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BACKGROUND@#Previous studies have shown that ASPM is a tumorigenesis associated protein, mutations in ASPM can lead to MCPH. This study mainly explores the relationship between the ASPM expression of lung adenocarcinoma and the development and prognosis of lung cancer. The aim of this study was to investigate the relationship between the expression of abnormal spindle-like microcephaly-associated protein (ASPM) in lung adenocarcinoma and the development and prognosis in lung cancer.@*METHODS@#A total of 90 cases of lung adenocarcinoma tissue specimens and 90 cases of benign pulmonary lesions were collected, the expression of ASPM was detected by immunohistochemical technique, and the expression of ASPM in 12 pairs of tissues was detected by real-time quantity polymerase chain reaction and western blot.@*RESULTS@#(1) The expression of ASPM in the tissue specimens of benign pulmonary lesions was negative while the expression level of ASPM in lung adenocarcinoma was significantly higher than lung tissue of benign pulmonary lesions (P<0.05). (2) The expression level of ASPM has no remarkable difference in lung adenocarcinoma with lymph node development and the lung cancer without lymph node development, there was no statistically significant (P<0.05). (3) The ASPM expression level in the tumor's size ≥4 cm was significantly higher than than of the size<4 cm (P<0.05). (4) Hierarchical analysis results show that T stage is related to ASPM expression level (P<0.05). (5) The high expression level of ASPM in lung adenocarcinoma was significantly positively correlated with the poor prognosis (P<0.05).@*CONCLUSIONS@#(1) The expression level of ASPM in lung cancer is obviously increased and closely related to the progress of lung adenocarcinoma. (2) The expression level of ASPM in lung adenocarcinoma was significantly positively correlated with poor prognosis (P<0.05). (3) Detection of the expression level of ASPM in lung adenocarcinoma help to predict the prognosis of lung adenocarcinoma in advance.
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Objective To develop a MOSAIQ Integration PlatformCHN (MIP) based on the workflow of radiotherapy (RT) and to meet the actual requirements in China and the special needs for the radiotherapy department.Methods MIP used C/S (client-server) structure mode running on the local network in the hospital and its database was based on the Treatment Planning System (TPS) and MOSAIQ database.Five network servers,as the core hardware,supplied data storage and network service based on cloud services.The core software was developed based on Microsoft Visual Studio Platform using C# network programming language.The MIP server could simultaneously offer network service for about 200 workstations,including entry,query,statistics,and print of data.Results MIP had 15 core function modules,such as Notice,Appointment,Billing,Document Management (application/execution),and System Management,which almost covered the whole workflow of radiotherapy.Up to June 2016,the recorded data in the MIP were as follows:13546 patients,13533 plan application forms,15475 RT records,14656 RT summaries,567048 billing records,and 506612 workload records.Conclusions The MIP based on the RT workflow has been successfully developed and used in clinical practice.It is an important part of radiotherapy information system construction with the advantages of intuitive operation,real-time performance,data security,and stable operation.It is digital,paperless,user-friendly,and convenient for the retrieval and statistics of data as well as information sharing and department management,and can significantly improve the efficiency of the department.More functions can be added or modified to enhance its potentials in research and clinical practice.
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Objective To carry out hand hygiene(HH) quality control circle(QCC) activity by using WeChat group, improve HH compliance of health care workers(HCWs), and enhance the circle members' ability to solve problems.Methods In June 2015, 11 healthcare-associated infection control professionals in a hospital created HH WeChat group by using cellphones, activity cycle was once every two weeks, professionals analyzed the existing problems, and formulated countermeasures as well as implemented methods by group chat form, circle members introduced and implemented strategies to HCWs in their departments, so as to achieve the implementation effect.Results After the creating of WeChat QCC, HCWs' HH compliance increased from 56.71% before activity to 85.94% after activity, difference was statistically significant (X2=61.928, P<0.05);QCC members' responsibility, self-confidence, enthusiasm, harmony degree, team cohesiveness, quality control technique, communication, coordination, and problem-solving skill were all significantly improved.Conclusion Application of WeChat QCC activity can improve HH compliance of HCWs and the ability of circle members.
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Objective To systematically review the effect of team-based learning (TBL) versus the traditional lecture-based learning (LBL) teaching model on basic medical courses in undergraduate medical education. Methods The CNKI, VIP and Wanfang medical databases were electronically searched to retrieve randomized controlled trial studies on TBL applied in undergraduate basic medi-cal courses up to June 2014. In these studies TBL teaching model was used in experiment group with LBL teaching model as control group and course grades were adopted to evaluate the effect of learn-ing. Literature screening, data extraction, and quality assessment were performed in strict accordance with the inclusion and exclusion criteria, and then data were analyzed using RevMan 5.3 software. Results This Meta-analysis examined 12 studies, all of them with low quality at C level. Meta analysis shows that the score of the course of TBL teaching is better than the traditional LBL teaching, and the difference is statistically significant [weighed mean difference (WMD): 9.33, 95%CI (5.67, 13.00), P=0.000]. Conclusion Compared with the LBL teaching, the application of TBL teaching in medical undergraduate basic medical courses has the promotion effect, but need more rigorously randomized controlled trials to verify.
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PURPOSE: Several accelerated partial breast irradiation (APBI) techniques are being investigated in patients with early-stage breast cancer. The present study evaluated the feasibility, early toxicity, initial efficacy, and cosmetic outcomes of accelerated partial breast intensity-modulated radiotherapy (IMRT) for Chinese female patients with early-stage breast cancer after breast-conserving surgery. METHODS: A total of 38 patients met the inclusion criteria and an accelerated partial breast intensity-modulated radiotherapy (APBI-IMRT) plan was designed for each patient. The prescription dose was 34 Gy in 10 fractions, 3.4 Gy per fraction, twice a day, in intervals of more than 6 hours. RESULTS: Of the 38 patients, six patients did not meet the planning criteria. The remaining 32 patients received APBI-IMRT with a mean target volume conformity index of 0.67 and a dose homogeneity index of 1.06. The median follow-up time was 53 months and no local recurrence or distant metastasis was detected. The most common acute toxicities observed within 3 months after radiotherapy were erythema, breast edema, pigmentation, and pain in the irradiated location, among which 43.8%, 12.5%, 31.3%, and 28.1% were grade 1 toxicities, respectively. The most common late toxicities occurring after 3 months until the end of the follow-up period were breast edema, pigmentation, pain in the irradiated location, and subcutaneous fibrosis, among which 6.2%, 28.1%, 21.9%, and 37.5% were grade 1 toxicities, respectively. Thirty-one patients (96.8%) had fine or excellent cosmetic outcomes, and only one patient had a poor cosmetic outcome. CONCLUSION: It is feasible for Chinese females to receive APBI-IMRT after breast conserving surgery. The radiotherapeutic toxicity is acceptable, and both the initial efficacy and cosmetic outcomes are good.
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Female , Humans , Asian People , Breast Neoplasms , Breast , Edema , Erythema , Fibrosis , Follow-Up Studies , Mastectomy, Segmental , Neoplasm Metastasis , Pigmentation , Prescriptions , Radiotherapy , Radiotherapy, Intensity-Modulated , RecurrenceABSTRACT
Objective To assess the psychological characteristics of EORTC QLQ-H&N35 scale,and to explore whether QLQ-H&N35 scale is suitable to measure the qulity of life (QOL) in nasopharyngeal carcinoma (NPC) patients.Methods The data of 391 NPC patients from Cancer Hospital of Sun Yat-Sen University was collected.Split-half reliability,Cronbach's α coefficient,content validity,construct validity,discriminant validity,and feasibility of QLQ-H&N35 were performed.Person separation index (PSI),the order of item threshold,and differential item functioning were analyzed.Results Cronbach'sα coefficient and split-half reliability of QLQ-H&N35 were higher than 0.7,except for sense parameter.All Test-retest coefficients of QLQ-H&N35 were higher than 0.7.The result of factor analysis showed that the data was consistent with the theoretical model.Most of the domain scores and dimension scores of patients with different radiotherapy stages were significantly different (P ＜ 0.05).PSI of the model was 0.90.Most of the order of item threshold were normal.All the items had no uniform or non-uniform DIF among different genders and age groups.Conclusion QLQ-H&N35 scale is a reliable,operable,and valid disease-specific scale for the evaluation QOL in NPC patients.
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Objective To evaluate the quality of life (QOL) of nasopharyngeal carcinoma (NPC) tumorfree survivors,and analyze the factors affecting the QOL of NPC patients.Methods The QOL and demographic variables (gender,age,education,marital status,income,dialects,concomitant chronic disease,clinical stage,treatment method,radiation course,and radiotherapy stages) were collected.ANOVA and t test were used to compare the QOL of NPC patients among different demographic variables. Multivariate ANOVA was used to select the influencing factors. Results The influencing factors of psychological QOL included radiotherapy stage, radiation course and concomitant chronic disease. NPC patients had higher psychological domain QOL whose survival greater than five years, had a completed course of radiation, and without other diseases (P ＜0.05).The influencing factors of social QOL included radiotherapy stage and treatment method (P＜ 0.05). The influencing factors of side-effect QOL included radiotherapy stage(P ＜ 0.05).Conclusion The NPC tumor-free survivors who survival longer, have more course of radiation and with chronic diseases should be pay more attention.Prevention interventions should be preformed to reduce radiation injury to patients; side effects,and improve QOL of NPC tumor-free patients.
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Objective To evaluate the effcacy of electron-beam chest-wall irradiation in patients with breast cancer after mastectomy.Methods From June 1999 to December 2007,280 women with localized breast cancer received postmastectomy radiotherapy using electron beam to chest wall.The effcacy and toxicity of these 280 women was compared with 118 women treated during the same period using tangential field with photon beam.Results The follow-up rate was 93.2%.140 patients had a minimum followed up time of 5 years and 12 patients had a minimum follow up time of 10 years.The 5-year and 10-year chest wall recurrence rates were 6.8%and 5.0%.14.8%and 10.1%for patients irradiated with electron and photon(X2=1.12,P=0.290).The corresponding 5-year and 10-year disease-free survival rates were 60.6%and 65.5%,47.6%and 57.3%(X2=0.97,P=0.325).The 5-year and 10-year overall survival rates were 77.5%and 79.6%,48.4%and 53.3%(X2=0.37,P=0.545).Grade Ⅱ or more acute skin toxicity occurred in 10.4%and 16.9%of patients irradiated with electron and photon(X2=3.34.P=0.090).Pulmonary fibrosis developed in 28.8%and 22.1% of patients irradiated with electron and photon(X2=1.27,P=0.300).Conclusion Electron-beam chest-wall irradiation is as effective as photon-beam irradiation in breast cancer after mustectomy.
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Objective To analyze the prognosis of T1-T2 stage breast cancer with 1 -3 positive axillary nodes after mastectomy, and to explore a subgroup of patients who could benefit from adjuvant radiotherapy. Methods In the retrospective study of 412 eligible patients, survival analysis was performed using the Kaplan-Meier method. Univariate and multivariate analyses were performed using the Log-rank method and Cox regression analysis, respectively. Results The follow-up rate was 98. 7%. 215 and 41patients were followed up for 5 and 10 years,respectively. The 5-and 10-year overall survival (OS) rate was 90. 0% and 81.3%, respectively. The 5-and 10-year locoregional recurrence (LRR) rate was 10. 7% and 18. 6%, respectively. In univariate analysis, T2 statging, more than one positive node, hormone receptornegative ( ER&PR-negative), ratio of positive lymph nodes (LNR) ＞ 25%, Her-2 positive, no hormonal therapy were associated with a significantly higher rate of LRR. T2 staging, more than one positive node,hormone receptor-negative were the risk factors for LRR with statistical significance in the multivariate analysis. Basing on these 3 risk factors, the high-risk group (with 2 -3 factors) had a 10-year LRR rate of 36. 9% compared with 3.9% in the low-risk group ( with 0 - 1 factors;x2 =20. 64,P =0. 000). The 5-year and 10-year distant metastasis (DM) rate was 12.9% and 24. 5%, respectively. LRR, and LNR ＞25%were statistically significant predictors of DM in the multivariate analysis. The 5-year DM rate for patients with LRR was 36. 6% compared with 9. 7% without LRR (x2 = 16. 34,P =0. 000). The 5-year OS rate for patients with LRR was 69. 9% compared with 92. 9% without LRR ( x2 = 20. 79, P = 0. 000). LRR was associated with a higher risk of distant metastasis and worse survival. Conclusions LRR after mastectomy has a significant impact on the outcome of patients with T1 -T2 breast cancer and 1 - 3 positive axillary nodes.Patients who have 2 -3 risk factors might benefit from radiotherapy.
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Objective To investigate the polymorphism of human cytomegalovius UL143 gene of low passage clinical isolates in Guangzhou,China.Method PCR was performed to amplify the entire HCMV ULl43 gene region of 3 clinical isolates,which had been proven by multiplex PCR.The amplification products were cloned into pMD18-T-Vector and subjected to sequencing.The result of DNA sequences were analyzed together with the one of published homologous sequences in GenBank from 14 clinical isolates.Result There were several stop codons in UL143 gene due to a base deletion in open reading frame (ORF) of D3 isolate,which could lead to produce non-functional protein.UL143 ORF of Toledo isolate consisted of 279 nueleotides,encoding a protein with 92 amino acids.UL143 ORFs of other isolates consisted of 252 nueleotides,encoding a protein with 83 amino acids.The DNA sequences were quite conserved and all the variations were base substitution.The amino acid sequences of different isolates were highly conserved.with variation of 1.2%-2.4%.There were no additional or deleted sites of post translational modification of UL143 protein in all clinical isolates except Toledo isolate.There were some differences in the secondary structure among different isolates.The isoelectric point of UL143 protein of all clinical isolates except Toledo isolate was 8.75.Conclusion All DNA and deduced amino acid sequences of UL143 gene shared great similarity among HCMV clinical strains regardless of their polymorphism.