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Esophageal cancer is a complex digestive tract cancer. Currently, the study of radiotherapy and chemotherapy for non-surgical esophageal cancer has reached the bottleneck. In recent years, with the in-depth study of tumor signal pathway related targets and immunotherapy, tumor treatment methods are becoming more and more diversified. At present, research shows that a variety of gene targets and immune receptors are related to esophageal cancer, including epidermal growth factor receptor, vascular endothelial growth factor, human epidermal growth factor receptor 2, programmed death-1/programmed death ligand-1, etc. In addition, tumor vaccine and adoptive cell therapy are also being studied. These factors contribute to the individualized and accurate treatment of esophageal cancer and improve survival rate and local control rate.
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Objective:To analyze the advantages of IPSA combined with increasing cervical center dose in intracavitary and interstitial brachytherapy (IC/IS) for locally advanced cervical cancer.Methods:A total of 46 stage Ⅱ B cervical cancer patients with, local lesion size≥5 cm after 45 Gy/25f external intensity-modulated radiotherapy (IMRT) were recruited. Uterine tandem and needles were implanted, CT was performed, and then HR-CTV, rectum, bladder, sigmoid colon and the area of cervix increased dose (HR-cervix) were delineated, IPSA was used for optimization. According to whether the dose of HR-cervix was increased or not, all patients were divided into IC/IS+ HR-cervix group (group A) and IC/IS group (group B). The differences in dosimetric parameters were compared between two groups. Results:The relative uterine tandem dwell time was significantly extended in group A ( P<0.001). In group B, the V 150% and V 200% volumes of HR-cervix were increased from 63.94% and 30.80% to 91.54% and 64.06%. The D 90% and D 100% in group A were significantly lower than those in group B (both P<0.05). There was no statistical difference in organ at risk (OAR) dose. Conclusion:IPSA combined with increasing cervical center dose can meet the HR-CTV D 90% dose requirement, normal tissue dose limits, and can escalate the doses to local areas of the cervix.
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The main treatment options for cervical cancer include surgery and/or radiotherapy combined with chemotherapy. Radiotherapy consists of external beam radiotherapy and brachytherapy (BT). BT contains high-dose-rate (HDR-BT) and low-dose-rate brachytherapy (LDR-BT). The prognosis of cervical cancer is relatively good. However, some patients experience substantial treatment failures, such as intra-pelvic and/or extra-pelvic recurrences. Recurrent cervical cancer (RCC) has poor prognosis due to lack of effective and safe approach. In 2002, Professor Wang Junjie introduced CT-guidance into the field of LDR-BT, and fully applied 3D printing technology in BT in 2015, which met the requirement of preoperative LDR-BT planning, and significantly improving the precision, quality and efficiency of BT. In 2018, Professor Wang Junjie proposed the concept of stereotactic ablation brachytherapy (SABT). Chinese experts have attempted to treat RCC with BT for nearly two decades and accumulated certain clinical experience. Based on the 3D-printing template (3D-PT) assisted CT-guidance, the standard and consensus of BT for RCC were established, including the indications, dosimetric requirements, technological procedures and radiation protection, etc. At present, there is still a lack of phage Ⅲ clinical and evidence-based medicine for the treatment of RCC with 3D-PT guidance, which requires prospective multi-center, randomized studies to improve the evidence-based level of BT.
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Radiation therapy has a major role in curative treatment of vulvar cancer patients including preoperative radiotherapy, radical radiotherapy and postoperative radiotherapy. Radiation therapy with concurrent chemotherapy may be able to achieve better clinical outcomes, but the rate of acute and chronic toxicities may be higher. So we should develop individual radiotherapy and chemotherapy program, strictly limit the dose and avoid treatment interruption. It is recommended to apply intensity-modulated radiotherapy, which is supe-rior to conventional radiotherapy in dose and clinical efficacy. Interstitial brachytherapy can be used selectively, but it requires a high level of surgical experience, and the doses to target and organs at risk need to be further discussed.
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Radiation therapy has a major role in curative treatment of vulvar cancer patients including preoperative radiotherapy,radical radiotherapy and postoperative radiotherapy. Radiation therapy with concur-rent chemotherapy may be able to achieve better clinical outcomes,but the rate of acute and chronic toxicities may be higher. So we should develop individual radiotherapy and chemotherapy program,strictly limit the dose and avoid treatment interruption. It is recommended to apply intensity-modulated radiotherapy,which is supe-rior to conventional radiotherapy in dose and clinical efficacy. Interstitial brachytherapy can be used selectively, but it requires a high level of surgical experience,and the doses to target and organs at risk need to be further discussed.
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Brachythrapy is a technique to implant radioactive isotype into or near tumors.The obvious properties of brachytherapy are a very high dose distribution of center,and rapid dose attenuation with the increasing of distance.Brachytherapy generally includes three major categories:low dose rate,high dose rate and pulse dose rate.The most significant clinical value of brachytherapy is that it could create dose distribution to tumor tissues,but decreased radiation injury of normal tissues close to tumor.The development of the clinical brachytherapy technique is always involved in the radiobiological characteristics.The basic concepts involving clinical brachytherapy radiobiology mainly includes:dose-rate effect,repair of radiation injury,re-oxygenation,cell cycle redistribution and repopulation.An amount of translational medical approach is needed to guide the application of clinical brachytherapy by exploring the interaction between brachytherapy radiobiology and clinical brachytherapy effect,as well as taking advantage of brachytherapy radiobiological characteristics.The ultimate goal is to improve tumor local control rate,reduce the occurrence of adverse reactions,and improve patients' overall survival.
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Objective To analyze the dosimetric advantages of CT-guided interstitial brachytherapy for recurrent cervical cancer. Methods A total of 16 patients with recurrent cervical cancer after radical surgery and adjuvant external beam radiotherapy received interstitial brachytherapy with CT-guided implantation of metal needles. The high-risk clinical target volume (HR-CTV) was given 36 Gy in 6 fractions.D90for HR-CTV in the brachytherapy and the cumulative D2 cm3values for the bladder,rectum,and sigmoid colon in the previous external beam radiotherapy and the brachytherapy were analyzed.Results The mean D90value for HR-CTV was 52.5±3.3 Gy. The cumulative D2 cm3values for the bladder, rectum, and sigmoid colon were 85.6±5.8 Gy,71.6±6.4 Gy,and 69.6±5.9 Gy,respectively.The mean number of metal needles was 6.1±1.5 in each brachytherapy. The actual 1-year overall survival and local control were 81% and 69%, respectively. Conclusions CT-guided interstitial brachytherapy for recurrent cervical cancer shows good dose-volume histogram parameters and few complications, so it may be clinically feasible. However,its long-term clinical efficacy needs further observation.
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Objective To discuss the dosimetric advantage of computed tomography-guided interstitial brachytherapy compared with the conventional intracavitary brachytherapy for locally advanced cervical cancer,offering a more advantageous clinical treatment approach. Methods Twenty-eight locally advanced cervical cancer patients with bulky tumors ( tumor size>5 cm) after external beam radiotherapy received computed tomography-guided interstitial brachytherapy. Dosimetric outcomes of the current study, including the total dose ( external beam radiotherapy+ brachytherapy ) D90 for the HR-CTV and D2cc for the bladder,rectum, and sigmoid, were compared with a former patient group consisting of 30 patients who received the conventional intracavitary brachytherapy ( uterine tandem+ ovoid pairs ) . Results The mean D90 value for HR-CTV in the intracavitary brachytherapy group and interstitial brachytherapy group were (76.9±5. 7) and ( 88.1± 3. 3) Gy, respectively. The D2cc for the bladder, rectum, and sigmoid in the intracavitary brachytherapy group and interstitial brachytherapy group were (84.7±6. 8) Gy,(69.2±4. 2) Gy,(67.8±4. 5) Gy and (81.8±6. 5) Gy,(6.8±4. 0) Gy,(64.8±4. 1) Gy,respectively.1-year local tumor control rate in the intracavitary brachytherapy group and interstitial brachytherapy group were 59. 3％ and 85. 2％, respectively. Conclusions CT-guided interstitial brachytherapy shows a significant dosimetric advantage compared with the conventional intracavitary brachytherapy, and is, thereby, clinically possible feasible. However,the long term curative effect and toxicity need to be further investigated.
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Objective:To treat the hepatocellular carcinoma stem cells silenced by Chk-1 with caffeine combined with 4 Gy X-ray irradiaition,and to explore their synergistic killing effects on the hepatocellular carcinoma stem cells by detecting the cell proliferation,cell cycle and apoptosis.Methods:The lentivirus silencing Chk-1 was transfected into the 293T cells;after the HepG2 cells were infected by the lentivirus,the Chk-1 protein expression was detected by Western blotting to confirm the silencing efficency,and non-target control was established,and HepG2-Chk-1 and HepG2-control were named.The cells highly expressed CD133 were cultured by suspension culture method,S-HepG2-Chk-1 and S-HepG2-control were named respectively.After the cells were treated by caffeine,they were irradiated by 4 Gy X-ray;the proliferation activity was measured by MTT,and the cell cycle distribution and the apoptotic rate were measured by PI single staining and AnnexinⅤ-FITC double staining using FCM,respectively.For proliferation,cell cycle and apoptosis assays,there were control,caffeine,4 Gy and caffeine+4 Gy groups.Results:The Western blotting results showed that after the HepG2 cells were infected by lentivirus,the Chk-1 protein expression was significantly decreased,but it was not obvious in non-target control group,it demonstrated that the cell models HepG2-Chk-1 and HepG2-control were obtained successfully.After the HepG2-Chk-1 and HepG2-control cells were cultivated by suspension,the CD133 protein expression were increased,it demonstrated that there were high proportion of CD133+ cells,they were hepatocellular carcinoma stem cells.Compared with control group,the proliferation activities in caffeine group and 4 Gy group were significantly decreased (P＜0.05 or P＜0.01),the percentages of cells at G2/M phage and the apoptotic rates were significantly increased (P＜0.05 or P＜0.01),and the percentage of cells at S phage in caffeine group was significantly increased (P＜0.05);the percentage of cells at G0/G1 phage in 4 Gy group was increased (P＜0.05 or P＜0.01),the effect was more stronger in caffeine+4 Gy group.Compared with S-HepG2-control,the proliferation activities of S-HepG2-Chk-1 ceils in caffeine group and 4 Gy group were decreased,the apoptotic rates were increased (P＜0.05 or P＜0.01),and the percentage of cells at G1/M phage was significantly decreased (P＜0.05 or P＜0.01).Collusion:The hepatoccellular carcinoma stem cells silenced by Chk-1 with positive CD133 are obtained successfully;Caffeine combined with X-ray irradiation can inhibit the cell proliferation and induce the apoptosis,and enhance the G2/M arrest,and both of them have synergistic effects.
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Objective To observe the effects of alprostadil injection on intestinal mucosal barrier function in patients with acute pancreatitis(AP). Methods Seventy-eight AP patients admitted in Department of Medicine in Yuhang District Second People's Hospital of Hangzhou City from May 2016 to March 2017 were divided into 2 groups using random number method,including 38 cases in the control group and 40 cases in the treatment group. Patients in the control group received routine treatment. Patients in the treatment group were given intravenous 10 μg/d alprostadil injection in addition to routine treatment continuously for 14 days. Another 40 healthy volunteers who underwent routine examination in the same period were enrolled as healthy control group. The scores of MCTSI and APACHEⅡwere recorded at admission and 2 days after the treatment. The levels of serum DAO, endotoxin (ET) and IFABP were detected by ELISA. Results There were no significant difference on the scores of MCTSI and APACHEⅡ, the levels of serum DAO, ET, IFABP before treatment between control and treatment group(P>0.05), but were increased significantly than those in the healthy control group(P<0.01). After treatment,the scores of MCTSI and APACHEⅡ,the levels of serum DAO, ET, IFABP were decreased significantly than those before treatment in two groups(P<0.05 or P<0.01), but the scores of MCTSI and APACHEⅡ, the levels of serum DAO, ET and IFABP were decreased significantly than those in the control group(3.78 ± 0.43)vs (5.89 ± 0.13),(5.65 ± 1.77)vs (9.05 ± 1.61),(2.18 ± 0.16)U/ml vs (3.22 ± 0.15)U/ml,(0.15 ± 0.06)EU/ml vs (0.25 ± 0.09)EU/ml,(62.01 ± 12.82)ng/L vs (85.43 ± 16.79)ng/L; all P<0.05). There was a significant positive correlation between serum DAO, ET, IFABP and the scores of MCTSI (P<0.01). There was a significant positive correlation between serum DAO, ET, IFABP and the scores of APACHEⅡ, too (P<0.01). Conclusions Patient with acute pancreatitis have obvious intestinal mucosal barrier injury. Alprostadil injection can improve clinical symptoms and the scores of MCTSI to a certain extent by protecting intestinal mucosal barrier function.
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Objective To investigate the dosimetric difference between inverse planning simulated annealing(IPSA)and manual optimized plan for isodose line in interstitial brachytherapy for locally advanced cervical cancer and to provide a better optimization method for clinical application. Methods A total of 104 patients with cervical cancer were enrolled in this study. They received pelvic external beam radiotherapy and interstitial brachytherapy in five fractions. Both IPSA and manual optimized plan for isodose line were used to optimize the dose in each fraction. Dose volume parameters of the two plans were compared to analyze the dosimetric outcome by paired t-test. Results There were no significant differences in mean D 90and D 100for high-risk clinical target volume(HR-CTV)and D 90for intermediate-risk clinical target volume(IR-CTV)between the two groups(P>0.05). The IPSA group had a significantly higher D 100for IR-CTV than the manual optimized group(58.36±2.06 Gy vs. 53.99±2.17 Gy, P=0.025). For organs at risk,the IPSA group had a significantly lower mean rectum D 2ccand a significantly higher bladder D 2ccthan the manual optimized group(68.53± 2.85 Gy vs. 71.77± 1.79 Gy, P=0.002;80.49± 3.36 Gy vs. 78.71± 2.64 Gy,P=0.034). There was no significant difference in sigmoid D 2ccbetween the two groups(P>0.05). The IPSA group had significantly higher relative dose homogeneity index(HI)and conformity index (CI)of radiation dose for target volume than the manual optimized group(P<0.05), and there was no significant difference in overdose volume index(OI)between the two groups(P= 0. 1 0 7).Conclusions Compared with manual optimized plan for isodose line, IPSA can improve the dose distribution of tumor tissue,reduce mean rectum D 2cc,and increase CI and HI,so it is a preferable optimized treatment planning method in clinical application.
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Objective:To investigate the influencing factors of prognosis in the patients with advanced cervical cancer,and to evaluate the influence of single-agent cisplatin and docetaxel combined with cisplatin concurrent chemoradiotherapy in the prognosis of the patients and the security,and to provide the basis for clinical treatment of advanced cervical cancer.Methods:A total of 218 patients with advanced cervical cancer who received the singleagent cisplatin or docetaxel combined with cisplatin concurrent chemoradiotherapy were enrolled as the subjects.The patients were divided into two groups according to their chemoradiotherapy treatments:single-agent group and docetaxel combined with cisplatin concurrent group.All the patients had received external beam radiation therapy combined with high-dose rate intracavitary hrachytherapy.A follow-up in 218 patients was performed until January 2017.The information about clinical characteristics including age,tumor diameter,clinical stage,chemotherapy treatments,pathological grade,pathological type,primiparous age and adverse effects after treatment were collected by telephone follow-up,outpatient service and reexamination.The differences in the clinical characteristics of the patients were compared between two groups,the association between the clinicopathological characteristics and the prognosis of the patients was analyzed,and the security of these two treatments was evaluated.Results:There were no statistical differences in the age,tumor diameter,clinical stage,pathological grade,pathological type and primiparous age of the patients between two groups (P＞0.05).The 1-year,3-year and 5-year overall survival (OS) rates of 218 patients were 96.33％,76.15％ and 63.76％,respectively.The 5-year OS rate of the patients in docetaxel combined with cisplatin group was higher than that of the patients in single-agent cisplatin group (x2 =8.032,P=0.005).The univariate analysis results indicated that tumor diameter,clinical stage,chemotherapy treatments,and adenocarcinoma were the potential predictive factors (P＜0.05).The Cox regression analysis results showed that clinical stage [stage Ⅲ:P=0.016,HR (95％CI) =1.90 (1.13-3.19) [stage Ⅳ:P＜ 0.001,HR (95％CI) =19.13 (7.84-46.68)],chemotherapy treatments [P=0.009,HR (95 ％CI) =0.54 (0.34-0.86)] and adenocarcinoma pathological type [P=0.021,HR (95％CI) =1.88 (1.10-3.21)] were the prognostic risk factors of the patients,the patients in clinical stage Ⅱ B,received docetaxel combined with cisplatin concurrent chemoradiotherapy and with pathological types of squamous cell carcinomas had a better outcome.Compared with docetaxel combined with cisplatin group,leucopenia (Z=-2.060,P =0.039) and neutropenia (Z=-2.246,P =0.025) in single-agent cisplatin group were lighter.Conclusion:Clinical stage,chemotherapy treatments and adenocarcinoma were the independently prognostic factors of the patients with advanced cervical cancer.The patients receive docetaxel combined with cisplatin concurrent chemoradiotherapy have a better prognosis and no severer adverse effects compared with single-agent cisplatin treatment.
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Objective:To investigate the influencing factors of prognosis in the patients with advanced cervical cancer,and to evaluate the influence of single-agent cisplatin and docetaxel combined with cisplatin concurrent chemoradiotherapy in the prognosis of the patients and the security,and to provide the basis for clinical treatment of advanced cervical cancer.Methods:A total of 218 patients with advanced cervical cancer who received the singleagent cisplatin or docetaxel combined with cisplatin concurrent chemoradiotherapy were enrolled as the subjects.The patients were divided into two groups according to their chemoradiotherapy treatments:single-agent group and docetaxel combined with cisplatin concurrent group.All the patients had received external beam radiation therapy combined with high-dose rate intracavitary hrachytherapy.A follow-up in 218 patients was performed until January 2017.The information about clinical characteristics including age,tumor diameter,clinical stage,chemotherapy treatments,pathological grade,pathological type,primiparous age and adverse effects after treatment were collected by telephone follow-up,outpatient service and reexamination.The differences in the clinical characteristics of the patients were compared between two groups,the association between the clinicopathological characteristics and the prognosis of the patients was analyzed,and the security of these two treatments was evaluated.Results:There were no statistical differences in the age,tumor diameter,clinical stage,pathological grade,pathological type and primiparous age of the patients between two groups (P＞0.05).The 1-year,3-year and 5-year overall survival (OS) rates of 218 patients were 96.33％,76.15％ and 63.76％,respectively.The 5-year OS rate of the patients in docetaxel combined with cisplatin group was higher than that of the patients in single-agent cisplatin group (x2 =8.032,P=0.005).The univariate analysis results indicated that tumor diameter,clinical stage,chemotherapy treatments,and adenocarcinoma were the potential predictive factors (P＜0.05).The Cox regression analysis results showed that clinical stage [stage Ⅲ:P=0.016,HR (95％CI) =1.90 (1.13-3.19) [stage Ⅳ:P＜ 0.001,HR (95％CI) =19.13 (7.84-46.68)],chemotherapy treatments [P=0.009,HR (95 ％CI) =0.54 (0.34-0.86)] and adenocarcinoma pathological type [P=0.021,HR (95％CI) =1.88 (1.10-3.21)] were the prognostic risk factors of the patients,the patients in clinical stage Ⅱ B,received docetaxel combined with cisplatin concurrent chemoradiotherapy and with pathological types of squamous cell carcinomas had a better outcome.Compared with docetaxel combined with cisplatin group,leucopenia (Z=-2.060,P =0.039) and neutropenia (Z=-2.246,P =0.025) in single-agent cisplatin group were lighter.Conclusion:Clinical stage,chemotherapy treatments and adenocarcinoma were the independently prognostic factors of the patients with advanced cervical cancer.The patients receive docetaxel combined with cisplatin concurrent chemoradiotherapy have a better prognosis and no severer adverse effects compared with single-agent cisplatin treatment.
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Objective To examine the dosimetric advantages of three-dimensional (3D) computed tomography (CT)-guided interstitial brachytherapy (BT) for target volume and surrounding normal tissue in patients with locally advanced cervical cancer,and to provide a simple and effective clinical treatment approach.Methods A total of 52 patients who had poor tumor response to external beam radiotherapy (EBRT) with a residual tumor greater than 5 cm at the time of BT were included.The patients were treated by 3D CT-guided interstitial BT using a hybrid applicator comprised of uterine tandem and free metal needles.The high-risk clinical target volume (HR-CTV),intermediate-risk clinical target volume (IR-CTV),and organs at risk (OAR) were contoured.The total dose,including external beam radiotherapy and high dose-rate BT,was biologically normalized to conventional 2 Gy fractions (EQD2).D90and D100for both HR-CTV and IR-CTV,and D2 ccfor the bladder,rectum,and sigmoid were analyzed.Results The mean D90value for HR-CTV was 88.4±3.5 Gy.The D2 ccfor the bladder,rectum,and sigmoid were 81.1±5.6,65.7±5.1,and 63.1±5.4 Gy,respectively.D2 cc≤90 Gy for the bladder and D2 cc≤70 Gy for the sigmoid were observed in all the patients.D2 cc≤70 Gy for the rectum was observed in 89% of patients.Conclusions 3DCT-guided interstitial BT has a significant dosimetric advantage for target volume accompanied by few minor complications,and thereby may be clinically feasible for treating locally advanced cervical cancer.However,its long-term efficacy and possible toxicities will require further clinical observation.
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Objective To investigate the dynamical changes of serum SOCS-3 in patients with acute pancreatitis (AP) and discuss the potential clinical significance.Methods Seventy-five patients with AP admitted in Yuhang District Second People's Hospital of Hangzhou City from February 2015 to December 2016 were selected,who were divided into 2 groups according to disease severity:40 cases in mild AP (MAP) group and 35 cases in moderate and severe AP (MSAP + SAP) group.The levels of serum SOCS-3,IL-6 and TNF-α were determined by enzyme linked immunosorbent assay (ELISA) on the 1,3,5 and 7 day after admission.Thirty healthy people who were age and gender matched were included in the normal control group.Results The levels of serum SOCS-3,IL-6 and TNF-α in AP patients on the 1 day after admission were significantly increased than that in the control group (P ＜ 0.01 or P ＜ 0.05),which were gradually increased with the time,peaked on the 5 day and then started to decrease on 7 day after admission which was still higher than that on the 1 day after admission.The levels of serum SOCS-3,IL-6 and TNF-α in MSAP + SAP group were significantly higher than that in MAP group (P ＜0.01),and there were significant differences (F =112.80,P =0.001;F =170.21,P =0.000;F =112.82,P =0.000).Significant differences were also found among different time points between two groups (F =258.38,P =0.000;F =4.82,P =0.000;F =5.52,P =0.001).Additionally,the significantly positive correlations of SOCS-3 with IL-6 and TNF-α were found (r=0.785,r=0.828,both P＜0.01).Conclusions SOCS-3 may participate in early excessive inflammatory reactions in AP.Dynamic detection of SOCS-3 may be helpful for AP clinical classification and prognosis evaluation.
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Objective:To investigate the effect of Methylmercury chloride chronic exposure on PKCδexpression developing cer-ebellum.Methods:Establishment of cerebellum damage model of developmental rats by chronic MMC exposure .In Situ Hybridization and Western blot analysis were performed to detect the expression of PKC isozyme .Results: PKCδ was expressed at high levels at birth, but no significant change was observed with the increase in the time of birth corresponding to brain Hg 2+level, expression of PKCδ in cerebellum of experimental groups was markedly higher than that of control group .Conclusion: Neurotoxicity of Methylmercury chloride exposure might be mediated by PKCδexpression up-regulating in developmental cerebellum .
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Objective To compare the clinical efficacy of proximal femoral nail anti-rotation ( PFNA ) fixation and hemiarthroplasty in the treatment of elderly unstable intertrochanteric fractures .Methods 72 cases with unstable intertrochanteric fractures were divided into the two groups by random number table ,each group had 36 ca-ses,the control group was given implementation of hemiarthroplasty while the observation group was given PFNA fixa -tion,the clinical therapeutic effect were compared between the two groups .Results It showed no significant differ-ence in operative time between the two groups (t =2.58,P>0.05);the blood loss of the observation group was (187.52 ±10.83)mL,which was significantly less than that of the control group (t=9.56,P0.05). Conclusion PFNA fixation and hemiarthroplasty for treatment in elderly unstable intertrochanteric fractures have good effect ,and the patients should be based on the specific clinical circumstances , under strict control of surgical contraindications choose the right surgery .
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Objective To discuss the difference of preoperative examination and matters needing attention between osteoarthritis(OA)and rheumatoid arthritis(RA)patients who received total knee replacement(TKR).Methods Preoperative examination results were analyzed retrospectively between OA patients(362 cases)and RA patients(91 cases)who received TKR.Results The age of OA patients was significantly higher than RA patients[(66.55±7.78)years vs.(58.93±13.46)years,P＜0.05].There was significant difference in rate of diabetes between OA and RA patients[26.52％(96/362)vs.37.36％(34/91),P＜0.05].There was no significant difference in the rate of lumbar vertebrae disease between OA and RA patients[33.43％(121/362)vs.23.08％(21/91),P＞0.05].The body mass index,haematocrit and hemoglobin in OA patients were significantly higher than those in RA patients[(27.71±3.98)kg/m2 vs.(24.37±4.30)kg/m2,0.38±0.05 vs.0.33±0.06,(130.17±17.59)g/L vs.(111.45±18.56)g/L,P＜0.01].The erythrocyte sedimentation rate,C-reactive protein and D-dimer in OA patients were significantly lower than those in RA patients[(27.77±27.66)mm/1 h vs.(59.76±32.00)mm/1 h,(17.23±27.66)mg/L vs.(30.00±32.27)mg/L,(268.54±299.83)μ g/L vs.(990.09±550.91)μg/L,P＜0.01 or＜0.05].The rate of using glucocorticoid in RA patients was significantly higher than OA patients[8.8％(8/91)vs.0,P＜0.01].There was no significant difference in the rate of urinary system infection(P＞0.05).Conclusions The preoperative examination is found significantly different between OA and RA patients who received TKR.According to different focuses on,dealing with various kinds of complications and correct guidance on preoperative treatment,can ensure the safety of operation.
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Objective To evaluate the antitumor effects of interferon (IFN)γ-endostatin based gene radiotherapy in a metastatic breast tumor model of mice, and to elucidate the possible mechanisms involved. Methods Murine mammary adenocarcinoma 4T1 cells transfected with pEgr-IFN-γ and pEgrendostatin plasmids were irradiated with 2-20 Gy of X-rays. IFN-γ and endostatin levels in the culture supernatants were measured. Female BALB/c mice were inoculated with 1 × 105 of 4T1 cells by mammary fat pad injection, and divided randomly into control, empty vector, gene therapy (pEgr-IFN-γ and pEgrendostatin), radiotherapy, and combined gene-radiotherapy groups. Tumor/body weight ratio, lung metastases, and survival of the tumor-bearing mice were observed. Splenic cytotoxic T-lymphocyte (CTL)and natural killer (NK) cell activity and intratumor microvessel density were also assessed. Results Irradiation significantly enhanced the section of IFN-γ and endostatin from the transfected 4T1 cells.Compared with gene therapy or radiotherapy alone, combined gene-radiotherapy resulted in the maximal attenuation in tumor growth rate, lung metastases and increased survival. The activities of CTL and NK cells were significantly enhanced and intratumor microvessel density reduced ( t = 2. 120-22.140, P ＜ 0.05 ).Conclusions IFN-γ-endostatin-based gene-radiotherapy could provide a potential antitumor effect in a murine metastatic breast tumor model, which may be related to IFN-γ-stimulated CTL and NK cell activation, and endostatin-induced antiangiogenic activity. Gene-radiotherapy could serve as a neoadjuvant therapy for the locally advanced breast cancer.
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Objective To research the value of bed fiber bronchial microscope technology ha neurosurgical ICU. Methods 28 cases in neurosuxgical ICU who had received bed fiber bronchial microscope operations,including blood and vomit aspiration, bronchoalveolar lavage, sputum bolt clearance were retrospectively analyzed. Results 4 cases of blood and vomit aspiration was cleaned ha time,improvement of respiratory function,31 cases was sputum as- piration by bed fiber bronchial microscope and bronchoalveolax lavage, 31 cases was sputum collected by fiber bronchial microscope and positive rate is 100% ,4 cases of atelectasis was lung recruitment by fiber bronchial micro- scope sputum aspiration. Conclusion Bed fiber bronchial microscope technology can eliminate waste effectivdy, clean dust,there axe great value in treatment of neurosurgical ICU patients with respiratory diseases.