Efficacy and Safety of Pulse Magnetic Therapy System in Insomnia Disorder: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial

Objective@#This study’s objective is to assess the efficacy and safety of Pulsed Magnetic Therapy System (PMTS) in improving insomnia disorder. @*Methods@#Participants with insomnia disorder were randomly assigned to receive either PMTS or sham treatment for four weeks (n= 153; PMTS: 76, sham: 77). Primary outcomes are the Insomnia Severity Index (ISI) scores at week 0 (baseline), 1, 2, 3, 4 (treatment), and 5 (follow-up). Secondary outcomes are the Pittsburgh Sleep Quality Index at baseline and week 4, and weekly sleep diary-derived values for sleep latency, sleep efficiency, real sleep time, waking after sleep onset, and sleep duration. @*Results@#The ISI scores of the PMTS group and the sham group were 7.13±0.50, 11.07±0.51 at week 4, respectively. There was a significant group×time interaction for ISI (F3.214, 485.271=24.25, p<0.001, ηp 2=0.138). Only the PMTS group experienced continuous improvement throughout the study; in contrast, the sham group only experienced a modest improvement after the first week of therapy. At the end of the treatment and one week after it, the response of the PMTS group were 69.7% (95% confidence interval [CI]: 58.6%–79.0%), 75.0% (95% CI: 64.1%–83.4%), respectively, which were higher than the response of the sham group (p<0.001). For each of the secondary outcomes, similar group×time interactions were discovered. The effects of the treatment persisted for at least a week. @*Conclusion@#PMTS is safe and effective in improving insomnia disorders.

The Prevalence and Predictors of Obstructive Sleep Apnea in Chinese Bariatric Surgery Candidates: A Single-Center Study

Purpose@#The purpose of the study is to determine the prevalence and predictors of OSA in Chinese bariatric surgery candidates. @*Materials and Methods@#The clinical data were collected from 326 patients evaluated for bariatric surgery and referred for polysomnography. Multiple logistic regression was used for identifying independent predictors of presence of OSA and ROC curve analysis to determine the best cut-off value for continuous variable. @*Results@#Baseline BMI and age were 33.3±3.7 kg/m2 and 24.3±3.1 years. 62.9% of the patients fulfilled the diagnostic criteria for OSA; Of these, 22.7% had mild OSA; 11.3% had moderate OSA, and 28.8% had severe OSA. The prevalence was significantly higher in males (84.2%) than in females (47.3%) (P＜0.001). The superobese patients and the obese patients aged older than 50 years that all of those were diagnosed with OSA. A multivariate logistic regression model displayed that increasing age, BMI and neck circumference together with presence of habitual snoring and male sex were identified as risk factors of OSA. The best cut-off values for the presence of OSA for age, BMI, neck circumference were 24.5 years, 39.45 kg/m2 , 40.40 cm. @*Conclusion@#The prevalence of OSA is very prevalent (62.9%) in Chinese bariatric surgery candidates, especially in male patients (84%). Age, BMI and neck circumference together with presence of habitual snoring and male sex are independent predictors of OSA in these patients. As clinical predictors are not enough to be a properly screening for OSA, routine PSG testing should be recommended to bariatric surgery candidates.

The Prevalence and Predictors of Obstructive Sleep Apnea in Chinese Bariatric Surgery Candidates: A Single-Center Study

Purpose@#The purpose of the study is to determine the prevalence and predictors of OSA in Chinese bariatric surgery candidates. @*Materials and Methods@#The clinical data were collected from 326 patients evaluated for bariatric surgery and referred for polysomnography. Multiple logistic regression was used for identifying independent predictors of presence of OSA and ROC curve analysis to determine the best cut-off value for continuous variable. @*Results@#Baseline BMI and age were 33.3±3.7 kg/m2 and 24.3±3.1 years. 62.9% of the patients fulfilled the diagnostic criteria for OSA; Of these, 22.7% had mild OSA; 11.3% had moderate OSA, and 28.8% had severe OSA. The prevalence was significantly higher in males (84.2%) than in females (47.3%) (P＜0.001). The superobese patients and the obese patients aged older than 50 years that all of those were diagnosed with OSA. A multivariate logistic regression model displayed that increasing age, BMI and neck circumference together with presence of habitual snoring and male sex were identified as risk factors of OSA. The best cut-off values for the presence of OSA for age, BMI, neck circumference were 24.5 years, 39.45 kg/m2 , 40.40 cm. @*Conclusion@#The prevalence of OSA is very prevalent (62.9%) in Chinese bariatric surgery candidates, especially in male patients (84%). Age, BMI and neck circumference together with presence of habitual snoring and male sex are independent predictors of OSA in these patients. As clinical predictors are not enough to be a properly screening for OSA, routine PSG testing should be recommended to bariatric surgery candidates.

A Case Report of Checkpoint Inhibitor Pneumonitis Caused by PD-1 Antibody-Safety and Effectiveness of Pirfenidone / 中国肺癌杂志

BACKGROUND@#Immune checkpoint inhibitor associated pneumonia (CIP) is a serious side effect of immune checkpoint inhibitors. There is a consensus on the treatment of acute phase of CIP, but the treatment of pulmonary interstitial fibrosis after the acute phase is still a clinical problem to be solved.@*METHODS@#The diagnosis and treatment of a non-small cell lung cancer (NSCLC) patient with immune checkpoint inhibitor associated pneumonia in the Stereotactic Radiotherapy Department of Qingdao Central Hospital were retrospectively analyzed, and literatures were reviewed.@*RESULTS@#A 70-year-old male patient was diagnosed with Poorly differentiated squamous cell carcinoma of left lung with mediastinal lymph node metastasis T3N3M0 stage IIIc, EGFR/ALK/ROS1/RAF negative, PD-L1 (22c3) immunohistochemistry negative. After the progression of first-line chemotherapy, the patient was diagnosed as immune checkpoint inhibitor associated pneumonia grade 3 during second-line monotherapy with Nivolumab. After initial high-dose glucocorticoid pulse therapy, the lung computed tomography (CT) imaging and clinical symptoms of the patients were partially relieved, and then pirfenidone (300 mg tid) was given orally for more than 11 months. During the treatment of pirfenidone, the CT imaging and clinical symptoms of the patients were significantly improved, and there were no other adverse reactions except grade 1 nausea. During this period, chemotherapy and Anlotinib was given concurrently with pirfenidone and showed good safety profile.@*CONCLUSIONS@#This case report is the first report of pirfenidone in the treatment of CIP, which provides a new idea for the clinical practice and research of CIP treatment.

Application of bevacizumab for malignant brain edema / 国际肿瘤学杂志

Anti-angiogenic drugs such as bevacizumab can effectively alleviate the patients′brain edema and clinical symptoms and improve the patients′life quality by reducing vascular permeability and the blood-brain barrier damage.Bevacizumab has got positive efficacy in the clinical,so that it is considered as an effective and safe treatment for malignant brain edema.

Clinical application of FOLFIRINOX regimen for pancreatic cancer / 国际肿瘤学杂志

Clinical studies have confirmed the FOLFIRINOX regimen (oxaliplatin + irinotecan + fluorouracil + leucovorin) is an effective regimen for advanced pancreatic cancer patients with good performance status.Current clinical studies on FOLFIRINOX regimen mainly include neoadjuvant therapy for unresectable and borderline resectable pancreatic cancer and first-line therapy for locally advanced pancreatic cancer and metastatic pancreatic cancer,which improved patient's surgical resection opportunities and survival.In addition,the toxicity,safety of FOLFIRINOX regimen and effective population selection for FOLFIRINOX regimen are also the problems concerned by researchers.

Research progress of radiation-induced heart disease / 中华放射医学与防护杂志

Radiation therapy is one of the important comprehensive treatment strategies for thoracic neoplasms,but it also can cause radiation-induced heart disease (RIHD) which can affect the quality of life and even endanger the lives of patients while killing tumor.With the development of comprehensive treatment for cancer,the patients achieve better survival outcomes.And the study reported about RIHD increased as well,which made RIHD became an important complication of thoracic neoplasms' treatment.Though modem radiotherapy techniques and new therapeutic principles have significantly made the incidence of RIHD decreased,the harm of RIHD should not be ignored.In this article,we review the research progress of RIHD.

Initial muscle-enclosing protection of large segment of exposed Achilles tendon and second stage repair of Achilles tendon rupture complicated with cutaneous defect:observation of 32 cases / 中国基层医药

Objective To discuss the methods and evaluate the effects of initial muscle-enclosing protection of large segment of exposed Achilles tendon and second stage repair of Achilles tendon rupture complicated with cuta-neous defect.Methods Among patients treated between August 2005 to April 2014 in our hospital,there were 32 patients,who were diagnosed with Achilles tendon rupture complicated with cutaneous defect.Of the 32 patients, there are 21 male and 11 female.Their ages range from 23 to 69,with an average age of 46.2 ±3.5.In all the patients described above,there are soft tissue contusion injuries and cutaneous defects on their posterior lower legs near the ankles,with the area of skin defects ranging from 3cm ×4cm to 5 ×12cm,and the Achilles tendons were ruptured, extracted,dissociated and completely uncovered.All patients were initially treated with triceps surae muscle-enclosing method to put aside and protect the large segment of exposed Achilles tendon.Later,the ruptured Achilles tendons were repaired,together with the transfer of skin flap to repair skin defects,at the second stage.The therapeutic effects were evaluated during postoperative follow-up periods.Results The mean follow-up period was 18 months,ranged from 11 to 32 months.According to the therapeutic effect evaluation standard of Arner-Lindholm,there were Excellent results in 22 patients,Good in 7 cases and Poor in 3 cases,with a combined excellent/good rate of 90.62%.Conclusion Initial muscle-enclosing protection of large segment of exposed Achilles tendon and second stage repair of Achilles tendon rupture complicated with cutaneous defect is advantageous to the function of patients with rapid recovery.

Casein phosphopeptide-amorphous calcium phosphate nanocom-plexes as a preventive agent for radiation caries and dental sensi-tivity in irradiated head and neck cancer patients / 中国肿瘤临床

Objective: To compare the efficacy of casein phosphopeptide-amorphous calcium phosphate nanocomplexes (CPP-ACP) and Duraphat varnish on preventing radiation caries and dentin hypersensitivity (DH) in irradiated head and neck cancer pa-tients. Methods:A total of 112 patients with head and neck cancer who will undergo radiotherapy were selected and randomly divided into the CPP-ACP group (experimental group) and the Duraphat varnish group (control group). A day prior to the scheduled radiothera-py, CPP-ACP containing paste had been applied once a day for 5 weeks to the teeth surface of the experimental group. Duraphat varnish was applied with the same frequency in the control group. The decay missing filling tooth (DMFT), decay missing filling surface (DMFS), and DH of two groups before radiotherapy and 12 months after radiotherapy were observed and statistically analyzed. Re-sults:Before radiotherapy, DMFT, DMFS, and DH showed no significant differences between the groups (P>0.05). However, signifi-cant increase in DMFT, DMFS, and DH was noted in the two groups 12 months after the radiotherapy (P<0.05). A higher increase was observed in the DMFT, DMFS, and DH of the control group compared with those in the experimental group (P<0.05). Conclusion:CPP-ACP effectively reduced radiation caries and sensitivity in irradiated head and neck cancer patients and deservesclinical applica-tion.

Simultaneous Determination of N3-methyladenine and N3-ethyladenine in DNA by Liquid Chromatography-Tandem Mass Spectrometry / 分析化学

A liquid chromatography-tandem mass spectrometry ( LC-MSMS ) method has been developed for the simultaneous determination of N3-methyladenine ( N3-MeA ) and N3-ethyladenine ( N3-EtA ) in calf thymus DNA. The DNA samples has been purified and enriched by cation exchange cartridge ( Waters Oasis MCX) . d3-N3-MeA and d5-N3-EtA were used as isotope internal standard. The DNA samples were injected with autosampler. The injected volume was 3 μL and analysis time was 13 min. The sample separation was carried out on hydrophilic interaction chromatograph ( Waters XBridge HILIC ) with 10 mmol/L ammonium formate-acetonitrile (5:92, V/V, pH=4. 0) as mobile phase. The flow rate was set at 250 μL/min. Mass spectrometry was performed by electrospray ionization ( ESI ) with multi-reactions monitoring ( MRM ) . The optimized operation conditions of MS were as follows: nebulizer gas 369 Pa; curtain gas 185 Pa, turbo ionspray temperature 400 ℃, ionspray voltage 5500 V, dwell time 40 ms. The limits of detection were 0. 043 and 0. 007 μg/L for N3-MeA and N3-EtA, respectively. The recoveries were between 87. 8% and 103. 0%for N3-MeA and N3-EtA. This method was successfully applied to the determination of N3-MeA and N3-EtA in calf thymus DNA by cigarette smoke condensate ( CSC) exposure. This method is appropriate for routine analysis and accurate quantification of N3-MeA and N3-EtA by CSC exposure.

Concurrent chemotherapy and intensity-modulated radiation therapy positioned by PET/CT for patients with locally advanced non-small cell lung cancer / 中国肿瘤临床

Objective:This work aimed to compare the three-year results, prognostic analysis, and adverse reactions of intensi-ty-modulated radiation therapy (IMRT) positioned by PET-CT and conventional radiotherapy in locally advanced non-small cell lung cancer (NSCLC) patients who underwent concurrent chemotherapy. Methods:A clinical trial was carried out in Qingdao Cancer Hospi-tal. The patients who joined our study were divided into IMRT and conventional radiotherapy (CRT) groups. A total of 48 patients were in the IMRT group and another 40 were in the CRT group. The total dose was 60 Gy throughout the 6-week treatment. The plati-num-based concurrent chemotherapy, combined with regimens such as docetaxel, navelbine, and pemetrexed, was conducted for two cy-cles followed by two to four cycles of consolidation chemotherapy. Results:Significant differences were observed between the curative ratio of the IMRT (77.1%) and CRT (52.5%) groups (P=0.015). No significant difference existed between the short-term survival rates of the two groups. The 1-, 2-and 3-year survival rates were 77.1%, 54.2%, and 22.9%in the IMRT group, as well as 65.0%, 47.5%, and 17.5%in the CRT group, respectively. Significant differences existed in some adverse reactions between the two groups, such as radia-tion gastrointestinal reactions, esophagitis, and pneumonia. More patients died of local recurrence and radiation pneumonia in the CRT group than in the IMRT group. The local recurrence rate was also lower in the IMRT group than in the CRT group. Conclusion:IMRT has obvious advantages in improving the short-term curative effect and reducing adverse reactions. Regarding the survival rate, a long-term follow-up of the two groups is required in the future.

Outcomes of docetaxel and cisplatin induction chemotherapy followed by concurrent chemoradiotherapy in locally advanced non-small cell lung cancer / 中华放射肿瘤学杂志

Objective To investigate the efficacy and side-effect of docetaxel and cisplatin induction chemotherapy followed by concurrent chemoradiotherapy in locally advanced non-small cell lung cancer (NSCLC).MethodsEighty-six patients with histologically confirmed locally advanced NSCLC were randomized into induction chemotherapy followed by concurrent chemoradiotherapy (ICCRT)arm or concurrent chemoradiotherapy (CCRT) arm. Both arms were treated with intensity-modulated radiation therapy. Induction and concurrent chemotherapy regimen consist of docetaxel and cisplatin. Results Follow-up rate of the whole group is 100％.The response rate in the CCRT arm and ICCRT arm is 70％ and 80％ ( χ2 =1.26,P =0.261 ),respectively; and 1-,2-,3-year survival rate is 65％ and 85％,40％ and 50％,33％ and 44％ (χ2 =3.90,P=0.048),respectively; the median survival time and time to progression is 17.5 and 22.0 months and 14.0 and 19.0 months respectively.Major adverse effects are leukopenia (43 and 32 cases,χ2 =3.48,P =0.062),radiation esophagutis (26 and 20 cases,χ2 =0.12,P =0.730),anemia (26 and 16 cases,χ2 =2.34,P =0.126) and radiation pneumonitis (13 and 9 cases,χ2 =0.37,P =0.541 ).ConclusionsICCRT for locally advanced NSCLC can improve the overall survival rate and time to progression,induction chemotherapy did not increase side-effects.There was no difference in response rate between CCRT and ICCRT arm.

Effect of Concurrent Chemoradiotherapy on Patients'Serum CD44v6 and VEGF Levels and Its Clinical Significance / 中国肿瘤临床

Objective: To investigate the changes in serum CD44v6/v EGF(sCD44v6/sVEGF)levels after concurrent chemoradiotherapy in patients with inoperable non-small cell lung cancer(NSCLC)patients and to analyze the correlation of serum markers with patients'prognosis. Methods: The sCD44v6/v EGF levels were detected by ELISA in 50 inoperable NSCLC patients before and after concurrent chemorediotherapy. Results: The sCD44v6 and sVEGF levels before treatment was significantly higher than that in the control group.The pre-treatment sVEGF level was closely related to cTNM stage.metastasis,cell differentiation and primary tumor size,but was not correlated with histological classification,lymph node status,age or gender.The pre-treatment sCD44v6 level was closely correlated with cTNM stage,metastasis,cell differentiation,and primary tumor size,but was not correlated with histological classification,age or gender.Patients'sCD44v6 before treatment(570.89±63.30 ng/L)was significantly higher than that after treatment(281.44±74.28 ng/L).Patients'sVEGF before treatment(241.09±85.96 ng/L)was significantly higher than that after treatment(133.64±67.69 ng/L).PD patients had the highest level of sCD44v6 and sVEGF and CR patients had the lowest sCD44v6 and sVEGF level.The sVEGF level was highly correlated with sCD44v6(r=0.291,P<0.05).Conclusion:The sCD44v6 and sVEGF levels might be helpful for evaluation of the biological behavior and prognosis of NSCLC.

Correlation of serum vascular endothelial growth factor with inoperable non-small cell lung cancer treated with concurrent chemoradiotherapy / 中华放射肿瘤学杂志

Objective To investigate the correlation among expression of serum VEGF without operation between pre-and post-chemoradiotherapy in non-small cell lung cancer (NSCLC) patients, to explore the correlation of markers on prognosis and effect. Methods The serum vascular endothelial growth factor (VEGF) were detected in 50 patients without operation between pre-and post-chemoradiotherapy with NSCLC by ELISA method. The group t-test was played into before concurrent chemoradiotherapy and normal control. The paired t-test was played into before and after concurrent chemoradiotherapy. Results The prechemoradiotherapy serum VEGF ( 241.09 ± 52.45 ) ng/L in NSCLC patients was significantly higher than those in normal control patients (103.72 ± 39. 22) ng/L (t = 2. 50,P ＜0. 05 ). The pre-chemoradiotherapy serum VEGF in NSCLC patients was closely related to pTNM stage, distant metastasis, grade of cell differentiation and the size of the primary tumors ( t = 9. 61 - 14. 94, all P ＜ 0. 05 ), but not to the histological classification, type of the tumor, lymph node status, age, gender of the patients or smoking or not (t =0. 58 - 1.84, all P ＞ 0. 05 ). The pre-chemoradiotherapy serum VEGF ( 24 1.09 ± 52. 45 ) ng/L was significantly higher than that of the post-chemoradiotherapy ( 133.64 ± 33.62) ng/L ( t = 12. 20, P ＜ 0. 01 ). The post-chemoradiotherapy serum VEGF decreases to the pre-was the biggest in the CR patients (( 92.35 ± 37.48ng/L) ,t =3.79,P ＜0. 01 ) ,the smallest in the PA patients ( (276.32 ±47.98) ng/L,t = 1.32,P ＞0. 05) ) ,and bigger in the PR patients and the NC patientspatients ( ( 113.10 ± 39. 20) ng/L,t = 13.58,P ＜0. 01 and ( 198.10 ± 42.68 ) ng/L, t = 4. 78, P ＜ 0. 05 ) ), respectively. Conclusions Elevation of serum VEGF exists in patients with NSCLC . The serum VEGF in patients with NSCLC might be helpful to evaluate the biological behavior of lung cancer. Detection of VEGF expression maybe helpful for predicting the prognosis of NSCLC patients.

Microsurgical treatment of cerebellum hemangioblastoma / 中国综合临床

Objective To investigate the operative technique and treatment effect for the cerebellum he-mangioblastoma. Methods The clinical data of 18 patients with cerebellum hemangioblastoma who underwent sur-gery were analyzed retrospectively. The clinical data included imaging data,the operative approach and microsurgery method. Results In the 18 cases, 15 undertook complete remove of tumor,and the other 3 cases experienced partial remove. 16 patients were followed up for 1 to 3 years,and 2 cases experienced recurrence. No death occurred. Con-clusion The measures including sufficient preoperative imaging and gentle manipulation during the operation can significantly increase the rate of total removal of the tumors, while radioneurosurgery or γ treatment is applicable after operation.

A Randomized Clinical Study:Concurrent Chemoradiotherapy Combined with Consolidation or Induction Chemotherapy for Locally Advanced Non-small Cell lung Cancer / 医学研究杂志

Objective To investigate the efficacy and the side-effects of concurrent chemoradiotherapy combined with consolidation or induction chemotherapy for locally advanced non-small cell lung cancer(NSCLC).Methods64 patients with stage ⅢA and ⅢB NSCLC were divided randomly into the CCT group(concurrent chemoradiotherapy followed by consolidation chemotherapy) and the ICT group(induction chemotherapy followed by concurrent chemoradiotherapy).All patients were deliverd to thoracic planning target with total dose of 54~66Gy(median dose 60Gy)in 6~7 weeks.CCT group started to irradiate by conformal radiotherapy technique on day 1,and ICT started on day 43 with single fraction dose 200 cGy and 5 fractions every week.ResultsThe response rate in CCT and ICT group was 60.0% and 58.8% respectively(P=0.924),with no statistic significance between the CCT and ICT group.The side-effects were mainly granulo-cytopernia,radiation espohagitis and radiation pneumonitis.ConclusionConcurrent chemoradiotherapy combined with consolidation or induction chemotherapy for locally advanced NSCLC is well tolerated.The sequence of adjuvant chemothreapy to concurrent chemoradiotherapy produced no significant difference for NSCLC in recent response.

Concurrent three dimension conformal radiation therapy and chemotherapy followed by consolidation chemotherapy for locally advanced non-small cell lung cancer / 中华放射肿瘤学杂志

0.05). Conclusions For patients with locally advanced non-small cell lung cancer, concurrent conformal radiotherapy and chemotherapy followed by consolidation chemotherapy can improve the progression-free survival, but have few effects on overall survival and toxicity. Multicenter clinical trial with more patients should be carried out to confirm the benefit from the additional consolidation chemotherapy.