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Objective:To analyze the prognostic factors of patients with Ⅰ B1-Ⅱ A cervical cancers after surgery and to assess the effects and adverse reactions of intensity-modulated radiotherapy(IMRT)combined with concurrent chemotherapy(CCRT). Methods:A retrospective analysis was performed based on the clinical and follow-up data of 362 patients with Ⅰ B1-Ⅱ A cervical cancers who were treated in Changzhou Second People′s Hospital from January 2009 to December 2019. Meanwhile, these patients suffered large primary tumors(LPT; tumors size: ≥4 cm), lymphatic vascular space invasion (LVSI), and deep stromal invasion(DSI; stromal infiltration depth: ≥1/2) after surgery and showed at least one intermediate-risk factor. Among these cases, 161 cases were treated with CCRT, 131 cases under-went single radiotherapy (RT), and 70 cases received unadjuvanted radiotherapy. The Kaplan-Meier method and the logrank test were adopted for univariate survival analysis, the binary logistic regression was used to analyze the recurrence risk, and Cox regression model was used for multivariate survival analysis. Results:The 3 and 5-year overall survival (OS) rates were 94.20% and 88.39%, respectively. The retrospective analysis showed that the risk factors of recurrence included tumor size ≥ 4 cm and poorly differentiated cancers( OR=3.287, 2.870, 95% CI: 1.366-7.905, 1.105-7.457, P<0.05). Compared with the treatment without adjuvant radiotherapy and RT, CCRT reduced the recurrence rate of tumors with tumor size of ≥ 4 cm, adenocarcinomas or adenosquamous carcinomas (pathological types), and poorly differentiated carcinomas( χ2=6.725-7.518, P<0.05). A multivariate analysis showed that the CCRT improved the recurrence-free survival ( HR=0.290, 95% CI: 0.128-0.659, P=0.003) and OS ( HR=0.370, 95% CI: 0.156-0.895, P=0.024). A subgroup analysis indicated that CCRT prolonged the OS of patients with tumor size ≥ 4 cm or poorly differentiated cancers compared to the patients receiving no radiotherapy or those treated with RT (χ 2=7.614, 5.964, P<0.05). Compared with the cases receiving single radiotherapy, those receiving CCRT did not suffer an increase in the incidence of hematology, radiation enteritis, and cystitis above grade 3 according to observation ( P>0.05). Conclusions:Among the intermediate-risk factors leading to the recurrence of postoperative cervical cancers, the factors of large primary tumors or poorly differentiated cancers affect the prognosis of patients.Compared with RT and the treatment without adjuvant radiotherapy, IMRT combined with concurrent chemotherapy can prolong the recurrence-free survival and overall survival of patients with large tumors or poorly differentiated cancers and adverse reactions induced are tolerable.
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Objective To predict the tolerance range of set-up errors in clinical practice by predicting the virtual set-up errors of postoperative radiotherapy patients for breast cancer. Methods A retrospective analysis was made of the patients who underwent radiotherapy after breast cancer surgery in recent 3 years. According to different treatment method, 10 cases of breast cancer after modified radical mastectomy and 10 cases after breast conserving radical mastectomy were selected. The target area was delineated, the volume modulated radiation therapy plan was made, the virtual moving error of the center point of the plan was moved, and the maximum moving error was 5 mm by 1 mm step. After recalculating the dose, the corresponding data including the clinical target areas ( CT ) , CTV ( V50 ) , average heart volume, V20 of the affected lung and CTV volume were recorded. SPSS 19. 0 software was used for statistical analysis, and repeated measurement of variance analysis was used to analyze the changes of the actual dose in the target area after moving the center point. Linear regression analysis method was used to analyze the correlation between the CTV volume and the dose change after the CTV moving midline. Results The virtual set-up error had little influence on the axis direction of the approximate mammary tangent direction, while the vertical direction of the approximate mammary tangent direction had greater influence. After moving more than 3 mm on the vertical axis, the CTV ( V50 ) decreased to below 90％, which was lower than the general requirement for the target area of CTV. Statistical analysis of set-up errors in all directions showed that there was significant difference in dosimetric changes ( F=34. 182, 12. 877, 16. 443, 9. 846, 46. 829, 10. 122, 57. 931, P <0. 05) in all directions except the B direction of left breast set-up errors (P>0. 05). Between breast conserving surgery and modified radical mastectomy, there was little effect on target movement. Through correlation analysis, it was found that the volume of CTV in the target area of breast cancer patients was linearly related to the errors caused by the movement of B, C and B directions of left breast and right breast(F=5. 733, 18. 496, 6. 630, P<0. 05). Conclusions In postoperative radiotherapy for breast cancer, the errors perpendicular to the section of breast should be paid special attention to whether left or right breast. When the error of this direction exceeds 3 mm, CTV is obviously less than V50 below 83. 85％. The effect of set-up error on the dose of CTV was not related to the operation mode of breast cancer and there was no obvious correlation with the volume of the target area.
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Objective To explore the relationship between left ventricular volume parameters and cardiac function in elderly patients with heart failure. Methods From January 1st, 2012 to December 31st, 2014,five hundred and twenty-eight heart failure elderly patients with coronary heart disease,hypertension,heart valve disease, dilated cardiomyopathy, and hypertrophic cardiomyopathy in Kailuan General Hospital were collected in this study. The left ventricle diastolic end volume ( LVEDV ) , left ventricle end systolic volume ( LVESV) and left ventricular ejection fraction of the patients were measured. The concentrations of N type brain natriuretic peptide ( NT-proBNP ) and related biochemical indexes were detected. Results Among the 528 patients with cardiac insufficiency,367 were males and 161 were females. Among them,there were 199 cases of heart function I,163 cases of heart function II,99 cases of heart function III and 67 cases of heart function IV. Correlation analysis showed that the correlation coefficients of LVEDV, LVESV and age were 0. 431 ( P=0. 001) ,0. 472 ( P=0. 001 ) and 0. 243 ( P<0. 001 ) , respectively. Logistic regression analysis showed that LVEDV ( OR=2. 654, 95%CI 2. 124-3. 894, P=0. 004 ) , LVESV ( OR=2. 939, 95%CI 2. 539-3. 256, P=0. 001),LVESV),NT-proBNP (OR=2. 921,95%CI 2. 888-3. 562,P=0. 002) were risk factors for heart failure. Conclusion The correlation between LVESV and cardiac function in elderly patients with heart failure is better than that in LVEDV,and the correlation between the two and cardiac function is better than that of age.
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Background and Purpose: With the rapid development of minimally invasive technique, robotic surgery is widely used in the gynecological surgery. This study aimed to compare the clinical data of roboticassisted laparoscopy and laparotomy in the treatment of early ovarian cancer. Methods: A total of 22 patients with early ovarian cancer receiving stage Ⅰ operation between Jan. 2015 and Dec. 2016 in Jilin Province Tumor Hospital were randomly divided into two groups: 8 patients received robotic-assisted surgery (robotic-assisted laparoscopic group), 14 patients received laparotomy (laparotomy group). Results: All patients underwent successful operation without changing surgical approach. The operation time in robotic-assisted laparoscopic group was longer than that in laparotomy group [(194.50±10.90) min vs (178.71±10.58) min, P＜0.05]. Blood loss volume [(60.10±8.88) mL vs (73.71±12.99) mL], 24 hours postoperative drainage volumes of robotic-assisted laparoscopic group were less than those in laparotomy group [(96.88±10.21) mL vs (108.00±11.43) mL, P＜0.05]. Others had no statistical significance (P＞0.05). Conclusion: In the clinical treatment of early ovarian cancer, there is no difference between robotic-assisted laparoscopic operation and laparotomy. Robotic-assisted laparoscopic operation is worthy of clinical promotion and application.
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Objective To explore the effect of the joint edaravone in early rehabilitation on the prognosis of patients with ischemic stroke.Methods The general branch of Kailuan group of patients with ischemic stroke who were conformed to the 1995 national conference on the 4th cerebrovascular diagnostic criteria with head CT or MRI imaging diagnosis,were collected from January 2012 to December 2014.A total of 324 cases were the first onset,who had been treated with conventional drugs,and were randomly divided into the observation group(edaravone associated with early rehabilitation)and the control group(early rehabilitation)with 162 cases in each group.Patients of the observation group were given venous application of edaravone and received the standardized rehabilitation treatment within 48 hours.The control group were given standard rebabilitation therapy at 2 weeks after attacked.NIHSS and MMSE scores of the two groups of patients were evaluated at the beginning of the rehabilitation course,4 weeks and 12 weeks of the treatments.Results There were no statistically significant difference and the clinial manifestations of the lesion site between the two groups of patients on admission.At the beginning of the rehabilitation,the NIHSS and MMSE score of control group were statistically significant different from that of observation group [NIHSS:(14.8 ±5.3)vs.(16.1 ±5.1),PNIHSS =0.049;MMSE:(15.9 ±6.3)vs.(14.2 ±6.2),PMMSE =0.041].The sec-ond and third evaluation were respectively conducted at 4 weeks[NIHSS:(10.1 ±6.3)vs.(8.2 ±5.7),MMSE:(17.7 ±5.5)vs.(20.9 ±5.9)]and 12 weeks[NIHSS:(6.6 ±4.9)vs.(4.7 ±3.6),MMSE:(21.0 ±4.8)vs. (24.6 ±4.9)].The results of the observation group were significantly better than the control group(P4W NIHSS =0.036,P4W MMSE =0.035;P12W NIHSS =0.006,P12W MMSE =0.003),and the differences were statistically significant. Conclusion Edaravone associated with early rehabilitation can obviously improve the prognosis of patients with ischemic stroke.
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OBJECTIVE:To investigate the effect of atorvastatin calcium on the carotid intima-media thickness(IMT)and other related indicators in patients with metabolic syndrome(MS). METHODS:The data of 1 444 patients with MS were retrospectively analyzed and randomly divided into observation group(874 cases)and control group(570 cases)by different medication. All patients were given healthy lifestyle,antihypertensive,hypoglycemia and lowering blood lipid guidance. On this basis,treatment group was orally given atorvastatin calcium 20 mg,once every evening. The follow-up was conducted for 3 years. The clinic data in 2 groups was compared,including body mass index(BMI),waist circumference(WC),systolic blood pressure(SBP),diastolic blood pressure (DBP),pulse pressure(PP),IMT,total cholesterol(TC),triglyceride(TG),low conspired lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),high-sensitivity C-reactive protein(hs-CRP),fasting plasma glucose(FPG)and incidence of adverse reactions before and after treatment. RESULTS:After treatment,compared with before and control group,the BMI、WC、SBP、DBP、PP、IMT、TC、TG、LDL-C、HDL-C、hs-CRP and FPG in observation group were significantly improved,only TG、LDL-C and HDL-C in control group were significantly improved,the differences were statistically significant(P<0.05). There were no obvious adverse reactions during treatment. CONCLUSIONS:Based on the conventional treatment,atorvastatin calcium can effectively improve the IMT and blood lipid,blood pressure and blood glucose of patients with MS,with good safety.
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OBJECTIVE:To observe the clinical efficacy and safety of edaravone combined with early rehabilitation in the treat-ment of cerebral hemorrhage,and to provide clinical evidence for rehabilitation management and drug treatment of cerebral hemor-rhage patients. METHODS:168 patients with cerebral hemorrhage,collected from neurology department of our hospital during Jan. 2012 to Dec. 2014,were randomly divided into observation group and control group with 84 cases in each group. Both groups re-ceived routine treatment;observation group was additionally given edaravone intravenously on the basis of routine treatment,and be-gan to receive standardized rehabilitation treatment within 48 hours after the onset of symptom;control group began to receive stan-dardized rehabilitation treatment 2 weeks after the onset of symptom. NIHSS and MMSE score of 2 groups were conducted before re-habilitation treatment,and after 4 and 12 weeks of treatment. RESULTS:There was no statistically significant difference in lesion site and clinical manifestations between 2 groups on admission(P>0.05);both NIHSS and MMSE score of observation group were better than those of control group after 4 and 12 weeks of treatment,there was statistical significance(P<0.05). CONCLUSIONS:Edaravone associated with early rehabilitation can obviously improve the prognosis of patients with cerebral hemorrhage.
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Objective To investigate the sleep structure of children with attention deficit hyperactivity disorder (ADHD) and the differences among subtypes of ADHD.Methods Ninety children with ADHD were diagnosed in Department of Neurology, the Children's Hospital Affiliated to Capital Institute of Pediatrics between June 2012 and June 2013, including 75 boys and 15 girls,6-14 years old [(9.5 ± 2.4) years old], and among them there were 55 cases of ADHD-combined type, 25 cases of ADHD-inattentive type, and 10 cases of ADHD-hyperactive impulsive type.Thirty healthy children whose age and sex matched with ADHD group,came from Beijing and the surrounding area,were selected as the healthy control group,including 23 boys and 7 girls,6-14 years old [(9.2 ± 2.9) years old].Two groups underwent full overnight sleep assessment.Results The latency of rapid eye movement(REM) in children with ADHD was (146.58 ± 47.28) minutes, and the sleep latency was 19.00 minutes [(8.25-37.50) minutes];while the latency of REM in healthy control group was (87.55-± 13.59) minutes, and the sleep latency was 9.00 minutes [(3.50-13.63)minutes].Compared with healthy control group, children with ADHD demonstrated the increased latency REM and sleep latency, and decreased sleep efficiency,the increasing times of awakening and total duration,and these differences were all statistically significant(all P ＜ 0.05).The percentage of non-rapid eye movement(NREM) phase Ⅱ in ADHD hybrid was lower than the ADHD attention-deficit(t =2.012,P ＜ 0.05).Sleep latency in ADHD attention-deficit was longer than the ADHD hybrid(t =2.964,P ＜ 0.05).No statistical differences were found among the various types in other indicators.The prevalence of periodic limb movements in sleep(PLMS) was 27.78％ (25/90 cases) in ADHD group and the prevalence of PLMS was 3.30％ (1/30 cases) in the healthy control group.The differences in prevalence between 2 groups were statistically significant (x2 =8.053, P ＜ 0.05).Conclusions Children with ADHD significantly display more problems with sleep.Sleep latency and NREM Ⅱ are different between ADHD attention-deficit and ADHD hybrid.
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Objective To study the association of metabolic syndrome (MS)with cardiovascular disease (CVD).Methods According to the diagnostiv criteria for MS,1457 MS patients as the research objects,who were screened out of the tangshian harbor economic development zone hospital.All patients were detected with waist circ-umference,seat systolic blood pressure(SBP),diastolic boold pressure(DBP),fasting Plasma glucose(FPG),total cholesterol(TC),low -density lipoprotein cholesterol(LDL -C),high density lipoprotein cholesterol(HDL -C),tri-glyceride(TG).By 3 years follow -up and the carotid ultrasound detection of carotid intima -media thickness(IMT), all the patients were divided into three groups according to the diagnosis:event group (Coronary heart disease +Hypertensive heart disease,stroke,Coronary heart disease +Hypertensive heart disease +stroke)and control group. Results The patients′SBP[(145.5 ±15.7)mmHg,(149.9 ±13.8)mmHg,(156.3 ±14.6)mmHg],DBP [(92.5 ±8.7)mmHg,(97.9 ±9.0)mmHg,(101.0 ±10.0)mmHg],FPG[(6.3 ±2.6)mmol/L,(6.0 ± 2.5)mmol/L,(6.9 ±2.6)mmol/L],TC[(5.46 ±1.28)mmol/L,(5.10 ±1.15)mmol/L,(5.37 ±1.21)mmol/L], LDL -C[(3.40 ±0.75)mmol/L,(3.08 ±0.65)mmol/L,(3.24 ±0.72)mmol/L],TG[(3.44 ±1.60)mmol/L, (3.31 ±1.52)mmol/L,(3.38 ±1.58)mmol/L]of the event group were significantly higher than the control group [(139.2 ±17.4)mmHg,(85.6 ±9.1 )mmHg,(5.5 ±2.1 )mmol/L,(1.4 ±0.4 )mmol/L,(2.59 ± 0.64)mmol/L,(2.61 ±1.28)mmol/L]and HDL -C[(1.13 ±0.38)mmol/L,(1.2 ±0.4)mmol/L,(0.9 ± 0.23)mmol/L]was significantly lower than the control group[(1.4 ±0.4)mmol/L](P <0.05).Detection rates of all the event groups were significantly higher in age[(53.4 ±6.4)years,(54.6 ±6.6)years,56.3 ±6.8)years], hypertensive heart disease(67.8%,74.8%,88.0%),high blood sugar(46.7%,42.9%,49.7%),and carotid atherosvletosis (19.9%,18.9%,29.3%)than the control group[(47.2 ±6.5)years,47.2%,24.3%,5%)](P <0.05).Conclusion There was a correlation between Mdtabolic syndrome and Cardiovascular disease.
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<p><b>OBJECTIVE</b>To investigate the impact of premature birth on long term cardio-cerebral vascular events of puerpera.</p><p><b>METHODS</b>Ambispective cohort study method was used and 3 659 pregnant women giving birth during October 1976 to December 2008 at Kailuan medical group were included and divided into premature birth (PTB) group (n = 226) and non-PTB (NPTB) group (n = 3 433) by the history of PTB. Incidence of cardio-cerebral vascular events (myocardial infarction, cerebral infarction and cerebral hemorrhage) was obtained during follow-up. Multivariable Cox proportional hazards regression models was used to assess the relative risk of cardio-cerebral vascular events.</p><p><b>RESULTS</b>(1) The childbearing age, proportion of pregnancy-induced hypertension, systolic blood pressure and diastolic blood pressure before delivery were significantly higher while weight and height of newborn were significantly less in PTB group than in NPTB group (P < 0.05 or 0.01). (2) There were 71 cardio-cerebral vascular events during the follow-up of (15.19 ± 7.75) years. In PTB group, the incidence of cardio-cerebral vascular events and myocardial infarction was 3.23/1 000 person-years and 2.05/1 000 person-years, respectively, while the corresponding incidence was 1.15/1 000 person-years and 0.42/1 000 person-years, respectively in NPTB group (all P < 0.05). After adjustment for other traditional cardiovascular risk factors, the risk of total cardio-cerebral vascular events, myocardial infarction in PTB group was 2.03 fold (95% CI: 1.02-4.04, P = 0.002) and 3.11 fold (95% CI: 1.18-8.18, P < 0.001) higher than in NPTB group.</p><p><b>CONCLUSION</b>PTB is an independent risk factor for total cardio-cerebral vascular events, especially myocardial infarction of puerpera.</p>
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Female , Humans , Pregnancy , Blood Pressure , Cardiovascular Diseases , Epidemiology , Cohort Studies , Hypertension, Pregnancy-Induced , Incidence , Myocardial Infarction , Epidemiology , Premature Birth , Proportional Hazards Models , Risk Factors , StrokeABSTRACT
<p><b>OBJECTIVE</b>To investigate the relationship between resting heart rate (RHR) and brachial-ankle pulse wave velocity (baPWV) in healthy Chinese population.</p><p><b>METHODS</b>This was a retrospective cohort study, and a total of 5 852 participants were selected with stratified random sampling from the 101 510 workers of Tangshan Kailuan company who received the health examination during 2010-2011 including epidemiological investigation, biochemical indicators measurement and baPWV measurement. A total of 5 440 participants met the inclusion criteria (aged 40 years or older, without stroke, transient ischemic attack and myocardial infarction) and 5 153 participants (3 110 males, mean age (55.1 ± 11.8) years old) with integral data were finally recruited into the final analysis. The observation population was divided into four groups according to RHR collected during health examinations:quartile 1 (RHR ≤ 63 beats/min, n = 1 405); quartile 2 (63 beats/min < RHR ≤ 69 beats/min, n = 1 176); quartile 3 (69 beats/min < RHR ≤ 76 beats/min, n = 1 322); quartile 4 (RHR > 76 beats/min, n = 1 250). Multivariate logistic regression analysis was used to analyze the relationship between RHR and baPWV.</p><p><b>RESULTS</b>(1) The mean baPWV was (1 586 ± 400) cm/s, and the detection rates of baPWV ≥ 1 400 cm/s was 61.8% (3 185/5 153). (2) The baPWV of quartile 1, 2, 3 and 4 were (1 511 ± 338) cm/s, (1 533 ± 329) cm/s, (1 574 ± 368) cm/s and (1 734 ± 462) cm/s, respectively, and the detection rates of baPWV ≥ 1 400 cm/s were 54.7% (769/1 405) , 56.0% (658/1 176), 63.1% (834/1 322) and 74.3% (929/1 150) , respectively. (3) Multiple logistic regression analysis showed that the detection rates of baPWV were significantly higher in quartile 2, 3 and 4 compared to quartile 1, and the OR values were 1.37 (95% CI: 1.11-1.69), 1.96 (95% CI: 1.59-2.41) and 2.60 (95% CI: 2.07-3.25), respectively, after adjusting for age, gender and systolic blood pressure, body mass index, fasting blood glucose, triglyceride, total cholesterol, high density lipoprotein cholesterol, hs-CRP, antihypertensive agents, smoking and exercise status.</p><p><b>CONCLUSION</b>RHR is positively associated with baPWV in healthy Chinese population.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Ankle , Ankle Brachial Index , Asian People , Blood Flow Velocity , Blood Pressure , Body Mass Index , Cardiovascular Diseases , Cholesterol, HDL , Cohort Studies , Heart Rate , Pulsatile Flow , Pulse Wave Analysis , Retrospective StudiesABSTRACT
This report presented a male patient aged 69 years,who was admitted into our hospital for fever,hemoptysis and chest pain.Chest X-Ray showed shadows on the right lung and pleural thickening.The effect of broad spectrum antibiotic therapy was poor.With the disease progressed,pleural effusion appeared on the right side.Blood culture showed methicillin-resistant staphylococcus aureus.Pleural effusion tests indicated pyothorax,but the effects of closed chest drainage and sensitive antibiotic therapy were poor.After disentangling with open thoracic exploration,the right middle lobe was resected and the right lung lobe pathology showed Wegener granulomatosis.His blood antineutrophil cytoplasmic autoantibodies was negative.The paranasal sinus CT scan and renal function showed no abnormalities.The definitive diagnosis was pulmonary limited Wegener granulomatosis.
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Objective To study the effect of recombinant human endostatin (rhES)on the radiosensitivity of esophageal squamous cells KYSE-150 and its preliminary mechanism.Methods Cells were divided into four groups:control group without treatment,rhES group treated with recombinant human endostatin,radiation alone group exposed with X-rays,and combination group exposed with X-rays plus endostatin.Colony formation assay was used to measure cell survival fraction.A single-hit multi-target model was used to fit cell survival curve and calculate the sensitive enhancement ratio (SER).Influence of rhES combined with X-ray radiation on cell cycle and apoptosis was measured by flow cytometry.Expressions of Cyclin B1,Cyclin D1,Bcl-2 and Bax mRNAs were determined by RT-PCR.Protein expressions of HIF-1α,VEGF,and VEGFR were determined by Western blot.Results D0,Dq and SF2 value of KYSE-150 cells decreased along with the concentration of rhES.At D0dose,the SER for 100 and 200 μg/ml rhES was 1.14 and 1.27,respectively.Compared with the radiation alone group,the apoptosis rate and bax expression increased,while the expressions of VEGF and HIF-1α decreased in the combination group (t =7.97,3.02,117.55,7.22,P ＜ 0.05).Conclusions rhES has radiosensitive effect on esophageal carcinoma cells KYSE-150 in vitro by inhibiting the expressions of HIF-1α and VEGF,regulating bax expression,and inducing apoptosis.
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Objective To prospectively study the dynamic variation of vascular endothelial growth factor (VEGF),the short-term efficiency and the tolerability of the esophageal cancer patients treated by radiotherapy combined with thalidomide.Methods The serum samples of 86 esophageal cancer patients were collected before,during and after the radiotherapy.The VEGF levels were assayed by enzyme-linked immunosorbent assay (ELISA).3 patients interrupted the treatment because of intolerance radiotherapy.Based on the changes of VEGF level,32 esophageal cancer cases whose VEGF levels increased or remained were assigned to the group to which thalidomide was given during the whole course of radiotherapy.The rest 51 patients whose VEGF level decreased received radiotherapy without thalidomide during the whole course.In addition,30 healthy cases were included in control group.Then the efficiency and safety of the introduction of thalidomide in radiotherapy were investigated. Results The VEGF levels of 86 esophageal cancer cases were significantly higher than the 30 healthy control cases ( t =5.07,P ＜ 0.01 ),which were also correlated with the primary tumor size ( t =4.55,P ＜ 0.01 ),lymph node metastasis ( t =7.50,P ＜0.01 ),histological type( F =3.40,P ＜ 0.01 ) and clinical stage ( t =2.52,P ＜ 0.0 l ).However,it was irrelevant to the lesion site,distant metastasis,X-ray pathologic type,gender or age ( P ＞ 0.05).For the thalidomide involved group, the VEGF level after radiotherapy was significantly lower than during radiotherapy (t =2.37,P ＜0.05 ) with an effective rate of 71.88％.For the rest 51 cases without using thalidomide,the effective rate was 78.43％ yet there was no significant difference between the VEGF levels during and after radiotherapy ( t =0.18,P ＞ 0.05 ).62.50％ patients reported symptoms of dizzy and burnout after using thalidomide,while this incidence was 15.69％ for the rest patients (x2 =19.28,P =0.000).For the groups with or without thalidomide combination,the sleepiness incidences were 18.75％and 1.96％,respectively (x2 =5.168,P =0.023 ); the Ⅲ - Ⅳ grade esophagitis incidences were 12.50％ and 11.76％,respectively (x2 =0.061,P =0.806) ; the Ⅱ - Ⅳ grade leukocyte decrease incidences were 6.25％ and 9.80％,respectively (x2 =0.026,P =0.872) ; the Ⅲ - Ⅳ grade platelet descend incidences were 3.13％ and 5.88％,respectively (x2 =0.002,P =0.965 ) ; the Ⅲ - Ⅳ grade nausea and vomiting incidences were 9.38％ and 27.45％,respectively (x2 =2.913,P =0.088 ). No anaphylaxis was observed. Conclusions Thalidomide can decrease the VEGF expression level of esophageal cancer patients.Patients treated with thalidomide show good tolerance and compliance.
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The level of serum high-sensitivity C-reactive protein (hsCRP) in the population with new-onset diabetes was detected and its influential factors were analyzed.The concentrations of hsCRP increased with age in the population with new-onset diabetes( Ptrend＜0.01 ).The percentage of subjects with hsCRP levels ＞3 mg/L was 18.8％in men and 26.7％ in women.A logistic regression analysis indicated that age,gender,body mass index,waist circumference,fasting plasma glucose,and triglyceride were the influential factors of hsCRP levels in diabetic population( P＜0.05 or P＜0.01 ).A variety of cardiovascular factors affected hsCRP level and a strong association existed between hsCRP and abdominal obesity.
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Objective To investigate the changes and clinical value of serum vascular endothelial growth factor (VEGF) level before,during and after radiotherapy in patients with esophageal carcinoma.Methods The sera of 67 esophageal carcinoma patients and 30 healthy control cases were collected.The VEGF level in serum samples were measured with enzyme-linked immunosorbent assay (ELISA) method.The relations among VEGF level changes,clinical stages and radiotherapy effect were analyzed.Results The VEGF levels of patients with esophagus cancer before,during and after radiotherapy were significantly higher than those in control group ( F =11.65,P ＜ 0.01 ).The VEGF level after radiotherapy was significant lower than that before radiotherapy ( F =10.72,P ＜ 0.01 ).The average VEGF level of patients with T3 and T4 was significantly higher than that of control group ( F =14.10,P ＜ 0.01 ).The average VEGF level of patients with N1 and N2 was significantly higher than that of control group( F =8.64,P ＜0.01).In 62 patients,the serum VEGF level increased in 21 cases but decreased in 41 cases after radiotherapy.With difference in radiotherapy efficiency of 61.90％ and 90.24％,respectively(x2 =6.08,P＜ 0.05).The average VEGF level during and after radiotherapy for 50 cases of CR + PR were significantly lower than that before radiotherapy( F =7.98,P ＜ 0.01 ).Conclusions Monitoring the serum VEGF level of patients with esophagus cancer can help evaluate the radiosensitivity,which has a significance in predicting the prognosis of radiotherapy.
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Objective To study the risk prediction for new intracerebral hemorrhage (ICH) with high sensitivity C-reactive protein ( hs-CRP) level. Methods In a retrospective, nested, case-controlled study, 323 cases of ICH were identified and matched with 646 controls. The hs-CRP levels at baseline were compared between the two groups. The relevance of different hs-CRP levels and the risk of ICH were analyzed. Results The ICH group had a higher median hs-CRP levels (1.10 mg/L) as compared with the control group (0. 66 mg/L) with significant difference ( P<0.01 ). In addition, the increase of risk associated with hs-CRP levels was primarily observed in the individuals with the highest quartile of hs-CRP levels(>2.12 mg/L). These patients had an increased risk of ICH (OR 2. 58, 95% CI 1. 77 to 3. 76) as compared with those in the lowest quartile(≤=0.30 mg/L). Individuals with basiline hs-CRP levels above the specified cut point of 3 mg/L ormore and those in the 80th percentile were at a markedly increased risk of ICH (for specified cut point of 3 mg/L,0R2.26, 95% CI 1.60-3.20, P<0.01; for 80th percentile, OR 2.24,95% CI 1.60-3.13, P <0.01, respectively). Conclusions Risk of ICH might be predicted with the level of hs-CRP. With the increase of hs-CRP level at baseline, the risk of ICH was increased.
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Objective To investigate the regulation effect of promoter methylation of deathassociated protein kinase (DAPK) on mRNA and protein expression of DAPK in tissue of primary gastric cancer (GC). Methods The cancerous and noncancerous samples from 62 patients with GC were determined by RT-PCR for mRNA expression of DAPK. The DAPK promoter methylation was detected by methylation-specific PCR. The protein expression of DAPK in 34 patients with methylation was determined by Western blot. Results mRNA and protein expre.ssions of DAPK in cancerous tissues were reduced significantly compared to noncancerous tissues (0. 2863d±0. 2027 vs 0. 57364±0. 1968,0. 2616±0. 0913 vs 0. 65294±0. 1808, P＜0.01). Methylation frequency of DAPK in cancerous tissues was higher than that in noncancerous tissues (54.8% vs 17.7%, P＜0.01). Furthermore, DAPK mRNA expression was decreased in methylation group compared to unmethylation group (0.1399±0. 0835 vs 0. 46404±0. 1569, P＜0. 01). Moreover, a significant correlation was demonstrated between the TNM stage and DAPK promoter methylation (P = 0. 04). Conclusion Expression of DAPK is down-regulated in cancerous tissues at mRNA and protein levels. Low expression of DAPK is associated with hypermethylation of the promoter of DAPK gene.
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In majority of malignant lymphoma patients the overexpression of mutant p53 gene can be found,and experiments show that p53 gene and the genesis currence and development of malignant lymphoma are closely related.Thus,normal p53 gene carried by recombinant adenovirus vector into tumor cells and its stable expression will play a theraputic role in the treatment of malignant lymphoma.This has been confirmed by the basic research.
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Objective To explore the association between the concentration of the high-sensitivity C-reac-tive protein(hs-CRP) and acute myocardial infarction(AMI).Methods The concentration of hs-CRP and serum cholesterol were determined by latex-enhanced immunoturbidimetry in 356 patients with AMI and 356 healthy con-trols.Results The concentration hs-CRP was significantly higher in patients with AMI[(18.6±6.9)mg/L ]than in healthy controls[(2.5±1.7)mg/L,P<0.01].and so the concentration of triglyceride(TG)and low-density lip-oprotein(LDL-C)(P<0.05).Conclusion The concentration of serum hs-CRP can predict the risk of AMl with higher prediction value than TG and LDL-C.