As a significant treatment for tumors, radiotherapy is often considered a local therapy.However, an increasing number of researches indicate that reasonable radiation dose schedules can improve the tumor environment, induce immunogenic tumor cell death, provide in situ vaccine, and stimulate systemic antitumor effect.Meanwhile, immunotherapy can enhance the effect induced by radiotherapy, which has been proved in preclinical studies and is widely investigated in clinical studies.This review focuses on the immune response and mechanisms of radiotherapy, and advances in the application of radiotherapy in combination with immunotherapy.

Objective To investigate the expressions of miR-210-3p,miR-221-3p,miR-21-5p and miR-150-Sp in the plasma of breast cancer patients before and after radiotherapy in order to establish reliable early biomarkers of non-uniform radiation injuries.Methods Blood samples were collected from 13 patients before radiotherapy (0 Gy) and 24 h after radiotherapy of 2,10,20,30 Gy.The miRNAs in the blood plasma were detected with qRT-PCR.Results The levels of miR-210-3p,miR-221-3p,miR-21-5p had no significant difference among different dosage groups after radiotherapy(P ＞ 0.05).There was no significant difference between the expression of miR-150-5p before and after 2 Gy radiotherapy (P ＞ 0.05).While the relative level of miR-150-5p gradually decreased to 0.808,0.605,0.565 (x2 =18.76,P ＜ 0.05) with increased accumulative dosage of 10,20,and 30 Gy,respectively.In addition,the miR-150-5p expression levels had no relationship (P ＞ 0.05) with situations (positive or negative group) of human epidermal growth factor receptor 2 (HER2),estrogen receptor (ER) and progesterone receptor (PR) in the breast cancer cells.Conclusions Ionizing radiation could reduce the expression of miR-150 in the plasma of breast cancer patients in a dose-dependent manner.

BACKGROUND:Mesenchymal stem cels have the specific chemotaxis to the inflammation and tumor tissue, but the effect of mesenchymal stem cels on the growth of cervical cancer cels becomes an urgent problem. OBJECTIVE:To investigate the effect of human umbilical cord mesenchymal stem cels on the proliferation of cervical cancer Hela cels. METHODS:Hela cels were co-cultured with human umbilical cord mesenchymal stem cels at different number or its conditioned medium at different concentrations for 3 days. Then, cel counting kit-8 was used to detect the proliferation of Hela cels. RESULTS AND CONCLUSION:When Hela cels were co-cultured with human umbilical cord mesenchymal stem cels at ratios of 1:3, 1:2, 1:1, 2:1, 4:1, 8:1, the relative proliferation inhibition rates were 67.12%, 47.18%, 31.15%, 27.61%, 15.55% and 15.95%, respectively. When the Hela cels were co-cultured with human umbilical cord mesenchymal stem cel conditioned medium at 5, 10, 20, 40, 60, 100 mg/L, the relative proliferation inhibition rates were 0.61%, 40.1%, 63.47%, 80.61%, 93.56%, 90.65%, respectively. These findings indicate that the proliferation of Hela cels can be inhibited by co-culture with human umbilical cord mesenchymal stem cels at a certain concentration-dependent manner.

Objective To analysis the relationships between bone markers, bone-specific alkaline phosphatase (BAP) and cross-linked telopeptide of type Ⅰ collage (ICTP), and bone metastasis of breast cancer.Methods A total of 217 patients' serum were collected.The 217 cases were divided into two groups:109 cases with bone metastasis, 108 cases without bone metastasis. Serum BAP and ICTP was measured by ELISA. The relationships between factors of bone metastasis and serum levels of BAP, ICTP were analyzed.Results The levels of serum BAP and ICTP in bone metastases group were significantly higher than those in non-bone metastasis group[BAP:24.8 μg/L(7.60-213.70 μg/L) vs 21.2 μg/L(7.3～68.8 μg/L),ICTP:7.0μg/L(1.4～32.4 μg/L) vs 4.1 μg/L(0.0～15.8 μg/L) (P=0.003,P=0.000)].The level of serum BAP and ICTP in patients with multiple bone metastasis was significantly higher than that in patients with single bone metastasis[BAP:32.3 μg/L(9.A～213.7 μg/L) vs 18.1 μg/L(7.6～60.0 μg/L),ICTP:7.6 μg/L(1.4～32.4 μg/L) vs 4.9 μg/L(1.8～10.5 μg/L),(P=0.001,P=0.010)].The sensibility of BAP and ICTP was 45.0 ％ (49/109)and 46.8 ％ (51/109),respectively.The specificity of ICTP and BAP was 83.3 ％ (90/108)and 84.3 ％ (91/108),respectively.Joint detection of BAP and ICTP had improved sensibility in the diagnosis of bone metastasis in breast cancer patients. Conclusion Joint detection of serum bone biochemical markers ICTP and BAP have a little values for diagnosing bone metastasis in breast cancer patients.

Objective To evaluate the correlation of the clinical effects and prognosis in patients receiving medical ovarian suppression (goserelin)combined with anastrozole treatment with premenopausal metastatic breast cancer.Methods 44 hormone dependent mastatic breast cancer patients were treated by goserelin,3.6mg hypodermic injection every 28 days and anastrozole 1 mg were administered orally,clinical effects and prognosis were analysed.Results The clinical benefit rates of goserelin combination with anastrozole in patients with metastatic breast cancer were 52.4 ％(23/44),and the median progression free survival (PFS)was 8.3(5.3-11.2)months.In the analysis of whether to accept chemotherapy,the PFS of the not received chemotherapy group was better than received chemotherapy group (16.9 months vs 5.8 months P=0.048).Conclusion The combination of goserelin and anastrozole is an effective endocrine therapy regiment for patients with premenopausal metastatic breast cancer.It can be recommended for the premenopausal and hormone dependent mastatic breast cancer patients.

Objective To explore the operative indication , therapeutic effects and feasibility of immedi-ate mammoplasty with lateral thoracic steato-fascia flap.Methods A retrospective study was carried out on clini-copathologic data of 26 patients receiving nipple-areola complex preserving modified radical mastectomy and im-mediate mammoplasty with lateral thoracic wall adipofascial flap and 5 patients receiving segmental mastectomy and immediate mammoplasty with lateral thoracic wall adipofascial flap because of benign breast diseases .In these patients receiving nipple-areola complex preserving modified radical mastectomy , 22 patients received lateral tho-racic wall adipofascial flap , and 4 patients received lateral thoracic wall adipofascial flap combined with silicone prosthesis .The surgical complications and cosmetic effects were evaluated by both subjective and objective stand -ard postoperatively .Results 24 patients were satisfied with the appearance of their breasts and the two sides seemed to be symmetrical .There was no flap or nipple necrosis .The patients received adjuvant chemotherapy after surgery.No local recurrence or distant metastasis occurred during the follow up (2 to 12 months).Five patients with benign breast diseases were very satisfied with their breast appearance after surgery .Conclusion For patients in early stage breast cancer receiving modified radical mastectomy with nipple-areolar complex preserved and patients with benign breast diseases having segmental mastectomy , immediate mammoplasty with lateral thoracic wall adipo-fascial flap is a good method which can help to keep well breast apperance without additional incision , and it is also economical , feasible , and can reduce patients'psychological pressure due to loss of the breast .

To evaluate the effect of mobilization of peripheral blood stem cells (PBSC) with high dose cyclophosphamide combination chemotherapy and G-CSF in breast cancer patients, a new mobilization protocol was designed on the basis of standard combination chemotherapy regimen, in which the dose of cyclophosphamide was raised to 2 to 4 times, and G-CSF began to be used at the dose of 150 micro g twice everyday when white blood cell (WBC) decreased below 1.0 x 10(9)/L. PBSC collection was performed while WBC increased over 5.0 x 10(9)/L during bone marrow recovering. The PBSC mobilization protocol was completed in 10 patients, the median nadir of WBC was 0.8 (0.4 - 1.0) x 10(9)/L, the median time of PBSC collection was 2 (2 - 4), the median number of collected CD34(+) cells was 6.43 (1.99 - 8.75) x 10(6)/kg. The results showed that the protocol, high dose cyclophosphamide combination chemotherapy, was an optimal PBSC mobilization regimen in breast cancer patients.

OBJECTIVETo evaluate the efficacy and adverse effects of lentaron for postmenopausal patients with recurrent and metastatic breast cancer.

METHODSThirty-four patients with recurrent and metastatic breast cancer received 250 mg lentaron by intramuscular injection every 2 weeks for at least one month.

RESULTSIn 34 patients who were evaluable for efficacy and toxicity, the complete response rate (CR), partial response rate (PR), disease stabilization rate (SD) and progressive disease rate (PD) were 0%, 14.7%, 58.8% and 26.5%. The clinical benefit rate (CR + PR + SD >/= 6 months) was 50.0%. (17/34) with 12 patients (35.3%) having SD for at least 6 months. The response rates for bone, soft tissue and visceral metastasis were 28.6% (3/14), 13.6% (3/22) and 5.3% (1/19), respectively. There were no severe adverse effects in the treatment bylentaron.

CONCLUSIONLentaron is a well tolerated agent with reasonable efficacy but low toxicity for postmenopausal patients with recurrent and metastatic breast cancer.

Androstenedione ; adverse effects ; analogs & derivatives ; therapeutic use ; Antineoplastic Agents ; adverse effects ; therapeutic use ; Breast Neoplasms ; drug therapy ; pathology ; Disease Progression ; Female ; Humans ; Neoplasm Metastasis ; Neoplasm Staging ; Postmenopause ; Treatment Outcome

Objective To observe the changes of serum iron in patients with bronchopneumonia (bacterial pneumonia,mycoplasmal pneumonia) before and after treatment,and to discuss whether it can be used as an indicator of infection.Methods Forty cases with bacterial pneumonia and 41 cases with mycoplasmal pneumonia were recruited.The serum iron levels before and after treatment in bacterial pneumonia group and mycoplasmal pneumonia group were compared and analyzed.The correlation between white blood cell count,percentage of neutrophils,serum C-reactive protein (CRP) levels and the serum iron levels before treatment,and changes of the serum iron before and after treatment were analyzed.Results The level of serum iron after treatment in the bacterial pneumonia group [(16.28 ±5.81) μmol/L] was significantly higher than that before treatment [(4.83 ± 2.12) μ mol/L] (t =-11.19,P＜0.001).The level of serum iron after treatment in the mycoplasmal pneumonia group [(15.17 ±5.31) μmoL/L] was also significantly higher than that before treatment [(4.77 ± 1.99) μmol/L] (t =-11.29,P ＜0.001).The serum iron levels between the two groups before and after treatment had no statistically significant differences (t =0.135,0.898,P =0.893,0.373).There was no correlation between white blood cell count,percentage of neutrophils,CRP and serum iron levels before treatment (bacterial pneumonia group:r =-1.87,-0.219,-0.152;mycoplasmal pneumonia group:r =-0.032,-0.302,-0.274) and changes of the serum iron before and after treatment (bacterial pneumonia group:r =0.098,0.062,0.205;mycoplasmal pneumonia group:r =0.01 1,0.171,-0.105,P ＞ 0.05).Conclusion The serum iron level is significantly decreased in children with pulmonary infectious diseases and increased to normal level after anti-infection treatment.Serum iron can not be used as an indicator of infection in children.

Objective:To investigate the clinical characteristics of infantile neuroblastoma (NB) and the factors that affect prognosis.Methods:We retrospectively analyzed the clinical data collected from 44 cases of NB who received treatment in The Fourth Affiliated Hospital of China Medical University from March 2008 to March 2017 to summarize the clinical characteristics of NB and the factors that affect prognosis.Results:Among the 44 cases, 21 were male and 23 were female, with a median age of 5.5 months (range, 0 days-12 months). Four cases had stage I NB, seven cases stage II NB, five cases stage III NB, 15 cases stage IV NB, and 13 cases stage IVs NB. The tumors were located in the adrenal glands and retroperitoneum ( n = 26, 59.1%), posterior mediastinum ( n = 15, 34.1%), pelvis ( n = 2, 4.5%), and neck ( n = 1, 2.3%). The median follow-up time was 90 months (range, 2-144 months). The 3-year and 5-year overall survival rates were 93.2% and 90.9%, respectively. Among 35 cases who survived more than 5 years, 30 cases survived healthily, 5 cases survived with tumor, and 4 cases died. Bone marrow metastasis, bone metastasis, and the extent of tumor resection greatly affect the prognosis of NB ( χ2 = 6.92, 12.19, 4.70, all P < 0.05). Conclusion:The overall prognosis of NB is good in infants. NB mainly occurs in the abdomen. The survival rate of infants with stage IVs NB is lower than that of infants with stages I, II, and III NB. The prognosis of NB occurring in the abdomen is poorer than that occurring in other regions. Bone marrow metastasis, bone metastasis, and the extent of tumor resection are adverse factors affecting the prognosis.