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Objective To discuss the therapeutic effect of chemoradiotherapy on 74 patients with early stage nasal NK/T cell lymphoma and their prognostic factors. Methods 74 patients with early nasal NK/T cell lymphoma that were treated in Shanxi Cancer Hospital from January 2005 to November 2013 were analyzed retrospectively. Among them, 28 patients received radiotherapy alone, 10 patients received concurrent chemoradiotherapy and 36 patients received alone. In 36 patients with chemotherapy, 25 cases were treated with CHOP (cyclophosphamide+doxorubicin+vincristine+prednisone), 4 cases were treated with DICE (dexamethasone + etoposide + cisplatin + isofosfamide) and 7 cases were treated with L-asparaginase +dexamethasone+ifosfamide+methotrexate + etoposide. According to Ann Arbor classification, 60 patients were stage Ⅰ and 14 patients were stage Ⅱ. Kaplan-Meier test was used for survival analysis, log-rank method was used for single factor analysis, and Cox proportional hazard model was used for multi factor analysis. Results All patients completed the treatment. 24 patients were died. 3-year overall survival (OS) rate was 72.5 %. The OS rate in simple radiotherapy group was 92.7 %, simple chemotherapy group was 62.3%, and the concurrent chemoradiotherapy group was 79.1%. The OS rates in simple radiotherapy and simple chemotherapy groups had statistical difference (χ2 = 10.676, P< 0.05), The difference in the simple radiotherapy and concurrent chemoradiotherapy groups was not statistically significant (χ2= 2.019, P> 0.05). In radiotherapy alone group, the rates of complete remission (CR), partial remission (PR), stable rate and progress rate of disease were 89.3%(25/28), 7.1%(2/28), 3.6%(1/28), and 0;in chemotherapy alone group, they were 55.6 % (20/36), 25.0 % (9/36), 8.0 % (3/36), and 11.1 % (4/36); in concurrent chemoradiotherapy group, they were 80.0 % (8/ 10), 10.0 % (1/10), 0, and 10.0 % (1/10), respectively. There was significant difference between radiotherapy group and chemotherapy group (χ2 = 8.584, P< 0.05); there was no significant difference between radiotherapy group and concurrent chemoradiotherapy group (χ2=0.556, P>0.05). Single factor analysis showed that age, ECOG score, B symptoms, Ann Arbor stage, IPI and treatment options were related to the prognosis. Multivariate analysis showed that age, ECOG score and Ann Arbor stage were independent prognostic factors. Conclusions As the main treatment method of early stage nasal NK/T cell lymphoma, radiotherapy can obtain good short-term curative effect and long-term curative effect. Age, ECOG score, B symptoms, Ann Arbor stage, IPI and treatment options are related to survival prognosis. Age, ECOG score and Ann Arbor stage are the independent prognostic factors.

Objective To evaluate the prognosis influencing factors of early non-small cell luny cancer (NSCLC) after radiotherapy.Methods 81 early NSCLC patients received definitive radiotherapy and were eligible.Among these patients,60 were diagnosed as squamous cell carcinoma,16 were adenocarcinoma and 5 were diagnosed through imaging instead of pathology.45 patients received conventional radiotherapy,36 patients received three dimensional conformal radiotherapy (3D-CRT),All of them received a total dose of 50-96 Gy with a median dose of 67.8 Gy. Kaplan-Meier survival curves and Cox regression model analysis were applied to evaluate the survival and prognostic factors. Results The median survival time was 34 months.The 1-,3- and 5-year survival rates (OS) were 88.7 ％,41.9 ％,21.8 ％,respectively.Karnofsky performance status≥80,Clinical stage, diameter≤4 cm and the therapeutic effect were associated with improving overall survival.Cox hazards model showed that Karnofsky performance status≥ 80 and diameter≤4 cm were likely to be independent positive prognostic factors. Conclusion Karnofsky performance status and tumor diamater can be used to evaluate the prognosis of early NSCLC after radiotherapy.

Objective At present, the methods of separating and identifying nasopharyngeal cancer stem cells are not yet mature.This study was to explore the methods of culturing nasopharyngeal cancer stem cell microspheres and identify the cancerous stem cell biological features of CNE-2 cell microspheres. Methods We conducted suspension culture of human nasopharyngeal cancer CNE2 cells and C666-1 cells in serum-free medium ( SFM) containing growth factors.Then we measured the proportion of CD133 +cells in CNE2 monolayer ( CNE2-MN) and CNE2 microsphere cells ( CNE2-SC) by flow cytometry, determined their in vitro invasiveness through Transwell chamber experiments, and detected their in vivo tumorigenicity via nude mouse experiments.We ob-served the differentiation potency of the CNE2-SCs in the adherent-cultured serum-containing medium and detected the expressions of the cancer stem cell-related genes Bmi-1, Oct4, and Twist1 in CNE2-MN and CNE2-SCs by flow cytometry and RT-PCR analysis. Results In the special blend of SFM, both of the cell lines can form microspheres that can be stably transferred.Fresh SFM prepara-tion, substituting cell separation agent Accutase for pancreatic enzyme for transfer, and maintaining the state of cell suspension contrib-uted to the formation and proliferation of microspheres.Adherent culture with serum-containing medium induced the differentiation of CNE2-MN cells, which exhibited no significant difference from the CNE2 microsphere cells.The CD133 +cells accounted for 98.79%in the CNE2 microspheres, significantly higher than 0.98%in the CNE2 cells (P<0.01).Compared with the CNE2-MN cells, the CNE2-SCs showed highly increased expressions of Bmi-1, Oct4, and Twist1 (P<0.01).The numbers of membrane-penetrating cells in the CNE2-SCs and CNE2-MN cells were 122 ±6 and 36 ±7 per visual field, the former with a stronger invasive ability than the latter genesis of 1 ×106 CNE2-SCs vs that of the same number of CNE2 -MNcells was (2.332 ±0.549) cm 3 sv (0.669 ±0 .278) cm3 ( P<0.01). Conclusion Using suspension culture with a specially prepared SFM, nasopharyngeal cancer CNE2 microsphere cells can be obtained, in which there are large numbers of cancer stem cells.This culture method may provide a base for further studies of naso-pharyngeal cancer stem cells.

Objective To explore the imaging features of papillary thyroid microcarcinoma(PTMC) with real time contrast-enhanced ultrasound.Methods One hundredand forty-three cases with 149 thyroid nodules(no diffuse lession) were divided into two groups according to the diameter size(group 1,＜0.5 cm;group 2,0.5-1.0 cm) and examined by contrast-enhanced ultrasound during preoperation.Pathology was followed up as golden diagnosis criteria.Results Seventy-five benign tumors and 74 PTMC were confirmed by pathology.There were significant differences in echoes homogeneity between benign and malignant tumors in group 2(W =1 029.5,Z =-5.524,P =0.000) but no in group 1(W =933.0,Z =-1.738,P =0.082).And nonhomogeneous enhancement were showed in most PTMC in group 2.But most PTMC showed homogeneous enhancement in group 1.Conclusions Contrast-enhanced ultrasound is valuable in diagnosis of PTMC with the diameter size of 0.5-1.0 cm.

AIM: To illuminate the effect of SWI/SNF-related, matrix-associated, actin-dependent regulator of chromatin, subfamily b, member 1 (SMARCB1) in early diagnosis and prognosis of hepatocellular carcinoma (HCC) by determining the clinical expression of SMARCB1 in HCC tissue and benign liver tissue.METHODS: The specific target gene SMARCB1 was selected from these genes by using The Cancer Genome Atlas (TCGA).SMARCB1 expression in HCC tissue and benign liver tissue was measured by immunohistochemistry.Further statistical analysis of TCGA was performed to illuminate the role of SMARCB1 on HCC occurrence and progression.RESULTS: Compared with the benign liver tissue, immunohistochemical staining showed that SMARCB1 expression was significantly up-regulated in the HCC tissue (P<0.01).In addition, SMARCB1 expression was significantly associated with advanced tumor stage (P<0.05).The relation between SMARCB1 expression at mRNA level and clinical prognosis was analyzed.The results indicated that high SMARCB1 expression was an independent prognostic factor for HCC (P<0.05).CONCLUSION: SMARCB1 may play a part as a carcinogenic gene in tumorigenesis.We can distinguish primary HCC samples from non-malignant samples according to its different clinical expression.High SMARCB1 expression probably predicts poor outcome in HCC patients.

Objective:To estimate the predictive performance of the population pharmacokinetics software JPKD-vancomycin on predicting the vancomycin steady-state trough concentration, and to analyze the related factors affecting the predictive performance.Methods:The clinical data of patients who were treated with vancomycin and received therapeutic drug monitoring (TDM) admitted to Suzhou Hospital Affiliated to Nanjing Medical University from July 2013 to December 2018 were enrolled. All patients were designed an empirical vancomycin regimen (initial regimen) according to vancomycin medication guidelines. Steady-state trough concentrations of vancomycin were determined at 48 hours after the first dose and 0.5 hour before the next dose. Dosage regimen was adjusted when steady-state trough concentration was not in 10-20 mg/L (adjustment regimen), and then the steady-state trough concentration was determined again 48 hours after adjustment. First, the JPKD-vancomycin software was used to calculate the initial regimen and predict the steady-state trough concentration according to the results calculated by classic pharmacokinetic software Vancomycin Calculator. Second, the JPKD-vancomycin software was used to adjust the vancomycin dosage regime and predict the steady-state trough concentration of adjustment regimen. The weight residual (WRES) between the predicted steady-state trough concentration (C pre) and the measured steady-state trough concentration (C real) was used to evaluate the ability of the JPKD-vancomycin software for predicting the vancomycin steady-state trough concentration. The TDM results of initial regimen were divided into accurate prediction group (WRES < 30%) and the inaccurate prediction group (WRES ≥ 30%) according to the WRES value. Patient and disease characteristics including gender, age, weight, height, the length of hospital stay, comorbidities, vasoactive agent, mechanical ventilation, smoking history, postoperative, obstetric patients, trauma, laboratory indicators, vancomycin therapy and TDM results were collected from electronic medical records. Univariate and multivariate Logistic regression analysis was used to screen the related factors that influence the predictive performance of JPKD-vancomycin software, and the receiver operating characteristic (ROC) curve was drawn to evaluate its predictive value. Results:A total of 310 patients were enrolled, and 467 steady-state trough concentrations of vancomycin were collected, including 310 concentrations of initial regimen and 157 concentrations of adjustment regimen. Compared with the initial regimen, the WRES of adjusted regimen was significantly reduced [14.84 (6.05, 22.89)% vs. 20.41 (11.06, 45.76)%, P < 0.01], and the proportion of WRES < 30% increased significantly [82.80% (130/157) vs. 63.87% (198/310), P < 0.01]. These results indicated that JPKD-vancomycin software had a better accuracy prediction for steady-state trough concentration of the adjusted regimen than the initial regimen. There were 198 concentrations in the accurate prediction group and 112 in the inaccurate prediction group. Univariate Logistic regression analysis showed that women [odds ratio ( OR) = 0.466, 95% confidence interval (95% CI) was 0.290-0.746, P = 0.002], low body weight ( OR = 0.974, 95% CI was 0.953-0.996, P = 0.022), short height ( OR = 0.963, 95% CI was 0.935-0.992, P = 0.014), low vancomycin clearance (CL Van; OR < 0.001, 95% CI was 0.000-0.231, P = 0.023) and postoperative patients ( OR = 1.695, 95% CI was 1.063-2.702, P = 0.027) were related factors affecting the predictive performance of JPKD-vancomycin software. Multivariate Logistic regression analysis indicated that women ( OR = 0.449, 95% CI was 0.205-0.986, P = 0.046), low CL Van ( OR < 0.001, 95% CI was 0.000-0.081, P = 0.015) and postoperative patients ( OR = 2.493, 95% CI was 1.455-4.272, P = 0.001) were independent risk factors for inaccurate prediction of JPKD-vancomycin software. The ROC analysis indicated that the area under ROC curve (AUC) of the CL Van for evaluating the accuracy of JPKD-vancomycin software in predicting vancomycin steady-state trough concentration was 0.571, the sensitivity was 56.3%, and the specificity was 57.1%. The predictive performance of JPKD-vancomycin software was decreased when CL Van was lower than 0.065 L·h -1·kg -1. Conclusions:JPKD-vancomycin software had a better predictive performance for the vancomycin steady-state trough concentrations of adjustment regimen than initial regimen. JPKD-vancomycin software had a poor predictive performance when the patient was female, having low CL Van, and was postoperative. The predictive performance of JPKD-vancomycin software was decreased when CL Van was lower than 0.065 L·h -1·kg -1.

Objective To evaluate the predictive value and to verify the clinical effect of JPKD-vancomycin for the trough concentration of vancomycin in patients with augmented renal clearance (ARC), and to provide a reference for clinical individualized drug therapy. Methods A retrospective analysis was conducted. The clinical data of 48 adult patients with ARC using vancomycin and monitoring steady-state trough concentration of vancomycin admitted to Suzhou Hospital Affiliated to Nanjing Medical University from July 2013 to July 2017 were collected. A combination of classical Vancomycin Calculator software and JPKD-vancomycin software was used. Based on the individual conditions of patients [gender, age, height, weight, serum creatinine (SCr), disease status], Vancomycin Calculator software was used to obtain the recommended regimen and its steady-state trough concentration, and then JPKD-vancomycin software was used to predict the steady-state trough concentration of initial regimen. If the regimen was adjusted during the treatment, JPKD-vancomycin software was used to predict the steady-state trough concentration of the adjusted regimen. The measured values of steady-state trough concentration were recorded. The weight deviation between predicted concentration and measured concentration (WRES) was calculated. WRES < 30% was considered as good prediction, and the predictive value of JPKD-vancomycin software was evaluated for vancomycin trough concentration. Results Forty-eight patients with ARC were enrolled, of whom 24 patients had adjusted the dosing regimen during the treatment. The initial concentration of blood samples was 48, after adjusting the dosage regimen, 24 blood samples were collected. The initial and adjusted daily dose of vancomycin was (2 000±500) mg/d and (2 500±600) mg/d, respectively, and the initial trough concentrations and adjusted trough concentrations was (8.4±7.3) mg/L and (9.1±4.3) mg/L, respectively. Only 14.6% and 25.0% of initial and adjusted trough concentrations reached the target range (10-20 mg/L) without significant difference (P > 0.05). The WRES value of adjusted trough concentrations predicted by JPKD-vancomycin software was significantly lower than that of initial regimen [10.6% (3.0%, 16.4%) vs. 14.3% (10.5%, 38.2%), P < 0.05], and the percentage of WRES < 30% also tended to increase [95.8% (23/24) vs. 70.8% (34/48), P < 0.05]. The well predictive rate of JPKD-vancomycin software for vancomycin trough concentration was 79.2% (57/72), but there were 15 patients with WRES > 30%. Conclusions JPKD-vancomycin software has good predictive value for the vancomycin trough concentration of ARC patients, especially for the trough concentration after adjusting the treatment regimen. JPKD-vancomycin can provide a reference for the design of clinical individualized application of vancomycin.

OBJECTIVE To stu dy the effects of different processing me thods on the contents of the pharmacodynamic index components in Citrus aurantium and their antioxidant activity. METHODS According to the general principles of 2020 edition of Chinese Pharmacopoeia （volume Ⅳ） and the relevant processing methods in 2015 edition of Processing Specifications of Traditional Chinese Medicine in Zhejiang Province ，the samples of C. aurantium were prepared by steaming with water ，boiling with water ，stir-frying with vinegar ，stir-frying with wine ，stir-frying with bran ，processing with bran and processing with honey. The contents of moisture and ash in different products of C. aurantium were detected. The contents of naringin and neohesperidin in different products of C. aurantium were determined by high performance liquid chromatography. The antioxidant activity of different products was investigated by DPPH and ABTS + radical scavenging experiments and the total reducing power test. RESULTS The contents of moisture ，ash，naringin and neohesperidin were in line with the relevant requirements in 2015 edition of Processing Specifications of Traditional Chinese Medicine in Zhejiang Province . The content of naringin in descending order was as follow ： unprocessed sample ＞sample processed with honey ＞sample processed with bran ＞sample boiled with water ＞sample stir-fried with vinegar＞sample stir-fried with wine ＞sample stir-fried with bran ＞sample steamed with water. The content of neohesperidin in descending order was as follow ：unprocessed sample ＞sample boiled with water ＞sample processed with bran ＞sample processed with honey ＞sample stir-fried with vinegar ＞sample steamed with water ＞sample stir-fried with wine ＞sample stir-fried with bran. The samples after boiling with water ，processing with bran ，and stir-fried with bran had better DPPH radicals scavenging ability （IC50 were 7.49，8.37 and 10.22 mg/mL，respectively）. The samples after boiling with water ，steaming with water ，and processed with bran had better ABTS + radicals scavenging ability （IC50 were 1.76，2.03 and 2.72 mg/mL，respectively）. In addition ， compared with sample stir-fried with wine and processed with 发。E-mail：wanglu1286@163.com honey，unprocessed sample and other processed products of C.aurantium had bet ter total reducing ability. CONCLUSIONS After processing ，the contents of the main pharmacodynamic index components in C. aurantium have been reduced ，but they were also in line with the relevant requirements in 2015 edition of Processing Specifications of Traditional Chinese Medicine in Zhejiang Province . The antioxidant ability of some processed products has been enhanced.