简介：Glioblastoma(GBM)isatypeoftumorthatishighlylethaldespitemaximaltherapy.Standardtherapeuticapproachesprovidemodestimprovementinprogression-freeandoverallsurvival,necessitatingtheinvestigationofnoveltherapies.Oncologictherapyhasrecentlyexperiencedarapidevolutiontoward'targetedtherapy',withdrugsdirectedagainstspecifictargetswhichplayessentialrolesintheproliferation,survival,andinvasivenessofGBMcells,includingnumerousmoleculesinvolvedinsignaltransductionpathways.Inhibitorsofthesemoleculeshavealreadyenteredorareundergoingclinicaltrials.However,significantchallengesintheirdevelopmentremainbecauseseveralpreclinicalandclinicalstudiespresentconflictingresults.Inthisarticle,wewillprovideanup-to-datereviewofthecurrenttargetedtherapiesinGBM.

简介：Differentapproachesfortreatinglungcancerhavebeendevelopedovertime,includingchemotherapy,radiotherapyandtargetedtherapiesagainstactivatingmutations.Lately,betterunderstandingoftheroleoftheimmunologicalsystemintumorcontrolhasopenedmultipledoorstoimplementdifferentstrategiestoenhanceimmuneresponseagainstcancercells.Itisknownthattumorcellseludeimmuneresponsebyseveralmechanisms.Thedevelopmentofmonoclonalantibodiesagainstthecheckpointinhibitorprogrammedcelldeathprotein1(PD-1)anditsligand(PD-L1),onTcells,hasledtohighactivityincancerpatientswithlonglastingresponses.Nivolumab,anantiPD-1inhibitor,hasbeenrecentlyapprovedforthetreatmentofsquamouscelllungcancerpatients,giventhesurvivaladvantagedemonstratedinaphaseIIItrial.Pembrolizumab,anotherantiPD-1antibody,hasreceivedFDAbreakthroughtherapydesignationfortreatmentofnon-smallcelllungcancer(NSCLC),supportedbydatafromaphaseItrial.ClinicaltrialswithantiPD-1/PD-L1antibodiesinNSCLChavedemonstratedverygoodtolerabilityandactivity,withresponseratesaround20%andamediandurationofresponseof18months.

简介：AIM:ToevaluatetheefficacyandsafetyofN-butyl-2-cyanoacrylateintreatingacutebleedingofgastricvaricesinchildren.METHODS:Theretrospectivestudyincluded21childrenwith47episodesofactivegastricvaricealbleedingwhoweretreatedbyendoscopicinjectionofN-butyl-2-cyanoacrylateatAsanMedicalCenterChildren’sHospitalbetweenAugust2004andDecember2011.Toreducetheriskofembolism,eachinjectionconsistedof0.1-0.5mLof0.5mLN-butyl-2-cyanoacrylatedilutedwith0.5or0.8mLLipiodol.Theprimaryoutcomewasincidenceofhemostasisaftervaricealobliterationandthesecondaryoutcomewascomplicationoftheprocedure.RESULTS:The21patientsexperienced47episodesofactivegastricvaricealbleeding,includingrebleeding,forwhichtheyreceivedatotalof52cyanoacrylateinjections.Following42bleedingepisodes,hemostasiswasachievedafteroneinjectionandfollowingfivebleedingepisodesitwasachievedaftertwoinjections.Themeanvolumeofeachsinglealiquotofcyanoacrylateinjectedwas0.3±0.1mL(range:0.1-0.5mL).Injectionachievedhemostasisin45of47(95.7%)episodesofacutegastricvaricealbleeding.Elevenpatients(52.4%)developedrebleedingevents,withthemeandurationofhemostasisbeing11.1±11.6mo(range:1.0-39.2mo).Notreatment-relatedcomplicationssuchasdistalembolismwerenotedwiththeexceptionofabdominalpaininonepatient(4.8%).Amongfourmortalities,onepatientdiedofvaricealrebleeding.CONCLUSION:Endoscopicvaricealobliterationusingasmallvolumeofaliquotswithrepeatedcyanoacrylateinjectionwasaneffectiveandsafeoptionforthetreatmentofgastricvaricesinchildren.

简介：StandardTherapyforHeartFailureUntilnowtheprincipalfocusofheartfailuretherapyhasbeenonthesympatheticnervoussystemandtherenin-angiotensinsystem.Betablockadecounterstheunwantedeffectsofcatecholaminesonthemyocardiumaswellasmoderatelyreducingafterload.Sinceangiotensinisavasoconstrictorandhassometoxiceffectonthemyocardium,bothcontributingtoheartfailure,inhibitionoftherenin–angiotensinsystemhasbeenlogicaltherapyforheartfailure.However,useofangiotensinconvertingenzyme(ACE)inhibitorsmayincreasebradykininlevels,whichareresponsibleforthecoughthatmaybeassociatedwiththeiruseaswellasangioedemathatmayresultfromthesamemedications.

简介：Triple-negativebreastcancer(TNBC)isdiagnosedmorefrequentlyinyoungerandpremenopausalwomenandishighlyprevalentinAfricanAmericanwomen.TNBCisatermderivedfromtumorsthatarecharacterizedbytheabsenceofER,PgR,andHER2.SopatientswithTNBCdonotbenefitfromhormonalortrastuzumab-basedtherapies.TNBCsarebiologicallyaggressive,althoughsomereportssuggestthattheyrespondtochemotherapybetterthanothertypesofbreastcancer,prognosisremainspoor.Thisisdueto:shorteneddisease-freeintervalintheadjuvantandneoadjuvantsettingandamoreaggressivecourseinthemetastaticsetting.

简介：Wearecurrentlyfacedwithanagingpopulation,whichisrapidlygrowingworldwide.Twothirdsofcanceroccursintheover65-yearagegroup.Societalconceptionsfromthepasthavecreatedageiststereotypes;oldageisassociatedwithfrailtyandtheelderlyareperceivedtobedestinedfordeteriorationandlossofindependence.Cancerwithintheelderlyisalsosubjecttothesestereotypes,withelderlycancerpatientsconsideredbysomenotaslikelytorecoverasyoungerpatientswithcancer.Wesummariseandreviewthecurrentconcernsregardingelderlymanagementandtreatmentsutilisedforthemanagementofoncologicaldiseaseintheelderly,anddiscusstheimpactofunder-treatmentwithinthispopulation.

简介：Bell’spalsyisacommonlyseencranialnervediseaseandcanresultincompromisedfacialappearanceandfunctions.Itsetiology,prognosisandtreatmentarestillbeingdebated.Thispaperisareviewofrecentdevelopmentintheunderstandingofetiology,diagnosisandnon-surgicaltreatmentofBell’spalsy.

简介：AIM:Toreviewpublishedclinicalstudiesexaminingtheeffectofnatamycininthetreatmentoffungalkeratitis.METHODS:WeselectedthepublicationsinCENTRAL,MEDLINE,EMBASE,CNKI,andCBM.Thisstudysystematicallyreviewedpublishedrandomizedcontrolledtrials(RCTs)thatcomparednatamycintootherantifungalagents,andconductedfeasibleMeta-analysisofefficacyresultsusingRevman5.2software.RESULTS:WeincludedseventrialswhichweremainlycarriedoutindevelopingcountriesofAsia,withfivetrialsconductedinIndia,oneeachinChinaandBangladesh.Atotalof804participantswererandomizedtofollowingcomparisons:2%econazoleversus5%natamycinshowedlittledifferenceintheeffectsoftreatmentoffungalkeratitis[RR=0.99,95%confidenceinterval(CI),0.8to1.21];chlorhexidinegluconateversus5%natamycinindicatedthattheresultsonhealingoftheulcerat21dwaslessconclusive(RR=0.77,95%CI,0.55to1.08;I2=0%);1%voriconazoleversus5%natamycinsuggestedthatnatamycintreatmentappearedtobesignificantlybetteroutcomesthanvoriconazole(regressioncoefficient=-0.18logMAR;95%CI,-0.30to-0.05;P=0.006),especiallyinFusariumcases(regressioncoefficient=-0.41logMAR;95%CI,-0.61to-0.20;P<0.001);natamycinversusfluconazoleshowedasignificantdifferenceincurerate(χ2=5.048,P<0.05)andnatamycingroupwasmoreeffectivethanfluconazoleinaverageperiodoftherapy(t=7.94,P<0.01).CONCLUSION:Natamycinwasapreferablechoiceinthetreatmentoffungalkeratitis,especiallyintheearlyperiodofFusariumcases.

简介：Polyethylenimine-polyL-lysinePEI-PLL共聚物经由PEI开始的L离氨酸N-carboxyanhydrideLysZ-NCA的戒指洞聚合被综合。有siRNA的PEI-PLL的complexation被粒子尺寸和希腊语的第六个字母潜力大小学习。流动cytometric分析和共焦的成像显示出它的优秀细胞内部的trafficking能力。PEI-PLL在vitro比商业PEI-25k显示了更高的基因silencing效率和更低的cytotoxicity。在antitumor学习，PEI-PLL进一步与siVEGF被相结合并且显然为CT26肿瘤模型的处理显示出肿瘤抑制效果。因此，PEI-PLL是在vivo的进一步的antitumor处理的一个有希望的siRNA搬运人候选人。

简介：Objective:Toreportasurgicalmethodforthetreatmentofpre-auricularfistulatolowerpost-operativerecurrencerate.Methods:Clinicaldataof187patientswithpre-auricularfistulawhounderwentenblocresectionattheAffiliatedHospitalofLuzhouMedicalCollegefromAugust2006toNovember2012wereretrospectivelyreviewed.FactorsthatmightaffecttheprognosisfollowingEnblocfistularesectionborderedbythesuperficialtemporalisfascia,helixperichondriumandauriculocephalicsulcuswereinvestigated.Results:Ofthe187patients,181achievedprimaryhealingand6endedupwithdelayedhealing.Duringthefollow-upperiod(onetosevenyears),therewere4casesofrecurrence(2.1%).Conclusions:Cleardemarcationofsurgicalresectioncanfacilitateeasyandthoroughresectionofpreauricularfistulaandleadtolowrecurrencerate.Propertimingandcarefulsearchforpotentialfistulabranchesarethetwocrucialfactorsaffectingprognosis.

简介：Brainischemicstrokeistheleadingcauseoflong-lastinginjury,disability,anddeathinadults.Althoughthebrainrepresentsonlyabout2%ofthetotalbodymass,itconsumesalmost20%ofthebody’soxygen.Asaresult,braincellsareextremelysensitivetohypoxia.Oncecerebralischemiaoccurs,thecoreofthe

简介：SinceMurakamidefinedearlygastriccancer(EGC)asa'carcinomalimitedtothegastricmucosaand/orsubmucosaregardlessofthelymphnodestatus',severalauthorshavefocusedonthemostinfluentialhistopathologicalparametersforpredictingthedevelopmentoflymphnodemetastasesbyconsideringthelymphnodestatusasanimportantprognosticfactor.AfewauthorshavealsoconsideredthedepthofinvasionasoneofthekeystoexplainingtheexistenceofsubgroupsofpatientsaffectedbyEGCwithpoorprognoses.Inanycase,EGCisstillconsideredaninitialphaseoftumorprogressionwithgoodprognosis.Theintroductionofmodernendoscopicdeviceshasallowedaprecisediagnosisofearlylesions,whichcanleadtoimproveddefinitionsoftumorsthatcanberadicallytreatedwithendoscopicmucosalresectionorendoscopicsubmucosaldissection(ESD).Giventhewidespreaduseofthesetechniques,theJapaneseGastricCancerAssociation(JGCA)identifiedin2011thestandardcriteriathatshouldexcludethepresenceoflymphnodemetastases.Atthattime,EGCswithnodalinvolvementshouldhavebeenassertedasnolongerfittingthedefinitionofanearlytumor.Someauthorshavealsodemonstratedthatthemorphologicalgrowthpatternofatumor,accordingtoKodama'sclassification,isoneofthemostimportantprognosticfactors,therebysuggestingtheneedtoreportitinhistopathologicaldrafts.NotwithstandingtheacquiredknowledgeregardingtheclinicalbehaviorofEGC,Murakami'sdefinitionisstillbeingused.Thisdefinitionneedstobeupgradedaccordingtothemodernstagingofthediseasesothattheappropriatetreatmentwouldbeselected.

简介：Gastrointestinaltoxicities(GIT),includingoralmucositis,nauseaandvomiting,anddiarrhea,arecommonsideeffectsofchemotherapyandtargetedagentsinpatientswithadvancedcolorectalcancerandpancreaticcancer.Beingoftenunderreported,itisstilldifficulttopreciselyestablishtheirburdenintermsofbothpatient’squalityoflifeandcancercarecosts.Moreover,withtheuseofmoreintensiveupfrontcombinationregimens,thefrequencyofthesetoxicitiesisrapidlygrowingwithapotentialnegativeeffectalsoonpatient’soutcome,asaresultofdosereductions,delaysorevendiscontinuationofactivetreatments.Thus,identifyingpatientsathigherriskofdevelopingGITaswellasanoptimalmanagementareparamountinordertoimprovepatient’scomplianceandoutcome.Afterthedescriptionofthemaintreatment-inducedGIT,wediscussthecurrentknowledgeonthepathophysiologyofthesesideeffectsandcommentthescalescommonlyusedtoassessandgradethem.WethenprovideacriticalupdateonGITincidencebasedontheresultsofkeyrandomizedtrialsconductedinpatientswithmetastaticcolorectalcancerandadvancedpancreaticcancer.

简介：Objective:Patientswithheadandneckcanceroftensufferfrommalnutrition.Thisstudyaimstoinvestigatetheinfluenceofbodymassindex(BMI)ontheprognosisoflaryngealsquamouscellcarcinoma(LSCC).Methods:Atotalof473patientswithLSCCinitiallytreatedatSunYat-senUniversityCancerCenterbetweenJanuary2005andJuly2009wereretrospectivelyreviewed.SurvivalanalysiswasperformedbytheKaplan-MeiermethodandCoxregressionmodel.Results:LowBMIbeforetreatmentwassignificantlyassociatedwithpooroverallsurvivalinpatientswithLSCC(P<0.001).BMIwasanindependentprognosticfactorforpatientswithLSCC.Conclusion:LeannessbeforetreatmentwasassociatedwithpoorprognosisinpatientswithLSCC.GoodnutritionalstatusisfavorabletoimprovesurvivalinpatientswithLSCC.

简介：OBJECTIVE:Tosystematicallyevaluatethelong-termeffectandsafetyofXingnaoKaiqiaoneedlingmethodinischemicstroketreatment.DATARETRIEVAL:Weretrievedrelevantrandomandsemi-randomcontrolledtrialsthatusedtheXingnaoKaiqiaoneedlingmethodtotreatischemicstrokecomparedwithvariouscontroltreatmentssuchasconventionaldrugsorotheracupuncturetherapies.SearcheddatabasesincludedChinaNationalKnowledgeInfrastructure,WeipuInformationResourcesSystem,WanfangMedicalDataSystem,ChineseBiomedicalLiteratureDatabase,CochraneLibrary,andPubMed,fromMay2006toJuly2014.SELECTIONCRITERIA:Twoauthorsindependentlyconductedliteraturescreening,qualityevaluation,anddataextraction.ThequalityofarticleswasevaluatedaccordingtotheCochraneReviewers’Handbook5.1,andthestudywascarriedoutusingCochranesystemassessmentmethods.RevMan5.2wasusedformeta-analysisoftheincludedstudies.MAINOUTCOMEMEASURES:Mortalityrate,recurrencerate,anddisabilityratewereobserved.RESULTS:Ninerandomizedandsemi-randomizedcontrolledtrialstreating931casesofischemicstrokewereincludedinthisreview.Meta-analysisresultsshowedthattherewerenosignificantdifferencesinmortalityreduction(riskratio(RR)=0.58,95%confidenceinterval(CI):0.17–1.93,Z=0.89,P=0.37)orrecurrencerate(RR=0.55,95%CI:0.18–1.70,Z=1.04,P=0.30)ofischemicstrokepatientsbetweentheXingnaoKaiqiaoneedlingandcontroltreatmentgroups.However,theXingnaoKaiqiaoneedlingmethodhadatendencytowardshigherefficacyinmortalityreductionandrecurrencerates.TheXingnaoKaiqiaoneedlingmethodwassignificantlybetterthanthatofthecontroltreatmentinreducingdisabilityrate(RR=0.51,95%CI:0.27–0.98,Z=2.03,P<0.05).CONCLUSION:TheXingnaoKaiqiaoneedlingmethodhasabettereffectthancontroltreatmentinreducingdisabilityrate.Thelong-termeffectofXingnaoKaiqiaoneedlingagainstischemicstrokeisbetterthanthatofc

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简介：BackgroundPatientswithunstableanginapectorisanddiabetesmellitusareverycommon.Whentheyreceiveinterventionaltherapy,contrastagentscancauserenalinjuryandplateletactivation.Alprostadilhasbeenshowntodecreaseinflammationandmicrovascularresistance.Thereisnoanyreportontheprotectioneffectsofalprostadilonrenalinjuryandtheplateletactivationduringcardiacinterventionaltherapy.MethodsAtotalof57patientsweredividedintotwogroups,alprostadilgroup(n=35)andnormalgroupn=22).BUN(bloodureanitrogen)andSCr(serumcreatine)weremeasuredastherenalfunctionparameters.GFR(glomerularfiltrationrate)wascalculatedbytheMDRDformula.Plateletparameters:PLT(plateletcount,109),PDW(plateletdistributionwidth,fL),MPV(meanplateletvolume,fL),PLCR(largeplateletscaleratio,%)weremeasuredastheplateletactivationindex.TtestandChi-squaretestwereusedasstatisticalmethods,andP<0.05wasconsideredstatisticallysignificant.ResultsInthealprostadilgroup,SCrwas71.1±13.8μmol/Land65.9±12.6μmol/L,beforeandafterinterventionaltherapy(P<0.05).BUNwas5.68±1.79mmol/Land3.86±1.19mmol/L(P<0.001),beforeandafterinterventionaltherapy.Intheplatelettests,MPVwasseemedtobetheonlyusefulplateletparameter,beforeandafterinterventionaltherapy(11.8±1.8fLand11.1±1.2fL,P<0.05),whilethePLT(109/L),PDW(fl),PLCR(%)didn'tshowanysignificantdifference.Inthenormalgroup,allthesetests'resultsdidn'tsignificantlychangeafterinterventionaltherapy.ConclusionsThepatientswiththeunstableanginapectorisanddiabetesmellitushaveontheriskofrenalfunctiondamageandplateletactivationwhenundertakingcardiacinterventionaltherapy.Alprostadilprotectsrenalfunctionandalleviatesplateletactivation.

简介：Therearefewpopulation-baseddataininvestigatingtheimpactofdiabetesonchemotherapyadverseeffectsandtreatmentoutcomesofnon-metastaticbreastcancer.Thepurposeofthisstudyistoevaluatewhetherdiabetesaffectsthepatternsofuseinchemotherapy,toxiceffectsofchemotherapy,andtreatmentoutcomesfornon-metastaticbreastcancerinTaiwan.Thestudyresultscanprovidephysiciansformakingadecisionwhetherornottousechemotherapybasedontheindividualpatients’condition.

简介：Objective:Upto40%ofwomenover70yearswithprimaryoperablebreastcancerintheUKaretreatedwithprimaryendocrinetherapy(PET)asanalternativetosurgery.Avarietyoffactorsareimportantindeterminingtreatmentforolderbreastcancerpatients.Thisstudyaimedtoidentifythepatientandtumorfactorsassociatedwithtreatmentallocationinthispopulation.Methods:Prospectivelycollecteddataontreatmentreceived(surgeryvs.PET)wereanalysedwithmultivariablelogisticregressionusingthevariablesage,modifiedCharlsonComorbidityIndex(CCI),activitiesofdailyliving(ADL)score,Mini-MentalStateExamination(MMSE)score,HER2status,tumoursize,gradeandnodalstatus.Results:Datawereavailablefor1,122cancersin1,098patientsrecruitedbetweenFebruary2013andJune2015from51UKhospitals.About78%ofthepopulationweretreatedsurgically,withtheremainderbeingtreatedwithPET.Increasingpatientageatdiagnosis,increasingCCIscore,largetumorsize(5cmormore)anddependenceinoneormoreADLcategorieswereallstronglyassociatedwithnon-surgicaltreatment(P<0.05).Conclusion:Increasingcomorbidity,largetumorsizeandreducedfunctionalabilityareassociatedwithreducedlikelihoodofsurgicaltreatmentofbreastcancerinolderpatients.However,ageitselfremainsasignificantfactorfornon-surgicaltreatment;reinforcingtheneedforevidence-basedguidelines.