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Objective: To investigate the application of 3D-printed minimally-invasiveguided template in the treatment of recurrent cer-vical cancer after surgery, assisting interstitial brachytherapy. Methods: From July 2017 to April 2018, a total of 10 patients admitted to Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine in Hebei province with recurrent cervical cancer after radi-cal surgery underwent the 3D-printed customized template-assisted interstitial brachytherapy. According to the specific conditions of patients, different vaginal localization templates were selected for CT simulation localization. The main guidance needle space distribu-tion was designed, and 3D minimally-invasive guidance templates were printed. Then, needles were inserted according to the main guide channel of the template commissioned by medical photosensitive resin. The high-risk clinical target volume (HR-CTV) of 6 Gy/fraction was administered (4 to 6 fractions). Results: Overall, 10 patients were treated with implantation for a total of 52 times. Treat-ment with average scanning CT number for each brachytherapy was (1.58±0.70) times. The average elapsed time for each brachythera-py implant treatment, from plug implant to inserting planting needle satisfactorily with the location of the tumor, was (10.88±2.94) minutes. The mean number of metal needles used was (5.69±1.91) in each brachytherapy. The mean D90 value for high-risk clinical tar-get volume (HR-CTV) was (6.41±0.29) Gy. The cumulative D2cm3 values for the bladder, rectum, and sigmoid colon were (4.75±0.37) Gy, (3.93±0.26) Gy, and (4.33±0.24) Gy, respectively. After 3 months of treatment, the efficacy was evaluated in 8 cases with CR and 2 cas-es with PR. Conclusions: The technology of 3D-printed minimally-invasive guided template shows the advantage of accurate location and superior repeatability in the application of interstitial brachytherapy in treating recurrent cervical cancer after operation, which in-volves less time and insertion needles. The patients had minor aches and few complications. The tumor shrank significantly, which indi-cated a bright future of the technology's clinical application.
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Rhodiola capsules show the resistant effects on ischemia, anoxia, radiation, fatigue and virus and so on, and can im-prove the body immune function to relief the plateau symptoms such as fatigue and cerebral hypoxia. The influence mechanism of rhodi-ola capsules in the effect of anti-high altitude pulmonary edema was summarized in the paper.
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Objective To explore radiation-induced esophagitis and its related factors in the patients with local advanced non-small cell lung cancer ( NSCLC ) which were treated with three-dimensional conformal radiation therapy (3D-CRT). Methods From January 2001 to December 2008, 203 patients who suffered from stageⅢNSCLC were achieved, including 163 males and 40 females, with a median age of 63 years old, while 79 cases were in stageⅢa and 124 in stageⅢb . The equivalent median dose of tumor was 62 Gy( range of 50-78 Gy) . Among them, 74 cases were administered with radiotherapy alone, 45 with sequential radiotherapy and chemotherapy, 87 cases with concurrent radiochemotherapy. Radiation esophagitis was evaluated with RTOG standard. The dosimetric parameters was estimated from dose volume histogrma ( DVH ) . The clinical and dosimetric parameters of radiation esophagitis were evaluated by spearman correlatived univariate and Logistic multivariable analysis. Results After radiotherapy, out of 203 patients, 87 had acute radiation esophagitis(RE), 47 in grade 1, 37 in grade 2, and 3 in grade 3 RE. According to spearman correlatived analysis, the correlatived factors included ages, chemotherapy, GTV, PTV, the mean doses of PTV and lung, the max and mean dose of esophagus, V40 , V45 ,V50 ,V55 ,V60 , length of esophagus( total circumference) treated with 45 Gy ( LETT45 ) , and LETT50 ( r=-0. 162-0. 235,P0. 05). There were 21 factors, such as gender, age, smoking, clinical stage, site of tumor, chemotherapy, GTV, PTV, mean dose of PTV and lung, max and mean dose of esophagus, V40 -V60 of esophagus, LETT45-60 , incorporated into multivariable analysis, only chemotherapy and V45 of esophagus were independent predicted factors(Wald=4. 626, 9?882, P<0. 05). Conclusions In local advanced NSCLC after 3D-CRT, chemotherapy ( especially concurrent radiochemotherapy) could increase radiation-induced esophagitis. The parameter of DVH could also be used to predict radiation-induced esophagitis, V45 of esophagus may be the most valuable predictor.
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Objective To investigate the effects of UDP glucuronosyltransferase (UGT) 1A9 I399 C ＞ T single nucleotide polymorphism on postoperative sedation with propofol in patients undergoing breast surgery.Methods One hundred and fifty-two ASA Ⅰ or Ⅱ female patients,aged 20-50 yr,weighing 50-70 kg,scheduled for elective benign breast tumor excision under general anesthesia,were enrolled in this study.The polymorphic sites of the UGT1A9 I399 C ＞ T allele were analyzed by polymerase chain reaction-restriction fragment length polymorphism.The patients were assigned to one of 3 groups according to their genotypes:wild homozygote (C/C) group,mutation heterozygote (C/T) group and mutation homozygote (T/T) group.During induction and maintenance of anesthesia,propofol was given by target-controlled infusion with the plasma concentration (Cp) of 3μg/ml.Blood samples were taken at 60 min after target-controlled infusion of propofol was started for determination of the Cp of propofol using high-performance liquid chromatography.The time when OAAS was 4 after stopping the infusion of propofol was recorded and the BIS value and effect-site concentration of propofol were also recorded at this time.The time when BIS value was 80 was recorded and the effect-site concentration of propofol was also recorded at this time.Results Genotyping analysis revealed that genotype distribution of UGT1A9 I399 C ＞ T polymorphism was C/C 24 cases,C/T 96 cases and T/T 32 cases.The T allele frequency was 53％.The C allele frequency was 47.4％.There was no significant difference in the Cp of propofol,time when OAAS was 4,BIS value and effectsite concentration of propofol when OAAS was 4,time when BIS value was 80 and effect-site concentration of propofol when BIS value was 80 among the three groups (P ＞ 0.05).Conclusion UGT1 A9 I399C ＞ T single nucleotide polymorphism is not the genetic factor contributing to the individual variation in the patient' s response to postoperative analgesia with propofol in patients undergoing breast surgery.
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Objective To explore the prognosis and related factor of esophageal carcinoma with locoregional lymph node metastasis ( N1 ) treated with three-dimensional conformal radiotherapy (3DCRT) or intensity modulated radiation therapy (IMRT).Methods From January 2001 to December 2008,60 patients of esophageal carcinoma with localregional lymph node metastasis were treated with 3DCRT and 52 with IMRT.For all patients,dose of tumor was 56 - 70 Gy/28 - 35 fraction/5.6 - 7.0 weeks.Among them,58 cases was treated with chemotherapy including cisplatin and 5-fluorouracil;40 with concurrent chemoradiotherapy and 18 with sequential radiotherapy and chemotherapy.Results After radiotherapy,the total efficiency rate was 98.2％,96.7％ in 3DCRT and 100％ in IMRT ( x2 =1.77,P =0.184 ).The follow-up rate was 99.1％.The number of patients completed follow-up were 68 and 53,respectively at 2-year and 3-year.The 1 and 3-year overall survival rates were 62.5％,23.7％,respectively; the median survival time was 17 months.The 1and 3-year survival rates and median were 52％,19％ and 12.4 months in 3DCRT and 75％,40％ and 17 months in IMRT,respectively (x2 =4.74,P =0.030).The 1 and 3-year free-recurrence survival rates were 64％,45％ in 3DCRT and 72％,59％ in IMRT ( x2 =2.27,P =0.132),respectively.With uninvariate analysis,for female,ages ≤ 65,tumor located in cervical and upper-thoracic,＞5 cm lesion length in barium esophagogram,≤4 cm the largest diameter of lesion in CT scanning image,T4 stage,or semiliquid or liquid diet before radiotherapy,survival rate were higher in IMRT than in 3DCRT group (x2 =4.63,5.56,7.19,5.08,4.43,4.48,8.25;P=0.031,0.018,0.007,0.025,0.035,0.034,0.004,respectively) ; but for male,ages ＞ 65,tumor located in middle and lower-thoracic,≤5 cm lesion length in barium esophagogram,＞4 cm the largest diameter of lesion in CT scanning image,T1 -3 stage,or normal diet before radiotherapy,chemotherapy and dose of radiotherapy ( ＜66 Gy vs ≥66 Gy),no significant difference were found between IMRT and 3DCRT (x2 =1.28,0.27,0.17,0.03,1.98,0.01,0.43,2.45,1.73,1.24,2.64;P=0.258,0.602,0.684,0.859,0.160,0.973,0.511,0.117,0.189,0.234,0.104,respectively).By Cox multivariable regression,only T stage was independent prognostic factor (x2=9.50,P =0.002 ).Conclusions There was some advantage treated with IMRT compared with 3DCRT in patients of esophageal cancer with locoregional lymph node metastasis,but further prospective clinical study is needed to support the conclusion.