Moderate Hypofractionated Helical Tomotherapy for Older Patients with Localized Prostate Cancer: Long-term Outcomes of a Phase I–II Trial

BackgroundOur previous study showed that two different regimens of moderate hypofractionated radiotherapy (HFRT) delivered with helical tomotherapy (HT) are well tolerated in older prostate cancer patients. We provide a longterm efficacy and toxicity after > 7 years of follow-up.Patients and methodsThe study recruited 33 patients from February 2009 to July 2011 (76 Gy/34F; Group-1); and 34 from July 2011 to February 2014 (71.6 Gy/28F; 50.4 Gy/25F for the risk of pelvic lymph nodes involvement (LNI) >15%; Group-2). The primary outcomes were biochemical failure (BF), biochemical failure and clinical disease failure (BCDF), progression-free survival (PFS), overall survival (OS), late genitourinary (GU) and gastrointestinal (GI) toxicity.ResultsThe average ages of two groups were 80 and 77 years and the proportions of patients with LNI > 15% were 69.7% and 73.5%, respectively. At the final follow-up in February 2020, 27.3% and 20.6% cases experienced BF, with a median time until BF of 3.3 years. A total of 38.8% patients reached primary endpoints, in which 18 deaths were reported BCDF events (45.5% vs. 32.4%, p = 0.271). There was no significant difference in 7-year PFS (68.6% vs. 74.8%, p = 0.591), BCDF (45.5% vs. 32.4%, p = 0.271) and OS (71.9% vs. 87.5%, p = 0.376) for full set analysis and for subgroup analysis (all p > 0.05). The incidence of grade ≥ 2 late GU (6.2% vs. 6.3%, p = 0.127) and GI toxicities (9.4% vs. 15.6%, p = 0.554) was comparable.ConclusionsIn older patients with localized prostate cancer, two moderate hypofractionated regimens were all well tolerated with similar, mild late toxicities and satisfactory survival, without necessity of prophylactic pelvic node irradiation.Key words: helical tomotherapy, radiation dose hypofractionation, progression-free survival, follow-up studies, prostatic neoplasms, adenocarcinoma     

松茸不同提取部位的体外抗肿瘤作用

摘 要 目的： 研究松茸不同提取部位的体外抗肿瘤活性。 方法: 采用MTT法测定松茸乙醇提取物各部位及多糖部位对HepG-2细胞、Hela细胞和MCF-7细胞的抑制作用;采用流式细胞术检测多糖部位诱导HepG-2细胞和Hela细胞凋亡的作用。结果:松茸多糖部位体外对3种肿瘤细胞的IC₅₀分别为53.77μg·ml^-1(HepG-2)、40.04 μg·ml^-1(Hela)、100.65 μg·ml^-1(MCF-7),抑制作用均优于其他各部位,且对HepG-2细胞和Hela细胞抑制作用呈现良好的时间与浓度依赖性;松茸多糖部位能诱导HepG-2细胞和Hela细胞凋亡。结论: 松茸多糖部位能显著抑制HepG-2和Hela等肿瘤细胞的生长,具有诱导凋亡的作用,为松茸抗肿瘤的主要活性部位。     

中药饮片质量标准研究中的几个关键问题

中药饮片质量标准是中药炮制研究的重要内容,也是整个中药标准化体系的关键环节。尽管中药饮片有了国家标准,但是中药饮片标准化水平仍然处于较低水平。在中药饮片质量标准研究中,还存在一些实际问题需要我们加以重视和思考。本文结合作者长期的研究和生产实践,提出在中药饮片质量标准研究中要更加注重和传统炮制理论、炮制机理研究与药效物质研究的结合,努力构建更加全面、科学、合理的中药饮片质量标准。     

戊二酰辅酶A脱氢酶基因沉默及高浓度赖氨酸对BRL肝细胞活性的影响

目的探讨戊二酰辅酶A脱氢酶(GCDH)基因沉默和赖氨酸代谢物蓄积对肝细胞活性的影响。方法将BRL肝细胞分为正常对照组、阴性对照组和GCDH沉默组。构建含靶向沉默GCDH基因的sh RNA慢病毒载体,分别用该病毒和阴性对照病毒感染GCDH沉默组和阴性对照组BRL肝细胞。感染后细胞再用含5 mmol/L赖氨酸培养基培养。免疫荧光技术检测慢病毒感染效率;Western blot法检测GCDH蛋白表达水平;MTT法检测细胞活性,Hoechest 33342染色检测细胞凋亡,Western blot法检测细胞凋亡的经典指标Caspase3水平。结果构建的慢病毒可有效沉默肝细胞GCDH表达(P0.01)。MTT及Hoechest 33342染色检测各组间细胞活性及细胞凋亡比较差异无统计学意义(P0.05)。Caspase3蛋白表达在各组间比较差异亦无统计学意义(P0.05)。结论 GCDH基因沉默和赖氨酸代谢物蓄积对肝细胞无明显损伤作用。     

多焦点人工晶状体的临床应用研究

目的　探讨多焦点人工晶状体 (MIOL)在白内障治疗中的作用。方法　在小切口超声乳化白内障吸除术中 ,30例 (36只眼 )白内障患者植入MIOL(试验组 ) ,32例 (40只眼 )白内障患者植入单焦点人工晶状体 (SIOL) (对照组 )。观察患者的术后视力、焦距深度、角膜散光度数、对比敏感度和眩光敏感度、手术并发症及视觉不良症状 ,随访时间 6 0～ 18 0个月。结果　术后 6个月裸眼近视力≥ 0 5者试验组占 80 6 % (2 9/36 ) ,对照组占 2 5 0 % (10 /4 0 ) ,两组比较差异有显著意义 (P <0 0 5 ) ;矫正近视力和远视力、裸眼远视力两组比较 ,差异均无显著意义 (P >0 0 5 )。在 1 0 0～ - 1 0 0D调节范围内 ,视力≥ 0 5者试验组占 97 2 % (35 /36 ) ,对照组占 97 5 % (39/4 0 ) ,差异无显著意义 (P >0 0 5 ) ;在 - 1 5 0D和 - 2 5 0～ - 3 5 0D调节范围内 ,视力≥ 0 5者试验组 [97 2 % (35 /36 )、88 9% (32 /36 ) ]明显多于对照组 [0 0 % (0 /4 0 )、0 0 % (0 /4 0 ) ](P <0 0 5 )。在视力≥ 0 5的术眼中 ,焦距深度试验组为4 5 0D ,对照组为 2 0 0D。术后 1周、1个月、3个月、6个月两组角膜散光度数与术前比较 ,差异均无显著意义 (P >0 0 5 )。低频段对比敏感度和眩光敏感度试验组 (2 8 4 9± 6 4 5和     

乳兔雪旺细胞对成兔视神经挫伤修复的作用

目的 研究乳兔雪旺细胞(Schwann cell,SC)对成兔视神经挫伤修复的作用。 方法 建立成兔视神经挫伤模型,伤后24 h分别向伤眼玻璃体腔内注入SC悬液(A组)、生理盐水(B组)各0.1 ml。伤后不同时间点进行视网膜节细胞(retinal ganglion cell,RGC)、轴突染色记数及闪光视觉诱发电位(flash visual evoked potentials,FVEP)检测。 结果 伤后4周A、B组RGC平均记数分别为(19.89±3.79) /mm和(12.67±4.12) /mm,轴突密度分别为(94.569±793) /mm ²和(36.085±285) /mm²,A组明显高于B组(P<0.01)。伤后3 d A组伤眼与健眼FVEP幅值比由48%上升至88%,8周时仍为78%,各时间点均明显高于B组(P＜0.01)。 结论 乳兔SC能够提高成兔视神经挫伤后RGC存活率,减轻轴突变性,显著促进视神经功能恢复,对视神经挫伤修复具有明显的促进作用。(中华眼底病杂志,2000,16:91-93)      

Comparison of posterior capsule folds following intracapsular implantation of three types of intraocular lenses with different haptic design

AIM: To compare the incidence of posterior capsule folds among different types of intraocular lens (IOL) to determine risk factors of posterior capsule folds. METHODS: It was a retrospective study. We collected the cases in which the patients underwent phacoemulsification (PHACO) and IOL implantation and at least one of the three types of IOL was implanted, including 2-haptic 3-piece IOLs (HOYA PY60AD), 4-haptic 1-piece IOLs (Bausch&Lomb AO), 2-haptic 1-piece IOLs (AMO Tecnis ZCB00). The posterior capsule folds were measured using slit lamp microscope 2d after the surgery. Information of patient’s age, gender, length of ocular axis, intraocular pressure, types of IOL were recorded. Posterior capsule fold risk indicators were identified by using logistic regression analysis. RESULTS: One hundred eighty-seven patients (242 eyes) had been collected, including 80 eyes implanted with HOYA PY60AD IOLs, 81 eyes implanted with Bausch&Lomb AO IOLs, 81 eyes implanted with AMO Tecnis ZCB00 IOLs. The incidence of posterior capsule folds of patients implanted with HOYA PY60AD IOLs was significantly higher than those of patients implanted with AMO Tecnis ZCB00 IOLs. While the incidence of patients implanted with Bausch&Lomb AO IOLs was significantly lower than those of patients implanted with AMO Tecnis ZCB00 IOLs. Multi-factor logistics regression analysis demonstrated that independent risk factors were type of IOLs and length of ocular axis. Compared with AMO Tecnis ZCB00 IOLs, using HOYA PY60AD IOLs increased the risk of posterior capsule folds [P=0.020, OR (95%CI)=2.145 (1.129, 4.073)], while using Bausch&Lomb AO IOLs reduced the risk [P=0.001, OR (95%CI)=0.274 (0.127, 0.591)]. Shorter ocular axis might increase the risk of posterior capsule folds [P=0.012, OR (95%CI)=0.669 (0.489, 0.915)]. CONCLUSION: Haptic design should be an important consideration in IOL design. Compared with AMO Tecnis ZCB00 IOLs, using HOYA PY60AD IOLs is more likely to lead to posterior capsule folds formation, while using Bausch&Lomb AO IOLs is less likely to lead the formation. The posterior capsule folds are more engendered in eyes with shorter ocular axis.