The Effect of Previous Irradiation for Patients With Prosthetic Breast Reconstruction: A Meta-Analysis.

BACKGROUND: Results regarding immediate prosthetic breast reconstruction after postmastectomy radiation therapy (PMRT) have been inconsistent. OBJECTIVES: The authors aimed to assess the efficacy and safety of PMRT before immediate prosthetic breast reconstruction for patients with breast cancer. METHODS: Electronic databases (PubMed, EmBase, and the Cochrane Library) were systematically searched to identify eligible studies from their inception until March 2020. The pooled odds ratio (OR) with 95% confidence intervals (CIs) was applied as an effect estimate and calculated using the random-effects model. RESULTS: Nineteen studies including a total of 6757 patients were selected for final meta-analysis. The pooled OR showed that PMRT was associated with a higher incidence of reconstruction failure (OR = 2.57; 95% CI =1.55-4.26; P < 0.001), capsular contracture (OR = 5.99; 95% CI = 3.12-11.47; P < 0.001), and overall complications (OR = 2.52; 95% CI = 1.68-3.79; P < 0.001). It was also associated with a lower incidence of patient satisfaction (OR = 0.29; 95% CI = 0.16-0.52; P < 0.001) and good aesthetic results (OR = 0.25; 95% CI = 0.12-0.52; P < 0.001) compared with those who did not undergo PMRT. These significant associations could be affected by study design, mean age, stage of immediate breast reconstruction, follow-up, and study quality. CONCLUSIONS: Although PMRT is the standard adjuvant therapy for mastectomy patients treated with immediate implant-based breast reconstruction, PMRT for patients undergoing immediate implant-based breast reconstruction has been associated with high risks of reconstruction failure, capsular contracture, and overall complications as well as low incidences of patient satisfaction and good aesthetic results.

Radiomics on multi-modalities MR sequences can subtype patients with non-metastatic nasopharyngeal carcinoma (NPC) into distinct survival subgroups.

OBJECTIVES: To explore and evaluate the feasibility of radiomics in stratifying nasopharyngeal carcinoma (NPC) into distinct survival subgroups through multi-modalities MRI. METHODS: A total of 658 patients (training cohort: 424; validation cohort: 234) with non-metastatic NPC were enrolled in the retrospective analysis. Each slice was considered as a sample and 4863 radiomics features on the tumor region were extracted from T1-weighted, T2-weighted, and contrast-enhanced T1-weighted MRI. Consensus clustering and manual aggregation were performed on the training cohort to generate a baseline model and classification reference used to train a support vector machine classifier. The risk of each patient was defined as the maximum risk among the slices. Each patient in the validation cohort was assigned to the risk model using the trained classifier. Harrell's concordance index (C-index) was used to measure the prognosis performance, and differences between subgroups were compared using the log-rank test. RESULTS: The training cohort was clustered into four groups with distinct survival patterns. Each patient was assigned to one of the four groups according to the estimated risk. Our method gave a performance (C-index = 0.827, p < .004 and C-index = 0.814, p < .002) better than the T-stage (C-index = 0.815, p = .002 and C-index = 0.803, p = .024), competitive to and more stable than the TNM staging system (C-index = 0.842, p = .003 and C-index = 0.765, p = .050) in the training cohort and the validation cohort. CONCLUSIONS: Through investigating a large one-institutional cohort, the quantitative multi-modalities MRI image phenotypes reveal distinct survival subtypes. KEY POINTS: • Radiomics phenotype of MRI revealed the subtype of nasopharyngeal carcinoma (NPC) patients with distinct survival patterns. • The slice-wise analysis method on MRI helps to stratify patients and provides superior prognostic performance over the TNM staging method. • Risk estimation using the highest risk among slices performed better than using the majority risk in prognosis.

Correction to: Radiomics on multi-modalities MR sequences can subtype patients with non-metastatic nasopharyngeal carcinoma (NPC) into distinct survival subgroups.

The original version of this article, published on 14 March 2019, unfortunately contained a mistake.

TCR repertoire profiling of tumors, adjacent normal tissues, and peripheral blood predicts survival in nasopharyngeal carcinoma.

The T-cell immune responses in nasopharyngeal carcinoma patients have been extensively investigated recently for designing adoptive immunotherapy or immune checkpoint blockade therapy. However, the distribution characteristics of T cells associated with NPC pathogenesis are largely unknown. We performed deep sequencing for TCR repertoire profiling on matched tumor/adjacent normal tissue from 15 NPC patients and peripheral blood from 39 NPC patients, 39 patients with other nasopharyngeal diseases, and 33 healthy controls. We found that a lower diversity of TCR repertoire in tumors than paired tissues or a low similarity between the paired tissues was associated with a poor prognosis in NPC. A more diverse TCR repertoire was identified in the peripheral blood of NPC patients relative to the controls; this was related to a significant decrease in the proportion of high-frequency TCR clones in NPC. Higher diversity in peripheral blood of NPC patients was associated with a worse prognosis. Due to the peculiarity of the Vß gene usage patterns in the peripheral blood of NPC patients, 15 Vß genes were selected to distinguish NPC patients from controls by the least absolute shrinkage and selection operator analysis. We identified 11 clonotypes shared by tumors and peripheral blood samples from different NPC patients, defined as "NPC-associated" that might have value in adoptive immunotherapy. In conclusion, we here report the systematic and overall characteristics of the TCR repertoire in tumors, adjacent normal tissues, and peripheral blood of NPC patients. The data obtained may be relevant to future clinical studies in the setting of immunotherapy for NPC patients.

Antimicrobial Susceptibility Evaluation and Multiple-Locus Variable Number Tandem Repeat Analysis of Neisseria gonorrhoeae Isolates in China in 2012.

OBJECTIVE: This study aimed to gain information on the antimicrobial susceptibility and molecular epidemiological typing of Neisseria gonorrhoeae (NG) isolates in China in 2012. METHODS: A total of 244 NG isolates were consecutively recovered from patients with uncomplicated gonorrhea attending sexually transmitted disease clinics in 3 Chinese cities-Guangzhou, Nanjing, and Tianjin-in 2012. Neisseria gonorrhoeae susceptibilities to penicillin and tetracycline were examined by detecting penicillinase-producing NG (PPNG) and high-level tetracycline-resistant NG, and NG susceptibilities to ciprofloxacin, spectinomycin, ceftriaxone, and cefixime were determined using an agar dilution method. Neisseria gonorrhoeae isolates were typed by multiple-locus variable number tandem repeat analysis. We conducted a χ analysis to compare clusters with Bonferroni correction and Kruskal-Wallis test. RESULTS: Neisseria gonorrhoeae isolates gathered from the 3 cities differed significantly in the prevalence of tetracycline-resistant NG (P < 0.001) and NG treated with ceftriaxone with a minimum inhibitory concentration of 0.125 mg/L or higher (P < 0.001). The analysis of the combination of the 7 variable number of tandem repeats loci for all of the 244 isolates yielded 110 multiple-locus variable number tandem repeat analysis types falling into 5 clusters. Cluster III was associated with PPNG, whereas cluster II was associated with non-PPNG (P < 0.05) and NG treated with ceftriaxone with a minimum inhibitory concentration of 0.125 mg/L or higher (P < 0.05). CONCLUSIONS: Antimicrobials that can be used with confidence to treat NG infection currently in China include ceftriaxone and spectinomycin, but not penicillin, tetracycline, ciprofloxacin, and cefixime. Moreover, some of the resulting clusters were associated with PPNG and NG with decreased ceftriaxone susceptibility.

Prognostic value of grading masticator space involvement in nasopharyngeal carcinoma according to MR imaging findings.

PURPOSE: To derive a suitable method for grading masticator space invasion in nasopharyngeal carcinoma on the basis of magnetic resonance (MR) images and to determine its prognostic value in patients undergoing intensity-modulated radiation therapy. MATERIALS AND METHODS: After institutional review board approval and informed consent were acquired, 808 patients with nasopharyngeal carcinoma who were treated with definitive intensity-modulated radiation therapy were analyzed retrospectively. The anatomic sites of masticator space involvement were identified with MR imaging. Overall survival, local relapse-free survival, and distant metastasis-free survival were calculated by using the Kaplan-Meier method and were compared by using the log-rank test. Potential prognostic factors were identified by means of multivariate analysis. RESULTS: Masticator space involvement was diagnosed in 163 of 808 patients (20.2%). Patients with lateral invasion (involvement of the lateral pterygoid muscle of the masticator space and beyond) had significantly poorer overall survival and distant metastasis-free survival than those with medial invasion (involvement of the medial pterygoid muscle of the masticator space) (P = .035 and P = .026, respectively). Furthermore, their overall survival, local relapse-free survival, and distant metastasis-free survival were significantly poorer compared with patients with stage T2 or T3 disease (all P ≤ .023) but similar to patients with stage T4 disease. The grade of masticator space involvement was an independent prognostic factor for overall survival, local relapse-free survival, and distant metastasis-free survival (all P ≤ .023). CONCLUSION: Masticator space involvement in nasopharyngeal carcinoma should be graded as medial (stage T2 disease) or lateral (stage T4 disease). This can facilitate staging of nasopharyngeal carcinoma and may be a suitable prognostic indicator of survival.

The prevalence of urethral and rectal Mycoplasma genitalium among men who have sex with men in China, a cross-sectional study.

BACKGROUND: Although Mycoplasma genitalium (MG) is a common sexually transmitted infection (STI), very little information regarding the prevalence of MG among MSM (men who have sex with men) is available in China. The objective of this study was to determine the prevalence of MG among MSM in the city of Shenzhen, Guangdong Province, China, and to identify the potential risk factors associated with MG infection in this population. METHODS: Between January and May 2010, a total of 409 MSM were recruited in Shenzhen, Guangdong Province, China. An anonymous questionnaire was used to collect information regarding their sociological and sexual behaviors. In addition, their first-void urine (FVU) samples and rectal swabs were collected for PCR-based MG testing. RESULTS: Among the 406 FVU and 405 rectal swab samples were collected from 409 MSM, the overall MG prevalence was 8.1% (33/406, 95% CI 5.7%-10.6%), with a FVU positivity of 3.4% (95% CI 1.7%-5.4%) and a rectal positivity of 5.4% (95% CI 3.5%-7.7%). Using both univariate and multivariable logistic regression analyses, urethral MG infection was significantly associated with having more heterosexual behaviors (AOR 7.16, 95% CI 1.89-27.13), and with having unprotected anal intercourse in the past six months (AOR 4.80, 95% CI 1.40-16.47). Rectal MG infection was significantly associated with HIV infection based on univariate logistic regression analysis (OR = 4.49, 95% CI 1.18-17.12). CONCLUSIONS: In this study, we investigated the prevalence of MG infection in the population of interest, as determined from both urethral and rectal specimen. We showed that MG was more prevalent in MSM who had bisexual behaviors compared to those who engaged only in homosexual behaviors. Further work is needed to establish the mode of MG transmission and to identify its role in HIV transmission. Meanwhile, more attention should be paid to MG infection among MSMs, and especially bisexual MSMs, which might have critical implications for effective HIV/STD control in China.

[Comparison of ultraviolet A and ultraviolet B on 1,25-dihydroxy-vitamin D3 and bone metabolism in ovariectomized rats].

OBJECTIVE: To investigate the effects of ultraviolet A (UVA) and ultraviolet B (UVB) on serum 1,25-dihydroxy-vitamin D3 and bone metabolism of ovariectomized rats and to compare them on bone metabolism. METHODS: In the study, 40 six-month female Sprague-Dawley rats were randomly divided into sham-operated control group (sham), osteoporosis model group (OVX), UVA irradiation group (OVX+UVA) and UVB irradiation group (OVX+UVB). Except the sham-operated control group, the remaining rats were ovariectomized to establish the osteoporosis models. After the model establishment, the UVA and UVB groups were exposed to UV irradiation with wavelengths of 340 nm and 313 nm, respectively. After the 15-week UV irradiation treatment, bone material density and serum 1,25(OH)2D3, osteocalcin (bone gamma-carboxyglutamic acid protein, BGP), calcium (Ca) and phosphorus (P) contents were measured. RESULTS: Compared with the sham group, the body weights [(486.5±55.7) g, (488.3±32.1) g, (494.1±49.8) g, vs. (408.6±36.1) g, P<0.01] were significantly higher in the model group, UVA group and UVB group; proximal femur BMD [(0.318±0.025) g/cm(2), (0.316±0.031) g/cm(2), (0.322±0.036) g/cm(2), vs.(0.386±0.027) g/cm(2), P<0.01], central BMD [(0.321±0.038) g/cm(2), (0.319±0.051) g/cm(2), (0.320±0.053) g/cm(2), vs.(0.347±0.044) g/cm(2), P<0.05], distal femur BMD [(0.320±0.028) g/cm(2), (0.318±0.030) g/cm(2), (0.322±0.036) g/cm(2), vs.(0.361±0.046) g/cm(2), P<0.01] were significantly lower in the model group, UVA group and UVB group. After the 15-week treatment of UV radiation, compared with the sham group, proximal femur BMD [(0.162±0.125) g/cm(2) vs.(0.293±0.076) g/cm(2), P<0.01], central BMD [(0.205±0.102) g/cm(2) vs.(0.306±0.031) g/cm(2), P<0.01] , distal femur BMD [(0.153±0.119) g/cm(2) vs.(0.274±0.017) g/cm(2), P<0.01] were significantly decreased in the model group; serum 1,25(OH)2D3 [(19.80±1.67) ng/L vs. (28.35±4.32) ng/L, P<0.01], BGP [(11.00±0.01) ng/L vs.(16.64±0.01) ng/L,P<0.01] and Ca [(2.14±0.10) mmol/L vs.(2.68±0.16) mmol/L,P<0.01] were significantly lower in the model group. Compared with the model group, proximal femur BMD [(0.248±0.092) g/cm(2), (0.218±0.123) g/cm(2), vs.(0.162±0.125) g/cm(2), P<0.01], central BMD [(0.272±0.010) g/cm(2), (0.275±0.036) g/cm(2), vs.(0.205±0.102) g/cm(2), P<0.01] and distal femur BMD [(0.251±0.009) g/cm(2), (0.242±0.063) g/cm(2), vs.(0.153±0.119) g/cm(2), P<0.01] were significantly increased in the UVA group and UVB group; serum 1,25(OH)2D3 [(29.47±4.54) ng/L, (27.56±6.33) ng/L, vs.(19.80±1.67) ng/L, P<0.01], BGP[(15.70±0.01)ng/L, (15.62±0.02) ng/L, vs.(11.00±0.01) ng/L, P<0.01] and Ca [(2.48±0.22) mmol/L, (2.58±0.13) mmol/L, vs.( 2.14±0.10) mmol/L, P<0.01] were significantly higher in the UVA group and UVB group. There were no statistical differences among the UVA group, UVB group and sham group. CONCLUSION: Both UVA and UVB may improve serum 1,25(OH)2D3 content of ovariectomized rats, promote bone formation, increase bone material density, and relieve bone loss due to osteoporosis.

[Optical characteristics of InGaN/GaN light emitting diodes on patterned sapphire substrate].

In the present paper, optical characteristics of InGaN/GaN multiple quantum wells light emitting diodes fabricated on the conventional (C-LEDs) and patterned sapphire substrates (PSSLEDs) were investigated by electroluminescence (EL) and photoluminescence (PL). PSSLEDs show higher light output power and smaller full width at half maximum (FWHM) of EL than those of C-LEDs for their better crystalline quality. The FWHM of EL for PSSLEDs exhibits faster broadening as current increases than C-LEDs, while the same broadening of FWHM of PL as excitation power increases is shown in PSSLEDs and C-LEDs, which indicate that there is stronger band filling effect in PSSLEDs caused by relatively higher carrier density in their QWs at the same current injection level. Besides, smaller blue-shift of peak wavelength of EL as injection current increases in PSSLEDs suggests that piezoelectric field in PSSLEDs is weaker than that in C-LEDs. Therefore, comparing the changes in external quantum efficiency as current increases for PSSLEDs and C-LEDs, more serious efficiency droop for PSSLEDs could not be mainly caused by piezoelectric field in QWs.

MRI-based radiomics models can improve prognosis prediction for nasopharyngeal carcinoma with neoadjuvant chemotherapy.

BACKGROUND: The purpose of this study was to explore the prognostic value of imaging features and related models in nasopharyngeal carcinoma (NPC) patients that received neoadjuvant chemotherapy. MATERIALS AND METHODS: We systematically reviewed the data of 110 NPC patients who received radiotherapy and neoadjuvant chemotherapy. The patients were randomly divided into the training cohort (n = 88) and the verification cohort (n = 22). The imaging data collected in this study were screened via Pyramidics and used to construct prediction models based on histology and clinical nomographs. The models' accuracy was evaluated via calibration curves and the consistency index (C-index). In addition, we also explored the correlation between radiomics expression patterns, quantitative histological characteristics, and clinical data and then constructed a model to predict the prognosis of NPC. RESULTS: The models that integrated radiomics contours with all the clinical data were superior to those based on the clinical data alone (C-index 0.746 vs. C-index 0.814, respectively) and the calibration curves showed good consistency. The heat map showed that the radiomics expression pattern and selected histological characteristics were correlated with the clinical stage, T stage, and N stage (p < 0.05), and no radiomics feature was associated with lactate dehydrogenase expression, lymphocyte count, or mononuclear cell count. CONCLUSION: MRI-based radiomics can significantly improve the efficacy of traditional TNM staging and clinical data in predicting the progression-free survival (PFS) of patients with advanced NPC, which may provide an opportunity for precision medicine.

Establishment and Validation of a Novel MRI Radiomics Feature-Based Prognostic Model to Predict Distant Metastasis in Endemic Nasopharyngeal Carcinoma.

Purpose: We aimed to establish a prognostic model based on magnetic resonance imaging (MRI) radiomics features for individual distant metastasis risk prediction in patients with nasopharyngeal carcinoma (NPC). Methods: Regression analysis was applied to select radiomics features from T1-weighted (T1-w), contrast-enhanced T1-weighted (T1C-w), and T2-weighted (T2-w) MRI scans. All prognostic models were established using a primary cohort of 518 patients with NPC. The prognostic ability of the radiomics, clinical (based on clinical factors), and merged prognostic models (integrating clinical factors with radiomics) were identified using a concordance index (C-index). Models were tested using a validation cohort of 260 NPC patients. Distant metastasis-free survival (DMFS) were calculated by using the Kaplan-Meier method and compared by using the log-rank test. Results: In the primary cohort, seven radiomics prognostic models showed similar discrimination ability for DMFS to the clinical prognostic model (P=0.070-0.708), while seven merged prognostic models displayed better discrimination ability than the clinical prognostic model or corresponding radiomics prognostic models (all P<0.001). In the validation cohort, the C-indices of seven radiomics prognostic models (0.645-0.722) for DMFS prediction were higher than in the clinical prognostic model (0.552) (P=0.016 or <0.001) or in corresponding merged prognostic models (0.605-0.678) (P=0.297 to 0.857), with T1+T1C prognostic model (based on Radscore combinations of T1 and T1C Radiomics models) showing the highest C-index (0.722). In the decision curve analysis of the validation cohort for all prognostic models, the T1+T1C prognostic model displayed the best performance. Conclusions: Radiomics models, especially the T1+T1C prognostic model, provided better prognostic ability for DMFS in patients with NPC.

GaN-based light-emitting diodes with photonic crystals structures fabricated by porous anodic alumina template.

In this paper, we propose and demonstrate a convenient and flexible approach for preparation large-area of photonic crystals (PhCs) structures on the GaN-based LED chip. The highly-ordered porous anodic alumina (AAO) with pitch of wavelength scale was adopted as a selective dry etching mask for PhCs-pattern transfer. The PhCs with different pore depths were simultaneously formed on the entire surfaces of GaN-based LED chip including ITO, GaN surrounding contacts and the sidewall of the mesa by one-step reactive ion etching (RIE). The light output power improvement of PhCs-based GaN LED was achieved as high as 94% compared to that of the conventional GaN-based LED.

[DSA types and treatment strategy of venous malformations of the tongue： an analysis of 132 consecutive patients].

PURPOSE: To explore the DSA classification and treatment strategy of tongue venous malformation. METHODS: From February 2016 to February 2019, the DSA manifestations of 132 cases with venous malformations of the tongue were summarized. They were classified into 4 types according to imaging characteristics: typeⅠ(non-drainage type), typeⅡ(lower- drainage type), type Ⅲ (higher-drainage type), type Ⅳ(extensive type). Different therapeutic schemes were selected according to the types. The non- drainage type was treated with pingyangmycin alone, the lower-drainage type was treated with lauromacrogol foam alone, the higher- drainage type was treated with absolute alcohol combined with lauromacrogol foam, the extensive type was treated as higher-drainage type first and then combined with plastic resection. Among the cases, therapeutic effects and adverse reactions of each group were recorded and compared. RESULTS: One hundred and thirty-two cases in this study were followed up for 12 to 41 months with an average of 15.8 months. After sclerosing therapy, the venous malformations of the tongue of all patients significantly reduced or even disappeared. Type Ⅰincluded 8 cases with an efficiency of 100%, type Ⅱ included 17 cases with an efficiency of 100%, type Ⅲ included 98 cases with an efficiency of 90.8%, typeⅣincluded 9 cases, with an efficiency of 77.8%.The main adverse reactions were tissue necrosis: 0 in typeⅠ, 1(5.88%) in typeⅡ, 16(16.33%) in type Ⅲ, and 7(77.78%) in type Ⅳ. CONCLUSIONS: The classification of venous malformations of the tongue based on DSA is significant and valuable in guiding clinical treatment. The majority of tongue venous malformations are type Ⅲ, and the smallest propotion is type Ⅰ. Transmucosal sclerotherapy with absolute ethanol is of significance for the treatment of venous malformations of the tongue classified in type Ⅲ and type Ⅳ.

Radiologic criteria of retropharyngeal lymph node metastasis in nasopharyngeal carcinoma treated with radiation therapy.

PURPOSE: To determine the appropriate radiologic criteria of metastatic retropharyngeal lymph nodes (RLNs) in patients with nasopharyngeal carcinoma (NPC). MATERIALS AND METHODS: After institutional review board approval and informed consent, 303 consecutive NPC patients treated with definitive radiation therapy were examined after completion of therapy. RLNs were classified as metastatic on the basis of the results of magnetic resonance (MR) imaging follow-up.The receiver operating characteristic curve and area under the curve were determined to assess the accuracy of different size criteria in the diagnosis of RLN metastasis. RESULTS: Initial MR images revealed 523 RLNs in 265 patients. Two hundred sixty-four (50.5%) RLNs positive for malignant involvement were confirmed in 177 patients. The remaining 259 (49.5%) nodes were classified as negative for benign process at follow-up. The minimal axial diameter was found to be more accurate than the maximal axial diameter for assessing metastatic RLNs. The most accurate size criterion of metastatic RLNs was a minimal axial diameter of 6 mm or larger, resulting in an accuracy of 87.5% (457 of 522). Central necrosis or groups of two or more of RLNs had a 100% specificity for diagnosis of RLN metastases. CONCLUSION: The radiologic criteria that should be used for assessment of RLN metastases in NPC patients are nodes with a minimal axial diameter 6 mm or larger, any node with central necrosis, groups of two or more RLNs, or any medial RLN; these criteria may be useful in tumor staging and treatment planning.

A case of zonal syringocystadenoma papilliferum of the axilla mimicking verruca vulgaris.

Syringocystadenoma papilliferum (SCAP) most frequently arises from an organoid nevus on the head and neck. Zonal or segmental lesions occurring in other locations are rare. Here, we report a case of a 39-year-old woman with an SCAP clinically mimicking verruca vulgaris in a zonal distribution on her right axilla after her birth. Histopathologic examination showed it to be a typical SCAP. Furthermore, the tumor had a warty surface, which histologically revealed some signs of viral infection. Although polymerase chain reactions for low- and high-risk human papilloma virus types were negative, the relationship of SCAP with viral infection needs further investigation.

[Distributions of primary nasopharyngeal carcinoma tumor and patterns of skull base erosion detected by magnetic resonance imaging].

OBJECTIVE: To evaluate the distributions of primary nasopharyngeal carcinoma (NPC) and the patterns of skull base involvement in NPC patients using magnetic resonance imaging (MRI). METHODS: After the approval of institutional review board and informed consent, 838 consecutive newly-diagnosed and untreated NPC patients were examined by MRI. Their MR images were reviewed by two independent radiologists. RESULTS: Among all cases, the incidence rates of superior side and post-superior side involvement were 98.57% (826/838) and 98.21% (823/838) respectively. The differences were not significant between these two sides (P > 0.05). Lateral side erosion was demonstrated in 784 (93.56%) cases. Posterior side was involved in 391 (46.66%) cases. The total incidence rate of skull base involvement was 65.51% (549/838). According to the anatomic site, the pathways of skull base involvement were classified into 5 spreading routes: anterior; superior; super-lateral; super-anterior and super-posterior. According to the incidence rates and the results of chi-square test, the anatomic sites around the nasopharynx were classified into three groups of risk grades: high-risk (≥ 35%), medium-risk (≥ 5% - 35%) and low-risk (< 5%). CONCLUSION: Skull base involvement of NPC spreads stepwise from proximal site to more distal sites. The area of skull base involvement in NPC is classified into high-grade, medium-grade and lower-grade groups respectively. The high and medium-grade groups are related with T3 stage while the lower-grade group T4 stage. Thus T3 stage should be subdivided into T3a and T3b. These schemes may be useful in a more accurate NPC staging and a delineation of clinical target volume for radiotherapy in NPC patients.

[Research on AlInGaN quaternary alloys as MQW barriers in GaN-based laser diodes].

InGaN/GaN, InGaN/InGaN and InGaN/AlInGaN multi-quantum-well (MQW) laser diodes (LDs) were grown on (0001) sapphire substrate by metalorganic chemical vapor deposition (MOCVD). The GaN (0002) synchrotron X-ray diffraction (XRD), electroluminescence (EL) and optical power-current (L-I) measurement reveal that AlInGaN quaternary alloys as barriers in MQWs can improve the crystal quality, optical emission performance, threshold current and slope efficiency of the laser diode structure to a large extent compared with other barriers. The relevant mechanisms are that: 1. The Al component increases the barrier height of the MQWs so that more current carriers will be caught in. 2. The In component counteracts the strain in the MQWs that decreases the dislocations and defects, thereby the nonradiative recombination centers are decreased. 3. The In component decreases the piezoelectric electric field that makes the electrons and the holes recombine more easily.

Pyoderma gangrenosum with pulmonary involvement?

Pyoderma gangrenosum is a rare, painful, noninfectious, ulcerative, reactive neutrophilic skin condition. It is characterized by ulcers that can spread quickly showing undermined violaceous borders. Since there is no single diagnostic test, early diagnosis is always challenging. The aggressive nature of classical pyoderma gangrenosum may become apparent only with time. Pulmonary involvement of pyoderma gangrenosum maybe underreported. We describe a case of classical pyoderma gangrenosum in a 65-year-old man with pulmonary involvement, who presented with a painful fluctuate nodule and ulcer with mucopurulent and hemorrhagic exudates, and with a monoclonal gammopathy, IgA type. One month later the ulcer and hemoptysis all disappeared after treatment with glucocorticosteroids. The pulmonary manifestations of pyoderma gangrenosum were also reviewed.

Clinical efficacy, onset time and safety of bright light therapy in acute bipolar depression as an adjunctive therapy: A randomized controlled trial.

BACKGROUND: Bright light therapy (BLT) is an effective treatment for seasonal affective disorder and non- seasonal depression. The efficacy of BLT in treating patients with bipolar disorder is still unknown. AIMS: The aim of this study is to examine the efficacy, onset time and clinical safety of BLT in treating patients with acute bipolar depression as an adjunctive therapy (trial registration at ClinicalTrials.gov: NCT02009371). METHODS: This was a multi-center, single blind, randomized clinical trial. Seventy-four participants were randomized in one of two treatment conditions: BLT and control (dim red light therapy, dRLT). Sixty-three participants completed the study (33 BLT, 30 dRLT). Light therapy lasted for two weeks, one hour every morning. All participants were required to complete several scales assessments at baseline, and at the end of weeks 1 and 2. The primary outcome measures were the clinical efficacy of BLT which was assessed by the reduction rate of HAMD-17 scores, and the onset time of BLT which was assessed by the reduction rate of QIDS-SR16 scores. The secondary outcome measures were rates of switch into hypomania or mania and adverse events. RESULTS: 1) Clinical efficacy: BLT showed a greater ameliorative effect on bipolar depression than the control, with response rates of 78.19% vs. 43.33% respectively (p < 0.01). 2) Onset day: Median onset day was 4.33 days in BLT group. 3) BLT-emergent hypomania: No participants experienced symptoms of hypomania. 4) Side effects: No serious adverse events were reported. CONCLUSION: BLT can be considered as an effective and safe adjunctive treatment for patients with acute bipolar depression.

[Study on extracting raman spectra of single component and structure from impure amorphous spectra].

X-ray diffraction and Raman spectra show that the used amorphous SiC and GaN samples are impure. Adopting the new subtracting method with weighted impurity spectra, we obtained amorphous SiC and GaN Raman spectra involving only single component and structure. The good fitting between the calculated phonon density of states (PDOS) and the reduced Raman spectra confirms that the purified Raman spectra is really the amorphous Raman spectra, and the adopted spectral subtracting method with weighted impurity spectra is successful.