Comprehensive Characterization of Organic Light-Emitting Materials in Breast Milk by Target and Suspect Screening.

Organic light-emitting materials (OLEMs) are emerging contaminants in the environment and have been detected in various environment samples. However, limited information is available regarding their contamination within the human body. Here, we developed a novel QuEChERS (quick, easy, cheap, effective, rugged, and safe) method coupled with triple quadrupole/high-resolution mass spectrometry to determine OLEMs in breast milk samples, employing both target and suspect screening strategies. Our analysis uncovered the presence of seven out of the 39 targeted OLEMs in breast milk samples, comprising five liquid crystal monomers and two OLEMs commonly used in organic light-emitting diode displays. The cumulative concentrations of the seven OLEMs in each breast milk sample ranged from ND to 1.67 × 103 ng/g lipid weight, with a mean and median concentration of 78.76 and 0.71 ng/g lipid weight, respectively, which were higher compared to that of typical organic pollutants such as polychlorinated biphenyls and polybrominated diphenyl ethers. We calculated the estimated daily intake (EDI) rates of OLEMs for infants aged 0-12 months, and the mean EDI rates during lactation were estimated to range from 30.37 to 54.89 ng/kg bw/day. Employing a suspect screening approach, we additionally identified 66 potential OLEMs, and two of them, cholesteryl hydrogen phthalate and cholesteryl benzoate, were further confirmed using pure reference standards. These two substances belong to cholesteric liquid crystal materials and raise concerns about potential endocrine-disrupting effects, as indicated by in silico predictive models. Overall, our present study established a robust method for the identification of OLEMs in breast milk samples, shedding light on their presence in the human body. These findings indicate human exposure to OLEMs that should be further investigated, including their health risks.

ΔRDW Could Predict Major Adverse Cardiovascular Events in Patients with Heart Failure with Reduced Ejection Fraction After Sacubitril/Valsartan Treatment.

Objective: This study aimed to evaluate the association between red blood cell distribution width (RDW) changes and major adverse cardiovascular event (MACE) occurrences during sacubitril/valsartan treatment in patients with heart failure with reduced ejection fraction (HFrEF). Methods: This study retrospectively analyzed the medical records of patients with HFrEF hospitalized from April 2018 to February 2021. The patients were divided into two groups according to the inclusion of sacubitril/valsartan in the personal drug treatment regimen, the traditional and the sacubitril/valsartan group. RDW values before and after sacubitril/valsartan treatment were recorded respectively as RDW1 and RDW2. ΔRDW was defined as the difference between RDW2 and RDW1. The patients in the sacubitril/valsartan group were divided into two subgroups according to ΔRDW >0 or ≤0. MACEs, such as readmission for HF, acute myocardial infarction, ischemic stroke, and malignant arrhythmia and death, were recorded during the 1-year follow-up period in each group. Results: MACE development was lower in patients treated with sacubitril/valsartan than those treated with conventional therapy (log-rank, P<0.001). The incidence of cardiac events during the follow-up period was greater in the group with ΔRDW >0 than in the group with ΔRDW ≤0 (Breslow, P<0.001). Increased RDW was associated with a higher likelihood of developing MACE than decreased RDW (odds ratio [OR] =2.055, 95% confidence interval [CI]:1.301-3.246), and the risk of developing MACE increased by 22.1% for each unit increase in RDW (OR=1.221, 95% CI:1.074-1.389). Conclusion: Sacubitril/valsartan treatment is effective in reducing the risk of MACEs in HFrEF. Additionally, RDW changes are predictors of MACEs after sacubitril/valsartan treatment.

Multiparametric MRI-Based Radiomics Signature with Machine Learning for Preoperative Prediction of Prognosis Stratification in Pediatric Medulloblastoma.

RATIONALE AND OBJECTIVES: Despite advances in risk-stratified treatment strategies for children with medulloblastoma (MB), the prognosis for MB with short-term recurrence is extremely poor, and there is still a lack of evaluation of short-term recurrence risk or short-term survival. This study aimed to construct and validate a radiomics model for predicting the outcome of MB based on preoperative multiparametric magnetic resonance images (MRIs) and to provide an objective for clinical decision-making. MATERIALS AND METHODS: The clinical and imaging data of 64 patients with MB admitted to Shenzhen Children's Hospital from December 2012 to December 2021 and confirmed by pathology were retrospectively collected. According to the 18-month progression-free survival, the cases were classified into a good prognosis group and a poor prognosis group, and all cases were divided into training group (70%) and validation group (30%) randomly. Radiomics features were extracted from MRI of each child. The consistency test, t-test, and the least absolute shrinkage and selection operator were used for feature selection. The support vector machine (SVM) and receiver operator characteristic were used to evaluate the distinguishing ability of the selected features to the prognostic groups. RAD score was calculated based on the selected features. The clinical characteristics and RAD score were included in the multivariate logistic regression, and prediction models were constructed by screening out independent influences. The radiomics nomogram was constructed, and its clinical significance was evaluated. RESULTS: A total of 1930 radiomic features were extracted from the images of each patient, and 11 features were included in the construction of radiomics score after selected. The area under the curve (AUC) values of the SVM model in the training and validation groups were 0.946 and 0.797, respectively. The radiomics nomogram was constructed based on the training cohort, and the AUC values in the training group and the validation group were 0.926 and 0.835, respectively. The results of clinical decision curve analysis showed that a good net benefit could be obtained from the nomogram. CONCLUSION: The radiomics nomogram established based on MRI can be used as a noninvasive predictive tool to evaluate the prognosis of children with MB, which is expected to help neurosurgeons better conduct preoperative planning and patient follow-up management.

Risk-adapted stereotactic body radiotherapy for patients with cervical spinal metastases.

Owing to the complex anatomical structure and biomechanics, the current standard palliative treatments for cervical spinal metastases are associated with a high risk of recurrence and complications. Stereotactic body radiotherapy (SBRT) can provide radical dose to tumors while protecting normal organs to the maximum extent. However, the efficacy and safety of SBRT for cervical spinal metastases is not well characterized. Data from 71 patients with cervical spine metastases who were treated with SBRT using CyberKnife between 2006 and 2021 were obtained from our prospectively maintained database. Primary endpoint was pain response at 12 weeks following SBRT completion; secondary endpoints included local control (LC), overall survival (OS), and adverse events. Standard-risk patients were planned to receive 30 Gy (range 21-36) with median fractions of 3 (range 1-3) and high-risk patients 35 Gy (range 24-50) with median fractions of 5 (range 4-5) according to the spinal cord and esophagus dose constraints. The median follow-up time was 17.07 months (range 3.1-118.9). After 12 weeks of SBRT completion, 54 (98.2%) of 55 patients with baseline pain achieved pain response and 46 (83.6%) achieved complete pain response. LC rates were 93.1% and 90% at 1 year and 2 year, respectively. The 1-year and 2-year OS rates were 66.2% and 37.4%, respectively. Eight patients experienced grades 1-4 adverse events (six vertebral compression fracture [VCF], five of them had VCF before SBRT; and two hemiparesis). No grade 5 adverse events were observed. Therefore, risk-adapted SBRT for cervical spine metastases achieved high pain control and LC rates with acceptable adverse events.

Safety and Efficacy of Stereotactic Ablative Radiotherapy for Ultra-Central Lung Cancer.

Background: Ultra-central lung cancer (UCLC) is difficult to achieve surgical treatment. Over the past few years, stereotactic ablative radiotherapy (SABR) or stereotactic body radiotherapy (SBRT) obviously improved the clinical efficacy and survival of UCLC patients. However, the adapted scheme of radiation therapy is still controversial. For this, a single arm retrospective analysis was performed on UCLC patients treated with SBRT. Material and Methods: We retrospectively studied primary UCLC patients who were treated with SBRT of 56 Gy/6-8f between 2010 and 2018. UCLC was defined as planning target volume (PTV) touching or overlapping the proximal bronchial tree, trachea, esophagus, heart, pulmonary vein, or pulmonary artery within 2 cm around the bronchial tree in all directions. Results: A total of 58 patients whose median age was 68 years (range, 46-85) were included in our study, 79.3% of whom did not undergo any previous therapy. The median dose of the PTV was 77.8 Gy (range, 43.3-91.8), and the median PTV of tumors was 6.2 cm3 (range, 12.9-265.0). With a median follow-up of 57 months (range, 6-90 months), the median cumulative overall survival (OS) rate was 58 months (range, 2-105). In addition, the 1-year, 2-year and 5-year OS rates were 94.7%, 75.0% and 45.0%, respectively. In our univariable analysis (p=0.020) and multivariate analysis (p=0.004), the OS rate was associated with the PTV. The 5-year OS rates for PTV <53.0 cm3 and PTV ≥53.0 cm3 were 61.6% and 37.4%, respectively. Regarding toxicity after SBRT, there were two cases (3.5%) with grade ≥3 adverse events, of which 1 case died of sudden severe unexplained hemoptysis. Conclusions: Patients with UCLC can benefit from SBRT at a dose of 56 Gy/6-8f. On the other hand, smaller PTV was associated with superior outcomes, and the cure difference needs to be validated by prospective comparative trials.

ΔRDW: A Novel Indicator with Predictive Value for the Diagnosis and Treatment of Multiple Diseases.

Elevated red blood cell distribution width (RDW) is a powerful predictor of poor prognosis in a variety of diseases, but a single measurement of RDW cannot reflect the dynamic change of diseases. ΔRDW, as a risk stratification tool, can be used to record changes in RDW before and after treatment; also, it allows investigators to name the unit change of RDW in the studied population. So far, there have been few relevant studies on the predictive value of ΔRDW for different diseases; this article aims to review the studies and summaries of the current understandings on the correlation between ΔRDW and disease outcomes.

Analyzing the delays of target lane vehicles caused by vehicle lane-changing operation.

Vehicle lane-changing on urban roads is the most common traffic behavior, in which the driver changes the direction or increases the speed of the vehicle by changing its trajectory. However, in high-density traffic flow, when a vehicle changes lanes, a series of vehicles following the target vehicle in the target lane will be delayed. In this study, DJI Phantom 4 drones were used to vertically record the traffic on a road section. Tracker software was then used to extract vehicle information from the video taken by the drones, including the vehicle operating speeds, etc. SPSS 22 and Origin analysis software were then employed to analyze the correlations between different vehicle operating parameters. It was found that the operating speed of the first vehicle following the target vehicle in the target lane is related to the speeds and positions of both the target vehicle and the vehicle preceding it. Under the condition of high-density traffic flow, when the target vehicle is inserted into the target lane, the speed of the vehicles following the target vehicle in the target lane will change. To model this process, the corresponding Sine and DoseResp models were constructed. By calculating the delays of vehicles following the target vehicle in the target lane, it was concluded that the overall delay of the fleet is 3.9-9.5 s.

Treatment barriers and clinical outcome of children with medulloblastoma in China: a report from the Chinese Children's Cancer Group (CCCG).

BACKGROUND: Medulloblastoma (MB) is the most common malignant central nervous system tumor of childhood. Management requires interdisciplinary care and is associated with unique challenges in developing regions. Here, we report the characteristics, clinical outcome and treatment barriers for Chinese children with MB based on a multi-institutional cohort from the Chinese Children's Cancer Group (CCCG). METHODS: Retrospective cohort study among 12 Chinese pediatric oncology units from the CCCG Brain Tumor Workgroup on patients aged <18 years diagnosed with MB from 2016 to 2019. RESULTS: 221 patients (male:female = 138:83) were included, 175 (79%) were ≥3 years of age, and 46 (21%) <3 years. 177 patients (80%) were completely staged, among which 50 (28%) had metastasis and 70 (40%) were considered to have high-risk (HR) disease. Gross/near-total resection was achieved in 203 patients (92%). In patients where molecular grouping could be assigned, 19 (16%), 35 (29%), and 65 (54%), respectively had WNT-activated, SHH-activated, and Group 3/4 MB. The median duration between resection and initiation of adjuvant therapy was 36 days. Respective 2-year PFS and OS rates were 76.0 ± 3.0% and 88.0 ± 2.3%. PFS was significantly associated with age, metastatic status and clinical risk grouping. Chemotherapy use during CSI or alkylator choice were not significant predictors for patient outcome. CONCLUSIONS: We reported the clinical profiles and outcome from the largest cohort of Chinese children with MB after multi-modal therapy. Strengths and limitations on the local provision of neuro-oncology service are identified.

The potentially therapeutic targets of pediatric anaplastic ependymoma by transcriptome profiling.

Ependymoma (EPN) is a type of tumor that occurs in the central nervous system of children and adults. EPN produces resistance to chemotherapy, and there are no targeted drugs available as a proper cure. Therefore, the use of high-throughput sequencing technologies to elucidate pathogenic mechanisms is of prime importance to identify potential tumor target genes helpful for developing effective therapeutic approaches against EPN. With this objective, we used RNA-seq analysis to identify differentially expressed genes (DEGs) and pathways in 4 pairs of EPN tissues and adjacent tissues. In total, we found 5,445 differentially expressed genes. The synaptic vesicle cycle and extracellular matrix (ECM) receptor interaction pathways were highly enriched in the ependymoma group. Nine differentially expressed genes (SNAP25, GRM4, CELSR1, LAMA1, WNT5A, ROR2, CCND1, EPHB2, FOXJ1) were randomly verified by RT-qPCR, supporting the authenticity of our sequencing results. This study provides global gene information and some new potential biomarkers for the diagnosis and therapeutic targets of ependymoma.

Prevalence and trend of low vision among primary and secondary school students in Wuhan from 2019 to 2020 / 中国学校卫生

Objective@#To provide a largescale assessment the prevalence of poor vision in 2020 among children and adolescents in Wuhan City, Hubei province and to provide basis for healthy vision promotion.@*Methods@#This crosssectional epidemiological study was conducted among 156 783 students, who lived in Wuhan during the COVID-19 period participated the vision screening through the online applet designed by Wuhan Center for Adolescent Poor Vision Prevetion and Control under the guidance of their guardians between June 19 and July 6, 2020. The demographic information and daily hours spent on various activities in the past week were investigated. The corresponding visual acuity data of students in 2019 before the COVID-19 outbreak was extracted from school vision monitoring records for each semester, which was measured by the experienced eye care professionals.@*Results@#The detection rate of poor vision (51.04%) in 2020 was significantly higher than that in 2019(43.04%)( χ 2=68 944.95, P <0.01). After adjustment for covariates, the odds ratio and 95% confidence interval for poor vision were 1.17(1.13-1.20), 1.07(1.04-1.10), 0.67 (0.65-0.69) and 0.62(0.60-0.64) in students with online class time, recreational screen time, indoor and outdoor activity time in the highest tertile, compared with the lowest tertile groups.@*Conclusion@#Increased rate of poor vision among primary and secondary schoool students deserves further concern. It is necessary to strengthen intervention of eyesight protection. Policies and programs aimed at improving opportunities for physical activities and decreasing multiple screen behaviors should be given priority.

Risk-adapted stereotactic body radiation therapy for central and ultra-central early-stage inoperable non-small cell lung cancer.

To determine the therapeutic efficacy and safety of risk-adapted stereotactic body radiation therapy (SBRT) schedules for patients with early-stage central and ultra-central inoperable non-small cell lung cancer. From 2006 to 2015, 80 inoperable T1-2N0M0 NSCLC patients were treated with two median dose levels: 60 Gy in six fractions (range, 48-60 Gy in 4-8 fractions) prescribed to the 74% isodose line (range, 58%-79%) for central lesions (ie within 2 cm of, but not abutting, the proximal bronchial tree; n = 43), and 56 Gy in seven fractions (range, 48-60 Gy in 5-10 fractions) prescribed to the 74% isodose line (range, 60%-80%) for ultra-central lesions (ie abutting the proximal bronchial tree; n = 37) on consecutive days. Primary endpoint was overall survival (OS); secondary endpoints included progression-free survival (PFS), tumor local control rate (LC), and toxicity. Median OS and PFS were 64.47 and 32.10 months (respectively) for ultra-central patients, and not reached for central patients. Median time to local failure, regional failure, and any distant failures for central versus ultra-central lesions were: 27.37 versus 26.07 months, 20.90 versus 12.53 months, and 20.85 versus 15.53 months, respectively, all P < .05. Multivariate analyses showed that tumor categorization (ultra-central) and planning target volume ≥52.76 mL were poor prognostic factors of OS, PFS, and LC, respectively (all P < .05). There was one grade 5 toxicity; all other toxicities were grade 1-2. Our results showed that ultra-central tumors have a poor OS, PFS, and LC compared with central patients because of the use of risk-adapted SBRT schedules that allow for equal and favorable toxicity profiles.

Cystic brain metastases had slower speed of tumor shrinkage but similar prognosis compared with solid tumors that underwent radiosurgery treatment.

PURPOSE: Traditionally, radiosurgery was considered less effective for patients with cystic brain metastases. However, comparisons of prognosis between cystic and solid brain metastases in cancer patients have been seldom reported. We aimed to compare the survival between cystic and solid brain metastases and assess risk factors for overall survival after brain metastases (BMOS) in patients who underwent radiosurgery treatment. PATIENTS AND METHODS: The Kaplan-Meier method and multivariate Cox regression analysis were used to compare survival time and evaluate risk factors for BMOS. RESULTS: A total of 356 patients (including 498 brain metastases) were analyzed in our study, including 67 patients (67/356, 18.8%) with 75 cystic brain metastases. There is no statistical significance in BMOS between patients with cystic (17 months, range: 3-64 months) and solid (17.5 months, range: 1-65 months) brain metastases (P=0.148). However, the volume of cystic brain metastases decreased more slowly than solid brain metastases (P<0.05). The results indicated that high recursive partitioning analysis classification (P=0.006), large volume of brain metastases (P=0.006), and different primary lesion (especially gastrointestinal tract tumor) (P=0.001) were associated with poor prognosis in patients with brain metastases. CONCLUSION: There is no difference in prognosis and local control between patients with cystic and solid brain metastases who underwent radiosurgery. However, the rate and speed of tumor shrinkage were lower in cystic brain metastases after radiotherapy. Patients with larger brain metastases had shorter survival time, regardless of cystic or solid brain metastases.

Genetic Transformation of Cotton with the Harpin-Encoding Gene hpaXoo of Xanthomonas oryzae pv. oryzae and Evaluation of Resistance Against Verticillium Wilt.

The soilborne fungal pathogen Verticillium dahliae Kleb causes Verticillium wilt in a wide range of crops including cotton (Gossypium hirsutum). To date, most upland cotton varieties are susceptible to V. dahliae, and the breeding for cotton varieties with the resistance to Verticillium wilt has not been successful. Hpa1Xoo is a harpin protein from Xanthomonas oryzae pv. oryzae which induces the hypersensitive cell death in plants. When hpa1Xoo was transformed into the susceptible cotton line Z35 through Agrobacterium-mediated transformation, the transgenic cotton line (T-34) with an improved resistance to Verticillium dahliae was obtained. Here, we describe the related research approach, such as Western blot, Southern blot, immuno-gold labeling, evaluation of resistance to Verticillium dahliae, and how to detect the micro-hypersensitive response and oxidative burst elicited by harpinXoo in plant tissue.

A Second Course of Stereotactic Image-Guided Robotic Radiosurgery for Patients with Cerebral Metastasis.

OBJECTIVES: The purpose of this research was to study the outcome of brain metastases in a cohort of patients undergoing a second course of stereotactic image-guided robotic radiosurgery and to identify predictors corelated with survival. METHODS: A total of 63 patients with primary malignancies underwent a second course of CyberKnife radiosurgery for intracranial progression, including recurrence and new metastases after initial stereotactic radiosurgery (SRS). Overall survival (OS) and control rate were calculated by the Kaplan-Meier method. A Cox proportional hazards model was used to analyze predictive factors for survival. RESULTS: With a median follow-up duration of 12 months after second SRS, the median OS of the second course of radiosurgery was 18 months. On multivariate analysis, the sum of total planned target volume (hazard ratio, 2.112; 95% confidence interval, 1.069-4.173) and minimum dose (hazard ratio, 1.990, 95% confidence interval, 1.017-3.892) were significantly associated with OS. Median intracranial progression-free survival was 23 months. The 6-month and 12-month local control rates of the targets were 97.0% and 94.4%, respectively. Univariate analysis showed that only tumor number significantly influenced intracranial progression-free survival (P = 0.012). Nine patients (14.2%) developed brain necrosis. Median time to brain necrosis in regions in which brain necrosis occurred after a single course of SRS was not reached, compared with 16 months for those treated with repeat SRS (P = 0.041). CONCLUSIONS: A second course of CyberKnife radiosurgery seems to be an effective salvage option for brain progression after initial SRS. The total planned target volume shows prediction for OS. Tumor volume of initial SRS may influence selection of the potential population that may benefit from salvage radiosurgery.

Wogonoside alleviates inflammation induced by traumatic spinal cord injury by suppressing NF-κB and NLRP3 inflammasome activation.

Wogonoside possesses anti-oxidative, anti-inflammatory, anti-allergy and anti-tumor properties. The aim of the present study was to evaluate whether wogonoside alleviates spinal cord injury (SCI)-induced inflammation via nuclear factor (NF)-κB and nucleotide-binding oligomerization domain-like receptor family pyrin domain containing 3 (NLRP3) inflammasome activation. Sprague-Dawley rats were positioned in the jaws of a calibrated aneurysm clip with a closing pressure of 55 g. The jaws were placed on the dorsal and ventral surfaces of the spinal cord and left in place for 1 min. SCI rats were treated with 12, 25 and 50 mg/kg wogonoside. Following this, the locomotor function was assessed using the Basso Beattie Bresnahan scale. The water content of the spinal cord was measured, tumor necrosis factor-α (TNF-α), interleukin (IL)-1ß and IL-6 levels were assessed and western blot analysis was performed to evaluate the expressions of NF-κB and NLRP3. Wogonoside was demonstrated to significantly ameliorate the SCI-induced reduction in Basso Beattie Bresnahan score (P<0.01) and significantly reduce the water content of the spinal cord in rats with SCI-induced inflammation (P<0.01). Results also indicated that treatment with wogonoside significantly reduced the levels of IL-1ß, TNF-α and IL-6 in rats with SCI-induced inflammation (P<0.01), potentially via the phosphorylation of NF-κB inhibitor α. Furthermore, treatment with wogonoside inhibited the expressions of toll-like receptor 4, NLRP3 and caspase-1 protein in SCI model rats (P<0.01). In conclusion, the results of the present study suggest that wogonoside alleviates SCI-induced inflammation by suppressing NF-κB and NLRP3 inflammasome activation.

Clinical study on the influence of motion and other factors on stereotactic radiotherapy in the treatment of adrenal gland tumor.

BACKGROUND: The aim of this study was to investigate the adrenal tumor motion law and influence factors in the treatment of adrenal gland tumor and provide a reference value basis for determining the planning target volume margins for therapy. MATERIALS AND METHODS: The subjects considered in this study were 38 adrenal tumor patients treated with CyberKnife with the placement of 45 gold fiducials. Fiducials were implanted into each adrenal tumor using ß-ultrasonic guidance. Motion amplitudes of gold fiducials were measured with a Philips SLS simulator and motion data in the left-right, anterior-posterior, and cranio-caudal directions were obtained. Multiple linear regression models were used to analyze influencing factors. t-Test was used for motion amplitude comparison of different tumor locations along the z-axis. RESULTS: The motion distances were 0.1-0.4 cm (0.27±0.07 cm), 0.1-0.5 cm (0.31±0.11 cm), and 0.5-1.2 cm (0.87±0.21 cm) along the x-, y-, and z-axes, respectively. Motion amplitude along the z-axis may be affected by tumor location, but movement along the other axes was not affected by age, height, body mass, location, and size. CONCLUSION: The maximum motion distance was along the z-axis. Therefore, this should be the main consideration when defining the planning target volume safety margin. Due to the proximity of the liver, adrenal gland tumor motion amplitude was smaller on the right than the left. This study analyzed adrenal tumor motion amplitude data to evaluate how motion and other factors influence the treatment of adrenal tumor with a goal of providing a reference for stereotactic radiotherapy boundary determination.

A plasmonic colorimetric strategy for visual miRNA detection based on hybridization chain reaction.

In this work, a novel colorimetric strategy for miRNA analysis is proposed based on hybridization chain reaction (HCR)-mediated localized surface plasmon resonance (LSPR) variation of silver nanoparticles (AgNPs). miRNA in the sample to be tested is able to release HCR initiator from a solid interface to AgNPs colloid system by toehold exchange-mediated strand displacement, which then triggers the consumption of fuel strands with single-stranded tails for HCR. The final produced long nicked double-stranded DNA loses the ability to protect AgNPs from salt-induced aggregation. The stability variation of the colloid system can then be monitored by recording corresponding UV-vis spectrum and initial miRNA level is thus determined. This sensing system involves only four DNA strands which is quite simple. The practical utility is confirmed to be excellent by employing different biological samples.

Light-intensity grazing improves alpine meadow productivity and adaption to climate change on the Tibetan Plateau.

To explore grazing effects on carbon fluxes in alpine meadow ecosystems, we used a paired eddy-covariance (EC) system to measure carbon fluxes in adjacent fenced (FM) and grazed (GM) meadows on the Tibetan plateau. Gross primary productivity (GPP) and ecosystem respiration (Re) were greater at GM than FM for the first two years of fencing. In the third year, the productivity at FM increased to a level similar to the GM site. The higher productivity at GM was mainly caused by its higher photosynthetic capacity. Grazing exclusion did not increase carbon sequestration capacity for this alpine grassland system. The higher optimal photosynthetic temperature and the weakened ecosystem response to climatic factors at GM may help to facilitate the adaption of alpine meadow ecosystems to changing climate.

Analysis of clinical efficacy of CyberKnife(®) treatment for locally advanced pancreatic cancer.

OBJECTIVE: To evaluate the efficacy and safety of CyberKnife(®) treatment for locally-advanced pancreatic cancer (LAPC). METHODS: The efficacy of CyberKnife(®) treatment was analyzed in 59 LAPC patients treated between October 2006 and September 2014. The median tumor volume was 27.1 mL (13.0-125.145 mL). The median prescribed dose was 45 Gy (35-50 Gy), delivered in 5 fractions (3-8 fractions). The overall survival (OS) rates and freedom from local progression (FFLP) rates were estimated using the Kaplan-Meier survival curve. RESULTS: The median follow-up for all patients was 10.9 months (3.2-48.7 months) and 15.6 months (3.9-37.6 months) among surviving patients. The median OS was 12.5 months, and the 1-year and 2-year survival rates were 53.9% and 35.1%, respectively. The 1-year FFLP rate was 90.8% based on the computed tomography (CT) evaluation. Grade 1-2 acute and late-stage gastrointestinal (GI) reactions were observed in 61% of the patients. One patient experienced grade 3 toxicity. CONCLUSION: Excellent clinical efficacy was obtained after treatment of LAPC using CyberKnife(®), with minimal toxicity.

Stereotactic body radiation therapy using the CyberKnife(®) system for patients with liver metastases.

The aim of this study was to evaluate the efficacy and toxicity of stereotactic body radiation therapy (SBRT) in the treatment of patients with liver metastases. Between August 2006 and July 2011, patients with 1-4 liver metastases were enrolled and treated with SBRT using the CyberKnife(®) system at Tianjin Medical University Cancer Institute and Hospital. The metastases were from different primary tumors, with a maximum tumor diameter of less than 6 cm. The primary endpoint was local control. Secondary endpoints were overall survival, progression-free survival, distant progression-free survival, and adverse events. Fifty-seven patients with 80 lesions were treated with SBRT. The 1-year and 2-year local control rates were 94.4% and 89.7%, respectively. The difference in local control between patients who received adjuvant treatment before SBRT and those who did not reached statistical significance (P=0.049). The median overall survival for the entire cohort was 37.5 months. According to the primary tumor sites, the median overall survival was not reached. The 2-year overall survival rate was 72.2% in the favorable group (primary tumors originating from the colon, breast, or stomach, as well as sarcomas); however, in the unfavorable group (primary tumors originating from the pancreas, lung, ovary, gallbladder, uterus, hepatocellular carcinoma, as well as olfactory neuroblastoma), the median overall survival and 2-year overall survival rates were 37.5 months and 55.9%, respectively (P=0.0001). Grade 1-2 fatigue, nausea, and vomiting were the most common adverse events, and no grade 3 and higher adverse events were observed. With excellent local control in the absence of severe toxicity, SBRT provides an alternative for patients with 1-4 liver metastases who cannot undergo surgery or other treatments.