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1.
Chin Med J (Engl) ; 128(22): 3003-7, 2015 Nov 20.
Article in English | MEDLINE | ID: mdl-26608978

ABSTRACT

BACKGROUND: The prevalence of malnutrition is very high in patients with cancer. The purpose of this study was to investigate whether or not a nutrition support team (NST) could benefit esophageal cancer patients undergoing chemoradiotherapy (CRT). METHODS: Between June 2012 and April 2014, 50 esophageal cancer patients undergoing concurrent CRT were randomly assigned into two groups: The NST group and the control group. The nutritional statuses of 25 patients in the NST group were managed by the NST. The other 25 patients in the control group underwent the supervision of radiotherapy practitioners. At the end of the CRT, nutritional status, the incidence of complications, and completion rate of radiotherapy were evaluated. Besides, the length of hospital stay (LOS) and the in-patient cost were also compared between these two groups. RESULTS: At the completion of CRF, the nutritional status in the NST group were much better than those in the control group, as evidenced by prealbumin (ALB), transferrin, and ALB parameters (P = 0.001, 0.000, and 0.000, respectively). The complication incidences, including bone marrow suppression (20% vs. 48%, P = 0.037) and complications related infections (12% vs. 44%, P = 0.012), in the NST group were lower and significantly different from the control group. In addition, only one patient in the NST group did not complete the planned radiotherapy while 6 patients in the control group had interrupted or delayed radiotherapy (96% vs. 76%, P = 0.103). Furthermore, the average LOS was decreased by 4.5 days (P = 0.001) and in-patient cost was reduced to 1.26 ± 0.75 thousand US dollars person-times (P > 0.05) in the NST group. CONCLUSIONS: A NST could provide positive effects in esophageal cancer patients during concurrent CRT on maintaining their nutrition status and improving the compliance of CRF. Moreover, the NST could be helpful on reducing LOS and in-patient costs.


Subject(s)
Chemoradiotherapy , Esophageal Neoplasms/drug therapy , Esophageal Neoplasms/therapy , Nutritional Support/methods , Adult , Female , Humans , Length of Stay , Male , Middle Aged , Nutritional Status , Patient Care Team , Treatment Outcome
2.
Zhonghua Yi Xue Za Zhi ; 95(10): 766-9, 2015 Mar 17.
Article in Chinese | MEDLINE | ID: mdl-26080850

ABSTRACT

OBJECTIVE: To explore the effects of glutamine, eicosapntemacnioc acid (EPA) and branched-chain amino acids supplements in esophageal cancer patients on concurrent chemoradiotherapy and gastric cancer patients on chemotherapy. METHODS: From April 2013 to April 2014, a total of 104 esophageal and gastric carcinoma patients on chemotherapy or concurrent chemoradiotherapy were recruited and randomly divided into experimental and control groups. Both groups received dietary counseling and routine nutritional supports while only experimental group received supplements of glutamine (20 g/d), EPA (3.3 g/d) and branched-chain amino acids (8 g/d). And body compositions, blood indicators, incidence of complications and completion rates of therapy were compared between two groups. RESULTS: After treatment, free fat mass and muscle weight increased significantly in experiment group while decreased in control group (P < 0.05). And albumin, red blood cell count, white blood cell count and blood platelet count remained stable in experiment group while declined significantly in control group. During treatment, compared to control group, the incidences of infection-associated complication were lower (6% vs 19%, P < 0.05) and the completion rates of therapy were significantly higher in experiment group (96% vs 83%, P < 0.05). CONCLUSION: Supplements of glutamine, EPA and branched-chain amino acids can help maintain nutrition status, decrease the complications and improve compliance for esophageal cancer patients on concurrent chemo-radiotherapy and gastric cancer patients on postoperative adjuvant chemotherapy.


Subject(s)
Esophageal Neoplasms , Nutritional Status , Stomach Neoplasms , Amino Acids, Branched-Chain , Chemoradiotherapy , Chemotherapy, Adjuvant , Dietary Supplements , Glutamine , Humans , Nutritional Support , Patient Compliance
3.
Zhonghua Zhong Liu Za Zhi ; 34(11): 846-9, 2012 Nov.
Article in Chinese | MEDLINE | ID: mdl-23291135

ABSTRACT

OBJECTIVE: To assess the value of application of percutaneous radiofrequency ablation (RFA) with artificial hydrothorax for liver cancer in the hepatic dome. METHODS: Thirty-two patients with 43 lesions of hepatic malignant tumors in the hepatic dome underwent ultrasound-guided percutaneous radiofrequency ablation (RFA) with artificial hydrothorax. Artificial hydrothorax was created by infusion of saline via an intrathoracically placed 14-G central venous catheter, which was ultrasound-guided percutaneously inserted before RFA, separating the right lung from the hepatic dome. The adverse reaction and therapeutic efficacy were also analyzed. RESULTS: In the 32 patients with 43 lesions in the hepatic dome (4 tumors in segment IV 21 tumors in segment VII and 18 tumors in segment VIII), 18 lesions of 14 patients were not observed by ultrasound before the operation. Thirty-two patients received the ultrasound-guided placement of intrathoracical catheter, and (1606.3 ± 485.9) ml (1000 - 2500 ml) saline solution was infused successfully. After obtaining an image of the whole tumor, 31 patients received percutaneous RFA therapy on schedule, and 22 patients received percutaneous transdiaphragmatic RFA therapy. One patient with 2 lesions gave up the treatment, because one of his tumors was not detectable by ultrasound. Diaphragmatic muscle hemorrhage was seen in two patients, subcutaneous edema in two patients, and pneumothorax in one patient. All the complications were cured, and no serious complications or related death occurred. 1-month follow-up with contrast-enhanced CT/MRI images showed that 29 patients had complete ablation, and the effective rate of this technique was 93.5% (29/31). CONCLUSIONS: Artificial hydrothorax helps us not only to visualize the whole tumor in the hepatic dome, but also offers a transdiaphragmatic route for therapy. Ultrasound-guided percutaneous RFA with artificial hydrothorax is a feasible, safe, and effective technique for treating liver cancer in the hepatic dome and worthy of being promoted.


Subject(s)
Carcinoma, Hepatocellular/surgery , Catheter Ablation/methods , Liver Neoplasms/surgery , Adult , Aged , Carcinoma, Hepatocellular/diagnostic imaging , Female , Follow-Up Studies , Humans , Hydrothorax , Liver Neoplasms/diagnostic imaging , Male , Middle Aged , Sodium Chloride , Ultrasonography, Interventional
4.
Cancer Sci ; 101(6): 1501-10, 2010 Jun.
Article in English | MEDLINE | ID: mdl-20345479

ABSTRACT

Chronic infections by hepatitis B virus (HBV) and hepatitis C virus (HCV) appear to be the most significant causes of hepatocellular carcinoma (HCC). Aberrant promoter methylation is known to be deeply involved in cancer, including in HCC. In this study, we analyzed aberrant promoter methylation by methylated DNA immunoprecipitation-on-chip analysis on a genome-wide scale in six HCCs including three HBV-related and three HCV-related HCCs, six matched noncancerous liver tissues, and three normal liver tissues. Candidate genes with promoter methylation were detected more frequently in HCV-related HCC. Candidate genes methylated preferentially to HBV-related or HCV-related HCCs were detected and selected, and methylation levels of the selected genes were validated by quantitative methylation analysis using MALDI-TOF mass spectrometry using 125 liver tissue samples, including 61 HCCs (28 HBV-related HCCs and 33 HCV-related HCCs) and 59 matched noncancerous livers, and five normal livers. Among analyzed genes, preferential methylation in HBV-related HCC was validated in one gene only. However, 15 genes were found to be methylated preferentially in HCV-related HCC, which was independent from age. Hierarchical clustering of HCC using these genes stratified HCV-related HCC as a cluster of frequently methylated samples. The 15 genes included genes inhibitory to cancer-related signaling such as RAS/RAF/ERK and Wnt/beta-catenin pathways. Methylation of dual specificity phosphatase 4 (DUSP4), cytochrome P450, family 24, subfamily A, polypeptide 1 (CYP24A1), and natriuretic peptide receptor A (NPR1) significantly correlated with recurrence-free survival. It was indicated that genes methylated preferentially in HCV-related HCC exist, and that DNA methylation might play an important role in HCV-related HCC by silencing cancer-related pathway inhibitors, and might perhaps be useful as a prognostic marker.


Subject(s)
Carcinoma, Hepatocellular/genetics , DNA Methylation , Hepatitis C/complications , Liver Neoplasms/genetics , Aged , Carcinoma, Hepatocellular/etiology , Carcinoma, Hepatocellular/pathology , Chromatin Immunoprecipitation , Female , Humans , Liver Neoplasms/etiology , Liver Neoplasms/pathology , Male , Middle Aged , Promoter Regions, Genetic
5.
Immunol Lett ; 123(2): 103-13, 2009 Apr 27.
Article in English | MEDLINE | ID: mdl-19428557

ABSTRACT

Although enhanced green fluorescent protein (EGFP) is widely used as a molecular tag in cell biology, it has become evident that immunogenicity of transgenic or transduced EGFP is important when it applies to transplantation model. Indeed, it appears that applications of EGFP-expressing cells, tissues and organ transplantation are limited in vivo due to the ultimate rejection of the graft. Nevertheless, the immunological behavior of transduced EGFP, in particular, as a minor histocompatibility antigen is not fully understood. Thus employing two strains of EGFP transgenic (Tg) rats generated by the same vector construct, e.g., EGFP-F344 Tg (RT11) and EGFP-DA Tg (RT1a), and its F(1) hybrid with a non-transgenic rat, behavior of EGFP-transgenic antigen(s) was examined by in vivo assays, such as EGFP-transgenic test skin grafts or regulation of EGFP-transgenic lymphocytes. In the latter system, EGFP-specific, T-cell-mediated immune regulation of local graft-versus-host reaction (GvHR) was further investigated with a special reference of in vivo cytotoxic assay, i.e., elimination of colored lymphocytes with either EGFP-incompatible or CFSE-labeled sex-mismatched lymphocytes. We provide evidence that differential immunological behavior of EGFP-transgenic minor histocompatibility antigen was observed in vivo. Thus, immune responses to EGFP-minor histocompatibility antigen(s) were not always accompanied with the rejection of test skin isograft. It only becomes apparent for EGFP-specific elimination and suppression of both systemic and local GvHR induced by EGFP-transgenic T lymphocytes after EGFP-specific sensitization. However, this was not the case where test skin isografting was applied even under extensive sensitization protocols. These findings demonstrate that minor histocompatibility antigen specific immune elimination of EGFP-transgenic T lymphocytes or regulation of local GvHR provides more sensitive and better immune assay systems in vivo than classical test skin isograft systems.


Subject(s)
Graft vs Host Reaction/immunology , Green Fluorescent Proteins/immunology , Minor Histocompatibility Antigens/immunology , Skin Transplantation/immunology , Animals , Female , Graft Survival/immunology , Male , Rats , Rats, Transgenic , Skin/immunology , Skin/metabolism , Transplantation, Isogeneic/immunology
6.
Surg Today ; 38(9): 815-25, 2008.
Article in English | MEDLINE | ID: mdl-18751947

ABSTRACT

PURPOSE: To study the effect of B7-CD28 costimulatory signal blockade by adenovirus-mediated cytotoxic T-lymphocyte-associated antigen 4 immunoglobulin (AdCTLA-4Ig) on cardiac allograft survival in DA (RT1(a)) to LEW (Lewis RT1(l)) rat combinations. METHODS: We evaluated the effect of combined AdCTLA-4Ig and anti-inducible costimulator (ICOS) antibody immunotherapy on rat cardiac allograft acceptance. RESULTS: Unlike AdCTLA-4Ig alone, anti-ICOS immunotherapy combined with AdCTLA-4Ig induced stable tolerance without causing chronic rejection. The combined immunotherapy also prevented the accelerated cardiac rejection caused by donor-type test skin grafting. Immunohistochemical analyses revealed remarkable inflammatory mononuclear cell infiltration with typical vasculopathy, especially ICOS-positive cells in the grafts, in recipients treated with AdCTLA-4Ig alone. In contrast, anti-ICOS therapy combined with AdCTLA-4Ig reduced the ICOS-positive inflammatory cell infiltration of the graft significantly. The most important finding is that possible cardiac arrest caused by secondary donor-type skin graft was prevented by combined immunotherapy of AdCTLA-4Ig and anti-ICOS antibody, despite skin graft rejection. CONCLUSIONS: Our results identified a major role played by the ICOS-ICOSL pathway in chronic and accelerated cardiac allograft rejection, providing a novel approach to preventing the chronic rejection of vascularized organ allografts.


Subject(s)
Antibodies, Monoclonal/pharmacology , Antigens, Differentiation, T-Lymphocyte/immunology , Graft Rejection/immunology , Heart Transplantation/immunology , Immune Tolerance/drug effects , Immunosuppressive Agents/pharmacology , Immunotherapy , Abatacept , Adenoviridae , Animals , Antigens, Differentiation, T-Lymphocyte/blood , Genetic Vectors , Graft Survival/drug effects , Graft Survival/immunology , Heart Transplantation/pathology , Immunoconjugates/pharmacology , Inducible T-Cell Co-Stimulator Protein , Male , Rats , Rats, Inbred Lew , Skin Transplantation/immunology , Transplantation, Heterotopic
7.
Anticancer Res ; 27(4B): 2427-31, 2007.
Article in English | MEDLINE | ID: mdl-17695534

ABSTRACT

Antineoplaston A10 (3-phenylacetylamino-2,6-piperidinedion) is a naturally occurring substance and was the first antineoplaston in the human body to be chemically identified. The effect of antineoplaston A10 on human hepatocellular carcinoma cell lines HepG2 and HLE has been examined. Antineoplaston A10 displayed anti-proliferative action inhibiting cell growth in a dose- and time-dependent manner in vitro as measured by 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide (MTT) and clonogenic assays. Incubation with antineoplaston A10 for 48 h induced apoptotic events such as a typical apoptotic morphology, formation of a characteristic ladder pattern of DNA migration and accumulation of sub-G1 phase cells. Next, hepatoma xenografts in nude mice were employed to study the antitumor effects of antineoplaston A10 in vivo. Oral administration of antineoplaston A10 delayed the growth of HepG2 and HLE cells in the mice without a reduction in body weight. A higher proportion of apoptotic cells in xenografts was observed by means of terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL) staining. In addition, the level of expression of apoptotic marker p53 increased while that of anti-apoptotic protein bcl-2 decreased, as evaluated with immunohistochemical staining in the xenografts. These results suggested that antineoplaston A10 may inhibit the growth of human hepatoma cells through the induction of apoptosis.


Subject(s)
Apoptosis/drug effects , Benzeneacetamides/pharmacology , Carcinoma, Hepatocellular/drug therapy , Liver Neoplasms/drug therapy , Piperidones/pharmacology , Animals , Carcinoma, Hepatocellular/metabolism , Carcinoma, Hepatocellular/pathology , Cell Growth Processes/drug effects , Cell Line, Tumor , Chromatin/drug effects , Chromatin/metabolism , DNA, Neoplasm/metabolism , Female , Humans , Liver Neoplasms/metabolism , Liver Neoplasms/pathology , Mice , Mice, Inbred BALB C , Proto-Oncogene Proteins c-bcl-2/biosynthesis , Tumor Suppressor Protein p53/biosynthesis , Xenograft Model Antitumor Assays
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