ABSTRACT
Objective To study the clinical efficiency and adverse reactions of simultaneous modulated accelerated radiotherapy (SMART)and intensity-modulated radiation therapy (IMRT)in advanced cervical cancer. Methods Sixty patients with advanced cervical cancer were collected from April 2011 to April 2017 in our hospital. The 60 patients were randomly divided into experimental group (30 cases)and control group (30 cases)by using stratified randomization method. The two groups were given intracavitary irradiation and concur-rent chemotherapy. The patients in experimental group were treated with SMART and the patients in control group were treated with IMRT. 95％ planned target volume was 50. 4 Gy/ 28 F in the two groups and the dose for IMRT with simultaneous integrated boost was 64. 4 Gy/ 28 F to the planning target volume. Disease progres-sion,survival time and adverse reactions of the two groups were compared. Results At the end of radiothe-rapy,the experimental group had 23 patients with complete response (CR),4 patients with partial response (PR),2 patients with unaltered stable disease (SD),1 patient with progressive disease (PD),and the control group had 22 patients with CR,3 patients with PR,3 patients with SD,2 patients with PD. The overall effi-ciency of the experimental group was slightly higher than that of the control group (90. 0％ vs. 83. 3％),but the difference was not statistically significant (χ2 = 0. 144,P = 0. 704). After 3 months of radiotherapy,the experimental group had 28 patients with CR,1 patient with PR,1 patient with PD,and the control group had 22 patients with CR,2 patients with PR,3 patients with SD,3 patients with PD. The overall efficiency of the experimental group (96. 7％)was higher than that of the control group (96. 7％ vs. 80. 0％),but the diffe-rence was not statistically significant (χ2 = 2. 588,P = 0. 108). The median overall survival time of the experi-mental group and control group were 43 months and 38 months,and the difference was statistically significant (χ2 = 7. 087,P = 0. 008). The 1-year survival rates of the two groups were 96. 6％ and 85. 7％,and the 3-year survival rates were 86. 2％ and 60. 7％,respectively. There were no significant differences in the inci-dences of gastrointestinal reaction (66. 7％ vs. 63. 3％,χ2 = 0. 073,P = 0. 787),urinary system reaction (33. 3％ vs. 30. 0％,χ2 = 0. 077,P = 0. 781)and bone marrow suppression (83. 3％ vs. 86. 7％,χ2 =0. 000,P = 1. 000)between the two groups. Conclusion The efficiency of advanced cervical cancer patient treated with SMART is better than IMRT,and the adverse reactions are tolerable,which is worthy of clinical promotion.
ABSTRACT
Objective To compare the differences in the long-term survival rate and the tumor shrinkage rate of inoperable hepatocellular carcinoma (HCC) between transcatheter arterial chemoembolization (TACE) combined with percutaneous ablation therapy and simple TACE therapy in order to provide the basis for the clinical treatment of HCC.Methods Randomized controlled trials (RCT) for comparing the difference in survival rates between TACE plus PA and simple TACE for inoperable HCC were searched from medical literature database,from which the relevant data were extracted.According to Cochrane manual standard,the quality of inclusion literature was evaluated.Results A total of 15 RCT papers were included in this study,including 859 HCC patients.The results of meta-analysis showed that all the 1-year,2-year and 3-year survival rates in TACE plus PA group were better than those in simple TACE group (RR=1.454,95％CI=1.333and 1.586,Z=8.56,P＜0.001;RR=1.781,95％CI=1.511 and 2.099,Z=6.88,P＜0.001;RR=2.351,95％CI=1.808 and 3.059,Z=6.37,P＜0.001,respectively).The tumor shrinkage rate in TACE plus PA group was also better than that in simple TACE group (RR=1.314,95％CI=1.190 and 1.452,Z=5.38,P＜0.001).The sensitivity analysis indicated that the results of the differences in survival rate and tumor shrinkage rate between the two groups were reliable.Conclusion The 1-year,2-year and 3-year survival rates as well as the tumor shrinkage rate of TACE plus PA group are higher than those of simple TACE group.
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ObjectiveTo explore the damage of blood vessels in carbon monoxide poisoning patients by hyperbaric oxygen, especially for damage of vein, to understand the factors aggravating inflammatory response, thus work out the homologous protective measures.MethodsFrom January 2006 to January 2008, 80 patients of carbon monoxide poisoning were selected as the observation group. Another 80 patients with other diseases were set as the control group. Two groups both accepted hyperbaric oxygen treatment. The time of angioplerosis was compared between the two groups, besides, pain reaction of the observation group was also observed.ResultsThe time of angioplerosis was significantly different between the two groups, pain sensibility intensified in the observation group compared with that before treatment.ConclusionsHyperbaric therapy is closely related with vascular inflammatory reaction of carbon monoxide poisoning patients. Protective measures should be established in order to prevent further damage of vessel, relieve pain of patients and ensure smooth progress of the treatment.
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Objective To observe PDX-1 expression in the pancreas of type 2 diabetic rat model and effects of rosiglitazone (RGZ) on it. Methods Type 2 diabetic rat model was induced by long-term feeding with high-fat foods followed by a single intraperitoneal injection of low dose of streptozotocin (STZ). The morphological changes of pancreas were examined by microscopy and immunohistochemistry. The mRNA levels of PDX-1 and insulin were determined by RT-PCR. PDX-1 protein expression was detected with Western blot. Results The percentage of insulin-positive cells(12.75±2.18)，the average optical densities of PDX-1-positive area(0.240±0.051)，PDX-1 mRNA level (0.153±0.071)and PDX-1 protein level(0.253±0.028) were significantly lower in untreated diabetic rats than in the controls(42.61±2.68，0.648±0.087，0.49±0.032，0.720±0.036 respectively)(all P＜0.01)，and in RGZ-treated versus untreated group those parameters increased significantly (all P＜0.05~0.01). Conclusions Rosiglitazone could protect islet cell function，and improve PDX-1 expressions in both mRNA and protein levels.