Etoposide and cisplatin versus paclitaxel and carboplatin with concurrent thoracic radiotherapy in unresectable stage III non-small cell lung cancer: a multicenter randomized phase III trial

Background

The optimal chemotherapy regimen administered currently with radiation in patients with stage III non-small cell lung cancer (NSCLC) remains unclear. A multicenter phase III trial was conducted to compare the efficacy of concurrent thoracic radiation therapy with either etoposide/cisplatin (EP) or carboplatin/paclitaxel (PC) in patients with stage III NSCLC.

Patients and methods

Patients were randomly received 60-66 Gy of thoracic radiation therapy concurrent with either etoposide 50 mg/m2 on days 1-5 and cisplatin 50 mg/m2 on days 1 and 8 every 4 weeks for two cycles (EP arm), or paclitaxel 45 mg/m2 and carboplatin (AUC 2) on day 1 weekly (PC arm). The primary end point was overall survival (OS). The study was designed with 80% power to detect a 17% superiority in 3-year OS with a type I error rate of 0.05.

Results

A total of 200 patients were randomized and 191 patients were treated (95 in the EP arm and 96 in the PC arm). With a median follow-up time of 73 months, the 3-year OS was significantly higher in the EP arm than that of the PC arm. The estimated difference was 15.0% (95% CI 2.0%-28.0%) and P value of 0.024. Median survival times were 23.3 months in the EP arm and 20.7 months in the PC arm (log-rank test P = 0.095, HR 0.76, 95%CI 0.55-1.05). The incidence of Grade ≥2 radiation pneumonitis was higher in the PC arm (33.3% versus 18.9%, P = 0.036), while the incidence of Grade ≥3 esophagitis was higher in the EP arm (20.0% versus 6.3%, P = 0.009).

Conclusion

EP might be superior to weekly PC in terms of OS in the setting of concurrent chemoradiation for unresectable stage III NSCLC.

Trial registration ID

NCT01494558.

[Analgesic effect and related mechanism of peripheral acupoints electroacupuncture on superficial partial-thickness burn rats]

Objective: To observe the analgesic effect and related mechanism of peripheral acupoints electroacupuncture on superficial partial-thickness burn rats. Methods: Eighty SD rats were divided into sham injury group (SI), pure burn group (PB), electroacupuncture group (E), and sham electroacupuncture group (SE) according to the random number table, with 20 rats in each group. Right posterior leg of rats in group SI were sham injured, while superficial partial-thickness scald (hereinafter referred to as burn) model was reproduced on the right posterior leg of rats in the latter three groups. Electroacupuncture of peripheral acupoints of right posterior leg of rats (equivalent to Zusanli point and Sanyinjiao point of human) in group E were performed from post injury hour (PIH) 12 on, while rats in group SE were treated with sham electroacupuncture, with 30 min each time, one time a day for 3 days. Before injury and at PIH 12, 24, 36, 48, 60, and 72, the threshold of mechanical pain of 5 rats in each group was tested, and the threshold of heat pain of another 5 rats in each group was tested. At PIH 48, brain tissue of 5 rats in each group was obtained to observe the morphology and distribution of astrocytes with positive expression of glia fibrillary acidic protein (GFAP) in periaqueductal gray (PAG) area by immunohistochemical staining, and the number of astrocytes was calculated. At the same time, brain tissue of the rest 5 rats in each group was obtained to determine the expression of GFAP of astrocytes in PAG area with Western blotting. Data were possessed with analysis of variance of repeated measurement, one-way analysis of variance, and SNK test. Results: (1) Compared with that in group SI, the threshold of mechanical pain of rats in groups PB and SE had no significant change before injury and at PIH 12 (with P values above 0.05), but was significantly decreased from PIH 24 to 72 (with P values below 0.05); while the threshold of mechanical pain of rats in group E was significantly decreased from PIH 36 to 72 (with P values below 0.05). The threshold of mechanical pain of rats in group E was significantly higher than that in groups PB and SE at PIH 24 (with P values below 0.05). (2) Compared with that in group SI, the threshold of heat pain of rats in groups PB and SE had no significant change before injury (with P values above 0.05), but was significantly decreased from PIH 12 to 72 (with P values below 0.05); while the threshold of heat pain of rats in group E was significantly decreased from PIH 12 to 60 (with P values below 0.05). The threshold of heat pain of rats in group E was significantly higher than that in groups PB and SE from PIH 24 to 48 (with P values below 0.05). (3) The distribution of astrocytes with positive expression of GFAP in PAG area of rats in group SI was diffuse. The cell volume was small with cell body unobvious, and the projections were sparse, fine and short. The distribution of astrocytes with positive expression of GFAP in PAG area of rats in group PB was relatively concentrated. The cell body was hypertrophy and swelling, and the projections were increased and extended. The morphology and distribution of astrocytes with positive expression of GFAP in PAG area of rats in groups SE and E was similar to that in group PB. The numbers of astrocytes with positive expression of GFAP in PAG area of rats in groups SI, PB, E, and SE were 44±4, 39±4, 27±4, and 36±5, respectively. The number of astrocytes with positive expression of GFAP in PAG area of rats in group PB was significantly less than that in group SI (P<0.05), but similar to that in group SE (P>0.05). The number of astrocytes with positive expression of GFAP in PAG area of rats in group E was significantly less than that in groups PB and SE (with P values below 0.05). (4) The expressions of GFAP of astrocytes in PAG area of rats in groups SI, PB, E, and SE were 1.11±0.16, 0.66±0.15, 0.34±0.06, and 0.56±0.09, respectively. The expression of GFAP of astrocytes in PAG area of rats in group PB was significantly lower than that in group SI (P<0.05), but similar to that in group SE (P>0.05). The expression of GFAP of astrocytes in PAG area of rats in group E was significantly lower than that in groups PB and SE (with P values below 0.05). Conclusions: Electroacupuncture of peripheral acupoints can release the pain followed superficial partial-thickness burn in rats at early stage, and the possible mechanism is that it reduces the activation of astrocytes in PAG area.

CAMK2γ in intestinal epithelial cells modulates colitis-associated colorectal carcinogenesis via enhancing STAT3 activation

Inflammation is one of the major risk factors for cancer. Here, we show that calcium/calmodulin-dependent protein kinase II gamma (CAMK2γ) in intestinal epithelial cells (IECs) modulates inflammatory signals and promotes colitis-associated cancer (CAC) in mice. We have identified CAMK2γ as a downstream target of colitis-induced WNT5a signaling. Furthermore, we have shown that CAMK2γ protects against intestine tissue injury by increasing IEC survival and proliferation. CAMK2γ knockout mice displayed reduced CAC. Furthermore, we used bone marrow transplantation to reveal that CAMK2γ in IECs, but not immune cells, was crucial for its effect on CAC. Consistently, transgenic over-expression of CAMK2γ in IECs accelerated CAC development. Mechanistically, CAMK2γ in IECs enhanced epithelial STAT3 activation to promote survival and proliferation of colonic epithelial cells during CAC development. These results thus identify a new molecular mechanism mediated by CAMK2γ in IECs during CAC development, thereby providing a potential new therapeutic target for CAC.

Microstructural study of the lunate in stage III Kienböck's disease with micro-computed tomography imaging

Seventeen fresh lunates with stage III Kienböck's disease were scanned with micro-computed tomography. Four regions of interest were selected to measure trabecular parameters, which were compared with those from normal lunates. Within the three regions in the distal surface, there was more compact trabecular bone in the middle region when compared with the palmar and dorsal regions. In the central part, the trabeculae of the Kienböck's lunates were much thicker than those in normal lunates. The diameters of the palmar nutrient foramina of the Kienböck's lunates were significantly smaller than those in normal lunates. In affected lunates, the bony disruptions were mostly located in the palmar or dorsal areas, which were shown from trabecular bone structure analysis to be structurally weaker. This leads to separation of the distal part of the fractured bone, disruption of the blood supply, poor bone remodelling and proneness to secondary fracture and eventual collapse.

Microstructural study of the lunate in stage III Kienböck's disease with micro-computed tomography imaging

Seventeen fresh lunates with stage III Kienböck's disease were scanned with micro-computed tomography. Four regions of interest were selected to measure trabecular parameters, which were compared with those from normal lunates. Within the three regions in the distal surface, there was more compact trabecular bone in the middle region when compared with the palmar and dorsal regions. In the central part, the trabeculae of the Kienböck's lunates were much thicker than those in normal lunates. The diameters of the palmar nutrient foramina of the Kienböck's lunates were significantly smaller than those in normal lunates. In affected lunates, the bony disruptions were mostly located in the palmar or dorsal areas, which were shown from trabecular bone structure analysis to be structurally weaker. This leads to separation of the distal part of the fractured bone, disruption of the blood supply, poor bone remodelling and proneness to secondary fracture and eventual collapse.

Oscillation in tissue oxygen index during recovery from exercise

It was hypothesized that an oscillation of tissue oxygen index (TOI) determined by near-infrared spectroscopy during recovery from exercise occurs due to feedback control of adenosine triphosphate and that frequency of the oscillation is affected by blood pH. In order to examine these hypotheses, we aimed 1) to determine whether there is an oscillation of TOI during recovery from exercise and 2) to determine the effect of blood pH on frequency of the oscillation of TOI. Three exercises were performed with exercise intensities of 30 % and 70 % peak oxygen uptake (V(.)o(2)peak) for 12 min and with exercise intensity of 70 % V(.)o(2)peak for 30 s. TOI during recovery from the exercise was analyzed by fast Fourier transform in order to obtain power spectra density (PSD). There was a significant difference in the frequency at which maximal PSD of TOI appeared (Fmax) between the exercises with 70 % V(.)o(2)peak for 12 min (0.0039+/-0 Hz) and for 30 s (0.0061+/-0.0028 Hz). However, there was no significant difference in Fmax between the exercises with 30 % (0.0043+/-0.0013 Hz) and with 70 % V(.)o(2)peak for 12 min despite differences in blood pH and blood lactate from the warmed fingertips. It is concluded that there was an oscillation in TOI during recovery from the three exercises. It was not clearly shown that there was an effect of blood pH on Fmax.

Azimuthal Anisotropy in U+U and Au+Au Collisions at RHIC

Collisions between prolate uranium nuclei are used to study how particle production and azimuthal anisotropies depend on initial geometry in heavy-ion collisions. We report the two- and four-particle cumulants, v_{2}{2} and v_{2}{4}, for charged hadrons from U+U collisions at sqrt[s_{NN}]=193  GeV and Au+Au collisions at sqrt[s_{NN}]=200  GeV. Nearly fully overlapping collisions are selected based on the energy deposited by spectators in zero degree calorimeters (ZDCs). Within this sample, the observed dependence of v_{2}{2} on multiplicity demonstrates that ZDC information combined with multiplicity can preferentially select different overlap configurations in U+U collisions. We also show that v_{2} vs multiplicity can be better described by models, such as gluon saturation or quark participant models, that eliminate the dependence of the multiplicity on the number of binary nucleon-nucleon collisions.

Oscillation of tissue oxygen index in non-exercising muscle during exercise

The purpose of the present study was to examine how oscillation of tissue oxygen index (TOI) in non-exercising exercise is affected during high-intensity and low-intensity exercises. Three exercises were performed with exercise intensities of 30% and 70% peak oxygen uptake (Vo(2)peak) for 12 min and with exercise intensity of 70% Vo(2)peak for 30 s. TOI in non-exercising muscle (biceps brachii) during the exercises for 12 min was determined by nearinfrared spectroscopy. TOI in the non-exercising muscle during the exercises was analyzed by fast Fourier transform (FFT) to obtain power spectra density (PSD). The frequency at which maximal PSD appeared (Fmax) during the exercise with 70% Vo(2)peak for 12 min (0.00477 ± 0.00172 Hz) was significantly lower than that during the exercise with 30% Vo2peak for 12 min (0.00781 ± 0.00338 Hz). There were significant differences in blood pH and blood lactate between the exercise with 70% Vo(2)peak and the exercise with 30% Vo(2)peak. It is concluded that TOI in nonexercising muscle oscillates during low-intensity exercise as well as during high-intensity exercise and that the difference in Fmax between the two exercises is associated with the difference in increase in blood lactate derived from the exercise.

Precision Measurement of the Longitudinal Double-Spin Asymmetry for Inclusive Jet Production in Polarized Proton Collisions at sqrt[s]=200 GeV

We report a new measurement of the midrapidity inclusive jet longitudinal double-spin asymmetry, A_{LL}, in polarized pp collisions at center-of-mass energy sqrt[s]=200  GeV. The STAR data place stringent constraints on polarized parton distribution functions extracted at next-to-leading order from global analyses of inclusive deep-inelastic scattering (DIS), semi-inclusive DIS, and RHIC pp data. The measured asymmetries provide evidence at the 3σ level for positive gluon polarization in the Bjorken-x region x>0.05.

Coherence between tissue oxygen indexes in vastus lateralis and gastrocnemius in repetition of impulse exercise with high intensity

The purpose of this study was to determine whether tissue oxygen indices (TOIs) in two muscle groups oscillated and were synchronized in repetition of impulse exercise with high intensity. Five impulse exercises of 400 watts for 10 s were repeated with intervals of 6 min. During this period, TOI was determined by near-infrared spectroscopy in the vastus lateralis and gastrocnemius muscles. TOIs in the two muscles oscillated at rest. The TOIs rapidly decreased during each impulse exercise and then recovered and overshot after each impulse. The TOIs oscillated during each interval period. During this test period, coherent and phase differences were determined. There was high coherence between TOIs in the two muscles with a peak value at 0.019 Hz. There was a phase difference of -45 ± 32.4 degrees between TOIs in the two muscles. This phase difference corresponded to about 6 s in time scale. It seemed from this time delay that impulse exercise was not a trigger factor for the starting point of TOIs in the two muscles. It has been concluded that TOIs oscillate and are synchronized between two muscles in repetition of impulse exercise with high intensity.

ΛΛ Correlation function in Au+Au collisions at √[S(NN)]=200 GeV

We present ΛΛ correlation measurements in heavy-ion collisions for Au+Au collisions at sqrt[s_{NN}]=200  GeV using the STAR experiment at the Relativistic Heavy-Ion Collider. The Lednický-Lyuboshitz analytical model has been used to fit the data to obtain a source size, a scattering length and an effective range. Implications of the measurement of the ΛΛ correlation function and interaction parameters for dihyperon searches are discussed.

Combination of high-intensity focused ultrasound irradiation and hydroxyapatite nanoparticle injection to injure normal goat liver tissue in vivo without costal bone incision

The aims of this study were to evaluate the in vivo safety of intravenous nano-hydroxyapatite (nano-HA), to explore how nano-HA might influence the effects of high-intensity focused ultrasound (HIFU) on normal liver tissue, and to investigate whether intravenous nano-HA could enhance HIFU for hepatocellular carcinoma ablation in a goat model. The present study, for the first time, indicated that the delivery of abundant nano-HA into the body over short periods of time could be assembled by the hepatic reticuloendothelial system, subsequently leading to a rapid rise of ultrasound-induced overheating, and ultimately resulting in enlargement of the coagulation necrotic area for ablated hepatocellular carcinoma in goats both in vivo and ex vivo. On the other hand, therapeutic doses of nano-HA were much lower than the lethal dose, and consequently presented transient and mild abnormalities of hepatic enzymes and renal function during the first 24 h after nano-HA injection. These results suggested that the combined application of nano-HA and HIFU is potentially a more effective alternative option compared to surgery for hepatocellular carcinoma local ablation in a safe and feasible manner.

Observation of D0 meson nuclear modifications in Au+Au collisions at sqrt[s(NN)] = 200 GeV

We report the first measurement of charmed-hadron (D(0)) production via the hadronic decay channel (D(0) → K(-) + π(+)) in Au+Au collisions at sqrt[s(NN)] = 200 GeV with the STAR experiment. The charm production cross section per nucleon-nucleon collision at midrapidity scales with the number of binary collisions, N(bin), from p+p to central Au+Au collisions. The D(0) meson yields in central Au + Au collisions are strongly suppressed compared to those in p+p scaled by N(bin), for transverse momenta p(T) > 3 GeV/c, demonstrating significant energy loss of charm quarks in the hot and dense medium. An enhancement at intermediate p(T) is also observed. Model calculations including strong charm-medium interactions and coalescence hadronization describe our measurements.

Efficacy of intravenous propacetamol hydrochloride in the treatment of an acute attack of migraine

BACKGROUND

Triptans are a family of selective serotonin (5-HT1B/1D) receptor agonists that are widely used to treat acute migraine attacks. Their efficacy is limited by side effects and the gastrointestinal manifestations of migraine.

AIM

To compare the efficacy of a single intravenous administration of propacetamol, a prodrug of paracetamol (acetaminophen) with a single dose of oral rizatriptan in treating acute migraine attacks.

METHODS

Patients were selected from those who presented to the emergency room with a diagnosed migraine attack and who had not previously taken any analgesics. They were randomized into 2 groups: treatment with a single 1g IV dose of propacetamol or with a single oral dose of 5mg rizatriptan. Their Visual Analogue Scale (VAS) pain scores were assessed before and at 30, 60, and 120min after treatment.

RESULTS

The patients who received the propacetamol had significantly improved VAS scores at 60min compared to the rizatriptan group. There were no significant differences in VAS scores at 30 or 120min post-treatment.

CONCLUSION

Propacetamol is either equivalent or superior in efficacy to rizatriptan for treating acute migraine attacks, while having the advantage of parenteral administration in patients whose migraines are accompanied by nausea and vomiting.

Beam energy dependence of moments of the net-charge multiplicity distributions in Au+Au collisions at RHIC

We report the first measurements of the moments--mean (M), variance (σ(2)), skewness (S), and kurtosis (κ)--of the net-charge multiplicity distributions at midrapidity in Au+Au collisions at seven energies, ranging from sqrt[sNN]=7.7 to 200 GeV, as a part of the Beam Energy Scan program at RHIC. The moments are related to the thermodynamic susceptibilities of net charge, and are sensitive to the location of the QCD critical point. We compare the products of the moments, σ(2)/M, Sσ, and κσ(2), with the expectations from Poisson and negative binomial distributions (NBDs). The Sσ values deviate from the Poisson baseline and are close to the NBD baseline, while the κσ(2) values tend to lie between the two. Within the present uncertainties, our data do not show nonmonotonic behavior as a function of collision energy. These measurements provide a valuable tool to extract the freeze-out parameters in heavy-ion collisions by comparing with theoretical models.

Measurement of longitudinal spin asymmetries for weak boson production in polarized proton-proton collisions at RHIC

We report measurements of single- and double-spin asymmetries for W^{±} and Z/γ^{*} boson production in longitudinally polarized p+p collisions at sqrt[s]=510  GeV by the STAR experiment at RHIC. The asymmetries for W^{±} were measured as a function of the decay lepton pseudorapidity, which provides a theoretically clean probe of the proton's polarized quark distributions at the scale of the W mass. The results are compared to theoretical predictions, constrained by polarized deep inelastic scattering measurements, and show a preference for a sizable, positive up antiquark polarization in the range 0.05<x<0.2.

Beam-energy dependence of charge separation along the magnetic field in Au+Au collisions at RHIC

Local parity-odd domains are theorized to form inside a quark-gluon plasma which has been produced in high-energy heavy-ion collisions. The local parity-odd domains manifest themselves as charge separation along the magnetic field axis via the chiral magnetic effect. The experimental observation of charge separation has previously been reported for heavy-ion collisions at the top RHIC energies. In this Letter, we present the results of the beam-energy dependence of the charge correlations in Au+Au collisions at midrapidity for center-of-mass energies of 7.7, 11.5, 19.6, 27, 39, and 62.4 GeV from the STAR experiment. After background subtraction, the signal gradually reduces with decreased beam energy and tends to vanish by 7.7 GeV. This implies the dominance of hadronic interactions over partonic ones at lower collision energies.

Dielectron mass spectra from Au+Au collisions at √[s(NN)]=200 GeV

We report the STAR measurements of dielectron (e(+)e(-)) production at midrapidity (|y(ee)|<1) in Au+Au collisions at √[s(NN)]=200  GeV. The measurements are evaluated in different invariant mass regions with a focus on 0.30-0.76 (ρ-like), 0.76-0.80 (ω-like), and 0.98-1.05 (ϕ-like)   GeV/c(2). The spectrum in the ω-like and ϕ-like regions can be well described by the hadronic cocktail simulation. In the ρ-like region, however, the vacuum ρ spectral function cannot describe the shape of the dielectron excess. In this range, an enhancement of 1.77±0.11(stat)±0.24(syst)±0.33(cocktail) is determined with respect to the hadronic cocktail simulation that excludes the ρ meson. The excess yield in the ρ-like region increases with the number of collision participants faster than the ω and ϕ yields. Theoretical models with broadened ρ contributions through interactions with constituents in the hot QCD medium provide a consistent description of the dilepton mass spectra for the measurement presented here and the earlier data at the Super Proton Synchrotron energies.

Telomerase: a target for therapeutic effects of curcumin and a curcumin derivative in Aβ1-42 insult in vitro

This study was designed to investigate whether telomerase was involved in the neuroprotective effect of curcumin and Cur1. Alzheimer's disease is a consequence of an imbalance between the generation and clearance of amyloid-beta peptide in the brain. In this study, we used Aβ1-42 (10 µg/ml) to establish a damaged cell model, and curcumin and Cur1 were used in treatment groups. We measured cell survival and cell growth, intracellular oxidative stress and hTERT expression. After RNA interference, the effects of curcumin and Cur1 on cells were verified. Exposure to Aβ1–42 resulted in significant oxidative stress and cell toxicity, and the expression of hTERT was significantly decreased. Curcumin and Cur1 both protected SK-N-SH cells from Aβ1–42 and up-regulated the expression of hTERT. Furthermore, Cur1 demonstrated stronger protective effects than curcumin. However, when telomerase was inhibited by TERT siRNA, the neuroprotection by curcumin and Cur1 were ceased. Our study indicated that the neuroprotective effects of curcumin and Cur1 depend on telomerase, and thus telomerase may be a target for therapeutic effects of curcumin and Cur1.