Cardiomyopathy, Hypertrophic ; complications ; Down Syndrome ; complications ; Humans ; Infant, Newborn ; Male

Animals ; Cyanides ; toxicity ; Mice ; Random Allocation ; Toxicity Tests, Chronic

Objective To evaluate the short-term therapeutic effect and radiation reaction of stereotactic radiotherapy for early stage non-small cell lung cancer in the elderly patients. Methods Thirty-one patients with stage Ⅰ - Ⅱ non-small cell lung cancer were treated with stereotactic radiotherapy. Patients aged 70-88 years, median age 76; 21 were stage I patients, and 10 stage Ⅱ ; 14 patients had tumor

Objective To evaluate the clinical feasibility of quality assurance of intensity modulated radiation therapy(IMRT) through a series of clinical case studies. Methods Helios inverse planning system was used to provide optimized IMRT treatment plans for brain tumor, nasopharyngeal carcinoma, pancreatic cancer, spinal metastatic tumor and prostatic cancer. To verify the conformation between the fluence map of each beam predicted by the planning system and that actually delivered, a piece of film under a homogeneous polystyrene phantom was irradiated vertically with each of the beams to record the deposited dose. This measured fluence map was compared with that predicted by the planning. The dose distribution was recorded by irradiating the film in an anthropomorphic phantom using patients' treatment plan, then compared with that predicted by the planning. An ionization chamber in a water phantom was used to measure the central point dose and another eccentric point dose. Results The fluence map measured by the film was well consistent with that predicted by the planning. The error between the measured dose and predicted dose in the central point was less than 3%, whereas the error of the dose in another eccentric point varied greatly. The isodose distribution (on axial plane) measured by the film was consisent with the predicted one. Conclusions The procedures for quality assurance of IMRT are feasible in our experience.

Objective To evaluate the efficacy and tolerance of preoperative concurrent chemoradiotherapy in the treatment of locally advanced middle-low rectal cancer.Methods From June 2007 to June 2013,51 untreated patients with histopathologically proven rectal cancer (T3/T4 or N (+))were included in this study.Three-dimensional radiotherapy was delivered to the whole pelvic cavity at 45.0-50.4 Gy/25-28 fractions.Two cycles of chemotherapy with FOLFOX4 or XELOX were given concurrently at weeks 1 and 4 of radiotherapy.Surgery was performed at 4-8 weeks after chemoradiotherapy.Adjuvant chemotherapy with FOLFOX4 or XELOX was given within one month after surgery.The Kaplan-Meier method was used to calculate survival rates,and the log-rank test was used for univariate analysis;the Cox regression model was used for multivariate prognostic analysis.Results Fortynine patients completed the preoperative chemoradiotherapy and surgery.The median follow-up was 2.9 years.The overall sphincter preservation rate was 65％;the overall downstaging rate was 59％.Ten (20.4％) of all patients achieved a pathologic complete response (pCR).Grade ≥3 toxicities occurred in 25％ of all patients,and the overall postoperative complication rate was 31％.The 3-and 5-year sample sizes were 24,12,respectively.The 3-and 5-year overall survival rates were 81％ and 69％,respectively;the 3-and 5-year disease-free survival (DFS) rates were 76％ and 60％,respectively;the 3-and 5-year local recurrence-free survival (LRFS) rates were 78％ and 70％,respectively;the distant metastasis-free survival rates were 82％ and 74％,respectively.The multivariate analysis showed that tumor downstaging was an independent prognostic factor for 5-year DFS and LRFS.Conclusions For locally advanced middle-low rectal cancer,preoperative radiotherapy with concurrent FOLFOX4/XELOX chemotherapy can increase pathologic downstaging rate,pCR rate,and sphincter preservation rate.Patients with tumor downstaging may have a better survival advantage.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular ; diagnosis ; epidemiology ; virology ; Child ; China ; epidemiology ; Female ; Genes, Viral ; Genotype ; Hepatitis B virus ; genetics ; Humans ; Liver Neoplasms ; diagnosis ; epidemiology ; virology ; Male ; Middle Aged ; Viral Load ; Young Adult

Objective To compare the planning systems of the simplified manual intensity modulated (SMIM) irradiation and standard tangential (ST) irradiation,in order to explore the application of SMIM technique in clinic.Methods In 64 cases of breast cancers after breast conserving surgery,each underwent both SMIM and ST planning systems.SMIM planning was designed by copying additional fields for shielding the high dose areas from internal or lateral tangential field.The high dose areas were reduced by adjusting the size of the additional field and open tangential field.To optimize the SMIM planning,3 high dose areas (＞ 103% ,＞ 105% and ＞ 107%) were shielded and 3 protocols carried out.The wedges were also optimized in ST plan.The target coverage and dose homogeneity and dose of organ at risk were compared between SMIM and ST planning systems.Results When the dose was normalized to cover the volume of 95% CTV,85% of the shielded areas in optimal SMIM planning were that of ＞ 103% high dose area,and 94% of target area was covered.The study on the volume of breast CTV showed that,in the large breast group,SMIM could not only significantly reduce the high dose areas,and the maximum dose as well as the dose of organ at risk,but also enhance the dose homogeneity index.However,no such effect was not significant in the small breast group.Conclusions The simplified manual intensity modulated technique can improve target dose homogeneity in the large breast cases instead of the standard tangential technique.

Objective To investigate the correction of manual monitor unit calculation for asymmetric fields using the Varian enhanced dynamic wedge.Methods Monitor unit (MU) was calculated when the field sizes ranged from 6 cm × 6 cm to 20 cm × 20 cm at a depth of 5 cm using Varian Eclipse and both 6 MV and 10 MV X-rays data from Varian Clinac 23EX for all seven available EDW angles,including 10°15°,20°,25°,30°,45°and 60° The field size was kept fixed,and the distance between geometry center of field and isocenter was increased in increments of 1 cm,ranging from -9 cm to 4 cm.When the field size was the same,the correction factor was defined as the ratio of MU calculated for asymmetric field to monitor unit calculated for symmetric field.To ensure the correction factors obtained above could be used in routine manual calculation for EDW fields,measurements were made at a depth of 5 cm for 30°and 45°EDW with field size of 10 cm × 10 cm using 6 MV X-rays.Results The correction factor was independent of field dimensions,so the average value was adopted to make practical calculation.Without correction,the maximum error was 18% for 30°,and 30% for 45.After the results of monitor unit calculation were corrected,the largest error was - 1.8% and - 1.7% for 30° and 45°EDW,respectively.The magnitude of errors was within the clinical tolerance limits.Conclusions For asymmetric EDW fields,there is very large difference between the prescribed dose by manual calculation using EDW factors measured for symmetric fields and that delivered during treatment in order to obtain correct dose to reference point.The errors are decreased to be acceptable after correction.The method of correction is simple and independent of machine specific beam parameters.

BACKGROUND:The bispectral (BIS) index is a processed electroencephalogram (EEG) parameter with extensive validation and demonstrated clinical utility. The study aimed to investigate the correlation between the BIS index and the prognosis of patients with coma in the ICU. METHODS:A total of 208 patients with coma in the ICU were enrolled in this study. According to the BIS value, the patients were divided into four groups:group I, BIS value 0 to 20; group Ⅱ, BIS value 21 to 40; group Ⅲ, BIS value 41 to 60; and group IV, BIS value greater than 60. The difference in BIS values with the differences in prognosis of patients with coma was compared between the four groups, and the prognosis of patients with coma was stratified into consciousness, coma, vegetative state, and brain death. Subsequently, the best cut-off score of BIS values calculated for determining the correlation between BIS value and mental state was proposed. RESULTS:There are no significant differences in the age and APACHE Ⅱ scores between the four groups (P>0.05). An inverse correlation was observed between BIS value and mental state (r=–0.749, P=0.00). According to the ROC curve, as BIS value was greater than 42.5, there were higher sensitivity and specificity in conscious-coma patients. CONCLUSION:BIS value is correlated with the prognosis of patients with coma in ICU, and BIS value can be a useful marker for estimating the prognosis of comatose patients.

OBJECTIVETo maked a Nrf2 down-regulated cell line by over-expressing Keap1 in H460 cells to study the role of Nrf2 in drug resistance.

METHODSTransfecting H460 cells with mKeap1-pEGFP and screenig for Keap1 expressing clones by Western blotting with antibodies against Nrf2, HO-1, NQO1 and AKR1C. The cell line with Keap1 over-expression was further confirmed by real-time PCR. The cytotoxicity of H460-N5 to anti-cancer drugs was evaluated by MTS assay.

RESULTMTS assay results showed the enhanced cytotoxicity of anticancer drugs (Oxaliplatin, Doxorubicin and Etopside) to the H460 cell line with keap1 overexpression compared to the control cell line. In H460-N0 cells, the IC(50) values of Oxaliplation and Etopside were 93 micromol/L and 100 micromol/L respectively whereas the IC(50) values of the two drugs were 42 micromol/L and 30 micromol/L correspondingly in H460-N5 cells. A Nrf2 down-regulated cell line H460-N5 and a control cell line with GFP over-expression have been identified.Down-regulation of Nrf2 enhanced the cytotoxicity of Oxaliplatin, Doxorubicin and Etopside. The IC(50) value of Doxorubicin to H460-N0 cell was above 3 mg/L, but that to H460-N5 cell was about 2 mg/L.

CONCLUSIONA Nrf2 down-regulated cell line H460-N5 and a control cell line with GFP over-expression have been identified. Down-regulation of Nrf2 enhanced the cytotoxicity of Oxaliplatin, Doxorubicin and Etopside.

Antineoplastic Agents ; pharmacology ; Antioxidants ; metabolism ; pharmacology ; Carcinoma, Non-Small-Cell Lung ; metabolism ; pathology ; Cell Line, Tumor ; Down-Regulation ; Drug Resistance, Neoplasm ; genetics ; Gene Expression Regulation, Neoplastic ; drug effects ; Humans ; Intracellular Signaling Peptides and Proteins ; genetics ; metabolism ; Kelch-Like ECH-Associated Protein 1 ; Lung Neoplasms ; metabolism ; pathology ; NF-E2-Related Factor 2 ; genetics ; metabolism ; physiology ; Response Elements ; physiology ; Signal Transduction ; physiology ; Transfection