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Immunohistochemical expression of histone modification pattern in adult glioblastoma. 成人胶质母细胞瘤组蛋白修饰模式的免疫组化表达。
IF 1.3 4区 医学 Q3 Medicine Pub Date : 2024-01-01 Epub Date: 2022-11-18 DOI: 10.4103/jcrt.jcrt_257_22
B Archana, Lawrence D'Cruze, Sandhya Sundaram, Krishnakumar Ramanathan, Krishnamurthy Ganesh

Background: Despite the growing advances in molecular research and therapeutics, glioblastomas are still considered highly invasive aggressive tumors with a median survival of 15 months. Genetic alterations have been studied in detail; however, additionally, there is now growing evidence on the role of epigenetic alterations in glioblastoma. Recently, histone modification patterns have been found to have a significant part in gene expression and prognosis. However, further research in this field is warranted to establish its role for the betterment of these patients with the deadly disease.

Aims: To determine the immunohistochemical expression of histone modifications like histone-3-lysine-18 acetylation (H3K18Ac) and histone-4-lysine 20 trimethylation (H4K20triMe) in glioblastoma patients.

Materials and methods: This is a retrospective study of 48 glioblastoma patients who underwent surgery. Immunohistochemistry (IHC) for tri-methyl-histone-H4 (Lys20) (H4K20triMe) and acetyl-histone-H3 (Lys18) (H3K18Ac) was performed in paraffin-embedded tissues manually, and the expression was noted. Data on the mitotic index and overall survival was collected and statistically analyzed.

Results: The mean age was 50 years with a M: F ratio of 1.6:1. Out of 48 cases, 60% (28 cases) demonstrated positivity for H3K18Ac and 98% (46 cases) for H4K20triMe. The pattern of expression was nuclear with increased expression adjacent to necrosis and at the invasive front. The overall median Q score for H3K18Ac was 1/12 and for H4K20triMe was 6/12. No significant statistical significance was observed between histone expression, Ki67%, and overall survival.

Conclusion: Histone modification patterns are being explored in detail in an array of tumors. They also have a potential role in glioblastoma for risk stratification and instituting appropriate treatment based on the prognosis. Epigenetic changes like histone modification patterns, in addition to genetics, can pave the way for a better molecular understanding of glioblastomas and provide hope in the future to improve the survival of these patients with deadly diseases.

背景:尽管分子研究和治疗方法不断进步,胶质母细胞瘤仍被认为是侵袭性极强的肿瘤,中位生存期仅为 15 个月。基因改变已被详细研究过,然而,现在有越来越多的证据表明表观遗传改变在胶质母细胞瘤中的作用。最近,人们发现组蛋白修饰模式在基因表达和预后中起着重要作用。目的:确定胶质母细胞瘤患者组蛋白修饰的免疫组化表达,如组蛋白-3-赖氨酸-18乙酰化(H3K18Ac)和组蛋白-4-赖氨酸20三甲基化(H4K20triMe):这是一项回顾性研究,研究对象为接受手术的48例胶质母细胞瘤患者。人工对石蜡包埋组织进行三甲基组蛋白-H4(Lys20)(H4K20triMe)和乙酰组蛋白-H3(Lys18)(H3K18Ac)的免疫组化(IHC),并记录其表达情况。收集有丝分裂指数和总生存率数据并进行统计分析:平均年龄为 50 岁,男女比例为 1.6:1。在 48 个病例中,60%(28 例)显示 H3K18Ac 阳性,98%(46 例)显示 H4K20triMe 阳性。H3K18Ac和H4K20triMe的表达模式为核型,在坏死附近和侵袭前沿表达增多。H3K18Ac 的总体 Q 评分中位数为 1/12,H4K20triMe 为 6/12。组蛋白表达、Ki67%和总生存率之间没有明显的统计学意义:结论:组蛋白修饰模式正在一系列肿瘤中被详细探索。它们在胶质母细胞瘤中也有潜在的作用,可用于风险分层,并根据预后情况进行适当的治疗。除遗传学外,组蛋白修饰模式等表观遗传学变化可为更好地从分子角度了解胶质母细胞瘤铺平道路,并为改善这些致命疾病患者的生存状况带来希望。
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引用次数: 0
Sexual function status after adjuvant radiation including vaginal cuff brachytherapy in survivors of cancer cervix 宫颈癌幸存者接受包括阴道袖带近距离治疗在内的辅助放射治疗后的性功能状况
IF 1.3 4区 医学 Q3 Medicine Pub Date : 2023-12-29 DOI: 10.4103/jcrt.jcrt_114_21
Isha Puri, Rahul Sharma, Deepika Dewan, Shabab Angurana, Deepak Abrol, Dinesh Kumar

Context: 

Adjuvant radiation therapy plays an important role in the management of high-risk cervical cancer after radical hysterectomy or inadvertent hysterectomy. The prime concern with the use of dual modality is steep decline in sexual well-being in cervical cancer survivors. Intravaginal brachytherapy (IVBT) delivered by vaginal cylinder or ovoids is essential for local control but at the cost of impairment of sexual function.

Aim: 

The purpose of this study was to assess the sexual well-being of cervical cancer survivors, who underwent surgery followed by adjuvant radiation and compare the subgroups of ovoids with sorbo brachytherapy.

Settings and Design: 

This was an observational, cross-sectional, and analytical study, whereby we evaluated sexual function of cervical cancer survivors by the Female Sexual Function Index (FSFI) instrument.

Subjects and Methods: 

Seventy-five women, identified as cervical cancer survivors who had received adjuvant radiation and IVBT, were administered FSFI questionnaire in face-to-face interviews.

Results: 

The mean age of 75 interviewed women was 48.64 years. Fifty survivors had received IVBT with a sorbo applicator and twenty-five with ovoids. FSFI full score ranged from 4.4 to 32.40. The mean full score for the whole group was 11.3. The mean FSFI full score was 24.91 (± standard deviation [SD] 5.71) in the ovoid group versus 4.49 (± SD 0.35) in the sorbo group. On Pearson’s correlation analysis, age and type of brachytherapy were significantly correlated with FSFI full score (P = 0.006) with correlation coefficient of − 0.312 and − 0.948, respectively.

Conclusions: 

Sexual dysfunction was found prevalent in 83% of cervical cancer survivors. The patients treated with IVBT with sorbo had worse sexual functioning than those treated with ovoids.

背景:辅助放射治疗在根治性子宫切除术或不慎切除子宫后的高危宫颈癌治疗中发挥着重要作用。使用双模式治疗的首要问题是宫颈癌幸存者的性生活质量急剧下降。阴道内近距离放射治疗(IVBT)通过阴道圆柱或卵巢进行,对局部控制至关重要,但代价是性功能受损。目的:本研究旨在评估接受手术后辅助放射治疗的宫颈癌幸存者的性生活质量,并比较卵巢近距离放射治疗与索波近距离放射治疗的亚组情况:这是一项观察性、横断面和分析性研究,我们通过女性性功能指数(FSFI)工具评估了宫颈癌幸存者的性功能:对 75 名接受过辅助放射治疗和 IVBT 的宫颈癌幸存者进行了面对面访谈,并发放了 FSFI 问卷:结果:75 名受访妇女的平均年龄为 48.64 岁。结果:75 名受访女性的平均年龄为 48.64 岁,其中 50 人接受过使用索波涂抹器的 IVBT,25 人接受过使用椭圆形涂抹器的 IVBT。FSFI 满分从 4.4 分到 32.40 分不等。全组的平均满分是 11.3 分。卵形组的平均 FSFI 满分是 24.91(± 标准差 [SD] 5.71),而 Sorbo 组的平均 FSFI 满分是 4.49(± 标准差 0.35)。根据皮尔逊相关分析,年龄和近距离治疗类型与 FSFI 满分显著相关(P = 0.006),相关系数分别为 - 0.312 和 - 0.948:结论:83%的宫颈癌幸存者普遍存在性功能障碍。接受索波 IVBT 治疗的患者的性功能要比接受敖包治疗的患者差。
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引用次数: 0
Chinese expert consensus on the management of patients with hematologic malignancies infected with SARS-CoV-2 关于管理感染 SARS-CoV-2 的血液系统恶性肿瘤患者的中国专家共识
IF 1.3 4区 医学 Q3 Medicine Pub Date : 2023-12-28 DOI: 10.4103/jcrt.jcrt_782_23
Jun Wang, Liang Shao, Jing Liang, Qingming Wu, Baoli Zhu, Qiwen Deng, Zelin Liu, Liqiong Liu, Danyu Wang, Zhijian Yu, Xiaohua Tan, Fuxiang Wang, Jingye Meng, Xiaojun Xu, Zhongjun Xia, Zhiming Li, Hua Wang, Liang Wang, Wei Wu, Qi Xie, Xiaoxing Huang, Zhiqiang Sun, Yu Zhang, Hao Zhou, Hui Zhou, Wenyan Yang, Hua Ren, Zhe Liu, Mingqiang Qiao, Feifei Tang, Xiaofei Qi, Huijing Wu, Lijuan Deng, Li Gao, Hongyan Zhang, Peng Chen, Hongyu Zhang, Xinyou Zhang, Jihao Zhou, TU Chuanqing, Ling Guan, Qian Yin, Rong Shu, Feng Chen, Mingxin He, Qiang Wang, Zhi Guo, Tumor and Microecology Committee of China Anti-Cancer Association, Chinese Collaborative Group on Transformation of Infectious Immunology and Microecology Research, Tumor and Microecology Committee of China Anti-Cancer Association, Chinese Collaborative Group on Transformation of Infectious Immunology and Microecology Research

In December 2022, the Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) became dominant in China due to its high infectivity and lower mortality rate. The risk of critical illness and mortality among patients with hematologic malignancies who contracted SARS-CoV-2 was particularly high. The aim of this study was to draft a consensus to facilitate effective treatments for these patients based on the type and severity of the disease. Following the outbreak of the novel coronavirus in China, a steering committee consisting of experienced hematologists was formed by the Specialized Committee of Oncology and Microecology of the Chinese Anti-Cancer Association. The expert group drafted a consensus on the management and intervention measures for different types of hematologic malignancies based on the clinical characteristics of the Omicron variant of the SARS-CoV-2 infection, along with relevant guidelines and literature. The expert group drafted independent recommendations on several important aspects based on the epidemiology of the Omicron variant in China and the unique vulnerability of patients with hematologic malignancies. These included prophylactic vaccinations for those with hematologic malignancies, the use of plasma from blood donors who recovered from the novel coronavirus infection, the establishment of negative pressure wards, the use of steady-state mobilization of peripheral blood hematopoietic stem cells, the provision of psychological support for patients and medical staff, and a focus on maintaining a healthy intestinal microecology.

2022 年 12 月,严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)的 Omicron 变种因其传染性强、死亡率低而在中国占据主导地位。血液系统恶性肿瘤患者感染 SARS-CoV-2 后出现危重症和死亡的风险尤其高。本研究旨在起草一份共识,以便根据疾病的类型和严重程度对这些患者进行有效治疗。新型冠状病毒在中国爆发后,中国抗癌协会肿瘤学与微生态学专业委员会成立了一个由经验丰富的血液病专家组成的指导委员会。专家组根据 SARS-CoV-2 奥米克龙变异型感染的临床特点,结合相关指南和文献,起草了不同类型血液恶性肿瘤的管理和干预措施共识。专家组根据 SARS-CoV-2 奥米克龙变异型在中国的流行情况和血液系统恶性肿瘤患者的特殊易感性,就几个重要方面起草了独立的建议。这些建议包括为血液系统恶性肿瘤患者接种预防性疫苗、使用新型冠状病毒感染后康复的献血者血浆、建立负压病房、使用稳态动员外周血造血干细胞、为患者和医务人员提供心理支持,以及注重维持健康的肠道微生态。
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引用次数: 0
Aberrantly expressed HIF-1α enhances HCC stem cell-like traits via Wnt/β-catenin signaling activation after insufficient radiofrequency ablation 射频消融不足后,畸形表达的 HIF-1α 通过 Wnt/β-catenin 信号激活增强了 HCC 干细胞样特征
IF 1.3 4区 医学 Q3 Medicine Pub Date : 2023-12-28 DOI: 10.4103/jcrt.jcrt_1458_21
Ning Zhang, Ruoxue Chen, Xin Cao, Lu Wang

Background: 

Radiofrequency ablation has become a favorable treatment modality for small hepatocellular carcinoma (HCC) recently; however, insufficient radiofrequency ablation (RFA) was shown to lead to enhanced invasiveness and metastasis of HCC in our previous study, while the underlying molecular mechanism has not been understood.

Materials and Methods: 

In order to explore the influence of the hypoxic microenvironment on residual cancer and cancer stem cell (CSC)-like characteristics of HCC cells in this process, an in vitro hypoxic model and an insufficient RFA mouse model were established with HCC cancer cell lines. Immunochemistry staining and western blot were used to examine the expression of hypoxia-inducible factor (HIF)-1α and liver CSC markers. The 3D colon formation assay, tumor cell invasion assay, and gene transfection assays were applied to test the change in liver CSC stemness and HCC cell invasion.

Results: 

After insufficient RFA treatment, the upregulated HIF-1α expression was associated with an increase in the CSC-like population in residual cancer. In vitro, hypoxic tumor cells showed aggressive CSC-like properties and phenotypes. Wnt/β-catenin signaling activation was shown to be necessary for the acquisition of liver CSC-like characteristics under hypoxic conditions.

Conclusion: 

Overall, the aberrantly enhanced HIF-1α expression enhanced the liver CSC-like traits via abnormal Wnt/β-catenin signaling activation after insufficient RFA, and the overexpressed HIF-1α would be a vital factor and useful biomarker during the HCC recurrence and metastasis.

背景:近年来,射频消融已成为治疗小肝细胞癌(HCC)的一种有利方式;然而,我们之前的研究表明,射频消融(RFA)不足会导致HCC的侵袭性和转移性增强,而其潜在的分子机制尚不清楚:为了探讨缺氧微环境对HCC细胞残留癌和癌症干细胞(CSC)样特征的影响,我们用HCC癌细胞系建立了体外缺氧模型和RFA不足小鼠模型。免疫化学染色和免疫印迹法检测了缺氧诱导因子(HIF)-1α和肝脏干细胞标志物的表达。应用三维结肠形成试验、肿瘤细胞侵袭试验和基因转染试验检测肝脏CSC干性和HCC细胞侵袭的变化:结果:RFA治疗不足后,HIF-1α表达上调与残留癌中CSC样群体的增加有关。在体外,缺氧肿瘤细胞表现出侵袭性 CSC 样特性和表型。Wnt/β-catenin信号激活被证明是缺氧条件下获得肝脏CSC样特征的必要条件:总之,HIF-1α的异常表达增强了RFA不足后通过异常Wnt/β-catenin信号激活的肝脏CSC样特征,过表达的HIF-1α将成为HCC复发和转移过程中的一个重要因素和有用的生物标志物。
{"title":"Aberrantly expressed HIF-1α enhances HCC stem cell-like traits via Wnt/β-catenin signaling activation after insufficient radiofrequency ablation","authors":"Ning Zhang, Ruoxue Chen, Xin Cao, Lu Wang","doi":"10.4103/jcrt.jcrt_1458_21","DOIUrl":"https://doi.org/10.4103/jcrt.jcrt_1458_21","url":null,"abstract":"<h3>Background: </h3>\u0000<p>Radiofrequency ablation has become a favorable treatment modality for small hepatocellular carcinoma (HCC) recently; however, insufficient radiofrequency ablation (RFA) was shown to lead to enhanced invasiveness and metastasis of HCC in our previous study, while the underlying molecular mechanism has not been understood.</p>\u0000<h3>Materials and Methods: </h3>\u0000<p>In order to explore the influence of the hypoxic microenvironment on residual cancer and cancer stem cell (CSC)-like characteristics of HCC cells in this process, an <em xmlns:mrws=\"http://webservices.ovid.com/mrws/1.0\">in vitro</em> hypoxic model and an insufficient RFA mouse model were established with HCC cancer cell lines. Immunochemistry staining and western blot were used to examine the expression of hypoxia-inducible factor (HIF)-1α and liver CSC markers. The 3D colon formation assay, tumor cell invasion assay, and gene transfection assays were applied to test the change in liver CSC stemness and HCC cell invasion.</p>\u0000<h3>Results: </h3>\u0000<p>After insufficient RFA treatment, the upregulated HIF-1α expression was associated with an increase in the CSC-like population in residual cancer. <em xmlns:mrws=\"http://webservices.ovid.com/mrws/1.0\">In vitro</em>, hypoxic tumor cells showed aggressive CSC-like properties and phenotypes. Wnt/β-catenin signaling activation was shown to be necessary for the acquisition of liver CSC-like characteristics under hypoxic conditions.</p>\u0000<h3>Conclusion: </h3>\u0000<p>Overall, the aberrantly enhanced HIF-1α expression enhanced the liver CSC-like traits via abnormal Wnt/β-catenin signaling activation after insufficient RFA, and the overexpressed HIF-1α would be a vital factor and useful biomarker during the HCC recurrence and metastasis.</p>","PeriodicalId":15208,"journal":{"name":"Journal of cancer research and therapeutics","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139065099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Local treatment of liver metastasis in a patient with advanced malignant melanoma: A case report 晚期恶性黑色素瘤患者肝转移的局部治疗:病例报告
IF 1.3 4区 医学 Q3 Medicine Pub Date : 2023-12-28 DOI: 10.4103/jcrt.jcrt_394_22
Hongxi Hong, Lujun Shen, Hongtong Tan, Ying Wu, Ying Liu, Weijun Fan

Melanoma is a fatal malignant tumor with a high rate of metastasis. Liver metastasis of melanoma is always associated with insensitivity to immunotherapy and a poor prognosis. However, the combination of cryoablation, which is believed to stimulate the antitumor immune response in the body, with immunotherapy can improve the therapeutic response to this condition. Herein, we present the case of a 79-year-old woman with BRAF (B-Raf proto-oncogene) wild-type melanoma who later developed liver metastasis. The patient received intravenous antiprogrammed cell death 1 antibody, which showed poor efficacy, and subsequent treatment with immunotherapy combined with cryoablation yielded a partial response. However, after the second cryoablation, the patient refused further treatment due to a fear of bleeding. Therefore, only immunotherapy was provided, which resulted in disease progression. This report demonstrates the need to consider immunotherapy plus cryoablation for the treatment of liver metastases in patients with BRAF wild-type melanoma.

黑色素瘤是一种致命的恶性肿瘤,转移率很高。黑色素瘤的肝转移总是与对免疫疗法不敏感和预后不良有关。然而,冷冻消融术被认为可以刺激体内的抗肿瘤免疫反应,与免疫疗法相结合可以改善对这种疾病的治疗反应。在此,我们介绍了一名 79 岁女性患者的病例,她患有 BRAF(B-Raf 原癌基因)野生型黑色素瘤,后来出现了肝转移。患者静脉注射了抗程序性细胞死亡 1 抗体,但疗效不佳,随后接受了免疫疗法联合冷冻消融治疗,取得了部分反应。然而,在第二次冷冻消融术后,患者因害怕出血而拒绝进一步治疗。因此,患者只接受了免疫治疗,结果导致病情恶化。该报告表明,在治疗 BRAF 野生型黑色素瘤患者的肝转移灶时,有必要考虑免疫疗法加冷冻消融术。
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引用次数: 0
5-Fluorouracil-induced leukoencephalopathy. 5-氟尿嘧啶诱发的白质脑病。
IF 1.3 4区 医学 Q3 Medicine Pub Date : 2023-10-01 Epub Date: 2023-01-12 DOI: 10.4103/jcrt.jcrt_2165_21
Muthu Manikandan, Biju Azariah, Rajiv Sharma

Abstract: The incidence of 5-Fluorouracil (5FU)- induced leukoencephalopathy is <5% among the patients treated with this agent. It may present with disorientation, confusion, agitation, seizure, and coma. It should be suspected when patients present with any of these symptoms during or immediately after 5FU chemotherapy. Early detection of drug-induced leukoencephalopathy is important as the clinical symptoms can be reversed by early discontinuation of the drug. Therefore, clinicians should be aware of the possibility of this adverse neurologic effect of 5FU. We describe the case of a 35-year-old female with carcinoma esophagus with 5FU-induced leukoencephalopathy.

摘要:5-氟尿嘧啶(5FU)诱发的白质脑病的发病率是
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引用次数: 0
Antiproliferative effect of Potentilla fulgens on glioblastoma cancer cells through downregulation of Akt/mTOR signaling pathway. 虎杖通过下调 Akt/mTOR 信号通路对胶质母细胞瘤癌细胞的抗增殖作用
IF 1.3 4区 医学 Q3 Medicine Pub Date : 2023-10-01 Epub Date: 2022-07-15 DOI: 10.4103/jcrt.jcrt_1886_21
Sevgi Irtegun Kandemir, Polat Ipek

Background: Glioblastoma multiforme (GBM) is the most aggressive brain tumor that is common among adults. This aggression is due to increased invasion, migration, proliferation, angiogenesis, and decreased apoptosis. Plant-based compounds have a high potential to be used as an anticancer agent due to their various mechanisms and less undesirable side effects. Potentilla fulgens is a medicinal plant, and methanolic root extract of P. fulgens (PRE) has anti-inflammatory and anticancer properties.

Objective: In this study, we aimed to investigate antiproliferative effect of PRE on U118 and T98G glioblastoma cancer cells and to reveal which molecular signaling pathways regulate this mechanism of action.

Materials and methods: The effect of PRE on cell viability of GBM cells was investigated by MTT assay. Involvement of PRE with cell growth and survival signaling pathways, phosphatidylinositol 3-kinase (PI3K)/Akt/mTOR and c-Src/signal transducer and activator of transcription 3 (STAT3), was examined using Western Blot.

Results: PRE reduced cell viability of GBM and human dermal fibroblast (HDF) cells in a dose-and time-independent manner. PI3K expression/phosphorylation level remained unchanged in both GBM and HDF cells after PRE treatment, but Akt/mTOR signaling pathway was downregulated in PRE-treated cells. PRE treatment did not affect c-Src expression/phosphorylation level in GBM cells; however, expression of c-Src was suppressed in HDF cells. Similar results were observed for STAT3 expression and phosphorylation status.

Conclusion: PRE has the ability to suppress cell viability in GBM cells, by targeting the Akt/mTOR signaling pathway.

背景:多形性胶质母细胞瘤(GBM多形性胶质母细胞瘤(GBM)是成人中常见的侵袭性最强的脑肿瘤。这种侵袭性是由于侵袭、迁移、增殖、血管生成增加以及凋亡减少造成的。植物性化合物具有多种机制,且不良副作用较小,因此很有可能被用作抗癌剂。黄花菜是一种药用植物,其甲醇根提取物(PRE)具有抗炎和抗癌特性:本研究旨在探讨 PRE 对 U118 和 T98G 胶质母细胞瘤癌细胞的抗增殖作用,并揭示调控这一作用机制的分子信号通路:MTT试验研究了PRE对GBM细胞活力的影响。利用 Western Blot 检测了 PRE 与细胞生长和存活信号通路(磷脂酰肌醇 3- 激酶(PI3K)/Akt/mTOR 和 c-Src/signal transducer and activator of transcription 3 (STAT3))的关系:结果:PRE以剂量和时间无关的方式降低了GBM和人真皮成纤维细胞(HDF)的细胞活力。PRE处理后,GBM和HDF细胞中的PI3K表达/磷酸化水平保持不变,但PRE处理的细胞中Akt/mTOR信号通路下调。PRE 处理不影响 GBM 细胞中 c-Src 的表达/磷酸化水平;但 HDF 细胞中 c-Src 的表达受到抑制。STAT3 的表达和磷酸化状态也观察到了类似的结果:结论:PRE 能够通过靶向 Akt/mTOR 信号通路抑制 GBM 细胞的活力。
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引用次数: 0
Development of a quality assurance system in radiation oncology: A 12-year experience in a University Hospital. 放射肿瘤学质量保证系统的开发:一家大学医院 12 年的经验。
IF 1.3 4区 医学 Q3 Medicine Pub Date : 2023-10-01 Epub Date: 2022-08-26 DOI: 10.4103/jcrt.jcrt_39_22
Wannapha Nobnop, Vicharn Lorvidhaya, Somsak Wanwilairat, Anirut Watcharawipha, Ekkasit Tharavichitkul, Wimrak Onchan, Somvilai Chakrabandhu, Pitchayaponne Klunklin, Bongkot Jia-Mahasap, Pooriwat Muangwong, Imjai Chitapanarux

Purpose: This study aimed to report 12 years of experience in the development of a quality assurance system in radiation oncology in a university hospital.

Material and methods: We developed the Quality Assurance Program in Radiation Oncology (QUAPRO) in 2008 to detect treatment deviation in the radiotherapy (RT) process with three steps of near-miss detection: simulation and prescription (primary check, PC), treatment planning (secondary check, SC), and treatment delivery process (tertiary check, TC). We transferred our paper-based medical records to electronic-based radiotherapy information systems (RTISs) in 2013. QUAPRO was completely integrated into RTIS in 2017. Since then, electronic-based incident reporting has been conducted. The program is called the Radiation Incident Learning System (RILS). The near-miss rates were compared during the three time periods: 2008-2012, 2013-2017, and 2017-2020.

Results: Five years of paper-based QUAPRO for 2008-2012 demonstrated a fluctuation in the checking ratio, with a gradually increasing rate of near misses of 3.5-19.7%. After electronic-based medical records were developed in 2013, the results revealed a dramatic increase from a rate of 2.7 to 4.2 in the number of checks per patient and achieved an increased rate of near misses of 24.7% for PC, SC, and TC. The rate of near misses gradually decreased to 5.3% after 2017 because of RT workflow improvement.

Conclusion: The analysis of 12 years in near-miss data reflected the effectiveness of our quality assurance program. The QUAPRO system can detect near-miss incidents in the whole RT workflow and illustrate the detection improvement when integrated into electronic-based medical records. Regular feedback and exploration of near-miss reporting are recommended for proper RT workflow improvement.

目的:本研究旨在报告一家大学医院开发放射肿瘤学质量保证系统的 12 年经验:我们于 2008 年制定了放射肿瘤学质量保证计划(QUAPRO),通过模拟和处方(一级检查,PC)、治疗计划(二级检查,SC)和治疗实施过程(三级检查,TC)三个步骤来检测放射治疗(RT)过程中的治疗偏差。2013 年,我们将纸质医疗记录转移到电子放射治疗信息系统(RTIS)。QUAPRO 于 2017 年完全集成到 RTIS 中。从那时起,我们开始进行基于电子的事故报告。该计划被称为辐射事故学习系统(RILS)。对 2008-2012 年、2013-2017 年和 2017-2020 年这三个时间段的险情发生率进行了比较:2008-2012年五年的纸质QUAPRO显示出检查率的波动,近失误率逐渐上升,为3.5%-19.7%。2013 年开发出电子病历后,结果显示每位患者的检查次数从 2.7 次急剧增加到 4.2 次,PC、SC 和 TC 的近失率增加了 24.7%。由于 RT 工作流程的改进,2017 年后近失率逐渐降至 5.3%:12年的近失误数据分析反映了我们质量保证计划的有效性。QUAPRO系统可以检测整个RT工作流程中的近失误事件,并说明在与电子病历整合后,检测效果有所改善。建议定期反馈和探索近错报告,以适当改进 RT 工作流程。
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引用次数: 0
Protective effect of rosmarinic acid on the transmembrane transporter Ctr1 expression in cisplatin-treated mice. 迷迭香酸对顺铂治疗小鼠跨膜转运体 Ctr1 表达的保护作用
IF 1.3 4区 医学 Q3 Medicine Pub Date : 2023-10-01 Epub Date: 2022-09-10 DOI: 10.4103/jcrt.jcrt_1428_21
Juheb Akhter, Poonam Goswami, Mirza Masroor Ali Beg, Shahzad Ahmad, Abul Kalam Najmi, Sheikh Raisuddin

Aims: Cisplatin (cis-diamminedichloroplatinum(II), CP) is a platinum-based anticancer drug widely used in the treatment of solid malignancies. However, its side effects, particularly nephrotoxicity, are limiting factors in its clinic use. Rosmarinic acid (RA), a natural antioxidant compound, is reported to attenuate oxidative stress and associated pathophysiological outcomes. Our study aimed to explore the protective effect of RA against CP-induced acute kidney injury (AKI).

Materials and methods: We investigated the effect of RA at the dose of 100 mg/kg on AKI induced by CP (20 mg/kg) in mice. Various parameters of nephrotoxicity such as levels of serum electrolytes, albumin, and globulin were measured using standardized methods. Besides, a specific biomarker of damage to proximal tubular cells, kidney injury molecule-1 (Kim-1), was measured in the serum by ELISA. mRNA expression of Kim-1 and a transmembrane transporter, copper transporter 1 (Ctr1), was analyzed by quantitative reverse transcriptase-polymerase chain reaction. CTR1 expression was also analyzed by western blot technique.

Results: RA treatment restored the downregulated CTR1 , a renal transmembrane transporter in CP-treated mice. It was accompanied by a reduction in the level of serum albumin and globulin. Serum electrolytes such as Na+, K+, and Ca2+ in CP-treated mice were found to be restored with RA treatment. Moreover, RA also significantly downregulated the increased expression of nephrotoxicity biomarker KIM-1.

Conclusions: Overall, RA proved to be an effective nephroprotective compound which afforded protection at cellular and subcellular levels with an appreciable modulatory effect on a transmembrane transporter.

目的:顺铂(cis-diamminedichloroplatinum(II),CP)是一种以铂为基础的抗癌药物,广泛用于治疗实体恶性肿瘤。然而,它的副作用,尤其是肾毒性,是限制其临床应用的因素。据报道,天然抗氧化化合物迷迭香酸(RA)可减轻氧化应激和相关的病理生理结果。我们的研究旨在探讨 RA 对 CP 诱导的急性肾损伤(AKI)的保护作用:我们研究了 100 mg/kg 剂量的 RA 对 CP(20 mg/kg)诱导的小鼠 AKI 的影响。采用标准化方法测量了肾毒性的各种参数,如血清电解质、白蛋白和球蛋白的水平。此外,还通过酶联免疫吸附法测定了血清中近端肾小管细胞损伤的特异性生物标志物--肾损伤分子-1(Kim-1)。结果显示,RA 治疗恢复了下调的铜转运体 1(CTR1)表达:结果:RA 治疗恢复了 CP 治疗小鼠肾跨膜转运体 CTR1 的下调。与此同时,血清白蛋白和球蛋白水平也有所下降。CP 治疗小鼠的血清电解质(如 Na+、K+ 和 Ca2+)在 RA 治疗后得到恢复。此外,RA 还能显著降低肾毒性生物标志物 KIM-1 的表达:总之,RA 被证明是一种有效的肾脏保护化合物,可在细胞和亚细胞水平提供保护,并对跨膜转运体具有明显的调节作用。
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引用次数: 0
Pseudoangiomatous stromal hyperplasia: A clinical perspective and a brief review. 假性血管瘤基质增生症:临床视角与简要回顾。
IF 1.3 4区 医学 Q3 Medicine Pub Date : 2023-10-01 Epub Date: 2023-01-03 DOI: 10.4103/jcrt.jcrt_127_22
Gaurav Patel, Sandip Bipte, Swati Narurkar

Abstract: Pseudoangiomatous stromal hyperplasia (PASH) is a benign entity of the breast and typically found incidentally or as a palpable mass. It usually affects women in the reproductive age group. In men, it is associated with gynecomastia. While the exact etiology is unknown, PASH is considered hormonally responsive. The mammography and ultrasonography findings are nonspecific. Grossly, PASH is a well-circumscribed, firm, rubbery mass with solid, homogenous, gray-white cut surface. On histologic examination, it is characterized by the presence of open slit-like spaces in dense collagenous stroma. The spindle cells express progesterone receptors and are positive for vimentin, actin, and CD34. PASH lesions should be surgically excised if increasing in size or associated with symptoms, also in cases of suspicious imaging findings or other lesions are synchronously diagnosed that require excision. In other small incidentally detected asymptomatic cases observation with clinicoradiological follow-up can be considered. It is associated with a good prognosis with no increased risk to develop breast cancer. Hence, the operating surgeon and pathologist should be aware of this not so uncommon entity so that patients are not subjected to unnecessary excision and subsequent physical and mental morbidity associated with it. In this article, we present a case report and also provide a brief review of the sparse literature on PASH, discussing clinical presentation, etiology and pathogenesis, radiopathological features, differential diagnosis, and the implications for further patient management and prognosis.

摘要:假性血管瘤性基质增生(PASH)是乳腺的一种良性病变,通常是偶然发现或可触及肿块。它通常影响育龄妇女。在男性中,它与妇科炎症有关。虽然确切的病因不明,但 PASH 被认为是激素反应性疾病。乳房 X 射线照相术和超声波检查结果无特异性。从外观上看,PASH 是一个圆形、坚硬、橡胶样的肿块,表面呈均匀、灰白色的实性切面。在组织学检查中,其特征是在致密的胶原基质中存在开放的缝隙样空间。纺锤形细胞表达孕酮受体,波形蛋白、肌动蛋白和 CD34 阳性。如果 PASH 病变增大或伴有症状,以及影像学结果可疑或同步诊断出其他需要切除的病变,则应手术切除。对于其他偶然发现的无症状小病例,可考虑通过临床放射学随访进行观察。这种病的预后良好,不会增加患乳腺癌的风险。因此,手术外科医生和病理学家应了解这种并不罕见的病例,以免患者接受不必要的切除手术,并因此造成身心疾病。在本文中,我们报告了一个病例,并简要回顾了有关 PASH 的稀少文献,讨论了临床表现、病因和发病机制、放射病理特征、鉴别诊断以及对进一步患者管理和预后的影响。
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引用次数: 0
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Journal of cancer research and therapeutics
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