We have performed guided chemoembolization on 84 patients of moderate and advanced carcinoma of liver using adriamycin lipiodol emulsion (A/L) since 1986. Result showed that the rate of improvement of symptoms was 86.1%, in 75% cases the AFP were decreased and in 79.2% the size of tumor were reduced. The mean survival time was 10.3 months which was much higher than that of the control group (5.6 months,Plt;0.001). THe survival rates of 1/2,1,2,3 year were 89.3%,43.4%,13.5% and 3.8% respctively that were significantly higher than those of the control group (51.2%, 11.5%,0) (Plt;0.01). Three patients underwent secondary resection after using A/L chemoembolization ans gelatin spinge central embolization with a longer survival rate. This may be a good method of treatment to the nonresectable liver cancers and may also be an easy way for postoperative observation.
Objective To assess and report on the current situation of the families of students, who were involved in the Wenchuan earthquake, to provide data for the government to make decisions that should help with recovery from the earthquake. Methods We selected 2 towns and 4 villages using stratified sampling to take account of different levels of destruction. We performed on-site surveys and secondary research. Results The psychological problems of the parents of the students were serious. These families’ economic situations were not good. Conclusion We should build ‘Mutual Aid’ organization and take the advantage of rural hospitals to promote the long-acting mechanism of the psychological intervention.
ObjectiveTo study value of long noncoding RNA H19 and HOTTIP in plasma in predicting efficacy of neoadjuvant chemotherapy (NAC) for resectable locally advanced gastric cancer. MethodsForty patients with T3–4aN+M0 gastric cancer and 40 patients with benign gastric diseases treated in the Yantai Yuhuangding Hospital Affiliated to Qingdao University from August 2020 to May 2021 were prospectively included. The expressions of H19 and HOTTIP in the plasma of gastric cancer and benign gastric diseases patients without any treatment after admission were detected before treatment (CAPEOX regimen was used in the patients with gastric cancer), then which were detected after 2 NAC courses for patients with gastric cancer. Meanwhile, some clinical items were detected and the efficacy of NAC was evaluated. The complete remission (CR) and partial remission (PR) were classified as objective remission, CR, PR, and disease stability were classified as disease control. The expressions of H19 and HOTTIP between the different patients were compared and the receiver operating characteristic (ROC) curve was used to evaluate their values in the diagnosis of resectable locally advanced gastric cancer. ResultsThere were 13 cases of T downstaging and 27 cases of T non-downstaging and 25 cases of objective remission and 35 disease control after NAC. The median relative expression levels of H19 and HOTTIP before NAC in the patients with gastric cancer were higher than those in the patients with benign gastric diseases (H19: 1.42 versus 0.98, Z=–3.835, P<0.001; HOTTIP: 2.15 versus 1.04, Z=–5.062, P<0.001), and which were in the patients with T downstaging and disease control were lower than those in the patients with T non-downstaging and 5 cases of disease progression (For T staging, H19: 1.12 versus 1.54, Z=–2.960, P=0.002; HOTTIP: 1.49 versus 2.30, Z=–2.310, P=0.019. For efficacy of NAC, H19: 1.39 versus 2.48, Z=–3.211, P<0.001; HOTTIP: 1.96 versus 3.25, Z=–2.393, P=0.014). The median relative expressions of H19 and HOTTIP after NAC were lower than those before NAC in the patients with gastric cancer (H19: 1.12 versus 1.42, Z=–3.965, P<0.001; HOTTIP: 1.30 versus 2.15, Z=–4.839, P<0.001). There were no significant differences in the changes of H19 and HOTTIP before and after NAC between the patients with T downstaging and T non-downstaging, and between disease control and disease progression (P>0.05). The areas of ROC curve of H19, HOTTIP, and combination of H19 and HOTTIP in diagnosis of resectable locally advanced gastric cancer were higher than 0.7. ConclusionsLncRNA H19 and HOTTIP might be potential tumor markers in gastric cancer, and their diagnostic values for resectable locally advanced gastric cancer are higher. Gastric cancer patients with low expressions of H19 and HOTTIP in plasma might be more sensitive to NAC.
ObjectiveTo understand the effect of programmed death-1 (PD-1) inhibitors on defective mismatch repair (dMMR) / microsatellite instability-high (MSI-H) advanced colorectal cancer (CRC). MethodThe literature of recent research relevant PD-1 inhibitors in the utility for patients with dMMR/MSI-H advanced CRC was reviewed and summarized. ResultsAt present, there were many studies exploring the utility of anti-PD-1 inhibitors for the treatment of dMMR/MSI-H advanced CRC (including locally advanced CRC and metastatic CRC), and some studies were still in trials. Studies had consistently shown that the use of PD-1 inhibitors in dMMR/MSI-H advanced CRC as first-line or subsequent therapy, as well as in the neoadjuvant setting, leading to significant survival benefits. These benefits were particularly notable in cases of dMMR/MSI-H metastatic CRC with concurrent BRAF/RAS mutations and in the context of neoadjuvant immunotherapy aimed at organ preservation in locally advanced dMMR/MSI-H CRC. Moreover, there were numerous studies exploring “dual immunotherapy”, and most studies found that its efficacy was superior to that of single immunotherapy. However, the more adverse events were reported by the “dual immunotherapy” compared to the single immunotherapy. ConclusionsOverall, based on results of the literature reviewed, PD-1 inhibitors have shown significant clinical benefits in dMMR/MSI-H advanced CRC, but there are still more issues that need to be further explored, such as discovering more first-line PD-1 inhibitors, overcoming drug resistance and adverse events. Future clinical practice should prioritize more precise individualized identification and the application of more effective combination therapy regimens to further optimize outcomes for patients with dMMR/MSI-H advanced CRC.
ObjectiveTo recognize the latest research progress of immunotherapy for advanced gastric cancer (AGC). MethodThe domestic and international literature on immunotherapy for AGC in recent years were retrieved and reviewed. ResultsThe immunotherapy for AGC mainly focused on immune checkpoint inhibitors (ICIs), cellular immunity, and antitumor vaccines. The most immunotherapy researched was ICIs, especially for programmed death protein-1 / programmed death protein ligand 1, cytotoxic T lymphocyte associated antigen 4, and lymphocyte activating gene 3. The cellular immunotherapy and tumor vaccine therapy were less relatively. Although immunotherapy alone did not have a particularly good effect, its therapeutic effect was not inferior to that of chemotherapy alone and the incidence of adverse reactions was lower. Moreover, most studies had concluded that the use of immunotherapy in combination with other therapy had shown a good clinical efficacy, especially in combination with anti-human epidermal growth factor receptor 2 antibody, and chimeric antigen receptor T cells targeting Claudin 18.2 site had promising results in the AGC. ConclusionsWith the development of immunotherapy research, the strategies of immunotherapy for AGC are also constantly improving. Precision medicine is important in the process of immunotherapy. Targeted screening suitable patients and adopting precise treatment can further benefit the survival of patients with AGC.
ObjectiveTo evaluate the safety and efficacy of lenvatinib as targeted therapy for locally advanced thyroid cancer. MethodsThe data of 17 patients with locally advanced thyroid cancer who received targeted therapy in the Department of Head and Neck Surgery, Clinical Oncology School of Fujian Cancer Hospital from September 2021 to June 2023 were prospectively collected and analyzed. ResultsSeventeen patients received lenvatinib for a median of 8 weeks (4–32 weeks), 5 patients achieved partial response, 11 patients achieved stable disease, and 1 patient experienced progressive disease. The objective response and disease control rates were 29.4% (5/17) and 94.1% (16/17) respectively, the median tumor diameter of the target lesion decreased from 43 mm before treatment to 12 mm after treatment. Five patients did not undergo surgery because of tumor progression and their refusal; R0/1 resection was achieved in 11 of the 12 remaining patients (91.7%). All patients suffered from drug-related adverse events, and the commonest drug-related adverse events were hypertension (7/17, 41.2%), diarrhea (6/17, 35.3%), and proteinuria (5/17, 29.4%). There were no major drug-related adverse events. ConclusionPreliminary analysis indicates that lenvatinib is effective and safe for targeted therapy of locally advanced thyroid cancer, with a relatively high rate of R0/1 resection.
ObjectiveTo investigate the effectiveness of the V-Y advanced retroauricular flap for repairing mild and moderate earlobe defect.
MethodsBetween September 2014 and July 2015, V-Y advanced retroauricular flap was used to repair earlobe defect in 6 patients. There were 1 male and 5 females, aged 18 to 30 years (mean, 23 years). The left earlobe was involved in 2 cases and the right earlobe in 4 cases, including 2 cases of congenital earlobe defect and 4 cases of secondary earlobe defect; 1 patient had congenital deformity of upper auricle. According to self-made criteria for earlobe defect, 5 cases were rated as mild defect and 1 case as moderate defect.
ResultsAll incisions healed at the first stage, and the flaps survived smoothly. The patients were followed up 3 to 12 months, with an average of 9 months. The reconstructed earlobes had natural size and shape, and smooth curve; the texture and color were close to the adjacent skin. The effectiveness was satisfactory.
ConclusionThe V-Y advanced retroauricular flap for repairing mild and moderate earlobe defect can achieve natural earlobe and aesthetic plastic effectiveness, so it is a safe and ideal earlobe reconstruction method.
ObjectiveTo summarize controversy and progress of multi-slice spiral CT in efficacy evaluation of transformation therapy for advanced gastric cancer.MethodThe recent studies published at home and abroad on the spiral CT in evaluating the therapeutic effect of transformation therapy for the advanced gastric cancer were reviewed and analyzed.ResultsIn recent years, though the energy spectrum and dual-energy CT examinations had appeared, the most common tool in evaluating of the efficacy of transformation therapy for the advanced gastric cancer was the spiral CT. The most common evaluation standard was still the RECIST standard.ConclusionsSpiral CT has its outstanding diagnostic significance in therapeutic evaluation of transformation therapy for advanced gastric cancer. Although there is some controversy, with advancements of a large number of studies, it will greatly help diagnosis and treatment of advanced gastric cancer.
ObjectiveTo evaluate prognostic value of change of immune status in locally advanced gastric cancer (LAGC) patients. Methods We retrospective collected 210 LAGC patients who underwent treatment in our department from January 2013 to December 2018, then we collected lymphocyte-to-monocyte ratio (LMR) and cLMR (change of lymphocyte-to-monocyte ratio, cLMR) before operation and after three cycles of adjuvant chemotherapy. We had developed a new immune state change score (ICS) based on preoperative LMR (pLMR) and cLMR, and explored its prognostic value. The definition of ICS in this study was: ICS=1, pLMR≤4.53 and cLMR≤1; ICS=2, pLMR≤4.53 and cLMR>1, or pLMR>4.53 and cLMR≤1; ICS=3, pLMR>4.53 and cLMR>1. Results The results of multivariate Cox proportional hazard regression model showed that ICS was an influencing factor for overall survival [ICS=2, RR=0.397, 95%CI (0.260, 0.608), P<0.001; ICS=3, RR=0.080, 95%CI (0.040, 0.162), P<0.001), patients with ICS scores of 2 and 3 had better overall survival. In addition, the prognostic accuracy of ICS was superior to pLMR and Clmr, and the C-index of ICS [0.806, 95%CI (0.746, 0.865)] was higher than that of pLMR [0.717, 95%CI (0.635, 0.799), P=0.003)] and cLMR [0.723, 95%CI (0.641, 0.806), P=0.005)]. Based on this, a Nomogram model included ICS, CEA, and pTNM staging was constructed to predict the 3-year and 5-year survival rates of patients. The calibration curve and C-index [0.821, 95%CI (0.783, 0.859)] showed high discrimination and accuracy of Nomogram, and decision curve analysis confirmed that the model had good clinical application value. Conclusions The dynamic changes in the patient’s immune status before and after adjuvant therapy are related to the overall survival of LAGC patients. As an evaluating system which combined the cLMR and pLMR, ICS can better predict the prognosis of LAGC patients.
