Cancer is one of the main diseases that threaten the health of human.In order to increase the cure rate of cancer,the accurate therapy of cancer must be developed speedily.The most effective method for curing cancer is intensity modulated radiation therapy(IMRT),which can increase the local control rate of cancer and decrease complications of tissues.IMRT is considered to be an important breakthrough in cancer therapy.The dose produced by it is better than 3D-CRT and can achieves better results of therapy,which has been confirmed in the clinical therapies of head cancer,neck cancer,prostate cancer,breast cancer,cervical cancer and pancreas cancer etc.The developing course of IMRT,the methods of intensity modulation,the enforcement process of IMRT and the feasibility test of therapy plans are emphatically introduced.

Objective To explore the protective effects of dipeptidyl peptidase-4 inhibitor (DPP-4I) on AD-like neurodegenerative changes and its mechanism. Methods The human neuroblastoma cell line SH-SY5Y on the logarithmic phase was divided into six groups:control group (CON group, treated with PBS contained 1‰DMSO for 12 h), wortmannin intervention group (W group, treated with 0.03 μmol/L wortmannin for 12 h), DPP-4I intervention group (DPP-4I group, treated with 10μmol/L DPP-4I for 12 h), both DPP-4I and wortmannin intervention group (DPP-4I+W group, pre-treated with 10 μmol/L DPP-4I for 2 h, then 0.03 μmol/L wortmannin for 12 h), DPP-4I, wortmannin and Ex9-39 intervention group (DPP-4I+W+Ex9-39 group, pre-treated with 10μmol/L Ex9-39 for 2 h, then 10μmol/L DPP-4I for 2 h followed by 0.03μmol/L wortmannin for 12 h), and Ex9-39 intervention group (Ex9-39 group, treated with 10μmol/L Ex9-39 for 12 h). MTT assay was used to detect the cell vitality. Western blot assay was used to detect the level of total tau protein (tau-5) and phosphorylated tau at different sites (pSpS199/202, pT231 and pS396), the level of phosphorylated neurofilaments (NF-H, NF-M) and phosphorylation of critical enzyme in PI3K/Akt/GSK-3β signaling pathway. Results (1) The cell vitality decreased, the levels of pSpS199/202, pT231, pS396 and NF-H/M increased significantly in W group than those in CON group. However, comparing with CON group, the above mentioned parameters reversed in DPP-4I group. Comparing with W group, the cell vitality increased and phosphorylated levels of above mentioned indices were decreased in DPP-4I+W group. (2) The cell vitality showed a decline trend while the levels of phosphorylation tau at three different sites and NF-H/M were higher in Ex9-39 group than those in CON group. Comparing with DPP-4I+W group, the results of the phosphorylated levels showed the same changes in DPP-4I+W+Ex9-39 group. (3) Comparing with CON group, the expression levels of phosphorylated PI3K, Akt and GSK3β increased significantly in DPP-4I group, while those decreased in W group. Additionally, the expression levels of phosphorylated PI3K, Akt and GSK3β were significantly increased in DPP-4I+W group than those in W group. Conclusion DPP-4I can enhance the level of GLP-1 and activate PI3K/Akt/GSK-3βinsulin signaling pathway to improve the hyperphosphorylated tau and NFs induced by wortmannin, and to protect AD-like neurodegeneration.

Objective To investigate clinical manifestations and clinical diagnosis and treatment and pathological and immunohistochemical features in gastrointestinal stromal tumors. Methods The clinical data of fifty-two cases with gastrointestinal stromal tumors were collected, whose clinical diagnosis and treat-ment and pathological features were retrospectively analyzed from January 1995 to December 2007. Results All patients received operation therapy, only forty-five cases with complete surgical resection. The immu-nohistochemical staining showed that the cases with CD117 positive accounted for 100% (52/52) and CD34 positive accounted for 88.5% (46/52). Conclusions Surgery was necessary for all patients, especially complete surgical resection. Gastrointestinal stromal tumors were poor in preoperative diagnosis, which diag-nosis was based on the immunohistochemical staining of the tumor tissue. CD117 and CD34 tumor markers may help to diagnose gastrointestinal stromal tumors.

0.05). Nausea, vomiting, alopecia, and bone marrow suppression in the combinedly chemotherapic group were more severe than in the intravenously treated group, but abdominal distension and pain were the major toxic side effect in combinedly chemotherapic group(P

Ovarian cancer, one of the gynecological malignancies, poses a serious threat to women's health. The machine learning combines statistics and computer science. Researchers apply the machine learning to the clinical diagnosis and prognosis research of ovarian cancer. This article reviews the applications of machine learning in ovarian cancers. The results show that the predictive ability of machine learning models is better than traditional statistical models, but further test and verification are needed in prospective large-scale studies.

The incidence rate of ovarian cancer ranks the third among female malignant tumors, the mortality rate ranks the first and the prognosis is poor. Ovarian cancer poses a serious threat to the health of women's lives. The incidence of ovarian cancer is related to heredity, endocrine disorders and adverse lifestyle factors. In recent years, some scholars have carried out the impact of lifestyle, especially shift work, on the occurrence and development of ovarian cancer. Shift work can lead to circadian disruption, which affects hormonal balance in the body and may be a risk factor for ovarian cancer. This review summarizes four cohort studies and two case-control studies on the relation between shift work and ovarian cancer. The conclusion of the studies is inconsistent, suggesting that further researches are needed.

Objective To provide objective parameters for differentiating pancreatic cystic tumors via using computed tomography texture analysis (CTTA) to quantify the special imaging features of pancreatic cystadenomas.Methods Enhanced CT images of pancreas from patients who were admitted in Department of Radiology in First Hospital affiliated with Zhejiang University and First People's Hospital of Hangzhou City and pathologically diagnosed as pancreatic serous cystadenomas (n =48) and mucinous cystadenomas (n =34) from January 2009 to December 2016 were retrospectively analyzed.Regions of interest were drawn on the parenchymal phase CT images in 5 slices according to the border of the tumors.Mean grey level intensity (M),variance (V),entropy (E),skewness (Ske) and kurtosis (Kur) were obtained from fine texture (σ =1.0) to coarse texture (σ =2.5).Receiver operating characteristic (ROC) curve for texture parameters with statistically difference was drawn,and the area under curve (AUC),diagnostic sensitivity and specificity were calculated.The diagnostic accuracy of senior and junior doctors was compared with the traditional CT analysis method.Results Reliability coefficient of the two radiologists was 0.809 ～ 0.997 with high consistency.Compared with mucinous cystic tumors,serous cystadenomas had a significantly different V (5.93 ± 9.02 vs 1.29±0.62),E (2.39±0.61 vs2.02±0.39) and Kur(30.18 ±42.55 vs 8.80-±4.34) in Ske0 of 2.5 (P ＜0.05),and there were no statistically significant differences on other parameters.The AUC of differential parameters for diagnosing two kinds of cystic tumors ranged from 0.56 to 0.84.The diagnostic accuracy of the traditional CT analysis method by junior doctor and senior radiologist was 60％ and 71％,respectively.Conclusions CTTA can not only effectively quantify the heterogeneity of pancreatic cystadenomas,but also is effective in the differentiation.

Objective:To explore the value and risk of electronic bronchoscope applied in perioperative management of children with congential tracheoesophageal fistula.Methods:Sixty-five children with congential tracheoesophageal fistula performed electronic bronchoscope examination from September 2014 to November 2020 were enrolled in this study.The results of examination and complications were analyzed.Results:Sixty-three children with congenital tracheoesophageal fistula were diagnosed by electronic bronchoscopy.The diagnosis rate was 96.92%.Fifty-four children with congenital tracheoesophageal fistula were diagnosed by esophagography.The diagnosis rate was 91.53%.Sixty-one children with congenital tracheoesophageal fistula were diagnosed by multislice spiral computed tomography.The diagnosis rate was 93.85%.Airway anatomic abnormity was found in 27 children, including three cases of nasopharyngeal soft tissue collapse, 14 cases of laryngomalacia, five cases of tracheal stenosis, nine cases of tracheobronchomalacia, and nine cases of tracheobronchial and abnormal opening of the bronchus.The incidence was 41.54%.Three children with difficult ventilator weaning were related to tracheobronchial stenosis or tracheobronchomalacia.They were gradually weaning from ventilator after a long period of mechanical ventilation and treatment.Two children with transient decrease in oxygen saturation were noticed as complication.Conclusion:Electronic bronchoscopy is a safe and effective method for the diagnosis of congenital tracheoesophageal fistula and recurrence after operation.It is of great value to the airway management after operation by early detection of respiratory anatomic abnormity.

Objective:To compare the clinical efficacy and safety of continuous dosing or alternate-day dosing of apatinib combined with SOX regimen as first-line treatment for patients with advanced gastric cancer.Methods:A total of 52 patients with human epidermal growth factor receptor 2 (HER2) negative and inoperable locally advanced or advanced gastric cancer who were pathologically diagnosed from January 2018 to January 2021 in the Second Affiliated Hospital of Shandong First Medical University were collected. The patients were divided into continuous dosing group and alternate-day dosing group by random number table method. The continuous dosing group received apatinib (250 mg, once a day) combined with SOX regimen (S-1+oxaliplatin); the alternate-day dosing group received apatinib (250 mg, once every other day) combined with SOX regimen. Twenty-one days were a cycle, and the efficacy was evaluated after 2 cycles. After 4-6 cycles, patients with stable disease received apatinib and S-1 for maintenance therapy. The therapeutic effects and adverse reactions of the two groups were compared.Results:The curative effect could be evaluated in 51 patients, including 26 in the continuous dosing group and 25 in the alternate-day dosing group. The disease control rates in the continuous dosing group and the alternate-day dosing group were 84.6% (22/26) and 76.0% (19/25) ( χ2 = 0.60, P = 0.499), and the median progression-free survival time was 7.50 months (95% CI 6.17-8.83 months) and 8.30 months (95% CI 6.99-9.61 months) ( χ2 = 0.71, P = 0.401), and the median overall survival time was 15.50 months (95% CI 11.30-19.69 months) and 15.60 months (95% CI 13.63-17.57 months) ( χ2 = 1.82, P = 0.177). The main adverse reactions in the two groups were leukopenia, thrombocytopenia, hypertension, nausea, vomiting, fatigue, hand-foot syndrome, proteinuria, liver and kidney damage. The incidence rates of ≥grade 3 adverse reactions in the continuous dosing group and the alternate-day dosing group were 42.3% (11/26) and 12.0% (3/25), and the difference was statistically significant ( χ2 = 4.46, P = 0.035). Conclusions:The efficacy of continuous dosing or alternate-day dosing of apatinib combined with SOX regimen as first-line treatment for advanced gastric cancer is similar, but the incidence of ≥grade 3 adverse reactions in alternate-day dosing group is lower, which improves the compliance and tolerance of patients.

Objective To use in vitro experiments to verify the changes of proliferation, senescence and apoptosis of hepatocellular carcinoma cells after inhibiting the expression of NEK7, and to explore the related molecular mechanism. Methods Western blot and RT-PCR were used to detect the expression of NEK7 in hepatocellular carcinoma cells and THLE-2 cells. A viral vector was designed to inhibit the expression of NEK7 based on the gene sequence. After hepatocellular carcinoma cells were transfected, we observed the changes of proliferation activity, cell senescence, cell apoptosis and cell cycle in vitro. Western blot was used to detect the expression of cell cycle-related factors. Results Compared with THLE-2 cells, NEK7 was highly expressed in hepatocellular carcinoma cells. After inhibiting the expression of NEK7 with shRNA, the proliferation of hepatocellular carcinoma cells was inhibited, the proportions of cell senescence and apoptosis were increased, meanwhile, the cell number in stage S and G₂/M was significantly reduced, the cell cycle progression was blocked, the expression levels of C-myc, c-Fos, cyclin D1 and cyclin E were inhibited, P16 and P27 expression were increased, and CDK2, CDK4 and CDK6 expression were not significantly changed. Conclusion After inhibiting the expression of NEK7, the proliferation ability of hepatocellular carcinoma cells is reduced, cell senescence is promoted and apoptosis is induced; meanwhile, the cell cycle progress is blocked.