AIM:To investigate the effects of bcl-3 gene on the migration and apoptosis of human colon cancer cell line RKO, and the changes of cyclin D1 and apoptosis-related proteins.METHODS:After silencing of bcl-3 gene expression in human colon cancer cell line RKO by lentiviral vector with RNA interference, the changes of RKO cell migration ability were investigated by wound healing assay.The changes of RKO cell apoptotic rate after bcl-3 gene silencing were detected by flow cytometry with Annexin V/PI staining.The protein expression of cyclin D1 and apoptosis-related proteins in the RKO cells after bcl-3 gene silencing was determined by Western blot.RESULTS:The wound healing rates of the RKO cells were 84.00% and 40.00% before and after bcl-3 gene silencing, respectively, with statistically significant difference (P<0.05).Annexin V/PI staining showed that the cell apoptotic rates were 12.89% and 59.67% before and after bcl-3 gene silencing, respectively, when RKO cells were treated with 5 μmol/L cisplatin for 24 h, with statistically significant difference (P<0.05).The expression of cyclin D1 decreased, while the expression of Bax increased after bcl-3 gene silencing (P<0.05).CONCLUSION:After bcl-3 gene silencing, the migration ability of RKO cells decreases, and the apoptotic rate increases, accompanying with the changes of cyclin D1 and Bax.bcl-3 gene can affect the apoptosis of RKO cells by changing the expression of cyclin D1 and Bax.

Objective To investigate the changes in volume and spatial location of target areas and normal tissues before and during intensity?modulated radiotherapy (IMRT) for cervical cancer by quantitative means. Methods Forty patients with cervical cancer who were treated with IMRT were enrolled as subjects. Computed tomography ( CT) was performed before IMRT and during IMRT when a dose of 27 Gy ( 15 fractions) was reached. Clinicians delineated the target areas and organs at risk in the two groups of CT images. The target areas and organs at risk in one group of images were mapped to the other group of CT image by image registration using the Pinnacle treatment planning system. Volume changes in target areas and organs at risk were analyzed, and changes in the spatial location were evaluated by volume difference method and Dice similarity method. Comparison was made by paired t?test. Results There were significant differences in gross target volumes of primary tumor lesions ( GTV?T) and pelvic metastatic lymph nodes (GTV?N) before and during IMRT ( P= 0?? 000; P= 0?? 000). According to the evaluation by volume difference method, the average rate of change in GTV?T was (38.64±19?? 50)% with a range between 3?? 16%and 86?? 49%, while the average rate of change in GTV?N was (42.49± 25?? 68)% with a range between 2?? 79% and 87?? 42%. In the organs at risk, the bladder had the maximum rate of volume change, the average of which was (55.13±33?? 40)% with a range between 3?? 25% and 116?? 01%. According to the evaluation by Dice similarity method, the average Dice similarity coefficient for GTV?T was 0.50± 0?? 18 with a range between 0?? 10 and 0?? 85, while the average Dice similarity coefficient for GTV?N was 0.31±0?? 20 with a range between 0?? 00 and 0?? 71. The rectum had the minimum Dice coefficient in the organs at risk, the average of which was 0.57± 0?? 14 with a range between 0?? 18 and 0?? 76 . Conclusions For patients with cervical cancer to receive IMRT, since there are substantial changes in volume and spatial location of target areas and normal tissues before and during treatment, it is quite necessary to modify the treatment regimen in time in order to provide adequate doses for target areas and avoid overdose for organs at risk.

Objective To investigate the influence of pre-administration of flurbiprofen on the hyperalgesia after remifentanil anesthesia.Methods This study included a total of 96 patients with abdominal surgery in the department of general surgery of our hospital.According to the random number table method,they were divided into 4 groups (n =24).Flurbiprofen axetil 1.5 mg/kg was injected intravenously before anesthesia in groups A1 and A2,flurbiprofen axetil was not injected in-travenously before anesthesia in groups B1 and B2.Anesthesia was maintained with infusion of remifentanil 0.1 μg·kg-1 ·min-1 in groups A1 and B1 0.4 μg·kg-1 ·min-1 in groups A2 and B2. The spontaneous breathing recovery time, consciousness recovery time,extubation time and anesthesia recover period of nausea,vomiting,restlessness and pain VAS scores were recorded. Results There was no significant difference in breath recovery time,consciousness recovery time and extubation time between the four groups.VAS score (9.0±1.8)was the highest in group B2,VAS score was significantly higher than the other three groups (P <0.05).VAS score (3.1±1.1)was the lowest in group A1, which was significantly lower than the other three groups (P < 0.05 ). Conclusion Pre-application of flurbiprofen 1.5 mg/kg can reduce postoperative hyperalgesia after remifentanil anesthesia in patients undergoing abdominal surgery.

Objective To study the safety and efficacy of fast track program in anorectal surgery perioperative period. Methods One hundred and sixty-nine cases of rectal cancer were divided into the study group of 86 patients with fast track program, and the control group of 83 patients with traditional programs by random digits table. Both groups were compared from the time out of bed, the first intestinal discharge time,intravenous fluids stopping time,length of hospital stay,total cost of treatment and the incidence of postoperative complications. Results The study group compared with the control group: the first intestinal discharge time [(33.6 ± 12.9) h vs. (81.7 ± 20.1) h], intravenous fluids stopping time [(4.5 ±1.3) d vs.(7.4 ± 1.6) d],and length of hospital stay [(5.6 ± 1.2) d vs.(8.9 ±2.7) d],the total cost of treatment [(15 000 ± 3000) yuan vs. (16 000 ± 4000) yuan], the differences were statistically significant (P ＜ 0.01 or ＜ 0.05),and had less incidence of postoperative complications in study group than that in control group [5.8% (5/86) vs. 16.9% (14/83)], the difference was statistically significant (P ＜ 0.05).Conclusions Fast track program in anorectal surgery perioperative period is safe and effective, beneficial,conducive to rehabilitation of patients.

Objective To analyze the status of quality of life (QOL) and the related factors in pa-tients with uasopharyngeal carcinoma (NPC) after radiotherapy, and to explore the significance of intensity modulated radiotherapy (IMRT) in decreasing side effects and improving QOL. Methods A questionnaire including 35 items was designed according to EORTC QLQ-30 and the related symptoms and side effects of NPC. 142 NPC patients surviving with disease-free after radiotherapy were surveyed for the evaluation of QOL. The median follow-up was 25 months. The information of social demography and clinical details were collected. The patients were divided into IMRT group (75 patients) and conventional radiotherapy (CRT) group (67 patients). A statistical software package SAS 8.1 was used to compare the marks of QOL between the groups and analyze the influencing factors. Results In IMRT group and CRT group, the marks of affec-tire cognitive domain were 82.8±14.7 and 77.5±16.0(t=2.07, P=0.040);and the marks of disease and treatment-related symptoms, and reactive domain were 78.9±10.3 and 69.8±13.3 (t=4.59, P=0.000). The marks were significantly different in xerostomia, trismus, deglutitory choke, hoarseness, re-striction of neck movement and dysphagia (P < 0.05). Of the influencing factors of QOL, the domain of body function was sex (regression coefficient was -4.692), the self-evaluation of total QOL were follow-up time and educational background (regression coefficients were -0.618 and 12.316, respectively), the fi-nancial status was family monthly income per capita (regression coefficient was -11.133), and the disease and treatment-related symptoms and reactive domain were group (techniques of radiation) and age (regression coefficients were -9.384 and -5.853, respectively). Conclusions IMRT could improve the QOL through decreasing the side effects of patients with NPC including xerostomia, trismus, restriction of neck movement and dysphagia. Sex, age, family monthly income per capita, educational background, fol-low-up time and the irradiation techniques may affect QOL.

Objective Infliximab is a kind of recombinant human mouse chimeric anti-tumor necrosis factor monoclonal antibody. Here we aimed to examine the impact of infliximab therapy on RANK/RANKL/OPG system in the peripheral blood of rheumatoid arthritis (RA) patients. Methods Fifty patients with RA were rigorously screened and randomly divided into 2 groups. One group was treated with infliximab (3 mg/kg)and methotrexate (MTX). As control, the other group was treated with MTX alone. Infliximab was administered at weeks 0, 2, 6 and 14. The expression of RANK, RANKL mRNA in the peripheral blood, serum OPG and clinical indicators changes at week 0 and 18 were compared.x2-test or t-test were used for statistical analysis.Results After treated with infliximab, bone damage of joints were slowed down when examined by radiography in RA patients compared with the control group. And the ratio of OPG/RANKL was also decreased in RA peripheral blood (w0: 80.25;w 18: 63.2); (control group w0: 83.37; w18: 30.87)(P＞0.05). Although after the treatment with either MTX alone [w0: (238±15) pg/ml; w18: (118±10) pg/ml] or infliximab combined with MTX [(w0: (223.1±6.2) pg/ml; w18:(162.4±5.5) pg/ml], the serum levels of OPG were all decreased (P＞0.05), the level of OPG in infliximab treatment group was declined slower than those in the control group. Conclusion RA bone destruction can be inhibited by the combination therapy of infliximab and MTX. The mechanism may be partly through the RANK/RANKL/OPG system.

OBJECTIVE To investigate the characteristics of hypopharyngeal carcinoma detected by narrow band imaging(NBI)endoscopy and evaluate the value of NBI in the early diagnosis of hypopharyngeal carcinoma. METHODS Between December 2008 and July 2009,a total of 46 consecutive patients with hypopharyngeal squamous cell carcinoma were enrolled in this study. High performance endoscopic system equipped with the white light mode and NBI mode was introduced in the examination of pharynx and larynx. The quality of visualization of morphologies of epithelial capillary and demarcation line of each lesion under NBI view was evaluated in comparison with conventional white light endoscopy. RESULTS Among the 46 patients,a total of 86 lesions were detected. The notable characteristic of hypopharyngeal squamous cell carcinoma is the well demarcated brownish area and scattered brown dots. The NBI laryngoscope could provide better visualization of morphologies of epithelial capillary and demarcation line in superficial carcinoma of hypopharynx than the white light mode(P

Objective To compare and analyze the dosimetric discrepancy of combind intracavitary/interstitial brachytherapy using three different kinds of optimization method in locally advanced cervical cancer.Methods Totally 20 cases of locally advanced cervical cancer were selected and divided into three groups according to different optimization method which include manual optimization group (MO) based on graphical optimization,inverse planning simulated annealing (IPSA 1)based on simulated annealing optimization algorithm,IPSA 2 based on IPSA 1 with limitation on maximum dose of target.The dose volume histogram parameters of the targets (V200,V150,V100,D100,D90,HI) and the OARs(D0.1 cm3,D1 cm3 and D2 cm3) were analyzed.Results For CTV,compared with MO,there was no significantly statistical difference in D100between IPSA 1 and IPSA 2(P ＞ 0.05).However,V200,V150,V100 and HI for ISPA1 were better than for ISPA2 (t =-3.422-9.910,P ＜ 0.05).In addition,V100 and D100 in ISPA1 were better than in ISPA2 (t =7.238,5.032,P ＜0.05).For OARs,D0.1 cm3,D1 cm3 and D2 cm3 in rectum,bladder,sigmoid colon of both ISPA 1 and ISPA 2 were dramatically lower than those of MO (t =2.235 5.819,P ＜ 0.05),without significantly statistical difference found between ISPA1 and ISPA2.Conclusions For combined intracavitary/interstitial brachytherapy in locally advanced cervical cancer,all treatment plans based on three different kinds of optimization methods can meet the clinical need.Moreover,inverse optimization can ensure dose coverage over target and reduce maximum dose of rectum,bladder and sigmoid colon.

Purpose: RIOK1 has been proved to play an important role in cancer cell proliferation and migration in various types of cancers—such as colorectal and gastric cancers. However, the expression of RIOK1 in breast cancer (BC) and the relationship between RIOK1 expression and the development of BC are not well characterized. In this study, we assessed the expression of RIOK1 in BC and evaluated the mechanisms underlying its biological function in this disease context. Materials and Methods: We used immunohistochemistry, western blot and quantitative real-time polymerase chain reaction to evaluate the expression of RIOK1 in BC patients. Then, knockdown or overexpression of RIOK1 were used to evaluate the effect on BC cells in vitro and in vivo. Finally, we predicted miR-204-5p could be a potential regulator of RIOK1. Results: We found that the expression levels of RIOK1 were significantly higher in hormone receptor (HR)–negative BC patients and was associated with tumor grades (p=0.010) and p53 expression (p=0.008) and survival duration (p=0.011). Kaplan-Meier analysis suggested a tendency for the poor prognosis. In vitro, knockdown of RIOK1 could inhibit proliferation, invasion, and induced apoptosis in HR-negative BC cells and inhibited tumorigenesis in vivo, while overexpression of RIOK1 promoted HR-positive tumor progression. MiR-204-5p could regulate RIOK1 expression and be involved in BC progression. Conclusion These findings indicate that RIOK1 expression could be a biomarker of HR-negative BC, and it may serve as an effective prognostic indicator and promote BC progression.

OBJECTIVE To provide reference for rational use of cyclin-dependent kinase 4/6 （CDK4/6） inhibitors. METHODS Retrieved from Web of Science， PubMed， SpringerLink， CNKI， Wanfang Data and VIP database， and so on， the literature about lung toxicity related to CDK4/6 inhibitors were collected and analyzed statistically with Excel 2013 software. RESULTS A total of 12 literature which met the inclusion and exclusion criteria were included； 13 patients were involved， among which 3 cases were from the United States， 3 from Japan， 2 from India， and 1 from Israel， Spain， France， Australia and Saudi Arabia respectively； all patients were female， aged between 43-89 years， of whom 8 were treated with palbocicilib， 3 with abemacilib， and 2 with ribociclib. The lung toxicity of patients after medication occurred from 1 week to 15 months； the majority of patients were hospitalized with the symptom such as difficulty breathing， chest tightness， shortness of breath， dry cough， etc. The lung toxicity mainly manifested as interstitial lung disease， eosinophilic pneumonia， mediastinal and pulmonary granulomatous reaction， drug-induced pneumonia， diffuse alveolar damage， organizing pneumonia and so on. The shortest treatment duration was 3 weeks， and the longest was 6 months. The treatment measures included drug withdrawal， intravenous use of antibiotics， intravenous use of systemic steroids， oxygen inhalation， and so on； after treatment， 8 patients improved or recovered， and 5 patients died due to deterioration. One patient developed lung toxicity again after reuse of such drugs and must stop drugs permanently. CONCLUSIONS Lung toxicity related to CDK4/6 inhibitors possibly cause mortality. It is necessary to make early judgment， stop the drug in time， and give patients systemic steroids， oxygen inhalation and other treatment measures as soon as possible.