The treatment of recurrent head and neck cancers has improved from single modality interventions of surgery and radiation therapy alone to include combined modality therapy with surgery, chemotherapy and radiation. Combined therapy has led to improved local control and disease-free survival. New developments in radiation oncology such as intensity-modulated radiotherapy, brachytherapy, stereotactic radiosurgery, fractionated stereotactic radiotherapy, have helped to improve this outlook even further. These recent advances allow for a higher dose to be delivered to the tumor while minimizing the dose delivered to the surrounding normal tissue. This article provides an update of the new developments in radiotherapy in the management of previously-irradiated recurrent head and neck carcinoma.

To elucidate the mechanism of mitochondrial damage induced by rotenone and the possible biological function of NADH in repairing mitochondrial damage of PC12 cells, cytotoxicity test, immunocytofluorescence and flow cytometric analysis were used to investigate the changes of cell proliferation genes (c myc, c erbB 2), apoptosis inhibition genes bcl 2, p53 tumor suppressor protein, cell immediate early gene (c fos) and proliferating cell nuclear antigen (PCNA) in PC12 cells before and after exposure to rotenone. The results showed that rotenone could significantly inhibit the proliferation rate of PC12 cells and expression of c erbB 2, c myc, p53, and bcl 2 in PC12 cells, NADH could restore the proliferation activity of PC12 cell damaged by rotenone by gene regulation. It is suggested that rotenone could induce PC12 cells apoptosis not only by regulating mitochondria phosphorylation process, but also by down regulating the expression of oncogene proteins (C erbB 2, c myc), anti apoptotic gene protein (bcl 2), p53 tumor suppressor gene protein, and upregulating the expression of the immediate early gene c fos. Regulation of bcl 2, c myc, c erbB 2 and p53 might be involved in the repair of mitochondrial damage of PC12 cells.

Objective: To compare the difference of Response Evaluation Criteria in Solid Tumors 1.1 (RECIST 1.1) and modified Re-sponse Evaluation Criteria in Solid Tumors (mRECIST) in the treatment of hepatocellular carcinoma (HCC) after stereotactic body radio-therapy (SBRT). Methods:From Janurary 2014 to August 2015, thirty-five patients with HCC treated with SBRT were included in De-partment of Radiation Oncology and Integrative Oncology of Navy General Hospital of PLA, and SBRT efficacy was evaluated based on RECIST 1.1 and mRECIST criteria. Results:Under RECIST 1.1, one patient had complete response (CR), 20 had partial response (PR), and 11 achieved stable disease (SD) at three months. Three patients had progressive disease (PD). The overall best response rate (CR+PR) was 60%. In comparison, under mRECIST, 10 patients had CR, 16 had PR, and 6 achieved SD at three months. Three patients had PD. The overall best response rate was 74.28%. The statistical analysis showed that Kappa=0.402 (χ2=43.3, P<0. 001) was less than 0.75 but greater than 0.4, indicating that it had not reached the two diagnostic criteria of consistency degree of satisfaction. According to the mRECIST criteria, the objective remission group (CR+PR) was superior to the nonobjective remission group (SD+PD) in progression-free survival (P<0.001). Conclusion:For unresectable HCC, mRECIST may be more useful than RECIST 1.1 in evaluating HCC response to SBRT.

Objective To collect the hot spots, development trends, high yield authors and their affiliated institutions by analyzing the papers on pancreatic cancer chemotherapy in recent 5 years. Methods The papers on pancreatic cancer chemotherapy were downloaded from PubMed. Their high frequency subject headings extracted by BICOMB were analyzed by bibliometric double clustering analysis and strategic coordinate analysis. The high yield authors were analyzed by co-authorship group analysis. Results The current studies on pancreatic cancer chemotherapy in foreign countries were focused on the pathological features of pancreatic duct adenocarcinoma before and after chemotherapy, drug therapy of pancreatic cancer according to its genetics, metabolism and pharmacology of antitumor drugs, surgical treatment combined with radiotherapy and chemotherapy for pancreatic cancer. The high yield authors could be divided into two large groups from Japan and USA and a number of small groups. Conclusion New breakthrough points should be found from the matured topics, the topics with a further developmental space should be greatly concerned, and cooperation should be strengthened between study groups or teams.

Objective To explore the event-related potentials (ERPs) P300 is changeable or not before and after treatment. Methods 99 cases of patients with first onset of depression diagnosed by DSM-Ⅳ as case group,and 100 cases matched with patients as control group were collected. P300 of two groups were obtained before and after treatment for 6 weeks,12 weeks,24 weeks. T test was used to analysis the difference of indicators of P300 among groups; repeated measure analysis of variance was used to analysis the longitudinal changes. Results shorter latency of N2-P3 ( (P ＜ 0.01 ); and lower amplitude of N2, P3, N2-P3 (P ＜ 0. 05 ), higher amplitude of P2-tency and a upward one in N2-P3 latency in the four periods; a upward trend could also be found in P3, N2-P3 amplitude, but there were no statistical differences(P ＞ 0. 05 ). The results of paired-samples t test: P3, N2-P3 amplitude in case group were higher after treatment for 6 weeks than before, the difference was significant (P ＜ 0.01 ); no significant results were found in P300 latency or amplitude between the 62 cases of depression after treatment for 24 weeks and the 65 normal controls selected (P ＞ 0. 05 ). Conclusion P300 latencies and amplitudes tend to be partly recovered after the acute treatment in patients with depression, but after the long-term therapy not clear.

Objective:To conduct a systematic study of the immunologic response of rats to transplanted glutaraldehyde ( GA)-treated porcine blood vessels in vivo.Methods: The experiment was divided into two groups:fresh group and glutaraldehyde-treated group.Twenty cases of fresh and glutaraldehyde-treated porcine pulmonary arteries were subcutaneously embedded in rats.We compared the changes using HE staining and immunohistochemistry.Results:HE staining showed that there were stronger expression on day 12 and day 30 in the fresh group than that in the glutaraldehyde group.There were similar results in morphology in CD68,C3,IgG.The results of integral optical density ( IOD) in immunohistochemistry showed that IOD started rising from day 4 and got the peak on day 12 or day 30 and or fell on day 60.Conclusion: Innate immunity played an important role in the research on xenogenic immunological rejection mechanism.The immunogenicity of glutaraldehyde-treated xenogenic blood vessels is lower than that in fresh blood vessels.However there is still immunogenicity in glutaraldehyde-treated xenogenic blood vessels.We will explore better ways to obviously weaken the rejection.

Objective:To explore the correlations among coping style, self-consistency and stigma in bipolar disorder depression patients.Methods:From June 2017 to December 2018, this study selected 217 bipolar disorder depression inpatients of Department of Mental Health at a Class Ⅲ Grade A hospital in Taiyuan by convenience sampling. All of them were investigated with the general information questionnaire, Perceived Devaluation-Discrimination Scale (PDD) , Self-Consistency and Congruence Scale (SCCS) and the Simplified Coping Style Questionnaire (SCSQ) . Amos 22.0 was used to path analysis.Results:The scores of PDD, SCSQ and positive coping style and negative coping style were (30.92±6.41) , (101.54±16.99) , (21.63±6.46) and (13.36±5.03) respectively. Pearson correlation analysis showed that positive coping style of patients had negative correlations with the self-consistency and stigma ( r=-0.748, -0.655; P<0.01) ; negative coping style had positive correlations with the self-consistency and stigma ( r=0.553, 0.742; P<0.01) ; self-consistency had a positive correlation with the stigma ( r=0.763, P<0.01) . Mediating effect test showed that self-consistency only had partial mediating role between the negative coping style and stigma and the mediating effect accounted for 40.54% of the total effect. Conclusions:The negative coping style not only has a direct impact on the stigma in bipolar disorder depression patients, but also has an indirect impact on stigma by self-consistency. Medical staff can carry out intervention based on this path to reduce the stigma of bipolar disorder depression patients.

Objective:To assess the clinical efficacy and safety of image-guided γ-ray stereotactic body radiation therapy(IG γ-SBRT)in treating advanced pancreatic cancer.Methods:A total of fifty-six patients with advanced pancreatic cancer admitted to Senior Department of Oncology Medicine of the Fifth Medical Center of Chinese PLA General Hospital(Department of Oncology of the Sixth Medical Center)from February 2017 to September 2020 were selected.All patients were treated with IG γ-SBRT,and the 50%-60%of isodose curve covered the planned target volume(PTV).The peripheral dose of each time was 3.0-4.5 Gy,and there were 10-11 times of treatment.The therapeutic effect was observed and was evaluated by follow-up.The visual analog scale(VAS)score was adopted to assess the situation of the pain of patients before and 3 months after treatment,and the adverse reaction of them.Results:In the 56 patients,52 cases occurred epigastric pain with VAS ranging from 3 to 10 points,among which 32 patients accompanied by symptoms such as lower back pain and abdominal distension.After 3 months of treatment,the results of reexamination and follow-up indicated that there were 48 patients whose VAS scores decreased 3 scores and above 3 scores on the basis of original scores,and the efficiency of treating pain was 92.3%.In addition,the VAS scores of 3 patients decreased 1-2 scores on the basis of original scores,which ratio was 5.85%of the total number of people.All 56 patients were reexamined at the 3rd month after treatment,and 13 cases of them obtained complete response(CR),and 37 cases obtained partial response(PR),and 1 case obtained progressive disease(PD),and 5 cases obtained stable disease(SD),and the objectively response rate(ORR)was 89.3%,and the locally control rate was 98.2%.In addition,median progression-free survival(PFS)was 6.5 months,and 1-year survival rate was 62.5%(35/56),and 2-year survival rate was 23.2%(13/56).The adverse reactions of 56 patients were the adverse reactions of digestive system and blood system,among which 47 patients occurred upper digestive tract reaction,and the incidence of adverse reactions was 83.9%(47/56).A total of 43 patients occurred myelosuppression,and the incidence of myelosuppression was 76.8%(43/56).Conclusion:IG γ-SBRT can effectively relieve the symptoms of metastatic pancreatic cancer,and improve the effectiveness of treatment,the local control rate and survival rate.The tolerance of adverse reaction of that is favorable,and the safety of that is higher.

In February 2023, the National Health Commission, together with the Ministry of Science and Technology, the Ministry of Education, and the State Administration of Traditional Chinese Medicine issued the Ethical Review Measures for Life Science and Medical Research Involving Humans, which emphasizes that research participants involving vulnerable groups such as children, intellectual disabilities, and mental disabilities should be given special protection. This paper expounded the current situation of protecting vulnerable groups from six aspects: inadequate protection of vulnerable groups by relevant laws and regulations, unclear definition of vulnerable groups, insufficient supervision by relevant departments, insufficient review ability of ethics committee to satisfy the protection of vulnerable groups, difficulty in fair inclusion of vulnerable groups, and the need to improve the ethical awareness of researchers and vulnerable groups. This paper also analyzed the new requirements for the protection of vulnerable groups in the Ethical Review Measures for Life Science and Medical Research Involving Humans from the following three aspects: expanding attention to potentially vulnerable research participants, paying more attention to the consent of research participants without or with limited capacity for civil conduct, and re-informed consent after the improvement of civil capacity level. Finally, suggestions on strengthening the protection of vulnerable groups were put forward from six aspects: improving the relevant legal system, clarifying the category of vulnerable groups, strengthening the implementation by regulatory departments, establishing a research participant protection system by research institutions, improving the ethical review capacity of ethics committees, formulating review guidelines by industry associations, and strengthening the education and training of all parties, so as to minimize the risk of vulnerable groups participating in clinical research and boost the quality and speed of clinical research in China.

ObjectiveTo investigate the expression levels of miR-128-3p， SIRT1， and AMPK in the peripheral blood of patients with type 2 diabetes mellitus （T2DM） comorbid with nonalcoholic fatty liver disease （NAFLD）， as well as the role of miR-128-3p in predicting NAFLD in T2DM patients. MethodsA total of 80 patients with T2DM who were hospitalized in The First Affiliated Hospital of Anhui University of Chinese Medicine from September 2022 to August 2023 were enrolled and divided into T2DM group with 40 patients and NAFLD group with 40 patients， and according to the NAFLD fibrosis score （NFS）， the patients were further divided into progressive liver fibrosis group with 16 patients and non-progressive liver fibrosis group with 64 patients. General data and biochemical parameters were collected； quantitative real-time PCR was used to measure the mRNA expression levels of miR-128-3p， SIRT1， and AMPK in peripheral blood， and Western blot was used to measure the protein expression levels of SIRT1 and AMPK. The independent-samples t test was used for comparison of normally distributed data between two groups， and the Mann-Whitney U test was used for comparison of data with skewed distribution between two groups； the chi-square test was used for comparison of categorical data between two groups. The logistic regression analysis was used to identify the influencing factors for the presence of NAFLD and progressive liver fibrosis， and the receiver operating characteristic （ROC） curve analysis was used to determine the optimal cut-off value of miR-128-3p for predicting NAFLD. ResultsThere were significant differences between the NAFLD group and the non-NAFLD group in body mass index， fasting plasma glucose， glycated hemoglobin， fasting insulin， fasting C-peptide， alanine aminotransferase （ALT）， aspartate aminotransferase， gamma-glutamyl transpeptidase， alkaline phosphatase， fibronectin， triglycerides， high-density lipoprotein cholesterol， total triiodothyronine （TT3）， Homeostasis Model Assessment of Insulin Resistance （HOMA-IR）， and NFS （all P<0.05）. Compared with the non-NAFLD group， the NAFLD group had a significantly higher mRNA expression level of miR-128-3p in peripheral blood （t=-8.765， P<0.001） and significant reductions in the mRNA and proteins expression levels of SIRT1 and AMPK （P<0.001）. There were significant differences between the progressive liver fibrosis group and the non-progressive liver fibrosis group in age， ALT， free triiodothyronine， TT3， superoxide dismutase， and miR-128-3p （all P<0.05）. The logistic regression analysis showed that miR-128-3p was an independent risk factor for the development of NAFLD （odds ratio ［OR］=8.221， 95% confidence interval ［CI］： 2.735 — 24.714， P<0.001） and progressive liver fibrosis （OR=1.493， 95%CI： 1.117‍ ‍—‍ ‍1.997， P=0.007）. The ROC curve analysis showed that miR-128-3p had an area under the ROC curve of 0.890 （95%CI： 0.829 — 0.950）， with an optimal cut-off value of 13.165， a sensitivity of 89.3%， and a specificity of 72.7%. ConclusionThere is an increase in the expression of miR-128-3p in peripheral blood of T2DM patients with NAFLD， while there are reductions in the expression levels of SIRT1 and AMPK， suggesting that miR-128-3p has a certain diagnostic value in identifying NAFLD and liver fibrosis in such population.