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ObjectiveTo explore the potential mechanism of Zuoguiwan in ameliorating polycystic ovary syndrome （PCOS） by network pharmacology and liquid chromatography-mass spectrometry （LC-MS）-based metabolomics. MethodThe active ingredients and potential targets of Zuoguiwan for treating PCOS were predicted by bioinformatics. SD rats were assigned into a control group and a modeling group. The rat model of PCOS was established by gavage with letrozole （1 mg·kg-1） combined with feeding with a high-fat diet. At the end of modeling， the modeled rats were assigned into model （normal saline）， metformin （300 mg·kg-1）， and Zuoguiwan （concentrate 1.62 g·kg-1） groups. The body weight and oestrous cycle of each rat were recorded， and the ovary was stained with hematoxylin and eosin for observation of ovarian morphology. Enzyme-linked immunosorbent assay was employed to determine the serum levels of follicle-stimulating hormone （FSH）， luteinizing hormone （LH）， anti-mullerian hormone （AMH）， testosterone （T）， and estradiol （E2）， and the LH/FSH ratio was calculated. Serum metabolomics of rats was conducted by orthogonal partial least squares-discriminant analysis （OPLS-DA） to screen the metabolite-enriched pathways. Furthermore， network pharmacology and association analysis were employed construct the compound-response-enzyme-gene network. ResultA total of 503 potential targets of Zuoguiwan and 5 843 targets of PCOS were screened out， with 271 common targets. The Gene Ontology enrichment analysis revealed that the common targets were involved in the response to lipopolysaccharide， etc.， and the Kyoto Encyclopedia of Genes and Genomes （KEGG） enrichment yielded 119 pathways. Animal experiments showed that compared with the control group， the model group presented increased body weight （P<0.01）， elevated LH and AMH levels （P<0.01）， increased LH/FSH ratio （P<0.01）， lowered E2 level （P<0.01）， and increased cystic follicles. Compared with the model group， Zuoguiwan and metformin decreased the body weight （P<0.01）， reduced atretic follicles and cystic follicles， increased mature follicles and corpus luteum， and thickened the granulosa layer. Moreover， Zuoguiwan lowered the T， FSH， LH， and AMH， and LH/FSH levels （P<0.01） and elevated the E2 level （P<0.01）. The principal component analysis and OPLS-DA in metabolomics showed that the differential metabolites between Zuoguiwan and model groups included 26 up-regulated metabolites in the Zuoguiwan group. There were 8 common pathways predicted by the KEGG enrichment analysis in network pharmacology and the metabolite enrichment in metabolomics. The results of topological analysis revealed the pathways of steroid hormone biosynthesis and glycerol-phospholipid metabolism， and the constructed compound-response-enzyme-gene network revealed that the key targets were protein kinase B1 （Akt1）， epithelial growth factor receptor （EGFR）， prostaglandin-endoperoxide synthase 2 （PTGS2）， and mitogen-activated protein kinase 1 （MAPK1）. ConclusionZuoguiwan regulated the steroid hormone biosynthesis pathway to recover hormone levels， promote follicle production and development， and improve ovarian function， which may be the potential mechanism of this medicine in treating PCOS.
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ObjectiveTo investigate the effect of Zuoguiwan on the ovarian function in the rat model of cyclophosphamide-induced premature ovarian failure （POF） based on the changes of ferroptosis pathway. MethodForty SD rats were randomized into blank， model， and low- and high-dose （2， 8 g·kg-1， respectively） Zuoguiwan groups， with 10 rats in each group. The rats in the other groups except the normal group were intraperitoneally injected with CTX at a dose of 50 mg·kg-1 on the first day and 8 mg·kg-1 from the second day to the fifteenth day for the modeling of POF. After modeling， the rats were administrated with corresponding drugs or normal saline by gavage for four weeks. Hematoxylin-eosin staining was performed to observe the pathological changes in the ovarian tissue. The mitochondria of the ovarian tissue was observed by electron microscopy. The serum levels of follicle-stimulating hormone （FSH）， estradiol （E2）， luteinizing hormone （LH）， anti-Mullerian hormone （AMH）， malondialdehyde （MDA）， catalase （CAT）， superoxide dismutase （SOD）， and iron ion were measured by biochemical methods and enzyme-linked immunosorbent assay. Western blot was employed to determine the protein levels of glutathione peroxidase 4 （GPX4）， solute carrier family 7 member 11 （SLC7A11）， ferritin heavy chain （FTH1）， and acyl-CoA synthetase long chain family member 4 （ACSL4）. ResultCompared with the blank group， the model group showcased significantly increased atretic follicles， atrophied， fragmented， and vacuolated mitochondria， and reduced， loose， and disordered cristae in mitochondria. Compared with the model group， high-dose Zuoguiwan increased mature follicles， the volume of mitochondria in the ovary， alleviated the vacuolation， and improved the number and arrangement of mitochondrial cristae. Compared with the blank group， the modeling elevated the levels of iron， MDA， FSH， and LH， up-regulated the expression of GPX4， SLC7A11， and FTH1 （P<0.05， P<0.01）， decreased the activities of SOD and CAT， lowered the levels of E2 and AMH， and down-regulated the expression of ACSL4 （P<0.05， P<0.01）. Compared with the model group， drug interventions lowered the levels of iron， MDA， FSH， and LH， down-regulated the expression of GPX4， SLC7A11， and FTH1 （P<0.05， P<0.01）， increased the activity of CAT， elevated the levels of E2 and AMH， and up-regulated the expression of ACSL4 （P<0.05， P<0.01）. ConclusionZuoguiwan may inhibit the occurrence of ferroptosis by regulating the SLC7A11/GPX4 axis， thereby improving the ovarian function of POF rats.
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ObjectiveThe active ingredients， action targets， and signaling pathways of Cuscutae Semen to control premature ovarian failure were initially predicted by network pharmacology and molecular docking techniques， and an animal model of premature ovarian failure was constructed to explore the mechanism of Cuscutae Semen based on lipid and atherosclerosis signaling pathways. MethodThe effective components and corresponding targets of drugs were obtained from Traditional Chinese Medicines Systems Pharmacology Platform （TCMSP）， Swiss Target Prediction， Pharmmapper， and other databases. GeneCards database was used to collect disease-related targets. Venny2.1.0 online tool was used to screen out the intersection targets of drugs and diseases， and STRING database and Cytoscape v3.7.2 software were used to construct the network diagram of "drug-component-target" and protein-protein interaction （PPI）. The gene ontology （GO） and the Kyoto encyclopedia of genes and genomes （KEGG） enrichment analyses of the intersection targets were performed by running the R language script. The molecular docking technology was utilized to dock drug components with targets and visualize some of the docking results. The mice were randomly divided into a blank group， a model group， a Cuscutae Semen group， and an estradiol valerate group， and the ovarian premature failure model was prepared by chronic stress. The blank group and the model group were gavaged with the same amount of normal saline， and the Cuscutae Semen group was given a Cuscutae Semen decoction of 2.6 g·kg-1·d-1. The estradiol valerate group was given an estradiol valerate solution of 0.13 mg·kg-1·d-1. After four weeks， samples were collected， and hematoxylin-eosin （HE） staining was performed to observe the histopathological changes in the ovary. Serum levels of follicle-stimulating hormone （FSH）， luteinizing hormone （LH）， estradiol （E2）， Muller's tube inhibitor/anti-Muller's tube hormone （AMH）， total cholesterol （TC）， high-density lipoprotein cholesterol （HDL-C）， and low-density lipoprotein cholesterol （LDL-C） were determined by enzyme-linked immunosorbent assay （ELISA）. The expression levels of extracellular regulatory protein kinase （ERK）， nuclear transcription factor-κB p65 （NF-κB p65）， nuclear transcription factor-κB suppressor α （IκBα）， interleukin-1β （IL-1β）， IL-6， and tumor necrosis factor-α （TNF-α） were measured by Western blot. ResultA total of 171 targets of Cuscutae Semen for the prevention and treatment of premature ovarian failure were screened， mainly including tumor protein p53 （TP53）， protein kinase B1 （Akt1）， sarcoma （SRC）， tumor necrosis factor （TNF）， epidermal growth factor receptor （EGFR）， etc. KEGG pathway enrichment analysis predicts that Cuscutae Semen is mainly involved in lipid and atherosclerosis， TNF signaling pathway， and TP53 signaling pathway to control premature ovarian failure. The animal experiments show that compared with the premature ovarian failure model group， the Cuscutae Semen group can significantly upregulate AMH， E2， and HDL-C （P<0.05， P<0.01）， significantly downregulate LH， TC， and LDL-C （P<0.01）， greatly reduce IL-1β， IL-6， and TNF-α protein levels， as well as ERK， NF-κB p65， and their phosphorylation levels （P<0.01）. ConclusionCuscutae Semen can regulate hormone levels and improve ovarian function through a multi-component， multi-target， and multi-pathway approach， and the mechanism may be related to the regulation of lipid and atherosclerosis signaling pathways.
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Objective To investigate the clinical efficacy of neoadjuvant chemoradiotherapy in the treatment of locally advanced low and middle rectal cancer,and evaluate the effect of related clinical factors upon the long-term survival. Methods Clinical data of 101 patients with locally advanced low and middle rectal cancer admitted to our hospital from January 1,2010 to December 31,2014 were collected. All patients completed the preoperative intensity-modulated radiation therapy DT45-50. 4 Gy,synchronized with oxaliplatin+capecitabine/5-fluorouracil or single drug capecitabine chemotherapy,and total mesorectal excision) was performed 4-13 weeks after the end of the neoadjuvant therapy. The short-term efficacy and long-term prognosis of these patients were evaluated. Kaplan-Meier method was used for survival analysis,and Cox’s regression model for multivariate analysis. Results The total sphincter preservation rate was 53. 5%.The decrease rates of T,N staging and TNM total staging were 73. 26%,67. 32% and 72. 3%,respectively. The pathological complete response ( pCR) rate was 16. 8%.The median follow-up time was 41 months. The 3-year overall survival (OS), desease-free survival (DFS),local recurrence and distant metastases rates were 82. 2%,80. 7%,7. 2% and 12. 1%,respectively. The single factor analysis demonstrated that ypT and ypN stages were the risk factors affecting the 3-year OS,DFS anddistant metastases ( all P＜0. 05).Multivariate analysis revealed that ypT stage was an independent factor affecting the 3-year OS,and ypT and ypN stages were the independent factors of the 3-year DFS ( all P＜ 0. 05 ). ConclusionsNeoadjuvant chemoradiotherapy combined with TME in the treatment of locally advanced middle and low rectal cancer can partially decrease the tumor staging,enhance the sphincter preservation rate and improve long-term clinical prognosis. Both ypT and ypN stages are correlated with the clinical prognosis of patients.
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Objective This study was conducted to evaluate treatment-related toxicities,the patterns of failure,overall survival(OS)and progression-free survival(PFS)by comparing IFI with ENI in combination with chemotherapy. Methods Eligible patients were treated with concurrent chemoradiotherapy and randomized into either an IFI or ENI arm. The primary end points wereacute treatment-related toxicities. The secondary end points were patterns of failure,OS and PFS. Kaplan?Meier survival rate of the method for calculating the Logrank test difference method. Results Between April 2012 and October 2016,a total of 228 patients were enrolled from nine centers in china. Grade≥3,Grade≥2 radiation esophagitis and pneumonitis in the IFI arm were significantly lower than that of the ENI arm(P=0.018,0.027).No significant differences were observed in overall failure rates,loco-regional failure,distant failure rates,in-field and out-field lymph node failure between the two arms(P=0.401,0.561,0.510,0.561,0.681).The 1-,2-, 3-,4-yearand median OS in the ENI arm and IFI arm were 84.1%,57.3%,39.4%,31.6%,28 months and 83.6%,62.1%,44.5%,31.5%,32 months(P=0.654),respectively. The 1-,2-,3-yearand median PFS in the ENI arm and IFI arm were 71.9%,42.3%,32.7%,20 months and 70.1%,45.0%,35.9%,22 months (P=0.885),respectively. Conclusions Compared to ENI,IFI resulted in decreased radiation pneumonitis and esophagitis without sacrificing loco-regional lymph nodal control,PFS and OS in thoracic ESCC. Clinical Trial Registry Chinese Clinical trail registry,registration number:NCT01551589.
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Objective To explore the nutritional increased risk related factors in esophageal cancer patients after chemoradio‐therapy .Methods Sixty‐eight esophageal cancer patients undergoing concurrent chemoradiotherapy were prospectively investiga‐ted .The patient‐generated subjective global assessment(PG‐SGA) was adopted to grade the nutritional risk .All of the patients re‐ceived early nutrition education and short‐term nutrition support for severe malnutrition ,nutritional status was assessed again at the end of radiotherapy .The patients were divided into the mild‐to‐moderate malnutrition group[PG‐SGA(B)group] and the severe malnutrition group [PG‐SGA(C)group] according to the PG‐SGA score on admission .The body mass ,albumin(Alb) ,hemoglobin (Hb) ,white blood cells ,platelets ,neutrophils ,lymphocytes ,monocytes and other objective nutrition indicators were collected before and after chemoradiation .Results There were 24 cases in the PG‐SGA(B) group and 44 cases in the PG‐SGA(C) group;the gen‐der ,age and ethnic had no statistical differences between the two groups(P>0 .05) .Hb(χ2 =2 .710 ,P=0 .009) and Alb(χ2 =3 .743 ,P=0 .000) before chemoradiotherapy had no statistical difference between the two groups(P>0 .05);Hb and Alb after che‐moradiotherapy in the PG‐SGA(B) group were higher than those in the PG‐SGA(C) group .The body mass index(BMI)before and after chemoradiotherapy had statistically significant difference between the two groups (P<0 .05) .The percentage of body mass decrease in the two groups had no statistical significance (P=0 .487) .The PG‐SGA scores after chemoradiotherapy were positively correlated with the change of Hb ,Alb ,BMI parameters and percentage of weight decrease before and after chemoradiotherapy(rs=0 .240 ,0 .249 ,0 .282 ,0 .447 ,P<0 .05) .Conclusion The poor understanding of malnutrition ,the change of Hb ,Alb ,BMI parame‐ters and percentage of body weight decrease before and after chemoradiotherapy are the nutritional increased risk factors in esopha‐geal cancer patients after chemoradiotherapy .
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OBJECTIVE: The aim of this study was to compare the cross-follow-up results in DDD or AAISafeR mode and to describe the safety and effectiveness of this pacing mode. METHODS: The Symphony 2450/2550 cardiac pacemakers were implanted in 30 patients with sick sinus syndrome between February 2006 and September 2006. They were randomized to the DDD mode or AAISafeR mode for 3 months and then crossed over to the alternate pacing modality for an additional 3 months. RESULTS: No AAISafeR-related adverse event was observed. All documented episodes of paroxysmal atrial ventricular block caused the immediate switch of the pacing mode from AAI to DDD. The cumulative percent ventricular pacing was significantly reduced in the AAISafeR mode compared with the DDD mode (0.9% [0%-3%] versus 51.3% [2%-91%] P = 0.001; 2.94% [0%-18%] versus 41.18% [0%-65%] P = 0.0001). After 3 months in DDD mode, left atrial diameter, left ventricular enddiastolic diameter, and left ventricular end-systolic diameter increased significantly and left ventricular ejection fraction decreased. However, no obvious changes appeared in 3 months of AAISafeR mode. Switches to DDD occurred during follow-up in 21 patients due to different-degree atrial ventricular block. CONCLUSION: The AAISafeR mode substantially reduces the amount of unnecessary right ventricular pacing in the bradycardia population and effectively prevents the deleterious effects on cardiac performance. An international randomized study will further ascertain the efficacy of this new pacing mode specifically in the prevention of heart failure hospitalization and atrial fibrillation.
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Estimulación Cardíaca Artificial/métodos , Marcapaso Artificial , Síndrome del Seno Enfermo/terapia , Anciano , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Objective To evaluate the clinical factors associated with pathological complete response (pCR) after preoperative neoadjuvant chemoradiotherapy for rectal cancer.Methods A retrospective analysis was performed on the clinical data of 116 patients with rectal cancer,who underwent neoadjuvant chemoradiotherapy followed by radical surgery from January 2009 to December 2012.All patients received pelvic intensity-modulated radiotherapy (50 Gy/25 fractions) with concurrent fluorouracilbased chemotherapy and then underwent radical surgery 4-8 weeks later.The clinical factors associated with pCR or non-pCR were analyzed by Logistic regression.Results Of the 116 patients,20 (17.2％) achieved a pCR after neoadjuvant chemoradiotherapy.The univariate analysis showed that percentage of circumference of the rectal tube invaded by the tumor,preoperative serum carcinoembryonic antigen (CEA) level,T stage,N stage,distance from the anal verge,degree of tumor differentiation,and maximum tumor diameter were associated with pCR or non-pCR after neoadjuvant chemoradiotherapy for rectal cancer.The multivariate analysis revealed that percentage of circumference of the rectal tube invaded by the tumor,preoperative serum CEA level,and T stage were predictive factors for pCR or non-pCR after neoadjuvant chemoradiotherapy for rectal cancer.Conclusions Non-circumferential tumor (percentage of circumference of the rectal tube invaded by the tumor ＜ 75 ％),low CEA level,and early T stage before treatment may be associated with pCR after neoadjuvant chemoradiotherapy for rectal cancer.
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Objective To explore the preliminary study of the four-dimensional CT-based respiratory gating applications in the IGRT treatment of lung cancer .Methods 38 patients′ were scanned with 4D-CT ,and could got 10 images:0-90% each one ,and then two kinds of radiation treatment plans :Plan-3D and Plan-4D were used ,respectively .Treatment of the patients in the IGRT mode with Plan-4D and following up were done in two months after treatment to evaluate the efficacy and complication probability . Meanwhile evaluation of the two plans by the volume histogram was done .Results The displacement of lung tumor respiratory mo-tion was different in three dimensions ,especially in the Vertical direction ,about(9 .1 ± 2 .2)mm .Accuracy of the distance was 2 .6 mm .The Plan-4D′s CTV was bigger than Plan-3D ,but its PTV was less than the Plan-3D significantly ,at the same time its lung V20 ,MLD were both less than the Plan-3D ,and the difference was statistically significant(P< 0 .05) .The total efficiency(CR+PR)was 77 .78% (28 case);the incidence of 1 ,2 ,3 acute radiation-induced lung injury were 86 .11% ,11 .11% ,2 .78% ,respectively ;the incidence of 1 ,2 acute radiation esophagitis injury were 80 .56% ,8 .33% .Conclusion The respiratory gating techniques based on 4D CT applied in image guided radiotherapy of lung cancer in clinical is feasible ,and it can reduce the volume of the planning tar-get volume ,and help to improve the accuracy of radiotherapy .The degree of respiratory motion is significantly different in individu-als ,and expanding outside the target ranges should be individualized .
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Objective To study the CBCT image registration of PTV enlarging distance and IMRT planning(CT-1) for patients with lung cancer,and evaluate their characters.Methods Ten patients with lung cancer were included in the study.Two sets image,before and after radiotherapy,were acquired every week.Then delineated the targeted volume and made the planning (CT-2) according the enlarging distance data.To comparize the parameters of DVH for lung and spinal cord,volumes and dose of PTV and NTCP with CT-1 and CT-2.The difference of two plan was analyzed by covariance analysis or Wilcoxson's z-test.Results The max,min and mean dose of PTV,the lung V5,V10,V20,V30,V50 were similar in both plans (P =0.242-0.663).There was superiority in CT-2 of PTV and lung's mean dose(P =0.049,0,035).The NTCP had the decent tendency followed by the increasing of lung Vs,V10,V20(P =0.146,0.053,0.000).Conclusions CBCT based image registration can reduce PTV,the mean dose of lung,NTCP,and increase PTV dose.This provides a tool for exploring acurate radiotherapy strategies.
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Background Given the increasing number of patients who require dual antiplatelet (DAP) therapy and electrophysiological device (EPD) placement, perioperative antiplatelet management is a current challenge. In this study, we investigated the incidence of pocket hema-toma formation after EPD placement in patients undergoing DAP therapy or an alternative low-molecular-weight heparin (LMWH) regimen. Methods This clinical observational study was performed from July 2010 to July 2012. In total, 171 patients were enrolled in the analysis after meeting the inclusion criteria. These patients were divided into two groups: 86 patients were treated with DAP therapy at the time of device implantation, and the DAP therapy was discontinued for 5 to 7 days and replaced with enoxaparin before device implantation in the other 85 patients. Adenosine phosphate (ADP)-mediated platelet aggregation and arachidonic acid-induced platelet aggregation were tested preoperatively. We compared the incidence of pocket hematoma between the two groups and the association of pocket hematoma develop-ment with ADP-mediated platelet aggregation and arachidonic acid-induced platelet aggregation.Results The incidence of pocket hema-toma in the patients who continued DAP was lower than that in the patients who replaced the dual antiplatelet regimen with LMWH (3.49%vs. 16.47%, respectively;X2 = 6.66,P < 0.01). Among the patients who continued DAP therapies, the rate of ADP-mediated platelet aggre-gation inhibition in patients with pocket hematomas was higher than that in patients without pocket hematomas. None of the patients under-going DAP or enoxaparin therapy developed pocket infection, thromboembolic events, or other serious complications. Multiple logistic re-gression analysis revealed that LMWH therapy was an independent risk factor for the development of pocket hematoma (RR = 0.054, 95%CI = 0.012-0.251). Furthermore, patients undergoing LMWH therapy were 5.1-fold more likely to develop pocket hematomas than were DAP-treated individuals.Conclusion Continuance of DAP therapy does not increase the risk of pocket hematoma formation after EPD placement.
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Objective To investigate the relationship between the protein expression of X-ray repair cross-complementing protein 3 (XRCC3) and human 8-hydroxyguanine glycosylase 1 (HOGG1) in esophageal squamous cell carcinoma (ESCC) tissue and the prognosis in ESCC patients after radiotherapy.Methods Immunohistochemical SP method was used to measure the protein expression of XRCC3 and HOGG1 in 171 ESCC tissue samples before radiotherapy.The Kaplan-Meier method was used for survival analysis,and the logrank test was used for analyzing the survival difference between negative and positive samples.The Cox model was used for multivariate prognostic analysis.Results The follow-up rate was 87.2％ ; 140 patients were followed up for at least 1 year,136 patients for at least 2 years,and 129 patients for at least 3 years.XRCC3 was mainly expressed in the nucleus,and HOGG1 was mainly expressed in the nucleus and mitochondria,with a coincidence degree of 72.5％ (x2 =23.94,P =0.000).The patients with positive XRCC3 expression and negative XRCC3 expression had similar short-term responses (x2 =0.98,P =0.614)as well as similar survival rates,and both patient groups had a median survival time of 54 months (x2 =0.17,P =0.683).The patients with positive HOGG1 expression and negative HOGG1 expression had similar short-term responses (x2 =0.26,P =0.880) as well as similar survival rates,and both patient groups had a median survival time of 49 months (x2 =0.08,P =0.780).The multivariate prognostic analysis showed that the response evaluation and tumor length were related to the prognosis of ESCC (x2 =7.99,P =0.005 ; x2 =3.76,P =0.045).Conclusions The protein expression of XRCC3 and HOGG1 may be unrelated to the prognosis of ESCC after radiotherapy.
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Objective To compare image-guided radiotherapy(IGRT) and intensity-modulated radiotherapy(IMRT) treatment in patients with recent efficacy and toxicity of radioactive reaction ,discuss factors affecting prognosis .Methods Collection of 52 cases of IGRT and 55 cases of IMRT patients with non-small-cell lung cancer(NSCLC) ,satisfy the requirement of target prescription dose in the case ,the recent efficacy of tumor ,comparing two treatments in patients with radioactive toxic effects and factors affect-ing the prognosis .Results The incidence of radioactive pneumonia in IGRT group was lower than the IMRT group (P0 .05) .The survival rates of IGRT group 1 , 1 .5 ,2 years after radiotherapy were 57 .7% ,35 .0% ,27 .3% ,IMRT group were 50 .9% ,34 .1% ,21 .8% .The median survival time of IGRT group and IMRT group was 17 months and 13 months respectively ,there was no statistically significant difference(P>0 .05) .Conclusion In NSCLC treatment ,compared with IMRT ,TGRT could reduce the toxic reaction of radiotherapy ,but the effect of two kinds of treatment for the recent difference is not obvious .
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Objective To study the relationship between the single nucleotide polymorphisms (SNP)of X-ray repair cross-complementing group-3(XRCC3),human 8-hydroxyguanine glycosylase-1 (HOGG1)gene of repair DNA and the radiosensitivity in esophageal squamous cell carcinoma(ESCC).Methotis Genome DNA was exracted from whole blood cells of ESCC patients.XRCC3 and HOGG1 genotypes were determined by polymerase chain reaction-restriction fragment length polymorphism method.The relationship was analyzed between SNP of XRCC3 Thr242 Met,HOGG1 Ser326 Cys and the response to radiotherapy in ESCC.Results Totally 199 ESCC patients were treated with radical radiotherapy.The response rate w88 81.4%.The response rate in patients with the XRCC3 Thr/Met genotype was significant higher than that in patients with Thr/Thr genotype(91.5%vs 77.1%,X2=5.67,P=0.017),with the same in HOGGlSet/Ser,Ser/Cys and Cys/Cys genotype(74.1%,84.2%,83.9%,X2=2.64,P=0.268).The esophageal radioactivity injury rate in patients with the XRCC3 Thr/Met genotype was also significant higher than that in patients with Thr/Thr genotype(35.6%vs 20.0%,X2=5.44,P= 0.020),with the same in HOGG1 Ser/Ser,Ser/Cys and Cys/Cys genotype(24.1%,24.6%,25.8%,X2=0.03,P=0.984).In Iogistic multivariate analysis,the SNP of XRCC3 was the independent influencing factor closely correlating with the mdiosensitivity of esophageal cancer(X2=16.12,4.43,P=0.009.0.035).No significant difierence was observed between the SNP in HOGG1 Ser326 Cys and the response rate of radiotherapy or the rate of esophageal radioactivity injury(X2=3.74,0.58,P=0.053,0.445).Conclusions SNP of XRCC3 Thr/Met is associated with the radiosensitivity in ESCC patients,which suggests that the XRCC3 Thr/Met SNP may be a predictor for ESCC patients who likely to response to radiotherapy.
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Objective To study the effect of radiotherapy and prognostic factors for patients with post-operative loco-regional recurrence of esophageal carcinoma. Methods From 2000 to 2005,91 patients with esophageal carcinoma who developed post-operative loco-regional recurrence were analyzed retrospectively. The interval between surgery and recurrence was 1 -35 months, with a median interval of 11.1 months. There were 4 patients with anastomosis relapse, 6 with anastomosis and mediastinal lymph nodes relapse,4 with abdominal lymph node relapse, 20 with supra-clavicular lymph node relapse, 34 with mediastinal lymph node relapse, and 23 with mediastinal and supra-clavicular lynph node relapse. There were 56 and 35 patients who received conventional and three-dimensional conformal radiation therapy respectively, with a total radiation dose of 50 -70 Gy. Sixty-eight patients received adjuvant chemotherapy.Results The follow-up rate was 95%. The 1-,2-and 3-year overall survival rates were 52%, 20% and 14%, respectively. In univariate analysis, the recurrence time (P = 0. 001), postoperative stage (P =0. 000), radiation dose (P =0. 001) ,overall response rate (P =0. 000) ,T stage (P =0. 028), and N stage (P = 0. 003) were related with prognosis. Multivariate analysis showed that the recurrence time (P =0. 014), postoperative stage (P = 0. 006), radiation dose (P = 0. 009), overall response rate (P = 0. 000)were independent prognostic factors for survival. Conclusions Radiotherapy may improve the survival of esophageal carcinoma patients with postoperative recurrence. Patients with long recurrence-free time, early stage, high response rates, and radiation dose of higher than 60 Gy have better prognosis.
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Objective To compare the effects of aspirin and warfarin in the elderly patients with chronic nonvalve atrial fibrillation.Methods 431 elderly patients with chronic non-valvalar atrial fibrillation were randomly divided into two groups: group A received aspirin; group B received warfarin.After patients were treated with aspirin or warfarin for two years,the incidence rate of stroke and hemorrhage rate were counted. Results Aspirin was as effective as warfarin in preventing stroke in patients age 65 to 75 years old without risk factor,and warfarin was more effective than aspirin in preventing stroke in patients (≥75) and all patients with risk factors. Warfarin and aspirin had low incidence rate of bleeding. Conclusion For the patients aged 65 to 75 years old have no risk factors, they should be treated with aspirin in preventing stroke .For the older patients older than 75 years old and patients have risk factors, they should be treated with warfarin,which is more efficient than asprin in preventing stroke.
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The right chest electric admittance plethsmography (RCEAP) is a simple no invasive and reliable method in detecting the blood flow volume in the pulmomary artery and vein, an indirection of the left heart function. In this clinical study, the RCEAP, left heart catheterization for measurement of LVEDP and coronary angiogram and echocardiography for investigating the LVEF were performed on 34 patients with coronary heart disease. Of these 34 patients,24 had single or no left vessel lesion (Group A), 10 had left main coronary artery or its double branches lesions (Group B) ;8 underwent percutaneous trans-lumin coronary angioplasty (PTCA)and 10 had coronary artery bypass graft (CABG).The data obtained were analysed and compared to evaluate their respective diagnostic values. Correlation analysis demonstrated the values of hc/hz ratio, ha/hz ratio were moderated with LVEDP(r = 0. 68 or 0. 73,P
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Objective To evaluate the clinical effectiveness of treating small coronary artery disease(diameter
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AIM To investigate the effects of propofol on Na +, K + ATPase and Ca 2+ ATPase activities in rat brain. METHODS Forty rats were divided randomly into five groups. The animals were administered intraperitoneally (ip) propofol 100 mg?kg -1 or equal volume of normal saline (control group) respectively. These rats were immediately decapitated before (induction group) and after (anesthesia group) the disappearance of righting reflex, and when righting reflex appeared again (recovery group), and rats were completely conscious (awake group). Brain tissues were dissected on ice, then homogenized and centrifuged. Na +, K + ATPase and Ca 2+ ATPase activities were estimated by spectrophotometry. RESULTS Propofol 100 mg?kg -1 ip significantly inhibited Na +, K + ATPase and Ca 2+ ATPase activities of cortex, hippocampus and brain stem as compared with that of normal saline group ( P
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AIM To study the effects of propofol on membrane fluidity and intracellular free Ca 2+ concentration ([Ca 2+ ] i ) in PC12 cells and discuss its relevant mechanism. METHODS PC12 cell lines were divided into seven groups: control, solvent and propofols(1,3,10,30,100 mg?L -1 ). Fluorescence depolarization method was used to measure dynamically microviscosity in PC12 cells and [Ca 2+ ] i was detected using calcium fluorescentprobe Fluo 3/AM and a laser scanning confocal microscope. RESULTS ①Acute administration of various doses of propofol induced a significant decrease of microviscosity in PC12 cells dose dependenty. ② Solvent, propofol at dose of 10 mg?L -1 had no effect on [Ca 2+ ] i in PC12 cells, however, after 30 and 100 mg?L -1 administration, [Ca 2+ ] i increased markedly at 20～30 seconds (increase percentage were 119% and 140% respectively) and then recovered to their pre administration levels within 50 seconds. CONCLUSION The propofol can significantly increase membrane fluidity in PC12 cells in a dose dependent manner and elevate [Ca 2+ ] i in PC12 cells at doses of 30 and 100 mg?L -1 . These changes are consistent with each other and related closely with anesthetic effect of propofol.