Objective Adenoid cystic carcinoma (ACC), a rare malignancy in head and neck region, is predominately found in the salivary glands. Our study is to retrospectively analyze the treatment outcomes and prognostic factors of ACC originated from the major salivary glands. Methods A total of 54 patients diagnosed as ACC were treated in our institution, including 24 cases originated from the parotid gland and 30 from the submandibular or sublingual gland. According to the records, 26 patients received surgery alone and 28 were treated with surgery followed by radiotherapy with a median dose of 58 Gy (range, 50 -65 Gy). Results The Follow-up rate was 94%, and 15 patients from postoperative radiotherapy group and 20 from surgery alone group were followed up more then 5 years. The 5-year overall survival rate, local-regional control rate, distant metastasis rate, and disease-free survival rate were 97%, 71%, 13% and 69%, respectively. Lung metastasis, occurred in 7 patients, was the most common distant failure. Fifteen recurrences were observed, including 13 in surgery alone group and 2 in postoperative radiotherapy group. The 5-year local-regional control and disease-free survival rates were 90% and 85% for patients treated with postoperative radiotherapy, 54% and 55% for those treated with surgery alone. Univariate and multivariate analyses showed that postoperative radiotherapy was the only prognostic factor of local-regional control and survival rates. Other parameters such as nerve involvement did not significantly influence the treatment results. Conclusions Postoperative radiotherapy can improve the prognosis of ACC originate from the major salivary glands compared with surgery alone. Distant metastasis is an obstacle in curing the disease, which indicates the value of systemic treatment.

Background and purpose:Studies have shown that some molecular markers could serve as prognostic factors for nasopharynx carcinoma, but the predictive role of catenins and cyclin D1 remains uncertain for the disease. Our paper is to investigate the expression of catenins(?-,?- and ?-) and cyclin D1 in nasopharyngeal carcinoma as well as to analysis their relation to clinic factors and prognosis. Methods:We retrieved 38 paraffin-embedded specimens of nasopharynx carcinoma, immunohistochemistry was used to examine the expression of ?-,?- and ?-catenin , cyclin D1 and tumor proliferation activity marker ki-67.Results:Reduced expression of ?-,?- ,?-catenin and cyclin D1 was observed in most of the tumors. Our preliminary study demonstrated that there was no significant correlation between their expression with T-stage, N-stage, clinical stage and primary tumor volume, as well as with ki-67 stain. In unviarance analysis, patients with reduced expression of ?-catenin had poorer prognosis than those with high expression, 5 year overall survival and disease free survival rates of these two groups were 53.2%, 29.0% and 81.9%, 76.0%, respectively(P

60 cm 3). Primary tumor volume was found to be an independent prognostic factor of local control in multivariant analysis without any statistical significance to predict the disease-free survival or distant relapse-free survival rates. Conclusion The greater volume disparity with the same T stage and the data extension overlap with different T stages are demonstrated and the primary tumor volume may be considered as a prognostic factor in the treatment of nasopharyngeal carcinoma.

Background and purpose:Radiotherapy is the main method to manage head and neck tumors.About half of the patients with malignant tumor in head and neck could obtain long term survival through radiotherapy or other therapy combined with radiotherapy.However,it is necessary to clinically detect whether carotid stenosis is a major sequela of head and neck irradiation,especially in long term survivors such as patients with nasopharyngeal carcinoma.We analyzed this injury and the degree of carotid stenosis,and its related factors to provide information to reduce and delay the incidence of this injury.Methods:We analyzed the degree of arterial stenosis of the nasopharyngeal carcinoma patients who received radiotherapy and had survived more than three years in Cancer Hospital Fudan University,compared with newly diagnosed as nasopharyngeal carcinoma before radiotherapy.The degree of carotid artery injury was observed and the clinical factors which affect its occurrence and development.All patients were low differentiated squamous cell carcinoma confirmed by pathology.All patients were examined with color doppler ultrasound to detect the carotid artery.The main end points were the diameter of carotid artery,the peak systolic and end diastolic velocities.Results:Arterial stenosis was more common in the reserch group than the control group(80% vs 20%,P＜0.001).The common and internal carotid arteries were most commonly involved(70% vs 20%,P＜0.001;6313% vs 10%,P＜0.001),followed by the external carotid artery(30% vs 3.3%,P=0.015).Significant stenosis was only found in the research group,common carotid arteries 36.7%,internal carotid arteries 23.3%,external carotid arteries10%.Conclusion:This study showed that radiation could cause significant carotid stenosis in nasopharyngeal carcinoma patients who had received radiotherapy more than 3 years previously.Carotid stenosis developed more frequently in the common carotid artery and intemal carotid artery on the side that had received radiotherapy.

With the increasing incidence and mortality of coronary heart disease (CHD) in China, the prevention and treatment of CHD is no time to delay. Since Professor Gruentzig completed the first human case of percutaneous transluminal coronary angioplasty (PTCA) in 1977, percutaneous coronary intervention (PCI) had reached to a new page. After three decades of development and change, PCI has been improved and matured gradually from the early PTCA to the current stent era. With the advent of stents, the rate of restenosis after PCI was significantly reduced from 30%-50% to 10%-20%. But stent restenosis was still with no total cure. The issue of how to prevent the stent restenosis has become a long-term major issue for the exploration in both clinical and preclinical medicine. Therefore, this paper reviewed the etiology, pathology, related risk factors, latest diagnosis methods, prevention and treatment of stent restenosis by integrative medicine.

Objective To detect the B cell epitopes of human MCHR1 recognized by serum autoantibodies in patients with vitiligo. Methods The DNA encoding antigen fragments of MCHR1 from amino acid (aa) 1 to 94 were amplified from pcDNA3/MCHR1 by PCR and inserted into the vector pGEX-4T-1. After identification, the recombinant plasmid pGEX-4T-1/MCHR1 was transfected into E. coli for fusion protein production which was purified by GST agarose affinity chromatography later. The sera from 38 vitiligo patients were examined for MCHR1 antibodies by enzyme-linked immunoabsorbent assay. Results Amino acids (aa) 1 to 94 of MCHR1 which most possibly included in B cell epitopes were selected to express. The recombinant plasmid pGEX-4T /MCHR1 was confirmed by sequence analysis. SDS-PAGE showed that a Mr 37 kD fusion protein was expressed by E.coli. Of the sera from vitiligo patients examined by ELISA, 5 of 38 were considered positive for MCHR1 antibody. Conclusion There are B cell epitopes in amino acids(aa) 1 to 94 of MCHR1 which can be recognized by antibodies from vitiligo patients.

This study was aimed to observe the safety and effectiveness ofShugan Jieyu Capsules in the treatment of vasovagal syncope (VVS) with mild-to-moderate depression and anxiety, and to compare the effect with Flupentixol and Melitracen Tablets. A total of 89 VVS cases with mild-to-moderate depression and anxiety were randomly divided into 3 groups, which were group A (Shugan Jieyu Capsules group), group B (Flupentixol and Melitracen Tablets) and group C (control group). Based on the conventional therapy of VVS treatment, treatments were given to all three groups for 8 weeks. And the negative conversion ratio of VVS in each group was observed. Hamilton Depression Scale (HAMD 24 items) and Hamilton Anxiety Scale (HAMA) were evaluated for the calculation of reductive rate. Treatment emergent symptoms scale (TESS) was used in the evaluation of adverse reactions of both medications during the treatment. In the 12-month follow-up after treatment, the recurrence rate of syncope was observed in each group. The results showed that compared with pretreatment, HAMD-24 and HAMA scores of group A and group B after treatment were significantly reduced (P < 0.05). Compared with group C, the heat-up tilt testing-negative rate, HAMD-24 and HAMA reductive rate of group A and group B after treatment were significantly increased (P < 0.05). Compared with group B, the negative rate, HAMD-24 and HAMA reductive rate of group A were more significant (P < 0.05). After treatment, scores for TESS of group A was significantly lower than group B (P< 0.05). In the 24-month follow-up, the recurrence rate of syncope of group A and group B was significantly lower than group C (P < 0.05); and group A was obviously better than group B (P < 0.05). It was concluded thatShugan Jieyu Capsules can be used in the treatment of VVS with mild-to-moderate depression and anxiety. Its effectiveness and safety may be better than Flupentixol and Melitracen Tablets.

This study was aimed to investigate the effect ofDanlou pills on prevent atherosclerosis from hypercholesterolemia rabbit and its relationship with inflammatory factors as well as PI3K/AKT signal pathways. A total of 24 Japanese male white rabbits were randomly divided into the control group (CL), model group (M) and Danlou group (DL), with 8 in each group. Normal diet was given to CL rabbits. High-fat diet was given to rabbits in other groups to establish the atherosclerosis model. Danlou pills (0.5 g·kg-1·d-1) were also given to DL rabbits. Rabbits were sacrificed after 9-week medication. The contents of blood lipid, TNF-α and IL-6 were detected. HE staining was used in the observation of histological changes in the aorta. Western blot was used to observe PI3K and p-AKT expression in the aorta. The results showed that compared with CL, the contents of TG, TC, LDL, IL-6 and TNF-α were significantly increased in M (P < 0.01); PI3K and p-AKT expression in the aorta were significantly decreased (P < 0.01). Compared with M, blood lipid, IL-6 and TNF-α were significantly reduced in DL (P < 0.05, orP < 0.01); PI3K and p-AKT expression were significantly increased (P < 0.01). It was concluded thatDanlou pills had prevention effects on atherosclerosis through reducing blood lipid and inflammatory factors. The action mechanism maybe related to the activation of PI3K/AKT signal pathways.

OBJECTIVETo explore the interaction between herbal medicines and western drugs based on CYP3A4 enzyme metabolism by using testotesrone as a probe in liver microsome metabolism system in vitro.

METHODThe mixed liver microsome enzymatic system consisting of rat liver microsomes by ultra-high-speed centrifuge was established. The substrate testosterone was added into the system and enzyme CYP3A4 metabolic activity was expressed by the output of 6beta-hydroxy-testosterone which was measured by HPLC method. The proper conditions for testotesrone metabolism in liver microsome system included substrate concentration, incubation time, pH and incubation temperature. When the conditions in vitro were determined, three kinds of Chinese herbal medicinal ingredients (Tetrahydropalmatine, neferine, panax notoginseng saponins) were diluted into different concentrations and incubated with testotesrone in the liver microsomes incubation system, respectively. The results were measured through metabolite production with or without the presence of Chinese medicines. We assessed the Chinese herbal medicinal ingredients effect on the metabolism of CYP3A4 enzyme through 6beta-hydroxy metabolite of testosterone production.

RESULTLiver microsomes were incubated in the system, the testosterone metabolited into 6beta-hydroxy testosterone. The metabolism conditions were proper at the concentration of testosterone 200 micromol x L(-1) which was incubated for 3.5 hours at 37 degrees C in pH 7.0, PBS 0.1 mol x L(-1). The inhibition of tetrahydropalmatine and panax notoginseng saponins on testotesrone were weak with IC50 > 100 micromol x L(-1). The neferine had a little inhibition on testotesrone metabolism, IC50 < 100 micromol L(-1).

CONCLUSIONTetrahydropalmatine and panax notoginseng saponins had no obvious effect on testotesrone metabolism. Neferine had a little effect on testotesrone metabolism. It prompted that drug-interaction could not be apparent between two kinds of Chinese medicines and the CYP3A4 enzyme substrate, Neferine could bring about drug-interaction.

Animals ; Cytochrome P-450 CYP3A ; Cytochrome P-450 Enzyme System ; metabolism ; Drug Interactions ; Drugs, Chinese Herbal ; analysis ; pharmacokinetics ; Male ; Microsomes, Liver ; chemistry ; drug effects ; enzymology ; Rats ; Rats, Wistar ; Testosterone ; analysis ; pharmacokinetics

[Abstra ct] Objective To investigate the long-term efficacy and adverse effects of intensity-modulated radiotherapy (IMRT) for nasopharyngeal carcinoma (NPC).Methods A total of 869 patients with biopsy-proven NPC without distant metastasis who underwent the whole course of IMRT from 2009 to 2010 were enrolled.Of all the patients, 84.8%received cisplatin-based chemotherapy.The prescribed dose to the primary lesion in the nasopharynx was 66-70Gy in 30-32 fractions, and the dose to the positive lymph nodes in the neck was 66 Gy in 30-32 fractions.The Kaplan-Meier method was used to calculate survival rates, the log-rank test was used for difference analysis and univariate prognostic analysis , and the Cox proportional hazards model was used for multivariate prognostic analysis .Rseu lts The 5-year overall survival( OS ) , local recurrence-free survival, regional recurrence-free survival, distant metastasis-free survival, and disease-free survival ( DFS ) were 84.0%, 89.7%, 94.5%, 85.6%, and 76.3%, respectively.In the patients with locally advanced NPC,concurrent chemotherapy tended to reduce distant metastasis (83.6%vs.75.7%, P=0.050) and improve OS (82.6%vs.77.0 %, P=0.082).Induction chemotherapy tended to improve OS ( 80.7% vs.71.4%, P=0.057 ) , and the induction chemotherapy containing docetaxel or gemcitabine tended to improve OS (83.3%vs.72.2%, P=0.058).The patients who received a boost after the initial radiotherapy had a significantly lower DFS rate than those who did not (52.2%vs.71.1%, P=0.004).The concurrent chemotherapy increased the incidence rates of long-term xerostomia and trismus, while a high dose of cisplatin increased the incidence rates of xerostomia and hearing impairment.Conclusions IMRT for NPC provides satisfactory long-term efficacy.Concurrent chemotherapy combined with IMRT tends to reduce the incidence of distant metastasis, and other values need further investigation.The boost therapy after radiotherapy may be associated with poor prognosis.Chemotherapy increases the incidence of long-term toxicities.