Shandong Province, with a population of 84 million and located in the east coastline of China, is rich in natural resources and ranks middle in economic develpment of the whole nation. Around 90000 people are dead of ...Shandong Province, with a population of 84 million and located in the east coastline of China, is rich in natural resources and ranks middle in economic develpment of the whole nation. Around 90000 people are dead of cancer each year. In the recent twenty years, trends in malignant neoplasm展开更多
Aim: To investigate possible correlation factors for prostate cancer by a population-based case-control study in China. Methods: We carded out a mass screening of prostate cancer in Changchun, China, using a prostat...Aim: To investigate possible correlation factors for prostate cancer by a population-based case-control study in China. Methods: We carded out a mass screening of prostate cancer in Changchun, China, using a prostate-specific antigen assisted by Japan International Cooperation Agency. From June 1998 to December 2000, 3 940 men over 50 years old were screened. Of these, 29 men were diagnosed with prostate cancer. We selected 28 cases and matched them with controls of low prostate-specific antigen value (〈 4.1 ng/mL) by 1:10 according to age and place of employment. A case-control study of diet and prostate cancer was then carded out. Results: After adjustment for education, body mass index (BMI), smoking, alcohol consumption, marriage and diet, intake of soybean product was discovered to be inversely related to prostate cancer. Men who consumed soybean product more than twice per week on different days had a multivariate odds ratio (OR) of 0.38 (95% confidence interval [CI], 0.13-1.12). In addition, men who consumed soybean products more than once per day had a multivariate OR of 0.29 (95% CI, 0.11-0.79) compared with men who consumed soybean products less than once per week. The P for trend was 0.02, which showed significant difference. There was no significant difference in P trend for any dairy food. Even when we matched the cases and controls by other criteria, we found that soybean food was the only preventive factor associated with prostate cancer. Conclusion: Our study suggests that consumption of soybeans, one of the most popular foods in Asia, would decrease the risk of prostate cancer.展开更多
The purpose of this study was to review the magnitude of contribution of chemotherapy(CT) in the local control of muscle invasive bladder carcinoma in the studies where a combined radio-chemotherapy(RCT) was used(how ...The purpose of this study was to review the magnitude of contribution of chemotherapy(CT) in the local control of muscle invasive bladder carcinoma in the studies where a combined radio-chemotherapy(RCT) was used(how much higher local control rates are obtained with RCT compared to RT alone).Studies on radiotherapy(RT) and combined RCT,neo-adjuvant,concurrent,adjuvant or combinations,reported after 1990 were reviewed.The mean complete response(CR) rates were significantly higher for the RCT studies compared to RT-alone studies:75.9% vs 64.4%(Wilcoxon ranksum test,P = 0.001).Eleven of the included RCT studies involved 2-3 cycles of neo-adjuvant CT,in addition to concurrent RCT.The RCT studies included the onephase type(where a full dose of RCT was given and then assessment of response and cystectomy for nonresponders followed) and the two-phase types(where an assessment of response was undertaken after an initial RCT course,followed 6 wk later by a consolidation RCT for those patients with a CR).CR rates between the two subgroups of RCT studies were 79.6%(one phase) vs 71.6%(two-phase)(P = 0.015).Theaverage achievable tumour control rates,with an acceptable rate of side effects have been around 70%,which may represent a plateau.Further increase in CR response rates demands for new chemotherapeutic agents,targeted therapies,or modified fractionation in various combinations.Quantification of RT and CT contribution to local control using radiobiological modelling in trial designs would enhance the potential for both improved outcomes and the estimation of the potential gain.展开更多
<strong>Background:</strong> A dual bronchodilator, long-acting anticholine drugs (glycopyrronium, LAMA) and the long running <em>β</em>-<sub>2</sub> stimulant (indacaterol, LABA),...<strong>Background:</strong> A dual bronchodilator, long-acting anticholine drugs (glycopyrronium, LAMA) and the long running <em>β</em>-<sub>2</sub> stimulant (indacaterol, LABA), are effective for the treatment of chronic obstructive pulmonary disease (COPD). To evaluate the effectiveness of the perioperative intervention of LAMA/LABA, a randomized prospective trial was performed for the lung cancer patients receiving a lobectomy with normal pulmonary function and COPD. <strong>Methods:</strong> Based on the results of the preoperative pulmonary function test, 25 patients were diagnosed with COPD [% forced expiratory volume in 1 second (%FEV<sub>1</sub>) < 70%]. Thirty-seven patients were enrolled as non-obstructive patients (70% ≤ %FEV<sub>1</sub>), who were randomized into two groups, the LAMA/LABA (n = 19) and the Control group (n = 18). The LAMA/LABA and the COPD groups daily received inhaled LAMA (50 μg) and LABA (110 μg) for 1 week before surgery and for least 4 weeks after surgery. The Control group had no treatment of the dual bronchodilator. The actual values were measured during the perioperative pulmonary function at three points of the preoperative baseline, the postoperative 1 week and the postoperative 4 weeks;these changes and changed ratios were then calculated. The patient-reported outcomes of the quality of life (PRO-QOL) were evaluated by the Cancer Dyspnea Scale (CDS), the COPD assessment test, and the St. George’s Respiratory Questionnaire. <strong>Results:</strong> Regarding the value of FEV<sub>1</sub> at the baseline, that in the LAMA/LABA group was 79.2% ± 6.4% and that in the Control group was 80.9% ± 6.4%, but that in the COPD groups was 57.9% ± 8.7%;there was a significant difference between the COPD and the Control group (p < 0.0001). At the postoperative 1 week point, the FEV<sub>1</sub> value in the Control group was 1.3 ± 0.5 L and that in the LAMA/LABA group was 1.7 ± 0.5 L. On the other hand, that in the COPD group was 1.7 ± 0.5 L, which was significantly higher compared to that in the Control group (p = 0.0251 and p = 0.0369). The intervention of LAMA/LABA for the COPD and non-obstructive patients resulted in the less decreased degree of the pulmonary function in FEV<sub>1</sub> compared to that in the Control group. Based on the PRO-QOL by the CDS, the intervention of LAMA/LABA significantly reduced the total dyspnea in the LAMA/LABA group compared to that in the Control group (p = 0.0348). <strong>Conclusion:</strong> The perioperative intervention of LAMA/LABA should lead to maintaining the postoperative pulmonary function of the FEV<sub>1</sub> during the lobectomy with COPD and non-obstructive patients and the improvement of PRO-QOL.展开更多
BACKGROUND Adjuvant radiotherapy is given following surgery in breast cancer patients. Hypofractonated radiotherapy can significantly reduce the waiting time for radiotherapy, working load on machines, patient visits ...BACKGROUND Adjuvant radiotherapy is given following surgery in breast cancer patients. Hypofractonated radiotherapy can significantly reduce the waiting time for radiotherapy, working load on machines, patient visits to radiotherapy departments and medical costs. Material and Methods 244 patients with high-risk breast cancer (stage IIB, stage III and stage IA with any of the following criteria: lymphovascular invasion, hormonal receptor negative, young age) who underwent Breast conservative surgery (BCS) or Modified radical mastectomy (MRM) were enrolled in this study. All patients received adjuvant radiotherapy with different hypofractionation schedules either 3900 cGY/13 fractions or 4240 cGY/16 fractions or 4005 cGY/15 fractions using linear accelerator with 6 MV photon beam. Lateral/Medial tangential and Ipsilateral supraclavicular fields were employed and the ipsilateral axilla was also irradiated if required to the same dose with posteroanterior field. Patients were followed every 3 mons for the first 2 years and every 6 mons thereafter. Outcomes were analyzed in terms of tumor control and survival. Results 244 patients with high-risk breast cancer requiring postoperative radiotherapy to the intact breast or chest wall were treated. The mean age was 48 years (range 28 - 69 years). The 5-year locoregional free survival of all patients was 93.8% the local relapse reported in 15 patients (6.2%) 7 patients at site of operated scar & 8 patients at the regional lymph nodes. The median follow up period was 75 months ranged from 49 to 102 months. Distant metastasis free survival was 92.2%, the distant metastasis reported in 19 patients which represent (7.8%) of all patients, median survival is 75 months ranged from 49 to 102 months and overall survival was 88.6%. Conclusion It is concluded that hypofractionated radiotherapy is a simple and effective protocol in patients with high-risk breast cancer regarding tumor control and survival.展开更多
Patients are often nervous prior to surgery and females might suffer the most. Increased nervousness needs attention as it can negatively affect postoperative recovery. Support from nurses, i.e. being present, attenti...Patients are often nervous prior to surgery and females might suffer the most. Increased nervousness needs attention as it can negatively affect postoperative recovery. Support from nurses, i.e. being present, attentive, empowering and helpful to the patient, and talking about what is on the patient’s mind, might help to reduce nervousness. However, there is a lack of evidence as to the ideal level of attention and resources to reduce preoperative nervousness. The objective of the current study was to compare a range of care combinations with standard care to female patients prior to sedation and cancer surgery primarily on difference in change in nervousness from admission until sedation before cancer surgery, measured on a Visual Analouge Scale. Using simple randomization and numbers in sealed envelopes, adult gynaecological patients scheduled for open cancer surgery were allocated to care provided by a nurse anaesthetist and: A) a surgical nurse, B) no additional care, C) a known nurse , and D) a relative. Only the statistician was blinded. The trial stopped when the calculated numbers were included. In the full analysis set, compared to standard care A) (n = 61), we observed the following mean changes and [95% confidence intervals]: B) (n = 65) 1.05 [CI: 0.298 to 1.794] with p = 0.006, C) (n = 61): -0.38 [-1.140 to 0.385] with p = 0.330, D) (n = 71): 0.23 [-0.498 to 0.967] with p = 0.528. Female cancer patients will benefit from supportive care by a surgical nurse from the time of arrival on the operating ward plus supportive care from a nurse anesthetist from 5 - 10 minutes after entering the operating ward. It is not recommended at any time to rely fully on the support of relatives. The effect on adults of preoperative painful procedures and patients’ time alone on the operating ward should be further investigated.展开更多
Surgery following neoadjuvant chemoradiotherapy(NCRT) is a common multidisciplinary treatment for resectable esophageal cancer(EC). After analyzing 12 randomized controlled trials(RCTs), we discuss the key issues of s...Surgery following neoadjuvant chemoradiotherapy(NCRT) is a common multidisciplinary treatment for resectable esophageal cancer(EC). After analyzing 12 randomized controlled trials(RCTs), we discuss the key issues of surgery in the management of resectable EC. Along with chemoradiotherapy, NCRT is recommended for patients with squamous cell carcinoma(SCC) and adenocarcinoma(AC), and most chemotherapy regimens are based on cisplatin, fluorouracil(FU), or both(CF). However, taxane-based schedules or additional studies, together with newer chemotherapies, are warranted. In nine clinical trials, post-operative complications were similar without significant differences between two treatment groups. In-hospital mortality was significantly different in only 1 out of 10 trials. Half of the randomized trials that compare NCRT with surgery in EC demonstrate an increase in overall survival or disease-free survival. NCRT offers a great opportunity for margin negative resection, decreased disease stage, and improved loco-regional control. However, NCRT does not affect the quality of life when combined with esophagectomy. Future trials should focus on the identification of optimum regimens and selection of patients who are most likely to benefit from specific treatment options.展开更多
Objective: To study the expression and clinical value of apoptosis control gene bcl-2 and bax in breast cancer. Methods: Protein bax and bcl-2 in 41 breast cancers obtained from operations in our hospital in 1996 were...Objective: To study the expression and clinical value of apoptosis control gene bcl-2 and bax in breast cancer. Methods: Protein bax and bcl-2 in 41 breast cancers obtained from operations in our hospital in 1996 were detected using ABC immunohistochemical stain assay and compared with 10 cases with normal breast tissues. Results: The positive rate of bax in normal breast tissue was 90% and in breast cancer was 59%, with a significant statistical difference between them (P<0.05), but there was no statistical difference in bcl-2 protein expression. Among the 41 breast cancer, the group with lymph node metastasis (21 cases) had obviously low bax expression (43%) and high bcl-2 expression (76%), showing significant difference to the group without lymph node metastasis (P<0.05). Conclusion: The antiapoptosis function of bcl-2 was stronger than bax in breast cancer. Protein bax and bcl-2 assay may be useful in understanding the biological behaviors of breast cancer.展开更多
Objective: To evaluate the efficacy and feasibility of screening procedure for upper gastrointestinal cancer in both high-risk and non-high-risk areas in China. Setting: Seven cities/counties, representing three eco...Objective: To evaluate the efficacy and feasibility of screening procedure for upper gastrointestinal cancer in both high-risk and non-high-risk areas in China. Setting: Seven cities/counties, representing three economical-geographical regions (Eastern, Central and Western) in China, were selected as screening centers: three in high-risk areas and four in non-high-risk areas. Participants: Villages/communities in these seven centers regarded as clusters were randomly assigned to either intervention group (screening by endoscopic examination) or control group (with normal community care) in a 1:1 ratio stratified by each center. Eligible participants are local residents aged 40-69 years in the selected villages/communities with no history of cancer or endoscopic examination in the latest 3 years who are mentally and physically competent. Those who are not willing to take endoscopic examination or are unwilling to sign the consent form are excluded from the study. Totally 140,000 participants will be enrolled. Interventions: In high-risk areas of upper gastrointestinal cancer, all subjects in screening group will be screened by endoscopy. In non-high-risk areas, 30% of the subjects in screening group, identified through a survey, will be screened by endoscopy. Primary and secondary outcome measures: The primary outcome is the mortality caused by upper gastrointestinal cancer. The secondary outcomes include detection rate, incidence rate, survival rate, and clinical stage distribution. Additional data on quality of life and cost-effectiveness will also be collected to answer important questions regarding screening effects. Conclusions: Screening strategy evaluated in those areas with positive findings may be promoted nationally and applied to the majority of Chinese people. On the other hand, negative findings will provide scientific evidence for abandoning a test and shifting resources elsewhere. Trial registration: The study has been registered with the Protocol Registration System in Chinese Clinical Trial Registry (identifier: ChiCTR-EOR-16008577).展开更多
The goal of the present study is to utilize cis-diamminedichloroplatinum (cisplatin) loaded polymer nanoparticles (NPs) to give a controlled, extended, and local drug therapy for the treatment of cancer. We have used ...The goal of the present study is to utilize cis-diamminedichloroplatinum (cisplatin) loaded polymer nanoparticles (NPs) to give a controlled, extended, and local drug therapy for the treatment of cancer. We have used biodegradable and biocompatible poly(lactic-co-glycolic acid) (PLGA) to prepare the NPs by adjusting the double emulsion technique using poly(vinylalcohol) as a surface active agent. The PLGA NPs were characterized for particle size and shape, controlled release of cisplatin, and degradation. Cisplatin solubility in deionized water was increased up to 4 mg/mL by simply changing the solution parameters. Cisplatin encapsulated NPs were incubated in phosphate buffered saline (PBS) at 37?C to study the release kinetics of cisplatin. Cisplatin was released in a sustained manner with less than 20% release during a 3-day period followed by 50% release during a 21-day period. A degradation study of PLGA NPs demonstrated the loss of spherical shape during a 21-day period. We also examined the cisplatin sensitive A2780 cell apoptosis when cells were incubated with cisplatin encapsulated PLGA NPs. A large number of cell apoptosis occurred as a result of cisplatin release from the PLGA NPs. These results suggest that cisplatin encapsulated PLGA NPs can be used to treat the cancer cells by injecting them into a localized site minimizing the side effects.展开更多
Background: Worldwide, breast cancer (BC) is the most frequently diagnosed neoplastic disease in women around menopause that is the leading cause of DALYs, because it causes a significant reduction of these women’s a...Background: Worldwide, breast cancer (BC) is the most frequently diagnosed neoplastic disease in women around menopause that is the leading cause of DALYs, because it causes a significant reduction of these women’s ability to function normally in everyday life. Methods: The present hospital-based case-control study was carried out between January and August 2018 using a structured questionnaire on 105 breast cancer women and 210 controls who are clinically free from breast cancer. Data about the study cases were collected in the oncology day-care clinics of the two main hospitals in Gaza strip “Al-Shifa and European Gaza hospitals”. Univariate logistic regression and multivariate logistic regression analyses were employed to identify the significant factors associated with BC. Results: Multivariate logistic regression analyses with adjustment for all confounders revealed that woman with BMI more than or equal 30 kg/m2 are under risk of getting BC 2.9 times greater than those having BMI less than 29 kg/m2 (AOR = 2.895;95% CI: 1.305 - 6.423). Analysis of risk according to reaching menopause showed that the estimated AOR was greater among those reached menopause (3.137, 95% CI 1.824 - 5.395) than among those that did not reach menopause. The risk of developing BC in the case of a history of incidence of BC in the family was more than two times higher (AOR = 2.632, 95% CI 1.528 - 4.535) than in case of the history of a free family of BC. Conclusion: In this context, the above-mentioned risk factors must be taken into consideration in BC management processes in the Gaza strip.展开更多
Average size of hematite and magnetite micro and nanopowders and polydispersity index, zeta potential and distribution of particles were studied. Analysis showed that average size of the obtained particles for magneti...Average size of hematite and magnetite micro and nanopowders and polydispersity index, zeta potential and distribution of particles were studied. Analysis showed that average size of the obtained particles for magnetite is 740.9 nm, for hematite particles 30 - 35 nm. Alternate current feed source was created for hyperthermia. Proceeding from the requirements of the objectives, the U type MnZn material magneto conductors were selected, in which 10.0 and 8.0 mm width gaps were cut and glass test tubes with magnetite or hematite suspensions were placed in them. Series of experiments at various field intensity and frequencies showed that for efficient magnetic hyperthermia therapy more powerful device was needed with frequency of up to 10 Mega Hertz to achieve the temperature 43°C - 45°C necessary for full activation of Neel and Brown mechanisms in particles. At the next stage, on the basis of experimental material the anticancer mono-therapeutic effect of hyperthermia and its adjuvant action in poly chemotherapeutic treatment was presented by the use of a device created by us “Lezi”. As a result of the experiment it was shown that in all animals (outbred albino mice, 3 months old) inhibition of cancer growth was fixed and intratumoral necrosis was developed, while after 7 and 10 sessions tumors were ulcerated, which refers to positive effect of the experiment (Conclusion of Pathologicanatomical Laboratory “PATGEO”, Tbilisi, Georgia ).展开更多
Objective To compute and compare the tumor control probability(TCP) of volumetric modulated arc therapy(VMAT) for breast cancer after conservative surgery based on two types of multileaf collimator(MLC) through a retr...Objective To compute and compare the tumor control probability(TCP) of volumetric modulated arc therapy(VMAT) for breast cancer after conservative surgery based on two types of multileaf collimator(MLC) through a retrospective planning study.Methods For a group of 9 patients diagnosed with left breast cancer,VMAT plan based on Agility MLC and beam modulator(BM) MLC were designed.The prescription dose was 50 Gy covering at least 95% of the planning target volume,2 Gy per fraction.TCPs were calculated according to dose-volume histogram(DVH) analysis.Results The TCP of the BM VMAT plan was slightly higher than that of the Agility VMAT plan(94.61% vs 94.23%) but was inferior with respect to delivery efficiency;the delivery time was reduced for Agility VMAT plan by 35% compared to BM VMAT plan.Conclusion For breast cancer radiation therapy after conservative surgery,BM VMAT plans provide slightly higher TCP while the delivery of Agility VMAT plans is significantly faster than the BM VMAT plans.展开更多
A mathematical optimal-control tumor therapy framework consisting of radio- and anti-angiogenesis control strategies that are included in a tumor growth model is investigated. The governing system, resulting from the ...A mathematical optimal-control tumor therapy framework consisting of radio- and anti-angiogenesis control strategies that are included in a tumor growth model is investigated. The governing system, resulting from the combination of two well established models, represents the differential constraint of a non-smooth optimal control problem that aims at reducing the volume of the tumor while keeping the radio- and anti-angiogenesis chemical dosage to a minimum. Existence of optimal solutions is proved and necessary conditions are formulated in terms of the Pontryagin maximum principle. Based on this principle, a so-called sequential quadratic Hamiltonian (SQH) method is discussed and benchmarked with an “interior point optimizer—a mathematical programming language” (IPOPT-AMPL) algorithm. Results of numerical experiments are presented that successfully validate the SQH solution scheme. Further, it is shown how to choose the optimisation weights in order to obtain treatment functions that successfully reduce the tumor volume to zero.展开更多
AIM To characterize the survival of cirrhotic patients with Barcelona Clinic Liver Cancer(BCLC) stage C hepatocellular carcinoma(HCC) and to ascertain the factors predicting the achievement of disease control(DC).METH...AIM To characterize the survival of cirrhotic patients with Barcelona Clinic Liver Cancer(BCLC) stage C hepatocellular carcinoma(HCC) and to ascertain the factors predicting the achievement of disease control(DC).METHODS The cirrhotic patients with BCLC stage C HCC evaluated by the Hepatocatt multidisciplinary group were subjected to the investigation. Demographic, clinical and tumor features, along with the best tumor response and overall survival were recorded. RESULTS One hundred and ten BCLC stage C patients were included in the analysis; the median overall survival was 13.4 mo(95%CI: 10.6-17.0). Only alphafetoprotein(AFP) serum level > 200 ng/m L and DC could independently predict survival but in a time dependent manner, the former was significantly associated with increased risk of mortality within the first 6 mo of follow-up(HR = 5.073, 95%CI: 2.159-11.916, P = 0.0002), whereas the latter showed a protective effect against death after one year(HR = 0.110, 95%CI: 0.038-0.314, P < 0.0001). Only patients showing microvascular invasion and/or extrahepatic spread recorded lower chances of achieving DC(OR = 0.263, 95%CI: 0.111-0.622, P = 0.002).CONCLUSION The BCLC stage C HCC includes a wide heterogeneous group of cirrhotic patients suitable for potentially curative treatments. The reverse and time dependent effect of AFP serum level and DC on patients' survival confers them as useful predictive tools for treatment management and clinical decisions.展开更多
Research has demonstrated facilitative effects of social support on psychological and physical well-being of individuals suffering from chronic health problems. Social support can change not only patients’ perception...Research has demonstrated facilitative effects of social support on psychological and physical well-being of individuals suffering from chronic health problems. Social support can change not only patients’ perception of their health problems, but also the consequences of their illness. In the present study with cervix cancer patients, the relationship of social support and illness control agency with illness consequences and health outcome beliefs was examined. Emotional, informational, social companionship and practical supports were found to be negatively correlated with the severity of interpersonal, physiological and psychological consequences of illness. Patients’ belief in self-control and doctor-control was related to less severity and less pain of illness, and strong hope for better health outcomes.展开更多
Background: Cancer has become a leading cause of death world-wide. In Hong Kong, cancer accounted for 24.8% of deaths in 1980, rising to 31.3% in 1998. The conventional treatment of cancer usually includes surgery, ra...Background: Cancer has become a leading cause of death world-wide. In Hong Kong, cancer accounted for 24.8% of deaths in 1980, rising to 31.3% in 1998. The conventional treatment of cancer usually includes surgery, radiotherapy and chemotherapy. These conventional therapies do not guarantee not relapse and are often associated with serious side effects. Using Chinese Medicine (CM) as an adjunctive treatment is commonly practiced in Chinese Communities to support patients being treated with conventional modern medicine, with the aim of alleviating the side effects, and improving self-defense and their quality of life. Well-designed and conducted clinical trials could give evidence of the efficacy of CM. This study investigated the clinical efficacy through the well designed clinical trial, and the implementation of carrying out the trial, to assess the adjuvant and supportive effect on lung cancer patients. Methods: The clinical study was designed as a randomized controlled trial to investigate the dose-dependent effects. Primary endpoint was the difference of Functional Assessment of Cancer Therapy-General (FACT-G) score. Results: 41 eligible subjects were enrolled and randomly divided into 2 groups, 21 in high dose group and 20 in low dose group. Sub-domains of PWB (Physical well-being) and EWB (Emotional well-being) as well as FACT-G total score were significantly improved in high dose group when compared with low dose group after 12 weeks treatment (p = 0.015, 0.006 and 0.012, respectively). Conclusions: Holistic approach using quality of life as parameters to evaluate the efficacy of CM is an important compromise. Well-designed clinical trial can provide convincing evidence to support CM’s efficacy. The study demonstrated that quality of life of patients with lung cancer could be beneficial from the supportive care with CM.展开更多
The messenger RNA 3'-untranslated region(3'UTR)plays an important role in regulation of gene expres-sion on the posttranscriptional level. The 3'UTR con-trols gene expression via orchestrated interactionbe...The messenger RNA 3'-untranslated region(3'UTR)plays an important role in regulation of gene expres-sion on the posttranscriptional level. The 3'UTR con-trols gene expression via orchestrated interactionbetween the structural components of mRNAs(cis-ele-ment) and the specific trans-acting factors(RNA bind-ing proteins and non-coding RNAs). The crosstalk ofthese factors is based on the binding sequences and/or direct protein-protein interaction, or just functionalinteraction. Much new evidence that has accumulatedsupports the idea that several RNA binding factors canbind to common mRNA targets: to the non-overlappingbinding sites or to common sites in a competitive fash-ion. Various factors capable of binding to the sameRNA can cooperate or be antagonistic in their actions.The outcome of the collective function of all factorsbound to the same mRNA 3'UTR depends on manycircumstances, such as their expression levels, affinity to the binding sites, and localization in the cell, which can be controlled by various physiological conditions. Moreover, the functional and/or physical interactions of the factors binding to 3'UTR can change the character of their actions. These interactions vary during the cell cycle and in response to changing physiological condi-tions. Abnormal functioning of the factors can lead to disease. In this review we will discuss how alterations of these factors or their interaction can affect cancer development and promote or enhance the malignant phenotype of cancer cells. Understanding these altera-tions and their impact on 3'UTR-directed posttran-scriptional gene regulation will uncover promising new targets for therapeutic intervention and diagnostics. We will also discuss emerging new tools in cancer di-agnostics and therapy based on 3'UTR binding factors and approaches to improve them.展开更多
文摘Shandong Province, with a population of 84 million and located in the east coastline of China, is rich in natural resources and ranks middle in economic develpment of the whole nation. Around 90000 people are dead of cancer each year. In the recent twenty years, trends in malignant neoplasm
基金We would appreciate the contribution of Prof. Kuwahara (Miyagi Prefecture Cancer Center, Japan) in this project. We would appreciate Mr. Robert Lister's critical reading and revision of our manuscript. This research was supported by the National Natural Science Foundation of China (Grant No. 30700827), Changchun City Science and Technology Department (Grant No. 2007125), and Northeast Normal University (Grant No. NENU-STC07005).
文摘Aim: To investigate possible correlation factors for prostate cancer by a population-based case-control study in China. Methods: We carded out a mass screening of prostate cancer in Changchun, China, using a prostate-specific antigen assisted by Japan International Cooperation Agency. From June 1998 to December 2000, 3 940 men over 50 years old were screened. Of these, 29 men were diagnosed with prostate cancer. We selected 28 cases and matched them with controls of low prostate-specific antigen value (〈 4.1 ng/mL) by 1:10 according to age and place of employment. A case-control study of diet and prostate cancer was then carded out. Results: After adjustment for education, body mass index (BMI), smoking, alcohol consumption, marriage and diet, intake of soybean product was discovered to be inversely related to prostate cancer. Men who consumed soybean product more than twice per week on different days had a multivariate odds ratio (OR) of 0.38 (95% confidence interval [CI], 0.13-1.12). In addition, men who consumed soybean products more than once per day had a multivariate OR of 0.29 (95% CI, 0.11-0.79) compared with men who consumed soybean products less than once per week. The P for trend was 0.02, which showed significant difference. There was no significant difference in P trend for any dairy food. Even when we matched the cases and controls by other criteria, we found that soybean food was the only preventive factor associated with prostate cancer. Conclusion: Our study suggests that consumption of soybeans, one of the most popular foods in Asia, would decrease the risk of prostate cancer.
文摘The purpose of this study was to review the magnitude of contribution of chemotherapy(CT) in the local control of muscle invasive bladder carcinoma in the studies where a combined radio-chemotherapy(RCT) was used(how much higher local control rates are obtained with RCT compared to RT alone).Studies on radiotherapy(RT) and combined RCT,neo-adjuvant,concurrent,adjuvant or combinations,reported after 1990 were reviewed.The mean complete response(CR) rates were significantly higher for the RCT studies compared to RT-alone studies:75.9% vs 64.4%(Wilcoxon ranksum test,P = 0.001).Eleven of the included RCT studies involved 2-3 cycles of neo-adjuvant CT,in addition to concurrent RCT.The RCT studies included the onephase type(where a full dose of RCT was given and then assessment of response and cystectomy for nonresponders followed) and the two-phase types(where an assessment of response was undertaken after an initial RCT course,followed 6 wk later by a consolidation RCT for those patients with a CR).CR rates between the two subgroups of RCT studies were 79.6%(one phase) vs 71.6%(two-phase)(P = 0.015).Theaverage achievable tumour control rates,with an acceptable rate of side effects have been around 70%,which may represent a plateau.Further increase in CR response rates demands for new chemotherapeutic agents,targeted therapies,or modified fractionation in various combinations.Quantification of RT and CT contribution to local control using radiobiological modelling in trial designs would enhance the potential for both improved outcomes and the estimation of the potential gain.
文摘<strong>Background:</strong> A dual bronchodilator, long-acting anticholine drugs (glycopyrronium, LAMA) and the long running <em>β</em>-<sub>2</sub> stimulant (indacaterol, LABA), are effective for the treatment of chronic obstructive pulmonary disease (COPD). To evaluate the effectiveness of the perioperative intervention of LAMA/LABA, a randomized prospective trial was performed for the lung cancer patients receiving a lobectomy with normal pulmonary function and COPD. <strong>Methods:</strong> Based on the results of the preoperative pulmonary function test, 25 patients were diagnosed with COPD [% forced expiratory volume in 1 second (%FEV<sub>1</sub>) < 70%]. Thirty-seven patients were enrolled as non-obstructive patients (70% ≤ %FEV<sub>1</sub>), who were randomized into two groups, the LAMA/LABA (n = 19) and the Control group (n = 18). The LAMA/LABA and the COPD groups daily received inhaled LAMA (50 μg) and LABA (110 μg) for 1 week before surgery and for least 4 weeks after surgery. The Control group had no treatment of the dual bronchodilator. The actual values were measured during the perioperative pulmonary function at three points of the preoperative baseline, the postoperative 1 week and the postoperative 4 weeks;these changes and changed ratios were then calculated. The patient-reported outcomes of the quality of life (PRO-QOL) were evaluated by the Cancer Dyspnea Scale (CDS), the COPD assessment test, and the St. George’s Respiratory Questionnaire. <strong>Results:</strong> Regarding the value of FEV<sub>1</sub> at the baseline, that in the LAMA/LABA group was 79.2% ± 6.4% and that in the Control group was 80.9% ± 6.4%, but that in the COPD groups was 57.9% ± 8.7%;there was a significant difference between the COPD and the Control group (p < 0.0001). At the postoperative 1 week point, the FEV<sub>1</sub> value in the Control group was 1.3 ± 0.5 L and that in the LAMA/LABA group was 1.7 ± 0.5 L. On the other hand, that in the COPD group was 1.7 ± 0.5 L, which was significantly higher compared to that in the Control group (p = 0.0251 and p = 0.0369). The intervention of LAMA/LABA for the COPD and non-obstructive patients resulted in the less decreased degree of the pulmonary function in FEV<sub>1</sub> compared to that in the Control group. Based on the PRO-QOL by the CDS, the intervention of LAMA/LABA significantly reduced the total dyspnea in the LAMA/LABA group compared to that in the Control group (p = 0.0348). <strong>Conclusion:</strong> The perioperative intervention of LAMA/LABA should lead to maintaining the postoperative pulmonary function of the FEV<sub>1</sub> during the lobectomy with COPD and non-obstructive patients and the improvement of PRO-QOL.
文摘BACKGROUND Adjuvant radiotherapy is given following surgery in breast cancer patients. Hypofractonated radiotherapy can significantly reduce the waiting time for radiotherapy, working load on machines, patient visits to radiotherapy departments and medical costs. Material and Methods 244 patients with high-risk breast cancer (stage IIB, stage III and stage IA with any of the following criteria: lymphovascular invasion, hormonal receptor negative, young age) who underwent Breast conservative surgery (BCS) or Modified radical mastectomy (MRM) were enrolled in this study. All patients received adjuvant radiotherapy with different hypofractionation schedules either 3900 cGY/13 fractions or 4240 cGY/16 fractions or 4005 cGY/15 fractions using linear accelerator with 6 MV photon beam. Lateral/Medial tangential and Ipsilateral supraclavicular fields were employed and the ipsilateral axilla was also irradiated if required to the same dose with posteroanterior field. Patients were followed every 3 mons for the first 2 years and every 6 mons thereafter. Outcomes were analyzed in terms of tumor control and survival. Results 244 patients with high-risk breast cancer requiring postoperative radiotherapy to the intact breast or chest wall were treated. The mean age was 48 years (range 28 - 69 years). The 5-year locoregional free survival of all patients was 93.8% the local relapse reported in 15 patients (6.2%) 7 patients at site of operated scar & 8 patients at the regional lymph nodes. The median follow up period was 75 months ranged from 49 to 102 months. Distant metastasis free survival was 92.2%, the distant metastasis reported in 19 patients which represent (7.8%) of all patients, median survival is 75 months ranged from 49 to 102 months and overall survival was 88.6%. Conclusion It is concluded that hypofractionated radiotherapy is a simple and effective protocol in patients with high-risk breast cancer regarding tumor control and survival.
文摘Patients are often nervous prior to surgery and females might suffer the most. Increased nervousness needs attention as it can negatively affect postoperative recovery. Support from nurses, i.e. being present, attentive, empowering and helpful to the patient, and talking about what is on the patient’s mind, might help to reduce nervousness. However, there is a lack of evidence as to the ideal level of attention and resources to reduce preoperative nervousness. The objective of the current study was to compare a range of care combinations with standard care to female patients prior to sedation and cancer surgery primarily on difference in change in nervousness from admission until sedation before cancer surgery, measured on a Visual Analouge Scale. Using simple randomization and numbers in sealed envelopes, adult gynaecological patients scheduled for open cancer surgery were allocated to care provided by a nurse anaesthetist and: A) a surgical nurse, B) no additional care, C) a known nurse , and D) a relative. Only the statistician was blinded. The trial stopped when the calculated numbers were included. In the full analysis set, compared to standard care A) (n = 61), we observed the following mean changes and [95% confidence intervals]: B) (n = 65) 1.05 [CI: 0.298 to 1.794] with p = 0.006, C) (n = 61): -0.38 [-1.140 to 0.385] with p = 0.330, D) (n = 71): 0.23 [-0.498 to 0.967] with p = 0.528. Female cancer patients will benefit from supportive care by a surgical nurse from the time of arrival on the operating ward plus supportive care from a nurse anesthetist from 5 - 10 minutes after entering the operating ward. It is not recommended at any time to rely fully on the support of relatives. The effect on adults of preoperative painful procedures and patients’ time alone on the operating ward should be further investigated.
文摘Surgery following neoadjuvant chemoradiotherapy(NCRT) is a common multidisciplinary treatment for resectable esophageal cancer(EC). After analyzing 12 randomized controlled trials(RCTs), we discuss the key issues of surgery in the management of resectable EC. Along with chemoradiotherapy, NCRT is recommended for patients with squamous cell carcinoma(SCC) and adenocarcinoma(AC), and most chemotherapy regimens are based on cisplatin, fluorouracil(FU), or both(CF). However, taxane-based schedules or additional studies, together with newer chemotherapies, are warranted. In nine clinical trials, post-operative complications were similar without significant differences between two treatment groups. In-hospital mortality was significantly different in only 1 out of 10 trials. Half of the randomized trials that compare NCRT with surgery in EC demonstrate an increase in overall survival or disease-free survival. NCRT offers a great opportunity for margin negative resection, decreased disease stage, and improved loco-regional control. However, NCRT does not affect the quality of life when combined with esophagectomy. Future trials should focus on the identification of optimum regimens and selection of patients who are most likely to benefit from specific treatment options.
文摘Objective: To study the expression and clinical value of apoptosis control gene bcl-2 and bax in breast cancer. Methods: Protein bax and bcl-2 in 41 breast cancers obtained from operations in our hospital in 1996 were detected using ABC immunohistochemical stain assay and compared with 10 cases with normal breast tissues. Results: The positive rate of bax in normal breast tissue was 90% and in breast cancer was 59%, with a significant statistical difference between them (P<0.05), but there was no statistical difference in bcl-2 protein expression. Among the 41 breast cancer, the group with lymph node metastasis (21 cases) had obviously low bax expression (43%) and high bcl-2 expression (76%), showing significant difference to the group without lymph node metastasis (P<0.05). Conclusion: The antiapoptosis function of bcl-2 was stronger than bax in breast cancer. Protein bax and bcl-2 assay may be useful in understanding the biological behaviors of breast cancer.
基金supported by the Special Fund for Health Research in the Public Interest(No.201502001)
文摘Objective: To evaluate the efficacy and feasibility of screening procedure for upper gastrointestinal cancer in both high-risk and non-high-risk areas in China. Setting: Seven cities/counties, representing three economical-geographical regions (Eastern, Central and Western) in China, were selected as screening centers: three in high-risk areas and four in non-high-risk areas. Participants: Villages/communities in these seven centers regarded as clusters were randomly assigned to either intervention group (screening by endoscopic examination) or control group (with normal community care) in a 1:1 ratio stratified by each center. Eligible participants are local residents aged 40-69 years in the selected villages/communities with no history of cancer or endoscopic examination in the latest 3 years who are mentally and physically competent. Those who are not willing to take endoscopic examination or are unwilling to sign the consent form are excluded from the study. Totally 140,000 participants will be enrolled. Interventions: In high-risk areas of upper gastrointestinal cancer, all subjects in screening group will be screened by endoscopy. In non-high-risk areas, 30% of the subjects in screening group, identified through a survey, will be screened by endoscopy. Primary and secondary outcome measures: The primary outcome is the mortality caused by upper gastrointestinal cancer. The secondary outcomes include detection rate, incidence rate, survival rate, and clinical stage distribution. Additional data on quality of life and cost-effectiveness will also be collected to answer important questions regarding screening effects. Conclusions: Screening strategy evaluated in those areas with positive findings may be promoted nationally and applied to the majority of Chinese people. On the other hand, negative findings will provide scientific evidence for abandoning a test and shifting resources elsewhere. Trial registration: The study has been registered with the Protocol Registration System in Chinese Clinical Trial Registry (identifier: ChiCTR-EOR-16008577).
文摘The goal of the present study is to utilize cis-diamminedichloroplatinum (cisplatin) loaded polymer nanoparticles (NPs) to give a controlled, extended, and local drug therapy for the treatment of cancer. We have used biodegradable and biocompatible poly(lactic-co-glycolic acid) (PLGA) to prepare the NPs by adjusting the double emulsion technique using poly(vinylalcohol) as a surface active agent. The PLGA NPs were characterized for particle size and shape, controlled release of cisplatin, and degradation. Cisplatin solubility in deionized water was increased up to 4 mg/mL by simply changing the solution parameters. Cisplatin encapsulated NPs were incubated in phosphate buffered saline (PBS) at 37?C to study the release kinetics of cisplatin. Cisplatin was released in a sustained manner with less than 20% release during a 3-day period followed by 50% release during a 21-day period. A degradation study of PLGA NPs demonstrated the loss of spherical shape during a 21-day period. We also examined the cisplatin sensitive A2780 cell apoptosis when cells were incubated with cisplatin encapsulated PLGA NPs. A large number of cell apoptosis occurred as a result of cisplatin release from the PLGA NPs. These results suggest that cisplatin encapsulated PLGA NPs can be used to treat the cancer cells by injecting them into a localized site minimizing the side effects.
文摘Background: Worldwide, breast cancer (BC) is the most frequently diagnosed neoplastic disease in women around menopause that is the leading cause of DALYs, because it causes a significant reduction of these women’s ability to function normally in everyday life. Methods: The present hospital-based case-control study was carried out between January and August 2018 using a structured questionnaire on 105 breast cancer women and 210 controls who are clinically free from breast cancer. Data about the study cases were collected in the oncology day-care clinics of the two main hospitals in Gaza strip “Al-Shifa and European Gaza hospitals”. Univariate logistic regression and multivariate logistic regression analyses were employed to identify the significant factors associated with BC. Results: Multivariate logistic regression analyses with adjustment for all confounders revealed that woman with BMI more than or equal 30 kg/m2 are under risk of getting BC 2.9 times greater than those having BMI less than 29 kg/m2 (AOR = 2.895;95% CI: 1.305 - 6.423). Analysis of risk according to reaching menopause showed that the estimated AOR was greater among those reached menopause (3.137, 95% CI 1.824 - 5.395) than among those that did not reach menopause. The risk of developing BC in the case of a history of incidence of BC in the family was more than two times higher (AOR = 2.632, 95% CI 1.528 - 4.535) than in case of the history of a free family of BC. Conclusion: In this context, the above-mentioned risk factors must be taken into consideration in BC management processes in the Gaza strip.
文摘Average size of hematite and magnetite micro and nanopowders and polydispersity index, zeta potential and distribution of particles were studied. Analysis showed that average size of the obtained particles for magnetite is 740.9 nm, for hematite particles 30 - 35 nm. Alternate current feed source was created for hyperthermia. Proceeding from the requirements of the objectives, the U type MnZn material magneto conductors were selected, in which 10.0 and 8.0 mm width gaps were cut and glass test tubes with magnetite or hematite suspensions were placed in them. Series of experiments at various field intensity and frequencies showed that for efficient magnetic hyperthermia therapy more powerful device was needed with frequency of up to 10 Mega Hertz to achieve the temperature 43°C - 45°C necessary for full activation of Neel and Brown mechanisms in particles. At the next stage, on the basis of experimental material the anticancer mono-therapeutic effect of hyperthermia and its adjuvant action in poly chemotherapeutic treatment was presented by the use of a device created by us “Lezi”. As a result of the experiment it was shown that in all animals (outbred albino mice, 3 months old) inhibition of cancer growth was fixed and intratumoral necrosis was developed, while after 7 and 10 sessions tumors were ulcerated, which refers to positive effect of the experiment (Conclusion of Pathologicanatomical Laboratory “PATGEO”, Tbilisi, Georgia ).
基金Supported by a grant from the Innovation Project of the PLA Army General Hospital of China(No.2015-LC-18)
文摘Objective To compute and compare the tumor control probability(TCP) of volumetric modulated arc therapy(VMAT) for breast cancer after conservative surgery based on two types of multileaf collimator(MLC) through a retrospective planning study.Methods For a group of 9 patients diagnosed with left breast cancer,VMAT plan based on Agility MLC and beam modulator(BM) MLC were designed.The prescription dose was 50 Gy covering at least 95% of the planning target volume,2 Gy per fraction.TCPs were calculated according to dose-volume histogram(DVH) analysis.Results The TCP of the BM VMAT plan was slightly higher than that of the Agility VMAT plan(94.61% vs 94.23%) but was inferior with respect to delivery efficiency;the delivery time was reduced for Agility VMAT plan by 35% compared to BM VMAT plan.Conclusion For breast cancer radiation therapy after conservative surgery,BM VMAT plans provide slightly higher TCP while the delivery of Agility VMAT plans is significantly faster than the BM VMAT plans.
文摘A mathematical optimal-control tumor therapy framework consisting of radio- and anti-angiogenesis control strategies that are included in a tumor growth model is investigated. The governing system, resulting from the combination of two well established models, represents the differential constraint of a non-smooth optimal control problem that aims at reducing the volume of the tumor while keeping the radio- and anti-angiogenesis chemical dosage to a minimum. Existence of optimal solutions is proved and necessary conditions are formulated in terms of the Pontryagin maximum principle. Based on this principle, a so-called sequential quadratic Hamiltonian (SQH) method is discussed and benchmarked with an “interior point optimizer—a mathematical programming language” (IPOPT-AMPL) algorithm. Results of numerical experiments are presented that successfully validate the SQH solution scheme. Further, it is shown how to choose the optimisation weights in order to obtain treatment functions that successfully reduce the tumor volume to zero.
文摘AIM To characterize the survival of cirrhotic patients with Barcelona Clinic Liver Cancer(BCLC) stage C hepatocellular carcinoma(HCC) and to ascertain the factors predicting the achievement of disease control(DC).METHODS The cirrhotic patients with BCLC stage C HCC evaluated by the Hepatocatt multidisciplinary group were subjected to the investigation. Demographic, clinical and tumor features, along with the best tumor response and overall survival were recorded. RESULTS One hundred and ten BCLC stage C patients were included in the analysis; the median overall survival was 13.4 mo(95%CI: 10.6-17.0). Only alphafetoprotein(AFP) serum level > 200 ng/m L and DC could independently predict survival but in a time dependent manner, the former was significantly associated with increased risk of mortality within the first 6 mo of follow-up(HR = 5.073, 95%CI: 2.159-11.916, P = 0.0002), whereas the latter showed a protective effect against death after one year(HR = 0.110, 95%CI: 0.038-0.314, P < 0.0001). Only patients showing microvascular invasion and/or extrahepatic spread recorded lower chances of achieving DC(OR = 0.263, 95%CI: 0.111-0.622, P = 0.002).CONCLUSION The BCLC stage C HCC includes a wide heterogeneous group of cirrhotic patients suitable for potentially curative treatments. The reverse and time dependent effect of AFP serum level and DC on patients' survival confers them as useful predictive tools for treatment management and clinical decisions.
文摘Research has demonstrated facilitative effects of social support on psychological and physical well-being of individuals suffering from chronic health problems. Social support can change not only patients’ perception of their health problems, but also the consequences of their illness. In the present study with cervix cancer patients, the relationship of social support and illness control agency with illness consequences and health outcome beliefs was examined. Emotional, informational, social companionship and practical supports were found to be negatively correlated with the severity of interpersonal, physiological and psychological consequences of illness. Patients’ belief in self-control and doctor-control was related to less severity and less pain of illness, and strong hope for better health outcomes.
文摘Background: Cancer has become a leading cause of death world-wide. In Hong Kong, cancer accounted for 24.8% of deaths in 1980, rising to 31.3% in 1998. The conventional treatment of cancer usually includes surgery, radiotherapy and chemotherapy. These conventional therapies do not guarantee not relapse and are often associated with serious side effects. Using Chinese Medicine (CM) as an adjunctive treatment is commonly practiced in Chinese Communities to support patients being treated with conventional modern medicine, with the aim of alleviating the side effects, and improving self-defense and their quality of life. Well-designed and conducted clinical trials could give evidence of the efficacy of CM. This study investigated the clinical efficacy through the well designed clinical trial, and the implementation of carrying out the trial, to assess the adjuvant and supportive effect on lung cancer patients. Methods: The clinical study was designed as a randomized controlled trial to investigate the dose-dependent effects. Primary endpoint was the difference of Functional Assessment of Cancer Therapy-General (FACT-G) score. Results: 41 eligible subjects were enrolled and randomly divided into 2 groups, 21 in high dose group and 20 in low dose group. Sub-domains of PWB (Physical well-being) and EWB (Emotional well-being) as well as FACT-G total score were significantly improved in high dose group when compared with low dose group after 12 weeks treatment (p = 0.015, 0.006 and 0.012, respectively). Conclusions: Holistic approach using quality of life as parameters to evaluate the efficacy of CM is an important compromise. Well-designed clinical trial can provide convincing evidence to support CM’s efficacy. The study demonstrated that quality of life of patients with lung cancer could be beneficial from the supportive care with CM.
文摘The messenger RNA 3'-untranslated region(3'UTR)plays an important role in regulation of gene expres-sion on the posttranscriptional level. The 3'UTR con-trols gene expression via orchestrated interactionbetween the structural components of mRNAs(cis-ele-ment) and the specific trans-acting factors(RNA bind-ing proteins and non-coding RNAs). The crosstalk ofthese factors is based on the binding sequences and/or direct protein-protein interaction, or just functionalinteraction. Much new evidence that has accumulatedsupports the idea that several RNA binding factors canbind to common mRNA targets: to the non-overlappingbinding sites or to common sites in a competitive fash-ion. Various factors capable of binding to the sameRNA can cooperate or be antagonistic in their actions.The outcome of the collective function of all factorsbound to the same mRNA 3'UTR depends on manycircumstances, such as their expression levels, affinity to the binding sites, and localization in the cell, which can be controlled by various physiological conditions. Moreover, the functional and/or physical interactions of the factors binding to 3'UTR can change the character of their actions. These interactions vary during the cell cycle and in response to changing physiological condi-tions. Abnormal functioning of the factors can lead to disease. In this review we will discuss how alterations of these factors or their interaction can affect cancer development and promote or enhance the malignant phenotype of cancer cells. Understanding these altera-tions and their impact on 3'UTR-directed posttran-scriptional gene regulation will uncover promising new targets for therapeutic intervention and diagnostics. We will also discuss emerging new tools in cancer di-agnostics and therapy based on 3'UTR binding factors and approaches to improve them.