Objective To study the setup error under deep inspiration breath hold (DIBH) guided by optical surface monitoring system (OSMS) and free breathing (FB) FB1 and FB2 (without OSMS guidance, directly set up the body marker line by laser lamp) in radiotherapy after radical mastectomy for left breast cancer, and to provide a basis for individualized clinical target volume-planning target volume (CTV-PTV) expansion for the doctor in charge to delineate the target volume. Methods A total of 36 patients with left breast cancer after radical mastectomy were selected and divided into three groups, in which cone beam computed tomography (CBCT) images were taken in three states: DIBH, FB1, and FB2, respectively. CBCT and CT images were analyzed for registration; the absolute error data of linear displacement in the ventro-dorsal, cranio-caudal, and left-right directions were recorded, and the expanding margin was calculated. Results The translation errors in the ventro-dorsal, cranio-caudal, and left-right directions were (0.06 ± 0.22) cm, (0.05 ± 0.23) cm, and (0.01 ± 0.24) cm in the DIBH group, (0.07 ± 0.21) cm, (0.02 ± 0.23) cm, and (0.02 ± 0.21) cm in the FB1 group, and (0.07 ± 0.24) cm, (0.07 ± 0.34) cm, and (0.25 ± 0.09) cm in the FB2 group. The statistical results of the DIBH group and FB1 group in the ventro-dorsal, RTN, and ROLL directions were significantly different (P < 0.05). The statistical results of the FB1 group and FB2 group in the ventro-dorsal direction were significantly different. The relation of three groups in the value of margin of planning target volume was DIBH < FB1 < FB2 in the ventro-dorsal and cranio-caudal directions and FB1 < DIBH < FB2 in the left-right direction. Conclusion OSMS-guided DIBH radiotherapy in patients with left breast cancer after radical mastectomy can reduce the setup error and provide an important basis for individualized CTV-PTV expansion for the doctor in charge to delineate the target volume.

Diabetic nephropathy (DN) is one of the most common complications of diabetes mellitus, which is characterized in renal tubulointerstitial fibrosis (TIF). The current study was designed to investigate the protective effect of Jujuboside A (Ju A) on TIF in type 2 diabetes (T2DM) mice, and explore its underlying anti-fibrosis mechanism. A mouse T2DM model was established using high fat diet (HFD) feeding combined with intraperitoneal injection of streptozotocin (STZ). Then, diabetic mice were treated with Ju A (10, 20 and 40 mg·kg^-1·d^-1, i.g.) for 12 weeks. Results showed that administration of Ju A not only down-regulated fasting blood glucose (FBG) levels, but also improved hyperlipidemia and renal function in diabetic mice. Moreover, the reduced ECM accumulation was observed in the renal cortex of Ju A treated diabetic mice, while the TIF progression was also attenuated by Ju A through blocking the epithelial-to-mesenchymal transition (EMT) of renal tubular epithelial cells (RTECs). Further mechanism studies showed that Ju A treatment effectively down-regulated the protein expression and subsequent nuclear translocation of Yin Yang 1 (YY1) in the renal cortex of diabetic mice, and reduced the levels of transforming growth factor-β1 (TGF-β1) in the serum and renal cortex of Ju A treated mice. According to invitro studies, the up-regulated YY1/TGF-β1 signaling pathway was restored by Ju A in high glucose (HG) cultured HK-2 cells. Taken together, these findings demonstrated that Ju A can ameliorate the TIF of DN through down-regulating the YY1/TGF-β1 signaling pathway.
Animals ; Blood Glucose ; Diabetes Mellitus, Experimental/metabolism* ; Diabetes Mellitus, Type 2/drug therapy* ; Diabetic Nephropathies/metabolism* ; Fibrosis ; Mice ; Saponins ; Signal Transduction ; Streptozocin ; Transforming Growth Factor beta1/metabolism*

Objective: To evaluate the efficacy and safety of autologous hematopoietic stem cell transplantation (auto-HSCT) in elderly patients (≥65 years old) with multiple myeloma (MM) . Methods: From June 1, 2006 to July 31, 2020, 22 MM patients (≥65 years old) who were diagnosed in the First Affiliated Hospital, Sun Yat-sen University and received novel drug induction followed by auto-HSCT were analyzed retrospectively. These patients were evaluated for important organ functions before transplantation, and the International Myeloma Working Group frail score was used in 2016 to screen out transplant-eligible patients. Results: The median (interquartile range, IQR) age at the time of transplantation of the 22 patients was 66.75 (IQR 4.50) years. A total of 20 patients received stem cell mobilization. The median number of mononuclear cells collected was 4.53×10(8)/kg, that of CD34(+) cells was 3.37×10(6)/kg, and the median number of apheresis procedures performed was 2. After stem cell transfusion, the median time of neutrophil implantation was 11 days, that of platelet implantation was 13 days, and the treatment-related mortality was 0 at 100 days after transplantation. The median follow-up was 48.7 months. The median time to progression time was not reached, and the median overall survival time was 111.8 months. Conclusion: Auto-HSCT is a safe and effective treatment for selected elderly patients of 65 years or older with MM.
Aged ; Hematopoietic Stem Cell Mobilization/methods* ; Hematopoietic Stem Cell Transplantation/adverse effects* ; Humans ; Multiple Myeloma/drug therapy* ; Retrospective Studies ; Transplantation, Autologous/methods* ; Treatment Outcome

Objective:To retrospect the clinical characters and medical evaluations of the aircrew with intracranial aneurysms (IAs) based on the hospitalized cases in Air Force Medical Center and published literatures.Methods:The cases and clinical reports on the subject of aircrew IAs were searched through the electrical case system in our center and medical literature database. We summarized the the clinical characters and medical evaluations of these aircrews.Results:Six cases with 7 IAs were found in this study, including 5 males and 1 female aged from 21 to 48 yrs. There were 3 pilots, 1 correspondent, 1 machinist and 1 attendant. Three cases were asymptomatic and 3 cases were symptomatic. Six IAs located in the cerebral anterior circulation system and one located in the cerebral posterior circulation system. All the IAs were the small aneurysms with diameter≤7 mm. Two asymptomatic cases were decided waiver by the aeromedical evaluation. Three symptomatic cases were treated by surgery clipping or endovascular coiling. One of them was given the waiver consideration.Conclusions:There are certain population with IAs in aircrew. The screening of asymptomatic IAs should be cared because of their potential risk in flight. Symptomatic IAs and the IAs with high risk to rupture are needed to be treated by surgery or endovascular coiling. The flight risk should be comprehensively assessed in conjunction with the clinical symptoms, aneurysms characteristics (morphology and hemodynamics), flight factors, flight duty therapy outcome and prognosis.

Objective:To retrospect the clinical characters and medical evaluations of the aircrew with intracranial aneurysms (IAs) based on the hospitalized cases in Air Force Medical Center and published literatures.Methods:The cases and clinical reports on the subject of aircrew IAs were searched through the electrical case system in our center and medical literature database. We summarized the the clinical characters and medical evaluations of these aircrews.Results:Six cases with 7 IAs were found in this study, including 5 males and 1 female aged from 21 to 48 yrs. There were 3 pilots, 1 correspondent, 1 machinist and 1 attendant. Three cases were asymptomatic and 3 cases were symptomatic. Six IAs located in the cerebral anterior circulation system and one located in the cerebral posterior circulation system. All the IAs were the small aneurysms with diameter≤7 mm. Two asymptomatic cases were decided waiver by the aeromedical evaluation. Three symptomatic cases were treated by surgery clipping or endovascular coiling. One of them was given the waiver consideration.Conclusions:There are certain population with IAs in aircrew. The screening of asymptomatic IAs should be cared because of their potential risk in flight. Symptomatic IAs and the IAs with high risk to rupture are needed to be treated by surgery or endovascular coiling. The flight risk should be comprehensively assessed in conjunction with the clinical symptoms, aneurysms characteristics (morphology and hemodynamics), flight factors, flight duty therapy outcome and prognosis.

Objective: To study the efficacy, safety and long-term outcomes of integrated strategy of bortezomib-based induction regimens followed by autologous hematopoietic stem cell (ASCT) and maintenance therapy in Chinese multiple myeloma (MM) patients. Methods: 200 MM patients receiving integrated strategy of bortezomib--based induction regimens followed by ASCT and maintenance therapy were retrospectively and prospectively analyzed from December 1. 2006 to April 30. 2018. Results: The complete remission rates (CR) and better than very good partial remission rates (VGPR) after induction therapy, transplantation and maintenance therapy were respectively 31% and 75.5%, 51.8% and 87.7%,73.6% and 93.4%. There was no difference between 4 cycles and more than 5 cycles induction chemotherapy. The negative rate of MRD detection by flow cytometry was 17.6% and 38.2% respectively after induction and 3 months after transplantation. The negative rate of MRD gradually increased during the maintenance therapy. The success rate of high dose CTX combined with G-CSF mobilization was 95.5% and transplantation related mortality (TRM) was zero. The median time to progress (TTP) was 75.3 months and the median overall survival (OS) was 99.5 months. TTP of patients obtaining CR and negative MRD after induction were longer that those of no CR and positive MRD. TTP and OS of patients receiving triple-drug induction and ASCT in early stage were longer than those of double-drug induction and ASCT in late stage. LDH≥240 U/L, high risk cytogenetics, ISS II+III stage and HBsAg positive were prognostic factors at diagnosis. However, only MRD and high risk cytogenetics were independent prognostic factors after transplantation and maintenance therapy. The clinical characteristics of patients of TTP ≥6 years were listed below: light-chain type M protein, ISS I stage, normal level of hemoglobin and platelet, normal LDH, HBsAg negative, chromosome 17p-negative, good response and sustained good response. Conclusions: Integrated strategy of bortezomib-based induction regimens followed by ASCT and maintenance therapy can significantly improve the short-term and long-term efficacy. The prognostic factors of TTP in different disease stages were different. Response to treatment, especially MRD, played a more important role in prognostic factors.
Antineoplastic Combined Chemotherapy Protocols ; Bortezomib/therapeutic use* ; Follow-Up Studies ; Hematopoietic Stem Cell Transplantation ; Humans ; Induction Chemotherapy ; Multiple Myeloma/therapy* ; Retrospective Studies ; Stem Cell Transplantation ; Transplantation, Autologous ; Treatment Outcome

AIM To compare the diuretic effects of Descurainiae Semen (DS),Coicis Semen (CS) and Plantaginis Semen (PS),and to observe their mechanical similarities and differences.METHODS Metabolic cage method was applied to investigating the diuretic effects of DS (2.34 g/kg),CS (7.00 g/kg) and PS (3.50 g/kg),whose diuretic mechanisms were studied by cryoscopic method,enzyme method,ion selective electrode method,ELISA and Western blot.RESULTS DS,CS and PS obviously increased saline-loaded rats' urine volume (P ＜ 0.05) and reduced their body weight (P ＜ 0.05) after administration for 7 h,which exhibited no significant effects on urine creatinine (Ucr),serum creatinine (Scr) and blood urea nitrogen (BUN)(P ＞ 0.05).DS showed its diuretic effect mainly by lowering the levels of serum Na +,atrial natriuretic peptide (ANP),brain natriuretic peptide (BNP),pulmonary AQP3,renal AQP1 and AQP2;CS showed its diuretic effect mainly by reducing the levels of serum Na +,Cl-,ANP,pulmonary AQP3,gastric AQP3,renal AQP1 and AQP2;PS showed its diuretic effect mainly by decreasing the levels of serum Na + and Cl-,pulmonary AQP3,gastric AQP3,renal AQP1 and AQP2.CONCLUSION Three medicinal materials have significant diuretic effects without obvious renal harm.DS categorized as a medicinal plant of lung channel and tropism has a great effect on netriuretic peptide system,CS categorized as a medicinal plant of spleen channel and tropism has a great effect on gastric AQP3,and PS categorized as a medicinal plant of renal channel and tropism has a great effect on renal AQPs.

Objective To evaluate the clinical efficacy and safety of bi-calutamide combine with goserelin in the treatment of advanced prostate cancer.Methods Fifty cases of advanced prostate cancer patients were randomly divided into treatment group (25 cases) and control group (25 cases).Treatment group was given oral bicalutamide 50 mg, qd +sub-cutaneous goserelin 3.6 mg, once 4 weeks, a monthly review of serum prostate-specific antigen ( PSA ) content , when the serum PSA <0.2 ng· mL-1, disabled two drugs, when PSA>4 ng· mL-1, begin a new round of treatment.Control group was given the continuous dosing , the same dosage and usage as the treatment group.The course of treatment for two groups was 12 months.Comparison of the clinical efficacy , serum PSA value and adverse drug reactions.Results After 6, 9, 12 months of treatment , the clinical efficacy of treatment group was significantly higher than that of control group (P<0.05).After 3, 6, 9, 12 months of treatment , the serum PSA value was significantly lower than that of before treatment ( P<0.05 ) , and there was no significant difference in serum PSA between the two groups at each time point ( P>0.05 ).The main adverse drug reactions of the two groups were the castration syndrome , blood vessel contraction , osteoporosis , and liver toxicity, and the incidence rate of adverse drug reactions were not statistically different between the two groups ( P>0.05 ).Conclusion The clinical efficacy of intermittent administration for bicalutamide combined with goserelin in the treatment of advanced prostate cancer was significantly better than the continuous dosing , without increasing the incidence of adverse drug reactions.

The analysis of essential oil in seeds ofDeseurainia sophia provided an experimental basis for further research on essential oil activity test at the first time. Essential oil was extracted by steam distillation method. Analysis and identification were made by gas chromatography-mass spectrometry (GC-MS) technology in combination with retention indices. A total of 33 components in seeds ofD. sophia were detected by GC-MS and 28 compounds were identified by MS in combination with Kovats retention index. The compounds with high contents were as follows: 3-methylene-nonane (68.14%), 1,3-diazine (29.32%), 2-n-butylacrolein (0.58%), methyl nipecotate (0.43%), 4-oxo-butanenitrile (0.31%), 8-chloro-neoisol-ongifolene (0.25%) and so on. It was concluded that 28 volatile components were identified by GC-MS combined with retention indices. The total detected components were 99.91%. This method was able to improve the accuracy of qualitative detection results.