Objective To discuss the effect of interferon ?-2a on the radiosensitivity and cell cycle for nasopharyngeal carcinoma cell line CNE-I. Methods Interferon ?-2a was given by different concentration. Then the cells were radiated with X-ray (6?MV) and the cell survival rate was calculated. The change of cell cycle dynamics was measured with flow cytometry. Results The cell survival fraction was 0.62, 0.43 and 0.20 respectively after the interferon ?-2a was given by different concentration(0.5?106, 1.0?106 and 1.5?106?IU/L). The radiosensitization ratio was 1.16, 1.57 and 1.93 respectively. Compared with the control group, increasing cell percentage in G_1 and G_2+M phage and decreasing cell percentage in S phage were observed on 24 h after the interferon ?-2a(1?106?IU/L) was given(P

OBJECTIVETo evaluate a new type of diatomite-based machinable ceramic biocompatibility by studying its induced apoptosis on L929 cell in contrasted with other prosthodontics materials.

METHODSCell line was treated with extracting liquid containing different concentrations of diatomite-based machinable ceramic and other materials. Flow cytometry tested cell cycle progression and induced cell apoptosis. Annexin V-FITC/PI apoptosis staining kit quantitative detected cell death patterns. The expression of Bcl-2 and Bax mRNA were determined by reverse transcription-polymerase chain reaction.

RESULTSThe experimental groups had no special influence on cell cycle. Apoptosis rates of the new ceramic closed to the negative group (P > 0.05). The apoptosis rate of resin was the highest, and the cell necrosis level of resin was increased, which had significant difference to the new ceramic (P < 0.05). The Bcl-2 and Bax mRNA levels of the new ceramic and the negative group were closed to each other, which had no statistical significance (P > 0.05).

CONCLUSIONThe new diatomite-based machinable ceramic has no apparent cytotoxicity, which is consistent with the clinical application of the basic requirements of biocompatibility.

Animals ; Annexin A5 ; Apoptosis ; Cell Line ; Dental Materials ; Flow Cytometry ; Fluorescein-5-isothiocyanate ; analogs & derivatives ; Mice ; Necrosis

Brachytherapy is a key part of radical radiotherapy for cervical cancer. Along with the persistent development of radiotherapy techniques, the combined application of brachytherapy and intensity-modulated radiotherapy ( IMRT) has been proposed by scholars for cervical cancer patients presenting with large residual tumors accompanied by parametrial infiltration after IMRT. In this article, recent research progress on IMRT combined with brachytherapy applied in the treatment of cervical cancer was reviewed.

Objective To compare the effect of intensity modulated radiotherapy (IMRT) and conventional radiotherapy (CRT) combined with intracavitary brachytherapy on patients with cervical stump cancer. Methods A total of 47 patients with cervical stump cancer who were admitted to the First Hospital of China Medical University from October 2007 to September 2017 were retrospectively reviewed. Of the 47 patients, 19 patients received CRT combined with intracavitary brachytherapy (CRT group), and 28 patients received IMRT combined with intracavitary brachytherapy (IMRT group). In order to reduce the effects of selection bias and confounding factors, propensity score matching was performed to compare the groups. Results After the propensity score matching, there were 19 patients in each group. The 1-, 3-and 5-year overall survival (OS) rate for matched patients were 100.0％, 85.1％ and 63.8％ in IMRT group, and 84.2％, 57.9％ and 42.1％ in CRT group, respectively, and the difference in survival between the two groups was statistically significant (PLog-rank= 0.029, PCox= 0.043, HR= 3.723, 95％CI 1.044-13.280). The median progression-free survival (PFS) time of the IMRT group was better than that of the CRT group [median PFS time had not been reached (7-72 months) vs. 17 months (2-125 months), PLog-rank= 0.032, PCox= 0.042, HR=2.773, 95％CI 1.037-7.417]. The incidence of late rectal and bladder radiation injury was 15.8％ (3/19) and 0 (0/19) in IMRT group, and 57.9％ (11/19) and 26.3 ％(5/19) in CRT group, respectively, and the difference was statistically significant (P= 0.017, P= 0.046). Conclusion Compared with CRT combined with intracavitary brachytherapy, IMRT combined with intracavitary brachytherapy has a better effect on patients with cervical stump cancer, and the incidence of complications is low, this method is worthy of clinical application.

OBJECTIVETo investigate the clinical results of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for lumbar spinal stenosis with lumbar instability.

METHODSRetrospective study was done on 42 cases of lumbar spinal stenosis with lumbar instability treated with bilateral decompression via unilateral approach and MIS-TLIF through an expandable tubular retractor from March 2010 to January 2011. There were 18 males and 24 females, and mean age was 61.7 years (rang, 48 - 79 years). The level of surgery was L(3-4) in 4 patients, L(4-5) in 26 patients, and L(5)-S(1) in 12 patients. All patients had symptoms of intermittent claudication. And 24 patients had symptoms of lower extremity pain and numbness in one side, and 18 patients had same symptoms in both legs. Operation time, intra-operative bleeding, postoperative hospital stay and complications were recorded. Visual analogue scale (VAS) scores for low back pain and leg pain were recorded before and after surgery. Oswestry disability index (ODI) scores were also recorded before and after surgery. The Bridwell criterion was used for evaluating the interbody fusion, and the MacNab criterion was used for assessment after surgery.

RESULTSThe mean operative time was 150.4 minutes (range, 120 - 170 minutes), and mean blood loss was 147.1 ml (range, 50 - 400 ml). The hospitalization time after surgery was 5 - 18 d, an average of 8.8 d. All cases were followed-up for 6 - 14 months (average 11 months). VAS score of low back pain before surgery was 7.3 ± 1.0, and were 2.9 ± 0.8 and 2.0 ± 0.8 at three months after surgery and the last follow-up respectively. VAS score of leg pain before surgery was 7.9 ± 0.7, and were 2.0 ± 0.5 and 1.0 ± 0.7 at three months after surgery and the last follow-up respectively. ODI score was 75% ± 6% before surgery, were 16% ± 6% and 12% ± 5% at three months after surgery and the last follow-up respectively. VAS and ODI scores showed statistically significant improvements (t = 3.110 - 56.323, P < 0.01). There were 40 cases were grade I and II, according to the Bridwell criteria. The clinical results were excellent in 16 cases, good in 22 cases and fair in 4 cases to the MacNab criteria at the final follow-up.

CONCLUSIONSMIS-TLIF is an ideal surgical method for single segment lumbar spinal stenosis with lumbar instability, but close attention should be paid to specific patients, surgeons and hospitals.

Aged ; Female ; Follow-Up Studies ; Humans ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Retrospective Studies ; Spinal Diseases ; surgery ; Spinal Fusion ; methods ; Spinal Stenosis ; complications ; surgery

BACKGROUNDTrans-sacral axial L5/S1 interbody fusion (AxiaLIF), a novel surgical procedure, recently adopted in clinical practice, has excellent clinical outcomes. However, there is inadequate data on the feasibility of the approach in all adult patients and the optimal surgical approach is currently unclear; therefore, further studies are required. In order to enhance the surgical approach for AxiaLIF, prospective anatomical imaging optimization is necessary. The objective of this study was to investigate the ability of magnetic resonance imaging (MRI) to achieve an optimal procedural setting.

METHODSThe subjects (n=40) underwent lumbosacral MRI examination. The median sagittal MRI images were analyzed and four measurement markers were defined as follows: the center of the L5/S1 disc (A), the anterior margin of the S1/2 disc space (B), the sacrococcygeal junction (C), and the coccygeal tip (D). The measurement markers were connected to each other to produce five lines (AB, AC, AD, BC, and BD), as reference lines for surgical approaches. The distance between each reference line and the anterior and posterior margins of the L5 and S1 vertebral bodies was measured to determine the safety of the respective approaches.

RESULTSIn all patients, Lines AB and AC satisfied the imaging safety criteria. Line AB would result in a significant deviation from the median and was determined to be unsuitable for AxiaLIF. Line AD satisfied the imaging safety criteria in 39 patients. However, the anal proximity of the puncture point proved to be limiting. For lines BC and BD, the imaging safety criteria were satisfied in 70% and 45% of patients, respectively.

CONCLUSIONSThe AxiaLIF procedure is a safe technique for insertion of fusion implants in all subjects. Line AC is a favorable reference line for surgical approach and safe for all subjects, while line BC is not suitable for all subjects.

Adult ; Aged ; Aged, 80 and over ; Fractures, Bone ; surgery ; Humans ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Sacrum ; surgery ; Spinal Fusion ; methods ; Treatment Outcome

ObjectiveTo compare the clinical results between minimally invasive transforaminal lumbar(mini-TLIF) and posterior open surgery in treatment of lumbar spondylolisthesis.MethodsFrom March 2008 to August 2010,a total of 49 cases with lumbar spondylolisthesis underwent surgical intervention were retrospectively analyzed,including 23 cases with mini-TLIF and 26 with open surgery.Operation time,intra-operative bleeding,and radiation exposure times were recorded.Pre- and postoperative back pain was assessed by visual analogue scale(VAS),and lumbar function was evaluated by Oswestry disability index (ODI).The clinical results were assessed by Macnab criterion,and the pre and postoperative radiologic parameters were compared.ResultsThe mean follow-up time was 11 months(ranged,9-22).Both groups got good clinical results and satisfactory radiologic parameters.The group of mini-TLIF was superior to the group of open surgery in intra-operative bleeding,VAS of the second day postoperatively and the willingness of reoperation(P＜0.05).The ODI in the patients with open surgery were decreased from 31.2％±8.2％ to 16.1％±6.8％ corresponding to the pre-oporation and the final follow-up.The ODI in the patients with mini-TLIF were decreased from 34.4％±11.7％ to 15.3％±4.3％ corresponding to the pre-operation and the final follow-up.There is no significant difference of the change of ODI between two groups (t=0.673,P=0.412).The group of mini-TLIF need more operation time and were exposed to more X-ray when compared to the open surgery group(P＜0.05).ConclusionMini-TLIF and open surgery can both get satisfactory clinical outcomes in treatment of lumbar spondylolisthesis.Mini-TLIF was superior to open surgery in intra-operative bleeding and VAS of the second day postoperatively,but it needs more operation time and radiation exposure.

OBJECTIVETo study the impact of an agonist anti-CD(40) monoclonal antibody 5C11 on the induction and biological characteristics of leukemic dendritic cells.

METHODSCombinations of 5C11 and different cytokines were used to induce differentiation of leukemic blasts into dendritic cells. Morphology was observed by light microscopy. Surface antigens of the induced cells were analyzed by fluorescence-activated cell sorting (FACS), the yields of dendritic cell by cell counting, the levels of IL-6 and IL-12 by ELISA, T cell proliferating activity by allo-mixed lymphocyte reaction (MLR) in vitro. Allogeneic T cells were stimulated with leukemic dendritic cells and T-cell cytotoxicity was measured by MTT assay.

RESULTSWhen cultured with combinations of 5C11 and different cytokines, the leukemic cells isolated from the patients could differentiate into dendritic cells. The morphology showed typical features of dendritic cells, which expressed high levels of CD(40), CD(80) and CD(86). In comparison with the original leukemia cells, the leukemic dendritic cells secreted less IL-6 but more IL-12 (P < 0.05). The leukemic dendritic cells were potent to stimulate the proliferation of allogeneic T cells, and the latter was able to lyse the original leukemia cells.

CONCLUSIONLeukemic blasts could be induced to differentiate into functional dendritic cells. It may be of great value in the adoptive immunologic therapy of leukemia.

Antibodies, Monoclonal ; immunology ; CD40 Antigens ; physiology ; Cell Differentiation ; Dendritic Cells ; immunology ; Humans ; Immunophenotyping ; Immunotherapy ; Interleukin-12 ; biosynthesis ; Interleukin-6 ; biosynthesis ; Leukemia ; immunology ; pathology ; therapy

Objective To evaluate the dosimetric feasibility of three-dimensional(3D)intracavitary brachytherapy in combination with applicator-guided intensity-modulated radiation therapy(IMRT)boost for patients with locally advanced cervical cancer who have unfavorable topography following external beam irradiation. Methods A total of 7 patients with locally advanced cervical cancer who had unfavorable topography following external beam irradiation were included. Two plans were generated for brachytherapy using Oncentra 4.3 treatment planning system:3D intracavitary brachytherapy and 3D intracavitary brachytherapy in combination with applicator-guided IMRT boost.To further evaluate cumulative doses to organs at risk(OAR)in the four fractions of combined plans,two methods were used:simple dose-volume histograms(DVH)parameter addition and deformable image registration(DIR)-based DVH accumulation. The D90, V100, and conformity index(CI)were evaluated. The paired t-test or Wi1coxon signed rank test was used for statistical analysis. Results Compared with the 3D plan,the combined plan yielded higher D90, V100, and CI(P=0.000), but showed no significant difference in D2ccof the rectum,sigmoid colon,and bladder(P>0.05). There were also no significant differences in D2ccof the rectum, sigmoid colon, and bladder calculated by the two methods for calculating OAR cumulative doses, simple DVH parameter addition and DIR-based DVH accumulation(P>0.05). Conclusions For patients with cervical cancer who have unfavorable topography following external beam irradiation,3D intracavitary brachytherapy in combination with applicator-guided IMRT boost can improve target coverage and CI, without increasing OAR doses. DIR-based DVH accumulation and simple DVH parameter addition may be both acceptable for assessing OAR cumulative doses.

OBJECTIVETo analyze the relation between pathologic tumor response in preoperative radiotherapy and long-term survival in patients with esophageal carcinoma and the significance of radiosensitivity in the treatment of esophageal carcinoma.

METHODS176 esophageal cancer patients received preoperative radiotherapy and tumor resection from 1977 to 1989. The radio-response was classified into severe, moderate and mild according to the tumor pathologic response to radiotherapy. 191 patients treated by surgery alone served as control. The relation between radiation response of tumor and long-term survival and disease free survival was analyzed.

RESULTSThe 5-year survival rates of severe, moderate, mild and control groups were 60.7%, 46.4%, 21.1% and 38.8%. The survival was significantly improved in severe than moderate one (P = 0.029), moderate than mild group (P = 0.013) and severe than the control group (P = 0.000). It was only slightly improved in the moderate than control group (P = 0.295), but decreased in mild than the control group (P = 0.034). The 5-year disease-free survival (DFS) rates were 55.7%, 40.7%, 18.7% and 33.3% in severe, moderate, mild and control groups. The DFS was significantly improved in severe than moderate group (P = 0.029), moderate than mild group (P = 0.018), severe than the control group (P = 0.000 4). It was only slightly improved in moderate than the control group (P = 0.23), but decreased in the mild than the control group (P = 0.096). In the severe group, the proportion of stage T4, N1 lesion, TNM stage I-II and number of radical resection were 9.8%, 18%, 90.2%, and 90.2%. In the moderate group, they were 20.3%, 15.9%, 79.7% and 82.6%. In the mild group, they were 42.2%, 37.8%, 53.3% and 46.7%. In the control group, they were 50.3%, 40.8%, 37.7% and 77.5%. The rates of downstaging and surgical resection were improved only in severe and moderate groups (P < 0.01).

CONCLUSIONThe fact that only patients in whom severe radiation response are observed would appreciably benefit from preoperative radiotherapy whereas the others do not, illustrates that there might be no benefit of radiotherapy for radioresistant esophageal carcinoma. Radiosensitivity measurement before preoperative radiotherapy would be valuable for individualized treatment.

Adult ; Aged ; Combined Modality Therapy ; Esophageal Neoplasms ; mortality ; pathology ; radiotherapy ; surgery ; Female ; Humans ; Male ; Middle Aged ; Prognosis