Objective To study the long-term effect of neoadjuvant chemotherapy on advanced breast cancer. Methods The CAF neoadjuvant chemotherapy 〔CTX 500 mg/m2（1st day, 8th day), 5-FU 500 mg/m2（1st day, 8th day), and ADM 30 mg/m2 (1st day) every 3 weeks〕 was carried out in 31 breast cancer patients (stageⅢ,Ⅳ) for 2 cycles before operation, compared with 30 patients (stage Ⅲa) whose therapies were never done and operations could be feasible. Results The overall response rate was 87.1%(27/31). The stages of 19 patients among 31 (61.3%) declined (6 patients to stage Ⅲa, 8 to stageⅡb, 4 to stageⅡa, 1 to stage 0, 1 to complete response and none to pathological complete response). The diseasefree survival time of the patients was 56.3 months which was obviously longer than that of the patients without neoadjuvant chemotherapy (43.5 months, P＜0.05). The 5-year diseasefree survival rate of the patients with neoadjuvant chemotherapy was 38.7% which was a little higher than that (33.3%) of the patients without the chemotherapy, and the two groups had no significant difference. Conclusion The neoadjuvant chemotherapy can reduce the stages of patients with advanced breast cancer, obviously prolong the diseasefree survival time of patients, and reduce or delay recurrence or metastasis.
Large sample-size registries have become a necessary complement to randomized controlled trials. This study introduced the registries in the field of clinical application of implantable cardioverter defibrillator, especially the two large registries of the US NCDR ICD and Boston Scientifićs ALTITUDE, described the current status and future direction, thus to guide such registry researches in China.
ObjectiveTo explore course content and teaching-learning strategies of advanced nursing practice in graduate nursing education, so as to provide reference for nursing schools to develop relevant courses.MethodsA teamof course teachers was set up, and the course was developed. The course was implemented in grade 2015 and 2016 graduate nursing students. The students’ perception and evaluation of course contents, teaching methods, teaching quality, curriculum value and course satisfaction were collected through questionnaires and interviews.ResultsA totalof 23 students were enrolled. The mean scores of teaching quality, curriculum value and course satisfaction were 93.48±1.01, 51.04±4.88, and 17.00±2.28, respectively. Students recognized the necessity and the importance of including the advanced nursing practice in each specialty in the course content, and hoped to add in practice sections.ConclusionsIt is advisable to include the advanced nursing practice in each specialty as well as the practice section, so as to strengthen the students’ concrete understanding of the advanced nursing practice. Seminar and discussion are the teaching methods with first priority.
ObjectiveTo investigate the association between the stress-induced hyperglycemia ratio (SHR) and all-cause, cardiovascular, and diabetes-related mortality in patients with advanced cardiovascular-kidney-metabolic (CKM) syndrome, and to evaluate the value of SHR as an independent prognostic marker. MethodsThis retrospective cohort study used data from the 1999–2018 U.S. National Health and Nutrition Examination Survey (NHANES). A total of 2 135 patients with advanced CKM (stages 3 and 4) were included. Kaplan-Meier analysis and multivariable Cox regression models were applied to assess the relationship between SHR and mortality outcomes. Restricted cubic spline (RCS) analysis was employed to explore potential non-linear associations. Subgroup analyses were conducted to identify possible effect modifiers. ResultsOver a mean follow-up of 248 months, 674 all-cause, 198 cardiovascular, and 31 diabetes-related deaths occurred. Elevated SHR was significantly associated with diabetes-related mortality (HR=3.48, P<0.001) in a dose-response manner. SHR exhibited a U-shaped relationship with both all-cause and cardiovascular mortality (non-linearity P<0.001), indicating increased risk at both low and high SHR levels. Subgroup analyses revealed that sex, BMI, and hyperlipidemia significantly modified the association between SHR and diabetes-related death. ConclusionSHR is an independent predictor of mortality risk in patients with advanced CKM syndrome, particularly for diabetes-related death. These findings support the integration of SHR into risk stratification of high-risk CKM populations and provide a basis for metabolic stress-targeted interventions.
Objective To investigate the implication of oxidation protein product ( advanced oxidation protein product, AOPP) , an index of oxidative stress in obstructive sleep apnea-hypopnea syndrome ( OSAHS) . Methods 47 patients with OSAHS and 48 normal controls were enrolled. The concentration of AOPP was measured by spextrophotometry after ameliorated, while superoxide ( SOD) , malonaldehyde ( MDA) , glutathione peroxidase ( GSH-PX) in morning blood samples were detected by Xanthine oxidase test. Results ( 1) Plasma AOPP and MDA were significantly elevated in OSAHS compared with those in control group ( both P lt;0. 01) . Plasma SOD and GSH-PX were significantly lower in OSAHS compared with those in control group ( both P lt;0. 01) . There were significant differences in the plasma AOPP, MDA, SODand GSH-PX among different severity of OSAHS ( all P lt; 0. 01) . Plasma AOPP and MDA were increased and SOD and GSH-PX were gradually decreased with the progression of OSAHS. ( 2) Plasma AOPP correlated well with MDA, SOD and GSH-PX, moreover, AOPP was positively correlated with apnea hyponea index or lowest oxygen saturation. Conclusion AOPP is an alternative index reflecting both oxidative streess and tissue injury in patients with OSAHS.
ObjectiveTo investigate the risk factors of hepatoduodenal lymph node (HDLN) metastasis in patients with advanced gastric cancer and its effect on prognosis. MethodsClinical datas of patients with advanced gastric cancer who underwent D2 radical gastrectomy for gastric cancer and HDLN dissection between Jan 2011 and Nov 2013 in department of general surgery of Ankang Central Hospital were retrospectively reviewed. Multivariate logistic regression analysis was performed to identify the independent risk factors associated with HDLN metastasis. Survival curves were performed to compare the survival rate of patients with or without HDLN metastasis and of patients with HDLN metastasis or with other lymph node metastasis. A Cox proportional hazards model was used for the multivariate analysis of risk factors for death in advanced gastric cancer. ResultsThe incidence of HDLN metastasis was 10.7% in patients with advanced gastric cancer. Multivariate logistic regression analyses revealed that the middle or lower stomach cancer (OR=6.014, P=0.002) and stage T3 or T4 (OR=5.133, P=0.021) were independent risk factors for HDLN metastasis. The 2-year overall survival (OS) rate was 36.7% in patients with HDLN metastasis. It was lower in patients with HDLN metastasis compared with those without (P=0.002). Limited to node-positive patients, patients with HDLN metastasis demonstrated decreased 2-year OS rate compared with node-positive patients without HDLN metastasis (P=0.027). Cox proportional hazard analysis identified poorly differentiated or undifferentiated cancer, stage of T3 or T4, and HDLN metastasis were independent poor prognostic factors in the patients with advanced gastric cancer (P < 0.05). ConclusionsCancer located in the middle or lower stomach, and stage T3 or T4 were independent risk factors for HDLN metastasis in patients with advanced gastric cancer. HDLN metastasis demonstrated a poor prognosis.
Objective To study the expression of receptor of advanced glycation end products (RAGE) in autogenous vein graft of streptozotocin induced diabetic rats and the inhibitory effects of aminoguanidine on intimal hyperplasia. Methods Sixty male Sprague-Dawley rats were randomly divided into three groups: aminoguanidine group, distilled water group and control group. Autogenous vein graft models were established in all groups. Streptozotocin was injected into abdominal cavity to induce diabetes in both aminoguanidine group and distilled water group, and they were intragastric administrated with aminoguanidine or distilled water, respectively before and after transplantation. Specimens were collected from autogenous vein graft 7 days and 14 days after surgery to undergo histological examination. At the same time, the level of serum advanced glycation end products (AGE) was tested. Western blotting and immunohistochemistry were used to detect the protein expression of RAGE and NF-κB p65. RAGE and NF-κB p65 mRNA were measured by reverse transcription-PCR. Results The mRNA and protein expressions of RAGE, NF-κB p65, the level of serum AGE and the intimal thickness of vein graft in distilled water group increased in comparison with those in control group 7 days and 14 days after surgery （P＜0.05). The level of serum AGE, mRNA and protein expressions of NF-κB p65 and the intimal thickness of vein graft in aminoguanidine group were lower than those in distilled water group （P＜0.05), and showed no significant difference compared with control group （P＞0.05). Conclusion The over-expression of RAGE in vein graft activats NF-κB in streptozotocin-induced diabetic rat, which has a close relation with intimal hyperplasia. Aminoguanidine can block the binding of AGE and RAGE by inhibiting the production of AGE, which will prevent intimal hyperplasia of vein graft.
Objective To investigate the clinical efficacy and safety of hyperthermic intraperitoneal perfusion chemotherapy (HIPC) in treatment of advanced colorectal cancer.Methods The Meta-analysis was applied to analyze 8 randomized controlled quantitative studies published at domestic and abroad. These patients treated by HIPC after radical operation with colorectal cancer were included for the treatment group, and those treated only by radical operation with colorectal cancer for the control group. Relative risk (RR) of outcome variable of 3-year and 5-year survival rate and safety between the two groups were compared. Results There were 8 selected literatures, including 1 501 cases, in which 765 cases for treatment group, and 736 cases for control group. RR of 5-year survival rate of the total patients was 2.39 (95% CI: 1.66-3.45). RR of 3-year survival rate of the total patients was 2.13 (95% CI: 1.45-3.13). The results demonstrated that HIPC could improve 5-year and 3-year survival rate, and sensitivity analysis confirmed the conclusions more reliable. The security was described in 5 literatures, the available information showed smaller potential security issue. Conclusions HIPC after radical operation of advanced colorectal cancer can increase 5-year and 3-year survival rate of patients, improve the prognosis of patients. Whether patients with increased incidence of postoperative complications related to the HIPC is no clear-cut conclusions for lack of related research.
Objective To evaluate the efficacy and toxicity of the combination of S-1 and oxaliplatin in the first-line chemotherapy of patients with advanced gastric cancer. Methods From March 2012 to April 2013, 57 patients in the First Affiliated Hospital of Guangxi Medical University were enrolled in this study. Oxaliplatin was administered at 130 mg/m2 on day 1, while S-1 was administered orally (< 1.25 m2: 40 mg twice per day; 1.25-1.50 m2: 50 mg twice per day; > 1.50 m2: 60 mg twice per day) for 14 days. The response was evaluated every two chemotherapy cycles. Results The objective response rate was 52.6%, and the disease control rate was 84.2%. The median time to progression was 5.8 months, and the median survival time was 13.5 months. The major grade 3/4 hematological toxic effects were neutropenia (12.3%) and thrombocytope nia (12.3%), and the grade 3/4 non-hematological toxic effects were vomiting, fatigue and sensory neuropathy. The rate of clinical benefit response was 71.9% (41/57). Conclusion The regimen of oxaliplatin and S-1 shows precise efficacy and good tolerance against advanced gastric cancer, and it is worthy of promotion and application in the future.
ObjectiveTo observe the clinical curative effect of interventional chemotherapy in the treatment of advanced gastric cancer. MethodsThirty advanced gastric cancer patients underwent arterial infusion chemotherapy and embolization treatment between January and December 30, 2013. The treatment was carried out every three weeks. We evaluated the clinical results after the third treatment. The clinical improvement was assessed based on alleviation of such symptoms as epigastric pain, poor appetite, nausea, vomiting and fecal occult blood. The tumor size was evaluated through abdominal CT examination. ResultsAbdominal pain relieved in 19 out of 28 patients (67.9%); appetite improved in 18 out of 24 patients (75.0%); vomiting relieved in 15 out of 16 cases (93.8%); and fecal 9 out of 12 patients with positive occult blood turned to negative (75.0%). The total effective rate was 83.3%, and 8 patients accepted interventional therapy after operation. The survival rates during the 6, 12 and 24-month follow-up were respectively 85.0%, 65.0%, and 25.0%. ConclusionsInterventional chemotherapy and embolization treatment are effective for advanced gastric cancer, which can relieve symptoms and lower tumor stage. Some patients have a second chance of operation, which can be an effective method in the treatment of advanced gastric cancer.