目的 分析脊柱关节病型银屑病关节炎关节受累的影响因素,寻找早期发现该病的可能指标.方法 回顾性选取2016年9月至2022年2月就诊于首都医科大学附属北京友谊医院风湿内科及皮肤科的358例银屑病关节炎的患者作为研究对象,根据受累部位不同将患者分为脊柱关节病型银屑病关节炎组(n=117)和外周关节病银屑病关节炎组(n=241).根据强直性脊柱炎疾病活动(ASDAS)评分对脊柱关节病型银屑病关节炎患者进行疾病活动度分组,疾病轻度活动组(ASDAS<2.1,n=47),重度活动组(ASDAS≥2.1,n=70).分析影像学分级、银屑病面积与严重性指数(PASI)评分、格拉斯哥超声附着点评分系统(GUESS)评分、自身抗体、炎症指标等与脊柱关节病型银屑病关节炎疾病活动度之间的相关性.结果 脊柱关节病型银屑病关节炎组患者的眼部受累的比率、HLA-B27阳性率、红细胞沉降率(ESR)、GUESS评分分别为14.5％、20.1％、(21.8±16.6)mm/h、(23.0±12.1)分,高于外周关节病变型银屑病关节炎组[6.2％、10.4％、(34.6±21.3)mm/h、(9.5±10.3)分],差异均有统计学意义(P<0.05).在脊柱关节病型银屑病关节炎患者中,轻度活动组与重度活动组骶髂关节CT分级差异无统计学意义(P>0.05);重度活动组患者PASI评分、GUESS评分为(14.5±9.1)、(12.8±9.6)分,均高于轻度活动组[(10.6±6.1)、(2.2±3.4)分],差异均有统计学意义(P<0.05);轻度活动组与重度活动组组间HLA-B27阳性率、抗环瓜氨酸肽(CCP)抗体阳性率比较(14.7％vs.22.9％、8.8％vs.12.0％),差异无统计学意义(P>0.05);重度活动组患者的平均ESR和C反应蛋白(CRP)值为9.4 mm/h、4.8 mg/L,均显著高于轻度活动组(1.6 mm/h、1.0 mg/L),差异均有统计学意义(P<0.05).多因素Logistic回归发现PASI评分(OR=1.075,95％CI=0.930～1.243,P<0.05)与GUESS评分(OR=0.476,95％CI=1.057～2.453,P<0.05)是脊柱关节病型银屑病重度疾病活动度的独立影响因素.结论 临床医师在早期评估银屑病关节炎患者时,应将PASI评分及GUESS评分作为整体评估脊柱关节病型银屑病关节炎的重要手段.

目的 探讨18氟-氟代脱氧葡萄糖正电子发射计算机断层显像(18 F-FDG PET/CT)对多发性肌炎/皮肌炎(PM/DM)的诊断价值及其对疾病活动度的评价作用.方法 采用回顾性研究方法,选取2017年12月至2019年12月首都医科大学附属北京友谊医院收治的接受18 F-FDG PET/CT检查的PM/DM患者13例,其中PM5例,DM8例,合并肿瘤3例(肺癌2例,鼻咽癌1例),有肺间质病变6例.同时收集年龄和性别匹配的健康体检者13例,记录并比较患者及健康人7个区域近端肢带肌群(肩背部肌肉、肱二头肌、颈椎旁肌肉、胸椎旁肌肉、腰椎旁肌肉、臀部肌肉、股四头肌)的标准化摄取值(SUV),采用两样本t检验、χ2检验,相关性分析采用Pearson分析方法处理数据.结果 PM患者肌肉SUV为(1.83±0.45)g/ml,DM患者肌肉SUV为(2.39±1.98)g/ml,均高于健康体检者(1.07±0.23)g/ml,差异具有统计学意义(P<0.001).相关性分析显示,PM/DM患者肌肉SUV与肌酸激酶(CK)(r=0.600,P<0.05)、乳酸脱氢酶(LDH)(r=0.855,P<0.01)、α-羟丁酸脱氢酶(HBDH)(r=0.834,P<0.01)、疾病活动度(r=0.723,P<0.05)均呈正相关.ROC曲线分析显示,肌肉SUV最佳临界值为1.393 g/ml,诊断PM/DM的灵敏度为84.6％,特异度为92.3％,ROC曲线下面积为0.895(95％CI:0.824～0.966).结论 18 F-FDG PET/CT测定的近端肢带肌群SUV值对PM/DM具有诊断价值,肌肉SUV值与肌力、肌酸激酶水平、疾病活动度具有相关性,可反映疾病活动度.18 F-FDG PET/CT可以作为评估PM/DM病情活动度的工具之一.

目的:评价白芍总苷胶囊用于风湿免疫及皮肤科就诊患者的常见不良事件发生情况,探究不良事件发生的影响因素.方法:采用多中心、非干预观察登记研究,纳入2017年10月～2018年12月7家医院的1 422例患者.采用描述性分析患者人口统计学指标、白芍总苷胶囊使用情况、不良事件发生情况等,并计算不良事件发生率;采用x2检验和Logistic回归模型探讨研究期间不良事件发生的影响因素.结果:研究期间共有100例次患者发生不良事件,90.00％以上为腹泻,67.00％发生在服药后2d内,94.00％的患者在发生不良事件10 d内出现转归,无严重不良事件发生.随访1周末不良事件发生率为10.48％,随访1月末不良事件发生率为3.66％.干燥综合征患者在研究期间便秘情况逐渐减少.影响因素分析显示,初始大便性状与研究期间是否发生不良事件之间存在关联,基线发生腹泻为危险因素.结论:白芍总苷胶囊总体安全性较好,服用该药可能会增加腹泻发生例数,但症状较轻,且大多数患者发生腹泻后逐渐好转.临床处方白芍总苷胶囊时应考虑患者是否已发生腹泻,对正在发生腹泻的患者应避免服用白芍总苷胶囊.服用白芍总苷胶囊可能改善干燥综合征患者的大便干燥情况.

Objective:Shizukuishi scoring method was used to compare the diagnostic value of parotid gland and submandibular gland scintigraphy for Sj?gren's syndrome (SS).Methods:Parotid gland and submandibular gland scintigraphy were conducted in 124 SS patients and 91 control subjects respectively, the results of scintigraphy of each gland were evaluated by excretion rate and 0-3 points per gland, the diagnostic accuracy of parotid and submandibular gland scintigraphy was compared by receiver operating characteristic curve (ROC).Results:The score of parotid scintigraphy was 0-6, with the cut-off value of 2, the sensitivity for diagnosis of SS was 76.9%, the specificity was 72.6%, the area under the curve (AUC) was (0.798±0.030). The score of submandibular scintigraphy was 0-6, with the cut-off value of 2. The sensitivity for diagnosis of SS was 78.0%, the specificity was 78.2%, the area of AUC was 0.854±0.026.Conclusion:The diagno-stic value of the submandibular gland scintigraphy is good.

Objective To explore the clinical effect of nutritional therapy combined with resistance exercise in anorexiacachexia patients (early stage). Methods A total of 100 patients diagnosed as anorexia cachexia early stage were randomly divided into two groups : routine treatment group (n=50) and nutritional therapy combined with resistance exercise group (n=50). Among them, 52 were male and 48 were female, aged from 33 to 80 years. The average age was (55.0±7.5) years old. By comparing the baseline of the two groups of patients, the intervention of 4 weeks, 8 weeks, differences in patientgenerated subjective global assessment (PG-SGA) improvement rate, appetite score, multidimensional fatigue symptomshort from (MFSI-SF) and quality of life scale (FACT-G) scores were analyzed, and evaluate the clinical intervention effect of nutritional therapy combined with anti-resistance exercise on early patients with anorexia-cachexia. Results A total of100 patients with anorexia and cachexia in early stage were enrolled; 52.0％ were males, 48.0％ were females and 60.0％were over 60 years old. There was no significant difference in sex, age, pathological type, PG-SGA score and appetite score between the two groups (P＞0.05). Nutrition therapy combined with anti-resistance exercise intervention for 4 weeks and 8 weeks follow-up outside hospital improved the nutritional status by 66.0％ and 86.0％ respectively which were significantly higher than those in the control group (22％ and 34％), the difference was statistically significant (P＜0.05), indicating that the combined program significantly improved the nutritional status of patients. There was no significant difference in the scores of appetite, fatigue and quality of life between the nutrition therapy combined with anti-resistance exercise group and the routine group before intervention (P＞0.05). The scores of appetite, fatigue and quality of life of the two groups of patients were significantly better than those before the intervention at 4 weeks of hospital intervention and 8 weeks follow-up outside hospital, and the difference was statistically significant (P＜0.05), the total score improvement of appetite, fatigue and quality of life of the nutrition therapy combined with anti-resistance exercise group was better than that of the conventional group and the difference was statistically significant. And the total score of quality of life after 8 weeks follow-up outside hospital is still better than that after 4 weeks of in-hospital intervention, the difference is statistically significant (P＜0.05) which shows that the combined scheme not only improves the appetite, fatigue and quality of life of patients in a short period of time, but also shows significant intervention effect for 4 weeks after discharge. Conclusion Nutritional therapy combined with resistance exercise can delay the progress of cachexia to some extent and improve appetite, fatigue and quality of life of anorexia-cachexia patients in early stage.

患者,男性,46岁,因"发现双下肢及阴囊水肿1个月"入院. 1个月前无明显诱因出现双下肢及阴囊水肿,无明显尿量减少,无血尿、泡沫尿,无尿痛等症状,就诊于当地医院行相关检查后诊断"肾病综合征". 当地医院予以控制血压、消除蛋白尿、调节血脂等对症治疗(具体药物不详),症状未见明显好转,遂就诊于我院肾内科进一步治疗.既往史:无肿瘤家族史,吸烟史38年.入院查体:血压:146/95 mmHg,颜面部及眼睑水肿,双肺呼吸音粗,双下肺闻及湿性 音;腹部移动性浊音阴性,双下肢中度凹陷性水肿,阴囊稍水肿. 辅查:血常规显示白细胞11.48×109/L、 红细胞 3.65×1012/L、 血红蛋白104 g/L;尿常规显示尿潜血+-、尿蛋白+3 mg/L、红细胞20个/μL、 白细胞12个/μl;24 h尿蛋白为8.703 g/24 h;24 h尿量为2.6 L; 肝功能示总蛋白为34.1 g/L、白蛋白12.7 g/L;血脂结果示甘油三酯为3.13 mmol/L、 总胆固醇为 9.24 mmol/L;C-反应蛋白为46.53 mg/L;红细胞沉降率为74 mm/1 h;凝血功能显示国际标准化比率 0.82、 纤维蛋白原5.85 g/L;免疫球蛋白G为3.92 g/L;乙肝五项显示表面抗体、E抗体、核心抗体均阳性;本周氏蛋白为阴性;肾功能未见明显异常. 入院后初步诊断:①肾病综合征 (nephrotic syndrome,NS)(原发性);②肺部感染. 治疗上予以改善循环、控制血压、减少尿蛋白、消肿、保肾、调节血脂、抗凝、抗感染等对症支持治疗.

目的 系统评价核磁共振显像(MRI)在判断宫颈癌宫旁侵犯的诊断价值.方法 计算机检索PubMed、CNKI和WanFang Data数据库,搜集MRI判断宫颈癌宫旁侵犯的诊断性试验,检索时限从2010年1月-2018年10月.由2位研究者独立筛选文献、提取资料和评价纳入研究的偏倚风险后,采用Stata 14软件进行统计分析,计算其合并敏感度(Sen合并)、特异性(Spe合并)、诊断比值比(DOR)等.结果 共纳入6个研究,包括418例患者.Meta分析结果显示:核磁共振显像(MRI)判断宫颈癌宫旁侵犯的 Sen合并、Spe合并、DOR分别为0.74 [95%(0.59,0.85)]、0.93 [95%(0.89,0.96)]、10.8 [95%(6.6,17.8)]、0.28 [95%(0.17,0.46)]、39 [95%(16,91)].结论 MRI诊断宫旁侵犯特异性较高而敏感度较低,单独应用时漏诊率较高,应与妇科查体联合应用.

目的:探讨卵巢癌组织Rho GTP酶结合蛋白2(RHPN2)表达变化与卵巢癌预后的关系.方法:用Kaplan-Meier plotter数据库分析卵巢癌组织和正常组织中RHPN2基因表达的差异,并分析不同RHPN2基因表达状态下卵巢癌的总生存差异,探索RHPN2基因表达的预后价值.结果:Kaplan-Meier plotter数据库包含了1653个病例样本.数据分析结果显示正常卵巢组织中RHPN2基因低表达,卵巢癌组织中RHPN2基因高表达.根据预设的截断值,308例为高表达组,347例患者为低表达.RHPN2基因低表达组卵巢癌中位总生存时间为52.03个月,高表达组为35.53个月,差异有统计学意义[风险比(HR)=1.47,95％CI(1.2,1.8),P=0.001].结论:RHPN2基因高表达是降低卵巢癌总生存的不良预后因素.

目的 评价细胞因子诱导的杀伤细胞(CIK)联合紫杉醇+顺铂(TP)方案治疗复发卵巢癌的疗效,探讨CIK与化疗药物间的相互关系.方法 回顾分析2009年1月至2016年11月该院腹部肿瘤科收治的经手术和TP方案化疗后失败的复发性卵巢癌患者70例,其中在TP方案化疗后加用CIK治疗(联合治疗组)35例,仅采用TP方案治疗(单纯化疗组)35例.观察比较两组治疗方法的总有效率(RR)、疾病控制率(DCR)、卡氏评分(KPS)情况、中位无进展生存期(PFS)及总生存期(OS).结果 全组患者中位随访16个月,联合治疗组和单纯化疗组的RR、DCR、中位PFS、KPS下降百分比为65.7％、88.6％、8个月(95 ％CI:7.9～11.1个月)、14.29％和40.0％、68.6％、6个月(95％CI:5.6～8.6个月)、37.14％,两组比较差异均有统计学意义(P＜0.05).两组中位OS分别为17个月(95％CI:20.9～42.8个月)和16个月(95％CI:15.7～28.5个月),差异无统计学意义(P＞0.05).结论 CIK联合TP化疗治疗复发卵巢癌有效,其综合疗效优于单纯化疗,具有一定的临床应用前景.

肿瘤的生长依赖肿瘤微环境,炎症与肿瘤的发生和预后存在密切联系,而中性粒细胞是肿瘤微环境中参与炎症反应的主要细胞,是存在于肿瘤微环境中的免疫细胞,与肿瘤的发生、发展密切相关.肿瘤微环境中的中性粒细胞称为肿瘤相关中性粒细胞,其中N1型抑制肿瘤生长,N2型促进肿瘤的发生和发展.在微环境中,外周血和肿瘤组织中性粒细胞数量的增加及其分泌的细胞因子在宫颈癌的发生、转移和免疫抑制性微环境形成中扮演重要角色,其作用越来越受人们的重视.未来,进一步了解免疫细胞在肿瘤微环境的作用,将为宫颈癌的治疗和预后研究提供新思路.

Objective: To investigate the effect of serum containing different concentrations of Antai Xieding Formula on the proliferation of the human trophoblast cell HTR-8 in vitro, and ERK1/2 signaling pathway, and then to explore the mechanism of pregnancy maintenance. Methods: Female SD rats were perfused to prepare blank serum and drug containing serum each group. HTR-8 cells were divided into 5 groups: blank control group, the dydrogesterone group, high dose, middle and low dose group (5％, 10％, 20％ drug containing serum). The absorbance of 24, 48 and 72h was detected by MTT, and the proliferation activity of cells was measured. The expression level of EGF, EGRR and ERK1/2 in 48h cells was detected by immunohistochemistry. HTR-8 cells can be divided into 5 groups: the blank control group, the dydrogesterone control group, Antaixieding formula high, medium and low dose group; low dose group (5％ medicated serum), middle dose group (10％ medicated serum), high dose group (20％ medicated serum). MTT method was used to detect the absorbance of 24h, 48h and 72h in three time periods, which indicated the cell proliferation activity. Immunohistochemistry method was used to detect the expression of EGF, EGRR and ERK1/2. Results: Compared with the blank control group, except the low dose group, others are statistically significant among the three periods (P<0.05); In the expression of EGF, EGFR and ERK1/2, the medium and high dose group are significantly increased (P<0.05); Compared with the dydrogesterone group, the low dose group has statistically significant among the three periods, the expression of EGF, EGFR and ERK1/2 are significantly decreased (P<0.05). Compared with low dose group, the absorbance in three periods and 48h EGF, EGFR, ERK1/2 expression in high and middle dose group have significantly increased (P<0.05). Conclusion: Antaixieding formula can effectively maintain pregnancy by improving the cell proliferation activity. The mechanism may be achieved by appropriately upregulating the expression of EGF and EGFR in the cell and promoting the phosphorylation of ERK1/2.

In China, cervical cancer is the fifth most commonly diagnosed cancer, and the outcomes for patients with advanced or recurrent disease are poor. Apatinib, a small molecule inhibitor of vascular endothelial growth factor receptor (VEGFR-2), is an orally bioavailable agent, which has shown survival benefit in multiple solid tumors. Based on previous research, this phase II clinical trial aims to verify apatinib’s efficacy and safety in patients with advanced or recurrent cervical cancer.

目的:探索脾肾双补方对人早孕绒毛滋养细胞中凋亡相关蛋白TNF-α、Caspase-3表达的影响.方法:采用动物含药血清,体外分组培养HTR-8细胞48 h,采用免疫组织化学法检测各组细胞凋亡蛋白TNF-α、Caspase-3表达的情况.结果:与空白对照组比,脾肾双补方高、中剂量组HTR-8细胞凋亡蛋白TNF-α、Caspase-3的表达均降低(P＜0.05),地屈孕酮组HTR-8细胞TNF-α、Caspase-3的表达显著低于空白对照组(P＜0.01);与地屈孕酮组比,脾肾双补方高、中剂量组TNF-α、Caspase-3的表达差异无统计学意义(P＞0.05);脾肾双补方高、中剂量组间TNF-α的表达差异无统计学意义(P＞0.05).结论:脾肾双补方含药血清可以促进人早孕绒毛滋养细胞数目增加,其机制可能是:减少人早孕绒毛滋养细胞的凋亡,保护细胞存活,继而有利于早期妊娠的维持,其作用途径可能是:脾肾双补方含药血清通过降低细胞凋亡诱导蛋白TNF-α的表达,抑制死亡受体途径,减少凋亡执行蛋白Caspase-3的表达,从而抑制人早孕绒毛滋养细胞的凋亡,保护细胞存活,维持妊娠.

癌细胞直接浸润和淋巴结转移是宫颈癌的重要转移途径.血管内皮生长因子A(VEGF-A)、血管内皮生长因子C(VEGF-C)是血管内皮生长因子家族的重要成员,可参与多种生理病理过程.VEGF-A与其受体特异性结合,刺激肿瘤血管内皮细胞新生而参与宫颈癌的侵袭转移及复发过程;VEGF-C与其受体特异性结合,诱导淋巴管内皮细胞及血管的生成而参与宫颈癌的侵袭转移及复发过程.

Objective To evaluate the effectiveness of chemotherapy combined with cytokine-Induced killer cells (CIK) in the treatment of ovarian cancer.Methods "Cytokine-induced killer cells" "CIK" "DC-CIK" "chemotherapy" "ovarian cance" as the retrieval words,the databases such as PubMed,Embase,the Cochrane Library,Medline,CNKI,VIP and WanFang Date were retrieved from the time of the database established to June 2017.Satisfactory randomized controlled clinical trial (RCT) or non-randomized concurrent control trial (NRCCT) were included.Meta-analysis was conducted by RevMan 5.3 software.Results Overall,10 studies involving 788 patients with ovarian cancer were included.The results of Meta-analysis showed that,compared with chemotherapy alone group,the response rate (OR=1.93,95％CI:1.36-2.74,P=0.0002),disease control rate (OR=2.42,95％CI:1.46-4.02,P=0.0007),1-year survival rate (OR=2.71,95％CI:1.46-5.03,P=0.002),2-year survival rate (OR=2.30,95％CI:1.31-4.04,P=0.004) and progression-free survival (MD=3.66,95％CI:1.31-6.01,P=0.002) in the chemotherapy combined with adoptive transfer of CIK group were improved.However,there were no significant differences between two groups in overall survival (MD=4.75,95％CI:-3.58 -13.07,P=0.26).Conclusion For patients with ovarian cancer,the adoptive transfer of CIK can improve the efficacy of chemotherapy and delay progression,but it has no significant effect on the overall survival.

OBJECTIVE NCCN guidelines recommend that anti-VEGF or anti-EGFR as a standard regimen for first-line treatment of metastatic colorectal cancer (mCRC)with RAS wild-type,but there is no systematic review to eval-uate the prognosis difference between anti-VEGF and anti-EGFR in metastatic colorectal cancer.The effect of anti-EGFR and anti-EGFR targeted drug combined with chemotherapy on metastatic colorectal cancer was analyzed.METHODS Co-chrane,Pubmed,Web of Science,Embase,clinical trial database were retrieved by computer,and the reference were retro-spectively reviewed.Head-to-head randomized controlled trials (RCTs)of anti-VEGF combined with chemotherapy versus anti-EGFR combined with chemotherapy in the treatment of metastatic colorectal cancer (mCRC)were collected.Quality Evaluation Criteria was performed according to the Cochrane System Evaluation Manual 5.3.Stata 12.0 Software and Revman 5.3 were used for meta-analysis.RESULTS Three randomized controlled trials involving 2014 participants,meta-analysis showed that mCRC patients who received either anti-VEGF or anti-EGFR combined with chemotherapy,regard-less of KRAS wild type (HR =1.03,95%CI:0.93- 1.13)or RAS wild type (HR=0.91,95%CI:0.74- 1.13),PFS were not statistically significant.OS in patients receiving first-line anti-EGFR treatment was prolonged compared with pa-tients receiving anti-VEGF therapy (KRAS wild-type HR = 0.82,95% CI:0.72 - 0.93,RAS wild-type HR = 0.79, 95%CI:0.67-0.93).KRAS wild-type mCRC patients receiving anti-EGFR chemotherapy compared to anti-VEGF com-bined with chemotherapy had a more significant increase in ORR (RR=0.84,95%CI:0.76-0.94),This effect was even stronger for all RAS wild-type patients (RR=0.80,95%CI:0.68-0.93).Regardless of the use of anti-EGFR or anti-VEGF combined with chemotherapy,left colorectal cancer patients were significantly better than those with right-sided co-lon cancer(PFS,HR=0.64,95%CI:0.45 -0.91,OS,HR=0.53,95%CI:0.36-0.76).CONCLUSIONS As the first-line treatments for mCRC with KRAS or RAS wild-type,anti-EGFR monoclonal antibody may be a substitute for anti-VEGF treatment as the best initial treatment.For the tumor location,regardless of what kind of targeted drug treatment, left colon cancer patients have better survival advantage than the right colon cancer.

Objective:To investigate the effects of RNA interference(RNAi)-mediated silencing of Peroxiredoxin 1(PRDX1)gene on the invasion and migration of human colorectal cancer SW480 cells.Methods: Lentiviruses negative control vector and PRDX1 RNAi were transfected respectively into colorectal cancer SW480 cells.The transfected cells were divided into PRDX1 silencing group(si-PRDX1)and negative control group(Vector).The expressions of PRDX1 mRNA and protein in SW480 cells were exa mined by quantitative real-time PCR(qRT-PCR)and immunoblotting(Western blot),respectively.The cell migration and invasion capabilities were evaluated with transwell chamber assay and transwell chamber,respectively.The protein expressions of TIMP-2,MMP-2 and MMP-9 were detected by Western blot.Results: Compared with control group,the expressions of PRDX1 mRNA and protein were significantly decreased in PRDX1 silencing group(P<0.01),PRDX1 gene silencing cell line was successfully constructed.The levels of invasion and migration capacities of SW480 cells transfected with si-PRDX1 were lower than those in the cells transfected with control-siRNA(vector)(P<0.01).The expression of TIMP-2 was significantly increased,while the expressions of MMP-2 and MMP-9 were significantly decreased(P<0.05).Conclusion: Silencing of PRDX1 inhibits the invasion,migration and metastasis of human colorectal cancer SW480 cells by regulating the expressions of TIMP-2,MMP-2 and MMP-9.

Objective To explore the effect of neoadjuvant chemotherapy combined with radical surgery for treating patients with stage Ⅰ,Ⅱ cervical cancer.Methods The data sources for the search included PubMed,The Cochrane Library,Embase,Web of Science,CNKI and Wanfang Data.Inclusion criteria included studies published from 2000 to 2016,and FIGO stages [to Ⅱ.All eligible documents were assessed for quality and extracted data was performed by a Meta-analysis.The statistical analysis was performed using Review Manager 5.3 software.Results Data was collected from 1351 patients enrolled in 10 randomized controlled trials.The results of Meta-analysis showed that,compared with the RST alone group,the NACT group was superior in reducing the incidence of lymph node metastasis (OR=0.37,95％CI:0.26-0.53,P ＜ 0.000 01),incidence of lymphovascular space invasion (OR =0.51,95％CI:0.28-0.94,P =0.03) and the incidence of positive parametrial involvement (OR =0.60,95％CI:0.43-0.84,P =0.003).However,there were no significant differences between two groups in 1-year survival rate (OR =1.15,95％CI:0.40-3.32,P =0.79),3-year survival rate (OR =1.05,95％CI:0.73-1.51,P =0.80) and 5-year survival rate (OR =1.50,95％CI:0.77-2.92,P =0.23).Conclusion For stage Ⅰ,Ⅱ cervical cancer patients,neoadjuvant chemotherapy can reduce the incidence of high-risk pathology,but it has no significant effect on the survival of patients.Due to the limitation of quantity and quality of the included studies,more high quality studies are needed to verify the above conclusion.

Objective This paper aims to assess the clinical efficacy of pemetrexed maintenance therapy in patients with advanced non-small cell lung cancer( NSCLC) through Meta analysis.Me thods Systematic lit-erature searches were performed in Cochrane、Pubmed,Web of science, Embase and ClinicalTrials databases.The related references had been traced.We made quality assessment of qualified randomized controlled trials( RCTs) of pemetrexed maintenance therapy compared with best supportive care( BSC) in advanced NSCLC.Besides,we u-tilized stata 12.0,Revman 5.3 and GRADEpro software to evaluate the overall quality of the evidence,according to the Cochrane collaboration to perform Meta-analysis.Resutl s Three RCTs were eligible and included 1257 patients.Meta-analysis results suggested that:compared to BSC,pemetrexed maintenance therapy had a statisti-cally significant benefit in improving progression-free survival(PFS)(HR =0.55,95% CI:0.48~0.64)and overall survival(HR=0.76,95%CI:0.65~0.88).The objective response(ORR)did not reach statistical signif-icance(RR=0.97,95%CI:0.86~1.10).Conclusion Compared with BSC,pemetrexed maintenance therapy statistically significantly improve PFS and OS,but has no demonstrable impact on ORR in patients with advanced NSCLC.

Objective To investigate the clinical pathological factors related to recurrence and metastasis of colorectal cancer patients treated with resection ,expect to improve the treatment effects .Methods The clinicopathologic and follow-up data of 212 patients with stage Ⅰ - Ⅲ colorectal cancer patients treated with resection from January 2009 to December 2013 were retrospec-tively analyzed by univariate and multivariate Logistic regression methods .Results Univariate analysis showed that T staging sys-tems ,gross type ,intestinal obstruction or perforation ,lymphatic and vascular invasion were correlated to recurrence of colorectal cancer after operation(P< 0 .05) ;age ,tumor size ,lymph node involvement ,T staging systems ,histological differentiation ,intestinal obstruction or perforation ,lymphatic and vascular invasion were correlated to metastasis of colorectal cancer after operation(P <0 .05) .Multivariate Logistic regression analysis showed that age ,tumor size and histological differentiation were independent factors for metastasis rate of colorectal cancer after operation(P< 0 .05) .There were no significant differences in Logistic regression analy-sis for recurrence(P> 0 .05) .Conclusion Age ,tumor size and histological differentiation are independent factors for metastasis rate of colorectal cancer after operation .