Inductive chemotherapy and concurrent chemoradiotherapy have been a focus on the clinical research in the treatment of nasopharyngeal carcinoma.Cisplatin,as a kind of representative platinum drug,can improve the curative effect,but it also brings a lot of side effects to nasopharyngeal carcinoma patients.The new kind of platinum drug-nedaplatin,can not only guarantee the curative effect but also reduce the side effects of chemotherapy.

Bmi-1 is a core member of the polycomb group genes.As a proto-oncogene,Bmi-1 plays an important role in cell self-renewal,proliferation and apoptosis.Several studies have shown that Bmi-1 is highly expressed in some head and neck malignant tumors,such as nasopharyngeal cancer and laryngeal carcinoma.Furthermore,the expression level of Bmi-1 is closely related to the occurrence,development,incursion and prognosis of tumor.Bmi-1 is expected to become a novel tumor molecular marker,and provides a new direction for the treatment of the head and neck malignant tumor.

Radiation-induced stomatitis is a frequent side effect for head and neck cancer patients undergoing radiotherapy, which affects both the treatment and the life quality. The direct effects of radiation, oxidative stress, transcription factor, proinflammatory cytokine and pathogenic microorganism are involved in the onset of radiation-induced stomatitis. The pathologic process can be divided into five phases including initiation, up-regulation, amplification, ulceration and healing. Understanding of the pathogenesis and risk factors provides basis for prevention and control of radiation-induced stomatitis.

Objective To investigate the clinical effects, the therapy reactions,the living qualities of three treatments in advanced nasopharyngeal carcinoma. Methods From Jan 2001 to Jun 2002, 120 patients pathologically confirmed NPC who firstly underwent radiotherapy were divided into two groups: radiotherapy with concurrent chemotherapy group(RC, n = 60, 5 fractions per week, one time per day, 200 cGy per day to a total dose of 7 000 ～ 8 000 cGy. cisplatin and 5-Fu two cycles in the first and fourth week during radioation); radiotherapy with AiDi injection group(RAD, n = 60, radiotherapy was the same as that of RC. Continuously injecting AiDi for 10 days 50 ml per day was one cycle which was repeated 3 cycles every alternation of 7 days); another 60 patients who contemporaneity reciceved radiotherapy alone (radiotherapy was the same as that of RC) because of some reasons and were comparable in clilical materials were regarded as the third group (R) to compare with the above two groups. The life quality, 3-year survival rate, and acute or chronic radiation reactions in the three groups were observed. Results All patients were followed up for more than 3 years: the 3-year survival rate in RC (73.3%),which was homologous as that in RAD(65.0 %, P =0.347), was higher than that in R group(53.3%,P = 0.028), and the local recurrent was inverse(10.0%,26.7%,P = 0.033 6). The acute and chronic radiation reactions in RC was highest whereas that in RAD group is lowest(P

Objective: To revise the Gratitude, Resentment, and Appreciation Test (GRAT) for Chinese college students. Methods: On the translation of the Gratitude, Resentment, and Appreciation Test (GRAT), some items was modified and developed a revised gratitude scale in the context of Chinese culture. The GRAT was filled by 1000 students from six universities. Results: The results of EFA have three factors, lack of a sense of deprivation (or sense of abundance), appreciation for simple pleasures, and social appreciation, the three factors are similar for study of Watkins. The result of CFA indicated that the validity of formal questionnaire was acceptable with the factor loading of each item. Internal consistency analysis showed that the Cronbach ? coefficient was 0.910, split -half correlation coefficients was 0.902. And the test-retest stability coefficient was 0.850. Conclusion: The reliability and validity of GRAT are verified.

Objective To observe the clinical effect of Sarcandra glabra extracts against oxida-tive damage. Methods 46 patients diagnosed as nasopharyngeal careinoma stage Ⅲ and Ⅳ a were ran-domly divided into control group (n=25) and study group (n=21). All patients underwent combined chemoradiotherapy treatment. Besides, the patients in study group were given Sarcandra glabra 20 g/d orally. The total activity of superoxide dismutase (SOD) and plasma eontent of malonaldehyde (MDA) were measured before and after treatment. The tumor regression and aeute chemoradiotherapy side reaction were observed after treatment. Results All patients fulfilled the whole range treatment, After treatment, the total plasma SOD activity decreased and plasma MDA level was elevated in con-trol group, while both SOD aetivity and MDA level were reduced in study group (P<0. 05). When the therapy ended, the SOD of study group was higher and MDA was lower than that of control group (P<0.05). There was no difference in tumor local control rate after radiotherapy between two groups (P>0.05). The incidence rate and severity of acute chemoradiotherapy side reaction were slighter in study group than those in control group (P<0. 05). Conclusion Sarcandra glabra extracts exerts obvious inhibitory effect on oxidative damage. Combined with chemoradiotherapy, Sarcandra glabra contributes to the tumor regression of patients with stage Ⅲ and Ⅳa nasopharyngeal carcinoma and at-tenuation of chemoradiotherapy side reaction.

Objective To explore the protective effect of Tea polyphenols(TP) on radiation injury in submandibular glands. Methods Sixty rats were randomly divided into radiation group(R-group) and tea polyphenols combined radiation group (TPR-group), both groups were irradiated with a single exposure of 15 Gy γ-rays delivered to the head and neck area. The rats were intragastrically administered with normal sodium or TP from 14 days before radiation to the experiment ended. On day 3, day 6 and day 30 after radiation, ten submandibular glands glands were taken from each groups. TUNEL method was used to examine the apoptosis of submandibular glands cells and immunohistochemical technique was used to detect the Bcl-2 and the Bax expression in the glands. The morphologic changes of submandibular glands were observed by transmission electron microscopy. Results Apoptosis index in the cell of submandibular glands were significant decreased on days 3, days 6 and days 30 after irradiation, compared with R-group ( F = 56.383, P ＜ 0.01 ). Expression of Bcl-2 and Bax were not significant difference between the two groups. The lesions of submandibular glands in TPR-group were lighter and the apoptosis in cell nuclear were not typical than that of R-group from electron microscope study. Conclusion TP could protect the sumandibular glands against radiation injuries and the mechanism might be realized with the anti-apoptosis in the glands cell.

Objective To evaluate long-term efficacy of microwave hyperthermia combined with chemoradiotherapy for nasopharyngeal carcinoma (NPC) with cervical lymph node metastasis. Methods A total of 154 patients with stage N2 or N3 NPC ('92 staging system) were randomized into two groups:microwave hyperthermia combined with chemoradiotherapy (Group A, 76 cases) and chemoradiotherapy alone (Group B, 78 cases). Both of the two groups received 1 -2 cycles of chemotherapy of cisplatin and 5-fluorouracil, followed by conventional radiotherapy of 70 - 78 Gy in 35 - 39 fraction to the nasopharynx and 68 -72 Gy in 34 - 36 fractions to the neck. Group A received microwave hyperthermia to the metastatic cervical nodes at the beginning of radiotherapy. The hyperthermia was given as 45 min every time, twice a week for 8 - 14 times totally. Results The 5-year complete response rates of cervical lymph nodes in group A and B were 97% and 77% (x2 = 14. 24,P<0. 01). The distant metastasis rates in the two groups were 37% and 44% (x2 = 0. 73, P > 0. 05). The disease-free survival rates were 51% and 21% (x2 = 15.91, P <0. 01). The 5-year overall survival rates were 59% and 41%, respectively (x2 = 5.09, P < 0. 05).Conclusions For patients with stage N2 or N3 NPC, microwave hyperthermia combined with chemoradiotherapy can improve the complete response, disease-free survival and overall survival.

Objective To study the effect of Sarcandra Glabra on the expression of signal transduction molecules of TGF-β1/Smads signaling pathway in miniature pig of radiation-induced lung injury.Methods 75 miniature pigs were divided into control group,radiation group and radiation plus medication group randomly.At 1 week before exposure of right lung with 15 Gy γ-rays,the miniature pigs in radiation plus medication group were given Sarcandra glabra,while those in the other groups received an equal amount of saline.Right lung were taken at weeks 2,4,8,12 and 24 after irradiation,the pathological changes in the lung tissue were observed by HE staining,and the expression of mRNA and protein of TGF-β1,Smad2,Smad3,and Smad7 were detected by real-time PCR and western blotting,respectively.Results Sarcandra glabra reduced the inflammation and fibrosis of the lung tissue in miniature pig after irradiation.Compared with control group,the expressions of TGF-β1 and Smad3 were significantly increased at 2 weeks after irradiation(P ＜ 0.05),Smad2 and Smad7 were increased at 8 and 12 weeks after irradiation(P ＜ 0.05),respectively,in the radiation group.Compared with the radiation group,the expressions of TGF-β1 and Smad2 were significantly decreased(P ＜ 0.05) from the fourth and eighth week,respectively,Smad3 had no obvious change while Smad7 was significantly increased from the second week in the radiation plus medication group (P ＜ 0.05).Conclusions Sarcandra Glabra plays protective effect on radiation-induced lung injury in miniature pig by regulating TGF-β1,Smad2 and Smad7 expressions in the TGF-β1/Smads signaling pathway.

Objective To evaluate the short- and long-term efficacy of microwave hyperthermia combined with chemoradiotherapy in treating metastatic nasopharyngeal carcinoma to the cervical lymph nodes. Methods A total of 154 cases of stage N2-N3 nasopharyngeal carcinoma (1992 stage system) were randomized into two groups: group A (76 cases, treated with microwave hyperthermia combined with chemoradiotherapy) and group B (78 ca-ses, treated with chemoradiotherapy alone). Both groups received 1 to 2 cycles of chemotherappy with cisplatin and 5-fluorouracil and then received regular radiotherapy. The total doses of radiotherapy were 70-78 Gy/35-39 f, 47-51 d for the primary loci of nasopharynx and 68-72 Gy/34-36 f,46-50 d for the metastatic loci in the neck. Group A received microwave hyperthermia on the metastatic cervical node at the beginning of radiotherapy, with the micro-wave hyperthermia administered for 45 min every time,two times a week, totaling 8 to 14 times. Results The complete extinction rates of neck metastatic carcinoma were 80.3% and 61.5% , respectively, in groups A and B (P<0.05). The overall response rates of neck metastasis in the two groups were 100% and 96.2% , respective-ly. When the cervical lymph node metastasis disappeared, the radiotherapy doses in group A and B were (45.8 ± 5.46 ) Gy and (58.8±5.03 ) Gy, respectively (P<0.01). The 5-year local control rates of cervical lymph node in group A and B were 97.4% and 76.9%(P<0.05 ), respectively. The one-, three- and five- year survival rates were 97.4% , 76.3% and 59.2% respectively, in group A, versus 93.6% (P>0.05) ; and 52.6% (P< 0.01) and 41.0% (P<0.05), respectively, in group B. Conclusions Microwave hyperthermia combined with chemoradiotherapy can elevate the complete extinction rate of cervical lymph node metastasis of nasopharyngeal carcinoma and reduce the radiotherapy dose needed of effective control. The 5-year local control rate of cervical lymph node metastasis in combined therapy group is superior to that in the chemoradiotherapy alone group,and can elevate the long-term survival rate of patients.