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La endoscopía digestiva ha evolucionado de una técnica puramente diagnóstica a un procedimiento terapéutico. Esto es posible en muchos casos gracias al uso de fluoroscopía, lo cual conlleva la exposición a radiaciones ionizantes tanto de los pacientes como del personal actuante. La colangiopancreatografía retrógrada endoscópica (CPRE), que requiere necesariamente de fluoroscopia, es catalogada por la Food and Drug Administration como un examen con potencial riesgo de desencadenar lesiones inducidas por radiación. El presente artículo de revisión repasa los efectos biológicos de las radiaciones, los tipos de equipos radiológicos utilizados en CPRE, así como las magnitudes y unidades dosimétricas, para finalmente abordar los elementos de radio protección en la sala de endoscopia. El objetivo es brindar al lector la informacion para poder realizar estos procedimientos con la mayor seguridad radiológica tanto para los pacientes como para el personal ocupacionalmente expuesto.
Endoscopy has evolved from a purely diagnostic technique to a therapeutic procedure. This is possible in many cases thanks to the use of fluoroscopy, which entails exposure to ionizing radiation for both patients and the personnel involved. Endoscopic retrograde cholangiopancreatography (ERCP), which necessarily requires fluoroscopy, is classified by the Food and Drug Administration as an examination with a potential risk of triggering radiation induced injuries. This article reviews the biological effects of radiation, the types of radiological equipment used in ERCP, as well as the magnitudes and dosimetric units, to finally address the radio protection elements in the endoscopy room. The objective is to provide the reader with the information to be able to perform these procedures with the greatest radiological safety for both patients and occupationally exposed personnel.
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Irradiation injuries anti-agents refer to drugs that can inhibit the initial stage of radiation injuries, or reduce the development of radiation injuries and promote the recovery of injuries when used early after irradiation exposure. According to the mechanism of action and the time of intervention, the irradiation injuries anti-agents are divided into four categories: radioprotectors, radiomitigators, radiation therapeutics for external radiation exposure, and anti-agents for internalized radionuclides. In this paper, the research progress of irradiation injuries anti-agents in recent years is reviewed.
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Humans , Radiation-Protective Agents/therapeutic use , Radiation Injuries/prevention & controlABSTRACT
ABSTRACT The characteristic optical coherence tomography finding in solar maculopathy is a well-defined outer retinal hyporeflective space primarily involving the photoreceptor inner and outer segment layers. This typical optical coherence tomography image may be present in a few other pathologies, which currently constitute their main differential diagnoses. Our study shows the report of 12 eyes of 6 patients treated at the Hospital de Olhos do Paraná, presenting their clinical history and diagnostic images, with the purpose of comparing the findings of the first 3 patients (diagnosed with solar maculopathy) with the last 3 patients, which are also cases of external macular holes.
RESUMO O achado característico da tomografia de coerência óptica na maculopatia solar é um espaço hiporrefletivo retiniano externo bem definido, envolvendo principalmente as camadas dos segmentos interno e externo dos fotorreceptores. Essa imagem típica da tomografia de coerência óptica pode estar presente em algumas outras patologias, que atualmente constituem seus principais diagnósticos diferenciais. Nosso estudo mostra o relato de 12 olhos de 6 pacientes atendidos no Hospital de Olhos do Paraná, apresentando sua história clínica e imagens diagnósticas, com o objetivo de comparar os achados dos 3 primeiros pacientes (diagnosticados com maculopatia solar) com os 3 últimos pacientes, que também são casos de buracos maculares externos.
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Objective:To investigate the efficacy and safety of argon plasma coagulation (APC) in the treatment of patients with hemorrhagic chronic radiation proctitis (HCRP).Methods:The clinical data of 36 HCRP patients who received APC treatment in Shanxi Province Cancer Hospital between January 2017 and June 2021 were retrospectively analyzed. The severity of HCRP was assessed by using the Zinicola endoscopic score and the Vienna proctoscopy score. The elimination of rectal bleeding or occasional bloody stools that did not require further treatment within 6 months of the last APC treatment was considered to be the therapy success.Results:The median follow-up time was 1.63 years (0.85-2.68 years). There were 20 (55.6%) patients with severe HCRP according to the Zinicola endoscopic score. After APC treatment, 32 patients with HCRP obtained adequate rectal hemostasis, whereas 4 patients with severe HCRP still experienced rectal bleeding symptoms after APC treatment for several times. All patients received APC treatment for (2.7±1.0) times in total. The endoscopic scores of HCRP patients before and after APC treatment were (3.6±0.8) scores, (1.4± 1.1) scores, respectively; Vienna proctoscopy scores were (3.8±0.8) scores, (1.2±1.1) scores, respectively; and the differences were statistically significant ( t values were 22.37, 18.96; all P < 0.001). The hemoglobin levels of HCRP patients before and after APC treatment were (85±15) g/L, (100±17) g/L, respectively, and the difference was statistically significant ( t = 17.86, P < 0.001). Serious side effects including strictures, perforations, or fistulas and other severe complications related to APC therapy were not found. Conclusions:APC may be an effective and safe treatment option for patients with HCRP.
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Objective:To observe the effects of cervical region Ⅱ and oral target area optimization on therapeutic efficacy, salivary gland function and oral mucosal response during intensity modulated radiation therapy (IMRT) for oropharyngeal cancer.Methods:A total of 50 patients with oropharyngeal squamous cell carcinoma in Xuzhou Cancer Hospital from January 2012 to May 2017 were collected. According to the random number table, they were divided into normal radiotherapy group (the control group), oral and cervical target area optimization group (the observation group), 25 cases in each group. Both groups were treated with IMRT and platinum-chemotherapy. The control group received bilateral cervical region Ⅱ-Ⅳ lymphatic drainage area irradiation (the positive side of the cervical lymph node included Ⅰ B region), and bilateral cervical region Ⅱ was given a tumor dose of 60 Gy (positive lymph nodes were given intensified irradiation); the observation group was optimized for the target area, and the contralateral cervical region Ⅱ B (the side with no positive lymph node) was given a tumor dose of 50 Gy; the observation group's oral structure was delineated as an organ at risk and the average radiation dose (D mean) was limited to <32 Gy. The differences in radiation dose of parotid gland, acute oral mucosal reaction and long-term xerostomia (6 months after the end of radiotherapy), objective remission rate (ORR), local recurrence rate (LRR), 3-year overall survival (OS) were compared between the two groups. Results:In the control group, the contralateral parotid gland D mean was (29±4) Gy, the proportion of irradiation volume exposed to 34 Gy (V 34) was (48±5)%; in the observation group, contralateral parotid gland D mean was (23±3) Gy, V 34 was (41±5)%, and there are statistically significant differences between the two groups ( t values were 6.14, 4.98, all P < 0.05). In the control group, oral D mean was (35±6) Gy, the proportion of volume exposed to 30 Gy (V 30) was (36±5)%; in the observation group oral D mean was (29±4) Gy, V 30 was (28±4)%, and there were statistically significant differences between the two groups ( t values were 4.11, 5.98, all P < 0.05). The incidence of ≥ grade Ⅱ acute oral mucosal adverse reaction and the duration time of oral mucosal ≥ 2 weeks was 64% (16/25) and 76% (19/25), respectively in the control group, 36% (9/25) and 40% (10/25), respectively in the observation group; and the differences were statistically significant ( χ2 values were 3.92, 6.65; P values were 0.048, 0.009). The incidence of ≥ grade Ⅱ long-term xerostomia reaction was 72% (18/25) and 44% (11/25), respectively in the control group and the observation group, and the difference between the two groups was statistically significant ( χ2 = 4.02, P = 0.044). The ORR, LRR, and 3-year OS rates were 80%, 28%, 48% in the control group, and 76%, 24%, 44% in the observation group. There was no statistically significant difference in the OS between the two groups ( χ2 = 0.04, P = 0.849). Conclusions:Optimization of the target area of the oral and cervical region Ⅱ during IMRT for oropharyngeal carcinoma can improve the function of salivary glands, thereby reducing dry mouth and oral mucosal reactions, improving the quality of life of patients; and it does not affect the efficacy of tumor treatment.
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Radiation-induced brachial plexus neuropathy (RIBPN) is a rare and delayed non-traumatic injury to the brachial plexus, which occurs following radiation therapy to the chest wall, neck, and/or axilla in previously treated patients with cancer. The incidence of RIBPN is more common in patients treated for carcinoma of the breast and Hodgkin lymphoma. With the improvement in radiation techniques, the incidence of injury to the brachial plexus following radiotherapy has dramatically reduced. The currently reported incidence is 1.2% in women irradiated for breast cancer. The progression of symptoms is gradual in about two-thirds of cases; the patients may initially present with paresthesia followed by pain, and later progress to motor weakness in the affected limb. We present the case of a 68-year-old female patient with breast cancer submitted to surgery, chemotherapy, and radiotherapy in the year 2000. Eighteen years later, she developed symptoms and signs compatible with RIBPN and was successfully submitted to omentoplasty for pain control. Omentoplasty is an alternative treatment for RIBPN refractory to conservative treatment, which seems to be effective in improving neuropathic pain. However, postoperative worsening of the motor strength is a real possibility, and all candidates for this type of surgery must be informed about the risk of this complication.
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Humans , Female , Aged , Radiation Injuries/therapy , Brachial Plexus Neuropathies/therapy , Pain, Intractable/etiology , Postoperative Complications , NeurosurgeryABSTRACT
Radiation brain injury in the temporal lobe is the most common and severe neurological complication after radiotherapy for nasopharyngeal carcinoma. Early detection and treatment are the key to control the progress of radiation brain injury. However, when abnormal changes were found in conventional MRI, brain injury had developed to irreversible middle and late stage frequently. Functional MRI, including magnetic resonance spectroscopy imaging, perfusion-weighted imaging, diffusion-weighted imaging, diffusion-tensor imaging, and diffusion-kurtosis imaging, can quantitatively reflect the microstructure changes of tissues through many parameters. Some of the parameters could be considered as image markers for diagnosis of radiation brain injury in the early stage. Research advances of functional MRI in early brain injury after radiotherapy for nasopharyngeal carcinoma were reviewed in this article.
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Objective@#To investigate the value of 18F-fluorodeoxyglucose (FDG) PET/CT imaging and cardiac MRI (CMR) in the diagnosis of radiation-induced heart disease (RIHD) in Beagle models.@*Methods@#Twenty-four normal male Beagle dogs (1-year old) were randomly divided into control group and irradiated groups (3-month, 6-month and 12-month after radiation). The left anterior myocardium of Beagle dogs in irradiated groups was irradiated locally with a single dose of 20 Gy X-ray. Cardiac 18F-FDG PET/CT imaging and CMR were performed on all dogs, and the mean standardized uptake value (SUVmean) and the area of lesions with increased 18F-FDG uptake were obtained. After imaging examinations were finished, dogs were sacrificed and their hearts were taken out to perform Masson staining and electron microcopy. One-way analysis of variance was used for data analysis.@*Results@#There was basically no uptake in myocardium in control group. The myocardium showed increased uptake of 18F-FDG in the irradiated groups. The SUVmean of myocardium in 3-month, 6-month and 12-month after radiation groups and control group were 5.90±1.31, 4.66±2.21, 3.21±0.82 and 1.13±0.21, respectively (F=11.81, P<0.05). The area with increased 18F-FDG uptake in the irradiated groups decreased progressively with the prolongation of irradiation time (F=195.74, P<0.01). The reduction in myocardial perfusion and myocardial fibrosis were observed by CMR early at 6-month after irradiation. Compared with the control group, the 6-month and 12-month after radiation groups had increased end diastolic volume (EDV) and end systolic volume (ESV; F=15.479 and 16.908, both P<0.01), and decreased left ventricular ejection fraction (LVEF; F=63.715, P<0.01). The progressive aggravation of myocardial fibrosis was displayed in irradiated groups by Masson staining. The mitochondria degeneration, swelling and the count reduction in irradiated groups were observed by electron microscopy.@*Conclusions@#The increased 18F-FDG uptake in the irradiated myocardium may predict the risk of RIHD. 18F-FDG PET/CT imaging can detect RIHD earlier than CMR.
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Objective To investigate the value of 18F-fluorodeoxyglucose (FDG) PET/CT imaging and cardiac MRI (CMR) in the diagnosis of radiation-induced heart disease (RIHD) in Beagle models.Methods Twenty-four normal male Beagle dogs (1-year old) were randomly divided into control group and irradiated groups (3-month,6-month and 12-month after radiation).The left anterior myocardium of Beagle dogs in irradiated groups was irradiated locally with a single dose of 20 Gy X-ray.Cardiac 18F-FDG PET/CT imaging and CMR were performed on all dogs,and the mean standardized uptake value (SUVmax) and the area of lesions with increased 18F-FDG uptake were obtained.After imaging examinations were finished,dogs were sacrificed and their hearts were taken out to perform Masson staining and electron microcopy.Oneway analysis of variance was used for data analysis.Results There was basically no uptake in myocardium in control group.The myocardium showed increased uptake of 18F-FDG in the irradiated groups.The SUV of myocardium in 3-month,6-month and 12-month after radiation groups and control group were 5.90± 1.31,4.66±2.21,3.21±0.82 and 1.13±0.21,respectively (F=11.81,P＜0.05).The area with increased 18F-FDG uptake in the irradiated groups decreased progressively with the prolongation of irradiation time (F =195.74,P＜0.01).The reduction in myocardial perfusion and myocardial fibrosis were observed by CMR early at 6-month after irradiation.Compared with the control group,the 6-month and 12-month after radiation groups had increased end diastolic volume (EDV) and end systolic volume (ESV;F =15.479 and 16.908,both P＜0.01),and decreased left ventricular ejection fraction (LVEF;F=63.715,P＜0.01).The progressive aggravation of myocardial fibrosis was displayed in irradiated groups by Masson staining.The mitochondria degeneration,swelling and the count reduction in irradiated groups were observed by electron microscopy.Conclusions The increased 18F-FDG uptake in the irradiated myocardium may predict the risk of RIHD.18F-FDG PET/CT imaging can detect RIHD earlier than CMR.
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Objective: To screen and optimize the modeling condition for radiation-induced heart damage (RIHD) models characterized by inflammatory-fibrosis pathological injury. Methods: The rats were irradiated with single whole-body X-ray to screen the maximal tolerated dose. Based on the screened whole-body dose, single local heart irradiation doses were used to screen the minimal X-ray dose which could induce the significant cardiac damage. And the RIHD rat model was established by exposure to the screened dose of X-ray. Tissue samples were harvested 1 day, 1 week, 2 weeks, 4 weeks and 6 weeks after irradiation. The cardiac pathological injury score, collagen volume fraction (CVF) in myocardial tissues by Masson staining, plasma myocardial enzyme level, and the expression of inflammatory and fibrosis factors in myocardial tissues were examined for evaluating the animal model. Results: The tolerance dose of whole-body irradiation was lower than 16 Gy for rats. Local irradiation dose at least 25 Gy could induce RIHD in rats. The pathological injury score of myocardial tissues, CVF in myocardial tissues and creatine kinase isoenzyme MB (CK-MB) and cardiac troponin (cTn) in plasma were increased in the RIHD model rats. Inflammatory factors including nuclear factor (NF)-κB p65, NF-κB p50 and tumor necrosis factor α (TNF-α) in myocardial tissues were increased 1 day after irradiation in the RIHD rats and maintained high to the fourth week. The expression levels of fibrotic molecules transforming growth factor β1 (TGF-β1), collagen type I (Col I) and Col III in myocardial tissues were increased gradually, and reached the peaks at week 4 after irradiation. Conclusion: Stable RIHD rat model can be established by irradiating the precardiac region with 25 Gy X-ray. Pathological observation and CVF can dynamically reflect the early inflammatory changes and the progression of fibrosis in RIHD rats. The sustained high expression of NF-κB p65, NF-κB p50 and TNF-α at early stage and the progressive increases of TGF-β1, Col I and Col III can be used to evaluate the acute inflammatory injury and delayed fibrosis in the RIHD inflammatory-fibrosis model.
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Objective@#To investigate the feasibility and dosimetric characteristics of using dual-arc volumetric modulated arc therapy and multiple partial-arc VMAT for T3 lung cancer.@*Methods@#From June 2016 to May 2018, thirteen lung cancer patients with large planning target volume were replanned with dual full arcs VMAT(F-VMAT) and six partial-arc s VMAT(P-VMAT)on RayStation v4.5 RayArc function.PTV volume median was 550.9cm3(ranged 402.2-834.8cm3) and to a prescribed dose of 60 Gy in 30 fractions.Equivalent target coverage was required for all plans, and clinical goals were evaluated using various dose-volume metrics.These included PTV dose conformity, mean lung/heart dose, lung V5, V10, V20, V30, heart V30 and V40, and Dmax of spinal canal.The total monitor units (MUs) were also examined.@*Results@#All VMAT plans satisfied the treatment criteria.F-VMAT achieved better homogeneity index(HI) and MUs than P-VMRT(t=-3.904, P=0.002), and the conformal number(CN) of tumor volumes was likely clinically indistinguishable.However, F-VMAT significantly reduced lung V5, V10 and mean lung dose[V5: (51.31±5.36)% vs.(43.44±5.28)%, t=6.908, P=0.00; V10: (38.34±3.26)% vs.(34.05±3.74)%, t=4.632, P=0.001; Dmean: (1 449±117.19)cGy vs.(1 375.38±148.98)cGy, t=4.93, P=0.00], and heart dosimetric parameters were also observed in favor of P-VMRT[V30: (20.6±10.4)% vs.(16.4±8.9)%, t=3.822, P=0.02; V40: (14.6±7.5)% vs.(11.88±7.1)%, t=3.096, P=0.009; Dmean: (1 442.9±651.2)cGy vs.(1 263.5±605.6)cGy, t=3.986, P=0.02], and there were no statistically significant differences in lung V20, V30 and spinal cord Dmax between the two groups(all P>0.05).@*Conclusion@#VMAT is an effective treatment for stage T3 lung cancer patients.The primary advantage of P-VMAT was the reduction in low dose area and decreased risk of symptomatic radioactive lung injury.It may be a priority for pulmonary malignancy patients with the large planning target volume.
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Objective@#To evaluate the efficacy and safety of fecal microbiota transplantation for radiation intestinal injury.@*Methods@#Retrospective analysis of the clinical data of 32 radiation intestinal injury patients including 6 males and 26 females, aged (59.4±9.5) years, with an age range of 51-86 years who underwent fecal microbiota transplantation from August 2017 to August 2018 in the Intestinal Microenvironment Treatment Centre, Tenth People′s Hospital of Tongji University was performed. The efficacy (cure rate, improvement rate), nutritional indicators (body weight, albumin, hemoglobin), inflammation index (C-reactive protein), gastrointestinal quality of life index score and adverse events were compared after 1 year of fecal microbiota transplantation. The patients were followed up for 1 year by telephone, outpatient and network. The follow-up was carried out in combination with the above-mentioned effectiveness and safety indicators. The time was until August 2019. The measurement data were expressed as mean±standard deviation (Mean±SD), the count data were expressed as percentage. The paired t test was used for comparison between groups.@*Results@#The clinical cure rate and clinical improvement rate of patients who received fecal microbiota transplantation for 1 year were 56.3% and 15.6%, respectively. Body weight increased from pre-treatment (53.7 ± 9.6) kg to (60.8 ± 2.1) kg after 1 year of fecal microbiota transplantation, albumin increased from pre-treatment (30.7±4.6) g/L to (37.5±3.8) g/L after 1 year of fecal microbiota transplantation, and hemoglobin increased from pre-treatment (108.5±13.1) g/L to (123.3±13.4) g/L after 1 year of fecal microbiota transplantation. C-reactive protein decreased from pre-treatment (24.1±4.5) mg/L to (3.2±4.5) mg/L after 1 year of fecal microbiota transplantation. Gastrointestinal quality of life index scores were significantly increased after fecal microbiota transplantation, from (88.4±7.1) scores to (112.2±3.2) scores after 1 year of fecal microbiota transplantation. No serious adverse events occurred during the whole follow-up. The difference was statistically significant (P<0.05).@*Conclusions@#Fecal microbiota transplantation techndogy is effective and safe for radiation intestinal injury patients, which is worthy of clinical research.
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Objective To explore the clinical effect of new type rectal cancer radiotherapy individualized fixation device in the radiotherapy of rectal cancer. Methods From June 2015 to December 2016,60 patients with rectal cancer who accepted the external irradiation in Zhejiang Tumor Hospital were divided into two groups by random number table method. A group(31 cases) received new type rectal cancer radiotherapy position fixation devices with thermoplastic film. B group(29 cases) received simple foam pad with thermoplastic film. Before each treatment,Cone beam CT(CBCT) scan was conducted. The applied CBCT image and the planned reconstruction image were compared in the direction of X(left and right),Y(upper and lower)and Z(front and rear) axis. The setup error was recorded, and the correlation between the two groups was analyzed. Results The average setup error of patients in A group in X (left and right),Y(upper and lower),Z(front and rear) axis were (1. 61 ± 0. 18)mm,(1. 82 ± 0. 13)mm,(1. 91 ± 0. 11)mm,respectively. The average setup error of patients in B group in X(left and right),Y(upper and lower),Z (front and rear) axis were (2. 22 ± 0. 13)mm,(2. 43 ± 0. 14)mm,(2. 36 ± 0. 13)mm,respectively. There were statistically significant differences between the two groups(t=14. 958,17. 501,11. 283,all P＜0. 001). Conclusion The new type of rectal cancer radiotherapy position fixing device is more comfortable than the simple foam pad,and the setting error is smaller than the simple foam pad.
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Objective To investigate the feasibility and dosimetric characteristics of using dual - arc volumetric modulated arc therapy and multiple partial-arc VMAT for T3 lung cancer.Methods From June 2016 to May 2018,thirteen lung cancer patients with large planning target volume were replanned with dual full arcs VMAT (F-VMAT) and six partial-arc s VMAT( P-VMAT) on RayStation v4.5 RayArc function.PTV volume median was 550.9cm3(ranged 402.2-834.8cm3 ) and to a prescribed dose of 60 Gy in 30 fractions.Equivalent target coverage was required for all plans,and clinical goals were evaluated using various dose-volume metrics.These included PTV dose conformity,mean lung/heart dose,lung V5 ,V10 ,V20 ,V30 ,heart V30 and V40 ,and Dmax of spinal canal.The total monitor units ( MUs) were also examined. Results All VMAT plans satisfied the treatment criteria. F - VMAT achieved better homogeneity index ( HI) and MUs than P -VMRT( t = -3.904,P =0.002),and the conformal number(CN) of tumor volumes was likely clinically indistinguishable.However,F-VMAT significantly reduced lung V5 ,V10 and mean lung dose[V5:(51.31 ± 5.36)% vs.(43.44 ± 5.28)%,t=6.908,P=0.00;V10:(38.34 ± 3.26)% vs.(34.05 ± 3.74)%,t=4.632,P=0.001;Dmean:(1 449 ± 117.19)cGy vs.(1 375.38 ± 148.98)cGy, t=4.93, P =0.00 ], and heart dosimetric parameters were also observed in favor of P - VMRT [ V30 : (20.6 ± 10.4)% vs.(16.4 ± 8.9)%,t =3.822,P =0.02;V40:(14.6 ± 7.5)% vs.(11.88 ± 7.1)%,t =3.096,P =0.009;Dmean:(1 442.9 ± 651.2)cGy vs.(1 263.5 ± 605.6)cGy,t=3.986,P=0.02],and there were no statisti-cally significant differences in lung V20,V30 and spinal cord Dmax between the two groups(all P>0.05).Conclusion VMAT is an effective treatment for stage T3 lung cancer patients. The primary advantage of P - VMAT was the reduction in low dose area and decreased risk of symptomatic radioactive lung injury.It may be a priority for pulmonary malignancy patients with the large planning target volume.
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Objective To evaluate the efficacy and safety of fecal microbiota transplantation for radiation intestinal injury.Methods Retrospective analysis of the clinical data of 32 radiation intestinal injury patients including 6 males and 26 females,aged (59.4 ± 9.5) years,with an age range of 51-86 years who underwent fecal microbiota transplantation from August 2017 to August 2018 in the Intestinal Microenvironment Treatment Centre,Tenth People's Hospital of Tongji University was performed.The efficacy (cure rate,improvement rate),nutritional indicators (body weight,albumin,hemoglobin),inflammation index (C-reactive protein),gastrointestinal quality of life index score and adverse events were compared after 1 year of fecal microbiota transplantation.The patients were followed up for 1 year by telephone,outpatient and network.The follow-up was carried out in combination with the above-mentioned effectiveness and safety indicators.The time was until August 2019.The measurement data were expressed as mean ± standard deviation (Mean ± SD),the count data were expressed as percentage.The paired t test was used for comparison between groups.Results The clinical cure rate and clinical improvement rate of patients who received fecal microbiota transplantation for 1 year were 56.3％ and 15.6％,respectively.Body weight increased from pre-treatment (53.7 ± 9.6) kg to (60.8 ± 2.1) kg after 1 year of fecal microbiota transplantation,albumin increased from pre-treatment (30.7 ± 4.6) g/L to (37.5 ± 3.8) g/L after 1 year of fecal microbiota transplantation,and hemoglobin increased from pre-treatment (108.5 ± 13.1) g/L to (123.3 ± 13.4) g/L after 1 year of fecal microbiota transplantation.C-reactive protein decreased from pre-treatment (24.1 ±4.5) mg/L to (3.2 ±4.5) mg/L after 1 year of fecal microbiota transplantation.Gastrointestinal quality of life index scores were significantly increased after fecal microbiota transplantation,from (88.4 ± 7.1) scores to (112.2 ± 3.2) scores after 1 year of fecal microbiota transplantation.No serious adverse events occurred during the whole follow-up.The difference was statistically significant (P ＜ 0.05).Conclusions Fecal microbiota transplantation techndogy is effective and safe for radiation intestinal injury patients,which is worthy of clinical research.
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BACKGROUND: Our previous findings indicate that inflammation-activated bone marrow mesenchymal stem cell conditioned medium (MSC-CM) contribute to repairing the structure and function of the small intestine after radiation-induced acute intestinal injury. However, it is unclear whether the repair effect can be achieved by regulating small intestinal stem cells. OBJECTIVE: To investigate the effects of inflammation-activated bone marrow MSC-CM on the small intestinal epithelial stem cells after acute radiation-induced intestinal injury and to further discuss the repairing mechanism. METHODS: Bone marrow mesenchymal stem cells of Sprague-Dawley rats were separated, cultured and identified. Then, the bone marrow mesenchymal stem cells were co-cultured with normal or radiation-induced IEC-6 cell lines in the Transwell system for 24 hours. Inflammation-activated bone marrow mesenchymal stem cells were cultured alone for 48 hours. Non-activated MSC-CM (MSC-CMNOR) and MSC-CM under radiation-induced inflammatory condition (MSC-CMIR) were collected. Adult Sprague-Dawley rats (provided by the Experimental Center of Sun Yat-Sen University North Campus) were randomly divided into four groups with 20 rats in each group: control group, radiation group, radiation+MSC-CMNOR group and radiation+MSC-CMIR group. The rats in the latter three groups were exposed to one-off 14 Gy whole abdominal radiation to make a rat model of acute radiation-induced small intestinal injury. Three-day continuous administration beginning within 4 hours after successful modeling was given via the tail vein and intraperitoneal implantation of Alzet micro-osmotic pumps: EMEM-F12 (200 μL/d) for the radiation group, MSC-CMNOR for radiation+MSC-CMNOR group and MSC-CMIR for radiation+MSC-CMIR group. There was 2 mL of concentrated conditioned medium in the pump which was released at a constant rate of 10 μL/h into the abdominal cavity after implantation. Intestinal samples were collected at 1, 3, 5, 7 days after radiation for immunochemistry staining, western blot and qRT-PCR detection. RESULTS AND CONCLUSION: (1) On the 3rd day after radiation, Lgr5 positive cells, which were actively proliferating on the base of crypts, became significantly reduced compared with the normal control group, and there was nearly no existing Lgr5 positive cells. However, after infusion of MSC-CMIR, Lgr5 positive intestinal stem cells were significantly increased compared with the radiation group, while in the radiation+MSCNOR group, there was no significant increase in Lgr5 positive intestinal stem cells. (2) On the 3rd day after radiation injury, Bmi1 positive intestinal stem cells were almost invisible. After infusion of MSC-CMIR, Bmi1 positive intestinal stem cells increased significantly, and it was observed not only in the +4 cell position but also in the common position used to be Lgr5 stem cells, indicating that Bmi1 stem cells could differentiate into Lgr5 positive cells to act its repairing effect. (3) Western blot and qRT-PCR further confirmed that the radiation+MSC-CMIR group was significantly higher on the Lgr5 expression level than the radiation group and the radiation+MSC-CMNOR group, and it returned to the normal level on the 7th day after the continuous high expression level. The repair effect of radiation+MSC-CMNOR group was weaker, and only on the 7th day, the expression level of Lgr5 was statistically different from the radiation group. To conclude, inflammation-activated bone marrow MSC-CM exert a protective effect on the small intestinal epithelial stem cells after acute radiation-induced intestinal injury
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Abstract Radiation combined injury, a life-threatening condition, has higher mortality than simple radiation injury. The aim of the present study was to analyze the efficiency of Aloe vera and silver nanoparticles in improving the healing of ulcerated oral mucosa after irradiation. Thirty male Albino mice were divided into five groups: control, radiation, Aloe vera (AV), silver nanoparticles (NS), and AV+NS. The mice were exposed to whole body 6Gy gamma-radiation. After one hour, 20% acetic acid was injected into the submucosal layer of the lower lip for ulcer induction. The animals received topical treatment with the assigned substances for 5 days. Lip specimens were subjected to hematoxylin and eosin and anti alpha-smooth muscle actin immunohistochemical staining. Results demonstrated occurance of ulcer three days post irradiation in all groups except in the AV+NS group where only epithelial detachment was developed. After seven days, data revealed persistent ulcer in radiation group, and almost normal epithelium in the AV+NS group. A significant reduction of epithelial thickness was detected in all groups at the third day as compared to control. At the seventh day, only the AV+NS group restored the epithelial thickness. Area percent of alpha-smooth muscle actin expression was significantly decreased in radiation group at the third day followed by significant increase at the seventh day. However, all treatment groups showed significant increase in alpha-smooth muscle actin at the third day, which decreased to normal level at the seventh day. Our study demonstrated the efficiency of Aloe vera and silver nanoparticles in enhancing ulcer healing after irradiation.
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Animals , Male , Mice , Aloe/chemistry , Gamma Rays/adverse effects , Metal Nanoparticles/therapeutic use , Oral Ulcer/drug therapy , Oral Ulcer/etiology , Radiation Injuries, Experimental/drug therapy , Silver/therapeutic use , Acetic Acid , Actins/analysis , Administration, Topical , Epithelial Cells/drug effects , Epithelial Cells/radiation effects , Fibroblasts/drug effects , Immunohistochemistry , Microscopy, Electron, Transmission , Oral Ulcer/pathology , Radiation Injuries, Experimental/pathology , Reference Values , Reproducibility of Results , Time Factors , Treatment Outcome , Wound Healing/drug effectsABSTRACT
Aquaporins (AQPs) are the specific channel proteins located in cell membrane for transporting water, and they play an important role in maintaining the body’s water balance. AQPs are widely distributed in human tissues and organs, and their abnormal expressions are closely related to a series of diseases caused by water balance disorders. In recent years, great advances have been made in molecular researches, specific inhibitors, and targeted therapies of AQPs. In this review, we summarized the recent research progresses.
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Objective To investigate the effects of cerium oxide nanoparticles of different sizes on the number and constructions of immune cells in peripheral blood of mice after X-ray irradiation. Methods Mice were randomly divided into 4 groups according to body weight layer and the weight of each mouse was weighed. All mice were divided into 6 groups according to weight from high to low, and there were 4 mice in each group. Then 1 mouse was randomly taken from each group to form the control group. Model group, 5 nm and 25 nm cerium oxide nanoparticles groups were formed in turn. There were 6 mice in each group. The mice in model group and cerium oxide nanoparticles administration groups were irradiated once with 3 Gy of X-rays. The mice in cerium oxide nanoparticles groups began to be intraperitoneally administrated once a day with 10 μg 5 nm or 25 nm cerium oxide nanoparticles per kilogram body weight on the 4th day before irradiation and once every other 2 days after irradiation. The mice in the control group and model group were intraperitoneally administrated with 0.9 % saline. The mice were killed on the 10th days after irradiation. White cells count (WBC) and classification in peripheral blood were detected by using automatic globulimeter, and lymphocyte subsets were analyzed by using flow cytometry. Results Compared with the control group, the number of WBC, neutrophil granulocytes, monocytes, lymphocytes, total T lymphocytes, CD4+and CD8+T lymphocytes and the percentages in the model group were decreased (all P＜0.05), and percentages of the lymphocytes, B cells and NK cells and ratio of CD4 to CD8 were increased in model group (all P＜ 0.05). Compared with the model group, the above parameters except percentages of T lymphocytes, CD4+and CD8+T lymphocytes were improved in mice of 5 nm cerium oxide nanoparticle group (all P ＜0.05). Compared with the control group, the number of WBC and lymphocytes were decreased in the 5 nm cerium oxide nanoparticle group (P＜0.05), and there were no significances in other parameters compared with the control group (all P ＞0.05). Compared with the control group, the number of WBC and lymphocytes, the number and percentages of T lymphocytes, CD4+and CD8+T lymphocytes and the percentages were decreased (all P＜ 0.05), and percentage of NK cells and ratio of CD4 to CD8 were significantly increased in 25 nm cerium oxide nanoparticles group (all P＜ 0.05). The number of lymphocytes and CD8+T lymphocytes in 25 nm cerium oxide nanoparticles group was lower than that in 5 nm cerium oxide nanoparticles group (all P ＜ 0.05). Conclusions The effects of cerium oxide nanoparticles of different sizes on the immune cells of mice after X-ray irradiation are different, and 5 nm cerium oxide nanoparticle is superior to 25 nm cerium oxide nanoparticle.
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Objective To investigate the value of local myocardial blood flow and myocardial function parameters in monitoring the dynamic changes of radiation induced heart disease (RIHD) using 13NNH3 PET gated myocardial perfusion imaging(GMPI).Methods Six healthy male Beagle dogs underwent 13N-NH3 PET GMPI 1 week before irradiation and 3,6 and 12 months after irradiation in the anterior wall of the left ventricle with a single dose of 20 Gy.Global myocardial function parameters including left ventricular ejection fraction (LVEF),end-diastolic volume (EDV),end-systolic volume (ESV),and regional myocardial function parameters including wall motion (WM),wall thickening (WT),end-diastolic perfusion (EDP),end-systolic perfusion (ESP) before and after irradiation were compared by repeated measures analysis of variance and paired t test.Results There were no significant changes between EDV,ESV and LVEF at baseline and those at 3 months after irradiation.EDV at 6 months after irradiation still had no change,compared with baseline value and EDV at 3 months after irradiation,but ESV was increased and LVEF was decreased.Twelve months after irradiation,ESV was further expanded,LVEF was further reduced,and EDV began to increase (F values:20.974-177.846,all P＜0.05).Compared with the baseline,WM,WT,EDP and ESP were increased in 10％(2/20),20％(4/20),10％(2/20) and 15％(3/20) of myocardial segments at 3 months after irradiation (t values:14.446-672.315,all P＜0.05);those parameters were decreased in 15％(3/20),20％(4/20),15％(3/20) and 25％(5/20) of myocardial segments at 6 months after irradiation (t values:18.171-723.156,all P＜0.05),and were decreased in 35％(7/20),45％(9/20),40％(8/20) and 60％ (12/20) of myocardial segments at 12 months after irradiation (t values:14.783-711.259,all P＜0.05).Conclusions 13N-NH3 PET GMPI could be used to detect RIHD early and monitor the dynamic development of RIHD.Compared with the global left ventricular function parameters,regional myocardial function parameters (WM,WT,EDP and ESP) are more sensitive,which may be served as the early monitoring indicators for RIHD.