Objective： Biological markers performable in routine practice and able to predict the clinical outcome of advanced non-small cell lung cancer （NSCLC） treated with gefitinib are urgently needed. Methods： We analyze...Objective： Biological markers performable in routine practice and able to predict the clinical outcome of advanced non-small cell lung cancer （NSCLC） treated with gefitinib are urgently needed. Methods： We analyzed EGFR / HER2 / HER3 primary tumour immunohistochemical expression in a prospective and consecutive series of 90 Chinese patients. Platinumpretreated patients received a 250 mg oral dose of gefitinib once daily until disease progression; EGFR / HER2 / HER3 tumour status was related with the clinical outcome in terms of response rate （RR）, time to disease progression （TTP）, and overall survival （OS）. Results： A high expression （scores 2-3） of EGFR, HER2 and HER3 was venfied in 16.7%, 43.3% and 21.1% of tumors, respectively. EGFR and HER3 status were not significantly related with response, while the HER2 overexpression result was significantly associated with a higher RR （35.9% vs. 15.7%, P = 0.027）. The RR in the 13 patients with both HER2 and HER3 expression was also significantly higher than in the other 77 patients （53.8% vs. 22.1%, P = 0.036）. EGFR / HER2 / HER3 status was not significantly correlated with TTP or OS. Conclusion： The HER2 immunohistochemical expression can play a role in the clinical management of Chinese patients with advanced NSCLC who are candidates for gefitinib therapy.展开更多
Objective： To analyze the clinical outcomes of arthroscopic anterior cruciate ligament （ACL） reconstruction with irradiated bone-patellar tendon-bone （BPTB） allograft compared with non-irradiated allograft and au...Objective： To analyze the clinical outcomes of arthroscopic anterior cruciate ligament （ACL） reconstruction with irradiated bone-patellar tendon-bone （BPTB） allograft compared with non-irradiated allograft and autograft. Methods： All BPTB allografts were obtained from a single tissue bank and the irradiated allografts were sterilized with 2.5 mrad of irradiation prior to distribution. A total of 68 patients undergoing arthroscopic ACL reconstruction were prospectively randomized consecutively into one of the two groups （autograft and irradiated allograft groups）. The same surgical technique was used in all operations done by the same senior surgeon. Before surgery and at the average of 31 months of follow-up （ranging from 24 to 47 months）, patients were evaluated by the same observer according to objective and subjective clinical evaluations. Results： Of these patients, 65 （autograft 33, irradiated allograft 32） were available for full evaluation. When the irradiated allografl group was compared to the autograft group at the 31 -month follow-up by the Lachman test, the anterior drawer test （ADT）, the pivot shift test, and KT-2000 arthrometer test, statistically significant differences were found. Most importantly, 87.8% of patients in the autograft group and just only 31.3% in the irradiated allograft group had a side-to-side difference of less than 3 mm according to KT-2000. The failure rate of the ACL reconstruction with irradiated allograft （34.4%） was higher than that with autograft （6.1%）. The anterior and rotational stabilities decreased significantly in the irradiated allograft group. According to the overall International Knee Documentation Committee （1KDC）, functional and subjective evaluations, and activity level testing, no statistically significant differences were found between the two groups. Besides, patients in the irradiated allograft group had a shorter operation time and a longer duration of postoperative fever. When the patients had a fever, the laboratory examinations of all patients were almost normal. Blood routine was normal, the values of erythrocyte sedimentation rate （ESR） were 5-16 mm/h and the contents of C reactive protein （CRP） were 3-10 mg/L. Conclusion： We conclude that the short term clinical outcomes of the ACL reconstruction with irradiated BPTB allograft were adversely affected. The less than satisfactory results led the senior authors to discontinue the use of irradiated BPTB allografl in ACL surgery and not to advocate using the gamma irradiation as a secondary sterilizing method.展开更多
Objective： To validate the hypothesis that there exists an optimal axial compression stress range to enhance tibial fracture healing.Methods： Rabbits with a surgically induced V-shaped tibial fracture were separated...Objective： To validate the hypothesis that there exists an optimal axial compression stress range to enhance tibial fracture healing.Methods： Rabbits with a surgically induced V-shaped tibial fracture were separated into 2 main groups： the control group （C Group, n=6） without application of any axial compression stress stimulation postoperatively and the stimulation group （ S Group, n=90）. The S Group was further divided into 20 subgroups （S11 to S54） in terms of 5 axial compression stress stimulation levels （112.8 kPa, 289.8kPa, 396.5 kPa, 472.7 kPa, and 602.3 kPa） and 4 experimental endpoints （1, 3, 5 and 8 weeks after operation）. A custom made circular external fixator was used to provide the axial compression stress of the fracture sites. Based on X-ray observation, a fracture healing scoring system was created to evaluate the fracture healing process.Results： At 8 weeks after operation, there existed a ＂⌒-shape＂ relationship between healing score and axial compression stress stimulation level of fracture site. The optimal axial compression stress stimulation ranged from 289.8 kPa to 472.7 kPa, accompanying the best fracture healing, i.e. the fracture line became indistinct or almost disappeared, and a lot of callus jointed the two fracture ends. Meanwhile, at 5 weeks after operation, corresponding to the relatively low healing scores, there was a fracture healing performance similar to that at 8 weeks. Besides, at 1 or 3 weeks after operation, for all the axial compression stress levels （0-602.3 kPa）, no obvious healing effect was found.Conclusions： It is implied from the stated X-ray observation results in this study that the potential optimal axial compression stress stimulation and optimal fracture healing time are available. The axial compression stress level of 289.8-472.7 kPa and fracture healing time of more than 8 weeks jointly comprise the optimal axial compression stress stimulation conditions to enhance tibial fracture healing.展开更多
文摘Objective： Biological markers performable in routine practice and able to predict the clinical outcome of advanced non-small cell lung cancer （NSCLC） treated with gefitinib are urgently needed. Methods： We analyzed EGFR / HER2 / HER3 primary tumour immunohistochemical expression in a prospective and consecutive series of 90 Chinese patients. Platinumpretreated patients received a 250 mg oral dose of gefitinib once daily until disease progression; EGFR / HER2 / HER3 tumour status was related with the clinical outcome in terms of response rate （RR）, time to disease progression （TTP）, and overall survival （OS）. Results： A high expression （scores 2-3） of EGFR, HER2 and HER3 was venfied in 16.7%, 43.3% and 21.1% of tumors, respectively. EGFR and HER3 status were not significantly related with response, while the HER2 overexpression result was significantly associated with a higher RR （35.9% vs. 15.7%, P = 0.027）. The RR in the 13 patients with both HER2 and HER3 expression was also significantly higher than in the other 77 patients （53.8% vs. 22.1%, P = 0.036）. EGFR / HER2 / HER3 status was not significantly correlated with TTP or OS. Conclusion： The HER2 immunohistochemical expression can play a role in the clinical management of Chinese patients with advanced NSCLC who are candidates for gefitinib therapy.
基金Project (No. 2004GG2202034) supported by the Natural Science Foundation of Shandong Province, China
文摘Objective： To analyze the clinical outcomes of arthroscopic anterior cruciate ligament （ACL） reconstruction with irradiated bone-patellar tendon-bone （BPTB） allograft compared with non-irradiated allograft and autograft. Methods： All BPTB allografts were obtained from a single tissue bank and the irradiated allografts were sterilized with 2.5 mrad of irradiation prior to distribution. A total of 68 patients undergoing arthroscopic ACL reconstruction were prospectively randomized consecutively into one of the two groups （autograft and irradiated allograft groups）. The same surgical technique was used in all operations done by the same senior surgeon. Before surgery and at the average of 31 months of follow-up （ranging from 24 to 47 months）, patients were evaluated by the same observer according to objective and subjective clinical evaluations. Results： Of these patients, 65 （autograft 33, irradiated allograft 32） were available for full evaluation. When the irradiated allografl group was compared to the autograft group at the 31 -month follow-up by the Lachman test, the anterior drawer test （ADT）, the pivot shift test, and KT-2000 arthrometer test, statistically significant differences were found. Most importantly, 87.8% of patients in the autograft group and just only 31.3% in the irradiated allograft group had a side-to-side difference of less than 3 mm according to KT-2000. The failure rate of the ACL reconstruction with irradiated allograft （34.4%） was higher than that with autograft （6.1%）. The anterior and rotational stabilities decreased significantly in the irradiated allograft group. According to the overall International Knee Documentation Committee （1KDC）, functional and subjective evaluations, and activity level testing, no statistically significant differences were found between the two groups. Besides, patients in the irradiated allograft group had a shorter operation time and a longer duration of postoperative fever. When the patients had a fever, the laboratory examinations of all patients were almost normal. Blood routine was normal, the values of erythrocyte sedimentation rate （ESR） were 5-16 mm/h and the contents of C reactive protein （CRP） were 3-10 mg/L. Conclusion： We conclude that the short term clinical outcomes of the ACL reconstruction with irradiated BPTB allograft were adversely affected. The less than satisfactory results led the senior authors to discontinue the use of irradiated BPTB allografl in ACL surgery and not to advocate using the gamma irradiation as a secondary sterilizing method.
基金This work was supported by grants from the Chongqing Academician Foundation （No. 1998-93）, the National Natural Science Foundation of China （No. 30122202 and No. 30928005） and the Third Military Medical University Research Foundation （No. 2009 XHG16）,
文摘Objective： To validate the hypothesis that there exists an optimal axial compression stress range to enhance tibial fracture healing.Methods： Rabbits with a surgically induced V-shaped tibial fracture were separated into 2 main groups： the control group （C Group, n=6） without application of any axial compression stress stimulation postoperatively and the stimulation group （ S Group, n=90）. The S Group was further divided into 20 subgroups （S11 to S54） in terms of 5 axial compression stress stimulation levels （112.8 kPa, 289.8kPa, 396.5 kPa, 472.7 kPa, and 602.3 kPa） and 4 experimental endpoints （1, 3, 5 and 8 weeks after operation）. A custom made circular external fixator was used to provide the axial compression stress of the fracture sites. Based on X-ray observation, a fracture healing scoring system was created to evaluate the fracture healing process.Results： At 8 weeks after operation, there existed a ＂⌒-shape＂ relationship between healing score and axial compression stress stimulation level of fracture site. The optimal axial compression stress stimulation ranged from 289.8 kPa to 472.7 kPa, accompanying the best fracture healing, i.e. the fracture line became indistinct or almost disappeared, and a lot of callus jointed the two fracture ends. Meanwhile, at 5 weeks after operation, corresponding to the relatively low healing scores, there was a fracture healing performance similar to that at 8 weeks. Besides, at 1 or 3 weeks after operation, for all the axial compression stress levels （0-602.3 kPa）, no obvious healing effect was found.Conclusions： It is implied from the stated X-ray observation results in this study that the potential optimal axial compression stress stimulation and optimal fracture healing time are available. The axial compression stress level of 289.8-472.7 kPa and fracture healing time of more than 8 weeks jointly comprise the optimal axial compression stress stimulation conditions to enhance tibial fracture healing.
