Objective The literature study the setup errors of head and neck, thoracic, abdominal and pelvic tumors by megavoltage fan-beam CT based image guidance in TOMO-HD to provide the margin enlarging from clinic target volume (CTV) to planning target volume (PTV) in treatment planning system of TOMO-HD. Methods 103 patients with head and neck (30 patients), thoracic (42 patients), abdominal and pelvic (31 patients) carcinoma were enrolled. Megavoltage fan-beam CT based image guidance in tomotherapy-HD was used to acquire CT scan before every treatment. The left-right (X), superior-inferior (Y), anterior-posterior (Z) and rotation (Fy) setup errors of patients can be obtained from the tomography image automatically restructured by the system. Calculating the systematic error and the random error in the three dimensions and check whether the setup data accord with the normal distribution or not, then acquire the data expand in the three directions. Results According to 2593 fan-beam CT scans, the shift errors (µ ± s) in X, Y, Z and Fy (rotation) of three study group were [(−0.31 ± 2.16) mm、(1.09 ± 3.56) mm、(2.36 ± 2.27) mm, (0.29 ± 0.96)°] (head and neck tumor), [(−0.98 ± 2.95) mm、(0.45 ± 6.86) mm、(3.79 ± 2.47) mm, (0.18 ± 0.60)°] (thoracic cancer) and [(−0.86 ± 2.85) mm、(−1.59 ± 6.91) mm、(5.77 ± 2.40) mm, (0.20 ± 0.68)°](abdominal and pelvic carcinoma). The systematic errors (∑) and random errors (σ) in X, Y, Z dimensions of patients with head and neck, thoracic, abdominal and pelvic tumors were (1.06 mm and 1.84 mm), (1.93 mm and 3.43 mm), (2.41 mm and 2.71 mm), (1.10 mm and 2.56 mm), (3.79 mm and 5.46 mm), (1.38 mm and 1.99 mm) and (1.39 mm and 0.87 mm), (4.98 mm and 5.69 mm), (1.19 mm and 2.05 mm), respectively. Conclusion It is recommended as a reference for image guidance in TOMO-HD according to the frequency distribution of setup errors, for patients with head and neck, chest and abdominal and pelvic tumors, the maximum range of motion in three dimensions are (5.00, 5.00, 5.00) mm, (6.63, 17.25, 16.00) mm and (6.49, 16.24, 13.60) mm.

Objective To compare the set up errors derived from different registration methods of the X-ray volume imaging (XVI) system for radiotherapy in the treatment of middle/lower-segment esophageal cancer, and to provide a reference for radiation treatment of esophageal cancer. Methods We randomly selected 63 patients with middle/lower-segment esophageal cancer, and obtained their reconstructed XVI images at the first therapy to perform automatic registration with gray-value and bone registration methods. We acquired and compared the three translation errors (along x [left to right], y [head to feet], and z [front to back] axes) and three rotation errors (around the x, y, and z axes) derived from the two registration methods. Results Gray-value registration had significantly smaller translation errors along the x and z axes than bone registration (x azes t = −2.78, z azes t = −2.15, P < 0.05), but there was no significant difference along the y axes (P > 0.05). The rotation errors around the three axes were all smaller than 1°, and were smaller with gray-value registration than with bone registration, but without significant differences (P > 0.05). Conclusion We recommend gray-value registration for radiotherapy in the treatment of middle/lower-segment esophageal cancer. Manual verification or fine-tuning is recommended after automatic registration in clinical practice. Besides translation errors, rotation errors should also be paid attention to.

OBJECTIVETo explore the factors influencing total complete remission (CR), recurrence, disease-free survival (DFS) rate and overall survival (OS) rate in adults with Philadelphia (Ph) chromosome negative acute lymphoblastic leukemia (ALL) and the effect of subsequent allogeneic hematopoietic stem cell transplantation (allo-HSCT) on prognosis.

METHODSThe clinical data of 87 adult patients with Ph negative ALL were retrospectively analyzed, the CHOP regimen plus L-asparaginase (L-Asp) was used for the induction therapy, and the CHOP+ modified Hyper-CVAD or methotrexate was set up as the consolidation chemotherapy regimen. After consolidation chemotherapy for 3-6 courses, 45 patients (51.72%) received allo-HSCT , and 42 patients (48.28%) continually received the maintained consolidation chemotherapy. The average follow up time of the surviving patients was 40.13 (3-60 months).

RESULTSOut of 87 patients with PhALL one patient died (1.15%). In 86 patients who could be evaluated, 68 cases (79.67%) reached CR at the end of 1 course, 80 cases obtained CR (93.02%). Multivariate regression analysis showed that the enlargement of lever, spleen and lymphomode, WBC count≥ 100×10/L were affecting factors for total CR (P<0.05). Among 80 cases with CR, 27 cases (33.75%) relapsed, 5 years' overall survival (OS) rate and disease-free survival (DFS) rate were 47.50% and 45.00% respectively. Multivariate regression analysis yet showed that the induction chemotherapy without L-Asp, presence of CNS leukemia at diagnosis, absence of allo-HSCT and no CR after indution chemotherapy for 4 weeks were affecting factors for relapse and poor prognosis of patients (P<0.05). According to 4 prognostic factors such as presence of CNS leukemia or no, WBC count≥100×10/L or no, induction chemotherapy with L-Asp or no and CR after induction chemotherapy for 4 weeks or no, 86 patients were divided into low-risk group (without poor prognostic factor), middle-risk group (with 1 poor prognostic factor), high-risk group (with 2-4 poor prognostic factors). Statistical results showed that allo-HSCT treatment in low-risk group had no significant effect on OS and DFS (P>0.05). The rate of OS and DFS in middle and high-risk group were significantly higher than those of patients without allo-HSCT treatment (P<0.05).

CONCLUSIONPatients with central nervous system leukemia, high white blood cell count (≥100×10/L), induction chemotherapy without L-Asp, no CR after 4 weeks of chemotherapy and absence of allo-HSCT treatment are the factors influencing the prognosis of adult patients with Ph negative ALL, so the patients with those poor prognostic factors should take active treatment of allo-HSCT.

Adult ; Disease-Free Survival ; Hematopoietic Stem Cell Transplantation ; Humans ; Philadelphia Chromosome ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Prognosis ; Remission Induction ; Retrospective Studies

OBJECTIVETo investigate the predictive value of P53, Ki-67, HER2 protein detection in neoadjuvant chemotherapy for adenocarcinoma of gastroesophageal junction (AGEJ).

METHODSPreoperative biopsy specimens and clinical data of 72 patients of locally advanced Siewert II AGEJ between June 2010 and December 2013 were reviewed. All the patients received SOX scheme neoadjuvant chemotherapy, and were divided into effective group (complete response plus partial response) and ineffective group (stable disease plus progressive disease). Expressions of above 3 proteins were detected by immunohistochemistry in all the patients before neoadjuvant chemotherapy. The relationship between various proteins and efficacy of chemotherapy was analyzed by univariate and logistic multivariate regression analyses.

RESULTSAll the 72 patients successfully completed 2 cycles of SOX neoadjuvant chemotherapy, among them, 5 cases (6.9%) with complete response, 30 cases (41.7%) with partial response, 31 cases (43.1%) with stable disease, 6 cases (8.3%) with progressive disease, including 35 cases in effective group and 37 cases in ineffective group. Compared with ineffective group, the positive expression rate of P53 was significantly reduced (25.0% vs. 45.9%, P=0.020), and that of Ki-67 significantly increased (77.1% vs. 43.2%, P=0.003), however, there was no significant difference in the expression rate of HER2 between the two groups (P>0.05). Multivariate analysis showed that Ki-67 was the independent predictive factor for the efficacy of neoadjuvant chemotherapy (P=0.015). Spearman rank correlation showed that Ki-67 expression was positively correlated with HER2 expression (r=0.259, P=0.028), but P53 expression was not correlated with Ki-67 or HER2 (r=0.140, 0.042, P=0.240, 0.725, respectively).

CONCLUSIONSSOX neoadjuvant chemotherapy is safe and effective for AGEJ, especially for patients with depressed expression of P53 and elevated expression of Ki-67, which both may be used as reference for the prediction of chemotherapy efficacy. There is no correlation between P53 and Ki67 proteins, so combined detection may improve the predictive value.

Adenocarcinoma ; diagnosis ; drug therapy ; Esophageal Neoplasms ; diagnosis ; drug therapy ; Esophagogastric Junction ; pathology ; Humans ; Immunohistochemistry ; Ki-67 Antigen ; metabolism ; Neoadjuvant Therapy ; Receptor, ErbB-2 ; metabolism ; Remission Induction ; Tumor Suppressor Protein p53 ; metabolism

OBJECTIVETo explore the characteristics of cell apoptosis and proliferation of corpus cavernosum smooth muscle (CCSM) cells in diabetic rats.

METHODSFrom a SD rat model of diabetes induced by a single dose of streptozotocin, CCSM cells were isolated for primary culture and identified using immunocytochemical assays for SMα-actin. The proliferation of CCSM cells was evaluated by WST-1 assay, and flow cytometry was used to detect the cells apoptosis. Real-time fluorescence quantitative RT-PCR (qRT-PCR) was used to analyze the relative expression of proliferation cell nucleus antigen (PCNA) and caspase-3 mRNA.

RESULTSThe proliferation rate of the primarily cultured CCSM cells from diabetic rats was significantly decreased and the apoptosis rate significantly increased compared with those of the cells from the control rats. The expression of PCNA mRNA was significantly lowered while caspase-3 mRNA significantly increased in the corpus cavernosum of the diabetic rats (P<0.001).

CONCLUSIONIn rats with persisted hyperglycemia, a higher apoptosis rate and a lower proliferation rate both contribute to the reduction of CCSM cells.

Animals ; Apoptosis ; physiology ; Cell Proliferation ; Diabetes Mellitus, Experimental ; pathology ; Male ; Myocytes, Smooth Muscle ; pathology ; Penis ; cytology ; physiopathology ; Primary Cell Culture ; Proliferating Cell Nuclear Antigen ; genetics ; metabolism ; RNA, Messenger ; genetics ; metabolism ; Rats ; Rats, Sprague-Dawley

The purpose of this study was to compare the detection of trisomy 8 in myelodysplastic syndrome (MDS) patients with interphase fluorescence in situ hybridization (FISH) and cytogenetic karyotype analysis. Using Spectrum Green labeled chromosome 8 centromere probe, interphase FISH was established. The trisomy 8 clones were simultaneously detected in 48 MDS cases with FISH and conventional cytogenetic analysis (CCA). Results showed that the CCA revealed no significant difference of constitutional proportion between MDS-RA and MDS-RAEB with karyotypes of whole +8, partial +8 and one +8. With FISH, detectable rates were 66.1% for whole +8. Partial +8 and sole +8 were significantly higher than one +8 and complex +8, respectively. The percentages of trisomy 8 were similar in MDS-RA and MDS-RAEB. Trisomy 8 was detected in 1 of 15 specimens with normal or abnormal karyotype without trisomy 8 by FISH. There was linear correlation between the percentages of partial +8 detected by FISH and CCA. Two patients received CCA and FISH examination at diagnosis and during treatment, the percentage of trisomy 8 was increased with progress of disease. In conclusion, our results showed that FISH is a sensitive and accurate technique to detect trisomy 8 in MDS patients. It can provide contribute to diagnosis, assessment of curative effect and predicting progress of disease in MDS. Clone size of trisomy 8 does not related to classification of MDS, but sole +8 is seems to see in MDS-RA frequently.
Chromosomes, Human, Pair 8 ; genetics ; Humans ; In Situ Hybridization, Fluorescence ; Karyotyping ; Myelodysplastic Syndromes ; genetics ; pathology ; Reproducibility of Results ; Sensitivity and Specificity ; Trisomy

Adult ; Aged ; Aged, 80 and over ; Colles' Fracture ; therapy ; Female ; Fracture Fixation ; Humans ; Male ; Middle Aged ; Splints

OBJECTIVE: To explore the association among job burnout, tolerance to uncertainty and working with sickness in clinical nurses. METHODS: A total of 1 159 clinical nurses from 10 cities in Henan Province and Fujian Province were recruited by stratified cluster sampling method and tested by questionnaires including the Chinese Perceived Stress Scale-14, the Intolerance of Uncertainty Scale-12, the Sickness Presenteeism Questionnaire, and the Maslach Burnout Inventory-general Survey. Bootstrap was used to analyze the association among perceived stress, tolerance to uncertainty, working with sickness and job burnout. RESULTS: Perceived stress score was(31.4±4.8), and 802(69.2%) of nurses had high perceived stress level. The score of tolerance to uncertainty was(29.8±8.5), and the score of working with sickness score was(5.5±2.0). The job burnout score was(47.9±11.8), and 570(49.2%) nurses had job burnout. Bootstrap test results showed that the perceived stress score positively affected job burnout score [standardized partial regression coefficient(β)=0.30, P<0.01]. Working with sickness score played a regulatory role between perceived stress and job burnout scores(β=0.16, P<0.01), and tolerance to uncertainty score played an intermediary role between perceived stress and job burnout scores(β=0.08, P<0.01). The regulating effect of working with sickness score played a role through the mediation of tolerance to uncertainty score. CONCLUSION: Job burnout was very serious in clinical nurses. Perceived stress can directly or through tolerance to uncertainty affect the job burnout of clinical nurses and is synergistically affected by sickness presenteeism.

Objective: To explore the mediating effect of interpersonal sensitivity between social adaptation and openness, as well as the moderating role of peer attachment among offenders in community. Methods: Totally 155 offenders from 5 communities in Yinchuan city were investigated by symptom self-rating scale, NEO five-factor inventory(NEO-FFI), social adaptability scale and the inventory of parent and peer attachment-revised. Using the macro program PROCESS of SSPS to test the mediating effect of interpersonal sensitivity and the moderating role of peer trust. Results: The scores of interpersonal sensitive subscale of the symptom checklist 90, the openness subscale of NEO five-factor inventory, the inventory of parent and peer attachment-revised were (1.52±0.48), (3.05±0.30), (0.72±0.60) and (83.40±12.17), respectively. Openness, peer attachment were positively correlated with social adaptation (r=0.25, 0.44, P<0.01), and negatively correlated with interpersonal sensitivity (r=-0.18, -0.37, P<0.05). Interpersonal sensitivity was negatively correlated with social adaptation (P<0.01). Peer trust had a significant moderating effect on openness and interpersonal sensitivity (β=0.02, SE=0.01, P<0.05). Interpersonal sensitivity played a mediating role in the relationship between openness and social adaptation (β=-0.38, SE=0.10, P<0.01). In case of high peer trust(β=-0.59, SE=0.19, P<0.001) and mid-level of peer trust(β=-0.28, SE=0.11, P<0.05), there were both significant effect between openness and social adaptation. Conclusion Openness influences the social adaptation though interpersonal sensitivity, while peer trust moderates the effect of openness on social adaptation.

Objective:To investigate the effect of actin related protein 2/3 complex subunit 2 (ARPC2) gene silencing on the biological characteristics of papillary thyroid carcinoma (PTC) TPC-1 cells through lentivirus-mediated RNA interference.Methods:TPC-1 cells infected with nonsense short hairpin RNA (shRNA) sequence lentivirus (shCtrl) was used as the control group. TPC-1 cells infected with ARPC2 shRNA interference sequence lentivirus (shARPC2) was used as the experimental group, in which the expression of ARPC2 gene was specifically interfered. The effects of silencing the expression of ARPC2 gene on the proliferation of TPC-1 cells were detected by using methyl thiazolyl tetrazolium (MTT) assay, flow cytometry, Western blot and colony formation test. Flow cytometry and Western blot were conducted to detect the effect of silencing ARPC2 gene on TPC-1 cells apoptosis and related proteins.Results:shARPC2 could efficiently infect TPC-1 cells, and the expression efficiency of green fluorescent protein was over 85%. Compared with the control group, TPC-1 proliferation was inhibited in the experimental group. The ratio of S-phase cells in the experimental group was reduced compared with that in the control group [(14.79±0.21)% vs. (21.13±0.33)%, t = 27.77, P < 0.05]. The ratio of G 1 and G 2/M-phase cells in the experimental group was increased compared with that in the control group [G 1 phase: (67.57±0.08)% vs. (62.06±0.36)%, t=25.56, P < 0.05; G 2/M phase: (17.64±0.12)% vs. (16.91±0.17)%, t=6.154, P < 0.05]. Meanwhile, the expressions of cell cycle-related proteins CDK2, CyclinE and CyclinD were reduced in the experimental group. The number of clone formation in the experimental group was less than that in the control group, the difference was statistically significant [(10±2) vs. (161±6), t=9.011, P < 0.05]. In addition, the apoptotic ratio of cells in the experimental group was higher than that in the control group [(8.60±0.77)% vs. (4.08±0.40)%, t=9.011, P < 0.05]. Western blot showed that the expressions of anti-apoptotic factors p21 and bcl-2 were reduced in the experimental group, while the expression of pro-apoptotic factor bax was increased. Conclusion:The interference with the expression of ARPC2 regulated by shRNA can inhibit the proliferation, and promote the apoptosis of PTC TPC-1 cells, indicating that ARPC2 may be a possible biological new target for the treatment of PTC.