ABSTRACT
Objective:To explore the effects of bladder volumes from CT simulation on bladder volume consistency and set-up errors during radiotherapy for prostate cancer, aiming to provide a reference for clinical practice.Methods:A retrospective analysis was conducted for of 66 prostate cancer patients treated with intensity-modulated radiation therapy in the Sun Yat-sen University Cancer Center from August 2015 to November 2020. They underwent CT scan or radiotherapy after voluntarily holding in urine. Cone beam computed tomography (CBCT) scans were performed for them to measure their set-up errors in left-right (L-R), superior-inferior (S-I), and anterior-posterior (A-P) directions before each treatment. The bladder contours of the patients were delineated on CT simulation images and CBCT images. Accordingly, bladder volumes were calculated. Based on the calculated bladder volumes derived from the CT simulation images, the patients were divided into three groups: 18 cases in the 200-300 ml group, 24 cases in the 300-400 ml group, and 24 cases in the >400 ml group. Finally, this study analyzed the effects of bladder volumes derived from CT simulation on set-up errors and the changes of CBCT-derived bladder volumes relative to planned volumes during radiotherapy.Results:The bladder volumes in the 200-300 ml, 300-400 ml, and >400 ml groups during radiotherapy were reduced by 15%, 26%, and 32%, respectively. The pairwise comparison indicates statistically significant differences in the changes of bladder volumes among the three groups ( Z=3.43, 7.97, 4.83, P<0.05). Regarding the three-dimensional set-up errors, there were statistically significant differences in S-I set-up errors among the three groups ( H=26.72, P<0.05), but there was no statistically significant difference in L-R and A-P set-up errors ( P>0.05) among these groups. The 200-300 ml, 300-400 ml, and >400 ml groups exhibited S-I set-up errors of 0.00 (-0.20, 0.20) cm, 0.00 (-0.20, 0.30) cm, and -0.10 (-0.30, 0.20) cm, respectively. Therefore, the >400 ml group displayed larger the S-I set-up errors than other two groups, with statistically significant differences ( Z=4.17, 4.66, P< 0.05), while there was no statistically significant differences in S-I set-up errors between other two groups ( P> 0.05). Conclusions:Controlling the bladder filling volumes at 200-300 ml in CT simulation is beneficial for maintaining bladder volume consistency and reducing set-up errors of patients during radiotherapy.
ABSTRACT
Objective To investigate the mechanism of pioglitazone preventing diabetes and the role of nuclear factor of actived T cells (NFAT) on non-obese diabetic(NOD) mice .Methods (1)Female NOD mice at 4 weeks of age were randomly divided into pioglitazone group(n=21) and control group(n=21) .The accumulative diabetes incidence was followed-up to 30 weeks of age in each group of NOD mice .(2)Pancreas were removed from NOD mice at 12 weeks of age in each group(n=15) to score insulitis se-verity by routine HE staining .IL-4 ,IFN-γand peroxisome proliferator-activated receptor γ(PPARγ) mRNA levels in spleens were tested by RT-PCR .IL-4 and IFN-γlevels in sera ,the activity of PPARγand NFATc1 nuclear protein in spleens were measured by enzyme linked immunosorbent assay (ELISA) .Results (1) At 15 weeks of age ,the diabetes incidence was 4 .76% in pioglitazone group ,and 33 .33% in control group(P0 .05) .(2) At 12 weeks of age ,the insulitis score in pioglitazone group was lower than that in control group[(1 .79 ± 0 .75) vs .(2 .38 ± 0 .66) ,P<0 .05] .(3) IFN-γ mRNA level in pioglitazone group was lower than that in control group[(0 .16 ± 0 .07) vs .(0 .53 ± 0 .26) ,P<0 .05] ,and PPARγmRNA level in pioglitazone group was higher than that in control group(0 .91 vs .0 .25 ,P<0 .05) .(4)IFN-γ level in pioglitazone group was lower than that in control group [(561 .05 ± 78 .61)pg/mL vs .(666 .43 ± 28 .42)pg/mL ,P<0 .05] .(5)At 12 weeks of age ,the spleen PPARγnuclear protein activity in pioglitazone group was higher than that in control group [(0 .05 ± 0 .01) vs .(0 .02 ± 0 .01) ,P<0 .05)] ,and NFATc1 nuclear protein activity was low-er than that in control group[(0 .23 ± 0 .04) vs .(0 .33 ± 0 .04) ,P<0 .05] .Conclusion Pioglitazone could activate PPARγ nuclear protein ,inhibit activity of NFATc1 nuclear protein ,downregulate IFN-γ,diminish Th cells deviating to Th1 ,and sequently prevents insulitis and diabetes onset in NOD mice .
ABSTRACT
Objective To investigate the mechanism of preventing islet β-cell apoptosis in NOD mice with pioglitazone.Methods Female NOD mice at 4 weeks of age were divided into pioglitazone group ( n =21,0.02％pioglitazone was added into the feed ) and control group ( n =21,fed with regular diet).The accumulative incidence of diabetes was followed-up to 52 weeks of age in each group of NOD mice.Pancreas was removed from NOD mice at 12 weeks of age in each group ( n =15 ) to score severity of insulitis by routine H-E staining.The apoptotic β-cells in islets were observed with double-labeling technique of TUNEL in situ combined with standard sensitive avidin-biotin complex (sABC) immunohistochemical method.The spleens were taken for cell culture; IL-4 and IFN-γ levels in sera and supernatants of cultured splenocyte,the activity of PPARγ and NF-κB nuclear proteins in cultured splenocyte were measured by ELISA.Results (1)At 30 and 52 weeks of age,the respective incidences of diabetes were 57.1％ and 76.2％ in pioglitazone group,and 76.2％ and 90.5％ in control group ( all P＞0.05 ).At 15 weeks of age,the incidence became 4.8％ in pioglitazone group,and 33.3 ％ in control group ( P =0.045 ).( 2 ) At 12 weeks of age,the percentages of non infiltrated islet and peri-insulitis islet in pioglitazone group were higher than those in control group ( 14.73％ vs 5.69％,P＜0.01 ; and 26.02％ vs 15.72％,P＜0.01 ),and that of intraislet insulitis was lower than that in control group ( 59.25％ vs 78.59％,P＜0.01 ).The percentage of apoptotic β-cell in pioglitazone group was lower than that in control group( 6.17％ ±3.62％ vs 10.62％ ±4.43％,P=0.008 ).(3) In sera,IFN-γ level in pioglitazone group was lower than that in control group [( 561.05±78.61 ) vs ( 666.43 ± 28.42 ) pg/ml,P =0.045].In cultured splenocyte supernatant,the level of IFN-γ in pioglitazone group was lower than that in control group[(605.84+65.60) vs (692.20+44.98) pg/ml,P=0.041].(4) In cultured splenocyte,PPARγ nuclear protein activity in pioglitazone group was higher than that in control group ( 0.06 ± 0.01 vs 0.03 ± 0.01,P =0.013 ),and NF-κB nuclear protein activity was lower than that in control group ( 0.03 ± 0.01 vs 0.08± 0.01,P =0.001 ).Conclusions Pioglitazone activates PPARγ nuclear protein,inhibits activity of NF-κB nuclear protein,downregulates IFN-γ,diminishes differeutiation of Th cells to Th1,and subsequently prevents insulitis and β-cell apoptosis in NOD mice.