Progress of Clinical Research on the Treatment of Spinal Disorders by the Tongdu Method

Spinal disorders are diseases caused by congenital, degenerative, postural errors, trauma, and external evils that result in lesions of bones, discs, ligaments, and muscles, thus compressing the nerves. Spine-related diseases include scoliosis, intervertebral disc herniation, intervertebral stenosis, spinal fracture, ankylosing spondylitis, spinal cord injury, spinal tumour, etc., which seriously affect people’s daily life. This paper summarises the relevant studies on the treatment of spinal diseases by Tongzhu therapy. The mechanism of action of Tongzhu therapy in treating spinal diseases is closely related to the control of inflammatory factors, the improvement of local microcirculation, analgesia, and the promotion of nerve repair. This paper describes the application and modern mechanism of Tongzhu therapy in the treatment of spinal diseases, which will provide a direction for future research on Tongzhu therapy.

Efficacy of capecitabine-based combination therapy and singleagent capecitabine maintenance therapy in patients with metastatic breast cancer

Objective： The purpose of this study was to observe the efficacy and toxicities of capecitabine-based chemotherapy and capecitabine monotherapy as maintenance therapy in the treatment of metastatic breast cancer（MBC）.Patients and methods： A total of 98 MBC patients were treated with capecitabine combined with vinorelbine（NX）. Results： The median number of treatment was 6 cycles（1-7 cycles）. There were two cases of complete remission（CR）, 58 partial remission, 27 stable disease（SD）, 11 progression disease. The overall response rate（ORR）（CR ＋ PR） was 61.2%. The clinical benefit rate（CBR） was 75.5%. Fifty of effective patients received with capecitabine monotherapy as maintenance therapy. The ORR（CR ＋ PR） was 4%. The CBR was 48%. The median progression-free survival（PFS） was 12 months. In maintenance therapy or not, the median post metastasis survival rate（MSR） was 63 and 28 months, respectively. In the combination therapy group, the major grade 3/4 toxicities included hand-foot syndrome（3.1%）, skin pigmentation（2.0%）, diarrhoea and abdominal distension（5.1%）, stomatitis（1.0%）, and leukopenia（20.4%）.Conclusions： Capecitabine-based combination therapy and single-agent capecitabine maintenance therapy were well tolerated and effective to MBC.

Diagnostic diversity and heterogeneity of tumors: a real-world study of metastasis re-biopsy in advanced breast cancer

Background::Re-biopsy of metastasis in advanced breast cancer(ABC)has become an international convention to assist the diagnosis and evaluation of tumor heterogeneity.This study aimed to detect diagnostic diversity and inconsistencies among estrogen receptor(ER),progesterone receptor(PR),and human epidermal growth factor receptor 2(HER2)expression levels between primary and metastatic lesions.Methods::We conducted a retrospective analysis of 1670 cases of ABC patients who had undergone at least one lesion re-biopsy from January 2010 to December 2018.The pathological diagnosis of biopsies,distribution of biopsy sites,and severe puncture complications at each site were collected.In addition,the inconsistency rates and related factors of ER,PR,and HER2 expression between primary and metastatic lesions were analyzed fully considering patients’demographic profiles and disease characteristics.Results::In total,1670 cases of breast cancer(BC)patients diagnosed by pathology underwent one to four biopsies of recurrences or metastases in different sites or at different stages during the rescue treatment,producing 2019 histopathological specimens which were analyzed in the study.Pathological diagnosis showed that eight patients had benign pathological diagnoses,11 patients had second primary malignant tumors but without recurrences of breast cancer,and 17 patients had pathologically confirmed breast cancer recurrences combined with second primary cancer.In 1173 patients who presented ER,PR,and HER2 expressions in primary and metastatic lesions,the inconsistency rates of ER,PR,and HER2 were 17.5%(205/1173),31.3%(367/1173),and 13.9%(163/1173),respectively.The multivariate analysis showed that the age at the onset of breast cancer or adjuvant endocrine therapy was an independent factor affecting changes in PR expression level.Except one liver puncture with local hemorrhage and two lung punctures with hemopneumothorax,no other severe puncture complications occurred in 1950 non-surgical rebiopsies.Conclusions::The pathological diagnosis of metastasis re-biopsy of ABC was diverse,and the ER,PR,and HER2 expression levels were inconsistent between primary and metastatic lesions.Therefore,more attention should be paid to perform biopsies of relapsed and metastatic breast cancers routinely in clinical practice.

Shared-probe system:An accurate,low-cost and general enzyme-assisted DNA probe system for detection of genetic mutation

Enzyme assisted DNA probes are powerful tools in molecular diagnostics for their simplicity,rapidity,and low detection limit.However,cost of probes,difficulty in optimization and disturbance of secondary structure hindered the wider application of enzyme assisted DNA probes.To solve the problems,we designed a new system named shared-probe system.By introducing two unlabeled single stranded DNA named Sh1 and Sh2 as the bridge between probe and the substrate,the same sequence of dually labeled probe with stable performance was shared for different mutations,thus sparing the expense and time cost on designing,synthesizing and optimizing corresponding probes.Besides,the hybridization between Sh1 and the substrate could overcome secondary structures,which guaranteed the detection of different substrates.The performance and generality of the design were tested by low abundance detection in synthetic single DNA samples and the limit of detection was 0.05%for PTENR130 Q,EGFR-L858 R and 0.02%for BRCA1-NM007294.3.In genomic DNA samples,the limit of detection of 0.1%can be achieved for EGFR-L858 R,demonstrating the potential of clinical application in our design.