Acute and long-term toxicity in patients undergoing induction chemotherapy followed by thermoradiotherapy for advanced cervical cancer.

OBJECTIVES: To determine rates of vascular toxicity, acute kidney injury (AKI), chronic kidney disease (CKD) and survival in high-risk cervical cancer patients treated with platinum-based induction chemotherapy followed by thermoradiotherapy. METHODS: Between January 1999 and April 2017, patients with large primary tumors (>6cm) and/or para-aortic lymph node (LN) metastases >1 cm and/or para-iliac LN >2 cm were included. Patient and tumor characteristics, Common Toxicity Criteria v4.03 scores, laboratory tests and treatment data were retrieved from patient records. CT scans were reviewed for the presence of thrombo-embolic events (TEE). The study protocol was approved by the Medical Ethics Review Committee of Erasmus MC, Rotterdam (MEC2017-133). RESULTS: The 105 included patients had a mean age of 47.9 years (range 22-79) and a median follow-up time of 43 months (IQR 14-72). Median tumor size was 6.0 cm (range 2.6-11.5), 30% had a clinical FIGO stage ≥ IIIB and 42% had enlarged para-aortic LN. Cisplatin-based therapy was started in 86 patients (82%), of whom 30 (35%) switched to carboplatin and 47% of patients completed six cycles of platinum-based chemotherapy. All patients received external beam radiotherapy as planned, 98 patients (93%) underwent brachytherapy as planned or received an external boost, and 95 patients (90%) completed all five planned hyperthermia treatments. During cisplatin chemotherapy, 34 patients experienced AKI (39%). At last follow-up, 35% of patients had chronic renal toxicity (GFR 59 - 15/min/1.73 m2). At presentation, a TEE was present in 10 (10%) and another 23 (22%) patients experienced a TEE (18% venous, 4% arterial) during chemotherapy. Five-year overall survival was 58% (95% CI 47.8-68.6 SE 0.053). CONCLUSION: Achieving a five-year overall survival of 58%, platinum-based induction chemotherapy followed by thermoradiotherapy is an effective treatment for advanced-stage high-risk cervical cancer. However, treatment is accompanied by an unacceptably high prevalence of chemotherapy-associated TEE and acute kidney injury, as well as chronic kidney disease. Future studies should investigate the role of carboplatin in reducing toxicity and the effect of thromboprophylaxis in high-risk patients.

Phase transitions in the classical exchange-anisotropic Kitaev-Heisenberg model.

The Kitaev model on the honeycomb lattice has been receiving substantial attention due to the discovery of quantum spin liquid state associated with this model. Consequently, its classical partners such as the Kitaev-Heisenberg (KH) model and associated phase transitions become concerned. Specifically, an intermediate Kosterlitz-Thouless (KT) phase engaged in the transition from the high-temperature (T) disordered state to the low-T sixfold degenerate state is predicted in the isotropic KH model [Phys. Rev. Lett. 109, 187201 (2012)10.1103/PhysRevLett.109.187201], but so far no sufficient experimental proof has been reported. In this work, we consider an essential extension of this KH model on the honeycomb lattice by including the Kitaev exchange anisotropy that is non-negligible in realistic materials. The associated phase transitions are thus investigated using the Monte Carlo simulations. It is found that such an anisotropy will result in a degradation of the sixfold degeneracy of the ground state in the isotropic KH model down to the fourfold or twofold degenerate ground state, and the finite-T phase transitions will also be modified remarkably. Interestingly, the intermediate KT phase can be suppressed by this Kitaev exchange anisotropy. This work thus provides a more realistic description of the physics ingredient with the KH model and presents a possible explanation on absence of the intermediate phase in real materials where the Kitaev exchange anisotropy can be more or less available.

SF1670 inhibits apoptosis and inflammation via the PTEN/Akt pathway and thus protects intervertebral disc degeneration.

OBJECTIVE: Intervertebral disc degeneration (IVDD) is associated with the apoptosis of nucleus pulposus (NP) cells. Previous studies have shown that PTEN plays crucial roles in cell survival and apoptosis. The effect of PTEN inhibitors on cell survival following IVDD has been rarely examined. In this study, we investigated the protective effect of SF1670, as a specific PTEN inhibitor, on an in vitro NP cells degenerated model. PATIENTS AND METHODS: We collected human disc samples from IVDD patients and detected PTEN expression in them with different degenerated degrees. NP cells were isolated from the samples and exposed to IL-1ß with or without SF1670. Then, cells viability was determined by CCK-8 assay. We also measured the levels of collagen II, p16, p53, PTEN, Akt, aggrecan, caspase 3/9, Bax, Bcl-2, and several inflammatory factors in NP cells. RESULTS: We found that the expression of PTEN markedly increased in severely degenerated disc tissues. The data showed that IL-1ß upregulated the expressions of p16, p53, PTEN, caspase 3/9, and Bax, but decreased the expressions of collagen II, Akt, aggrecan, and Bcl-2. Surprisingly, the treatment with SF1670 could significantly reverse the regulatory effects of IL-1ß. Moreover, relative levels of IL-6, IL-8, TNF-α, and MMP3/9/13 were significantly suppressed by SF1670 stimuli compared with IL-1ß group. CONCLUSIONS: Overall, these results demonstrated that SF1670 prevented NP degradation via suppressing apoptosis and inflammation through inhibition of PTEN and activation of Akt. SF1670 may become a novel target for the therapy of IVDD in the future.

S-phase kinase-associated protein-2 (Skp2) promotes nucleus pulposus cell proliferation by inhibition of p27 in attenuating intervertebral disc degeneration.

OBJECTIVE: Nucleus pulposus (NP) cell proliferation plays a key role during the process of intervertebral disc degeneration (IDD). S-phase kinase-associated protein-2 (Skp2) has been proved as an important regulator for cell growth factors in vitro. Nonetheless, whether Skp2 attenuates IDD by mediating NP cell proliferation still remains unclear. Therefore, the aim of this study was to explore how Skp2 affected NP cell proliferation and the potential mechanism in vitro. PATIENTS AND METHODS: In this study, we first collected different degenerated human NP samples and isolated NP cells from these tissues. NP cell degenerated model was established with IL-1ß, and the cells were transfected with lentivirus to achieve Skp2 overexpression. Besides, SKPinC1 was used to suppress Skp2 expression in vitro. Western blot, RT-PCR, and immunocytofluorescence were applied to detect genetic differences among groups. Furthermore, cell viability and cell cycle were determined by CCK-8 assay and flow cytometry, respectively. RESULTS: Skp2 expression decreased significantly in degenerated disc samples (p<0.05). IL-1ß stimulation significantly promoted NP cell degeneration, which could be reversed by Skp2 overexpression (p<0.05). Meanwhile, Skp2 in IDD significantly inhibited the expression level of medial p27 and promoted cell cycle by CDK2 activation (p<0.05). In addition, Skp2 suppression affected NP cell proliferation in vitro. CONCLUSIONS: NP cells exhibited significantly inhibited proliferation ability when down-regulated the expression level of Skp2. Our findings provided a more meritorious viewpoint of Skp2 in NP cell proliferation. Furthermore, the above results suggested that Skp2 was a novel target in the treatment of IDD.

Helical and skyrmion lattice phases in three-dimensional chiral magnets: Effect of anisotropic interactions.

In this work, we study the magnetic orders of a classical spin model with anisotropic exchanges and Dzyaloshinskii-Moriya interactions in order to understand the uniaxial stress effect in chiral magnets such as MnSi. Variational zero temperature calculations demonstrate that various helical orders can be developed depending on the interaction anisotropy magnitude, consistent with experimental observations at low temperatures. Furthermore, the uniaxial stress induced creation and annihilation of skyrmions can be also qualitatively reproduced in our Monte Carlo simulations. Our work suggests that the interaction anisotropy tuned by applied uniaxial stress may play an essential role in modulating the magnetic orders in strained chiral magnets.

Magnetic impurity doping induced spin-glass state and short-range zigzag order in the honeycomb iridate Na2IrO3.

Based on the modified Heisenberg-Kitaev model, the effects of magnetic substitution on the magnetic properties of the honeycomb-lattice iridate [Formula: see text] [Formula: see text] are studied using Monte Carlo simulations. It is observed that the long-range zigzag state of the original system is rather fragile and can be replaced by a spin-glass state even for small substitution, well consistent with the experimental observation in Ru-substituted samples (Mehlawat et al 2015 Phys. Rev. B 92 134412). Both the disordered Heisenberg and Kitaev interactions caused by the magnetic ion-doping are suggested to be responsible for the magnetic phase transitions in the system. More interestingly, a short-range zigzag order is suggested to survive above the freezing temperature even at high magnetic impurity doping levels.

Ashkin-Teller criticality and weak first-order behavior of the phase transition to a fourfold degenerate state in two-dimensional frustrated Ising antiferromagnets.

We study the thermal phase transition of the fourfold degenerate phases (the plaquette and single-stripe states) in the two-dimensional frustrated Ising model on the Shastry-Sutherland lattice using Monte Carlo simulations. The critical Ashkin-Teller-like behavior is identified both in the plaquette phase region and the single-stripe phase region. The four-state Potts critical end points differentiating the continuous transitions from the first-order ones are estimated based on finite-size-scaling analyses. Furthermore, a similar behavior of the transition to the fourfold single-stripe phase is also observed in the anisotropic triangular Ising model. Thus, this work clearly demonstrates that the transitions to the fourfold degenerate states of two-dimensional Ising antiferromagnets exhibit similar transition behavior.

Understanding the multiferroicity in TmMn2O5 by a magnetically induced ferrielectric model.

The magnetically induced electric polarization behaviors in multiferroic TmMn2O5 in response to varying temperature and magnetic field are carefully investigated by means of a series of characterizations including the high precision pyroelectric current technique. Here polycrystalline rather than single crystal samples are used for avoiding the strong electrically self-polarized effect in single crystals, and various parallel experiments on excluding the thermally excited current contributions are performed. The temperature-dependent electric polarization flop as a major character is identified for different measuring paths. The magneto-current measurements indicate that the electric polarization in the low temperature magnetic phase region has different origin from that in the high temperature magnetic phase. It is suggested that the electric polarization does have multiple components which align along different orientations, including the Mn3+-Mn4+-Mn3+ exchange striction induced polarization PMM, the Tm3+-Mn4+-Tm3+ exchange striction induced polarization PTM, and the low temperature polarization PLT probably associated with the Tm3+ commensurate phase. The observed electric polarization flop can be reasonably explained by the ferrielectric model proposed earlier for DyMn2O5, where PMM and PTM are the two antiparallel components both along the b-axis and PLT may align along the a-axis. Finally, several issues on the unusual temperature dependence of ferroelectric polarizations are discussed.

Effect of further-neighbor interactions on the magnetization behaviors of the Ising model on a triangular lattice.

In this work, we study the magnetization behaviors of the classical Ising model on the triangular lattice using Monte Carlo simulations, and pay particular attention to the effect of further-neighbor interactions. Several fascinating spin states are identified to be stabilized in certain magnetic field regions, respectively, resulting in the magnetization plateaus at 2/3, 5/7, 7/9 and 5/6 of the saturation magnetization M S, in addition to the well-known plateaus at 0, 1/3 and 1/2 of M S. The stabilization of these interesting orders can be understood as the consequence of the competition between Zeeman energy and exchange energy.

Role of further-neighbor interactions in modulating the critical behavior of the Ising model with frustration.

In this work, we investigate the phase transitions and critical behaviors of the frustrated J(1)-J(2)-J(3) Ising model on the square lattice using Monte Carlo simulations, and particular attention goes to the effect of the second-next-nearest-neighbor interaction J(3) on the phase transition from a disordered state to the single stripe antiferromagnetic state. A continuous Ashkin-Teller-like transition behavior in a certain range of J(3) is identified, while the four-state Potts-critical end point [J(3)/J(1)](C) is estimated based on the analytic method reported in earlier work [Jin, Sen, and Sandvik, Phys. Rev. Lett. 108, 045702 (2012)]. It is suggested that the interaction J(3) can tune the transition temperature and in turn modulate the critical behaviors of the frustrated model. Furthermore, it is revealed that an antiferromagnetic J(3) can stabilize the staggered dimer state via a phase transition of strong first-order character.

Low-field Switching Four-state Nonvolatile Memory Based on Multiferroic Tunnel Junctions.

Multiferroic tunneling junction based four-state non-volatile memories are very promising for future memory industry since this kind of memories hold the advantages of not only the higher density by scaling down memory cell but also the function of magnetically written and electrically reading. In this work, we demonstrate a success of this four-state memory in a material system of NiFe/BaTiO3/La0.7Sr0.3MnO3 with improved memory characteristics such as lower switching field and larger tunneling magnetoresistance (TMR). Ferroelectric switching induced resistive change memory with OFF/ON ratio of 16 and 0.3% TMR effect have been achieved in this multiferroic tunneling structure.

Expression of EpCAM and Wnt/ ß-catenin in human colon cancer.

The aims of this study were to explore the correlation between the expression of EpCAM and the Wnt/ß-catenin pathway in human colon cancer and its clinical significance for the evaluation of cancer prognosis. Samples from colon cancer, para-carcinoma, or benign intestinal tissue from individual patients (50) and from normal intestinal mucosal tissues (20) were obtained from the Pathology Department of the Shandong Province Binzhou People's Hospital (Shandong, China). Immunohistochemistry was used to detect the expression levels of EpCAM and ß-catenin proteins in these tissues, and the prognoses of the patients from whom the samples were derived were determined on follow-up examination. The corresponding in vitro mechanistic siRNA experiments were subsequently performed in the human colon cancer cell line HCT116 to observe the regulatory effects of silencing EpCAM expression on the Wnt/ß-catenin pathway. From these analyses, we determined that the expression levels of EpCAM and ß-catenin were higher in cancer tissues compared with other tissues from the same patient, and that the expression of EpCAM and Wnt/ß- catenin in colon cancers were positively correlated. The prognostic analysis showed an inverse correlation between EpCAM and Wnt/ß- catenin expression and patient prognosis. A further examination of cellular mechanisms confirmed that the silencing of EpCAM led to decreased expression of Wnt/ß-catenin, and thus reduced proliferation and increased the apoptosis ratio in the cells. These results suggest that suppression of EpCAM might be a new approach for treating colon cancer.

Multi-step magnetization of the Ising model on a Shastry-Sutherland lattice: a Monte Carlo simulation.

The magnetization behaviors and spin configurations of the classical Ising model on a Shastry-Sutherland lattice are investigated using Monte Carlo simulations, in order to understand the fascinating magnetization plateaus observed in TmB(4) and other rare-earth tetraborides. The simulations reproduce the 1/2 magnetization plateau by taking into account the dipole-dipole interaction. In addition, a narrow 2/3 magnetization step at low temperature is predicted in our simulation. The multi-step magnetization can be understood as the consequence of the competitions among the spin-exchange interaction, the dipole-dipole interaction, and the static magnetic energy.

Vortex polarization states in nanoscale ferroelectric arrays.

Two-dimensional arrays of ferroelectric lead zirconate titanate (PZT) nanodots were fabricated using pulsed laser deposition through ultrathin anodic aluminum oxide membrane stencil masks. The static distribution of polarization configurations was investigated using in- and out-of-plane piezoresponse force microscopy (PFM). The observed presence of an in-plane polarization component in nominally (001) oriented PZT suggests the existence of a significant deviation from the regular tetragonal structure that allows the formation of complex core-polarization states. Core-polarization states may indicate the presence of quasi-toroidal polarization ordering. The experimental results are compared with a theoretical model to determine the fingerprint of a vortex polarization state in PFM.

[Experimental study of allogenic tendon with sheath grafting in chicken].

OBJECTIVE: To investigate availability of deep freeze stored allogenic tendon with sheath grafting in repairing the tendon and sheath defect in the II area of flexor digitorum tendon. METHODS: Sixty chickens with tendon and sheath defect were divided into 2 groups randomly, group A was treated with allogenic grafting and group B was treated with autogenic grafting, these two groups were divided into two subgroups respectively, they were, group A1 allogenic tendon with whole sheath grafting, group A2 allogenic tendon with partial sheath grafting, group B1 autogenic tendon with whole sheath grafting and group B2 autogenic tendon with whole sheath grafting. All the allogenic grafts were treated by deep freeze. Histomorphological study, histoimmunological study and slipping function of the grafts were measured after operation. RESULTS: In group A1 and B1, the local reaction was sever, the nutrition of tendon graft was barricaded by the whole sheath resulting in adhesion, degeneration and necrosis. In group A2 and B2, the tendon graft healed well and little adhesion existed between tendon and sheath. The results showed that there were significant differences between tendon grafting with whole sheath and tendon grafting with partial sheath. CONCLUSION: Deep freeze store can reduce the immunogenicity of allogenic tendon with sheath. Allogenic tendon with partial sheath grafting can be used as a new biological material for repairing the tendon and sheath defect.

Influence of cell membrane potential, and selectivity of the Na+/H+ exchanger and Cl-/HCO3- exchanger on the intracellular accumulation of adriamycin.

Intracellular accumulation of adriamycin (ADR) has been reported to be influenced by cell membrane potential. We first evaluated intracellular accumulation of ADR and 3,3'-(di-n-hexyl)-2,2'-oxacarbocyanine iodide (NK-2280), an indicator of cell membrane potential, and found a good correlation between ADR and NK-2280 intracellular accumulation in several cell lines. This suggests that ADR accumulation may be influenced by cell membrane potential or the mechanisms of NK-2280 accumulation may be similar to those of ADR accumulation. Next, we observed the influence of the NA+/H+ exchanger and Cl-/HCO3- exchanger on the intracellular accumulation of ADR and NK-2280, and found that ADR accumulation decreased with increasing concentrations of 3,5-diamino-6-chloro-N-(diaminomethylene)pyrazinecarboxamide (amiloride), an inhibitor of the Na+/H+ exchanger, and 4,4'-diisothiocyanato-stilbene-2,2'-disulfonic acid (DIDS), an inhibitor of the Cl-/HCO3- exchanger, however, NK-2280 accumulation was increased by amiloride, and decreased by DIDS. The increased accumulation of NK-2280 induced by amiloride may be due to the increased cell membrane potential caused by the inhibition of H+ ion efflux and NA+ ion influx due to the inhibition of the Na+/H+ exchanger. The decreased accumulation of NK-2280 may be also due to the decreased cell membrane potential caused by the inhibition of Cl- ion efflux due to the inhibition of the Cl-/HCO3- exchanger by DIDS. However, the decreased rate caused by DIDS was greater than the increased rate caused by amiloride. Therefore, it is suggested that the decreased accumulation of NK-2280 by DIDS may be influenced by other factors apart from cell membrane potential. These results suggest that the Cl-/HCO3- exchanger may be related to both ADR accumulation, and NK-2280 accumulation, and that the Na+/H+ exchanger may be related to ADR accumulation, but not NK-2280. This suggests that the Cl-/HCO3- exchanger is of low selectivity.

Sensitivity of anticancer drugs in NIH3T3' cells transfected with oncogenes accompanied by pSV2neo vector.

NIH3T3 cells and NIH3T3 cell lines, which were transfected with several oncogenes accompanied by pSV2neo vector, were observed for their survival rate when treated with commonly used anticancer drugs. The survival rates in the cell line transfected with the pSV2neo vector only did not differ significantly from that of parental NIH3T3 cells against bleomycin, nimustine and adriamycin, but it was significantly more resistant to cisplatin and more sensitive to mitomycin C. Therefore, the survival rate in each transfectant was compared with that in the pSV2neo transfectant. The Val-12, v-Ha-ras, v-int-2, v-erbB or v-abl transfectants accompanied by pSV2neo vector were significantly more sensitive to cisplatin than transfection with pSV2neo vector only. The Val-12, v-Ha-ras, v-int-2 and v-abl transfectants were significantly more sensitive, and the v-erbB transfectant more resistant to bleomycin than the pSV2neo transfectant. The v-int-2, v-erbB, frg, v-raf and v-myc transfectants were more sensitive, and the v-Ha-ras transfectant more resistant to nimustine than the pSV2neo transfectant. The N-ras, v-Ha-ras, v-sis, v-int, v-abl and v-myc transfectants were significantly more sensitive to adriamycin than the pSV2neo transfectant. The v-sis and v-int-2 transfectants were more sensitive, and the c-Ki-ras, Val-12, v-erbB and the v-src transfectants more resistant to mitomycin C than the pSV2neo transfectant. Thus there was no relationship between the drug sensitivity and the location of oncogenes, but the transfection was associated with either increased or decreased sensitivity to a number of commonly used anticancer drugs. Therefore, it may be important to take into consideration or overexpression of oncogenes in cancer chemotherapy.

Hyperthermotherapy for postoperative local recurrences of rectal cancer.

Between November 1984 and August 1992 we used hyperthermotherapy in six cases of local recurrence of rectal cancer. Hyperthermotherapy was performed on the average 8.7 times (range: 3-18) for each patient for 60 min each. All patients underwent combined radiotherapy and received a mean radiation dose of 42.5 Gy (range: 9-60 Gy). Five patients underwent heating within 1 h after irradiation and one patient simultaneously with the irradiation. Four patients underwent combined chemotherapy and two patients immunotherapy. Before the treatment all patients had painful lesions, but pain decreased posttherapeutically in five patients. Performance status improved in two patients. High carcinoembryonic antigen levels prior to the therapy in four patients decreased in all cases after treatment. Posttherapeutical computed tomograms revealed only minor response or no changes. After the treatment, four patients died of exacerbations of recurrent tumors and one patient of distant metastases. The patient who underwent simultaneous radiohyperthermotherapy is presently alive, in August 1992, 38 months after initiation of the treatment. The 50% survival time after initiation of the treatment was 25 months (range: 10-38 months). Hyperthermotherapy combined with radiotherapy, chemotherapy and/or immunotherapy was useful for the alleviation of pain in patients who developed local recurrence after surgery, and improved survival after recurrences can be expected.

[Absorptive capacity of upper gastrointestinal tract with Chinese herbal medicine].

285 reports on the intoxication of Chinese herbal medicine per os were reviewed. The toxic symptoms occurred after oral administration for less than 10 min in about 110 reports. Some components of these herbal medicines might be absorbed and then reach effective level more rapidly. By segmental ligation of GI tract, experiments in rabbits, cats, rats or mice were conducted, in which principal ingredients of Rheum palmatum, Coptis chinensis, Veratrum nigrum, and aconitine were absorbed in esophagus or stomach within short period of time was observed. It suggested that the absorptive capacity of upper GI tract might have universal significance. The treatment of acute diseases by oral administration of Chinese herbal medicines is feasible.