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Objective@#To verify the safety and efficacy of IONTRIS particle therapy system (IONTRIS) in clinical implementation.@*Methods@#Between 6.2014 and 8.2014, a total of 35 patients were enrolled into this trial: 31 males and 4 females with a median age of 69 yrs (range 39-80). Ten patients had locally recurrent head and neck tumors after surgery, 4 cases with thoracic malignancies, 1 case with hepatocellular carcinoma, 1 case with retroperitoneal sarcoma, and 19 cases with non-metastatic prostate carcinomas. Phantom dose verification was mandatory for each field before the start of radiation.@*Results@#Twenty-two patients received carbon ion and 13 had proton irradiation. With a median follow-up time of 1 year, all patients were alive. Among the 16 patients with head and neck, thoracic, and abdominal/pelvic tumors, 2, 1, 12, and 1 cases developed complete response, partial response, stable disease, or disease progression, respectively. Progression-free survival rate was 93.8% (15/16). Among the 19 patients with prostate cancer, biological-recurrence free survival was 100%. Particle therapy was well tolerated in all 35 patients. Twenty-five patients (71.4%) experienced 33 grade 1 acute adverse effects, which subsided at 1 year follow-up. Six (17.1%) patients developed grade 1 late adverse effects. No significant change in ECOG or body weight was observed.@*Conclusions@#IONTRIS is safe and effective for clinical use. However, long term follow-up is needed to observe the late toxicity and long term result.
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Objective To evaluate the effects of sodium-glucose cotransporter 2 ( SGLT2) inhibitors on the stroke risk for patients with type 2 diabetes mellitus (T2DM). Methods A systemic meta-analysis including 30 random control trails ( RCTs) was performed to compare the risk of stroke between type 2 diabetic patients treated with SGLT2 inhibitors and control drugs. Then their bias risk and quality were assessed and meta-analysis was conducted using Stata12.0 software. Results Thirty RCTs enrolling 74456 participants were selected for meta-analysis. The stroke incidence in the group receiving SGLT2 inhibitor monotherapy or combination therapy did not significantly differ from that in control group, with relative risk (RR) 1.01 (95％CI 0.93-1.10, P=0.978) and 1.00 (95％CI 0.92-1.09, P=0. 874 ) , respectively. Three SGLT2 inhibitors canagliflozin, dapagliflozin, and empagliflozin did not increase the risk of stroke, with similar RR values ( RR=0.91, 0.99, 1.13, respectively) . Subgroup analyses showed that there was no correlation between SGLT2 inhibitors and stroke risk in different gender, age, diabetes duration, body mass index, or HbA1C levels. Conclusions Whether administered as monotherapy or add-on therapy, SGLT2 inhibitors did not increase stroke incidence, and there were no significant within-class differences.
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Objective To explore the influence and it′s mechanism of workplace mindfulness on thriving at work of nursing staffs. Methods A cross-section survey was conducted to collect data with an online method, the multiple line hierarchical regression analysis method was performed to test the relations between variables. Results The mean workplace mindfulness score of nursewas 4.74±0.63, the mean thriving score was 3.07 ± 0.71. Workplace mindfulness had a significantly positive prediction on thriving at work (β=0.344, P<0.01) of nurses. Conclusions Workplace mindfulness could affect nurses′thriving at work, which is beneficial to improve the growth and vitality of nursing staffs, which in turn to enhance them to abundant and vigorous life.
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Background and purpose: The literature on dose-volume parameters and pneumonitis is extensive. The results are inconsistent, both for the best predictive metrics and significant comorbid factors. This study aimed to investigate a prospective functional equivalent uniform dose (fEUD) with perfusion single photon emission computed tomography (SPECT) images as predictors of radiation pneumonitis (RP) in patients undergoing curative radiotherapy (RT). Methods: Functional lung imaging was performed using SPECT for perfusion imaging. Perfusion factors were defined as the mean percentile perfusion levels of the 4 areas, top to 75%, 75% to 50%, 50% to 25%, 25% to 0%, re-spectively. fEUD was calculated from perfusion factors and standard dose-volume parameters extracted from treatment planning computed tomography (CT) scans. Total lung (TL), ipsilateral (IL) and contralateral lung (CL) volumes minus gross tumor volume (GTV), whole-lung V5, V20, whole lung fEUD, IL and CL fEUD, and general equivalent uniform dose (gEUD) were analyzed to evaluate correlations between RP using Common Terminology Criteria for Adverse Events (CTCAE) version 4.03. Statistical significance was defined as P<0.05. Results: A total of 15 patients treated with intensity modulated RT or 3D conformal RT were analyzed, grades≥3 RP were observed in 6 patients. There was only a trend toward significance for unilateral (UL) fEUD of higher dose side (P=0.007). Whole-lung V5, V20 were almost identical between patients who developed pneumonitis and patients who did not, as the values were below the recommended thresholds from published papers. Unilateral fEUDs were linear with unilateral gEUDs (t=0.815, P=0.000). Conclusion: SPECT-based equivalent uniform dose appears to be a better predictor of RP compared to stan-dard dose-volume parameters. Planning constraints should aim to keep unilateral fEUD below 21 Gy.
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Background Suture stitching is currently the standard treatment for corneal penetrating injuries.The shortcomings of suture stitching have led to the exploration of non-sutured surgical methods.Tissue adhesive is a promising non-suture replacement procedure.Objective This study was to observe the effect of fibrin glue on large irregular rabbit corneal penetrating injury.Methods Eighteen pure white healthy rabbits were randomly divided into suture group and adhesive group.A total length of 6-mm non-self-sealing corneal penetrating injury in nonpupillary-area of the right eye formed with a 15° corneal puncture knife was repaired with fibrin glue plus temporary suture and therapeutic corneal contact lens (9 eyes) or with 3 to 5 interrupted 10-0 nylon sutures (9 eyes) with the fellow eyes acted as the internal controls respectively.Operative time was compared between the two groups.Clinic observation was performed with slit lamp microscope.Animals were humanely sacrificed for histologic examination at week 1,3,and 8 to evaluate wound healing.Results The average operation time was (3.48±0.48) minutes in the adhesive group,which was significantly lower than that in the suture group ([7.77 ± 1.30] minutes) (t =9.28,P＜ 0.01).The postoperative slit lamp microscope observation indicated corneal wounds were quickly and regularly healed in the glued corneas compared with the stitched ones.The histologic examination revealed that glued corneas had regular healing,mild inflammation,and no corneal neovascularization,while sutured corneas showed irregular fibrin arrays,a large number of inflammatory cells and macrophages infiltration around the suture,heavy inflammatory response.Neovascularization was found at week 3 postoperatively.Conclusions Fibrin glue combined with temporary suture and therapeutic corneal contact lens is an effective treatment in sealing large irregular corneal wounds with considerable advantages over traditional sutures,ircluding simplified operative technique,short surgery time,less postoperative irritation,mild inflammation,more regular wound healing,short healing time,and no corneal neovascularization.
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<p><b>OBJECTIVE</b>To analyze the results of postoperative radiotherapy with electronic beam for patients with keloids in our hospital.</p><p><b>METHODS</b>From September 2006 to May 2009, radiotherapy was given within 24 hours after operation in 53 keloid patients. With single vertical field irradiation, 6-12 Mev electronic beams of Linear Accelerator were selected for different incision depth in different sites. The field size was 1.0 cm (range: 0.5-2.0 cm) away from both incision ends and 1.25 cm (range: 0.75-2.50 cm) away from incision laterally. The radiation was given daily with median treatment course of 4 days (range: 3-21 days) at 3.5 Gy/Fx to a median total dose of 14 Gy (range: 8-20 Gy). SPSS 21. 0 was used for analysis.</p><p><b>RESULTS</b>All postoperative incisions healed in one stage, the median follow-up was 34 months (range: 18-63 months). The overall local control rate was 79.7%. For patients who received the dose of more than 14 Gy versus less than 14 Gy, the local control rate was 81.6%, 75.2%, respectively (P > 0.05). For male and female, the 3 year local recurrence rate were 45.3%, 9.9% respectively (P = 0.008). Multivariate analysis showed that the sex (male versus female) was an independent prognostic factor (P = 0.036).</p><p><b>CONCLUSION</b>Surgery combined with electronic beam irradiation is a rather effective way to treat keloids. The local control rate would have a better trend if the total dose was higher than 14 Gy. Sex is an independent prognostic factor.</p>
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Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Follow-Up Studies , Keloid , Radiotherapy , Postoperative Care , Treatment OutcomeABSTRACT
Epithelial-mesenchymal transition (EMT) is the basis of biological process of embryonic development,and is also closely related with tumor cell in situ invasion and distant metastasis.Recent studies find that EMT and cancer stem cells (CSCs) have a close relationship.CSCs have a strong ability to selfrenewal,tumorigenicity and cell differentiation potential.Identifing the markers,in-depth study of CSCs resistance,may provide a new path for cancer treatment.
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The ras-mitogen activeted protein kinase pathway is responsible for regulation of many cel-lular processes, including differentiation, cytoskeletal organization, and protein trafficking. Much attention has been paid to them and their role in cancer therapy recently, and its inhibitor pathways are applied to clinical tes-ting, such as, Raf kinse inhibitors, MEK inhibitor, Src kinase inhibitor.
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Objective To investigate the expression of peroxisome proliferator-activated receptor?(PPAR?) in human gastric carcinoma and the effect of its ligand 15-deoxy-△~(12,14)-Prostagliandxin J_(2)(15d-PGJ_(2)) on the growth of human gastric carcinoma MGC803 cells.Methods PPAR? and survivin mRNA were examined by RT-PCR;PPAR?,survivin,Skp2 and p27 protein were examined in cells by Western blot;proliferation was examined by MTT assay,apoptosis and cell cycle distribution were examined by flow cytometry;PPAR? protein in tissue was examined by immunohistochemistry;morphological change of apoptosis was examined by Hoechst33342 staining.Results The positive rate of PPAR? protein was significantly higher in gastric carcinomas 75.0%(40 cases) than in their paired adjacent mucosa(25.0%)((40 cases))(and)(normal)(mucosa)(20.0%(40cases)),(and)(there)(was)(no) difference between the latterones. The positive rate of PPAR?mRNA and protein were significantly higher in intestinal gastric carcinoma 95.0%(20 cases)than that in diffuse gastric carcinoma 55.0%(20 cases).Proliferation inhibition rate and apoptosis rate of MGC803 cells after_()24h were all significantly higher following 5,10,20,30 and (40 mol/L) 15d-PGJ_(2)treatment than(0 mol/L)(P
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0.05); The result of FCM indicates that the cells transfected with p16 changed in cell cycle distribution ; proportion of G 2 M phase was increased, while that of S phase was decreased.Conclusions:Introduction of p16 gene into low expression human lung adenocarcinoma cell line Anip973 alters the radiation effect in a way which perhaps was correlated with the inhibition of sublethal damage repair and the cell cycle distribution change, but not in the high expression cell line AGZY83a.