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Introduction: It is worth to explore a more effective treatment method to minimize the damage for patients during the treatment process. Aim: To explore the method, feasibility and efficacy of B-ultrasound or computed tomography (CT)-guided 3D printing individualized non-coplanar template brachytherapy in the treatment of locally uncontrolled recurrent head and neck squamous cell carcinoma. Material and methods: Ten patients with locally uncontrolled recurrent head and neck squamous cell carcinoma who were treated in our department from August 2021 to February 2023 were collected and treated by 3D printing individualized non-coplanar template brachytherapy under the guidance of B-ultrasound or CT, using the 192Ir high-dose rate afterloading treatment machine of NUCLETRON Technologies GmbH. The radiation source was 192Ir, with a diameter of 0.5 mm, a length of 3.5 mm, a total dose of 10-24 Gy, 5-8 Gy/time, once a week. Results: According to the efficacy evaluation criteria, CT scan was performed after 1-6 months, followed up for 24 months, including CR 40% (4/10), PR 50% (5/10), NC 10% (5/10), PD 0 (0). The total effective rate of CR + PR was 90% (9/10), the 6-month local control rate was 90%, the 12-month local control rate was 80%, the 18-month local control rate was 70%, and the 24-month local control rate was 70%. The overall survival rate at 24 months was 100%. Conclusions: Safe and effective interpolation is used to guide the 3D printing of a single non-coplanar template with B-ultrasound or CT in the radiotherapy of local and uncontrolled recurrent head and neck squamous cell carcinoma. According to the guidance of B-ultrasound or CT, the 3D printing individualized non-coplanar template has an obvious healing effect especially in the brachytherapy, and can also protect the functional organs well, with less side effects and fewer complications. Therefore, this method is the most effective for the treatment of locally uncontrolled recurrent head and neck squamous cell carcinoma.
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Curcumin is one of the most studied chemo-preventive agents, which may cause suppression, retardation, or inversion of carcinogenesis. But its application is currently limited because of its poor water-solubility and bioaccessibility. A curcumin O/W emulsion was prepared by high-pressure homogenization, using triglyceride monolaurate as an emulsifier and medium chain triglycerides (MCT) as the oil phase. The effects of emulsifiers, emulsifier concentration, oil type, oil-to-water ratio, and homogenization pressure and processing cycles on the physical stability and droplet size distribution of curcumin-encapsulated O/W emulsions were evaluated in this study. The results showed that the mean droplet size of the O/W emulsions remained remarkably stable during 60 days of storage under both light and dark conditions. Curcumin retentions in O/W emulsions after 60 days of storage under light and dark conditions were 97.9% and 81.6%, respectively. In addition, during the simulated gastrointestinal digestion process, the mean droplet size of the O/W emulsions increased from 260 nm to 2743 nm after incubation with simulated gastric fluid (SGF) for 24 h, while the mean droplet size remained unchanged after incubation with simulated intestinal fluid (SIF). The results displayed negligible changes in curcumin content during incubation with simulated gastrointestinal fluids, indicating that effective protection of curcumin was achieved by encapsulation in the O/W emulsion. It is expected that curcumin will acquire high bioaccessibility and bioavailability when the O/W emulsion is to be used in clinical applications.
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Antineoplásicos , Curcumina , Emulsões , Emulsificantes , Água , Tamanho da PartículaRESUMO
Current graphene-based plasmonic devices are restricted to 2D patterns defined on planar substrates; thus, they suffer from spatially limited 2D plasmon fields. Here, 3D graphene forming freestanding nanocylinders realized by a plasma-triggered self-assembly process are introduced. The graphene-based nanocylinders induce hybridized edge (in-plane) and radial (out-of-plane) coupled 3D plasmon modes stemming from their curvature, resulting in a four orders of magnitude stronger field at the openings of the cylinders than in rectangular 2D graphene ribbons. For the characterization of the 3D plasmon modes, synchrotron nanospectroscopy measurements are performed, which provides the evidence of preservation of the hybridized 3D graphene plasmons in the high precision curved nanocylinders. The distinct 3D modes introduced in this paper, provide an insight into geometry-dependent 3D coupled plasmon modes and their ability to achieve non-surface-limited (volumetric) field enhancements.
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In this study, we explore a new method based on color variation data to derive the kinetics of the entire process of the hydration of alkali-activated slag (AAS). Using this image analysis technique, we can monitor the induction period that cannot be observed using conventional microcalorimetry techniques. Color variation was recorded across a sequence of 9999 images, which were processed via MATLAB software package. Further, an average pixel value (APV) was determined to represent the color in each image. Reaction parameters, such as color variation velocity v(t), reaction speed ε(t), and hydration degree α(t), that govern the entire hydration process were determined. On the basis of the reaction parameters and a Krstulovic-Dabic kinetic model, integral and differential equations were derived to simulate the three basic processes of AAS hydration. Equations describing the reaction kinetics of AAS with solutions of three different concentrations of NaOH were extracted using this method.
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The ability to transform two-dimensional (2D) materials into a three-dimensional (3D) structure while preserving their unique inherent properties might offer great enticing opportunities in the development of diverse applications for next generation micro/nanodevices. Here, a self-assembly process is introduced for building free-standing 3D, micro/nanoscale, hollow, polyhedral structures configured with a few layers of graphene-based materials: graphene and graphene oxide. The 3D structures have been further modified with surface patterning, realized through the inclusion of metal patterns on their 3D surfaces. The 3D geometry leads to a nontrivial spatial distribution of strong electric fields (volumetric light confinement) induced by 3D plasmon hybridization on the surface of the graphene forming the 3D structures. Due to coupling in all directions, resulting in 3D plasmon hybridization, the 3D closed box graphene generates a highly confined electric field within as well as outside of the cubes. Moreover, since the uniform coupling reduces the decay of the field enhancement away from the surface, the confined electric field inside of the 3D structure shows two orders of magnitude higher than that of 2D graphene before transformation into the 3D structure. Therefore, these structures might be used for detection of target substances (not limited to only the graphene surfaces, but using the entire volume formed by the 3D graphene-based structure) in sensor applications.
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Benzoxazinoids (BXs) are tryptophan-derived indole metabolites and play a role in various physiological processes, such as auxin metabolism. Auxin is essential in the process of somatic embryogenesis (SE) in plants. In this study, we used bioinformatics, transcriptome data, exogenous treatment experiments, and qPCR analysis to study the evolutionary pattern of Bx genes in green plants, the regulatory mechanism of DlBx genes during early SE, and the effect of 2,4-dihydroxy-7-methoxy-1,4-benzoxazine-3-one (DIMBOA) on the early SE in Dimocarpus longan Lour. The results showed that 27 putative DlBxs were identified in the longan genome; the Bx genes evolved independently in monocots and dicots, and the main way of gene duplication for the DlBx was tandem duplication (TD) and the DlBx were strongly constrained by purification selection during evolution. The transcriptome data indicated varying expression levels of DlBx during longan early SE, and most DlBxs responded to light, temperature, drought stress, and 2,4-dichlorophenoxyacetic acid (2,4-D) treatment; qRT-PCR results showed DlBx1, DlBx6g and DlBx6h were responsive to auxin, and treatment with 0.1mg/L DIMBOA for 9 days significantly upregulated the expression levels of DlBx1, DlBx3g, DlBx6c, DlBx6f, DlB6h, DlBx7d, DlBx8, and DlBx9b. The correlation analysis showed a significantly negative correlation between the expression level of DlBx1 and the endogenous IAA contents; DIMBOA significantly promoted the early SE and significantly changed the endogenous IAA content, and the IAA content increased significantly at the 9th day and decreased significantly at the 13th day. Therefore, the results suggested that DIMBOA indirectly promote the early SE by changing the endogenous IAA content via affecting the expression level of DlBx1 and hydrogen peroxide (H2O2) content in longan.
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INTRODUCTION: Ceftazidime-avibactam (CAZ-AVI) is a new option to treat KPC- and OXA-48 carbapenem-resistant Klebsiella pneumoniae (CRKP) infections. However, clinical evidence is limited regarding its use in treating CRKP infections, especially in solid organ transplantation (SOT) recipients. In this study, we assessed the efficacy of CAZ-AVI in treating CRKP infections in both the general population and the SOT recipients in comparison with other antibiotic regimens. METHODS: This is a single-centre retrospective cohort study of patients admitted between January 1, 2018 and June 30, 2021 with the diagnosis of CRKP infections receiving either CAZ-AVI or other regimens ≥ 72 hours and clinical outcomes were analysed. RESULTS: Of 200 patients with CRKP infections, 67 received CAZ-AVI, 133 received other regimens, and 50 were SOT recipients. In the SOT cohort, 30 patients received CAZ-AVI, and 20 received other regimens. The overall 30-day mortality was 38% in the SOT cohort. Compared with patients receiving other regimens, CAZ-AVI therapy resulted in lower 30-day mortality (23.3% vs. 60%, P = 0.014) and 90-day mortality (35.7% vs. 86.7%, P = 0.003), higher clinical cure (93.3% vs. 40%, P < 0.001) and microbiological clearance. Similar promising results of CAZ-AVI were also shown in the whole population cohort. Moreover, clinical outcomes of SOT recipients receiving CAZ-AVI were not inferior to those without SOT. CONCLUSIONS: CAZ-AVI therapy was associated with better clinical outcomes in CRKP infections in both the general population and SOT recipients. Considering the limitations of the present study, well-conducted RCTs are still warranted to confirm these findings.
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Antibacterianos , Compostos Azabicíclicos , Ceftazidima , Combinação de Medicamentos , Infecções por Klebsiella , Klebsiella pneumoniae , Transplante de Órgãos , Humanos , Ceftazidima/uso terapêutico , Compostos Azabicíclicos/uso terapêutico , Masculino , Feminino , Estudos Retrospectivos , Pessoa de Meia-Idade , Klebsiella pneumoniae/efeitos dos fármacos , Infecções por Klebsiella/tratamento farmacológico , Infecções por Klebsiella/mortalidade , Infecções por Klebsiella/microbiologia , Antibacterianos/uso terapêutico , Idoso , Transplante de Órgãos/efeitos adversos , Enterobacteriáceas Resistentes a Carbapenêmicos/efeitos dos fármacos , Transplantados , Adulto , Carbapenêmicos/uso terapêutico , Resultado do Tratamento , Testes de Sensibilidade MicrobianaRESUMO
Oral microorganisms are closely related to oral health, the occurrence of some oral diseases is associated with changes in the oral microbiota, and many studies have demonstrated that traditional smoking can affect the oral microbial community. However, due to the short time since the emergence of e-cigarettes, fewer studies are comparing oral microorganisms for users of e-cigarettes versus cigarettes. We collected saliva from 40 non-smokers (NS), 46 traditional cigarette smokers (TS), and 27 e-cigarette consumers (EC), aged between 18 and 35 years. We performed 16S rRNA gene sequencing on the saliva samples collected to study the effects of e-cigarettes versus traditional cigarettes on the oral microbiome. The results showed that compared with the NS group, the alpha diversity of oral flora in saliva was altered in the TS group, with no significant change in the e-cigarette group. Compared with the NS and EC groups, the relative abundance of Actinomyces and Prevotella was increased in the TS group. However, compared with the NS and TS groups, the relative abundance of Veillonella was increased, and the relative abundance of Porphyromonas and Peptostreptococcus was decreased in the EC group. These results showed that both e-cigarettes and traditional cigarettes could alter the structure and composition of oral microbiota. The use of traditional cigarettes promotes the growth of some anaerobic bacteria, which may contribute to dental decay and bad breath over time. E-cigarettes have a different effect on the structure and composition of the oral microbial community compared to conventional cigarettes. In order to better understand the effects of e-cigarettes and traditional cigarettes on users' mouths, future studies will investigate the relationship between diseases such as dental caries and periodontitis and changes in oral microbial species levels.
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Blending octene random copolymer (ORC) with other polymers is a promising approach to improving ORC mechanical properties, such as tensile strength and elongation. In this study, octene block copolymer (OBC) with lower density than ORC and high-density polyethylene (HDPE) were used to blend with ORC. The effect of both OBC and HDPE on ORC was analyzed using scanning electron microscopy (SEM), differential scanning calorimetry (DSC), dynamic mechanical analysis (DMA) and small-angle X-ray scattering (SAXS). For ORC/OBC blends, a small amount of OBC can improve the crystallization ability of ORC. Meanwhile, for ORC/HDPE blends, the crystallization ability of ORC was significantly suppressed, attributed to good compatibility between ORC and HDPE as indicated by the homogeneous morphology and the disappearance of the α transition peak of ORC in ORC/HDPE blends. Therefore, the tensile strength and elongation of ORC/HDPE blends are significantly higher than those of ORC/OBC blends. For ORC/OBC/HDPE ternary blends, we found that when ORC:OBC:HDPE are at a ratio of 70:15:15, cocrystallization is achieved. Although HDPE improves the compatibility of ORC and OBC, the three-phase structure of the ternary blends can be observed through SAXS when HDPE and OBC exceed 30 wt%. Blending HDPE and OBC (≤30 wt%) could improve the mechanical property of ORC.
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OBJECTIVES: The management of sepsis, a potentially lethal overreaction to infection, is limited by the lack of prognostic tools to guide its treatment. Our aim is to identify a novel metabolic biomarker panel for predicting sepsis mortality based on a literature review and liquid chromatography-mass spectrometry (LC-MS)-based metabolomics. METHODS: In the literature, we found metabolomics biomarkers reported to predict sepsis mortality. We determined the classifications, reported frequency, and KEGG pathway enrichment of these markers. Using serum samples from 20 sepsis survivors and 20 non-survivors within 28 days after admission to the intensive care unit (ICU), we performed LC-MS-based metabolomics. Based on the literature review and metabolomics, a prognostic biomarker panel for sepsis was identified and its area under the curve (AUC) values was assessed. RESULTS: Kynurenate, caffeine, and lysoPC 22:4 were selected as a prognostic biomarker panel for sepsis. The panel had an area under the curve (AUC) of 0.885 (95% CI, 0.694-1) evaluated by linear support vector machine (SVM) and 0.849 (0.699-1) by random forest (RF), which was higher than that of the Sequential Organ Failure Assessment (SOFA). A combination of kynurenate, caffeine, and lysoPC 22:4 and SOFA provided the best discriminating performance, with AUCs of 0.961 (0.878-1) for SVM and 0.916 (0.774-1) for RF. CONCLUSIONS: The prognostic biomarker panel consisting of kynurenate, caffeine, and lysoPC 22:4 may aid in the identification of sepsis patients at a high risk of death, leading to personalized therapy in clinical practice that will improve sepsis survival.
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The song of zebra finch is stable in life after it was learned successfully. Vocal plasticity is thought to be a motor exploration that can support continuous learning and optimization of performance. The activity of RA, an important pre-motor nucleus in songbird's brain, influences the song directly. This variability in adult birdsong is associated with the activity of NMDA receptors in LMAN-RA synapses, but the detailed mechanism is unclear. The control of gain refers to modulation of a neuron's responsiveness to input and is critically important for normal sensory, cognitive, and motor functions. Here, we observed the change of gain in RA projection neurons after exogenous NMDA was applied to activate NMDA receptors using the whole-cell current clamp recording. We found that NMDA substantially increased the slope (gain) of the firing rate-current relationship in RA projection neurons. The AMPA receptor-dependent excitability played a crucial role in the modulation of gain by NMDA. These results suggested that NMDA receptors may regulate the dynamics of RA projection neurons by input-output gain.
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N-Metilaspartato/fisiologia , Rede Nervosa/fisiologia , Plasticidade Neuronal/fisiologia , Prosencéfalo/citologia , Prosencéfalo/fisiologia , Potenciais de Ação/fisiologia , Fatores Etários , Animais , Tentilhões , Masculino , N-Metilaspartato/metabolismo , Rede Nervosa/metabolismo , Vias Neurais/fisiologia , Receptores de N-Metil-D-Aspartato/agonistas , Receptores de N-Metil-D-Aspartato/fisiologia , Aves Canoras , Vocalização Animal/fisiologiaRESUMO
As the proportion of renewable energy gradually increases, it brings challenges to the stable operation of the combined heat and power (CHP) system. As an important flexible resource, energy storage (ES) has attracted more and more attention. However, the profit of energy storage can't make up for the investment and operation cost, and there is a lack of measurement system for multiple values, which seriously hinders the development of energy storage industry. Based on this, this paper makes a quantitative analysis on the system value of multiple energy storage in CHP. Firstly, the uncertain output of renewable energy is characterized by Kullback-Leibler (KL) divergence, and a two-level dispatching model is constructed based on the distributionally robust optimization method, so as to study the optimal operation strategy of the ES-CHP system. Secondly, based on the system value theory, this paper analyzes the system value of multiple energy storage, including internal value and external value, and constructs the value quantitative model, respectively. Finally, in a typical ES-CHP system, the system value of multiple energy storage is quantified. The effectiveness of the two-level model constructed in this paper can be seen from the simulation results, and the influence of different electricity prices on the system value of multiple energy storage is further analyzed.
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Lung diseases such as acute respiratory distress syndrome affect the patient's lung compliance, which in turn affects the ability of gas exchange. Changes in alveolar diameter relate to local lung compliance. How alveolar diameter affects gas exchange, particularly oxygen concentrations in alveolar capillaries, is a topic of concern for researchers, and can be studied using mathematical models. The level of small-scale mathematical models of the pulmonary circulatory system was the alveolar capillaries, but existing models do not consider the gas-exchange function and fail to reflect the influence of alveolar diameter. Therefore, we proposed a pulmonary acinar capillary model with gas exchange function, and most importantly, introduced alveolar diameter into the model, to analyze the effect of alveolar diameter on the gas exchange function of the pulmonary acini. The model was tested by three respiratory function simulation experiments. According to the simulation results of changing diameter, we found that the alveolar diameter mainly affects the alveolar gas exchange function of lung acinar inlets and the middle section compared with the peripheral section.
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Troca Gasosa Pulmonar , Síndrome do Desconforto Respiratório , Capilares , Humanos , Pulmão , Complacência Pulmonar , Alvéolos PulmonaresRESUMO
Water lily is an important ornamental flower plant which is capable of viviparous plantlet development. But no study has been reported on the molecular basis of viviparity in water lily. Hence, we performed a comparative transcriptome study between viviparous water lily Nymphaea micrantha and a nonviviparous species Nymphaea colorata at four developmental stages. The higher expression of highly conserved AUX/IAA, ARF, GH3, and SAUR gene families in N. micrantha compared to N. colorata is predicted to have a major impact on the development and evolution of viviparity in water lily. Likewise, differential regulation of hormone signaling, brassinosteroid, photosynthesis, and energy-related pathways in the two species provide clues of their involvement in viviparity phenomenon. This study revealed the complex mechanism of viviparity trait in water lily. The transcriptomic signatures identified are important basis for future breeding and research of viviparity in water lily and other plant species.
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Nymphaea , Flores/genética , Flores/metabolismo , Melhoramento Vegetal , Transcriptoma/genéticaRESUMO
Objective: To evaluate the efficacy, safety, and prognostic value of low-dose apatinib in combination with temozolomide in the treatment of primary or recurrent high-grade gliomas (HGGs). Methods: A retrospective analysis of patients with postoperative and recurrent HGGs treated in our hospital from April 1, 2018, to April 30, 2020. Patients should be treated by combination therapy (surgery + radiotherapy + chemotherapy). Patients who received apatinib combined with temozolomide chemotherapy were allocated to the research group (RG), while patients who received temozolomide chemotherapy alone were allocated to the control group (CG). The efficacy and toxic side effects were compared between the two groups. Results: There were 67 qualified patients retrieved, including 37 cases in the RG and 30 cases in the CG. There were no significant differences in objective remission rate (ORR) or disease control rate (DCR) between the control group and the study group (P > 0.05). However, the overall improvement of clinical efficacy in the observation group was better than that in the control group (P < 0.05). There was no significant difference in the incidence of adverse effects between the two groups (P > 0.05). There were no significant differences in overall survival (OS) or progression-free survival (PFS) between the two groups (P > 0.05). Conclusion: Low-dose apatinib combined with temozolomide and radiotherapy for HGGs is effective in improving efficacy, relieving brain edema, reducing the use of glucocorticoid drugs, and improving patients' quality of life. It has mild adverse effects and is well tolerated by patients.
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Sepsis, a complex multisystem disorder, is among the top causes of hospitalization and mortality in older adults. However, the mechanisms underlying the disproportionate susceptibility to sepsis and worse outcomes in the elderly are not well understood. Recently, changes in DNA methylation have been shown to be linked to aging processes and age-related diseases. Thus, we postulated that age-related changes in DNA methylation may play a role in the onset and prognosis of sepsis in elderly patients. Here, we performed genome-wide methylation profiling of peripheral blood from patients with sepsis and controls. Among the CpG sites whose methylation changes may contribute to an increase in sepsis susceptibility or mortality, 241 sites that possessed age-related changes in DNA methylation in controls may partly explain the increased risk of sepsis in older adults, and 161 sites whose methylation significantly correlated with age in sepsis group may be the potential mechanisms underlying the worse outcomes of elderly septic patients. Finally, an independent cohort was used to validate our findings. Together, our study demonstrates that age-related changes in DNA methylation may explain in part the disproportionate susceptibility and worse outcomes of sepsis in older adults.
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The epitaxial growth of functional oxides using a substrate with a graphene layer is a highly desirable method for improving structural quality and obtaining freestanding epitaxial nanomembranes for scientific study, applications, and economical reuse of substrates. However, the aggressive oxidizing conditions typically used in growing epitaxial oxides can damage graphene. Here, we demonstrate the successful use of hybrid molecular beam epitaxy for SrTiO3 growth that does not require an independent oxygen source, thus avoiding graphene damage. This approach produces epitaxial films with self-regulating cation stoichiometry. Furthermore, the film (46-nm-thick SrTiO3) can be exfoliated and transferred to foreign substrates. These results open the door to future studies of previously unattainable freestanding oxide nanomembranes grown in an adsorption-controlled manner by hybrid molecular beam epitaxy. This approach has potentially important implications for the commercial application of perovskite oxides in flexible electronics and as a dielectric in van der Waals thin-film electronics.
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Lysosomal protein transmembrane 4 beta (LAPTM4B) is a protein that contains four transmembrane domains. The impact of LAPTM4B on the malignancy of nasopharyngeal carcinoma (NPC) remains unclear. In the present study, we aimed to investigate the role of LAPTM4B in NPC. NPC tissue samples were used to evaluate the expression of LAPTM4B and its relationship with patient prognosis. Furthermore, we inhibited the expression of LAPTM4B in NPC cell lines and examined the effects of LAPTM4B on NPC cell proliferation, migration, and invasion. We found that LAPTM4B protein was mainly localized in the cytoplasm and intracellular membranes of NPC cells. LAPTM4B protein was upregulated in NPC tissues and cell lines. High LAPTM4B expression was closely related to pathological subtypes and disease stages in NPC patients. NPC patients with high LAPTM4B expression had a worse prognosis. LAPTM4B knockdown inhibited the proliferation, migration, and invasion ability of NPC cells. LAPTM4B plays a cancer-promoting role in the progression of NPC and may be a potential target for NPC therapy.
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Proteínas de Membrana/metabolismo , Neoplasias Nasofaríngeas/patologia , Proteínas Oncogênicas/metabolismo , Linhagem Celular Tumoral , Movimento Celular , Proliferação de Células , Progressão da Doença , Humanos , Invasividade Neoplásica/patologia , Prognóstico , Células Tumorais Cultivadas , Regulação para CimaRESUMO
Enhanced serum secreted clusterin (sCLU) protein was associated with progression, poor prognosis and chemotherapy sensitivity evaluation in malignant patients. However, the clinical significance of serum sCLU protein levels in patients with invasive breast cancer (IBC) is unknown. In this study, the serum sCLU protein in 2648 patients with IBC was detected. The diagnostic value and treatment responses of serum sCLU protein in patients with IBC were also performed. The results showed that the serum sCLU protein level was signiï¬cantly higher in IBC patients compared to the healthy controls (P < 0.0001), and strongly correlated with higher clinical tumor stage (P < 0.001), lymph node metastasis (P < 0.001), shorter overall survival (OS) (P = 0.032) and disease-free survival (DFS) (P = 0.029), respectively. Using the cutoff value of 18.46 µg/mL, the sensitivity and speciï¬city were 86.26% and 73.46% to separate IBC patients from noncancerous and healthy controls. The postoperative patients showed lower serum sCLU levels compared to the preoperative patients (P = 0.003). The chemoresistant patients showed higher serum sCLU levels compared to the chemosensitive patients (P < 0.001). These data indicated that serum sCLU levels are effective indicators for diagnosis and chemotherapy sensitivity evaluation in patients with IBC.
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Neoplasias da Mama , Clusterina/sangue , Neoplasias da Mama/sangue , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/mortalidade , Feminino , Humanos , Pessoa de Meia-Idade , Prognóstico , Resultado do TratamentoRESUMO
BACKGROUND: In recent years, the incidence of cervical cancer has increased with increasing life pressures and changes in women's social roles, posing a serious threat to women's physical and mental health. AIM: To explore the clinical effect of Endo combined with concurrent radiotherapy and chemotherapy in the treatment of advanced cervical squamous cell carcinoma. METHODS: A total of 120 patients admitted to the oncology department of our hospital were selected as the research subjects. They were equally divided into the test group and the control group (60 patients each) with a random number table. The test group was treated with Endo combined with concurrent radiotherapy and chemotherapy, and the control group was treated with concurrent radiotherapy and chemotherapy. We compared the serum thymidine kinase 1 (TK1), human epididymis protein 4 (HE4), vascular endothelial growth factor (VEGF), and squamous cell carcinoma-associated antigen (SCC-Ag) levels, the clinical effects and survival before and after radiotherapy and chemotherapy, the quality score, and the 3-year follow-up outcomes between the two groups. RESULTS: After chemotherapy, the complete remission + partial remission rate was 85.00% in the test group and 68.33% in the control group; the difference was not statistically significant (P > 0.05). Before chemotherapy, the serum TK1, HE4, VEGF, and SCC-Ag levels of the two groups were not significantly different (P > 0.05). After chemotherapy, the levels of serum TK1 (1.27 ± 0.40 pmol/L), HE4 (81.4 ± 24.0 pmol/L), VEGF (235.1 ± 38.0 pg/mL), and SCC-Ag (1.76 ± 0.55 ng/mL) were lower than those in the control group [TK1 (1.58 ± 0.51 pmol/L), HE4 (98.0 ± 28.6) pmol/L, VEGF (284.2 ± 54.1 pg/mL), and SCC-Ag (2.34 ± 0.78 ng/mL)]. The difference was statistically significant (P < 0.05). Before chemotherapy, there were no significant differences in the physical, role, mood, cognition, social and symptom scale scores of the two groups (P > 0.05). After chemotherapy, the physical, role, mood, cognitive and social scores were higher in the test group than in the control group, and the difference was statistically significant (P < 0.05). The symptom scale scores of the test group were all lower than those of the control group, and the difference was statistically significant (P < 0.05). The 3-year progression-free survival (PFS) rate was 43.33% in the test group and 26.67% in the control group; the overall survival (OS) rate was 48.33% in the test group and 33.33% in the control group; the differences were not statistically significant (P > 0.05). The 3-year PFS time of the test group was 20.0 mo, which was longer than that of the control group (15.0 mo), and the difference was significant (P < 0.05). The OS time of the test group was 30.0 mo, which was longer than that of the control group (18.0 mo), and the difference was significant (P < 0.05). CONCLUSION: Endo combined with concurrent radiotherapy and chemotherapy for the treatment of advanced cervical squamous cell carcinoma has a positive effect on reducing the level of tumor markers in patients, prolonging the PFS and OS times of patients, and improving the quality of life.