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Tumor progression is closely related to tumor tissue metabolism and reshaping of the microenvironment. Oral squamous cell carcinoma (OSCC), a representative hypoxic tumor, has a heterogeneous internal metabolic environment. To clarify the relationship between different metabolic regions and the tumor immune microenvironment (TME) in OSCC, Single cell (SC) and spatial transcriptomics (ST) sequencing of OSCC tissues were performed. The proportion of TME in the ST data was obtained through SPOTlight deconvolution using SC and GSE103322 data. The metabolic activity of each spot was calculated using scMetabolism, and k-means clustering was used to classify all spots into hyper-, normal-, or hypometabolic regions. CD4T cell infiltration and TGF-β expression is higher in the hypermetabolic regions than in the others. Through CellPhoneDB and NicheNet cell-cell communication analysis, it was found that in the hypermetabolic region, fibroblasts can utilize the lactate produced by glycolysis of epithelial cells to transform into inflammatory cancer-associated fibroblasts (iCAFs), and the increased expression of HIF1A in iCAFs promotes the transcriptional expression of CXCL12. The secretion of CXCL12 recruits regulatory T cells (Tregs), leading to Treg infiltration and increased TGF-β secretion in the microenvironment and promotes the formation of a tumor immunosuppressive microenvironment. This study delineates the coordinate work axis of epithelial cells-iCAFs-Tregs in OSCC using SC, ST and TCGA bulk data, and highlights potential targets for therapy.
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Humans , Carcinoma, Squamous Cell/metabolism , Squamous Cell Carcinoma of Head and Neck , Mouth Neoplasms/metabolism , Immunosuppression Therapy , Transforming Growth Factor beta , Head and Neck Neoplasms , Gene Expression Profiling , Tumor MicroenvironmentABSTRACT
Experiential teaching is a practical, reflective, and situational teaching method. Based on the systematic review of literature published worldwide, this paper summarizes the characteristics and organizational forms of experiential teaching, with a focus on its current application and existing problems in teaching geriatric nursing. This review provides suggestions for the reform of teaching methods of geriatric nursing in China.
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Cancer cell membrane (CCM) derived nanotechnology functionalizes nanoparticles (NPs) to recognize homologous cells, exhibiting translational potential in accurate tumor therapy. However, these nanoplatforms are majorly generated from fixed cell lines and are typically evaluated in cell line-derived subcutaneous-xenografts (CDX), ignoring the tumor heterogeneity and differentiation from inter- and intra- individuals and microenvironments between heterotopic- and orthotopic-tumors, limiting the therapeutic efficiency of such nanoplatforms. Herein, various biomimetic nanoplatforms (CCM-modified gold@Carbon, i.e., Au@C-CCM) were fabricated by coating CCMs of head and neck squamous cell carcinoma (HNSCC) cell lines and patient-derived cells on the surface of Au@C NP. The generated Au@C-CCMs were evaluated on corresponding CDX, tongue orthotopic xenograft (TOX), immune-competent primary and distant tumor models, and patient-derived xenograft (PDX) models. The Au@C-CCM generates a photothermal conversion efficiency up to 44.2% for primary HNSCC therapy and induced immunotherapy to inhibit metastasis via photothermal therapy-induced immunogenic cell death. The homologous CCM endowed the nanoplatforms with optimal targeting properties for the highest therapeutic efficiency, far above those with mismatched CCMs, resulting in distinct tumor ablation and tumor growth inhibition in all four models. This work reinforces the feasibility of biomimetic NPs combining modular designed CMs and functional cores for customized treatment of HNSCC, can be further extended to other malignant tumors therapy.
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Animals , Humans , Squamous Cell Carcinoma of Head and Neck/therapy , Heterografts , Photothermal Therapy , Biomimetics , Disease Models, Animal , Head and Neck Neoplasms/therapy , Cell Line, Tumor , Tumor MicroenvironmentABSTRACT
【Objective】 To investigate the application value of three-dimensional printed guiding device in sacral neuromodulation in children. 【Methods】 A total of 17 patients admitted during Jan.2017 and Nov.2022 were divided into two groups: control group (n=8), using traditional method to locate sacral foramen for puncture; three-dimensional printed guiding device group (n=5), using three-dimensional printing technology to make individual guiding device for puncture. The clinical indexes of the two groups were evaluated, including puncture time, puncture numbers, intraoperative X-ray exposure times, postoperative evaluation time and second-stage conversion rate. The evaluation indexes of postoperative complications were wound bleeding, wound infection, wound rupture, electrode fracture, displacement or prolapse. 【Results】 In the control group, 1 case was diagnosed as bladder-bowel dysfunction, the remaining 7 were neurogenic bladder; in the three-dimensional printed guiding device group, all 9 cases were diagnosed as neurogenic bladder. The puncture time was shorter in the three-dimensional printed guiding device group than in the control group [85(70-90) min vs.138(133-208) min], the puncture numbers were fewer [15(12-20) vs.22(18-26)], and the X-ray exposure times were fewer [12(12-17) vs.19(16-23)] (all P<0.05). The initial stimulation voltage, postoperative evaluation time and second-stage conversion rate were not statistically significant. 【Conclusion】 Compared with the traditional method, the use of three-dimensional printed guiding device can reduce the puncture numbers and shorten the puncture time in the process of sacral neuromodulation in children.
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Objective:To investigate the influencing factors for inadequate bowel preparation of colonoscopy.Methods:A total of 677 patients who underwent colonoscopy at Peking Union Medical College Hospital from December 2021 to January 2023 were recruited, and all patients underwent standardized bowel preparation by using 3 L polyglycol electrolyte powder with fractional dose. The quality of bowel preparation was assessed by Boston bowel preparation scale, and the influencing factors for inadequate bowel preparation were analyzed by logistic regression analysis.Results:The rate of inadequate bowel preparation was 31.5% (213/677). Among the patients with inadequate bowel preparation, 85.4% (182/213) inadequate bowel preparation was only in proximal colon, 14.1% (30/213) was in both proximal and distal colon, and 0.5% (1/213) was only in distal colon. Inadequate bowel preparation in distal colon and total colon were combined into inadequate bowel preparation in distal colon. The results of logistic regression analysis showed that inadequate bowel preparation in proximal colon was more likely to occur in men ( P=0.001, OR=2.253, 95% CI: 1.399-3.629), outpatients ( P<0.001, OR=4.175, 95% CI: 2.410-7.231), those with no family history of colorectal cancer ( P=0.001, OR=2.117, 95% CI: 1.365-3.284), and diagnostic colonoscopy ( P=0.003, OR=1.978, 95% CI: 1.261-3.102). And spinal disease ( P=0.044, OR=7.430, 95% CI: 1.051-52.511), outpatients ( P<0.001, OR=135.577, 95% CI: 29.135-630.883),non-compliance of dietary requirements ( P=0.006, OR=4.772, 95% CI: 1.576-14.453), adverse reaction during bowel preparation ( P=0.015, OR=4.341, 95% CI: 1.329-14.179), no family history of colorectal cancer ( P=0.003, OR=7.110, 95% CI: 1.912-26.438), and poor last stool character ( P=0.001, OR=25.922, 95% CI: 3.779-177.832) were risk factors for inadequate bowel preparation in distal colon. Conclusions:The inadequate bowel preparation of colonoscopy mainly occurs in proximal colon, and the risk factors for the inadequate bowel preparation vary in different colonic segments. Therefore, the specific interventions should be performed according to the character of different colon segments to improve the quality of bowel preparation.
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Objective:To study the efficacy, feasibility and safety of transjugular intrahepatic portosystemic shunt (TIPS) in treatment of recurrent portal hypertension after splenectomy and devascularization in patients presenting with upper gastrointestinal bleeding.Methods:Cirrhotic patients with recurrent portal hypertension after splenectomy and devascularization and presenting with upper gastrointestinal bleeding from August 2015 to December 2020 were studied. Thirty-nine patients were included in this study. There were 24 males and 15 females, with age of (51.56±9.08) years old. These patients were treated with TIPS by using the Viabahn stent. Intraoperative portal vein pressure, success operative rate, hemostasis rate after surgery, changes in hematological indicators and postoperative efficacy and complication rate were studied.Results:Thirty-eight of 39 patients successfully underwent TIPS shunt and 1 patient failed because of portal vein spongiosis. The success rate was 97.44%(38/39). Thirty-three patients underwent TIPS and variceal vein embolization, while 5 patients were treated with TIPS alone. Thirty-nine Viabahn stents with a diameter of 8 mm were implanted in 38 patients, of which 5 patients had the stent expanded to its nominal diameter of 8 mm. The remaining 33 patients (86.84%) had a shunt with a diameter of 6 mm. The hemostasis rate of postoperative gastrointestinal bleeding was 97.37% (37/38). The portal vein pressure and portal venous pressure gradient decreased from (31.28±6.24), (20.61±5.14) mmHg (1 mmHg=0.133 kPa) to (19.58±4.69), (9.24±3.07) mmHg respectively, the differences were significant (all P<0.001). All patients were followed-up for 3 to 36 months, with a median follow-up of 12 months. The postoperative rebleeding rate was 6.90% (2/29). The incidence of hepatic encephalopathy was 13.79% (4/29), and the incidence of shunt disorder was 13.79% (4/29). Conclusion:TIPS was safe, effective and feasible in treating patients with recurrent portal hypertension after splenectomy and devascularization presenting with upper gastrointestinal bleeding. Most patients obtained good clinical outcomes with a 6 mm diameter shunt.
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Supermicrosurgery is a hot topic in the field of microsurgery and reconstruction. The core concept of supermicrosurgery is precision and minimally invasive, which coincides with the concept of maxillofacial reconstruction. Oral and maxillofacial regions play an important role in aesthetics and function, and the structure of oral and maxillofacial tissues is complex. Various types of flaps, especially vascularised free flaps, are required for the repair of various complex maxillofacial defects. However, at present, conventional microsurgery does meet the requirement of mandibular reconstruction in special cases. Super microsurgical technique can further supplement the deficiency of conventional methods of repair and reconstruction in maxillofacial reconstruction. Under the guidance, many new methods of maxillofacial surgery have inevitably emerged. The application of supermicrosurgery in maxillofacial head and neck is still in its early stage, and there are still many difficulties to overcome and many technical issues to be furtherresolved. Supermicrosurgery is not only an advanced technique, but also an advanced concept in surgery. Supermicrosurgery is expected to show its clinical value in oral and maxillofacial reconstruction. In this paper, the application of supermicrosurgery in maxillofacial reconstruction is reviewed and its application prospect is prospected.
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Objective:To evaluate the potential effects of serum lipid levels, appendicular skeletal muscle mass index (ASMI) and body mass index (BMI), together with its dynamic changes, on tumor progression in renal clear cell carcinoma patients, so as to inform body weight management.Methods:This prospective cohort study included a total of 100 patients with high-risk clear cell renal cell carcinoma. Serum lipid levels were detected, ASMI and BMI were measured using bioelectrical impedance analysis and the dynamic changes of BMI were tracked. The effects of BMI, ASMI and serum lipid levels on tumor progression within 2 years were explored.Results:Patients with normal BMI and low ASMI had 5.248 (95% CI: 1.946 to 14.153, P = 0.001) times higher risk of tumor progression than those who were overweight or obese. For every 0.1-unit increase in pre-operative HDL-C, the risk of tumor progression decreased by 0.771 (95% CI: 0.631 to 0.942, P = 0.011) times. Patients who experienced more than 5% decrease in BMI compared with baseline had 5.165 (95% CI: 1.735 to 15.370, P = 0.003) times the progression risk of patients whose BMI changed within ±5% from baseline. Conclusions:The advantage of obese clear cell carcinoma patients over normal-weight patients in tumor progression-free survival may be influenced by ASMI, pre-onset involuntary weight loss and lipid levels. Therefore, patient weight management should not merely focus on absolute BMI but tailor to individual characteristics, including cancer stage, body composition and metabolic status.
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Podoplanin (PDPN) is a small transmembrane mucin-like glycoprotein which is expressed on the surface of lymphatic endothelial cells, glomerular podocytes, type-Ⅰ alveolar epithelial cells and some tumor cells. PDPN plays crucial function in variety of physiological and pathological processes such as embryonic development, immunoreaction, inflammation and cancer. C-type lectin-like receptor 2 (CLEC2) is mainly expressed on the platelet which specific ligand is PDPN. The interaction between PDPN and CLEC2 has received extensive attention. In this review, we summarized recent researches on the role of in sepsis and elaborated the possible mechanisms and some potential therapies for sepsis by targeting PDPN, which may provide theoretical basis for the mechanism and treatment of sepsis.
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Objective:To investigate the effects of nurse-led interRAI-based multidisciplinary team management on body composition and metabolic parameters among elderly patients with metabolic syndrome.Methods:100 elderly patients aged 60-74 with the diagnosis of metabolic syndrome were randomized into control group ( n=50) and study group ( n=50). The control group was followed up after routine physical examination. Based on interRAI assessment, the study group received nurse-led individualized intervention which integrated management regarding geriatric internal medicine, clinical nutrition, psychology and physical rehabilitation. This 12-week study measured body composition indexes body protein, body fat mass (BFM), skeletal muscle mass (SMM), body mass index (BMI), waist-to-hip ratio (WHR) and biochemical indexes [triglycerides (TG), high density lipoprotein cholesterol (HDL-C) and glycosylated hemoglobin (HbA1c)] on the first day and 12 weeks after enrollment and compared those parameters between the two groups. Results:After 12 weeks of intervention, compared with the control group, the study group showed significantly increased body protein [(10.48±2.02) kg vs (9.72±1.65) kg, P=0.043], SMM [(29.61±6.07) kg vs (27.36±4.96) kg, P=0.046], BFM [(17.86±3.42) kg vs (19.64±5.07)kg, P=0.042], WHR (0.88±0.05 vs 0.89±0.03, P=0.021) and TG [(2.31±0.42) mmol/L vs (2.95±0.52) mmol/L, P=0.014]. There was no significant difference in BMI [(25.06±3.41) kg/m 2vs (24.40±2.48) kg/m 2, P=0.272], HDL-C [(0.94±0.10) mmol/L vs (0.91±0.31) mmol/L, P=0.246] and HbA1c [(6.11±0.51)% vs (6.37±0.42)%, P=0.185]. After 12 weeks of intervention, body fat [(17.86±3.42) kg vs (20.71±5.98) kg, P=0.004], WHR (0.88±0.05 vs 0.91±0.05, P=0.001), TG [(2.30±0.42)mmol/L vs (2.75±0.37) mmol/L, P=0.032] and HbA1c [(6.11±0.51) mmol/L vs (6.35±0.63) mmol/L, P=0.015] in the study group were significantly lower compared with baseline and there was no difference in those parameters at baseline and 12 weeks after enrollment in the control group. Conclusion:The nurse-led multidisciplinary management model based on interRAI assessment can effectively improve the body composition and certain metabolic indexes of the elderly with metabolic syndrome.
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Radiotherapy (RT) is one of the three prevailing therapeutics for tumors. With rapid development of immunotherapy (IM), the combination of IM and RT has gainned increasingly widespread attention. Cytotoxic T lymphocyte associated protein-4(CTLA-4) inhibitor is an important checkpoint target in immune activation and regulation, which exerts significant anti-tumor effects in melanoma and non-small cell lung cancer, etc. Accordingly, the combination of RT and anti-CTLA-4 antibody has become a hot spot. This article reviews research progress on pre-clinical and clinical evidences of RT combined with anti-CTLA-4 antibody, which provides evidence for further exploration in this field.
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Objective@#To investigate the therapeutic effect of free superficial circumflex iliac artery perforator (SCIP)flap for reconstruction of soft tissue defects secondary to resection of retromolar and lateral buccal squamous cell carcinoma.@*Methods@#From January 2014 to January 2017, eight patients with retromolar and lateral buccal squamous cell carcinoma received radical resection and reconstructed with SCIP flap immediately. CTA and color Doppler sonography were routinely performed before the surgery. According to the size of the defect in the recipient area, the flap vascularized by the perforator vessel was carefully prepared and transferred to the buccal-pharynx-palate composite defect. The recipient area and donor area were sutured tightly after arteriovenous anastomosis under microscope. The survival and functional recovery of the flap were observed after operation.@*Results@#The flap sizes ranged from 5 cm× 6 cm to 7 cm×9 cm.The mean diameter of the superficial circumflex iliac arteries was 0.65 mm. And the mean diameter of the veins was 1.2 mm. The mean arterial pedicle length was 7.0 cm, and the venous pedicle length was 8.0 cm. Eight flaps were all survived. The shape of the buccal-parapharyngeal-palate was good and the mouth opening was normal after operation.@*Conclusions@#Superficial circumflex iliac artery perforator flap was a good choice for repairing the defect of parapharyngeal squamous cell carcinoma in the posterior molar region.
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Objective: To explore the correlation between standard remnant liver volume(SRLV) and post-hepatectomy liver failure (PHLF)in patients with hepatocellular carcinoma(HCC)and cirrhotic livers.Methods:In total,181 patients who underwent hemihepa-tectomy in Affiliated Tumor Hospital of Guangxi Medical University from September 2013 to August 2016 were enrolled in the study. Total liver,tumor,remnant liver,and resected liver volumes were measured using the Myrian liver surgical planning system before sur-gery. Intraoperative resected liver volume (including resected normal liver and tumor volumes) were collected using the drainage method.The patients were divided into the PHLF(22 cases)and non-PHLF groups(159 cases)according to whether PHLF occurred based on the"50/50"criteria.The risk factors of PHLF were then explored.The cut-off of SRLV and efficiency of predicting PHLF were analyzed in the subgroup of patients with cirrhotic livers.The grade of liver cirrhosis was retrospectively analyzed using helical comput-ed tomography(CT).Results:Twenty-two of the 181 patients developed PHLF and one died of it.Preoperative total bilirubin levels and SRLV were identified as independent factors for predicting PHLF using a Logistic regression model.In total,102 patients with cirrhotic livers were selected in subgroup analysis based on postoperative cirrhotic pathology.Eighteen patients developed PHLF and one died of PHLF in the subgroup.Using receiver-operating characteristic(ROC)curve analysis,340 mL/m2was the cut-off of SRLV for patients with HCC and cirrhotic livers(area under the curve:0.861,P<0.01;sensitivity and specialty rates were 94.4% and 74.7%,respectively). Eighty-four cases were of grade Ⅰ or Ⅱ cirrhosis,18 cases were of grade Ⅲ cirrhosis,and there were no cases of grade Ⅳ cirrhosis based on retrospective analysis using helical CT.Conclusions:Patients with cirrhotic livers with an anticipated SRLV of≤340 Ml/m2after he-patic resection are at increased risk for PHLF after emihepatectomy.
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Objective To observe the value of endovascular treatment of portal vein stenosis (PVS) after pediatric liver transplantation for biliary artesia.Methods The data of 14 children with PVS after liver transplantation for biliary atresia were retrospectively evaluated.All children were confirmed by portal vein angiography,and were treated with 1-2 times of percutaneous transluminal angioplasty with or without percutaneous transluminal stent angioplasty.The effect of endovascular interventional therapy in 14 children was analyzed.Results A total of 14 children received 23 times of endovascular interventional therapy.The technical success rate of the first treatment was 82.61％ (19/23).Ten children were treated with balloon dilatation,and stent angioplasty was performed in 4 children after balloon dilatation.These stents were not narrowed after implantation.There were no complications related to treatment in 14 cases.Conclusion Endovascular treatment for PVS after liver transplantation for biliary atresia is safe and effective.
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Objective To improve the quality of clinical biochemistry laboratory by quality indicators of pre-analytical,analytical,post-analytical phase and the whole process.Methods Analytical Phase:The Sigma values of items were calculated,applying the equation Sigma =(TEa％-Bias％)/CV％.Total allowable error (TEa) is from analyticalal specification defined in WS/T403-2012 of China,Bias％ is from the evaluation results of National Center for Clinical Laboratory (NCCL) trueness verification PT series and CV％ is from internal quality control data during the last 6 months in our lab.Normalized Sigma metrics plot was made to evaluate the analysis performance and the quality control strategies were designed accordingly.The quality goal indexes (QGI) were also calculated to propose improvement measures for items below 6 Sigma.Quality indicators of pre-,post-analytical and whole analytical phase,such as quality of specimen,critical value notification,critical value notification in time,TAT of hs-cTnT,TAT of emergency biochemical items,rewrite of laboratory reports and unacceptable performance in EQA-PT were measured in Sigma metrics too.The Sigma metrics changes before and after taking improvement measures were compared to conform the effectiveness.Results The average Sigma value of 17 biochemical tests was 5.29,of which 8 items (UA,K,ALP,CK,AMY,AST,TG,Na) achieved excellent to world class level (≥ 5 Sigma),6 items (LDH,Cre,TC,ALT,Mg,Glu) achieved marginal to good level (5 ＞ Sigma ≥ 3),BUN performed poorly (3 ＞ Sigma ≥ 2),Ca,TP performed unacceptably (Sigma ＜ 2) with serious quality defects.The Sigma values of unacceptable specimen,critical value notification,critical value notification in time,unacceptable turn around time (TAT) of hs-cTnT,unacceptable turn around time (TAT) of emergency biochemical items,rewrite of laboratory reports,unacceptable performance in EQA-PT were 4.17,3.60,2.75,1.72,3.27,4.52,3.33 respectively,rising to 4.30,4.30,2.90,2.45,3.75,4.80,3.60 accordingly after improvement.Conclusions Sigma metrics is potentially an ideal approach for clinical biochemistry laboratories management,which is helpful to find out problems,put forward improvement measures,and confirm the effectiveness,so as to achieve the purpose of continuous quality improvement.
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Objective To evaluate the value of percutaneous transhepatic angioplasty in treatment of portal vein stenosis (PVS) after pediatric liver transplantation.Methods The data of 8 pediatric patients with PVS after liver transplantation were retrospectively evaluated.All cases were confirmed by portal vein angiography,and were treated with percutaneous transluminal angioplasty and/or percutaneous transluminal stent angioplasty.The effect of endovascular interventional therapy in 8 cases was analyzed.Results A total of 12 times of 8 patients received endovascular interventional therapy.The success rate was 66.67％ (8/12).The clinical success rate of the first treatment was 62.50％ (5/8).Three cases were treated with balloon dilation after the first balloon dilation,and there was no recurrence of PVS after operation in 2 cases.After the treatment of balloon dilation,stent angioplasty was performed in 1 case.There were no complications related to treatment in 8 cases.Conclusion Endovascular interventional treatment is a safe and effective way for PVS after pediatric liver transplantation.
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Objective To study CT-guided localization of additional pulmonary nodules with microcoils prior to video-assisted thoracoscopic surgery (VATS) resection in patients with suspected lung cancer.Methods Eleven patients suspected lung cancer underwent preoperative microcoils localization towards additional small pulmonary nodules.The head of microcoil was pinpointed adjacent to the target nodule while its end tail remained above the visceral pleura.VATS were performed within 24 hours, and comprehensive assessments were conducted according to surgical and pathological outcomes of primary and additional lesions, and suitable surgical processes were followed.Results All 11 localizing pulmonary nodules (4-15 mm in diameter) were successfully removed after VATS, 9 microcoils'' end tails of which were placed above visceral pleural surface.There were no serious complications related with localizing procedure.Other 16 lesions including 11 primary ones were resected.The surgical and pathological outcomes for lung lesions were utterly assessed.Conclusion Microcoil preoperative localization provides helpful orientation for complete resection and assessment of multiple pulmonary lesions in patients with suspected lung cancer.
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Hepatic venous outflow obstruction is a vascular complication after pediatric liver transplantation.Endovascular treatment has become the first therapeutic option for hepatic venous outflow obstruction after pediatric liver transplantation.The progresses in endovascular treatment of hepatic venous outflow obstruction after pediatric liver transplantation were reviewed in this article.
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Solitary fibrous tumor (SFT) is a rare spindle cell neoplasm that usually develops in the pleura and peritoneum. The head and the neck region is involved in only 6% of the cases. We described a rare case of large SFT originated from the right neck region in a 32-year-old man. Enhanced CT scan revealed two large completely resected masses in the carotid sheath region and the right thyroid gland. Immunohistochemical studies showed positive CD34, CD99, NSE and bcl-2, and negative Desmin, NF, S-100, CD31, F8, CK, MBP, indicating that the tumor was benign. It showed no evidence of recurrence on the patient during 9 years follow-up.
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Adult , Humans , Male , Head and Neck Neoplasms , Diagnosis , Solitary Fibrous Tumors , Diagnosis , Tomography, X-Ray ComputedABSTRACT
Objective To research the effect of radiosurgery in combination of temozolomide therapy in vitro on invasion and endocrine function of rat pituitary adenoma cells.Methods Rat pituitary adenoma cell lines GH3 and MMQ were divided into control group,10 Gy irradiation group,20 Gy irradiation group,temozolomide treatment group,and radiosurgery in combination of temozolomide group;cells without exposure were used as control group,cells treated with gamma knife radiation respectively with marginal doses of 10 and 20 Gy (all to the 99％ isodose line) were used as 10 Gy irradiation group and 20 Gy irradiation group,cells treated with 250 μmol/L and 615 μmol/L temozolomide for 24 h after 20 Gy radiation were used as radiosurgery in combination of temozolomide group,and cells treated with 250 μmol/L and 615 μmol/L temozolomide for 24 h were used as temozolomide treatment group.Real time-PCR and Western blotting were employed to measure the mRNA and protein expressions of matrix metalloproteinase (MMP)-9 and vascular endothelial growth factor (VEGF);and secretion of prolactin (PRL) and growth hormone (GH) was detected by ELISA.Results As compared with the control group,the 10 Gy irradiation group and 20 Gy irradiation group had significantly lower mRNA and protein expressions of MMP-9 and VEGF,and secretion of PRL and GH (P＜0.05);and these levels in the 20 Gy irradiation group were significantly lower than those in the 10 Gy irradiation group (P＜0.05);As compared with the 10 Gy irradiation group,20 Gy irradiation group,and temozolomide treatment group,the radiosurgery in combination of temozolomide group had significantly lower mRNA and protein expressions of MMP-9 and VEGF,and secretion of PRL and GH (P＜0.05) Conclusion Gamma knife radiosurgery combined temozolomide could significantly inhibit the invasive ability and endocrine function of rat pituitary adenoma cell lines GH3 and MMQ,which has better effect than radiotherapy or temozolomide treatment alone.