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Nanozymes are promising antimicrobials, as they produce reactive oxygen species (ROS). However, the intrinsic lack of selectivity of ROS in distinguishing normal flora from pathogenic bacteria deprives nanozymes of the necessary selectivities of ideal antimicrobials. Herein, we exploit the physiological conditions of bacteria (high alkaline phosphatase (ALP) expression) using a novel CuO nanoparticle (NP) nanoenzyme system to initiate an ALP-activated ROS prodrug system for use in the on-demand precision killing of bacteria. The prodrug strategy involves using 2-phospho-L-ascorbic acid trisodium salt (AAP) that catalyzes the ALP in pathogenic bacteria to generate ascorbic acid (AA), which is converted by the CuO NPs, with intrinsic ascorbate oxidase- and peroxidase-like activities, to produce ROS. Notably, the prodrug system selectively kills Escherichia coli (pathogenic bacteria), with minimal influence on Staphylococcus hominis (non-pathogenic bacteria) due to their different levels of ALP expression. Compared to the CuO NPs/AA system, which generally depletes ROS during storage, CuO NPs/AAP exhibits a significantly higher stability without affecting its antibacterial activity. Furthermore, a rat model is used to indicate the applicability of the CuO NPs/AAP fibrin gel in wound disinfection in vivo with negligible side effects. This study reveals the therapeutic precision of this bifunctional tandem nanozyme platform against pathogenic bacteria in ALP-activated conditions.
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Fosfatase Alcalina , Antibacterianos , Cobre , Desinfecção , Escherichia coli , Pró-Fármacos , Espécies Reativas de Oxigênio , Cobre/química , Cobre/farmacologia , Animais , Pró-Fármacos/farmacologia , Pró-Fármacos/química , Fosfatase Alcalina/metabolismo , Ratos , Antibacterianos/farmacologia , Antibacterianos/química , Escherichia coli/efeitos dos fármacos , Espécies Reativas de Oxigênio/metabolismo , Desinfecção/métodos , Ácido Ascórbico/farmacologia , Ácido Ascórbico/química , Ácido Ascórbico/análogos & derivados , Nanopartículas Metálicas/química , Ratos Sprague-Dawley , MasculinoRESUMO
@#Objective To investigate the retrospective study of the treatment of primary immune thrombocytopenia(ITP)with Aitracopol.Methods Medical records of 90 patients with ITP who received treatment in our hospital from October 2018 to February 2022 were retrospectively analyzed and grouped according to different treatment methods,with an average n=45.Dexamethasone group was treated with dexamethasone group,and itrepopopa group was treated with dexamethasone group and itrepopopa group combined with dexamethasone group,all n=45.The immune function,therapeutic effect and adverse reactions were compared.Results At 4 weeks after treatment,the levels of interleukin(IL)-2 and interferon(INF)-γ in the Altropopar group and dexamethasone group were lower than before treatment,and the levels of IL-4 in the Altropopar group and dexamethasone group were higher than before treatment.Aitripopal group was higher than dexamethasone group(P<0.05);At 4 weeks after treatment,the proportions of platelet(PLT)≥30×109/L were 68.89%and 40.00%in the Altropopar group and dexamethasone group,and the proportions of PLT≥50×109/L were 55.55%and 20.00%,respectively.The proportions in the Altropopar group were higher than those in the dexamethasone group(P<0.05).The proportions of PLT≥50×109/L in the half time and dexamethasone groups were 66.67%and 33.33%,respectively,and the proportions of PLT≥50×109/L for at least one time were 93.33%and 44.44%,respectively.The proportions of PLT≥50×109/L at least once after 9 months of treatment were 60.00%and 26.67%,respectively,and the attripopal group was higher than dexamethasone group(P<0.05).A comparison of the adverse reaction rate between aitopopal group and dexamethasone group(P>0.05).Conclusion Aitracopal can significantly reduce the risk of bleeding in patients with ITP,improve immune function,improve therapeutic effect,and high safety.
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With the increasing application of immune checkpoint inhibitors(ICI)in anti-tumor therapy,ICI related infections are often neglected.Mycobacterium tuberculosis(MTB)is also a common pathogen.We reported a case of ICI related pulmonary tuberculosis from Zhongshan Hospital,Fudan University.Meanwhile,18 cases of ICI related tuberculosis infection were collected through literature search,and the characteristics of ICI related tuberculosis were analyzed to improve the understanding in clinic practice.All the cases were confirmed TB including 15 cases of pulmonary tuberculosis(1 case with complication of intestinal tuberculosis)and 4 cases of extra-pulmonary tuberculosis(1 case of disseminated tuberculosis,bone tuberculosis,tuberculous pericarditis and tuberculous pleurisy,respectively).The chest CT characteristics of pulmonary tuberculosis mainly included centrilobular nodules,ground glass nodules,empty lesions,patchy shadows,consolidation and large infiltration.Eighteen cases started anti-tuberculosis treatment,while 4 cases continued ICI treatment.Three cases suspended ICI(2 cases had remission after reuse)and 11 cases stopped ICI,and 1 case was not mentioned.ICI related tuberculosis may be a direct complication of tumor immunotherapy.It is necessary to screen tuberculosis infection and exclude active tuberculosis before immunotherapy.If there are suspected symptoms such as fever,cough and sputum during ICI treatment,active tuberculosis should be taken into account.
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With the evolving of information technology and push models,as an important mobile application in the Inter-net,WeChat official account is an important platform for the implementing the"Internet plus Medical"model.Effective dissemi-nation of more medical knowledge is also an important component of achieving a healthy China.This is not only a task for public hospitals,but also a responsibility.This paper takes the health communication strategy managed by the WeChat official account of Guangdong Provincial People's Hospital as the research object.From the perspective of health communication,we conducted a comprehensive analysis of its development overview,content production,and push effectiveness.On the basis of sorting and sum-marizing the existing problems,suggestions were proposed to focus on content construction,strengthen overall management,and deepen training supervision.The study aims to provide reference for public hospitals to improve the operation and construction of WeChat official account,offer practical reference for scientific,standardized,and orderly management of self media so as to a-chieve high-quality health communication.
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Objective To compare the differences in virulence-related factor aspartate protease,biofilm formation,and gene expression among clinical isolates of Candida parapsilosis(C.parapsilosis).Methods Gene sequencing and microsatellite typing(MT)method were adopted to identify C.parapsilosis isolated from patients with clinical fungal infection.The production of secreted aspartate protease and biofilm formation ability of each strain were de-tected,and the expression of biofilm formation related-genes BCR1,EFG1,and HWP1,as well as aspartate prote-ase virulence genes SAPP1,SAPP2,SAPP3 were compared among the strains.Results A total of 8 clinically iso-lated C.parapsilosis strains were collected,all of which were identified as genotype Ⅰ.Based on microsatellite ty-ping results,8 clinical strains were divided into 4 microsatellite types.G1,G2,and G3 strains isolated from the urine,peripherally inserted central catheters(PICC),and blood of patient A were of different subtypes.J1,J2,J3,J4,and J5 strains were of the same type,and isolated from blood specimens of patient B at different periods.All 8 clinical strains could form biofilm,and their biofilm formation ability was higher than that of the standard strain of C.parapsilosis(ATCC 22019).G1,G3 and J5 strains had strong biofilm formation ability,J1,J2,J3,and J4 strains had moderate biofilm formation ability,and G2 strain had weak biofilm formation ability.All of the eight clinical isolates secreted aspartate protease,and their in vitro expression levels of the enzyme were higher than that of the standard strain(ATCC 22019).G3,G1,and G2 strains showed low,moderate,and high in vitro enzyme expression respectively,with statistical differences(all P<0.05).Enzyme expressed moderately in J1 and J5 strains,and highly in J2,J3,and J4 strains.Difference between moderate and high expressions was statistically significant(P<0.05).The expression levels of biofilm formation genes BCR1,EFG1,and HWP1 in various strains isolated from patients A and B increased.In strains isolated from patient A,the expression level of EFG1 gene in G1 strain was higher than that in G2 strain(P<0.05).There was no statistically significant difference in BCR1,EFG1,and HWP1 gene expression levels among strains isolated from patient B.The expression levels of as-partate protein genes(SAPP1,SAPP2,and SAPP3)in various strains isolated from patients A and B increased.The expression levels of SAPP1 and SAPP2 in strain G1 were higher than those in G2 and G3(both P<0.05).There was no statistically significant difference in the expression levels of SAPP1,SAPP2,and SAPP3 genes in strains from patient B.Conclusion Clinical isolates of C.parapsilosis have higher biofilm formation and aspartate protease production abilities than standard strain.The expression of virulence factors varies among strains isolated from different specimens,while there is no significant difference in the expression of virulence factors among strains isolated at different periods.Patients may have been infected with different MT types of C.parapsilosis in multiple sites during the same period.
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This paper reported a rare case of hypercalcemic crisis caused by a parathyroid adenoma with hemorrhage and cystic degeneration. Preoperative imaging examination of the patient was unable to determine the histological origin of the cervical cystic lesion. Despite aggressive medical treatment and hemodialysis, hypercalcemic crisis could not be relieved. Therefore, surgical exploration and excision of the cervical lesion were performed, and final diagnosis of parathyroid adenoma with hemorrhage and cystic degeneration was confirmed by pathology. Blood calcium level and renal function returned to normal after the surgery.
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Background@#Developmental hypothyroidism impairs learning and memory in offspring, which depend on extensive neuronal circuits in the entorhinal cortex, together with the hippocampus and neocortex. The entorhinal-dentate gyrus pathway is the main entrance of memory circuits. We investigated whether developmental hypothyroidism impaired the morphological development of the entorhinal-dentate gyrus pathway. @*Methods@#We examined the structure and function of the entorhinal-dentate gyrus pathway in response to developmental hypothyroidism induced using 2-mercapto-1-methylimidazole. @*Results@#1,1´-Dioctadecyl-3,3,3´,3´-tetramethylindocarbocyanine perchlorate tract tracing indicated that entorhinal axons showed delayed growth in reaching the outer molecular layer of the dentate gyrus at postnatal days 2 and 4 in hypothyroid conditions. The proportion of fibers in the outer molecular layer was significantly smaller in the hypothyroid group than in the euthyroid group at postnatal day 4. At postnatal day 10, the pathway showed a layer-specific distribution in the outer molecular layer, similar to the euthyroid group. However, the projected area of entorhinal axons was smaller in the hypothyroid group than in the euthyroid group. An electrophysiological examination showed that hypothyroidism impaired the long-term potentiation of the perforant and the cornu ammonis 3–cornu ammonis 1 pathways. Many repulsive axon guidance molecules were involved in the formation of the entorhinaldentate gyrus pathway. The hypothyroid group had higher levels of erythropoietin-producing hepatocyte ligand A3 and semaphorin 3A than the euthyroid group. @*Conclusion@#We demonstrated that developmental hypothyroidism might influence the development of the entorhinal-dentate gyrus pathway, contributing to impaired long-term potentiation. These findings improve our understanding of neural mechanisms for memory function.
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Nanoscale zero-valent iron (nZVI) shows excellent reduction of Cr(â ¥), but the passivation on its outer surface can restrict its longevity and performance. To tackle this problem, this work introduced Shewanella oneidensis MR-1, a dissimilatory iron-reducing bacterium, into the chemical reduction system of aged nZVI/biochar (B) and Cr(â ¥). The potential synergistic effect of Cr(â ¥) reduction of aged nZVI/B and MR-1 was systematically investigated under varying conditions. The results indicated that aged nZVI/B and MR-1 exhibited a synergistic effect at a pH of 7, and the removal rate of Cr(â ¥) increased by 51.3%. Further research showed that the synergistic effect could be attenuated with the increase in the initial Cr(â ¥) concentration and enhanced with the increase in the MR-1 concentration. The XPS spectra confirmed that Cr(â ¥) was mainly removed through reduction. The dissimilatory iron-reducing ability of MR-1 played a key role in enhancing the Cr(â ¥) reduction. The reductive dissolution of the oxidation layers not only released reactive sites inside the nZVI, but also reduced Cr(â ¥) by producing ferrous ions. Moreover, B promoted the reduction by dispersing the nZVI and mediating the extracellular electron transfer. This study provides a new insight into solving the passivation problem of the long-term application of nZVI for Cr(â ¥) removal, which is considered a promising solution for synergistically improving the performance of nZVI in environmental remediation.
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Ferro , Poluentes Químicos da Água , Carvão Vegetal , Cromo , Shewanella , Poluentes Químicos da Água/análiseRESUMO
Objective@#To verify the effectiveness of adolescent peer education on psychological resilience of adolescents, so as to provide a scientific reference for preventing adolescents physical and mental health problems.@*Methods@#The non equivalent comparison group design method was conducted involving 2 towns which were divided into an intervention group(n=732) and a control group(n=881). The intervention group received 1 year peer education. Their resilience and basic information was assessed by using a adolescent psychological resilience scale and a self-designed basic situation questionnaire.@*Results@#After the intervention, in the control group, target concentration, emotional control, family support, interpersonal assistance, and total psychological resilience were reduced by 0.96, 0.72, 0.63, 1.16 and 3.31, respectively(t=5.75, 3.91, 3.52, 5.86, 6.29, P<0.05); in the intervention group, emotional control, interpersonal assistance, and total psychological resilience were increased by 1.05, 0.54 and 1.72, respectively(t=-4.89, -2.46, -2.76, P<0.05). Multiple linear regression showed that the intervention group s target concentration(B=0.38), emotional control (B=0.85), family support(B=0.29), interpersonal assistance(B=0.83), and total psychological resilience(B=2.40) increased higher than the control group(P<0.05).@*Conclusion@#Adolescent peer education is effective in improving the target concentration, emotional control, family support, interpersonal assistance, and total psychological resilience.
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Objective:To evaluate the efficacy of intensity-modulated radiation therapy (IMRT) combined with chemotherapy for treating patients with T 1-2N 1M 0 nasopharyngeal carcinoma (NPC). Methods:343 patients diagnosed with T 1-2N 1M 0 NPC in Zhejiang Cancer Hospital and Sun Yat-sen University Cancer Center from January 2008 to December 2016 were recruited in this study. All patients received IMRT and divided into the radiotherapy (RT) and chemoradiotherapy (CRT) groups. Patients in the CRT group were further assigned into the concurrent chemoradiotherapy (CCRT), induction chemotherapy+ CCRT (IC+ CCRT) and CCRT+ adjuvant chemotherapy (AC) groups. Locoregional failure-free survival (LRFFS), distant metastasis-free survival (DMFS), progression-free survival (PFS), cancer-specific survival (CSS) and overall survival (OS) were estimated by Kaplan- Meier method. Multivariate prognostic analysis was performed by Cox models. Results:The median follow-up time for surviving patients (303/343) was 91(range: 49-138) months. The 5-year OS, CSS, PFS, LRFFS, and DMFS rates in the CRT group were not superior to those of the RT group (93.7%: 93.9%, 93.7%: 93.9%, 89.0%: 87.7%, 93.8%: 92.8%, 93.8%: 91.2%, all P>0.05). No significant difference was found in treatment outcomes of patients with T 1N 1 or T 2N 1 NPC between two groups (all P>0.05). In multivariable analyses, only age was an independent prognostic factor for OS, PFS, CSS and DMFS, and negative correlation was found between them. No survival benefits were achieved in the CCRT, IC+ CCRT, CCRT+ AC and RT groups, and no significant differences were found in clinical efficacy among the three combined (all P>0.05). Conclusions:IMRT alone yields comparable clinical efficacy to CRT in treating patients with T 1-2N 1M 0 NPC. However, whether CT can be eliminated in the T 1-2N 1M 0 population still needs further confirmation by prospective, randomized and controlled clinical trials.
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Objective:To explore the research focus, frontier and trend of global reseaches about low back pain using bibliometrics and visualization technology. Methods:The researchs in the Web of Science core database from 2016 to 2020 were retrieved with the subject terms of "low back pain" and categories of rehabilitation, and analyzed with Creating Citation Reports and Analyzing Retrieval Results of Web of Science, as well as the CiteSpace. Results:A total of 2026 papers were retrieved. The total frequency of citations in the last five years was 6793. The number of papers and citations increased year by year. Most of the papers came from the countries of America, Europe and Australia; the top five university institutions also with high centrality; and funded by US National Research Fund mostly. The top ten journals for number of papers and cited frequency were mainly rehabilitation journals, and the researches mainly focused on orthopedics, sports medicine and healthcare medicine. A total of 468 key words were obtained, including 33 key words with high centrality and 29 key words with Strongest Citation Bursts. Nine papers of highly cited were suggested by Web of Science. A total of 466 references were obtained through CiteSpace, including 35 references with high centrality and 53 references with Strongest Citation Bursts. The researches of key node literature were mainly randomized controlled trails and systematic review. Conclusion:The researches of low back pain mainly focus on the mechanism and management of pain, such as central sensitization, pressure pain threshold, pain pattern classification, pain directional preference and centralization, pain physiology/neuroscience education, and nonpharmacologic strategies for comprehensive pain care; as well as the psychological and social factors, such as behavioral cognitive therapy/psychologically informed physical therapy, self-efficacy, kinesiophobia, fear avoidance, and variables and interventions related to return-to-work. The trial studies of STarT Back tool, core instruments and standardization of core outcome reporting in clinical trials, and individualized and targeted treatment, would be the global trends in the research of low back pain.
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Osteoporosis is one of the common clinical orthopedic diseases, which can lead to a variety of complications. There are many pathogenic factors in this disease. The latest research found that ATP6V1H is a new gene leading to the occurrence of osteoporosis, and it is likely to become a new target for the future drug treatment of osteoporosis.This paper introduces the biological structure and characteristics of H subunit, summed up the human body caused by loss of ATP6V1H and animal models such as zebrafish, mice bone loss and osteoporosis symptom such as related research reports of the loss, from osteoclast, osteoblast and marrow stromal cell level and the connection between the various subunits further expounds the H subunit regulate bone dynamic balance of mechanism, to explore ATP6V1H in bone developmentand bone related diseases has laid a solid foundation, also provide new ideas for clinical treatment of osteoporosis.
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Animais , Camundongos , Osso e Ossos , Osteoblastos , Osteoclastos , Osteoporose/genética , Peixe-ZebraRESUMO
Ferroptosis is a non-apoptotic regulated cell death caused by iron accumulation and subsequent lipid peroxidation. Currently, the therapeutic role of ferroptosis on cancer is gaining increasing interest. Baicalin an active component in
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Objective@#To explore the relationship between adolescent knowledge-attitude-practice(KAP) and resilience in Chinese left-behind children, and provide the basis to develop the adolescent health education.@*Methods@#A total of 1 244 left-behind children from grade 4-9 was investigated through the self-designed Adolescent KAP Questionnaire and Adolescent Resilience Scale.@*Results@#Male and middle school students had better resilence than female and primary school students in left-behind children(t=4.70,4.27,P<0.01); the left-behind children with harmonious relationship between parents, richer family economic status and democratic parenting style obtained greater resilence(F=35.86,31.66,3.25,57.23,P<0.05), and adolescent KAP had positive prediction on target concentration(B=0.11), emotional control(B=0.07), positive cognition(B=0.09), family support(B=0.05), interpersonal assistance(B=0.09) and total resilience(B=0.41) of left-behind children(P<0.01).@*Conclusion@#For left-behind children, adolescent KAP may be have a positive association with resilence and more attention should be paid on adolescent health education.
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Objective@#To explore the effects of prenatal exposure to polybrominated diphenyl ethers (PBDEs) on placental size and birth outcomes.@*Methods@#Based on the perspective Wenzhou Birth Cohort, this nested case-control study included 101 fetal growth restriction (FGR) and 101 healthy newborns. Maternal serum samples were collected during the third trimester and measured for PBDEs by gas chromatography tandem mass spectrometry. The basic information of mother-newborn pairs was collected from questionnaires, whereas the placental size and birth outcomes of newborns were obtained from hospital records.@*Results@#A total of 19 brominated diphenyle ether (BDE) congeners were detected in maternal serum samples. Higher concentrations of BDE-207, -208, -209, and ∑ @*Conclusion@#A negative association was found between PBDE levels in maternal serum and placental size and birth outcomes. Prenatal PBDE exposure may be associated with elevated risk of the incidence of FGR birth.
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Feminino , Humanos , Recém-Nascido , Gravidez , Estudos de Casos e Controles , China/epidemiologia , Retardo do Crescimento Fetal/epidemiologia , Éteres Difenil Halogenados/sangue , Incidência , Placenta/fisiologia , Fatores de RiscoRESUMO
Objective@#To explore the relationship between pubertal status, pubertal KAP and adolescents quality of life and the moderating effect of pubertal KAP between pubertal status and quality of life, and to provide a reference for making measures to improve adolescents quality of life.@*Methods@#A descriptive cross-sectional study design which recruited 6 746 adolescents in two districts of Chongqing with cluster sampling was applied. Data was collected by Adolescent Quality of Life Scale developed by our team, Pubertal Development Scale(PDS) from Petersen and Crockett, self-designed KAP questionnaire and basic situation questionnaire.@*Results@#The early puberty, mid-puberty and late puberty suffered lower physical, psychological and total quality of life than the pre-pubertal(P<0.05). The mid-puberty (B=-1.10, P<0.01) and late puberty (B=-2.88, P<0.01) had lower social quality of life than the pre-pubertal Significant difference was not found between pubertal dimension and pubertal status(P>0.05). Pubertal KAP impacted on psychological(B=0.02), social(B=0.04), pubertal(B=0.04) dimensions and total quality of life(B=0.09) positively(P<0.01), but no physical dimension(P=0.06). Moderating effect results revealed that pubertal KAP moderated the negative impact of pubertal status on social dimension (B=0.03, P=0.02) and total quality of life(B=0.06, P=0.01), but no psychological dimension(P>0.05).@*Conclusion@#Promoting puberty health education of adolescents was the key to improving their quality of life.
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Objective:To investigate the effects of electroacupuncture at Baihui (DU20) and Shenting (DU24) on brain function of APP/PS1 mice. Methods:Sixteen 4-month-old APP/PS1 mice in the same litter were randomly divided into model group (n = 8) and electroacupuncture group (n = 8). Eight transgenic negative mice in the same litter were as control group. The electroacupuncture group accepted electroacupuncture at Baihui and Shenting for 16 weeks. They were assessed with Object Recognition Test before and after intervention, and observed under small animal functional magnetic resonance imaging with regional homogeneity (ReHo) analysis. Results:Compared with the control group, the discrimination ratio decreased in the model group after intervention (P < 0.05), while it increased in the electroacupuncture group compared with that in the model group (P < 0.05). Compared with the control group, ReHo of right basal forebrain and left hippocampus decreased in the model group before intervention. Compared with the control group, ReHo decreased in bilateral hippocampus group and increased in retrosplenial cortex in the model group after intervention; while it increased in bilateral hippocampus and motor cortex and decreased in anterior cingulate gyrus in the electroacupuncture group compared with that in the model group. Conclusion:Electroacupuncture at Baihui and Shenting may delay the decline of learning and memory ability in Alzheimer's disease model mice, which may relate to the regulation of functional activities in hippocampus.
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OBJECTIVE: To evaluate the effect of tai chi exercise on cardiac and static lung function for older community-dwelling adults at risk of ischemic stroke. METHODS: A total of 170 older community-dwelling adults (aged 55-75 years old) at risk of ischemic stroke were allocated to either tai chi training group (85 cases, five 60-min sessions of tai chi training per week for 12 weeks) or control group (85 cases, usual pbysical activity for 12 weeks) using a computer-generated randomization. The echocardiographic parameters of cardiac structure, cardiac function and static lung function were measured at baseline, after 12 weeks of intervention and additional 12-week follow-up period by a blinded professional staffmember using a color Doppler ultrasound imaging device or a cardiopulmonary function instrument. The t test and linear mixed model based on the intentionto-treat analysis principle was used to calculate the effect. The adverse effect was observed. RESULTS: Most of echocardiographic parameters on the cardiac structure, cardiac function and static lung function between the tai chi group and control group did not have a significant difference either post 12-week intervention or additional 12-week follow-up period. Only three parameters involving in right ventricular diameter (P=0.024), main pulmonary artery diameter (P=0.002) and vital capacity maximum (P=0.036) were beneficial to be improved in the tai chi group compared to the control group by the analysis of mixed linear model. No adverse effects were found during the intervention period. CONCLUSION: The 12-week tai chi exercise did not have an obvious beneficial effect on cardiac structure, cardiac function and static lung function in older community-dwelling adults at risk of ischemic stroke. The study with a longer duration of intervention should be necessary. (Trial registration No. ChiCTR-TRC-13003601).
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Isquemia Encefálica/fisiopatologia , Isquemia Encefálica/terapia , Coração/fisiopatologia , Vida Independente , Pulmão/fisiopatologia , Acidente Vascular Cerebral/fisiopatologia , Acidente Vascular Cerebral/terapia , Tai Chi Chuan , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Masculino , Fatores de Risco , Tai Chi Chuan/efeitos adversosRESUMO
PURPOSE: The aim of this study is to evaluate the prognostic significance of paranasal sinus invasion for nasopharyngeal carcinoma (NPC) and its suitable position in the T classification. MATERIALS AND METHODS: The magnetic resonance imaging (MRI) scans of 695 patients with previously untreated, biopsy-proven, non-metastatic NPC that was treated with intensity-modulated radiotherapy (IMRT) were reviewed retrospectively. RESULTS: The incidence of paranasal sinus invasion was 39.4% (274 of 695 patients). Multivariate analysis showed that paranasal sinus invasion was an independent negative prognostic factor for local failure-free survival (LFFS) (p < 0.05). According to the eighth American Joint Committee on Cancer (AJCC) staging system, 275 patients were classified as T3 classification. Of these, 78 patients (28.4%) developed paranasal sinus invasion (T3b) and 197 (71.6%) didn't (T3a). The estimated 5-year LFFS and overall survival (OS) rates for the patients with T3b and T3a classification were 88.6% versus 95.0% (p=0.047), and 84.5% versus 93.3% (p=0.183), respectively. The estimated 5-year LFFS and OS rates for the patientswith T4 classificationwere 89.5% and 83.2%,whichwere similarwith the outcomes of patients with T3b classification. CONCLUSION: MRI-determined paranasal sinus invasion is an independent prognostic factor of NPC treated by IMRT. Paranasal sinus invasion is recommended to classify as T4 classification in the 8th AJCC staging system for NPC.
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Humanos , Classificação , Incidência , Articulações , Imageamento por Ressonância Magnética , Análise Multivariada , Seios Paranasais , Radioterapia de Intensidade Modulada , Estudos RetrospectivosRESUMO
Objective To explore the impact of oral nutritional supplements in the local advanced nasopharyngeal carcinoma patients receiving chemoradiotherapy. Methods From 2016 to 2018, we prospectively collected 114 patients into our study, including intervention group ( n=58) and control group ( n=56) . Patients in the intervention group were given oral nutritional supplements from the beginning of radiotherapy, while the control group patients were receiving usual diet care. We collected data of weight, hematological index and nutrition related information before, during and after treatments. Results All patients experienced weight loss during radiotherapy. The declining trend was more obvious in intervention group but with no statistical difference ( P>0.05) . Radiotherapy interruption was lower, completion rate of 2 cycles of concurrent chemotherapy was higher( 78% vs 64%, P=0.02) and level of total serum protein and albumin was more stable ( P=0.003, 0.001) in the intervention group. No difference was found in acute toxicities between the two groups ( P>0.05) . During the treatment period, the nutrition risk screening score declined, more patients with NRS 2002 ≥3 in the control group than the intervention group ( P<0.05) , while no statistically significant difference was found in PG-SGA between the two groups ( P>0.05 ) . Conclusions Oral nutritional supplements can improve treatment tolerance and keep the stability of serum protein level, nevertheless, it has no obvious advantage in maintenance of weight and short-term nutritional status