Objective: The aim of this study was to evaluate the effect of chemotherapy combined with radiotherapy for the treatment of the patients with advanced nasopharyngeal carcinoma. Methods: Between June,1992 and January,1995, 110 patients with Stage Ⅲ , Ⅳ a nasopharyngeal carcinoma ( 92 stage system) at random received one course of chemotherapy [cisplatin 20 mg· (m2· d)-1 iv on days 1-5 and 5-fluorouracil 500 mg· (m2· d)-1 iv on days 1-5.] before radiotherapy (which started 3 days after the first cycle of chemotherapy ) and three to five cycles of postradiotherapy chemotherapy (chemotherapy/radiotherapy: including 55 patients) or radiotherapy alone (radiotherapy group:including 55 patients). The methods and time/dose schedule of radiotherapy were similar in the two groups. Results: The 5-year survival rate was 65.5％ in the chemotherapy/radiotherapy as compared with 34.5％ in the radiotherapy group (P=0.0012). The primary lesion control rates were 69.1％ (chemotherapy/radiotherapy) and 43.6％ (radiotherapy group), respectively(P=0.0071). The cervical lymph node control rates were 67.3％ (chemotherapy/radiotherapy) and 45.4％ (radiotherapy group), respectively (P=0.021). The distant metastatic rate was 21.8％ (chemotherapy/radiotherapy) versus 41.8％ (radiotherapy group), respectively (P=0.0243). There was no significant difference in the incidence and severity of acute mucositis between the two groups during radiotherapy. Conclusion:This prospective study has demonstrated that alternating cisplatin/5-fluorouracil chemotherapy and early administration of locoregional radiotherapy can improve the survival and local disease control , and delay the distant metastasis in the patients with advanced nasopharyngeal carcinoma.

OBJECTIVETo investigate the effects of inspiratory muscle training followed by non-invasive positive pressure ventilation in patients with severe chronic obstructive pulmonary disease (COPD).

METHODSThis investigator-initiated randomized, controlled trial recruited 88 patients with stable GOLD stage IV COPD, who were randomized into 4 equal groups to continue oxygen therapy (control group) or to receive inspiratory muscle training followed by non-invasive positive pressure ventilation (IMT-NPPV group), inspiratory muscle training only (IMT group), or noninvasive positive pressure ventilation only (NPPV group) for at least 8 weeks. The outcomes of the patients were assessed including the quality of life (SRI scores), maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), dyspnea (MRC scores), 6-min walking distance (6MWD) and lung function.

RESULTSs Compared to baseline values, SRI scores, 6MWT and MRC scores increased significantly after 8 weeks in IMT-NPPV, IMT and NPPV groups, and the improvements were significantly greater in IMT-NPPV group than in IMT and NPPV groups (P<0.05 for all). In IMT-NPPV and IMT groups, MIP and MEP increased significantly after the training (P<0.05), and the improvement was more prominent in IMT-NPPV group (P<0.05). No significant changes were found in pulmonary functions in the groups after 8 weeks of treatment (P>0.05).

CONCLUSIONInspiratory muscle training followed by non-invasive positive pressure ventilation, compared with inspiratory muscle training or non-invasive positive pressure ventilation alone, can better enhance the quality of life, strengthen the respiratory muscles, improve exercise tolerance and relieve the dyspnea in patients with COPD.

Dyspnea ; therapy ; Exercise Tolerance ; Humans ; Lung ; physiopathology ; Noninvasive Ventilation ; Physical Conditioning, Human ; Positive-Pressure Respiration ; Pulmonary Disease, Chronic Obstructive ; therapy ; Quality of Life ; Respiratory Muscles ; physiopathology

Objective To explore the possible role of voltage-gated potassium channel-interacting protein 1 (KChIP1) in the pathogenesis of epilepsy. Methods Sprague Dawley female adult rats were treated with pentylenettrazole (PTZ) to develop acute and chronic epilepsy models. The approximate coronal sections of normal and epilepsy rat brain were processed for immunohistochemistry. Double-labeling confocal microscopy was used to determine the coexistence of KChIP1 and gamma-aminobutyric acid (GABA). Results KChIP1 was expressed abundantly throughout adult rat brain. KChIP1 is highly co-localize with GABA transmitter in hippocampus and cerebral cortex. In the acute PTZ-induced convulsive rats, the number of KChIP1-postive cells was significantly increased especially in the regions of CA1 and CA3 (P < 0.05); whereas the chronic PTZ-induced convulsive rats were found no changes. The number of GABA-labeled and co-labeled neurons in the hippocampus appeared to have no significant alteration responding to the epilepsy-genesis treatments. Conclusion KChIP1 might be involved in the PTZ-induced epileptogenesis process as a regulator to neuronal excitability through influencing the properties of potassium channels. KChIP1 is preferentially expressed in GABAergic neurons, but its changes did not couple with GABA in the epileptic models.

The rapidly evolving aging society in China is associated with increased incidences of osteoporosis and fractures, which have become common health problems that threaten the quality of life of the elderly. Gut microbiota colonizing in the human intestinal tract form a mutual symbiotic relationship with the host and play an important role in the metabolism and immune regulation of the host. In recent years increasing studies have demonstrated that gut microbiota not only affect the digestive system but also contribute to the disease conditions involving the immune system, and have a close relationship with the occurrence and progression of osteoporosis. This review summarizes the progress and hotspots in recent researches of the associations among gut microbiota, the immune system, osteoporosis.
Aged ; Aging ; China ; Gastrointestinal Microbiome ; Gastrointestinal Tract ; microbiology ; Humans ; Microbiota ; Osteoporosis ; microbiology ; Quality of Life

OBJECTIVETo compare the long-term outcomes of arthroscopy and non-surgical therapy in patients with knee synovial plica syndrome (SPS).

METHODSThirty-one patients with knee SPS undergoing arthroscopic surgery and 27 SPS patients undergoing conservative treatment with articular cavity injection of sodium hyaluronate (control group) were compared for visual pain score (VAS) and the Lysholm score before and after the operation. The patients were followed-up for more than 5 years, and the long-term outcomes were compared using Kaplan-Meier survival analysis.

RESULTSs VAS and the Lysholm scores in both groups were significantly lowered after treatment (P<0.05). The postoperative VAS score was significantly lower while the Lysholm score significantly higher in arthroscopic surgery group than in the control group (P<0.05). Arithmetic mean and the median time of curative effect maintenance were 49 and 43 months in arthroscopic surgery group, as compared with 33 and 29 months in the control group, respectively; the cumulative effect maintenance rate in arthroscopic surgery group was significantly higher than that in the control group (Χ2=4.933, P=4.933).

CONCLUSIONArthroscopic treatment produces better therapeutic effect on knee joint SPS and ensures longer long-term therapeutic effect maintenance than conservative treatment.

Adult ; Arthroscopy ; Female ; Follow-Up Studies ; Humans ; Hyaluronic Acid ; administration & dosage ; Injections, Intra-Articular ; Joint Diseases ; surgery ; Knee Joint ; pathology ; surgery ; Male ; Pain, Postoperative ; Postoperative Period ; Synovectomy ; Synovial Membrane ; pathology ; Treatment Outcome

OBJECTIVETo study the clinical value of digital 3D technique combined with nanocarbon-aided navigation in endoscopic sentinel lymph node biopsy for breast cancer.

METHODSThirty-nine female patients with stage I/II breast cancer admitted in our hospital between September 2014 and September 2015 were recruited. CT lymphography data of the patients were segmented to reconstruct digital 3D models, which were imported into FreeForm Modeling Surgical System Platform for visual simulation surgery before operation. Endoscopic sentinel lymph node biopsy and endoscopic axillary lymph node dissection were then carried out, and the accuracy and clinical value of digital 3D technique in endoscopic sentinel lymph node biopsy were analyzed.

RESULTSs The 3D models faithfully represented the surgical anatomy of the patients and clearly displayed the 3D relationship among the sentinel lymph nodes, axillary lymph nodes, axillary vein, pectoralis major, pectoralis minor muscle and latissimus dorsi. In the biopsy, the detection rate of sentinel lymph nodes was 100% in the patients with a coincidence rate of 87.18% (34/39), a sensitivity of 91.67% (11/12), and a false negative rate of 8.33% (1/12). Complications such as limb pain, swelling, wound infection, and subcutaneouseroma were not found in these patients 6 months after the operation.

CONCLUSIONEndoscopic sentinel lymph node biopsy assisted by digital 3D technique and nanocarbon-aided navigation allows a high detection rate of sentinel lymph nodes with a high sensitivity and a low false negative rate and can serve as a new method for sentinel lymph node biopsy for breast cancer.

Axilla ; Breast Neoplasms ; diagnosis ; Endoscopy ; Female ; Humans ; Imaging, Three-Dimensional ; Lymph Node Excision ; Lymphatic Metastasis ; Nanoparticles ; Sentinel Lymph Node ; pathology ; Sentinel Lymph Node Biopsy

OBJECTIVETo delineate the effects of HBV X gene and of As(2)O(3) on p53 expression and activity in HepG2 cells by shRNA-mediated RNA interference (RNAi).

METHODSHepG2 cells and cells with stable expression of HBV X gene, HepG2-X, were treated with 2 micromol/L As(2)O(3), and the corresponding untreated cells were used as controls. Cell and nuclear lysates were extracted. Total level and the relative activity absorbance of p53 were detected by modified ELISA. HBV X gene sequence-specific shRNA expression vectors, Xi-S1 and Xi-S2, and sequence-unrelated control Xi-S3 were transfected into HepG2-X. The effect of As(2)O(3) on p53 expression and activity were retested.

RESULTSTotal p53 level was up-regulated and its relative activity ratio was enhanced by As(2)O(3) in HepG2 and HepG2-X cells. The total p53 level induced by As(2)O(3) was further up-regulated by HBX expression, while its relative activity was significantly suppressed. The suppression was removed after HBX expression was suppressed by shRNA.

CONCLUSIONAs(2)O(3) could up-regulate p53 expression and enhance its activity. shRNA-mediated RNA interference is conveniently being used in studies on the effect of HBV X gene expression on p53 expression and activity. HBV X expression could up-regulate p53 gene expression level induced by As(2)O(3), while it suppressed the activity of p53.

Apoptosis ; Arsenicals ; pharmacology ; Gene Expression ; Hep G2 Cells ; Hepatitis B virus ; genetics ; Humans ; Oxides ; pharmacology ; RNA, Small Interfering ; Trans-Activators ; genetics ; Tumor Suppressor Protein p53 ; genetics ; metabolism

OBJECTIVETo investigate foot biomechanics characteristic of patients with type 2 diabetes mellitus.

METHODSThis study was conducted among 303 patients with type 2 diabetes. The whole foot was divided into 10 regions, namely the first toe (T1); the second to fifth toes (T2-5); the first, second, third, fourth, and fifth metatarsals (M1, M2, M3, M4, and M5, respectively); midfoot (MF), and the heel medial (HM). Foot arch index, foot angle and maximum peak pressure (MPP) of the 10 regions were measured using a Footscan gait system.

RESULTSThe maximum peak pressure of 10 regions decreased in the order of M3>M2>HM>M4>HL>M1>M5>T1>ML>T2-5 for the left foot, and in the order of M3>M2>HM>M4>HL>M1>M5>T1>ML>T2-5 for the right foot. The MPP in M1 region was higher in the right than in the left foot (P<0.05). The MPP in M3, M4, M5, and MF was higher in the left than in the right foot (P<0.05). The percentage of high-risk foot (defined by a total plantar pressure ≥70 N/cm) was 34% on the left and 17.7% on the right. An increased BMI was associated with a significant increase in high-risk foot, but not for the right foot in underweight patients. Foot flat phase was extended and forefoot push-off phase shortened in stance phase in the patients. Compared with the right foot, the left foot showed a significantly increased foot arch index and increased low and high arch rates with a decreased normal arch rate. Total plantar pressure was higher in of the left high arch foot than in normal arch foot. The foot angle was significantly larger on the right than on the left. The bilateral total plantar pressures were significantly greater in male patients (P<0.05) and increased with age but were not associated with the duration of DM, foot angle, or glycosylated hemoglobin level.

CONCLUSIONDiabetic patients have obvious alterations in foot biomechanics with abnormalities of the plantar pressure, and the percentage of high-risk foot increases in overweight and obese patients, suggesting the need of body weight control in these patients when administering offloading treatment for prevention of diabetic foot ulcer.

Biomechanical Phenomena ; Diabetes Mellitus, Type 2 ; physiopathology ; Diabetic Foot ; prevention & control ; Female ; Foot ; physiopathology ; Gait ; Heel ; physiopathology ; Humans ; Male ; Obesity ; physiopathology ; Overweight ; physiopathology ; Pressure

BACKGROUNDHepatitis B virus (HBV) X protein (HBx) and p53 could mutually down-regulate at transcriptional level and HBx could bind with p53 protein within its transactivation domain and inhibit the function of p53 protein. In recent years, effects of arsenic trioxide (As2O3) on the expression of p53 protein have been widely studied, while little is known about the activity of p53 protein. This study was undertaken to delineate the effect of HBV X gene and As2O3 on p53 protein expression (level and activity) in HepG2 cells by small hairpin RNA (shRNA)-mediated RNA interference (RNAi) technique.

METHODSCell line HepG2 and cells with stable expression of HBV X gene (HepG2-X) were treated with 2 micromol/L As2O3, with corresponding untreated cells serving as controls. Cell lysates and nuclear extracts were extracted. Total level and the relative activity of p53 protein were detected by modified enzyme-linked immunosorbent assay (ELISA). HBV X gene sequence-specific shRNA expression vector (pXi-1 and pXi-2) and sequence-unrelated control (pXi-3) were transfected into HepG2-X. Single cell clone with stable expression of shRNA was selected and exposed to propagating culture. The effect of As2O3 on p53 protein expression and activity was re-observed.

RESULTSTotal p53 protein level was up-regulated and its relative activity ratio was enhanced by As2O3 in HepG2 and HepG2-X cells. The total p53 protein level induced by As2O3 was up-regulated by HBV X gene expression, while its relative activity was significantly suppressed. The suppression was removed after HBV X gene expression was repressed by shRNA.

CONCLUSIONSAs2O3 up-regulates p53 protein expression and enhance its activity. HBV X up-regulates As2O3 induced-p53 protein expression while suppresses its activity.

Arsenicals ; pharmacology ; Cell Line, Tumor ; Enzyme-Linked Immunosorbent Assay ; Humans ; Oxides ; pharmacology ; RNA Interference ; Trans-Activators ; genetics ; Tumor Suppressor Protein p53 ; analysis

OBJECTIVETo investigate the effects of inhaled short-acting bronchodilators on diaphragm function and neural respiratory drive in patients with chronic obstructive pulmonary disease (COPD) during maximal isocapnic ventilation (MIV).

METHODSForty-seven patient with moderate to severe COPD were randomized into 4 groups: placebo group (n=12), salbutamol group (n=13), ipratropium group (n=10), and combined group (salbutamol and ipratropium, n=12). Each subject received an initial MIV for 3 min at baseline and inhaled placebo (400 µg), salbutamol (400 µg), ipratropium (80 µg), or both salbutamol and ipratropium, followed 30 min later by another 3 min of MIV. The parameters of diaphragm function and neural respiratory drive were monitored continuously and calculated during MIV.

RESULTSDuring the initial MIV, all the patients experienced a linear increase in root mean square (RMS) of diaphragm electromyogram with a gradual decrease in transdiaphragmatic pressure (Pdi), minute ventilation (VE), and VE/RMS, and these parameters all improved significantly after inhalation of the bronchodilators. Compared with the placebo group at the same time point, the 3 bronchodilator-treated groups showed significantly decreased RMS and Borg score and increased Pdi, VE and VE/RMS; VE/RMS was the highest in the combined treatment group (P<0.05). The Delta Borg was significantly correlated with Delta Pdi, Delta VE, Delta RMS, and Delta VE/RMS (P<0.05).

CONCLUSIONSIn COPD patients, inhaled short-acting bronchodilators can alleviate diaphragm fatigue during MIV, increase lung ventilation, reduce neural respiratory drive, and improve neuro-ventilatory coupling to relieve dyspnoea, and the combination of β-2 agonists and anti-muscarinic antagonists produces a stronger efficacy.

Administration, Inhalation ; Albuterol ; therapeutic use ; Bronchodilator Agents ; therapeutic use ; Diaphragm ; drug effects ; Humans ; Ipratropium ; therapeutic use ; Pulmonary Disease, Chronic Obstructive ; drug therapy ; Respiration