Evaluation of the EMBOPIPE flow diverter device: in vivo and in vitro experiments.

BACKGROUND: Although flow diverter device (FDD) has brought revolutionized advances in endovascular treatment of intracranial aneurysms, it also presents considerable drawbacks as well, as the innovation for novel device has never stopped. This preclinical research aims to evaluate the safety and efficacy of a newly developed FDD, the EMBOPIPE, through in vivo and in vitro experiments. METHODS: Aneurysms were induced in 20 New Zealand white rabbits which were randomized to three follow-up groups according to the time elapsed after EMBOPIPE implantation (28, 90, and 180 days). Additional EMBOPIPEs were implanted in the abdominal aorta to cover the renal artery in nine rabbits. Angiography was performed immediately after device placement in all groups. Aneurysm occlusion, patency of renal arteries, and pathological outcomes were assessed. For the in vitro experiments, we measured the thrombogenic potential of EMBOPIPEs (n = 5) compared with bare stents (n = 5) using the Chandler loop model. Evaluation indicators were the platelet counts, macroscopic observations and scanning electron microscopy. RESULTS: EMBOPIPEs were successfully deployed in 19 of 20 rabbit aneurysms (95.0%). The rates of complete or near-complete aneurysm occlusion were 73.3%, 83.3%, and 100% in the 28-, 90-, and 180-day groups, respectively. All renal arteries covered by EMBOPIPEs remained patent, and the mean difference in renal artery diameter before and after the device placement in the three groups was 0.07 mm, 0.10 mm, and 0.10 mm, respectively (p = 0.77). Renal pathology was normal in all cases. The pathological findings of the aneurysms were as follows: thickened and adequate neointimal coverage at the aneurysm neck, minimal inflammatory response, near-complete smooth muscle cell layer, and endothelialization along the device. In vitro experiments showed that the platelet counts were significantly higher in EMBOPIPE blood samples than in bare stent samples and that platelet adhesion to the device was lower in the EMBOPIPE stent struts compared with bare stent struts through macroscopic observations and scanning electron microscopy. CONCLUSIONS: The EMBOPIPE can achieve high rates of aneurysm occlusion while maintaining excellent branch artery patency. It exhibited wonderful pathological results. This novel device with phosphorylcholine surface modification could reduce platelet thrombus attached to the stent struts.

Development and preliminary validation of a PROS scale for Chinese bladder cancer patients with abdominal stoma.

Bladder cancer is a common malignant tumor, and patients who have undergone radical cystectomy and urinary diversion require a lifelong abdominal stoma. This greatly affects their physiological, psychological, and social well-being. However, there is currently a lack of a self-assessment outcome scale specifically designed for bladder cancer patients with abdominal stomas. Therefore, we developed and validated a self-assessment outcome scale (PROS-BCAS) for Chinese bladder cancer patients with abdominal stomas. The scale was initially developed through literature research and expert consultation, and it comprised four dimensions: physiological, psychological, social, and treatment, with a total of 66 items. After item analysis, 44 items were retained. We collected scale data from 382 patients to examine its validity and reliability. The results showed that the PROS-BCAS scale had good content validity (S-CVI/Ave = 0.992), construct validity (KMO > 0.6), and discriminant validity (correlation coefficient 0.404-0.870). The Cronbach's alpha coefficients (0.801-0.954), test-retest reliability (0.778-0.956), and split-half reliability (0.896-0.977) all demonstrated good internal consistency for each dimension and the overall scale. The study demonstrated that the PROS-BCAS scale is a reliable and valid tool for accurately assessing the health-related quality of life of bladder cancer patients with abdominal stomas, providing reference for developing individualized clinical care plans.

Amorphous Modulation of Atomic Nb-O/N Clusters with Asymmetric Coordination in Carbon Shells for Advanced Sodium-Ion Hybrid Capacitors.

Anode materials with excellent properties have become the key to develop sodium-ion hybrid capacitors (SIHCs) that combine the advantages of both batteries and capacitors. Amorphous modulation is an effective strategy to realize high energy/power density in SIHCs. Herein, atomically amorphous Nb-O/N clusters with asymmetric coordination are in situ created in N-doped hollow carbon shells (Nb-O/N@C). The amorphous clusters with asymmetric Nb-O3/N1 configurations have abundant charge density and low diffusion energy barriers, which effectively modulate the charge transport paths and improve the reaction kinetics. The clusters are also enriched with unsaturated vacancy defects and isotropic ion-transport channels, and their atomic disordering exhibits high structural stress buffering, which are strong impetuses for realizing bulk-phase-indifferent ion storage and enhancing the storage properties of the composite. Based on these features, Nb-O/N@C achieves notably improved sodium-ion storage properties (reversible capacity of 240.1 mAh g-1 at 10.0 A g-1 after 8000 cycles), and has great potential for SIHCs (230 Wh Kg-1 at 4001.5 W Kg-1). This study sheds new light on developing high-performance electrodes for sodium-ion batteries and SIHCs by designing amorphous clusters and asymmetric coordination.

Efficacy of induction chemotherapy in lymph node-positive stage III nasopharyngeal carcinoma and identification of beneficiaries based on clinical features: A propensity score matching analysis.

PURPOSE: To investigate the role of induction chemotherapy (IC) in lymph node-positive (LN-positive) stage III nasopharyngeal carcinoma (NPC) receiving concurrent chemoradiotherapy (CCRT). METHODS: In total, 627 patients with newly diagnosed LN-positive stage III NPC receiving CCRT or IC plus CCRT were included. The primary endpoint was progression-free survival (PFS). Propensity-score matching (PSM) was conducted to balance the intergroup covariates. Kaplan-Meier method with log-rank test was employed to compare survival curves. Subgroup analyses were conducted based on baseline characteristics. RESULTS: After 1:1 PSM, 414 patients were identified (207 patients per group). Compared with CCRT, IC plus CCRT provided better survival (5-year PFS 88.4% vs. 78.6%, P = 0.01; overall survival [OS] 94.8% vs. 85.3%, P = 0.003; and distant metastasis-free survival [DMFS] 93.1% vs. 85.6%, P = 0.03). The IC beneficial effects on PFS were mainly present in patients with grade 2-3 ENE, elevated serum lactate dehydrogenase (LDH > 170U/L), and N2 disease. Patients with grade 2 CNN had comparable PFS benefits to those with grade 0-1 CNN. For patients with grade 0-1 ENE combined with LDH ≤ 170U/L, survival between the two groups was similar with 5-year PFS 93.6% vs. 90.4% (P = 0.50), OS 94.2% vs. 93.0% (P = 0.72), and DMFS 98.6% vs. 97.7% (P = 0.98). CONCLUSION: Adding IC before CCRT improved survival in LN-positive stage III NPC patients. Additional IC did not provide better survival for patients with grade 0-1 ENE combined with LDH ≤ 170U/L and could be avoided in this population. CNN may not be a good risk factor for tailoring a personalized treatment plan.

Novel dual-action vanillic acid pretreatment for efficient hemicellulose separation with simultaneous inhibition of lignin condensation.

Aromatic acids play a selective role in the separation of hemicellulose. Phenolic acids have demonstrated an inhibitory effect on lignin condensation. In the current study, vanillic acid (VA), which combines the characteristics of aromatic and phenolic acids, is used to separate eucalyptus. The efficient and selective separation of hemicellulose is achieved simultaneously at 170 °C, 8.0% VA concentration, and 80 min. The separation yield of xylose increased from 78.80% to 88.59% compared to acetic acid (AA) pretreatment. The separation yield of lignin decreased from 19.32% to 11.19%. In particular, the ß-O-4 content of lignin increased by 5.78% after pretreatment. The results indicate that VA, as a "carbon positive ion scavenger", it preferentially reacts with the carbon-positive ion intermediate of lignin. Surprisingly, the inhibition of lignin condensation is achieved. This study provides a new starting point for the development of an efficient and sustainable commercial technology by organic acid pretreatment.

Pretreatment of poplar with eco-friendly levulinic acid to achieve efficient utilization of biomass.

Organic acid pretreatment is an effective method for green separation of lignocellulosic biomass. However, repolymerization of lignin seriously affects the dissolution of hemicellulose and the conversion of cellulose during organic acid pretreatment. Therefore, a new organic acid pretreatment, levulinic acid (Lev) pretreatment, was studied for the deconstruction of lignocellulosic biomass without adding additional additives. The preferred separation of hemicellulose was realized at Lev concentration 7.0%, temperature 170 °C, and time 100 min. The separation of hemicellulose increased from 58.38% to 82.05% compared with acetic acid pretreatment. It was found that the repolymerization of lignin was effectively inhibited in the efficient separation of hemicellulose. This was attributed to the fact that γ-valerolactone (GVL) is a good green scavenger of lignin fragments. The lignin fragments in the hydrolysate were effectively dissolved. The results provided theoretical support for creating green and efficient organic acid pretreatment and effectively inhibiting lignin repolymerization.

Nitrogen-Rich WN Clusters with Atomic Disorders and Non-Grain Boundaries Confined in Carbon Nanosheets Boosting Sodium-Ion Storage.

Sodium-ion batteries (SIBs) as economic candidates have received considerable attention for large-scale energy storage applications. However, crystalline metal compounds with specific transport routes and rigid structures restrict their practical applications. Herein, the atomically dispersed N-rich amorphous WN clusters confined in the carbon nanosheets (WN/CNSs) are reported. Through advanced tests and calculations, the structural advantages, reaction mechanisms, and kinetic behaviors of the clusters are systematically analyzed. Compared with the crystalline W2 N with low theoretical capacity (only 209.3 mAh g-1 ), the amorphous WN clusters have the advantages of atomic disorders and non-grain boundaries and can afford abundant active sites (unsaturated dangling bonds) and isotropic charge transfer channels, which can be further enhanced by the N-rich characteristics and high electronegativity of the clusters. The encapsulation of CNSs has high conductivity and structural stability, which promotes electron transfer and effectively buffers volume expansions. As a SIB anode, the reversible capacity of WN/CNSs reaches 421.2 mAh g-1 at 0.1 A g-1 . Even at 20 A g-1 , the reversible capacity of 170.7 mAh g-1 is maintained after 8000 cycles. This study focuses on the advantages of amorphous nitrides, which have important guiding significance for the design of atomic clusters for high-performance metal ion batteries.

Superior separation of hemicellulose-derived sugars from eucalyptus with tropic acid pretreatment.

Organic acid pretreatments can efficiently separate biomass-based hemicellulose and selectively produce hemicellulose-derived sugars. In this study, hemicellulose is separation as xylose, oligosaccharides in the tropic acid-catalyzed hydrothermal pretreatment of eucalyptus. The maximum yield of hemicellulose-derived sugars (85.78 %) with 71.25 % xylose selectivity (based on the total xylose in raw material) was achieved in the hydrolysate under optimal conditions (5 % TA, 160 ℃, 80 min). The yield of hemicellulose-derived sugar and the separation yield of hemicellulose increased by 11.06 % and 11.45 % compared with glycolic acid pretreatment in the similar severity factor. The separation yield of cellulose and lignin was decreased by 4.23 % and 0.98 %, respectively. This resulted in residual solids with higher biological stability (higher fiber crystallinity index, higher thermal stability, and higher lignin content). Therefore, higher hemicellulose separation selectivity and rich hemicellulose-derived sugars were obtained using TA pretreatment. The work would bring up a new method for biomass refining.

High-efficiency separation of hemicellulose from bamboo by one-step freeze-thaw-assisted alkali treatment.

The selectivity of alkali treatment (AT) for hemicellulose separation is reduced due to the alkali solubility of lignin. It was improved using freeze-thaw-assisted alkaline treatment (FT/AT). In this study, bamboo hemicellulose was separated via a one-step freeze-thaw-assisted alkali treatment (OFT/AT). The effects of freezing temperature, freezing time, alkali concentration, and treatment time on bamboo components were studied. The separation yield of hemicellulose was 73.26%, compared to 64.00% using conventional FT/AT. The separation of lignin and cellulose was inhibited as alkali concentration decreased from 7.0% to 5.0%. The extraction yield of hemicellulose increased from 46.35% to 56.12%. Structural analysis of extracted hemicellulose revealed the effective inhibition of the breakage of the xylose backbone and arabinose side chain of hemicellulose. This indicated that the molecular structure of extracted hemicellulose was relatively complete. It provides theoretical support for the efficient separation of hemicellulose by AT.

Highly selective separation of eucalyptus hemicellulose by salicylic acid treatment with both aromatic and hydroxy acids.

Aromatic and hydroxyl acid treatments demonstrate their respective characteristics for the separation of lignocellulosic biomass. In this study, the effect of salicylic acid (SA-A) treatment on the separation of eucalyptus components with both aromatic and hydroxyl acid properties was analyzed. The optimal conditions were SA-A concentration 9.0%, reaction temperature 140 °C and time 75 min. The separation yield of xylose was 85.93%. The separation of cellulose and lignin was inhibited by SA-A treatment in contrast to the separation by glycolic acid and p-toluenesulfonic acid treatment. Moreover, SA-A treatment resulted in a larger fiber crystallinity index and higher thermal stability. The SA-A-treated samples contained lignin that was rich in ß-O-4 and hydroxyl groups. The degradation and condensation of lignin was inhibited. The selectivity of aromatic acids for separating hemicellulose and protecting the lignin structure using hydroxy acids was demonstrated. Thus, new and efficient organic acid treatments can be developed.

Optimization of Demineralization and Pyrolysis Performance of Eucalyptus Hydrothermal Pretreatment.

The preparation of bio-oil through biomass pyrolysis is promoted by different demineralization processes to remove alkali and alkaline earth metal elements (AAEMs). In this study, the hydrothermal pretreatment demineralization was optimized by the response surface method. The pretreatment temperature, time and pH were the response elements, and the total dissolution rates of potassium, calcium and magnesium were the response values. The interactions of response factors for AAEMs removal were analyzed. The interaction between temperature and time was significant. The optimal AAEMs removal process was obtained with a reaction temperature of 172.98 °C, time of 59.77 min, and pH of 3.01. The optimal dissolution rate of AAEMs was 47.59%. The thermal stability of eucalyptus with and without pretreatment was analyzed by TGA. The hydrothermal pretreatment samples exhibit higher thermostability. The composition and distribution of pyrolysis products of different samples were analyzed by Py-GC/MS. The results showed that the content of sugars and high-quality bio-oil (C6, C7, C8 and C9) were 60.74% and 80.99%, respectively, by hydrothermal pretreatment. These results show that the removal of AAEMs through hydrothermal pretreatment not only improves the yield of bio-oil, but also improves the quality of bio-oil and promotes an upgrade in the quality of bio-oil.

Tunable Surface Selenization on MoO2 -Based Carbon Substrate for Notably Enhanced Sodium-Ion Storage Properties.

Transition metal chalcogenides with high theoretical capacity are promising conversion-type anode materials for sodium ion batteries (SIBs), but often suffer from unsatisfied cycling stability (hundreds of cycles) caused by structural collapse and agglomerate. Herein, a rational strategy of tunable surface selenization on highly crystalline MoO2 -based carbon substrate is designed, where the sheet-like MoSe2 can be coated on the surface of bundle-like N-doped carbon/granular MoO2 substrate, realizing partial transformation from MoO2 to MoSe2 , and creating b-NC/g-MoO2 @s-MoSe2 -10 with robust hierarchical MoO2 @MoSe2 heterostructures and strong chemical couplings (MoC and MoN). Such well-designed architecture can provide signally improved reaction kinetics and reinforced structural integrity for fast and stable sodium-ion storage, as confirmed by the ex situ results and kinetic analyses as well as the density functional theory calculations. As expected, the b-NC/g-MoO2 @s-MoSe2 -10 delivers splendid rate capability and ultralong cycling stability (254.2 mAh g-1 reversible capacity at 5.0 A g-1 after 6000 cycles with ≈89.0% capacity retention). Therefore, the tunable surface strategy can provide new insights for designing and constructing heterostructures of transition metal chalcogenides toward high-performance SIBs.

Gan-Qing-Ning Formula Inhibits the Growth of Hepatocellular Carcinoma by Promoting Apoptosis and Inhibiting Angiogenesis in H22 Tumor-Bearing Mice.

OBJECTIVE: Gang-Qing-Ning (GQN) is a traditional Chinese medicine formula that has been used in the treatment of hepatocellular carcinoma (HCC) in the folk population for decades. However, scientific validation is still necessary to lend credibility to the traditional use of GQN against HCC. This study investigates the antitumor effect of GQN on H22 tumor-bearing mice and its possible mechanism. METHODS: Fifty H22 tumor-bearing mice were randomly assigned to five groups. Three groups were treated with high, medium, and low dosages of GQN (27.68, 13.84, and 6.92 g/kg, respectively); the positive control group was treated with cytoxan (CTX) (20 mg/kg) and the model group was treated with normal saline. After 10 days' treatment, the tumor inhibitory rates were calculated. Pathological changes in tumor tissue were observed, and the key proteins and genes of the mitochondrial apoptosis pathway were measured, as well as the mRNA expression levels of VEGF in tumor tissue. RESULTS: The tumor inhibitory rates of high, medium, and low dosages of GQN groups were 47.39%, 38.26%, and 22.17%, respectively. The high dosage of the GQN group significantly increased the protein and mRNA expression levels of Bax, Cyt-C, and cleaved Caspase 3 (or Caspase 3) (P < 0.01) but decreased the expression levels of Bcl-2, VEGF, and microvessel density (MVD) (P < 0.01). CONCLUSIONS: The high dosage of GQN can significantly inhibit the tumor growth in H22 tumor-bearing mice. It exerts the antitumor effect by enhancing proapoptotic factors and inhibiting the antiapoptotic factor of the mitochondrial apoptosis pathway and inhibiting tumor angiogenesis.

Identification of non-invasive biomarkers for predicting the radiosensitivity of nasopharyngeal carcinoma from serum microRNAs.

Serum microRNAs (miRNAs) have been reported as novel biomarkers for various diseases. But circulating biomarkers for predicting the radiosensitivity of nasopharyngeal carcinoma (NPC) have not been used in clinical practice. To screen out of differently expressed serum miRNAs from NPC patients with different radiosensitivity may be helpful for its individual therapy. NPC patients with different radiosensitivity were enrolled according to the inclusion and exclusion criteria. RNA was isolated from serum of these NPC patients before treatment. We investigated the differential miRNA expression profiles using microarray test (GSE139164), and the candidate miRNAs were validated by reverse transcription-quantitative real time polymerase chain reaction (RT-qPCR) experiments. Receiver operating characteristic (ROC) analysis has been applied to estimate the diagnostic value. In this study, 37 serum-specific miRNAs were screened out from 12 NPC patients with different radiosensitivity by microarray test. Furthermore, RT-qPCR analysis confirmed that hsa-miR-1281 and hsa-miR-6732-3p were significantly downregulated in the serum of radioresistant NPC patients (P < 0.05), which was consistent with the results of microarray test. ROC curves demonstrated that the AUC for hsa-miR-1281 was 0.750 (95% CI: 0.574-0.926, SE 87.5%, SP 57.1%). While the AUC for hsa-miR-6732-3p was 0.696 (95% CI: 0.507-0.886, SE 56.3%, SP 78.6%). These results suggested that hsa-miR-1281 and hsa-miR-6732-3p in serum might serve as potential biomarkers for predicting the radiosensitivity of NPC.

Multicarbazole-Based D-π-A Dyes Sensitized Hydrogen Evolution under Visible Light Irradiation.

Donor-π bridge-acceptor (D-π-A) organic dyes, well studied in dye-sensitized solar cells (DSSCs), are found to possess great potential in light-inducing hydrogen evolution due to their distinguished light-harvesting ability and suitable electron energy level. In this work, multicarbazole-based organic dyes (2C, 3C, 4C) were used as photosensitizers of Pt/TiO2 for photocatalytic hydrogen evolution (PHE) from water under visible light irradiation. 3C-Pt/TiO2 shows the best photocatalytic activity among the three dye-sensitized photocatalysts, with a hydrogen evolution rate of 24.7 µmol h-1 and a turnover number of 247 h-1. The activity of 3C-Pt/TiO2 declines significantly after 3 h irradiation. The deactivation was caused by the partial degradation of the electron acceptor, cyanoacrylate moiety, during the photocatalytic process, which was evidenced by UV-vis, Fourier transform infrared spectra (FT-IR), NMR, and mass spectra. This work is expected to contribute toward the understanding of stability issues of organic dyes and the development of more efficient and steady dyes for hydrogen evolution from water splitting.

Encapsulating N-Doped Carbon Nanorod Bundles/MoO2 Nanoparticles via Surface Growth of Ultrathin MoS2 Nanosheets for Ultrafast and Ultralong Cycling Sodium Storage.

Conversion-type anode materials possess high theoretical capacity for sodium-ion batteries (SIBs), owing to multi-electron transmission (2-6 electrons). Mo-based chalcogenides are a class of great promise, high-capacity host materials, but their development still undergoes serious volume changes and low transport kinetics during the cycling process. Here, MoO2 nanoparticles anchored on N-doped carbon nanorod bundles (N-CNRBs/MoO2) are synthesized by a facile self-polymerized route and a following annealing. After hydrothermal sulfuration, N-CNRBs/MoO2 composites are encapsulated by surface growth of ultrathin MoS2 nanosheets, acquiring hierarchical N-CNRBs/MoO2@MoS2 composites. Serving as the SIB anode, the N-CNRBs/MoO2@MoS2 electrode exhibits significantly improved sodium-ion storage properties. The reversible capacity is up to 554.4 mA h g-1 at 0.05 A g-1 and maintains 249.3 mA h g-1 even at 10.0 A g-1. During 5000 cycles, no obvious capacity decay is observed and the reversible capacities retain 334.8 mA h g-1 at 3.0 A g-1 and 301.4 mA h g-1 at 5.0 A g-1. These properties could be ascribed to the vertical encapsulation of MoS2 nanosheets on high-crystalline N-CNRBs/MoO2 substrates. The hierarchical architecture and unique heterostructure between MoO2 and MoS2 synergistically facilitate sodium-ion diffusion, relieve volume changes, and boost pseudocapacitive charge storage of N-CNRBs/MoO2@MoS2 electrode. Therefore, the rational growth of nanosheets on complex substrates shows promising potential to construct anode materials for high-performance batteries.

Amyloid Beta (A4) Precursor Protein: A Potential Biomarker for Recurrent Nasopharyngeal Carcinoma.

BACKGROUND AND AIM: Nasopharyngeal carcinoma (NPC) is one of the most common cancers in Southern China, Southeast Asia. Radiotherapy is the main treatment for NPC. Still, about 20% of patients with NPC have a recurrence. No effective serum biomarkers are available for recurrent nasopharyngeal carcinoma (rNPC) to date. This study aimed to explore whether amyloid beta (A4) precursor protein (APP) might serve as a valuable diagnostic and prognostic biomarker for patients with rNPC. METHODS: In a previous study, a tandem mass tag-based proteomic test was performed, which screened 59 differentially expressed proteins (DEPs) between nonrecurrent nasopharyngeal carcinoma (nrNPC) and rNPC. In this study, a protein-protein interaction was conducted to screen the key proteins among the 59 DEPs. APP was validated and evaluated by enzyme-linked immunosorbent assay in 70 serum samples [recurrence (n = 35) and no-recurrence (n = 35)]. Also, the receiver operating characteristic (ROC) curve was plotted to evaluate the predictive value of APP. RESULTS: The area under the ROC curve was 0.666 (95% CI: 0.514-0.818, P = 0.044). The best cutoff point of the relative expression levels for APP was 1.23 (concentration = 16.95 ng/mL), at which the sensitivity was 55.2% and the specificity was 90.9%. CONCLUSION: The findings indicated that APP might be a valuable diagnostic and prognostic biomarker for patients with rNPC.

Enhanced cell affinity of PHBHHx composite scaffold with polylactide-graft-hydroxyapatite as compatibilizer.

Poor interfacial bonding and liability to aggregation were the major obstacles for designing of composite scaffolds. Herein, hydroxyapatite (HA) surface-grafted with poly (l-lactide) via ring-opening polymerization was prepared and introduced into PHBHHx-based complex scaffold serving as oligomer compatibilizer. The physicochemical properties, including superficial roughness and wettability, mechanical strength, as well as in vitro bioactivity were systematically investigated. Improved cellular response was acquired owing to the favourable uniformity and interfacial compatibility, as well as the decreased contact angle and elevated roughness, through surface-modification strategy. Moreover, some of the osteogenic marker genes (COL I, Runx2, OCN and OPN) were up-regulated, thus made for the osteogenic differentiation. Our study extrapolated that the PHBHHx-based composite scaffold combined with surface-graft HA compatibilizer might be a potential candidate for bone repairing.

Identification of CALM as the potential serum biomarker for predicting the recurrence of nasopharyngeal carcinoma using a mass spectrometry-based comparative proteomic approach.

To date, there are no serum biomarkers available for the prediction of recurrent nasopharyngeal carcinoma (rNPC). The diagnosis of rNPC mostly depends on imaging and biopsy of diseased tissue; however, both of these methods work mostly if the target tumor is at an advanced stage. Therefore, the identificaqtion of recurrent biomarkers is urgently required. In the present study, we used tandem mass tag (TMT) labeling and high performance liquid chromatography (HPLC) fractionation followed by liquid chromatography-tandem mass spectrometry (LC­MS/MS) to identify differentially expressed proteins. Serum was collected from 40 patients with NPC [recurrence (n=20) and no recurrence (n=20)]. Compared to non­recurrent NPC (nrNPC), we found 59 proteins to be significantly dysregulated in rNPC; most of these have been previously reported to play a role in carcinogenesis. The dysregulation of calmodulin (CALM) was confirmed in 74 new patients [recurrence (n=32) and no recurrence (n=42)] by ELISA. Moreover, we performed a preliminary pathway analysis which revealed that oxidative phosphorylation was altered in the patients with rNPC compared to those with nrNPC. Taken together, these data identify a potential diagnostic biomarker for rNPC and elucidate the potential molecular mechanisms that are dysregulated and contribute to the pathogenesis of rNPC.