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Objective:To investigate the effectiveness, safety, and advantages of modified radical neck dissection by gasless unilateral axillary approach (GUA-MRND) in the surgical management of selected patients with papillary thyroid cancer.Methods:We retrospectively analyzed patients with papillary thyroid cancer who underwent GUA-MRND (endoscopic group, n=16) versus unilateral open modified radical neck dissection (MRND) (open group, n=32) during the period from Jan. 2019 to Jun. 2021, including the differences in surgical efficiency, complication rate, and incisional satisfaction.Results:Compared MRND with GUA-MRND, the patients were younger ( P<0.05) , operative time and postoperative drainage anterior ( P<0.01) were slightly inferior in the latter, but it had obvious advantages in cervical swallowing discomfort and incision satisfaction evaluation ( P<0.05) . There was no significant difference in the incidence of temporary recurrent laryngeal nerve injury, intraoperative and postoperative bleeding, hematoma, infection, lymphatic or chylous leakage and supraclavicular numbness after surgery ( P>0.05) . The number of dissected lymph nodes in area II in the GUA-MRND was lower ( P<0.05) , but it was significantly higher ( P<0.01) in area III. And the average regional cleaning efficiency in the GUA-MRND was level Ⅲ (35.5%) , level Ⅵ (28.59%) , level Ⅳ (23.21%) , level Ⅱ (7.18%) and level Ⅴ (7.12%) , suggested that GUA-MRND had higher efficacy for level III, level Ⅵ and Level IV. Conclusion:GUA-MRND is safe, effective, and has high cosmetic satisfaction in the treatment of selected patients with lateral cervical lymph node metastases from papillary thyroid cancer.
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Radiation enteritis is a kind of intestinal radiation injury in patients with pelvic and retroperitoneal malignancies after radiotherapy, and its occurrence and development process are very complicated. At present, studies have confirmed that intestinal microecological imbalance is an important factor in the formation of this disease. Abdominal radiation causes changes in the composition of the flora and a decrease in its diversity, which is mainly manifested by a decrease in beneficial bacterial species such as Lactobacilli and Bifidobacteria. Intestinal dysbacteriosis aggravates radiation enteritis, weakens the function of the intestinal epithelial barrier, and promotes the expression of inflammatory factors, thereby aggravating the occurrence of enteritis. Given the role of the microbiome in radiation enteritis, we suggest that the gut microbiota may be a potential biomarker for the disease. Treatment methods such as probiotics, antibiotics, and fecal microbiota transplantation are ways to correct the microbiota and may be an effective way to prevent and treat radiation enteritis. Based on a review of the relevant literature, this paper reviews the mechanism and treatment of intestinal microbes in radiation enteritis.
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Purpose@#To analyze the gene mutation, immune infiltration and tumor growth of primary tumor and distant tumor under different treatment modes. @*Materials and Methods@#Twenty B16 murine melanoma cells were injected subcutaneously into the of both sides of the thigh, simulating a primary tumor and a secondary tumor impacted by the abscopal effect, respectively. They were divided into blank control group, immunotherapy group, radiotherapy group, and radiotherapy combined immunotherapy group. During this period, tumor volume was measured, and RNA sequencing was performed on tumor samples after the test. R software was used to analyze differentially expressed genes, functional enrichment, and immune infiltration. @*Results@#We found that any treatment mode could cause changes in differentially expressed genes, especially the combination treatment. The different therapeutic effects might be caused by gene expression. In addition, the proportions of infiltrating immune cells in the irradiated and abscopal tumors were different. In the combination treatment group, T-cell infiltration in the irradiated site was the most obvious. In the immunotherapy group, CD8+ T-cell infiltration in the abscopal tumor site was obvious, but immunotherapy alone might have a poor prognosis. Whether the irradiated or abscopal tumor was evaluated, radiotherapy combined with anti-programmed cell death protein 1 (anti-PD-1) therapy produced the most obvious tumor control and might have a positive impact on prognosis. @*Conclusion@#Combination therapy not only improves the immune microenvironment but may also have a positive impact on prognosis.
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Objective:To analyze the prognostic factors of patients with Ⅰ B1-Ⅱ A cervical cancers after surgery and to assess the effects and adverse reactions of intensity-modulated radiotherapy(IMRT)combined with concurrent chemotherapy(CCRT). Methods:A retrospective analysis was performed based on the clinical and follow-up data of 362 patients with Ⅰ B1-Ⅱ A cervical cancers who were treated in Changzhou Second People′s Hospital from January 2009 to December 2019. Meanwhile, these patients suffered large primary tumors(LPT; tumors size: ≥4 cm), lymphatic vascular space invasion (LVSI), and deep stromal invasion(DSI; stromal infiltration depth: ≥1/2) after surgery and showed at least one intermediate-risk factor. Among these cases, 161 cases were treated with CCRT, 131 cases under-went single radiotherapy (RT), and 70 cases received unadjuvanted radiotherapy. The Kaplan-Meier method and the logrank test were adopted for univariate survival analysis, the binary logistic regression was used to analyze the recurrence risk, and Cox regression model was used for multivariate survival analysis. Results:The 3 and 5-year overall survival (OS) rates were 94.20% and 88.39%, respectively. The retrospective analysis showed that the risk factors of recurrence included tumor size ≥ 4 cm and poorly differentiated cancers( OR=3.287, 2.870, 95% CI: 1.366-7.905, 1.105-7.457, P<0.05). Compared with the treatment without adjuvant radiotherapy and RT, CCRT reduced the recurrence rate of tumors with tumor size of ≥ 4 cm, adenocarcinomas or adenosquamous carcinomas (pathological types), and poorly differentiated carcinomas( χ2=6.725-7.518, P<0.05). A multivariate analysis showed that the CCRT improved the recurrence-free survival ( HR=0.290, 95% CI: 0.128-0.659, P=0.003) and OS ( HR=0.370, 95% CI: 0.156-0.895, P=0.024). A subgroup analysis indicated that CCRT prolonged the OS of patients with tumor size ≥ 4 cm or poorly differentiated cancers compared to the patients receiving no radiotherapy or those treated with RT (χ 2=7.614, 5.964, P<0.05). Compared with the cases receiving single radiotherapy, those receiving CCRT did not suffer an increase in the incidence of hematology, radiation enteritis, and cystitis above grade 3 according to observation ( P>0.05). Conclusions:Among the intermediate-risk factors leading to the recurrence of postoperative cervical cancers, the factors of large primary tumors or poorly differentiated cancers affect the prognosis of patients.Compared with RT and the treatment without adjuvant radiotherapy, IMRT combined with concurrent chemotherapy can prolong the recurrence-free survival and overall survival of patients with large tumors or poorly differentiated cancers and adverse reactions induced are tolerable.
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Objective:To validate the effect of TUT4 on the radiosensitivity of esophageal epithelial cells (HEEC) by regulating the uridylation of miR132/212 clusters.Methods:The expression of TUT4 in HEEC at 0, 6, 18, 24 and 48 h after 0, 2, 4, 6 and 8 Gy X-ray irradiation was detected by PCR. The HEEC cells were divided into four groups: NC group, shTUT4 group, 6 Gy group, and 6 Gy+ shTUT4 group. The effects of TUT4 on cell radiosensitivity, cell proliferation, cell cycle, mitochondrial damage, and oxygen free radical production were detected respectively. The effect of down-regulated TUT4 expression on miR132/212 uridylation was detected by RT-PCR, and the radiosensitivity of HEEC with overexpression of miR132/212 or miR132/212+ UUU was detected by clone formation and proliferation assay, respectively. Proliferation assay was performed to detect the proliferation of HEEC when TUT4 expression was down-regulated and miR132/212 or miR132/212+ UUU was overexpressed.Results:TUT4 expression increased after different doses of X-ray irradiation ( t=12.84, 62.06, 27.86, 32.43, P<0.05). Downregulation of TUT4 expression increased the radiosensitivity of HEEC ( t=13.2, 5.85, 7.31, P<0.05) with a SER D0of 1.41 and D0=0.79, Dq=1.61, SF2=0.47. Compared with 6 Gy group, cell proliferation in 6 Gy+ shTUT4 group was decreased ( t=7.12, 13.63, P<0.05), cells in S phase were increased ( t=11.98, P<0.05), mitochondrial damage was increased ( t=11.98, P<0.05), and ROS level was increased ( t=15.65, P<0.05). Down-regulation of TUT4 expression increased miR132/212 expression and decreased miR132/212+ UUU expression ( t=27.90, 60.99, P<0.05). Overexpression of miR132/212 increased the radiosensitivity of HEEC, and overexpression of miR132/212+ UUU decreased the radiosensitivity of HEEC, with SER D0 of 1.20 and 0.71, respectively. Cell proliferation of shTUT4 + miR132/212 group waslower than that of shTUT4 group( t=4.76, 7.65, P<0.05), and cell proliferation of shTUT4 + miR132/212+ UUU group was higher than that of shTUT4 ( t=7.22, P<0.05). Conclusions:X-ray irradiation increased the expression of TUT4 in HEEC, and the down-regulation of TUT4 reduced HEEC radiosensitivity and radiation damage, where the uridylation of miR132/212 was involved in.
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Hemophagocytic syndrome (HPS) is a rare, life-threatening inflammatory response syndrome characterized by overactivation of the immune system, which leads to organ damage. Secondary HPS is usually triggered by infection, tumor and autoimmune disease. It has been clinically found that many HPS-like manifestations also occur during drug therapy. This article reviews the related progress of HPS induced by immune checkpoint inhibitors, ibrutinib and lamotrigine, in order to provide a guidance for clinical practice.
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OBJECTIVE：To develop a method for simultaneous determination of 5 components in classical formula Huaihua san，including rutin ，naringin，neohesperidin，quercetin and pulegone. METHODS ：HPLC wavelength switching method was adopted. The determination was performed on Cosmosil C 18 column with mobile phase consisted of acetonitrile- 0.05％ phosphoric acid solution （gradient elution ）at the flow rate of 1.0 mL/min. The detection wavelengths were set at 257 nm for rutin ，283 nm for naringin and neohesperidin ，254 nm for quercetin ，252 nm for pulegone ，respectively. The column temperature was set at 30 ℃， and sample size was 10 μL. RESULTS：The linear range was 21.7-2 170 μg/mL for rutin，46-4 600 μg/mL for naringin，22.3- 2 230 μg/mL for neohesperidin，0.96-96 μg/mL for quercetin，2.7-270 μg/mL for pulegone（all r＞0.999），respectively. RSDs of precision，stability（24 h）and reproducibility tests were all lower than 2％（n＝6）. Average recoveries were 100.70％，99.31％， 101.10％，100.03％ and 99.63％（all RSD ＜2％，n＝9）. Among 3 batches of Huaihua san samples ，the contents of above 5 components were 20.055-22.615，25.557-27.806，11.428-13.250，0.350-0.478，2.372-4.011 mg/g，respectively. CONCLUSIONS ： Established method is simple ，accurate and reproducible ，and could be used for the simultaneous determination of 5 components in Huaihua san.
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Objective:To investigate the genetic correlation of interleukin-12 (IL-12) pathway-related gene single nucleotide polymorphisms (SNPs) with psoriasis vulgaris and their interaction with HLA-Cw*0602 in populations of Mongolian and Han nationalities in Inner Mongolia.Methods:From December 2012 to March 2018, 1 409 inpatients with psoriasis vulgaris (1 030 of Han nationality and 379 of Mongo-lian nationality) and 1 483 healthy controls (965 of Han nationality and 518 of Mongolian nationality) were collected from the Affiliated Hospital of Inner Mongolia Medical University, and served as patient group and control group respectively. Five milliliters of peripheral venous blood samples were collected from these subjects, and DNA was extracted. Nine SNPs located in the coding regions of IL-12 pathway-related genes were selected, including IL-12B (rs2082412, rs2288831, rs3212227, rs3213094, rs7709212) , IL-23R (rs11209026, rs2201841, rs7530511) and IL-28RA (rs4649203) genes, and detected by next-generation sequencing. HLA-Cw*0602 was genotyped by polymerase chain reaction with sequence-specific primers (PCR-SSP) . Statistical analysis was carried out with PLINK1.07 software, Chi-square test was used to compare allele frequencies between the 2 groups, relative risk estimates of alleles were calculated by using odds ratio ( OR) , and chi-square test for R × C contingency tables was used for haplotype analysis. Results:The allele frequencies of rs2082412, rs2288831, rs3212227, rs3213094 and rs7709212 in the IL-12B gene were significantly lower in the patients with psoriasis vulgaris of Han nationality than in the controls of Han nationality (all P < 0.005) ; the allele frequency of rs3213094 in the IL-12B gene was significantly lower in the patients of Mongolian nationality than in the controls of Mongolian nationality ( P < 0.005) . The prevalence of HLA-Cw*0602 was significantly lower in the patients with psoriasis vulgaris of Han and Mongolian nationalities than in the controls of corresponding nationalities (both P < 0.005) . As stratification analysis showed, the allele frequencies of rs2082412, rs2288831, rs3212227, rs3213094 and rs7709212 in the IL-12B gene were significantly lower in HLA-Cw*0602-positive patients of Han nationality than in HLA-Cw*0602-positive controls of Han nationality (all P < 0.005) , while there was no significant difference between HLA-Cw*0602-negative patients of Han nationality and HLA-Cw*0602-negative controls of Han nationality (all P > 0.05) . Among the HLA-Cw*0602-positive or negative populations of Mongolian nationality, no significant difference was observed in the allele frequencies between the patients and controls (all P > 0.005) . Haplotypes were constructed using 5 SNPs in the IL-12B gene, and there was no significant difference in the frequencies of 6 haplotypes between the patients and controls of Mongolian or Han nationality (all P > 0.005) ; stratification analysis showed that there was no significant difference in the frequencies of 7 haplotypes between HLA-Cw*0602-positive/negative patients and controls of Mongolian or Han nationality (all P > 0.005) . Conclusion:IL-12 pathway-related gene polymorphisms are associated with psoriasis vulgaris in the populations of Mongolian and Han nationalities in Inner Mongolia, and there may be interaction between IL-12B and HLA-Cw*0602 in the occurrence of psoriasis vulgaris.
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Objective:To evaluate the effect of ribosomal protein L34 (RPL34) gene knockdown on the proliferation and apoptosis of human cutaneous squamous cell carcinoma (cSCC) cells.Methods:From January 2016 to January 2017, 14 paraffin-embedded skin samples of cSCC and 16 paraffin-embedded normal skin tissue samples were collected from Department of Dermatology and Venereology, the Affiliated Hospital of Inner Mongolia Medical University, and RPL34 expression in the skin tissues was analyzed by immunohistochemical study. A lentivirus vector containing short hairpin RNA targeting RPL34 gene was constructed and used to transfect a human cSCC cell line SCL-1 (shRNA group) , SCL-1 cells transfected with an empty lentivirus vector served as control group, and the knockdown efficiency was verified by real-time quantitative PCR (RT-PCR) and Western blot analysis. At 72 hours after the transfection, flow cytometry was performed to analyze the cell cycle and detect apoptosis of SCL-1 cells, and methyl thiazolyl tetrazolium (MTT) assay to evaluate the cellular proliferative activity of SCL-1 cells. Comparisons between 2 groups were performed by using t test or rank sum test. Results:Immunohistochemical study showed that the cytoplasmic expression score of RPL34 was significantly higher in the cSCC tissues (2.143±1.956) than in the normal control tissues (0.500±0.516, z=3.53, P< 0.05) . RT-PCR showed that the relative mRNA expression of RPL34 in the SCL-1 cells was significantly lower in the shRNA group (0.149±0.016) than in the control group (1±0.018, t=36.95, P< 0.05) ; Western blot analysis revealed that the relative protein expression of RPL34 in the SCL-1 cells was significantly lower in the shRNA group than in the control group. Compared with the control group, the shRNA group showed a significantly increased proportion of S-phase cells ( t=13.76, P< 0.05) , but a significantly decreased proportion of G1-phase cells ( t=36.62, P< 0.05) ; the apoptosis rate was significantly higher in the shRNA group (9.42%±0.16%) than in the control group (4.58%±0.41%, t=19.02, P< 0.05) . MTT assay showed that the cell viability was significantly decreased in the shRNA group (0.815±0.005) than in the control group (1.886±0.005, t=265.91, P< 0.05) after additional 120-hour culture. Conclusion:The RPL34 gene was overexpressed in the cSCC tissues, and knockdown of the RPL34 gene in SCL-1 cells could interfere with cell cycle, decrease their proliferative activity, and promote their apoptosis.
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Objective To investigate the effect and mechanism of interleukin (IL)-17C in mice undergoing kidney transplantation. Methods The life-supporting kidney transplantation mice models were established using Balb/c (H-2Kd) mice as the donors, IL-17C gene knock out (IL-17CKO) mice (knockout group) and C57BL/6J(H-2Kb) mice (wild group) were chosen as the recipients. The postoperative body mass and survival time of mice were statistically compared between two groups. Pathological examination of the kidney graft was performed by using hematoxylin-eosin (HE) staining and periodic acid-Schiff (PAS) staining. The expression levels of granzyme B, interferon (IFN)-γ, tumor necrosis factor (TNF)-α, IL-6 and IL-1β messenger ribonucleic acid (mRNA) in the kidney graft tissue were quantitatively measured by reverse transcription polymerase chain reaction (RT-PCR). The proportion of inflammatory cell infiltration in the kidney graft tissue was detected by flow cytometry. Results In the knockout group, the survival time of mice after kidney transplantation was significantly shorter than that of the wild mice (P=0.031). The body mass was more evidently decreased in the knockout group with no statistical significance from that in the wild group. Pathological examination demonstrated that the kidney graft injury in the knockout group was significantly worse than that in the wild group. The mRNA expression levels of granzyme B, IFN-γ, TNF-α, IL-6 mRNA in the knockout group were significantly up-regulated compared with those in the wild group (all P < 0.01). The mRNA expression level of IL-1β showed a decreasing trend with no statistical significance (P=0.16). Flow cytometry analysis revealed that the infiltration of CD45+CD11b+Ly6G+ neutrophil and CD45+CD11b+Ly6Chi monocyte in the kidney graft of knockout mice was significantly higher compared with that of the wild mice (P < 0.05, P < 0.01), whereas the infiltration of CD45+Ly6ChiF4/80+ macrophage did not significantly differ between two groups (P > 0.05). Conclusions IL-17C participates in the regulation of inflammatory response after kidney transplantation. It can alleviate acute rejection and improve the survival of kidney graft by down-regulating the expression of pro-inflammatory cytokines and infiltration of inflammatory cells.
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Objective:To investigate the relationship of polymorphisms in metabolic syndrome-related genes with psoriasis vulgaris (PsV) and their interaction with HLA-C*06:02 in populations of Mongolian nationality.Methods:Totally, 379 PsV inpatients of Mongolian nationality and 518 healthy controls of Mongolian nationality were collected from the Affiliated Hospital of Inner Mongolia Medical University from December 2012 to March 2018. Sixteen previously reported single nucleotide polymorphisms (SNPs) and HLA-C*06:02, which were related to metabolic syndrome and its components, were selected. Next-generation sequencing and polymerase chain reaction-sequence specific primer (PCR-SSP) typing were performed to determine the genotypes of these subjects. Minor allele frequencies of the 16 mutation sites and HLA-C*06:02 were calculated in the PsV group and control group, and chi-square test was used to analyze the differences in the minor allele frequencies of SNPs between the 2 groups.Results:There was no significant difference in the minor allele frequencies of the 16 SNPs susceptible to metabolic syndrome between the Mongolian PsV patients and healthy controls (all P > 0.05), while the minor allele frequency of HLA-C*06:02 significantly differed between the 2 groups ( P = 4.09 × 10 -35, OR = 3.41). Among the HLA-C*06:02-positive subjects, the minor allele frequencies of rs7593730_T and rs6931514_G significantly differed between the 252 PsV patients and 191 healthy controls ( P = 0.016, OR = 0.64; P = 0.041, OR = 1.33, respectively) ; no significant difference was observed in the minor allele frequencies of the 16 SNPs between the PsV patients and healthy controls among the HLA-C*06:02-negative subjects ( P > 0.05) . Conclusion:The SNPs of rs7593730 and rs6931514 may be related to PsV in populations of Mongolian nationality in Inner Mongolia, and may interact with HLA-C*06:02.
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Objective@#To explore whether social support has a moderating effect on the relationship between negative emotions including depression, anxiety, stress with suicidal behaviors, and to provide reference for the suicide prevention among college students.@*Methods@#Three universities were selected in Qinghai, Ningxia and Xinjiang province, and 4 893 college students were selected using cluster sampling method. The Social Support Scale, Depression-Anxiety-Stress Scale(DASS) and Suicidal Behavior Questionnaire-Revised self-evaluation questionnaires were used to collect data. Hierarchical linear regression model was employed to explore the moderating effect of social support.@*Results@#A total of 4 893 college students completed full questionnaires and included in the final analysis. Among them, 738(15.08%) were under high risk of suicidal behaviors. The regression model showed that DASS score was positively associated with suicidal behavior (β=0.31, P<0.01), and social support was negatively associated with suicidal behavior (β=-0.08, P<0.01); Additionally, the interaction between social support and DASS negatively correlated with suicidal behavior (β=-0.05, P<0.01).@*Conclusion@#Social support may have buffering effects on the relationship between negative emotions (depression, anxiety and stress) and suicidal behaviors.
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Objective@#To investigate the in vitro and in vivo effects of apatinib in esophageal squamous cell carcinoma and the underlying mechanisms.@*Methods@#The esophageal cancer cells, KYSE-150 and ECA-109, were divided into control group and apatinib treatment group at the concentrations of 2.5, 5, 10, 20 and 40 μmol/L respectively. All of experiments were performed in triplicate. MTT and colony formation assays were used to measure cell proliferation. Transwell assay was used to determine the migration capacity. The effect of apatinib on cell cycle and apoptosis was analyzed by flow cytometry. The expression of VEGF and VEGFR-2 was measured by real-time quantitative PCR (qRT-PCR). The concentration of VEGF in the cell supernatant was assessed by enzyme-linked immunosorbent assay (ELISA). The expression levels of MEK, ERK, p-MEK, p-ERK, JAK2, STAT3 and p-STAT3 after VEGF stimulation were detected by Western blot. Furthermore, the nude mice xenograft model was established. The tumor-bearing mice were randomly divided into control group, apatinib low dose treatment group (250 mg) and apatinib high dose treatment group (500 mg), respectively. Tumor inhibition rates of different groups were calculated. And then the expressions of VEGF and VEGFR2 were detected in xenograft tissues by immunohistochemical staining.@*Results@#In the presence of 20 μmol/L and 40 μmol/L of apatinib for 24 hours, the migration cell numbers of KYSE-150 and ECA-109 were 428.67±4.16 and 286.67±1.53 as well as 1 123.67±70.00 and 477.33±26.84, respectively, that were significantly lower than control group (P<0.05 for all). In addition, after treatment with 10 μmol/L, 20 μmol/L and 40 μmol/L of apatinib for 7 days on KYSE-150 and ECA-109, the colony formation rates were (65.12±25.48)%, (58.19±24.73)% and (29.10±22.40)% as well as (70.61±15.14)%, (61.12±17.21)% and (43.09±11.13)%, respectively. The colony formation rates of 20 μmol/L and 40 μmol/L of apatinib treatment groups were significantly lower than control group (100.00±0.00, P<0.05). The cell cycle ratio of G2/M phase and apoptosis rate of control group and 20 μmol/L apatinib group in KYSE-150 cells were (12.14±2.13)% and (3.49±0.74)% as well as (26.27±3.30)% and (15.65±1.54)%, respectively. The corresponding ratios in ECA-109 cells were (3.44±0.57)% and (6.31±1.43)% as well as (22.64±2.36)% and (49.26±1.62)%, respectively. The results show that apatinib suppressed cell cycle progression at G2/M phase and induced cell apoptosis in both KYSE-150 and ECA-109 cells (P<0.05 for all). In the presence of 20 μmol/L and 40 μmol/L of apatinib in KYSE-150 cells, the relative levels of VEGF mRNA were (42.57±10.43)% and (25.69±1.24)%, and those of VEGF-2 mRNA were (36.09±10.82)% and (13.99±6.54)%, which were all significantly decreased compared to control group (100.00±0.00, P<0.05 for all). For ECA-109 cells, the relative expression of VEGF and VEGFR2 showed similar tendency (P<0.05 for all). Moreover, after treatment with 20 μmol/L and 40 μmol/L of apatinib in KYSE-150 cells, the VEGF concentrations were (766.48±114.27) pg/ml and (497.40±102.18)pg/ml, which were significantly decreased compared to control group [(967.41±57.75) pg/ml, P<0.05)]. The results in ECA-109 were consistent (P<0.05). Furthermore, after treatment with 40 μmol/L of apatinib in KYSE-150 and ECA-109, the relative expression of p-MEK and p-ERK were 0.49±0.05 and 0.28±0.03 as well as 0.63±0.03 and 1.22±0.15, which were significantly lower than control group (1.23±0.19 and 0.66±0.07 as well as 1.03±0.20 and 1.76±0.20; P<0.05). The relative expression of STAT3, p-STAT3 in control group and experimental group were 0.96±0.15 and 0.85±0.16 as well as 0.62±0.09 and 0.36±0.13, respectively. The results showed that the protein levels of STAT3 and p-STAT3 were significantly lower than the control group (P<0.05 for all). The inhibition rates of apatinib in xenograft nude mice were 29.25% and 19.96% for 250 mg and 500 mg treatment groups. The concentration of VEGF were (25.11±4.12) pg/ml, (16.40±2.81) pg/ml and (15.04±4.88)pg/ml for control, 250 mg and 500 mg treatment groups, respectively.@*Conclusions@#Apatinib can inhibit cell proliferation, induce apoptosis and suppress migration of esophageal cancer cells in vitro and in vivo. This effect was mainly mediated via the alterations of Ras/Raf/MEK/ERK pathway and JAK2/STAT3 pathway.
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Objective@#To investigate the adverse events and efficacy in cervical cancer patients receiving intensity modulated radiationtherapy (IMRT) plusbrachytherapy with or without chemotherapy, and to indentify the factors that may affect the prognosis.@*Methods@#In this retrospective analysis, we analyzed the clinical and follow-up data of the 422 cervical cancer patients, who received IMRT plus brachytherapy with or without chemotherapy.Among these patients, 353 cases received concurrent chemoradiotherapy and the other 69 cases received radiotherapy alone. Kaplan-Meier method was utilized to calculate the overall survival (OS) rates. Log-rank-test and Cox regression were performed to executing the univariate and multivariate analysis of the OS, respectively.@*Results@#The rate of complete response (CR) in the patients receiving concurrent chemoradiotherapy was significantly higher than that of the patients who received single radiotherapy (77.6% vs. 65.2%, χ2=4.812, P<0.05). The 1-, 3-, and 5-year OS rates were 93.4%, 79.4%, and 65.0%, respectively. Univariate analysis showed that age, Federation International of Gynecology and Obstetr(FIGO)2009 staging, lymph node metastasis, pathological type, chemotherapy experiences concurrent with radiotherapy, short-term efficiency, and sequential chemotherapy could affect the OS (χ2=6.375-613.123, P<0.05). Multivariate analysis showed that FIGO staging, lymph node metastasis, pathological type, chemotherapy experiences concurrent with radiotherapy, and the short-term efficacy were the independent determinants for the prognosis (χ2=3.930-42.994, P<0.05). For patients with positive pelvic lymph node, there were no statistical differences in the para-aortic lymph node (PALN) metastasis whether undergoing prophylactic extended field irradiation of the PALN or not(PALN metastasis rates: 6.1% vs. 16.8%, P>0.05). The OS for the patients receiving prophylactic extended field irradiation of the PALN was higher than that of patients without prophylactic radiation (χ2=3.953, P<0.05).@*Conclusions@#Cervical cancer patients receiving IMRT plus brachytherapy with or without chemotherapy had achieved promising prognosis. Prophylactic extended field irradiation of the PALN contributed to the improved OS in the patients with pelvic lymph node metastasis. FIGO staging, pathology type, lymph node metastasis, radiotherapy concurrent with chemotherapy or not, and short-term efficiency were independent factors for the prognosis.
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Objective@#To investigate the adverse effects and clinical efficacy of the intensive modulated radiotherapy(IMRT)and intravaginal brachytherapy combined with versus without chemotherapy in elderly patients with cervical cancer, and to analyze its prognostic factors.@*Methods@#Clinical data and follow-up results of 214 patients with cervical cancer aged ≥60 years undergoing IMRT and intravaginal brachytherapy combined with or without chemotherapy were retrospectively analyzed.The overall survival(OS)rate was calculated by using the Kaplan-Meier method.Prognostic factors were analyzed by Log-rank single factor test and Cox multivariate analysis.@*Results@#The rates of myelosuppression(≥grade 3)was higher in the concurrent chemo-radiotherapy group than in simple radiotherapy group(48.6% vs.15.8%, χ2=27.372, P<0.05). The complete response(CR)rate was higher in the concurrent chemo-radiotherapy group than in the simple radiotherapy group(83.0% vs.68.3%, χ2=5.993, P=0.014). The 1-, 3- and 5-year OS rate were 92.2%, 79.3% and 65.6%, respectively in all patients.Univariate analysis showed that the staging, lymph node metastasis status, pathological type and short-term efficacy of cervical cancer(based on FIGO guideline)were influencing factors for the prognosis(χ2=4.321-30.316, all P<0.05). Multivariate analysis showed that the FIGO staging, lymph node metastasis status and short-term efficacy were independent influencing factors for the prognosis(χ2=5.284-14.261, all P<0.05).@*Conclusions@#The intensive modulated radiotherapy and intravaginal brachytherapy combined with chemotherapy have a good efficacy and favorable long-term survival rate for the treatment of cervical cancer in elderly patients, and its major adverse effects can be tolerated.The FIGO staging, lymph node metastasis status and short-term efficacy are independent influencing factors for the prognosis in elderly patients with cervical cancer.
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Objective To investigate the adverse effects and clinical efficacy of the intensive modulated radiotherapy (IMRT)and intravaginal brachytherapy combined with versus without chemotherapy in elderly patients with cervical cancer,and to analyze its prognostic factors.Methods Clinical data and follow-up results of 214 patients with cervical cancer aged ≥60 years undergoing IMRT and intravaginal brachytherapy combined with or without chemotherapy were retrospectively analyzed.The overall survival(OS) rate was calculated by using the Kaplan-Meier method.Prognostic factors were analyzed by Log-rank single factor test and Cox multivariate analysis.Results The rates of myelosuppression(≥grade 3)was higher in the concurrent chemo-radiotherapy group than in simple radiotherapy group(48.6％％ vs.15.8 ％,x2 =27.372,P ＜ 0.05).The complete response (CR)rate was higher in the concurrent chemo-radiotherapy group than in the simple radiotherapy group (83.0％ vs.68.3％,x 2=5.993,P=0.014).The 1-,3-and 5-year OS rate were 92.2 ％,79.3 ％ and 65.6 ％,respectively in all patients.Univariate analysis showed that the staging,lymph node metastasis status,pathological type and short-term efficacy of cervical cancer (based on FIGO guideline)were influencing factors for the prognosis (x2 =4.321-30.316,all P ＜ 0.05).Multivariate analysis showed that the FIGO staging,lymph node metastasis status and short-term efficacy were independent influencing factors for the prognosis(x2 =5.284-14.261,all P＜0.05).Conclusions The intensive modulated radiotherapy and intravaginal brachytherapy combined with chemotherapy have a good efficacy and favorable long-term survival rate for the treatment of cervical cancer in elderly patients,and its major adverse effects can be tolerated.The FIGO staging,lymph node metastasis status and short-term efficacy are independent influencing factors for the prognosis in elderly patients with cervical cancer.
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Objective@#To observe the pathological response in tumor tissues and the vascular endothelial growth factor (VEGF) changes in serum of patients with esophageal carcinoma receiving radiotherapy or concurrent chemoradiotherapy, and to investigate the relationship between these two factors and the prognosis of these patients.@*Methods@#A total of eighty-nine patients with esophageal carcinoma treating with radiotherapy or concurrent chemo-radiotherapy were prospective included. Gastroscopy and biopsy were performed at 4 week of radiotherapy to assess pathologicalresponse. VEGF serum levels were measured by double antibody sandwich avidin-biotin ELISA prior to, at 4 week of, and 1 week after radiotherapy. The relationship between pathological response in tumor tissues and VEGF serum changes and the prognosis of the patients were analyzed. The survival curve and survival rate were respectively drawn and calculated by the Kaplan-Meier method, and the Log-rank test was used for survival analysis. Multivariate Cox proportional hazard model was used to analyze the prognostic factors.@*Results@#Pathological responses were classified into two degrees: Non-CR responses (22 cases), and CR responses (67 cases). The 1-, 3- and 5-year OS rates in CR group and non-CR group were 77.6%, 46.3%, 35.2% (median OS: 30.0 months, 95%CI 14.3-45.6 months) and 50.0%, 0.0%, 0.0% (median OS: 11.4 months, 95%CI 4.2-18.6 months), respectively, showing that the OS in CR group were significantly higher than that in non-CR group (P<0.001). Meanwhile, the 1-, 3- and 5-year PFS rates in CR group and non-group were 69.7%, 40.9%, 34.3% (median PFS: 21.7 months, 95%CI 13.1-30.3 months) and 36.4%, 0.0%, 0.0% (median PFS: 7.4 months, 95%CI 2.1-12.4 months), respectively, showing that the PFS in CR group was significantly higher than that in non-CR group (P<0.001). VEGF serum changes were classified into three degrees: increased group (16 cases), stable group (43 cases) and decreased group (30 cases). The 1-, 3- and 5-year OS rates in VEGF increased group were 50.0%, 18.8%, 12.5% (median OS: 9.2 months, 95%CI 2.2-17.9 months), respectively, while the 1-, 3- and 5-year OS rates in VEGF stable group were 67.4%, 30.2%, 19.9% (median OS: 19.9 months, 95%CI 14.9-24.9 months), respectively, and the 1-, 3- and 5-year OS rates in VEGF-decreased group were 86.7%, 50.0%, 42.9% (median OS: 28.7 months, 95%CI 5.4-51.2 months), respectively, showing that the OS in VEGF-decreased group was significantly the highest among the three groups (P<0.05). The 1-, 3- and 5-year PFS rates in VEGF-increased group were 43.8%, 12.5%, 0 (median PFS: 8.0 months, 95%CI 2.5-15.9 months), respectively, while the 1-, 3- and 5-year PFS rates in VEGF stable group were 57.1%, 26.2%, 20.8% (median PFS: 15.5 months, 95%CI 10.7-20.4 months), respectively, and the 1-, 3- and 5-year PFS rates in VEGF decreased group were 76.7%, 46.7%, 39.7% (median PFS: 20.1 months, 95%CI 2.4-40.1 months), respectively, showing that the PFS in VEGF decreased group was significantly the highest among the three groups (P=0.013).@*Conclusions@#Pathological response and VEGF changing trend during radiotherapy were both closely related to prognosis of patients with esophageal carcinoma.@*Trial registration@#This clinical trial was registered in the United States Trial, ID: NCT01551641
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Objective To evaluate the radiosensitivity effects of apatinib on the esophageal cancer cell line ECA-109 and its cancer stem-like cells,and to investigate the underlying mechanism.Methods A serum-free medium (SFM) was used to culture esophageal cancer stem cell line ECA-109 and enrich the esophageal stem-like spheres.ECA-109 and its stem-like cells were divided into control group,drug treatment group,radiation group and drug plus radiation group.Cell proliferations of ECA-109 and its stem-like cells were detected with CCK-8 method.The concentration of vascular endothelial growth factor (VEGF) in the cell culture medium was determined by enzyme linked immunosorbent assay(ELISA).Cell cycle and apoptosis were detected by flow cytometry method.The expressions of CHK2 and P-STAT3 proteins were detected by Western blot assay.Results With the administration with apatinib for 24,48 and 72 h,the half of the inhibitory concentration (IC50) of ECA-109 stem-like cells was significantly higher than that of the parent cells (t =8.17,9.29,18.85,P ＜ 0.05) in a time dependent manner (parental cells:r2 =0.94-0.97,P ＜0.05;stem-like cells:r2 =0.94-0.98,P ＜0.05).After administration with different concentrations of apatinib (parental cells:10 and 20 μmol/L;stem-like cells:30 and 40 μmol/L) combined with different dose of X-rays (6 and 8 Gy),the proliferations of ECA-109 and its stem-like cells were significantly (t =5.20-39.68,P ＜ 0.05) inhibited compared with radiation alone group.VEGF secretion from both ECA-109 cells and its stem like cells were significantly decreased in different manner (t =7.45,P ＜ 0.05).Compared with control group,the cell apoptosis rate and the percentages of cells in G2/M phase were significantly increased in drug plus radiation group (t =8.83,11.59,P ＜ 0.05),and the expressions of CHK2 and P-STAT3 were decreased in drug group (t =3.36,4.10,P ＜ 0.05).Compared with radiation group,the expressions of CHK2 and P-STAT3 were decreased in drug plus radiation group (t =9.05,2.36,P ＜ 0.05).Conclusions Apatinib enhanced the radiosensitivity of ECA-109 cells and its stem-like cells,which was much more effective on ECA-109 cells and may be related to the radiation-induced inhibition of VEGF signal pathway that can further inhibit cell proliferation,promote cell apoptosis and induce cell cycle redistribution.The higher intrinsic level of VEGF protein may contribute to radioresistance of ECA-109 stem-like cells.
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Objective:To observe the compatibility of Xiaoaiping injection and insulin for injection in glucose infusion. Methods:The changes in appearance, particles and pH of the mixture in 24h at ambient temperature were observed. The concentration of chloro-genic acid and insulin were determined by HPLC. Results:There were no obvious changes in appearance, pH, precipitation or turbidi-ty generation, and the contents of insulin and chlorogenic acid kept stable in 12 h. The number of insoluble particles was stable in 12 h, and then gradually increased in 24 h. Conclusion:Xiaoaiping injection and insulin in 5％ glucose infusion is stable in 12h under the testing conditions.
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BACKGROUND:Polysulfone membrane holds good anti-biodegradation ability, but how to use it to prepare hol ow fiber dialysis membrane and its blood compatibility have not been ful y understood. OBJECTIVE:To study the preparation, transfer property and biocompatibility of hol ow fiber dialysis membrane. METHODS:With polysulfone as the film material, diethylene glycol as the porogen, polyvinyl pyrrolidone as the modifier, N, N-dimethylacetamide as the solvent, and the hol ow fiber dialysis membrane was prepared using nonsolvent-induced phase separation. The performance was measured using scanning electron microscopy, ultra-depth three-dimensional microscope imaging and porosity test;the transfer parameters including reject rate and water flux were detected by ultrafiltration device;the blood compatibility was determined through hemolysis test, dynamic clotting time test and platelet adhesion test. Type II medical polyurethane material served as negative control. RESULTS AND CONCLUSION:The section of hol ow fiber dialysis membrane was asymmetric. 17%dialysis membrane showed a porous middle layer, while 19%, 21%and 23%membrane showed a sponge-like middle layer. Under the same membrane area, the density of fiber dialysis membrane was significantly lower than that of the negative control material, and the porosity of fiber dialysis membrane was significantly higher than that of the negative control material (P<0.05). The water volume and water flux of the hol ow fiber dialysis membrane were significantly higher than those of the negative control material (P<0.05). Results from three hemolytic tests showed that the average absorbance values and hemolysis rate of the hol ow fiber dialysis membrane were significantly higher than those of the negative control material (P<0.05). The dynamic clotting time test and the platelet adhesion test revealed that the dynamic clotting time of hol ow fiber dialysis membrane at 20, 40 and 70 minutes was significantly shorter than that of the negative control material (P<0.05). These results suggest that polysiloxane can be used as the membrane material to prepare hol ow fiber dialysis membrane using nonsolvent-induced phase separation, and holds a good biocompatibility, blood compatibility and transfer efficiency.