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OBJECTIVE: To investigate the effect of miR-17-5p on vascular lesion and expression of very low density lipoprotein receptor (VLDLR) in atherosclerotic (AS) mice. METHODS: ApoE-/- mice were fed with high fat diet for 15 weeks to establish atherosclerotic mice models, and these mice were injected with miR-17-5p inhibitor antagomiR-17-5p 20 mg/kg from week 13 to week 15 to interfere the expression of miR-17-5p. AS model group (injection of normal saline) and NC miRNA group (injection of negative control inhibitors) were set and C57BL/6 mice were fed with normal diet for 15 weeks as normal control group (NC group, injection of normal saline during week 13-15). HE staining was used to detect the pathological changes of arterial vessels in each group and the vascular morphological changes were measured as well, so as to investigate the therapeutic effect of interfering miR-17-5p on AS vascular lesions. According to the prediction of Targetscan target gene prediction database, VLDLR as the target gene of miR-17-5p, the distribution of VLDLR in vascular tissues of mice in each group was observed by immunofluorescence. The effect of miR-17-5p on the expression of VLDLR mRNA in the arterial tissues of each group was detected by real-time PCR, and the changes of VLDLR protein expression caused by miR-17-5p in the arterial tissues in each group was detected by Western blot. RESULTS: The results of HE staining showed thatcompared with the NC group, the AS model group had obvious plaques in vascular endothelium, smooth muscle cell disorder and intimal hyperplasia, while the antagomiR-17-5p treated mice had significantly less lesions compared with the NC miRNA group. The intimal area of mice in the AS model group was bigger compared with NC group, but decreased after the inhibition of miR-17-5p. There was no statistically significant difference in the area of the media in each group. Vascular lumen area was smaller and intima/media ratio (I/M) values were lower in the AS model group and the NC miRNA group compared with the NC group, while the antagomiR-17-5p group alleviated this effect (P<0.05). Immunofluorescence showed that the expression of VLDLR in the AS model group was decreased, and that in the antagomiR-17-p group was higher than that in the NC miRNA group. The expression of VLDLR gene in the AS model group was lower than that in the NC group (P<0.01), while the VLDLR gene expression was higher in the antagomiR17-p group than that in the NC miRNA group (P<0.05). The results of VLDLR expression detected by Western blot were similar. CONCLUSION: miR-17-5p inhibitors may effectively alleviate the pathological changes of arterial vessels in AS mice by up-regulating the expression of VLDLR in arterial tissues, and may become a new therapeutic target for AS disease.
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Aterosclerosis/terapia , MicroARNs/antagonistas & inhibidores , Receptores de LDL/metabolismo , Animales , Aterosclerosis/patología , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados para ApoERESUMEN
OBJECTIVE: To identify the features of Chinese genetic prion diseases. METHODS: Suspected Creutzfeldt-Jakob disease (CJD) cases that were reported under CJD surveillance were diagnosed and subtyped using the diagnostic criteria issued by the WHO. The general information concerning the patient, their clinical, MRI and EEG data, and the results of CSF 14-3-3 and PRNP sequencing were carefully collected from the database of the national CJD surveillance program and analyzed using the SPSS 11.5 statistical software program. RESULTS: Since 2006, 69 patients were diagnosed with genetic prion diseases and as having 15 different mutations. The median age of the 69 patients at disease onset was 53.5 years, varying from 19 to 80 years. The majority of patients displaying clinical symptoms were in the 50-59 years of age. FFI, T188K gCJD and E200K were the three most common subtypes. The disease appeared in the family histories of 43.48% of the patients. The clinical manifestations varied considerably among the various diseases. Patients who carried mutations in the N-terminus displayed a younger age of onset, were CSF 14-3-3 negative, had a family history of the condition, and experienced a longer duration of the condition. The clinical courses of T188K were significantly shorter than those of FFI and E200K gCJD, while the symptoms in the FFI group appeared at a younger age and for a longer duration. Moreover, the time intervals between the initial neurologist visit to the final diagnosis were similar among patients with FFI, T188K gCJD, E200K gCJD and other diseases. CONCLUSION: The features of Chinese genetic prion diseases are different from those seen in Europe and other Asian countries.
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Encéfalo/patología , Síndrome de Creutzfeldt-Jakob/diagnóstico , Priones/genética , Proteínas 14-3-3/análisis , Proteínas 14-3-3/genética , Adulto , Anciano , Anciano de 80 o más Años , Pueblo Asiatico/genética , Secuencia de Bases , China/epidemiología , Síndrome de Creutzfeldt-Jakob/clasificación , Síndrome de Creutzfeldt-Jakob/epidemiología , Monitoreo Epidemiológico , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Proteínas Priónicas , Análisis de Secuencia de ARN , Adulto JovenRESUMEN
Since 2006, China has conducted the surveillance program for Creutzfeldt-Jakob disease (CJD) and other subtypes of prion diseases covering 12 provinces. In this study, the characteristics and special role of Beijing CJD surveillance network in the national CJD surveillance system were analyzed. Based on the registered permanent resident places, all reporting suspected CJD cases and diagnosed CJD cases via Beijing CJD surveillance network between 2006 and 2013 were grouped as the cases from Beijing and from outside of Beijing. Both numbers of the suspected and diagnosed CJD cases via Beijing CJD surveillance network constantly increased along with the years, totally 532 reporting cases and 192 diagnosed CJD cases were obtained in the past 8 y. About 75% of suspected and diagnosed CJD cases via Beijing CJD surveillance network came from other provinces, mainly from neighboring provinces. Altogether, 46 different hospitals in the Beijing region have reported suspected CJD cases to the CJD surveillance system during the period from 2006 to 2013. Five hospitals continually reported suspected CJD cases during those 8 y and 5 other hospitals had reported cases except for 1 to 2 y. Additionally, we found that the diagnosed CJD patients from Beijing region had less numbers of hospital transfer and shorter interval from the disease onset to the final diagnosis than those outside of Beijing. It indicates that as the most important component, Beijing CJD surveillance network functions more actively, which supplies the special medical services not only for Beijing residents but also for patients from all of China.
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Síndrome de Creutzfeldt-Jakob , Vigilancia de la Población/métodos , Beijing , China , HumanosRESUMEN
A population-based case-control study was conducted to evaluate the relative factors in the environments, agricultural works, outdoor activities, and the effectiveness of Lyme borreliosis (LB)- associated personal protective measures in Beijing. Thirty-four cases and 272 controls were personally interviewed by well-trained interviewers. Venous blood samples were taken from each subject. Sowing or harvesting in summer (OR=2.571, 95% CI: 1.109-5.962), living in house with weeding in the yard (OR=2.247, 95% CI: 1.062-4.755), and residence at the plain area (OR=2.630, 95% CI: 1.050-6.588) were the independent relative factors for seropositive LB. Wearing long pants and clothes with cuffs was the only protective behavior against tick bite (OR=0.186, 95% CI: 0.041-0.846). The findings showed that local farmers were easily infected with LB and almost no protective measure was taken against LB infection. Infection with LB was easier in residents of plain regions. Pets raising and outdoor activities were not the risk factors for infection with LB. Further studies are needed to fully understand the risk of infection with LB in China.
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Enfermedad de Lyme/epidemiología , Enfermedad de Lyme/prevención & control , Adulto , Anciano , Agricultura , Estudios de Casos y Controles , China/epidemiología , Ciudades , Ambiente , Femenino , Actividades Humanas , Humanos , Enfermedad de Lyme/microbiología , Masculino , Persona de Mediana Edad , Factores de Riesgo , Adulto JovenRESUMEN
OBJECTIVE: To explore seroepidemiological status and vaccine coverage of hepatitis B in children aging under 15 years old in Chaoyang district of Beijing. METHODS: A total of 1602 children aging under 15 years old, residents or floating population who had lived here more than six months, were randomly selected by multistage cluster sampling, from Chaoyang district of Beijing in year 2010. The demographic information and vaccine coverage of hepatitis B vaccine (HepB) were collected by self-designed questionnaire.5 ml blood was collected from each subject and the serum HBsAg, anti-HBs and anti-HBc were detected by Abbott microparticle enzyme-linked immunoassay. Those whose HBsAg was positive were then tested HBeAg and anti-HBe. The positive rate of hepatitis B indicators and coverage rate of HepB in different population were compared. RESULTS: The positive rate of HBsAg, anti-HBs and anti-HBc were 0.56% (9/1602), 64.17% (1028/1602) and 2.12% (34/1602), respectively; while the age standardized rates were separately 0.57%, 66.36% and 1.98%; and the gender-adjusted rates were 0.56%, 64.23% and 2.12% respectively. The positive rate of anti-HBs was statistically significant (χ(2) = 165.445, P = 0.000). The positive rate of anti-HBs was up to 90.73% (235/259) among 1-2 years old children, followed by 76.22% (141/185) among 13 - 15 years old children, 67.21% (166/247) among 3 - 4 years old children, 61.22% (150/245) among 9 - 10 years old children, 60.68% (142/234) among 11 - 12 years old children, 49.05% (103/210) among 5 - 6 years old children and 40.99% (91/222) among 7 - 8 years old children. The average coverage rate of HepB was 90.44% (1371/1516), separately 93.76% (661/705) in residents and 87.55% (719/811) in floating population. The difference was statistically significant (χ(2) = 16.829, P = 0.000). CONCLUSION: HBsAg positive rate in children under 15 years old in Chaoyang district of Beijing dropped to less than 1% and the coverage rate of HepB had reached over 90%. It is suggested that we should pay more attention to increase the coverage rate of HepB among floating children under 15 years old.
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Anticuerpos contra la Hepatitis B/sangre , Hepatitis B/epidemiología , Hepatitis B/prevención & control , Vacunación/estadística & datos numéricos , Adolescente , Niño , Preescolar , China/epidemiología , Femenino , Vacunas contra Hepatitis B/administración & dosificación , Humanos , Lactante , Masculino , Estudios SeroepidemiológicosRESUMEN
AtNUDT5 is a cytosol Nudix that catalyzes the hydrolysis of a variety of substrates. In this report, a 1,387-bp 5'-flanking region of the AtNUDT5 gene was isolated from Arabidopsis thaliana. The tissue-specific activity of the 5'-flanking region was investigated by using the GUS gene as a reporter in transgenic A. thaliana plants. Weak GUS activity appeared in vascular tissues of young plants, strong GUS activity appeared in the axial roots, but no GUS activity was observed in the root cap, lateral roots, rosette leaf, mature silique and reproductive tissues such as stamen, pistil, and petal. Furthermore, by using these transgenic A. thaliana plants, results of the histochemical staining and fluorometric assays of GUS activity showed that the AtNUDT5 promoter can be activated by both avirulent Pst avrRpm1 and virulent Pst strains at 5 h post-infiltration and that the activity of AtNUDT5 promoter increased significantly at 24 h post-infiltration. Taken together, our results demonstrated that the AtNUDT5 promoter is pathogen-responsive. The promoter may be used to develop transgenic plants with an increased tolerance to pathogenic stresses.
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Proteínas de Arabidopsis/genética , Arabidopsis/genética , Proteínas Bacterianas/genética , Regulación de la Expresión Génica de las Plantas , Raíces de Plantas/genética , Pseudomonas syringae/genética , Pirofosfatasas/genética , Región de Flanqueo 5' , Arabidopsis/metabolismo , Arabidopsis/microbiología , Proteínas de Arabidopsis/metabolismo , Proteínas Bacterianas/metabolismo , Secuencia de Bases , Flores/genética , Flores/metabolismo , Flores/microbiología , Interacciones Huésped-Patógeno , Datos de Secuencia Molecular , Hojas de la Planta/genética , Hojas de la Planta/metabolismo , Hojas de la Planta/microbiología , Raíces de Plantas/metabolismo , Raíces de Plantas/microbiología , Tallos de la Planta/genética , Tallos de la Planta/metabolismo , Tallos de la Planta/microbiología , Plantas Modificadas Genéticamente , Regiones Promotoras Genéticas , Pseudomonas syringae/metabolismo , Pirofosfatasas/metabolismo , Hidrolasas NudixRESUMEN
Eight cases of rare genetic Creutzfeldt-Jakob disease (gCJD) with a mutation T188K in PRNP have been identified and diagnosed genetically in China since 2006. Among the eight cases, the median age of disease onset was 58years old (ranging from 39 to 76years old). Progressive dementia and pyramidal or extrapyramidal dysfunction appeared in all cases and lasted during the entire clinical course. Myoclonus and visual or cerebellar disturbances were also frequently observed. The median duration of disease was 3months. Cerebral MRI findings revealed high caudate and putamen signals in four out of eight cases. CSF in six out of eight patients tested positive for the 14-3-3 protein. Only one case showed periodic sharp-waves (PSW) in EEG. Most cases lacked a family history of associated diseases, though one patient's mother died of a neurologic disorder without a definite diagnosis. Our data reveal that Chinese T188K gCJD cases have clinical characteristics similar to that of sporadic CJD (sCJD). Compared with other inherited prion disease-associated mutations in China, the genetic frequencies of T188K in PRNP of Han-Chinese are relatively high.
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Síndrome de Creutzfeldt-Jakob/diagnóstico , Síndrome de Creutzfeldt-Jakob/genética , Mutación , Priones/genética , Proteínas 14-3-3/líquido cefalorraquídeo , Adulto , Anciano , China , Femenino , Humanos , Masculino , Persona de Mediana Edad , LinajeRESUMEN
OBJECTIVE: To explore the family aggregation and risk factors of hepatitis B virus (HBV) transmission in Chaoyang district of Beijing. METHODS: A total of 5266 families were randomly selected for the multi-stage cluster sampling study in Chaoyang district of Beijing in 2010. The family members who aged between 1 and 70 years old and lived constantly in Beijing for over half a year, were recruited as subjects. There were 14 491 subjects in total, including temporary residents who did not have Beijing household account, except foreigners. 5 ml venous blood was drawn from every subject. A self-designed questionnaire was used to collect the basic information of the population and the risk factors of the hepatitis B transmission. Microparticle enzyme-linked immunoassay was applied to test five indicators of hepatitis B. Negative binomial distribution test was used among the HBsAg positive families to calculate the family aggregation rate of hepatitis B. Single factor analysis and multi-factor logistic regression model were used to analyze the risk factors of HBV transmission. RESULTS: In all, 308 out of 5266 families had HBsAg positive members, accounting for 5.85%.383 out of 14 410 subjects were HBsAg positive, rating at 2.66%. The HBsAg positive rate among subjects under 14 years old was the lowest, at 0.56% (9/1603); and the positive rate among subjects aging between 35 and 44 years old was the highest, at 4.27% (47/1029). Negative binomial distribution test showed that the family aggregation rate of HBV infection was 7.66% (χ² = 15.10, P < 0.05). The analysis of family aggregation of HBsAg positive showed that 17.39% (8/46) of the transmission was from father to child, 13.04% (6/46) was from mother to child, 30.44% (14/46) was between couples, and another 39.13% (18/46) was between siblings or other relatives. Both single factor analysis and multi-factor logistic regression analysis showed that hepatitis B positive family members (OR = 5.40, 95%CI: 5.24 - 5.55), hepatitis B positive friends and colleagues (OR = 1.55, 95%CI: 1.11 - 1.99) and blood donation and transfusion history (OR = 1.96, 95%CI: 1.76 - 2.15) were the risk factors of HBV infection. CONCLUSION: HBV transmission showed family aggregation in Beijing, however, the risk factors needed further studies.
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Composición Familiar , Hepatitis B/epidemiología , Hepatitis B/transmisión , Adolescente , Adulto , Anciano , Portador Sano , Niño , Preescolar , China/epidemiología , Femenino , Virus de la Hepatitis B , Humanos , Lactante , Masculino , Persona de Mediana Edad , Factores de Riesgo , Adulto JovenRESUMEN
In 2006, an unusual nosocomial outbreak of anaplasmosis occurred in Anhui Province, China. To follow these emerging tickborne-rickettsioses, a larger survey of Ehrlichia chaffeensis and Anaplasma phagocytophilum seroprevalence among farm worker populations, and the divergence of the partial 16S rRNA gene sequences of A. phagocytophilum among domestic animals, were conducted in Yanqing, Miyun, and Tongzhou Counties in Beijing from March to April, 2009. Blood samples from 562 farmers, 90 goats, 73 cattle, and 2 dogs were collected. IgG antibodies against E. chaffeensis and A. phagocytophilum were assayed by micro-indirect immunofluorescence assay (IFA). Partial fragments of 16S rRNA genes of A. phagocytophilum were amplified from blood DNA from domestic animals and their sequences analyzed. The total E. chaffeensis and A. phagocytophilum seroprevalence among the farm worker population was 16.4% and 14.1%, respectively. For domestic animals, the seropositive rates of A. phagocytophilum for goats, cattle, and dogs, were 2.3%, 0%, and 0%, respectively. The PCR-positive rates for A. phagocytophilum in goats and cattle were 48.9% and 23.9%, respectively. Three dominant genetic groups of Chinese A. phagocytophilum isolates were determined for goats and cattle, and these isolate varieties were broadly identified in China, Japan, and Korea. The prevalence of E. chaffeensis and A. phagocytophilum among farmers and domestic animals in Beijing rural areas was also demonstrated. The diagnoses and differential diagnoses of these emerging infectious diseases should be emphasized in clinics, and further ecological investigation of E. chaffeensis and A. phagocytophilum vectors and hosts is needed.
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Anaplasma phagocytophilum/inmunología , Anaplasmosis/epidemiología , Ehrlichia chaffeensis/inmunología , Ehrlichiosis/epidemiología , Enfermedades por Picaduras de Garrapatas/epidemiología , Adulto , Agricultura , Anaplasma phagocytophilum/genética , Anaplasma phagocytophilum/aislamiento & purificación , Anaplasmosis/microbiología , Animales , Anticuerpos Antibacterianos/sangre , Secuencia de Bases , Bovinos , Enfermedades de los Bovinos/epidemiología , Enfermedades de los Bovinos/microbiología , China/epidemiología , Enfermedades de los Perros/epidemiología , Enfermedades de los Perros/microbiología , Perros , Ehrlichia chaffeensis/genética , Ehrlichia chaffeensis/aislamiento & purificación , Ehrlichiosis/microbiología , Femenino , Enfermedades de las Cabras/epidemiología , Enfermedades de las Cabras/microbiología , Cabras , Humanos , Masculino , Persona de Mediana Edad , Datos de Secuencia Molecular , Filogenia , Análisis de Secuencia de ADN , Estudios Seroepidemiológicos , Enfermedades por Picaduras de Garrapatas/microbiologíaRESUMEN
OBJECTIVE: To study the prevalence of hepatitis B infections and carrier status among general population in Chaoyang district, Beijing in 2010. METHODS: From May to December 2010, 14 491 subjects over 12 months old were selected by multistage random cluster sampling method from residents in Chaoyang district, Beijing. Five millilitre venous blood specimens were collected from these subjects to test hepatitis B virus antigens and antibodies. Status of hepatitis B infections were analyzed in different age, sex and registered permanent residence groups. RESULTS: The overall positive rate of surface antigen (HBsAg) was 2.66% (383/14 410). The lowest rate of 0.56% (9/1603) was found in the 1 to 14 years old group and the 35 to 44 years old group had the highest rate of 4.27% (92/2154). The rate in subjects younger than 24 years old was 1.03% (31/2986). The overall positive rate of surface antibody (anti-HBs) was 40.21% (5798/14 421). The highest positive rate of anti-HBs (80.59%, 407/505) was found in the 1 to 4 years old group. The overall positive rate of core antibody (anti-HBc) was 30.26% (4364/14 424). The overall hepatitis B virus infection rate was 30.32% (4364/14 393). For male and female groups, the positive rates of HBsAg were 2.93% (179/6108) and 2.44% (202/8287) respectively (χ² = 3.32, P > 0.05); anti-HBs were 41.93% (2563/6113) and 38.96% (3231/8293) respectively (χ² = 12.88, P < 0.01); and anti-HBc were 31.39% (1919/6114) and 29.39% (2438/8295) respectively (χ² = 6.65, P = 0.01). For local residents group and mobile population group, the positive rates of HBsAg were 2.46% (283/11 510) and 3.60% (98/2719) respectively (χ² = 11.08, P < 0.01); anti-HBs were 37.11% (4293/11 568) and 53.07% (1445/2723) respectively (χ² = 233.51, P < 0.01); and anti-HBc were 30.83% (3567/11 570), and 28.41% (774/2724) respectively (χ² = 6.08, P < 0.05). CONCLUSION: The positive rate of HBsAg in population younger than 24 years old has reached a relatively low level. The mobile population has significantly higher positive rate of HBsAg than local residents, indicating the need for enhancing prevention and control measures for hepatitis B for the mobile population and local residents over 25 years old.
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Hepatitis B/epidemiología , Adolescente , Adulto , Anciano , Niño , Preescolar , China/epidemiología , Femenino , Hepatitis B/sangre , Antígenos de Superficie de la Hepatitis B/sangre , Humanos , Lactante , Masculino , Persona de Mediana Edad , Prevalencia , Estudios Seroepidemiológicos , Población Urbana , Adulto JovenRESUMEN
OBJECTIVE: To investigate the status of Ehrlichia (E.) chaffeensis and Anaplasma (A.) phagocytophilum infection among farming populations and domestic animals in the rural area of Beijing, China. METHODS: Blood samples from 562 farmers and 163 blood samples including 90 goats, 71 ox and 2 dogs, were collected. Specificity of IgG antibodies against E. chaffeensis and A. phagocytophilum were tested by micro-indirect immunofluorescent assay (mIFA). 16S rRNA genes of A. phagocytophilum were amplified from the domestic animal blood samples and products were sequenced and analyzed by nested PCR. RESULTS: The positive rates of E. chaffeensis and A. phagocytophilum antibody were 16.5% and 14.0% respectively for farmers. The total positive rates of A. phagocytophilum were 2.3% and 0 for both goats and oxen respectively. No antibody was found for the 2 tested dogs. The PCR positive rates were 48.9% and 23.9% for goats and oxen respectively. Three dominant varieties of A. phagocytophilum were demonstrated in goats and oxen. CONCLUSION: The prevalence rates of E. chaffeensis and A. phagocytophilum were identified in the rural areas of Beijing.
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Anaplasma phagocytophilum/aislamiento & purificación , Ehrlichia chaffeensis/aislamiento & purificación , Ehrlichiosis/epidemiología , Adulto , Animales , Animales Domésticos/microbiología , Bovinos , China/epidemiología , Perros , Femenino , Cabras , Humanos , Masculino , Persona de Mediana EdadRESUMEN
An interesting phosphine-containing Lewis base catalyzed highly regioselective [3 + 2] cycloaddition and a novel nitrogen-containing Lewis base catalyzed highly geometric selective [4 + 2] cycloaddition of isatin derived α,ß-unsaturated diesters with α-allenic ester have been disclosed to give the corresponding cyclic products in good to excellent yields under mild conditions. A plausible reaction mechanism has also been proposed on the basis of previous literature and our own investigation.
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A novel phosphine-catalyzed highly diastereoselective [3+2] cycloaddition of isatin derived α,ß-unsaturated ketones with α-allenic ester has been developed.
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OBJECTIVE: To observe clinical therapeutic effect of acupuncture plus cupping for treating insomnia in college students. METHODS: Ninety two college students suffering from insomnia were randomly divided into a treatment group (52 cases) and a control group (40 cases). Acupuncture plus cupping was used for profiting the brain and tranquilizing the mind in the treatment group, and conventional differentiation of symptoms and signs was used in the control group. Therapeutic effect, number of treatment, self-rating sleeping scaling (SRSS), and subtracted rate were evaluated after one month of treatment. RESULTS: There was a significant difference in effective rate between the two groups (P < 0.05). For the cases with moderate insomnia, the effective rate was obviously better in the treatment group than that in the control group (P < 0.05), and for the cases with slight and moderate insomnia, the average treatment number was remarkably less in the former than that in the latter (P < 0.01). SRSS was reduced in both groups (P < 0.01, P < 0.05) with a significant difference between the two groups (P < 0.05). The subtracted rate in the former was more than that in the latter (P < 0.05). CONCLUSION: The therapeutic effect in the treatment group was better than that in the control group, showing superiority in the cases with moderate insomnia with less treatments and more improved and cured rates.
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Terapia por Acupuntura , Medicina Tradicional China , Trastornos del Inicio y del Mantenimiento del Sueño/terapia , Puntos de Acupuntura , Adolescente , Adulto , Femenino , Humanos , Masculino , Estudiantes , Resultado del Tratamiento , Adulto JovenRESUMEN
BACKGROUND AND OBJECTIVE: Radiotherapy is effective in treating nasopharyngeal carcinoma (NPC). This study evaluated the treatment efficacy, toxicity, and prognostic factors of intensity-modulated radiotherapy (IMRT) in the treatment NPC. METHODS: Between September 2003 and September 2006, 305 patients with NPC were treated with IMRT in Fujian Provincial Cancer Hospital. IMRT was delivered as follows: gross tumor volume (GTV) received 66.0-69.8 Gy in 30-33 fractions, high-risk clinical target volume (CTV-1) received 60.0-66.65 Gy, low-risk clinical target volume (CTV-2) and clinical target volume of cervical lymph node regions (CTV-N) received 54.0-55.8 Gy. Patients with stages III or IV disease also received cisplatin-based chemotherapy. All patients were assessed for local-regional control, survival, and toxicity. RESULTS: With a median follow-up of 35 months (range, 5-61 months), there were 16, 8, and 39 patients who had developed local, regional, and distant recurrence, respectively. The 3-year rates of local control, regional control, metastasis-free survival, disease-free survival, and overall survival were 94.3%, 97.7%, 86.1%, 80.3%, and 89.1%, respectively. Multivariate analyses revealed that T-classification had no predictive value for local control and survival, whereas N-classification was a significant prognostic factor for overall survival (P < 0.001), metastasis-free survival (P < 0.001), and disease-free survival (P = 0.003). For stages III-IV disease, concurrent and adjuvant chemotherapy did not influence prognosis. The most severe acute toxicities included Grade III mucositis in 14 patients (4.6%), Grade III skin desquamation in 90 (29.5%), and Grades III-IV leucocytopenia in 20 (6.5%). There were 7% patients with Grade II xerostomia after 2 years of IMRT, no Grades 3 or 4 xerostomia was detected. CONCLUSIONS: IMRT provided favorable locoregional control and survival rates for patients with NPC, even in those with locally advanced disease. The acute and late toxicities were acceptable. N-classification was the main factor of prognosis. Further study is needed on chemotherapy for patients with NPC.
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Neoplasias Nasofaríngeas/radioterapia , Radioterapia de Intensidad Modulada/métodos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Niño , Cisplatino/administración & dosificación , Terapia Combinada , Supervivencia sin Enfermedad , Femenino , Estudios de Seguimiento , Humanos , Leucopenia/etiología , Metástasis Linfática , Masculino , Persona de Mediana Edad , Mucositis/etiología , Neoplasias Nasofaríngeas/tratamiento farmacológico , Neoplasias Nasofaríngeas/patología , Recurrencia Local de Neoplasia , Estadificación de Neoplasias , Dosificación Radioterapéutica , Radioterapia de Intensidad Modulada/efectos adversos , Estudios Retrospectivos , Tasa de Supervivencia , Xerostomía/etiología , Adulto JovenRESUMEN
BACKGROUND & OBJECTIVE: Setup error is the key factor in determining the margin of planning target volume (M(PTV)) for conformal radiotherapy of nasopharyngeal carcinoma (NPC). This study was to establish a method using radiopaque fiducial markers which were embedded in occlusal splint ("occlusal splint method") to acquire setup errors to calculate M(PTV) in CRT for NPC. METHODS: The occlusal splint method was performed in 22 NPC patients who received CRT. Setup errors were calculated by comparing the coordinates of 3 fiducial markers read from portal images with those read from computed tomography (CT) data. According to the formulation, the size of MPTV with or without consideration of organ motion was also calculated. RESULTS: The standard deviations of systematic errors (Sigma) were 1.13 mm, 1.47 mm, and 1.31 mm in X (medio-lateral), Y (antero-posterior) and Z (cranio-caudal) axes, respectively; the standard deviations of random errors were 0.81 mm, 0.45 mm, and 0.80 mm in X, Y, and Z axes, respectively. Without consideration of organ motion, the sizes of M(PTV) were 3.40 mm, 3.98 mm, and 3.83 mm in X, Y, and Z axes, respectively; with consideration of organ motion, the sizes of M(PTV) were 3.75 mm, 4.35 mm, and 4.16 mm in X, Y, and Z axes, respectively. CONCLUSION: Using the "occlusal splint method", each institution can precisely calculate setup error data, and stipulate the size of M(PTV) adequate to one's own situation.