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Objective:To investigate whether TNM staging combined with systemic immune inflammation index (SII) has a high predictive value for the clinical prognosis of elderly patients with esophageal cancer.Methods:Clinical data of 118 elderly patients with esophageal cancer who received radiotherapy and chemotherapy were retrospectively analyzed, and the SII was calculated. SII and clinicopathological features were included in the Cox proportional risk model, and the prognostic index (PI) equation was obtained. Kaplan- Meier survival analysis was adopted. According to PI, the survival of patients was predicted and the predictive values of PI and TNM were statistically compared. Results:Univariate analysis showed that SII, N staging and TNM staging were closely correlated with the overall survival (all P<0.01). Cox multivariate analysis revealed that SII and N staging were the independent risk factors for overall survival. According to the results of Cox analysis, the equation of PI=0.961 × SII grouping+ 0.523 × N staging was obtained. The receiver operating characteristic (ROC) curve was drawn according to PI and overall survival, and the critical value was obtained and divided into different groups. The 1-, 2-and 3-year survival rates in the low-risk group were significantly higher than those in the high-risk group ( HR=0.365, 95% CI: 0.221-0.604, P<0.001). The prediction of overall survival by SII-N[area under curve (AUC)=0.707] was significantly better than that by TNM staging (AUC=0.560, P<0.001). Conclusion:This study preliminarily proves that the SII-N prognosis score model is better than the traditional TNM staging, which may have guiding significance for the selection of therapeutic strategies for elderly patients with esophageal cancer, and is worthy of further study.
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BACKGROUND: In the treatment of senile distal tibia fractures, locking compression plate (LCP) combined with minimally invasive percutaneous plate osteosynthesis (MIPO) exerts a satisfactory repair effect, and contributes to the function recovery of lower limbs.OBJECTIVE: To retrospectively analyze the efficacy of LCP combined with MIPO versus intramedullary interlocking nailing for senile distal tibia fractures.METHODS: Fifty-six elderly patients with distal tibia fracture were allotted to minimally invasive and intramedullary nailing groups (n=28 per group), and received the treatment of LCP combined with MIPO and intramedullary interlocking nailing fixation, respectively. The operation time, intraoperative blood loss, postoperative AOFAS ankle-hind foot scale scores, postoperative ambulation time, healing time, postoperative complications and the excellent and good rate in Johner-Wruhs' criteria were compared between two groups.RESULTS AND CONCLUSION: (1) The operation time, AOFAS ankle-hind foot scale scores, ambulation time, and healing time in the minimally invasive group were significantly superior to those in the intramedullary nailing group (P < 0.05). (2) The minimally invasive group showed a significantly higher excellent and good rate (96%) than the intramedullary nailing group (79%) (P < 0.05). (3) Compared with the intramedullary nailing group, the incidence of complications was significantly reduced in the minimally invasive group (P < 0.05). (4) Our findings suggest that the combination of LCP and MIPO not only preserves the most of blood supply, and soft tissues surrounding the fracture end as suggested by the BO principle, but also is conducive for fracture healing, and holds good efficacy.
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Some of the patients with rectal cancer are less sensitive to preoperative concurrent chemoradiotherapy (CCRT).Patients who are resistant to CCRT have a poor local tumor control and CCRT may also increase adverse reactions.The sensitivity of rectal cancer patients to CCRT can be predicted by magnetic resonance imaging (MRI),positron emission tomography,serum carcinoembryonic antigen,molecular biomarkers and gene expression profiling before treatment.According to the predicted results,the clinicians are instructed to choose individualized treatment for the patients so that the therapeutic effects of rectal cancer are further improved.
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To investigate the effect of RAD18-siRNA on cell proliferation and chemotherapy sensitivity of esophageal squamous cell carcinoma (ESCC) ECA-109 cells.RAD18-siRNA was transfected into human ECA-109 cells by Lipofectamine 3000. Quantitative PCR and Western blot were performed to detect RAD18 and CyclinD1 expression; CCK-8 assay was used to determine cell proliferation and chemotherapy drug sensitivity; flow cytometry was used to determine cell cycle. Correlation between RAD18 and CyclinD1 mRNA expression was analyzed by Pearson's correlation.Compared with non-transfected cells, the expression of RAD18 in RAD18-siRNA group was significantly decreased (<0.05). The cell proliferation was inhibited (<0.05) and the cell number of G1 phase was increased, G2/M phase cells decreased (<0.05) in RAD18-siRNA group. After treatment with different concentrations of cisplatin or 5-FU, the survival rate of the two cell groups was reduced (all<0.05), and the IC50 of RAD18-siRNA group was significantly lower than that of non-transfected group (<0.05). The mRNA expression of RAD18 was positively correlated with CyclinD1 expression in ESCC tissues(=0.478,<0.01).Down-regulated expression of RAD18 can decrease the cell proliferation and increase chemo-sensitivity of ESCC cells, and CyclinD1 may participate in the process.
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Humans , Adjuvants, Pharmaceutic , Pharmacology , Carcinoma, Squamous Cell , Drug Therapy , Cell Cycle , Cell Line, Tumor , Cell Proliferation , Cisplatin , Pharmacology , Cyclin D1 , Genetics , DNA-Binding Proteins , Pharmacology , Down-Regulation , Genetics , Drug Resistance, Neoplasm , Drug Screening Assays, Antitumor , Methods , Drug Synergism , Esophageal Neoplasms , Drug Therapy , Fluorouracil , Pharmacology , G1 Phase , G2 Phase , Metaphase , RNA, Small Interfering , Pharmacology , Transfection , Ubiquitin-Protein Ligases , PharmacologyABSTRACT
Biological therapy for cancer has became a highpoint in recent years.It has been widely applied in clinical field.Management of their unique toxicities becomes more and more important.Cytokine release syndrome (CRS) is a potentially life-threatening toxicity.This review discusses the mechanisms that cause CRS,and new developments in the prevention and treatment of CRS.
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Objective To study the dosimetry and safety of the non-coplanar IMRT plan for advanced lung cancer.Methods The two groups IMRT plans were designed with coplanar (5,7F) and non-coplanar field (5,7F-n) for patients.To compare the dosimetry of two groups and perform 4 patients F7-n IMRT plan.Results With the increase of the fields in each group PTV's CI were improved (all P =0.000),especially the 7F-n plan PTV's Dmean,Dmax,V95％ and HI also were improved (P=0.001,0.001,0.009,0.000) ; in the coplanar group each lung' s V5 increased (P =0.000,0.002,0.000) and whole lung's Dmean increased (P =0.000),but non-coplanar group whole lung's and contralateral lung's V5 reduce (P =0.001,0.005).Between the groups,7F-n plan PTV's indicators were all improved to compared with 5F plan (all P =0.000),and each lung's V20 reduced (all P =0.000),and whole lung's Dmean,V30,contralateral lung' s V5 reduced (P =0.000,0.001,0.000),and spinal cord' s Dmax also reduced (P =0.033),but ipsilateral lung's V5 and heart's Dmean increased (P =0.000,0.003);with compared to 7F plan,the 7F-n's ipsilateral lung's V5 and heart's Dmean also increased (P =0.000,0.048),but whole lung' s and contralateral lung's V5 decreased (all P =0.000).Four patients were performed successfully non-coplanar IMRT treatment,no collision occurred.Conclusions 7 fields non-coplanar IMRT plan not only improve the dose distribution of PTV,but also effectively control the volume of low dose lung increase,lung V20 and Dmean reduce too.Thus recommended to use this design in patients with advanced lung cancer for radiotherapy
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To elucidate the effects of human keratinocyte-derived HaCaT cells [HIV-TAT] protein transduction domains [PTD] coupled heme oxygenase-1 [HO-1] fusion protein [TAT-HO-1] on radiation-induced human keratinocyte-derived HaCaT cells. This study was conducted between May 2010 and February 2013 in the School of Radiation Medicine and Protection, Soochow University, Suzhou, China. This experimental study was designed to explore the protective role of TAT-HO-1 in skin cells. The human HO-1 gene was fused with a gene fragment encoding TAT PTD to produce in-frame TAT-HO-1. The distribution of TAT-HO-1 was measured by immunostaining and Western blot. The radioprotection for TAT-HO-1 was determined using clonogenic assay. Alterations in apoptosis were analyzed by flow cytometry. The expressed and purified TAT-HO-1 recombinant protein could be incorporated into human HaCaT cells. We then evaluated the protective role of TAT-HO-1 against ionizing radiation. The TAT-HO-1 attenuated the generation of reactive oxygen species and decreased HaCaT cell radiosensitivity to irradiation. Moreover, HaCaT cells pretreated with TAT-HO-1 resulted in less apoptosis by radiation. In addition, TAT-HO-1 could penetrate rat skin. These results suggest that TAT-HO-1 can protect HaCaT cells from ionizing radiation
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DNA polymerase iota (Polt),as well as Revl,Polκ and Polη,are all Y family DNA polymerases,which are able to replicate damaged DNA via translesion synthesis pathway.However,Pol(t) has the lowest fidelity among all DNA polymerases in both correct and inaccurate DNA templates.Also Pol(t) can bypass certain DNA damages and accumulate mutations.Recent studies show that the aberrant expression of Pol(t) is observed in human uveal melanoma,breast cancer,bladder cancer,lung cancer and esophageal cancer,which may contribute to the tumorigenesis and progression of tumor.The special role of Pol(t) in replicating damaged DNA may contribute to the resistance in oncotherapy.
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Objective To investigate the effect of heme oxygenase-1 ( HO-1 ) on the acute radiation-induced skin injury by gene transfer.Methods Thirty-three male SD rats were randomly divided into three groups as PBS-injected group,Ad-EGFP-injeeted group and Ad-HO-1-injected group ( n =11 ).In each group,three rats were used for determining the expression of target gene and the other rats were irradiated on the buttock skin with 40 Gy electron beam generated by a linear accelerator.Immediately after irradiation,rats were administered with a subcutaneous injection of PBS,Ad-EGFP or Ad-HO-1,respectively.Subsequently,the skin reactions were measured twice a week using the semi-quantitative skin injury scale.Results The strong positive expression of HO-1 was observed in subcutaneous dermal tissue after injection of Ad-HO-1.Compared to the PBS-injected group or the Ad-EGFP-injected group,a significant mitigation of skin injury was observed in Ad-HO-1-injected mice 14 d after irradiation (q =0.000-0.030,P ＜ 0.05 ).Conclusions HO-1 could significantly mitigate radiation-induced acute skin injury and Ad-HO-1 could be used to treat radiation-induced skin injury.