【Abstract】ObjectiveTo discuss the molecular structures and functions of Alu repeats,and its relationships with malignant tumors. MethodsAdvances in molecular biology and oncology of Alu repeats in recent years had been reviewed. ResultsHomologous recombination between Alu repeats may result in various genetic exchanges,including duplications, deletions and translocations,cause a series of malignancy alteration by activating some oncogenes. ConclusionAlu repeats as a sort of multifunction regulatory sequences may play an important role during the carcinogenesis and progression of some tumors.
Malignant tumors are the major diseases which threat human beings. Anti-cancer medicines play important roles in the treatment of malignant tumors, especially for the new targeted therapies. They bring the life hope for cancer patients who were sentenced to death, and improve quality of life, and some patients may achieve normal lifetime. However, the new anti-cancer medicines are usually too expensive to afford, and most of them have not yet been included in Chinese public health security system, the accessibility of the new anti-cancer medicines is seriously limited. This paper introduces the accessibility of high-cost anti-cancer medicines in China, analyzes the influence factors, and proposes policy recommendations to improve the accessibility of high-cost anti-cancer medicines in China.
OBJECTIVE: To evaluate the results of limb function and the methods of bone and soft tissue reconstruction of patients treated with allografting. METHODS: From May 1992 to January 1999, 90 patients suffered from bone malignant tumor were treated with allografting in different methods of internal fixations. The average follow-up was 37.5 months. The limb postoperative function, complications related to different surgical methods were compared according to Enneking evaluation system. RESULTS: Skin necrosis, infection, non-union, fracture of allograft were the main complications which affect patients’ limb postoperative functions. Of the 90 fresh-frozen allografting procedures, the final results of operation showed that hip joints and knee joints were better than the shoulder joints. More than 80% of the patients treated with interlocked intramedullary nail and allograft-prosthesis combination led to an over-all result that was excellent and good. Interlocked intermedullary nail was of recommended method of internal fixation. Early exercises of operative limbs could promote function recovery. CONCLUSION: Using of interlocked intramedullary nail and allograft-prosthesis combination are of recommended operation method and can be applied with better results, and early exercises of operative limbs will lead to better functions.
Objective To evaluate the efficacy of transposition of the medial gastracnemius muscle flap in the limbsalvage operation of the proximal tibial tumors. Methods From January 2001 to September 2005, 13 patients (8 males,5 females; aged 14-57 years, averaged 29.7 years) suffering from the proximal tibial tumors were treated with a limbsalvage operation. Among them, there were 4 patients with osteosarcoma, 6 with malignant fibrous histocytoma, 1 with malignant giant cell tumor, 1 with synovial sarcoma, and 1 with Ewing’s sarcoma. According to the Enneking staging system, 1 case was in Stage ⅠB, 9 in Stage ⅡA, and 3 in Stage ⅡB. One or two cycles of neo-adjuvant chemotherapy were used to each of the patients before operation. All of the patients underwent the medial head of the gastrocnemius muscle flap transposition to reconstruct the soft tissues after resection of the tumors and reconstruction of the bone defect by prothesis or bone-graft or the two methods combined. Results The follow-up for 7-47 months (average, 19.2 months) in all the patients revealed that. there was no flap necrosis, no skin necrosis at the incision margins, and no infection or fracture of the implanted bone. The patient with malignant fibrous histocytoma died of systemic metastasis 20 monthsafter operation. The patient with Ewing’s sarcoma had a local tumor recurrence 18 months after operation; though treated with the focal cleaning and the bone cement filling, the patient still developed lung metastasis of the tumor 26 months after operation. The patient with osteosarcoma underwent amputation 12 months after operation because of the tumor recurrence. According to the function assessment by the Mankin system, there were 6 patients who had an excellent result, 4 had a good result, and 3 had a poor result, with a satisfaction rate of 77%. Conclusion The flap transposition of the medial head of the gastrocnemius muscle can reconstruct the soft tissue defect, decrease the local complication rate and improve the clinical outcome of the limb salvage for the proximal tibia malignant tumor.
Objective To investigate the epidemiological characteristics of malignant tumor deaths in the registered population of Zhuhai city. Methods A retrospective survey of death from malignant tumor during 2004 and 2005 was performed in the registered population of Zhuhai city. This was based on the retrospective protocol of the third national survey of death cause. The mortality of main malignant tumor and cause of deaths were analyzed. Results During 2004 to 2005, the mean crude mortality and age-specific standardized mortality of malignant tumor were 90.3/100 000 and 97.2/100 000, respectively. Malignant tumor death was the most common cause of death in Zhuhai city, accounting for 21.8% of all deaths. The standardized mortalities in males and females were 119.7/100,000 and 71.6/100,000, respectively. The standardized rate in the male population was significantly higher than that of the female population (u=10.3, Plt;0.01). The mortality of malignant tumor tended to increase with age. The top five causes of malignant tumor deaths were lung cancer, liver cancer, colorectal cancer, nasopharyngeal cancer and gastric cancer. Their standardized mortalities were 20.9, 18.0, 8.7, 8.2, 8.1/100,000, respectively. Conclusion The mortality of mal ignant tumors has showed an increasing trend in Zhuhai city, with the main tumors being lung cancer, liver cancer, colorectal cancer, nasopharyngeal cancer and gastric cancer. Malignant tumor has become a common and frequently-occurring disease with a major impact on the life and health of people in Zhuhai city.
ObjectiveTo summarize the research progress of constitutive photomorphogenesis 9 signalosome (CSN) in malignant tumor in recent years. MethodsLiteratures about the relationship between CSN and maglinant tumor which were published in recent years were collected to make a review. ResultsMany malignant tumors were found to have high expression level of CSN, and CSN could degrade various tumor suppressor genes, such as p53 gene, mainly through regulating the ubiquitin protein degradation pathway, which played an role in promoting tumor growth. CSN5 was the deneddylation active center of CSN, and the activity of CSN was based on the integrity of CSN, which meant CSN6 (CSN core scaffold structure) have to exist. Current study found that CSN6 could promote tumorigenesis and development through a variety of signaling pathways, and CSN5 was mainly involved in cell cycle regulation and DNA damage repair to promote tumor growth. ConclusionsThe research of CSN in malignant tumors has lay a foundation of targeted therapies for cancer. However, the specific function of each of its subunit still remains unclear, and its upstream regulatory factors also need to be further explored.
Objective To assess the methodological quality of clinical studies using Shen-Mai injection as an adjunct therapy to tumor chemotherapy and to evaluate its efficacy and safety. Methods A comprehensive search strategy was designed to identify all randomized controlled trials (RCT) comparing Shen-Mai injection plus routine chemotherapy versus routine chemotherapy alone by searching for the CBMdisc (issue 3) and TCMLRS database (1981-2001). The methodological quality of the trials was assessed by two reviewers independently for which a meta analysis was perfermed. Results Thirteen RCTs met the inclusion criteria. methodological quality was poor (all the trials included were level C). Compared with the control group, the combined outcome of Shen-Mai injection increased the effect of chemotherapy (OR 1.73 95%CI 1.27 to 2.34, P＝0.000 4), reduced the side effect of bone marrow inhibition (OR 0.29, 95%CI 0.16 to 0.52, P＝0.000 04) in WBC counting and (OR 0.11, 95%CI 0.02 to 0.49, P＝0.004 in PLT count. And Shen-Mai injection relieved the symptoms of nausea and vomiting (OR 0.26, 95%CI 0.16 to 0.43, Plt;0.000 01). Conclusions The methodological quality of the trails using Shen-Mai injection should be improved. Based on the results of the review and the meta-analysis, Shen-Mai injection may have positive effects on chemotherapy in patients with malignant tumor, although the evidence is weak. No serious adverse events are reported. Further well-designed clinical trials should be performed.
Objective To summarize the research status and prospect of immunotherapy for biliary tract cancer (BTC). Method The literatures about immunotherapy of BTC at home and abroad in recent years were reviewed. Results Surgical resection was still the first choice and only radical treatment for BTC. However, the recurrence rate of BTC was high, and most of the patients were in the middle and late stage with metastasis and lose the opportunity of operation. Patients with local progression, metastasis or recurrence could only receive chemotherapy and other comprehensive treatment, but they could not get satisfactory results. The continuous update of targeted drugs brings new hope for drug therapy of BTC, and immunotherapy had become a new treatment of tumor targeted therapy following radiotherapy and chemotherapy. ConclusionImmunotherapy can be used as an option for the treatment of advanced BTC and its postoperative recurrence and metastasis, and has attracted more and more attention.
【Abstract】Objective To investigate the recent studies on the biocharacters of keratin family (e.g. genetic mutations and abnormal expressions) and their relationships with the malignant tumors. Methods The literatures of recent years on the biocharacters of keratin family (e.g. genetic mutations and abnormal expressions) and their relationships with the malignant tumors were reviewed. Results Keratin family is a kind of structural proteins in cell which plays an important role in cytomechanics and regulates cell-cycle. The mutations of keratin genes (mRNA) or the overexpression of keratin proteins would interfere with the order of cell-cycle or the integrity of cytomechanics, and lead to some diseases and malignant tumors finally. Conclusion The studies on biocharaters of keratin family (e.g. genetic mutations and abnormal expressions) are helpful in the diagnosis, staging and the evaluation of prognosis of some diseases and cancers, e.g. liver cirrhosis, breast cancer, rectum carcinoma, etc.
Objective To analyze risk factors of malignancy in patients with small pulmonary nodules （diameter ≤2 cm） using univariate analysis and multivariate logistic regression，and establish a mathematical prediction model to estimatethe probability of malignancy. Methods Clinical data of 147 patients with small pulmonary nodules who underwentsurgical resection with definite postoperative pathological diagnosis from January 2005 to September 2012 in the 161st Central Hospital of PLA were retrospectively analyzed. There were 84 male and 63 female patients with their age of 31-78（56.2±10.1） years. Univariate analysis using Chi-square test or t test was performed to analyze risk factors including patientage，gender，symptoms，history and quantity of smoking，history of heavy drinking，history of tumor，tumor site，diameter，lobulation，spiculation，pleural indentation，ground-glass opacity，cavity，enlarged hilar and mediastinal lymph nodes.Independent predictors of malignancy were screened with multivariate logistic regression analysis. A mathematical predictionmodel was built to estimate the probability of malignancy and then examined. Results Univariate analysis showed that there was statistical difference in patient age（t=7.146，P＜0.001），heavy smoking history（χ2=6.169，P=0.013），nodule diameter（t=3.375，P=0.001），spiculation（χ2=5.609，P=0.018），lobulation（χ2=5.675，P=0.017），and pleural indentation（χ2=12.994，P＜0.001）between benign and malignant small pulmonary nodule groups. Multivariate logistic regression analysis showed that patient age （OR=1.110，P=0.000），nodule diameter （OR=2.050，P=0.029），lobulation （OR=1.672，P=0.045），spiculation（OR=2.054，P=0.032） and pleural indentation（OR=4.090，P=0.024）were independent predictors of malignancy in patients with small pulmonary nodules （P＜0.05） . The mathematical prediction model to estimate the probability of malignancy was：Logit （P） =ez/ （1 ＋ ez），Z=-6.657 ＋ （0.104×age） ＋ （0.718×diameter） ＋ （0.720×spiculation） ＋（0.514×lobulation） ＋ （1.409×pleural indentation），and e was natural logarithm. Both Hosmer-Lemeshow test （χ2=1.802，P=0.986） and maximum likelihood ratio test （Cox-Snell R2=0.310，Nagelkerke R2=0.443） showed satisfactory goodness of fit. The diagnostic accuracy was 85.71%，sensitivity was 87.50%，specificity was 81.40%，positive predictive value was 91.92%，and negative predictive value was 72.92% when the cut-off value was 0.58. Conclusions Patient age，nodule diameter，spiculation，lobulation and pleural indentation are independent predictors of malignancy in patients with small pulmonary nodules. The mathematical prediction model can accurately estimate the probability of malignancy for patients with small pulmonary nodules.