Cardiac dosimetry analysis and quality of life evaluation of internal breast lymph node irradiation in postoperative left breast cancer / 国际肿瘤学杂志

Objective:To analyze the cardiac dosimetry of lymph node irradiation in the internal breast region after left-sided breast cancer surgery and to assess its impact on patients' quality of life.Methods:The clinical data of 108 patients who underwent inverse intensity modulated radiotherapy (IMRT) after left-sided breast cancer surgery in Cancer Hospital of Nantong University from May 2019 to May 2021 were collected and retrospectively analyzed, and divided into a study group (with internal breast, 55 cases) and a control group (without internal breast, 53 cases) according to whether the postoperative radiotherapy included lymph node irradiation in the internal breast region. The dosimetric indexes of planned target area (PTV) , cardiac tolerance, serum myocardial injury markers and quality of life before and after radiotherapy were compared between the two groups.Results:In terms of PTV dosimetry, the conformality index (CI) of the study group and the control group were 0.73±0.07 and 0.75±0.08, the homogeneity index (HI) were 0.17±0.03 and 0.17±0.02, the D max were (55.69±1.02) Gy and (55.46±1.13) Gy, the D mean were (50.54±0.23) Gy and (50.48±0.21) Gy respectively, there were no statistically significant differences ( t=1.38, P=0.169; t<0.01, P>0.999; t=1.11, P=0.269; t=1.41, P=0.160) . In terms of cardiac receptivity, the D mean of the two groups were (5.93 ± 0.32) Gy, (5.64 ± 0.30) Gy, V 40 were (0.47 ± 0.10) %, (0.41 ± 0.11) %, and V 30 were (2.48 ± 0.51) %, (2.06 ± 0.49) % respectively, and there were statistically significant differences ( t=4.86, P<0.001; t=2.97, P=0.004; t=4.36, P<0.001) . The levels of serum troponin Ⅰ (cTnⅠ) before radiotherapy in the study group and the control group were (0.09±0.02) ng/ml and (0.09±0.01) ng/ml, creatine kinase isoenzyme MB (CK-MB) were (0.27±0.08) U/L and (0.25±0.08) U/L, myoglobin (MYo) were (3.84±1.02) μg/L and (3.69±0.97) μg/L, and brain natriuretic peptide (BNP) were (172.35±16.24) pg/ml and (169.81±15.93) pg/ml respectively, there were no statistically significant differences ( t<0.01, P>0.999; t=1.30, P=0.197; t=0.78, P=0.436; t=0.82, P=0.414) . One month after radiotherapy, the levels of serum cTnⅠ in the two groups were (0.09±0.03) ng/ml and (0.09±0.02) ng/ml, CK-MB were (0.29±0.09) U/L and (0.28±0.08) U/L, MYo were (4.06±1.08) μg/L and (4.01±1.03) μg/L, and BNP were (175.13±17.09) pg/ml, (172.47±16.28) pg/ml respectively, there were no statistically significant differences ( t<0.01, P>0.999; t=0.61, P=0.544; t=0.25, P=0.806; t=0.83, P=0.410) . The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) scores before radiotherapy in the study and the control groups were (60.24±5.13) points and (61.19±5.46) points, (74.12±7.20) points and (75.35±7.88) points at 1 month after radiotherapy, (77.53±7.14) points and (78.95±7.08) points at 6 months after radiotherapy, and (75.02±6.93) points and (76.68±6.74) points at 1 year after radiotherapy respectively, there were no statistically significant differences ( t=0.93, P=0.353; t=0.85, P=0.399; t=1.04, P=0.302; t=1.26, P=0.210) . The EORTC QLQ-C30 scores at 1 month, 6 months, and 1 year after radiotherapy were higher than those before radiotherapy in the two groups, and there were statistically significant differences (all P<0.001) . Conclusion:IMRT containing lymph node irradiation in the internal breast region after left breast cancer surgery brings a certain degree of increased cardiac dose, but it is feasible to control it within a certain range and does not affect the patients' cardiac function or quality of life in the short term.

Effect of pioglitazone on expression of p38 mitogen-activated protein kinase in myocardium of rats following I/R injury / 中华老年心脑血管病杂志

Objective To study the effect of pioglitazone,a member of the thiazolidinedione (TZD) class with hypoglycemic action to treat diabetes,on expression of p38 mitogen-activated protein kinase in myocardium of rats following I/R injury.Methods Twenty-four healthy SD rats were randomly divided into sham group,I/R injury group,pioglitazone treatment group and pioglitazone+peroxisome proliferator-activated receptors-γ specific antagonist GW9662 treatment group (6 in each group).A rat I/R injury model was established by ligating the left anterior descending coronary artery.Apoptosis of myocardial cells was assayed by Terminal dUTP deoxynucleotidyl transferase nick end labeling.Expression of p-p38 protein was detected by Western blot.Results The apoptosis index of myocardial cells was significantly lower in sham operation group and piogl itazone treatment group than in I/R injury group and was significantly higher in pioglitazone+ GW9662 treatment group than in pioglitazone treatment group (8.6％±4.3％,21.4％±8.8％ vs 40.1％±12.3％,P＜0.05;37.0％-10.5％ vs 21.4％±8.8％,P＜0.05).The expression level of p-p38 was significantly lower in sham operation group and pioglitazone treatment group than in I/R injury group and was significantly higher in pioglitazone+GW9662 treatment group than in pioglitazone treatment group (P＜0.05).Conclusion Pioglitazone can inhibit I/R injury-induced apoptosis of myocardial cells by downregulating the expression of p-p38 protein.

Radiosensitivity of berberine on hypoxia esophageal cancer cells / 中华放射医学与防护杂志

Objective To explore the radiosensitivity of berberine on esophageal cancer cells under hypoxia condition.Methods MTT assay and clonogenic survival assay were used to evaluate the effect of berberine on proliferation inhibition and radiosensitivity of esophageal cancer cells,respectively.Immunofluorescence was employed to examine the expression of HIF-1.The change of cell cycle distribution and cell apoptosis was assayed by flow cytometry.The expression of HIF-1 was measured by Western blot.DNA damage was detected by γ-H2AX Foci counting.Results With a clear dose and time effect,berberine inhibited cell proliferation and enhanced cell radiosensitivity(t =3.69,P＜0.05)with a sensitizing enhancement ratio(SER)of 1.42.Berberine caused a dose-dependent decrease in HIF-1 protein expression and also significantly increased the cell apoptosis in ECA-109 population(t=4.74,P＜0.05).Compared with the radiation alone group,berberine enhanced X-ray induced DNA double chain breaks(DSB).Conclusions Berberine can increase the radiosensitivity of esophageal cell line ECA-109,which may be associated with decrease of HIF-1 expression and induction of apoptosis in ECA-109 cells.

Relationship between N-terminal-pro-B-type Natriuretic Peptide and Left Ventricular Mass Index in Elderly Hypertension Patients / 中国康复理论与实践

@#Objective To investigate the N-terminal-pro-B-type natriuretic peptide (NT-proBNP) concentration in the difference myocardial wall motion after essential hypertension. Methods 326 patients with essential hypertension and normal heart function and 265 control subjects were measured with their NT-proBNP. According to Canau's categories, the ventricle geometries of patients with high left ventricular mass index were divided into 2 groups. Results NT-proBNP was significantly higher in patients with hypertension than in controls. After grouped by different myocardial wall motion, the patients with concentric hypertrophy were highest among all the groups; the groups with eccentric hypertrophy was secondly highest; concentric remodeling and normal geometric pattern were not significantly higher than the controls. Conclusion NT-proBNP is different in patients with different myocardial wall motion before heart failure, which may play an important role in myocardial remodeling.