Low prognostic nutritional index is associated with poor outcome in middle-aged and elderly patients with non-metastatic nasopharyngeal carcinoma: a retrospective cohort study.

BACKGROUND: Prognostic nutritional index (PNI) and age are effective prognostic factors for patients with non-metastatic nasopharyngeal carcinoma (NPC), and an interaction between them may exist. However, the age cutoff value is generally set at 45 years in current studies. The clinical implications of PNI in middle-aged and elderly patients are unclear. Therefore, we aimed to uncover this issue. PATIENTS AND METHODS: We retrospectively collected data from 132 middle-aged and elderly (≥ 45 years old) patients with non-metastatic NPC. The association between covariates and the PNI was analyzed using 2 or t-test. The effect of PNI on the prognosis was evaluated using univariate and multivariate Cox regression analyses. Unadjusted and multivariate-adjusted models were applied. Stratified and interactive analyses were performed to investigate the potential source of heterogeneity. RESULTS: Median age (61.0 years versus 59.5 years) and the proportion of patients aged ≥ 60 years (57.6% versus 50.0%) in the low-PNI group were higher than those in the high-PNI group (P > 0.05). The patients with a low PNI had shorter overall survival (OS) (hazard ratio (HR) = 0.86, 95% confidence interval (CI) = 0.80-0.93; P < 0.001) and progression-free survival (PFS) (HR = 0.93, 95% CI = 0.87-0.99; P = 0.034). The results remained stable after three adjusted models of covariates, including age (P < 0.05). No significant interactions were observed in middle-aged (45-59 years) and elderly (≥ 60 years) subgroups for OS and PFS (P for interaction > 0.05). CONCLUSION: Although there is an interaction between PNI and age, PNI is an independent prognostic factor in middle-aged and elderly patients with non-metastatic NPC.

Predicting Bone Metastasis Risk Based on Skull Base Invasion in Locally Advanced Nasopharyngeal Carcinoma.

Objective: To develop and validate a bone metastasis prediction model based on skull base invasion (SBI) in patients with locally advanced nasopharyngeal carcinoma (LA-NPC). Methods: This retrospective cohort study enrolled 290 patients with LA-NPC who received intensity-modulated radiation therapy in two hospitals from 2010 to 2020. Patient characteristics were grouped by SBI and hospital. Both unadjusted and multivariate-adjusted models were used to determine bone metastasis risk based on SBI status. Subgroup analysis was performed to investigate heterogeneity using a forest graph. Cox proportional hazard regression analysis was used to screen for risk factors of bone metastasis-free survival (BMFS). A nomogram of BMFS based on SBI was developed and validated using C-index, receiver operating characteristic curve, calibration curves, and decision curve analysis after Cox proportional hazard regression analysis. Results: The incidence of bone metastasis was 14.83% (43/290), 20.69% (24/116), and 10.92% (19/174) in the overall population, SBI-positive group, and SBI-negative group, respectively. In the unadjusted model, SBI was associated with reduced BMFS [HR 2.43 (1.32-4.47), P = 0.004], and the results remained stable after three continuous adjustments (P <0.05). No significant interaction was found in the subgroup analyses (P for interaction >0.05). According to Cox proportional hazard regression analysis and clinical value results, potential risk factors included SBI, Karnofsky performance status, TNM stage, induction chemotherapy, concurrent chemoradiotherapy, and adjuvant chemotherapy. Using a training C-index of 0.80 and a validation C-index of 0.79, the nomogram predicted BMFS and demonstrated satisfactory prognostic capability in 2, 3, and 5 years (area under curve: 83.7% vs. 79.6%, 81.7% vs. 88.2%, and 79.0% vs. 93.8%, respectively). Conclusion: Skull base invasion is a risk factor for bone metastasis in patients with LA-NPC. The SBI-based nomogram model can be used to predict bone metastasis and may assist in identifying LA-NPC patients at the highest risk of bone metastasis.

Musa basjoo regulates the gut microbiota in mice by rebalancing the abundance of probiotic and pathogen.

Musa basjoo is a kind of popular slimming fruit in southern China. However, even though the trophic component and physiological effect are well studied, its internal mechanism in reconstructing gut microbiota remains unclear. In this study, maturity of M. basjoo were divided into four levels. Results indicated that M. basjoo in level Ⅱ (with 35% maturity) represented the greatest increase in the growth in vitro of probiotics, Lactobacillus plantarum FMNP01 and Lactobacillus casei FMNP02. After feeding M. basjoo with the middle dose (2.67 g/kg·BW) to mice for 21 days, gut microbiota from mice feces was isolated and sequenced. Results of 16SrDNA sequencing showed that the scattered genera of gut microbiota were significantly gathered. The amounts of different pathogens were decreased, while probiotics such as genera Bacteroides and Roseburia were significantly increased (p < 0.05). Results of function prediction indicated that the reconstruction of gut microbiota may due to the change in carbohydrate transportation, biosynthesis of cell wall, cell membrane, and cell envelope. This study has drawn a basic mechanism in reconstructing gut microbiota by feeding M. basjoo and lay out a foundation for further reach on the interaction between human as diner and M. basjoo as food.

[Protective effect of vitamin A on residual pancreatic ß cell function in children with type 1 diabetes mellitus].

OBJECTIVE: To study the protective effect of vitamin A on residual pancreatic ß cell function in children with type 1 diabetes mellitus (T1DM) and its mechanism. METHODS: A total of 46 children with T1DM (with a course of disease of 0.5-1 year) were randomly divided into an intervention group and a non-intervention group (n=23 each). The children in both groups were given insulin treatment, and those in the intervention group were also given vitamin A at a daily dose of 1 500-2 000 IU. A total of 25 healthy children were enrolled as the control group. The daily dose of insulin was calculated for the children with T1DM, and the serum levels of glycosylated hemoglobin (HbA1C), stimulated C-peptide, vitamin A, and interleukin-17 (IL-17) were measured before intervention and 3 months after intervention. RESULTS: Before vitamin A intervention, the intervention group and the non-intervention group had a significantly lower serum level of vitamin A and a significantly higher level of IL-17 than the control group (P<0.01). After 3 months of intervention, the intervention group had significantly lower serum IL-17 level and insulin dose and a significantly higher level of stimulated C-peptide than the non-intervention group (P<0.05). CONCLUSIONS: Vitamin A may protect residual pancreatic ß cell function, possibly by improving the abnormal secretion of IL-17 in children with T1DM.

Effect of lianhuaqingwen capsules on airway inflammation in patients with acute exacerbation of chronic obstructive pulmonary disease.

Chronic obstructive pulmonary disease (COPD) is characterized by a chronic inflammatory response that is worsened by acute exacerbations. Lianhuaqingwen (LHQW) has anti-inflammatory and immune regulatory functions and may inhibit the airway inflammation that occurs during an acute exacerbation of COPD. In this study, 100 participants were recruited and randomly assigned, 1 : 1, to the LHQW and the conventional groups, which were treated, respectively, with LHQW capsules and conventional Western medicine or only conventional Western medicine. The scores of the CAT scale and levels of inflammatory cytokines in blood and sputum were measured during treatment. In addition, subjects were subdivided into high-risk and low-risk subgroups. The CAT scores in the LHQW group and high-risk subgroup were clearly improved from the 5th day, but the other groups improved only after treatment was completed. Expression levels of IL-8, TNF- α , IL-17, and IL-23 in the sputum and of IL-8 and IL-17 in the blood were significantly decreased after treatment, and similar results were found in subgroups. These data suggested that LHQW capsules can accelerate the improvement of AECOPD patients, especially for the high-risk subgroup, and the mechanism of action may be related to the decreased release of inflammatory mediators.

Lipoprotein(a) level and its association with tumor stage in male patients with primary lung cancer.

BACKGROUND: Recently, attention has been focused on the effect of lipoprotein(a) [Lp(a)] on tumors because of its possible role in development of tumor angiogenesis. The aim of this study was to investigate Lp(a) serum levels in patients with lung cancer and its association with the stages of disease. METHODS: Fasting venous blood samples were collected from 418 untreated male patients with stages I-IV lung carcinoma and were analyzed for Lp(a). The results were compared with the data from 65 healthy male controls. RESULTS: Lp(a) levels were elevated (median 157 mg/L, range 16-1497 mg/L) in patients with lung carcinoma compared to control subjects (median 110 mg/L, range 35-706 mg/L) (p=0.004). Subgroup analysis showed that patients with stages II-IV disease had significantly higher Lp(a) concentrations than did healthy controls (p-0.05). There was an independently positive correlation between tumor stage and Lp(a) levels among patients with stages I-III (r=0.162, p=0.006). However, there was a decrease in Lp(a) in stage IV compared to stage III patients (p=0.03). CONCLUSIONS: There is a significant association between Lp(a) and the presence and stage of lung cancer. Additional investigations with a larger number of lung cancer patients are needed to confirm these findings.

[Preliminary study on autoregulation of samR involved in development and differentiation of Streptomyces ansochromogenes].

The previous result showed that samR plays an important role in the development progress of Streptomyces ansochromogenes. It was reported that the differentiation progress of S. ansochromogenes was accelerated by a recombinant plasmid containing an extra copy of samR gene. However, the differentiation progress of S. ansochromogenes was not further accelerated by a multicopy plasmid containing samR gene. Electrophoresis mobility shift assay (EMSA) demonstrated that SamR binds to its own promoter region specifically. All these results hint that samR is an autoregulatory gene in Streptomyces ansochromogenes.