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1.
Article in Chinese | WPRIM | ID: wpr-884487

ABSTRACT

Objective:To investigate the effectiveness of abdominal compression in tumor motion and the target volume, and analyze the suitable margins of planning target volume (PTV) for patients treated with lung-SBRT based on 4DCT.Methods:Patients diagnosed with peripheral pulmonary tumor were enrolled. The patients were divided into the whole group, upper-middle-lobe group (group A) and the lower-lobe group (group B). Each patient underwent 3DCT, 4DCT with abdominal compression (4DCT com) and 4DCT with free breath (4DCT free) scans. The GTVs were delineated and IGTVs on these images. PTV MIP 5 mm, PTV MIP 4 mm, PTV MIP 3 mm were constructed with a 5, 4, 3 mm margin in left-right (LR), anterior-posterior (AP) directions and cranial-caudal (CC) directions. Results:The median motion vector with compression reduced by 30.92% in whole group, increased by 3.42% in group A and reduced by 18.80% in group B, respectively. And there were no significant differences of TMA LR, TMA AP, TMA CC and motion vector by the Wilcoxon test ( P>0.05). The median sizes of IGTV MIP com , IGTV MIP free and IGTV10 com, IGTV10 free were 4.01, 5.36 cm 3and 6.59, 7.65 cm 3, with statistically significant difference ( Z=-3.45, -3.14, P<0.01). The median ratio of DI of IGTV CBCT com in PTV MIP 5 mm, PTV MIP 4 mm and PTV MIP 3 mm≥95% was 100%, 100% and 83.33%, respectively. Conclusions:The patients′ respiratory pattern changed with abdominal compression and abdominal compression is useful in reducing the size of IGTV MIP and IGTV10, which could reduce the target volume and protect the normal tissue. Adding a 4 mm margin to IGTV MIP com based on 4DCT account for respiration in SBRT is a tendency for precise radiotherapy.

2.
Article in Chinese | WPRIM | ID: wpr-910560

ABSTRACT

Stereotactic body radiotherapy (SBRT/SABR) has become an important option in the treatment of early non-small-cell lung cancer (NSCLC). Radiation pneumonitis (RP) is the main side effect of early NSCLC patients after SBRT/SABR. Patient factors, tumor factors and treatment factors are all associated with the occurrence of RP in early NSCLC patients after SBRT/SABR. In recent years, relevant studies have further clarified the relationship between these factors and RP. In addition, the prediction factors related to RP occurrence are further discussed. In this paper, relevant research progresses in recent years were reviewed.

3.
Article in Chinese | WPRIM | ID: wpr-910544

ABSTRACT

Objective:To evaluate the spatial position and functional parameters of 18F-FDG PET-CT and diffusion-weighted imaging (DWI) before and during radiotherapy (RT) based on the medium of 3DCT in patients with esophageal cancer and to explore whether the high-signal area derived from DWI can be used for individualized definition of the volume in need of dose-escalation for esophageal cancer. Methods:Thirty-two patients with esophageal cancer treated with concurrent chemoradiotherapy or neoadjuvant chemoradiation sequentially underwent repeated 3DCT, 18F-FDG PET-CT and enhanced MRI scans before RT and at the 15 th time of RT. All images were fused with the 3DCT images by deformable registration. The gross tumor volume (GTV) was delineated based on PET Edge on the first and second 3DCT, PET-CT and DWI and corresponding T 2-weighted MRI (T 2W-MRI) fused images, and defined as GTV CTpre and GTV CTdur, GTV PETpre, GTV PETdur, GTV DWIpre and GTV DWIdur, respectively. SUV (SUV max, SUV mean, SUV peak), MTV, TLG, ADC (ADC min and ADC mean) values and △SUV (△SUV max, △SUV mean, △SUV peak), △MTV, △TLG, △ADC (△ADC mean and △ADC min) of lesions were measured before and during RT. Results:The differences in SUV (SUV max, SUV mean, SUV peak), MTV, TLG, ADC mean and ADC min of the GTV before and during RT were statistically significant (all P<0.001). The tumor ADC and SUV values before and during RT showed no significant correlation, and there was no correlation between △ADC and △SUV (both P>0.05). The conformity index (CI) of GTV PETpre to GTV DWIpre was significantly higher than that of GTV PETdur to GTV DWIdur ( P<0.001). The shrinkage rate of maximum diameter (△LD DWI)(24%) and the shrinkage rate of tumor volume (VRR DWI)(60%) based on DWI during RT were significantly greater than the corresponding PET-based △LD PET (14%) and VRR PET (41%)( P=0.017 and P<0.001). Conclusions:The location of high residual FDG uptake based on PET-CT yields poor spatial matching compared with the area with residual high signal based on DWI during RT. Tumor ADC and SUV values may play complementary roles as imaging markers for prediction of patterns of failure and for definition of the volume in need of dose-escalation. In addition, the shrinkage rates of tumor maximum diameter/volume based on DWI during RT are significantly faster than those based on PET-CT. Therefore, the feasibility of selecting boosting of the high signal area derived from DWI for individualized definition of the volume for esophageal cancer is not clear.

4.
Article in Chinese | WPRIM | ID: wpr-910426

ABSTRACT

Objective:To develop and validate a nomogram model for predicting radiation-induced pneumonitis in esophageal cancer based on CBCT radiomics characteristics combined with clinical characteristics and lung dosimetric parameters.Methods:Clinical data, dosimetric parameters and CBCT images of 96 patients with thoracic middle esophageal squamous cell carcinoma treated by intensity-modulated radiation therapy (IMRT) from 2017 to 2019 were analyzed retrospectively. The CBCT images of each patient in three different time periods were obtained. All patients were assigned randomly into the primary cohort ( n=67) and validation cohort ( n=29). Double lungs were selected as the region of interest (ROI), and 3D-slicer software was used for image segmentation and feature extraction. The LASSO regression were applied to identify candidate radiomic features and construct the Rad-score. The optimal time period, clinical and dosimetric parameters were selected to construct the nomogram model, and then the area under the receiver operating characteristic curve (AUC) was used to evaluate the prediction effect of the model. Results:The predictive capacity of the model in the first time period was the highest. In the primary cohort, the AUC was 0.700(95% CI: 0.568-0.832), the sensitivity was 61.5%, and the specificity was 75.0%. In the validation cohort, the AUC was 0.765(95% CI: 0.588-0.941), the sensitivity was 84.6% and the specificity was 64.7%, respectively. In the combined nomogram model, the AUC in the primary cohort was 0.836(95% CI: 0.700-0.918), the sensitivity was 96.0% and the specificity was 54.8%. In the validation cohort, the AUC was 0.905(95% CI: 0.799-1.000), the sensitivity was 92.9% and the specificity was 73.3%, respectively. The diagnostic efficiency of combined nomogram model was the best. Conclusions:The nomogram model based on early lung CBCT radiomics has certain predictive efficiency for RP. The model of lung CBCT radiomics in early stage of radiotherapy can predict RP of esophageal cancer. The nomogram model based on Rad-score combined with V 5Gy, MLD and tumor stage yields better predictive accuracy, which can be used as a quantitative prediction model for RP.

5.
Article in Chinese | WPRIM | ID: wpr-868742

ABSTRACT

Objective:To assess the feasibility of delayed-enhancement MRI in contouring the lumpectomy cavity (LC) for patients with invisible seroma or a low cavity visualization score (CVS≤2) in the excision cavity after breast-conserving surgery (BCS).Methods:Twenty-six patients with stage T 1-2N 0M 0 who underwent prone radiotherapy after BCS were recruited. The LC delineated on CT simulation images was denoted as LC CT. The LCs delineated on T 2WI, as well as on different delayed phases (2-, 5-and 10-minute) of delayed-enhancement T 1WI were defined as LC T2, LC 2T1, LC 5T1 and LC 10T1, respectively. Subsequently, the volumes and locations of the LCs were compared between CT simulation images and different sequences of MR simulation images using deformable image registration. Results:The volumes of LC T2, LC 2T1, LC 5T1 and LC 10T1 were all larger than that of LC CT. A statistical significance was found between the volume of LC CT and those of LC 2T1 or LC 5T1, respectively (both P<0.05). The conformal index (CI), degree of inclusion (DI), dice similarity coefficient (DSC) and the distance between the center of mass of the targets (COM) of LC CT-LC 10T1 were better than those of LC CT-LC T2, LC CT-LC 2T1 and LC CT-LC 5T1, however, there was no statistical difference among them (all P>0.05). Conclusions:It is feasible to delineate the LC based on prone delayed-enhancement MR simulation images in patients with low CVS after BCS. Meanwhile, the LCs derived from prone delayed-enhancement T 1WI of 10-minute are the most similar with those derived from prone CT simulation scans using titanium clips, regardless of the volumes and locations of LCs.

6.
Article in Chinese | WPRIM | ID: wpr-868713

ABSTRACT

Subject To compare the irradiation-induced injury and clinical efficacy between SIB-IMRT and LB-IMRT for early-stage breast cancer after breast-conserving surgery.Methods:From November 2002 to February 2012, 353 early breast cancer patients who underwent IMRT after breast-preserving surgery at Shandong Cancer Hospital were selected, of whom 218 patients receiving SIB-IMRT and 135 patients receiving LB-IMRT.The prescription dose of the SIB-IMRT group was the ipsilateral breast (PTV b ) 1.8-1.9 Gy, 27-28 times, and concurrent tumor bed (PTV t) 2.15-2.3 Gy, 27-28 times. In the LB-IMRT group, the prescription dose was PTV b 2.0 Gy, 25 times, followed by PTV t boost 2.0 Gy, 5-8 times. Results:The median follow-up time was 92 months. The excellent, good, fair, and poor cosmetic results in the SIB-IMRT and LB-IMRT groups were 10.1% and 12.6%, 85.8% and 80.7%, 3.7% and 5.2%, 0.5%, and 0.7%, respectively ( P=0.731). The 5-year locoregional recurrence rates (LRRs) in the SIB-IMRT and LB-IMRT groups were 3.21% and 5.93% and the 10-year LRRs were 4.13% and 6.67%, respectively ( P=0.209, 0.280). The 3-, 5-, 8-, and 10-year overall survival rate in the SIB-IMRT and LB-IMRT groups were 97.7% and 97.8%, 96.3% and 95.2%, 94.9% and 92.0%, 93.6% and 90.3%, respectively ( P=0.288). The 3-, 5-, 8-, and 10-year disease-free survival in the SIB-IMRT and LB-IMRT groups were 95.4% and 93.8%, 91.8% and 87.7%, 89.9% and 84.1%, 89.0% and 82.1%, respectively ( P=0.160). Conclusion:There is no significant difference in the cosmetic effect, local control rate, and survival rate between SIB-IMRT and LB-IMRT after breast-preserving surgery in patients with early-stage breast cancer. SIB-IMRT is a safe and feasible treatment.

7.
Article in Chinese | WPRIM | ID: wpr-868638

ABSTRACT

Objective:To investigate the application value of 18F-FDG PET-CT combined with MRI in the radiotherapy for esophageal carcinoma by comparing the differences in the gross target volume (GTV), position length delineated on the end expiratory (EE) phase of 4DCT, PET-CT and T 2-weighted MRI (T 2W-MRI). Methods:Twenty-six patients with thoracic esophageal cancer scheduled to receive concurrent chemoradiotherapy sequentially underwent 3DCT, 4DCT, PET-CT and enhanced MRI for thoracic localization. All images were fused with the 3DCT images by deformable registration. GTV CT, GTV 50% GTV PET2.5, GTV MRI and GTV DWI were delineated on 3DCT, the EE phase of 4DCT images, PET-CT with the thresholds of SUV≥2.5, T 2W-MRI and diffusion-weighted images, respectively. Results:GTV PET2.5 was significantly larger than GTV 50% and GTV MRI ( P<0.001 and P=0.008), whereas the volume of GTV MRI was similar to that of GTV 50%( P=0.439). Significant differences were observed between the CI of GTV MRI to GTV 50% and GTV PET2.5 to GTV 50%( P=0.004). The conformity indexes (CIs) of GTV MRI to GTV CT and GTV PET2.5 to GTV CT were statistically significant ( P=0.004 and P=0.039). The CI of GTV MRI to GTV PET2.5 was significantly smaller than that of GTV MRI to GTV 50%, GTV MRI to GTV CT, GTV PET2.5 to GTV 50% and GTV PET2.5 to GTV CT ( P=0.000-0.021). The length of gastroscopy was similar to those of GTV PET2.5 and GTV DWI (both P>0.05), and there was no significant difference in the length between GTV PET2.5 and GTV DWI ( P=0.072). Conclusion:GTV MRI yields significantly different volume and poor spatial matching compared with GTV PET2.5. The application of PET-CT combined with MRI under respiratory gating system in the delineation of GTV should be used with caution in thoracic squamous esophageal cancer. MRI-DWI can replace PET-CT to help determine the upper and lower boundaries of GTV based on CT images.

8.
Article in Chinese | WPRIM | ID: wpr-868622

ABSTRACT

Objective:To explore the interobserver variabilities in the delineation of the target volume using simulation three-dimensional computed tomography (3DCT) between the supine and prone positions for external-beam partial breast irradiation (EB-PBI) after breast-conserving surgery (BCS).Methods:Twenty-seven breast cancer patients who were scheduled to receive EB-PBI after BCS from July 2016 to April 2017 were enrolled in this study. All patients underwent axial 3DCT simulation scanning in the supine and prone positions during free breathing. Based on two different simulation 3DCT acquired, the gross target volume (TB) formed by using surgical clips and the clinical target volume (CTV) were delineated by five radiologists using specific guidelines. The following parameters including the target volume, coefficient of variations (COV) and matching degree (MD) were calculated to analyze the interobserver variability. Twenty-seven breast cancer patients who were scheduled to receive EB-PBI after BCS from July 2016 to April 2017 were enrolled in this study.Results:Whether in the supine or prone position, the interobserver variabilities for TB and CTV were statistically significant ( P<0.001, P=0.001, P<0.001, P=0.001). And the intersection of CTV in the prone position was 5.79 cm 3 greater than that in the supine position ( P=0.011). The interobserver variability of COV CTV in the prone positionwas significantly lower than that in the supine position ( P=0.014). And the interobserver variabilities of MDTB TB and MDTB CTV in the prone positionwere statistically greater than those in the supine position, respectively ( P<0.001, P= 0.001). Conclusions:When delineating the target volume of EB-PBI in the prone position, the interobsever variability can be reduced compared with that in the supine position. Hence, it is more reasonable to carry out EB-PBI in the prone position in free breathing.

9.
Article in Chinese | WPRIM | ID: wpr-868551

ABSTRACT

Dose-guided radiotherapy (DGRT) is a potentially useful adaptive radiotherapy method which dosimetrically compensates for interfractional non-rigid deformation.With the improvement of in-room imaging quality,development of the deformation registration algorithm and innovation of computer science,the wide application of DGRT might be realized.The purpose of this article is to briefly summarize the work flow,clinical application and prospect of DGRT.

10.
Article in Chinese | WPRIM | ID: wpr-868533

ABSTRACT

Objective:To investigate the effects of clinical characteristics, irradiation techniques and dose-volume parameters on radiation pneumonitis(RP) in thoracic segment esophageal cancer patients, so as to provide reference for the formulation of radiotherapy protocol for thoracic esophageal cancer.Methods:The incidence of RP in 247 patients with thoracic segment esophageal cancer from June 2014 to June 2019 was analyzed retrospectively, then univariate and multivariate analyses were performed on the clinical characteristics, radiation techniques and lung dosimetry parameters of these patients. The area under receiver operating characteristic (ROC) curve was used to verify the diagnostic efficacy of RP≥grade 1, ≥grade 2 and ≥grade 3.Results:There were 118 cases (47.8%)with RP≥grade 1, 54 cases (21.9%)with RP≥grade 2, 17 cases (6.9%)with RP≥grade 3. The result of univariate analysis showed that lung V5- V40 and MLD were both related to the occurrence of RP≥grade 1( Z=-5.802 to -4.306, P<0.05). ≥grade 2, and≥grade 3, respectively( F=0.057 to 11.616、0.087 to 3.392, P<0.05). GTV volume, PTV volume, GTV/lung volume(%) and PTV/lung volume(%) were related to RP≥grade 1( Z=-3.377 to -2.041, P<0.05)and RP≥grade 2( F=3.600 to 9.801, P<0.05). Smoking index >400 was significantly correlated with RP≥grade 3( χ2=13.295, P<0.05), and chronic obstructive pulmonary disease (COPD) was significantly correlated with RP≥grade 1( χ2=9.146, P<0.05). However, there was no significant correlation between RP and different irradiation techniques, chemotherapy factors, radiotherapy dose, esophageal cancer stage and cancer location.The result of multivariate analysis showed that V5 and V40 were independent risk factors of RP≥grade 1(AUC 55.74%、4.13%)、MLD was independent risk factors of RP≥grade 2 (AUC 11.91 Gy), and V5 was independent risk factors of RP≥grade 3(AUC 57.60%). The smoking index>400 was the independent risk factor of RP≥grade 3 ( Wald=5.964, P<0.05), and COPD was the independent risk factor of RP≥1 grade ( Wald=6.110, P<0.05). Conclusions:The incidence of RP is low after radiotherapy for thoracic segment esophageal cancer. The dosimetric parameters such as lung V5, V40, MLD, smoking degree, COPD and other clinical characteristics are closely related to the occurrence of RP of corresponding grades.

11.
Article in Chinese | WPRIM | ID: wpr-868442

ABSTRACT

Objective:To compare positional and volumetric differences between the gross target volumes (GTV) delineated on three-dimensional CT (3D-CT) referencing 18F-FDG PET/CT and the GTV on the deformed image derived from 3D-CT and 18F-FDG PET/CT for primary thoracic esophageal cancer (EC). Methods:Seventy-two patients underwent chemoradiotherapy were enrolled. All the patients sequentially underwent 18F-FDG PET/CT scans for diagnosis and 3D-CT scans for simulation. The GTV 3D was delineated on 3D-CT without referencing 18F-FDG PET/CT. The GTV PET-ref was delineated on 3D-CT referencing 18F-FDG PET/CT. The GTV PET-regwas delineated on the deformed image derived from 3D-CT and 18F-FDG PET/CT by MIM deformable registration software. The differences in position, volume, length, conformity index (CI), and degree of inclusion (DI) of target volumes were compared, respectively. Results:The median volume of GTV 3D, GTV PET-ref, GTV PET-reg were 44.90, 40.36 and 41.15 cm 3, respectively. There was no statistical difference between the volumes of any two targets. The mean lengths of GTV 3D, GTV PET-ref, GTV PET-reg were 8.54, 9.29 and 8.38 cm, respectively. The length of GTV PET-ref was longer than that of GTV 3D ( t=2.134, P<0.05). The median DIs of GTV PET-ref, GTV PET-regin GTV 3D were 0.86, 0.82( Z=-2.741, P<0.05), and that of GTV 3D in GTV PET-ref, GTV PET-reg were 0.87, 0.84 ( Z=-1.429, P<0.05). The median CIs of GTV 3D in GTV PET-ref and GTV PET-reg were 0.72, 0.68 ( Z=2.756, P<0.05), and the difference was significant. The CIs of GTV 3D and GTV PET-ref, GTV 3D and GTV PET-reg, GTV PET-ref and GTV PET-reg had significant negative correlation with the distance of target centers. Conclusions:There was no significant difference between GTV contoured on three-dimensional CT (3D-CT) referencing 18F-FDG PET/CT and the GTV on the deformed image derived from 3D-CT and 18F-FDG PET/CT either in volume size or in spatial position. Therefore, it is recommended that radiation oncologists can refer to the recent diagnostic PET/CT when delineating the gross target volume for primary thoracic esophageal cancer.

12.
Article in Chinese | WPRIM | ID: wpr-866398

ABSTRACT

Objective:To investigate the effect of oxygen-driven aerosol inhalation of anti-asthmatic drugs in the treatment of elderly patients with chronic bronchitis and its influence on the quality of life.Methods:From January 2015 to January 2018, 68 elderly patients with chronic bronchitis in Zhejiang Xin'an International Hospital were randomly selected and divided into control group and observation group according to different treatment methods, with 34 cases in each group.The control group was given anti-infective, relieving cough and asthma, ultrasonic atomized inhalation and other treatments, meanwhile oral health education and routine care were also given.The observation group was implemented oxygen-driven aerosol inhalation of anti-asthmatic drugs based on the control group.The phlegm quantity of the two groups was recorded on the 1st, 2nd, 3rd, 4th and 5th day of treatment.The respiratory rate, heart rate and SpO 2 were measured during the treatment period.The improvements of clinical symptoms and signs were compared.The anxiety, depressive symptoms, treatment adherence, subjective well-being and quality of life of the two groups before and after intervention were evaluated. Results:The amount of sputum in the observation group was significantly higher than that in the control group on day 1, 2 and 3[(18.53±2.96)mL vs.(15.42±2.72)mL, (27.69±7.22)mL vs.(21.52±4.58)mL, (36.11±5.24)mL vs.(25.48±4.57)mL] ( t=4.511, 4.208, 8.915, P=0.000, 0.000, 0.000). At the 4th day after treatment, the amount of sputum had no statistically significant difference between the two groups ( t=0.013, P=0.989). At the 5th day after treatment, the amount of sputum in the observation group was significantly less than that in the control group[(26.62±4.47)mL vs.(33.11±8.74)mL]( t=3.855, P=0.000). The respiratory rate and heart rate had no statistically significant differences between the two groups during treatment (all P>0.05). The SpO 2 level in the observation group was significantly lower than that in the control group[(92.00±3.00)% vs.(95.00±2.00)%]( t=4.852, P=0.000). The cough improvement time, dyspnea relief time and the improvement time of lung wet snoring sound in the observation group were significantly shorter than those in the control group[(2.88±0.55)d vs.(3.91±0.74)d, (3.17±0.62)d vs.(3.96±0.75)d, (3.63±0.61)d vs.(4.08±0.76)d]( t=6.514, 4.734, 2.693, P=0.000, 0.000, 0.001). The treatment adherence and quality of life scores of the two groups after intervention were significantly higher than before intervention (control group: t=7.226, P=0.000; observation group: t=18.073, P=0.000). The scores of treatment adherence and quality of life in the observation group were (93.58±6.25)points and (89.63±9.88)points, which were significantly higher than those in the control group [(82.15±6.33points and (78.93±10.22)points] ( t=7.492, 4.389, P=0.000, 0.000). The subjective well-being scores of the two groups after intervention were significantly lower than before intervention (control group: t=10.338, 4.474, P=0.000, 0.000; observation group: t=16.354, 8.939, P=0.000, 0.000), the decline of the observation group was more significant compared with the control group ( t=13.936, P=0.000). Conclusion:Oxygen-driven aerosol inhalation of anti-asthmatic drugs has good antispasmodic and antitussive effect in the treatment of elderly patients with chronic bronchitis.At the same time, oxygen inhalation can be guaranteed to increase the oxygen partial pressure, accelerate the patients’ condition, stabilize the patients’ mood and improve the patients’ self-confidence, thereby improving its treatment compliance, better control the disease to improve their quality of life and happiness.

13.
Article in Chinese | WPRIM | ID: wpr-863181

ABSTRACT

Cerebral microbleeds (CMBs) is a imaging manifestation of cerebral small vessel disease. At present, more and more opinions believe that vascular endothelial injury plays an important role in the pathogenesis of CMBs. The destruction of the blood-brain barrier and inflammatory response caused by vascular endothelial dysfunction may promote the occurrence and development of CMBs. At the same time, the deposition of hemosiderin around the lesion of CMBs may also trigger an inflammatory response. However, the relevant mechanisms and causality have not yet been fully elucidated. This article reviews the vascular endothelial inflammatory factors related to CMBs and their mechanism in the pathogenesis of CMBs.

14.
Article in Chinese | WPRIM | ID: wpr-798810

ABSTRACT

Dose-guided radiotherapy (DGRT) is a potentially useful adaptive radiotherapy method which dosimetrically compensates for interfractional non-rigid deformation. With the improvement of in-room imaging quality, development of the deformation registration algorithm and innovation of computer science, the wide application of DGRT might be realized. The purpose of this article is to briefly summarize the work flow, clinical application and prospect of DGRT.

15.
Article in Chinese | WPRIM | ID: wpr-751741

ABSTRACT

Objective To observe the effect of Chaihu-Longgu-Muli decoction combined flupentixol and melitracen tablets for the post-stroke depression (PSD).Methods The random number table method was used to divide the 150 patients with PSD into the observation group and control group,75 cases in each group.On the basis of conventional treatment of stroke,the control group took oral flupentixol and melitracen tablets,and the treatment group add Chaihu-Longgu-Muli decoction on the basic treatment of control gorup.The treatment of two groups last 1 month.The serum APN concentration was detected before and after treatment.Besides,the HAMD,NIHSS scores,and the clinical curative effect were observed and compared.Results The total effective rate of the observation group was 81.3%,and control group was 58.7%,which the difference between the two groups showed the statistical significance (P<0.05).After treatment,the serum APN (7.8 ± 3.7 mg/L vs.6.1 ± 3.3 mg/L,t=2.970) level in the observation group was significantly higher than that in the control group (P<0.05).The HADM (16.4 ± 3.6 vs.19.6 ± 4.9,t=4.558),NIHSS (5.0 ± 1.6 vs.7.7 ± 2.0,t=9.129) scores in the observation group were significantly lower than those in the control group (P<0.01).Conclusions The Chaihu-Longgu-Muli decoction combined flupentixol and melitracen tablets can reduce the serum APN level of PSD patients,improve patients with depression,alleviate patients' neurologic deficits.

16.
Article in Chinese | WPRIM | ID: wpr-801073

ABSTRACT

18F-FDG PET-CT is recommended for the diagnosis and treatment of non-small cell lung cancer (NSCLC), and guiding the optimization of radiotherapy planning. The target area determined by biological information carried by functional images is defined as biological target volume (BTV). However, BTV significantly differs from the gross tumor volume (GTV) and internal target volume (ITV) defined by the International Commission on Radiation Units and Measurements (ICRU) report. It is still a challenging task to directly apply BTV to radiotherapy planning. The limitation of PET image, the accuracy of fusion with auxiliary anatomic images and the influence of respiratory movement cause the uncertainty of BTV definition in NSCLC patients. Referring to different anatomical images, multiple approaches can be employed to achieve BTV motion information compensation. Application of PET-CT in predicting the prognosis of NSCLC patients after radiotherapy and distinguishing the recurrence risk of biological sub-target contribute to achieving the dose planning for radiotherapy planning.

17.
Article in Chinese | WPRIM | ID: wpr-798039

ABSTRACT

Construction and application of immunization information system is an important part of health information, which is very useful to improve the quality, efficiency and safety of vaccination. The background, system architecture, functions and applications, working conditions and characteristics of Shandong province Immunization Information System (IIS) are introduced in this article. It is expected to provide experiences for the development of immunization information system of other provinces.

18.
Article in Chinese | WPRIM | ID: wpr-745252

ABSTRACT

Objective To compare the size of the internal target volume (ITV),biological target volume (BTV) and internal biological target volume (IBTV) based on PET-CT and 4DCT for primary nonsmall cell lung cancer (NSCLC),as well as try to apply IBTV in radiotherapy planning.Methods A total of 15 patients with NSCLC were sequentially scanned by an axial enhanced 3DCT,4DCT and 18F-FDG PET-CT in the thoracic region.The gross target volumes (GTVs) of ten phases of 4DCT images were contoured,and ITV was obtained by fusion of ten GTVs.BTV based on PET-CT images was determined by the SUV 2.0.The IBTV was defined by fusion of ITV and BTV.Planning target volumes (PTVs) based on ITV,BTV,and IBTV (PITV,PBTV,PIBTV) were obtained by ITV,BTV and IBTV with a 10-mm expansion respectively.The metrics of PIBTV,PITV and PBTV were compared,and the planning parameters of target volumes and risk organs were evaluated.Results There was no significant difference between ITV and BTV,but there was significant difference between IBTV and ITV and BTV (F=22.533,P < 0.05).To include more than 95% volume of IBTV,it is necessary to expand the margin of 9.0(6.0,12.0)mm based on BTV or 10.00(7.0,12.0)mm based on ITV.There was no significant difference between the two groups (P > 0.05).Dice's similarity coefficient of BTV and ITV was 0.72(0.54,0.79).The intensity modulated radiotherapy plan based on PBTV can guarantee 85.6% (80.5%,91.2%) of PITV to reach the prescription dose,compared with 80.2% (74.4%,87.6%) of PBTV by the plan from PITV.Additionally,the conformity index and homogeneity index were not ideal.The dosimetric parameters of PITV and PBTV in the PIBTV plan were much better than those in PBTV-and PITV plan.Conclusions The radiotherapy plan based on PET-CT or 4DCT could not guarantee a reasonable dose distribution of PTV expanded from ITV or BTV.Thus,using IBTV for radiotherapy is advised.

19.
Article in Chinese | WPRIM | ID: wpr-742718

ABSTRACT

Objective:To investigate the regulatory effect of lumbrukinase (LBK) on the gastric cancer SGC7901cells, and to clarify its mechanism.Methods:The SGC7901cells in the logarithmic growth phase were selected and divided into control group and 2, 4, 8U·mL-1 LBK groups.MTT assay was used to detect the inhibitory rates of proliferation of SGC7901cells in various groups in vitro at different time (24, 48and 72h) .Cell scratch assay was used to detect the migration abilities of the SGC7901cells in vitro in various groups.Flow cytometry was used to determine the apoptotic rates of SGC7901cells and the pencentages of cells at different cell cycles in various groups.The expression levels of Bcl-2, Bax, and caspase-3in the SGC7901cells in various groups were detected by Western blotting method.Results:The results of MTT assay showed that compared with control group, the inhibitory rates of SGC7901cells in different doses of LBK groups after treated for 24, 48and 72hwere increased (P<0.01) .The cell scratch assay results showed that compared with control group, the migration distances of SGC7901cells in4and 8U·mL-1 LBK groups were increased significantly (P<0.01) .The flow cytometry results showed that compared with control group, the apoptotic rates of SGC7901cells in 4and 8U·mL-1 LBK groups were increased significantly (P<0.01) ;the percentages of cells in G1and S phases were decreased (P<0.01) ;the percentages of cells in G2phase were increased (P<0.01) .The results of Western blotting method showed that compared with control group, the Bcl-2protein expression level in the SGC7901cells in 8U·mL-1 LBK group was decreased (P<0.05) ;the Bax and caspase-3protein expression levels were increased (P<0.05) .Conclusion:LBK can inhibit the proliferation and migration abilities of SGC7901cells in vitro and induce the apoptosis;its mechanism is achieved through the regulation of expression levels of Bcl-2, Bax, and caspase-3proteins.

20.
Article in Chinese | WPRIM | ID: wpr-773536

ABSTRACT

OBJECTIVE@#To investigate the inhibitory effect of matrine on the proliferation of human non-small cell lung cancer (NSCLC) and explore the possible molecular mechanism.@*METHODS@#Cultured human NSCLC A549 cells were treated with 0.4, 0.8, 1.2, 1.6, and 2.0 g/L matrine for 24, 48 or 72 h. CCK-8 assay was used for measuring the changes in A549 cell viability. The morphological changes of the cells were observed under a fluorescence microscope, and flow cytometry was employed for analyzing the cell apoptosis. The effects of matrine and the PI3K specific inhibitor LY294002 (10 nmol/L) on AKT pathway and autophagy-related proteins in A549 cells were investigated using Western blotting.@*RESULTS@#Matrine significantly inhibited the proliferation of A549 cells in a time- and dose-dependent manner ( < 0.05). At the concentration of 1.6 g/L or higher, matrine caused obvious cell shrinkage and fragmentation and significantly increased floating cells; autophagy vacuoles could be observed in the cells after acridine orange staining. Within the concentrations range of 0.8-1.6 g/L, matrine time- and dosedependently increased the cell apoptosis. Treatment of the cells with 1.6 g/L matrine and 10 nmol/L LY294002 resulted in significantly lowered expressions of p-AKT and p-mTOR proteins and increased the expression of light chain 3B (LC 3B), an autophagy-related protein, as compared with those in the control cells ( < 0.05).@*CONCLUSIONS@#We demonstrate that matrine inhibits the proliferation and induces autophagy and apoptosis of A549 cells by deactivating AKT pathway, suggesting the potential of matrine as an anti-cancer agent for lung cancer.


Subject(s)
Alkaloids , Apoptosis , Autophagy , Carcinoma, Non-Small-Cell Lung , Cell Proliferation , Humans , Lung Neoplasms , Phosphatidylinositol 3-Kinases , Proto-Oncogene Proteins c-akt , Quinolizines , Signal Transduction , TOR Serine-Threonine Kinases
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