Objective:To evaluate the safety and efficacy of accelerator-based boron neutron capture therapy (AB-BNCT) in the treatment of recurrent and refractory malignant tumors.Methods:The data of 14 patients admitted to Xiamen Humanity Hospital from September 2022 to April 2023 were prospectively collected, including 7 patients with primary brain malignancies and 7 patients with locally recurrent inoperable head and neck malignancies. All patients received intravenous infusion of boron drug (NBB-001, p-dihydroxyborylphe nylalanine, a patented freeze-dried formulation) at a total nominal dosage of 500 mg/kg (11 patients) or 750 mg/kg (3 patients), and were irradiated with neutrons (operating with NeuPex system). Adverse events after treatment were recorded and assessed. The primary efficacy endpoint was the 90 d objective response rate (ORR), while the secondary endpoints included progression-free survival (PFS) and complete response rate (CRR). Data were compiled and analyzed by SAS 9.4 software. The rate and 95% CI were calculated using Clopper-Pearson method. Results:The median dose delivered to 80% of the target volume (D 80%) was 16.80 GyE (range: 8.93-23.79 GyE). The most common adverse reactions were hyperamylasemia, alopecia, and hyperprolactinemia. Five patients experienced 8 cases of grade 3 or above adverse events, including 1 case of grade 4 acute kidney injury and 7 cases of grade 3 adverse events. All adverse events were recovered after observation or treatment. At 90 d after treatment, the ORR of all patients was 9/14 (64%, 95% CI: 35%-87%), disease control rate (DCR) was 10/14 (71%, 95% CI: 42%-92%), CRR was 2/14 (14%, 95% CI: 2%-42%); and the best overall response during the entire course included an ORR of 10/14 (71% ,95% CI: 42%-92%), DCR of 13/14 (93%, 95% CI: 66%-100%), and CRR of 3/14 (21% ,95% CI: 5%-51%). The 1-year survival rate for head and neck malignancies was 71.4%, and the 2-year survival rate was 42.8%. The 1-year survival rate for recurrent brain malignancies was 42.8%. Conclusion:AB-BNCT demonstrates favorable safety and promising efficacy in treating primary brain malignancies and recurrent/refractory head and neck malignancies, representing a potential therapeutic option.

Objective:To evaluate the safety and efficacy of accelerator-based boron neutron capture therapy (AB-BNCT) in the treatment of recurrent and refractory malignant tumors.Methods:The data of 14 patients admitted to Xiamen Humanity Hospital from September 2022 to April 2023 were prospectively collected, including 7 patients with primary brain malignancies and 7 patients with locally recurrent inoperable head and neck malignancies. All patients received intravenous infusion of boron drug (NBB-001, p-dihydroxyborylphe nylalanine, a patented freeze-dried formulation) at a total nominal dosage of 500 mg/kg (11 patients) or 750 mg/kg (3 patients), and were irradiated with neutrons (operating with NeuPex system). Adverse events after treatment were recorded and assessed. The primary efficacy endpoint was the 90 d objective response rate (ORR), while the secondary endpoints included progression-free survival (PFS) and complete response rate (CRR). Data were compiled and analyzed by SAS 9.4 software. The rate and 95% CI were calculated using Clopper-Pearson method. Results:The median dose delivered to 80% of the target volume (D 80%) was 16.80 GyE (range: 8.93-23.79 GyE). The most common adverse reactions were hyperamylasemia, alopecia, and hyperprolactinemia. Five patients experienced 8 cases of grade 3 or above adverse events, including 1 case of grade 4 acute kidney injury and 7 cases of grade 3 adverse events. All adverse events were recovered after observation or treatment. At 90 d after treatment, the ORR of all patients was 9/14 (64%, 95% CI: 35%-87%), disease control rate (DCR) was 10/14 (71%, 95% CI: 42%-92%), CRR was 2/14 (14%, 95% CI: 2%-42%); and the best overall response during the entire course included an ORR of 10/14 (71% ,95% CI: 42%-92%), DCR of 13/14 (93%, 95% CI: 66%-100%), and CRR of 3/14 (21% ,95% CI: 5%-51%). The 1-year survival rate for head and neck malignancies was 71.4%, and the 2-year survival rate was 42.8%. The 1-year survival rate for recurrent brain malignancies was 42.8%. Conclusion:AB-BNCT demonstrates favorable safety and promising efficacy in treating primary brain malignancies and recurrent/refractory head and neck malignancies, representing a potential therapeutic option.

Objective:To investigate the relationship between intracerebral high-density foci and progressive stroke (PS) morbidity by using dual-energy CT, which can quantify the intracerebral high-density foci of patients with acute ischemic stroke after endovascular treatment.Methods:Ninety-two patients with acute ischemic stroke who received interventional treatment in Gaozhou People′s Hospital from May 2019 to August 2020, and underwent dual-energy CT scan immediately after intervention, were analyzed. The patients were divided into PS group ( n=35) and non-PS group ( n=57) according to the National Institutes of Health Stroke Scale (NIHSS) score, and the patients whose NIHSS score increased≥4 points within 72 hours of stroke were included in the PS group, while the patients whose NIHSS score increased<4 points were included in the non-PS group. The clinical data, volume of high-density foci and CT values were compared between the 2 groups. Logistic regression analysis was used to adjust for confounding factors and screen for risk factors. The correlations of the admission NIHSS score, presence and volume of high-density lesions, maximum CT (CTmax) value and average CT (CTave) value with the onset of PS were analyzed, and the receiver operating characteristic curve was used to screen predictive indicators of PS. Results:In the PS group, the NIHSS score (18.80±8.50 vs 14.40±9.58, t=2.229, P=0.028), proportion of high-density foci [29/35(82.9%) vs 32/57 (56.1%), χ 2=6.928, P=0.008], high-density focal volume [13.23 (39.33) cm 3vs 0.76 (9.82) cm 3, U=1 440.000, P<0.001], CTmax value [80.00 (92.00) HU vs 65.00 (87.50) HU, U=1 337.000, P=0.005] and CTave value [53.48 (23.79) HU vs 45.94 (55.11) HU, U=1 345.000, P=0.004] were higher than those in the non-PS group. The NIHSS score ( OR=1.054, 95% CI 1.004-1.106, P=0.033; rs=0.255, 95% CI 0.051-0.447, P=0.014), presence of high-density foci ( OR=3.776, 95% CI 1.358-10.503, P=0.011; rs=0.274, 95% CI 0.093-0.460, P=0.008), high-density focal volume ( OR=1.026, 95% CI 1.003-1.049, P=0.027; rs=0.381, 95% CI 0.183-0.560, P<0.001), CTmax value ( OR=1.006, 95% CI 1.001-1.011, P=0.014; rs=0.292, 95% CI 0.088-0.475, P=0.005) and CTave value ( OR=1.021, 95% CI 1.007-1.035, P=0.004; rs=0.299, 95% CI 0.092-0.484, P=0.004) were all risk factors affecting PS morbidity and were positively correlated with PS morbidity. The area under the receiver operating characteristic curve of NIHSS score, high-density lesion volume, CTmax value, and CTave value to predict the onset of PS was 0.652, 0.722, 0.670 and 0.674, respectively. The volume of high-density lesions had moderate predictive value for the onset of PS. Conclusions:For AIS patients, CT examination should be performed immediately after interventional operation. The volume, CTmax value and CTave value of high-density lesions newly appeared in the ischemic area are positively correlated with the onset of PS. Quantifying the volume of high-density lesions can help to predict the onset of PS.

Objective To evaluate the effect of limited open reduction in the treatment of femoral shaft fractures with intramedullary nail.Methods The clinical data of 39 patients with femoral shaft fractures in the Department of Orthopedic Surgery,Southern Medical University Xiaolan Affiliated Hospital from January 2016 to December 2017 were retrospectively analyzed.All patients were treated with intramedullary nailing.Among them,25 cases were treated with limited open reduction (observation group) and 14 cases were treated with closed reduction (control group).The operation time,fluoroscopy frequency,blood loss volume,infection rate and curative effect were compared between 2 groups.Results The 39 patients were followed up for 7 to 25 (10.3 ± 2.8) months.The operation time and fluoroscopy frequency in observation group were significantly lower than those in control group:(111.4 ± 20.3) min vs.(129.3 ± 21.4) min and (7.0 ± 2.6) times vs.(22.6 ± 7.8) times,but the blood loss volume was significantly higher than that in control group:(454.0 ± 131.4) ml vs.(342.9 ± 120.7) ml,and there were statistical differences (P＜0.05 or ＜0.01);there was no statistical difference in the infection rate and excellent/ good rate between 2 groups (P＞0.05).Conclusions Limited open reduction simplifies the operation steps,shortens the operation time,and has fewer fluoroscopy times and less X-ray time.It can achieve the same effect as closed reduction,and can be used as an effective supplementary means when closed reduction equipment and technology are deficient.

Objective    To describe the effect of sequential pulmonary balloon angioplasty for patients with chronic thromboembolic pulmonary hypertension, who was accompanied with progressed pulmonary hypertension after pulmonary endarterectomy surgeries. Methods    From 2014 to December 2017, 7 patients were treated with a combination therapy of pulmonary endarterectomy and sequential pulmonary balloon angioplasty. There were 1 male and 6 females at age of 58 (43–59) years. A follow-up period of more than 1 year was accomplished. The result of right sided heart catheterization and ultrasonic cardiogram between and after the pulmonary endarterectomy or balloon angioplasty was collected. Results    Seven patients were treated with a combination of pulmonary endarterectomy and sequential pulmonary balloon angioplasty, which included 1 patient of single pulmonary balloon angioplasty and 6 patients of multiple pulmonary balloon angioplasties. The balloon dilation times was 2 (2–6), and the number of segments during each single balloon dilatation was 3–5, compared with the first clinical results before  the first balloon dilation, systolic pulmonary artery pressure [53 (47–75) mm Hg vs. 45 (40–54) mm Hg, P=0.042), mean pulmonaryartery pressure [38 (29–47) mm Hg vs. 29 (25–39) mm Hg, P=0.043], N terminal-B type natriuretic peptide [1 872 (1 598–2 898) pg/ml vs. 164 (72–334) pg/ml, P=0.018] improved significantly after the last balloon angioplasty. Heart function classification (NYHA) of all the 7 patients were recovered to Ⅰ-Ⅱclasses (P<0.05). Conclusion    Sequential pulmonary balloon angioplasty after pulmonary endarterectomy can further reduce the patient's right heart after load, improve the heart function for patients with progressed pulmonary hypertension after pulmonary endarterectomy surgeries.

Objective To investigate the expression of apolipoprotein (Apo) F in hepatocellular carcinoma (HCC) and its application value in the prognosis of patients with HCC. Methods 50 HCC samples were procured from patients undergoing surgical resection in the Third Affiliated Hospital of Sun Yat-sen University between September 2015 and September 2016, and all the samples were confirmed by postoperative pathological examination. The informed consents of all patients were obtained and the local ethical committee approval was received. There were 37 males and 13 females, aged from 31-67 with a median age of 53 years old. The expression of ApoF mRNA in HCC tissues was detected by RT-PCR. The expression profile was analyzed by using data from the Gene Expression Omnibus (GEO). The expression of ApoF between two groups were compared by t test. Correlation analysis of clinical related parameter was conducted by Chi-square test, and survival prognosis was analyzed by Kaplan-Meier test and Log rank test. Results The average relative expression of ApoF mRNA in HCC tissues was 0.15±0.07, significantly lower than 0.55±0.09 in the adjacent tissues (t=-6.26, P<0.05). GEO online analysis showed that expression of ApoF was significantly correlated with the status of liver cirrhosis, and most HCC patients with liver cirrhosis presented low expression of ApoF (χ2=4.626, P<0.05). The 5-year disease-free survival was respectively 55.9% and 32.0% in ApoF high expression group and low expression group, where significant difference was observed (χ2=3.939, P<0.05). Conclusions Low expression of ApoF exists in HCC tissues, and it is related to the liver cirrhosis status of patients. Patients with low ApoF expression present poorer prognosis. ApoF plays a role in inhibiting the cancer.

Objective To explore the impact of telomerase regulation factor PinX1 to the proliferation and invasion ability of hepatoma cells. Methods Hepatoma cells PinX1-7721 (experimental group) with stable expression of PinX1 as well as control cell VECTOR-7721 (control group) were constructed. The expression of PinX1 mRNA was detected by RT-PCR. The proliferation ability and clonality of hepatoma cells were detected by CCK-8 method and plate clonality assay, and the invasion ability of hepatoma cells by Transwell assay. Comparison of the experiment data was conducted by t test. Results Expression level of PinX1 mRNA in experiment group was (13.9±2.0)×10-3, which was significantly higher than (1.1±0.2)×10-3in control group (t=10.98, P<0.05). A450of the cells on 1-7 d in experiment group was respectively 0.260±0.004, 0.340±0.008, 0.450±0.040, 0.500±0.020, 0.730±0.030, 1.350±0.040 and 1.640±0.050, which were significantly lower than 0.280±0.009, 0.410±0.007, 0.680±0.044, 0.730±0.029, 0.850±0.070, 1.700±0.020 and 2.080±0.280 in control group (t=-5.82, -12.99, -6.36, -5.96, -28.42,-18.98, -5.08; P<0.05). The plate clonality assay results showed that the clone formation quantity of cells in experiment group was 143±32, which was significantly lower than 305±25 in control group (t=-6.91, P<0.05).Transwell assay results showed that the quantity of trans-membrane cell in experiment group was 230±16, which was significantly lower than 650±30 in control group (t=-21.40, P<0.05). Conclusion PinX1 could inhibit the proliferation and invasion ability of hepatoma cells.

Objective To investigate expression of plasmalemmal vesicle-associated protein (PLVAP) in hepatocellular carcinoma (HCC) tissues and its relationship with clinicopathological features.Methods Tissue specimens were collected from 108 patients with HCC in the Third Affiliated Hospital of Sun Yat-sen University from January 2013 to December 2015.92 patients were male and 16 female,aged (48±5) years on average.The informed consents of all patients were obtained and the local ethical committee approval was received.The expression level of PLVAP was analyzed based on the data of HCC in public databases.The expression level of PLVAP mRNA in HCC and paracarcinoma tissues was detected by RT-PCR,and the relationship between the expression of PLVAP and clinicopathological characteristics of HCC was analyzed.The relationship between PLVAP and prognosis of HCC patients was investigated with the data from cancer genome atlas (TCGA) database.The expression levels of PLVAP mRNA between HCC tissues and para-carcinoma tissues were compared by Kruskal-Wallis rank-sum test.Correlation analysis was performed by Chi-square test.Survival analysis was conducted by Kaplan-Meier survival curve and Log-rank test.Results According to Human Protein Atlas and Oncomine databases,the expression level of PLVAP in HCC tissues was significantly higher than that in normal liver tissues.RT-PCR showed that the median expression level of PLVAP mRNA in HCC tissues was 0.172(0.004-0.607),significantly higher compared with 0.091(0.002-0.513) in para-carcinoma tissues (Z=6.839,P＜0.05).The expression level of PLVAP in HCC patients was significantly correlated with TB,tumor size and microvascular invasion (x2=4.183,3.924,6.075;P＜0.05).In PLVAP high expression group,the overall survival and tumor-free survival were 58.8(0.5-107.0) and 42.2(0.1-67.2) months,where no significant difference from 55.7(0.2-120.7) and 20.9(0.1-109.4) months in PLVAP low expression group (x2=0.054,0.065;P＞0.05).Conclusions The expression level of PLVAP is significantly correlated with the development and progression of HCC,whereas it is probably not associated with the prognosis of HCC patients.

Objective To investigate the effect and mechanism of long noncoding RNA (lncRNA) PTEN pseudogene 1 (PTENP1) on the proliferation and migration of hepatocellular carcinoma (HCC) cells. Methods Lentiviral vectors expressing PTENP1 were constructed. HCC cells BEL-7404 were infected with LV003-GFP-PTENP1 and control vectors LV003-GFP. BEL-7404 cells stably expressing PTENP1 were constructed and the experimental and control groups were established. The proliferation and clone formation abilities of HCC cells in two groups were detected by CCK-8 assay and clonogenic assay. The migration ability of HCC cells was detected by wound healing assay. The expression of p44/42 mitogen-activated protein kinase (MAPK) and p38 MAPK proteins were detected by Western blot. Results The absorbance values A450 of the cells at 48 and 72 h in the experimental group were 1.4±0.3 and 2.3±1.1, signiifcantly lower compared with 3.2±1.7 and 3.4±1.1 in the control group (t=-5.78,-4.23;P<0.05). The number of cell clone formation in the experimental group was 55±12, signiifcantly less than 154±45 in the control group (t=-3.98, P<0.05). The percentage of cell migration in the experimental group was (21.7±2.6)%, signiifcantly lower than (57.7±4.9)%in the control group (t=-8.34, P<0.05). Western blot revealed that the expression of p44/42 MAPK and p38 MAPK proteins in the experimental group was significantly down-regulated compared with those in the control group. Conclusion lncRNA PTENP1 can inhibit the proliferation and migration of HCC cells probably through regulating MAPK signaling pathway.

ObjectiveTo investigate the clinical characteristics of primary liver cancer (PLC) complicated with non-Hodgkin’s lymphoma.MethodsClinical data of 2 patients with PLC complicated with non-Hodgkin's lymphoma admitted and treated in the Third Afifliated Hospital of Sun Yat-sen University between January 2006 and July 2015 as well as 18 patients reported by the literature were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. The incidence, diagnosis and treatment process, therapeutic regimen, curative effect and prognosis were observed. Relevant literature in PubMed database from January 1994 to December 2015 was searched for literature review.ResultsAmong the patients, 17 were males and 3 were females with the onset age ranging from 35 to 80 years old and the median of 64 years old. Nineteen cases were with hepatocellular carcinoma and 1 with mixed type liver cancer. Hepatitis virus infection was found in 90%(18/20) of the patients with 8 cases of hepatitis B virus (HBV) infection and 10 of hepatitis C virus (HCV) infection. All patients were complicated with B-cell non-Hodgkin's lymphoma. The main type was diffuse large B-cell lymphoma, accounting for 60%(12/20). And the other types were follicular lymphoma (n=5), mucosa-associated lymphoid tissue (MALT) lymphoma (n=1), marginal zone lymphoma (n=1) and unspeciifed lymphoma (n=1). The main lesions of non-Hodgkin's lymphoma respectively located in the liver (n=9), spleen (n=3), lymph node (n=3), stomach (n=3), vertebral body (n=1), other non-tissue and visceral organ (n=1). The therapeutic regimens were operation + chemotherapy (n=9), radiofrequency ablation or transcatheter arterial chemoembolization (TACE) + chemotherapy (n=6), liver transplantation (n=1) and palliative treatment (n=4). The median postoperative survival time of the patients was 48(5-105) months, while the survival time of the patients receiving palliative treatment was less than 1 month.ConclusionsMost PLC patients complicated with non-Hodgkin's lymphoma are male, and the pathological type of all the non-Hodgkin's lymphoma is B-cell type. The morbidity is closely associated with HBV infection. There are no speciifc clinical manifestations, and the conifrmed diagnosis depends on the pathological examination. Radical resection is the ifrst choice for treatment.