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Background/Aim: Irritable Bowel Syndrome (IBS) is a common chronic functional bowel disorder and the evidence shows most drug therapies in the treatment of IBS are weak. Recently, some studies showed probiotics may have a positive effect in IBS and they are widely used to improve the symptom of IBS, which indicate probiotics may play an important role in the treatment of IBS. However, the exact effectiveness and safety of probiotics are largely unknown. This systematic review focuses on identifying the efficacy and safety of probiotics in the treatment of IBS. Materials and Methods: Data sources were searched up to February 2019. Databases included MEDLINE, CENTRAL, CINAHL, and Embase. Randomized controlled trials (RCTs) comparing probiotics including complex or individual probiotics with placebo or no therapy were screened, extracted, and appraised by two independent reviewers. The data were pooled using a random-effects model. The methodological quality of all RCTs was assessed using the Cochrane risk of bias and Jadad scale. Outcomes included symptom-relevant and patient-relevant characteristics, such as symptom relief, abdominal pain, bloating, flatulence, quality of life, and adverse event. Results: This review includes 28 studies with a total of 3606 participants. Particular combinations of probiotics, or specific species and strains, showed probiotics have beneficial effect on overall IBS symptoms (22 studies, n = 3144, RR of improvement in overall IBS symptoms = 1.5, CI 1.23 to 1.83) or overall IBS symptom and abdominal pain scores (18 studies, n = 2766, SMD = -0.31, CI -0.45 to -0.17). In addition, adverse events were not significantly higher with probiotics (8 studies, n = 923, RR = 1.05; 95% CI 0.85-1.31). However, there was no significant benefit on individual IBS symptom scores and quality of life. Conclusion: Current evidence shows particular combinations, species or strains of probiotics are effective for overall IBS symptoms. However, it is hard to derive a definite conclusion due to high heterogeneity and unclear risk of bias of some trials. Large well-designed and rigorous trials are warranted.

Background Diarrhea is a common adverse reaction in patients with cancer receiving chemotherapy, for which there is currently no effective method of treatment. Shengjiang Xiexin decoction (SXD), a classic traditional Chinese medicine (TCM) formula, has shown efficacy in alleviating irinotecan-induced diarrhea in preliminary clinical studies. The current study is designed to assess the efficacy and safety of SXD for prophylaxis against irinotecan-induced diarrhea. Additionally, we employ a new approach to analyze and evaluate the data based on the patients’ uridine diphosphate glucuronosyltransferase 1A1 (UGT1A1) genotype, which predicts the risk of diarrhea. Methods and design A prospective, double-blind, randomized, placebo-controlled trial will be conducted in patients with small cell lung cancer (SCLC) from five hospitals in China. For this study, 100 irinotecan-naïve patients will be randomly allocated to either the SXD or placebo arms in a 1:1 ratio. Stratified randomization will be used to divide subjects by UGT1A1 genotype into groups with differing risk of diarrhea. The trial will consist of two cycles of chemotherapy with 14 days of oral administration of SXD or placebo administered beginning between 3 days before and up to 11 days after initiation of each chemotherapy cycle. The primary study outcome is the incidence of diarrhea. Secondary outcomes include the degree of diarrhea, the degree of neutropenia, the rate of alterations in chemotherapy regimens, the amount of antidiarrheal drug taken, the rate of hospitalization, and evaluation of chemotherapy efficacy. Discussion This study is the first to use the UGT1A1 genotype to stratify patients into groups based on their risk of diarrhea, and to provide a complete assessment of chemotherapy-related diarrhea (CRD), including records of diarrhea duration, grading the severity of diarrhea, and evaluating concomitant symptoms. Study results will provide high-level clinical evidence on the use of SXD as prophylaxis for CRD. Trial registration Chinese Clinical Trial Register: ChiCTR1800018490. Registered on 20 September 2018. Retrospectively registered. http://www.chictr.org.cn/edit.aspx?pid=25250&htm=4c

OBJECTIVE To evaluate vitality principle in breast cancer rats by pharmacologically developing a model for anticancer surveillance. METHODS The breast cancer in rats was replicated with 7,12-Dimethylbenz[a]anthracene (DMBA, i.g., 100 mg/kg) at d001. The anticancer surveillance was defined as the intervals between the primary sensitization and the first challenge stirred with complete Freund's adjuvant (CFA), the various intervals (k = 0.80) were dominated from d025 (600.00 h) to d095 (2288.82 h). The optimal surveillant status was confirmed with the median effective interval (EI50) from tumor volume regressive curve, for developing the pharmacodynamic model. The tumor and tumor infiltrating lymphocyte histopathology was used to confirm the immune surveillance being affected with CFA in breast cancer tumorigenesis. The availability of this model was confirmed with Shugan Liangxue prescription (SLP), from the vitality principle, and assured further from interleukin-12 levels. RESULTS The regressive curve was set up between the intervals and tumor volumes, the EI50 in SLP-treated rats (1475.00 h, YSLP = 0.1026 + 0.8780/[1 + 10(27.1425-8.565×)]) was postponed, which was 1.87 multiple of the EI50 in CFA rats (791.40 h, y = −0.0525 + 0.9452/[1 + 10(30.4870-10.52×)], so did prepone the curve between the intervals and the immunological biomarker, serum inter-leukin-12 levels, the EI50 in SLP-treated rats (744.90 h, YSLP = −0.0145 + 0.7455/[1 + 10(52.09636-18.13×)]) be 0.78 multiple of the EI50 in CFA rats (960.10 h, YCFA = 0.2460 + 0.7270/[1 + 10(− 67.1546 + 22.52×)]), this immunological action being mediated the anticancer prognosis. Tumor histology was confirmed the more tumor infiltrating lymphocytes activated in SLP rats with CFA stirred immunity than rats only received CFA. CONCLUSION The model for anticancer surveillance was pharmacologically established as the optimal interval (791.40 h) between the primary sensitization and the first challenge stirred with complete Freund's adjuvant. This available model was confirmed with SLP, from the vitality principle, for evaluating immunological effects against breast cancer.

Background: In a phase III study, sunitinib led to a significant increase in progression-free survival (PFS) versus placebo in patients with pancreatic neuroendocrine tumours (panNETs). This study was a post-marketing commitment to support the phase III data. Methods: In this ongoing, open-label, phase IV trial (NCT01525550), patients with progressive, advanced unresectable/metastatic, well-differentiated panNETs received continuous sunitinib 37.5 mg once daily. Eligibility criteria were similar to those of the phase III study. The primary endpoint was investigator-assessed PFS per Response Evaluation Criteria in Solid Tumours v1.0 (RECIST). Other endpoints included PFS per Choi criteria, overall survival (OS), objective response rate (ORR), and adverse events (AEs). Results: Sixty-one treatment-naive and 45 previously treated patients received sunitinib. By March 19, 2016, 82 (77%) patients had discontinued treatment, mainly due to disease progression. Median treatment duration was 11.7 months. Investigator-assessed median PFS per RECIST (95% confidence interval [CI]) was 13.2 months (10.9–16.7): 13.2 (7.4–16.8) and 13.0 (9.2–20.4) in treatment-naive and previously treated patients, respectively. ORR (95% CI) per RECIST was 24.5% (16.7–33.8) in the total population: 21.3% (11.9–33.7) in treatment-naive and 28.9% (16.4–44.3) in previously treated patients. Median OS, although not yet mature, was 37.8 months (95% CI, 33.0–not estimable). The most common treatment-related AEs were neutropenia (53.8%), diarrhoea (46.2%), and leukopenia (43.4%). Conclusions: This phase IV trial confirms sunitinib as an efficacious and safe treatment option in patients with advanced/metastatic, well-differentiated, unresectable panNETs, and supports the phase III study outcomes. AEs were consistent with the known safety profile of sunitinib.

Introduction Inflammation, ulcer, reflux, polyp, and metaplasia or dysplasia of the upper gastrointestinal tract are frequently encountered non-malignant upper gastrointestinal disorders (NUGDs) in clinical practice. Abnormal tongue features (ATFs) are a series of morphological changes occurring on the dorsal surface of the tongue according to traditional Chinese medicine theory. Red tongue, purple tongue, yellowish, greasy tongue, fissured tongue, teeth-printed tongue, ecchymotic tongue, peeled or geographically coated tongue are the most frequently encountered ATFs and show a close relationship to chronic diseases. This study was to investigate the prevalence of ATFs in NUGDs and to explore the potential correlation between them. Methods This was a cross-sectional study conducted at China–Japan Friendship Hospital, China. Patients aged over 18 years old and met the standards set for upper gastrointestinal endoscopy in the endoscopic center were included. The tongue images of all the participants were captured using a smart phone. The seven ATFs were determined using a manual-interpretation-based, computer-aided tongue diagnosis method by three TCM practitioners.The participants were then categorized into different NUGDs according to endoscopic findings and pathological examinations. Chi-square test was performed to analyze the distribution differences of ATFs by gender and age. Univariate and multivariate logistic regression analyses were used to determine the relationship between ATFs and NUGDs. Results Among disease manifestations, inflammation (98.2%) and gastroesophageal reflux disease (62.4%) were highly prevalent, whereas fissured tongue (34.3%) was the most common ATF. The prevalence of ATFs was significantly influenced by gender and age. Fissured tongue, red tongue, and yellowish, greasy tongue (all P Conclusion Fissured tongue was found to be related to the UGPLs. Since the participants of this study were from a hospital-based population, a multi-center, community-based study is warranted to confirm these results in the future.

Meckel diverticulum is one of the most important causes of small bowel bleeding in children. Reports suggest that ultrasonography can be used as an alternative examination for children with negative radionuclide scanning results or children with atypical clinical manifestations. To evaluate the diagnostic accuracy of high-frequency ultrasound in children with bleeding Meckel diverticulum. We collected the data of children who were admitted to our hospital for the main symptom of bloody stool from February 2006 to December 2017. Ultrasonography was performed in all children. The final diagnosis was confirmed by pathological analysis or clinical follow-up observation. We evaluated the diagnostic performance of ultrasonography according to the final diagnosis. A total of 784 eligible children were enrolled in the study. Presenting symptoms or findings included black and red stool in 528 (67.3%), bright red stool in 51 (6.5%) and obscure or occult bloody stool in 205 (26.1%). Anemia was diagnosed in 489 (62.4%). Ultrasonography diagnosed Meckel diverticulum with a sensitivity of 93.6% (95% confidence interval [CI] 91.0–95.6%) and a specificity of 98.1% (95% CI 95.9–99.3%). High-frequency ultrasound diagnosis of Meckel diverticulum in children has high sensitivity and specificity.

OBJECTIVES The purpose of this study was to investigate the potential utility of shear wave elastography (SWE) for diagnosis of biliary atresia and for differentiating biliary atresia from infantile hepatitis syndrome by measuring liver stiffness. METHODS Thirty-eight patients with biliary atresia and 17 patients with infantile hepatitis syndrome were included, along with 31 healthy control infants. The 3 groups underwent SWE. The hepatic tissue of each patient with biliary atresia had been surgically biopsied. Statistical analyses for mean values of the 3 groups were performed. Optimum cutoff values using SWE for differentiation between the biliary atresia and control groups were calculated by a receiver operating characteristic (ROC) analysis. RESULTS The mean SWE values ± SD for the 3 groups were as follows: biliary atresia group, 20.46 ± 10.19 kPa; infantile hepatitis syndrome group, 6.29 ± 0.99 kPa; and control group, 6.41 ± 1.08 kPa. The mean SWE value for the biliary atresia group was higher than the values for the control and infantile hepatitis syndrome groups (P < .01). The mean SWE values between the control and infantile hepatitis syndrome groups were not statistically different. The ROC analysis showed a cutoff value of 8.68 kPa for differentiation between the biliary atresia and control groups. The area under the ROC curve was 0.997, with sensitivity of 97.4%, specificity of 100%, a positive predictive value of 100%, and a negative predictive value of 96.9%. Correlation analysis suggested a positive correlation between SWE values and age for patients with biliary atresia, with a Pearson correlation coefficient of 0.463 (P < .05). CONCLUSIONS The significant increase in liver SWE values in neonates and infants with biliary atresia supports their application for differentiating biliary atresia from infantile hepatitis syndrome.

e21590 Background: Lung cancer remains the leading cause of cancer-related death in China. DCVAC/LuCa is an active autologous cellular immunotherapy consisting of autologous DCs loaded with NSCLC antigens from NSCLC cell lines. SQFZ is a kind of TCM injection commonly uesed for NSCLC, made from Ginseng and Astragalus membranaceus. Intent of this study is to evaluate the efficacy and safety of DCVAC/LuCa plus chemotherapy and TCM in patients with advanced NSCLC and wild type driving gene(EGFR/ALK). Methods: This study consist of screening/leukapheresis/treatment/follow-up period. On the treatment period, chemotherapy started after leukapheresis. Four cycles are recommended with limitation to maximum 6 cycles. Up to 12 subcutaneous doses of DCVAC/LuCa treatment were administrated on the 15th day of chemotherapy cycle every 3 weeks for 4 doses, and continued alone after chemotherapy finishes/stops every 6 weeks for the remaining 8 doses. TCM therapies were administered on the -3 to 3 days of DCVAC/LuCa. After completion of the total 12 doses DCVAC/LuCa or discontinuation of study treatment, patients will be followed up until experienced OS event or till 1 year of survival time. The primary efficacy endpoint included ORR, PFS and survival. Results: 23 pts were included, 19 males and 4 females, median age 63(48-80). Pathological type:16 adenocarcinoma, 5 squamous cell carcinoma and 1 other. 7 Ⅲb and 16 Ⅳ stage. ORR was 17.39%(4/23), DCR was 60.87%(14/23). Median PFS was 10.9 months, median follow-up in surviving patients was 22.3 months, 1-year survival is currently 92.86%, 18-months survival is currently 79.59%. 1 case was diagnosed as acute myelogenous leukemia myelodysplastic syndrome after 9 doses of DCVAC/LuCa. There were no other adverse events related to DCVAC/LuCa treatment TCM therapies in this study. Conclusions: DCVAC/LuCa, combined with standard chemotherapy and TCM had exhibited the potential to improve the survival in patients with advanced NSCLC, and decrease the occurrence of adverse events. But the sample size of this study is small, a further clinical investigation is needed.

e24127 Background: RIOM is a common side effect of radiotherapy for head and neck cancer patients, however, no standard and effective treatment existed so far. WC03 is an oily Traditional Chinese Herbal Medicine recipe for external-use in mouth, which had been utilized to treat RIOM in China-Japan Friendship Hospital for more than ten years. This trial aimed to investigate the safety and efficacy of WC03 in treating RIOM. Methods: Between May 2017 and June 2018, we conducted a multicenter, non-randomized controlled trial within 7 hospitals in China. Inclusion criteria included head and neck cancer patients who developed RIOM (≥ grade II) undergoing radiotherapy or after radiotherapy (within 6 months). They were assigned to different groups based on their willingness. Patients in treatment group were treated by WC03, which was daily applied to the oral mucosa for 30 min twice a day. Patients in control group were treated with Kangfuxin (Periplaneta americana) Lotion combined with conventional treatment such as vitamin B12 and rhGM-CSF. The interventions lasted for 2 weeks. The primary outcome was overall effective rate, which was calculated through changes of radio-induced oral mucositis grade before and after interventions (according to National Cancer Institute Common Toxicity Criteria). Secondary outcome was oral pain which was measured by Numeric Pain Rating Scale. Results: 48 eligible participants were enrolled, 24 in treatment group and 24 in control group, respectively. 2 patients in treatment group were withdrawn from the study in the first week because of developing secondary infection and treatment got changed. Thus, 22 were included at the terminal of the study. All the 24 participants in control group were included. After the intervention, the overall effective rate was 95.45%(21/22) in the treatment group, which was significantly higher than that of 70.83% (17/24) in the control group (p = 0.049). Similarly, 86.36%(19/22) of the participants in treatment group got cured, which was significantly higher than that of 45.83%(11/24) in the control group(p = 0.007). There is a trend that oral pain relief rate in the treatment group was higher than that of the control group, but not statistically significant (100.00% vs. 87.50%, p = 0.210). Patients in treatment group used less time to get relieved from RIOM than control group (5 vs. 8 days, p < 0.001). No adverse event had been observed in both two groups. Conclusions: WC03 is safe and effective in treating radiotherapy-induced oral mucositis. RCT is necessary in future studies.

Background Molecular targeted anticancer drugs such as multikinase inhibitors have shown obvious therapeutic advantages in a variety of tumors. The occurrence of hand-foot skin reaction (HFSR) is positively correlated with therapeutic effect, but it is also the most common cause of dose limiting toxicity for this treatment. This can lead to interruption or decrement of the treatment, a reduction in quality of life for patients, as well as potentially leading to secondary infections. As a result, the curative effect of targeted anticancer drugs will be negatively impacted. Currently, there is no certain and effective therapy. External use of Chinese herb medicine LC09 in the early treatment of HFSR has shown positive outcomes, but it is necessary to carry out further clinical research to confirm. Objectives The purpose of this study was to investigate the efficacy and safety of topical soaks of Chinese herbal medicine LC09 for HFSR induced by molecular targeted anticancer drugs. Methods The trial is a prospective, randomized, controlled, double-blind, monocentric, and interventional study. A total of 66 patients with HFSR will be recruited and randomly assigned to receive either LC09 Granules or placebo. The primary outcomes are the assessment of HFSR grade and pain score. The secondary outcomes are the evaluation of the quality of life, incidence of targeted drug dosage reduction, and incidence of targeted drug withdrawal. Discussion This prospective, randomized clinical trial will provide valuable data regarding the efficacy and safety of topical soak treatments with LC09 granules for HFSR. Positive results would provide evidence-based complementary therapeutic approach future treatments of HFSR. Trial registration Chinese Clinical Trial Registry, http://www.chictr.org.cn, ChiCTR1900023679. Registered on 7 June 2019.

The aim of the present study was to prospectively evaluate the clinical efficiency of 2-D shear wave elastography (2-D-SWE) for differentiating hepatoblastoma and hepatic hemangioma in children under 3 y of age. 2-D-SWE was performed in 109 consecutive patients with confirmed hepatic neoplasms by pathologic analysis or contrast-enhanced computed tomography plus follow-up observation, in which 71 patients were defined as the test group, and the remaining 38 patients were defined as the validation group. An elasticity value was obtained from each lesion. The diagnostic performance and optimal cut-off value were determined by receiver operating characteristic (ROC) analysis in the test group, and the accuracy of this threshold was analyzed in the validation group. The interclass correlation coefficient (ICC) and Spearman rank correlation tests were applied to assess the reproducibility of elastic measurement and the relationship between the elasticity value and potential influencing parameters. The mean elasticity values were 58.4 ± 19.5 kPa for hepatoblastoma and 19.0 ± 16.0 kPa for hemangioma (Z = –7.685, p = 0.000). The cut-off value in the test group was 39.5 kPa with an area under the ROC curve for differentiation of 0.915, sensitivity of 88.1% and specificity of 86.2%. The accuracy of this threshold in the validation group was 86.8%. The ICCs for inter- and intra-observer reproducibility for acquisition of the elastic measurement were 0.946 and 0.971, respectively. No significant correlation was found between the elasticity value and age for either hemangioma (r = 0.205, p = 0.167) or hepatoblastoma (r = 0.047, p = 0.715). The elasticity value was positively correlated with lesion size (r = 0.332, p = 0.023) in patients with hemangioma but not in patients with hepatoblastoma (r = 0.222, p = 0.082). As a complementary method, 2-D-SWE may aid the differentiation of hepatoblastoma and hemangioma.

Background: Oral mucositis (OM) is a common and unavoidable side effect in patients suffering from head and neck cancer who are undergoing radiotherapy. It is characterized by unbearable pain, as well as eating and speech disorders. This has serious negative effects on the patients’ quality of life and can even reduce radiotherapy tolerance, ultimately resulting in a poor prognosis. At present, many prevention and treatment methods are still in the experimental stage, and the efficacies are controversial. Methods: Four English databases: Medline via pubmed, EMBASE, the Cochrane Library, Web of Science and another 4 Chinese databases: China National Knowledge Infrastructure (CNKI), China Science and Technology Journal database (VIP), Wanfang Database and CBM, will be searched from inception to August 2019. All randomized controlled trials in Chinese and English language will be included. Literature selection, data extraction and quality assessment will be completed by 2 independent authors. The primary outcomes will include the incidence of OM (1–4 grade) and the pain degree. The onset time of OM, the improvement rate for quality of life, and any adverse effects will be evaluated as the secondary outcomes. The data will be synthesized by Review Manager and Stata software. Results: This study provides a high-quality synthesis from existing evidence for Chinese herbal medicine in radiotherapy induced OM treatment, according to the criteria: incidence of OM, onset time of OM, status changes in quality of life and adverse events. Conclusion: This study will provide evidence to help determine whether Chinese herbal medicine is effective and safe for use in the prevention and/or treatment of radiotherapy induced OM. Ethics and dissemination: No additional formal ethical recognition or informed consent is required since no primary data collection is involved. The study result will be published in peer-reviewed journals or at related conferences. PROSPERO registration number: PROSPERO CRD42019141900.

Chemotherapy-induced peripheral neuropathy (CIPN) is a serious dose-limiting toxicity of many anti-neoplastic agents, especially paclitaxel, and oxaliplatin. Up to 62% of patients receiving paclitaxel regimens turn out to develop CIPN. Unfortunately, there are so few agents proved effective for prevention or management of CIPN. The reason for the current situation is that the mechanisms of CIPN are still not explicit. Traditional Chinese Medicine (TCM) has unique advantages for dealing with complex diseases. Wen-Luo-Tong (WLT) is a TCM ointment for topical application. It has been applied for prevention and management of CIPN clinically for more than 10 years. Previous animal experiments and clinical studies had manifested the availability of WLT. However, due to the unclear mechanisms of WLT, further transformation has been restricted. To investigate the therapeutic mechanisms of WLT, a metabolomic method on the basis of UPLC- MS was developed in this study. Multivariate analysis techniques, such as principal component analysis (PCA) and partial least squares discriminate analysis (PLS-DA), were applied to observe the disturbance in the metabolic state of the paclitaxel-induced peripheral neuropathy (PIPN) rat model, as well as the recovering tendency of WLT treatment. A total of 19 significant variations associated with PIPN were identified as biomarkers. Results of pathway analysis indicated that the metabolic disturbance of pathways of linoleic acid (LA) metabolism and glycerophospholipid metabolism. WLT attenuated mechanical allodynia and rebalanced the metabolic disturbances of PIPN by primarily regulating LA and glycerophospholipid metabolism pathway. Further molecular docking analysis showed some ingredients of WLT, such as hydroxysafflor yellow A (HSYA), icariin, epimedin B and 4-dihydroxybenzoic acid (DHBA), had high affinity to plenty of proteins within these two pathways.

After a thorough search through the database as PubMed database and Embase database, the clinical experimental articles have been selected out on the effects of early surgery on the treatment of active native infective endocarditis. The quality of the trials included in this study was assessed by researcher according to the Cochrane Handbook for Systematic Reviews of Interventions, version 5.1.0. A meta-analysis was carried out in terms of clinical efficacy criteria by RevMan 5.3 software. Based on the results, we cautiously conclude that early surgery used for active native infective endocarditis could reduce in-hospital mortality, follow-up mortality, and IE-related mortality.

Background. Treatment of chemotherapy-induced peripheral neuropathy (CIPN) remains a big challenge for oncologists. The aim of this study is to evaluate the effects of Radix Astragali- (RA-) based Chinese herbal medicine in the prevention and treatment of oxaliplatin-induced peripheral neuropathy, including the incidence and grading of neurotoxicity, effective percentage, and nerve conduction velocity.Methods. All randomized controlled trials (RCTs) were found using PubMed, Cochrane, Springer, China National Knowledge Infrastructure (CNKI), and Wanfang Database of China Science Periodical Database (CSPD) by keyword search. Meta-analysis was conducted using RevMan 5.0.Results. A total of 1552 participants were included in 24 trials. Meta-analysis showed the incidence of all-grade neurotoxicity was significantly lower in experimental groups and high-grade neurotoxicity was also significantly less. Effective percentage was significantly higher and sensory nerve conduction velocity was improved significantly, but changes in motor nerve conduction velocity were not statistically significant. No adverse events associated with RA-based intervention were reported.Conclusion. RA-based intervention may be beneficial in relieving oxaliplatin-induced peripheral neuropathy. However, more double-blind, multicenter, large-scale RCTs are needed to support this theory.Trial Registration. PROSPERO International prospective register of systematic reviews has registration number CRD42015019903.

To retrospectively compare contrast-enhanced multislice computed tomography (MSCT) and ultrasound (US) imaging for the assessment of cystic renal masses in children using the Bosniak classification system. Twenty-two consecutive patients (age 1 month to 5.2 years, mean 2.4 years) with 24 cystic renal masses (7 benign, 17 malignant) pathologically confirmed after surgical resection underwent both MSCT and US imaging, and were retrospectively analyzed using the Bosniak classification. A senior and a junior radiologist retrospectively and independently reviewed imaging findings. The sensitivity, specificity, positive predictive value and negative predictive values of MSCT and US were assessed using diagnostic statistics. The statistical significance of differences was determined by the McNemar test. Both radiologists accurately predicted lesions of categories I and IV with the Bosniak classification using MSCT and US. All masses classified as Bosniak classes I and II were proven to be benign, and all malignant lesions were correctly characterized in all cases both on ultrasound images and on the contrast-enhanced CT (CECT) images. Two benign multilocular cystic nephromas and one multicystic dysplastic kidney were classified into category III or even IV based on the classification scheme because of their multilocular nature and thick septation. The diagnostic accuracy of CECT was slightly better than ultrasound (CECT vs. US: senior reader, 92% vs. 88%; junior reader, 88% vs. 83%). However, there was no statistically significant difference between the two sets (p>0.05). The two radiologists had perfect inter-observer agreement on the two modalities. Both MSCT and US provide highly accurate diagnosis for the malignant renal cystic masses in children using the Bosniak classification system, but assessment of benign masses still needs improvement. We would recommend US is the best screening modality in Bosniak I and II, In Bosniak III and IV, MSCT are first the choice.

e15579 Background: More than 50% esophageal cancer cases of the world are in China. The main causative factors that contribute to extremely high incidence of esophageal cancer (9.15/ million) in certain rural areas of China has not yet been elucidated. Screening and diagnosis of precancerous lesions and early stage cancer are main neasures of decreasing incidence rate and mortality rate. Methods: High-risk population (40-69 years old) in high risk areas of esophageal cancer, Cixian and Yangcheng were screened, and 4742 cases were included. They were divided into 4 groups: normal group, esophagitis/gastritis, esophageal neoplasia low-level group and esophageal neoplasia high-level group, according to pathology and electronic gastroscope diagnosis. Diagnostic testing lingual information collection system (DS01-B) was used and tongue image were collected, including tongue color, coating color, fur character, tongue shape, local ecchymosis, et al. Difference of tongue image information was analyzed by multi-factor logistic regression using SPSS and R statistical software. Results: Logistic regression analysis showed that dark purplish tongue colour, and tongue local ecchymosis were correlated to precancerous lesions and early stage cancer (P < 0.01 or P < 0.05). Red and crimson tongue, yellow and white coated tongue, spotted tongue and tongue local ecchymosis were correlated to esophagitis and gastritis(P < 0.01 or P < 0.05). Logistic regression model had diagnostic total coincidence rate (69.4%) for early esophageal cancer screening. Conclusions: Multi-factor logistic regression model based on tongue image information has clinical value of prediction esophageal precancerous lesion.

Objective China is experiencing a rapid increase in cancer incidence in elderly patients. In order to better understand this group, a large study of patients from multiple tertiary centers in the Beijing area was designed. This study was designed to provide insight into their unique treatment preferences, including the use of traditional Chinese medicine (TCM). Materials and Methods 803 patients from nine hospitals in the Beijing area were enrolled into this study. The inclusion criteria were patients who were 65 years or older and had a diagnosis of cancer at any stage. The CGA questionnaire used with these patients included the Chinese translation of the Gero-Oncology Health and Quality of Life Assessment tool. The questionnaire was provided to patients by a research nurse and was administered in Mandarin. Results The mean age of the patients was 72 years (range 65–94). The patients were mainly male (59.8%) and of Han ethnicity (95.4%). About 45% of these patients also had concurrent TCM in addition to their other cancer treatments. About 70% were able to manage their activities of daily living without assistance. Patients on TCM were more likely to have higher number of co-morbidities compared to their counterparts. Conclusion This is the largest prospective study of CGA assessments done on elderly patients with cancer in Asia. The study demonstrates that CGA provides insights into understanding the needs of elderly Chinese patients with cancer. TCM is used frequently in China, and its impact on quality of life needs further investigation.

A patient with angina pectoris and Sheehan's syndrome underwent off-pump coronary bypass grafting. Perioperative hydrocortisone and oral thyroxin replacement were used, and no relative complication was found postoperatively. Careful perioperative hormonal management is necessary and safe for patients with hypopituitarism to receive off-pump coronary artery bypass grafting.

e12006 Background: Capecitabine(Cape) maintenance therapy after response to Cape-based combination chemotherapy(chemo) is one of the standard regimens recommended by NCCN for metastatic breast canc...

e15164 Background: The diagnosis and management of gastric neuroendocrine neoplasms (g-NENs) is not familiar to most physicians even cancer doctors due to its low incidence, and misdiagnosis and mistreatment (overtreatment or undertreatment) have occurred occasionally.Here we reported our center experiences on subtype classification and management of 39 cases with g-NENs, with the aim of promoting standardized diagnosis and treatment of g-NENs in China. Methods: Patients from our NET clinic from June 2012 to December 2013, in addition to EGD and biopsy, the serum gastrin and gastric pH measurement were performed in all g-NEN cases, image studies such as CT/MRI/SRS were done in some cases. Subtype classification criteria: after EGD and pathological diagnosis, g-NENs with elevated serum gastrin and elevated gastric pH belong to type 1, those with elevated serum gastrin and ZES belong to type 2, for those with normal gastrin values and normal gastric acid secretion, well differentiated NET G1, G2 or G3 are c...

1088 Background: With the capecitabine being increasingly used in the treatment of metastatic breast cancer (MBC), the common side effect of capecitabine, hand-foot syndrome (HFS) has become a main problem which can distress both physicians and patients. Severe HFS such as severe pain can have a negative impact on quality of life (QOL) of these patients and cause reduced dosage or even stopping chemotherapy. No effective treatment for HFS can be available at present. Over the years we have used LC07, a kind of external agents from Chinese herbs (Herba Geranii, etc.), to treat capecitabine-induced HFS. In this study, the efficacy and safety of LC07 were evaluated in patients with MBC and HSF. Methods: Eligible patients includes patients with MBC, who had HFS (NCI-CTC grade ≥1) after receiving single capecitabine chemotherapy (1,250 mg/m2, PO, twice daily, cycled days 1–14, every 21 days). LC07 granules 10g was dissolved in 1,000mL of warm water (keep 34°C-37°C in a footbath), the patients soaked their feet and hands in this lotion for 20 minutes, twice daily for 7 days. An independent researcher assessed symptoms before and after treatment. Evaluation criteria, CR as symptom disappearing completely, PR as NCI-CTC grade for HFS decreasing by more than 1 level after treatment, the total response rate as CR+PR. The QOL of these patients were also evaluated before and after treatment using a FACT-B questionnaire (Version 4.0-Chinese). Results: 42 patients (pts) have been enrolled in this study. All of them are Asian and female. Media age 51.5 yrs (25–72). Grade 1 for HFS was seen in 8 pts, G2 in 19 pts, and G3 in 15 pts. The total response rate was 83.3% (35/42), CR 38.1% (16/42), PR 45.2% (19/42). The average time from therapy to pain relief was 1.8±0.8 days, the skin lesion of HFS including dermatitis, peeling, ulceration have been improved after treatment. The QOL scores before and after treatment were 77.24±25.69 and 109.17±20.53, respectively (p < 0.01). No side effects such as skin allergies related to LC07 was found in this study. Conclusions: In the treatment of capecitabine-induced HFS, the external Chinese medicine LC07 is fast effective for relieving pain, and it has the features of easy use and no skin allergies. Thus LC07 can improve the QOL of patients with MBC and HFS. No significant financial relationships to disclose.