[摘 要] 目的：探究甘氨胆酸（GCA）对肺腺癌A549细胞移植瘤小鼠放射治疗敏感性的影响及其机制。方法：建立A549人肺腺癌细胞裸鼠移植瘤模型，随机分为移植瘤对照组（对照组）、GCA组、放疗组（RT组）和GCA + 放疗组（GCA + RT组）。RT组和GCA + RT组接受单次10  Gy照射，GCA组及GCA + RT组连续7 d每日灌胃GCA 280  mg/kg。间隔2 d测量1次移植瘤体积，末次给药后处死小鼠并取移植瘤组织，检测移植瘤组织中超氧化物歧化酶（SOD）与谷胱甘肽过氧化物酶（GSH-Px）活性，qPCR法和WB法分别检测放疗关键基因（MCM6、ITGA6、CASP3等）mRNA和蛋白表达水平，H-E染色观察移植瘤组织的形态变化。通过GEO（GSE276500、GSE294906、GSE218171）及TCGA数据库数据验证放疗关键基因。结果：GCA单用对瘤体生长有一定抑制作用，但联合放疗的GCA + RT组相比单纯放疗组表现出放疗抵抗的效应（P < 0.05）。GCA处理显著提高移植瘤组织SOD活性（P < 0.01）、降低GSH-Px活性（P < 0.01），提示GCA可改变移植瘤抗氧化酶平衡，减弱放疗诱导的氧化应激。GCA干预上调移植瘤组织中MCM6与ITGA6 mRNA表达、下调CASP3 mRNA表达（均P < 0.05）。GCA + RT组移植瘤组织中的MCM6蛋白表达显著高于对照组（P < 0.05）。H-E染色显示，GCA组部分瘤组织坏死，而GCA + RT组坏死组织面积较RT组有所缩小。GEO和TCGA数据库验证支持MCM6、ITGA6高表达与放疗抵抗和预后不良相关。结论：GCA通过增强SOD活性、降低GSH-Px活性并上调ITGA6、MCM6的表达改变氧化应激与关键信号网络，从而削弱A549移植瘤对放疗的敏感性。

[摘 要] 目的：探讨DNA甲基转移酶1（DNMT1）通过稳定zeste基因增强子同源物2（EZH2）促进结直肠癌（CRC）HCT8细胞增殖与迁移的机制。方法：利用生物信息学方法分析DNMT1在CRC组织中的表达水平。WB法检测DNMT1在CRC细胞HCT8、SW620和正常结肠上皮细胞NCM460中的表达。通过siRNA或慢病毒载体转染HCT8细胞，分为siNC组、siDNMT1组、Vector组、DNMT1-OE组、siTRAF6组、siEZH2组、siEZH2 + DNMT1-OE组。采用克隆形成实验、CCK-8法、Transwell实验和划痕愈合实验检测敲低或过表达DNMT1对HCT8细胞增殖与迁移的影响，WB和qPCR法检测EZH2蛋白和mRNA水平，免疫沉淀（IP）法检测EZH2泛素化水平，免疫荧光双染检测肿瘤坏死因子受体相关因子6（TRAF6）与EZH2的细胞内共定位情况，克隆形成和划痕愈合实验验证EZH2对DNMT1功能的逆转作用。收集2022—2025年间郑州大学附属洛阳中心医院手术切除的12例CRC患者的癌及癌旁组织标本，采用免疫组化法检测CRC组织中DNMT1、TRAF6和EZH2的表达水平。结果：DNMT1在CRC组织中表达显著高于癌旁组织（P < 0.01），且在CRC细胞中表达上调（P < 0.05）；DNMT1敲低显著抑制HCT8细胞增殖及迁移（均P < 0.01），过表达则相反（均P < 0.01）。DNMT1正向调控EZH2的蛋白水平（P < 0.01），而mRNA水平不变（P > 0.05）。MG132可恢复siDNMT1组的EZH2蛋白表达（P < 0.01），且siDNMT1组EZH2泛素化水平升高。DNMT1负向调控TRAF6的表达（P < 0.01），且TRAF6与EZH2在细胞质中共定位，IP证实两者直接结合。敲低TRAF6可减弱EZH2的泛素化水平，敲低EZH2可逆转DNMT1对HCT8细胞增殖、迁移的促进作用（均P < 0.01）。DNMT1和EZH2在CRC组织中呈高表达（P < 0.01），TRAF6在CRC组织中表达显著低于癌旁组织（P < 0.05）。结论：DNMT1通过抑制TRAF6稳定EZH2促进CRC细胞的增殖和迁移，DNMT1、TRAF6和EZH2可能是CRC治疗的潜在靶点。

Objective To compare the dosimetric and radiobiological differences of helical tomotherapy (HT) and volumetric modulated arc therapy (VMAT) in craniospinal irradiation. Methods The CT images of 15 patients who received craniospinal irradiation in our hospital were selected. The target volumes and organs at risk (OARs) were contoured, and HT and VMAT plans were designed. The dosimetric parameters of the two plans were compared. A Matlab program based on equivalent uniform dose was developed to calculate the normal tissue complication probability (NTCP). The NTCP values of the two plans were compared. Results The homogeneity index of the target volume in the HT group was better than that in the VMAT group, with values of 0.06 ± 0.01 and 0.08 ± 0.24, respectively, and the difference was statistically significant (P=0.03). However, there was no significant difference in the conformity index of the target volume (P>0.05). There were significant differences in key indicators (D_mean, V₅, D_max) of the lungs, liver, lens, and eyeballs between the two groups (P<0.05). Regarding OARs, the NTCP values of the lens, optic chiasm, lungs, and liver in the HT and VMAT groups were as follows: 0.04 ± 0.03 vs. 0.1 ± 0.06 in the left lens, 0.04 ± 0.06 vs. 0.1 ± 0.07 in the right lens, 0.16 (0.14-0.17) vs. 0.21 (0.18-0.24) in the optic chiasm, 3.89 × 10⁻⁴ (2.45 × 10⁻⁴-7.3 × 10⁻⁴) vs. 8.95 × 10⁻⁴ (5.19 × 10⁻⁴-1.75 × 10⁻³) in the lungs, and 3.45 × 10⁻⁸ (6.0 × 10⁻⁹-1.036 × 10⁻⁷) vs. 9.54 × 10⁻⁸ (1.70 × 10⁻⁸-2.056 × 10⁻⁷) in the liver; the HT group was superior to the VMAT group, and all differences were statistically significant (P<0.05). The NTCP values of the heart in the two groups were 1.35 × 10⁻⁸ (6.34 × 10⁻⁹-2.06 × 10⁻⁹) vs. 5.06 × 10⁻⁹ (2.29 × 10⁻⁹-7.9 × 10⁻⁹), significantly lower in the VMAT group than in the HT group (P<0.05). Conclusion HT has high homogeneity and consistency. The two plans have their own advantages in OAR protection. For OARs with no significant differences in physical dosimetry, NTCP results can be used as a reference. Therefore, comparing the dosimetric parameters and OAR NTCP of HT and VMAT plans can help select the optimal clinical treatment strategy.

Patient cancer care education aims to inform and empower patients by providing clear, relevant information about cancer, including its mechanisms, treatment options, and management strategies. This study evaluated the effectiveness and accuracy of existing patient cancer care education materials in Malaysia, specifically assessing patients’ understanding of treatment, side effects, and their management. Method: A descriptive, correlational study was conducted involving 20 cancer patients at Gleneagles Penang Medical Center, using the Patient Cancer Education Needs Assessment questionnaire. Data analysis was performed using SPSS version 21.0 and Microsoft Excel 2013. Result: Patient age, education level, occupation, and socioeconomic status were not significant factors influencing understanding. Findings highlight the need to improve existing educational materials to enhance patient comprehension and ensure materials are comprehensive, culturally appropriate, and innovative. Conclusion: Patient cancer care education materials should be comprehensive, interactive, and patient is friendly. Current materials require revision and enhancement to keep pace with technological developments, ensuring they are accessible, understandable, and effective in supporting patients’ knowledge of cancer treatment, side effects, management strategies, and psychosocial aspects.

Purpose: Adjuvant radiotherapy (RT), while effective in reducing cancer recurrence and improving survival rates, often comes with radiation toxicity that can adversely affect the patient’s quality of life (QoL). Evaluating toxicity after RT is crucial because it helps to identify and manage adverse effects that can significantly impact a patient’s QoL. By monitoring toxicity, we can adjust treatment plans to mitigate these effects, improve patient comfort, and ensure a better overall outcome. Therefore this study aimed to evaluate and compare QoL following 3D-conformal hypofractionated RT in breast cancer patients. Methods: We included twenty-one Malaysian women with unilateral breast cancer treated with lumpectomy (n=15) or mastectomy (n=6) followed by 3D-conformal hypofractionated RT. QoL was evaluated using the EORTC QLQ-BR45 questionnaire before, during, and after RT. Results: During RT, there was a significant increase in the mean score of the breast symptoms scale compared to baseline (p=0.002), with the most common symptoms being skin problems, followed by swelling and oversensitivity. However, these symptoms were generally mild for most patients. The other quality of life scales remained stable during RT. Post-RT, most QoL scales showed improvements compared to both baseline and during RT, with significant enhancements in the mean breast symptoms score and breast satisfaction score (all p<0.05). Conclusion: Radiotherapy negatively impacted the QoL of our breast cancer patients, specifically on the breast symptoms scale. However, these symptoms improved after 4 months, resulting in high breast satisfaction and indicating a near-excellent cosmetic outcome. Future studies with larger cohorts are essential to validate these findings, as the small sample size (n=21 at baseline; n=13 post-RT) may have limited the detection of more subtle changes

[摘 要] 目的：明确线粒体DNA（mtDNA）部分缺失对结肠上皮细胞NCM460的影响。方法：通过溴化乙锭（EB）诱导建立mtDNA部分缺失细胞模型（mtDNA-reduced）及恢复模型（reverted），采用CCK-8、活性氧（ROS）及线粒体膜电位检测评估线粒体功能，通过葡萄糖、乳酸及糖酵解关键酶活性检测评估代谢表型，通过Transwell实验及WB法检测细胞侵袭及上皮-间质转化（EMT），通过polyHEMA包被培养检测失巢凋亡抵抗能力；检测PI3K/Akt/mTOR信号通路及程序性死亡配体1（PD-L1）表达，并通过PI3K抑制剂LY294002验证。结果：GEPIA数据库分析显示mtDNA编码基因在结直肠癌中低表达（P < 0.05）；组织芯片显示COX1蛋白在正常结肠组织高表达，在癌组织中低表达（P < 0.05）。mtDNA-reduced NCM460细胞线粒体功能受损（生长速率下降、ROS生成减少、线粒体膜电位降低，P < 0.05），呈现Warburg效应（葡萄糖摄取增加、乳酸分泌增多、糖酵解关键酶活性增强，P < 0.05），侵袭能力增强（P < 0.05）且发生EMT，并抵抗失巢凋亡（P < 0.05）。该细胞PI3K/Akt/mTOR通路激活且PD-L1表达上调；经LY294002处理后，葡萄糖含量有降低趋势（P > 0.05）、细胞活性下降（P < 0.05），PD-L1表达下调（P < 0.05）。结论：结肠上皮细胞NCM460中mtDNA部分缺失可诱导其恶性转化及免疫逃逸。

Nasopharyngeal carcinoma (NPC) is endemic to southern China. Currently, its treatment and prognosis reply primarily on the TNM staging system and EBV-DNA testing; however, these parameters have limitations in fully capturing the tumor’s biological heterogeneity and the host's immunonutritional status. In recent years, systemic inflammatory and nutritional indices, such as the neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), pan-immune-inflammation value (PIV), prognostic nutritional index (PNI), and skeletal muscle index (SMI), have proven effective for assessing systemic inflammation and nutritional status. Accumulating evidence has demonstrated that these indicators are closely associated with treatment response, progression-free survival (PFS), and overall survival (OS) in NPC patients, and also show promise in predicting the efficacy of immune checkpoint inhibitors. This review aims to systematically elaborate on the prognostic value of these inflammatory and nutritional indicators in the context of NPC immunotherapy, to inform the development of individualized precision treatment strategies.

A 51-year-old male presented with nasal obstruction, followed by progressive hearing loss and blurred vision. Imaging identified space-occupying lesions in the paranasal sinuses, orbits, and paraspinal regions, while laboratory tests confirmed positive anti-proteinase 3 anti-neutrophil cytoplasmic antibody(PR3- ANCA) immunoglobulin G (IgG)and markedly elevated serum IgG4. Despite treatment with corticosteroids, immunosuppressants, and radiotherapy, the patient exhibited steroid dependency with relentless disease progression. Following multidisciplinary consultation, a diagnosis of inflammatory myofibroblastic tumor (IMT) coexisting with ANCA- associated vasculitis (AAV) was favored, though IgG4-related disease remained a critical differential. Ultimately, profound immunosuppression precipitated a severe herpesvirus infection, leading to disseminated intravascular coagulation and multiple organ dysfunction syndrome. This case underscores the rarity and diagnostic complexity of concurrent IMT and AAV, highlights the therapeutic dilemma of balancing primary disease control against fatal opportunistic infections, and emphasizes the critical role of multidisciplinary collaboration in the diagnosis and treatment of complex diseases.

Gorham-Stout disease(GSD) is a rare osteolytic disorder characterized by spontaneous and progressive osteolysis, along with abnormal angiogenesis and lymphangiogenesis, with no new bone formation. We present a case of a 15-year-old female admitted due to " recurrent right leg pain for 5 years, 11 months after undergoing right femoral fracture surgery". Through comprehensive integration of the patient's clinical phenotype, laboratory tests, imaging findings, pathological examinations, and molecular biological test results, GSD was considered highly likely. A multidisciplinary treatment approach was conducted, including a combination of zoledronic acid and sirolimus to inhibit osteolysis, along with rehabilitation training and orthopedic intervention, providing a personalized and comprehensive treatment strategy.

Purpose: The present study investigates the psychological factors impacting female cancer patients receiving radiotherapy and the individuals providing care for them, within a sociocultural environment that frequently marginalizes and depends on women. This research highlights a strategy for cancer care that may enhance results for both patients and caregivers by attending to psychosocial needs. The primary objectives are to measure the levels of anxiety, depression, quality of life, and perceived stress in both patients and caregivers, as well as to determine how psychosocial counseling affects these factors. Methods: It was a single-group pre-post observational study. Before starting radiotherapy, assessment of various psychosocial factors was done in female cancer patients and their respective caregivers. Psychosocial counseling sessions were conducted at weekly intervals during radiotherapy. At the 6th week after radiotherapy, assessment of same psychosocial factors was done again in both the patients as well as their caregivers. Results: The results show that both patients and caregivers had serious psychological disorders, such as anxiety, depression, perceived stress, and decreased quality of life. Psychosocial modulation was associated with improvement in quality of life measures like overall health and emotional and physical functioning. Conclusion The findings highlight how crucial it is to include psychological support in radiotherapy regimens. Despite limitations of the study, such as its exclusive focus on female patients, the results highlight the need to provide clinical staff with psycho-oncological training. The study recommends further investigation to ascertain the long-term effects of psychological health on treatment compliance and patient survival.