Apatinib combined with temozolomide in diffuse midline glioma: a novel and effective therapy.

PURPOSE: Diffuse midline glioma (DMG), H3 K27M-mutant is a type of diffuse high-grade glioma that occurs in the brain midline carrying an extremely poor prognosis under the best efforts of surgery, radiation, and other therapies. For better therapy, we explored the efficacy and toxicity of a novel therapy that combines apatinib and temozolomide in DMG. METHODS: A retrospective analysis of 32 patients with DMG who underwent apatinib plus temozolomide treatment was performed. Apatinib was given 500 mg in adults, 250 mg in pediatric patients once daily. Temozolomide was administered at 200 mg/m2/d according to the standard 5/28 days regimen. The main clinical data included basic information of patients, radiological and pathological characteristics of tumors, treatment, adverse reactions, prognosis. RESULTS: The objective response rate was 24.1%, and the disease control rate was 79.3%. The median PFS of all patients was 5.8 months, and median OS was 10.3 months. A total of 236 cycles of treatment were available for safety assessment and the toxicity of the combination therapy was relatively well tolerated. The most common grade 3 toxicities were myelosuppression including leukopenia (5.08%), neutropenia (4.24%), lymphopenia (2.12%), thrombocytopenia (1.69%) and anemia (1.27%). Grade 4 toxicities included neutropenia (2.12%), thrombocytopenia (2.12%) and proteinuria (1.69%). All the adverse events were relieved after symptomatic treatment or dose reduction. CONCLUSIONS: Apatinib plus temozolomide could be an effective regimen with manageable toxicities and favorable efficacy and may outperform temozolomide monotherapy, particularly in newly diagnosed adults with tumors located outside the pons. The novel therapy deserves further investigation in adult DMG patients.

Delayed Facial Palsy After Microvascular Decompression for Hemifacial Spasm.

OBJECTIVE: We explored the risk factors for the occurrence of delayed facial paralysis (DFP) after microvascular decompression (MVD) for hemifacial spasm (HFS). METHODS: A retrospective study was conducted of 636 patients who had undergone MVD for HFS by the same neurosurgery department of China-Japan Friendship Hospital from January 2006 to May 2016. Of the 636 patients, 50 (7.9%) had presented with DFP, which had developed from 2 to 60 days postoperatively (average, 12.9 ± 10.0005 days). All 50 patients with DFP had recovered completely within 10-300 days (average, 88.7 ± 61.389 days) after the onset of DFP. We randomly selected 100 patients from the 586 patients without DFP as the control group. Univariate and multivariate logistic analyses were used to analyze the risk factors involved in the occurrence of DFP. RESULTS: Univariate analysis showed that the disease course was the only factor associated with the development of DFP (P = 0.003). Furthermore, on multivariate logistic analysis, the course of HFS was the only risk factor associated with the development of DFP (P = 0.01). Additionally, the Spearman test revealed a positive correlation between the onset of DFP and the duration of the DFP symptoms (rs = 0.682; P < 0.001). CONCLUSION: Although DFP frequently occurred after MVD, it can recover spontaneously. The longer the course of HFS, the more frequently DFP will occur after MVD. The earlier that DFP develops, the shorter will be the time to recovery.

[Composition, Characteristics, and Accumulation of Antibiotics in the Soil in Agricultural Land].

Exploring the composition and accumulation of antibiotics in agricultural land soil for soil for quality management of agricultural land and control of antibiotic pollution is of great significance. A total of 95 soil samples were collected from farmland soil in a typical agricultural and sideline production base of northern China. In this study, the concentrations of 10 antibiotics, including tetracycline antibiotics (TCs), macrolide antibiotics (MLs), and sulfonamide antibiotics (SAs), were determined in soil samples from different land use types using HPLC-MS/MS. In addition, the composition and spatial distribution of the antibiotics were compared. The relationships between the concentration distributions and the distance from livestock farms, highways, and rivers were analyzed. Moreover, the composition and accumulation of antibiotics in the soil with different planting patterns and soil properties were preliminarily discussed. The results showed that the concentrations of antibiotics in the soil were low-level, while the detection rate was high; in particular, the detection rate of the total amount of antibiotics was as high as 100%. In the study area, TCs were the dominant antibiotic types, accounting for 94% of the total. The coefficient variation (CV) was high, which reflected a significant difference in the spatial variation of these antibiotics. The spatial distribution and accumulation of antibiotics in the soil in this area were affected by the intensity of human activity. The detection rate and concentrations of the various antibiotics decreased with increasing distance between the soil sample and livestock farms, highways, and rivers. Among these, there was a significant negative correlation between the concentration of antibiotics and the distance between livestock farms and the soil samples (P<0.05). The detection rate of three types of antibiotics in soil samples from within 50 meters of a river reached 100%. The total concentration of the 10 antibiotics was the highest in orchards, followed by vegetable plots, and mixed fruit and vegetable areas. Furthermore, the sources and concentrations of antibiotics in a peach orchard and open-air vegetable field were significantly different from those in a walnut orchard, greenhouse vegetable field, and mixed field. Moreover, the soil pH, soil organic matter (SOM), cation exchange capacity (CEC), total nitrogen (TN), available phosphorus (AP), and available potassium (AK) were selected to characterize soil properties. Redundancy analysis showed that soil properties such as pH, SOM, CEC, AP, AK have a greater impact on the distribution of antibiotics. The distribution of antibiotics was most closely related to AK, and the effect of TN was relatively weak. The results of this study suggested that the composition and accumulation of soil antibiotics in the area were affected by human activities and soil properties.