Early-stage Hodgkin Lymphoma(HL) is curable by extended-field radiotherapy alone. To reduce the long-term toxicities and complications with similar overall survival, randomized controlled trials of combined-modality therapy have been investigated nearly two decades. Recent years, many large-scale randomized controlled trials showed superior disease-free survival of combined-modality treatment compared with radiotherapy or chemotherapy alone for early-stage classical HL. Thus, short-course chemotherapy plus involved-field and low-dose radiotherapy is the standard treatment for early-stage HL. With this regimen,several studies have been proved that long-term complications had been reduced, but long-time results should be awaited.

Objective To investigate the frequencies of genotype and allele distribution of IL-12A gene single nucleo?tide polymorphisms (SNP) rs568408 and IL-12B gene SNP rs3212227 in Zhuang populations in Guangxi, and to compare the distribution of IL-12A and IL-12B polymorphisms among different races. Methods The IL-12A SNP rs568408 and IL-12B SNP rs3212227 were detected by SNaPshot SNP genotyping technique in 165 Zhuang people in Guangxi, frequen?cies of genotype and allele of IL-12A gene rs568408 and IL-12B rs3212227 polymorphisms were analyzed in Zhuang popu?lations compared with the other four populations(HapMap-HCB, HapMap-JPT, HapMap-YRI, HapMap-TSI)from Hap?Map database. Results There were polimorphisms of IL-12A and IL-12B gene in Zhuang populations in Guangxi. The fre?quencies of allele and genotype distribution of IL-12A gene rs568408 polymorphisms were not significantly differenct com?pared with HapMap-HCB, HapMap-JPT and HapMap-TSI(P>0.05), but were significantly different compared with Hap?Map-YRI(P<0.01);The frequencies of allele and genotype distribution of IL-12B rs3212227 polymorphisms were not sig?nificantly differenct compared with HapMap-HCB and HapMap-JPT(P>0.05), but were significantly different compared with HapMap-YRI and HapMap-TSI(P<0.01). Conclusion There are significant differences in the frequencies of allele and genotype distribution of IL-12A gene rs568408 and IL-12B gene rs3212227 between Zhuang populations and other eth?nic populations, and this variation might contribute to a variety of clinical manifestation and morbidity of some IL-12 related diseases.

BACKGROUND:Interleukin-12 (IL-12) may function as an immune regulator in the pathogenesis of osteoarticular tuberculosis. OBJECTIVE:To explore the association of single-nucleotide polymorphisms in IL-12A rs568408 G/A and IL-12B rs3212227 A/C with susceptibility to osteoarticular tuberculosis and serum interleukin-12 levels in Guangxi Zhuang population. METHODS:The single-nucleotide polymorphisms in IL-12A rs568408 G/A and IL-12B rs3212227 A/C polymorphisms were detected by polymerase chain reaction-single base extension technique and direct DNA sequencing in 150 patients with osteoarticular tuberculosis (disease group) and 165 healthy individuals (control group) in Guangxi Zhuang population. The genotype and al ele frequencies of IL-12 and the relationship of genotypes to the susceptibility to osteoarticular tuberculosis were analyzed. In addition, the association of genotypes of single-nucleotide polymorphisms in IL-12A rs568408 G/A and IL-12B rs3212227 A/C with serum IL-12 levels were analyzed. RESULTS AND CONCLUSION:There was no significant difference in the genotype and al ele frequencies of IL-12A rs568408 G/A and IL-12B rs3212227 A/C between the disease group and the control group (P>0.05). Moreover, there was no difference in four haplotypes of IL-12 gene between the disease group and the control group (P>0.05). Serum IL-12 levels in subjects with osteoarticular tuberculosis carrying the variant rs568408 GA/AA genotypes and wild-type rs568408 GG genotypes were similar (P>0.05). Similarly, there was no significant difference in serum IL-12 levels between subjects with osteoarticular tuberculosis carrying the variant rs3212227 AC/CC genotypes and wild-type rs3212227 AA genotypes (P>0.05). These findings suggest that the single-nucleotide polymorphisms in IL-12A rs568408 G/A and IL-12B rs3212227 A/C polymorphisms are not associated with susceptibility to osteoarticular tuberculosis in Guangxi Zhuang population.

Humans ; Labyrinth Diseases ; diagnosis ; Otolithic Membrane ; Semicircular Canals ; Vertigo

{L-End}Objective To investigate the current status of academic procrastination, psychological resilience, and emotional intelligence among undergraduate nursing students in Hebei Province. {L-End}Methods A total of 2 121 undergraduate nursing students from seven medical universities in Hebei Province were selected as the research subjects using a convenient sampling method. The Academic Procrastination Scale, Psychological Resilience Scale, and Emotional Intelligence Scale were used to investigate their academic procrastination, psychological resilience, and emotional intelligence. {L-End}Results The median score for academic procrastination among undergraduate nursing students was 62.5 points. The scores for psychological resilience and emotional intelligence were (79.9±10.1) and (100.7±11.6) points, respectively. The results of the multiple logistic regression analysis showed that students from urban areas experienced more severe academic procrastination than those from rural areas (P<0.05). Students with indifferent family relationships experienced more severe academic procrastination than those with close family relationships (P<0.05). Higher grade levels, lower scores in psychological resilience, and lower scores in emotional intelligence were associated with more severe academic procrastination among these nursing students (all P<0.05). {L-End}Conclusion The overall degree of academic procrastination among undergraduate nursing students in Hebei Province is at a moderate level. The level of psychological resilience and emotional intelligence can negatively affect the degree of academic procrastination among these undergraduate nursing students.

Objective To detect the expression of interleukin (IL)-18 of the peripheral blood cells and IL-18 receptor α chain(IL-18Rα) on the surface of CD_3~+ cells in patients newly diagnosed as immune thrombocytopenia (ITP) before medication and to explore the roles of IL-18 and IL-18Rα in the development of ITP. Methods Eighteen out-patients or inpatients with acute ITP accepting treatment in Qilu Hospital were enrolled in this study and 15 matching healthy subjects were taken as control. Plasma IL-18 level was detected with enzyme linked immunosorbent assay (ELISA), the expression of IL-18Rα on CD_3~+ lymphocytes and total lymphoeytes were measured with flow cytometry; T-bet and GATA-3 mRNA were measured with reverse transcriptase polymcrase chain reaction (RT-PCR). Results The expression of IL-18 in acute ITP plasma was (468. 57 ± 141.62) ng/L and IL-18Rα on the surface of CD_3~+ cells and lymphocytes were (8.50 ±3. 16)% and (9. 16±2.98)% respectively. The levels of IL-18 and IL-18Rα were increased in active ITP patients as compared with those in the controls (P <0. 05). The levels of IL-18 mRNA (0. 12 ±0. 02) and T-bet mRNA (0. 07 ±0. 02) were significantly increased in patients with active ITP as compared with those in the controls (P <0.05), while GATA-3 mRNA (0.0039±0.0014) were significantly decreased in patients with active ITP (P < 0. 05). The balance between T-bet and GATA-3 was significantly disturbed in ITP. Conclusions Through the variation of the levels of gene and protein, our study showed that IL-18 and IL-18Rα might upregulate the expression of Th1-cytokines in ITP patients. It is also suggested that IL-18 has potential association with the development of ITP. Especially, it may provide a new treatment method for ITP by regulating the ratio of T-bet and GATA-3 and resuming the balance of Th1/ Th2.

Objective To evaluate the outcome of radiotherapy for locally advanced pancreatic cancer. Methods From January 2000 to December 2007,41 patients with inoperable locally advanced (stage Ⅲ) pancreatic cancer were treated with three-dimensional conformal radiation therapy(3DCRT) or intensity-modulated radiation therapy (IMRT). Among these patients, 30 received concurrent radio-chemo-therapy. Results The median survival time(MST) and 1-year overall survival were 9.2 months and 23%. Patients with pretreatment KPS≥80 ,no regional lymph nodes metastasis, and CR/PR after radiotherapy had better prognosis. The corresponding MSTs were 11.1 months vs 5.8 months (χ2 = 7.50, P = 0.006), 10. 8months vs 6.5 months (χ2 = 5.67, P = 0.017), and 19.5 months vs 9.1 months (χ2= 7.28, P = 0. 007), re-spectively. Concurrent radio-chemotherapy tended to improve the overall survival (χ2 = 3.25, P = 0. 072). After radiotherapy, 18 patients had clinical benefit response, mainly being abdominal pain relief. Neither grade 4 hematologic nor grade 3 non-hematologic toxicities were observed. Conclusions For patients with locally advanced pancreatic cancer, both 3DCRT and IMRT are effective in alleviation of disease-related symptoms. Patients with better porformance status before treatment, no regional lymph nodes metastasis, and better response to radiotherapy may have better prognosis. Concurrent radio-chemotherapy trend to improve overall survival when compared with radiotherapy alone.

Carcinoma, Hepatocellular ; Combined Modality Therapy ; Humans ; Liver Neoplasms

ObjectiveTo investigate the risk factors for needle tract implantation after radiofrequency ablation for primary liver cancer and the clinical effect of ablation. MethodsA retrospective analysis was performed for the clinical data of 4 patients with needle tract implantation after radiofrequency ablation for primary liver cancer who underwent ablation therapy in Center of Interventional Oncology and Liver Diseases, Beijing YouAn Hospital, from January 2017 to October 2018. Risk factors, the clinical effect of ablation, and complications were analyzed. ResultsAll four patients had intrahepatic tumor lesions located near the Glisson′s capsule, and among these patients, two had poorly differentiated hepatocellular carcinoma (HCC), one had moderately differentiated HCC, and one had well-differentiated HCC. The time from radiofrequency ablation to needle tract implantation ranged from 3.6 to 14.3 months, and all four patients had a single lesion of needle tract implantation, which was located at the anterior abdominal wall in three patients and at the right abdominal wall in one patient. Of all patients, three underwent argon-helium cryoablation, and one underwent radiofrequency ablation. Two patients experienced pyrexia and transient aggravation of pain after surgery, and the symptoms were relieved after symptomatic treatment. No serious complication was observed. Contrast-enhanced computed tomography performed at one month after surgery showed complete ablation of metastatic lesion in three patients, with no recurrence after follow-up for 2-19 months. One patient was found to have local residual lesion, with marked relief of pain, and no enlargement of the residual lesion was observed after follow-up for 3 months. All patients had significant reductions in serum alpha-fetoprotein and abnormal prothrombin at one month after surgery. ConclusionAblation therapy, especially argon-helium cryoablation, has a good clinical effect in the treatment of needle tract implantation at the abdominal wall, with the advantages of few complications and good tolerability. Therefore, it is a good choice for patients who cannot tolerate surgical operation or are unwilling to undergo surgical operation.

Objective To evaluate the toxicities and long-term survival of a pilot study of radical surgery followed by concurrent capecitabine and radiotherapy for stage Ⅱ/Ⅲ rectal cancer patients.Methods From March 1,2005 to December 31,2007,131 pathologically proved stage Ⅱ and Ⅲ rectal cancer patients received radical surgery followed by chemoradiotherapy and adjuvant chemotherapy.Capecitabine was delivered daily in twice,for 2 weeks followed by a 2nd cycle after a rest of 7 days during radiotherapy,with the dosage of 1600 mg/m2/d.Three-dimensional conformal radiotherapy was encouraged to the dose of 50 Gy in 25 fractions,and Oxaliplatin/5-fluorouracil or leucovorin based adjuvant chemotherapy was recommended.Results Grade 3 +4 toxicities during concurrent chemoradiotherapy were observed in 28.2％ of patients.The follow-up rate was 93.9％.The 3-year overall survival (OS),locoregional-free survival and distant metastasis-free survival rates were 85.1％,96.7％ and 79.5％,respectively.Among the 31 patients with relapse,5 had loco-regional recurrence and 28 had distant metastasis.Univariate analysis indicated that patients with low and moderate-low differentiated adenocarcinoma,no adjuvant chemotherapy,stage ⅢC disease or positive lymph node ratio (LNR) more than 30％ had lower OS ( x2 =15.49,15.85,8.80 and 9.76,P ＝ 0.000,0.000,0.011 and 0.002 ).Patients with N2 disease had more loco-regional recurrence.Patients with stage ⅢC,without adjuvant chemotherapy,or LNR more than 30％ were at higher risk of distant metastasis ( x2 =6.51,11.57 and 9.70,P =0.034,0.001 and 0.002 ).However,patients who didn ' t receive adjuvant chemotherapy were likely to have low differentiated adenocarcinoma and T4 stage disease ( x2 =7.20,6.48,P =0.027,0.039).Conclusions After radical surgery and concurrent eapecitabine and radiotherapy for stage Ⅱ/Ⅲ rectal cancer patients,loco-regional recurrence rate is pretty low.Distant metastasis is the main treatment failure.