ObjectiveTo systematically review the efficacy and safety of gefitinib versus pemetrexed as second-line treatment for advanced non-small cell lung cancer (NSCLC). MethodsDatabases including PubMed, The Cochrane Library (Issue 4, 2016), EMbase, CNKI, VIP and WanFang Data were searched to collect randomized controlled trials (RCTs) about gefitinib versus pemetrexed as second-line treatment for advanced NSCLC from inception to April 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was performed by using RevMan 5.3 software. ResultsA total of 11 RCTs involving 1 005 patients were finally included. The results of meta-analysis showed that: the rate of progression free survival (PFS) in the gefitinib group was superior to the pemetrexed group (HR=0.59, 95%CI 0.47 to 0.73, P<0.000 01). However, there were no significant differences between two groups in overall response rate (RR=1.28, 95%CI 0.86 to 1.90, P=0.22), disease control rate (RR=0.92, 95%CI 0.77 to 1.12, P=0.41) and the rate of overall survival (HR=0.75, 95%CI 0.56 to 1.01, P=0.05). The incidences of skin rash (RR=8.72, 95% CI 3.65 to 20.84, P<0.000 01) and diarrhea (RR=2.87, 95% CI 1.29 to 6.38, P=0.01) were significantly higher, but the incidences of neutropenia (RR=0.12, 95%CI 0.05 to 0.26, P<0.000 01) and fatigue (RR=0.46, 95%CI 0.30 to 0.72, P=0.000 6) were lower in the gefitinib group than those in the pemetrexed group. ConclusionGefitinib shows more superiority to pemetrexed, and it can be used as the second-line drug for advanced NSCLC． Due to the limited quality and quantity of included studies, more high quality studies are needed to verify the above conclusion.
ObjectiveTo discuss clinical significance of total endoscopic thyroidectomy (TET) via chest-breast approach. MethodsThe clinical data of 890 patients with thyroid diseases from September 2008 to September 2015 in this hospital were analyzed retrospectively. These patients were divided into TET group (received TET, n=420) and traditional group (received traditional thyroidectomy, n=470). The data of operation and postoperative recovery were compared between these two groups. ResultsThere was no significant difference between the TET group and the traditional group in the operation time [(73.571 4±28.533 9) min versus (70.212 8±27.199 8) min, t=1.80, P=0.072 7], bleeding volume [(30.714 3±14.225 1) mL versus (29.106 4±13.559 1) mL, t=1.73, P=0.084 8], postoperative drainage [(60.000 0±27.287 9) mL versus (56.595 7±27.803 5) mL, t=1.84, P=0.066 2], postoperative hospitalization time [(5.333 3±1.085 1) d versus (5.446 8± 1.089 0) d, t=1.55, P=0.120 4], postoperative 24 h pain score [(5.333 3±2.308 7) points versus (5.404 3±2.182 1) points, t=0.47, P=0.637 8] and postoperative injury rate of recurrent laryngeal nerve [0.714 2% (3/420) versus 0.851 1% (4/470), x2=0.053 2, P=0.817 6] and hypoparathyroidism rate [0.476 2% (2/420) versus 0.851 1% (4/470), x2=0.465 5, P=0.495 1]. The score of aesthetic effect of incision on day 7 after operation in the TET group was significantly higher than that in the traditional group [(7.809 5±1.296 9) points versus (3.361 7±1.391 8) points, t=49.14, P < 0.000 1]. ConclusionTET is safe and effective, and could improve cosmetic effect for patients with thyroid diseases.
ObjectiveTo systematically review the efficacy and safety of intrapleural injection of endostar combined with cisplatin in treatment of non-small cell lung cancer (NSCLC) with malignant pleural effusion. MethodsDatabases including PubMed, The Cochrane Library (Issue 2, 2016), EMbase, Web of Science, CNKI, VIP and WanFang Data were searched to collect randomized controlled trials (RCTs) about endostar combined with cisplatin for NSCLC with malignant pleural effusion from inception to February 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was performed by using RevMan 5.3 software. ResultsA total of 10 RCTs involving 610 patients were finally included. The results of meta-analysis showed that: The overall response rate and the improvement rate of quality of life in the endostar combined with cisplatin group were higher than that of the cisplatin alone group (RR=1.71, 95%CI 1.49 to 1.95, P<0.00001; RR=1.68, 95%CI 1.44 to 1.96, P<0.00001, respectively). However, There were no significant differences between two groups in incidence of gastrointestinal reaction, incidence of leucopenia and incidence of thrombocytopenia (all P values>0.05). ConclusionCompared with cisplatin, intrapleural injection of endostar combined with cisplatin can improve the overall response rate and improve the quality of life of NSCLC patients with malignant pleural effusion. Due to the limited quality and quantity of included studies, more high quality studies are needed to verify the above conclusion.
ObjectiveTo investigate the effect of surgery and influence of posttreatment with non-standardized and standardized operation by reviewing and analyzing the sporadic medullary thyroid carcinoma operation cases. MethodsThe clinical data of 26 patients with sporadic medullary thyroid carcinoma treated by surgery from January 2000 to March 2013 in this hospital were analyzed retrospectively.These patients were divided into non-standardized operation group and standardized operation group (total thyroidectomy with lymph node dissection) according to the operation models.The biochemical cure rate, the complication rates of recurrent laryngeal nerve injury and hypopara-thyroidism of these two groups were investigated and compared. ResultsThe 1-year biochemical cure rate had no statistical difference between the non-standardized operation group and standardized operation group (84.21% versus 100%, χ2=1.249 4, P > 0.05), the 1-year recurrence rate was 15.79% and 0, respectively.The 5-year biochemical cure rate of the standardized operation group was significantly higher than that of the non-standardized operation group (100% versus 16.67%, χ2=4.444 4, P < 0.05).The 5-year recurrence rate was 0 and 83.33%, respectively.However, there was no obvious difference between the two groups on the injury rate of recurrent laryngeal nerve (χ2=0.070 8, P > 0.05), as well as the rate of hypoparathyroidism (χ2=2.722 7, P > 0.05). ConclusionsCompared with the non-standardized model, the standardized operation model (total thyroidectomy with lymph node dissection) shows a higher cure rate and a lower recurrent rate, and it does not increase the complication rates of hypoparathyroidism and recurrent laryngeal nerve injury