We conducted a prospective study to assess the non-inferiority of adjuvant chemotherapy alone versus adjuvant concurrent chemoradiotherapy (CCRT) as an alternative strategy for patients with early-stage (FIGO 2009 stage IB-IIA) cervical cancer having risk factors after surgery. The condition was assessed in terms of prognosis, adverse effects, and quality of life. This randomized trial involved nine centers across China. Eligible patients were randomized to receive adjuvant chemotherapy or CCRT after surgery. The primary end-point was progression-free survival (PFS). From December 2012 to December 2014, 337 patients were subjected to randomization. Final analysis included 329 patients, including 165 in the adjuvant chemotherapy group and 164 in the adjuvant CCRT group. The median follow-up was 72.1 months. The three-year PFS rates were both 91.9%, and the five-year OS was 90.6% versus 90.0% in adjuvant chemotherapy and CCRT groups, respectively. No significant differences were observed in the PFS or OS between groups. The adjusted HR for PFS was 0.854 (95% confidence interval 0.415-1.757; P = 0.667) favoring adjuvant chemotherapy, excluding the predefined non-inferiority boundary of 1.9. The chemotherapy group showed a tendency toward good quality of life. In comparison with post-operative adjuvant CCRT, adjuvant chemotherapy treatment showed non-inferior efficacy in patients with early-stage cervical cancer having pathological risk factors. Adjuvant chemotherapy alone is a favorable alternative post-operative treatment.
Female ; Humans ; Uterine Cervical Neoplasms/drug therapy* ; Prospective Studies ; Quality of Life ; Neoplasm Staging ; Chemoradiotherapy ; Chemotherapy, Adjuvant/adverse effects* ; Adjuvants, Immunologic ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Retrospective Studies

OBJECTIVE：To establish HPLC fingerprints of different polar parts of Zhuang medicine Calonyction muricatum ， and to study its spectrum-effect relationship with analgesic and anti-inflammatory effects. METHODS ：The total part ，ethyl acetate part，n-butanol part and water part of C. muricatum were prepared. HPLC fingerprints of different polar parts were established by HPLC method combined with the Similarity Evaluation System of TCM Chromatogramtic Fingerprint （2012A），and the common peaks were identified. Using writhing times and ear swelling degree in mice as analgesic and anti-inflammatory indexes ，analgesic and anti-inflammatory activity of different polar parts of C. muricatum were investigated. The correlation of the common peaks of HPLC fingerprint with analgesic and anti-inflammatory indexes was analyzed by grey correlation analysis ，bivariate correlation analysis and partial least square （PLS） method. RESULTS ： There were 11 common peaks for the different polar parts of C. muricatum ，and 5 components were identified by reference comparison，i.e. neochlorogenic acid （peak 3），chlorogenic acid （peak 5）， cryptochlorogenic acid （peak 6）， isochlorogenic acid A （peak 10），isochlorogenic acid C （peak 11）. The grey correlation analysis showed that the correlation between all common peaks and analgesic and anti- inflammatory effects were greater than 0.6 （except the correlation between peak 6 and analgesic effects ），showing correlation relationship ；the correlation of peaks 3，7 and 10 with analgesic and anti-inflammatory effects were all greater than 0.8，which was highly related. Bivariate correlation analysis showed that the correlation of peak 1，3，4，7，9，10，11 with analgesic and anti-inflammatory effects were all greater than 0.6，showing correlation relationship. PLS method showed that peaks 1，3，4，7，9，10，11 contributed greatly to playing an analgesic and anti-inflammatory role. CONCLUSIONS ：HPLC fingerprints of different polar parts of C. muricatum is established and five common peak components were identified. Neochlorogenic acid ，isochlorogenic acid A ，isochlorogenic acid C and chemical components represented by peaks 1，4，7，9 may be the pharmacodynamic substances of C. muricatum to exert analgesic and anti-inflammatory effects.

Objective:To explore the effect of laparoscopic surgery on postoperative rehabilitation and stress response of patients with colorectal cancer.Methods:From January 2018 to September 2019, 94 patients with colorectal cancer were selected in the General Hospital of Marine Police of the Chinese People's Armed Police Force.They were divided into observation group (47 cases) and control group (47 cases) according to the random digital table method.The observation group was treated with laparoscopic surgery, while the control group was treated with open surgery.The changes of perioperative indicators, postoperative rehabilitation indicators, postoperative complications and 24-hour stress response indicators were compared between the two groups.Results:The time of lymph node dissection and operation had no statistically significant differences between the two groups (all P>0.05). The amount of bleeding of the observation group [(153.61±27.58)mL] was less than that of the control group [(271.32±23.25)mL] ( t=22.371, P<0.05). In the observation group, the exhaust time [(43.27±6.18)h] and the recovery time of bowel sounds [(20.31±3.28)h] were faster than those in the control group [(67.38±9.91)h and (34.54±5.17)h] ( t=14.153, 15.934, all P<0.05). The incidence of postoperative complications in the observation group (4.26%) was lower than that in the control group (21.28%) (χ 2=6.114, P<0.05). The serum levels of norepinephrine (NE) [(92.13±10.45)μg/L], C-reactive protein (CRP) [(17.38±3.01)mg/L] and Cor [(137.87±23.15)μg/L] in the observation group were lower than those in the control group [(136.27±15.42)μg/L, (26.73±2.34)mg/L and (185.42±27.39)μg/L] ( t=16.245, 16.813, 9.090, all P<0.05). Conclusion:Laparoscopic radical resection of colorectal cancer has good effect on patients with colorectal cancer.It can speed up postoperative rehabilitation and reduce stress response.It is worthy of popularizing.

Objective: Comparison of alkaloid and polysaccharides content in different parts of whole plant of wild aconitum in Nanyang, and to explore the medicinal value of aboveground part and fibrous root of wild aconitum in Nanyang. Methods: The contents of three monoester alkaloids, three diester alkaloids in wild aconitum, radix aconiti carmichaeli, fibrous root and aboveground parts in Nanyang were determined by HPLC method; The content of crude polysaccharides was determined by sulfuric-phenol method, crude polysaccharides content from different tissues of wild aconitum in Nanyang in different harvest time was compared, including wild aconitum in Nanyang, wild radix aconiti carmichaeli in Nanyang, fibrous root, aboveground part. Results: Among the 4 parts of the wild Aconitum in Nanyang, the contents of 3 mono ester alkaloids rang from high to low: wild aconitum in Nanyang＞ wild radix aconiti carmichaeli in Nanyang＞ fibrous root＞ aboveground part (P ＜ 0.05), the contents of three diester alkaloids rang from high to low: wild radix aconiti carmichaeli in Nanyang＞ fibrous root＞ wild aconitum in Nanyang＞ aboveground part (P ＜ 0.05), the order of total alkaloid content from high to low is: wild radix aconiti carmichaeli in Nanyang＞ fibrous root＞ wild aconitum in Nanyang＞ aboveground part (P ＜ 0.05), The content of crudepolysaccharides in different tissues of wild aconitum in Nanyang were in the sequence of wild radix aconiti carmichaeli in Nanyang＞ wild aconitum in Nanyang＞ aboveground part＞ fibrous root (P ＜ 0.05) . Conclusion: In this study, an attempt was made to explore the differences of 6 kind salkaloid content in different parts of whole plant of wild aconitum in Nanyang, which provided scientific basis for the medicinal value of the fibrous roots and the aboveground parts.

Objective To observe the clinical efficacy of heat-sensitive moxibustion plus point-toward-point needling in treating poststroke strephenopodia.Method Eighty patients with poststroke strephenopodia were randomized into a treatment group intervened by heat-sensitive moxibustion plus point-toward-point needling and a control group intervened by rehabilitation, 40 cases in each group. In addition to the basic treatment, the treatment group was given heat-sensitive moxibustion plus point-toward-point needling, and the control group was given rehabilitation treatment. Holden's Functional Ambulation Classification (FAC), Fugl-Meyer Assessment (FMA) of the lower-limb motor function, and Tinetti Gait Assessment (TGA) were adopted for evaluation of the two groups, and the clinical efficacies were compared.ResultThe effective rate was 90.0% in the treatment group versus 77.5% in the control group, and the difference was statistically significant (P<0.05); after the treatment,there was a significant difference in comparing the Holden's FAC between the two groups (P<0.05); the FMA score changed significantly after the treatment in both groups (P<0.05), and there was a significant difference in comparing the FMA score between thetwo groups after the treatment (P<0.05); the TGA score changed significantly after the intervention in both groups (P<0.05), and there was a significant difference in comparing the TGA score between the two groups after the intervention (P<0.05).ConclusionHeat-sensitive moxibustion plus point-toward-point needling can produce a significant efficacy in treating poststroke strephenopodia, as it can enhance the effective rate and improve the lower-limb motor function.

Objective To investigate the efficacy of skin scraping plus movable cupping in treating neck-shoulder syndrome. Method One hundred and eighty patients with neck-shoulder syndrome were randomly allocated to treatment and control groups. The treatment group received skin scraping plus movable cupping and the control group, acupuncture. Result The total efficacy rate was 88.8% in the treatment group and 77.5% in the control group; there was a statistically significant difference between the two groups (P<0.05). Conclusion Skin scraping plus movable cupping has a good therapeutic effect on neck-shoulder syndrome.

Objective To explore the value of an innovative teaching model which combined problem based learning (PBL) method with case based learning (CBL) method in clinical oncology Teaching.Methods 68 students were divided into the combinational teaching group (30 cases) and the LBL group (38 cases).The combinational teaching group was taught by PBL method combined with CBL method, and this dual track teaching was based on cases and problems.The traditional teaching group was taught by LBL method.The teaching effect was evaluated by students' questionnaire survey and test score.SPSS 13.0 was used to two groups to do t test for statistical analysis in test score and x2 test for degree of satisfaction.Results In the final examination, the score of non-case test of combinational teaching group was similar to that of traditional teaching group (50.30 ± 7.19 vs.52.04 ± 8.01, P=0.358).The combinational teaching group had significant improvement in case analysis test (35.76 ± 5.28 vs.31.80 ± 5.16), and the difference was statistically significant (P=-0.003).In the course of teaching satisfaction survey, the dual track teaching group, compared with the conventional teaching group, has a better effect on self study ability, communication skills, communication skills, and higher satisfaction for teaching, and more willing to continue to carry out teaching (P＜0.05).Conclusion The PBL+CBL combinational teaching model can make a great contribution to improving the teaching quality and satisfaction, and worthy of being popularized and applied.

Background and objectiveIt has been proven that tumor necrosis factor receptor-associated factor 6 (TARF6) was a commonly ampliifed oncogene in lung cancer. However, the precise role of TARF6 protein in lung cancer has not been extensively investigated. hTis study analyzed the effects of TARF6 on the proliferation, apoptosis, cell cycle, migration, and invasion capability of lung cancer cell lines, as well as the potential molecular mechanisms involved.MethodsTo address the expression of TARF6 in lung cancer cells, four lung cancer cell lines (A549, H1650, SPC-A-1 and Calu-3) were assayed to determine the expression of TARF6 protein by Western blot and TARF6 mRNA via qRT-PCR. Moreover, siRNA targeting TARF6 was introduced into SPC-A-1 and Calu-3 cells. Nuclear factor-?B (NF-?B) DNA-binding activity, apoptosis rates, cell proliferation, cell cycle, migration, and invasion were determined by electrophoretic mobility shitf assay, lfow cytometry, MTS assay, lfow cytometry, scratch test, and transwell chamber assay, respectively. Western blot analysis was also performed to evalu-ate the expression of the following proteins through K63-ubiquitination: P65, CD24 and CXCR4. Whole-genome sequencing analysis was conducted using a second-generation sequencer in SPC-A-1 cells.Results TARF6 was highly up-expressed in SPC-A-1 and Calu-3 cell lines than the other two cells, which also showed K63-ubiquitinization in TARF6. However, consti-tutive activation of NF-?B was observed only in SPC-A-1 lung cancer cells. Downregulation of TARF6 suppressed the NF-κB activation, cell migration, and invasion but promoted the cell apoptosis of SPC-A-1 cells. Markedly decreased expression of CD24 and CXCR4 was observed in SPC-A-1 cells transfected by TARF6 siRNA. Nevertheless, TARF6 downregulation did not affect the proliferation and cell cycle of SPC-A-1 cells. Additionally, TARF6 regulation did not affect the proliferation, apoptosis, cell cycle, migration, and invasion of Calu-3 cells. No mutations and no changes in gene copy numbers of TARF6 were found by whole-exome sequencing of SPC-A-1 cells.ConclusionTARF6 may be involved in cell migration, invasion, and apoptosis of SPC-A-1 cells, possibly through regulating the NF-?B-CD24/CXCR4 pathway.

The chronic-hypoxia-resistant gastric cancer cell line was established, and its biological characteristics were explored and compared with the parental cell line. Gastric cancer cell lines were cultured under the degressive oxygen concentration. Cell doubling time was calculated by cell counting method. Chemo-resistance ability of cells was tested by MTT assay. Irradiation tolerance of cells was evaluated by colony forming method. Cell cycle distribution was tested with flow cytometry. Invasive ability was tested by Transwell method. The expression levels of GLUT-1 and HIF-1α were detected by using Western blot. MNK45/HYP cells successfully survived under the 1% concentration of oxygen and its cell doubling time was 35.01±1.02 h, while that of MNK45 was 27.35±0.83 h (P<0.01). The percentage of MNK45/HYP cells in G(0)/G(1) stage was (58.3±6.1)%, and that of MNK45 cells was (42.2±6.0)% (P<0.05). Comparing with the parental cells MNK45, drug resistance indexes of 5-Fu, PTX, OXA, Sn38, GEM and VP16 in MNK45/HYP cells were respectively 5.3, 1.3, 3.6, 2.2, 4.8 and 4.4. Colony forming ability of MNK45/HYP cells after irradiation was also significantly higher than MNK45 cells. The invasive number of MNK45/HYP cells was 107.7±17.5, while that of MNK45 cells was 59.0±9.9. The expression levels of GLUT-1 and HIF-1α in MNK45/HYP cells were significantly higher than those in MNK45 cells. MNK45/HYP cells hold biological characteristics of hypoxia tumor with good tolerance to chronic hypoxia, and can be used for the research of solid tumor under chronic hypoxia condition.

The chronic-hypoxia-resistant gastric cancer cell line was established,and its biological characteristics were explored and compared with the parental cell line.Gastric cancer cell lines were cultured under the degressive oxygen concentration.Cell doubling time was calculated by cell counting method.Chemo-resistance ability of cells was tested by MTT assay.Irradiation tolerance of cells was evaluated by colony forming method.Cell cycle distribution was tested with flow cytometry.Invasive ability was tested by Transwell method.The expression levels of GLUT-1 and HIF-1α were detected by using Western blot.MNK45/HYP cells successfully survived under the 1％ concentration of oxygen and its cell doubling time was 35.01±1.02 h,while that of MNK45 was 27.35±0.83 h (P＜0.01).The percentage of MNK45/HYP cells in G0/G1 stage was (58.3±6.1)％,and that of MNK45 cells was (42.2±6.0)％ (P＜0.05).Comparing with the parental cells MNK45,drug resistance indexes of 5-Fu,PTX,OXA,Sn38,GEM and VP16 in MNK45/HYP cells were respectively 5.3,1.3,3.6,2.2,4.8 and 4.4.Colony forming ability of MNK45/HYP cells after irradiation was also significantly higher than MNK45 cells.The invasive number of MNK45/HYP cells was 107.7±17.5,while that of MNK45 cells was 59.0±9.9.The expression levels of GLUT-1 and HIF-1α in MNK45/HYP cells were significantly higher than those in MNK45 cells.MNK45/HYP cells hold biological characteristics of hypoxia tumor with good tolerance to chronic hypoxia,and can be used for the research of solid tumor under chronic hypoxia condition.