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     

Relationships between self-reflectiveness and clinical symptoms in individuals during pre-morbid and early clinical stages of psychosis

BackgroundSelf-reflectiveness, one dimension of cognitive insight, plays a protective role in an individual’s mental state. Both high and low levels of self-reflectiveness have been reported in patients with schizophrenia and individuals at clinical high risk for the illness.AimsThis study aimed to explore the relationship patterns between self-reflectiveness and clinical symptoms in individuals during the pre-morbid and early clinical stages of psychosis.MethodsA total of 181 subjects, including individuals with attenuated positive symptoms (APS, n=122) and patients with first-episode psychosis (FEP, n=59), completed the Beck Cognitive Insight Scale and were evaluated using the Schedule of Assessment of Insight and Positive and Negative Syndrome Scale. All subjects were classified into three groups according to their level of self-reflectiveness: low level (LSR, n=59), medium level (MSR, n=67) and high level (HSR, n=55). Both linear and non-linear relationships between self-reflectiveness and clinical symptoms were explored.ResultsMore individuals with APS were classified into the MSR group, while more patients with FEP were classified into the LSR group. The LSR group demonstrated less awareness of illness than the MSR and HSR groups, more stereotyped thinking and poorer impulse control but less anxiety than the MSR group, and lower levels of blunted affect and guilt feelings than the HSR group. The MSR group demonstrated lower stereotyped thinking than the HSR group. Compared to the LSR group, the MSR group had increased self-reflectiveness, improved awareness of illness, decreased stereotyped thinking, and better impulse control, but increased feelings of guilt. The HSR group showed increased stereotyped thinking when compared to the MSR group, but the other variables did not change significantly between these two groups. Overall, self-reflectiveness demonstrated an approximately inverse S-shaped relationship with the awareness of illness, a U-shaped relationship with stereotyped thinking and poor impulse control, and an almost linear relationship with anxiety and guilt feelings.ConclusionsSelf-reflectiveness demonstrates complex relationships with clinical symptoms and fails to exert significant positive effects when reaching a certain high level.     

口腔粘接与粘固的区别和联系

口腔粘接、粘固材料有着不同的分类、特点与界面处理方式,应用于不同的临床情况.本文将从原理和临床实践出发,就口腔临床工作中粘接与粘固的区别及联系展开讨论,为临床医生了解、熟悉相关知识提供参考,从而选择合适的粘接、粘固材料,提高粘接修复的效果.     

酸枣仁中黄酮类镇静催眠有效成分的研究

本文对辽宁产的酸枣仁中的黄酮类成分进行了初步研究,从中分离出一种淡黄色无定形粉末,经鉴定为黄酮碳甙(spinosin)。动物实验证明,酸枣仁中镇静催眠作用的成分不仅是皂甙成分,黄酮也是主要成分之一。     

广佛手药材HPLC指纹图谱的研究

目的建立广佛手药材HPLC指纹图谱,以便比较完整地反映广佛手的内在化学信息,全面评价广佛手药材质量,与其他产地佛手进行鉴别。方法应用HPLC法测定了12批佛手的指纹图谱,乙腈-0.5%冰醋酸为流动相进行梯度洗脱,检测波长290nm,体积流量1.0mL/min,柱温30℃,收集75min。结果建立了广佛手HPLC指纹图谱共有模式,并对不同产地药材进行了相似度比较。结论该方法稳定可靠,信息量大,为广佛手药材鉴别和质量评价提供了依据。     

三七开花习性观察

本文报道了在云南省文山州气候条件下三七的开花、散粉规律，可为三七的杂交育种工作提供依据。     

调肝与健脾对节育器致人子宫异常出血症子宫内膜组织ERK1/2、PI_3K信号通路的影响差异

目的:探讨柴胡止血液对置器后子宫异常出血患者的影响机制。方法:原代培养置器后子宫异常出血患者的宫内膜组织,给含药血清后,分别采用western blot和ELISA的方法测定ERK1/2和PI3K磷酸化的水平。结果:4号组织的归脾汤组升高了PI3K磷酸化水平,P<0.05;1号组织的柴胡止血液组有升高ERK1/2磷酸化水平的趋势;3号组织的柴胡止血液组有升高ERK1/2磷酸化水平的趋势;5号组织的柴胡止血液组有升高PI3K磷酸化水平的趋势;2号组织的归脾汤组有升高ERK1/2磷酸化水平的趋势;4号组织的归脾汤组有升高ERK1/2和PI3K磷酸化水平的趋势。结论:对于出血量大的肝旺患者,柴胡止血液可能通过激活ERK1/2通路来增强血管的收缩从而达到止血的目的;对于出血量较小的肝旺患者证,柴止血液可能通过激活PI3K通路来调节组织抗炎作用,从而达到治疗效果。     

中药代谢分析研究进展＊

中药具有多成分、多靶点的特性，药效物质基础及药物代谢途径不明确严重制约中药的发展。中药小分子经过体内代谢后转化成代谢物发挥药效或者清除。近年来随着MS技术的飞速发展，通过LC-MS技术进行精准定性定量分析，以阐明中药代谢物与机体生理及病理相关变化的关系，从而明确中药的药效物质基础及体内代谢路径。本文从中药代谢研究思路、研究方法、影响因素以及应用等方面，就近年来中药代谢分析领域的研究进展进行综述。     

脊髓纵裂的手术疗效观察

收治脊髓纵裂４６例，其中２９例作神经功能状态的临床评价及胫后神经皮层体感诱发电位检查。结果：非手术组随访后神经功能缺陷无改善（Ｐ＞０．０５）；２０例手术组神经功能的临床评分明显增加及胫后神经皮层体感诱发电位明显改善（Ｐ＜０．０５）。表明手术不仅可阻止神经功能缺陷的发展，而且可使其得到改善，是一有效的治疗手段。     

Leflunomide therapy for adult patients with steroid-dependent minimal change disease or primary focal segmental glomerulosclerosis

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