ABSTRACT
Objective@#To investigate the epidemiological characteristics of injury cases admitted to department of emergency in sentinel hospitals in Fuyang District, Hangzhou City from 2015 to 2020, so as to provide insights into injury prevention and intervention in rural areas.@*Methods@# Data of injury cases were collected from the department of emergency of two sentinel hospitals in Fuyang District from 2015 to 2020, and the incidence of injury was standardized by the data from the China's seventh national population census in Fuyang District. The demographics, causes, severity and outcomes of injury were descriptively analyzed.@*Results@#Totally 84 360 injury cases were recorded in the department of emergency of two sentinel hospitals in Fuyang District from 2015 to 2020, and the annual average standardized incidence of injury was 15.85%. The injury cases included 48 330 men (57.29%) and 36 030 women (42.71%), and there were 10 653 cases at ages of <19 years (12.63%), 25 398 cases at ages of 19 to <46 years (30.11%), 39 951 cases at ages of 46 to <71 years (47.36%), and 8 359 cases at ages of 71 years and older (9.91%). Taking a private car (motor vehicles and non-motor vehicles) was the predominant way to seek medical care (75 246 cases, 89.20%). Blunt force injury and puncture wound/incision wound (23 668 cases, 28.06%), and fall injury (22 855 cases, 27.09%) were predominant causes of injury, and there were 45 961 cases with mild injury (54.48%), 28 043 cases with moderate injury (33.24%), and 356 cases with severe injury (0.42%). Returning home after hospital treatments was the predominant outcome of injury (74 401 cases, 88.19%). Mild injury was predominant among patients at ages of <19 years (81.48%), with a high rate of transfer to other hospitals (2.43%), and moderate to severe injury was predominant among patients at ages of 71 years and older (43.08% and 0.77%), with a high rate of hospital stay (18.71%) and a high mortality rate (0.14%).@*Conclusions@#Mild injury was predominant among patients admitted to the department of emergency of two sentinel hospitals in Fuyang District from 2015 to 2020, and blunt force injury, puncture wound/incision wound and fall injury were predominant causes of injury. There were age-specific epidemiological characteristics of injury cases.
ABSTRACT
Purpose@#This study was aimed to investigate long-term survivals and toxicities of early-stage nasopharyngeal carcinoma (NPC) in endemic area, evaluating the role of chemotherapy in stage II patients. @*Materials and Methods@#Totally 187 patients with newly diagnosed NPC and restaged American Joint Committee on Cancer/ International Union Against Cancer 8th T1-2N0-1M0 were retrospectively recruited. All received intensity-modulated radiotherapy (IMRT)±chemotherapy (CT) from 2001 to 2010. @*Results@#With 15.7-year median follow-up, 10-year locoregional recurrence-free survival, distant metastasis-free survival (DMFS), disease-specific survival (DSS), and overall survival (OS) were 93.3%, 93.5%, 92.9% and 88.2%, respectively. Multivariable analyses showed cervical lymph nodes positive and pre-treatment prognostic nutritional index ≥ 52.0 could independently predict DMFS (p=0.036 and p=0.011), DSS (p=0.014 and p=0.026), and OS (p=0.002 and p 45 years (p=0.002) and pre-treatment lactate dehydrogenase ≥ 240 U/L (p 0.05). Unsurprising, patients in IMRT+CT had more acute gastrointestinal reaction, myelosuppression, mucositis, late ear toxicity, and cranial nerve injury (all p < 0.05) than IMRT alone group. @*Conclusion@#Superior tumor control and satisfying long-term outcomes could be achieved with IMRT in early-stage NPC with mild late toxicities. As CT would bring more toxicities, it should be carefully performed to stage II patients.
ABSTRACT
Objective:To investigate the effects of Clostridium butyricum on colitis and intestinal microbiota in mice with or without antibiotic pretreatment. Methods:Thirty specific pathogen free BALB/c mice were randomly divided into the blank control group, dextran sulfate sodium (DSS) group, antibiotic + DSS group, Clostridium butyricum + DSS group and antibiotic+ Clostridium butyricum + DSS group, with 6 mice in each group. After the mice were pretreated with quadruple antibiotics (ampicillin 1 g/L, neomycin 1 g/L, metronidazole 1 g/L, and vancomycin 0.5 g/L) in normal drinking water for 30 d, the mice colitis model was induced with DSS. At the same time, the mice in Clostridium butyricum + DSS group and antibiotics+ Clostridium butyricum + DSS group were given 1×10 6colony-forming unit (CFU) Clostridium butyricum by gavage. The effect of Clostridium butyricum on mice with colitis was evaluated by disease activity index (DAI), colon length and histopathological score. The level of serum inflammatory factors was detected by enxyme linked immunosorbent assay, and the effect of Clostridium butyricum on gut microbita in mice was determined by fecal 16S rRNA sequencing. Results:The general condition of mice of the blank control group were good, and their DAI scores fluctuated around 0. Since the fourth day after DSS drinking water was given, the mice of the DSS group showed signs of colitis such as weight loss, unformed stools and bloody stools. On the fourth day after intervention, the DAI score of Clostridium butyricum + DSS group was lower than that of DSS group (0.000±0.000 vs. 0.444±0.111), and the difference was statistically significant ( t=4.000, P=0.016 1). On the tenth and twelfth day after the intervention, the DAI scores of antibiotic+ Clostridium butyricum + DSS group were both lower than those of antibiotic+ DSS group (0.000±0.000 vs. 1.111±0.222, 0.667±0.000 vs. 1.889±0.222), and the differences were statistically significant ( t=5.000 and 5.500, both P<0.05). The histopathological score of mice colon tissue of Clostridium butyricum + DSS group was lower than that of DSS group (2.50±1.73 vs. 5.50±1.00), and the histopathological score of mice colon tissue of antibiotic+ Clostridium butyricum+ DSS group was lower than that of antibiotic+ DSS group (1.25±0.96 vs. 5.00±0.82), and the differences were statistically significant ( t=3.000 and 5.960, both P<0.05). The serum level of interleukin (IL)-1β Clostridium butyricum+ DSS group was higher than that of blank control group ((4.464±0.075) ng/L vs. (3.907±0.080) ng/L), the serum levels of tumor necrosis factor-α, IL-6 and IL-1β of Clostridium butyricum+ DSS group and antibiotic+ Clostridium butyricum + DSS group were all lower than those of DSS group ((2.402±0.383) ng/L , (1.845±0.345) ng/L vs. (6.958±1.084) ng/L, (1.752±0.146) ng/L, (1.307±0.048) ng/L vs. (3.537±0.608) ng/L, (4.464±0.075) ng/L, (4.066±0.190) ng/L vs. (7.477±0.339) ng/L), and the differences were statistically significant ( t=5.005, 3.964, 4.495, 4.693, 6.294, 8.674 and 8.774 , all P<0.05). The results of 16S rRNA sequencing showed that there were a significantly large number of anti-inflammatory or short-chain fatty acid producing bacteria in the gut microbiota of mice intervened by Clostridium butyricum, among which the dominant bacteria genus in Clostridium butyricum + DSS group and antibiotic+ Colstridium butyicum+ DSS group were Mucispirillum (linear discriminant analysis (LDA)=3.667 log10, P=0.004) and Stenotrophomonas (LDA=2.778 log10, P=0.044). In the antibiotic+ Clostridium butyricum+ DSS group, the dominant bacteria genus were Peptococcus (LDA=2.685 log10, P=0.018), Butyricimonas (LDA=2.712 log10, P=0.011), Bilophila (LDA=3.204 log10, P=0.014), Intestinimonas (LDA=3.346 log10, P=0.010), Candidatus- Saccharimonas (LDA=3.363 log10, P=0.029), Desulfovibrio (LDA=3.402 log10, P=0.025), Oscillibacter (LDA=2.870 log10, P=0.019) and Akkermansia (LDA=4.031 log10, P=0.005). Conclusions:Clostridium butyricum can effectively improve colitis in mice and regulate the intestinal microbial structure of mice, whlie antibiotic pretreatment can strengthen its regulation of intestinal microbiota to and enhance the efficacy of Clostridium butyricum.
ABSTRACT
Objective:To investigate the effect of pulmonary rehabilitation therapy on the exercise capacity and dyspnea of persons with chronic obstructive pulmonary disease (COPD).Methods:One hundred COPD patients were randomly divided into a control group and an observation group, each of 50. Both groups were given routine medication, while the observation group was additionally provided with health guidance, oxygen therapy, respiratory physiological therapy and exercise for 3 months. Before and after the intervention, both groups′ forced expiratory volume in 1 second (FEV1) and the first and second forced expiratory volume as a percentage of FEV (FEV1%) were measured. The subjects′ motor functioning was evaluated using the 6-minute walk test. Enzyme-linked immunosorbent assays and immunoturbidimetry quantified their expression of inflammatory factors. And their ability in the activities of daily living (ADL) was evaluated using the Barthel index. The COPD quality of life questionnaire (CRQ) was also used to assess their life quality.Results:After the intervention, the average clinical efficacy in the observation group was 96%, significantly higher than that of the control group (80%). Moreover, the average FEV1, FEV1%, 6-minute walk test time of the former group were all significantly better than before the intervention and better than the control group′s results after the intervention. Their average CRP, IL-6 and TNF-α levels were all significantly lower as well. After the intervention, the observation group′s average total CRQ score and its average scores on the instrument′s emotion, fatigue, wheezing and disease control components were all better than the control group′s averages. The observation group′s average ADL score was also significantly higher than that of the control group.Conclusions:Supplementing conventional medication with pulmonary rehabilitation therapy can effectively improve the lung function, motor functioning and life quality of COPD patients. It can also lower their level of serum inflammatory factors.
ABSTRACT
Objective To evaluate the validity and reliability of the Chinese version of Xerostomia Questionnaire ( XQ-C) in nasopharyngeal carcinoma patients treated with radiotherapy. Methods XQ-C was translated according to the International Quality of Life Assessment project approach. Patients with nasopharyngeal carcinoma in different radiotherapy stages were enrolled in this study and assessed by using the XQ-C. The validity and reliability of the questionnaire results were evaluated. The content validity was assessed by experts grading method. The construct validity was assessed by exploratory factor analysis. The discriminant validity was determined by non-parametric method. The reliability was evaluated by Cronbach′s α and split-half reliability to assess the internal consistency. Results A total of 212 questionnaires were completely filled out. Content validity showed that the item content validity index ( I-CVI) ≥0.80, Scale-CVI/Ave=0.97, and P value of Kendall′s W test was 0.701. Exploratory factor analysis revealed that XQ-C was a unidimensional scale. The scale scores of patients at different stages of radiotherapy significantly differed, suggesting that the discriminant validity was good. Cronbach′s α of the scale was 0.951 and Guttman′s semi-reliability coefficient was 0.940. Conclusion The XQ-C is valid and reliable, which can be widely applied in the clinical diagnosis, treatment and research of xerostomia in Chinese nasopharyngeal carcinoma patients after radiotherapy.
ABSTRACT
PURPOSE: Little is known about combination of the circulating Epstein-Barr viral (EBV) DNA and tumor volume in prognosis of stage II nasopharyngeal carcinoma (NPC) patients in the intensity modulated radiotherapy (IMRT) era. We conducted this cohort study to evaluate the prognostic values of combining these two factors. MATERIALS AND METHODS: By Kaplan-Meier, we compare the differences of survival curves between 385 patients with different EBV DNA or tumor volume levels, or with the combination of two biomarkers mentioned above. RESULTS: Gross tumor volume of cervical lymph nodes (GTVnd, p 0 copy/mL, GTVtotal 0 copy/mL, GTVtotal ≥ 30 cm³). When patients in the low-risk group were compared with those in the high-risk group, 3-year PFS (p=0.003), LRFS (p=0.010), and DMFS (p=0.031) rates were statistically significant. CONCLUSION: Pretreatment plasma EBV DNA and tumor volume were both closely correlated with prognosis of stage II NPC patients in the IMRT era. Combination of EBV DNA and tumor volume can refine prognosis and indicate for clinical therapy.
Subject(s)
Humans , Biomarkers , Cohort Studies , DNA , Herpesvirus 4, Human , Lymph Nodes , Nasopharynx , Plasma , Prognosis , Radiotherapy , Tumor BurdenABSTRACT
PURPOSE: The purpose of this study was to evaluate the long-term clinical outcome and toxicity of induction chemotherapy (IC) followed by concomitant chemoradiotherapy (CCRT) compared with CCRT alone for the treatment of children and adolescent locoregionally advanced nasopharyngeal carcinoma (LACANPC). MATERIALS AND METHODS: A total of 194 locoregionally advanced nasopharyngeal carcinoma patients youngerthan 21 years who received CCRT with or without IC before were included in the study population. Overall survival (OS) rate, progression-free survival (PFS) rate, locoregional recurrence-free survival (LRFS) rate, and distant metastasis-free survival (DMFS) rate were assessed by the Kaplan-Meier method and a log-rank test. Treatment toxicities were clarified and compared between two groups. RESULTS: One hundred and thiry of 194 patients received IC+CCRT. Patients who were younger and with more advanced TNM stage were more likely to receive IC+CCRT and intensive modulated radiotherapy. The addition of IC before CCRT failed to improve survival significantly. The matched analysis identified 43 well-balanced patients in both two groups. With a median follow-up of 51.5 months, no differences were found between the IC+CCRT group and the CCRT group in 5-year OS (83.7% vs. 74.6%, p=0.153), PFS (79.2% vs. 73.4%, p=0.355), LRFS (97.7% vs. 88.2%, p=0.083), and DMFS (81.6% vs. 81.6%, p=0.860). N3 was an independent prognostic factor predicting poorer OS, PFS, and DMFS. The addition of IC was associated with increased rates of grade 3 to 4 neutropenia. CONCLUSION: This study failed to demonstrate that adding IC before CCRT could provide a significant additional survival benefit for LACANPC patients. Further investigations are warranted.
Subject(s)
Adolescent , Child , Humans , Chemoradiotherapy , Cohort Studies , Disease-Free Survival , Follow-Up Studies , Induction Chemotherapy , Methods , Neutropenia , RadiotherapyABSTRACT
Objective To analyze the 10-year survival outcome and failure patterns for patients with nasopharyngeal carcinoma (NPC) after intensity-modulated radiotherapy (IMRT),aiming to provide reference for optimized treatment for NPC.Methods Clinical data of 866 patients with NPC receiving IMRT from January 2001 to December 2008 were retrospectively analyzed.Survival analysis was performed using the Kaplan-Meier estimator.Univariate analysis was carried out by log-rank test and multivariate analysis was performed using Cox proportional hazards model.Results The median follow-up time was 132 months.The 10-year local recurrence-free survival (LRFS),distant metastasis-free survival (DMFS),progression-free survival (PFS) and disease specific survival (DSS) were 92.0％,83.4％,75.7％ and 78.6％,respectively.A total of 210 patients died including 124 patients (59.0％) from distant metastasis,which was the primary cause of death,and 47 (22.3％) from local regional recurrence.Independent negative factors of DSS included age＞50 years (P=0.00),LDH ≥ 245 IU/L (P=0.00),Hb＜ 120 g/L (P=0.01),T2-T4 staging (P=0.00),N1-N3 staging (P=0.00) and GTV-nx＞20 cm3(P=0.00).The 10-year LRFS,DMFS and DSS of stage Ⅱ NPC patients did not significantly differ after IMRT alone and chemoradiotherapy (P=0.83,0.22,0.23).For patients with stage Ⅲ NPC,the 10-year LRFS and DSS in the chemoradiotherapy arm were significantly higher than those in the IMRT alone (P=0.01,0.01),whereas no statistical significance was observed in the DMFS between two groups (P=0.14).The overall survival of stage Ⅳa+Ⅳb NPC patients is relatively poor.Conclusions IMRT can improve the long-term survival of NPC patients.Distant metastasis is the primary failure pattern.Patients with stage Ⅰ-Ⅱ NPC can obtain satisfactory survival outcomes after IMRT alone.The addition of chemotherapy can further enhance the LRFS and DSS of stage Ⅲ NPC patients.However,the optimal therapeutic strategy remains to be urgently investigated for stage a+ Ⅳb NPC patients.
ABSTRACT
Objective:To explore the association between phase angle (PA) of bioelectrical impedance analysis (BIA) and nutritional risk assessed by Nutritional Risk Screening (NRS-2002) Subjective Global Assessment (SGA),and hospital length of stay (LOS) in patients undergoing thoracic surgery.Methods:60 patients who underwent thoracic surgery were evaluated for nutrition risk and hospital length of stay (LOS) by NRS2002,SGA,albumin and bioelectrical impedance analysis.Results:The PA values were lower in the patients [men(3.85 ± 1.0)°,women(4.9 ± 0.6)°] than the control group [men(6.0 ± 1.0)°,women(5.4 ± 0.9)°,P ＜ 0.01].Patients were more likely to have lower PA values than the control group.NRS 2002:no risk (relative risk (RR) 2.8,95％ confidence interval (CI) =1.2 ～ 6.9),moderate risk (RR 3.9,95％ CI =1.8 ～ 8.6) and severe risk (RR 4.2,95％ CI =2.0 ～ 8.7);similar results were obtained by SGA:eutrophy (RR 2.5,95％ CI =0.9 ～ 6.9),Moderate malnutrition (RR 4.4,95％ CI =2.1 ～ 9.4),severe malnutrition (RR 3.9,95％CI =1.9 ～ 8.0);Patients with low PA values were more inclined to be hospitalized for more than 21 days compared with the control group (LOS ≥ 21 days,RR =4.4,95％ CI =2.2 ～ 2.8).Conclusion:There is a significant association between low PA values and nutritional risk and prolonged LOS.PA is helpful to identify patients who are at nutritional risk at hospital admission in order to provide an objective basis for determining the nutritional interventions of patients and judging the outcomes of the diseases.
ABSTRACT
AIM To observe the curative effects of Modified Buzhong Yiqi Decoction (Codonopsis Radix,Astragali Radix,Atractylodis macrocephalae Rhizoma,ect.) on perioperative period of intertrochanteric fractures in elderly patients with Qi deficiency and blood stasis type.METHODS One hundred and twenty cases of elderly intertrochanteric fractures were randomly divided into treatment group and control group,60 cases in each group.All patients underwent closed fracture reduction and proximal femoral nail anti-rotation (PFNA) fixation.During the perioperative period,the control group only received conventional treatment,while the treatment group received conventional treatment and Modified Buzhong Yiqi Decoction once a day.The levels of interleukin-6 (IL-6),interleukin-10 (IL-10) and tumor necrosis factor (TNF-α) of both groups in preoperative and in the 1st day,the 7th day,the 14th day of postoperative were observed and compared.The complications and the curative effects according to the Harris score also were observed and compared between the two groups.RESULTS In preoperative,there was no significant difference in levels of IL-6,IL-10 and TNF-α between the two groups (P ＞ 0.05).The levels of IL-6 and TNF-α in the 1 st day of postoperative in the control group were significantly higher than those in the treatment group (P ＜0.05,P ＜0.01).And the levels of IL-10 were similar between the two groups (P ＞0.05).In addition,in the 7th day and the 14th day of postoperative,the levels of IL-6,IL-10 and TNF-α in both groups were all decreased,moreover,the descent degree in treatment group was more significant than those in the control group (P ＜ 0.05,P ＜ 0.01).The treatment group had the lower incidence of complications and the higher curative effects than those in the control group,both differences were statistically significant (P ＜0.05).CONCLUSION Modified Buzhong Yiqi Decoction applying to the perioperative period of femoral intertrochanteric fractures in elderly patients with Qi deficiency and blood stasis,can effectively reduce the perioperative inflammatory response,reduce the incidence of postoperative complications,and improve the curative effects.So it has a positive effect on the rehabilitation for the traumatic patients and is worthy of clinical promotion.
ABSTRACT
Background:Fusobacterium nucleatum (Fn)is a common oral pathogen. Studies have shown that Fn is closely related to the occurrence and development of colorectal cancer,especially the inflammation-related colorectal cancer. Aims:To investigate the mechanism of Fn in forming an inflammatory microenvironment in colon cancer cells. Methods:An inflammation model of Caco-2 cells infected by Fn was constructed,and miRNA sequencing was performed. miR-181b mimics or inhibitor was transfected into Fn infected Caco-2 cells. mRNA and protein expressions of TNF-α were determined by qRT-PCR and Western blotting,respectively,and concentration of TNF-α in supernatant was measured by ELISA, number of lymphocyte penetrating the membrane was measured by Transwell chamber. Results:Compared with control group,mRNA and protein expressions of TNF-α were significantly increased (P < 0. 05),concentration of TNF-α in supernatant was significantly increased (P < 0. 05),and number of lymphocyte penetrating the membrane was significantly increased in Fn group (P < 0. 05). miRNA sequencing and qRT-PCR results showed that expression of miR-181b was significantly decreased in Fn group than in control group (P < 0. 05). Compared with control group,mRNA and protein expressions of TNF-α were significantly decreased in miR-181b mimics + Fn group (P < 0. 05),however,mRNA and protein expressions of TNF-α were significantly increased in miR-181b inhibitor group (P < 0. 05). Bioinformatics tools and Luciferase assay confirmed that TNF-α might be the target gene of miR-181b in Caco-2 cells. Conclusions:Fn can up-regulate the expression of TNF-α by inhibiting miR-181b in Caco-2 cells and recruiting lymphocytes to form an inflammatory microenvironment.
ABSTRACT
Background:Fusobacterium nucleatum (Fn)is a common oral pathogen. Studies have shown that Fn is closely related to the occurrence and development of colorectal cancer,especially the inflammation-related colorectal cancer. Aims:To investigate the mechanism of Fn in forming an inflammatory microenvironment in colon cancer cells. Methods:An inflammation model of Caco-2 cells infected by Fn was constructed,and miRNA sequencing was performed. miR-181b mimics or inhibitor was transfected into Fn infected Caco-2 cells. mRNA and protein expressions of TNF-α were determined by qRT-PCR and Western blotting,respectively,and concentration of TNF-α in supernatant was measured by ELISA, number of lymphocyte penetrating the membrane was measured by Transwell chamber. Results:Compared with control group,mRNA and protein expressions of TNF-α were significantly increased (P < 0. 05),concentration of TNF-α in supernatant was significantly increased (P < 0. 05),and number of lymphocyte penetrating the membrane was significantly increased in Fn group (P < 0. 05). miRNA sequencing and qRT-PCR results showed that expression of miR-181b was significantly decreased in Fn group than in control group (P < 0. 05). Compared with control group,mRNA and protein expressions of TNF-α were significantly decreased in miR-181b mimics + Fn group (P < 0. 05),however,mRNA and protein expressions of TNF-α were significantly increased in miR-181b inhibitor group (P < 0. 05). Bioinformatics tools and Luciferase assay confirmed that TNF-α might be the target gene of miR-181b in Caco-2 cells. Conclusions:Fn can up-regulate the expression of TNF-α by inhibiting miR-181b in Caco-2 cells and recruiting lymphocytes to form an inflammatory microenvironment.
ABSTRACT
OBJECTIVE@#To explore the clinical repair value of facial skin and tissue defect caused by tumour, trauma and infection with the axial flap.@*METHOD@#The clinical data of 38 patients with facial skin and tissue defect were analyzed retrospectively. All of them were repaired by the axial flap.@*RESULT@#The axial flap was alive in all patients, and all incision healed in the first stage. All patients had a satisfied result after the second stage of flap surgery.@*CONCLUSION@#The method of the axial flap in face can be clinically applied in the facial skin and tissue defects caused by tumour, trauma injury and infection. Because the axial flap cotained named blood vessel, the survival rate of it is high.
Subject(s)
Humans , Dermatologic Surgical Procedures , Face , General Surgery , Plastic Surgery Procedures , Retrospective Studies , Skin Transplantation , Surgical Flaps , Wound HealingABSTRACT
Objective To explore the feasibility of employing a risk category system in evaluating the treatment outcome of locoregionally advanced nasopharyngeal carcinoma (NPC) treated by intensitymodulated radiation therapy (IMRT) alone,and offering evidence for relevant perspective studies.Methods Totally 185 locoregionally advanced NPC patients were divided into high-risk and low-risk groups for evaluation and comparison.The patients who met at least one of the following criteria were defined as high-risk group and others as low-risk group:GTVnx ＞ 30 cm3;Clinical stage T4N2M0;multiple neck node metastases with 1 node size ＞4 cm,and N3 with any T stage.Results With a median follow up of 110.9 months (6.7-152.4 months),the 5-year overall survival,locoregional relapse-free survival,distant metastasis-free survival for the high-risk group vs.the low-risk group were 61.0％ vs.90.5％ (x2 =30.298,P＜0.05),78.3％ vs.91.5％ (x2 =6.352,P＜0.05)and 71.6％ vs.92.0％ (x2 =16.346,P ＜0.05).Conclusions As a simple and practicable method,the risk category system is helpful for discriminating locoregionally advanced nasopharyngeal carcinoma with different risk-group of treatment failure and in further perspective clinical research.
ABSTRACT
A simple and cost-effective indirect competitive enzyme-linked immune sorbent assay (ic-ELISA) was developed to rapidly screen the content of aflatoxin B1 (AFB1) in lotus seeds, and the results were confirmed by ultra-fast liquid chromatography-tandem mass spectrometry( UFLC-MS/MS). Matrix-matched calibration expressed a good linearity ranging from 0. 171 to 7. 25 µg · L(-1) for AFB, with R2 > 0.978. The medium inhibitory concentration( IC50 ) for AFB1 was 1.29 µg · L(-1), the recovery for AFB1 was 74.73% to 126.9% with RSD < 5%, and the limit of detection (IC10) was 0.128 µg · L(-1). The developed ic-ELSIA method was applied to rapid analysis of AFB, in 20 lotus seeds samples and the results indicated that the contents of AFB, in samples 1-15 were in the range of 1. 19- 115. 3 µg · kg(-1) and in 40% of the samples exceeded the legal limit(5 µg · kg(-1)), while the contamination rate of AFB, in samples 16-20 was 40%. Pearson correlation coefficient(r) reached 0.997 for AFB1 content in the samples detected by ic-ELSIA and UFLC-MS/MS methods. The results proved that the developed ic-ELISA method is simple, sensitive and reliable, and can be used for rapid and high-throughput screening of AFB1 in lotus seeds
Subject(s)
Aflatoxin B1 , Drug Contamination , Enzyme-Linked Immunosorbent Assay , Methods , Lotus , Chemistry , Seeds , ChemistryABSTRACT
<p><b>INTRODUCTION</b>The properties of a tumor itself were considered the main factors determining the survival of patients with locally recurrent nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiotherapy (IMRT). However, recurrent tumors were mainly evaluated by using the American Joint Committee on Cancer staging system, which was modeled on primary tumors and did not incorporate the tumor volume. This study aimed to investigate the prognostic values of the primary tumor location and tumor volume, and to determine whether evaluating these parameters could improve the current staging system.</p><p><b>METHODS</b>Magnetic resonance (MR) images for 229 patients with locally recurrent NPC who underwent IMRT were analyzed retrospectively.</p><p><b>RESULTS</b>The skull base, parapharyngeal space, and intracranial cavity were the most common sites of tumors. There was a difference in the survival between patients with T1 and T2 diseases (77.6% vs. 50.0%, P<0.01) and those with T3 and T4 diseases (33.0% vs. 18.0%, P=0.04) but no difference between patients with T2 and T3 diseases (50.0% vs. 33.0%, P=0.18). Patients with a tumor volume≤38 cm3 had a significantly higher survival rate compared with those with a tumor volume>38 cm3 (48.7% vs. 15.2%, P<0.01).</p><p><b>CONCLUSIONS</b>A new staging system has been proposed, with T3 tumors being down-staged to T2 and with the tumor volume being incorporated into the staging, which may lead to an improved evaluation of these tumors. This new system can be used to guide the treatment strategy for different risk groups of recurrent NPC.</p>
Subject(s)
Humans , Carcinoma , Nasopharyngeal Neoplasms , Neoplasm Staging , Prognosis , Radiotherapy, Intensity-Modulated , Recurrence , Retrospective Studies , Survival Rate , Tumor BurdenABSTRACT
Objective: To compare the efficacy of induction chemotherapy (IC) plus intensity-modulated radiotherapy (IMRT) with that of concurrent chemo-radiotherapy (CCRT) plus adjuvant chemotherapy (AC) for patients with loco-regionally advanced naso-pharyngeal carcinoma (NPC). Methods:Data of 240 patients with loco-regionally advanced NPC were reviewed. These patients were admitted to the Sun Yat-sen University Cancer Center between January 2004 and December 2008. Among the 240 patients, 117 under-went the IC+IMRT and 123 were treated with the CCRT+AC. The IC+IMRT group received a regimen including cisplatin and 5-fluoro-uracil (5-FU). The CCRT+AC group received cisplatin concurrently with radiotherapy and subsequently received adjuvant cisplatin and 5-FU. The survival rates of the patients were assessed by Kaplan-Meier analysis, and the survival curves were compared by Log-rank test. Multivariate analysis was conducted using Cox proportional hazard regression model. Results:The 5-year overall survival (OS), disease-free survival, distant metastasis-free survival, local relapse-free survival, and the nodal relapse-free survival were 78.0%versus 78.7%, 68.9%versus 67.5%, 79.0%versus 77.0%, 91.6%versus 91.0%, and 95.3%versus 93.7%in the IC+IMRT and CCRT+AC groups, respectively. The survival between the two groups exhibited no significant differences. Higher rates of Grades 3 to 4 nau-sea-vomiting (8.1%vs. 1.7%, P=0.023) and leukopenia (9.7%vs. 0.9%, P=0.006) were observed in the CCRT+AC group. Multivariate analysis revealed that N stage and age were significant prognostic factors for the OS of the patients with loco-regionally advanced NPC. Conclusion:The treatment outcomes of IC+IMRT and CCRT+AC were similar. Distant metastasis remained as the predominant mode of treatment failure.
ABSTRACT
Postradiation nasopharyngeal necrosis is an important late effect of radiotherapy that affects prognosis in patients with nasopharyngeal carcinoma. In the present study, we reviewed the clinical and imaging features of 67 patients with pathologically diagnosed postradiation nasopharyngeal necrosis who were treated at Sun Yat-sen University Cancer Center between June 2006 and January 2010. Their clinical manifestations, endoscopic findings, and imaging features were analyzed. Early nasopharyngeal necrosis was limited to a local site in the nasopharyngeal region, and the tissue defect was not obvious, whereas deep parapharyngeal ulcer or signs of osteoradionecrosis in the basilar region was observed in serious cases. Those with osteoradionecrosis and/or exposed carotid artery had a high mortality. In conclusion, Postradiation nasopharyngeal necrosis has characteristic magnetic resonance imaging appearances, which associate well with clinical findings, but pathologic examination is essential to make the diagnosis.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Carcinoma , Magnetic Resonance Imaging , Nasopharyngeal Neoplasms , Radiotherapy , Nasopharynx , Pathology , Radiation Effects , Necrosis , Osteoradionecrosis , Diagnosis , Radiation Injuries , Diagnosis , Radiotherapy, Intensity-ModulatedABSTRACT
Objective To investigate the long-term outcomes of patients with nasopharyngeal carcinoma (NPC) in different stages treated by intensity-modulated radiotherapy (IMRT) and explore their treatment strategies.Methods A retrospective analysis was performed on the clinical data of 868 NPC patients without distant metastasis who received radical IMRT from May 2001 to October 2008.These patients were divided into early N0 (T1-2N0) group (n =137),early N1 (T1-2N1) group (n =129),locally advanced (T3-4N0-1) group (n =322),regionally advanced (T1-2 N2-3) group (n=107),and locoregionally advanced (T3-4 N2-3) group (n =173).There groups were compared in terms of treatment outcome and treatment strategy.Results The follow-up rate was 91.4％,and 314 patients completed 5-years follow-up.The 5-year overall survival rate,local recurrence-free rate,and distant metastasis-free rate (DMFR) were 83.5％,91.8％,and 84.6％,respectively.The early N0 group had the best treatment outcome,with a 5-year disease-specific survival (DSS) rate up to 99.1％.Each group had a similar outcome after receiving either IMRT alone or IMRT combined with chemotherapy.The locally advanced group and regionally advanced group had similar failure patterns and treatment outcomes.The locoregionally advanced group had the worst treatment outcome,with a 5-year DMFR of 67.2％ and a DSS of 68.0％.The regionally advanced group and locoregionally advanced group had a similar treatment outcome after receiving IMRT alone,induction chemotherapy plus IMRT,or concurrent chemotherapy and IMRT.Conclusions Patients with NPC in different stages have different survival outcomes.It is recommended that different treatment strategies should be adopted according to the T and N stages of NPC.IMRT alone can produce satisfactory results in patients with T1-2N0 NPC,but a more effective medication should be added to IMRT in patients with advanced NPC,particularly those with T3-4N2-3 NPC who have a relatively low DMFR.
ABSTRACT
ObjectiveTo explore the prognostic value of pretreated maximum standardized uptake value (SUVmax) using 18-fluorodeoxyglucose positron emission tomography with computed tomography (18FDG PET/CT) in locally-advanced nasopharyngeal carcinoma (NPC) treated by intensity-modulated radiotherapy (IMRT).MethodsOne hundred and forty previously untreated stage Ⅲ - Ⅳb ( UICC/AJCC 6th) patients with biopsy-proven nasopharyngeal carcinoma were examined.All of the enrolled patients accepted whole body/head-neck 18FDG PET/CT before radical IMRT. 18FDG uptakes were recorded as SUVmax of primary tumor (SUVmax-P) and SUVmax of cervical lymph nodes (SUVmax-N).The relationships between SUVmax and long-term clinical outcomes were analyzed.ResultsThe median SUVmax-P was 10.4,and the median SUVmax-N was 6.2.The SUVmax-P was weakly correlated with T-stage ( R =0.279,P =0.001 ).The SUVmax-N was weakly correlated with N stage ( R =0.334,P =0.000 ).There were no difference of the median SUVmax-P (9.2 vs.10.4,U =560.50,P =0.805 ) and the median SUVmax-N (4.0vs.5.0,U =576.00,P =0.908) between patients with and without local recurrence.The median SUVmax-P of patients with distant metastasis was significantly higher than those without metastasis (11.9 vs.9.8,U =987.50,P =0.014).The SUV of 10.2 was taken as a cut-off for high and low uptake tumors.For patients with SUVmax-P ＞ 10.2,the 5-year distant metastasis-free survival (DMFS) and 5-year overall survival (OS)were significantly higher than those with SUVmax-P ≤ 10.2 (69.1％ vs.95.5％,x2 =15.88,P =0.000;68.4％ vs.94.0％,x2 =15.56,P =0.000,respectively).Multivariate analysis showed that SUVmax-P was the only independent risk factor of 5-year DMFS and OS ( HR =7.87,P =0.001 and HR =5.14,P =0.003). Conclusion SUVmax-P is a useful biomarker predicting long-term clinical outcomes in newly diagnosed locally-advanced NPC patients.