Objective To determine the expression of CD38 and HLA -DR on CD +8 T cells in patients with chronic hepatitis B and HBV carriers,and to disscuss the relation between immune activation and disease progression of HBV infection.Methods Thirty -two chronic hepatitis B patients receiving adefovir dipivoxil treatment,31 HBV carriers and 28 normal controls were collected.The counts of CD +4 and CD +8 T cells and the percentage of CD +8 CD +38 and CD +8 HLA -DR +T cells were tested by flow cytometry.HBV DNA and liver function were tested in the central laboratory of our hospital.Results The percentage of CD +8 CD +38 T cells in CHB patients was (58.4 ±12.7)%,and was higher than that in HBV carriers (46.8 ±8.5)% and normal controls (46.8 ±8.5)%,and decreased after adefovir dipivoxil treatment (34.2 ±9.4%)(F =8.27,P =0.000).The percentage of CD +8 CD +38 T cells in HBV carriers was (43.3 ±12.5)%,and was much higher than that in normal controls (9.8 ±5.7)%(F =13.48,P =0.000).The percentage of CD +8 HLA -DR + T cells in CHB patients was higher than that in normal controls,but similar to that in HBV carriers (37.1 ±11.3)%.CD +8 HLA -DR + T cells in CHB patients also decreased after adefovir dipivoxil treatment (P <0.05 ).Conclusion Our study demonstrates that activation of CD +8 T cells is increased in HBV infection but decreased by adefovir dipivoxil treatment.The percentages of CD +8 CD +38 and CD8 +HLA -DR +T are good markers for disease progression of HBV infection.

Objective To investigate the therapeutic efficacy and safety of using total glucosides of paeony (TGP)for treatment of patients with systemic lupus erythematosus(SLE)accompanied by low white blood cell(WBC) count. Methods According to the revised SLE Classification Standard of American College of Rheumatology in 1982,62 cases of SLE accompanied by low WBC consistent with the standard were randomly divided into experimental group(31 cases)and control group(31 cases). The conventional therapy plus prednisone of 0.5-1.0 mg?kg-1?d-1 was applied for treatment in both groups,and in the experimental group,additionally TGP(0.6 g orally each time,three times a day)was given. The therapeutic course in both groups was 12 weeks. The changes in following parameters of two groups were noted at baseline and after treatment:WBC,complement C3,erythrocyte sedimentation rate (ESR),C-reactive protein(CRP),liver and kidney function,etc;the SLE disease activity index(SLEDAI)score, the therapeutic effects and incidence of adverse reactions were evaluated in two groups. Results After 12 weeks of treatment,WBC and C3 were significantly increased,and ESR,CRP,SLEDAI were significantly decreased in the two groups,the improvement being more significant in the experimental group〔WBC(×109/L):5.38±1.32 vs. 4.16±1.39,complement C3(g/L):1.28±0.32 vs. 0.86±0.26,ESR(mm/1 h):22.36±5.26 vs. 28.85±8.56, CRP(g/L):23.25±8.26 vs. 28.32±8.52,SLEDAI(score):2.58±1.86 vs. 4.18±2.31,P<0.05 or P<0.01〕. Compared with the control group,the total effective rate was significantly higher in experimental group〔93.55%(29/31) vs. 70.97%(22/31)〕,the average daily dosage of prednisone and its total dosage in 12 weeks were significantly less in experimental group〔prednisone dosage(mg/d):16.26±9.85 vs. 25.32±9.68,the total dosage of prednisone (mg)2 016.5±125.6 vs. 2 983.6±152.8,both P<0.01〕. The incidence of infection in experimental group was obviously lower than that in the control group(9.68% vs. 35.48%,P<0.05),there was no significantly statistical difference in incidence of adverse reactions between experimental group and control group(12.90%vs. 16.13%,P>0.05). Conclusion TGP is a safe and effective treatment for patients with SLE accompanied by low WBC,and it also can significantly reduce the use of glucocorticoid dosage and the incidence of infection in such patients.

Objective To study the prevention and corresponding measures for the allergy of contrast agent in scanning, and discuss the targeted prevention mode.MethodsSelection from June 2015 to August 2016, 400 cases was conducted in the people's hospital of ningbo yinzhou MR enhancement scanning patients as the research object, in the process of the study were randomly divided into control group and experimental group, 200 cases in each group.In the control group, patients were given routine procedure, including psychological counseling, diet control and health, education, etc.All patients were treated with the use of gadolinium bate as a contrast agent and intravenous injection.Compare two sets of contrast agent allergy.ResultsTwo groups of patients showed different levels of allergic reactions.The control group had five mild allergies, one moderate allergy, one severe allergy, and seven cases of allergy.There were two cases of mild allergy, 1 case of moderate allergy, no severe allergies, and 3 cases of allergies.Compared with the experimental group, the difference was statistically significant (P<0.05).ConclusionIn MR enhancement scanning to psychological counseling, diet, health education and other measures, to reduce the probability of contrast media in patients with allergic, have clinical significance.

Objective To analyze the response rate and prognostic factors for patients with locally recurrent rectal cancer treated with hypofractionated chemoradiotherapy without reresection.Methods Totally 52 patients with locally recurrent rectal cancer received hypofractionated irradiation and concurrent chemotherapy from January 2006 to January 2013 were enrolled.All patients received intensity-modulated radiotherapy (IMRT).The median dose was 63.4 Gy (61.6-64.4 Gy) at 2.2-2.3 Gy/f,5 f/week.Thirteen patients underwent prophylactic irradiation at lymph nodes region,the total dose of 45-50.4 Gy with conventional fraction and a simultaneous integrated boost was used.All patients received concurrent chemotherapy,capecitabine at 1 650 mg·m-2 ·d-1,divided into 2 times,5 d/week.The variables were compared by the chi-square test or Fisher's exact test.Local control (LC) and overall survival (OS) were calculated with using the Kaplan-Meier method.Results For all patients,the clinical complete response (CR),partial response (PR),stable disease (SD) and progressive disease (PD) was 23.1％,38.5％,32.7％ and 5.8％,respectively.The response rate (CR + PR) for patients with previous irradiation to pelvis and without were 37.1％ and 71.1％,respectively (x2 =5.40,P ＜ 0.05);for patients with 1 and 2 or more recurrent subsites were 81.8％ and 46.7％,respectively (x2 =6.63,P ＜ 0.05).Acute grade 3 skin and hematologic toxicities occurred in 19 patients (36.5％) and 1 patient (1.9％),respectively.None occurred grade 4 toxicity and none occurred grade 3 or more gastrointestinal and urologic toxicities.Four patients showed severe late toxicity of anastomotic stricture and performed a stoma at transverse colon.No other severe late toxicities were observed.The LC at 5 years was 49.1％ and the OS was 23.1％.Conclusions For patients with locally recurrent rectal cancer,hypofractionated chemoradiotherapy without resection is an acceptable and effective regimen,the response rate and long-term outcomes are promising.

Objective:To evaluate the application of PG-SGA,NRS 2002 and BIA in nutritional assessment and screening of patients with gynecologic cancers.Methods:118 patients were randomly selected.Nutritional status were evaluated by PG-SGA,NRS 2002 and BIA,and consistency between each tools were compared.Results:The prevalence of malnutrition or nutritional risk of patients were 64.4％ (PG-SGA),57.6％ (NRS 2002),and 33.9％ (BIA) respectively.In all patients,the consistency of PG-SGA and NRS 2002 was high (P ＜ 0.001),while there were not significantly consistent between BIA and PG-SGA,or between BIA and NRS 2002 (P ＜ 0.001).Conclusion:According to the evaluation of PG-SGA or NRS 2002 in gynecologic patients,the prevalence of malnutrition or nutritional risk is high,and these two scales are suitable for nutritional assessment and screening of gynecologic cancer patients,especially in ovarian cancer patients.In addition,BIA may be a promising tool to evaluate cervical cancer patients' nutritional status.

Objective To determine the margins of planning target volume (MPTV) in primary cervical cancer patients with tomotherapy and evaluate the importance of automatic registration(AR) plus manual registration.Methods The setup errors of 29 primary cervical cancer patients receiving external radiation from June 2012 to Dec 2014 were measured by megavoltage computed tomography (MVCT),which were performed at least two times weekly before treatment and were registered with the planning CT.The setup errors between automatic registration and total shift (TS) including both AR and manual registration were compared MPTV was calculated.Results Setup errors were collecte from 443 sets of MVCT in 29 patients.AR and total shift (TS) values in the x,y,z directions and rotation angle were (-0.9±2.3),(0.0±3.1),(1.0±2.6) mm,0.2° ±0.8° and (-0.8±1.8),(-0.4±3.4),(l.4 ± 2.5) mm,0.1° ± 0.5°,respectively.There were statistically significant differences between the two groups in all directions except for the x axis (t =5.1,-5.2,3.2,P ＜ 0.05).MPTV were 4.6,5.7,3.3 mm in the x,y,z directions,respectively.Conclusions Manual registration is necessary after automatic registration in cervical cancer patients with tomotherapy.For patients with cervical cancer treated by tomotherapy,planning target volume MPTV parameters are suggested to be 5,6,4 mm in the x,y,z directions.

Objective To observe the interfractional variation and actual dose for cervical cancer patients treated with tomotherapy.Methods Five patients who received tomotherapy were chosen from Aug 2013 to Feb 2014.A megavohage computed tomography (MVCT) scan was performed before treatment and then registered with the planning CT images.Dose distributions were recalculated and targets were contoured on the MVCT images.The differences between the actual radiation and planning were analyzed.Results In the patients received external radiotherapy, the decline in cervix volume and maximum diameter was 68.90％ and 26.91％ , respectively (t =5.21, 8.39, P ＜0.05).Cervix, uterus and CTV movement in left-right, anteroposterior, superoinferior were 1.43,-7.72, 0.02,-0.40,-1.24, -6.51,-0.43,-1.68and-0.22mm.The medianCTV V95％ was 99.40％ (95.96％-100％), and missing volume was 6.94 cm3 (0-32.30 cm3).Conclusions During radiotherapy for cervical cancer patients, the volume, position and doses are different between initial plan and actual radiation.Based on image guided radiation therapy (IGRT), missing targets are limited.

Objective To compare acute toxicity for stage Ⅱ-Ⅲ patients with rectal cancer irradiated with helical tomotherapy (HT) and conventional five-field intensity-modulated radiotherapy (5-IMRT).Methods The data of 84 stage Ⅱ-Ⅲ patients with rectal adenocarcinoma treated with concurrent chemoradiotherapy (CRT) were retrospectively analyzed.19 patients underwent postoperative CRT,and 65 patients underwent preoperative CRT.43 patients received radiotherapy with HT and 41 patients with 5-IMRT.The delineation on clinical target volume (CTV) and gross tumor target (GTV) was similar for two groups.The CTV to plan tumor volume (PTV) margins were 1.0 cm for patients with 5-1MRT and 0.5 cm for patients with HT.For all patients,a dose of 45.0-50.4 Gy,in daily fractions of 1.8 Gy,was delivered to PTV.For 45 patients with high risk factors,simultaneous integrated boost (SIB) was given to the tumor or tumor bed of a total dose of 55.0-60.0 Gy,in daily fractions of 2.1-2.3 Gy.Before treatment,the patients treated with HT underwent scanning by the tomotherapy-integrated megavoltage computed tomography (MVCT) scan modality and were positioned by co-registration of these images to the original kilovoltage planning CT image set.Concurrent capecitabine every day 1 600 mg/m2,twice daily on every day in the week.Results The rates of grade ≥ 2 acute cystitis were 7.0 ％ (3 cases) in HT group and 2.4 ％ (1 case) in 5-IMRT group (P =0.616),and ≥3 grade acute diarrhea were 4.7 ％ (2 cases) and 12.2 ％ (5 cases),respectively (P =0.259).≥2 grade leukopenia were 48.8 ％ (21 cases) and 19.5 ％ (8 cases),respectively (P =0.005),≥1 grade anemia were 34.9 ％ (15 cases) and 14.6 ％ (6 cases),respectively (P =0.032),and ≥1 grade thrombocytopenia were 23.3 ％ (10 cases) and 14.6 ％ (6 cases),respectively (P =0.314).Conclusions There is no significant difference in acute diarrhea and cystitis for patients treated with HT and 5-IMRT.Leukopenia and anemia in patients treated with HT are worse than those in patients with 5-IMRT,and thrombocytopenia is similar in the two groups.

Objective:To evaluate the effect of radical image-guided radiotherapy (IGRT) on the target dose in cervical cancer and investigate the appropriate application mode.Methods:Twenty patients with cervical cancer treated with helical tomotherapy (HT) in Seventh Medical Center of PLA General Hospital from 2012 to 2016 were selected. A megavoltage CT (MVCT) scan was performed before each treatment. The obtained MVCT images were used for dose parameter in the adaptive module of HT to obtain the actual dose (Plan 1) and the non-image-guided dose parameter was simulated (Plan 2). Each single dose distribution and the corresponding fused CT images were transferred to the software Mimvista 6.5 to obtain the total radiation dose parameter by dose superposition.Results:The motion of CTV, uterus and GTV in Plan 2 was significantly larger than that of Plan 1(all P<0.05), and the largest changes were seen in the ventrodorsal and uterine direction. The V 45Gy, V 50Gy, D 98% and D mean of CTV and uterus and V 50Gy of GTV in Plan 2 were significantly decreased compared with those in Plan 1(all P<0.05). The left-right motion of Plan 1 was negatively correlated with D 2% and D 98% of CTV and uterus (both P<0.05). The head-foot motion was negatively associated with V 45Gy and V 50Gy of GTV (both P<0.05). The ventrodorsal motion was negatively correlated with D 98% of uterus ( P<0.05). The left-right motion of Plan 2 was negatively correlated with D 2% of CTV and V 50Gy of uterus (both P<0.05). The head-foot motion was negatively associated with D 98% of CTV, and D 98%, D mean, V 45Gy and V 50Gy of uterus (all P<0.05). The ventrodorsal motion was negatively correlated with D 98% of CTV, D 98%, D mean, V 45Gy and V 50Gy of uterus, and D mean and V 45Gy of GTV (all P<0.05). Conclusions:In intensity-modulated radiotherapy for cervical cancer, the uterine body displacement is large and the low CTV area is mainly located in the uterine body. IGRT can significantly reduce the dosimetric deviation induced by organ movement.

Background and purpose: XB130 protein plays an important role in proliferation and invasiveness of tumor cells. However, there is little research on the role of XB130 protein in hepatocellular carcinoma (HCC) and the effect of XB130 is still unclear. This study investigated the role of XB130 gene in the proliferation of HCC cell and its potential mechanism. Methods: The protein expressions of XB130 in HCC cell lines, Huh7, HepG2 and SNU449, and liver cell line HL7702 were detected by Western blot. Huh7 cells were transfected with XB130-siRNA. Then cell viability was measured using cell counting kit-8 (CCK-8), and cell cycle was examined by flow cytometry. Protein expressions of p-AKT, p-GSK3β, cyclin D1 and p-Rb were detected by Western blot, while mRNA expression levels of E2F/DP1 target genes (cyclin E1, c-Myc and PCNA) were measured by reverse transcription-polymerase chain reaction (RT-PCR). Results: The relative protein expressions of XB130 in Huh7, HepG2, SNU449 and HL7702 cells were 0.66±0.10, 0.78±0.11, 0.83±0.08 and 0.32±0.06, respectively. The difference between HCC cell lines and HL7702 cell line was statistically significant (P＜0.01). The transfection efficacy of XB130-siRNA was confirmed to be highly effective in Huh7 cells, and the viability of XB130-siRNA transfected Huh7 cells declined 72 h after transfection (P＜0.001). The ratio of Huh7 cells in G0/G1 phase was increased, while the ratio in S or G2/M was decreased 48 h after XB130-siRNA transfection (P＜0.01). In addition, compared with negative control, protein expressions of p-AKT, p-GSK3β, cyclin D1 and p-Rb, and mRNA expression levels of cyclin E1, c-Myc and PCNA were all decreased in XB130-siRNA transfected Huh7 cells (P＜0.001). Conclusion: XB130 promotes the proliferation of HCC cells by regulating cell cycle-related proteins and downstream transcription factors.