Efficacy of concurrent chemoradiotherapy combined with nimotuzumab in the treatment of nasopharyngeal carcinoma with cervical lymph node metastasis.

OBJECTIVES: First, we retrospectively compared the clinical efficacy of concurrent chemoradiotherapy combined with nimotuzumab vs. chemoradiotherapy alone in patients with nasopharyngeal carcinoma (NPC) and cervical lymph node metastasis. Second, we analyzed the value of Ki-67 as a predictor of nimotuzumab efficacy. METHODS: From January 2012 to December 2019, 1250 patients with cervical lymph node metastasis eligible for enrollment were included, of whom 383 were treated with concurrent chemoradiotherapy combined with nimotuzumab (targeted therapy group), and 867 were treated with concurrent chemoradiotherapy (CRT group). A total of 381 pairs of patients were matched using 1:1 propensity score matching, and differences in clinical prognosis were compared between the two groups. RESULTS: Overall survival (OS) (P = 0.028), disease-free survival (DFS) (P = 0.040), and distant metastasis-free survival (DMFS) (P = 0.040) were better in the targeted therapy compared to the CRT group. Multivariate analysis revealed that clinical staging, chemotherapy, and nimotuzumab therapy were predictors of OS and DFS. In the targeted therapy group, patients with ≥ 50% Ki-67 positivity had better OS and DFS rates than those with < 50% Ki-67 positivity. CONCLUSIONS: In patients with stage N1-3 NPC and lymph node metastasis, the addition of nimotuzumab to concurrent chemoradiotherapy may provide additional survival benefits. Ki-67 is a potential biomarker with clinical predictive value for the efficacy of nimotuzumab combined with chemoradiotherapy.

STAT3 regulates SRGN and promotes metastasis of nasopharyngeal carcinoma through the FoxO1-miR-148a-5p-CREB1 axis.

Nasopharyngeal carcinoma (NPC), which is marked by a distinct distribution, is a common subtype of epithelial carcinoma arising from the nasopharyngeal mucosal lining. SRGN acts as an important and poor prognostic factor of NPC through multiple different mechanisms. However, the biological role and mechanism of SRGN in NPC remain unknown. Expression levels of miR-148a-5p, CREB1, FoxO1, and SRGN in NPC tissues and cell lines were tested by qRT-PCR or/and Western blot. The impacts of miR-148a-5p, CREB1, FoxO1, and SRGN on NPC cell viability, proliferation, migration, and invasion were estimated in vitro by CCK-8, colony formation, wound healing and Transwell experiments, and in vivo by a xenograft tumor model. JASPAR analysis was used to predict the binding activity of Foxo1 (CREB1) with the miR-148a-5p (SRGN) promoter, and the interaction was validated by EMSA and ChIP assays. The miR-148a-5p-CREB1 interaction was validated by a dual-luciferase reporter and RIP assays. CREB1 and SRGN were increased while miR-148a-5p was decreased in NPC. Silencing of SRGN and CREB1, as well as miR-148a-5p overexpression, repressed NPC tumor progression in vitro and in vivo. CREB1 promoted SRGN expression in NPC by targeting the promoter area of SRGN. Silencing of FoxO1 facilitated NPC tumor progression, while silencing of STAT3 repressed NPC tumor progression. FoxO1 bound to and regulated miR-148a-5p in NPC, and miR-148a-5p targeted CREB1. Additionally, FoxO1 knockdown abolished the downregulation of CREB1 and SRGN induced by STAT3 silencing. Our results suggest that STAT3 regulates SRGN and promotes the growth and metastasis of NPC through the FoxO1-miR-148a-5p-CREB1 axis.

LINC00641 contributes to nasopharyngeal carcinoma cell malignancy through FOXD1 upregulation at the post-transcriptional level.

Nasopharyngeal carcinoma (NPC) is a common tumor in the head and neck and is prevalent in China, especially in the southern regions. Molecular mechanisms have attracted much attention in NPC research. FOXD1 has been reported to be a tumor promoter in various cancers. The present study was designed to explore the function of FOXD1 in NPC cells. Functional analyses, including the trypan blue staining assay, EdU and JC-1 assay, and flow cytometry analysis, revealed that FOXD1 facilitated NPC cell proliferation and inhibited NPC cell apoptosis. Next, by means of "starBase" database and mechanism analyses, such as RIP assay, RNA pull-down assay and luciferase reporter assay, miR-378a-3p was found to target FOXD1 and negatively regulate FOXD1 expression in NPC cells. Moreover, miR-378a-3p plays a suppressive role in NPC cells. LINC00641 was identified as a sponge of miR-378a-3p and positively modulated FOXD1 expression in NPC cells. Finally, a series of rescue assays indicated that LINC00641 accelerated NPC cell proliferation and hindered NPC cell apoptosis through FOXD1 upregulation. In conclusion, the present study demonstrated an innovative ceRNA mechanism of LINC00641/miR-378a-3p/FOXD1 in NPC cells, which might provide new insights into NPC treatment.

Bioinspired Hierarchical Surfaces Fabricated by Femtosecond Laser and Hydrothermal Method for Water Harvesting.

The world is facing a global issue of water scarcity where two-thirds of the population does not have access to safe drinking water. Water harvesting from the ambient environment has a potential equivalent to ∼10% of the fresh water available on the earth's surface, but its efficiency requires a special control of surface morphology. We report a novel facile physicochemical hybrid method that combines femtosecond laser structuring with hydrothermal treatment to create a surface with a well-arranged hierarchical nanoneedle structures. Polydimethylsiloxane treatment of the thus-produced hierarchical structures nurtured superhydrophobic functionality with a very low water sliding angle (∼3°) and a high water adhesion ability. About 2.2 times higher water-collection efficiency was achieved using hierarchical structures over untreated flat Ti surfaces of the same area under a given experimental condition. The comparison of water-collection behavior with other samples showed that the improved efficiency is due to the structure, and wettability induced superior water attraction and removal ability. Moreover, a uniform water condensation under low humidity (28%) is achieved, which has potential applications in harvesting water from arid environments and in high-precision drop control.

Feed-forward digital phase compensation for long-distance precise frequency dissemination via fiber network.

We demonstrate precise microwave frequency dissemination of a hydrogen maser synchronized frequency comb over a 120 km commercial fiber link. The phase noise was compensated by a feed-forward digital compensation scheme, where the value of locally detected phase noise was first transmitted to the remote user end via a wavelength division multiplexing channel in the same fiber link and then compensated directly at the user end. The fractional frequency instability was measured to be at 5.28×10(-16)/s.

[Diagnosis of nasopharyngeal carcinoma with convolutional neural network on narrowband imaging].

Objective:To evaluate the diagnostic accuracy of the convolutional neural network（CNN） in diagnosing nasopharyngeal carcinoma using endoscopic narrowband imaging. Methods:A total of 834 cases with nasopharyngeal lesions were collected from the People's Hospital of Guangxi Zhuang Autonomous Region between 2014 and 2016. We trained the DenseNet201 model to classify the endoscopic images, evaluated its performance using the test dataset, and compared the results with those of two independent endoscopic experts. Results:The area under the ROC curve of the CNN in diagnosing nasopharyngeal carcinoma was 0.98. The sensitivity and specificity of the CNN were 91.90% and 94.69%, respectively. The sensitivity of the two expert-based assessment was 92.08% and 91.06%, respectively, and the specificity was 95.58% and 92.79%, respectively. There was no significant difference between the diagnostic accuracy of CNN and the expert-based assessment （P=0.282, P=0.085）. Moreover, there was no significant difference in the accuracy in discriminating early-stage and late-stage nasopharyngeal carcinoma（P=0.382）. The CNN model could rapidly distinguish nasopharyngeal carcinoma from benign lesions, with an image recognition time of 0.1 s/piece. Conclusion:The CNN model can quickly distinguish nasopharyngeal carcinoma from benign nasopharyngeal lesions, which can aid endoscopists in diagnosing nasopharyngeal lesions and reduce the rate of nasopharyngeal biopsy.

A new hybrid fractal algorithm for predicting thermophilic nucleotide sequences.

Knowledge of thermophilic mechanisms about some organisms whose optimum growth temperature (OGT) ranges from 50 to 80 degree plays a major role in helping design stable proteins. How to predict a DNA sequence to be thermophilic is a long but not fairly resolved problem. Chaos game representation (CGR) can investigate the patterns hiding in DNA sequences, and can visually reveal previously unknown structure. Fractal dimensions are good tools to measure sizes of complex, highly irregular geometric objects. In this paper, we convert every DNA sequence into a high dimensional vector by CGR algorithm and fractal dimension, and then predict the DNA sequence thermostability by these fractal features and support vector machine (SVM). We have conducted experiments on three groups: 17-dimensional vector, 65-dimensional vector, and 257-dimensional vector. Each group is evaluated by the 10-fold cross-validation test. For the results, the group of 257-dimensional vector gets the best results: the average accuracy is 0.9456 and average MCC is 0.8878. The results are also compared with the previous work with single CGR features. The comparison shows the high effectiveness of the new hybrid fractal algorithm.

Prognostic value of hypothyroidism in patients undergoing intensity-modulated radiation therapy for nasopharyngeal carcinoma.

BACKGROUND: The purpose of this study was to investigate the effect of hypothyroidism and thyroxine replacement therapy on the prognosis of nasopharyngeal carcinoma (NPC) patients. METHODS: The clinical data of 284 NPC patients, who received intensity-modulated radiation therapy (IMRT) between January 2011 and December 2016, were retrospectively analyzed. RESULTS: Hypothyroidism occurred in 38% of patients. Patients with hypothyroidism had significantly better disease-free survival (DFS) (p = 0.002) and relapse-free survival (RFS) (p = 0.008). Multivariate analysis showed that hypothyroidism was a positive independent prognostic factor (DFS and RFS). Among the patients with hypothyroidism, thyroxine replacement therapy did not yield inferior survival (DFS, RFS, all p > 0.05). CONCLUSIONS: The NPC patients with complete response are at risk of hypothyroidism, which is attributable to escalating dose. These patients experienced clinical hypothyroidism could be adequately treated with thyroid hormone replacement. Further investigation of the underlying biological mechanism and potential therapeutic implications are required.

Observing 0D subwavelength-localized modes at ~100 THz protected by weak topology.

Topological photonic crystals (TPhCs) provide robust manipulation of light with built-in immunity to fabrication tolerances and disorder. Recently, it was shown that TPhCs based on weak topology with a dislocation inherit this robustness and further host topologically protected lower-dimensional localized modes. However, TPhCs with weak topology at optical frequencies have not been demonstrated so far. Here, we use scattering-type scanning near-field optical microscopy to verify mid-bandgap zero-dimensional light localization close to 100 THz in a TPhC with nontrivial Zak phase and an edge dislocation. We show that because of the weak topology, differently extended dislocation centers induce similarly strong light localization. The experimental results are supported by full-field simulations. Along with the underlying fundamental physics, our results lay a foundation for the application of TPhCs based on weak topology in active topological nanophotonics, and nonlinear and quantum optic integrated devices because of their strong and robust light localization.

Clinical outcomes of patients with nasopharyngeal carcinoma treated with antibiotics for radiation-induced mucositis: a retrospective study.

OBJECTIVE: To examine the effects of antibiotic administration on radiation-induced oral and oropharyngeal mucositis, and on the prognosis of patients with nasopharyngeal carcinoma (NPC). METHODS: We retrospectively analyzed data for patients with NPC with grade 1/2 or 3/4 mucositis. Forty-two patients with grade 3/4 mucositis received antibiotics. Univariate survival analysis was assessed by Kaplan-Meier survival curves, survival curves were compared using log-rank tests, and multivariate analysis was carried out by Cox regression. RESULTS: A total of 463 patients with NPC were included in the study (194 grade 1/2 mucositis, 269 grade 3/4 mucositis). Univariate analyses identified T-stage, N-stage, clinical stage, type of treatment, and antibiotic use as factors affecting overall and disease-free survival. Multivariate analysis also determined that T-stage, N-stage stage, type of treatment, and antibiotic usage were independent factors affecting overall and disease-free survival. Mucositis improved in 32 of the 42 patients who received antibiotics (76.19%). However, red blood cell count and hemoglobin levels decreased in all patients after antibiotic treatment. CONCLUSIONS: Antibiotics may be effective for the treatment of severe radiation-induced mucositis (grade 3/4) during chemoradiotherapy, but may potentially adversely affect the prognosis of patients with NPC.

Effects of hepatitis B virus infection and antiviral therapy on the clinical prognosis of nasopharyngeal carcinoma.

PURPOSE: To investigate the clinical characteristics of nasopharyngeal carcinoma (NPC) and a concomitant hepatitis B virus (HBV) infection, as well as the potential effects of HBV infection and antiviral therapy on prognosis. METHODS: We conducted a retrospective chart review of all NPC patients from December 2010 to December 2014. After collecting medical records and conducting follow-ups on patients, a total of 876 eligible NPC patients were included. For each patient, medical records were reviewed. Factors predictive of outcome were compared using the log-rank test and Cox regression analysis. RESULTS: Among the 876 participants, 106 (12.1%) patients were HBV-infected patients. The hepatitis B surface antigen-positive [HBsAg(+)] group had a lower CD4+ T cell count than the HBsAg(-) group (P = .048). Among patients with stage I/II NPC, 5-year overall survival (OS), disease-free survival (DFS), relapse-free survival, and distant metastasis-free survival (DMFS) of the HBsAg(+) group were 82.5%, 70.7%, 87.7%, and 76.6%, respectively, whereas those of the HBsAg(-) group were 91.4%, 86.0%, 93.8%, and 92.1%, respectively. Statistically significant differences in OS, DFS, and DMFS existed between both groups (P = .017, .018, and .004, respectively). The multivariate analysis indicated that HBsAg status and N stage are independent risk factors affecting OS, DFS, and DMFS of NPC patients. A statistically significant difference in 5-year DMFS existed between the antivirus (90.0%) and no-antivirus groups (70.0%) (P = .043). CONCLUSIONS: Hepatitis B virus infection is an independent risk factor for early stage NPC, which may be associated with its reduced immune functions compared to the HBsAg(-) group. Anti-HBV treatment may improve the prognosis of HBV-infected NPC patients.

Effects of Surgery Combined with Chemoradiotherapy on Short- and Long-Term Outcomes of Early-Stage Nasopharyngeal Carcinoma.

OBJECTIVE: The efficacy of surgery as the primary treatment modality for nasopharyngeal carcinoma (NPC) is yet to be clarified. Therefore, we aimed to explore the short- and long-term efficacy of surgery for early-stage NPC. METHODS: We retrospectively evaluated 341 patients diagnosed with early-stage NPC between September 2010 and December 2015. Among them, 58 patients underwent endoscopic nasopharyngectomy combined with chemoradiotherapy, whereas 283 patients underwent conventional chemoradiotherapy. The patients who underwent concurrent chemoradiotherapy or radiotherapy alone were matched to patients who underwent surgery in a 1:2 ratio using propensity score matching to analyze the clinical efficacy of each therapeutic modality. The primary endpoint was survival, and the secondary endpoints were tumor regression rate and reduction in Epstein-Barr virus (EBV)-DNA levels. RESULTS: After matching, 156 patients were enrolled (58 patients in the surgery group; 98 patients in the non-surgery group). The baseline data of the matched patients had good inter-group comparability (All P>0.05). The surgery group had significantly higher 5-year overall survival (98.30% vs. 91.70%), disease-free survival (98.30% vs. 81.40%), and recurrence-free survival (100.00% vs. 90.10%) rates than did the non-surgery group (All P<0.05). In total, 0 and 14 patients in the surgery and non-surgery groups, respectively, had residual cancer at the end of treatment (P=0.001). All patients in the surgery group tested negative for EBV-DNA, whereas two patients in the non-surgery group tested positive. The incidence of hematologic toxicity during treatment was similar between the two groups (All P>0.05). Still, the incidence of severe oral mucositis was lower in the surgery group than in the non-surgery group (37.9% vs. 54.08%, P=0.051). CONCLUSION: Surgery can improve the clearance rate of EB virus and reduce tumor residue. Surgery may be a safe and effective treatment for early NPC.

Long Noncoding RNAs and Messenger RNAs Expression Profiles Potentially Regulated by ZBTB7A in Nasopharyngeal Carcinoma.

Our previous studies showed that ZBTB7A played an important role in promoting nasopharyngeal carcinoma (NPC) progression. However, molecular mechanisms of different levels of ZBTB7A are still unclear. It is necessary to search molecular markers which are closely connected with ZBTB7A. We selected NPC sublines CNE2 with stably transfecting empty plasmid (negative control, NC) and short hair RNA (shRNA) plasmid targeting ZBTB7A as research objectives. Microarray was used to screen differentially expressed long noncoding RNAs (lncRNAs) and messenger RNAs (mRNAs) via shRNA-CNE2 versus NC-CNE2. Quantitative PCR (qPCR) was used to validate lncRNAs and mRNAs from the sublines, chronic rhinitis, and NPC tissues. Bioinformatics was used to analyze regulatory pathways which were connected with ZBTB7A. The 1501 lncRNAs (long noncoding RNAs) and 1275 differentially expressed mRNAs were upregulated or downregulated over 2-fold. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis revealed that the upregulated or downregulated carbohydrate and lipid metabolisms probably involved in carcinogenicity of shRNA-CNE2 (P-value cut-off was 0.05). In order to find the molecular mechanisms of ZBTB7A, we validated 12 differentially expressed lncRNAs and their nearby mRNAs by qPCR. Most of the differentially expressed mRNAs are closely connected with carbohydrate and lipid metabolisms in multiply cancers. Furthermore, part of them were validated in NPC and rhinitis tissues by qPCR. As a result, NR_047538, ENST00000442852, and fatty acid synthase (FASN) were closely associated with NPC. ZBTB7A had a positive association with NR_047538 and negative associations with ENST00000442852 and FASN. The results probably provide novel candidate biomarkers for NPC progression with different levels of ZBTB7A.

Stable knockdown of ZBTB7A promotes cell proliferation and progression in nasopharyngeal carcinoma.

AIMS: Although high expression of ZBTB7A is positively relative to metastasis in nasopharyngeal carcinoma (NPC) patients, the association between its low expression and metastasis of NPC remains unclear. The present study aimed to definitely identify the association. METHODS: The level of ZBTB7A was effectively knocked down by stable transfection of short hair RNA plasmid in NPC cell lines CNE2 and 5-8F (shRNA-CNE2 and shRNA-5-8F), compared with the cells that stably transfected empty plasmid (NC-CNE2 and NC-5-8F). The levels of ZBTB7A were assessed by real-time polymerase chain reaction and Western blot in the cell lines. MTT assay, colorimetric focus-formation assay, flow cytometry, wound healing assay, transwell assays, and xenograft model were performed to analyze cell vitality, proliferation, cell cycle, migration, invasion, and tumorigenicity. RESULTS: The levels of ZBTB7A were effectively reduced in shRNA-CNE2 and shRNA-5-8F. Their carcinogenicity was stronger separately than the abilities of NC-CNE2 and NC-5-8F. NC-CNE2 and shRNA-CNE2 were selected to establish the xenograft model because of their stronger tumorigenicity than NC-6-10B and shRNA-5-8F. The assay showed that shRNA-CNE2 had stronger tumorigenicity than NC-CNE2. CONCLUSIONS: The results demonstrated the reverse association between the expression of ZBTB7A and the tumorigenicity of NPC. We postulate that some oncogenic pathways, which are suppressed by ZBTB7A, will vicariously promote the proliferation and progression of NPC when ZBTB7A is decreased.

Femtosecond Laser Fabrication of Anatase TiO2 Micro-nanostructures with Chemical Oxidation and Annealing.

The fabrication of nanoporous anatase TiO2 on a microstructured Ti base is achieved through an innovative hybrid fabrication method involving femtosecond laser ablation coupled with H2O2 oxidation and annealing. The anatase TiO2 micro-nanostructures have superior photocatalytic degradation of methyl orange due to enhanced light harvesting capacity and surface area. The photodegradation efficiency increases by a maximum of 80% compared to the nanoporous anatase TiO2 fabricated through H2O2 oxidation and annealing only (without femtosecond laser ablation). Meanwhile, The anatase TiO2 micro-nanostructures show good cyclic performance, indicating a great potential for practical application. The proposed hybrid method can easily tune the morphology and size of microstructure by simply adjusting the femtosecond laser parameters, showing advantage in fabricating of micro-nanostructures with a rich variety of morphologies.

Stabilization of heavy metals in soil using two organo-bentonites.

Stabilization of Cu, Zn, Cd, Hg, Cr and As in soil using tetramethylammonium (TMA) and dodecyltrimethylammonium (DTMA) modified bentonites (T-Bents and D-Bents) as amendments was investigated. Toxicity characteristic leaching procedure (TCLP) was used to quantify the metal mobility after soil treatment. The structural parameters of modified bentonites, including the BET surface area, basal spacing and zeta potential were obtained as a function of the TMA and DTMA loading at 40, 80, 120, 160 and 200% of the bentonite's cation exchange capacity, respectively. The results indicated that the characteristics of the organo-bentonites fundamentally varied depending on the species and concentration of modifiers loaded on bentonite. T-Bents and D-Bents manifested distinct immobilization effectiveness towards various metals. In association with the organo-bentonite characteristics, the main interactive mechanisms for Cu, Zn and Cd proceeded via cation exchange, Hg proceeded via physical adsorption and partitioning, Cr and As proceeded via specific adsorption and electrostatic attraction, respectively. This study provided operational and mechanistic basis for optimizing the organic clay synthesis and selecting as the appropriate amendment for remediation of heavy metal contaminated soils.

Diagnosis of nonexophytic nasopharyngeal lesion with endoscopy-guided core needle biopsy after narrow band imaging.

BACKGROUND: Due to the obstruction of the surrounding structures or stiff mucosa, the primary and recurrent nonexophytic nasopharyngeal carcinoma (NE-NPC) patients are difficult to be diagnosed histologically by traditional forceps biopsy. RESULTS: All the 15 cases had adequate biopsy for histological diagnosis. There were 5 cases of primary and 7 cases of recurrent NE-NPC, and 3 cases of inflammatory lesion. The histopathological diagnosis was consistent with the follow-up visit. The bleeding quantity during the CNB procedure ranged from 1 to 5 ml (mean 1.93 mL). The pain score during CNB were between 2 and 7 (mean 4.20). There were no serious complications. MATERIALS AND METHODS: From April 2009 to March 2016, after conventional white-light and novel narrow-band imaging, nasal endoscope-guided core needle biopsy (CNB) were performed on 15 cases of nonexophytic nasopharyngeal lesion with a semiautomatic biopsy gun. CONCLUSIONS: CNB is able to get adequate biopsy specimens and thus the diagnosis accuracy of CNB is high for NE-NPC. Nasal endoscope-guided CNB is the direct approach with a short distance in the tissue before reaching the tumor. It has the advantages of minimal trauma, short operative time, and no serious complications. It is simple, safe, and worth of application in clinic.

Decreased prefrontal brain activation during verbal fluency task in patients with somatoform pain disorder: An exploratory multi-channel near-infrared spectroscopy study.

BACKGROUND: Pain is a common phenomenon. Patients with somatoform pain disorder (SPD) suffer from lasting chronic pain which may cause cognitive impairment. The dysfunction of prefrontal cortex (PFC) may be involved in pain-induced cognition impairment, which is the most important part in regulating of cognitive function. Multi-channel near-infrared spectroscopy (NIRS) is a noninvasive and low-cost functional neuroimaging technique being used to detect the prefrontal cortex activation during cognitive tasks to demonstrate the relationship between PFC dysfunction and cognition impairment in SPD patients. METHODS: 24 patients with SPD and 24 age-, gender- and education level-matched healthy controls were examined by NIRS of the relative concentration of oxygenated hemoglobin (oxy-Hb) in PFC during verbal fluency task (VFT). All data analysis procedures were accomplished under MATLAB, SPM and SPM-fNIRS which is an SPM12-based software for fNIRS analysis. RESULTS: 1. The number of words generated during the VFT tasks in SPD patients were fewer than healthy controls. 2. The activated areas in SPD patients were smaller than healthy controls. 3. The average activation strength of [oxy-Hb] in SPD patients was much lower than healthy controls. 4. The difference of activation areas between left and right lobe were particularly obvious in SPD patients. CONCLUSION: There are evidences suggested that the markedly dysfunction in PFC especially bilateral dorsolateral prefrontal cortex (DLPFC) areas may be involved in the cognitive deficiency in patients with SPD.

[Analyses of therapeutic and prognostic factors for rN3 neck recurrence of nasopharyngeal carcinoma after primary radiotherapy].

OBJECTIVE: To investigate the treatment and prognosis for rN3 neck recurrence of nasopharyngeal carcinoma (NPC) after primary radiotherapy. METHODS: A total of 37 cases with rN3 neck recurrence after radiotherapy in NPC between October 2003 and August 2013 were retrospectively analyzed. Of them 19 cases presented with lymph node (LN) metastasis in supraclavicular fossa, 18 cases had metastasis LN > 6 cm, 10 cases received chemoradiotherapy, and 27 cases underwent neck dissection including modified radical neck dissection (MRND) for 9 cases, radical neck dissection (RND) for 18 cases. Six of 18 cases with RND underwent reconstructive surgery with pectoralis major flap, 12 cases received postoperative radiotherapy and 20 cases had postoperative adjuvant chemotherapy. RESULTS: Eight patients had documented recurrence or residue, 17 patients developed distant metastases, one patient showed recurrence and distant metastasis. The 5-year overall survival rate and disease-free survival rate were 27.5% and 21.6% respectively, and the median survival time was 41 months. The survival rate in surgery group was significantly higher than that in chemoradiotherapy group, and the prognosis of patients with LN > 6 cm was better than that of patients with metastasis LN to supraclavicular fossa. CONCLUSIONS: Patients with rN3 NPC are prone to metastasis, and patients with supraclavicular fossa lymph node metastasis had poor prognosis. Surgery combined with chemoradiotherapy is an effective treatment for the patients without distant metastasis.

Simultaneously precise frequency transfer and time synchronization using feed-forward compensation technique via 120 km fiber link.

Precision time synchronization between two remote sites is desired in many applications such as global positioning satellite systems, long-baseline interferometry, coherent radar detection and fundamental physics constant measurements. The recently developed frequency dissemination technologies based on optical fiber link have improved the transfer instability to the level of 10(-19)/day at remote location. Therefore it is possible to keep clock oscillation at remote locations continuously corrected, or to reproduce a "virtual" clock on the remote location. However the initial alignment and the correction of 1 pps timing signal from time to time are still required, besides the highly stabilized clock frequency transfer between distant locations. Here we demonstrate a time synchronization based on an ultra-stable frequency transfer system via 120-km commercial fiber link by transferring an optical frequency comb. Both the phase noise compensation in frequency dissemination and temporal basis alignment in time synchronization were implemented by a feed-forward digital compensation (FFDC) technique. The fractional frequency instability was measured to be 6.18 × 10(-20) at 2000 s. The timing deviation of time synchronization was measured to be 0.6 ps in 1500 s. This technique also can be applied in multi-node fiber network topology.