Objective: To evaluate the prognostic factors of patients with stage Ⅳ gastric cancer. Meth-ods: A total of 138 patients with stage Ⅳ gastric cancer treated with platinum-based chemotherapy were ana-lyzed. Survival rate was estimated by Kaplan-Meier method. The prognostic factors were analyzed by univari-ate (Log rank) and multivariate (Cox model) analysis methods. Results: Univariate analysis and multivariate analysis showed that poor performance status (P=0.001), weight loss (P=0.001), depth of invasion (P=0.000), presence of peritoneal metastasis (P=0.005), more than 1 metastatic site (P=0.029) and elevated total biliru-bin (P=0.018) were independent prognostic factors. According to the outcomes of the Cox model analysis, a formula of the prognostic index was developed. According to the values of PI, 16 patients were categorized as the high-risk group (PI≤9.817), 28 patients were categorized as the moderate-risk group (9.817

Objective:To explore the role and mechanism of 4-1BBL and B7-1 molecules in the activation and proliferation of human peripheral blood T lymphocyte. Methods:T lymphocyte was purified by magnetic beads negative selecting. The proliferation of T cells in primary allogenic MLR was evaluated by using 3H-TdR incorporation; The immunophenotype of T cells was analyzed by FACS and the quantitative measurement of IL-2 in culture supernatant were performed by ELISA.Results:After negative selection, the purity of CD3+ T cells was over 90%; 4-1BBL and B7-1 molecules stably expressed on XG cells after 4-1BBL and B7-1 cDNA transfection; 4-1BBL or B7-1 gene transfected XG cells could more effectively mediate the activation, proliferation and IL-2 secretion of T cells than XG cells did, and the results also showed that the costimulatory molecules had a co-activating effect on T cells.Conclusion:Human multiple myeloma cells failed to induced antitumor immunoresponse because of the lack or weak expression of costimulatory molecules. The costimulatory molecules of 4-1BBL and B7-1 has a synthetic effect on endowing myeloma cells with enhancing the activation、proliferation and IL-2 secretion of T cells in vitro. [

Independent check is one of the key measures of quality control (QC) in radiotherapy and is essential for the assurance of radiotherapy accuracy.In recent years,with the application of computer-aided system,the automaticity of independent check,as well as its accuracy and efficiency,increases.Meanwhile,QC has evolved from a device-centered to a process-centered program.Therefore,independent check has been increasingly systematic and specific.This review gives a brief summary of the implementation and development of independent check.

In vivo dosimetry (IVD) is currently the most direct and effective means of quality assurance.The electronic portal imaging device (EPID) has been widely used for IVD verification owing to its favorable dosimetric properties.In recent years,an increasing number of EPID-based IVD studies have emerged around the world.The purpose of this paper is to give an overview of the present progress in EPID-based IVD studies,and to provide a reference for the subsequent application of EPID in IVD.

Objective:To explore the effect of irbesartan in the treatment of the patients with hypertension complicated with diabetes mellitus and its influence on urine trace albumin. Methods:Totally 62 cases of patients with hypertension complicated with diabetes mel-litus were divided into the observation group and the control group randomly with 31 patients in each. The patients in the control group were given the conventional blood sugar and blood pressure control, and the patients in the observation group were treated with irbesartan additionally. The treatment course was 3 months. The changes of blood pressure and urine trace albumin of the patients in the two groups before and after the treatment were compared, and the effect of blood pressure control and the adverse effects were evaluated as well. Re-sults:The total effective rate of the observation group was 96. 8%, which was much higher than that of the control group (83. 9%, P<0. 05) , and the difference had statistical significance (P<0. 05). After the treatment, the systolic blood pressure and diastolic blood pressure of the patients in the two groups were reduced significantly (P<0. 05), and the urinary albumin excretion rate (UAER) and the level of urine trace albumin (mAlb) of the patients in the two groups were obviously lowered (P<0. 05), and the decrease in the obser-vation group was more notable than that in the control group (P<0. 05). No significant difference in the incidence of adverse reactions was shown between the two groups(P>0. 05). Conclusion:The clinical effect of irbesartan in the treatment of patients with hypertension complicated with diabetes mellitus is promising with low incidence of adverse effects,which can effectively protect renal function as well.

OBJECTIVE To observe the bacterial content on the suspension bed sheet in burns intensive care unit.METHODS To detect the bacterial content on the suspension bed sheet and the common sickbed sheet(20 sheets in each group) after sampling them before use and 12 and 24 hours after use and to compare them.RESULTS The bacterial content on two sorts of the sheets before use was accorded with the Ministry of Health standards.but 12 hours after use the significant bacterial content on the common sickbed sheet [(4.9?2.1) CFU/cm2] was much higher than that on the suspension bed [(3.2?1.1) CFU/cm2,P0.01].CONCLUSIONS Using suspension bed could reduce bacterial content on the sheet and ease nurse workload.

Objective To provide the nurse care evidence of nutritional intervention in patients with lung cancer during radiotherapy and chemotherapy by analyzing the nutritional status of these patients.Methods 55 patients with lung cancer who received chemotherapy and radiotherapy were selected.The nutritional status of these patients were evaluated by laboratory examination data at the time of hospitalized,ongoing and the end of radiotherapy. Results The hemoglobin(Hb),albumin(ALB),body mass and body mass index(BMI)were (130.50 ±17.80)g/L, (41.02 ±5.68)g/L,(61.29 ±8.75)kg,(22.36 ±2.78)kg/m2 respectively at admission;(115.90 ±19.00)g/L, (37.94 ±5.55)g/L,(59.95 ±9.05 )kg,(21.86 ±2.86)kg/m2 respectively during the course of radiotherapy;(110.40 ±19.40)g/L,(36.91 ±5.30)g/L,(58.91 ±9.30)kg,(21.48 ±2.99)kg/m2 respectively at the end of radiotherapy.At different stages of radiotherapy,the nutritional index gradually decreased,the Hb was lower in the middle of the radiotherapy than on admission,the difference was significant(t =8.611,P <0.05).The Hb in the late stage of radiotherapy was lower than the middle,the difference was significant(t =2.492,P <0.05).Although the ALB in the latter stage of radiotherapy was lower than the middle,but the difference was not statistically significant (t =1.464,P >0.05),and the difference was significant compared with on admission(t =4.815,P <0.05).The weight of the patients in the middle period of radiotherapy was less than the time of admission,but the difference was not statistically significant(t =0.781,P >0.05).The weight of patients in the late stage of radiotherapy was lower than the medium term,but the difference was not statistically significant as well(t =0.601,P >0.05),and there was no significant difference compared with on admission(t =1.382,P >0.05).The BMI of the patients with radiotherapy was lower than that at the time of admission,the difference was not statistically significant(t =0.091,P >0.05).The BMI of patients with radiotherapy was lower than that in the medium term,whereas the difference was not statistically significant(t =0.690,P >0.05),and the difference was not statistically significant compared with on admission(t =1.599,P >0.05).The Hb (F =16.643,P =0.000)and ALB(F =7.736,P =0.001)decreased significantly in particular.Conclusion The risk of malnutrition in patients with lung cancer is exist during radiotherapy and chemo-therapy,and it is obvious in the middle -late stage,the changes of physical and biochemical indexes have been appeared,and among them,Hb and ALB are the most obvious,so should be monitored and managed cause these data varied significantly.

Objective To evaluate clinical safety and efficacy of autologous tissue antigens loaded dendritic cells (DC)in the treatment of elderly patients with gastric cancer.Methods Fresh tumor cells were isolated from surgical specimens in twenty patients with gastric cancer. Single cell suspensions were obtained and induced to apoptosis by heat shock. The apoptotic tumor cells were frozen before use.Peripheral blood mononuclear cells were isolated and cultured with recombinant human granulocyte macrophage-colony stimulating factor (GM-CSF) and interleukin-4 (IL-4).DCs were loaded with apoptotic tumor cells. The immunological and clinical responses were examined after the final vaccination. ResultsVaccination of dendritic cells was well tolerated and no toxicity was observed. The cytokine levels in serum such as IL-2(46 pg/mg vs 89 pg/mg), IL-12(44 pg/mg vs. 86 pg/mg) and IFN-γ(38 pg/mg vs.82 pg/mg) were increased after vaccinations as compared with pretherapy. DTH test were positive in five patients (5/10). The antigen special cells for CD8+/ IFN-γ+ were increased in five patients(5/10). The size of retroperitoneal lymph node of one patient was reduced. The tumor marker CEA level were decreased in five patients, stable in eight patient and increased in two patients.Conclusions Autologous DC vaccines loaded with autologous tumor antigens could improve function of non specific immunity and elicit specific T cells immunologic response and is one of safe and effective treatments for gastric cancer.

Objective: To detect the gene expression of Ku70, Ku80, ERCC4, lig4 and DNA-PKcs in non-homologous end joining pathway in human pdmary glioma tissues and normal brain tissues and to explore the underlying mechanism. Methods: The expression levels of Ku70, Ku80, ERCC4, lig4 and DNA-PKcsin in 36 glioma samples and 12 normal brain tissue samples were measured by SYBR Green real-time quantitative PCR. Methylation of DNA-PKcs was detected by methylation-specific PCR (MSP). Results: There was no significant difference in Ku70, Ku80, ERCC4 and lig4 expression between human primary glioma and normal brain tissues (P<0.05), while DNA-PKcs was significantly up-regulated (P= 0.002). The expression of DNA-PKcs was significantly higher in grade Ⅲ and Ⅳ glioma than that in grade Ⅱ glioma and normal brain tissues (P<0.05). Moreover, glioma tissues showed weaker methylation than normal brain tissues. Conclusion: The up-regulation of DNA-PKcs may be associated with pathogenesis of glioma. Demethylation of DNA-PKcs promoter is an important reason for its up-regulated expression in glioma.

Objective To analyze the impact of electronic portal imagingdevice (EPID) position error on three-dimensional dose verification of volumetric modulated arc therapy (VMAT).Metbods Five Suremark SL-20 lead points were fixed on Elekta tray,and EPID images were collected in 0-360° rotation,one image per 5°.The position error relative to the accelerator was analyzed via Matlab.Then the images position error was corrected according to the analysis,and the 3D dose was reconstructed with the corrected images.The dose distributions of double arcs,clockwise arc(arc 1),and counterclockwise arc (arc 2) of 16 nasopharyngeal carcinoma patients' VMAT plan were evaluated by γ analysis,and the results of before and after position error correction were compared.Results Compared to 0° gantry angle,the error of source to the image distance (SID) was maximum (1.20 cm) when the gantry angle was 180°.On account of the SID change,the maximum error along the up-down (y) direction in the iso-center planar was 2.28 mm and the left-right (x) direction error was within ± O.5 mm.The 3D γ analyses of 16 nasopharyngeal carcinoma in VMAT plans were obviously increased after the position error along y was corrected.The double arcs,arc1 and arc 2 were increased by (4.12 ±1.67) ％ (t =-9.86,P＜ 0.05),(3.47±1.64) ％ (t=-8.46,P＜ 0.05) and (5.08±1.30) ％ (t=-15.63,P＜ 0.05) in 5％/3 mm standard,respectively.However,in 3％/3 mm standard,γ value of the double arcs,arc 1 and arc2 were increased by (7.63 ±2.24) ％ (t =-13.63,P＜ 0.05),(6.03 ±2.07) ％ (t =-11.66,P＜ 0.05),(9.17 ±2.23) ％ (t =-16.41,P＜ 0.05),respectively.Since the EPID position error along x was corrected after y,the 3D γ analysis of reconstruction dose indicated that the average of the 5％/3 mm and 3％/3 mm γ value were increased by 0.23％ and 0.24％,respectively.Conclusions EPID motion error along the gantry to table direction of the accelerator can't be ignored.When reconstruct dose based on EPID,a modification should be made for rebuilding more accurate patients' 3D dose distribution.