Objective To explore the prognosis and its related factors of three-dimensional conformal radiotherapy (3D-CRT) for elderly patients with esophageal carcinoma. Methods From January 2001 to August 2007, 89 elderly patients aged 65 years or more with esophageal carcinoma were treated with 3D-CRT. And the local control rates, survival rates and its related prognostic factors were evaluated retrospectively, using SSPS11.5 software. Results The 1-, 2-, 3-and 4-year local recurrence-free survival rates were 65.2%, 43.0%, 27.3% and 22.3%, respectively. The 1-,2-, 3-and 4-year overall survival rates were 68.5%, 48.8%, 36.8% and 25.2%, respectively. And the median survival time was 21.5 months. With univariate analysis, the significant prognostic factors included the different diet before radiotherapy (χ~2=6.26, P=0. 012), T stage (χ~2=8. 80, P=0. 003), N stage (χ~2=4.33, P=0. 038), clinical stage (χ~2=7.88, P=0. 005), the largest diameter of tumor in CT scanning image (χ~2=10.88, P=0.004), recent efficacy (χ~2=5.28, P=0. 022) and chemotherapy (χ~2=5.49, P=0.019). And the factors which were not related with prognosis included gender (χ~2=0.74, P=0. 390), age (χ~2=1.89, P=0. 170), lesion length showed by esophageal angiography (χ~2=2. 38, P=0.123), lesion length showed by CT (χ~2=2.69, P=0.101),primary tumor site (χ~2=2.12, P=0. 146), coexistent disease (χ~2=0. 03, P=0. 874), exposure mode (χ~2=0.04, P=0.847) and radiation dose (χ~2=0. 24, P=0. 627). Multivariate analysis revealed that the different diet before treatment (P=0. 002), the clinical stage (P=0. 007) and chemotherapy (P=0. 011) were independent prognostic factors. Radiation induced esophagitis was observed in 20 cases in grade 0, 30 cases in grade 1, 32 cases in grade 2, 7 cases in grade 3. And acute radiation pneumonitis was observed in 89 patients, with 57 in grade 0, 20 in grade 1, 8 in grade 2, 2 in grade 3 and 2 in grade 5. Until the end date of follow-up, 60 patients had died: 29 cases died of local recurrence or uncontrolled disease, 11 cases died of metastasis, 5 cases died of local recurrence with metastasis, and 15 cases died of other reasons. Conclusions 3D-CRT can be considered as an effective and feasible approach for elderly patients with esophageal cancer. The 3D-CRT provides them with less obstruction of diet, early clinical stage and longer survival time. 3D-CRT combined with chemotherapy may improve survival rate.

Kidney stones are mixed by various inorganic salts and organic matter according to certain rules. The process of crystal nucleation, growth and aggregation is the key step of kidney stone formation. The different crystal structures will bring about the different formation process and physicochemical properties of kidney stones. It is of great significance to study the crystal structures and formation characteristics of kidney stone to clarify the causes of it and prevent the recurrence of it. In this paper, based on the microstructure and crystal structure of kidney stones, the distribution of different crystals and components in kidney stones, the nucleation and growth process of crystal forming kidney stones, and the different treatment methods based on crystal structure are reviewed in recent years.

Oxalate is an organic dicarboxylic acid that is a common component of plant foods.The kidneys are essential organs for oxalate excretion,but excessive oxalates may induce kidney stones.Jupiter micro-tubule associated homolog 2(JPT2)is a critical molecule in Ca2+mobilization,and its intrinsic mecha-nism in oxalate exposure and kidney stones remains unclear.This study aimed to reveal the mechanism of JPT2 in oxalate exposure and kidney stones.Genetic approaches were used to control JPT2 expression in cells and mice,and theJPT2 mechanism of action was analyzed using transcriptomics and untargeted metabolomics.The results showed that oxalate exposure triggered the upregulation of JPT2,which is involved in nicotinic acid adenine dinucleotide phosphate(NAADP)-mediated Ca2+mobilization.Tran-scriptomic analysis revealed that cell adhesion and macrophage inflammatory polarization were inhibited by JPT2 knockdown,and these were dominated by phosphatidylinositol 3-kinase(PI3K)/AKT signaling,respectively.Untargeted metabolomics indicated that JPT2 knockdown inhibited the produc-tion of succinic acid semialdehyde(SSA)in macrophages.Furthermore,JPT2 deficiency in mice inhibited kidney stones mineralization.In conclusion,this study demonstrates that oxalate exposure facilitates kidney stones by promoting crystal-cell adhesion,and modulating macrophage metabolism and in-flammatory polarization via JPT2/PI3K/AKT signaling.