ABSTRACT
Radiation pneumonitis and pulmonary fibrosis are important dose-limiting side effects of radiotherapy that influence the prognosis and quality of life of patients with thoracic cancer. The disorder of the immune system plays a key role, especially macrophages. With the discovery of underlying molecular mechanisms, including the chemotaxis and polarization of macrophages, the infiltration of inflammatory cells, the release of inflammatory and pro-fibrotic factors, extracellular matrix deposition and the remodeling of lung structure, increasing strategies are under investigation to facilitate the prevention or treatment of lung injury via targeting macrophages. In this paper, the role of macrophages in the development of radiation pneumonitis, pulmonary fibrosis, and potential drug use strategies were reviewed.
ABSTRACT
Background Osteoclast stimulatory transmembrane protein (OC-STAMP) is involved in silicosis fibrosis induced by silicon oxide (SiO2) exposure. Its role in silicosis fibrosis by inducing ferroptosis of alveolar type II epithelial cells and its related mechanism remain unclear. Objective To explore the effect and possible mechanism of OC-STAMP on ferroptosis of alveolar type II epithelial cells and silicosis fibrosis in rats under SiO2 exposure. Methods Twenty male Wistar rats of SPF grade were randomly divided into two groups: control (Sham) group and SiO2 group, 15 rats in each group. Rats in the SiO2 group were given 1 mL of 50 mg·L−1 SiO2 suspension at one time through the non-exposed intratracheal instillation method to establish an animal model of silicosis, and rats in the Sham group were give 1 mL of 0.9% sodium chloride solution in the same way. Rats were sacrificed after 8 weeks. Samples of lung tissue were fixed in glutaraldehyde or paraformaldehyde for observing ultrastructure of mitochondria by transmission electron microscopy; HE, Masson, VG, and Prussian blue were used to observe changes in lung tissue structure and iron deposition. The expression level of OC-STAMP and the degree of lung fibrosis were evaluated by immunohistochemistry and immunofluorescence. The expression level of OC-STAMP in rat lung tissue was detected and the transfection effect of OC-STAMP was verified by real-time fluorescence quantitative polymerase chain reaction (RT-PCR). Overexpression (OCS group) and inhibition expression (SI-OC group) models were constructed by OC-STAMP plasmid and OC-STAMP small interfering RNA (siRNA) transfection to cultured MLE-12 cells, respectively. The relative expression levels of glutathione peroxidase 4 (GPX4), solute carrier family 7 member 11 (SLC7A11), and other proteins in lung tissue and MLE-12 were detected by Western blotting. Results The results of HE, Masson, and VG staining showed that the silicosis modeling was successful after 8 weeks of SiO2 exposure. The immunofluorescence results showed that OC-STAMP and ATP binding cassette subfamily A member 3 (ABCA3) co-localized in alveolar type II epithelium. The immunohistochemical results showed that the levels of OC-STAMP and collagen I in the SiO2 group were significantly higher than those in the Sham group (P<0.01). The RT-PCR results showed that the OC-STAMP mRNA in the lung tissue of the SiO2 group was significantly higher than that of the Sham group (P<0.01). The Prussian blue staining in the lung tissue of the SiO2 group showed positive brownish-yellow particles. Compared with the Sham group which showed normal mitochondrial structure, the mitochondrial structure was generally swollen and the mitochondrial cristae dissolved and disappeared in the SiO2 group by transmission electron microscope observation. The Western blotting results showed that the expression levels of SLC7A11 and GPX4 both decreased in the lung tissue of the SiO2 group (P<0.05, P<0.01), and the expression level of Vimentin increased (P<0.01). In the transfected MLE-12 cells, compared with the Sham group, the expression levels of SLC7A11 and GPX4 in the OCS group were significantly reduced (P<0.05, P<0.01). Conclusion OC-STAMP may affect the expression of proteins related to ferroptosis, and promote lung fibrosis induced by SiO2 exposure.
ABSTRACT
Objective To investigate the effects of Loropetalum chinense extracts on the proliferation of lung adenocarcinoma A549 cells cultured in vitro. Methods CCK-8 assay was performed to evaluate the effect of Loropetalum chinense extracts on the proliferation of A549 cells, and the clonal growth ability of A549 cells was determined by clone formation assay. Flow cytometry Annexin V-APC/PI double staining was used to measure the apoptosis of A549 cells. Western blot was used to measure the expressions of apoptosis-related proteins Bax, Fas, Bcl-2 Caspase3 and cleaved-Caspase 3. Results Loropetalum chinense extracts significantly inhibited the proliferation and colony formation of A549 cells in a time- and dose-dependent manner. The viability of A549 cells decreased by 50% after 48h treatment of 0.5mg/ml extracts, and 100% inhibition of colony formation rate achieved when the cells were treated with 40μg/ml extracts for 14 days. When A549 cells were treated with Loropetalum chinense extracts for 24h, apoptotic rates increased in a dose-dependent manner. Compared with the control group, the protein levels of Fas, Bax, Caspase3 and cleaved-Caspase3 were up-regulated, while Bcl-2 was down-regulated. Conclusion Loropetalum chinense extracts inhibit the growth of human lung adenocarcinoma cells in vitro, and the mechanisms may be related to the activation of mitochondrial and death receptor apoptosis pathway.
ABSTRACT
Objective:To explore the changes in activity of indoleamine 2, 3-dioxygenase(IDO)before and after stereotactic body radiation therapy (SBRT) in early stage non-small cell lung cancer(NSCLC) and its relationship with survival.Methods:The retrospective study was to assess IDO activity by serum kynurenine (Kyn) and Kyn to tryptophan (Trp) ratio before and after SBRT of early stage NSCLC.Thirty early stage NSCLC patients who received SBRT in the Cancer Hospital of the University of Chinese Academy of Sciences were enrolled, from December 2014 to July 2017. High-performance liquid chromatography and mass spectrometry were used to detect serum Kyn and Trp before and after SBRT. The ratios of Kyn after SBRT to Kyn before SBRT were divided into high and low group according to the median value. Similarly, the ratios of Kyn to Trp after SBRT were divided into high and low group.The correlation between overall survival (OS), progression-free survival (PFS) and IDO activity was evaluated. The factors influencing prognosis were analyzed.Results:In all patients, lower ratio of Kyn after SBRT to Kyn before SBRT significantly was correlated with better PFS (median PFS: not reached vs. 26.8 months, HR=0.31, 95% CI =0.11-0.90, P<0.05). The lower Kyn∶Trp ratio after SBRT had longer OS (median OS: not reached vs. 36.5 months, HR=0.27, 95% CI =0.079-0.95, P<0.05). In multivariate analysis, smoking <30 packs/year, higher BED, and lower ratio of Kyn after SBRT to Kyn before SBRT were associated with longer PFS. Lower Kyn∶Trp ratio after SBRT and higher BED were associated with longer OS. Conclusions:SBRT could alter IDO-mediated antitumor immune activity. IDO is a potentially valuable biomarker for monitoring immune status and predicting survival in early NSCLC patients after SBRT.
ABSTRACT
Objective@#To investigate the clinical efficacy and adverse effects of stereotactic body radiotherapy (SBRT) in the treatment of T2N0M0 non-small cell lung cancer (NSCLC) patients.@*Methods@#By retrospectively analyzing the clinical data of 30 inoperable patients with stage T2N0M0 NSCLC treated by SBRT, the overall survival, progression-free survival, cancer-specific survival and adverse effects were determined.@*Results@#The median follow-up was 18.4 months. The 1-, 2-, and 3-year overall survival rates were 92.2%, 92.2% and 80.6%, respectively. The corresponding cause-specific survivals were 95.7%, 95.7% and 83.7%. The progression-free survivals were 70.2%, 54.1% and 40.6%. The local control rates were 100%, 94.4%, and 94.4%. The regional controls were 84.2%, 72.1%, and 54.1%; and distant controls were 84.6%, 72.4% and 64.3%, respectively. Twenty patients (66.7%) developed symptoms of grade 1 radiation-related toxicities: dyspnea, chest pain, fatigue, cough, esophagitis, or pneumonia. Among these, 5 patients suffered grade ≥2 radiation pneumonitis, and one patient experienced grade 4 radiation pneumonitis.@*Conclusions@#SBRT was efficient and safe for patients with inoperable T2N0M0 NSCLC, imposing tolerable toxicities.
ABSTRACT
Objective To investigate the clinical efficacy and adverse effects of stereotactic body radiotherapy (SBRT) in the treatment of T2N0M0 non-small cell lung cancer (NSCLC) patients.Methods By retrospectively analyzing the clinical data of 30 inoperable patients with stage T2N0M0 NSCLC treated by SBRT,the overall survival,progression-free survival,cancer-specific survival and adverse effects were determined.Results The median follow-up was 18.4 months.The 1-,2-,and 3-year overall survival rates were 92.2％,92.2％ and 80.6％,respectively.The corresponding cause-specific survivals were 95.7％,95.7％ and 83.7％.The progression-free survivals were 70.2％,54.1％ and 40.6％.The local control rates were 100％,94.4％,and 94.4％.The regional controls were 84.2％,72.1％,and 54.1％;and distant controls were 84.6％,72.4％ and 64.3％,respectively.Twenty patients (66.7％) developed symptoms of grade 1 radiation-related toxicities:dyspnea,chest pain,fatigue,cough,esophagitis,or pneumonia.Among these,5 patients suffered grade ≥ 2 radiation pneumonitis,and one patient experienced grade 4 radiation pneumonitis.Conclusions SBRT was efficient and safe for patients with inoperable T2N0M0 NSCLC,imposing tolerable toxicities.
ABSTRACT
As a sensor of the olfactory system, olfactory epithelium plays an important role in the olfactory system. In addition, olfactory epithelium is the only neuroepithelial epithelium in mammals that can maintain its self-renewal all along. There are of great significance in researching regenerating and repairing neural tissues, transplanting and treatment neural stem cells as well as the occurrence of olfactory disorders and intervention. This review will describe the characteristics of olfactory epithelial stem cells, and mainly summerize the function and significance of each transcription factor in the process of olfactory epithelial stem cell development and differentiation, in order to provide new ideas for the study of olfactory epithelial stem cells.
ABSTRACT
Objective To compare the efficacy of trimodality therapy and chemoradiation therapy (CRT) alone in patients with locally advanced resectable esophageal squamous cell carcinoma (SCC).Methods A total of 124 cases with locally advanced resectable esophageal SCC were retrospectively analyzed and classified into 2 groups.Fifty-four cases in trimodality group were treated with surgery and preoperative chemoradiation,while 70 cases in CRT alone group only received radiation and chemotherapy.Local tumor control,3-year survival and treatment-related mortality were assessed.Results The local recurrent rate of the resected patients was 18.5％ in trimodality group and 35.7％ in CRT alone group,respectively(x2 =4.445,P ＜ 0.05).The 3-year progression-free survival (PFS) was 65.3％ (95％ CI 50.7-80.5) in trimodality group and31.9％ (95％CI 19.6-44.2) in CRT alone group (P＜0.05),while the overall survival (OS) 66.3％ (95％ CI43.0-89.6) and 34.4％ (95％ CI 21.1-47.7),respectively(P ＜ 0.05).Treatment-related mortality was 1.9％ in trimodality group and 2.9％ in CRT alone group (P ＞ 0.05).For CRT alone group,the sub-group analysis showed that there was no statistically significant difference in the 3-year OS between patients who received 50-50.4 Gy and those who received the dose over 50.4 Gy (39.9％ 95％ CI 18.5-61.3 vs.31.5％ 95％ CI 14.8-48.2,P ＞0.05).Conclusions Compared with CRT alone,trimodality therapy showed the superior local control,PFS and OS,with similar treatment-related mortality in the treatment of patients with SCC of esophagus.The role of surgery could not be replaced by CRT alone even with the augment of radiation dose.
ABSTRACT
Esophageal cancer is a common gastrointestinal cancer in China with poor prognosis.Radiotherapy is the main treatment of esophageal cancer,and radiosensitivity of the tumor cell is a significant reason for the efficacy of radiotherapy.Mesenchymal-epithelial transition factor (c-Met) and its signaling pathway play an significant role in tumorigenesis,development,invasion,metastasis and treatment resistance.This review summarizes the association between expression of c-Met and radiosensitivity in esophageal cancer.
ABSTRACT
Objective To evaluate the safety and clinical efficacy of stereotactic body radiation therapy (SBRT) for lung cancer.Methods A retrospective analysis was performed on 200 patients with primary non-small cell lung cancer (NSCLC)(118 patients) or solitary pulmonary metastasis (82 patients) who underwent SBRT in Zhejiang Cancer Hospital from January 2012 to September 2015.The 80% isodose line covered 95% of the planning target volume,and the 100% isodose line covered 100% of the internal gross tumor volume.The fractional dose was 4.0-18.0 Gy daily or every other day,and the biologically equivalent dose ranged from 40.0 to 151.2 Gy (median 100 Gy).Results All patients completed treatment.The follow-up rate was 96.0%.The complete response and partial response rates were 14.8%(17/115) and 65.2%(75/115) for the primary tumor group,versus 25%(19/77) and 38%(29/77) for the metastasis group.The incidence rates of grade Ⅱ and Ⅲ acute radiation pneumonitis were 4.7% and 3.1%,respectively.The median follow-up was 14.9 months.The 1-and 2-year local control rates were 95.7% and 84.3% for the primary tumor group,versus 92% and 73% for the metastasis group.The 1-and 2-year overall survival rates were 94.5% and 92.0% for the primary tumor group,versus 85% and 62% for the metastasis group.Conclusions SBRT is a safe and effective treatment for early primary NSCLC and solitary pulmonary metastasis,resulting in high 1-and 2-year local control and overall survival rates and low rate of complications.
ABSTRACT
Objective To compare the clinical efficacy and safety of endoscopic papillary balloon dilation (EPBD) and endoscopic papillary balloon dilation (EPBD) combined with small endoscopic sphincterotomy (SEST) in treatment of large choledocholithiasis. Methods 78 patients with large choledocholithiasis from January 2014 to December 2015 were randomly divided into EPBD group, and combination treatment group. The level of bilirubin, transaminase, alkaline phosphatase (ALP) before and after the operation, the success rates of stone removal, serum amylase of 24 h after the operation, the operation times of endoscopic retrograde cholangiopancreatography (ERCP) and whether complicated with postoperative pancreatitis were compared between the two groups. Results There was no significant difference of the success rates of stone removal, serum amylase of 24 h after the operation, the operation times of ERCP between the two groups. The level of bilirubin, transaminase, alkaline phosphatase (ALP) was declined after EPBD or EPBD and SEST, and the results of the two groups had no statistical significance (P > 0.05). Also there was no significant difference of the incidence of postoperative pancreatitis, postoperative bleeding and postoperative hyperamylasemia between the two groups (P > 0.05). Conclusion EPBD is worthy of promoting because it has a similar clinical efficacy and safety to EPBD and SEST in treatment of large choledocholithiasis.
ABSTRACT
Esophageal cancer is one of the most common gastrointestinal cancers, and chemoradiotherapy is an important part of the multidisciplinary treatment for this disease.In recent years,18Fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET-CT) is widely used in esophageal cancer for delineation of gross tumor volume, local boost irradiation in the late stage of radiotherapy, and assessment of the pathologic remission rate after neoadjuvant chemoradiotherapy, response to definitive chemoradiotherapy, and prognosis.In this article, we review the application of FDG PET-CT in the chemoradiotherapy for esophageal cancer.
ABSTRACT
Objective To investigate the clinical effect and survival quality of raltitrexed and radiotherapy in treatment of esophagus cancer. Methods 100 cases with esophagus cancer were selected. There were 50 cases using raltitrexed combined with concurrent radiotherapy as observation group. Others were treated with 5-Fu combined with concurrent radiotherapy as control group. The clinical therapeutic effect and survival situation of two groups were evaluated. Results After treatment, the total response rate of observation group (86.0%) was higher than control group (58.0%), the differences between the two groups was statistical difference(P<0.05).The one- and two-year survival rates in observation group were higher than control group (χ2 = 4.32, 7.954, P=0.038, 0.005<0.05).There was no significant difference between the two groups in incidence rate of acute esophagitis, acute bone marrow suppression and acute skin reaction. Conclusion The clinical therapy of raltitrexed plus radiotherapy in treatment of esophagus cancer is distinct, and improve the survival time and the quality of life of patients.
ABSTRACT
Objective To investigate the clonal relatedness of A.baumannii isolates from senile patients by conducting cross-sectional and longitudinal studies on antimicrobial susceptibility profiling and genomic diversity.Methods Cross-sectional study was done among the 170 non-repetitive A.baumannii isolates which were collected from senile patients during two years.Longitudinal study was conducted among 77 A.baumannii collected from 8 senile patients within longtime hospitalization.Results 75.3 ％ of the 170 isolates were non-susceptible to carbapenems,and the phenotype were XDR or MDR which spread evenly all over the senile wards.The isolates belonged to 36 pulsotypes determined by PFGE.Groups Ⅰ (contain119 isolates) were major epidemic strains,which were CRAB with XDR phenotype.In longitudinal study,comparison of pulsotypes was performed for each patient and all isolates were clustered into group Ⅰ except one isolate.All the 77 isolates were XDR.Conclusion Extensive drug-resistance of A.baumannii was a serious problem in the gerontal wards.Clone dissemina tion was the most important style of XDR strains spread.Horizontal infection control measures to interrupt person-to-person transmission should be reinforced to reduce the further spread of XDR A.baumannii.
ABSTRACT
OBJECTIVE:To observe the clinical efficacy and safety of caspofungin acetate in the treatment of invasive pulmo-nary fungal infection(IPFI). METHODS:70 patients with IPFI were selected and randomly divided into observation group(40 cas-es) and control group (30 cases). Control group was given Itraconazole injection with initial dose of 250 mg,bid,decreasing to 200 mg,qd,2 days later;observation group was given Caspofungin acetate injection 70 mg on the first day,decreasing to 50 mg, ivgtt,qd,within 1 h. Clinical efficacy,the rate of nacterial smear negative conversion and ADR were observed in 2 groups. RE-SULTS:The total effective rate of observation group was 92.50%,which was significantly higher than that of control group (76.67%);the rate of nacterial smear negative conversion was 72.00% in observation group,which was significantly higher than that of control group(42.10%);the incidence of ADR was 7.50%in observation group,which was significantly lower than that of control group (13.33%),with statistical significance (P<0.05). CONCLUSIONS:Caspofungin acetate is effective for IPFI with low incidence of ADR.
ABSTRACT
Objective To compare the clinical efficacy of covered and uncovered metal stents in treatment of malignant biliary obstruction. Methods 123 cases of malignant biliary obstruction from May 2003 to May 2014. The survival time, the stent patency rates, the effective and biochemical indexes between the two groups were analyze and compared, follow-up period ended in March 2015. Results The level of bilirubin, transaminase, alkaline phosphatase (ALP) was declined after the covered and uncovered metal stents placed by ERCP, and the results of the two groups had no statistical significance (P > 0.05). Also there was no significant difference of the incidence of postoperative cholangitis and the cumulative survival rate between the two groups (P > 0.05). One year survival rates was related to tumor types (r = -1.55, P < 0.05). Conclusions Covered and uncovered metal stents for malignant biliary obstruction have no statistically significant about remission of liver function, stent occusion and the cumulative survival rate.
ABSTRACT
OBJECTIVE:To observe clinical efficacy and safety of rivaroxaban in the treatment of pulmonary embolism. METHODS:100 patients with pulmonary embolism were selected and randomly divided into observation group and control group, with 50 cases in each group. Both groups were given nursing intervention for rehabilitation. Observation group was treated with riva-roxaban 15 mg,bid,for consecutive 3 weeks,3 weeks later adjusting to 20 mg,qd;control group was given low molecular weight heparin 1 mg/kg,bid,combined with warfarin sodium 5 mg,qd,for more than 5 days,stopped taking low molecular weight heparin until the INR reached the target 2-3 and given warfarin alone orally. Treatment course of 2 groups lasted for 3 months. Clinical efficacy of 2 groups were observed,and PaO2,PaCO2 and D-dimer levels were observed in 2 groups before and af-ter treatment;the improvement of clinical symptoms as cough,pectoralgia,dyspnea,and the incidence of ADR were recorded in 2 groups. RESULTS:The total effective rate of observation group (90.0%) was significantly higher than that of control group (74.0%),with statistical significance(P<0.05). After treatment,PaO2,PaCO2 and D-dimer levels of 2 groups were increased signif-icantly,compared with before treatment;the observation group was higher than the control group,with statistical significance(P<0.05). The remission rate of clinical symptoms as cough,pectoralgia,dyspnea in observation group was significantly higher than in control group,with statistical significance (P<0.05). The incidence of ADR in observation group (12.0%) was significantly lower than in control group (30.0%),with statistical significance (P<0.05). CONCLUSIONS:Rivaroxaban supplemented by reasonable nursing intervention can effectively improve clinical efficacy of patients with pulmonary embolism with low incidence of ADR.
ABSTRACT
At present,the treatment for non-small cell lung cancer (NSCLC) consists of surgery,radiation,chemotherapy,targeted therapy,etc.The epidermal growth factor receptor (EGFR) gene mutation opened a new era of individualized treatment.Multidisciplinary treatment come next after the combination of different treatment approaches,and the modality of targeted therapy like epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) in combination with radiation was included.The present work reviews clinical progress for the EGFR-TKI combined with radiotherapy in advanced NSCLC.
ABSTRACT
Objective To establish the quality standard of Radix Toddaliae Asiaticae. Methods Thin layer chromatography ( TLC) and high performance liquid chromatography ( HPLC) were used to identify and determine chloride nitidine and toddalolactone in Radix Toddaliae Asiaticae. The moisture and total ash contents were detected according to the methods recorded in appendix of Chinese Pharmacopeia (2010 edition) . Results Toddalolactone and chloride nitidine were detectable by TLC, the spots were clear and the dissociation was good. The established HPLC method was simple and accurate. The linear ranges of toddalolactone and chloride nitidine in Radix Toddaliae Asiaticae were 2.84~42.6 μg/mL and 25.6~385 μg/mL, and their recovery rates were 99.2 % ( RSD=1.12%) and 100 % ( RSD=0.71%) , respectively. The content of moisture was in the range of 75.8~98.9 mg/g and that of total ash was in the range of 12.4~33.6 mg/g. Conclusion The developed method is specific and accurate, and can provide useful reference for establishing quality standard of Radix Toddaliae Asiaticae.
ABSTRACT
Objective:To analyze the characteristics of regional lymph node metastasis in patients with resectable non-small cell lung cancer (NSCLC) and assess its clinical significance in surgical mediastinal lymph dissection and the target volume definition of postoperative radiotherapy. Methods:We retrospectively reviewed 810 patients with NSCLC, and analyzed the metastatic frequency of each regional lymph node station as well as the correlation between tumor location and regional lymph node metastases. Results:Re-gional lymph node metastases were significantly associated with the age of patients, histology, tumor size, and tumor location (P=0.013, 0.000, 0.009 and 0.000, respectively). Conclusion:The younger patients with left lung adenocarcinomas and large tumor size tended to regional lymph node metastases. The trend of regional lymphatic drainage in the lobes of lung occurred differently. The prior location of involved regional lymph nodes in different lobes of the NSCLC patients was as follows:The station 2-4 for right upper lobe tumors, the station 2-4 and 7 for right middle lobe tumors and right lower lobe tumors, the station 5-6 for left upper lobe tumors, and the station 5-6 and 7 for left lower lobe tumors. We should pay more attention to the regions regarding the higher frequencies of lymph node metastases, when determining the extent of lymph node dissection or delineating the target volume of postoperative radiotherapy for NSCLC patients.