Objective We have monitored the set up errors of radiotherapy for thoracic cancer using ontime imaging system. The discrepancy of couch top between treatment machine (net bracket) and simulator (plate) was observed. Set up errors were analyzed quantitively according to variable distribution, ratio and extent of displacement. Methods Three hundred eighty nine orthogonal portal images of 30 patients were compared to the simulation films. Set up deviation in lateral, longitudinal and vertical direction were measured respectively. The systematic and random errors were evaluated. Results The distribution of set up errors in each direction approximated a normal distribution. The systematic error in lateral and longitudinal was lower with a mean of 1～2 mm, and however, it was 6.8 mm in vertical direction without immobilization device as compared to 1.5 mm with immobilization device. The random error was larger and ratio of vertical displacement was higher without immobilization. Conclusions The decline of treatment couch top (with net bracket) could result in a larger systematic error with a mean of 6.8 mm. We must pay attention to the coordination of couch top between treatment machine and simulator when radiation field is set. The use of immobilization device during thoracic radiotherapy is able to improve the geometrical quality.

Objective To study the impact of local fractionated irradiation on lung metastasis in H22-bearing mice, and to explore its mechanism involved. Methods Subcutaneous transplantation tumor model bearing with H22 was established. Mice were divided into three groups as healthy control, tumor control and irradiation groups. The size of subcutaneous tumors was measured and lung metastasis was observed. The expressions of PCNA, VEGF and MVD were detected immunohistochemically. The plasma levels of CD4 and CD8 were determined by using flow cytometry. Results The tumor size in irradiated group was smaller than that in tumor control group. The tumor inhibition rate in irradiated group was 30%.Lung metastasis in irradiated group was more severe than that in tumor control group (x2 = 8.31,4.48,9. 60, P＜ 0.05 ). The expressions of PCNA, VEGF and MVD in two groups were statistically different( t =23.78,-2.47, -6.43, P ＜ 0. 05). The levels of CD4 and CD8 in irradiated group were statistically different compared to healthy control group ( t = 4. 72 and 3.31, P＜ 0.05 ). Conclusions For the H22 model, radiation might inhibit the local transplantation tumor, but increase the risk of lung metastasis.

Chimeric antigen receptor T (CAR-T) cell therapy is one of the most significant advances in cancer treatment in the last few decades, revolutionizing the treatment paradigm for patients with refractory / recurrent diffuse large B-cell lymphoma (R/R DLBCL) and effectively improving the survival rate of these patients. However, due to the high incidence of grade III-IV side effects of CAR-T cell therapy and the fact that some patients did not obtain remission after CAR-T cell therapy or developed rapid disease progression within a short period of time, researchers are attempting to explore combined therapies, such as chemotherapy, radiotherapy and immunotherapy, to reduce the incidence of side effects and prolong the duration of persistent remission in patients. Among these options, radiotherapy in combination with CAR-T cell therapy have been proven to improve clinical prognosis. In this article, the theoretical basis of synergistic treatment of radiotherapy and CAR-T cell therapy in patients with R/R DLBCL, the safety and efficacy of radiotherapy, the sequence of radiotherapy and CAR-T cell therapy, and the dose of the target area of radiotherapy were reviewed, aiming to provide more evidence for the application and optimization of radiotherapy combined with CAR-T cell therapy for R/R DLBCL.

Atherosclerosis(AS), characterized with the accumulation of lipids on the vessel wall, is an immune-related inflammatory disease which promotes the progression of cardiovascular diseases(CVD). The imbalance of Treg/Th17 accelerates the progression of AS. Yangyin Huoxue Prescription(YHF)is an efficient traditional Chinese medicine used in the treatment of AS, but the effects of YHF on the balance of immunity have still not been clarified. This project was designed to investigate the effects of YHF on the imbalance of Treg/Th17 and AS in ApoE-/- mice induced by high-fat diet(HFD). ApoE-/- mice were given HFD to induce AS and administered low-dose YHF(18 g/kg)or high-dose YHF(36 g/kg)for 20 weeks. Atherosclerotic plaque area was analyzed by oil red O staining. Serum lipids were measured by biochemical kits. Treg or Th17 cells in peripheral blood were detected by flow cytometry. mRNA and protein expression of Foxp3 and RORγt of aortas were determined by qRT-PCR, Western blot and immunohistochemistry. Splenic CD4+T cells of mice were isolated and activated by anti-CD3/CD28, and then treated with lipopolysaccharide(LPS)and YHF. The expression of mRNA and protein of Foxp3 and RORγt were detected by qRT-PCR and immunofluorescence. It was found that YHF reduced the plaque area, decreased lipid level and increased the ratio of Treg cells in peripheral blood. Moreover, YHF increased mRNA or protein expression of Foxp3 in aortas in vivo or CD4+T cells in vitro while decreasing mRNA or protein expression of RORγt. These results suggested that YHF can regulate the imbalance of Treg/Th17 in ApoE-/- mice induced by HFD, and reduce the inflammatory stimulation of LPS on CD4+T cells, thereby improving AS.

BACKGROUNDThe prevalence of thyroid nodules (TN) is increasing rapidly. This study analyzed the epidemiological and clinical characteristics of TN in surgically treated patients and identified the risk factors for malignant nodules (MN) to provide more understanding of the differential diagnosis of TN.

METHODSA total of 6 304 TN cases who underwent thyroid surgery were included in this retrospective study. The clinical data were collected to evaluate the clinical and epidemiological characteristics and related risk factors for MN. The nature of TN (benign nodules (BN) or MN), medical records, laboratory data, and imaging data were analyzed. The risk factors for MN were screened using Spearman's rank correlation analysis and nonconditional binary Logistic regression analysis.

RESULTSThe number of surgically treated TN cases increased yearly. A total of 34.33% of cases were MN and 65.67% were BN. Up to 56.74% of these cases underwent unnecessary surgery. Among the MN cases, papillary thyroid carcinoma accounted for 94%, in which 46.71% coexisted with benign thyroid disease and 32.28% with multiple foci. Single-related factor analysis showed that age, employment, disease duration, history of breast nodules and/or hypertension, the levels of serum thyroid-stimulating hormone (TSH), thyroglobulin antibody (TgAb), and thyroid peroxidase antibody (TPoAb), and ultrasound features of TN were related to MN. Stepwise nonconditional binary Logistic regression analysis showed that 13 factors may be the independent risk factors for MN, including <40 years old, previous history of breast nodules and/or hypertension, disease duration <1 month, employment, hypoechoic nodule, irregular nodules, nodule calcification, solid echo nodule, fuzzy boundary, rich blood flow within nodules, abnormal lymph nodes around the neck, nodule diameter <1 cm, and abnormally high TgAb.

CONCLUSIONSOur results demonstrate a rapid increase in surgically treated TN cases and ratio of MN and indicate unnecessary surgeries in some cases. This study also suggest that age, duration of thyroid disease, history of breast disease and/or hypertension, the levels of serum TSH, TgAb, and TPoAb, and ultrasound features of TN are related to MN, and some of these factors may be the risk factors for MN.

Adult ; China ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Thyroid Neoplasms ; epidemiology ; Thyroid Nodule ; epidemiology

Objective: To compare the predictive efficacy of the two thrombosis risk assessment scores (Padua and IMPEDE scores) in venous thromboembolism (VTE) within 6 months in patients with newly diagnosed multiple myeloma (NDMM) in China. Methods: This study reviewed the clinical data of 421 patients with NDMM hospitalized in Beijing Jishuitan Hospital from April 2014 to February 2022. The sensitivity, specificity, accuracy, and Youden index of the two scores were calculated to quantify the thrombus risk assessment of VTE by the Padua and IMPEDE scores. The receiver operating characteristics curves of the two evaluation scores were drawn. Results: The incidence of VTE was 14.73%. The sensitivity, specificity, accuracy, and Youden index of the Padua score were 100%, 0%, 14.7%, and 0% and that of the IMPEDE score was 79%, 44%, 49.2%, and 23%, respectively. The areas under the curve of Padua and IMPEDE risk assessment scores were 0.591 and 0.722, respectively. Conclusion: IMPEDE score is suitable for predicting VTE within 6 months in patients with NDMM.
Humans ; Venous Thromboembolism/etiology* ; Multiple Myeloma/diagnosis* ; Risk Assessment ; Risk Factors ; ROC Curve ; Retrospective Studies