Comparison of spatiotemporal burial and contamination of heavy metals in core sediments of two plateau lakes with contrasting environments: implication for anthropogenic-driven processes.

Investigating the impacts of climatic factors and human activities on sedimentary records of heavy metal (HM) contamination in lakes is essential for decision-making in global environmental monitoring and assessment. Spatiotemporal distributions of grain size (GS) and HM (Al, Cr, Mn, Ni, Cu, Zn, As, and Pb) concentrations have been conducted in core sediments that are collected from two adjacent plateau fault-bound lakes in southwest China with contrasting environments, i.e., deep oligotrophic Lake Fuxian (FX) and shallow hypertrophic Lake Xingyun (XY). Results showed that the average value of d50 in FX (4.61 µm) was lower than that in XY (8.35 µm), but the average concentrations of HMs (except Cr and Mn) in XY were higher than those in FX. Heavy metal burial rates (HMBR) were mainly controlled by sediment accumulation rates (SARs) rather than HM concentrations. The correlation coefficients between GS and HM concentrations became strong as the increasing water depths were associated with a stable sedimentary environment. Time-integrated enrichment factors (EF) and source identification of HMs between FX and XY represented that Cr, Ni, and Cu originated from natural sources but Mn, Zn, As, and Pb from anthropogenic sources, respectively. Regardless of FX and XY, the transition times of HMs from natural to anthropogenic sources occurred in the mid-1960s. Comparison of qualification impacts of climatic factors and human-induced factors on increased anthropogenic HMBR by the partial least squares path modeling (PLS-PM) implied that socio-economic activities, such as population density (PD) and gross domestic product (GDP), provided higher contributors to increased anthropogenic HMBR in XY (0.23/0.71) than FX (0.11/0.18). The comparative results of this study provided new insights into environmental monitoring and management of HM contamination for adjacent lakes with contrasting environments.

A comprehensive and clinical-oriented evaluation criteria based on DVH information and gamma passing rates analysis for IMRT plan 3D verification.

PURPOSE: To accomplish the 3D dose verification to IMRT plan by incorporating DVH information and gamma passing rates (GPs) (DVH_GPs) so as to better correlate the patient-specific quality assurance (QA) results with clinically relevant metrics. MATERIALS AND METHODS: DVH_GPs analysis was performed to specific structures of 51 intensity-modulated radiotherapy (IMRT) treatment plans (17 plans each for oropharyngeal neoplasm, esophageal neoplasm, and cervical neoplasm) with Delta4 3D dose verification system. Based on the DVH action levels of 5% and GPs action levels of 90% (3%/2 mm), the evaluation results of DVH_GPs analysis were categorized into four regions as follows: the true positive (TP) (%DE> 5%, GPs < 90%), the false positive (FP) (%DE ≤ 5%, GPs < 90%), the false negative (FN) (%DE> 5%, GPs ≥ 90%), and the true negative (TN) (%DE ≤ 5%, GPs ≥ 90%). Considering the actual situation, the final patient-specific QA determination was made based on the DVH_GPs evaluation results. In order to exclude the impact of Delta4 phantom on the DVH_GPs evaluation results, 5 cm phantom shift verification was carried out to structures with abnormal results (femoral heads, lung, heart). RESULTS: In DVH_GPs evaluation, 58 cases with FN, 5 cases with FP, and 2 cases with TP were observed. After the phantom shift verification, the extremely abnormal FN of both lung (%DE = 21.52%±8.20%) and heart (%DE = 19.76%) in the oropharyngeal neoplasm plans and of the bilateral formal heads (%DE = 26.41%±13.45%) in cervical neoplasm plans disappeared dramatically. DVH_GPs analysis was performed to all evaluation results in combination with clinical treatment criteria. Finally, only one TP case from the oropharyngeal neoplasm plans and one FN case from the esophageal neoplasm plans did not meet the treatment requirements, so they needed to be replanned. CONCLUSION: The proposed DVH_GPs evaluation method first make up the deficiency of conventional gamma analysis regarding intensity information and space information. Moreover, it improves the correlation between the patient-specific QA results and clinically relevant metrics. Finally, it can distinguish the TP, TN, FP, and FN in the evaluation results. They are affected by many factors such as the action levels of DVH and GPs, the feature of the specific structure, the QA device, etc. Therefore, medical physicist should make final patient-specific QA decision not only by taking into account the information of DVH and GPs, but also the practical situation.

Vitexin induces apoptosis through mitochondrial pathway and PI3K/Akt/mTOR signaling in human non-small cell lung cancer A549 cells.

BACKGROUND: Currently, the prognosis of patients with non-small cell lung cancer (NSCLC) remains dismal; hence, it is critical to identify effective anti-NSCLC agents with limited side effects. This study aimed to evaluate the therapeutic potential of flavonoid compound vitexin in human NSCLC cells and the underlying mechanisms. RESULTS: The experimental results indicated that vitexin reduced the viability of A549 cells in a dose-dependent manner with nearly no toxicity against normal human bronchial epithelial 16HBE cells. Vitexin also dose-dependently increased A549 cell apoptosis, accompanied by the decreased Bcl-2/Bax ratio and the increased expression of cleaved caspase-3. Moreover, the in vivo anticancer activity of vitexin was further determined in nude mice bearing A549 cells. In addition, vitexin induced the release of cytochrome c from the mitochondria to the cytosol and the loss of mitochondrial membrane potential. Vitexin also significantly reduced the levels of p-PI3K, p-Akt and p-mTOR, and the pro-apoptotic effect of vitexin on A549 cells was partly blocked by SC79, an Akt activator. CONCLUSIONS: Accordingly, we believed that vitexin could be used as a potential therapeutic agent for the treatment of NSCLC in the future.

Optimization and Evaluation of Ventilation Mode in Marine Data Center Based on AHP-Entropy Weight.

The ventilation mode affects the cooling efficiency of the air conditioners significantly in marine data centers. Three different ventilation modes, namely, underfloor ventilation, overhead ventilation, side ventilation, are numerically investigated for a typical marine data center. Four independent parameters, including temperature, velocity, air age, and uniformity index, are applied to evaluate the performances of the three ventilation modes. Further, the analytic hierarchy process (AHP) entropy weight model is established and further analysis is conducted to find the optimal ventilation mode of the marine data center. The results indicate that the underfloor ventilation mode has the best performance in the airflow patterns and temperature distribution evaluation projects, with the highest scores of 91.84 and 90.60. If low energy consumption is required, it is recommended to select the overhead ventilation mode with a maximum score of 93.50. The current evaluation results agree fairly well with the three dimensional simulation results, which further proves that the AHP entropy weight method is reasonable and has a high adaptability for the evaluation of air conditioning ventilation modes.

SENP2 regulated the stability of ß-catenin through WWOX in hepatocellular carcinoma cell.

SUMOylation and deSUMOylation are dynamic mechanisms regulating a spectrum of protein activities. The SUMO proteases (SENP) remove SUMO conjugate from proteins, and their expression is deregulated in cancers. SENP2 has been reported to play a critical role in the control of hepatocellular carcinoma (HCC) cell growth by modulating the stability of ß-catenin. However, the underlying mechanism remains largely unknown. Here, we show that the WW domain-containing oxidoreductase (WWOX), a novel inhibitor of the Wnt/ß-catenin pathway, is required for stabilization of ß-catenin regulated by SENP2 in HCC cells. The transcriptional level of WWOX is tightly regulated by SENP2. Moreover, knockdown of WWOX by siRNA attuned SENP2-induced ß-catenin degradation and decreased SENP2-mediated HCC cell proliferation arrest. Taken together, our data suggested that WWOX is a key downstream modulator of the SENP2 tumor suppressor function in HCC cell.

Comparative study on laparoscopic sleeve gastrectomy and laparoscopic gastric bypass for treatment of morbid obesity patients.

BACKGROUND/AIMS: Laparoscopic Roux-en-Y gastric bypass (LRYGB) is one of the most widely used bariatric procedures for the treatment of morbid obesity. Laparoscopic sleeve gastrectomy (LSG) is a relatively innovative procedure which has been increasingly accepted as a sole bariatric procedure in the Asian-Pacific region. This study aims to compare mid-term outcomes in morbid obesity patients undergoing LRYGB and LSG. METHODOLOGY: Between January 2008 and May 2011, 94 morbid obesity patients were assigned by patient choice after informed consent to either a LSG (n = 56) or LRYGB (n = 38) group. We compared operation time, amount of bleeding, hospital length-of-stay, complications, improvement of diabetic patients, BMI, and excess weight loss (EWL) at 6-30 months post-operation. RESULTS: There was no death in either group. The operating time, hospital length-of-stay, and complications were significantly shorter in the LSG group (P < 0.05). There was no significant difference in the overall improvement of diabetes mellitus (P > 0.05). LRYGB had better effectiveness than LSG in BMI decrease and EWL in the first year (P < 0.05), but there was no significant difference after 1 year (P > 0.05). CONCLUSIONS: The two procedures are safe and effective, but the LRYGB procedure incurs a high number of complications and long hospital stay. LSG is a promising bariatric procedure and the results of LSG as a single procedure are equally effective to LRYGB at 2 years follow-up on weight reduction. Furthermore, the LSG group has a more stable EWL in the early stage. However, studies with large number of patients and longer follow-up are necessary to make a definitive conclusions.

Management of Budd-Chiari: a single-center experience of 280 cases.

OBJECTIVE: Budd-Chiari syndrome (BCS) is a rare and life-threatening disorder secondary to hepatic venous outflow obstruction. How to manage this complex disease has haunted many surgeons. The aim of this study is to investigate the treatment of Budd-Chiari syndrome in our hospital. METHODS: The clinical data of 280 BCS patients were analyzed retrospectively in our hospital between July 2000 and March 2013. RESULTS: The total effective rate was 90% (252/280). The rate of mortality was 7.14% (20/280), the rate of complication was 17.14% (48/280). We carried out followup in 198 cases from 6 months to 10 years, the rate of recurrence was 6.07% (12/198). CONCLUSIONS: Treatment of BCS need to get a corrective diagnosis and classification at first, then select corrective methods of treatment based on different pathological change of IVC and main hepatic vein.

Advanced navigation technology enables endobronchial brachytherapy for peripheral lung cancer: An old technique plays a new role.

PURPOSE: To investigate the feasibility of super-selectively endobronchial brachytherapy in the treatment of peripheral lung cancer guided by advanced navigation technology. METHODS AND MATERIALS: Six patients with peripheral lung tumors successfully underwent treatment with super-selectively endobronchial brachytherapy guided by advanced navigation technology following pathway planning and were subsequently followed up to assess survival and treatment-related toxicities. RESULTS: The endobronchial applicators were successfully placed inside the tumors of all patients using advanced navigation techniques according to the pretreatment plan, and brachytherapy was delivered at curative doses after evaluation using radiotherapy planning software. None of the patients showed local progression of the treated lesions during the follow-up for a duration ranging from 11 months to 35 months, with a median follow-up time of 23 months. The patient with the longest follow-up, nearly 3 years, exhibited a stable condition. After undergoing endobronchial brachytherapy, patients predominantly experienced localized fibrosis as indicated. No significant alterations in cardiopulmonary function were detected during the follow-up, and no other adverse effects were found. CONCLUSIONS: The use of endobronchial brachytherapy for the curative treatment of peripheral lung cancers is feasible. Furthermore, the development of novel bronchial navigation techniques has the potential to broaden the application of endobronchial brachytherapy.

Evaluation of the sensitivity of two 3D diode array dosimetry systems to setup error for quality assurance (QA) of volumetric-modulated arc therapy (VMAT).

The purpose of this study is to evaluate the sensitivities of 3D diode arrays to setup error for patient-specific quality assurance (QA) of volumetric-modulated arc therapy (VMAT). Translational setup errors of ± 1, ± 2, and ± 3 mm in the RL, SI, and AP directions and rotational setup errors of ± 1° and ± 2° in the pitch, roll, and yaw directions were set up in two phantom systems, ArcCHECK and Delta4, with VMAT plans for 11 patients. Cone-beam computed tomography (CBCT) followed by automatic correction using a HexaPOD 6D treatment couch ensured the position accuracy. Dose distributions of the two phantoms were compared in order to evaluate the agreement between calculated and measured values by using γ analysis with 3%/3 mm, 3%/2 mm, and 2%/2 mm criteria. To determine the impact on setup error for VMAT QA, we evaluated the sensitivity of results acquired by both 3D diode array systems to setup errors in translation and rotation. For the VMAT QA of all patients, the pass rate with the 3%/3 mm criteria exceeded 95% using either phantom. For setup errors of 3 mm and 2°, respectively, the pass rates with the 3%/3mm criteria decreased by a maximum of 14.0% and 23.5% using ArcCHECK, and 14.4% and 5.0% using Delta4. Both systems are sensitive to setup error, and do not have mechanisms to account for setup errors in the software. The sensitivity of both VMAT QA systems was strongly dependent on the patient-specific plan. The sensitivity of ArcCHECK to the rotational error was higher than that of Delta4. In order to achieve less than 3% mean pass rate reduction of VMAT plan QA with the 3%/3 mm criteria, a setup accuracy of 2 mm/1° and 2 mm/2° is required for ArcCheck and Delta4 devices, respectively. The cumulative effect of the combined 2 mm translational and 1° rotational errors caused 3.8% and 2.4% mean pass rates reduction with 3%/3 mm criteria, respectively, for ArcCHECK and Delta4 systems. For QA of VMAT plans for nasopharyngeal cancer (NPC) using the ArcCHECK system, the setup should be more accurate.

Sediment records of black carbon variations over the last two centuries in North China.

Reconstructing historical black carbon (BC) variations based on sedimentary records are significant for understanding long-term BC emissions, tracing sources, and establishing effective strategies for pollution control. By comparing BC profiles between four lake sediment cores, historical BC variations were reconstructed on the southeastern Mongolian Plateau in North China. Except one, the other three records show close fluxes and similar temporal trends of soot, indicating their repetitiveness on revealing historical variations at a regional scale. Unlike soot, char and BC in these records, derived mainly from local sources, reflected the occurrence of natural fires and human activities near the lakes. Before the ∼1940s, these records showed no well-established anthropogenic BC signals except some occasional natural-related increases. This was different from the global BC increased since the Industrial Revolution, indicating a negligible influence of transboundary BC on the region. Anthropogenic BC in the region had increased since the 1940s-1950s ascribed to emissions from Inner Mongolia and nearby provinces. The increases were moderate in the 1950s-1970s, corresponded with the initial development of industry after the founding of the P.R. China. The most pronounced BC increases occurred in 1980s-2016, commensurate with rapid socio-economic development after the Reform and Opening-up in 1978. Different from model estimations on Chinese BC emissions, our records show unexpected BC increases in recent two decades caused by pollutant emission rises in this undeveloped region. This suggests that BC emissions in relatively small cities and rural areas in China were likely underestimated and their role on national BC cycling needs to be reassessed.

Two-century sediment records of atmospheric mercury variations in North China and their relations with regional and global emissions.

Sedimentary mercury (Hg) records from remote areas are significant for revealing historical variations of regional Hg and understanding the influence of regional and global Hg emissions. In this study, sediment cores were retrieved from two subalpine lakes in Shanxi Province in North China and employed to reconstruct atmospheric Hg variations over the last two centuries. The two records show similar anthropogenic Hg fluxes and evolution trends, corresponding with that they were affected mainly by regional atmospheric Hg deposition. Before ~1950, the records show negligible Hg pollution signals. Atmospheric Hg in the region had increased rapidly since the 1950s, lagged more than a half-century compared to the global Hg. This indicates that they were seldom affected by Hg emissions dominated by Europe and North America after the industrial revolution. The Hg increases since the 1950s in the two records corresponded well with rapid industrial developments in and around Shanxi Province after the founding of the China, implying the dominant contribution of domestic Hg emissions. By comparing other Hg records, we find that widespread increases in atmospheric Hg in China likely occurred post ~1950. This study rouses to re-examine historical variations in atmospheric Hg at various settings, which is significant to understanding global Hg cycling in the industrial era.

Circular_0086414 induces SPARC like 1 (SPARCL1) production to inhibit esophageal cancer cell proliferation, invasion and glycolysis and induce cell apoptosis by sponging miR-1290.

Circular RNA (circRNA) plays an important role in cancer progression. Here, we investigated the function of circ_0086414 in the malignant progression of esophageal cancer (EC). RNA expression of circ_0086414, microRNA-1290 (miR-1290), and SPARC like 1 (SPARCL1) was detected by quantitative real-time polymerase chain reaction. The protein levels of N-cadherin, E-cadherin, and SPARCL1 were checked by Western blotting analysis. Cell proliferation was investigated by 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT), 5-Ethynyl-29-deoxyuridine (EdU), and cell colony formation assays. Cell invasion and apoptosis were analyzed by transwell invasion assay and flow cytometry analysis, respectively. Glycolysis was evaluated by analyzing glucose consumption and lactate production. In an xenograft mouse model, the effect of circ_0086414 on tumor tumorigenesis was investigated. The interactions among circ_0086414, miR-1290, and SPARCL1 were identified by dual-luciferase reporter and RNA pull-down assays. Results showed that circ_0086414 and SPARCL1 expression were significantly downregulated, while miR-1290 was upregulated in EC tissues and cells. EC patients with low circ_0086414 expression had a poor prognosis. Increasing circ_0086414 expression led to decreased EC cell proliferation, invasion and glycolysis and increased cell apoptosis, accompanied by a decrease of N-cadherin expression and an increase of E-cadherin expression. Also, the enforced expression of circ_0086414 delayed tumor tumorigenesis. Besides, circ_0086414 acted as a miR-1290 sponge and regulated EC cell processes by binding to the miRNA. MiR-1290 also participated in EC malignant progression through SPARCL1. Further, circ_0086414 stimulated SPARCL1 production by negatively regulating miR-1290. Thus, circ_0086414 inhibited EC cell malignancy through the miR-1290/SPARCL1 pathway, providing a reliable target for the therapy of EC.

Exceptional terrestrial warmth around 4200-2800 years ago in Northwest China.

One of the Holocene abrupt events around 4200 years ago, lasting for âˆ¼ 200 years, is thought to have caused cultural disruptions, yet terrestrial climatic status right after the cold/dry event remains poorly defined and is often presumed that a generally cool condition prevailed during the Bronze Age (∼ 4000-2200 years ago). Here we report an alkenone-based summer temperature record over the past âˆ¼ 12,000 years, in addition to two updated alkenone records, from Northwest China, providing new insights into the climatic status right after the event. Our results indicate that exceptional terrestrial warmth, up to âˆ¼ 6 °C, occurred around 4200-2800 years ago during the Bronze Age, superimposed on the long-term Holocene cooling trend. The exceptional warmth in Northwest China, together with other climate anomalies elsewhere, suggests an unusual large-scale climatic reorganization at 4200-2800 years ago when solar activity remained high, with important implications to the climate background for cultural developments during the Bronze Age.

Effect of Pelvic Bone Marrow Sparing Intensity Modulated Radiation Therapy on Acute Hematologic Toxicity in Rectal Cancer Patients Undergoing Chemo-Radiotherapy.

BACKGROUND: While chemo-radiotherapy improves local control in patients with locally advanced rectal cancer, it can also increase acute hematological toxicity (HT), which leads to poor outcomes. Patients receiving bone marrow radiation have been shown to develop acute HT. However, the safety and efficacy of bone marrow sparing is undetermined. The aim of our study was to explore the feasible dosimetric constraints for pelvic bone marrow (PBM) that can be widely used in rectal cancer patients undergoing chemo-radiotherapy. METHODS: 112 rectal cancer patients were selected and divided into the PBM sparing IMRT group (60 cases) and the non-PBM sparing IMRT group (52 cases). All patients underwent pelvic radiotherapy with concurrent capecitabine-based chemotherapy. The PBM dosimetric constraints in the PBM sparing IMRT group were set to:V10 ≤ 85%, V20 ≤ 65% and V30 ≤ 45%. An independent sample t test was applied for the dose-volume parameters, and Chi-squared analysis was applied for clinical parameters and adverse events. RESULTS: The radiation dose to PBM (V5~V45, Dmean, P<0.05), PBM sub-regions (V10~V35, Dmean, P<0.05) and both femoral heads (V5~V40, Dmean, P<0.05) decreased significantly in the PBM sparing IMRT group compared with that of the non-PBM sparing IMRT group (P<0.05). There was no significant difference in any dose-volume parameters of the bladder and small bowel in either groups, and none in the planning target volume (PTV) dose homogeneity and conformity (P>0.05). For acute HT observation, the incidence of grade 3 acute HT (χ2 = 7.094, P=0.008) was significantly reduced in patients treated with PBM sparing IMRT compared with patients treated with non-PBM sparing IMRT. There was no statistical difference in the incidence of vomiting, diarrhea, fatigue, anorexia, nausea, hand-foot syndrome, cystitis, perianal pain and perianal dermatitis in patients of both groups (P >0.05). CONCLUSIONS: Applying PBM dosimetric constraints (V10 ≤ 85%, V20 ≤ 65% and V30 ≤ 45%) can significantly reduce the radiation dose to PBM. The patients treated with PBM sparing IMRT had a lower incidence of acute HT compared with those treated with non-PBM sparing IMRT. Applying the PBM dosimetric constraints proposed by our study can benefits the patients with rectal cancer undergoing capecitabine-based chemo-radiotherapy.

Long non-coding RNA XIST promotes the progression of esophageal squamous cell carcinoma through sponging miR-129-5p and upregulating CCND1 expression.

Long non-coding RNA (lncRNA) X inactive specific transcript (XIST) has been identified as an oncogenic lncRNA in a series of human cancers, including esophageal squamous cell carcinoma (ESCC). In this study, we aimed to further explore the underlying mechanism of XIST on ESCC progression. qRT-PCR assay was used to determine the levels of XIST and miR-129-5p. Western blot analysis was performed to assess cyclin D1 (CCND1) expression. Bioinformatic analysis was performed using starBase v2.0 software. Dual-luciferase reporter and RNA immunoprecipitation assays were employed to confirm the interaction between XIST and miR-129-5p or miR-129-5p and CCND1. Cell cycle progression and apoptosis were measured by flow cytometric analysis, and cell migration and invasion were detected by transwell assay. Mouse studies were used to observe the effect of XIST silencing on tumor growth in vivo. Our results indicated that XIST was upregulated and miR-129-5p was downregulated in ESCC. XIST silencing or miR-129-5p overexpression repressed cell cycle progression, proliferation, migration, invasion, and promoted the apoptosis in ESCC cells. Moreover, XIST directly interacted with miR-129-5p and repressed miR-129-5p expression. MiR-129-5p mediated the regulatory effect of XIST on ESCC cell progression in vitro, and XIST promoted CCND1 expression by sponging miR-129-5p. Additionally, XIST silencing inhibited tumor growth in vivo. Our findings suggested that XIST silencing repressed the progression of ESCC at least partly through regulating the miR-129-5p/CCND1 axis. Targeting XIST might be a potential therapeutic strategy for ESCC treatment.

Role of SNPs in the Biogenesis of Mature miRNAs.

Single nucleotide polymorphisms (SNPs) play a significant role in microRNA (miRNA) generation, processing, and function and contribute to multiple phenotypes and diseases. Therefore, whole-genome analysis of how SNPs affect miRNA maturation mechanisms is important for precision medicine. The present study established an SNP-associated pre-miRNA (SNP-pre-miRNA) database, named miRSNPBase, and constructed SNP-pre-miRNA sequences. We also identified phenotypes and disease biomarker-associated isoform miRNA (isomiR) based on miRFind, which was developed in our previous study. We identified functional SNPs and isomiRs. We analyzed the biological characteristics of functional SNPs and isomiRs and studied their distribution in different ethnic groups using whole-genome analysis. Notably, we used individuals from Great Britain (GBR) as examples and identified isomiRs and isomiR-associated SNPs (iso-SNPs). We performed sequence alignments of isomiRs and miRNA sequencing data to verify the identified isomiRs and further revealed GBR ethnographic epigenetic dominant biomarkers. The SNP-pre-miRNA database consisted of 886 pre-miRNAs and 2640 SNPs. We analyzed the effects of SNP type, SNP location, and SNP-mediated free energy change during mature miRNA biogenesis and found that these factors were closely associated to mature miRNA biogenesis. Remarkably, 158 isomiRs were verified in the miRNA sequencing data for the 18 GBR samples. Our results indicated that SNPs affected the mature miRNA processing mechanism and contributed to the production of isomiRs. This mechanism may have important significance for epigenetic changes and diseases.

Survival outcome after stereotactic body radiotherapy for locally advanced and borderline resectable pancreatic cancer: A systematic review and meta-analysis.

BACKGROUND: Some studies reported stereotactic body radiotherapy (SBRT) has demonstrated superior therapeutic results than conventional radiotherapy. Nevertheless, this statement is controversial and the trial attempting to prove this is underway. We conducted this systemic review and meta-analysis aiming to combine the latest and most complete information about the survival outcomes and toxicities following SBRT for locally advanced pancreatic cancer (LAPC) and borderline resectable pancreatic cancer (BRPC). METHODS: Items involving SBRT and pancreatic cancer were searched in PubMed, EMBASE, Cochrane Library, SCOPUS and Web of Science. Median overall survival (OS), 1/2/3-year OS, median progression-free survival (PFS), 1/2/3-year PFS and incidence of grade 3-5 toxicities were the endpoints of interest in this meta-analysis. These endpoint proportions were pooled and analyzed using R. RESULTS: For the LAPC series, the median OS was 14.1 months; pooled 1/2/3-year OS rates were 57%, 19% and 10%, respectively; the median PFS was 10 months; pooled 1/2/3-year PFS rates were 36%, 12% and 4%; pooled incidence rates of acute gastrointestinal (GI), acute hematologic and late GI toxicity (grade≥3) were 2%, 4% and 8%. For the BRPC series, the median OS was 17.5 months; pooled 1/2-year OS rates were 75% and 29%; the median PFS was 12.2 months; pooled 1/2-year PFS rates were 48% and 18%; the incidence rates of toxicity (grade ≥ 3) were all 0%. CONCLUSIONS: Our meta-analysis based on published results of OS, PFS and incidence rates of toxicity demonstrated that SBRT does not show desirable therapeutic result than the standard therapies for LAPC and BRPC.

Contrasting Trends of Surface PM2.5, O3, and NO2 and Their Relationships with Meteorological Parameters in Typical Coastal and Inland Cities in the Yangtze River Delta.

The contrasting trends of surface particulate matter (PM2.5), ozone (O3), and nitrogen dioxide (NO2) and their relationships with meteorological parameters from 2015 to 2019 were investigated in the coastal city of Shanghai (SH) and the inland city of Hefei (HF), located in the Yangtze River Delta (YRD). In both cities, PM2.5 declined substantially, while O3 and NO2 showed peak values during 2017 when the most frequent extreme high-temperature events occurred. Wind speed was correlated most negatively with PM2.5 and NO2 concentrations, while surface temperature and relative humidity were most closely related to O3. All of the studied pollutants were reduced by rainfall scavenging, with the greatest reduction seen in PM2.5, followed by NO2 and O3. By contrast, air pollutants in the two cities were moderately strongly correlated, although PM2.5 concentrations were much lower and Ox (O3 + NO2) concentrations were higher in SH. Additionally, complex air pollution hours occurred more frequently in SH. Air pollutant concentrations changed more with wind direction in SH. A more effective washout effect was observed in HF, likely due to the more frequent strong convection and thunderstorms in inland areas. This research suggests pertinent air quality control measures should be designed accordingly for specific geographical locations.

[Duodenum-preserving pancreatic head resection in treating patients with chronic pancreatitis].

OBJECTIVE: To evaluate the therapeutic efficacy of duodenum-preserving pancreatic head resection (DPPHR) for severe chronic pancreatitis (CP). METHODS: From February 2004 to March 2010, duodenum-preserving resection of pancreatic head was performed in 21 patients with severe CP. A "modified-DPPHR" was carried out in 14 patients of them and a "Frey's DPPHR" in the other 7 patients. The values of fasting plasma blood (FPB), oral glucose tolerance test (OGTT), body weight (BW), visual analogue pain intensity scale (VAS score) and the quality of life indices were evaluated before and 6(th) month after surgery. RESULTS: There was no hospital mortality. The complications from adjacent organs were resolved definitively. Pancreatic fistula was the major and the most frequent morbidity occurring in 23.8% of the patients. After operation 85.7% of the patients were completely pain-free and 14.3% had continuing abdominal pain. The VAS score decreased more after surgery comparing with before and there was a significant difference (81.1 ± 5.6 vs 7.8 ± 3.6, P < 0.05). The value of FPB in post-operative patients was similar to that in pre-operative ones and there was no significant difference [(5.3 ± 0.4) mmol/L vs (5.4 ± 0.4) mmol/L, P > 0.05]. The value of 2 h-OGGT in post-operative patients was also similar to that in pre-operative ones and it did not differ significantly [(8.0 ± 0.6) mmol/L vs (7.9 ± 0.6) mmol/L, P > 0.05]. After operation 77.8% of patients gained more than 5% of their pre-operative body weight with a mean increment of (4.8 ± 0.7) kg (58.8 ± 1.8 vs 53.9 ± 2.0, P < 0.05). A significant rise of the overall quality of life index was observed after surgery (78.1 ± 7.3 vs 61.0 ± 6.2, P < 0.05). CONCLUSION: DPPHR is both safe and effective with regard to pain relief, a definitive control of complications affecting adjacent organs and an improvement of overall quality of life. It leads to no further deterioration of pancreatic functions.

[Volumetric and geometric changes of parotids occurring during IMRT for nasopharyngeal carcinoma (NPC) using daily CBCT].

OBJECTIVE: To study the volumetric and geometric changes of parotids occurring during IMRT treatment for NPC. METHODS: The pre-treatment CBCT images of 10 patients were obtained using kV-CBCT and transmitted back to TPS. The gross tumor volumes (GTVs) and volumes of parotids were manually drawn slice by slice on the CBCT images by the same person using image analysis software system Tomcon 3.0. For position changes, the center-of-mass (COM) were calculated using Pinnacle 8.0 software. Then the distance from the parotid to the atlas was assessed. RESULTS: The volumetric changes of GTVs and parotids were correlated with the days of treatment. The volumes of GTVs decreased with a mean total loss of 9.85 cm3 (5.10-21.40 cm3) and a median change rate of 0.20 cm3/d (0.10-0.46 cm3/d). The volumes of left parotids decreased with a median total loss of 5.70 cm3 (3.20-12.00 cm3) and a median change rate of 0.13 cm3/d (0.07-0.27 cm3/d). The volumes of right parotids decreased with a median total loss of 8.05 cm3 (3.00-13.40 cm3) and a median change rate of 0.18 cm3/d (0.06-0.29 cm3/d). The distance between the left parotid and the atlas decreased with a median total loss of 3.45 mm (0.70-7.60 mm) and a median change rate of 0.07 mm/d (0.01-0.11 mm/d). The distance between the right parotids and the atlas decreased with a median total loss of 2.60 mm (1.50-4.40 mm) and a median change rate of 0.05 mm/d (0.03-0.12 mm/d). CONCLUSION: Significant reductions of GTVs occur after the third or forth week of IMRT treatment for NPC, which indicates that a second plan of CT scanning or treatment replanning might be necessary after 3-4 weeks of treatment to minimize radiations to vital organs.