The application of precision medicine in cancer treatment is becoming increasingly common as a result of the continuous advancement in basic research and physical techniques.The revolution of radiotherapy techniques, development of multimodal imaging technology, application of biological target dose carving and adaptive radiotherapy, availability of big data-based radiotherapy planning systems, and selection of chemotherapy regimen have all made the treatment of nasopharyngeal carcinoma increasingly precise.The growing interaction between laboratory research and clinical practice not only underscores the importance of translational medicine, but also prompts the development of biological immunotherapy and screening of prognostic factors.As a result, these changes mark the beginning of a new era for the diagnosis and treatment of nasopharyngeal carcinoma.This review provides a summary from 61 articles on the current progress in translational study and clinical application of precision medicine in nasopharyngeal carcinoma.

Objective:This study aims to investigate the protein expression of CD133, CD117, and Ki-67 in human osteosarcoma tissues and explore their relationships with the clinico-pathological features and risk of osteosarcoma. Methods:Immunohistochemical method was used to examine the protein expression of CD133, CD117, and Ki-67 gene in the paraffin specimens of 55 and 20 cases of osteosarcoma and osteochondroma, respectively. SPSS17.0 statistical software was used to explore the relationships among the expressions of CD133, CD117, and Ki-67 gene and the biological behavior and prognosis of osteosarcoma. Test criterion:P<0.05 was considered statistically significant. Results:The positive expression rates of CD133, CD117, and Ki-67 were significantly higher in the osteosarcoma tissues than in the benign osteochondroma tissues, and the differences were significant (P=0.016, P=0.008, and P<0.001, respectively). The mean survival and metastasis time were shorter in the CD133 or Ki-67 positively expressed osteosarcoma patients than in those with CD133 or Ki-67 negatively expressed osteosarcoma. The differences were significant (P<0.05). The expression of CD133 and Ki-67, surgical staging, and distal metastasis were relevant to the prognosis of osteosarcoma patients. The expression of CD133 and distal metastasis are the independent risk factors that affect the prognosis of these patients. Conclusion:The positive expressions of CD133 and Ki-67 closely correlated with the occurrence and progression of osteosarcoma, and may be used as an indicator for prognosis of the cancer.

Objective: To investigate the clinical efficacy of acupuncture combined with tuina in treating patients with cervical vertigo. ＜br> Methods: According to the principle of randomization, 258 cases with cervical vertigo who met the inclusion criteria for the study were randomly divided into an observation group and a control group, with 129 cases in each. The patients in the observation group received acupuncture combined with tuina therapy, while those in the control group were just treated by the same acupuncture therapy as in the observation group. After 10-day continuous treatments, the clinical efficacies of the two groups were analyzed and compared. ＜br> Results: The total effective rate of the observation group was 100%, versus 86.0% of the control group, and the difference was significant (P＜0.05). After treatment, cervical range of motion (ROM) scores in both groups were statistically significantly different from those before treatment (allP＜0.05); in addition, there was a statistically significant difference in inter-group comparison of ROM score (P＜0.05). ＜br> Conclusion: Compared with simple acupuncture treatment, acupuncture combined with tuina therapy has a better effect in improving the ROM of cervical vertigo patients, with higher clinical efficacy.

Objective To compare the local control and survival rates of hyperfractionated radiotherapy plus concurrent chemotherapy with hyperfractionated radiotherapy alone in the treatment of stage Ⅲ-Ⅳ nasopharyngeal carcinoma (NPC).Methods Between December 1992 and December 1995, 150 NPC patients were randomized into hyperfractionated radiotherapy plus concurrent chemotherapy (R+C) and hyperfractionated radiotherapy alone (R alone) groups. Radiotherapy were similar in the two groups: 1.2 Gy/f, twice a day. Chemotherapy was given to R+C patients before and during the course of radiotherapy. Results The overall 5-year survival (OS), disease-free survival and distant metastasis-free survival rates were 57.3%, 55.9% and 55.9% . The 5-year survival rates of the R+C and R alone groups were 64.0% and 50.7%, with the difference statistically significant (P=0.037). One patient in the R+C group and 5 patients in the R alone group developed nasopharyngeal recurrence and the corresponding 5-year local control rates were 98.7% and 93.4%. The acute mucosal reaction in the R+C patients was severer than that of the R alone, but well tolerated and did not develop any severe complications. Conclusions Hyperfractionated radiotherapy plus concurrent chemotherapy can improve the local control and survival in patients with stage Ⅲ-Ⅳ nasopharyngeal carcinoma with well tolerated mucosal reactions. Chemotherapy gives greater benefit on the survival of stage Ⅳ patients.

Objective To evaluate the safety of cetuximab combined with intensity-modulated radiotherapy (IMRT) plus concurrent cisplatin chemotherapy in locoregionally advanced nasopharyngeal carcinoma (NPC) in a Chinese multicenter clinical study.MethodsFrom July 2008 to April 2009,100Patients with primary stage Ⅲ- Ⅳb non-keratinizing NPC were enrolled.The planned dose of IMRT to gross tumor volume and positive cervical lymph nodes was 66.0-75.9 Gy and 60-70 Gy in 30-33 fractions.Cisplatin (80 mg/m2,q3 week (w)) and cetuximab (400 mg/m2 one w before radiation,and then 250mg/m2 per w) were given concurrently.The adverse events (AEs) were graded according to common terminology criteria for adverse events v3.0.ResultsThe compliance of the entire group of patient was satisfactory.Actual median dose to gross tumor volume was 69.96 Gy,and the median dose to positive cervical lymph nodes was 68 Gy.Median dose of cisplatin was 133 mg,median first-dose of cetuximab was 690 mg,and median weekly dose was 410 mg.AEs were well tolerated and manageable,mainly consisting of acneiform skin eruptions,dermatitis and mucositis.Grade 4 mucositis was observed in 2％ of the patients and no other grade 4 AEs were observed.ConclusionsThe combined treatment modality of IMRT +concurrent chemotherapy + cetuximab in loco-regionally advanced NPC is well tolerated.

Objective To evaluate the long-term results and prognostic factors in 582 nasopharyngeal carcinoma ( NPC ) patients treated by intensity modulated radiotherapy ( IMRT ) . Methods 582 newly diagnosed NPC patients treated by IMRT in Sichuan cancer hospital from Jan. 2001 to Dec. 2004were reviewed. According to 2002UICC staging system, there were 36 stage Ⅰ , 144 stage Ⅱ , 224 stage Ⅲ, 178 stage Ⅳa. The Kaplan-Meier method was used to calculate the survival rate.Acute and late toxicities were graded according to the radiation therapy oncology group (RTOG) radiation morbidity scoring criteria. Results The follow up rate was 93.5％. The 5-year local control, regional control, distant metastasis-free survival, disease free survival, disease specific survival and overall survival rate was 89. 8％,95. 2％, 74. 1％, 69.6％, 83.2％ and 77. 1％. There were 29, 13 and 117 patients who had developed local, regional and distant recurrence respectively. The incidence of grade 3 acute ( salivary gland、 oral mucosa and skin) and late toxicity was 44. 5％ and 4. 2％. No grade 4 acute and late toxicity reaction was found. Multivariate analysis showed that clinical stage, N stage, radiotherapy interruption, age, HGB and weight loss were the independent prognostic factors for the overall survival. ConclusionsNPC treated with IMRT could get good long-term survival with high quality of life. The clinical stage and N stage were the main prognostic factors for the overall survival. The acute and late toxicities were mainly grade 1 and 2.Distant metastasis is the main cause of treatment failure.

Objective To investigate whether timing of image acquisition influenced infarct size estimation using delayed CeMRI,and the association of left ventricular ejection fraction between magnetic resol3anee imaging and left ventrieulography Was also studied.Method From Junary 2005 to April 2006,27 first,onset AMI patients [23 male,mean age(54.3±10.5)years]were enrolledinthistudr.Allpatients receivedleft ventrictdographyas well as coronary angiography.The average checking time was(13.2±5.2)clays after the onset of AMI.MR imaging was performed with a 1.5-T magnet(SIMENS).After breath-hold eine images were acquired,patients re.ceived afI intravenous bolus of 0.05 mmol/kg Gd-DTPA at a rate of 5 ml/8.A first-pass perfusion scan was ac.qllired.Then a second bolus of 0.15 mmoVkg Gd-DTPA was give.at a rate of 2 mE/Is.After the hyperenhancement localized,the typical short axis slice with hyperenhancement WaS chosen to repeat imaging for IlleasuriIin.farct size every5minutesfrom5minutes after secondinjection ofcontrast until 20minutes.Results Twexty-seren patients showed hyperenhancement at the delayed CeMRI and hypoenhancement at the first pass enhancement(FPE).The average infarct size estimated by CeMRI WaS(17.9士9.8)%of LV nlass.Myocardial enhancement at a repesentative short-axis slice WIllS(7.2±6.2)%of LV Imss at 5 minutes,(8.5±7.4)%at 10 minutes,(7.3±6.3)%at 15 minutes and(6.9-t-6.4)%at 20 minutes respectively.There WltlS significant difference be-tween lmfninmes and 20-minutes enhancement size(P<0.05).Correlations of EF obtained by cineventriculo-grapIIy and MR irr,lg were significant(r=0.867,P<0.01).There were also correlations between infarction size and pe.k CK(r:O.819,P

Objective To investigate the diagnostic value of head-up tilt test (HUT) in cough syncope (CS).Methods Forty-seven outpatients or inpatients with CS and 79 patients with suspected vasovagal syncope(SVVS) due to syncope history in our hospital from January 2011 to May 2015 served as the observation group and control group respectively.HUT was performed in the two groups.The cough response during HUT,changes of systolic pressure and diastolic pressure caused by cough,HUT positive results and hemodynamic type were observed,Results In the observation group,4 cases(8.51％) were cough caused syncope,26 cases (55.32 ％) were presyncope and 17 cases (36.17 ％) had no symptoms,while 79 cases in the control group had no symptoms,the differences were statistically significant (P＜ 0.05).The total positive rate of cough response in the observation group was 63.83％,and the specificity was 100.00％.The systolic blood pressure had statistical difference between the two groups(.P＜0.05).The diastolic pressure had statistical difference between the cases of non-symptoms with the cases of syncope and cases of presyncope in the observation group (P＜0.05),but had no statistical difference compared with the cases of non-symptoms in the control group(P＞0.05).The heart rate(HR) had no statistical difference among various groups(P＞0.05).The HUT positive rate in the observation group was lower than that in the control group(P＜0.05).The hemodynamic type had no statistical difference between the two groups(P＞0.05).Conclusion Severe coughing during HUT may cause the blood pressure decrease,induces syncope or presyncope,can increase the diagnostic sensitivity of CS patients,which is very useful in the suspected diagnosis of CS patients,especially for CS patients with a unclear history.

Nasopharyngeal carcinoma (NPC) is a common head and neck malignant tumor with high incidence in southern China. Local recurrence is one of the main failure modes of locally advanced NPC. The dose-escalation after radical radiotherapy for locally advanced NPC remains controversial. In the era of modern radiotherapy, the mainstream treatment mode of locally advanced NPC is neoadjuvant chemotherapy plus concurrent chemoradiotherapy. There is no consensus on whether to prescribe dose-escalation, how and when to conduct dose-escalation, how much dose to prescribe for patients with residual lesion proved by MRI or pathology. How to accurately determine the target volume and dose / fraction to maximize the local control of the tumor are the directions of clinical practice for locally advanced NPC, which remain to be further studied.

China still has more than 30,000 patients of advanced schistosomiasis while new cases being reported consistently. D-dimer is a fibrin degradation product. As ascites being the dominating symptom in advanced schistosomiasis, the present study aimed to explore a prediction model of ascites with D-dimer and other clinical easy-achievable indicators. A case-control study nested in a prospective cohort was conducted in schistosomiasis-endemic area of southern China. A total of 291 patients of advanced schistosomiasis were first investigated in 2013 and further followed in 2014. Information on clinical history, physical examination, and abdominal ultrasonography, including the symptom of ascites was repeatedly collected. Result showed 44 patients having ascites. Most of the patients' ascites were confined in the kidney area with median area of 20 mm². The level of plasma D-dimer and pertinent liver function indicators were measured at the initial investigation in 2013. Compared with those without ascites, cases with ascites had significantly higher levels of D-dimer (0.71±2.44 μg/L vs 0.48±2.12 μg/L, P=0.005), as well ALB (44.5 vs 46.2, g/L) and Type IV collagen (50.04 vs 44.50 μg/L). Receiver operating characteristic curve analyses indicated a moderate predictive value of D-dimer by its own area under curve (AUC) of 0.64 (95% CI: 0.54–0.73) and the cutoff value as 0.81 μg/L. Dichotomized by the cutoff level, D-dimer along with other categorical variables generated a prediction model with AUC of 0.76 (95% CI: 0.68–0.89). Risks of patients with specific characteristics in the prediction model were summarized. Our study suggests that the plasma D-dimer level is a reliable predictor for incident ascites in advanced schistosomiasis japonica patients.
Area Under Curve ; Ascites* ; Case-Control Studies ; China ; Cohort Studies ; Collagen Type IV ; Fibrin ; Humans ; Kidney ; Liver ; Physical Examination ; Plasma* ; Prospective Studies* ; ROC Curve ; Schistosoma japonicum ; Schistosomiasis japonica* ; Schistosomiasis* ; Ultrasonography