不同介入时机预防性全脑照射对局限期小细胞肺癌疗效的影响

目的分析不同介入时机预防性全脑照射(PCI)对局限期小细胞肺癌(LSCLC)交替放化疗完全缓解(CR)后脑转移率和生存率的影响。方法对该院90例LSCLC患者进行回顾性分析,将其分为短周期组(51例),长周期组(39例)。两组均进行胸部放疗、化疗(依托泊苷+顺铂)2个周期。短周期组化疗2个周期后给予PCI治疗;而长周期组化疗4个周期后给予PCI治疗,并比较两组脑转移率和生存率。结果短周期组3年内脑转移率为12/51(23.53%),长周期组为20.51%(8/39);两组3年内脑转移率比较,差异无统计学意义(P>0.05)。短周期组第1、2及3年总生存率分别为82.35%、39.22%及21.57%,中位生存时间为15个月;长周期组第1、2及3年总生存率分别为76.92%、43.59%和23.08%,中位生存时间为18个月。两组第1、2及3年总生存率比较,差异无统计学意义(P>0.05)。短周期组第1、2及3年局部无进展生存率分别为54.90%、19.61%和15.69%,长周期组分别为66.67%、23.08%和12.82%,且两组中位局部无进展生存期均为16个月。两组第1、2及3年局部无进展生存比较,差异无统计学意义(P>0.05)。两组不良反应发生率、肿瘤复发及转移发生率比较,差异无统计学意义(P>0.05)。结论采取不同介入时机PCI对LSCLC交替放化疗CR后脑转移率和生存率较为接近,无较大差异。

Gut-lung crosstalk in pulmonary involvement with inflammatory bowel diseases

Pulmonary abnormalities,dysfunction or hyper-reactivity occurs in association with inflammatory bowel disease(IBD) more frequently than previously recognized.Emerging evidence suggests that subtle inflammation exists in the airways among IBD patients even in the absence of any bronchopulmonary symptoms,and with normal pulmonary functions. The pulmonary impairment is more pronounced in IBD patients with active disease than in those in remission. A growing number of case reports show that the IBD patients develop rapidly progressive respiratory symptoms after colectomy,with failure to isolate bacterial pathogens on repeated sputum culture,and often request oral corticosteroid therapy. All the above evidence indicates that the inflammatory changes in both the intestine and lung during IBD. Clinical or subclinical pulmonary inflammation accompanies the main inflammation of the bowel.Although there are clinical and epidemiological reports of chronic inflammation of the pulmonary and intestinal mucosa in IBD,the detailed mechanisms of pulmonaryintestinal crosstalk remain unknown. The lung has no anatomical connection with the main inflammatory site of the bowel. Why does the inflammatory process shift from the gastrointestinal tract to the airways? The clinical and subclinical pulmonary abnormalities,dysfunction,or hyper-reactivity among IBD patients need further evaluation. Here,we give an overview of the concordance between chronic inflammatory reactions in the airways and the gastrointestinal tract. A better understanding of the possible mechanism of the crosstalk among the distant organs will be beneficial in identifying therapeutic strategies for mucosal inflammatory diseases such as IBD and allergy.

Significance and relationship between infiltrating inflammatory cell and tumor angiogenesis in hepatocellular carcinoma tissues

AIM: To investigate the relationship between infiltrating inflammatory cell and tumor angiogenesis in hepatocellular carcinoma (HCC) tissues and their clinicopathological features.METHODS: The paraffin-embedded specimens from 70 cases with HCC were stained using EliVision immunohistochemistry with mAbs against CD68, tryptase,and CD34. The counts of tumor-associated macrophage (TAM), mast cell (MC) and tumor microvessel (MV) were performed in the tissue sections.RESULTS: The mean counts of TAM, MC, and MV in HCC tissues were significantly higher than those in pericarcinomatous liver tissues (TAM: 69.31± 11.58 vs 40.23±10.36; MC: 16.74±5.67 vs 7.59±4.18; MV:70.11±12.45 vs 38.52± 11.16, P＜0.01). The MV count in the patients with metastasis was markedly higher than that with non-metastasis (P＜0.01). In addition, the MC count in the patients with poorly differentiated HCC was obviously higher than that with well differentiated HCC (P＜ 0.01). The correlation analysis showed that the TAM count was significantly correlated with the count of MV(r=0.712, P＜0.01), and the MC count was obviously correlated with the MV count (r= 0.336, P＜ 0.05).CONCLUSION: TAM and MC might be closely related to the enhancement of tumor angiogenesis. The MV count might be associated with tumor invasion and metastasis.Moreover, the MC count might be associated with tumor differentiation and prognosis of HCC.

Changes of microcirculation in healthy volunteers and patients with septic shock in Xining

Objective: The purpose of this study is to investigate the characteristic of microcirculation in healthy volunteers and patients with septic shock in both Xining(2 260 m) and Nanjing(10 m). Methods: A total of 62 cases, 33 healthy volunteers, 22 cases in Xining,(2 260 m above sea level) and 11 cases in Nanjing(10 m above sea level); and 29 septic shock, 13 cases in Xining and 16 cases in Nanjing were collected. The total vessel density(TVD), perfused vessel density(PVD), proportion of perfused vessel(PPV) and microcirculation flow index(MFI) of both healthy volunteers and septic shock had been investigated by using sidestream dark field(SDF). Analyzed and managed the image data by using AVA3.0 software. Results: In the healthy volunteers in Xining area(22 cases),the volume of TVD(15.59 ± 2.58 mm/mm^2), PVD(15.58 ± 2.58 mm/mm^2) and PPV(96.60% ± 4.63%) were significant higher than the volume of TVD(10.0 ± 2.10 mm/mm^2), PVD(10.81 ± 2.38 mm/mm^2) and PPV(84.24% ± 8.00%) of the volunteers(11 cases) in Nanjing(11 cases). But the MFI(2.17 ± 0.31) of the healthy volunteers in the Xining was significant lower(P<0.05) than the MFI(3.21 ± 0.34) in the healthy volunteers of Nanjing. In the septic shock group(13 cases) in the Xining, the volume of TVD(5.44 ± 1.94 mm/mm^2), PVD(4.18 ± 1.61 mm/mm^2), PPV(42.14%± 5.38%) and MFI(1.05 ± 0.32) compared with the volume of the healthy volunteers in Xining, the TVD(15.59 ± 2.58 mm/mm^2), PVD(5.58 ± 2.58 mm/mm^2), PPV(96.60% ± 4.63%) and MFI(2.17 ± 0.30) were significant lower(P<0.05). In the healthy volunteers compare with septic shock group in Nanjing area, the TVD(6.80±1.72 vs 10.00±2.10, P<0.05), PVD(5.86±1.58 vs10.81±2.38,P<0.05), PPV(45.42±4.86 vs 84.24±4.86, P<0.05), MFI(1.28±0.28 vs 3.21±0.34 P<0.05), there was significant decreased. In the septic shock group in the Xining compared with the septic shock in Nanjing, there was no significant difference. 10 of 13 patients with septic shock were survived in Xining. 13 of 16 patients with septic shock were survived in Nanjing. Conclusion: The changes of physiological and pathophysiological characteristic in microcirculation induced by hypoxia would be useful for clinical treatment of septic shock at high altitude.

Monte Carlo simulation of fast neutron-induced fission of 237Np

The potential-driving model is used to describe the driving potential distribution and to calculate the preneutron emission mass distributions for different incident energies in the 237 Np(n, f)reaction. The potential-driving model is implemented in Geant4 and used to calculate the fission-fragment yield distributions, kinetic energy distributions, fission neutron spectrum and the total nubar for the 237 Np(n, f)reaction. Compared with the built-in G4 ParaFissionModel, the calculated results from the potential-driving model are in better agreement with the experimental data and evaluated data. Given the good agreement with the experimental data, the potential-driving model in Geant4 can describe well the neutron-induced fission of actinide nuclei, which is very important for the study of neutron transmutation physics and the design of a transmutation system.