【Abstract】Objective To understand the features of lymphatic vessel, and to summarize the foundation and mechanism of the promotion and inhibition of tumor lymphangiogenesis recorded on the current studies of animal experiments and clinical researches. Methods The related literatures of the structural features of lymphatic vessel, lymphatic endothelial molecular markers, the origin of lymphatic tumors, the molecular mechanisms and regulatory factors were reviewed, and the relationship between tumor lymphangiogenesis and lymphatic metastasis, the treatment targeting at the formation of the anti-tumor lymphatic vessel and its existing problems were also analyzed. Results Hyperplasia of lymphatic vessels occurred during the process of tumor formation and progression. The structural features of the lymphatic vessels in the tumor were conducive to tumor lymphatic metastasis. In recent years, methods of anti-lymphangiogenesis and inhibition of tumor lymphatic metastasis had achieved considerable success in animal experiments. However, there were still a lot of problems need to be solved. Conclusion Tumor lymphangiogenesis has a significantly positive correlation between tumor lymphatic metastasis and patients’ prognosis, which may indicate that treatment against the formation of tumor lymphatic vessel maybe effective.
目的：比较肝胆手术后两种腹腔引流管的应用效果。方法：将我院2005年5月～2007年3月间行肝脏手术病人106例随机分为实验组(57例)和对照组（49例），实验组采用自制双套管持续负压冲洗引流，对照组采用传统的单腔腹腔引流管引流，分析、比较两组引流的疗效。结果：采用双套管负压冲洗引流的病人发生引流管堵塞3例，隔下感染及积液4例，采用传统的单腔腹腔引流管引流的病人发生引流管堵塞12例，隔下感染及积液15例，差异有统计学意义（Ｐ＜0.05）。结论：肝脏手术后应用双套管持续负压冲洗引流在防止引流管堵塞、隔下感染疗效优于传统的单腔腹腔引流管引流。
Objective To analyze the clinical relationship between primary hyperthyroidism and thyroid carcinoma, and diagnosis and treatment for the combination of the two. Methods The clinical data of 15 patients with primary hyperthyroidism complicated with thyroid carcinoma from January 1998 to December 2008 were retrospectively analyzed. Results Fifteen cases were smoothly discharged. The morbidity was 2.56% (15/585) of primary hyperthyroidism complicated with thyroid carcinoma. There were no operative complications. Five cases showed thyroid nodules and all cases were performed thyroidectomy. Neither hyperthyroidism nor thyroid carcinoma recurred during 9 months to 10 years (average 5.5 years) follow-up.Conclusions The diagnosis of primary hyperthyroidism complicated with thyroid carcinoma is still difficult to be made preoperatively and chiefly depend on postoperative pathology. Rational surgical treatment can result in good effectiveness and better prognosis.
Objective To systematically evaluate the efficacy and safety of tiotropium plus budesonide/formoterol compared with tiotropium in Chinese patients with chronic obstructive pulmonary disease (COPD). Methods PubMed (from 1980 to March, 2015), Wiley Online Library (from 1990 to March, 2015), Elsevier (from 1990 to March, 2015), CNKI(from 1990 to March, 2015), VIP(from 1990 to March, 2015) and WanFang Data(from 1990 to March, 2015) were searched for randomized controlled trials (RCTs) of tiotropium plus budesonide/formoterol compared with tiotropium in treating Chinese patients with COPD from the establishment of the database to March 2015. The quality of included studies was assessed according to Cochrane Methods 5.1 for Systematic Review, and Meta-analysis was conducted by RevMan 5.3 software. Results Atotal of 9 studies involving 503 patients were included. Compared with the tiotropium therapy group, tiotropium plus budesonide/formoterol in treating Chinese patients with COPD can more significantly improve FEV1 (MD=0.10, 95%CI 0.05 to 0.15, P<0.000 01), FEV1%pred (MD=4.27, 95%CI 2.44 to 6.09, P<0.000 01), FEV1/FVC (MD=3.48, 95%CI 3.21 to 3.74, P<0.000 01), mMRC (MD=-0.27, 95%CI -0.38 to -0.17, P<0.000 01), CAT (MD=-0.91, 95%CI -1.74 to -0.08, P=0.03), 6MWT (MD=27.64, 95%CI 11.76 to 37.53, P<0.000 01) and the frequency of repeated exacerbations (OR=0.25, 95%CI 0.08 to 0.76, P=0.01) while no significant difference was found between two groups in SGRQ (MD=-5.11, 95%CI -11.57 to 1.36, P=0.12). There was no significant differences in adverse reaction rates (OR=1.33, 95%CI 0.65 to 2.73, P=0.44) between the tiotropium plus budesonide/formoterol group and the control group. Conclusions Tiotropium plus budesonide/formoterol is effective in treating Chinese patients with COPD. It can effectively improve treatment efficiency and does not increase the incidence of adverse drug reactions. However, due to the limitation of both quantity and quality of included studies, this conclusion should be further confirmed by more high quality and large sample studies.
ObjectiveTo systematically evaluate the efficacy and safety of budesonide/formoterol combined with tiotropium versus budesonide/formoterol alone for Chinese patients with COPD. MethodsWe electronically searched databases including PubMed, EMbase, The Cochrane Library (Issue 3, 2015), CNKI, VIP and WanFang Data to collect randomized controlled trials (RCTs) about budesonide/formoterol combined with tiotropium vs. budesonide/formoterol alone for Chinese COPD patients from inception to March 2015. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was conducted by RevMan 5.3 software. ResultsA total of 15 studies involving 1123 Chinese patients were included. The results of meta-analysis showed that, compared with the budesonide/formoterol alone group, the budesonide/formoterol plus tiotropium group could significantly improve the levels of FEV1 (MD=0.19, 95%CI 0.12 to 0.25, P<0.00001), FVC (MD=0.35, 95%CI 0.14 to 0.57, P=0.001), FEV1% (MD=5.96, 95%CI 4.48 to 7.43, P<0.00001), FEV1% pred (MD=6.82, 95%CI 2.21 to 11.43, P=0.004), FEV1/FVC (MD=7.72, 95%CI 5.69 to 9.75, P<0.00001), mMRC (MD=-0.43, 95%CI -0.52 to -0.33, P<0.00001), CAT (MD=-1.45, 95%CI -2.26 to -0.64, P=0.0005), SGRQ (MD=-7.05, 95%CI -9.16 to -4.94, P<0.00001) and 6MWT (MD=32.52, 95%CI 16.68 to 48.37, P<0.00001). While there was no significant difference in adverse reaction rates between the two groups (OR=1.77, 95%CI 0.79 to 3.98, P=0.16). ConclusionCurrent evidence shows that budesonide/formoterol plus tiotropium can improve lung function and clinical symptom in Chinese patients with COPD. Due to the limited quality and quantity of included studies, more high quality studies are needed to verify the above conclusion.
Objective To systematically evaluate the efficacy and safety of salmeterol/fluticasone combined with tiotropium versus salmeterol/fluticasone alone for Chinese patients with chronic obstructive pulmonary disease (COPD). Methods The databases including PubMed, EMbase, The Cochrane Library (Issue 4, 2017), CNKI, VIP and WanFang Data were electronically searched to collect randomized controlled trials (RCTs) about salmeterol/fluticasone combined with tiotropium vs. salmeterol/fluticasone alone for Chinese COPD patients from inception to April 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was conducted by RevMan 5.3 software. Results A total of 30 RCTs involving 3 121 Chinese patients were included. The results of meta-analysis showed that, compared with the salmeterol/fluticasone alone group, the salmeterol/fluticasone plus tiotropium group could significantly improve the levels of FEV1[MD=0.30, 95%CI(0.22, 0.39), P<0.000 01], FVC [MD=0.31, 95%CI (0.23, 0.40), P<0.000 01] and FEV1/FVC [MD=9.07, 95%CI (6.69, 11.44), P<0.000 01]. While there was no significant difference in adverse reaction rates between the two groups [OR=1.17, 95%CI (0.83, 1.66), P=0.37]. Conclusions Current evidence shows that salmeterol/fluticasone plus tiotropium can improve lung function in Chinese patients with COPD. Due to the limited quality and quantity of included studies, more high quality studies are needed to verify the above conclusion.
Objective To investigate the expression of hypoxia inducing factor 1 alpha (HIF-1α) in human breast cancer and its relationships with microvessel density （MVD）, proliferating cell nuclear antigen (PCNA) protein, other tumor biomarkers and clinicopathologic factors. Methods Immunohistochemical staining (SP) was used to measure the expressions of HIF-1α and PCNA in human breast fibroadenoma, usual hyperplasia and adenocarcinoma, and the MVD was determined by anti-CD34 immunostaining. Results No HIF-1α was observed in the lesions of breast fibroadenoma and hyperplasia. However, the positive expression rate of HIF-1α in the ductal carcinoma in situ （DCIS） was 55.0% (11/20) and the infiltrative breast cancer was 85.0%(51/60). The total high expression rate of PCNA in breast cancer was 75.0% (60/80), in which the rate of DCIS counted for 65.0% (13/20) and the rate of infiltrative adenocarcinoma counted for 78.3% (47/60). There were positive correlations between the expresson of HIF-1α and the expression of PCNA (r=0.693， P＜0.01) and MVD in DCIS (r=0.682, P＜0.05), respectively, but there was no relation between HIF-1α and MVD in infiltrative breast cancer. The expression of HIF-1α was associated with tumor cell proliferation, lymph node metastasis, estrogen receptor status (P＜0.01). Conclusion The expression of HIF-1α increased in breast cancer and it is associated with tumor cell proliferation, lymph node metastasis, estrogen receptor status. Thus, HIF-1α may play an important role in the tumor cell proliferation, vasiformation, progression and metastasis of breast cancer, and may become a new target for tumor treatment.