AIM: To study antipyretic, anti-inflammtory, analgesia and antisepsis effect of Renshenbaidu Pills.(Rhizouia Seu Radix Notopterygii, Radix Bupleuri, Radix Ginseup, etc) METHODS: The antipyretic effect of the pills was observed using rabbits fever model carrageenine caused foot swelling of rat, analgesic effect was tested by the method of writhes of mice, the method was applied antibacterial in vitro. RESULTS: Renshenbaidu Pills remarkably brought down the body temperature in experimental animal with fever 1.5 g/kg of Renshenbaidu Pills had the obvious anti-inflammatory effect and notable analgesic action on the reaction of writhes of mice induced by acestic acid, it had antisepsis effect. CONCLUSION: Renshenbaidu Pills are better than Renshenbaidu Powder, it has antiyretic, antiinflammatory, analgesia and antisepsis effects.

Objectives:To investigate the efficacy and toxicity of the full coverage radiation to primary and all metastatic lesions in patients with oligometastatic castration-resistant prostate cancer (CRPC).Methods:Forty-four patients with oligometastatic CRPC was retrospective analyzed from Oct. 2011 to Jun. 2017 at Peking University 1 st Hospital. Before radiotherapy, average age was 72(57-86), the median value of initial PSA was 38.545 (6.640-1 066.000)ng/ml, the median value of PSA nadir after initial androgen deprivation therapy(ADT) was 0.259(0.011-18.762)ng/ml, the time interval between initial ADT to diagnosis of metastatic castration resistant prostate cancer(mCRPC) was 12(4-96) months, and the median PSA value pre-radiotherapy was 3.765(2.040-187.000) ng/ml. There were 23(52.3%)patients with Gleason score 9-10 and 15(34.0%) patients with Gleason score 8. At the time of initial diagnosis, there was 41(93.2%) cases with stage T 3-T 4, 23(52.3%)cases with lymph node metastasis, and 29 (63.9%) case with distant metastasis. The number of metastatic foci before radiotherapy was 1 in 22(50.0%)cases, 2 in 12(27.3%)cases, 3 in 6(13.6%)cases and 4 in 4(9.1%)cases. There were 3 cases of pelvic lymph node metastasis (6.8%), 9 cases of retroperitoneal lymph node metastasis(20.5%), 21 cases of bone metastasis(47.7%), 11 cases of bone metastasis+ lymph node metastasis(25.0%), and no visceral metastasis. Image-guided volumetric modulated arc therapy(IGRT-VMAT) was used to fully cover primary and metastatic foci. The prostate and seminal vesicle were routinely underwent 76Gy/38 fractions, and the bioequivalent dose(BED 3) was 126.67 Gy. For those with pelvic lymph node metastasis, the drainage area of pelvic lymph node was 46Gy/23 fractions. According to the tolerance of different normal tissues around the lesions, the median BED 3 of local radiotherapy dose in the metastatic foci was 112.26(91.14-140.77)Gy. The efficacy and side effects of all these patients were recorded. Kaplan-meier method was used to analyze the overall survival and the new metastasis-free survival. Results:Only 1 patient had grade 3 urinary tract obstruction and underwent indwelling catheter. All the other patients had grade 1-2 toxic and side effects. After a median follow-up of 34.5(9-96) months, the PSA-nadir after radiotherapy was 0.088(0.003-132.000)ng/ml. Forty(90.9%) patients showed a decrease in PSA after radiotherapy, and 34(77.3%) cases. showed a decrease of >80%. The 1, 3, and 5-year overall survival rates were 90.9%, 54.5%, 36.8%, the 1, 3, and 5-year new metastasis free survival rates were 47.7%, 25.0%, 12.9%, respectively.Conclusion:The full coverage radiotherapy to primary and metastatic lesions showed high PSA response rate, the satisfactory survival and tolerable toxicity in oligometastatic CRPC patients.

Objective To study the relationship between changes in prostate volume and neoadjuvant hormone therapy ( NHT) duration in prostate cancer radiotherapy. Methods Fifty patients with prostate cancer who received NHT were enrolled in the study continuously. The diameters along the x?, y?, and z?axes of the prostate were measured, and the volume of prostate was calculated weekly during radiotherapy. The relationship of prostate volume reduction with NHT duration, prostate volume before radiotherapy, and prostate cancer risk groups was analyzed during radiotherapy. Results The prostate volume in all patients decreased after radiotherapy. Patients with short NHT duration had larger changes in prostate volume and diameters than those with long NHT duration. Compared with those with a large prostate volume, patients with a normal prostate volume had larger changes in prostate volume and diameters long three axes after 7 weeks of radiotherapy, shorter NHT duration before radiotherapy, and lower risk of prostate cancer. In patients with low?and medium?risk prostate cancer, the prostate volumes were significantly reduced to 68?10% and 78?70%, respectively, of those before radiotherapy after no more than 4 months of NHT ( P=0?002) , but remained similar after more than 4 months of NHT. In patients with high?risk and more severe prostate cancer, the prostate volumes were significantly reduced to 76?59% and 85?46%, respectively, of those before radiotherapy after no more than 6 months of NHT (P=0?001), but remained similar after more than 6 months of NHT. Conclusions The changes in prostate volume and diameters along three axes during radiotherapy become smaller with longer NHT duration. Patients with low?or medium?risk prostate cancer have slight changes in prostate volume after more than 4 months of NHT, while patients with high?risk or locally advanced prostate cancer have slight changes in prostate volume after more than 6 months of NHT.

Objective To analyze the survival and prognostic factors in the treatment of angiosarcoma. Methods A retrospective study was performed on clinical data of 30 patients pathologically diagnosed with angiosarcoma who were admitted to our hospital from 1988 to 2015 and had complete follow?up data. In those patients, 18 patients received comprehensive treatment, containing 9 patients treated with surgery plus radiotherapy, 4 patients with surgery plus chemoradiotherapy, and 5 with surgery plus chemotherapy;12 patients received non?comprehensive treatment, containing 11 patients treated with surgery alone and 1 patient radiotherapy alone. The survival rates were calculated using the Kaplan?Meier method and analyzed using the log?rank test. The Cox regression model was used for multivariate prognostic analyses. Results The 1?, 2?, and 5?year sample sizes were 29,26, and 18, respectively. The 1?, 2?, and 5?year overall survival ( OS) rates were 70?1%, 49?1%, and 40?9%, respectively;the 1?, 2?, and 5?year local relapse?free survival rates were 52?8%, 44?0%, and 35?2%, respectively;the 1?, 2?, and 5?year distant metastasis?free survival rates were 81?6%, 68?0%, and 56?7%, respectively. The multivariate analysis showed that tumor site, tumor size, staging, and visible tumor residue after initial treatment were prognostic factors for OS ( P= 0?027, 0?027, 0?011, 0?000 );In the patients with stage Ⅰ or Ⅱ disease, the comprehensive treatment achieved a significantly lower local?relapse rate than the individual treatment ( P=0?006);gender, age, staging, and tumor site were prognostic factors for distant metastasis ( P=0?028, 0?011, 0?015, 0?022 ) . Conclusions Early diagnosis and early treatment are recommended for angiosarcoma, which has high local recurrence and distant metastasis rates. Comprehensive treatment ( surgery plus radiotherapy and/or chemotherapy) is recommended for patients with stage Ⅰ or Ⅱ disease. Tumor site, tumor size, staging, and visible tumor residue after initial treatment are prognostic factors.

Objective:To explore the amplitude of normal kidney motion in the 3D direction and its influencing factors under free-breathing condition.Methods:Clinical data of 28 patients with a KPS score≥80 who received 4D CT scan from March 2018 to March 2019 were collected. All patients were diagnosed with liver, pancreatic or lung tumors. The kidney was outlined and the geometric center and 3D coordinate values were recorded. The motion of bilateral kidneys in each direction and the 3D direction was calculated. The volume of kidney and surrounding organs, age, sex, height and body mass index (BMI) were recorded. Clinical data were statistically compared by t-test or nonparametric test. Results:The motion of the left and right kidneys in the the sup-inf (SI) direction were the largest up to (8.39±3.18) mm and (7.71±3.55) mm. The motion amplitudes of bilateral kidneys in male patients were significantly larger than those of the female counterparts in the left-right (LR), SI and 3D directions (all P<0.05). The motion amplitudes of bilateral kidneys in patients taller than 165 cm were significantly larger than those of their counterparts with a height of ≤165 cm (all P<0.05). Patients with a BMI≥25 kg/m 2 had significantly larger motion amplitudes of the left kidney in the LR and ant-post (AP) directions compared with those of normal weight counterparts (all P<0.05). The motion amplitude of the left kidney in the AP direction in patients with the left kidney volume of >180 cm 3 was significantly larger than that of patients with smaller left kidney volume ( P=0.014). Age was not significantly associated with kidney motion in each direction ( P>0.05). Conclusions:Kidney motion mainly occurs in the SI direction. The kidney motion amplitudes in male and taller patients are larger. Special attention should be paid to the use of breath motion control device to decrease the normal tissue damage.

Objective To assess the acute toxicity of a hypo-fractionated regimen of intensity-modulated radiotherapy to the prostatic bed after prostatectomy.Methods From February to August 2017,twenty cases with prostate adenocarcinoma after prostatectomy were recruited.The prescribed dose to the whole pelvis and the prostatic bed was 45 Gy delivered in 1.8 Gy per fraction and 62.75 Gy delivered in 2.51 Gy per fraction,respectively.Acute toxicity was recorded and graded according to Radiation Therapy Oncology Group (RTOG) criteria and Common Terminology Criteria for Adverse Events (CTCAE) 4.0.Results The median follow-up was 7.5 months.Grade 2 acute genitourinary and gastrointestinal toxicity was observed respectively in two cases (10％) and one (5％),respectively.Two cases (10％) complained of grade 2 urinary incontinence during radiation therapy,but recovered to grade 0 or grade 1 after the first month of follow-up.Conclusions After prostatectomy,moderately hypo-fractionated radiotherapy (2.51 Gy × 25) compared with conventional fractionated radiotherapy previously reported did not increase the risk of acute toxicity.The incidence of urinary incontinence did not increase during short-term of follow-up.

Objective To analyze the adverse events in patients diagnosed with oligometastasized castration resistant prostate carcinoma (CRPC) receiving radiotherapy for the primary and metastatic prostate carcinomas.Methods Twenty patients with oligometastasized CRPC admitted to our hospital between 2011 and 2015 were treated with image-guided volumetric modulated arc therapy (VMAT).The dose for prostate+ seminal vesicle was 76 Gy/38 f,46 Gy/23 f for the pelvic lymph node and the median dose for the metastatic lesions was 60 Gy (52-66)/23 f.Relevant clinical data and adverse events were analyzed.Results All patients completed the radiotherapy.Only 1 patient showed grade Ⅲ urinary obstruction and received catheterization.In terms of acute adverse events of ≥ grade Ⅱ,urinary tract was observed in 4 cases (20％),rectum in 2 (10％) and blood system in 2(10％).The rectal V50 was correlated with acute adverse events of ≥ grade Ⅱ.The median follow-up time was 24.2 months.No patient suffered from late adverse events of ≥ grade Ⅱ.All cases showed a decline in the level of prostate specific antigen (PSA) after radiotherapy.The median PSA reduction rate was 99％.Among them,16 cases (80％) had a PSA reduction rate of over 90％.Conclusions It is safe and efficacious to perform radical dosage radiotherapy for primary and metastatic prostate carcinomas in patients with oligometastasized CRPC.

Objective To compare the toxicity between different dose fractionation regimens in postoperative radiotherapy for prostate cancer. Methods Patients with prostate cancer who received postoperative radiotherapy with moderate hypo-fractionation ( 62. 75 Gy in 25 fractions, 2. 51 Gy per fraction) or conventional fractionation (72 Gy in 36 fractions, 2 Gy per fractions) in our hospital from 2011 to 2017 were enrolled as subjects.All patients received intensity-modulated radiotherapy and daily cone-beam computed tomography image-guided radiotherapy. According to the propensity score matching ( PSM ) method, 35 patients treated with moderately hypo-fractionated radiotherapy were matched to 35 patients treated with conventionally fractionated radiotherapy based on age, irradiated volume, hormonal therapy, interval between surgery and radiotherapy, and comorbidities ( diabetes and hypertension). Toxicity was evaluated according to Radiation Therapy Oncology Group criteria. Comparison was made by the Fisher's exact probability test. Results One hundred and thirteen patients, consisting of forty-one in moderate hypo-fractionation group and seventy-two in conventional fractionation group, were enrolled as subjects. The median follow-up time in the two groups was 5. 6 and 45. 0 months, respectively. There were no significant differences in incidence rates of grade 2 acute gastrointestinal (GI) or genitourinary (GU) toxicity between the two groups ( 7% vs. 7%, P＝ 1. 000; 15% vs. 17%, P＝ 0. 847). After PSM, there were still no significant differences in incidence rates of grade 2 acute GI or GU toxicity between the two groups (9% vs. 11%, P＝0. 814; 14% vs. 11%, P＝ 0. 670). None of patients reported ≥grade 3 GI or GU toxicity. Conclusions Preliminary results show that moderate hypo-fractionation, compared with conventional fractionation, does not increase the risk of acute GI or GU toxicity in patients undergoing postoperative radiotherapy for prostate cancer.

Objective To apply real-time transperineal ultrasound ( TPUS) to monitor the intra-fractional prostate motion,collect and analyze the data of the prostate motion,aiming to provide evidence for the optimization of the target area and plan of radiotherapy for prostate cancer. Methods TPUS is a non-invasive monitoring technique that utilizes an automatic scanning ultrasound probe to dynamically monitor and correct the motion of organs during radiotherapy. In this study, TPUS was utilized to collect 1588 intra-fractional data of 70 patients with prostate cancer. Prior to each cycle of radiotherapy,CBCT was adopted to correct the errors between intra-factional data by using VMAT. During radiotherapy, real-time ( once per second) ultrasound images were acquired to monitor the 3D motion of the prostate on the x (left+,right-),y (cranial+, caudal-), and z ( abdominal+, dorsal-) axes, emphasizing the analysis of 4D motion of the prostate. Results All patients successfully completed the treatment and data collection. The median time of effective monitoring per faction was 179 seconds (132-286 seconds). During 95% of the monitoring time,the distance of prostate motion was 2. 22 mm in the left direction,2. 17 mm in the right,2. 08 mm in the cranial, 1. 98 mm in the caudal,2. 44 mm in the abdominal and 2. 97 mm in the dorsal direction,respectively. In the x,y and z axes,the percentage of time in which the distance of prostate motion less than 1 mm among the total time was 83. 07%,85. 46% and 78. 27%,respectively,whereas 97. 70%,97. 87% and 96. 45% for＜3 mm, respectively. Conclusions TPUS is a non-invasive real-time monitoring technique,which can detect the 4D motion of the prostate during radiotherapy. By using VMAT,the range of prostate motion is relatively small, and the motion range is less than 3 mm in each direction within 95% of the time.

Objective:To analyze the influencing factors of hemoglobin changes in prostate cancer patients during radiotherapy combined with androgen-deprivation therapy (ADT) and analyze the relationship between the hemoglobin changes and long-term prognosis.Methods:The changes of hemoglobin levels in 145 prostate cancer patients treated with radiotherapy combined with ADT in Department of Radiation Oncology of Peking University First Hospital from November 2011 to May 2015 were retrospectively analyzed. Intensity-modulated radiotherapy (IMRT) was employed for conventionally fractionated radiotherapy. Luteinizing hormone-releasing hormone agonist was utilized for endocrine therapy.Results:The median hemoglobin reduction during radiotherapy combined with ADT was 8 g/L. The higher the baseline level of hemoglobin, pelvic irradiation and GS score before radiotherapy, the more obvious the decrease of hemoglobin during treatment (all P<0.001). Pelvic radiotherapy significantly increased the decline tendency of hemoglobin throughout the combined treatment (86.8% vs. 72.8%, P=0.05). The duration of endocrine therapy before radiotherapy and the hemoglobin changes during endocrine therapy alone were not significantly correlated with the degree of hemoglobin decline during subsequent radiotherapy ( P=0.53 and 0.837). The biochemical failure-free survival did not significantly differ between patients with significant and mild hemoglobin reduction ( P=0.686). Conclusions:The baseline level of hemoglobin before radiotherapy is negatively correlated with the decrease of hemoglobin during combined therapy. Pelvic radiotherapy is positively correlated with hemoglobin reduction during combined therapy. Hemoglobin reduction during combined therapy is not associated with the long-term biochemical failure-free survival of patients.