Correlation analysis between left ventricular global longitudinal strain and major adverse cardiovascular event occurrence in patients with end-stage renal disease.

OBJECTIVE: To explore the correlation between left ventricular global longitudinal strain (LVGLS) and major adverse cardiovascular event (MACE) occurrence in patients with end-stage renal disease (ESRD). METHODS: From January 2019 to December 2023, ESRD patients undergoing maintenance dialysis and LVGLS measurement admitted to the First People's Hospital of Lanzhou City were selected as subjects. They were followed up for 12 months to record the occurrence of MACEs, and divided into MACE group and non-MACE group according to MACE presence or absence. RESULTS: A total of 158 ESRD patients were included, with 32 patients in the MACE group and 126 patients in the non-MACE group. In the MACE group, high-sensitivity C-reactive protein (hs-CRP) level, peak troponin T (TNT) and the ratio of early diastolic mitral inflow velocity to early diastolic septal mitral annulus velocity (E/e') were higher, while hemoglobin, left ventricular ejection fraction (LVEF) and absolute LVGLS were lower compared with the non-MACE group (P < 0.05). Multivariate COX regression analysis revealed that LVGLS (HR = 1.06, 95% CI 1.02-1.10) and hs-CRP (HR = 1.17, 95% CI 1.23-1.31) were independent predictors of MACE occurrence in ESRD patients (P < 0.05). The area under the ROC curve (AUC) for MACE occurrence within 12 months was 0.83 (95% CI 0.74-0.95), with a sensitivity of 89.9% and a specificity of 76.8%. The MACE-free survival rate in the high LVGLS group was higher compared to the low LVGLS group (P < 0.05). CONCLUSION: Reduced LVGLS is an independent risk factor for MACE occurrence in ESRD patients within 12 months and a good prognostic indicator.

A blinded-endpoint, randomized controlled trial of Sanyrene with natural active ingredient for prophylaxis of radiation dermatitis in patients receiving radiotherapy.

BACKGROUND: Randomized controlled study was conducted to evaluate the efficacy of Sanyrene® vs. control intervention (DaBao®, a complex of hyaluronic acid and Vitamin E) for acute radiation dermatitis in patients receiving radiotherapy. METHODS: Patients with breast cancer or head and neck cancer undergoing radiotherapy (≥ 50 Gy) were eligible. Participants were randomly assigned to either Sanyrene arm or control intervention arm in a ratio of 1:1. The primary endpoint was incidence rate of ≥ grade 2 radiation induced dermatitis. (Trial Registration: ChiCTR2100050910, registration date: 9/7/2021) RESULTS: A total of 102 eligible patients were randomly assigned into the study. The rate of ≥ grade 2 radiation dermatitis was 22% in Sanyrene group, as compared with 67.3% in the control intervention group (P<0.001). The incidence of grade 3 radiation dermatitis was 20.4% and 8.0% in control intervention group and Sanyrene group, respectively (P = 0.076). Patients in Sanyrene group had a longer median time to reach ≥ grade 2 radiation dermatitis compared to these in control intervention group, with hazard ratio of 0.231 (95%CI:0.116-0.458, p < 0.001). Mean score of SD-16 were much higher in control intervention group than Sanyrene group at end of radiotherapy (25 vs.8.3), 2 weeks after radiotherapy (22.9 vs. 0.5) and 4 weeks after radiotherapy (4.2 vs.0), with significantly statistical difference between two groups. CONCLUSIONS: This trial suggests that Sanyrene is effective on preventing serious radiation dermatitis and improving skin related quality of life in patients with breast cancer or head and neck cancer receiving radiotherapy.

PLOD2 promotes colorectal cancer progression by stabilizing USP15 to activate the AKT/mTOR signaling pathway.

Procollagen-lysine, 2-oxoglutarate 5-dioxygenase 2 (PLOD2) has been reported as an oncogenic gene, affecting various malignant tumors, including endometrial carcinoma, osteosarcoma, and gastric cancer. These effects are mostly due to the enhanced deposition of collagen precursors. However, more studies need to be conducted on how its lysyl hydroxylase function affects cancers like colorectal carcinoma (CRC). Our present results showed that PLOD2 expression was elevated in CRC, and its higher expression was associated with poorer survival. Overexpression of PLOD2 also facilitated CRC proliferation, invasion, and metastasis in vitro and in vivo. In addition, PLOD2 interacted with USP15 by stabilizing it in the cytoplasm and then activated the phosphorylation of AKT/mTOR, thereby promoting CRC progression. Meanwhile, minoxidil was demonstrated to downregulate the expression of PLOD2 and suppress USP15, and the phosphorylation of AKT/mTOR. Our study reveals that PLOD2 plays an oncogenic role in colorectal carcinoma, upregulating USP15 and subsequently activating the AKT/mTOR pathway.

LARP6 suppresses colorectal cancer progression through ZNF267/SGMS2-mediated imbalance of sphingomyelin synthesis.

BACKGROUND: With increasing incidence and mortality, colorectal cancer (CRC) seriously endangers human health. LARP6, a member of La-related protein (LARP) family, is a RNA binding protein and probably associates with CRC progression, but its specific roles and mechanisms in CRC still remain unknown. METHOD: Quantitative real-time PCR (qPCR), western blot, and immunohistochemistry were employed to examine LARP6 expression in CRC tissues. Using the stable LARP6 overexpression or interference CRC cell lines, the effect of LARP6 on CRC progression were evaluated. High-throughput RNA immunoprecipitation sequencing (RIP-seq) and a series of relevant experiments were conducted to explain how LARP6 functions. SPSS software was used for statistical analysis. RESULT: In this study, we found that LARP6 expression is downregulated in CRC and correlates with patients' overall survival and relapse-free survival. Furthermore, altered LARP6 expression influences CRC cells invasion and metastasis. Mechanically, we discovered that LARP6 bind ZNF267 mRNA and regulated its stability and translation. LARP6 inhibited expression of SGMS2, a downstream target of ZNF267, resulting in ceramide and sphingomyelin imbalance in CRC cells. Interestingly, LARP6 also enhances autophagy activity of CRC cells, and the effect was at least partially determined by the inhibition of SGMS2-mediated sphingomyelin synthesis. CONCLUSION: Our study showed how LARP6/ZNF267/SGMS2 axis influence CRC progression, which contributes to further understanding of the molecular mechanisms underlying CRC development.

MRGBP promotes colorectal cancer metastasis via DKK1/Wnt/ß-catenin and NF-kB/p65 pathways mediated EMT.

MRG domain binding protein (MRGBP) has been proposed to participate in the development of multiple tumors. However, the role of MRGBP in colorectal cancer (CRC) still remains largely unknown. Here, we found that MRGBP expression is significantly elevated in CRC, and that higher MRGBP expression correlates with poorer survival in CRC patients. Experiments in vivo and in vitro indicated that MRGBP promotes CRC cells proliferation, migration, invasion, epithelial-mesenchymal transition (EMT) and xenograft tumor growth. Mechanically, for one thing, we discovered that MRGBP suppresses DKK1 expression, thus further activating the Wnt/ß-catenin pathway in CRC cells. For another, MRGBP also enhances acetylation of NF-kB/p65 pathway. Treatment with Wnt/ß-catenin and NF-kB pathways inhibitors further confirmed the mediation of these two pathways in MRGBP-promoted CRC cell processes. In conclusion, these findings together suggest that MRGBP promotes CRC progression via DKK1/Wnt/ß-catenin and NF-kB/p65 pathways mediated EMT, identifying MRGBP as a promising prognostic and therapeutic target for CRC.

LINC00839 promotes colorectal cancer progression by recruiting RUVBL1/Tip60 complexes to activate NRF1.

The long noncoding RNA LINC00839 has been shown to be involved in the progression of some cancer types, such as bladder cancer, prostate cancer, breast cancer, and neuroblastoma. However, if LINC00839 has roles in colorectal cancer (CRC), it has not been elucidated so far. Here, we focus on the biological role and involved mechanisms of LINC00839 in CRC. We show that LINC00839 is selectively upregulated in CRC and locates to the nucleus. High expression of LINC00839 is associated with poor outcomes in CRC patients. Functional experiments show that LINC00839 promotes CRC proliferation, invasion, and metastasis in vitro and in vivo. Mechanistically, LINC00839 recruits Ruvb1 to the Tip60 complex and increases its acetylase activity. LINC00839 guides the complex to the NRF1 promoter and promotes acetylation of lysines 5 and 8 of histones H4, thereby upregulating the expression of NRF1. Subsequently, NRF1 activates mitochondrial metabolism and biogenesis, thereby promoting CRC progression. In summary, our study reports on a mechanism by which LINC00839 positively regulates NRF1, thus promoting mitochondrial metabolism and biogenesis, as well as CRC progression.

LMO3 promotes proliferation and metastasis of papillary thyroid carcinoma cells by regulating LIMK1-mediated cofilin and the ß-catenin pathway.

LIM domain only 3 (LMO3) interacts with transcription factors to regulate target genes involved in embryonic development. The oncogenic role of LMO3 in hepatocellular carcinoma, gastric cancer, and neuroblastoma has been reported recently. However, little is known about the biological function of LMO3 in papillary thyroid carcinoma (PTC). First, expression of LMO3 was dramatically enhanced in the PTC tissues and cell lines. Second, knockdown of LMO3 in PTC cells repressed cell proliferation and promoted cell apoptosis with downregulated Bcl-2 and upregulated cleaved caspase-3/PARP. In vitro cell migration and invasion of PTC were also retarded by siRNA-mediated silence of LMO3. Third, protein expression of LIM kinase (LIMK) 1-mediated phosphorylation of cofilin and nuclear translocation of ß-catenin were reduced by the knockdown of LMO3. pcDNA-mediated overexpression of LIMK1 promoted cofilin phosphorylation and attenuated LMO3 silence-induced decrease of cofilin phosphorylation. Last, enhanced LIMK1 expression promoted PTC cell proliferation and metastasis and counteracted the suppressive effects of LMO3 silence on PTC cell proliferation and metastasis. In conclusion, LMO3 promoted PTC cell proliferation and metastasis by regulating LIMK1-mediated cofilin and the ß-catenin pathway.

RSL1D1 promotes the progression of colorectal cancer through RAN-mediated autophagy suppression.

RSL1D1 (ribosomal L1 domain containing 1), a member of the universal ribosomal protein uL1 family, was suggested to be a new candidate target for colorectal cancer (CRC). However, the role of RSL1D1 in cancer, including CRC, remains largely elusive. Here, we demonstrated that RSL1D1 expression was significantly elevated in tumors from CRC patients and that high expression of RSL1D1 was correlated with poorer survival of CRC patients. Functionally, RSL1D1 promoted the proliferation, invasion, and metastasis of CRC cells by suppressing autophagy. Interestingly, RSL1D1 interacted with RAN and inhibited its deacetylation by competitively binding with Sirt7. By affecting the acetylation of RAN, RSL1D1 inhibited the accumulation of nuclear STAT3 and the STAT3-regulated autophagic program. Taken together, our study uncovered the key role of the RSL1D1/RAN/STAT3 regulatory axis in autophagy and tumor progression in CRC, providing a new candidate target for CRC treatment.

Expression of heat-resistant ß-glucosidase in Escherichia coli and its application in the production of gardenia blue.

Gardenia blue is a natural blue pigment that is environmentally friendly, non-toxic, and stable. The hydrolysis of geniposide, catalyzed by ß-glucosidase, is a critical step in the production process of gardenia blue. However, ß-glucosidase is not resistant to high temperatures, limiting the production of gardenia blue. In this study, we investigated the effectiveness of a heat-resistant glucosidase obtained from Thermotoga maritima in the production of gardenia blue. The enzyme exhibited a maximum activity of 10.60 U/mL at 90 °C. Single-factor and orthogonal analyses showed that exogenously expressed heat-resistant glucosidase reacted with 470.3 µg/mL geniposide and 13.5 µg/mL glycine at 94.2 °C, producing a maximum yield of 26.2857 µg/mL of gardenia blue after 156.6 min. When applied to the dyeing of denim, gardenia blue produced by this method yielded excellent results; the best color-fastness was achieved when an iron ion mordant was used. This study revealed the feasibility and application potential of microbial production of gardenia blue.

CSRP2 suppresses colorectal cancer progression via p130Cas/Rac1 axis-meditated ERK, PAK, and HIPPO signaling pathways.

Metastasis is a major cause of death in patients with colorectal cancer (CRC). Cysteine-rich protein 2 (CSRP2) has been recently implicated in the progression and metastasis of a variety of cancers. However, the biological functions and underlying mechanisms of CSRP2 in the regulation of CRC progression are largely unknown. Methods: Immunohistochemistry, quantitative real-time polymerase chain reaction (qPCR) and Western blotting (WB) were used to detect the expression of CSRP2 in CRC tissues and paracancerous tissues. CSRP2 function in CRC was determined by a series of functional tests in vivo and in vitro. WB and immunofluorescence were used to determine the relation between CSRP2 and epithelial-mesenchymal transition (EMT). Co-immunoprecipitation and scanning electron microscopy were used to study the molecular mechanism of CSRP2 in CRC. Results: The CSRP2 expression level in CRC tissues was lower than in adjacent normal tissues and indicated poor prognosis in CRC patients. Functionally, CSRP2 could suppress the proliferation, migration, and invasion of CRC cells in vitro and inhibit CRC tumorigenesis and metastasis in vivo. Mechanistic investigations revealed a physical interaction between CSRP2 and p130Cas. CSRP2 could inhibit the activation of Rac1 by preventing the phosphorylation of p130Cas, thus activating the Hippo signaling pathway, and simultaneously inhibiting the ERK and PAK/LIMK/cortactin signaling pathways, thereby inhibiting the EMT and metastasis of CRC. Rescue experiments showed that blocking the p130Cas and Rac1 activation could inhibit EMT induced by CSRP2 silencing. Conclusion: Our results suggest that the CSRP2/p130Cas/Rac1 axis can inhibit CRC aggressiveness and metastasis through the Hippo, ERK, and PAK signaling pathways. Therefore, CSRP2 may be a potential therapeutic target for CRC.

CT imaging features and image evolution characteristics of coronavirus disease 2019. / 2019å† çŠ¶ç— æ¯’ç— çš„è‚ºéƒ¨CTå½±åƒå­¦è¡¨çŽ°åŠç— ç¶æ¼”å˜ç‰¹ç‚¹.

OBJECTIVES: To analyze the imaging features of coronavirus disease 2019 (COVID-19) in different periods, and summarize the characteristics with itsdevelopment. METHODS: We retrospectively analyzed the CT image data of COVID-19 patients diagnosed by nucleic acid test and CT examination in 57 patients in Zhuzhou Central Hospital and Zhuzhou First People's Hospital, and summarized the characteristics of CT imaging and the development of lesions. RESULTS: Most of the cases were characterized by peripheral distribution of lesions. A total of 37 cases (64.91%) were purely peripherally distributed, 16 cases (28.07%) coexisted with peripheral and mid-internal distribution, and 4 cases (7.02%) had simple mid-inner band distribution. In peripherally distributed cases, the long axis of the lesion was mostly parallel to the pleura in 36 cases (63.16%). In the case of inner-middle zone distribution, the long axis of the lesion was mostly parallel and surrounded the bronchial vascular bundle, or distributed along the lung lobules (31.58%). All cases had ground-glass-density foci, 31 cases (54.38%) had fine grid shadows in the lesions, 46 cases (80.70%) had thick vascular shadows in the lesions, and 23 cases (40.35%) showed signs of bronchial inflation. Among the 10 cases of "wrinkling shape" lesions in the first CT examination, except for 1 case without reexamination, the remaining 9 cases had different degrees of absorption in the second CT examination. Among the 26 cases of "wrinkling shape" lesions in the second CT examination, except for 11 cases without reexamination, the other 15 patients had different degrees of absorption in the third CT examination. CONCLUSIONS: The early CT manifestations of COVID-19 are mostly ground-glass-density foci distributed in the subpleural region, some of which are distributed near the bronchial blood vessel bundle and in the central area of the lobule. As the course of the disease progresses, there may be varying degrees of solid components in the lesion. When the lesions show a "wrinkling shape", it is often suggested that the lesions will evolve towards the direction of absorption. These characteristics are of great value in assisting clinical diagnosis and dynamically observing changes undersuch condition.

Homeodomain protein DLX4 facilitates nasopharyngeal carcinoma progression via up-regulation of YB-1.

Nasopharyngeal carcinoma (NPC) is a malignant tumor in nasopharynx tissues and lacks effective treatment strategies. Dysregulation of distal-less homeobox 4 (DLX4) participates in the development of tumors. Understanding the regulatory mechanism of DLX4 in NPC progression may address this issue. Here, we first identified an up-regulation of DLX4 in NPC cell lines compared to normal epithelial cells. Data from colony formation and transwell assays showed that knockdown of DLX4 inhibited cell proliferation and invasion of NPC, respectively. Moreover, DLX4 knockdown blocked the cell cycle of NPC at G1 phase, suggesting the antitumor effect of DLX4 knockdown on NPC. The downstream target of DLX4 was identified as Y-box binding protein 1 (YB-1), whose expression was increased by over-expression of DLX4, while decreased by knockdown of DLX4. The binding capacity between DLX4 and YB-1 was verified by chromatin immunoprecipitation (ChIP), and the result showed that DLX4 could not directly bind to the promoter of YB-1. Mechanically, YB-1 over-expression reversed the effects of DLX4 knockdown on cell proliferation, cell cycle arrest and cell invasion of NPC. In conclusion, our findings indicated that DLX4 promoted NPC progression via up-regulation of YB-1, which would shed light on therapeutic schedule in NPC.

Waveband selection of reagent-free determination for thalassemia screening indicators using Fourier transform infrared spectroscopy with attenuated total reflection.

A reagent-free determination method for the thalassemia screening indicators hemoglobin (Hb), mean corpuscular Hb (MCH), and mean corpuscular volume (MCV) was developed based on Fourier transform infrared spectrometers equipped with an attenuated total reflection accessory. A random and stability-dependent rigorous process of calibration, prediction, and validation was conducted. Appropriate wavebands were selected using the improved moving window partial least squares method with stability and equivalence. The obtained optimal wavebands were 1722 to 1504 cm⁻¹ for Hb, 1653 to 901 cm⁻¹ for MCH, and 1562 to 964 cm⁻¹ for MCV. A model set equivalent to the optimal model was proposed for each indicator; the public waveband of Hb equivalent wavebands was 1717 to 1510 cm⁻¹, and the public equivalent waveband for MCH and MCV was 1562 to 901 cm⁻¹. All selected wavebands were within the MIR fingerprint region and achieved high validation effects. The sensitivity and specificity were 100.0% and 96.9% for the optimal wavebands and 100.0% and 95.3% for the equivalent wavebands, respectively. Thus, the spectral prediction was highly accurate for determining negative and positive for thalassemia screening. This technique is rapid and simple in comparison with conventional methods and is a promising tool for thalassemia screening in large populations.

Clinical outcomes for early-stage nasopharyngeal carcinoma with predominantly WHO II histology treated by intensity-modulated radiation therapy with or without chemotherapy in nonendemic region of China.

BACKGROUND: The clinical outcomes for early-stage nasopharyngeal carcinoma (NPC) in northwest China were evaluated. METHODS: A retrospective study was performed from 69 patients with NPC patients treated with intensity-modulated radiation therapy (IMRT) with or without chemotherapy. RESULTS: Median follow-up was 34 months. World Health Organization (WHO) type II was the predominant histology (71%). All treatment failures occurred in T2N1 NPCs (14.5%), with metastasis the major reason. The 3-year overall survival (OS), local recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) were 93.3%, 94.1%, and 94.8% respectively. The 3-year survival rate for T2N1 and IMRT alone group were both significantly poorer than the T1N0, T2N0, and T1N1 groups and the chemoradiation group, respectively (p < .05). N1 classification, T2N1 classification, and addition of chemoradiation were significant independent predictors (p < .05). No grade IV toxicities were observed. CONCLUSION: T2N1 classification is a unique subgroup with higher risk of distant metastasis. Improved outcomes of T2N1 NPC with predominantly WHO II histology after chemoradiation has not been reported.

[Fourier transform infrared spectroscopy combined with attenuated total reflection applied to reagent-free quantitative analysis of thalassemia screening indicators].

UNLABELLED: A simultaneous quantitative analysis method for the thalassemia screening indicators mean corpuscular hemoglobin (MCH), mean corpuscular volume (MCV), and hemoglobin (Hb) was developed with Fourier transform infrared (FTIR) spectrometers and attenuated total reflection (ATR) combined with partial least squares (PLS). A total of 380 human peripheral blood samples were collected, which were composed of 180 positive samples and 200 negative samples according to the criteria of hematological indicator screening for thalassemia. One hundred fifty samples (64 negative, 86 positive) were randomly selected from all samples as the validation set, the remaining 230 samples (136 negative, 94 positive) were used as modeling samples; and then the modeling set was further subdivided into calibration set (68 negative, 47 positive, and 115 in total) and prediction set (68 negative, 47 positive, and 115 in total) for 200 times. Comparison of experimental results show that the prediction effect of PLS models in mid-infrared (MIR) fingerprint region (1,600-900 cm(-1)) was significantly better those of PLS models in the full scanning region (4,000-600 cm(-1)), and model complexity is significantly reduced. Based on PLS model in MIR fingerprint region, the optimal numbers of PLS factors for MCH, MCV and Hb were 10, 10 and 6, respectively, and the root mean square error (M_SEP(Ave)) and the correlation coefficient (M_Rp, Ave) of prediction in the modeling set were 2.19 pg, 0.902 for MCH, 5.13 fL, 0.898 for MCV and 8.0 g · L(-1), 0.922 for Hb, respectively. The root mean square error (V_SEP) and the correlation coefficient (V_Rp) of prediction in the validation set were 2.22 pg, 0.900 for MCH, 5.38 fL, 0.895 for MCV and 7.7 g · L(-1), 0.929 for Hb, respectively. The sensitivity and specificity for thalassemia screening achieved 100.0% and 95.3%, respectively. CONCLUSION: FTIR/ATR spectroscopy combined with PLS method could provide a new reagent-free and rapid technique for thalassemia screening for large populations.

In vivo study of breast carcinoma radiosensitization by targeting eIF4E.

BACKGROUND: Eukaryotic initiation factor eIF4E, an important regulator of translation, plays a crucial role in the malignant transformation, progression and radioresistance of many human solid tumors. The overexpression of this gene has been associated with tumor formation in a wide range of human malignancies, including breast cancer. In the present study, we attempted to explore the use of eIF4E as a therapeutic target to enhance radiosensitivity for breast carcinomas in a xenograft BALB/C mice model. MATERIALS AND METHODS: Ninety female BALB/C mice transfected with EMT-6 cells were randomly divided into six groups: control, irradiation (IR), pSecX-t4EBP1, pSecX-t4EBP1+irradiation, pSecX and pSecX+irradiation. At the end of the experiments, all mice were sacrificed, the xenografts were harvested to measure the tumor volume and mass, and the tumor inhibition rates were calculated. Apoptosis was detected with a flow cytometric assay. Immunohistochemistry was used to detect the expression of HIF-1α. RESULTS: The xenografts in pSecX-t4EBP1 mice showed a significantly delayed growth and smaller tumor volume, with a higher tumor inhibition rate compared with the control and pSecX groups. A similar result was obtained in the pSecX-t4EBP1+IR group compared with IR alone and pSecX+irradiation. The expression of HIF-1α in the tumor cells was significantly decreased, while the apoptosis index was much higher. CONCLUSIONS: pSecX-t4EBP1 can significantly inhibit tumor growth and enhance the radiosensitivity of breast carcinoma xenografts in BALB/C mice. This is possibly associated with the downregulation of HIF-1α expression, which suggests that pSecX-t4EBP1 may serve as an ideal molecular target for the radiosensitization of breast carcinoma.

Failure patterns and survival in patients with nasopharyngeal carcinoma treated with intensity modulated radiation in Northwest China: a pilot study.

PURPOSE: To evaluate the clinical outcomes and patterns of failure in patients with nasopharyngeal carcinoma (NPC) treated with intensity modulated radiotherapy (IMRT) in Northwest China. METHODS AND MATERIALS: From January 2006 to December 2009, 138 NPC patients were treated at Xijing Hospital. Of them, 25 cases with stage I-II received IMRT only, 113 cases with stage III-IVb received IMRT plus accomplished platinum-based chemotherapy. The IMRT prescribed dose was PTV 68-74 Gy to gross disease in nasopharynx and 66-72 Gy to positive lymph nodes in 30-33 fractions, and high risk and low risk region PTV was 60-63 Gy and 50.4~56 Gy in 30~33 and 28 fractions respectively. Plasma Epstein Barr virus (EBV) DNA load was measured before treatment. The clinical toxicities, outcomes and patterns of failure were observed. RESULTS: The median follow up time was 23 months (range 2 to 53 months). EBV infection positive was only 15.9%. Overall disease failure developed in 36 patients, 99% belonged to stage III/IV disease. Among these, there were 26 distant metastases, 6 local recurrence, and 4 regional recurrence. The 3-year local control rate(LCR), distant metastasis-free survival (MFS), disease-free survival (DFS) and the overall survival (OS) was 93.9%, 79.5%, 70% and 83.1% respectively. Multivariate analyses revealed that age and anemia pre-radiotherapy were independent predictors for OS. CONCLUSION: IMRT with or without chemotherapy can improve the long term survival of NPC patients in Northwest China. Distant metastasis becomes the main cause of treatment failure. Age and anemia before radiotherapy were the main prognosis factors of NPC patients.

Adjuvant chemotherapy and radiotherapy in triple-negative breast carcinoma: a prospective randomized controlled multi-center trial.

BACKGROUND AND PURPOSE: Triple-negative breast cancer (TNBC) presents a high risk breast cancer that lacks the benefit from hormone treatment, chemotherapy is the main strategy even though it exists in poor prognosis. Use of adjuvant radiation therapy, which significantly decreases breast cancer mortality, has not been well described among poor TNBC women. The aim of this study was to evaluate whether the combination of chemotherapy and radiotherapy could significantly increase survival outcomes in TNBC women after mastectomy. PATIENTS AND METHODS: A prospective randomized controlled multi-center study was performed between February 2001 and February 2006 and comprised 681 women with triple-negative stage I-II breast cancer received mastectomy, of them, 315 cases received systemic chemotherapy alone, 366 patients received radiation after the course of chemotherapy. Recurrence-free survival (RFS) and overall survival (OS) were estimated. Simultaneously local and systemic toxicity were observed. RESULTS: After a median follow-up of 86.5 months, five-year RFS rates were 88.3% and 74.6% for adjuvant chemotherapy plus radiation and adjuvant chemotherapy alone, respectively, with significant difference between the two groups (HR 0.77 [95% CI 0.72, 0.98]; P=0.02). Five-year OS significantly improved in adjuvant chemotherapy plus radiation group compared with chemotherapy alone (90.4% and 78.7%) (HR 0.79 [95% CI 0.74, 0.97]; P=0.03). No severe toxicity was reported. CONCLUSIONS: Patients received standard adjuvant chemotherapy plus radiation therapy was more effective than chemotherapy alone in women with triple-negative early-stage breast cancer after mastectomy.

Three-dimensional conformal radiation therapy for refractory laryngeal granuloma.

AIMS AND BACKGROUND: The etiology of laryngeal granulomas is often multifactorial and the benefit of pharmacological therapy remains unclear. Anti-reflux treatment is only effective in granulomas definitely induced by gastroesophageal reflux. Steroid inhalation has shown favorable results but it is unclear whether it shortens the healing process. Surgical excision is associated with high recurrence rates. The aim of this study was to evaluate the role of 3-dimensional conformal radiation therapy (3DCRT) in the treatment of refractory laryngeal granuloma. METHODS AND STUDY DESIGN: The study was a retrospective review including all patients presenting to the Department of Radiation Oncology at Xijing Hospital from January 2004 to March 2007. We studied a total of 15 cases of refractory laryngeal granuloma that had recurred ≥2 times. Patients had previously been managed with voice rest, corticosteroids, antibiotics, antacids, surgery and botulinum toxin. All patients accepted surgical excision and immediate adjuvant 3DCRT at a total dose of 15 Gy over 5 days. RESULTS: All patients were successfully treated with surgery and 3DCRT. There has been no granuloma recurrence in 3 years of follow-up. CONCLUSIONS: 3DCRT is a safe and effective therapy for refractory laryngeal granulomas, especially when other methods have failed.