[Individualization of dose and fractionation of radiotherapy for head and neck cancers]

Head and neck cancers comprise a variety of tumours depending on the sub-site, for which target volumes and the prescribed doses need to be individualized according to each patient's history and presentation. This article aims at describing the main factors involved in decision-making regarding dose and volume, as well as ongoing research. Contouring and treatment guidelines, use of altered fractionation, major prognostic factors, the role of Human papillomavirus and of functional imaging will be presented and discussed.

[Endogenous Klebsiella pneumoniae endophthalmitis associated with Klebsiella pneumoniae pneumonia: 3 cases report and literature review]

Objective: To study the clinical features and the diagnosis and treatment of endogenous Klebsiella pneumoniae endophthalmitis associated with Klebsiella pneumoniae pneumonia. Methods: Three cases of endogenous Klebsiella pneumoniae endophthalmitis associated with Klebsiella pneumoniae with microbiological evidence were studied. The related literatures published from January 2008 to June 2018 were reviewed with "pneumonia" , "endogenous endophthalmitis" and "Klebsiella pneumoniae" as the keywords in CNKI, Wanfang, PubMed and Web of Science databases. Results: The 3 patients, all males, aged 54 years, 82 years and 48 years respectively. They all had a history of type 2 diabetes mellitus. Endophthalmitis occurred in one eye in all of them, and the patients had eye symptoms including eye pain, progressive loss of vision, periorbital area inflammation, conjunctivitis, weakening or disappearance of pupil light reflex, corneal edema and anterior chamber effusion. All of 3 cases had multiple patchy pulmonary lesions, and Klebsiella pneumoniae was proven to be the pathogen by blood culture. Two cases had pulmonary abscess and liver abscess, and one of them had brain abscess. A total of 28 literatures with 81 cases of endogenous Klebsiella pneumoniae endophthalmitis associated with Klebsiella pneumoniae pneumonia were retrieved from CNKI, WanFang, PubMed and Web of Science database. Conclusions: Klebsiella pneumoniae was one of the most common pathogens of pneumonia and endogenous endophthalmitis, which would seriously damage the lung and the eye. The early clinical features were not specific. Misdiagnosis or missed diagnosis might cause serious consequences. Eye pain and visual disturbance symptoms, ophthalmic examination, chest imaging, blood and aqueous humor etiology were of great value in the diagnosis of this disease.

Application of ultrasound for green extraction of proteins from spirulina. Mechanism, optimization, modeling, and industrial prospects

A green and innovative method, manothermosonication (MTS), for proteins extraction from dry Arthrospira platensis cyanobacteria assisted by ultrasound was designed in this work. Manothermosonication (probe, 20 kHz) was compared to a conventional process performed in the same conditions without ultrasounds. The extraction was carried out with a continuous flow rate at 15 mL/hour. Extraction parameters were optimized using a central composite design. Moreover, mathematic modelling and microscopic investigations were realized to allow a better understanding of ultrasound physical and structural effects on spirulina filaments and mass transfer phenomena over time. Crude extract and sections stained with toluidine blue were analyzed with optical and scanning electron microscopies. According to experimental results, MTS promoted mass transfer (high effective diffusivity, D_e) and enabled to get 229% more proteins (28.42 ± 1.15 g/100 g DW) than conventional process without ultrasound (8.63 ± 1.15 g/100 g DW). With 28.42 g of proteins per 100 g of dry spirulina biomass in the extract, a protein recovery rate of 50% was achieved in 6 effective minutes with a continuous MTS process. Microscopic observations showed that acoustic cavitation impacted spirulina filaments by different mechanisms such as fragmentation, sonoporation, detexturation. These various phenomena make extraction, release and solubilization of spirulina bioactive compounds easier.

New concept of the Axin2 rs2240308 polymorphism and cancer risk: an updated meta-analysis

Previous meta-analyses reported that the variant T allele of Axin2 rs2240308 is associated with a decreased cancer risk. However, more recent findings have been inconsistent. Therefore, we carried out an updated meta-analysis to examine whether this polymorphism is still associated with a decreased cancer risk. Twelve articles, including 14 case-control studies (2,215 cases and 2,481 controls), were included in our study. Surprisingly, different from previous meta-analyses, no significant association between Axin2 rs2240308 polymorphism and cancer risk was observed (dominant model: OR=0.85; 95% CI=0.68-1.06). In further stratified analyses, rs2240308 was significantly associated with a decreased cancer risk only in Asians (dominant model: OR=0.76; 95% CI=0.66-0.88), while for Caucasians the variant showed no significant association with cancer risk (dominant model: OR=1.09; 95% CI=0.67-1.76). Moreover, the rs2240308 variant exhibited a significant association with a decreased risk of lung cancer and prostate cancer. These findings provided new evidence that differed from previous meta-analyses; Axin2 rs2240308 may not modify general cancer susceptibility. Similar with previous meta-analyses, our analysis indicated that Axin2 rs2240308 may modify cancer susceptibility in an ethnicity- and/or type-specific manner. These findings indicate that further replication studies with large sample sizes are warranted to re-evaluate the relationship between Axin2 rs2240308 and cancer risk, especially in Caucasians.

A randomized trial of induction docetaxel-cisplatin-5FU followed by concomitant cisplatin-RT versus concomitant cisplatin-RT in nasopharyngeal carcinoma (GORTEC 2006-02)

Background

Concomitant chemotherapy (CT)-radiotherapy (RT) is a standard of care in locally advanced nasopharyngeal carcinoma (NPC) and a role for induction CT is not established.

Methods

Patients with locally advanced NPC, WHO type 2 or 3, were randomized to induction TPF plus concomitant cisplatin-RT or concomitant cisplatin-RT alone. The TPF regimen consisted of three cycles of Docetaxel 75 mg/m2 day 1; cisplatin 75 mg/m2 day 1; 5FU 750 mg/m2/day days 1-5. RT consisted of 70 Gy in 7 weeks plus concomitant cisplatin 40 mg/m2 weekly.

Results

A total of 83 patients were included in the study. Demographics and tumour characteristics were well balanced between both arms. Most of the patients (95%) in the TPF arm received three cycles of induction CT. The rate of grade 3-4 toxicity and the compliance (NCI-CTCAE v3) during cisplatin-RT were not different between both arms. With a median follow-up of 43.1 months, the 3-year PFS rate was 73.9% in the TPF arm versus 57.2% in the reference arm [hazard ratio (HR) = 0.44; 95% confidence interval (CI): 0.20-0.97, P = 0.042]. Similarly the 3 years overall survival rate was 86.3% in the TPF arm versus 68.9% in the reference arm (HR = 0.40; 95% CI: 0.15-1.04, P = 0.05).

Conclusion

In conclusion, several important aspects can be emphasized: the compliance to induction TPF was good and TPF did not compromise the tolerance of the concomitant RT-cisplatin phase. The improved PFS and overall survival rates needs to be confirmed by further trials.

First Measurements of Absolute Branching Fractions of the Ξ_{c}^{0} Baryon at Belle

We present the first measurements of absolute branching fractions of Ξ_{c}^{0} decays into Ξ^{-}π^{+}, ΛK^{-}π^{+}, and pK^{-}K^{-}π^{+} final states. The measurements are made using a dataset comprising (772±11)×10^{6} BB[over ¯] pairs collected at the ϒ(4S) resonance with the Belle detector at the KEKB e^{+}e^{-} collider. We first measure the absolute branching fraction for B^{-}→Λ[over ¯]_{c}^{-}Ξ_{c}^{0} using a missing-mass technique; the result is B(B^{-}→Λ[over ¯]_{c}^{-}Ξ_{c}^{0})=(9.51±2.10±0.88)×10^{-4}. We subsequently measure the product branching fractions B(B^{-}→Λ[over ¯]_{c}^{-}Ξ_{c}^{0})B(Ξ_{c}^{0}→Ξ^{-}π^{+}), B(B^{-}→Λ[over ¯]_{c}^{-}Ξ_{c}^{0})B(Ξ_{c}^{0}→ΛK^{-}π^{+}), and B(B^{-}→Λ[over ¯]_{c}^{-}Ξ_{c}^{0})B(Ξ_{c}^{0}→pK^{-}K^{-}π^{+}) with improved precision. Dividing these product branching fractions by the result for B^{-}→Λ[over ¯]_{c}^{-}Ξ_{c}^{0} yields the following branching fractions: B(Ξ_{c}^{0}→Ξ^{-}π^{+})=(1.80±0.50±0.14)%, B(Ξ_{c}^{0}→ΛK^{-}π^{+})=(1.17±0.37±0.09)%, and B(Ξ_{c}^{0}→pK^{-}K^{-}π^{+})=(0.58±0.23±0.05)%. For the above branching fractions, the first uncertainties are statistical and the second are systematic. Our result for B(Ξ_{c}^{0}→Ξ^{-}π^{+}) can be combined with Ξ_{c}^{0} branching fractions measured relative to Ξ_{c}^{0}→Ξ^{-}π^{+} to yield other absolute Ξ_{c}^{0} branching fractions.

Abstract P4-07-10: Epithelial-mesenchymal transition sensitizes breast cancer cells to paraptosis-mediated cell death via the fungus-derived sesterpenoid, Ophiobolin A

The epithelial-mesenchymal transition (EMT) enables the dissociation of cancer cells from the primary tumor by facilitating tolerance to lack of cell-adhesion, decreasing cellular division and increasing motility of individual cells, which leads to an invasive phenotype that links EMT to metastasis. Furthermore, EMT results in the acquisition of stem-cell markers and an increased ability to initiate tumor growth, supporting the concept that EMT may contribute to the development of a small, persistent sub-population of the tumor called cancer stem cells (CSCs). Cells that have undergone EMT have characteristically suppressed cell cycles, making them resistant to commonly used chemotherapies that target DNA replication or microtubule dynamics, processes essential to replicating cells. Nonspecific treatments can also rely on inducing apoptotic cell death; however, recent debates challenge the efficacy of apoptosis in solid tumors, citing high rates of acquired resistance. Utilizing a compound that induces alternative cell death, namely paraptosis, becomes attractive when these other treatments fail. Relying on an activated gene expression program, paraptosis results in the swelling of the mitochondria and endoplasmic reticulum and Apaf-1-independent alternative caspase-9 activity. Treating with paraptosis-inducing compounds such as Ophiobolin A (OpA) specifically targets otherwise-insensitive CSC and EMT cells to re-sensitize bulk tumor populations to chemotherapies. We describe EMT as a key driver of enhanced sensitivity to paraptosis-induced cell death following short-term treatment with OpA or other paraptosis-inducing compounds. Further, paraptosis selectively eliminates the CSC sub-population by reducing stem cell activity and highlights the potential of this pathway in breast cancer treatment.

Citation Format: Reisenauer K, Tao Y, Ingros A, Philip T, Evidente A, Kornienko A, Romo D, Taube J. Epithelial-mesenchymal transition sensitizes breast cancer cells to paraptosis-mediated cell death via the fungus-derived sesterpenoid, Ophiobolin A [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-07-10.

Correlations of insulin resistance and HbA1c with cytokines IGF-1, bFGF and IL-6 in the aqueous humor of patients with diabetic cataract

OBJECTIVE

The study aimed to investigate the correlations of insulin resistance and hemoglobin A1c (HbA1c) with cytokines [insulin-like growth factor 1 (IGF-1), basic fibroblast growth factor (bFGF) and interleukin-6 (IL-6)] in the aqueous humor of patients with diabetic cataract.

PATIENTS AND METHODS

59 patients with diabetic cataract and 58 patients with simple cataract treated in Jining No. 1 People´s Hospital (Jining, China) from January 2017 to February 2018, were selected randomly. The levels of homeostasis model assessment of insulin resistance (HOMA-IR) and HbAlc, as well as IGF-1, bFGF and IL-6 in the aqueous humor were compared between the two groups. The correlations of HOMA-IR and HbAlc with IGF-1, bFGF and IL-6 were analyzed. In control group, the levels of HOMA-IR and HbAlc, as well as IGF-1, bFGF and IL-6 in the aqueous humor were significantly lower than those in observation group (p<0.05).

RESULTS

Compared with the group with HbAlc ≤ 7%, the groups with HbAlc ≥ 9% and 7% <HbAlc< 9% had increased relevant indexes. HbAlc was positively correlated with IGF-1, bFGF and IL-6 (r=0.8309, p<0.001; r=0.8968, p<0.001; r=0.8205, p<0.001). HOMA-IR had positive correlations with IGF-1, bFGF and IL-6 (r=0.9091, p<0.001; r=0.9605, p<0.001; r=0.8118, p<0.001). IGF-1 was positively related to bFGF and IL-6 (r=0.9475, p<0.001; r=0.9112, p<0.001).

CONCLUSIONS

For patients with diabetic cataract, HOMA-IR and HbAlc were associated with IGF-1, bFGF and IL-6 in the aqueous humor. The measurement of those indexes can help to judge the disease conditions accurately, having good predictive value.

Capacity of a body shape index and body roundness index to identify diabetes mellitus in Han Chinese people in Northeast China: a cross-sectional study

AIM

To assess the capacity of a body shape index and body roundness index to identify people with diabetes mellitus and those with prediabetes, and to determine whether a body shape index and/or body roundness index is superior to the traditional overall adiposity index, BMI, in Han Chinese people in Northeast China.

METHODS

A total of 15 078 participants were enrolled from Jilin province in 2012 using a multi-stage stratified random cluster sampling method. Demographic data were collected, and anthropometric indices and biochemical indices were measured. Receiver-operating characteristic curves were used to compare the validity of each anthropometric index, and the area under the receiver-operating characteristic curve was calculated for each anthropometric index.

RESULTS

Body roundness index had the highest areas under the receiver-operating curve for prediabetes, diagnosed diabetes and undiagnosed diabetes in both men and women (all P<0.01). The optimum threshold values for body roundness index for prediabetes, undiagnosed diabetes and diagnosed diabetes, respectively, were 2.8, 3.7 and 3.3 in men, and 3.4, 3.8 and 3.6 in women. The cumulative proportions of prediabetes, undiagnosed diabetes and diagnosed diabetes identified by the optimum threshold values of body roundness index were 79.2%, 67.5% and 77.0% (82.3%, 62.5% and 75.3% in men; 74.6%, 74.9% and 78.3% in women), respectively.

CONCLUSIONS

BMI, a body shape index and body roundness index may identify the presence of diabetes. Among the three anthropometric indices, BMI had the weakest association with diabetes. Body roundness index is an alternative index for assessing diabetes in Han Chinese people in Northeast China.

Observation of an Excited Ω^{-} Baryon

Using data recorded with the Belle detector, we observe a new excited hyperon, an Ω^{*-} candidate decaying into Ξ^{0}K^{-} and Ξ^{-}K_{S}^{0} with a mass of 2012.4±0.7(stat)±0.6(syst)  MeV/c^{2} and a width of Γ=6.4_{-2.0}^{+2.5}(stat)±1.6(syst)  MeV. The Ω^{*-} is seen primarily in ϒ(1S),ϒ(2S), and ϒ(3S) decays.

The interruptive effect of electric shock on odor response requires mushroom bodies in Drosophila melanogaster

Nociceptive stimulus involuntarily interrupts concurrent activities. This interruptive effect is related to the protective function of nociception that is believed to be under stringent evolutionary pressure. To determine whether such interruptive effect is conserved in invertebrate and potentially uncover underlying neural circuits, we examined Drosophila melanogaster. Electric shock (ES) is a commonly used nociceptive stimulus for nociception related research in Drosophila. Here, we showed that background noxious ES dramatically interrupted odor response behaviors in a T-maze, which is termed blocking odor response by electric shock (BOBE). The interruptive effect is not odor specific. ES could interrupt both odor avoidance and odor approach. To identify involved brain areas, we focused on the odor avoidance to 3-OCT. By spatially abolishing neurotransmission with temperature sensitive Shibire^TS1 , we found that mushroom bodies (MBs) are necessary for BOBE. Among the 3 major MB Kenyon cell (KCs) subtypes, α/β neurons and γ neurons but not α'/β' neurons are required for normal BOBE. Specifically, abolishing the neurotransmission of either α/β surface (α/β_s ), α/β core (α/β_c ) or γ dorsal (γ_d ) neurons alone is sufficient to abrogate BOBE. This pattern of MB subset requirement is distinct from that of aversive olfactory learning, indicating a specialized BOBE pathway. Consistent with this idea, BOBE was not diminished in several associative memory mutants and noxious ES interrupted both innate and learned odor avoidance. Overall, our results suggest that MB α/β and γ neurons are parts of a previously unappreciated central neural circuit that processes the interruptive effect of nociception.

Pharmacological modulation of radiation-induced oral mucosal complications

Radiation-induced mucositis is a common toxicity, especially in patients with head and neck cancers. Despite recent technological advances in radiation therapy, such as intensity-modulated radiotherapy, radiation-induced mucositis is still causing treatment disruptions, negatively affecting patients' long and short term quality of life, and impacting medical resources use with economic consequences. The objective of this article was to review the latest updates in the management of radiation-induced mucositis, with a focus on pharmaceutical strategies for the prevention or treatment of mucositis. Although numerous studies analysing the prevention and management of oral radiation-induced mucositis have been conducted, there are still few reliable data to guide daily clinical practice. Furthermore, most of the tested drugs have shown no (anti-inflammatory cytokine, growth factors) or limited (palifermin) effect. Therapies for acute oral mucositis are predominantly focused on improving oral hygiene and providing symptoms control. Although low-level laser therapy proved efficient in preventing radiation-induced oral mucositis in patients with head and neck cancer, this intervention requires equipment and trained medical staff, and is therefore insufficiently developed in clinical routine. New effective pharmacological agents able to prevent or reverse radio-induced mucositis are required.

[Longitudinal study of the early prelingual auditory development of children with cochlear implants]

Objective:To explore the early prelingual auditory development (EPLAD) of children with cochlear implants.Method:Children with cochlear implants switched on at 1 and 2 years old in our center were recruited in this longitudinal study, and the EPLAD of them would be tested with the ITMAIS at 3months, 6months, and 12months after switch on. Each children could be permitted to miss follow-up one time.Result:Seventy-five children with unilateral cochlear implants were recruited in the study, and divided into 2 age groups according to the age at switch on,1 year group (32 children) and 2 years group (43 children). The EPLAD of children in both groups improved as the time they wore the cochlear implants increased. The speeds of improvement in both groups were similar to that of normal children and faster than those of children with different hearing impairments and without any interventions. The mean total score at 12 months after switch on in 1 year groups could achieve the average level of mild hearing impaired peer without interventions. In addition, the total scores in both groups were significantly different at 3 months after switch on(P<0.05),and nosignificantly different at 6 and 12 months after switch on(P>0.05).Conclusion:Cochlear implant could help the children with profound sensorineural hearing loss to improve the abilities of EPLAD, and the speed of improvement in the 12 months after switch on was similar to that of normal children. And the results also indicated that the mean total scores at 12 months after switch on in both groups could be close to or achieve the average level of mild hearing impaired peer without interventions, it provided evidences to us for counseling and rehabilitation exercise. In addition, the result, total scores in both groups were just significantly different at 3 months after switch on, emphasized the importance of early intervention as well.