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The major treatments of non-small cell cancer (NSCLC) contain surgery, chemotherapy, radiotherapy, targeted therapy, immunotherapy and the combinations of them. Among them, stereotactic body radiation therapy (SBRT) is applied more and more extensively. Based on the immunoregulatory effects of SBRT, the combination with immune checkpoint inhibitors (ICIs) is used in all stages of NSCLC. This kind of treatment mode needs to be continuously explored to maximize the radio-immunity synergistic effect.
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Extrahepatic cholangiocarcinoma is a rare, aggressive malignancy of the digestive system with high recurrence rate and poor prognosis. With the development of modern medicine and radiotherapy technology, combined with surgery, chemotherapy, and biliary stent, etc., radiotherapy plays a more and more important role in the treatment of resectable and unresectable patients. At present, a large number of studies have shown that external beam radiotherapy, intraluminal brachytherapy, stereotactic body radiation therapy and other kinds of radiotherapy techniques have good safety and efficacy, but its clinical application is still controversial.
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Objective@#To describes and compare the effect of humidity heat exchanger and ultrasound on artificial airway patients in a hospital at high altitude.@*Methods@#The patients with artificial airway admitted to the People's Hospital of Tibet Autonomous Region from August to December 2017 were divided into two groups according to the time of admission. A total of 125 patients in the humid heat exchanger group were humidified by the humid heat exchanger during the offline process. In the ultrasonic humidification group, 106 patients underwent airway humidification with an ultrasonic humidifier during weaning. After 24, 48 and 72 hours offline, sputum viscosity, eschar formation, airway temperature, PaO2 and PaCO2 were investigated.@*Results@#Before humidification, 1 day after humidification, 2 days after humidification and 3 days after humidification, the proportion of first degree sputum in the ultrasonic humidification group was 77.36% (82/106), 80.19% (85/106), 95.28% (101/106) and 99.06% (105/106), respectively. In the heat-moisture exchange group, 99.20% (124/125), 99.20% (124/125), 95.20% (119/125), 72.80% (94/125), respectively. There were differences between the two groups before, 1 day and 3 days after humidification. There was statistical significance (χ2= 28.35, 24.06, 28.75, P < 0.01). There was no significant difference in PaCO2 between the two groups (P > 0.05). PaO 2 in the two and three days after humidification was (92.62 ± 5.76), (91.34 ± 4.85) mmHg, which was lower than that in the ultrasonic humidification group (97.38 ± 5.55), (99.16 ± 5.43) mmHg. There were significant differences between the two groups (t= 6.367, 11.558, P < 0.01). There were significant differences between the two groups (t=6.367, 11.558, P < 0.01).@*Conclusions@#The rate of eschar formation was higher in the wet heat exchanger group, and the frequency of sputum suction was higher in the ultrasonic wetting group.
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Objective To investigate the inhibitory effect of rapamycin,an mammalian target of rapamycin (mTOR) pathway inhibitor,on the proliferation,migration and fibrosis of human pterygium fibroblasts (PFBs).Methods Pterygium tissues were collected from patients with primary pterygium who underwent surgical excision in Shenyang Fourth People's Hospital from May to July 2015.The tissues were cultured in vitro and the PFBs were identified by anti-human vimentin immunofluorescence assay.The 3 to 5 generation cells were used for the experiments.The viability of cells treated with different concentrations of rapamycin was detected by methyl thiazolyl tetrazolium (MTT).The cells were divided into normal control group and rapamycin group,and the scratch wound healing test was used to evaluate migration of the PFBs.The expressions of MKI67,α-smooth muscle actin (α-SMA),fibronectin,caspase3,mammalian target of rapamycin (mTOR) and LC3B mRNA were detected by real-time quantitative PCR.Results The cultured cells showed morphology of long spindle and were vimentin immunopositive.The cell viability in rapamycin treated PFBs demonstrated a dose-dependent decrease.At 24 hours after culture,The cell viability in 30 μmol/L rapamycin group was (76.67±8.84)％ of that in 0 μmol/L rapamycin group (P＜0.001).The relative residual scratch width in 30 μ mol/L rapamycin group was (35.40±11.62) ％ 48 hours after scratch,which was significantly greater than (2.45±0.76) ％ in the normal control group (P＜0.05).Real-time quantitative PCR showed that the mRNA expressions of MKI67,α-SMA,fibronectin and mTOR in rapamycin group were significantly decreased when compared with those in normal control group (all at P＜0.05).The expression of LC3B mRNA in rapamycin group was significantly higher than that in normal control group (P＜0.05).The mRNA expression of caspase3 was not significantly different between the two groups (P=0.861).Conclusions Rapamycin can effectively inhibit the proliferation,migration and fibrosis of PFBs without affecting the cell survival.Detailed mechanism remains to be further studied.Rapamycin may serve as an anti-fibrosis agent to prevent the progression and recurrence of pterygium in the future.
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Objective To describes and compare the effect of humidity heat exchanger and ultrasound on artificial airway patients in a hospital at high altitude. Methods The patients with artificial airway admitted to the People's Hospital of Tibet Autonomous Region from August to December 2017 were divided into two groups according to the time of admission. A total of 125 patients in the humid heat exchanger group were humidified by the humid heat exchanger during the offline process. In the ultrasonic humidification group, 106 patients underwent airway humidification with an ultrasonic humidifier during weaning. After 24, 48 and 72 hours offline, sputum viscosity, eschar formation, airway temperature, PaO2 and PaCO2 were investigated. Results Before humidification , 1 day after humidification, 2 days after humidification and 3 days after humidification, the proportion of first degree sputum in the ultrasonic humidification group was 77.36% (82/106), 80.19% (85/106), 95.28% (101/106) and 99.06% (105/106), respectively. In the heat-moisture exchange group, 99.20% (124/125), 99.20% (124/125), 95.20% (119/125), 72.80% (94/125), respectively. There were differences between the two groups before, 1 day and 3 days after humidification. There was statistical significance (χ2=28.35, 24.06, 28.75, P<0.01). There was no significant difference in PaCO2 between the two groups (P>0.05). PaO 2 in the two and three days after humidification was (92.62 ± 5.76), (91.34 ± 4.85) mmHg, which was lower than that in the ultrasonic humidification group (97.38 ± 5.55), (99.16 ± 5.43) mmHg. There were significant differences between the two groups (t = 6.367, 11.558, P < 0.01). There were significant differences between the two groups (t=6.367, 11.558, P < 0.01). Conclusions The rate of eschar formation was higher in the wet heat exchanger group, and the frequency of sputum suction was higher in the ultrasonic wetting group.
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Objective To explore the nursing effect of modified prone position and traditional prone position in the skin protection of patients with prone position in ICU. Methods A total of 60 ICU patients with prone position treatment were selected in June 2014 to May 2015. According to the digital method the patients were randomly divided into the control group and the experimental group with 30 cases in each.The control group adopted traditional way of prone position with the head and chest pad pushed up. used by patients not pad up way of improvement of prone position. The incidence of skin pressure injury and the incidence of stress in the two groups were compared. Results The incidence of skin pressure injury was 20.0％(6/30) in the experimental group and 66.7％(20/30) in the control group, and the difference was statistically significant (χ2=13.30, P < 0.05). Conclusions Modified prone position has obvious advantages in reducing the incidence of skin pressure ulcer and is suitable for patients with clinical prone position.
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Objective To investigate the inhibitory effect of rapamycin,an mammalian target of rapamycin (mTOR) pathway inhibitor,on the proliferation,migration and fibrosis of human pterygium fibroblasts (PFBs). Methods Pterygium tissues were collected from patients with primary pterygium who underwent surgical excision in Shenyang Fourth People's Hospital from May to July 2015. The tissues were cultured in vitro and the PFBs were identified by anti.human vimentin immunofluorescence assay. The 3 to 5 generation cells were used for the experiments. The viability of cells treated with different concentrations of rapamycin was detected by methyl thiazolyl tetrazolium ( MTT) . The cells were divided into normal control group and rapamycin group, and the scratch wound healing test was used to evaluate migration of the PFBs. The expressions of MKI67,α.smooth muscle actin (α.SMA), fibronectin,caspase3, mammalian target of rapamycin ( mTOR ) and LC3B mRNA were detected by real.time quantitative PCR. Results The cultured cells showed morphology of long spindle and were vimentin immunopositive. The cell viability in rapamycin treated PFBs demonstrated a dose.dependent decrease. At 24 hours after culture,The cell viability in 30μmol/L rapamycin group was (76. 67±8. 84)％ of that in 0μmol/L rapamycin group ( P<0. 001 ) . The relative residual scratch width in 30μmol/L rapamycin group was ( 35. 40 ± 11. 62 )％ 48 hours after scratch,which was significantly greater than (2. 45±0. 76)％ in the normal control group (P<0. 05). Real.time quantitative PCR showed that the mRNA expressions of MKI67,α.SMA,fibronectin and mTOR in rapamycin group were significantly decreased when compared with those in normal control group (all at P<0. 05). The expression of LC3B mRNA in rapamycin group was significantly higher than that in normal control group (P<0. 05). The mRNA expression of caspase3 was not significantly different between the two groups (P=0. 861). Conclusions Rapamycin can effectively inhibit the proliferation, migration and fibrosis of PFBs without affecting the cell survival. Detailed mechanism remains to be further studied. Rapamycin may serve as an anti.fibrosis agent to prevent the progression and recurrence of pterygium in the future.
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Objective To assess the short-term efficacy and tolerability of different radiotherapy doses schedules as 46 Gy and 50 Gy for locally advanced rectal cancer patients undergoing neoadjuvant chemoradiotherapy.Methods All patients with locally advanced rectal cancer who had received neoadjuvant chemoradiotherapy between Aug 2010 and May 2015 were enrolled.This retrospective analysis was performed according to the radiotherapy dose grouping of 46 Gy and 50 Gy groups.Concurrent chemotherapy regimen was capecitabine-based and oxaliplatin was added only when young patients (＜ 75 years old) were in a good condition.Total mesorector excision was scheduled 6-8 weeks after concurrent chemoradiotherapy.Results Totally 213 patients were enrolled in our analysis,including 61 cases in 46 Gy group and 152 cases in 50 Gy group.There were 145 male and 68 female patients.There were 22 patients diagnosed clinically with T2,180 with T3,and 11 with T4.Tumor distance from the anal verge was ≤5,＞5 and ＜ 10 cm,or ≥10 cm in 82,115 and 16 patients,respectively.T downstaging was observed in 95 (44.6％) patients,pathologic complete response (PCR) was shown in 48 (22.5％) patients.In the 46 Gy and 50 Gy groups,the rate of PCR was 18.0％ vs.24.3％ (P ＞0.05).In addition,good response rate (TRG 3 + 4) was 67.2％ vs.75.0％ (P ＞ 0.05),and T downstaging rate was 39.3％ vs.46.7％ (P ＞0.05).Subgroup analysis for T3N2/T4 patients,the rate of PCR was 6.3％ vs.23.3％ (P＞0.05),good response rate (TRG 3 +4) was 50.0％ vs.72.1％ (P＞0.05),and T downstaging was 31.3％ vs.46.5％ (P ＞0.05).There was no significant difference in treatment-related toxicity between the two groups.Conclusions The two different radiation dose fractionation (50 Gy vs.46 Gy) had no impact on pathologic tumor regression and T downstaging for locally advanced rectal cancer.Nonetheless,a further long-term follow-up is warranted to confirm the preliminary study.
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To investigate the effect of RAD18-siRNA on cell proliferation and chemotherapy sensitivity of esophageal squamous cell carcinoma (ESCC) ECA-109 cells.RAD18-siRNA was transfected into human ECA-109 cells by Lipofectamine 3000. Quantitative PCR and Western blot were performed to detect RAD18 and CyclinD1 expression; CCK-8 assay was used to determine cell proliferation and chemotherapy drug sensitivity; flow cytometry was used to determine cell cycle. Correlation between RAD18 and CyclinD1 mRNA expression was analyzed by Pearson's correlation.Compared with non-transfected cells, the expression of RAD18 in RAD18-siRNA group was significantly decreased (<0.05). The cell proliferation was inhibited (<0.05) and the cell number of G1 phase was increased, G2/M phase cells decreased (<0.05) in RAD18-siRNA group. After treatment with different concentrations of cisplatin or 5-FU, the survival rate of the two cell groups was reduced (all<0.05), and the IC50 of RAD18-siRNA group was significantly lower than that of non-transfected group (<0.05). The mRNA expression of RAD18 was positively correlated with CyclinD1 expression in ESCC tissues(=0.478,<0.01).Down-regulated expression of RAD18 can decrease the cell proliferation and increase chemo-sensitivity of ESCC cells, and CyclinD1 may participate in the process.
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Humans , Adjuvants, Pharmaceutic , Pharmacology , Carcinoma, Squamous Cell , Drug Therapy , Cell Cycle , Cell Line, Tumor , Cell Proliferation , Cisplatin , Pharmacology , Cyclin D1 , Genetics , DNA-Binding Proteins , Pharmacology , Down-Regulation , Genetics , Drug Resistance, Neoplasm , Drug Screening Assays, Antitumor , Methods , Drug Synergism , Esophageal Neoplasms , Drug Therapy , Fluorouracil , Pharmacology , G1 Phase , G2 Phase , Metaphase , RNA, Small Interfering , Pharmacology , Transfection , Ubiquitin-Protein Ligases , PharmacologyABSTRACT
Objective To compare the dose distribution of reserved planned tangential beam IMRT(2-field IMRT) with multifields beams IMRT(6-field IMRT) of the bulk-recurrent chest wall in postmastectomy breast cancer patients.Methods For 8 patients with chest wall in postmastectomy breast cancer bulk-recurrence,2-field IMRT and 6-field IMRT plans were generated on PTV in Pinnacle Planning System.The prescribed dose of PTV was 50 Gy in 25 fractions and GTV was 66-70 Gy which irradiated incrementally by subsequent plan in 8-10 fractions.The conformal index (CI) and homogeneity index (HI) of 95％ of prescribed dose over PTV were compared,while the dose distribution on ipsilateral lung and heart were evaluated.Results The CI of PTV by 6-field IMRT (0.66 ± 0.08) was higher than that of the2-field IMRT (0.53±0.10)(t=7.99,P＜0.05).The HI ofPTV by6-field IMRT (1.36±0.08)waslower than that of 2-field IMRT (2.19 ±0.78) (t =9.04,P ＜0.05).There was no statistical difference in V5,V10,V20 and V35 for ipsilateral lung and in D V35 and D for heart between two plans.Conclusions Compared with 2-field IMRT,6-field IMRT might have a better dose distribution on planning target volume(PTV) for chest wall in postmastectomy breast cancer bulk-recurrence patients,butthere is no significant difference in dose-volume of ipsilateral lung and heart between two plans.
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Objective To explore the relationship between body composition and arterial function index,especially augmentation index(AI),and make clear the impacts of gender and age on the relationship.Methotis A total of 3859 health adults were enrolled in this study.Boay composition was measured by bioelectrical impedance,and AI and pulse wave velocity(PWV) were viewed as indictors for arterial function.Correlation analysis and liner regression analysis were used for data comparison.Results Both body mass index(BMI) and body fat rate positively changed with PWV(r=0.114,both P<0.01).However,BMI showed no relation to AI(r=0.022,P>0.05).Body fat rate was positively and independently associated with AI(r=0.263, P<0.01),which was gender-dependent(female:r=0.219,P<0.01;male:r=0.033,P>0.05).When age was concerned,above relationship was more stronger in participants ≤50 years(β=0.479 vs β=0.321,P<0.01).Conclusion Body fat mass may be a predicting factor of changes in AI.Gender and age could affect the relationship between body fat and rtery function.
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Objective To investigate the correlation between augmentation index (AI) of the radial artery and diastolic heart function in patients with hypertension.Methods Echocardiographs were obtained for 305 patients with hypertension.AI,pulse wave velocity (PWV) of peripheral arteries and serum pro-brain natriuretic peptide (proBNP) levels were determined.Correlations and receiver operating characteristic (ROC) curves were drawn between AI values and impaired diastolic function.Results AI levels were significantly increased in patients with impaired diastolic function diagnosed by ultrasound.Assessment of diastolic heart function based on proBNP levels revealed that AI and aortic pulse wave velocity were significantly elevated in patients with impaired diastolic function.The operating curve indicated that AI may be a more accurate and efficient index for the evaluation of impaired diastolic function compared to pWV.Correlation analysis also showed that proBNP levels had altered in parallel with changes in AI and PWV.After adjusting for various factors including age,gender,blood pressure and blood lipid,a positive correlation was observed between proBNP and AI with a correlation coefficient of 0.3697 (P =0.003).However,no correlation between proBNP and aortic PWV was seen after adjustment.Conclusions Changes in radial AI levels may reflect parallel changes in diastolic cardiac function in patients with hypertension,suggesting that AI may be utilized as a non-invasive clinical indicator of diastolic heart function.
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Background and purpose:Somatostatin receptors have been found in a variety of tumors and are therefore amenable to treatment with somatostatin analogs, like octreotide. However, the study of SSTRs expression has been rarely studied in nasopharyngeal cancer.We investigated the expression of somatostatin receptors gene subtypes in human nasopharyngeal cancer cell line CNE_ 2 . Methods:We have harvested cultured human nasopharyngeal cancer cell line CNE_ 2 . Using both techniques, reverse transcriptase-polymerase chain reaction (RT-PCR) and immunohistochemical assay, we analysed mRNA of different subtypes of somatostatin receptors in human nasopharyngeal cancer cell line CNE_ 2 .Results:The positive rate of somatostatin receptors subtype SSTR_ 1 SSTR_ 2 SSTR_ 4 was manifested in the human nasopharyngeal carcinoma cell line CNE_ 2 by RT-PCR and immunohistochemical assay. According to immunohistochemical assay, SSTR_ 1 and SSTR_ 2A showed strongly positive expression and SSTR_ 3 and SSTR_ 5 negative expression,respectively.Conclusions:There are more than one SSTR subtypes expressed in the human nasopharyndeal carcinoma cell line CNE_ 2 . This study demonstrated the presence of SSTR_1,SSTR_ 2 in the human nasopharyndeal carcinoma cell line CNE_ 2 .
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Objective Study the possible mechanisms of inhibiting hepatic fibrosis of IFN-? by observing the effects of IFN-? on the expression of smad3 mRNA in rat hepatic fibrosis model.Methods 70 rats were divided into three groups at random-fibrosis model group、IFN-? treatment group and normal control group.There are 30 rats in fibrosis model group which were induced to hepatic fibrosis by subcutaneous injection of carbon tetrachloride(CCl4) for 12 weeks.In the meantime,using IFN-? to treat the rats in IFN-? treatment group for 12 weeks.Histopathology changes and degree of fibrosis in livers of all rats were observed.Eventually,Smad3 mRNA were detected and quantified by real-time RT-PCR.Results In contrast with normal control group,the degrees of fibrosis in rat fibrosis model were significantly increased(P
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<p><b>OBJECTIVE</b>To analyze the efficacy of recurrence prophylaxis using radiation and chemotherapy following bladder conservation surgery for muscle invasive bladder cancer.</p><p><b>METHODS</b>23 patients with muscle invasive bladder cancer were treated with radiotherapy combined with bladder mitomycin infusion after bladder conservation surgery (study group). Radiotherapy was given using an external beam at an average dose of 5148 +/- 462 cGy with conventional fractionation. For comparison, 29 similar patients treated with postoperative bladder mitomycin infusion without radiation served as control (control group). All patients were followed up for more than 3 years, an average of 41.6 months (36 - 60 months).</p><p><b>RESULTS</b>The 3-year pelvic recurrent rate of muscle invasive bladder cancer was 17.4% in the study group and 44.8% (P = 0.036) in the control group. The 3-year distant metastasis rates were 17.4% and 24.1%, respectively (P = 0.554). The 3-year overall survival rates were 81.8% and 86.2%, respectively (P = 0.670). Two patients from the study group had their treatment interrupted, one for 3 days and the other for one week due to acute cystitis, while the rest of the patients were able to complete the treatment according to schedule.</p><p><b>CONCLUSION</b>Radiotherapy plus chemotherapy after bladder conservation surgery for muscle invasive bladder cancer can decrease the rate of pelvic recurrence effectively and be used as a realistic adjuvant treatment.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Combined Modality Therapy , Neoplasm Recurrence, Local , Survival Rate , Urinary Bladder Neoplasms , Mortality , TherapeuticsABSTRACT
Objective To evaluate the local control effect of radiotherapy and intravesical chemotherapy following bladder preserving surgery for musculoinvasive bladder cancer. Methods Twenty three patients with muscle invasive bladder cancer were treated by bladder preserving surgery followed by external radiation ( mean dose 52.5 Gy) combined with intravesical mitomycin infusion after bladder preserving operation (study group).For comparison, 29 similar patients received the same treatment without radiation served as control (control group).Results All patients in the study group completed their designed treatment,except two patients whose protocol was interrupted for 3 days and one week due to acute cystitis. The mean follow up duration was 41.6 months. The 3 year local recurrence rates were 18.8% in the study group and 44.8% in the control group(P=0.026).The 3 year distant metastasis rates were 18.2% and 24.1% (P=0.437),and the 3 year overall survival rates were 81.8% and 86.2% (P=0.670),respectively. Conclusion It is demonstrated that adjuvant radiotherapy and intravesical infusion chemotherapy following organ preserving surgical procedure are encouraging by giving favorable local control for musculoinvasive bladder cancer.