| Radiotherapy is one of the main means for malignant tumor,and the effect of radiotherapy is proportional to the dose of radiation.Acute radiation injuries and chronic radiation injuries can occur in patients with tumor after radiation therapy.With the increase of radiation measurement,radiation damage is gradually aggravated,so radiation damage is the main factor that restricts the effect of radiotherapy.Clinically,as to the same disease,the same radiotherapy site,the same radiotherapy equipment,the same dose,even the same target area delineation,the treatment effect is different,and the combined radiation damage is not the same.From the drug sensitivity test and tumor susceptibility gene test performed,we found in the detection process,gene mutation or deletion will occur to individual chemotherapy and tumor susceptible individuals,and there are differences in the effect of chemotherapy and their susceptibility to tumors,thus we doubt whether the genetic changes will impact the radiotherapy effect? Do different genes differ in their severity of radiation damage? Is it possible to predict the occurrence of radiation damage by clinical biochemical tests? And what medicine can be effective in the treatment of radiation injuries after acute radiation injury?The difference in radiation damage among different individuals is so large that they cannot be explained only from radiotherapy equipment,radiotherapy techniques and their underlying diseases.Some people believe that radiation therapy and basic diseases can only explain 1/3 of the radiation damaged individuals.What are the remaining causes of radiation damage? With the development of molecular biology and molecular genetics,the research on gene mutation and radiotherapy is more andmore.At the molecular level,as to the relationship between gene mutations and radiation,the most studied is that gene mutations can affect radio sensitivity,and homozygous or heterozygous mutations can reduce radio sensitivity.But there is little mention of the association between genetic mutations and radiation damage.X-ray repair cross complementing gene 1(DNA repair gene)can protect the cell from radiation damage by base excision and single strand break repair.On the protective effect of XRCC1 against radiation injury of the normal tissue,there are two kinds of theory,the MAPK / ERK signaling pathway,by regulating the expression of the pathway to protect normal tissues from radiation injury.The second theory is that the sensitivity of normal cells to radiation is affected by the XRCC1 of the DNA double strand breaks(DNA double strand break,DSB)mechanism,therefore whether the radiation dose can be detected by XRCC1 and thus to predict cell tolerance estimation and the side effects of radiotherapy of long-term curative effect?Polymorphism of human glutathione transferase(HGSTs)gene is common in the population.Its main functions are anti-oxidation,detoxifying,scavenging free radicals,reducing inflammation,and repairing damaged genes.This lack of gene polymorphism causes that the genes cannot encode corresponding active enzymes and enzyme proteins,thus reduce the body metabolism reaction and ability to resist outside chemical damage,so that the human body is susceptible to the corresponding environmental risk factors,and the ability of tissue repair is reduced.Therefore,the polymorphism of the reduced glutathione gene should also play an important role in the occurrence and development of radiation damage.In the era of precision medicine,more and more attention has been paid to the development of targeted individualized therapy guided by gene testing.The molecular factors that affect radiation injury are to be found by gene test,and the clinical treatment was guided by this theory.It has positive significance for improving the clinical symptoms,controlling the disease and improving the quality of life.Part 1 Detection of glutathione transferase T1 gene1 Peripheral blood samples were extracted from the patients and genomic DNA was extracted.2 Real-time quantitative PCR was used to amplify and sequence,and then the GSTT1 gene mutation was detected by liquid site directed sequencing.3 Polymerase chain reaction agarose gel electrophoresis was used to detect GSTT1 gene deletion imaging.4 Using SPSS 19 analysis software for data analysis,measurement data to X+ S expression,group comparison using variance analysis and ?2 test,to P <0.05,the difference is statistically significant.To observe the correlation between GSTT1 and radiation injury.methodResult1 Pure GSTT1 gene deletion is not associated with radiation damage,the severe radiation injury group GSTT1 base deletion of 36 people,accounting for 41.9% of the number of detection;GSTT1 base not missing 50 people,accounting for 58.1% of the number of testing;2 Mild radiation injury group GSTT1 base deletion 37 people,accounting for41.2% of the number of testing;GSTT1 base not missing 53 people,accounting for58.8% of the number of testing;control group GSTM1 base deletion 42 people,accounting for 46.7% of the number of testing;Conclusion GSTT1 without deletion or single deletion was not associated with radiation injury severity(p>0.05).Part 2 Detection of glutathione transferase M1 genemethod1 Peripheral blood samples were extracted from the patients and genomic DNA was extracted.2 Real-time quantitative PCR was used to amplify and sequence,and then the GSTM1 gene mutation was detected by liquid site directed sequencing.3 Polymerase chain reaction agarose gel electrophoresis was used to detect GSTM1 gene deletion imaging.4 Detection of GSTT1 and GSTM1 associated loss associated with radiation damage.5 Using SPSS 19 analysis software for data analysis,measurement data to X + S expression,group comparison using variance analysis and ?2test,to P <0.05,the difference is statistically significant.Result1 The GSTT1 gene deletion and radiation injury unrelated,severe radiation injury group GSTM1 deletion of 37 people,accounting for 43.1% of the number of detection,GSTM1 base without missing 49 people,accounting for 56.9% of the number of detection;mild radiation injury group GSTM1 deletion of 42 people,accounting for 46.7% of the number of detection,GSTM1 base without missing 48 people,accounting for 53.3% of the number of detection not a single;deletion or deletion,not associated with the severity of radiation injury(p>0.05);2 Severe radiation injury group GSTT1,GSTM1 joint deletion number is 31 people,accounting for 36.1% of the number of testing;the mild radiation injury group GSTT1,GSTM1 joint deletion number is 14 people,accounting for 15.5% of the number of the test;Conclusion The combined deletion of GSTT1 and GSTM1 was associated with the severity of radiation injury,and radioactivity was more serious when GSTT1 and GSTM1 were combined.Part 3 X-ray repair cross complementing protein gene detectionmethod1 Peripheral blood samples were extracted from the patients and genomic DNA was extracted.2 Real-time quantitative PCR was used to amplify and sequence,and then the XRCC1 gene mutation was detected by liquid site directed sequencing.3 Using SPSS 19 analysis software for data analysis,measurement data to X + S expression,group comparison using variance analysis and?2 test,to P <0.05,the difference is statistically significant.Detect the association of XRCC1 gene mutations with radiation damage.Result1 XRCC1 gene C26304 T severe radiation injury group,wild type(CC)62people,accounting for 72% of the detection results;homozygous mutation(TT)and heterozygous mutation(CT)were 6 cases and 18 cases,accounting for 7.1% and20.9% of the total number of tests,respectively.The total number of mutations in the severe radiation injury group was 24,accounting for 28% of the total number.Arg399 Gln severe radiation injury group,wild type(AA)63 people,accounting for73.3% of the detection results;homozygous mutations(GG)and heterozygous mutations(GA)were 7 cases and 16 cases,accounting for 8.1% and 18.6% of the total number of tests,respectively.The total mutation rate in the Arg399 Gln severe radiation injury group was 23,accounting for 26.7% of the total number.2 XRCC1 gene C26304 T mild radiation injury group,wild type(CC)67 people,accounting for 74.4% of the detection results;homozygous mutation(TT)and heterozygous mutation(CT)were 7 cases and 16 cases,accounting for 7.9% and17.7% of the total number of tests,respectively.The total number of mutations in the mild radiation injury group was 23,accounting for 25.6% of the total number.Arg399 Gln mild radiation injury group,wild type(AA)69 people,accounting for76.7% of the detection results;homozygous mutations(GG)and heterozygous mutations(GA)were 6 cases and 15 cases,accounting for 6.6% and 16.7% of the total number of tests,respectively.The total mutation rate in the Arg399 Gln mild radiation injurygroup was 21,accounting for 23.3% of the total number.The overall mutation rates in XRCC1,C26304 T,and Arg399 Gln severe radiation injury and mild radiation injury groups were 26.7% and 23.3%,respectively,3 In 60 cases of radiation injury complicated with esophageal cancer,lung cancer,Arg/Arg total of 31 cases,Arg/Gln 18 cases,Gln/Gln11 cases,according to each subtype in patients with skin detection,throat esophagus,lung and gastrointestinal injury and percentage of patients without radioactive radiation injury of three subtypes of XRCC1 X2 test results found that XRCC1 homozygous mutation or whether heterozygous mutations were not associated with radioactive skin injury,radiation esophagitis,radiation-induced lung injury,there is a correlation between the trend and the upper digestive tract.4 Among 5 cases of GSTM1,GSTT1,XRCC1 deletion patients,two cases are of esophago tracheal fistula,a case of severe radiation pneumonitis death,a case of frozen abdominal,one case of severe diarrhea(more than 40 times per day stool frequency),due to the small sample size,it fails to exhibit the significance,but GSTT1,GSTM1,XRCC1 combined deletion patients,radiation injury is severer,their association still needs further large sample observation.Conclusion Therefore,the pure and XRCC1 mutation and heterozygous mutation has no correlation with acute radiation injury(p>0.05),but 5 cases of GSTT1,GSTM1,XRCC1 patients,two cases of esophageal tracheal fistula,one case of severe radiation pneumonia death,a case of frozen abdomen,a rectal bladder leak,due to the small sample size,although there was no statistically significant but,GSTT1,GSTM1,XRCC1 combination of the three in the absence of radiation damage,much heavier,the association still need a large sample of follow-up observation.Part 4 The treatment of radiation injurymethod1 Case control method was used to divide 50 patients with radiation lung injury into treatment group and control group(two groups),to study the curative effect of different treatment schemes in radiation injury.The control group of 23 people with hormone and vitamin and other conventional treatment,the treatment group and 27 in the group on the basis of medication,combined with glutathione reductase,acetyl glutamine,magnesium ion and Thymosin al,15 days for a course of treatment,efficacy evaluation criteria to recent clinical symptoms of stable or downgrade for effective treatment,evaluation of therapeutic effects of two groups of patients after the end of treatment of radiation-induced lung injury.2 Using SPSS 19 analysis software for data analysis,measurement data with X +S,comparison between groups by ANOVA and ?2test,P <0.05 said the difference was statistically significant;two therapeutic schemes to detect whether there is a statistically significance.Result In the curative effect evaluation,only 6 cases in the control group were treated effectively,the effective rate was 26.08%;the treatment group 22 were effective,and the effective rate was 81.48%.In the control group,the improvement of clinical symptoms at the beginning of treatment was not obvious,all of them were transferred to the treatment group.Therefore,the final results in the treatment group based on symptomatic treatment of hormone,plus reduced glutathione and acetyl glutamine and alanyl glutamine,magnesium ion and Thymosin al treatment is better than simple hormone control group,the difference was significant(x2 =15.46,p< 0.005).Conclusion It has significant curative effect to strengthen the glutathione and magnesium ions as the core of the antioxidant treatment of radiation-induced lung injury. |
PDF Full Text Request