Objective:This study was designed to explore the distribution pattern of TCM syndrome types in patients with Chronic Kidney Disease (CKD) stage 3-5 without alternative treatment after objective collection of TCM quad-diagnostic instruments.Methods:The four-diagnostic instruments of Chinese medicine were used to collect the four-diagnostic information of patients with stage CKD 3-5 non-alternative treatment for syndrome determination, and the correlation between TCM syndrome and basic disease characteristics of patients was analyzed.Results:The distribution of TCM syndrome types in 464 patients with CKD 3-5 stage non-substitution therapy was based on deficiency syndrome, and had both standard and solid syndrome. Qi-deficiency syndrome was the most common type, accounting for 24.6% (114/464), followed by kidney-yang deficiency syndrome, heart-qi deficiency syndrome, kidney-yin deficiency syndrome, heart-blood deficiency syndrome, spleen-yang deficiency syndrome and lung-yin deficiency syndrome. The positivism type of this deficiency is blood stasis, dampness-heat, moisture, turbidity and turbidity toxicity. There was no significant difference in gender and age distribution among patients with different CKD stages ( P>0.05), but the proportion of deficiency syndrome gradually increased with the increase of age. There were differences in the distribution of primary deficiency syndrome in different CKD stages ( χ2=57.48, P<0.001), but no difference in the distribution of primary deficiency syndrome ( χ2=2.59, P=0.957). Conclusions:According to the four diagnostic instrument of traditional Chinese medicine, the distribution of TCM syndrome types in patients with stage CKD3-5 non-alternative treatment is based on deficiency syndrome, combined with deficiency of primary and solid syndrome. The syndrome types in CKD3 stage were mainly qi deficiency and kidney qi deficiency, while the TCM syndrome types in CKD stage 4 were qi deficiency and kidney Yang deficiency. With the progression of the disease, the TCM syndromes of stage 5 CKD were mainly heart-qi deficiency and kidney-yang deficiency.

OBJECTIVE: To evaluate the prognostic implication of human papillomavirus (HPV) viral load in cervical cancer patients who underwent radical hysterectomy. METHODS: We conducted a retrospective review of patients with stage IA2 through stage IIIA cervical carcinoma who underwent radical hysterectomy at Sun Yat-sen University Cancer Center between January 2005 and December 2009. Patients who had undergone preoperative hybrid capture 2 testing to detect HPV DNA were included. A total of 346 patients positive for HPV DNA were enrolled and stratified into two groups according to the median HPV viral load. RESULTS: HPV viral load was significantly correlated with lymphovascular space invasion (p=0.026) and deep stromal invasion (p=0.024). However, other factors, such as age, stage, histologic grade, histologic type, lymph node metastasis, and tumor size, were not significantly associated with viral load. Low HPV viral load was correlated with poor disease-free survival in univariate analysis (p=0.037) and multivariate analysis (p=0.027). There was no significant difference in overall survival with regard to initial HPV viral load. CONCLUSION: Low initial HPV viral load may be a poor prognostic factor for cervical cancer patients who have undergone radical hysterectomy.
Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell/*diagnosis/surgery/virology ; Female ; Humans ; Middle Aged ; Papillomaviridae/*isolation & purification ; Papillomavirus Infections/complications/diagnosis/surgery/virology ; Prognosis ; Retrospective Studies ; Treatment Outcome ; Uterine Cervical Neoplasms/*diagnosis/surgery/virology ; *Viral Load ; Young Adult

Objective To evaluate the management and survival of lymph node region recurrence of epithelial ovarian cancer (EOC),and discuss its suitable therapeutic strategy.Methods Thirty-eight patients with the recurrence of lymph node region were extracted from 1945 patients who were diagnosed EOC and treated in Sun Yat-sen University Cancer Center from January 1995 to December 2008.The clinical characteristics,therapy methods and survival of them were retrospectively analyzed.Patient age at initial diagnosis was ＞ 50 years old in 24 patients and ≤50 years old in 14 patients.There were 15 cases with stage Ⅱ and 23 cases with stage Ⅲ in terms of initial International Federation of Gynecology and Obstetrics (FIGO,1987) staging.Classified with histological grade,7 cases were in G1,14 cases were in G2,17 cases were in G3 ;according to the histological types,19 cases were with serous adenocarcinomas,and 19 cases were with non-serous adenocarcinomas (including 9 endometrioid adenocarcinoma,1 mucinous adenocarcinoma and 9 unclassified adenocarcinoma).The median follow-up time was 59 months (ranged 16 to 124 months).Results (1) Feature of recurrences:the median interval of last treatment to recurrence was 18 months (range 9 to 96 months).Most of them were absence of symptoms.The serum level of CA125 was elevated in 15 patients(39％,15/38).(2) Treatment of recurrences:of the 38 patients,19 underwent lymphadnectomy for recurrence regions and received adjuvant chemotherapy (surgery + chemotherapy group),14 received local radiotherapy and adjuvant chemotherapy (radiotherapy + chemotherapy group),5 received chemoherapy only (chemotherapy group).There were 35 cases achieved complete response (CR),including 19 patients underwent secondary debulking surgery in surgery + chemotherapy group,14 cases in radiotherapy + chemotherapy group (12 of them treated by radiotherapy,the other 2 cases reached CR after adjuvant chemotherapy) and 2 cases in chemotherapy group.While only 3 patients reached partial response in chemotherapy group.(3) Survival and second recurrences:during follow-up,14 cases died of tumor,4 cases survival with tumor while 20 cases survival without evidence of tumor.The 5-year post-recurrence survival rate of 38 cases was 66.5％,with 71.8％,68.8％ and 40.0％ in surgery +chemotherapy,radiotherapy + chemotherapy,and chemotherapy group,respectively,and there was no significant difference in survival rate between them (P ＞ 0.05).A total of 15 patients experienced second recurrences,including 7 cases with peritoneal and 8 cases with lymph node region recurrences.(4) Prognosis factors:the univariate analysis shown that survival after recurrence was significantly related to patient age,tumor-free interval and number of recurrence disease (P ＜ 0.05),while not to FIGO stage,histological type,histological grade,and lymphadnectomy during primary surgery (P ＞ 0.05).The multivariate analysis showed that patient age and tumor-free interval were independent prognostic variables for survival after recurrence (P ＜ 0.05).Conclusions The lymph node region recurrence of EOC may be have good prognosis and distinctive clinical process.Local treatment strategies including secondary surgery and radiotherapy should be considered,which may significantly improve survival in ovarian cancer patients with lymph node region recurrence.