Effects of Tetrabasic Zinc Chloride on Growth Performance, Nutrient Digestibility and Fecal Microbial Community in Weaned Piglets.

The study was conducted to explore the effects of tetrabasic zinc chloride (TBZC), as an alternative to zinc oxide (ZnO), on growth performance, serum indexes, and fecal microbiota of weaned piglets. A total of 108 weaned piglets (average initial body weight of 7.84 ± 0.97 kg) were randomly allocated into one of three dietary treatments with six replicate pens and six piglets per pen. The dietary treatments included a control diet (CON, negative control), a ZnO diet (CON + 1,600 mg Zn/kg from ZnO, positive control), and a TBZC diet (CON + 1,000 mg Zn/kg from TBZC). The average daily gain of pigs in the TBZC group was greater (P < 0.05) than those in CON and ZnO groups during the whole period. Piglets fed the ZnO and TBZC diets showed lower (P < 0.05) diarrhea incidence than those fed the CON diet during d 1-14 and the whole period. Piglets fed the TBZC diet had higher (P < 0.05) digestibility of crude protein and gross energy than those fed the CON diet. Serum concentrations of IGF-I and GH, as well as ALP activity, were significantly elevated (P < 0.05) in the TBZC treatment group compared to the CON group on d 14. Piglets fed the ZnO diet had greater (P < 0.05) acetate and total short-chain fatty acids concentrations, while the TBZC diet had greater (P < 0.05) fecal acetate and propionate concentrations on d 28. Moreover, TBZC supplementation significantly increased (P < 0.05) microbial α-diversity compared with the CON group. The fecal microbiota of piglets in ZnO and TBZC treatment groups tended (P = 0.08) to have greater relative abundance of Prevotellaceae compared with the CON piglets. In conclusion, TBZC acted as a suitable alternative to ZnO to reduce zinc excretion, and improve growth performance of weaned piglets.

Adjuvant chemotherapy in patients with locoregionally advanced nasopharyngeal carcinoma: Long-term results of a phase 3 multicentre randomised controlled trial.

AIM OF THE STUDY: Previous results from our trial showed that adjuvant cisplatin and fluorouracil chemotherapy did not significantly improve survival after concurrent chemoradiotherapy (CCRT) in locoregionally advanced nasopharyngeal carcinoma (NPC) at 2 years. Here, we present the data of long-term survival and late toxicities to further assess the ultimate therapeutic index of adjuvant chemotherapy (AC). METHODS: Patients with stage III-IVB (except T3-4N0) NPC were randomly assigned to receive CCRT plus AC or CCRT only at seven institutions in China. Patients in both groups received cisplatin 40 mg/m2 weekly up to 7 weeks concurrently with radiotherapy. The CCRT plus AC group subsequently received adjuvant cisplatin 80 mg/m2 and fluorouracil 800 mg/m2/d for 120 h every 4 weeks for three cycles. The primary end-point was failure-free survival. RESULTS: Two hundred and fifty-one patients were randomised to the CCRT plus AC group and 257 to the CCRT only group. After a median follow-up of 68.4 months, estimated 5-year failure-free survival rate was 75% in the CCRT plus AC group and 71% in the CCRT only group (hazard ratio 0.88, 95% confidence interval 0.64-1.22; p = 0.45). 66 (27%) of 249 patients in the CCRT plus AC group and 53 (21%) of 254 patients in the CCRT only group developed one or more late grade 3-4 toxicities (p = 0.14). CONCLUSION: Adjuvant cisplatin and fluorouracil chemotherapy still failed to demonstrate significant survival benefit after CCRT in locoregionally advanced NPC based on the long-term follow-up data, and addition of adjuvant cisplatin and fluorouracil did not significantly increase late toxicities. REGISTRATION NUMBER: NCT00677118.

Concurrent chemoradiotherapy plus adjuvant chemotherapy versus concurrent chemoradiotherapy alone in patients with locoregionally advanced nasopharyngeal carcinoma: a phase 3 multicentre randomised controlled trial.

BACKGROUND: The effect of the addition of adjuvant chemotherapy to concurrent chemoradiotherapy in locoregionally advanced nasopharyngeal carcinoma is unclear. We aimed to assess the contribution of adjuvant chemotherapy to concurrent chemoradiotherapy versus concurrent chemoradiotherapy alone. METHODS: We did an open-label phase 3 multicentre randomised controlled trial at seven institutions in China. Randomisation was by a computer-generated random number code. Patients were stratified by treatment centre and randomly assigned in blocks of four. Treatment allocation was not masked. We randomly assigned patients with non-metastatic stage III or IV (except T3-4N0) nasopharyngeal carcinoma to receive concurrent chemoradiotherapy plus adjuvant chemotherapy or concurrent chemoradiotherapy alone. Patients in both groups received 40 mg/m(2) cisplatin weekly up to 7 weeks, concurrently with radiotherapy. Radiotherapy was given as 2·0-2·27 Gy per fraction with five daily fractions per week for 6-7 weeks to a total dose of 66 Gy or greater to the primary tumour and 60-66 Gy to the involved neck area. The concurrent chemoradiotherapy plus adjuvant chemotherapy group subsequently received 80 mg/m(2) adjuvant cisplatin and 800 mg/m(2) per day fluorouracil for 120 h every 4 weeks for three cycles. Our primary endpoint was failure-free survival. We did efficacy analyses in our intention-to-treat population. Our trial is ongoing; in this report we present the 2 year survival results and acute toxic effects. This trial is registered with ClinicalTrials.gov, number NCT00677118. FINDINGS: 251 patients were assigned to the concurrent chemoradiotherapy plus adjuvant chemotherapy group and 257 to the concurrent chemoradiotherapy alone group. After a median follow-up of 37·8 months (range 1·3-61·0), the estimated 2 year failure-free survival rate was 86% (95% CI 81-90) in the concurrent chemoradiotherapy plus adjuvant chemotherapy group and 84% (78-88) in concurrent chemoradiotherapy only group (hazard ratio 0·74, 95% CI 0·49-1·10; p=0·13). Stomatitis was the most commonly reported grade 3 or 4 adverse event during both radiotherapy (76 of 249 patients in the concurrent chemoradiotherapy plus adjuvant chemotherapy group and 82 of 254 in the concurrent chemoradiotherapy alone group) and adjuvant chemotherapy (43 [21%] of 205 patients treated with adjuvant chemotherapy). INTERPRETATION: Adjuvant cisplatin and fluorouracil chemotherapy did not significantly improve failure-free survival after concurrent chemoradiotherapy in locoregionally advanced nasopharyngeal carcinoma. Longer follow-up is needed to fully assess survival and late toxic effects, but such regimens should not, at present, be used outside well-designed clinical trials. FUNDING: Sun Yat-sen University Clinical Research 5010 Programme (No 2007037), Science Foundation of Key Hospital Clinical Programme of Ministry of Health PR China (No 2010-178), and Guangdong Province Universities and Colleges Pearl River Scholar Funded Scheme (2010).

Non-fatal injuries among Chinese aged 65 years and older: findings from the Fourth National Health Services Survey.

OBJECTIVE: To understand the epidemiology of non-fatal injuries among adults aged 65 years and older in China. DESIGN: Cross-sectional survey (the Fourth National Health Services Survey of China). PARTICIPANTS: Urban and rural residents aged 65 years and older from 56,400 households in China. MAIN OUTCOME MEASURES: The incidence rate was calculated as the number of persons injured in the previous 12 months divided by the population x 1000. RESULTS: The incidence rate of non-fatal injuries among elderly individuals in the previous 12 months was 37.5 per 1000 population. Home, street, working environment, and public buildings were the most common places of occurrence, accounting for more than 90% of injuries. Falls were the leading cause of non-fatal injuries. After adjusting for other factors, Han people were 39% more likely to be injured than non-Han people, and the divorced and the widowed were found to have, respectively, 4.6 and 2.2 times the risk of injury compared with single persons, p<0.05. Education, per capita household income and urbanisation did not significantly affect the injury risk when confounding factors were controlled for. CONCLUSION: Almost 4% of adults aged 65 years and over sustain injuries each year in China. Falls should be a priority of injury prevention for elderly people, efficient home injury prevention programmes need to be developed, and the divorced and widowed should be targeted as groups at high risk of injury.