Objective To observe the physique and anatomy changes in patients with nasopharyngeal carcinoma (NPC) during intensity-modulated radiotherapy (IMRT), using repeated CT images and deformable registration technique, and analyze their impact on delivery dose distribution.Methods Ten NPC patients were randomly selected from those who had received IMRT treatment.Gross tumor volume of nasopharyn (GTVnx), GTV of metastastatic lymph node (GTVnd), clinical target volume (CTV) and normal tissue or organ (OAR) were re-contoured on the in-course repeated CT images using a kind of deformable registration and auto-segmentation software according to the original planning contouring.Changes in volume of treatment targets and organs at risk were evaluated and the trends were then analyzed.Dose distributions were recalculated with repeated CT images and compared to the original plans.Results The volume of GTVnx were decreased by 6.44%,10.23% and9.72%(F=1.34,P=0.278) in the 2-,4-and 6-week after IM RT comparing with before IM RT, with 6.59%, 30.98 % and 35.13 % (F = 9.22, P =0.000) in GTVnd, 0.73%, 1.86% and 1.41% (F=0.33,P=0.722) in CTV1, -1.78%, -6.47%and -9.34% (F =16.89 ,P =0.000) in CTV2, 13.96%, 32.97% and 37.77%(F=17.17,P=0.000)in the left parotid , and 3.56% , 29.57% and 35.63% (F = 13.49 , P = 0.000) in the right parotid.The mean dose change rate of GTVnx were -0.39%, 0.08% and 0.32% (F =0.15 ,P =0.860) in the 2-,4- and 6-week after IMRT comparing with planning faction dose, with 0.53%, 1.19% and 0.69% (F=0.81,P=0.455) in GTVnd, 1.95%, 2.70% and 3.78% (F=0.61,P=0.552) in the spinal cord,0.32%, 0.81% and 0.62% (F=0.03,P=0.975) in the brain stem, 4.50%, 4.66% and 7.20% (F=0.33,P=0.725) in the left parotid, 2.20%, 7.17% and 7.12% (F= 1.24,P=0.306) in the right parotid.Conclusions The GTVnd, CTV2 and parotids shrinks obviously along with the treatment times for NPC patients during IMRT.Although changes in fraction dose of GTV, CTV, spinal cord, stem and parotids are not significant, further study with larger samples is needed.

Objective To evaluate the safety of cetuximab combined with intensity-modulated radiotherapy (IMRT) plus concurrent cisplatin chemotherapy in locoregionally advanced nasopharyngeal carcinoma (NPC) in a Chinese multicenter clinical study.MethodsFrom July 2008 to April 2009,100Patients with primary stage Ⅲ- Ⅳb non-keratinizing NPC were enrolled.The planned dose of IMRT to gross tumor volume and positive cervical lymph nodes was 66.0-75.9 Gy and 60-70 Gy in 30-33 fractions.Cisplatin (80 mg/m2,q3 week (w)) and cetuximab (400 mg/m2 one w before radiation,and then 250mg/m2 per w) were given concurrently.The adverse events (AEs) were graded according to common terminology criteria for adverse events v3.0.ResultsThe compliance of the entire group of patient was satisfactory.Actual median dose to gross tumor volume was 69.96 Gy,and the median dose to positive cervical lymph nodes was 68 Gy.Median dose of cisplatin was 133 mg,median first-dose of cetuximab was 690 mg,and median weekly dose was 410 mg.AEs were well tolerated and manageable,mainly consisting of acneiform skin eruptions,dermatitis and mucositis.Grade 4 mucositis was observed in 2％ of the patients and no other grade 4 AEs were observed.ConclusionsThe combined treatment modality of IMRT +concurrent chemotherapy + cetuximab in loco-regionally advanced NPC is well tolerated.

OBJECTIVE: To investigate the serological and molecular characteristics of a pedigree carrying an allele for ABO*BW.11 blood subgroup. METHODS: The ABO blood type of 9 pedigree members were determined by serological methods. Exons 6 and 7 of the ABO gene were amplified by PCR and directly sequenced. The patient and her father were also subjected to clone sequencing analysis. RESULTS: Serological tests demonstrated that the proband and her younger brother had an ABw subtype, whilst her father and two daughters had Bw subtype. Clone sequencing found that the exon 7 of the ABO gene of the proband had a T>C substitution at position 695, which was identified as a BW.11 allele compared with the reference sequence B.01. This BW.11 allele was also identified in the proband's father, brother and two daughters. Due to allelic competition, the A/BW.11 and BW.11/O alleles demonstrated significantly different phenotypes. CONCLUSION The c.695T>C substitution of the ABO gene may lead to allelic competition in the Bw11 subtype. Combined molecular and serological methods is helpful for precise blood grouping.
ABO Blood-Group System/genetics* ; Alleles ; Female ; Genotype ; Humans ; Male ; Pedigree ; Phenotype

Objective To investigate the intervention effect and mechanism of Suanzaoren decoction(SZRD)on insomnia and depression model mice based on pharmacodynamics and network pharmacology.Methods According to the insomnia disease model,the mice were randomly divided into control,insomnia model,SZRD low-dose,high-dose and diazepam groups;according to the depression disease model,the mice were randomly divided into control,depression model,SZRD low-dose,high-dose and Xiaoyao pill groups.The contents of 5-hydroxytryptamine(5-HT),norepinephrine(NE),and dopamine(DA)in the brains of mice were measured on days 7 and 28,and behavioral evaluations were performed in each group of mice.With the help of network pharmacology method to predict the key targets and related pathways of Suanzaoren decoction in the treatment of insomnia and depression,and to explore its mechanism.Results Behavioral tests and neurotransmitter content determination showed that SZRD could prolong sleep time(P<0.05),improve insomnia behavioral performance in model mice(P<0.05),reduce NE and DA contents in brain tissue of insomnia mice,increase 5-HT content(P<0.05),and was more significant in the low-dose group(P<0.05);SZRD could improve depression behavioral performance,increase sugar water preference,and reduce immobility time in model mice(P<0.05,P<0.01),and increase NE,DA,and 5-HT contents in brain tissue of depression mice(P<0.05),and was more significant in the high-dose group(P<0.05).18 core targets of SZRD in the treatment of insomnia and 34 core targets in the treatment of depression were predicted with the help of network pharmacology methods,and gene ontology(GO)functional analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway analysis showed that SZRD mainly involved biological processes such as dopamine neurotransmitter receptor activity,synaptic transmission and cellular response to reactive oxygen species,and acted on pathways such as the cGMP-PKG signaling pathway and IL-17 signaling pathway to exert therapeutic effects.Conclusion The changes of NE,DA and 5-HT contents in insomnia and depression model mice are not consistent,and the intervention effect of Suanzaoren decoction is also different.Low and high doses of Suanzaoren decoction can exert the best therapeutic effect on insomnia and depression model mice,respectively,and its promoting sleep and antidepressant effects may be related to the cGMP-PKG signaling pathway and IL-17 signaling pathway.

OBJECTIVE：To establish the HPLC fingerprints of Yuebi jiazhu decoction ，determine the contents of ephedrine hydrochloride and pseudoephedrine hydrochloride and carry out chemical pattern recognition analysis. METHODS ：Using ammonium glycyrrhizinate as control ，HPLC fingerprint of 10 batches of Yuebi jiazhu decoction was established and the similarity was evaluated with Similarity Evaluation System for TCM Chromatographic Fingerprint （2012 edition），and common peaks were identified in combination with mixed control. HPLC method was used to determine the contents of ephedrine hydrochloride and pseudoephedrine hydrochloride. SPSS 26.0 software was used for cluster analysis ；SIMCA 13.0 software was used for principal component analysis and partial least squares discriminant analysis ；the differential components affecting the quality were screened. RESULTS：There were 20 common peaks in the fingerprint of Yuebi jiazhu decoction ，and the similarities with control fringerprint were all greater than 0.92. Two peaks were identified ，which were liquiritin （peak 11）and ammonium glycyrrhizate （peak 18）. The linear range of ephedrine hydrochloride and pseudoephedrine hydrochloride were 0.98-48 μg/mL（r＝0.999 9）and 1.02-51 μg/mL （r＝0.999 2），respectively. RSDs of precision ，reproducibility and stability tests （24 h）were all less than 2％. The average recoveries were 105.67％（RSD＝2.88％，n＝9）and 104.15％（RSD＝2.02％，n＝9），respectively. The contents of ephedrine hydrochloride and pseudoephedrine hydrochloride were 0.008 1-0.014 3，0.002 5-0.011 8 mg/mL. Results of cluster analysis showed that among the 10 batches of Yuebi jiazhu decoction ，S1 was clustered into one class ，S3 was clustered into one class ，and S2，S4-S10 were clustered into one class. The results of principal component analysis showed that S 3 was located at the far right side of the scoring plot ，S1 at the right side of the scoring plot ，and S 2，S4-S10 at the middle of the scoring plot. The results of partial least squares discriminant analysis were basically consistent with the results of cluster analysis and principal component analysis. The variable importance projection values of peak 9，peak 3，peak 12，peak 8，peak 19，peak 18 （ammonium glycyrrhizinate），peak 13，peak 20 and peak 11（liquiritin）were greater than 1. CONCLUSIONS ：Established HPLC fingerprint and the method for content determination are simple and accurate. Combined with chemical pattern recognition ，they can be used for the quality control of Yuebi jiazhu decoction. Nine components such as peak 9 are the differential components affecting the quality of Yuebi jiazhu decoction.