Objectives To evaluate the effectiveness of cognitive behavioral therapy (CBT) treating insomnia in patients with breast cancer. Methods Such databases as CENTRAL (April 2011), The Cochrane Library (2005 to November 2011), MEDLINE (1948 to April 2011), EMbase (Junuary 1966 to April 2011), CINAHL (Cumulative Index to Nursing and Allied Health Literature, 1982 to April 2011), CBM (1978 to 2011) and CNKI (1979 to 2011) were searched to collect the randomized controlled trials (RCTs) about CBT treating insomnia in patients with breast cancer. Literature screening, data extraction and methodological quality assessment of the included studies were conducted according to the inclusion and exclusion criteria. Then RevMan 5.0 software was used for meta-analysis. Results A total of 5 RCTs were included. The results of meta-analysis showed that, compared with the control group, the CBT group was higher in the score of subjective sleep efficiency; however, it was lower in the subjective sleep onset latency. There were no significant differences between the two groups in the sleep efficiency, total sleep time, sleep onset latency and wake time after sleep onset measured by hypnocinematograph. Conclusion Cognitive behavioral therapy may improve the subjective sleep efficiency and sleep quality, and shorten the sleep onset latency in patients with breast cancer. However, its effect of improving objective sleep quality is still unverifiable at present. It suggests the following measures should be taken for providing better evidences: increasing sample size, adopting blind methods, confirming allocation concealment, and using unified hypnocinematograph.
Objective To assess the effectiveness and safety of nedaplatin combined with 5-fluorouracil (5-Fu) for advanced esophageal cancer. Methods Such databases as PubMed, The Cochrane Library, EMbase, CBM, CNKI, VIP and WanFang Data were searched from the date of their establishment to May 4th, 2012 to collect the randomized controlled trials (RCTs) about nedaplatin combined with 5-Fu versus cisplatin combined with 5-Fu for advanced esophageal cancer. According to the inclusion and exclusion criteria, two reviewers independently screened literature, extracted data and assessed the quality of the included studies. Then meta-analysis was conducted using RevMan 5.1 software. Results A total of 15 RCTs invloving 863 patients were included. The results of meta-analysis suggested that, compared with cisplatin combined with 5-Fu, nedaplatin combined with 5-Fu could improve short-term effects (RR=1.31, 95%CI 1.14 to 1.52, P=0.000 2) and reduce gastrointestinal reaction and renal function impairment, but it was associated with aggravated myelosuppression, increase of thrombocytopenia and leukopenia, and decrease of hemoglobin. There were no significant differences between the two groups in liver function impairment, diarrhea and peripheral neurovirulence. Conclusion Nedaplatin combined with 5-fluorouracil can increase short-term effects and reduce gastrointestinal reaction and renal function impairment. However, nedaplatin is associated with aggravated myelosuppression, so it should be applied in clinic with cautious. Nedaplatin combined with 5-fluorouracil can be used as a replacement chemotherapy regimen for advanced esophageal cancer, but the evidence about long-term effects and safety is still required. For the quality and quantity limitation of the included studies which decreases the level of evidence, so the conclusion of this systematic review only provides some references for clinical practice and research.
Objective To evaluate the effectiveness and safety of nedaplatin combined with chemotherapy versus cisplatin combined with chemotherapy for advanced non-small cell lung cancer (NSCLC). Methods The randomized controlled trials (RCTs) on nedaplatin combined with chemotherapy versus cisplatin combined with chemotherapy for advanced NSCLC were searched in The Cochrane Library, PubMed, EMbase, CBM, VIP and WanFang Data from the date of their establishment to January 2012. According to the inclusion and exclusion criteria, two reviewers independently screened the studies, extracted the data and assessed the quality. Then RevMan 5.0 software was used for meta-analysis. Results A total of 15 RCTs involving 1 076 patients were included. The results of meta-analysis showed that, compared with the cisplatin combined with chemotherapy, nedaplatin combined with chemotherapy could reduce the risks of nausea and vomiting (RR=0.56, 95%CI 0.48 to 0.65, Plt;0.000 01), decrease the risk of renal function impairment (RR=0.47, 95%CI 0.30 to 0.74, P=0.001), but increase the risk of thrombocytopenia (RR=1.59, 95%CI 1.20 to 2.11, P=0.001). There were no significant differences between the two groups in objective response rate (ORR) (RR=1.09, 95%CI 0.92 to 1.29, P=0.03), leukopenia (RR=1.05, 95%CI 0.92 to 1.19, P=0.50), and hemoglobin reduction (RR=0.92, 95%CI 0.80 to 1.07, P=0.30). Conclusion Compared with cisplatin combined with chemotherapy for advanced NSCLC patients, nedaplatin in combination with chemotherapy can significantly reduce the risks of nausea, vomiting and renal function impairment. Although the ORRs are similar in the two groups, nedaplatin combined with chemotherapy can cause a higher risk of thrombocytopenia. For the quality restriction and possible publication bias of the included studies, more high quality RCTs are required to further verify this conclusion.
Objective To analyze and screen the risk factors of both immunohistochemistry and pathology for lung cancer lymphatic metastasis, and to build a mathematical model for preliminary evaluation. Methods By conducting retrospective studies, the information of lung cancer patients in the General Hospital of Air Force from 2009 to 2011 were collected. Both single and multiple unconditional logistic regression analyses were applied to screen total 27 possible factors for lymphatic metastasis. After the factors with statistical significance were selected, the relevant mathematical model was built and then evaluated by means of receiver operating characteristic (ROC) analysis. Results A total of 216 patients were included. The single analyses on 27 possible factors showed significant differences in the following 10 factors: pathological grade (P=0.00), age (P=0.00), tumor types (P=0.01), nm23 (P=0.00), GSTII (P=0.01), TTF1 (P=0.01), MRP (P=0.01), CK14 (P=0.02), CD56 (P=0.02), and EGFR (P=0.03). The multiple factors unconditional logistic regression analyses on those 10 risk factors screened 4 relevant factors as follows: pathological grade (OR=2.34), age (OR=1.02), nm23 (OR=1.66), and EGFR (OR=1.47). Then a mathematical diagnostic model was established based on those 4 identified risk factors, and the result of ROC analysis showed it could improve the diagnostic sensitivity and specificity compared with the single factor mathematical diagnostic model. Conclusion Pathological grade, age, nm23, and EGFR are related with lung cancer lymphatic metastasis, and all of them are the risk factors which have higher adjuvant diagnostic value for lung cancer lymphatic metastasis.
ObjectiveTo evaluate the impact of video-assisted thoracoscopic surgery (VATS) esophagectomy and routine operation on the short-term quality of life in patients with esophageal cancer. MethodsFrom January 2012 through January 2014, 157 esophageal cancer patients were classified into a VATS group (n=42) and a routine operation group (n=115) in our hospital. All patients in the two groups completed the Chinese versions of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (QLQ)-C30 and QLQ-OES18 at one, six and 12 months after operation separately. ResultsAt the end of 6, 12 months after operation, the evaluation on global health status was higher in the VATS group(68.8±12.3 vs. 62.7±13.7, P<0.05; 76.2±10.4 vs. 68.6±8.8, P<0.05). At the end of 1, 6, 12 months after operation, the scores of symptom pain were less significantly in the VATS group than those in the routine operation group (P<0.05). One month after operation, the score of active ability in the VATS group was higher (P<0.05). At the end of 6, 12 months after operation, the score of emotional function and social role in the VATS group was higher (P<0.05). At the end of 12 months after operation, the score of role function and cognitive function in the VATS group was also higher (P<0.05). ConclusionVATS is of better effect on improving short-term quality of life of esophageal cancer patients compared with routine operation.
ObjectiveTo analyze the surgical techniques and perioperative patient management of bronchial sleeve resection and plasty, carinal resection and reconstruction, and angioplasty in the treatment of locally advanced central type of lung cancer and summarize the experiences. MethodsWe retrospectively analyzed the clinical data of 21 locally advanced central type of lung cancer patients with bronchial sleeve resection and plasty, carinal resection and reconstruction, and angioplast in our hospital from December 2011 through November 2014. There were 17 males and 3 females with a mean age of 63.2±6.2 years. All operations were successful. The time of operation was 3.29±0.75 h. The hospitalization time was 25.48±22.31 days. No death ocurred during perioperative period. Postoperative complications were found in 3 patients, including 2 patients with atelectasis and 1 patient with bronchopleural fistula. ConclusionBronchial sleeve resection and plasty, carinal resection and reconstruction, and angioplasty apply to treat locally advanced central type of lung cancer not only maximally remove the lung cancer tissue, but also maximally reserve the healthy lung tissue.
Objective To evaluate the diagnostic accuracy of the aberrant methylation of genes in stool for colorectal tumor. Methods Databases including The Cochrane Library, PubMed, EMbase, CBM, Web of Science, CNKI and WanFang Data were searched to collect the diagnostic trials on the aberrant methylation of genes in stool for colorectal tumor published from January 1990 to February 2012. QUADAS items were used to evaluate the quality of the included studies, and the meta-analysis was conducted using Meta-Disc 1.4 software. Results A total of 32 studies involving 3 951 patients were included. The results of meta-analysis showed that, for detecting the colorectal tumor, the weighted sensitivity, specificity, diagnostic odds ratio (DOR), area under the summary receiver operating characteristic (SROC) curve and Q were 92% (95%CI 91% to 93%), 63% (95%CI 61% to 65%), 20.79 (95%CI 15.13 to 28.57), 0.861 9 (SE=0.020 4), and 0.792 6 (SE=0.019 8), respectively. For detecting the colorectal cancer, the weighted sensitivity, specificity and area under the curve (AUC) were 91% (95%CI 89% to 92%), 75% (95%CI 73% to 77%), and 0.900 7, respectively. For detecting the colorectal adenoma, the weighted sensitivity, specificity and AUC were 79% (95%CI 76% to 83%), 75% (95%CI 73% to 77%), and 0.845 7, respectively. Conclusion With high sensitivity (92%) and moderate specificity (63%), aberrant methylation of genes in stool can be used as an optional noninvasive method for the diagnosis of colorectal tumor.
The resistance of non-small cell lung cancer (NSCLC) to epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) has been brought into focus. COX-2 signal pathway was found to be closely related to EGFR signal pathway by recent researches, and there has been a growing interest to focus the researches on whether COX-2 pathway inhibition improves the efficacy of EGFR-TKIs in treating advanced NSCLC. In this review, we will illustrate recent advances of combined inhibition of EGFR and COX-2 signal pathways in NSCLC therapy.
Objective To explore the incidence, age distribution and change tendency of female breast cancer in urban Shenyang from 2000 to 2009. Methods The incidence data of female breast cancer recorded in Shenyang Center for Disease Control and Prevention from 2000 to 2009 were collected, and the incidence and standardized incidence of breast cancer were analyzed by using SPSS 16.0 software. The incidence trend was analyzed by means of χ2 trend test and linear regression. Results The annual average crude incidence rate of female breast cancer in urban Shenyang from 2000 to 2009 was 46.03/100 000, while the annual average standardized incidence rate was 35.63/100 000, increased by 160.41% and 109.39% respectively during past 10 years, and the annual average increase was 11.22% and 8.56%, respectively. Both crude incidence rate and standardized incidence rate were in increasing trends with statistical significance (Plt;0.001). The crude incidence rate of the female at age of 50-64 showed a perpendicular rise trend, increased by 271.97%, and the annual average increase was 15.72%. The χ2 trend test and linear regression showed a significant difference (χ2=276.743, P=0.000; y= –22 355.560+11.205x, P=0.000). Conclusion The incidence of female breast cancer in urban Shenyang tends to rise with a younger-aged trend, and the female at age of 50-64 are commonly affected.
Objective To investigate the correlation between RUNX3 expression and human gastric cancer, as well as its clinically pathologic features. Methods Such databases as PubMed, EMbase, VIP, WanFang Data and CBM were searched from their inception to February 28th, 2013 to collect case-control studies about the correlation between RUNX3 expression and human gastric cancer, as well as its clinically pathologic features, and the relevant references of the included literature were also retrieved. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data, and assessed the methodological quality. Then meta-analysis was conducted using RevMan 5.0 software. Results A total of 6 case-control studies were included, which included 405 cases in the gastric cancer group and 185 cases in the normal gastric mucosa group. The results of meta-analysis showed that, RUNX3 expression was lower in the gastric cancer group than the normal gastric mucosa group, with a significant difference (OR=0.07, 95%CI 0.04 to 0.12, Plt;0.000 01); it was also lower in the subgroup of gastric cancer accompanied with lymph node metastasis than that without lymph node metastasis (OR=0.37, 95%CI 0.23 to 0.61, Plt;0.000 1); but it was higher in the subgroup of gastric cancer that had infiltrated into serosa than that had not, with a significant difference (OR=3.92, 95%CI 2.29 to 6.71, Plt;0.000 01); and it was also higher in the subgroup of well differentiated gastric cancer that the moderately and poorly differentiated, with a significant difference (OR=0.36, 95%CI 0.22 to 0.58, Plt;0.000 1). Conclusion RUNX3 expression is notably correlated to gastric cancer and its clinically pathologic features. For the quantity and quality limitation of the included studies, this conclusion still needs to be further proved by performing more high quality studies.