Background and purpose:As the second general platinum antineoplastic agent, carboplatin has been applied in treating more and more malignant tumors clinically. But it has severe bone marrow suppression when applied in large doses. The purpose of this research was to explore the influence of carboplatin of fractional dose, combined with X ray,on the immunity of Lewis lung cancer in mice. Methods:The model of tumor-bearing mice was induced by injecting Lewis lung cancer cells into the right infra-axillary dermis. In cases given the same total dose, the tumor growth and the immune suppression effect of carboplatin of single dose or of fractional dose , combined with X ray radiation, on the mouse with Lewis lung cancer were observed. Results:The concentration of IL-10 and TNF-? in serum,the spleen exponent were respectively(144.9?48.4)ng/ml,(194.63?64.4)ng/ml,(12.07?2.2)mg/ g in the control group;(279.0?46.9)ng/ml,(71.5?8.4)ng/ml,(5.52?1.31)mg/g in carboplatin of single dose with X ray radiation group, which ,compared with the control group, can dramatically increase the concentration of IL-10,decrease the concentration of TNF-? in the serum ,and dramatically decrease the spleen exponent(P

AIM:To probe whether CpG oligodeoxyribonucleotides 7909 (CpG ODN7909) combined with Toll like receptor (TLR)9 affected the chemotherapeutic sensitivity of doctaxel (DOC) in human lung cancer A549 and H520 cell lines.METHODS:Sequences of TLR9 siRNAs were designed.A549 and H520 cells were transfected with TLR9 siR-NA by lipofectamine.The expression of TLR9 was detected by Western blot .The cell activity was measured by CCK-8 as-say.The experiments were divided into blank control group , control siRNA group and TLR9 siRNA interference group.The cell cycle distribution and cell apoptosis were analyzed by flow cytometry .The expression of P38 and Bax was determined by Western blot .The cells in each group were exposed to CpG ODN 7909 and/or DOC.RESULTS: In A549 cells and H520 cells, CpG ODN7909 alone had no obvious effect on the cell activity , G2/M phase arrest and apoptosis , but in-creased the protein expression of P 38 and Bax ( P<0.01) .In addition, there was no significant changes of the above inde-xes in CpG ODN7909 treated-TLR9 siRNA group was observed .DOC alone significantly inhibited the cell activity , higher the G2/M phase fractions, apoptotic rates and Bax expression (P<0.01), but didn’t affect the expression of P38 in all 3 groups.Compared with the cells treated with DOC alone , the cells treated with CpG ODN7909 combined with DOC exhibi-ted lower cell activity, higher G2/M phase fractions, apoptosis rates and more Bax expression (P<0.01), showed no sig-nificant change of P38 expression.In addition, there was no significant change of the above indexes in CpG ODN 7909 com-bined with DOC treated-TLR9 siRNA group was observed .CONCLUSION:CpG ODN7909 may enhance the chemothera-peutic sensitivity of DOC in human lung cancer cells by combining with TLR 9.The mechanism might be related to enhan-cing the inhibitory effect and apoptosis of DOC on the cell activity in vitro, arresting the cells at G 2/M phase of the cells .

AIM: To explore the effect of Bu Shen Yang Xue Ming Mu (BSYXMM) Formula on hydroquinone-induced oxidative stress injury in ARPE-19 cells.METHODS: The oxidative injury model of ARPE-19 cell was induced by exposure to various concentrations of hydroquinone (HQ) to determine the optimal concentration.Intestinal absorption solutions of BSYXMM Formula were prepared.Effect of intestinal absorption solutions of BSYXMM Formula on the cell viability was detected by CCK-8 assay,and the percentage of apoptotic cells was measured by TUNEL assay.The levels of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) in ARPE-19 cells were detected by means of chemical colorimetry.RESULTS: It was found that ARPE-19 cell viability significantly decreased when the concentration of HQ was higher than 90μmol/L.Compared with the model group,1% and 2% intestinal absorption solutions in the pre-treatment group could significantly alleviate HQ-induced injury (P<0.01) and 0.5% and 5% intestinal absorption solutions in the pre-treatment group could alleviate the injury in certain degree(P<0.05).While in the treatment group 1% and 2% intestinal absorption solutions could alleviate the injury to some extent (P<0.05).TUNEL results showed that the apoptosis rate decreased significantly in the pre-treatment group (P<0.01)and to some extent in the treatment group (P<0.05)compared with the model group.It was shown that both levels of SOD and GSH-Px in pre-treatment group and treatment group were markedly higher than that of model group(P<0.05),and pre-treatment group had more significant effect (P<0.01,P<0.05).CONCLUSION: BSYXMM Formula could protect against HQ-induced oxidative stress injury in ARPE-19 cells,which may be related with the increasing of antioxidant enzyme in the cells.

Objective To evaluate the therapeutic effect and side effects of three-dimensional conformal re-irradiation combined with nedaplation plus 5-fluorouracil synchronously in treatment of recurrent esophageal carcinoma.Methods Fifty-four patients with recurrentesophageal carcinoma were randomly divided into two groups:study group with 27 patients who were treated with three-dimensional conformal re-irradiation (50 ～ 56Gy/25 ～ 28 F) combined with chemotherapy synchronously and control group with 27 patients who were treated with re-irradiation (50 ～56 Gy/25 ～ 28 F)combined with chemotherapy orderly.The patients of study group were treated with nedaplation80 mg/(m2 · d)plus5-FU 350 mg/( m2 · d),from 1 to 5 day synchronously in radiotherapy and after radiotherapy.The patients of control group were treated with nedaplation80 mg/( m2 · d)plus 5-FU 350 mg/(m2 · d)d from 1 to 5 day orderly after radiotherapy.The patients were treated every 3 -4weeks as a cycle with total 2 - 4 cycles in these two groups.Results ( 1 ) The short-term effect:the short-term effect(CR + PR)of the two groups were 59.2％ (16/27) and 55.5％ (15/27) respectively,there was no statistical difference between the two groups( x2 =0.076,P =0.5 ).( 2 ) The survival rate:the survival rate of one,two and three years were 54.2％,26.4％,15.7％ in study group and 40.3％,19.7％,10.8％ in control group respectively The survival rate in study group was significantly higher than that in control group ( x2 =6.87,P =0.032 ).( 3 ) The study of side effects:there was significant difference on the hematologic toxicity between the study group and the control group ( x2 =5.882,P =0.043 ).And there was no significant difference on the non-hematologic toxicity between the two groups ( x2 =4.25,P =0.75 ).(4) The acute radiationesophagitis:There was no statistical difference on radiation-esophagitis between the two groups ( x2 =0.869,P =0.661 ).Conclusion Three-dimensional conformal re-irradiation combined with nedaplation plus 5-fluorouracil synchronously for recurrent esophageal carcinoma has a good efficacy and can also improve the survival rate.

Objective To explore the combination effect of unmethylated cytosine-phosphate-guanine oligodeoxynucleotide (CpG ODN) 1826 and X-rays on Lewis lung cancer in mouse and the dose response of CpG ODN.Methods The tumor-bearing mouse model was established by injecting Lewis lung cancer cells into the right infra-axillary dermis of mouse.Sixty-four C57BL /6 J mice were evenly randomized into eight groups with 8 mice each:control group,IR group,CpG OND1826 0.15 mg group,CpG OND1826 0.3 mg group,CpG OND1826 0.45 mg group,CpG OND1826 0.15 mg + IR group,CpG OND1826 0.30 mg+ IR group,and CpG OND1826 0.45 mg + IR group.On the 1st,2nd,and 9th days,CpG ODN was injected into mouse.After 3 hours of injection,the mice were start to irradiate with X-rays once a day on the 2nd-6th days,and the total dose was 12.50 Gy.Tumor growth and TGD were measured,and the apoptosis of tumor cells were examined with TUNEL.Results The Lewis lung cancer-bearing model was successfully established in all mice.Under the treatments of CpG OND1826 and irradiation,the tumor volumes were smaller than that of control group,and the tumor volumes of CpG OND1826 0.45 mg+IR group was the smallest.TUNEL results revealed that the apoptosis rate were (2.40 ± 0.51 )％ in control group,(5.62 ±0.50)％ in IR,(7.13±0.83)％ in CpG OND1826 0.15 mg,(11.63±1.06)％ in CpG OND1826 0.3 mg,(19.13 ±0.83)％ in CpG OND1826 0.45 rag,( 12.88±0.83)％ in CpG OND1826 0.15 mg+ IR,(20.57±2.37)％ in CpG OND1826 0.3 mg+ IR,and (28.17 ±3.31)％ in CpG OND1826 0.45 mg + IR group,and thus the apoptosis rate of every therapy group was higher than that in control ( t=11.15,7.91,17.82,39.48,24.73,16.61 and 17.05,P＜0.05).The apoptosis rates of CpG ODN1826 plus X-ray irradiation group were significantly higher than those in IR alone ( t =13.78,15.08 and 17.47,P＜0.05 ) or CpG ODN group (t=18.53,9.66and7.51,P＜0.05).Conclusions CpG ODN1826 can dramatically increase the efficiency of radiotherapy by inhibiting tumor growth and promoting lumor apoptosis.

Objective To investigate the efficacy and safety of perioperative use of different hemostatic drugs in elderly patients undergoing transurethral resection of the prostate (TURP).Methods A total of 480 elderly patients with benign prostatic hyperplasia (BPH) admitted to the Departments of Urology and Gerontology of our hospital from January 2010 to October 2014 were selected and randomly divided into 6 groups (n =80,each).Patients in all groups were given preoperative oral finasteride for 1 week,with each of the non-control groups receiving perioperative heamocoagulase agkistrodon,mangabeys hemocoagulase,reptilase,ethylenediamine diaceturate,or dicynone + paraaminomethyl benzoic acid (PAMBA).Intraoperative bleeding,perioperative hematocrit,hemoglobin change,continuous bladder irrigation time,adverse reactions and other clinical parameters were recorded.Results Operations went smoothly with all patients.Changes in perioperative blood routine indexes,coagulation function,intraoperative bleeding volume and continuous bladder irrigation time had significant differences between the control group and the groups treated with hemostatic drugs (all P＜0.05).No significant differences in perioperative blood routine indexes,coagulation function,intraoperative bleeding volume and continuous bladder irrigation time were found between groups treated with heamocoagulase agkistrodon,mangabeys hemocoagulase and reptilase,or between groups treated with ethylenediamine diaceturate and dicynone+PAMBA (all P＞ 0.05).There were significant differences in the perioperative blood routine indexes,coagulation function,intraoperative bleeding volume and continuous bladder irrigation time between the groups with and without blood coagulation enzymes (all P ＜0.05).Fibrinolytic responses occurred in 2 patients in the heamocoagulase agkistrodon group and were mitigated after drug withdrawal and fibrinogen infusion.Conclusions A reasonable perioperative dose of a hemostatic drug has good clinical effects in elderly patients undergoing TURP.Hemostatic drugs such as blood coagulation enzymes have certain advantages including safety over other types of hemostatic drugs,but their doses should not be too large.

Objective To investigate the diagnosis,treatment and prognosis of bilateral renal clear cell carcinoma in the elderly.Methods Clinical data from 38 cases of elder patients admitted with bilateral renal clear cell carcinoma in our department from 2010 to 2014 were retrospectively analyzed.Among the total 38 cases diagnosed by B ultrasound and CT,13 cases(A group)were treated with laparoscopic radical nephrectomy on one side,combined with microwave ablation on the other side;another 25 cases(B group)were treated with microwave ablation on bilateral sides.Patients were followed up for 24-36 months,with regularly checking by B ultrasound,CT and renal function.Results The operations were successful in total 38 cases (A +-B group),and no postoperative complications were found.All cases were diagnosed as pathologically proven bilateral renal clear cell carcinoma.Postoperative renal functions of the cases were decreased at different degrees as compared with preoperative renal functions,but not needing dialysis treatment.The microwave ablation on bilateral sides(B Group) versus A Group,significantly decreased the surgical time cost (P =0.012) and hospital stay(P =0.021).For both A and B group,postoperative renal function were declined in different degree.The damage extents of blood urea nitrogen,creatinine and creatinine clearance rate were less in group B than in group A at one week after surgery(P=0.008,0.009 and 0.006).Atpostoperative follow-up for 3 month,it was found that the damage extents of blood urea nitrogen,creatinine and creatinine clearance rate were less in group B than in group A (P =0.037,0.020 and 0.018).At postoperative follow-up for 30 months in average,no local recurrence or metastasis was found.Diagnosis of bilateral kidney clear cell carcinoma in the elderly mainly depended on B ultrasound,CT scan and MRI imaging.Conclusions As to the treatment of elderly patients with early renal clear cell carcinoma,considering both the general healthy condition of patients and tumor therapy and choosing microwave ablation might be good for efficiency and prognoses.

OBJECTIVE: To summarize advances in clinical application of ureter stent and its biocompatibility. METHODS: A computer-based online search of CNKI (1989/2009) and Medline (1989/2009) was performed with the key words of "ureter, biocompatibility, stent, treatment, complications" in Chinese and English respectively. A total of 51 articles were collected. and 21 were included. The treatment advances and its biocompatibility of ureter stent were summarized, and clinical application advances, biocompatibility and complication prevention of ureter stent were explored. RESULTS: Ureter stent includes polymerizer, metal and degradable material stents. As the common implants in treatment of upper urinary tract diseases, ureter stent functions as stent and internal drainage, and relieve ureteral obstruction, prevent leakage of urine postoperatively and ureterostenosis. Complications following ureter stent implantation include stent shifting, urine reflux, irdtative symptoms of bladder, fouling and stone formation as well as infection. However, these complications can be relieved through positive treatment. CONCLUSION: Ureter stent is an effective approach to treat urologic disease, but the biocompatibility required improvement. Rigorous operation during stent implantation and positive treatment of complication can effectively prevent complications.

Objective To explore the role of pyruvate kinase M2 (PKM2) siRNA in the radiosensitivity of human lung cancer A549 cells.Methods PKM2 siRNA was synthesized according to the coding sequence of PKM2 mRNA and then was transferred into A549 cells with lipofectamine.The expressions of PKM2 gene and protein was detected by RT-PCR and Western blot,respectively.The experiments were divided into PKM2 siRNA interference group,siRNA negative control group,and blank control group.The cells of each group were exposure to 6 MV X-rays in different dose.Radiosensitivity was evaluated by colony formation assay.Flow cytometry was applied to analyze cell cycle distribution and apoptosis.Data are representative of three independent experiments.Results Ccompared with blank control cells,the expressions of PKM2 gene and protein in the PKM2 siRNA transferred A549 cell was efficiently diminished (t =20.91,47.00,P ＜0.01) with inhibition rates of (70.27 ± 1.38)％ and (70.42 ± 1.18) ％,respectively.Compared with control,PKM2 siRNA transfection significantly decreased the D0,Dq,N and SF2 values (t =43.82,28.44,15.60,29.63,P ＜ 0.01) and hence yield a sensitization enhancement ratio (SER) of 1.27.In addition,the percentage of G2/M phase cells in the siRNA group and irradiated group were both significantly higher than that of the blank control group (t =8.35,27.87,P ＜ 0.01).The combined treatments of PKM2 siRNA interference and irradiation arrested more cells in the G2/M phase compared to either treatment alone.The apoptosis rate of siRNA group was not dramatically different from that of blank control group.The apoptosis rate of irradiation group was higher than that of blank control group (t =23.99,P ＜ 0.01),and the combined treatments of siRNA and irradiation enhanced the apoptotic rate compared to either treatment alone (t=9.42,65.21,P ＜ 0.01).Conclusions Specific blockage of PKM2 expression by gene silencing could enhance the sensitivity of human lung cancer A549 cells to radiotherapy in vitro,which may due to the cell cycle arrest and apoptosis induction after irradiation.

Objective To evaluate the influence of belly beard device and the distended bladder on the dose distribution of PTV and the dose-volume histograms(DVHs)of organs at risk(OARs)for postoperative radiation tIlerapy of rectal cancer.Methods A total of 23 patients(8 and 15)with distended bladder receiving 3-field postoperative radiation therapy were dealed with or without a special belly beard in the prone position.At the same time,15 cages with belly board were scanned with empty bladder.The volume of irradiated small bowel was calculated for doses between 5-50 Gy at 5 Gy intervals.With prescription dose in plan target volume(PTV)of 50 Gy,we compared the dose distribution,DVH of OARs,conformity index(CIPTV),the volume of irradiated small bowel and the acute toxicity under the condition of thlee different moulds.Results There was no significant difference in PTV's converge,DVHs of femoral head and CI among 3 moulds(P＞0.05).With the belly board,the high-dose volume of irradiated small bowel(V20-V52.5)was significantly decreased(P＜0.05),specially with distended bladder.However,the low dose volume(V5-V15)was slightly increased.The bladder distension significanfly decreases the volumes of the irradiated small howel at dose levels from 15-52.5 Gy(P＜0.05).Furthermore,the mean volume(V5-V30)of irradiated small bowel differed significantly between patients experiencing Grade 0.1 and ≥2 diarrhea(P＜0.05).Conclusions The combination of belly board and distended bladder was more effectively to reduce the irradiated small bowel volume among 3 moulds,so as to minimized acute diarrhea toxicity.