0.05).As for patients' age the old age group had the statistical significance vs the non-old age group(P

Radiation?induced heart disease ( RIHD) is a common type of radiation?induced damages in chest radiotherapy. There are no obvious short?term symptoms in patients with RIHD. However, RIHD causes irreversible permanent damages to the heart over time, which undermines the quality of life. Patients with severe RIHD even have a risk of death from myocardial infarction caused by coronary atherosclerosis. This paper summarizes the research advances in epidemiology, diagnosis, mechanisms of radiation?induced injury in various parts of the heart, radiotherapy techniques, and treatment. Reduction in radiation range and dose, early diagnosis, and early treatment are recommended for patients to reduce heart injury and improve the quality of life.

Although it has been frequently used to treat thoraxic tumors,radiation induced lung injury (RILI) is the major factor of dose limitation in thoracic radiotherapy.Amount of endogenous and exogenous reactive oxygen / nitrogen species (ROS/RNOS) could be generated in the radiated organisms and further cause molecular damage of DNA,protein and membrane lipids,which results in celluar structure damage,dysfunction and RILI.In addition,a series of cytokines could also induce chronic oxidative stresses that contribute to increases in cell membrane permeability,tissue edema and extracellular matrix proteins accumulation and even further result in pulmonary fibrosis.Oxidative stress theory offers new clues and strategies for further understanding the mechanism of RILI,and some anti-oxidative stress drugs may have potential clincial application in RILI treatment.

Peritumoral edema (PTE) of the metastasis tumor of brain (MTB) refers to the abnormal increase of moisture in the surrounding cerebral parenchyma of the brain tumor. The mechanism of PTE occurrence of MTB is complicated, and the influencing factors are diverse. PTE is one of the key factors that affect patient survival and cure. Researchers from China and overseas believe that it may be related to the expression of the vascular endothelial growth factor (VEGF) or VEGF receptor, aquaporin-4 (AQP-4), matrix metalloproteinase-9, interleukin-6, hypoxia inducible factor-1a, and other molecular biology factors. Studies of these molecular biologi-cal factors provide objective scientific evidence for the prevention, control, monitoring, treatment, and prognosis of PTE of metasta-sized brain tumor. In addition to the traditional dehydration therapy of PTE, the use of PTE-related molecular biological factors pro-vides a new approach for the treatment. AQP-4 agonists or antagonists and VEGF receptor antagonists also have good therapeutic poten-tials. In this paper, the authors reviewed the PTE-related molecular biological factors of MTB.

Objective To investigate effects of preoperative application of parecoxib on postoperative analgesia and coagulation function in neurosurgical patients.Methods A total of 90 patients (38 males and 52 females,ASA physical status Ⅰ or Ⅱ) undergoing crainotomy were randomly divided into two groups(n=45): parecoxib group (group P) and control group (group C).At 30 min before operation,group P received intravenous injection of parecoxib 40 mg (5 ml),group C intravenous injection of saline 5 ml.Postoperative patient-controlled intravenous analgesia (PCIA) was performed in all patients.PCIA formula of sufentanil 2 μg/kg+tropisetron 0.2 mg/kg,were diluted with normal saline to 120 ml.The visual analogue scale (VAS),the total and effective PCIA pump compressions,Ramsay sedation scale of 2,4,16,24,48 h after operation were recorded.Coagulation function was measured before and 2 h,48 h after parecoxib administration.Meanwhile,adverse reactions were recorded.Results Comparion of VAS between the two groups was made within 48 h after surgery,the total and effective PCIA pump compressions,were much more in group C than in group P (P<0.05).Ramsay sedation scale of group C was higher than that in group P at 2 h after operation.There were no significant differences in coagulation function.And the percentage of patients′ adverse effects in group P was lower than that in group C (P<0.05).Conclusion Parecoxib,as an analgesic,can enhance analgesic effect of sufentanil PCIA.Not only does it reduce the amount of sufentanil and incidence of adverse reactions,but also it has no significant effect on blood coagulation function.

Objective To evaluated the role of postoperative radiotherapy (PR) after surgery in patients with uterine sarcoma,and analyzed the prognostic factors.Methods A total of 182 patients with uterine sarcoma were included between June 1994 and October 2014.Radiotherapy dose were 30-50 Gy/10-25 fractions/5 fractions/week.The LRFFS and OS were calculated with Kaplan-Meier method,and difference was analyzed with log-rank method.Cox regression analyses were used to determine prognosticators.Results There were 114 patients which survived more than 5-years in this whole group,including PR 24 cases and no PR 90 cases.The 5-year LRRFS and OS were 62.1％ and 56.2％,respectively.The 5-year LRRFS were 78.0％ and 55.3％ on PR and no PR (P=0.013);with OS 64.1％ and 51.7％ on PR and no PR (P=0.070).A multivariate analysis showed that pathological types,histological grade and clinical stage were associated with LRRFS and OS (P=0.032,0.008,0.000 and 0.046,0.000,0.000).PR was significant influencing factor for OS (P=0.013).Conclusions Uterine sarcoma patients treated with PR after surgery had an improved LRRFS compared to those treated with surgery,especially those with leiomyosarcoma.The role of PR personalized radiation for uterine sarcoma still needs to be further discussed.

Objective To investigate and compare the clinical effects of radiochemotherapy alone or in combination with adoptive immunotherapy with cytokine-induced killer ( CIK) cells in patients with locally advanced non-small cell lung cancer (NSCLC).Methods The clinical data of 125 patients with locally advanced NSCLC who were admitted from 2011 to 2012 and did not undergo surgery were analyzed retrospectively, and among these patients, 102 received radiochemotherapy alone ( control group) , and 23 received radiochemotherapy combined with adoptive immunotherapy with CIK cells ( multimodality therapy group) .The two groups were matched at a ratio of 1:2 using propensity score matching, and the factors considered included tumor stage, radiochemotherapy regimen, and outcome after radiochemotherapy.Then 59 patients ( 22 from the multimodality therapy group and 37 from the control group) were enrolled, and survival and tumor control were compared between the two groups.The Kaplan-Meier method was used to calculate survival rates and the log-rank test was used for survival difference analysis and univariate prognostic analysis.Results The 1-, 2-, and 3-year overall survival ( OS) rates were 73%, 32%, and 16%, respectively, in the control group, and 91%, 59%, and 41%, respectively, in the multimodality therapy group ( P=0.030) .The 1-, 2-, and 3-year progression-free survival rates were 61%, 21%, and 17%, respectively, in the control group, and 45%, 10%, and 10%, respectively, in the multimodality therapy group ( P=0.538) .As for the patients with stage ⅢB NSCLC, those in the multimodality therapy group had a significantly higher 3-year OS rate than those in the control group (47%vs.11%, P=0.026). In the patients receiving sequential chemoradiotherapy, those in the multimodality therapy group had a significantly higher 3-year OS rate than those in the control group ( 46%vs.11%, P=0.003) .As for the
patients with squamous cell carcinoma, those in the multimodality therapy group had a significantly higher 3-year distant metastasis-free survival rate than those in the control group ( 73%vs.22%, P=0.029) .The two groups showed similar incidence rates of adverse events, and compared with the control group, the multimodality therapy group had a lower incidence rate of radiation pneumonitis (9%vs.15%, P=0.889) and a higher incidence rate of radiation esophagitis (12%vs.7%, P=0.097).Conclusions Some patients with locally advanced NSCLC can benefit from radiochemotherapy combined with adoptive immunotherapy with CIK cells, but the intended population, timing, and dose safety still need further investigation.

ObjectiveTo evaluate the relationship of human papillomavirus(HPV) intection with expressions of cell cycle regulatory proteins cyclin D1,E and their dependent kinase inhibitor p27 in bowenoid papulosis(BP).MethodsTissue specimens were obtained from the lesions of 44 patients with BP,and circumcised foreskin tissue from 10 males served as the control.Gene chip was used to determine the genotypes of HPV,and immunohistochemistry to quantify the expressions of cyclin D1,E,p27,in these specimens.Results Of the 44 BP specimens,all were positive for HPV DNA,38(86.36％) for high risk types of HPV,and 6 for low risk types of HPV.Of the high risk HPV-positive specimens,30(68.18％) harbored HPV16,16 harbored single HPV 16,14 harbored other types of HPV besides HPV 16,8 harbored other high risk types of HPV.HPV 6 predominated in low risk HPV-positive specimens.The expression of cyclin D1 was significantly higher in patients with high-risk HPV(u =53.00,P＜ 0.05),with both high and low risk HPV(u =5.00,P＜ 0.01) and with low risk HPV (u =22.50,P＜ 0.05) than in normal human controls,and higher in patients with both high and low risk HPV (u =44.00,P＜ 0.01) and with low risk HPV (u =22.50,P＜ 0.05) than those with high risk HPV.In the case of cyclin E expression,patients with high risk HPV (u =0.00,P ＜ 0.01 ),with both high and low risk HPV (u =4.00,P ＜ 0.01 ),and with low risk HPV(u =1.50,P ＜ 0.01 ) were higher than normal human controls,and patients with high risk HPV were higher than those with low risk HPV(u =11.00,P ＜ 0.01).No significant difference was observed in the expression of p27 between patients with high and low risk types of HPV.A significant increase was observed in the expression of p27 in patients aged ＞ 50 years compared with patients aged 20-30 years(u =47.00,P＜ 0.05) and aged 31-50 years (u =55.50,P＜ 0.05),as well as in the expression of cyclin E in patients aged ＞ 50 years compared with those aged 20-30 years(u =45.50,P ＜ 0.05),and in female patients compared with male patients (u =137.50,P＜ 0.05).ConlusionThere is a significant difference in the expression of cyclin D1,E and p27 among patients with BP infected with different types of HPV.

High-affinity α-glucosidase inhibitors were screened from Cichorium glundulosum Boiss.et Hout seed (CGS) extract by ultra-filtration affinity-liquid chromatography-mass spectrometry (UF-LC-MS) and molecular docking.By taking 4-nitrobenzene-α-D-glucopyranoside (PNPG) as substrate and acarbose as positive control to evaluate the inhibitory activity of CGS extract, IC50 of acarbose and CGS extract were 0.003 mg/mL and 0.447 mg/mL, respectively.Meanwhile, 4 compounds from CGS extract by UF-LC-MS were screened and identified.Then by using autodock software, the compounds that combined with α-glucosidase were well screened out, including chlorogenic acid and isochlorogenic acid A.The inhibitory activity of chlorogenic acid and chlorogenic acid A against α-glucosidase was verified in vitro.The results showed that the inhibitory activity of the compounds toward α-glucosidase presented the sequence of acarbose>isochlorogenic acid A>chlorogenic acid.The inhibition rate of isochlorogenic acid A was close to acarbose.The experimental results illustrated that UF-LC-MS and molecular docking could be used to screen high affinity enzyme inhibitors from CGS.

Objective:To observe the locoregional recurrence and survival of stageⅢA-N2 non-small cell lung cancer (NSCLC) after in-duction chemotherapy and surgery, to analyze the prognosis influenced by nodal downstaging, and to explore the necessity for postop-erative radiotherapy. Methods:A total of 116 cases of stageⅢA-N2 NSCLC were treated with induction chemotherapy and surgery be-tween January 2009 and June 2014. These cases underwent R0 resection. Kaplan-Meier method was employed to calculate the local recurrence-free survival (LRFS), distant metastasis-free survival (DMFS), and overall survival (OS) of the patients. Log-rank test was con-ducted to compare the differences between groups. Cox models were used to perform multivariate analysis. Results:The median fol-low-up of the patients was 24.42 months. The numbers of patients with pN0, pN1, and pN2 were 40 (34.5%), 16 (13.8%), and 60 (51.7%), respectively. The 3-year local recurrence rates of patients with pN0, pN1, and pN2 were 27.5%, 56.2%, and 51.7%, respectively. In the group treated with adjuvant chemotherapy, the 3-year local-recurrence rates of patients with pN0, pN1, and pN2 were 26.9%, 58.3%, and 46.2%, respectively. Multivariate analysis revealed that the significant predictor of LRFS was pN0 during the surgery. The LRFS of patients with pN0 was greater than that of the patients with pN1 (P=0.048). The LRFS of patients with pN1 was not significantly associated with that of patients with pN2 (P=0.314). The 5-year OS rate of the groups was 46.6%. The multivariate analysis also demon-strated that pT1, pN0-1, and induction chemotherapy effects were associated with OS. The patients with pN2 yielded a poorer OS than those with pN0 and pN1 (P<0.05). The patients with pN0 did not significantly differ from those with pN1 in terms of OS (P=0.412). Conclu-sion:Although the occurrence of pathologic downstaging is a well-known positive prognostic indicator after stageⅢ-N2 NSCLC is sub-jected to chemotherapy, the local-recurrence rate of nodal-downstaged patients remains high, even when they receive adjuvant che-motherapy. Therefore, new postoperative strategies after induction chemotherapy and surgery should be developed.