Carcinoma, Hepatocellular ; radiotherapy ; therapy ; Combined Modality Therapy ; Humans ; Liver Neoplasms ; radiotherapy ; therapy ; Radiotherapy ; methods

Objective:To investigate the relationship between the department where patients with nasopharyngeal carcinomas was first admitted and the delayed diagnoses(or misdiagnosis).Methods:The data of 1998 cases of nasopharyngeal carcinomas were collected and analyzed.Results:The department of otolaryngology and the radiation oncology have the high correction rates for the first diagnosis,but misdiagnosis rates in departments of surgical,internal medicine and traditional Chinese medicine were very poor.Conclusion:The clinical knowledge about nasopharyngeal carcinomas was the most important factor for the first diagnoses.

Objective To investigate the effect of VPA and molecular hydrogen(H2)on phenotypes of microglia treated with hypoxia. Methods Mouse hypoxic BV2 microglia were treated with VPA or H2. The levels of phenotypic markers of supernatant and cells were detected by ELISA, flow cytometry and real?time PCR,respectively. Results Hypoxia significantly increased mRNA level of M1 marker(iNOS)and reduced mRNA levels of M2 markers(CD206 and TGF?β)in BV2(P<0.05). Besides,the ratio between the mRNA levels of M1 increased(P<0.05). VPA significantly reduced protein level(CD16/32)and mRNA production(iNOS)of M1 markers in hypoxia?treated BV2(P<0.05). The ratio be?tween the mRNA levels of M1 markers and M2 markers(CD16:CD206,CD32:CD206,iNOS:CD206 and iNOS:TGF?β)were also significantly decreased(P<0.05). H2 significantly reduced both protein levels(TNF?α,CD16/32 and iNOS)and mRNA production(iNOS)of M1 markers and increased secretion of M2 marker(IL?10)in hypoxia?treated BV2(P<0.05). The ratio between the mRNA levels of M1 markers and M2 markers(CD16:CD206,iNOS:CD206 and iNOS:TGF?β)were also highly declined(P<0.05). Conclusion Hypoxia can induce microglial cells toward pro?inflammatory phenotype. Both VPA and H2 can inhibit hypoxia?induced inflammatory effect on microglia.

Objective To develop a predictive model for pulmonary embolism(PE)based on the related clinical symptoms,signs,and the labo-ratory index,so as to improve the positive rate of CTPA. Methods The model was developed from a database of 119 patients with suspected PE. The risk factors of suspected PE were analyzed by logistic regression analysis ,which included significant differences in the prevalence of PE be-tween non-diseased and non-diseased groups. Receiver operating characteristic(ROC)curves was draw to determine the cut-off value of the clini-cal probability. It was validated in an independent sample of 106 patients with suspected PE. Results According to the univariate analysis ,17 of 51 variables show a significant difference between PE and non-PE patients. The model comprised 4 variables:age,dyspnea,D-dimer and unilater-al leg swelling. The area under the ROC curve is 0.776,and the cut-off value is supposed to be 0.38. In the validation sample,27% patients had PE confirmed by CTPA. The prevalence of PE was 54%when the clinical probability was above 0.38. Conclusion The proposed predictive mod-el in this study can improve the positive rate of CTPA ,simplify the diagnosis process of suspected PE patients.

Objective To analyze the effects of valproic acid(VPA),a histone deacetylase(HDAC)inhibitor,on macrophage polarization in?duced by paraquat(PQ)or lipopolysaccharide(LPS). Methods Mouse RAW264.7 cells were cultured at 37℃with 5%CO2,passaged,and then given one of the following treatments:(1)PQ;(2)PQ+VPA(classⅠandⅡa HDAC inhibitor);(3)PQ+apicidin(classⅠHDAC inhibitor);(4)PQ+MC1568(classⅡa HDAC inhibitor);(5)LPS;(6)LPS+VPA;(7)LPS+apicidin;(8)LPS+MC1568. The cells and culture supernatants were harvested after 8 h of treatment. RT?PCR,ELISA,and flow cytometry were conducted to assess the expression levels of macrophage phenotyp?ic markers. Results Both PQ and LPS skewed the macrophage functional polarity toward proinflammatory phenotype. VPA,apicidin,and MC1568 all inhibited PQ?and LPS?induced macrophages polarizing toward pro?inflammatory phenotype ,but the inhibitory effects were different in some ways. Conclusion VPA inhibits the proinflammatory function of macrophages induced by PQ and LPS ,but the effect of VPA on PQ?and LPS?induced macrophages has its own characteristics.

Animals ; Antineoplastic Agents, Phytogenic ; therapeutic use ; Liver Neoplasms, Experimental ; drug therapy ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Neoplasm Transplantation ; Radiation-Sensitizing Agents ; therapeutic use ; Taxoids ; therapeutic use

OBJECTIVETo retrospectively investigate the difference in survival of pancreatic adenocarcinoma patients treated by radical surgery with or without adjuvant radiation therapy.

METHODSForty-four patients with pancreatic cancer underwent surgical resection with a curative intent, and were divided into two groups: surgery alone (n = 24) or surgery combined with postoperative external beam radiotherapy (EBRT) (n = 20). Survival as an endpoint was analyzed between the two groups.

RESULTSAll 44 patients completed their scheduled treatment. The median survival time of the patients treated with radical resection alone was 379 days versus 665 days for those treated with combined therapy. The 1-, 3-, 5-year survival rates of the patients treated with radical resection alone were 46.3%, 8.3%, 4.2% versus 65.2%, 20.2%, 14.1% for the patients treated with combined therapy, respectively, with a significant difference between the two groups (P = 0.017). The failures in local-regional relapse were significantly lower in the postoperative EBRT group than that in the surgery alone group (P < 0.05), while the additional postoperative radiation therapy did not increase the complication rate (P > 0.05).

CONCLUSIONPostoperative external beam radiation therapy can improve the survival in patients with pancreatic adenocarcinoma.

Adenocarcinoma ; pathology ; radiotherapy ; surgery ; Female ; Follow-Up Studies ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Pancreatectomy ; methods ; Pancreatic Neoplasms ; pathology ; radiotherapy ; surgery ; Postoperative Period ; Radiotherapy, Adjuvant ; Radiotherapy, High-Energy ; Retrospective Studies ; Survival Rate

Objective:To explore the value of salivary gland imaging based on deep learning and Delta radiomics in assessing salivary gland injury after 131I treatment in post-thyroidectomy thyroid cancer patients. Methods:A retrospective analysis on 223 patients (46 males, 177 females, age(47.7±14.0) years ) with papillary thyroid cancer, who underwent total thyroidectomy and 131I treatment in Affiliated Hospital of Guilin Medical University between December 2019 and January 2022, was conducted. All patients underwent salivary gland 99Tc mO 4- imaging before and after 131I therapy. The patients were categorized according to salivary gland function based on 99Tc mO 4- imaging results (normal salivary gland vs salivary gland injury), and divided into training and test sets in a ratio of 7∶3. A ResNet-34 neural network model was trained using images at the time of maximum salivary gland radioactivity and those based on background radioactivity counts for structured image feature data. The Delta radiomics approach was then used to subtract the image feature values of the two periods, followed by feature selection through t-test, correlation analysis, and the least absolute shrinkage and selection operator( LASSO) algorithm, to develop logistic regression (LR), support vector machine (SVM), and K-nearest neighbor (KNN) predictive models. The diagnostic performance of 3 models for salivary gland function on the test set was compared with that of the manual interpretation. The AUCs of the 3 models on the test set were compared (Delong test). Results:Among the 67 cases of the test set, the diagnostic accuracy of 3 physicians were 89.6%(60/67), 83.6%(56/67), and 82.1%(55/67) respectively, with the time required for diagnosis of 56, 74 and 55 min, respectively. The accuracies of LR, SVM, and KNN models were 91.0%(61/67), 86.6%(58/67), and 82.1%(55/67), with the required times of 12.5, 15.3 and 17.9 s, respectively. All 3 radiomics models demonstrated good classification and predictive capabilities, with AUC values for the training set of 0.972, 0.965, and 0.943, and for the test set of 0.954, 0.913, and 0.791, respectively. There were no significant differences among the AUC values for the test set ( z values: 0.72, 1.18, 1.82, all P>0.05). Conclusion:The models based on deep learning and Delta radiomics possess high predictive value in assessing salivary gland injury following 131I treatment after surgery in patients with thyroid cancer.

Objective:To evaluate the safety and primary outcome of stereotactic body radiation therapy(SBRT) for the consolidation treatment in patients with residual hepatocellular carcinoma after transarterial chemoembolization(TACE).Methods:From December 2012 to December 2015, clinical data of sixteen patients with hepatocellular carcinoma who received TACE combination with SBRT in Zhongshan Hospital affiliated to Fudan University were analyzed retrospectively.The median age was 55 years (range 41-80 years),and the residual tumor was single (the median diameter was 2.8 cm).All cases were performed by 4-dimensional CT positioning, showing the visible residual tumor lesions.Image guided-radiation therapy was used, total irradiation doses ranged from 48 Gy to 50 Gy in 5 to 10 fractions, and the supportive treatment was administrated during SBRT.Tumor responses were evaluated using the modified Response Evaluation and Criteria in Solid Tumors (mRECIST).Results:All of 16 cases completed SBRT.Based on mRECIST, 9 patients (56.3%) achieved complete response (CR), 6 cases (37.5%) achieved partial response (PR), but there were 1 patient (6.25%) with stable disease (SD)and no patient with progressive disease (PD) in radiation field.The overall objective response rate (CR+PR) was 93.8%.The overall survival (OS) rate at 1, 2, and 3 years was 100%, 93.6% and 93.6%, respectively.No radiation-induced liver disease was appeared.Conclusions:SBRT is safety and effective to treat patients with residual hepatocellular carcinoma after TACE.TACE combination with SBRT, as an effective combination for the treatment of advanced liver cancer, is worthy of further study.

Objective:To analyze the positioning deviation of two different body position fixing methods for hepatic carcinoma patients by meta-voltage computed tomography (MVCT) .Methods:The positioning data of 40 hepatic carcinoma patients treated by helical tomotherapy during March to October ,2015 in our Department of Radiotherapy were collected and divided into two groups :users of carbon fiber fixator with vacuum pad (Group C) and users of the vacuum bag (Group V) . MVCT scan was performed before each treatment ,and the amount of both linear and rotary positioning deviation was obtained . The two sets of data were compared through mean functional t-test .Finally ,PTV extended boundary was calculated according to the extension formula M=2 .5Σ+0 .7δ.Results:From deviation direction of linear positioning ,the differences of X-axis and Z-axis on two sets of data had statistical significance (t=22 .02 ,2 .56;P=0 .04 ,0 .01 ;P<0 .05) .From deviation direction of rotary positioning ,the differences of Pitch and Yaw on two sets of data also had statistical significance (t=22 .16 ,2 .26 ;P=0 .03 ,0 .02 ;P<0 .05) .PTV extended boundary of Group V were 8 .29 mm ,9 .87 mm and 7 .72 mm .PTV extended boundary of Group C were 4 .81 mm ,5 .27 mm and 4 .57 mm .Conclusions:In helical tomotherapy ,MVCT image guidance technology could enhance the accuracy of radiotherapy for hepatic carcinoma patients .Compared with vacuum bag ,carbon fiber fixator could fix the patients better ,which could reduce positioning deviation and PTV boundary .