetite, and constipation (P<0.05, P<0.01).

CONCLUSIONSCM therapy could relieve the clinical symptoms of aged patients with advanced NSCLC and improve their QOL.

Aged ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Lung Neoplasms ; drug therapy ; Male ; Middle Aged ; Phytotherapy ; Quality of Life ; Surveys and Questionnaires ; Treatment Outcome

OBJECTIVETo investigate the local cellular immune response after injection of superantigen, the highly agglutinative staphylococin (HAS), into the tumor bed after ultrasound-guided percutaneous microwave coagulation therapy (PMCT) in the liver cancer patients.

METHODSNinety-two patients with pathologically proven primary liver cancer were divided into two groups: 45 in group A were treated by PMCT alone and 47 in the group B by combined with ultrasound-guided percutaneous injection of highly agglutinative staphylococin (HAS). Before and after PMCT and HAS treatment, the patients underwent ultrasound-guided percutaneous biopsy from the tumor bed and the samples were examined by pathology and immunohistochemistry. The infiltration of CD3+, CD4+, CD57+ and CD68+ lymphocytes in treatment zone was compared between the two groups. Moreover, the infiltrating immunocytes were observed by transmission electron microscopy.

RESULTSOne week after HAS injection, the densities of CD3+, CD4+, CD57+ and CD68+ cells in the group B were 54.50 +/- 18.44, 38.14 +/- 12.44, 33.38 +/- 10.79 and 45.56 +/- 16.53, respectively. All the above mentioned parameters increased significantly in varying degrees compared with that before PMCT or HAS injection (P < 0.05). Four weeks after HAS injection, the density of CD3+, CD4+, CD57+ and CD68+ cells in the group B were 32.67 +/- 10.42, 23.43 +/- 6.99, 18.63 +/- 7.89 and 30.01 +/- 11.05, respectively, still significantly higher than those before PMCT (P < 0.05). Five weeks after PMCT and HAS injection, the densities of CD3+, CD4+, CD57+ and CD68+ cells in the group B were 54.50 +/- 18.44, 38.14 +/- 12.44, 33.38 +/- 10.79 and 45.56 +/- 16.53, versus 32.03 +/- 8.11, 15.67 +/- 8.32, 15.23 +/- 8.26 and 29.67 +/- 11.98 in the group A, respectively, still with a significant difference between the two groups (P < 0.05). A lot of lysosomes, endoplasmic reticulum and mitochondria in the immune cells after injection of HAS were observed by transmission electron microscopy.

CONCLUSIONThe local cellular immunity in liver cancer treatment area can be significantly improved by ultrasound-guided injection of highly agglutinative staphylococin after percutaneous microwave coagulation therapy.

Adult ; Aged ; Antigens, CD ; immunology ; Antigens, Differentiation, Myelomonocytic ; immunology ; CD3 Complex ; immunology ; CD4 Antigens ; immunology ; CD57 Antigens ; immunology ; Electrocoagulation ; methods ; Female ; Humans ; Liver Neoplasms ; pathology ; therapy ; Male ; Microwaves ; therapeutic use ; Middle Aged ; Superantigens ; therapeutic use ; T-Lymphocytes ; immunology

BACKGROUNDThe solitary pulmonary nodule (SPN) is one of the most common findings on chest radiographs. The objectives of clinical practice are to differentiate malignant nodules from benign nodules in the least invasive way and to make a specific diagnosis. This study was aimed to evaluate the correlation between perfusion imaging features and microvessel density (MVD) and vascular endothelial growth factors (VEGF) in SPNs using multi-slice computed tomography (MSCT); and to provide the theoretical basis for SPN blood flow pattern and blood flow quantitative features. Also, the study called for the discussion of the method's clinical application value in the differential diagnosis of benign and malignant SPNs.

METHODSSixty-eight patients with SPN underwent multi-location dynamic contrast enhanced (nonionic contrast material was administrated via the antecubital vein at a rate of 4 ml/s) MSCT. Precontrast and postcontrast attenuations on every scan was studied. Perfusion, peak height, and the ratio of the peak height of the SPN to that of the aorta were analyzed. Perfusion was calculated using the maximum gradient of the time-density curves (TDC) and the peak height of the aorta. The quantitative parameters (perfusion, peak height, ratio of peak height of the SPN to that of the aorta) of the blood flow pattern were compared with MVD and the VEGF expression of immunohistochemistry.

RESULTSThe perfusion peak heights of malignant ((96.15 +/- 11.55) HU) and inflammatory ((101.15 +/- 8.41) HU) SPNs were significantly higher than those of benign ((47.24 +/- 9.15) HU) SPNs (P < 0.05, P < 0.05). Ratios of SPN-to-aorta of malignant and inflammatory SPNs were significantly higher than those of benign SPNs (P < 0.05, P < 0.05). No significant differences were found between the peak height and SPN-to-aorta ratio of malignant SPNs and inflammatory SPNs (P > 0.05, P > 0.05). The precontrast densities of inflammatory SPNs were lower than those of malignant SPNs (P < 0.05). Perfusion values of malignant and inflammatory SPNs were significantly higher than those of the benign SPNs (P < 0.05, P < 0.05). The VEGF positive expressions appeared in 32 patients with malignant SPNs and 2 patients with benign SPNs, and the average value of the MVD was higher in patients with malignant SPNs (36.88 +/- 6.76) than in patients with either benign (4.51 +/- 0.60) or inflammatory (26.11 +/- 5.43) SPNs (P < 0.05, P < 0.05). There were statistically significant correlations between the CT perfusion feature and the MVD. The highest correlation was between the peak height of SPN and the MVD (r = 0.657, P < 0.05).

CONCLUSIONSTumor microvessel density and VEGF expression facilitate the exploration of the pathophysiological basis of CT perfusion in SPNs. Multi-slice CT perfusion has shown strong positive correlations with angiogenesis in SPNs.

Adult ; Aged ; Female ; Humans ; Immunohistochemistry ; In Vitro Techniques ; Lung ; diagnostic imaging ; metabolism ; pathology ; Male ; Microvessels ; pathology ; Middle Aged ; Neovascularization, Pathologic ; Perfusion Imaging ; Solitary Pulmonary Nodule ; diagnostic imaging ; metabolism ; pathology ; Tomography, X-Ray Computed ; methods ; Vascular Endothelial Growth Factor A ; analysis