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Objective:To analyze the correlation between nutritional status and acute toxicity induced by concurrent chemoradiotherapy in patients with rectal cancer.Methods:A total of 115 patients with rectal cancer who underwent concurrent chemoradiotherapy in Zhejiang Cancer Hospital from March 2018 to August 2019 were prospectively selected. Nutritional risk was assessed by NRS 2002 and PG-SGA nutritional screening tools before, during and after radiotherapy. The acute toxicity was assessed by RTOG and CTCAE 3.0 scoring criteria. The correlation between nutritional status and the acute toxicity of chemoradiotherapy was analyzed by Spearman′ s correlation analysis. Results:The nutritional risk of the cohort was gradually increased from the beginning of chemoradiotherapy to the fourth week of chemoradiotherapy, and then decreased gradually. Spearman′ s correlation analysis showed that NRS 2002 and PG-SGA scores were positively correlated with acute hematological toxicity ( r=0.26, P<0.05; r=0.31, P<0.01), upper gastrointestinal toxicity ( r=0.51, P<0.01; r=0.63, P<0.01), proctitis ( r=0.23, P<0.05; r=0.45, P<0.01) and fatigue ( r=0.47, P<0.01; r=0.64, P<0.01) in patients with rectal cancer undergoing chemoradiotherapy. The correlation coefficients between PG-SGA and various toxicities were higher than those of NRS 2002. Stratified analysis showed that patients with stage Ⅱ-Ⅲ B, age<65 years and postoperative adjuvant chemoradiotherapy, nutritional status was significantly associated with the severity of toxicity (all P<0.05). Conclusions:Patients with rectal cancer has a high risk of malnutrition during concurrent chemoradiotherapy. The higher the risk of malnutrition, the greater the acute toxicity of chemoradiotherapy. Therefore, dynamic nutrition assessment and nutritional support should be strengthened for rectal cancer patients during chemoradiotherapy.
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Objective To propose the concept of “Diffusion Index”to replace Oxygenation Index as independent indicators to evaluate prognosis on ARDS patients under mechanical ventilation treatments,and comparison carried out between them preliminarily.Methods Calculation of “1 000 × (PaO2 /FiO2 /PEEP)”was taken as “Diffusion Index”.A total of 130 ARDS patients under mechanical ventilation support (MVS)were admitted to Peking Union Medical College Hospital ICU from July 2013 to July 2014.The data of these patients were retrospectively analyzed.Of them,15 patients were excluded because these patients refused invasive ventilation support.Respirator parameter setting and haemogas figures were recorded accordingly. Both Diffusion Index and Oxygenation Index were used separately to predict detachment of MVS from patients in 28 days,and the correlation between these two indexes and ARDS prognosis were determined.Results According to the outcomes of patients in 28 days,patients were divided into 3 groups:detached group (n =44),failed to detach group (n =14)and death group (n =57).There was obvious difference in trend diagrams observed among three groups between diffusion index and oxygenation index.COX regression analysis of survival curve demonstrated that if Diffusion Index kept greater than 405.8,probability of detachment of MVS from patients was higher and the correlation was significant (P =0.009 ).Conclusions Compared with Oxygenation Index,“Diffusion Index” is a comprehensive indicator for ARDS prognosis with better reliability and validity.
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To determine whether lentinan could upregulate the expression of human-beta-defensin-2(HBD-2) in pulmonary epithelial cells (SPC-A-1), we stimulated pulmonary epithelial cells with lentinan and detected the expression of HBD-2mRNA by RT-PCR test. The results demonstrated that the expression of HBD-2mRNA in SPC-A-1 could be induced by lentinan in a concentration and time-dependent manner.
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Humans , Adjuvants, Immunologic , Pharmacology , Epithelial Cells , Metabolism , Lentinan , Pharmacology , Lung , Cell Biology , Metabolism , RNA, Messenger , Genetics , Metabolism , beta-Defensins , Genetics , MetabolismABSTRACT
OBJECTIVE: To explore the effects of Houttuynia Cordata on expression of human beta-defensin-2 (HBD-2) in pulmonary epithelial cells (SPC-A-1) in vitro; and to observe the correlationship between the level of HBD-2 mRNA and the concentrations or treatment times of Houttuynia Cordata. METHODS: The SPC-A-1 cells were cultured with different concentrations of Houttuynia Cordata in vitro, including 0, 12.5, 25, 50, 100 and 200 microg/ml. And then, the SPC-A-1 cells were cultured with the optimal concentration of Houttuynia Cordata in different lengths of time, including 1, 2, 4, 8, 16 and 24 hours. After the treatment, the mRNA level of HBD-2 in pulmonary epithelial cells was detected by means of semi-quantitative reverse transcription polymerase chain reaction (RT-PCR). RESULTS: After being cultured with Houttuynia Cordata, the expression of HBD-2 mRNA had positive correlation with the stimulus concentrations (rs=0.829, P=0.042) and stimulus time (rs=0.914, P=0.003). The highest expression of HBD-2 mRNA was induced by 100 microg/ml Houttuynia Cordata after 8-hour treatment. In comparison with the normal control group and the interleukin-1beta group, 100 microg/ml Houttuynia Cordata could significantly up-regulate the expression of HBD-2 mRNA in SPC-A-1 cells after 8-hour treatment (P<0.01). CONCLUSION: Houttuynia Cordata can up-regulate expression of HBD-2 mRNA in SPC-A-1 cells, and the highest expression level of HBD-2 mRNA can be obtained by culture with 100 microg/ml Houttuynia Cordata for 8 hours.