Application of multimedia information technology on precision radiotherapy for patients with head and neck malignant tumors / 中国辐射卫生

Objective To investigate the effects of multimedia information technologies on precision radiotherapy of head and neck malignant tumors (HNT). Methods A total of 96 patients with HNT recruited from 2016 to 2019 were randomly assignedto group A and group B with the same planning methodand therapists/technicians. Conventional and multimedia information technologies were respectively used in group A and group B for medical science popularization, individualized education, and doctor-patient communication before radiotherapy planning and positioning. Medical compliance, radiotherapy responses, setup errors, and machine occupancy time were investigated. Results Medical compliance was significantly higher (P < 0.05) in group A (96.5%) than in group B (73.8%). Skin acute radiation reaction was significantly lower (P < 0.05) in group A than in group B. Three-dimensional absolute setup errors were 0.69 ± 0.29 mm, 0.97 ± 0.69 mm, and 0.79 ± 0.47 mm in group A, which were significantly lower than 1.39 ± 0.81 mm, 1.87 ± 1.19 mm, and 2.50 ± 0.99 mm in group B(P < 0.05). Traditional three-dimensional setup errors were 0.73 ± 0.39 mm, 0.51 ± 0.69 mm, and 0.74 ± 0.17 mm in group A, which were significantly lower than 1.32 ± 0.76 mm, 1.89 ± 1.21 mm, and 1.37 ± 0.57 mm in group B (P < 0.05). Planning time was 145.15 ± 28.45 sin group A, which was significantly lower than 240.38 ± 50.45 sin group B (P < 0.05). Positioning time was 115.15 ± 18.45 s in group A, which was significantly lower than 173.38 ± 24.45 sin group B (P < 0.05). Conclusion The application of multimedia information technologies inmedical science popularization, individualized education, and doctor-patient communication forpatients who received precision radiotherapy for HNT can significantly increase patient compliance, alleviate acute radiation reactions, reduce setup errors, and shorten the machine occupancy time of planning and positioning.

Analyzing quality of life and influencing factors in patients with bone metastasis of hepatocellular carcinoma before and after radiotherapy by bone pain scale / 中华放射医学与防护杂志

Objective:To study the effect of radiotherapy on the quality of life (QOL) of patients with bone metastasis of hepatocellular carcinoma by analyzing the Function Assessment of Cancer Treatment(FACT), and to analyze the influence of clinical factors on the improvement of the QOL after radiotherapy.Methods:The FACT bone pain scale in 43 patients with bone metastasis of hepatocellular carcinoma before and after radiotherapy was retrospectively analyzed. The changes in QOL score before and after radiotherapy were analyzed by T test from five aspects: overall QOL score, general functional status, pain degree, physical function and social psychology. Further analysis was made on the scores of patients whose QOL had not been improved. Chi-square test was used to analyze the correlation between clinical factors and QOL improvement after radiotherapy. Results:After radiotherapy, the QOL of patients were improved in all aspects compared with those before radiotherapy, and there were statistical differences ( t=7.621, 5.887, 9.407, 7.785, 4.487, P<0.05). In patients whose QOL did not improve after radiotherapy, the scores of overall QOL and psychosocial assessment decreased significantly, and there were significant differences ( t=3.381, 4.982, P<0.05). Among the clinical factors, soft tissue mass at bone metastasis site and radiotherapy prescription dose had significant effects on the improvement of patients′ life after radiotherapy (χ 2=5.180, 7.457, P<0.05). Whether there were soft tissue masses in bone metastases before radiotherapy, the improvement rates of QOL after radiotherapy were 50.00% and 85% respectively. The improvement rates of QOL after radiotherapy were 44.44% and 84% in patients with prescription dose of <40 Gy and≥40 Gy respectively. Multivariate analysis showed that soft tissue mass at bone metastasis site, the dose of radiotherapy prescription and numeric rating scale (NRS) of pain had more significant effects on QOL ( OR=0.296, 0.020, 1.592, P<0.05). Conclusions:Radiotherapy at bone metastasis sites can significantly improve the QOL of liver cancer patients with bone metastasis. Psychosocial status can affect the QOL of patients. In the case of soft tissue mass in bone metastasis site, the prescription dose of radiotherapy (≥40 Gy) can better improve the QOL.

Up-regulation of NHE8 by somatostatin ameliorates the diarrhea symptom in infectious colitis mice model

Na⁺/H⁺ exchangers (NHEs) have been shown to be involved in regulating cell volume and maintaining fluid and electrolyte homeostasis. Pooled evidences have suggested that loss of Na⁺/H⁺ exchanger isoform 8 (NHE8) impairs intestinal mucosa. Whether NHE8 participates in the pathology of infectious colitis is still unknown. Our previous study demonstrated that somatostatin (SST) could stimulate the expression of intestinal NHE8 so as to facilitate Na⁺ absorption under normal condition. This study further explored whether NHE8 participates in the pathological processes of infectious colitis and the effects of SST on intestinal NHE8 expression in the setting of infectious colitis. Our data showed that NHE8 expression was reduced in Citrobacter rodentium (CR) infected mice. Up-regulation of NHE8 improved diarrhea symptom and mucosal damage induced by CR. In vitro, a similar observation was also seen in Enteropathogenic E. coli (EPEC) infected Caco-2 cells. Seglitide, a SST receptor (SSTR) 2 agonist, partly reversed the inhibiting action of EPEC on NHE8 expression, but SSTR5 agonist (L-817,818) had no effect on the expression of NHE8. Moreover, SST blocked the phosphorylation of p38 in EPEC-infected Caco-2 cells. Taken together, these results suggest that enhancement of intestinal NHE8 expression by SST could ameliorate the symptoms of mice with infectious colitis.

Efficacy of intensive radiotherapy combined with mesylate apatinib for treatment of elderly patients with locally advanced cardia cancer and its effect on vascular endothelial growth factor receptor / 肿瘤研究与临床

Objective To observe the clinical effect of intensity modulated radiation therapy (IMRT) combined with apapatinib mesylate in the treatment of elderly patients with locally advanced cardia adenocarcinoma and its effect on vascular endothelial growth factor receptor (VEGFR). Methods Forty-six elderly patients with locally advanced cardia cancer who were unwilling to accept surgery or couldn't get complete removal of cancers in Xuzhou Hospital Affiliated to Jiangsu University between January 2015 and April 2016 were collected. All the patients were randomly divided into the control group (23 cases) and the observation group (23 cases) according to the random number table method. The control group received radiotherapy alone. In the observation group, oral apatinib (500 mg/d) was taken in the first day of radiotherapy after breakfast until the disease progress or death occurred. Results The total effective rate was 92 % (19/23) in the observation group and 60 % (10/23) in the control group. There was a significant difference between the two groups(χ2=5.86,P <0.05). After treatment, the average level of VEGFR in both groups was decreased[(76.3±4.9)vs.(55.0±2.3)pg/ml],and there was a significant difference between the two groups (t = 3.93, P < 0.05). The common adverse reactions were blood adverse reactions and gastrointestinal reactions. The incidence rate of gastrointestinal reaction was both 83 %, and the blood adverse reaction was 100 %, and there was no significant difference between the two groups (both P > 0.05). Hypertension, proteinuria and rash response in the observation group were increased compared with the control group,but noⅣ grade of adverse reactions occurred. The median progression-free survival time was 10 months in the observation group and 8 months in the control group respectively (P = 0.01). Conclusion IMRT combined with apatinib in the treatment of elderly patients with locally advanced gastric cardia has a favorable efficacy and tolerance.

Effects of cleaning and disinfection of thermoplastic masks on hospital infection in patients receiving precise radiotherapy for nasopharyngeal carcinoma / 中华放射肿瘤学杂志

Objective To investigate the effects of cleaning and disinfection of thermoplastic masks on the hospital infection in patients receiving precise radiotherapy for nasopharyngeal carcinoma ( NPC). Methods A prospective study was performed among 102 patients receiving precise radiotherapy for NPC from 2013 and 2016, consisting of 18 patients with early?stage ( I, Ⅱ) disease and 84 patients with advanced (Ⅲ, IV) disease. All patients were randomly divided into group A and group B using a random number table. For group A, the marker lines of thermoplastic masks were sandwiched by double plastic tapes;cleaning and disinfection plus ultraviolet ( UV ) disinfection were applied to the masks 1 h prior to radiotherapy and immediately after radiotherapy. For group B, only conventional UV disinfection was applied to the masks. The surface of the masks was examined and hospital infection during radiotherapy was evaluated. Results At the 18th radiotherapy, group A had a significantly lower mask surface colony count than group B (7.90±650 vs. 139.05±12929 CFU/cm2, P=0000). Group A also had a significantly lower incidence of hospital infection than group B (725% vs. 882%, P=0046). For the patients with early stage NPC, particularly, there was no significant difference in the incidence of infection between the two groups (556% vs. 667%, P=0629). For patients with advanced NPC, group A had a significantly lower incidence of infection than group B ( 762% vs. 929%, P=0035) . There were no significant differences in incidence rates of oral mucosal, skin, and respiratory system infections between the two groups ( 471% vs. 510%, P=0692;176% vs. 235%, P=0463;78% vs. 137%, P=0338) . In both groups A and B, the incidence of oral mucosal infection was significantly higher than the incidence rates of skin infection ( P=0001, 0000) and respiratory system infection ( P=0004, 0000) . Conclusions Thermoplastic mask is one of the risk factors for hospital infection in patients receiving precise radiotherapy for NPC. Timely cleaning and disinfection plus UV disinfection can significantly reduce the surface colony count and the incidence of hospital infection in patients with NPC, particularly in those with advanced NPC receiving precise radiotherapy. The incidence of hospital infection is the highest in the oral mucosa, followed by the skin and the respiratory system.

Expression of UHRF1 protein in breast cancer tissue and its correlation with local recurrence / 肿瘤研究与临床

Objective To investigate the expression of UHRF1 protein in breast cancer and adjacent normal tissues, and its relationship with local recurrence. Methods Immunohistochemistry (IHC) was applied to detect the expression of UHRF1 protein in 69 specimens of breast cancer and 33 specimens of corresponding adjacent normal tissues; Chi-square test was used to analyze the relationship between UHRF1 protein expression and clinical factors. Results The positive rate expression of UHRF1 protein in breast cancer was 55.1 % (38/69), and UHRF1 protein expression was not found in adjacent normal tissues. The positive expression rate of UHRF1 protein in stage III was higher than that in stageⅠ-Ⅱ[68.4%(26/38) vs. 38.7 % (12/31), P< 0.05]. The positive expression rate of cancer tissue in breast cancer patients with chest wall recurrence after radiotherapy within 1 year was higher than that in patients without recurrence [83.3 %(10/12) vs. 49.1 % (28/57), P< 0.05], and UHRF1 protein expression of patients in different age and Herb-2 had no statistical significance (P> 0.05). Conclusions The positive expression rate of UHRF1 protein is obviously higher than that in adjacent normal tissue. Besides, UHRF1 protein is related to the stage and chest wall of local recurrence after radiotherapy.

Expression of UHRF1 protein in breast cancer tissue and its correlation with local recurrence / 肿瘤研究与临床

Objective To investigate the expression of UHRF1 protein in breast cancer and adjacent normal tissues, and its relationship with local recurrence. Methods Immunohistochemistry (IHC) was applied to detect the expression of UHRF1 protein in 69 specimens of breast cancer and 33 specimens of corresponding adjacent normal tissues; Chi-square test was used to analyze the relationship between UHRF1 protein expression and clinical factors. Results The positive rate expression of UHRF1 protein in breast cancer was 55.1 % (38/69), and UHRF1 protein expression was not found in adjacent normal tissues. The positive expression rate of UHRF1 protein in stage III was higher than that in stageⅠ-Ⅱ[68.4%(26/38) vs. 38.7 % (12/31), P< 0.05]. The positive expression rate of cancer tissue in breast cancer patients with chest wall recurrence after radiotherapy within 1 year was higher than that in patients without recurrence [83.3 %(10/12) vs. 49.1 % (28/57), P< 0.05], and UHRF1 protein expression of patients in different age and Herb-2 had no statistical significance (P> 0.05). Conclusions The positive expression rate of UHRF1 protein is obviously higher than that in adjacent normal tissue. Besides, UHRF1 protein is related to the stage and chest wall of local recurrence after radiotherapy.

Therapeutic effect of losecplatin combined with compound matrine in the intraperitoneal perfusion treatment of ovarian cancer with malignant ascites and its effect on TNF / 中国基层医药

Objective To evaluate the effect of losecplatin combined with compound matrine in the intraperitoneal perfusion treatment of ovarian cancer with malignant ascites and its influence on the levle of serum tumor necrosis factor alpha(TNF-) of ovarian cancer marker.Methods 60 ovarian cancer patients with malignant ascites were divided into three groups:losecplatin combined with compound matrine perfusion group(combination group),single losecplatin perfusion group(losecplatin group) and single compound matrine perfusion group(compound matrine group),20 cases in each group.Before treatment,all the three groups were drained intraperitoneal fluid,then given the above-mentioned group of intraperitoneal perfusion therapy.The effects,side effects and serum TNF- levels of the three groups were compared.Results The patients of the three groups were successfully completed treatment,the effective rate of the combination group was 95%,which of the losecplatin group was 60%,which of the compound matrine group was 55%.The effective rate of the combination group was significantly higher than that of the single drug group(χ2=7.025,P0.05).The serum TNF- levels of the three groups after the perfusion treatment were significantly decreased(t=15.40,13.82,8.90,all P<0.05),TNF- level of the combination group was significantly lower,the difference was statistically significant(F=9.719,P<0.05).Conclusion Losecplatin combined with compound matrine in the intraperitoneal perfusion is a more effective method for the treatment of ovarian cancer with malignant ascites,which is worthy of promotion.

The application of self-made adjustable wedge plate in radiotherapy positioning / 中华放射医学与防护杂志

Objective To investigate the repeatability of precise radiotherapy placement of self-made adjustable angle wedge plate,negative pressure vacuum pad and conmon soft pillow,corresponding to 3 groups.The study is demonstrated with a thermoplastic membrane immobilization technology in kyphotic deformity patients with head and neck cancer (including primary and secondary),respectively.Methods From Jun 2014 to Apr 2016,48 cases of severe head and neck cancer patients received radiotherapy humpback who were randomly divided into 3 groups.Combined with thermoplastic head and neck shoulder film position fixation,the right foot direction at the end of the skull styloid process layer center was set as a reference point.On the left foot at the end of the direction of styloid process layer center,localization of the origin of the coordinate system in patients around the head and foot,dorsoventrally (x,y,z) analysis of the direction change of position measurement was performed.Results There was no significant difference between the adjustable angle wedge plate and negative pressure vacuum pad groups of the coordinate system (P ＞ 0.05).Compared with common soft pillow group,three dimensional positioning errors and three dimensional coordinate system transfer errors of the adjustable angle wedge plate and negative pressure vacuum pad groups were statistically significantly different (t =-6.99 to-2.69,-5.13 to-2.71,P＜0.05).Conclusions The self-made adjustable angle wedge plate has good repeatability,saves time and money,is simple and durable on precise radiotherapy positioning of kyphotic deformity patients with head and neck cancer.

Study of radiotherapy positioning repeatability of kyphosis patients with head and neck cancer / 肿瘤研究与临床

Objective To compare the repeatability of radiotherapy placement between negative pressure vacuum pad (A group) and common soft pillow (B group) combined with a thermoplastic membrane immobilization technology in severe kyphosis patients with head and neck cancer.Methods From September 2013 to December 2014,22 cases of severe kyphosis patients with primary or secondary head and neck cancer who received radiotherapy were randomly divided into group A and group B.Padding waist hips with negative pressure vacuum pad and ordinary soft pillow were used so that the patients could lay in CT-Sim bed,and the head cushion was set on the headrest.After the fixing of thermoplastic head and neck shoulder membrane,CT-Sim was located.Every five times of radiotherapy were accompanied by CT-Sim school position once.In the direction of the last layer of right styloid process center point as the reference point,CT-sim software was used to measure the location change with left and right sides,head,and under direction (x,y,z,respectively) in patients,and the data were analyzed.Results Group A significantly reduced the osseous placement error between tags compared with group B (P ＜ 0.05).The average placement errors were as follows,x:(0.68±0.14) mm vs (1.15±0.77) mm,y:(0.48±0.23) mm vs (1.49±1.24) mm,z:(0.76±0.54) mm vs (2.11±1.02) mm,while the average transfer errors were as follows,x:(0.70±0.21) mm vs (1.15±0.93) mm,y:(0.50±0.31) mm vs (1.50±1.28) mm,z:(0.85±0.26) mm vs (1.77±0.88) mm.Conclusion Vacuum suction pad combined with thermoplastic membrane has good repeatability on radiotherapy positioning for severe kyphosis patients with head and neck cancer.

Research on the relationship of treatment toxicity with chemoradiotherapy order in limited -stage small cell lung cancer / 中国基层医药

Objective To explore the severity of toxicity reaction after treated by the sequential chemoradio-therapy,alternate chemoradiotherapy or concurrent chemoradiotherapy in limited -stage small cell lung cancer. Methods 63 cases of limited -stage small cell lung cancer were reviewed,according to the chemoradiotherapy order,all cases were divided into:sequential chemoradiotherapy 15 cases,alternate chemoradiotherapy 25 cases, concurrent chemoradiotherapy 23 cases.The correlation of the factors(leukocypenia,gastrointestinal reaction,pneumo-nia,esophagitis)with different treatment groups after treated in 2 months,4 months,6 months were analyzed.Results Three groups of all the factors treated in 2 months had no significant change(χ2 =0.275,0.051,0.513,1.215, 0.051,0.231,all P >0.05).In 4 months the cases of sequential chemoradiotherapy >or =2 myelosuppression,the gastrointestinal reaction,the pneumonia and the esophagitis were 33.3%,33.3%,0.0%,0.0%;In the cases of alternate chemoradiotherapy >or =2 myelosuppression,the gastrointestinal reaction,the pneumonia and the esophagitis were 16.0%,4.0%,16.0%,0.0%;In the cases of concurrent chemoradiotherapy >or =2 myelosuppression,the gastroin-testinal reaction,the pneumonia and the esophagitis were 52.2%,34.8%,34.8%,4.3%;>or =2 myelosuppres-sion,each level gastrointestinal reaction and the pneumonia of the three groups treated were statistically significant (χ2 =7.054,9.702,7.947,6.145,7.373,all P or =2 myelosuppression,the gastrointestinal reaction,the pneumonia and the esophagitis were 26.7%,13.3%,13.3%, 0.0%;In the cases of alternate chemoradiotherapy >or =2 myelosuppression,the gastrointestinal reaction,the pneu-monia and the esophagitis were 40.0%,56.0%,12.0%,0.0%;In the cases of concurrent chemoradiotherapy >or =2 myelosuppression,the gastrointestinal reaction,the pneumonia and the esophagitis were 69.6%,65.2%,43.5%,0.0%;each level myelosuppression,>or =2 gastrointestinal reaction and the pneumonia of the three groups treated were statistically significant(χ2 =6.174,7.663,10.544,6.286,all P <0.05).Conclusion Leukopenia and gastrointestinal reaction are closely related with chemotherapy,chemoradiotherapy results in the worsen of myelosuppression.Pneumonia and esophagitis are closely related with chemotherapy,chemoradiotherapy result in the worsen of radiation pneumonitis.

Changes in the ultrastructure of sperm flagella in severe idiopathic asthenospermia patients: observation of 22 cases / 中华男科学杂志

<p><b>OBJECTIVE</b>To observe the ultrastructural changes of sperm flagella in patients with severe idiopathic asthenospermia.</p><p><b>METHODS</b>Using the transmission electron microscope, we examined the ultrastructure of sperm flagella from 22 patients with severe idiopathic asthenospermia.</p><p><b>RESULTS</b>Ultrastructural anomalies were found in all the 22 patients, 6 with partial or complete absence of internal and external dynamic arms in dedicative of primary ciliary dyskinesia, 1 with hyperplasia, hypertrophy and disordered organization of the fibrous sheath usually referred to as dysplasia of the fibrous sheath, and the other 15 with non-specific flagellar anomalies.</p><p><b>CONCLUSION</b>Examination of the ultrastructure of sperm flagella in severe idiopathic asthenospermia patients can help to distinguish congenital from acquired flagellar structural anomalies and give valuable guidance in the treatment.</p>

Comparative study on radiation pneumonitis occurred in lung cancer with mediastinal tumors and esophageal after radiotherapy / 肿瘤研究与临床

Objective A comparative study of clinical factors and dose-volume histogram (DVH)parameters on the impact of radiation pneumonitis occurred in the three-dimensional conformal radiotherapy of lung cancer (lung target)and mediastinal tumors and esophageal (mediastinal target).Methods Review 83cases lung cancer,mediastinal tumors and esophageal patients,and analyzed with chi-square tests on the correlation of the clinical factors (gender,age,tumor location,stage,chemotherapy) with radiation pneumonitis;have relevance analysis between the DVH parameters of two targets and radiation pneumonitis; lung target and mediastinal target volume DVH parameters compared to the t-test.Results ≥2 radiation pneumonitis was 36.5 ％.≥2 radiation pneumonitis occurred in various clinical factors had no significant effect.DVH parameters of the two targets,V5,V10,V20,V30,whole lung dose (MLD) were significantly related to RP.Two targets of RP patients V5 [(50.9±17.8) ％,(69.9±20.4) ％],V10 [(38.6±15.2) ％,(53.5±18.8) ％] were statistically significant by t-test (t =2.434,P ＜ 0.05),while V20 (t =0.388,P ＞ 0.05),V30 (t =0.005,P ＞ 0.05) and MLD (t =0.138,P ＞0.05) were no significant difference (P ＞ 0.05),so the same results with the two targets of patients without RP obtained.Conclusion In the lung target and mediastinal target of radiotherapy radiation pneumonitis is related with DVH parameters,especially V20,V30 and MLD impact on the occurrence of RP.

Radiosensitizing effect of artesunate on nude mice transplanted with HeLa cells of cervical cancer / 中华放射医学与防护杂志

Objective To investigate the radiosensitization of artesunate on nude mouse transplanted with HeLa cells,and to explore its possible mechanisms.Methods HeLa cells were inoculated into the nude mice to establish tumor model.Mice were randomly divided into 4 groups as blank control,artesunate group,radiation group and artesunate + radiation group when average volume of tumor were about 5 mm × 5 mm× 5 mm.During the term of treatment,the volume of tumors were measured every 2days.After 14 days treatment,the mice were killed and tumor tissues were harvested for flow cytometry to detect the alteration of cell cycle.Meanwhile,the pathological change of the tumor tissue was observed with HE staining method,and the change of expression of cycle regulatory protein Cyclin B1,Cdc2 and Wee1 were detected by Western blot.Results The growth of tumor was significantly inhibited by artesunate combined with radiation and its inhibition rate was 72.34％.Flow cytometry results showed that the percent of cells in G1 phase increased and G2 phase decreased in the artesunate + radiation group compared with those in irradiation group ( t =4.41,4.12,P ＜ 0.05 ).The expression level of Cyclin B1 was obviously increased while that of Wee1 decreased in the artesunate + radiation compared with irradiation group.There was no difference in the expression of Cdc2 among the four groups.Conclusions Artesunate can dramatically increase the radiosensitivity of transplanted tumor of HeLa cells.The possible mechanism might be related to the decreasing G2 phase by regulating the expression of Cyclin B1 and Wee1.