Objective:To explore the influencing factors of bowel preparation quality in hospitalized elderly patients, and to find the appropriate waiting time from the end of bowel preparation to the beginning of colonoscopy.Methods:Baseline and clinical data of elderly patients over 60 years old who underwent colonoscopy in the Tenth People′s Hospital, Tongji University from February 2021 to August 2021 were collected. Multivariate analysis was used to screen the factors that might affect the quality of bowel preparation in hospitalized elderly patients. Patients were grouped according to waiting time before colonoscopy. After eliminating confounding factors using propensity matching analysis, the difference of bowel preparation quality among groups was compared.Results:251 patients were included in the study. Multivariate analysis revealed that, hypertension ( OR=3.530, 95% CI 1.295-9.618), chronic constipation ( OR=3.302,95% CI 1.132-9.632), dietary compliance ( OR=0.161, 95% CI 0.070-0.371), medication and drinking water compliance ( OR=0.167, 95% CI 0.070-0.397), exercise compliance after medication ( OR=2.245, 95% CI 1.040-4.845), The frequency of defecation after medication ( OR=0.446, 95% CI 0.308-0.647) and waiting time ( OR=0.537, 95% CI 0.387-0.745) were important factors affecting the quality of bowel preparation in hospitalized elderly patients ( P<0.05). There were differences in bowel preparation quality between groups of waiting times. The overall quality of bowel preparation in 120-180 min group was significantly better than that in 241-300 min group, 301-360 min group and>360 min group ( P<0.05). The overall quality of bowel preparation in 181-240 min group was better than that in >360 min group ( P<0.05). There were no significant differences among other groups( P>0.05). The scores of cecum and ascending colon were the best in 120-180 min group, and the cleanliness of descending colon, sigmoid colon and rectum was significantly higher in 241-300 min group, 301-360 min group and > 360 min group. The scores of descending colon, sigmoid colon and rectum showed that the intestinal preparation quality of 181-240 min group was better than that of 301-360 min group and > 360 min group. Conclusions:The best examination time for elderly patients is about 180 minutes after bowelpreparation. Medical workers should flexibly guide the medication time to ensure that patients are in the best clean state of intestinal tract during examination.

Radiomics and radiogenomics are used to provide comprehensive tumor biological characte-ristics and further clinical information by extracting,screening and analyzing the most valuable quantitative ra-diomics features. In recent years,numerous studies have shown that radiomics plays a role in the diagnosis, treatment and predicting efficacy and prognosis of lung cancer. Radiogenomics shows a great value in the pre-diction of lung cancer gene phenotype and individualized precision treatment by combining radiomics features with genomics,proteomics and so on. Radiomics and radiogenomics are non-invasive,quantitative,and repro-ducible,and they can provide multidirectional tumor biological characteristics,which are expected to be widely used in the precise medical treatment of lung cancer in the future.

The judgment of early curative effect is important to the treatment of nasopharyngeal carcinoma and the prognosis of the patients.As a rapid imaging technique,magnetic resonance diffusion weighted imaging (DWI) is used to quantitatively analyze the changes of water molecules in the tissue by means of apparent diffusion coefficient (ADC),so as to diagnose the small lesions of nasopharyngeal carcinoma accurately,evaluate the early curative effect and observe the prognosis.With the continuous improvement and progress of MRI and data analysis technology,DWI in the diagnosis and treatment of nasopharyngeal carcinoma shows a broader application prospect.

OBJECTIVES: The aim of this study was to investigate the feasibility and safety of percutaneous ¹²⁵I seed permanent implantation for advanced hypopharyngeal carcinoma from toxicity, tumor response, and short-term outcome. METHODS: ¹²⁵I seeds implant procedures were performed under computed tomography for 34 patients with advanced hypopharyngeal carcinoma. We observed the local control rate, overall survival, and acute or late toxicity rate. RESULTS: In the 34 patients (stage III, n=6; stage IV, n=28), the sites of origin were pyriform sinus (n=29) and postcricoid area (n=5). All patients also received one to four cycles of chemotherapy after seed implantation. The post-plan showed that the actuarial D90 of ¹²⁵I seeds ranged from 90 to 158 Gy (median, 127 Gy). The mean follow-up was 12.3 months (range, 3.4 to 43.2 months). The local control was 2.1–31.0 months with a median of 17.7 months (95% confidence interval [CI], 13.4 to 22.0 months). The 1-, 2-, and 3-year local controls were 65.3%, 28.6%, and 9.5% respectively. Twelve patients (35%) died of local recurrence, fourteen patients (41%) died of distant metastases, and three patients (9%) died of recurrence and metastases at the same time. Five patients (15%) still survived to follow-up. At the time of analysis, the median survival time was 12.5 months (95% CI, 9.5 to 15.4 months). The 1-, 2-, and 3-year overall survival rates were 55.2%, 20.3%, and 10.9%, respectively. Five patients (15%) experienced grade 3 toxic events and nine patients (26%) have experienced grade 2 toxic events. CONCLUSION: This review shows relatively low toxicity for interstitial ¹²⁵I seed implantation in the patients with advanced stage hypopharyngeal cancer. The high local control results suggest that ¹²⁵I seed brachytherapy implant as a salvage or palliative treatment for advanced hypopharyngeal carcinoma merit further investigation.
Brachytherapy ; Drug Therapy ; Follow-Up Studies ; Humans ; Hypopharyngeal Neoplasms ; Neoplasm Metastasis ; Palliative Care* ; Pyriform Sinus ; Recurrence ; Survival Rate

ABSTRACT:Objective To explore the effects of virus interleukin‐10 (vIL‐10 ) on different expressions of MHC‐I antigen processing “the operon” .Methods We collected nasopharyngeal carcinoma cells (CNE‐1 and CNE‐2) treated by vIL‐10 at different time points ,and detected the changes of MHC‐I antigen processing “the operons” (TAP‐1 ,TAP‐2 ,LMP‐2 ,LMP‐7 and HLA‐I) by RT‐PCR and Western blot .Results ① mRNA level :There was no difference in the expression of TAP‐1 in CNE‐1 and CNE‐2 cells at various time points .The expressions of TAP‐2 and LMP‐2 in CNE‐1 and CNE‐2 did not change at 1 ,4 ,6 ,12 h ,but downregulated and even disappeared at 24 h .The expression of LMP‐7 in CNE‐1 decreased 4 h after vIL‐10 was added ,and that in CNE‐2 decreased at 6 h .The expression of HLA‐I in CNE‐1 and CNE‐2 showed significant decrease at 24 h .② Protein expression :The expression of TAP‐1 in CNE‐1 and CNE‐2 showed significant decrease at 24 h .The expression of TAP‐2 in CNE‐1 and CNE‐2 was gradually downregulated at different time points .The expressions of LMP‐2 and LMP‐7 in CNE‐2 were gradually downregulated at different periods ,while that in CNE‐1 was only decreased at 12 h .The expression of HLA‐I in CNE‐1 and CNE‐2 was gradually downregulated ,but there was no significant difference at each period in CNE‐1 ,while the expression of HLA‐I in CNE‐2 at 24 h was significantly downregulated .Conclusion vIL‐10 can inhibit the expression of MHC‐I antigen processing “the operon” in NPC in the time‐dependent manner .

Breast Neoplasms ; diagnosis ; Diffusion Magnetic Resonance Imaging ; Female ; Humans

OBJECTIVETo study the correlation between the MRI apparent diffusion coefficient (ADC) value and histological grade and molecular biology of breast invasive ductal carcinoma (IDC).

METHODSThis retrospective study included 125 patients with IDC verified by pathology from February 2010 to February 2013. Conventional MRI and diffusion-weighted imaging (DWI) examination were performed using a 3.0T scanner with diffusion factor of 0 and 800 s/mm(2). The region of interest (ROI) was drawn on the largest lesion and/or its two adjacent slices. The ADC value of the whole tumor was calculated as the mean ADC value. The correlation between mean ADCs and histological grade and biological factors was analyzed.

RESULTSThe mean ADC of pathological grade I, II and III IDC was (1.152 ± 0.072)×10(-3) mm(2)/s, (1.102 ± 0.101)×10(-3) mm(2)/s, and (1.035 ± 0.107)×10(-3) mm(2)/s, respectively. There was a statistically significant difference among them (P = 0.003). Statistically a significant difference was observed between grade III and I (P = 0.034), grade III and II (P = 0.006), but not between grade I and II (P = 0.741). A significant correlation was observed between ADC value and pathological grade (r = -0.342, P < 0.001). The median ADC values were significantly higher in the ER-negative than in the ER-positive cases [(1.130 ± 0.115)×10(-3) mm(2)/s vs. (1.060 ± 0.089) ×10(-3) mm(2)/s, P < 0.001)], in PR-negative than in PR-positive cases [(1.121 ± 0.106)×10(-3) mm(2)/s vs. (1.055 ± 0.096) ×10(-3) mm(2)/s, P < 0.001)], and in Ki-67-negative than in Ki-67-positive cases [(1.153 ± 0.090)×10(-3) mm(2)/s vs. (1.063 ± 0.101) ×10(-3) mm(2)/s, P < 0.001]. A statistically significant correlation was observed between ADC value and expressions of ER, PR, and Ki-67 (r = -0.311, r = -0.317, r = -0.414, P < 0.001).

CONCLUSIONADC value of breast invasive ductal carcinoma is correlated with histological grade, and expression of ER, PR and Ki-67.

OBJECTIVE: To study the combined transfection of the siRNA target for Hif-lα and Survivin gene to human NPC CNE-2 cell and its effects on the proliferation and cycle of this cell. METHOD: Combined transfection of the siRNA target for Hif-lα and Survivin gene to human NPC CNE-2 cell, these plasmids were respectively transfected into the same cells. Cell proliferation was detected with MTT assay. The inhibitory effects on target genes were evaluated with RT-PCR and Western Blot at the levels of mRNA and protein, respectively. RESULT: MTT showed that CNE-2 cell proliferation in multi-gene plasmid group was more significantly inhibited than a single gene. The expression of mRNA and protein of two different genes were both decreased in HS group, and the interference effect of multiple genes was better than the single-gene(P<0.01). CONCLUSION HS group could restrain cell proliferation and interference the mRNA and protein expression in nasopharyngeal carcinoma CNE-2 cell, which was better than the other groups.
Apoptosis ; Carcinoma ; Cell Line, Tumor ; Cell Proliferation ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit ; genetics ; Inhibitor of Apoptosis Proteins ; genetics ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; genetics ; Plasmids ; RNA, Messenger ; RNA, Small Interfering ; Survivin ; Transfection

Erlotinib,a kind of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs),has been effectively used in the treatment of non-small cell lung cancer (NSCLC).Although it prolongs patients survival time,erlotinib is limited to be further applied for its resistance.It has been proved that threonine to methionine mutations in codon 790 (T790M),Kirsten rat sarcoma viral oncogene homolog (KRAS) mutation and the amplification of met oncogene play important roles in the drug resistance.Based on the different molecular mechanisms of resistance,multiple clinical trials of the second generation TKIs,retreatment of chemotherapy or erlotinib and subsequent treatment according to failure modes have been developed.

OBJECTIVE: Through analyzing the 13 cases with primary hyperparathyroidism (PHPT) retrospectively, We detected the reasons of the misdiagnosis and the strategy of diagnosis and treatment for the disease. METHOD: Thirteen cases of clinical materials on PHPT were collected from 2002 to 2012. Initial symptom, laboratory examination and imaging findings were analyzed. Thirteen cases of patients with PHPT all were performed surgery. The period of postoperative follow up was from 3 to 24 months, averaged for 12.2 months. RESULT: Surgeries on 13 patients were successful, including 12 cases of parathyroid adenoma and 1 case of parathyroid hyperplasia. After the operation, blood calcium went back to normal, and the symptoms of bone and urinary tract were relieved. CONCLUSION Initial symptoms of PHPT are predominantly manifested as bone and kidney types. Elevated PTH/blood calcium levels, B-ultrasound/CT and ECT localization are the important diagnosis basis of this disease. Surgical excision of the lesion parathyroid tissue is the most effective treatment.
Adolescent ; Adult ; Aged ; Calcium ; blood ; Female ; Humans ; Hyperparathyroidism, Primary ; diagnosis ; surgery ; Male ; Middle Aged ; Parathyroid Glands ; surgery ; Retrospective Studies ; Young Adult