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Photobiomodulation therapy (PBMT) is the use of red or near-infrared light to heal, restore, and stimulate physiological processes that repair damage caused by trauma or a disease. PBMT is widely used in sports injuries, arthritis, neuropathic pain, and back and neck pain. In recent years, PBMT is a safe and effective tool for toxic reactions associated with cancer treatment, such as oral mucositis in patients undergoing chemo-radiotherapy for head and neck cancer or stem cell transplantation, radiation-associated dry mouth, taste disorders, radiation dermatitis, post-radiotherapy fibrosis, and lymphedema associated with head and neck cancer and breast cancer. However, the equipment and optimal dosimetric parameters for PBMT have not been fully defined and need to be further explored.
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Radiotherapy combined with chemotherapy is the main treatment for stage Ⅱ-Ⅳa nasopharyngeal carcinoma (NPC). In the era of intensity-modulated radiation therapy, the timing and implementation of chemotherapy are still controversial. In the past, the clinical guidelines for NPC generally described the specific radiotherapy technology, dose fractionation and the specific scheme of combined application of radiotherapy and chemotherapy, and may lack specific practical guidance. The joint international guidelines for NPC by CSCO and ASCO elaborates the mode and specific implementation recommendations of radical chemoradiotherapy for stage Ⅱ-Ⅳa NPC. This article aims to interpret the specific details of the guideline.
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Objective To explore the mechanism of HIF-1α promoting malignant development of nasopharyngeal carcinoma by upregulating PD-L1 expression under hypoxic conditions. Methods CNE2 cells were divided into normoxia (20%O2), hypoxia (1%O2), HIF-1α-siRNA+hypoxia and NC-siRNA+hypoxia groups. Cell proliferation, apoptosis, the mRNA levels of HIF-1α, STAT3 and PD-L1, the protein levels of HIF-1α, PD-L1, STAT3 and STAT3 phosphorylation were detected by MTT assay, flow cytometry, RT-PCR and Western blot, respectively. Results Cell proliferation of hypoxia group was significantly higher than that of normoxia group (P=0.000). The cell proliferation rate of HIF-1α-siRNA+hypoxia group was significantly lower than those in other groups (P=0.000). The apoptosis rate of HIF-1α-siRNA+hypoxia group was remarkably higher than those in other groups (P=0.001). RT-PCR detection showed that the mRNA levels of HIF-1α, PD-L1 and STAT3 in the HIF-1α-siRNA+hypoxia group were significantly lower than those in hypoxia group and NC-siRNA+hypoxia group. The protein expression of HIF-1α, PD-L1 and STAT3 showed similar tendency in Western blot assays compared with the mRNA levels. The pSTAT3 protein expression level in HIF-1α-siRNA+hypoxia group was significantly lower than those in hypoxia group and HIF-1α-siRNA+hypoxia group (P=0.001). Conclusion Under hypoxic microenvironment, HIF-1α may up-regulate the expression of PD-L1 through STAT3, thereby promoting the immune escape of cancer cells, leading to the malignant development of nasopharyngeal carcinoma.
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Objective@#To investigate the clinical application value of symmetrical three-hole laparoscopic sleeve gastrectomy (LSG).@*Methods@#The retrospective and descriptive study was conducted. The clinical data of 232 patients with obesity who were admitted to Zhengzhou Central Hospital Affiliated to Zhengzhou University from April 2017 to December 2018 were collected. There were 40 males and 192 females, aged (32±8)years, with a range of 17-63 years. All the 232 patients underwent symmetrical three-hole LSG. Observation indicators: (1) surgical and postoperative conditions; (2) complications; (3) follow-up. Follow-up was conducted by telephone interview and WeChat to collect the patient satisfaction with cosmetic effects of wounds at 3 months after surgery up to March 2019. Measurement data with normal distribution were expressed as Mean±SD. Count data were expressed as absolute numbers or percentages.@*Results@#(1) Surgical and postoperative conditions: of the 232 patients, 230 underwent symmetrical three-hole LSG successfully, without conversion to open surgery. Two patients had one puncture hole added due to spleen bleeding to help pull the omentum to stop bleeding, and no spleen hemorrhage recurred after improving the surgical procedure. Of the 232 patients, the operation time, volume of intraoperative blood loss, and duration of postoperative hospital stay were (115±7)minutes, (10±5)mL, and (3.0±0.8)days. (2) Complications: of the 232 patients, 10 had postoperative complications of fat liquefaction in the umbilical incision, and were cured after repeated dressing changes. All patients had no serious complications such as gastrointestinal bleeding, abdominal bleeding, or gastric fistula. (3) Follow-up: of the 232 patients, 230 undergoing successful symmetrical three-hole LSG were followed up for 3 months. Of the 230 patients, 3 were dissatisfied with the cosmetic effects of wounds, 12 were satisfied, and 215 were very satisfied. The satisfaction rate was 98.70%(227/230).@*Conclusion@#Symmetrical three-hole LSG is safe and feasible, with a good cosmetic effects of wounds.
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Objective To investigate the clinical application value of svmmetrical three-hole laparoscopie sleeve gastrectomy (LSG).Methods The retrospective and descriptive study was conducted.The clinical data of 232 patients with obesity who were admitted to Zhengzhou Central Hospital Affiliated to Zhengzhou University from April 2017 to December 2018 were collected.There were 40 males and 192 females,aged (32±8)years,with a range of 17-63 years.All the 232 patients underwent symmetrical three-hole LSG.Observation indicators:(1) surgical and postoperative conditions;(2) complications;(3) follow-up.Follow-up was conducted by telephone interview and WeChat to collect the patient satisfaction with cosmetic effects of wounds at 3 months after surgery up to March 2019.Measurement data with normal distribution were expressed as Mean±SD.Count data were expressed as absolute numbers or percentages.Results (1) Surgical and postoperative conditions:of the 232 patients,230 underwent symmetrical three-hole LSG successfully,without conversion to open surgery.Two patients had one puncture hole added due to spleen bleeding to help pull the omentum to stop bleeding,and no spleen hemorrhage recurred after improving the surgical procedure.Of the 232 patients,the operation time,volume of intraoperative blood loss,and duration of postoperative hospital stay were (115±7) minutes,(10±5) mL,and (3.0±0.8) days.(2) Complications:of the 232 patients,10 had postoperative complications of fat liquefaction in the umbilical incision,and were cured after repeated dressing changes.All patients had no serious complications such as gastrointestinal bleeding,abdominal bleeding,or gastric fistula.(3) Follow-up:of the 232 patients,230 undergoing successful symmetrical three-hole LSG were followed up for 3 months.Of the 230 patients,3 were dissatisfied with the cosmetic effects of wounds,12 were satisfied,and 215 were very satisfied.The satisfaction rate was 98.70％(227/230).Conclusion Symmetrical three-hole LSG is safe and feasible,with a good cosmetic effects of wounds.
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Objective:To investigate the role of planning risk volume (PRV) in estimating the radiation dose for various cardiac substructures (CS). Methods:The CS of 23 patients with left-sided breast cancer who underwent postoperative intensity-modulated ra-diotherapy (IMRT) was delineated. PRV was expanded from CS with an additional margin determined by the mean amplitude of cardi-ac motion. Two IMRT plans were designed. The volume, mean dose, maximal dose (D2%), and standard deviation of CS and its PRV were calculated. Results:In comparison to the volume of CS, the PRV of the heart, specifically the left ventricle, increased by 50%to 80%, whereas the PRV of the main coronary arteries and sub-branches increased by 18.7 times to 42.6 times. In the two IMRT plans, the mean dose to the heart, anterior myocardial territory, anterior descending artery, and their corresponding PRVs ranged from 9.4 Gy to 11.4 Gy, 11.0 Gy to 17.5 Gy, and 22.6 Gy to 27.8 Gy, respectively. The D2%to CS and its PRV was 24.5 Gy to 36.2 Gy, 28.2 Gy to 38.8Gy, and 36 Gy to 45 Gy. The mean dose and D2%to the coronary arteries, including both left and right main coronary arteries, right marginal artery, and left circumflex artery, were 8.6 Gy to 14.9 Gy and 12.5 Gy to 23.7 Gy, respectively. The difference of the mean dose and D2%to CS and its corresponding PRVs was 2.5%to 12.5%and 8.0%to 43.1%, respectively. Compared with the stan-dard deviation of the radiation dose to CS, majority of the standard deviation to PRVs increased significantly. Conclusion:The radia-tion dose difference between CS and its corresponding PRVs is<12%.
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Objective To study the toxicity and efficacy of induction chemotherapy followed by concurrent cisplatin chemotherapy and three dimensional conformal radiotherapy (3DCRT) for inoperable locally advanced non-small cell lung cancer (LA-NSCLC). Methods Totally 76 patients with LA-NSCLC received two cycles induction chemotherapy followed by 3DCRT with a median dose of 68 Gy (64 to 74 Gy).During the 3DCRT, cisplatin (25 mg/m2, weekly) was given intravenously for 6-7 times. Results The CR rate, PR rate and overall response rate of induction chemotherapy were 3% ,42% and 45%. After the concurrent chemoradiation, the corresponding figures were 10%, 62% and 72%. The median survival time (MST) and median progression-free survival (PFS) of all patients were 16.6 months and 10.3 months. The 1-, 2- and 3-year overall survival (OS) and PFS rates were 67% , 35% , 21% and 42% , 15%, 6%. Of patients with stage ⅢA and stage ⅢB disease,the MST were 19.7 months and 15.6 months, the PFS were 10.8 months and 9.4 months. The major treatment-related toxicities included radiation esophagitis, radiation pneumonitis, nausea ( or vomiting) and leukopenia. The major pattern of treatment failure was distant metastasis. Forty-five patients (59%) experienced the local recurrence or/and distant metastasis, including 4 (9%) with in-field failure, 38 (84%) distant metastasis and 3 (7%) malignant pleural effusion. Conclusions Induction chemotherapy followed by concurrent weekly cisplatin and 3DCRT for inoperable locally advanced NSCLC results in encouraging outcomes and acceptable tolerance.
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Objective To evaluate the acute side effects and efficacy of three dimensional conformal radiotherapy(3DCRT) combined with chemotherapy(CT) for locally advanced non small cell lung cancer(LANSCLC). Methods From Sept. 2000 to Dec.2001,24 patients with LANSCLC were treated with three dimensional conformal radiotherapy combined with chemotherapy navelbine+cisplatin NP. Results The overall response rate(CR+PR)was 91.7% for the primary tumor, and 100% for metastatic mediastinal lymph nodes.The leucopenia rate was 95.8%(54.2% grades 3,4). Acute radiation esophagitis occurred in 54.2% of patients(Grades 1,2). Acute radiation pneumonitis was observed in 12.5% of patients (Grades1,2). Conclusions 3DCRT combined with CT is well tolerated in most patients with LANSCLC. Its early responses are milder than the conventional radiotherapy combined with chemotherapy . Remote results await further follow up.