Direct detection of unamplified hepatoma upregulated protein RNA in urine using gold nanoparticles for bladder cancer diagnosis

ObjectiveTo develop a gold nanoparticle (AuNP) assay for direct detection of unamplified HURP RNA in urine.Design and methodsHURP RNA was extracted from urine samples (50 bladder carcinoma patients, 25 benign bladder lesions, and 25 controls) and further purified using magnetic nanoparticles (MNPs), functionalized with HURP RNA-specific oligonucleotides, and then detected by RT-PCR or gold nanoparticles.ResultsThe developed HURP RNA AuNP assay has a sensitivity and a specificity of 88.5% and 94%, respectively, and a detection limit of 2.4 nmol/L. The concordance between the HURP AuNP assay with RT-PCR after RNA purification using functionalized MNPs was 97%.ConclusionsThe developed colorimetric HURP RNA AuNP assay is sensitive, simple, and can aid noninvasive diagnosis of bladder cancer.     

Music intervention on physiological and psychological responses of patients with cancer: A protocol for meta-analysis

Background:Cancer is a life-threatening condition and also one of the biggest challenges facing human health and the medical community. This meta-analysis was to investigate the effects of music intervention on physiological and psychological responses of patients with cancer.Methods and analysis:The following electronic databases will be searched from inception to December 2020: PubMed, EMBASE, Web of Science, Chinese Biomedical Literature Database, Chinese National Knowledge Infrastructure Database, Chinese Science and the Wanfang Database. We only included music intervention vs placebo in cancer patients and pooled results were summarized by STATA 12.0 software. Two investigators independently selected the studies according to the inclusion and exclusion criteria, extracted the data, and assessed the quality of the selected studies. The existence of statistical heterogeneity would be evaluated by Chi² test and its extension by the I² test (I² > 50% indicates high heterogeneity among studies). Publication bias was ruled out by funnel plot and statistically assessed by Begg test (P > .05 as no publication bias).Results:The study results will be published in relevant peer-reviewed journals and key findings will be presented at international scientific meetings.Conclusion:Our study aims to systematically assess the effects of music intervention in cancer patients, which will be provide clinical guidance for cancer patients.     

鼻咽癌IMRT与VMAT治疗的计划与剂量验证比较研究

目的:比较研究IMRT与VMAT技术在鼻咽癌治疗中的计划与剂量验证。方法:对8位鼻咽癌患者,分别设计了7野IMRT计划,单弧与双弧VMAT计划,比较分析各计划参数,并对各计划进行治疗前的剂量验证。结果:鼻咽癌的IM-RT,单弧与双弧VMAT计划的靶区覆盖率分别为百分之99.00±0.79,89.92±6.32和97.98±1.29;γ分析相对剂量通过率分别为百分之91.91±4.64,97.65±1.45和97.36±2.25。IMRT,单弧与双弧VMAT计划的优化时间分别为:4.74±1.06,20.8±4.83和40.36±12.55分钟;所需要的出束时间分别为:11.01±0.43,1.75±0.07和4.01±0.28分钟;所需的MU平均值分别为1020.88±106.95,425.88±25.34和566.38±54.38。结论:对于鼻咽癌病人,单弧VMAT计划的靶区覆盖率不够,双弧VMAT计划可获得与IMRT相似的靶区覆盖率,同时减少所需的MU与出束时间。现有加速器与计划系统能够准确地计算和执行VMAT计划。     

不同剂量方案贝伐珠单抗治疗放射性脑坏死的疗效观察

目的 评估贝伐珠单抗治疗放射性脑坏死（cerebral radiation necrosis,CRN）的疗效及安全性,为临床合理应用提供指导。方法 回顾性分析既往接受甘露醇及激素治疗失败的或初治的放射性脑坏死患者14例。所有入组患者按治疗方案的不同分为2组（5.0 mg/kg组每14 d重复1次和7.5 mg/kg组每21 d重复1次）。分别比较2组患者头颅MRI T1W1相增强病灶的变化情况及T2W1相病灶水肿情况,记录患者的临床症状、卡氏（KPS）评分改变情况及药物的不良反应。结果 14例患者均完成了至少2个周期的治疗。治疗2个周期后,2组患者KPS评分均较前改善,5.0 mg/kg组KPS评分较治疗前平均提高31.66分,7.5 mg/kg组KPS评分较治疗前平均提高27.50分。分别比较2组患者治疗前后的MRI T1W1相增强病灶的变化情况及T2W1相病灶水肿变化情况均有不同程度改善,其中5.0 mg/kg组CRN病灶体积平均减少（46.0±9.4）%（t=6.57,P<0.05）,病灶水肿区体积平均减少（68.9±8.9）%（t=3.32,P<0.05）,7.5 mg/kg组CRN病灶体积平均减少（53.9±10.7）%（t=7.89,P<0.05）,病灶水肿区体积平均减少（77.1±14.3）%（t=4.22,P<0.05）,差异有统计学意义。而2组患者在CRN病灶平均体积及病灶水肿区体积的减小程度上比较差异无统计学意义（P>0.05）。5.0 mg/kg组患者总的治疗过程中与7.5 mg/kg组相比,不良事件发生率差异无统计学意义（P>0.05）。结论 贝伐珠单抗能明显改善放射性脑坏死患者的临床症状并提高生活质量,5.0 mg/kg每14 d重复1次的治疗方案安全性与7.5 mg/kg每21 d重复1次的治疗方案相似,对CRN的治疗有借鉴意义。     

基于人工神经网络模型的鼻咽癌VMAT计划质量控制方法

目的训练放疗计划个体化三维剂量预测模型,并使用该模型建立计划质量控制方法。方法回顾性分析99例已临床实施的早期鼻咽癌同步加量容积旋转调强放疗(VMAT)计划,提取7个几何特征,包括各危及器官(OARs)到PTV、加量靶区和外轮廓的最小距离,及4个坐标位置关系特征。训练(89例)并验证(10例)基于人工神经网络(ANN)的三维剂量分布预测模型;然后基于该预测模型建立放疗计划质量控制方法。以各危及器官剂量学参数D2%、D25%、D50%、D75%和平均剂量(MD)为质量控制指标,通过标准为人工计划和预测剂量差别≤10%。采用由低年资物理师设计的10例计划,对该质量控制方法进行测试。结果18个头颈部OARs的主要剂量学指标,预测剂量与专家计划结果差异无统计学意义。剂量预测结果与专家计划相比,D2%、D25%、D50%、D75%和平均剂量(MD)的差别均控制在1.2 Gy以内。由低年资物理师设计的10例计划均达到常规临床剂量限值的要求,而利用建立的质量控制方法检出1例计划的脊髓、脊髓危及器官的计划体积(PRV)、脑干和脑干PRV剂量限制有待改善。根据模型预测值重新优化计划后,脊髓和脑干D2%分别降低了8.4和5.8 Gy。结论提出了一种简单易行的放疗计划质量控制方法,能克服统一性剂量限值未考虑患者特异性的缺陷,可提高个体化计划质量和稳定性。     

Acyclovir-resistant herpes simplex encephalitis in a patient treated with anti-tumor necrosis factor-α monoclonal antibodies

Herpes simplex virus is the most common cause of severe sporadic encephalitis. We report a case of herpes simplex type 1-encephalitis in a 50-year-old woman receiving anti-tumor necrosis factor-α monoclonal antibodies adalimumab. Although she was an acyclovir naïve patient, a mixed viral population (wild-type and acyclovir-resistant bearing a thymidine-kinase mutation) was identified in the cerebrospinal fluid. The virus in cerebrospinal fluid evolved and a second thymidine-kinase mutant virus emerged. Combined foscavir and acyclovir treatment resolved the herpes simplex encephalitis. To our knowledge, this is the first report of acyclovir-resistant herpes simplex encephalitis in a patient treated with adalimumab.     

辛伐他汀对荷瘤小鼠抑瘤作用的实验研究

目的研究辛伐他汀对小鼠肝癌细胞H22抑瘤作用的影响.方法采用小鼠H22肝癌细胞实体瘤模型进行体内抑瘤实验,观察荷瘤动物的生长情况和肿瘤生长曲线,测定肿瘤生长抑制率,以及生存期的改变.结果辛伐他汀对小鼠的H22实体瘤生长具有明显的抑制作用,抑瘤率达50%以上.未发现生存期的改变.结论辛伐他汀具有较强的体内抗肿瘤作用.     

Relationship between 5-fluorouracil disposition, toxicity and dihydropyrimidine dehydrogenase activity in cancer patients

Background:Previous work demonstrated that 5-fluorouracil(5-FU) metabolism is a critical factor for treatment tolerability. Inorder to study the predictivity of pharmacokinetics with respect to theoccurrence of 5-FU toxicity, this study investigates the relationshipbetween the pharmacokinetics of 5-FU and its metabolite5-fluoro-5,6-dihydrouracil (5-FDHU), dihydropyrimidine dehydrogenase(DPD) activity in peripheral blood mononuclear cells (PBMNC) andtreatment tolerability. Patients and methods:Pharmacokinetics and metabolismof 5-FU and activity of DPD in PBMNC were examined in110 colorectal cancer patients given adjuvant 5-FU 370mg/m² plus L-folinic acid 100 mg/m² for five daysevery four weeks. Drug levels were examined by HPLC, while toxicitieswere graded according to WHO criteria. Results:DPD activity in patients with mild toxicities (WHOgrade 1) was 197.22 ± 11.34 pmol of 5-FDHU/min/mg of protein,while in five patients with grade 3–4 gastrointestinal toxicity,DPD ranged from low to normal values (range 31.12–182.37pmol/min/mg of protein). In these patients, 5-FU clearance (CL) waslower (range 14.12–25.17 l/h/m²), and the area underthe curve (AUC) was higher (range 14.70–26.20 h×µg/ml)than those observed in 84 patients with mild toxicities (CL, 56.30± 3.60 l/h/m²; AUC, 7.91 ± 0.44h×µg/ml). The severity of adverse events was associated withincreased 5-FU/5-FDHU AUC ratio and reduced 5-FU CL, while 5-FU and5-FDHU pharmacokinetics were not related to DPD activity. Conclusion:This study shows that DPD activity in PBMNC isunrelated to 5-FU/5-FDHU disposition and patients with severe toxicitydisplay marked pharmacokinetic alterations while a reduction of DPDactivity may not occur.     

食管癌三维适形放疗的护理

目的总结食管癌三维适形放疗期护理经验。方法对62例食管癌患者加强放疗期护理,放疗前做好心理护理,放疗期间加强皮肤护理,密切观察病情,做好放射性食管炎、食管-气管瘘等并发症的护理,并做好出院指导。结果62例患者中59例完成治疗计划,3例因食管-气管瘘中断治疗,放疗期间出现急性气管炎26例,急性食管炎34例,均经过处理而未影响治疗,无严重皮肤反应及脊髓炎发生。结论加强食管癌患者放疗期护理,可有效提高放疗的症状缓解率,改善生存质量。