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Objective To investigate the relationship between serum inflammatory cytokines and atherosclerosis in type 2 diabetic patients with obstructive sleep apnea hypopnea syndrome (OSAHS).Methods One hundred and three patients with type 2 diabetes were divided into OSAHS group (OSAHS group) and type 2 diabetes mellitus group (non-OSAHS group) according to the results of polysomnography(PSG),and 35 healthy subjects were selected as control group.Serum levels of total cholesterol,triglyceride,fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1c),tumor necrosis factor-α(TNF-α),high-sensitivity C-reactive protein (hs-CRP) and carotid intima-media thickness (IMT) were measured,and their relationship with OSAHS were analyzed.Results The waist circumference,BMI,FPG,HbA1c,IMT,TNF-α and CRP in OSAHS group were significantly higher than those in non-OSAHS group (P＜0.05).Logistic regression analysis showed that,IMT was independently associated with TNF-α and hs-CRP.Conclusion Patients of T2DM with OSAHS have poor blood glucose control and higher incidence of atherosclerosis.High levels of TNF-α and hs-CRP may be involved in the formation of atherosclerosis and plaque occurrence and development.
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ObjectiveTo evaluate the long term outcomes, toxicities and prognostic factors of the patients in Northwest China with nasopharyngealcarcinoma (NPC)treated by intensity-modulated radiotherapy (IMRT). MethodsFrom January 2006 to December 2009, 133 NPC Patients were treated by IMRT in Xijing Hospital, the Fourth Military Medical University. There were 22 treated by radiotherapy alone, 111 treated by platinum-based current chemo-radiothreapy. The prescription dose to the gross tumor volume was 66 - 76. 6 Gy/30 - 33 fractions, positive lymph nodes was 66. 0 - 72. 4 Gy/30 - 33 fractions.The higher and lower risk clinical target volume were irradiated with 56. 0 - 63. 5 Gy/28 - 33 fractions and 50. 4 -53. 2 Gy/28 fractions respectively. ResultsThe follow-up rate was 97. 7％. Follow-up time more than 2years,3years were 37cases ,44cases. The l-,2-and 3-year overall survival (OS) were 93. 8％, 88. 3％and 83.2％ ; local control rate were 99. 2％ ,95.4％ and 95.4％ ; regional control rate ( RC ) were 99. 2％,96. 8％ and 96.8％ ; and distant metastasis-free rate (DMFR) were 82. 8％, 79. 8％ and 79. 8％ ; the disease-free survival (DFS) were 84. 3％ ,76. 7％ and 76. 7％, respectively. Multivariate analyses revealed that N stage, age and anemia before radiotherapy were independent predietors for OS (x2 =5.56,9. 10,4.89,P=0. 018,0.003,0.027), and N stage was also independent predictors for DFS (x2 =8.98,P=0.003).Thegrade 3acutetoxicitiesweremueositis(34.7％),xerostomia(20. 1％ ), skin reaction ( 1.4 ％ ) and leucocytopenia ( 1. 4 ％ ). No grade4 acute and late toxieities were detected. Conclusions IMRT with or without chemotherapy achieved good long term survival in nasopharyngeal carcinoma treated by intensity-modulated radiotherapy, especially in LC and RC. Distant metastasis becomes the main treatment failure.N stage, age, and anemia before radiotherapy were the main prognostic factors in nasopharyngeal cancer patients.