Objective To evaluate the efficacy of hypofractionated 3DCRT for primary liver cancer(PLC) with portal vein tumor thrombosis(PVTT).Methods Between April 1999 and August 2003,34 PLC patients with PVTT received hypofractionated 3DCRT.The severity of hepatic cirrhosis was 23 in Child-Pugh gradeA and 11 gradeB.The median value of GTV was 773?cm~3(105-2097?cm~3).The radiotherapy regimen consisted of 38-63?Gy in 7-15 fractions with 4-8?Gy per fraction(median value 5?Gy),the treatment was delivered 3 times per week during every other day.Results Having response rate(CR+PR) of 76%(26/34),the overall 1-,2-,and 3-year survival rate at was 36%,19% and 13%,respectively.Conclusion Hypofractionated three-dimensional conformal radiotherapy is effective for primary liver cancer with portal vein tumor thrombosis.

Objective To evaluate the potential influencing factors associated with pathologic complete response ( pCR) after neoadjuvant chemoradiotherapy for locally advanced rectal cancer ( LARC) . Methods A retrospective analysis was performed on the clinical data 265 patients with stageⅡandⅢ( the 7th version of AJCC) rectal cancer admitted to our hospital from 2011 to 2013. All patients underwent neoadjuvant concurrent chemoradiotherapy ( CCRT ) followed by surgery with/or without induction chemotherapy during the interval between the complete of CCRT and surgery. The predictors associated with pCR were analyzed by univariate and multivariate logistic regression analyses. With the use of the independent predictive variables for pCR from multivariate analysis, a clinical risk score model was established according to the following criteria:no?risk group (0 factor);low?risk group (1 factor);high?risk group ( 2 factors) . Results Among these 265 patients, 50( 18. 9%) achieved pCR. The univariate analysis showed that carcinoembryonic antigen ( CEA) level before CCRT ( P=0. 017) , T stage before CCRT ( P=0. 001), interval between complete of CCRT and surgery (P=0. 000), and the maximum tumor thickness before CCRT ( P=0. 040) were significantly associated with pCR. The multivariate analysis showed that pre?CCRT CEA level ( P=0. 021 or 0. 446) and interval between the complete of CCRT and surgery ( P=0. 000 or 3. 774) were significant predictors of pCR. When stratifying for smoking status, only low pre?CCRT CEA level was significantly associated with pCR in the non?smoking patients ( P=0. 044) . For the prediction of pCR by the clinical risk score model, the sensitivity was 0. 805, the specificity was 0. 460, the area under the receiver operating curve was 0. 690 ( 95% CI= 0. 613?0. 767 ) , the positive predictive value was 35 . 4 9%, the negative predictive value was 8 6 . 5%, and the predictive accuracy was 7 3 . 9%. Conclusions For locally advanced rectal cancer, pCR can be achieved in some patients after neoadjuvant therapy. Low pre?CCRT CEA level and long interval time between CCRT and surgery are independent factors associated with pCR, and only low pre?CCRT CEA level is an associated factor in the group of nonsmokers. The clinical risk score model based on pre?CCRT CEA level>5 ng/ml and time interval from CCRT completion to surgery≤8 weeks can be used to predict pCR after neoadjuvant chemoradiotherapy for LARC.

Objective To evaluate the accuracy of cone?beam breast CT (CBBCT) on tumor sizing in patients with invasive breast carcinoma and analyze the influence factors. Methods The preoperative CBBCT images of 82 female patients (85 breast lesions) with invasive breast carcinoma confirmed by pathology from November, 2011 to December, 2017 in Tianjin Medical University Cancer Hospital were included in this retrospective study. All the patients underwent the pathology and immunohistochemical test after operation. Tumor size estimation were performed on preoperative CBBCT images. Referring to tumor size measurement on pathology, all the lesions were divided into two groups. Concordance was defined as the discrepancy in diameter less than 0.5 cm, and the discordance was more than 0.5 cm. Pathology examination was performed after resection, and estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2(HER?2) and Ki?67 result were recorded. All the lesions were classified into molecular subtype, including 14 Luminal A, 50 Luminal B, 11 HER?2?enriched and 10 triple?negative. Intraclass correlation coefficient (ICC) and Pearson correlation coefficient were used to analyze the reliability of CBBCT on tumor sizing. CBBCT?pathology discordance was analyzed based on the clinical, histopathology and CBBCT features by using t test, Chi?square and Fisher exact test. ROC curve was used to analyze the cut?off value between tumor size and CBBCT?pathology discordance. Results The agreement between CBBCT (2.155 ± 0.799) cm and pathology (1.986 ± 0.933) cm measurement was on moderate degree based on the ICC value (ICC=0.781, P<0.01) and had positive correlation (r=0.803, P<0.01). CBBCT?pathology concordance was found in 71 lesions, and discordance in 14 lesions. The factors of family history, symptom, pathology type, molecular subtypes, histological grade, surrounding fat invasion, lymphatic invasion, axillary lymph node metastasis, HER?2 positive and Ki?67 high expression had no significant difference between two groups. ER or PR positive had significant difference, suggesting that the accuracy of evaluation on ER or PR negative lesions could be reduced. The cut?off value of ROC curve between tumor size and CBBCT?pathology discordance was 2.08 cm, and the area under curve was 0.70. In 85 lesions. 66 of 75 mass lesions and 5 of 10 non?mass lesions were consistent. The lesion type had significant difference between two groups (χ2=6.705, P=0.010), which suggested the CBBCT evaluation on non?mass could have discrepancy with pathology. Conclusion CBBCT has high accuracy on tumor size evaluation on invasive carcinoma. ER or PR negative, large lesions or non?tumor lesions should be alert to the impact of CBBCT?pathology discordance before surgery which may cause the alteration of surgical protocols.

Objective To evaluate the safety and efficacy of denosumab in treatment of patients with pelvic giant cell tumor of bone (GCTB) during perioperative period. Methods This is a retrospective observational study. Twenty-three patients diagnosed with pelvic GCTB undergoing perioperative denosumab treatment in Musculoskeletal Tumor Center of Peking University People's Hospital from January 2014 to December 2016 were reviewed. The subjective adverse reactions and mandibular X-ray films were used to assess the drug safety. As for efficacy, imaging findings (including X-ray, CT, magnetic resonance imaging) were reviewed. MSTS-93 scoring system was applied in the postoperative functional assessment. Histological response rate, objective response rate, clinical benefit rate and event-free survival rate were all used to deficit the efficacy of denosumab in the treatment of pelvic GCTB combined with surgery. All the results of postoperative were compared statistically with pelvic GCTB patients who underwent surgery in the same hospital from 1999 to 2009. Results All the patients were firstly diagnosed as classic GCTB except for one case which was malignant pelvic GCTB. All patients received denosumab preoperatively and/or postoperatively, and the average number of medications was 8.43. According to the surgical patterns, patients were divided into intralesional surgery group (13 cases) and wide resection group (10 cases). The follow-up was 5-47 months(mean:27.30 months),recurrence was observed in 2 cases in the intralesional surgery group, none in the wide resection group. After drug administration, 13 cases were partial response, 7 cases were stable disease, the objective response rate was 65.0 % (13/20), and the histologically clearance rate of giant cells was 85.0 % (17/20). No case of osteonecrosis of the jaw was observed in this study, and all laboratory indicators were normal. The average postoperative MSTS-93 score was 26.87. Compared with pelvic GCTB patients who underwent surgical treatment from 1999 to 2009, in the intralesional surgery group, there was no significant difference in the recurrence rate [15.4 % (2/13) vs. 30.8 % (4/13), P = 0.514], but the limb function was significantly increased (P= 0.002). Conclusions Denosumab combined with surgery plays an important role in the multidisciplinary treatment of pelvic GCTB. The neoadjuvant strategy can reduce patient's intraoperative blood loss by shrinking the tumor size which makes the intralesional curettage surgery possible, and also diminishing the recurrence rate. But more attention should be paid to secondary malignant GCTB during the use of denousmab.

ObjectiveOptimize the latex perfusion technique and apply it to the construction of a murine craniofacial venous vascular model.Methods A total of nine 8-week-old male C57BL/6 mice weighing (25.0±1.3) g were randomly divided into three groups: 60% latex physiological saline group, 60% latex heparin group, and 30% latex heparin group. After completion of the perfusion, the specimens were immersed in 4 °C formalin fixative for 24 h, followed by dissection, observation, and measurement of the extracranial blood vessel diameters. Results After 200 μL latex perfusion solution was injected into the external jugular vein, the supraorbital vein, infraorbital vein, temporal vein, retrofacial vein, masseter vein and external jugular vein were perfused in each group.After comparing the perfusion degree of the distal branches of blood vessels, sublingual vein and tip venule, it was found that the 30% latex heparin group had the best perfusion effect, followed by the 60% latex heparin group, and the 60% latex saline group had the worst perfusion effect.ConclusionThe optimized latex perfusion technique can effectively infuse the veins in the head and face of mice, and this technique can provide a good reference for the study of the direction and morphology of facial veins in mice.

Objective To analyze the recurrence of breast cancer without use of chest wall bolus during adjuvant intensity modulated radiotherapy after modified radical mastectomy, so as to investigate the necessity of bolus use. Methods A total of 218 patients undergoing adjuvant intensity modulated radiotherapy after modified radical mastectomy during the period from January 2013 to June 2019 were enrolled as the study subjects. The chest wall bolus was not used during the whole period of radiotherapy after modified radical mastectomy, and the recurrence of breast cancer in the chest wall was analyzed after radiotherapy. Results The post-surgical follow-up through outpatient records, inpatients records, local residents’ health system and telephone was performed until June 31, 2021. The proportion of follow-up was 100%, and the mean follow-up period was 48.9 months. There were three cases with breast cancer recurrence in the chest wall, including one case with recurrence in the chest wall alone and two cases with recurrence in the chest wall and regional lymph nodes, and the overall recurrence of breast cancer was 1.4% in the chest wall. Among the 3 cases with breast cancer recurrence in the chest wall, there were two cases with N3 stage and positive for HER2, and one triple-negative breast cancer case, and all three cases developed distal metastases upon local recurrence. Among 218 study subjects, there were 5 cases with grade Ⅰ radioactive skin reaction, 3 cases with grade Ⅱ radioactive skin reaction, and no grade Ⅲ or Ⅳ radioactive skin reaction occurred. In addition, no grade Ⅲ or Ⅳ acute radioactive injury was seen in the chest wall skin among the 218 study subjects. Conclusion No use of chest wall bolus may be considered during adjuvant intensity modulated radiotherapy after modified radical mastectomy in presence of systemic therapy if tumor invasion into skin is not observed prior to therapy.

AIM:To explore the molecular mechanism of Tiaopi Chengqi decoction (TpCqD) improving hyperthermia and high-protein food-induced hyperphagia mice based on transcriptomics. METHODS:C57 mice were randomly divided into a control group, model group, low-dose TpCqD group, high-dose TpCqD group, and domperidone group. The general condition of the experimental mice was observed and the average food intake was counted, and the rate of gastric emptying and intestinal propulsion was determined for each group of mice. H&E staining was used to observe pathological changes in gastric tissue. PAS staining was used to observe glycogen changes in gastric tissue. Pepsin activity was determined by colorimetry. pH value of gastric contents was measured by acid-base titration. Transcriptome sequencing was used to analyze the differential genes in gastric tissue, a volcano map and a cluster heat map were made for the differential genes, and KEGG was used to analyze the signal pathway enrichment of the differential genes. RT-qPCR verified the differential genes obtained by screening. RESULTS:After treatment with TpCqD, the body weight and average food intake of mice with food accumulation increased (P<0.05), and the intestinal propulsion rate and gastric emptying speed of mice with food accumulation accelerated (P<0.05). TpCqD could protect gastric tissue structure and glycogen degradation, increase pepsin activity (P<0.05), and reduce gastric content pH (P<0.05). Transcriptome results showed that TpCqD could regulate the expression of Acox2 and cilp2, regulate fat digestion and absorption, protein digestion and absorption, and pancreatic secretion signals. RT-qPCR showed that compare with model group, TpCqD up-regulated Acox2 (P<0.05) and down-regulated the mRNA level of cilp2 (P<0.05). CONCLUSION:TpCqD ameliorated digestive dysfunction in mice with high-calorie and high-protein diets leading to food accumulation involving the regulation of the fat and sugar metabolism genes Acox2 and cilp2, and pancreatic secretory signaling.

BACKGROUND: Idiopathic pulmonary fibrosis (IPF) is an idiopathic chronic, progressive interstitial lung disease with a diagnosed median survival of 3-5 years. IPF is associated with an increased risk of lung cancer. Therefore, exploring the shared pathogenic genes and molecular pathways between IPF and lung adenocarcinoma (LUAD) holds significant importance for the development of novel therapeutic approaches and personalized precision treatment strategies for IPF combined with lung cancer. METHODS: Bioinformatics analysis was conducted using publicly available gene expression datasets of IPF and LUAD from the Gene Expression Omnibus (GEO) database. Weighted gene co-expression network analysis was employed to identify common genes involved in the progression of both diseases, followed by functional enrichment analysis. Subsequently, additional datasets were used to pinpoint the core shared genes between the two diseases. The relationship between core shared genes and prognosis, as well as their expression patterns, clinical relevance, genetic characteristics, and immune-related functions in LUAD, were analyzed using The Cancer Genome Atlas (TCGA) database and single-cell RNA sequencing datasets. Finally, potential therapeutic drugs related to the identified genes were screened through drug databases. RESULTS: A total of 529 shared genes between IPF and LUAD were identified. Among them, SULF1 emerged as a core shared gene associated with poor prognosis. It exhibited significantly elevated expression levels in LUAD tissues, concomitant with high mutation rates, genomic heterogeneity, and an immunosuppressive microenvironment. Subsequent single-cell RNA-seq analysis revealed that the high expression of SULF1 primarily originated from tumor-associated fibroblasts. This study further demonstrated an association between SULF1 expression and tumor drug sensitivity, and it identified potential small-molecule drugs targeting SULF1 highly expressed fibroblasts. CONCLUSIONS This study identified a set of shared molecular pathways and core genes between IPF and LUAD. Notably, SULF1 may serve as a potential immune-related biomarker and therapeutic target for both diseases.
Humans ; Lung Neoplasms/genetics* ; Adenocarcinoma of Lung/genetics* ; Idiopathic Pulmonary Fibrosis/genetics* ; Adenocarcinoma ; Cancer-Associated Fibroblasts ; Prognosis ; Tumor Microenvironment ; Sulfotransferases

Objective: To compare the diagnostic efficiency of lesion in dense breast between cone beam breast computer tomography (CBBCT) and mammography. Methods: From May 2012 to August 2014, 160 patients with 165 breasts who underwent mammography and CBBCT examinations were included in this study. The diagnostic results of CBBCT and mammography were reviewed and compared with pathological results. Results: In the 165 breast, 24 were dense breasts and 141 were dense breasts. The diagnostic results were similar in 109 lesions, but different in 56 lesions. According to the analysis of the 165 breasts using receiver operation characteristics (ROC) curve, the area under the ROC curves (AUC) of CBBCT and mammography were 0.923 (95%CI: 0.878-0.967, P<0.05) and 0.959 (95%CI: 0.926-0.992, P<0.05), respectively. With Breast Imaging-Reporting and Data System (BI-RADS) 4b as the critical value, the sensitivity and specificity were 70.0% and 98.7% using mammography, and 83.3% and 97.3% using CBBCT, respectively. The AUC of CBBCT and mammography of the 141 dense breasts was 0.919(95%CI: 0.868-0.969, P<0.05) and 0.973(95%CI: 0.947-0.999, P<0.05), respectively. With BI-RADS 4b as the critical value, the sensitivity and specificity were 69.0% and 98.6% by mammography, and 83.1% and 98.6% by CBBCT, respectively. Conclusions CBBCT showed higher sensitivity and specificity in the diagnosis of breast malignant tumors compared to mammography. It is expected to be applied to breast cancer detection in the future, especially in dense breast.