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Objective:To compare the effect of neoadjuvant chemotherapy vs. concurrent chemoradiotherapy on the target volume and organs at risk for locally advanced bulky (>4 cm) cervical cancer. Methods:From March 1, 2019 to June 30, 2021, 146 patients pathologically diagnosed with cervical cancer were selected and randomly divided into two groups using random number table method: the neoadjuvant chemotherapy (NACT) + concurrent chemoradiotherapy (CCRT) group ( n=73) and CCRT group ( n=73). Patients in the NACT+CCRT group received 2 cycles of paclitaxel combined with cisplatin NACT, followed by CCRT, the chemotherapy regimen was the same as NACT. In the CCRT group, CCRT was given. Statistical description of categorical data was expressed by rate. The measurement data between two groups were compared by Wilcoxon rank-sum test for comparison of two independent samples, and the rate or composition ratio of two groups was compared by χ2 test. Results:Before radiotherapy, GTV in the NACT+CCRT group was (31.95±25.96) cm 3, significantly lower than (71.54±33.59) cm 3 in the CCRT group ( P<0.01). Besides, CTV and PTV in the NACT+CCRT group were also significantly lower compared with those in the CCRT group (both P<0.05). In terms of target volume dosimetry, D 100GTV, D 95CTV, V 100GTV, V 100CTV and V 95PTV in the NACT+CCRT group were significantly higher than those in the CCRT group (all P<0.05). The complete remision (CR) rates in the NACT+CCRT and CCRT groups were 86.3% and 67.6%, with statistical significance between two groups ( P<0.01) . Regarding organs at risk, NACT+CCRT group significantly reduced the dose to the bladder, rectum, small intestine and urethra compared with CCRT group (all P<0.05). Conclusions:NACT can reduce the volume of tumors in patients with large cervical masses, increase the radiation dose to tumors, reduce the dose to organs at risk, and make the three-dimensional brachytherapy easier. Therefore, NACT combined with CCRT may be a new choice for patients with locally advanced cervical cancer with large masses.
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Objective:To investigate the optimal bladder filling volume in the 3D brachytherapy of postoperative cervical cancer.Methods:Totally 111 early cervical cancer patients with positive incisal margins or insufficient safety boundaries were included. The normal saline 50, 60, 70, 80, 90, and 100 ml were filled into their bladders, and accordingly six groups were determined, and 66, 69, 66, 69, 72, 56 person-times in each group, respectively. The CT-based simulation positioning was performed. According to the ICRU 89 report, high-risk clinical target volume and organs at risk such as bladder and rectum were delineated. The Oncentra planning system was used to prepare the treatment program. The high-risk clinical target volume (HR-CTV), D90, and the D2 cm 3 and D1 cm 3 of organs at risk under different volumes were recorded. Results:Compared to the 60 ml group, the volume and dosage of HR-CTV in the groups of 50, 70, 80, 90, and 100 ml had no significant difference ( P>0.05). The D2 cm 3 and D1 cm 3 of the bladder and rectum of patients in these groups significantly decreased, and the difference was statistically significant ( tbladder = 3.21, 5.83, 2.89, 12.95, 7.96, Pbladder = 0.031, 0.010, 0.041, 0.000, 0.001; trectum = 2.94, 4.66, 2.53, 5.89, 4.13, Prectum = 0.037, 0.024, 0.049, 0.005, 0.028). The pairwise comparison among these groups except for the 60 ml group showed that the volume and dosage of HR-CTV and the D2 cm 3 and D1 cm 3 of bladder and rectum had no significant difference ( P > 0.05). Moreover, the D2 cm 3 and D1 cm 3 of sigmoid colon and small intestine of these groups had no significant difference ( P > 0.05). Conclusions:In the 3D brachytherapy of postoperative early cervical cancer, a bladder filling volume of 60 ml can ensure the volume and dose of HR-CTV and can protect the bladder and rectum compared with other filling volumes.
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Objective To explore the predictive value of the expression of CD44v6 and EGFR on the efficacy of neoadjuvant chemotherapy (NACT) in stageⅡ-Ⅲ cervical cancer. Methods A total of 53 patients with stageⅡ-Ⅲ cervical cancer diagnosed by pathology were selected. All patients received two cycles of paclitaxel+platinum NACT. The pathological tissue samples of cervical tumors before NACT treatment were collected. The expression of CD44v6 and EGFR were detected by the immunohistochemical SP method, and we analyzed their predictive value of NACT in stageⅡ-Ⅲ cervical cancer. Results Among the 53 patients, 38 were in the NACT effective group (CR+PR), and 15 were in the NACT ineffective group (SD+PD). The expression of CD44v6 in the ineffective group was significantly higher than that in the effective group (P < 0.05). The expression of CD44v6 was significantly different in patients with CR, PR, and SD (P < 0.05). The AUC of CD44v6 to NACT effect on stage Ⅱ-Ⅲ cervical cancer was 0.74 (P < 0.05). The patients in the high expression group of CD44v6 had worse efficacy in NACT than those in the low expression group of CD44v6 (P < 0.05). Pearson test showed that CD44v6 and EGFR expression were correlated (R=0.34, P < 0.05). Conclusion High expression of CD44v6 may reduce the efficacy of NACT in stageⅡ-Ⅲ cervical cancer, suggesting that the expression of CD44v6 has a certain predictive value and clinical significance in the efficacy of paclitaxel+platinum NACT on cervical cancer. Moreover, CD44v6 is positively correlated with EGFR expression.
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Objective To observe the effect of cupping plus medication on the quality of life and estrogen level in perimenopausal syndrome patients. Method A total of 40 eligible perimenopausal syndrome patients were randomized into a cupping-medication group and a Chinese medication group, 20 cases in each group. The Chinese medication group was intervened by Er Xian decoction, the cupping-medication group was intervened by moving cupping on the back in addition to the treatment given to the Chinese medication group, once a week. Each item of the Menopause-specific Quality of Life (MENQOL), the levels of estradiol (E2), follicle-stimulating hormone (FSH) and luteotropic hormone (LH) in serum were observed before and after the treatment, and the results were analyzed. Result After two treatment courses, the vasomotor symptoms, mental state, physiological state, and sexual life scores in the two groups were significantly improved compared to the scores before the treatment (P0.05). Conclusion Moving cupping on the back plus Er Xian decoction can effectively improve the quality of life of perimenopausal syndrome patients and significantly increase the serum E2 level, superior to using Er Xian decoction alone.
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Objective To investigate the impact of clinical factors on survival in patients receiving concurrent chemotherapy and three?dimensional radiotherapy ( 3DRT) for stage IV non?small cell lung cancer ( NSCLC) . Methods A total of 203 patients were enrolled in a prospective clincial study from 2008 to 2012, and among these patients, 178 patients were eligible for analysis of clinical factors. All patients were treated with platinum?based doublets chemotherapy, with a median number of chemotherapy cycles of 4( 2?6 cycles) and a median dose of 3DRT of 60?3 Gy (36?0?76?5 Gy).The Kaplan?Meier method was used to calculate overall survival ( OS) rates, the log?rank test was used to compare survival rates between groups, and the Cox regression model were used for multivariate analysis. Results The 1?, 2?, and 3?year overall survival rates were 56%, 16%, and 10%, respectively, and the median survival time was 13 months (95% CI=11?500?14?500). The univariate analysis showed that platelet count ≤221×109/L, neutrophil count ≤5.2×109/L, white blood cell count<7×109/L, and improvement in Karnofsky Performance Scale ( KPS) after treatment significantly prolonged OS ( P=0?000,0?022,0?003, and 0?029) , and metastasis to a single organ and hemoglobin≥120 g/L tended to prolong OS (P=0?058 and 0?075). The multivariate analysis showed that white blood cell count<7×109/L, platelet count ≤221×109/L, and improvement in KPS after treatment were beneficial to OS ( all P<0?05) . Conclusions White blood cell count and platelet count before treatment and KPS after treatment are prognostic factors for patients with stage IV NSCLC receiving concurrent chemotherapy and 3DRT. Clinical Trial Registry ClinicalTrials. gov, registration number:ChiCTRTNC10001026.
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The Akabane's test is one of the meridian diagnostic methods. Compared with the current meridian diagnostic methods, it has the advantages of convenience and efficiency, but it also has several disadvantages such as the accuracy is difficult to control, the outcome interpretation is limited, etc. In this paper, the influence factors of Akabane's test were analyzed one by one, especially proposed personal opinion on outcome interpretation, which could ascertain the location and nature of disease, leading to disease syndrome. With accurate syndrome, the treatment plan could be established. The application prospect of Akabane's test was initially explored, and it was proposed that wearable automation equipment could be one of the development directions.
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Objective To research the function of the vagus nerve center nucleus of solitary tract(NTS)in the influence of gastric pressure by acupuncture at "Zusanli" in rats with motility disturbances of the stomach.Methods Adopting electrophysiological methods,the extracellular discharge signals of neuronic action in NTS were recorded with glass microelectrode.The influence of the discharges of NTS neurons and gastric pressure responding to the acupuncture at "Zusanli" point were observed in normal status and the condition of Atropine or Metoclopramide intravenous injection.Results In the normal status,acupuncture at "Zusanli" activated the discharges of NTS neurons and promote the gastric pressure remarkably.After Atropine intravenous injection,the background discharges of NTS neurons decreased.There was no statistical difference in the discharges responding to the effect of acupuncture before and after Atropine administration.And the gastric motion reinforced obviously by acupuncture at "Zusanli" after Atropine administration.But after intravenous injection of Metoclopramide,the background discharges of NTS neurons increased.There was also no statistical difference in the discharges responding to the effect of acupuncture before and after Metoclopramide administration.Moreover,the function of promoting gastric motion by acupuncture at "Zusanli" got more obviously after Metoclopramide administration.Conclusion The function of adjusting gastric motion by acupuncture at "Zusanli" point has close relation to the activation of NTS neurons,and the increasing amplitude of the discharges of NTS neurons wasn't influenced by cholinergic receptor blocker Atropine and dopamine-receptor antagonist Metoclopramide.
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Purpose: To investigate the influence of needling bilateral points Hegu (LI 4) before colonoscopy on the examined patients and the time of inserting colonoscope. Methods: 185 patients to receive colonoscopy were randomly divided into an acupuncture group (93 cases) and a control group (92 cases) in order of examination. Bilateral points Hegu (LI 4) were needled before colonoscopy in the acupuncture group. No preventive measures were taken in the control group.Pain grades during the period that colonoscope passes the sigmoid and transverse colons were observed and the time of inserting colonoscope was recorded. Results: One hundred and sixty-five patients underwent colonoscopic insertion successfully, which were taken as the effective cases. Of them, 84 cases were in the acupuncture group and 81 cases in the control group. Statistics indicated that pain grades during colonoscope's passing the sigmoid and transverse colons were significantly lower in the acupuncture group than in the control group (P＜ 0.01); the time of inserting colonoscope was significantly shorter in the acupuncture group than in the control group (P ＜ 0.05).Conclusion: Needling bilateral points Hegu(LI 4) before colonoscopy can effectively relieve the patients'discomfort and shorten the colonoscopic time during the examination.
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The Nissl and Golgi staining methods and electron microscopy were u(?)o investigate the architecture of dorsal commissure nucleus (DCN) of the sacral spinal cord in cat. A morphologically specific nucleus could be identified in the medial part of the lamina Ⅵ of dorsal horn. The nucleus located beside the dorsal funiculus at the lumbar level and gradually moved toward the midline of the dorsal gray commissure in the ventromedial direction as the dorsal gray commissure enlarged at the segments S_(1-2) and two ellipsoid nuclei was formed at the two sides of the midline. A large triangular nucleus was gradually formed by fusion of the two nuclei at S_3-Co_1. Golgi stain positive neurons could be classified into three types: (1) small-triangular neurons (60%); (2) fusiform neurons (30%); (3) oval and irregular neurons (10%). The cell organells of most neurons were plentiful. The cell nucleus was irregular and often with deep invaginations. A large number of free ribosomes and saccules could be found in the canals formed by the nuclear invagination. There were axo-dentritic, axo-axonic, axo-somatic synaptic contacts in the DCN with percentages of 89%, 6%, and 5% respectively. The serial synapse, axo-spinous synapse and crest synapses could also be found.
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2?l 10% ricin were injected into the pelvic nerve of cats. After 3～5 survival days 20% HRP solution was injected into the ipsilateral lateral parabrachial nucleus, 2～3 days later the animals were perfused with paraformaldehyde and glutaraldehyde, the brain and spinal cord were removed and processed for light and electron microscopy. It was confirmed that the primary afferent terminals (degenerated) of pelvic nerve formed axo-dendritic and axo-somatic synapses with the retrograde labelled neurons projected to the lateral parabrachial nucleus which were located in the dorsal commissure nucleus (DCN), intermediolateral nucleus (IML) and lamina Ⅰ of sacral spinal cord. Hence, the secondary afferent pathway of pelvic visceral sensation, as. indicated at the ultrastructural level, might originate from DCN, IML and lamina Ⅰ of sacral spinal cord and project to the lateral parabrachial nucleus.