1.Toxicity and treatment outcome of intensity-modulated radiation therapy for early stage nasal and Waldeyer ring NK/T-cell lymphoma
Hua WANG ; Yexiong LI ; Weihu WANG ; Jing JIN ; Yongwen SONG ; Shunan QI ; Shulian WANG ; Yueping LIU ; Qingfeng LIU ; Zhaoyang WANG ; Xinfan LIU ; Jianrong DAI ; Zihao YU
Chinese Journal of Radiation Oncology 2010;19(2):120-125
Objective Radiotherapy is the primary therapy for early stage nasal-type NK/T-cell lymphoma of the nasal or Waldeyer ring. This study aimed to investigate the clinical outcome of the disease treated with intensity-modulated radiation therapy (IMRT). Methods From November 2003 to June 2008, 48 patients with nasal or Waldeyer ring NK/T-ceil lymphoma underwent IMRT. The tumors were located in the nasal in 42 patients ,and the Waldeyer ring in 6. According to the Ann Arbor staging system, the disease was stage Ⅰ_E in 37 patients (77%), stage Ⅱ_E in 11 (23%). Of these patients, 22 received radiotherapy alone, the other 26 received combined chemotherapy and radiotherapy. Prescribed radiation dose was defined as a minimun dose of 95% PTV. Acute and late toxicities were scored by Radiation Therapy Oncology Group morbidity criteria. Survival probabilities were estimated using Kaplan-Meier method. Results With a median follow-up of 18 months, the 2-year local control, overall survival and progression-free survival rates were 100%, 75% and 73%, respectively. The average maximum, mean and minimum delivered doses were 62.6 Gy, 55.0 Gy and 20.3 Gy to the PTV. Only 2.4% of the PTV received less than 95% of the prescribed dose. The average maximum dose to the brain, spinal cord, optic chiasm, left optical nerve, right optical nerve, left len and right len was 43.5 Gy, 32. 7 Gy, 48.2 Gy, 50. 3 Gy, 51.3 Gy, 7. 8 Gy and 7.6 Gy, respectively. The average mean dose to the left parotid, right parotid, pituitary, left T-M joint and right T- M joint was 17. 1 Gy , 16. 5 Gy , 32. 5 Gy , 47.3 Gy and 46. 8 Gy , respectively. Acute mucositis was observed in 37% of patients with Grade 1, 41% with Grade 2, and 16% with Grade 3. Skin toxicity was observed in 78% of patients with Grade 1 and 16% with Grade 2. Acute xerestoma was observed in 65% of patients with Grade 1 and 18% with Grade 2. Conclusions IMRT provids excellent tumor target coverage and reduces the dose to the critical normal tissues such as the salivary glands. Longer follow-up is needed to assess the long-term overall survival and local control.
2.Toxicity of hypofractionated intensity-modulated radiotherapy in patients with prostate cancer
Hui FANG ; Yexiong LI ; Yueping LIU ; Weihu WANG ; Jing JIN ; Shulian WANG ; Yongwen SONG ; Xinfan LIU ; Shunan QI ; Qingfeng LIU ; Jianrong DAI ; Zihao YU
Chinese Journal of Radiation Oncology 2009;18(3):209-213
Objective To analyze the acute and late toxicities in patients with prostate cancer trea-ted with hypofractionated intensity-modulated radiotherapy (IMRT). Methods Between June 2006 and June 2008, 37 patients with prostate cancer were treated with hypofractionated IMRT. The clinical target vol-ume (CTV) was the prostate, seminal vesicles and pelvic lymph nodes in 24 patients, the prostate and semi-hal vesicles in 12, and only the tumor bed in 1. The dose per fraction was 2.3 - 2.8 Gy, with 2.7 Gy in 26 patients. The minimal dose was 62.5-75.0 Gy to the prostate and seminal vesicles, and 50 Gy to the pelvic lymph nodes. Results The median follow-up was 14 months. None of the patients experienced grade 4 a-cute gastro-intestinal (GI) toxicity. Grade 1, 2 and 3 acute GI toxicity occurred in 24.3%, 35.1% and 2.7% of the patients, respectively. The rectal V50>27% and V55>20% were highly significantly associat-ed with grade ≥1 acute GI toxicity. Grade 1,2 and 3 acute genitourinary (GU) toxicity occurred in 68%, 0% and 3% of the patients, respectively. The bladder V50> 10% was significantly associated with grade ≥1 acute GU toxicity. The incidence of late GI toxicity was low. No grade ≥3 late GI toxicity was observed. The incidence of late grade 1 and 2 GI toxicity was 24% and 5%, respectively. The rectal V65> 10% was highly significantly associated with grade ≥1 late GI toxicity. No late grade 4 GU toxicity was observed. The incidence of grade 1, 2 and 3 late GU toxicity was 49%, 11% and 3%, respectively. Grade ≥2 late GU toxicity was correlated with V40, V50 and mean dose of the bladder. Conclusions Acute and late toxicity of hypofractionated IMRT is acceptable in patients with prostate cancer.
3.Prospective phase Ⅱ trial of hypofractionated intensity-modulated radiotherapy for localized prostate cancer
Yueping LIU ; Yexiong LI ; Weihu WANG ; Hui FANG ; Jing JIN ; Shulian WANG ; Yongwen SONG ; Hua REN ; Xinfan LIU ; Zihao YU ; Jianrong DAI
Chinese Journal of Radiation Oncology 2012;21(3):237-240
Objective To prospectively evaluate the efficacy and toxicity of hypofractionated intensity-modulated radiotherapy (IMRT) for prostate cancer.MethodsFifty-two consecutive patients with localized prostate cancer were enrolled in this study between Feb.2009 and Mar.2011.All patients received hypofractionated IMRT (2.7 Gy/fx,25 fractions,total 67.5 Gy) to the prostate and seminal vesicles.32 high risk patients also received prophylactic irradiation to the pelvic lymph nodes concurrently (2 Gy/fx,25 fractions).Imaging-guided radiotherapy was employed in 35 patients.Androgen deprivation therapy was adopted in 48 of 52 patients.ResultsAfter a median follow-up of 13 months,the mean prostate specific antigen (PSA) was reduced from (40.3 ± 36.6) ng/ml before treatment to (0.5 ± 1.7)ng/ml at the last follow-up.By the time of last follow-up,2 patients (4%) failed.One had PSA failure and the other had both PSA failure and pelvic lymph node relapse.25% of the patients experienced grade 2 acute gastrointestinal (GI) toxicity and 4% experienced grade 3 GI toxicity.Acute grade 2 and grade 3genitourinary ( GU ) toxicity occurred in 15% and 2%,respectively.The incidence of late grade 2 and grade 3 GI toxicity was 17% and 0%,respectively.Late grade 2 and 3 GU toxicity was 8% and 2%.The potency was unable to evaluate because most of the patients received androgen deprivation therapy.Conclusions The short-term PSA-free survival after 2.7 Gy/fx,25 fractions' hypofractionated IMRT for localized prostate cancer is favorable,and the acute and late GI and GU toxicity are acceptable.A longer time follow-up is warranted to ascertain the long term efficacy and safety of this regimen.
4. Risk factors of cancer recurrence in stomach after non-curative endoscopic resection for early gastric cancer
Chinese Journal of Digestive Endoscopy 2019;36(12):897-900
Objective:
To analyze the risk factors of cancer recurrence in stomach after non-curative endoscopic resection for early gastric cancer (EGC).
Methods:
Data of 59 patients with early gastric cancer, who underwent non-curative resection at endoscopy center of Shanghai Renji Hospital from October 2008 to June 2018, were analyzed with the univariate Logistic regression for the risk factors of cancer recurrence in the stomach.
Results:
The follow-up period ranged from 4 to 77 months, with the median time of 40 months. There were 11 cases of cancer recurrence in the stomach. The univariate Logistic regression analysis showed lymphatic vessel invasion (
5. Role of Early Capsule Endoscopy and Device⁃assisted Enteroscopy in Diagnosis of Overt Small Bowel Bleeding
Chinese Journal of Gastroenterology 2022;27(12):705-710
Small bowel bleeding is defined as bleeding from the gastrointestinal tract where the cause cannot be clearly identified after routine gastroscopy and colonoscopy, of which bleeding visible to the naked eye is classified as overt bleeding. Endoscopy, such as capsule endoscopy and device⁃assisted enteroscopy, occupies a dominant position in the diagnosis of overt small bowel bleeding, and how to choose the right time for endoscopy is closely related to the diagnostic yield. This article provided an overview of the timing and diagnostic role of early capsule endoscopy and device⁃assisted enteroscopy in overt small bowel bleeding.
6.Effect of Neibu Huangqi Decoction combined with Kangfuxin Liquid on wound healing after hemorrhoid fistula
Chungeng LI ; Xuexian LIU ; Liming DAI ; Xiaoqiao LIU ; Jun MA ; Zaihua LI ; Yonghui WEI ; Feng GU ; Zihao CHEN ; Yajun JIANG
International Journal of Traditional Chinese Medicine 2023;45(8):973-976
Objective:To investigate the effects of Neibu Huangqi Decoction combined with Kangfuxin Liquid on wound healing after hemorrhoid fistula.Methods:Randomized controlled trial. A total of 90 patients with hemorrhoid fistula surgery in Tangshan Hospital of Traditional Chinese Medicine from January 2020 to June 2021 were selected as the observation objects and divided into 2 groups by random number table method, with 45 cases in each group. The control group was treated with Kangfuxin Liquid after surgery, and the observation group was treated with Neibu Huangqi Decoction. Both groups were treated continuously for 14 days. Wound symptom score was performed before and after treatment. The levels of TNF-α, IL-6 and IL-8 were determined by ELISA. The wound healing time was observed and the wound healing rate was calculated. Adverse reactions were recorded and clinical efficacy was evaluated.Results:The total effective rate was 93.33% (42/45) in the observation group and 66.67% (30/45) in the control group, with statistical significance ( χ2=9.89, P=0.002). After treatment, the scores of pain [(0.63±0.14) vs. (0.97±0.27), t=7.50], exudation [(0.67±0.12) vs. (1.09±0.31), t=8.48], edema [(0.78±0.17) vs.(1.25±0.36), t=7.92], pruritus [(0.78±0.20) vs. (1.32±0.33), t=9.39] were lower than those in the control group ( P<0.01); serum TNF-α [(33.46±2.86) μg/L vs. (45.78±3.92) μg/L, t=25.39], IL-6 [(41.86±5.84) μg/L vs. (56.12±6.75) μg/L, t=15.98], IL-8 [(27.40±3.58) ng/L vs. (36.16±3.84) ng/L, t=16.69] were lower than those in the control group ( P<0.01). The wound healing time of the observation group was shorter than that of the control group ( t=8.60, P<0.01), and the wound healing rate was higher than that of the control group ( t=24.65, P<0.01). During treatment, the incidence of adverse reactions was 11.11% (5/45) in the observation group and 6.67% (3/45) in the control group, without statistical significance ( χ2=0.14, P=0.711). Conclusion:Neibu Huangqi Decoction combined with Kangfuxin Liquid can promote wound healing, reduce inflammatory cytokines, relieve pain and exudation, improve clinical efficacy, and have few adverse reactions.
7. Dosimetric evaluation of conventional two-dimensional radiotherapy after modified mastectomy for breast cancer patients
Yirui ZHAI ; Shulian WANG ; Yu TANG ; Jianrong DAI ; Bo CHEN ; Hui FANG ; Hua REN ; Shunan QI ; Ningning LU ; Yuan TANG ; Ning LI ; Yueping LIU ; Yongwen SONG ; Zihao YU ; Jing JIN ; Yexiong LI
Chinese Journal of Radiation Oncology 2019;28(9):696-700
Objective:
To investigate the dosimetric characteristics of conventional two-dimensional radiotherapy of the chest wall, supra-and infra-clavicular regions, and the incidental irradiation dosage of the internal mammary region after modified mastectomy in breast cancer patients.
Methods:
Clinical data of 20 breast cancer patients including 10 left and 10 right cases who received radiotherapy after modified mastectomy between 2015 and 2016 were retrospectively analyzed. All patients received irradiation to the chest wall, supra-and infraclavicular regions at a prescription dose of 43.5 Gy in 15 fractions with conventional technique. One anterior-posterior (AP) photon field irradiation was delivered for the supra-and infra-clavicular regions, and one electron field for the chest wall. The supra-and infraclavicular regions were re-planned by using two AP/PA fields and the doses of organ at risk were evaluated.
Results:
With conventional radiotherapy, the D90 of the supra-and infra-clavicular regions were more than 39.15 Gy (EQD2≥45 Gy) in 17 patients (85%), and the median D90 of the chest wall was 35.38 Gy. The median dose of incidental internal mammary region was 13.65 Gy. Patients with lower body mass index (BMI) received higher D90 in both supra-and infra-clavicular and chest wall irradiation (
8.Application of immunosuppressant facilitates the therapy of optic neuritis combined with Sjögren's syndrome.
Hongyang LI ; Zihao LIU ; Yan GONG ; Zhaocai JIANG ; Yixin ZHANG ; Yanli DAI ; Yan ZHANG ; Shihui WEI
Chinese Medical Journal 2014;127(17):3098-3104
BACKGROUNDOptic neuritis (ON) is often the first symptom of multiple sclerosis (MS) and neuromyelitis optica (NMO) while there has been very little research reported on ON combined with Sjögren's syndrome (SS). The aim of this study is to provide different treatments and services for and NMO patients combined with SS.
METHODSTwenty-seven patients with ON combined SS were divided into two groups: corticosteroid group (C group, methylprednisolone sodium succinate, 14 patients) and corticosteroid+ immunosuppressant group (C+I group, leflunomide, 13 patients). ON relapse times in 1 year after treatment, number of patients who relapsed to NMO/MS in 1 years, visual acuity and retina nerve fiber layer (RNFL) thickness were measured. Mann Whitney-Wilcoxon test was used to compare continuous variables and Chi-square test or Fisher's exact test was to compare proportions.
RESULTSON combined with SS patients had higher incidence rates in middle-aged women who have binocular damage and heavier visual function damage or when there is an easy relapse, and the patients are often hormone dependent. The patients are more likely anti-aquaporin-4 IgG seropositive (70.4%). They are liable to form a centrocecal scotoma and tubular vision. The times of relapse decreased in patients who used immunosuppressant, and a significant difference was found between immunosuppressant and non-immunosuppressant groups in visual acuity recovery during 6-month follow-up period (P < 0.05); however, the RNFL thickness at the four quadrants was not significantly different.
CONCLUSIONSThe effect of immunosuppressant plus corticosteroid on the early onset of ON combined with SS was to provide ON remedy and to prevent recurrence in clinics. This study provides a significant reference for the prevention and treatment of ON on the basis of immunosuppressant and corticosteroid.
Adolescent ; Adrenal Cortex Hormones ; therapeutic use ; Adult ; Aged ; Female ; Humans ; Immunosuppressive Agents ; therapeutic use ; Magnetic Resonance Imaging ; Male ; Methylprednisolone Hemisuccinate ; therapeutic use ; Middle Aged ; Optic Neuritis ; drug therapy ; Sjogren's Syndrome ; drug therapy ; Visual Acuity ; drug effects ; Young Adult
9.Survey on natural language processing in medical image analysis.
Zhengliang LIU ; Mengshen HE ; Zuowei JIANG ; Zihao WU ; Haixing DAI ; Lian ZHANG ; Siyi LUO ; Tianle HAN ; Xiang LI ; Xi JIANG ; Dajiang ZHU ; Xiaoyan CAI ; Bao GE ; Wei LIU ; Jun LIU ; Dinggang SHEN ; Tianming LIU
Journal of Central South University(Medical Sciences) 2022;47(8):981-993
Recent advancement in natural language processing (NLP) and medical imaging empowers the wide applicability of deep learning models. These developments have increased not only data understanding, but also knowledge of state-of-the-art architectures and their real-world potentials. Medical imaging researchers have recognized the limitations of only targeting images, as well as the importance of integrating multimodal inputs into medical image analysis. The lack of comprehensive surveys of the current literature, however, impedes the progress of this domain. Existing research perspectives, as well as the architectures, tasks, datasets, and performance measures examined in the present literature, are reviewed in this work, and we also provide a brief description of possible future directions in the field, aiming to provide researchers and healthcare professionals with a detailed summary of existing academic research and to provide rational insights to facilitate future research.
Humans
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Natural Language Processing
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Surveys and Questionnaires
10.KIF2C: a novel link between Wnt/β-catenin and mTORC1 signaling in the pathogenesis of hepatocellular carcinoma.
Shi WEI ; Miaomiao DAI ; Chi ZHANG ; Kai TENG ; Fengwei WANG ; Hongbo LI ; Weipeng SUN ; Zihao FENG ; Tiebang KANG ; Xinyuan GUAN ; Ruihua XU ; Muyan CAI ; Dan XIE
Protein & Cell 2021;12(10):788-809
Hepatocellular carcinoma (HCC) is the most common primary liver malignancy and is the fourth-leading cause of cancer-related deaths worldwide. HCC is refractory to many standard cancer treatments and the prognosis is often poor, highlighting a pressing need to identify biomarkers of aggressiveness and potential targets for future treatments. Kinesin family member 2C (KIF2C) is reported to be highly expressed in several human tumors. Nevertheless, the molecular mechanisms underlying the role of KIF2C in tumor development and progression have not been investigated. In this study, we found that KIF2C expression was significantly upregulated in HCC, and that KIF2C up-regulation was associated with a poor prognosis. Utilizing both gain and loss of function assays, we showed that KIF2C promoted HCC cell proliferation, migration, invasion, and metastasis both in vitro and in vivo. Mechanistically, we identified TBC1D7 as a binding partner of KIF2C, and this interaction disrupts the formation of the TSC complex, resulting in the enhancement of mammalian target of rapamycin complex1 (mTORC1) signal transduction. Additionally, we found that KIF2C is a direct target of the Wnt/β-catenin pathway, and acts as a key factor in mediating the crosstalk between Wnt/β-catenin and mTORC1 signaling. Thus, the results of our study establish a link between Wnt/β-catenin and mTORC1 signaling, which highlights the potential of KIF2C as a therapeutic target for the treatment of HCC.
Adult
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Aged
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Animals
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Carcinoma, Hepatocellular/pathology*
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Cell Line, Tumor
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Cell Movement
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Cell Proliferation
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Epithelial-Mesenchymal Transition/genetics*
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Female
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Gene Expression Regulation, Neoplastic
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Humans
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Intracellular Signaling Peptides and Proteins/metabolism*
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Kinesins/metabolism*
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Liver Neoplasms/pathology*
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Male
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Mice
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Mice, Inbred BALB C
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Middle Aged
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Neoplasm Staging
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Prognosis
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Protein Binding
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RNA, Small Interfering/metabolism*
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Survival Analysis
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Tumor Burden
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Wnt Signaling Pathway
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Xenograft Model Antitumor Assays
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beta Catenin/metabolism*