Objective To study the relationship between metalloproteinases (MMPs) and breast cancer. Methods The literature in recent years on the relationship between the expression of MMPs and breast cancer was reviewed. Results The balance between MMPs and tissue inhibitors of metalloproteinases (TIMPs) is keeping normally kept in human body. Many of the studies showed that the expression of MMPs is increased in breast cancer. Conclusion The growth, invasion and metastasis of breast cancer is closely related with the increased expression of MMPs. This suggests that MMPs is a valuable prognostic marker and TIMPs would be a novel drug against cancer.
ObjectiveTo analyze the follow-up data of colorectal cancer in the Database from Colorectal Cancer (DACCA).MethodsThe information in the Dacca database was screened, and the one whose operative date and follow-up date were not blank in the total data was selected. The follow-up data were analyzed, including length of follow-up, survival outcomes, coping styles (doctors’ attitude and reaction for follow-up), follow-up path (whether to choose out-patient, Wechat, QQ tools, phone call, text message, mobile application, face-to-face), the number of follow-up (the number of out-patient follow-up, the number of telephone follow-up, and the number of follow-up within 5 years).ResultsA total of 6 437 data items were analyzed for colorectal cancer adjuvant follow-up. ① The follow-up period of five years (2004–2015) was 56.6% (3 642/6 437), and the follow-up time was 0–201, 67 (26, 97) months. ② The highest data composition ratio of survival outcomes was “Survival” (79.7%, 4 611/5 787), and in the data with five-year follow-up period (2004–2015), the highest data composition ratio of survival outcomes was “Survival” (75.0%, 2 550/3 401), and the survival rate of the five-year follow-up period in 2008 was the highest (91.4%, 235/257). ③ The highest data composition ratio of the coping styles was the doctors’ active follow-up (76.8%, 2 121/2 762). ④ The highest data composition ratio of the follow-up path was out-patient service (90.6%, 4 236/4 676). ⑤ The highest data composition ratio of the number of out-patient follow-up was conducted by the original surgical team (100%, 4 380/4 380), the specific number was 0–130、5 (2, 10) times. The data composition ratio of telephone follow-up was 86.9% (3 808/4 380) and the specific number was 0–68、0 (0, 1) times. The highest frequency of follow-up was in the first year (89.9%, 3 044/3 386) and the specific number was 0–73、5 (3, 9) times.ConclusionBy expounding the characteristics of the colorectal cancer follow-up from colorectal cancer in DACCA, it provides some references for using big data to determine prognosis.
Objective To explore the whole constructive conception and organization structure strategy of multi-disciplinary team (MDT) for colorectal cancer (CRC). Methods Combined the characteristics of large public hospital, with recognized treatment pathway in MDT for CRC and the way of medical project construction, MDT for CRC project team summarized a system of MDT for CRC of West China Hospital (MDT-CRC-WCH) by own characteristics and subject feature. Results MDT for CRC summarized the 5 basic characteristics about profession, classification, interaction, optimization and fast. The project has the core competencies: system new operation types for colorectal cancer and volunteer culture. By the matrix organization structure, MDT set the main departments: database team, follow-up team, nursing team and public team. Conclusion With effective MDT whole construction and suitable organization structure, MDT will develop in long time.
Objective The article explained how to build the data system and its running strategy in the mode of multi-disciplinary team （MDT） for colorectal carcinoma. Methods It illuminated the cause of the data system building, also described the essential composition of the data system and how to support the running of the data system, and it discussed the value feedback of the data system, lastly the author proposed the prospect of the data system building. Results The data system could work normally through consultation of doctors, follow-up, clinical support and appropriate implement of construction of information flow-sheet in colorectal carcinoma MDT mode. Conclusion As the foundation of colorectal carcinoma MDT, data system could show both medical and social value through change of medical mode.
Objective To explore the personnel framework strategy of multi-disciplinary treatment (MDT) for colorectal cancer. Methods Combined the characteristics of large public hospital, with recognized treatment pathway in international MDT for colorectal cancer and management of medical human resource, colorectal cancer MDT project team summarized a system of multi-disciplinary treatment-working for colorectal cancer of West China Hospital (MDT-CRC-WCH) by own management mechanism and subject feature. Results Based on the main four principles——whole, match, voluntary and interactive, MDT-CRC-WCH constructed reciprocation “concentric circle” with the team of directors, coordinators, colorectal surgeons, related professors, nursing and other assistants.Conclusion With construction of multi-layers, MDT for colorectal cancer is completing MDT personnel framework and suitable layers relation. And how to construct prolong active and innovative system of MDT human resource management needed more research.
ObjectiveTo explore the expression of collagen Ⅳ in breast cancer and its clinical significance. We analyzed the correlation of the results with other prognostic parameters which included tumor size, status of estrogen receptor, axillary nodal status, TNM grade, and 5 years survival. The expression of collagen Ⅳ in 93 cases of human primary breast cancer as well as 5 cases of benign breast masses were examined.MethodsUsing monoclonal antibodies of collagen Ⅳ, the expression of collagen Ⅳ in breast masses were detected with immunohistochemical technique (LSAB).ResultsThe absent expression of collagen Ⅳ in the tumor masses was correlated with axillary lymph node involvement, tumor size and poor prognosis (5 years survival). The patients who had no expression of collagen Ⅳ in tumor masses had a shorter survival. ConclusionThe expression of collagen Ⅳ in tumor samples are correlated with axillary node involvement and prognosis. Collagen Ⅳ would be helpful for evaluation of invasion and treatment in breast carcinoma.
ObjectiveTo summarize research progress of comprehensive treatment based on gene therapy, immunotherapy, and targeted therapy in recent years in order to improve understanding and treatment level of triple negative breast cancer (TNBC).MethodThe literatures about TNBC treatment in recent 5 years were reviewed and summarized.ResultsTNBC was more invasive than other types of breast cancer due to its lack of targeted receptors, and its recurrence and metastasis were earlier. The treatment plan was still mainly surgical treatment, supplemented by the chemotherapy and radiotherapy.ConclusionsAlthough recent studies of TNBC in surgical treatment, chemoradiotherapy, targeted therapy and other aspects have shown a good clinical application prospect, more evidences of clinical trials with large samples are still needed. With the deepening of molecular mechanism research, endocrine therapy and targeted drug therapy, including androgen-receptor-positive, have provided some new ideas for treatment of TNBC.
ObjectiveTo unscramble personal data and its tags and structures of Database from Colorectal Cancer (DACCA) in West China Hospital.MethodThe way of words for description was used.ResultsThe definition and setting of 23 items with 18 categories for the personal data from DACCA in West China Hospital was performed. The relevant data label of each item and the structured way needed at the big data application stage were elaborated and the corrective precautions of classification items were described. The three classification items involved privacy attention were described in detailed.ConclusionsBased on description about personal data from DACCA in West China Hospital, it is provided a clinical standard and guide for analyzing of DACCA in future. It also could provide enough experience for construction of colorectal cancer database by staff from same occupation.
【摘要】 目的 探讨米卡芬净在有侵袭性真菌感染（invasive fungal infection，IFI）病史的患者行造血干细胞移植（haematopoietic stem cell transplantation，HSCT）时二级预防（secondary anti-fungal prophylaxis，SAP）的有效性和安全性。 方法 选择2009年1月-2011年1月行HSCT治疗血液病患者中有IFI史的18例患者，从预处理进行SAP，13例开始即使用米卡芬净钠，5例开始选用伏立康唑，后换为米卡芬净。预防至危险期结束（白细胞植活、无感染症状），18例患者随访时间62～220 d，中位随访时间为124 d。 结果 米卡芬净治疗有效17例，1例在预防期间+27 d出现真菌突破感染。预防过程中1例在输注的第2天出现躯干充血性皮疹伴瘙痒，经抗过敏治疗后逐渐好转。17例患者在米卡芬净使用过程中未观察严重不良反应发生，也未因此而调整环胞素A治疗浓度。 结论 米卡芬净作为HSCT中SAP的备选用药之一是安全、有效的。【Abstract】 Objective To investigate the efficacy of micafungin on secondary anti-fungal prophylaxis (SAP) in hematopoietie stem cell transplantation (HSCT) recipients who had a history of antecedent invasive fungal infection (IFI) and to observe the safety of micafungin. Methods The patients with hematological diseases，who underwent HSCT between January 2009 and January 2011, received our routine conditioning regimen. The patients, who had a history of antecedent IFI, were given by micafungin for SAP from the start of conditioning chemotherapy until the end of the risk period. Results There were 18 patients had a history of antecedent IFI. The overall efficacy of micafungin was 17/18. One patients had IFI on the +27th day during SAP; one patient had body congestive rash accompanied with pruritus in the prevention period 2 days after treatment, who got better gradually after antianaphylaxis treatment. No patients had server adverse reaction and the concentration of cyclosporine A was not changed. Conclusion Micafungin as one of drugs for SAP Is effective and safe for HSCT.
Objective To explore anesthetic quality of epidural anesthesia with general anesthesia applied for surgery of rectal cancer. Methods One hundred and seventy-eight patients who were diagnosed as rectal cancer and received operation in the Central Hospital of Bazhong City from June 2010 to June 2012 were included retrospectively. These patients were divided into two groups according to the type of anesthesia， and the patients who received general anesthesia only were defined as group A， the patients who received epidural anesthesia with general anesthesia were defined as group B. The anesthetic quality and anesthetic adverse reaction were observed in two groups. Results The differences of baseline characteristics in two groups were not significant （P＞0.05）. The difference of anesthetic quality in two groups was not significant （P＞0.05）. In terms of anesthetic adverse reaction， the incidence rate of hypertension， hypotension，tachycardia， or postoperative nausea and vomiting of the group B was significantly lower than those of the group A （P＜0.05）. The incidence rate of bradycardia， premature ventricular contractions， or time of gastrointestinal function recovery had no significant differences （P＞0.05）. There was no nerve dysfunction of lower limb in two groups. Conclusion Epidural anesthesia with general anesthesia applied for surgery of rectal cancer as compared with general anesthesia only not only has the same anesthetic quality， but also has obvious advantages in decreasing anesthetic adverse reaction.