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Objective To evaluate the effect of preoperative radiotherapy with boost dose to lateral pelvic lymph nodes (LPN) on the prognosis of patients with locally advanced rectal cancer (LARC) treated with preoperative simultaneous chemoradiotherapy. Methods The clinical data of 116 LARC patients with complete follow-up who received adjuvant chemoradiotherapy and curative resection between March 2011 and April 2017 in Liuzhou Worker's Hospital were analyzed retrospectively. The patients were classified into two groups according to the LPN metastatic status from preoperative image: patients without suspected LPN metastasis who received preoperative simultaneous chemoradiotherapy (pelvic irradiation: 45-50.4 Gy;chemotherapy regimen: based on 5-fluorouracil) plus radical operation (the regular group, 85 cases), and patients with suspected LPN metastasis who received local boost radiation on the basis of whole radiotherapy in pelvic cavity (the boost group, 31 cases). Additional radiation boost with a total dose of 59.4-61.6 Gy to LPN was administrated to patients in the boost group. The adverse reactions of acute radiotherapy in both groups were compared by usingχ2 test and Fisher exact test. Kaplan-Meier method was used to make survival analysis and Log-rank was used to make the testing. Results The common acute adverse reactions of both groups were grade 1-2 in newly adjuvant chemoradiotherapy. Significant acute adverse reactions (grade 3 or higher) in the regular group and the boost group included diarrhea [15.3％ (13/85) vs. 19.4％ (6/31), χ2=0.273, P= 0.601], leukopenia [9.4％ (8/85) vs. 9.7％ (3/31), χ2 = 0.006, P= 0.941], and radiodermatitis [4.7％ (4/85) vs. 6.5％ (2/31), P= 0.657]. The median follow-up time was 30.3 months (11.1-82.3 months). Locoregional recurrence occurred in 10 patients of the regular group and 4 patients of the boost group, and 16 patients and 6 patients died of the regular group and the boost group respectively. Kaplan-Meier survival results showed that there were no significant differences in local recurrence-free survival rate (χ2=0.121, P=0.728) and overall survival rate (χ2= 0.605, P = 0.469). Conclusion Radiotherapy boost to LPN can offset the poor prognosis of LPN metastases on patients with LARC and can be considered as a safe and effective treatment option for LARC patients with suspected LPN metastasis.
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Objective To study the clinical significance of apolipoprotein B and apolipoprotein A1 ratio (ApoB/ApoA1) in patients with polycystic ovary syndrome (PCOS) combined metabolic syndrome (MS),by detecting the level of ApoB and ApoA1 in patients' serum.Methods 160 patients with PCOS were selected in our hospital from Jan.2014 to Dec.2015,and they were divided into MS group and non-MS group according to the diagnostic criteria of MS.The anthropometric measurements,endocrine markers,glucose and lipid metabolism indexes of patients in the two groups were measured and compared.Correlation of ApoB/ApoA 1 ratio and components of MS were analyzed,respectively.Relationship between ApoB/ApoA1 ratio and the number of abnormal components in MS were also investigated.Results Significant difference was found in the levels of ApoB ((1.01±0.34) g/L) and ApoA1((1.15±0.29) g/L) between MS group and non-MS group (P＜0.05),and ApoB/ApoA1 ratio in MS group was obviously higher than that in non-MS group (P＜0.05).ApoB/ApoAl ratio was positively correlated with BMI,waist circumference (WC),systolic blood pressure (SBP),diastolic blood pressure (DBP),fasting plasma glucose (FPG),insulin resistance index (HOMA-IR),high triglycerides (TG) and low density lipoprotein (LDL-C),respectively,and it was negatively correlated with high density lipoprotein (HDL-C)(P＜0.05).However,there was no significant correlation between ApoB/ApoA1 ratio and the age,fasting insulin (FINS),as well as the total cholesterol (TC) (P＞0.05).Moreover,ApoB/ApoA1 ratio increased with increase in the number of abnormal components (P＜0.05).Conclusion ApoB/ApoA1 ratio is closely related to the components of MS,and it may have important clinical significance for diagnosis of PCOS combined MS and preventing long-term complications of PCOS.
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Objective To explore the change and significance of blood lipid and oxidative stress in subchnical hypothyroidism during pregnancy.Methods 100 pregnant women with subclinical hypothyroidism during pregnancy were chosen and set as the disease group,while 100 healthy pregnant women were chosen and set as the control group.Thyroid function index:free three iodine thyroid original glycine (FT3),free thyroid hormones (FT4),thyroid stimulating hormone (TSH),blood lipids index:triglyceride (TG),total cholesterol (TC),high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C),and oxidative stress indicators:superoxide dismutase (SOD),malondialdehyde (MDA),type oxidized low density hpoprotein (ox-LDL) in the two groups were detected and analyzed.Results FT3 and FT4 between the two groups had no statistical significance (P＞0.05).TSH in the disease group was (4.63±1.09) mIU/L,significantly higher than that of the control group(P＜0.05).The comparison of TG,HDL-C between the two groups had no statistical significance(P＞0.05).TC and LDLC in the disease group were significantly higher than those of the control group (P＜0.05).MDA and ox-LDL in the disease group were significantly higher than those of the control group,while SOD was significanTLy lower than that of the control group(P＜0.05).Conclusion Subclinical hypothyroidism during pregnancy can cause metabolic disorder of blood lipid and reduce oxidative stress ability.Monitoring and intervention of blood lipid and oxidative stress status is necessary.
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Objective To detect the ERCC1 expression in nasopharyngeal cancer(NPC),to analyze its relationship with concurrent chemo-radiotherapy.Methods The biopsy specimens were obtained through nasopharyngeal endoscopy from patients with NPC in the Fourth Affiliated Hospital of Guangxi Medical University from January 2008 to December 2008.The ERCC1 expression in the cancer tissue was detected using MaxVision immunohistochemistry.Eight weeks after the chemo-radiotherapy,MRI was performed,The MRI results were used to assess the efficacy according to RECIST 1.1 standard,with sensitive group including complete relief (CR) and partial relief (PR) and insensitive group including stable disease(SD) and progress disease (PD).MRI was re-performed every three months with follow-up 3 years.The relationships between ERCC1 expression and concuTent chemo-radiotherapy in the short-term sensitivity and overall survival in patients with nasopharyngeal cancer were analyzed.Results 76 cases were collected.All cases were evaluable for the short-term sensitivity,and only 72 cases were evaluable for progression-free rate and overall survival (OS).In 76 short-term curative effect evaluable cases,CR was 56 cases (73.68 ％),PR was 11 cases (14.47 ％),SD was 3 cases (3.95 ％),PD was 6 cases (7.89 ％),respectively.RR (effective efficiency) was 88.16 ％ and DCR (disease control rate) was 92.1％.The positive rate of ERCC1 expression was 42.1％ (32/76),with 37.3 ％ (24/67) in the sensitive group (CR+PR) and 88.8 ％ (8/9) in the non-sensitive group (SD+PD).RR and DCR in the negative ERCC1 expression group were higher (97.7 ％,97.7 ％) than those in the positive expression group (75 ％,81.3 ％,x2 =7.119,P ＜ 0.05).Of 72 case,twelve month progression-free survival (PFS) rate was 91.7 ％ (66/72),with 95.5 ％ (39/41) in the negative ERCC1 expression group and 87.1％ (27/31) in the ERCC 1 positive group,and there was no significant difference between the 2 groups (x 2 =0,623,P =0.430).Of 72 cases,one year OS rate was 93.0 ％ (67/72),two years OS rate was 84.7 ％ (61/72),three years OS rate was 72.2 ％(52/72).Of 31 ERCC1 positive cases one year OS rate was 90.6 ％(28/31),two years OS rate was 77.4 ％ (27/31),and three years OS rate was 61.3 ％ (19/31).Of 41 ERCC1 negative eases one year OS rate was 95.5 ％(39/41),two years OS rate was 90.2 ％ (37/41),and three years OS rate was 82.9 ％ (34/41).The ERCC1 expression demonstrated significant correlation with the short-term sensitivity and OS (x2 =4.192,P =0.041).Conclusion The ERCC1 expression in NPC has negative correlation with the chemo-radiotherapy and short-term sensitivity,which may predict the chemo-radio therapy sensitivity in NPC.The ERCC1 expression in NPC has significant correlation with OS.It may predict the prognosis of NPC.