Objective To investigate the effectiveness and preliminary mechanisms of icariin (ICA) in enhancing the reparative effects of adipose-derived stem cells (ADSCs) on skin radiation damagies in rats. Methods Twelve SPF-grade Sprague Dawley rats [body weight (220±10) g] were subjected to a single dose of 10 Gy X-ray irradiation on a 1.5 cm×1.5 cm area of their dorsal skin, with a dose rate of 200 cGy/min to make skin radiation damage model. After successful modelling, the rats were randomly divided into 4 groups (n=3), and on day 2, the corresponding cells were injected subcutaneously into the irradiated wounds: group A received 0.1 mL of rat ADSCs (1×107cells/mL), group B received 0.1 mL of rat ADSCs (1×107cells/mL)+1 μmol/L ICA (0.1 mL), group C received 0.1 mL of rat ADSCs (1×107cells/mL) pretreated with a hypoxia-inducible factor 2α (HIF-2α) inhibitor+1 μmol/L ICA (0.1 mL), and group D received 0.1 mL of rat ADSCs (1×107cells/mL) pretreated with a Notch1 inhibitor+1 μmol/L ICA (0.1 mL). All treatments were administered as single doses. The skin injury in the irradiated areas of the rats was observed continuously from day 1 to day 7 after modelling. On day 28, the rats were sacrificed, and skin tissues from the irradiated areas were harvested for histological examination (HE staining and Masson staining) to assess the repair status and for quantitative collagen content detection. Immunohistochemical staining was performed to detect CD31 expression, while Western blot and real-time fluorescence quantitative PCR (qRT-PCR) were used to measure the protein and mRNA relative expression levels of vascular endothelial growth factor (VEGF), platelet-derived growth factor BB (PDGF-BB), fibroblast growth factor 2 (FGF-2), interleukin 10 (IL-10), transforming growth factor β (TGF-β), HIF-2α, and Notch1, 2, and 3. ResultsAll groups exhibited skin ulcers and redness after irradiation. On day 3, exudation of tissue fluid was observed in all groups. On day 7, group B showed significantly smaller skin injury areas compared to the other 3 groups. On day 28, histological examination revealed that the epidermis was thickened and the dermal fibers were slightly disordered with occasional inflammatory cell aggregation in group A. In group B, the epidermis appeared more normal, the dermal fibers were more orderly, and there was an increase in new blood vessels without significant inflammatory cell aggregation. In contrast, groups C and D showed significantly increased epidermal thickness, disordered and disrupted dermal fibers. Group B had higher collagen fiber content than the other 3 groups, and group D had lower content than group A, with significant differences (P<0.05). Immunohistochemical staining showed that group B had significantly higher CD31 expression than the other 3 groups, while groups C and D had lower expression than group A, with significant differences (P<0.05). Western blot and qRT-PCR results indicated that group B had significantly higher relative expression levels of VEGF, PDGF-BB, FGF-2, IL-10, TGF-β, HIF-2α, and Notch1, 2, and 3 proteins and mRNAs compared to the other 3 groups (P<0.05). Conclusion ICA may enhance the reparative effects of ADSCs on rat skin radiation damage by promoting angiogenesis and reducing inflammatory responses through the HIF-2α-VEGF-Notch signaling pathway.
ObjectiveTo discuss the clinical value of internal radiation therapy with hepatic intraarterial iodine131 labeled material for the treatment of hepatocellular carcinoma (HCC). MethodsThis summarized paper was made on literature review. ResultsIodine131lipiodol and several reported iodine131labeled antibodies to HCC associated antigens were concentrated in the foci of HCC with a high tumortonormaltissue absorbed dose ratios. No severe side effects occurred. It was used in various kinds of HCC patients, and mostly showed a significant tumor response. Survival rate of HCC patients was raised in several clinical trials.Conclusion Internal radiotherapy with hepatic intraarterial iodine131 labeled material may be considered as an effective method to treat HCC.
Objective To research the effect of γ-radiation released from 103Pd radioactive stent on the expression of Fas gene and its relation with apoptosis of bile duct cancer cells lines. Methods The cancer cells of bile duct were dissociated into suspension in culture flasks, and the number of cells was counted by hemacytometry. The suspension was then stored in 2 ml freezing tubes in the density of 1×105/ml. They were set in two stents: general stent （general stent group） and 103Pd radioactive stent (103Pd stent group). The expression of Fas gene and apoptosis of bile duct cancer cells in general stent group and 103Pd stent group were analysed with immunohistochemistry technique and TUNEL method, respectively. Results The expression level of Fas gene in 103Pd stent group was significantly higher than that in general stent group （P＜0.05）, and the number of apoptotic cancer cells in 103Pd stent group was also significantly more than that in general stent group （P＜0.01）. Conclusion There is a correlation between the expression of Fas gene and the apoptosis of bile duct cancer cells, which means that 103Pd radioactive stent may increase the expression of Fas gene and promote the apoptosis of cancer cells. It may be helpful for the further study of treatment for bile duct cancer using 103Pd radiative stent.
Objective To investigate the results of human amniotic membrane(HAM) which are loaded with marrow mesenchymal stem cells(MSCs) and epidermis cells in treating fullthickness skin defect combined with radiation injury. Methods Eight minipigs were used in this study. Three round fullthickness wounds（Ф3.67cm）, which combined with radiation injury, were created on the dorsum of each side close to the vertebral column in each animal. Among 48 wounds, 24 left side wounds were treated with HAM loaded with MSCs and epidermis cells as experimental group (group A), 16 right side wounds with simple HAM (HAM group, group B) and 8 right side wounds with oil gauze as control (group C). The granulation tissue, reepithelization and wound area were observed after 1,2 and 3 weeks. Immunohistochemistry was performed using vWF as a marker for blood vessels.Image analysis was employed to test new area of wound at different interval time and healing rate of wound.Results The healing time of group A was 6 to 7 days faster than that of group C and 5 to 6 days faster than that of group B. After 15-17 days of graft, there were significant differences in new area of wound and healing rate between group A and groups B,C(Plt;001). New epidermis fully covered whole wound surface in group A, and their granulation tissue, which contained a lot of vWF, fibroblasts, capillaries and collagen, grew well. Many inflammatory cells still were seen in groups B and C, and their contents of vWF, fibroblasts, capillaries and collagen in granulation tissue were smaller than that in group A.Conclusion The graft of HAM loaded with MSCs and epidermis cells played an effective role in promoting healing of wound combined radiation injury with high quality.
摘要:目的: 评估手术、栓塞及γ刀综合治疗脑动静脉畸形的疗效。 方法 :回顾性分析了我科自2002年3月至2009年7月期间综合治疗的43例脑AVM患者,分析评估这43例脑AVM的临床特点及治疗效果,随访患者并对其进行GOS评分。 结果 :本组病例采取栓塞＋手术治疗3例、栓塞＋γ刀治疗26例、手术＋γ刀治疗11例、栓塞+手术＋γ刀治疗3例。术后随访28例,随访时间4月至7年6月,GOS评分5分者25例,患者均能重新回到工作或学校;GOS评分4分者2例,患者生活能够自理;GOS评分1分者1例,患者死亡。 结论 :对大型、功能区、有深部静脉引流的脑AVM综合治疗有一定的优越性,它不仅使脑AVM治愈率明显提高,而且与治疗相关的各种并发症和病死率也明显降低。Abstract: Objective: To evaluate the efficacy of multimodality treatment of cerebral arteriovenous malformations(AVMs) with surgery, embolization and γknife radiation. Methods : A retrospective analysis of 43 cases of cerebral AVMs applied with multimodality treatment in our department From March 2002 to July 2009 has been made, meanwhile we have analyzed and assessed the clinical characteristics and treatment outcome of these 43 patients with cerebral AVMs. Results : Patients received multimodality treatment with embolization followed by surgery(n=3), embolization followed by γknife radiation(n=26), surgery followed by γknife radiation(n=11), or embolization, surgery, and γknife radiation(n=3). Postoperative followup of 28 cases, the followup time is 4 months to 7 years and 6 months. GOS score 5 in 25 cases, who can be able to return to work or school. GOS score 4 in 2 cases, who can be able to live independently. GOS score 1 in 1 case, who is dead. Conclusion : In the cerebral AVMs which are large, or located within or immediately adjacent to eloquent regions of the brain, or have deep venous drainage, multimodality treatment has some superiority. It can not only improve the cure rate of cerebral AVMs significantly, but also reduce the treatmentrelated complications and mortality.
【Abstract】Objective To research relation of apoptosis muscular cell in 103Pd radioactive stent of dog biliary muscular formation and inhibition of biliary ductal stricture. Methods Twelve dogs were randomly divided into two groups, which were general stent group and 103Pd radioactive stent group. General stent and 103Pd radioactive stent were respectively put into extrahepatic biliary tract of two groups. After 30 days all dogs were killed, and biliary tract were taken out. Apoptotic cells were detected by immunohistochemical methodsand agar electrophoresis, and nucleus browyellow was positive cell. Dog biliary duct cross-sections were stained by hematoxylin-erosin; area and perimeter of lumen,thickness of inner membrane and stenosis degree in bile duct were analysed by image analysis software of computer.Results The apoptotic biliary duct smooth muscle cell ［(87.9±7.96)/cm2］ was more significantly increased in the 103Pd radioactive stent group than in the general stent group ［(5.6±0.51)/cm2］, P＜0.05; and comparing with the general stent group, the 103Pd radioactive stent significantly reduced biliary muscular formation thickness. Conclusion The result shows that 103Pd radioactive stent can inhibit proliferation of biliary ductal smooth muscle cell.
Objective To evaluate the effectiveness and prognosis of patients in advanced hepatocellular carcinoma (HCC) with portal vein (PV) tumor thrombus received external-beam radiation therapy (EBRT). Methods The clinical data of 126 HCC patients with PV tumor thrombus who were referred for EBRT at our institution from January 2000 to November 2009 were analyzed retrospectively. EBRT was designed to focus on the tumor thrombus with or without primary intrahepatic tumors， to deliver a median total conventional dose of 50 Gy (range of 30-60 Gy). Predictors of survival were identified using univariate and multivariate analysis. Results Unfavorable pretreatment predictors were associated by multivariate analysis with lower albumin and higher α-fetoprotein levels, poorer Child-Pugh liver function classification, poorer intrahepatic tumor control， lymph node metastases， and the two-dimensional EBRT technique. The dose of EBRT showed no significant in both univariate and multivariate survival analysis. Conclusions In patients with HCC， EBRT is effectively prevents progression in cases of PV tumor thrombus， but palliative dose of EBRT is not related to survival.EBRT is not related to survival.
The simultaneous objectives of destroying tumor cells while protecting normal pelvic organs present a dual clinical and technical challenge within the realm of pelvic tumor radiotherapy. This article reviews the latest literatures, focusing on technological innovations in key aspects of radiotherapy such as positioning, planning, and delivery. These include positioning fixation techniques, organ-at-risk avoidance irradiation, non-coplanar irradiation techniques, as well as organ displacement protection and image-guided adaptive techniques. It summarizes and discusses the research progress made in the protection of critical organs during pelvic tumor radiotherapy. The paper emphasizes technological advancements in the protection of critical organs throughout the processes of radiotherapy positioning, planning, and implementation, aiming to provide references for further research on the protection of critical organs in the external irradiation treatment of pelvic tumors.
ObjectiveTo summarize clinical application progress of stereotactic radiotherapy for primary hepatocellular carcinoma. MethodsThe literatures about the research progress of the stereotactic radiotherapy for primary hepatocellular carcinoma were reviewed. ResultsRadiotherapy for hepatocellular carcinoma is importantly based on the radiation biology of the liver and the radiophysics of the liver cancer. Stereotactic precision radiotherapy is an effective and low toxic treatment for early hepatocellular carcinoma, moreover, it alone or in combination with microwave ablation, hepatic artery chemoembolization for unresectable hepatocellular carcinoma is safe and effective method for the treatment. ConclusionsThe optimal dose model for hepatocellular carcinoma, hepatocellular carcinoma radical dose level are problems that need further exploration, and radiobiology, radiation physics research must be strengthened to explore it, stereotactic precision radiotherapy treatment modalities in the treatment of hepatocellular carcinoma position will become increasingly people attention.
Objective To investigate the clinical factors and dosimetric parameters associated with grade≥2 radiation pneumonitis (RP) after thoracic radiotherapy in patients with locally advanced non-small cell lung cancer (NSCLC). Methods The clinical factors and dosimetric parameters in patients with locally advanced NSCLC who received thoracic radiotherapy at West China Hospital of Sichuan University between January 2016 and January 2018 were retrospectively analyzed. The potential factors associated with the occurrence of grade≥2 RP were analyzed with logistic regression analysis. Results A total of 104 patients were included, and the incidence rate of grade≥2 RP was 19.2%. Multivariate logistic regression analysis showed that the percentage of the heart volume that received more than 20 Gy (V20) [odds ratio (OR)=1.068, 95% confidence interval (CI) (1.004, 1.137), P=0.036], lung mean dose (Dmean) [OR=1.003, 95%CI (1.000, 1.006), P=0.031] and superior vena cava Dmean [OR=1.001, 95%CI (1.000, 1.001), P=0.041] were associated with grade≥2 RP. Receiver operating characteristic (ROC) curve analysis showed that the area under the ROC curve combined with heart V20, lung Dmean and superior vena cava Dmean to predict grade≥2 RP was 0.839 [95%CI (0.752, 0.926)]. In addition, the optimal critical values for heart V20, lung Dmean and superior vena cava Dmean to predict grade≥2 RP were 20%, 13 Gy and 38 Gy, respectively. Conclusions Heart V20, lung Dmean and superior vena cava Dmean are associated with grade≥2 RP after thoracic radiotherapy in patients with locally advanced NSCLC. In addition, taking heart V20<20%, lung Dmean<13 Gy and superior vena cava Dmean<38 Gy as normal organ dose limits may reduce the risk of grade≥2 RP after thoracic radiotherapy for locally advanced NSCLC patients.