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1.
Article in Chinese | WPRIM | ID: wpr-930062

ABSTRACT

Brain metastases are one of the most common distant metastases in patients with non-small cell lung cancer (NSCLC), and the prognosis will be extremely poor. The effect of chemotherapy and operation is limited. As a standard treatment, radiotherapy is widely used in clinical practice. Radiotherapy alone includes whole brain radiotherapy, stereotactic radiotherapy and whole brain radiotherapy combined with stereotactic radiotherapy. With the continuous development of radiotherapy and the progress of gene sequencing, radiotherapy has been combined with targeted drugs, anti-angiogenic drugs and immunodrugs in the treatment of NSCLC brain metastasis, which can improve the survival of patients with NSCLC brain metastasis.

2.
Article in Chinese | WPRIM | ID: wpr-910385

ABSTRACT

Objective:To investigate the prognostic factors of oligometastatic (OM) non-small cell lung cancer (NSCLC) patients and the safety and effectiveness of early radiotherapy intervention.Methods:A retrospective analysis was conducted, including 159 OM NSCLC cases (metastatic sites≤5, metastasis organs≤3) admitted to Department of Radiation Oncology in First Affiliated Hospital of Soochow University from January 2015 to December 2018. Among 159 cases, there were 107 males and 52 females, with the median age of 63 years. 137 cases were administrated via early radiotherapy intervention, and 22 cases via delayed radiotherapy intervention. The receiver operating characteristic curve (ROC) was used to determine the progression-free survival time (PFS)/overall survival time (OS) to ascertain the best cut-off value for local control and prognosis. Survival analysis was calculated by Kaplan-Meier curves, and Log rank test was used for comparison of these curves. Cox proportional hazards regression model was used for multivariate survival analysis.Results:The median follow-up time of 159 cases was 28.2 months. During the follow-up period, there were 16 cases with complete remission (10.1%), 53 cases with partial remission (33.3%), 27 cases with stable disease (17.0%), and 63 cases with progressed disease(39.6%). The local control rates at 3, 6 and 12 months were 83.9%, 59.7% and 41.0%, respectively. The median progression-free survival (PFS) of 159 patients was 8.0 months, the median survival time (OS) was 35.0 months, and 1, 2, and 3-year survival rates were 77.3%, 63.0% and 45.1%, respectively. Adverse reactions related to radiotherapy were relatively mild, mostly grade 1 and 2. PFS/OS= 0.3 is the best cut-off value for determining the patient′s local control and prognosis. The result of univariate analysis showed that gender, number of OM organs, T staging, radiotherapy intervention mode, tumor target volume absorbed dose (DT-GTVnx), PFS/OS were significantly related to median PFS ( χ2=4.175, 16.508, 4.408, 10.300, 6.842, 38.175, P<0.05); gender, pathological type, number of OM organs, initial diagnosis stage, T stage, N stage, lobectomy, radiotherapy intervention mode, tumor target volume (V-GTVnx), tumor load, local control status were significantly related to median OS ( χ2=6.672, 8.330, 21.299, 5.398, 6.874, 6.893, 5.611, 115.206, 4.017, 5.110, 21.299, P< 0.05). The result of multivariate analysis showed that delayed radiotherapy intervention ( HR=3.728, 95% CI 2.099-6.622, P<0.001) was an independent risk factor for PFS in patients with OM NSCLC, and PFS/OS>0.3 ( HR=0.123, 95% CI 0.062-0.246, P<0.001) was an independent protective factor for PFS in patients with OM NSCLC; male ( HR=1.665, 95% CI 1.024-3.043, P=0.033), high tumor burden ( HR=2.113, 95% CI 1.088-4.107, P=0.027), delayed radiotherapy interventions ( HR=15.076, 95% CI 7.925-28.680, P<0.001) were independent risk factors for OS in patients with OM NSCLC. Conclusions:OS of patients with OM NSCLC is significantly prolonged in female, low tumor burden and early radiotherapy intervention. Early radiotherapy intervention significantly improved the prognosis, and radiotherapy-related adverse reactions could be tolerated. These might suggest that local radiotherapy is safe and effective in the treatment of OM NSCLC patients.

3.
Article in Chinese | WPRIM | ID: wpr-907591

ABSTRACT

Cyclin-dependent kinase (CDK) 4/6 inhibitors are a new class of molecular targeted drugs, which can enhance radiotherapy sensitivity by anti angiogenesis, inhibiting DNA damage repair and inhibiting mammalian target of rapamycin signal transduction. Existing clinical trials have confirmed that radiotherapy combined with CDK4/6 inhibitors can effectively control the local symptoms of breast cancer metastases and prolong progression-free survival. Compared with CDK4/6 inhibitors alone, the combination with radiotherapy does not significantly increase the incidence and severity of adverse reactions. However, there are also reports about severe adverse reactions of normal tissue happened in the radiation field in individual cases of combined treatment, and its efficacy and safety need to be clarified by more basic and clinical observational researches.

4.
Article in Chinese | WPRIM | ID: wpr-863462

ABSTRACT

Objective:To investigate the prognostic value of TCBI in middle-aged and elderly patients with thoracic esophageal squamous cell carcinoma (ESCC) who received radiotherapy.Methods:The clinical data of 191 patients with thoracic ESCC who underwent radiotherapy in the department of Radiation Oncology of the First Affiliated Hospital of Soochow University from January 2010 to December 2015 were retrospectively analyzed. According to the TCBI value on admission [TCBI=serum triglyceride (mg/dl) × total cholesterol (mg/dl) × body weight (kg)/1 000], patients were divided into TCBI low-value group ( n=79) and TCBI high-value group ( n=112). The relationships between TCBI and clinicopathological characteristics of patients were analyzed. The Kaplan-Meier method was used to calculate the overall survival (OS). The log-rank test was adopted to compare the differences in survival between different groups. The Cox proportional hazard model was used to analyze the factors affecting the prognosis of middle-aged and elderly patients with thoracic ESCC. The receiver operating characteristics (ROC) curve was applied to verify the accuracy of TCBI for survival prediction. Results:The mean pre-radiotherapy TCBI was 1 082±945 in all patients. The cutoff value of the TCBI was 749. The patients with TCBI<749 served as the TCBI low-value group , and patients with TCBI≥749 served as the TCBI high-value group. TCBI was associated with treatment ( χ2=4.235, P=0.040) and geriatric nutritional risk index (GNRI, χ2=8.795, P=0.003). Univariate analysis suggested that male ( HR=2.220, 95% CI: 1.223-4.030, P=0.009), stage N 1-3 ( HR=1.453, 95% CI: 1.023-2.065, P=0.037), GNRI<98 ( HR=1.949, 95% CI: 1.168-3.255, P=0.011) and TCBI<749 ( HR=1.846, 95% CI: 1.298-2.627, P=0.001) were risk factors affecting OS in middle-aged and elderly patients with thoracic ESCC. Besides, postoperative adjuvant radiotherapy ( HR=0.641, 95% CI: 0.449-0.915, P=0.014) was a protective factor. Furthermore, multivariate analysis showed that male ( HR=2.147, 95% CI: 1.173-3.929, P=0.013) and TCBI<749 ( HR=1.664, 95% CI: 1.166-2.376, P=0.005) were independent risk factors for OS. Besides, postoperative adjuvant radiotherapy ( HR=0.630, 95% CI: 0.439-0.903, P=0.012) was an independent protective factor. The area under the curve calculated by the ROC curve was 0.619, the sensitivity was 0.742, and the specificity was 0.496 ( P=0.007), confirming the role of TCBI in the prognostic evaluation. Survival analysis showed that the median OS of patients in the TCBI high-value group was 42 months, and the 1-year and 3-year survival rates were 86.6% and 52.7%, significantly higher than those in the TCBI low-value group (20 months, 68.4% and 29.1% respectively; χ2=12.286, P<0.001). Subgroup analysis showed that among patients with radical radiotherapy, 3-year survival rate in patients with lower TCBI ( n=37) was lower than that in patients with higher values ( n=36) (21.6% vs. 44.4%, χ2=8.505, P=0.004). Conclusion:TCBI is a predictor of OS for middle-aged and elderly patients with thoracic ESCC who received radiotherapy. The lower the TCBI, the poorer the survival prognosis.

5.
Article in Chinese | WPRIM | ID: wpr-868691

ABSTRACT

Objective:To validate the feasibility of a deep learning-based clinical target volume (CTV) auto-segmentation algorithm for cervical cancer in clinical settings.Methods:CT data sets from 535 cervical cancer patients were collected. CTVs were delineated according to RTOG and JCOG guidelines, reviewed by experts, and then used as reference contours for training (definitive 177, post-operative 302) and test (definitive 23, post-operative 33). Four definitive and 6 post-operative cases were randomly selected from the testing cohort to be manually delineated by junior, intermediate, senior doctors, respectively. Dice coefficient (DSC), mean surface distance (MSD) and Hausdorff distance (HD) were used for test and comparison between auto-segmentation and RO delineation. Meantime, auto-segmentation time and manual delineation time were recorded.Results:Auto-segmentation models of dCTV 1, dCTV 2 and pCTV 1 were trained with VB-Net and showed good agreement with reference contours in the testing cohorts (DSC, 0.88, 0.70, 0.86 mm; MSD, 1.32, 2.42, 1.15 mm; HD, 21.6, 22.4, 20.8 mm). For dCTV 1, the difference between auto-segmentation and all three groups of doctors was not significant ( P>0.05). For dCTV 2 and pCTV 1, auto-segmentation was better than the junior and intermediate doctors (both P<0.05). Auto-segmentation time consumption was considerably shorter than that of manual delineation. Conclusions:Deep learning-based CTV auto-segmentation algorithm for cervical cancer achieves comparable accuracy to manual delineation of senior doctors. Clinical application of the algorithm can contribute to shortening doctors′ manual delineation time and improving clinical efficiency. Furthermore, it may serve as a guide for junior doctors to improve the consistency and accuracy of cervical cancer CTV delineation in clinical practice.

6.
Article in Chinese | WPRIM | ID: wpr-868391

ABSTRACT

Objective To investigate the relationship between the metabolites in the fecal samples from cervical cancer patients and radiation-induced acute intestinal symptoms during radiotherapy.Methods A total of 51 cervical cancer patients who received radiotherapy in our hospital from September 2017 to June 2018 were enrolled.One patient was excluded due to efficiant sample failure,so a total of 50 patients were included in the study.Totally 200 fecal samples were collected at four time points,i.e.before radiotherapy,2 weeks post radiotherapy starting,4 weeks post radiotherapy starting and end of radiotherapy.These fecal samples were analyzed by non-targeted metabolomics using liquid chromatography-mass spectrometry (LC-MS).Data were analyzed with statistical method including partial least squares-discriminant analysis (PLS-DA),agglomerate hierarchical clustering to investigate the trend of metabolites expression in feces.Results A total of 5 770 metabolic peaks were detected and 121 biomarkers were identified,of which 77 biomarkers were up-regulated and 44 biomarkers were downregulated.Nineteen biomarkers were significantly changed at four time points after radiotherapy,including 1-methylxanthine,linoleic acid,5-aminopentanoic acid,phenethylamine,styrene,N-acetylglutamate,nandrolone,4-acetylaminobutyric acid,N-acetyl-L-phenylalanine,daidzein,cholic acid,arachidonic acid,methyl leucine,N-formyl-L-methionine,quercetin,phenylalanine,gluconic acid,melibiose and α-CMBHC.Four metabolic pathways of phenylalanine tyrosine,niacin and nicotinamide,linoleic acid and lysine degradation (Pathway imPact > 0.1) were found to be related to acute radiation enteritis.Conclusions The metabolites in the feces of cervical cancer patients change significantly during radiotherapy,and some biomarkers in the fecal supernatant are up-or down-regulated to varying degrees as doses increase,which provides new ideas and method for the prediction of acute radiation enteritis.

7.
Article in Chinese | WPRIM | ID: wpr-911628

ABSTRACT

Objective:To explore the clinical characteristics, diagnosis and treatment of secondary adrenocortical insufficiency(SACI)after kidney transplantation.Methods:Retrospective analysis was conducted for clinical data of 12 recipients with SACI after transplantation from March 2018 to November 2019(observation group). Meanwhile, 10 healthy subjects(control group)were randomly selected for in-hospital physical reexaminations during the same period. General data and morning cortisol levels of adrenocorticotropic hormone(ACTH)and aldosterone were compared between two groups.Results:In observation group, there were 8 male and 4 female with an average age of (43.67±8.81) years. Six cases(50.0%)of SACI occurred during recovery period within 30 days and 3 cases(25.0%)within 30 to 90 days post-transplantation. Deceased citizen donation(DCD)was performed in 9 cases(75.0%)and re-transplanted in 3 cases(25.0%). Oral immunosuppressive regiments were administered in a low-dose prednisone-based triple/quadruple regimen. The mean eGFR of observation group was(54.08±20.03)ml/min. The first patient had adrenal crisis, the fourth had sole symptom of fatigue and the remainder stayed asymptomatic. All of them had persistent hyperkalemia and hyponatremia. The average level of plasma cortisol was(62.24±24.16)mmol/L and it was much lower than normal in all patients at 8 am. The determination of plasma ACTH at 8 am showed that 7 patients(58.33%)were lower than normal and the remaining 5 slightly surpassed the low limit of normal. The average level of plasma cortisol at 8 am was significantly lower in observation group than that in control group(141.34±26.28)nmol/L( t=-7.349, P<0.001). The average ACTH level of observation group at 8 am was(1.08±0.515)pmol/l and it was significantly lower than that of control group(2.53±1.06)pmol/L( t=-4.178, P<0.001). The level of aldosterone was normal in both groups and showed no significant difference. All patients in observation group received an intravenous injection of hydrocortisone with satisfactory outcomes. Conclusions:Transplant surgeons should be on a high alert for an occurrence of SACI in renal transplant recipients. Serum potassium and sodium levels may be the predictors of SACI.

8.
Article in Chinese | WPRIM | ID: wpr-798771

ABSTRACT

Objective@#To investigate the relationship between the metabolites in the fecal samples from cervical cancer patients and radiation-induced acute intestinal symptoms during radiotherapy.@*Methods@#A total of 51 cervical cancer patients who received radiotherapy in our hospital from September 2017 to June 2018 were enrolled. One patient was excluded due to efficiant sample failure, so a total of 50 patients were included in the study. Totally 200 fecal samples were collected at four time points, i. e. before radiotherapy, 2 weeks post radiotherapy starting, 4 weeks post radiotherapy starting and end of radiotherapy. These fecal samples were analyzed by non-targeted metabolomics using liquid chromatography-mass spectrometry (LC-MS). Data were analyzed with statistical method including partial least squares-discriminant analysis (PLS-DA), agglomerate hierarchical clustering to investigate the trend of metabolites expression in feces.@*Results@#A total of 5 770 metabolic peaks were detected and 121 biomarkers were identified, of which 77 biomarkers were up-regulated and 44 biomarkers were down-regulated. Nineteen biomarkers were significantly changed at four time points after radiotherapy, including 1-methylxanthine, linoleic acid, 5-aminopentanoic acid, phenethylamine, styrene, N-acetylglutamate, nandrolone, 4-acetylaminobutyric acid, N-acetyl-L-phenylalanine, daidzein, cholic acid, arachidonic acid, methyl leucine, N-formyl-L-methionine, quercetin, phenylalanine, gluconic acid, melibiose and α-CMBHC. Four metabolic pathways of phenylalanine tyrosine, niacin and nicotinamide, linoleic acid and lysine degradation (Pathway imPact >0.1) were found to be related to acute radiation enteritis.@*Conclusions@#The metabolites in the feces of cervical cancer patients change significantly during radiotherapy, and some biomarkers in the fecal supernatant are up- or down-regulated to varying degrees as doses increase, which provides new ideas and method for the prediction of acute radiation enteritis.

9.
Article in Chinese | WPRIM | ID: wpr-822995

ABSTRACT

@#The incidence of liver disease is increasing year by year. Due to the complex predisposing factors and unclear pathogenesis of liver diseases, the cure rate is still not ideal, so it is urgent to clarify its mechanism to find more effective therapeutic targets and drugs. Long non-coding RNA (lncRNA), as a non-coding RNA with a length of more than 200 nt, is a research hotspot in liver diseases in recent years. Focusing on the main signal transduction pathways in liver diseases, this review mainly summarizes the latest research progress of lncRNA in regulating liver disease-related signaling pathways, and elaborates that lncRNAs participate in various physiological processes such as cell proliferation, apoptosis, invasion, and migration by regulating key signaling pathways in liver diseases, thereby promoting the occurrence and development of liver diseases. This review provides new ideas for studying the mechanism of liver diseases, and new directions for finding new targets and biomarkers for the treatment of liver diseases.

10.
Article in Chinese | WPRIM | ID: wpr-791837

ABSTRACT

Objective To explore whether therapeutic dosing timing of proteasome inhibitor bortezomib(BZ) would impact its clinical efficacy .Methods From 2012 to 2018 ,35 biopsy-confirmed cases of acute antibody-mediated kidney transplant rejection (AMR) were collected .They received intravenous immunoglobulin (IVIG) plus sirolimus (Sir) plus bortezomib (BZ) .Three groups were assigned according to dosing timing of BZ .After a diagnosis of AMR ,ET (early treatment ) group began BZ dosing within 7 days (n=16) while DT (delayed treatment) group within 8-14 days (n=11) and LT (late treatment) group > 14 days (n= 8).Their clinical parameters and incidence of complications were analyzed .Results DSA reversal rate of ET ,DT and LT groups was 87 .5% , 45 .5% and 25 .0% (P=0 .006) while DSA declining rate 93 .8% ,90 .9% and 50% respectively (P=0 .019);recurrent rate of AMR was lower in ET/DT group than LT group (6 .6% vs 10% vs 75% , P=0 .042) .No significant differences existed in blood perfusion score of allograft at 1 month post-dosing among three groups .In three groups ,creatinine (Cr) of ET group was lower than DT group at month 1/3/12 while DT group was lower than LT group .No significant difference existed in the incidence of adverse reactions among 3 groups .Conclusions More likely to enter the window period , early dosing of BZ is more effective for treating acute AMR .An earlier intervention yields a better efficacy .

11.
Article in Chinese | WPRIM | ID: wpr-734695

ABSTRACT

Objective To compare the trigger delay and work of trigger between neurally adjusted ventilatory assist (NAVA) and pressure support ventilation (PSV) in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients with intrinsic positive end-expiratory pressure (PEEP) during mechanical ventilation. Methods AECOPD patients with intrinsic PEEP (PEEPi) greater than or equal to 3 cmH2O (1 cmH2O=0.098 kPa) were enrolled during invasive mechanical ventilation. Subjects were ventilated with low, medium and high pressure under either NAVA or PSV mode. Servo Tracker software continuously recorded the waveform of ventilator and respiratory mechanics indexes (including respiratory frequency, inspiratory tidal volume (Vti), minute ventilation volume (VE), peak airway pressure (PIP), inspiratory time), and calculated trigger and expiratory conversion delay time, work of trigger and total work of breath. Results A total of 14 AECOPD patients were enrolled with the average PEEPi (4.3±1.3) cmH2O. PSV inspiratory trigger delay time was positively correlated with PEEPi (r=0.913, P<0.05). Compared with PSV, NAVA significantly decreased trigger delay time in low, medium and high pressure level groups [(48±17) ms vs. (167±86) ms, (63±65) ms vs. (247±240) ms, (63±49) ms vs. (342±192) ms,respectively all P<0.05]. Similar results were shown as to work of trigger [(0.92±0.36) μV?s vs. (1.22±0.70) μV?s, (1.08±0.51) μV?s vs. (1.62 ± 1.25) μV?s, (1.20 ± 0.96) μV?s vs. (2.29 ± 1.02) μV?s, all P<0.05]. Trigger delay time increased according to the increase of pressure level in PSV mode.Conclusion The presence of PEEPi in AECOPD patients leads to obvious trigger delay under PSV mode, which is positively correlated with PEEPi level. NAVA significantly reduces trigger delay time and work of trigger compared with PSV mode.

12.
Article in Chinese | WPRIM | ID: wpr-754994

ABSTRACT

In recent years,the relationship between gut microbiota and malignant tumors has been a hot topic.Beneficial gut microbiota microenviroment can promote the efficacy of anti-PD-1-based immunotherapy against epithelial or melanoma,and this efficacy can be achieved by fecal microbiota transplantation.For patients who have received pelvic radiotherapy,gut microbiota composition is significantly changed,and taking probiotics can reduce the radiation-induced toxicities such as diarrhea caused by radiotherapy.The studies have shown that the gut microbiotaof patients who have been given chemotherapy had changed significantly.So improving the related bacteria number can increase the efficacy and tolerance.Balancing the gut microbiome is expected to be a new supportive therapy for the treatment of malignant tumors.

13.
Article in Chinese | WPRIM | ID: wpr-745653

ABSTRACT

Objective To evaluate the effect of doxofylline on pulmonary inflammatory response induced by mechanical ventilation in rats with chronic obstructive pulmonary disease (COPD).Methods Thirty adult male Sprague-Dawley rats,aged 8 weeks,weighing 200-250 g,were divided into 3 groups (n=10 each) using a random number table method:control group (C group),COPD group and doxofylline group (Dox group).Rats were fed in normoxia for 2 months,and normal saline 0.2 ml was injected into the trachea on 1st and 30th days in C group.Rats were exposed to cigarette smoke for 30 min every day,lasting for 2 months,and lipopolysaccharide 200 μg (0.2 ml) was injected into the trachea on 1st and 30th days in COPD and Dox groups.Two months later,rats in each group were anesthetized,tracheally intubated,and then mechanically ventilated.Doxofylline 50 mg/kg was intravenously injected immediately after intubation in Dox group,and the equal volume of normal saline was given instead in C and COPD groups.Pulmonary specimens were taken after 120 min of mechanical ventilation for examination of pathological changes and for determination of wet/dry weight ratio (W/D ratio) and tumor necrosis factor-alpha (TNF-α) and interleukin-10 (IL-10) contents (by enzyme-linked immunosorbent assay).Results No significant pathological change of lung tissues was found in C group,and COPD pathological changes were observed in COPD and Dox groups.Compared with C group,the W/D ratio and TNF-α level were significantly increased,and the IL-10 level was decreased in COPD and Dox groups (P<0.05).Compared with COPD group,the W/D ratio and TNF-α level were significantly decreased,and the IL-10 level was increased in Dox group (P<0.05).Conclusion Doxofylline can reduce the pulmonary inflammatory response induced by mechanical ventilation in rats with COPD.

14.
Article in Chinese | WPRIM | ID: wpr-745287

ABSTRACT

Radiotherapy is one of the most important treatments of high-grade gliomas (HGG).Currently,there has been no consensus on the standards for the delineation of the gross tumor volume (GTV) based on the simulated computed tomography (CT) scanning and conventional magnetic resonance imaging (MRI).As the radiological technology advances,researchers have found that the application of multimodal MRI including 1 H magnetic resonance spectroscopy (1 H-MRS),blood oxygenation level dependent functional MRI (BOLD-fMRI),diffusion-weighted MRI (DWI) and diffusion tensor imaging (DTI) can evaluate the range of HGG invasion and locate the surrounding vital tissues,thereby serving as a supplement for the delineation of target volume and protection of organs at risk.Moreover,multimodal MRI can be utilized to evaluate the clinical efficacy of radiotherapy,detect the radiation-induced injury and differentiate the progressive disease from pseudoprogression.In this article,the application of multimodal MRI in the postoperative radiotherapy for patients with high-grade glioma was reviewed.

15.
Article in Chinese | WPRIM | ID: wpr-693542

ABSTRACT

Esophageal cancer is a common gastrointestinal tumor in China with high morbidity and mortality.As a new radiotherapy technique,volumetric modulated arc therapy (VMAT) is increasingly used for the treatment of esophageal cancer.VMAT can reduce the dose of endanger organs,protect the organs and reduce the side effects of radiotherapy.For esophageal cancer patients with different location and volume,VMAT can effectively improve the safety and efficiency of treatment by reducing the treatment time and improving the conformability of the target area.Combined with chemotherapy before operation,VMAT increases the chance of tumor reduction,and improves the success rate of operation.Besides,studies have shown that increasing the number of VMAT programs can improve the accuracy of target area and reduce the time of treatment.VMAT has become an important way to treat patients with esophageal cancer.

16.
Article in Chinese | WPRIM | ID: wpr-708325

ABSTRACT

Objective To explore the feasibility and safety of integrated intensity-modulated radiation therapy (IMRT) technology applied in craniospinal irradiation in a supine position. Methods The patients were fixed in a supine position using thermoplastic mask and vacuum mat. Three isocenters with a fixed interval of 20-25 cm were adopted according to the height of patients. A total of 13 beams with a length of 2-3 cm in the overlapping region were included in the treatment plan. Fixed jaw technique was employed and overall calculation was performed by the inverse optimization method. The γ-passing rate and absolute point dose verification were performed for three isocenters and two overlapping regions. Cone-beam CT (CBCT) images were scanned for three isocenters before treatment. The setup error of each isocenter in the x,y and z directions of the same coordinate system was recorded and overall analysis was conducted. Results Among 28 patients,the γ-passing rate (%) of three isocenters and two overlapping regions was 99. 36%, 99. 60%,99. 75%,94. 77% and 95. 09%,whereas the absolute point dose verification error was 1. 56%,-1. 56%,0. 52%,-0. 76% and -1. 68%,respectively. Twenty-eight patients received 162 groups of IGRT with 486 setup errors from the CBCT images. The average deviation in the x, y and z direction for three isocenters (neck,chest and abdomen) was 0. 17 mm,0. 10 mm,0. 02 mm,0. 06 mm,0. 04 mm,0. 46 mm, 0. 19 mm, 0. 26 mm and 0. 41 mm, respectively. Conclusions The integrated IMRT techniques for craniospinal irradiation in a supine position is feasible and safe,which is worthy of clinical application.

17.
Article in Chinese | WPRIM | ID: wpr-618859

ABSTRACT

Objective To investigate the effect of Celecoxib on human brain microvascular endothelial cells release6-keto-PGF1α,TXB2 and apotosis after irradiation.Methods The logarithmic growth phase cells were divided into control groups (Con),simple irradiation (IR) groups and combination groups (IR+C).CCK-8 and clone formation experiment were used to evaluate the effects of radiosensitivity and toxicity of celecoxib.The results were observed atthe time point of 6 h,12 h,24 h,48 h after irradiation.ELISA was used to test the contents of 6-keto-PGF1α and TXB2,which metabolized by PGI2 and TXA2 from culture medium after irradiation at different time points in different groups.TXB2/6-keto-PGF1αratios were calculated.Annexin V-FITC/PI double staining method was used to measure the apoptosis rates at different time points in different groups.Western blot was used to measure the protein expression.Paired t test difference.Results Compared with simple irradiation group,there were no significant radiosensitivity (SER=0.96) in combination groups incubated with30 μmol/L of celecoxib.Compared with the control group,the ratio of TXB2/6-keto-PGF1αincreased at each time point in IR and IR+C (P<0.05),and the apoptosis rates increased (P<0.05).Cox-2,P-JNK and Cleaved caspase-3 increased.Compared with IR,the ratio of TXB2/6-keto-PGF1αdecreased at each time point in IR+C (P<0.05),and the apoptosis rates decreased (t=3.34~6.38,P< 0.05).The protein expression of Cox-2,P-JNK and Cleaved caspase-3 decreased.Conclusions Celecoxib may help to protect HBMECs from releasing TXA2 and decreasing the ratio of TXB2/6-keto-PGF1α,and inhibitting apoptosis after irradiation.The mechanisms of apoptosis inhibition may be related to the inhibition of Cox-2 and P-JNK,caspase-3 Cleaved proteinexpressions.

18.
Article in Chinese | WPRIM | ID: wpr-610588

ABSTRACT

Objective To describe the experiences when different methods were used to treat early-onset antibody-mediated rejection (AMR) after kidney transplantation.Methods The clinical data of 42 recipients who experienced early-onset acute AMR after kidney transplantation in our department from Jan.2010 to Apr.2016 were retrospectively analyzed.The recipients were divided into 3 groups based on different strategies against AMR:group A (plasma exchange with intravenous immunoglobin);group B (bortezomib solo),and group C (combination of bortezomib and sirolimus).Results All the AMR episodes were diagnosed by kidney biopsy 9-27 days after transplantation.The AMR reversal rate in groups B and C was significantly higher than that in group A (100% versus 60.00%,P=0.034;100% versus 60.00%,P=0.007).The AMR recurrence rate in groups B and C was significantly lower than that in group A (0 versus 41.67%,P =0.035;0 versus 41.67%,P =0.007).The recipient survival rate was 100% in all the three groups.There were 11 graft losses in group A,and none in group B or C.The graft survival rate in group B at 6 months,1 year and 3 years was significantly higher than in group A (100% versus 60.00%,P =0.034;100% versus 55.00%,P =0.021;100% versus 50.00%,P =0.013).The graft survival rate in group C at 6 months and 1 year was significantly higher than in group A (100% versus 60.00%,P =0.007;100% versus 55.00%,P =0.003).There was no significant difference in AMR reversal rate,AMR recurrence rate and graft survival rate between groups B and C.There was no significant difference in incidences of infection,hyperlipidemia and bone marrow suppression among the three groups.The incidence of diarrhea in groups B and C was significantly higher than in group A (50.00% versus 0,P =0.001;42.86% versus 0,P =0.001).The incidence of peripheral neuritis in group B was significantly higher than in group A (25.00% versus 0,P =0.02),but similar to group C.There was no significant difference in average serum creatinine level among three groups within 1 year after treatment (P> 0.05).Antibodies against human leukocyte antigen (HLA) and donor specific antibodies were detected in all the 42 recipients before treatment.The negative conversion ratio of panel reactive antibody (PRA) in group A was significantly lower than in groups B and C (10.00% versus 87.50%,P< 0.001;10.00% versus 92.86%,P < 0.001).The PRA recurrence rate in group A was significantly higher than in groups B and C (85.00% versus 37.50%,P<0.001;85.00% versus 0,P<0.001),while that in group B was significantly higher than in group C (37.50% versus 0,P =0.014).The ratio of Treg in peripheral blood at 3-12 month after treatment in group C was significantly higher than in groups A and B (P<0.05).Conclusion Treatment for early-onset AMR after kidney transplantation based on bortezomib might be an effective and safe strategy.Graft longterm survival might benefit from the combination of bortezomib and sirolimus.

20.
Chinese Journal of Virology ; (6): 179-184, 2016.
Article in Chinese | WPRIM | ID: wpr-296200

ABSTRACT

To analyze the genetic characterization of epidemic mumps virus strains in Liaoning Province and provide the basis for mumps control. A total of 32 mumps viruses strains were isolated during 2008-2104. The fragment of SH genes and HN genes were amplified by RT-PCR, the PCR products were sequenced and analyzed. Basing on the 316 nucleotides of SH gene, The phylogenetic analyses were processed with the data of WHO mumps reference strains downloaded from GenBank and 32 mumps viruses strains. It showed that the 31 mumps virus strains belong to F genotype except MuVi/Liaoning. CHN/16.11 which was G genotype . Comparing to the A reference strains (Jeryl-Lynn and S-79), F genotype MuV were mutated on 12 amino acids sites and 27 amino acids siteson on HN gene. F genotype MuV added one N-glycosylation site in 464th-466th amino acids. The antigenic sites on HN were mutated on 121th, 123th, 279th, 287th, 336th, 356th and 442th. Maybe, it will influence the MuV antigenic.


Subject(s)
Base Sequence , China , Genotype , HN Protein , Chemistry , Genetics , Humans , Molecular Sequence Data , Mumps , Virology , Mumps virus , Chemistry , Classification , Genetics , Phylogeny , Sequence Alignment , Viral Proteins , Chemistry , Genetics
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