Lung cancer is the main cause of cancer-related death worldwide. Non-small cell lung cancer (NSCLC) accounts for about 80% of lung cancer cases, but only 25%-30% of initially diagnosed patients have the option of radical surgery because of the lack of effective measures for early diagnosis. For locally advanced and advanced NSCLC, radiotherapy alone or comprehensive treatment with chemoradiotherapy is the main treatment method; however, the curative effect is unsatisfactory. Recently, increasing evidence sug-gests that targeted drugs, such as epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs), combined with radiotherapy/chemoradiotherapy represent a promising treatment modality for NSCLC. This review will discuss the research status of EGFR-TKIs and radiotherapy for locally advanced and advanced NSCLC.

Background:CXC chemokine receptor type 2(CXCR2)is a member of G protein coupled receptor superfamily,and is mainly involved in the growth of tumor,angiogenesis and the pathogenesis of inflammatory diseases. Studies showed that CXCR2 was associated with the pathogenesis of inflammatory bowel disease(IBD),but the exact role has not yet been clarified. It was found that the interaction of interleukin-8(IL-8)with CXCR1 and CXCR2 played an important role in the pathogenesis of IBD. Aims:To investigate the expressions and significance of CXCR2 and IL-8 in patients with IBD. Methods:A total of 121 IBD patients in active stage from October 2013 to December 2014 at Zhongnan Hospital of Wuhan University were enrolled and assigned into Crohn’s disease(CD)group and ulcerative colitis(UC)group. Seventy healthy subjects were served as controls(HC). Expressions of IL-8 mRNA and CXCR2 mRNA in peripheral blood and intestinal mucosal tissue were determined by real-time PCR;expression of CXCR2 protein in intestinal mucosal tissue was determined by Western blotting. Results:In peripheral blood,expression of IL-8 mRNA in UC group was significantly higher than that in HC group(P = 0. 017),while expressions of CXCR2 mRNA in CD,UC and HC groups were not significantly different (P = 0. 285). In intestinal mucosal tissue,expressions of IL-8 mRNA in CD,UC and HC groups showed no significant difference(P = 0. 206),while expressions of CXCR2 mRNA in CD and UC groups were significantly higher than that in HC group(P = 0. 002;P < 0. 001),and expression of CXCR2 mRNA in UC group was significantly higher than that in CD group(P = 0. 005);expressions of CXCR2 protein in UC and CD groups were higher than that in HC group(P = 0. 049 P =0. 080). Conclusions:Expressions of CXCR2 mRNA and protein in intestinal mucosal tissue of patients with IBD, especially UC are significantly increased. Down regulation of CXCR2 expression in intestinal mucosa may provide a new target for treatment of UC. IL-8 is significantly highly expressed in peripheral blood of patients with UC,which suggests that IL-8 might be related mainly with UC.

Objective To investigate differential expressed protein in the intestinal mucosa of patients with inflammatory bowel disease (IBD) with antibody chips,and to explore the possible role of the screened proteins in pathogenesis of IBD.Methods The mucosa tissues of nine patients with ulcerative colitis (UC),nine patients with Crohn's disease (CD) and nine control individuals were collected.After total protein of each group was extracted,the differential expressed protein of each group was analyzed by Raybiotech L-series human cytokine antibody chips.The mucose tissues of other nine patients with UC,nine patients with CD and nine control individuals were collected,and were used to verify the greatly differential expressed proteins by Western blot.The t-test was performed to compare two groups.Results Compared with the control group,there was significantly difference in 263 cytokines of UC group,and 414 cytokines of CD group.And then the higher expressions of herpes virus entry mediator,leukemia inhibitory factor and platelet factor 4 in the mucosa tissues of IBD patients were confirmed by Western blot and the differences were statistically significant (UC:t=23.85,9.53,18.88; CD:t=13.54,16.65,13.67,all P＜0.01).Conclusion The screened differential expressed cytokines in the mucosa tissues of IBD patients by cytokine antibody chips could be helpful to reveal the pathogenesis of IBD and discover new molecular biomarkers.

Objective To investigate the effect of early cerebrospinal fluid replacement on nuclear factor-κB (NF-κB) level and clinical outcomes in patients with aneurismal subarachnoid hemorrhage (aSAH) after endovascular embolization.Methods Patients with aSAH received aneurysm embolization were enrolled.They were divided into a cerebrospinal fluid replacement group and a non-cerebrospinal fluid replacement group according to the treatment scheme.All patients were treated with cerebral aneurysm coil embolization within 3 days after admission.The cerebrospinal fluid replacement group performed lumbar puncture cerebrospinal fluid replacement within 24 h after coil embolization,once every other day,20-30 ml of cerebrospinal fluid was replaced each time and 3 mg dexamethasone was injected intrathecally.The NF-κB levels in cerebrospinal fluid were detected at day 1,7 and 14 after the coil embolization.The primary outcome measures were the clinical outcomes determined by the modified Rankin scale (mRS) and the Glasgow outcome scale (GOS) at 3 months after onset.Good outcome was defined as mRS score 0-2 or GOS ＞ 3.The secondary outcome measures included severe complications (hydrocephalus,cerebral vasospasm,cerebral infarction,and rebleeding) and death.Results A total of 81 patients with aSAH received aneurysm embolization were enrolled,including 42 in the cerebrospinal fluid replacement group and 39 in the non-cerebrospinal fluid replacement group.There was no significant differences in the baseline data between the cerebrospinal fluid replacement group and the non-cerebrospinal fluid replacement group (all P ＞0.05).The duration of neck stiffness in the cerebrospinal fluid replacement group was significantly shorter than that in the non-cerebrospinal fluid replacement group (11.3 ± 3.2 d vs.16.5 ± 3.5 d;t =6.985,P ＜ 0.001).The cerebrospinal fluid NF-κB levels were progressively reduced at day 1,7 and 14 after coil embolization in the cerebrospinal fluid rephcement group and non-cerebrospinal fluid rephcement group (all P ＜0.05),but the ccerebrospinal fluid levels of NF-κB in the cerebrospinal fluid replacement group at each time point were significantly lower than those in the non-cerebrospinal fluid replacement group (all P ＜ 0.01).The good outcome rates evaluated according to the mRS score (92.9％ vs.56.4％;x2 =14.446,P ＜ 0.001) and GOS score (97.6％ vs.76.9％;x2 =8.004,P=0.005) in the cerebrospinal fluid replacement group at 3 months were significantly higher than those in the non-cerebrospinal fluid replacement group,and the incidence of cerebral vasospasm was significantly lower than that in the non-cerebrospinal fluid replacement group (14.3％ vs.33.3％;x2 =4.086,P =0.043).Conelusiom Cerebrospinal fluid replacement therapy can reduce the incidence of cerebral vasospasm in patients with aSAH receiving aneurysm embolization and improve clinical outcomes.Its mechanism may be associated with the decrease of NF-κB level in cerebrospinal fluid.

Cell Membrane ; metabolism ; Gastrointestinal Stromal Tumors ; diagnosis ; metabolism ; Humans ; Immunohistochemistry ; Proto-Oncogene Proteins c-kit ; analysis

Objective To explore the causes of biliary complications related with liver donor fol- lowing liver transplantation.Methods Ninty-nine patients with improved liver donor treatment during liver transplantation from May 2005 to April 2006 were followed up and the clinical data were ana- lyzed.At the same time,the rate of biliary complications was compared with that occurring on 43 pa- tients with unimproved liver donor treatment.Results Only 4 in 99 patients with improved liver donor treatment had biliary leakage with the rate of biliary complications being 4% in comparison with 11% in those with unimproved liver donor treatment.Conclusion The improvement of liver donor treat- ment,including shortening heat-ischemia time,completely washing bile duct and remaining the whole blood supply of bile duct,can decline the occurrence of biliary complications.

Objective To investigate whether the change of beam set-up methods will influence the dosimetric quality of intensity modulated radiation therapy (IMRT) for non-small cell lung cancer (NSCLC).Methods Twenty-one stage Ⅰ-Ⅲ NSCLC patients were selected for this study.The technique of step and shoot was used and three different beam set-up methods were chosen for IMRT planning,including IMRT-7 with nine equal-spaced beams angled 0°,51°,102°,153°,204°,255°and 306°; IMRT-5 with five equal-spaced beams angled 0°,72°,144°,216°and 288°; and IMRT-5m which was created from IMRT-7 but excluded 2 fields (51°and 102° were omitted if there was lesion in the right lung,while 255°and 306° were excluded if there was lesion in the left lung).The dose constrains ofnormal lungs for IMRT were set according to V5-V60 of normal lungs obtained from the same patient's actually treated 3D-CRT dose volume histogram.The prescription dose for IMRT started from 65 Gy,and then escalated or decreased step by step by 2 Gy once a time until the best plan was obtained.Results For normal lung dose,IMRT-5m had lower V5-V25 than the other two groups; but there was no significant difference in V30-V40.IMRT-5 was the worst for V45-V60; and mean lung dose was lowest in IMRT-5m.Dose parameters of esophagus and spinal cord,target conformity index,and total monitor units were all similar among difference plans.IMRT-5m had lowest heart V40 compared to the other two groups.For target heterogeneity index,IMRT-5 was higher than IMRT-7,but there were no significant differences among IMRT-5m,IMRT-5 and IMRT-7.Compared to 3D-CRT,the prescription dose could be increased by (5.1 ±4.6) Gy for IMRT-7,(3.1 ±5.3) Gy for IMRT-5,and (5.5 ±4.8)Gy for IMRT-5m.Conclusion Fewer beams and modified beam angles could result in similar,even better plan quality.

Objective To preliminarily investigate the levels of interleukin (IL)-1 family and IL-34 in serum of patients with ankylosing spondylitis (AS) and their roles.Methods Serum IL-1 family levels were detected from 6 AS patients and 4 healthy controls by using protein-chip technique.Enzyme-linked immunosorbent assay (ELISA) method was used to detect the levels of serum IL-34 from 65 AS patients and 85 healthy controls and the relationships of serum IL-34 levels and clinical or laboratory features were analyzed.T test and Spearman correlation were used for statistical analysis.Results IL-1Ra [(3302±1352) pg/ml vs (10778±2764) pg/ml]and IL-36Ra [(1363±194) pg/ml vs (3875±996) pg/ml] levels were significantly down-regulated in AS patients compared with that of healthy controls (t=5.363 and 4.289 respectively,both P＜0.05).The levels of IL-1α,IL-18,IL-36α and IL-37 were increased more remarkable in AS patients than in healthy controls (t=-2.532,-5.400,-5.023 and-5.783 respectively,both P＜0.05).Moreover,serum IL-34 levels were elevated more significantly in AS patients than in healthy controls [(169±153) pg/ml vs (54±31) pg/ml,t=6.722,P＜0.01] and were positively correlated with the levels of CRP and ESR.Serum IL-34 levels were markedly up-regulated in human leukocyte antigen (HLA)-B27 positive patients than in HLA-B27 negative patients(P＜0.05).Conclusion Part of IL-1 family and IL-34 may be involved in inflammatory or immunological process of AS.

SCLC can spare more volume of the normal lungs and e-sophagus, and has the ability of dose escalation.

Objective To select the optimal registration method for on-line kilovoltage cone-beam CT (KVCBCT) guided lung cancer radiation and evaluate the reproducibility of the selected method. MethodsSixteen patients with non-small cell lung cancer were enrolled into this study.A total of 96 pre treatment KVCBCT images from the 16 patients were available for the analysis.Image registration methods were bone-based automatic registration,gray-based automatic registration,manual registration and semi-auto matic registration.All registrations were accomplished by one physician.Another physician blindly evaluated the results of each registration,then selected the optimal registration method and evaluated its reproducibili ty.Results The average score of the bone-based automatic registration,gray-based automatic registration, manual registration and semi-automatic registration methods was 2.4,2.7,3.0 and 3.7,respectively.The score of the four different groups had statistics significant difference (F = 42.20,P < 0.001).Using the semi-automatic registration method,the probability of the difference between two registration results more than 3 ram in the left-right,superior-inferior,and anterior-posterior directions was 0,3% and 6% by the same physician,0,14% and 0 by different physicians,and 8%,14% and 8% by physician and radiation therapist.Conclusions Semi-automatic registration method,possessing the highest score and accepted re producibility,is appropriate for KVCBCT guided lung cancer radiation.