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Objective:To explore the clinical effect of simultaneous whole-course hyperfractionated intensity-modulated radiation therapy combined with chemotherapy and nimotuzumab in the treatment of advanced nasopharyngeal carcinoma.Methods:A total of 64 patients with advanced nasopharyngeal carcinoma who were admitted to Kaiping Central Hospital of Guangdong Province from June 2017 to January 2019 were selected and divided into the observation group and control group according to the random number table method, with 32 cases in each group. Both groups were given chemotherapy and nimotuzumab on the basis of radiotherapy. The observation group received simultaneous whole-course hyperfractionated intensity-modulated radiation therapy, and the control group received conventional fractionated intensity-modulated radiation therapy. The short-term efficacy, Karnofsky score, overall survival rate, progression-free survival rate, acute radiation reaction, and late radiation injury in the two groups were observed.Results:Six months after radiotherapy, the efficient rate of the observation group was higher than that of the control group [96.9% (31/32) vs. 75.0% (24/32), χ2 = 6.335, P < 0.05]. At the end of radiotherapy and 3 months after the end of radiotherapy, the Karnofsky scores of the observation group were higher than those of the control group, and the differences were statistically significant [(75±3) points vs. (71±3) points, t = 5.891, P < 0.05; (80±4) points vs.(77±4) points, t = 3.201, P = 0.002]. All patients were well tolerated, no grade 4 acute radiation reaction was observed, and radiotherapy was completed as planned. The incidence rate of oral mucosal reaction in the observation group was lower than that in the control group [21.9% (7/32) vs. 50.0% (16/32), χ2 = 5.497, P < 0.05]. The incidence rates of severe dry mouth and neck soft tissue fibrosis in the observation group were lower than those in the control group [6.2% (2/32) vs. 28.1% (9/32), χ2 = 5.379, P = 0.043; 3.1% (1/32) vs. 21.9% (7/32), χ2 = 5.143, P < 0.05]. The follow-up time was 14-20 months, and the median follow-up time was 17 months. There was no statistical difference in overall survival time between the two groups ( χ2 = 0.553, P = 0.557). The progression-free survival time of the observation group was better than that of the control group ( χ2 = 3.954, P = 0.044). Conclusion:The simultaneous whole-course hyperfractionated intensity-modulated radiation therapy combined with chemotherapy and nimotuzumab are effective in the treatment of advanced nasopharyngeal carcinoma, and the adverse reactions can be tolerated.
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Objective To evaluate the minimally invasive splayed incisions in the internal fixation with a conventional calcaneal plate for calcaneal fractures of sanders types Ⅱ and Ⅲ.Methods This prospective study was conducted from May 1st,2016 to December 1st,2017 in the 40 patients with calcaneal fracture at Department of Orthopedics,Shanghai Pudong Hospital.Their ages ranged from 23 to 55 years (average,39.5 years).According to the Sanders classification,27 fractures were type Ⅱ and 13 type Ⅲ.They were all treated with a conventional calcaneal plate through minimally invasive splayed incisions.The B(o)hler and Gissane angles,the height,width and length of the affected calcaneus were compared between preoperation,3 months after operation and the last follow-up;the clinical function of the affected feet was graded using the Maryland foot score;postoperative complications were observed.Results The 40 patients were followed up for an average of 12.5 months (from 11 to 16 months).All the skin incisions healed well with no skin necrosis or wound infection.No injury to the sural nerve occurred.All the fractures healed after an average of 8 weeks (from 7 to 10 weeks).All the patients resumed their routine daily activities and returned to their former work post after an average time of 4.1 months (from 3 to 6 months).At pre-operation,3 months after operation and the last follow-up,their B(o)hler angles were respectively 19.2°± 6.3°,30.5°±6.4° and 29.9° ± 6.5°;their Gissane angles 103.9° ± 14.8°,119.3° ± 5.6° and 119.8° ± 6.3°;their calcaneal heights (32.5 ±3.5) mm,(36.8 ± 1.5) mm and (36.5 ± 1.8) mm;their calcaneal widths (36.8 ± 3.4) mm,(33.1 ±3.8) mmand (33.0±3.2) mm;their lengths (61.4±4.5) mm,(65.5±6.9) mmand (65.5 ±9.4) mm.In all the patients,the B(o)hler and Gissane angles and the calcaneal heights and lengths increased significantly while the calcaneal widths decreased significantly at 3 months after operation and the last follow-up (P ＜ 0.05).There were no significant differences between 3 months after operation and the last follow-up in the B(o)hler or Gissane angle,the height,width or length of the affected calcaneus (P ＞ 0.05).Their Maryland foot scores showed 35 excellent cases,4 good cases and one fair case,giving an excellent and good rate of 97.5％.Conclusions A conventional calcaneal plate plus minimally invasive splayed incisions can be effective for calcaneal fractures of Sanders types Ⅱ and Ⅲ,leading to reduced wound complications,anatomical restoration of calcaneal morphology,and smooth subtalar articular surface.
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Objective@#To evaluate the minimally invasive splayed incisions in the internal fixation with a conventional calcaneal plate for calcaneal fractures of sanders types Ⅱ and Ⅲ.@*Methods@#This prospective study was conducted from May 1st, 2016 to December 1st, 2017 in the 40 patients with calcaneal fracture at Department of Orthopedics, Shanghai Pudong Hospital. Their ages ranged from 23 to 55 years (average, 39.5 years). According to the Sanders classification, 27 fractures were type Ⅱ and 13 type Ⅲ. They were all treated with a conventional calcaneal plate through minimally invasive splayed incisions. The Böhler and Gissane angles, the height, width and length of the affected calcaneus were compared between preoperation, 3 months after operation and the last follow-up; the clinical function of the affected feet was graded using the Maryland foot score; postoperative complications were observed.@*Results@#The 40 patients were followed up for an average of 12.5 months (from 11 to 16 months). All the skin incisions healed well with no skin necrosis or wound infection. No injury to the sural nerve occurred. All the fractures healed after an average of 8 weeks (from 7 to 10 weeks). All the patients resumed their routine daily activities and returned to their former work post after an average time of 4.1 months (from 3 to 6 months). At pre-operation, 3 months after operation and the last follow-up, their Böhler angles were respectively 19.2°±6.3°, 30.5°±6.4° and 29.9°±6.5°; their Gissane angles 103.9°±14.8°, 119.3°±5.6° and 119.8°±6.3°; their calcaneal heights (32.5±3.5) mm, (36.8±1.5) mm and (36.5±1.8) mm; their calcaneal widths (36.8±3.4) mm, (33.1±3.8) mm and (33.0±3.2) mm; their lengths (61.4±4.5) mm, (65.5±6.9) mm and (65.5±9.4) mm. In all the patients, the Böhler and Gissane angles and the calcaneal heights and lengths increased significantly while the calcaneal widths decreased significantly at 3 months after operation and the last follow-up (P<0.05). There were no significant differences between 3 months after operation and the last follow-up in the Böhler or Gissane angle, the height, width or length of the affected calcaneus (P>0.05). Their Maryland foot scores showed 35 excellent cases, 4 good cases and one fair case, giving an excellent and good rate of 97.5%.@*Conclusions@#A conventional calcaneal plate plus minimally invasive splayed incisions can be effective for calcaneal fractures of Sanders types Ⅱ and Ⅲ, leading to reduced wound complications, anatomical restoration of calcaneal morphology, and smooth subtalar articular surface.
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The Eph receptors and their ligand Ephrins are closely associated with angiogenesis,cell migration,neuronal local-ization and embryonic development.More and more studies have shown that the Eph receptor and Ephrins are involved in the occur-rence and development of various cancers.In this article,we will focus on the Eph receptor family involved in the formation and devel-opment of lung cancer and metastasis,drug resistance and other mechanisms as well as their potential as targeted therapy of lung canc-er.