原发性子宫大B细胞淋巴瘤一例报告及文献复习

摘要 目的：总结原发性子宫恶性淋巴瘤的临床表现、影像及病理学特点,以期提高对原发性子宫恶性淋巴瘤的认识及诊治水平。方法：通过PubMed、万方、维普、中国知网数据库检索2001年1月至2019年12月报道的原发性子宫恶性淋巴瘤的文献,结合首都医科大学附属北京妇产医院收治的1例原发性子宫大B细胞淋巴瘤的病例资料,对此类患者临床表现、影像及病理学特点、治疗方案及预后进行总结。结果：患者女,64岁,发现盆腔肿物半月伴有绝经后阴道流血,盆腔CT提示：宫体与宫颈局部巨大团块状软组织密度灶,宫底及宫体上段可见内膜。宫腔镜下组织活检病理：（宫内物）符合低分化恶性肿瘤,结合免疫组化结果,诊断原发性子宫大B细胞淋巴瘤。行开腹全子宫及双侧附件、大网膜及腹膜后淋巴结清扫术,术后接受CHOP方案化疗六程,现治疗后随访17月,未发现复发。结论：原发性子宫恶性淋巴瘤极少见,组织学上以大B 细胞淋巴瘤为主,临床表现缺乏特异性。最终需要结合免疫组化确诊。该疾病恶性程度高,治疗上以根治性手术联合化疗为主,预后较差。     

Assessment of skin dose in breast cancer radiotherapy: on-phantom measurement and Monte Carlo simulation

AimThe main purpose of the present study is assessment of skin dose in breast cancer radiotherapy.BackgroundAccurate assessment of skin dose in radiotherapy can provide useful information for clinical considerations.Materials and methodsA RANDO phantom was irradiated using a 6 MV Siemens Primus linac with medial and tangential radiotherapy fields for simulating breast cancer treatment. Dosimetry was also performed on various positions across the fields using an EBT3 radiochromic film. Similar conditions of measurement on the RANDO phantom including field size, irradiation angle, number of fields, etc. were subsequently simulated via the Monte Carlo N-Particle Transport code (MCNP). Ultimately, dose values for corresponding points from both methods were compared.ResultsConsidering dosimetry using radiochromic films on the RANDO phantom, there were points having underdose and overdose based on the prescribed dose and skin tolerance levels. In this respect, 81.25% and 18.75% of the points had underdose and overdose, respectively. In some cases, several differences were observed between the measurement and the MCNP simulation results associated with skin dose.ConclusionBased on the results of the points which had underdose, it was suggested that a bolus should be used for the given points. With regard to overdose points, it was advocated to consider skin tolerance dose in treatment planning. Differences between the measurement and the MCNP simulation results might be due to voxel size of tally cells in simulations, effect of beam’s angle of incidence, validation time of linac’s head, lack of electronic equilibrium in the build-up region, as well as MCNP tally type.     

Positioning accuracy of a single-isocenter multiple targets SRS treatment: A comparison between Varian TrueBeam CBCT and Brainlab ExacTrac

PurposeThis study compared the positioning accuracy between cone-beam CT (CBCT) and ExacTrac (ETX) for a single-isocenter multiple target stereotactic radiosurgery (SRS) on two TrueBeam STx systems.MethodsA single-isocenter treatment plan was simulated on an anthropomorphic head phantom with six spherical steel ball bearings (BBs). One of the BBs was chosen to be the isocenter. The five off-isocenter targets were located at various distances from the isocenter. MV portal images were generated to evaluate the deviations between the expected and the real center of the targets after CBCT and ETX positioning, respectively.ResultsThe evaluation of the positioning accuracy for the isocenter target showed that CBCT and ETX positioning provided comparable, sub-millimetric results. Deviations in positioning accuracy were also calculated for all other targets, also showing comparable results for CBCT and ETX. Moreover, our study showed that the deviation between CBCT and ETX positioning were in better agreement for TBSTx1 and deviated slightly higher on TBSTx2 (maximum: 1.23 mm at S/I direction), due to a less perfect alignment between the CBCT coordinate system and the ETX coordinate system on TBSTx2 compared to TBSTx1. This study also showed a correlation between the target positioning accuracy and the distance to the isocenter.ConclusionThe positioning accuracy of ETX and CBCT for targets located at isocenter and off-isocenter locations was compared on two treatment machines and found comparable. Our study highlights the importance of a proper calibration procedure, to ensure correct alignment between the CBCT, ETX and machine coordinate systems.     

Calibration of MTT assay in proton beams using radiochromic films

PurposeThis study provides methodology of calibrating as well as controlling the output for an MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) colorimetric assay irradiated in a low energy proton beam using EBT3-model GAFCHROMIC^TM film, without correcting for quenching effect.MethodsA calibrated Markus ionization chamber was used to measure the depth dose and beam output for 26.5 MeV protons produced by a CS30 cyclotron. A time-controlled aluminum cylinder was added in front of the horizontal beam-exit serving as a radiation shutter. Following the TRS-398 reference dosimetry protocol for proton beams, the output was calibrated in water at a reference depth of 3 mm. EBT3 film was calibrated for doses up to 8 Gy at the same depth. To verify the dose distribution for each 96-well MTT assay plate, EBT3 film was placed at the reference depth during irradiation and cell doses were scaled by measured percent depth dose (PDD) data.ResultsThe radiochromic film dosimetry system in this study provides dose measurements with an uncertainty better than 3.3% for doses higher than 1 Gy. From a single exposure and utilizing the Gaussian shape of the beam, multiple dose points can be obtained within different wells of the same plate ranging from 6.9 Gy (sigma ∼4%) in the central well, and 2 Gy (sigma ∼8%) for wells positioned closer to the periphery.ConclusionsWe described a methodology for radiochromic film-based dose monitoring system, using low-energy protons, which can be used for the MTT assay in any proton beam, except within Bragg peak region.     

Management of pine wilt disease vectoring Monochamus alternatus adults using spray and soil application of Metarhizium anisopliae JEF isolates

Chemical control is widely used to control the Japanese pine sawyer beetle, Monochamus alternatus, but strong chemical regulations require an environmentally sound management strategy. In this work, we investigated the use of entomopathogenic fungi and their application as a means of practical pest management. Thirty-two diverse species of fungal isolates were assayed against adult pine sawyer beetles using a contact method under laboratory conditions, and four isolates showed over 70% virulence consequently. These isolates, two each of Beauveria bassiana and Metarhizium anisopliae were sprayed on the adult beetles at 1 × 10⁷ conidia/ml in plastic containers, respectively. The M. anisopliae-treated adult beetles showed 67% mortality. M. anisopliae isolates JEF-197 and JEF-279 demonstrated dosage-dependent insecticidal activity. Following the laboratory experiments, semi-field trials were conducted in young pine trees under high (RH 94%) and low (RH 35%) humidity conditions. In the high humidity conditions, most of the adult beetles stayed on the top of the branches. When the two M. anisopliae isolates were sprayed on the beetles, they showed ca. 50–70% insecticidal activity 11 days after application. In contrast, in low humidity conditions, the adult beetles tried to move off the branches and onto the soil. When the beetles reached the JEF-197 and JEF-279-treated soil, we measured >90% insecticidal activity. This work suggests that M. anisopliae was the most virulent entomopathogenic fungus against adult Japanese pine sawyer beetles, and this forest insect could be ecologically controlled by the spray and soil application of the M. anisopliae isolates.     

细胞程序性死亡因子家族分子在细胞凋亡中的调控作用

细胞程序性死亡因子(programmed cell death,PDCD)是一类与肿瘤发展相关并在进化上高度保守的蛋白质。PDCD家族由多个成员构成。其中,研究较为深入的包括PDCD1、PDCD2、PDCD4、PDCD5、PDCD6、PDCD7、PDCD8及PDCD10。PDCD在人类的各组织及细胞中广泛分布,其主要功能是对细胞凋亡的调控。目前研究发现,PDCD家族成员可通过不同信号通路实现对肿瘤细胞活力的调控,且某些家族成员的缺失或过表达都会引起机体发生病变,证明其在多种疾病当中具有重要作用。本文汇总了PDCD1、PDCD2、PDCD4、PDCD5、PDCD6、PDCD7、PDCD8、PDCD9、PDCD10、PDCD11、PDCD12的基因结构与蛋白质结构,介绍了各家族成员在细胞程序性死亡过程中的关系,并总结目前所报道的PDCD家族成员在肿瘤,以及多种疾病中所发挥的调控作用,以期帮助科研工作者了解其在细胞凋亡中的作用,以及为肿瘤和相关疾病发生发展的分子机制提供参考。     

In vitro antibacterial activities of methanol and aqueous leave extracts of selected medicinal plants against human pathogenic bacteria

People use medicinal plants as diet, and for treatment of infectious and noninfectious diseases and they use brief procedures like frying and cooking to do so. Medicinal plants; Moringa oleifera, Azadirachta indica, and Lepidium sativum which is believed to have active components that help to treat and manage various diseases were investigated for their antibacterial activities against Staphylococcus aureus, Salmonella Typhi, Streptococcus agalactiae and Shigella boydii. Solvent methanol and aqueous were used for extraction of crudes by means of maceration. Susceptibility testing was determined by using disc diffusion method and Minimum inhibitory concentration was determined by broth dilution method. Heat treated plant material activity against test pathogen was aimed to identify resistance capacity of plant material at different interval of time and temperature. All plant extracts under study was active against all tested pathogen after exposure to 45 °C for 30 min. The antibacterial activities of the non-heat-treated extracts of Azadirachta indica were relatively low; the results of this study show that extracts of Azadirachta indica have better residual antibacterial activities. Methanol extracts of all plant leaves showed highest activity as compared to the aqueous extracts. This is probably assigning the choice of extraction solvent for extracting desired active phytochemical from plants. Many of the people in the study area were illiterate and they did not have awareness about the ways use of medicinal plants. They use the medicinal plants by cooking and frying for different purposes. In the main, plant material can be affected as the temperature of treatment is increases with respect to various times of exposures.     

Pentoxifylline with metformin treatment improves biochemical parameters in patients with nonalcoholic steatohepatitis

BackgroundThe progression of the nonalcoholic fatty liver disease to nonalcoholic steatohepatitis (NASH) is multifactorial, and there is still a lack of approved medications for its treatment. The study aimed to evaluate the impact of combined treatment with Pentoxifylline and Metformin on biochemical parameters in patients with Nash. Setting: Outpatient hepatology clinic.MethodsA prospective trial was conducted. The first cohort included patients with biopsy-proven Nash, while the second cohort consisted of patients with biopsy-confirmed NAFLD. Blood tests were checked at baseline and every three months. Pentoxifylline at a dosage of 400 mg t.i.d. and Metformin at the dosage of 500 mg t.i.d. were introduced for six months in Nash group. The impact of the treatment was assessed based on biochemical results after combined treatment with low-cost medications.ResultsAll 33 Nash patients completed 24 weeks of treatment. We observed significant improvement (p<0.05) of median values after treatment for the following parameters: serum uric acid levels decreased by 51.0 mmol/L, calcium decreased for 0.27 mmoL/L, magnesium showed an increase of 0.11 mmoL/L. Insulin resistance improved as a reduction of HOMA - IR by 1.3 was detected. A significant decrease of median in liver enzymes, alanine aminotransferase, aspartate aminotransferase and gamma-glutamyltransferase by 24.0 U/L, 9.1 U/L, 10.8 U/L respectively, was noted.ConclusionsPentoxifylline and Metformin may provide possible treatment option in Nash. Some new potential benefit of the therapy in improving liver function whilst decreasing cardiovascular risk was perceived.     

大兴安岭泥炭地不同菌根类型木本植物叶片凋落物分解及其温度敏感性差异

以我国大兴安岭多年冻土区泥炭地常见的3种外生菌根木本植物(细叶沼柳Salix rosmarinifolia、白桦Betula platyphylla和柴桦B.fruticosa)和4种欧石楠菌根木本植物(笃斯越桔Vaccinium uliginosum、狭叶杜香Ledum palustre、甸杜Chamaedaphne calyculata和小叶杜鹃Rhododendron parrifolum)为研究对象,通过315天培养试验测定10和20℃叶片凋落物分解过程中的碳(C)累积矿化量和重量损失,并分析其温度敏感性。结果表明:外生菌根植物叶片凋落物的C矿化量和重量损失在10和20℃均高于欧石楠菌根植物;外生菌根植物凋落物分解过程中C矿化量的温度敏感性系数高于欧石楠菌根植物,但重量损失的温度敏感性系数低于欧石楠菌根植物;在每一培养温度下,C矿化量和重量损失均与凋落物全氮(N)和全磷(P)浓度呈正相关,与C/N和C/P呈负相关;尽管C矿化量的温度敏感性系数与凋落物初始化学组成无显著相关性,但重量损失的温度敏感性系数与凋落物全N和全P浓度呈负相关,与C/N和C/P呈正相关。本研究结果为认识和预测气候变暖及其引起的物种组成变化对北方泥炭地植物凋落物分解的影响提供理论依据。