Systemic therapies for recurrent or metastatic nasopharyngeal carcinoma: a systematic review.

BACKGROUND: The majority of published studies in recurrent or metastatic nasopharyngeal carcinoma (RM-NPC) are single-arm trials. Reliable modelling of progression-free survival (PFS) and overall survival (OS) outcomes, therefore, is difficult. This study aim to analyse existent literature to estimate the relative efficacy of available systemic regimens in RM-NPC, as well as provide estimates of aggregate OS and PFS. METHODS: We conducted a systematic search of MEDLINE, EMBASE and the Cochrane Library to March 2015. Clinical trials (in English only) investigating cytotoxic and molecularly targeted agents in adult patients with RM-NPC were included. All relevant studies were assessed for quality using Downs and Blacks (DB) checklist (maximum quality score of 27). Aggregate data analysis and Student's t-test were performed for all identified studies (model A). For studies that published analysable Kaplan-Meier curves, survival data were extracted and marginal proportional hazards models were constructed (model B). RESULTS: A total of 56 studies were identified and included in model A, 26 of which had analysable Kaplan-Meier curves and were included in model B. The 26 studies in model B had significantly higher mean DB scores than the remaining 30 (17.3 vs 13.7, P=0.002). For patients receiving first line chemotherapy, the estimated median OS was 15.7 months by model A (95% CI, 12.3-19.1), and 19.3 months by model B (95% CI, 17.6-21.1). For patients undergoing second line or higher therapies (2nd+), the estimated median OS was 11.5 months by model A (95% CI 10.1-12.9), and 12.5 months by model B (95% CI 11.9-13.4). PFS estimates for patients undergoing first-line chemotherapy by model A was 7.6 months (95% CI, 6.2-9.0), and 8.0 months by model B (95% CI, 7.6-8.8). For patients undergoing therapy in the 2nd+ setting, the estimated PFS by model A was 5.4 months (95% CI, 3.8-7.0), and 5.2 months by model B (95% CI, 4.7-5.6). CONCLUSIONS: We present the first aggregate estimates of OS and PFS for RM-NPC patients receiving first and second-line or higher treatment settings, which could inform the design of future clinical trials in this disease setting.

Antioxidant activity and chemical composition of oleoresin from leaves and flowers of Brunfelsia uniflora.

In this study, the temperature and pressure of supercritical CO2 extraction were evaluated to obtain oleoresin of Brunfelsia uniflora leaves and flowers. The oleoresin compounds were identified by gas chromatography-mass spectrometry. The antioxidant activity was evaluated by three different methods. The highest oleoresin yields were 3.32% at 40°C and 200 bar for the leaves, and 1.03% at 60°C and 200 bar for the flowers. The main extracted compounds from leaves were phytol varying from 11.95 to 36.42% and α-tocopherol from 15.53 to 43.10%, and from flowers were geranyl linalool from 11.05 to 21.42% and α-amyrin from 9.66 to 22.12%. Oleoresin obtained at 60°C and 150 bar from leaves presented high antioxidant activity by DPPH (IC50 1.90 mg/mL) and by FRAP (1.8 µmol Fe2+/mg). ß-carotene/linoleic acid co-oxidation oleoresin from leaves at 0.25 mg/mL presented higher antioxidant activity than Trolox. The total phenolic content of the oleoresin from leaves ranged from 66.20 to 83.33 µg/mg and from flowers it was just up to 12.46 µg/mg. The extraction conditions affected yield, chemical composition, and antioxidant activity of oleoresin from leaves and flowers. This is the first report on the antioxidant activity of B. uniflora oleoresin from leaves and flowers and provides subsidies for potential applications in chemical, pharmaceutical, and food industries.

[Portal vein: variations of its branches (about 32 dissections)]. / Veine porte: mode de division et ses variantes A propos de 32 dissections.

PURPOSE: The aim of this study is to precise the variations of portal vein branches and also to elucidate anatomic basis of partial hepatectomy. MATERIAL AND METHODS: Thirty-two post-mortem specimens, with ages ranged from one day to sixty-five years in both two sexes, were dissected. Latex and Rhodopas were used for visualizing and drawing the portal vein course and its branches. RESULTS: Nine types of different variations of portal vein branches were observed. Most of cases were similar to those previously reported in literature. But four types must be especially noted, because they were not available in literature. DISCUSSION: this study updates the anatomy of portal vein and its tributaries, and also finds out four types of distribution which must be known by surgeons with regards to partial hepatectomy.

Protein degradation in the rumen and amino acid absorption in the small intestine of lactating dairy cattle fed various protein sources.

Four lactating Holstein cows fitted with a rumen cannula and T-type cannulae in the duodenum and ileum were used in an experiment with a 4 X 4 Latin square arrangement of treatments. Diets containing soybean meal (SBM), corn gluten meal (CGM), wet brewers grains (WBG) and distillers dried grains with solubles (DDG) were compared with regard to protein degradability in the rumen and amino acid flow and absorption in the small intestine. The test protein sources provided about 50% of the dietary protein. Spot samples of digesta were collected during a 96-h period and lanthanum (La) was used as an indigestible marker to estimate flow and digestibility of nutrients. Apparent organic matter digestibility in the rumen was 31 +/- 4.8%, while true digestibility based on measurements of microbial organic matter averaged 55 +/- 5.1%. Ruminal ammonia-nitrogen (NH3-N) concentrations (mg/100 ml) were 10.1, 5.6, 6.9 and 6.4 for the SBM, CGM, WBG and DDG diets, respectively. Using diaminopimelic acid as a microbial marker, protein degradation in the rumen was higher for the SBM diet (70%) than for the CGM (45%), WBG (52%) and DDG (46%) diets. Flow of amino acids to the small intestine was generally higher than amino acid intake for all diets. Apparent absorption of amino acids from the small intestine was 70, 77, 71 and 66% of the amino acids entering the duodenum for the SBM, CGM, WBG and DDG diets, respectively. Actual amounts absorbed (g/d) were lowest for the SBM diet. It was concluded that diets containing CGM, WBG or DDG will generally supply more total amino acids to the intestine than a diet containing SBM. Net amounts of amino acids available for absorption in the intestine were also higher for these diets because protein availability in the intestine was not impaired even though protein was more resistant to microbial breakdown in the reticulorumen.

[The uteropelvic junction in children: from the clinical problems to the morphogenetic approach]. / La jonction pyélourétérale chez l'enfant: de la problématique clinique à l'approche morphogénique.

The responsibility of the uteropelvic junction (UPJ) syndrome or abnormalities for renal affections and also for high obstructive uropathy is well-known. But, controversies still remain about the anatomic approach of this clinical feature. Our purpose is to elucidate the developmental anatomy of UPJ and eventually to set the steps of the anatomic approach of the UPJ abnormalities. This study also leads to a better understanding of the mechanism of the intrinsic ureteropelvic junction obstructions. A total number of 122 post-mortem specimens with ages ranging from 1 day to 30 months in both sexes underwent formalin treatment for histological investigation. We performed both transverse and longitudinal sections. Hematein-eosin-safran and Masson's trichrome staining were used. Histological examination revealed that myoarchitecture of UPJ set increasingly up. Circular muscle fibers were first to put in. They had an initial arrangement as a ring in neonates and infants. We conclude that circular layer appears first and sooner than others. On the other hand, coincidence in time between ages of our specimens and ages of patients sufferning from UPJ syndrome leads to further investigations to determine the implication of ring-shaped circular layer in intrinsic ureteropelvic junction obstruction.

[Importance of the testicular artery: histo-functional approach and comparison between juvenile and adult rats]. / Valeur de l'artère testiculaire: approche histofonctionnelle et comparative chez le raton et le rat.

The aim of this study is to demonstrate the role of spermatic or testicular artery with regard to fertility. 100 male rats Sprague-Dawley, consisted of 50 young rats (aged from 10 to 12 days old) and 50 adult rats were concerned. Unilateral ligation of the testicular artery with delayed controlateral orchiectomy were performed in 20 young rats. Only unilateral orchiectomy was planned in 20 other young rats and the 10 remaining were the absolute control group. Mating was observed for 2 weeks after 14 weeks of life. In adult rats, 20 underwent a bilateral ligation and division of the spermatic artery while 20 others were submitted to unilateral ligation-division associated with controlateral orchiectomy in 20 others. The 10 remaining represented the control group. The mating period was 3 weeks. After sacrificing animals, results were noted with regard to histological features and fertility. Among young rats, 45% were fertile and had normal gonadal tissue. From adult rats, only 10 to 15% were fertile. Atrophic testes were observed in 55% of infertile young rats while acute inflammatory lesions were predominant in most of adults. We conclude that ligation or division of spermatic artery is responsible for histological changes thus occurring in infertility in young and adults rats.

Protein degradation in rumen and amino acid absorption in small intestine of lactating dairy cattle fed heat-treated whole soybeans.

Four lactating Holstein cows fitted with rumen cannulae and T-type cannulae in proximal duodenum and terminal ileum were used to measure protein degradation in the rumen and amino acid flow and absorption in the small intestine. Soybean meal, whole soybeans, and whole soybeans extruded at 132 and 149 degrees C provided 50% of the protein in diets that contained 51% grain, 36% corn silage, and 13% alfalfa hay (dry matter). Spot samples of digesta were collected from duodenum and ileum during 96 h, and lanthanum was an indigestible marker to estimate flow and digestibility of nutrients. With diaminopimelic acid as a microbial marker, apparent degradations of dietary crude protein in the rumen were 73, 80, 66, and 60% for diets containing soybean meal, whole soybeans, and whole soybeans extruded at 132 and 149 degrees C. Because of the extensive degradation of protein with the raw soybean diet, less total amino acids reached the duodenum, and because of decrease of availability, absorption from the small intestine (g/day) was lowest with this diet. Feeding diets containing extruded whole soybeans increased availability of total essential amino acids in the small intestine compared with diets containing soybean meal and whole soybeans. Absorption from the small intestine (g/day and percent entering) of individual amino acids was generally higher for extruded whole soybean diets.