OBJECTIVETo evaluate the therapeutic effect and toxicity of intensity-modulated radiation therapy (IMRT) or three-dimensional conformal radiotherapy combined with chemotherapy (3-DCRT) with docetaxel and cisplatin in the treatment of locally advanced esophageal carcinoma.

METHODSSixty patients with locally advanced esophageal carcinoma were randomly assigned in two equal groups to receive IMRT or 3-DCRT, both combined with the chemotherapy with docetaxel and cisplatin. The total dose of radiotherapy was 64 Gy, administered in 30 fractions in 6 weeks.

RESULTSThe complete response rate (complete and partial remissions) of IMRT group was 90.0%, significantly higher than the rate of 80.0% in 3-DCRT group (P>0.05). The 1-, 2-, and 3-year survival rates of IMRT group were 86.7%, 70.0%, and 66.7%, as compared to 70.0%, 63.3%, and 63.3% in 3-DCRT group, respectively, showing no significant differences between the two groups (P>0.05). IMRT showed advantages over 3-DCRT in terms of the V20 and V30 parameters of the lung (P<0.05), and the incidences of radiation-induced esophagitis were comparable between the two groups (P>0.05).

CONCLUSIONWhen combined with the chemotherapy with docetaxel and cisplatin, IMRT appears to be a more effective treatment than 3-DCRT for locally advanced esophageal cancer.

Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Carcinoma, Squamous Cell ; therapy ; Cisplatin ; administration & dosage ; Combined Modality Therapy ; Esophageal Neoplasms ; therapy ; Female ; Humans ; Male ; Middle Aged ; Radiotherapy, Conformal ; methods ; Taxoids ; administration & dosage

OBJECTIVETo establish a method for efficient induction and expansion of Epstein Barr virus (EBV)-specific cytotoxic T lymphocytes (CTL) in vitro and evaluate the possibility of using this strategy for treatment of nasopharyngeal carcinoma (NPC).

METHODSEBV-transformed B lymphoblastoid cells (BLCLs) were used as the antigen stimuli and antigen-presenting cells. EBV-specific CTL was induced by co-culture of the autologous peripheral blood mononuclear cells (PBMCs) and the irradiated BLCLs, and expanded with a cocktail method consisting of OKT-3, irradiated homologous PBMC, and IL-2. The specific activity of the CTL against the NPC cells was measured with MTT assay.

RESULTSEBV-specific CTL was successfully induced and expanded by 600 folds. The killing efficiency of the CTL was 76% for autologous BLCLs, 13% for homologous BLCLs, 51% for autologous NPC cells, and 27% for homologous CNE cell line, and after expansion, the corresponding killing efficiencies were 63%, 25%, 49%, and 33%, respectively. The non-specific killing only slightly increased after the expansion.

CONCLUSIONEBV-specific CTL can be successfully induced and expanded in vitro for specific killing of autologous NPC cells, suggesting the potential of this strategy in the treatment of NPC.

Antigen-Presenting Cells ; cytology ; immunology ; Antigens, Viral ; immunology ; B-Lymphocytes ; cytology ; immunology ; virology ; Cells, Cultured ; Coculture Techniques ; Herpesvirus 4, Human ; immunology ; Humans ; Immunotherapy, Adoptive ; Nasopharyngeal Neoplasms ; immunology ; pathology ; therapy ; T-Lymphocytes, Cytotoxic ; cytology ; immunology ; virology ; Tumor Cells, Cultured

OBJECTIVETo observe the Chinese herbal medicine Selaginella-induced radiosensitization of terminal nasopharyngeal carcinoma (NPC).

METHODSTotally 180 patients with NPC were divided equally into 3 groups with the same radiotherapeutic protocols. The patients in group A received radiotherapy alone, those in group B were given daily Selaginella (30 g) prepared into 50 ml decoction during the entire course of radiotherapy, and those in group C had Selaginella 30 g daily in the late course of radiotherapy.

RESULTSThe complete remission rate of nasopharyngeal primary lesions in groups B and C was significantly higher than that in group A, with also significantly higher complete remission rates of the cervical lymph nodes. The acute toxicity of the skin and mucous membrane was milder in the latter two groups, but the differences were not significant.

CONCLUSIONSelaginella may induce radiosensitization for terminal NPC and does not increase the acute toxicity of radiotherapy.

Adult ; Carcinoma, Squamous Cell ; drug therapy ; radiotherapy ; Combined Modality Therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; drug therapy ; radiotherapy ; Phytotherapy ; Radiation-Sensitizing Agents ; therapeutic use ; Selaginellaceae ; chemistry ; Treatment Outcome

BACKGROUNDElective radiation of lower neck is controversial for nasopharyngeal carcinoma (NPC) without lymph node metastasis (N0 disease). Tumor volume is an important prognostic indicator. The objective of this study is to explore the potential impact of tumor volume on the indication of the lower neck irradiation for N0-NPC, by a qualitative evaluation of the relationship between tumor volume and nodal metastasis.

METHODSMagnetic resonance (MR) images of 99 consecutive patients with NPC who underwent treatment were retrospectively reviewed. Primary tumor volumes of NPC were semi-automatically measured, nodal metastases were N-classified and neck level involvements were examined. Distributions of tumor volumes among N-category-based groups and distributions of N-categories among tumor volume-based groups were analyzed, respectively.

RESULTSThe numbers of patients with N0 to N3 disease were 12, 39, 32, and 16, respectively. The volumes of primary tumor were from 3.3 to 89.6 ml, with a median of 17.1 ml. For patients with nodal metastasis, tumor volume did not increase significantly with the advancing of N-category (P > 0.05). No significant difference was found for the distribution of N1, N2, and N3 categories among tumor volume-based groups (P > 0.05). Nevertheless patients with nodal metastasis had significantly larger tumor volumes than those without metastasis (P < 0.05). Patients with larger tumor volumes were associated with an increased incidence of nodal metastasis.

CONCLUSIONSCertain positive correlations existed between tumor volume and the presence of nodal metastasis. The tumor volume (>10 ml) is a potential indicator for the lower neck irradiation for N0-NPC.

Adolescent ; Adult ; Aged ; Carcinoma ; Female ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; pathology ; radiotherapy ; Neck ; radiation effects ; Retrospective Studies ; Tumor Burden

Objective To explore and compare the efficacy and safety of different transurethral enucle-ation procedures for treating benign prostatic hyperplasia.Methods A retrospective analysis was conducted on the clinical data of 215 patients with benign prostatic hyperplasia admitted to our hospital from January 2021 to May 2023.According to the surgical procedures,they were divided into plasma resection group(n=81),treated with transurethral plasma resection of the prostate,laser resection group(n=92),treated with transurethral laser resection of the prostate,and green laser enucleation group(n=42),treated with transurethral green laser enucle-ation of the prostate.The three groups were compared in terms of perioperative indicators(surgical time,intraop-erative bleeding volume,bladder flushing time,indwelling catheter time,postoperative hemoglobin concentration,and hospital stay),urodynamic indicators(RUV,IPSS score,Qmax,and QOL score),and postoperative compli-cations.Results The green laser enucleation group and laser resection group demonstrated a significantly higher total effective rate compared to the plasma electrosurgery group(P<0.05).The three groups showed no statisti-cally significant difference in hospital stay(P>0.05),but the green laser enucleation group showed a signifi-cantly shorter surgical time compared to the other two group(P<0.05).The green laser enucleation group and laser resection group had superiority in intraoperative bleeding,bladder flushing time,and indwelling catheter time compared to the plasma resection group,and a significantly higher postoperative hemoglobin concentration compared to the plasma resection group(P<0.05).Repeated measurement analysis of variance showed that the three groups all exhibited significantly decreases in RUV,IPSS score,and QOL score(P<0.05),and a signifi-cantly increase in Qmax at 1 month and 3 months after surgery(P<0.05).The laser resection group and green laser enucleation group presented with significant decreases in RUV,IPSS score,and QOL score(P<0.05),and a significantly decrease in Qmax compared to the plasma resection group at 1 month and 3 months after surgery(P<0.05).However,the laser resection group and the green laser enucleation group had no statistically signifi-cant difference in RUV,IPSS score,Qmax,and QOL score at 1 month and 3 months after surgery(P>0.05).The green laser enucleation group had the lowest total incidence of postoperative complications,following by the laser resection group and plasma resection group in order(7.14%vs.21.74%vs.35.80%,P<0.05).Conclusion The three surgical procedures all have good therapeutic effects on benign prostatic hyperplasia.Transurethral laser prostatectomy and green laser enucleation have superiority to those of transurethral plasma resection of the prostate in efficacy and safety,and they can promote early recovery of patients.Transurethral green laser enucleation is the best in safety.

Adolescent ; Adrenal Cortex Diseases ; complications ; pathology ; surgery ; Adult ; Child ; Female ; Humans ; Hydrocortisone ; blood ; urine ; Male ; Middle Aged ; Pigmentation Disorders ; complications ; pathology ; surgery

Adrenal Cortex Neoplasms ; diagnosis ; pathology ; Adrenocortical Adenoma ; diagnosis ; pathology ; Aged ; Humans ; Immunohistochemistry ; Male ; Myxoma ; diagnosis ; pathology

BACKGROUNDRecently, arsenic trioxide (As2O3) was considered as a novel anti-tumor agent. However, it showed severe toxicity effect on normal tissue at the same time. To improve its therapeutic efficacy and decrease its toxicity,we prepared arsenic trioxide-loaded albuminutes immuno-nanospheres [As2O3-(HAS-NS)-BDI-1] targeted with monoclonal antibody (McAb) BDI-1 and tested its specific killing effect against bladder cancer cell.

METHODSAs2O3-HAS-NS was prepared by chemical cross-linking method. Monoclonal antibody BDI-1 was purified with ammonium sulphate saltingout and chromatography. Albuminutes microspheres were conjugated with McAb by SPDP cross-linking method. Concentration of As in As2O3-(HAS-NS)-BDI-1 and As2O3-HAS-NS was measured by atomic fluometry method. As2O3-(HAS-NS)-BDI-1 and its activity were detected by SDS-PAGE reduction electrophoresis, indirect immunofluorescence test, light microscope and scanning electron microscope observation. Acridine orange staining and tritiated thymidine (3H-TdR) incorporation tests were used to indicate specific killing activity of As2O3-(HAS-NS)-BDI-1 in vitro.

RESULTSIn As2O3-(HAS-NS)-BDI-1 groups, we saw two protein bands in SDS-PAGE reduction electrophoresis. Albuminutes immuno-nanospheres were rounded with clear green fluorescence by immunofluorescence test. Under microscope, we observed that BIU-87 cells were covered with the As2O3-(HAS-NS)-BDI-1 and that As2O3-(HAS-NS)-BDI-1 moved with the BIU-87 cells. The albuminutes immuno-nanospheres were tightly junctioned with the BIU-87 cells. Specific killing activity of As2O3-(HAS-NS)-BDI-1 on bladder tumor cells was observed by acridine orange staining and 3H-TdR incorporation assays.

CONCLUSIONSAs2O3-(HAS-NS)-BDI-1 might bind specifically against BIU-87 cells, thus leading to high activity of killing bladder tumor cells.

Animals ; Antibodies, Monoclonal ; pharmacology ; Antineoplastic Agents ; administration & dosage ; Apoptosis ; drug effects ; Arsenicals ; administration & dosage ; pharmacology ; Cell Line, Tumor ; Cell Survival ; drug effects ; Drug Delivery Systems ; Fluorescent Antibody Technique ; Mice ; Mice, Inbred BALB C ; Nanotubes ; Oxides ; administration & dosage ; pharmacology ; Serum Albumin ; pharmacology ; Urinary Bladder Neoplasms ; drug therapy ; pathology

Objective To investigate the phenotype, frequency and function of CD4 + T cell subsets and the relevant cytokines, as well as the relationship between these cells and appearance of pneumonia of novel (H1N1 ) influenza A patients. Methods 68 healthy people,53 confirmed novel A( H1N1 ) influenza patients without pneumonia and 16 confirmed severe novel A( H1N1 ) influenza patients with pneumonia were enrolled in this study. Viral load in nasopharyngeal swabs specimens was measured by real time PCR assay.The phenotype and percentage of CD4+ T cell subsets including Th1, Th2, Th17, and Treg cells were measured by Flow cytometry analysis. The relevant cytokines in plasma including TGF-β, IL-6 and IFN-γ were measured by ELISA. Data was analyzed by one way ANOVA. Results It was found that peak viral load and viral shedding period of severe patients with pneumonia was significantly increased compared with mild patients without pneumonia ( P ＜ 0. 05 ). The percentage of Th17 cells of severe patients with pneumonia was significantly diminished compared to that of healthy subjects and mild patients without pneumonia( P ＜ 0. 05 ). However, Th1 ,Th2, Treg cells frequencies had no significant differences ( P ＞ 0. 05 )among these three groups. The level of TGF-β in plasma for the severe patients with pneumonia was also significantly decreased compared to that of healthy subject and mild patients without pneumonia( P ＜0. 05 ).The viral shedding period inversely correlated with the frequency of Th17 cells ( r = - 0. 38, P ＜ 0.05 ).Conclusion H1N1 influenza A virus can inhibit Th17 cells to differentiate, particularly more extent in patients with pneumonia. Impaired Th17 cells may correlate with viral clearance and pneumonia of novel H1N1 influenza A patients.

Objective:To investigate the value of serum free light chain(sFLC)and serum calcium ion in the diagnosis and prognosis of multiple myeloma(MM).Methods:Forty patients with MM treated in Henan Provincial People's Hospital from January 2018 to January 2022 were selected as the observation group,and 40 healthy volunteers were selected as the control group.The differences of sFLC-κ,sFLC-λ,sFLC-κ/λ,serum calcium ions,etc between the two groups were compared.Meanwhile,the differences of sFLC-κ,sFLC-λ,sFLC-κ/λ,serum calcium ions,etc in different international staging systems(ISS),chemotherapy efficacy and prognosis patients were analyzed.Results:The levels of sFLC-κ[(98.39±21.19)vs(12.01±4.45)mg/L],sFLC-λ[(210.20±45.54)vs(14.10±5.11)mg/L]and proportions of hypocalcemia(65％vs 0)in the observation group were significantly higher than those in the control group(P＜0.05),while sFLC-κ/λ ratio[(0.44±0.10)vs(0.87±0.12)]and serum calcium ions[(1.98±0.46)vs(2.42±0.40)mmol/L]were significantly lower than those in the control group(P＜0.05).The sFLC-κ,sFLC-λ,the proportion of hypocalcemia and the course of hypocalcemia in ISS stage Ⅲ patients in the observation group were significantly higher than those in stage Ⅰ and Ⅱ patients(P＜0.05),while sFLC-κ/λ ratio,and serum calcium ions were significantly lower than those in stage Ⅰ and Ⅱ patients(P＜0.05).The levels of sFLC-κ[(107.76±21.22)vs(94.67 ±20.11)mg/L],sFLC-λ[(245.54±41.12)vs(205.54±50.22)mg/L]of patients with hypocalcemia in the observation group was significantly higher than those without hypocalcemia(P＜0.05),while the sFLC-κ/λ ratio was significantly lower than those without hypocalcemia[(0.42±0.04)vs(0.47±0.06);P＜0.05].The levels of sFLC-κ[(107.29±20.14)vs(91.11±18.92)mg/L],sFLC-λ[(247.98±42.26)vs(179.29±39.32)mg/L]in patients with ineffective chemotherapy were significantly higher than those in patients with effective chemotherapy(P＜0.05),while the sFLC-κ/λ ratio was significantly lower than those in patients with effective chemotherapy[(0.43± 0.10)vs(0.50±0.09);P＜0.05)].The area under the ROC curve for sFLC-κ,sFLC-λ,sFLC-κ/λ predicting ineffective chemotherapy was 0.803,0.793 and 0.699 respectively,P＜0.05.There was no significant difference in sFLC-κ,sFLC-λ,sFLC-κ/λ ratio,serum calcium ion,hypocalcemia ratio and hypocalcemia course between survival and death patients(P＞0.05).Conclusion:sFLC and serum calcium are related to 1SS stage of MM patients.sFLC level has a certain value to predict the curative effect of chemotherapy in MM patients.However,the prognostic values of sFLC and serum calcium are not yet confirmed for MM patients.