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Objective:To analyze the clinically acceptable and reproducible bladder and rectum volumes of prostate cancer patients during radiotherapy under bladder and bowel preparation, aiming to provide quantitative indicators for bowel and bladder preparation before and after radiotherapy.Methods:Clinical data of 275 prostate cancer patients with strict bladder and bowel preparation and completion of whole course radical radiotherapy at Sun Yat-sen University Cancer Center from April 2015 to December 2020 were retrospectively analyzed. Patients were scanned with cone beam CT (CBCT) before each treatment and the setup error was recorded. Sixty-six patients were selected by simple random sampling and the bladder and rectum on daily CBCT was outlined using MIM software. The relationship between the ratio of daily bladder or rectum volume to the planned bladder or rectum volume (relative value of volume) and setup error was analyzed. Quantitative data were expressed as mean±SD. Normally distributed data were analyzed by paired t-test while non-normally distributed data were assessed by Kruskal-Wallis test.Results:The bladder and rectum volume on planning CT were (370.87±110.04) ml and (59.94±25.07) ml of 275 patients. The bladder and rectum volumes on planning CT were (357.51±107.38) ml and (65.28±35.37) ml respectively of the 66 selected patients with 1611 sets of CBCT images. And the bladder and rectum volumes on daily CBCT were (258.96±120.23) ml and (59.95 ± 30.40) ml. The bladder volume of patients was decreased by 3.59 ml per day on average during the treatment and 0.37 ml for the rectum volume. According to the bladder volume on planning CT, all patients were divided into three groups: <250 ml, 250-450 ml and >450 ml groups. The relative value of volume in the 250-450 ml group during the course of radiotherapy was the smallest. And the setup error in the superior and inferior (SI) direction was (0.28±0.24) cm and (0.19±0.17) cm in the left and right (LR) direction, significantly lower than those in the other two groups (both P≤0.027). According to the rectum volume on planning CT, all patients were divided into four groups: <50 ml, 50-<80 ml, 80-120 ml and >120 ml groups. The <50 ml group had the smallest relative value of volume during radiotherapy, and the setup error in the SI direction was (0.26±0.22) cm and (0.24±0.22) cm in the anterior and posterior (AP) direction, significantly smaller than those in the other groups (both P≤0.003). The setup errors in the SI, LR, AP directions of the enrolled 66 patients were (0.30±0.25) cm, (0.20±0.18) cm and (0.28±0.27) cm, respectively. Among them, the relative value of bladder volume in the AP direction was (0.73±0.37) in the setup error <0.3 cm group, which was statistically different from those in the setup error 0.3-0.5 cm and >0.5 cm groups (both P<0.05). Conclusion:Under the bladder and bowel preparation before planning CT, the appropriate bladder and rectum volumes are in the range of 250-450 ml and <50 ml, which yields higher reproducibility and smaller setup error.
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Objective@#To explore the clinical application of individualized design of facial artery perforator flap for the repair of midfacial defect caused by tumor resection.@*Methods@#From January 2015 to January 2018, a total of 36 cases of midfacial defect were repaired by individualized designed facial artery. Flaps were designed and harvested according to the location and size of the midfacial defect resulted from tumor resection, including propeller flaps, droplet flaps and swallowtail-shape flaps. Flap size was between 1.3 cm × 1.6 cm and 2.0 cm × 4.2 cm with the donor site being sutured in the first stage.@*Results@#During the 6 months to 3 years of postoperative follow-up, no tumor recurred. All the 36 cases of individualized designed facial artery perforator flaps survived well. Furthermore, flaps being designed according to the wound defect had a good appearance, the flaps matched the color and texture of the surrounding skin and had a favorable appearance. Besides, flaps had a certain degree of sensory recovery while there was no obvious scarring presented in the donor area.@*Conclusions@#Individualized design of facial artery perforator flap has great advantages of simple and flexible, easy manipulation, reliable flap blood flow and minimal donor injury, which render it valuable for clinical application.
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【Objective】To investigate the influence of serum containing Hechan Tablets(HT)on the proliferation and apoptosis of human lung adenocarcinoma cell(LAC)line.【Methods】Serum containing HT was prepared.Human LAC line was cultured by the routine method firstly,and then was planted respectively in the culture medium including serum containing HT at the concentration of 30%(group A),in the culture medium including blank serum at the same concentration(group B)and in RPMI-1640 culture medium(group C).The growth of LAC was monitored under inverted phase contrast microscope,histological features of apoptotic LAC nucleus examined under fluorescence microscope and the apoptosis of LAC observed by flow cytometry with the methods of DNA content analysis and terminal-deoxynucleotidyl transferase mediated nick end labeling(TUNEL).【Results】After treatment with serum containing HT,the apoptotic changes of LAC were as follows: apoptotic rate was 5.6% in group A,lower than 0.9% in group B and 0.1% in group C;DNA content analysis showed that the number of LAC which was in phase S and phase G2-M was less in group A than that in groups B and C 72 hours after the culturing,so did the cell proliferation index;the results of TUNEL examination showed that the incidence of cell apoptosis was 12.3% in group A,5.7% in group B and 1.2% in group C 72 hours after the culturing.【Conclusion】Serum containing HT has an inhibitory effect on the proliferation of LAC,and its mechanism may be related to inhibiting DNA synthesis and division of LAC,restraining LAC at the phase G0 and G1 and promoting LAC apoptosis.