An open-label, single-arm phase II clinical study of induction chemotherapy and sequential Nimotuzumab combined with concurrent chemoradiotherapy in N3M0 stage nasopharyngeal carcinoma

INTRODUCTION

The purpose of this study was to analyze the efficacy and safety of induction chemotherapy and sequential Nimotuzumab combined with concurrent chemoradiotherapy in N3M0 stage nasopharyngeal carcinoma (NPC).

METHODS

This study included 45 N3 stage NPC patients treated with induction chemotherapy, sequential Nimotuzumab plus concurrent chemoradiotherapy. The intensity modulated radiation therapy (IMRT) doses for planning target volume (PTV) were 70-72 Gy for gross disease in the nasopharynx, and 66-70 Gy for positive lymph nodes. The doses for high risk and low risk regions PTV were 60-62 Gy and 54-56 Gy in 31-33 fractions. Induction chemotherapy consisted of 3 cycles of docetaxel (75 mg/m2, day 1) plus lobaplatin (30 mg/m2, day 1). Concurrent with radiotherapy, patients received chemotherapy consisting of lobaplatin 50 mg/m2, day 1. Targeted drug therapy given on the first time of IMRT consisted of Nimotuzumab (200mg, iv weekly for 7 courses). Cycle repetition of chemotherapy was every 21 days.

RESULTS

The efficacy of 3 cycles of induction chemotherapy before the start of concurrent chemoradiotherapy was 100%, and the overall efficacy after the end of chemoradiotherapy was also 100%. Three-year overall survival (OS), distant metastasis-free survival (DMFS), locoregional control (LRC) and progression-free survival (PFS) rates were 85.6, 81.9, 97.8 and 79.5%, respectively. The main adverse reactions were hematologic toxicity, particularly neutropenia (100%), anemia (88.9%) and thrombocytopenia (68.9%). Patients developed a relatively low degree of mucositis and vasculitis. Chronic toxicity was mainly grade I-II radiation-induced xerostomia (18 cases). There were 11 cases of hearing loss and 4 cases of neck skin fibrosis. No cases of treatment-related death and radiation-induced cranial nerve damage or trismus were observed.

CONCLUSION

In N3 stage NPC, induction chemotherapy and sequential Nimotuzumab plus concurrent chemoradiotherapy yielded an excellent survival benefit, and the toxicities were tolerable. Distant metastasis was the main cause of treatment failure.

Efficacy of concurrent chemoradiotherapy combined with nimotuzumab for low-risk T4 stage nasopharyngeal carcinoma: A pilot study

BACKGROUND

The purpose of this study was to analyze the efficacy and safety of concurrent chemoradiotherapy combined with Nimotuzumab for low-risk T4 stage nasopharyngeal carcinoma (NPC).

METHODS

This study included 49 low-risk T4 stage NPC patients treated with concurrent chemoradiotherapy plus Nimotuzumab. The IMRT doses were planning target volume (PTV) 70-72 Gy for gross disease in the nasopharynx, and 66-70 Gy for positive lymph nodes. The doses for high risk and low risk region PTV were 60-62 Gy and 54-56 Gy in 31-33 fractions. All patients received a chemotherapy program consisting of Cisplatin 100mg/m2, day 1, Q3w and were treated by Nimotuzumab (Nimotuzumab 200mg, iv, Qw).

RESULTS

All 49 patients completed at least two cycles of chemotherapy and seven weeks of Nimotuzumab. The total efficiency of therapy was 100.0%. The 3-year overall survival (OS), distant metastasis-free survival (DMFS), local-regional control (LRC) and progression-free survival (PFS) rates were 89.7%, 87.8%, 97.9% and 85.7%, respectively. No regional lymph node recurrence was detected. The most serious acute toxicity was mucositis, with prevalence of Grades 0 to IV being 0.0%, 57.1%, 34.7%, 8.2%, and 0.0%, respectively. Late toxicity manifested as Grades I and II xerostomia in 32 and 10 patients.

CONCLUSION

In patients with low-risk T4 stage NPC, concurrent chemoradiotherapy combined with Nimotuzumab yielded an excellent local control rate, and the toxicities were mild and tolerable. Distant metastasis was the main cause of treatment failure.

Enzymatic Synthesis of Glycerol Carbonate Using a Lipase Immobilized on Magnetic Organosilica Nanoflowers as a Catalyst

For synthesizing glycerol carbonate (GC) by a reaction between glycerol (GL) and dimethyl carbonate (DMC), a lipase immobilized on magnetic organosilica nanoflowers was prepared and utilized as a biocatalyst. Candida antarctica lipase B (CALB) was chosen as a model enzyme for preparing an immobilized biocatalyst (CALB@nanoflowers). The obtained CALB@nanoflowers was characterized using scanning electron microscopy, transmission electron microscopy, and confocal laser scanning microscopy. Effects of GL/DMC molar ratio, biocatalyst amount, temperature, surfactant and molecular sieve addition, and reaction time on the conversion of GL and the selectivity of CALB@nanoflowers were investigated. The optimal catalytic performance (yield of GC: 88.66% and conversion of GL: 94.24%) was achieved under the condition of 1:20 molar ratio of GL to DMC with 0.2 g of molecular sieves added at 50 °C for 24 h. After recycling seven times, the CALB@nanoflowers maintained over 79% of its initial activity and the yield of GC was 70.31%.

A retrospective study of concurrent chemoradiotherapy plus S-1 adjuvant chemotherapy on curative effect for treatment of patients with N3 stage nasopharyngeal carcinoma

Introduction

The purpose of this study was to analyze the efficacy and safety of concurrent chemoradiotherapy plus S-1 adjuvant chemotherapy for N3 stage nasopharyngeal carcinoma (NPC).

Methods

This study included 44 N3 stage NPC patients treated with concurrent chemoradiotherapy plus S-1 adjuvant chemotherapy. The intensity-modulated radiation therapy doses were planning target volume (PTV) 70–72 Gy for gross disease in the nasopharynx and 66–70 Gy for positive lymph nodes. The doses for high-risk- and low-risk region PTV were 60–62 and 54–56 Gy in 31–33 fractions. All patients received a concurrent chemotherapy program consisting of cisplatin 100 mg/m², day 1, and the cycle repetition was every 21 days. The adjuvant chemotherapy program consisted of 4 cycles of S-1. The dose of S-1 was determined according to the body surface area (BSA): 40 mg twice a day for BSA <1.25 m²; 50 mg twice a day for 1.25 m²≤BSA<1.5 m²; and 60 mg twice a day for BSA ≥1.5 m². S-1 was given on days 1–28, given 6 weeks apart.

Results

All 44 patients completed at least 2 cycles of concurrent chemotherapy and 4 cycles of adjuvant chemotherapy. The total efficiency of therapy was 100.0%. The 3-year overall survival (OS), distant metastasis-free survival (DMFS), local-regional control, and progression-free survival rates were 86.4%, 84.1%, 97.7%, and 81.8%, respectively. There were no differences in the OS, DMFS, and efficiency between fast-fading group (reaching partial response before the second cycle of concurrent chemotherapy) and general-fading group (the rest of the group). The incidence of rash in the entire group was low, and there was also no association with prognosis.

Conclusion

In patients with N3 stage NPC, concurrent chemoradiotherapy plus S-1 adjuvant chemotherapy yielded an excellent survival benefit, and the toxicities were mild and tolerable. Distant metastasis was the main cause of treatment failure.

Superconductivity switch from spin-singlet to -triplet pairing in a topological superconducting junction

The interedge coupling is the cardinal characteristic of the narrow quantum spin Hall (QSH) insulator, and thus could bring about exotic transport phenomena. Herein, we present a theoretical investigation of the spin-resolved Andreev reflection (AR) in a QSH insulator strip touching on two neighbouring ferromagnetic insulators and one s-wave superconductor. It is demonstrated that, due to the interplay of the interedge coupling and ferromagnetic configuration, there could be not only usual local ARs leading to the spin-singlet pairing with the incident electron and Andreev-reflected hole from different spin subbands, but also novel local ARs giving rise to the spin-triplet pairing from the same spin subband. However, only the latter exists in the absence of the interedge coupling, and therefore the two pairings in turn testify the helical spin texture of the edge states. By proper tuning of the band structures of the ferromagnetic layers, under the resonance bias voltage, the usual and novel local ARs of [Formula: see text] can be all exhibited, resulting in fully spin-polarized pure spin-singlet superconductivity and pure spin-triplet superconductivity, respectively, which suggests a superconductivity switch from spin-singlet to -triplet pairing by electrical control. The results can be experimentally confirmed by the tunneling conductance and the noise power.

Free amino acid profiling of gastric juice as a method for discovering potential biomarkers of early gastric cancer

Background: Prior studies showed that aromatic amino acids (AAAs) could be used as potential gastric juice biomarkers in screening gastric cancer (GC). To identify new biomarkers for early diagnosis of GC, the characteristics of gastric juice free amino acid (GJFAA) profiling was determined. Method: First, gastric juice was collected from 130 consecutive patients who underwent gastroscopy. They were divided into GC group (n = 47) and non-neoplastic gastric disease (NGD) group (n = 83) according to the pathological diagnosis. The concentrations of 34 GJFAAs were examined by amino acid analyzer. Multivariate and univariate analyses were used for comparing the alterations of GJFAA profiles between the two groups. Then candidate differential GJFAAs were verified by LC-MS/MS in another set of patients, which included 32 GC patients and 38 NGD patients. The diagnostic performance of GJFAAs was evaluated by ROC curve. Results: Significant alterations in GJFAA profiles were observed in GC patients compared to NGD patients in the training set. A total of 14 amino acids were screened as differential GJFAAs. Leucine, threonine and serine were the most frequently altered. Combined AUC of the three non-AAAs [0.869 (95% CI, 0.805-0.934)] was superior to the combined three AAAs [0.841 (95% CI, 0.773-0.908)]. In addition, a combined AUC comprisingthe six ones was further improved to 0.871 (95% CI, 0.809-0.933) in the diagnosis of GC. A similar variation trend and diagnostic value were observed in the validation set. Conclusion: This study indicates the potential of GJFAA profiling as a promising approach for the early detection and screening of GC.

Detection of gastritis-associated pathogens by culturing of gastric juice and mucosa

It is well known that Helicobacter pylori (H. pylori) is not the only indigenous bacterium in the stomach, as numerous studies have revealed that the gastric microbiota contributes to the pathogenesis of gastric disease. However, the correlation between the gastric bacterial flora and gastritis is unclear. By comparing differences in viable gastric bacteria between a gastritis group and a healthy group, we examined the potential species related to chronic gastritis. We collected juice and mucosa samples from 103 consecutive patients and identified 81 species by culturing and matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS). The positive rates of Streptococcus and Neisseria were markedly higher in the gastritis group than those in the normal group, suggesting that certain bacterial species may play vital roles in the development of gastritis rather than acting as transient microbes. This finding can be applied to the diagnosis and treatment of chronic gastritis as evidence supporting non-Helicobacter pylori infection-related gastritis.

A randomized, double blind, controlled, multi center study of Ilaparazole in the treatment of reflux esophagitis-Phase III clinical trial

AIM AND BACKGROUND

Proton pump inhibitors (PPIs) are the main drugs for the treatment of reflux esophagitis. Phase II clinical trials showed that, compared with Esomeprazole, the new PPI Ilaparazole is great in terms of efficacy for reflux symptoms relief and curling for esophagitis. The aim of this study was to confirm suitable dose of Ilaparazole in the treatment of reflux esophagitis.

METHODS

This study used a randomized, double-blind, parallel positive drug control, multi-center design. A total of 537patients diagnosed as reflux esophagitis by gastroscopy were randomly divided into Ilaparazole group (n = 322, Ilaparazole 10 mg QD) and esomeprazole group (n = 215, Esomeprazole 40 mg QD). The patients in the two groups were treated for 8 weeks. Heartburn and reflux symptoms prior to treatment, and 2, 4 and 8 weeks after the treatment were assessed. Gastroscopy was performed after 4 weeks of treatment. Unhealed patients within 4 weeks underwent gastroscopy again at the end of 8 weeks.

RESULTS

A total of 471 cases completed the treatment. In Esomeprazole and Ilaparazole groups. After 8 weeks treatment, the healing rate in Esomeprazole group and Ilaparazole group were 82.79% (94.94%) and 83.54% (92.50%), respectively. The corresponding rate difference [Ilaparazole-esomeprazole] was 0.75% (-2.44%) and the two-sided 95% CI was -5.72 to 7.22 (-6.90 to 2.01). The symptom disappearance rates for FAS (PPS) were 75.81% (82.02%) and 76.71% (80.36%) P = 0.8223 (0.7742). Adverse reactions related to the drugs were: 10.70% and 11.80%, (P = 0.7817).

CONCLUSIONS

The efficacy and safety of Ilaparazole (10 mg/day) in treating reflux esophagitis was similar to esomeprazole (40 mg/day). Ilaparazole (10 mg/day) can be used in the treatment of esophagitis. The clinical trial registration number of the study is NCT 02860624.

[Experimental study on the effect of Yiqi Wenyang Decoction on nasal mucosa infiltration of NK cells in mice with allergic rhinitis]

Objective: To observe the effect of Yiqi Wenyang Decoction on the infiltration and activation of NK cells in nasal mucosa of mouse model with allergic rhinitis (AR), and to explore the potential mechanism for effective intervention of AR with Yiqi Wenyang Decoction. Methods: Fourty-eight mice were randomly divided into blank group, model group, low, medium and high dose of Yiqi Wenyang Decoction group and Cetirizine group, with 8 rats in each group. After modeling of AR, the model group was filled with 0.9% sodium chloride solution. Yiqi Wenyang Decoction groups of each dose were given different concentrations of Yiqi Wenyang Decoction water extract, while the Cetirizine group was given aqueous solution of Cetirizine. The behavior, morphological changes of nasal mucosa and infiltration of NK cells in nasal mucosa were observed. The levels of IL-4 and INF-γ in nasal lavage fluid were measured. Besides, the drug safety was observed by acute toxicity test. Results: In the respect of behavioral scoring, middle and high dose of Yiqi Wenyang Decoction group were superior to the model group (number of sneezing: q value was 7.189, 8.748, respectively; number of scratching nose: q value was 12.074, 14.560, respectively; all P<0.05). In middle and high dose of Yiqi Wenyang Decoction group, the infiltration of NK cells and nasal lavage fluid IL-4 levels were lower than those in model group (IOD: q value was 10.073, 12.322, respectively; IOD/Area: q value was 10.954, 14.073, respectively; IL-4: q value was 4.705, 6.801, respectively; all P<0.05). There was no significant difference in nasal lavage fluid of INF-γ among each group (Fv=1.166, P>0.05). In acute toxicity test, no obvious poisoning symptoms and death occurred in mice. Conclusion: Yiqi Wenyang Decoction can control the nasal symptom, reduce the local NK cell infiltration of nasal mucosa and inhibit the expression of the 2-type cytokines released by NK cells, which may be related with the potential mechanism of effective intervention of AR with Yiqi Wenyang Decoction.

Metabolic profiles of gastric cancer cell lines with different degrees of differentiation

Gastric cancer is a commonly found malignant tumor, yet research on biomarkers of gastric cancer still face tremendous challenges. This study is the first to use gas chromatography-mass spectrometry (GC-MS) to measure and compare the metabolic profiles of gastric cancer cell lines with varying degrees of differentiation (MKN-28, SGC-7901, and AGS) with that of a normal gastric epithelial cell line (GES-1). OPLS-DA models were established to distinguish gastric cancer cell lines from a normal gastric epithelial cell line. In this study, we identified 278 metabolites, of which 111 show similarity scores greater than 700. Most notably, 6 metabolites (alanine, α-ketoisocaproic acid, proline, glyceric acid, pantothenic acid, and adenosine) showed varying expression levels between gastric cancer cell lines and a normal gastric epithelial cell line. These metabolites are potential biomarkers of gastric cancer and may be of great significance for the diagnosis, treatment and prognosis of gastric cancer patients.

An integrated nanocatalyst combining enzymatic and metal–organic framework catalysts for cascade degradation of organophosphate nerve agents

An integrated nanocatalyst that combined a metal–organic framework-based catalyst and a biocatalyst was developed for cascade degradation of organophosphate nerve agents.

Conversion of levulinic acid into alkyl levulinates: Using lipase immobilized on meso-molding three-dimensional macroporous organosilica as catalyst

For conversion of biomass-derived levulinic acid into alkyl levulinates, a novel kind of lipase-based biocatalyst was prepared through immobilized lipase B from C. antarctica (CALB) on organosilica material with highly ordered 3D macroporous organosilica frameworks and a 2D hexagonal meso-structure (named 3DOM/m-OS) for the first time. The catalytic performance of the immobilized lipase (NER@3DOM/m-OS) was investigated. NER@3DOM/m-OS was used as biocatalyst to catalyze the esterification reaction between levulinic acid (LA) and n-butanol. Under optimized reaction conditions, 74.59% of ester yield was achieved after 12h of reaction. NER@3DOM/m-OS was also used to production of other alkyl levulinates, the ester yields increased to 84.51% (octyl levulinate) and 91.14% (dodecyl levulinate), respectively. When NER@3DOM/m-OS was used repeatedly in batch reactions, the ester yields of n-butyl, octyl, and dodecyl levulinate could retain 46.18%, 82.33% and 81.25% after 9 reaction cycles, respectively, which was better than commercial lipase Novozym 435 under the same condition.

Co-immobilization of glucose oxidase and catalase in silica inverse opals for glucose removal from commercial isomaltooligosaccharide

In this work, glucose oxidase (GOD) and catalase (CAT) were co-immobilized on novel silica inverse opals (IO-SiO₂) through sol-gel process. The immobilized bi-enzyme system named GOD/CAT@IO-SiO₂ was successfully fabricated and characterized. Morphology characterization indicated that GOD/CAT@IO-SiO₂ had hierarchical porous structure, and the pore diameter of macroporous and mesoporous were 500±50nm and 6.8nm, respectively. The macrospores were connected through windows of 100±30nm. The results of stability tests indicated that both acid (or base) resistance and thermal tolerance of GOD/CAT@IO-SiO₂ were improved. When GOD/CAT@IO-SiO₂ was used to remove glucose from commercial isomaltooligosaccharide (IMO), the immobilized bi-enzyme system exhibited the good performance. The removal efficiency of glucose reached up to 98.97% under the conditions of GOD/CAT activity ratio of 1:30, the amount of enzyme of 68.8mg, reaction time of 9.39h, reaction temperature of 35.2°C and pH of 7.05. After reused 6 times, 79.19% of removal efficiency could be still retained. The present work demonstrates that the immobilized bi-enzyme (GOD/CAT@IO-SiO₂) is not only a very promising system for glucose removal but also has great potential for applications in production of gluconic acid, preparation of biosensors, enzyme bioreactors, etc.

Non-pylori Helicobacters (NHPHs) Induce Shifts in Gastric Microbiota in Helicobacter pylori-Infected Patients

To explore the effects of gastric non-H. pylori Helicobacter species(NHPH) on the structure and potential function of gastric microbiota, we employed 16S rRNA gene sequencing on 164 gastric biopsy specimens from NHPH (H. suis, H. felis, H. salomonis) /H. pylori coinfection individuals, H. pylori monoinfection individuals and healthy controls. The results demonstrated that marked structural and functional variations between H. pylori mono- and coinfection samples (HPHS, HPHF, HPHM). The changes in bacterial structure induced by NHPH are mainly attributed to their ability of gastric acid secretion inhibition as well as bacterial chemotaxis. Both the HPHS and HPHF groups showed significant increases in phylotype richness and significant decreases in β diversity, but this trend was not found in HPHM group. Regarding the top five phyla and top thirty-five genera, the HPHS and HPHF groups had similar variation trends in relative abundance. The increased relative abundance levels of the genera Vibrio, Pseudoalteromonas, Photobacterium, and Clostridium were associated with increases in predicted signal transduction/metabolic pathways among the three coinfection groups. The relative abundance levels of bacteria involved in the formation of N-nitroso compounds were significantly decreased in the HPHS and HPHF groups (e.g., Streptococcus, Neisseria, Haemophilus, Veillonella, Clostridium, etc.). The significantly decreased relative abundance levels of the phyla Firmicutes and Bacteroidetes in the HPHS and HPHF groups were associated with the observed increases in predicted lipid metabolism pathways. The results in this study implied that NHPH can arouse the variation of structure and function of gastric microbiota, which may pave the way to further research on the pathogenesis of gastric diseases.

Gastric cancer: Metabolic and metabolomics perspectives (Review)

Gastric cancer is one of the most malignant tumors worldwide and remains a major health threat in Asia-Pacific regions, while its pathological mechanism is generally unknown. Recent research has advanced the understanding of the relationship between metabolic reprogramming and carcinogenesis. In particular, metabolic regulation and cancer research are being further brought into sharp focus with the emergence of metabolomics. Not only can metabolomics provide global information on metabolic profiles of specific tumors, but it can also act as a promising tool to discover biomarkers regarding diagnosis, metastatic surveillance and chemotherapeutic sensitivity prediction. Meanwhile, metabolism-based anticancer therapies will be further discovered. Up to now, accumulative studies have highlighted the application of metabolomics in gastric cancer research regarding different aspects; therefore we summarized the current available results of how metabolic changes are linked to gastric carcinogenesis, and how metabolomics holds promise for the diagnosis, metastatic surveillance, treatment and prognosis prediction of gastric cancer.

Color-tunable emission and energy transfer investigation in Sr3Y(PO4)3:Ce3+,Tb3+ phosphors for white LEDs

A novel color-tunable phosphor Sr₃Y(PO₄)₃:Ce³⁺,Tb³⁺ was synthesized through solid-state reaction method. Several techniques, such as X-ray diffraction, Fourier transform infrared spectroscopy, scanning electron microscopy, and energy dispersive X-ray spectroscopy, were used to investigate the obtained phosphors. Results of luminescence spectra and decay time measurements revealed that an efficient energy transfer occurred from Ce³⁺ to Tb³⁺ via a dipole-dipole mechanism, where Ce³⁺ exhibited a strong excitation band in the near-ultraviolet region. CIE chromaticity coordinates were tuned from deep blue (0.162, 0.090) to green (0.230, 0.411) by adjusting the relative concentrations between Ce³⁺ and Tb³⁺ ions. Results revealed that the as-synthesized phosphors had color-tunable characteristics and can be used as promising materials in the field of phosphor-converted white light-emitting diodes.

Autoimmune metaplastic atrophic gastritis in chinese: a study of 320 patients at a large tertiary medical center

OBJECTIVES

Autoimmune metaplastic atrophic gastritis (AMAG) is an uncommon disease worldwide and may predispose to gastric carcinoid tumors or adenocarcinomas. The aims of this study were to outline the clinical characteristics of Chinese AMAG patients, including demographic pattern, hematologic features, and gastroscopic and histopathologic findings.

PATIENTS AND METHODS

A total of 320 Chinese patients with AMAG, from January 2007 to December 2014, were reviewed in a regional hospital of China.

RESULTS

Of the 320 AMAG patients, the mean age was 60.6 ± 12.3 years [range 26-86; 206 (64.4%) women]. The coarse annual detection rate was 0.9%. Anemia was present in only 19.3% patients (53/275) and 3.5% (11/315) AMAG patients also had primary biliary cirrhosis. One hundred and thirty-six had endoscopically identifiable lesions. These lesions consisted of 130 polypoid lesions (63 hyperplastic polyps, 2 oxyntic mucosa pseudopolyps, 2 intestinal-type gastric adenomas, 2 fundic gland polyps, 5 concurrent polyps, 14 well-differentiated neuroendocrine neoplasms, 7 submucosal tumors and 35 chronic gastritis), 6 adenocarcinomas. The detection rate of atrophy and intestinal metaplasia in antral mucosa were 47.2 and 37.5%, respectively.

CONCLUSIONS

AMAG is more frequent than expected in China and display a female predominance, accompanied with other autoimmune disorders. AMAG should be paid more attention by clinicians through a multidisciplinary team approach.