Waste Biomass-Mediated Synthesis of TiO2/P, K-Containing Grapefruit Peel Biochar Composites with Enhanced Photocatalytic Activity.

In this study, TiO2/P, K-containing grapefruit peel biochar (TiO2/P, K-PC) composites were synthesized in situ biomimetically using grapefruit peel as the bio-template and carbon source and tetrabutyl titanate as the titanium source. This was achieved using the two-step rotary impregnation-calcination method. Adjusting the calcination temperature of the sample in an air atmosphere could regulate the mass ratio of TiO2 to carbon. The prepared samples were subjected to an analysis of their compositions, structures, morphologies, and properties. It demonstrated that the prepared samples were complexes of anatase TiO2 and P, K-containing carbon, with the presence of graphitic carbon. They possessed a unique morphological structure with abundant pores and a large surface area. The grapefruit peel powder played a crucial role in the induction and assembly of TiO2/P, K-PC composites. The sample PCT-400-550 had the best photocatalytic activity, with the degradation rate of RhB, MO, and MB dye solutions reaching more than 99% within 30 min, with satisfactory cyclic stability. The outstanding photocatalytic activity can be credited to its unique morphology and the efficient collaboration between TiO2 and P, K-containing biochar.

Enhanced photocatalytic activity of porous TiO2 containing C/P/K derived from grapefruit peel.

Grapefruit peel possesses a porous structure and a significant specific surface area. In this study, we introduce an innovative and eco-friendly approach for synthesizing porous TiO2. This was accomplished by employing grapefruit peel as a bio-template and tetrabutyl titanate as the precursor, utilizing a two-step rotary impregnation-calcination process. The TiO2 faithfully reproduced the structural characteristics of the grapefruit peel across different scales, simultaneously incorporating C, P, K elements from the original grapefruit peel into the final samples. The fabricated samples were analyzed using XRD, XPS, SEM, TEM, BET, and UV-vis DRS. The results showed that the TiO2 displays an anatase phase, and possesses a high specific surface area. The investigation of photocatalytic performance demonstrated that the CPK-TiO2-10 sample exhibited outstanding photocatalytic activity against Rhodamine B (RhB) solution, achieving complete degradation within 60 minutes. Additionally, the total organic carbon (TOC) removal rate reached 91.34% after 60 minutes of irradiation. The sample maintained a high degradation efficiency, even after five recycling cycles. This exceptional performance can be attributed to its porous structure, enriched with pores and a larger surface area, as well as the beneficial effects of doping with C, P, K elements in TiO2.

Effectiveness and safety of REBACIN as a non-invasive intervention for persistent high-risk human papillomavirus infection: A real-world prospective multicenter cohort study.

BACKGROUND: We previously reported that REBACIN effectively eliminates persistent high-risk human papillomavirus (hrHPV) infection. Here, we conducted a prospective multicenter cohort study to evaluate the safety and effectiveness of REBACIN, taking into account factors such as specific hrHPV subtype and patient's age. METHODS: According to inclusion/exclusion criteria and participant willingness, 3252 patients were divided into REBACIN group while 249 patients into control group. Patients in REBACIN group received one course treatment of intravaginal administration of REBACIN while no treatment in control group. After drug withdrawal, participants in both groups were followed up. RESULTS: The clearance rate of persistent hrHPV infection in REBACIN group was 60.64%, compared to 20.08% in control group. Specifically, the clearance rates for single-type infection of HPV16 or HPV18 were 70.62% and 69.23%, respectively, which was higher than that of HPV52 (59.04%) or HPV58 (62.64%). In addition, the single, double, and triple/triple+ infections had a clearance rate of 65.70%, 53.31%, and 38.30%, respectively. Moreover, 1635 patients under 40 years old had a clearance rate of 65.14%, while it was 55.08% for 1447 patients over 40 years old. No serious adverse effects were found. CONCLUSION: This study confirmed that REBACIN can effectively and safely eliminate persistent hrHPV infection, which the clearance rate of HPV16/18 is higher than that of HPV52/58, the clearance rate of single-type infection is higher than that of multiple-type infections, and the clearance rate in young patients is higher than that in elder patients, providing a guidance for REBACIN application in clearing hrHPV persistent infection in real-world settings. CLINICAL TRIAL REGISTRATION: Chinese Clinical Trial Registry Registration Number: ChiCTR1800015617 http://www.chictr.org.cn/showproj.aspx?proj=26529 Date of Registration: 2018-04-11.

Highly expressed circ_0000285 from serum and cervical exfoliated cells as a novel biomarker for the diagnosis of early stage-cervical cancer.

Circ_0000285 is reported to play an oncogenic role in the development of cervical cancer (CC). The aim of this research was to investigate the diagnostic power of circ_0000285 in CC. The expression of circ_0000285 in 116 healthy volunteers, 65 early-stage CC (ESCC) patients, and 87 locally advanced CC (LACC) patients was detected by qRT-PCR. The diagnostic values of circ_0000285 for CC and ESCC were evaluated by ROC curves analysis. The circ_0000285 expression was upregulated in serum and cervical exfoliated cells from preoperative CC patients compared to that of healthy volunteers. Increased circ_0000285 expression was found in preoperative LACC patients more than that in ESCC patients. The circ_0000285 expression was downregulated in serum from CC patients after surgery. The postoperative CC patients with high serum circ_0000285 expression was more prone to have a tumour relapse. High circ_0000285 expression was positively correlated with SCC-Ag level and HPV positive rate. The AUC of circ_0000285 for the diagnosis of CC and ESCC were 0.855 and 0.804, better than CA125 and SCC-Ag. When circ_0000285, CA125, SCC-Ag and HPV were combined, the AUC could reach 0.911 and 0.894. In summary, highly expressed circ_0000285 from serum and cervical exfoliated cells might be a promising diagnostic biomarker for ESCC.Impact statementWhat is already known on this subject? The CA125 and SCC-Ag have limitations in the diagnosis of ESCC. Recently, circRNAs have caused great attention and have been developing rapidly in clinical diagnosis of malignant tumours.What do the results of this study add? Highly expressed circ_0000285 from serum and cervical exfoliated cells might be used as a novel, non-invasive biomarker for the diagnosis of ESCC.What are the implications of these findings for clinical practice and/or further research? Circ_0000285 is superior to CA125 and SCC-Ag for the diagnosis of ESCC in clinical practice. The results help to supplement the shortcomings of traditional tumour markers and improve the diagnosis of ESCC.

Effect of intensity modulated radiotherapy on lymphocytes in patients with esophageal squamous cell carcinoma and its clinical significance.

Background: Radiotherapy usually leads to a decrease in the total number of lymphocytes in patients with esophageal cancer. The factors that causing lymphopenia and the clinical significance of lymphopenia are studied in this article. Patients and methods: 110 patients with esophageal squamous cell carcinoma who had undergo intensity-modulated radiation therapy were enrolled. Statistical methods were used to analyze the correlation between lymphopenia and total survival in patients with esophageal cancer during radiotherapy, and analyze the correlations between nutritional factors and lymphopenia. Results: There were 11 patients with the lowest lymphocyte value with level 1-2 during radiotherapy, accounting for 10% of all the patients, and 110 patients with level 3-4, accounting for 90% of all the patient. In all the enrolled patients, the incidence of lymphocyte nadir G1, G2, G3 and G4 MinALC during radiotherapy accounted for 0.91%, 9.09%, 62.73% and 27.27%, respectively.KM survival analysis showed that the overall survival of patients in the group (MinALC ≤ 0.41×109/L) was significantly lower than that of the patients in the other group (MinALC>0.43×109/L). Nutritional indicators were positively correlated with the decline degree of lymphocytes. The minimal value of lymphocyte can predict the occurrence of grade 3-4 radiation pneumonitis. Conclusion: Lymphopenia induced by radiotherapy can predict survival and radiation pneumonitis. Nutritional factors such as hemoglobin and albumin were positively correlated with total lymphocytes numbers induced by radiotherapy.

Artificial intelligence in brachytherapy for cervical cancer.

Brachytherapy (BT) consists in the insertion of radioactive implants directly into the tissue through an applicator, in order to kill tumor cells. This is for the tumor tissue to receive a higher dose, whereas the surrounding normal tissues receive a lower dose of radiation because of the rapid fall of the dose. Because of the special anatomical position of the cervix, smaller organ mobility, and higher tolerable doses of radiotherapy in the vagina and uterus, BT has been most widely used to treat cervical cancer and is an important part of radical radiotherapy for this type of cancer. Furthermore, it is closely related to the prognosis of patients. However, the treatment process, including target area delineation, applicator reconstruction, plan design, and optimization, is time-consuming, which may lead to changes in patient's bladder filling or gastrointestinal peristalsis. Therefore, this not only yields a poor patient experience, but may also affect the accuracy of the treatment and prognosis. With the development of computer hardware, deep learning has been gradually applied in different fields and different networks have been developed to solve various problems. By combining deep learning technology with three-dimensional BT technology, the automation of BT planning can be realized, which, in turn, can significantly shorten the treatment time, alleviate the pain of the patient, and improve treatment efficacy. This article summarizes and gives the prospects of the application of artificial intelligence in the context of BT for cervical cancer.

Applications of artificial intelligence in radiophysics.

Artificial intelligence (AI) is playing an important role in radiation oncology. One of the most important applications is in radiotherapy physics. In this field, it has improved the automation of radiotherapy plan design and quality control (QC), thereby promoting and ensuring individualized precision treatment. This article reviews the applications and research on AI in the physics of radiotherapy and projects the prospects of AI in the following aspects: radiotherapy plan design, radiotherapy quality assurance, and QC, organs at risk contouring, dose prediction, etc.

Impact of radiotherapy on circulating lymphocyte subsets in patients with esophageal cancer.

Radiotherapy (RT) can affect the immune function of patients with cancer. The purpose of this study was to investigate the effect of RT on lymphocyte and its subsets in patients with esophageal cancer (EC).All patients received RT with a mean dose of 5369 cGy (gray). Blood parameters were measured in 31 patients on 3 occasions (before, at the end of radiotherapy, and at 3 months follow-up). The whole blood count and lymphocyte subsets were measured and correlated with short time efficiency and radiation dose parameters.White blood count (WBC) and lymphocyte count (ALC) were greatly decreased at the end of radiotherapy, and the percentages of CD3+, CD3+CD8+ T cells were significantly increased, on the other hand, a decrease in the CD4/CD8 ratio was observed. The percentages of CD3-CD16/56+NK cells and CD19+ B cell were decreased at the end of RT compared with prior RT. The percentages of CD3+ T cells before RT and the WBC and ALC count after RT can be used as prognostic indicators for survival. The PTV dose can cause significant changes in lymphocytes count after RT. CD3+T cells after RT were significantly correlated with mean heart dose and heart V50.Our study identified that RT causes changes in lymphocyte subsets, and these changes may indicate differences in immune function between individuals. Radiotherapy plan should be designed to minimize normal tissue dose to reduce the impact on WBC and lymphocytes.

Prognostic value of combined preoperative prognostic nutritional index and neutrophil to lymphocyte ratio in esophageal squamous cell carcinoma.

BACKGROUND: Preoperative nutritional status and some inflammatory indexes are associated with survival in various malignancies. Prognostic nutritional index (PNI) or neutrophil to lymphocyte ratio (NLR) was demonstrated associated with survival in patients with esophageal squamous cell carcinoma (ESCC). The purpose of the present study was to investigate whether the combination index of PNI and NLR (PNI-NLR) is superior to either alone in survival prognosis of patients with ESCC. METHODS: In total, 271 patients with ESCC who underwent radical esophagectomy from Qianfoshan Hospital from May 2009 to July 2014 were enrolled. Preoperative PNI and other clinical data were collected and analyzed. Using the 5-year survival rate as an end point, a receiver operating characteristic (ROC) analysis was used to find the best cutoff value for PNI and NLR was 49.1 and 3.14, respectively. And all the enrolled patients were classified into three groups: group 1 (score 0, NLR ≤3.14 and PNI >49.1), group 2 (score 1, NLR >3.14 or PNI ≤49.1) and group 3 (score 2, NLR >3.14 and PNI ≤49.1). RESULTS: The combined index of PNI-NLR was a sensitive index in survival prognosis, and patients in the group 1, 2 and 3 had median survival times of 64, 47 and 36 months, respectively. Patients in group1 had significantly longer survival time than those of group 2 and group 3. In multivariate analyses, TNM stage, lymph stage, PNI and PNI-NLR affected the overall survival (OS). PNI was significantly correlated with TNM stage. CONCLUSIONS: Preoperative PNI-NLR was an independent predictor of survival of patients with ESCC. The index of PNI-NLR can improve the accuracy of prognoses for patients with ESCC than the index of NLR.

Downregulated Long Noncoding RNA DGCR5 Acts as a New Promising Biomarker for the Diagnosis and Prognosis of Ovarian Cancer.

Emerging evidence have indicated that dysregulated long noncoding ribonucleic acids act as a novel diagnostic and therapeutic target in the progression of ovarian cancer. Long noncoding RNA DiGeorge syndrome critical region gene 5 has been reported to participate in some types of human cancer progresses, but its clinical roles in ovarian cancer had been rarely reported. This study aimed to explore the expression, clinicopathological features, diagnostic, and prognostic values of DiGeorge syndrome critical region gene 5 in ovarian cancer. The total levels of DiGeorge syndrome critical region gene 5 transcript variant 1 (NR_002733.2) and 2 (NR_045121.1) in patients with ovarian cancer were determined by quantitative reverse transcription polymerase chain reaction. The correlation of DiGeorge syndrome critical region gene 5 expression with clinicopathological factors was statistically analyzed by χ2 test. Overall survival analysis was carried out with the Kaplan-Meier curves with the log-rank test. Univariate and multivariate Cox regression analyses were performed to identify the prognostic significance of DiGeorge syndrome critical region gene 5 expression. Receiver operating characteristic curves were constructed to estimate the diagnostic and prognostic usefulness of DiGeorge syndrome critical region gene 5 in ovarian cancer. Results showed that relative DiGeorge syndrome critical region gene 5 expression was reduced by 36.81% and 65.79% in ovarian cancer tissues of patients and Gene Expression Omnibus DataSets (GSE119056) in contrast to normal tissues, respectively. Patients with lymph node metastasis and distant metastasis exhibited lower levels of DiGeorge syndrome critical region gene 5 in contrast to those patients with non-lymph node metastasis and non-distant metastasis, respectively. Low expression of DiGeorge syndrome critical region gene 5 was significantly associated with large tumor size, more lymph node metastasis, present distant metastasis, advanced clinical stage, and short overall survival in patients with ovarian cancer. Low expression of DiGeorge syndrome critical region gene 5 was an independent unfavorable prognostic factor for overall survival in patients with ovarian cancer. Receiver operating characteristics curves for prognosis yielded significant area under curves for lymph node metastasis, clinical stage, and overall survival. In conclusion, our study demonstrated that downregulated DiGeorge syndrome critical region gene 5 may be a new promising biomarker for predicting clinical progression and prognosis in patients with ovarian cancer.

Intensity-modulated radiotherapy, coplanar volumetric-modulated arc, therapy, and noncoplanar volumetric-modulated arc therapy in, glioblastoma: A dosimetric comparison.

OBJECTIVE: Advanced techniques such as volumetric-modulated arc therapy (VMAT) may reduce radiation damage and improve the quality of life for patients.We performed a study comparing dose distributions to the planning target volumes(PTVs) and other organs at risk (OARs) of intensity-modulated radiotherapy (IMRT),coplanar VMAT (coVMAT), and non-coplanar VMAT (ncVMAT). PATIENTS AND METHODS: 13 patients with GBM who had undergone postoperative radiotherapy were enrolled. Three plans for each patient were created, namely, IMRT, coVMAT, and ncVMAT. Prescription doses and normal-tissue constraints were identical for these three plans. The dosimetric differences of target dose distribution, conformity index (CI), homogeneity index (HI), the gradient index (GI), dose of OARs, monitor units (MUs) and beam-on times among these three plans were investigated. RESULTS: These three techniques resulted in comparable maximum, minimum, and mean PTV doses. Small but insignificant differences were observed in GI,CI, and HI. Compared with IMRT, VMAT plans showed statistically significant reductions in the mean doses to the optic chiasm (P < 0.05). Compared with IMRT, VMAT techniques significantly reduced the number of MUs and less beam-on time than IMRT techniques (P ＜ 0.05). However, calculation times were significantly longer for ncVMAT and coVMAT plans at 12 and 12.3 min, versus 2.6 min for IMRT. Our study showed that IMRT or VMAT planning is feasible and efficient for patients with GBM.Compared to IMRT plans, ncVMAT or coVMAT plans showed similar PTV coverage and comparable OARs sparing. VMAT plans significantly reduces the mean doses to the optic chiasm than IMRT plans. CONCLUSION: There was no obvious superiority of ncVMAT over coVMAT in target coverage and sparing of OARs.Compared with IMRT, VMAT techniques significantly reduced the number of MUs and beam-on time but extended the calculation times.

The evolution of proton beam therapy: Current and future status.

Proton beam therapy (PBT) has been increasingly used in a variety of cancers due to its excellent physical properties and superior dosimetric parameters. PBT may improve patient survival by improving the local tumor treatment rate while reducing injury to normal organs, which may result in fewer radiation-induced adverse effects. However, the significant cost of establishing and maintaining proton facilities cannot be overlooked. In addition, there has been significant controversy regarding routine application of this treatment in certain types of cancer. The challenges of PBT in the future mainly include the lack of basic clinical trials, unclear biological effects, immature imaging technology and miniaturization of imaging guidance. Overcoming these limitations may promote the rapid development of PBT. We herein provide an overview of the existing literature on the efficacy and toxicity of common oncological applications of proton beam therapy.

The relationship between tumor necrosis factor-α polymorphisms and gastric cancer risk: An updated meta-analysis.

The aim of the present study was to evaluate the relationship between tumor necrosis factor-α (TNF-α) and the development of gastric cancer, and to investigate whether it can be used as a biological marker for gastric cancer. In the current study, a new meta-analysis was performed to assess the association between TNF-α gene polymorphisms and gastric cancer susceptibility. Subgroup analyses based on ethnicity, control population source and non-cardia cancers were also conducted. Summary odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a random-effects model. TNF-α 308 polymorphisms indicated a significant relationship with gastric cancer risk among a normal population [GA/AA vs. GG; 1.17 (1.10-1.23)]. In analysis stratified by ethnicity, TNF-α 238 displayed an association with gastric cancer risk in eastern populations [GA/AA vs. GG: 1.24 (1.02-1.50)], but not in western populations [GA/AA vs. GG: 0.96 (0.79-1.18)]. The overall ORs (95% CIs) for TNF-α 857, TNF-α 1031 and TNF-α 863 were 1.13 (1.04-1.24), 0.94 (0.85-1.05) and 0.89 (0.78-1.02), respectively, under dominant genetic model comparison. Among the above three SNPs, only TNF-α 857 was robustly associated with gastric cancer inclination, and this association remained consistently robust when limited to non-cardia gastric cancers [GA/AA vs. GG: 1.16 (1.03-1.31)]. TNF-α 308 and TNF-α 857 genotypes were potential risk factors of statistical significance in gastric cancer, and TNF-α 238 indicated to be significantly associated with gastric cancer risk only in eastern populations. TNF-α 1031 and TNF-α 863 were not significantly associated with gastric cancer risk.